One-Piece Versus Two-Piece Abutments for Single Crowns in the Esthetic Zone: A Clinical Trial.

OBJECTIVE: To evaluate whether a two-piece abutment is equivalent to a one-piece in peri-implant esthetics, patients' satisfaction, and oral health-related quality of life (OHRQOL) for implant-supported anterior single crown placement. MATERIAL AND METHODS: Thirty implants were allocated sequentially: 15 in the one-piece abutment group (OP) and 15 in the two-piece abutment group (TP). Peri-implant esthetics were evaluated by the pink esthetic score (PES) at temporary crown insertion (T1), after tissue conditioning (T2), and at 30 days after the final crown insertion (T3). OHRQOL was measured using the OHIP-14 and satisfaction was evaluated using the visual analog scale (VAS) at baseline, T1, and T3. Treatment was considered equivalent if the 95% coefficient interval (CI) for mean difference in PES was between -1.5 and +1.5 points. Statistical analysis was performed using Mann-Whitney, SPANOVA, and Student's t-test, with Sidak's posttest, adopting p < 0.05. RESULTS: No differences were found between the groups for any variable and during follow-up. A significant increase in OHRQOL and satisfaction was observed at T3, when compared to baseline (p < 0.05) for both groups. Significant improvements in peri-implant esthetics were also observed throughout the treatment, particularly after tissue conditioning (p < 0.05). Primary and secondary outcomes were evaluated for equivalence, and both abutment types were considered equivalent following the insertion of the temporary crowns. CONCLUSIONS: Two-piece abutment was equivalent to one-piece abutment for peri-implant esthetics, quality of life, or the satisfaction of patients rehabilitated with metal-free single crowns. Tissue conditioning and final crown insertion appear to play a role in improving these outcomes.

Development and Validation of the Epidemiological Diagnostic Instrument for Temporomandibular Disorders.

BACKGROUND: Temporomandibular disorders (TMD) are a highly misreported health problem. Its diagnosis is complex and requires the use of valid and reliable instruments. OBJECTIVE: To develop and validate the Epidemiological Diagnostic Instrument for TMD (EDI/TMD). METHODS: Content validity (CV), response process (RP), construct validity (EFA), reliability (inter and intraobserver consistency), and convergence validity of the EDI/TMD were assessed and compared to the Diagnostic Criteria for TMD (DC/TMD). RESULTS: An instrument composed of a 9-question questionnaire and a 12-step clinical protocol was developed. CV analysis reduced the instrument to a 5-question and 7-step clinical protocol (CVI = 0.93). Some instructions were included after the RP. The EFA found three factors: myogenous TMD, arthrogenous TMD, and differential diagnosis. The reliability scores ranged from substantial to excellent. When compared to the DC/TMD, the EDI/TMD total score indicated that this instrument is valid and provides satisfactory diagnostic criteria (Kappa = 0.906; p < 0.001), and can distinguish non-TMD and TMD individuals, with a cut-off point of 4.9 (Sensitivity = 1.0; Specificity = 1.0; AUC = 1.0). For individuals who had both myogenous and arthrogenous TMD, the cut-off point was 14 or higher (Sensitivity = 0.8; Specificity = 1.0; AUC = 0.987). For individuals who had either myogenous TMD (Sensitivity = 1.0; Specificity = 0.88; PPV = 0.89; NPV = 1.0) or arthrogenous TMD (Sensitivity = 0.95; Specificity = 0.87; PPV = 0.83; NPV = 0.96), the cut-off point was between 5 and 13.9, with the highest EFA score being the determinant factor for final diagnosis. CONCLUSION: Based on its psychometric properties, the EDI/TMD is a valid and reliable assessment tool that is capable of diagnosing TMD and classifying its subtypes.

Retrospective assessment of patients' risk for peri-implant diseases using the implant disease risk assessment (IDRA) tool: A cohort study.

INTRODUCTION: The implant disease risk assessment (IDRA) tool was designed to assess an individual's risk of developing peri-implant diseases by evaluating and integrating multiple risk factors. This study aimed to evaluate the IDRA tool to determine the risk of developing peri-implant disease in patients rehabilitated with dental implants. METHODS: A retrospective observational cross-sectional study was conducted, collecting data from 92 patients with 92 selected dental implants. Data included the history of periodontitis, sites with bleeding on probing (BoP), teeth and/or implants with probing depths (PDs) ≥ 5 mm, alveolar bone loss relative to the patient's age, susceptibility to periodontitis, the frequency of supportive periodontal therapy (SPT), the distance from the restorative margin (RM) of the implant-supported prosthesis to the marginal bone crest (MBC), and factors related to the prosthesis itself. Additionally, the validated instrument periodontal risk assessment (PRA) was employed for comparison. Statistical analyses utilized Chi-square, Mann-Whitney, and ROC curve. RESULTS: Outcomes indicated that 62 implants (67.4%) were classified as high-risk. Among the IDRA parameters, history of periodontitis was the primary factor contributing to an increased risk (p < 0.001). IDRA revealed high sensitivity (100%) and low specificity (63%) (AUC = 0.685; 95% CI: 0.554-0.816; p = 0.047), and there was a low agreement between the IDRA and PRA tools (Kappa = 0.123; p = 0.014). The peri-implant disease developed in 16 implants with 5.44 (±2.50) years of follow-up, however, no significant association was observed between the high- and low-medium risk groups and the occurrence of peri-implant diseases. CONCLUSION: Most of the evaluated implants presented high IDRA risk. The IDRA tool exhibited high sensitivity and low specificity; no significant association was observed between the risk profile and the development of peri-implant diseases.

Impact of Silicon Carbide Coating and Nanotube Diameter on the Antibacterial Properties of Nanostructured Titanium Surfaces.

This study aimed to comprehensively assess the influence of the nanotube diameter and the presence of a silicon carbide (SiC) coating on microbial proliferation on nanostructured titanium surfaces. An experiment used 72 anodized titanium sheets with varying nanotube diameters of 50 and 100 nm. These sheets were divided into four groups: non-coated 50 nm titanium nanotubes, SiC-coated 50 nm titanium nanotubes, non-coated 100 nm titanium nanotubes, and SiC-coated 100 nm titanium nanotubes, totaling 36 samples per group. P. gingivalis and T. denticola reference strains were used to evaluate microbial proliferation. Samples were assessed over 3 and 7 days using fluorescence microscopy with a live/dead viability kit and scanning electron microscopy (SEM). At the 3-day time point, fluorescence and SEM images revealed a lower density of microorganisms in the 50 nm samples than in the 100 nm samples. However, there was a consistently low density of T. denticola across all the groups. Fluorescence images indicated that most bacteria were viable at this time. By the 7th day, there was a decrease in the microorganism density, except for T. denticola in the non-coated samples. Additionally, more dead bacteria were detected at this later time point. These findings suggest that the titanium nanotube diameter and the presence of the SiC coating influenced bacterial proliferation. The results hinted at a potential antibacterial effect on the 50 nm diameter and the coated surfaces. These insights contribute valuable knowledge to dental implantology, paving the way for developing innovative strategies to enhance the antimicrobial properties of dental implant materials and mitigate peri-implant infections.

Primary central nervous system germ cell tumors in Central America and the Caribbean Region: an AHOPCA 20-year experience.

Background: Primary central nervous system germ cell tumors (GCT) are rare neoplasms in pediatrics. Treatment depends on the histological subtype and extent of the disease. Overall survival (OS) is above 90% for germinomas and 70%-80% for nongerminomatous GCT (NGGCT) in high-income countries (HIC) while data are usually lacking for patients in Low-Middle Income country (LMIC). Objective: This study aims to describe the experience of treating patients with CNS GCT in four of eight countries, members of the Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA), and determine their 5-year OS. Design/methods: We conducted a retrospective chart review of patients treated for CNS GCT. Epidemiological and clinical characteristics, histology, treatment modalities, and outcomes were analyzed. Results: From 2001 to 2021, 48 patients were included: 22 from Guatemala, 18 from Nicaragua, three from the Dominican Republic, and five from El Salvador. Thirty-one (64.6%) were boys; the median age at diagnosis was 10.2 years (range: 1 to 17 years). Presenting symptoms were headaches (n = 24, 50%), visual disturbances (n = 17, 35.4%), vomiting (n = 12, 25%), nausea (n = 8, 16.7%), and diabetes insipidus (n = 7, 14.6%). Two patients with NGGCT presented with precocious puberty. Biopsy or tumor resection was performed in 38 cases (79.2%): 23 (88.4%) germinomas, 11 (78.6%) NGGCT, and four (50%) CNS GCT. Eight patients were diagnosed and treated based on CSF tumor marker elevation; four germinomas (BHCG 11.32-29.41 mUI/mL) and four NGGCT (BHCG 84.43-201.97 mUI/mL or positive AFP > 10 UI/mL). Tumor locations included suprasellar (n = 17, 35.4%), pineal (n = 13, 27.1%), thalamus/basal ganglia (n = 5, 10.4%), other (n = 12, 25%), and one bifocal. Four (8.3%) had metastatic disease, and six had positive CSF; staging data were incomplete in 25 patients (52%). Patients were treated with varied chemotherapy and radiotherapy modalities. Nine patients had incomplete data regarding treatment. Five-year OS was 65% (68% for germinoma, 50.6% for NGGCT, and 85.7% for unclassified GCT). Conclusions: Germinoma was the most common histology, and there was a male predominance. More than half of patients had incomplete staging data and treatment was variable across the region. OS is lower compared to HIC. Standardized treatment protocols will aid in adequate staging and treatment planning, prevent complications, and improve survival.

Impact of splinting implant-supported crowns on the performance of adjacent posterior implants: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: While rehabilitation with implant-supported crowns in the posterior region is widely practiced, guidance on clinical considerations when choosing between splinted or nonsplinted implant-supported crowns is limited. PURPOSE: The purpose of this systematic review with meta-analysis was to assess whether adjacent implants with internal connections in the posterior region should be treated with splinted or nonsplinted crowns. MATERIAL AND METHODS: The systematic review was registered on the prospective register of systematic reviews (PROSPERO) under the code, CRD42021248525. Two authors searched 4 electronic databases (PubMed, Cochrane Library, Scopus, and Web of Science) independently for articles published up to December 2023. Additionally, a hand search was conducted in the nonpeer-reviewed literature and the reference lists of included articles. Only clinical studies comparing splinted and nonsplinted hexagonal or conical internal connection adjacent implants in the posterior region were considered. A single-arm meta-analysis was conducted using RevMan. Risk of bias and quality were assessed using the Cochrane Collaboration's Tool for Assessing Risk and the Newcastle-Ottawa scale. RESULTS: Qualitative synthesis included 17 studies, and quantitative synthesis involved 13 studies. A total of 2085 implants (1244 splinted and 841 nonsplinted) were inserted in 1027 participants, with observation times ranging from 5 months to 16 years. Thirteen studies related the type of crown retention (cemented or screw-retained). Only 2 studies related annual bone loss results considering the type of crown retention, but whether they were splinted or nonsplinted crowns and significant differences were not specified. The meta-analysis revealed no statistical differences between splinted and nonsplinted implants for biological complications (P=.95, I2=0%). However, the nonsplinted implants exhibited significantly more mechanical complications than the splinted implants (P<.001, I2=1%, RR 0.37; 95% IC [0.26-0.54]). The studies included demonstrated a low risk of bias and were of good quality. CONCLUSIONS: Splinting was not found to affect the incidence of biological complications in posterior adjacent implants. However, more mechanical complications occurred in nonsplinted crowns than splinted ones.

Impact of CAD/CAM burs lifetime on surface properties of dental zirconia: Implications for biocompatibility of custom abutments.

OBJECTIVE: To evaluate the effect of the deterioration of computer aided design/computer aided manufacturing (CAD/CAM) burs during zirconia milling, on surface roughness, contact angle, and fibroblast viability. MATERIALS AND METHODS: Ceramic blocks were milled and 75 ceramic disks (8 × 1.5 mm) made and allocated into three groups (n = 25): G1-brand new 2L and 1L burs, G2-2L bur at the end of lifetime and brand new 1L bur and G3-both burs at the end of their lifetimes. Roughness (Ra, Rq, and Rz) was evaluated using a 3D optical profilometer, the contact angle by the sessile drop method and the cell viability of the mouse NIH/3T3 fibroblast, using the Alamar Blue assay at intervals of 24, 48, and 72 h (ISO 10993-5). Data were analyzed by one-way ANOVA and Kruskal-Wallis tests (p ≤ 0.05). RESULTS: Roughness increased as the burs deteriorated and G3 (0.27 ± 0.04) presented a higher value for Ra (p < 0.001). The highest contact angle was observed in G3 (86.2 ± 2.66) when compared with G1 (63.7 ± 12.49) and G2 (75.3 ± 6.36) (p < 0.001). Alamar Blue indicated an increase in cell proliferation, with no significant differences among the groups at 24 and 72 h (p > 0.05). CONCLUSIONS: The deterioration of the burs increased the surface roughness and decreased the wettability, but did not interfere in cell viability and proliferation. CLINICAL SIGNIFICANCE: The use of custom zirconia abutments represents an effective strategy for single crowns restorations. Our findings suggest that these abutments can be efficiently milled using CAD/CAM burs within their recommended lifetime.

International Society of Paediatric Oncology (SIOP) Global Mapping Programme: Latin American Society of Pediatric Oncology (SLAOP) country-level report.

BACKGROUND: Latin American countries are improving childhood cancer care, showing strong commitment to implement the Global Initiative for Childhood Cancer, but there are scant publications of the situation at a continental level. METHODS: As part of the International Society of Paediatric Oncology Global Mapping project, delegates of each country participating in the Latin American Society of Pediatric Oncology (SLAOP) and chairs of national pediatric oncology societies and cooperative groups were invited to provide information regarding availability of national pediatric cancer control programs (NPCCP), pediatric oncology laws, pediatric oncology tumor registries, and training programs and support to diagnosis and treatment. RESULTS: Nineteen of the 20 countries participating in SLAOP responded. National delegates reported nine countries with NPCCP and four of them were launched in the past 5 years. National pediatric tumor registries are available in eight countries, and three provided published survival results. Fellowship programs for training pediatric oncologists are available in 12 countries. National delegates reported that eight countries provide support to most essential diagnosis and treatments and 11 provide partial or minimal support that is supplemented by civil society organizations. Seven countries have a pediatric oncology law. There are three international cooperative groups and four national societies for pediatric oncology. CONCLUSION: Despite many challenges, there were dramatic advances in survivorship, access to treatment, and availability of NPCCP in Latin America. Countries with highest social development scores in general provide more complete support and are more likely to have NPCCP, training programs, and reported survival results.

Confecção de guia multifuncional para planejamento de reabilitação implantossuportada: relato de caso / Preparation of a multifuncional guide for the planning of implant-supported rehabilitations: case report / Elaboración de una guía multifuncional para la planificación de rehabilitación implantosoportada: informede caso

Introdução:Em busca da estética e da função mastigatória,é cada vez mais crescente aprocurapor reabilitações implantossuportadas. O guia multifuncional surgepara orientar a disponibilidade óssea e contribuir no planejamento da instalação tridimensional dos implantes, seguindo os princípios do planejamento reverso.Objetivo:Descrever, por meio de um caso clínico, a possibilidade de obtenção de resultados de excelente previsibilidade em coroas unitárias implantossuportadas, por meio do uso de guias multifuncionais, no planejamento do início ao fim de tratamento.Relato decaso:Paciente A.M.F, 44 anos, sexo feminino, compareceu à clínica de Prótese dentária do Departamento de Odontologia/UFRN com queixa de insatisfação da sua prótese removível e harmonia do sorriso. Ao exame clínico e radiográfico, observou-se ausência do elemento 12, apresentando um espaço interoclusal de 5mm e distância médio-distal de 7mm. Foi confeccionado o guia em resina acrílica, o qual foi preenchido o espaço desdentado com um dente de estoque. Em seguida, o dente deste guia teve seu centro perfurado com uma broca esférica para peça reta na região de cíngulo e com isso, preenchida com guta percha em bastão. Após isso, o paciente foi encaminhado para realizar uma tomografia computadorizada cone beam com o guia multifuncional em posição.As imagens obtidas permitiram o planejamento para instalação do implante, como inclinação e posicionamento favorável, bem como ausência de disponibilidade óssea na região. Além disso, o guia funcionou em outras etapas do tratamento da paciente, como na fase provisória.Conclusão:Os guias auxiliam em diversas fases do tratamento e permitem maior previsibilidade dos resultados em reabilitações protéticas unitárias implantossuportadas, apresentando-se como um dispositivo promissorpara ocorreto posicionamento do implante (AU).

Introduction:In search of esthetics and improved masticatory function, the demand for implant-supported rehabilitation is increasing. Multifunctional guides emerge to assess bone availability and help plan the three-dimensional installation of implants, following the principles of reverse planning. Objective:To describe, through a clinical case, the possibility of obtaining excellent predictability in implant-supported single crowns, through the use of multifunctional guides, inthe planning of a treatment from beginning to end. Case report:Patient A.M.F, 44 years old, female, came to the Prosthodontics clinic at the Department of Dentistry/UFRN complaining of dissatisfaction with her removable prosthesis and the harmony of her smile. Clinical and radiographic examination revealed the absence of element 12, with an interocclusal space of 5mm and a mid-distal distance of 7mm. The acrylic resin guide was made and the edentulous space was filled with a stock tooth. The center of theguide tooth was then drilled with a spherical straight-bit burr in the cingulum region and filled with gutta-percha stick. The patient was then referred for a cone beam computed tomography with the multifunctional guide in position. The images obtained allowed planning for implant installation, such as favorable inclination and positioning, as well as the absence of bone availability in the region. In addition, the guide was effective during other stages of the patient's treatment, such as the provisional phase.Conclusion:The guides assist in various phases of treatment and allow greater predictability of results in implant-supported single prosthetic rehabilitations, presenting themselves as a promising device for correct implant positioning (AU).

Introducción:En busca de estética y función masticatoria, la demanda de rehabilitaciones implantosoportadas es cada vez mayor. La guía multifuncional hasurgido para orientar la disponibilidad ósea y ayudar a planificar la instalación tridimensional de implantes, siguiendo los principios de la planificación inversa. Objetivo: Describir, a través de un caso clínico, la posibilidad de obtener una excelente predictibilidad en coronas unitarias implantosoportadas, mediante el uso de guías multifuncionales, en la planificación desde el início hasta el final del tratamiento. Informe de caso: Paciente A.M.F, 44 años, sexo femenino, compareció a la clínica de Prostodoncia del Departamento de Odontología/UFRN quejándose estar insatisfecha con su prótesis removible y con la armonía de su sonrisa. El examen clínico y radiográfico reveló la ausencia del elemento 12, con un espacio interoclusal de 5 mm y una distancia medio-distal de 7 mm. Se confeccionó una guía de resina acrílica y se rellenó el espacio edéntulo con un diente provisorio. A continuación, se perforó el centro del diente guía con una broca recta esférica en la región del cíngulo y se le rellenó con gutapercha en barra. Posteriormente, el paciente fue remitido a una tomografía computarizada cone beamcon la guía multifuncional en posición. Las imágenes obtenidas permitieron planificar la instalación del implante, como inclinación y posicionamiento favorables, así como la ausencia de disponibilidad ósea en la región. La guía también funcionó en otras fases del tratamiento del paciente, como en la fase provisional. Conclusión:Las guías ayudan en varias fases del tratamiento y permiten una mayor previsibilidadde los resultados en rehabilitaciones protésicas unitarias implantosoportadas, presentándose como un dispositivo prometedor para el correcto posicionamiento de los implantes (AU).

O condicionamento de tecido peri-implantar na reabilitação estética de próteses unitárias sobre implantes: relato de caso clínico / Peri-implant tissue conditioning in the esthetic rehabilitation of unitary prostheses on implants: Clinical case report / Acondicionamiento del tejido periimplantario en la rehabilitación estética de prótesis unitarias sobre implantes: Informe de caso clínico

Introdução:A reabilitação protética implantosuportada de espaços edêntulos na região do sorriso é um desafio para o cirurgião-dentista. Para obtenção da estética em próteses unitárias sobre implante é necessário considerar aspectos como o correto posicionamento do implante e sua harmonia com os tecidos moles e duros. Objetivo:relatar o resultado estético e funcional de um tratamento com auxílio de coroa provisória associada ao condicionamento gengival na reabilitação final com coroa unitária implantossuportada. Relato de caso clínico: Paciente MJFA, 36 anos, sexo feminino, compareceu à clínica de Prótese Dentária do Departamento de Odontologia/UFRN queixando-se de trauma dentário com perda do elemento dentário 15 e necessidade de "ficar com sorriso mais bonito". Após instalação de implante com conexão cônica e período de osseointegração, foi realizada a confecção da coroa provisória sobre implante e iniciada sessões de condicionamento gengival por meio de acréscimos com resina acrílica, utilizando a técnica de pressão gradual sob a margem gengival. Observou-se uma melhora no tecido periimplantar e um perfil de emergência adequado. O caso possui proservação de 3 anos. Conclusões:a realização de condicionamento gengival previamente a prótese final é uma etapa importante para alcançar umareabilitação com característicasestéticas e funcionais semelhantes à de dentes naturais (AU).

Introduction:Implant-supported prosthetic rehabilitation of edentulous spaces in the smile areais a challenge for dental surgeons. To achieve pleasing esthetics in single implant prostheses it is necessary to consider aspects such as the correct positioning of the implant and its harmony with the soft and hard tissues.Objective:to report the esthetic and functional results of a treatment with the aid of a provisional crown associated with gingival conditioning in the final rehabilitation with a single implant-supported crown.Clinical case report:Patient MJFA, 36 years old, female, attended the Prosthodonticsclinic of the Department of Dentistry/UFRN complaining of dental trauma with loss of tooth 15 and the need to "havea more beautiful smile". Afterinstalling an implant with a conical connection and a period of osseointegration, a temporary crown was made on the implant and gingival conditioning sessions were initiatedby means of acrylic resin augmentations, using the gradual pressure technique under the gingival margin. An improvement in the peri-implant tissue and an adequate emergenceprofile were observed. The case has a 3-year follow-up period.Conclusions:performing gingival conditioning prior to the final prosthesis is an important step in achieving rehabilitation with esthetic and functional characteristics similar to those of natural teeth (AU).

Introducción: La rehabilitación protésica implantosoportada de espacios edéntulos en el áreade la sonrisa es un desafío para el cirujano dentista. Para conseguir una buena estética en las prótesis unitarias sobre implanteses necesario tener en cuentaaspectos como el posicionamiento correctodel implante y su armonía con los tejidos blandos y duros.Objetivo: informar losresultadosestéticosy funcionalesde un tratamiento con ayuda de coronas provisionales asociado al acondicionamiento gingival en la rehabilitación final con corona única implantosoportada.Relato de caso clínico: Lapaciente MJFA, 36 años, sexo femenino, se dirigióa la clínica de Prostodonciadel Departamento de Odontología/UFRN quejándose de un traumatismodental con pérdida del diente 15 y de la necesidad de "tener una sonrisa más bonita". Después de la colocación de un implante con conexión cónica y de un período de osteointegración, se realizó una corona provisional sobre el implante y se iniciaron sesiones de acondicionamiento gingival con aumentos de resina acrílica, utilizando la técnica de presión gradual bajo el margen gingival. Se observó una mejora del tejido periimplantario y un perfil de emergencia adecuado. El caso tiene un seguimiento de 3 años. Conclusiones: el acondicionamiento gingival previo a la prótesis definitiva es una etapaimportante para conseguiruna rehabilitación con características estéticas y funcionales similares a las de los dientes naturales (AU).

Juventudes rurales en América Latina: evidencias desde la literatura académica

Estudiosos del tema plantean la imposibilidad de definir a la juventud de manera homogénea. Ante su diversidad, este artículo se centra analizar las dinámicas políticas, sociales, culturales y económicas de las juventudes rurales en América Latina en el período 2000-2021. Para ello, se desarrolló una revisión documental en la base de datos Scielo a través de las investigaciones que abordan a esta población en el siglo XXI. Los resultados exponen cuatro principales ejes de análisis: identidades y representaciones; la preocupación por el envejecimiento del campo; el territorio y las estrategias de vida; y por último las violencias. Se concluye que analizar las juventudes rurales pasa por reflexionar sobre su invisibilidad en los estudios, a la vez que evidencia las grandes problemáticas/ potencialidades que involucran a las juventudes en América Latina.

Scholars argue that it is impossible to define youth in a homogeneous way. Given their diversity, this article focuses on analyzing the political, social, cultural, and economic dynamics of rural youth in Latin America in the 2000-2021 period. To this end, a documentary review was carried out in the Scielo database of research on this population in the 21st century. The results show four main axes of analysis: identities and representations; concern for the aging of the countryside; territory and life strategies; and finally, violence. It is concluded that analyzing rural youth entails reflecting on their invisibility in studies, while at the same time, it highlights the major issues/potentialities that involve youth in Latin America.

Rhabdomyosarcoma in low- and middle-income countries: A report from the Asociacion de Hemato-oncología Pediatrica de Centro América (AHOPCA).

This report describes the results of an observational study dedicated to rhabdomyosarcoma developed by the Asociación de Hemato-oncología Pediatrica de Centro América (AHOPCA) between 2001 and 2018. Overall, 337 previously untreated patients < 18 years old were included in the analysis; 58% had unresected disease, and 19% were metastatic at diagnosis. With a median follow-up of 6.6 years, five-year event-free and overall survival rates were 30% and 33%, respectively. Local progression/relapse was the main cause of treatment failure.

Effect of Silicon Carbide Coating on Osteoblast Mineralization of Anodized Titanium Surfaces.

The objective of this study was to evaluate the influence of the titanium nanotube diameter and the effect of silicon carbide (SiC) coating on the proliferation and mineralization of pre-osteoblasts on titanium nanostructured surfaces. Anodized titanium sheets with nanotube diameters of 50 and 100 nm were used. The following four groups were tested in the study: (1) non-coated 50 nm nanotubes; (2) SiC-coated 50 nm titanium nanotubes; (3) non-coated 100 nm nanotubes and (4) SiC-coated 100 nm nanotubes. The biocompatibility and cytotoxicity of pre-osteoblasts were evaluated using a CellTiter-BlueCell Viability assay after 1, 2, and 3 days. After 3 days, cells attached to the surface were observed by SEM. Pre-osteoblast mineralization was determined using Alizarin-Red staining solution after 21 days of cultivation. Data were analyzed by a Kruskal−Wallis test at a p-value of 0.05. The results evidenced biocompatibility and non-cytotoxicity of both 50 and 100 nm diameter coated and non-coated surfaces after 1, 2 and 3 days. The statistical analysis indicates a statistically significant higher cell growth at 3 days (p < 0.05). SEM images after 3 days demonstrated flattened-shaped cells without any noticeable difference in the phenotypes between different diameters or surface treatments. After 21 days of induced osteogenic differentiation, the statistical analysis indicates significantly higher osteoblast calcification on coated groups of both diameters when compared with non-coated groups (p < 0.05). Based on these results, we can conclude that the titanium nanotube diameter did not play any role on cell viability or mineralization of pre-osteoblasts on SiC-coated or non-coated titanium nanotube sheets. The SiC coating demonstrated biocompatibility and non-cytotoxicity and contributed to an increase in osteoblast mineralization on titanium nanostructured surfaces when compared to non-coated groups.

Primary headache and myofascial pain: a data based study / Cefaleia primária e dor miofascial: um estudo baseado em dados

Aim: This study aimed to evaluate the relationship be-tween the presence of primary headaches and myofascial pain in orofacial patients. Materials and methods: Six hundred and ninety-nine records of patients seeking treatment in a specialized orofacial pain clinic were assessed. The primary diagnostic categories of heada-che and myofascial pain were recorded. Data analyses were carried out by Pearson Chi-square and Logistic Regression, with a p-value of 0.05. Results: Average age of patients was 34.6 years. Females constituted 82.8% of the sample. A relationship between the presence of tension-type headache and myofascial pain was found (p=0.00); however, this relationship was not found for the presence of migraine and myofascial pain (p>0.05). Discussion: Tension-type headaches may be triggered or perpetuated by trigger points in orofacial structures. Conclusion: It can be concluded that trigger points in myofascial pain patients can play an important role in the genesis of tension-type headache.

Objetivo: Este estudo avaliou a relação entre a presença de cefaleia primária e dor miofascial em pacientes orofaciais. Materiais e métodos: Foram avaliados 699 prontuários de pacientes que buscavam atendimento em clínica especiali-zada em dor orofacial. As categorias diagnósticas primárias de cefaleia e dor miofascial foram registradas. A análise dos dados foi realizada pelo Qui-quadrado de Pearson e Regressão Logística, com valor de p=0,05. Resultados: A idade média dos pacientes foi de 34,6 anos. O sexo feminino constituiu 82,8% da amostra. Foi encontrada relação entre a presença de cefaleia do tipo tensional e dor miofascial (p = 0,00); en-tretanto, essa relação não foi encontrada para a presença de enxaqueca e dor miofascial (p> 0,05). Discussão: As cefaleias primárias do tipo tensionais podem ser desencadeadas ou perpetuadas por pontos-gatilhos nas estruturas orofaciais. Conclusão: Pode-se concluir que os pontos-gatilhos em pacientes com dor miofascial podem desempenhar um papel importante na gênese da cefaleia do tipo tensional.

Which surface treatment promotes higher bond strength for the repair of resin nanoceramics and polymer-infiltrated ceramics? A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Which surface treatment provides the optimal bond strength (BS) for the repair of resin nanoceramics (RNCs) and polymer-infiltrated ceramics (PICs) is unclear. PURPOSE: The purpose of this systematic review and meta-analysis of in vitro studies was to determine the best surface treatment protocols for the repair of PICs and RNCs. MATERIAL AND METHODS: The PubMed, Scopus, and Web of Science electronic databases were searched to select in vitro studies in English up to March 2020. Studies with fewer than 5 specimens, those that did not evaluate the BS of PICs or RNCs, and those with aging for fewer than 30 days and 5000 cycles were excluded. Data sets were extracted, and the mean differences were analyzed by using a systematic review software program. RESULTS: Among 284 potentially eligible studies, 21 were selected for full-text analysis, and 9 were included in the systematic review, of which 6 were used in the meta-analysis. The meta-analyses were performed for each treatment surface versus their respective control group and their combinations according to material: RNCs and PICs. For RNCs, airborne-particle abrasion with aluminum oxide (Al2O3) treatment was statistically higher than tribochemical silica airborne-particle abrasion (CoJet) (P=.02, I2=90%) and that in the hydrofluoric acid (HF) (P<.001, I2=0%) groups and was statistically similar to diamond rotary instrument grinding (P=.40, I2=54%). For PICs, the treatment with hydrofluoric acid (HF) was statistically significantly higher than with CoJet (P=.03, I2=62%) and airborne-particle abrasion with Al2O3 (P<.001, I2=98%). CONCLUSIONS: The best surface treatment protocol for repair varied according to the restorative material. HF followed by silanization is suggested for PICs, and airborne-particle abrasion with Al2O3 or preparation with a diamond rotary instrument for RNCs.

Bone evaluation of single edentulous areas of maxilla: short communication / Avaliação óssea de regiões maxilares candidatas à reabilitação unitária implantossuportada: uma comunicação curta

Objective: Evaluate the height and bone thickness in healed sites of single implant areas. Materials and Methods:In this cross-sectional study, cone-beam computed tomography (CBCT) images of single edentulous areas of maxilla of patients who needed aesthetic single implant rehabilitations were evaluated for measure the height and thickness using an implant planning software. Data were statistically analyzed using the Mann-Whitney and Pearson correlation test, considering the time, reason and region of tooth loss. For all tests, a p-value <0.05 was considered significant. Results: 48 patients with single tooth loss were included. The statistical analysis demonstrated that reason for the loss was not related to height or bone thickness. Bone thickness was statis-tical significant higher in the posterior region. For the anterior region, the bone thickness was significantly higher when the tooth was lost within 5 years. Pearson correlation test showed a moderate negative signifi-cant correlation between time of tooth loss and bone thickness in anterior region. Conclusion: Reason for tooth loss had no influence on the bone measurements of the residual ridge. In contrast, bone thickness may vary according to the region of tooth loss. The time of tooth loss and bone thickness in the anterior region were inversely proportional. Registration number at https://ensaiosclinicos.gov.br/rg/RBR-5cnyjj.

Objetivo: Avaliar a altura e espessura óssea em sítios unitários cicatrizados. Materiais e Métodos: Neste estudo transversal, imagens de tomografia computa-dorizada de feixe cônico (TCFC) de regiões edêntulas unitárias maxilares de pacientes candidatos a reabilitação unitária implantossuportada foram mensuradas em relação à altura e espessura óssea usando um software de planejamento de implante. Os dados foram analisados estatisticamente por meio do teste Mann-Whitney e de correlação de Pearson, considerando o tempo, o motivo e região da perda dentária. Para todos os testes, um valor de p <0,05 foi considerado significativo. Resultados: Foram incluídos 48 pacientes com perda dentária unitária. A análise estatística demonstrou que o motivo da perda dentária não influenciou na altura ou na espessura óssea. A espessura óssea foi estatisticamente maior na região posterior. Para a região anterior, a espessura óssea foi significativamente maior quando o dente foi perdido em até 5 anos. O teste de correlação de Pearson demonstrou uma correlação significativa negativa moderada entre o tempo de perda do dente e a espessura óssea na região anterior. Conclusão: O motivo da perda dentária não influenciou nas medidas ósseas do rebordo residual. Em contraste, a espessura do osso pode variar de acordo com a região da perda dentária. O tempo de perda dentária e a espessura óssea da região anterior foram inversamente proporcionais. Número de registro em https://ensaiosclinicos.gov.br/rg/RBR-5cnyjj

Pain intensity and depression level in chronic temporomandibular disorders patients / Intensidade da dor e nível de depressão em pacientes com disfunção temporomandibular crônica

Aim: The aim of this study was to assess the correlation between pain intensity and the level of depression in pa-tients with chronic temporomandibular disorders (TMD). Materials and methods: Fifty-five volunteers diagnosed by the Research Diagnostic Criteria (RDC/TMD) were assessed for pain intensity and level of depression. Pain intensity and level of depression were assessed using a visual analysis scale and Beck depression inventory, respectively. Data analysis was conducted using confi-dence intervals and Pearson's chi-square test (p< 0.05). Results: The results demonstrated that non-depressed individuals (43.6%) showed a mean pain intensity of 28.27mm, those with mild depression (38.2%) 34.24mm, and those moderate depression (18.2%) 50.7mm. Statistical analysis showed that there was a positive and significant correlation between pain intensity and level of depres-sion (p=0.004). Discussion: This study found a positive correlation between painintensity and depression level in chronic TMD patients. However, it has not been elu-cidated yet how TMD are correlated to depression and in which way depression can influence its onset and perpetuation. Conclusion: The levelof depression may play an important role in the intensity of chronic pain, therefore, a multidisciplinary intervention seems to be important for the treatment success.

Objetivo: Este estudo objetivou avaliar a correlação entre a intensidade da dor e o nível de depressão em pacientes com disfunção temporomandibular (DTM) crônica. Materiais e métodos: Cinquenta e cinco voluntários diagnosticados pelos Critérios de diagnóstico para pesquisa das disfunções temporomandibulares (RDC / DTM) foram avaliados quanto à intensidade da dor e nível de depressão. A intensidade da dor e o nível de depressão foram avaliados por meio da escala analógica visual e do inventário de depressão de Beck, respectivamente. A análise dos dados foi realizada usando intervalos de confiança e teste do qui-quadrado de Pearson (p <0,05). Resultados: Os resultados demonstraram que os não deprimidos (43,6%) registraram média de intensidade de dor de 28,27mm, os com depressão leve (38,2%), 34,24mm, e os com depressão moderada (18,2%), 50,7mm. A análise estatística mostrou que houve correlação positiva e significativa entre a intensidade da dor e o nível de depressão (p=0,004). Discussão: Este estudo encontrou uma correlação positiva entre a intensidade da dor e o nível de depressão em pacientes com DTM crônica. No entanto, ainda não foi elucidado como a DTM está relacionada à depressão e de que forma a depressão pode influenciar seu aparecimento e perpetuação. Conclusão: O nível de depressão pode desempenhar um papel importante na intensidade da dor crônica, portanto, uma intervenção multidisciplinar parece ser importante para o sucesso do tratamento.

Diagnostic and screening inventories for temporomandibular disorders: A systematic review.

Objective: To evaluate reliable and validated temporomandibular disorder (TMD) diagnostic instruments for use as diagnostic tools in epidemiological surveys.Methods: Two independent reviewers performed searches in the Medline/PubMed, Cochrane Library, and Web of Science databases to identify validation studies of diagnostic and screening instruments for TMD published up to March 2021.Results: Sixteen studies were included for the systematic review. Different TMD instruments were evaluated, such as FAI, RDC/TMD, DC/TMD, Helkimo Index, and AAOP Questionnaire. The instruments differed according to the number of items. Some questionnaires appear to be effective for the initial screening of TMD patients and can be incorporated in clinical practice and epidemiological studies since they are easy and fast to apply.Conclusion: To provide an accurate TMD diagnosis, it is important to use instruments that involve a clinical examination. Authors suggest the development of a new validated diagnostic tool for use in epidemiological surveys.

Relationship of Porphyromonas gingivalis and Alzheimer's disease: a systematic review of pre-clinical studies.

OBJECTIVES: This study aimed to analyze the following PICO question: Are animals infected with Porphyromonas gingivalis (P. gingivalis) or bacterial lipopolysaccharide (Pg-LPS) more affected by neurodegeneration, similar to the pathogenesis generated by Alzheimer's disease (AD), compared with non-infected animals? METHODS: Databases PubMed, Lilacs, SciELO, Science Direct, Scopus, Web of Science, and Cochrane were searched for pre-clinical in vivo studies in which mice were infected with P. gingivalis or received Pg-LPS, in order to assess the brain tissue and cognitive impairment. No limit for date or publication language was imposed and this study was registered at the International Prospective Register of Systematic Reviews (PROSPERO), with nine articles included. Syrcle's protocol was used to evaluate bias in the selected studies. RESULTS: Nine articles were included. Infection by P. gingivalis or the administration of Pg-LPS increased the production of the inflammatory mediators, TNF-α (tumor necrosis factor-alpha), IL-6 (interleukin-6), and IL-1ß (interleukin-1beta), augmented Aß (amyloid beta) production, and activated the complement system, causing inflammation, brain tissue degeneration, and cognitive impairment, consistent with the damage in AD. CONCLUSIONS: Infection by P. gingivalis and Pg-LPS administration appears to be in relation with the pathogenesis of AD by activating the complement cascade, increasing Aß production and augmenting pro-inflammatory cytokine expression, causing age-dependent brain inflammation, neuroinflammation, and neurodegeneration. CLINICAL RELEVANCE: Taking into account the importance of holistic treatment in the dental office, this study focuses on identifying highly prevalent oral diseases, such as periodontal disease, as risk factors for the aggravation of degenerative diseases in the elderly population.