Treatment options for cisplatin-ineligible patients with locally advanced head and neck squamous cell carcinoma: a systematic review.

PURPOSE: There is no agreed-upon standard option for patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC) unfit for cisplatin-based regimens. Therefore, we performed a systematic review to explore alternative options for this population. METHODS: We searched PubMed, Cochrane, and Embase databases for observational studies and clinical trials (CTs) assessing treatment options for LA HNSCC cisplatin-ineligible patients. This study was registered in PROSPERO under the number CRD42023483156. RESULTS: This systematic review included 24 studies (18 observational studies and 6 CTs), comprising 4450 LA HNSCC cisplatin-ineligible patients. Most patients were treated with cetuximab-radiotherapy [RT] (50.3%), followed by carboplatin-RT (31.7%). In seven studies reporting median overall survival (OS) in patients treated with cetuximab-RT, it ranged from 12.8 to 46 months. The median OS was superior to 40 months in two studies assessing carboplatin-RT, and superior to 15 months in two studies assessing RT alone. For other regimens such as nimotuzumab-RT, docetaxel-RT, and carboplatin-RT plus paclitaxel the median OS was 21, 25.5, and 28 months, respectively. CONCLUSIONS: Our systematic review supports the use of a variety of therapy combinations for LA HNSCC cisplatin-ineligible patients. We highlight the urgent need for clinical studies assessing treatment approaches in this population.

Mandibular molar rehabilitation using orthodontic extrusion associated with odontoplasty.

The aim of this clinical report is to describe the successful treatment of a mandibular first molar presenting an extensive fracture at the buccal aspect in a young patient. The extension of the fracture was a negative prognostic factor for tooth maintenance. An alternative clinical treatment was proposed since the patient was young and presented with good oral hygiene and periodontal health. The treatment was based on orthodontic forced eruption associated with odontoplasty. A 3-year follow-up after the surgical procedure demonstrated the maintenance of periodontal health and good plaque control. It can be concluded that orthodontic forced eruption associated with odontoplasty promoted favorable conditions for prosthetic rehabilitation and is a feasible procedure in the treatment of tooth fracture extended below the cementoenamel junction.

Band cementation materials: solubility and fluoride release.

PURPOSE: The aim of this study was to evaluate the solubility and the fluoride release of different materials used for orthodontic band cementation in different solutions and at different times. MATERIALS AND METHODS: Three materials were selected: Ultra Band-Lok (UBL); RelyX (RLX) and Ketac-Cem (KTC). Sixteen standard samples from each material were prepared, according to the manufacturers' instructions. The samples were stored in two different solutions (n = 8): 0.9% saline solution (pH 7.0) and 0.1 mol/l lactic acid (pH 4.0). The storage solutions were changed after 24 h and after 7, 15 and 30 days. The fluoride release was determined with an ion-specific electrode (Analion). For the solubility evaluation, the formula Wsl = (m1-m2)/V was used to determine the loss of mass. Data were submitted for statistical analysis using the non-parametric Kruskal-Wallis test. RESULTS: With respect to the solubility, immersion in lactic acid increased the solubility when compared with saline solution (P < 0.01). In both the solutions, there were differences among materials (P < 0.01) with the following rankings: UBL < RLX < KTC for lactic acid and UBL < RLX < KTC for saline solution. The ranking of fluoride release was UBL < KTC < RLX. In the two tested solutions, RLX exhibited the highest fluoride release (P < 0.01), whereas KTC showed more fluoride release than that of UBL (P < 0.05). Fluoride release decreased over time and the storage solution influenced the fluoride-releasing capacity of some materials. CONCLUSIONS: It was found that fluoride release was influenced by storage solution, materials and immersion time. Materials and storage solution were the significant factors for solubility.

Surface roughness of orthodontic band cements with different compositions.

OBJECTIVES: The present study evaluated comparatively the surface roughness of four orthodontic band cements after storage in various solutions. MATERIAL AND METHODS: Eight standardized cylinders were made from 4 materials: zinc phosphate cement (ZP), compomer (C), resin-modified glass ionomer cement (RMGIC) and resin cement (RC). Specimens were stored for 24 h in deionized water and immersed in saline (pH 7.0) or 0.1 M lactic acid solution (pH 4.0) for 15 days. Surface roughness readings were taken with a profilometer (Surfcorder SE1200) before and after the storage period. Data were analyzed by two-way ANOVA and Tukey's test (comparison among cements and storage solutions) or paired t-test (comparison before and after the storage period) at 5% significance level. RESULTS: The values for average surface roughness were statistically different (p<0.001) among cements at both baseline and after storage. The roughness values of cements in a decreasing order were ZP>RMGIC>C>R (p<0.001). After 15 days, immersion in lactic acid solution resulted in the highest surface roughness for all cements (p<0.05), except for the RC group (p>0.05). Compared to the current threshold (0.2 µm) related to biofilm accumulation, both RC and C remained below the threshold, even after acidic challenge by immersion in lactic acid solution. CONCLUSIONS: Storage time and immersion in lactic acid solution increased the surface roughness of the majority of the tested cements. RC presented the smoothest surface and it was not influenced by storage conditions.

Efetividade de mantedores de espaço em odontopediatria: revisão sistemática / Effectiveness of space maintainers in pediatric dentistry: a systematic review

Objetivo: o objetivo deste estudo é avaliar por meio de revisão sistemática a efetividade dos dispositivos na manutenção do espaço para dentes permanentes quando da perda precoce do dente decíduo. Materiais e método: realizou-se uma pesquisa bibliográfica de estudos publicados até março de 2014, principalmente nas bases de dados PubMed e SciELO. Os critérios para seleção foram: estudos em ensaios clínicos randomizados (ECR) e ensaios clínicos controlados (ECC), com crianças de seis a doze anos com dentição decídua ou mista, com perda precoce de dentes decíduos na região anterior e/ou posterior. Foram considerados todos os tipos de mantedores de espaço tanto removíveis quanto fixos. Os desfechos considerados foram avaliação clínica, radiográfica e/ou análise de modelos. A análise dos textos e a coleta de dados foram realizadas por dois revisores de forma independente. Resultados: a busca resultou em um total de 438 artigos, após a remoção das duplicatas, e apenas um contemplou todos os critérios de inclusão. O artigo que preencheu os critérios comparou dois diâmetros de fio ortodôntico utilizados para a confecção do aparelho mantedor de espaço, arco lingual, referindo que o mais efetivo foi confeccionado com fio de menor calibre (0,9 mm) quandocomparado ao de maior calibre (1,25 mm). Essa diferença ocorreu devido às falhas que ocorrem com maior frequência no dispositivo de maior calibre. Considerações finais: evidenciou-se, por meio deste estudo, que devido à carência de ensaios clínicos, não é possível definir o mantedor de espaço mais efetivo, o que torna necessário o desenvolvimento de novos estudos com delineamentos adequados para responder essa questãode forma precisa.

Surface roughness of orthodontic band cements with different compositions

OBJECTIVES: The present study evaluated comparatively the surface roughness of four orthodontic band cements after storage in various solutions. MATERIAL AND METHODS: Eight standardized cylinders were made from 4 materials: zinc phosphate cement (ZP), compomer (C), resin-modified glass ionomer cement (RMGIC) and resin cement (RC). Specimens were stored for 24 h in deionized water and immersed in saline (pH 7.0) or 0.1 M lactic acid solution (pH 4.0) for 15 days. Surface roughness readings were taken with a profilometer (Surfcorder SE1200) before and after the storage period. Data were analyzed by two-way ANOVA and Tukey's test (comparison among cements and storage solutions) or paired t-test (comparison before and after the storage period) at 5 percent significance level. RESULTS: The values for average surface roughness were statistically different (p<0.001) among cements at both baseline and after storage. The roughness values of cements in a decreasing order were ZP>RMGIC>C>R (p<0.001). After 15 days, immersion in lactic acid solution resulted in the highest surface roughness for all cements (p<0.05), except for the RC group (p>0.05). Compared to the current threshold (0.2 µm) related to biofilm accumulation, both RC and C remained below the threshold, even after acidic challenge by immersion in lactic acid solution. CONCLUSIONS: Storage time and immersion in lactic acid solution increased the surface roughness of the majority of the tested cements. RC presented the smoothest surface and it was not influenced by storage conditions.

Estudo morfofuncional do segmento medial, porção superior, do músculo orbicular da boca em crianças com má oclusão de Classe II, divisão 1 de Angle e com modos respiratórios predominantemente nasal ou bucal / Morfofunctional study of the medial superior region of the orbicular muscle of the mouth in children with Angle Class II, division 1 and with respiratory manner predominantly nasal or buccal

A respiração bucal crônica pode ser definida como uma respiração habitual pela boca, ao invés de ser realizada pelo nariz, devido à elevada resistência nasal, acarretando adaptações de tecidos moles e estruturas esqueléticas adjacentes no sentido de manter suficientemente aberto o espaço faringeano, o que resulta em modificações na posição postural da mandibula, dando margem ao surgimento da má oclusão. No presente estudo foi realizada uma avaliação morfofuncional da região medial superior do músculo orbicular da boca, investigando possíveis correlações com a respiração bucal. A amostra consistiu de 50 crianças entre seis e nove anos de idade, brasileiras, leucodermas, sendo 25 do gênero feminino e 25 do gênero masculino, com má oclusão de Classe II, divisão 1 de Angle e modos respiratórios predominantemente nasal ou bucal. A forma do lábio superior foi estudada em telerradiografias de perfil, utilizando-se mensurações lineares representativas da altura e da espessura do mesmo. A avaliação funcional consistiu na análise eletromiográfica, realizada durante a situação de repouso e em mais 21 movimentos lábio-mandibulares, por meio de eletrodos de superfície. Os dados coletados foram submetidos à estatística descritiva, teste t(Student) para amostras independentes e teste F para duas variâncias. Os resultados revelaram que não houve diferença estatisticamente significativa entre os dois grupos estudados em relação à forma do lábio superior, assim como para a função, não havendo correlação entre a morfologia e comportamento funcional da região medial, porção superior, do músculo orbicular da boca para toda a amostra avaliada, independentemente do modo respiratório