An assessment of Brazilian dentists' knowledge about tooth fragment reattachment: A cross-sectional study.

BACKGROUND/AIM: Crown fractures are common traumatic dental injuries and tooth fragment reattachment is a viable option for restoring a fractured tooth. The aim of this study was to assess the knowledge and experience of dentists in the Federal District regarding the tooth fragment reattachment technique for enamel and dentin fractures. MATERIALS AND METHODS: For the cross-sectional observational study, an electronic form was designed with objective and self-report questions for dentists. The data were analyzed using descriptive statistics, with their absolute and relative frequencies. For the analysis of categorical variables, the nonparametric chi-squared or Fisher exact association tests were used in the statistical software R (version 4.2.1). RESULTS: A total of 416 dentists participated in the study (58.9% female and 41.1% male). Of these, 70% declared they knew about fragment reattachment, but only 42.3% reported previous experience with this procedure. The most common storage medium used for the fractured fragment was milk (78.1%), and the bonding material used for reattachment was light-cured composite resin (86.3%). A majority (66.3%) reported that for a patient with enamel and dentin fracture, with the crown fragment in good condition, they would choose to do the reattachment. CONCLUSION: Dentists demonstrated that they had adequate knowledge about the tooth fragment technique, although many did not have previous experience with this procedure.

Mutagenicity, hepatotoxicity, and neurotoxicity of glyphosate and fipronil commercial formulations in Amazon turtles neonates (Podocnemis expansa).

Pesticides are considered one of the main causes of the population decline of reptiles worldwide, with freshwater turtles being particularly susceptible to aquatic contamination. In this context, we investigated the potential mutagenic, hepatotoxic, and neurotoxic effects in neonates of Podocnemis expansa exposed to substrate contaminated with different concentrations of glyphosate and/or fipronil during embryonic development. Eggs collected from the natural environment were artificially incubated in sand moistened with pure water, water added with glyphosate Atar 48® at concentrations of 65 and 6500 µg/L (groups G1 and G2, respectively), water added with fipronil Regent® 800WG at 4 and 400 µg/L (groups F1 and F2, respectively) and, water added with the combination of 65 µg/L glyphosate and 4 µg/L fipronil or with 6500 µg/L glyphosate and 400 µg/L fipronil (groups GF1 and GF2, respectively). For mutagenicity analysis, we evaluated the frequency of micronuclei (MN) and other erythrocyte nuclear abnormalities (ENAs), while for evaluation of hepatotoxicity and neurotoxicity, livers and encephalon were analyzed for histopathological alterations. Exposure to pesticides, alone or in combination, increased the frequency of erythrocyte nuclear abnormalities, particularly blebbed nuclei, moved nuclei, and notched nuclei. Individuals exposed to fipronil exhibited congestion and inflammatory infiltrate in their liver tissue, while, in the encephalon, congestion, and necrosis were present. Our study confirms that the incubation of eggs in substrate polluted with glyphosate and fipronil causes histopathological damage and mutagenic alteration in P. expansa, highlighting the importance of using different biomarkers to evaluate the ecotoxicological effects of these pesticides, especially in oviparous animals.

Use of selected samples to diagnose a tricky feline viral disease in a cat with uveitis and neurological signs.

This case involved a 2-year-old neutered male domestic mixed-breed cat that was rescued from the street eight months earlier. The animal presented with weakness, hyporexia, progressive weight loss, fatigue, uveitis, pale mucous membranes, dehydration (7%), and pelvic limb paresis. Aqueous humor was collected for molecular analysis for the differential diagnosis of potential etiological agents [Feline coronavirus (FCoV), Feline leukemia virus (FeLV), Feline immunodeficiency virus (FIV), Toxoplasma gondii, Cryptococcus spp., Felid herpesvirus-1 (FHV-1) and Bartonella spp.] of feline uveitis. The sample was positive by real-time reverse transcription-polymerase chain reaction (RT-qPCR) for FCoV and RT-qPCR and real-time polymerase chain reaction (qPCR) for FeLV and qPCR FIV. The cat was euthanized due to poor clinical outcomes and prognosis. A cerebrospinal fluid (CSF) sample was collected and tested, and the same pathogens were found in the aqueous humor. Small-cell follicular multicenter lymphoma and multifocal pyogranulomatous meningoencephalitis were observed upon histopathological analysis. In this study, aqueous humor and cerebrospinal fluid samples were efficient for the detection of coinfection with FIV, FeLV, and FCoV.

O caso refere-se a um gato de dois anos de idade, sem raça definida, resgatado da rua há oito meses. O animal apresentava fraqueza, hiporexia, emagrecimento progressivo, cansaço fácil, uveíte, mucosas pálidas, desidratação (7%) e paresia de membros pélvicos. O humor aquoso foi coletado para o diagnóstico molecular diferencial de potenciais agentes etiológicos [coronavírus felino (FCoV), vírus da leucemia felina (FeLV), vírus da imunodeficiência felina (FIV), Toxoplasma gondii, Cryptococcus spp., herpesvírus felino tipo 1 (FHV-1) and Bartonella spp.] causadores de uveíte felina. A amostra foi positiva na reação em cadeia da polimerase precedida por transcrição reversa em tempo real (RT-qPCR) para FCoV, RT-qPCR e reação em cadeia da polimerase em tempo real (qPCR) para FeLV e qPCR para FIV. O animal foi submetido à eutanásia - devido ao quadro clínico e prognóstico desfavorável. Amostra de líquido cefalorraquidiano (LCR) foi coletada e testada, confirmando a identificação dos mesmos patógenos encontrados no humor aquoso. Linfoma multicêntrico folicular de pequenas células e meningoencefalite piogranulomatosa multifocal foram observados na análise histopatológica. Neste relato, as amostras de humor aquoso e líquido cefalorraquidiano foram eficientes para a detecção de coinfecção por FIV, FeLV e FCoV.

Eggshell composition of Amazon turtle (Podocnemis expansa) is altered after incubation in substrates containing glyphosate and fipronil formulations.

Besides its crucial role during embryo development, eggshells are an essential bioindicator of environmental contaminants. However, the effects of contaminant exposure during incubation on the eggshell composition remain poorly known for freshwater turtles. Accordingly, we tested the effects of incubating the eggs of Podocnemis expansa in substrates containing glyphosate and fipronil formulations on the eggshell's level of mineral and dry matter, crude protein, nitrogen, and ethereal extract. Eggs were incubated in sand moistened with water contaminated with glyphosate Atar 48 at concentrations of 65 or 6500 µg/L, fipronil Regent 800 WG at concentrations of 4 or 400 µg/L, or the combination of 65 µg/L glyphosate and 4 µg/L fipronil and 6500 µg/L glyphosate with 400 µg/L fipronil. Exposure to the tested pesticides, alone or in association, altered the chemical composition of the eggshell of P. expansa, reducing the eggshell's moisture and crude protein content and increasing levels of ethereal extract. These changes may cause significant deficiencies in the mobilization of water and nutrients to the embryo, affecting the development and reproductive success of P. expansa.

Manejo de cárie radicular: um guia para o dentista brasileiro baseado na tradução e adaptação cultural do consenso internacional/ORCA E EFCD / Management of root caries: a guide for the Brazilian dentist based on the translation and cultural adaptation of the international consensus/ORCA and EFCD

Objetivo: A cárie radicular é um problema da Odontologia moderna, porém é notável a falta de diretrizes sobre o seu manejo. Objetivamos elaborar e adaptar um guia a partir da tradução das recomendações do consenso in-ternacional European Organization for Caries Research (ORCA) e European Federation of Conservative Dentistry (EFCD) para as tomadas de decisão clínica na intervenção do processo de cárie na pessoa idosa, com foco na cárie radicular. Materiais e métodos: O protocolo de tradução das recomendações do consenso internacional consistiu nas etapas: (1) tradução inicial, (2) síntese da tradução, (3) retradução, (4) revisão por comitê de especialistas, com adaptação cultural. A partir da tradução, foi desenvolvido um guia com diretrizes para tratamento de cárie radicular no Brasil. Resultados: Para prevenção de novas lesões é recomendada a escovação diária com dentifrício >1.500ppm/F. Dentifrícios com 5.000ppm/F ou vernizes (>20.000ppm/F) podem ser indicados para paralisar lesões radiculares ativas e para prevenção em pessoas idosas com alta suscetibilidade à cárie radicular, e o Diamino Fluoreto de Prata (>30%) para paralisar lesões ativas. Intervenções invasi-vas diretas são indicadas dependendo da situação clínica. Discussão: Nota-se uma falta de interesse em estudos primários sobre tratamentos para cárie radicular, criando assim uma lacuna em relação ao seu manejo, que reflete no nível de evidência detectado pelo consenso. Conclusão: Guias clíni-cos são importantes para reduzir a lacuna entre a pesquisa e a prática clínica. Essa tradução para o português facilitará o acesso dos dentistas bra-sileiros em relação a evidência consolidada até o momento para o manejo de cárie radicular.

Aim: Root caries are a problem in modern dentistry, but the lack of guidelines regarding their management is notable. We aim to develop and adapt a guide based on the translation of the recommendations of the international consensus as outlined by the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) for clinical decision-making in the intervention of the caries process in the elderly, with a focus on root caries. Materials and methods: The protocol for translating the recommendations of the international consensus consisted of the following steps: (1) initial translation, (2) synthesis of the translation, (3) back-translation, (4) review by an expert committee with cultural adaptation. Based on the translation, a guide was developed with guidelines for the treatment of root caries in Brazil. Results: To prevent new lesions, daily brushing with toothpaste >1,500ppm/F is recommended. Toothpaste with 5,000ppm/F or varnishes (>20,000ppm/F) may be recommended to paralyze active root lesions and for prevention in elderly people with high susceptibility to root caries, and Silver Diamine Fluoride (>30%) to paralyze active lesions. Direct invasive interventions are indicated depending on the clinical situation. Discussion: There is a lack of interest in primary studies on treatments for root caries, thus creating a gap in relation to its management, which is reflected by the level of evidence detected in the consensus. Conclusion: Clinical guidelines are important to reduce the gap between research and clinical practice. This translation into Portuguese will facilitate access by Brazilian dentists to the consolidated evidence gathered to date for the management of root caries.

Composite Resin Preheating Techniques for Cementation of Indirect Restorations.

Purpose: Resin-based materials have been preheated by using different techniques and commercial devices. However, a consensus on the clinical protocol for cementing with preheated composite resins is lacking. The aim of this scoping review was to identify the different methods used for heating composite resins as used for cementing indirect adhesive restorations and to determine the benefits and limitations. Study Selection. A search was performed on PubMed/MEDLINE, Embase, Cochrane, Web of Science, Scopus, LIVIVO, and the nonpeer-reviewed literature database. Studies on preheating composite resins for cementing indirect restorations were included, with no restrictions on the type of study, year of publication, or language. The following data were extracted: preheating technique, the device used for preheating, preset temperature, and warming time. Results: In total, 304 studies were identified. After removing duplicates, 270 articles were selected, and 14 articles were included in the final evaluation. Half of the included studies reported similar preheating techniques using the Calset device for composite resins. The temperatures of 54°C and 68°C were most frequently reported, with a mean warming time of 5 minutes. Conclusions: Preheating composite resins for the cementation of indirect restorations reduces viscosity, but the material must be used promptly after removal from the device. Practical Implications. Different methodologies for preheating composite resins have been reported and used in clinical dental practice. To achieve good results and guide the clinician on use, the techniques for heating composite resins for cementation need to be standardized. Keeping the material warm until the restorative procedure, the thickness of the indirect restoration, and the composition of the composite resins can directly affect the outcome of the procedure.

Traumatic dental injuries in the primary dentition and sequelae in the permanent dentition: a 7-year retrospective study / Lesões dentárias traumáticas na dentição decídua e sequelas na dentição permanente: um estudo retrospectivo de 7 anos

Objective: Traumatic dental injuries (TDIs) affect the aesthetics and function of primary teeth and can cause sequelae in their permanent successors. This study assessed the distribution of TDIs and sequelae in the primary dentition and the respective permanent dentition in children treated at the Dental Trauma Centre in Brazil. Material and Methods: This cross-sectional study was conducted by collecting data from 256 dental records over 7 years. Descriptive statistical analyses and the Fisher exact test were used (p=0.05). Results: Sixty-two patients presented with trauma in the deciduous teeth. TDIs were observed mostly in boys (64.50%) and in the 2 to 4-year age group (44.10%); most injuries occurred from fall from the child's own height (40.30%) and at home (71.20%). The most common type of trauma was subluxation (22.90%). The most prevalent clinical and radiographic sequelae were mobility (45.60%) and periapical lesion (31.80%), respectively. Regarding the permanent dentition, the most frequent sequela was hypomineralization (33.30%). Conclusion:According to this study, TDIs in deciduous teeth made up 29.24% of all the cases in the Dental Trauma Program. The major type of trauma in children was subluxation, with sequelae in both dentitions. Follow-up after trauma is important to the maintenance of primary dentition and to prevent and treat possible sequelae in the permanent dentition.(AU)

Objetivo: Lesões dentárias traumáticas (TDIs) afetam a estética e a função dos dentes decíduos e podem causar sequelas em sucessores permanentes. Este estudo avaliou a distribuição das TDIs e sequelas na dentição decídua e sua respectiva dentição permanente em crianças atendidas no Centro de Trauma Odontológico no Brasil. Material e Métodos: Trata-se de um estudo transversal realizado por meio da coleta de dados de 256 prontuários odontológicos ao longo de 7 anos. Foram utilizadas análises estatísticas descritivas e teste exato de Fisher (p <0,05). Resultados:Sessenta e dois pacientes apresentaram trauma na dentição decídua. As TDIs foram observadas principalmente em meninos (64,50%) e na faixa etária de 2 a 4 anos (44,10%); a maioria das lesões ocorreu por queda da própria altura (40,30%) e em casa (71,20%). O tipo de trauma mais comum foi a subluxação (22,90%). As sequelas clínicas e radiográficas mais prevalentes foram mobilidade (45,60%) e lesão periapical (31,80%), respectivamente. Em relação à dentição permanente, a sequela mais frequente foi a hipomineralização (33,30%). Conclusão: De acordo com este estudo, as TDIs em dentes decíduos foram de 29,24% de todos os casos do Programa de Trauma Dental. O principal tipo de trauma em crianças foi a subluxação, com sequelas em ambas as dentições. O acompanhamento após o trauma é importante para a manutenção da dentição decídua e para prevenir e tratar possíveis sequelas na dentição permanente. (AU)

Impact of dental treatment and the severity of traumatic dental injuries on the quality of life of Brazilian schoolchildren.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are most prevalent during adolescence and infancy, and they have an important impact on the oral health-related quality of life (OHRQoL). The aim of this study was to assess the effect of dental treatment and the severity of TDI on the OHRQoL of schoolchildren in public schools in Brazil. MATERIALS AND METHODS: This cross-sectional study evaluated schoolchildren aged 11 to 14 years in Brasilia, Brazil. The criteria used for the examinations were TDI-O'Brien criteria; Dental caries-DMFT criteria; and malocclusion-the Dental Aesthetic Index. The impact of oral health on the children's quality of life was assessed with the Child Perceptions Questionnaire (CPQ11-14 ) that was completed by the children while on the school premises. Socio-demographic information was also collected from the parents. Statistical analysis was performed using non-parametric and association tests, as well as linear regression. RESULTS: A total of 20.2% of the students had some TDI in their permanent anterior teeth; 20% of traumatized teeth were treated, and 80% were not treated. Sorting by severity, 75.1% of the schoolchildren had a TDI involving only the enamel, and 24.9% had a TDI extending beyond the enamel. Significant differences were observed between the severity of a TDI and the total scores of CPQ11-14 (Kruskal-Wallis; p = 0.0026), emotional well-being (p = 0.0006), and social well-being (p = 0.0001) when the group with TDI extending beyond the enamel was compared with the other groups (control and with TDI involving only the enamel), even after adjustment for socio-demographic and clinical variables. For oral symptoms and functional limitation, no differences were observed among the groups. CONCLUSIONS: Dental trauma and fractures extending beyond the enamel, treated or not, have a negative impact on the OHRQoL of schoolchildren, suggesting effects on self-perception and in the social and emotional spheres.

Radiographic Methods Are as Accurate as Magnetic Resonance Imaging for Graft Sizing Before Lateral Meniscal Transplantation.

BACKGROUND: Accurate allograft matching is deemed critical for meniscal transplantation; thus, precise measurements are essential to correctly calculate meniscal size. Several methods for meniscal sizing have been described, but there remains a discussion on which is the most accurate for the lateral meniscus. PURPOSE: To compare the accuracy of radiographic, anthropometric, and magnetic resonance imaging (MRI) methods of determining width and length of the lateral meniscus with actual dimensions after anatomic dissection. STUDY DESIGN: Controlled laboratory study. METHODS: Ten fresh-frozen human cadaveric knees without any evidence of meniscal or ligamentous injury were primarily imaged using radiography and MRI and subsequently underwent dissection to assess the anatomic size of each meniscus. Four methods were used to predict the size of the lateral menisci: anthropometric, radiographic (Pollard and Yoon), and MRI. Absolute differences in length and width between actual and predicted sizes were determined. RESULTS: The anatomic lateral meniscal width and length were 33.01 ± 4.25 mm (mean ± SD; range, 24.84-40.18 mm) and 31.41 ± 5.06 mm (range, 25.2-40.05 mm), respectively. Regarding width, the anthropometric method demonstrated an absolute difference from anatomic measurement significantly greater when compared with the Pollard technique and MRI (P = .002). Regarding length, the Pollard method presented an absolute difference significantly greater than all other techniques (P = .003). In terms of the ability to measure width and length, MRI accurately predicted meniscal size within 10% of the anatomic size in 65% of measurements, the Yoon method in 54%, and the Pollard method in 20% (P = .01). Radiographs tended to overestimate the true size of the lateral meniscus, while the anthropometric technique overestimated width in all specimens. CONCLUSION: This study demonstrated that MRI and the Yoon radiographic method are comparable in terms of accuracy for graft sizing before lateral meniscal transplantation. While MRI is useful, a contralateral MRI is required, which makes the Yoon radiographic method recommended given the ease and cost advantage. The original Pollard technique and the anthropometric method are not recommended. CLINICAL RELEVANCE: Over- and undersizing of meniscal transplants has been implicated in graft failure. Therefore, increasing the reliability of preoperative meniscal measurements is deemed important for the success of meniscal allograft transplantation.

Restorations after selective caries removal: 5-Year randomized trial.

OBJECTIVE: To compare the survival of restorations placed in deep caries lesions after selective caries removal to soft dentin (SCRSD) over a 5-year period. A secondary aim was to investigate whether the material (amalgam or resin composite) affected the survival of restorations. METHODS: This study used data derived from a multicenter randomized controlled clinical trial (Clinical trials registration NCT00887952). Inclusion criteria were: patients with permanent molars presenting occlusal or proximal deep caries lesions (≥1/2 of the dentin thickness on radiographic examination), positive response to a cold test, absence of spontaneous pain, negative sensitivity to percussion, and absence of periapical lesions. The teeth were randomized into SCRSD and restoration in a single visit or stepwise excavation (SW). Each of these groups was divided according to the filling material: amalgam (AM) or resin composite (RC). Survival analyses were performed to estimate therapy success rates over 5 years (adjusted Weibull regression model). RESULTS: 172 restorations were evaluated, 95 from SCRSD group and 77 from SW group, being 61 AMG and 111 RC. The 5-year survival analysis showed similar success rates for SW (76 %) and SCRSD (79 %) as well as for AM and RC (p > 0.05). CONCLUSION: This study showed that, after a 5-year follow-up period, the presence of decayed tissue beneath restorations in deep caries lesions did not seem to affect restoration survival. Amalgam and resin composite restorations had similar survival rates, irrespective of the caries removal technique used - SCRSD or SW. CLINICAL SIGNIFICANCE: Selective caries removal to soft dentin can be used in the management of deep caries to avoid pulp exposure and preserve tooth structure without affecting restoration longevity.

Reattachment of fractured teeth using a multimode adhesive: Effect of different rewetting solutions and immersion time.

BACKGROUND/AIMS: Following coronal tooth fracture, keeping the fragment hydrated is of the utmost importance in the tooth fragment bonding technique. The aim of this study was to evaluate the effects of different immersion times in different storage media on multimode adhesive bonding between reattached fragments and teeth. MATERIALS AND METHODS: A total of 195 bovine incisors were fractured and randomized into the following storage groups (n = 15): G0-control group (sound tooth); GA-saline solution: for 1 hour (A1) or 24 hours (A2); GB-artificial saliva: for 1 hour (B1) or 24 hours (B2); GC-coconut water: for 1 hour (C1) or 24 hours (C2); GD-tap water: for 1 hour (D1) or 24 hours (D2); GE-milk: for 1 hour (E1) or 24 hours (E2); GF-dry (dehydration): for 1 hour (F1) or 24 hours (F2). Tooth fragments were then reattached using a multimode adhesive in a self-mode technique with a flowable resin composite. Fracture resistance was evaluated in a universal testing machine under a compressive load (1 mm/min). The data were submitted to two-way analysis of variance and the post hoc Tukey test (5%). RESULTS: The group submitted to the dehydration factor (GF) exhibited a mean value of 599.1 ± 144.2 N, while those submitted to all hydration protocols (GA, GB, GC, GD, GE) exhibited a mean value of 751.8 ± 285.4 N. Dehydration significantly affected the fracture strength values (P = .005). No significant interaction between the rewetting solutions was observed (P > .05). CONCLUSIONS: Hydration of the tooth fragment increased fracture resistance, regardless of the storage solution and/or immersion time.

Transmission of Toxoplasma gondii Infection Due to Bone Marrow Transplantation: Validation by an Experimental Model.

Toxoplasmosis is an opportunistic infectious disease and may present a fatal outcome for human bone marrow transplant (BMT) recipients, due to the rapid disease course in immunosuppressed individuals. Several reports about occurrence of toxoplasmosis after BMT have been published in the literature, but this disease has been associated mainly due to reactivation of latent infection rather than primary infection. Even though there are reports of acute toxoplasmosis in recipients who were seronegative for T. gondii, suggesting transmission of infection after BMT, the source of infection in those cases has not been clearly demonstrated, whether it is due to the transplantation procedure by itself or from environmental source. Thus, the present study aimed to observe if it could be possible to demonstrate the parasite's ability to infect bone marrow (BM) cells and cause toxoplasmosis, when using an experimental model. Our results showed that 11% of hematopoietic and 7.1% of nonhematopoietic lineages may become infected when using in vitro experiments. Also, in vivo experiments demonstrated that, when C57BL/6 mice were infected with RH-RFP or ME-49-GFP T. gondii strains, the BM cells may be infected at different time points of infection. The parasites were detected by both fluorescent microscopy and qPCR. Also, when those BM samples were collected and used for BMT, the transplanted animals presented high rates of mortality and 87.5% of them became seropositive for T. gondii. Taken together, our results clearly demonstrated that it is possible to acquire primary T. gondii infection from the donor cells after BMT. Therefore, we are emphasizing that, before transplantation, serological screening for T. gondii infection from both donors and recipients, in addition to DNA search for this parasite from donor bone marrow cells, are necessary procedures to avoid the risk of T. gondii infection for immunocompromised patients.

Intake, digestibility, microbial protein production, and nitrogen balance of lambs fed with sorghum silage partially replaced with dehydrated fruit by-products.

The objective of this study was to evaluate intake, digestibility, microbial protein production, and nitrogen balance of lambs fed with different dehydrated fruit residues replacing sorghum silage. The experiment was conducted using 25 mixed-breed male lambs (20.64 ± 4.20 kg) with an average age of 8 months. Treatments consisted of sorghum silage and 75% (DM basis) replacement of sorghum silage for dehydrated pineapple, banana, mango, or passion fruit by-products. The experiment was conducted in a completely randomized design with five treatments and five repetitions. Results were subjected to one-way analysis of variance and means were compared using the Tukey test at 5% of probability. Daily nutrient intake did not differ (P > 0.05) between the different treatments evaluated regardless of how it was expressed (kg/day or % body weight [BW]), except for NDFap (% BW) that was higher (P < 0.05) in the diet with passion fruit residue than in diets with banana and mango residues. The digestibility of ethereal extract was higher (P < 0.05) for diets with sorghum silage, pineapple, and passion fruit compared to the diet with banana residue. The digestibility of neutral detergent fiber corrected for ashes and protein was higher (P < 0.05) on animals receiving sorghum silage than diets with mango and passion fruit residues. No difference (P > 0.05) was observed for purine derivative excretion, microbial efficiency, nitrogen intake, nitrogen loss (urine and feces), and nitrogen balance between diets. In conclusion, dehydrated fruit by-products (pineapple, banana, mango, and passion fruit) are good options for partial replacement of sorghum silage (75%) and potentially reduce feeding costs.

In vitro tooth reattachment techniques: A systematic review.

BACKGROUND/AIMS: Fragment reattachment is a procedure that offers advantages, such as preservation of tooth structure and maintenance of color, shape, and translucency of the original tooth. The aim of this study was to analyze the reattachment techniques used to restore anterior teeth fractured by trauma. MATERIALS AND METHODS: The PubMed, LILACS, Web of Science, Cochrane, and Scopus databases were searched in October 2016, and the search was updated in February 2017. A search of the gray literature was performed in Google Scholar and OpenGrey. Reference lists of eligible studies were evaluated to identify additional studies. Two authors assessed studies for inclusion and extracted the data. In vitro studies that evaluated permanent human teeth fractured by trauma were included. RESULTS: Twenty-one studies remained after screening. The bond strength between the fragment and the crown was evaluated in 119 experimental groups. Ten different techniques were evaluated as follows: no preparation, chamfer, bevel, anchors, overcontour, internal groove, no preparation associated with chamfer after reattachment, fragment dentin removal associated with chamfer after reattachment, bevel associated with overcontour, and groove associated with shoulder. Five different materials were used to reattach the fragment: bonding system, luting composite resin, flowable composite, microhybrid composite, and nanocomposite. CONCLUSION: Fragment reattachment using a technique with no preparation and an adhesive system associated with an intermediate composite with good mechanical properties can restore part of the resistance of the fractured tooth.

Tooth fragment reattachment techniques-A systematic review.

BACKGROUND/AIM: Several strategies have been developed for tooth fragment reattachment following fracture. Although many techniques have been reported, there is no consensus on which one has the best results in terms of the bond strength between the fragment and the dentin over time. The aim of this study was to assess the currently reported tooth fragment reattachment techniques for fractured crowns of anterior teeth. MATERIALS AND METHODS: The PubMed, LILACS, Web of Science, Cochrane, and Scopus databases were searched in October 2016, and the search was updated in February 2017. A search of the gray literature was performed in Google Scholar and OpenGrey. Reference lists of eligible studies were cross-checked to identify additional studies; gray literature and ongoing trials were investigated. Two authors assessed studies to determine inclusion and undertook data extraction. Case reports/series of three or more cases, cross-sectional studies, cohort studies, and in vivo clinical trials in all languages were included. RESULTS: Five articles remained after screening. These studies predominantly reported on fragment reattachment with composite resin and resin cement. There was little consistency among the studies in regard to the technique used for tooth fragment reattachment and length of the follow-up period. CONCLUSIONS: According to the evidence found in the studies included in this review, simple tooth fragment reattachment was the preferred reattachment technique. An increase in the bond strength between tooth fragment and dentin was observed when an intermediate material was used. Further investigation is needed, using standard follow-up periods and larger samples.

Prevalence of dental trauma in disabled persons seen at the dental clinic for special-needs patients of the Catholic University of Brasília (UCB) / Prevalência de traumatismo dentário em pacientes com deficiência atendidos na clínica de pacientes especiais da Universidade Católica de Brasília (UCB)

Introduction: In Brazil, dental trauma (DT) is considered a public health problem. However, few studies in the literature report the prevalence of DT in disabled persons (DP). Objective: The aim of this study was to assess the prevalence of DT among DP seen at the Dental Clinic for Special-Needs Patients (COPE) of the Catholic University of Brasília. Material and method: A retrospective, descriptive study analyzing 73 medical charts of DP seen at the COPE between 2014 and 2016 was conducted. Clinical and sociodemographic data were collected. The t-test was used to check for significant differences between the categories of the variables analyzed. The Statistical Package for Social Sciences (SPSS), version 23.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses (p < 0.05). Result: A DT prevalence of 33/73 (45.2%) was found among DP. The predominant type of fracture was crown fracture (26/33-78.8%). The majority of patients were over 20 years old (63/73 - 86.3%), at a proportion significantly higher than those for the other age categories (p < 0.008). The patients in the sample had a variety of diseases, predominantly in the following categories: mental (22/73- 30.1%), multiple (19/73-26%), and systemic (14/73-19.2%). Conclusion: A high prevalence of DT was found in DP, with the majority of cases being related to mental and multiple diseases. Further research is needed to assess the prevalence of DT in this patient group throughout the Federal District.

Introdução: No Brasil, o traumatismo dentário (TD) é considerado um problema de saúde pública. No entanto, poucos estudos na literatura relatam a prevalência de TD em pessoas com deficiência (PD). Objetivo: O objetivo deste trabalho foi avaliar a prevalência de TD em PD atendidas na Clínica de Pacientes Especiais da Universidade Católica de Brasília (COPE). Material e método: Este estudo seguiu um delineamento descritivo e retrospectivo, e foi realizado por meio da análise de 73 prontuários de PD atendidas na COPE entre 2014 e 2016. Foram coletados dados sociodemográficos e clínicos. O teste t foi utilizado entre as proporções para determinar se houve diferenças significativas entre as categorias das variáveis analisadas. O programa "Statistical Package for Social Sciences" (SPSS), versão 23.0 (IBM Corporation, Armonk, NY, EUA) foi utilizado nas análises (p<0,05). Resultado: Encontrou-se uma prevalência de TD de 33/73 (45,2%) entre os PD. A fratura predominante foi a do tipo coronária, com uma frequência de 26/33 (78,8%). A maioria dos pacientes tinha acima de 20 anos, com uma frequência de 63/73 (86,3%), significativamente maior do que as frequências das outras categorias (p < 0,008). Os pacientes da amostra apresentavam doenças variadas, sendo as mais prevalentes as das categorias mental, com frequência de 22/73 (30,1%), múltipla com 19/73 (26%), e sistêmica com 14/73 (19,2%). Conclusão: Foi encontrada uma alta prevalência de TD em PD, sendo a maioria dos casos relacionados a doenças mentais e múltiplas. Futuras pesquisas são necessárias para avaliar a prevalência de TD nesse grupo de pacientes em todo o Distrito Federal.

Percutaneous Biopsy of Lesions in the Cavernous Sinus: A Systematic Review.

BACKGROUND: A wide variety of lesions may develop in the cavernous sinus region, including tumors or pseudotumors of inflammatory origin. Sometimes imaging is insufficient to ascertain a pathologic diagnosis. Percutaneous biopsy performed through the foramen ovale route may aid therapeutic decision making, avoiding unnecessary open surgery when lesions are confirmed to be nonsurgical or unresectable. We conducted a systematic review to determine the efficacy of percutaneous biopsy of cavernous sinus lesions. METHOD: A systematic search in PubMed, LILACS, Web of Science, and Scopus yielded 4495 potentially eligible abstracts. Fourteen studies describing 75 biopsy procedures for lesions in the cavernous sinus region were reviewed. The primary outcome measure was diagnostic success. Data were analyzed according to standard systemic review techniques. RESULTS: A diagnosis was obtained in 65 of the 75 cases described in the literature. Among all series, only 3 patients had permanent deficits. No individual studies reported mortality. The histopathologic evaluation revealed neoplastic diseases in 58 lesions. Meningiomas were found in 26 biopsy samples. Nonneoplastic diseases, originating from infectious, inflammatory, or deposition diseases, accounted for 6 biopsy samples. CONCLUSIONS: Percutaneous biopsy of cavernous sinus lesions is effective for diagnosis. Biopsy can be performed in patients with cavernous sinus masses, especially when neuroimaging fails to provide sufficient histopathologic data.

Remote diagnosis of traumatic dental injuries using digital photographs captured via a mobile phone.

BACKGROUND: Intra-oral photographs have been aided diagnosis of several pathologies in teledentistry. Mobile phone cameras may produce high-quality photographs, presenting itself as a viable tool for remote diagnosis of traumatic dental injuries. AIM: To evaluate the levels of interexaminer agreement in cases of traumatic dental injuries when comparing diagnoses conducted in person and remotely. MATERIAL AND METHODS: The sample included 40 patients with 73 traumatized teeth, and a total of 90 diagnoses, who had presented to two dental clinics, one private, and the other public, in Brazil's Federal District. The dental history and clinical examination data were registered in electronic forms, and digital photographs were captured with a mobile phone camera and uploaded to a cloud drive. Six remote examiners formulated their diagnoses based solely on photographic analysis. Thereafter, they were provided with additional clinical data and asked to provide a second round of diagnoses. These diagnoses were compared to those conducted in person, which were considered the gold standard. The data were analyzed with Gwet's AC1 interexaminers' measure to evaluate the agreement between the in-surgery and remote diagnoses. RESULTS: The levels of interexaminer agreement between the in-surgery and remote diagnoses formulated exclusively with images were 0.83 or higher (95% confidence interval: 0.73-0.91), and 0.93 or higher (95% confidence interval: 0.88-0.97), when clinical information was available. CONCLUSION: The precision of the remote diagnoses was comparable to the diagnoses conducted in person. The levels of interexaminer agreement were higher when clinical data were included with the images. Mobile phones may be an effective tool for capturing images that assist in the remote diagnosis of traumatic dental injuries.

Effect of dehydration and rehydration intervals on fracture resistance of reattached tooth fragments using a multimode adhesive.

BACKGROUND/AIMS: The tooth fragment bonding technique, frequently used to restore traumatized teeth, may be affected by dehydration/rehydration periods. The aim of this study was to evaluate the effects of different dry and wet storage intervals on multimode adhesive bonding between reattached fragments and teeth. MATERIALS AND METHODS: Eighty-four bovine incisors were fractured and randomized into groups (n=12). After teeth fracturing, each specimen was assigned to one of the following groups: G0: control group (sound tooth); GA1 and GA2: 1-h dehydration and a 15-min or 24-hours rewetting period, respectively; GB1 and GB2: 24-hours dehydration and a 15-minutes or 24-hours rewetting period, respectively; and GC: 1-hour (GC1) or 24-hours (GC2) dehydration period only. Tooth fragments were then reattached using a multimode adhesive in a self-mode technique with a flowable resin composite. The fracture resistance was evaluated in a universal testing machine under a compressive load (1 mm/min-1 ). Data were submitted to two-way analysis of variance and post hoc Tukey test (5%). RESULTS: No significant interaction between dehydration and rehydration intervals was observed (P>.05). Only the step of rehydration significantly affected the reattachment strength when compared to the groups submitted only to dehydration, regardless of the interval (15 minutes or 24 hours). CONCLUSION: Rehydrating a tooth fragment for 15 minutes before bonding with a multimode adhesive maintained sufficient moisture to increase reattachment strength.