El Acta Odontológica Latinoamericana tiene por objetivo ofrecer a la comunidad científica un medio adecuado para la difusión internacional de los trabajos de investigación, realizados preferentemente en Latinoamérica, dentro del campo odontológico y áreas estrechamente relacionadas.
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Effect of mechanized instrumentation on distal wall thickness of the second mesiobuccal canal
Dentine wall thickness in the mesial roots of molars is critical to prevent root stripping. Understanding the effect of rotatory instruments on the second mesiobuccal canal is crucial to prevent weakening and periodontal communication. Aim: To evaluate the effect of different conservative tapered mechanized instrumentation systems on the distal wall thickness of the second mesiobuccal canal of maxillary first molars in 3D dental replicas. Materials and Method: Fifty radiopaque 3D printed replicas were made of a maxillary first molar with Vertucci classification IV and Schneider curvature (<10°), 23 mm in length. The specimens were divided into 5 groups of 10. In all cases, the second mesiobuccal canal was instrumented to the working length. Group 1 was instrumented with Race Evo (FKG) up to file 30/04, Group 2 with AF F One (Fanta-Dental) up to file 35/04, Group 3 with Slim Shaper (Zarc4Endo) up to file 30/04, and Group 4 with Trunatomy, while the control group was not instrumented. Distal wall thicknesses were measured in the cervical, middle and apical thirds by CBCT before and after instrumentation. Descriptive statistics were calculated, after which analysis of variance and Tukey’s test for multiple comparisons were performed (p < 0.05). Results: Analysis of variance showed a significant effect of instrumented group and thirds (p < 0.001). The multiple comparison test showed that the control and Race Evo groups differed significantly from the other three groups. Within each group, the differences between thirds were statistically significant. Conclusion: Trunatomy, Slim Shaper and Fanta AF One systems are suitable for shaping second mesiobuccal canals while maintaining critical distal wall thickness.
Copyright (c) 2025 Acta Odontológica Latinoamericana https://creativecommons.org/licenses/by-nc/4.0
Oral health services in primary care: a study in southern Brazil
The evaluation of oral health services is an essential component of surveillance efforts aimed at improving health indicators and the quality of care. Aim: The aim of this cross-sectional study was to describe the characteristics of the oral healthcare work process in primary care settings in Porto Alegre, a major city in southern Brazil. Materials and Method: Data on patient profiles and process evaluation components were provided by the Porto Alegre Primary Healthcare Board. An electronic questionnaire was administered to dentists to assess the structure components. Data were classified into three modules: patient profile (sex and age), structure (human resources), and process (actions and procedures). Descriptive statistical analyses were conducted, including the calculation of absolute and relative frequencies. Results: In 2022, a total 414,682 dental appointments were recorded, the majority involving women and individuals aged 35–59 years. Most dentists were young women, primarily specialized in collective health. The process analysis highlighted a strong focus on preventive and health promotion actions, although fluoride applications, sealants, and cariostatic agents were underutilized. Composite resin restorations in permanent teeth were common. Dental emergencies accounted for 17% of cases, and 95% of surgical procedures consisted of extractions and sutures. Additionally, dentists performed integrative practices and other activities, such as rapid testing and vital sign measurements, particularly in response to the COVID-19 pandemic. Conclusions: The findings of this study are intended to inform strategies and service management aimed at improving oral health care in the primary care setting of Porto Alegre.
Level of agreement among dental students and general dentists on the diagnosis of periodontitis using the new classification of periodontal diseases
The new classification system of periodontal diseases, introduced in 2017, aims to provide more precise diagnostic criteria for identifying and classifying periodontitis. It defines periodontal disease based on staging, grading and extent, facilitating a more accurate approach for general dentists and periodontists. Aim: The aim of this study was to establish the inter-observer agreement and diagnostic accuracy among three groups with different levels of education and experience in dentistry in assigning stages, grades and extent of periodontitis using the 2017 AAP-EFP classification system. Materials and Method: The study involved 32 participants divided into three groups: Group 1-dental students (n=12), Group 2-dentists with up to 3 years’ experience (n=10), and Group 3-general dentists with more than 4 years’ clinical experience (n=10). Twelve periodontitis cases were evaluated by all participants, who classified each case by stage, grade and extent. The evaluations were compared with the gold standard provided by a panel of expert periodontists. Statistical analysis, including Fleiss’ kappa and chi-square tests, was performed to assess agreement and diagnostic accuracy. Results: Significant differences were observed in stage classification, with students and recent graduates more likely to underestimate the severity of the disease, while experienced dentists tended to overestimate it. No significant differences were found in grade and extent classifications. Diagnostic accuracy was comparable across all groups, but students showed slightly higher agreement with the gold standard compared to other groups. Conclusions: The 2017 AAP-EFP classification system can be applied by both general dentists and dental students, but further clinical practice is needed to improve diagnostic accuracy. Misclassification tendencies, such as over- or underestimation of disease severity, highlight the need for additional training and familiarity with the system.
Hand file and manual rotary file behavior in curved canals: an ex vivo micro-CT study
Several instrumentations systems are available in the market and it is necessary to assess their behavior in curved root canals. Aim: To analyze the ability of two manual instrumentation techniques to center mesial root canals of mandibular molars, studied by computed microtomography (micro-CT). Materials and Method: Twenty mesial root canals of mandibular molars were matched based on similar morphological dimensions using micro-CT evaluation and divided in 2 groups (n=10): (1) Crown-down technique with Gates-Glidden drills and K-Flexofiles and (2) M manual NiTi rotary system. Changes in volume, surface area and canal transportation were compared using an unpaired t-test with a 5% significance level. Results: No significant differences were observed between groups regarding volume surface area after root canal preparation (p>0.05). Variation in the centroid differed between groups in the total canal length, and in the cervical and middle thirds, with better centralization for the M files (p<0.05). Conclusions: Both manual instrumentation techniques had similar volume and surface area variation. Both techniques left unprepared canal areas with similar values. M manual NiTi files caused minor canal transportation.
Smile-related oral characteristics in vietnamese students
Aim: We evaluated various oral features related to the smile among Vietnamese students. Additionally, we identified gender differences in the oral features and the prevalence of attractive smiles. Materials and Method: We recruited 490 Vietnamese students with 18-29 years old and recorded their dynamic smiles. We determined the prevalence of the qualitative smile morphological features and the mean and standard deviation of the quantitative features, namely the buccal corridor space, the smile index, and dynamic smile symmetry. Results: There were diverse smile-related oral characteristics among the participants. The most common anterior smile line was “average” (42.6%), and “parallel” was the most prevalent smile arc (43.1%). We observed a “downward” upper lip curvature in 55.9% of the participants, and the “second premolar” was the most frequently displayed posterior tooth (58.6%). Most of the participants (79.2%) showed no contact between the upper teeth and the lower lip while smiling. The mean buccal corridor space was 0.59 ± 0.47 cm, the smile index was 5.85 ± 1.48, and dynamic smile symmetry was 1.01 ± 0.06. There were significant gender differences for several smile related characteristics. Conclusions: Women more often display a favorable smile arc and more teeth when smiling, while men are more likely to have an attractive anterior smile line and upper lip curvature. These insights are vital to tailor effective aesthetic treatments.
Influence of Bio-C and AH Plus sealers on bond strength determined by push-out of a fiberglass post installed with self-adhesive sealer
Given the limitations of the intrarradicular adhesion procedure and the significant challenge of achieving effective bonding, it is essential to assess the potential impact of various endodontic sealers on the bond strength between fiberglass posts and root dentin. Aim: The aim of this study was to evaluate the bond strength of fiberglass posts to the root dentin of teeth filled with different endodontic sealers. Material and Methods: Forty-five single-rooted teeth were instrumented, filled using the single-cone technique, and divided into three groups according to the selected sealer (n=15): Bio-C sealer (GBC), AH Plus (GAH), and control group without sealer (GC). The post was installed using RelyX U200 self-adhesive resin sealer. Specimens were cut into a cervical, middle and apical thirds, to analyze one slice per third. Bond strength was evaluated using a push-out extrusion test. The failure modes in each third were observed under the microscope, and classified as adhesive, cohesive or mixed. Results: It was found a difference between groups in the cervical and apical thirds, with GAH having stronger adhesion in the cervical third than GBC (p=0.0015), although there was no difference with GC. In the apical third, GAH had higher adhesion values than GBC (p=0.0014) and GC (p=0.0005). In the middle third, there was no difference between groups (p=0.1386). The same sealer in the different thirds only differed significantly in the GBC group, where bond strength was higher in the middle and apical thirds, with a significant difference from the cervical third (p<0.05). There was no difference between failure types in any of the groups (p>0.05). Conclusion: The predominant failure between dentin and sealer was adhesive. It was concluded that the use of AH Plus endodontic sealer resulted in less impairment of the bond strength of resin cemented fiberglass posts compared to bioceramic sealer.
Assessment of two designs for an Oral surgery Postoperative Leaflet
Around the world it is considered good practice to provide patients with a postoperative instruction and advice leaflet following tooth extractions. It has never been reported whether the design or the content is effective or helpful for a patient’s recovery. Aim: To assess the opinions of patients about two postoperative instructions leaflets with similar content but different designs. Materials and Method: A questionnaire was administered to 32 patients who had recently undergone oral surgery. The questionnaire asked patients about their satisfaction with the information and their overall opinion of two postoperative leaflet designs (a conventional and a daily planner design). Results: 53% of the patients preferred the daily planner design and 6.3% preferred the conventional model. 60% of the patients recommended the daily-planner leaflet for future patients. Conclusion: The results of this study suggest that patients find postoperative instructions leaflets to be helpful because they can help to guide patient to follow instructions after surgery. The daily planner was preferred because it was easy to review every day during recovery.
Upregulation of cannabinoid receptor gene expression in oral tissues subjected to hyposalivation and periodontitis
Cannabinoid receptors (CBr) 1 and 2 (CB1r and CB2r) are present in periodontal tissues and salivary glands and play a significant role in the pathogenesis of oral diseases. Aim: To study the gene expression of CB1r and CB2r in gingival tissue and submandibular glands (SMG) of rats subjected to experimental periodontitis (EP) and/or hyposalivation (H), and discuss their possible implication in oral health. Material and methods: Rats were divided into controls, rats with EP induced by application of lipopolysaccharide (1 mg/ml), rats with H induced by bilateral submandibulectomy, and rats with both EP and H. Alveolar bone loss was measured with a digital caliper, mRNA expression of CBr and bone parameters were determined by endpoint RT-PCR, PGE2 glandular content was assessed by radioimmunoassay, and stimulated salivary secretion was collected and weighed. Results: CB1r and CB2r mRNA in gingival tissue were upregulated in groups EP, H and EP+H as compared to controls (CB1r (AU): C 0.27±0.06A, EP 0.46±0.05B, H 0.51±0.08B, EP+H 0,49±0,1B; CB2r (AU): C 0.38±0.04A, EP 1.22±0.08B, H 0.98±0.06C, EP+H 1,041±0,1BC). Groups EP, H and EP+H showed alveolar bone loss as opposed to controls, while only groups EP and EP+H evidenced RANKL/OPG imbalance measured in the dental attachment tissue. Likewise, CB1r and CB2r mRNA in SMG showed upregulation in group EP as compared to controls (CB1r (AU): C 0.52±0.09A, EP 0.95±0.13B; CB2 (AU): C 0.23±0.12A, EP 1.48±0.22B). In group EP, salivary secretion was lower and the content of PGE2 (inhibitory mediator of said function) was higher than in controls. Conclusion: The upregulation of CB2r in oral tissues under the pathophysiological conditions studied suggests that they participate actively in the response to oral diseases.
Palatal height, thickness and density according to facial biotype in Peruvian adults: a tomographic study
Micro-screw stability requires adequate bone quantity and quality. Micro-screws are often placed inthe hard palate, in which anatomy may vary according to vertical growth. Aim: To compare the height,width and density of the palate according to facial biotype using cone beam computed tomography(CBCT). Materials and Method: Observational cross-sectional study on a sample of 39 CBCT scansof adults aged 18 to 50 years (19 females and 20 males) assigned to facial biotypes according to SNGoGn. The height (mm), cortical width (mm) and density in Hounsfield units (HU) were measured at 20coordinates on the left side of the palate coordinates corresponding to the combinations of four pointsmedial to the suture (3, 5, 7 and 9 mm) and five points posterior to the incisive foramen (3, 6, 9, 12 and15 mm). ANOVA and Kruskal-Wallis tests were used for statistical analysis at a significance level of p< 0.05. Results: Values were: hypodivergent (height: 2.16 - 6.32 mm; width: 1.61 - 2.02 mm; density:1117.28 - 1182.83 HU), normodivergent (height: 2.71 - 9.21 mm; width: 1.67 - 2.08 mm; density:1106.53 - 1177.86 HU) and hyperdivergent (height: 2.37 - 12.32 mm; width: 1.62 - 2.07 mm; density:1088.2 - 1156.7 HU). Compared to hyperdivergent subjects, in hypodivergent individuals 60% of themeasurement points had lower heights and 15% of measurement points showed thinner, denser cortices,with significant differences (p <0.05). Conclusion: Facial biotypes were found to be associated withpalate bone characteristics, with greater cortical heights and widths in hyperdivergent subjects andgreater densities in hypodivergent subjects.
María E Rodríguez-Rimachi Rodríguez-Rimachi
Carlos I Tisnado-Florián Tisnado-Florián
Evaluation of filling material removal in curved canals after different protocols: an ex vivo study with micro-computed tomography
Complete removal of the filling material is essential to the success of endodontic retreatment. However, this step can be challenging due to anatomical difficulties, the nature of the sealer, or operational factors. Aim: To evaluate the efficacy of filling removal using ProDesign R and Reciproc Blue retreatment, with supplementary irrigation step with XP-Endo Finisher R. Materials and Method: Twenty mandibular molar mesial canals were prepared using ProTaper Next, and filled using the single-cone technique (n=10). The fillings were subsequently removed using either ProDesign R (25/0.06) or Reciproc Blue (25/0.08 in the 3 mm from the tip of the file, decreasing towards the cervical, with average taper varying from 0.06 to 0.05 along the instrument). The XP-Endo Finisher R system was used for supplementary cleaning for both systems. Micro-computed tomography was used to assess filling material volume and reduction percentage. The significance level was set at 5% (p< 0.05). Results: It was found that ProDesign R and Reciproc Blue removed 91.2% and 82.7% of the filling material, respectively (p > 0.05), and after use of XP-Endo Finisher R, there was a significant increase in filling removal by 42.7 and 27.7%, respectively. Conclusion: ProDesign R and Reciproc Blue were equally effective, but neither system completely removed the filling material from the mesial canals of mandibular molars.
Core curriculum in cariology for dentistry degrees in the Republic of Argentina
Aim: To prepare a consensus document of the cariology contents and competences included in the curriculum for the dentistry degree at Argentine dental faculties/schools. Materials and Method: Planning the process in stages: Stage 1- Diagnosis of the situation (Google Form) and invitation to participate extended to the 20 academic units (AU) that offer dentistry degrees. Stage 2- Assessment process of Content (C) and Competences (I) agreements in the five domains: D1 Basic Sciences, D2 Risk and diagnosis of dental caries, D3 Decision-making for non-invasive treatments, D4 Decision-making for invasive treatment, and D5 Evidence-based cariology at community level. Stage 3- Consensus. Stages 2 and 3 were held in Workshop format in virtual mode (W). Results: Stage 1- Of the total 20 Google forms sent to the AU, 13 responses were received: 7 from National Universities and 6 from Private Universities. All participants agreed to be part of the consensus. Stage 2- W: 20 representatives from 10 AU participated. It began with a contextualizing conference, after which the representatives were divided into 5 groups to assess the agreements of each D. Stage 3- The Cariology Curriculum document was organized into 5 Domains, and 23 C and 31 I of clinical application were defined for teaching cariology. The contents and competences for each domain were agreed upon. The final document was sent to all W participants for their approval and dissemination in each AU involved. Conclusion: Cariology contents were defined for dentistry students at Universities in the Argentine Republic
dental caries - cariology - education - consensus - cariology teaching - Argentina
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Unprepared areas and centralization of oval canals prepared with WaveOne Gold or XP-endo Shaper: microcomputed tomographic analyses
Current instrumentation systems cannot fully prepare oval root canal systems. This may cause accumulation of hard tissue debris and fail to eliminate bacteria from areas inaccessible to instrumentation, which could perpetuate periapical inflammation and jeopardize the success of endodontic treatment. Aim: To evaluate the performance of two endodontic systems in oval canals by investigating the changes in volume, unprepared areas, and centering ability of XP-endo Shaper (XPS) and WaveOne Gold (WOG) in oval canals using microcomputed tomography (micro-CT). Materials and Method: Thirty mandibular canines were scanned before and after preparation with WOG (25/.07 and 35/.06) or XPS (30/.01) to evaluate the volume, surface area, and canal centralization at 4 mm and 10 mm from the apical foramen. Results: Volume and surface area increased significantly after preparation with both systems (p < 0.05). However, no significant difference was observed in the unprepared areas, regarding either the entire canal (26.21% for WOG and 30.10% for XPS), or the apical segment (18.82% for WOG and 14.63% for XPS) (p >0.05). Conclusions: Both systems maintained canal centralization, with no difference between them. XPS and WOG had similar shaping abilities in the mandibular canine, but left almost one third of the unprepared areas.
endodontics - root canal preparation - X ray microtomography.
Fluoride in drinking groundwater and prevalence of fluorosis in children and adolescents: A systematic review
Fluorosis is a worldwide public health problem. One of the factors related to it is the type of water consumed, such as groundwater. High fluoride concentration in groundwater may be explained by contamination from local industries. Since fluoride and arsenic are the main pollutants of groundwater, some studies correlate groundwater consumption with high prevalence of fluorosis. Aim: The aim of this study was to conduct a systematic review to determine whether children’s risk of fluorosis is related to drinking groundwater. Materials and Method: The protocol for this systematic review was registered at the National Institute of Health Research Database (CRD42021227298). A comprehensive search was conducted to identify potentially relevant studies by exploring a range of electronic databases (Medline via PubMed, Scopus, Cochrane Library, Science Direct, Web of Science Core Collection, Medline via Ovid, Lilacs, Embase, and grey literature). Results: A total 2189 articles were found. After reading titles and abstracts, 63 were selected for screening, and the final data was extracted from 15 articles. Conclusion: A relationship was identified between drinking fluoridated water from wells and the prevalence of fluorosis in individuals up to 18 years old. This is the first study to assess the issue systematically worldwide.
fluoride - groundwater - fluorosis - children
Morphological assessment of the isthmus in mesial root canals of first mandibular molars
Root canal morphology and its anatomical variations pose a great challenge to endodontists. Aim: The aim of this in silico study was to perform a qualitative and quantitative analysis of the threedimensional morphological characteristics of the isthmus in the mesial root canals of mandibular molars using microcomputed tomography (micro-CT). Material and Method: Six hundred first mandibular molars were selected, including 317 with two mesial canals with isthmuses between the canals, and fully formed root. Isthmus morphology was determined in 3D longitudinal sections using Fan et al. (2010) classification. Root length, and the volume and area of apical and coronal level were measured. Additionally, the structural model index (SMI) of the canals were also assessed. Results: The prevalence of isthmuses in the mesial root canals was 32% type II, 29% type III, 22% type IV, and 17% type I. The root length was found to be 9.1±0.5 mm, the volume and area, of all root canal system, were 41.8±40.1 mm3 and 63.6±24.2 mm2 respectively. The isthmi volume and area alone were 11.06±9.03 mm3 and 30.02±11.02 mm2 . The study confirmed that isthmuses are present in mesial canals of mandibular first molars, being more frequent in the apical third. Conclusion: The high prevalence of isthmuses with complex morphological features underscores the importance of using intracanal medications to disinfect areas unprepared by instruments.
endodontics - root canal therapy - X ray microtomography.
Langerhans cell histiocytosis oral lesions in pediatric patients
La Histiocitosis de células de Langerhans (LCH) (Langerhans cell histiocytosis) es una enfermedad de etiología aún desconocida. Se presenta en forma unisistémica (afecta un solo órgano o tejido) o multisistémica (con o sin órganos de riesgo afectados). La cavidad bucal puede estar comprometida o ser el sitio de la primera manifestación. Objetivo: describir, agrupar y determinar la frecuencia de las lesiones bucales de pacientes pediátricos con LCH, relacionarlas con la edad y los diferentes subtipos de la enfermedad. Materiales y Método: se evaluaron mediante exámenes clínicos y radiográficos 95 pacientes entre 0 y 16 años con diagnóstico de LCH, derivados a la Cátedra de Odontología Integral Niños, Facultad de Odontología, Universidad de Buenos Aires. Se confeccionaron historias clínicas y se obtuvieron los consentimientos informados. Las lesiones fueron diagnosticadas a través de observación, palpación y biopsias, y se agruparon según los tejidos afectados en óseo, mucoso y óseo-mucoso. Resultados: el 42.1% presentó lesiones bucales y en el 14.73% estas fueron la primera manifestación de LCH. El 90% mostró solo lesiones óseas, mientras que en el 10 % restante se observaron lesiones óseo-mucosas y mucosas. En el subtipo unisistémico el 52.5% presentó lesiones óseas. En los subtipos multisistémicos, “con” o “sin” órganos de riesgo, se hallaron los tres tipos de lesiones. La relación entre la edad de diagnóstico de LCH y el compromiso de tejidos bucales evidenció que las lesiones óseo-mucosas ocurren en niños pequeños (edad promedio 1.4 años) con diagnóstico de LCH multisistémica. La mucosa bucal solo se vio afectada en las reactivaciones de la enfermedad. Conclusiones: Se observó una alta frecuencia de lesiones bucales, siendo en ocasiones la primera manifestación de la enfermedad, afectando con mayor frecuencia al tejido óseo. El odontólogo puede desempeñar un rol activo en el diagnóstico inicial de la enfermedad
Histiocytosis, Langerhans Cell - oral lesions, children
Efficacy of Roncolab mobile application for diagnosing the primary sign of sleep-disordered breathing (snoring) in children
Los trastornos respiratorios del sueño (TRS) son un grupo de padecimientos asociados con anormalidades respiratorias del sueño. Una de las manifestaciones más comunes es el ronquido; signo fácil de detectar por el ruido que emite y se considera como el signo principal. Este trastorno es característico del ruido respiratorio durante el sueño, sin apneas, hipoventilación, ni interrupciones del sueño. Este puede ocasionar disminución del porcentaje del sueño y aumentar los microdespertares, esto debido al esfuerzo respiratorio o al intercambio de gases. En la actualidad existen cuestionarios validados y adaptados para la población pediátrica útiles como herramienta clínica para el tamizaje y selección de pacientes que requieran pruebas de laboratorio. El Pediatric Sleep Questionnaire (PSQ) permite el cribado de TRS e identificación de signos primarios como el ronquido. RoncoLab es una aplicación móvil que registra y mide la intensidad y frecuencia del ronquido. Objetivo: Comparar la eficacia del diagnóstico del ronquido por medio del RoncoLab contrastado con el PSQ. Materiales y Método: Estudio observacional, analítico, en el cual se incluyeron 31 niños de 7 a 11 años, que acudieron a la clínica de odontopediatría de la Benemérita Universidad Autónoma de Puebla, México (BUAP) Se aplicó el PSQ a los 31 niños para el diagnóstico de TRS, después se le instruyó al tutor como descargar y utilizar la aplicación móvil para registrar los datos obtenidos en las horas de sueño en casa. El análisis estadístico de concordancia entre los instrumentos diagnósticos se realizó con el Índice Kappa de Cohen a un nivel de confianza del 95%. Resultados: El Índice de Kappa para la identificación de los ronquidos primarios fue de 0.743 (p<0.05). La sensibilidad de la aplicación fue de 0.92, mientras la especificidad fue de 0.82. Conclusión: Existe buena concordancia entre el PSQ y el RoncoLab en el diagnóstico de ronquido primario, con sensibilidad y especificidad aceptable.
Phytotherapy: knowledge, experience and prescription in oral healthcare. A cross-sectional survey of dental practitioners
Herbal medicine is widely used as an integrative complementary treatment for common chronic diseases, yet potential risks include adverse effects and coprescription. Aim: This exploratory survey assessed Brazilian dentists’ knowledge, attitudes, and practices regarding phytotherapy. Materials and Method: This study used a consecutive sample of registered dentists who were active in clinical practice and attending advanced training for complex oral rehabilitation at a leading dental school in Latin America. Participants responded to a semi-structured 38-item instrument designed to collect data on sociodemographic, professional and health variables, and on their knowledge, use, prescription and opinions of phytotherapy. Quantitative data were analyzed with descriptive and inferential statistics. Qualitative data were described and analyzed with a thematic approach. Results: A total 53 dentists responded the survey (88.3% response rate). Six dentists reported formal education in phytotherapy and 33 had informal knowledge. Twenty-one dentists (39.6%) reported using herbal medicine, and 17 (32.1%) prescribed phytotherapy to their patients, mostly traditional medicinal plants. A logistic regression model showed that post-graduate degree and personal use of phytotherapy were associated with phytotherapy prescription. Opinions on how to improve the rational use of phytotherapy included the need for research evidence, specific academic education, and knowledge dissemination to clinicians. As a clinical recommendation, it was proposed that questions on herbal medicine should be asked during the dental patient’s anamnesis. Conclusions: Dentists with post-graduate degrees and personal use of phytotherapy prescribe herbal medicines for their patients in real-world clinics, regardless of formal education on the subject. Qualitative findings indicate the need to implement scientific initiatives.
herbal medicine - oral health - perception - phytotherapy
Cone-Beam Computed Tomography to evaluate changes in trabecular lower jawbone microstructure caused by bone loss and antiresorptive treatment
For decades, conventional histomorphometry has been the gold standard for analyzing trabecular bone microarchitecture. In recent years, micro-computed tomography (µCT) devices have been validated and are now considered the gold standard for quantifying bone microstructure. Aim: The aim of this preliminary report is to evaluate the usefulness of CBCT to assess trabecular mandible microstructural properties in normal ewes and to compare the quantitative changes associated with ovariectomy and antiresorptive treatment. Material and Method: Twelve adult Corriedale ewes (n=4/group) aged 3-4 years were divided into 3 groups and studied for 28 months. Eight ewes were ovariectomized (OVX) and divided into OVX and OVX+ZOL groups (n=4/group) which were treated as follows, by jugular injection: OVX received saline solution and OVX+ZOL received zoledronate (Zol) (Gador SA, CABA, Argentina) (4 mg/month). Another four ewes were subjected to sham surgery (SHAM group) and received saline solution. Results: Densitometry showed that jaw mineral content (BMC) and density (BMD) were significantly lower in OVX than in SHAM and OVX+ZOL ewes; no difference was observed between OVX+ ZOL and SHAM groups. CBCT analysis showed that bone volume (BV/TV%); trabecular thickness (TbTh); connectivity density (CD) and anisotropy degree (AD) were significantly lower, and trabecular spacing (TbSp), significantly higher in OVX than in SHAM ewes. AD was significantly higher and TbSp significantly lower in OVX+ZOL than in OVX groups. BV/TV%, TbTh and CD showed a clear tendency to being higher in OVX+ZOL than in OVX groups. No statistical difference was observed between OVX+ZOL and SHAM ewes. CBCT in a nondestructive, fast, very precise procedure for measuring bone morphometric indices without biopsies, which are not indicated for morphometric evaluation in osteoporosis. Conclusions: The current study demonstrated the potential of the high-resolution CBCT imaging to assess in vivo quantitative bone morphometry and bone quality of lower jaw cancellous bone under normal conditions and to differentiate changes associated with excessive bone loss induced by estrogen withdrawal and antiresorptive intervention.
cone beam computed tomography - osteoporosis - zoledronic acid
In vitro cytotoxicity of resin cement and its influence on the expression of antioxidant genes
Aim: This study evaluated cytotoxicity and antioxidant gene expression of resin cements on human gingival fibroblasts (hGF). Materials and Method: RelyX Ultimate™(RXU), Variolink™II(VLII), and RelyXU200™(RXU200) resin cements were incubated with culture medium for 24 h to obtain eluates. Then, the eluates were applied over hGF to assess cell viability at 24 h, 48 h, and 72 h and antioxidant gene expression at 24 h. hGF cultures non-exposed to the eluates were used as Control. Data were submitted to ANOVA and Bonferroni tests (α≤0.05). Results: RXU and RXU200 reduced the number of viable cells in 24 h. Longer exposure to cement extracts caused cell death. Gene expression showed peroxiredoxin 1 (PRDX1) induction by all resin cement types, and superoxide dismutase 1 (SOD1) induction by RXU200 and VLII. Moreover, RXU200 induced not only PRDX1 and SOD1, but also glutathione peroxidase 1 (GPX1), catalase (CAT), and glutathione synthetase (GSS). Conclusions: All resin cements showed toxicity, and induced antioxidant genes in hGF. Antioxidant gene induction is at least partly associated with cytotoxicity of tested cements to oxidative stress experience.
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Degree of Conversion and Mechanical Properties of a Commercial Composite with an Advanced Polymerization System
Advanced Polymerization System (APS) technology in a commercial composite resin enables reduction of the concentration of camphorquinone without altering composite physicochemical properties. Aim: The aim of this study was to evaluate the degree of conversion and mechanical properties of a commercial composite with an advanced polymerization system (APS) and compare it to other composites that do not use this system. Materials and Method: Five groups were analyzed. Group 1 (VT: Vittra APS - FGM); G2 (AU: Aura – SDI); G3 (ES: Quick Sigma Stelite – TOKOYAMA); G4 (FZ: Filtek Z350 XT – 3M ESPE); G5 (OP: Opallis -FGM). Degree of conversion (DC, n=3) was analyzed immediately and after 24h by analysis with FTIR spectroscopy. For Knoop hardness (KHN, n=3), 5 indentations were made at the top and bottom of specimens 2 mm thick. Flexural strength (FS, n=10) was determined by the three-point method in a universal testing machine. Polymerization stress (PS) was determined by light-curing the material (1.0 mm high) between polymethylmethacrylate rods in a universal testing machine. Light curing was performed with a Valo Cordless LED (1,000 mW/cm2 x 20 s: 20J). The results were analyzed using ANOVA and complemented by Tukey’s test (α=0.05). Results: The highest DC values (immediate and 24h after) were observed for VT and OP resins, followed by FZ, AU and ES. FZ (top and bottom) had the highest KHN values, similar to VT top. AU, ES, OP and VT had statistically different KHN between their top and bottom surfaces. The highest RF values were observed for FZ, followed by OP/VT, ES and AU. The highest TP values were observed for FZ, OP and VT. Conclusion: The Vittra APS resin with a new polymerization system presents satisfactory performance for the parameters evaluated.
The luminous transmittance of the quartz-glass fiber posts is superior to glass fiber posts
Fiber-reinforced prefabricated intraarticular posts have gained popularity due to several favorable characteristics for clinical use compared to metallic intraradicular posts. Aim: To evaluate the light transmission capacity of two types of fiber posts, using two different methods. Materials and Method: The posts were divided into two groups: experimental group - quartz-glass fiber posts (n=10) and control group – glass fiber posts (n=10). The light transmittance of the samples was compared by means of light intensity test by photographs and ultraviolet-visible spectrophotometer. This test was analyzed by thirds: coronal, middle, and apical. The spectophotometer tested the luminous transmittance along the length of the post. The statistical analysis was conducted with a significance level of 0.05. Results: Light transmission was 97% on the coronal third, 68% in the middle third, and 27.66% in the apical third in the posts of the experimental group. In the posts of the control group, the light transmission was 95.33% in the coronal third, 80.66% in the middle third, and 41.33% in the apical third. Light transmission was significantly higher in the middle third of the posts of the experimental group when compared to the control group (p<0.05). The luminous transmittance of the posts of the experimental group was 97.4% with wavelengths of 400 nm, 97% at 450 and 500 nm, and 96.9% at 550 nm. In the posts of the control group, the luminous transmittance was 72.3% with wavelengths of 400 nm, 68.6% at 450 nm; 64.6% at 500 nm and 61.5% at 550 nm. The posts of the experimental group demonstrated significantly higher light transmittance than the control group (p<0.001). Conclusion: the luminous transmittance of quartz-glass fiber posts is higher than glass fiber posts.
Effect of fried sunflower oil intake on mandibular biomechanical competence of growing rats
Previous studies by us demonstrated that the consumption of thermally oxidized oil diet adversely affects body growth, lipid metabolism, bone mass and femur biomechanical competence. Aim: The aim of this study was to evaluate the effects of a diet containing fried sunflower oil on the mandible of growing rats. Materials and Method: Male Wistar rats (21±1 day old) (n=21) were assigned at weaning to one of three diets for 8 weeks: a control diet (C), a diet containing sunflower oil (SFO) or a diet containing sunflower oil that had been repeatedly heated (SFOx); both SFO and SFOx were mixed with commercial rat chow at 13% (w/w). The consistency and viscosity of the 3 diets were similar. Zoometrics and food intake were recorded weekly. At wk=8, mandibular growth was assessed by measurements of anatomical points of cleaned bones, and mandible biomechanical competence was assessed to estimate the structural properties of the bone. Statistical analysis was performed by SPSS v. 20.0. Results: Rats fed SFOx diet attained the lowest final body weight (P=0.0074), mandibular weight (P=0.0001) and mandibular \length (P=0.0002). Load bearing capacity (Wf;N), load of yielding (Wy;N) and stiffness (Wy/dy;N/mm) of the mandible were negatively affected by both sunflower oil diets (fresh and fried) (P=0.001; P=0.002; P=0.003, respectively) though SFOx induced the most significant reduction in Wy/dy (C:44.4(5.4) > SFO:36.1(2.1) > SFOx: 26.3(3.7) N/ mm; P=0.003). The deleterious effect of SFOx on mandibular growth was more accentuated on the posterior part of the bone (C:11.4(0.3)=SFO:11.2(0.2)>SFOx: 10.7(0.2) mm; p=0.0005); the anterior/ posterior ratio (C:1.25(0.02)=SFO:1.27(0.02)<SFOx:1.32(0.03); p=0.0001) indicated that SFOx induced mandibular deformation. Conclusion: Consumption of SFOx diet during growth could affect mandibular morphometric properties and biomechanical competence, in terms of bone stiffness
Effect of chemical or mechanical finishing/polishing and immersion in staining solutions on the roughness, microhardness, and color stability of CAD-CAM monolithic ceramics
During the manufacture of ceramic restorations there is an important step of finishing and polishing and the effects of different types of these procedures on the surface characteristics of ceramics are not known for sure. Aim: To evaluate the effects of various surface treatments and immersion in coloring substances on the roughness, microhardness, and color stability of CAD-CAM monolithic ceramics. Materials and Method: The ceramics used were lithium disilicate reinforced with zirconium dioxide (Suprinity), lithium disilicate (E.max) or leucite (Empress). They were subjected to two surface treatments: glazing (group G) (n=20) or mechanical polishing (group P) (n=20). Then they were divided into two subgroups (n=10) to be treated with the staining substance (coffee or water). Roughness, microhardness and color were measured before and after treatment. Data were subjected to analysis of variance and multiple comparisons were performed with Tukey tests at 5% significance level. Results: Roughness was lower in all tested ceramics after polishing than after glazing. Microhardness was the same for polished and glazed E.max, higher in glazed than polished Empress, and higher in polished than glazed Suprinity. Analysis of the effects of glazing and polishing on the individual ceramics showed that the ∆E2000 and ∆WID data of the E.max ceramic subjected to polishing showed greater change. Mechanical polishing is a good option for surface treatment of monolithic ceramics. Conclusion: Glazing was inferior and less satisfactory than polishing. Glazing generates changes that can lead to color instability
gDNA extraction from Candida albicans and Candida dubliniensis in subgingival samples in Argentina. Evaluation of different methods
The oral cavity constitutes a unique ecosystem with highly variable ecological niches that harbor a great variety of microorganisms, including yeasts. Molecular methods are currently considered the gold standard for identifying species, although they involve limitations associated with the disruption of yeast cell walls to release the genomic DNA (gDNA) for amplification. Aim: The aim of this study was to compare the performance of different methods for extracting gDNA from Candida albicans and Candida dubliniensis, subsequently amplifying DNA by PCR. Materials and Method: Fifty-two isolates (16 C. albicans and 36 C. dubliniensis) were obtained from subgingival biofilm of HIV+ patients with clinical signs of periodontal disease. The study evaluated 6 gDNA extraction methods and two PCR amplification methods. Furthermore, the presence of alleles of HWP1 gene was determined in C. albicans. Results: Comparisons of six methods show statistically significant differences (p<0.001) except for C. albicans in two of them. For C. dubliniensis, statistical differences were observed in all comparisons. Commercial methods were more efficient for concentrating gDNA than in-house methods, and both PCRs were effective. Ten heterozygous C. albicans isolates for this allele were positive for the HWP1-1 / HWP1-2 allele, one was homozygous for Wild Type HWP1-1 allele, and 5 were homozygous for novel/rare HWP1-2 allele. Conclusions: This study aims to provide simple, inexpensive strategies for phenotypic identification and molecular confirmation of Candida albicans and Candida dubliniensis for non-reference laboratories with low complexity and/or low budgets.
Precision of polyether ether ketone (PEEK) or cobalt-chrome implant bar fit to implants after mechanical cycling
Based on its mechanical properties, PEEK (polyether-ether-ketone) might be useful in restorative procedures. In oral rehabilitation, its viability has been studied mainly for prostheses and dental implants. Aim: The aim of this study was to evaluate the fit accuracy of dental implant bars made of either PEEK or cobalt-chrome submitted to cycling mechanics. Materials and Method: This was an experimental in vitro study, where units were treated with two implants and mini-abutments, joined by cobalt-chrome or polyether-ether-ketone PEEK bars. A total 20 bars were prepared (n=10 per group) and subjected to mechanical cycling tests (1 million cycles on the distal cantilever of the bar in the vertical direction, 120N and sinusoidal loading, at a frequency of 2Hz). The fit at the abutment/implant interface was measured before and after cycling, and the counter-torque of the vertical screw of the mini abutments was measured after cycling, using a digital torquemeter. Data were analyzed by three-way ANOVA and Tukey’s test at 5% significance level. Results: No statistically significant interaction was found among the three factors considered (bar material, implant positioning and mechanical cycling) (p = 0.592). No significant difference was identified in the interaction between bar material and implant positioning (p = 0.321), or between implant positioning and mechanical cycling (p = 0.503). The association between bar material and mechanical cycling was statistically significant (p = 0.007), with the cobalt-chrome bar resulting in greater misfit with mechanical cycling. There was no difference in counter-torque values between groups. Conclusions: The PEEK bar provided better fit of the mini abutments to the implants, even after mechanical cycling. The counter-torque of the screws was similar in all scenarios considered.