Efficacy of two polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate restorations: One-year results of a split-mouth randomized controlled clinical trial.

STATEMENT OF PROBLEM: Selecting the optimal polishing procedure to reestablish surface smoothness after occlusal adjustment is essential for the long-term success of glass-ceramic restorations. While in vitro studies have shown different effective polishing protocols, clinical trials are lacking. PURPOSE: The purpose of this split-mouth controlled clinical trial was to evaluate the effectiveness of 2 polishing systems in reestablishing the surface smoothness of posterior monolithic lithium disilicate ceramic restorations. MATERIAL AND METHODS: Ninety-six restorations that required occlusal adjustment after bonding were randomized into 2 groups: Forty-eight restorations were polished by using the Exa Cerapol polishing kit, and the other 48 restorations were polished by using the Shofu polishing kit. The restorations were replicated with epoxy resin at 3 study times-after bonding (t1), after occlusal adjustment (t2), and after polishing (t3)-for quantitative roughness analysis (Ra). Representative specimens from each group were qualitatively analyzed by using a confocal laser microscope. Clinical analyses were performed after the polishing procedure and at 30, 180, and 365 days after the polishing procedure by following the United States Public Health Service (USPHS) criteria. ANOVA and the Tukey multiple comparisons parametric tests were computed (α=.05). The Kaplan-Meier test was used to analyze the survival rate of restorations. RESULTS: No statistically significant difference was found between the Exa Cerapol and Shofu groups (P=.086). A statistically significant difference was found between study times t1 and t2 and between t2 and t3 (both P<.001) in both experimental groups. No statistically significant difference was found between study times t1 and t3 (P=.181) in either experimental group. For the clinical criterion "integrity of restorations," all the elements analyzed indicated an alfa grade at all study times. The survival rate of the restorations was 100%. CONCLUSIONS: Both polishing kits were effective in reestablishing the surface smoothness of restorations after occlusal adjustment.

Effect of intermittent teriparatide (PTH 1-34) on the alveolar healing process in orchiectomized rats.

OBJECTIVE: To evaluate intermittent teriparatide therapy's influence on the alveolar healing process in rats with induced osteoporosis. MATERIALS AND METHODS: Fifty-four male rats were divided into three groups: fictitious surgery (SHAM), bilateral orchiectomy (ORQ NT), and bilateral orchiectomy treated with teriparatide (ORQ TERI). Right upper incisor extraction was performed. After 14 and 42 days, the rats were euthanized. Immunolabeling analysis was performed in order to characterize bone turnover through Wnt, alcaline phosphatase, osteocalcin, and TRAP presence in tissue; micro-CT analysis was performed in order to determine the bone volume fraction (BV/TV), trabecular thickness, separation, and number (Tb.Th, Tb.Sp, Tb.N). For the micro-CT data, statistical analysis was performed through one-way ANOVA and Tukey post-test, for parametrical data, with significance level adopted in p < 0.05. Days, Wnt, alkaline phosphatase, and osteocalcin revealed more labeling for ORQ TERI and less for TRAP. For the Tb.N in the ORQ NT group was 0.496 mm, a significant statistical difference was observed between the groups of ORQ NT and ORQ TERI (p < 0.05). For the BV/TV, Tb.Sp, and Tb.Th parameters, no significant statistical difference was observed among the three experimental groups (p > 0.05). CONCLUSIONS: Treatment with intermittent teriparatide reverted impairment in the metabolism of repairing bone tissue in orchiectomized animals. CLINICAL RELEVANCE: Cases of decreased bone density such as osteoporosis can lead to delayed alveolar repair process. PTH 1-34 has been shown to be a medication that improves this repair, making bone of low quality into one with normal features.

Large Dentigerous Cyst Associated to Maxillary Canine.

Dentigerous cysts are defined as a cyst originated by separation of the follicle of dental crown of a tooth unerupted. Although most dentigerous cysts are considered developmental cysts, some cases seem to have an inflammatory origin. The aim of this study was to show a case of an 8-year-old patient, male, presenting a lesion in maxilla with large proportions. Computed tomography scans showed a hypodense image, well-defined, associated to unerupted teeth. The case was treated by enucleation of the lesion under local anesthesia. Histopathological examination confirmed the diagnostic suspicious of dentigerous cyst. Currently, 3-year follow-up period showed no signs of recurrence, and it was observed eruption of the teeth associated to the lesion. This case highlights the importance of the association between clinical and radiographic analysis together to the surgical findings, aiming the best treatment for the patient.

Conservative Management of Central Cemento-Ossifying Fibroma.

Central cemento-ossifying fibroma is characterized by the combined production of osteoid and cementoid tissue. Radiographically, this lesion is presented as an outlined cortical and variable radiopaque spots, also can be present complete radiolucent or different degrees of radiopacity. The recommended treatment is curettage or enucleation, and the recurrence rate is less than 5%. Considering that surgical treatment is invasive, mainly in large lesions, this study aims to report a patient in whom conservative treatment was carried out by involving the preservation of teeth, with a long-term follow-up. A 48-year-old black female patient, diagnosed with central cemento-ossifying fibroma in mandible, treated conservatively and a 2 years of follow-up. It was concluded that the conservative treatment with a long term of follow-up for maintaining teeth was satisfactory.

The Importance of Correct Diagnosis of Crocodile Tears Syndrome.

The excessive unilateral tearing as a result of gustatory stimuli is a characteristic of crocodile tears syndromes. The aim of this study is to report 2 cases of Frey and crocodile tears syndromes, considering diagnosis, monitoring, and selection of appropriate treatment. A 74-year-old female patient presented with a history of Bell palsy, tearing on left eye at the moment of chewing, and absence of pain. The patient opted only for periodic case monitoring because the symptoms presented by the syndrome did not bother her, which made any invasive procedure unnecessary, and with the closed diagnosis she may be reassured and really know what was happening to her. So scientific divulgations about this syndrome should be made in order to increase the knowledge of dentists and oral and maxillofacial surgeons, because it is a rare syndrome and easily diagnosed. Due to the low knowledge in Brazil, the patient of this report had to wait about 9 years to get a diagnosis.

Evaluation of Vitamin D isolated or Associated with Teriparatide in Peri-Implant Bone Repair in Tibia of Orchiectomized Rats.

(1) Background: The objective of this study was to evaluate the morphometry of peri-implant bone tissue in orchiectomized rats, treated with vitamin D isolated or associated with teriparatide. (2) Methods: 24 rats were divided into 4 groups: ORQ-orchiectomy, without drug treatment, ORQ+D-orchiectomy, treated with vitamin D, ORQTERI-orchiectomy, treated with teriparatide and ORQTERI+D-orchiectomy, treated with teriparatide + vitamin D. Each animal received an implant in the tibial metaphysis. Euthanasia occurred 60 days after implant surgery. Computed microtomography (micro-CT) was performed to evaluate the parameters of volume and percentage of bone volume (BV, BV/TV), trabecular thickness (Tb.Th), number and separation of trabeculae (Tb.N, Tb.Sp) and percentage of total porosity (Po-tot). Data were subjected to 1-way ANOVA and Tukey post-test, with a significance level of 5%. (3) Results: For the parameters BV, BV/TV, Tb.Th, the ORQTERI+D group showed the highest values in relation to the other groups and for Po-tot, the lowest values were for ORQTERI+D. For Tb.Sp and Tb.N, there was no statistically significant difference when comparing intragroup results (p > 0.05). (4) Conclusions: It was possible to conclude that treatment with vitamin D associated with teriparatide increases bone volume and improves bone quality.

Clinical and Microbiologic Outcomes of Ceramic Laminate Veneers Bonded to Teeth Without a Finish Line: 1-year Results of a Prospective Study.

Purpose: To evaluate changes in the periodontium of teeth restored with ultrathin (0.2 to 0.39 mm) ceramic laminate veneers (CLVs) placed subgingivally without a finish line compared to the same teeth before restorative treatment and to nonrestored antagonist teeth in healthy periodontium patients. Materials and Methods: A total of 73 CLVs were bonded onto the enamel surface of teeth without a finish line and with the cervical margin placed about 0.5 mm subgingivally. The gingival crevicular fluid was collected before bonding (baseline) and at 7, 180, and 365 days after bonding to quantify S mitis, P intermedia, and P gingivalis by quantitative polymerase chain reaction analysis. Visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR), and marginal adaptation were evaluated from baseline to 365 days in both groups. Results: No statistically significant differences were observed in VPI, PD, or BOP at any time point in the intragroup or intergroup comparisons (P > .05). All restorations obtained the alpha concept for marginal adaptation (ie, the restoration margin remained ideal at all time points). There was a statistically significant difference for S mitis between 180 and 365 days (P = .03). No statistically significant difference was observed for P gingivalis at any time point (P > .05). Conclusion: The periodontium in the restored group showed a clinical behavior similar to baseline. Overcontouring of the ultrathin (up to 0.39 mm) CLV, similar to the cementoenamel junction convexity, did not contribute to plaque accumulation or changes in the oral microbiota of patients with a healthy periodontium and proper oral hygiene instruction.

[Impact of socio-economic inequities on the mortality of the City of Fortaleza, Ceara, Brazil during 2007]. / Efecto de las desigualdades socioeconómicas en la mortalidad de la ciudad de Fortaleza, Ceara, Brasil durante el año 2007.

BACKGROUND: Brazil is an important example to study the situation of poverty and its determinants. Brazil owns a great part of the poor population of Latin America and presents great potential to eradicate this situation. The present study tries to show the association between the mortality risk and poverty in the city of Fortaleza. METHODS: Cross-sectional ecological study, the unit of analysis was the districts of the city of Fortaleza. We included any death happened during year 2007. Mortality data were obtained through Unique System of Health, socioeconomic indicators and number of inhabitants was extracted from the Census of Inhabitants and Houses of the Brazilian Institute of Statistics of the year 2000. An index composed from the main simple indicators of deprivation was calculated using a Cluster technique. The deprivation index was divided in five groups, group 1 presented the best socio-economic conditions and group 5 the worst ones. Correlation analysis was done to evaluate the association between socioeconomic level and mortality. RESULTS: We observed a significant association of the socioeconomic level with total mortality (p < 0.001), circulatory disease (p < 0.001) and external causes (p < 0.001). In addition, 86% of the cases of aggression happened in groups 4 and 5. CONCLUSIONS: The results show a relation between socioeconomic conditions and mortality by any cause, by circulatory causes and by external causes.

Teriparatide improves alveolar bone modelling after tooth extraction in orchiectomized rats.

OBJECTIVE: The aim of this study was to evaluate bone metabolism in the alveolar repair process in orchiectomized male rats treated with teriparatide. MATERIALS AND METHODS: A total of 78 rats were divided into three groups: 26 oriectomized rats treated with teriparatide (ORQTRAT), 26 untreated orchiectomized rats (ORQ), and 26 rats which had undergone sham surgical procedures (SHAM), all these animals underwent extraction of the central incisor tooth. Thus, a histological analysis was performed (42 days). Real Time PCR (14 and 42 days) and immunohistochemical (42 days) analyses were performed based on the expression of RANK-L and osteoprotegerin (OPG). The calcein and alizarin were analyzed via laser confocal microscopy to verify alveolar bone turnover, and microtomographic analysis was performed to determine volume and bone quality (calcified tissues). In this analysis, the euthanasia period was 60 days post-extraction. The quantitative data were submitted to the statistical test and the significance level of 5% was adopted. RESULTS: Teriparatide increased bone turnover with a higher relative gene expression of RANKL and OPG at 14 days, and at 42 days, there was a significant decrease of RANKL and an increase of OPG, this standard can also be evaluated in the ratio of RANKL to OPG. Greater values of area and bone mineral deposition were found for the ORQTRAT group (p < 0.05), along with higher bone volume values (p < 0.05). The immunolabels revealed greater intensity in the relationship of RANKL and OPG, which led to intense remodeling aiding in the process of bone formation. CONCLUSION: The teriparatide treatment in orchiectomized rats increases bone volume and decreases the porosity, in addition to promoting greater intensity in bone turnover during alveolar repair.

Evaluation of the Different Biomaterials Used in Alveolar Cleft Defects in Children.

The aim of this study was to use a literature review to evaluate and compare the different biomaterials used in surgeries for the closure of the palatal and alveolar clefts as alternatives to isolated autografting. For the search strategy, the PubMed and Medline databases were used with the indexing terms "'cleft palate' (Mesh), 'biocompatible materials' (Mesh), and 'dentistry' (Mesh)." There was no restriction on language or publication time. After the research, 26 articles were found, and then, only the filter for clinical trials was selected. With this methodology, five articles were selected. The full texts have been carefully evaluated. The main issue among the five selected articles was the closure of a cleft palate and/or alveolar bone with the use of different types of biomaterials (e.g. autogenous bone from the iliac crest and chin, deproteinized bovine bone (DBB), ß-tricalcium phosphate (ß-TCP), synthetic resorption based on calcium sulfate, and the engineering of bone tissue); they evaluated preoperative and postoperative clinically and through imaging tests. The autogenous bone associated with DBB or ß-TCP significantly reduces the amount of autogenous bone harvested from the iliac crest, morbidity, and the hospitalization of the patient, and the isolated use of bovine hydroxyapatite resulted in lower bone density compared to that from autogenous bone.

Uso de substâncias psicoativas por universitários da área da saúde antes e durante a pandemia da covid-19: prevalência e fatores associados / Use of psychoactive substances by college students in the health sector before and during the COVID-19 pandemic: prevalence and associated factors / Uso de sustancias psicoactivas por los universitarios del área de la salud antes y durante la pandemia del COVID-19: prevalencia y factores asociados

A pandemia do coronavírus criou incertezas sobre os impactos da doença na saúde dos universitários relacionados ao padrão de uso de substâncias psicoativas. O objetivo deste estudo foi estimar a prevalência e os fatores associados ao uso de álcool, tabaco e drogas ilícitas entre universitários da área da saúde antes e durante a pandemia da covid-19. Trata-se de um estudo transversal com inquéritos repetidos. Para determinar o padrão de uso das substâncias psicoativas, utilizou-se o Teste de Triagem do Envolvimento com Álcool, Tabaco e Outras Substâncias (ASSIST). Foi realizada a análise de regressão logística com a medida do desfecho expressa por odds ratio e intervalo de confiança de 95%. Obtiveram-se as seguintes associações para o maior consumo de substâncias psicoativas antes da pandemia: homossexuais/bissexuais e tabaco no mês; não iniciantes no curso e álcool (na vida e no mês) e drogas ilícitas na vida. Ademais, a análise ajustada dos estudantes durante a pandemia demonstrou que a associação foi mantida: homossexuais/bissexuais e tabaco na vida e no mês, álcool no mês e drogas ilícitas na vida. Concluiu-se que a universidade deve buscar a implementação de políticas de assistência estudantil, garantindo aos alunos um bem-estar físico e emocional.

The coronavirus pandemic created uncertainty about the health impacts of the disease on college students related to the pattern of psychoactive substance use. The aim of this study was to estimate the prevalence and factors associated with alcohol, tobacco, and illicit drug use among university health students before and during the COVID-19 pandemic. This is a cross-sectional study, with repeated surveys. To determine the pattern of psychoactive substance use the Alcohol, Smoking and Substance Involvement Screening Test ­ (ASSIST) was used. The logistic regression analysis was performed with the measurement of the outcome expressed by odds ratio and 95% confidence interval. The following associations were obtained for the highest consumption of psychoactive substance before the pandemic: homosexuals/bisexuals and tobacco in the month; non-beginners in the course and alcohol (in life and in the month), and illicit drugs in life. Furthermore, the adjusted analysis of students during the pandemic showed that the association remained: homosexuals/bisexuals and tobacco in life and month, alcohol in month, and illicit drugs in life. In conclusion, the university must seek to implement student assistance policies, guaranteeing students' physical and emotional wellbeing.

La pandemia de coronavirus produjo incertidumbres sobre las repercusiones de la enfermedad en la salud de los estudiantes universitarios relacionadas con el patrón de consumo de sustancias psicoactivas. El objetivo de este estudio es estimar la prevalencia y los factores asociados al consumo de alcohol, tabaco y drogas ilícitas entre los estudiantes universitarios del área de la salud antes y durante la pandemia de COVID-19. Se trata de un estudio transversal, con encuestas repetidas. Para determinar el patrón de consumo de sustancias psicoactivas, se utilizó la Prueba de Detección de Consumo de Alcohol, Tabaco y Sustancias ­ASSIST. Se realizó un análisis de regresión logística con la medida de resultado expresada por odds ratio y un intervalo de confianza del 95%. Se obtuvieron las siguientes asociaciones para el mayor consumo antes de la pandemia: homosexuales/bisexuales y tabaco en el mes; no iniciados en el curso y alcohol (en la vida y en el mes) y drogas ilícitas en la vida. Además, el análisis ajustado de los estudiantes en la pandemia se mantuvo asociado con: homosexuales/bisexuales y tabaco en la vida y el mes, alcohol en el mes y drogas ilícitas en la vida. Se concluye que la universidad debe implementar políticas de asistencia a los estudiantes para garantizarles bienestar físico y emocional.

Scientific evidence on the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in oral and maxillofacial surgery.

PURPOSE: This study aimed to identify the main indications for the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for bone repair and maintenance in the maxilla and mandible through a review of clinical trials evaluating the viability of using rhBMP-2 to delay the installation of dental implants, thus allowing satisfactory bone formation and long-term osseointegration. METHODS: Literature search of the PubMed/Medline databases was performed using the following MeSH index terms-"bone morphogenetic protein 2" and "dentistry". Only clinical trials necessarily published in English, related to dentistry, and focused on bone reconstruction in critical defects, post-extraction alveoli, increasing the atrophic alveolar ridge, or surgery for maxillary sinus elevation were included, regardless of the age, sex, ethnicity, associated morbidities, or period of publication. RESULTS: Of the 17 studies identified based on the search filters, 2 were excluded. Therefore, 15 studies were finally included in this review. CONCLUSIONS: Based on the results of our review, we concluded that the use of rhBMP-2 for the preservation of the alveolar ridge after tooth extraction or for increasing the local defects is safe and viable. The use of rhBMP-2/Bio-Oss® for the elevation of the maxillary sinus membrane is unnecessary; however, it can improve and accelerate the maturation process in cases of guided bone regeneration in peri-implant defects. Compounds comprising rhBMP-2, allogenic bone, and plasma-rich platelet (PRP) can act as autograft substitutes in mandibular critical defects.

Efecto de las desigualdades socioeconómicas en la mortalidad de la ciudad de Fortaleza, Ceará, Brasil durante el año 2007 / Impact of socio-economic inequities on the mortality of the city of Fortaleza, Ceara, Brazil during 2007

Fundamentos: Brasil es un ejemplo para estudiar la situación de la pobreza y sus determinantes, ya que posee una gran parte de la población pobre de América Latina y presenta gran potencial para erradicar esta pobreza. El presente trabajo pretende mostrar la asociación entre la mortalidad y el índice de pobreza en la ciudad de Fortaleza, capital del estado Ceará. Métodos: Estudio ecológico transversal, la unidad de análisis fueron los barrios de la ciudad de Fortaleza. Los datos de mortalidad se obtuvieron a través del Sistema Único de Salud, incluyendo todas las defunciones del año 2007 y sus causas. Los indicadores socioeconómicos y número de habitantes se extrajeron del Censo de Habitantes y Viviendas del Instituto Brasileño de Estadísticas del año 2000. Se calculó un índice compuesto de privación a partir de los principales indicadores simples de privación utilizando una técnica de agrupamiento tipo Cluster y se realizó un análisis de correlación para valorar la asociación entre nivel socioeconómico y mortalidad. El índice compuesto de privación se dividió en cinco grupos, el grupo 1 presentaba las mejores condiciones socioeconómicas y el 5 las peores. Resultados: Se observó asociación significativa del nivel socioeconómico con la mortalidad total (p<0,001), por enfermedades circulatorias (p<0,001) y por causas externas (p<0,001). Además, el 86% de los casos de agresión sucedieron en los grupos 4 y 5. Conclusiones: Existe relación directa entre la condición socioeconómica y la mortalidad total por causas circulatorias y por causas externas(AU)

Background: Brazil is an important example to study the situation of poverty and its determinants. Brazil owns a great part of the poor population of Latin America and presents great potential to eradicate this situation. The present study tries to show the association between the mortality risk and poverty in the city of Fortaleza. Methods: Cross-sectional ecological study, the unit of analysis was the districts of the city of Fortaleza. We included any death happened during year 2007. Mortality data were obtained through Unique System of Health, socioeconomic indicators and number of inhabitants was extracted from the Census of Inhabitants and Houses of the Brazilian Institute of Statistics of the year 2000. An index composed from the main simple indicators of deprivation was calculated using a Cluster technique. The deprivation index was divided in five groups, group 1 presented the best socio-economic conditions and group 5 the worst ones. Correlation analysis was done to evaluate the association between socioeconomic level and mortality. Results: We observed a significant association of the socioeconomic level with total mortality (p<0,001), circulatory disease (p<0,001) and external causes (p<0,001). In addition, 86% of the cases of aggression happened in groups 4 and 5. Conclusions: The results show a relation between socioeconomic conditions and mortality by any cause, by circulatory causes and by external causes(AU)