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Background: This systematic review and meta-analysis aimed to evaluate if rapid maxillary expansion improves the activity of the masticatory muscles (masseter and temporal) in patients with unilateral posterior crossbite. Material and Methods: Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and grey literature. A manual search of orthodontic journals was also performed. Randomized clinical trials or longitudinal prospective studies were eligibles. Meta-analyses were conducted using R software with the "Meta" package, applying mean differences with a 95% confidence interval. Risk of bias was assessed using the Newcastle-Ottawa scale, and evidence certainty was evaluated using GRADE. Results: Nine articles were included. Qualitative analysis showed that RME treatment in patients with unilateral posterior crossbite showed a positive correlation with improvement in masseter and temporalis muscle activity. Meta-analyses indicated a significant difference for all models of muscle activity after treatment with rapid maxillary expansion, except for the temporal muscle in the force exerted on the maximum voluntary clenching on cotton rolls. The studies showed low bias risk, and the evidence certainty for each analysis was generally low to very low. Conclusions: This investigation demonstrated the benefits of R rapid maxillary expansion in treating unilateral posterior crossbite and its potential therapeutic effects on the masticatory muscles. Key words:Rapid maxillary expansion, masticatory muscles, unilateral posterior crossbite, systematic review, meta-analysis.
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The aim of this systematic review and meta-analysis (SRM) was to evaluate the effectiveness of the adjunctive use of antimicrobial photodynamic therapy (aPDT) in non-surgical periodontal treatment (NSPT) in subjects with Human Immunodeficiency Virus (HIV) and periodontitis. This SRM was registered in PROSPERO (CRD42023410180) and followed the guidelines of PRISMA 2020. Searches were performed in different electronic databases. Risk of bias was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized clinical trials (RCT). Meta-analysis was performed using Rev Man software. The mean difference (MD) measure of effect was calculated, the random effect model was applied with a 95% confidence interval, and heterogeneity was tested by the I2 index. The certainty of the evidence was rated using GRADE. A total of 1118 records were screened, and four studies were included. There was a greater reduction in the microbial load of periodontopathogens after NSPT with aPDT. Meta-analysis showed that probing depth (post 3 and 6 months) and clinical attachment loss (post 6 months) were lower for the aPDT-treated group than the NSPT alone: MD -0.39 [-0.74; -0.05], p = 0.02; MD -0.70 [-0.99; -0.41], p < 0.0001; MD -0.84 [-1,34; -0.34], p = 0.0001, respectively. Overall, the studies had a low risk of bias and, the certainty of evidence was rated as moderate. It is suggested that aPDT is a promising adjuvant therapy, showing efficacy in the reduction of the microbial load and in some clinical parameters of individuals with periodontitis and HIV.
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Infecciones por VIH , Periodontitis , Fotoquimioterapia , Humanos , Fotoquimioterapia/métodos , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Periodontitis/terapia , Periodontitis/tratamiento farmacológico , Periodontitis/microbiología , Antiinfecciosos/uso terapéutico , Antiinfecciosos/administración & dosificaciónRESUMEN
OBJECTIVES: This systematic review and meta-analysis (SRM) aimed to evaluate the efficacy of laser phototherapy (LPT) on the reduction in postoperative pain (PP) of endodontic origin after conventional/non-surgical reintervention of root canals. METHODS: This SRM was registered with PROSPERO (CRD42021243500) and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Meta-analysis was conducted using R software with the "META" package, the mean difference (MD) measure of effect was calculated, and the fixed effect model was applied with a 95% confidence interval (CI). The Cochrane collaboration scale was used to assess the risk of bias and the GRADE tool to assess the quality of evidence. RESULTS: Initially, 1028 articles were found, and five articles were included. Most studies were classified as "low" risk of bias. Of the five clinical studies, four showed a significant decrease in PP after endodontic reintervention in the LPT groups compared to the control group, especially in the first four days after the intervention. In symptomatic teeth with multiple roots, LPT led to less PP at 24 h (MD -0.52 [-1.03; -0.02] p = .04). However, no significant difference between the groups was found at 48 and 72 h (p > .05). The certainty of the evidence was classified as low. CONCLUSION: Despite the limitations of this SRM, LPT was shown to be a promising alternative for reducing and controlling PP in conventional endodontic reintervention. CLINICAL SIGNIFICANCE: The use of LPT in endodontic reintervention may be a safe and promising alternative to clinically efficacious agent for use in the management of PP in this procedure.
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Dolor Postoperatorio , Tratamiento del Conducto Radicular , Humanos , Tratamiento del Conducto Radicular/métodos , Terapia por Luz de Baja Intensidad/métodos , Reoperación , Dimensión del DolorRESUMEN
BACKGROUND: To evaluate the effectiveness of the use of antimicrobial photodynamic therapy (aPDT) in root canals disinfection in cases of endodontic retreatments. METHODS: This Systematic Review was registered in PROSPERO (CRD42021260013) and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Searches were performed in the electronic databases PubMeb, Scopus, Web of Science, Embase, Web of Science, Clinical Trials and Cochrane Library. Methodological quality and risk of bias were assessed by the Cochrane Risk of Bias tool for randomized clinical trials (RCT) and by the Newcastle-Ottawa (NOS) qualifier for non-RCT (prospective) studies. Meta-analysis was performed using R software, version 3.6.3 with the "META" package assistant by the RStudio platform. The odds ratio (OR) measure of effect was calculated and the random effect model was applied with a 95% confidence interval, and heterogeneity tested by the I2 index. The certainty of evidence was rated using GRADE. RESULTS: Regarding the 1513 studies screened, 10 met the eligibility criteria and were included, and 8 used in the quantitative synthesis. Meta-analysis showed that all of studies data presented a significant difference before and after of antimicrobial photodynamic therapy in the microbial load reduction in secondary endondontic infections (OR 0.15 [0.07; 0.32], p < 0.0001). Overall, the studies had a low risk of bias and, the analysis of evidence by GRADE assessment was rated as moderate. CONCLUSION: It is suggested that aPDT is a beneficial and promising tool, showing efficacy in reducing the microbial load in cases of endodontic retreatment.
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Antiinfecciosos , Fotoquimioterapia , Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Desinfección , Fotoquimioterapia/métodosRESUMEN
OBJECTIVE: This study aimed to investigate the antimicrobial activity and shear bond strength (SBS) of orthodontic brackets to bovine enamel using experimental composites with different concentrations of silicon dioxide-coated silver nanoparticles (Ag@SiO2 NPs). METHODS: Fifty bovine incisors were divided into five groups according to the composite (n = 10): G1 - Control Group (Transbond XT Resin), G2 - Experimental composite without Ag@SiO2 NPs; G3 - Experimental composite with 0.5% of Ag@SiO2 NPs; G4 - Experimental composite with 1% of Ag@SiO2 NPs; G5 - Experimental composite with 3% of Ag@SiO2 NPs. The SBS test was performed using a universal mechanical testing machine, and the adhesive remnant index (ARI) was analyzed by optical microscopy. For the antimicrobial activity evaluation, Streptococcus mutans (S. mutans) biofilm was formed for three days in hydroxyapatite discs. Posteriorly, S. mutans colony forming units (CFU) were evaluated. For SBS analysis, Analysis of Variance was used, followed by the Tukey test, at a 5% statistical significance level. The CFU data were analyzed by Kruskal-Wallis, followed by Dunn as a post-hoc test. The ARI results were analyzed descriptively. RESULTS: There was no statistically significant difference in SBS values between the experimental and control groups (p>0.05). A 3% incorporation of Ag@SiO2 NPs statistically reduced the SBS values (p<0.05) compared to the 1% group. The addition of 3% of Ag@SiO2 NPs to the composites significantly reduced S. mutans biofilm formation, compared to group G2 (p<0.05). CONCLUSION: Composites incorporating 3% of Ag@SiO2 NPs presented similar SBS values compared to the control group, and showed significant antimicrobial activity.
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Nanopartículas del Metal , Soportes Ortodóncicos , Animales , Bovinos , Resistencia al Corte , Dióxido de Silicio/farmacología , Plata/farmacología , Streptococcus mutansRESUMEN
BACKGROUND: The objective of this systematic review and meta-analysis (SRM) was to assess the evidence between the association of oral lichen planus and periodontal disease, evaluating the periodontal clinical parameters and biomarkers levels. METHODS: This systematic review and meta-analysis followed PRISMA and was registered in PROSPERO (CRD42020181513). Searches were accomplished in databases for articles published until June 2021. The meta-analysis was performed with the variables: plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (CAL). The mean difference was applied with a 95% confidence interval. RESULTS: Six articles were included. Qualitative analysis showed the levels of biomarkers (matrix metalloproteinases, interleukins, and periodontal microbiological profile) are increased in subjects with periodontal disease and oral lichen planus. In the meta-analysis, these subjects also presented increases in all periodontal clinical parameters evaluated: GI-gingivitis 0.22 [0.14, 0.31] p < 0.0001 and periodontitis 0.12 [0.06, 0.19] p = 0.0003; PI-gingivitis 0.22 [0.12, 0.31] p < 0.0001 and periodontitis 0.15 [0.08, 0.23] p < 0.0001; PD-gingivitis 0.27 [0.06; 0.48] p = 0.0107 and periodontitis 0.11 [0.01; 0.21] p = 0.0299; and CA-periodontitis 0.06 [0.01, 0.12] p = 0.0176. CONCLUSIONS: Evidence suggests a significant relationship between the severity of periodontal disease and the presence of oral lichen planus. Although the association is biologically plausible, further studies are needed using populations and well-defined biochemical and clinical outcomes with consideration of potential confounding factors. CLINICAL RELEVANCE: This SRM provides information on the interaction between OLP and periodontal disease and guides clinicians to make evidence-based decisions and suggests recommendations for further high-quality studies.
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Gingivitis , Liquen Plano Oral , Enfermedades Periodontales , Periodontitis , Gingivitis/microbiología , Humanos , Liquen Plano Oral/complicaciones , Enfermedades Periodontales/complicaciones , Índice PeriodontalRESUMEN
ABSTRACT Objective: This study aimed to investigate the antimicrobial activity and shear bond strength (SBS) of orthodontic brackets to bovine enamel using experimental composites with different concentrations of silicon dioxide-coated silver nanoparticles (Ag@SiO2 NPs). Methods: Fifty bovine incisors were divided into five groups according to the composite (n = 10): G1 - Control Group (Transbond XT Resin), G2 - Experimental composite without Ag@SiO2 NPs; G3 - Experimental composite with 0.5% of Ag@SiO2 NPs; G4 - Experimental composite with 1% of Ag@SiO2 NPs; G5 - Experimental composite with 3% of Ag@SiO2 NPs. The SBS test was performed using a universal mechanical testing machine, and the adhesive remnant index (ARI) was analyzed by optical microscopy. For the antimicrobial activity evaluation, Streptococcus mutans (S. mutans) biofilm was formed for three days in hydroxyapatite discs. Posteriorly, S. mutans colony forming units (CFU) were evaluated. For SBS analysis, Analysis of Variance was used, followed by the Tukey test, at a 5% statistical significance level. The CFU data were analyzed by Kruskal-Wallis, followed by Dunn as a post-hoc test. The ARI results were analyzed descriptively. Results: There was no statistically significant difference in SBS values between the experimental and control groups (p>0.05). A 3% incorporation of Ag@SiO2 NPs statistically reduced the SBS values (p<0.05) compared to the 1% group. The addition of 3% of Ag@SiO2 NPs to the composites significantly reduced S. mutans biofilm formation, compared to group G2 (p<0.05). Conclusion: Composites incorporating 3% of Ag@SiO2 NPs presented similar SBS values compared to the control group, and showed significant antimicrobial activity.
RESUMO Objetivo: O presente estudo objetivou investigar a atividade antimicrobiana e a resistência de união ao cisalhamento (RU) de braquetes ortodônticos colados em esmalte bovino, utilizando compósitos experimentais com diferentes concentrações de nanopartículas de prata revestidas com dióxido de silício (NPs Ag@SiO2). Material e Métodos: Cinquenta incisivos bovinos foram divididos em cinco grupos, de acordo com o compósito utilizado (n = 10): G1 - Grupo Controle (Resina Transbond XT); G2 - Compósito Experimental sem NPs Ag@SiO2; G3 - Compósito Experimental com 0,5% de NPs Ag@SiO2; G4 - Composto Experimental com 1% de NPs Ag@SiO2; e G5 - Compósito Experimental com 3% de NPs Ag@SiO2. O teste de RU foi realizado em máquina universal de ensaios mecânicos, e o índice de adesivo remanescente (IAR) foi analisado por microscopia óptica. Para a avaliação da atividade antimicrobiana, biofilme de S. mutans foi formado por três dias em discos de hidroxiapatita. Posteriormente, foram avaliadas as unidades formadoras de colônias (UFC) de S. mutans. Para a análise de RU, foi utilizada a Análise de Variância, seguida do teste de Tukey, com nível de significância estatística de 5%. Os dados de UFC foram analisados por meio do teste de Kruskal-Wallis, seguido do teste post-hoc de Dunn. Os resultados de IAR foram analisados descritivamente. Resultados: Não houve diferença estatisticamente significativa nos valores de RU entre os grupos experimentais e o grupo controle (p> 0,05). A incorporação de 3% de NPs Ag@SiO2 reduziu estatisticamente os valores de RU (p< 0,05), em comparação ao grupo com 1%. A adição de 3% de NPs Ag@SiO2 ao compósito reduziu significativamente a formação de biofilme de S. mutans, em relação ao grupo G2 (p< 0,05). Conclusão: Os compósitos com incorporação de 3% de NPs Ag@SiO2 apresentaram valores de RU semelhantes ao grupo controle e demonstraram significativa atividade antimicrobiana.
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Este trabalho objetivou realizar duas revisões sistemáticas com as seguintes propostas: 1) Avaliar se a fototerapia com laser resultaria em menor dor pós-operatória (PP) em pacientes submetidos a reintervenção endodôntica; e 2) Avaliar se o uso da terapia fotodinâmica antimicrobiana (aPDT) seria eficaz na desinfecção de canais radiculares em casos de reintervenção endodôntica. As Revisões Sistemáticas foram registradas no PROSPERO (CRD42021243500 e CRD42021260013, respectivamente) e seguiram as diretrizes dos Itens de Relatório Preferenciais para Revisões Sistemáticas e Meta-análise (PRISMA). As buscas foram realizadas nas bases de dados eletrônicas PubMeb, Scopus, Web of Science, Embase, Web of Science, Clinical Trials e Cochrane Library e nos bancos de dados da literatura cinza. A qualidade metodológica e o risco de viés foram avaliados pela ferramenta Cochrane Risk of Bias para ensaios clínicos randomizados (RCT) e pelo qualificador NewcastleOttawa (NOS) para estudos não RCT (prospectivos). A análise da qualidade de evidência foi realizada com base na abordagem GRADE. A meta-análise foi realizada com o R software Meta package, utilizando um intervalo de confiança (IC) de 95%. Quanto aos resultados do Artigo 1: Cinco artigos foram incluídos para análise. Os estudos foram classificados como "baixo" risco de viés. Dos cinco estudos clínicos, quatro estudos mostraram uma diminuição significativa da PP após a reintervenção endodôntica nos grupos de fototerapia a laser quando comparados ao grupo controle, principalmente nos primeiros dias após a intervenção. A certeza de evidência foi classificada como baixa. Devido à alta heterogeneidade clínica entre os estudos, não foi possível realizar qualquer meta-análise. Apesar das limitações desta revisão sistemática, a fototerapia se mostrou uma alternativa promissora na redução e controle da PP na reintervenção endodôntica não cirúrgica. Nos resultados do Artigo 2, dez estudos atenderam aos critérios de elegibilidade e foram incluídos, sendo 8 utilizados na síntese quantitativa. A meta-análise mostrou que todos os dados dos estudos apresentaram diferença significativa antes e depois da terapia fotodinâmica antimicrobiana na redução da carga microbiana em infecções endondônticas secundárias (OR 0,15 [0,07; 0,32], p < 0,0001). No geral, os estudos apresentaram baixo risco de viés e a análise das evidências foi classificada como moderada. Sugere-se que a terapia fotodinâmica seja uma ferramenta benéfica e promissora, mostrando eficácia na redução da carga microbiana nos casos de reintervenção endodôntica. Em suma, a abordagem da utilização da fototerapia se demonstrou eficaz na diminuição da dor pós-operatória e na desinfecção dos canais radiculares, podendo ser uma terapia indicada nos casos de reintervenção endodôntica(AU)
This study aimed to carry out two systematic reviews with the following proposals: 1) Evaluate whether laser phototherapy would result in less postoperative pain (PP) in patients undergoing endodontic reintervention; and 2) Evaluate whether the use of antimicrobial photodynamic therapy (aPDT) would be effective in disinfection of root canals in cases of endodontic reintervention. Systematic Reviews were registered in PROSPERO (CRD42021243500 and CRD42021260013, respectively) and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Metaanalysis (PRISMA). Searches were performed in the electronic databases PubMeb, Scopus, Web of Science, Embase, Web of Science, Clinical Trials and Cochrane Library and in the gray literature databases. Methodological quality and risk of bias were assessed by the Cochrane Risk of Bias tool for randomized clinical trials (RCT) and by the Newcastle-Ottawa (NOS) qualifier for non-RCT (prospective) studies. The analysis of the quality of evidence was performed based on the GRADE approach. The meta-analysis was performed using the R Meta package software, using a 95% confidence interval (CI). As for the results of Article 1: Five articles were included for analysis. Studies were classified as "low" risk of bias. Of the five clinical studies, four studies showed a significant decrease in PP after endodontic reintervention in the laser phototherapy groups when compared to the control group, mainly in the first days after the intervention. The certainty of evidence was rated low. Due to the high clinical heterogeneity between studies, it was not possible to perform any meta-analysis. Despite the limitations of this systematic review, phototherapy proved to be a promising alternative for the reduction and control of PP in conventional endodontic reintervention. In the results of Article 2, ten studies met the eligibility criteria and were included, being 8 used in the quantitative synthesis. The meta-analysis showed that all data from the studies showed a significant difference before and after antimicrobial photodynamic therapy in reducing the microbial load in secondary endodontic infections (OR 0.15 [0.07; 0.32], p < 0.0001). Overall, the studies presented a low risk of bias and the analysis of evidence was rated as moderate. It is suggested that photodynamic therapy is a beneficial and promising tool, showing efficacy in reducing the microbial load in cases of endodontic reintervention. In summary, the approach to the use of phototherapy has been shown to be effective in reducing postoperative pain and disinfection of root canals, and may be an indicated therapy in cases of endodontic reintervention(AU)
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Fototerapia , Fotoquimioterapia , Tratamiento del Conducto Radicular , Diente no Vital , Retratamiento , Dolor Postoperatorio , Obturación del Conducto Radicular , Desinfección , Cavidad Pulpar , Rayos Láser , AntibacterianosRESUMEN
Dental caries is still the most common pathology in childhood, caused mainly by lack of adequate prevention. The aim of this project was to evaluate the dental caries profile in children and the importance of multidisciplinary practice in dental caries. Material and methods: 1st stage- meetings were held with the teachers of the child education network and conferences addressed to parents and those responsible for the children. 2nd stage- Assessment and examination of oral health with education process and motivation for dental hygiene. Results: A total of 3390 children were analyzed, of which 859 had carious teeth, that is, 25.34% of the children had caries disease. There is a large presence of caries in the PRE II level, whose highest prevalence of caries is 41.73%, and the lowest recorded in Kindergarten I with 3.11%. This is mainly due to age, directly related to the period in which the basic oral health care program began in day care centers, as older children already had high caries rates when the preventive program was institutionalized to control the occurrences of caries and health promotion. Conclusion: The prevalence of caries in preschool children is still high, but the multidisciplinary approach has shown to be effective and able to reach the levels recommended by ONU 2030 appointment book for dental caries control. (AU)
A cárie dentária é a enfermidade mais comum na infância, causada essencialmente pela falta de prevenção adequada. O objetivo deste estudo foi avaliar o perfil da cárie dentária em crianças e a importância da ação multidisciplinar no controle da mesma. Na primeira fase, foram realizadas reuniões com os professores da rede de educação infantil e conferências dirigidas aos pais e responsáveis das crianças. Na 2ª fase: avaliação e exame de saúde bucal com orientação e motivação para higiene bucal. Foram analisadas 3390 crianças, das quais 859 apresentaram cárie dentária (25,34%). Obervou-se grande presença de cárie no nível PRE II, cuja maior prevalência de cárie é de 41,73%, e a menor registrada no Jardin I com 3,11%. Isso se deve principalmente à idade, relacionada diretamente ao período em que iniciou o Programa Básico de Atenção a Saúde Bucal nas creches, uma vez que as crianças mais velhas já apresentavam altas taxas de cárie quando o programa preventivo foi institucionalizado para controlar ocorrências de cárie e promoção da saúde bucal. Ainda existe alta prevalência de cárie em pré-escolares, entretanto, a abordagem multidisciplinar mostrou-se efetiva e capaz de alcançar os índices preconizados pela Agenda 2030 da ONU para o controle e prevenção da cárie dentária. (AU)
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Monitory's exercises must provide conditions that support academic and personal development for students in graduation, once the leveling possibilities in a way that monitors can fill the demand of students in previous seasons. Aim: This study has the goal to investigate the monitory's value in benefit of student's good scholar performance. Methods: In 2015 and 2016 second year Odontology students were monitored for the subject pharmacology. Facing need of accompanied study because high fails percentage. Accompanied theory classes were did weekly, study groups and content review to deal with. After two years of accompany was determined that percentage number of fails. The data were analyzed by variance and Student-Newman-Keuls test (p<0,001). Results: Majority had expressive results, since number of reproves decreased drastically, statically lower than in antecedent years. Conclusion: It was possible to prove that activity has a positive effect in learning for learners making possible access to knowledge and was indispensable for the regiments systematization, seen that advice and monitory students make them develop better skills to learn the disciplines