Effectiveness of dental implants in patients undergoing radiotherapy for head and neck cancer: An umbrella review.

OBJECTIVE: The objective of this overview is to evaluate the effectiveness of dental implants placed in patients who underwent radiotherapy for the treatment of head and neck cancer, as well as to assess the methodological quality of the included systematic reviews. METHODS: The study was conducted in four PubMed, Lilacs, Dare Cochrane and Google Scholar databases until July 2022, using the descriptors "Radiotherapy," "Dental implants," and "Head and Neck Cancer." RESULTS: 958 studies were found in the initial search and after applying the inclusion and exclusion criteria, fifteen systematic reviews were selected to compose this overview and had their methodological quality evaluated by the AMSTAR 2 tool. RESULTS: 24,996 implants in 5487 patients were evaluated with a rate of success rate of 86.2% in patients who underwent radiotherapy and 95.2% in patients who did not undergo radiotherapy. Only one of the systematic reviews was of high quality according to AMSTAR 2. CONCLUSION: Oral rehabilitation with dental implants in patients with a history of head and neck cancer undergoing radiotherapy is a valid therapy. However, given the level of evidence found, further studies with better design are necessary to provide greater confidence in the clinical decision.

Is HIV positive a risk factor or contraindication in dental implant therapy?

HIV pathogenesis affects TCD4+ lymphocytes, causing impairment of the immune system. Thus, the consequent immunological fragility of individuals with the disease and the absence of studies that serve as a guide for clinicians' decision-making make many healthcare professionals recognize it as a synonym of contraindication for oral rehabilitation treatments with dental implants.

Is low-level laser therapy effective in the treatment of herpes labialis? Systematic review and meta-analysis.

The objective of this systematic review is to evaluate the effectiveness of low-level laser therapy in the treatment of herpes labialis. The searches were carried out independently by 2 researchers and the articles were selected through the electronic databases according to the inclusion and exclusion criteria previously established. Initially, 480 articles were found, of which 7 randomized clinical trials and 1 clinical trial were selected. In total, 928 patients were included. In the meta-analysis, the mean healing time for laser use was significant, showing a mean reduction of 1.37 [CI 95% = 0.92 to 1.82] days for tissue healing (p < 0.0001). In the meta-analysis to evaluate the time for crust formation, there was no significant difference between the groups and no significant reduction in the mean time for crust formation (p = 0.150). Only one of the selected studies had a low risk of bias. The use of low-level laser proved to be effective in the treatment of herpes labialis. However, due to the high risk of bias in the included studies, there is a need to carry out new standardized studies to prove the effectiveness of this therapy.

Clinical applicability of natural products for prevention and treatment of oral mucositis: a systematic review and meta-analysis.

OBJECTIVE: A systematic review and meta-analysis was carried out to verify evidence regarding the efficacy and safety of the clinical applicability of natural products in the prevention and treatment of oral mucositis induced by chemotherapy and/or radiotherapy. METHODOLOGY: An electronic research according to the PICOS strategy, using the terms "natural products" and "oral mucositis," was carried out at Pubmed, Cochrane, Embase, and "gray literature." The stages of eligibility, data extraction, and quality assessment of the studies were carried out independently and in duplicate. RESULTS: The number of studies identified as eligible was 151, including 47 randomized controlled trials, reporting a total of 3075 participants undergoing some therapy with natural products on oral mucositis. The included clinical trials covered a variety of 31 types of natural products. Considering the risk of bias of the clinical trials, 24 studies (51.1%) were considered to have a low overall risk of bias, nine (19.1%) were at moderate risk, and 14 clinical trials (29.8%) were at high risk of bias. Honey was the most assessed natural agent. Fourteen studies (3.4%) reported that natural agents reduced pain. CONCLUSION: The results of the meta-analysis support a positive effect of honey and Aloe vera in reducing mucositis in patients receiving cancer therapy. CLINICAL RELEVANCE: The results found add relevant information to the scientific community regarding the prevention and treatment of mucositis. Graphical abstract.

Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced osteoradionecrosis of the jaws-a case series.

BACKGROUND: The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of osteoradionecrosis of the jaws. METHODS: Twenty-five patients diagnosed with osteoradionecrosis of the jaws treated with pentoxifylline 400 mg + tocopherol 400 mg three times daily (tid) were evaluated. Clinical records and image tests were reviewed. All patients were previously submitted to head and neck radiation therapy and presented with a clinical and radiographic diagnosis of osteoradionecrosis of the jaws. RESULTS: Following therapy with pentoxifylline and tocopherol, 76% (19/25) of the patients showed complete mucosal healing, in which 47.3% (9/19) did not undergo sequestrectomy. From this particular group, 77.7% (7/9) were in stage I and 33.3% (3/9) used the protocol for up to 3 months. Among those who underwent to sequestrectomy, complete mucosal healing was observed in 52.7% (10/19). Among these, 60% (6/10) were in stage I and 100% of the patients were using the protocol for more than 3 months. In all other patients, partial healing of the mucosa was observed since they presented advanced disease. These represented 24% of the sample (6/25), 66.6% (4/6) were in stage III, and 60% (4/6) used the protocol for over 6 months. CONCLUSION: Pentoxifylline and tocopherol may provide effective management of osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.

High prevalence of syphilis in a female prison unit in Northeastern Brazil.

Objective To determine the prevalence of syphilis and the associated risk factors in a female prison unit. Methods This was a cross-sectional study including 113 women whom data were collected in two stages: first, blood test to check for syphilis seropositivity; and then collection of information through a form to assess risk situations for sexually transmitted infections. Results Overall, syphilis prevalence was found to be 22.1% among the female prison population (n=25) and 28.6% among pregnant women. A statistically significant relationship was found between syphilis infection and previous history of sexually transmitted infections (p=0.04). However, most participants diagnosed with the disease were unaware of a history of sexually transmitted infection in the last 12 months (n=20/80.0%). The use of condom with fixed partners was considered to be a protective factor (odds ratio of 0.76; 95% of confidence interval 0.68-0.85). Conclusion The prevalence of syphilis among the female prison population was high, particularly among pregnant women. Preventive and therapeutic measures as well as appropriate prenatal care can minimize the impact of syphilis in prison systems and, consequently, improve such health outcomes nationwide.

High prevalence of syphilis in a female prison unit in Northeastern Brazil / Alta prevalência de sífilis em unidade prisional feminina do Nordeste brasileiro

ABSTRACT Objective To determine the prevalence of syphilis and the associated risk factors in a female prison unit. Methods This was a cross-sectional study including 113 women whom data were collected in two stages: first, blood test to check for syphilis seropositivity; and then collection of information through a form to assess risk situations for sexually transmitted infections. Results Overall, syphilis prevalence was found to be 22.1% among the female prison population (n=25) and 28.6% among pregnant women. A statistically significant relationship was found between syphilis infection and previous history of sexually transmitted infections (p=0.04). However, most participants diagnosed with the disease were unaware of a history of sexually transmitted infection in the last 12 months (n=20/80.0%). The use of condom with fixed partners was considered to be a protective factor (odds ratio of 0.76; 95% of confidence interval 0.68-0.85). Conclusion The prevalence of syphilis among the female prison population was high, particularly among pregnant women. Preventive and therapeutic measures as well as appropriate prenatal care can minimize the impact of syphilis in prison systems and, consequently, improve such health outcomes nationwide.

RESUMO Objetivo Determinar a prevalência de sífilis e fatores de risco associados no sistema prisional feminino. Métodos Foi realizado estudo transversal com 113 mulheres. A coleta de dados ocorreu em duas etapas: a primeira etapa correspondeu à coleta de sangue para verificar a soropositividade à sífilis e a segunda a um formulário para avaliar situações de risco para infecções sexualmente transmissíveis. Resultados A prevalência da doença foi de 22,1% (n=25). Quanto às gestantes, identificou-se prevalência de 28,6%. Foi verificada relação estatisticamente significativa entre a infecção pela sífilis e a história prévia de infecções sexualmente transmissíveis (p=0,04). Entretanto, a maioria das participantes diagnosticadas com a doença desconhecia um histórico de infecção sexualmente transmissível nos últimos 12 meses (n=20/80,0%). O uso de preservativo com parceiros fixos foi considerado fator de proteção (odds ratio de 0,76; intervalo de confiança de 95% de 0,68-0,85). Conclusão Foi alta a prevalência de sífilis na população carcerária feminina estudada, principalmente entre as gestantes. Medidas preventivas e de tratamento da doença, bem como cuidados pré-natais adequados, podem minimizar o impacto da sífilis nos sistemas prisionais e, consequentemente, melhorar esse indicador de saúde no país.

Clinical Assessment of Rosemary-based Toothpaste (Rosmarinus officinalis Linn.): A Randomized Controlled Double-blind Study.

The present study was to investigate the action of a toothpaste made from the extract of Rosmarinus officinalis Linn. (rosemary) in a clinical randomized, controlled, open and double-blind trial. One hundred and ten volunteers fulfilled the inclusion criteria and were randomly separated into two groups according to the toothpastes used: Group A (experimental) and Group B (control). They were assessed at baseline and 30 days after the study using the gingival bleeding index (GBI) and the plaque index (PI). Data analysis was conducted to calculate the effects of the two toothpastes on gingival bleeding and plaque, using measurements such as the excess relative risk (ERR), the Relative Risk Reduction (RRR), the Absolute Risk Reduction (ARR) and the Number Needed for Treatment (NNT). The two toothpastes provided similar results in terms of the reduction in the risk of gingival bleeding (relative and absolute): a reduction of 38% in Group A, ERR=0.38; a reduction of 29.3% in Group B, ERR=0.293; A and B reduced by 18% ARR=0.18). The reductions in bacterial plaque were also similar (22.7% reduction in Group A, RRR=0.227; 28% reduction in Group B, RRR= 0.28). The number needed for treatment values for bleeding and plaque were A and B NNT=5 and A and B NNT=7, respectively. The rosemary-based toothpaste effectively treated gingival bleeding and reduced bacterial plaque, when compared with conventional toothpaste.

Predisposition to Burnout Syndrome in prison officers / Predisposição à Síndrome de Burnout em agentes de segurança penitenciária

The aim of this study was to verify the predisposition of Penitentiary Security Agents (PSA) to develop Burnout Syndrome(BS). This study was carried out in 2017 at the Judge Flósculo da Nóbrega Prison in the city of João Pessoa/PB, using across-sectional approach, with a non-probabilistic sample, including 47 PSAs. The applied questionnaire was elaboratedand adapted by Chafic Jbeili, inspired by the Maslach Burnout Inventory (MBI), which measures the BS level. Data wereanalyzed using descriptive and inferential statistics. The Fisher exact test was applied, considering p0.05). The data indicate a high predisposition to BS development. This study does not diagnose BS, butallows for the early identification of the problem, supporting programmed actions for the well-being of the PSA, aiming at improving the quality of life of these workers

O estudo teve como objetivo verificar a predisposição dos Agentes de Segurança penitenciárias (ASP) em desenvolverSíndrome de Burnout (SB). O estudo foi realizado em 2017 no Presídio Desembargador Flósculo da Nóbrega na cidadede João Pessoa/PB, através de uma abordagem transversal, com amostra não probabilística, incluindo 47 ASP. Oquestionário aplicado foi elaborado e adaptado por Chafic Jbeili, inspirado no Maslach Burnout Inventory (MBI), quepermite a mensuração do nível da SB. Os dados foram analisados por meio de estatística descritiva e inferencial. Testeestatístico Exato de Fisher foi aplicado, considerando p0,05). Os dados indicam alta predisposição ao desenvolvimento da SB. O estudo não faz diagnósticoda SB, porém permite a identificação precoce do problema, favorecendo para que ações para o bem-estar do ASP sejamprogramadas, visando a melhora da qualidade de vida dos trabalhadores

Clinical assessment of rosemary-based toothpaste (rosmarinus officinalis linn. ): a randomized controlled double-blind study

Abstract The present study was to investigate the action of a toothpaste made from the extract of Rosmarinus officinalis Linn. (rosemary) in a clinical randomized, controlled, open and double-blind trial. One hundred and ten volunteers fulfilled the inclusion criteria and were randomly separated into two groups according to the toothpastes used: Group A (experimental) and Group B (control). They were assessed at baseline and 30 days after the study using the gingival bleeding index (GBI) and the plaque index (PI). Data analysis was conducted to calculate the effects of the two toothpastes on gingival bleeding and plaque, using measurements such as the excess relative risk (ERR), the Relative Risk Reduction (RRR), the Absolute Risk Reduction (ARR) and the Number Needed for Treatment (NNT). The two toothpastes provided similar results in terms of the reduction in the risk of gingival bleeding (relative and absolute): a reduction of 38% in Group A, ERR=0.38; a reduction of 29.3% in Group B, ERR=0.293; A and B reduced by 18% ARR=0.18). The reductions in bacterial plaque were also similar (22.7% reduction in Group A, RRR=0.227; 28% reduction in Group B, RRR= 0.28). The number needed for treatment values for bleeding and plaque were A and B NNT=5 and A and B NNT=7, respectively. The rosemary-based toothpaste effectively treated gingival bleeding and reduced bacterial plaque, when compared with conventional toothpaste.

Resumo O presente estudo investigou a ação de uma pasta de dente feita a partir do extrato de Rosmarinus officinalis Linn. (Alecrim) em um ensaio clínico randomizado, controlado, aberto e duplo-cego. Cento e dez voluntários preencheram os critérios de inclusão e foram separados aleatoriamente em dois grupos de acordo com as pastas usadas: Grupo A (experimental) e Grupo B (controle). Eles foram avaliados no início e 30 dias após o estudo usando o índice de sangramento gengival (GBI) e o índice de placa (PI). A análise dos dados foi realizada para calcular os efeitos das duas pastas dentárias sobre sangramento gengival e placa, usando medidas como o excesso de risco relativo (ERR), a Redução do Risco Relativo (RRR), a Redução do Risco Absoluto (ARR) e o Número Necessário para Tratamento (NNT). As duas pastas de dentes proporcionaram resultados semelhantes em termos de redução do risco de sangramento gengival (relativo e absoluto): redução de 38% no Grupo A, ERR=0,38; Uma redução de 29,3% no Grupo B, ERR=0,293; A e B reduziram-se em 18% ARR=0,18). As reduções na placa bacteriana também foram semelhantes (redução de 22,7% no Grupo A, RRR=0,227, redução de 28% no Grupo B, RRR=0,28). O número necessário para tratamento de sangramento e placa foi A e B NNT=5 e A e B NNT=7, respectivamente. A pasta de dente à base de alecrim tratou efetivamente o sangramento gengival e reduziu a placa bacteriana, quando comparada à pasta dentífrica convencional.

Self-Medication for Toothache and its Associated Factors in Children and Adolescents

Objective: To evaluate self-medication for toothache and its associated factors in children and adolescents. Material and Methods: A cross-sectional study was carried out with 252 children/adolescents aged 6-16 years. A questionnaire was applied with questions related to demographic and socioeconomic characteristics; experience of, and self-medication for, toothache; as well as aspects related to the condition. Descriptive and inferential statistical analyses (Pearson's Chi-square test and Fisher's exact test) were performed, with a 5% significance level. Results: The prevalence of toothache was 41.7%. In 96 cases analyzed, there was prevalence of 69.8% of self-medication for toothache. There were no statistically significant associations between self-medication for toothache and variables related to the children/adolescents (gender and age), their parents or guardians (age and schooling), socioeconomic characteristics (family income and number of people in the household) and aspects related to toothache (fever, crying and school absenteeism) (p>0.05). The most commonly used drug was paracetamol (60.7%), whose choice was based to its previous use by the study population for conditions not related to toothache (47.8%). Conclusion: There was a high prevalence of self-medication for toothache in the study population. No independent variable was associated with self-medication practice.

Síndrome do respirador bucal: prevalência das alterações no sistema estomatognático em crianças respiradoras bucais / Oral respirator syndrome: prevalence of changes in the stomatognathic system in breast-breathing children

Introdução: A respiração bucal (RB) em crianças altera o crescimento, desenvolvimento normal da face, oclusão dos dentes em função do desequilíbrio que ela provoca nas relações entre os sistemas muscular, ósseo e dental. Objetivo: Objetivou-se avaliar a prevalência de alterações no sistema estomatognático em crianças respiradoras bucais da Clínica Escola de Odontologia do Centro Universitário de João Pessoa-PB. Metodologia: Realizou-se um estudo exploratório, descritivo e transversal, com abordagem quantitativa. A coleta de dados foi realizada por meio do preenchimento de um formulário elaborado pelos pesquisadores que foi utilizado para a transcrição das informações pertinentes aos prontuários da Clínica Infantil, no total de 400 prontuários. Os dados coletados foram tabulados e compilados nos programas Microsoft Excel e Microsoft Word, em seguida foram analisados com total confidencialidade. Foi realizada análise descritiva e analítica de acordo com as variáveis obtidas. Resultados: De acordo com o resultado obtido nesta pesquisa, 44% das crianças pesquisadas por meio dos prontuários foram declaradas respiradoras bucais, e apenas 15.25% das crianças não apresentaram nenhum tipo de alteração pesquisada; 40,44% apresentaram mordida aberta, 37% apresentaram mordida cruzada, 22,59% deglutição atípica e 11,86% palato profundo. Conclusão: Conclui-se que a maioria das crianças respiradoras bucais atendidas na clínica escola do UNIPÊ apresentam algum tipo de alteração no Sistema Estomatognático.

Introduction: Oral breathing (OB) in children alters the growth, normal development of the face, occlusion of the teeth and the imbalance that it causes in the relationships between the muscular, bone and dental systems. Objective: The aim of this study was to evaluate the prevalence of changes in the stomatognathic system in mouth breathing children of the School of Dentistry of the University Center of João Pessoa-PB. Methodology: An exploratory, descriptive and cross-sectional study was carried out with a quantitative approach. Data collection was done by completing a form prepared by the researchers that was used to transcribe the pertinent information to the medical records of the Children's Clinic, in a total of 400 medical records. The collected data were tabulated and compiled in Microsoft Excel and Microsoft Word programs, and then analyzed with complete confidentiality. A descriptive and analytical analysis was performed according to the variables obtained. Results: According to the results obtained in this study, 44% of the children surveyed through mouthwashes were declared mouthwashes, where only 15.25% of the children did not present any type of alteration, and 40.44% presented open bite, 37% presented crossbite, 22.59% presented atypical swallowing and 11.86% presented deep palate. Conclusion: It is concluded that the majority of mouth breathing children attended at the UNIPÊ school clinic present some type of alteration in the Stomatognathic System.

Análise das lesões dentais nos laudos periciais produzidos pelo núcleo de medicina e odontologia legal da Paraíba, Brasil / Analysis of dental injuries from expert reports produced by Nucleus for Legal Medicine and Dentistry, Paraíba State, Brazil

Este estudo tem como objetivo estudar as lesões dentais nos laudos de lesão corporal do Núcleo de Medicina e Odontologia Legal do Instituto de Polícia Científica na cidade de João Pessoa-PB. Trata-se de uma pesquisa documental e descritiva com abordagem quantitativa que utilizou dados secundários da Instituição responsável pelos laudos traumatológicos de vítimas com lesões dentais. A amostra foi composta por 185 laudos nos anos de 2012 a 2014. Os resultados revelaram maior frequência do sexo masculino e a faixa etária entre 18 e 27 anos. A violência em acidentes terrestres foi o agente etiológico mais frequente (47%). A maioria das vítimas teve perdas de incisivos (84,3%). A avaliação do dano de acordo com o Art.129 do Código Penal Brasileiro mostrou que 44,9% dos casos analisados foram considerados com debilidade permanente, apenas 0,5% dos casos tinham incapacidade para as ocupações habituais por mais de 30 dias e 40,5% causaram deformidade às vítimas periciadas. Conclui-se que nos laudos de lesões dentais do NUMOL ­ PB existem distorções entre o que foi encontrado no exame físico e nas respostas aos quesitos, o que pode remeter à uma formação técnica deficitária ou falta de calibração entre os peritos que avaliam as lesões dentais.

This study aimed to assess dental injuries described in bodily injury reports of the Nucleus for Legal Medicine and Dentistry (NUMOL) of the Institute of Scientific Police in João Pessoa, PB, Brazil. It was a documentary and descriptive study using a quantitative approach of secondary data from the institute responsible for the reports of victims with dental injuries. The sample consisted of 185 reports from 2012 to 2014. The results revealed a higher prevalence of male and young individuals. Land accidents were the most frequent etiological agent of the injuries (47%). The majority of the victims lost incisor (84.3%). According to Brazilian Penal Code, Article 129, the measure of damages indicated that 44.9% of the victims had permanent impairment; and only 0.5% of them became unable to perform usual tasks for more than 30 days. In addition, 40.5% of the injuries caused deformities to the victims. It is concluded that the reports of dental injuries filed in NUMOL, PB, should be performed exclusively by experts in the field, as data distortions were observed.

Clinical and Metabolic Effects of two Periodontal Therapeutic Modalities in Diabetic Patients with Residual Pockets

Objective: To evaluate the metabolic control and compare the clinical effects between non-surgical and surgical therapies on periodontal treatment of residual pockets of type 2 diabetic patients. Material and Methods: 352 periodontal sites in 16 type 2 diabetic subjects with residual pockets of similar depths were randomly selected, whose contralateral quadrants were divided into G1 and G2 undergoing surgical and nonsurgical therapy, respectively, and evaluated 3 and 6 months after the first intervention. The data were analyzed by Statistical Package of Social Science (SPSS) version 20.0, using descriptive and inferential statistical methods. Fisher's exact test was used to verify differences between means obtained in the clinical parameters between G1 and G2. The significance level adopted was 5%. Results: The mean Hb1Ac values of patients were significantly reduced and the mean PD and CIL values were reduced in G1 with no significant difference when compared to G2. Conclusion: Periodontal treatment was effective in metabolic control of type 2 diabetic patients and that both therapies, surgical and non-surgical, behaved similarly when compared.

IL-17A and IL-17F polymorphisms in rheumatoid arthritis and Sjögren's syndrome.

OBJECTIVE: The aim of this study was to evaluate the influence of Th17 polymorphisms on the susceptibility or severity of rheumatoid arthritis (RA) and Sjögren's syndrome (SS). MATERIALS AND METHODS: The study sample comprised 206 individuals of both genders divided into three groups: exclusive rheumatoid arthritis (RA-100 patients), rheumatoid arthritis and Sjögren's syndrome (RA/SS-31 patients), and healthy controls (C-75 individuals). All the individuals were submitted to clinical evaluation, unstimulated sialometry, and Schirmer test; some patients with RA were also submitted to minor salivary gland biopsy for definition of SS diagnosis. Saliva samples were collected for isolation of DNA and genotyping of Th17 genes; IL-17A (-197G/A) and IL-17F (7488T/C). RESULTS: IL-17A (-197G/A) and IL-17F (7488T/C) SNPs were not associated with susceptibility to RA or secondary SS (sSS, p > 0.05 for both SNPs). In addition, they did not influence RA activity or clinical markers of SS. CONCLUSION: IL-17A (-197G/A) and IL-17F (7488T/C) polymorphisms are not associated with the susceptibility nor to the severity of RA and sSS in the studied population. CLINICAL RELEVANCE: A better understanding of the pathogenesis of SS is demanded to an adequate treatment as well as to the development of new management strategies.

Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer.

INTRODUCTION: Oral mucositis (OM) has been described as the oral complication most frequently associated with antineoplastic therapy. However, the influence on the quality of life of affected patients is still unclear. OBJECTIVE: To evaluate the impact of OM on the oral-health-related quality of life (OHRQoL) of patients diagnosed with cancer, who developed chemotherapy- and/or radiotherapy-induced OM. METHODS: This is a cross-sectional evaluation of QoL using oral health impact profile-14 (OHIP-14). The study group comprised a sample of 60 patients diagnosed with cancer, who developed OM during the treatment. The instrument (OHIP-14) composed of seven dimensions was used: functional limitation, physical pain, psychological discomfort, physical deficiency, psychological deficiency, social incapacity, and deficiency. RESULTS: The internal consistency of OHIP-14 measured by the Cronbach's α coefficient was of 0.76. Physical pain attained the highest score (worst quality of life) among the studied dimensions 60.8% (292/480), followed by physical limitation 52.7% (253/480), and psychological discomfort 50.8% (244/480). The dimension 'social limitation' obtained the lowest score 27.2% (131/480). There was statistically significant difference as regards gender (P = 0.021) for physical pain, with greater impact among patients of the male gender. CONCLUSION: Oral-health-related quality of life is significantly affected by OM in individuals diagnosed with cancer.