Photoanthropometric craniofacial parameters in individuals with osteogenesis imperfecta / Parámetros craneofaciales fotoantropométricos en personas con osteogénesis imperfecta

Background: This study aimed to evaluate facial photoanthropometric parameters in patients with OI.Material and Methods: We selected 20 Brazilian patients diagnosed with OI treated at the Extension Service forMinors in Need of Specialized Treatment of the Dentistry Course at the Federal University of Ceará (Fortaleza,Brazil), of both sexes, without age restriction, and able to understand and sign the informed consent form (ICF).As a control group, 38 non-syndromic Brazilian individuals, categorized as ASA I, able to understand and sign theICF, matched by sex, age, and Legan and Burstone facial profile were selected. The exclusion criteria were: previ-ous orthodontic treatment, craniofacial trauma and/or surgery, and the presence of any other systemic diseases.Photoanthropometric analysis of the 18 facial parameters proposed by Stengel-Rutkowski et al. (1984), previouslyestablished in the literature for craniofacial syndromes, were conducted. A single examiner digitally performedall effective and angular measurements with the CorelDRAWX7® software.Results: Horizontally shortened ears (p<0.001) but larger in height in relation to the face (p=0.012) were shownto be alterations belonging to individuals with OI.Conclusions: OI patients present distinct photoanthropometric parameters inherent in this condition.(AU)

Avaliação da sonolência e queixas de sono dos estudantes de odontologia da Universidade Federal do Ceará / Evaluation of sleepness and sleep complaints among dentistry students from the federal University of Ceará / Evaluación de somnolencia y quejas de sueño en estudiantes de odontología de la Universidad Federal de Ceará

O sono é um estado essencial para sobrevivência humana, ele exerce função biológica, restauradora e de conservação energética do organismo, promovendo equilíbrio físico e mental. Alta prevalência da má qualidade de sono e sonolência diurna excessiva (SDE) têm sido relatadas por estudantes universitários de diversos cursos, ocasionando prejuízos na concentração e queda dos rendimentos acadêmicos. O objetivo deste trabalho foi avaliar a qualidade de sono, a SDE e suas possíveis associações com sintomas depressivos em estudantes de odontologia. Foi realizado um estudo transversal e descritivo com 251 alunos do curso de odontologia da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará. Os instrumentos utilizados foram o Índice de Qualidade de Sono de Pittsburgh (IQSP), Escala de Sonolência de Epworth (ESE) e Inventário de Depressão de Beck (IDB). Verificou-se uma alta prevalência de má qualidade de sono (53,4%) e SDE (35,1%) entre os estudantes, sem diferença significante em relação ao sexo para ambas. Foi encontrada correlação positiva entre IDB com IQSP e ESE (r = 0,478; p = 0,000 e r = 0,202; p = 0,000, respectivamente). Os resultados mostraram uma alta prevalência de má qualidade de sono e SDE e ambos os achados apresentaram associação com sintomas depressivos.

Sleep is an essential state for human survival. It has a biological, restorative and energy conservation function for the organism, promoting physical and mental balance. A high prevalence of poor sleep quality and excessive daytime sleepiness (EDS) has been reported among university students from different courses, causing impaired concentration and a drop in academic performance. This study evaluates sleep quality, EDS and their possible associations with depressive symptoms in dentistry students. A cross-sectional descriptive research was conducted with 251 students from the Dentistry Course at the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará. Variables of interest were assessed by Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Beck Depression Inventory (BDI). Results show a high prevalence of poor sleep quality (53.4%) and EDS (35.1%) among students, with no significant difference regarding gender. BDI had a positive correlation with PSQI and ESS (r= 0.478, p= 0.000; and r= 0.202, p =0.000, respectively). Both findings were associated with depressive symptoms.

El sueño es un estado esencial para la supervivencia humana, tiene una función biológica, reparadora y de conservación de energía para el organismo, favoreciendo el equilibrio físico y mental. Se ha reportado una alta prevalencia de mala calidad del sueño y somnolencia diurna excesiva (SDE) en estudiantes universitarios de diferentes carreras que provoca alteración de la concentración y caída del rendimiento académico. El objetivo de este trabajo fue evaluar la calidad del sueño, la SDE y sus posibles asociaciones con síntomas depresivos en estudiantes de odontología. Se realizó un estudio descriptivo transversal con 251 estudiantes de la carrera de Odontología de la Facultad de Farmacia, Odontología y Enfermería de la Universidad Federal de Ceará. Los instrumentos utilizados fueron el Índice de Calidad del Sueño de Pittsburgh (PSQI), la Escala de Somnolencia de Epworth (ESS) y el Inventario de Depresión de Beck (BDI). Hubo una alta prevalencia de mala calidad del sueño (53,4%) y SDE (35,1%) entre los estudiantes, sin diferencia significativa en relación con el género para ambos. Se encontró una correlación positiva entre BDI con PSQI y ESS (r= 0,478; p= 0,000 y r= 0,202; p = 0,000, respectivamente). Los resultados mostraron una alta prevalencia de mala calidad del sueño y SDE, y ambos hallazgos se asociaron con síntomas depresivos.

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

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

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

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

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

Repercussões da pandemia de Covid-19 na alimentação, no estilo de vida e no cuidado com a saúde bucal em uma população pediátrica Brasileira / Repercussions of the Covid-19 pandemic on food, lifestyle, and oral health care in a Brazilian pediatric population

Objetivo: avaliar o impacto da pandemia de COVID-19 durante o isolamento mais rígido (lockdown) nos hábitos alimentares, no estilo de vida e na higiene bucal de crianças atendidas na clínica de Odontopediatria do Curso de Odontologia da Universidade Federal do Ceará. Métodos: foi realizado um estudo observacional transversal, em que foram entrevistados 50 pais e/ou responsáveis legais de crianças de 3-9 anos de idade. O questionário aplicado, composto por 47 questões, incluiu a versão traduzida em português do Brasil do Índice de Qualidade da Dieta Mediterrânea em Crianças e Adolescentes (KIDMED). Os dados foram tabulados no Microsoft Excel® e exportados para o software SPSS versão 20.0. Após categorização, as análises foram realizadas, utilizando os testes de Qui-quadrado de Pearson ou Exato de Fisher (p<0,05) e expressos em forma de frequência absoluta e percentual. Resultados: durante o lockdown, as crianças apresentaram altas porcentagens para consumo de açúcares fermentados (37; 74,0%), sedentarismo (36; 72,0%) e cuidados adequados com a higiene oral, incluindo uso de dentifrício fluoretado (49; 98,9%) e escovação noturna (41; 82,0%). Ademais, observou-se manutenção/aumento da variação do número de refeições estatisticamente significativo para as crianças que aumentaram a ingestão de alimentos açucarados (p=0,003) e tornaram-se sedentárias (p=0,022). Conclusões: apesar da dieta mais açucarada durante o lockdown, sugere-se um controle do risco de cárie, visto que a maioria das crianças manteve bons hábitos de higiene oral. Entretanto, tais hábitos alimentares aliados ao sedentarismo expõem o indivíduo ao risco de condições sistêmicas importantes, como obesidade e diabetes tipo 2.

Objective: to evaluate the impact of the COVID-19 pandemic during the stricter isolation (lockdown) on eating habits, lifestyle, and oral hygiene of children treated at the Pediatric Dentistry clinic of the Dentistry course at the Federal University of Ceará. Methods: a cross-sectional observational study was carried out, in which 50 parents and/or legal guardians of children aged 3-9 years were interviewed. The applied questionnaire consisting of 56 questions included the Brazilian Portuguese version of the Quality Index of the Mediterranean Diet in Children and Adolescents (KIDMED). Data were tabulated in Microsoft Excel® and exported to SPSS version 20.0 software. After categorization, analyzes were performed using Pearson's Chi-square or Fisher's exact tests (p<0.05) and expressed as absolute and percentage frequencies. Results: children showed a high percentage of consumption of fermented sugars (37; 74.0%), a sedentary lifestyle (36; 72.0%), and adequate care with oral hygiene, including the use of fluoride toothpaste (49; 98.9%), and night brushing (41; 82.0%) during the lockdown. Furthermore, a statistically significant maintenance/increase in the variation in the number of meals was observed for children who increased their intake of sugary foods (p=0.003) and became sedentary (p=0.022). Conclusions: despite the sugary diet during the lockdown, control of the risk of caries is suggested since most children maintained good oral hygiene habits. However, such eating habits combined with a sedentary lifestyle expose the individual to the risk of important systemic conditions, such as obesity and type 2 diabetes.

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

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

Dental treatment before surgery in a patient with cleft lip and palate: case report / Efeito do Cissus quadrangularis na cicatrização de fraturas em animais de laboratório

Introduction: orofacial clefts are common congenital malformations with an important social, psychological, and economic impact. The treatment of this condition may include different surgical procedures that previously require an adequate oral condition. Case report: we report a case of dental treatment before palatoplasty in a male patient of 17 years-old with bilateral cleft lip and palate and lesion in the jugal mucosa. Final considerations: the adequacy of the oral environment is a fundamental step in the treatment of patients with orofacial clefts and aims to restore oral health regardless of the degree of complexity of the dental treatment through the reduction of the pathogenic microbiota, elimination of retentive niches, instructions on diet and adequate oral hygiene and constant patient motivation.

Objetivos: as fissuras orofaciais são malformações congênitas comuns, com importante impacto social, psicológico e econômico. O tratamento dessa condição pode incluir vários procedimentos cirúrgicos que requerem previamente uma adequada condição bucal. Relato de caso: Relatamos o caso de tratamento odontológico prévio a palatoplastia em um paciente do gênero masculino de 17 anos de idade, com fissura transforame incisivo bilateral e lesão em mucosa jugal. Considerações finais: A adequação do meio bucal é uma etapa fundamental no tratamento de pacientes com fissuras orofaciais e visa restabelecer a saúde bucal independente do grau de complexidade do tratamento odontológico por meio da redução da microbiota patogênica, eliminação de nichos retentivos, orientações sobre dieta e higiene bucal adequada e motivação constante do paciente.

Oral health aspects in sporadic and familial primary hyperparathyroidism.

Background: Primary hyperparathyroidism (pHPT) is the third most common endocrinopathy, affecting 1-3% of postmenopausal women, with a total incidence of 21.6 cases per 100,000 people in the adult population. This study aimed to analyze the oral health and related aspects of individuals with pHPT. Material and Methods: A cross-sectional observational study was carried out on 51 patients diagnosed with pHPT associated with multiple endocrine neoplasia type 1 (MEN-1) (G1) or sporadic pHPT (G2). The oral aspects investigated were periodontal parameters, salivary flow, presence of dental caries, number of restored or missing teeth, and presence of tori. The biochemical parameters were collected in periods close to the dental evaluation. Results: In G1, 29 individuals (19 females) aged 40.24±13.06 years were included; in G2, 22 individuals (21 females) aged 64.09±10.01 years were included. Grade 2 mobility (p=0.031), mean probing depth (p<0.001), loss of clinical insertion level (p<0.001), gingival bleeding (p=0.009), and presence of palatine tori (p=0.007) were higher in G1. A higher mean of tooth loss (17.90±13.42; p=0.031), teeth with active and/or inactive caries (p<0.001), and visual change in enamel/enamel breakdown (p<0.001) were also observed in G1. Most patients were 50 years old or younger, with a higher prevalence of older individuals in G2 (p<0.001). G1 showed low socioeconomic status and G2 medium-high status (p<0.001). Conclusions: Despite the greater number of younger individuals, higher tooth loss and periodontal changes were observed in G1 patients. Differences in the degree of severity of pHPTor socioeconomic status alone could not explain these findings. Key words:Oral health, Primary hyperparathyroidism, Multiple endocrine neoplasia type 1, osteopenia, osteoporosis.

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

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

Does Platelet-Rich Fibrin Prevent Hemorrhagic Complications After Dental Extractions in Patients Using Oral Anticoagulant Therapy?

PURPOSE: The number of anticoagulated patients requiring dental extractions and other minor dentoalveolar surgical procedures has increased significantly. The purpose of this study was to determine whether the use of platelet-rich fibrin (PRF) prevents hemorrhagic complications after dental extractions in patients being treated with oral anticoagulants. METHODS: A 2-phase PROSPERO-registered systematic review of published within-subject controlled trials (CRD42020186678) was conducted in accordance with the PRISMA statement. Searches were conducted through Medline via PubMed, Web of Science, LILACS, Central Cochrane, Scopus, DOSS, and Google Scholar, until May 2020. The predictor variable was the study group (PRF vs use/non-use of other hemostatic agents). The main outcome of interest was the risk of bleeding after tooth extraction and the covariates were postoperative complications. Data analysis included synthesis of results, risk of bias (RoB) evaluation, meta-analysis (random effects; I²-based heterogeneity; 95% confidence), and certainty of evidence assessment. RESULTS: From a total of 216 articles, 3 articles (low-moderate RoB) were included for evaluation in this systematic review and meta-analysis. A total of 130 patients were involved. The outcomes of the meta-analysis showed that the use of PRF in extraction wounds did not reduce the risk of bleeding after extraction in anticoagulated patients (P= .330; I² = 99%). Furthermore, the use of PRF did not improve pain scores (P = .470; I² = 96%) or the risk of postoperative alveolitis (P = .4300; I² = 38%) in anticoagulated patients. The certainty of the evidence ranged from moderate to low. CONCLUSIONS: The findings of this systematic review and meta-analysis suggest that PRF does not prevent hemorrhagic complications after tooth extraction in patients using oral anticoagulant therapy.

Bruxism in children and adolescents with cerebral palsy / Bruxismo em crianças e adolescentes com paralisia cerebral

This study aims to summarize the existing evidence from primary studies in order to answer the following question: "are children and adolescents with cerebral palsy (CP) frequently affected by bruxism?". For such, databases Web of Science, Medline (via PubMed), Lilacs, SciELO, Scopus and Wiley Online Library were used, with the keywords "Cerebral Palsy" and "Bruxism" alone and in combination, without the restriction of the publication date. The search included all articles published until May 2020. A total of 229 publications were found, of which 12 were selected, after careful analysis. Retrospective data analyses, cross-sectional studies and observational casecontrol studies published in English and with samples composed of children and/or adolescents were included. Case reports, literature reviews and studies whose sample consisted of adults-only were excluded. In the evaluated studies, bruxism was present in all samples with cerebral palsy. However, oral signs and symptoms resulting from this parafunction were reported only in three studies, in which the presence of dental wear and pain was evaluated. Therefore, bruxism in children and adolescents with cerebral palsy is a frequent oral condition, however, knowledge about the associated and risk factors for the occurrence of this problem in these patients remains limited.

Esse estudo tem como objetivo resumir as evidências existentes de estudos primários, a fim responder à seguinte questão: "crianças e adolescentes com paralisia cerebral (PC) são frequentemente afetados pelo bruxismo?". Para tal, foram realizadas buscas nas bases de dados Web of Science, Medline (via PubMed), Lilacs, SciELO, Scopus and Wiley Online Library, utilizando os descritores "Paralisia Cerebral" e "Bruxismo" em inglês, e de forma associada, sem que houvesse delimitação de intervalo de tempo. A busca incluiu todos os artigos publicados até maio de 2020. Foi encontrado um total de 229 publicações, das quais foram selecionadas 12, após análise criteriosa das mesmas. Foram incluídas análises retrospectivas de dados, estudos transversais e estudos observacionais de caso-controle publicados em inglês e com amostras compostas por crianças e/ou adolescentes. Foram excluídos os relatos de casos, as revisões de literatura e os estudos cuja amostra era composta apenas por adultos. Nos estudos avaliados, o bruxismo esteve presente em todas as amostras com paralisia cerebral. Contudo, sinais e sintomas orais, decorrentes dessa para função foram relatados apenas em três estudos, nos quais se avaliou presença de desgastes dentários e dor. Assim sendo, o bruxismo em crianças e adolescentes com paralisia cerebral é uma condição oral frequente, no entanto, o conhecimento sobre os fatores associados e os fatores de risco para a ocorrência desse problema nesses pacientes permanece limitado.

Microtomographic analysis of the effect of sodium alendronate on orthodontic movement in rats.

OBJECTIVE: To evaluate the effect of sodium alendronate on orthodontic tooth movement in rats using microtomographic analysis. SETTINGS AND SAMPLE POPULATION: Thirty male Wistar rats (Rattus norvegicus) were divided into three groups of 10 rats and administered saline (control), 1 mg/kg sodium alendronate or 6 mg/kg sodium alendronate, respectively. MATERIALS AND METHODS: The drug was administered once per week for 5 weeks by gavage. Orthodontic movement was induced during the last 2 weeks of medication administration by inserting a closed nickel-titanium spring between the left upper first molar and central incisors. The opposite side served as the control. Tooth movement and bone trabeculation in the furcation region were evaluated by microtomographic analysis in the first (moved) and third (static) molars. The data were subjected to one-way or two-way ANOVA and Bonferroni test (P < .05). RESULTS: The microtomographic images of the group that received 6 mg/kg sodium alendronate demonstrated significantly less tooth movement (P = .048), less space between the trabeculae (P = .031) and greater number of bone trabeculae (P = .033) compared to the other groups. There were no statistically significant differences in bone volume and mean trabecular thickness between the three groups. The static teeth did not show the same alterations (P > .05). CONCLUSION: Sodium alendronate treatment reduced tooth movement in rats.

Salivary immunoglobulins (A, G, and M) in type 1 diabetes mellitus patients: A PROSPERO-registered systematic review and meta-analysis.

OBJECTIVE: To assess the difference in the salivary levels of immunoglobulins between patients with type 1 diabetes mellitus (DM1) and healthy controls. DESIGN: This systematic review was registered on the PROSPERO (CRD42020159198) database. All references were cross-checked and the risk of bias assessment was conducted using the Newcastle-Ottawa Scale. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to appraise the quality of evidence. The standardized mean difference and Cohen's d as the effect size were used in the meta-analysis. I-square statistics was used to estimate heterogeneity. Analysis was performed using the RevMan® software (p < 0.05) with a 95 % confidence interval. RESULTS: Of the total 92 articles, 9 were selected for this study. The meta-analysis included 333 DM1 patients and 325 healthy controls. DM1 patients showed a significant reduction in salivary flow (p = 0.0008; Cohen's d= -0.19, CI 95 %= -0.33, -0.05), although not significant enough to modify the IgA concentration (p = 0.120; Cohen's d = 0.58, CI 95 %= -0.15, 1.32). However, DM1 increased IgA concentration by reducing salivary flow (Cohen's d = 0.84; CI 95 % = 0.36, 1.32), with a strong estimate of effect (p = 0.0006). Regarding IgG, no significant change was noted with DM1 in the patient's saliva (p = 0.420). Furthermore, there was no significant variation in the salivary IgM levels (p = 0.300). CONCLUSIONS: The data suggest that the salivary levels of the evaluated immunoglobulins do not seem to be altered in DM1 patients when compared to that in healthy controls. However, the increase in IgA salivary concentration was dependent on total protein estimation.

Compositional and microhardness findings in tooth affected by X-linked hypophosphatemic rickets.

BACKGROUND: This study aimed to evaluate the X-linked hypophosphatemic rickets (XLHR)-related compositional and microhardness tooth aspects. MATERIAL AND METHODS: One affected and one non-affected teeth by XLHR were sectioned transversely, and each section was separated for Micro-Raman spectroscopy, Knoop microhardness and scanning electron microscopy with energy dispersive x-ray microanalysis (SEM-EDS). The outcomes of these analyses were assessed. RESULTS: Outcomes of Raman analysis of inorganic/organic components (~958/~1250+~1450 cm-1) and carbonate/phosphate (~1070/~958 cm-1) ratios showed areas of altered enamel and dentin (interglobular dentin, calcospherites, and mantle dentin) with an increase of inorganic content in the rickets tooth. Microhardness reduction was observed in the affected tooth, with a more evident drop in regions of mantle dentin, interglobular dentin, and calcospherites. SEM-EDS analysis showed demonstrated the absence of calcium and phosphorus in interglobular spaces. CONCLUSIONS: In conclusion, compositional and structural deficiencies were observed in deciduous tooth affected by XLHR. Also, it was observed the absence of hydroxyapatite in the interglobular dentin by using Raman spectroscopy analysis. Key words:Dentin, dentin permeability, X-linked hypophosphatemic rickets, tooth, tooth calcification, Raman spectroscopy.

RT-qPCR study of COX-1 and -2 genes in oral surgical model comparing single-dose preemptive ibuprofen and etoricoxib: A randomized clinical trialy.

BACKGROUND: This study aimed to evaluate the gene expression of cyclooxygenases (COXs) in an oral model of preemptive analgesia. MATERIAL AND METHODS: Gingival tissue was collected during extraction of lower third molars from a randomized, triple-blind, split-mouth and placebo-controlled study. The eligible patients were randomly sorted to receive a single dose either of ibuprofen 400mg, or etoricoxib 120 mg or a placebo, one hour prior to surgery. The temporal course of RNAm was evaluated for COX-1 and -2 by means of a quantitative polymerase chain reaction in real time (RT-qPCR) at time zero and 30 minutes after the surgical procedure began, and it was correlated with clinical parameters (pain and maximum mouth opening). RESULTS: There was a significant increase in COX-1 expression between T0 and T30 in ibuprofen (p=0.004) and etoricoxib (p=0.010) groups. As regards COX-2, there were increases from T0 to T30 in all groups (placebo, p=0.012; ibuprofen, p<0.001; etoricoxib, p<0.001). All groups showed a significant decrease in COX-2:COX-1 ratio from T0 to T30 (placebo, p=0.013; ibuprofen, p<0.001; etoricoxib, p=0.047). Experimental groups showed a significant correlation between COX-1 and COX-2 levels and clinical pain parameters. CONCLUSIONS: The present preemptive analgesia study concludes that COX-2 RNAm induction was directly linked to third molar-related tissue inflammation and that the relation between COX-1 and COX-2 levels were inversely proportional to the preemptively administered nonsteroidal anti-inflammatory drugs COX-2 selectivity. Key words:Preemptive analgesia, dental extraction, cyclooxygenases, real-time polymerase chain reaction.

Mandibular incisive canal-related prevalence, morphometric parameters, and implant placement implications: a multicenter study of 847 CBCT scans

BACKGROUND: This study evaluated the epidemiological and morphological features of the mandibular incisive canal (MIC) using cone beam computed tomography (CBCT) in a significant sample of subjects in Brazil. MATERIAL AND METHODS: This retrospective, multicenter study assessed 847 CBCT scans performed at four oral imaging centers. The sample comprised CBCT images acquired from dentate individuals who presented at least from tooth 35 to tooth 45 in the anterior mandible region. Data regarding patient sex and age, and MIC linear measurements (length and diameter in mm), anatomical distances (to the alveolar, buccal and lingual cortexes, inferior border of the mandible, and adjacent teeth apexes), and location were obtained. RESULTS: The MIC was more prevalent in women (76.3% [p < 0.001]) between the fourth and sixth decades of life (p < 0.001). It was present bilaterally (p < 0.001) and exhibited a mean length of 7.7 mm (standard deviation [SD]=3.7 mm). Spearman correlation and logistic regression analysis revealed collinearity between age and linear measurements (p < 0.05). The mean distances varied from the initial to the final portion of the MIC, respectively, in relation to the buccal cortex (mean = 2.6 mm, SD = 1.27; mean=3.96 mm; SD =1 .43), to lingual cortex (mean=5.13 mm; SD=1.7; mean = 4.61 mm, SD = 1.65), and to the inferior mandibular border (mean = 9.32 mm, SD = 1.92; mean=8.76 mm, SD = 2.07 mm). The difference in the proximity of the MIC to the apex of the inferior lateral incisor was statistically significant (p < 0.05). CONCLUSIONS: Results of this study revealed a high prevalence of MIC with a bilateral pattern in women who were between the fourth and sixth decades of life. Both the distance between the MIC and the lingual cortex of the mandibular alveolar bone, and the diameter of the MIC, decreased as its trajectory assumed a more anterior position

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Preemptive use of oral nonsteroidal anti-inflammatory drugs for the relief of inflammatory events after surgical removal of lower third molars: A systematic review with meta-analysis of placebo-controlled randomized clinical trials.

PURPOSE: To investigate the effectiveness of preemptive analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) for the relief of inflammatory events (pain, edema, and trismus) after surgical removal of third molars. MATERIALS AND METHODS: A two-phase PROSPERO-registered systematic review was conducted in accordance with the PRISMA statement. PubMed, Scopus, Web of Science, COCHRANE, LILACS, DOSS, and gray literature were searched using the following terms (MeSH) or their combinations: molar, third; anti-inflammatory agents, non-steroidal; analgesia; preoperative period; pain management. RESULTS: From a total of 2903 articles, 31 (n = 2184 subjects) were selected. All studies presented a low risk of bias but exhibited high heterogeneity in methodology. Ten studies were selected for the meta-analysis. Preemptive analgesia for removal of third molars reduced average pain scores, especially those 1 h and 6 h after surgery (n = 151, p < 0.001, 95% CI = -2.81 to -0.97), reduced the average consumption of medication, and decreased the number of patients requiring medication without affecting the average time for its first consumption. CONCLUSION: In summary, most NSAIDs showed good results for inflammatory events and reduced average pain scores and consumption of rescue medication. However, more homogeneous and well-delineated clinical studies are necessary to determine a possible association between NSAIDs and the relief of inflammatory events.

Pharmacological Characterization and Raman Spectroscopy Evaluation of Oral and Maxillofacial Surgery-Related Carnoy´S Solution Modified by Different Viscosity Agents.

BACKGROUND: There are several lesions of odontogenic and non-odontogenic origin in the oral cavity, such as odontogenic keratocyst, as well as many treatment options for such lesions. In order to reduce recurrence due to conservative treatments and less aesthetic and functional impairment of the patient (radical therapies), Carnoy's solution has been used as an adjuvant to surgery, showing satisfactory results. Its application is not standardized, presenting risks to adjacent tissues. Thus, we characterized the Carnoy's solution with different viscosity agents to enhance its applicability. MATERIAL AND METHODS: All solutions prepared (Carnoy with and without chloroform) were added with viscosity agent: ethyl cellulose, propylene glycol, and glycerol totaling eight solutions. The pharmacological characterization of the solutions was performed by determining the mass density and relative density (using a clean and dry pycnometer), pH (using pH meter), and concentration of Fe3+ (using ultraviolet/visible spectroscopy). The analyses of the inorganic components were determined by Raman micro spectrometry. Data were analyzed with statistical program BIOESTAT 5.3. RESULTS: Solutions with ethyl cellulose were discarded due to precipitate formation and suspension of the viscosity agent. In the other solutions, viscosity increase (propylene glycol solutions) and acidic pH were observed mainly in the glycerol group. The ferric chloride characterized as a hemostatic agent had its concentration increased with the use of thickening agents, theoretically favoring its action. CONCLUSION: The similarity of the propylene glycol and glycerol molecules justifies the Raman spectra of these substances to be similar and the difficulty in obtaining a "fingerprint".
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Dental alterations on panoramic radiographs of patients with osteogenesis imperfecta in relation to clinical diagnosis, severity, and bisphosphonate regimen aspects: a STROBE-compliant case-control study.

OBJECTIVE: This study aimed to assess the prevalence of dental findings on panoramic radiographs (PRs) of patients with osteogenesis imperfecta (OI) and correlate these results with epidemiologic and medical data. STUDY DESIGN: A case-control study was conducted with 24 patients with OI and 48 sex- and age-matched controls. Demographic, clinical, and bisphosphonate regimen-related data were recorded. The outcome variables were the presence or absence of dental alterations in PRs. Mann-Whitney U test, Pearson's χ2 test, and multinomial logistic regression analysis (95% confidence interval) were used (significance level of 5%). RESULTS: OI type 4 demonstrated a high prevalence (62.5%), followed by type 1 (37.5%). With regard to prevalence associated with severity, the moderate form was the most prevalent (P = .028). The mean time of intravenous pamidronate regimen was 6.6 ± 4.4 years. Dentinogenesis imperfecta was observed in 75% of patients with OI, and this group showed a high prevalence of dental abnormalities in comparison with controls (P < .05). Bisphosphonate therapy was associated with ectopic teeth (P = .007) and tooth impaction (P = .033). Pulp obliteration was significant with bisphosphonate treatment over a period of 7 years (P = .026). CONCLUSIONS: This study found a significant prevalence of dental alterations in patients with OI, and certain alterations were associated with bisphosphonate therapy, indicating its influence on the dentin-related physiopathology.