Original Research/Cariology Presentation of a new multifunctional oral cavity simulator: the “MOCS” MASKE, Tamires Timm CENCI, Maximiliano Sérgio PATZLAFF, Rafael MOCS, Iniative HASHIZUME, Lina Naomi MALTZ, Marisa ARTHUR, Rodrigo Alex Abstract in English: Abstract This article describes a new multifunctional oral cavity simulator (MOCS) that allows, with little technical support and easy handling, the laboratory development of dental hard tissue lesions under clinically similar conditions. The MOCS consists of a heating unit containing three independent cylindrical chambers with three specimen holders inside. Liquids flow through the surfaces of specimens by inlets on the lid of the chamber, which is connected to a medium/artificial saliva source through a computer-controlled peristaltic pump. The design, operational principles, and clinical application of this simulator, such as microcosm-induced development of carious-like lesions, acidic-induced erosion-abrasion like-lesions, and testing the anticariogenic effect of restorative materials, are shown. The MOCS can mimic several aspects of the oral cavity, being a promising device for assessing dental hard tissue lesions. |
Original research/Cariology Effect of pellicle modification with polyphenol-rich solutions on enamel erosion and abrasion MAILART, Mariane Cintra BERISHA, Ilirida REINALES, Ana Sofia Arana NIEMEYER, Samira Helena BORGES, Alessandra Bühler BAUMANN, Tommy CARVALHO, Thiago Saads Abstract in English: Abstracts The aim of the study was to compare the effect of salivary pellicle modification with polyphenol-rich solutions containing fluoride on enamel erosion and abrasion. Human enamel specimens (n = 14/group) were assigned to five pellicle-modifying groups: GSE+F (grape seed extract +500 ppm F-); CRA+F (cranberry extract +500 ppm F-); NaF (sodium fluoride solution -5 00ppm F-); Sn+F (commercial solution, SnCl2/NaF/AmF); and DW (deionized water, negative control). The specimens were submitted to 5 cycles, each one consisting of pellicle formation (120μl, 30 min, 37°C, no agitation), followed by pellicle modification with the experimental solutions (5 ml, 2 min, 25ºC, 70 rpm), and subsequent salivary pellicle formation (120 μl, 60 min, 37°C, no agitation). The specimens were then submitted to erosion (1% citric acid, 10 ml, 1 min, pH 3.6, 70 rpm, 25ºC). Subsequently, they were submitted to abrasion with a fluoride-based toothpaste slurry in a toothbrushing machine (50 strokes, 200 g load, 2 min exposed to slurry). The enamel surface was evaluated with an optical profilometer at baseline and after the 5 cycles to assess the surface loss. Data were submitted to Kruskal-Wallis followed by a multiple comparisons test (α = 0.05). Significant differences were found between the tested solutions (p <0.001). The highest surface loss was verified in the DW group (p < 0.001). The other tested solutions (GSE+F, CRA+F, Sn+F, NaF) promoted significant enamel protection against the erosive-abrasive challenges with no differences between them. In conclusion, the modification of salivary pellicle with both polyphenol-rich, commercial solution and fluoride solutions were able to protect the enamel surface from erosion and abrasion. |
Original Research/Community Dental Health Dental discrepancies in black adolescents: evaluating impacts on well-being LANGOSKI, Jean Érick MEIRA, Ana Claudia Lima de Oliveira SANTAMARIA-JUNIOR, Milton MENEZES, Carolina Carmo de MENEGHIM, Marcelo de Castro VEDOVELLO, Silvia Amélia Scudeler Abstract in English: Abstract The aim of this study was to compare the esthetic, functional, and psychosocial impact of mandibular crowding and maxillary midline diastema in black adolescents. A cross-sectional study was conducted with 420 black (brown and black, distinguished according to Brazilian Institute of Geography and Statistics – IBGE) adolescents aged 12 with normal occlusal relationships. Esthetic (OASIS) and functional/psychosocial (OHIP-14) impact related to the need for orthodontic treatment in groups with mandibular crowding and maxillary midline diastema, and those without these conditions: G1, without crowding and diastema (n 113); G2, without crowding and with diastema (n 67); G3, with crowding and without diastema (n 202); and G4, diastema, and crowding (n 38) were evaluated. Generalized linear models were estimated for the effects of diastema, crowding, and the interaction between them, with a significance level of 5%. There was no significant influence of crowding and diastema on the OHIP-14 (p>0.05). However, the groups with diastema had higher OASIS scores, irrespective of crowding (p<0.05). The maxillary midline diastema influenced the esthetic perception of black adolescents. |
Original Research/Dental Materials Occlusion, acid resistance, and elemental characterization of dentin treated with desensitizing agents RIBEIRO, Maria Carolina Lopes de Souza FERREIRA, Beatriz Araújo Jacinto RIBEIRO, Ana Carolina Freitas FRANÇA, Fabiana Mantovani Gomes TURSSi, Cecilia Pedroso BASTING, Roberta Tarkany VIEIRA-JUNIOR, Waldemir Francisco Abstract in English: Abstract The objective of this study was to evaluate the occlusion potential of in-office desensitizing agents, and characterize the human dentin elements after acid exposure. Twelve human dentin discs were sectioned into four specimens each, and randomized into treatments (n = 20): no treatment (negative control); no treatment and 6% citric acid exposure (positive control); application of Gluma desensitizer (Heraeus Kulzer) or PRG Barrier Coat (Shofu), followed by 6% citric acid exposure. Occlusion and dentin surface characteristics were determined by scanning electron microscopy (SEM, n = 10), and elemental composition (at%), by energy-dispersive X-ray spectroscopy (EDS, n = 10). Three calibrated, blinded evaluators used SEM to categorize the occlusion potential: 1 = occluded, 2 = partially unoccluded, 3 = equally occluded/unoccluded, 4 = partially occluded, 5 = unoccluded. Data were analyzed by weighted kappa, Friedman, and Nemenyi tests (α = 0.05). For SEM, mean occlusion scores were higher for the PRG Barrier Coat than the positive control (p = 0.0235). Most specimens in the controls scored 4 or 5. The most frequent scores for PRG Barrier Coat were 1(60%) and 2(20%), while 30% of Gluma specimens scored 1 and 2. Gluma showed intratubular precipitation, while PRG Barrier Coat covered dentinal tubules totally or partially. For EDS, the K% was lower for Gluma than the negative control (p = 0.0046), with Si peaks in dentin treated with PRG Barrier Coat. The bioactive in-office desensitizing agent with S-PRG filler (PRG Barrier Coat) promoted dentin tubule occlusion, and persisted after exposure to acid. |
Original Research/Dental Materials Aging and post-polymerization effects on conversion degree and properties of additive splint materials SANTIS, Leandro Ruivo de FERNANDES, Lucas Silveira VASQUES, Mayra Torres ZAMBRANA, Nataly Rabelo Mina VIANA, Ítallo Emídio Lira FORLIN, Taís Scaramucci SAAVEDRA, Guilherme de Siqueira Ferreira Anzaloni FRANCCI, Carlos Eduardo Abstract in English: Abstract The study objective was to analyze dimensional change, flexural strength, surface hardness, wear profile, and conversion degree of different additive splint materials under various post-polymerization conditions of time and artificial aging. Two additive manufacturing systems (Cara Print 4.0, Dima Print Ortho, Kulzer; SprintRay Pro, SprintRay Splint, SprintRay), and a thermally activated resin control (Clássico) were evaluated in artificial aging (deionized water or saliva; 28 or 84 days at 37°C), with recommended or doubled post-polymerization cycles. Dimensional change (surface metrology), flexural strength (ISO 20795-1:2013), fractography (SEM), Knoop hardness, two-body wear profilometry (150,000 cycles; 3mmØ; 20N; 2.1Hz), and conversion degree (FTIR spectroscopy) were assessed. Two-way ANOVA and post-hoc Tukey tests were used for parametric data, and Kruskal-Wallis and post-hoc Dunn tests, for non-parametric data (α = 0.05). Results indicated no statistically significant differences in dimensional change or flexural strength among the materials. Recommended post-polymerization cycles resulted in lower hardness for additive resins than the thermally activated control. Doubling post-polymerization time significantly increased flexural strength and hardness of Dima Print Ortho, but decreased flexural strength of SprintRay Splint, and did not affect wear resistance. Dima Print Ortho demonstrated the highest wear resistance. Artificial aging did not affect flexural strength, surface wear, or dimensional change, but negatively impacted the hardness of all materials except Dima Print Ortho. The conversion degree was unaffected by post-polymerization time, and no significant differences were found among the materials. Overall, additive materials exhibited mechanical and dimensional properties comparable to thermally activated resin, with doubling post-polymerization time positively influencing the properties. |
Original Research/Dental Materials Properties of 3D-Printed resins for interim restorations: effects of printing and post-curing protocols PACHECO, Leandro Edgar CASSIANO, Fernanda Balestrero STUANI, Vitor de Toledo SILVA, Isabela Sanches Pompeo da ALAMO, Larissa COSTA, Matheus de Castro LOVISON, Marcella Fernandes ISHIKIRIAMA, Sergio Kyioshi MONDELLI, Rafael Francisco Lia SOARES, Diana Gabriela Abstract in English: Abstract This study analyzed the properties of three-dimensional (3D)-printed resins designed for interim restorations and subjected to different printing and post-curing protocols. Specimens were manufactured with two 3D-printed resins for interim restorations at varying exposure times per layer, in accordance with the manufacturer’s recommendations (Tm) or using a calibrator (Tc). Subsequently, the specimens were post-cured for 5, 10, or 15 min. Trueness, surface roughness, and color analyses were performed. For biological characterization, the specimens were incubated for up to 72 h in a culture medium, and the extracts were applied at 24-h intervals to keratinocyte cells (NOK-Si). Cellular metabolism was evaluated after 1 and 3 days. Leaching of residual monomers from the extracts was evaluated. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD) test (α = 5%). The exposure time beyond Tc resulted in specimens with increased trueness and smoother surfaces. Color stability was also influenced by the type of resin and post-curing time; the longer the time, the greater the color change, allowing for brighter and clearer specimens. The resins were cytocompatible with NOK-Si, regardless of the printing and post-curing parameters, although residual monomer leaching was affected by the parameters tested. The evaluated resins were cytocompatible; however, variations in the exposure times per layer and post-curing duration affected their roughness, leaching, trueness, and color stability. |
Original research/Dental Materials Resin-based adhesives, composites, and luting agents: Investigation of article citations and altmetrics LAUER, Fernanda SILVA, Rodrigo Rohenkohl SARTORI, Leticia Regina COLLARES, Kauê SARKIS-ONOFRE, Rafael FAGGION JUNIOR, Clóvis MORAES, Rafael Ratto de Abstract in English: Abstract In this study, citations, altmetric scores, and field-normalized impact of articles investigating resin-based adhesives, luting agents, or restorative composites were investigated. Articles published in 2019 on resin-based dental materials indexed in Scopus were searched and assessed by independent investigators. Data collected in 2023 included several article variables and, as outcomes, citation in Scopus and Google Scholar, Altmetric Attention Scores (AAS), and Field-Weighted Citation Impact (FWCI). Data were analyzed using stepwise backward quasi-Poisson regression models (p < 0.05). A total of 707 articles were included, which evaluated restorative composites (58.3%), adhesives (27.2%), and luting agents (19.5%). The majority of corresponding authors were from Asia/Oceania (42.2%), with publications mainly subscription-based (54%) and lacking international collaboration (68.5%). Only 1.4% reported conflicts of interest, and 47.7% did not disclose sponsorship. Median citations were 7 in Scopus and 13 in Google Scholar, whereas the median FWCI was 1. The majority of articles had an AAS of zero. Multivariate analysis showed study sponsorship type and journal CiteScore influenced citations, while COI and the author’s continent impacted AAS and FWCI, respectively. Articles on luting agents were less likely to receive citations. The report of conflict of interest was associated with approximately 18 times higher AAS values. This study emphasizes the significance of the type of resin-based material, journal CiteScore, authors’ continent, and type of sponsorship in affecting citations, visibility, and impact of scientific articles. Research on luting agents may need better dissemination strategies for increased visibility. The substantial effect of COI presence underscores the importance of transparency. |
Original Research/Dentistry Bond strength to eroded dentin as per chlorhexidine use for controlling erosive wear or interface aging: an 18-month assay FARIAS-NETO, Aloísio de Melo LANDMAYER, Karin LIBERATTI, Giovanni Aguirra SHIMOKAWA, Carlos Alberto Kenji WANG, Linda HONÓRIO, Heitor Marques MATOS, Adriana Bona FRANCISCONI-DOS-RIOS, Luciana Fávaro Abstract in English: Abstract The aim of this study was to assess the effect of a chlorhexidine digluconate solution (CHX) applied as an antiproteolytic agent for controlling erosive tooth wear or as part of the adhesive treatment on long-term bond strength to eroded dentin. Dentin specimens were abraded with a 600-grit silicon carbide (SiC) paper for 1 min (sound dentin - S), subsequently treated with 2% CHX for 1 min (with excess removed, followed by a 6-hour rest), and eroded by exposure to Coca-Cola for 5 min, three times a day, for 5 days (CHX-treated and eroded dentin - CHXE), or only eroded (eroded dentin - E). The specimens were acid-etched (15 s), rinsed (30 s), dried (15 s), and rehydrated with 1.5 μL of distilled water for 1 min, with excess removed (control - S.C/CHXE.C/E.C) or 2% CHX (S.CHX/CHXE.CHX/E.CHX). Adper Single Bond 2 was scrubbed twice on the surface for 15 s each and then light-cured for 10 s, and resin composite cores were built up. Specimens were sectioned into beams and microtensile bond strength was tested (μTBS; 0.5 mm/min) immediately or after 18-month aging. Failure modes were analyzed using a digital microscope. Data (μTBS/MPa) were analyzed by three-way ANOVA, followed by Tukey’s test (α = 0.05). μTBS to E and CHXE, irrespective of the rehydration solution and aging period, were equivalent to each other and lower than that to S. CHX as the rehydration solution reduced immediate and long-term µTBS to S. Aging reduced μTBS. By controlling tooth wear or interface aging, CHX could not influence long-term bonding to eroded dentin. |
Original research/Dentistry Surface roughness of composite resins subjected to brushing with whitening toothpastes: an in vitro study FERREIRA, Nicolle Madruga Ramos LIPPERT, Vinicius Funghetto HECK, Amanda Baptista da Silva SPOHR, Ana Maria KUNRATH, Marcel Ferreira FELDENS, Carlos Alberto KRAMER, Paulo Floriani Abstract in English: Abstract The emergence of toothpastes containing different abrasive and whitening substances has been a constant concern among dental professionals. The aim of the present study was to perform an in vitro assessment of the surface topography of nanoparticle composite resins subjected to simulated brushing with dentifrices. Test samples were prepared with Filtek Universal (3M ESPE), Filtek Bulkfill (3M ESPE) and Z350 (3M ESPE), with 24 samples per resin. A testing machine was used to simulate brushing with the dentifrices Colgate Total 12, Oral B 100% and Oral B Gengiva Detox Gentle Whitening (8 samples per group). The constant speed of the machine was 250 cycles per minute, and 20.000 cycles were carried out, which corresponds to 24 months (1 hour and 20 minutes). Roughness features and qualitative surface topography were investigated. Statistical analysis involved the Kruskal–Wallis, Wilcoxon and Mann–Whitney tests. A significant increase in surface roughness was found for all the resins (p < 0.05). However, no significant difference was found among the resins in terms of final roughness values (p = 0.690). In contrast, a significant difference among dentifrices was found with respect to roughness measurements (p < 0.001). The qualitative analysis revealed an increase in surface roughness in all the samples and differences in the abrasive potential of the dentifrices. In conclusion, brushing with dentifrices increases the surface roughness parameters of composite resin restorations. Moreover, the differences in the abrasive effects of the dentifrices indicate a need for further studies to establish efficacy and safety criteria. |
Original Research/Dentistry Impact of polyethylene fiber-reinforced composite resin and thermomechanical cycling on dentin bond strength PIMENTEL, Maria Isabel Guimarães Carvalho Ribeiro KANTOVITZ, Kamila Rosamilia TURSSI, Cecília Pedroso AMARAL, Flávia Lucisano Botelho do BASTING, Roberta Tarkany MARTINS, Leandro de Moura FRANÇA, Fabiana Mantovani Gomes Abstract in English: Abstract This study evaluated the microtensile bond strength (μTBS) and fracture pattern of direct composite resin reinforced with polyethylene fiber (Ribbond®) on dentin substrate after thermomechanical cycling (TMC). Dentin blocks (dentin thickness=2 mm) were obtained from forty human third molars and randomly divided into four groups (n=10) according to type of restoration (composite resin with or without Ribbond®) and to whether they were or were not subjected to TMC (100,000 cycles of 50 N / 2 Hz / 1-minute baths of 5 and 55ºC). The 1-mm-thick square-shaped specimens were submitted to μTBS testing in a universal testing machine at 0.5 mm/min. The fracture patterns were assessed by stereoscopic magnifying glass (30X magnification). The μTBS (in MPa) and failure pattern data were subjected to the generalized linear model and G tests (a=0.05). Neither the polyethylene fiber nor TMC had any statistically significant effect (p=0.196 and p=0.136, respectively) on the μTBS of the composite resin to dentin. Adhesive failures were more prevalent in the composite resin group compared with the Ribbond-containing group when subjected to TMC. Additionally, the composite resin containing Ribbond® showed a higher proportion of cohesive failures in composite resin than the resin groups not containing this fiber, irrespective of TMC. It was concluded that reinforcing the direct layer of composite resin with Ribbond® polyethylene fiber did not influence the adhesive resistance to dentin, even when subjected to TMC. However, its incorporation did result in a higher frequency of cohesive failures in resin after TMC. |
Original Research/Endodontic Therapy Application of artifact suppression algorithm of post-processing CBCT software in root canal filling materials ESTRELA, Carlos Endo, Mônica Misaé Bueno, Mike Reis Azevedo, Bruno Correa Decurcio, Daniel Almeida Estrela, Lucas Rodrigues Araujo Abstract in English: Abstract: Cone beam computed tomography (CBCT) is an imaging exam used increasingly in various fields of dentistry, and a greater number of endodontists are progressively gaining access to this technology. This study focused on applying an artifact suppression algorithm featured in CBCT software, and designed specifically to address artifacts related to root canal filling materials. Method The sample consisted of eighty-four mandibular molars, with mesial root canals endodontically treated by using the lateral condensation technique. Four root canal sealers were applied: G1 – Sealapex®, G2 – AH Plus®, G3 – Endofill®, and G4 – Bio-C Sealer. CBCT scans were taken using PreXion 3D Elite®. Initially, the diameter of the root canal filling (in the mesiodistal and buccolingual directions) was measured using a digital micrometer (control). Next, these diameters were reevaluated in the CBCT images using the blooming artifact reduction (BAR) tool of the e-Vol DX software. The Van der Waerden nonparametric analysis of variance was performed, followed by applying the Tukey test to the normalized data. The significance level was set at α = 5%. Results There were no statistically significant differences (p>0.05) in the measurement of original root canal filling materials obtained by the micrometer versus the e-Vol DX software in the mesiodistal and buccolingual directions. Conclusions The tested software algorithm effectively suppressed artifacts resulting from obturation materials. |
Original Research/Endodontic Therapy The impact of intracanal medicaments on crown color, pH, and antimicrobial activity: a comparative study SIQUEIRA, Patrícia Correia de SOARES, Lorrayne da Costa Cassimiro WANDERLEY, Keryda Ramos Di Machado DEUS, Lara Borges de MELO, Higor Venâncio de ÁVILA, Maria Paula Andrade ESTRELA, Lucas Rodrigues de Araújo ESTRELA, Cyntia Rodrigues de Araújo Abstract in English: Abstract This study aimed to compare the effects of intracanal medication pastes Bio-C Temp® (BC), UltraCal XS® (UC), and Pure Calcium Hydroxide (CH) on crown color change, pH, and antimicrobial activity. Color change was assessed using the CIEL*a*b* color space system parameter. pH values were measured at 3, 24, 72, and 168 hours. Antimicrobial activity was evaluated using agar diffusion and direct exposure tests. Statistical analyses were conducted using ANOVA, Kruskal-Wallis, and Friedman tests (α = 0.05). After 15 days, BC exhibited significantly greater color variation than the control, and higher L* values at 60 days compared to baseline (p < 0.05). BC demonstrated lower pH values than UC and CH at 3 and 72 hours (p < 0.05). In the agar diffusion test, BC produced a smaller microbial inhibition halo than UC and CH. In the direct exposure test, CH completely inhibited microbial growth, whereas BC showed microbial growth at all evaluated time points. In conclusion, BC resulted in greater crown color change, lower pH, and reduced antimicrobial activity compared to UC and CH. |
Original research/Endodontic Therapy Vibrational characteristics of iVAC and three ultrasonic metallic inserts: analysis by laser Doppler vibrometry PAIVA, Hermano Camelo AKISUE, Eduardo DUARTE, Marco Antônio Húngaro CANDEIRO, George Táccio de Miranda ALVES, Marcílio GAVINI, Giulio Abstract in English: Abstract The iVAC system combines ultrasonic activation with negative-pressure irrigation, highlighting the importance of determining its vibration characteristics. This study aimed to evaluate the oscillation characteristics of the iVAC system using laser Doppler vibrometry and to compare them with those of metallic inserts used for ultrasonic irrigation. Four ultrasonic inserts—Irrisonic, Nitisonic, Ultra X Blue, and iVAC—were attached to an ultrasonic unit, secured in a holder, and operated at a power setting of 15%. A laser scanning vibrometer was used to scan the first four millimeters of each insert. Each measurement, lasting approximately 20 seconds, was repeated ten times per insert and performed at millimeter intervals. Displacement amplitude and frequency data were recorded for each insert. Furthermore, scanning electron microscopy was employed to evaluate the surface finish of the inserts, and their elemental compositions were analyzed using energy-dispersive X-ray spectroscopy (EDS). Analysis of variance and Tukey’s test were conducted to compare the performance of the inserts. The displacement amplitudes showed significant differences between inserts and among the scanned points (p < 0.05). All inserts demonstrated ultrasonic vibration frequencies exceeding 20 kHz. EDS analysis revealed that the elemental composition of the E1-Irrisonic tips was consistent with stainless steel. In contrast, the Nitisonic insert displayed a chemical composition characteristic of an equiatomic nickel–titanium (NiTi) alloy, whereas the Ultra X Blue insert contained additional elements beyond NiTi. The characteristics and composition of ultrasonic inserts significantly influence their displacement amplitude and vibration frequency. At the tested activation power, the iVAC insert, made of the organic thermoplastic polymer polyether ether ketone (PEEK), demonstrated an ultrasonic vibration pattern but exhibited the lowest oscillation amplitude among the inserts. |
Original research/Endodontic Therapy Effectiveness of supplementary protocols for filling material removal after sealer ultrasonic activation - a laboratory investigation ROSA, Amanda Freitas da CHAVES, Dayana Mara Silva DIAS-JUNIOR, Luiz Carlos de Lima GHIDINI, Gabriela Pasqualin SAVARIS, Julia Menezes SILVA, Rayssa Sabino da PEREIRA, Roberta Pinto BORTOLUZZI, Eduardo Antunes TEIXEIRA, Cleonice da Silveira GARCIA, Lucas da Fonseca Roberti Abstract in English: Abstract Ultrasonic activation of the endodontic sealer makes it difficult to remove the material during endodontic reintervention. Therefore, supplementary removal protocols should be tested to optimize the removal of the remaining filling material. This study assessed the effectiveness of supplementary protocols for filling material removal after sealer ultrasonic activation (UA). Sixty teeth were prepared and distributed into two groups: UA and No UA of the sealer before obturation. Teeth were re-instrumented and two supplementary removal protocols were tested, resulting in six groups (n = 10): NoUA; NoUA+XP (XP-endo Finisher); NoUA+CS (Clearsonic-R1); UA; UA+XP; and UA+CS. Root canals were analyzed under stereomicroscopy and scanning electron microscopy for quantification of the remaining filling material. Considering the total root canal area, the NoUA+CS group had the lowest remaining filling material compared to NoUA+XP, UA+XP and UA+CS groups (p < 0.05). When the root thirds were compared, there was no statistical difference among groups (p > 0.05). The XP-endo Finisher instrument demonstrated the lowest effectiveness when used as a supplementary step. In contrast, the Clearsonic-R1 insert exhibited the highest performance. |
Original Research/Implantodontology Carbon fiber-reinforced PEEK as a framework material for single implant-retained mandibular overdentures MATIAS, Luana Figueiredo da Silva BARBIN, Thaís MACHADO, Leonardo Mendes Ribeiro BARÃO, Valentim Adelino Ricardo MESQUITA, Marcelo Ferraz BORGES, Guilherme Almeida Abstract in English: Abstract This study aimed to assess the biomechanical behavior of reinforcement materials [cobalt chromium alloy (CoCr) and carbon fiber-reinforced polyether ether ketone (CFR-PEEK)] and their extensions (short: 15 mm and long: 25 mm) of single implant-retained mandibular overdentures (MO-1) by 3D finite element analysis (FEA), comparing them with MO-1 without a framework. Five models (CoCr-Short, CFR-PEEK-Short, CoCr-Long, CFR-PEEK-Long, and no framework) were created using the McNeel Rhinoceros 3D software, version 7.0. Stress distribution analysis by FEA was performed using the Optstruct solver, and a 30° oblique load (100 N) was applied in the anterior region (50 N on each central incisor). Biomechanical behavior was analyzed by overdenture displacement, maximum (MaxP) and minimum principal (MinP) stress, and von Mises stress. The MO-1 model ‘without a framework’ produced the largest dislocation, MinP stress on the mucosa, and MaxP stress in the cortical bone. Regardless of the extension of the framework, CFR-PEEK had minor MinP stress in the mucosa and lower overdenture displacement. The ‘CoCr-Long’ and ‘CFR-PEEK-Long’ models had higher von Mises stress on the implant housing, and MaxP stress on the O’ring nylon conventional implant and overdenture. The ‘CoCr-Short’ and ‘ CFR-PEEK-Short’ models showed a greater tendency for tension concentration solely in the framework. The incorporation of a framework into MO-1 decreased stress concentration on the overdenture, resulting in lower stress on the attachment, mucosa, implant, and peri-implant bone, irrespective of the material used. The short framework, however, performed better biomechanically in MO-1, and it is therefore the most recommended option. CFR-PEEK showed favorable biomechanical outcomes, and is suggested for reinforcement of MO-1. |
Original Research/Implantology Pterygoid implant: extensometric and photoelastic analysis of a maxillary rehabilitation model KOGA, Daniel Henrique CURI, Marcos Martins SANTIAGO JUNIOR, Joel Ferreira PESQUEIRA, Aldieris Alves CARVALHO, Wagner José Sousa CAMPANER, Márcio CARDOSO, Camila Lopes Abstract in English: Abstract Pterygoid implants have been demonstrated to have a high success rate. Nevertheless, there are few biomechanical tests to evaluate the tensile forces induced by force dissipation in peri-implant tissues. This study employed photoelasticity and extensometry to demonstrate and compare the biomechanical behavior of non-axial implants in a pterygoid model and a conventional model of oral rehabilitation, thus allowing for qualitative and quantitative analysis. Two models received an implant measuring 3.75 x 13 mm in the canine pillar at a 90 ° angle to the Frankfurt plane. In the control group, an implant with a diameter of 3.75 mm and a length of 11 mm was placed in the maxillary tuberosity parallel the medial implant. In the study group, an implant with a diameter of 3.75 mm and a length of 11 mm was installed with an angulation of 45 degrees in the antero-posterior direction and 15 degrees in the buccal-palatal direction, with apical anchorage in the pterygoid process of the sphenoid bone. In the extensometric analysis, the models were subjected to five cycles of repeated axial tensile loading (100 N) at a rate of 0.5 mm/min. A computer was connected to the amplifier in order to record the output signal of the polyurethane surface, and the acquisition system software was employed to record the data. The data were analyzed in accordance with data distribution, as determined by the Shapiro-Wilk test and equality of variance. Subsequently, the data were classified according to the variables. The Student’s t-test was employed when normal distribution of variances was identified, whereas the Mann-Whitney U test was utilized for data with non-normal distribution. A 5% significance level was employed. In the photoelastic analysis, replicas of both configurations were produced using photoelastic resin. The models were subjected to a single axial loading cycle, with a load of 100 N applied at a rate of 0.5 mm/min, and the resulting stress was observed under a circular polariscope. Photographs were taken at two time points: before and after loading. These images were then processed by the same operator using a computer graphics program, allowing for a more straightforward analysis of stress distribution. This was achieved by the formation of isochromatic fringes. The results of the strain gauge analysis revealed no statistically significant differences between the two groups (p = 0.37) or between the anterior (p = 0.08) and posterior (p = 0.74) implants. The photoelasticity analysis revealed the presence of high-intensity isochromatic fringes at the apex of the axial implant in the control model, as well as in the cervical-distal and apical regions of the pterygoid implant, where a high concentration was also observed. Although no statistically significant results were obtained from the quantitative analysis, our findings suggest that the favorable outcomes observed in the clinical studies are due to the high force dissipation observed in the pterygoid plate, which is composed of dense cortical bone. |
Original research/Oral Pathology Association between oral mucosal lesions and xerostomia: a cross-sectional study in a Brazilian population sample GROSSMANN, Soraya de Mattos Camargo PRADO, Luís Cláudio Santos SOUZA, Lorena de Andrade e DOMINGUES, Dayane Priscila BRUZINGA, Fábio Fernandes Borém LOPES, Laura Cascão SOUTO, Giovanna Ribeiro Abstract in English: Abstract This study aimed to establish the frequency of oral mucosal conditions and xerostomia, identify a possible association between them, and verify their associated factors from a sample of the population of Três Corações, Brazil. A cross-sectional study was conducted with volunteers without age restriction. To evaluate the presence of oral mucosal conditions, an intra-oral examination was performed and a clinical diagnosis was established based on the official classifications of oral diseases. The report of xerostomia was identified by a validated questionnaire completed during anamnesis. Descriptive and association statistics were performed using a significance level of 5%. A total of 1,052 volunteers were evaluated. Oral mucosal lesions were observed in 42.11%, variations of normal structures in 38.50%, and xerostomia in 60.64%. Women were more affected than men, particularly women aged 20-49. Xerostomia was not found to be associated to oral mucosal conditions in general (p > 0.05); however, inflammatory fibrous hyperplasia (27.99%) and oral candidiasis (24.38%), the most prevalent lesions in the study, were associated with xerostomia (p < 0.001 and p = 0.006, respectively) and denture use (p = 0.025 and p < 0.001, respectively). Use of tobacco and alcohol intake were not associated with the presence of oral lesions (p = 0.319 and p = 0.739, respectively). The findings of this study are important for determining the prevalence of oral conditions and xerostomia in the general population, serving as a baseline for further investigations into the association between xerostomia, inflammatory fibrous hyperplasia, and oral candidiasis. |
Original research/Orthodontics A 4-year follow-up of the need for orthodontic treatment using the Dental Aesthetic Index-DAI: an exploratory analysis VEDOVELLO, Silvia Amelia Scudeler CARVALHO, Ana Letícia Mello de CARNEIRO, Diego Patrik Alves MENEGHIM, Marcelo de Castro Abstract in English: Abstract This study aim was to evaluate the need for orthodontic treatment of mixed to permanent dentition using the Dental Aesthetic Index (DAI) in a 4-year follow-up. A longitudinal study was conducted with 353 children in the stages from mixed (T1) to permanent (T2) dentition. The need for orthodontic treatment was assessed using the DAI categorized into: DAI 1 (absence of malocclusion and orthodontic treatment need; DAI ≤ 25); DAI 2 (malocclusion is defined and elective orthodontic treatment is needed; DAI = 26 to 30); DAI 3 (severe malocclusion and a desirable orthodontic treatment need; DAI = 31 to 35) and DAI 4 (severe malocclusion and a mandatory orthodontic treatment need; DAI ≥ 36). The Bowker symmetry test was used to determine agreement in the categorization of DAI at T1 and T2, with a significance level of 5%. The results showed a significant disagreement in the need for orthodontic treatment between T1 and T2 (p<0.05). In 34.6% of children evaluated in T1, the same need for orthodontic treatment was maintained in T2. According to the DAI, in 60.8% of the children, the need decreased, and in 39.2% their need for orthodontic treatment increased. This preliminary longitudinal study using DAI, showed a decrease in malocclusion and need for orthodontic treatment as the dentition transitioned from mixed to permanent occurred. This finding has valuable implications for epidemiological data in orthodontics. |
Original Research/Orthodontics Impact of orthodontic treatment with aligners and fixed appliances on OHRQoL: a randomized clinical trial BORSATO, Thais Teixeira BITTENCOURT, Jéssica Madeira PAIVA, Saul Martins CONTI, Ana Cláudia de Castro Ferreira FERNANDES, Thais Maria Freire ALMEIDA-PEDRIN, Renata Rodrigues de ALMEIDA, Marcio Rodrigues de OLTRAMARI, Paula Vanessa Pedron Abstract in English: Abstract The aim of this study was to assess the impact of orthodontic treatment with orthodontic aligners (OAs) and fixed appliances (FAs) on oral health-related quality of life (OHRQoL). This parallel randomized clinical trial included 40 male and female patients aged 13 to 35 years diagnosed with Angle’s Class I malocclusion. Participants were assigned to two groups: OA (n = 20) and FA (n = 20). OHRQoL was assessed using the Brazilian OHIP-14, which was administered before treatment (T0), at 1 month (T1), 6 months (T2), and 12 months (T3) after treatment initiation. Data were analyzed using the independent t test, the chi-square test, the Mann-Whitney test, and Friedman test (p < 0.05). FAs had a significantly (p < 0.05) higher impact on OHRQoL at T1 in terms of functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, and overall score. Within-group comparison showed higher scores for the FA group in comparison to the OA group. Functional limitation scores were higher at T1 than at T0 (p = 0.034), while physical pain scores were higher at T1 compared to T0 (p = 0.034) and T2 (p = 0.010). Psychological discomfort scores were higher at T1 than at T2 (p = 0.015). Physical disability scores were higher at T1 compared to T0 (p = 0.008). Overall scores were higher at T1 than at T2 (p = 0.003). No significant changes were observed in the OA within-group comparison. Patients treated with OAs had less impact on OHRQoL compared to those treated with FAs in the first month. There was no difference between the groups at the 6-month follow-up. |
Original Research/Pediatric Dentistry Unilateral cleft lip and palate patients present cranial base modifications: a cross-sectional study VILLORIA, Eduardo Murad SOUKI, Bernardo Quiroga ASSIS, Marina Araújo Leite OLIVEIRA, Dauro Douglas AZEREDO, Thaís de Lima SOARES, Rodrigo Villamarim Abstract in English: Abstract The aim of this cross-sectional study was to perform a three-dimensional (3D) assessment of the cranial base of patients with unilateral cleft lip and palate (UCLP). Cone-beam computed tomography (CBCT) scans of 52 UCLP patients (21 females and 31 males; mean age, 10.0 ± 2.12 years) were compared with the scans of 72 individuals (24 females and 48 males; mean age, 11.0 ± 2.11 years) without CLP, matched by gender and age (control group, CG). The 3D Euclidean distances of anterior cranial base (N-S), posterior cranial base (S-Ba), total cranial base (N-Ba) lengths, cranial base width (Po-Po), as well as the cranial base flexure (NSBa), were measured using open-source software ITK-SNAP and 3D Slicer. Statistical analyses were carried out with the Student’s t-test at a significance level of 5%. UCLP demonstrated shorter 3D distances than CG in the N-S, S-Ba, and N-Ba cranial base lengths (p < 0.001). In comparison with female CG, female UCLP had a smaller cranial base flexure (NSBa; p = 0.020). No statistically significant differences between UCLP and CG were found for the cranial base width (Po-Po). UCLP patients presented distinct morphological cranial base characteristics in comparison with CG. These results indicate that morphological and positioning changes in the maxillary bones are not solely attributable to the cleft and/or surgical procedures. |
Original Research/Pediatric Dentistry Structural analysis of socioeconomic factors and school jet lag in traumatic dental injury among children BERNARDINO, Veruska Medeiros Martins LIMA, Larissa Chaves Morais de NEVES, Érick Tássio Barbosa PERAZZO, Matheus de França PAIVA, Saul Martins de GRANVILLE-GARCIA, Ana Flávia Abstract in English: Abstract The objective of this study was to analyze the directions by which school jet lag is associated with traumatic dental injury in children, evaluating direct and indirect effects of socioeconomic factors and sleep. A representative, population-based, cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians answered a sociodemographic questionnaire, the Sleep Disturbance Scale for Children and the Circadian Energy Scale. Four examiners underwent training and calibration exercises for the diagnosis of traumatic dental injury (K > 0.80) using the criteria proposed by Andreasen (2007). Descriptive analysis was followed by structural equation modeling to determine direct and indirect associations between the variables incorporated into the theoretical model. School jet lag [standardized coefficient (SC): -0.238, 95%CI: -0.390–0.087], income (SC: -0.151, 95%CI: 0.0010–0.292), and number of residents in the home (SC: -0.109, 95%CI: -0.212–0.007) were directly associated with traumatic dental injury, whereas sleep disturbances and schooling of the parents/guardians exerted an indirect effect. Sociodemographic factors and school jet lag were associated with traumatic dental injury in children eight to ten years of age. |
Original Research/Pediatric Dentistry Is sleep bruxism associated with smartphone use, neck pain, and sleep features among adolescents? PRADO, Ivana Meyer MOREIRA-SANTOS, Letícia Fernanda HOFFMAM, Gabriela de Faria e Barboza ABREU, Lucas Guimarães AUAD, Sheyla Márcia PORDEUS, Isabela Almeida SERRA-NEGRA, Júnia Maria Abstract in English: Abstract An association between bruxism and musculoskeletal disorders, such as neck pain, has been established. This study investigated the association of possible sleep bruxism (PSB) activities, including grinding, bracing, and thrusting, with smartphone use, smartphone-induced neck pain, and sleep features. This cross-sectional study involved 403 Brazilian adolescents aged 11 to 19 years. A self-administered questionnaire was used to assess the severity of PSB, smartphone use, smartphone-induced neck pain, and sleep features (sleep duration and quality and history of nightmares). Sociodemographic factors, as well as snoring and drooling on the pillow, were considered potential confounders and were assessed based on reports from parents/caregivers. Participants were selected using multiple-stage sampling. Descriptive analysis and multinomial regression were performed (p ≤ 0.05). Adolescents reporting nightmares at least once a month (OR = 3.402; 95%CI: 1.315–8.802) and sometimes experiencing smartphone-induced neck pain (OR: 3.697, 95%CI: 1.103–12.388) were more likely to report moderate/severe grinding. Drooling on the pillow (OR = 3.105, 95%CI: 1.316–7.329), poor/fairly good sleep quality (OR = 2.717, 95%CI: 1.279–5.770), and smartphone-induced neck pain (OR = 3.227, 95%CI: 1.121–9.285) were associated with mild bracing. Adolescents experiencing nightmares once a week (OR = 3.209, 95% CI: 1.202– 8.565) had a higher prevalence of mild thrusting. Self-reported smartphone-induced neck pain, nightmares, poor/fairly good sleep quality, and drooling on the pillow were associated with a higher prevalence of PSB activities among Brazilian adolescents. Clinicians and researchers are encouraged to include assessments of smartphone use and sleep features in anamnesis, promoting a comprehensive approach to PSB, from diagnosis to treatment. |
Original Research/Pediatric Dentistry Structural equation modeling of the association between oral health literacy and dental caries in children LIMA, Larissa Chaves Morais de NEVES, Érick Tássio Barbosa PERAZZO, Matheus França BERNARDINO, Veruska Medeiros Martins SILVA, Samara Ellen da PAIVA, Saul Martins de FERREIRA, Fernanda de Morais GRANVILLE-GARCIA, Ana Flávia Abstract in English: Abstract The aim of this study was to explore the association between oral health literacy (OHL) and dental caries in children, evaluating the direct and indirect effects of brushing frequency, obesity, and socioeconomic factors. A cross-sectional study was conducted with 739 schoolchildren aged eight to ten years and their parents/caregivers who answered a questionnaire addressing sociodemographic characteristics and oral hygiene habits as well as the OHL – Adult Questionnaire. Cavitated dental caries in the schoolchildren was evaluated using International Caries Detection and Assessment System criteria. Descriptive analysis was performed, followed by structural equation modeling into the theoretical model (95% CI). Goodness-of-fit indices were considered satisfactory (root mean square error of approximation < 0.06; comparative fit index > 0.90–0.95; standardized root mean square residual < 0.10 and Tucker-Lewis Index > 0.90–0.95). Mother’s age (standardized coefficient [SC]: -0.08; p < 0.01), caregiver’s schooling (SC: -0.22; p < 0.01), obesity (SC: 0.13; p < 0.01), and brushing frequency (SC: -0.09; p < 0.01) had a direct effect on dental caries, whereas OHL had an indirect influence on the outcome. Mother’s age, caregiver’s schooling, brushing frequency, and obesity directly affected the occurrence of cavitated carious lesions in children in the mixed dentition phase, whereas OHL had an indirect effect on this clinical outcome. |
Original Research/Pediatric Dentistry Effects of radiation therapy on the morphology and composition of root dentin and cementum in primary teeth CADILHO, Julio Cesar Ramos MIRA, Paôla Caroline da Silva BEM, Jéssica Peixoto RODRIGUES, Penélope Swerts THOMÉ, Francisco José de Queiroz OLIVEIRA, Harley Francisco de TORRES, Fernando Marin PAULA-SILVA, Francisco Wanderley Garcia NELSON-FILHO, Paulo QUEIROZ, Alexandra Mussolino de Abstract in English: Abstract The aim of this study was to evaluate, in vitro, the effects of radiation therapy on the morphology and chemical composition of root dentin and cementum of primary teeth. Roots of human primary teeth were exposed to varying doses of irradiation using a linear accelerator: Group 1 = irradiation dose of up to 30 Gy (n= 6); Group 2 = irradiation dose of up to 42 Gy (n= 6); and Group 3 = irradiation dose of up to 54 Gy (n= 6). Non-irradiated human deciduous teeth were used as controls (n= 3). Energy-dispersive X-ray spectroscopy (EDX) data were analyzed using the chi-square test (alpha = 5%). The morphological evaluation was performed using scanning electron microscopy (SEM). In the cementum, radiation increased inorganic composition and decreased oxygen levels. However, no morphological changes were observed. In the root dentin, obliterated dentinal tubules were observed in specimens irradiated with 54 Gy, with no changes in composition. Thus, radiation therapy significantly altered the morphology and composition of important tooth structures such as dentin and cementum, in primary teeth. |
Original Research/Pediatric Dentistry Educational strategies on tooth avulsion for teachers: an intervention study FOCHI, Thaíssa Chagas TUCHTENHAGEN, Simone TAUFER, Juliane Carla ORTIZ, Fernanda Ruffo Abstract in English: Abstract Tooth avulsion is an emergency dentoalveolar trauma, and knowledge of this condition can improve the prognosis of trauma. This study aimed to assess and improve elementary school teachers’ knowledge of tooth avulsion using two educational intervention methods. Data were obtained through a parallel, blinded educational intervention study involving 116 teachers from public and private schools. They participated and completed a structured questionnaire regarding the immediate measures required for dentoalveolar trauma to permanent teeth, storage methods, and the ideal time for the dental element to remain outside the socket. After randomly assigning teachers to the leaflet and video groups, they were provided guidance on dentoalveolar trauma and completed the questionnaire again. Comparison tests, namely chi-square and logistic regression, were performed to assess the post-intervention responses and compare the differences between the groups. The results were interpreted with a significance level of 5% and a 95% confidence interval. Most responses showed a statistically significant difference (p < 0.05), indicating that the interventions improved teachers’ knowledge, except for questions on time and immediate management after dentoalveolar trauma (p > 0.05). There was no statistical difference between the intervention methods, demonstrating that both the leaflets and videos improved teachers’ knowledge (p > 0.05). The results revealed that teachers’ knowledge of tooth avulsion improved regardless of the format of the educational intervention. |
Original Research/Pediatric Dentistry Association of PTH and vitamin D-related genes with dental development in Brazilian children: a cross-sectional study Madalena, Isabela Ribeiro Küchler, Erika Calvano Reis, Caio Luiz Bitencourt Matsumoto, Mirian Aiko Nakane Stuani, Maria Bernadete Sasso Vilalba Paniagua Machado do Nascimento, Thaís Kirschneck, Christian Baratto-Filho, Flares Menezes-Oliveira, Maria Angélica Hueb de Lepri, César Penazzo Abstract in English: Abstract The aim was to evaluate the association between dental development (dental maturity) and genetic polymorphisms in PTH and genes involved in vitamin D synthesis in a cohort of Brazilian children. This retrospective cross-sectional study was performed on children receiving orthodontic treatment. Patients who had already undergone orthodontic treatment previously, those with syndromes, congenital anomalies, craniofacial deformities, and those with a previous history of dental trauma and bilateral agenesis/missing tooth/teeth were excluded. Panoramic radiographs were used for dental age evaluation according to the method proposed by Demirjian, Goldstein, and Tanner (1976). A delta [dental age minus chronological age (DA-CA)] was calculated to determine whether the patient's dental age was normal, delayed (negative values), or advanced (positive values). DNA isolated from buccal cells was used for genotyping genetic polymorphisms in PTH (rs694, rs307247, and rs6256), VDR (rs7975232), CYP27B1 (rs464653), and CYP24A1 (rs927650). A statistical analysis was performed and p<0.05 indicated statistical difference. A total of 79 orthodontic patients were included (44 (55.70%) girls and 35 (44.30%) boys). Demirjian, Goldstein, and Tanner's method (1976) overestimated the age of patients by 0.75 years. None of the genetic polymorphisms were associated with dental age (p>0.05). In conclusion, there is no association between genetic polymorphisms in PTH and genes involved in vitamin D synthesis and dental maturity. |
Original research/Pediatric Dentistry Probability of referral to curative dental treatment in a preventive pediatric dentistry program ROCHA, Lorena Castro ASSUNÇÃO, Cristiane Meira SEVERINO, Larissa de Moura BENDO, Cristiane Baccin ABREU, Lucas Guimarães AUAD, Sheyla Márcia Abstract in English: Abstract Preventive maintenance in pediatric dentistry is essential for monitoring oral health and promoting healthy habits. This study aimed to evaluate how the frequency of follow-up appointments, as well as sex- and age-related differences, impact the probability of referral for curative treatment among pediatric dentistry patients at a Brazilian dental school. This retrospective longitudinal study included dental records of patients who had their first appointment between the second half of 2013 and the second half of 2019, completed treatment, and returned for at least one check-up visit. Descriptive and survival analyses were performed. A total of 296 dental records were evaluated, comprising 47.6% female and 52.4% male patients. The likelihood of referral to curative treatment increased with longer follow-up intervals, reaching 18.9% at six months and 82.7% at 48 months. Patients aged 9 years or younger were 2.07 times more likely to be referred to curative treatment than those aged 10 years or older. No significant difference was observed in referral probability between boys and girls. Longer intervals between check-up visits increased the likelihood of referral to curative treatment, which was higher among older children. Establishing personalized follow-up intervals based on individual patient needs is crucial for maintaining oral health. |
Original research/Periodontics Brazilian version of the OHIP 14 Periodontal Disease Questionnaire: cross cultural adaptation and validation MARTINS-CRUZ, Timilly Mayra SOARES, Kaio Henrique LEAL, Juliana Helena Gomes FLECHA, Olga Dumont DOUGLAS-DE-OLIVEIRA, Dhelfeson Willya GONÇALVES, Patrícia Furtado Abstract in English: Abstract Although it is recognized that periodontal disease negatively impacts quality of life, there is no validated instrument to assess this impact in Brazil. This study aimed to translate, cross-culturally adapt, and validate the OHIP 14 PD (Oral Health Impact Profile Applied to Periodontal Diseases) for application among Brazilian patients. The original instrument was translated and validated into Brazilian Portuguese in a cross-sectional study with 110 participants recruited from a Dental School clinic. The sample was divided into two groups: 55 with periodontal disease and 55 without periodontal disease. The instrument was self-administered twice within an interval of 7 to 10 days for patients with periodontal disease. The psychometric properties of the Brazilian version were verified using internal consistency (Cronbach’s α) and the reliability through the test-retest method (ICC, intraclass correlation coefficient), convergent validity (Spearman correlation), and discriminant validity (Mann-Whitney test), with p <0.05. Most of the sample consisted of women (n=69; ±40.65 years). The OHIP 14 DP - Br showed excellent internal consistency (α=0.997) and outstanding reliability using the test-retest method (ICC=0.945, p<0.001). There was a significant correlation between the scores obtained in all seven domains between this questionnaire and self-perceived gingival health (p=0.023). This study provides psychometric evidence supporting the cross-cultural validity of the OHIP 14 DP - Br version for use in Brazil. |
Original Research/Periodontics Bone mineral density in patients using aromatase inhibitors: a clinical, nutritional, and quality of life assessment SOUZA, Alessandra Figueiredo de BARRA, Sâmila Gonçalves ROCHA, Amanda Leal BEMQUERER, Larissa Marques OLIVEIRA, Sicilia Rezende CARVALHO, Larissa Nayane AMARAL, Tânia Mara Pimenta BRASILEIRO, Claudia Borges COSTA, Fernando Oliveira SOUZA, Leandro Napier CAMARGOS, Bruno Muzzi LIMA, Enaldo Melo de FERREIRA, Adaliene Versiani Matos HEREDIA, Joyce Elisa OLIVEIRA, Marina Chaves de MACARI, Soraia ABREU, Lucas Guimarães MESQUITA, Ricardo Alves SILVA, Tarcília Aparecida Abstract in English: Abstract The use of aromatase inhibitors (AIs) leads to an imbalance in bone remodeling and can cause osteoporosis. This study aimed to identify clinical, periodontal, nutritional, and biochemical determinants of bone mineral density (BMD) changes in patients using AIs. The sample consisted of 40 women using AIs and 32 controls. BMD was assessed by dual X-ray absorptiometry (DXA). Data on nutritional, anthropometric, oral and periodontal status, and oral health-related quality of life (OHRQoL) were collected. Cytokines and adipokines were quantified in saliva and serum. Thirty-nine of the 72 women had low BMD, with a similar distribution in the control and AIs groups. BMD was lower in older women using AIs (p = 0.009) and in smokers (p = 0.034). Anthropometric assessment demonstrated that women with low BMD who used AIs had lower weight (p = 0.028). Although the frequency of periodontitis was similar in all groups, higher IL-6 (p = 0.004), IL-1β (p = 0.002), and IL-33 (p = 0.006) levels were associated with poor periodontal status. Women who used AIs were 1.18 times more likely to report better OHRQoL than controls. While advanced age, smoking, and lower weight are factors associated with low BMD, the use of antiresorptive agents was a protective factor for maintaining BMD in women using AIs. |
Original Research/Social/Community Dentistry The influence of social networks on finding and selecting healthcare professionals GASPARONI, Letícia Miquelitto MARCOS, Vinícius Neves PANNUTI, Cláudio Mendes PEREIRA, Sílvia Maria Morales Abstract in English: Abstract Social networks consist of a group of individuals connected by family, work, or other interests and facilitated by an online structure or platform. They are also a relatively recent and widely used marketing phenomenon that is constantly evolving. The healthcare field includes professions such as social work, biology, biomedicine, physical education, nursing, pharmacy, physiotherapy, speech therapy, medicine, veterinary medicine, nutrition, dentistry, psychology, and occupational therapy. The present study aimed to analyze the influence of social networks in the process of finding and selecting healthcare professionals. The methodology was a survey using a structured questionnaire created on Google Forms. Descriptive research was carried out with non-probabilistic convenience and snowball sampling, followed by quantitative data analysis. A total of 268 participants who signed the informed consent were included in the study. The findings revealed that the most common way to find healthcare professionals is through recommendations from friends/relatives and other professionals, followed by the use of social networks. The majority of participants used social networks to search for healthcare professionals, with Instagram being the most widely used platform. Sponsored advertisements can be an effective way to reach potential new patients. The most valued characteristics in healthcare content creators were reliability, expertise, and the ability to convey messages, with health-related explanations in an easily understandable manner being the preferred type of content. Therefore, this study revealed that social networks can influence the search for and selection of healthcare professionals. |
Original Research/Social/Community Dentistry Caries risk factors among Indonesian adults: insights from the national health survey RACHMAWATI, Yuanita Lely PUTRI, Agustine Hanafi PRIYANTO, Rahmavidyanti NABILAH, Khansa Catraliya GANI, Ananda Dhea Salsabila MOHD-DOM, Tuti Ningseh Abstract in English: Abstract Although caries is a preventable disease, it is still a health burden in all countries in all age categories. This study aimed to identify the determinants associated with caries risk factors in Indonesian adults. This secondary analysis used 2018 National Health Survey data, which included 37,057 respondents aged ≥ 15 years. The sampling design was based on census blocks selected using linear systematic sampling with probability proportional to size (PPS). The survey included an interview to collect data on sociodemographic characteristics, oral health practice, and health behavior. An oral examination was conducted to measure the DMFT (decayed, missing, filled- teeth) index. Multivariable models were generated to estimate the odds ratio (OR) and confidence intervals (95% CI) using caries as the dependent variable. The highest average DMFT index was seen in those respondents aged over 45 years, those from rural areas, individuals with low formal education, those who consumed sweets and sugary beverages at least once a day, those who did not brush their teeth regularly, and those who smoked. The multivariable analysis showed the potential risk of caries: risk of 19.51 times for older adults, 74% for male, 94% for those living in rural areas, 1.62 times for those with lower formal education, 78% for those with no dental visits, 1.18 times for those who eat sweets often, 1.37 times for those who drink sugary beverages often, 1.48 times for those who do not brush their teeth regularly, and 1.3 times for those who smoke. The multifaceted nature of caries in the Indonesian adult population highlights the influence of various factors, ranging from lifestyle habits and oral hygiene practices to access to dental services, age, and educational level. |
Original research/Social/Community Dentistry Maternal health during pregnancy and oral health of 4-year-olds: a birth cohort study from Brazil FÔLHA, Clarissa Nachtigall SCHUCH, Helena Silveira KARAM, Sara Arangurem DOMINGUES, Marlos Rodrigues HALLAL, Pedro Curi DEMARCO, Flávio Fernando Abstract in English: Abstract Data were collected by trained interviewers at primary healthcare units and hospitals during pregnancy and childbirth, and by trained dentists when the children were 4 years old. A total of 3,644 mothers and 3,645 babies were included in the study, which evaluated the association between systemic diseases, maternal physical activity, weight gain during pregnancy, and the oral health of four-year-old children enrolled in the 2015 Pelotas Birth Cohort (Brazil). Exposure variables included systemic diseases, maternal physical activity, and gestational weight gain. Outcome variables were dental caries and caries experience in four-year-old children, assessed using the ICDAS index. Statistical analyses were performed using the Stata 15 software, and they included Pearson’s chi-square test and Poisson regression to estimate prevalence ratios and their respective 95% confidence intervals. Excessive weight gain during pregnancy was associated with a higher risk of dental caries in children (PR: 1.12; 95%CI: 1.01–1.23). Maternal physical activity before or during pregnancy was considered a protective effect against dental caries in the unadjusted analysis ([RP: 0.82; 95%CI: 0.71–0.93] [RP: 0.60; 95%CI 0.44–0.81]), respectively, but this association was no longer significant after adjusting for confounding factors. The presence of maternal systemic diseases during pregnancy was not associated with childhood caries. In conclusion, maternal systemic diseases during pregnancy were not associated with dental caries in children. On the other hand, an excessive increase in maternal weight during pregnancy was associated with poorer oral health among children. |
Original Research/Stomatology Oral condition of patients hospitalized for Covid-19 and its impact on quality of life DUAILIBE, Lara Ribeiro Feitosa RODRIGUES, Laise Nunes ARRUDA, Alanna Barros de SABINO-SILVA, Robinson FERREIRA, Rayenne Augusta Mota TAVAREZ, Rudys Rodolfo de Jesus COSTA, Cyrene Piazera Silva FERREIRA, Meire Coelho Abstract in English: Abstract The aim of this study was to assess the oral condition of individuals diagnosed with COVID-19 and its impact on their quality of life. The cross-sectional study participants were patients with or without a diagnosis of COVID-19, on room air, and conscious, admitted to the ICUs and wards of Public Hospital Units in São Luís, Maranhão, Brazil. The data collected included: demographic information, length of stay, comorbidities, and type of diet, obtained from medical records; Oral Health-Related Quality of Life (OHRQoL) [Oral Health Impact Profile (OHIP-14)]questions patients were asked; oral health (measured by the Bedside Oral Exam Scale); oral hygiene status (assessed by the Oral Hygiene Index - Simplified and lingual: degree of lingual coating); and salivary flow. The prevalence of COVID-19 was associated with gender (p = 0.038), with a higher incidence observed in male patients (61.9%). Moreover, there was a correlation between the hospitalization sector (p = 0.037) and the frequency of ICU admissions (53.7%). The prevalence of comorbidities was comparable between the two groups. Relative to oral health, 53% of individuals with confirmed COVID-19 had moderate oral health, while 9% exhibited poor oral health. The prevalence of hyposalivation was higher in the group with a confirmed diagnosis of COVID-19. The quality of life of individuals with confirmed COVID-19 was most significantly impacted by moderate to severe oral health concerns. The most significant alteration in oral health was a reduction in salivary flow, negatively impacting the quality of life of individuals hospitalized for COVID-19 complications. |
Original Research/Stomatology Oral adverse effects of head and neck radiotherapy with/without chemotherapy in a southern Brazil hospital Schorr, Joana Leticia Almeida Loureiro, Felippe José Frenzel Schuch, Lauren Petersen Wagner, Vivian Carrard, Vinicius Coelho Neves, Matheus Martins, Marco Antonio Trevizani Martins, Manoela Domingues Abstract in English: Abstract The aim of this study was to evaluate the main oral adverse effects and their relationship with dental care before radiotherapy (RT) and combined RT and chemotherapy (RT+CT). Additionally, we assessed the association of other risk factors with the development of these adverse effects. This paper is a retrospective cross-sectional analytical study of data from medical records of patients with head and neck cancer (HNC) who underwent RT or RT+CT attended at the stomatology unit in a southern Brazil hospital. The records of 78 patients with HNC were accessed. Demographic data, tumor characteristics, cancer treatment, follow-up data, adverse effects, and dental treatment prior to RT were evaluated individually for descriptive analysis. Kaplan-Meier survival curves were plotted. Risk factors were assessed using chi-square or Mann-Whitney test. The results showed that most patients were male (88.3%) in their 6th decade of life. Tumors were mostly located in the oral cavity (52.6%) and squamous cell carcinoma was the main diagnosis (94.8%). Most cases were diagnosed in advanced stages (67.9%). RT was of 2D or 3D types in 93.6% of patients. Oral adverse effects were observed in 94.7% of patients treated with RT or RT+CT. Osteoradionecrosis (ORN), oral mucositis (OM), candidiasis, and xerostomia were the main complications. Patients who received 2D RT had higher risk of developing ORN and xerostomia compared to those who received 3D RT. The risk of developing ORN was higher in smokers compared to non-smokers and in patients who had not previously consulted a dentist. This study showed that patients who underwent RT for HNC have a high occurrence of oral complications. Dentists play a key role in the management of these oral side effects. |
Original research/Stomatology Comorbidities in people living with HIV/AIDS and their impact on outpatient dental care BARTHOLO, Maria Fernanda TENÓRIO, Jefferson Rocha ANDRADE, Natália Silva SILVEIRA, Cristiane Barbosa ORTEGA, Karem López MARTINS, Fabiana GALLOTTINI, Marina Abstract in English: Abstract The objective of this study was to estimate the prevalence of comorbidities among people living with HIV/AIDS (PLWHIV) attending a dental outpatient clinic and discuss the impact of these comorbidities on dental management. A cross-sectional observational study evaluated 238 PLWHIV attending a specialized dental outpatient clinic in Brazil. We collected sociodemographic data, self-reported and physician-diagnosed comorbidities, hemogram results, CD4+ T cell count, viral load, use of combined antiretroviral therapy (cART), and information on harmful habits. The most prevalent comorbidities were sexually transmitted infections (STIs) (116/238; 48.7%), psychiatric disorders (105/238; 44.1%), and lipodystrophy (97/238; 40.8%). Men were more likely to have STIs (OR 4.0) and tuberculosis (OR: 2.5) (p < 0.05). Age ≥ 50 years increased the risk of diabetes mellitus by 2.6 times (p < 0.05). The risk of lipodystrophy (OR: 2.99, 95%CI 1.44–6.19) and psychiatric disorders (OR: 2.13, 95%CI 1.01–4.47) was greater in those who had been diagnosed with HIV for more than 20 years. In summary, psychiatric disorders and severe hematological alterations, such as anemia and neutropenia, are significant comorbidities that may limit dental treatment of HIV-positive patients. These findings underscore the need for integrated medical and dental care to address the complex health needs of PLWHIV. |
Critical Review/Imaginology Principles of radiological protection and application of ALARA, ALADA, and ALADAIP: a critical review MENDONÇA, Rafael Pereira de ESTRELA, Carlos BUENO, Mike Reis CARVALHO, Teresa Cristina Alves Silva Gonzalez ESTRELA, Lucas Rodrigues de Araújo CHILVARQUER, Israel Abstract in English: Abstract This study carried out a critical review of the principles of radioprotection, including the ALARA, ALADA, and ALADAIP principles. The Google Scholar and PubMed databases were the search resources, and the following keywords were searched: Linear No-Threshold (LNT); Biologic Effects of Ionizing Radiation (BEIR VII); As Low As Reasonably Achievable (ALARA); As Low As Diagnostically Acceptable (ALADA); As Low As Diagnostically Acceptable, being Indication-oriented and Patient-specific (ALADAIP). This critical review included studies with historical references, reviews, position papers, and clinical and experimental studies. Regarding data extraction, only original articles were selected after the screening process. Much of the current evolution of X-ray machines and radioprotection protocols has stemmed from legitimate concerns about this topic. This development has grown out of the relevant work of organizations like ICRP, UNSCEAR, and other renowned international organizations. Low doses of radiation, such as those used for diagnosis, also occur naturally and are present in everyday life. Although there is no agreement on the actual risk involving low doses, the recommendations of ALARA, ALADA, and ALADAIP prevail, in line with the trend to uphold principles that balance the importance of X-ray diagnostic imaging with the intention of keeping the doses as low as possible. The benefits of X-ray exams, when justified, tend to outweigh the low risks attributed to them. |
Critical Review of Literature/Occlusion Exploring masticatory performance: a bibliometric analysis of studies published in the Web of Science database from 1950 to 2024 Pereira, Luciano José Bezerra, Adriana Pinto Rocha, Aurélio de Oliveira Alcântara, Sarah Ferreira Mattos Rodrigues, Rayene Cardoso Carvalho, Mariane Cardoso Gonçalves, Thais Marques Simek Vega Abstract in English: Abstract Objectively evaluating an individual’s capacity for food fragmentation (masticatory performance) is crucial for understanding oral physiology and dental rehabilitation processes. Our aim was to conduct a bibliometric analysis of the literature focusing on masticatory performance. We conducted a survey in Web of Science up to August 31, 2024, applying specific category filters. Two calibrated reviewers manually tabulated the data, extracting information on title, authorship, keywords, institutions, countries, number of citations, year of publication, journal title, study design, masticatory test, population, and dentition status. VosViewer software generated collaborative network maps, while JAMOVI was used to perform ANOVA and Poisson regression analyses. The selection process resulted in 814 articles published between 1950 and 2024, with a recent increase to at least 50 articles per year. The average impact factor was 3.16, with around 30 citations per article. Citations were significantly influenced by the masticatory performance technique, publication year, and journal impact factor. The comminution test was the most prevalent (n = 411). Most studies focused on adults (n = 420) and older adults (n = 361), in which natural dentition (n = 404) and complete dentures (n = 214) were the most widely assessed parameters. The most frequent study designs were cross-sectional (n=489) and prospective (n = 145). The leading countries were Japan (n=202), Brazil (n=134), and the Netherlands (n = 69), and the Journal of Oral Rehabilitation was the most recurrent journal (n = 162). This study highlights the growing interest in evaluating masticatory performance, with a significant increase in publications over the years. This study highlights the need for further research involving children and longitudinal study designs, as well as studies evaluating rehabilitations with removable partial denture and implant-supported prostheses. |
Systematic Review/Orthodontics Patient-centered factors associated with orthodontic treatment success: a scoping review Santana, Lucas Garcia Gatti-Reis, Luisa Paiva, Saul Martins Ramos-Jorge, Maria Letícia Marques, Leandro Silva Abstract in English: Abstract The aim of this systematic review was to synthesize the available literature on pretreatment factors, from a patient-centered perspective, that predict successful orthodontic treatment. Systematic and unrestricted searches were conducted across the electronic MEDLINE, Embase, Web-of-Science, Scopus, Cochrane Library, and LILACS/Bireme databases. Grey literature was also searched to identify potential studies. Qualitative assessments of the role of patient-centered pretreatment factors in orthodontic treatment success (adherence, satisfaction, and discontinuation rates) were evaluated and synthesized. Study selection and data extraction were performed independently by two reviewers. A total of sixteen studies were included. Three main domains related to the patient emerged as positive predictors of orthodontic treatment success: previous patterns of social behavior, attitudes of parents/caregivers, and reasonable motivation. Certain personality traits were associated with both positive and negative levels of adherence and treatment satisfaction. The evidence did not support the notion that the impact of malocclusion on aesthetic self-perception could serve as an indicator of cooperation, satisfaction, or discontinuation rates related to orthodontic treatment. Positive social behavior patterns and parental/caregiver attitudes, along with realistic prior motivation toward treatment goals, were found to be reliable predictors of orthodontic treatment success. Additionally, some personality traits were found to be associated with successful treatment outcomes. However, the evidence did not support the impact of malocclusion on self-perceived aesthetics as an indicator of compliance and satisfaction levels with orthodontic treatment. |
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