Accuracy of an artificial intelligence algorithm for detecting moderate-to-severe vertebral compression fractures on abdominal and thoracic computed tomography scans.

Objective: To describe the accuracy of HealthVCF, a software product that uses artificial intelligence, in the detection of incidental moderate-to-severe vertebral compression fractures (VCFs) on chest and abdominal computed tomography scans. Materials and Methods: We included a consecutive sample of 899 chest and abdominal computed tomography scans of patients 51-99 years of age. Scans were retrospectively evaluated by the software and by two specialists in musculoskeletal imaging for the presence of VCFs with vertebral body height loss > 25%. We compared the software analysis with that of a general radiologist, using the evaluation of the two specialists as the reference. Results: The software showed a diagnostic accuracy of 89.6% (95% CI: 87.4-91.5%) for moderate-to-severe VCFs, with a sensitivity of 73.8%, a specificity of 92.7%, and a negative predictive value of 94.8%. Among the 145 positive scans detected by the software, the general radiologist failed to report the fractures in 62 (42.8%), and the algorithm detected additional fractures in 38 of those scans. Conclusion: The software has good accuracy for the detection of moderate-to-severe VCFs, with high specificity, and can increase the opportunistic detection rate of VCFs by radiologists who do not specialize in musculoskeletal imaging.

Objetivo: Descrever a acurácia do software HealthVCF na detecção incidental de fraturas compressivas de corpos vertebrais moderadas a graves em exames de tomografia computadorizada do tórax e abdome. Materiais e Métodos: Foram incluídos 899 exames consecutivos de pacientes com idades entre 51 e 99 anos. As imagens foram retrospectivamente avaliadas pelo software e por dois radiologistas especializados em musculoesquelético que investigaram fraturas compressivas de corpos vertebrais com perda da altura somática > 25%. A análise comparativa foi realizada entre o software e um radiologista geral, usando a avaliação do especialista como referência. Resultados: O software apresentou uma acurácia de 89,6% (IC 95%: 87,4­91,5%) para fraturas compressivas moderadas a graves, com sensibilidade de 73,8%, especificidade de 92,7% e valor preditivo negativo de 94,8%. Entre as 145 tomografias positivas detectadas pelo software, o radiologista geral deixou de relatar as fraturas em 62 (42,8%) e o algoritmo detectou fraturas adicionais em 38 dessas tomografias. Conclusão: O software possui boa acurácia na detecção de fraturas compressivas moderadas a graves, com alta especificidade, podendo aumentar a taxa de detecção oportunística dessas fraturas por radiologistas não especializados em musculoesquelético.

Differential effect of social mobility on tooth loss by race in adulthood: 1982 Pelotas Birth Cohort Study.

OBJECTIVES: To examine the association between social mobility and tooth loss in adults from the 1982 Pelotas Birth Cohort Study and whether race modifies this association. METHODS: The Oral Health Study used data from 541 individuals who were followed up to 31 years of age. Social mobility, composed of the participants' socioeconomic position (SEP) at birth and at age 30, was categorized as never poor, upwardly mobile, downwardly mobile and always poor. The outcome was the prevalence of at least one tooth lost due to dental caries when the participants were examined at 31 years of age. The effect modifier was race (Black/Brown versus white people). Log-binomial regression models were used to estimate crude and sex-adjusted prevalence ratios (PR) and to determine whether the association varied with race. Statistical interactions were tested using an additive scale. RESULTS: The prevalence of any tooth loss was 50.8% (n = 274). In social mobility groups, the prevalence of at least one tooth lost in the never-poor group was about 31% points higher for Black/Brown (68.2%) than for white people (37.4%). Antagonistic findings were found for the interaction between race and social mobility (Sinergy Index = 0.48; 95% CI 0.24, 0.99; and relative excess of risk due to the interaction = -1.38; 95% CI -2.34, -0.42), suggesting that the observed joint effect of race and social mobility on tooth loss was lower than the expected sum of these factors. The estimates for Black/Brown people were smaller for those who were always poor during their lives, relative to their white counterparts. CONCLUSIONS: The findings suggest a higher prevalence of at least one tooth lost among people in the downward mobile SEP group and Black/Brown people. Greater racial inequity was found among Black/Brown people who had never experienced episodes of poverty, with Black/Brown people having a greater prevalence of at least one tooth lost than their white counterparts.

Contextual inequalities in specialized dental public health care in Brazil.

The present study aimed to investigate the contextual inequalities of specialized public dental care (SPDC) in Brazil. The outcome was the trajectory of dental specialized production in municipalities with SPDC (from 2015 to 2017) obtained by group-based trajectory modeling. A Poisson regression model was used to analyze the factors associated with the high trajectory of SPDC production. The inequality indicators for SPDC production were the slope index and the concentration index according to contextual factors. The study included 954 SPDC units distributed across 893 municipalities. Among the municipalities evaluated, 62.9% had a low trajectory of SPDC. Large-sized municipalities had the highest production (IRR = 2.84, 95%CI: 1.94-4.14) and the southern region had the lowest production (IRR = 0.73, 95%CI: 0.58-0.92). Municipalities presenting a very high human development index (HDI) showed the greatest SPDC production (IRR = 3.34, 95%CI: 1.09-10.24), as well as municipalities with the highest tertile of schooling rate (IRR = 1.23, 95%CI: 1.00-1.50). The absolute inequality was 52.1 percentage points for the average monthly wage (p < 0.001), 61.0 percentage points for the HDI (p < 0.001), -22.1 for infant mortality rate (p <0.001), and 14.8 for the schooling rate (p = 0.012). Thus, there are contextual inequalities in the Brazilian SPDC. Higher scores for social indicators were associated with better SPDC performance.

Anterolateral Ligament and Kaplan Fiber Injury Both Occur Frequently in Acute Anterior Cruciate Ligament-Injured Knees.

BACKGROUND AND OBJECTIVES: The association of ALL and KF injuries in anterior cruciate ligament (ACL)-deficient knees remain topics of conflicting research despite improved magnetic resonance imaging (MRI). We aimed to evaluate the rate of the anterolateral ligament (ALL) and Kaplan fibers (KF) injuries in adults with acute ACL injuries using MRI. METHODS: We retrospectively reviewed 64 patients with clinical and MRI diagnoses of acute ACL tears. Two radiologists analyzed and categorized the status of the ALL and KF in all patients as intact, partially injured, or completely injured. Interobserver agreement was assessed. Injuries to the collateral ligaments, ITB and posterior cruciate ligament (PCL) were also evaluated. RESULTS: The mean age of the patients was 33 years. ALL injuries were observed in 46 (71%) patients, among whom 33 (71%) had partial and 13 (28%) had complete injuries. KF injuries were identified in 32 (50%) patients, with 28 (87.5%) of them having partial and 4 (12.5%) having complete injuries. Combined injuries of both ALL and KF were found in 25 (32.4%) patients (p-value of 0.266). The agreement between the examiners ranged from moderate to substantial (Kappa between 0.55 and 0.75), with the highest agreement observed in cases of KF injuries (Kappa = 0.75). CONCLUSIONS: ALL and KF injuries were prevalent in acute ACL-injured knees with rates of injury of 71% and 50%, respectively. ALL injuries were more frequent and more frequently severe compared to KF injuries.

Structural Relationships between Asthma and Dental Caries in Children: A Birth Cohort Study in Southern Brazil.

INTRODUCTION: There is an inconclusive causal association between asthma symptoms and dental caries in the primary dentition. This study aimed to investigate, using SEM (structural equation modeling), a possible causal relation between asthma and dental caries in the primary dentition. METHODS: Using data from the 2004 Pelotas Birth Cohort Study, a sub-sample of 1,303 individuals was selected. Dental caries was clinically evaluated at 5 years old based on decayed, missing, and filled tooth (dmft) index criteria. Asthma-related symptoms (wheezing and shortness of breath) at 1- and 4-year-olds composed a latent variable and were the main exposures to caries occurrence. SEM was used to identify possible direct, indirect, and mediated effects of asthma in primary dentition dental caries. RESULTS: The general prevalence of caries at age 5 was 1.95 (SD: 3.56). When comparing the dmft values for children with asthma symptoms and those without, they presented similar values in both periods where asthma symptoms were evaluated (1- and 4-year-old). SEM analysis showed that asthma was neither directly nor indirectly related to dental caries. CONCLUSION: Asthma, using a latent variable constructed based on asthma symptoms, showed no causal effect on dental caries occurrence in the primary dentition.

REML/BLUP methodology for selection intraspecific hybrids of Paspalum notatum Flügge by multivariate analysis.

The Paspalum genus has potential for further genetic improvement because of its adaptability to different ecosystems and production of high yields for grazing livestock. We estimate the genetic parameters of 195 intraspecific P. notatum hybrids using Restricted Maximum Likelihood (REML), followed by selection based on Best Linear Unbiased Prediction (BLUP) through multivariate analysis. The intraspecific hybrids studied showed considerable genetic variability in the evaluated forage traits, displaying their potential for progression in subsequent stages of the genetic improvement program. Notably, plant height emerged as an important trait for indirect selection to enhance forage production. The use of the REML/BLUP procedure proves to be a robust tool for data analysis, particularly for perennial species. Furthermore, multivariate analysis based on BLUPs should be used in the selection process within breeding programs. Based on the BLUP values, hybrids D3, D16, C17, C2 and B17 were identified as superior for forage production, and they hold promise for future breeding programs for future breeding initiatives aimed at direct selection to improve yield.

Discrimination and dental students: What is the reality in Brazilian institutions?

INTRODUCTION: This study aimed to evaluate whether there is discrimination in the dental educational environment, assess the main reasons for the discriminatory events, and if there is an association between discriminatory episodes and sociodemographic characteristics of undergraduate dental students. MATERIALS AND METHODS: This observational cross-sectional study was conducted with a self-administered questionnaire to students enrolled in three Brazilian dental schools. Questions included sociodemographic characteristics and the occurrence of discriminatory episodes in the dental academic environment. Descriptive analysis was performed in RStudio 1.3 (R Core Team, RStudio, Inc., Boston, USA) software and the associations were tested using Pearson's chi-square test, considering 95% confidence intervals. RESULTS: A total of 732 dental students were included, with a response rate of 70.2%. The vast majority of students were female (66.9%), with white/yellow skin colour (67.9%), and with a mean age of 22.6 (SD 4.1) years. Sixth-eight percent of students reported having experienced some discrimination in the academic environment and most reported feeling uncomfortable with the episode. The main reasons to have been discriminated against raised by students were specific behaviour/habit, have specific moral, ethical, and aesthetic values, gender, and socioeconomic status or social class. The occurrence of discriminatory episodes was associated with female gender (p = .05), non-heterosexual sexual orientation (p < .001), studying in public institutions (p < .001), receiving an institutional scholarship (p = .018), and being in the final undergraduate cycle (p < .001). CONCLUSION: The occurrence of discriminatory episodes was common in Brazilian dental higher education. Discriminatory situations generate traumas and psychological marks, causing a loss of diversity within the academic environment that leads to loss of productivity, creativity, and innovation. Thus, strong institutional policies against discrimination are crucial to create a healthy dental academic environment.

Perception of parents and caregivers about the need for dental appointments for adolescents from a Brazilian birth cohort.

OBJECTIVE: To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12-13 years and associated factors. METHODS: Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow-up (2015), respectively. The exposure variables 'previous history of dental pain', 'self-rated oral health', clinical variables and the outcome variable were obtained from the second oral health follow-up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI). RESULTS: At the first oral health follow-up (2009), 1303 five-year-old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14-1.32), self-rated oral health as fair or poor (PR 1.26; 95% CI 1.15-1.39), the presence of dental caries (PR 1.27; 95% CI 1.20-1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05-1.25). CONCLUSIONS: The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.

Unsuspected cerebrospinal fluid leak following a minor sacral fracture: A case report.

We describe a unique case of a 38-year-old female who presented at the emergency room due to a minor sacral fracture and local pain complicated by an initially undiagnosed cerebrospinal fluid (CSF) leak. This case emphasizes the importance of radiologists being attentive to subtle imaging findings of CSF leaks on computed tomography (CT) examinations, even in cases of low-energy traumas, as well as the complementary role of a dedicated magnetic resonance (MR) imaging protocol for such diagnosis.

Can oral health have an impact on academic performance and school absenteeism?: a systematic review and meta-analysis

Aim: The study aimed to evaluate the association between oral health and academic performance and/or school absenteeism. Methods: Electronic searches were performed of the PubMed, Web of Science, SCOPUS and LILACS/BVS databases. We included observational studies that evaluated the association between dental caries, tooth loss, dental pain or oral health status with school absenteeism or academic performance. The studies had to contain a representative sample of the population: schoolchildren, children or adolescents. After the removal of duplicates, the electronic searches produced 3,789 articles. Of these, 25 studies were included in the systematic review and 13 in the meta-analysis. Results: Considering all the studies evaluated in the meta-analysis, seven articles satisfied 100% of the Joanna Briggs Institute Critical Appraisal checklist, and six contained between 90% and 75% positive answers. The pooled effects showed that the chances of school absenteeism were 31% higher in subjects with dental caries (OR 1.31; 95%CI 1.12-1.54). Students with fair/poor dental health had a 50% higher chance of suffering poor academic performance (OR 1.50; 95%CI 1.22-1.84) and 34% higher chance of having problems at school (OR 1.34; 95%CI 1.06-1.70). Students with a history of toothache had a 3.7 higher chance of being absent from school (OR 6.65; 95%CI 1.60-8.32) and 71% higher chance of missing class due to toothache (OR 1.71; 95%CI 1.15-2.56). Subjects with a history of toothache had a 2.5 times higher chance of suffering poor academic performance (OR 2.58; 95% CI 2.04-3.27). Conclusion: Therefore, students with oral problems were more likely to take time off school and present inferior academic performance

Contextual inequalities in specialized dental public health care in Brazil

Abstract The present study aimed to investigate the contextual inequalities of specialized public dental care (SPDC) in Brazil. The outcome was the trajectory of dental specialized production in municipalities with SPDC (from 2015 to 2017) obtained by group-based trajectory modeling. A Poisson regression model was used to analyze the factors associated with the high trajectory of SPDC production. The inequality indicators for SPDC production were the slope index and the concentration index according to contextual factors. The study included 954 SPDC units distributed across 893 municipalities. Among the municipalities evaluated, 62.9% had a low trajectory of SPDC. Large-sized municipalities had the highest production (IRR = 2.84, 95%CI: 1.94-4.14) and the southern region had the lowest production (IRR = 0.73, 95%CI: 0.58-0.92). Municipalities presenting a very high human development index (HDI) showed the greatest SPDC production (IRR = 3.34, 95%CI: 1.09-10.24), as well as municipalities with the highest tertile of schooling rate (IRR = 1.23, 95%CI: 1.00-1.50). The absolute inequality was 52.1 percentage points for the average monthly wage (p < 0.001), 61.0 percentage points for the HDI (p < 0.001), -22.1 for infant mortality rate (p <0.001), and 14.8 for the schooling rate (p = 0.012). Thus, there are contextual inequalities in the Brazilian SPDC. Higher scores for social indicators were associated with better SPDC performance.

Accuracy of an artificial intelligence algorithm for detecting moderate-to-severe vertebral compression fractures on abdominal and thoracic computed tomography scans / Acurácia de um algoritmo de inteligência artificial na detecção de fraturas compressivas moderadas a graves na tomografia computadorizada abdominal e torácica

Abstract Objective: To describe the accuracy of HealthVCF, a software product that uses artificial intelligence, in the detection of incidental moderate-to-severe vertebral compression fractures (VCFs) on chest and abdominal computed tomography scans. Materials and Methods: We included a consecutive sample of 899 chest and abdominal computed tomography scans of patients 51-99 years of age. Scans were retrospectively evaluated by the software and by two specialists in musculoskeletal imaging for the presence of VCFs with vertebral body height loss > 25%. We compared the software analysis with that of a general radiologist, using the evaluation of the two specialists as the reference. Results: The software showed a diagnostic accuracy of 89.6% (95% CI: 87.4-91.5%) for moderate-to-severe VCFs, with a sensitivity of 73.8%, a specificity of 92.7%, and a negative predictive value of 94.8%. Among the 145 positive scans detected by the software, the general radiologist failed to report the fractures in 62 (42.8%), and the algorithm detected additional fractures in 38 of those scans. Conclusion: The software has good accuracy for the detection of moderate-to-severe VCFs, with high specificity, and can increase the opportunistic detection rate of VCFs by radiologists who do not specialize in musculoskeletal imaging.

Resumo Objetivo: Descrever a acurácia do software HealthVCF na detecção incidental de fraturas compressivas de corpos vertebrais moderadas a graves em exames de tomografia computadorizada do tórax e abdome. Materiais e Métodos: Foram incluídos 899 exames consecutivos de pacientes com idades entre 51 e 99 anos. As imagens foram retrospectivamente avaliadas pelo software e por dois radiologistas especializados em musculoesquelético que investigaram fraturas compressivas de corpos vertebrais com perda da altura somática > 25%. A análise comparativa foi realizada entre o software e um radiologista geral, usando a avaliação do especialista como referência. Resultados: O software apresentou uma acurácia de 89,6% (IC 95%: 87,4-91,5%) para fraturas compressivas moderadas a graves, com sensibilidade de 73,8%, especificidade de 92,7% e valor preditivo negativo de 94,8%. Entre as 145 tomografias positivas detectadas pelo software, o radiologista geral deixou de relatar as fraturas em 62 (42,8%) e o algoritmo detectou fraturas adicionais em 38 dessas tomografias. Conclusão: O software possui boa acurácia na detecção de fraturas compressivas moderadas a graves, com alta especificidade, podendo aumentar a taxa de detecção oportunística dessas fraturas por radiologistas não especializados em musculoesquelético.

Factors associated with periodontal diseases in pregnancy: Findings of the 2015 Pelotas Birth Cohort Study.

Although periodontal disease is common during pregnancy, little is known about socioeconomic, behavioral, or biological determinants related to clinically assessed periodontal condition during this period. We assessed the prevalence of periodontal disease and associated factors in pregnant women. This population-based survey used data used from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth between December 2014 and May 2016 were interviewed and clinically examined by trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Outcomes were periodontitis (using the 2012 Centers for Disease Control and Prevention and the American Academy of Periodontology criteria) and gingivitis (by the 2018 European Federation of Periodontology/ American Academy of Periodontology classification). Multivariate hierarchical Poisson regression was used to assess the associations between socioeconomic, systemic, and clinical oral factors and periodontal disease. A total of 2,474 pregnant women participated in the study. Prevalence of periodontitis and gingivitis was 14.63% and 21.67%, respectively. Lower educational level and calculus were associated with higher prevalence periodontitis and gingivitis (P<0.05). Smoking was also associated with periodontitis (P=0.05), and lower frequency of toothbrushing (P=0.005) with gingivitis. Periodontal disease, especially gingivitis, was prevalent in pregnant women and their determinants were socioeconomic, environmental, and clinical oral health factors.

Maternal depression in first 1000 days of life and early childhood caries prevalence at 48 months of age.

OBJECTIVES: The aim of this study was to investigate the effect of maternal's depression trajectory in the first 1000 days of the child's life on the prevalence of early childhood dental caries (ECC), in a birth cohort. MATERIALS AND METHODS: All infants born in Pelotas in 2015 were identified, and the mothers were invited to participate in the cohort. A total of 3645 children were included in the study. The outcome was ECC at 48 months of age assessed according to ICDAS. Maternal depression was collected using Edinburgh Postnatal Depression Scale (EPDS) antenatally, at 3, 12, and 24 months of age. Maternal depressive symptom trajectory variables were created using group-based trajectory models and adopting two cutoff points. Poisson regression model with robust variance was used to identify the total effect of maternal depressive symptom trajectories on ECC, adjusting by confounders. RESULTS: A total of 29.2% of the mothers presented a high trajectory for screening of depression, and 18.8% presented a high trajectory of depression diagnosis. The prevalence of ECC was 26.7%. After adjusted analysis, maternal depression trajectories (screening and diagnosis) from pregnancy to 24 months increased the risk for ECC at 48 months of age (RR = 1.14; 95% CI 1.02-1.28 and RR = 1.19; 95% CI 1.05-1.35). CONCLUSIONS: Children from mothers with high depression trajectory had higher risk of having dental caries at 48 months compared to children from mothers with low depression trajectory. CLINICAL RELEVANCE: Strategies of early detection and treatment of maternal mental disorders during the Golden Period should be considered of high priority in health services since it could impact positively in children's life.

Achyrocline satureioides Hydroalcoholic Extract as a Hypoallergenic Antimicrobial Substitute of Natural Origin for Commonly Used Preservatives in Cosmetic Emulsions.

Achyrocline satureioides is a South American herb used in traditional medicine to treat a wide range of ailments. The healing and antimicrobial effects of this plant have already been covered by many studies, which have confirmed its beneficial effects on human health. In this study, the antimicrobial effect of A. satureioides hydroalcoholic extract against Escherichia coli ATCC10536, Staphylococcus aureus ATCC25923, Staphylococcus epidermidis ATCC12228 and Lactobacillus acidophilus INCQS00076 was determined. The cytotoxicity of the extract was tested on human HaCaT keratinocytes showing very favourable effects on the proliferation and renewal of keratinocytes. According to the results of the HPLC and GC-MS analyses, the lyophilized extract contained only a minimal amount of fragrance allergens. The extract was then used in two cosmetic formulations, and one of them showed a significant synergistic interaction with other cosmetic components. We suggest the use of A.satureioides hydroalcoholic extract as a suitable antimicrobial component of natural origin for cosmetic preparations as a substitute for commonly used preservatives that can cause skin irritation and as a material with its own biological activity.

High-resolution Ultrasound of the Foot and Ankle.

High-resolution ultrasound (US) can be used to assess soft tissue abnormalities in the foot and ankle. Compared to MRI, it has lower cost, is widely available, allows portability and dynamic assessment. US is an excellent method to evaluate foot and ankle tendon injuries, ligament tears, plantar fascia, peripheral nerves, and the different causes of metatarsalgia.

Pre-, Peri-, and Postnatal Risk for the Development of Enamel Defects in Permanent Dentition: A Birth Cohort in Southern Brazil.

Purpose: The purpose of this study was to find potential risk factors associated with the occurrence of developmental defects of enamel (DDE) in permanent dentition of a birth cohort in Southern Brazil. Methods: This study is a 2004 birth cohort carried out in the city of Pelotas, Rio Grande do Sul, Brazil. A subsample of 996 children was clinically examined at 12 to 13 years of age. The pre- and perinatal variables used for this study were: twin pregnancy; type of delivery; prematurity; birth weight; Apgar score in the first and fifth minute; health problems at birth; and intensive care unit admission at birth. Gender and family income variables were also collected. Some postnatal variables were collected: "hospitalization in the first 24 months"; "breastfeeding"; "respiratory diseases in the first 48 months"; "urinary infection in the first 48 months"; and "ear pain in the first 48 months." To assess an association between the presence of DDE and various risk factors, unadjusted and adjusted Poisson regression with robust variance was performed with a respective prevalence ratio. Results: The prevalence of DDE was 40.8 percent. The variables investigated did not present a statistical association with DDE. Conclusion: No association of developmental defects of enamel in permanent dentition with any of the factors investigated in this study was found.

Prevalence of lectures about dental esthetics and female speakers in three Brazilian conferences.

This study analyzed the prevalence of lectures involving esthetics in the scientific program of Brazilian dental conferences and the gender distribution of speakers. All lectures presented in three dental conferences (Bahia, São Paulo, and Goiás states) held from 2016 to 2020 were evaluated. Three investigators individually divided the lectures according to the specialties recognized by the Brazilian Federal Council of Dentistry (FCD) based on their titles. The lectures were also classified as involving or not esthetics, and the speaker`s gender was recorded. Descriptive statistical analyses were performed, and Chi-square tests assessed possible associations between factors. The words most cited in the titles of the lectures were "esthetic" (13.6%), "dentistry" (9.9%), and "treatment" (8.1%). Oral diseases were barely mentioned in the titles (up to 1.3%). The highest number of lectures was observed for the specialty of Restorative Dentistry (22.3%), followed by Prosthodontics (18.5%). Approximately one-third of lectures involved some aesthetic aspect, but this percentage ranged from 71.9 to 78.6% for the two specialties with more lectures. Regarding the speaker`s gender, the inequity was higher for lectures involving esthetics (81.6% of males) than for topics unrelated to esthetics (66.7%). More male speakers than females were observed for all specialties. The highest gender gap was observed for Pediatric Dentistry with 62.4% male speakers, although only 10.6% of FCD registered specialists were men. In conclusion, the Brazilian dental conferences analyzed seemed to favor offering lectures dealing with esthetic topics and male speakers.

Discriminatory episodes negatively impact the quality of life of Brazilian dental students: A cross-sectional study.

PURPOSE: This study aimed to evaluate whether discriminatory episodes occurring in the university environment were associated with dental students' self-perceived overall quality of life and assess the cumulative effect of perceived discriminatory experiences on the overall quality of life. METHODS: In this cross-sectional study, all students enrolled in three Brazilian dental schools were invited to participate in a survey between August and October 2019. The outcome was students' self-perceived quality of life, measured through the overall quality of life item of the World Health Organization-Quality of Life Abbreviated Version (WHOQOL-BREF). Descriptive, bivariate, and multivariable logistic regression analyses (95% confidence intervals and α of 5%) were conducted using RStudio software. RESULTS: The sample was composed of 732 students (70.2% response rate). The great part was female (66.9%), white or yellow skin color (67.9%), and were children of highly educated mothers. About 68% of the students reported having experienced at least one of the seven discriminatory experiences presented in the questionnaire and 18.1% reported neutral or negative quality of life. In multivariable analyses, it was estimated that students who experienced at least one episode of discrimination were 2.54 times (95% CI: 1.47-4.34) more likely to report worse quality of life than their counterparts who reported no experience of discrimination. There was also a 25% (95% CI: 1.10-1.42) increase in the odds of reporting poorer quality of life for each additional discriminatory experience reported. CONCLUSION: Reporting at least one discriminatory situation in the academic environment was associated with worse quality of life among dental students, and a cumulative effect was also noted.

Chapter 9.4: Operative Treatment and Monitoring of Coronal Caries in Daily Practice.

After the caries lesion reaches a certain extent of tooth structure loss, a restoration is often needed to repair the defect. Operative interventions in cariology aim to aid biofilm removal and lesion arrest by cavity sealing, avoid pulpal damage, and restore form, function, and esthetics. There are no clear evidence-based parameters to determine the most appropriate treatment option for each clinical situation. Despite of this, direct composite resins have been the preferable restorative treatment. Scientific literature shows that composites and adhesive strategies play a minor role in treatment success. Patient-related risk factors (mainly those associated with lifestyle and health choices), in addition to the dentist's decision-making process, play a significant role in longevity of the restorations, which tend to fail for the same reasons that lead to the need for restoration (dental caries, tooth/restoration fracture, and esthetics). Therefore, monitoring old restorations in clinical service, even if those present clear signs of degradation, is possible and reasonable within the concept of minimal intervention in dentistry. Unnecessary reinterventions are harmful and costly to health systems, and the clinician's efforts must be directed to eliminating or reducing the etiological factors that can cause the restoration to fail. Thus, patient risk factors assessment is a crucial point in monitoring restorations. Clinician should - whenever possible - postpone operative reinterventions, monitoring the etiological factors that may compromise the restoration's longevity. Also, when operative reintervention is necessary, refurbishment, polishing, and repair should be prioritized over replacement.