Effects of estrogen deficiency on the progression of apical periodontitis. A systematic review of preclinical studies.

BACKGROUND: To answer the review's question "Does estrogen deficiency influence on the progression of apical periodontitis?" METHODS: Systematic searches were performed in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, EMBASE, and Grey Literature Report databases, without restriction for language or year of publication. The eligibility criteria were based on the PICOS strategy, as follows: (P) animals with estrogen deficiency; (I) induction of apical periodontitis; (C) animals without estrogen deficiency (control group or sham surgery); (O) bidimensional and/or tridimensional measures of apical periodontitis progression; (S) studies in animal models. Risk of bias was performed with SYRCLE Risk of Bias tool. Certainty of evidence was assessed with GRADE. RESULTS: In total, 12 studies were included according to eligibility criteria. All studies (100%) demonstrated that the estrogen deficiency influence the apical periodontitis progression. Most studies performed a histomorphometric analysis evaluating bone loss area (58.3%), radiographic bone loss area (41.7%), bone volume assessment with microcomputed tomography (25%), fluorescence microscopy lesion area in mm2 (16.7%), and radiographic density assessment in one study (8.3%). The most frequent period of analysis was 21 days after lesion induction (75%). GRADE assessment showed a moderate certainty of evidence. DISCUSSION: The included studies demonstrated several limitations regarding randomization, blinding and description of baseline characteristics. All studies showed that an hypoestrogenic condition can favor an increased progression of apical periodontitis. Further clinical studies are necessary to confirm this correlation. CONCLUSIONS: In animal models, the estrogen deficiency significantly impact on the progression of apical periodontitis generating larger lesions comparing to healthy sham animals.

Dentists' knowledge of dental trauma based on the International Association of Dental Traumatology guidelines: A survey in South Brazil.

BACKGROUND/AIM: Dental trauma is a public health issue with a high prevalence in children. The aim of this study was to evaluate the level of knowledge of dentists in Rio Grande do Sul, Brazil, of the management of traumatic dental injuries, using the International Association of Dental Traumatology (IADT) Guidelines as a reference. MATERIALS AND METHODS: An electronic questionnaire investigating personal and professional characteristics and 12 questions about dento-alveolar trauma, was sent to all registered dentists of the Regional Council of Dentistry of Rio Grande do Sul (n=14 753). The respondents were grouped according to the sociodemographic and professional profiles and the data were evaluated by the Student-T test or one-way ANOVA, with Tukey's post-hoc, with α = 5%. RESULTS: A total of 1414 dentists responded to the survey (9.59% response rate). The overall mean self-reported knowledge of dental trauma was 5.87 ± 1.57, of a maximum possible score of 12. Some factors associated with a higher knowledge of the IADT guidelines were: female gender, previous clinical experience, years from qualification, self-reported knowledge, and academic postgraduate degree. Dentists who are specialized in endodontics (6.58 ± 1.63) and pediatric dentistry (6.05 ± 1.44) achieved higher levels of knowledge on dental trauma. Analysis of the characteristics (gender, location, and proportion of specialists) of the respondents confirmed that they were representative of the target population. CONCLUSION: The overall level of knowledge of dentists from Rio Grande do Sul of the IADT guidelines is moderate. These results highlight the need for continuing education on dento-alveolar trauma in this population.