Pain management in periodontal therapy using local anesthetics and other drugs: an integrative review.

Background: Surgical and non-surgical periodontal procedures often lead to postoperative pain. Clinicians use pharmacological methods such as anesthetics, anti-inflammatory drugs, and analgesics for relief. However, the multitude of options makes it challenging to select the best approach for routine dental care. Objective: This review aimed to describe previous studies regarding the pharmacological management used for pain control during periodontal procedures as well as factors that may interfere with patients' perception of pain. Methods: We included studies (period of 2000-2023, whose approach corresponded to the pharmacological protocols used for preoperative, trans-operative, and postoperative pain control in adult patients undergoing surgical and non-surgical periodontal therapy. Results: A total of 32 studies were included in the analysis, of which 17 (53%) were related to anesthetic methods and 15 (47%) were related to therapeutic protocols (anti-inflammatory/analgesic agents). These studies predominantly involved nonsurgical periodontal procedures. Studies have reported that factors related to age, type of procedure, and anxiety can influence pain perception; however, only seven of these studies evaluated anxiety. Conclusions: Numerous methods for pain control can be applied in periodontal therapy, which are accomplished through anesthetic methods and/or therapeutic protocols. Factors such as anxiety, age, and type of procedure are related to pain perception in patients. Thus, it is the responsibility of dentists to evaluate each clinical situation and define the best protocol to follow based on the literature.

Prevalence of dentin hypersensitivity after orthodontic treatment: A cross-sectional study.

INTRODUCTION: The prevalence of cervical dentin hypersensitivity in patients after corrective orthodontic treatment has been poorly studied, although such hypersensitivity is very common. This study aimed to assess the prevalence of dentin hypersensitivity in patients who received corrective orthodontic treatment, the impact of general oral problems on quality of life, and the impact of hypersensitivity on the quality of life of this population. METHODS: This observational, cross-sectional study evaluated 232 patients who finished orthodontic treatment between 2000 and 2020 for self-reported hypersensitivity and clinically diagnosed hypersensitivity. The following tests were used: tactile, evaporative (bellows), evaporative (triple syringe), and thermal. The patients were also evaluated regarding their quality of life using questionnaires (Oral Health Impact Profile-14 and Dentine Hypersensitivity Experience Questionnaire). We evaluated data with nonparametric statistics. RESULTS: The prevalence of hypersensitivity was higher in women and in those aged <30 years; the most affected teeth were the mandibular incisors and premolars; different diagnostic tests for hypersensitivity may indicate different prevalence values; patients with hypersensitivity had a lower quality of life in most of the domains of both of the tests that were used. CONCLUSIONS: The prevalence of hypersensitivity among patients after orthodontic treatment may be higher than in the general population. Further investigation is needed to indicate the possible factors associated with orthodontic tooth movement.

Periodontal disease and quality of life in patients with circulatory diseases / Doença periodontal e qualidade de vida em pacientes com doenças circulatórias

Introduction: Circulatory system diseases are one of the leading causes of death. Periodontal health is a component of oral and general health that contributes to quality of life. Objective: To analyze periodontal conditions and quality of life in patients with circulatory diseases. Material and method: Cross-sectional study, with patients with circulatory diseases (n=125). The clinical periodontal examination was performed considering: biofilm, bleeding on probing, suppuration, probing depth, gingival recession, and clinical attachment level. Quality of life was assessed with the Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and Oral Health Impact Profile - short form (OHIP-14). Data were analyzed with parametric and nonparametric tests (α=5%). Result: Elderly and men had a greater severity of periodontal disease. The Elderly had lower values in the domains of "Functional capacity" and "Physical aspects" (SF-36). The domain "Pain" had lower values in subjects with health/gingivitis. OHIP-14 did not show differences in the comparisons. There was no correlation between quality of life and the severity of periodontal disease. Conclusion: Among patients with circulatory diseases, the elderly and men had greater severity of periodontal disease. The elderly had a poorer quality of life (functional capacity and physical aspects). There was no correlation between the severity of periodontal disease and quality of life.

Introdução: As doenças do aparelho circulatório representam uma das principais causas de mortes. A saúde periodontal é um componente da saúde bucal e saúde geral que contribui para a qualidade de vida. Objetivo: Analisar as condições periodontais e a qualidade de vida em pacientes com doenças circulatórias. Material e método: Estudo transversal, com pacientes com doenças circulatórias (n=125). O exame clínico periodontal foi realizado considerando: biofilme, sangramento à sondagem, supuração, profundidade de sondagem, recessão gengival e nível de inserção clínica. A qualidade de vida foi avaliada com o Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) e Oral Health Impact Profile - short form (OHIP-14). Os dados foram analisados com testes paramétricos e não paramétricos (α=5%). Resultado Idosos e os homens tiveram maior severidade da doença periodontal. Idosos apresentaram menores valores nos domínios "Capacidade funcional" e "Aspectos físicos" (SF-36). O domínio "Dor" teve menor valor nos indivíduos com saúde/gengivite. OHIP-14 não apresentou diferenças nas comparações. Não houve correlação entre qualidade de vida a severidade da doença periodontal. Conclusão Entre os pacientes com doenças circulatórias, os idosos e os homens tiveram maior severidade da doença periodontal. Idosos tiveram pior qualidade de vida (capacidade funcional e aspectos físicos). Não houve correlação entre a severidade da doença periodontal e a qualidade de vida.

A novel rat model of denture stomatitis and the role of antibiotics in the development of the disease.

This study compared different conditions to establish a rat model of denture stomatitis. Immunocompetent Wistar rats were divided into two groups (n = 35): Tetracycline = administration of 0.83 mg/ml of tetracycline hydrochloride 7 days before induction of denture stomatitis and amoxicillin = administration of 0.156 mg/ml of amoxicillin with clavulanic acid 4 days before induction of denture stomatitis. A suspension of Candida albicans was inoculated on the palate followed by the use of a palatal device contaminated with C. albicans inoculum for 4 days to induce denture stomatitis. As controls, some rats were not submitted to any procedure or used a sterile palatal device for 4 days. The development of denture stomatitis was confirmed by visual analysis, colony-forming units per milliliter (CFU/ml) count, histopathological and immunohistochemical analyses, and through myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats were euthanized right after device removal (T0), 4 (T4), or 6 (T6) days after device removal. Tetracycline improved the development of the disease, with more severe clinical signs at T0. Similar results were observed in the CFU/ml count and in the histometric and immunohistochemical analyses. Higher MPO expression was detected in the palates of the tetracycline group (P = .006). Despite the subtle differences between antibiotics, tetracycline showed better results in inducing and maintaining denture stomatitis for at least 4 days after device removal.

Denture stomatitis is an oral inflammatory disease with high recurrence rates. Different animal models have been reported in the literature, but some gaps still need to be addressed. A reproducible in vivo model should be established to test new treatment approaches.

Effect of bioactive glasses used as dentin desensitizers on the dentin-pulp complex in rats.

Bioactive glasses have been recommended for the occlusion of dentinal tubules in treating cervical dentin hypersensitivity. This study evaluates an in vivo model of dentin exposure, and tests the efficacy of bioglass treatments. Thirty male Wistar rats received gingival recession surgery on the upper left first molar. The treatments were applied over the surface of the exposed dentin every 4 days for 28 days. The groups were as follows: Naive; Gingival recession; Cavity varnish; Biosilicate®; Strontium bioglass; and Potassium bioglass. Changes in the dentin-pulp complex, and the presence of substance P, were evaluated through hematoxylin-eosin and immunohistochemical staining. The groups had similar results. Teeth with exposed dentinal tubules in rats showed a typical pattern in the dentin-pulp complex and immunotracing for substance P. The materials did not cause pulp damage. The effects of gingival recession and open dentinal tubules on pulp tissue require further clarification.

Efeito da clorexidina em microrganismos na saliva de doentes internados em unidade de terapia intensiva / Effects of chlorhexidine on the salivary microorganisms of patients in intensive care units / Efecto de la clorhexidina en los microorganismos de la saliva de pacientes ingresados en una unidad de cuidados intensivos

Resumo Enquadramento: O controlo do biofilme oral com anti-sépticos deve ser adequado aos protocolos elaborados para os doentes na unidade de terapia intensiva (UTI). Objetivo: Avaliar o efeito da solução de clorexidina 0,12% na redução de microrganismos na saliva de doentes de UTI. Metodologia: Estudo coorte com 45 voluntários divididos em: Clínica Médica (controlo, auto higiene oral), UTI não-entubado e UTI entubado. A higiene oral na UTI foi realizada com clorexidina. A análise microbiológica foi realizada com a contagem de microrganismos na saliva. A análise dos dados foi feita com ANOVA. Resultados: Houve uma redução dos microrganismos após higiene oral. O controlo apresentou diferença significativa com UTI entubado nos períodos imediato e após 30 min. Doentes entubados apresentaram redução dos microrganismos até 12 horas após higiene com clorexidina. Conclusão: A higiene com clorexidina reduz em até 12 horas os microrganismos bucais de doentes entubados. Estes resultados podem contribuir para elaboração de protocolos de higiene oral em UTI, além de sustentar estratégias como redução nos custos e efeitos colaterais associados à clorexidina.

Abstract Background: The control of oral biofilm with antiseptics should follow the protocols designed for patients in intensive care units (ICUs). Objective: To assess the effects of using 0.12% chlorhexidine solution in reducing the number of microorganisms in the saliva of ICU patients. Methodology: Cohort study with 45 volunteers divided into Medical Clinic (control group, oral self-care), non-intubated ICU, and intubated ICU. Oral hygiene in the ICU was performed with chlorhexidine. Microbiological analysis was performed through salivary bacterial count. Data were analyzed using ANOVA. Results: The number of microorganisms decreased after oral hygiene. A significant difference was found between the control and the ICU intubated groups in the immediate period and after 30 minutes. The number of microorganisms in intubated patients decreased 12 hours after oral hygiene with chlorhexidine. Conclusion: The number of oral microorganisms decreases in intubated patients 12 hours after oral hygiene with chlorhexidine. These results may contribute to elaborating oral hygiene protocols for ICUs and planning strategies, for example, to reduce the costs and the side effects associated with chlorhexidine use.

Resumen Marco contextual: El control de la biopelícula oral con antisépticos debe ser adecuado a los protocolos elaborados para los pacientes de una unidad de cuidados intensivos (UCI). Objetivo: Evaluar el efecto de la solución de clorhexidina al 0,12% en la reducción de los microorganismos en la saliva de los pacientes en una UCI. Metodología: Estudio de cohorte con 45 voluntarios divididos en Clínica Médica (control, autohigiene bucal), UCI no intubados y UCI intubados. La higiene bucal en la UCI se realizó con clorhexidina. El análisis microbiológico se realizó con el recuento de microorganismos en la saliva. El análisis de los datos se realizó con ANOVA. Resultados: Hubo una reducción de los microorganismos después de la higiene bucal. El control mostró una diferencia significativa con los pacientes intubados en la UCI en el momento y después de 30 minutos. Los pacientes intubados mostraron una reducción de los microorganismos hasta 12 horas después de la higiene con clorhexidina. Conclusión: La higiene con clorhexidina reduce en un máximo de 12 horas los microorganismos bucales en pacientes intubados. Estos resultados pueden contribuir a la elaboración de protocolos de higiene bucal en las UCI, además de apoyar estrategias como la reducción de costes y los efectos secundarios asociados a la clorhexidina.

Liposomal anesthetic gel for pain control during periodontal therapy in adults: a placebo-controlled RCT.

INTRODUCTION: Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. OBJECTIVE: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. METHODOLOGY: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. RESULTS: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. CONCLUSION: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.

Liposomal anesthetic gel for pain control during periodontal therapy in adults: a placebo-controlled RCT

Abstract Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy. Objective: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy. Methodology: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor. Results: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy. Conclusion: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.

Influence of ibuprofen-arginine on the concentration of amoxicillin in the plasma and tissues of rats with induced periapical lesion / Influência do ibuprofeno arginina sobre a concentração plasmática e tecidual da amoxicilina em ratos com lesão periapical induzida

ABSTRACT Objective The aim of this study was to evaluate the influence of ibuprofen-arginine on the concentration of amoxycillin in the plasma and periapical tissues of rats with induced apical periodontitis. Methods Twenty-eight Wistar rats were divided into the following four groups: PL: placebo (saline); AM: amoxycillin (100 mg/kg); IB: ibuprofen-arginine (100 mg/kg); and AM+IB: amoxycillin (100 mg/kg) + ibuprofen-arginine (100 mg/kg). The animals were submitted to pulp exposure in the first lower left molar, which remained open for fifteen days; this was then closed with composite resin and remained for a further seven days. The treatments were performed using a single dose of the medication (gavage) one hour before taking the samples. Two mL of blood was collected from the aorta to obtain the blood plasma and the periapical tissue samples, which were homogenized to obtain the supernatant. The samples (plasma and the supernatant periapical tissue) were used to obtain the antibiogram for the analysis of the levels of amoxycillin in the plasma and periapical tissues. Results The amoxycillin concentration was higher in the AM group compared to the other groups (p < 0.05, ANOVA with Tukey's test). Ibuprofen-arginine interfered with plasma concentration of amoxycillin; however, the AM+IB group had a higher concentration of amoxycillin than the PL and IB groups (p < 0.05, ANOVA with Tukey's test). The analysis of the supernatant from the periapical tissues showed no significant difference between the groups (p > 0.05, Kruskal-Wallis test). Conclusion Ibuprofenarginine can interfere with the plasma concentration of amoxycillin but this study failed to show the effect of ibuprofen-arginine on the concentration of amoxycillin in the periapical tissues .

RESUMO Objetivo A proposta desta pesquisa foi avaliar a influência do ibuprofeno arginina, sobre a concentração de amoxicilina no plasma e no tecido periapical de ratos com periodontite apical induzida. Métodos Foram utilizados 28 ratos Wistar, divididos em 4 grupos:PL: placebo (salina); AM: amoxicilina (100mg/kg); IB: ibuprofeno arginina (100mg/kg); e AM+IB: amoxicilina (100mg/kg) + ibuprofeno arginina (100mg/kg). Os animais foram submetidos à exposição pulpar do primeiro molar inferior esquerdo que permaneceu aberto por 15 dias e, então, fechado com resina composta, permanecendo por mais 07 dias. Os tratamentos foram realizados com dose única dos medicamentos (gavagem), uma hora antes da obtenção das amostras. Foram coletados 2mL de sangue da artéria aorta para a obtenção do plasma sanguíneo e amostras do tecido periapical que foram homogeneizadas para a obtenção do sobrenadante. A partir das amostras (plasma e sobrenadante do tecido periapical) realizou-se o antibiograma para análise da concentração plasmática e tecidual de amoxicilina. Resultados A concentração de antibiótico foi maior no grupo AM em comparação aos demais grupos (p<0,05, ANOVA com Tukey). O ibuprofeno arginina interferiu na concentração plasmática de amoxicilina, no entanto, a concentração de amoxicilina no grupo AM+IB foi maior que nos grupos PL e IB (p<0,05, ANOVA com Tukey). A análise do sobrenadante do tecido periapical não mostrou diferença significativa entre os grupos (p>0,05, Kruskal-Wallis). Conclusão O ibuprofeno arginina podeinterferir com a concentração plasmática de amoxicilina, porém o estudo não foi capaz de mostrar o efeito do anti-inflamatório na concentração de amoxicilina no tecido periapical.

Treinamento resistido em mulheres idosas na produção científica: uma pesquisa bibliométrica / Resistance training in elderly women in scientific production: a bibliometric research

Objetivo: foi realizar uma investigação bibliométrica na literatura sobre o tema do treinamento resistido em mulheres idosas. Metodologia: utilizou a bibliometria para as análises das seguintes variáveis: ano de publicação; autores com mais publicações; instituição de vínculo do autor; país da instituição de vínculo do autor; título do periódico e o fator de impacto (JCR 2017) dos periódicos. Foram utilizadas quatro bases de dados para a busca na literatura científica e técnica, com as palavras-chave "Older Women" e "Resistance Training", limitando o ano (2012-2016) e obrigatoriamente artigos científicos publicados na íntegra. Após a exclusão das duplicações, foram totalizados 152 artigos científicos para a análise quantitativa. Resultados: a Scopus retornou 107 artigos científicos, a Web of Science ­ 79, a Pubmed ­ 82 e a SciELO ­ 8. Os periódicos com mais publicações quantificadas em cada base de dados foram: o Experimental Gerontology (Scopus); Journal of Strength and Conditioning Research e Medicine and Science in Sports and Exercise (Web of Science); Journal of Strength and Conditioning Research (Pubmed); e as Revista Brasileira de Medicina do Esporte e a Revista Brasileira de Cineantropometria & Desempenho Humano (SciELO). Os autores Cyrino, E. S., da Universidade Estadual de Londrina, Brasil e a Liu- -Ambrose, T., da University of British Columbia, Canadá, foram os pesquisadores com maior produtividade, com 15 e 11 publicações, respectivamente. Conclusão: conclui-se que o Brasil foi o país de destaque nas publicações referentes ao treinamento resistido em idosas no quinquênio (2012-2016). Já a instituição destaque foi a Universidade Estadual de Londrina, localizada no Norte e no interior do estado do Paraná, tendo como líder o pesquisador Cyrino, E. S. (AU)

Objective: to carry out a bibliometric investigation in the literature on the subject of resistance training in elderly women. Methodology: we used bibliometrics in order to analyze the following variables: year of publication; authors with more publications; author's institution; country of the author's institution; title of the journal and the impact factor (JCR 2017). Four databases were used to search the scientific and technical literature, using the keywords: "Older Women" and "Resistance Training", publication dates (2012 to 2016) and full-text scientific articles published. After the duplication papers exclusion, a total of 152 scientific articles were included for the quantitative analysis. Results: Scopus returned 107 articles, Web of Science ­ 79, Pubmed ­ 82 and SciELO ­ 8. The journals with the most publications quantified in each database were: the Experimental Gerontology (Scopus); Journal of Strength and Conditioning Research and Medicine and Science in Sports and Exercise (Web of Science); Journal of Strength and Conditioning Research (Pubmed); and the Brazilian Journal of Sports Medicine and the Brazilian Journal of Cineanthropometry & Human Performance (SciELO). The authors Cyrino, E. S., State University of Londrina, Brazil and Liu-Ambrose, T., University of British Columbia, Canada, were the most productive researchers with 15 and 11 publications, respectively. Conclusion: it was concluded that Brazil was the leading country in the scientific publication regarding resistance training in elderly women in the five-year period (2012 to 2016). The main institution was the State University of Londrina, located on Paraná state, with the Cyrino, E. S. the most productive researcher. It is important to mention the great contribution of researcher Liu-Ambrose. (AU)

Effect of Premedication with Anti-inflammatory Drugs on Post-Endodontic Pain: A Randomized Clinical Trial.

In spite of advances in root canal therapy and better knowledge of pulpal and periapical inflammation, up 40% of endodontic patients report varying degrees of pain. The aim of this present study was to compare the effect of single preoperative dose of ibuprofen or dexamethasone on post-endodontic pain. Sixty volunteers were divided into three groups (n=20 per group): PL, placebo; IB, 400 mg of ibuprofen; and DE, 8 mg of dexamethasone. The primary outcome was the post-endodontic pain intensity measured with a numerical rating scale (4, 8, 12, 24, and 48 h). Secondary outcomes included number of anesthetic cartridges used and consumption of rescue medication. Data were analyzed by one-way ANOVA, chi-square and Kruskal-Wallis tests. There was no significant difference among groups (p>0.05) considering the pain intensity. Only 37% of IB group patients and 28% of DE group patients used some rescue medication. On the other hand, 74% of PL group patients mentioned the consumption of rescue medication; PL group had a statistically significant difference (p<0.05) in comparison with IB and DE groups. The number of anesthetic cartridges used had no statistically significant difference among the groups (p>0.05). Significant differences were not found in the reduction of pain intensity and the number of anesthetic cartridges used. Considering the consumption of rescue medication (secondary outcome), preoperative administration of Ibuprofen or dexamethasone reduces post-endodontic pain and discomfort in comparison with a placebo. Premedication with anti-inflammatory drugs drugs could be contributed to control of the post-endodontic pain, mainly in patients more sensible for pain.

Learning styles preferences and e-learning experience of undergraduate dental students / Preferências nos estilos de aprendizagem e experiência com e-learning de estudantes de graduação em Odontologia

Introduction: Education in the health sciences has been undergoing profound changes due to the incorporation of information and communication technologies. Students learn through a variety of approaches, according to their learning styles. Blended learning, which combines technology-aided learning (e-learning) with traditional face-to-face teaching methods, has been found to improve learning outcomes. Objective: The aims of the present study were to evaluate the learning styles of undergraduate dental students and their experience towards the use of e-learning. Material and method: Two electronic questionnaires were sent to 174 students. The learning styles were determined by the Felder & Soloman Index (ILS), which evaluates the following four dimensions of learning: processing information (active-reflexive); perceiving information (sensorial-intuitive); receiving information (visual-verbal); and understanding information (sequential-global). To determine the e-learning experience we used four questions (Likert scale - five-point) which addressed the experience and the use of information and communication technologies. Result: Most students presented a well-balanced style for the active-reflective (60%) and sequential-global (68%) domains. The sensing style (64%) was predominant. A lower percentage presented a global characteristic (9%). We did not find significant differences regarding the age groups (19-21 and 22-33 years) and genders (P>0.05, χ 2). However, in terms of age the difference was significant concerning websites helping in learning (P=0.0363, Mann-Whitney). Conclusion: We conclude that the students do not have the same learning styles and e-learning experience. Methods such as blended learning could provide advantages when teaching undergraduate dental students.

Introdução: A educação em ciências da saúde tem passado por profundas mudanças devido à incorporação de tecnologias de informação e comunicação (TICs). Os estudantes aprendem através de diferentes abordagens, de acordo com o seu estilo de aprendizagem. O ensino híbrido, que combina tecnologia (e-learning) com o ensino face-a-face, tem apresentado bons resultados. Objetivo: Os objetivos deste estudo são avaliar os estilos de aprendizagem de alunos de graduação em Odontologia e a experiência com e-learning. Material e método: Dois questionários eletrônicos foram enviados a 174 estudantes. Os estilos de aprendizagem foram determinados pelo Índice de Felder & Soloman (ILS), que avalia as quatro dimensões do aprendizado: processamento da informação (ativo-reflexivo); percepção da informação (sensorial-intuitivo); recebimento da informação (visual-verbal); e entendimento da informação (sequencial-global). Para determinar a experiência com e-learning foram usadas quatro perguntas (escala Likert de cinco pontos) sobre o uso das TICs. Resultado: A maioria dos estudantes apresentou um estilo equilibrado para ativo-reflexivo (60%) e sequencial-global (68%). O estilo sensitivo (64%) foi predominante. Uma porcentagem mais baixa apresentou características globais (9%). Não foram encontradas diferenças quanto aos grupos de idades (19-21 e 22-33 anos) e aos gêneros (P>0,05, χ2). Contudo, houve diferença entre os grupos de idades considerando a ajuda dos websites no aprendizado (P =0,0363, Mann-Whitney). Conclusão: Os estudantes não têm os mesmos estilos de aprendizado e experiência com e-learning. Métodos alternativos ao ensino convencional, como o ensino híbrido, podem significar vantagens no ensino da graduação em Odontologia.

Effect of premedication with anti-inflammatory drugs on post-endodontic pain: a randomized clinical trial

Abstract In spite of advances in root canal therapy and better knowledge of pulpal and periapical inflammation, up 40% of endodontic patients report varying degrees of pain. The aim of this present study was to compare the effect of single preoperative dose of ibuprofen or dexamethasone on post-endodontic pain. Sixty volunteers were divided into three groups (n=20 per group): PL, placebo; IB, 400 mg of ibuprofen; and DE, 8 mg of dexamethasone. The primary outcome was the post-endodontic pain intensity measured with a numerical rating scale (4, 8, 12, 24, and 48 h). Secondary outcomes included number of anesthetic cartridges used and consumption of rescue medication. Data were analyzed by one-way ANOVA, chi-square and Kruskal-Wallis tests. There was no significant difference among groups (p>0.05) considering the pain intensity. Only 37% of IB group patients and 28% of DE group patients used some rescue medication. On the other hand, 74% of PL group patients mentioned the consumption of rescue medication; PL group had a statistically significant difference (p<0.05) in comparison with IB and DE groups. The number of anesthetic cartridges used had no statistically significant difference among the groups (p>0.05). Significant differences were not found in the reduction of pain intensity and the number of anesthetic cartridges used. Considering the consumption of rescue medication (secondary outcome), preoperative administration of Ibuprofen or dexamethasone reduces post-endodontic pain and discomfort in comparison with a placebo. Premedication with anti-inflammatory drugs drugs could be contributed to control of the post-endodontic pain, mainly in patients more sensible for pain.

Resumo Apesar dos avanços no tratamento do canal radicular e melhor conhecimento da inflamação pulpar e periapical, 40% dos pacientes submetidos ao tratamento de endodôntico relatam diferentes graus de dor. O objetivo deste estudo foi comparar o efeito pré-operatório (dose única) de ibuprofeno ou dexametasona na dor pós-endodôntica. Sessenta voluntários foram divididos em três grupos (n=20 por grupo): PL, placebo; IB, 400 mg de ibuprofeno; e DE, 8 mg de dexametasona. O desfecho primário foi a intensidade da dor pós-endodôntica medida com uma escala numérica (4, 8, 12, 24 e 48 h). Os desfechos secundários incluíram o número de tubetes anestésicos utilizados e o consumo de medicação resgate. Os dados foram analisados com os testes ANOVA, qui-quadrado e Kruskal-Wallis. Não houve diferença entre os grupos (p>0,05) considerando a intensidade da dor. Apenas 37% dos pacientes do grupo IB e 28% do grupo DE utilizaram alguma medicação resgate. Por outro lado, 74% dos pacientes do grupo PL mencionaram o consumo de medicação resgate; o grupo PL apresentou diferença significativa (p<0,05) em comparação com os grupos IB e DE. O número de tubetes anestésicos utilizados não apresentou diferença significativa entre os grupos (p>0,05). Não encontramos diferença significativa na redução da intensidade da dor e no número de tubetes anestésicos utilizados. Considerando o consumo de medicação resgate (desfecho secundário), a administração pré-operatória de ibuprofeno ou dexametasona reduz a dor pós-endodôntica e o desconforto em comparação com placebo. A pré-medicação com anti-inflamatórios poderia contribuir para o controle da dor pós-endodôntica, principalmente em pacientes mais sensíveis à dor.

In vivo temperature rise in anesthetized human pulp during exposure to a polywave LED light curing unit.

OBJECTIVES: This in vivo study evaluated pulp temperature (PT) rise in human premolars during exposure to a light curing unit (LCU) using selected exposure modes (EMs). METHODS: After local Ethics Committee approval, intact first upper premolars, requiring extraction for orthodontic reasons, from 8 volunteers, received infiltrative and intraligamental anesthesia. The teeth (n=15) were isolated using rubber dam and a minute pulp exposure was attained. A sterile probe from a wireless, NIST-traceable, temperature acquisition system was inserted directly into the coronal pulp chamber, and real time PT (°C) was continuously monitored while the buccal surface was exposed to polywave light from a LED LCU (Bluephase 20i, Ivoclar Vivadent) using selected EMs allowing a 7-min span between each exposure: 10-s either in low (10-s/L) or high (10-s/H); 5-s-turbo (5-s/T); and 60-s-high (60-s/H) intensities. Peak PT values and PT increases from baseline (ΔT) after exposure were subjected to one-way, repeated measures ANOVAs, and Bonferroni's post hoc tests (α=0.05). Linear regression analysis was performed to establish the relationship between applied radiant exposure and ΔT. RESULTS: All EMs produced higher peak PT than the baseline temperature (p<0.001). The 60-s/H mode generated the highest peak PT and ΔT (p<0.001), with some teeth exhibiting ΔT higher than 5.5°C. A significant, positive relationship between applied radiant exposure and ΔT (r(2)=0.916; p<0.001) was noted. SIGNIFICANCE: Exposing intact, in vivo anesthetized human upper premolars to a polywave LED LCU increases PT, and depending on EM and the tooth, PT increase can be higher than the critical ΔT, thought to be associated with pulpal necrosis.

Direct measurement of time-dependent anesthetized in vivo human pulp temperature.

OBJECTIVES: Human intrapupal tooth temperature is considered to be similar to that of the body (≈37 °C), although the actual temperature has never been measured. This study evaluated the in vivo, human, basal, coronal intrapulpal temperature of anesthetized upper first premolars. METHODS: After approval of the local Ethics Committee was obtained (protocol no. 255,945), upper right and left first premolars requiring extraction for orthodontic reasons from 8 volunteers, ranging from 12 to 30 years old, received infiltrative and intraligamental anesthesia. The teeth (n=15) were isolated using rubber dam and a small, occlusal preparation was made using high-speed handpiece, under constant air-water spray, until a minute pulp exposure was attained. The sterile probe from a wireless, NIST-traceable, temperature acquisition system (Thermes WFI) was inserted directly into the coronal pulp. Once the probe was properly positioned and stable, real-time temperature data were continuously acquired for approximately 25 min. Data (°C) were subjected to 2-tailed, paired t-test (α=0.05), and the 95% confidence intervals for the initial and 25-min mean temperatures were also determined. RESULTS: The initial pulp temperature value (31.8±1.5 °C) was significantly lower than after 25-min (35.3±0.7 °C) (p<0.05). The 95% confidence interval for the initial temperature ranged from 31.0 to 32.6 °C and from 35.0 to 35.7 °C after 25 min. A slow, gradual temperature increase was observed after probe insertion until the pulp temperature reached a plateau, usually after 15 min. SIGNIFICANCE: Consistent coronal, human, in vivo temperature values were observed and were slightly, but significantly below that of body core temperature.

Effects of an orabase formulation with ethanolic extract of Malva sylvestris L. in oral wound healing in rats.

Malva sylvestris L. is widely used in medicine for treatment of inflammatory processes. The plant has anti-inflammatory properties due to substances such as mucilage, flavonoids, and tannins. A mouthwash with leaves from the plant can be used for the treatment of wounds in the oral mucosa. The aim of this study was to assess the wound healing effect of Malva sylvestris L. on a palate mucosa wound in rats. After intraperitoneal anesthesia, a 4-mm-diameter excisional wound was made in the center of the palatal mucosa of 136 rats, using a punch-out biopsy tool. Eight animals were used as baseline wound. The remaining rats were divided into four groups: CO, control; OB, orabase vehicle; CX, 2% chlorhexidine; and MA, 20% Malva in orabase. At 24 h postoperatively, the animals were immobilized without anesthetic to apply 25 mg of each substance twice a day, totaling 50 mg daily. The wound areas were measured photographically and the reepithelialization rates were determined histologically (%) after 0, 3, 7, 15, and 21 days. The data were analyzed by ANOVA and Tukey post hoc test. Similar healing pattern was observed among the groups (P>.05; ANOVA). According to the methodology, Malva sylvestris L. extract had no effect on wound healing in the palatal mucosa of rats.

The influence of tooth brushing supervision on the dental plaque index and toothbrush wear in preschool children / A influência da supervisão de escovação no índice de placa dental e desgaste de escovas infantis

Objective: To evaluate the effectiveness of tooth brushing supervision in one or more sessions on dental plaque removal and toothbrush wear. Material and Method: 3- to 5-year-old children received new toothbrushes and attended a puppet theater about oral health. Forty-nine children were randomly selected and divided into 3 groups (GI=20; GII=14; GIII=14). Fones' brushing method was demonstrated to the GI and GII groups to evaluate the following: the professional direct supervision and tooth brushing training in five sessions (GI), the professional direct supervision and a one-training session (GII) and the puppet theater influence only (GIII-control group). The dental plaque index (IPL) was recorded at baseline (T0), after 24 days (T1) and after 46 days (T2) and toothbrush wear (ID) was recorded on T1 and T2. The Kruskal-Wallis test and the Friedman test (IPL), as well as the one-way ANOVA and the paired Student's t-test (ID) (p<0.05) were employed to analyze the data. Result: GI showed a significant difference from the others groups in T1 and T2 (p<0.01).The index of toothbrush wear increased (p<0.0001) from 24 days (0.52±0.35mm) to 46 days (0.90±0.48mm), but there was no significant association between toothbrush wear and plaque index for T1 (r=0.230-p= 0.116) as well as for T2 (r=0.226-p=0.121). Conclusion: The multiple sessions of professional supervision were effective to reduce the dental plaque index, which was not influenced by toothbrush wear, showing continuous oral hygiene motivation needs.

Objetivo: Avaliar a efetividade da supervisão de escovação em uma ou mais sessões na remoção de placa dental e desgaste de escovas. Material e Método: Crianças de 3 a 5 anos de idade receberam escovas dentais novas e participaram de um teatro de fantoches sobre saúde bucal. Foram selecionadas 49 e distribuídas aleatoriamente em três grupos (GI=20; GII=14 e GIII=14). A técnica de Fones foi demonstrada aos grupos GI e GII para avaliar:a supervisão profissional direta e o treinamento de escovação em cinco sessões (GI), a supervisão profissional direta e o treinamento em uma única sessão (GII) e a influência do teatro de fantoches (GIII-grupo controle). Os índices de placa dental (IPL) foram registrados no início do estudo (T0), após 24 dias (T1) e 46 dias (T2) e os índices de desgaste das escovas dentais (ID) no T1 e T2. Os testes de Kruskal-Wallis e Friedman (IPL); ANOVA de um critério e o teste t de Student (ID) (p<0,05) foram empregados na análise dos dados. Resultado: O GI diferiu de forma significativa dos outros grupos no T1 e T2 (p<0,01). O índice de desgaste das escovas aumentou (p<0,0001) dos 24 dias (0,52±0,35mm) para os 46 dias (0,90±0,48mm) e não houve associação significativa entre desgaste de escova e índice de placa, tanto em T1 (r=0,230-p= 0,116), quanto em T2 (r=0.226-p=0,121). Conclusão: A supervisão profissional em sessões múltiplas foi efetiva para reduzir os índices de placa, os quais não foram influenciados pelo desgaste das escovas, mostrando a necessidade de contínua motivação em higiene bucal.

Effect of desensitizing toothpastes on dentin

The objective of this study was to analyze the effects of toothbrushing with desensitizing toothpastes on dentin permeability and dentinal tubule occlusion. Fifty rats provided two hundred incisor teeth divided into five groups: DW, brushed with distilled water (control); FT, brushed with fluoride toothpaste; SCT, brushed with strontium chloride toothpaste; PCT, brushed with potassium citrate toothpaste; and PNT, brushed with potassium nitrate toothpaste. Cavities were prepared to expose the dentinal tubules, and the incisor teeth were brushed using the experimental agents. After each treatment, Evans blue dye solution was applied to the teeth. Dentin permeability was analyzed using scanning electron microscopy and energy-dispersive X-rays (EDX). There were significant differences (p < 0.0001, ANOVA) among the groups regarding dentin permeability, number of dentinal tubules, diameter of dentinal tubules, and opened tubular area. In the SCT, PCT and PNT groups, opened and partially occluded tubules, deposits, and a few smear layers were observed. In the DW and FT groups, most of the dentinal tubules were open, with no deposits or smear layers on the dentin. EDX revealed peaks of calcium and phosphorus in all of the groups, as well as traces of strontium in the SCT group and of potassium in the PCT and PNT groups. Desensitizing toothpaste decreased dentin permeability, although it produced only partial dentin tubule occlusion.

Effect of desensitizing toothpastes on dentin.

The objective of this study was to analyze the effects of toothbrushing with desensitizing toothpastes on dentin permeability and dentinal tubule occlusion. Fifty rats provided two hundred incisor teeth divided into five groups: DW, brushed with distilled water (control); FT, brushed with fluoride toothpaste; SCT, brushed with strontium chloride toothpaste; PCT, brushed with potassium citrate toothpaste; and PNT, brushed with potassium nitrate toothpaste. Cavities were prepared to expose the dentinal tubules, and the incisor teeth were brushed using the experimental agents. After each treatment, Evans blue dye solution was applied to the teeth. Dentin permeability was analyzed using scanning electron microscopy and energy-dispersive X-rays (EDX). There were significant differences (p < 0.0001, ANOVA) among the groups regarding dentin permeability, number of dentinal tubules, diameter of dentinal tubules, and opened tubular area. In the SCT, PCT and PNT groups, opened and partially occluded tubules, deposits, and a few smear layers were observed. In the DW and FT groups, most of the dentinal tubules were open, with no deposits or smear layers on the dentin. EDX revealed peaks of calcium and phosphorus in all of the groups, as well as traces of strontium in the SCT group and of potassium in the PCT and PNT groups. Desensitizing toothpaste decreased dentin permeability, although it produced only partial dentin tubule occlusion.

Effect of lidocaine- and prilocaine-based topical anesthetics on the inflammatory exudates in subcutaneous tissue of rats.

The aim of this present study was to evaluate the irritative potential of 2 topical anesthetics used in intrapocket anesthesia for periodontal scaling/root planing when applied in subcutaneous tissue of rats. Sixty animals were divided into 4 groups: group 1, saline solution (control); group 2, poloxamer gel (thermosetting vehicle); group 3, lidocaine and prilocaine poloxamer thermosetting gel; group 4: EMLA, a lidocaine and prilocaine dermatological cream. Injections of 2% Evans blue were administrated intravenously into the lateral caudal vein. In order to analyze vascular permeability, the tested substances were injected intradermally. The rats were sacrificed 3, 6, and 9 hours after injection of the substances. The dorsal skin was dissected and removed. The vascular permeability was evaluated by the measurement of area of dye extravasation and the dye was subsequently extracted after immersion in formamide. Statistical analyses were made by ANOVA with Bonferroni's post hoc test and Pearson correlation. The 2 methods to analyze the exudative phase of the inflammatory process showed statistically significant difference among the groups and periods of evaluation (P < .05). Both methods had a significant correlation (P < .0001). Under the tested conditions, the anesthetic agents showed mild initial inflammatory response when implanted in subcutaneous connective tissue.