Mandibular fracture in medication-associated osteonecrosis following infliximab therapy: A case report.

INTRODUCTION: Medication-associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti-resorptive and anti-angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area. OBJECTIVE: The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab. CASE REPORT: A 53-year-old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti-angiogenic or anti-resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction. FINAL CONSIDERATIONS: Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.

Evaluation of photobiomodulation therapy (PBMT) on salivary flow and composition in head and neck cancer patients undergoing radiation therapy.

OBJECTIVE: Assess the impact of photobiomodulation therapy (PBMT) on xerostomia, salivary flow rate (SFR) and composition in patients undergoing radiotherapy (RT) for head and neck cancer (HNC). STUDY DESIGN: Thirty patients undergoing RT (65 Gy) for HNC were enrolled. Saliva and xerostomia evaluations collected pre- and post-PBMT-RT. PBMT involved irradiation of extra and intraoral points, 15-20 sessions, 2-3 times/week. SFR, trace elements, total protein, alkaline phosphatase, xerostomia, and pH were analyzed. RESULTS: The average age was 60.7 years. After treatment, there was not a significant reduction in SFR and there was no difference on xerostomia. Significant reductions in Al, Cd, Fe, Ni, P, and Sb concentrations were observed, along with a significant increase in Mg concentration. Sample data were organized into 3 groups based on a self-organizing map. Low concentrations of Al, As, Co, Cr, Cu, Fe, Mn, Mo, S, Sr, and Zn were the primary discriminatory factors for group A, while group B consisted of post-PBMT-RT samples with high concentrations of Ca, K, Mg, Na, and S. CONCLUSIONS: PBMT prevented a significant reduction in SFR and xerostomia induced by radiation therapy. These findings suggest that PBMT prevents salivary gland damage minimizing the decline in salivary flow.

The surgical management of a patient with chronic renal failure and macrothrombocytopenia related to the MYH9 gene mutation: A case report.

MYH9 disease is a rare genetic disorder in which there is a mutation in the gene for the non-muscle myosin heavy chain IIA. It initially causes macrothrombocytopenia followed by other clinical manifestations. When the patient reaches adulthood, he can develop chronic kidney failure. Thus, the risk of suffering a hemorrhage, difficulty in repairing and, infections increases in individuals with this disease. In addition, the use of drugs in these patients should be carefully evaluated. An adult patient sought dental care with a complaint associated with a tooth with advanced dental caries. He had severe thrombocytopenia (7000 platelets/mm3 ), hearing loss, and chronic kidney failure. The diagnosis of MYH9 disease was confirmed through genotyping. After clinical examination, extraction was planned. Local and systemic procedures were used to prevent hemorrhage, especially postoperatively. Although the patient had an infection at the surgical wound site and no episode of postoperative bleeding, the repair process occurred normally. The purpose of this article is to report the surgical management of a patient with MYH9 disease.

Implant Osseointegration in Grafted Autogenous Bone Blocks Fixed with Screws and Cyanoacrylate-Based Adhesive: Histomorphometric and Micro-CT Analyses.

PURPOSE: To evaluate implant osseointegration in grafted autogenous bone blocks fixed with cyanoacrylate-based adhesive and screws. Also, grafted bone fixed either with an adhesive or screw was evaluated. MATERIALS AND METHODS: Two surgical defects in the parietal region of rabbits (n = 12) were performed in each animal. Autogenous bone blocks obtained were fixed anteriorly with a screw or cyanoacrylate-based adhesive. After 30 and 45 days of grafting procedures, implants were placed in bone blocks. Histomorphometric and microcomputed tomography (micro-CT) analyses of the implant area were performed at 30 days after implant surgery in the screw (n = 6) and adhesive (n = 6) groups. Histomorphometric analyses of bone-grafted areas were performed at 60 and 75 days in the screw (n = 6) and adhesive (n = 6) groups. Histomorphometric evaluations were carried out in implant and grafted bone areas. The micro-CT parameters evaluated were bone-to-implant contact, bone area fraction occupancy, bone volume fraction, trabecular thickness, trabecular separation, and trabecular number. RESULTS: No differences were observed in the micro-CT parameters for the screw and adhesive groups in all experimental periods. However, an increased quantity of immature bone volume was observed on the adhesive group in the grafted area after 75 days. The grafted area in the screw group (75 days) presented a decrease in the volume density of the immature bone compared with the screw group (60 days). There were no differences in both groups and experimental periods in soft tissue in the grafted area. CONCLUSION: No differences were observed in the osseointegration of implants placed in grafted autogenous bone blocks fixed with cyanoacrylate-based adhesive and screws. Therefore, osseointegration in autogenous bone fixed with cyanoacrylate-based adhesive is viable.

Most used photobiomodulation dosimetry parameters to treat oral mucositis after preconditioning for hematopoietic stem cell transplantation: systematic review and meta-analysis.

Parameter reproducibility in photobiomodulation therapy (PBMT) is still scarce in literature for the management of oral mucositis (OM). This study aimed to identify the most used PBMT dosimetry parameters (DP) and their efficacy in OM management after preconditioning for hematopoietic stem cell transplantation (HSCT). This research was conducted according to the PRISMA guidelines. The search for primary studies was in PubMed/MEDLINE, Web of Science, Embase, BVS, and Cochrane Library. Gray literature was verified on BDTD-Ibict and Open Gray. A total of 1044 studies were identified. Nine met the eligibility criteria for qualitative assessment and 7 for meta-analysis. The studies involved 396 patients submitted to preconditioning for HSCT, 211 with PBMT and 185 without PBMT in the OM management. The WHO scale was the most used to assess OM degree. The most used parameters were 660-nm wavelength, 40-mw power, 0.16-J energy, 1-W/cm2 power density, 4-J/cm2 energy density, and 0.04-cm2 spot size. The meta-analysis demonstrated that PBMT decreased the severity of OM, with a protection factor 20% higher than the control group (without PBMT), and when the parameters are similar to the DP mentioned, the protection factor increases to 94%. These most used DP with similarity seem to be a therapeutic strategy for the management of OM in this population.

Use of Facebook as a pedagogical tool foruniversity education: student adherenceand reactions / Uso do Facebook como ferramenta pedagógica para o ensino superior: adesão e reações dos estudantes

This study aimed to analyze Facebook's use as a pedagogical tool for teaching didactics for graduate students in Dentistry. Seventy-two adult students participated in this study. These students attended theoretical classes, developed practical activities by Facebook, and evaluated the course through a questionnaire. Tasks were analyzed concerning the following criteria: time torespond to assignments and whether they have been finished or not. Additionally, post type and students' reactions to posts were also evaluated. Forty-three (59.8%) students have considered Facebook as a good pedagogical resource. Only 5 (22%) students answered that they had some difficulty in responding to the assignments of the course through Facebook. Most students completed their tasks through Facebook. However, in general, most students only fulfilled the assignments close to the deadline. The main reactions of the students were likes and comments. Despite its limitations, Facebook seems to be a great pedagogical resource to be inserted in post-graduate education. In addition, the students still show little participation even being in the virtual environment of Facebook (AU).

O objetivo deste estudo foi analisar a utilização do Facebook como ferramenta pedagógica para o ensino de didática para alunos de graduação em Odontologia. Setenta e dois alunos adultos participaram da pesquisa. Esses alunos participaram de aulas teóricas, desenvolveram atividades práticas no Facebook e avaliaram o curso por meio de um questionário. As tarefas foram analisadas em relação aos seguintes critérios: tempo para responder às atividades e se elas foram realizadas de forma completa ou incompleta. Além disso, os tipos de postagens e as reações dos alunos às postagens também foram avaliados. Quarenta e três (59,8%) alunos consideraram o Facebook um bom recurso pedagógico. Apenas 5 (22%) alunos responderam que tiveram alguma dificuldade em responder às atividades do curso pelo Facebook. A maioria dos alunos concluiu suas tarefas por meio do Facebook. No entanto, em geral, a maioria dos alunos só cumpriu astarefas perto do prazo. As principais reações dos alunos foram curtidas e comentários. Apesar de suas limitações, o Facebook parece ser um grande recurso pedagógico a ser inserido na pós-graduação. Além disso, os alunos ainda se mostram pouco participativos mesmo estando no ambiente virtual do Facebook (AU).

Dental students'knowledge and attitudes toward patients with epilepsy / Conhecimento e atitudes dos estudantes de um curso de Odontologia em relação à epilepsia

Epilepsy is defined as a group of symptoms resulting from several neuronal complications ranging from changes in consciousness and motor activity to sensory phenomena and aberrant behaviors. This health problem has been associated with cases of stigma that can seriously affect the patient's quality of life. This study's main objectivewas to investigate the knowledge and attitudes regarding the treatmentof patients diagnosed with epilepsy by undergraduate dentistry students. The methodology was based on applyinga structured questionnaire with 17 close-endedquestions that evaluated information such as sociodemographic data, knowledge about epilepsy and social tolerance. The sample consisted of 397 students enrolled in the Dentistry course atFederal University of Paranáand divided into: group 1, students attending the 1st to the 7th semester of the course,and group 2, students in the last semester of the course. Group 1 students had more opportunities to care for patients with epilepsy than group 2. Most students expressed positive attitudes towardliving with people suffering from epilepsy and considered that they could not exercise certain professional activities. The question with the least number of correct answers dealt with the treatment of patients with the disease. Students' knowledge of epilepsy was low. However, the level of positive attitudes towardliving with this type of patient was considered high (AU).

A epilepsia é definida como um complexo de sintomas resultantes de diversas complicações neuronais que variam de alterações da consciência e da atividade motora até fenômenos sensoriais e comportamentos aberrantes. Esse problema de saúde tem sido associado a casos de estigma que podem repercutir seriamente na qualidade de vida do paciente. Este estudo teve por objetivo principal investigar o conhecimento e as atitudes em relação ao manejo de pacientes com diagnóstico de epilepsia dos estudantes de graduação do curso de Odontologia. A metodologia foi baseada na aplicação de um questionário estruturado com 17 perguntas fechadas que avaliaram informações como dados sociodemográficos, conhecimento sobre epilepsia e tolerância social. A amostra foi composta por 397 estudantes matriculados no curso de Odontologia da Universidade Federal do Paraná e dividida em: grupo 1, alunos cursando do 1º até o 7º semestre do curso e grupo 2, alunos do último semestre do curso. Os estudantes dogrupo 1 tiveram mais oportunidades para atender pacientes com epilepsia do que os do grupo 2. A maioria dos estudantes manifestou atitudes positivas em relação ao convívio com pessoas que sofrem de epilepsia e considerou que elas não poderiam exercer determinadas atividades profissionais. A questão com menor número de acertos tratava do tratamento de pacientes com a doença. O conhecimento dos estudantes em relação à epilepsia foi baixo. Porém, o nível de atitudes positivas em relação ao convívio com esse tipo de paciente foi considerado alto (AU).

Atypical oral viral coinfection after allogeneic hematopoietic stem cell transplantation: Diagnosis and treatment challenge.

BACKGROUND: Viral reactivation in patients undergoing immunosuppressive therapy after hematopoietic stem cell transplantation (HSCT) is a serious complication associated with significant morbidity and mortality. Infections caused by human herpes viruses such as herpes simplex virus (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) can result in oral lesions. CASE PRESENTATION: A 40-year-old male patient who had undergone HSCT presented with ulcerated lesions in different areas of the mouth, for 7 months. The lesions had evolved to painful exophytic nodules with an erythematous, ulcerated surface. They were present on the tongue margins and soft and hard palate. Histological, immunohistochemical (IHC), and polymerase chain reaction analyses were performed, and the results were compatible with HSV-1 and -2 and CMV infections. Treatment comprised five sessions of antimicrobial photodynamic therapy (aPDT) and oral valganciclovir. Thirty days after combined antiviral therapy and aPDT, the lesions were completely resolved. Patient was followed up for 12 months without recurrence. CONCLUSION: Diagnosis and treatment of atypical oral infections in immunosuppressed patients is challenging. Assessment of both clinical and laboratory findings is mandatory for a conclusive diagnosis. The use of local antimicrobial and systemic therapies contributes to positive clinical response in such cases.

Histological Comparison between Biphasic Calcium Phosphate and Deproteinized Bovine Bone on Critical-Size Bone Defects.

The limited options for bone repair have led to an extensive research of the field and the development of alloplastic and xenogeneic grafts. The purpose of this study was to evaluate bone repair with two bone substitutes: deproteinized bovine bone (DBB) and biphasic calcium phosphate ceramic (BCP) in critical-size defect. A total of 8-mm defects were made in the parietal bones of rabbits (n=12). The animals were divided into three experimental groups: sham (defect filled with a blood clot), DBB (defect filled with DBB), and BCP (defect filled with BCP). After the experimental periods of 15 and 45 days, the animals were euthanized and submitted to histomorphometric analysis. The total defect area, mineralized tissue area, biomaterial area, and soft tissue area were evaluated. A greater amount of immature bone tissue and biomaterial particles were observed in the BCP group compared to DBB and sham at 45 days (p<0.05). There was no difference in the qualitative pattern of bone deposition between DBB and BCP. However, the sham group did not show osteoid islands along with the defect, presenting a greater amount of collagen fibers as well in relation to the DBB and BCP groups. There was a greater number of inflammatory cells in the DBB at 45 days compared to BCP and sham groups. In conclusion, BCP and DBB are options for optimizing the use of bone grafts for maxillofacial rehabilitation. Bone defects treated with BCP showed greater deposition of bone tissue at 45 days.

Oral health, organic and inorganic saliva composition of men with Schizophrenia: Case-control study.

BACKGROUND: Schizophrenia (SCZ) presents complex challenges related to diagnosis and clinical monitoring. The study of conditions associated with SCZ can be facilitated by using potential markers and patterns that provide information to support the diagnosis and oral health. METHODS: The salivary composition of patients diagnosed with SCZ (n = 50) was evaluated and compared to the control (n = 50). Saliva samples from male patients were collected and clinical parameters were evaluated. The concentration of total proteins and amylase were determined and salivary macro- and microelements were quantified by ICP OES and ICP-MS. Exploratory data analysis based on artificial intelligence tools was used in the investigation. RESULTS: There was a significant increase in the salivary concentrations of Al, Fe, Li, Mg, Na, and V, higher prevalence of caries (p < 0.001), periodontal disease (p < 0.001), and reduced salivary flow rate (p = 0.019) in SCZ patients. Also, samples were grouped into six clusters. As, Co, Cr, Cu, Mn, Mo, Ni, Se, and Sr were correlated with each other, while Fe, K, Li, Ti, and V showed the highest concentrations in the samples distributed in the clusters with the highest association between SZC patients and controls. CONCLUSIONS: The results obtained indicate changes in salivary flow, organic composition, and levels of macro- and microelements in SCZ patients. Salivary concentrations of Fe, Mg, and Na may be related to oral conditions, higher prevalence of caries, and periodontal disease. The exploratory analysis showed different patterns in the salivary composition of SCZ patients impacted by associations between oral health conditions and the use of medications. Future studies are encouraged to confirm the results investigated in this study.

Histological comparison between biphasic calcium phosphate and deproteinized bovine bone on critical-size bone defects

Abstract The limited options for bone repair have led to an extensive research of the field and the development of alloplastic and xenogeneic grafts. The purpose of this study was to evaluate bone repair with two bone substitutes: deproteinized bovine bone (DBB) and biphasic calcium phosphate ceramic (BCP) in critical-size defect. A total of 8-mm defects were made in the parietal bones of rabbits (n=12). The animals were divided into three experimental groups: sham (defect filled with a blood clot), DBB (defect filled with DBB), and BCP (defect filled with BCP). After the experimental periods of 15 and 45 days, the animals were euthanized and submitted to histomorphometric analysis. The total defect area, mineralized tissue area, biomaterial area, and soft tissue area were evaluated. A greater amount of immature bone tissue and biomaterial particles were observed in the BCP group compared to DBB and sham at 45 days (p<0.05). There was no difference in the qualitative pattern of bone deposition between DBB and BCP. However, the sham group did not show osteoid islands along with the defect, presenting a greater amount of collagen fibers as well in relation to the DBB and BCP groups. There was a greater number of inflammatory cells in the DBB at 45 days compared to BCP and sham groups. In conclusion, BCP and DBB are options for optimizing the use of bone grafts for maxillofacial rehabilitation. Bone defects treated with BCP showed greater deposition of bone tissue at 45 days.

Resumo As opções limitadas para reparo ósseo levaram ao desenvolvimento de abrangente pesquisa na área de enxertos aloplásticos e xenogênicos. O objetivo deste estudo foi avaliar o reparo ósseo com dois substitutos ósseos: osso bovino desproteinizado (DBB) e cerâmica fosfática de cálcio bifásica (BCP) em defeito de tamanho crítico. Material e métodos: defeitos críticos de 8 mm foram feitos nos ossos parietais de coelhos (n=12). Os animais foram divididos em três grupos experimentais: sham (defeito preenchido com coágulo sanguíneo), DBB (defeito preenchido com DBB) e BCP (defeito preenchido com BCP). Após os períodos experimentais de 15 e 45 dias, os animais foram sacrificados e submetidos à análise histomorfométrica. Foram avaliadas a área total de defeitos, área de tecidos mineralizados, área de biomateriais e área de tecidos moles. Resultados: maior quantidade de tecido ósseo imaturo e de partículas de biomaterial foram observados no grupo BCP em comparação aos grupos DBB e sham aos 45 dias (p<0,05). Não houve diferença no padrão qualitativo de deposição óssea entre DBB e BCP. Ainda, o grupo sham não apresentou ilhas osteóides ao longo do defeito, apresentando maior quantidade de fibras colágenas em relação aos grupos DBB e BCP. Houve maior quantidade de células inflamatórias no DBB aos 45 dias em comparação aos grupos BCP e sham. Conclusões: BCP e DBB são opções para otimizar o uso de enxertos ósseos na reabilitação de pacientes. Defeitos ósseos tratados com BCP mostraram maior deposição de tecido ósseo aos 45 dias.

Oral Reactive Lesions Associated to Incomplete Removal of Natal Teeth: Case Report.

Natal teeth are infrequent at birth. Dental extraction is the most recommended treatment to avoid complications. Reactive soft tissue lesions associated to natal tooth or its incomplete removal are rare. A five-month-old female presented natal teeth #71 and #81 which were removed the day after the birth. The baby evolved with two nodules in the region of #71 and #81, pedunculated, 10 and 9 mm, respectively, covered by a pink mucosa, firm in consistency. Periapical radiography showed two radiopaque areas, suggestive of root fragments. After 30 days the nodule located in the region of #81 became purple in color and ulcerated. Both lesions were removed with high intensity diode laser. Histopathological analysis was compatible with inflammatory fibrous hyperplasia (#71) and pyogenic granuloma (#81). Early diagnosis of oral lesions in newborns by means of histopathological examination and a minimum invasive treatment, such as laser surgery, should be of primary concern.

The characteristics of palate and upper dental arch can be an anatomical marker for men with schizophrenia? Case-control study: Palate can be a marker for schizophrenia?

AIMS: The aim of this study was to compare individuals with and without schizophrenia through the characteristics of the palate, such as width, length, depth, palate shape, and upper dental arch shape. METHODS AND RESULTS: The sample was divided into one case group (n = 45) and two control groups (n = 90; 45 individuals each group). Groups were paired by variables: sex, age, and malocclusion type. All analyses were performed on upper dental arch plaster models. All individuals were male and the mean age was 28.56 (SD: 7.82) years. The frequency of the malocclusion type observed was 54.1% (Class I), 22.2% (Class II), and 23.7% (Class III). Statistically significant difference was observed between the case and control groups for the variables palate shape (P = .004) and upper dental arch shape (P = .003). The case group had a higher frequency of the deep or grooved palate shape (57.8%) and parabolic dental arch shape (48.9%). There was no statistically significant difference for the palate width, length, and depth (P > .05). CONCLUSIONS: There was an evidence that the deep or grooved palate shape and parabolic dental arch shape are morphological characteristics of the palate in men with schizophrenia.

Experimental Acute Sepsis Reduced Number of Osteocalcin Immunolabeled Cells in Periodontal Ligament.

The aim of this study was to evaluate the effect of acute sepsis in the periodontal ligament, alveolar and furcation bone in absence of periodontitis induction through histological and immunohistochemical analyses. A septic rat model was established by cecal ligation and puncture (CLP). Twelve rats were randomly divided into CLP (n=6) and Sham (n=6) groups. The animals were euthanized at 24 h and hemimandibles were submitted to histomorfometric (bone matrix, collagenous fibers, fibroblasts, osteocytes, inflammatory cells, and blood vessels) and immunohistochemical (BMP-2/4, RANKL and osteocalcin) evaluation in alveolar bone, furcation bone and periodontal ligament. Our results demonstrated that histomorphometric parameters were similar in alveolar bone, furcation bone and periodontal ligament of Sham and CLP rats. Regarding to immunohistochemical analyses, the number of BMP-2/4 and RANKL immunolabeled cells was also similar in both groups. Furthermore, it was detected a reduction in the osteocalcin immunolabeled cells in periodontal ligaments of CLP compared to Sham rats (p=0.0014). In conclusion, the acute sepsis induction resulted in reduced number of osteocalcin labelled cells in periodontal ligament region. Moreover, no significant histological differences were observed in the periodontium of rats under acute sepsis. Considering the role of osteocalcin in bone remodeling, the study contributes to revealing the importance of careful periodontal evaluation in the presence of sepsis.

Experimental acute sepsis reduced number of osteocalcin immunolabeled cells in periodontal ligament

Abstract The aim of this study was to evaluate the effect of acute sepsis in the periodontal ligament, alveolar and furcation bone in absence of periodontitis induction through histological and immunohistochemical analyses. A septic rat model was established by cecal ligation and puncture (CLP). Twelve rats were randomly divided into CLP (n=6) and Sham (n=6) groups. The animals were euthanized at 24 h and hemimandibles were submitted to histomorfometric (bone matrix, collagenous fibers, fibroblasts, osteocytes, inflammatory cells, and blood vessels) and immunohistochemical (BMP-2/4, RANKL and osteocalcin) evaluation in alveolar bone, furcation bone and periodontal ligament. Our results demonstrated that histomorphometric parameters were similar in alveolar bone, furcation bone and periodontal ligament of Sham and CLP rats. Regarding to immunohistochemical analyses, the number of BMP-2/4 and RANKL immunolabeled cells was also similar in both groups. Furthermore, it was detected a reduction in the osteocalcin immunolabeled cells in periodontal ligaments of CLP compared to Sham rats (p=0.0014). In conclusion, the acute sepsis induction resulted in reduced number of osteocalcin labelled cells in periodontal ligament region. Moreover, no significant histological differences were observed in the periodontium of rats under acute sepsis. Considering the role of osteocalcin in bone remodeling, the study contributes to revealing the importance of careful periodontal evaluation in the presence of sepsis.

Resumo O objetivo deste estudo foi avaliar o efeito da sepse aguda no ligamento periodontal, osso alveolar e osso da furca por meio de análise histológica e imunohistoquímica. O modelo de sepse em ratos foi estabelecido pelo procedimento de ligação e perfuração do ceco (CLP). Doze ratos foram divididos de forma randomizada em ratos sépticos (n=6) e controle - grupo Sham (n=6). Os animais foram eutanasiados após 24 horas e suas hemimandíbulas foram submetidas aos procedimentos histotécnicos para análise histomorfométricos (matriz óssea, fibras colágenas, fibroblastos, osteócitos, células inflamatórias e vasos sanguíneos) e imunohistoquímicos (BMP-2/4, RANKL e osteocalcina) no osso alveolar, osso de furca e ligamento periodontal. Nossos resultados demonstraram que os parâmetros histomorfométricos foram similares no osso alveolar, osso de furca e ligamento periodontal dos animais do grupo sepse e do grupo Sham. Em relação à análise por imunohistoquímica, o número de células imunomarcadas para BMP-2/4 e RANKL também foi similar em ambos os grupos. Entretanto, houve redução (p=0.0014) no número de células imunomarcadas para osteocalcina no ligamento periodontal de ratos sépticos em relação ao grupo Sham. Como conclusão, o estabelecimento de sepse aguda resultou em um número reduzido de células imunomarcadas para osteocalcina na região do ligamento periodontal (p=0,0014). Além disso, não foram observadas diferenças histológicas significativas no periodonto de ratos na presença de sepse aguda. Considerando o papel da osteocalcina na remodelação óssea, este estudo contribui para revelar a importância da avaliação periodontal cuidadosa na presença de sepse.

Osteoconductivity of Biphasic Calcium Phosphate Ceramic Improves New Bone Formation: A Histologic, Histomorphometric, Gene Expression, and Microcomputed Tomography Study.

PURPOSE: The purpose of this study was to evaluate bone repair with two bone substitutes, deproteinized bovine bone and biphasic calcium phosphate ceramics, associated with autogenous bone. MATERIALS AND METHODS: The experimental groups were as follows: autogenous bone only (AB), autogenous bone/deproteinized bovine bone (1:1), and autogenous bone/biphasic calcium phosphate ceramic (1:1). After 30, 60, and 90 days, animals were euthanized and samples were collected for microcomputed tomography (micro-CT), histologic, histomorphometric, and expression analyses of VEGFA, RUNX2, ALP, COL1A1, OCN, PHEX, RANKL, and OPG genes by real-time polymerase chain reaction (PCR) array. RESULTS: Histomorphometric analysis showed no difference in the amount of immature bone between AB and AB/biphasic calcium phosphate ceramic at 30 and 60 days. There was less mature bone formation in the AB/deproteinized bovine bone at 60 days compared with AB/biphasic calcium phosphate ceramic and AB, and a lower amount of immature bone in the AB/deproteinized bovine bone at 30 and 60 days compared with the AB (P ≤ .05). Micro-CT analysis showed higher immature bone volume (BVI) in the AB/biphasic calcium phosphate ceramic at 60 days and lower BVI at 90 days (P ≤ .05). Molecular analysis showed a lower expression of all genes in the AB/deproteinized bovine bone and AB/biphasic calcium phosphate ceramic compared with AB at all time points. A greater expression of RANKL was found in the AB/deproteinized bovine bone compared with AB/biphasic calcium phosphate ceramic at 30 days (P ≤ .05), and a lower expression of the OC, RUNX2, and ALP genes in AB/deproteinized bovine bone and AB/biphasic calcium phosphate ceramic was found compared with AB at all time points (P ≤ .05). CONCLUSION: The use of biphasic calcium phosphate ceramic resulted in greater immature bone formation than deproteinized bovine bone at an early assessment. The studied bone regeneration genes were downregulated in comparison to the control.

Impact of oral medicine training on oral cancer-related knowledge among undergraduate dental students

Aim: The aim of this study was to evaluate knowledge and attitudes regarding potentially malignant oral lesions and oral cancer among undergraduate dental students with or without training in the oral medicine. Methods: A cross-sectional study was undertaken to assess all undergraduate dental student (1st to 5th year) in two private universities in the state of Paraná, Brazil. A structured questionnaire about knowledge regarding potentially malignant oral lesions, continuing education, and different approaches to diagnosis was administered to dental students with or without training in the oral medicine discipline between May and July 2015. Descriptive statistics were obtained, and the data were analyzed using a chi-square test to compare knowledge in dental students. Results: A total of 662 undergraduate dental students were invited to participate, and the response rate was 97.6% (n = 646). Of the responders, 472 were female (73.1%), 168 were male (26.0%), and 6 did not declare what sex they were (0.9%). Undergraduate dental students who had previously studied oral medicine tended to report that they always perform complete intraoral examination (76.3%) and identified alcohol (87%) and tobacco consumption (97%) and sun exposure (80%) as major risk factors for developing oral cancer. While students who had not yet studied oral medicine poorly identified these factors. Students who had previously studied the discipline did not identify cheilitis actinica (26%) and erythroplakia (32%) as potentially malignant lesions. Only, 32.6% of dental students participate in continuing education during the past year. Conclusions: Dental students trained in the oral medicine discipline exhibited satisfactory knowledge necessary for the prevention and early identification of potentially malignant oral lesions and oral cancer. Continuing education during undergraduate and after academic training is very important

The influence of early bisphosphonate treatment in bone reconstruction on craniofacial radiographic bone density / A influência do tratamento com bisfosfonatos na densidade óssea em área de reconstrução óssea craniofacial

Objective: To evaluate the effects of alendronate (AL), a bisphosphonate, on visual bone density by means of a radiographic analysis. Material and methods: Sixty-two Wistar rats were divided into four groups: Group AA (AL with autogenous graft); group AW (AL without autogenous graft) both receiving AL on alternate days for 4 weeks before surgery; control group CA (with autogenous graft); group CW (without autogenous graft) both receiving saline solution before surgery. Experimental periods of evaluation were 2 weeks and 4 weeks postsurgery. Conventional and digital radiographs were obtained, and a 5-point grading system (score) was used to assess visual radiographic bone density. Results: There were no statistical differences between CA and AA groups at 2 and 4 weeks. The AA group had a higher mean score of bone density than the CW and AW groups at 2 weeks (P < 0.05). The CA and AA groups had higher scores of bone density than the CW and AW groups at 4 weeks (P < 0.05). Conclusions: Treatment with AL did not affect radiographic bone density at 2 and 4 weeks after surgery. The presence of an autograft resulted in higher scores of bone density. (AU)

Objetivo: Avaliar os efeitos do alendronato (AL), um bisfosfonato, na densidade óssea através de uma análise radiográfica. Material e métodos: Sessenta e dois ratos Wistar foram divididos em quatro grupos: Grupo AA (AL com enxerto ósseo autógeno); grupo AW (AL sem enxerto ósseo autógeno); ambos receberam AL em dias alternados durante 4 semanas antes da cirurgia; grupo controle CA (com enxerto ósseo autógeno); grupo CW (sem enxerto ósseo autógeno) ambos receberam solução salina antes da cirurgia. Os tempos experimentais de avaliação foram 2 e 4 semanas após a cirurgia. Radiografias convencionais e digitais foram realizadas, e um sistema de escore de 5 pontos foi utilizado para avaliar a densidade óssea radiográfica visualmente. Resultados: Não houve diferença estatisticamente significativa entre os grupos CA e AA em 2 e 4 semanas. O grupo AA apresentou maior escore de densidade óssea do que os grupos CW e AW em 2 semanas (p < 0.05). Os grupos CA e AA apresentaram maior escore de densidade óssea do que os grupos AW e CW em 4 semanas (p < 0.05). Conclusões: O tratamento com AL não interferiu na densidade óssea radiográfica em 2 e 4 semanas após cirurgia. A presença do enxerto resultou em maior escore de densidade óssea. (AU)

Effects of low-level laser therapy and platelet concentrate on bone repair: Histological, histomorphometric, immunohistochemical, and radiographic study.

PURPOSE: Low-level laser therapy (LLLT) can increase bone metabolism, cell proliferation, and maturation, and reduce inflammation, while platelet concentrate (PC) assists bone healing process by releasing proteins and growth factors. Here, we evaluated the efficacy of combined LLLT and PC therapy in the healing of critical-size bone defects. MATERIALS AND METHODS: Calvarial critical-size defects 5 mm in diameter were made in 48 Wistar rats. Bones were removed, milled, and used as autogenous bone grafts. Animals were randomized into four groups: LP (LLLT + PC), PC, L (LLLT), and C (control, autogenous graft only). Animals were sacrificed at day 30 and 60 post-surgery. Specimens were submitted to radiographic (digital and conventional), histological, histomorphometric, and immunohistochemical analyses. RESULTS: Digital radiography was shown to be a better image analysis method compared with conventional radiography. Histological analysis demonstrated a significant difference in bone formation between animals in group L (p = 0.049) at day 60 than in other groups. Higher rates of inflammatory infiltrates and fibrosis were observed in the LP and PC groups at days 30 and 60, whereas the groups not receiving PC showed a higher rate of bone maturity. The inflammatory processes were reduced in the animals in the L group, together with new bone formation and maturation. Groups L and C had higher scores of positive osteocalcin immunostaining in bone and extracellular matrix. CONCLUSIONS: LLLT reduces inflammation and contributes to increased bone formation. PC treatment was shown to maintain connective tissue and to induce fibrosis during bone repair. Combined LLLT and PC treatment did not improve bone repair.