ABSTRACT
The aim of this systematic review was to determine the prevalence of the canalis sinuosus (CS) and accessory canals of the canalis sinuosus (ACCS) as identified on cone beam computed tomography (CBCT). Online searches were conducted in the MEDLINE (via PubMed), Scopus, LILACS, Cochrane CENTRAL, Web of Science, and SIGLE (via OpenGrey) databases. Primary studies that determined the prevalence of canalis sinuosus and/or its anatomical variations using CBCT were included. The risk of bias assessment was performed using the AQUA tool. The quality effects model using double arcsine transformation was used for the meta-analysis of prevalence. Heterogeneity, publication bias, and sensitivity analyses were performed. Of 3237 initial results, 17 papers were included for systematic review. The meta-analysis comprising 1994 patients showed a pooled prevalence of CS of 0.80 (95% confidence interval (CI) 0.51-0.99; P = 0.001; I2 = 99%). Publication bias analysis revealed minor asymmetry (LFK index 1.84). The meta-analysis of 4605 patients showed a pooled prevalence of ACCS of 0.54 (95% CI 0.38-0.69; P = 0.001; I2 = 99%). The sensitivity analysis showed a pooled prevalence of ACCS of 0.53 (95% CI 0.32-0.74; P = 0.001; I2 = 99%) for studies with ≥ 1000 patients and 0.55 (95% CI 0.33-0.76; P = 0.001; I2 = 98%) for studies with< 1000 patients. Canalis sinuosus showed a pooled prevalence of 0.80 and ACCS showed a pooled prevalence of 0.54; hence both should be considered as anatomical structures, which means that they are present in most people. Surgeons must be aware of the CS and ACCS on CBCT analysis during pre-surgical planning. PROSPERO REGISTRATION NUMBER: CRD42020154195.
Subject(s)
Cone-Beam Computed Tomography , Maxilla , Humans , Prevalence , Cone-Beam Computed Tomography/methods , BibliometricsABSTRACT
SUMMARY: The objective of this study was to determine the occurrence of anatomical variants in the exocranial surface of the jugular foramen, specifically, the presence of single or double and complete or incomplete septation. A cross-sectional anatomical study was performed using 96 Brazilian dry human skulls (53 male and 43 female). One examiner determined the number (single or double) and type (i.e. complete or incomplete) of osseous septation at the outer surface of jugular foramens. Data went through statistical analysis on GraphPad Prism 6.01. Our results shown that Male individuals where more likely to present normal jugular foramens (male = 71.69%, female = 34.88%; p = 0.003). However, one incomplete septation occurred more often on the right side of female individuals (1 incomplete septation, male = 16.98%; 1 incomplete septation, female = 34.88%; p = 0.044). Similarly, one complete septation (i.e. the presence of two fully divided jugular compartments) also occurred more often on the right side of female individuals (1 complete septation, male = 9.43%; 1 complete septation, female = 25.58%; p = 0.038). Anatomical variants of the jugular foramen regarding single or double complete or incomplete septations were more likely to be found on the right side of female individuals, whose also presented a higher rate of jugular foramens with any type of septation than regular non-altered jugular foramens.
RESUMEN: El objetivo de la presente investigación fue determinar la presencia de variaciones anatómicas en la superficie exocraneal del foramen yugular, especificamente, la presencia de septos únicos o dobles, completos o incompletos. El estudio fue realizado en 96 cráneos secos (53 masculinos y 43 femeninos) de indivíduos Brasileños. Se determinaron septos óseos completos o incompletos y número de ellos. Los resultados obtenidos fueron tratados estadísticamente con el programa GraphPad Prism 6.01. Los sujetos de sexo masculino fueron más propensos a presentar forámenes yugulares normales (sexo masculino: 71,69%; sexo femenino: 34,88%, p= 0,003). Sin embargo, se observaron septos incompletos con mayor frecuencia en el lado derecho y en el sexo femenino (sexo masculino: 16,98%; sexo femenino: 34,88%, p=0,044). Adicionalmente, una septación completa (presencia de dos compartimientos yugulares, divididos completamente), se presentaron más frecuentemente en el lado derecho de indivíduos femeninos (sexo masculino: 9,43%; sexo femenino: 25,58%, p= 0,038). Las variantes anatómicas del foramen yugular, en relación a septos simples o dobles, completos o incompletos, se encontraron con mayor frecuencia en el lado derecho de las mujeres, las que presentaron un alto rango de forámenes yugulares con algún tipo de septos respecto a los forámenes yugulares regulares no alterados.
Subject(s)
Humans , Male , Female , Jugular Foramina/anatomy & histology , Cross-Sectional Studies , Anatomic VariationABSTRACT
SUMMARY: The aim of the present study was to determine the accuracy, sensitivity, and specificity of the clinical and radiographic examination (CRE) method compared to the examination with the dental operating microscope (DOM) on the detection of anatomical features of mesiobuccal canals in maxillary first molars. One hundred maxillary first molars were selected to assess the number of canals orifice entrances, accessibility, and ending of their mesiobuccal canals using the CRE method and the examination with the DOM. The diagnostic tests of the CRE exhibited, in general, high levels of accuracy, sensitivity, and specificity. However, low levels of these outcomes occurred, mainly, on the detection of the number of canals entrance orifices of the mesiobuccal root. The statistically significant differences (p<0.05) occurred for accessibility and ending of canals in 61 of the 62 cases (out of 100) when two of them were present: 2 accessible root canals (48 cases; 77.42 %), and 1 accessible and 1 inaccessible canals (13 cases; 20.97 %); 1 foramen after fusion (18 cases; 29.03 %), 2 foramens (30 cases; 48.39 %), and 1 foramen and 1 blind foramen (13 cases; 20.97 %). This study proves that the clinical and radiographic method (still the most commonly used worldwide) can't be trusted absolutely in situations of complex internal anatomy regarding the mesiobuccal root canals of maxillary first molars.
RESUMEN: El objetivo del presente estudio fue determinar la precisión, sensibilidad y especificidad del método de examen clínico y radiográfico (ECR) en comparación al examen con el microscopio quirúrgico dental (MQD) en la detección de características anatómicas de los canales mesiovestibulares en primeros molares maxilares.Se seleccionaron 100 primeros molares maxilares para evaluar el número de entradas de los canales, la accesibilidad y la terminación de sus canales mesiovestibulares utilizando el método ECR y el examen con el MQD.Las pruebas de diagnóstico del ECR exhibieron, en general, altos niveles de precisión, sensibilidad y especificidad. Sin embargo, también hubo niveles bajos de estos resultados, principalmente, en la detección del número de orificios de entrada a los canales de las raíces mesiovestibulares. Hubo diferencias estadísticamente significativas (p<0,05) para la accesibilidad y terminación de los canales en 61 de los 62 casos (del total de 100), cuando dos de ellos estaban presentes: 2 canales radiculares accesibles (48 casos, 77,42 %), y 1 accesible y 1 inaccesible (13 casos, 20,97 %). Después de la fusión, un orificio (18 casos, 29,03 %), 2 orificios (30 casos, 48,39 %) y 1 orificio más otro, ciego (13 casos, 20,97 %). Este estudio demuestra que no se puede confiar plenamente en el método clínico y radiográfico (todavía el más utilizado en todo el mundo), cuando existe una anatomía interna compleja de los canales de la raíz mesiovestibular de los primeros molares superiores.
Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Molar/anatomy & histology , Molar/diagnostic imaging , Radiography, Dental , Sensitivity and Specificity , Maxilla , Microscopy/methods , MicrosurgeryABSTRACT
BACKGROUND: Oral rehabilitation of atrophic maxillae features high complexity, for which there are several therapeutic modalities reported on scientific literature. Zygomatic implant placement is a viable option that features low morbidity and allows immediate prosthetic loading. The purpose of the present study was to determine the methodological quality of systematic reviews that assessed the effectiveness of zygomatic implants placed in atrophic maxillae. MATERIAL AND METHODS: Searches were conducted on Medline via Pubmed, LILACS, Dare Cochrane, Scopus, and Sigle via Open Grey up to June 2019. RESULTS: Seven systematic reviews were eligible for Overview and comprised a total of 2313 patients, 4812 zygomatic implants, and a 96,72% success rate. Common surgical complications, in decreasing order, were: maxillary sinusitis, peri-implant mucositis, prosthetic fracture, and infections. Methodological quality was assessed using the AMSTAR 2 tool, which revealed that six systematic reviews showed critically low methodological quality and one review was assessed as of low methodological quality. CONCLUSIONS: Zygomatic implants seem to be an adequate option for atrophic maxilla rehabilitation, however, new studies with a higher methodological rigor are needed to provide more reliable results to professionals and patients undergoing this modality of oral rehabilitation.
Subject(s)
Dental Implants , Jaw, Edentulous/surgery , Maxillary Sinusitis , Dental Implantation, Endosseous , Dental Prosthesis, Implant-Supported , Follow-Up Studies , Humans , Maxilla/surgery , Systematic Reviews as TopicABSTRACT
BACKGROUND: Alveolar infection is known as a risk factor for implant failure. Current meta-analysis on the theme could not prove statistically that immediate dental implants placed into infected sites have a higher risk of failure than immediate dental implants placed into non-infected sites. The purpose of this meta-analysis was to determine the effectiveness of immediate dental implants placed into infected versus non-infected sites. MATERIAL AND METHODS: Seven databases were sought by two reviewers. Randomized or non-randomized clinical trials that compared the placement of dental implants into infected versus non-infected sites were eligible for the study. Exclusion criteria were: papers in which the survival rate was not the primary outcome; papers without a control group; studies with less than one year of follow-up; studies whose patients did not receive antibiotic therapy; studies with medically compromised patients; duplicated papers. Risk of bias assessment was performed with the Cochrane Collaboration tool. RESULTS: Of the 3.253 initial hits, 8 studies were included in both qualitative and quantitative synthesis (kappa=0.90; very good agreement). Forest plot for implant failure showed that immediate implants placed into infected sites presented a statistically significant risk of failure that is almost 3 times higher than when placed into non-infected sites (risk ratio= 2.99; 95% confidence interval: 1.04, 8.56; p= 0.04; 935 implants; i2= 0%). Peri-implant outcomes showed no statistical difference. CONCLUSIONS: Immediate dental implants placed into infected sites presented a statistically significant higher risk of failure than immediate dental implants placed into non-infected sites. Peri-implant outcomes were not statistically affected in this intervention.
Subject(s)
Dental Implants , Immediate Dental Implant Loading , Dental Implantation, Endosseous , Dental Restoration Failure , Humans , Treatment OutcomeABSTRACT
BACKGROUND: Since implant placement on diabetic patients still is a controversial topic and systematic reviews are at the top of scientific evidence hierarchy, a thorough assessment of the methodological quality of these reviews must be performed to inform clinicians if their conclusions and recommendations can be followed on clinical practice. An overview of systematic reviews was performed with the purpose to assess the methodological quality of systematic reviews regarding dental implant placement on diabetic patients. In addition, we presented a synthesis of clinical outcomes about the focused theme. MATERIAL AND METHODS: An online search was performed on MEDLINE via PubMed, EMBASE, DARE-Cochrane, Scopus, Web of Science, LILACS, and SIGLE via Open Grey. Searches were conducted from database inception to May 2018. Systematic review articles with or without meta-analysis about the placement of dental implants on diabetic patients were included. Exclusion criteria were: articles whose primary outcome was not the survival/success rate of dental implants on diabetic patients; studies that do not relate the survival/success rate of dental implants with diabetes; duplicated papers. Methodological quality assessment was performed with AMSTAR. A descriptive synthesis of clinical outcomes was performed. RESULTS: We identified 1.661 initial hits and eight articles were selected for overview (kappa=0.83; strong agreement). Six studies presented moderate methodological quality and two showed high methodological quality. Implant survival rate ranged from 31.8% to 100% and data from four meta-analysis showed that diabetes does not affect implant survival rate. On the other hand, data from two meta-analysis for marginal bone loss showed that diabetes statistically affects this outcome. CONCLUSIONS: Two of the eight included studies presented high methodological quality and their meta-analysis showed that implant placement on diabetic patients does not affect implant survival rate and statistically affects marginal bone loss. However, clinicians must be aware that marginal bone loss values were not clinically relevant and may not be safe to follow the conclusions and recommendations of these studies.
Subject(s)
Dental Implants , Diabetes Mellitus , Dental Restoration Failure , HumansABSTRACT
The purpose of this study was to determine the effectiveness of dental implants placed in the bone graft area of cleft patients. Electronic databases and relevant journals were searched to the end of August 2018. A total of 11 articles were eligible for systematic review considering the previously established inclusion and exclusion criteria, and then underwent risk of bias assessment. A total of 483 implants were placed and showed a survival rate of 93% after a mean follow-up of 60.5 months. The iliac bone was the most used for the reconstructive surgery in cleft patients, followed by the mandible. There is a high survival rate of dental implants placed in areas of bone grafts in patients with alveolar clefts. However, more studies with high methodological quality and with a longer follow-up are needed to offer more safety for practitioners and patients regarding the placement of dental implants in areas of alveolar clefts with bone grafting.
Subject(s)
Cleft Lip , Cleft Palate , Dental Implants , Bone Transplantation , Dental Implantation, Endosseous , Humans , IliumABSTRACT
The presence of the Accessory Foramina of the Mandibular Ramus (AFMR) may be related to anaesthetic failures in the inferior alveolar nerve block and complications in the ramus surgeries. The purpose of the present investigation was to determine the occurrence of the AFMR in adults and, when present, measure its distance to the Mandibular Foramen (MF), to the Mandibular Lingula (ML) and to the posterior margin of the mandibular ramus (PM), comparing data obtained in both sides of the mandible. Thirty dry human mandibles were selected to the present study. The AFMR was considered as every foramina identified between the MF and the PM. When present, its distance to the MF, to the ML and to the PM was measured. The AFMR was identified in 15 of the 30 examined mandibles (50 %), presenting exclusively on the right side in four cases (13.33 %), exclusively on the left side in other four cases (13.33 %) and simultaneously on both mandibular antimeres in seven of the 30 inspected mandibles (23.33 %). The AFMR is a structure considered as anatomic vari4ation but it was present in one of each two mandibles investigated, with the same occurrence in both mandibular sides. For the cases of occurrence of the AFMR, the professional will be able to locate it in a central position between the MF and the PM, distant about seven millimeters to the MF and 10.50 mm to the ML in both sides of the mandible.
La presencia de forámenes accesorios de la rama mandibular (FARM) puede estar relacionada con fallas que ocurren en el bloqueo anestésico del nervio alveolar inferior y con complicaciones durante cirugías de la rama mandibular. El propósito del presente estudio fue determinar la presencia de FARM en adultos brasileños y cuando éstos estuvieren presentes, medir la distancia al foramen mandibular (FM), a la língula de la mandíbula (LM) y al margen posterior de la rama mandibular (MP), comparando estos datos en ambos lados de la mandíbula. Para ello fueron seleccionadas 30 mandíbulas humanas secas. El FARM fue considerado como cada foramen identificado entre el FM y MP. El FARM fue identificado en 15 de las 30 mandíbulas examinadas (50 %), presentándose en el lado derecho en 4 casos (13,33 %), en el lado izquierdo en 4 (13,33 %) y en ambos lados en 7 (23,33 %). Los FARM son considerados como una variación anatómica pero en este estudio estuvo presente en una de cada dos mandíbulas, con la misma frecuencia en ambas mandíbulas. En el caso de presencia del FARM, el profesional será capaz de identificarlo en una posición central entre el FM y el MP, distante 7 mm aproximadamente del FM y a 10,5 mm de la LM en ambos lados de la mandíbula.
Subject(s)
Humans , Anatomic Variation , Mandible/anatomy & histology , BrazilABSTRACT
PURPOSE: The purpose of this study was to obtain morphological parameters of the mandibular foramen (MF) and the mandibular lingula (ML) as well as to use biometric data to locate these structures in the medial aspect of the mandibular ramus and to measure the angle that the inferior alveolar sulcus makes with the posterior margin of the ramus. METHODS: The sample was composed of 30 dry human mandibles. The quantitative variables were the distances between the MF and the ML, as well as the distances between these structures and the margins of the mandibular ramus. The angle between the inferior alveolar sulcus and the posterior margin was also measured. The qualitative variables were the shape of the MF and the ML. All variables were analyzed using statistical softwares and the admitted level of statistical significance was 5 %. RESULTS: The statistical analysis indicated a bilateral central positioning of the MF and the ML in relation to the medial surface of the mandibular ramus, however, with a more superior and posterior positioning when the relatives values-which also indicated an oval morphology of the MF and trapezoidal shape of the ML-were considered. The inferior alveolar sulcus was in an acute angle with the posterior margin of the ramus with a larger opening in the left side of the mandible-but equals, however, considering the margins of error. CONCLUSIONS: With the data presented in this study, the surgeon will obtain quantitative and qualitative parameters that can be added to the surgical literature available, facilitating the identification and preservation of the anatomic structures in check, reducing, thus, the risk of iatrogenic injuries.
Subject(s)
Mandible/anatomy & histology , Mandible/surgery , Anatomic Landmarks , Humans , Reference ValuesABSTRACT
Canatoxin, a urease isoform from Canavalia ensiformis seeds, shows insecticidal activity against different insect species. Its toxicity relies on an internal 10 kDa peptide (pepcanatox), released by hydrolysis of Canatoxin by cathepsins in the digestive system of susceptible insects. In the present work, based on the N-terminal sequence of pepcanatox, we have designed primers to amplify by PCR a 270-bp fragment corresponding to pepcanatox using JBURE-II cDNA (one of the urease isoforms cloned from C. ensiformis, with high identity to JBURE-I, the classical urease) as a template. This amplicon named jaburetox-2 was cloned into pET 101 vector to obtain heterologous expression in Escherichia coli of the recombinant protein in C-terminal fusion with V-5 epitope and 6-His tag. Jaburetox-2Ec was purified on Nickel-NTA resin and bioassayed in insect models. Dysdercus peruvianus larvae were fed on cotton seed meal diets containing 0.01% (w/w) Jaburetox-2Ec and, after 11 days, all individuals were dead. Jaburetox-2Ec was also tested against Spodoptera frugiperda larvae and caused 100% mortality. In contrast, high doses of Jaburetox-2Ec were innocuous when injected or ingested by mice and neonate rats. Modeling of Jaburetox-2Ec, in comparison with other peptide structures, revealed a prominent beta-hairpin motif consistent with an insecticidal activity based on either neurotoxicity or cell permeation.
Subject(s)
Canavalia/enzymology , Insecticides/isolation & purification , Urease/chemistry , Amino Acid Sequence , Base Sequence , Cloning, Molecular , DNA Primers , Electrophoresis, Polyacrylamide Gel , Insecticides/chemistry , Insecticides/toxicity , Molecular Sequence Data , Plant Proteins , Polymerase Chain Reaction , Sequence Homology, Amino Acid , Urease/genetics , Urease/isolation & purification , Urease/toxicityABSTRACT
Using a combination of two-dimensional gel electrophoresis protein mapping and mass spectrometry analysis, we have established proteome reference maps of embryogenic cell suspensions of cowpea (Vigna unguiculata). The cell suspensions were generated from young primary leaves and contained basically pro-embryogenic masses, which enabled us to dissect their proteome composition while eliminating the complexity of too many cell types. Over 550 proteins could reproducibly be resolved over a pI range of 3-10. A total of 128 of the most abundant protein spots were excised, digested in-gel with trypsin and analyzed by tandem mass spectrometry. This enabled the identification of 67 protein spots. Two of the most abundant proteins were identified as a chitinase and as a ribonuclease belonging to the family of PR-4 and PR-10 proteins, respectively. The expression of the respective genes was confirmed by RT-PCR and the pattern of deposition of the PR-10 protein in cell suspensions as well as in developing cowpea seeds, roots, shoots and flowers were determined by Western blot experiments, using synthetic antibodies raised against a 14-amino acid synthetic peptide located close to the C-terminal region of the PR-10 protein.
