Metabolic syndrome is a confluence of risk factors that increase the likelihood of developing cardiovascular diseases, strokes and diabetes. This condition manifests itself through several components, namely: markedly increased abdominal circumference due to excessive accumulation of fat in the region, high blood pressure, insulin resistance or type 2 diabetes, hepatic steatosis (accumulation of fat in the liver) and unregulated levels of cholesterol and other blood lipids (dyslipidemia). The objective of this descriptive, longitudinal and cross-sectional study is to correlate oral health, especially the presence of caries and periodontal disease, in individuals with diabetes mellitus with factors indicative of metabolic syndrome. Thus, considering the results presented, there was a positive correlation between the presence of risk factors for metabolic syndrome and the greater presence of oral changes in individuals with type 2 diabetes mellitus.

Predictive factors of success in the treatment of obstructive sleep apnea with mandibular advancement devices are still relatively understudied. Most research utilizes imaging exams that involve ionizing radiation or magnetic resonance, which present, respectively, increased biological risk and high cost. This study proposes an innovative approach by employing ultrasonography to analyze the morphology of suprahyoid soft tissues in patients with obstructive sleep apnea treated with mandibular advancement devices. Objective: To evaluate the efficacy of a new custom-made, 3D-printed mandibular advancement device for the treatment of obstructive sleep apnea, as well as to identify possible morphological predictors of therapy success through an innovative methodology based on ultrasonography of the suprahyoid tissues. Methods: Twenty participants with a prior diagnosis of obstructive sleep apnea through type 1 polysomnography, who had already begun CPAP treatment and were either non-compliant or seeking an alternative treatment, were included in the study. Participants were treated with a personalized mandibular advancement device. The effects of the therapy were analyzed using type 4 polysomnography. Measurements were taken at three distinct periods: 1) at the start of the treatment, without the mandibular advancement device (T0); 2) at the end of the titration (T1); 3) six months after the beginning of the treatment (T2). Imaging of anatomical structures of the upper airway and the tongue was conducted. Treatment response was defined as the difference between the values recorded at the end of titration and at the start of treatment for each polysomnographic variable studied. Results: The mandibular advancement device significantly improved all analyzed polysomnographic variables, and efficacy was maintained over the six-month evaluation period. Airway length was the only morphological factor identified by ultrasonography as a predictor of treatment efficacy, both in the reduction of ODI (R= 0.593; R2=0.351; p=0.012), T90 (R=0.561; R2=0.315; p=0.019), and Hypoxic Burden (R=0.61; R2=0.372; p=0.012). The longer the airway, the better the treatment responses observed. Conclusions: The studied mandibular advancement device was effective for the treatment of obstructive sleep apnea. Among the ultrasonographic variables studied, airway length proved to be a statistically significant predictor of therapy success with a mandibular advancement device in reducing ODI, T90, and Hypoxic Burden. A longer airway indicated a better treatment response, suggesting this structural factor may be important for choosing this device as a treatment. Ultrasonography is a promising exam for analyzing patients with obstructive sleep apnea.

“Objectives: This study aimed to compare the oral health-related quality of life (OHRQoL) of individuals with and without type 2 diabetes mellitus (T2D) and to identify factors associated with low OHRQoL among individuals with T2D. Additionally, the study sought to validate the ultra-short version of the Oral Health Impact Profile (OHIP-5) for Brazilian Portuguese. Methods: A cross-sectional study was conducted with dentate adults (>35 years) with and without T2D. Blood and salivary flow at rest samples were collected, and a complete periodontal examination performed. Sociodemographic data and the OHIP-5 questionnaires were administered. Comparisons between individuals with and without T2D were made using chi-square or Fisher's exact tests for nominal and categorical variables and the Mann-Whitney test for continuous variables, following the Shapiro-Wilk normality test. To identify factors associated with OHRQoL in individuals with T2D, simple linear regressions were performed for each independent variable, and multiple linear regression was conducted by including variables with p < 0.20 in the simple linear regression. For the validation of OHIP-5, Exploratory Structural Equation Modeling (ESEM) with Maximum Likelihood (ML) estimation was used. Model fit quality was assessed by the Comparative Fit Index (CFI), the Root Mean Square Error of Approximation (RMSEA), and the Standardized Root Mean Square Residual (SRMR). The significance level adopted was 5%. Statistical analyses were performed using SPSS software, version 26.0. Results: The study included 168 individuals, 87 with T2D (mean age 54.62 ± 10.51 years) and 75 without T2D (mean age 52.68 ± 10.68 years) (p = 0.169). A statistically significant difference was found between groups in the number of remaining teeth (with T2D = 20.62 ± 6.78 and without T2D = 22.5 ± 6.66, p = 0.032), number of medications (polypharmacy) (with T2D = 4.34 ± 2.74 and without T2D = 1.03 ± 1.42, p < 0.0001); OHIP-5 Sum (with T2D = 6.46 ± 4.83 and without T2D = 4.63 ± 4.06, p = 0.012), OHIP-5 mean (with T2D = 1.29 ± 0.97 and without T2D = 0.92 ± 0.81, p = 0.012) and OHIP5 discomfort (with T2D = 1.78 ± 1.63 and without T2D= 1.15 ± 1.36, p = 0.019). The multiple linear regression conducted to predict Quality of Life (OHIP Sum) included the variables "Sex," "Age," "Stopped taking care of Oral Health due to cost," "Prosthesis Use," "Diabetes Duration," "Number of teeth," "Fasting Glucose," "C-reactive Protein," "BMI," and "Periodontitis." The multiple regression model resulted in Z(10, 83) = 5.225, p < 0.0005, R² = 0.39, adjusted R² = 0.31. The OHIP-5 instrument validation test showed better psychometric properties for the group with T2D (CFI = 1.0; RMSEA < 0.0001; SRMR = 0.15) than for the group without T2D (CFI = 0.972; RMSEA = 0.074; SRMR = 0.056). Conclusions: OHIP-5 showed adequate psychometric properties for assessing OHRQoL among individuals with T2D. Individuals with T2DM had worse OHRQoL compared to those without T2DM. Factors associated with low OHRQoL among individuals with T2DM were diabetes duration, number of remaining teeth, BMI, and periodontitis.

“Objective: To evaluate the properties of water diffusion kinetics: sorption (SO), solubility (SL), and diffusion coefficient (CD); color stability; and microhardness of different polymeric materials used for conventional and printed temporary crowns. Materials and Methods: Printed resins (Prizma Bioprov, Makertech Labs), self-polymerizing acrylic resin (Dencôr, Classico), and bis-acrylic resin (Protemp 4, 3M ESPE) were utilized. For SO, SL, and CD testing, disc-shaped specimens (15 mm x 1 mm) were divided (n=5) into groups: printing resin (PR), self-polymerizing acrylic resin (AR), and bis-acrylic resin (BR). Testing was conducted according to ISO 4049:2009. The CD value in water (%) was calculated by summing sorption and solubility. For color stability testing, specimens of each material, in disc format (15x1mm), were immersed in distilled water (n=30), red wine (n=30), and coffee (n=30) for 7, 14, and 21 days. Subsequently, they were evaluated with the Easyshade® spectrophotometer (VITA). For Vickers microhardness testing, 5 specimens from each group (PR, AR, and BR) were assessed using a microhardness tester with three indentations at distinct locations; the obtained values were then combined to obtain the mean. The collected data underwent analysis of variance (ANOVA-1 criterion) for superficial microhardness, sorption, solubility, and diffusion coefficient tests. Two-way ANOVA with repeated measures was employed for color stability testing, considering each resin type, and Tukey's post-hoc test (p<0.05). Results: No statistically significant differences were found for microhardness (p=0.106) and solubility (p=0.932) tests concerning resin types. Both sorption and diffusion coefficient showed statistical differences (p<0.001) among the analyzed materials. Regarding color stability, there were statistical differences (p>0.001) in the interaction between immersion types and time in AR, BR, and PR. Additionally, there was a significant statistical difference in resin type and immersion time (p<0.002). AR exhibited color differences in wine and coffee immersions at 14 and 21 days compared to 7 days. BR showed color alteration with statistical differences when immersed in wine during the first 7 days, with a statistically significant increase over coffee immersion periods. For PR, the highest color change values occurred at 14 and 21 days. Conclusion: The three tested polymeric materials exhibit similar microhardness and solubility. The printing resin showed more significant color changes over time in red wine and coffee immersion and higher sorption and diffusion coefficients compared to self-polymerizing acrylic and bis-acrylic resins. Water diffusion kinetics may vary depending on the resin composition, which can be relevant for its long-term durability and clinical performance.”

Sodium Hypochlorite is the most common auxiliary chemical substance used in root canal treatment that also affect the resin bond strength to dentin. Reverting this process is possible by antioxidizing agents such as Ascorbic Acid and Sodium Thiosulfate. The present study evaluated UNIVERSIDADE DE BRASÍLIA Secretaria de Pós-Graduação da Faculdade de Ciências da Saúde Programa de Pós-Graduação em Odontologia (*) Observação 1: preenchimento obrigatório para todos os examinadores internos/externos com e sem vínculo com a FUB. after 90 days the bond strength of self-adhesive resin cement in fiber post luting after irrigation of root dentin by Sodium Thiosulphate and Ascorbic Acid. A total of 92 bovine incisor roots were divided into 4 groups with different irrigation protocol. G1: irrigation with saline solution; G2: irrigation with 5% NaOCL; G3: irrigation with 5% NaOCL and 10% Ascorbic Acid; G4: irrigation with 5% NaOCL and 5% Sodium Thiosulfate. After cementing the fiberglass posts, a pull-out test was performed. The data obtained were submitted to statistical analysis using ANOVA and Post Hoc tests with a significance level of 0.05. Statistical analysis of data revealed no significant differences between Ascorbic Acid group and Sodium Thiosulfate (p > .05). After 90 days, the use of ascorbic acid or sodium thiosulfate and sodium hypochlorite solutions prior to cementing the fiberglass post has shown not to affect the adhesive strength.

In the attempt to delay the carious process through a bioactive restorative material, the search for the addition of substances promoting antibacterial action has become increasingly common. Anacardic acid (LDT) is a polyphenol derived from a natural extract of cashew nut shells that has a promising effect on antimicrobial control and dentin biomodification. The aim of this study is to assess the mechanical properties of an experimental glass ionomer cement (GIC) with the addition of anacardic acid (LDT). Four groups were formed with different LDT concentrations: 0% group (control), 0.5% group, 1% group, and 2% group. The following mechanical tests will be conducted: sorption and solubility in aqueous medium, setting time, and surface roughness. The addition of LDT in different concentrations did not alter the mechanical properties of the experimental glass ionomer cements.

“Bone repair and regeneration are complex and continuous processes throughout life. However, there are acquired clinical conditions in which the bone repair process is compromised. Bone morphology and constitution are altered after the use of medications (anti-resorptives and antiangiogenics) or ionizing radiation, essential for the treatment of certain pathologies such as cancer. Adjunct therapies (hyperbaric oxygen and ozone) that promote the restoration of normal morphology and tissue function and reduce potential damage to the natural bone repair process are interesting in various clinical situations. In light of the above, the present study aims to evaluate the effect of hyperbaric oxygen and ozone on bone repair after the use of zoledronic acid in rats.”

Occlusal appliances are recommended for controlling Temporomandibular Disorders and managing bruxism. Due to their exposure to intense occlusal forces, they can suffer wear and/or fractures in their structure, generating the need for repair. Therefore, the objective of the present study was to evaluate and compare the adhesive interface of three repair materials in impression resin for occlusal appliances after different surface treatments. The adhesive interface was evaluated by the shear test carried out in a universal testing machine with a 5 KN load cell at a crosshead speed of 0.5 mm/min. One hundred resin discs (18x3mm) were made out of printing resin for occlusal appliances with repairs (RODs) in three resins (n= 267) [Group R: R1: flow; R2: bisacrylic; and R3: self-polymerizable], that were subjected in different types of surface treatment [TS Group: TS1: water SiC paper (CONTROL); TS2: SiC paper + alcohol; TS3: SiC paper + silane; TS4: SiC paper + aluminum oxide sandblasting and TS5: SiC paper + aluminum oxide sandblasting + silane]. The blocks were stored in distilled water for 24 hours at 37°C before the test. The bond strength (MPa) dataset was subjected to a two-factor Analysis of Variance (ANOVA) (surface treatment and repair material) followed by the Tukey test, with a significance level of 5%. The factors of surface treatment, repair material, and the interaction between the main factors showed statistically significant differences (p<0.001). In the control group, no statistically significant difference was found between the different repair materials evaluated. However, when considering surface treatments with SiC paper + alcohol, as well as SiC paper + sandblasting, flow resin (p<0.001) stood out as the superior choice for repair purposes. Furthermore, in the SiC paper + silane and SiC paper + sandblasting + silane groups, more favorable results were observed, especially when it was decided to use bisacrylic resin or flow resin as repair materials (p <0.001). An improvement in bond strength to the shear test was observed in repairs carried out with bisacrylic resin and flow, especially when subjected to associated mechanical (aluminum oxide sandblasting) and chemical (silanization) surface treatments. Within the limitations of this in vitro study, it is suggested that this protocol is the most recommended.

“Introduction: Introduction: Artificial intelligence (AI) tools are increasingly being used in dentistry, with the potential to revolutionize clinical practice. Currently, convolutional neural networks (CNNs) are widely used as computer vision algorithms for detecting and classifying diseases in images, such as computed tomography and panoramic radiography. They have also been applied to segment structures in these images and in predictive models. Recently, however, transformer networks, which are widely used in natural language processing, have also been applied to image analysis tasks, with the potential to outperform CNNs. Objective: The aim of this scoping review is to assess the application of the Transformer neural network for diagnosing dental and maxillofacial abnormalities in the most used dental imaging exams. Methodology: A search was conducted in the LILACS, Embase, PubMed/MEDLINE, SCOPUS, Web of Science, and IEEE Xplore databases. Additional research was also conducted in the grey literature, including Google Scholar and Proquest Dissertation & These. The search terms included free terms, (MeSH) descriptors, as well as controlled terms available in the Health Sciences Descriptors (DeCS). The Mendeley and Rayyan applications were used to select and manage the references. The Mendeley and Rayyan applications were used to select and manage the references. The inclusion criteria were: examinations of patients with hard tissue alterations in the jaws and face, studies that used Neural Network Transformer for Diagnosis, and studies that dealt with diagnostic imaging in Dentistry. Clinical trials, observational studies, and systematic reviews were eligible for the study. Results: A total of 5,182 studies were found, and 11 studies were included. Five studies used Panoramic Radiography (PR), four studies used Computed Tomography, two studies used Periapical Radiography, and one study used RP and Bitewing. All studies used Transformer, using Swin Transformer, U-net, VSP Transformer, SWin Unet, FlowgateUnet, Vision Transformer, CTA U-net and M-TransNet. The reference standard included expert evaluation through manual annotation. The total number of the dataset was 39,221, and it was not possible to quantify the total data used for testing, training and validation due to the lack of information in some studies. The studies confirmed, through the results of the metrics used, that the use of the neural network discussed here was favorable in its different applications. Conclusion: The use of the Transformer neural network is a tool with excellent results for application in diagnosis through imaging exams in Dentistry. Its applications are variable, and it can be used not only in the segmentation of teeth, but also to facilitate the identification of important lesions in the hard tissues of the jaws and face, becoming a facilitator in the diagnostic area of dental radiology.”

“The sense of coherence (SOC) can be considered a personal and subjective way of interpreting and dealing with everyday events. According to this concept, the greater an individual's SOC, the greater their ability to adapt to the environment and, consequently, the greater the chances of them adopting appropriate and positive health behaviors. Aaron Antonovsky, the author of the concept, covers three dimensions for assessing SOC: comprehensibility, manageability and meaningfulness. As well as contributing to psycho-emotional balance, a higher SOC can have a significant impact on the general and oral health of adults and children. The aim of this study was to demonstrate a possible association between maternal sense of coherence and caries experience in children. A crosssectional observational study was carried out with 4-year-old children belonging to a birth cohort at the University Hospital of Brasilia (HUB). The independent variable “sense of coherence” was measured using a 13-item questionnaire of the same name, while the dependent variable “caries experience” was measured using the Caries Assessment Spectrum and Treatment (CAST) instrument. In order to control for confounding bias, variables such as the child's age and gender, socioeconomic status, presence of visible plaque and gingival bleeding, daily brushing frequency, use of fluoridated toothpaste, access to fluoridated water supplies, daily sugar intake and exclusive breastfeeding for up to 6 months were considered in the study. Descriptive statistics and adjusted and unadjusted negative binomial regression models were used to analyze the relationship between the variables. Based on an initial group of 969 children recruited for the birth cohort, and meeting the eligibility criteria, a total of 254 children formed the final sample of this study. Among them, the prevalence of caries was 49.2% (125). SOC, in turn, was significantly associated with socioeconomic status, with the lower classes having a higher SOC (p=0.03), but there was no significant association with the presence of caries (p=0.45), nor with the number of decayed primary teeth (p=0.55). Through negative binomial regression analysis, SOC was a negative predictor, but was not associated with the number of decayed teeth per child (β -0.01; RTI 0.98; 95% CI 0.95-1.02; p=0.55), however it was possible to identify that children with gingival bleeding have 1.94 times more decayed teeth than children who did not have gingival bleeding (95% CI 1.01-3.71; p=0.04). We conclude that SOC is not associated with caries experience in 4-year-old children.”

“Temporary restorations are used to maintain aesthetics and function during the fabrication of indirect restorations. They are subject to the masticatory stresses of the oral cavity and can suffer fractures, wear, and other conditions that necessitate repair. Therefore, the objective of this work was to evaluate the Shearbond Strength (SBS) of four materials used in repairs of temporary crowns produced by 3D printing, immediately and after thermocycling. The adhesive interface was evaluated by a shear test performed on a universal testing machine, with a 5 KN load cell, at a speed of 0.5 mm/min. Sixteen cylindrical discs were made from 3D printing resin for temporary crowns (18 x 3 mm), with repairs (RODs) performed using four different resins (n=8/each time): AutoPolymerizing Acrylic Resin (GA), Bis-Acrylic Resin (GB), Flow Resin (GFF), and Flow Resin (GFS), evaluated after 24 hours (T0) or after 10,000 thermocycling cycles (T1). Before the repair, the surfaces of the printed resins were polished. The blocks were stored in distilled water for 24 hours at 37°C or subjected to thermocycling testing prior to the shear test. The type of adhesive failure was evaluated. The shearbond strength data (MPa) were subjected to two-way Analysis of Variance (ANOVA) (repair material and time), followed by Tukey's test (p<0.05). There was an interaction between the factors evaluated (p<0.001). At T0 and T1, the GFS group showed the highest SBS values with a statistically significant difference compared to the other groups (GFF, GB, and GA), which differed from each other (p<0.05). SBS values decreased after thermocycling for each material (p<0.05) except for GA (p>0.05). Among the limitations of this study, it was observed that the type of repair material and time influenced the SBS values. Flow Resin (GFS) may be the most suitable material for repairing temporary crowns made from the evaluated 3D printing resin.

“Introduction: Nutrition plays a crucial role in systemic and oral health, potentially affecting individuals' nutritional status and triggering a range of diseases, including some oral conditions. Loss of taste can be a characteristic of aging, leading to changes in food intake. Such changes can increase the risk of diet-related disorders, resulting in systemic issues, such as a higher likelihood of developing chronic non-communicable diseases, and oral issues, such as root caries in the elderly. Objective: To assess how different oral and systemic conditions related to Diabetes Mellitus influence macronutrient consumption in adults and the elderly. Methods: Two studies were conducted: a systematic review and a cross-sectional study. The systematic review was conducted according to PRISMA guidelines, with searches performed in four databases as well as in grey literature. Methodological quality was assessed using the Joana Briggs Institute tools for observational studies. A meta-analysis was performed. The cross-sectional study included 170 patients aged ≤ 35 years, attended at the University Hospital of Brasília from March 2023 to December 2023. Results: Eighteen observational studies were included, representing a total of 2,728 individuals, with 1,680 adults aged 18-59 years and 1,048 elderly individuals aged ≤ 60 years. The elderly showed a loss of taste perception compared to adults, with differences noted in the metaanalysis for sweet, salty, and umami flavors. The cross-sectional study observed that oral health status can affect macronutrient consumption. Conclusion: Changes in food intake may be influenced by taste perception and existing oral conditions. An altered diet, such as inadequate macronutrient consumption, can contribute to the emergence or worsening of oral problems.”

“Dental caries is a Non-Communicable Chronic Disease (NCD) that, although preventable and controllable, can have significant consequences in early childhood, affecting the quality of life of children and their caregivers, as well as generating an economic impact, such as an increase in spontaneous demand consultations. This observational study aims to analyze the procedures related to cariology and the care modalities in Primary Health Care (PHC) for children aged 0 to 5 years in Brazilian municipalities. Additionally, the study proposes to evaluate the adherence of schools to the Health in School Program (PSE) in different municipalities across the country, considering the importance of this program in promoting and preventing oral health, as well as in the execution of oral health procedures in PHC. Data collection was conducted through the Primary Health Care Information System (SISAB), established by Ordinance GM/MS No. 1,412, of July 10, 2013, replacing the Primary Health Care Information System (SIAB). Statistical analyses were conducted to assess the correlations between the studied variables, aiming to identify patterns and factors associated with PSE adherence, the dental procedures performed, and the care modality in oral health for children aged 0 to 5 years, within the PHC context. The results of this study have the potential to contribute to the improvement of public oral health policies, especially regarding the prevention and treatment of dental caries in early childhood."

“Endodontic treatment consists of several fundamental steps, ranging from cleaning and shaping the root canal system to the final obturation phase, steps that are crucial for the long-term success of the treatment. In addition to adequate sealing properties, the root canal filling material must stimulate or induce the repair of the remaining tissues in the root canal systems. In this context, root canal filling cements have evolved in their composition over time, where bioceramic cements have emerged as a significant innovation in stimulating mineralization and osteogenesis. The literature demonstrates a positive interaction of this type of material with the surrounding tissues, contributing to bone repair and regeneration, which is extremely important especially in the treatment of cases diagnosed with necrosis and apical lesion. AH Plus Bioceramic (AHP-BIO) is a bioceramic cement composed mainly of zirconia dioxide and tricalcium silicate that emerged as an improvement of its original formulation, associating the good properties that AH Plus presented with the bioactivity of a bioceramic cement. This cement has in its formulation a low proportion of calcium silicates and the presence of dimethyl sulfoxide and traces of lithium carbonate, changes that can impact its effect. Thus, this study aimed to investigate the biological effect of AHP-BIO, a relatively new material in endodontics. The work was structured in three chapters. The first chapter carried out a review of the literature on bioceramic cements, highlighting their characteristics, composition and advantages for endodontic treatment. The second chapter evaluated the chemical properties of AHP-BIO, revealing its capacity to release calcium ions and maintain an alkaline pH, factors associated with the biocompatibility and mineralizing potential of the material. In the third chapter, the impact of AHPBIO on osteoclastogenesis in RAW 264.7 cell cultures was studied. The results indicated that AHPBIO increased the expression of the TRAP and CATEPSIN genes, involved in the bone resorption process, and inhibited the Wnt pathway with low expression of the c-Myc and MMP-7 proteins. In addition, an increase in the number of multinucleated osteoclasts was observed, suggesting that AHP-BIO stimulates osteoclastic activity. The findings demonstrate the potential of AHP-BIO as an endodontic material, but caution should be exercised in cases requiring osteoclastogenesis control. This study thus contributes to the careful clinical selection of bioceramic cements based on scientific evidence of their properties and biological effects.”

“The success of endodontic treatments has shown a trend of stagnation over time, with little variation in outcomes, both in non-surgical and surgical cases. Complex challenges, such as the intricate anatomy of root canals and obstructions within the canals, contribute to persistent failures due to difficulty accessing necrotic contents and microbial contamination. Conventional endodontic treatment demands time and skill from the professional, as well as causing greater stress to the patient, wear on dental structures, and less precision compared to guided techniques. These limitations negatively impact dental resilience and can compromise the long-term prognosis of the tooth, as well as future success rates of endodontic treatments. Advanced technologies have demonstrated satisfactory results in complex treatments, such as computer-guided techniques. The aim of this doctoral thesis is to explore guided endodontics in four distinct chapters. The first chapter conducts a comprehensive literature review, entitled "The State of the Art of Guided Endodontics," addressing recent advances in guided techniques in endodontics and their technological implications, including the role of artificial intelligence and robotics in endodontic treatment. Emerging techniques are analyzed, providing a broad view of the current landscape, their clinical applications, and potential benefits. The second chapter presents an innovative case study, "Guided Endodontic Treatment in a Restricted Oral Access Region," describing the treatment of a mandibular molar with dystrophic calcification in the mesial root canals. CAD-CAM strategies and the creation of endodontic guides allowed for a safer and quicker approach. Chapters 3 and 4 discuss the thesis conclusions and their clinical relevance in overcoming challenges in complex treatments, also presenting the Press Release. By bringing together these chapters, this thesis offers a comprehensive analysis of the current state of guided endodontics and its potential to advance clinical practice, contributing to enhancing understanding of this area in its early stages of development.”

“In Brazil and around the world, the use of firearms represents the leading cause of violent deaths. Therefore, to investigate these deaths, it is crucial to understand the entire dynamic related to how the crime occurred. However, in many cases, forensic teams, both at the crime scene and during the autopsy, are unable to recover elements sufficient for more robust conclusions, leaving only the traces on the victim to be observed and analyzed. Furthermore, to correctly classify the criminal offense, it is necessary for the analyses performed by the experts to indicate the circumstances under which the shots were fired, such as which wounds correspond to entries and exits and their distances from the victims. With the aim of contributing to these analyses, a study was developed, resulting in an article. In this article, 59 neural convolutional networks for image classification were trained to differentiate between entry and exit wounds and determine the shooting distances through photographs and documents of fatal victim cases examined by the expert teams of the Civil Police of the Federal District between 2012 and 2022. A comprehensive database was constructed with 2,551 images, including 1,883 entry wounds and 668 exit wounds. The ResNet152 architecture demonstrated superior performance in both entry and exit wound classification and medico-legal shooting distance categorization. For the first, it achieved accuracy, recall, F1-score, and specificity of up to 86.90% and an AUC of 82.09%. For the medico-legal shooting distance classification, the ResNet152 showed an accuracy of up to 92.48%, although sample imbalance affected other metrics such as recall and F1- score. Our findings highlight the challenges of standardizing wound images due to varying capture conditions but reflect the practical realities of forensic work. This research underscores the significant potential of deep learning in enhancing forensic medicine practices, advocating for artificial intelligence as a supportive tool to complement human expertise in forensic investigations”

“Dental trauma refers to injuries affecting teeth and their supporting structures, often resulting from falls, collisions, or accidents. These injuries can cause damage and sequelae in both primary and permanent dentition and are of increasing interest due to their high prevalence in epidemiological surveys, which justifies investments in prevention and improvements in restorative techniques. The etiology, age group, gender, and most affected teeth are well-established factors, though individual characteristics vary depending on the study location. The severity of trauma seems to be associated with the patient's age, type of tooth, extent of the injury, and stage of development. Understanding the consequences of trauma is essential for accurate diagnosis and treatment, which are often performed urgently. Epidemiological studies enable the planning of preventive actions that reduce the prevalence of such traumas. In cases of enamel and dentin fractures without pulp involvement, the focus of this study, dental fragment reattachment is a conservative treatment approach, with its efficacy influenced by prior hydration of the fragment and the choice of intermediate material. This study aims to evaluate, through a cross-sectional study, the epidemiological profile of patients treated by the Dental Trauma Extension Project of the University of Brasília between 2011 and 2024, to monitor the treatment of coronal fractures by comparing fragment reattachment and composite resin restorations, and to develop a health education tool on the subject.”

“ Oral complications triggered by metabolic alteration caused by Diabetes Mellitus well documented in the literature, with hyposalivation being an aggravating and limiting factor for the reestablishment of the balance in health of individuals with the disease. In this context, the diagnosis and definition of adequate and predictable treatment should be conducted by the dental professionals involved in the care of this population, taking into account consideration of physiological, drug and acceptance limitations of treatment by individuals patients with Diabetes Mellitos. Physical stimulation of salivary flow with low-intensity laser and stimulation transcutaneous neural electric (TENS) is shown to be an excellent alternative to treatment, as they have few limited collagen effects and contraindications, good acceptance of low cost and easy replication of the technique. However, there are no clinical trials yet definition of validated clinical protocols. Thus, the objective of the work was to perform a detailed analysis of the entire training process salivary, its functions and stimulation methods, with emphasis on the physical stimulus by its advantages already described."

"coronavirus, popularly known as COVID-19, has created a challenging global crisis in health systems. Most cases are asymptomatic or trigger mild symptoms, such as a mild flu, but more severe responses can develop, such as fulminant pneumonia. During the COVID-19 pandemic, the severe health complications caused by SARS-CoV-2 increases the length of stay in the Intensive Care Unit (ICU), and increases the type and number of manifestations already found in the hospital environment. Many oral symptoms related to COVID-19 have already been described in the literature, however, there is a shortage of oral signs triggered by this infection. The objective of this Systematic Review is to assess the prevalence of oral cavity lesions in adult patients diagnosed with COVID-19 hospitalized at the infirmary or ICU. Methodology: A search was carried out in PUBMED/Medline, Embase, LILACS, Web of Science, Scopus, Livivo, Google Scholar, Open Gray and Proquest, in addition to a manual search of the reference list of included studies. For the research of studies, a combination of descriptors and free terms for “coronavirus”, “oral manifestations” and “hospitalized patients” were used. For selection and management of references, EndNoteBasic® and Rayyan applications were used. Studies published between 2020 and 2022 (period corresponding to the pandemic) were selected, which obligatorily included adult patients, over 18 years old, diagnosed with COVID-19, admitted to the infirmary or ICU, who had oral lesions. The methodological quality was analyzed using the tools in the Joana Briggs Institute (JBI) manual. The extracted data were organized in tables, and a rigorous narrative synthesis was carried out. Results: A total of 3,952 studies were found, leaving 79 for full reading, and 24 studies were included, namely: six case reports, four case series, three cohort studies, ten cross-sectional studies and one case control, developed in ten countries, being a single study without reporting the country of performance. In most studies, the type of test used for the diagnosis of COVID-19 was reported, as well as the type of ventilation used by the patient during hospitalization. All 24 studies reported the location and types of lesions, thus the decreasing prevalence of the types of lesions are candidiasis (11.42%), followed by nonspecific ulcerated lesions (9.5%), nonspecific oral bleeding (4.30%) and viral lesions (2.70%). The location of the lesions is described as lips, tongue, palate and gums. Conclusion: Patients hospitalized in a hospital environment develop lesions in the oral cavity, as well as patients diagnosed with COVID-19, with fungal lesions being the most prevalent both in hospital patients and in patients diagnosed with COVID-19. However, a high level of heterogeneity in the studies and applied methodologies, as well as the lack of standardization of the location and types of injuries, limited the comparison of results and outcomes. Thus, there is a need for more standardized studies, which therefore allow comparative analysis."

"Introduction:Brazilian Dentistry is recognized as the largest in the world in terms of number of professionals. To reach this level, dentistry courses were opened for the conception of new dentists, reaching around 20% of the world's share. Together, Permanent HealthEducation was developed with the aim of qualifying SUS health professionals, in this context the Open University of SUS (UNA-SUS) emerges as a promoter of distance education courses for the qualification of SUS professionals.
Objectives:The objective of this work is to study the trend towards an increase in the number of dentistry professionals caused by the increase in the number of courses offered for this profession (1980 to 2019), and the increase in registrations at UNA-SUS by Dental Surgeons (2010 to2019), and draw a predictive scenario of these variables for the year 2025 at national and regional level. Methodology:A Time Series (ST) study was carried out with data from the CFO, e-MEC and the Monitoring Panel of the Open University of SUS. The forecast for the coming years was performed using the GAM model for predicting records in the CFO and new courses in dentistry, and the Holt-Winters method for predicting records in the UNA-SUS. The Simple Linear Regression model was used to investigate trends, given the relationship between the number of records and the number of dentistry courses, and the number of records in the CFO given the number of admissions to the UNA-SUS, using the p-value for hypothesis testing. The analyzes were carried out in 6 scenarios, the first being at the national level and the other 5 by region.Results:In 1980 there were 66 dentistry courses in Brazil. From 1980 to 2019, 427 dentistry courses were opened, with the greatest increase in the Southeast and Northeast regions, with 31.14% (n=133) and 29.03% (n=124). It is estimated, for 2025, that in the southeast region there will be 18,318 (95%CI 15,509-21,126) new DCs, followed by the northeast region with 8,179 (95%CI, 7,374-8,984). In Brazil, from 2013 to 2019, each dentistrycourse was responsible for training 165 dentists (p<0.001, R2 96%) annually, with a higher incidence in the southeast region with 252 dentists (p<0.001, R2 88%). In all regions the H0 were rejected. In this period of 2010-2019, there were 59,790 admissions, by CDs, in search of professional qualification in the UNA-SUS system. It is estimated that there will be 22,649 (95%CI 3,621-41,677) new registrations of CDs at UNA-SUS in 2025. It was found that there is a relationship between the number of registrations at the CFO and the number of admissions at UNA-SUS (p<0.001, R2 93%). Conclusion:From the year 2000 onwards, most STs leave the sideways trend state, that is, without real growth for growth in an uptrend, while from 2015 they reach an upward trend with no resistance or signs of laterality. None of the observed time series shows a stabilization or downward trend for the next few years, so that a high upward trend was seen for all scenarios."

“The aim of this analytical observational cross-sectional study was to investigate the determinants of oral hygiene in schoolchildren aged 6 to 9 years old in two socioeconomically vulnerable areas of the Federal District. As a baseline for a research on the implementation of long-term interventions to improve the quality of life of children. Two questionnaires were applied to the parents, one referring to habits, mental and physical health, and the impact of health on routine household chores and the other regarding demographic information and socioeconomic conditions of the family. To evaluate body weight, anthropometric measurements were used.    Data were collected and analyzed using descriptive statistics (from univariate and multivariate frequency tables), chi-square test and Poisson regression model. All analyzes were performed considering the significance level of 5%. Of the 474 children responding to the questionnaires, 36.1% were 8 years old, 53.8% were boys, 85.2% had a per capita income of less than one minimum wage, 53.4% of the mothers had completed high school and 78.3 % of children were underweight. 79.7% of the children brushed their teeth twice a day or more and 78.1% of the children had visible biofilm. Per capita income (p=0.031) and visible biofilm (p=0.008) were statistically different when associated with brushing frequency. The other determinants did not show statistical difference, despite the univariate and multivariate analysis showing that older children, boys, mothers with less education and underweight children tend to brush their teeth less frequently. It is concluded that for this population sample, the determinant per capita income influences the frequency of brushing and that the frequency of brushing influences the visible biofilm.”

“ The objectives of the present study were: 1) to carry out a systematic review (SR) to assess the knowledge, attitudes, and practices (KAP) of dentists regarding Minimal Intervention Dentistry (MID); 2) to develop a questionnaire based on previous studies, measure its psychometric properties and evaluate the knowledge, skills, attitudes, and barriers of dentists in the Federal District (FD), regarding MID. 1) Cross-sectional studies that analyzed KAP results on MID main principles were included. Searches were conducted in January 2022. Two independent reviewers selected the included studies. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A proportion meta-analysis was performed. Cochran's Q test was used to assess heterogeneity and I2 statistics. Of the 2079 identified studies, twelve were included. The combined proportion of knowledge about MID was 75.66% and attitudes and practice was 47.95%. Findings suggest that dentists' knowledge of MID topics is acceptable, and attitudes and practices need improvement. Studies lack uniformity in methods and there is still a need for further studies to elucidate the KAP of dentists. 2) The questionnaire prepared was analyzed by a team of Brazilian experts on the subject. Two focus groups and a pre-test were carried out to check the wording, sequence, and understanding of the questions. The Content Validity Coefficient (CVC) was calculated. The necessary adjustments have been made. After application, Exploratory Factor Analysis was performed to evaluate the factorial structure of the questionnaire. Parallel Analysis was used with a random permutation of the data. A CVC greater than 0.80 was obtained for all items in the questionnaire. The parallel analysis suggested that the questionnaire items are divided into four factors. The factor loadings of the items were adequate in their respective factors. The questionnaire was sent via social media to dentists. Data were consolidated in an Excel® spreadsheet and presented with descriptive statistics. Logistic regression was performed. The significance level adopted was 5% (p<0.05). A sample of 404 participants was obtained. Most respondents, 74% (n=299), were female and had an average experience of 12 years. The best score was obtained in practice regarding guidance on daily toothbrushing with fluoride toothpaste, in which 95.6% (n=386) reported performing it; the worst was the question about knowledge on minimally invasive restorations, with 38.6% (n=156). Regarding the barriers to updating, the following items were identified as having “some difficulty”: “time and organization to update knowledge” (n=143; 35.4%), "appreciation of patients in paying for minimal intervention procedures (MI)” (n=109; 26.9%) and “adequate remuneration for MI procedures” with (n=116; 28.7%). This study showed an overall proportion of knowledge, skills, and attitudes of professionals adequate. It is concluded that the dentists have adequate competencies in MID and some barriers still need to be faced to improve the updating and practice of Minimal Intervention Dentistry.”

“Among the problems related to sleep and lifestyle, we can mention bruxism and gastroesophageal reflux disorder, which have associations and can occur in the same individual. Gastric acid has an extremely low pH and a high potential for corrosive damage. When in the oral cavity, it can affect teeth and dental materials, such as resins of occlusal splints, which are a reversible, atraumatic and conservative treatment of temporomandibular disorders, in addition to protect the dentition in episodes of sleep bruxism. These devices can be made of different materials, both by analogical and digital flow. Knowledge of how resins for occlusal splints behave when subjected to extremely acidic pH, such as that from hydrochloric acid, is still scarce and can help dentists in the selection of these materials in patients diagnosed with gastroesophageal reflux disorder. associated with other pathologies that require an occlusal splint approach. The objective of this work was to analyze the erosive effect of hydrochloric acid on the surface of resinous materials used for making occlusal splints. The evaluated materials were divided into 6 groups: self-curing resin, microwave thermosetting resin, hot water bath thermosetting resin, SmartDent impression resin, Makertech impression resin and milled resin. All samples were evaluated at three times: T0 - after manufacturing; T1 – after 45 hours of erosive challenge (HCL pH=2); T2 – after 91 hours of erosive challenge (HCL pH=2). The groups were evaluated for surface roughness, Vickers microhardness, flexural strength and modulus of elasticity. The data obtained were submitted to the two-way repeated measures ANOVA test for surface roughness and microhardness and two-way ANOVA for flexural strength and elastic modulus, followed by the Tukey Test with a significance level of 5%. For surface microhardness, only the hot water thermopolymerizable group showed an increase in initial values after the erosive challenge, demonstrating higher values when compared to the other groups. For surface roughness, only the Makertech printed group showed an increase. The milled group showed no differences and the other materials tested decreased their surface roughness. For flexural strength, the microwave energy thermopolymerizable resin and milled resin groups decreased their values. The other groups did not show statistical difference at the end of immersion in HCL. For the modulus of elasticity, the resins: self-curing, thermo-curing by microwave energy and milled decreased their values, while the thermo-curing resins by hot water bath and printing did not show statistical difference at the end of the erosive challenge. A divergence was observed between the results obtained in the different tests and with the different groups tested. We conclude that among analogue materials, hot water thermopolymerizable acrylic resin stands out when subjected to erosive challenge. Among the digital materials, the milled group showed more interesting mechanical properties.”

This systematic review aimed to evaluate the efficacy of type A botulinum toxin (BTX-A) treatment for the correction or attenuation of facial asymmetries resulting from facial paralysis. The protocol for this study was registered in PROSPERO (CRD42022335626). The development followed the guidelines for systematic reviews (PRISMA 2020). Seven electronic databases and grey literature were searched, along with the reference lists of included articles. The inclusion criteria comprised randomized controlled trials, non-randomized intervention studies, and case series with a minimum of 10 patients, comparing the effects of botulinum toxin use for the treatment of facial asymmetry due to facial paralysis with other therapies involving botulinum toxin or no therapy. After removing duplicate articles, 1340 articles remained, which were read in two phases resulting in the following 18 articles included in this review: six pre- and post-studies, three prospective cohorts, three retrospective cohorts, five randomized controlled trials, and one case series. The methodological quality of the articles was assessed using the Joanna Briggs Institute Critical Appraisal Tools. In all studies included in this review, there was an improvement in facial paralysis symptoms after the use of BTX-A. However, most studies had small sample sizes, limiting the generalizability of the results to a larger population. Furthermore, there were variations in dosage, type of BTX-A used, number of injections, and dose per injection point, which precluded the comparison between studies and to perform a meta-analysis. Based on the studies included in this systematic review, it can be concluded that the use of type A botulinum toxin may be effective in attenuating or correcting facial asymmetry caused by facial paralysis.

"The use of fiberglass posts can be indicated in large losses of tooth structure, in endodontically treated teeth. The adhesion of the post to the root canal can be altered with the irrigating solution prior to the cementation of these retainers, and the use of oxidizing agents prior to this stage has shown good results regarding this process. The present study aimed to evaluate the bond strength of fiberglass posts, through the pull-out test, after the use of Sodium Thiosulfate and Ascorbic Acid to reverse the deproteinization of the dentin. 92 endodontically treated single-rooted bovine teeth were used for this study, divided into four groups with different irrigation protocols, and after cementing the fiberglass posts and performing the pullout resistance test. The data obtained were submitted to statistical analysis, using the KruskalWallis test with a significance level of 0.05, showing a statistically significant difference between the four tested groups, with a higher mean adhesive strength in the group irrigated with 10% Ascorbic Acid after deproteinization with 5% NaOCL. The use of antioxidant agents prior to cementation of fiberglass posts can contribute to the reversal of deproteinization of dentin, and consequently improve bond strength."

"Bis-acrylic resins and resins obtained through 3D printing for clinical indication of temporary restorations are commercially available. Objective: To evaluate the mechanical properties of resins intended for temporary or "semi-permanent" use, produced through additive manufacturing, and compare them to established materials used for this purpose in clinical practice, such as bis-acrylic resins and composite resins. Materials and methods: The flexural strength (σ) and microhardness of two printed resins (BP, BioProv and BC, BioCrown, Makertech), two bis-acrylic resins (LT, LuxaTemp and LC, LuxaCrown, DMG), and one conventional composite resin (Z100, Filtek Z100, 3M) were evaluated. For the σ test, 40 bars (25x2x2mm, ISO 4049, n=8) were produced using silicone molds and 3D printer (Mars3, Elegoo) with post-processing as per the manufacturer's instructions. After 24h storage (37°C), σ (three-point bending) was tested using a universal testing machine. For the microhardness test (Vickers, HV), 50 discs (Ø6mmx2mm, n=10) were produced with the same resins, polished up to #2000 sandpaper, and subjected to microhardness testing after 7 days (37°C). Results: For both tests, statistical analysis was performed using one-way ANOVA and Tukey's post hoc test, with α= 5%. The σ (MPa±SD) of Z100 (131.1±7.7) and BC (128.7±16.7) was significantly higher than the other resins; LC (97.9±10.2) had higher σ than LT (78.5±11.9) and BP (76.3±7.2). The microhardness values (VHN±SD) demonstrated that Z100 resin (109,8±8.86) was superior to the other resins; BC (26.7±2.84) exhibited higher hardness than BP (19.7±3.31), LC LC (19.5± 2,27) and LT (20.6±2.09). Conclusion: The σ of a printed resin already resembles that of a conventional restorative composite resin. The HV of bis-acrylic and printed resins, although showing notable progress, remains lower. Further studies are necessary to understand the implications of these properties in clinical reality."

"This study evaluated two mechanical properties in the different thirds of two types of fiber post (FP). For the study, 50 extracted bovine teeth were used, which were divided between tests: Vickers microhardness (n=5) and push-out bond strength (n=20). The groups were named Commercial (Exacto post – Angelus, Londrina – PR, BR) and Experimental (glass and quartz fiber post patented) for both types of tests. The statistical evaluation of normality was performed using the Shapiro Wilk test, followed by Anova two-way test for comparing the variables, with a significance level of 0.05. The result obtained indicated that there was a statistically significant difference in bond strength between the same thirds of different FP. The commercial group obtained an average value of 4.07 MPa of bond strength on the apical third, while the experimental group presented an average of 8.02 MPa. Differentially, Vickers microhardness did not show this behavior. Thus, highest bond strength values in the most distant third from the crown were obtained in specimens in which glass and quartz fiber post was used."

Every year, more than half a million patients worldwide are diagnosed with head and neck cancer and, of these cases, approximately 75% are treated with radiotherapy. This frequent radiation affects the glandular tissues in the region, leading to the appearance of xerostomia. This saliva deficiency can cause several changes such as pain, susceptibility to ulcerations, dysphagia, dysphonia, among others, which affects the quality of life of these patients, with negative impacts both emotionally and mentally. Ozone therapy has proven to be very effective in several areas of medicine, in particular due to its antioxidant characteristic that acts to reduce the oxidative process, as well as increase vascularization and the immune system. The objective of this study was to evaluate the quality of life of patients with xerostomia after head and neck radiotherapy before and after treatment with ozonated gas. The study was submitted to the Research Ethics Committee and began execution after approval. 8 patients were evaluated and the Related Quality of Life Scale (XeQoLS) questionnaire was applied, of which 6 were male and 2 were female, the average score before treatment was around 66.75 and after ozone treatment it was 32,25, all patients claimed improvement in salivation after treatment. It can be concluded that the ozonized gas was effective in improving the salivation of the patients studied, improving their quality of life.

“Osteoporosis is a skeletal disease related to the loss of bone strength that predisposes individuals to fractures from minimal trauma. Fractures associated with the disease reduce quality of life for affected individuals, increase the number of hospitalizations, and can lead to increased mortality, especially in elderly, who, along with postmenopausal women, represent the highest-risk group. Additionally, fractures caused by osteoporosis are generally asymptomatic, making this disease considered silent. Therefore, methods for screening individuals at increased risk of fractures are needed to reduce socio-economic impact of the disease. Given that cone-beam computed tomography (CBCT) is a widely used examination in elderly population, especially for implant planning, and that mandibular changes have been reported in patients with osteoporosis, it becomes necessary to investigate this examination as an auxiliary tool in diagnosis. Artificial Intelligence tools based on radiomic features have been applied in diagnosis of pathologies due to their good performance in detecting tissue alterations. However, this tool has not yet been validated for detection of osteoporosis in quantitative bone analysis of the mandible by CBCT. This study aimed to determine radiomic signature of a pathological pattern in CBCT of postmenopausal women with osteoporosis. One hundred women after menopause were retrospectively selected according to criteria, who had CBCT and dual-energy X-ray absorptiometry (DXA) examination, with and without a diagnosis of osteoporosis. After determining the region of interest in CBCT, five segmentation sites were manually selected per examination: two for mandibular cortical bone, two for mandibular trabecular bone, and one for trabecular bone of axis. From segmentations, quantitative data were extracted and compiled into programming platforms, aiming to build computational codes and select the most relevant radiomic features. Forty-nine patients were diagnosed with osteoporosis according to the DXA examination, and 51 without osteoporosis. A total of 535 radiomic features per patient were extracted, distributed in seven classes: shape, firstorder, GLCM, GLDM, GLRLM, GLSZM, and NGTDM. Radiomics is a sophisticated image analysis resource, showing unique characteristics that become variables for the construction of diagnostic, prognostic, and/or predictive models. Its workflow includes various stages, including image acquisition, segmentation and feature extraction, and reproducibility. The validation of predictive radiomic models requires reproducibility and generalization of radiomic features. Strategies should be applied for building models and processing high-dimensional data that radiomics requires, as well as standardizing analysis processes.”

Recently, Temporomandibular disfunctions and bruxism are common complaints to a large portion of population. Among the treatments, we can highlight the occlusal splints. The materials used to produce occlusal splints, such as acrylic resins or 3D printed resins, presents adequate mechanical properties to control bruxism, however, due to daily use, cracks or small chips may occur, creating the need for repairs. The aim of the present study is to evaluate the shear bond resistance of 4 repairing materials for occlusal splints produced on 3D printers: Flow resin, Selfcuring acrylic resin, Bisacrylic resin and Splint resin for 3D printers. 33 discs with 18mm diameter and 3mm thickness were produced. After polishing, regularizing the surface, and placing the repairing materials, the samples were divided in 2 groups: Group 1 and 2. On group 1, the samples were stored in 32°C distilled water for 24 hours and on Group 2 the samples were thermocycled for 10.000 cycles, alternating 5°C and 55°C water. Afterwards, the shear bond test was performed with a knife-edge load unit, with 5 KN load and 0,5 mm/min crosshead speed until specimen failure. The shear bond strength was recorded, then, converted to tensile bond strength (MPa). A two-way ANOVA (for each material and time) was used, followed by the Tukey test, with a significance level of 5%. After the tests, on group 1, the Bisacrylic resin showed better shear bond strength results (P<0.05), however, this performance did not sustain when the sample was thermocycled. On group 2, all materials, except the Bisacrylic resin, kept the shear bond strength results close to group 1 (P<0.05). The Self-curing acrylic resin displayed the best results when tested on group 1, enhancing them after thermocycling (group 2). Considering the results, we can conclude that, among the materials tested, the Self-curing acrylic resin presented better shear bond strength results and should be eligible for repairing occlusal splints manufactured on Splint resin for 3D printers.

"Introduction: The use of fixed retainers in the lower arch is frequent; however, its presence increases the accumulation of biofilm and dental calculus. Objective: The objective of this research was to evaluate, in vitro, the accumulation of Streptococcus mutans (S. mutans) in 3 designs of fixed retainers. Method: Nine models were reproduced in heat-cured acrylic resin and divided into groups: straight retainer (SR), retainer with vertical strap (RVL), retainer with horizontal strap (RHL). The accumulation of S. mutans was assessed using the MTT assay (3-4,5-dimethyl-thiazol-2-yl-2,5- diphenyltetrazolium bromide) and then measured using an automated reader. Result: The RHL group showed less biofilm accumulation compared to the other groups (p<0.05). The distance between the tooth surface and the retainer showed a strong negative correlation with biofilm accumulation (rs=- 0.79, p=0.00037). Conclusion: The RHL showed significantly less accumulation of S. mutans due to the distance between the retainer and the tooth surface. This research provides relevant data for a future randomized clinical trial.”

"Background: Obesity and dental caries are two of the most common conditions affecting children and both have significant implications on their wellbeing and future health. Even though research into the relationship between the two conditions has been conducted for many years, results to date remain equivocal. Aim: The current study aimed to to evaluate the relationship between obesity and dental caries in Brazilian children aged 6 to 9 years and American children and adolescents aged 2 to 5 years and 8 to 19 years, as well as to investigate possible individual and environmental determinants associated with both conditions. Methods: The study was divided into three parts: data analysis (dental caries, body mass index (BMI), BMI z-score (ZBMI) and waist-to-hip ratio (WHR)) from the Estrutural Affordable Health Initiative (AHI) project in schoolchildren aged 6 to 9 years living in a highly deprived community in the Federal District, Brazil; data analysis (dental caries, BMI, ZBMI) of children aged 2 to 5 years from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 in the United States; and data analysis (dental caries, fat mass index (FMI) and fat percentage (BF%)) of children and adolescents aged 8 to 19 years also from NHANES 2011-2018. Associations were tested in regression models adjusted for confounding factors. Results: In regard to the AHI data, 62% of the children had caries experience according to the World Health Organization (WHO) criteria and 34% had unhealthy body weight according to the International Obesity Task Force (IOTF) reference. ROC (Receiver Operating Characteristic) analysis showed that BMI (AUC 0.492, 95% CI: 0.439 to 0.545) and WHR (AUC 0.514, 95% CI: 0.461 to 0.567) were weak predictors of dental caries. Regarding NHANES data from children aged 2 to 5 years, in crude models, obesity was associated with greater dt scores when using the IOTF standards (RR: 2.43, 95% CI: 1.11, 5.29), but not when using the WHO and the Centers for Disease Control and Prevention (CDC) standards; obesity was associated with greater dft scores when using the WHO (1.57, 95%CI: 1.11–2.22), CDC (1.70, 95%CI: 1.17–2.46) and IOTF standards (2.43, 95%CI: 1.73–3.42); obesity was associated with lifetime caries prevalence when using the WHO (1.55, 95%CI: 1.05–2.29), CDC (1.73, 95%CI: 1.14–2.62) and IOTF standards (2.45, 95%CI: 1.61–3.71), but not with untreated caries prevalence. These associations were fully attenuated after controlling for demographic factors, family SES and child’s intake of added sugars. In children and adolescents aged 8 to 19 years, FMI score was associated with the DMFT score (rate ratio: 1.03, 95%CI: 1.01-1.05) and lifetime caries prevalence (odds ratio: 1.06, 95%CI: 1.03-1.08), but the associations were attenuated after adjustment for confounders. Neither the BF% score nor the presence of excess adiposity, defined according to the BF% or FMI reference standards, were associated with dental caries. Conclusions: It was concluded that the relationship between obesity and caries in children and adolescents varied according to the measures of adiposity adopted, as well as the definition of obesity and dental caries used. Furthermore, the associations were fully attenuated after adjustment for household socioeconomic status and child added sugars intake."

"Introduction: Selective carious tissue removal is advocated to treat cavitated carious lesions not accessible to cleaning instruments and with signs of activity. This technique has different clinical approaches, depending on the depth of the carious lesion. The management of deep lesions is usually associated with professional therapeutic insecurity and with immediate or long-term pulpal complications. Objective: regarding the need for scientific evidence that favors therapeutic assertiveness in the intervention of deep lesions, the primary objective of this thesis was to compare, based on data from 1 and 2 years of follow-up, subjective versus objective criteria for selective removal of carious tissue in deep lesions. Method: This thesis is based on a community-based singleblind randomized controlled clinical trial. The sample consisted of vital and asymptomatic primary molars with deep caries lesions of students from six public schools in Paranoá - Federal District. The sample was randomized into (1) objective protocol (O) – selective removal with polymer burs and (2) subjective protocol (S) – selective removal using hand excavation. The treatment was carried out in a mobile dental unit by two previously trained dentists and the evaluation by two calibrated examiners. Results: 115 children were treated (177 restorations, 91S, 85O). Generalized linear models (GLM) and multi-level Cox-regression analysis were applied. After two years, out of 136 restorations (71S, 65O), 50S and 48O were successful (ART criteria 0/1, no pulpal complications, no re-intervention needed, or tooth extraction) and 70 S and 65 O survived (tooth retained with or without further retreatments being needed, or tooth exfoliated). There were 9 cases of pulpal complications (7S, 2O). There was no significant difference in treatment time, immediate patient satisfaction and risk of failure between O and S. The majority of failures were restorative, not pulpal, and distribution of ART codes was not significant differences between groups. Risk of failure was not significantly associated with the removal protocol, age, gender or dental arch. Greater risk of restorative failure was statistically associated with restorations involving multiple surfaces. Conclusion: Both protocols can be considered for the management of deep caries lesions"

"Pain permeates the dental clinic, whether due to oral problems such as dental caries and its complications or related to dental procedures performed. Pain evaluation in patients with communication difficulties (PCDs) poses a challenge for dentists, potentially compromising their treatment. The aim of this study was to develop and validate an instrument to assess the perception of dentists about pain in individuals with communication difficulties. This study follows a quantitative methodological approach involving constructing and validating an instrument administered to 50 dentists. The initial instrument consisted of 29 items divided into four domains. Content and construct validity and verification of internal consistency were confirmed. Content validation was performed by judges using the Content Validity Index. The instrument underwent construct validation and internal consistency assessments through exploratory factor analysis and confirmatory factor analysis, employing Cronbach's α, Kaiser-Meyer-Olkin, and Bartlett's sphericity tests. The final instrument consisted of 21 items, divided into three domains, with substantial Cronbach's α for one domain and moderate values for the others. The total variance accounted for was above 46.03%. Each factor retained at least three items, with factor loadings exceeding 0.3, commonalities greater than 0.2, and eigenvalues > 1. Despite the study's limitations, the instrument demonstrated its feasibility for application and potential in evaluating the perception and management of pain in individuals with communication difficulties (PCDs)."

An important parameter for the clinical success of dental implants is the formation of direct contact between the implant surface and the surrounding bone. A key determinant in the construction of this interface during osseointegration is the influence of the implant surface composition. Implants with surface treatments such as sandblasting, macroparticles and acid etching have been extensively studied both in vitro and in vivo. The present work aims to evaluate, using oca25® contact angle optical microscopy (DataPhysics Intruments GmbH, Filderstadt, Germany), the wettability of titanium discs with treated surface and smooth surface subjected to contact with ozone. The samples consisted of 30 titanium discs, 15 with a smooth surface (Implacil, São Paulo, Brazil) and 15 with a Maestro® treated surface (Implacil, São Paulo, Brazil). From each group, 14 discs were exposed to ozone for different exposure times. The wettability of each disc was evaluated through the contact angle of the water with the respective surfaces. The discs were exposed to ozone for periods of 8, 10, 12 and 24 hours. The results showed a significant increase in the wettability of all titanium discs that came into contact with ozone, especially those with a treated surface. The period of exposure to ozone in the present research seemed to have a greater influence on the smooth surface, where the difference between 08 and 24 hours proved to be more statistically significant. Based on the results obtained, it is pertinent to conclude that contact with ozone had a strong influence on the wettability potential of titanium discs on both smooth and treated surfaces.

“Introduction: The emergence of the new coronavirus (SARS-CoV-2) has resulted in a global public health crisis (COVID-19 pandemic), leading the World Health Organization (WHO) to declare it a public health emergency of international interest. In this pandemic context, it has become essential to ensure care for cancer patients, despite Lockdown and restrictions. Thus, Telemedicine proved to be a valuable tool in the evaluation and monitoring of the patient, as well as in the diagnosis of general or specific conditions. The non-face-to-face assistance, mediated by technology, was one of the alternatives found and was configured in a possible approach. But despite its potential benefits, what were its limitations? What could have been done differently? And in the field of dentistry: how was the assistance mediated by technology? Objectives: To evaluate the role of teledentistry in patients with oral cancer during the COVID-19 pandemic through an integrative review of the literature; to evaluate the feasibility of telehealth in the monitoring of patients with head and neck cancer through systematic review of remote technology, user adherence, user satisfaction and quality of life and to evaluate the use of artificial intelligence tools in cancer detection compared to traditional methods of diagnostic imaging through a panorama of systematic reviews. Methodology: Three literature reviews were carried out, being an integrative review, a systematic intervention review and a systematic diagnostic review to answer questions about the benefits, advantages and challenges of teledentistry during the COVID-19 pandemic19; the degree of user adherence, user satisfaction and quality of life in adopting telehealth for monitoring the treatment of patients with head and neck cancer; and how accurate are artificial intelligence applications for cancer detection in adult patients. The PICO (Population, Intervention, Comparison and Outcome) and PIRD (Participant, Index Test, Reference Test and Diagnosis of interest) strategy was used to define the inclusion and exclusion criteria in the reviews performed. Extensive research was conducted in databases such as PubMed, Cochrane Central Register of Controlled Studies (Cochrane), SciVerse Scopus (Scopus), Web of Science, Latin American and Caribbean Health Sciences (LILACS), Excerpta Medical Database (Embase)Scientific Electronic Library Online (Scielo), Business Source Complete (EBSCOhost) and in grey literature through PROQUEST, Google Scholar and JSTOR. Medical Subject Headings (MeSH) descriptors were used to develop the research strategy. The electronic search was standardized to identify relevant articles by combining all descriptors. Rayyan QCRI (https://rayyan.qcri.org/welcome) was used to remove duplicates, in addition to manual removal. The main primary outcomes considered were the benefits of the use of OT for patients undergoing treatment of mouth and head and neck cancer during the COVID-19 pandemic; application model already used in TM/Telehealth; number of patients who adhere to the use, quality of life and patient satisfaction in the use of the TM/Telehealth application and detection of cancer and diagnosis through artificial intelligence. The verification of methodological quality in individual studies was evaluated by the Critical Evaluation Checklist of the Joanna Briggs Institute (Instituto Joanna Briggs, 2014). This methodology was applied in systematic reviews. Results: In the first study, presented in chapter 2, it was observed that 78% of patients currently prefer teledentistry; 92% of patients would recommend the use of videoconsultation to other patients. The continuity of dental care, the reduction of visits of patients to the hospital, Reducing the risk of coronavirus infection and limiting face-to-face consultations to protect health professionals are benefits that reinforce the use of teledentistry by health institutions. In the second study, set out in chapter 3, although there was heterogeneity regarding the technology used, the included studies showed that remote monitoring and/or self-management of symptoms through mobile applications was feasible for most patients, with satisfactory degrees of acceptability, satisfaction, usability and adherence. In the third article, presented in chapter 4, it was demonstrated that several Artificial Intelligence approaches are promising in terms of specificity, sensitivity and diagnostic accuracy in the detection and diagnosis of malignant tumors.

Conclusion: From the articles, it was concluded that Technology-Mediated Assistance, during the COVID 19 pandemic, in the medical or dental fields, as a tool for remote monitoring of patients with oral cancer and head and neck cancer, was well accepted by patients, and contributed to the continuity of dental care, to reduce patient visits to the hospital, reducing the risk of coronavirus infection and limiting face-to-face care to protect health professionals. However, there was a need for a more userfriendly interface, an adequate evaluation of the user experience for a concrete applicability of these tools for monitoring patients with head and neck cancer. In this context, the detection and diagnosis of malignant tumors with the aid of AI seems to be feasible and accurate with the use of different technologies, deep learning and machine algorithms and radiomic analysis. The reviews indicate the benefits of technology-mediated care also for cancer patients, although these technologies are not able to replace the professional radiologist in the analysis of medical or dental images. Thus, although the evidence points out that technology-mediated care was a possible approach in times of pandemic, more longitudinal multicenter studies are needed for a better possibility of clinical application.”

"Dental trauma is a common dental public health problem, and it affects 20% to 30% of permanent dentition worldwide. Crown fractures and luxations of these teeth are the most commonly occurring of all dental injuries. Reattachment of a tooth fragment is a viable alternative to restore a fractured tooth. The aim of this study was to assess the knowledge and previous experience of dentists from Federal District towards tooth fragment reattachment procedures. This is a cross-sectional observational study approved by CEP/FS of the University of Brasília (CAAE 51465721.8.0000.0030) that an electronic study was available (Google Forms Platform), with objective and self-reported questions, for professionals with active CRO, regardless of the degree of training and/or specialty. A total of 416 dentists participated of the study, of which 58.9% were female and 41.1% male. From the total number of participants, 22.4% do not have a specialty, on the other hand, the most prevalent specialties were Orthodontics (16.1%) and Dental Prosthesis (13.9%). 70% declared having knowledge about fragment bonding, but only 42.3% reported that they had previous experience with this procedure. The most indicated storage medium for the fractured fragment was milk (78.1%) and the bonding materials indicated were adhesive + composite resin (86.3%). Most participants reported that in the face of a clinical case of uncomplicated coronary fracture, with the presence of a coronary fragment in good condition, they would choose to perform the crown reattachment (66.3%), however there was a great divergence between the choice of the time of fragment rehydration. It is concluded that the majority of participants of this study know the technique and demonstrate knowledge about how to lead in cases of fragment reattachment, however some points need to be reinforced regarding this procedure."

"Diabetes mellitus and periodontitis are two immunoinflammatory diseases that maintain a bidirectional relationship in which the chronic state of one can activate and maintain the progression of the other. Periodontitis is characterized by dysbiosis of the oral microbiotaand mediated by immune system events, while diabetes mellitus is a group of systemic disorders characterized by hyperglycemia resulting from defect in insulin secretion and/or action. The non surgicalapproachofscalingandrootplaningisthe“goldstandard”treatmentof periodontitis, but this therapy often does not produce the desired clinical results, especially in individuals with immunoinflammatory alterations and at risk of recurrence of oral disease, such as diabetes. Ozone therapy combined with periodontal treatment has been studied mainly for its antimicrobial effect; but ozone also has a biomodulation capacity, such as antioxidant, anti- inflammatory and antihypoxic effects, which represent an additional benefit for individuals with diabetes. Despite this, only two studies evaluated the effect of adjuvant ozone therapy to periodontal treatment in this group of patients. A review of the literature was carried out and, in the face of little direct evidence, the effects of ozone on molecular mechanisms and signaling pathways reported in other situations or diseases, but also present in periodontitis and diabetes, were reviewed too. Based on this literature review, a never-before-tested protocol was proposed combining the 3 forms of ozone application (water, gas, and oil) adjuvant to periodontal therapy and was used in seven patients with type 2 diabetes. Periodontal clinical data (bleeding index on probing, probing depth and clinical attachment level), biochemicals (glycated hemoglobin and C-reactive protein) were evaluated, in addition to microbiological analysis of some samples (real-time PCR). After 30 days of treatment, patients showed satisfactory periodontal results and also improved glycemic control, suggesting that ozone therapy can be a powerful tool in periodontal therapy of patients with type 2 diabetes and deserves to be further investigated and compared with non-surgical periodontal therapy only."

“The interest in dental materials possessing satisfactory biological properties is directly linked to the therapeutic needs of dental structures, such as the dentin-pulpal and periradicular tissue interfaces, affected by defects of congenital origin or by trauma and diseases, such as caries. The search for the biocompatibility of dental materials was raised in Dentistry by favorable biological responses, observed by B. W. Hermann, in 1920, when he suggested the use of calcium hydroxide (CH) for the conservative treatment of dental pulp. Based on this evidence, several other dental materials have been suggested, such as calcium silicate-based cements, also known as "bioceramic cements", to which superior biological properties have been attributed. In this sense, the present study aimed to verify the performance of bioceramic cements in the periradicular repair process. For this, initially, celebrating the centenary of CH in Dentistry, a bibliometric review was developed with the objective of analyzing the 100 most cited articles on this dental biomaterial (manuscript 1). The bibliometric analysis was conducted in the Web of Science Core Collection (WoS-CC) database. Title, authorship information, study design, year, journal, number of citations, CH use, and fields of Dentistry were extracted. The number of citations in the WoS-CC, Scopus, and Google Scholar databases was cross-matched with the Spearman correlation. From the 1,596 papers identified, a list was compiled with the 100 most-cited papers. The number of citations in WoS-CC ranged from 78 to 384 (mean: 131.4). The main CH uses were: intracanal dressing (61%), and pulp protection (29%). The fields of Dentistry with most studies on CH were Endodontics (62%) and Operative Dentistry (30%). The most frequent study design was laboratory studies (44%). Three hundred and thirty-five authors from 29 countries were identified. The United States of America (USA) was the leading country with 23 articles. Dag Ørstavik was the author with the most papers and citations (9 papers; 1,118 citations). Most papers were published between 1991 and 2015 and in the Journal of Endodontics (38%). A very strong positive correlation was observed among the number of citations in the databases. The 100 most-cited papers were published mainly by European journals or from USA, with laboratory and multifaceted interventional designs. The present study celebrated the centenary of CH, highlighting the role and importance of this biomaterial in Dentistry. Finally, as a form of analyzing the existence of evidence that indicates a better performance of bioceramic cements in the periradicular repair process, in manuscript 2 a narrative review was presented with a systematic search. Following a manual search of 134 publications in the PubMed and Web of Science databases, a total of 72 publications from 2005 to August 2022 were reviewed (Supplementary file 1). Search terms were “calcium silicate cements” and “repair”. Included were English-language were publications that addressed biological properties of calcium silicate-based cements and provided sufficient details of methodology to be summarized in this narrative review. The descriptive data of the present review are presented mainly in terms of the ability to induce a positive cellular or tissue response to the periradicular tissue repair process. The data collected are intended to represent the status quo of the literature on favorable biological responses of calcium silicate-based cements in the periradicular repair process. Within the limitations of the available data in the literature regarding the biological properties and performance of the calcium silicate-based cements in the periradicular repair process, these biomaterials present themselves as promising alternatives; however, more research is needed to support this understanding.”

"It is accepted that the attitudes and behaviors of the family and the mother affect the general and oral health of the child, with reports of an association between the development of dental caries in the child and the marital status of the parents. However, there is no consensus in the literature about this topic, which makes necessary more research about it. In the same way, the developmental defect of the enamel called Molar Incisor Hypomineralization (MIH) increases the chances of a child to present dental caries and when not well trained, dentists can misdiagnose them as caries lesion, which can increase the prevalence of the disease in the population. However, this issue has not been investigated yet. Therefore, the objective of the present study was to evaluate the impact of the family structure on the oral health status of children, in a high social vulnerable population, as well as to determine the increase in the prevalence of dental caries, when no differentiation between caries lesions and MIH is established. A total of 471 children were examined by a single dentist calibrated for dental caries and MIH, using the Caries Assessment Spectrum and Treatment (CAST) and the MIH Severity Scoring System (MIH-SSS), and their parents and/or guardians underwent an interview about socioeconomic variables and hygiene habits. The prevalence of caries in the sample, involving having dentin lesions as threshold was 43.74% and, including enamel lesions, 52.87%. The family structure (marital status of the mother and the householder) was not a predictor for caries onset; however, there was a significant association between low maternal education and severe cases of the disease (PR = 1.41; p = 0.0077), low maternal education and episodes of oral pain (PR = 1.47; p = 0. 0335), as well as non-own residence and substantial presence of plaque on the teeth (PR = 1.13; p = 0.0493). The prevalence of MIH was 13.59%. The percentage of patients with caries lesions on permanent teeth was significantly higher among those with MIH than among those without MIH (p < 0.0001), whereas the chances of a child with MIH to present caries lesions was 4.43 times greater than in a child without MIH. It can be conclude that, although the family structure did not have an influence on the occurrence of dental caries in the study population, the family socio-economical characteristics showed to be predictors of the problem as well as the presence of MIH."