Bioactive and biocompatible cement as a single element in pulpotomy of deciduous teeth: a randomized clinical trials / Cimento bioativo e biocompatível como elemento único em pulpotomia de dentes decíduos: ensaio clínico randomizado

ABSTRACT Objective: Pulpotomy in deciduous teeth maintains the integrity and health of deciduous teeth and supporting tissues until a permanent tooth has erupted. PBS HD CIMMO® cement was evaluated in deciduous teeth pulpotomies as base material and restoration. A randomized clinical trial was performed Methods: This study was approved by the Ethics Committee of (Universidade Vale do Sapucaí) UNIVÁS with Certificate of Presentation for Ethical Consideration, protocol number is: 1.771.929. 60 deciduous molar teeth from 32 healthy children were selected. These teeth were divided into two groups: G1 with 30 teeth, in which the classictreatment with formocresol was used, and G2 with 30 teeth, in which PBS HD CIMMO® cement was used as base and simultaneous final restoration. The evaluation was performed 12 months after the intervention through clinical and radiographic exams. Fisher's exact test was performed to correlate the clinical and radiographic aspects in both groups Results: There was no significant difference (p= 0.090) in the clinical-radiographic evaluation. PBS HD CIMMO® cement is option to be used as a single element in pulpotomies of deciduous teeth Conclusion: Longitudinal studies should be performed in order to demonstrate a significant association between these groups. The study was enrolled in clinical trials (clinical trials.gov) with registration NCT03200938.

RESUMO Objetivos: A pulpotomia em dentes decíduos mantém a integridade e a saúde dos dentes decíduos e dos tecidos de suporte, até a erupção de um dente permanente. O cimento PBS HD CIMMO® foi avaliado em pulpotomias de dentes decíduos como material de base e restauração. Um ensaio clínico randomizado foi realizado. Métodos: Este estudo foi aprovado pelo Comitê de Ética da Universidade Vale do Sapucaí, UNIVÁS, com Certificado de Apresentação para Consideração Ética, número do protocolo: 1.771.929. Foram selecionados 60 dentes molares decíduos de 32 crianças saudáveis. Esses dentes foram divididos em dois grupos: G1 com 30 dentes, no qual foi utilizado o tratamento clássico com formocresol e G2 com 30 dentes, no qual o cimento PBS HD CIMMO® foi utilizado como base e restauração final simultânea. A avaliação foi realizada 12 meses após a intervenção através de exames clínicos e radiográficos. O teste exato de Fisher foi utilizado para correlacionar os aspectos clínicos e radiográficos nos dois grupos. Resultados: Não houve diferença significativa (p = 0,090) na avaliação clínico-radiográfica. O cimento PBS HD CIMMO® é uma opção para ser usado como um elemento único em pulpotomias de dentes decíduos. Conclusão: Estudos longitudinais devem ser realizados para demonstrar uma associação significativa entre esses grupos. O estudo foi inscrito em ensaios clínicos (Clinical Trials.gov) com o registro NCT03200938.

Nickel allergy: blood and periodontal evaluation after orthodontic treatment / Alergia ao níquel: avaliação periodontal e sanguínea após o tratamento ortodôntico

The aim of this study was to assess periodontal status and bloodparameters in orthodontic patients with nickel allergy one monthafter removal of brackets. Ninety-six randomly selected patientswere initially evaluated. Allergy to nickel was diagnosed using apatch test. After determining the prevalence of subjects allergic tonickel, two groups were formed: 16 allergic (experimental) and 16non-allergic (control) patients. Their periodontal status wasdetermined regularly by a single, blinded, duly calibrated examinerusing the Lõe Index (GI) and their blood was tested (complete bloodtest, including nickel and IgE levels) after nine months oforthodontic treatment and again one month after removing theorthodontic appliances. Statistical analyses included paired andnon-paired t-tests, Mann-Whitney, Wilcoxon, McNemar and lineartrend chi-square tests (p≤0.05). Comparison of the values recordedduring orthodontic treatment and one month after removing theappliances showed that in the allergic group there was significantincrease in eosinophils (p=0.046), basophils (p=0.001) andmonocytes (p=0.002), and decrease in number of bands (p=0.000),while in the control group, there was increase in lymphocytes(p=0.039) and decrease in segmented neutrophils (p=0.030) andIgE levels (p=0.001). In both groups, plasma nickel levels increased(p=0.010; p=0.039) and GI scores decreased. One month afterremoving the brackets, blood and periodontal parameters frompatients with and without nickel allergy were similar.

O objetivo do presente estudo foi avaliar a condição periodontal eos parâmetros sanguíneos em pacientes alérgicos ao níquel, ummês após remoção dos aparelhos. Noventa e seis pacientesselecionados aleatoriamente foram inicialmente avaliadas. Alergiaao níquel foi diagnosticada usando um teste de contato. Após adeterminação da prevalência de alergia ao níquel, formaram-sedois grupos: 16 pacientes alérgicos (experimental) e 16 nãoalérgicos (controle). Condição periodontal foi diagnosticadaatravés do Índice de Lõe (IG). Parâmetros sanguíneos foramdeterminados por meio de um exame de sangue completo,incluindo a quantificação de níquel e níveis de IgE. Avaliações doestado periodontal foram realizados por um único examinador deforma cega, devidamente calibrado e amostras de sangue foramtomadas depois de nove meses de tratamento e um mês após aremoção dos aparelhos ortodônticos. Análise estatística utilizadafoi testes t pareado e não pareado, Mann-Whitney, Wilcoxon,McNemar e qui-quadrado de tendência linear (p≤0,05). Emcomparação com os valores observados durante o tratamento, onúmero de eosinófilos (p=0,046), basófilos (p=0,001) e monócitos(p=0,002) aumentou significativamente depois da remoção dosaparelhos ortodônticos, ao passo que o número de bastões(p=0,000) diminuiu entre os períodos no grupo alérgico. O númerode linfócitos (p=0,039) aumentou no grupo controle e o número desegmentados (p=0,030) diminuiu. A diminuição dos níveis de IgE(p=0,001) entre os períodos ocorreu no grupo de controle. Níveisde níquel no plasma aumentou após a remoção de aparelhosortodônticos em ambos os grupos (p=0,010; p=0,039). O IGdiminuiu em ambos os grupos. Parâmetros periodontais esanguíneos de pacientes com alergia ao níquel foram semelhantesaos não alérgicos um mês após a remoção dos aparelhos.

Is there justification for prophylactic extraction of third molars? A systematic review

The present systematic review was performed to investigate if there is evidence justifying the prophylactic extraction of third molars, one of the most frequent procedures in oral surgery. A series of searches was carried out for randomized, clinical trials and systematic reviews in seven databases (MEDLINE, BBO, LILACS, Web of Science, EMBASE, BIREME and Cochrane Library), with no restrictions regarding year or language. A supplemental manual search of the references of retrieved articles was also performed. The search strategy resulted in 260 papers. Both the data extracted and the quality of each paper were evaluated independently by two reviewers. After selection based on the preestablished eligibility criteria, four papers qualified for the final analysis. A medium degree of quality and methodological consistency was found in three studies, and low quality was found in one study. No studies showed a high degree of consistency. The most significant flaw was an inadequate sample size. The results of the present review indicate a lack of scientific evidence to justify the indication of the prophylactic extraction of third molars.

Nickel: humoral and periodontal changes in orthodontic patients

INTRODUCTION: Although several studies have discussed nickel influence on the development of immunological reactions in orthodontic patients, it is noticed that the evidence towards the appliances, as well as towards the possible consequences of this material on the oral and general health of the individual are still inconsistent. OBJECTIVE: The aim of this article is to present the current stage of knowledge on this issue, highlighting the most recent findings considering the periodontal and humoral aspects of allergic subjects.

Condições sanguíneas e gengivais em pacientes alérgicos ao níquel submetidos a tratamento ortodôntico com braquetes convencionais e níquel free / Conditions blood and gingival in nickel allergic patients undergoing orthodontic treatment with conventional and nickel free braces

Este estudo teve como objetivo identificar em uma população de pacientes ortodônticos aqueles que são alérgicos ao níquel, bem como verificar se existem diferenças entre esses indivíduos, considerando especificamente a condição gengival e sanguínea em caráter longitudinal, através da utilização de braquetes convencionais e níquel free no tratamento ortodôntico. A população do estudo foi composta por 80 pacientes, de ambos os gêneros, faixa etária 10 anos e 8 meses a 43 anos e 1 mês. Para diagnóstico da alergia ao níquel, foram realizados testes de contato 1 mês antes do início do tratamento. Quarenta e dois pacientes apresentaram alergia e foram divididos de forma randomizada em 2 grupos...

Allergic reactions and nickel-free braces: a systematic review

Nickel-free braces have gained popularity as a viable alternative for patients who are allergic to nickel. The purpose of this systematic review was to determine whether evidence exists to justify the use of nickel-free brackets in orthodontic patients who are allergic to nickel. An electronic search was performed using 7 databases (MEDLINE, BBO, LILACS, Web of Science, EMBASE, BIREME and Cochrane Library), without restriction regarding year or language, with supplemental manual searching of the references of retrieved articles. The search strategy produced 89 papers. The data extraction and quality score of each paper were evaluated independently by two reviewers, once each. After selection based on the eligibility criteria, four papers, including 2 controlled clinical trials and 2 clinical trials, qualified for the final analysis. Quality assessment of the included articles was also performed. Nickel-free braces (Ni content - 2 percent max.) seem to represent a viable alternative for orthodontic patients who are allergic to nickel. However, further in vivo studies, considering the immunology characteristics of patients, are needed to determine the clinical implications of the findings of this study.