Effects of the Irrigation Needle Design on Root Canal Disinfection and Cleaning.

INTRODUCTION: This ex vivo study evaluated the disinfecting and cleaning effects of root canal preparation using sodium hypochlorite irrigation with 3 different needle designs. METHODS: Mesial roots from extracted mandibular molars with Vertucci class II configuration were anatomically matched based on micro-computed tomography (micro-CT) analyses and distributed into 3 groups (n = 18/group). The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation using 2.5% sodium hypochlorite irrigation with open-ended flat needle (3 mm short of the working length - WL), closed-ended side-vented irrigation needle (1 mm short of the WL), or a closed-ended plastic needle with 2 lateral outlets (TruNatomy) (1 mm short of the WL). Bacteriological samples were taken from the canals before (S1) and after preparation (S2). After another micro-CT scan, the roots were sectioned and samples were also taken from the apical canal segment (S3). Bacterial reduction was assessed by quantitative real-time polymerase chain reaction. The amount of accumulated hard tissue debris was evaluated by micro-CT. RESULTS: A substantial reduction in bacterial counts was observed in all 3 groups when comparing S1 with S2 (99.95%, 98.93%, and 98.90% in the open-ended, closed-ended, and TruNatomy needle groups, respectively) (P < .01). No significant differences were observed between groups for bacterial reduction in the full and apical canal (P > .05). There were no intergroup differences in the amount of accumulated hard tissue debris either (P > .05). The open-ended needle group showed significantly more specimens with quantitative real-time polymerase chain reaction negative results for bacteria in S3 than TruNatomy (P < .05). CONCLUSION: When used up to an appropriate insertion depth, the 3 needle types result in similar antibacterial and cleaning performance, provided variables such as needle size and irrigant type, volume and flow rate are controlled. Exclusive analysis of the apical segment, including the isthmus, revealed that the open-ended needle yielded more cases negative for bacteria.

Oral health literacy and its association with oral health-related quality of life amongst pregnant women: a cross-sectional study.

PURPOSE: This study aimed to evaluate the association of oral health literacy (OHL) and oral health-related quality of life (OHRQoL) of pregnant women. METHODS: This cross-sectional study evaluated a representative sample of pregnant women assisted in public health services in southern Brazil. Demographic, socioeconomic, psychosocial and behavioural data were collected through structured questionnaires. The Oral Health Impact Profile (OHIP-14) questionnaire was used to evaluate the OHRQoL. The Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) was used to measure OHL. Dental caries and gingival bleeding were evaluated by clinical examinations. Adjusted multilevel Poisson regression models with a hierarchical approach were used to assess the associations. The results are presented as rate ratio (RR) and 95% confidence interval (95% CI). RESULTS: A total of 520 pregnant women were evaluated. Pregnant women with lower levels of OHL presented overall OHIP-14 scores 14% higher (RR 1.14; 95% CI 1.07-1.22) than their counterparts. High household income and high education level were related to low overall OHIP-14 scores. Furthermore, less dental attendance, low social support, untreated dental caries and gingival bleeding were also associated with high overall OHIP-14 scores. CONCLUSION: Our findings reinforce that health literacy levels influence patient-reported outcomes. Pregnant women with lower OHL were more likely to present poorer OHRQoL.

Bacteriologic Conditions of the Apical Root Canal System of Teeth with and without Posttreatment Apical Periodontitis: A Correlative Multianalytical Approach.

INTRODUCTION: This study used a correlative multianalytical approach to investigate the bacteriologic conditions in the apical root canal system of treated teeth with or without apical periodontitis and their correlation with the technical quality of the previous root canal obturation and the presence and volume of apical periodontitis lesions. METHODS: Root apexes were obtained from recently extracted root canal-treated teeth with (n = 23) and without (n = 22) apical periodontitis lesions as demonstrated by cone-beam computed tomographic examination. The root apexes were sectioned and subjected to micro-computed tomographic (micro-CT) scanning. The specimens were cryopulverized, and DNA extracted from the powder was used as a template in real-time polymerase chain reaction assays to quantify total bacteria and members of the Streptococcus genus and Actinobacteria phylum. The bacteriologic findings were compared between the 2 groups and also evaluated for associations with cone-beam computed tomographic and micro-computed tomographic data. RESULTS: Bacteria were detected in all apical canal samples except 1. The mean counts of total bacteria, streptococci, and actinobacteria did not differ significantly between teeth with or without apical periodontitis (P > .05). Streptococcus levels were significantly lower by 80% in the apical canals of teeth with small lesions compared with those without lesions (P < .05). The limit of filling >2 mm short was significantly associated with more total bacterial counts compared with canals filled 0-2 mm short (P < .05). An adequate coronal restoration was significantly associated with lesser counts of Streptococcus (P < .05). CONCLUSIONS: Comparable bacterial loads were observed in the apical canal system of treated teeth with and without apical periodontitis, suggesting that factors other than only the total bacterial levels may also influence the development and progression of apical periodontitis. Bacteria were found in the apical canal in virtually all cases with a high prevalence of streptococci and actinobacteria. Streptococci counts were significantly higher in the apical canal of teeth with inadequate restorations and teeth with no lesions. Underfilled canals showed higher bacterial counts.

Unvaccinated periodontal patients with a history of COVID-19: clinical findings in a Dental School setting.

This study analyzed the periodontal clinical data of individuals with a history of COVID-19 treated in a dental school during the pandemic in 2021 before vaccination. METHODS: This analysis included individuals older than 18 years with no history of systemic disorders other than systemic arterial hypertension. Individuals who had COVID-19 were classified according to the World Health Organization as asymptomatic, with mild, moderate, severe, or critical symptoms. RESULTS: A total of 95 individuals were evaluated, which included 24 with a history of COVID-19. Seventeen percent had been asymptomatic, 21% had mild, 25% moderate, 21% severe, and 17% critical symptoms, including intubation. Individuals with no history of COVID-19 presented significantly lower measurements of probing depth (p=0.003; Mann-Whitney test) and clinical attachment level (p=0.002) compared to individuals with a history of COVID-19. A significant negative association was found between bleeding on probing and the severity of characteristics of COVID-19 (rho= -0.233; p=0.023). Conversely, positive associations between the values of probing depth (rho= 0.292; p=0.004) and mean clinical attachment level (rho= 0.300; p=0.003) and the characteristics of COVID-19 were found. CONCLUSIONS: The periodontal data shows that patients who had COVID-19 before vaccination may present a worse periodontal status when compared to patients in the same clinical setting with no history of COVID-19. However, a more extensive study should confirm it with more participants.

Influence of sealer type on treatment outcome of teeth with apical periodontitis: a systematic review.

BACKGROUND: The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical periodontitis (PROSPERO registration: CRD42020205951). METHODOLOGY: A systematic review of original clinical studies was carried out following PRISMA guidelines to answer whether the type of sealer used in endodontic treatment or retreatment influences the repair of apical periodontitis determined by clinical and radiographic parameters. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library database, until May 2023. Gray literature and a hand search of reference lists were also performed. The risk of bias was assessed using Cochrane RoB2 for randomized trials and the Newcastle-Ottawa Scale (NOS) for prospective and retrospective cohort and case-control studies. RESULTS: Among 1046 studies, a total of 819 were selected by title and abstract, resulting in 23 for full-text review. In total, 11 studies met the inclusion criteria (1467 patients/teeth with apical periodontitis). The quality assessment using RoB2 included five randomized control trials, of which four had medium risk and one had a low risk of bias. According to the NOS scale, five studies were classified as low risk and one study was considered as medium risk of bias. The sealer type and obturation techniques varied, and the mean follow-up time was 3.7 years. Most studies used two-dimensional radiographic criteria to assess the treatment outcome sealers and not cements. Eight studies did not find significant differences when comparing cements. The healing rates ranged from 56.7% to 90%. CONCLUSIONS: The results of this review support that the current endodontic sealers do not seem to influence the treatment outcome of permanent teeth with apical periodontitis. Although the studies had medium and low risk of bias, the results should be interpreted with caution. More randomized studies of long-term outcomes comparing filling materials are needed to strengthen this claim and allow for a meta-analysis.

Unvaccinated periodontal patients with a history of COVID-19: clinical findings in a Dental School setting

Abstract This study analyzed the periodontal clinical data of individuals with a history of COVID-19 treated in a dental school during the pandemic in 2021 before vaccination. Methods: This analysis included individuals older than 18 years with no history of systemic disorders other than systemic arterial hypertension. Individuals who had COVID-19 were classified according to the World Health Organization as asymptomatic, with mild, moderate, severe, or critical symptoms. Results: A total of 95 individuals were evaluated, which included 24 with a history of COVID-19. Seventeen percent had been asymptomatic, 21% had mild, 25% moderate, 21% severe, and 17% critical symptoms, including intubation. Individuals with no history of COVID-19 presented significantly lower measurements of probing depth (p=0.003; Mann-Whitney test) and clinical attachment level (p=0.002) compared to individuals with a history of COVID-19. A significant negative association was found between bleeding on probing and the severity of characteristics of COVID-19 (rho= -0.233; p=0.023). Conversely, positive associations between the values of probing depth (rho= 0.292; p=0.004) and mean clinical attachment level (rho= 0.300; p=0.003) and the characteristics of COVID-19 were found. Conclusions: The periodontal data shows that patients who had COVID-19 before vaccination may present a worse periodontal status when compared to patients in the same clinical setting with no history of COVID-19. However, a more extensive study should confirm it with more participants.

Resumo Este estudo analisou os dados clínicos periodontais de indivíduos com histórico de COVID-19 tratados em uma escola de odontologia durante a pandemia em 2021, antes da vacinação. Métodos: Essa análise incluiu indivíduos maiores de 18 anos sem histórico de distúrbios sistêmicos, exceto hipertensão arterial sistêmica. Os indivíduos que tiveram COVID-19 foram classificados de acordo com a Organização Mundial da Saúde como assintomáticos, com sintomas leves, moderados, graves ou críticos. Resultados: 95 indivíduos foram avaliados, incluindo 24 com histórico de COVID-19. 17% eram assintomáticos, 21% tinham sintomas leves, 25% moderados, 21% graves e 17% críticos, incluindo intubação. Os indivíduos sem histórico de COVID-19 apresentaram medidas significativamente mais baixas de profundidade de sondagem (p=0,003; teste de Mann-Whitney) e nível de fixação clínica (p=0,002) em comparação com indivíduos com histórico de COVID-19. Foi encontrada uma associação negativa significativa entre o sangramento à sondagem e a gravidade das características da COVID-19 (rho= -0,233; p=0,023). Por outro lado, foram encontradas associações positivas entre os valores de profundidade de sondagem (rho = 0,292; p = 0,004) e o nível médio de apego clínico (rho = 0,300; p = 0,003) e as características da COVID-19. Conclusão: Os dados periodontais mostraram que os pacientes que tiveram COVID-19 antes da vacinação podem apresentar um pior estado periodontal quando comparados a pacientes no mesmo ambiente clínico sem histórico de COVID-19. No entanto, um estudo mais extenso deve ser realizado para confirmar tal achado com maior número de participantes.

Influence of sealer type on treatment outcome of teeth with apical periodontitis: a systematic review

Abstract The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical periodontitis (PROSPERO registration: CRD42020205951). Methodology: A systematic review of original clinical studies was carried out following PRISMA guidelines to answer whether the type of sealer used in endodontic treatment or retreatment influences the repair of apical periodontitis determined by clinical and radiographic parameters. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library database, until May 2023. Gray literature and a hand search of reference lists were also performed. The risk of bias was assessed using Cochrane RoB2 for randomized trials and the Newcastle-Ottawa Scale (NOS) for prospective and retrospective cohort and case-control studies. Results: Among 1046 studies, a total of 819 were selected by title and abstract, resulting in 23 for full-text review. In total, 11 studies met the inclusion criteria (1467 patients/teeth with apical periodontitis). The quality assessment using RoB2 included five randomized control trials, of which four had medium risk and one had a low risk of bias. According to the NOS scale, five studies were classified as low risk and one study was considered as medium risk of bias. The sealer type and obturation techniques varied, and the mean follow-up time was 3.7 years. Most studies used two-dimensional radiographic criteria to assess the treatment outcome sealers and not cements. Eight studies did not find significant differences when comparing cements. The healing rates ranged from 56.7% to 90%. Conclusions: The results of this review support that the current endodontic sealers do not seem to influence the treatment outcome of permanent teeth with apical periodontitis. Although the studies had medium and low risk of bias, the results should be interpreted with caution. More randomized studies of long-term outcomes comparing filling materials are needed to strengthen this claim and allow for a meta-analysis.

Resumo O objetivo deste artigo foi avaliar a influência do cimento no resultado do tratamento ou retratamento endodôntico não cirúrgico de dentes permanentes com periodontite apical (registro PROSPERO: CRD42020205951). Metodologia: Uma revisão sistemática de estudos clínicos originais foi realizada seguindo as diretrizes PRISMA para responder se o tipo de cimento usado no tratamento ou retratamento endodôntico influencia a reparação da periodontite apical determinada por parâmetros clínicos e radiográficos. Pesquisas eletrônicas foram realizadas no PubMed, Embase, Web of Science, Scopus e no banco de dados Cochrane Library, até maio de 2023. A literatura cinza e uma pesquisa manual das listas de referências também foram realizadas. O risco de viés foi avaliado usando Cochrane RoB2 para os estudos randomizados e Newcastle-Ottawa Scale (NOS) para coorte prospectiva e retrospectiva e estudos de caso-controle. Resultados: Entre 1.046 estudos, um total de 819 foram selecionados por título e resumo, resultando em 23 para revisão de texto completo. No total, 11 estudos preencheram os critérios de inclusão (1.467 pacientes/dentes com periodontite apical). A avaliação de qualidade usando RoB2 incluiu cinco estudos randomizados de controle, dos quais quatro tinham risco médio e um tinha baixo risco de viés. De acordo com a escala NOS, cinco estudos foram classificados com baixo risco e um estudo foi considerado com médio risco de viés. O tipo de cimento e as técnicas de obturação variaram, e o tempo médio de acompanhamento foi de 3,7 anos. A maioria dos estudos utilizou critérios radiográficos bidimensionais para avaliar o resultado do tratamento. Oito estudos não encontraram diferenças significativas ao comparar os cimentos. As taxas de reparação variaram de 56,7% a 90%. Conclusões: Os resultados desta revisão suportam que os cimentos endodônticos atuais não parecem influenciar o resultado do tratamento de dentes permanentes com periodontite apical. Embora os estudos tiveram médio e baixo risco de viés, os resultados devem ser interpretados com cautela. Mais estudos randomizados de resultados de longo prazo comparando materiais de obturação são necessários para fortalecer essa afirmação e permitir uma meta-análise.

Disinfection and Shaping of Vertucci Class II Root Canals after Preparation with Two Instrument Systems and Supplementary Ultrasonic Activation of Sodium Hypochlorite.

INTRODUCTION: This study compared disinfection and shaping after root canal preparation with either XP-endo Shaper or TruNatomy instrument systems, supplemented by ultrasonic activation of sodium hypochlorite (NaOCl) with either stainless-steel (SS) or nickel-titanium (NiTi) inserts. METHODS: Mesial roots from mandibular molars with Vertucci class II configuration were divided into 2 groups (n = 24) based on anatomically paired micro-computed tomography (micro-CT) analyses. Pre and postpreparation micro-CT scans were obtained to evaluate the shaping performance. The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation with either XP-endo Shaper or TruNatomy instruments using NaOCl irrigation. Supplementary ultrasonic activation of NaOCl was conducted using either an SS (TruNatomy group) or NiTi (XP-endo Shaper group) insert. Bacteriological samples were taken from the canals before preparation (S1), after preparation (S2), and after the supplementary approach (S3). Bacterial reduction was evaluated using a quantitative real-time polymerase chain reaction. RESULTS: Preparation with both instrument systems significantly reduced bacterial counts (P < .01). After preparation, 36% (TruNatomy) and 35% (XP-endo Shaper) were negative for bacteria. These values increased to 59% and 65% after ultrasonic activation with the SS and NiTi inserts, respectively. The quantitative data in S2 showed that XP-endo Shaper promoted a significantly higher bacterial reduction than TruNatomy (P < .05). No significant intragroup differences were observed after ultrasonic activation (P > .05), probably because the SS insert promoted a significantly higher S2-to-S3 reduction than the NiTi insert (P < .01). Micro-CT analysis revealed no significant differences in the unprepared areas between the groups (P > .05). CONCLUSIONS: The XP-endo Shaper caused a significantly higher bacterial reduction than TruNatomy in Vertucci class II canals. Better antibacterial results after ultrasonic activation were observed for the SS ultrasonic inserts than for the NiTi inserts.

Shaping ability of BlueShaper, TruNatomy, DC Taper and HyFlex EDM in long oval canals: An ex vivo study.

AIM: This study evaluated and compared the shaping ability of four rotary instrument systems in long-oval root canals using microcomputed tomographic (micro-CT) evaluation. Currently, there is no data available on the canal shaping abilities of BlueShaper and DC Taper instruments. METHODOLOGY: Sixty-four single-rooted mandibular premolars were matched based on similar root canal morphologic features as determined by (micro-CT) and randomly assigned to 1 of 4 experimental groups (n = 16) according to the instrument system used: BlueShaper, TruNatomy, DC Taper and HyFlex EDM One File. Changes in the root canal surface and volume, remaining dentine thickness, and number of prepared areas were assessed. RESULTS: No significant differences were found amongst the four instrument systems for the parameters evaluated (p > .05). There was a significant reduction in the number of unprepared areas and the remaining dentine thickness after each increase in size of the instruments tested (p < .05). CONCLUSIONS: The four instrument systems perform similarly in long oval root canals. Although none could prepare all canal walls, larger preparations incorporated significantly more surfaces in the final shape.

Influence of brushing motions on the shaping of oval canals by rotary and reciprocating instruments.

OBJECTIVE: The effects of brushing on shaping with three different instruments were assessed in oval canals. DESIGN: Mandibular incisors were assigned to 6 groups (n = 12/group) according to the system, each one with or without brushing: Reciproc Blue, VDW.Rotate, and Race EVO. Micro-computed tomography was performed before and after preparation. RESULTS: Brushing strokes caused no increase in canal volume, surface area, and structure model index independently of the system (p > 0.05), except for RaCe EVO in the full canal surface area (p < 0.05). Brushing did not increase the prepared areas (p > 0.05), except for Reciproc in the apical canal (p < 0.05). Reciproc with no brushing exhibited less pericervical dentin than with brushing (p < 0.05), while RaCe EVO with brushing resulted in less remaining dentin (p < 0.05). CONCLUSIONS: The brushing motion had no effects on the overall shaping performance of the 3 instruments tested. An exception was the increase in prepared surface area in the apical canal segment when the Reciproc instrument was used with brushing strokes.

Multi-Level Protective and Risk Factors Longitudinally Associated with Dating Violence Perpetration among Non-Urban Mexican-American Adolescents.

To assess the longitudinal relationship between individual and interpersonal risk and protective factors and dating violence perpetration among non-urban Mexican-American youth. With data from a 24-month prospective cohort study (2015-2019; baseline recruitment spanned from 2015-2017; four follow-up interviews every 6 months) of Mexican-American youth (8th grade at baseline) living in an agricultural region (Salinas, California), we utilized multivariable modified Poisson general estimating equations stratified by gender (n = 489) to assess the relationships of religiosity, non-violent problem-solving skills, school connectedness, family cohesion, and bullying victimization with dating violence perpetration. Among girls, but not boys, non-violent problem-solving skills [adjusted relative risk (ARR): 0.7; 95% confidence interval (CI): 0.56-0.99] and family cohesion (ARR: 0.7; 95% CI: 0.48-0.97) were negatively associated with dating violence perpetration, and frequency of bullying victimization was positively associated (ARR: 1.9; 95% CI: 1.37-2.59). Non-urban Mexican-American female youth may benefit from multi-level dating violence prevention that strengthens family cohesion by building upon the Mexican-American cultural value of familismo and addresses common risk factors for bullying and dating violence perpetration. Additionally, results affirm etiological differences between girls' and boys' dating violence perpetration and the need for improved measurement.

Cu/Nb2O5, Fe/Nb2O5 and Cu-Fe/Nb2O5 applied in salicylic acid degradation: Parameters studies and photocatalytic activity.

This study describes the synthesis of Cu/Nb2O5, Fe/Nb2O5, and Cu-Fe/Nb2O5 catalysts obtained by incorporating copper and/or iron metals into niobium pentoxide (Nb2O5). The new materials were characterized by the following techniques: Thermogravimetric Analysis (TA), surface and pore analysis, X-ray diffractometry (XRD), and Fourier Transform Infrared Spectroscopy (FT-IR). The catalyst was applied in the photocatalytic degradation of salicylic acid (SA). The influence of different parameters (calcined temperature, pH, and metal addition) on the photocatalytic reaction was evaluated. The results indicated that catalysts containing copper were more active and pH influenced the SA degradation process. SA removal results indicated that Cu/Nb2O5 photocatalyst presented a 1.5 fold higher degradation after 120 min in comparison to Cu-Fe/Nb2O5 and 4.6 fold higher than Fe/Nb2O5 catalyst, all them calcined at 400 °C. In tests carried out in the presence of formic acid, increasing the pH from about 3 to 7 allowed an almost 3.4-fold increase in SA degradation for the Cu-Fe/Nb2O5 catalyst calcined at 400 °C.

At least 3 years of self-responsibility for periodontal care after 2 years of supportive periodontal therapy.

OBJECTIVES: This study aimed to investigate the periodontal condition when patients became self-responsible for the continuation of periodontal care, after non-surgical periodontal therapy and 2 years of Supportive Periodontal Therapy (SPT). MATERIALS AND METHODS: Fifty-seven patients completed a previous 2-year SPT study and were afterward advised to seek for dental assistance for maintenance care. After 4.2 ± 0.45 years of self-responsibility for periodontal care (SRPC), 27 patients could be re-examined of which 9 patients had followed the advice to turn to a dental professional for SPT care. Visible Plaque (VPI), Gingival Bleeding (GBI), Periodontal Probing Depth (PPD), Bleeding on probing (BOP), and Clinical Attachment Loss (CAL) were obtained from SPT study: before and after non-surgical treatment, and after 2 years of SPT. The same parameters were reassessed for the present study. General linear models for repeated measures were used for data analysis. RESULTS: At the end of the SRPC period, mean GBI, BOP, and PPD values (43.5%, 55.7%, 2.76 mm, respectively) were back to pre-treatment, whereas VPI (64.3%) and CAL (3.76 mm) became significantly higher. The percentage of sites with PPD ≥5 mm as well as sites with CAL ≥4 or ≥5 mm also returned to pre-treatment values. However, the percentage of sites with PPD ≥4 mm was still significantly lower compared to pre-treatment values but higher than after 2 years of SPT. CONCLUSIONS: Self-responsibility for the continuation of periodontal care after professional treatment should be avoided. CLINICAL RELEVANCE: Clinicians and specialists must be conscious of making all efforts to maintain the patient's frequent recalls.

SARS-CoV-2 RNA in dental biofilms: Supragingival and subgingival findings from inpatients in a COVID-19 intensive care unit.

BACKGROUND: Saliva, salivary glands, gingival crevicular fluid, and supragingival biofilms may harbor SARS-CoV-2 RNA. This observational study aimed to investigate the presence and load of SARS-CoV-2 RNA in supragingival, and subgingival biofilms obtained from intensive care unit (ICU) patients. METHODS: A convenience sample, composed of 52 COVID-19+ participants (48.6 ± 14.8 years, 26.9% females), were evaluated for pre-existing comorbidities, number of teeth, and periodontal data [visible plaque (VPI), bleeding on probing (BOP), periodontal probing depth (PPD), and attachment loss (AL)]. Supragingival and subgingival samples (SubDeep: four sites with the deepest PPD; SubRemain: remaining shallower sites) were analyzed by RT-qPCR with corresponding cycle quantification (Cq). Statistical analyses considered the individual (P = 5%). RESULTS: Twenty-six participants tested positive for dental biofilms (Biofilm+) with 96.2% of them being positive for subgingival samples. Pre-existing comorbidities, number of teeth examined, VPI, PPD, AL, and BOP were similar between Biofilm+ and Biofilm-. SubDeep PPD (3.72 ± 0.86), AL (4.34 ± 1.33), and % of BOP (66.0 ± 31.1) values were significantly greater compared to SubRemain values (2.84 ± 0.48, 3.37 ± 0.34, and 20.4 ± 24.1, respectively). Biofilm+ Cqs showed no association with the periodontal condition. Cqs from Nasopharynx/Oropharynx (Naso/Oro; n = 36) were similar between Biofilm+ and Biofilm- participants. Length of time since ICU intake, last Naso/Oro RT-qPCR readings, onset of COVID-19 symptoms, and biofilm samplings were greater for Biofilm-. CONCLUSIONS: ICU patients harbored SARS-CoV-2 RNA in supragingival and subgingival biofilms, irrespective of the periodontal condition, and systemic viral load. The high number of positive patients highlights the need to better understand this habit to provide adequate oral care.

The relationship between commercial sexual exploitation of children (CSEC) and childhood sexual abuse (CSA) among boys and girls in Haiti.

To test the hypothesis that childhood sexual abuse (CSA) is a risk factor for commercial sexual exploitation of children (CSEC), we analysed data from the Haiti Violence Against Children Survey (VACS), a population-based sample of adolescents and young adults ages 13-24 (1459 males and 1457 females). Twenty-one percent of males and 25% of females reported CSA; 6% of males and 4% of females reported CSEC. The adjusted odds ratios (AORs) for CSEC based on exposure to CSA were 5.6 (95% confidence interval/CI: 3.1-10.2) for males and 5.9 (CI: 2.6-13.0) for females. For each year earlier that males first experienced CSA, the odds of CSEC increased 60% (AOR 1.6, CI 1.2-2.0). In this first nationally-representative study of lifetime CSEC, both boys and girls victimised by CSA in Haiti were more likely to have also experienced CSEC than other youth, with children who experienced CSA at younger ages at the greatest risk.

Tadalafil treatment improves cardiac, renal and lower urinary tract dysfunctions in rats with heart failure.

Tadalafil, a phosphodiesterase-5 (PDE5) inhibitor, shown to exert a protection to heart failure (HF) associated damage or lower urinary tract symptoms (LUTS). Thus, we investigated the contribution of tadalafil chronic treatment in the alterations of LUTS in HF rats. Male rats were subjected to aortocaval fistula model for HF induction. Echocardiography, cystometric, renal function and redox cell balance, as well as concentration-response curves to carbachol, KCl, ATP and frequency-response curves to electrical field stimulation (EFS) were evaluated in Sham, HF, Tadalafil and HF-Tadalafil (12 weeks endpoint) groups. HF group to present increased in left-ventricle (LV) mass and in LV end-diastolic- and LV end-systolic volume, with a decreased ejection fraction. Tadalafil treatment was able to decrease in hypertrophy and improve the LV function restoring cardiac function. For micturition function (in vivo), HF animals shown an increase in basal pressure, threshold pressure, no-voiding contractions and decreased bladder capacity, being that the tadalafil treatment restored the cystometric parameters. Contractile mechanism response (in vitro) to carbachol, KCl, ATP and EFS in the detrusor muscles (DM) were increased in the HF group, when compared to Sham group. However, tadalafil treatment restored the DM hypercontractility in the HF animals. Moreover, renal function as well as the oxidative mechanism was impaired in the HF animals, and the tadalafil treatment improved all renal and oxidative parameters in HF group. Our data shown that tadalafil has potential as multi-therapeutic drug and may be used as a pharmacological strategy for the treatment of cardiovascular, renal and urinary dysfunctions associated with HF.

The use of medium bristle toothbrushes is associated with the incidence of gingival fissures.

OBJECTIVES: The objective of this study was to compare the incidence of gingival fissures (GF) associated with the use of soft and medium bristle toothbrushes over three months. MATERIAL AND METHODS: A blind randomized crossover clinical trial was conducted with 20 high school students (14 females, 14-24 years old) using both toothbrushes type (soft and medium bristle) during 3 months each. Periodontal examinations and photographs of premolars and molars were recorded on days 0, 30, 60, and 90 of 1st phase. Following a 10-day washout period, the 2nd phase was carried out with the participants changing the assigned brush type. Toothbrushing perception was evaluated at the end of study through a questionnaire. A calibrated and blind examiner analyzed the photographs for GF presence. Differences in the GF incidence between toothbrushes type were analyzed by McNemar test, while factors associated with GF incidence were investigated by Poisson regression. RESULTS: Sixty-five percent (n = 13) of participants had at least one GF throughout the study, with 40% (n = 8) of them while using medium brushes only (p = 0.039). GF occurrence was significantly associated with medium brushes (IRR, 3.582; 95% CI 1.459-8.795; p = 0.005). 58.8% of participants reported gingival soreness or bleeding with medium brushes. CONCLUSIONS: Both toothbrushes led to the GF occurrence. Nonetheless, medium bristles toothbrushes determined a 3.58 times greater risk of developing these lesions. Clinical relevance The use of medium bristle brush is associated with greater incidence of gingival fissures. The presence of gingival fissures should be considered by the clinician when evaluating the toothbrushing habits of patients.

Influence of a High-fat Diet in the Progression of Apical Periodontitis.

INTRODUCTION: This study evaluated the effects of a high-fat diet (HFD) on the progression of apical periodontitis (AP) in rats. METHODS: Eight-week old Wistar rats (N = 24) were included in this study. Half of the animals received an HFD and the other half a control diet (CD). AP lesions were induced 8 weeks later by creating pulp exposure of the mandibular left first molars. The animal's body mass was verified on a weekly basis. After 21 and 40 days, the animals were sacrificed. Blood was collected for biochemical tests, and the liver was removed for hepatic triglycerides analysis. The left hemimandibles were removed, radiographed, and then prepared for histologic evaluation. The right hemimandibles (region near molars) were removed for bone mineral density analysis by dual-energy X-ray absorptiometry. RESULTS: Radiographs showed that AP lesions were significantly larger in the HFD group compared with the CD group (P < .05). Histologic analysis confirmed that the AP lesions were larger and revealed a more severe inflammatory infiltrate in the HFD group. Bone mineral density was reduced in the HFD group compared with the CD groups (P < .05). The HFD resulted in a significant increase in body mass (P < .05), liver mass (P < .05), relative liver mass (P < .05), and hepatic triglycerides (P < .05). The levels of triglycerides and very-low-density lipoprotein were significantly higher in the 40-day HFD group compared with the 21-day HFD and 21- and 40-day CD groups (P < .05). CONCLUSIONS: Findings suggest that an HFD can influence the progression and severity of AP.

Morphine Perinatal Exposure Induces Long-Lasting Negative Emotional States in Adult Offspring Rodents.

Psychoactive substances during pregnancy and lactation is a key problem in contemporary society, causing social, economic, and health disturbance. In 2010, about 30 million people used opioid analgesics for non-therapeutic purposes, and the prevalence of opioids use during pregnancy ranged from 1% to 21%, representing a public health problem. This study aimed to evaluate the long-lasting neurobehavioral and nociceptive consequences in adult offspring rats and mice exposed to morphine during intrauterine/lactation periods. Pregnant rats and mice were exposed subcutaneously to morphine (10 mg/kg/day) during 42 consecutive days (from the first day of pregnancy until the last day of lactation). Offspring were weighed on post-natal days (PND) 1, 5, 10, 15, 20, 30, and 60, and behavioral tasks (experiment 1) or nociceptive responses (experiment 2) were assessed at 75 days of age (adult life). Morphine-exposed female rats displayed increased spontaneous locomotor activity. More importantly, both males and female rats perinatally exposed to morphine displayed anxiety- and depressive-like behaviors. Morphine-exposed mice presented alterations in the nociceptive responses on the writhing test. This study showed that sex difference plays a role in pain threshold and that deleterious effects of morphine during pre/perinatal periods are nonrepairable in adulthood, which highlights the long-lasting clinical consequences related to anxiety, depression, and nociceptive disorders in adulthood followed by intrauterine and lactation morphine exposure.

Evaluation of Cerebellar Function and Integrity of Adult Rats After Long-Term Exposure to Aluminum at Equivalent Urban Region Consumption Concentrations.

High amounts of aluminum (Al) are found in soil and water. It is highly bioavailable, which makes it an important agent of environmental imbalance. Moreover, Al is considered a neurotoxic agent that is associated with several neurodegenerative diseases. Thus, this study investigated the effects of long-term Al chloride (AlCl3) exposure on motor behavior, oxidative biochemistry, and cerebellar tissue parameters. For this, adult Wistar rats were divided into three groups: Al-D1 (8.3 mg kg-1 day-1), Al-D2 (5.2 mg kg-1 day-1), and control (distilled water); all groups were orally exposed for 60 days by intragastric gavage. After the exposure period, animals performed the open field, elevated plus maze, rotarod, and beam walking tests. Then, the blood and cerebellum were collected to evaluate Al levels and biochemical and morphological analyses, respectively. Our results demonstrate that animals exposed to Al doses presented a higher Al level in the blood. In the spontaneous locomotor activity, Al exposure groups had traveled a lower total distance when compared with the control group. There was no statistically significant difference (p > 0.05) between exposed and control groups when anxiogenic profile, forced locomotion, fine motor coordination/balance, pro-oxidative parameter, and density Purkinje cells were compared. Thus, aluminum exposure in equivalent doses to human consumption in urban regions did not promote significant changes in the cerebellum or motor parameters.