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Aim To evaluate parents’ knowledge about obstructive sleep apnea syndrome in preschoolers in the primary dentition in the city of Parnaíba-PI. Methods The questionnaire on obstructive sleep apnea syndrome (OSAS) in children was applied to parents of children between 2 and 6 years of age, in the deciduous dentition who were attending preschool in public and private kindergarten. It contained objective questions distributed in two parts: the first that determined the epidemiological profile of parents and children; the second part with 22 questions that checked the parents’ knowledge about the child’s sleep and behavior during the day. As an interpretation, the questionnaires that presented 36.3% of the answers YES to the 22 specific questions, the child was considered at high probability for developing OSAS. Results The average age of the children was approximately 4 years old. Regarding weight, an average of 22 kilos and an average height of 107.45 cm and an average BMI of 18.75, confirmed by notes on the vaccination card. Loud snoring, loud or heavy breathing, and overweight were significantly associated with OSAS (p < 0.001). From a total of 250 children, it was observed that the prevalence rate of high possibility for the development of OSAS was 6% (n=15). Conclusion Parents were not aware of OSAS, but after applying the questionnaire, they were able to understand the suggestive signs of the syndrome and the importance of early diagnosis.

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Aim This study aimed to assess the effects of a hydroelectrolytic beverage on the surface roughness and microhardness of different bulk fill resin composites. Methods Sixty resin composite samples were prepared and divided into three groups: FiltekTM Z350 (C), FiltekTM One Bulk Fill (BF-F), and Opus Bulk Fill APS (BF-O). These were further subdivided to analyze two beverage groups: GatoradeTM Lemon (GL) and distilled water (control). Surface roughness (Ra), surface microhardness (KHN), and scanning electron microscopy (SEM) results were evaluated (n=10). The data were subjected to two-way ANOVA (for roughness) or three-way ANOVA (for microhardness), followed by Tukey’s post hoc test (α=0.05). Results The C group exhibited higher microhardness than the BF-F and BF-O groups, regardless of the solution used. A reduction in microhardness was observed in all groups when comparing initial and final time points. SEM images revealed variations in the size, amount, and arrangement of particles among the different resin composites. Conclusion The study concluded that the microhardness of different bulk fill resin composites decreases when exposed to either the hydroelectrolytic beverage or distilled water. However, the type of immersion liquid did not influence the surface roughness of the evaluated composite resins.

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Aim this study is to evaluate the effect of corrosion on flexural fracture resistance in orthodontic mini-implants composed of two materials and submerged in salivary substitutes with or without fluoride. Methods twenty mini-implants were used, 10 from SIN Company (Ti6AL4V alloys) and 10 from Morelli (steel alloys), (G1: Ti6AL4V in fluoride-free saliva solution; G2: Ti6AL4V in saliva solution with 1500 ppm of fluoride; G3: Steel in saliva without fluoride; and G4: Steel in saliva with 1500 ppm of fluoride). The samples were taken to a potentiostat to evaluate the corrosion, and then were evaluated under scanning electron microscopy (SEM). Then, the mini-implants underwent flexural fracture resistance tests. Kruskal-Wallis test with the Student-Newman-Keuls comparison evaluated the corrosion and pitting potentials of each group. ANOVA and Tukey’s comparison test at a 1% significance level. Results All groups suffered corrosion potential and pitting potential, but those that were in solutions with the presence of fluoride showed less resistance to the formation of corrosion pits (G1 and G3). In the SEM analysis after flexural resistance, small cavities suggestive of pitting corrosion were noted. The G4 was the only one that formed the passivation potential. In the fracture resistance test, mini-implants manufactured by Ti6AL4V fractured with less force applied (G1 and G2). Most steel mini-implants (G3 and G4) only deformed with a higher force application. Conclusion Fluoride acts to corrode mini-implants, regardless of their manufacturing material. Regarding flexural resistence, the corrosion rate of the mini implants did`nt influence the fracture resistance values.

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Aim Since the reactivity of fluoride with enamel decreases when the pH of slightly acidic solutions is not maintained, we evaluated the effect of acidic fluoridated solutions buffered with histidine on the formation of loosely (CaF2-like) bound products on enamel. Methods Demineralized enamel slabs were treated with 0.05% NaF solution at pH levels of 5.0, 5.5, 6.0, and 6.5, either buffered or not with histidine (n=12). CaF2-like product formation was determined in enamel, and the data were submitted to ANOVA, Tukey, and Dunnett’s tests. Results Buffered fluoride solutions, regardless of pH, formed higher concentrations of CaF2-like products on enamel than the respective group without buffering (p<0.05). Conclusion The findings show that the buffering increases CaF2-like formation on carious enamel, although a direct effect of histidine cannot be entirely ruled out.

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Background and Aim It is acknowledged that controlling the vertical dimension is a crucial and frequently challenging aspect of orthodontic treatment. The present study evaluated the micro-implant effect in angle class II malocclusion patients. Methods All articles published in international databases such as PubMed, Scopus, Science Direct, ISI Web of Knowledge, and Embase between 2012 and July 2022 are included. Meta-analysis data collected from selected studies were performed using Stata/MP.V17 software. Results The abstracts of 718 studies were reviewed, and finally, 12 studies were selected. The mean differences of vertical change of lower and upper molar between micro-implants were -0.88 (MD, 95% CI -1.15, -0.60; p=0.00). Conclusion Based on the present study’s findings, using a Micro-implant compared to conventional anchorage has better vertical control. It is suggested that future studies be conducted with a similar cognitive methodology of higher quality and get help from methodological guidelines.

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Aim To map the available evidence about the frequency of consumption of sugary foods among schoolchildren enrolled in public and private schools, in urban areas, in Brazil. Methods This scoping review followed the methodological procedures established by the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) for its reporting. Studies whose data were collected in the last 10 years until July 2021 were included. The search was conducted in five electronic databases: MEDLINE (via PubMed), Embase, Web of Science, Scopus, and LILACS, and for unpublished studies, the CAPES Theses and Dissertations Library. Results Of the 9.028 studies retrieved in the search, 24 were included in the review. The largest number of publications is between the years 2011 and 2016. Among the sugar-rich foods evaluated, the consumption of soft drinks was the most investigated. A high frequency of consumption of these foods among schoolchildren was observed. Conclusion This review allowed us to identify a high frequency of sugar-sweetened food consumption among schoolchildren, and thus contribute to the formulation and strengthening of public policies that favor healthier eating habits.

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Aim This study aimed to analyze if polymorphisms of metalloproteinases can influence endosseous implants’ osseointegration failure. Methods This meta-analysis was registered in PROSPERO (CRD42020172108). The literature search was performed on Pubmed/MEDLINE, EMBASE, Scielo, BVS (LILACS and BVS Odontology), and Cochrane Controlled Trials databases. The gray literature and a manual search in periodicals of specific relevance to dentistry and the orthopedics field were also performed. Two calibrated reviewers read all titles and abstracts of the articles and selected those related to the theme. Then, the authors reviewed the full selected articles, fulfilling the inclusion and exclusion criteria. The inclusion and exclusion criteria were related to the type of study design, article language, and population characteristics. The quality of individual studies was evaluated using the Newcastle-Ottawa scale. A meta-analysis was performed using the MetaGenyo software to analyze the association between MMP SNPs and the risk of implant osseointegration failure. The Fixed Effects Model (FEM) and Random Effects Model (REM) were used depending on the amount of heterogeneity in the data. Results Three hundred ninety-seven articles were screened, and nine studies were selected for the meta-analysis. The MMP-1 g.-1607 G>GG (rs1799750) is statistically associated with osseointegration failure as a protective factor (OR=0.15, 95% CI=0.05-0.45). The MMP-8 g.-799 C>T (rs11225395) is associated with a higher risk of implant osseointegration failure (OR=3.07, 95% CI=2.02-4.67). The MMP-1 g. 3’ UTR C>T (rs5854) is associated with a higher risk of implant failure only in the Caucasian population (OR=6.88, 95% CI=3.48-13.59) while in the Asian population is a protective factor (OR=0.35, 95% CI=0.17-0.74). Finally, the MMP-3 g.-1612 5A>6A (rs3025058) and MMP-1 g.-519 A>G (rs1144393) showed no association with osseointegration failure. Conclusion Even considering the limitations, our study suggests that some polymorphisms of metalloproteinases can be involved in the risk of osseointegration failure.

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Aim This systematic review aimed to evaluate the effects of Rapid Maxillary Expansion (RME) on hearing improvement in children and adolescents with conductive hearing loss. Methods A comprehensive search was conducted across eleven databases and grey literature. Studies included randomized controlled trials, cohort studies, and observational studies involving patients with maxillary atresia and conductive hearing loss due to otitis media. The primary outcome was hearing improvement measured in decibels (dB), assessed at pre-intervention, immediately post-intervention, and follow-up intervals of 3 to 24 months. The risk of bias was assessed using RoB 2.0 and ROBINS-I tools, while the GRADE system was used to evaluate the certainty of the evidence. A random-effects meta-analysis was performed, and heterogeneity was quantified using I2 statistics. Results Twelve studies, including 337 participants, were included. The meta-analysis demonstrated a significant improvement in hearing thresholds following RME, with a pooled mean difference of -6.56 dB (95% CI: -10.32 to -2.81). The RME vs. control group comparison showed a mean difference of -5.25 dB (95% CI: -9.89 to -0.62). However, high heterogeneity (I2 = 88%) was noted. Some studies reported a relapse in auditory improvements after the retention period. The GRADE assessment indicated moderate certainty of evidence due to methodological limitations. Conclusion RME improves hearing in patients with conductive hearing loss, but high-quality studies are needed to confirm long-term benefits and assess specific populations. Future research should address the variability in treatment protocols and follow-up durations.

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Transverse maxillary discrepancy, mandibular skeletal retrusion, and increased lower anterior face height have been recognized as frequent abnormalities in growing individuals, despite the paucity of available data. Aim This research looked at the relationship between treatment planning and Control of Vertical Dimension (CVD) effectiveness in orthopaedic and orthodontic therapy (OT). Methods We searched full-text publications in PubMed, Web of Science, Scopus, Embase, Google Scholar, and ScienceDirect databases from 1970 to 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) quality scale was used for the critical selection of the studies. Results We identified 43 articles, of which 28 were included in the review. Also observed that a strong and positive relation was established for the two parameters of CVD and OT for both growing subjects. Conclusion We can suggest from our study that rapid maxillary expansion (RME) can be used as an aid for the control of vertical dimension estimation.

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Teeth with root dilaceration represents a challenge in clinical practice when an intervention is needed, especially in cases requiring a multidisciplinary approach to resolve the issue. Aim This report describes the root dilaceration of a maxillary central incisor with severe apical periodontitis, involving a 4-year follow-up of endodontic surgical-orthodontic management using leukocyte and platelet-rich fibrin (L-PRF). Methods The planning process included treating the root canal and the central maxillary incisor affected by distoangular root dilaceration, by using orthodontic repositioning of the neighboring tooth, and an endodontic and periapical surgical approach. The operative procedure used cone-beam computed tomography (CBCT) scans of the left maxillary central incisor, taken prior to orthodontic tooth movement maxillary lateral incisor. Orthodontic treatment was performed after the endodontic treatment, and followed by surgical management with periapical lesion curettage, apicoectomy, retro-preparation, retro-filling and grafting with L-PRF, resulting in a successful conclusion. Conclusion The four-year clinical follow-up showed complete alignment of the maxillary lateral incisor and signs of periapical healing based on CBCT images.

Abstract in English:

Rehabilitation of atrophic maxilla can be challenging, being used bone augmentation and modified implant designs. Despite many studies on more complex techniques, such as zygomatic implants. There are practically no case reports in literature using extra-long implants with bicortical anchorage in canine pillars for immediate rehabilitation in atrophic maxillae. This clinical report aims to describe a case in which extra-long implants were placed with bicortical anchorage in canine pillars region to allow full-arch immediate rehabilitation of an atrophic maxilla. A 60-year-old male patient, in good general health, was referred to a Dental College (Curitiba, Brazil) with complaints about his upper partial dentures. Patient´s rehabilitation was initiated with lower arch to achieve a full-mouth balanced occlusion. Platform-switched Morse taper connection implants were placed in regions #34, #36, #44, and #46 to support single and multi-unit fixed prostheses. For rehabilitation of maxillary arch, an all-on-four rehabilitation was planned. Guided surgery was performed to place four platform-switched Morse taper connection implants bicortically anchored in the canine pillar´s region, the two distal extra-long implants. Patient was followed for 16 months and presented good clinical and radiographic outcomes, including adequate peri-implant bone level maintenance and soft tissue health. No biological or mechanical complications were reported within this period. Therefore, use of extra-long implants bicortical anchored in canine pillars seems to be a suitable treatment option for rehabilitation of atrophic maxilla, enhancing possibility of obtaining sufficient primary stability, more even distribution of load on the remaining bone, possibility of immediate rehabilitation and maintaining peri-implant tissue health.

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Aim To report a case of endodontic treatment of an upper lateral incisor with type II Dens Invaginatus with the aid of operative microscopy and ultrasonic tips. Case Report A 16 years-old female patient was referred for endodontic treatment of the left maxillary lateral incisor with diagnosis of symptomatic apical periodontitis and type II Dens Invaginatus. Removal of the intracanal calcified structure was carried out using long-shaft high-speed drills in conjunction with diamond-coated ultrasonic tips. Instrumentation was performed alternating between reciprocating and manual files up to the K 80 file. Intracanal medication based on 2% chlorhexidine gel and calcium hydroxide powder remained inside the canal for 14 days. Filling was executed by creating an apical plug with bioceramic sealer (Bio-C Repair, Angelus) and a Mineral trioxide aggregate (MTA, Angelus) backfill up to the cervical third. In the 14 months follow-up the periapical radiograph and CBCT showed signs of periapical bone repair. Conclusion This report highlights the critical role of CBCT and the use of UT combined with microscopy in comprehensive treatment planning and execution. Additionally, it provides valuable clinical evidence demonstrating the feasibility and effectiveness of this approach.

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Dental caries is the most common oral health disease among school-aged children worldwide. Aim This study aims to identify the prevalence of dental caries, oral hygiene practices, and food habits among school children. Methods A cross-sectional study was conducted at two secondary schools in Budhanikantha Municipality, Ward No. 2 and 12, with a total of 400 students participating. An oral examination was performed by a dentist, and decayed, missing, and filled teeth (DMFT) were used to determine the presence of dental caries. Statistical Package for the Social Sciences version 26 was used for all analyses. Results Among the participants, the majority (66.3%) were aged 10-14 years, with a mean age of 13.58 years (±1.85), and were male (57.3%). The prevalence of dental caries was 63.0%, with a mean DMFT score of 1.67 (±1.82). Only 38.0% of participants brushed their teeth twice a day, and all used a toothbrush for brushing. Drinking tea with sugar (61%), eating sweets/candy (42%), and biscuits, cakes, and cream cakes (37.8%) were the most frequently consumed items and were consumed on a daily basis. Health-seeking behavior was poor, with the majority (32.8%) of participants not visiting the dentist within 12 months, and 22% never receiving dental care. Conclusion The study reveals a high prevalence of dental caries among school children, indicating a need for improved oral health practices and healthcare utilization. The low frequency of tooth brushing and high consumption of sugary foods and drinks suggest that oral health education and promotion of healthy habits are essential.

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Aim This study evaluated the effect of different concentrations of transforming growth factor beta 1 (TGF-β1) on stem cells from human exfoliated deciduous teeth (SHED) viability, proliferation, migration and differentiation into odontoblasts. Methods SHED was treated with different concentrations of TGF-β1 (1.0, 5.0 and 10.0 ng/mL). Sulforhodamine B and MTT assays evaluated the cell proliferation and viability at 1, 3, 5, and 7 days and Migration assay at 24h. RT-PCR verified Dentin matrix protein1 (DMP-1) and Dentin Sialophosphoprotein (DSPP) mRNA expression for 1, 7 and 14 days. The data were analyzed by one-way and two-way ANOVA, followed by Tukey test (p<0.05). Results All tested TGF-β1 concentrations increased SHED proliferation compared with the negative control (untreated), from day 3 of treatment (p=0.000), with no loss of cell viability. Cell migration was higher in media containing TGF-β1 (1.0-10.0 ng/mL) than in negative and positive control media, with 10 or 20% Fetal Bovine Serum, respectively (p=0.000). Treatment with TGF-β1 for up to 14 days induced the expression of the odontoblast markers DMP-1 and DSPP. DMP-1 expression was intense early after treatment with 10.0 ng/mL TGF-β1 and increased progressively from days 1-14 of treatment with 1.0 and 5.0 ng/mL TGF-β1. In contrast, DSPP expression was detected after 14 days of treatment with 10.0 ng/mL TGF-β1. Conclusion Different concentrations of TGF-β1 on SHED promoted positive effect on proliferation and migration, with no loss of cell viability. The concentrations of 10.0 ng/mL TGF-β1 for 14 days induced the expression of the odontoblast markers DMP-1 and DSPP.

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Aim To evaluate the effect of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2] in the presence or absence of surfactant benzalkonium chloride (BAK) on the bond strength of an epoxy resin-based sealer to root dentin. Methods Fifty decoronated permanent human maxillary lateral incisors, with a single main canal and complete root development, were divided into 5 groups (n=10) according to the irrigant: 0.9% sodium chloride (NaCl), (control); 2.5% NaOCl; 2.5% NaOCl + 0.008% BAK; 2.5%Ca(OCl)2; and 2.5% Ca(OCl)2 + 0.008% BAK. Irrigation was performed using the syringe and needle. The root canal was prepared with 40.06 nickel-titanium instruments, under irrigation with 20 mL of the solution corresponding. Roots were filled using the single cone technique with gutta-percha and epoxy resin-based sealer. A slice from each third was obtained and subjected to the push-out test by applying an apical-coronal force until failure. Data were analyzed by post-hoc pairwise comparisons were performed using the Kruskal-Wallis test adjusted using the Bonferroni method (α = 0.05). Results The groups treated with 2.5% NaOCl and 2.5% Ca(OCl)2 showed bond strength similar to the control group (p > 0.05). The use of an additional 0.008% of BAK was able to increase the bond strength after the use of 2.5% Ca(OCl)2 (p < 0.05) and did not change the bond strength after the use of 2.5% NaOCl (p > 0.05). Conclusions The NaOCl and Ca(OCl)2 exhibited comparable bond strength values. Nevertheless, when the surfactant BAK was addition into both solutions, only Ca(OCl)2 demonstrated an increase in adhesion.

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Aim The objectives of this scoping review are to map the evidence available in the literature on using the GentleWave System (GWS) in endodontic treatments and to identify knowledge gaps. Methods Searches were conducted in PubMed, Scopus and Web of Science. We included randomized and non-randomized clinical trials, cohort studies, case series and cross-sectional studies that evaluated or reported using the GWS. In vitro studies assessing the GWS versus a control group were included. Studies were independently selected by two researchers based on eligibility criteria. Two reviewers each extracted data from half of the included studies. The following data were extracted: study design, purpose, number of study groups, sample size and sample type, analyzed outcome, outcome measurement and main results. A descriptive analysis of the data was performed. Results Twenty-seven studies were included. In vitro studies were the most frequent study design (85.2%). Of these studies, 13 evaluated root canal disinfection. The general results demonstrated that the GWS produces results superior to the observed comparison groups. Only four studies were conducted in humans (13.8%): three prospective clinical studies and one randomized clinical trial. However, the results of these studies seem to demonstrate that the GWS is a promising treatment. Conclusion Available evidence demonstrates that knowledge about GWS is still very limited. Although most of the studies in our review demonstrated that the GWS performed better than or similar to other observed systems, caution should be exercised regarding its clinical recommendation, as evidence of its superiority comes only from in vitro studies.

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Aim The aim of this study was to evaluate the antibacterial and antibiofilm capacity against Enterococcus faecalis of endodontic sealers AH Plus Jet and the calcium silicate-based sealers, Bio-C Sealer and Sealer Plus BC. Methods All experiments were performed with fresh endodontic sealers without setting. For this, antibacterial agar diffusion test, analysis of antibiofilm activity evaluated by confocal microscopy, assessment of cell viability and pH evaluation were used. Results In the agar diffusion test, all sealers showed an ability to inhibit bacterial growth. In the antibiofilm analysis by confocal microscopy, all the evaluated sealers showed the ability to reduce the mature bacterial biofilm. A pH analysis was also performed in the period from 1min to 72h; calcium silicate-based sealers presented a more alkaline pH than AH Plus Jet, and Bio-C Sealer presented a pH greater than 11 in all the analyzed periods. In the assessment of cell viability AH Plus Jet demonstrated a lower cell viability after 24h. However, after 72h, all sealers led to a reduction in cell viability when compared to control. Conclusions Bio-C Sealer and Sealer Plus BC and AH Plus Jet showed similar antibiofilm capacity against mature E. faecalis biofilms. Furthermore, all evaluated sealers showed antibacterial capacity in the agar diffusion test, and AH Plus Jet and Bio-C Sealer showed significantly greater inhibition of bacterial growth than Sealer Plus BC. Thus, evaluated sealers demonstrated antibacterial and antibiofilm activity against E. faecalis. Knowledge about the antibiofilm and antibacterial activity of endodontic sealers for E. faecalis is relevant, as it is currently one of the main causes of failure in endodontic treatment.

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Aim The aim of this study is to observe the perioperative discomfort resulting from oral surgeries, while also advancing the validation process of the Self-Perception Questionnaire of Dentoalveolar Oral Surgery (QCirDental). Methods The study was characterized as observational and cross-sectional. The sample was composed by 432 patients submitted to dental extractions. Where performed test-retest reliability, split-half reliability and exploratory factor analysis. Results The study demonstrated the reliability of the QCirDental questionnaire through test-retest (Cα .93) and split-half reliability analyses (First: r .92 p< .001; Second: r .92 p< .001). Three domains, namely Physical Feelings (PF), General Perceptions (GP), and Feeling of Loss (FL), were identified through exploratory factor analysis. The PF domain exhibited the strongest correlation (rs.95, p< .001) with the overall questionnaire score implying that it could be reduced to a set of 11 questions. Surgical time showed association with PF and GP; surgical complexity with PF and GP and; volume of local anesthesia with PF and GP. Conclusions This study provides insights into the factors influencing patient discomfort during oral surgeries. This research also advanced the validation process of QCirDental, confirming its reliability.

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Oral and maxillofacial prosthesis (OMP) is a specialty of Dentistry for prevention, protection, functional, and orofacial rehabilitation. Aim The present study aimed to describe the OMP Brazilian panorama, verifying specialists, patient access forms, and service characteristics. Methods OMP specialists were identified on the Federal Council of Dentistry (CFO) website. Additionally, professionals linked to the specialty were invited to answer a questionnaire (Google Forms®) through email or social networks. The questionnaire was available between October and November 2022. Data referring to the professional, service, and assistance were collected. Results CFO records showed 89 active registered OMP specialists. There were 35 responses to the online questionnaire. The majority of participants were women (74.1%), who were non-specialists (51.9%), with an average age of 54.26 years, while some were specialists in other areas of training such as dental prostheses and oral and maxillofacial surgery. Concerning services comprised universities, institutes, hospitals, and private networks, and most OMP services were located in the southeast region, especially in São Paulo, followed by the northeast and south regions. As for the developed prostheses, the most frequent etiology was malignant pathology, and the produced type is the ocular, followed by the obturator. Conclusions We concluded that OMP is still under development in Brazil and the number of professionals is small and regionalized. There is an imperative to establish new, specialized training centers and decentralize the presence of professionals, thus expanding access and enhancing services for oral and maxillofacial prostheses throughout Brazil.

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Aim To demonstrate the antifungal and healing properties of Calendula officinalis. Methods We included four assays: inhibition halo, germicidal test, cytotoxicity test, and scratch test. Results The extract at 100% and 50% concentrations was effective, and both presentations (Calendula officinalis extract and Calendula officinalis infusion) exhibited no cytotoxic effects. Furthermore, the infusion demonstrated a high healing effect without affecting the morphology of the cell monolayer and promoted fibroblastic proliferation. The extract did not show the expected healing results. Conclusions Calendula officinalis holds considerable potential for further research across various biological processes, highlighting its promise as a subject for continued investigation.

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The COVID-19 pandemic quickly spread throughout many countries, affecting the functioning of various important services, including services in dentistry, and led to profound changes. Aim This study aims to highlight the problems faced by members of the Brazilian Society of Stomatology and Oral Pathology (SOBEP), during the period of COVID-19 pandemic. Methods This was a cross-sectional study. Three hundred and eighteen members of the SOBEP received, by e-mail, an online structured questionnaire, on the Google Forms platform (Google®), with questions related to the clinical and research activities developed during the COVID-19 pandemic. Results Of the 318 members of the SOBEP, 139 (43.7%) answered the questionnaire. Of the 139 associates, 88 were females (63.3%), distributed in five Brazilian Regions, and twenty states, and Federal District. Thirty-three (23.7%) associates work in two areas, stomatology and oral pathology, being the workplace throughout the area of operation public higher education institutions. Importantly, 112 (80.6%) members reported that they are developing their activities with restriction, and 95 (68.3%) members reported changes in their workplace to meet the new biosafety standards. Ninety-one (65.5%) reported having noticed changes in their mental health. Conclusion The pandemic has caused numerous changes in the clinical activities of dentistry, and due to the risk of infection, several procedures within stomatology and oral pathology have been postponed. Thus, further studies are required in order to show the real impact of the pandemic in this area.

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Aim To investigate the effects of using social media application associated with active learning methodologies on adherence to dental treatment among young adults. Methods This study controlled intervention was conducted in the city of Piracicaba, São Paulo, Brazil, in 2017, with 40 participants (age range from 19 to 24 years) randomized into Control (n=20) and Intervention Groups (n=20). For ten months the intervention group was invited to participate in a WhatsApp® group. This group used the pedagogical method of problematization with a discussion of oral health-related topics, while the Control Group was only instructed to seek dental treatment. The outcome was treatment adherence, evaluated by the mean period of time elapsed from beginning with follow-up of the study through to the time of the first consultation (Initial Time), and the time counted in days from the first consultation to conclusion of the treatment (Final Time) in both groups. Fisher’s exact test was used to compare adherence between the Groups and the Student’s-t test was used for initial and final times. Results The results revealed that 66.7% of the Intervention Group and 23.5% of the Control Group adhered to treatment (p<0.05). The number of decayed teeth was higher in the Control Group (p<0.05). Self-efficacy was higher in the Intervention Group (p<0.05). Conclusions WhatsApp® associated with active learning methodologies increased adherence to dental treatment.

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Aim This study assessed the activity of neuron/odontoblast receptors and neuropeptide release, under an animal model of dentin hypersensitivity (DH). Methods Wistar rats were allocated in two groups (n=10): in test group DH was induced by a validated protocol in which a sports drink (pH 3.08) was ingested for 45d, while in control group, the animals ingested filtered water instead. Animals were euthanized and blood samples were collected to measure plasma corticosterone levels. Dental pulp samples (n=6) were processed for Western Blot and ELISA analysis of TRPV1 (mechano-, thermo- and chemoreceptor), P2X7 (adenosine triphosphate (ATP)-mechanosensitive receptor), TRPM8 (cold-sensitive receptor) and substance P (neurogenic peptide released by neuron activation and due to TRPV1 expression). Data were analyzed using Student’s t tests (α=0.05). Results DH significantly increased expression of TRPV1 (p=0.002), P2X7 (p=0.007) and substance P (p<0.001) but did not significantly affect the activity of TRPM8 (p=0.079). Conclusion Under DH condition, neurons and odontoblasts expressed TRPV1 and P2X7 receptors as well as increased substance P release, demonstrating cellular and molecular mechanisms underlying DH.

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The COVID-19 pandemic has impacted the well-being of all healthcare professionals. However, there are still few studies evaluating this aspect in dental professionals. Aim To identify the contextual and labor-related factors associated with psychological stress in dental professionals working in public healthcare services during the COVID-19 pandemic. Methods This is an analytical, cross-sectional, and observational study including 96 dental professionals who worked in public services in the municipalities of Piracicaba-SP and Poços de Caldas-MG from October 2021 to January 2022. A self-administered questionnaire was used to collect data on the independent variables [sociodemographic characteristics, health and professional conditions, self-efficacy (Generalized Self-Efficacy Scale – GSE), subjective work overload (Job Demands scale), and thoughts/feelings related to COVID-19] and the outcome (psychological stress - Kessler Psychological Stress Scale-6 - K-6). Simple and multiple logistic regressions were performed using the Stepwise method to test the associations between independent and dependent variables. Results In multiple regression, professionals who were not in a relationship (OR=4.61; 95% CI: 1.05–20.17) and those with greater subjective burden (OR: 47.18; 95% CI: 5.39–413.21) were more likely to experience psychological stress (p<0.05). Conclusion Dental professionals working in public health system with greater subjective work overload were more likely to experience greater psychological stress during the COVID-19 pandemic.

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Aim This study aimed to verify the percentage of Brazilian dentists who plan and prepare partially edentulous mouths to receive RPDs. Comparisons between Brazilian dental laboratories working with conventional and digital technology (DT) were also performed. Methods A questionnaire hosted on the Google Forms platform was sent to dental technicians, from all Brazilian regions, who work with RPD framework manufacturers to assess: (1) the technological level of the laboratory, (2) the percentage of master casts received with RPD-specific mouth preparation, and (3) the percentage of work request with RPD design sent by dentists to a laboratory. A Chi-square test was applied to analyze data and a significance level of 5% was adopted. A total of 158 dental technicians participated in this study. Results A total of 3371 master casts were evaluated by dental technicians, including all Kennedy classifications. However, only 607 (18.01%) of them had RPD-specific mouth preparation. Dental technicians working with DT present more master casts with mouth preparation (p=0.001) and work requests (p=0.001) compared to those who use conventional technology. In addition, no difference was noted in the quality of RPD-specific mouth preparations between master casts received by technicians working with conventional and DT (p>0.05). Conclusion Most Brazilian dentists (81.99%) do not perform RPD-specific mouth preparation. Besides, dental technicians who work with DT receive more master casts of higher quality, with mouth preparation, and work requests compared to those who do not.

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Aim This prospective clinical study evaluated the cephalometric effects of orthodontic treatment with lower incisor extraction associated with buccal torque. Methods Cephalograms were evaluated at the beginning (T1) and the end (T2) of orthodontic treatment of 20 patients with a mean age of 32.2 years, Angle Class I malocclusion, and anteroinferior crowding. Orthodontic treatment was performed with a MBT prescription bracket, 0.022” slot with modified torque programming in the lower incisors (central and lateral: +6º), and a single lower incisor was extracted. Cephalometric measurements were performed using Dolphin® software by a single calibrated examiner. Data analysis was performed using the t-test for dependent samples, with a significance level of 5%. Results No statistically significant differences were observed in the cephalometric measurements evaluated (p≥0.194). Conclusions Orthodontic treatment carried out with extraction of lower incisors and associated with buccal torque did not promote dental and tegumentary cephalometric changes, positively impacting the completion of the treatment.

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Utilization of early clinical exposure (ECE) model in undergraduate dental education can help to contextualize theory with skill development. Aim: To compare the knowledge and skills of dental students trained using conventional method with those trained with a combination of didactic lectures and early clinical exposure module. Methods: This randomized controlled study was conducted among second year dental students in preclinical prosthodontics and was randomly allocated to 2 groups of 36 each. Control group received theory and practical class in Manipal College of Dental Sciences Mangalore India whereas, study group in addition to above, a video demonstration of the impression procedure in the clinic was given. Cognitive assessment done using Multiple Choice Questions (MCQs) and psychomotor skills assessed by using Objective structured Practical Evaluation (OSPE). Student feedback regarding ECE, by 5point Likert scale was obtained. Results: In the pretest and post intervention mean scores obtained by the subjects in the control group was 5.41±1.09, 6.69±0.85 and study group 7.31±1.24, 8.64±1.42. Comparison of intragroup showed that there was a statistically significant increase in the mean scores in both groups after the intervention when compared with their baseline values. (p<0.001) Students response to perception of early clinical exposure revealed improved understanding of impression procedure (85.7% strongly agreed and 14.3% agreed). Conclusions: Knowledge and skills of students trained with combination of didactic lectures and early clinical exposure module showed improved scores when compared with students trained using conventional method.

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Aim The aim was to evaluate the influence of the patient’s skin color on the choice of dental treatment by academics from a university in the south of the state of Santa Catarina (SC). Methods This is a randomized trial carried out with undergraduate students in dentistry at the University of Criciúma, Santa Catarina. All academics regularly enrolled in the 5th to 10th phases of the dentistry course were invited to participate. Half of the students, randomly, received the clinical case with white skin color, and the other half, the same clinical case but with black skin color. After the distribution of the cases, the participants self-administered a questionnaire with sociodemographic aspects and with the options for choosing treatment for the caries lesion. Crude and adjusted analyses of the association between the patient’s skin color and the choice of treatment were performed through multinomial logistic regression, with a significance level of 5%. Results In total, 159 academics were studied. When using direct restoration with composite resin as a reference, patients with black skin color were 56% less likely to receive indirect restoration with composite resin (Onlay) when compared to white skin color (RRR=0.44; 95%CI 0.21-0.93; p=0.032). Conclusions This alarming result showed that the patient’s skin color influenced the caries treatment chosen by dental students, which can result in black patients not receiving better treatment.

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Aim This study aims to analyze the potential therapeutic effect of cannabidiol use on oral mucosa lesions in clinical and in vivo studies. Methods A scoping review was conducted considering the question: “Is there a therapeutic effect of the use of cannabidiol (CBD) on lesions of the oral mucosa?”. Four distinct databases were searched (PubMed/MEDLINE, Embase, Web of Science, and Scopus) and gray literature until August 2023. Original clinical and in vivo studies were included, involving human and animal subjects where CBD was applied topically to the oral mucosa or administered systemically for the treatment of lesions or superficial/deep alterations of the oral mucosa. Results A total of 610 records were found in the initial searches. Twelve studies were assessed in full text for eligibility and five studies were excluded. Seven studies were included in this review. Five studies were conducted with in vivo design and only two studies had clinical design in humans. Considering results from in vivo studies, all of them presented better clinical results for oral mucosa lesion groups treated with CBD-based therapy compared to placebo. Regarding histological features, four studies found statistically significant improvement in CBD-based therapy and only one study did not find a significant improvement. For clinical studies, all studies presented positive clinical results (primarily regarding pain control) in the use of CBD-based therapies. Conclusion CBD appears effective in treating oral mucosa lesions (oral mucositis, ulcers, burning mouth syndrome). CBD-based therapies can reduce inflammation in vivo studies and hold promise for pain control and lesion healing in oral mucosa lesions in clinical studies. However, the limited number of clinical trials, heterogeneity in cannabis-based therapies, and a lack of standardized protocols underscore the need for further rigorous, interdisciplinary research to establish consistent dosing and assess the efficacy of various cannabinoids in treating oral mucosa conditions.

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Patients admitted in the Intensive Care Units (ICUs) often experience various oral health issues during their hospitalization, which can lead to a shift in their oral flora from Gram-positive to pathogenic Gram-negative bacteria, including Pseudomonas aeruginosa. Aim This study aimed to identify the colonization of P. aeruginosa in the oral cavity of ICU patients, as well as to assess its antimicrobial susceptibility profile, phenotypic resistance mechanisms, and biofilm-forming capacity. Methods Oral cavity samples were collected from patients in ICUs across three public hospitals in Porto Velho, Rondônia, Brazil. Antimicrobial susceptibility testing was performed using the disk diffusion method, phenotypic research on resistance determinants was conducted using a disk method with and without the addition of enzymatic inhibitors, and biofilm formation was assessed by measuring absorbance in microplates. Results A total of 114 oral cavity samples were obtained, with 28% showing colonization by P. aeruginosa. The antimicrobial susceptibility profile revealed that 93.7% of the isolates were susceptible to Polymyxin B. The highest rate of non-susceptibility was observed with levofloxacin (46.8%), followed by carbapenems: imipenem (43.7%) and meropenem (40.6%). Additionally, 37.5% of the isolates were classified as multidrug-resistant (MDR). In phenotypic research for carbapenemases, 35.7% of the isolates were positive for plasmid-mediated AmpC, and 14.3% were positive for Metallo-β-lactamases. Regarding biofilm production, 75% of the isolates were classified as moderate/strong biofilm producers. Conclusion Therefore, oral cavity colonization by P. aeruginosa in ICU patients is evident, with notable multidrug resistance to antibiotics, highlighting the need for vigilant monitoring and effective oral hygiene practices for these patients.

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Aim: This epidemiological study evaluated the association of malocclusions in the smile zone and periodontal disease. Methods A population-based cross-sectional study was conducted with 700 adolescents aged 15 to 19. The occlusal conditions assessed were overjet, overbite, mandibular crowding, and spacing. Periodontal Screening and Recording (PSR) determined the presence of periodontal disease. The variables were analyzed using a simple logistic regression model, estimating raw odds ratios. Variables with P<0.20 in simple analyses were tested in multiple regression models. Only the variables with P≤0.05 remained in the final adjusted model after adjusting for the other model variables. Estimating adjusted odds ratios with the respective 95% confidence intervals. Results Periodontal disease was significantly associated with crowding in the anteroposterior region (OR= 1.97; 95% CI: 1.08-3.59), as well as with the presence of open bite (OR= 4.11; 95% CI: 1.57-10.76). Conclusions Malocclusions in the smile’s esthetic zone are associated with periodontal disease. Mandibular crowding and anterior open bite increase the risk of periodontal disease.

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Aim: To evaluate the fracture resistance and failure mode of complete crown and different designs of overlay restorations fabricated from different CAD/CAM ceramic materials. Methods Ninety upper premolars were randomly divided into nine groups (n=10/group) according to ceramic material and restoration design into: LD4: Lithium disilicate overlay with margin located 4millimeter (mm) above the Cementoenamel junction (CEJ). LD2: Lithium disilicate overlay with margin located 2mm above the CEJ. LD-F: Lithium disilicate crown. ZLS4: Zirconia-reinforced lithium silicate overlay with margin located 4mm above the CEJ. ZLS2: Zirconia-reinforced lithium silicate overlay with margin located 4mm above the CEJ. ZLS-F: Zirconia-reinforced lithium silicate crown. HC4: Hybrid ceramic overlay with margin located 4mm above the CEJ. HC2: Hybrid ceramic overlay with margin located 2mm above the CEJ. HC-F: Hybrid ceramic crown. The ceramic restorations were fabricated according to the manufacturer instruction and cemented to the prepared tooth surfaces. Universal testing machine was used to evaluate the fracture resistance at cross head speed of1mm/min until failure. The obtained results were statistically analyzed using One-way ANOVA test at 0.05 level of significance and failure mode were evaluated. Results There was a significant difference (p=0.00) between the restoration designs of the same ceramic material, with a higher fracture resistance for the overlay restoration design with 4mm above the CEJ. Also, there was a significant difference (p=0.00) between the restoration materials with the same restoration design. The failure mode was mainly of type III. Conclusion Minimal invasive restorations like overlay restorations can be used as an alternative for the full crown restorations. Keeping the finish line coronary as possible during indirect restoration preparation increases the fracture resistance of the tooth. The Type III fracture of the tested samples can probably be attributed to the high modulus of elasticity of the used materials.

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Aim This in-vitro study aims to assess the fracture load resistance of the central pontic of two implant-supported zirconia fixed partial dentures (FPDs) using five alternative connector designs. Methods The CAD/CAM production technique was used to mill the FPD of a three-unit zirconia prosthesis (from the mandibular second premolar to the second molar) (DDS, 3D White Zirconia). The STL file was generated for two implant-supported 3-unit bridges. The zirconia fixed partial substructure was designed with five types of connector designs. The pontic is connected to an implant-supported bridge with round, square, rectangular, triangular, and reverse-triangular shape connectors. This study was designed for a cementless-retained implant-supported fixed partial denture (FPD) of 50µm interface gap. The fracture resistance of a pontic of a 3-unit zirconia FPD was assessed under a crosshead speed of 1mm/min using an Instron universal machine. The study data were statistically analyzed using the ANOVA (post hoc Games-Howell) test with a significant interval of (P≤0.05). Results The highest fracture resistance was using the reverse-triangular design, and the lowest fracture resistance was using the triangular connector design with a significant mean difference of (P = .003). Conclusions It seems that the reverse-triangular connector design for implant-supported zirconia fixed partial substructure.

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Aim Oral lichen planus (OLP) is a relatively common chronic inflammatory mucocutaneous disease in middle-aged individuals that often affects the oral cavity, and its prevalence has increased in recent years. The aim of this study was, in addition to examining the epidemiological information on OLP, to investigate the referral pattern, the chief complaint of patients, and the clinical manifestations of the diseases in OLP patients in northeastern Iran. Methods The records of OLP patients referred to the Department of Oral and Maxillofacial Diseases at the Faculty of Dentistry of Mashhad University of Medical Sciences in Iran from 2004 to 2017 were examined. The data were collected from the records by completing a checklist that included age, sex, education, place of residence, location and type of lesion (reticular, papular, plaque-like, atrophic, erosive and bullous), the patient’s main complaint, referral pattern, and referral time. The data were analyzed using SPSS 22 and Chi-squared, Fisher’s exact, and Kendall’s Tau-b tests were used for data comparison. Results The records of 504 OLP patients were evaluated. 68.3% of the patients were female and 31.7% were male with a mean age of 50.10 ± 13.99 years. 32.3% of the cases were referred by general dentists and 26% by specialist dentists. The most common area of involvement was the buccal mucosa (84.1%) and the most complaint was the burning sensation (59.5%). The patient complaints were significantly associated with the clinical manifestations of erosive and non-erosive lesions (P <0.001). In addition, dysplasia was observed in 4.6% of the patients with biopsy (in subsequent biopsy). Based on the history of treatment, the number of patients with skin involvement was significantly higher than that of patients without skin involvement (P = 0.045). Furthermore, 43.8% of patients with skin involvement referred within 6 to 12 months, which was significantly higher than the number of patients without skin involvement (P = 0.016). Here, the most referrals were made by general dentists and the most common clinical manifestation was erosive (nonkeratotic) lesions. Conclusions The patient complaints were significantly associated with clinical manifestations, so that pain and burning sensation were more common in patients with erosive lesions. Knowledge of the main complaints and clinical manifestations helps dentists diagnose the disease at an early stage and refer patients to specialists in a timely manner.

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Aim The present study evaluated color changes caused by endodontic repair materials in a simulated regenerative endodontic procedure (REP). Methods Fifty-six bovine incisors were randomly distributed into three experimental groups according to the repair cement placed over the blood clot [Conventional white MTA (Angelus), MTA Repair HP (Angelus), and Bio-C Repair (Angelus)] and a control group (n=14). Color measurements were taken before the access cavity preparation, one week, one month, three months, and six months after REP. The CIELAB system was chosen to calculate color change (ΔE), and the generalized estimating equations model was used to compare mean ΔE values between cements and periods. Results Teeth from the three cement groups exhibited a clinically perceptible color change. No significant differences between groups were found in any experimental period. Within each group, MTA Repair HP and Bio-C Repair exhibited significantly greater color change at the six-month evaluation. Conclusions The three endodontic repair materials caused similar changes in tooth color when used as a cervical plug in a simulated REP.

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Aim Secondary caries can lead to a failure of composite and glass ionomer cement (GIC) restorations. Bioactive dental restoratives have been introduced to address this problem. However, the evidence supporting the antibacterial efficacy of these materials remains limited. The objective of this study was to compare the antibacterial efficacy of contemporary bioactive and conventional restoratives against S. mutans. Methods A conventional composite (Filtek Z350 - FT), a high viscosity GIC (Equia Forte - EQ) and three bioactive restoratives comprising a giomer (Beautifil II - BF), an alkasite (Cention N - CN), and a zirconia reinforced GIC (Zirconomer - ZC) were evaluated. Biofilm quantification was performed using crystal violet (CV) assays and colony forming units (CFU) counts to determine the biofilm biomass and S. mutans viability respectively. The surface roughness of the specimens was measured. Results FT had the lowest biofilm biomass (OD570nm) and BF had the lowest S. mutans viability (LogCFU/ml). The highest surface roughness was observed for EQ while the lowest surface roughness was observed for FT. Surface roughness after exposure to bacteria suspension was significantly higher in ZC compared to FT and BF. Conclusion GIC-based materials displayed significantly greater biofilm biomass, S. mutans viability, and surface roughness compared to resin-based ones. Surface roughness (immediately after fabrication) showed a strong correlation to S. mutans viability. Further studies are required to verify if surface roughness is the dominant factor affecting the antibacterial efficacy of dental restoratives.

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Aim The aim of this study was to describe the clinicopathological features of an oral mucoceles series, with emphasis on the unusual histological variants. Methods Between 2000 and 2019, all oral mucoceles diagnosed at a Brazilian Oral Pathology Laboratory, were analyzed. All slides stained in hematoxylin-eosin (HE) were reviewed for confirmation of diagnosis. The collected data were analyzed using the IBM SPSS Statistics software, version 24.0, obtaining the descriptive statistical analysis in absolute and relative numbers for all the described variables. Results From the 6,875 oral lesions, 401 (5.83%) were mucoceles. There was a predilection for females (58.6%), and the most affected site was the lower lip (78.8%). Excision was the treatment of choice for the most patients (68.1%). Among the uncommon histological variants, the superficial mucoceles (6.2%) were the most common, and the least frequent was the clear cells changes (0.5%). In 225 (56.1%) lesions, the predominant mucus was of the myxoid type. Conclusion Although most mucoceles did not represent a diagnostic challenge, they may present unusual histological variants. Thus, depending on the histological variant, other lesions, including neoplasms, should be considered in the histopathological differential diagnosis.

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Aim This study investigates the impact of various tightening protocols on torque requirements in screw-retained crowns, focusing on the Angulated Screw Channel (ASC) system. The ASC alters the screw channel angle in the crown while aligning the abutment with the implant, potentially enhancing function and aesthetics in cases of improper implant positioning. Methods The investigation involved three sample groups: DIO abutment with 0-degree screw access and regular screw (D0), Ti-base angled screw channel abutment with 0-degree access and ball torx screw (A0), and Ti-base with 20-degree access and ball torx screw (A20). Each group was subdivided into four protocol categories, using nine screws each. Screws were initially hand-tightened, then subjected to the respective tightening protocols, with torque measurements taken using a calibrated Digital Torque Meter. Results Significant statistical differences in torque requirements were observed between the D0 group and both the A0 and A20 groups. However, the torque reduction percentage did not vary significantly among the different tightening protocols or between the 0- and 20-degree angles in the ASC system. The results indicate notable distinctions in torque needs between standard and angled screw channel systems. The lack of significant variance in tightening protocols and angles within the ASC system suggests consistency in torque requirements, regardless of these factors. Conclusions While the ASC system demonstrates a significant difference in torque requirements compared to the traditional system, the angle of the screw channel and the tightening protocol do not substantially affect torque reduction in the ASC system.

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Aim The aim of the present study was to analyze fluoride levels in the public water supply of Teresina, Piauí, Brazil, following the change of the public supply service. Methods This is a prospective descriptive laboratory study. The water samples were collected from 13 random locations over a period of 13 months. Three neighborhoods were randomly selected from each of the four zones (north, south, east and southeast) of the municipality (n=12) and one location close to the Water Treatment Plant (WTP) (n=1). The samples collect followed the VIGIFLUOR guide. Fluoride concentration analyses were performed in duplicate using a specific ion electrode (Orion 96–06; Thermo Scientific Orion., Boston, MA, USA) coupled to a VersaStar potentiometer (Thermo Scientific Orion), and the results were expressed in mg F/L (ppm F). Descriptive analysis and classification of samples were carried out according to the criteria of the Ministry of Health Collaborating Center for Oral Health Surveillance. Results Out of the 169 samples analyzed, 158 samples (93.5%) were classified as inappropriate (ranging from 0.00 to 0.34 ppm F), and 11 samples were classified as appropriate (6.5%) (ranging from 0.45 to 0.74 ppm F). Conclusions The majority of the water samples from the public supply in Teresina, particularly from the southeast and east zones, exhibited fluoride concentrations below the range considered optimal for controlling dental caries and minimizing the risk of fluorosis. Implementing heterocontrol is essential to maintain the quality of water distributed to the population.

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Aim This paper aimed to evaluate the reproducibility of the Scale Oral Health Outcomes for Five-Year-Old Children (SOHO-5) applied to public school students in a sertão area in the Paraíba. Methods The study population consisted of the census of all children in the city with a 5-year-old child (59 students) who underwent a clinical examination based on World Health Organization criteria for dental care (dmft) and application of an oral health-related questionnaire quality of life (SOHO-5). This process was repeated 30 and 60 days after the initial test under the same application conditions for two calibrated examinators. To assess the reproducibility of the SOHO-5 instrument, the concordance correlation coefficient (ρc) was used and a Bland-Altman concordance analysis was performed to assess the variability (limit of concordance) existing between the time points of questionnaire administrations. Results For the study scenario, there was no agreement between students’ answers regarding their quality of life, as indicated by low values of the concordance coefficient. Furthermore, the 95% confidence intervals of these measures show that these values are not significant because the intervals in the t0 x t2 (-0.11) and t1 x t2 (-0.04) scenarios have “zero”, while the lower bound for the t0 x t1 scenario is 0.29. Conclusions Therefore, there was no agreement between the standard response of 5-year-old children at three points in time when the questionnaire was administered.

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Artificial Intelligence-based language model, ChatGPT, has gained significant traction due to its communicative interface and the relevance of the responses generated. This tool exhibits tremendous potential to be utilized in dentistry for dental education, and possibly as a clinical decision support system. Hence, it is imperative to evaluate the accuracy of the model in relation to the responses generated for dental-related queries and outline the limitations for its use in clinical practice. This study aims to evaluate the performance of ChatGPT-generated responses to questions from multiple dental specialties for their accuracy, completeness, and relevance. Methods This multi-centric study involved 27 subject experts from nine dental specialties of various institutions and 2 heads of institutions. A total of 243 questions were formulated and the answers generated by ChatGPT (version: 3.5) were rated in terms of accuracy (6-point Likert), completeness (4-point Likert), and relevance (5-point Likert). Results The mean accuracy of the ChatGPT-generated answers was 4.61 (SD 1.575), with a median of 5.33. For completeness, the mean score was 2.01 (SD 0.793), and the median was 2.33. Regarding relevance, a mean of 3.13 (SD 1.590) and a median of 3.67 were obtained. The highest ratings were observed for answers related to Oral Medicine and Radiology, as well as for open-ended questions, and questions labelled as easy in terms of difficulty. Conclusion The promising results observed in the study promote the application of ChatGPT for retrieving dental information. However, it is crucial to exercise caution and seek advice from a qualified healthcare for dental health-related queries. Further large-scale testing of the model is necessary before incorporating it into dental clinical practice.

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Aim the objective of the study was to evaluate the influence of systemic and local factors as implant and prosthesis characteristics on the survival rate of dental implants through a practice-based multicenter retrospective cohort study. Methods the sample consisted of 1417 patient records, with 4556 implants placed. Dental records were analyzed considering patients who received dental implants in a period up to 20 years. The complete loss (removal) of the implant was considered a failure. Cox proportional-hazards models were used to evaluate the influence of variables (systemic - age, sex, smoking; local – arch region, previously failed site; implant - shape, length, diameter, thread form, insertion torque; prosthesis - load type, prosthodontics type) on the condition of failed implant. The Backward stepwise selection was then performed based on the probability of the Wald statistic. The measure of effect was the hazard rate (HR). Results a total of 144 implants were lost by the patients (3.2%). The survival rate of the dental implants was 96.8% in a mean time of 5 years. For both Backward stepwise and Enter method, variables that negatively influenced the survival of dental implants were higher total medications (HR=1.511), male sex (HR=1.733), posterior (HR=1.903) and anterior (HR=1.991) maxillary region, previously failed site (HR=3.012), short length (HR=1.742), immediate load (HR=1.896), and overdenture rehabilitation (HR=15.761). Higher survival rate was observed for anterior mandibular region (HR=0.245) and medium (regular) diameter implants (HR=0.450). Age, total diseases, smoking, implant shape, thread form and torque variables did not influence the models. Conclusion it was possible to conclude that either systemic and local patient factors or implant and prosthesis characteristics influence the survival of dental implants.

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Aim To verify the relationship between poor quality of self-perceived sleep with determinates, among higher education students from four faculties in the health care field. Methods This cross-sectional study obtained a sample of 295 students from Nursing, Medicine, Dentistry, and Psychology courses. Data collection was performed online, using a self-administered questionnaire to assess sleep, signs and symptoms of anxiety, presence of temporomandibular disorders, in addition to sociodemographic data and aspects of daily routine. The frequencies of the variables were determined. Results In the multivariate analysis, crude and adjusted binary logistic regression was used to obtain the odds ratios (OR) and respective 95% confidence intervals (95% CI). Among the individuals, 25.8% classified their sleep as poor, and 15.3% reported insufficient sleep duration, with close to three times more chances of poor sleep quality when compared to those with adequate sleep time (OR=2.922; 95% CI, 1,420-6.014). Students with anxiety symptoms were almost four times more likely to have poor sleep quality than those who did not present with anxiety (OR=3.739; 95% CI, 2.049-6.822). Students who had a higher number of class shifts were twice as likely to have poor sleep quality (OR=2.280; 95% CI, 1,196-4.289). Students who attended college and work concomitantly present above 1.5 times the odds of having poor sleep quality (OR=1.787; 95% CI, 1.029-3.105). Conclusion An increased frequency of class shifts, inadequate sleep duration, concurrent work commitments alongside undergraduate studies, and the presence of symptoms indicative of anxiety collectively contribute to a heightened susceptibility to diminished sleep quality in individuals.

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Aim To evaluate the association between oral health conditions with sociodemographic variables and the use of psychoactive substances by drug addicts assisted by Psychosocial Care Centers for Alcohol and Drugs (CAPS-ADs). Methods This is an analytical cross-sectional study with a sample of 262 drug addicts assisted by CAPS-ADs in three cities in the state of São Paulo, Brazil. Participants were evaluated through intraoral clinical examinations (DMFT and CPI indexes) and they answered a socioeconomic questionnaire. The intensity of use of psychoactive substances was assessed through ASSIST questionnaire. Associations between variables were performed using the canonical correlation analysis method. Results It was observed that the mean DMFT index was 13.9; 60.2% of the sample used cocaine/crack and 46.5% used marijuana. Regarding the analyses, the canonical correlation coefficient of the highest possible correlation between the combination of variables of oral health problems and the combination of variables of intensity of drug use was 0.4642 (p=0.0005). In addition, the canonical correlation formed by the combination of socioeconomic condition variables and the combination of oral health was statistically significant (canonical correlation coefficient=0.4533; p<0.0001). Thus, it was observed that the high consumption of drugs, mainly cocaine/crack and marijuana, was associated with oral health problems; in addition, worse socioeconomic conditions, mainly lower level of education of the mother and father, were associated with oral health problems in drug users. Conclusion Both the type of psychoactive substance addiction and sociodemographic variables affected the oral health of drug addicts.

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Aim The purpose of this study was to investigate the effect of the height of scan body on the accuracy and scan time of making a digital implant impression in three implant positions. Methods Three maxillary reference models with partial dentition (missing teeth#1,2,3,4, and 14) were prepared for placing implants. Implants were placed in position of tooth#2 (named distant implant [Dis]), tooth#4 (named adjacent implant [Adj]), and #14 (named single implant [Sin]). Depth of insertion of implants and height of scan bodies were selected in a way that scan part of scan body stayed on heights of higher (Hi), lower (Lo), and equal (Eq) relative to the occlusal plane. The models were scanned with intraoral scanner (Omnicam) (22 scans for each model), and with desktop scanner (inEos X5) (one scan as reference scan). The scans were superimposed on the reference scan and deviations of each implant (single, adjacent to edentulous area, and distant in edentulous area) and scanning time of each group were measured (α=.05). Results In contrast to adjacent implant position, deviations in Equal (p< 0.03) and Lower (p<0.001) groups were significantly more than Higher in mean distance deviation in single implant position. Findings were similar in terms of different heights in the distant implant position. The three dimensional angular deviation comparison demonstrated that Sin-Eq group had greater deviation (p<0.0001). Kruskal Wallis test showed that there was a significant difference among the groups (p= 0.001) and the least scanning time was in the Lower height group. Conclusion The scan body higher than the occlusal plane is a safer option when there is an adjacent tooth. When there is space around the scan body there would be less rotational deviations.

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Aim Self-medication is a common practice, often underestimated in terms of its associated risks. This behavior is observed not only among individuals with formal education in healthcare but also among students and professionals in the field. This study aimed to assess the prevalence of self-medication among dental students and graduates with training in Pharmacology and Anesthesiology, while identifying the most frequently used medications for self-treatment. Methods This cross-sectional observational study was conducted using a virtual questionnaire comprising 17 items. The questionnaire was distributed to undergraduate and postgraduate dentistry students who had completed the Pharmacology and Anesthesiology courses at a private university in the interior of São Paulo, Brazil. Results Among the 195 respondents, the majority (82.05%) were women, and an overwhelming 98.75% reported engaging in self-medication. Analgesics were the most frequently used drug class, with headaches being the primary condition prompting self-medication. Despite the high prevalence of this practice, 85.64% of participants acknowledged its potential risks to their health. Conclusion Self-medication represents a significant concern in dental medicine, affecting both undergraduate students and graduates. Although these individuals are healthcare professionals or in training for such roles, the expectation that their medication use would be more cautious and informed is often not met, potentially leading to inappropriate drug use.

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Aim To evaluate the clinicopathological features of granulomatous inflammatory lesions through a retrospective analysis, emphasizing the importance of early and accurate diagnosis for timely treatment and improved prognosis. Methods A retrospective cross-sectional study analyzed archived data (1953–2022) approved by the Research Ethics Committee (CAAE: 5.429.194). Samples with clinical and histological diagnoses of granulomatous lesions, nonspecific chronic inflammations, paracoccidioidomycosis, leishmaniasis, and tuberculosis were included. Initially, 88 cases were identified, and 28 cases met inclusion criteria after exclusions. Results Granulomatous lesions predominantly presented as irregular ulcers (67.9%), located mainly on the tongue (32.1%), erythematous (46.4%), and symptomatic (50.0%). Histologically, lymphocytes and macrophages were present in all cases, while Langhans-type and foreign body-type giant cells appeared in 69%, and caseous necrosis was observed in 32%. Conclusions Biopsy is essential for diagnosing oral lesions. Understanding the prevalence and clinicopathological features of granulomatous inflammatory lesions is critical for developing preventive measures and effective treatment strategies which directly influences the individual’s prognosis, particularly considering the potential burden of these diseases.

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Aim This study aimed to evaluate the symmetry of root canal number and morphology between opposite premolars and molars in each jaw using Cone-Beam Computed Tomography. Methods 100 CBCT images of patients aged 18-65 were analyzed for diagnostic or therapeutic purposes. 96 premolars and mandibular molars, as well as 98 premolars and maxillary molars, were examined separately by two endo- and radiologists. Parameters such as canal numbers and root numbers in each root, and shape, and morphology of the canals were evaluated using NNT software. The symmetry of similar teeth in each jaw was also determined. Results This study found that most mandibular premolars have one root and one canal with a type I Vertucci, while there are two roots and three canals in mandibular molars. Mostly, there is one root, two canals, and a type IV canal in maxillary premolars, while maxillary molars have three roots and three or four canals. The jaws have symmetry in terms of canal type, root numbers, and canal numbers. The mandible has greater symmetry than the maxilla in all cases. Conclusion Assessing the symmetry of the canal numbers and premolars and molars morphology on both sides of each jaw using CBCT showed a significant correlation on both sides particularly between the first and second premolars and second molars, which can help dentists in comprehending root canal treatments and enhancing outcomes.

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Aim This study aimed to assess the efficacy of two molecular methods, namely PCR assay and checkerboard DNA-DNA hybridization, for the detection of specific endodontic pathogens in the root canals of deciduous teeth with primary endodontic infection. It also aimed to investigate the most prevalent species detected regardless of the method used. Methods Samples were taken from 44 cases of deciduous teeth with primary endodontic infection. DNA was extracted and the presence of microorganisms was checked by using PCR assay and checkerboard DNA-DNA hybridization assay. Fisher´s exact test was used to observe the possible difference in the prevalence of each pathogen concerning the molecular methods. Sensitivity, specificity, and accuracy tests were performed between both methods. The statistical significance level was 5%. Results In our study, PCR and checkerboard DNA-DNA hybridization had specificity higher than sensitivity, demonstrating that these assays can identify true-negative samples. Both methods showed a similar capacity to detect specific endodontic pathogens in root canals of deciduous teeth with primary endodontic infection. PCR and checkerboard showed no statistically significant differences for most species detected, except four species: P. micra and P. nigrescens, which were more prevalent by PCR, and F. alocis and P. intermedia, which were more prevalent by checkerboard DNA-DNA hybridization. Conclusions In conclusion, both methods are efficient in detecting endodontic pathogens and one should complement the other. Taking together the results from both methods, A. naeslundii and F. nucleatum were the most prevalent species.

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Failures in the cementation technique of intraradicular posts can pose risks for root canal treatment failure and crown loss. Aim This study assessed cementation failures of glass fiber post systems using two techniques with application of 3D digital prototyping and post-processing CBCT software. Methods Seventy-two maxillary central incisors were 3D-printed and divided into groups: 1. Splendor-SAP posts; 2. anatomical posts; 3. conventional glass fiber posts (control). Two cementation techniques were employed: manual and self-mixing. CBCT scans were taken, and root canal third images were analyzed using e-Vol DX software. The Chi-square test was applied at a significance level of 0.05%. Results Regardless of the cementation technique used, a statistically significant difference was observed among the post systems. Group 2 showed the best results, while Group 1 exhibited the worst. The cementation technique did not significantly affect the presence of gaps (voids) in Groups 2 or 1 across the three evaluated areas. For all post systems and both cementation techniques, there was a significant difference among the three thirds, except for Group 1 using manual cementation. Conclusions Irrespective of the cementation technique, significant differences were noted among various glass fiber post systems. The cementation technique did not impact the occurrence of voids in anatomical or Splendor-SAP glass fiber posts. However, with conventional glass fiber posts, the self-mixing cementation technique had a positive effect on reducing voids.

Abstract in English:

The proposed treatment for malignant neoplasms can be isolated or combined, involving resective surgery, radiotherapy, chemotherapy, and/or hormone replacement. Chemotherapy induces extensive immunosuppression and affects both healthy and abnormal cells. This cytotoxicity from the treatment has a significant effect that can lead to changes in the oral mucosa. The severity is related to the type of drug, duration of treatment, dosage used, level of oral hygiene during treatment, and the individual’s age. Therefore, monitoring oral health before, during, and after antineoplastic therapy is essential. Aim To evaluate the main oral manifestations that oncology patients presented before and after 15 days from the first administration of chemotherapy medication. Methods A prospective observational study was conducted with 31 individuals treated at a Hospital Oncology and Hematology Service. The evaluations included the following steps: (1) Patient identification and completion of assessment forms; (2) Clinical examination of the oral cavity before and after the start of chemotherapy; and (3) Providing guidance to patients regarding oral care during oncological treatment. Results It was observed that 70.96% of patients exhibited oral manifestations 15 days after the first infusion of antineoplastic drugs. The main changes identified included xerostomia and oral mucositis. Conclusion Dental follow-up during chemotherapy is essential for preventing and managing potential oral emergencies, thereby avoiding interruptions in systemic treatment and ultimately enhancing the quality of life for these patients.

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Aim to assess the levels of anxiety, depression, stress, and fear of COVID-19 among parents and caregivers of children with nonsyndromic cleft lip and/or palate (NSCL/P). Methods cross-sectional, case-control study at a Craniofacial Anomalies Rehabilitation Center, Brazil. Non-probabilistic convenience sampling was used and data were collected between October 2021 and November 2022. Variables were assessed by Depression, Anxiety and Stress Scale (DASS-21) and Fear of COVID-19 Scale (FC-19S). Pearson’s chi-square test and multivariate binary logistic regression model have been performed. Results data were obtained of 80 NSCL/P parents group and 130 by control group. Severe symptoms were higher in NSCL/P parents indicated by rates (8.8% vs 6.9% to anxiety; 12.5% vs 8.5% to depression and 17.5% vs 10.0% to stress). As for the predilection in case group there was an association (p<0.05) for manifestation of mild stress (OR: 4.09; 95%CI 1.28-13.06). Levels of fear of COVID-19 were higher in control group (43.8% vs 28.7% p<0.05). Conclusions a higher prevalence of anxiety, depression and stress extremely severe was observed in parents of children with NSCL/P. Control group was associated with higher fear of COVID-19.

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The knowledge and beliefs can affect the behavior of parents about preventive oral care of their children. Aim This study aimed to perform the semantic equivalence of an instrument that assesses beliefs, knowledge, behaviors and barriers to oral care of mothers/caregivers about early childhood caries in their children aged 0 to 5 years between the original English version and the Brazilian Portuguese language version. Methods Conceptual and item equivalence were initially performed. Following, semantic equivalence was evaluated according to the following steps: (1) translations of the instrument into Brazilian Portuguese, performed by two independent translators (both native in Brazilian Portuguese and fluent in English); (2) unification of the two translations by an expert committee; (3) two back-translations performed by two independent translators (both native in English and fluent in Brazilian Portuguese); (4) unification of the two back-translations by an expert committee; (5) unified back-translated version sent to the authors of the original instrument for evaluation; (6) committee review; (7) pre-test in a group of 20 Brazilian mothers/caregivers of children aged 0 to 5 years; (8) review and final version of the instrument in Brazilian Portuguese. Results All items adequately reflected the Brazilian culture. Small divergences were found during translations and back-translations, and the expert committee chose the versions that would best fit into Brazilian culture. Pre-test also brought important insights to the process. All changes made were presented and approved by the original authors. Conclusion The semantic equivalence allowed the development of a Brazilian Portuguese version of the instrument semantically equivalent to the original version.

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Aim This current in vitro study investigated the cytotoxicity and the ability to maintain cell viability of two bioglasses, the commercial 45S5 (Sylc®, OSspray Ltd, London, UK) and the experimental NbG (niobiophosphate bioactive glass), in comparison to MTA (MTA Angelus®, Parana, Brazil). Methods In the cell viability assay, human gingival fibroblasts were exposed to the bioactive materials/cements (NbG; 45S5; and MTA) diluted in the cell culture medium. According to ISO 10993-5, a cytotoxic effect was considered when there was a decrease in cell viability of more than 30%. The three bioactive materials were also analyzed under SEM (TM 3030, Hitachi, Tokyo, Japan) to assess the mean particle size, and under EDX analysis (EDX-720, Shimadzu, Tokyo, Japan) to verify composition and the presence of contaminants. Results Human gingival fibroblasts had the highest cell viability when exposed to NbG (p<0.001). The control group and the MTA group had similar values (p=0.2341). The lowest cell viability occurred for the 45S5 group (p<0.001). The average particle size of the materials tested was 5.2μm for 45S5; 54.0μm for NbG; and 4.0μm for MTA. 45S5 and NbG showed the presence of Si, Ca, and P. Conclusion The 45S5 bioglass was cytotoxic to fibroblasts, while MTA was not. The addition of niobium into the bioglass composition is advantageous.

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Aim This ex vivo study aimed to assess the influence of stainless-steel orthodontic brackets (SSOB) and the acquisition protocol on linear measurements of bone height and width for the planning of dental implants in inter-bracket regions. Methods Twenty extracted premolar teeth were adapted in artificial sockets on 10 bovine ribs, then adapted into a 3D printed jaw, coated with wax. Cone beam computed tomography (CBCT) scans with and without SSOB were performed using four acquisition protocols, varying the voxel size (280, 200, 125, and 80 μm). Three trained examiners evaluated all 80 CBCT scans, measuring height and width in the center of the simulated edentulous region between the teeth, in the cross-sectional plane. Intra- and inter-examiner reproducibility were assessed using the Intraclass Correlation Coefficient test. Linear measurements were compared using the Bland-Altman method and ANOVA for repeated measures. A significance level of 5% was used. Results Intra- and inter-examiner reproducibility presented excellent reliability for height measurements, while inter-examiner presented moderate and intra-examiner presented moderate to good reliability. The measurements showed a statistically significant difference between the examiners (p<0.001), regardless of the voxel size or the presence of SSOB. The Bland-Altman showed discrepancies between -0.18 mm and 1.15 mm in the width measurements. Conclusion The presence of SSOB and the CBCT voxel size do not affect the planning of dental implants in the inter-bracket region.

Abstract in English:

Aim To assess the quality of life in patients who have undergone hemimandibulectomy and rehabilitated with a guide flange prosthesis. Methods This is a prospective study conducted at two time points: immediately after prosthesis delivery and three months after prosthesis use. Forty-four patients who had undergone hemimandibulectomy and were rehabilitated with a guide flange prosthesis were included in the assessment. OHRQol was assessed in these patients using the Obturator Functioning Scale (OFS) and a novel scale Maxillofacial Prosthesis Performance Scale (MFPPS). The scores were obtained 1 week after and 3 months of guide flange prosthesis usage. The data were analyzed using unpaired and paired sample t-tests. Results After 3 months, the results showed significant improvement with the prosthesis. There was a notable improvement in chewing, swallowing, appearance, and psychological issues. The scores of OFS and MFPPS for mandibular guidance prosthesis after 1 week were 25.48 and 26.82, respectively, and scores after 3 months were 20.28 and 13.16, respectively. Conclusion The findings of the study show significant improvement in the scores after prosthesis usage in terms of functional, physical, social, and psychological parameters in the patients after following up.

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Aim The purpose of this study was to evaluate the effect of different distances of pecking motion on the cyclic fatigue of Hyflex EDM OneFile (Coltene/Whaledent AG, Altstatten, Switzerland) in simulated curved canal. Methods Sixty Hyflex EDM OneFile (#25/0.08) files were tested at three different pecking depths: G(1): 1-mm depth, G(2): 2-mm depth, G(3): 3-mm depth, and G(4): 4-mm depth. Cyclic fatigue resistance was tested measuring the time to fracture and the number of cycles to failure (NCF) in an artificial canal with a 60° angle and a 3-mm radius of curvature. Data were analyzed using the analysis of variance test and the Student-Newman-Keuls test for multiple comparisons. Results There was a significant difference between the four groups for the NCF (p < 0.05). G(1) group had lower NCF compared to the other groups. There was a significant difference between group 4 (1278.9) and the others (p < 0.05). Groups 2 and 3, with NCF means of 714.4 and 872.2, respectively, did not show any significant difference between them (p > 0.05). Conclusion The results showed that different pecking distances can significantly extend the life span of Hyflex EDM rotary files. Our results suggest that a longer pecking depth may reduce the risk of instrument fracture.

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Aim Review the characteristics of endodontic bioceramics in comparison with other endodontic materials using the currently available literature. Methods A bibliographical research was carried out using the electronic databases Public Medline (PubMed), Scopus, Embase, Scielo and Web of Science, using the search terms “Bioceramics”, “Endodontic cements”, “BIO-C TEMP”, “Antimicrobial activity”, “Biocompatibility’ and “Osteclastogenic potential”. Inclusion criteria were original research articles published in English within the last 10 years, with exceptions for classic articles on Mineral Trioxide Aggregate (MTA) published before 2013. Results 464 articles were found on the topic and 223 were selected for this Review, including a search of the physical-chemical and biological properties of endodontic bioceramic sealer, bioceramic repair, and bioceramic intracanal medication over a period of 10 years. The main characteristics found in the studies were antimicrobial activity, biocompatibility, cytotoxicity, and osteoclastogenic potential. A total of 30 studies were included. Conclusion The physicochemical and biological properties were favorable to the success of endodontic treatment. However, the bioactivity of BIO-C TEMP medication needs to be better studied.

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Objective To assess the influence of the combination of the antibacterial monomer dimethylaminohexadecyl methacrylate (DMAHDM) and amorphous calcium phosphate nanoparticles (NACP) on the antibacterial and ion release potentials, as well as the physical properties of experimental resin infiltrants. Methodology The study comprised the following groups: ERI (Pure Experimental Resin Infiltrant [ERI]: 75% TEGDMA + 25% BisEMA, 0.5% camphorquinone [CQ], and 1% ethyl 4-dimethylaminobenzoate [EDMAB]); ERIDM (ERI + 3% DMAHDM), ERINACP (ERI + 1.5% NACP), and ERIDM_NACP (ERI + 3% DMAHDM + 1.5% NACP). From samples of each group, Degree of Conversion (DC; n=6) and Sorption and Solubility (SO/SOL; n=8) were assessed. The antibacterial potential was evaluated through biomass accumulation (BA; n=6) and bacterial metabolism (BM; n=6) assays after cultivating Streptococcus mutans biofilm on the materials. Ionic release (IR; n=3) of Ca2+ and PO4(3-) from the groups after 7, 14, and 28 days of immersion was also analyzed. Data were analyzed for normality and homoscedasticity, and statistical analysis was performed using appropriate tests with a significance level of 5%. Results For DC, ERIDM showed no statistical difference from ERI. ERI had the lowest means of SO/SOL, and ERIDM_NACP had the highest. ERIDM exhibited no statistical difference from ERI. For BM, ERIDM and ERIDM_NACP had the lowest means. ERINACP and ERIDM_NACP exhibited ionic release during the analyzed period. Conclusions The resin infiltrant containing DMAHDM and NACP exhibits potent antibacterial activity against S. mutans and Ca2+ and PO4(3-) ionic release.

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This study aimed to analyze the occurrence of stress and minor mental disorders (MMD) among dental students. Participants included students in the pre-clinical stage (N=123) and clinical stage (N=169) of the dental program. Data collection was carried out using sociodemographic data, Dental Environmental Stress (DES) and Self-Reporting Questionnaire (SRQ-20) to evaluate the minor mental disorders (DMM). Analysis was conducted using the Mann-Whitney test, Fisher’s exact test, and logistic regression with a significance level of 5%. The overall mean for stressors was 2.7, indicating a range between “Mildly Stressful” and “Moderately Stressful,” with higher levels observed in the clinical stage (2.8) and among women (2.9). The main stressors were “Exams and grades” (pre-clinical - 3.7, clinical - 3.9; p=0.0314), “Fear of failing a subject or losing the year” (pre-clinical - 3.6, clinical - 3.7; p=0.7596), “Completing graduation requirements” (pre-clinical - 3.4, clinical - 3.6; p=0.1092), and “Lack of time for relaxation or leisure” (pre-clinical - 3.3, clinical - 3.6; p=0.0037). The overall prevalence of MMD was 78.5%, with higher rates observed in the clinical stage (82.2%) and among women (81.6%). Of the variables in the regression analysis, two remained significant: “Difficulties at work” (p=0.001) and “Loss of interest in things” (p=0.033). The environment experienced by the participants in this study presents stressors, with a high prevalence of suspected MMD among female students in both stages of the dental program.

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Objectives Facial paralysis is recognized as the most prevalent complication following parotidectomy. This study aimed to evaluate the symptoms and post-operative complications of parotidectomy while employing facial nerve preservation techniques. Methods The study involved 14 patients (9 men and 5 women) with a mean age of 53.0 ± 16.5 years. Clinical characteristics, facial paralysis, and other complications in these patients were monitored at three post-operative intervals: 1 week, 1 month, and 3 months. Results Following ultrasonography, homogeneous echo textures were observed in 64.3% of tumors compared with 35.7% with heterogeneous textures. Regarding tumor locations, 50% were found in the superficial lobe, 14.3% in the deep lobe, and 35.7% involving both lobes. The FNA (Fine Needle Aspiration) test identified 64.3% of the tumors as pleomorphic, 13.3% as oncocytomas, 7.1% as Warthin tumors, and 14.3% as other benign tumors, with no cases suspected of cancer. Post-operative complications Temporary facial paralysis was noted in 57.1% of cases at one week post-operation, declining to 28.6% after one month and 14.3% after three months. Hemorrhage occurred in 7.1% of patients, with no reports of infection, skin flap necrosis, or post-operative seroma. Additionally, 92.9% of patients experienced ear numbness at one week post-operation, decreasing to 21.4% by three months. Conclusion the study demonstrates that parotidectomy, when performed with careful preservation of the facial nerve, is an effective and constructive approach for removing pleomorphic tumors in the parotid gland.

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Aim High heterogeneity in ligature and repair models might reflect different disease status and preclude comparisons. This study aimed to characterize time-dependent alveolar bone loss, histological changes, and immunoinflammatory profiles in rats during ligature-induced periodontitis progression and repair in the long term. Methods Forty-eight male Wistar rats were included. The negative control group (n=8) received no ligature, while experimental groups (Ligature and Repair; n=40) received a cotton ligature around the lower first molars, bilaterally. After 7d (baseline), ligatures were either maintained or removed for another 28 or 56 days (n=8/group). Hemi-mandibles were collected for radiographic, histological and stereometric analyses. Serum and gingival tissues were collected for the analysis of inflammatory markers using multiplex. Results Mean bone loss progressively increased in ligated rats (p<0.05). Ligature placement increased the percentage of inflammatory cells at all timepoints and blood vessels at 7 and 35 days, while reducing fibroblasts and extracellular matrix (p<0.05). After 56 days of ligature removal, radiographic bone loss increased compared to 28 days (p<0.05). Ligature removal significantly decreased the percentage of inflammatory cells and blood vessels, while increasing fibroblasts and extracellular matrix only at 56 days. Immunological assay revealed significant time-dependent alterations in serum and gingival markers during disease progression and repair. Conclusion Ligatures led to cumulative alveolar bone loss and heightened pro-inflammatory cytokines, with distinct inflammatory profiles over time. During repair, despite reducing inflammatory cells and cytokines, bone loss increased in the long term. Our data can assist in designing future experiments and clarify previously published findings.

Abstract in English:

Aim To assess the reliability of morphometric measurements performed on the maxillary sinus and the distance of mental foramen from the lower border of mandible for gender determination by cone beam computed tomography (CBCT). Materials and Methods: A total of 390 CBCT images were included in this study. The length, width and height of the maxillary sinus and the distance from the superior and inferior border of the mental foramen to the lower border of mandible were assessed. All the measured parameter data was then subjected to discriminative statistical analysis and analyzed using unpaired t-test. P-value ≤0.05 was considered as significant. Logistic regression analysis was done to determine which measures were more predictive of sexual dimorphism. Discrimination values were determined by receiver operating characteristic curve analysis, thus generating area under the curve (AUC) values, which ranged from 50% (very weak) to 100% (very strong). Results The overall values of the maxillary sinus dimensions were significantly greater (p ≤ 0.05) in males as compared to females except right maxillary sinus length and left maxillary sinus width (p =0.162). The distances from the superior and inferior border of mental foramen to lower border of mandible were significantly greater (p ≤ 0.05) in males as compared to females. The accuracy of the maxillary sinus and the mental foramen for gender identification was found to be 65.5% and 73.8% respectively. Conclusion CBCT measurement of the maxillary sinus and distance from the mental foramen to the lower border of the mandible can be used as a supplementary tool for gender determination in forensic anthropology.

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Aim This study aimed to evaluate changes in surface roughness of an experimental resin infiltrant, in comparison with the commercial infiltrant Icon® and the resin sealant Prevent®, following different erosive challenges and abrasive simulations with brushing cycles. Methods A total of 20 samples per group were prepared: (I) Commercial Infiltrant Icon® (IC), (II) Experimental Infiltrant (EI), and (III) Commercial Resin Sealant Prevent® (SR). Surface roughness was assessed using a rugosimeter at three distinct time points: prior to the erosive challenge (T0), post-erosive challenge (T1), and following the abrasive simulation (T2). Each group was subdivided into two subgroups (n=10) to undergo different erosive challenges: intrinsic acid and extrinsic acid simulations. The intrinsic acid challenge was conducted by immersing the samples in a hydrochloric acid demineralizing solution (pH=2.3), while the extrinsic acid challenge involved immersion in a soft drink demineralizing solution (pH=2.9). Following the erosive challenges, the specimens were maintained in relative humidity and surface roughness was reassessed (T1). Subsequently, the same groups underwent brushing simulation (10.000 cycles), after which surface roughness was measured again. Data were analyzed by three-way ANOVA with repeated measures, followed by Tukey’s post-hoc test for multiple comparisons, with a significance level set at 5%. Results All groups demonstrated an increase on surface roughness, regardless of demineralizing method used (p<0.001). The resin sealant exhibited the highest surface roughness changes under both erosive conditions when compared to the resin infiltrants. There was no statistical difference between the two erosive challenges, regardless of the material and time. Conclusion In conclusion, all three tested materials showed an increase in surface roughness following erosive and abrasive challenges.

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Aim This in vitro study investigates how light temperature and room wall colors influence color differences in two commonly used tooth shade guide scales for color selection in dentistry. Methods We examined the effects of three light temperatures (warm light at 3000K, neutral light at 4000K, cool light at 6500K), four room wall colors (white, blue, red, black), chromatic shade values (low, medium, high), and two shade-guide scales (Vita Classical and Biotone). Color differences were measured using an EasyShade spectrophotometer, with ΔE00 calculated via the CIEDE2000 method to assess perceptibility and acceptability thresholds. Results The study revealed that high chromatic shade values on both scales showed a greenish shift in the a* coordinate, while medium and low values inclined towards redness. All b* values exhibited a tendency towards yellowness. For the Vita Classical scale, neutral light conditions did not significantly affect ΔE00 across any room wall colors (p > 0.05). However, for the Biotone scale, high chromatic values under specific light conditions significantly surpassed the clinical perceptibility threshold in white versus red room simulations (p < 0.05), indicating a notable impact on color perception. Conclusions Our findings suggest that both light temperature and room wall color significantly affect tooth shade perception. Adjustments in environmental conditions can corroborate for more accurate color matching between natural tooth and dental restorations. Special attention must be given to extreme light temperatures and contrasting wall colors. These results support the importance of standardized environmental settings in dental practices to ensure reliable esthetic outcomes.

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Aim The objective of this study was to evaluate the impact of manual and rotary instruments on the microtensile bond strength of high-viscosity glass ionomer cements (GICs) to caries-affected dentin. Methods Twelve sound molars and 24 molars with dentin caries were sectioned perpendicular to the long axis at the mid-dentin region. Teeth were divided into six groups (n=6) according to the carious tissue removal method (E: excavator, B: rounded bur), and restorative material (EQ: Equia® Forte Fil, RIV: Riva Self-Cure). The control group was formed by sound teeth (S: sound) restored with both materials. After a 24-hour storage in distilled water at 37°C, the teeth were sectioned along the long axis to obtain 1 mm thick slices and the adhesive interface was reduced to 1.2 mm with a diamond bur. The specimens were subjected to microtensile bond strength tests at a 1.0 mm/min crosshead speed in a universal testing machine. Data were submitted to two-way ANOVA, followed by the Games-Howell test with a significance level of 5%. Results No significant differences were found for caries removal technique and restorative material (p˃0.05), but the interaction between these variables was statistically significant (p<0.05). The EQ-S and RIV-E groups showed significantly higher microtensile bond strength than the other groups (p<0.05), except for the RIV-B, which exhibited no significant difference when compared to all the other groups (p>0.05). Conclusion The caries removal method did not negatively affect the dentin bond strength of Riva Self-Cure, while Equia® Forte had higher bond strength to sound dentin.

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Aim Dental caries is a multifactorial disease where aspects such as socioeconomic status, caregivers’ health education, and dietary and hygiene patterns are recognized factors associated with this condition. However, the literature remains inconclusive regarding sex differences, especially in children. Therefore, this study aimed to assess the relationship between dental caries prevalence and sex in preschoolers. Methods A cross-sectional study was conducted with a representative sample of 432 children aged 18 to 36 months, enrolled in Early Childhood Education Centers (CMEIs) in São José dos Pinhais, PR, Brazil. Data on demographic and socioeconomic conditions, dietary practices, hygiene habits, and bottle-feeding were collected through a questionnaire directed to parents. Children were assessed for dental caries (DMFT and modified DMFT index) by a calibrated researcher (Kappa≥0.80). Bivariate analysis was performed to verify the association between dental caries and other covariates, with a significance level of 0.05. Results There was no difference in per capita household income between boys and girls. The dmft value in girls was 0.12 (SD=0.59; median 0; interquartile range 0), and in boys, it was 0.34 (SD=1.37; median 0; interquartile range 0), with no statistically significant difference (p=0.197, Mann-Whitney test). The prevalence of caries was also not statistically different between boys and girls (p=0.087, Chi-square test). Conclusion It can be concluded that in this age group, there was no association between sex and dental caries.

Abstract in English:

Aim The physiological stress response is shaped in childhood and the intensity, frequency, and duration of stressful stimuli determine it. Adverse emotions experienced in early childhood can have profound and lasting physiological and psychological consequences. Therefore, it is important to understand how dental treatment can be a significant stressful in a child’s life and recognize the potential lifelong impact. It is also crucial to comprehend how chronic stress can negatively affect oral health over time. Methods In the present study, a critical review was conducted by analyzing scientific articles related to stress, salivary cortisol levels, child neurodevelopment, and the association of these factors during pediatric dental care, from 1981 to 2024, in databases such as PubMed and SciElo. Results Across 69 studies, the review emphasizes the connections between adverse childhood experiences (ACEs), dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and their cumulative effect on pediatric oral health. The findings illustrate how ACEs can disrupt normal brain functioning, leading to chronic stress, poor oral health outcomes, and altered behavior during dental care. Conclusion Dental professionals must approach pediatric care with a deep understanding of the child’s emotional and psychological state. By doing so, they can contribute to healthier oral outcomes and help mitigate the long-term impact of childhood adversities on oral health.

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Aim To conduct a scientific mapping of stomatognathic system functions and orthognathic surgery (OS) with a scientometric approach. Methods The articles were retrieved from the PubMed, Scopus, and Web of Science databases in April 2022. The research included studies approaching OS and stomatognathic function assessment, without time or language restrictions. The Bibliometrix package and VosViewer software analyzed and mapped the scientific knowledge of stomatognathic functions and OS. The researchers extracted and analyzed data including productive institutions, highly cited articles, journals, authors, references, and keywords. Results Altogether, 223 articles were included, covering the period from 1981 to 2024. The average annual growth rate was 2.96%, with a mean of 18.4 citations. There were 942 co-authored papers, and only six were authored by a single person, resulting in an average of 4.99 co-authors per document and a 2.691% proportion of international co-authorships. Network analysis revealed three clusters, covering topics such as “speech,” “cleft lip and palate,” “dentofacial deformity,” and “obstructive sleep apnea.” Keyword co-occurrence analysis also highlighted emerging trends; terms such as “orthognathic surgery,” “maxillary advancement,” and “obstructive sleep apnea” gained prominence. Conclusion The continuous increase in studies and diversity of journals reflects the growing relevance of the relationship between OS and stomatognathic functions. The mapping emphasizes the importance of an interdisciplinary and collaborative approach in advancing knowledge of the functional and clinical implications of OS.

Abstract in English:

Aim The choice between retention systems in implant-supported prostheses impacts marginal bone loss (MBL), a key factor for implant longevity. Due to variability in the findings of systematic reviews, this overview aims to assess the methodological quality and synthesize available evidence from systematic reviews on the effects of cement- versus screw-retained implant-supported prostheses on MBL. Methods Six databases were searched for systematic reviews comparing MBL in screw- versus cement-retained implant-supported prostheses. The methodological quality was assessed using AMSTAR 2, and the MBL effects were classified as favoring cemented, no difference, or favoring screwed systems based on the conclusions of the reviews. Additionally, quantitative data on MBL at different intervals—up to 1, 3, 4, and more than 4 years—were extracted from primary articles and visually plotted for interpretation. Results The search identified 8 systematic reviews, mainly classified as critically low quality, which found no significant difference in MBL between retention systems. Evaluating the quantitative data, both systems exhibited minor variations over time, with cemented implant-supported prostheses showing slightly less bone loss at the five-year follow-up. Beyond 4 years, both systems demonstrated similar MBL ranges. Conclusion Both screw-retained and cement-retained implant-supported prostheses appear to be reliable options, with no significant difference in MBL observed in most systematic reviews, especially over longer follow-up periods. However, due to the low quality of existing systematic reviews, conclusions should be approached with caution, underscoring the need for better-designed studies to reach a clearer clinical consensus.