Morphological changes of the apical foramen after enlargement: A scoping review of in vitro studies.

Background: To outline the current evidence on root morphological changes after enlarging the apical foramen with NiTi instruments. Material and Methods: A search was performed in the Virtual Health Library, PubMed, EMBASE, Scopus, Web of Science, Science Direct and SciELO databases, in addition to a manual search in Google Scholar, between January 2017 and October 2023. Articles published in English that describe in vitro studies investigating root morphological changes after instrumentation 1 mm beyond the major apical foramen were included. The quality of evidence in the included studies was also analyzed. Results: The search retrieved 367 articles. Of these, four studies were eligible for data synthesis and analysis, all of them in vitro studies. Synthesis of the results of these in vitro studies showed a larger number of root morphological changes such as experimental dentinal microcraks in samples submitted to instrumentation beyond the apical foramen when compared to micro-CT images obtained before preparation. Conclusions: The in vitro studies analyzed in this scoping review indicate that instrumentation beyond the major foramen of the root canal, promotes morphological changes in this area and that the adoption of standardized methodologies would not only increase the accurate detection and characterization of these changes but also facilitate the application of these findings in clinical trials and patient care. Key words:Endodontics, apical morphology, root canal preparation.

Pulp Canal Obliteration Following Traumatic Dental Injury in an Upper Lateral Incisor: A Case Report with 3-year Follow-up.

Endodontic management of teeth afflicted with pulp canal obliteration faces a challenge due to the heightened risk of complications including excessive wear, perforation, and suboptimal chemomechanical preparation. This report aims to elucidate the clinical endodontic strategy employed in addressing pulp canal obliteration after a history of dental trauma and an associated periradicular lesion in an upper lateral incisor. A patient visited the dental emergency department with symptoms of apical swelling, acute persistent pain, and discoloration of tooth 22. Following comprehensive clinical evaluation and cone-beam computed tomography, the diagnosis of pulp canal obliteration involving the cervical and middle thirds of the tooth, alongside an acute periradicular abscess was established. Root canal was accessed using tomographic image planning, augmented by loupe magnification and ultrasonic instrumentation. Precise identification of the access cavity was radiographically confirmed, preceded by thorough irrigation with 2.5% sodium hypochlorite and subsequent cervical and middle third preparation. Verification of the working length by an electronic apex locator ensured precise apical preparation, followed by passive ultrasonic irrigation to optimize disinfection and to enhance penetrability of intracanal calcium hydroxide medication, administered for 15 days to eliminate microbial invasion. Upon resolution of symptoms, root canal obturation employing thermo-mechanical compaction and coronal sealing with composite resin was accomplished. Radiographic assessment after a one-year interval presented evidence of lesion regression and bone repair. Subsequent cone-beam computed tomography imaging at the three-year follow-up confirmed complete healing of the periradicular tissues, attesting to the efficacy of the endodontic intervention.

Clinicopathological characteristics of odontogenic carcinosarcoma: A systematic review.

BACKGROUND: The aim of the present systematic review was to summarize evidence on odontogenic carcinosarcoma, analyzing clinical, epidemiological, imaging, histopathological, immunohistochemical, therapeutic, and prognostic features of this tumor. MATERIALS AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the Ovid MEDLINE (Wolters Kluwer), PubMed (National Library of Medicine), Web of Science (Thomson Reuters), Scopus (Elsevier), and LILACS (Latin American and Caribbean Center on Health Sciences Information) databases, without publication date or language restrictions. Case reports or case series of OCS reporting clinical, radiological, and histopathological data that confirmed the diagnosis were selected. The Joanna Briggs Institute-University of Adelaide tool was used for critical appraisal of the included articles. RESULTS: Odontogenic carcinosarcoma is a rare, aggressive tumor associated with high mortality; however, the metastasis rate is low. The tumor has a male predilection. The mean patient age is 40 years, but there is no predilection for age. The left posterior mandible is the most affected site, but no specific radiographic features have been reported. CONCLUSION: Given its rarity, dentists, oral-maxillofacial surgeons, and physicians need to be aware of odontogenic carcinosarcoma in order to increase the diagnostic potential, preventing delays in diagnosis and treatment and thus contributing to lower morbidity of the tumor.

Scope of Preparation of Oval and Long-Oval Root Canals: A Review of the Literature.

Successful endodontic treatment depends on cleaning and disinfecting the root canals, in order to provide conditions for three-dimensional filling, which should prevent root canal reinfection. However, anatomical complexities pose a challenge during endodontic treatment. The present study was a literature review carried out in the following databases: PubMed, SciELO, and MEDLINE, which were searched for articles published from 2017 to 2021. Micro-CT studies published in English, which analysed the capacity for preparation of oval and long-oval root canals, were included. The following keywords were used: "oval-shaped canals," "long-oval-shaped canals," "endodontics," and "micro-CT." The aim of this study was to carry out a literature review of micro-CT studies on the scope of the capacity for preparation performed in oval and long-oval root canals with rotary and reciprocating instruments.

Impact of oral health on nutritional status, self-perception of oral health and quality of life of institutionalized elderly.

BACKGROUND: This study aimed to investigate the influence of oral health on nutritional status, self-perception of oral health and health related quality of life of institutionalized elders. MATERIAL AND METHODS: A cross-sectional study was conducted with 193 institutionalized elders living in the metropolitan region of João Pessoa (Brazil). The independent variables included were: 1) caries experience (DMFT index and its components); 2) use and need of dental prostheses; and 3) type of edentulism. The dependent variables included were related to nutritional status, self-perception of oral health and health-related quality of life. Data were submitted to a descriptive and comparative analysis, through correlation, association and difference tests, considering a significance level of 5% (p<0.05). RESULTS: No statistical significant correlations or associations between the oral health status and nutritional status and quality of life were found (p>0.05). Individuals who did not need prosthesis had higher scores for nutritional status. Self-perception of oral health and health-related quality of life did not vary significantly according to the studied variables. CONCLUSIONS: The oral health status has a limited impact on the nutritional status, and does not impact the self-perception of oral health and quality of life of the institutionalized elders. Key words:Nursing homes, oral health, quality of life.

Fatores associados ao acúmulo de biofilme visível em idosos institucionalizados / Factors associated with visible biofilm accumulation in institutionalized elders

O objetivo desse estudo foi avaliaro acúmulo de biofilme visível e verificar os fatores associados em idosos institucionalizados. Realizou-se um estudo transversal com idosos (n = 193) em instituições de longa permanência (n = 7) da região metropolitana de João Pessoa (PB). A presença de biofilme visível nos dentes e/ou nas próteses dentárias foi considerada como variável dependente. As variáveis independentes do estudo foram: características sociodemográficas, estado físico, hábitos de higiene e presença de agravos bucais. A influência das variáveis independentes sobre as variáveis dependentes foi analisada segundo regressão logística (α < 0,05). Foi possível perceber que a presença de biofilme dental visível (63,3%) está associada com idade superior a 80 anos (OR = 1,53), presença de cálculo dental (OR = 4,91) e frequência de escovação até uma vez ao dia (OR = 1,96). Diante disso, o acúmulo de biofilme visível está associado com avanço da idade, presença de cálculo dental e baixa frequência de higiene.

To evaluate the presence of visible biofilm accumulation and check associated factors in institutionalized elders. We conducted in a cross-sectional study with elders (n=193) from long-term care facilities (n=7) in the metropolitan region of João Pessoa-PB. The presence of visible biofilm in teeth and/or dentures was considered as dependent variable. The independent variables of the study were: socio-demographic characteristics, physical state, hygiene habits, and presence of oral diseases. The influence of independent variables on dependent variables was analyzed according to logistic regression (α<0.05). The presence of visible dental biofilm (IPV) (63.3%) is associated with age over 80 years (PR=1.53), presence of dental calculus (OR=4,91) and brushing frequency up to once a day (OR=1.96). The increase in visible biofilm is associated with advancing age, presence of dental calculus and low frequency of hygiene.

Physical and psychological states interfere with health-related quality of life of institutionalized elderly: a cross-sectional study.

BACKGROUND: Nursing home elders experience many problems that may influence their quality of life, in example of cognitive, mental, nutritional and physical disabilities. Concerning about elders' wellbeing may help them living with dignity. This study aimed to investigate factors associated with Health-Related Quality of Life (HRQoL) of institutionalized elders in a capital city of Brazilian Northeast. METHODS: A cross-sectional study was conducted with 125 institutionalized elders living in the metropolitan region of João Pessoa (Brazil). The following variables were tested regarding their association with the elders' HRQoL: Socio-demographic characteristics; Performance of daily-living activities, Frailty status, Cognitive status, Nutritional status, Self-perception of oral health and Depression status. Hierarchical multiple Poisson loglinear and binary logistic regressions analyses were performed in order to assess the impact of each independent variable on HRQoL, considering a significance level of 5%. RESULTS: The median of HRQoL of institutionalized elders was 64. Multivariate regression models showed that retirement, frailty and depression were statistically associated with poor HRQoL (p < 0.05). Not-frail elderly and less depressed were more likely to present higher HRQoL scores. CONCLUSIONS: Lower HRQoL of institutionalized elderly is associated with decline of physical and psychological states. Institutions should be advised to plan and implement actions that would improve the HRQoL of institutionalized elderly.

Biochemical and microbiological analysis of the saliva of institutionalized elderly: With edentulism, use of dentures and presence of biofilm.

BACKGROUND: To analyze biochemical and microbiological parameters of the saliva of institutionalized elders and to investigate the relation of these parameters with edentulism, use of dentures and presence of biofilm. MATERIAL AND METHODS: A cross-sectional study carried was out in seven long-term institutions. Samples (n=161) of unstimulated saliva were collected for analysis of salivary flow, quantification of total proteins and identification of microorganisms. Oral examination was carried out to verify the number of missing teeth, the use of dentures and the presence of visible biofilm on the surface of teeth and dentures. Associations were performed using chi-square or Fisher's exact test (α<0.05). Mann-Whitney Test was used to identify differences in the salivary flow and total proteins (α<0.05). RESULTS: There was no association between the type of edentulism and use of dentures with biochemical and microbiological parameters of saliva (p>0.05). Associations were observed between the presence of dentures biofilm and the colonization of Streptococcus sp. (p=0.038) and Candida sp. (p=0.03). CONCLUSIONS: The absence of teeth and use of dentures do not influence the amount of total proteins and the microorganisms count in saliva. Denture biofilms are associated with the presence of Streptococcus sp. and Candida sp. in saliva of institutionalized elders. Key words:Candida, long-stay institutions for elders, saliva, Streptococcus, Staphylococcus.