Can rapid maxillary expansion affect speech sound production in growing patients? A systematic review.

Rapid maxillary expansion (RME) may change speech sound parameters due to the enlargement of oral and nasal cavities. This study aimed to systematically review the current evidence on speech changes as a side effect of RME. An electronic search was conducted in nine databases, and two of them accessed the 'grey literature'. The eligibility criteria included clinical studies assessing orthodontic patients with maxillary transverse deficiency and the relationship with speech alterations without restricting publication year or language. Only interventional studies were included. The JBI Critical Appraisal Tool assessed the risk of bias. The initial search provided 4853 studies. Seven articles (n = 200 patients) met the inclusion criteria and were analysed. The primary source of bias was the absence of a control group in four studies. RME altered speech production by changing vowel fundamental frequency and fricative phoneme formant frequency. Shimmer and jitter rates changed in one and two studies, respectively. Two studies presented deterioration during orthodontic treatment, but speech improved after appliance removal. Despite the limited evidence, RME affects speech during and after treatment.

Viability and oxidative stress of dental pulp cells after indirect application of chemomechanical agents: An in vitro study.

AIM: This study evaluated the transdentinal cytotoxic effects of enzymatic agents (EA) for chemomechanical carious tissue removal on human dental pulp cells. METHODOLOGY: The groups were based on the performed dentine treatments (n = 8): G1: Positive Control (PC - no treatment); G2: Negative Control (NC - 35% H2 O2 for 2 min); G3: Brix 3000™ (BX) for 30 s; G4: BX for 2 min; G5: Papacarie Duo™ (PD) for 30 s; G6: PD for 2 min. The cells were evaluated for viability (VB; MTT assay) and production of reactive oxygen species (ROS; DCFH-DA assay) and nitric oxide (NO; Griess reagent). A scanning electron microscope provided morphological chemical analyses and energy-dispersive X-ray spectroscopy. The data were submitted to the one-way anova statistical test complemented by Tukey (p < .05). RESULTS: Cell viability decreased by 21.1% and 58.4% in G5 and G6, respectively. ROS production in G3 and G4 maintained basal levels but increased by 171.2% and 75.1% in G5 and G6, respectively. CONCLUSIONS: The Brix3000™ enzymatic agent did not cause indirect cytotoxic effects on pulp cells, regardless of the application time. Conversely, Papacarie Duo™ reduced viability and increased ROS production by pulp cells.

Assessment of color changes and adverse effects of over-the-counter bleaching protocols: a systematic review and network meta-analysis.

OBJECTIVES: To assess color change efficacy and the adverse effects of varied over-the-counter (OTC) bleaching protocols. METHODOLOGY: The study included randomized clinical trials evaluating color changes from OTC bleaching agents. Nine databases were searched, including the partial capture of the grey literature. The RoB2 tool analyzed the individual risk of bias in the studies. Frequentist network meta-analyses compared treatments through common comparators (∆Eab* and ∆SGU color changes, and tooth sensitivity), integrating direct and indirect estimates and using the mean and risk differences as effect measures with respective 95% confidence intervals. The GRADE approach assessed the certainty of the evidence. RESULTS: Overall, 37 remaining studies constituted the qualitative analysis, and ten composed the meta-analyses. The total sample included 1,932 individuals. ∆Eab* was significantly higher in groups 6% hydrogen peroxide (HP) strips (≥ 14 h). ∆SGU was significantly higher in groups at-home 10% carbamide peroxide (CP) (≥ 14 h), followed by 6% HP strips (≥ 14 h) and 3% HP strips (≥ 14 h). At-home 10% CP (7-13 h) and placebo showed lower risks of tooth sensitivity without significant differences between these treatments. CONCLUSION: Considering the low level of evidence, OTC products presented satisfactory short-term effects on tooth bleaching compared to the placebo, with little to no impact on dentin hypersensitivity and gingival irritation. CLINICAL RELEVANCE: OTC products are proving to be practical alternatives for tooth whitening. However, patients should be advised about the possible risks of carrying out such procedures without professional supervision.

Survival of temporomandibular total joint replacement: A systematic review and meta-analysis.

BACKGROUND: Prosthetic total joint replacement has been incorporated as a treatment for complex temporomandibular disorder; however, the survival of those devices is unknown. OBJECTIVE: To assess the survival rate of the total temporomandibular joint (TMJ) prothesis and their main causes of failure. METHODS: An electronic search was conducted in eight databases until March 2023. Prospective studies reporting the survival rate of total TMJ prothesis with a minimum follow-up of 12 months were included. Studies with partial TMJ prostheses or those no longer available on the market were excluded. Two reviewers assessed the individual risk of bias using the JBI Systematic Reviews for Quasi-experimental studies tool. Meta-analysis of proportions was conducted to summarise the survival rate, using 95% confidence intervals (CI). The GRADE approach assessed the certainty of the body of evidence. RESULTS: Data from 320 patients were collected from six prospective studies. The number of prothesis losses varied from none to four. All studies presented sources of bias related to follow-up description of the patients. The follow-up time varied from 12 months to 21 years. In most of the studies, prosthesis failure occurred within the first 6 months after surgery due to infection. The overall survival of total TMJ protheses was 97% (95% CI: 95%; 99%), with low heterogeneity (I2 = 29%) and a very low certainty of evidence. CONCLUSION: TMJ total prosthesis apparently is a safe procedure with a high survival rate and the evidence is very uncertain and presents important sources of bias.

Do blood concentrates influence inflammatory signs and symptoms after mandibular third molar surgery? A systematic review and network meta-analysis of randomized clinical trials.

OBJECTIVES: To investigate, through a network meta-analysis, the effectiveness of blood concentrates in reducing pain perception, trismus, and edema after mandibular third molar extraction. MATERIALS AND METHODS: An electronic search was performed in nine databases to locate randomized clinical trials comparing blood concentrate use after mandibular third molar extraction. Two authors selected and extracted the data independently. The individual risk of bias in the studies was assessed with the RoB v2.0 tool. A network meta-analysis compared postoperative pain and trismus scores after applying different blood concentrates, using the mean difference (MD) as an effect estimate. The GRADE approach assessed the certainty of evidence. RESULTS: Thirty-one randomized clinical trials were included in the review and 18 in the meta-analysis. Leukocyte- and platelet-rich fibrin (L-PRF) was the most used blood concentrate, followed by platelet-rich plasma (PRP). The network meta-analysis, depending on the analyzed period, evaluated up to 1240 surgeries. Among the analyzed blood concentrates, advanced platelet-rich fibrin (A-PRF) performed better among the analyzed blood concentrates, decreasing postoperative pain in 1, 2, 3, and 7 days and reducing trismus up to the inflammatory peak compared to blood clots. Only two studies had a low risk of bias. CONCLUSIONS: Based on very low certainty of evidence, using concentrates seemed efficient compared to blood clots in reducing pain and trismus after mandibular third molar surgeries. A-PRF decreased postoperative pain throughout the evaluated time and trismus during the acute inflammatory peak. CLINICAL RELEVANCE: A-PRF after mandibular third molar extractions performed better among the analyzed blood concentrates and seemed efficient in improving postoperative quality by decreasing inflammatory signs and symptoms.

Artificial Intelligence for Detecting Cephalometric Landmarks: A Systematic Review and Meta-analysis.

Using computer vision through artificial intelligence (AI) is one of the main technological advances in dentistry. However, the existing literature on the practical application of AI for detecting cephalometric landmarks of orthodontic interest in digital images is heterogeneous, and there is no consensus regarding accuracy and precision. Thus, this review evaluated the use of artificial intelligence for detecting cephalometric landmarks in digital imaging examinations and compared it to manual annotation of landmarks. An electronic search was performed in nine databases to find studies that analyzed the detection of cephalometric landmarks in digital imaging examinations with AI and manual landmarking. Two reviewers selected the studies, extracted the data, and assessed the risk of bias using QUADAS-2. Random-effects meta-analyses determined the agreement and precision of AI compared to manual detection at a 95% confidence interval. The electronic search located 7410 studies, of which 40 were included. Only three studies presented a low risk of bias for all domains evaluated. The meta-analysis showed AI agreement rates of 79% (95% CI: 76-82%, I2 = 99%) and 90% (95% CI: 87-92%, I2 = 99%) for the thresholds of 2 and 3 mm, respectively, with a mean divergence of 2.05 (95% CI: 1.41-2.69, I2 = 10%) compared to manual landmarking. The menton cephalometric landmark showed the lowest divergence between both methods (SMD, 1.17; 95% CI, 0.82; 1.53; I2 = 0%). Based on very low certainty of evidence, the application of AI was promising for automatically detecting cephalometric landmarks, but further studies should focus on testing its strength and validity in different samples.

Critical appraisal of confounding factors of observational studies on the association between dentofacial features and dental trauma in a Brazilian population.

AIMS/OBJECTIVES: Dental trauma is a highly prevalent dental emergency. Children and adolescents without inadequate lip coverage, increased overjet, and anterior open bite are associated with the occurrence of traumatic dental injuries. Observational studies do not allow the inference of causality, one of the reasons being: the potential confounding factors. Therefore, this review aimed to critically appraise the confounding factors considered in epidemiological studies that associate dentofacial features with the occurrence of dental trauma in Brazilian children and adolescents. METHODS: Studies included in the qualitative synthesis of a recently published comprehensive systematic review and meta-analysis on the topic were screened. Studies that only mentioned the performance of bivariate analyzes or that did not mention the performance of multivariate analyzes were excluded. Evaluation of control statements for possible confounders and bias consideration was performed for each selected study. Confounding factors in these studies were also identified and categorized according to their domains. RESULTS: Fifty-five observational studies were screened, of which 11 were excluded due to the mention of only bivariate analyzes or the lack of multivariate analyses. The remaining 44 studies were critically appraised. Of these, 9 studies specifically mentioned the term confounding, and 12 studies mentioned the term bias. However, only 14 studies mentioned limitations on confounding factors in their findings. Among the 99 different variables identified, the most used were type of trauma, followed by sex and age. CONCLUSION: Most studies did not acknowledge the control for possible confounding factors and rarely stressed the need for caution in interpreting their results. Cross-sectional studies do not allow inferring a cause-and-effect relationship between dentofacial features and dental trauma.

Pulp changes from rapid maxillary expansion: A systematic review.

INTRODUCTION: This study aimed to systematically review the current evidence on the occurrence of pulp changes as side effects from orthopaedic rapid maxillary expansion (ORME) or surgically assisted rapid maxillary expansion (SARME). METHODS: An electronic search was performed in eleven databases. The eligibility criteria included clinical studies assessing vitality, sensibility or dimensions of the pulp chamber of permanent teeth before and after ORME or SARME, without restrictions on publication year or language. The risk of bias was analysed with the NIH 'Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group' and the 'JBI for quasi-experimental studies' tool. The GRADE tool was used to assess the certainty of evidence. RESULTS: The initial search resulted in 1,197 records, from which only seven before-after studies were included. There was a change in the pulpal blood flow (PBF) of maxillary incisors and canines up to 5 days after SARME, which gradually returned after 7 days to 3 months. After ORME, one study observed an increased PBF and one study observed a reduced PBF, which gradually returned after the end of expansion. Two studies observed that both ORME and SARME caused temporary changes in pulp sensibility. Three studies observed a significant reduction in the pulp chamber after ORME or SARME. The outcomes presented a very low certainty of evidence. CONCLUSIONS: Although limited, the evidence shows that ORME and SARME caused temporary changes in pulp vitality and sensibility, with the possibility of inducing a reduction in pulp chamber dimensions.

Knowledge and practice of dentists in processing polishing points: A cross-sectional study.

BACKGROUND: Adequately processing polishing points used to polish composite resin restorations is necessary for microbiological control in dentistry, but there is no specific protocol to guide professionals. Therefore, this study aimed to assess the knowledge and practice of dentists in processing these instruments. METHODS: This cross-sectional observational study included the application of an online questionnaire via Google Forms and social media promotion. The study evaluated the association of field of activity, time since graduation, age, and sex of professionals with processing practice. The statistical analysis was performed with absolute and relative frequencies and logistic and Poisson regressions at a 5% significance level. RESULTS: Overall, 473 questionnaires were analyzed. A rate of 51% of professionals reported using inadequate processing methods, and almost 68% claimed to have good knowledge of the topic. Both regression analyses were significantly associated, showing a direct effect of age and time since graduation on adequate processing practices. CONCLUSIONS: Although most professionals reported understanding the processing of polishing points, they do not perform it most adequately. CLINICAL SIGNIFICANCE: An expressive number of dentists process polishing points improperly. The topic is significant for representing a semi-critical instrument extensively used in esthetic restorations.

Impacts of using orthodontic appliances on the quality of life of children and adolescents: systematic review and meta-analysis.

BACKGROUND: Although there are previous systematic reviews about the oral health-related quality of life (OHRQoL) impact among children and adolescents after orthodontics treatment, there is no definition for the magnitude of these impacts during the therapy. OBJECTIVE: To systematically analyse the literature on changes in the quality of life of children and adolescents during orthodontic treatment. LIMITATIONS: Almost all the studies included in this review are non-randomized clinical trials, which are susceptible to several biases that affect the certainty of evidence obtained, especially by confounding factors and the lack of a control group. CONCLUSIONS AND IMPLICATIONS: Based on very low certainty of evidence, wearing appliances does not seem to have a significant negative impact during the first year of orthodontic treatment. However, the meta-analytic results suggest that functional limitations in the first 3 months of treatment can be slightly more critical for the impact on the oral health quality of life and consequent patient adherence to treatment. FUNDING: This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES), Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil (CNPq), and Fundação de Amparo à Pesquisa do Estado de Minas Gerais - Brazil (FAPEMIG). REGISTRATION: CRD42021234407.

Use of air polishing for supra- and subgingival biofilm removal for treatment of residual periodontal pockets and supportive periodontal care: a systematic review.

AIM: To systematically review the literature to compare the efficacy of air polishing to hand or ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care. METHODS: Electronic searches were performed in five different databases, and two databases were used to capture the "grey literature partially." Clinical trials that compared the use of an air-polishing device to either conventional scaling and root planing (hand and/or ultrasonic instrumentation) or no treatment during periodontal therapy were included without restriction of year and publication status. The Joanna Briggs Institute instrument for clinical trials was used to appraise the studies critically. The results were submitted to qualitative descriptive analysis. The systematic review protocol was registered in PROSPERO (CRD420220156176). RESULTS: Electronic searches found 1100 hits published between 2008 and 2019. Thirteen studies were included in the review, out of which four had a follow-up longer than 180 days. Results indicated no differences between the efficacy of air polishing and hand or ultrasonic instruments to reduce periodontal inflammation. CONCLUSIONS: Our findings suggest that there is no difference in the efficacy of air polishing and hand or ultrasonic instrumentation to control biofilm and reduce periodontal inflammation. However, these findings must be carefully interpreted owing to methodological issues, including a short follow-up, and a potential conflict of interest related to industry funding. CLINICAL RELEVANCE: Air polishing for biofilm control may be used as an alternative to hand and ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care.

Effectiveness of anesthetic solutions for pain control in lower third molar extraction surgeries: a systematic review of randomized clinical trials with network meta-analysis.

OBJECTIVE: To assess the effectiveness of different anesthetic solutions for pain control immediately after the extraction of lower third molars. METHODS: Nine databases were used to identify randomized clinical trials, without restriction of language or year of publication. The "JBI Critical Appraisal Tools for Systematic Reviews" was used to assess the risk of bias in the studies. The network meta-analysis was performed to compare the effectiveness of different anesthetics to control the pain immediately after the surgery of lower third molars, using the standardized mean difference (SMD) as the effect estimate. The GRADE approach was used to assess the certainty of evidence. RESULTS: The search presented 13,739 initial results, from which 45 met the eligibility criteria and presented low to moderate risk of bias. Thirteen studies were included in the meta-analysis. The 2% lidocaine + clonidine presented the lowest pain scores (SMD = - 1.44; - 2.72 to - 0.16) compared to 4% articaine + adrenaline, followed by 0.5% bupivacaine + adrenaline (SMD = - 1.36; - 2.13 to - 0.59). The certainty of evidence varied between very low to moderate. CONCLUSION: 2% lidocaine + clonidine and 0.5% bupivacaine + adrenaline were the anesthetics with the highest probability for pain control immediately after the surgical procedure of removing impacted lower third molars. CLINICAL SIGNIFICANCE: The use of an adequate anesthetic with effective pain control can contribute to a more comfortable postoperative period.

Is interdental papilla filling using hyaluronic acid a stable approach to treat black triangles? A systematic review.

PURPOSE: To evaluate the stability of interdental papilla filling using hyaluronic acid (HA) to treat black triangles in esthetic regions. METHODS: The protocol was registered in PROSPERO. Six databases (PubMed, Scopus, Embase, Lilacs, SciELO, and Web of Science) were used as primary search sources, and OpenGrey and OpenThesis were used to capture the "gray literature." Only before-after studies were included. The JBI Checklist assessed the risk of bias. Only four studies met the inclusion criteria and were considered for the analyses. The studies were published from 2010 to 2016. All studies presented a low risk of bias. Considering the studies do not have control groups, a weighted average by sample size was calculated to obtain a general estimate of the percentage of papillary filling after 6 months and the number of HA applications. RESULTS: The studies showed the percentage of papillary reconstruction after 6 months of application, the weighted average by sample size was 77.41% (SD = 20.68), with an average number of applications of 3.17 (SD = 0.31). CONCLUSION: The application of HA may be used to repair anesthetic defects in the papilla. CLINICAL SIGNIFICANCE: Interdental papilla reconstruction with injectable HA is an option of nonsurgical treatment for interdental papilla deficiencies. However, there is still concern about the quality of the evidence available, considering that studies with different experimental designs can produce contradictory results. Moreover, further understanding is required on the stability of tissue gain promoted by HA in black triangles.

External control of fluoridation in the public water supplies of Brazilian cities as a strategy against caries: a systematic review and meta-analysis.

BACKGROUND: Among the methods currently available to provide fluoride in population levels, fluoridated water is the most successful for presenting high efficacy, safety and good cost-benefit. However, recent studies on external control have shown great variability of fluoride concentrations in the water from treatment stations in Brazilian cities, which must present concentration between 0.6 and 0.8 mg/L to be considered acceptable in most cities. Thus, this study aimed to perform a systematic review of the literature to assess the adequacy of fluoride concentration in the water in Brazilian cities using external control. METHODS: The protocol was registered in PROSPERO. Six databases were used as primary search sources and three databases were used to partially capture the "gray literature". Only observational studies that assessed the fluoride concentration of artificially fluoridated water from the public supply network were included. The JBI Critical Appraisal Tools for Systematic Reviews was used to assess the risk of bias of the studies. A proportion meta-analyses using random-effect models were performed. The heterogeneity between studies was determined by I2 statistic. Meta-regressions were conducted to identify relevant moderators to be used in stratified meta-analyses. Publication bias was investigated by Egger's tests. RESULTS: The search provided 2038 results, from which 14 met the eligibility criteria and were included in the data extraction of the review. Overall, the water samples were collected from 449 different sources in three Brazilian regions. Thirteen studies presented a low risk of bias. The mean concentration of fluoride ranged from 0.17 to 0.89 ppmF. The meta-analyis demonstrated that more than half of the water samples analyzed had fluoride concentration levels outside the acceptable range (56.6%; 95% CI 45.5; 67.3), with high heterogeneity. CONCLUSION: More than half of the public water supply analyzed in the studies selected had fluoride concentration levels outside the acceptable range, which may affect the risk of developing oral diseases in the Brazilian population, having an important impact on public health.

Use of mobile apps for controlling of the urinary incontinence: A systematic review.

OBJECTIVE: The primary objective was to evaluate the impact of app use on urinary incontinence control through pelvic floor muscle training when compared to the postal treatment plan. The secondary objectives were to evaluate how app use may affect the quality of life (QoL) of users and treatment adherence. MATERIAL AND METHODS: Eight databases (PubMed, SciELO, Embase, Web of Science, LILACS, Open Gray, Open Thesis, and OATD) were used as research sources. The protocol was registered in PROSPERO (CRD 42020145709). Randomized controlled trials assessing urinary incontinence (UI) control with app use, with no restriction of year, language, and status of publication were included. The JBI Systematic Reviews Checklist for Randomized Controlled Trials assessed the risk of bias of the studies selected. The mean scores of QoL between the pre- and postintervention periods were compared through standardized mean differences, which were weighted according to the number of months between the two periods. RESULTS: Only three studies met the eligibility criteria and were included. The methodological quality of the studies was from "low" to "moderate" risk of bias. The full sample included 203 patients with app-based treatment e 203 controls of postal treatment. All studies showed the reduction of urinary symptoms. In addition, two studies showed a reduction of QoL scores specific for the condition, while one study presented increased scores. CONCLUSION: Reminder therapy seems to be a promising strategy for controlling UI.

Saliva as an alternative to blood in the determination of uremic state in adult patients with chronic kidney disease: a systematic review and meta-analysis.

OBJECTIVES: To assess whether salivary urea and creatinine levels accurately reflect their serum levels in blood samples of adults to detect chronic kidney disease. MATERIALS AND METHODS: A systematic review was conducted in eight electronic databases. The protocol was registered in PROSPERO. Only diagnostic test studies were included. The JBI critical appraisal tools assessed the risk of bias. A meta-analysis of proportions was performed. The GRADE tool assessed the quality of evidence and strength of recommendation across the studies included. RESULTS: Eight studies met the eligibility criteria and were included. Six studies assessed salivary urea, and six studies assessed salivary creatinine. All studies presented moderate risk of bias. The meta-analysis depicted an overall sensitivity of 93.3% (95% CI = 88.6; 97.9) for salivary creatinine levels and 87.5% (95% CI = 83.2; 91.8) for salivary urea levels, while the overall specificity was 87.1% (95% CI = 82.8; 91.3) and 83.2% (95% CI = 65.0; 101.4) for salivary creatinine and urea levels, respectively. The overall accuracy of salivary creatinine was 5.2 percentage points higher compared with salivary urea levels (90.8% vs. 85.6%). According to the GRADE tool, the analysed outcomes were classified as having low to moderate level of certainty. CONCLUSION: Compared with blood samples, salivary urea and creatinine levels presented high diagnostic values for chronic kidney disease screening, but should not be considered equivalent to levels obtained from blood at stages three, four, or five of the disease. CLINICAL SIGNIFICANCE: Chronic kidney disease patients could receive a clinically significant benefit from replacing blood with saliva for potentially monitoring renal function. Saliva collection presents greater simplicity, comfort, safety, and lower collection cost.

Maxillary incisor root morphology in patients with nonsyndromic tooth agenesis: A controlled cross-sectional pilot study.

INTRODUCTION: This study aimed to investigate the association between root morphology of maxillary incisors and nonsyndromic tooth agenesis in patients compared with a control group without agenesis. METHODS: This controlled cross-sectional pilot study (1:4) was performed with a random sample of 335 records from Brazilian applicants for orthodontic treatment, paired by sex and age. Panoramic and periapical radiographs were analyzed to diagnose tooth agenesis and to assess root morphology. The agenesis group (n = 67) included patients with nonsyndromic tooth agenesis, and the control group (n = 268) included patients without tooth agenesis. The statistical analysis included the Student t test and z test, conditional logistic regression, and odds ratio estimates. RESULTS: Occurrence of root morphological changes was significantly higher among patients with agenesis (P <0.05). Significant morphological changes (short, blunt, apically bent, and pipette-shaped roots) were found in the roots of remaining teeth when comparing agenesis and control groups (P <0.05). Patients with agenesis were more likely to show root morphological changes (odds ratio, 74.23; 95% confidence interval, 16.93-325.46; P <0.001). CONCLUSION: Patients with agenesis are more likely to present root morphological changes, which should be considered to minimize problems during orthodontic treatments.

Influence of glide path kinematics during endodontic treatment on the occurrence and intensity of intraoperative and postoperative pain: a systematic review of randomized clinical trials.

BACKGROUND: Preliminary canal enlargement (glide path preparation) may play a significant role in the development of pain. The aim of this systematic review of randomized clinical trials was to assess the influence of glide path kinematics during endodontic treatment on the occurrence and intensity of intraoperative and postoperative pain. METHODS: A search was performed in June 2019 in six electronic databases (PubMed, Scopus, LILACS, SciELO, Embase and Web of Science) and two grey literature databases (OpenGrey and OpenThesis). The bibliographic references of the eligible articles were also hand-searched. The included clinical studies assessed the occurrence and intensity of intraoperative and/or postoperative pain after root canal preparation without glide path preparation (WGP) or with glide path preparation using manual (M-GP), continuous rotary (CR-GP), or reciprocating (R-GP) instruments. The primary outcome was the occurrence and intensity of intraoperative and postoperative pain, while analgesic consumption was the secondary outcome. The full texts of the eligible studies were analyzed by two reviewers who performed calibration exercises to verify the risk of bias and quality of the individual studies using the Joanna Briggs Institute Critical Appraisal tool. RESULTS: From 1283 identified articles, only six studies were included in the qualitative analysis of the results, with a total sample of 884 patients/teeth. Three studies presented a high risk of bias, while three studies presented a moderate risk. Two studies reported that CR-GP causes lower pain levels than M-GP and WGP, and three studies showed no differences between CR-GP and R-GP. Regarding analgesic consumption, two studies found no differences among glide path kinematics, and one study reported lower consumption for CR-GP than for M-GP. Because of the limited number of studies and methodological differences, no statistical analyses were performed for the glide path kinematics comparisons. CONCLUSIONS: Compelling evidence indicating a significantly different occurrence and intensity of pain among glide path kinematics is lacking. The systematic review protocol was registered in the PROSPERO database [CRD42020139989].

Emotional, physical and sexual violence against female students undergoing medical, dental and psychology courses in South Brazil.

Violence against women is a hot topic in the spotlight of contemporary science. In the academy, most of the courses are structured in a hierarchical system, in which students-especially female-become potentially vulnerable to emotional, physical and even sexual harm. This study aimed to describe the prevalence and the study-associated factors of emotional, physical and sexual violence against female students in medical, dental and psychological courses in South Brazil. A questionnaire-based survey was performed combining two previously validated tools for the investigation of workplace violence. The questionnaires were digitally provided to women undergoing medicine, dentistry and psychology courses in South Brazil. The study was conducted between April and July, 2018. The final sample consisted of 241 students (57 medical students; 91 dental students and 93 psychology students). Reports of general violence reached a prevalence rate of 45.2%. In particular, emotional violence reached 78.9% of the cases, whilst physical and sexual violence reached 4.6% and 8.3%, respectively. Amongst the identified offenders, professors figured as the most prevalent (18.4%). Alarming rates of violence against women were detected in this study. Institutional preventive strategies must be designed to protect female students in their study/workplace and enable a safe routine of academic activities.

Deoxyribonucleic Acid Extraction and Quantification from Human Saliva Deposited on Foods with Bitemarks.

AIM: The aim of this study is to evaluate the potential of deoxyribonucleic acid (DNA) recovery from bite marks in foods, in different collection types, from DNA quantification. MATERIALS AND METHODS: The sample consisted of 80 swabs, obtained from 20 cheese pieces, bitten by the same person, using the double-swab technique in the center and the periphery of the bite. A statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) statistical software version 20.0, with values of p < 0.05 being considered statistically significant. RESULTS: The DNA was recovered in all cheese pieces, regardless of the collection types and the bite region. However, the comparative analysis of DNA recovery potential in the four swabs allowed us to infer that the collections in the central region of the bite (DC and WC) were the ones that presented better precision, in addition to extracting a higher DNA concentration, the dry swab being in the center of the bite which presented better results. CONCLUSION: The results proved the effectiveness of the double-swab technique for collecting genetic materials in bite marks; however, in the food used, a single collection at the center of the bite would be enough, optimizing the resources and time needed for the analysis. CLINICAL SIGNIFICANCE: Due to the difficulties of physically comparing a site of a skin lesion and the dental arches of the suspect, the evidence of DNA in saliva has been used to indicate the perpetrator of the bite. In addition, the collection, preservation, and isolation of saliva DNA can be done at low cost and provide flexibility for clinical and laboratory workflow.