Search

Statement of problem Evidence provided by implant-supported mandibular overdenture research on different loading protocols is important. However, methodological inconsistency, as well as inadequate reporting of results, hampers a consistent decision in terms of clinical applicability. Purpose The purpose of this systematic review and meta-analysis was to evaluate whether immediate or early loading protocols can achieve comparable clinical outcomes when compared with a conventional loading protocol in edentulous patients rehabilitated with mandibular overdentures. Material and methods In accordance with the Participant, Intervention, Comparison, Outcome strategy, prospective clinical studies without restrictions as to language or follow-up period were included. The Cochrane collaboration and ROBINS-I tools were used for quality assessment and risk-of-bias evaluation. The follow-up for the different outcomes ranged from 3 to 168 months, with the focus on implant success and survival rates, marginal bone loss, bleeding on probing, probing depth, plaque index, and the implant stability quotient. Statistical analyses in which standard mean differences were applied with a 95% confidence interval when continuous data were included were performed. For dichotomous data, risk difference was adopted. Results The search strategy resulted in 14 234 references. Twenty-three studies fulfilled the inclusion criteria. Meta-analysis showed statistically significant differences for plaque index at 12 months (standard mean difference=0.284 [0.022, 0.545], P=.033, I2=35%), probing depth at 36 months (standard mean difference=0.460 [0.098, 0.823], P=.013, I2=0%), and on pooled results for plaque index (standard mean difference=0.157 [0.031, 0.284], P=.015, I2=18%) in which the conventional loading protocol presented lower indices than those of immediate loading protocol or early loading protocol. Implant stability quotient presented a statistically significant difference only at 3 months (standard mean difference=0.602 [0.309, 0.895], P .05) were not found. Conclusions Immediate loading protocol or early loading protocolfor mandibular overdentures has been determined to be a well-established treatment and worthy of consideration in clinical practice.

Summary Implant devices have = proven a successful treatment modality in reconstructive surgeries. However, increasing rates of peri-implant diseases demand further examination of their pathogenesis. Polymicrobial biofilm formation on titanium surfaces has been considered the main risk factor for inflammatory processes on tissues surrounding implant devices, which often lead to implant failure. To overcome microbial accumulation on titanium surfaces biofilm targeting strategies have been developed to modify the surface and incorporate antimicrobial coatings. Because antibiotics are widely used to treat polymicrobial infections, these agents have recently started to be incorporated on titanium surface. This review discusses the biofilm formation on titanium dental implants and key factors to be considered in therapeutic and preventative strategies. Moreover, a systematic review was conducted on coatings developed for titanium surfaces using different antibiotics. This review will also shed light on potential alternative strategies aiming to reduce microbial loads and control polymicrobial infection on implanted devices., Graphical Abstract, Highlights • Polymicrobial biofilms are the main etiologic factor of implant-related infections • Titanium (Ti) biomaterial is a substrate for microbial accumulation • Antibiotic-loaded coating on titanium is a promising strategy this accumulation • These strategies need to improve drug releasing and are tested by polymicrobial models, Microbiofilms; Surface Science

Objective To compare the effectiveness and acceptability of a newly developed pediatric sialometer as an alternative to the conventional spitting method. Methods A clinical study was carried out with healthy children (G1; n = 30) and oncological children (G2; n = 30). A newly developed pediatric sialometer was compared to the traditional spitting method to determine unstimulated salivary flow (mL/min), with a one-hour wash out period between sample collections. A semi-structured questionnaire was applied to G1 and G2 using the Facial Anxiety Scale to evaluate the device’s acceptability. The children’s behavior was also observed throughout saliva collection. The data were analyzed by Mann-Whitney U, Wilcoxon, Student’s t and Chi-Square tests (α = 5%). Results There was no significant difference between groups and methods (P > 0.05). However, the saliva collected with the pediatric sialometer was clearer and had less apparent contamination. The device characteristics were rated positively, with high acceptability even among children with more difficult conditioning (G2) (P > 0.05). Conclusion The newly developed pediatric sialometer presented herein can be an alternative option for saliva collection in pediatric dentistry, with good reproducibility and acceptability by children.

Polymicrobial infection is the main cause of dental implant failure. Although numerous studies have reported the ability of titanium (Ti) surface modifications to inhibit microbial adhesion and biofilm accumulation, the majority of solutions for the utilization of Ti antibacterial surfaces have been testedin in vitro and animal models, with only a few developed surfaces progressing into clinical research. Motivated by this huge gap, we critically reviewed the scientific literature on the existing antibacterial Ti surfaces to help understand these surfaces' impact on the "puzzle" of undesirable dental implant-related infections. This manuscript comprises three main sections: (i) a narrative review on topics related to oral biofilm formation, bacterial-implant surface interactions, and on how implant-surface modifications can influence microbial accumulation; (ii) a critical evidence-based review to summarize pre-clinical and clinical studies in an attempt to "fit pieces into the puzzle" to unveil the best way to reduce microbial loads and control polymicrobial infection around dental implants showed by the current in vivo evidence; and (iii) discussion and recommendations for future research testing emerging antibacterial implant surfaces, connecting basic science and the requirements for future clinical translation. The findings of the present review suggest no consensus regarding the best available Ti surface to reduce bacterial colonization on dental implants. Smart release or on-demand activation surface coatings are a "new piece of the puzzle", which may be the most effective alternative for reducing microbial colonization on Ti surfaces, and future studies should focus on these technologies.

Objective: To evaluate the agreement and applicability of the Chronological Dental Mineralization Table of Nicodemo, Moraes and Medici Filho (1974) to estimate age held by undergraduate Dentistry students at the Federal University of Paraiba. Material and Methods: Field research applied with a sample of 50 students according to inclusion and exclusion criteria. Sequentially, 3 panoramic radiographs were exposed (actual age known only by teachers), and students were instructed to interpret them from the selection of 2-4 teeth under formation. Data were analyzed using SPSS software (Statistical Package for Social Sciences), version 20.0, adopting significance level of 5%. Results: Most students chose 3 teeth, with percentages of 56.0% (n = 28); 38.0% (n = 19) and 58.0% (n = 29) for radiographs 1, 2 and 3, respectively. Teeth selected with greater frequency were: 47 (20.1%, n = 33) and 45 (19.5%, n = 32) - radiography 1; 38 (22.7%, n = 32) and 18 (13.4%, n = 19) - radiography 2; and 47 (17.9%; n = 26) and 36 (13.7%; n = 20) - radiography 3. The agreement between estimated and actual ages was 60.0% for radiography 1, 12.0% for radiography 2 and 32.0% for radiography 3. Age was underestimated in 40.0% (n = 20) and 88.0% (n = 44) in radiographs 1 and 2, respectively. Overestimation of the actual age occurred only in radiography 3 (68.0%; n = 34). The linear regression analysis revealed that it is possible to estimate the actual age from the maximum age stipulated by training students with 88.1% success rate. Conclusion: The method is applicable; however, the correlation between estimated and actual ages varied considerably among radiographs, and maximum estimated values were closer to the actual age than minimum values.

O estudo teve o objetivo de explicar a “inibição de sorrir” em pacientes oncológicos pediátricos a partir de variáveis relacionadas à má oclusão, cárie e doença periodontal. Esta é uma pesquisa transversal realizada em um hospital de referência no estado da Paraíba, sendo a amostragem feita por conveniência, composta por 52 pacientes com idades de 12 anos e15 a19 anos. Utilizaram-se como instrumentos de coleta duas fichas (exame clínico e entrevista) do levantamento Saúde Bucal Brasil2010. Apesquisa foi realizada entre anos de2011 a2014. Os dados foram analisados no software R (versão 3.1.1), recorrendo a técnicas estatísticas descritivas e inferenciais. Na análise descritiva, utilizaram-se valores absolutos e percentuais e medidas de tendência central e dispersão. Na análise inferencial, por intermédio da regressão logística binária, se identificou as variáveis significantes para explicar a inibição ao sorrir dos pacientes do estudo. Observou-se como fatores de risco para a inibição ao sorrir, ter desalinhamento maxilar (OR=6,59), relação molar alterada (OR=9,16), número de dentes cariados (OR=1,71), e presença de sangramento gengival (OR=15,88). A má oclusão, cárie dentária e gengivite são fatores associados à vergonha de sorrir nos pacientes pediátricos oncológicos.