MedNEXT Journal of Medical and Health Sciences

Taxation formula for tobacco in Sri Lanka

Fri, 17 Mar 2023 00:00:00 +0000

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

Thu, 16 Mar 2023 00:00:00 +0000

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

Thu, 16 Mar 2023 00:00:00 +0000

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

Fri, 10 Mar 2023 00:00:00 +0000

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:

Thu, 09 Mar 2023 00:00:00 +0000

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

Fri, 03 Mar 2023 00:00:00 +0000

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.

Main factors of bone loss and the processes of osseointegration for dental implant: a systematic review

Wed, 22 Feb 2023 00:00:00 +0000

Introduction: In the cellular, molecular and structural scenario for dental implants, primary or mechanical stability in implant dentistry is considered a prerequisite for successful osseointegration. The alveolar bone architecture of the implant drilling site dictates the success of anchored endosteal implants. Objective: It was to carry out a systematic review to highlight the main variables that can compromise bone formation and osseointegration for dental implants. 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 2010 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 220 articles were found, and 65 articles were evaluated in full and 22 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 45 studies with a high risk of bias and 92 studies that did not meet GRADE. The success of the prosthetic restoration supported by osseointegrated implants and the health of the surrounding tissues, such as the reduction of bone loss, are closely related to the precision and adaptation of the components, the stability of the implant/abutment interface, as well as the resistance of this interface when it is subjected to loads during masticatory function. It is necessary to provide a complete understanding of the biological events that occur during osseointegration. Factors that can compromise bone healing are cholesterol, hyperlipidemia, and low vitamin D intake. Furthermore, the prominent influence of osteocytes and immune cells is influenced as being the main regulators during osseointegration and maintenance of the dental implant.

Atrophic maxilla and osseointegrated implants: a systematic review

Fri, 17 Feb 2023 00:00:00 +0000

Introduction: In the scenario of the dental implants, what makes implantology unique is the ability to achieve this goal, however, the more teeth a patient loses the more challenging the task becomes. Osteoporosis may be a risk factor for the use of implants. Alternative approaches such as guided surgery and placement of short implants are progressively supplanting more invasive bone regeneration procedures. There are some drugs that help in the treatment of postmenopausal osteoporosis, they are calcitonin, bisphosphonates and the selective modulators of estrogen receptors. Objective: Foi realizar uma revisão sistemática sobre as principais considerações e desfechos clínicos da maxila atrófica no cenário dos implantes dentários osseointegrados, osteoporose e o uso dos bifosfonatos. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October 2022 to January 2023 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 according to the Cochrane instrument. Results and Conclusion: A total of 225 articles were found, and 65 articles were evaluated in full and 31 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 45 studies with a high risk of bias and 90 studies that did not meet GRADE. In the scenario of atrophic maxilla issues, it was concluded that osteoporosis is a metabolic condition that affects alveolar bone density, but does not present problems for the installation of osseointegrated implants, provided there is enough bone mass in the region where the tooth will be implanted. The rehabilitation of atrophic maxilla through dental implants is still challenging, however, alternatives such as guided surgery and the installation of short implants are progressively supplanting the more invasive bone regeneration procedures. Some drugs that help in the treatment of postmenopausal osteoporosis, are calcitonin, bisphosphonates, and the selective modulators of estrogen receptors. Bisphosphonates have been the best drug associated with significant improvement in the quality of life of patients with bone diseases such as Paget's disease, bone metastases, osteogenesis imperfecta, hypercalcemia, and even severe osteoporosis.

Maxillary sinus surgery with autologous or allogenic graft with platelet-rich plasma/fibrin for dental implants: a systematic review

Fri, 17 Feb 2023 00:00:00 +0000

Introduction: In the context of bone grafts and regenerative processes, the maxillary sinus acts in the equalization of barometric pressures in the nasal cavity, which is lined by a membrane called Schneider's membrane. When grafting procedures are needed, our focus is often on the type of biomaterial to be used, and the success and predictability of our results do not depend only on the biomaterial. Objective: It was to perform a systematic review of the main clinical approaches of maxillary sinus surgery with autologous and/or allogeneic graft, using platelet-rich plasma or fibrin. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to January 2023 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 according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found, 55 articles were evaluated in full and 27 were included and developed in this 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 20 studies that did not meet GRADE. It can be concluded from the present study that there is no statistical superiority observed between platelet-rich plasma, PerioGlas, or Bio-Oss in terms of their use as a grafting material along with the immediate implant placement procedure. Furthermore, the combination of autograft/xenograft and plasma rich in growth factors in the periosteal pocket flap technique is a simpler, cheaper, and faster technique than the guide bone regeneration technique to achieve moderate lateral bone augmentation in implant treatment. Tricalcium β-phosphate is a promising biomaterial for clinical situations that require bone augmentation. However, the addition of platelet-rich plasma results in decreased bone loss around dental implants.

Major clinical outcomes of melatonin regulation in obesity: a systematic review

Darwin dos Santos Ribeiro — Fri, 27 Jan 2023 00:00:00 +0000

Introduction: In the scenario of non-communicable chronic diseases, obesity has briefly impacted the global population, causing serious public health problems. There are approximately 2.0 billion overweight and obese people in the world. Brazil ranks fifth in the world with approximately 18.0 million people. Research has advanced on the physiological role of melatonin (MEL) as a therapeutic agent for the treatment of obesity. Objective: It was to highlight the main clinical outcomes of melatonin regulation in obesity through a systematic review of the literature. Methods: The present study followed a concise systematic review model, following the systematic review rules (PRISMA). The literary search process was carried out from September to October 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The low quality of evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: It was founded 139 studies were submitted to the eligibility analysis, then, 46 of the 54 total studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with I2 =98.4% >50%. Studies have shown an important role for melatonin in metabolic diseases such as obesity, type 2 diabetes mellitus, and metabolic syndrome. It is possible to define some pathological syndromes related to MEL and discuss general guidelines for clinical therapy. However, there is still no consensus on the possible role of melatonin as an adjuvant in the treatment of metabolic diseases. More studies are needed to define the possible risks and benefits of melatonin as a therapeutic agent. Furthermore, several precautions must be taken into account, such as restricting the administration of chronic melatonin to the night, carefully choosing the time of administration according to the desired effect, and adapting the dosage and formulation individually to build a melatonin blood profile that mimics the physiological and ends early in the morning.

Main considerations of the temporomandibular joint, its disorders, and treatments: a systematic review

Thu, 26 Jan 2023 00:00:00 +0000

Introduction: The temporomandibular joint (TMJ) can be affected by end-stage pathologies such as arthritic disease, trauma, and ankylosis. The main debilitating symptoms result in limited mouth opening and pain. The TMJ prosthesis is indicated for diseases that result in anatomical changes and aims to restore joint function with pain relief. Prosthetic replacement for terminal TMJ disease is gradually becoming a common procedure due to good functional results and low morbidity. Objective: A concise systematic review was carried out to present the main considerations about the temporomandibular joint, as well as the main clinical results of the treatment of temporomandibular disorders (TMD). 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 2013 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 240 articles were found, 65 articles were evaluated in full and 26 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 45 studies with a high risk of bias and 94 studies that did not meet GRADE. It was concluded that the etiology of temporomandibular disorder is multifactorial, with muscle disorders, joint disorders, and muscle disorders affecting mastication muscles. As a treatment, each CAD/CAM component is manufactured using the patient's data. This system is designed for the specific patient situation and should provide a perfect fit. However, the communication of the fossa and condyle articular surfaces of the implant are standardized, as in the stock system. The treatment of TMD 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.

Immune system and epigenomics under the light of spirituality/religiosity

Dayse Silva Caldeira — Thu, 26 Jan 2023 00:00:00 +0000

Introduction: In the scenario of spirituality, immunity, and health, psychological science is considering spirituality/ religiosity (S/R) as a legitimate issue in understanding the human experience, as it can reduce pro-inflammatory cytokines, aberrant DNA methylation, and strengthen immunity. Objective: It was to evaluate the results of clinical studies that addressed the influence of spirituality/ religiosity on the human immune system, gene expression, and health in general. 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 120 articles were found, 55 articles were evaluated in full and 31 were included and developed in this 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 32 studies that did not meet GRADE. Results and Conclusion: Spirituality/religiosity plays an important role in epigenomic modulations, given that altered gene transcription and aberrant DNA methylation were observed in the CNS and peripheral T lymphocytes. Church attendance is associated with less herpesvirus reactivation, as indicated by lower levels of CMV IgG antibody titers. Furthermore, better self-reported health was associated with better functioning of the immune system. Spirituality can be considered a good coping strategy used by health professionals to promote mental health, well-being, and strengthening immunity during the COVID-19 pandemic.

Major aspects of the use of bisphosphonates for dental implants in patients with or without osteoporosis:

Fri, 20 Jan 2023 00:00:00 +0000

Introduction: In the setting of Medication-Related Osteonecrosis of the Jaw (MRONJ) it was first reported in association with the use of bisphosphonates (BP) by maxillofacial surgeons. The potency and route of administration of BPs are identified as important risk factors. Objective: It was to evaluate the use of bisphosphonates and their side effects in patients with or without osteoporosis, with emphasis on osteonecrosis of the jaws, for dental implants. 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 120 articles were found, and 55 articles were evaluated in full and 34 were included and developed in this 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 32 studies that did not meet GRADE. For patients with established osteoporosis, there are drugs that, in general, act directly on the bone remodeling process, seeking to reduce bone resorption, including BP, which are drugs of proven efficacy that act in the prevention and treatment of several bone diseases. Osteoporosis is a factor that delays the regeneration of the maxillary bone in patients submitted to implant surgery, prolonging the normal recovery time of the maxillary bone, which can vary from three to six months. Alendronate sodium is used to decrease bone resorption, the drug should be considered an adjuvant therapeutic agent for the treatment of osteoporosis. However, studies have shown that there is a risk of osteonecrosis with the use of bisphosphonates.

Major clinical results of orthognathic surgery and maxillomandibular advancement in obstructive sleep apnea syndrome

Thu, 12 Jan 2023 00:00:00 +0000

Introduction: Obstructive sleep apnea involves obstruction or narrowing of an individual's airway during sleep and is associated with several comorbidities. Management can be surgical or nonsurgical, and Phase II of the Stanford Protocol for surgical management involves maxillomandibular advancement. Objective: It was to carry out a concise systematic review to present the main considerations and clinical results of orthognathic surgery in obstructive sleep apnea syndrome. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in 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 270 articles were found, 47 articles were evaluated and 23 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies at high risk of bias and 125 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with I2 =95.9% >50%. Maxillomandibular advancement surgery is a successful treatment for obstructive sleep apnea, but there are still concerns about the aesthetic results due to the great advances involved. The bimaxillary advancement osteotomy significantly increases the oropharyngeal volume and constricted surface areas, which remains stable between 6 months to 1 year postoperatively.

Use of fat graft to correct facial asymmetries in patients undergoing Orthognathic Surgery: the systematic review

Thu, 05 Jan 2023 00:00:00 +0000

Introduction: Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible. In this scenario, fat grafting is a powerful tool for corrections and also for facial aesthetic improvement together or after OS. The benefits of fat grafting during orthognathic surgery; to maximize aesthetic results, minimize swelling and optimize wound healing. Objective: To analyze the main clinical studies on the benefits and risks of facial fat grafting in orthognathic surgery, to know the current state of the art. Methods: It followed a systematic literature review model on the main clinical findings of orthognathic surgery and fat grafting, according to the rules of PRISMA. The research was carried out from January 2021 to May 2021 and developed based on Google Scholar, Scopus, PubMed, Ovid, Scielo, and Cochrane Library. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: 123 studies were analyzed, with only 52 medium and high-quality studies selected, according to GRADE rules, and with risks of bias that do not compromise scientific development, based on the Cochrane instrument. Studies have shown that OS aims to establish harmonious facial esthetics, excellent functional occlusion, and improved airway conditions. As an important adjunct to OS, fat grafting is becoming more and more common due to its anti-inflammatory role and effects on facial swelling. High patient satisfaction with the results. Postoperative swelling resolved at week 12 in the fat graft group and persistent edema. The edema decrease over time, with almost complete resolution within 1 year, improvement in facial morphology, function, quality, and skin texture in most of their patients. The use of assisted lipo transfers containing mesenchymal stem cells derived from adipose tissue, enables improvement in skin quality, smoothing of wrinkles, pore size, and attenuation of pigmentation and resolution of scars. Furthermore, enrichment of the lipoaspirate with stem cells derived from adipose tissue increases graft retention. Conclusion: Most of the studies analyzed in this review study showed that fat grafting in orthognathic surgery is a safe and effective tool to improve wound healing, improve aesthetic results, present an anti-inflammatory effect and reduce edema.

Major clinical outcomes of cellular and molecular regulation in maxillofacial bone regeneration: a systematic review

Mon, 02 Jan 2023 00:00:00 +0000

Introduction: The importance of knowing the constitution of this epithelium is because these hair cells play a fundamental role in the physiology of the maxillary sinus. 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 will occur. Objective: It was to demonstrate, through a systematic review, the main clinical outcomes of cellular and molecular regulation in maxillofacial bone regeneration. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to October 2022 in 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. A total of 110 articles were found, 41 articles were evaluated and 31 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 31 studies at high risk of bias and 25 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with I2 =98.9% >50%. Results and Conclusion: It was found that the search for a solution to large bone defects guided the studies for regeneration therapy tissue or bone regeneration. These studies can promote the use of fillers and epithelial barriers that help in the treatment as an adjuvant to bone graft techniques, favoring greater predictability in alveolar and peri-implant reconstructions and with a good prognosis. The main filler biomaterials can be fibrin-rich plasma (FRP), Bio-Oss®. It is necessary to understand the chemical, physical and biological processes of both the biological material and the biological niche of the host. Crossing compatible information between microenvironments allows cell recognition and signaling cascades for neovascularization and regeneration and bone filling.

Major clinical approaches to osseointegrated implants: a concise systematic review

Adryan de Carvalho, Elias Naim Kassis — Mon, 26 Dec 2022 00:00:00 +0000

Introduction: Reconstructive surgery is an important component of the specialty of oral and maxillofacial surgery. The maxillofacial skeleton is subject to various types of defects secondary to trauma, craniofacial/congenital deformities, and tumor ablation. The complex anatomy and function of the maxillomandibular complex impact the choice of reconstruction for maxillofacial defects. Objective: It was to carry out a concise systematic review to present the main considerations of osseointegrated implants. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in 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 127 articles were found, and 57 articles were evaluated and 30 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =95.8% >50%. It was concluded that orofacial defects affect both the form and function of the most prominent and complex part of the body, the face. Several options, such as vascularized flaps, non-vascularized autogenous grafts, or allogeneic materials, are available to reconstruct maxillofacial defects. The complex anatomy and function of the maxillomandibular complex impact the choice of reconstruction for maxillofacial defects. The real effect of bisphosphonates on osseointegration and survival of dental implants is still not well established.

Successful orthodontic and surgical treatment of a patient with Class III malocclusion: a clinical case report

Mon, 26 Dec 2022 00:00:00 +0000

Introduction: Class III malocclusion affects between 5% and 15% of the entire Brazilian population. Objective: The present study aimed to present a clinical case report of the ortho-surgical treatment of a patient with class III malocclusion, showing the follow-up of the good evolution of the treatment and the improvement of the patient's quality of life. Case Report: The patient EOMO, male and 53 years old, presented class III and on 02/03/2003 the patient submitted the orthodontic documentation. The first phase was the surgical expansion of the maxilla, orthodontic treatment of alignment, and maxillomandibular leveling. The second phase was maxillary advancement and mandible reduction surgery. On 07/31/2003, EOMO decided to undergo orthodontics and the indicated surgeries. Today, after years of treatment and surgeries, EOMO lives well and his appearance has improved 100%, and today he lives with a good quality of life. Final considerations: According to the clinical case presented, the treatment of Class III must be fundamentally based on the diagnosis so that the treatment is installed to correct the compromised structures instead of being compensated in places not affected by this malocclusion, that is, it must The degree of involvement of the maxilla and mandible must be evaluated so that the treatment is directed to that bone base and achieves its objectives 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 midface can only be affected with treatment as long as the growth zones can respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects will be.

Endodontic treatment and retreatment: a large systematic review

Mon, 26 Dec 2022 00:00:00 +0000

Introduction: In the context of treatment endodontics, endodontic surgery encompasses various procedures for the treatment of teeth with a history of endodontic treatment failures, such as apical surgery, crown and root resections, surgical repair of perforations, and intentional replantation. Endodontic microsurgery is the evolution of traditional apicectomy techniques and incorporates high magnification, ultrasonic preparation of the root end, and filling of the root end with biocompatible materials. Objective: It was to carry out a vast literature review in a systematic way to show the main considerations of endodontic treatment and retreatment. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in 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 120 articles were found, and 75 articles were evaluated and 35 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 13 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =96.2% >50%. Modern endodontic surgery uses the dental operating microscope and cone beam computed tomography for preoperative diagnosis and treatment planning. In the presence of persistent endodontic lesions or endodontic failure, endodontic treatment or endodontic surgery is required. In the long term, the risk of failure is identical for both groups, with only a slightly higher risk of failure for non-surgical endodontic retreatments when only two years of follow-up are considered.

Protocol for obtaining and characterizing the stromal vascular fraction of human adipose tissue by mechanical dissociation: an original article

Mon, 26 Dec 2022 00:00:00 +0000

The present technical study presented the mechanical dissociation protocol of adipose tissue from manual liposuction, as well as showed the immunobiological characterization (immunophenotyping), cell viability of the stromal vascular fraction of human adipose tissue, and cell concentration per milliliter. It was observed that the technique of the present study obtained a characterization yield of the stromal vascular fraction of the adipose tissue in terms of cell viability, cell concentration per milliliter, and immunophenotyping comparable and superior to most published studies with good scientific evidence.

Major approaches to ozone therapy in endodontic treatments for bone infections and necrosis: a systematic review

Mon, 05 Dec 2022 00:00:00 +0000

Introduction: The bacterium Staphylococcus aureus is, in most cases, the agent of the disease. Thus, inflammation of the bone marrow can cause compression of the bone tissue walls and decrease or blockage of blood supply in the region's blood vessels, which can induce bone necrosis. Clinical studies have demonstrated the efficiency of ozone therapy in the treatment of peritonitis, infected wounds, and advanced ischemic disease. Objective: It was demonstrate the main scientific findings of the use of antiseptic ozone therapy in endodontic treatment. Methods: The research was carried out from July to October 2022 in 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 127 articles were found, and 57 articles were evaluated and 29 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =96.8% >50%. Ozone therapy is scientifically proven and demonstrated in this work, it proved to be effective for tissue repair and the prevention and treatment of bone necrosis. It was observed that patients undergoing chemotherapy, radiotherapy, and antiresorptive drugs are more affected by bone necrosis. It was also observed the importance of the patient feeling that the treatment works and is restoring his ability to reinvent himself and adapt to his social environment. Treatments should not only be based on established numbers and protocols, without analyzing the specific sensations and perceptions of each patient with their lived reality.

Echoendoscopy-guided drainage of pancreatic collections using self-expanding metallic prosthesis: a retrospective observational cross-sectional study

Fri, 25 Nov 2022 00:00:00 +0000

Background: Pancreatic fluid collections are local complications of acute pancreatitis. Advances in research and the development of new techniques to address local complications have allowed minimally invasive therapeutic options. Endoscopic ultrasound-guided drainage is currently the procedure of choice. Objective: To describe the results of the placement of a self-expanding metallic prosthesis for echoendoscopy-guided drainage of pancreatic collections in patients. Methods: This study followed a retrospective observational cross-sectional model (STROBE rules). The study was sent and approved by the Institutional Ethics Committee of the Federal University of the State of Rio de Janeiro, Brazil. For data analysis, descriptive statistical analysis (mean and standard deviation), non-parametric analysis (Kruskal-Wallis, with p<0.05 with a statistical difference in CI95%), and parametric analysis (One-Way Anova, with p>0.05 with a statistical difference in CI95%), and logistic regression analysis, with p<0.05 with statistical significance in CI95%. Results: Thirteen patients were referred for drainage of collections, and 4 patients were excluded. Of the 9 patients studied, there was a predominance of males (7:2) with a mean age of 54.5 years. Eight patients had walled-off necrosis (WON). The device used was the Hot AxiosTM self-expanding luminal apposition metallic prosthesis, which was inserted uneventfully in all patients. Complete resolution of the condition was found in 88.8% of cases. After logistic regression analysis between the categorical predictors (Gender and Age) versus the response predictors (Necrosectomy, Review Interval, and Stent Permanence), it was observed that certain Gender or Age can influence the response predictors. Conclusion: Drainage of pancreatic collections using minimally invasive techniques is a safe and effective procedure.

Crohn's disease with acute ileitis and its complications: a clinical case report

Wed, 23 Nov 2022 00:00:00 +0000

Crohn's disease is a chronic, granulomatous inflammatory disease that can affect the entire gastrointestinal tract. Complications such as intestinal obstructions, fistula, or abscesses may determine the need for surgical treatment, with initial clinical stabilization. Therefore, the present work aimed to present a clinical case report, showing a patient who presented complications resulting from Crohn's disease to determine surgery as the definitive treatment and, emphasizes the importance of optimized treatment for this disease to avoid complications.

Quality of life of medicine students in the pandemic: a prospective observational cross-sectional study

Wed, 23 Nov 2022 00:00:00 +0000

The COVID-19 pandemic has had major impacts on the mental and psychological health of young students. Stress, anxiety, depression, and a sedentary lifestyle are some of the consequences generated during the necessary social isolation. In this way, medical education has transformed due to the current Covid 19 epidemic, which has affected students and teachers of medical education in the country. In this way, the present research intends to collect data to evaluate the affected areas of the students in terms of quality of life, health, and other areas of their lives, thus being able to bring new information that can be used for a better approach to the theme. Therefore, this study evaluated the quality of life of medical students during the pandemic through the application of a remote questionnaire.

Main clinical evidence of ultrasound and ozone therapy in the endodontics treatments: the systematic review

Mon, 14 Nov 2022 00:00:00 +0000

Introduction: Issues related to endodontic treatment are intrinsically linked to the prevention and total control of pulp and periapical infections. The presence of microorganisms is not limited to the endodontic but is also present in the periradicular regions, characterized by an apical biofilm that is strongly adhered to the surface. In this context of decontamination of root and periapical canals, ozone has been highlighted as an important sanitizer. Objective: To demonstrate the main experimental and clinical findings of the use of ozone therapy alone and in association with conventional treatments as an antiseptic in the treatment of root canals. Methods: The research was carried out from May 2021 to June 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: There is moderate evidence to provide important preliminary information about ozone therapy. As for reducing the microbial load for patients undergoing root canal treatment, ozone therapy has inferior results when compared to conventional chemomechanical techniques using NaOCl. The joint action of these treatments proved to be quite effective. Conclusion: Ozone therapy is proving to be a useful new treatment modality that offers great benefits to patients. The strong antimicrobial power of ozone, together with its ability to stimulate the circulatory system and modulate the immune response, makes it a corrective agent of choice in the treatment of various oral infectious diseases. More research is needed to help with its reproducibility, its use should be indicated by the dentist in clinical practice.

Major approaches and clinical findings of cataract surgery using the femtosecond laser: a systematic review

Mon, 14 Nov 2022 00:00:00 +0000

Introduction: In the scenario of eye problems, cataract is a disease characterized by the opacification of the lens, which leads to a decrease in visual acuity, due to a change in the refractive index. A cataract is the leading cause of blindness worldwide and surgery for its correction is the most performed surgical procedure in the world, with an estimated 19 million surgeries per year. The Femtosecond laser was approved for ophthalmic surgery in 2000, having been recently developed to integrate cataract surgery. Objective: It was to highlight the main clinical and scientific considerations related to the application of the Femtosecond laser in cataract surgery, highlighting its efficacy and safety to the conventional phacoemulsification technique. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from the last 15 years. 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 229 articles were found, of which only 55 were part of this systematic review, after an eligibility analysis. Femtosecond laser-assisted cataract surgery appears to be beneficial in some patient groups, ie those with low baseline endothelial cell counts, or those planning to receive multifocal intraocular lenses. However, considering that the advantages of femtosecond laser-assisted cataract surgery may not be clear in all routine cases, it cannot be considered cost-effective. The adoption of the Femtosecond laser in cataract surgery has divided opinions as it results from the adaptation of a technology already used in other areas to a surgical procedure that, at the time, was already successful.

Correlation of periodontal disease and complications of COVID-19: an integrative review

Mon, 14 Nov 2022 00:00:00 +0000

COVID-19 is a disease caused by a virus called SARS-CoV-2 that can cause damage to the lungs and other organs, of which most patients with COVID-19 have mild symptoms, however, some can develop serious illnesses such as pneumonia, edema lung disease, acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndromes that can lead to death. In patients with compromised oral health who become infected with the SARS-CoV-2 virus, the virus can enter the systemic circulation of the periodontal pockets via gingival crevicular fluid (GCF) and then mix with saliva, or it can enter the systemic circulation via periodontal capillaries. In this way, the viruses associated with the periodontium can infect cells of the immune system that continually infiltrate the periodontal pocket. The literature reviews used and the observation of randomized studies were from the Bireme, PubMed, SciElo, and LILACS databases from 2007 to March 2021. To show that periodontal disease can further increase the release of cytokines via altered microflora, which cause complications in patients affected by Covid-19.

The advancement of adhesive dentistry with the endocrown technique and its diffusion among professionals: a literature review

Mon, 14 Nov 2022 00:00:00 +0000

Introduction: In the decades with the advancement of materials fabrication, such as restorations with the latest improvements in their dental fabrication process, or as restorations with improvements in their dental fabrication process, or as the latest restorations in their dental fabrication process, dentistry, or as the latest restorations in their restorative materials manufacturing process. Objective: This work aims to demonstrate through a literature review the use of the endocrown technique. Methods: The research was carried out from January to May 2022 and was developed based on PubMed, Scielo, and Google Scholar. Results: There were 11 a total of 13 articles on Endocrowns. In total, 47 articles were complete and 19 were included in this study. Dentistry, contributing to a better resolution of cases, presents little interocclusal space, so the indirect endocrown restoration technique becomes an excellent option, presenting a good alternative and less dental wear for making. Conclusion: It was concluded that the use of the endocrown technique has shown, for the most part, employing clinical results that it is an excellent restorative option for the restoration of molars with great coronary destruction, and its clinical survival rate was comparable to the use of intraradicular posts of fiber.

Perception of food patterns among adults using restrictive diets: a prospective observational cross-sectional study

Mon, 14 Nov 2022 00:00:00 +0000

Introduction: Obesity is a disease of increasing prevalence among adults in Brazil. It is an undesirable condition both from a health and an aesthetic point of view. The cult of the thin body sometimes motivates the adoption of restrictive diets, which significantly limit the menu. However, the use of this type of diet may be associated with unhealthy repercussions on food, well-being, and weight loss. Objective: To evaluate the perception of the dietary pattern of adult users of restrictive diets in a city in the northwest of São Paulo. Methods: Prospective observational cross-sectional study, carried out through an online questionnaire, with 108 subjects of both genders who perform/have already performed restrictive diets. Results: Predominance of female individuals (84.3%) aged between 18 and 21 years (49.1%). Regarding the Body Mass Index (BMI), 48.1% were classified within the normal range and 31.5% as preobese. In the period before the diet, 72.2% of the participants believed they were overweight. The beginning of the diet was motivated mainly by the desire to lose weight (87%) and its accomplishment happened, in most cases, without professional supervision (58.3%). Excessive eating episodes during the diet period were significant (only 14.8% never experienced it), with feelings of guilt associated in 71.3% of the cases. Conscious control during meals to avoid weight gain occurred with high frequency in 72.3% of cases. Conclusion: A portion of the population presents problematic perceptions about the experience with restrictive diets, which are associated with eating and psychological disorders.

The impact of salary level on the diagnosis and treatment of children with cow's milk protein allergy: a prospective observational cross-sectional study

Mon, 14 Nov 2022 00:00:00 +0000

Cow's milk protein allergy (CMPA) is a type of food allergy (FA), that is, a reaction of the immune system in the gastrointestinal tract due to the ingestion of proteins such as beta-lactoglobulin, alphalactalbumin, and casein. This condition most substantially affects children in the early stages of their development, about 2% of the American child population, and, consequently, directly or indirectly influences the families of each of them. In the Brazilian context, the epidemiological analysis is shallow in quantitative and qualitative data. Because of this, this study aims to understand the path of patients with CMPA, from diagnosis to treatment, and how their income and their knowledge of their rights in the Unified Health System interfere throughout this process. A form was used as a method to collect data from families with CMPA patients, accounting for 107 in all, which were consulted through online communities. Facing the financial and nutritional challenges of treating a child with CMPA and, at the same time, with the results obtained, the authors of this study were able to verify that, despite the high cost of adapting the diet of this AA, the economic factor was not it was relevant within this consulted microcosm regarding treatment, but slightly influential in the diagnosis. Analyzing the knowledge of the benefit offered by SUS concerning the child's nutritional supplementation, it was possible to verify that, of a total of 44 people, about 45%, know the benefit, but do not use it, and do not perform the supplementation. So, for this and other obtained relations, the study concluded that low income is not a limiting factor for the treatment of patients with CMPA, being slightly influential in the way in which families seek the diagnosis of this FA. In line with this view, it was possible to note the high evasion of SUS Primary Care and the non-use of the formulas offered, although they are sometimes known by the target audience.