Resumo em Inglês:

Abstract This systematic review summarized findings on the association between screen time and bruxism in children and adolescents (PROSPERO- CRD42023429775). Two researchers conducted the search and selection of studies, extracted the data, and analyzed the risk of bias. The quality of the evidence was assessed using the GRADE tool. Five databases were screened on September 25th, 2025. Studies exploring the association between bruxism and the use of screen devices in individuals aged 0–18 were included, considering different and valid study designs, screen devices, and methods of detection of bruxism behavior with or without circadian distinction. Qualitative data synthesis was performed. Eleven cross-sectional and two cohort studies were included. Eight studies found an association between bruxism and the use of screen devices in children and adolescents, while five studies did not find a significant association. In conclusion, an association between screen use or duration and bruxism in children and adolescents cannot be established. Although some studies reported positive associations for awake, sleep, and unspecified bruxism, particularly in research evaluating longer daily screen time or indicators of problematic digital use, the certainty of the evidence was very low. Further well-designed longitudinal studies should be conducted to broaden the overview of this association.

Resumo em Inglês:

Abstract This study aimed to investigate if sense of coherence (SOC) is associated with dental attendance (DA) patterns among Brazilian adolescent students. A cross-sectional study was conducted in the midwestern region of Brazil. A total of 2,905 adolescents aged 13 to 19 years from 14 public schools in 13 towns/cities in the state of Goiás were included in the study. Data on oral health-related behaviors and psychosocial factors were collected using self-administered questionnaires completed by students during regular school hours. The dependent variables were DA in the past year (yes/no) and the reason for DA (toothache/preventive check-up). SOC was assessed using the Antonovsky’s Orientation to Life questionnaire (SOC-13). Adjusted odds ratios (OR) and 95% confidence intervals were estimated using binary logistic regression. Results showed that 56.2% of the students had visited a dentist within the past year, most commonly for a preventive check-up (38.7%). SOC scores ranged from 13 to 91 (mean = 49.3; SD = 12.1). In the regression model adjusted for adolescents’ sociodemographic characteristics (age, sex, skin color or race, and maternal education), higher prevalence rates of DA in the past year (OR = 1.02; p < 0.001) and DA motivated by preventive check-ups (OR = 1.02; p < 0.001) were found among those with higher SOC scores. In conclusion, a significant association was found between higher SOC levels and healthier DA patterns among adolescents, regardless of socioeconomic characteristics.

Resumo em Inglês:

Abstract: This study investigated socioeconomic, psychosocial, behavioral, and clinical factors directly and indirectly associated with subjective happiness among recruits from southern Brazil. This cross-sectional study included a sample of recruits performing mandatory military service at two military bases in southern Brazil. Questionnaires were administered to collect socioeconomic data (mother's education, family income, and participant education level), behavioral habits (toothbrushing frequency and flossing), and psychosocial variables, such as sense of coherence (SoC-13 scale), oral health-related quality of life (OHRQoL), assessed using the Oral Health Impact Profile (OHIP-14), and degree of happiness (Subjective Happiness Scale). A clinical dental examination was performed by a single trained and calibrated examiner to determine the gingival bleeding index and dental caries experience (DMFT, number of decayed, missing due to caries, or filled permanent teeth). Pathway analysis was conducted to test the direct and indirect paths linking socioeconomic, psychosocial, behavioral, and clinical factors to happiness (Stata software). Results are presented as beta coefficients (β) and p values. A total of 499 recruits aged 18–19 years were evaluated. High levels of SoC were directly associated with greater happiness (β = 0.49, p < 0.001), whereas higher OHIP-14 scores, indicating poorer OHRQoL, were directly associated with lower happiness (β = −0.09, p < 0.05). Untreated dental caries was indirectly associated with lower happiness (β = −0.03, p < 0.05) via OHRQoL. No significant paths were observed from socioeconomic or behavioral variables to happiness. In conclusion, psychosocial and clinical factors were associated with happiness levels among Brazilian Army recruits.

Resumo em Inglês:

Abstract: This study aimed to identify misinformation related to dental caries in Brazilian Portuguese on Instagram, analyzing factors associated with its dissemination and corresponding engagement metrics. Two independent investigators conducted a qualitative analysis of 500 posts published between August 2018 and August 2022. Posts were selected using the CrowdTangle tool and assessed for author's profile, content, motivation, facticity, format, and sentiment. Data were evaluated using descriptive analysis, the Mann–Whitney U test, and path analysis through generalized structural equation modeling. Topic modeling analysis was also performed using QDA Miner software with the WordStat module to identify underlying topics in dental caries-related information and misinformation. The findings indicated that 21.8% of the analyzed posts contained misinformation, primarily on content shared by regular users regarding dental caries treatment. No significant relationship was observed between misinformation and user engagement; however, posts with misinformation showed a significantly higher median total interaction than those without. Overperformance scores were positively correlated with business and health-related profiles, as well as higher total interaction levels. Financial motivation was less frequently associated with treatment-related posts, reflecting the tendency of promotional content to focus on preventive technologies. Lastly, whereas the misinformation predominantly addressed dental caries treatment, diet, microorganisms, and oral hygiene, the accurate information mainly covered prevention, treatment, and oral hygiene. Although these findings were not associated with higher user engagement, they underscore concerns regarding the dissemination of misleading information about dental issues online. Business and health professional profiles demonstrated good potential to disseminate reliable information with higher engagement metrics.

Resumo em Inglês:

Abstract This study aimed to investigate the influence of the year in the course on dental students’ knowledge about syphilis and its oral manifestations. A cross-sectional study was conducted with dental students at the Federal University of Espírito Santo, Brazil, who were divided into two groups: earlier years of the Dentistry program (second and third years) and later years (fourth and fifth years). Data were collected using a questionnaire with 16 questions addressing knowledge of the main characteristics of syphilis. The Chi-square test (or Fisher’s exact test with Yates correction) was used to assess the association between variables, with a significance level of 5%. The prevalence ratio (PR) and the 95% confidence interval (95% CI) were used as measures of effect size. Overall, 171 students were invited, and 169 participated in the study. Only 40 (23.7%) students answered correctly about the stages of the disease. Nearly all participants answered that syphilis presents oral manifestations; however, only 44 (26%) answered the question correctly. Regarding differential diagnoses, only 63 (37.3%) reported knowledge of the subject. The direction of the bivariate analysis was inverse to the year of study, indicating a possible association between students enrolled in the early years of the Dentistry program and better knowledge about etiologic agents (p < 0.001), clinical manifestations (p < 0.001), disease stages (p < 0.001), oral manifestations (p < 0.001), differential diagnosis (p = 0.019), and drugs (p = 0.001) related to the disease compared with students enrolled in the later years.

Resumo em Inglês:

Abstract: The expression of hBD-3 and quantification of immune and inflammatory response cells (non-degranulated and degranulated mast cells, mature and immature plasmacytoid dendritic cells, mature and immature Tregs, T lymphocytes, cytotoxic T lymphocytes, and B lymphocytes) were evaluated in the radicular cysts (epithelium/capsule) of primary and permanent teeth. The relationship between the size of the radiographic lesion and expression of hBD-3 was also evaluated. Radicular cysts were subjected to immunohistochemical analysis to quantify the immune and inflammatory response cells and to evaluate hBD-3 staining and its relationship with radiographic lesion size. The results were analyzed using the D’Agostino & Pearson, Mann–Whitney, t-test, Kruskal–Wallis, and Dunn's post-tests (5%). hBD-3 was expressed in cysts of primary and permanent teeth. In primary teeth, hBD-3 expression was higher in small lesions than in large lesions (p < 0.05). All the evaluated cell types were detected in all radicular cysts. Cysts of primary teeth showed a higher expression of plasmacytoid dendritic cells, B lymphocytes, and T lymphocytes (p < 0.05), whereas those of permanent teeth showed a higher expression of T lymphocytes, immature plasmacytoid dendritic cells, cytotoxic T lymphocytes, and B lymphocytes (p < 0.05). hBD-3 was expressed in the epithelium/capsule of primary and permanent teeth radicular cysts. Immature plasmacytoid dendritic cells were the predominant cells in radicular cysts of primary teeth, whereas T lymphocytes were more abundant in permanent teeth.

Resumo em Inglês:

Abstract This study evaluated the influence of brightness and contrast adjustments on the diagnosis of proximal caries lesions in radiographs acquired with a handheld X-ray device. A complementary metal oxide semiconductor sensor (SnapShot, Instrumentarium Imaging, Milwaukee, WI, USA) and a handheld Eagle X-ray device (Alliage, São Paulo, Brazil) were used to acquire radiographs of 20 mandibular molars and 20 mandibular premolars randomly arranged in 20 phantoms. The device settings were 60 kVp, 2.5 mA, and 0.45 seconds of exposure. Brightness and contrast of the resulting radiographs were modified in four combinations: a) −30% brightness and +30% contrast; b) −15% brightness and +15% contrast; c) +15% brightness and −15% contrast; and d) +30% brightness and −30% contrast. After randomization, the original radiographs and the four modified versions were individually assessed by five oral and maxillofacial radiologists to detect proximal caries lesions. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated from the examiners’ responses and compared with one-way analysis of variance (p<0.05). Intra- and inter-examiner agreement for radiographic diagnosis was assessed using the weighted kappa index. Sensitivity values for detecting proximal caries lesions on radiographs with increased brightness and decreased contrast (+ 30% brightness and −30% contrast) were significantly lower compared with the other combinations (p < 0.05), whereas AUC and specificity values were not influenced by the adjustments tested (p > 0.05). Therefore, increasing brightness and decreasing contrast on radiographs acquired with a handheld X-ray device is not recommended, since it may impair diagnostic accuracy for proximal caries lesions.

Resumo em Inglês:

Abstract: To date, no instrument with demonstrated structural validity has been available to assess dentists’ knowledge, skills, and attitudes regarding the core concepts of Minimal Intervention Dentistry (MID). Therefore, this study aimed to develop and evaluate the psychometric properties of a self-administered instrument designed to measure Brazilian dentists’ knowledge, skills, and attitudes towards MID. A cross-sectional study was conducted among dentists practicing in the Federal District of Brazil to evaluate the psychometric properties of the instrument. Item generation was followed by expert review by Brazilian MID specialists. Subsequently, two focus groups and a pre-test were conducted to assess item wording, sequence, and comprehensibility. After the necessary revisions, the instrument was administered to 454 dentists. Exploratory Factor Analysis, combined with parallel analysis, was performed (p < 0.05). A total of 404 dentists comprised the final sample for the psychometric analyses. Parallel analysis indicated a two-factor solution as the most representative, corresponding to knowledge, skills, and attitudes. Composite reliability was adequate for all factors (≥ 0.40). The factorial structure showed acceptable model fit indices, except for the RMSEA (RMSEA = 0.092). Unidimensionality was rejected, as UniCo = 0.939 (0.907–0.975) and ECV = 0.762 (0.719–0.830) did not reach the recommended thresholds. The findings suggest that the instrument presents an appropriate structure and satisfactory reliability for measuring dentists’ knowledge, skills, and attitudes related to MID. This is the first study in the field of MID competencies to comprehensively report the steps involved in constructing, adapting, and psychometrically evaluating an instrument for dentists.

Resumo em Inglês:

Abstract: This cross-sectional study evaluated the knowledge, skills, attitudes, and perceived barriers of dentists from the Federal District, Brazil, regarding Minimal Intervention Dentistry (MID). A validated online questionnaire was administered using non-probabilistic snowball sampling, and 404 dentists participated (74% female; mean professional experience: 12 ± 10.9 years). Data were analyzed using descriptive and inferential statistics, including multiple linear regression (p < 0.05). The dependent variables were knowledge, skills, attitudes, and barriers, while the independent variables included administrative region, years of professional experience, type of graduation institution, academic qualification, professional role, and information-seeking behavior. Overall, participants demonstrated high levels of competency in MID, particularly in the preventive and diagnostic domains; however, selective carious tissue removal was the procedure performed least frequently (38.6%). Regression analyses showed that dentists involved in teaching or research reported significantly fewer barriers (β = −2.56; 95% CI: −3.90 to −1.23; p < 0.001). Dentists who had received formal training in MID achieved higher scores in knowledge (β = 2.95; 95%CI: 2.31 to 3.59; p < 0.001) and in skills and attitudes (β = 3.40; 95%CI: 2.18 to 4.62; p < 0.001), as well as fewer perceived barriers (β = −1.52; 95%CI: −2.35 to −0.68; p < 0.001). Information-seeking behavior was positively associated with greater knowledge (β = 2.35; 95%CI: 1.56 to 3.14; p < 0.001) and improved skills and attitudes (β = 3.06; 95%CI: 1.55 to 4.56; p < 0.001). Graduates from public universities presented higher scores for skills and attitudes (β = 2.17; 95%CI: 1.15 to 3.18; p < 0.001) and reported fewer barriers (β = −0.88; 95%CI: −1.61 to −0.15; p < 0.01). Brazilian dentists demonstrated a strong theoretical understanding of MID; however, practical implementation remains limited. Academic background, involvement in education and research, and proactive learning behaviors were key determinants of higher competency levels and reduced barriers to the adoption of MID

Resumo em Inglês:

Abstract Radiotherapy is the cornerstone of head and neck cancer (HNC) treatment, but it has been frequently associated with changes in the acquired enamel pellicle (AEP), potentially affecting the early stages of dental biofilm formation. Thus, this study aimed to characterize the bacterial proteomic profiles of early colonizers adhering to the AEP in patients with HNC undergoing radiotherapy, with emphasis on radiation-induced changes that may influence oral biofilm development and oral health outcomes. AEP samples were collected from nine patients with HNC before radiotherapy (BRT), during radiotherapy (DRT), and after radiotherapy (ART), as well as from nine orally healthy individuals. Pellicles were obtained 120 min after formation and analyzed by shotgun label-free proteomics using nanoLC-ESI-MS/MS. Protein expression levels were compared between groups using the t test (p < 0.05). AEP showed elevated levels of bacterial proteins predominantly attributed to Actinomyces, mainly associated with DNA binding, chromatin organization, and glucose metabolism. The bacterial proteomic profile shifted markedly DRT, with exclusive detection of proteins involved in carbohydrate transport and metabolism, oxidative stress response, and protein folding, including several ATP-binding cassette transporters and glycolytic enzymes. Proteins related to stress tolerance, transcriptional regulation, and secretion systems were detected ART, many of them associated with bacterial species commonly linked to periodontal diseases, such as Tannerella and Oribacterium. Notably, Cysteine synthase was identified exclusively BRT in all comparisons, suggesting its potential as a biomarker. These findings indicate that radiotherapy induces dynamic changes in the AEP bacterial proteome, potentially favoring dysbiotic biofilm development and increasing susceptibility to oral diseases in patients with HNC.

Resumo em Inglês:

Abstract This study investigated the effects of incorporating 3wt% titanium dioxide nanotubes (nTiO2) into calcium hydroxide [Ca(OH)2]-based intracanal medicament (ICM) formulations on the proliferation, viability, and mitochondrial metabolic activity of mouse dental papilla cells (MDPC-23). Five experimental groups were evaluated (n=3 per group): Cells (control), Calen, Calen + 3wt% nTiO2, Ultracal, and Ultracal + 3wt% nTiO2. Cell proliferation, viability, and mitochondrial metabolic activity were assessed using the Trypan Blue exclusion and MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assays at 24, 48, and 72 h. Data analysis included the Shapiro–Wilk and Levene tests and generalized linear models (p<0.05). At 24 and 48 h, both Ultracal and Ultracal + 3wt% nTiO2 showed significantly higher proliferation than the Calen groups (p<0.0001). The control group (Cells) exhibited the highest viable cell counts (p<0.0005). At 72 h, Calen + 3wt% nTiO2 showed the lowest proliferation compared with both the Cells and the Ultracal groups (p<0.0001). No significant differences were observed in non-viable cell counts or viable/non-viable ratios over time (p>0.05). Furthermore, Calen and Calen + 3 wt% nTiO2 at 24 and 48 h, as well as Calen + 3wt% nTiO2 at 72 h, demonstrated the lowest metabolic activity (p<0.0001), with no significant effect of nTiO2 (p>0.05). No significant intra-group differences over time were observed for the Cells or Ultracal groups (p=0.0608 and p=0.1417, respectively). Overall, the incorporation of nTiO2 did not adversely affect the biological parameters of Ca(OH)2-based ICMs assessed in this study. Further investigations are warranted to elucidate potential clinical implications.

Resumo em Inglês:

Abstract Bone regeneration is a critical area in tissue engineering because of the increasing incidence of bone defects resulting from trauma, degenerative diseases, and congenital disorders. The focus of this study is the synthesis of hydroxyapatite (HAp) from two natural calcium-rich biowastes: Anadara granosa (blood cockle) and Achatina fulica (snail). The shells were calcined at 900 °C to form calcium oxide (CaO) and then converted into HAp via the wet precipitation method using a Ca/P molar ratio of 1.67. The synthesized HAp powders were evaluated for their chemical properties and biological performance. Fourier transform infrared (FTIR) spectroscopy confirmed the presence of phosphate and hydroxyl functional groups, and among the samples, An 100 showed the highest crystallinity. MC3T3-E1 cell viability was assessed using a 3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide (MTT) assay at 24, 48, and 72 hours. At 72 hours, An 100, An 75, and An 50 maintained a viability above 70%, indicating good biocompatibility. In contrast, An 25 and Ac 100 exhibited significant cytotoxicity (p < 0.05). Only the noncytotoxic concentrations were used for the in vitro scratch wound-healing assay, where An 100 demonstrated the most rapid wound closure, indicating increased osteoblast migration. Furthermore, in this study, the elemental composition and structural integrity of Hap was analyzed to understand the factors affecting its stability and performance in biological environments. These findings suggest that naturally derived HAp is a promising, sustainable, and effective biomaterial for bone tissue engineering and has favorable effects on cell viability and migration.

Resumo em Inglês:

Abstract The biological response of gingival fibroblasts to restorative materials is a key factor in determining the clinical success. This study aimed to evaluate the effects of four restorative materials on the viability of gingival fibroblast cell cultures using a real-time cell analysis system with direct extract methods. Four different restorative materials with bioactive properties were used in this study: Glasiosite (VOCO GmbH, Cuxhaven, Germany), BEAUTIFIL-Bulk Restorative (Shofu Inc., Kyoto, Japan), EQUIA Forte™ HT Fil (GC Corporation, Tokyo, Japan), and Activa BioACTIVE Restorative® (Pulpdent Corporation, Watertown, USA). Disc-shaped specimens were prepared for each material group (n = 18 and n = 9 for each test method). The effects of the materials on gingival fibroblast viability were determined using both direct and extract methods with a real-time cell analysis system (xCELLigence) at two different time periods (24 h and 48 h). A significance level of α = 0.05 was adopted for all statistical analyses. The control group exhibited the highest cell viability, and the differences between the groups were statistically significant at both 24 h and 48 h (p < 0.05). At both 24 h and 48 h, Glasiosite showed the highest cell viability among the tested materials, whereas the BEAUTIFIL-Bulk Restorative exhibited the lowest cell viability (p < 0.05). Cell viability was significantly higher with the extract method than with the direct contact method across all materials, except for the control (p < 0.05). This study revealed that the cell viability varied significantly depending on the material type, exposure time, and test method. Glasiosite showed the highest biocompatibility, while the BEAUTIFIL-Bulk Restorative exhibited the lowest value.

Resumo em Inglês:

Abstract: This study aimed to conduct an in vitro evaluation of the antierosive potential of a solution and an experimental toothpaste enriched with natural antioxidants derived from cocoa (Theobroma cacao L.) on eroded dentin. Cocoa beans underwent fermentation, drying, roasting, grinding, and freeze-drying to obtain an aqueous cocoa extract. The extract was analyzed for total polyphenols and antioxidant capacity using the oxygen radical antioxidant capacity (ORAC) assay. A control toothpaste was then formulated and enriched with the concentrated cocoa extract. Eighty bovine dentin specimens were pre-eroded in citric acid and randomized into four groups (n = 20): G1 (negative control) – toothpaste without active ingredients; G2 – concentrated cocoa polyphenol solution; G3 – experimental toothpaste enriched with cocoa polyphenols; and G4 (positive control) – Elmex Protect commercial toothpaste (Colgate). Specimens underwent 3 days of erosive cycling. Surface loss (dSL-eroded) was measured by optical profilometry; collagen degradation (dColl) was calculated after collagenase exposure; and calcium release (CaR) was quantified by atomic absorption spectrometry. Surface morphology was qualitatively assessed by scanning electron microscopy (SEM). Data were analyzed by one-way ANOVA and Tukey's test (α=0.05). The cocoa extract showed higher levels of total polyphenols than did the enriched toothpaste (p = 0.037). Antioxidant activity decreased after toothpaste manipulation (p = 0.025). G2 exhibited significantly lower dSL-eroded, dColl, dSL-total, and calcium release compared with the other groups (p<0.05). SEM analysis of G3 revealed partially or totally occluded dentinal tubules. In conclusion, cocoa extract exhibited a higher polyphenol content and significant antierosive effects, leading to reduced dentin surface loss and enhanced tubule occlusion.

Resumo em Inglês:

Abstract Implant overdenture attachments serve as the crucial link between dental implants and removable dentures, significantly enhancing the stability, retention, and function of the prosthesis. This study was designed to assess the effectiveness of locator and TITACH attachments in retaining mandibular two-implant overdentures, maximum bite force, and marginal bone loss. The study involved 36 edentulous patients, each receiving new complete dentures (CDs) designed with the bilateral balanced occlusal concept. Two implants were positioned in the mandibular canine regions. Participants were randomly assigned to two equal groups: Group I (LOA) with overdentures using locator attachments, and Group II (TIA) with overdentures using TITACH attachments. Retention and maximum bite forces were measured using a digital force meter and bite force transducers at baseline (T0), and at 6 months (T6), and 12 months (T12) post-insertion. After insertion, marginal bone loss (MBL) was evaluated using digital periapical radiographs at T6 and T12. Retention significantly decreased over time across all groups (p = 0.024 for CD, p < 0.001 for LOA and TIA). Maximum bite forces significantly declined for LOA (p = 0.007) and TIA (p = 0.003) at all measurement intervals. TIA demonstrated the highest retention and bite forces, followed by LOA, while CDs exhibited the lowest retention and bite forces. TIA was associated with significantly greater MBL than LOA (p = 0.002 and p < 0.001 for TIA). TITACH attachments showed superior retention and maximum bite force compared to locator attachments. Both attachment types offered improved retention and maximum bite forces relative to complete dentures. Additionally, locator attachments were associated with less peri-implant bone loss than TITACH attachments.

Resumo em Inglês:

Abstract Bovine teeth-derived nanoparticles show strong potential in regenerating alveolar bone tissue damaged by periodontitis. They possess osteoinductive and osteoconductive properties that stimulate cell differentiation, proliferation, and extracellular matrix formation. This study characterized nanoparticles from bovine teeth and evaluated their potential for alveolar bone regeneration via particle size analysis, transmission electron microscopy (TEM), X-ray diffraction (XRD), X-ray fluorescence (XRF), Brunauer–Emmett–Teller (BET) analysis, micro-computed tomography, and Fourier-transform infrared spectroscopy (FTIR). Twenty Wistar rats were divided into four groups: one control and three treatment groups, which were observed on days 7, 14, and 28. The rats were injected with lipopolysaccharides from Porphyromonas gingivalis to create a model of periodontitis model. Bovine teeth nanoparticles were applied to the periodontal pockets and covered with a periodontal dressing. The particle sizes ranged from 3.67 to 36.75 nm. TEM images revealed that the particles were spherical, while XRD analysis showed that the components consisted of 63% hydroxyapatite and 37% whitlockite. XRF analysis showed that the mineral content was highest in calcium (81.96%) and phosphorus (15.90%). BET analysis indicated that the characteristics of the nanoparticle material were similar to those of commercial bovine bone material. FTIR analysis revealed the presence of hydroxyapatite groups, including −OH, H2O, and P-4. BMP-2 expression levels were notably higher in the repaired bone on day 28 than on days 7 and 14. In conclusion, bovine teeth-derived nanoparticles demonstrate significant potential as biomaterials for alveolar bone regeneration in periodontitis therapy.

Resumo em Inglês:

Abstract: This study aimed to determine whether microneedles (MN) can enhance the efficacy of a commercially available topical anesthetic (EMLA®) when applied to the palatal mucosa. In a randomized, double-blind, crossover trial, 30 male volunteers received bilateral applications of MN patches and flat patches (FL, without MN) on the palatal mucosa. EMLA® was subsequently applied for either 2 or 5 min in separate sessions. Immediately thereafter, infiltrative anesthesia was administered, and pain intensity associated with needle insertion and local anesthetic injection was measured using a 0-100 Visual Analogue Scale. No differences in pain intensity were observed during needle insertion or local anesthetic injection when MN and FL patches were compared, irrespective of the duration of EMLA® application. However, a significantly higher proportion of participants reported pain-free infiltrative anesthesia when EMLA® was applied for 2 min following MN pretreatment (40%) compared with FL pretreatment (10%) (p = 0.008). MN application was not associated with adverse effects. Pretreatment with MN enhances the clinical efficacy of intraoral topical anesthesia in males. These findings open new avenues for exploration of advanced transbuccal drug delivery technologies focused on fast-release systems that may improve clinical outcomes in topical dental anesthesia.

Resumo em Inglês:

Abstract The aim of this study was to evaluate the effect of immersion in an acidic (butyric acid – BA; pH 4.1) or neutral (phosphate-buffered saline - PBS; pH 7.0) environment on the physical behavior of Bio-C Sealer (BCS) or AH Plus Jet (AHPJ) after filling oval root canals with different thicknesses of sealer. Thirty-two oval root canals were prepared and filled with BCS or AHPJ (n = 16), using the single-cone technique. Greater, middle, and smaller thicknesses of sealer were established in the cervical, middle, and apical thirds of the root canals, respectively. Then, the samples were immersed in BA or PBS (n = 8) for time intervals of 7 and 30 days. Micro-CT scans were performed after the materials set and after the experimental time intervals ended. Volumetric change and the percentage of voids and gaps at the material/dentin interface were evaluated. Kruskal-Wallis and Dunn, Friedman, Wilcoxon paired, and ANOVA/Tukey tests were performed (α = 0.05). Significant volumetric change and percentage of voids and gaps at the interface of BCS and AHPJ were observed in BA after 30 days (p < 0.05). Both materials showed a higher percentage of voids and volumetric loss in the greater sealer thickness (p < 0.05). Baseline showed a lower percentage of voids and gaps at the interface when compared with the experimental periods (p < 0.05). An acidic environment harms the properties of endodontic sealers after 30 days. The greater sealer thickness negatively affected the volumetric change and presence of voids in oval root canals.

Resumo em Inglês:

Abstract The goal of this study was to evaluate, in vivo, the synthesis of inflammatory and repair mediators in dental pulp after capping with a reparative bioactive material. Pulp capping was performed with mineral trioxide aggregate (n = 20) and gutta-percha (n = 10) on mandibular first molars of C57Bl6 mice. After 7 and 70 days, tissues were stained with hematoxylin and eosin for histopathological, histometric, and immunohistochemical evaluation to investigate the synthesis of ALP, IL-1β, IL-4, IL-6, PECAM-1, and VEGF. Data regarding measurement of the area of newly formed mineralized tissue, number of inflammatory cells in dental pulp, and intensity of immunostaining were compared using Student’s t-test at a significance level of 5%. At 7 days, an inflammatory response was found in contact with MTA and gutta-percha, while at 70 days, inflamation was reduced in both groups. However, mineralized tissue formation was observed only with MTA. IL-1β, VEGF, and PECAM-1 were detected in cells in close contact with MTA at 7 days, which reduced overtime. On the other hand, synthesis of ALP, IL-4, and IL-6 was mild at 7 and 70 days without difference between the periods. Mineralized tissue formation was observed only with MTA. IL-1β, VEGF, and PECAM-1 were synthesized by dental pulp and inflammatory cells in close contact with the material, whereas IL-4, IL-6, and ALP synthesis were scarcely found. Understanding the molecular and cellular responses elicited by MTA can enhance the development of more effective treatments, potentially leading to improved long-term outcomes for patients with dental pulp injuries or diseases.

Resumo em Inglês:

Abstract The aim was to evaluate the effects of different strategies on broken instrument removal and root fracture strength. After canal preparation of anterior single-rooted teeth, the samples were divided into one control group (n = 10) and six experimental groups (n = 15). A #25/.06 rotary file was broken at a length of 4 mm in the middle-third canal region in the experimental groups, and no instrument fractures were created in the control group. Access to the instrument was achieved with Gates-Glidden (GG) burs or ultrasonic tips. Dentin around the instrument was removed to create partial or full platforms. Finally, the instruments were removed with ultrasonic tips or a BTR Pen. The effectiveness of broken instrument removal, the duration of removal, and any complications that occurred were recorded. All the root canals were obturated. Fracture strength analysis was performed using a universal testing machine. Statistical analysis was performed using the Kruskal-Wallis and Dunn tests (p < 0.05). All broken instruments were successfully removed. The access time to the broken instrument in the groups using GG burs was shorter than that in the groups using ultrasonic tips (p < 0.05), while there was no significant difference between the groups in terms of total removal time (p > 0.05). The fracture strength of the control group was similar to that of the group in which ultrasonic tips were used to access the broken instrument and to create a full platform, and the BTR Pen was used for the removal of the broken instrument (p > 0.05), but showed higher fracture strength than that of the other experimental groups (p < 0.05). Different strategies used in the removal of broken instruments affected access time and root fracture strength.

Resumo em Inglês:

Abstract This randomized clinical trial evaluated the ability to negotiate second mesiobuccal (MB2) root canals in maxillary molars using nickel-titanium (NiTi) instruments in rotary and reciprocating kinematics. A total of 110 patients with MB2 canals were randomly assigned to two groups: EL – Easy Logic2 rotary instruments (n = 57) and X1B – MKLife X1 Blue reciprocating instruments (n = 53). Canals reached to full working length (FWL) were classified as “negotiable”. In the X1B group, 96.2% of MB2 canals were negotiable, compared to 86% in the EL group, with no statistically significant difference (p = 0.152). Mean shaping time was shorter in the EL group (12.92 ± 4.36 min) than in the X1B group (14.33 ± 4.72 min), showing a significant difference (p = 0.047). Both systems showed high MB2 negotiability. However, regarding negotiability, both systems did not show statistically significant differences when adjusted Cox regression was used (Hazard ratio: 0.77; 95% confidence interval: 0.51 – 1.14). Rotary instruments showed a slight advantage in shaping time efficiency.

Resumo em Inglês:

Abstract The purpose of this study was to evaluate the effect of immersion in butyric acid (BA, pH 4.1) or phosphate-buffered saline (PBS, pH 7.0) on the properties of Clinker (CL) with particle sizes of 2 to 30 µm or < 2 µm associated with zirconium oxide and manipulated with distilled water (DW) or liquid with additives (LA) compared with Bio-C Repair (BCR) and Biodentine (BIO). Dentin tubes were prepared and filled with materials. After 24 hours, the specimens were immersed in BA or PBS (n = 5) for 7 and 28 days. Micro-computed tomography was used to evaluate volumetric change, porosity, and material/dentin interface. Surface analysis was performed by scanning electron microscopy (SEM). Statistical analyses included Kruskal-Wallis and Dunn, Mann-Whitney, Wilcoxon, unpaired t-test, paired t-test, and ANOVA and Tukey tests (α = 0.05). All groups exhibited volumetric changes similar to BCR and BIO (p > 0.05). BA significantly increased porosity (approximately 8%) compared with PBS (approximately 2%), except for CL 2 to 30 µm with LA (p < 0.05). After 28 days in BA, all groups showed increased porosity and gaps at the interface compared with baseline values (p < 0.05). CL 2 to 30 µm with DW showed greater porosity and interface gaps than the other groups (p < 0.05). SEM analysis revealed that all groups showed hydroxyapatite formation on the material surface in PBS, and structural loss in BA. Findings: Acidic pH damages the material/dentin interface, increases porosity, and promotes dimensional changes in calcium silicate cements. Distilled water without additives increases the Clinker’s porosity, interface gaps, and volume loss.

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Abstract This study aimed to evaluate the in vitro cytotoxicity and bioactivity, and the in vivo biocompatibility, collagen maturation, and bioactivity, of PBS Cimmo HP and Bio-C Repair Ion+ in comparison with white MTA-Angelus. Osteoblast-like cell viability was assessed using the Alamar Blue assay, while bioactivity was assessed by alkaline phosphatase (ALP) activity and Alizarin Red staining. For the in vivo analysis, polyethylene tubes containing the materials or empty tubes (control) were implanted in the dorsum of mice. After 7 and 30 days (n = 8), the animals were euthanised and the specimens were processed for haematoxylin-eosin, Picrosirius Red, von Kossa (VK), and polarised light (PL) analyses. Data were statistically analysed (p < 0.05). Most materials extracts were cytocompatible (P > 0.05), except for the PBS Cimmo HP 1:4 extract at 48-h (p < 0.05). All materials showed increased ALP activity (p < 0.05). Mineralized nodules were significantly present in most material extracts (p < 0.05), except in the undiluted PBS Cimmo HP extract and in the white MTA-Angelus 1:4 extract. At 7 days, PBS Cimmo HP induced moderate-to-severe inflammation, whereas the other groups induced moderate inflammation (p > 0.05). At 30 days, all groups showed reduced inflammation (p > 0.05). Overall, the fibrous capsule was thick at 7 days and thin at 30 days. At 7 days, the control and PBS Cimmo HP groups showed a greater presence of immature collagen (p < 0.05); at 30 days, more mature collagen was observed in all groups (p > 0.05). The materials exhibited positivity for VK or PL in both periods. In conclusion, PBS Cimmo HP and Bio-C Repair Ion+ were cytocompatible and biocompatible, and demonstrated bioactivity and collagen maturation similar to those of white MTA-Angelus.

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Abstract This study aimed to evaluate the long-term outcomes of dental implants placed in alveolar ridges augmented with collagenated xenogeneic bone blocks (CXBB) or autogenous bone blocks (ABB). In this non-interventional study, 20 patients (CXBB: n = 11; ABB: n = 9) from a previous randomized controlled clinical trial were followed for four years. These patients had undergone lateral alveolar ridge augmentation with either CXBB or ABB, with implants placed after a 30-week healing period. The following parameters were assessed: implant survival and success rates, peri-implant clinical parameters, Pink Esthetic Scores (PES), and patient-reported outcome measures (PROMs). Both groups demonstrated high implant survival rates, with only one late failure occurring in the ABB group. There were no statistically significant differences between the CXBB and ABB groups regarding implant survival and success rates (p > 0.05). Peri-implant clinical assessments indicated healthy tissue surrounding the implants in both groups, with no significant differences between CXBB- and ABB-grafted sites. While overall PES scores were similar, the ABB group showed significantly higher scores for soft tissue level and contour (p < 0.05). Patient-reported outcomes, accessed via the OHIP-14 questionnaire, indicated comparable satisfaction levels between the two groups. Both CXBB and ABB groups exhibited comparable long-term outcomes for implant survival and success. Although the ABB group demonstrated slightly better esthetic results, CXBB showed comparable clinical and patient-reported results, suggesting it may be a feasible alternative for staged lateral alveolar ridge augmentation. These findings should, however, be interpreted with caution given the limited number of patients.

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Abstract This study evaluated the biomechanical behavior of narrow-diameter Morse taper implants (3.5 mm) placed in bone of different densities and at different depths, using finite element analysis. Sixteen three-dimensional virtual models, meshed with tetrahedral elements, were created. Each model comprised cortical bone, cancellous bone, a Morse taper implant, an abutment, and a single maxillary central incisor crown. An oblique force (30 degrees buccally) of 150 N was applied to evaluate peri-implant stress distribution across four bone densities (D1, D2, D3, and D4) and at four placement depths (0, 1, 2, and 3 mm). The interfaces were modeled as perfectly bonded, except at the implant-abutment interface (friction coefficient = 0.3). All materials were assumed to be linearly elastic and isotropic. After a nonlinear analysis, the maximum and minimum principal stresses, maximum principal strain, and Mohr-Coulomb ratio were recorded. The results revealed a stress distribution pattern with lower peak stress values at shallower placement depths and in D1 bone. All groups showed a similar trend: as the implant placement depth increased, the point of greatest stress concentration shifted apically. Implant placement in cortical bone provided a protective effect under oblique loads. In D3 and D4 bone types, crestal placement showed better biomechanical performance than subcrestal placement.

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Abstract: Despite evidence regarding the severity of occupational accidents involving biological material (OAIBM) during dental instrument cleaning, these risks remain underestimated by many workers. Few studies, however, have focused on the epidemiology of OAIBM during dental instrument cleaning. Thus, this study aimed to identify, analyze, and estimate the incidence rate of OAIBM during dental instrument cleaning by dental care professionals in Brazil. Notifications registered between January 2015 and July 2020 were then extracted from the Notifiable Diseases Information System (SINAN), a Brazilian government agency responsible for reporting and investigating infectious diseases. Reports of OAIBM were analyzed by dental care professionals (dentists, oral health assistants [OHA], and oral health technicians [OHT]) from all 26 Brazilian states and the Federal District. The mean incidence rate of OAIBM among dental care professionals in Brazil during dental instrument cleaning was 314.5 cases per 100,000 professionals. Of these cases, 88.2% involved OHTs, and most affected individuals were female (94.4%). Serum, blood, or plasma accounted for most exposures (71.8%), and 85.1% of exposures were percutaneous. Gloves were the most commonly used personal protective equipment (PPE) at the time of the accidents. Therefore, this study highlights the role of the dentist as the leader and technical authority, responsible for providing resources, standardizing processes, training the team, and supervising performance to ensure occupational safety, quality processing, and contributions to patient safety.

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Abstract This study aimed to investigate the clinicopathological characteristics of thrombi in the oral and maxillofacial region. A cross-sectional study was conducted in nine reference centers for oral and maxillofacial pathology diagnosis in Brazil, from which biopsy records were obtained. The data were analyzed descriptively. A total of 93,036 biopsies from the oral and maxillofacial region were evaluated, 187 (0.2%) of which were diagnosed as thrombi. The highest occurrence was in females, with a mean age of 52.4 ± 17.7 years. The lip was the most frequently affected anatomical location. A clinical diagnostic hypothesis of thrombus was considered in 4.2% of cases. Oral thrombi were uncommon lesions in the studied population, with a higher occurrence among females in the seventh decade of life. This study provides a clinicopathological profile of oral and maxillofacial thrombi and offers information that may assist clinicians in establishing a diagnosis.

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Abstract This study analyzed the frequency and distribution of biopsied oral and maxillofacial lesions in a Brazilian geriatric population. Biopsy records of patients aged ≥60 years diagnosed over the last 45 years were retrospectively reviewed. Data on sex, age, anatomical site, and histopathological diagnosis were collected. Absolute and relative frequencies and their associations with clinicopathological variables were evaluated using the chi-square test and the two-proportions Z test. Among 21,367 lesions diagnosed between 1978 and 2023, 2,794 (13.1%) occurred in patients aged ≥60 years, predominantly in the 60–79 age group (90.6%) and in females (54.6%). The most frequent diagnostic categories were reactive lesions (56.6%), neoplasms (25.1%), and cysts/pseudocysts (8.5%). Fibrous hyperplasia (32.9%) and oral squamous cell carcinoma (15%) were the most common individual diagnoses. Females showed higher proportions of reactive lesions, immunological diseases, and bone lesions, with male-to-female ratios of 1:1.7, 1:2.2, and 1:5.7, respectively. The frequency and profile of oral and maxillofacial lesions in older Brazilians are consistent with previous reports. The high burden of inflammatory and neoplastic lesions reflects the cumulative effects of poor oral health and limited healthcare access. These findings highlight the need for strengthened preventive, diagnostic, and long-term oral healthcare strategies, particularly focusing on the aging population.

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Abstract: Head and neck cancer (HNC) affects thousands of people worldwide. It is characterized by lesions in the oral cavity, larynx, and pharynx and is often associated with smoking and alcohol consumption. Surgery and radiotherapy improve survival but can cause sequelae that affect daily functioning and quality of life (QoL). This study aimed to assess QoL and functioning in individuals with HNC treated by surgery and radiotherapy. This descriptive, cross-sectional, prospective study enrolled 80 patients between July and September 2024. QoL was measured using the UW-QOL questionnaire, and clinical and sociodemographic data were collected through anamnesis. Statistical analyses were performed using the Friedman–Dunn test for QoL domains, and Fisher's exact test or Pearson's chi-square test for associations. Variables with p < 0.200 were further evaluated by multinomial logistic regression at a 95% confidence level using SPSS v20.0. The participants were predominantly male (70%), with a mean age of 61 years. Most patients (52.5%) reported low QoL; 43.8% reported moderate QoL. The most frequent complaints were fatigue (38.8%) and pain (20%). Low education, pain history, three-dimensional conformal radiation therapy (3D-RT) modality, and previous surgery were significantly associated with reduced QoL (p < 0.05), with low education being the main predictive factor. HNC significantly affected the QoL and functional status of patients. Rehabilitation focusing on physical and emotional support is essential for improving affected domains.

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Abstract This study aimed use cone beam computed tomography (CBCT) to compare the maxillary sinus volume and transverse dimensions between sides with and without palatally impacted maxillary canines. The CBCT records of 47 patients with unilateral palatally impacted canines (18 males, 29 females; mean age: 22.19 ± 7.71 years) were included. The maxillary sinus volume was measured using semiautomatic segmentation, and transversal maxillary dimensions were assessed in the posterior region. Deviation of the nasal septum and alveolar pneumatization were also evaluated. Statistical analyses were performed using SPSS 25.0 with a significance level set at p < 0.05. As compared with the nonimpacted side, the maxillary and molar basal widths were significantly smaller and the septum deviation angle was greater on the impacted side (p < 0.05). A one-unit increase in the septal deviation angle increased the probability of impaction by 1.177 times. A negative correlation was detected between the maxillary sinus intensity and zygomatic width, molar basal width, and molar alveolar width (r = 0.431, 0.316, and 0.351, respectively). The incidence of pathological sinus findings did not differ significantly between sides (38.3% vs. 51.06%). Similarly, the rates of alveolar pneumatization were comparable (51.06% vs. 48.94%). The mean sinus volumes were 13,147.96 voxels on the impacted side and 13,194.38 voxels on the nonimpacted side, with no significant difference (p > 0.05). In conclusion, although palatally impacted maxillary canines are associated with narrower posterior maxillary transverse dimensions and increased septal deviation, they do not have a considerable effect on the maxillary sinus volume. These findings provide clinically relevant information for orthodontic diagnosis and surgical planning.

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Abstract The study aimed to validate a questionnaire for the Brazilian adolescent population assessing patient’s perceptions of orthodontic treatment and to verify whether its original psychometric properties were preserved during the transcultural adaptation process. A total of 160 adolescents, assessed before and after orthodontic treatment at two different orthodontic clinics,answered a self-administered questionnaire translated into Portuguese. Patients were equally assigned to two groups: non-treated adolescents (NTA) and adolescents receiving orthodontic treatment (AOT). Both male and female adolescents were selected (age range: 12 to 17 years). A trained orthodontist examined all patients to record the aesthetic dental index (ADI) and the decayed, missing, and filled teeth (DMFT) index. The adolescents’ legal guardians answered a socioeconomic questionnaire. Reliability was assessed by evaluating the instrument’s internal consistency and stability, using Cronbach’s alpha, the intraclass correlation coefficient (ICC), and Cohen’s kappa coefficient (k). Construct validity was assessed through cross-cultural validation and hypothesis testing. Cronbach’s alpha was 0.7 for the NTA group and 0.9 for the AOT group. The instrument demonstrated excellent stability for the NTA group, yielding an ICC > 0.9. The k values showed a strong to almost perfect correlation (between 0.701 and 0.999) for the AOT group. The Brazilian version of the QPAOT proved to be a reliable and stable instrument, with good psychometric properties and can therefore be considered an appropriate instrument for assessing adolescents’ perceptions and expectations regarding orthodontic treatment.

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Abstract This study aimed to investigate the relationship between post-eruptive dental fractures, hypomineralization, and psychosomatic factors such as anxiety, headache, awake bruxism, and temporomandibular disorder (TMD) in children aged 7 to 12 years. A cross-sectional study involving 274 children was conducted using clinical examinations based on the European Academy of Pediatric Dentistry (EAPD) criteria for the diagnosis of hypomineralization and post-eruptive breakdown. Structured and validated questionnaires were administered through interviews to assess psychosomatic factors such as anxiety, headache, awake bruxism, and TMD. Statistical analysis included descriptive and inferential analyses using Fisher’s exact test and the chi-square test. The margin of error was 5%, with a 95% confidence interval. Tissue breakdown was observed in 6.2% of children, with a higher prevalence in posterior teeth. A significant association was found between tissue breakdown and hypomineralization in deciduous (p=0.002) and permanent teeth (p < 0.001), especially when hypomineralization presented as yellow-brown (p < 0.001). Anxiety, awake bruxism, and TMD were not significantly associated with such fractures, but they were significantly associated with headache (p = 0.023). Additionally, dental caries (p = 0.003) and occlusal wear (p < 0.001) were associated with tissue breakdown. Post-eruptive breakages were found to be associated with dental enamel hypomineralization in deciduous and permanent teeth. Furthermore, dental caries and occlusal wear were identified as key contributing factors for these fractures. In conclusion, post-eruptive fractures were associated with enamel hypomineralization in both deciduous and permanent teeth, as well as with dental caries and occlusal wear. Among psychosomatic factors, only headache showed a significant association.

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Abstract Dental caries remains a significant public health issue, particularly among children from low-income areas, where limited access to preventive and restorative care increases the disease burden. In Costa Rica, recent data on the prevalence of caries in children under seven years of age are lacking. This nationwide study aimed to determine the prevalence and severity of dental caries lesions in Costa Rican children aged 12–81 months living in poverty and enrolled in the Centers for Education and Nutrition and Comprehensive Child Nutrition and Care Centers (CEN-CINAI), which are national childcare and nutrition programs. A cross-sectional descriptive study was conducted with 800 children from urban and rural areas. The probability-proportional-to-size (PPS) method was used to select 40 centers, with systematic random sampling of 25 children per center. Clinical examinations were performed by eight calibrated examiners following the International Caries Detection and Assessment System (ICDAS) criteria to assess oral health conditions. The inter- and intraexaminer kappa values ranged from 0.80–0.93. The overall prevalence of caries lesions was 84.81% (ICDAS codes 1–6), with 47.19% of the participants presenting moderate-to-severe carious lesions (ICDAS codes 3–6). The highest prevalence was observed in the 37–48-month age group (91.45%). Differences in the prevalence of caries by sex were more evident in younger age groups and minimal in the older age groups. Only 28.75% of the children with caries had received restorative treatment. The 37–48-month age group presented the highest prevalence of caries, with most lesions being moderate to severe and treatment coverage remaining low.

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Abstract Malocclusions in primary teeth affect chewing, speech, and aesthetics. Few studies have assessed their impact on preschoolers’ self-reported quality of life. This study aims to determine the association between malocclusions in primary teeth and preschoolers’ quality of life based on reports from children and their parents/guardians. A cross-sectional study was conducted Using a stratified, simple, randomly probabilistic sample. Based on sample size estimation, the study included 566 five-year-old preschoolers and their parents/guardians from Teresina, Brazil. Pediatric Quality of Life InventoryTM questionnaire and sociodemographic forms were applied, and clinical examination was performed. The dmft index, modified developmental defects of enamel, and Foster & Hamilton criteria were used for diagnosis. Descriptive analysis and Poisson regression were performed (p < 0.05; 95% CI). Prevalence of malocclusion was 51.2%. Parents/guardians reported edge-to-edge overjet negatively affected physical capacity (RR = 1.11; 95%CI: 1.02–1.20) and social aspects (RR = 1.11; 95%CI: 1.03–1.19). According to children’s self-reports, posterior crossbite affected the total score (RR = 1.43; 95%CI: 1.03–1.97) and oral health (RR = 1.08; 95%CI: 1 .04–1.13), whereas reduced overbite was linked to negative effects on the emotional aspect (RR = 1.10; 95%CI: 1.01–1.18) and oral health (RR = 1.08; 95%CI: 1.01–1.16). Malocclusions have a negative impact on the quality of life of preschoolers, as reported by parents and children.

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Abstract This study evaluated the oxygen saturation of pulp tissue (SaO2) in first primary molars (FPM) with and without molar incisor hypomineralization (MIH) and explored the correlations between MIH severity and pulp SaO2 levels. The cross-sectional design involved 29 children (16 girls and 13 boys, aged 7–11 years), yielding 116 FPM. The FPM were categorized into groups based on the presence or absence of MIH: Group 1 (G1) included teeth without MIH (n = 48); Group 2 (G2), mild MIH cases (n = 30); and Group 3 (G3), severe MIH cases (n = 38). Pulse oximetry was used to assess SaO2, with measurements conducted twice for each tooth, each lasting 30 seconds. Significant variations in the SaO2 levels were observed relative to the severity of MIH. The median SaO2 in G1 was 94% (IQR 90–98%), while MIH cases showed lower levels: 79% (IQR 71.5–83.5%) for mild MIH (G2) and 68% (IQR 55–75%) for severe MIH (G3) (p < 0.001). The FPM affected by MIH (G2 and G3) demonstrated lower SaO2 levels than those in G1, with severe cases exhibiting even lower levels than mild cases. This study provides important insights into the relationship between MIH severity and pulp SaO2 and suggests significant implications for clinical management strategies.

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Abstract The aims of this retrospective radiographic study were to assess the occurrence of dental anomalies in children and patients with disabilities and to investigate the association of these anomalies with pre-, peri-, and post-natal medical history. A total of 289 panoramic radiographs of children (0–14 years) and patients with disabilities (including all age groups) were used to identify developmental dental anomalies, and information was collected from medical records for statistical analysis. Data were expressed as relative frequency (percentage). The chi-square test, Fisher’s exact test, relative risk calculation, and the Mann-Whitney test were used for statistical comparisons with a significance level of 5%. Occurrence of dental alterations was 50.34% in children and 37.50% in patients with disabilities. Agenesis was the most common alteration (24.14% in children and 30.55% in patients with disabilities). The study found a relative risk of 2.6 for agenesis in children with a history of prematurity (p = 0.02). The variable “performing medical treatment” was a risk factor for the presence of dental alterations in children. The age and the medical conditions of the patients with disabilities varied greatly, with neurological diseases being the most prevalent disability. However, the health history of mothers during pregnancy was not associated with dental alterations in patients with disabilities (p > 0.05). Developmental dental anomalies were frequently observed in both groups, with agenesis being the most common condition. Prematurity was identified as a predictive factor for agenesis.

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Abstract This study aimed to evaluate the relationship between social cohesion and gingival bleeding levels in adolescents from Santa Maria, southern Brazil. This cross-sectional study was nested within a cohort study initiated in 2010 with a representative sample of preschool children aged 1 to 5 years in the city. Participants were re-evaluated at ages 11 and 15 years, resulting in a 10-year follow-up period. The current study used data from this follow-up. Social cohesion was assessed at an individual level through questions about perceptions of neighborhood relationships and the frequency of participation in neighborhood gatherings. Gingival bleeding was evaluated clinically using the Community Periodontal Index (CPI). Sociodemographic and clinical variables were considered as potential confounders. Multilevel adjusted Poisson regression was used to assess associations, and results were expressed as rate ratios (RR) with 95% confidence intervals (95%CI). A total of 429 adolescents were included. In the adjusted model, poor perception of neighborhood relationships was associated with higher gingival bleeding levels (RR = 1.08; 95%CI: 1.03–1.13). Adolescents who did not attend local gatherings had even higher bleeding levels (RR = 1.45; 95%CI: 1.34–1.47). Additionally, non-white adolescents, those with lower income, irregular dental visits, and higher plaque levels also showed greater bleeding. Girls had lower gingival bleeding levels compared to boys. Lower social cohesion, reflected by negative neighborhood perceptions and lack of community participation, was associated with higher gingival bleeding in adolescents. Public health strategies aiming to improve adolescent oral health should focus on strengthening neighborhood relationships and promoting active community engagement as key social determinants.

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Abstract: This study aimed to assess whether the sense of coherence (SOC) moderates the association between self-reported sleep bruxism (SB) and self-reported awake bruxism (AB) on oral health-related quality of life (OHRQoL). A cross-sectional analysis was conducted with a random sample of 406 adolescents aged 11 to 17 years from Southern Brazil. OHRQoL was measured using the Child Perception Questionnaire (CPQ11-14). Both SB and AB were assessed by self-report (weekly frequency). SOC was measured using the 13-item Sense of Coherence Scale (SOC-13). Demographic, socioeconomic, and clinical variables were included as potential confounders. Poisson regression models were used to test interaction effects. Adolescents with bruxism behaviour—either SB or AB—presented significantly higher CPQ11-14 scores, indicating poorer OHRQoL. SOC moderated this association: adolescents with SB and low SOC reported worse OHRQoL than those with high SOC. Similar results were observed for AB. In addition, the moderating effect was stronger for AB, with a greater difference in predicted CPQ11-14 scores across SOC levels. These findings suggest that SOC may buffer the psychosocial and functional effects of bruxism. Strengthening SOC could be a promising avenue for interventions aimed at minimizing the quality-of-life burden of bruxism in adolescents.

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Abstract Social capital plays a key role in health outcomes, including oral health-related quality of life (OHRQoL). With increased digital interactions, online social capital has emerged as a potential determinant of adolescent well-being. This study aimed to explore the relationship between online social capital, associated factors, and OHRQoL among adolescents. This cross-sectional study was nested within a cohort study initiated in 2010 with a representative sample of preschool children from Santa Maria, Brazil. Individuals were re-evaluated from 2022 to 2023 (n = 406), when they were between 14 and 18 years of age. OHRQoL was assessed using the Child Perception Questionnaire (CPQ 11-14). Online social capital was measured using two proxy indicators (frequency of social media use and perceived online trust) based on prior literature. Offline social capital and demographic, socioeconomic, psychosocial, and clinical variables were considered confounders. Poisson regression was used to assess associations. Results are reported as rate ratios (RR) and 95% confidence intervals (95% CI). Most adolescents (95.3%) used social media daily, and 62.9% reported having trusted online contacts. Adolescents with low online social trust had CPQ11–14 scores 8% higher (RR = 1.08; 95%CI: 1.01–1.15), indicating poorer OHRQoL. Low offline social capital was also associated with poorer OHRQoL, whereas moderate and high sense of coherence (SOC) were associated with lower impacts on OHRQoL. Social media usage frequency showed no significant association with OHRQoL. Our findings suggest that online social trust, offline social capital, and SOC are positively associated with adolescents’ OHRQoL.

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Abstract: Body mass index (BMI) disorders and dental caries are common and interrelated conditions in children, sharing risk factors such as inadequate diet and socioeconomic factors. This longitudinal study was designed to improve understanding of the determinants of children's health and, consequently, to promote health from childhood. The research was conducted between August 2017 and November 2018 in Diamantina, Brazil, and investigated the association between the incidence of dental caries and BMI in preschool children. The final sample included 122 children aged three to four years and 11 months, who were evaluated at two points over a one-year interval. The analysis showed that reduced family income (RR = 3.94; 95%CI: 1.26–12.39) and the incidence of caries (RR = 1.86; 95%CI: 1.01–3.42) were significant risk factors for low weight. Although maternal education initially appeared relevant (RR = 4.67; 95%CI: 1.48–14.73), its influence diminished when family income was considered. In conclusion, this study found an association between incidence of dental caries and low BMI (underweight) in preschoolers after one year of follow-up. The incidence of caries and the reduction or maintenance of low monthly family income were identified as risk factors for low weight in preschoolers during one year of follow-up.

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Abstract The aim was to test a structural equation model examining the direct and indirect pathways between early childhood caries (ECC) severity and oral health-related quality of life (OHRQoL) in Brazilian preschool children, incorporating dental pain, treatment urgency, dental visits, anterior open bite (AOB), and maternal schooling into the model. A population-based study was conducted using data on five-year-old children from the 2023 Brazilian National Oral Health Survey (SB Brasil). The Brazilian version of the SOHO-5 was used to measure the impact of oral health conditions on OHRQoL. Calibrated dentists assessed ECC (dmft and pufa indices), AOB (Foster & Hamilton), and urgent oral health care needs. Parents or caregivers answered a questionnaire addressing dental pain, dental visits, and mother’s schooling. Structural equation modeling was performed. Children with greater ECC severity (β = 0.674; p < 0.001) and dental pain (β = 0.241; p < 0.019) were more likely to require urgent care. Greater ECC severity was also directly associated with worse OHRQoL by both by the self-report (β = 0.261; p < 0.001) and proxy-report (β = 0.303; p < 0.001), and indirectly mediated by dental pain in both the self-report (β = 0.426; p < 0.001) and proxy report (β=0.401; p<0.001). Dental pain was associated with worse OHRQoL according to both self-report (β = 0.633; p < 0.001) and proxy-report (β = 0.597; p < 0.001). The structural model demonstrated that ECC severity negatively impacts OHRQoL through direct effects and indirect pathways mediated by dental pain. ECC and dental pain were also associated with a higher likelihood of urgent treatment.

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Abstract Periodontitis is a chronic inflammatory disease characterized by progressive destruction of tooth-supporting tissues, primarily driven by a dysregulated host immune response to subgingival biofilms. Toll-like receptors (TLR-2 and TLR-4) and tumor necrosis factor-alpha (TNF-α) are key mediators of immune signaling and tissue breakdown, making them potential biomarkers of periodontal disease activity. This prospective, non-randomized interventional study evaluated TLR-2, TLR-4, and TNF-α levels in gingival crevicular fluid (GCF) for periodontal disease monitoring and assessed the effects of nonsurgical periodontal therapy (NSPT) on clinical parameters. Forty systemically healthy individuals were enrolled and assigned to either periodontitis or healthy groups. Clinical indices—gingival index, plaque index, clinical attachment loss, and probing pocket depth—were recorded at baseline and 8 weeks after NSPT. GCF samples were analyzed using enzyme-linked immunosorbent assay to determine biomarker concentrations. At baseline, TNF-α and TLR-2 levels were significantly higher in periodontitis patients compared with healthy controls (p < 0.001). Following therapy, marked clinical improvements were observed, accompanied by significant reductions in TNF-α and TLR-4 levels (p < 0.05), while TLR-2 levels remained stable. receiver operating characteristic analysis demonstrated that TNF-α and TLR-2 reliably distinguished disease from health. In conclusion, NSPT effectively improved clinical outcomes and reduced TNF-α and TLR-4 levels in GCF, reflecting a decreased local inflammatory burden. The persistence of TLR-2 expression post-treatment suggests a stable role in immune surveillance rather than acute inflammatory response.

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Abstract The aim of this study was to evaluate the effects of the COVID-19 pandemic on parents’ perceptions of their children’s oral health related quality of life (OHRQoL). This longitudinal study was performed in two stages: baseline (T1), before the pandemic, and follow-up (T2), from August to November 2021. Children aged eight to eleven years and their parents who were seeking dental care or were referred to the Pediatric Dental Clinic of the School of Dentistry, residing in Pelotas, state of Rio Grande do Sul (RS) were included. OHRQoL served as the primary outcome measure and was assessed using the Brazilian short-form of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) at T1 and T2. Child’s sex and age, caries status (dmft/DMFT), parents’ education, and household income were collected at T1. Variables related to COVID-19 were collected at T2: fear of COVID-19 and of family virus transmission, job loss, and children’s dental pain in the past 4 weeks. The non-parametric Wilcoxon test was used to compare OHRQoL. Changes in OHRQoL over time were analyzed using a multilevel negative binomial regression model. The random intercept and fixed effects model considered repeated measurements (level 1) grouped into individuals (level 2). The level of significance was set at 5%. There was no statistically significant difference between the median for total score and for each domain. In the multilevel analysis, fear of COVID-19 was linked to poorer OHRQoL perceptions. Having dental pain and younger children also negatively impacted these perceptions. Emotional and psychological factors and non-normative parameters significantly influenced parental perceptions of OHRQoL during the pandemic.

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Abstract: This single-blind, randomized clinical trial evaluated the impact of a strict oral hygiene (OH) phase on self-reported halitosis and quality of life (QoL) in patients with periodontitis. This study reports a secondary analysis of a single-blind randomized controlled trial (parallel, 1:1), registered at RBR-5jmx32v. The study included 24 individuals diagnosed with periodontitis who were randomly assigned to the intervention group (IG; n = 12) and the no-intervention group (NIG; n = 12). After receiving personalized OH instructions, the IG participants followed a rigorous OH phase for 45 days, whereas the NIG participants received no guidance during this period. The halitosis-associated QoL test (HALT) was administered at baseline and after 45 days. Data were analyzed using t-tests, chi-square tests, and multilevel linear regression, with significance set at p < 0.05. The average age of the study participants was 47.2 years, with a balanced sex distribution and no differences in income or education. Self-reported halitosis decreased from 100% to 50% in the IG after 45 days, whereas it remained at 91.6% in the NIG (p = 0.034). The IG also showed a mean HALT score reduction of 11.9 points (−11.88; 95% CI: −19.40 to −4.36), with significant improvements in social impact and self-esteem (p < 0.05). Clinically, BOP (p < 0.001) and VPI (p = 0.03) improved significantly in the IG, with no significant changes in NIG. This exploratory trial demonstrates that implementing a strict OH phase in patients with periodontitis may help reduce self-reported halitosis, improve HALT scores, and improve clinical outcomes, supporting its role as an adjunctive strategy in periodontal care.

Resumo em Inglês:

Abstract Periodontitis is a chronic infectious disease characterized by the progressive destruction of tooth-supporting tissues. Identifying reliable, noninvasive biomarkers is essential for improving early detection and monitoring. This cross-sectional case‒control study evaluated clinical periodontal parameters and quantified periostin and transforming growth factor-beta 1 (TGF-β1) levels in the saliva and gingival crevicular fluid (GCF) of patients with stage I–II periodontitis and periodontally healthy controls. A total of 60 systemically healthy, nonsmoking participants aged 20–60 years were included (30 periodontitis patients and 30 periodontally healthy controls). Clinical periodontal parameters, including the plaque index, gingival index, probing depth, and clinical attachment level, were recorded. GCF and saliva samples were analyzed using an enzyme-linked immunosorbent assay (ELISA). Compared with periodontally healthy controls, stage I–II periodontitis patients had significantly greater numbers of clinical periodontal parameters (p < 0.001). They also had elevated salivary periostin (1,234.5 ± 505.82 ng/mL vs. 596.32 ± 320.47 ng/mL; p = 0.001), GCF TGF-β1 (10.14 ± 4.44 pg/mL vs. 6.50 ± 3.13 pg/mL; p = 0.003), and salivary TGF-β1 (31.59 ± 7.69 pg/mL vs. 20.25 ± 9.48 pg/mL; p = 0.001) levels. GCF periostin levels did not significantly differ between the periodontitis group (311.3 ± 210.3 ng/mL) and the periodontally healthy control group (208.6 ± 147.6 ng/mL) (p = 0.092). These findings suggest that salivary periostin and TGF-β1, together with GCF TGF-β1, may serve as promising noninvasive biomarkers for the diagnosis and monitoring of early-stage periodontitis. Salivary periostin showed particularly strong discriminatory potential and may hold promise for future chairside diagnostic applications.

Resumo em Inglês:

Abstract Alternative therapies using plant-derived extracts are currently being studied due to their beneficial properties. This study investigated the Amazonian extract of Pentaclethra macroloba, pure and in combination with calcium hydroxide, regarding its biological properties in endodontics. Osteoblast Saos-2 and Fibroblast L929 cell lines were used for evaluation of cell viability/metabolism by MTT (48h), cell proliferation with Alamar blue (1, 3, 5 and 7 days), mineralization with Alizarin Red (7 days) and alkaline phosphatase activity (7 days). In Saos-2, lower concentrations of the medications were less cytotoxic in the MTT assay. There was cell proliferation on days 3 and 5. Mineralization nodules were observed in the 3 groups. In L929 cells, the lowest concentrations were not cytotoxic in the MTT assay, and there was cell proliferation on days 3, 5, and 7. Pentaclethra macroloba extract was not cytotoxic, it induced cell proliferation, and was able to form mineralization nodules, essential characteristics for endodontic medications.

Resumo em Inglês:

Abstract Dental Specialty Centers (CEOs in Portuguese) are health facilities that offer services of medium complexity in oral health, enabling comprehensive care. The objective of this study is to evaluate the sociodemographic and accessibility characteristics that may be associated with the degree of satisfaction of CEO users. A cross-sectional study was conducted using secondary data from the second cycle of the Program to Improve Access and Quality of CEOs (PMAQ-CEO), available in the public domain on the Ministry of Health website, from 2020. The outcome (satisfaction) was measured by the question “In general, the service you receive in this CEO is?” and Poisson regression analysis was performed using a robust estimator. In total, 10,391 users and 1,042 CEOs were interviewed. More than half of the participants (58.4%) rated the CEO’s service as very good, and 38.2% as “good.” In the final model, greater satisfaction with the CEO was associated (p<0.05) with White individuals who received more than one minimum wage, who did not reside in the same municipality where the establishment operated, who did not want to change the CEO, and with hours of operation compatible with the demands of users. A high percentage of users were satisfied with Brazilian CEOs’ services. By analyzing the literature and data from the previous cycle of the PMAQ-CEO, an improvement in service delivery can be seen, which may have influenced user satisfaction.

Resumo em Inglês:

Abstract Remote examinations have become increasingly common in Dentistry, especially with the use of applications. This preliminary cross-sectional study evaluated the accuracy of remote examination of oral mucositis (OM) and severe oral mucositis (SOM) using photos obtained through the Telepediatric Dentistry in Oncology (TON) application, comparing its results with the in-person clinical examination (gold standard). A total of 21 pediatric patients (13 boys, 8 girls; mean age 9.05 ± 3.46 years) undergoing chemotherapy were examined, totaling 28 in-person examinations and 224 photographic images assessed remotely by four calibrated dentists (Kappa > 0.7). The photos covered eight oral cavity sites (lips, right and left buccal mucosa, tongue dorsum, lateral tongue, palate, and floor of the mouth) and were analyzed for the presence or absence of OM and SOM. Among the 28 examinations, 11 presented OM and 3 presented SOM. The remote examination identified all positive cases (sensitivity 100%; 95%CI: 0.741–1), while specificity was 59% for OM, reflecting the occurrence of false positives, especially in the lips and buccal mucosa. Agreement between remote examiners and the gold standard ranged from 0.17 to 1.0, depending on the region and evaluator, being higher in the tongue dorsum, lateral tongue, and floor of the mouth. The results indicate that remote examination via TON may be feasible and has the ability to detect OM and SOM, potentially serving as a complementary tool in dental monitoring of children and adolescents undergoing oncology treatment, particularly when in-person examination is not possible.

Resumo em Inglês:

Abstract Abnormal coagulation function is closely associated with the prognosis of patients with malignant tumors. In this study, we aimed to explore the prognostic value of preoperative coagulation scoring system in patients with oral squamous cell carcinoma (OSCC). A total of 267 patients with OSCC who were treated at the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University between January 2016 and December 2019 were included. Survival prediction values for fibrinogen level and international normalized ratio (INR) were identified according to receiver operating characteristic (ROC) cut-off analysis. Patients were divided into three groups based on the F-INR score combined with fibrinogen and INR: score 2 group (both high fibrinogen and high INR), score 1 group (either elevated fibrinogen or INR), and score 0 group (neither abnormality). The association between F-INR score and clinicopathological parameters was evaluated. The clinical risk factors were evaluated using univariate and multivariate Cox regression analyses. Kaplan-Meier analysis was used to estimate the survival of patients with OSCC. The predictive value of preoperative F-INR in OSCC was better than that of fibrinogen and INR alone (area under the curve, (AUC): 0.766 vs. 0.704 vs. 0.611). Multivariate Cox regression analysis showed that F-INR may be an independent predictor of cancer-specific survival (CSS) in OSCC (F-INR 1, hazard ratio [HR] = 8.210, 95%CI: 1.156–58.282, p = 0.035; F-INR 2, HR = 2.475, 95%CI: 1.284–4.772, p = 0.007). Kaplan-Meier analysis indicated that patients with high fibrinogen levels or F-INR had a poor prognosis (p < 0.05). Preoperative F-INR may be an independent prognostic factor in patients with OSCC.

Resumo em Inglês:

Abstract This study compared oral hygiene and prognostic scores in intensive care unit patients who were either exposed or not exposed to an antimicrobial oral rinse. Both the Simplified Acute Physiology Score (SAPS 3), and Sequential Organ Failure Assessment (SOFA) score - recorded on the day of admission (D1) and on the day of the oral examination (Dv) - were retrieved from electronic medical records. Oral data obtained through intraoral examination were used to calculate the Critical Patient Oral Hygiene Index (CPOHI). Eighty-four patients were included in the group exposed to the oral rinse containing chlorhexidine, cetylpyridinium chloride, and propolis extract (CCPG), whereas 42 patients were assigned to the reference group (RefG). Gingival inflammation (47.6% vs. 16.7%; p < 0.001) and spontaneous bleeding (9.5% vs. 0%; p = 0.004) were more frequent in the RefG than in the CCPG, respectively. Oral hygiene was satisfactory in 53.2% of patients, with no difference between groups. Median SAPS3 and SOFA Dv were worse in the RefG. Patients in CCPG with poor oral hygiene (6.0 (0-14)) showed worse SOFA Dv scores than those with good oral hygiene (1.0 (0-13), p=0.001). Intubation was the only variable negatively associated with all prognostic scores in the multivariate analysis. Critically ill patients exposed to the antimicrobial oral rinse showed better prognostic scores and a lower frequency of gingival inflammation and spontaneous bleeding, supporting the indication of the antimicrobial rinse in oral hygiene protocols for critically ill patients.

Resumo em Inglês:

Abstract: This study was aimed at comparatively evaluating the relationship between temporomandibular disorder (TMD) and subjective tinnitus, as well as the effects of TMD treatment on masticatory muscle activity, tinnitus symptoms, and patient perception. In this prospective cohort study, patients diagnosed with both TMD and tinnitus were divided into groups with or without bruxism. The inclusion criteria were confirmed diagnosis of TMD and tinnitus. The exclusion criteria were history of prior TMD treatment, neurological disorders, or systemic diseases affecting muscle function. The primary outcome measures were electromyographic (EMG) assessments of masseter muscle maximum voluntary contraction (MVC) and the percentage of overlapping coefficient (%POC), determined via surface EMG (sEMG). The secondary outcomes included changes in tinnitus symptoms, assessed with the Tinnitus Handicap Inventory (THI), and pain levels, evaluated with the Visual Analog Scale (VAS). A total of 70 eligible participants were evenly distributed between groups. Tinnitus symptoms resolved in 35.7% of patients and did not significantly differ between groups (p > 0.05). Masseter MVC values decreased numerically but non–significantly after treatment (p > 0.05). In contrast, significant post–treatment improvements were observed in %POC, VAS, and THI scores (p < 0.05). Pre– and post–treatment comparisons of MVC, %POC, VAS, and THI revealed no significant intergroup differences (p > 0.05). TMD treatment appeared to effectively decrease subjective tinnitus symptoms and improve quality of life. Our findings suggest that TMD management might play an important role in tinnitus treatment and indicate that tinnitus is more associated with underlying internal disorders than with masticatory muscle activity directly influenced by bruxism.

Resumo em Inglês:

Abstract Open science aims to promote more transparent, collaborative, and accessible practices in the scientific process. However, barriers such as fear of exposure or reluctance to share data and methods make researchers hesitant to amply engage with this movement. This study analyzes the global open science movement and the persistent gap between its discourse and practice. Based on a critical narrative review of historical milestones, the analysis demonstrates that although open science promotes transparency, collaboration, reproducibility, and stronger connections among science, society, and policy, its adoption remains uneven and limited. Individual barriers, such as a lack of training and fear of misuse, along with institutional obstacles related to publishing models, evaluation metrics, and financial constraints, hinder the full implementation of open practices. Contrastingly, significant benefits are evident, including cost reduction, acceleration of scientific progress through data reuse, and reinforcement of evidence-based public policies. Worldwide experiences highlight both the advances and inequalities in access and infrastructure, demonstrating that the global impact of open science depends on more equitable participation. In conclusion, bridging the gap between discourse and practice requires structural changes in research evaluations, cultural shifts that prioritize collective knowledge, and stronger integration between researchers, policymakers, and society. Implementing open science is essential to ensure that knowledge production truly serves global development and social equity.

Resumo em Inglês:

Abstract This review synthesizes current laboratory and clinical evidence on nickel-titanium (NiTi) endodontic instruments and translates it into guidance for clinical practice, addressing inconsistencies in the translation of research findings and a lack of standardization. Evidence on the evolution, metallurgy, heat treatments (e.g., M-Wire, Gold, and Blue), geometric design, mechanical properties, and clinical performance of contemporary NiTi systems were synthesized, with emphasis on shaping outcomes, including canal transportation, volumetric changes, unprepared canal walls, and remaining dentin thickness. Modern NiTi instruments, particularly those with advanced heat treatments, provide superior flexibility and cyclic fatigue resistance compared with conventional alloys, enabling safer and more predictable canal preparation. Continuous rotary systems often achieve better canal centering and less transportation than reciprocating systems; however, both leave a substantial portion of canal walls untouched, highlighting the essential role of chemical debridement. Long-term clinical success depends primarily on biological factors and careful technique rather than on the specific instrument system. Therefore, NiTi instruments represent the standard of care, offering anatomically respectful canal shaping. Clinicians should integrate knowledge of alloy properties, design features, and failure mechanisms with conservative, load-managing techniques to maximize safety and efficiency.

Resumo em Inglês:

Abstract This review summarizes the literature on association between gastroesophageal reflux disease (GERD) and bruxism. A systematic search was performed in June 2024 and updated in October 2025 across electronic databases (MedLine/PubMed, LILACS/BBO, SciELO, EMBASE, Scopus, and Web of Science) and grey literature (OpenGrey, ProQuest, and LIVIVO). Case reports, clinical trials, and observational studies addressing the GERD-bruxism association in individuals of any age without systemic diseases, syndromes, or neuromotor disorders were included. Study selection and data extraction were independently conducted by two reviewers. Twenty-two articles met inclusion: six case reports, six cross-sectional studies, four case-control studies, and six clinical trials, totaling 15,889 participants (73.4% women; mean age 44.5 years). All but three cross-sectional studies reported an association between GERD and bruxism. Clinical studies have consistently demonstrated that esophageal acidification, whether experimentally induced or present in patients with GERD, increases the hourly frequency of rhythmic masticatory muscle activity (RMMA), short bursts and RMMA with grinding. Two clinical trials that tested proton pump inhibitors observed a reduced RMMA frequency. One clinical study assessed awake bruxism, and two observational studies assessed sleep bruxism. Bibliometric analysis identified 9 author clusters and 17 collaboration networks, with research concentrated in Japan but showing marked global growth from 2018 to 2025. Bruxism and GERD showed a positive association. However, methodological heterogeneity and numerous confounders prevented robust evidence and limited the clinical inference. Bibliometric analysis shows that research remains centered in Japan but is expanding globally, reflecting growing interdisciplinary interest and the need for greater international and methodological integration.