MedNEXT Journal of Medical and Health Sciences

Factors related to H. pylori infection in Nablus region: cross sectional analysis from west bank

Duha Najajra — 2024-06-27

H. pylori infection is common infection in developing countries and is associated with gastric and extra-gastric complications was not studied before in Occupied Palestinian territories. We wanted to measure the prevalence of H. pylori infection in a sample from Nablus region in West Bank and to study risk factors and clinical outcomes. We found that 122 patients who visited medical laboratories in Nablus were recruited to participate in the study. A questionnaire was collected from the study group on information that included; demographic variables, diseases history, blood groups. A sample of stool was collected and evaluated for H. pylori infection using H. pylori Antigen Test. SPSS software was used to perform statistical analysis of the study. 41.8% of the study participants had H. pylori infection. Patients without Diabetes mellitus type were less likely to have H. pylori infection (OR= 0.15(95% CI, 0.04, 0.60, p=0.008). Also, not having GI was associated with less H. pylori infection OR= 0.40, 95% CI, 0.39, 1.75, p=0.018). H. pylori infection was more common in patients with O blood group, but this did not reach statistical significance. Smoking and hygiene practices were not related to H. pylori infection. In conclusion, H. pylori infection is prevalent in Nablus and is associated with higher risk for Diabetes and GI problems.

Major aspects of minimally invasive endodontic surgery using microsurgery: a systematic review

Cleber Lorensini Gonzales — 2024-06-18

Introduction: Knowledge about endodontic infections has increased significantly over the last 50 years and, although many issues still require elucidation, endodontics has become the dental science that has the most improved approaches and technologies to increase the success and longevity of treatments dental organs. Endodontic microsurgery has produced highly successful results in preserving teeth with persistent or recurrent cases of periapical periodontitis that could not be successfully treated by non-surgical endodontic approaches. Objective: It was to list the main clinical considerations of minimally invasive endodontic surgery using apical microsurgery, as well as point out the success rate of this technique. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to March 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 117 articles were found, 50 articles were evaluated in full and 20 were included and developed in the present 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 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=58.5%<50%. It was concluded that the success of apical endodontic surgery in terms of healing existing periapical pathology, together with a good long-term prognosis, depends on correct diagnosis and planning, as well as the association of surgical techniques, well-executed protocols, and biocompatible materials. The apical endodontic microsurgery approach is predictable and has a high success rate, which resulted from the introduction of cone beam computed tomography, microscope, ultrasonic instruments, and materials such as mineral trioxide aggregate (MTA) and bioceramics for retro-fillings.

Pilot study about the use of alternative materials to teach surgical skills to medical students: a cross-sectional observational study

Mariana Gomes de Oliveira Santos — 2024-05-30

Introduction: Suturing is an important surgical procedure in which tissue margins are joined after incision or laceration, it is a fundamental medical skill and requires extensive practice to improvement, especially during the medical educational process. In the Basic Surgical Skills Course training suture is one of the foundations to learn hospital procedure techniques, that are essential during the routine of a medical professional. Objective: This study aims to evaluate the capability that EVA, eggplant, elastic tape, and chicken thigh must mimic basic surgical scenarios and replace expensive materials during the medical education of undergraduates and the development of the skills needed as future health professionals. Methods: This is a cross-sectional descriptive observational study, which evaluated students during the surgical skills class to perform suture practice on materials such as EVA, eggplant, elastic tape, and chicken thigh. Results: The materials were evaluated as useful components for training suturing practice. However, eggplant, and elastic tape were considered superior materials. Furthermore, practicality of use correlated with greater instrumental knowledge. Conclusions: The use of alternative materials for training surgical sutures is more accessible because of the low cost, however the results represent a prototype of an analysis that requires an expansion in the number of samples to better determine the cause-effect conditions.

Major outcomes of clinical and experimental studies to highlight the importance of using silane in composite resin restorations in modern dentistry: a systematic review

Julia Mayorquim Garcia — 2024-05-31

Introduction: Dental restorations are often placed due to caries or fractures, and composite resin is often the material of choice to restore teeth. Several factors may play a role related to the application of silane coupling agents, such as the type of silane (hydrolyzed or non-hydrolyzed) and the service life of the defective composite resin restoration being repaired. Objective: It was to analyze the main outcomes of clinical and experimental studies to highlight the importance of using silane in composite resin restorations in modern dentistry. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 111 articles were found, 36 articles were evaluated in full and 30 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=78.4%>50%. It was concluded that the previous application of silane reduced the bond strength values. The two-bottle adhesive showed better results than single-bottle or self-etching systems for composite resin repairs. Furthermore, the association of preheated hydrofluoric acid/silane applied or not with electric current promoted different values of micro shear resistance, types of fracture, and contact angles in the resin cement/ceramic connection. Silane application is essential for surfaces conditioned by hydrofluoric acid, but the use of adhesive is optional when silane is applied.

Major maxillary sinus augmentation techniques for dental implant: a systematic review

Gabriela Corrêa Neves Gabioli Coutinho — 2024-05-30

Introduction: In around 25% of all maxillary sinuses, there is an accessory bone that is located in a lower portion than the main ostium. When a dental element is lost in the posterior region of the maxilla, there is natural reabsorption of the alveolar process and at the same time, pneumatization of the maxillary sinus occurs. It will increase its volume towards the location where the roots existed and this will often make it difficult or unfeasible to restore implants in that location. Various surgical techniques can be used to reconstruct the atrophic alveolar ridge, techniques alone or associated with autogenous, allogeneic, xenogeneic grafts, and alloplastic biomaterials. Objective: It was to develop a systematic review to list the main clinical and surgical approaches to bone elevation techniques for dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to March 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 119 articles were found, 35 articles were evaluated in full and 23 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 15 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=71.6%>50%. It was concluded that the placement of the implant with the simultaneous use of PRP or PRF creates a good relationship between the hard tissue and the soft tissue. The Bio-Oss® biomaterial is one of the most used in guided bone regeneration procedures in regenerative dentistry, and its particles become an integral part of the newly formed bone structure and retain their volume in the long term. Furthermore, Bio-Oss® offers a lot of space for the formation of blood vessels (angiogenesis) and the deposit of neoformed bone, helping the growth of osteoblasts. Notable studies have shown results on the combined use of Bio-Oss® and PRF. Also, it is possible to develop a pre-operative planning method, associated with the area of implant dentistry, using digital images. Furthermore, the conventional surgical guide has some advantages such as being cheaper, simpler, and easier to perform, however, it leads to a greater operative risk for the patient. However, the accuracy of the location to be implanted is not the best and there is a greater probability of this guide becoming worn out, due to the contact of the drills with it.

Major clinical outcomes of minimally traumatic and aesthetic post-tooth extraction: a systematic review

Rebeca Rocha Martim — 2024-05-22

Introduction: After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. These changes can be difficult or even impede the placement of dental implants and prosthetic rehabilitation. Minimizing bone remodeling means optimizing the aesthetics and functional aspects, and mainly, the success of implant treatment. To avoid residual ridge resorption different techniques and bone graft materials have been proposed. Objective: A systematic review was carried out to identify the main clinical outcomes of minimally traumatic and aesthetic tooth extraction. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to February 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 189 articles were found, 45 articles were evaluated in full and 36 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies with a high risk of bias and 41 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=72.5%>50%. The present study suggests that the alveolar graft technique may increase the risk of disease transmission, cost, and time of treatment. Several studies have stated that the graft material is not fully incorporated into the newly formed bone, indicating less vital bone tissue. Spontaneous scarring is still the most used feature since, in intact alveoli and small defects, it is a procedure that does not present significant losses that justify the use of edge preservation techniques. In larger defects, techniques after spontaneous healing, such as a block graft, can be used without the drawbacks of alveolar grafting, such as delayed healing and poor bone quality. The use of a buccal subepithelial connective tissue graft for extraction sockets in the anterior maxilla can be considered a predictable approach to preserving the contour of the alveolar ridge

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

Vitor Eberharte Gubert — 2024-05-21

Introduction: The temporomandibular joint (TMJ) can be affected by end-stage pathologies, such as arthritic disease, trauma, and ankylosis. Around 70% of the general population has suffered at least one symptom of temporomandibular disorder (TMD), which constitutes TMJ disease that may be related to the joints, muscles, ligaments, bones, teeth, and psychological aspects. As a treatment, the implantation of a total alloplastic TMJ prosthesis is an innovative approach. Objective: It was to present the main considerations and outcomes of clinical studies on the treatments of temporomandibular disorders using customized or prefabricated prostheses. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 2024 in the Web of Science, 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 according to the Cochrane instrument. Results and Conclusion: A total of 121 articles were found, 40 articles were evaluated in full and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=57.8%>50%. It was concluded that stock and CAD/CAM prostheses suggested great improvements in mouth opening and pain reduction as a result of the rehabilitation of TMJ function. The results showed comparable data for both types of prosthesis design at 6 months postoperatively. However, the additional advantages of custom prosthetics, along with increasing access to digital technology, will likely result in custom devices dominating the market in TMJ total joint replacement systems. The custom-made combined prosthesis with custom design and 3D printing fabrication represents a safe and reliable implantable reconstruction method for combined TMJ-skull base injuries.

Dentistry and palliative care: a concise systematic review

Mayle Carla Coelho Pinto — 2024-05-20

Introduction: In recent decades, there has been a change in the age pyramid, through progressive population aging. This aging presents itself as a risk factor for several diseases, such as cancer and chronic degenerative diseases. Patients should be regularly questioned and evaluated regarding their oral health conditions. Patients in palliative care present severe functional restrictions and impairment of oral functions, which is even more common when the disease itself already affects the oral cavity, such as head and neck cancer. Objective: It was to carry out a systematic review to present the main considerations and clinical importance of palliative care in dentistry. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to March 2024 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 according to the Cochrane instrument. Results and Conclusion: Atotal of 129 articles were found, 45 articles were evaluated in full and 18 were included and developed in the present 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 32 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=77.8%>50%. It was concluded that understanding the importance of the dentist in caring for patients with diseases that threaten the continuity of life, through relieving suffering and promoting quality of life, based on oral health. Thus, with the work of the multidisciplinary health team, the patient, their family members, and caregivers will have adequate assistance, based on the particularities of each case.

Squamous cell carcinoma, are healthcare professionals prepared to identify it? A case report

David Hadson Arroyo — 2024-05-14

Squamous cell carcinoma (SCC), also known as squamous cell carcinoma, is a type of cancer that originates in the squamous cells of the skin and has different stages according to the involved cellular layer. In the early stage, the process begins with chronic sun exposure, leading to DNA damage in the squamous cells of the epidermis. Initiating in pre-cancerous lesions such as actinic keratosis, occurring in the outermost layers of the epidermis. In the intermediate stage, squamous cells undergo additional mutations, becoming cancerous but still restricted to the epithelial layer without invading deeper structures. While it is only in the epidermis, it is considered carcinoma in situ, as it is confined to this cellular layer and has not invaded the basement membrane. In the advanced stage, cancer cells invade the deeper layers of the epidermis, crossing the basement membrane, becoming basal cell cancer, and can reach the dermis. After reaching the dermis, cancer cells have the potential to spread to distant areas from the primary site, where the metastasis process begins and occurs, potentially affecting regional lymph nodes and other organs. In addition to the layers of the skin, cancer cells can spread to other tissues and organs, forming metastases that are cellular copies of their site of origin. At all stages, it is crucial to emphasize that the progression of squamous cell carcinoma involves progressive genetic mutations that confer malignant characteristics to the cells. Early diagnosis and treatment are essential to improve recovery prospects. Furthermore, prevention by avoiding alcohol, tobacco, and adequate sun protection plays a crucial role in reducing the risk of developing this type of cancer. Therefore, the present study aims to present a clinical case report on Labial Squamous Cell Carcinoma and the main considerations for preparing health professionals for the identification and diagnosis of LSCC.

Mental health status among corporate- and public sector health care workers in India during COVID-19 pandemic (second-wave): Impact of awareness, work satisfaction, risky work-environment practices and social media usage on DASS-21 & IES-R scores

Sanjeev Sreenivasan — 2024-05-06

Introduction: With the advent of coronavirus pandemic, health care workers (HCWs) faced numerous professional, financial, and emotional challenges in addition to social stigma. Objective: It was intended to analyse the correlation of depression, anxiety, and stress among corporate and public sector HCWs, with awareness, risky work environment practises, work-environment satisfaction and social media preferences. Materials and Methods: Doctors, nurses and paramedical staff in critical care, obstetrics, neuro-anaesthesia and neurosurgery wards/ICUs in a public and corporate sector hospital were administered DASS-21 (depression-anxiety-stress scale), IES-R (impact of event scale-revised) and a common perception-based survey to assess the HCW awareness (AWA), work environment satisfaction (WES), risky work environment practises (RWE) and social media preferences (SM scale). Results: In corporate sector, being a nurse correlated with higher scores of stress (rs =1, p=0), DASS (rs =0.34, p=.114), depression (rs =0.54, p=.007), anxiety (rs =0.42, p=.041) and IES-R (rs =0.34, p=0.13). SM score negatively correlated with anxiety (rs =0.58, p=0.045), stress (rs =0.418, p=.041), DASS (rs =0.62, p=.001) and IES-R (rs =0.45, p=.031). In public sector, female HCWs had higher DASS (t=2.61, p=.018), anxiety (t=2.2, p=.03), stress (t=-2.11, p=.011) and IES-R (t=-1.86, p=0.07). AWA score negatively correlated with anxiety (R=-0.56, p= .005), DASS (rs=-0.48, p=.004) depression (p= .283), stress (p= .11) and IES-R (p= .101). RWE score strongly correlated with anxiety (rs =0.39, p= .027). Depression (D total, p= .010) and IES-R (p= .024) were significantly higher in public sector HCWs. Anxiety (A total, p= .108) and stress (S total, p= .246) were lower in corporate sector HCWs. Conclusion: Corporate sector nurses and female HCWs in the public sector showed significantly higher stress, depression, and anxiety scores. Increasing awareness about disease could mitigate stress, anxiety, and depression while prevailing social media preferences aggravate anxiety, stress, and depression.

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

Vitor Eberharte Gubert — 2024-05-06

Optimization of facial aesthetics through orthognathic treatment: a systematic review

Laiane Martins dos Santos — 2024-04-23

Introduction: In the aesthetics scenario, facial optimization is considered an essential outcome of orthognathic treatment (OT) due to its potential advantages in reducing the duration and cost of treatment, providing early aesthetic improvement, and increasing patient satisfaction. Objective: It presents a systematic review study listing the main optimizations of facial aesthetics through orthognathic surgery, to highlight the importance of this treatment for improving patients' comfort and quality of life. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to March 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 179 articles were found, 45 articles were evaluated in full and 39 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 15 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=69.5%>50%. It was concluded space maintenance is one of the most important activities in the prevention of malocclusion. The maintenance of the lost space is of paramount importance to ensure normal eruption and development of the dentition. Aesthetic/functional rehabilitation is necessary until the eruption of permanent successor teeth occurs. A practical option to obtain this rehabilitation is through the installation of aesthetic or functional space maintainers. There are several requirements, such as maintaining the desired interproximal space, not interfering with the occlusion of the opposing teeth nor with the eruption of the permanent tooth, allowing sufficient mesiodistal space for the permanent tooth alignment to erupt, not inferring in phonetics and chewing and present a simple framework and be easily sanitized. Thus, the neuromuscular stability of the stomatognathic system may be impaired by the presence of deleterious habits.

Outcomes of clinical studies of mindset and lifestyle in sports performance: a systematic review

Jessica Mendes de Souza — 2024-04-23

Introduction: The athlete's lifestyle and mindset become an integral part of sports performance. The quest to improve the performance of world-class athletes involves understanding the attributes, skills, strategies, support, environment, and lifestyles of elite performers. Objective: It was to develop a systematic review to highlight the main outcomes of clinical studies of mindset and lifestyle in sports performance. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from September to October 2023 in the Web of Science, 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 according to the Cochrane instrument. Results and Conclusion: A total of 151 articles were found, and 34 articles were evaluated in full, and 27 were included and developed in the present 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 44 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=61.9%>50%. It was concluded that champion athletes attribute their good mindset as the main predictor of competitive success. Furthermore, championship performance requires a particular way of life that integrates mindset, performance factors, lifestyle, and relationships. High-performance strategies include using sharp mental rehearsal skills and practice retrieval.

Major evidence of the relationship of cardiovascular disease and tooth extraction: a systematic review

Maria Angélica Tognolo — 2024-03-27

Introduction: Cardiovascular diseases can present a congenital origin, that is present from birth, such as interatrial and interventricular communication, defects of the artery, coronary arteries, or acquired coronary artery anomalies that involve several risk factors such as smoking, alcohol, old age, and sedentary lifestyle. Thus, the acquired ones are the most frequent in the routine of a dental practice, so the dentist should be able to attend to those patients who need special care, regarding the correct use of medications due to the risk of drug interactions, the type of local anesthetic to be used and the management of patients who use anticoagulant therapy. Objective: It was to develop a concise systematic review to highlight the main clinical outcomes of the relationship between cardiovascular diseases and tooth extraction. Methods: The research and development of the work were carried out from December 2023 to February 2024 in the databases Scopus, PubMed, Science Direct, and Scielo, following the PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was based on the Cochrane instrument (Funnel Plot). Results and Conclusion: A total of 112 studies were found that were subjected to eligibility analysis. The final sample had 36 eligible studies and 21 studies were described in the systematic review. Most studies showed homogeneity in their results, with X² =63.9% >50%, with p<0.05. It was concluded that the virtual reality technique was effective in controlling blood pressure and heart rate within an acceptable range and can help in the management of blood pressure and heart rate during tooth extraction in patients with hypertension. 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.

Major clinical approaches to tooth whitening techniques and differences in terms of sensitivity and protection: a systematic review

Drica Garcia Zanelatto — 2024-03-26

Introduction: Tooth whitening is an initial step in the analysis and reproduction of the aesthetics of the smile, so the dentist must know how to diagnose the causes of color changes, and recommend whitening before proposing the appropriate dental procedure. With technological advances, tooth whitening techniques have emerged to facilitate their use improve comfort and safety, and reduce time spent performing the technique. The conventional means of external tooth whitening is with carbamide peroxides or light-activated hydrogen or not. However, both at-home and in-office whitening procedures cause tooth sensitivity. There is a new whitening proposal on the market without the use of whitening gels, thus reducing post-treatment sensitivity. This proposal highlights ultraviolet light as a whitening agent. Objective: It was to carry out a concise systematic review of the main clinical approaches to tooth whitening techniques, to point out the differences between them in terms of sensitivity and tooth protection. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to February 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 178 articles were found, 40 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=67.4%>50%. It was concluded that tooth whitening can be indicated in practically all situations in which tooth darkening occurs, such as pulp tissue decomposition, internal hemorrhage, trauma, use of medications, restorative materials, and systemic conditions such as fluorosis, jaundice, and fetal erythroblastosis, among others. others. Contraindications for tooth whitening treatment occur in children under 10 years of age. Whitening using the home technique uses products with lower concentrations, between 10% and 22% carbamide peroxide. In-office, 16% carbamide peroxide was effective. In office-based tooth whitening, higher concentrations of whitening substances are used and laser, LED, ultraviolet, and halogen light can be used to intensify the whitening process. Patients undergoing vital teeth whitening report sensitivity or discomfort during treatment. Oxidative stress generated by bleaching agents can cause apoptosis and damage to periodontium DNA (genotoxicity) and cellular cytotoxicity. A new generation of whitening agents with low concentrations of hydrogen peroxide (3.5% and 15%) was introduced on the market for in-office teeth whitening, aiming to achieve greater safety and efficiency in tooth whitening.

Major clinical outcomes of the alveolar ridge preservation post-extraction sockets: a systematic review

Isabelly Lima Rocha — 2024-03-23

Introduction: After tooth extraction, the alveolar ridge will commonly decrease in volume and change morphologically. These changes can be difficult or even impede the placement of dental implants and prosthetic rehabilitation. Minimizing bone remodeling means optimizing the esthetics and functional aspects, and mainly, the success of implant treatment. To avoid residual ridge resorption different techniques and bone graft materials have been proposed. Objective: It was to evaluate the efficiency of the many techniques of extraction socket treatment in the alveolar ridge dimension preservation. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 158 articles were found, 62 articles were evaluated in full and 34 were included and developed in the present 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 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=63.6%>50%. It was concluded that the application of autologous growth factor concentrate after surgical extraction offers an easy, low-cost, and efficient option for preserving the alveolar ridge. Therefore, the use of autologous growth factor concentrate by dentists during tooth extractions can be encouraged, especially when preservation of the alveolar ridge is necessary. The present study suggests that the alveolar graft technique may increase the risk of disease transmission, cost, and time of treatment. Several studies have stated that the graft material is not fully incorporated into the newly formed bone, indicating less vital bone tissue. Spontaneous scarring is still the most used feature since, in intact alveoli and small defects, it is a procedure that does not present significant losses that justify the use of edge preservation techniques. In larger defects, techniques after spontaneous healing, such as a block graft, can be used without the drawbacks of alveolar grafting, such as delayed healing and poor bone qualit.

Major clinical approaches of dental treatment in cancer patients: a systematic review

Mylena Gabrielly Neves Silva — 2024-03-18

Introduction: According to the National Cancer Institute, a total of 16,290 new cases of oral cancer were estimated in Brazil in 2017, with 12,370 new cases of oral cavity cancer in men and 4,010 in women corresponding to an estimated risk of 11.54 cases new for every 100 thousand men and 3.92 for each 100 thousand women. In this sense, oral cancer therapy is associated with a multitude of head and neck sequelae including hyposalivation, increased risk of tooth decay, osteoradionecrosis of the jaw, radiation fibrosis syndrome, mucositis, chemotherapy-induced neuropathy, dysgeusia, dysphagia, mucosal lesions, trismus, and infections. Objective: It was to present the main clinical approaches to dental treatment in cancer patients through a systematic review. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 156 articles were found, 58 articles were evaluated in full and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=61.8%>50%. It was concluded that preparing a comprehensive treatment plan for cancer patients is essential to help minimize the risks of developing these oral and dental complications. Additionally, dentists should consider the patient's ongoing oncology therapy for those patients who see the dentist while receiving cancer treatment.

Main processes of bone formation and regeneration through molecules and cells as biostimulators in buccomaxillofacial surgery: a systematic review

Luís Fernando Inada — 2024-03-12

Introduction: At a cellular and molecular level, tissue engineering offers numerous advantages that meet the needs of the injured tissue or organ for the bone regeneration process in buccomaxillofacial surgeries. To achieve this, it is necessary to understand the chemical, physical, and biological processes of both the biological material and the target biological niche. Objective: It was to carry out a concise systematic review of the main processes of bone formation and regeneration using molecules and cells as biostimulators in buccomaxillofacial surgeries. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2023 to February 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 182 articles were found, 60 articles were evaluated in full and 36 were included and developed in the present 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 and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=54.7%>50%. The bone regeneration process occurs through the activation of osteoblasts and vascular control guided by PDGFs and TGF-β. These growth factors also promote matrix formation and osteoblast differentiation. Some biodegradable natural polymers (chitosan®) associated with inorganic materials such as tricalcium phosphate were tested as spongy carriers for PDGF-BB. Chitosan® has been attributed to hemostatic properties, inducing bone formation and regulating the release of bioactive agents. The use of platelet-rich plasma and mesenchymal stem cells (exosomes and microRNAs) has been indicated and used in other areas of oral and buccomaxillofacial surgery, accelerating a process of bone regeneration that normally already occurs and this process continues its path until the formation of bone mature.

Use of platelet-rich plasma isolated or in combination in osteoarthritis of the temporomandibular joint: a systematic review

Paulo Cesar dos Santos — 2024-03-11

Introduction: Temporomandibular joint osteoarthritis (TMJ-OA) is a common disease in the oral and maxillofacial regions and is the most serious type. Among temporomandibular disorders, TMJ-OA accounts for 18% to 85% of all cases. The use of platelet-rich plasma (PRP) has been highlighted, as well as in combination with other types of treatments such as hyaluronic acid, arthrocentesis, and corticosteroids. Objective: to highlight the main clinical outcomes of the treatment of osteoarthritis of the temporomandibular joint through the injectable use of platelet-rich plasma, alone or in combination with other types of treatment. Methods: The research and development of the work were carried out from December 2023 to February 2024 in the databases Scopus, PubMed, Science Direct, and Scielo, using scientific articles from 2013 to 2023, following the PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was based on the Cochrane instrument (Funnel Plot). Results and Conclusion: A total of 178 studies were found that were subjected to eligibility analysis. The final sample had 45 eligible studies and 31 studies were described in the systematic review. Most studies showed homogeneity in their results, with X² =66.7% >50%, with p<0.05. The symmetric funnel plot did not suggest a risk of bias among studies with a small sample size. The results showed that platelet-rich plasma performed better than hyaluronic acid in the treatment of osteoarthritis of the temporomandibular joint during longterm follow-up in terms of reducing pain and increasing interincisal distance. Combined injection of hyaluronic acid and platelet-rich plasma after arthrocentesis is more effective than hyaluronic acid or platelet-rich plasma alone in the treatment of osteoarthritis of the temporomandibular joint, as well as platelet-rich plasma with hyaluronic acid after arthrocentesis showed significant clinical efficacy long-term concerning pain relief. Furthermore, it was found that intra-articular injections of platelet-rich plasma reduced pain on palpation of the temporomandibular joint more effectively compared to hyaluronic acid and corticosteroids. Platelet-rich plasma injection can significantly improve pain, mouth opening, abnormal joint sound, and jaw function in patients with temporomandibular joint osteoarthritis, and has a good repair effect on condylar bone defects. Furthermore, platelet-rich plasma injection combined with physical therapy can effectively control medium and long-term pain in patients.

Clinical results of orthognatic surgery in the treatment of obstructive sleep apnea syndrome: a systematic review

Ingrid Caroline de Carvalho Ferreira — 2024-03-11

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent partial or complete obstruction of the airways during sleep and is called OSAS syndrome when associated with day/night 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 (OC) can correct deformities of the maxillary and mandibular bones in OSAS. Objective: It was to develop the main approaches and clinical results of orthognathic surgery for the treatment of obstructive sleep apnea syndrome through a systematic review. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 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 according to the Cochrane instrument. Results and Conclusion: 146 articles were found, 58 articles were evaluated and 26 were included in this systematic review. Considering the Cochrane tool for risk of bias, the global assessment resulted in 32 studies with a high risk of bias and 22 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X² =65.8%>50%. Maxillomandibular advancement surgery is a successful treatment for obstructive sleep apnea, but there are still concerns about cosmetic results due to the major advances involved. Bimaxillary advancement osteotomy significantly increases oropharyngeal volume and contracted superficial areas, which remain stable between 6 months and 1 year postoperatively.

Major clinical approaches at the aesthetic level and complications of bichectomy: a systematic review

Laura Ribeiro — 2024-03-08

Introduction: According to the Brazilian Society of Plastic Surgery in 2016, 7,362 people underwent bichectomy (BC), which represents 0.5% of the total number of aesthetic surgeries. In an attempt to achieve facial harmonization, BC surgery presents little complexity and is based on some well-defined steps. Even when appropriately indicated, it is still a controversial procedure, as there is no surgical technique adequately systematized in current literature, aiming to make it safe and reproducible. Objective: It was to present the main aesthetic considerations and complications of bichectomy, as well as discuss its safe management to avoid and treat problems. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 96 articles were found, 40 articles were evaluated in full and 28 were included and developed in the present 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 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=67.9%>50%. It was concluded that on an aesthetic level, performing a bichectomy thins the middle third of the face, outlining and highlighting the bone angulations of the zygomatic region, contributing to a more pleasant facial aesthetics. Surgical removal of the Bichat ball induces a mild inflammatory process controlled by rescue medication, significantly reduces facial volume, and improves the quality of life and satisfaction with facial aesthetics 3 months postoperatively. Several studies have presented the importance of using the Bichat ball as an oral layer to close fistulas and also to cover bone grafts in implant dentistry.

Major clinical outcomes of laser therapy in endodontic treatments: a systematic review

Nayra Roberta Coculo Santos — 2024-03-05

Introduction: In the setting of endodontic treatment, postoperative pain continues to be a problem in up to 58% of patients. This is due to the release of inflammatory mediators whenever the pulp or periradicular tissues are injured during root canal treatment or retreatment. The application of lasers in endodontics has increased due to their safety and effectiveness in dental treatments. Objective: It was to develop a systematic review to present the main clinical outcomes of the use of laser therapy in endodontic treatments. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2023 to January 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 98 articles were found, 35 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=72.7% <50%. It was concluded that low-level laser therapy has been used in endodontics to promote analgesia, modulation of inflammation, and tissue healing. Analgesia mediated by low-level laser therapy results in vasodilation, and increased levels of adenosine triphosphate and cortisol, inhibiting the production of inflammatory factors. Recent studies reported that the use of low-level lasers enabled the treatment of post-endodontic pain compared to control. Furthermore, studies have shown that laser therapy can increase collagen synthesis and, concerning bone, modulate inflammation, accelerate cell proliferation, as well as stimulate bone stem cells, and accelerate their repair process.

Major approaches of inflammatory processes and peri-implant infections in the cellular and molecular scenario of mesenchymal stem cells, exosomes, and microRNAs: a systematic review

Danilo Martins Paladino — 2024-03-01

Introduction: Bone diseases are denoted by fractures, osteoporosis, and osteoarthritis that affect a large number of individuals, with a rising prevalence of osteopenia for 64.3 million American individuals and osteoporosis for 11.9 million by the year 2030. Dental implants are not free from possible complications with consequent failure, the causes of which are still the subject of debate in the dental scientific community. In particular, peri-implant infections are multifactorial pathological conditions characterized by inflammation of the peri-implant mucosa with or without progressive loss of supporting bone. Specific expression profiles of microRNAs (miRNAs) extracted from peri-implant tissues are predictive of specific clinical outcomes of dental implants and can be used as biomarkers in implant dentistry for diagnostic and prognostic purposes. Objective: It was to address the main approaches to inflammatory processes and peri-implant infections and dental implants in the cellular and molecular scenarios of mesenchymal stem cells, exosomes, and microRNAs, emphasizing the main biomarkers in the therapeutic control of harmful dental implant processes. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 138 articles were found, 44 articles were evaluated in full and 34 were included and developed in the present 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 24 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=67.9%>50%. It was concluded that specific expression profiles of miRNAs extracted from peri-implant tissues are predictive of specific clinical outcomes of dental implants and can be used as biomarkers in implant dentistry for diagnostic and prognostic purposes. Studies have shown that many of the miRNAs extracted from the implant's peri-crevicular fluid were common to those detected in soft tissues taken from the same peri-implant sites. Evidence suggests that exosomes derived from adipose-derived stem cells exhibit similar functions to those cells, with low immunogenicity and no tumorization. Insufficient bone volume directly impacts the placement of dental implants. Adipose-derived stem cells can accelerate bone healing when combined with dental implants. An increase in the concentration of exosomes with negative expression of miRNA-21-3p and miRNA-150-5p may be related to the development of peri-implantitis.

Immediate dental implants and major approaches: a systematic review

Gabriel Nunes Gomes — 2024-02-28

Introduction: The use of dental implants in the rehabilitation of partially or completely edentulous patients followed a protocol of submerging the implant for 3-6 months during osseointegration to reduce the risk of implant failure caused by movements at the interface. In this context, subsequent improvements in surgical techniques such as implant structure and masticatory forces have led to evidence that immediate loading procedures can be successful (immediately loaded dental implant -ILI). Objective: It was to demonstrate, through a systematic review, the main clinical approaches of immediate dental implants with other types of dental implants, presenting the indication criteria and follow-up of the procedures. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 133 articles were found, 45 articles were evaluated in full and 37 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 23 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=59.9%>50%. It was concluded that success rates with the ILI technique are compatible with those of delayed loading, as long as certain guidelines are followed, which were divided into factors related to the patient, surgical technique, implant, prosthesis, and aesthetics. The high success rate is a consequence of correct surgical and prosthetic planning, and harmony between the implant system, patient, and dental surgeon. Regarding the region, it can currently be said that ILI in total jaw rehabilitation is a procedure with high success rates that should and can be applied in all cases in which the technique is efficient in providing adequate primary stability to the implants. Furthermore, the immediate provisional restoration did not have a significant peri-implant impact on the soft and hard tissues surrounding the immediately placed single dental implants.

Major characteristics and clinical results of the all-on-four technique in implant dentistry: a systematic review

Caio Bronca Maranini — 2024-02-27

Introduction: In the context of dental implant methods, the all-on-four technique has proven to be beneficial in reducing stress around dental implants and is a very effective treatment option for edentulous patients. Objective: A systematic review was carried out to present the main characteristics and clinical results of the all-in-four technique in implant dentistry. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 82 articles were found, 40 articles were evaluated in full and 22 were included and developed in the present 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 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=55.7%>50%. It was concluded that technical knowledge and anatomical understanding in all-on-four mandibular surgery are essential for predictable and consistent surgical results. The all-on-four configuration proved to be biomechanically superior to parallel implants, considering the radial stresses on the implants and cortical bone. All-on-four treatments are based on the insertion of two anterior implants and two angled ones to cover a larger area. Therefore, implant-supported prostheses may have higher success and survival rates. The cost of treatment can be reduced. Chewing stress can also be minimized to a greater extent. It was observed that the lowest stress was observed in both lateral and vertical loads in the peri-implant region

The alcohol effect on the performance of athletes of a Medical School in the Northwest of São Paulo: a cross-sectional observational study

Isadora Gimenes Marchesan — 2024-02-27

Introduction: The medical schools of the São Paulo region perform sports competitions as a way of socialization and integration between them. Thus, each medical school has its training routine and focuses on performance during the year. However, these study places also have parties, which have as a characteristic the high consumption of alcoholic drinks. Objective: The present study aims to analyze the constancy of alcohol consumption by the students of a medical school in the northwest of São Paulo who practice physical exercises, as well as to evaluate the reasons and possible consequences of this substance in the organism of these academics. Methods: The research is observational and transversal, done by a virtual formulary, via "Google Forms". Results: It observed the ingest of alcohol, mostly, twice a week by 75% of the interviewed, as approximately 74% reported loss or failure in the efficiency at the next day's activities. Some of the symptoms by the majority were tiredness, sleepiness, fatigue, dehydration, and low concentration, and in the minority, cramps, spasms, and photosensitivity. Furthermore, 94% of the academics practice some exercise in their daily, third times a week. Finally, 86% of the interviewees who are competitors and ingest alcohol don’t consume it when the competition date is close. Conclusion: The medical students' routine has parties and sports, as well as the incentive for alcohol consumption. In this way, the alcohol effects, one day after ingestion, already show up and are malefic not only to the sports performance but also to the academic and personal performances. It can also be concluded that sports competitions are very important to some students since they don't consume alcoholic drinks days before the championship.

Major clinical and surgical approaches to treating orbitozygomatic and zygomatic maxillary complex fractures: a systematic review

Priscila Karimy Nery Baraúna — 2024-02-27

Introduction: In the scenario of orbitozygomatic fractures, facial and head injuries account for half of deaths due to trauma, and thousands are left with long-term or permanent injuries. Fractures of the zygomatic-maxillary complex (ZMC) and zygomatic arch are common athletic injuries. Operative treatment is indicated in cases of significant displacement or functional disturbance. Technology such as virtual surgical planning, intraoperative navigation, and intraoperative imaging has the potential to improve the accuracy of treatment of challenging fractures. Objective: It was to develop a systematic review of the main clinical and surgical approaches to the treatment of orbitozygomatic and zygomatic maxillary complex fractures. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October 2023 to January 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 102 articles were found, 26 articles were evaluated in full and 25 were included and developed in the present 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 12 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=57.9%>50%. A single-piece fracture of the fronto-orbito-zygomatic-maxillary bone connected to a temporoparietal bone may require additional osteotomy to achieve successful results in an acute setting. Orbital volume analysis offers a valid modality for objectively evaluating the efficiency of the management of orbitozygomatic complex fractures. The success rate of the fixation procedure at 1 point of the zygomaticomaxillary complex is high, with minimal complications. Intraoperative CT/three-dimensional imaging should be used in the treatment of ZMC fractures requiring orbital floor reconstruction, where adjacent fractures require fixation and/or when ≥ 2 axes are displaced ≥ 5 mm.

Evidence of the relationship between periodontal diseases/caries and cardiovascular diseases: a systematic review

Isabella Romero de Freitas — 2024-02-21

Introduction: Dental caries is highly prevalent worldwide and is responsible for significant morbidity. Metabolic diseases such as diabetes and obesity share several common environmental determinants with tooth decay. Cardiovascular disease is a common and complex disease, with high morbidity and mortality rates, representing a serious threat to human health. Objective: It was to develop a systematic review to present, through clinical studies and systematic reviews/meta-analyses, evidence of the relationship between periodontal diseases/cavities and cardiovascular diseases. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to January 2024 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 according to the Cochrane instrument. Results and Conclusion: A total of 108 articles were found, 36 articles were evaluated in full and 17 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 24 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR2. Most studies did not show homogeneity in their results, with X²=64.7%<50%. It was concluded that dental diseases such as periodontitis and tooth decay increase the risk of cardiovascular diseases. The number of missing teeth is significantly associated with selfreported history of stroke. The bacterium Streptococcus mutans, harboring the Cnm gene encoding the Cnm collagen-binding protein, is associated with the development of hypertensive intracerebral hemorrhage.

Clinical significance of the main methods of root canal irrigation in endodontics: a systematic review

Amanda Cristina Segala — 2024-02-17

Introduction: In the context of endodontic treatments, irrigation is one of the most important aspects of the biomechanical preparation of the root canal. The arsenal of irrigation solutions designed for endodontic treatment and commercially available is broad. The choice of the correct solution depends on the combination of the properties of the solution associated with the effects to be obtained with irrigation, according to the clinical condition. Objective: It was to carry out a systematic review of the different endodontic irrigation methods, as well as to show the different clinical indications for use, comparing the effectiveness, biocompatibility, and influence on the dentin surface of irrigation solutions. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 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 according to the Cochrane instrument. Results and Conclusion: A total of 115 articles were found, 50 articles were evaluated in full and 41 were included and developed in the present 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 25 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=57.8%<50%. It was concluded that irrigation plays a fundamental role in the success of endodontic treatment. Although hypochlorite is the most important irrigating solution, no irrigant can perform all of the tasks required by irrigation. A detailed understanding of the mode of action of various solutions is important for optimal irrigation. New developments such as mechanical devices will help promote safe and effective irrigation. Within the limitations of this study, the use of the selfadjusting file system with the combination of EDTA and NaOCl improved Ca(OH)₂ removal. The passive ultrasonic irrigation and the self-adjusting file system were more effective in removing Ca(OH)₂ from the lateral grooves in the apical parts of the root canal than the EndoVac and conventional syringe irrigation systems.

Major clinical outcomes of the relationship of metabolic syndrome with the success of dental implants: the systematic review

Graziele Bertoldo Lopes da Silva — 2024-02-09

Introduction: Studies show that around 55% of dental implants can be affected by peri-implantitis, a chronic inflammatory process induced by bacteria, which promotes osteoclast-mediated bone resorption and inhibits bone formation, leading to progressive bone loss around the implants. implants. Current evidence points to an increased risk of developing peri-implantitis in both obesity/metabolic syndrome (MS) and diabetes mellitus (DM) conditions compared to the healthy population. Objective: It was to develop a systematic review to present the main clinical outcomes of the relationship between metabolic syndrome and the success of dental implants. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to December 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 according to the Cochrane instrument. Results and Conclusion: A total of 92 articles were found, 26 articles were evaluated in full and 19 were included and developed in the present 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 12 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X²=53.5%>50%. It was concluded that there is a correlation between the presence of metabolic syndrome and a higher prevalence of some bacterial species in the peri-implant groove, regardless of the peri-implant status. Metabolic syndrome has been shown to significantly reduce bone formation in the periimplant area in the short term. Metabolic syndrome and diabetes mellitus represent an increased risk of developing peri-implantitis. Peri-implantitis requires treatment to induce new bone formation around an implant. However, this is challenging as peri-implantitis, particularly in obese or diabetic conditions, has a microenvironment that is characterized by increased inflammation.