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).

Factors associated with total edentulism in the elderly and their impact on the self-perception of oral health and food.

OBJECTIVE: to identify the prevalence of and factors associated with total edentulism in the elderly Brazilian population. In addition, we sought to verify whether edentulism influences the self-perception of oral health and difficulty in eating. MATERIALS AND METHODS: This cross-sectional, population-based study used the database of the National Health Survey conducted in Brazil. The chi-square test was initially used for data analysis. Subsequently, a multivariate analysis of the Poisson multiple regression type was performed to verify the adjusted prevalence ratios. RESULTS: A total of 43,554 elderly people participated in the study, of whom 32% had completely lost their teeth. This total edentulism, based on the multivariate analysis, was associated with female gender (p < 0.001), advances age (p < 0.001), illiterate (p < 0.001), smokers (p < 0.001), and those who did not have health insurance (p < 0.001) or dental insurance (p < 0.001). Total edentulism had an impact on better self-perception of oral health (p < 0.001) and greater difficulties in eating (p = 0.001). CONCLUSION: It was concluded that total edentulism in the elderly is associated with worse socioeconomic conditions and a worse lifestyle. This condition has a negative impact on diet and positively affects self-perception of oral health.

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).

The Effect of Amino Sugars on the Composition and Metabolism of a Microcosm Biofilm and the Cariogenic Potential against Teeth and Dental Materials.

Amino sugars N-acetylglucosamine (GlcNAc) and glucosamine (GlcN) are abundant sources of carbon and nitrogen in the oral cavity. The aim of this study was to investigate the effects of GlcNAc metabolism on the genomics and biochemistry of a saliva-derived microbial community, and on the surface integrity of human teeth and restorative surfaces. Pooled cell-containing saliva (CCS) was used to establish a microcosm biofilm in vitro in a biofilm medium (BM) containing 5 different carbohydrates. The microbial composition of each biofilm was analyzed by 16S rRNA amplicon sequencing, and the concentrations of eight organic acids were determined for selected sugars by targeted metabolomics. Meanwhile, extracted human teeth and polished titanium and ceramic disks were submerged in BM supplemented with 1% of glucose or GlcNAc, inoculated with CCS and Streptococcus mutans UA159, and incubated for 30 days. To mimic the effects of other microbial byproducts, the specimens were immersed in 10 mM hydrogen peroxide and 10 mM ammonium hydroxide for 30 days. The surface of each specimen was evaluated by profilometry for roughness (Ra) and imaged by scanning electron microscopy. The pH of the biofilm supernatant was significantly higher for the medium containing GlcNAc (p < 0.0001), and was higher in samples containing teeth than the two restorative disks for media containing the same sugar. For both teeth and titanium specimens, the samples treated with glucose-biofilm presented higher roughness values (Ra) than those with GlcNAc-biofilm and every other group. SEM images of the teeth and titanium disks largely supported the profilometry results, with glucose-biofilm samples demonstrating the largest deviation from the reference. For ceramic disks, slightly higher Ra values were obtained for the ammonia group. These findings provide the first direct evidence to support the ability of amino sugars to significantly reduce the cariogenic potential of oral biofilms by altering their biochemistry and bacterial composition. Additionally, amino sugar metabolism appears to be less detrimental to teeth and restorative surfaces than glucose metabolism.

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 Zirconia Surface-cleaning Strategy Improves Adhesion of Resin Composite Cement after Saliva Contamination? A Systematic Review and Meta-Analysis.

PURPOSE: To identify the most effective cleaning method for saliva-contaminated zirconia surface before adhesive cementation through a systematic review and meta-analysis. MATERIALS AND METHODS: PubMed, Scopus, and Web of Science databases were searched to select in vitro studies published through October 2021. Studies that did not perform aging methods, had a sample size less than 5 per group, or did not present a group with zirconia contaminated only with saliva were excluded. Data were extracted and risk of bias was assessed. Statistical analysis comparing the cleaning methods was conducted, and the standardized mean difference was assessed using the R software program. RESULTS: Among 804 potentially eligible studies, 36 were selected for full-text reading, of which 13 were included in qualitative analysis, and 11 of these were subsequently included in the quantitative analysis. A meta-analysis revealed a significant difference in the bond strength between the cleaning methods. Sandblasting with Al2O3  showed a higher bond strength than cleaning solution (Ivoclean, Ivoclar Vivadent) (p < 0.01, I2 = 65%), and both methods promoted higher resin-bond strength to zirconia than water cleaning. In addition, there was no significant difference in the bond strength between alcohol (p = 0.35, I2 = 79%), phosphoric acid (p < 0.23, I2 = 90%), and water cleaning. CONCLUSION: Sandblasting with Al2O3 seems to be the best method for zirconia surface cleaning before adhesive luting, promoting better resin-bond strength to zirconia.

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.

A Cross-Sectional Analysis on Factors Associated With Peri-Implant Pathologies at the Implant Level.

Pathologies in peri-implant tissues are common and may disturb long-term implant supported rehabilitation. We aimed to evaluate the occurrence of such peri-implant diseases and their associated factors in this study. Peri-implantitis and mucositis were diagnosed based on clinical and radiological findings. Statistical analysis was performed with the X2 and logistic regression. Peri-implant mucositis and peri-implantitis were observed in 43.4% and 13.8% of patients with implants evaluated, respectively. Univariate analysis found associations with systemic changes (P = .016; yes), medication use (P = .010; yes), implant location (P < .0001; upper jaw), implant region (P = .008; posterior), previous augmentation procedure (P = .023; yes), time of prostheses use (P < .0001; >2 years), keratinized mucosa (P < .0001; absence); and gingival bleeding index (P = .005; >30%). In the multiple analysis, independent predictors were: >2 years of prostheses use (P < .0001; PR = 1.720), upper jaw location (P < .0001; PR = 1.421), gingival bleeding index >30% (P = .001; PR = 1.496), and use of medication (P < .0001; PR = 1.261). The frequency of peri-implant pathologies is high (approximately 57.2%) with several aspects of the occurrence being related to the patients' prosthesis. Prostheses type and the complexity of rehabilitation are worth highlighting. Factors include the location of the dental implant, gingival bleeding index, patient's use of medication(s), and the time of prostheses use.

COVID-19: Perspectives for the management of dental care and education.

The rapid and abrupt transmission pattern of the SARS-CoV-2 unleashed the current COVID-19 pandemic, as recognized by the World Health Organization in March 2020. Considering the high risk of transmission of the virus in dental environments and the specificities in clinical practice, COVID-19 posed immediate challenges for dental care and education. Due to the need to establish infection prevention and control guidance in dental health settings to enable a safe clinical practice, this review aims to list the challenges and perspectives in managing dental care in services and schools. This review employed materials collected from PubMed and the main guidelines and studies on the novel coronavirus to provide an overview of the clinical procedures and decisions made by health care personnel in dental offices and dental schools. We expect the COVID-19 scenario to promote significant changes in clinical practice and dental education; dentists should seek specific and particular regulations for dental practice established by their state or country. Biosafety checklists are strongly recommended for appointments at dental services and face-to-face activities in dental schools.

Evaluation of periodontal parameters on Removable Partial Denture abutment teeth with direct and indirect retainers: A 48-month follow-up.

OBJECTIVES: To evaluate periodontal parameters of abutment teeth and interproximal sites, in patients with mandibular class I Kennedy Removable Partial Dentures (RPD), after 4 years of periodontal treatment. METHODS: Fourteen patients with periodontal disease were treated and evaluated for the following parameters: plaque index (PI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), clinical attachment loss (CAL) and keratinized mucosa (KM). Parameters were compared between abutment teeth with direct and indirect retainers at all time-points. Periodontal maintenance was recorded at 6, 18 and 48 months. Data were analyzed using the Friedman and Wilcoxon Tests. RESULTS: Most patients (n=11; 78.6%) included were female and had a mean age of 66 years (± 7.8). After 48 months, a significant reduction was only observed in PI for both abutment teeth; in contrast, PD, GR, CAL and KM all increased by the end of the study. BOP increased at 48 months for the abutment teeth with direct retainers. The distal site of the abutment teeth with direct retainers presented higher values for GR and CAL. CONCLUSIONS: Non-surgical periodontal therapy was effective during the first 18 months, but periodontal conditions were worse at 48 months after therapy. The distal sites of abutment teeth with direct retainers presented the worst periodontal conditions.

Orientação acadêmica: percepções de discentes e docentes sobre a prática pedagógica na formação em Odontologia / Academic tuition: perceptions of students and professors concerning pedagogical practice in dental education

Oestudo objetivou avaliar o papel da orientação acadêmica e os desafios atuais relacionados a essa prática pedagógica durante a formação acadêmica em Odontologia, na percepção de docentes e discentes. Trata-se de estudo de natureza quantiqualitativa, desenvolvido no curso de Odontologia da Universidade Federal do Rio Grande do Norte (UFRN). A coleta de dados foi realizada por meio de questionários semiestruturados, respondidos por106 estudantes e 15 professores de Odontologia com experiência em orientação acadêmica. A análise quantitativa dos resultados utilizouestatísticasdescritivase,na sequência, realizou-se avaliação qualitativapor meio da técnica de análise de conteúdo. As percepções discentes demostraram fragilidadesno desempenho dos professores orientadores acadêmicos, principalmente em relação ao vínculo com a turma, período e frequência dos encontros, assim comometodologia adotada. Osdocentesapontarama necessidade de estratégias de educação permanente, visandosua qualificação para o exercício dessa função. Conclui-se que existesubaproveitamento dessa prática pedagógica na formação em Odontologia. Para superar estafragilidade e os desafios inerentes à prática, na visão dos discentes é necessário que osorientadores acadêmicos se tornem mais presentes no cotidiano universitáriodesde o primeiro período, com orientações precoces sobre as suas obrigações e mediando o processo de formação acadêmica em todas as fases do curso. Paraos docentes, énecessário investir em processos permanentes de desenvolvimento docente (AU).

This study aimed to evaluate the role of academic tuition and the challenges related to this pedagogical practice during academic education in Dentistry, considering the perception of professors and students. This is a quantitative-qualitative study, developed in the Dental school of Federal University of Rio Grande do Norte (UFRN). Data was collected by means of semi-structured questionnaires, answered by 106 students, and 15 professors with expertise in academic tuition. Data analysis was descriptive and a qualitative analysis was carried out using the content analysis method. Student perceptions showed weaknesses in the performance of academic tuition, mostly concerning the relationship between tutor and students, frequency of discussions, as well as the method adopted. The professors pointed out the need for permanent education strategies, aiming at their qualifications to the tuition. It is concluded that there is an underuse of this pedagogical practice in dentistry education. To overcome this weakness and the challenges inherent to the practice, in the view of the students, it is necessary that the tutors become more present during the onset of their university life by early directions on their responsibilities and supervision of the education process along the graduation. For professors, it is necessary to provide permanent strategies for academic tuition improvements (AU).

Longitudinal Improvement in Periodontal Parameters between RPD Abutment Teeth with Direct and Indirect Retainers, after Periodontal Therapy.

PURPOSE: To evaluate the effect of basic periodontal treatment on clinical periodontal parameters associated with abutment teeth of patients with mandibular Kennedy class I removable partial dentures (RPD) 18 months after treatment. MATERIALS AND METHODS: Thirty patients with periodontal disease were treated and evaluated according to the following periodontal parameters: visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), clinical attachment loss (CAL), and keratinized mucosa (KM). These parameters were compared between abutment teeth with direct and indirect retainers at baseline, and after 6 and 18 months. Data were analyzed by Friedman Test and Wilcoxon Test for all variables. RESULTS: Most patients (n = 26; 86.7%) included in the study were female and had a mean age of 61 years (±7.54). Results showed that VPI and BOP decreased over time, and that VPI values were higher in abutment teeth with direct retainers (p = 0.001). There was a reduction in PD after 6 months, which was maintained up to 18 months. In general, abutment teeth with direct retainers had significantly higher values for PD, GR, and CAL (p = 0.029). Data also indicated that the parameters for VPI, BOP, and PD improved; however, abutment teeth with direct retainers presented smaller improvements, compared with abutment teeth with indirect retainers, which presented significant improvements for almost all variables. CONCLUSION: Periodontal treatment and oral hygiene care of patients were adequate for maintenance of adequate periodontal conditions, regardless of the use of prostheses.

Caracterização tomográfica das áreas edêntulas previamente à reabilitação com implantes unitários / Tomographic characterization of edentulous areas before rehabilitation with single implant

Introdução: Recursos de imagem são indispensáveis para o diagnóstico e preparação de um plano de tratamento adequado, sendo imprescindível para o sucesso reabilitador com implantes dentários. Objetivo: O objetivo deste estudo seccional foi caracterizar áreas edêntulas de pacientes candidatos à reabilitação com um implante dentário osseointegrado unitário em região estética da maxila por meio das tomografias computadorizadas de feixe cônico (TCFC) e correlacionar parâmetros de interesse. Material e método: Catorze TCFC foram avaliadas em um programa de computador de acordo com os seguintes parâmetros: distância da Junção Cemento-Esmalte (JCE) até a crista óssea (CO), distância entre as CO e distância entre as coroas dentárias dos dentes adjacentes ao espaço protético (EP), largura e altura óssea do EP, espessura do palato na região dos segundos pré-molares e molares bem como a espessura horizontal e vertical do tecido mole na região do EP. Resultado: Os resultados foram analisados por meio de estatística descritiva e do teste de Correlação de Spearman. Correlações fracas e moderadas e sem diferenças estatísticas significativas foram encontradas na maioria das comparações (≤ 0,29 e ≥ 0,30 ≤ 0,49, respectivamente). Apenas para a correlação espessura da mucosa do EP versus distância entre JCE e CO no dente mesial ao EP foi encontrada diferença estatística significativa (p= 0,03) e correlação moderada (r = 0,56). Conclusão: A TCFC é uma ferramenta viável para a região maxilofacial, pois permitiu a mensuração de diversos parâmetros de tecido mole e duro da cavidade bucal úteis para o planejamento e previsibilidade de tratamento reabilitador com implantes dentários.

Introduction: Imaging resources are indispensable to assist the professional dental surgeon in the formulation of the diagnosis and preparation of an adequate treatment plan for the patient, being essential for the successful rehabilitation with dental implants. Objective: The purpose of this cross-sectional study was to characterize the edentulous areas of patients who will be rehabilitated with single osseointegrated dental implant in the aesthetic area of the maxilla by means of computerized tomography and correlate parameters of interest. Material and method: Fourteen cone beam computerized tomographies were evaluated in a program according to the following parameters: distance from the cementoenamel junction (CEJ) to the bone crest (BC), distance between the BC and distance between the dental crowns of the teeth adjacent to the prosthetic space (PS), bone width and height of PS, thickness of the palate in the region of the second premolars and molars as well as the horizontal and vertical thickness of the soft tissue in the PS region. Result: The results were analyzed by means of descriptive statistics and the Spearman Correlation test. Weak and moderate correlations and no statistically significant differences were found in most comparisons (≤ 0.29 and ≥ 0.30 ≤ 0.49, respectively). Only for the correlation between PS mucosa thickness versus distance between CEJ and BC in the mesial tooth to PS was found significant statistical difference (p = 0.03) and moderate correlation (r = 0.56). Conclusion: Cone beam computerized tomography is a viable tool for the maxillofacial region because it allowed the measurement of several parameters of soft and hard tissue of the buccal cavity useful for planning with dental implants, which may increase the predictability of successful rehabilitation treatments.

Comportamento dos tecidos peri-implantares quando utilizada carga imediata em implantes unitários na região anterior de maxila: uma revisão sistemática / Peri-implantation tissue behavior when used immediate loading in unit implants in the previous region of maxila: a systematic review

Objetivo: Avaliar o comportamento dos tecidos peri-implantares (moles e duros) após a carga imediata de implantes unitários em áreas estéticas de maxila. Material e Métodos: Uma busca eletrônica foi realizada nas bases de dados BVS e PubMed por dois avaliadores independentes. Quando não houve consenso entre os avaliadores, depois de ler o artigo completo, um terceiro revisor foi incluído. Foram acrescidos textos completos de ensaios clínicos dos últimos 15 anos que avaliaram os seguintes parâmetros: altura da crista óssea, altura da papila interdental e recessão gengival vestibular. Resultados: Um total de nove artigos foi selecionado. Os dados mostraram que o comportamento dos tecidos peri-implantares em implantes com carga imediata foi muito semelhante aos observados em implantes com carga tardia. Além disso, em maiores períodos de acompanhamento, foi verificado que as papilas podem migrar coronalmente ao longo do tempo e que os tecidos duros apresentaram perda óssea média a 1,0 mm, independentemente da utilização ou não de carga imediata. No que diz respeito à estética, em geral, os pacientes ficaram satisfeitos e as perdas notadas ao longo do tempo parecem não interferir da satisfação estética do paciente. Conclusões: A perda de papilas, recessão gengival vestibular e perda óssea podem ocorrer silenciosamente, sendo o tempo mais importante para sua ocorrência que a utilização de carga imediata ou não, o que torna a carga imediata uma alternativa viável e promissora em regiões estéticas sem comprometer o comportamento dos tecidos peri-implantares. (AU)

Objective: Evaluate the behavior of peri-implant tissues (soft and hard) after loading. Low implants in aesthetic maxilla units. Material and methods: Therefore an electronic search was performed in the VHL and PubMed databases by two independent evaluators. When there was no consensus among the reviewers, after reading the full article, a third reviewer was included. We included complete texts of clinical trials of the last 15 years, which ancestors the respective parameters: height of the bone crest, height of the interdental papilla and gingival vestibular recession. Results: A total of nine articles were selected. The data showed that the behavior of the peri-implant tissues in loaded implants. There were very important observations in late load implants. In addition, at longer follow-up periods, it was verified that as papillae may migrate coronally over time and with hard tissues they presented mean bone loss of 1.0 mm, regardless of whether or not the load was used. With regard to aesthetics, patients were generally satisfied and perceived losses over time without interference from the aesthetic satisfaction of the patient. Conclusions: Thus, a loss of papillae, vestibular gingival recession and bone loss can occur silently, being the most important time for its occurrence that the use of load, there is not, which makes a load of a viable and promising alternative in aesthetic regions without Compromise the behavior of peri-implant tissues. (AU)

Quality of life in patients rehabilitated with implant-supported prostheses

Purpose: To evaluate the impact of rehabilitation with implant-supported prostheses on the quality of life (QoL) of patients. Methods: The OHIP-14 questionnaire was applied to 114 patients and information regarding gender, age, type of prosthesis and time of use were obtained. To analyze whether there were any statistically significant differences between the mean scores of the seven parameters of the OHIP-14, the Mann-Whitney and Kruskal-Wallis test were used. All data were evaluated using a significance level of 5%. Results: Patients were predominantly female (78.9%) and single crowns users (41.2%). Patients reported a good QoL (3.07). Psychological discomfort and physical pain were the worst dimensions evaluated by the subjects. Results differed significantly (p<0.05) only for functional limitations and psychological discomfort in the different genders. Conclusions: Patients presented a high level of quality of life, regardless of age, duration of use and the type of prosthesis used. However, women presented more psychological distress and functional limitations than men (AU)

Frequency of peri-implant diseases and associated factors.

OBJECTIVE: To evaluate the frequency of peri-implant diseases and factors associated with its occurrence. MATERIAL AND METHODS: One hundred and fifty-five patients with dental implants were evaluated in this cross-sectional study. Dental implants were clinically and radiographically evaluated to diagnose their peri-implant condition, according to Mombelli (Proceedings of the 3rd European Workshop on Periodontology, 1999, Quintessence, London). Associations between peri-implant diseases and independent variables (socioeconomic, demographic and periodontal characteristics) were evaluated through bivariate analysis with chi-squared and Fisher's exact tests, as well as by multiple logistic regression. The significance level was set at 5%. RESULTS: The frequencies of the peri-implant diseases, mucositis and peri-implantitis, in individuals were 54% and 28% (CI, 95%), respectively. The sample was almost exclusively of patients with untreated periodontal disease (93%). Bivariate analysis showed that these peri-implant diseases were associated with male patients (prevalence ratio [PR], 3.38), medication use (PR, 2.94), systemic diseases (PR, 2.25), number of implants (PR, 2.53), visible plaque index (PR, 2.49) and gingival index (PR, 2.70). Multiple logistic regression analysis showed that medication use (prevalence ratio adjusted [PRadj], 1.23; 95% CI: 1.04-1.46; P = 0.017), having two or more implants (PRadj, 1.22; 95% CI: 1.02-1.46; P = 0.029) and gingival bleeding index > 10% (PRadj, 1.22; 95% CI: 1.03-1.44; P = 0.022) were associated with the presence of peri-implant disease. CONCLUSION: Peri-implant diseases were diagnosed in 54% of patients; gingival index of greater than 10%, having more than two implants and use of medication were associated with the frequency of peri-implant disease.

Does TGF-ß play a role in degenerative temporomandibular joint diseases? A systematic review.

OBJECTIVES: The objective of this review was to assess the literature for evidence investigating the role of TGF-ß in temporomandibular joint disease with osteoarthritis. METHOD: An electronic and manual search was carried out on the databases, MEDLINE/PubMed, Cochrane Library, Web Of Science, and EMBASE, from 1975 to December 2015 by two independent evaluators to identify clinical and laboratory trials in English. RESULTS: The search produced 693 records. Following a process of selection based on certain criteria, eight articles were included. DISCUSSION: This systematic review suggests that TGF-ß administration alone does not result in joint regeneration; other factors may be involved, such as TGF-ß receptor expression ,and TGF-ß receptor mutations that do not allow a correct transduction, resulting in TGF-ß deficiency. The anabolism induced by this growth factor is also able to neutralize the catabolic processes that are elevated in osteoarthritis. Therefore, further studies are essential to determine how the concentration of TGF-ß in the temporomandibular joints acts as a potential marker for the development of degenerative conditions.

Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency.

The aim of this non-randomized controlled clinical trial was to evaluate the oral health-related quality of life and masticatory efficiency of patients rehabilitated with mandibular two-implant overdentures with immediate loading or conventional dentures. Fifty completely edentulous patients wearing bimaxillary conventional dentures, for at least one year, were recruited. The patients were then assigned to either two treatment groups: mandibular overdentures supported by two implants with bar-clip system and a maxillary conventional denture (n = 25), and new maxillary and mandibular conventional complete dentures (n = 25). Masticatory efficiency and oral health-related quality of life were assessed before and 3 months after denture insertion. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral health-related quality of life. Masticatory efficiency was evaluated with chewing capsules through a colorimetric method. The results revealed fewer oral health-related quality of life problems in patients wearing mandibular two-implant overdentures compared to the conventional dentures group. In addition, the implant overdenture group presented statistically significant improvement in masticatory efficiency (p = 0.001). There was no correlation between masticatory efficiency and OHIP in the implant group (p > 0.05), however a correlation was found in the conventional denture group (p < 0.05). Therefore, these short-term results suggest that mandibular overdenture retained by 2 implants with immediate loading combined with maxillary conventional dentures provide better masticatory efficiency and oral health-related quality of life than mandibular conventional dentures.