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To answer the following focus question: Are narrow-diameter implants feasible to support fixed dental prostheses (FDPs) and partial removable dental prostheses (PRDPs)?This review followed the PRISMA statement and was registered in the PROSPERO database (CRD42020153729). Six databases and the gray literature were searched through October 2021 without language, publication time, or follow-up restrictions. The main outcomes were survival, success, and marginal bone loss (MBL). Risk of bias was assessed for each study design, and random-effects meta-analyses were performed (α = .05).Seventeen studies were included in the qualitative analysis, and 3 were included in the meta-analyses. In total, 1,624 NDIs and 339 standard-diameter implants (SDIs) were placed in 1,060 patients. Follow-up varied from 1 to 10 years, and 17 failures (implant loss) were recorded. No differences in survival rate for FDPs supported by NDIs vs SDIs were found (odds ratio [OR] = 0.59, 95% CI: 0.18 to 1.92, P = .38). However, Kaplan-Meier analysis evaluating only NDI performance revealed a higher survival rate of NDIs ≥ 3.3-mm diameter (P = .002), placed with delayed loading (P = .024), and placed in the maxilla (P = .014). FDPs supported by NDIs vs SDIs presented similar success rates (OR = 1.48, 95% CI: 0.41 to 5.34, P = .55); however, MBL was lower in the NDI group (mean difference = -0.23 mm, 95% CI: -0.41 to -0.06, P = .01). Insufficient data regarding PRDPs were available.Despite the limited studies available, FDPs supported by NDIs presented survival and success rates comparable to those supported by SDIs, with slightly lower MBL. For PRDPs, strong conclusions were not possible.

We aim to investigate the infection rate, the clinical characteristics and outcomes of COVID-19-disease in a cohort of people living with HIV in Madrid (Spain), during the first year of pandemics.Observational single-center study, in which we included all HIV-infected patients (aged ≥ 18 years) with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as of February 28, 2021, at the Hospital Universitario 12 de Octubre.Confirmed disease was defined as any patient with a positive antigen test, reverse transcriptase polymerase chain reaction, or serology for SARS-CoV-2. We compared the characteristics of patients with mild disease (asymptomatic included) with those with moderate or severe disease (requiring admission).Of 2344 HIV-infected patients, 158 (82.9% male; median age, 46.5 years) were diagnosed with SARS-CoV-2 (infection rate, 6.74%; 95% confidence interval, 5.79 to 7.83). Thirty-nine individuals (24.7%) had moderate or severe disease, 43.7% had mild disease, and 31.6% were asymptomatic. Hypertension (23.4%) and obesity (15.8%) were the most prevalent comorbidities; 12.7% had at least 2 comorbidities. One hundred forty-five patients (97.3%) had RNA-HIV viral load of50 copies per milliliter, and only 3 had CD4 cell count of200 cells per cubic millimeter before infection. Of those admitted to hospital, 59% required oxygen support and 15.4%, invasive mechanical ventilation. Five patients died. None of the patient taking tenofovir-disoproxil-fumarate required admission. In the multivariate analysis, age remained as the only independent factor for moderate-severe disease (odds ratio, 1.09; 95% confidence interval 1.04 to 1.14; P0.001).People living with HIV are at risk of severe SARS-CoV-2 infection. Age was the only variable with an independent association with moderate-severe disease, after adjusting by comorbidities and other factors.

Objectives To investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts of the activation and/or installation of different orthodontic appliances (fixed labial, lingual appliances, and clear aligners). Materials and Methods Six electronic databases and gray literature were searched (up to May 2021) for relevant studies evaluating mastication and nutrition after activation/installation of orthodontic appliances. This review followed PRISMA guidelines and was registered at PROSPERO (CRD42020199510). The risk of bias (RoB 2 and ROBINS-I) and evidence quality Grading of Recommendations Assessment, Development, and Evaluation were analyzed. Results Of 4226 recorded and screened, 15 studies were finally included. Masticatory performance (standardized mean difference [SMD]: 1.069; 95% coefficient interval [CI]: 0.619 to 1.518) and bite force (SMD: -2.542; 95% CI: −4.867 to −0.217) reduced in the first 24 to 48 hours of fixed labial appliance installation/activation, but they were both normalized after 30 days (P > .05). The swallowing threshold remained constant (P > .05). Nutritional intake was rarely reported but showed copper (P = .002) and manganese (P = .016) reductions, with higher calorie and fat intake (P < .05). Lingual appliances impacted chewing more than labial, and clear aligner wearers reported fewer chewing problems (P < .001). Low to very low levels of evidence were found. Conclusions Based on low to very low levels of evidence, mastication was reduced during the first 24 to 48 hours of fixed labial appliance activation/installation, but it was transitory (up to 30 days). Due to insufficient data, the nutritional impact of orthodontic appliances was not conclusive.

In this pilot clinical trial, we evaluated rates of residual replication in persons without lamivudine resistance-associated mutations in proviral DNA population sequencing who switched to dolutegravir plus lamivudine. After 144 weeks, there was no signal of changes in residual viremia based on qualitative detection methods, irrespective of past lamivudine resistance. Clinical Trials Registration. NCT03539224.

Background Although switching antiretroviral therapy (ART) in people with human immunodeficiency virus experiencing insomnia due to dolutegravir-related neurotoxicity is well founded upon evidence, there is a lack of proof in regard to the outcome of stopping dolutegravir-based ART in people without insomnia but reporting poor sleep quality. Methods This is a randomized, multicenter, open-label study to evaluate the reversibility of patient-reported sleep disturbances in patients on dolutegravir/lamivudine/abacavir without insomnia after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. The participants were randomized to switch ART at baseline or at week 4 and then completed 8 weeks of darunavir/cobicistat/emtricitabine/tenofovir alafenamide. Our primary objective was to compare changes in sleep quality between arms at week 4. Secondary objectives were to compare changes in mood and neuropsychiatric symptoms (NS) at week 4 and 4 and 8 weeks after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. The participants completed a survey, including the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression scale (HADS), and specific questions to explore NS, at each visit to assess those objectives. Results We included 72 participants. The results show that study arms were similar at baseline; however, at week 4, PSQI scores remained unchanged with dolutegravir/lamivudine/abacavir, whereas patients improved significantly after switching to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. Similar differences between arms were also observed in HADS and NS changes. At weeks 4 and 8 after all participants switched to darunavir/cobicistat/emtricitabine/tenofovir alafenamide, we have observed significant improvements in PSQI and HAD scores and in NS. Conclusions In patients reporting subclinical sleep disturbances without insomnia, switching from dolutegravir/lamivudine/abacavir to darunavir/cobicistat/emtricitabine/tenofovir alafenamide was associated with better sleep quality and improvements in mood and NS.

The eLAB System allows an objective shade communication, however, it depends on a perfect integration between the surgery and the laboratory, for the acquisition of the reference picture, perfectly contemplating all the rigid parameters of the system.

STATEMENT OF PROBLEM High-performance polymers including polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) have been used as substitutes for metal frameworks in dental prostheses. However, the clinical performance of polymer-based frameworks is still uncertain. PURPOSE The purpose of this systematic review was to compare the clinical performance of PEEK and PEKK with that of metal frameworks for different dental prostheses. MATERIAL AND METHODS This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and non-peer-reviewed literature (without language or follow-up restrictions) were searched for studies conducted before February 2022. Only clinical studies, either randomized clinical trials (RCTs) or nonrandomized clinical trials (N-RCTs), comparing the clinical performance of polymer and metal frameworks were included. The risk of bias and certainty of the evidence were assessed with the RoB 2.0, ROBINS-I, and GRADE. Biologic (plaque and gingival indices, probing depth, bleeding scores, implant stability quotient, marginal bone loss) and mechanical outcomes (ridge base relation, prosthetic marginal gap, and fracture) were assessed. RESULTS Only 9 studies (7 RCTs and 2 N-RCTs) were included, all with moderate to serious risk of bias and low to very low certainty of evidence. No meta-analysis was possible, but qualitative analysis revealed lower plaque and gingival indices, probing depth, and marginal bone loss, with higher survival rates for implant-supported fixed prostheses and overdentures fabricated with PEEK than for metal frameworks. No significant differences were found between groups for removable partial dentures. The marginal fit of PEEK frameworks was also better for single crowns. Three fractures were reported in the 3 PEKK fixed dental prostheses with cantilevers. CONCLUSIONS PEEK and PEKK seem to be promising materials for dental prostheses, with acceptable response from the periodontal tissue. However, further well-designed studies are necessary to better understand their clinical and long-term limitations.

Com o intuito de refletir sobre a Gestão Democrática Participativa, estabelecendo uma análise minuciosa sobre os aspectos mais relevantes dessa nova forma de gerir as escolas em consonância com o processo de construção de uma sociedade mais democrática de participativa, o presente trabalho centra a sua atenção na atuação do Conselho Escolar da Escola de Ensino Médio Barão de Aracati, por entender que este colegiado traz em si mesmo a essência da Gestão Democrática Participativa, pois agrega em sua composição a representação da comunidade que tem como principais funções: consultar, deliberar, normatizar, fiscalizar e avaliar todos os assuntos que envolvem a instituição, pedagógico, financeiro e administrativo. Assim, a pesquisa objetiva estabelecer os graus de participação do colegiado, identificando os avanços e possíveis obstáculos para a implantação da Gestão Democrática.

A capacidade das Instituições de Ensino Superior (IES) adotarem políticas e dinâmicas promotoras de interculturalidade para a inclusão dos estudantes apresenta-se como um desafio face aos relatos de vivências de exclusão académica dos participantes deste estudo. Foi objetivo deste estudo compreender a experiência vivida pelos participantes, na academia, como fenómeno de inclusão/exclusão. Relativamente aos métodos, trata-se de um estudo qualitativo, fenomenológico-interpretativo, com recurso à entrevista fenomenológica. Participaram trinta e um elementos da comunidade académica (estudantes, docentes e não docentes) de uma IES de Portugal, de abril a julho de 2019. A análise dos dados emergentes foi qualitativa e realizada com ajuda do software Nvivo12. Este estudo insere-se num projeto mais amplo intitulado “Práticas inclusivas no Ensino Superior: O desafio de construir comunidade”, autorizado pela Comissão de Ética da Instituição onde se realizou o estudo. Quanto aos Resultados, das categorias emergentes destacamos a Experiência e significado de inclusão, com destaque para a “Indiscriminação”, “Igualdade e equidade” e “Integração na comunidade”; as Barreiras à inclusão na instituição, com ênfase nas “Barreiras Arquitetónicas”, na “Desarticulação hierárquica institucional, “dificuldades linguísticas” e, ainda, a categoria Sentimentos vivenciados em experiências de exclusão, enfatizados pelos participantes, como a “desvalorização”, a “solidão” e a “tristeza”. Em conclusão, os participantes consideram que os principais desafios institucionais à inclusão e interculturalidade se centram no derrubar as barreiras arquitetónicas e linguísticas, de forma a que os edifícios tenham acessos adequados à mobilidade, que garantam a sua integração e minimizem sentimentos de desvalorização, solidão e tristeza.

This systematic review aimed to assess the effectiveness of anesthetic methods for mandibular posterior teeth with symptomatic irreversible pulpitis, comparing to the inferior alveolar nerve block (IANB) by meta-analysis. Studies were identified from Cochrane Library, Embase, Lilacs, PubMed, Scopus, and Web of Science databases up to May 2021. Randomized clinical trials comparing the anesthetic success rate of IANB and any other alternative anesthetic method were included. The quality of the selected studies was assessed by the Cochrane Risk of Bias 2.0 tool. Meta-analyses using Mantel–Haenszel method and random-effect models were performed to find the pooled estimates of risk ratio (RR) with 95% confidence interval (CI). The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Twenty-two studies were selected, which included fourteen anesthetic methods. Two studies were classified as high risk of bias, five as uncertain risk and fifteen as low risk. Vazirani-Akinosi nerve block (VANB) [RR = 1.27; p = 0.007; 95% CI, 1.07–1.52; I2 = 0%] and intraosseous injection (IOI) [RR = 1.48; p = 0.04; 95% CI, 1.02–2.15; I2 = 46%] had superior effectiveness compared to IANB, with low certainty of evidence, as well as buccal infiltrations associated with IANB (BI + IANB) [RR = 1.84; p = 0.004; 95% CI, 1.22–2.79; I2 = 52%], with very low certainty. Evidence suggests that buccal infiltrations associated with IANB, VANB, and IOI are more effective than IANB at anesthetizing posterior mandibular teeth with symptomatic irreversible pulpitis. Alternative primary methods of anesthesia might be indicated for mandibular posterior teeth presenting symptomatic irreversible pulpitis.

International audience; Background & aims: Debate still exists about the impact of dental implant-supported prostheses on nutritional status of partially and complete edentulous patients. This review aims to answer the focused question: "Do complete and partial edentulous patients, using implant-supported prostheses, present better nutritional and masticatory functions when compared to those using conventional rehabilitations?". A possible cause-effect relationship between masticatory improvements and nutritional gain was also evaluated.Methods: Literature search included 6 databases (PubMed/Medline, Embase, LILACS, Scopus, Web of Science, and The Cochrane Library - CENTRAL), grey literature (Google Scholar, Proquest Dissertations and Thesis and Open Grey databases) and manual search (last update June 2020), without language, publication time and follow-up restrictions. We included only studies evaluating both masticatory and nutritional outcomes. The PICO question comprised complete and partial edentulous patients (Population), submitted to implant-supported prostheses (Intervention), in comparison to conventional dental prosthetic rehabilitation, evaluating masticatory function and nutrition parameters (outcomes). Risk of bias was assessed by using Cochrane Collaboration's tool (randomized clinical trials), Joanna Briggs Institute critical appraisal checklist (paired clinical trials), and Meta-Analysis of Statistics Assessment and Review Instrument" (JBI - MAStARI) critical appraisal tools (cohort studies). All meta-analyses were conducted at 5% level of significance. This report followed the PRISMA guidelines. (Review registration PROSPERO - CRD42019135744).Results: We identified 1199 articles while searching databases. Fourteen articles met eligibility criteria, including 817 prostheses installed in 660 patients (mean age = 66.8 years-old). Patients wearing implant overdentures (IOD) presented better masticatory function in comparison to conventional complete denture (CD) wearers (p < 0.05). However, bioavailability of several nutrients remained within the same range, except for serum folate that was lower in IOD patients after 6 (mean difference 3.51 nmol/L; p = 0.01) and 12 months of rehabilitation (mean difference 3.69 nmol/L; p = 0.003). When comparing the effects of CD and IOD rehabilitations along time (for the same patient), serum albumin and vitamin B12 levels also decreased for both groups after 12 months-follow-up, but still within the reference range. The additional retention of the implants did not interfere in body weight, but reduced the risk of malnutrition (using the Mini Nutritional Assessment). Implant-supported partial prostheses also improved mastication in comparison to the conventional ones, increasing short-term daily intake of carbohydrates, protein, calcium, fiber, and iron, whereas decreasing the consumption of cholesterol.However, no long-term changes on bioavailability of most nutrients were observed, expect for a slight increase in ferritin and cholinesterase, and a small reduction in folate and Vitamin A.Conclusion: Current evidence indicates significant masticatory improvements for dental fixed implant-supported prostheses in comparison to conventional removable prostheses. However, bioavailability remained stable for most of the nutrients, especially for complete edentulous patients. These results indicate the importance of a multidisciplinary approach during oral rehabilitation (nutrient specialist), in order to enhance food choices and promote health benefits to the patients. (C) 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.