MedNEXT Journal of Medical and Health Sciences

Forensic dentistry: a systematic review

2023-06-03T00:50:35+00:00

Introduction: It was verified that the identifications carried out by forensic dentists in mass disasters reach about 70% of the identifications in the world. With the population increase in recent decades, mass disasters have increased, both in natural catastrophes and by anthropic action, making it imperative to increase the numbers of forensic identification methods, to accelerate the recognition of fatal victims and the teeth are the only elements that can be used for identification. Objective: It was to highlight the importance of professional specialist in forensic dentistry and their diligence in the investigative process, to increase the diligence of greater richness of details and optimized work for the recognition of the bodies. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles with different dates up to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 119 articles were found, 38 articles were evaluated and 32 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 32 studies that did not meet GRADE. the function of the forensic dentist in investigations of charred victims is notorious. The analysis performed by a professional with specific training in the field of dentistry is essential, and the importance of medical records, photographs, and radiographs for proper identification must also be considered. However, it is necessary to increase and improve the activities of forensic dentists in the work of recognition of charred bodies, being imperative to a set of factors for the elucidation of cases so that the identifications are complete. It is concluded that it is necessary to use several methods to optimize the practice of forensic dentistry, from cases of identification through the oral cavity, which was the beginning of the history of forensic identification in the field of dentistry, to the nowadays, its rise in history was analyzed for an effective elucidation of recognition of charred bodies.

Technical approaches and clinical outcomes of the treatment of temporomandibular dysfunction with prostheses: a systematic review

2023-06-03T00:39:27+00:00

Introduction: Temporomandibular joint (TMJ) replacement is usually a last resort in the surgical treatment of end-stage joint disease. For all this gear to work efficiently, occlusion, articulation, musculature, ligaments, and psychological factors must be in complete harmony. As a treatment, implantation of a total alloplastic TMJ prosthesis. Objective: It was to demonstrate, through a systematic review, the main considerations and clinical outcomes of the treatment of temporomandibular disorders with different types of prostheses. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2013 to 2023. Results and Conclusion: A total of 127 articles were found, 60 articles were evaluated and 31 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 33 studies that did not meet GRADE. Based on the results, temporomandibular disorders (TMD) treatment is diverse and depends on the type of disease, as well as the duration and subjective level of pain. Alloplastic reconstruction can be advantageous in obtaining a rapid improvement in symptoms and rapid rehabilitation of masticatory function. Treatment of functional TMD is commonly based on conservative therapy, including physical therapy, pain therapy, and splinting therapy. Depending on the severity of TMD, treatment varies according to the degree of surgical invasion. Thus, the TMJ prosthesis seems to be reserved for patients with persistent pain, bone or fibrous ankylosis, or osteomyelitis after primary closed or open treatment of mandibular condyle fractures. Quality of life, mouth opening, and daily eating improved significantly after total TMJ prosthesis.

Highlight the major clinical studies on orthognathic surgery in the correction of anomalies in Class III patients: a systematic review

2023-06-01T21:06:42+00:00

Introduction: In the setting of orthognathic surgery, malocclusion is the third most common oral health problem after caries and periodontal diseases. Malocclusion is found in ages between 7 and 15 years with a prevalence of 6% in Brazil. Objective: The present study aimed to highlight the main considerations and findings of clinical studies on the importance of orthognathic surgery in the correction of anomalies in class III patients. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles with different dates up to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found, 70 articles were evaluated and 56 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 20 studies that did not meet GRADE. Based on the results, the treatment of Class III must be fundamentally based on the diagnosis so that the treatment can be installed in order to correct the compromised structures instead of being compensated in places not affected by this malocclusion. In other words, the degree of involvement of the maxilla and mandible must be evaluated so that the treatment is directed to that bone base and really achieves its goals and impacts of facial improvement. Redirection of growth in Class III cases is indicated as soon as the anomaly is diagnosed, as the displacement processes that occur in the middle face can only be affected with treatment while the growth zones are able to respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects.

Phacoemulsification associated with loss of endothelial cells in cataract surgery: a systematic review of main surgical techniques

2023-05-30T23:09:44+00:00

Introduction: Phacoemulsification (PE) cataract surgery is the gold standard in ophthalmology, being effective in improving vision in more than 90.0% of patients. In this context, authors found that PE was associated with 16.67% of endothelial cell loss, which correlated with the degree of trauma during surgery. Endothelial changes are considered an important parameter for assessing trauma and for estimating the safety of a surgical technique. In this sense, more modern PE machines are capable of removing cataracts using optimized parameters such as high vacuum, aspiration flow, and low amount of ultrasonic energy. Objective: It was to present and discuss the main phacoemulsification techniques for optimizing the treatment of cataracts, in an attempt to reduce the loss of corneal endothelial cells. Methods: Experimental and clinical studies were included (case reports, retrospective, prospective, and randomized studies) with qualitative and/or quantitative analysis. Initially, the keywords were determined by searching the DeCS tool (Descriptors in Health Sciences, BIREME base) and later verified and validated by MeSH Terms. The search literature was carried out from January to April 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Results: A total of 122 articles involving phacoemulsification and endothelial cells were found. Initially, the existing title and duplications were excluded according to the interest described in this work. After this process, the abstracts were evaluated and a new exclusion was performed. A total of 80 articles were evaluated in full and 59 were included and discussed in this study. At the beginning of treatment with PE, without the endothelial protection of viscoelastic agents and the use of ultrasound in the anterior chamber, the endothelial loss was greater than in extracapsular cataract extraction. With the modernization of PE, the use of viscoelastic agents, the emergence of techniques for fracture of the nucleus within the capsular bag, and the use of ultrasound in the posterior chamber, the loss of endothelial cells reduced from 7 to 12% on average. Conclusion: Endothelial changes are considered an important parameter to assess trauma and estimate the safety of a surgical technique. Highlighted, the main predictors associated with the loss of corneal endothelial cells are the duration of the ultrasound used in the surgery, the turbulence of the liquid in the anterior chamber, and the mechanical trauma.

Neoumbilicoplasty technique offers a more natural and easier performance result: a retrospective observational study (more than 2,500 patients) supported by a concise systematic review

2023-05-29T22:58:34+00:00

Introduction: In the aesthetic scenario after abdominoplasty, umbilicoplasty stands out, as the navel forms the central aesthetic subunit of the abdomen, and it needs to be aesthetically pleasing. Thus, neoumbilicoplasty describes the creation of a navel again. The ideal umbilical reconstruction should be reliable, reproducible, aesthetically appropriate, and associated with low morbidity, as well as single-stage. Objective: It was to present a neoumbilicoplasty that uses a part of the native umbilicus, leaving the final scar with a hexagonal aspect, to provide a more natural and easy-to-perform result. Methods: This retrospective observational study on the analysis of the neoumbilicoplasty technique selected the results of six patients who underwent an abdominoplasty. The skin where the neo-navel was placed was incised in the shape of an X, for a perfect accommodation of the flaps and sutured. It is noteworthy that this technique has already been performed in more than 2,500 patients by the plastic surgeon in the present study, and all cases were successfully performed. The presentation of the neoumbilicoplasty technique consisted of keeping a part of the native umbilicus, leaving the final scar with a hexagonal appearance, with a very low level of occurrence of hypertrophic scarring, providing a more natural and easy-to-perform result. Results: This study demonstrated the success of the procedures in maintaining a part of the native umbilicus, with a final scar in a hexagonal aspect, and practically without the occurrence of hypertrophic scar, contributing to another advance in the quality and improvement of neoumbilicoplasty and patient satisfaction. According to the systematic review supporting the present study, it was found 105 articles involving neoumbilicoplasty. A total of 32 articles were fully evaluated and 11 clinical studies were included and developed in the systematic review. These studies did not present a risk of bias that could compromise the results presented, however, there is still no ideal and standardized technique for neoumbilicoplasty in abdominoplasty. Conclusion: The neoumbilicoplasty technique of this study presented all the necessary characteristics for an aesthetically favorable umbilicus, maintaining a part of the native navel with a hexagonal scar, providing a more natural and easy-to-perform result.

Biomaterials, surgical processes and bone formation for dental implants: a systematic review

2023-05-29T22:57:52+00:00

Introduction: Several factors have been reported related to implant success, such as the development and maintenance of healthy peri-implant soft tissues. The development of biomaterials for use in dental clinics in recent years has represented a powerful therapeutic tool in the correction of bone defects. Objective: The present study aimed to carry out a systematic review of the main approaches to the use of biomaterials, surgical methods, and bone regeneration for dental implants. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from January to March 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 1991 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 204 articles were found, 78 articles were evaluated and 66 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 96 studies with a high risk of bias and 20 studies that did not meet GRADE. For a successful dental implant practice, osseointegration is essential. However, it is a complex process with many factors interfering in the formation and maintenance of bone tissue around the implant, such as topography and surface roughness, biocompatibility, and loading conditions. The dental surgeon must master the knowledge of the healing process of the post-extraction sockets, to provide correct planning of the cases. The optimized processes of implant dentistry and biomaterials allow the installation of implants in areas of low bone thickness, width, and height, with simpler surgeries and greater success rates and patient comfort.

Major clinical approaches to osteotomy of the middle third face: a concise systematic review

2023-05-29T22:56:54+00:00

Introduction: Orthognathic surgery is a standardized procedure used to improve the patient's facial appearance and to correct maxillary and mandibular deformities resulting from malocclusion, disease, or trauma. Non-ossification between the maxillary bones after osteotomies is an important complication that may occur after performing this surgical procedure. Objective: It was to evaluate and quantify the three-dimensional space between the mandibular bone segments after advances in bilateral sagittal osteotomies of the mandible, involving the middle third of the face, with a consequent indication of bone grafting to achieve better surgical results, in terms of bone healing, stability, complications and prevention of aesthetic defects. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 104 articles were found, 28 articles were evaluated and 22 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 46 studies with a high risk of bias and 20 studies that did not meet GRADE. Bilateral sagittal osteotomy involving the middle third of the face is the most used technique in mandibular orthognathic surgery, allowing mandibular movements in the sagittal, vertical, and transverse directions, with good results and few complications. Also, in orthognathic surgeries, bone grafting can accelerate bone formation.

Bucco-maxillo and systemic repercussions of the mouth breathing syndrome: a comprehensive review

2023-05-24T21:28:16+00:00

Introduction: Mouth breathing syndrome is characterized by full or partial breathing through the mouth. Its most frequent causes are allergic rhinitis and enlarged tonsils and/or adenoids. These conditions interfere with the passage of air through the nose and upper airways, causing the child to breathe through the mouth. The treatment of the syndrome is done in a multidisciplinary way and counts on the participation of the dental surgeon, who will monitor and take care of any damage to oral health. Objective: It was to present, through a comprehensive review, the main considerations of mouth breathing syndrome in childhood and youth and the role of orthodontics in the management of this problem. Methods: The research and development of the work were carried out from January to March 2023 in the Scopus, PubMed, Science Direct, and Scielo databases, using scientific articles from 2009 to 2022, following the PRISMA rules. Results and Conclusion: It was found 94 studies performed eligibility analysis. The final sample had 28 eligible studies and only 13 studies were described in the comprehensive review. The major cause of mouth breathing syndrome is nasal obstruction, but nasal and facial deformities, allergic rhinitis, septum deviation, tonsils, and nasal conchae, and adenoid hypertrophy also frequently occur. Mouth breathing syndrome negatively affects the respiratory system, cardiovascular system, sleep, hematopoietic system, gastrointestinal tract, endocrine system, and Dental-Skull-Facial development. Thus, the dental surgeon needs to acquire in-depth knowledge about the subject, so that he can develop educational-preventive programs in the place where he works, to promote health and quality of life.

Periapical repair action and antimicrobial activity through calcium hydroxide-based dressings: a comprehensive review

2023-05-22T15:53:10+00:00

Introduction: Endodontic therapy aims at shaping, cleaning, and disinfecting the root canal, being performed by removing all pulp tissue or necrotic remains and microorganisms present in the root canal system. Among the substances proposed as a delay dressing in the endodontic treatment of teeth with chronic periapical reaction, calcium hydroxide stands out. Objective: It was to demonstrate, through a comprehensive review, the main properties of calcium hydroxide, as well as its antibacterial action mechanisms. Methods: After literary search criteria, the selected studies were explored for the construction of the present study, following the PRISMA review rules. The review protocol was based on literary search criteria in major databases such as PubMed, Medline, Bireme, EBSCO, Scielo, and Web of Science. Results and Conclusion: A total of 65 articles were found. Initially, duplication of articles was excluded, resulting in 35 articles. A total of 20 articles were evaluated and 12 were included and developed in this review study. Calcium hydroxide is the most commonly used medication to fight disease-causing bacteria, but when used alone, it may not be able to eliminate these microorganisms. The association of other medications incorporated into calcium hydroxide contributes to positive results with the elimination of more resistant bacteria. Intracanal medications based on calcium hydroxide allow a positive effect on microbial reduction, decreasing the levels of pro-inflammatory cytokines and metalloproteinases.

Use of ablative fractional CO2 laser in facial rejuvenation: a prospective observational cohort study

2023-05-18T18:38:22+00:00

Introduction: Over the years, techniques for treating facial aging have evolved, with oral, antioxidant, and nutritional treatments, topical cosmeceuticals, peelings, and technologies such as radiofrequency, infrared, intense pulsed light, and lasers. Currently, among the lasers used for rejuvenation, there are ablative and non-ablative ones. Objective: To show the effectiveness of ablative fractional CO2 laser in facial rejuvenation. Methods: The presented article is a study that shows the superiority in results when compared with other lasers and treatments, evaluating its side effects and recovery time. Results: the author presented the result through images that are in the work. Conclusion: The ablative fractional CO2 laser proved to be an important option for the treatment of facial rejuvenation, even with a technology that has more intense side effects and longer recovery periods compared to other fractional ablative lasers.

Endodontically treated dental elements: a retrospective comparative observational cohort study

2023-05-15T20:12:09+00:00

Generation X is a generation of great intensity, with great social and financial anxiety in pursuit of self-improvement. Millennials are lazier and narcissistic, but more confident. This study aimed to search the database of the UNORTE – Universidade do Norte de São Paulo dentistry clinic for endodontically treated elements and draw a comparison between generations X and Y. 150 medical records that fit within the parameters were selected. It was concluded that Generation X has approximately 70% more endodontically treated elements than Generation Y.

Dental balance in the arcs for the implants: a concise systematic review

2023-05-11T20:40:51+00:00

The teeth together perform the functions of mastication, protection, and support of related soft tissues, help in the articulation of words, and are an important factor in the aesthetics of the face. The macro geometry of the implant provides influences on osseointegration. In this sense, the various isolated characteristics (thread type, thread pitch, thread depth, face angle) must be studied so that the implant geometry can balance the compressive stress and tensile stress and produce a minimum shear force. The present study aimed to carry out a concise systematic review of the main considerations of dental balance in the arches in implant dentistry. Thus, knowledge of the direction of the teeth is of great importance in clinical implant dentistry for the correct installation of implants, which are very important for maintaining the balance of forces exerted by masticatory muscles (masseter muscle, temporal muscle, medial pterygoid muscle). In addition to this, the evaluation of the amount and density of bone available in the patient's edentulous site. It was concluded that the optimized aesthetic positioning of the implant presents numerous factors for the good aesthetic performance of an implant-supported prosthesis. The main conditions of the soft tissues, the amount of bone, and the location and inclination of the placed implant can be cited as the main ones. The correct positioning of the implant is linked to the location and axial inclination of the implant, aiming to favor the emergence profile and aesthetic contours of the prosthesis. The ideal location for the implant would be the one assumed by the lost tooth root. Also, the location of the height of the cervical portion of this implant concerning the adjacent teeth is important for determining the prosthetic space available for making the restoration, as well as its emergence profile and the biological space of the surrounding soft tissues.

Major approaches on the use of ultrasound at the point-of-care at the pre-hospital level: a systematic review

2023-05-08T21:38:00+00:00

Introduction: Point-of-Care Ultrasound (POCUS) has been established as an ideal imaging modality when used by clinicians trained in the clinical setting. Thus, sophisticated but relatively inexpensive handheld devices have also contributed to point-of-care ultrasound (POCUS) becoming the norm at the prehospital level. Objective: This study aimed to present, through systematic review, the main considerations about the use of ultrasound at the point of care at the prehospital level. Methods: The present study followed a systematic review model. After the criteria of literary search using MeSH Terms clinical studies were collated and submitted to the eligibility analysis. The search strategy was performed in the PubMed, Embase, Ovid and Cochrane Library, Web Of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), and OneFile databases. Results and Conclusion: A total of 156 articles were found. Initially, duplication of articles was excluded. After this process, the abstracts were evaluated and a new exclusion was performed, removing the articles that did not include the theme of this article, resulting in 112 articles. A total of 64 clinical studies were collated and submitted to the eligibility analysis and, after that, 20 studies were selected for the systematic review, dated from 2016 to 2022. On-site ultrasound is spreading through Emergency Medicine, Critical Care, and Prehospital Care. However, there is an underlying inherited conflict with established specialties by conducting comprehensive examinations. Thus, in-service ultrasound in the light of disruptive innovation is a different perspective than ultrasound that had not been academically examined before. Therefore, it can be concluded that ultrasound in the hospital can be implemented in several medical fields for the bedside examination of patients, especially in the prehospital environment. Scientific evidence supports the fact that the addition of ultrasound technology in daily practice (portable ultrasound device), called by some 'future stethoscopes', improves patient care and allows early diagnosis in a hospital setting.

Polymethylmethacrylate injections for augmentation and strengthening of abdominal muscles: an experimental model

2023-05-03T16:46:00+00:00

Introduction: Polymethylmethacrylate (PMMA) is a synthetic, inert, biocompatible and nontoxic polymer, the applications in the medical field are numerous, and indications are increasingly broad. Objectives: To evaluate whether the fibrous response to injection of PMMA microspheres into striated muscles confers increased volume and resistance to muscle stretch. Methods: A total of 20 Wistar rats were injected with, 30% PMMA gel into the right rectus abdominis muscle, while the left rectus muscle received SHAM injections. After 4 weeks, all abdominal rectus muscles were measured and stretched on a bench dynamometer until rupture. The samples were analyzed histologically to verify the tissue response to PMMA. Results: The right rectus abdominis muscles of rats that received PMMA gel injection had increased volume and the breaking strength was greater than 100% compared to the left rectus muscles that received SHAM injections. There was a significant deposition of type I and III collagen fibers around the PMMA injection sites. Conclusion: PMMA microspheres implanted into the rectus abdominis muscle of Wistar rats promote neocollagenesis and significantly increase the breaking strength when subjected to stretch test. The mild and desired foreign body type tissue reaction around the PMMA is not objection to the augmentation of the rectus abdominis muscle.

Major relationships of tooth extraction in patients with cardiovascular diseases: a concise systematic review

2023-04-16T23:45:32+00:00

Introduction: Cardiovascular diseases (CVD) are the leading cause of death worldwide. The number of tooth extraction patients with cardiovascular disease in our country is increasing year by year. Blood pressure control, determination of cardiac function, recognition of arrhythmias, glycemic control, and use of antiplatelet agents or oral anticoagulants need to be investigated. Objective: It was to carry out a concise systematic review of the main relationships of tooth extraction in patients with cardiovascular diseases, to emphasize the main risk predictors. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to March 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2009 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 124 articles were found, 38 articles were evaluated and 24 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 40 studies that did not meet GRADE. It was concluded that the cardiovascular response of elderly outpatients with systemic diseases during tooth extraction is quite significant. Age, sex, systemic diseases, and some tooth extractions may be risk factors closely associated with cardiovascular response. It is necessary for the dental treatment of these patients with heart disease a good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.

Isolate or combined use of platelet-rich plasma in the treatment of temporomandibular joint osteoarthritis: a concise systematic review

2023-04-16T23:39:32+00:00

Introduction: In the context of temporomandibular disorders (TMD), temporomandibular joint osteoarthritis (TMJOA) is a common disease in the oral and maxillofacial regions, as well as being the most severe type. The incidence of TMD is high, affecting approximately 5%-12% of the population. There is evidence for the potential superiority of intra-articular platelet-rich plasma (PRP) injections in patients with TMJOA. Objective: This study aimed to carry out a systematic review to highlight the main clinical outcomes of the minimally invasive treatment of osteoarthritis of the temporomandibular joint through the injectable use of platelet-rich plasma. Methods: The research and development of the work were carried out from December 2022 to March 2023 in the Scopus, PubMed, Science Direct, and Scielo databases, using scientific articles from 2011 to 2022, following the PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias by the Cochrane instrument (Funnel Plot). Results and Conclusion: It was found 134 studies that underwent eligibility analysis. The final sample had 48 eligible studies and only 25 studies were described in the systematic review. Most studies showed homogeneity in their results, with X² =91.2% >50%, with p<0.05. The symmetrical funnel plot did not suggest a risk of bias among studies with small sample sizes. Based on the objective of the present study, important clinical outcomes of the treatment of osteoarthritis of the temporomandibular joint were evidenced through the injectable use of platelet-rich plasma, alone or in combination with other types of treatment. However, it was observed that despite the extensive literature on the use of PRP in the treatment of joint disorders, its application in TMD is still largely unexplored.

Osteonecrosis of the jaw with the use of bisphosphonates and treatment with laser therapy and magnetotherapy: a concise systematic review

2023-04-11T13:18:37+00:00

Introduction: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) has been increasing, mainly as a consequence of the treatment of osteoporosis in elderly women. During bone resorption, bisphosphonates (BP) are taken into osteoclasts and exhibit cytotoxicity, producing a long-lasting anti-bone resorptive effect. several energy-based devices have been used with substantial clinical improvement in the treatment. Devices are widely used in various types of treatment, such as LASER, LED, TEMs, infrared devices, Ultrasound, and radiofrequency, among others. Objective: It was to analyze the main findings and weave approaches of scientific evidence of the occurrence of osteonecrosis by the use of bisphosphonates, as well as the possible treatments, highlighting laser therapy and magnetotherapy. Methods: The present study was followed by a systematic review model (PRISMA). The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The Cochrane Instrument was used to assess the risk of bias from the included studies. The present study was carried out from December 2022 to March 2023. Results and Conclusion: A total of 138 articles were found. Initially, duplicate articles were excluded. After this process, the abstracts were evaluated and a new exclusion was performed based on the GRADE Instrument and Risk of Bias. A total of 58 articles were fully evaluated and 26 were included and discussed in this study. It was concluded that photobiomodulation therapy and magnetotherapy showed safety and efficacy in the treatment of BRONJ, through the reduction of phlogistic signs, faster healing, and reduction of postoperative morbidity. Only four applications of low-intensity laser and magnetotherapy were enough to reduce the inflammatory process in the surgical wound, stimulate the tissue repair process and provide postoperative analgesia.

Main approaches of biofilm formation in composite resins: a concise systematic review

2023-04-07T17:24:42+00:00

Introduction: Composite resins are widely used in clinical dental practice to restore the structure lost by caries and dental defects, achieving aesthetic and functional results. Failures in the photoactivation process can cause problems in the mechanical resistance to wear in regions of direct occlusal contact on the restorative material. This occurs due to the reduction in the degree of conversion of monomers into polymers, compromising the clinical performance of the composite resin. Polymerization shrinkage leads to microleakage of the restoration, leading to staining and the development of bacterial biofilms. Objective: It was to carry out a systematic review of the main scientific evidence of biofilm formation on composite resin veneers, identifying potential predictors, as well as proposals to mitigate this problem. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to March 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2015 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found, 25 articles were evaluated and 20 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 70 studies that did not meet GRADE. It was concluded that the surface properties of resin-based composite materials, as well as surface treatments, can strongly affect bacterial adhesion and biofilm formation. In addition, scientific evidence highlights that cariogenic biofilm formation can alter the surface properties of materials, thus stimulating bacterial adhesion and biofilm formation. Photoactivation allows the curing and crosslinking of polymer chains, essential for the clinical longevity of the composite resin. Insufficient photoactivation culminates in marginal microleakage in restorations and biofilm accumulation on surfaces exposed to the oral environment.

Major considerations and clinical outcomes of aligner plates in orthodontic treatments to achieve dental harmonization: a concise systematic review

2023-04-07T17:13:46+00:00

Introduction: Harmonized teeth are synonymous with a healthy mouth, and age is no longer an obstacle to starting orthodontic treatment. There are numerous options involving technologies that serve people of the most varied ages and lifestyles. Among them, the aligner plates are ideal for those who want to correct imperfections in the dental position. Objective: It was to carry out a concise systematic review to highlight the main considerations and clinical outcomes of aligner plates in orthodontic treatments to achieve dental harmonization and aesthetic balance. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to February 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2012 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 68 articles were found, 22 articles were evaluated and 16 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 22 studies that did not meet GRADE. It was concluded that the aligners are created by computer software, require only one impression, require a few additional tests, and allow excellent predictability of the treatment when used within their indications. They have a satisfactory aesthetic level, are comfortable, easy to clean, and cause less trauma when compared to conventional fixed appliances. However, serious skeletal discrepancies cannot be treated with the aligner plates, there may also be non-cooperation on the part of the patient, in which the use of the device is insufficient, making the treatment ineffective, high cost, slight intrusion of posterior teeth may occur, speech disturbances, dysphagia, and increased salivary flow.

Orthognathic surgery in class II patients and the treatment of obstructive sleep apnea syndrome: a concise systematic review of the clinical studies

2023-04-06T12:12:59+00:00

Introduction: Obstructive sleep apnea (OSA) is characterized by intermittent partial or complete obstruction of the airways during sleep, being called OSA syndrome (OSA) when associated with daytime/nighttime symptoms and/or comorbidities, such as systemic arterial hypertension or diabetes mellitus. The prevalence reaches 32% in the general population, varies between 1% and 20% when associated with COPD (overlap syndrome), and is described as above 60% in populations with COPD and obesity, Orthognathic Surgery (OS) corrects the deformities of the bones of the maxilla and mandible. Objective: It was to highlight the main considerations and outcomes of clinical studies on the importance of orthognathic surgery in class II patients and the treatment of obstructive sleep apnea syndrome. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October to December 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2005 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 420 articles were found, 157 articles were evaluated and 25 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 103 studies with a high risk of bias and 42 studies that did not meet GRADE. It was concluded that obstructive sleep apnea syndrome is related to comorbidities such as systemic arterial hypertension or diabetes mellitus. Orthognathic surgery treats patients with moderate and severe facial deformities, enabling the achievement of functional balance and harmony in facial aesthetics. Maxillomandibular advancement is an orthognathic surgery procedure that has been used to treat obstructive sleep apnea syndrome. However, maxillomandibular advancement often leads to unsatisfactory esthetic results. Proper early diagnosis and treatment can significantly improve a patient's quality of life, reduce sudden death, and prevent various complications. significantly increased compared to those before surgery, which can significantly improve the symptoms of obstructive sleep apnea syndrome and even achieve complete disappearance of symptoms.

Relationship of the occurrence and main approaches to osteonecrosis of the jaw with the use of bisphosphonates: a concise systematic review

2023-04-04T01:04:10+00:00

Introduction: In the setting of bucomaxillo facial surgery, bone tissue is a specialized connective tissue made up of cells and a mineralized extracellular matrix. To reduce the excessive resorption observed in these pathologies, it has been studied more rigorously in pre-clinical and clinical studies to improve anti-resorptive drugs that allow for treating or preventing pathologies of bone metabolism, such as bisphosphonates (BP) and denosumab (DN) as well as some angiogenesis inhibitors, can induce osteonecrosis of the mandible (ONJ). Objective: Was to carry out a concise systematic review of the relation of occurrence and main approaches to osteonecrosis of the mandible and/or maxilla with the use of bisphosphonates. Methods: The present study was followed by a systematic review model (PRISMA). The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The Cochrane Instrument was used to assess the risk of bias from the included studies. The present study was carried out from December 2022 to January of 2023. Results and Conclusion: A total of 108 articles were found. Initially, duplicate articles were excluded. After this process, the abstracts were evaluated and a new exclusion was performed based on the GRADE Instrument and Risk of Bias. A total of 55 articles were fully evaluated and 22 were included and discussed in this study. The American Association of Oral and Maxillofacial Surgeons proposed for the first time its nomenclature "Bisphosphonates Related Osteonecrosis of the Jaws". ONJ is the term used to describe bone cell death when the osteocyte becomes necrotic. Osteonecrosis of the jaws can be considered a severe adverse effect of BP therapy. Osteonecrosis of the jaws induced by the use of antiresorptive drugs commonly occurs in the oral cavity, mainly because the bone tissue is covered and protected only by a thin layer of periosteum and epithelium. Bisphosphonates inhibit RANKL expression, as well as stimulate OPG production by bone marrow cells and osteoblasts, inhibiting the RANK-RANKL interaction. These synergistic actions lead to a decrease in the recruitment of osteoclasts and, consequently, to a reduction in bone resorption.

Dental stem cells and tissue regeneration in odontology: a brief systematic review

2023-03-31T22:45:57+00:00

Introduction: New ideas for tooth and tissue regeneration began to appear with rapid developments in tissue engineering theories and technologies. Numerous types of stem cells have been isolated from dental tissue, such as dental pulp stem cells (DPSC), human pulp stem cells isolated from exfoliated primary teeth (SHED), periodontal ligament stem cells (PDLSC), apical papillary stem (SCAP) and dental follicular cells (DFC). All these cells can regenerate tooth tissue. Objective: It was to present the main considerations of bioengineering techniques and report the results obtained in experiments with dental stem cells, as well as their real trends in application in dentistry. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October to December 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2001 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 118 articles were found, 27 articles were evaluated and 16 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 29 studies with a high risk of bias and 42 studies that did not meet GRADE. It is concluded that the collection of mesenchymal stem cells from deciduous teeth should be widely disseminated, as it is of great importance and wide applicability, allowing the repair of the most diverse cell types. In addition, it has several advantages, such as a non-invasive technique, respecting the period of dentition change, there are more than 20 collection possibilities, it presents high compatibility with the donor and family members and storage for an indefinite period. The studies showed that implantation of stem cells from deciduous teeth led to the regeneration of three-dimensional pulp tissue equipped with blood vessels and sensory nerves up to 12 months after treatment, as well as increased root length and reduced apical foramen width, not showing adverse events over 24 months of follow-up.

Major aspects of mesenchymal stem cell signaling and differentiation into osteoblasts in the optimization of bone formation for dental implant: a systematic review

2023-03-30T14:57:34+00:00

Introduction: In recent decades, the number of dental implant procedures has shown significant growth worldwide, reaching about one million dental implants per year. In Brazil, in recent decades, there has been a very rapid evolution in implant dentistry with high success rates. Several materials can be used as a bone graft, each with different properties, for example, regarding neovascularization. Guided bone regeneration favors the formation of new bone tissue. When grafting procedures are required, the focus is often on the type of biomaterial to be used and the success and predictability of the results. Objective: It was to carry out a concise systematic review of bone regeneration processes using biomaterials and the main molecular and cellular constituents for implant dentistry. Methods: The survey was carried out from January to February 2023 in the Scopus, PubMed, Science Direct, and Scielo databases, using older scientific articles with a gold standard reference up to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias by the Cochrane instrument. Results and Conclusion: It was founded on 128 studies that underwent eligibility analysis. The final sample had 34 eligible studies that were described in the systematic review. Most studies showed homogeneity in their results, with X²=89.8.8% <50%. Due to bone regeneration and biological barriers in graft surgeries, there has been a technological growth of these materials as they point to potential tools for treating bone loss. The greater potential of guided bone regeneration was associated with the graft material due to the higher grade of vital bone and the lower percentage of residual graft particles. All studied bone substitute materials resulted in efficient bone formation for dental implants and alveolar ridge preservation procedures.

3D bioprinting strategies and their application in studies in vivo and in vitro animal models for skin regeneration: a concise systematic review and meta-analysis

2023-03-25T13:28:17+00:00

Introduction: Annually, 50% of medical expenses worldwide stem from damage to the body's tissues and organs. Large skin defects can be caused by tumor excision, venous ulcers, diabetic foot ulcers, and burns. The 3D bioprinting of skin has an advantage compared to other technologies for skin substitutes, the capacity for directional and spatial handling at the cellular level with variable density. Objective: It was to identify the most efficient 3D bioprinting strategies and their application in studies in vivo and in vitro animal models, to demonstrate state of art in skin regeneration, and to direct new clinical research with translational studies. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from November 2022 to February 2023 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 237 articles were found and 97 articles were evaluated in full, and 16 were included and described in the present study. According to the GRADE instrument, most studies (X2 =90.5%>50%) followed a controlled clinical study model and had a good methodological design. the biases did not compromise the scientific basis of the studies. Conclusion: Most organotypic skin models have an epidermal layer of keratinocytes and a dermal layer of fibroblasts embedded in an extracellular matrix-based biomaterial. Furthermore, skin comprising epidermis, dermis, and hypodermis stratified with blood vessels, nerves, muscles, and cutaneous appendages can be fabricated. These findings provided evidence for further advances in translational studies in humans.

Taxation formula for tobacco in Sri Lanka

2023-03-17T13:45:53+00:00

Article 06 of the WHO Framework Convention on Tobacco control emphasizes the importance of implementing effective tax and price policies for Tobacco products. To fight against the Tobacco epidemic WHO has introduced the MPOWER package which R stands for raising taxes on Tobacco. According to WHO standards, 70% of the excise tax from the retail price will contribute to an effective Tobacco tax indexation policy. National Authority on Tobacco and Alcohol organized Tobacco Taxation and Illicit Trade virtual workshop with the collaboration of WHO FCTC Knowledge Hub on Tobacco Taxation, Research Unit on the Economics of Excisable Products, University of Cape Town. The developed Tobacco tax indexation formula of the National Authority on Tobacco and Alcohol was modified by including exogenous factor with the guidance of experts of WHO FCTC Secretariat Knowledge Hub on tobacco taxation. Tobacco tax simulation modeling can be used to predict how much tobacco consumption will decrease, and government revenue will increase if there is a change in the tobacco excise tax structure and an increase in the level of taxation. Preliminary evidence from the TETSiM model predicts that a 91.6 to 124.6 billion increase in tobacco excise taxation from the current 2022 to 2026 would lead to a 1.1 % drop in consumption and approximately 101.8 to 136.9 billion increases in government revenue. The finding of the modeling of Tobacco taxes with the TETSiM model will lead to an increase in Tobacco tax revenue and decrease Tobacco consumption in Sri Lanka.

Major considerations of dental care and treatments for pregnant and breast-feeding women: a concise systematic review

2023-03-16T00:38:47+00:00

Introduction: Dental treatment for pregnant women is still a source of insecurity for many professionals, including those in the dental field. Among the changes present is the increase in the rate of dental caries, acid enamel erosion, and, of paramount importance, a greater predisposition to periodontal disease. Objective: It was to present the main considerations of dental care and treatment in pregnant and lactating women through a concise systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to February 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2014 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 120 articles were found, 29 articles were evaluated in full and 16 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 32 studies that did not meet GRADE. Drug therapy in pregnant and breastfeeding women, as well as any form of surgical intervention, always requires a careful assessment of the risks potentially involved in this practice. In this way, the dental surgeon must prescribe rationally and responsibly, to avoid the undesirable effects that may be caused by the use of medications. It is of paramount importance, the constantly updating of the professional, through the search for recent information in updated references or specialized centers, about the drugs and their possible harmful effects on the mother and the child.

Clinical evidence and diagnosis of temporal arteritis: a concise systematic review

2023-03-15T22:55:08+00:00

Introduction: Temporal arteritis (TA), or giant cell arteritis, is a systemic autoimmune vasculitis that affects patients over 50 years of age. Temporal artery biopsy is considered the gold standard for diagnosis, although it has low sensitivity. It was shown that TA can lead to irreversible blindness in about 20% of untreated cases. Objective: A concise systematic review was carried out to contribute to the diagnosis and treatment of temporal arteritis, assessing whether a series of patients met the clinical and laboratory criteria for diagnosis, regardless of the biopsy result, as well as whether these results alter the management of these patients. Methods: The research was carried out from December 2022 to January 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, following the PRISMA rules for systematic review. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 140 articles were found, and a total of 32 articles were evaluated and 6 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies with a high risk of bias and 43 studies that did not meet GRADE. It was concluded that, regardless of the biopsy result, all patients should immediately start treatment with corticosteroids. Early diagnosis and treatment must be performed to avoid compromising the contralateral eye. In addition, it is necessary to perform other diagnostic imaging tools to increase the sensitivity and closure of the diagnosis of temporal arteritis.

Main clinical findings of oral and maxillofacial osteonecrosis, bisphosphonates and alternative treatment with photobiomodulation and magnetotherapy: a systematic review

2023-03-10T17:25:27+00:00

Introduction: Bisphosphonates are drugs of a class widely used in several medical specialties. Its main property is to inhibit calcium phosphate precipitation, decrease bone calcification and reabsorption, and reduce osteoclastic action by inducing apoptosis in these cells. Bisphosphonates have anti-angiogenic effects. Low Power Laser is widely used for surgical purposes and it acts through various effects, such as photothermal, photomechanical-acoustic, photoionizing, and photoablation. Laser with low power can be divided into 2 groups, according to the respective types of photoreceptors: Low-Intensity Laser (LIL), with endogenous action, and Photodynamic Therapy (PDT), acting in the exogenous environment, as well as magnetotherapy. Objective: It was to highlight the main clinical findings of oral and maxillofacial osteonecrosis through the use of bisphosphonates, as well as an alternative treatment with photobiomodulation and magnetotherapy. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to February 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 1985 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 320 articles were found, 59 articles were evaluated in full and 39 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 101 studies with a high risk of bias and 42 studies that did not meet GRADE. Patients being treated with bisphosphonates should be informed about the potential risk of bisphosphonates-related osteonecrosis of the jaws. In addition, providers responsible for breastfeeding therapy would be advised to refer patients for dental check-ups before starting treatment, allowing for patient follow-up by a multidisciplinary team. Although the morbidity of this pathology is not high, prevention must be mandatory, thus avoiding mutilating and painful processes. However, if the surgical procedure is required, the use of these new adjuvant therapies such as low-intensity laser and magnetotherapy.

Perivascular malignant epithelioid cell tumor (PEComa) of the uterus:

2023-03-09T15:26:21+00:00

Perivascular epithelioid cell tumors, called PEComas, have a mesenchymal origin with immunoreactivity for melanocytic and smooth muscle markers. Its incidence in the form of uterine involvement is rare, between 1 and 2 cases per million inhabitants, affecting mainly women in their fifth decade of life. The present study was elaborated according to the rules of the CARE case report. The patient's medical record was analyzed, and who authorized access to it and signed the Free and Informed Consent Form, together with those involved in this work. This patient underwent treatment and medical follow-up with the supervisor of this work. Therefore, this study aimed to describe a rare clinical case report of uterine malignant perivascular epithelioid cell tumor (PEComa). Although the literature on this subject is scarce and there are no consistent criteria for diagnosis and treatment, our case in question presented aspects of unfavorable evolution (a large number of cytological atypia and high mitotic index) characterizing a PEComa with uncertain malignant potential, requiring a treatment adjuvant after surgery. The patient evolved well after the surgery and adjuvant treatment, undergoing quarterly follow-ups at the oncology and gynecology outpatient clinic, with a physical examination and nuclear magnetic resonance of the pelvis for control purposes.

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

2023-03-02T22:51:17+00:00

Introduction: In the setting of corneal ectasias, keratoconus (KC) is a bilateral and asymmetrical disease that results in progressive thinning and tilting of the cornea, leading to irregular astigmatism and decreased visual acuity. The condition affects all ethnicities and both sexes. KC prevalence and incidence rates are close to between 0.2 and 4790 per 100,000 people and 1.5 and 25 cases per 100,000 person-years, respectively. For surgeons who implant Ferrara rings, the manufacturer has developed an online nomogram aimed at optimizing patient outcomes. Objective: The present study carried out a systematic review to present the main clinical outcomes of keratoconus treatment using the Ferrara ring. Methods: The systematic review rules of the PRISMA Platform were followed. The literature search was carried out from January to February 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Scientific articles from the last 15 years were selected. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 60 articles were found, of which only 21 were part of this systematic review, after an eligibility analysis.It was concluded that the insertion of Ferrara rings in keratoconic eyes with previous cross-linking history using the company's nomogram results in significant improvements in visual, refractive, and tomographic results. Corneal densitometry in the anterior layer of the cornea decreases after the implantation of intrastromal corneal ring segments and correlates with corneal keratometry. Over 5 years, Ferrara-type intrastromal corneal ring segment implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus old.