Impact of L-PRF on pain and healing outcomes in lower third molar surgery: a randomized split-mouth trial.

This study explored the effects of L-PRF on pain, soft tissue healing, periodontal condition, and post-extraction bone repair of mandibular third molars (3Ms). A randomized, prospective, triple-blind, split-mouth clinical trial was conducted with 34 volunteers. Eligible patients were randomly allocated into two treatments: G1 (without L-PRF), G2 (alveoli filled with L-PRF), in which the removal of bilateral 3Ms was performed at the same surgical time. Outcomes were assessed according to a visual analogue scale (pain), soft tissue scoring system (wound healing), periodontal probing of mandibular second molar. Bone repair was determined by volumetric analysis (ITK-SNAP software) and fractal analysis (ImageJ software). An intention-to-treat approach to Statistical analysis was used. L-PRF reduced pain in the 7-day postoperative follow-up (p = 0.019) and not only improved soft tissue healing after 1 month of follow-up (p = 0.021), but also probing depth (distal face) in 3 months postoperatively (p = 0.011). Significant alveolar reduction occurred in 3 months after surgery in both treatments (p < 0.05), however, this was more significant in G1 (p = 0.016). The fractal dimension showed no statistical differences. L-PRF improved postoperative clinical parameters of pain, soft tissue healing, and periodontal condition, suggesting that it has a beneficial effect on preserving the alveolar ridge and accelerating the initial repair process.

Injury Risk Estimation in Mandible-Related Surgical Procedures: A CBCT Study Based on Vital Interforaminal Anatomical Structures.

The mandibular interforaminal region has been considered safe for surgical procedures; nevertheless, the risk of injury to neurovascular structures, such as the mental foramen (MF) and its related structures (anterior loop [AL] and lingual foramina [LF]) should not be overlooked. The study aimed to evaluate the relative risk of injury to these structures during surgical procedures in the anterior region of the mandible based on cone-beam computed tomography (CBCT) scans. A retrospective cross-sectional and observational study was performed on 250 CBCTs from adults (18-69 years) with dentate jaws. Linear measurements of the MF, AL, and LF were evaluated to estimate the risk of injury to these structures during chin-related surgical procedures. The most frequent distance between the base of the mandible (BM) and MF was 8 mm (30.2%). In addition, 20.4% of the CTs had 6 mm from the vestibular cortical bone to the LF. The commonly found measurement from LF to the apex of the nearest tooth was 7 mm (24.0%); 64.2% of the CTs showed a 2-mm distance between the most distal point of the dental implant site to the most anterior point of the AL. Safety distances for genioplasty techniques (MF to mandible base > 6 mm, 96.6% [CI 95%, 95.0%-98.2%]) were observed. Considering the 5-mm cut-off point between the lower limit of a hypothetical bone graft and the chin, 65.4% (CI 95%, 58.9%-71.9%) of CTs were within this distance. Regarding the safety margin of 8 mm, 85.6% (CI 95%, 80.8%-90.4%) were up to this value. This study found safety margins for genioplasty and chin bone grafting surgical techniques that adopt a 5-mm cut-off point. Further similar studies assessing other surgical methods and employing larger samples from different geographical origins may contribute to this field of investigation.

Mammal responses to global changes in human activity vary by trophic group and landscape.

Wildlife must adapt to human presence to survive in the Anthropocene, so it is critical to understand species responses to humans in different contexts. We used camera trapping as a lens to view mammal responses to changes in human activity during the COVID-19 pandemic. Across 163 species sampled in 102 projects around the world, changes in the amount and timing of animal activity varied widely. Under higher human activity, mammals were less active in undeveloped areas but unexpectedly more active in developed areas while exhibiting greater nocturnality. Carnivores were most sensitive, showing the strongest decreases in activity and greatest increases in nocturnality. Wildlife managers must consider how habituation and uneven sensitivity across species may cause fundamental differences in human-wildlife interactions along gradients of human influence.

Anthropometric measures and obstructive sleep apnea in children and adolescents: a systematic review of the literature and meta-analysis.

BACKGROUND: Anthropometric measurements can be used to identify children at risk of developing obstructive sleep apnea (OSA). The study aimed to assess which anthropometric measurements (AMs) are most associated with an increased predisposition to develop OSA in healthy children and adolescents. METHODS: We performed a systematic review (PROSPERO #CRD42022310572) that searched eight databases and gray literature. RESULTS: In eight studies with low-to-high risk of bias, investigators reported the following AMs: body mass index (BMI), neck circumference, hip circumference, waist-to-hip ratio, neck-to-waist ratio, waist circumference, waist-to-height ratio, and facial AMs. The meta-analysis showed that the OSA group had an average of 1.00 cm greater for the neck circumference (p < 0.001; Cohen's d = 2.26 [0.72, 5.23]), 3.07 cm greater for the waist circumference (p = 0.030; Cohen's d = 0.28 [0.02, 0.53]), 3.96 cm greater for the hip circumference (p = 0.040; Cohen's d = 0.28 [0.02, 0.55]), 5.21° greater for the cervicomental angle (p = 0.020; Cohen's d = 0.31 [0.03, 0.59]), and 1.23° greater for maxillary-mandibular relationship angle (p < 0.001; Cohen's d = 0.47 [0.22, 0.72]) than the control group. The mandibular depth angle had a reduction of 1.86° (p = 0.001; Cohen's d = -0.36° [-0.65, -0.08]) in control than in patients with OSA. The BMI (p = 0.180), waist-to-hip ratio (p = 0.280), neck-to-waist ratio (p = 0.070), maxillary depth angle (p = 0.250), and upper/lower face height ratio (p = 0.070) showed no significant differences between groups. CONCLUSIONS: Compared to the control group, the OSA group exhibited a greater mean difference in neck circumference, the only anthropometric measurement with high certainty of evidence.

Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study.

Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.

Does Postpartum Hypopituitarism Influence the Craniofacial Pattern? A Case-Control Study with Sheehan's Syndrome Patients

This study aimed to assess the craniofacial morphologic aspects of Sheehan's syndrome (SHS) patients.An observational study was performed with 19 women diagnosed with SHS and 19 controls matched by age and sex. Lateral cephalometric radiographs were obtained, and 30 linear and angular measurements were analyzed using the Radiocef Studio 2 software. The mean age of patients was 65.47 ± 10.19 years. The main findings were propositioned maxilla (52.63 %) and mandible (52.63 %) relative to the cranial base, mandibular prognathism in 73.68 %, deep growth pattern in 42.1 %, increased mandibular plane in 36.84 %, and reduction in anterior facial height. The SHS group showed statistically significant differences in SNB (p=0.026), N-Me (p=0.006), soft palate length (p=0.011), and Ena-Me (p<0.001) in comparison with controls. The standard deviation score analysis revealed altered values in relation to total maxillary and mandibular lengths. SHS showed altered craniofacial morphology, characterized by maxillo- mandibular prognathism, brachyfacial type, increased mandibular plane, and reduction in soft palate length. This study reports novel findings in SHS.

Este estudio tuvo como objetivo evaluar los aspectos morfológicos craneofaciales de los pacientes con síndrome de Sheehan (SHS). Se realizó un estudio observacional con 19 mujeres diagnosticadas con SHS y 19 controles asociados por edad y sexo. Se obtuvieron radiografías cefalométricas laterales y se analizaron 30 medidas lineales y angulares mediante el software Radiocef Studio 2. La edad media de los pacientes fue de 65,47 ± 10,19 años. Los principales hallazgos fueron proposición maxilar (52,63 %) y mandíbula (52,63 %) con respecto a la base del cráneo, prognatismo mandibular en 73,68 %, patrón de crecimiento profundo en 42,1 %, aumento del plano mandibular en 36,84 % y reducción de la altura facial anterior. El grupo SHS mostró diferencias estadísticamente significativas en SNB (p=0,026), N-Me (p=0,006), longitud del paladar blando (p=0,011) y Ena-Me (p<0,001) en comparación con los controles. El análisis de la puntuación de la desviación estándar reveló valores alterados en relación con las longitudes maxilares y mandibulares totales. El SHS mostró una morfología craneofacial alterada, caracterizada por prognatismo maxilomandibular, tipo braquifacial, aumento del plano mandibular y reducción de la longitud del velo del paladar. Este estudio informa hallazgos novedosos en SHS.

Surgically assisted maxillary expansion with or without pterygoid disjunction alters maxillomandibular positioning.

PURPOSE: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD). METHODS: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and 3D Slicer software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis (3D Slicer software). RESULTS: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group. CONCLUSIONS: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.

Methodological parameters for upper airway assessment by cone-beam computed tomography in adults with obstructive sleep apnea: a systematic review of the literature and meta-analysis.

BACKGROUND: A reliable method for analyzing the upper airway (UA) remains a challenge. This study aimed to report the methods for UA assessment using cone-beam computed tomography (CBCT) in adults with obstructive sleep apnea (OSA). METHODS: We performed a systematic review (PROSPERO #CRD42021237490 and PRISMA checklist) that applied a search strategy to seven databases and grey literature. RESULTS: In 29 studies with moderate-to-high risk of bias, investigators mostly reported the body position during CBCT (upright or supine) and hard tissue references, diverging in UA delimitation and terminologies. The meta-analysis showed two subgroups (upright and supine), and no statistical differences were identified (p = 0.18) considering the UA area. The volume in the OSA group was smaller than that in the control group (p < 0.003 and Cohen's d = - 0.81) in the upright position. Patients with OSA showed smaller anteroposterior dimensions than the control group and were not affected by the position during image acquisition (p = 0.02; Cohen's d = - 0.52). The lateral measurements were also lower in the OSA group (supine) (p = 0.002; Cohen's d = - 0.6). CONCLUSIONS: Patients with OSA showed smaller UA measurements in the upright (volume) and supine (lateral dimension) positions. The anteroposterior dimension was also reduced in patients with OSA compared to the control group, regardless of the position during CBCT acquisition.

Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study

Abstract Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.

Dissection of Besnoitia besnoiti intermediate host life cycle stages: From morphology to gene expression.

Cyst-forming Apicomplexa (CFA) of the Sarcocystidae have a ubiquitous presence as pathogens of humans and farm animals transmitted through the food chain between hosts with few notable exceptions. The defining hallmark of this family of obligate intracellular protists consists of their ability to remain for very long periods as infectious tissue cysts in chronically infected intermediate hosts. Nevertheless, each closely related species has evolved unique strategies to maintain distinct reservoirs on global scales and ensuring efficient transmission to definitive hosts as well as between intermediate hosts. Here, we present an in-depth comparative mRNA expression analysis of the tachyzoite and bradyzoite stages of Besnoitia besnoiti strain Lisbon14 isolated from an infected farm animal based on its annotated genome sequence. The B. besnoiti genome is highly syntenic with that of other CFA and also retains the capacity to encode a large majority of known and inferred factors essential for completing a sexual cycle in a yet unknown definitive host. This work introduces Besnoitia besnoiti as a new model for comparative biology of coccidian tissue cysts which can be readily obtained in high purity. This model provides a framework for addressing fundamental questions about the evolution of tissue cysts and the biology of this pharmacologically intractable infectious parasite stage.

Radiomorphometric indices for sex estimation in edentulous individuals: A receiver operating characteristic curve and discriminant function analysis-based study.

This study aimed to evaluate sexual dimorphism in Brazilian edentulous individuals using a formula based on mandible-related linear radiomorphometric measurements. A cross-sectional observational study was conducted with 390 panoramic radiographs (PRs) distributed into three age groups (51-60, 61-70, and 71-80 years). PRs were used to obtain linear measurements of the mandible and derived indices (superior and inferior panoramic mandibular indices [s-PMI and i-PMI, respectively], alveolar bone resorption [ABR] index), and the mandibular cortical index (MCI). Sex-related differences (and sex classifications) increased in the oldest cohort. Both s-PMI and i-PMI were shown to be significant in predicting sex in the age group from 71 to 80 years (p = 0.001 and p = 0.003, respectively) and, when considering the mean of the sides, only the s-PMI was significant (p = 0.037). The ABR index was significantly associated with sex (p = 0.004) and not influenced by MCI, and was used to construct a formula for sex estimation, which demonstrated 69.0% accuracy in the age group of 71-80 years. Sexual dimorphism was evidenced by the formula based on the s-PMI, i-PMI, and ABR indices.

The Use of Surgical Splints in Orthognathic Surgery: A Bibliometric Study.

Introduction Orthognathic surgeries require the use of surgical splints (SS) to stabilize the occlusion and the segments fixed with plates and screws. Technological advances in the field of computing and the possibility of generating three-dimensional (3D) images have brought different possibilities for making SS, which has generated greater predictability and customization of surgical plans. The bibliometric study can have a qualitative character through the scope of articles in a certain area of knowledge. It is a selection process that can track a topic or scientific production. Methods The present study aimed to carry out a bibliometric literature review, in order to assess the evolution of the use of SS and the different planning protocols in orthognathic surgery. The Scopus database was used, with the terms "splint" and "orthognathic surgery." Results A total of 331 articles were found. These were exported to Rayyan for application of the inclusion and exclusion criteria and selection of articles. A total of 76 references were selected and exported to the VOSviewer application for the analysis of bibliometric data. Conclusions Orthognathic surgery was initially not associated with any computerized technological resource; however, it underwent updates between the years 2010 to 2012. These advances allowed surgical planning to become faster, cheaper, and more accurate.

COVID-19 and HIV among children and adolescents: Current inequalities.

The HIV epidemic enters its fifth decade amid a global pandemic. The increasing poverty, mental health problems, and abuse are raising the risk of infection for children, adolescents, and women. The inequalities driving the HIV epidemic, which are now exacerbated by COVID-19, demonstrate the social and clinical inequalities of more children infected with HIV and more children losing their fight against AIDS. In this context, current evidence highlights that, alarmingly, two out of five children living with HIV worldwide are unaware of their status, and just over half of children with HIV are receiving antiretroviral treatment. Discrimination and gender inequalities permeate significant situations in HIV services due to COVID-19 in early 2020 and throughout 2021. It was observed in recent studies substantial reductions in births in health facilities, maternal HIV testing, and initiation of antiretroviral treatment for HIV. An AIDS-free generation should be possible, but we are not there yet. HIV remains a burden.

Is jaw fractal dimension a reliable biomarker for osteoporosis screening? A systematic review and meta-analysis of diagnostic test accuracy studies.

OBJECTIVES: To summarize the evidence on the feasibility of maxillomandibular imaging exams-related fractal dimension (FD) in screening patients with osteoporosis. METHODS: This registered systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy statement. High sensitivity search strategies were developed for six primary databases and grey literature. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) items evaluated the risk of bias, and the GRADE approach assessed the evidence certainty. RESULTS: From 1034 records initially identified through database searching, four studies were included (total sample of 747 patients [osteoporosis, 136; control group, 611]). The meta-analysis showed that the overall sensitivity and specificity of the FD were 86.17 and 72.68%, respectively. In general, all studies showed low RoB and applicability concern. The certainty of the evidence was very low to moderate. CONCLUSIONS: This systematic review showed that the jaw-related FD presented sensitivity and specificity values higher than 70%, and its sensitivity in osteoporosis screening was a better parameter than specificity.

Systematic review and meta-analysis of lingual foramina anatomy and surgical-related aspects on cone-beam computed tomography: a PROSPERO-registered study.

PURPOSE: This study aimed to summarize the evidence regarding lingual foramen (LF) characteristics using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A registered systematic review (#42,019,145,962) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. An electronic search without date or language restrictions was performed in five databases, including grey literature (Google Scholar and ProQuest). The Meta-Analysis of Statistics Assessment and Review Instrument was used to evaluate the selected studies. RESULTS: A total of 6641 articles were identified, and 26 studies (8255 CBCT scans) were selected after a three-step selection process. There was a female predominance, and age ranged between 10 and 93 years. A total of 4336 LFs were observed among men (n = 2042) and women (n = 2294). Of this LF-related sample, 43.5% of the studies were from Asia, followed by Europe (33.5%), North America (14%), and South America (9%). Different distances from the LF to the alveolar crest (11.04-20.4 mm), buccal (4.73-4.91 mm), and lingual (8.75 mm) cortices and the inferior border of the mandible (8.48-26.59 mm) were evaluated. CONCLUSION: In summary, this systematic review found that LF is an anatomical structure with a high prevalence among the included studies (greater than 90%), regardless of the population evaluated. The occurrence of at least one LF was the most common pattern.

Characterization of a MOB1 Homolog in the Apicomplexan Parasite Toxoplasma gondii.

Monopolar spindle One Binder1 (MOB1) proteins are conserved components of the tumor-suppressing Hippo pathway, regulating cellular processes such as cytokinesis. Apicomplexan parasites present a life cycle that relies on the parasites' ability to differentiate between stages and regulate their proliferation; thus, Hippo signaling pathways could play an important role in the regulation of the apicomplexan life cycle. Here, we report the identification of one MOB1 protein in the apicomplexan Toxoplasma gondii. To characterize the function of MOB1, we generated gain-of-function transgenic lines with a ligand-controlled destabilization domain, and loss-of-function clonal lines obtained through CRISPR/Cas9 technology. Contrary to what has been characterized in other eukaryotes, MOB1 is not essential for cytokinesis in T. gondii. However, this picture is complex since we found MOB1 localized between the newly individualized daughter nuclei at the end of mitosis. Moreover, we detected a significant delay in the replication of overexpressing tachyzoites, contrasting with increased replication rates in knockout tachyzoites. Finally, using the proximity-biotinylation method, BioID, we identified novel members of the MOB1 interactome, a probable consequence of the observed lack of conservation of some key amino acid residues. Altogether, the results point to a complex evolutionary history of MOB1 roles in apicomplexans, sharing properties with other eukaryotes but also with divergent features, possibly associated with their complex life cycle.

Mental Foramen and Anterior Loop Anatomic Characteristics: A Systematic Review and Meta-analysis of Cross-sectional Imaging Studies.

INTRODUCTION: The present study aimed to review the epidemiologic, topographic, and morphometric aspects of the mental foramen (MF) and anterior loop (AL) on cone-beam computed tomographic imaging studies. METHODS: An International Prospective Register of Systematic Reviews (PROSPERO)-registered systematic review (CRD42018112991) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers independently performed data extraction from observational studies that evaluated MF and AL on 7 electronic databases. MedCalc (MedCalc Software bv, Ostend, Belgium) software was used to perform a meta-analysis with a 95% confidence level. RESULTS: Of 1545 articles, 66 met the inclusion criteria, totaling 14,233 patients from 5 continents, with a total of 6655 females and 5884 males (some studies did not report sex), with an age range between 8 and 89 years. The most prevalent shapes of MF were oval (48.72%) and circular (44.36%), and the most frequent horizontal positions were between premolars (43.66%) and in line with the long axis of the second premolar (43.12%). CONCLUSIONS: Based on the articles that assessed AL, the mean prevalence was 43.18%, with most studies reporting bilateral localization as the most prevalent.

Forest Coverage and Socioeconomic Factors Associated with Dengue in El Salvador, 2011-2013.

Dengue virus serotypes 1, 2, 3, and 4 are transmitted by Aedes aegypti and Aedes albopictus mosquitoes, which cause illness in an estimated 100 million annually. Although dengue viruses are endemic throughout El Salvador, very little is known about their ecology and epidemiology. The principal methods to prevent and reduce dengue cases are through vector control and by adoption of a vaccine. In addition, understanding the environmental and socioeconomic factors associated with dengue could contribute to case reduction by targeting prevention efforts in dengue hotspots. This study investigated environmental and socioeconomic factors associated with dengue cases in El Salvador. Dengue cases were obtained from 2011 to 2013 for 262 municipalities. The mean incidence was determined for each municipality for the 3 year period. Negative binomial regression models evaluated the relationship between dengue cases and the environmental factors elevation, forest coverage, mean annual temperature, and cumulative precipitation. Twelve socioeconomic and infrastructure variables and their relationship with dengue were also investigated by using negative binomial regression. A total of 29,764 confirmed dengue cases were reported. The mean dengue incidence for 2011-2013 was 135/100,000. The highest number of dengue cases occurred in San Salvador and surrounding municipalities, as well as in two additional cities, Santa Ana and San Miguel; the highest incidence of dengue cases (per 100,000) occurred in cities in the west and at the center of the country. Significant environmental variables associated with dengue included temperature, precipitation, and non-forested area. The socioeconomic variables poverty rate, illiteracy rate, and school attendance, and the infrastructure variables percent of homes with sanitary service, municipal trash service, electricity, and cement brick flooring, as well as population density, were also significant predictors of dengue. Understanding these environmental and socioeconomic factors and their relationship with dengue will help design and implement timely prevention strategies and vector control to reduce dengue in El Salvador.

Does Subcrestal Position Affect Insertion Torque of Different Implant Designs at Different Bone Densities? An In Vitro Model Study.

PURPOSE: To evaluate the insertion torque at the equicrestal and subcrestal positions of three implant designs in synthetic polyurethane blocks simulating different bone conditions. MATERIALS AND METHODS: Overall, 72 implants with three different designs (two conical and one cylindrical) were inserted at equicrestal and subcrestal positions (-2 mm) into polyurethane blocks simulating the anterior (0.32 g/cm3) and posterior (0.48 g/cm3) regions of the maxilla. The final insertion torque of all implants was measured using a digital torque meter, and the results were evaluated and statistically analyzed. RESULTS: For all implant systems, insertion torque decreased significantly when placed at the subcrestal position (P < .05), except for cylindrical implants placed in the bone blocks with high cancellous density. The implants with higher body conicity and square threads had higher insertion torque values than the cylindrical and conical implants with a lower body conical angle and trapezoidal threads. The implants inserted into higher-density blocks showed greater stability. CONCLUSION: The different implant systems lost insertion torque in a nonuniform manner at the subcrestal position and varied according to bone density. Implant design significantly influenced the initial stability at the equicrestal and subcrestal positions, especially in lower-density bone.