COVID-19 and dental sleep medicine: risks, precautions and patient guidance.

COVID-19 is the offcial name for the disease caused by SARS-CoV-2, which has become a pandemic, infecting more than 5 million people worldwide. Transmission occurs by inhaling droplets generated when an infected person coughs, sneezes or exhales, or by touching contaminated surfaces and then rubbing their hands over their eyes, nose or mouth. Some infected people become seriously ill, while others have no symptoms, but even though they are asymptomatic, they can still transmit the virus. As vaccines and effective medications do not yet exist, the only way to handle the devastating consequences of the pandemic is prevention. Quality of sleep is essential for the immune system to be prepared to receive, fight and restore itself after a viral infection. Therefore, patients with obstructive sleep apnea (OSA) should continue treatment, and only suspend or change the therapeutic modality under the guidance of a sleep physician. In the era of COVID-19, due to the high probability of contamination promoted by CPAP, the mandibular repositioning device has been considered as the first choice for patients with OSA. However, as the dental approach is at high risk of contamination, due to the proximity of the dental surgeon to the patient, it is essential that the professional who works in this field knows the risks to which they are exposed. Precautions must be adopted and patients should be guided in order to control and use of their intraoral devices.

Assessment of interobserver concordance in polysomnography scoring of sleep bruxism.

INTRODUCTION: Objective evaluation of sleep bruxism (SB) using whole-night polysomnography (PSG) is relevant for diagnostic confirmation. Nevertheless, the PSG electromyogram (EMG) scoring may give rise to controversy, particularly when audiovisual monitoring is not performed. Therefore, the present study assessed the concordance between two independent scorers to visual SB on a PSG performed without audiovisual monitoring. METHODS: Fifty-six PSG tests were scored from individuals with clinical history and polysomnography criteria of SB. In addition to the protocol of conventional whole-night PSG, electrodes were also placed bilaterally on the masseter and temporal muscles. Visual EMG scoring without audio video monitoring was scored by two independent scorers (Dentist 1 and Dentist 2) according the recommendations formulated in the AASM manual (2007). Kendall Tau correlation was used to assess interobserver concordance relative to variables "total duration of events (seconds), "shortest events", "longest events" and index in each phasic, tonic or mixed event. RESULTS: The correlation was positive and significant relative to all the investigated variables, being T>0.54. CONCLUSION: It was found a good inter-examiner concordance rate in SB scoring in absence of audio video monitoring.

Resistência de união à dentina: efeito da umidade e da contaminação com saliva / Effects of moist and saliva contamination on bond strength to dentin

Este estudo analisou, por meio de teste de tração in vitro, a resistência de união à dentina de 2 sistemas adesivos (SBMP-Plus/3M e Prime & Bond 2.0/Dentsply) que foram utilizados de 3 formas diferentes: 1) secamento com ar após a lavagem do condionamento ácido; 2) re-umedecendo com água destilada após a secagem, e 3) contaminando com saliva fresca após a secagem. Sessenta dentes molares humanos extraídos foram incluídos em resina acrílica incolor, desgastados com lixa de papel até exposição de dentina no sentido longitudinal e divididos em 6 grupos. Sobre esses dentes foram confeccionados cones de resina composta Z-100 (3M) aderidos com os 2 diferentes sistemas adesivos nas 3 condições descritas anteriormente. Os corpos-de-prova foram submetidos a testes de tração numa máquina de ensaios Universal Wolpert a uma velocidade de 0,5 mm/min. Os resultados obtidos foram transformados em MPa de acordo com a área de adesão e submetidos a análise estatística pela ANOVA e teste de Tukey. Os resultados mostraram que os 2 sistemas adesivos não apresentaram diferença estatisticamente significante entre si (p>0,05); os dentes que foram secos (7,31 ± 2,91) apresentaram a menor resistência, à tração e aqueles que foram umedecidos com água destilada (12,74 ± 6,59) apresentaram a maior resistência, sendo a diferença entre eles estatisticamente significante no nível de 1 por cento. Os dentes que foram contaminados com saliva fresca (10,62 ± 4,75) apresentaram um valor intermediário entre os dois anteriores, não sendo este estatisticamente diferente de nenhum dos outros dois tratamentos realizados