"Caminando Con Riesgo": perceptions of occupational injury, workplace safety and workers rights among Spanish-speaking hospitalized patients.

Introduction: Occupational health disparities are well documented among immigrant populations and occupational injury remains a high cause of morbidity and mortality among immigrant populations. There are several factors that contribute to the high prevalence of work-related injury among this population and those without legal status are more likely to experience abusive labor practices that can lead to injury. While the work-related injuries and experiences of Spanish-speaking workers have been explored previously, there is a paucity of literature documenting injury among hospitalized patients. Additionally, there are few documented hospital-based occupational injury prevention programs and no programs that implement workers rights information. The purpose of this study was to further explore the context of work related injuries primarily experienced by Spanish speaking patients and knowledge of their rights in the workplace. Methods: This was a semi-structured qualitative interview study with Spanish speaking patients admitted to the hospital for work related injuries. The study team member conducting interviews was bilingual and trained in qualitative methodology. An interview guide was utilized for all interviews and was developed with an immigrant workers rights organization and study team expertise, and factors documented in the literature. Participants were asked about the type and context of the injury sustained, access and perceptions of workplace safety, and knowledge of participants rights as workers. All interviews were conducted in Spanish, recorded, transcribed in Spanish and then translated into English. A codebook was developed and refined iteratively and two independent coders coded all English transcripts using Dedoose. Interviews were conducted until thematic saturation was reached and data was analyzed using a thematic analysis approach. Results: A total of eight interviews were completed. All participants reported working in hazardous conditions that resulted in an injury. Participants expressed a relative acceptance that their workplace environment was dangerous and acknowledged that injuries were common, essentially normalizing the risk of injury. There were varying reports of access to and utilization of safety information and equipment and employer engagement in safety was perceived as a facilitator to safety. Most participants did have some familiarity with Occupational Safety and Health Administration (OSHA) inspections but were not as familiar with OSHA procedures and their rights as workers. Discussion: We identified several themes related to workplace injury among Spanish speaking patients, many of which raise concerns about access to workplace safety, re-injury and long-term recovery. The context around immigration is particularly important to consider and may lead to unique risk factors for injury, recovery, and re-injury both in the workplace and beyond the workplace, suggesting that perhaps immigration status alone may serve as a predisposition to injury. Thus, it is critical to understand the context around work related injuries in this population considering the tremendous impact of employment on one's health and financial stability. Further research on this topic is warranted, specifically the exploration of multiple intersecting layers of exposure to injury among immigrant populations. Future work should focus on hospital-based strategies for injury prevention and know your rights education tailored to Spanish speaking populations.

Comparison of 3D-Printed Single Crown Outcomes Among Different Computer-Aided Design Software Programs.

PURPOSE: Low-cost resin 3D printers have been used to produce affordable interim single crowns in public and private dental practices. The purpose of this study was to assess the impact of different computer-aided design (CAD) software programs on 3D trueness, microscopic marginal and internal gaps, time to design, and interproximal contacts of low-cost 3D-printed single crowns. MATERIALS AND METHODS: This in vitro study was performed on a total of 90 standardized resin-prepared teeth adapted to a dental manikin. For comparison among CAD software programs, 45 tooth preparations received 3D-printed crowns designed with one of three CAD software programs by an experienced technician and identified as groups TRIOS (n = 15), EXOCAD (n = 15), and ZZ (Zirkonzahn; n = 15). To assess interoperator reproducibility, 15 additional crowns were designed by a dental clinician (group ZZ-DENT) and 15 by a dental prosthetic technician (group ZZ-PROS), both with basic 1-week CAD/CAM training. Finally, as a control group, 15 crowns were milled using a high-end five-axis milling device (group ZZ-CONTROL). Statistically significant differences for 3D trueness, microscopic gaps, time to design, and interproximal contacts among groups were assessed with the Kruskal-Wallis test. RESULTS: No statistically significant differences in 3D trueness or marginal or internal gaps were found, either among different software programs or CAD operators (P > .05). However, Group TRIOS took significantly longer to design than EXOCAD and ZZ groups (P = .001). Less-experienced operators were significantly outperformed in time and interproximal contacts (P = .001) by the CAD technician using the same software program. Finally, control milled crowns (ZZ-CONTROL) significantly outperformed the respective 3D-printed copies (ZZ) in all assessed variables (P < .001). CONCLUSIONS: Different CAD software programs may affect the time required to design, but they do not significantly affect clinical outcomes of low-cost 3D-printed resin crowns if designed by an experienced CAD technician.

Does Clinical Experience Affect Chairside Digital Waxing of Single Crowns More Than Software Training?

PURPOSE: To compare the accuracy of dentists with different levels of expertise in computer-aided design (CAD) and prosthodontics to digitally design single crowns. MATERIAL AND METHODS: This in vitro study was conducted on 12 prepared teeth in 2 reference dental study models. The models were scanned using an intraoral scanner. Four dentists with different levels of clinical and CAD expertise (PROS: clinicians experienced in prosthodontics [n = 2]; CAD: experts in CAD [n = 2]) performed digital waxing on all prepared teeth using the same CAD software program. The resulting digital crown designs were compared to STL files of the original teeth to assess 3D deviations. The total cervical, distal, mesial, and occlusal surface deviations of the crowns from both groups were compared using paired t and Wilcoxon signed-rank tests (α = .05). RESULTS: The total median 3D deviation was 0.10 mm (range: 0.03 to 0.61 mm) for the PROS group and 0.14 mm (range: 0.07 to 0.58 mm) for the CAD group. The PROS group presented significantly smaller total 3D (P = .021) and cervical margin (P = .001) deviations. There were no significant differences between groups on the distal, mesial, or occlusal surfaces (P > .05). The CAD group performed digital waxing significantly faster (P = .001). CONCLUSION: Within the limitations of this study, the present findings suggest that clinical experience has a higher impact on the accuracy of digital wax patterns of single crowns than CAD experience.

Computer-aided design expertise affects digital wax patterns of CAD/CAM laminate veneers more than single crowns.

AIM: There is controversy in the literature regarding clinical outcomes of CAD/CAM laminate veneers. The aim of the present study was to assess the impact of different levels of CAD expertise and different software programs on the reliability and reproducibility of digital wax patterns of laminate veneers and single crowns. MATERIALS AND METHODS: The present preliminary in vitro study was performed on 10 prepared maxillary central incisors available in dental study models. Of the total, five central incisors were prepared with shoulder finish lines for single crowns, whereas the other five underwent incisal shoulder preparation for laminate veneers. The models were scanned using an intraoral scanner. Four dentists (group DENT) and four CAD dental technicians (group CAD) with expertise in different software programs performed digital diagnostic waxing on all prepared teeth. The resulting digital wax patterns (n = 80) were exported as standard tessellation language (STL) files and superimposed on gold standard digital wax patterns (obtained from the original shape of the teeth before preparations). 3D mesh deviations at the cervical margins as well as distal, mesial, and incisal/palatal surfaces between each STL and the gold standard digital wax patterns were calculated in millimeters using a CAD software program. The mean time required by each operator to perform digital waxing was also recorded. Paired comparisons between groups DENT and CAD as well as between nondental and dental software programs were performed for the crowns and laminate veneers using the Wilcoxon signed-rank and paired t tests (α = 0.05). RESULTS: For group DENT, median deviations for single crowns were 0.15 mm (range: 0.08 to 1.05 mm) and for laminate veneers they were 0.15 mm (range: 0.08 to 0.76 mm). For group CAD, median deviations for single crowns were 0.16 mm (range: 0.09 to 0.73 mm) and for laminate veneers they were 0.10 mm (range: 0.06 to 0.53 mm). The Wilcoxon signed-rank test revealed a statistically significant difference between groups DENT and CAD (P = 0.041) and between the software programs (P = 0.029) for laminate veneers, but not for single crowns (P > 0.05). Furthermore, mean times required for group CAD and for dental software programs were significantly shorter than those for group DENT (P = 0.001) and for nondental software programs (P = 0.001), respectively. CONCLUSION: Within the limitations of the present study, the findings suggest that CAD expertise and the software program significantly affect digital wax patterns for laminate veneers, but not for single crowns. (Int J Comput Dent 2022;25(4):361-0; doi: 10.3290/j.ijcd.b3555819).

Prevalence of Housing Insecurity in Survivors of Traumatic Injury.

BACKGROUND: Almost 20% of the US population are housing insecure (HI) due to inadequate living conditions, imbalanced costs to income, nonsustainable shelter, or overcrowding. Housing insecure and physical trauma share similar risk factors, but their direct association is not well elucidated. The objective of our study was to determine the prevalence of HI in survivors of traumatic injury. METHODS: We conducted a prospective cohort study at an urban, level 1 trauma center. A survey on social determinants of health was administered to adult patients, and demographic, injury specifics, and clinical outcomes data were collected. HI was defined by affirmative answers to questions related to history of homelessness or concern about sustainable shelter. The cohort was stratified by HI; groups were compared using the Mann-Whitney U and Fisher exact tests, as appropriate. RESULTS: Of 116 study participants, four were excluded due to missing data. Of the 112, 42 (37.8%) reported HI and most were black (69%) males (73.8%). There were no demographic differences between groups. Conversely, HI patients had a higher rate of penetrating traumatic injury (34.1% vs 14.5%, P-value = .03) and were significantly less educated compared to secure participants (P-value = .03) [no degree (26.2% vs 10.3%), high school degrees (21.4% vs 41.2%)] with concomitant illicit drug use (63.4% vs 27.9%, P < .001), and history of addiction (52.4% vs 7.2%, P < .001). CONCLUSION: HI far exceeds national averages in our cohort. Although difficult to ascertain a cause-effect relationship, HI may be a modifiable risk factor for trauma that negatively influences outcomes.

Digital workflow to produce esthetic space maintainers for growing patients.

Digital workflows have been used to enhance the predictability of oral rehabilitations. However, techniques to digitally design and manufacture esthetic space maintainers by following a prosthetically driven treatment plan for young patients are lacking. This technique report describes a full digital workflow to produce computer-aided design and computer-aided manufacturing (CAD-CAM) esthetic space maintainers by using intraoral scans, a dental CAD software program, and a milling machine. CAD-CAM space maintainers can be provided for young patients with satisfactory patient compliance and with minimal chairside adjustment.

Mutational spectrum of breast cancer susceptibility genes among women ascertained in a cancer risk clinic in Northeast Brazil.

PURPOSE: There is a paucity of data on the spectrum and prevalence of pathogenic variants among women of African ancestry in the Northeast region of Brazil. METHODS: We performed BROCA panel sequencing to identify inherited loss-of-function variants in breast cancer susceptibility genes among 292 Brazilian women referred to a single institution cancer risk assessment program. RESULTS: The study included a convenient cohort of 173 women with invasive breast cancer (cases) and 119 women who were cancer-free at the time of ascertainment. The majority of the women self-reported as African-descended (67% for cases and 90.8% for unaffected volunteers). Thirty-seven pathogenic variants were found in 36 (20.8%) patients. While the spectrum of pathogenic variants was heterogeneous, the majority (70.3%) of the pathogenic variants were detected in high-risk genes BRCA1, BRCA2, PALB2, and TP53. Pathogenic variants were also found in the ATM, BARD1, BRIP1, FAM175A, FANCM, NBN, and SLX4 genes in 6.4% of the affected women. Four recurrent pathogenic variants were detected in 11 patients of African ancestry. Only one unaffected woman had a pathogenic variant in the RAD51C gene. Different risk assessment models examined performed well in predicting risk of carrying germline loss-of-function variants in BRCA1 and/or BRCA2 in breast cancer cases. CONCLUSION: The high prevalence and heterogenous spectrum of pathogenic variants identified among self-reported African descendants in Northeast Brazil is consistent with studies in other African ancestry populations with a high burden of aggressive young onset breast cancer. It underscores the need to integrate comprehensive cancer risk assessment and genomic testing in the management of newly diagnosed Black women with breast cancer across the African Diaspora, enabling improved cancer control in admixed underserved and understudied populations.

Effect of varying levels of expertise on the reliability and reproducibility of the digital waxing of single crowns: A preliminary in vitro study.

STATEMENT OF PROBLEM: The digital waxing of single crowns can be affected by the quality of intraoral scans and use of computer-aided design (CAD) software programs. However, clinical outcomes of the resulting crowns are also affected by computer-aided manufacturing (CAM) methodologies. Studies on the effect of different levels of expertise on digital waxing are lacking. PURPOSE: The purpose of this in vitro study was to assess the impact of different levels of expertise on the reliability and reproducibility of margin outlining during digital waxing. MATERIAL AND METHODS: Thirty analogs of implant stock abutments (Ø4.8×4 mm) were embedded into resin blocks. To simulate different clinical situations, abutments were divided into 3 groups: 10 abutments (group GOS) received artificial gingiva and were scanned with an open system intraoral scanner, while 10 abutments with (group GIS) and 10 abutments without artificial gingiva (group IS) were scanned with an intraoral scanner within an integrated CAD-CAM system. All resulting standard tessellation language (STL) files were used by 2 different observers (an experienced CAD professional and a clinician with basic CAD knowledge) to digitally design a left mandibular central incisor in the same software program. All resulting digital crown designs were exported to STL files to assess crown margin accuracy at the coupling interface by superimposition with the control STL file of the scan body designed for the same abutment by the manufacturer. For this purpose, a CAD software program was used to automatically calculate median, minimum, and maximum deviations of margins in millimeters. Statistically significant pairwise differences among groups and between observers were assessed with the Wilcoxon signed-rank test (α=.05). RESULTS: For the CAD professional, median deviations between designed crown STL files and the control STL of the scan body were 0.08 mm (range: 0.04 to 0.15) for group GOS; 0.10 mm (range: 0.06 to 0.18) for group GIS; and 0.05 mm (range: 0.03 to 0.08) for group IS. For the clinician, median deviations were 0.08 mm (range: 0.04 to 0.12) for group GOS; 0.11 mm (range: 0.07 to 0.17) for group GIS; and 0.05 mm (range: 0.04 to 0.11) for group IS. There were no significant differences between observers (P>.05). However, statistically significant differences were found between group IS and the other 2 groups (P=.001) but not between groups GOS and GIS (P>.05). CONCLUSIONS: The present findings suggest that a digital wax pattern made with a dental CAD software program is not affected by varying levels of expertise but might be affected by subgingival margins.

Influence of receiver bandwidth on MRI artifacts caused by orthodontic brackets composed of different alloys.

PURPOSE: The aim of this in vitro study was to assess the role of bandwidth on the area of magnetic resonance imaging (MRI) artifacts caused by orthodontic appliances composed of different alloys, using different pulse sequences in 1.5 T and 3.0 T magnetic fields. MATERIALS AND METHODS: Different phantoms containing orthodontic brackets (ceramic, ceramic bracket with a stainless-steel slot, and stainless steel) were immersed in agar gel and imaged in 1.5 T and 3.0 T MRI scanners. Pairs of gradient-echo (GE), spin-echo (SE), and ultrashort echo time (UTE) pulse sequences were used differing in bandwidth only. The area of artifacts from orthodontic devices was automatically estimated from pixel value thresholds within a region of interest (ROI). Mean values for similar pulse sequences differing in bandwidth were compared at 1.5 T and 3.0 T using analysis of variance. RESULTS: The comparison of groups revealed a significant inverse association between bandwidth values and artifact areas of the stainless-steel bracket and the self-ligating ceramic bracket with a stainless-steel slot (P<0.05). The areas of artifacts from the ceramic bracket were the smallest, but were not reduced significantly in pulse sequences with higher bandwidth values (P<0.05). Significant differences were also observed between 1.5 T and 3.0 T MRI using SE and UTE, but not using GE 2-dimensional or 3-dimensional pulse sequences. CONCLUSION: Higher receiver bandwidth might be indicated to prevent artifacts from orthodontic appliances in 1.5 T and 3.0 T MRI using SE and UTE pulse sequences.

Complicaciones posquirúrgicas del manejo del dorso nasal con la técnica cartílago en puente / Post-surgical complications of the management of the nasal dorsum with the cartilage-bridging technique

Introducción: en Cartagena, desde hace aproximadamente una década, se está realizando una nueva técnica de injerto dorsal denominada cartílago en puente (CEP), realizada en rinoplastias cerradas por un solo otorrinolaringólogo. No obstante, no existen estudios que caractericen las complicaciones de esta técnica. Objetivo del estudio: caracterizar las complicaciones posquirúrgicas del manejo del dorso nasal con CEP en pacientes sometidos a una rinoplastia. Metodología: estudio observacional descriptivo, de corte transversal y de carácter retrospectivo, que abarca los registros clínicos de pacientes sometidos a una rinoplastia cerrada con la técnica CEP entre 2013 y 2016. Se midieron variables sociodemográficas, características del procedimiento y se registraron las complicaciones detectadas durante el seguimiento posoperatorio: aparición de infección, extrusión, desplazamiento y reabsorción del injerto Resultados: se identificaron 882 historias clínicas. La mediana de edad fue de 28 años, siendo el 81 % del género femenino. La rinoplastia fue primaria en 80,6 %, el material del injerto dorsal fue solo cartílago en 80,6 %, Gore-Tex® en 1,7 % y una combinación de cartílago y Gore-Tex® en 17,7 %. La mediana de duración de las rinoplastias fue de 78 minutos (rango intercuartílico [RIC]: 72-85), siendo el principal procedimiento adicional la septoplastia en 82,2 %. El 18,2 % de los pacientes presentaron complicaciones. El desplazamiento fue la principal complicación reportada (14,7%), seguida de la reabsorción (4,0 %) e infección (0,1 %). Conclusiones: la técnica CEP mostró como principales complicaciones el desplazamiento y la reabsorción del injerto, con una frecuencia similar a la descrita en otros estudios.

Introduction: In Cartagena, a new dorsal graft technique called Cartilage in Bridge (CEP) has been carried out for approximately a decade, performed in rhinoplasties closed by a single otorhinolaryngologist. However, there are no studies that characterize the complications of this technique. Objective: To characterize postoperative complications of the management of the nasal dorsum with bridge cartilage in patients undergoing rhinoplasty. Methodology: Retrospective, descriptive, observational cross-sectional study, covering clinical records of patients who underwent closed rhinoplasty with the bridge cartilage technique between 2013 and 2016. Sociodemographic variables, characteristics of the procedure, and complications detected during follow-up were recorded postoperative: appearance of infection, extrusion, displacement, and reabsorption of the graft Results: 882 medical records were identified. The median age was 28 years, being 81 % female. Rhinoplasty was primary in 80.6 %, the dorsal graft material was only cartilage in 80.6 %, Gore-Tex® in 1.7 % and combination of cartilage and Gore-Tex® in 17.7 %. The median duration of the rhinoplasties was 78 minutes (ICR: 72-85), with the main additional procedure being septoplasty in 82.2 %. 18.2 % of the patients presented complications. Displacement (14.7 %) was the main complication reported, followed by reabsorption (4.0 %) and infection (0.1 %). Conclusions: The cartilage bridge technique showed graft displacement and reabsorption as main complications, with a frequency similar to that described in other studies.

Use of free CAD software for 3D printing individualized face masks based on face scans.

AIM: To describe a method of digitally customizing 3D-printed face mask designs using 3D face scans and free software. MATERIALS AND METHODS: The procedure of creating customized face masks initially involved importing and aligning STL files of face scans and mask components in free CAD software. The imported mask described in this article is composed of three different STL files (body, filter structure, and grid). The body of the mask was then edited to fit precisely into the face scan STL by using the software's offset tool, followed by adjustments and smoothening of the surfaces of the edges. The resulting customized body of the mask plus the filter and grid STL files were exported and 3D printed with polylactic acid (PLA) filament using a fused deposition modeling (FDM) 3D printer. For the purposes of comparison, a conventional 3D-printed mask (from the original STL files, without being customized for the face scan) was also 3D printed from the original STL files. Both face masks were tested on the same two volunteers. RESULTS: The customized 3D-printed face mask presented a higher adaptation compared with the conventional face mask. The area of facial contact matched the one digitally designed in the software. The 3D-printed grid could clip exactly into the filter, which in turn could be precisely screwed into the body of the face mask. CONCLUSION: Within the limitations of this technical report, the present findings suggest that customized 3D-printed face masks with enhanced adaptation can be digitally designed using face scans and free CAD software.

Caracterización de las manifestaciones otorrinolaringológicas en pacientes con infección por VIH/Sida en la ciudad de Cartagena / Characterization of the otorrinolaringological manifestations in patients with HIV/AIDS infection in the city of Cartagena

Introducción: en Colombia, la incidencia por virus de inmunodeficiencia humana (VIH) ha ido en aumento; la ciudad de Cartagena tiene una de las más altas del país. Las manifestaciones otorrinolaringológicas en personas con VIH se estiman entre un 20%-80%, lo que genera un gran impacto en la calidad de vida. Objetivo: determinar las características epidemiológicas y las manifestaciones otorrinolaringológicas en un grupo de personas con VIH/Sida de la ciudad de Cartagena. Metodología: diseño observacional descriptivo de corte transversal y prospectivo. Se recolectó información de pacientes con VIH de la ciudad de Cartagena, que asistieron a dos centros médicos. Se les aplicó un cuestionario para obtener datos epidemiológicos, signos y síntomas otorrinolaringológicos, así como un examen físico otorrinolaringológico completo. Resultados: se incluyeron 150 pacientes en el estudio, con una media de edad de 31 años, 59,3% del género masculino y 40,7% del femenino. El antecedente patológico no otorrinolaringológico más frecuente fue la coinfección por sífilis en un 10%; el otorrinolaringológico fue la sinusitis y la candidiasis oral, cada uno con un 3,3%. El 73% de los pacientes manifestó alteración otorrinolaringológica en el momento de la evaluación. Las más frecuentes fueron las otológicas, con el 39,9% de los pacientes. Además, se observó una relación estadísticamente significativa entre los conteos de CD4 y hallazgos como disfonía en laringe (p = 0,045). Conclusiones: las manifestaciones otológicas fueron las más frecuentes en nuestro medio y se encontró una relación entre el conteo de CD4 y las manifestaciones laríngeas de la enfermedad.

Introduction: In Colombia, the incidence of the disease has been increasing and Cartagena has the highest numbers of the country. Otorhinolaryngological manifestations in people with HIV/AIDS are estimated between 20%-80% generating a great impact on quality of life. Objective: To determine the epidemiological characteristics and otorhinolaryngological manifestations in a group of people with HIV / AIDS in the city of Cartagena. Methodology: Observational, descriptive, cross-sectional and prospective design. Information was collected from patients with HIV from the city of Cartagena who attended 2 medical centers, a questionnaire was applied to obtain epidemiological data, otorhinolaryngological signs and symptoms, as well as a complete otorhinolaryngological physical examination. Results: 150 patients were included in the study, with a mean age of 31 years, 59.3% male and 40.7% female. The most frequent non-otorhinolaryngological pathological antecedent was syphilis coinfection in 10% and otorhinolaryngological, sinusitis and oral candidiasis each with 3.3%. 73% of the patients at the time of the evaluation manifested otorhinolaryngological alteration, the otological ones being the most frequent with 39.9% of the patients. Furthermore, a significant relationship was observed between CD4 counts and findings such as laryngeal dysphonia (p = 0.045). Conclusions: The otological manifestations were the most frequent in our environment and a relationship was found between the CD4 count and the laryngeal manifestations of the disease.

Clinical relevance of Digital Dentistry during COVID-19 outbreak: a scoped review

Aim: To perform a scoped literature review on advantages of digital workflows in dentistry that could be widely adopted to address safety issues raised during the coronavirus (COVID-19) pandemic. Methods: Recent studies on any advantages of digital dentistry ­ as compared to conventional methods ­ that could help addressing the new safety demands for dental treatments that emerged due to the current pandemic were included. PUBMED, Embase, and Web of Knowledge databases were searched for eligible articles published in the last five years. The guidelines of PRISMA statement were followed during data extraction and evaluation. Results: The present search strategy yielded 181 publications. After application of exclusion criteria, a total of 34 studies were finally considered eligible to be discussed. Among the most important advantages of digital dentistry that contribute to safety during the current pandemic are: reduced number of clinical appointments required, shorter chairside time, less invasive surgeries and safer procedures. Conclusion: Within the limitations of this study, the findings observed herein suggest that the use of digital workflows in dentistry could lead to increased safety and reduced transmission of COVID-19 during the current pandemic

Extra-skeletal manifestations in mice affected by Clcn7-dependent autosomal dominant osteopetrosis type 2 clinical and therapeutic implications.

Autosomal dominant osteopetrosis type 2 (ADO2) is a high-density brittle bone disease characterized by bone pain, multiple fractures and skeletal-related events, including nerve compression syndrome and hematological failure. We demonstrated that in mice carrying the heterozygous Clcn7 G213R mutation, whose human mutant homolog CLCN7 G215R affects patients, the clinical impacts of ADO2 extend beyond the skeleton, affecting several other organs. The hallmark of the extra-skeletal alterations is a consistent perivascular fibrosis, associated with high numbers of macrophages and lymphoid infiltrates. Fragmented clinical information in a small cohort of patients confirms extra-skeletal alterations consistent with a systemic disease, in line with the observation that the CLCN7 gene is expressed in many organs. ADO2 mice also show anxiety and depression and their brains exhibit not only perivascular fibrosis but also ß-amyloid accumulation and astrogliosis, suggesting the involvement of the nervous system in the pathogenesis of the ADO2 extra-skeletal alterations. Extra-skeletal organs share a similar cellular pathology, confirmed also in vitro in bone marrow mononuclear cells and osteoclasts, characterized by an impairment of the exit pathway of the Clcn7 protein product, ClC7, through the Golgi, with consequent reduced ClC7 expression in late endosomes and lysosomes, associated with high vesicular pH and accumulation of autophagosome markers. Finally, an experimental siRNA therapy, previously proven to counteract the bone phenotype, also improves the extra-skeletal alterations. These results could have important clinical implications, supporting the notion that a systematic evaluation of ADO2 patients for extra-skeletal symptoms could help improve their diagnosis, clinical management, and therapeutic options.

Teaching Cell Biology to Dental Students with a Project-Based Learning Approach.

Although the discipline of cell biology (CB) is part of the curricula of predoctoral dental schools, students often fail to recognize its practical relevance. The aim of this study was to assess the effectiveness of a practical-theoretical project-based course in closing the gaps among CB, scientific research, and dentistry for dental students. A project-based learning course was developed with nine sequential lessons to evaluate 108 undergraduate dental students enrolled in CB classes of a Brazilian school of dentistry during 2013-16. To highlight the relevance of in vitro studies in the preclinical evaluation of dental materials at the cellular level, the students were challenged to complete the process of drafting a protocol and performing a cytocompatibility assay for a bone substitute used in dentistry. Class activities included small group discussions, scientific database search and article presentations, protocol development, lab experimentation, and writing of a final scientific report. A control group of 31 students attended only one laboratory class on the same theme, and the final reports were compared between the two groups. The results showed that the project-based learning students had superior outcomes in acknowledging the relevance of in vitro methods during biocompatibility testing. Moreover, they produced scientifically sound reports with more content on methodological issues, the relationship with dentistry, and the scientific literature than the control group (p<0.05). The project-based learning students also recognized a higher relevance of scientific research and CB to dental practice. These results suggest that a project-based approach can help contextualize scientific research in dental curricula.

Assessment of predictivity of volatile organic compounds carcinogenicity and mutagenicity by freeware in silico models.

The application of in silico methods is increasing on toxicological risk prediction for human and environmental health. This work aimed to evaluate the performance of three in silico freeware models (OSIRIS v.2.0, LAZAR, and Toxtree) on the prediction of carcinogenicity and mutagenicity of thirty-eight volatile organic compounds (VOC) related to chemical risk assessment for occupational exposure. Theoretical data were compared with assessments available in international databases. Confusion matrices and ROC curves were used to evaluate the sensitivity, specificity, and accuracy of each model. All three models (OSIRIS, LAZAR and Toxtree) were able to identify VOC with a potential carcinogenicity or mutagenicity risk for humans, however presenting differences concerning the specificity, sensitivity, and accuracy. The best predictive performances were found for OSIRIS and LAZAR for carcinogenicity and OSIRIS for mutagenicity, as these softwares presented a combination of negative predictive power and lower risk of false positives (high specificity) for those endpoints. The heterogeneity of results found with different softwares reinforce the importance of using a combination of in silico models to occupational toxicological risk assessment.

An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: A case report with cone-beam CT follow-up.

One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

Transition from failing dentition to full-arch fixed implant-supported prosthesis with a staged approach using removable partial dentures: a case series.

The present retrospective case series is aimed at evaluating a staged approach using a removable partial denture (RPD) as an interim prosthesis in treatment to correct a failing dentition until such time as a full-arch fixed implant-supported prosthesis may be inserted. Eight patients, who had undergone maxillary full-arch rehabilitation with dental implants due to poor prognosis of their dentitions, were analyzed. All treatment included initial periodontal therapy and a strategic order of extraction of hopeless teeth. An RPD supported by selected teeth rehabilitated the compromised arch during implant osseointegration. These remaining teeth were extracted prior to definitive prosthesis delivery. Advantages and drawbacks of this technique were also recorded for the cases presented. Among the advantages provided by the staged approach are simplicity of fabrication, low cost, and ease of insertion. Additionally, RPD tooth support prevented contact between the interim prosthesis and healing abutments, promoting implant osseointegration. The main drawbacks were interference with speech and limited esthetic results. Implant survival rate was 100% within a follow-up of at least 1 year. The use of RPDs as interim prostheses allowed for the accomplishment of the analyzed rehabilitation treatments. It is a simple treatment alternative for patients with a low smile line.

O uso de mini-implantes na intrusão de dentes anteriores / The use of mini-implants in the intrusion of anterior teeth: a literature review

Um dos fatores comumente encontrados em pacientes na Odontologia é a ocorrência de sorriso gengival e mordida profunda, que por sua vez pode ser causada pela presença de dentes extruídos. Tratamentos convencionais com o arco utilidade demandam considerável tempo clínico e podem causar a extrusão de molares. No entanto, outra opção para estes casos tem sido descrita na literatura nos últimos 20 anos, embora por poucos estudos, sendo esta o uso de mini-implantes. O presente trabalho visou revisar a literatura atual relativa ao uso de mini-implantes na intrusão de dentes anteriores, por meio de uma análise de artigos disponíveis nas bases de dados Web of Science, MedLine, e Scopus, entre 1991 a 2012. Como conclusão, o uso de mini-implantes pode representar uma simples e importante alternativa para casos de sorriso gengival e mordida profunda, não dependendo da cooperação do paciente.

One of the factors commonly found in patients in dentistry is the occurrence of gummy smile and overbite, which in turn can be caused by the presence of extruded teeth. Conventional treatments with the utility arch require considerable time and may cause the extrusion of molars. Another option for such cases, which has been reported in the literature over the past 20 years by a few studies, is the use of mini-implants. This study aimed to review the current literature on the use of mini-implants in the anterior teeth intrusion, through an analysis of available articles in the Web of Science, MedLine and Scopus databases from 1991 to 2012. In conclusion, the use of mini-implants may represent a simple and important alternative for cases of gummy smile and deep bite, not depending on the patient's cooperation.

Citocompatibilidade do cimento reparador ceramicrete em cultura primária de osteoblastos humanos / Cytocompatibility of the ceramicrete repair cement in primary culture of human osteoblasts

Ainda são muito raras as informações sobre a resposta de osteoblastos humanos ao Ceramicrete (CC), um material proposto para ser usado como cimento reparador que apresenta características bastante promissoras. Assim, o objetivo do presente estudo foi verificar o grau de citocompatibilidade do CC em culturas primárias de osteoblastos humanos. Para isso, foi utilizado um modelo experimental baseado na quantidade de material usado em uma retro-obturação, criando condições mais próximas a situação clínica real. Retrocavidades obturadas com CC foram colocados em poços de cultura contendo meio de cultura (α-MEM), por 24h (n=4). Meios de cultura contendo dentes retro-obturados com ProRoot MTA e OZE foram usados como controle negativo e positivo, respectivamente. Todos os meios foram armazenados. Posteriormente, foram cultivados osteoblastos humanos (2 x 104 células/amostra), por 24h, em poços com os meios armazenados dos 3 materiais. Foi avaliada a citocompatibilidade utilizando um Kit específico (Cytotox Kit, Xenometrix, Alemanha), que possibilita o estudo de 3 parâmetros (XTT, NR e CVDE) utilizando a mesma amostra. Foi encontrada uma diferença estatisticamente significativa entre os 3 materiais para todos os 3 parâmetros avaliados (ANOVA, p< 0,05). O CC e o MTA foram sempre estatisticamente superiores ao OZE (Duncan, p<0,05). Entretanto, não foram encontradas diferenças entre os 2 cimentos reparadores, CC e MTA (Duncan, p> 0,05). Portanto, pode-se concluir que o Ceramicrete expressa um padrão de citocompatibilidade similar a do MTA, em cultura primária de osteoblastos humanos, quando usado como material retro-obturador.

Ceramicrete is an endodontic material with very promising characteristics. However, information about the response of human osteoblasts to CC is very rare. So, the purpose of this study was to assess the cytocompatibility of CC in primary cultures of human osteoblasts. For this, we used a modelo f retro-obturation, creating conditions close to real clinical situation. The apical portions of canines were retro-obturated with CC or control materials. The, the teeth were placed in Wells containing culture médium (α-MEM) for 24h (n=4). ProRoot MTA and ZOE were used as negative and positive controls, respectively. All media were stored. Subsequently, human osteoblasts were cultured (2x104 cells) for 24 h in Wells with the stored medium. The cytocompatibility was evaluated using a specific kit (Cytotoxic, Xenometrix, Germany), which enables the study of three parameters of cell viability using the same sample (CTT, NR and CVDE). It was found significant difference among the three materials Fo all parameters (ANOVA, p> 0.05). The CC and the MTA were always statistically superior to ZOE (Duncan, p> 0.05). However, no differentes were found between the two cements, CC and MTA (Duncan, p> 0.05). It can be concluded that CC is an endodontic cement as cytocompatible as MTA when used as a retro-obturation material in primary cultures of human osteoblasts.