An oral cancer screening program in Brazil: Analysis of seven years of outcome after its implementation in the suburban cities of São Paulo.

OBJECTIVE: To describe the implementation of an oral cancer screening program at the Barretos Cancer Hospital (BCH) and present the outcome based on data obtained from 2014 to 2020. MATERIALS AND METHODS: The residents of the Regional Health District of Barretos (DRS-V) were personally invited by community health agents or nurses, and among 13,973 people, 15,222 oral examinations were carried out over the years in 18 of its municipalities. Oral examinations were performed at the Mobile Dental Unit and at the Prevention Department of the BCH. Inclusion criteria were being 35 years of age or older, having a personal history of tobacco or alcohol consumption, or having a lesion in the oral cavity found by community health agent or self-reported, regardless of age or risk factors. RESULTS AND CONCLUSION: The main result of our study was the stages of oral cancer among screen detected cases were smaller compared to cases in the hospital registry, in the state and in Brazil. Oral cancer detection rate per 1,000 oral examinations was 10.7.The early stages of oral cancer found by screening in primary care facilities or using mobile units suggest that, when organized, screening may improve the prognosis of oral cancer.

Quantitative analysis of culturable bacteria, levels of endotoxins, inflammatory mediators and substance P in teeth with symptomatic irreversible pulpitis and in teeth with vital normal pulp tissues.

AIM: To comparatively analyse the levels of culturable bacteria, endotoxins (LPS), tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1ß) and substance P in teeth with symptomatic irreversible pulpitis (SIP) and vital normal pulp (VNP) tissues. METHODOLOGY: Thirty-two patients were included (20 teeth with SIP and 12 teeth with VNP tissues) in this cross-sectional study. Samples were collected from the full length of the root canals (microbial analysis) and periapical tissues (2 mm beyond the apex for immunological analysis), using sterile absorbent paper points. The levels of culturable bacteria (culture method), endotoxins (LAL Pyrogent 5000), TNF-α, IL-1ß and substance P (ELISA) were assessed. The Mann-Whitney test was used for comparisons between the levels of CFU/mL, LPS, TNF-α, IL-1ß and substance P in the SIP and VNP groups. The statistical analysis was performed with the significance level set at 5%. RESULTS: Culturable bacteria were recovered from all teeth with SIP. On the other hand, no positive cultures were observed in the VNP tissues group (p > .05). The levels of LPS were approximately four times higher in teeth with SIP than in teeth with VNP tissues (p < .05). Higher levels of TNF-α and substance P were detected in teeth with SIP (p < .05). On the other hand, no difference in the levels of IL-1ß was detected between the two groups (p > .05). CONCLUSION: Teeth with symptomatic irreversible pulpitis present higher levels of culturable bacteria, endotoxins, TNF-α and substance P than those with vital normal pulp tissues. On the other hand, the levels of IL-1ß were similar in teeth from both groups suggesting reduced implications of this inflammatory mediator in the early stages of infection.

Pressure-dependence Raman spectroscopy and the lattice dynamic calculations of Bi2(MoO4)3 crystal.

This work reports a pressure-dependent Raman spectroscopic study and the theoretical lattice dynamics calculations of a Bi2(MoO4)3 crystal. The lattice dynamics calculations were performed, based on a rigid ion model, to understand the vibrational properties of the Bi2(MoO4)3 system and to assign the experimental Raman modes under ambient conditions. The calculated vibrational properties were helpful to support pressure-dependent Raman results, including eventual structural changes induced by pressure changes. Raman spectra were measured in the spectral region between 20 and 1000 cm-1 and the evolution of the pressures values was recorded in the range of 0.1-14.7 GPa. Pressure-dependent Raman spectra showed changes observed at 2.6, 4.9 and 9.2 GPa, these changes being associated with structural phase transformations. Finally, principal component analysis (PCA) and hierarchical cluster analysis (HCA) were performed to infer the critical pressure of phase transformations undergone by the Bi2(MoO4)3 crystal.

Evaluation of Novel Plant-derived Monomers-based Pretreatment on Bonding to Sound and Caries-affected Dentin.

This study evaluated the influence of new monomers derived from cashew nut shell liquid (CNSL) applied for dentin biomodification on resin-dentin bond strength, nanoleakage, and micropermeability to sound and artificially-created caries-affected dentin. Human dentin specimens were assigned to five groups, according to the following dentin pretreatment solutions: Absolute ethanol (control), 2 wt% grape seed extract (Vitis vinifera), 2 wt% cardol [from cashew nut shell liquid (CNSL)], 2 wt% cardol-methacrylate or 2 wt% cardanol-methacrylate applied on sound and artificial caries-affected dentin. Specimens were analyzed after 24 hour or 1 year of water storage. Microtensile bond strength (µTBS) (n=6), interface micropermeability (n=3), and silver nanoleakage (n=6) were assessed using a universal testing machine, confocal laser scanning microscope, and scanning electron microscope, respectively. In sound dentin, no difference in bond strength was observed between the groups in either storage period. In artificial caries-affected dentin, pretreatment with cardol-methacrylate resulted in statistically higher bond strength than all the other treatments in both storage periods. Cardol-methacrylate treatment resulted in less nanoleakage, along with improved interfacial integrity, compared to further treatments in artificial caries-affected dentin. Regarding micropermeability analysis, all treatments depicted deficient sealing ability when applied on artificial caries-affected dentin, with the presence of gaps in the control group. In conclusion, cardol-methacrylate is a promising plant-derived monomer to reinforce the hybrid layer, since it preserved resin-dentin bond strength and improved dentin bonding, especially to caries-affected dentin, a well-known harsh substrate for adhesion longevity.

A temperature-dependent Raman scattering and X-ray diffraction study of K2Mo2O7·H2O and ab initio calculations of K2Mo2O7.

This study reports a temperature-dependent Raman scattering and X-ray diffraction study of K2Mo2O7·H2O. The high-temperature Raman scattering analysis shows that the material remains structurally stable, with triclinic symmetry, in a temperature range from 300 to 413 K and undergoes a structural phase transition between 413 and 418 K. This phase transition is most likely connected with the dehydration process of K2Mo2O7·H2O. The temperature-dependent X-ray diffraction patterns are measured from 30 to 573 K. The results show that the discovered phase transition occurs between 419 and 433 K, in good agreement with the Raman scattering results. According to the Raman data, with increasing temperature, the dehydrated crystal of K2Mo2O7 undergoes a new phase transformation at 603 K and melts at ~843 K. Principal component and hierarchical cluster analyses are performed based on the treatment of the raw spectral data to infer the phase transformations occurring in the material. Assignments of the Raman modes for the K2Mo2O7 system at ambient conditions are studied through first-principles calculations based on density functional perturbation theory. These calculations are applied to understand the electronic properties, including the band structure and the associated projected density of states, of K2Mo2O7 under the local density approximation.

Post-retained Restorations: A Cost-minimization Analysis Nested in a Randomized Clinical Trial.

OBJECTIVES: The aim of this study was to assess four post-retained restorative strategies for endodontically treated teeth using cost-minimization analysis. METHODS AND MATERIALS: The cost-minimization analysis was based on primary data from a randomized clinical trial and followed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Two hundred twenty-five teeth (141 patients) restored using four strategies-teeth with ferrules+ restored with either glass fiber posts or direct composite or crowns, and teeth without ferrules- restored with either glass fiber or cast metal posts with crowns-were evaluated annually between 2009 and 2018. Initial costs and incremental costs per year were calculated. Survival curves were created using the Kaplan-Meier method and log-rank test. Kruskal-Wallis analysis was followed by Dunn's test, which was used to compare restorative treatments, with a significance level of 5%. RESULTS: Initial costs were greater for cast metal posts without crowns (US$153.14). Glass fiber posts with composite (US$27.11) were least costly; the most failures occurred in this group, but they were primarily repairable restoration fractures. The number of extractions, and thus cost, was greater for glass fiber posts with crowns. The mean annual cost was significantly lower for teeth restored with composite (p<0.001). Ferrule presence did not significantly impact annual costs. CONCLUSIONS: The use of glass fiber posts and direct composite incurred significantly lower annual costs than did other alternatives involving crowns or metal posts.

Is there bacterial infection in the intact crowns of teeth with pulp necrosis of sickle cell anaemia patients? A case series study nested in a cohort.

AIM: To evaluate the presence of bacteria in permanent teeth with intact crowns (without caries, periodontal disease or dental trauma) in patients with sickle cell anaemia (HbSS genotype) by analysing their clinical, imaging and microbiological parameters. METHODOLOGY: This is a case series study nested in a cohort. In the first follow-up of this cohort study (Journal of Endodontics, 2013, 39, 177), 10 HbSS patients with at least one tooth with an intact crown and clinically diagnosed with pulp necrosis by pulse oximetry adapted for dentistry and a cold pulp sensitivity test (n = 27 teeth) were selected. Changes in the pulp chamber, root and periodontal ligament were identified in the tomographic analysis. Bacterial culture, staining for live and dead bacteria, and real-time polymerase chain reaction with 16S rRNA primers were used to identify the presence of bacteria. Culture sample collection was performed immediately after access to the pulp chamber. The microbiome was analysed with a MiSeq sequencer (Illumina, San Diego, CA). RESULTS: The diagnosis of pulp necrosis was confirmed clinically in 82% (22/27) of the teeth. The amount of bacterial load identified was less than 100 copies µL-1 in 23% (5/22) of the teeth with intact crowns and pulp necrosis. Thirteen bacterial species were identified that are commonly found in urinary tract infections, septicaemia and infective endocarditis. Only one of these species, Granulicatella adjacens, has also be found in primary endodontic infections. CONCLUSION: Prospective clinical, imaging and microbiological analyses suggest that pulp necrosis of teeth with intact crowns in HbSS patients is not associated with the presence of bacteria.

Nanofiller Particles and Bonding Durability, Water Sorption, and Solubility of Universal Adhesives.

The aim of this study was to evaluate the influence of nanofiller particles in simplified universal adhesive on the long-term microtensile bond strength and silver nitrate up-take, as well as water sorption and solubility. Commercial adhesives Ambar Universal (FGM) in nanofilled-containing version (filled) and same lot without fillers (unfilled) were donated and applied by means of etch-and-rinse strategy. Microtensile bond strength was surveyed after 24-hours or 1-year water storage. Silver nitrate uptake was assayed using scanning electron microscopy (SEM). Water sorption and solubility experiments were performed based on ISO 4049:2009. Statistical analysis was performed using two-way ANOVA and Tukey test (p<0.05). The bond strength of both the adhesives were statistically similar at 24 hours (p>0.05), but the filled group attained significant bond strength reduction after aging when compared to initial bond strength (p<0.001). Conversely, unfilled adhesive presented stable adhesion after 1-year storage (p=0.262). Silver nitrate uptake was similar for both adhesives, with little silver impregnation at the hybrid and adhesive layers. Water sorption was higher with filled adhesive compared to the unfilled one (p=0.01). Conversely, solubility was higher in unfilled in comparison to filled one (p=0.008). The presence of nanofillers in universal adhesive achieves higher water sorption and dentin bond degradation, which did not occur in the unfilled adhesive.

Cell-free DNA as an obesity biomarker.

Obesity is a disease that affects about 13 % of the world population (2016) (Who 2018). This condition generates a process of systemic inflammation that may contribute to the release of cell-free DNA (cfDNA) into the bloodstream. cfDNA has been considered a potential biomarker to monitor several physiological and pathological conditions, such as tumors, exercise intensity and obesity. Therefore, the objective of this study was to evaluate the association of cfDNA levels with the amount of weight and fat mass lost six months after bariatric surgery. Thirty-eight subjects classified as obese (BMI, 43.5+/-6.2; BFP, 46.6+/-4.8) were evaluated anthropometrically and underwent bariatric surgery. Weight, BMI, body fat percentage (BFP), waist circumference, C-Reactive Protein (CRP) and cfDNA levels were evaluated before and six months after surgery; furthermore, a correlation was performed between cfDNA levels and BFP and CRP. Decrease in total body weight and CRP were observed after bariatric surgery; however, the cfDNA levels remained unchanged. There was a weak correlation between cfDNA levels and BFP before the bariatric surgery, and a moderate correlation between cfDNA and CRP. Obese subjects who underwent bariatric surgery, the decrease in body fat percentage did not result in changes in cfDNA levels six months after surgery.

Lattice dynamics calculations and high-pressure Raman spectra of the ZnMoO4.

We report here the analysis of vibrational properties of the ZnMoO4 by using theoretical and experimental approaches, well as results of high pressure experiments in this system. The analysis of the lattice dynamics calculations through the classical rigid ion model, was applied to determine the mode assignment in the triclinic phase of the ZnMoO4. Additionally, the experimental high-pressure Raman spectra of the ZnMoO4 were carried out from 0 GPa up to 6.83 GPa to shed light on the structural stability of this system. The pressure-dependent studies showed that this crystal undergoes a first order phase transition at around 1.05 GPa. The Raman spectrum analysis of the new phase shows a significant change in the number of modes for the spectral range of 20-1000 cm-1. The instability of this phase occurs due to the decrease of the MoO bond lengths in the high-pressure phase, connected with tilting and/or rotations of the MoO4 tetrahedra leading to a disorder at the MoO4 sites. The second and third phase transformations were observed, respectively, at about 2.9 GPa and 4.77 GPa, with strong evidences, in the Raman spectra, of crystal symmetry change. The principal component analysis (PCA) and the hierarchical cluster analysis (HCA) were used in order to infer the intervals of pressure where the different phases do exist. Discussion about the number of non equivalent sites for Mo ions and the kind of coordination for molybdenum atoms is also furnished.

Coexistence of DIPNECH and carotid body paraganglioma: is it just a coincidence?

SUMMARY: We describe the case of a 56 year-old woman with the almost simultaneous appearance of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) and a carotid body paraganglioma. Of interest, 6 years earlier, the patient underwent total thyroidectomy due to papillary thyroid carcinoma and, in the meantime, she was submitted to mastectomy to treat an invasive ductal carcinoma of the breast. In order to explain these lesions, an extensive genetic study was performed. Results showed positivity for the presence of the tumor suppressor gene PALB2, whose presence had already been detected in a niece with breast cancer. The patient underwent different procedures to treat the lesions and currently she is symptom-free over 2 years of follow-up. LEARNING POINTS: The presence of two rare neoplasms in a single person should raise the suspicion of a common etiology. To the best of our knowledge, this is the first case that shows the coexistence of DIPNECH and paraganglioma. The contribution of the PALB2 gene in the etiology of these rare neoplasms is a possibility.

Efficacy of reciprocating and ultrasonic activation of 6% sodium hypochlorite in the reduction of microbial content and virulence factors in teeth with primary endodontic infection.

AIM: To evaluate in a clinical trial the efficacy of reciprocating and ultrasonic activation of 6% sodium hypochlorite (NaOCl) in the microbial composition and reduction in microbial load as well as in levels of lipopolysaccharide (LPS) and lipoteichoic acid (LTA) in teeth with primary endodontic infections. METHODOLOGY: Samples were collected from 24 root canals with pulp necrosis and periapical lesions, before and after chemo-mechanical canal preparation. The teeth were randomly divided according to the activation protocol as follows: control group without activation (WA, n = 8), reciprocating activation group using Easy Clean tip (EC, n = 8) and ultrasonic activation group using Irrisonic insert (US, n = 8). Microbiological specimens were processed using a culture technique and microbiota composition was analysed using the checkerboard technique. The levels of LPS and LTA were quantified using limulus amebocyte lysate (LAL) and enzyme-linked immunosorbent assay (ELISA), respectively. The Fisher's exact test, Kruskal-Wallis, Dunn's and Wilcoxon's test with a significance level of P < 0.05 were used for statistical analysis. RESULTS: All initial specimens had growth of viable bacteria in fastidious anaerobe agar (FAA), with an average of 105  CFU mL-1 , whereas only one case had such growth after chemo-mechanical canal preparation. LPS and LTA were recovered in 100% of the cases. Chemo-mechanical canal preparation significantly decreased the levels of LPS and LTA (P < 0.05), but no significant differences were found between the groups (P > 0.05). Through the checkerboard technique, bacteria were found in 100% of the initial specimens with concentrations between <105 and 106 . The most frequently identified microorganisms were Prevotella nigrescens and Enterococcus hirae. After chemo-mechanical canal preparation, many species were not detected in any of the three groups tested. A significant reduction occurred in Group US, followed by Groups EC and WA. CONCLUSIONS: Activation of 6% NaOCl reduced the levels of LPS and LTA with no differences between the groups. However, ultrasonic activation was associated with a greater reduction in microbial load within root canals.

Temperature dependence Raman spectroscopy and DFT calculations of Bi2(MoO4)3.

This work reports a theoretical and experimental study on the electronic and vibrational properties of Bi2(MoO4)3. First-principle calculations were applied to increase the understanding on the properties of the chemical composition through the energy bands. The conduction band minimum (CBM) is found at the high symmetric Γ-point, while the valence-band maximum (VBM) is located between the Z and the Γ-points. Therefore, these facts confirm that the Bi2(MoO4)3 crystal is a semiconductor compound with an indirect band-gap of about 2.1 eV. Moreover, lattice dynamic properties were calculated using density functional perturbation theory (DFPT) in order to assign the experimental Raman bands. In addition, we performed temperature-dependent Raman spectroscopic studies in the Bi2(MoO4)3 crystals to obtain information on structural changes induced by effects of the temperature change. From the changes observed in the Raman spectra phase transitions at ∼ 668 and 833 K were inferred, with the last one possibly related to the disorder due to the heating process.

Is there association between chronic kidney disease and dental caries? A case-controlled study.

BACKGROUND: The purpose of this study was to assess the association between chronic kidney diseases (CKD) and dental caries. MATERIAL AND METHODS: 107 patients with CKD and 107 with no systemic alteration were randomly included. DMFT (decayed, missing, and filled teeth), plaque index, colony-forming units (CFU) of Streptococcus mutans and salivary composition (IgA total, IgA anti- Streptococcus mutans, calcium and urea) were evaluated. McNemar and Wilcoxon tests were used to compare test and control groups. Spearman test was used to correlate time of hemodialysis and variables studied. Associations between variables were evaluated by logistic regression analysis. RESULTS: The number of filled teeth, the amount of IgA anti-Streptococcus mutans, salivary urea, education level, monthly income and the amount of CFU of Streptococcus mutans were statistically different between groups. There was a positive correlation between the duration of hemodialysis (Hd) and the amount of IgA anti-Streptococcus mutans, urea in saliva, and the number of CFU of Streptococcus mutans. In the adjusted model, a higher incidence of CFU mutans streptococci, elevated salivary urea, smaller number of filled teeth, lower DMFT, and less calcium salivary were associated with CKD. CONCLUSIONS: Programs to prevent and treat oral problems and regular follow-up at the beginning of dialysis are necessary to increase patients' awareness of their condition.

ACE inhibition in goats under fixed-time artificial insemination protocol increases the pregnancy rate and twin births.

To assess the effect of the angiotensin-converting enzyme (ACE) inhibition on the efficiency of the fixed-time artificial insemination (TAI), 69 goats were divided randomly into two groups: enalapril (n = 35) and control (n = 34). In the experiment, all animals underwent the protocol of fixed-time artificial insemination for 12 days. Enalapril group received enalapril maleate dissolved in saline (Enalapril, Lab Teuto Ltda) subcutaneously at the following doses: 0.2 mg/kg/day in D0-D2; 0.3 mg/kg/day in D3-D6 and 0.4 mg/kg/day in D7-D11. The control group received the corresponding volume of 0.9% saline solution. We performed a single insemination 36 hr after sponge removal using frozen semen from two adult male goats with recognized fertility. The ultrasound pregnancy diagnosis was 30 days after the artificial insemination (AI). There was significant increase in pregnancy rates and twinning as well as a decrease in foetal loss in animals receiving enalapril (p < .01). The use of ACE inhibitors during the TAI protocol was shown to be a promising alternative to increase the efficiency of such reproductive biotechnology.

Glycerol-dimethacrylate as alternative hydrophilic monomer for HEMA replacement in simplified adhesives.

OBJECTIVES: Hydroxyethyl-methacrylate (HEMA) is still widely used in simplified adhesives. Indeed, several shortcomings occur with this monomer, such as water uptake and formation of linear polymers. This study aimed to compare the effects of HEMA replacement by glycerol-dimethacrylate (GDMA) on selected physicochemical properties and bonding performance of simplified model adhesives. MATERIALS AND METHODS: Experimental simplified etch-and-rinse and self-etch adhesives were formulated containing 20 wt% HEMA or GDMA. Three-point bending test was used to obtain the elastic modulus of bar-shaped specimens, and water sorption and solubility were attained by ISO-4049 (ISO, 2009) method. Degree of conversion was surveyed by Micro-Raman spectroscopy, and microtensile bond strength was tested after 24 h or 6 months simulated pulpal pressure aging. Statistical analysis was realized with two-way ANOVA and Tukey's test (p < 0.05). RESULTS: GDMA promoted higher elastic modulus to the self-etch adhesive, and GDMA-containing etch-and-rinse adhesive achieved overall lower water sorption and solubility. The degree of conversion was statistically higher for GDMA adhesives than for HEMA etch-and-rinse one. All bond strengths dropped significantly after aging, except that of GDMA self-etch adhesive. The nanoleakage was higher and gaps were found in the interface of HEMA-containing adhesives, which were less present in GDMA equivalents. CONCLUSIONS: GDMA is a feasible hydrophilic dimethacrylate monomer to replace HEMA in simplified adhesives, thereby providing better polymerization, mechanical properties and dentin adhesion as well as lower water uptake and solubility.