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1.
BMC Oral Health ; 20(1): 41, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024498

RESUMO

BACKGROUND: This study aimed to evaluate the efficacy of ozonized water on pain, oedema and trismus after impacted third molar mandibular surgeries when compared to double distilled water. A randomized triple blind trial was conducted. METHODS: Patients with third molars class II-B of Pell-Gregory were included, and surgical extraction was performed. Irrigation was done with ozonized (group 1) or double distilled water (group 2). The type of irrigation and the side to be operated were randomized. Neither the patients nor the operator or evaluator were aware of the irrigation solution. Pain, oedema and trismus were evaluated at baseline, 24-h, 48-h, 72-h and 7-days after treatment. The data were evaluated by Friedman, Wilcoxon, Mann-Whitney tests, and size effect. RESULTS: It was included 8 men and 12 women, with a mean age of 20.9y.o. The initial pain mean was 7.94 (±12.81) (group 1) and 5.50 (±9.12) (group 2) (p > 0,05). There was a statistically significant reduction of pain, oedema and trismus in intragroup analysis (p < 0.05). There was no statistically significant difference (p > 0.05) when comparing the oedema and trismus between groups. The size effect ranged from small (0.23) to large (1.29). CONCLUSIONS: It was concluded that ozonized water was compatible as irrigation method, not inferior to double distilled water, and had satisfactory effects on management of pain, oedema and trismus after surgical removal of the third molar. TRIAL REGISTRATION: This clinical trial was registered in ClinicalTrials.gov NCT03501225 on April 18, 2018.

2.
Arch Oral Biol ; 110: 104597, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31739076

RESUMO

OBJECTIVES: To systematically review and evaluate what is known regarding contemporary biological therapy capable of accelerating orthodontic tooth movement (OTM) in animal model. MATERIALS AND METHODS: MedLine, Scopus, Web of Science and OpenGrey were searched without restrictions until June 2019. Following study retrieval and selection, relevant data was extracted using a standardized table. Risk of bias (RoB) assessment was performed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. RESULTS: Fifty-one animal studies were included. Two biological therapies were identified as capable of accelerating the OTM: chemical methods (49 studies) and gene therapy (2 studies). The main substances that increased the OTM rate were cytokines (13 studies), followed by growth factors (6 studies) and hormones (5 studies). Most studies were assessed to be at unclear or high RoB. The application protocols, measurement and reporting of outcomes varied widely and methodologies were not adequately reported. CONCLUSIONS: Although biological therapies to accelerate OTM have been widely tested and effective in preclinical studies, the validity of the evidence is flawed to support translational of these results. There is a need for well-designed experimental studies to translate these methods for clinical field.


Assuntos
Terapia Biológica , Técnicas de Movimentação Dentária , Animais , Modelos Animais de Doenças , Proteômica
3.
J Maxillofac Oral Surg ; 18(4): 490-499, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31624426

RESUMO

Introduction: Labial frenectomy is a common procedure in the oral surgery specialty. Nowadays, laser surgery seems to provide better post-operative results than scalpel surgery. Thus, the aim of this study was to analyze whether trans-surgical and postoperative variables of labial frenectomy are better when performed with laser than with conventional scalpel. Materials and Methods: A systematic review has been performed based on PRISMA criteria. The search included three databases, with no limitations of time or language. After screening, seven papers were included in qualitative analysis and six in meta-analysis. Bias analysis was performed according to Cochrane Handbook. Pain during the first (MD - 3.18, 95% CI - 4.03 to - 2.32) and seventh post-surgical days (MD - 1.04, 95% CI - 1.45 to - 0.64); discomfort during speech on the first (MD - 2.15, 95% CI - 3.94 to - 0.37) and the seventh post-surgical days (MD - 1.60, 95% CI - 1.96 to - 1.24); discomfort during chewing on the first (MD - 2.90, 95% CI - 3.35 to - 2.45) and the seventh days (MD - 1.56, 95% CI - 2.21 to - 0.91); and average surgery time (MD - 1.84, 95% CI - 3.22 to - 0.46) were lower in the laser group than in the scalpel group. Conclusion: The results of this systematic review have shown better results to laser group in the following variables: pain, discomfort during speech and chewing. However, the evidence is limited due the high risk of bias.

4.
Arch Oral Biol ; 107: 104486, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31374491

RESUMO

OBJECTIVE: The aim of this study was to investigate the association between mandibular third molar position and occurrence of pericoronitis. DESIGN: The systematic review was performed based on PRISMA criteria (Prospero: CRD42018102835). The electronic search was performed in Medline, Virtual Health Library and Web of Science (until August 2018), without language restriction. Two researchers independently selected studies, extracted data, and assessed methodologic quality. Twenty-one articles were included in the review, comprising 6895 patients, with 1913 third mandibular molars being affected by pericoronitis. Ten studies were incuded in meta-analysis. RESULTS: The third molar in vertical position of Winter is the one with the greatest chance of presenting pericoronitis, compared to the other positions, while the horizontal position decreases this chance. There was no significant difference in the chance of pericoronitis between positions I and II of Pell & Gregory (OR: 0.29; IC: 0.07-1.23, I2 = 88%). Third molars classified in position A had greater chance of pericoronitis when compared to those in position B (OR: 7.13; IC: 1.31-38.74, I2 = 93%). The vertical position of the lower third molar is more associated with the occurrence of pericoronitis when compared to the other positions. CONCLUSIONS: Vertical position of the lower third molar is more associated with the occurrence of pericoronitis when compared to the other Winter' positions. Considering Pell and Gregory positions, position A had a greater chance of pericoronitis compared to position B. The prophylactic removal of lower third semi-erupted vertical molar or in position A is indicated to prevent pericoronitis.


Assuntos
Dente Serotino , Pericoronite/etiologia , Dente Impactado/complicações , Humanos , Mandíbula
5.
Int. arch. otorhinolaryngol. (Impr.) ; 23(2): 221-228, Apr-June 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1012299

RESUMO

Abstract Introduction Cold therapy (cryotherapy) is a common procedure recommended by dental surgeons after surgical removal of thirdmolars, which is an invasive intervention that often deals with an expressive inflammatory response. Objective To investigate whether cryotherapy interferes with clinical outcomes such as pain, edema, and trismus in the postoperative period of mandibular third molar surgeries. Data Synthesis An electronic search was conducted in the OVID, PubMed, VHL, Science Direct, Cochrane Library, and Web of Science databases, through March 2018. The eligibility criteria included clinical trials that evaluated the effect of cryotherapy in at least one of the following variables: pain, swelling, and trismus. Two independent reviewers assessed the studies. The methodological quality of each article was analyzed. The search strategy resulted in 1,088 articles. Following the selection process, 11 studies were included in the systematic review and 4 of them in the meta-analysis. High risk of bias was found in most of the studies according to the Cochrane Handbook assessment. Patients receiving cryotherapy had less edema than patients in the control group at second day follow-up (mean difference [MD]: -0.94; 95%CI [-1.49; -0.39]). There were no statistically significant results when comparing trismus between experimental and control group (MD: 0.43; 95%CI [-0.34;1.20]). There were insufficient available data to support influences in postoperative pain. Conclusions Cryotherapy applied on thefirstday aftermandibular third molar removal can manage edema in the patients.Well-designed randomized clinical trials to test the efficacy of cryotherapy after surgical removal of third molars are needed to justify its indication.

6.
Int Arch Otorhinolaryngol ; 23(2): 221-228, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30956709

RESUMO

Introduction Cold therapy (cryotherapy) is a common procedure recommended by dental surgeons after surgical removal of third molars, which is an invasive intervention that often deals with an expressive inflammatory response. Objective To investigate whether cryotherapy interferes with clinical outcomes such as pain, edema, and trismus in the postoperative period of mandibular third molar surgeries. Data Synthesis An electronic search was conducted in the OVID, PubMed, VHL, Science Direct, Cochrane Library, and Web of Science databases, through March 2018. The eligibility criteria included clinical trials that evaluated the effect of cryotherapy in at least one of the following variables: pain, swelling, and trismus. Two independent reviewers assessed the studies. The methodological quality of each article was analyzed. The search strategy resulted in 1,088 articles. Following the selection process, 11 studies were included in the systematic review and 4 of them in the meta-analysis. High risk of bias was found in most of the studies according to the Cochrane Handbook assessment. Patients receiving cryotherapy had less edema than patients in the control group at second day follow-up (mean difference [MD]: -0.94; 95%CI [-1.49; -0.39]). There were no statistically significant results when comparing trismus between experimental and control group (MD: 0.43; 95%CI [-0.34;1.20]). There were insufficient available data to support influences in postoperative pain. Conclusions Cryotherapy applied on the first day after mandibular third molar removal can manage edema in the patients. Well-designed randomized clinical trials to test the efficacy of cryotherapy after surgical removal of third molars are needed to justify its indication.

7.
Phytother Res ; 33(3): 473-481, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30484910

RESUMO

The aim of this systematic review was to evaluate the clinical evidences of the bromelain in minimizing inflammatory parameters such as pain, edema, and trismus after lower third molar surgeries. An electronic search was conducted in six databases through November 2017. The eligibility criteria included randomized and non-randomized clinical trials and/or comparative studies that used bromelain after lower third molar surgeries. The search strategy resulted in 117 articles. Following the selection process, seven studies were included in the systematic review and four in the meta-analysis. In terms of the risk of bias analysis, all the evaluated studies were classified as low or unclear risk of bias in the following criteria: selection bias, detection bias, and reporting bias. The final quantitative analysis of the variables showed that the use of bromelain resulted in greater reduction of pain levels (mean difference [MD]: -0.38; 95% confidence interval [CI; -0.66 to -0.09]), edema (MD: -0.34; 95% CI [ -0.68 to -0.01]), and trismus (MD: -2.01; 95% CI [ -3.99 to -0.02]) among the analyzed groups. The results suggest that the bromelain appears to be effective in the control of pain, edema, and trismus after lower third molar surgeries; however, further high-quality studies are needed to confirm this finding.


Assuntos
Bromelaínas/uso terapêutico , Edema/tratamento farmacológico , Inflamação/tratamento farmacológico , Dor Pós-Operatória/tratamento farmacológico , Extração Dentária/efeitos adversos , Trismo/tratamento farmacológico , Edema/etiologia , Humanos , Inflamação/etiologia , Dente Serotino/efeitos dos fármacos , Dente Serotino/cirurgia , Dor Pós-Operatória/etiologia , Resultado do Tratamento , Trismo/etiologia
8.
Acta Odontol Scand ; 77(1): 55-60, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30264624

RESUMO

OBJECTIVE: To investigate whether there are differences between the root canal disinfection, comparing the passive ultrasonic irrigation technique with the conventional technique. MATERIALS AND METHODS: The following electronic databases were searched: Pubmed; VHL; Web of Sciences and OVID with no publication date restriction. The study's quality evaluation was carried out using the Handbook by Cochrane. The online research identified 5464 studies. From the nine studies selected for a full reading of the text, five were included in the present systematic review. Meta-analysis was performed in three articles, which evaluated the root canal's cleanness through microbiological analysis. RESULTS: Only one article concluded that the ultrasonic passive irrigation showed a better performance compared with the conventional irrigation. None of the articles analyzed presented a low risk of bias in all domains. According to the results of the meta-analysis, there was no statistical difference between the groups (OR = 0.34, IC 95%: 0.10-1.19). CONCLUSIONS: The level of evidence comparing the two techniques is fragile since in all studies some type of bias was observed which may interfere in the results and conclusions.


Assuntos
Cavidade Pulpar/microbiologia , Desinfecção/métodos , Irrigantes do Canal Radicular , Irrigação Terapêutica/métodos , Ultrassom/métodos , Humanos , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/métodos
9.
Int. arch. otorhinolaryngol. (Impr.) ; 23(2): 221-228, 2019. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1015570

RESUMO

Introduction: Cold therapy (cryotherapy) is a common procedure recommended by dental surgeons after surgical removal of thirdmolars, which is an invasive intervention that often deals with an expressive inflammatory response. Objective: To investigate whether cryotherapy interferes with clinical outcomes such as pain, edema, and trismus in the postoperative period of mandibular third molar surgeries. Data Synthesis: An electronic search was conducted in the OVID, PubMed, VHL, Science Direct, Cochrane Library, and Web of Science databases, through March 2018. The eligibility criteria included clinical trials that evaluated the effect of cryotherapy in at least one of the following variables: pain, swelling, and trismus. Two independent reviewers assessed the studies. The methodological quality of each article was analyzed. The search strategy resulted in 1,088 articles. Following the selection process, 11 studies were included in the systematic review and 4 of them in the meta-analysis. High risk of bias was found in most of the studies according to the Cochrane Handbook assessment. Patients receiving cryotherapy had less edema than patients in the control group at second day follow-up (mean difference [MD]: -0.94; 95%CI [-1.49; -0.39]). There were no statistically significant results when comparing trismus between experimental and control group (MD: 0.43; 95%CI [-0.34;1.20]). There were insufficient available data to support influences in postoperative pain. Conclusions: Cryotherapy applied on thefirstday aftermandibular third molar removal can manage edema in the patients.Well-designed randomized clinical trials to test the efficacy of cryotherapy after surgical removal of third molars are needed to justify its indication (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Extração Dentária/efeitos adversos , Crioterapia , Inflamação/terapia , Cuidados Pós-Operatórios , Trismo/terapia , Resultado do Tratamento , Procedimentos Cirúrgicos Bucais/reabilitação , Edema/terapia , Manejo da Dor , Dente Molar/cirurgia
10.
Int. arch. otorhinolaryngol. (Impr.) ; 22(2): 181-189, Apr.-June 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-954025

RESUMO

Abstract Introduction Mandibular fractures represent a high percentage of all facial fractures, and the bite force is a fundamental parameter to measure the actual mandibular function and, subsequently, the masticatory efficiency and quality of life. Objectives The purpose of the present systematic review was to verify if there is any difference in the bite forces of patients with mandibular fractures fixed by locking or non-locking plates, testing the null hypothesis of no difference in this parameter. Data Synthesis A systematic review of the literature was conducted using four databases (PubMed, Virtual Health Library,Web of Science and Science Direct) without restrictions as to publication date or language. We found 3,039 abstracts, and selected 4 articles for this review. Conclusion The overall results show better performance in bite force for the locking plates when compared with the non-locking plates in the incisor region (mean deviation [MD]: 1.18; 95% confidence interval [95%CI]: 0.13-2.23), right molar region (MD: 4.71; 95%CI: 0.63-8.79) and left molar region (MD: 10.34; 95%CI: 4.55-16.13). Although the results of this study indicated a better bite force result with the locking plates, there is still no sufficient evidence to support this information safely.

11.
Qual Life Res ; 27(10): 2477-2489, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29797177

RESUMO

OBJECTIVE: The purpose of this systematic review was to assess the impact of third molar removal on patient's quality of life. METHODS: To address the study purpose, investigators designed and implemented a systematic review. The primary outcome variable was the quality of life after third molar extraction. An electronic search was conducted through March, 2017, on the PUBMED, Virtual Health Library (VHL), Web of Science, and OVID, to identify relevant literatures. Research studies (randomized or non-randomized clinical trials) were included that evaluated the quality of life in individuals before and after third molar extraction, using validated measures of oral health-related quality of life with quantitative approach, besides procedures performed under local anesthesia. The R software was used to measure the mean difference on the quality of life between the preoperative period and follow-up days. RESULTS: A total of 1141 studies were identified. Of this total, 13 articles were selected in the present systematic review, of which six studies were included in the meta-analysis. All of these 13 articles used the OHIP-14, and 4 of this 13 used OHQoLUK-16 to evaluate the quality of life. Regarding quality assessment, four of the 13 included studies in this review received a maximum score of 9 points, according to the Newcastle-Ottawa (NOS). The OHIP-14 mean score on the first postoperative day was 17.57 (95% CI 11.84-23.30, I2 = 96%) higher than the preoperative period. On the seventh postoperative day, the quality of life assessed by OHIP-14 got worse again. CONCLUSION: This systematic review revealed that the highest negative impact on quality of life of individuals submitted to third molar surgery was observed on the first postoperative day, decreasing over the follow-up period.


Assuntos
Dente Serotino/cirurgia , Qualidade de Vida/psicologia , Extração Dentária/métodos , Adulto , Feminino , Humanos , Adulto Jovem
12.
J Maxillofac Oral Surg ; 17(2): 129-141, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29618876

RESUMO

Purpose: The aim of this meta-analysis was to determine which characteristics of mandibular third molars (MTMs) are more often associated with an increase in the prevalence/incidence of caries on the distal surface of mandibular second molars (MSMs). Methods: Three electronic databases were analyzed: PubMed; OVID and the Virtual Health Library. Observational studies were included, and the risk of bias was assessed using The Newcastle-Ottawa Scale. The Comprehensive Meta-Analysis software program was used for meta-analysis. Results: Fifteen studies were included in this systematic review, and five were included in the meta-analysis. The distal surface of MSMs were more likely to exhibit caries in the following scenarios: when MTMs were found in the A position, rather than the C position (OR: 3.45, 95% CI: 2.28-5.22, p<0.001); when the horizontal position was compared with the vertical (OR: 8.12, 95% CI: 3.75-17.58, p<0.001) and distoangular (OR: 9.75, 95% CI: 3.49 - 27.25, p<0.001) positions; and when the mesioangular position was compared with the vertical (OR: 7.25, 95% CI: 3.48-15.10, p<0.001) and distoangular (OR: 9.54, 95% CI: 3.47 - 26.21, p<0.001) positions. Conclusion: The results of this study suggest that the presence of MTMs increases the incidence of caries on the distal surface of MSMs. Furthermore, caries on the distal surface of MSMs is more commonly associated with position A and horizontal and mesioangular mandibular molars.

13.
Int Arch Otorhinolaryngol ; 22(2): 181-189, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29619110

RESUMO

Introduction Mandibular fractures represent a high percentage of all facial fractures, and the bite force is a fundamental parameter to measure the actual mandibular function and, subsequently, the masticatory efficiency and quality of life. Objectives The purpose of the present systematic review was to verify if there is any difference in the bite forces of patients with mandibular fractures fixed by locking or non-locking plates, testing the null hypothesis of no difference in this parameter. Data Synthesis A systematic review of the literature was conducted using four databases (PubMed, Virtual Health Library, Web of Science and Science Direct) without restrictions as to publication date or language. We found 3,039 abstracts, and selected 4 articles for this review. Conclusion The overall results show better performance in bite force for the locking plates when compared with the non-locking plates in the incisor region (mean deviation [MD]: 1.18; 95% confidence interval [95%CI]: 0.13-2.23), right molar region (MD: 4.71; 95%CI: 0.63-8.79) and left molar region (MD: 10.34; 95%CI: 4.55-16.13). Although the results of this study indicated a better bite force result with the locking plates, there is still no sufficient evidence to support this information safely.

14.
Int. j. odontostomatol. (Print) ; 12(1): 76-85, Mar. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-893305

RESUMO

SUMMARY: The aim of this research was to assess the hemodynamic variations during the extraction of impacted lower third molars using lidocaine 2 % or articaine 4 %, as local anesthetics. Fourteen patients with a mean age of 22.4 (SD=3.25), were submitted to the bilateral extraction of lower third molars, with an interval of three to four weeks between the two extractions. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate and oxygen saturation in the blood were assessed at seven specific time points: baseline; anesthetic puncture; two minutes after anesthesia; osteotomy; suture and five minutes after the procedure had been completed. The statistical analysis involved descriptive analysis, the Shapiro-Wilk test, the Mann-Whitney test, the t-test and the repeated measurements test. No significant differences were found for any of the hemodynamic behavior variables when comparing lidocaine 2 % and articaine 4 %. Significant differences were found between the time points assessed within each group, particularly in relation to the variable heart rate. In the articaine group, systolic blood pressure exhibited a significant decrease five minutes after the procedure. There were no significant variations in hemodynamic behavior between the two different anesthetic groups (articaine 4 % and lidocaine 2 %).


RESUMEN: El objetivo de esta investigación fue evaluar las variaciones hemodinámicas durante la extracción de terceros molares inferiores impactados utilizando lidocaína al 2 % o articaína al 4 %, como anestésicos locales. Catorce pacientes con una edad promedio de 22,4 (SD = 3,25), fueron sometidos a la extracción bilateral de terceros molares inferiores, con un intervalo de tres a cuatro semanas entre las dos extracciones. Se evaluaron la presión arterial sistólica, la presión arterial diastólica, la presión arterial media, la frecuencia cardíaca y la saturación de oxígeno en la sangre, en siete momentos específicos: línea base; punción anestésica; dos minutos después de la anestesia; osteotomía; sutura y cinco minutos después de que el procedimiento fue completado. El análisis estadístico involucró el análisis descriptivo, la prueba de Shapiro-Wilk, la prueba de Mann-Whitney, la prueba t y la prueba de mediciones repetidas. No se encontraron diferencias significativas para ninguna de las variables de comportamiento hemodinámico al comparar lidocaína 2 % y articaína 4 %. Se encontraron diferencias significativas entre los puntos de tiempo evaluados dentro de cada grupo, particularmente en relación con la frecuencia cardíaca variable. En el grupo de articaína, la presión arterial sistólica exhibió una disminución significativa cinco minutos después del procedimiento. No se observaron variaciones significativas en el comportamiento hemodinámico entre los dos grupos anestésicos diferentes (articaína 4 % y lidocaína 2 %).

15.
Artigo em Inglês | MEDLINE | ID: mdl-29325853

RESUMO

OBJECTIVE: This study aimed to examine whether Sjögren syndrome (SS) is related to periodontal status. STUDY DESIGN: A systematic review was performed on the basis of PRISMA (PROSPERO: CRD42017055202). A search was performed in the PubMed/MEDLINE, LILACS, Web of Science, and Science Direct databases. Hand searches and review of the gray literature were also performed. Three researchers independently selected studies, extracted data, and assessed methodologic quality. Studies that correlated primary and/or secondary SS with plaque index, gingival index, probing depth, and bleeding on probing were included. The risk of bias was estimated on the basis of the Newcastle-Ottawa scale. RESULTS: Seventeen studies were included in the review and 9 included in the meta-analysis, with a total of 518 and 544 patients, with or without SS, respectively. The mean difference of plaque index (0.29; 95% confidence interval [CI] 0.17-0.41), gingival index (0.52; 95% CI 0.14-0.89), and bleeding on probing (9.92; 95% CI 4.37-15.47) were larger in patients with SS than in controls. In primary SS (0.47; 95% CI 0.10-0.83) and secondary SS (0.74; 95% CI 0.10-1.38), only the mean gingival index was larger compared with that in control group. The majority of the included studies were judged as having a high risk of bias. CONCLUSIONS: The present review did not provide strong evidence that periodontal status is affected by SS.


Assuntos
Doenças Periodontais/etiologia , Síndrome de Sjogren/complicações , Humanos , Higiene Bucal , Doenças Periodontais/prevenção & controle , Fatores de Risco , Síndrome de Sjogren/prevenção & controle
16.
Arch Oral Biol ; 87: 180-190, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29306074

RESUMO

OBJECTIVES: Studies have observed the presence of extra-intestinal manifestations of celiac disease (CD), including involvement of the oral cavity, such that developmental defects of enamel (DDE) occur. Thus, the aim of this review was to access the polled prevalence of DDE in individuals with CD, and to establish the strength of the association between these two variables. METHODS: To carry out the systematic review, four electronic databases and the Grey Literature were searched, complemented by a manual search of reference lists within the selected articles. Two pairs of independent reviewers selected the articles, and perform the data extractions and bias risk assessment Studies evaluating the presence of DDE in individuals with CD as well as in healthy individuals and which performed the DDE diagnosis by direct visualization of tooth enamel changes and the CD diagnosis were included. Meta-analyses were performed using the software R. RESULTS: Of 557 studies, 45 were selected for review, encompassing 2840 patients. The prevalence of DDE in people with CD was 50% (95% CI 0.44-0.57, I2 = 88%). In a general analysis, it was observed that patients with CD had a significantly higher prevalence of enamel defects compared to healthy people (RR: 2.31, 95% CI: 1.71-3.12, I2 = 98%). Only developmental defects of enamel diagnosed using Aine's method were associated with the disease (RR: 3.30, 95% CI 2.39-4.56, I2 = 75%). In a sensitivity analysis involving the deciduous, mixed and permanent dentitions, only individuals with deciduous dentition were observed to have association with the disease (RR: 2.34, 95% CI 1.25-4.39, I2 = 39%). CONCLUSIONS: Patients with enamel developmental defects should be screened for the possibility of their having celiac disease.


Assuntos
Doença Celíaca/complicações , Hipoplasia do Esmalte Dentário/etiologia , Dentição Permanente , Humanos , Dente Decíduo
17.
J Craniomaxillofac Surg ; 46(1): 168-172, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29208487

RESUMO

OBJECTIVE: To compare the mechanical resistance of conventional plates with a modified Y-plate in mandibular condyle fracture. MATERIALS AND METHODS: 40 synthetic hemi-mandibular polyurethane replicates were used. Two groups of fixing materials were included: 20 mandibles fixed with 40 straight plates with four roles each (2.0 mm system) and 20 mandibles fixed with 20 Y-shaped plates (2.0 mm system and 1.5 mm thickness). The samples were submitted to linear loading in the following directions: 10 mandibles from each group from lateral to medial and 10 mandibles from each group from anterior to posterior. A universal loading machine, Instron Universal 4411, was used to performed the tests, and the resistance of each fixed mandible was assessed at displacements of 1 mm, 3 mm, and 5 mm. The t-test for independent samples was performed. The p value was set at <0.05. RESULTS: The worst mechanical resistance was found in the Y-plates loaded from anterior to posterior. The best mechanical resistance was in two straight hole plates loaded from lateral to medial. The Y-plates and two straight hole plates showed similar resistance when a lateral to medial load was applied. CONCLUSION: There was no difference between the plates when lateral to medial loading was tested.


Assuntos
Placas Ósseas , Fixação Interna de Fraturas , Côndilo Mandibular/lesões , Fraturas Mandibulares/cirurgia , Humanos , Modelos Anatômicos , Desenho de Prótese
18.
Head Neck Pathol ; 12(1): 75-81, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28597210

RESUMO

Cellular neurothekeomas (CNs) are distinctive benign tumors of uncertain histogenesis, with predilection for the skin of the head and neck region. We describe the first case of multiple desmoplastic CNs (DCNs) affecting the oral cavity in a 9-year-old girl. Histopathologic evaluation showed a proliferation of spindle and epithelioid cells, forming nests and bundles, supported by exuberant fibrous stroma, as well as scattered multinucleated floret-like giant cells. The tumor cells were immunopositive for vimentin, CD63, CD56, whereas AE1/AE3, S100, CD34, α-SMA, GFAP, EMA, CD57 and NSE were negative. Ki-67 was <2%. Multiple DCNs should be considered in the differential diagnosis of oral nodular lesions.


Assuntos
Neoplasias Bucais/patologia , Neoplasias Primárias Múltiplas/patologia , Neurotecoma/patologia , Biomarcadores Tumorais/análise , Criança , Feminino , Humanos
19.
J Oral Maxillofac Surg ; 76(1): 60-66, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28675812

RESUMO

PURPOSE: We aimed to compare the effect of dexamethasone, 8 mg, and diclofenac sodium, 50 mg, associated with codeine, 50 mg, on the control of pain, swelling, and trismus after extraction of impacted third molars. MATERIALS AND METHODS: Fifteen healthy patients with a mean age of 22.8 years (SD, 12.62 years) received a single oral dose of either drug 1 hour before each surgical procedure (left and right teeth). At 24, 48, and 72 hours after surgery, swelling was determined by use of linear measurements on the face and trismus was determined by maximal mouth opening. Postoperative pain was self-recorded by the patients using a numerical rating scale at 24-hour intervals for a period of 72 hours. Data analysis involved descriptive statistics and Shapiro-Wilk, Wilcoxon, and paired t tests (P < .05). RESULTS: Dexamethasone controlled pain (P = .016) and edema (P = .08) within 48 hours better than diclofenac sodium associated with codeine. No statistically significant differences were found between drugs regarding trismus and consumption of rescue analgesics (acetaminophen). CONCLUSIONS: The results of this study suggest that pre-emptive administration of dexamethasone, 8 mg, showed better control of pain and swelling in bilateral extractions of third impacted mandibular molars.


Assuntos
Analgésicos Opioides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Codeína/uso terapêutico , Dexametasona/uso terapêutico , Diclofenaco/uso terapêutico , Edema/prevenção & controle , Dente Serotino/cirurgia , Manejo da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Dente Impactado/cirurgia , Trismo/prevenção & controle , Adolescente , Adulto , Combinação de Medicamentos , Feminino , Humanos , Masculino , Medição da Dor , Extração Dentária , Resultado do Tratamento
20.
Anesth Prog ; 64(3): 136-143, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28858550

RESUMO

The aim of the present study was to assess the effectiveness of preemptive dexamethasone in surgery of the lower third molars and to compare it with other oral anti-inflammatories. An electronic search was conducted for preemptive effects related to lower third-molar surgery in 3 separate databases. The variables pain, swelling, and trismus were assessed. Meta-analysis was used to calculate the pooled effect measures for mean and standard deviation values (95% confidence interval [CI]). Seven split-mouth clinical trials were selected. Two studies were included in the meta-analysis. Three studies showed a low risk of bias; 2 studies exhibited a moderate risk and 2 a high risk of bias. Dexamethasone was better than nonsteroidal anti-inflammatories for preemptive effectiveness. Meta-analysis for swelling confirmed better results for dexamethasone than for methylprednisolone after 2 days (95% CI = -1.28 to -0.38), 4 days (95% CI = -1.65 to -0.71), 7 days (95% CI = -1.42 to -0.71), and overall (95% CI = -1.25 to -0.72). Dexamethasone was better than methylprednisolone for mouth opening after 4 days (95% CI = 0.18 to 1.07). There is insufficient evidence through meta-analysis to conclude that dexamethasone is better than other nonsteroidal anti-inflammatories or methylprednisolone as a preemptive analgesic. The results of this meta-analysis suggest that dexamethasone is more effective than methylprednisolone for swelling and trismus.


Assuntos
Anti-Inflamatórios/uso terapêutico , Dexametasona/uso terapêutico , Extração Dentária/métodos , Administração Oral , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/uso terapêutico , Dexametasona/administração & dosagem , Edema/prevenção & controle , Humanos , Dente Serotino/cirurgia , Trismo/prevenção & controle
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