Activation of gelatinases in permanent human teeth after different experimental radiotherapy protocols.

The objective of this study was to compare the activation of gelatinases in dentin-enamel junction (DEJ) and underlying dentin of permanent teeth after experimental radiotherapy in conventional and hypofractionated modalities. Newly extracted third molars (n = 15) were divided into three experimental radiotherapy groups: control, conventional (CR), and hypofractionated (HR) (n = 5 per group). After in vitro exposure to ionizing radiation, following standardized protocols for each modality, a gelatinous substrate was incubated on the tooth slices (n = 10 per group). Activation of gelatinases was measured by in situ zymography, expressed in arbitrary fluorescence units (mm2) from three tooth regions: cervical, cuspal, and pit. Fluorescence intensity was compared among radiotherapy protocols and tooth regions in each protocol, considering a significance level of 5%. Considering all tooth regions, the fluorescence intensity of the CR group was higher than the HR and control groups, both in DEJ and underlying dentin (p <0.001). In addition, the fluorescence intensity was higher in underlying dentin when compared to DEJ in all groups (p <0.001). Considering each tooth region, a statistically significant difference between CR and HR was only observed in the pit region of underlying dentin (p <0.001). Significant and positive correlations between fluorescence intensities in DEJ and underlying dentin were also observed (p <0.001). Experimental radiotherapy influenced the activation of gelatinases, as well as exposure to the conventional protocol can trigger a higher activation of gelatinases when compared to hypofractionated, both in DEJ and underlying dentin.

Caries-related hospital morbidity in the Brazilian Unified Health System from 2008 to 2022.

Dental caries is an important Public Health issue. However, the treatment of this disease in tertiary dental care requires further investigation. Therefore, the objective of this study was to evaluate caries-related hospital morbidity in the Brazilian Unified Health System (SUS) from 2008 to 2022. An ecological study was conducted with secondary data on caries-related Hospital Admission Authorizations (AIH) and in-hospital dental procedures (IDP). Data were collected nationwide and statistical analysis was performed with a significance level (p) of 5%. In the last 15 years, 3,474 caries-related AIH and 63,657 IDP were approved within SUS. There was a significant upward trend in the number of caries-related AIH (p = 0.018) and a stationary trend in the number of caries-related IDP (p = 0.841). Moreover, from 2008 to 2022, R$ 1,160,843.09 was allocated for caries-related AIH. Hospital mortality was 0.29% (10 deaths), and 75.1% were elective inpatient admissions. Among SUS users, adults constituted the majority (49%), with a higher frequency of males (59.8%) and whites (46.2%). The most frequent type of caries-related IDP was restoration of permanent teeth (55.3%). Nonetheless, during the COVID-19 pandemic years, significant reductions in caries-related AIH and IDP within the SUS were observed (all p <0.05). Thus, within the SUS, caries-related tertiary dental care has shown a specific pattern over the last 15 years, including an increase in hospitalizations and a high number of in-hospital dental procedures, especially before the COVID-19 pandemic onset.

Efficacy of ClinproTMXT Varnish surrounding brackets on the enamel surface of white spot lesion.

Orthodontics patients usual develop demineralization and present cavity caries lesions after six months. Minimally invasive procedures have been the goal in modern dental practice. The aim of this study was to evaluate the effect of ClinproTMXT Varnish, on the enamel surface roughness and severity of white spot lesions. Twenty premolars were submitted to bond brackets and experimental induction of demineralization and randomly divided into 2 groups: GI - fluoride varnish (Colgate Duraphat®); GII - Ionomeric Sealant (ClinproTMXT Varnish). The treatment was applied around the brackets. The surface roughness of specimens was analyzed, before treatment and 12 weeks after treatment by laser confocal microscopy, and the severity of the white spot lesion was by laser fluorescence device. The data were analyzed by non-parametric Wilcoxon and Mann-Whitney Test, at 5% significance, roughness percentage reduction was performed. The severity of demineralization decreased in both, GI (p = 0.005) and GII (p = 0.019). Enamel superficial roughness levels decreased in GI and GII. As well as the roughness percentage, being more expressive in the ClinproTMXT Varnish group (85,09%). Colgate Duraphat® or Clinpro™ XT Varnish reduced the severity of the demineralization and decreased the superficial roughness on the enamel. The Clinpro™ XT Varnish was superior to superficial roughness on enamel.

Effect of chlorhexidine mouthwashes on periodontal parameters and extrinsic tooth staining in orthodontic patients.

INTRODUCTION: Periodontal health and biofilm control are primordial to success in orthodontic treatment. This study aimed to evaluate the effect of chlorhexidine (CHX) mouthwashes on periodontal status and extrinsic tooth staining in orthodontic patients. METHODS: Thirty-three patients of both sexes, aged 11-33 years, under orthodontic treatment with fixed appliances at <16 months, were randomly distributed into 2 groups. In the control group, patients received mechanical hygiene instruction, and in the experimental group, patients also used CHX wash twice a week for 60 days. The effectivity of the protocols was evaluated using the plaque, gingival, gingival bleeding, and discoloration indexes before the hygiene protocol was applied, 15, 30, and 60 days after protocol implementation. RESULTS: In the experimental group, there was a decrease in the plaque, gingival, and gingival bleeding indexes at the different evaluation periods (P <0.05). In addition, there was a significant difference in the discoloration index at 60 days compared with initial time points after implementing hygiene protocols in the experimental group (P <0.05). In contrast, there were no significant differences in plaque, gingival, gingival bleeding, and discoloration indexes in the control group at any time (P >0.05). CONCLUSIONS: CHX mouthwash administered 30 days, twice a week, significantly improved the periodontal status with mild brown staining. After this period, expressive extrinsic tooth staining was observed.

Efficacy of ClinproTMXT Varnish surrounding brackets on the enamel surface of white spot lesion

Abstract Orthodontics patients usual develop demineralization and present cavity caries lesions after six months. Minimally invasive procedures have been the goal in modern dental practice. The aim of this study was to evaluate the effect of ClinproTMXT Varnish, on the enamel surface roughness and severity of white spot lesions. Twenty premolars were submitted to bond brackets and experimental induction of demineralization and randomly divided into 2 groups: GI - fluoride varnish (Colgate Duraphat®); GII - Ionomeric Sealant (ClinproTMXT Varnish). The treatment was applied around the brackets. The surface roughness of specimens was analyzed, before treatment and 12 weeks after treatment by laser confocal microscopy, and the severity of the white spot lesion was by laser fluorescence device. The data were analyzed by non-parametric Wilcoxon and Mann-Whitney Test, at 5% significance, roughness percentage reduction was performed. The severity of demineralization decreased in both, GI (p = 0.005) and GII (p = 0.019). Enamel superficial roughness levels decreased in GI and GII. As well as the roughness percentage, being more expressive in the ClinproTMXT Varnish group (85,09%). Colgate Duraphat® or Clinpro™ XT Varnish reduced the severity of the demineralization and decreased the superficial roughness on the enamel. The Clinpro™ XT Varnish was superior to superficial roughness on enamel.

Resumo Pacientes ortodônticos geralmente desenvolvem desmineralização e apresentam lesões de cárie após seis meses de tratamento. Procedimentos minimamente invasivos têm sido o objetivo na prática odontológica moderna. O objetivo deste estudo foi avaliar o efeito do ClinproTM XT selante ionomérico, ao redor do bráquete, com relação a rugosidade superficial do esmalte e a severidade da lesão induzida. Vinte pré-molares foram submetidos a colagem de bráquetes e indução experimental de desmineralização e divididos aleatoriamente em 2 grupos: GI - verniz fluoretado (Colgate Duraphat®); GII - Selante Ionomérico (ClinproTM XT). O tratamento foi aplicado ao redor dos bráquetes. A rugosidade da superfície dos espécimes foi analisada, antes do tratamento e 12 semanas após o tratamento por microscopia confocal a laser e severidade da lesão de mancha branca por dispositivo de fluorescência a laser. Os dados foram analisados pelo teste não paramétrico de Wilcoxon e Mann-Whitney, a 5% de significância. A taxa de redução da lesão foi calculada. A severidade da desmineralização diminuiu tanto no GI (p = 0,005) quanto no GII (p = 0,019). Os níveis de rugosidade superficial do esmalte diminuíram no GI e GII, assim como o percentual de rugosidade, sendo mais expressivo no grupo ClinproTMXT (85,09%). Colgate Duraphat® e Clinpro™ XT reduziram a severidade da desmineralização e diminuíram a rugosidade superficial do esmalte. O selante ionomérico Clinpro™ XT foi superior na redução percentual de rugosidade.

Activation of gelatinases in permanent human teeth after different experimental radiotherapy protocols

Abstract The objective of this study was to compare the activation of gelatinases in dentin-enamel junction (DEJ) and underlying dentin of permanent teeth after experimental radiotherapy in conventional and hypofractionated modalities. Newly extracted third molars (n = 15) were divided into three experimental radiotherapy groups: control, conventional (CR), and hypofractionated (HR) (n = 5 per group). After in vitro exposure to ionizing radiation, following standardized protocols for each modality, a gelatinous substrate was incubated on the tooth slices (n = 10 per group). Activation of gelatinases was measured by in situ zymography, expressed in arbitrary fluorescence units (mm2) from three tooth regions: cervical, cuspal, and pit. Fluorescence intensity was compared among radiotherapy protocols and tooth regions in each protocol, considering a significance level of 5%. Considering all tooth regions, the fluorescence intensity of the CR group was higher than the HR and control groups, both in DEJ and underlying dentin (p <0.001). In addition, the fluorescence intensity was higher in underlying dentin when compared to DEJ in all groups (p <0.001). Considering each tooth region, a statistically significant difference between CR and HR was only observed in the pit region of underlying dentin (p <0.001). Significant and positive correlations between fluorescence intensities in DEJ and underlying dentin were also observed (p <0.001). Experimental radiotherapy influenced the activation of gelatinases, as well as exposure to the conventional protocol can trigger a higher activation of gelatinases when compared to hypofractionated, both in DEJ and underlying dentin.

Resumo O objetivo deste estudo foi comparar a ativação de gelatinases na junção dentina-esmalte (DEJ) e na dentina subjacente de dentes permanentes após a radioterapia experimental nas modalidades convencional e hipofracionada. Os terceiros molares recém-extraídos (n = 15) foram divididos em três grupos de radioterapia experimental: controle, convencional (CR) e hipofracionada (HR) (n = 5 por grupo). Após a exposição in vitro à radiação ionizante, seguindo protocolos padronizados para cada modalidade, um substrato gelatinoso foi incubado nas fatias de dente (n = 10 por grupo). A ativação das gelatinases foi medida por zimografia in situ, expressa em unidades arbitrárias de fluorescência (mm2) de três regiões do dente: cervical, cúspide e fossa. A intensidade da fluorescência foi comparada entre os protocolos de radioterapia e as regiões do dente em cada protocolo, considerando um nível de significância de 5%. Considerando todas as regiões do dente, a intensidade de fluorescência do grupo CR foi maior do que a dos grupos HR e controle, tanto no DEJ quanto na dentina subjacente (p <0,001). Além disso, a intensidade da fluorescência foi maior na dentina subjacente quando comparada à DEJ em todos os grupos (p <0,001). Considerando cada região do dente, uma diferença estatisticamente significativa entre CR e HR foi observada apenas na região da fossa da dentina subjacente (p <0,001). Também foram observadas correlações significativas e positivas entre as intensidades de fluorescência no DEJ e na dentina subjacente (p <0,001). A radioterapia experimental influenciou a ativação das gelatinases, assim como a exposição ao protocolo convencional pode desencadear uma maior ativação das gelatinases quando comparada ao hipofracionamento, tanto no DEJ quanto na dentina subjacente.

Caries-related hospital morbidity in the Brazilian Unified Health System from 2008 to 2022

Abstract Dental caries is an important Public Health issue. However, the treatment of this disease in tertiary dental care requires further investigation. Therefore, the objective of this study was to evaluate caries-related hospital morbidity in the Brazilian Unified Health System (SUS) from 2008 to 2022. An ecological study was conducted with secondary data on caries-related Hospital Admission Authorizations (AIH) and in-hospital dental procedures (IDP). Data were collected nationwide and statistical analysis was performed with a significance level (p) of 5%. In the last 15 years, 3,474 caries-related AIH and 63,657 IDP were approved within SUS. There was a significant upward trend in the number of caries-related AIH (p = 0.018) and a stationary trend in the number of caries-related IDP (p = 0.841). Moreover, from 2008 to 2022, R$ 1,160,843.09 was allocated for caries-related AIH. Hospital mortality was 0.29% (10 deaths), and 75.1% were elective inpatient admissions. Among SUS users, adults constituted the majority (49%), with a higher frequency of males (59.8%) and whites (46.2%). The most frequent type of caries-related IDP was restoration of permanent teeth (55.3%). Nonetheless, during the COVID-19 pandemic years, significant reductions in caries-related AIH and IDP within the SUS were observed (all p <0.05). Thus, within the SUS, caries-related tertiary dental care has shown a specific pattern over the last 15 years, including an increase in hospitalizations and a high number of in-hospital dental procedures, especially before the COVID-19 pandemic onset.

Photoelastic, microhardness and roughness analysis of zirconia and stainless steel crowns for primary molars.

PURPOSE: To compare the stress distribution through photoelasticity, microhardness and roughness of intact crowns of primary molars (CC) and the preformed crowns of stainless steel (SSC) and zirconia (ZC) used in dental restorations in pediatric dentistry. METHODS: Six healthy primary molars were selected. For the photoelastic models, the teeth were fixed in photoelastic resin. A load of 100 N was applied, and the models were analyzed by transmission polariscope. The Tardy method was used to quantify the fringe order which calculates the maximum stress (T) value in each selected point. The teeth were prepared for cementation of the crowns. The photoelastic test was repeated for each experimental crown. Knoop microhardness was assessed on the buccal surfaces of the CCs, SSCs, and ZCs using a microhardness tester. Parameters were 50 gf for 5 seconds. Roughness was evaluated using a confocal 3-D laser scanning microscope/software at 216x magnification. Roughness average (Ra) values from each model (expressed in µm) were collected and group means were calculated. The stress distribution, microhardness, and roughness data were compared by using one-way ANOVA and the Tukey's test (α= 0.05). RESULTS: There was no difference in the stress distribution for the CCs, SSCs and ZCs. For the microhardness analysis, the ZCs obtained the highest values compared to the CCs and the SSCs (P< 0.001). The CCs were significantly higher than the SSCs (P= 0.027). There was no difference in roughness for the three models (P= 0.615). The SSCs and ZCs showed satisfactory mechanical behavior. CLINICAL SIGNIFICANCE: The use of preformed crowns, especially those made of esthetic materials, is currently increasing in the field of pediatric dentistry. The knowledge of mechanical properties of stainless steel- and zirconia-prefabricated crowns provides scientific foundation for safe clinical application, especially in primary teeth.

Online teaching, quality of life and anxiety of Brazilian dental professors during the COVID-19 outbreak.

The COVID-19 pandemic led to changes in academic teaching and dental education, but the impact on dental professors' mental health and quality of life remains poorly understood. Thus, the objective of this study was to evaluate the impacts of social distancing and online teaching related to COVID-19 on the quality of life and anxiety of Brazilian dental professors. This was a cross-sectional study conducted from August 2020 to October 2020. Three instruments were used in an online version: a questionnaire about personal data, academic information and online teaching activities, the Generalized Anxiety Disorders 7 (GAD7) scale, and the Abbreviated World Health Organization Quality of Life (WHOQOL-bref) scale. All instruments were sent by e-mail, social media, and messaging apps to private and public universities and professors. Of the 318 responses, 187 (58.8%) were from female professors. Moreover, lack of good internet access and adequate place for online teaching, difficulties in producing teaching materials, and housework roles had a significant impact on the quality of life and anxiety scores (all p-values < 0.05). Also, Brazilian dental professors who declared that they would make greater efforts if the activities were face-to-face had significantly worse quality of life and anxiety scores, and female professors had significantly higher anxiety scores (all p-values < 0.05). These results provide evidence of a negative effect of social distancing and online teaching activities related to COVID-19 outbreak on the health-related quality of life and mental health of Brazilian dental professors.

Online teaching, quality of life and anxiety of Brazilian dental professors during the COVID-19 outbreak

Abstract: The COVID-19 pandemic led to changes in academic teaching and dental education, but the impact on dental professors' mental health and quality of life remains poorly understood. Thus, the objective of this study was to evaluate the impacts of social distancing and online teaching related to COVID-19 on the quality of life and anxiety of Brazilian dental professors. This was a cross-sectional study conducted from August 2020 to October 2020. Three instruments were used in an online version: a questionnaire about personal data, academic information and online teaching activities, the Generalized Anxiety Disorders 7 (GAD7) scale, and the Abbreviated World Health Organization Quality of Life (WHOQOL-bref) scale. All instruments were sent by e-mail, social media, and messaging apps to private and public universities and professors. Of the 318 responses, 187 (58.8%) were from female professors. Moreover, lack of good internet access and adequate place for online teaching, difficulties in producing teaching materials, and housework roles had a significant impact on the quality of life and anxiety scores (all p-values < 0.05). Also, Brazilian dental professors who declared that they would make greater efforts if the activities were face-to-face had significantly worse quality of life and anxiety scores, and female professors had significantly higher anxiety scores (all p-values < 0.05). These results provide evidence of a negative effect of social distancing and online teaching activities related to COVID-19 outbreak on the health-related quality of life and mental health of Brazilian dental professors.

Apical Periodontitis Healing Following Treatment is Impacted by Root Canal Sealer Composition: An in Vivo and in Vitro Investigation

Abstract Objective: To evaluate the periapical healing following root canal treatment in teeth with apical periodontitis (in vivo) and the cytotoxic potential of root canal sealers in vitro. Material and Methods: Apical periodontitis was induced in 60 dogs' teeth and root canals were filled with Sealapex (40 roots), EndoREZ (40 roots), intracanal dressing (20 roots), or left untreated (20 roots). After 30 and 90 days, histopathological analyses were made. In vitro, J774.1 macrophages were stimulated with root canal sealers extracts, cytotoxicity was assessed using lactate dehydrogenase assay, and qRT-PCR was used to analyze TNF-α gene expression. Results: In vivo, smaller apical periodontitis and lower inflammatory cell infiltrate were found in teeth treated with Sealapex compared to EndoREZ. In vitro, EndoREZ was cytotoxic and induced TNF-α gene expression by macrophages differently from Sealapex. Conclusion: Sealapex allowed improved tissue repair following root canal treatment in teeth with apical periodontitis compared to EndoREZ. Synthesis of TNF-α induced by LPS was enhanced by EndoREZ, whereas Sealapex prevented pro-inflammatory gene expression (AU).

Múltiplas lesões dentárias em paciente com Síndrome de Lennox-Gastaut / Multiple dental lesions in a patient with Lennox-Gastaut Syndrome

Introdução: A Síndrome de Lennox-Gastaut (SLG) é uma encefalopatia epiléptica grave na infância. Seu tratamento é complexo, principalmente devido à multiplicidade das crises epilépticas, o que favorece à ocorrência de lesões dentais Objetivo: O objetivo deste relato é apresentar o manejo clínico de um paciente com SLG, vítima de traumas recorrentes, discutir os achados dentais observados e o tratamento odontológico realizado. Relato do caso: Paciente L.H.D.L., do sexo masculino, com 15 anos de idade, apresentando grande acúmulo de biofilme dental, alto risco de cárie, fluorose leve e gengivite generalizada. Clinicamente foi possível observar fratura de esmalte dos dentes 12 e 14. Os dentes 21, 22, 32 e 42 estavam ausentes clinicamente, o que se confirmou radiograficamente. Além disso, notou-se giroversão de 180 graus do dente 11, com a face palatina voltada para a vestibular. O dente apresentou-se com leve alteração de cor, mas com resposta positiva aos testes de vitalidade. Resultados: Técnicas de manejo de comportamental, foram adotadas e orientações quanto à higiene bucal e dietéticas foram fornecidas tanto ao paciente quanto ao seu cuidador. Quatro sessões de profilaxia e aplicação tópica de flúor foram realizadas semanalmente. O tratamento endodôntico foi realizado no dente 12, seguido da restauração de resina composta do dente 12 e 14 e a restauração estética do dente 11 (girovertido). Por fim, foi realizada uma prótese adesiva para restaurar a estética da região de incisivo central superior. Apesar das dificuldades para tratar pacientes com SLG, no presente caso foi possível obter resultados funcionais e estéticos satisfatórios com um diagnóstico e tratamento cuidadoso, envolvendo uma equipe multiprofissional treinada no atendimento de pacientes com necessidades especiais. Conclusão: Pode-se concluir que o cirurgião dentista deve estar familiarizado com as possíveis manifestações bucais da SLG e realizar uma pesquisa criteriosa de sinais de traumatismo dental e, sempre que possível, solicitar um exame radiográfico para que traumatismos não identificados ao exame clínico não passem desapercebidos.

Introduction: Lennox-Gastaut Syndrome (LSG) is a severe childhood epileptic encephalopathy. Its treatment is complex, mainly due to the multiplicity of epileptic crises, which in turn favors the occurrence of dental injuries. Objective: The aim of this case report is to present the clinical management of a patient with LGS, victim of recurrent trauma, discuss the observed dental findings and the dental treatment. Case report: Patient L.H.D.L., male, 15 years old presenting high quantity of oral biofilm, mild fluorosis and generalized gingivitis. Clinically, it was possible to observe enamel fractures of teeth 12 and 14. Teeth 21, 22, 32 and 42 were clinically absent, which was confirmed radiographically. In addition, a 180-degree rotation of tooth 11 was noted, with the palate facing the buccal aspect. The tooth presented a slight change in color, but with a positive response to vitality tests. Results: Behavioral management techniques were adopted and guidelines on oral hygiene and diet were provided to both the patient and their caregiver. Four sessions of prophylaxis and topical application of fluoride were performed weekly. Endodontic treatment was performed on tooth 12, followed by aesthetic restoration of teeth 12 and 14 and esthetic restoration of tooth 11 (rotated). Finally, an adhesive prosthesis was performed to restore the esthetics of the upper central incisor region. Despite the difficulties of treating patients with LGS, in the present case it was possible to obtain satisfactory functional and aesthetic results with a careful diagnosis and treatment, involving a multidisciplinary team trained in the care of patients with special needs. Conclusion: It can be concluded that the dental surgeon must be aware with the possible oral manifestations of GLS and carry out a careful search for signs of dental trauma and, whenever possible, request a radiographic examination so that unidentified traumas on clinical examination do not pass unnoticed.

Tratamento odontológico de paciente com Síndrome de Singleton-Merten / Dental treatment of a patient with Singleton-Merten Syndrome

Introdução: A Síndrome de Singleton-Merten (SMS) é uma doença autossômica dominante hereditária rara caracterizada por alterações cardiovasculares, ósseas e dentais, pouco discutida na literatura em relação ao tratamento odontológico. Objetivo: O objetivo do presente estudo foi relatar o caso de uma paciente com SMS, descrevendo seus aspectos bucais e o plano de tratamento proposto, em conjunto com uma equipe multiprofissional. Relato do caso: Durante a anamnese constatou-se que o paciente apresentava alterações cutâneas decorrentes da síndrome. Os exames clínico, radiográfico e tomográfico revelaram maxila e mandíbula parcialmente edêntulas, ampla reabsorção do osso maxilar, além da maioria dos dentes permanentes incluídos e com raízes curtas. O plano de tratamento multidisciplinar incluiu a extração de dentes com formação radicular deficiente, tração ortodôntica dos caninos superiores incluídos e a confecção de próteses parciais superiores e inferiores removíveis, para reabilitação das funções mastigatória, fonética e estética. Conclusão: É importante ressaltar que durante o atendimento odontológico de pacientes com SMS, deve-se considerar o estado geral de saúde anterior, principalmente em relação às possíveis complicações cardiovasculares existentes, e a necessidade de reabilitação destes pacientes, por apresentarem perda dentária extensa.

Intoduction: Singleton-Merten Syndrome (SMS) is a rare in herited autosomaldominant disorder. Characterized by cardiovascular, bone and dental alterations, little discussed in the literature regarding dental treatment. Objective: The aim of this study was to report the case of a patient with SMS, describing her oral aspects and the proposed treatment plan, together with a multidisciplinary team. Case report: During the anamnesis it was found that the patient has alterations due to the syndrome. Clinical, radiographic and tomographic examinations revealed partially edentulous maxilla and mandible, wide resorption of maxillary bone, in addition to most of the permanent teeth included and with short roots. The multidisciplinary treatment plan included the extraction of teeth with deficient root formation, orthodontic traction of the included upper canines and the making of removable upper and lower partial dentures, for rehabilitation of masticatory, phonetic and aesthetic functions. Conclusion: It is important to emphasize that during dental care of patients with SMS, the previous general state of health should be considered, especially in relation to possible existing cardiovascular complications, and the need for rehabilitation of these patients, since they will present extensive tooth loss.

Web search trends related to oral health issues during the Covid-19 outbreak in Brazil: an infodemiological survey

Objective: To compare the web search trends related to oral health issues during the COVID-19 outbreak with the previous year, focusing on dental trauma (DT), bruxism (BX) and toothache (TA). Methods: It was an infodemiological study carried out using Google Trends tool. Popular terms related to oral health issues investigated were used in Portuguese to retrieve relative search volumes (RSV) normalized by the algorithm. The case period consisted of data relating to the interval from December 12, 2019 to December 12, 2020, while the control period referred to the interval from December 11, 2018 to December 11, 2019. Results: Within the case and control periods, popular terms related to TA were significantly more searched on the web, followed by BX and DT terms (all p-value <0.05). There were higher RSV for all popular terms related to oral health issues investigated during the COVID-19 outbreak than in the previous year (all p-value <0.05), especially in the third and fourth quarters. The mean frequencies were significantly higher in the case period for all oral health issues (all p-value <0.05). Conclusion: In Brazil, it was possible to observe that the web search trends related to oral health issues investigated were greater during the COVID-19 outbreak than in the previous year.

Objetivo: Comparar as tendências de pesquisa na web relacionadas a problemas de saúde bucal durante o surto de COVID-19 com o ano anterior, com foco em trauma dentário (TD), bruxismo (BX) e dor de dente (DD). Métodos: Foi um estudo infodemiológico realizado com a ferramenta Google Trends. Termos populares relacionados aos problemas de saúde bucal investigados foram usados ​​em português para recuperar os volumes relativos de pesquisa (RSV) normalizados pelo algoritmo. O período do caso consistiu em dados referentes ao intervalo de 12 de dezembro de 2019 a 12 de dezembro de 2020, enquanto o período de controle referiu-se ao intervalo de 11 de dezembro de 2018 a 11 de dezembro de 2019. Resultados: Nos períodos de caso e controle, os termos populares relacionados à DD foram significativamente mais pesquisados ​​na web, seguidos pelos termos BX e TD (todos os valores de p<0.05). Houve maior RSV para todos os termos populares relacionados aos problemas de saúde bucal investigados durante o surto de COVID-19 do que no ano anterior (todos os valores de p<0,05), especialmente no terceiro e quarto trimestres. As frequências médias foram significativamente maiores no período do caso para todos os problemas de saúde bucal (todos os valores de p<0,05). Conclusão: No Brasil, foi possível observar que as tendências de buscas na web relacionadas aos problemas de saúde bucal investigados foram maiores durante o surto de COVID-19 do que no ano anterior.

Photosensitizers and exposure times to light showed tissue compatibility in isogenic mice / Fotossensibilizadores e tempo de exposição a luz em relação a compatibilidade de tecidos em ratos isogênicos

Objective: The aim of this study was to evaluate the subcutaneous tissue response after different protocols to photodynamic therapy (PDT). In Phase 1, were tested the diode laser (used for 1min) associated to the photosensitizer phenothiazine chloride solution (PCS) in different concentrations. In Phase 2 ­ the diode laser and LED were tested associated to two different photosensitizers, PCS and Curcumin, in different exposure times of light application. Material and Methods: After 7, 21 and 63-days the animals were euthanized and the subcutaneous tissue processed to histological analysis. Qualitative and semi-quantitative descriptions of the inflammatory process and immunohistochemical technique were performed. The obtained data were analyzed by Kruskal-Wallis and Dunn's post-test (α= 0.5). Results: On Phase 1, the tissue response was very similar among the groups. For the inflammatory infiltrate, PCS with concentration of 10mg/mL exhibited the most intense reaction (p > 0.05). On Phase 2, at 7-days period, the analyzed parameters presented small magnitude and after 21 and 63-days, all the parameters demonstrated tissue compatibility. Conclusion: Both photosensitizers presented proper tissue compatibility regardless the different concentrations used on Phase 1 and different durations of light exposure on Phase 2 (AU)

Objetivo: Este estudo avaliou a resposta do tecido subcutâneo após terapia fotodinâmica, utilizando na Fase 1 - laser diodo por 1min e solução fotossensibilizadora de cloreto de fenotiazina (CF) em diferentes concentrações e Fase 2 - laser diodo e LED e dois fotossensibilizadores, CF e Curcumina, em diferentes tempos de exposição da aplicação de luz. Material e Métodos: Após 7, 21 e 63 dias, foram realizadas descrições qualitativas e semiquantitativas do processo inflamatório e técnica de imunoistoquímica. Os dados foram analisados pelo pós-teste de Kruskal-Wallis e Dunn (α = 0,5). Resultados: Na Fase 1, a resposta do tecido foi muito semelhante. O infiltrado inflamatório, na concentração de 10 mg / mL, exibiu reação mais intensa (p > 0,05). Na Fase 2, aos 7 dias, os parâmetros analisados apresentaram pequena magnitude. Aos 21 e 63 dias, todos os parâmetros demonstraram compatibilidade com o tecido. Conclusão: Ambos os fotossensibilizadores apresentaram compatibilidade de tecido adequada, independentemente das diferentes concentrações utilizadas na Fase 1 e diferentes durações de exposição à luz na Fase 2 (AU)

Evaluation of microbial contamination and efficacy of antimicrobial agents in disinfection of handicapped patients' toothbrushes

This study aimed to evaluate the contamination of toothbrushes usedby patients with disabilities, by microbial culture and cariogenic biofilm formation,and to explore two methods of disinfection. Methods: Experimental procedures were divided into three stages, with the same interval between each stage. In the first stage, the patients brushed their teeth, rinsed them with water, and their toothbrushes were sprayed with sterilized tap water. In the second and third stages, the steps were similar to those of Stage I, except the toothbrushes were sprayed with 0.12% chlorhexidine and 0.05% cetylpyridinium chloride solutions, respectively. At the end of each stage, the toothbrush bristles were cultured in bacitracin sucrose broth (CaSaB) medium. Data were analyzed through Friedman's nonparametric test (5% significance level). Results: In Stage I, mutans group streptococci (MS) were present in 30 toothbrushes (76.9%), and the number of colonies/biofilms ranged from 0 to +100. In Stage II, no MS colonization was observed. In Stage III, only 10.2% of the toothbrushes were contaminated with MS, and the number of colonies/biofilms ranged from 1 to 31. Conclusion: Bristles of toothbrushes used by patients with disabilities became contaminated with MS after a single brushing. The 0.12% chlorhexidine solution eliminated all microorganisms from the bristles of the toothbrushes used by the patients. Both 0.12% gluconate chlorhexidine and 0.05% cetylpyridinium chloride spray solutions can effectively be used for toothbrush disinfection to reduce contamination.

Objetivo: O presente estudo teve como objetivo avaliar a contaminação de escovas de dente utilizadas por pacientes especiais, por meio de cultura microbiana e formação de biofilme cariogênico, explorando dois métodos de desinfecção. Métodos: O estudo foi dividido em três estágios, com o mesmo intervalo de tempo entre cada estágio. No primeiro estágio, os pacientes escovaram os dentes e enxaguaram com água, em seguida, suas escovas foram borrifadas com água destilada. No segundo e terceiro estágios, as etapas foram semelhantes às do estágio I, exceto que as escovas de dente foram borrifadas com soluções de clorexidina 0,12% e cloreto de cetilpiridínio 0,05%, respectivamente. Ao final de cada etapa, as cerdas das escovas de dente foram cultivadas em meio de Caldo Sacarose Bacitracina (CaSaB). Os dados foram analisados por meio do teste não paramétrico de Friedman (nível de significância de 5%). Resultados: No estágio I, os estreptococos do grupo mutans (EM) estavam presentes em 30 escovas de dente (76,9%), e o número de colônias / biofilmes variou de 0 a +100. No estágio II, nenhuma colonização por MS foi observada. No estágio III, apenas 10,2% das escovas de dente estavam contaminadas com MS, e o número de colônias / biofilmes variou de 1 a 31. Conclusão: As cerdas das escovas de dente utilizadas por pacientes especiais contaminaram-se com EM após uma única escovação. A solução de clorexidina 0,12% eliminou todos os microrganismos das cerdas das escovas de dente utilizadas pelos pacientes. Ambas as soluções em spray (gluconatode clorexidina 0,12% e cloreto de cetilpiridínio 0,05%) podem ser utilizadas com eficácia para desinfecção das escovas de dente para reduzir a contaminação.

Negative Pressure Irrigation Presents Mineralizing Potential in Dogs' Immature Teeth with Periapical Lesion.

The objective of this in vivo study was to assess the effect of the root canal irrigation by negative and positive apical pressure on the expression of molecules that are an indicative of cell differentiation with mineralizing phenotype in teeth of dogs with incomplete rhizogenesis and induced periapical lesion. A total of 30 teeth (60 roots) were distributed into 3 groups (n=20): EndoVac®, Conventional and Control. After 90 days, the routine histotechnical procedures were performed and the sections were submitted to immunohistochemical technique for the staining of osteopontin (OPN), alkaline phosphatase (ALP) and the RUNX2 transcription factor in the apical and periapical regions of the roots. A semi-quantitative analysis of the positive immunostaining was performed and the intensity of the expression was classified in absent (0), mild (1), moderate (2), or intense (3). Scores data were statistically analyzed by the Kruskal-Wallis non-parametric test and Dunn post-test, and the significance level was set at 5%. RUNX2 immunostaining revealed that in the negative pressure group there was a significantly stronger (p<0.05) immunostaining in comparison to the control group. Regarding the OPN expression, it was not possible to detect a statistically significant difference between the groups (p>0.05). After analyzing ALP immunostaining, a statistically significant difference was observed between the groups (p<0.05), and the negative pressure group showed a markedly stronger mark immunostaining than the control group. The results of the present in vivo study allowed concluding that negative apical pressure irrigation presents mineralizing potential in immature teeth with apical periodontitis.

Tissue Response after Subcutaneous Implantation of Different Glass Ionomer-Based Cements.

The aim of this study was to evaluate the subcutaneous connective tissue response of isogenic mice after implantation of different glass ionomer-based cements (EQUIA® Forte Fil, EQUIA® Fil and Ketac™ Universal Aplicap™). Eighty-seven isogenic BALB/c mice were allocated in 12 groups, 9 were considered as experimental groups (Ketac, E. Fil and E. Forte at 7, 21 and 63 days) and 3 controls (empty polyethylene tubes at 7, 21 and 63 days). After the experimental periods, the subcutaneous connective tissue surrounding the implanted material was removed and subjected to histotechnical processing and staining with hematoxylin and eosin. A histopathological description of the tissue reaction surrounding each material and a semi-quantitative analysis of collagen fiber formation and inflammatory infiltrate were performed. Additionally, the thickness of the granulomatous tissue in contact with each material was measured. Data were analyzed statistically (α=0.05) by the Kruskal-Wallis test, followed by Dunn post-test. Initially, the collagen fiber formation was not different among all the tested materials (p>0.05) but was different at 21 days with the control group presenting the most advanced stage of collagen fiber formation. At 63 days, EQUIA® Forte Fil group showed the most advanced stage of collagen fiber formation, compared to EQUIA® Fil group (p<0.05). The inflammatory infiltrate was not different among the tested materials in any experimental period (p>0.05). The thickness of the granulomatous tissue was greater in the E. Forte group, compared to control in all periods. All glass ionomer-based cements showed tissue compatibility, according to the evaluated parameters.

Comparison of apical periodontitis repair in endodontic treatment with calcium hydroxide-dressing and aPDT.

This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on the endodontic treatment of apical periodontitis (AP). AP was induced in 48 premolars of 6 dogs. After biomechanical preparation, the teeth were divided into 4 groups: Calcium-Hydroxide (CH)/120d and CH/180d: root canals filled with CH-based dressing for 15 days before obturation; aPDT/120d and aPDT/180d: conditioning with phenothiazine photosensitizer (10 mg/mL) for 1 minute and irradiation with diode laser in the same session as obturation. Root filling was performed with AH Plus sealer. After the experimental periods, animals were euthanized and teeth were submitted for histology. HE staining was performed for descriptive analysis of the periapical region, measurement of apical periodontitis and for inflammatory cells, and blood vessels count. Immunohistochemistry was performed for osteopontin (OPN) and alkaline phosphatase (ALP). Data were analyzed statistically by two-way ANOVA and chi-square test (α = 5%). Teeth in Group CH/120d presented only a slightly enlarged periodontal ligament (PL) with advanced repair. Group aPDT/120d presented the PL moderately enlarged, with moderate inflammatory infiltrate and few collagen fibers. The same pattern was observed at 180 days. AP lesions in CH-treated groups were smaller than those in aPDT-treated groups (p < 0.001) with more blood vessels (p < 0.0001), regardless of the evaluation period, without significant differences in the number of inflammatory cells (p > 0.05). CH-treated groups showed significantly more intense immunostaining for ALP and OPN (p < 0.001) in both periods. Although aPDT stimulated angiogenesis and expression of bone formation markers, the two-session endodontic treatment with CH-based dressing promoted better apical periodontitis repair.

Quantification of pro-inflammatory cytokines and osteoclastogenesis markers in successful and failed orthodontic mini-implants.

OBJECTIVES: Miniscrew has been frequently used, considering that anchorage control is a critical point in orthodontic treatment, and its failure, the main adverse problem. Using two groups of stable (successful) and unstable (failed) mini-implants, this in vivo study aimed to quantify proinflammatory cytokines IL-1 α, IL-6, IL-17, and TNF-α and osteoclastogenesis marker RANK, RANKL, and OPG in gingival tissue, using the real-time polymerase chain reaction technique. METHODOLOGY: Thirteen patients of both sexes (11-49 years old) under orthodontic treatment were selected, obtaining 11 successful and 7 failed mini-implants. The mini-implants were placed and removed by the same surgeon, in both jaws. The mean time of permanence in the mouth was 29.4 months for successful and 7.6 months for failed mini-implants. At removal time, peri-mini-implant gingival tissue samples were collected and processed for quantification of the proinflammatory cytokines and osteoclastogenesis markers. Nonparametric Wilcoxon rank-sum test considering the clusters and Kruskal-Wallis test were used for statistical analysis (α=0.05). RESULTS: No significant difference (p>0.05) was observed between the groups for either quantification of cytokines or osteoclastogenesis markers, except for IL-6 (p<0.05). CONCLUSIONS: It may be concluded that the expression of IL-1α, IL-17, TNF-α, RANK, RANKL, and OPG in peri-implant gingival tissue were not determinant for mini-implant stability loss, but the higher IL-6 expression could be associated with mini-implant failure.