Use of Local Melatonin with Xenogeneic Bone Graft to Treat Critical-Size Bone Defects in Rats with Osteoporosis: A Randomized Study.

The aim of this study was to evaluate the effect of local administration of melatonin (MLT) on molecular biomarkers and calvaria bone critical defects in female rats with or without osteoporosis, associated or not with a xenogeneic biomaterial. Forty-eight female rats were randomly divided into two groups: (O) ovariectomized and (S) placebo groups. After 45 days of osteoporosis induction, two critical-size defects (5 mm diameter) were created on the calvaria. The groups were subdivided according to the following treatment: (C) Clot, MLT, MLT associated with Bio-Oss® (MLTBO), and Bio-Oss® (BO). After 45 days, the defect samples were collected and processed for microtomography, histomorphometry, and biomolecular analysis (Col-I, BMP-2, and OPN). All animals had one femur harvested to confirm the osteoporosis. Microtomography analysis demonstrated a bone mineral density reduction in the O group. Regarding bone healing, the S group presented greater filling of the defects than the O group; however, in the O group, the defects treated with MLT showed higher mineral filling than the other treatments. There was no difference between the treatments performed in the S group (p = 0.05). Otherwise, O-MLT had neoformed bone higher than in the other groups (p = 0.05). The groups that did not receive biomaterial demonstrated lower levels of Col-I secretion; S-MLT and S-MLTBO presented higher levels of OPN, while O-C presented statistically lower results (p < 0.05); O-BO showed greater BMP-2 secretion (p < 0.05). In the presence of ovariectomy-induced osteoporosis, MLT treatment increased the newly formed bone area, regulated the inflammatory response, and increased OPN expression.

Oral health and quality of life of the geriatric patient: contexts of autonomy / Salud bucal y calidad de vida del paciente geriátrico: contextos de autonomía

Background: The state of oral health plays an important role in the concept of frailty among the elderly, as they tend to suffer from poor oral health conditions. Objective: The aim of our systematic review is to study the impact of oral health on the quality of life of the geriatric patient in different contexts of autonomy. Material and Methods: A systematic literature review was carried out of which the selection of articles, with publication date between 2008 and 2020 was conducted through computer platforms. The studies were analyzed and evaluated respecting the previously established inclusion criteria. The review corpus consisted of 16 articles, which presented methodological quality. Results: Oral health has an impact on the quality of life of the elderly, both in the context of institutionalization and at a community level. Oral health has an effect on the quality of life of the elderly, namely in the dimensions of physical pain, physical disability, psychological discomfort, functional limitation, psychological and social disability. The higher the level of dependency the lower the oral health which has the greatest impact on quality of life. The presence of periodontitis, dental caries, edentulism, oral lesions and unsuitable dental prostheses result in a worse perception of quality of life. Conclusion: The evidence found in this study reveals that the state of oral health among the elderly influences their quality of life, regardless of the context of autonomy, indicating the need for oral health policies aimed at this specific population.

Fundamento: El estado de salud bucal juega un papel importante en el concepto de fragilidad entre los ancianos, ya que tienden a padecer de malas condiciones de salud bucal. Objetivo: El objetivo de nuestra revisión sistemática es estudiar el impacto de la salud bucal en la calidad de vida del paciente geriátrico en diferentes contextos de autonomía. Material y Métodos: Se realizó una revisión sistemática de la literatura, se seleccionó artículos con fecha de publicación entre 2008 y 2020 a través de plataformas informáticas. Los estudios fueron analizados y evaluados respetando los criterios de inclusión previamente establecidos. El corpus de revisión estuvo compuesto por 16 artículos, que presentaron calidad metodológica. Resultados: La salud bucal tiene impacto en la calidad de vida de los ancianos, tanto en el contexto de institucionalización como a nivel comunitario. La salud bucal tiene un efecto sobre la calidad de vida de los ancianos, concretamente en las dimensiones de dolor físico, discapacidad física, malestar psicológico, limitación funcional, discapacidad psicológica y social. Cuanto mayor es el nivel de dependencia, menor es la salud bucal, lo que tiene un mayor impacto en la calidad de vida. La presencia de periodontitis, caries dental, edentulismo, lesiones bucales y prótesis dentales inadecuadas redundan en una peor percepción de la calidad de vida. Conclusión: Las evidencias encontradas en este estudio revelan que el estado de salud bucal de los ancianos influye en su calidad de vida, independientemente del contexto de autonomía, indicando la necesidad de políticas de salud bucal dirigidas a esa población específica.

Acceptability of the contraceptive Sayana® Press when injected every four months: Results from a twelve-month trial in Brazil, Chile and the Dominican Republic.

OBJECTIVE: We assessed the acceptability of subcutaneous depot-medroxyprogesterone acetate 104 mg (Sayana® Press) when injected every 4 months for 12 months. STUDY DESIGN: We assessed acceptability using questionnaires within a clinical trial to evaluate contraceptive effectiveness of Sayana® Press when the reinjection interval was extended from 3 to 4 months. We enrolled 750 women aged 18 to 35 years and at risk of pregnancy at 3 centers in Brazil, Chile, and the Dominican Republic who agreed to use Sayana® Press every 4 months for 12 months. Acceptability outcomes included responses to questions about perception of bleeding patterns and side effects, likes, and dislikes about the regimen. We descriptively compared outcomes across study centers and between those who completed the study and those who discontinued early. RESULTS: Across the 3 centers, participants differed in age, marital status, years of schooling, and race. At the final visit, 90% reported being satisfied with Sayana® Press and 75% reported preferring to use this contraceptive every 4 months. The most common reasons women liked using Sayana® Press were for its duration of effectiveness, followed by amenorrhea. The most common dislike, when a reason was identified, was its effect on uterine bleeding, including amenorrhea reported by some participants. We also observed center-level differences in the proportion of women who liked amenorrhea. CONCLUSIONS: Satisfaction with Sayana® Press injected every 4 months was high across the 3 demographically diverse Latin-American centers. However, participants had varied feelings towards contraceptive-induced amenorrhea. IMPLICATIONS: We found that Sayana® Press when injected every 4 months was highly acceptable among women in 3 Latin American settings despite differences in their feelings toward contraceptive-induced amenorrhea. Our results suggest that there will be interest in using this method every 4 months if introduced into these settings.

Oral health behaviour perception scale applied among a sample of portuguese adolescents / Escala de percepción del comportamiento de salud bucal aplicada en una muestra de adolescentes portugueses

Introduction: The application of a scale can be particularly useful for the epidemiological studies comparing different populations and for analysis of the influence of distinct aspects of oral health on the development of certain health conditions. The aim of this study consists in the creation of a scale to classify the level of perception of the oral health behaviors applicable to a sample of Portuguese adolescents. Material and Methods: An observational cross-sectional study was designed with a total of 649 adolescents between the ages of 12 and 18 years old from five public schools in the Viseu and Guarda districts, in Portugal. Data was collected by the application of a self-administered questionnaire and, after analysis of data collection, the newly Universidade Católica Portuguesa (UCP) oral health perception scale was created. Statistical analysis was performed using SPSS-IBM software version 24.0 (IBM SPSS, Chicago, Il., USA). In the descriptive statistical analysis, absolute and descriptive frequencies were used for variables with nominal measurement level, mean as a measure of central tendency and standard deviation as a measure of dispersion for interval variables. Results: Oral health behaviors perception respecting the assumptions defined by the present scale has been elaborated. The result showed that 67% of the sample presented a poor perception of their oral health behaviors, 23.9% intermediate/sufficient, while 8.2% refer having good perception, respecting the assumptions defined for the elaboration of the present scale. Conclusion: For this purpose, through the scale to classify the level of oral health behaviors applicable to the sample of portuguese adolescents, it is possible to compare the data of several samples and understand what are the most frequent oral or eating habits among adolescents

Introducción: La aplicación de una escala puede ser particularmente útil para los estudios epidemiológicos que comparan diferentes poblaciones y para el análisis de la influencia de distintos aspectos de la salud bucal en el desarrollo de determinadas condiciones de salud. El objetivo de este estudio consiste en la creación de una escala para clasificar el nivel de percepción de las conductas de salud bucal aplicable a una muestra de adolescentes portugueses. Material y Métodos: Se diseñó un estudio observacional transversal con un total de 649 adolescentes de entre 12 y 18 años de cinco escuelas públicas de los distritos de Viseu y Guarda, en Portugal. La recolección de datos se realizó mediante la aplicación de un cuestionario autoadministrado y, tras el análisis de la recolección de datos, se creó la nueva escala de percepción de salud bucal de la Universidad Católica Portuguesa (UCP). El análisis estadístico se realizó utilizando el software SPSS-IBM versión 24.0 (IBM SPSS, Chicago, Il., EE. UU.). En el análisis estadístico descriptivo se utilizaron frecuencias absolutas y descriptivas para variables con nivel de medida nominal, media como medida de tendencia central y desviación estándar como medida de dispersión para variables de intervalo. Resultados: ha elaborado la percepción de conductas de salud bucal respetando los supuestos definidos por la presente escala. El resultado mostró que el 67% de la muestra presentó mala percepción de sus conductas de salud bucal, el 23,9% intermedia / suficiente, mientras que el 8,2% refiere tener buena percepción, respetando los supuestos definidos para la elaboración de la presente escala. Conclusión: Para ello, a través de la escala para clasificar el nivel de conductas de salud bucal aplicable a la muestra de adolescentes portugueses, es posible comparar los datos de varias muestras y comprender cuáles son los hábitos orales o alimentarios más frecuentes entre los adolescentes.

Evaluation of clinical performance when intrauterine devices are inserted by different categories of healthcare professional.

OBJECTIVE: We evaluated clinical performance when the TCu380A intrauterine device (IUD) and the levonorgestrel (LNG) 52-mg intrauterine system (IUS) were inserted by different categories of healthcare professionals. METHODS: A retrospective study was conducted at the University of Campinas, Brazil. The medical records were reviewed of all women in whom an IUD was inserted between January 1980 and December 2018, with data for at least 1 year, and for whom information on the healthcare provider who inserted the device was available. RESULTS: Overall, 19 132 (76.9%) IUD and 5733 (23.1%) LNG-IUS insertions were included, with residents/interns performing 13 853 (55.8%), nurses 7024 (28.2%), and physicians 3988 (16.0%). Removals for pregnancy and infection were significantly higher when physicians inserted the device, while removals for bleeding/pain and other medical reasons were more common when nurses performed the insertion. Expulsion and removals for personal reasons were similar for all three categories. CONCLUSION: Clinical outcomes were similar regardless of whether trained nurses, residents/interns, or physicians inserted the device, and were irrespective of users' age and parity. These results could stimulate other healthcare services, particularly in regions where there is a shortage of physicians, to invest in training nurses to perform insertions of IUDs.

Dental caries and oral health behavior assessments among portuguese adolescents / Caries dental y evaluaciones del comportamiento de salud bucal en adolescentes portugueses

Introduction: Adolescents have a high risk of developing caries in Portugal. The present study is designed to assess dental caries experience among the adolescents by the application of DMFT index, characterize the oral health risk factors and to determine the association between caries experience and socio-demographic variables. The characterization of the oral health behaviors of adolescents of the central region of Portugal will help in the development of specific oral health education strategies to improve oral health among the local communities. Material and methods: A cross-sectional study was conducted among a convenient sample of 694 adolescents aged 12 to 18 years attending public schools in two Portuguese districts using a structured questionnaire designed to investigate oral health and behavior of participants. In addition, a clinical examination was carried out noting the decayed, missing and filled teeth. A descriptive analysis of the variables was performed using the Chi-square, Mann-Whitney and Kruskal-Wallis tests (p<0.05). A multivariate analysis was applied for analysis of the association between variables. Results: The mean DMFT index score of 2.91±2.9 was obtained. Of the total sample, 73% consumed sugary food daily, 50.1% considered having good oral health and 70.8% did not report pain in the last 12 months. Most adolescents (79.4%) brushed their teeth daily and 60% did not use dental floss. Of the total sample, 96.4% had a dental appointment in the last 12 months, 46.4% of which was for preventive purposes. Applying the Chi-square statistical test, we verified that the adolescents who brush their teeth daily presented a good perception about their oral health (p<0.001), the DMFT index scores were associated with the residence area (p=0.01) and the presence of dental caries was associated with the perception of oral health (p=0.049) and sugary food intake (p=0.029).Conclusion: Portuguese adolescents presented a low DMFT index. The DMFT index was associated with residence area, perception of oral health and sugary food intake. Daily toothbrushing was associated with self-perception of oral health. It is suggested that oral health promotion and prevention programs should aim to reduce the risks of oral disease development.

Introducción: Los adolescentes tienen un alto riesgo de desarrollar caries en Portugal. El presente estudio está diseñado para evaluar la experiencia de caries dental entre los adolescentes mediante la aplicación del índice CPOD, caracterizar los factores de riesgo para la salud bucal y determinar la asociación entre la experiencia de caries y las variables sociodemográficas. La caracterización de los comportamientos de salud bucal de los adolescentes de la región central de Portugal ayudará en el desarrollo de estrategias específicas de educación en salud bucal para mejorar la salud bucal entre las comunidades locales. Material y Métodos: Se realizó un estudio transversal en una muestra por conveniencia de 694 adolescentes de 12 a 18 años que asisten a escuelas públicas en dos distritos portugueses utilizando un cuestionario estructurado diseñado para investigar la salud bucal y el comportamiento de los participantes. Además, se llevó a cabo un examen clínico observando los dientes cariados, faltantes y obturados. Se realizó un análisis descriptivo de las variables mediante las pruebas de Chi-cuadrado, Mann-Whitney y Kruskal-Wallis (p <0,05). Se aplicó un análisis multivariado para el análisis de la asociación entre variables. Resultados: Se obtuvo la puntuación media del índice CPOD de 2,91 ± 2,9. Del total de la muestra, el 73% consumía alimentos azucarados diariamente, el 50,1% consideró tener buena salud bucal y el 70,8% no refirió dolor en los últimos 12 meses. La mayoría de los adolescentes (79,4%) se cepillaban los dientes a diario y el 60% no usaba hilo dental. Del total de la muestra, el 96,4% tuvo cita con el dentista en los últimos 12 meses, de la cual el 46,4% fue con fines preventivos. Aplicando la prueba estadística de Chi-cuadrado, verificamos que los adolescentes que se cepillan los dientes diariamente presentaban una buena percepción sobre su salud bucal (p <0.001), las puntuaciones del índice CPOD se asociaron al área de residencia (p = 0.01) y la caries dental se asoció con la percepción de salud bucal (p = 0,049) y con la ingesta de alimentos azucarados (p = 0,029). Conclusión: Los adolescentes portugueses presentaron un índice CPOD bajo. El índice CPOD se asoció con el área de residencia, la percepción de salud bucal y la ingesta de alimentos azucarados. El cepillado diario de los dientes se asoció con la autopercepción de la salud bucal. Se sugiere que los programas de promoción y prevención de la salud bucal deben ser enfocados en reducir los riesgos de desarrollo de enfermedades bucodentales.

Oral health behaviors, dental injuries and mouthguard awareness among a sample of portuguese athletes: a cross sectional study / Comportamientos de salud bucal, lesiones dentales y conciencia del uso de protectores bucales entre una muestra de atletas portugueses: estudio transversal

Aim: To determine the oral health behaviors, the prevalence of dental injuries, the level of information about first-aid procedures in the case of dental avulsion and the mouthguard awareness in a sample of Portuguese athletes. Materials and Methods: Cross-sectional researchamong 1,048 athletes from the district of Viseu, Portugal. A self-administered questionnaire included demographic data and questions about: I) oral hygiene habits, II) occurrence of orofacial trauma, III) use of mouthguards and IV) athletes' knowledge regarding first-aid management in case of dental avulsion was given. The comparison between different variables was made by Chi-square test with level of significant set at p-value ≤0.05. Results: The mean age of the sample (76.24% male) was 18.14±8.17 years. Overall, the results demonstrated a low use of dental floss (25.48%) and a high number of athletes (21.94%) that had not visited a dentist in more than a year. The prevalence of dental trauma was 5.06% and the most common dental injuries experienced by athletes were crown fractures (60.38%). Nearly half of the participants (45.23%) reported not knowing how to act following a dental avulsion. The rate of mouthguard use was very low (9.73%). There was a significant relationship between the prevalence of dental injuries and the use of mouthguards (p=0.000; Cramér's V=0.145). Conclusion: The prevalence of dental trauma in our population was low. A low number of athletes use a mouthguard and there is a lack of knowledge concerning dental trauma issues. Prevention programs and promoting actions among this population are important and should be adopted.

Objetivo: Determinar los comportamientos de salud bucal, la prevalencia delesiones dentales, el nivel de información sobre los procedimientos de primeros auxilios en el caso de la avulsión dental y el conocimiento de los protectores bucales en una muestra de atletas portugueses. Materiales y métodos: estudio transversal de 1048 atletas del distrito de Viseu, Portugal. Se utilizó un cuestionario auto administrado que incluyó datos demográficos y preguntas sobre: I) hábitos de higiene bucal, II) ocurrencia de traumatismos orofaciales, III) uso de protectores bucales y IV) conocimiento de los atletas sobre el manejo de primeros auxilios en caso de avulsión dental. La comparación entre diferentes variables se realizó mediante la prueba de chi-cuadrado con el nivel de significancia establecido en p≤0.05. Resultados: La edad promedia de la muestra (76,24% hombres) fue de 18,14±8,17 años. En general, los resultados demostraron un bajo uso de hilo dental (25,48%) y un alto número de atletas (21,94%) que no habían visitado un dentista en más de un año. La prevalencia de trauma dental fue de 5,06% y las lesiones dentales más comunes que experimentaron los atletas fueron las fracturas de corona (60,38%). Casi la mitad de los participantes (45,23%) informaron que no sabían cómo actuar después de una avulsión dental. La tasa de uso de protectores bucales fue muy baja (9,73%). Hubo una relación significativa entre la prevalencia de lesiones dentales y el uso de protectores bucales (p=0,000; V de Cramer=0,145). Conclusión: la prevalencia de trauma dental en nuestra población fue baja. Un número bajo de atletas usa un protector bucal y hay una falta de conocimiento sobre temas de trauma dental. Programas de prevención y acciones de promoción entre esta población son importantes y deben ser adoptados.

Eficácia da promoção da saúde oral no controlo do biofilme bucal / Oral health promotion efficiency in the control of oral biofilm / Eficácia de la promoción de la salud oral en el control del biofilm dental

Avaliar a eficácia das instruções de higiene oral, em particular no controlo dobiofilme dentário, bem como avaliar a eficácia do reforço dessas instruções. Métodos: Realizou-se estudo quasi-experimental na Clínica Universitária da Universidade Católica Portuguesa (UCP) em Viseu-Portugal, desenvolvido entre janeiro e junho de 2012. Efectuouse três avaliações a 30 indivíduos através do Índice de Placa de O?Leary e aplicação de questionário abordando o comportamento de saúde oral, com um mês de periodicidade entre cada medição. Na primeira avaliação, todos os indivíduos receberam as mesmas instruções de higiene oral, registo do Índice de Placa de O?Leary e aplicação do questionário. Na segunda avaliação, realizou-se um novo registo do índice a todos os indivíduos, mas apenas o grupo de intervenção (n=16) recebeu o reforço dessas instruções e na terceira avaliação executouse um novo registo a todos os indivíduos (n=30). Resultados: Tanto o grupo de intervenção como o controlo apresentaram uma redução do índice, mas aquele mostrou uma redução mais importante na última avaliação realizada quando comparada a este: 38,19% (n=16) vs. 69,57% (n=14), respectivamente (p<0,05). Relativamente à frequência de escovação dentária, no grupo de intervenção, 68,8% (n=11) escovavam pelo menos duas vezes por dia, enquanto no grupo de controlo apenas 57,1% (n=8) escovavam com a mesma frequência. Nesse caso, foram registadas diferenças significativas entre os dois grupos (p<0.05). Conclusão: A promoção da saúde oral por meio de instruções de higiene demonstrou ser eficaz na melhoria dos comportamentos de saúde e, consequentemente, no controlo do biofilme dentário...

To assess the efficacy of oral health instructions, particularly in the control of dental plaque, as well as assess the effectiveness of the reinforcement of the same instructions. Methods: A quasi-experimental study was conducted at the University Clinic of the Portuguese Catholic University (UCP) in Viseu-Portugal from January to June 2012. Three different assessments were performed with 30 participants using the O?Leary Plaque Index and a questionnaire on oral health behavior, with a one-month interval between each assessment. In the first assessment, all participants received the same instructions of oral hygiene and the O?Leary Plaque Index registration and the application of the questionnaire were performed; in the second assessment, a new registration of the O?Leary Index was made, but only the experimental group (n=16) received the reinforcement of oral health instructions, and in the third assessment, a new registration of the O?Leary Plaque Index was made for all the individuals (n=30). Results: Both control and experimental groups showed a decrease in the O?Leary Plaque Index, but the latter showed a more significant decrease in the last assessment: 38.19% (n=16) vs. 69.57% (n=14), p <0.05. Regarding the frequency of toothbrushing, in the experimental group, 68.8% (n=11) brushed the teeth at least twice a day, while in the control group only 57.1% (n=8) performed the same frequency of toothbrushing. In this case, statistically significant differences were found between the two groups (p<0.05). Conclusion: Oral health promotion through oral hygiene instruction was effective in improving oral health behaviors, and, consequentely, the control of dental biofilm...

Evaluar la eficacia de las instrucciones de higiene oral, en especial del control del biofilm dental así como evaluar la eficacia del refuerzo de dichas instrucciones. Métodos: Se realizó un estudio cuasi-experimental en la Clínica Universitariade la Universidad Católica Portuguesa (UCP) de Viseu- Portugal, desarrollado entre enero y junio de 2012. Se realizo tres evaluaciones en 30 individuos a través del Índice de Placa de O?Leary y la aplicación del cuestionario incluyendo la conducta de salud oral con un mes de intervalo para cada medición. Em la primera evaluación todos los individuos recibieron las mismas instrucciones de higiene oral, registro del Índice de Placa de O?Leary y la aplicación del cuestionario. En la segundaevaluación se realizó un nuevo registro del índice en todos los individuos pero solamente el grupo de intervención (n=16) recibió el refuerzo de esas instrucciones y en la tercera evaluación se hizo un nuevo registro de todos los individuos (n=30). Resultados: El grupo de intervención y el grupo control presentaron reducción del índice, pero el grupo de intervención mostro una reducción más importante en la última evaluación realizada al compararse al grupo control: el 38,19% (n=16) vs. el 69,57% (n=14), respectivamente (p<0,05). Respecto la frecuencia de cepillado dentario, en el grupo de intervención el 68,8% (n=11) cepillaban al menos dos veces al día mientras que en el grupo control solamente el 57,1% (n=8) cepillaban con la misma frecuencia.En ese caso, fueron registradas diferencias significativas entre los grupos (p<0.05). Conclusión: La promoción de la salud oral a través de instrucciones de higiene ha sido eficaz para la mejoría de conductas en salud y, por consiguiente, para el control Del biofilm dental...