The use of artificial intelligence tools in cancer detection compared to the traditional diagnostic imaging methods: An overview of the systematic reviews.

BACKGROUND AND PURPOSE: In comparison to conventional medical imaging diagnostic modalities, the aim of this overview article is to analyze the accuracy of the application of Artificial Intelligence (AI) techniques in the identification and diagnosis of malignant tumors in adult patients. DATA SOURCES: The acronym PIRDs was used and a comprehensive literature search was conducted on PubMed, Cochrane, Scopus, Web of Science, LILACS, Embase, Scielo, EBSCOhost, and grey literature through Proquest, Google Scholar, and JSTOR for systematic reviews of AI as a diagnostic model and/or detection tool for any cancer type in adult patients, compared to the traditional diagnostic radiographic imaging model. There were no limits on publishing status, publication time, or language. For study selection and risk of bias evaluation, pairs of reviewers worked separately. RESULTS: In total, 382 records were retrieved in the databases, 364 after removing duplicates, 32 satisfied the full-text reading criterion, and 09 papers were considered for qualitative synthesis. Although there was heterogeneity in terms of methodological aspects, patient differences, and techniques used, the studies found that several AI approaches are promising in terms of specificity, sensitivity, and diagnostic accuracy in the detection and diagnosis of malignant tumors. When compared to other machine learning algorithms, the Super Vector Machine method performed better in cancer detection and diagnosis. Computer-assisted detection (CAD) has shown promising in terms of aiding cancer detection, when compared to the traditional method of diagnosis. CONCLUSIONS: The detection and diagnosis of malignant tumors with the help of AI seems to be feasible and accurate with the use of different technologies, such as CAD systems, deep and machine learning algorithms and radiomic analysis when compared with the traditional model, although these technologies are not capable of to replace the professional radiologist in the analysis of medical images. Although there are limitations regarding the generalization for all types of cancer, these AI tools might aid professionals, serving as an auxiliary and teaching tool, especially for less trained professionals. Therefore, further longitudinal studies with a longer follow-up duration are required for a better understanding of the clinical application of these artificial intelligence systems. TRIAL REGISTRATION: Systematic review registration. Prospero registration number: CRD42022307403.

Radiomics in bone pathology of the jaws.

OBJECTIVE: To define which are and how the radiomics features of jawbone pathologies are extracted for diagnosis, predicting prognosis and therapeutic response. METHODS: A comprehensive literature search was conducted using eight databases and gray literature. Two independent observers rated these articles according to exclusion and inclusion criteria. 23 papers were included to assess the radiomics features related to jawbone pathologies. Included studies were evaluated by using JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. RESULTS: Agnostic features were mined from periapical, dental panoramic radiographs, cone beam CT, CT and MRI images of six different jawbone alterations. The most frequent features mined were texture-, shape- and intensity-based features. Only 13 studies described the machine learning step, and the best results were obtained with Support Vector Machine and random forest classifier. For osteoporosis diagnosis and classification, filtering, shape-based and Tamura texture features showed the best performance. For temporomandibular joint pathology, gray-level co-occurrence matrix (GLCM), gray level run length matrix (GLRLM), Gray Level Size Zone Matrix (GLSZM), first-order statistics analysis and shape-based analysis showed the best results. Considering odontogenic and non-odontogenic cysts and tumors, contourlet and SPHARM features, first-order statistical features, GLRLM, GLCM had better indexes. For odontogenic cysts and granulomas, first-order statistical analysis showed better classification results. CONCLUSIONS: GLCM was the most frequent feature, followed by first-order statistics, and GLRLM features. No study reported predicting response, prognosis or therapeutic response, but instead diseases diagnosis or classification. Although the lack of standardization in the radiomics workflow of the included studies, texture analysis showed potential to contribute to radiologists' reports, decreasing the subjectivity and leading to personalized healthcare.

The feasibility of telehealth in the monitoring of head and neck cancer patients: a systematic review on remote technology, user adherence, user satisfaction, and quality of life.

OBJECTIVES: This systematic review aimed to analyze the use of telehealth in monitoring patients with head and neck cancer regarding the application used, user adherence to technology, user satisfaction, and user quality of life. MATERIALS AND METHODS: A search strategy was developed using the PICO acronym and the terms "Head and Neck Cancer," "Telehealth," "Mobile Application," and "Supportive Care." A broad literature search was performed on PubMed, Cochrane Library, Scopus, Web of Science, Lilacs, and Embase databases and on grey literature through Open Grey, Google Scholar, and Jstor, for studies comparing the monitoring of head and neck cancer patients with telehealth apps to the monitoring performed in a traditional way at health units. No study design, publication status, publication time, or language restrictions were applied. Pairs of reviewers worked independently for study selection and risk of bias assessment. The protocol was registered in PROSPERO and the PRISMA checklist used for reporting the review. RESULTS: We found 393 references in the databases, 325 after duplicate removal; 19 met the criteria for full-text reading; 08 studies were included for qualitative synthesis. Although there was heterogeneity regarding the technology used, the studies included showed that remote monitoring and/or self-management of symptoms through mobile applications was feasible for most patients, with satisfactory degrees of acceptability, satisfaction, usability, and adherence. The health-related quality of life improved with the use of remote technologies for telehealth, associated with low to moderate self-efficacy, higher personal control, and higher knowledge of health with clinically acceptable levels of accuracy compared to traditional clinical evaluation. Even when the data presented were not statistically significant, patients reported improvement in health-related quality of life after the intervention. CONCLUSIONS: Telehealth monitoring through the use of remote technologies presents itself as an alternative way of educating and supporting patients during the treatment of Head and Neck Cancer (HNC). There is the need for a more user-friendly interface, adequate user experience assessment, and the concrete applicability of telehealth technologies for monitoring patients with HNC in order to legitimize the cost-effectiveness of developing long-term multicenter longitudinal studies term.

Fractal dimension analysis on CBCT scans for detecting low bone mineral density in postmenopausal women.

Purpose: The aim of this study was to compare the fractal dimension (FD) measured at 2 bone sites (second cervical vertebra and mandible) on cone-beam computed tomography (CBCT). The research question was whether FD could serve as an accessory tool to refer postmenopausal women for densitometric analysis. Therefore, the reliability and accuracy of FD were evaluated. Materials and Methods: In total, 103 postmenopausal women were evaluated, of whom 52 had normal bone mineral density and 51 had osteoporosis, according to dual X-ray absorptiometry of the lumbar spine and hip. On the CBCT scans, 2 regions of interest were selected for FD analysis: 1 at the second cervical vertebra and 1 located at the mandible. The correlations between both measurements, intra- and inter-observer agreement, and the accuracy of the measurements were calculated. A P value less than 0.05 was considered to indicate statistical significance for all tests. Results: The mean FD values were significantly lower at the mandibular region of interest in osteoporotic patients than in individuals with normal bone mineral density. The areas under the curve were 0.644 (P=0.008) and 0.531 (P=0.720) for the mandibular and vertebral sites, respectively. Conclusion: FD at the vertebral site could not be used as an adjuvant tool to refer women for osteoporosis investigation. Although FD differed between women with normal BMD and osteoporosis at the mandibular site, it demonstrated low accuracy and reliability.

Impact of COVID-19in residency in Oral and Maxillofacial Surgery of the Federal District Public Health System / Impacto da COVID-19 na residência em Cirurgia Buco-Maxilo-Facialda Secretaria de Saúde do Distrito Federal

With the social isolation resulting from the coronavirus pandemic, the residency in Oral and Maxillofacial Surgery of the Federal District Public Health System adapted to maintain the attendance and course schedule. Theoretical classes migrated to online and there was an abrupt change in practical activities, such as the reduction in elective care and newbiosafetyprotocols. The objective of this research was to understand the impact of the pandemic on the residency, including the analysis of perception and the level of satisfaction of the participants regarding online classes and practical activities, analysis of the number and type of surgeries performed in 2020 and residents'attitudes aimedfor professional career, through Likerttypequestionnaires. Only half of the tutors and less than half of the residentswere motivated to use the virtual teaching environment. In addition, the number of surgerieswasreduced by more than 40%. In addition, half of the residents responded that they do not feel capableto resolve unexpected events related to their training and that they are not confident in making decisions regarding theirprofessional career. COVID-19 will continue to have a greater impact on surgical practice, so hospitals should develop a detailed contingency plan, including for pandemics and schools should permanently incorporate options of complementary remote activitiesin their curriculum (AU).

Com o isolamento social decorrente da pandemia de coronavírus, a residência em Cirurgia Buco-Maxilo-Facialda Secretaria de Saúde do Distrito Federalse adaptou para manter o atendimento e o cronograma do curso. Aulas teóricas migraram para onlinee houve abrupta mudança das atividades práticas, como a diminuição do atendimento eletivo e novos protocolos de biossegurança. O objetivo dessa pesquisa foi entender o impacto da pandemia no ensino na residência, incluindo a análise de percepção e do nível de satisfação dos participantes quanto às aulas onlinee atividades práticas, análise do número e tipo de cirurgias realizadas em 2020 e atitudes dos residentes voltadas para carreira profissional, por meio de questionários do tipo Likert. Apenas metade dos preceptores e menos da metade dos residentes estavam motivados a usar o ambiente virtual de ensino. O número de cirurgias foi reduzido em mais de 40%. Além disso, metade dos residentes respondeu que não se sente capaz de resolver eventos inesperados relacionados à sua formação e que não está segura em tomar decisões relativas à sua carreira profissional. A COVID-19 continuará a ter maior impacto na prática cirúrgica, por isso, hospitais devem desenvolver um plano de contingência detalhado, inclusive para o caso de futuras pandemias e escolas devem incorporar opções de atividades remotas complementares permanentemente em seu currículo (AU).

The role of teledentistry in oral cancer patients during the COVID-19 pandemic: an integrative literature review.

OBJECTIVES: This integrative review aimed to assess the benefits of the use of teledentistry for patients undergoing treatment of oral and head and neck cancer during the COVID-19 pandemic. MATERIALS AND METHODS: We searched in PubMed, Cochrane, Scopus, Web of Science, Lilacs, Embase, Open Grey, Google Scholar, and Jstor databases for studies referring to the management, control, and assistance, through teledentistry, to patients with oral and head and neck cancer during the COVID-19 pandemic. RESULTS: We found 356 references in the databases, 209 after duplicates removal, 23 met criteria for full-text reading, and 11 studies were included for qualitative synthesis, in four categories: virtual visits, use of remote technology, patient's satisfaction, multidisciplinary approach in teledentistry. We found that 78% of patients currently preferred teledentistry; 92% of patients would recommend the use of video consultation to other patients. The continuity of dental care, the reduction of patient visits to the hospital, the reduction of the risk of infection with the coronavirus, and limitation of face-to-face consultations to protect health professionals are benefits that reinforce the use of teledentistry by health institutions. Two studies showed patients' satisfaction with the use of teledentistry in monitoring cancer patients and showed an improvement in quality of life. CONCLUSIONS: The teledentistry, as a remote technology for monitoring patients with oral and head and neck cancer, is well accepted by patients in preliminary studies. Although these studies pointed out some benefits of using remote technologies for the care of cancer patients, further robust scientific evidence is still needed in this regard.

The scope of dental education during COVID-19 pandemic: A systematic review.

INTRODUCTION: COVID-19 forced e-learning processes to develop abruptly and posed challenges to the educational infrastructure. Emergency Remote Teaching was designated to distinguish the new educational scheme. This concept involves production of online activities that may return to face-to-face format as soon as the isolation period ends. OBJECTIVE: From March through September of 2020, this systematic review attempted to elucidate experiences, benefits, and challenges enforced in dental education due to the pandemic, the learning technologies, and methods used to maintain education. METHODS: A literature search was conducted on Cochrane, Embase, Lilacs, Livivo, PubMed, Scopus, and Web of Science databases. Gray literature was also contemplated. Studies in which online teaching methods were described and dental learners were the subjects during pandemic were included. RESULTS: Learning technology, pedagogical model, knowledge gain, and dental learners' satisfaction and attitudes toward remote learning were assessed. The Joanna Briggs Institute JBI Critical Appraisal Checklist for Case Reports was applied as the methodological quality assessment to the 16 included studies. Assessments were related to demographic and historical characteristics of the participants, the intervention procedure, pre- and post-intervention descriptions, and identification of unanticipated events. All studies described the use of learning technology to ensure education continuity, and 15 studies highlighted the pedagogical model applied. Eight studies investigated knowledge gain while 12 searched the learners' satisfaction with online technologies. CONCLUSION: The evidence suggests that learning technologies can support continuity in dental education. Reported problems include poor knowledge of faculty members on how to deal with technology, Internet connection, and content transition to online education.

Differences between bisphosphonate-related and denosumab-related osteonecrosis of the jaws: a systematic review.

OBJECTIVE: Bisphosphonates and denosumab are both antiresorptive medications, each with their own mechanism of action; yet both may result in the same adverse effect: medication-related osteonecrosis of the jaw (ONJ). The present systematic review aims to answer the following question: "Are bisphosphonate-related ONJ and denosumab-related ONJ any different, regarding clinical and imaging aspects?" METHODS: This review followed the Joanna Briggs Review's Manual, and the searches were performed on PubMed, Cochrane, Scopus, Web of Science, and Lilacs databases and on the grey literature (ProQuest, Open Grey, and Google Scholar). RESULTS: The searches resulted in 7535 articles that were critically assessed. Based on the selection criteria, seven studies were included in the review: five cross-sectional studies and two randomized clinical trials. A total of 7755 patients composed the final population. An increase in bone sequestra, cortical bone lysis, and bone density was observed in bisphosphonate-related ONJ, while larger bone sequestra, more frequent periosteal reactions, and mandibular canal enhancement were noted in denosumab-related ONJ. CONCLUSION: This systematic review demonstrated that the imaging characteristics of bisphosphonate-related and denosumab-related ONJ are not similar. Although clinically similar conditions, they were found to be radiographically distinct. More studies are necessary to further elucidate these differences.

Acesso e cobertura populacional à saúde bucal após a implementação da Política Nacional de Saúde Bucal "Brasil Sorridente" / Access and oral health population coverage after implementation of the National Oral Health Policy "Smiling Brazil" / Acceso y cobertura de la salud oral después de la implementación de la Política Nacional de Salud Oral "Brasil Sonriente"

O objetivo foi analisar a Política Nacional de Saúde Bucal, na perspectiva do acesso e cobertura das ações desenvolvidas na odontologia do Sistema Único de Saúde, entre 2002 e 2016. A partir do quadro conceitual da Organização Mundial da Saúde, que se divide em blocos para garantir acesso, cobertura e qualidade dos sistemas de saúde, foi realizado um estudo de caso do Brasil Sorridente referentes à implantação e financiamento das equipes. O bloco "força de trabalho" revelou um crescimento superior a 470% no número de equipes de saúde bucal no Brasil; no bloco "financiamento" fica evidente o grande aporte financeiro destinado à política, com ênfase ao papel indutor deste processo nos municípios; o bloco "tecnologia" evidenciou o incremento tecnológico para viabilizar os serviços de saúde bucal em todo o Brasil; já no bloco "disponibilidade dos serviços de saúde" observa-se uma ampliação de 4% na atenção básica e os serviços especializados essas porcentagens ultrapassam os 200% entre 2001 e 2015, finalmente, no bloco "acesso e cobertura" foi possível verificar o aumento de cobertura populacional de 9% para 43% no Brasil. Os dados apontam que a política permitiu um avanço referente aos blocos estruturantes do framework e melhorou o acesso e a cobertura em saúde bucal. (AU)

The objective was to analyze the National Oral Health Policy, from the perspective of access and coverage of dentistry actions in the Unified Health System, between 2002 and 2016. Based on the World Health Organization conceptual framework, which is divided into blocks to guarantee access, coverage and quality of health systems, a case study was carried out in the Smiling Brazil considering the implementation and financing. As a result, the "workforce" block revealed a growth rate superior than 470% in the number of oral health teams in Brazil. In the "financing" block, the great financial support to the policy is evident, with emphasis on the role of this process in the municipalities. The "technology" block evidenced the technological increase to make oral health services viable in Brazil. Furthermore, in the block "availability of health services" was observed an increase of 4% in primary care. On the other hand, between 2001 and 2015, in the specialized services this percentage exceed 200%. Finally, in the block "access and coverage" was possible to verify the increase of population coverage from 9% to 43% in Brazil. The data indicate that the policy allowed an advance regarding the framework structuring blocks, as well as improved the access and coverage in oral health. (AU)

El objetivo fue analizar la Política Nacional de Salud Oral, desde la perspectiva de acceso y cobertura de las acciones desarrolladas en la odontología del Sistema Único de Salud, entre 2002 y 2016. Desde el marco conceptual de la Organización Mundial de la Salud, que se divide en bloques para garantizar el acceso, la cobertura y la calidad de los sistemas de salud, se realizó un estudio de caso de Smiling Brazil sobre la implementación y el financiamiento de los equipos. El bloque de "fuerza laboral" reveló un crecimiento de más del 470% en el número de equipos de salud bucal en Brasil; En el bloque de "financiamiento", la gran contribución financiera a la política es evidente, con énfasis en el papel inductivo de este proceso en los municipios; el bloque "tecnología" evidenció el aumento tecnológico para habilitar los servicios de salud bucal en todo Brasil; En el bloque "disponibilidad de servicios de salud" hay un aumento del 4% en atención primaria y servicios especializados, estos porcentajes superan el 200% entre 2001 y 2015, finalmente, en el bloque "acceso y cobertura" fue posible verificar el aumento Cobertura poblacional del 9% al 43% en Brasil. Los datos indican que la política permitió un avance con respecto a los componentes básicos del marco y un mejor acceso y cobertura en salud bucal. (AU)

A new cone-beam computed tomography-driven index for osteoporosis prediction.

OBJECTIVE: To verify whether mandibular cortical analyses accurately distinguish postmenopausal women with normal bone mineral density (BMD) from women with osteoporosis by means of a cone-beam computed tomography (CBCT)-driven composite osteoporosis index (three-dimensional mandibular osteoporosis index-3D MOI). MATERIAL AND METHODS: The comparison was performed between 52 women with normal BMD and 51 women with osteoporosis according to dual-energy X-ray absorptiometry (DXA) examination of the lumbar spine and hip. Mandibular cortical width (MCW) and cortical quality were evaluated on cross-sectional and panoramic reconstructed images. ANOVA, ROC curves and accuracy measurements were used for statistical analyses, as well as a predictive model combining the quantitative and qualitative analyses and age. RESULTS: All CBCT-driven measurements presented good to moderate intra- and interobserver agreements. MCW values were significantly lower in women with osteoporosis. Postmenopausal women with osteoporosis were 8 times more likely to have the cortex classified as C3, and 2.4 times more likely to have MCW thinner than 2.75 mm. The area under the ROC curve was 0.8 for the predictive model. CONCLUSIONS: The newly developed 3D MOI enables distinguishing women with osteoporosis from those with normal BMD with good sensitivity and specificity. CLINICAL RELEVANCE: Whenever a CBCT scan is performed for specific clinical indications, a 3D MOI may be performed to qualitatively and quantitatively assess the condition of the mandibular cortex. This may be surely helpful to assess the osteoporosis status in the ageing population and more specifically in peri- or postmenopausal women.

Evidence on the Use of Mobile Apps During the Treatment of Breast Cancer: Systematic Review.

BACKGROUND: Cancer is a major cause of morbidity, disability, and mortality worldwide, and breast cancer is the most common cause of death in women. Different modalities of cancer treatment can have adverse effects that reduce the quality of life of patients and lead to treatment interruptions, if not managed properly. The use of mobile technologies has brought innovative possibilities for improving health care. Mobile apps can help individuals manage their own health and well-being and may also promote healthy lifestyles and information access. OBJECTIVE: The aim of this study was to identify available evidence on the use of mobile apps to provide information and facilitate communication regarding self-care management related to the adverse effects of toxicities owing to breast cancer therapy. METHODS: This systematic review includes studies which were identified using a search strategy adapted for each electronic database: CINAHL, Cochrane Library, LILACS, LIVIVO, PubMed, SCOPUS, and Web of Science. In addition, a gray literature search was performed using Google Scholar. All the electronic database searches were conducted on April 17, 2019. Two investigators independently reviewed the titles and abstracts of the studies identified and then read the full text of all selected papers. The quality of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool and the Methodological Index for Non-Randomized Studies. RESULTS: A total of 9 studies which met the eligibility criteria-3 randomized clinical trials and 6 nonrandomized studies published in English from 2010 to 2018-were considered for this systematic review; 396 patients with breast cancer, as well as 40 experts in the medical and nursing fields, and 3 software engineers were included. CONCLUSIONS: The evidence from the studies included in this systematic review is currently limited but suggests that mobile apps for women with breast cancer might be an acceptable information source that can improve patient well-being; they can also be used to report symptoms and adverse treatment-related effects and promote self-care. There is a need to test more evidence-based apps in future randomized clinical trials.

A Conservative Approach for Localized Spongiotic Gingivitis Hyperplasia Using Photodynamic Therapy: A Case Report and Review of the Literature.

Objective: To describe a clinical case of successful conservative management of Localized Juvenile Spongiotic Gingivitis Hyperplasia (LJSGH) using photodynamic therapy (PDT) and reviews the current literature on this pathology. Background data: LJSGH is a recently described rare disease with controversial treatment results. As of today, 13 publications report surgical treatment approaches. The use of CO2 laser and cryotherapy was reported only in one study. The use of PDT was not previously reported. Patients and methods: A 9-year-old male patient was referred to our institution with the chief complaint of asymptomatic "inflamed gingiva" starting 1 year before. Clinical examination revealed an erythematous line accompanying the gingival contour, with a certain degree of hyperplasia. The diagnosis of LJSGH was performed based on clinical features and later confirmed histopathologically. A novel approach using PDT was then proposed. The photosensitizer was methylene blue, and a semiconductor laser diode was used. Results: One week after starting PDT, gingival hyperplasia was partially reduced. Immediately after the end of treatment, a significant reduction of gingival hyperplasia was observed. PDT proved to be safe, quick and painless, with no esthetic harm. Conclusions: This case illustrates the benefit of a more conservative approach as opposed to surgical procedure, with good clinical response and decreased morbidity over a 2-year follow-up period.

A Conservative Approach for Localized Spongiotic Gingivitis Hyperplasia Using Photodynamic Therapy: A Case Report and Review of the Literature.

OBJECTIVE: To describe a clinical case of successful conservative management of Localized Juvenile Spongiotic Gingivitis Hyperplasia (LJSGH) using photodynamic therapy (PDT) and reviews the current literature on this pathology. BACKGROUND DATA: LJSGH is a recently described rare disease with controversial treatment results. As of today, 13 publications report surgical treatment approaches. The use of CO2 laser and cryotherapy was reported only in one study. The use of PDT was not previously reported. PATIENTS AND METHODS: A 9-year-old male patient was referred to our institution with the chief complaint of asymptomatic "inflamed gingiva" starting 1 year before. Clinical examination revealed an erythematous line accompanying the gingival contour, with a certain degree of hyperplasia. The diagnosis of LJSGH was performed based on clinical features and later confirmed histopathologically. A novel approach using PDT was then proposed. The photosensitizer was methylene blue, and a semiconductor laser diode was used. RESULTS: One week after starting PDT, gingival hyperplasia was partially reduced. Immediately after the end of treatment, a significant reduction of gingival hyperplasia was observed. PDT proved to be safe, quick and painless, with no esthetic harm. CONCLUSIONS: This case illustrates the benefit of a more conservative approach as opposed to surgical procedure, with good clinical response and decreased morbidity over a 2-year follow-up period.

Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis.

BACKGROUND: The aim of this systematic review with meta-analysis was to analyze the effects of intra-pregnancy nonsurgical periodontal therapy on periodontal inflammatory biomarkers and adverse pregnancy outcomes. METHODS: On June 5, 2017, we searched PubMed, Cochrane, SCOPUS, Web of Science, LILACS, ProQuest, Open Grey, and Google Scholar databases. Randomized clinical trials in which pregnant women with chronic periodontitis underwent nonsurgical periodontal therapy, compared with an untreated group, tested for inflammatory biomarkers, and followed till delivery were included. Primary outcomes were preterm birth, low birth weight, and preeclampsia. Meta-analysis was performed with 5.3.5 version of Review Manager software. RESULTS: We found 565 references in the databases, 326 after duplicates removal, 28 met criteria for full text reading, and 4 met eligibility criteria for quantitative and qualitative synthesis. Intra-pregnancy nonsurgical periodontal therapy improved periodontal clinical parameters (periodontal pocket depth, clinical attachment level, and bleeding on probing) and reduced biomarker level from gingival crevicular fluid (GCF), and some from blood serum; however, it did not influence biomarker level from umbilical cord blood. Meta-analysis showed tendency for reduction of the risk of preterm birth before 37 weeks for treated group (risk ratio (RR) = 0.54, 95% CI 0.38-0.77; p = 0.0007; inconsistency indexes (I2) 32%) but did not show any difference for low birth weight occurrence (RR = 0.78, 95%CI 0.50-1.21; p = 0.27; I2 41%). No included study considered preeclampsia as a gestational outcome. CONCLUSIONS: These results demonstrated that the intra-pregnancy nonsurgical periodontal therapy decreased periodontal inflammatory biomarker levels from gingival crevicular fluid and some from serum blood, with no influence on inflammatory biomarker level from cord blood, and it did not consistently reduce adverse gestational adverse outcome occurrence. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015027750.

Early bony changes associated with bisphosphonate-related osteonecrosis of the jaws in rats: A longitudinal in vivo study.

OBJECTIVE: To evaluate early bony changes in an animal model of Medication-Related Osteonecrosis of the Jaw (MRONJ) at the side of the local trauma and at the contralateral side, comparing with a control group. Bony changes were evaluated by Microcomputed Tomography (MicroCT) at three times points: at baseline (T0), after drug administration (T1) and after dental extraction (T2). DESIGN: Two groups were compared: the experimental group in which zoledronic acid (ZA) was administered (17 rats) and the control group (13 rats). Dental extractions of the lower left first molars were performed in all animals. The left side was considered as the supposed affected area in the ZA group, and the right side was considered as the unaffected area. In these areas, the following structural microtomographic bone parameters were calculated: Bone Mineral Density (BMD), Trabecular Thickness (Tb.Th), and Bone Volume Proportion (BV/TV). The comparison of quantitative bone parameters among the different sides and experimental phases of both studied groups were performed by ANOVA-factorial. RESULTS: None of the animals of the control group developed MRONJ. In the ZA group, 76% presented bone exposure. From T0 to T1, Tb.Th and BV/TV increased, and in T2, the mean values were higher in ZA group than in the control group. BMD increased throughout the different phases of both groups. CONCLUSIONS: Structural bony changes occurred in the ZA group at both mandibular sides before the dental extraction (T1). Tb.Th and BV/TV should be further investigated as potential early bone markers of MRONJ.

E-learning em Diagnóstico Bucal: relato de experiência na Universidade de Brasília / E-learning in Oral Diagnosis: experience report at the University of Brasília

Define-se e-learning como qualquer tipo de situação educacional em que o conteúdo é disponibilizado eletronicamente via Internet quando e onde as pessoas precisam. Usando as possibilidades que o ambiente virtual oferece para o ensino, foi elaborado um e-módulo na Plataforma Moodle. O objetivo desse estudo foi verificar o acesso, desempenho e aceitação de estudantes de graduação em Odontologia frente à utilização do e-módulo nas atividades online da Disciplina de Diagnóstico Bucal na Universidade de Brasília. Avaliações de conteúdo (pré e pós-teste), pré-teste de expectativa e pós-teste de satisfação foram elaborados para avaliar o conteúdo e a aceitação do emódulo entre os participantes. Dos 25 participantes iniciais, dois concluíram o e-módulo, 11 começaram e não concluíram, nove não acessaram a Plataforma e três não aceitaram responder o pósteste de satisfação. Pré e pós-teste de conteúdo não apresentaram dados significativos. O pós-teste de satisfação mostrou que dos estudantes que não acessaram o e-módulo, ou acessaram e não concluíram, 80% alegaram "não ter tempo para acessar a Plataforma" e 15% afirmaram não participar, ou não concluir o e-módulo "porque este não trazia acréscimo de crédito ou nota". Em conclusão, apesar de os estudantes serem positivos em relação ao uso de novas metodologias, a participação foi muito baixa. Já o desempenho foi similar àquele das aulas presenciais. Vários fatores influenciam a atitude dos estudantes no e-módulo, incluindo o ganho de recompensas e a forma pedagógica dos conteúdos. Assim, persiste ao professor o papel motivacional e mediador entre aprendizado e mundo virtual (AU).

E-learning can be defined as any type of educational situation in which the content is available electronically via Internet when and where people need it. Using the possibilities that virtual environment provides for education, was developed an e-module in the Moodle Platform. The aim of this study was to verify the access, performance, and acceptance of undergraduate dentistry students to use the e-module in the online activities of Oral Diagnosis Discipline at the University of Brasilia. Evaluations of content (pre and post-test), pre-test of expectation and post-test of satisfaction were designed to evaluate the content and acceptance of e-module among participants. Of the 25 initial participants, 2 completed the e-module, 11 started and did not complete, 9 did not access the platform and three did not accept to answer the post-test of satisfaction. Pre and post-test of content showed no significant data. The post-test of satisfaction showed that the students who have not accessed the e-module, or accessed and did not complete, 80% said they "did not have time to access the Platform" and 15% said they did not participate or did not complete the e-module "because it would not improve GPA or course credit number". In conclusion, although students were positive regarding the use of new methodologies, the participation was very low. The performance was similar to presential classes. Several factors influence the attitude of the students in the emodule, including rewards gain and the pedagogical form of the contents. Thus, it is up to the teacher the motivational and mediating role between learning and the virtual world (AU).

Teaching and learning Oral Radiology via the social medium WhatsApp / Ensinando e aprendendo radiologia oral via mídia social WhatsApp

Social media can be defined as Internet-based applications that allow the widespread creation and exchange of user-generated content. The ease with which social media can be accessed through numerous mobile devices encourages medical educators to use social media to share content with students outside the classroom. The aim of this study was to introduce WhatsApp as a teaching tool in an Oral Radiology course. The secondary objective was to assess students' attitudes towards the use of this innovative tool in teaching of dentistry. In the first semester of 2016, 30 second-year undergraduate dental students at the University of Brasília were provided with weekly quizzes via a WhatsApp discussion group. The quizzes consisted of a tomographic or radiographic image from a real clinical case and a multiple-choice question. At the end of the semester students' attitudes were assessed using a satisfaction questionnaire. The results showed that students had a positive attitude towards the use of WhatsApp and considered it had helped them to learn about Oral Radiology. In conclusion, this technology can improve the way material is taught, since educators are prepared to develop better learning environments and students are concerned about the potential use of the social media in education (AU).

Mídias sociais podem ser definidas como um grupo de aplicativos baseados em Internet que permitem a criação e troca de conteúdos gerados pelo usuário de forma bastante expandida. A facilidade de as mídias sociais serem acessadas em dispositivos móveis encoraja educadores da área de saúde a compartilhar nessas mídias conteúdos que vão além da sala de aula. O objetivo desse estudo foi introduzir a mídia social WhatsApp como uma ferramenta de ensino no curso de Radiologia Oral. Como segundo objetivo, as atitudes dos estudantes ao utilizar essa nova ferramenta durante a graduação em Odontologia foram avaliadas. No primeiro semestre de 2016, quizzes semanais foram disponibilizados em um grupo de discussão no WhatsApp, criado com 30 alunos do segundo ano de Odontologia da Universidade de Brasília. Os quizzes eram compostos por uma imagem radiográfica ou tomográfica de um caso clínico real e uma questão de múltipla escolha. Ao final do semestre, avaliou-se o comportamento dos estudantes por um questionário de satisfação. O estudo mostrou que os alunos têm atitude positiva em relação ao uso do WhatsApp e o consideraram útil para auxiliar o aprendizado de Radiologia Oral. Em conclusão, essa tecnologia é capaz de aprimorar a forma como os conteúdos são ensinados, desde que os educadores estejam preparados para desenvolver melhores ambientes de aprendizado e os estudantes estejam conscientes sobre o potencial uso das mídias sociais para educação (AU).

Effectiveness of E-Learning in Oral Radiology Education: A Systematic Review.

E-learning has been used recently in dental curricula to support traditional learning methods. However, the published literature concerning e-learning in oral radiology has shown mixed conclusions. The aim of this systematic review was to provide a synthesis of the effectiveness of e-learning in oral radiology education when compared with traditional classroom learning methods. A search of the literature was conducted on the LILACS, PubMed, Science Direct, Scopus, and Web of Science databases. Trials registries were also consulted for ongoing trials, and a partial grey literature search was conducted. Controlled trials about oral radiology education that compared any e-learning method with a control group using any traditional classroom instruction method were included. E-learning effectiveness was measured using three outcomes from Kirkpatrick's model of evaluation: attitudes about e-learning, knowledge gain, and performance on clinical procedures. Data were analyzed descriptively. Qualitative appraisal was performed according to the Cochrane risk of bias tool for randomized trials and MINORS tool for non-randomized trials. Eleven studies met the inclusion criteria. Risk of bias was identified related to the selection procedures, blinding, lack of sample size calculation, and incomplete analyses. Ten studies reported that students had positive attitude when using e-learning. Results from the knowledge gain outcome were mixed. Only two studies examined performance on clinical procedures, showing contrasting results. The evidence reviewed in this study suggests that e-learning in oral radiology is at least as effective as traditional learning methods and that students have positive attitudes about e-learning.