Can exposure to panoramic radiographs induce genotoxic effects on the oral epithelium? A systematic review with meta-analysis.

OBJECTIVE: To evaluate, through a systematic review (SR) with meta-analysis, the occurrence of genotoxic effects in the oral epithelium after the exposure of patients to panoramic radiographs. METHODS: An SR was performed with the PICOS (Population, Intervention, Comparison, Outcome, and Study design) strategy, aiming to answer the following question: "Can panoramic radiographs induce genotoxic effects on the oral epithelium?" The study was registered in the PROSPERO (International prospective register of systematic reviews) platform. A systematic search was performed in the following electronic databases: PubMed (including MedLine), Scopus, Embase, LILACS, Medline EbscoHost, and Google Scholar. Treatment effects were defined as standardized mean difference (SMD), and 95% confidence intervals (CI) were established. The Joanna Briggs Institute questionnaire for observational studies was applied to assess the risk of bias. The GRADE tool was used to assess the quality of evidence of the SR. RESULTS: A total of 251 potentially relevant studies were selected through the search strategy. After screening titles and abstracts, 11 full-text manuscripts were assessed for eligibility and nine observational studies were included in the meta-analysis. The present study showed an increase in micronuclei after the exposure (SMD = 0.21, 95% CI, 0.03 to 0.28, p = 0.02), with a Tau2index = 0.00, Chi2 = 2.35, and p-value = 0.97. Therefore, the articles selected were considered homogeneous and the I² of 0% indicated low heterogeneity. CONCLUSION: According to the studies analysed, although the quality of evidence was considered low, panoramic radiographs can cause genotoxic damage in the oral epithelium but with a small effect size.

Estudo comparativo entre dois protocolos anestésicos envolvendo bloqueio do nervo alveolar inferior convencional e de Vazirani-Akinosi para exodontia de terceiro molar inferior / Comparative study of two anaesthetic protocols involving conventional and Vazirani-Akinosi alveolar inferior nerve block for lower third molar extraction

Introdução: O bloqueio do nervo alveolar inferior (BNAI) apresenta alta porcentagem de falha na Odontologia. A fim de melhorar esse índice, vêm-se estudando diferentes alternativas, como diferentes técnicas e soluções anestésicas. Objetivo: Avaliar duas diferentes técnicas - técnica convencional e de Vazirani-Akinosi - para o bloqueio do nervo alveolar inferior, bem como compará-las quanto à sua efetividade e quantificar o percentual de aspirações positivas nas duas diferentes técnicas. Material e Método: Foram avaliados 160 pacientes de ambos os sexos, sendo 80 submetidos ao bloqueio do nervo alveolar inferior de Vazirani-Akinosi e bloqueio do nervo bucal (G1), e 80 submetidos ao bloqueio do nervo alveolar inferior convencional e ao bloqueio do nervo bucal (G2). Em ambos os grupos, utilizou-se a combinação de articaína 4% com epinefrina 1:100.000 para bloqueio do nervo bucal, e lidocaína 2% com epinefrina 1:100.000 para bloqueio do nervo alveolar inferior. Foram avaliados: a quantidade de aspirações positivas, a eficácia da anestesia e o momento em que ocorreu a falha anestésica durante o procedimento cirúrgico. Resultado: Não houve diferenças estatisticamente significantes (p = 0,2453) entre os grupos G1 e G2 observando-se a eficácia e o índice de aspirações positivas, e o momento em que ocorreu a falha anestésica, observando-se uma maior eficácia de ambas as técnicas, quando comparadas com a literatura (90%) Conclusão: Não houve diferença significativa entre o BNAI pela técnica convencional e o BNAI pela técnica de Vazirani-Akinosi quanto a quantidade de aspirações positivas e eficácia, sendo que o uso da articaína 4% com epinefrina 1:100.000 no bloqueio do nervo bucal possivelmente aumentou a eficácia ...

Introduction: The inferior alveolar nerve block has a high percentage of failure in dentistry. To improve this ratio, has been studied different alternatives, as different techniques, as well as anesthetics. Objective: Evaluate two different techniques (conventional technique and Vazirani-Akinosi) for inferior alveolar nerve block, and compare them regarding their effectiveness and quantify the percentage of positive aspirations in both techniques. Material and Method: 160 patients were evaluated for both sex, with 80 undergoing Vazirani-Akinosi technique plus buccal nerve block (G1), and 80 to conventional inferior alveolar nerve block plus buccal nerve block (G2), both groups using a combination of 4% articaine with 1:100.000 epinephrine to buccal nerve block and 2% lidocaine with 1:100.000 epinephrine to inferior alveolar nerve block. We evaluated the amount of positive aspirations, the effectiveness or not of anesthesia (pain) and when it occurred during the surgical procedure. Result: There were no statistically significant differences (p = 0.2453) between G1 and G2 observing the positive aspiration. It was obtained efficiency of 90% for both techniques. Conclusion: No significant difference between the conventional alveolar inferior nerve block technique and Vazirani-Akinosi alveolar nerve block technique considering the amount of positive aspirations and efficacy, and the use of 4% articaine with 1:100.000 epinephrine in buccal nerve block possibly increased the anesthetic efficacy of both techniques. .