Comparative analysis between Open Field and Elevated Plus Maze tests as a method for evaluating anxiety-like behavior in mice.

Anxiety is being increasingly diagnosed in the elderly population. In this sense, epidemiologic data have linked late-life anxiety disorders to increased cognitive decline, morbidity, and even mortality. In addition, studies have already reported the influence of the environment on the association between aging and anxiety. Therefore, the present study aimed to conduct a comparative analysis between Elevated Plus Maze (EPM) and Open Field (OF) tests as methods for evaluating mice's anxiety-like behavior, considering environmental and age variables. For this, eighty Female albino Swiss mice aged 6, 12, and 18 months were housed in an impoverished environment (IE) and enriched environment (EE). Following this, the animals were tested in EPM and OF tests. The environment and age affect the anxiety-like behavior of the mice in the OF, with a difference between the animals of 6 and 18 months, only in the EE (p < 0.021). However, in the EPM, it does not occur. Despite that, the environment affected the distance traveled by the mice in the EPM, where the IE animals showed greater exploratory activity than the EE, only in the 18-month group (p < 0.001). No environmental influences were detected in the OF. Concerning age, in the EPM, animals in the 18-month-old group traveled shorter distances compared to the 6-month group (p < 0.001) and the 12-month group (p < 0.001), only in EE. In turn, in the OF there was a decrease in the distance traveled in the 18-month group compared to the 6-month group (p = 0.012), only in the IE. Thus, the divergences between the results of EPM and OF instigate a better evaluation of the parameters analyzed in each test.

Updating The General Practitioner on The Association Between Teeth Loss and Temporomandibular Disorders: A Systematic Review.

The belief about a possible association between the absence of one or more teeth and the presence of temporomandibular disorders (TMD), although old, is still present among the dental class. Although evidence points to a lack of association between loss of posterior support and the presence of TMD, we do not have critical studies on the extent, quantity, or location of these losses. In this sense, this systematic review aims to investigate the association between tooth loss and the presence of TMD signs or diagnostic subgroups. Search strategies using a combination of keywords tooth loss and TMDs were performed in six databases (PubMed, Embase, Web of Science, Livivo, Lilacs, and Scopus) and gray literature from August to September 2020. Observational studies that investigated the association between tooth loss in TMD were considered. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Assessment Checklist for cross-sectional analytical studies, case-control, and cohort studies. Finally, the level of certainty measured by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was assessed. Six articles were included in the review according to the eligibility criteria. Of these, five had a high risk of bias and one had a moderate risk. Only one study showed an association between the loss of posterior teeth and the presence of joint sounds and joint pain, the others found no significant association with sign or TMD subgroups diagnostic.There is no scientific evidence to support the association between one or more tooth loss and the presence of TMD signs and symptoms or diagnostic subgroups.

Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses.

BACKGROUND: Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. METHODS: This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. RESULTS: 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [- 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. CONCLUSIONS: The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

Is nutritional intervention an improvement factor in the management of periodontitis? A systematic review.

AIMS: This systematic review aimed to evaluate the effect of nutritional intervention in the management of periodontitis. METHODS: This study was registered on the Prospective International Registry of Systematic Reviews-PROSPERO, under the registration number CRD42017076674. The database searching was performed on: Pubmed, Scopus, Web of Science, Clinical Trials and Lilacs. The OpenGrey and Google Scholar were also assessed for searching the grey literature. The PICO framework was carried out, in which the participants (P) were humans with periodontitis receiving conventional periodontal therapy simultaneously with dietary supplements (I), compared (C) with those managed with conventional therapy only, having as an outcome (O) the influence-or not influence-of nutritional intervention in the management of periodontitis. After the searching, duplicates were removed and articles were first assessed by title and abstract, following the inclusion and exclusion criteria; then, the full text of the remaining articles were reviewed. All steps within the review process were performed independently by two reviewers and checked by a third-party disagreement evaluator. For quality/risk of bias assessment of the study selection, The Cochrane Collaboration's tool for randomized studies and Robins-TOOL for non-randomized studies (ROBINS-I) were performed. The Grading of recommendations, assessment, development and evaluation (GRADE) was used for assessing the level of evidence. RESULTS: A total of 2574 citations were recorded, but only four were considered eligible. The included studies reported different nutritional interventions such as fruit concentrate, vegetables and fruit juice powders, multivitamins, fish oil, and a customized dietary advice. The three studies using nutritional supplements showed improvements in at least one clinical parameter of periodontitis -reduction of probing depths, attachment gain, crevicular fluid decreased, reduced bleeding values on probing-after 2-6 months. Although, only two articles presented a moderate risk of bias, a very low level of evidence was found among the four studies taken together. CONCLUSIONS: Despite the results suggested that nutritional intervention is beneficial for periodontal therapy, the evidence in general, is inconsistent and imprecise. More interventional studies with longer periods of follow-up and the assessment of a specific nutritional intervention must be conducted.

Antioxidants as Adjuvants in Periodontitis Treatment: A Systematic Review and Meta-Analysis.

This systematic review with meta-analysis aimed to evaluate the effect of antioxidants as an adjuvant in periodontitis treatment. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane, Lilacs, OpenGrey, and Google Scholar. Based on the PICO strategy, the inclusion criteria comprised interventional studies including periodontitis patients (participants) treated with conventional therapy and antioxidants (intervention) compared to patients treated only with conventional therapy (control) where the periodontal response (outcome) was evaluated. The risk of bias was evaluated using the Cochrane RoB tool (for randomized studies) and ROBINS-I tool (for nonrandomized studies). Quantitative data were analyzed in five random effects meta-analyses considering the following periodontal parameters: clinical attachment loss (CAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and probing depth (PD). After all, the level of certainty was measured with the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) tool. Among the 1884 studies identified, only 15 interventional studies were according to the eligibility criteria and they were included in our review. From them, 4 articles presented a high risk of bias. The meta-analysis showed a statistically significant difference for CAL (SMD 0.29 (0.04, 0.55), p = 0.03, I 2 = 13%), PI (SMD 0.41 (0.18, 0.64), p = 0.0005, I 2 = 47%), and BOP (SMD 0.55 (0.27, 0.83), p = 0.0001, I 2 = 0%). The GRADE tool showed a moderate to high certainty in the quality of evidence depending on the clinical parameter and antioxidants used. These results suggest that the use of antioxidants is an adjunct approach to nonsurgical periodontal therapy which may be helpful in controlling the periodontal status.

Ultrastructural Alterations and Physical Changes on Bovine Dentin After Internal Bleaching with 35 % Hydrogen Peroxide / Alteraciones Ultraestructurales y Cambios Físicos en la Dentina Bovina Después del Blanqueamiento Interior con un 35 % de Peróxido de Hidrógeno

ABSTRACT: The aim of the study was to investigate the effect of internal bleaching on physical proprieties and ultrastructure of the bovine dentin.40 bovine incisors were used, divided in four experimental groups: control group, composed by teeth that did not receive the bleaching agent (G1); teeth submitted to a single internal bleaching session (G2); teeth submitted to two internal bleaching sessions (G3); teeth submitted to three internal bleaching sessions (G4). In each of the sessions, 35 % hydrogen peroxide was applied for 45 minutes on the dentin surface. Tests were performed (microhardness and roughness) and were analyzed using one-way analysis of variance (ANOVA) and Tukey's post-hoc test (p≤0.05). Electromicrographs were captured for quality analysis. In the analysis of the superficial microhardness of the dentin, the internal bleaching reduced the Knoop microhardness since the first session, being observed statistically significant differences between the experimental groups and the control. The surface roughness gradually increased in the G2, G3 and G4 groups, but only G4 presented a statistically significant difference from the others. The qualitatively evaluated electromicrographs showed damage to the dentin ultrastructure, with areas of erosion and greater involvement of the intertubular when compared to peritubular dentin. Internal bleaching with 35 % hydrogen peroxide caused injuries in bovine dentin from the first treatment session. Both modifications in physical properties and dentin ultrastructure have been identified. These changes were intensified the higher the number of dentin internal bleaching sessions was exposed.

RESUMEN: El objetivo de este estudio fue investigar el efecto del blanqueamiento interno sobre las propiedades físicas y la ultraestructura de la dentina bovina. Se utilizaron 40 incisivos bovinos, divididos en cuatro grupos experimentales: grupo de control, compuesto por dientes que no recibieron el agente blanqueador (G1); dientes sometidos a una única sesión interna de blanqueamiento (G2); dientes sometidos a dos sesiones internas de blanqueamiento (G3); dientes sometidos a tres sesiones internas de blanqueamiento (G4). En cada una de las sesiones, se aplicó peróxido de hidrógeno al 35 % durante 45 minutos en la superficie de la dentina. Se realizaron pruebas (microdureza y rugosidad). Los datos se analizaron mediante análisis de varianza de una vía (ANOVA) y prueba post-hoc de Tukey (p≤0,05). Las electromicrografías fueron capturadas para el análisis cualitativo. En el análisis de la microdureza superficial de la dentina, el blanqueamiento interno redujo la microdureza de Knoop desde la primera sesión, observándose diferencias estadísticamente significativas entre los grupos experimentales y el control [NF2]. La rugosidad superficial aumentó gradualmente en los grupos G2, G3 y G4, pero solo G4 presentó una diferencia estadísticamente significativa con respecto a los otros [NF3]. Las electromicrografías evaluadas cualitativamente mostraron daño a la ultraestructura de la dentina, con áreas de erosión y una mayor participación de la dentina intertubular en comparación con la dentina peritubular. El blanqueamiento interno con peróxido de hidrógeno al 35 % causó lesiones en la dentina bovina en la primera sesión del tratamiento. Ambas modificaciones, en propiedades físicas y en la ultraestructura dentinaria, han sido identificadas. Estos cambios se intensificaron a medida que se expuso a mayor número de sesiones de blanqueamiento interno en la dentina.

Association Between Periodontitis and Cognitive Impairment in Adults: A Systematic Review.

Periodontitis is an oral inflammatory disease and may contribute to low-grade systemic inflammation. Based on the contribution of periodontitis to systemic inflammation and the potential role of systemic inflammation in neuroinflammation, many epidemiological studies have investigated a possible association between periodontitis and mild cognitive impairment or dementia. The purpose of this study was to evaluate the clinical/epidemiological evidence regarding the association between periodontitis and cognitive decline in adult patients. A search conducted between September and October 2018 was performed in the electronic databases PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar, with no publication date or language restrictions. Analytical observational studies in adults (P-Participants), with (E-Exposure) and without periodontitis (C-Comparison) were included in order to determine the association between periodontitis and cognitive decline (O-Outcome). The search identified 509 references, of which eight observational studies were accorded with the eligibility criteria and evaluated. The results should, however, be interpreted cautiously due to the limited number of studies. This systematic review points to the need for further well-designed studies, such as longitudinal observational studies with control of modifiable variables, as diagnostic criteria and time since diagnosis of periodontitis and cognitive impairment, to confirm the proposed association.

Is there an association between asthma and periodontal disease among adults? Systematic review and meta-analysis.

This systematic review and meta-analysis aimed to investigate a possible association between asthma and periodontal disease in adults. This study was conducted by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the searches were performed on the following databases: PubMed, Scopus, Web of Science, Cochrane, LILACS, OpenGrey e Google Scholar. In this systematic review, observational studies with adult humans, which evaluated patients with and without asthma, were selected to verify the association between both diseases. To qualitative analysis, Fowkes and Fulton guidelines was used and for the quantitative analysis, it was used the mean and standard deviation from each group (with and without asthma), using confidence interval (CI) 95% and heterogeneity were tested using I2 index. Furthermore, a summary of the overall strength of evidence was presented using Grading of recommendations, assessment, development, and evaluation (GRADE). 3395 studies were identified, 11 were included on this systematic review to qualitative analysis and 6 of them to quantitative synthesis. Six meta-analyses were performed to the following clinical parameters: plaque index (PI), gingival index (GI), bleeding on probing (BOP), papillary bleeding index (PBI), calculus index (CI), clinical attachment loss (CAL). The meta-analysis results for CI was (p < 0.00001, I2 = 0%) PBI (p < 0.00001, I2 = 0%), CAL (p = 0,03, I2 = 98%) showed higher means for the asthmatic group. For BOP (p = 0.20 I2 = 83%), GI (p = 0.14 I2 = 97%) and PI (p = 0.53 I2 = 95%) non-statistical difference was found. The level of evidence analysis (GRADE) presented a low level of evidence among the clinical parameters. This systematic review and meta-analysis observed that asthmatic individuals present more periodontal disease, especially gingivitis, when compared to healthy individuals, but further studies with similar methods are necessary to evaluate interactions between both diseases.