Oral care practices for patients in intensive care unit: A systematic review.

OBJECTIVES: To critically analyse and discuss oral hygiene protocols in the hospital environment in patients admitted to the ICU, through a systematic review of the literature. METHODS: The electronic search was performed on Pubmed, Cochrane, Web of Science and Google Scholar databases. The indexing keywords according to the PRISMA protocol were: 'hospital dentistry', 'oral health', 'oral care' and 'intensive care unit'. RESULTS: The initial search resulted in a total of 2671 articles. Pre-selection based on titles led to the exclusion of 2510 articles and the remaining 36 were selected for abstract reading. After analysing the eligibility of the articles, eight studies were included in the review and submitted to qualitative analysis. CONCLUSION: It can be concluded that cleaning with a soft bristle brush, use of chlorhexidine and lip moisturizing are methods commonly used in dental care actions in patients hospitalized in intensive care units.

Do Patients with Extrinsic Black Tooth Stains Have a Lower Dental Caries Experience? A Systematic Review and Meta-Analysis.

Studies have suggested that individuals affected by extrinsic black tooth stains have less dental caries experience in comparison to those without this condition. The aim of the present study was to perform a systematic review and meta-analysis to determine whether there is scientific evidence demonstrating that extrinsic black stains are a protective factor for the occurrence of dental caries. This systematic review was developed in accordance with the PRISMA statement and the research question was determined using the PECO strategy. Electronic searches were conducted in the PubMed, Science Direct, Virtual Health Library, Cochrane, Web of Science, and Google Scholar databases for relevant articles published up to September 2018. All articles included were submitted to an appraisal of methodological quality using the Newcastle-Ottawa Scale and the data were extracted for meta-analysis. The search strategy resulted in the retrieval of 9,108 publications. After the application of the eligibility criteria, 18 articles were selected for analysis, 13 of which were included in the meta-analysis. The meta-analysis demonstrated that individuals with extrinsic black stains involving primary (median, MD: -0.78 [-1.09; -0.48]; I2 = 44%) and permanent (MD: -0.50 [-0.93; -0.08]; I2 = 86%) teeth have a lower dental caries experience in comparison to those without this condition. Patients with extrinsic black tooth stains have a lower dental caries experience in cross-sectional studies.

Association between histopathological features of dysplasia in oral leukoplakia and loss of heterozygosity.

AIMS: Oral leukoplakia (OL) dysplasia is graded on the basis of architectural and cytological features, and grade does not correlate well with malignant transformation. Loss of heterozygosity (LOH) profiles have been validated as risk predictors of OL malignant transformation. We aimed to assess whether the histological parameters used to grade dysplasia show different LOH profiles. METHODS AND RESULTS: Areas of epithelial dysplasia of 29 OL samples were microdissected, and LOH was assessed by use of a panel of 11 microsatellite markers located on chromosomes 3, 9, 11, and 17. Dysplasia was graded, and the cytological and architectural parameters were scored. Dysplasia was graded as mild in 18 samples, moderate in nine, and severe in two. The moderate/severe dysplasias and the mild dysplasias did not show different frequencies of allelic loss. Irregular epithelial stratification was associated with LOH at marker D3S1234 (3p14.2). In addition, the presence of drop-shaped rete ridges and premature keratinization in single cells showed associations with LOH at D9S162 (9p22) and P53 (17p13.1), respectively. CONCLUSIONS: We provide evidence that architectural and cellular changes in OL have different LOH patterns.

Analysis of p16(CDKN2A) methylation and HPV-16 infection in oral mucosal dysplasia.

OBJECTIVE: The purpose of this study was to investigate the relationship between p16(CDKN2A) methylation and epithelial dysplasia (ED). We also evaluated the expressions of proteins related to methylation (DNMT3B and DNMT1). Finally, we tested whether HPV-16/18 or the dmt3b (C46359T) polymorphism is associated with p16(CDKN2A) methylation status. METHODS: To test the hypothesis, a case-control study with 72 (control, n = 24; ED, n = 48) tissue samples from subjects was performed. Methylation-specific PCR, RFLP, and immunohistochemical analyses were performed to evaluate p16(CDKN2A) methylation status, dmt3b (C46359T) genotyping, and protein levels, respectively. RESULTS: The methylation of p16(CDKN2A) and HPV-16 was associated with ED gradation (p = 0.001 and 0.002, respectively). In addition, most HPV-16-positive samples (77.8%) exhibited p16(CDKN2A) methylation; however, changes in DNMT3B and DNMT1 protein levels were not observed in HPV-positive samples. Neither HPV-18 nor the dmt3b polymorphism was associated with p16(CDKN2A) methylation. CONCLUSIONS: There is an association between the presence of HPV-16 in ED and the occurrence of p16(CDKN2A) methylation. Both variables are also associated with ED development, but further studies are necessary to clarify if they operate independently and if they have any impact on OD malignization.

DNMT3B (C46359T) polymorphisms and immunoexpression of DNMT3b and DNMT1 proteins in oral lichen planus.

OBJECTIVE: To investigate the DNMT3B (C46359T) polymorphism and immunoexpression of DNMT3b and DNMT1 in oral lichen planus (OLP) compared to a control group. METHODS: We aimed to investigate the DNMT3B (C46359T) polymorphism and immunoexpression of DNMT3b and DNMT1 in OLP (n = 32), comparing it with oral mucosa (control; n = 24). The DNMT3B (C46359T) polymorphism was analyzed using the RFLP-PCR and DNMT1, and DNMT3a proteins were identified using immunohistochemistry. We also compared the DNMT3B expression in OLP and oral inflammatory fibrous hyperplasia (OIFH), another oral inflammatory disease. Differences between the groups were determined by specific statistical analyses. RESULTS: The CT genotype of DNMT3B was associated with OLP development (p = 0.012). Increased expression of DNMT3B and DNMT1 was observed in OLP compared to the control group (p = 0.014 and p = 0.001, respectively). A significant increase in DNMT3B protein levels was observed in the genotype CT in DNMT3B (C46359T) polymorphisms (p = 0.045). No DNMT3B expression differences between OLP and OIFH were observed. CONCLUSIONS: Our data show that the DNMT3B (C46359T) polymorphism is associated with OLP development. Furthermore, increased expression of the enzyme DNMT3B, an epigenetic-associated protein, is present in OLP.

Immunohistochemical analysis of p53, APE1, hMSH2 and ERCC1 proteins in actinic cheilitis and lip squamous cell carcinoma.

AIMS: This study has compared the tissue expression of the p53 tumour suppressor protein and DNA repair proteins APE1, hMSH2 and ERCC1 in normal, dysplastic and malignant lip epithelium. METHODS AND RESULTS: Morphological analysis and immunohistochemistry were performed on archived specimens of normal lip mucosa (n=15), actinic cheilitis (AC) (n=30), and lip squamous cell carcinoma (LSCC) (n=27). AC samples were classified morphologically according to the severity of epithelial dysplasia and risk of malignant transformation. LSCC samples were morphologically staged according to WHO and invasive front grading (IFG) criteria. Differences between groups and morphological stages were determined by bivariate statistical analysis. Progressive increases in the percentage of epithelial cells expressing p53 and APE1 were associated with increases in morphological malignancy from normal lip mucosa to LSCC. There was also a significant reduction in epithelial cells expressing hMSH2 and ERCC1 proteins in the AC and LSCC groups. A higher percentage of malignant cells expressing APE1 was found in samples with an aggressive morphological IFG grade. CONCLUSIONS: Our data showed that epithelial cells from premalignant to malignant lip disease exhibited changes in the expression of p53, APE1, hMSH2 and ERCC1 proteins; these molecular change might contribute to lip carcinogenesis.

Cryopreservation of mesenchymal stem cells derived from dental pulp: a systematic review.

OBJECTIVES: The aim of the present systematic review was to investigate the cryopreservation process of dental pulp mesenchymal stromal cells and whether cryopreservation is effective in promoting cell viability and recovery. MATERIALS AND METHODS: This systematic review was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the research question was determined using the population, exposure, comparison, and outcomes strategy. Electronic searches were conducted in the PubMed, Cochrane Library, Science Direct, LILACS, and SciELO databases and in the gray literature (dissertations and thesis databases and Google Scholar) for relevant articles published up to March 2019. Clinical trial studies performed with dental pulp of human permanent or primary teeth, containing concrete information regarding the cryopreservation stages, and with cryopreservation performed for a period of at least 1 week were included in this study. RESULTS: The search strategy resulted in the retrieval of 185 publications. After the application of the eligibility criteria, 21 articles were selected for a qualitative analysis. CONCLUSIONS: The cryopreservation process must be carried out in 6 stages: tooth disinfection, pulp extraction, cell isolation, cell proliferation, cryopreservation, and thawing. In addition, it can be inferred that the use of dimethyl sulfoxide, programmable freezing, and storage in liquid nitrogen are associated with a high rate of cell viability after thawing and a high rate of cell proliferation in both primary and permanent teeth.

Association of mast cell, eosinophil leucocyte and microvessel densities in actinic cheilitis and lip squamous cell carcinoma.

AIMS: To determine the contributions of mast cells (MC), eosinophil leucocytes (EL) and microvessel density (MVD) in lip carcinogenesis, and to establish the relationships between these biomarkers and their possible prognostic value in lip squamous cell carcinoma (LSCC). METHODS AND RESULTS: Archived specimens of lip mucosa (n=13), actinic cheilitis (n=29) and LSCC (n=29) were formalin-fixed, paraffin-embedded, sectioned and stained with toluidine blue and haematoxylin and eosin (H&E) in order to identify MC and EL and to measure their densities. Tumour angiogenesis was estimated by determining, with the use of CD31 antibody MVD in areas with the highest number of stained microvessels ('hot spots'). Progressive increases of MC, EL and MVD were observed during lip tumour development. Correlation analysis revealed positive associations between the biomarkers during tumour progression. In LSCC samples, significant associations were found between MVD values and metastatic disease. On multivariate analysis, MVD was a predictor of risk of cervical metastasis. CONCLUSIONS: The densities of MC, EL and microvessels increase during lip carcinogenesis, and for MC and EL this may be related to the stimulation of tumour angiogenesis. MVD could be a useful predictor of cervical metastasis in LSCC.

Oral disorders associated with the experience of verbal bullying among Brazilian school-aged children: A case-control study.

BACKGROUND: Dental features have been considered a potential target of verbal bullying (VB) among school-aged children. The authors conducted a study to investigate the association between the presence of oral disorders and the occurrence of VB among 8- through 10-year-old school-aged children. METHODS: The study included 445 school-aged children 8 through 10 years old. VB was verified by a specific validated question from the Child Perceptions Questionnaire 8-10 index. Oral disorders such as untreated caries, fluorosis, clinical consequences of untreated caries, and malocclusion were evaluated. The Pearson χ2 test and bivariate and multivariate conditional logistic regression analyses were used for statistical analysis. RESULTS: A total of 390 school-aged children completed the study. The results of the multivariate logistic regression model showed that a severe malocclusion (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.03 to 5.10), a greater maxillary misalignment (OR, 2.23; 95% CI, 1.05 to 4.73), and the presence of a tooth with pulp exposure (OR, 2.93; 95% CI, 1.58 to 5.45) were significantly associated with the occurrence of VB. CONCLUSION: Children aged 8 through 10 years with a severe malocclusion, larger maxillary misalignment, or the presence of pulp exposure had increased odds of experiencing VB compared with children without those oral health conditions. PRACTICAL IMPLICATIONS: Once oral disorders involved in VB are identified, appropriate approaches should be used to address this issue. With this course of action, oral health care professionals may use the treatment and preventive care to eliminate potential factors for peer aggression.

Efecto de los extractos fitoquímicos en la eliminación del barro dentinario en el tratamiento de conductos radiculares / Effects of phytochemical extracts on smear layer removal in root canal treatment

Introduction: Studies suggested that phytochemical products are considered potential solutions to smear layer removal due to their biological safety in cleaning root canal systems, lower toxicity, lower irritant effect and antimicrobial effect. Objective: The aim of the present study was to perform a systematic review to evaluate smear layer removal of root canal systems by different natural product solutions. Methods: systematic review. Search of the literature was performed on Pubmed, Scopus, Cochrane, Web of Science, Scielo and Google Scholar according the PRISMA protocol. Studies were included if they performed the experiments of smear layer removal on extracted permanent human teeth. Articles published in any language without restriction of year of publication were included in this review. The risk of bias assessment in the included studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. The search strategy resulted in the retrieval of 6221 publications. After the eligibility criteria application, 8 articles were selected for analysis. Results: It was observed that some natural products solutions showed effects on smear layer removal, especially on coronal third. The phytochemical products such as Salvadora persica, chamomile alcohol extract and grape seed extract demonstrated good potential of smear layer removal, however, its effectiveness and clinical applicability are still unclear. Conclusions: Although the limitations of this study, it is possible to highlight those phytochemical products such as Salvadora persica, chamomile alcohol extract and grape seed extract that demonstrated good potential on SL removal(AU)

Introducción: Los productos fitoquímicos se consideran soluciones potenciales para la eliminación del barro dentinario debido a su seguridad biológica en la limpieza del sistema de conductos radiculares, menor toxicidad, menor efecto irritante y efecto antimicrobiano. Objetivo: Evaluar la eliminación del barro dentinario de los sistemas de conductos radiculares mediante diferentes soluciones de productos naturales. Métodos: La búsqueda de la literatura se realizó en Pubmed, Scopus, Cochrane, Web of Science, SciELO y Google Scholar, según el protocolo PRISMA. Los estudios se incluyeron si realizaron los experimentos de eliminación del barro dentinario en dientes humanos permanentes extraídos. En esta revisión se incluyeron artículos publicados en cualquier idioma, sin restricción de año de publicación. La evaluación del riesgo de sesgo en los estudios incluidos se evaluó mediante la lista de verificación de evaluación crítica del Instituto Joanna Briggs para estudios cuasiexperimentales. La estrategia de búsqueda resultó en la recuperación de 6221 publicaciones. Después de la aplicación de los criterios de elegibilidad, se seleccionaron 8 artículos para su análisis. Resultados: Se observó que algunas soluciones de productos naturales mostraron efectos sobre la eliminación del barro dentinario, especialmente en el tercio coronal. Los productos fitoquímicos como salvadora pérsica, extracto de alcohol de manzanilla y extracto de semilla de uva demostraron un buen potencial de eliminación del barro dentinario; sin embargo, su efectividad y aplicabilidad clínica aún no están claras. Conclusiones: A pesar de las limitaciones de este estudio, es posible destacar aquellos productos fitoquímicos como salvadora pérsica, extracto de alcohol de manzanilla y extracto de semilla de uva demostraron buen potencial de eliminación del barro dentinario(AU)

Inter- and intra-lesional molecular heterogeneity of oral leukoplakia.

OBJECTIVES: Oral leukoplakia (OL) is the most common potentially malignant lesion of the oral cavity, and OL diagnosis is a risk factor for developing subsequent oral squamous cell carcinomas (OSCC). Notably, loss of heterozygosity (LOH) profiles have been validated as risk predictors of malignant transformation of OL. Similar to other solid malignant tumors, OSCC exhibit molecular heterogeneity. However, if and to what extent tumor heterogeneity is present in premalignant lesions of the oral cavity has not been addressed. As LOH analysis is currently being used to stratify OL patients at risk for OSCC development in chemoprevention studies, insight into the issue of molecular heterogeneity of OL is of clinical significance. MATERIALS AND METHODS: To address this issue, 11 polymorphic microsatellite markers localizing to chromosomes 3, 9, 11 and 17 were used to detect LOH in 28 samples of 14 OL patients, by capillary electrophoresis analysis. These samples were either clinically recurrent lesions, or two anatomically distinct biopsies from the same lesion, or even two different OL lesions located at distinct intraoral sites. RESULTS: In all but one of the biopsies pairs, distinct LOH patterns were displayed regardless of histopathological grade. These data provide evidence for inter- and intra-lesional molecular heterogeneity in OL. CONCLUSIONS: On the basis of these findings, molecular heterogeneity needs to be addressed in subsequent studies targeting specific carcinogenic pathways/genes in chemoprevention of malignant transformation of OL.

Comparative Analysis of Shear Bond Strength of Steel and Ceramic Orthodontic Brackets Bonded with Six Different Orthodontic Adhesives / Análisis Comparativo de la Resistencia al Corte de Brackets de Ortodoncia de Acero y Cerámica Unidos con Seis Adhesivos de Ortodoncia Diferentes

ABSTRACT: Orthodontic accessories bonding in tooth enamel has been a critical step since the introduction of direct bonding techniques due to the importance of bracket stability. The aim of this study was to evaluate adhesion strength of different adhesive systems used for bracket bonding on dental surface. The present in vitro study was made from the analysis of shear strength of steel and ceramic brackets bonding with six different types of orthodontic adhesives. The brackets were bonded to 120 human extracted first premolar teeth with Orthocem®, Orthocem® + Ambar Universal® primer, Orthobond Plus®, Biofix®, Transbond XT®, Ortholink VLC®. Shear strength tests were performed on a universal testing machine EZ-Test-Shimadzu® and the data were analyzed using ANOVA test with Post-Hoc Bonferroni and 95 % statistical significance (p <0.05). Transbond XT® and Ortholink VLC® resin values showed greater shear resistance for steel brackets bonding and Transbond XT® and Orthobond Plus® adhesives showed better adhesion results for ceramic brackets bonding.

RESUMEN: La unión de accesorios de ortodoncia en el esmalte dental ha sido un paso crítico desde la introducción de las técnicas de unión directa debido a la importancia de la estabilidad del soporte. El objetivo de este estudio fue evaluar la fuerza de adhesión de diferentes sistemas adhesivos utilizados para la unión de brackets en la superficie dental. El presente estudio in vitro se realizó a partir del análisis de la resistencia al corte de brackets de acero y de cerámica unidos con seis tipos diferentes de adhesivos de ortodoncia. Los brackets se unieron a 120 primeros premolares extraídos con los adhesivos Orthocem®, Orthocem® + Ambar Universal® primer, Orthobond Plus®, Biofix®, Transbond XT®, Ortholink VLC®. Las pruebas de resistencia al corte se realizaron en una máquina de prueba universal EZ-Test-Shimadzu® y los datos se analizaron usando la prueba ANOVA con Bonferroni Post-Hoc y 95 % de significación estadística (p <0,05). Los valores de resina Transbond XT® y Ortholink VLC® mostraron una mayor resistencia al corte para la unión de brackets de acero y los adhesivos Transbond XT® y Orthobond Plus® mostraron mejores resultados de adhesión para la unión de brackets cerámicos.

TP53 single nucleotide polymorphism rs1042522 in salivary gland neoplasms.

BACKGROUND: The TP53 single nucleotide polymorphism (SNP) rs1042522 encodes arginine (Arg) or proline (Pro). The Arg variant is more effective at inducing apoptosis than the Pro. METHODS: We assessed this SNP through direct sequencing of benign and malignant salivary neoplasms of Brazilian patients and compared the results with healthy controls' data. BAX, BCL-2, and CASPASE-3 mRNA levels were assessed by quantitative polymerase chain reaction (qPCR) in a set of salivary tumors, and the results were correlated with the tumor genotype. RESULTS: We found a higher frequency of the Arg/Arg genotype in the malignant group. However, the SNP did not influence the age of onset in either benign or malignant tumors. The SNP was not associated with the transcription levels of apoptotic/antiapoptotic genes. CONCLUSION: Malignant salivary neoplasms showed a higher frequency of the allele encoding Arg and a higher frequency of the Arg/Arg genotype. However, the different genotypes did not impact the transcription of genes involved in apoptosis.

Avaliação do status de ansiedade durante o atendimento odontológico / Evaluación del estado de ansiedad durante la atención odontológica / Assessment of patient anxiety during dental care

Introdução: A ansiedade é uma condição emocional relacionada a situações desconhecidas comumente associada ao atendimento odontológico. Objetivo: Avaliar os níveis de ansiedade dos pacientes frente ao atendimento odontológico. Métodos: O presente estudo, do tipo transversal analítico, foi realizado com uma amostra de conveniência composta por 300 pacientes oriundos de um centro de referencia em Odontologia da região sul do estado do Ceará - Brasil. Foram coletadas informações sobre idade, sexo, percepção da saúde bucal, dor de dente, experiência pregressa à tratamentos odontológicos e sobre aspectos psicológicos. O status de ansiedade dos pacientes foi avaliado através do instrumento Modified Dental Anxiety Scale. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa local sob o número de protocolo 1.759.075. Resultados: Dos 300 pacientes selecionados para o estudo, 222 (74,0 porcento) eram do sexo feminino e 78 (26,0 porcento) do masculino, com idade média de 32,7 anos. Em relação à ansiedade, 22,7 porcento (n= 68) dos indivíduos foram considerados ansiosos. Através da análise bivariada verificou-se associação estatisticamente significativa entre o status de ansiedade e os indivíduos do sexo feminino (p= 0,004) e pacientes com histórico de experiências desagradáveis no dentista (p= 0,015). Conclusão: A prevalência de ansiedade é maior nos indivíduos do sexo feminino e experiências odontológicas pregressas desagradáveis ou de sofrimento podem se configurar como um importante fator associado à ansiedade odontológica(AU)

Introducción: La ansiedad es una afección emocional relacionada con las situaciones desconocidas comúnmente asociadas con la atención dental. Objetivo: Evaluar el estado de ansiedad de los pacientes durante el cuidado dental. Métodos: El presente estudio, del tipo transversal analítico, fue realizado con una muestra de conveniencia compuesta por 300 pacientes atendidos en un centro de referencia en Odontología de la región sur del estado Ceará - Brasil. Se recolectó información sobre edad, sexo, percepción de salud bucal, dolor de muelas, tratamientos dentales previos y aspectos psicológicos. El estado de ansiedad se evaluó usando el instrumento Modified Dental Anxiety Scale. El estudio fue aprobado por el Comité de Ética en Investigación local con el número de protocolo 1.759.075. Resultados: De los 300 pacientes seleccionados para el estudio, 222 (74.0 por ciento) eran mujeres y 78 (26,0 por ciento) eran hombres, con una media de 32,7 años. Con respecto a la ansiedad, el 22,7 por ciento (n= 68) de los pacientes del estudio presentaron ansiedad. El asesoramiento de análisis bivariado mostró una asociación estadísticamente significativa entre el estado de ansiedad y las mujeres (p= 0,004) y pacientes con historial de experiencias desagradables en el dentista (p= 0,015). Conclusiones: La prevalencia de la ansiedad es mayor en las mujeres, y las experiencias odontológicas desagradables previas o el sufrimiento pueden ser un factor importante asociado con la ansiedad dental(AU)

Introduction: Anxiety is an emotional state related to the unfamiliar situations commonly associated with dental care. Objective: Evaluate the anxiety status of patients during dental care. Methods: An analytical cross-sectional study was conducted of a convenience sample composed of 300 patients attending a dental care reference center in the southern region of the state of Ceará in Brazil. Information was collected about age, sex, perception of oral health, toothache, previous dental treatment and psychological aspects. Anxiety status was evaluated with the Modified Dental Anxiety Scale. The study was approved by the local Research Ethics Committee with protocol number 1.759.075. Results: Of the 300 patients selected for the study, 222 were women (74.0 percent) and 78 were men (26.0 percent); mean age was 32.7 years. Regarding anxiety, 22.7 percent (n= 68) of the patients studied had anxiety symptoms. Bivariate analysis revealed a statistically significant relationship between anxiety and women (p= 0.004) and patients with a history of unpleasant experiences at the dentist (p= 0.015). Conclusions: Prevalence of anxiety is higher among women. Previous unpleasant experiences or suffering at the dentist may be important factors associated to dental anxiety(AU)

Atitudes imediatas dos praticantes de artes marciais frente à avulsão dentária / Immediate attitudes of martial arts practitioners against dental avulsion

Objetivo: O objetivo do presente estudo foi avaliar o nível de conhecimento dos praticantes de artes marciais da cidade de Juazeiro do Norte, Ceará, sobre avulsão dentária e como proceder mediante aos cuidados imediatos frente à ocorrência de avulsão dentária.Métodos: Um estudo transversal de carácter exploratório foi realizado com uma amostra de conveniência de 60 praticantes de artes marciais. As informações sobre avulsão dentária, experiências e condutas emergenciais frente a avulsão dentária e uso de protetores bucais e equipamentos de proteção foram coletadas através de um questionário autoaplicado. As análises dos dados envolveram estatísticas descritivas de frequência absoluta e relativa de todas as variáveis do estudo. Resultados: A média de idade dos participantes foi de 26,88 anos (DP ± 5,06), sendo 73,3% (n = 44) pertencentes ao sexo masculino. Do total de praticantes de artes marciais entrevistados, 48% praticavam Muay Thai e 18% Taekwondo. O estudo mostrou que apesar de 61,7% do total de entrevistados terem relatado saber o que era traumatismo dentário e 23,3% destes terem presenciado algum tipo de trauma dentário, 85,0% relataram não saber como proceder mediante os casos de avulsão. Entretanto, 95,0% consideraram esta informação como necessária para a prática de esportes. A maioria dos indivíduos praticantes de artes marciais (63,3%) relatou utilizar protetores bucais. Conclusão: A maioria dos praticantes de artes marciais entrevistados relatou saber o que o era traumatismo dentário, mas desconheciam como proceder diante dos casos de avulsão. A maioria dos entrevistados reconhecem a importância e afirmaram utilizar protetores bucais e equipamentos de proteção individual durante as práticas desportivas. (AU)

Aim:The present study sought to evaluate the level of knowledge of martial arts practitioners in the city of Juazeiro do Norte, Ceará, against dental avulsion and how to proceed through immediate care in the event of dental avulsion. Methods:A cross-sectional study was conducted with a convenience sample of 60 martial arts practitioners. Information on dental avulsion, experiences, and emergency behaviors against dental avulsion, as well as the use of mouth guards and protective equipment, were collected through a self-administered questionnaire. Data analysis involved descriptive statistics of the absolute and relative frequency of all variables in the study. Results: The mean age of the participants was 26.88 years (SD ± 5.06), of which 73.3% (n = 44) were males. Of the total number of martial arts practitioners, 48% practiced Muay Thai and 18% Taekwondo. The study showed that 61.7% of the respondents said they had knowledge about what dental trauma was, although only 23.3% had witnessed some type of dental trauma. In addition, 85.0% have never received guidance on how to proceed in cases of avulsion, but 95.0% consider this information to be necessary for the practice of sports. The majority of the individuals who practice martial arts (63.3%) use mouth guards. Conclusion: It was concluded that most of the martial arts practitioners interviewed in the present study do not have knowledge about dental avulsion and about the necessary immediate procedures in the event of dental avulsion. However, most of participants use mouth guards, wear personal protective equipment, and recognize the importance of these during sports practices. (AU)

Avaliação do status de ansiedade durante o atendimento odontológico / Evaluación del estado de ansiedad durante la atención odontológica / Assessment of patient anxiety during dental care

Introdução: A ansiedade é uma condição emocional relacionada a situações desconhecidas comumente associada ao atendimento odontológico. Objetivo: Avaliar os níveis de ansiedade dos pacientes frente ao atendimento odontológico. Métodos: O presente estudo, do tipo transversal analítico, foi realizado com uma amostra de conveniência composta por 300 pacientes oriundos de um centro de referencia em Odontologia da região sul do estado do Ceará - Brasil. Foram coletadas informações sobre idade, sexo, percepção da saúde bucal, dor de dente, experiência pregressa à tratamentos odontológicos e sobre aspectos psicológicos. O status de ansiedade dos pacientes foi avaliado através do instrumento Modified Dental Anxiety Scale. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa local sob o número de protocolo 1.759.075. Resultados: Dos 300 pacientes selecionados para o estudo, 222 (74,0 porcento) eram do sexo feminino e 78 (26,0 porcento) do masculino, com idade média de 32,7 anos. Em relação à ansiedade, 22,7 porcento (n= 68) dos indivíduos foram considerados ansiosos. Através da análise bivariada verificou-se associação estatisticamente significativa entre o status de ansiedade e os indivíduos do sexo feminino (p= 0,004) e pacientes com histórico de experiências desagradáveis no dentista (p= 0,015). Conclusão: A prevalência de ansiedade é maior nos indivíduos do sexo feminino e experiências odontológicas pregressas desagradáveis ou de sofrimento podem se configurar como um importante fator associado à ansiedade odontológica(AU)

Introducción: La ansiedad es una afección emocional relacionada con las situaciones desconocidas comúnmente asociadas con la atención dental. Objetivo: Evaluar el estado de ansiedad de los pacientes durante el cuidado dental. Métodos: El presente estudio, del tipo transversal analítico, fue realizado con una muestra de conveniencia compuesta por 300 pacientes atendidos en un centro de referencia en Odontología de la región sur del estado Ceará - Brasil. Se recolectó información sobre edad, sexo, percepción de salud bucal, dolor de muelas, tratamientos dentales previos y aspectos psicológicos. El estado de ansiedad se evaluó usando el instrumento Modified Dental Anxiety Scale. El estudio fue aprobado por el Comité de Ética en Investigación local con el número de protocolo 1.759.075. Resultados: De los 300 pacientes seleccionados para el estudio, 222 (74.0 por ciento) eran mujeres y 78 (26,0 por ciento) eran hombres, con una media de 32,7 años. Con respecto a la ansiedad, el 22,7 por ciento (n= 68) de los pacientes del estudio presentaron ansiedad. El asesoramiento de análisis bivariado mostró una asociación estadísticamente significativa entre el estado de ansiedad y las mujeres (p= 0,004) y pacientes con historial de experiencias desagradables en el dentista (p= 0,015). Conclusiones: La prevalencia de la ansiedad es mayor en las mujeres, y las experiencias odontológicas desagradables previas o el sufrimiento pueden ser un factor importante asociado con la ansiedad dental(AU)

Introduction: Anxiety is an emotional state related to the unfamiliar situations commonly associated with dental care. Objective: Evaluate the anxiety status of patients during dental care. Methods: An analytical cross-sectional study was conducted of a convenience sample composed of 300 patients attending a dental care reference center in the southern region of the state of Ceará in Brazil. Information was collected about age, sex, perception of oral health, toothache, previous dental treatment and psychological aspects. Anxiety status was evaluated with the Modified Dental Anxiety Scale. The study was approved by the local Research Ethics Committee with protocol number 1.759.075. Results: Of the 300 patients selected for the study, 222 were women (74.0 percent) and 78 were men (26.0 percent); mean age was 32.7 years. Regarding anxiety, 22.7 percent (n= 68) of the patients studied had anxiety symptoms. Bivariate analysis revealed a statistically significant relationship between anxiety and women (p= 0.004) and patients with a history of unpleasant experiences at the dentist (p= 0.015). Conclusions: Prevalence of anxiety is higher among women. Previous unpleasant experiences or suffering at the dentist may be important factors associated to dental anxiety(AU)

Evidence for loss of heterozygosity (LOH) at chromosomes 9p and 17p in oral granular cell tumors: a pilot study.

OBJECTIVE: The objective of this study was to assess loss of heterozygosity (LOH) in tumor suppressor gene loci in oral granular cell tumors (GCTs). STUDY DESIGN: We assessed LOH in 8 samples of oral GCT using polymorphic microsatellite markers at chromosome regions 3p, 9p, 11q, and 17p, flanking areas close to tumor suppressor genes. We further performed immunohistochemistry to detect the p53 and Ki-67 proteins and associated these expressions with the molecular results. RESULTS: Five samples showed LOH in 3 markers at chromosomes 9p and 17p (markers P53, AFM238WF2 and D9S162) with fraction of allelic loss of 42.8% for each of these markers. No LOH was identified in any other chromosome. LOH was not associated with the immunohistochemical expression of p53 and Ki-67. CONCLUSIONS: The present study shows LOH at chromosomes 9p and 17p in oral GCTs.

Evaluation of Symptoms of Temporomandibular Disorders in Orthodontic Appliance Users / Evaluación de los Síntomas de Trastornos Temporomandibulares en los Usuarios de Aparatos Ortodónicos

ABSTRACT: Temporomandibular joint disorders (TMD) are multifactorial pathological conditions that can generate significant impacts on quality of life of individuals. Orthodontics treatments have been discussed in the current literature due to its possible association with the development of TMD. The aim of this study was to evaluate the relationship between the use of fixed orthodontic appliances and the symptoms of TMD. This cross-sectional study was performed with a sample of 336 undergraduate dental students that answered a structured questionnaire about symptoms of TMD. The sample was paired for sex and use of fixed orthodontic appliances. The results highlighted that the most prevalent symptoms of TMD were headaches (21.4 %, n=72), temporomandibular joint noises (21.4 %, n=72) and head and/or neck pain (20.0 %, n=67). The most of sample, 60.4 % (n=203), showed mild TMD symptomatology. No statistical association was observed between the use of orthodontic appliances and TMD symptoms (p=0.121). It can be suggested that the use of fixed orthodontic appliances is not a factor associated with the symptoms of TMD. Still, it is possible to conclude that the prevalence of light TMD symptoms in dentistry students is high.

RESUMEN: Los trastornos de la articulación temporomandibular (TTM) son un grupo de patologías multifactoriales que pueden generar impactos significativos en la calidad de vida de las personas. Los tratamientos de ortodoncia se han discutido en la literatura actual debido a su posible asociación con el desarrollo de TTM. Evaluar la relación entre el uso de aparatos de ortodoncia fijos y los síntomas de TTM. Material y métodos: este estudio transversal se realizó con una muestra de 336 estudiantes de odontología que respondieron un cuestionario estructurado sobre los síntomas de TTM. La muestra fue emparejada por género y uso de aparatos de ortodoncia fijos. Los resultados destacaron que los síntomas más prevalentes de TTM fueron cefaleas (21,4 %, n=72), ruidos de la articulación temporomandibular (21,4 %, n=72) y dolor de cabeza y/o cuello (20,0 %, n=67). La mayor parte de la muestra, 60,4 % (n=203), presentó síntomas leves de TTM. No se observó asociación estadística entre el uso de aparatos de ortodoncia y los síntomas de TTM (p=0,121). Se puede sugerir que el uso de aparatos de ortodoncia fijos no es un factor asociado con los síntomas de TTM. Aun así, es posible concluir que la prevalencia de síntomas leves de TTM en estudiantes de odontología es alta.

Avaliação do conhecimento dos mototaxistas frente à ocorrência de avulsão dentária e fraturas coronárias / Atitudes Imediatas dos Mototaxistas de Juazeiro do Norte-CE Frente à Avulsão Dentária e Fratura Coronária / Assessment of the knowledge of motorcycle taxi drivers about immediate attitudes to dental trauma

Objetivo: Avaliar o conhecimento dos mototaxistas de Juazeiro do Norte-CE sobre os procedimentos imediatos frente à ocorrência de avulsão e fratura coronária, além de verificar o consumo de substâncias lícitas e ilícitas, bem como o uso de capacetes do tipo fechado durante as atividades laborais.Métodos: Um estudo transversal foi realizado com uma amostra de conveniência de mototaxistas regularmente registrados no sindicato de mototaxistas em Juazeiro do Norte, Ceará, Brasil. Informações sobre condutas emergenciais e possíveis experiências e atitudes tomadas frente à ocorrência de avulsão dentária e fratura coronária, uso de substâncias lícitas e ilícitas, bem como o uso de capacetes para proteção fechados foram coletadas através de questionário. A análise dos dados envolveu estatística descritiva da frequência absoluta e relativa das variáveis do estudo.Resultados: Do total de mototaxistas entrevistados, 56,3% afirmaram ter entendimento sobre o conceito de traumatismo dentário, 52,1% não procurariam o cirurgião-dentista nos casos de ausência de fratura coronária, 58,3% pegariam em qualquer parte do dente avulsionado, 25,0% transportariam o dente até o consultório odontológico com auxílio de um lenço e 33,3% afirmaram que poderiam procurar o dentista na mesma semana da ocorrência do trauma. A ingestão de drogas lícitas e ilícitas antes do trabalho foi relatada, respectivamente, por 8,3% e 6,3% dos entrevistados e o uso de capacete de proteção foi realizado por 41,7% dos mototaxistas.Conclusão: Foi detectada um baixo conhecimento dos mototaxistas de Juazeiro do Norte-CE sobre as condutas imediatas adequadas frente à avulsão dentária e fratura coronária. O relato de consumo de substâncias lícitas e ilícitas foi baixo. O uso de capacetes de proteção fechados durante o trabalho apresentou uma porcentagem considerável.

Aim: To evaluate the knowledge of motorcycle taxi drivers from Juazeiro do Norte, Ceará, Brazil about immediate attitudes regarding dental avulsion and coronary fracture, as well as to verify the consumption of licit and illicit substances and the use of protective helmets.Methods: A cross-sectional study was carried out with a convenience sample of motorcycle taxi drivers registered at the Union of Motorcycle taxi drivers of Juazeiro do Norte. Information on emergency behaviors and possible experiences and attitudes regarding the occurrence of trauma, the use of licit and illicit substances, and the use of closed protective helmets were collected using a questionnaire. Data analysis involved descriptive statistics of the absolute and relative frequency of all variables of the present study.Results: Of the total number of motorcycle taxi drivers interviewed, 56.3% stated that they had previous knowledge about the concept of dental trauma, 52.1% would not seek out a dentist in cases of the absence of a crown fracture, 58.3% would take the avulsed tooth anywhere, 25% would carry the tooth to the dental office wrapped in a piece of cloth, and 33.3% answered that they would go to the dentist in the same week of the trauma. Intake of licit and illicit substances before work was reported, respectively, by 8.3% and 6.3% of the interviewees, and the use of protective helmets was observed in 41.7% of motorcycle taxi drivers.Conclusion: This study showed a low knowledge of motorcycle taxi drivers from Juazeiro do Norte about appropriate immediate attitudes concerning the occurrence of dental avulsion and coronary fracture. The use of closed helmets during work was found in a considerable percentage of the drivers. The report of consumption of licit and illicit substances was low.

Assessing the contribution of HRPT2 to the pathogenesis of jaw fibrous dysplasia, ossifying fibroma, and osteosarcoma.

OBJECTIVE: To investigate HRPT2 in jaw ossifying fibroma (OF), fibrous dysplasia (FD), and osteosarcoma (OS). STUDY DESIGN: We combined microsatellite loss of heterozygosity (LOH), HRPT2 sequence alterations at the mRNA level by reverse-transcription polymerase chain reaction (PCR), cDNA sequencing, and quantitative PCR (qPCR) and immunohistochemistry (IHC) in a total of 19 OF, 15 FD, and 9 OS. Because HRPT2 (parafibromin) interacts with cyclin D1, we investigated cyclin D1 expression with the use of qPCR and IHC. RESULTS: LOH was detected in 3/5 FD, 6/9 OF, and 2/2 OS heterozygous samples. LOH was not associated with decreased mRNA levels or HRPT2 protein expression except for 1 OF which harbored an inactivating mutation. However, this tumor did not display altered transcription or protein levels of HRPT2 nor cyclin compared with the other OF. CONCLUSIONS: The contribution of HRPT2 inactivation to the pathogenesis of OF, FD, and OS is marginal at best and may be limited to progression rather than tumor initiation.