Repositório RCAAP

ABSTRACT Objective: To evaluate the bond strength of repairs with the self-adhering flowable composite Vertise Flow (Kerr) and a conventional composite resin Filtek Z350 (3M ESPE) subjected to different surface treatments. Methods: Forty specimens were divided into four groups: ZV (Filtek Z350 + Vertise Flow, without prior treatment); ZAV (Z350 + Vertise Flow with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); ZAZ (Filtek Z350 + Filtek Z350 with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); VV (Vertise Flow + Vertise Flow, without prior treatment). After 15 days of storage, the specimens were subjected to microtensile tests (Kratos IKCL3-USB, SP, Brazil), with speed of 0.5 mm/min and 20kg load. For statistical analysis, ANOVA with Tukey tests were used (p < 5%). Results: The mean values of the bond strength were highest respectively in the groups: ZV (36.07 ± 37.63); ZAZ (24.04 ± 28.51); VV (19.39 ± 28.24) and ZAV (16.06 ± 15.66). The bond strength of the repairs between the groups presented satisfactory results. Conclusion: The self-adhesive composite resin Vertise Flow seems to be a viable and fast alternative for composite resins repairs.

ABSTRACT Objective: This study aimed to evaluate the association between glycemic control status in type 2 diabetes mellitus (T2DM) patients and apical periodontitis. Methods: Twenty-seven patients were involved in this study. The survey was based on anamnesis, intra and extra oral examination and radiographic evaluation. Diabetes mellitus information involved type of diabetes and blood glucose analysis. Patients were divided according to their metabolic control status (glycemic controlled and poorly controlled T2DM patients). Results: A higher fasting blood glucose level (p = 0.004) and a higher percentage of HbA1c (p = 0.0001) were demonstrated in poorly controlled T2DM patients when compared to glycemic controlled T2DM. However, the frequency of apical periodontitis and the elapsed time since diabetes mellitus diagnosis were higher in controlled T2DM patients, reaching 64%. Nevertheless, controlled T2DM patients presented a higher number of apical periodontitis cases (p < 0.05). Findings support that controlled patients T2DM presented higher presence of apical periodontitis than poorly controlled T2DM ones. In these patients, the time elapsed since the diagnosis was higher, which may have provided a longer period of oscillation and/or uncontrolled metabolism. Conclusions: Therefore, it might contribute to the development and maintenance of apical periodontitis in glycemic controlled patients of this study.

ABSTRACT Objective: The present study aimed to analyze the accuracy of the Dolphin Imaging 11.9® computer program in the surgical prediction of the soft tissue facial profile. Methods: The investigators designed and implemented a retrospective study. It was used a sample of 55 patients, being 14 males and 41 females, aged from 19 to 55 years old. All patients were subjected to surgery orthognathic bimaxillary combined with mentoplasty, in Class II facial profile – Angle. Patients’ actual results were compared to the obtained up to a year and a half after the surgery procedure. The study was delineated in three phases. In the first phase, cephalometric preoperative radiographs were performed; in the second phase the postoperative cephalometries were made; in the third phase, the measurements of the soft profile of the virtual analysis were compared with the real post-surgical profile. The data was collected and subjected to statistical analysis in the “R” program, using the t test and ANOVA. Results: The results demonstrated that measures A’ and Eis were underestimated in -0.15 ± 0. 52 mm and -0.47 ± 1.05 mm, respectively, while measures Pg’ and ANL were overestimated at 0.76 ± 1.98 mm and 3.31 ± 3.60° respectively. There was no evidence of measures, Ls, Li and B’, being different between real and virtual. Conclusions: The results of this study suggest that Dolphin 11.9® computer program complies with the function of preserving with reliability virtual surgical planning.

ABSTRACT Objective: To analyze the self-perception that older adults have about rehabilitation regarding their uni or bimaxillary dentures. Methods: A form was applied to investigate the sociodemographic, economic and medical-dental variables of the users, a questionnaire to assess the satisfaction level of patients with their dentures, another to investigate the technical quality of the dentures from the aesthetic-functional point of view, and the Oral Health Impact Profile (OHIP-14) to ascertain the impact of prosthetic rehabilitation on the quality of life of users. Results: The majority of the participants (65.2%) used complete bimaxillary dentures, reported dissatisfaction during chewing, while the lower dentures had unsatisfactory technical quality for the retention requirements (69.6%) and stability (69.6%). The older adults’ complaints were predominantly related to the “physical pain” and “physical disability” domains. There were significant associations between general satisfaction with the dentures in use, their general technical quality and the OHIP-14 domains. Conclusion: The patient complaints were related to difficulties in their ability to chew, speak and with the retention and comfort of the lower dentures. The technical quality of the dentures had compromised retention and stability from the aesthetic-functional point of view. Dentures considered unsatisfactory caused negative impacts on the quality of life of users, especially in comfort during meals which was related to difficulty chewing and swallowing. The association between the instruments used in the study provides important tools for the performance of dental surgeons, in addition to enabling more adequate planning in the oral health services offered to the population.

ABSTRACT Objective: Therefore, the purpose of the currently study was to analyze the expression of the STRO-1 stem cell marker and the marker related to Hsp25 differentiation and dental development during odontogenesis in rats. Methods: Eighteen-day Wistar rat embryos and 7-day-old animals were analyzed morphologically via Hematoxylin and Eosin (HE) staining and via immunohistochemical marking for Stro-1 and Hsp25 in 5uM serial sections. Results: In the HE morphological analysis in 18-day embryos, the stage of tooth development was in the cap phase, while in the 7-day old animals it was in the bell phase. Conclusion: The expression of STRO-1 in the embryos was not found in the region of the dental papilla or enamel organ, however, in the 7-day-old animals, STRO-1-positive cells were found in the region of the dental follicle and dental papilla. As for the Hsp25, this exhibited weak marking in the cap phase while in the bell phase, there was a reaction, mainly in the odontoblasts. The expressions in the site of these markers vary according to the stage of tooth development.

ABSTRACT Objective: To show the relation between sugar intake in the infant diet and the presence of early childhood caries in a group of preschoolers. Methods: A retrospective analysis of medical records of patients aged 0 to 6 years attended at the Clinic of Babies from 2010 to 2016, at Universidade Federal de Santa Maria. The data analyzed were: patient identification, gender, age, sugar introduction (age and frequency), exclusive breastfeeding, use of a bottle containing sugar, brushing (with or without fluoride) and diagnosis of dental caries through the International Caries Detection and Assessment System. Descriptive analysis showed the characteristics of the sample and comparison analyzes were performed using Fisher and T-Student tests, to verify the relation between individual variables and sugary intake. Results: The average age of the children was 29 months. Of the 86 medical records analyzed, 80.0% of the children ingested sugary foods, and its were part of the eating routine. Only 36 medical records contained information about early childhood caries, in which 86.2% of prevalence was found. There was no statistical difference between sugary diet and other variables (p > 0.05). Conclusion: These results suggest an intense relationship between sugar and early childhood caries. The high frequency of sugar intake is a risk factor for the onset of caries in early childhood, and its insertion in infant feeding may be delayed. Food and hygiene orientation is fundamental in the treatment process as well as family awareness.

ABSTRACT Introduction: There is no consensus as to which cemented or screwed retention system is best to avoid bone loss around the implant from a fixed implant-supported restoration. Objective: To evaluate the prosthesis retention systems on screw and cemented implants, regarding: bone loss, survival and failure rate, biological complications and microbiological analysis. Methods: A search was made for scientific articles that contemplated the subject through the databases Pubmed and SciELO, without period restriction. The titles, abstracts and then access to the full text has been verified. Results: It was found that excess cement may play an important role in the development of peri-implant disease. Technical failures are most seen in prosthesis retained by screws, and biological complications in cemented crowns. The success rate for both restraint systems is high, and retention-independent implant prosthesis treatment provides predictability. Conclusion: The appropriate retention system for the patient depends on several factors, including indication, advantages and disadvantages, retention provided, aesthetics and clinical performance.

ABSTRACT Introduction: In Brazil, about 18.500 people have some kind of hereditary coagulopathy. In combination, the increase in life expectancy has led to an increasingly frequent presence of older people in medical offices. These patients make use of many drugs, including those that produce anticoagulant effects. The dentist should be aware about the impact of bleeding disorders during the approach of their patients, especially if invasive procedures are considered. Objective: To identify the most prevalent blood dyscrasias presented by patients covered by the Program of dental surgical care to patients with blood dyscrasias; to establish the presence of associated diseases and investigate the correlation between pre- and postoperative drug protocols and the occurrence of postoperative complications. Methods: This was an epidemiological retrospective cross-sectional study of medical reports used by the program. After the survey of defined variables, data were tabulated in Microsoft Excel ® software and evaluated using the chi-square and Fisher’s exact tests. Results: One patient was identified as having Human Immunodeficiency Virus and 18 with Hepatitis C virus. There was a statistically significant difference between patients with haemophilia B and Hepatitis C. The administration of tranexamic acid as pre- and post-surgical protocol was the therapy of choice. Of the 11 patients with vWD, 7 of them received tranexamic acid as preoperative medication. Conclusion: The appropriate retention system for the patient depends on several factors, including indication, advantages and disadvantages, retention provided, aesthetics and clinical performance.

ABSTRACT Objective: The aim of this cross-sectional study was to evaluate the anatomical characteristics of edentulous residual ridges in stone casts of complete dentures users and assess correlations with masticatory efficiency. Methods: The sample included 74 study casts, of which 37 were higher and 37 bottom. Measurements were performed using a drypoint compass and a transparent ruler. Arches and ridges of maxillae and mandibles were classified into small, medium, and large. Masticatory efficiency was obtained by the sieve method with the old prostheses and 3 months after placement of new prostheses. The correlations between the anatomical variables of the ridges and arches (height, width and size) and masticatory efficiency were verified by the Spearman correlation test. Significant differences in masticatory efficiencies were assessed by the Wilcoxon test. Results: People with larger maxillary alveolar ridge presented better masticatory performance with old and new dentures. There was no correlation between maxillary ridge width and size with masticatory efficiency, but a correlation was found between maxillary arch width and masticatory efficiency evaluated with the old dentures. Conclusions: With the new dentures, the correlation had a tendency for significance. For the mandible, no correlation was found between height, width, and size of the ridge or with width, length, and size of the arch and masticatory efficiency. In addition, there was no significant difference between masticatory efficiencies evaluated with the old and new prostheses. For the maxilla, ridge height and arch width influence masticatory efficiency. For the mandible, the anatomy had little influence on masticatory performance.

ABSTRACT The aim of this article was to discuss biosafety measures described in the main protocols for minimizing the risk of COVID-19 transmission during dental care. COVID-19 appeared in China in late 2019 and quickly spread to other countries. Factors inherent to dental practice, such as proximity to the patient, transmission through saliva and breath, and the generation of aerosols during procedures, place the dental team at the top of the list among the most vulnerable healthcare providers. Health authorities initially recommended only maintaining urgent and emergency care and suspending elective dental procedures. Currently, elective care is gradually being resumed and requires numerous adjustments to the environment and professional routine in terms of biosafety. Several methods had been recommended to prevent the spread of other infectious diseases prior to the outbreak of COVID-19. However, further modifications are needed for the waiting room, patient screening and flow, procedures, garments, and even in dental office itself. Thus, dental professionals need to be prepared to adopt the new recommendations in order to reduce the chance of disease transmission.

ABSTRACT COVID-19 began in December 2019 in Wuhan City, China, and on March 11, 2020 it was classified by the World Health Organization as a pandemic. It is an asymptomatic infection that can progress to severe respiratory conditions. In adults, it is more prevalent, but is also observed in children, with the occurrence of extra respiratory symptoms, such as oral and cutaneous manifestations. This literature review aims to report the oral and cutaneous manifestations of COVID-19 in pediatric patients. The bibliographic search strategy was carried out in the PubMed, SciELO and Bireme databases on August 1, 2020, using MeSH Terms “COVID-19”; “Child”; “Oral Manifestations”; “Skin Manifestations”; “Ageusia”; “Dysgeusia” and corresponding Decs, and also manual search, without language restriction. The stages of search, screening, selection, evaluation of studies and data extraction were performed by four independent reviewers. Nine studies that met the eligibility criteria were identified. The most cited oral and cutaneous manifestations were, respectively, taste dysfunction in adolescents and erythematous eruption in extremities and trunk. Health professionals should be aware of these manifestations, however, this is a recent theme in the literature, and more careful studies with greater strength of evidence still need to be performed.

ABSTRACT With improvements in dental aesthetic requirements an increasing number of adults are seeking orthodontic treatment that, along with current lifestyle and eating habits of the adult population, makes orthodontists more likely to encounter patients with metabolic disorders such as diabetes mellitus. Speculated that the diabetic patient during orthodontic treatment may not experience a physiological healing process as a healthy patient. Therefore, the objective of this work is to present a current and contextualized review of the mechanisms by which uncontrolled diabetes mellitus impacts on bone remodeling and orthodontic tooth movement during the application of orthodontic forces. The following databases were searched MEDLINE (via PubMed), Scopus, Web of Science, SciELO, LILACS and open grey with these MeSH “bone remodeling”, “diabetes mellitus”, “orthodontic” and “tooth movement”. Five articles remained after search strategy and were analyzed. In sum, no clinical studies were found, the evidence was limited to animal studies (rats). The results suggest that there are differences in bone remodeling and tooth movement during the application of orthodontic forces in animals with diabetes mellitus when compared to healthy animals, especially when the disease is associated with periodontal disease. However, the results are still controversial and may be due to different study protocols.

ABSTRACT The fast spread of COVID-19 around the world has generated significant impacts on the way societies lives, one of which is the scarcity of personal protective equipment (PPE) for workers in the front lines of combat against the virus. Sanitary insecurity has led populations and health professionals to a rampant search for protective equipment and other devices necessary for life maintenance, both for patients and professionals, revealing health system limitations during large-scale crisis, as the COVID-19 pandemic. On this paper, we aimed to present the initiatives of professionals and companies related to 3D printing to share programs and resources whose purpose is supplying workers in the front line, who have been important allies in combating the effects caused by coronavirus. A search was performed in four electronic databases: SCOPUS, BVS, EMBASE and MEDLINE via PUBMED. After analyzing the inclusion and exclusion criteria, a table of results was prepared with the main characteristics of the products manufactured and made available, as well as the institutions involved. It was concluded, therefore, that the applications of 3D printing in the initiatives had great contributions to public health and the additive industry during the pandemic period of COVID-19.

ABSTRACT The Covid-19 is a global health threatening pandemic, so dental surgeons need to look for strategies to perform dental care safely for the patient, the dental professional himself, and the dental team. The goal is to design strategies to optimize dental impression practice during the Covid-19 pandemic. The strategies that optimize dental impression practice during the pandemic are to adopt the digital fingerprint workflow. If necessary, a conventional impression technique that favors the professional’s performance, select the impression material that is easy to decontaminate and affinity for the professional; the plaster leak must be performed still inside the dental office, and then the disinfection of the plaster model must be previously sent to the prosthesis laboratory.

ABSTRACT News of the symptoms caused by a coronavirus in humans began to be documented in December 2019, when several cases of pneumonia caused by the virus occurred in China. Studies are showing the increasing role of saliva and oral cavity in the transmission of the virus, because the receptors of epithelial cells in this region play a critical role by allowing the virus to enter those cells. The standard method to diagnose the coronavirus is based on the collection of samples in the nasopharynx and oropharynx to detect viral RNA. However, this method results in the interaction between health care professionals and patients, which increases risk of transmission; moreover, this collection can be painful for the patient and cause bleeding. As an alternative, diagnosis can be made using saliva, which only requires patients to deposit the saliva sample in a sterile container. Thus, the objective of this literature review is to present the main forms of contagion and to describe the diagnosis tools, emphasizing the risk that dental professionals are exposed to and, therefore, the growing need for better and faster diagnostic methods for coronavirus, especially using saliva. Medline, PubMed, SciELO, and Bireme databases were used for the literature search with the descriptors: Salivary diagnosis, COVID-19, and Contagion. The review explored the scientific race to develop more effective forms of diagnosis, including saliva tests, and prevention methods taking into account time, accessibility, and cost-benefit and, as a consequence, the role of dentistry has been continuously increasing.

ABSTRACT COVID-19 outbreak may lead to major impacts in applied oral sciences. Remarkably, it could be expected that factors associated to pandemic may lead to a greater risk of developing, worsening and perpetuating TMD and its associated risk factors. This non systematic literature review aims to discuss how the COVID-19 pandemic can influence the emergence, maintenance or worsening of TMD worldwide. During epidemics: the number of people whose mental health is affected tends to be greater than the number affected by the infection, and fear increases anxiety and stress levels in healthy individuals; chronic pain patients probably not receipt important treatments; overuse of medications becomes frequent; there are manifestation of unconscious oral parafunctional habits and poor sleep quality. All these facts represent risk factors common to TMD. Dentists should be aware of these issues and adapt their practices to properly diagnose and treat these patients within a multifactorial approach, increasing the quality of life of these individuals.

ABSTRACT Resin matrix ceramics consist in a polymeric matrix with predominantly inorganic refractory compounds which may include porcelain, glass, ceramics, and glass ceramics, and are divided into three subgroups: Nanoceramics, Vitroceramics, and Zirconia-silica. The aim of this study was to compare, through a literature review, the mechanical and biological properties of resin matrix ceramics, with glass matrix ceramics and polycrystalline ceramics. After reviewing 44 articles found in the US National Library of Medicine (PubMed) database (studies published in English, human clinical studies, in vitro or in vivo studies) that evaluated some properties of this material, such as elasticity modulus, wear resistance, adhesiveness, stain resistance and hardness, this article concluded that, although they belong to the same group, resin matrix ceramics are different from each other due to their microstructures. Moreover, when compared to other ceramic groups, it showed some superior properties, such as flexural strength, fatigue strength and internal adaptation.

ABSTRACT The severe acute respiratory syndrome of the new coronavirus, SARS CoV-2, which became a pandemic, was first reported in Wuhan, Hubei, China, in December 2019. It can cause mild symptoms, but in some cases, it can cause serious complications, leading to death. The disease spreads through aerosol droplets and has an estimated incubation period between 2 and 14 days (a period in which the patient has high potential to infect other people). Endodontists have a high risk of exposure to COVID-19 when compared to other health professionals, since most of the work involves the generation of aerosols and care for patients in emergency situations, such as symptomatic irreversible pulpitis, symptomatic apical periodontitis, acute apical abscess and traumatic dental injuries, is imperative. Thus, this critical review addresses considerations about endodontic care in times of pandemic, whose emergencies imply a real need for treatment, as well as the care that must be adopted to minimize risks for both professionals and patients who seek the resolution of their clinical pain conditions.

ABSTRACT Although prior to the pandemic there was some resistance to the virtualization of dental education, the COVID-19 pandemic is providing us a unique opportunity to overcome several barriers that previously blocked the adoption of remote teaching and teledentistry. Thanks to the extended availability of telecommunications, digital technologies, and platforms, remote education and teledentistry appear to be the preferred choice to maintain dental education and patient care active under this pandemic, without contamination risks. In this paper, we review valid remote education strategies and possible alternatives useful in virtual transformation in dental education. Furthermore, the role of teledentistry and its advantages and challenges are also revised. Under the current pandemic context, as dental educators, we are called to be creative and flexible. Every dental school should adapt and use remote education as much as possible until clinical attention can be readopted. The evidence presented in this review supports our position that under this pandemic, remote education and telemedicine/teledentistry may be “the virtual convenient solution”, to adapt and improve the hitherto classic way of teaching dentistry through tele-education.

ABSTRACT The objective of this study was to report a clinical case of facial rehabilitation with an acrylic implant-retained nasal prosthesis after partial rhinectomy resulting from the resection of a basal cell carcinoma in the patient, a 53-year-old Caucasian, normosystemic, professional cowboy. After clinical examination and in possession of computed tomography images, surgery was performed for the placement of conventional dental implants in the premaxillary region (left side). After the surgery, a three-month period of waiting was observed to allow osseointegration of the implants. Later, the nasal prosthesis was prepared, and at the end of treatment, this presented satisfactory peripheral adaptation, retention and esthetics. The patient has returned for follow-up every 6 months, regarding analysis of the prosthesis color, peri-implant health, hygiene, and exchange of the magnets and relays when necessary. The authors concluded that this therapy may be well indicated in patients with partial and total nasal defects, provided that there is correct planning and execution of the surgical, clinical and laboratory phases.