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Objective: To evaluate questions concerning oral medicine- and pharmacology-related specialties of asynchronous dental teleconsulting sessions of the Telehealth Brazil Networks Program. Material and Methods: Data were collected from secondary databases of asynchronous dental teleconsulting sessions of the telehealth centers of Minas Gerais from July 2015 to July 2017. The variables for dental underlying fields and the types of questions were evaluated. Descriptive analysis was performed with the SPSS v.22.0 program. Results: 3,920 teleconsulting sessions were referred to the telehealth centers of Minas Gerais during the study period. Regarding oral medicine-related questions (n=745), most (n=469; 62.95%) addressed diagnosis, whereas the underlying field questions mostly regarded fungal, viral, and bacterial infections (17.3%), biopsies (16.4%), developmental defects and dental abnormalities (9.9%), and soft tissue tumors (9.4%). Pharmacology-related questions (n=738) mostly addressed general approaches (n=672; 91.06%), and the most common questions were about underlying fields' prescriptions (44.7%), anesthetics (17.6%), adverse effects of medications and anesthetics (10.2%), and selection of anesthetics for patients with systemic conditions (9.8%). Conclusion: Most teleconsulting sessions regarded conditions or procedures common in primary health care and essential for diagnosis and treatment planning at all care levels, which suggests a need for more academic learning processes for healthcare professionals, especially in dentistry primary fields.

Abstract Background The Telehealth Brazil Program aims to improve the quality of Primary Health Care. Objective This cross-sectional study evaluated the Telehealth Brazil Networks Program’s dental teleconsulting in Minas Gerais state to elucidate the prevalent questions in endodontics. Method Secondary databases of offline dental teleconsulting from the Clinical Hospital and Medical School of the Universidade Federal de Minas Gerais from July 2015 to July 2017 were used. The variables analyzed were telehealth center, dental specialty and sub-area, and question type. The results were descriptively analyzed using the SPSS v.22.0 program. Results A total of 3,920 teleconsulting sessions were carried out. Endodontics was the field with the sixth-highest demand for questions (7.4%). The most prevalent endodontic questions were related to pulpal and periapical alterations (32.3%), being more related to diagnosis, followed by dental trauma (15.6%), endodontic emergencies (11.4%), and intracanal medication (7.3%), all of them with most questions related to clinical conduct. Conclusion The endodontic field questions were related to prevalent conditions in the daily activities of the primary health care professionals. It is crucial to continuously update the professionals through continuing education programs and the search for new knowledge to reinforce these competencies.

Abstract This cross-sectional study nationally evaluated asynchronous dental teleconsulting services offered by the Telehealth Brazil Networks Program, using the 2019 Telehealth Results Monitoring and Evaluation System database and considering Brazilian regional differences. The following teleconsulting variables were collected: dentist’s sex and specialty, date/time of question and answer, response time; dental specialty, professional satisfaction, and patient referral. Five Brazilian regions were socioeconomically characterized according to the Human Development Index, estimated population, Gini coefficient, coverage of dental specialty centers, oral health teams in Family Health Strategy, and oral health teams in primary health care (PHC). In total, 2,703 teleconsulting sessions occurred in Brazil in the analyzed period. The Southeast exhibited the highest demand (49.1%). Most dentists were female (60.6%) and were dental surgeons from the Family Health Strategy (61.3%). Most teleconsulting sessions occurred during working hours (85.5%) and questions were answered within 72 hours (66.7%). Level of satisfaction and avoidance of referral yielded rates of 90.9% and 66.8%, respectively, among dentists who answered about these topics. Semiology was the most frequently demanded area in teleconsulting (33.9%). The different demands from the regions reflected regional differences. The most frequently demanded specialties represent the Brazilian PHC scenario. Professionals incorporated teleconsulting into their work routine and most teleconsultants responded within the stipulated timeframe. Professional feedback should be encouraged.

Objective: To analyze the profile of the dental teleconsulting in the Pediatric Dentistry field of Telehealth Brazil Networks Program, in Minas Gerais centers, Brazil. Material and Methods: Asynchronous dental teleconsulting was evaluated in the Pediatric Dentistry specialty, extracted from secondary databases of the telehealth centers: the Clinical Hospital of the Universidade Federal de Minas Gerais and UFMG Medical School, from July 2015 to July 2017. The variables collected were: type of issues and area and sub-area of Pediatric Dentistry. The results were descriptively analyzed using the SPSS v.22,0 program by frequencies. Results: Most of the issues in the Pediatric Dentistry specialty were about clinical conduct (81.4%). There was a predominance of issues regarding prevention (16.6%), surgery (15.3%), tooth eruption (15.1%), endodontics (12.1%), harmful oral habits (9.7%), patient cooperation (8.7%), primary teeth trauma (7.2%) and dentistry (6.7%). Regarding sub-areas, most issues were related to child oral hygiene (68.5%), tooth extraction (92%), tooth eruption chronology (65.6%), pulp diagnosis (49.0%), bruxism (64%), patient management (74.3%), post-trauma treatment (79.3%), and restoration (88.9%). Conclusion: Pediatric Dentistry teleconsulting suggested a difficulty of the professionals in the pediatric patient approach. Continuing education programs and training courses for professionals working in primary health care are crucial for the comprehensive care of pediatric patients.

Objective: To evaluate output of endodontic in oral public healthcare by analyzing differences in instrumentation techniques, quantitative and qualitatively. Material and Methods: Endodontic services were differentiated by instrumentation techniques: hand techniques with stainless steel instruments (SS) or rotary using NiTi rotary instruments. Secondary data on the productivity of 2011 were obtained from the information system. Student’s t and Mann-Whitney tests were used. Qualitative data were based on semi-structured interviews, direct observation and field diary. Results: Service I employed SS hand techniques, service II used both techniques, while NiTi rotary system was used in service III. Statistically significant differences were observed in total endodontic productivity, with I presenting more productive results than II (p=0.001) and III (p=0.009); III presenting more productive results than II (p

Abstract: The objective of this study was to compare the periradicular responses in endodontic infections among members of two populations: an urban Brazilian population and a non-mixed indigenous population. Samples were collected immediately and 7 days after the cleaning and shaping procedures (after reducing the intracanal microbial load) in an attempt to characterize the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-9, interferon (IFN)-γ, IL-17, IL-10, and the chemokines CXCR4, CCL2/monocyte chemotactic protein (MCP)-1, and CCR6. The endogenous cytokine and chemokine expression levels were analyzed using real-time PCR. Only the urban population showed a significant increase in TNF-α, CCL2/MCP-1, CXCR4, and CCR6 expression following the cleaning and shaping of the root canal system. The IFN-γ levels were increased at the 2nd collection (p < 0.05) in the indigenous population. In turn, a significant increase in IL-10 and IL-17 expression (p < 0.05) was observed after the cleaning and shaping procedures (2nd collection) in both populations. No significant differences in the IL-1β, IL-9, and CCL4 expression levels were observed between the 1st and 2nd collections in both populations. The results demonstrate a cytokine and chemokine expression profile that is specific to each analyzed population. However, immune modulation mediated by IL-10 began on the 7th day after the beginning of the endodontic treatment in both populations.

Abstract: This cross-sectional study aimed to evaluate the asynchronous dental teleconsulting of Telehealth Brazil Networks Program in Minas Gerais. Data were collected from secondary databases of the Clinical Hospital of the Universidade Federal de Minas Gerais (CH/UFMG) and Medical School of UFMG (MS/UFMG), from July 2015 to July 2017. The variables analyzed were telehealth center, sex and profession, date and time questions and answers, response time in days, whether the issue was duly addressed, whether the teleconsulting was attended, post status, professional's satisfaction, conduct adopted after teleconsulting, dental specialty area, and type of issues. Sociodemographic data from the Intermediate Geographical Regions (IGR) of Minas Gerais, including the Municipal Human Development Index (MHDI) and Gini Index were also collected. The results were analyzed using SPSS v.22.0. In total, 3,920 teleconsulting were recorded, with increasing demand in the study period. Most were requested by dentists (93.3%) and female professionals (78.6%), during office hours (78.6%), and related to general conducts (72.1%). Almost all were attended (99.7%), with a maximum response time of two days (75.0%). A low feedback on satisfaction and resolution of issues (missing data of 57.2% and 70.2%, respectively) was recorded. Only 5.2% had information on whether patients were referred. The most common inquires were of issues about Pathology/Stomatology specialties (19.0%) and Pharmacology/Anesthesiology (18.8%). The response occurred within the expected time, with prevalent issues in basic dental areas and general conducts. Feedback from professionals must be encouraged to allow a better analysis and improvements of the program.

Abstract The present study aims to evaluate the longitudinal effects of induced experimental infections in gnotoxenic animals on the expression of inflammatory chemokines and their receptors in periradicular tissues. The null hypothesis tested was that Enterococcus faecalis and Fusobacterium nucleatum had no effect on CCR5, CCL5, CXCL10, CCL2/MCP-1, CXCR2 and CCR1 expression. Two groups of five animals (n = 5) aged between 8 and 12 weeks were used in this study. The animals were anaesthetized, and coronary access was performed in the first molar on the right and left sides. Microorganisms were inoculated into the left molar, and the right molar was sealed without contamination to function as a control. Animals were sacrificed 7 and 14 days after infection, and periapical tissues were collected. The cytokine mRNA expression levels were assessed using real-time PCR. The chemokine mRNA expression levels demonstrated that the experimental infection was capable of inducing increased chemokine expression on day 7 compared to that on day 14, except for CCR5 and CCL5, which showed no changes. The gnotoxenic animal model proved to be effective and allowed evaluation of the immune response against a known infection. Additionally, this study demonstrates that gene expression of chemokines and their receptors against the experimental infection preferentially prevailed during the initial phase of induction of the periradicular alteration (i.e., on day 7 post-infection).

Abstract The aim of this study is to evaluate the expression of cytokines in response to mineral trioxide aggregate (MTA) plus selenium in germ-free mice with experimental furcal perforation. The first left maxillary molar was opened, and the furcal area was perforated and treated with post-MTA-Se (experimental group). The same surgical intervention was performed for the maxillary right first molar, which was treated with MTA (control group). Fifteen mice were sacrificed 7, 14, and 21 days after furcal perforation, and periapical tissue samples were collected. The mRNA expression levels of the cytokines TGF-β, TNF-α, IFN-γ, HPRT, IL-10, IL-4, RANK, RANKL, IL-1, and IL-17 were assessed by using real-time polymerase chain reaction. In the experimental group, at 21-days post-MTA-Se sealing, the mRNA levels of TNF-α and IL-10 were upregulated compared with those in the control group (p < 0.05). Futher assessment revealed basal mRNA expression levels of IL-1α, IFN-γ, RANK, RANKL, IL-17A, IL-4, and TGF-β, over long experimental times, in both the experimental and control groups (p > 0.05). In conclusion, MTA+Se sealing favoured increased expression of IL-10 and TNF-α at later time points (day 21).

Abstract: The objective of this study was to analyze the epidemiological profile of oral health of Sateré-Mawé indigenous people living in Barreirinha, Amazonas (AM), Brazil, and the Tikuna indigenous people living in the urban area of Manaus (AM), in addition to characterizing the need for endodontic treatment between the two ethnic groups. A total of 138 individuals participated in the study, of whom 98 were Tikuna and 40 were Sateré-Mawé; they were distributed in age groups ranging from seven to 75 years. A very high prevalence of caries was observed in both ethnic groups. For the Sateré-Mawé in the 7–12 age group, the decayed, missing, and filled teeth (DMFT) index presented a mean value of 3.17. Comparing the DMFT index and the need for endodontic treatment in each of the ethnicities, these variables were found to be correlated, because as the DMFT index increases, the chances of needing endodontic treatment increase. The Sateré-Mawé presented a higher prevalence of need for endodontic treatment compared to the Tikuna. The association of comorbidities and the need for endodontic treatment were demonstrated only in the Tikuna, and there was only a correlation of this necessity with the presence of diabetes mellitus (DM) in one case. The need to expand access to oral health in these communities is emphasized, taking into account geographical access and technological, environmental, linguistic, and cultural barriers.

No presente artigo nos preocupamos com a reflexão em torno da disputa teórica a respeito de ser possível a teorização do direito livre de avaliações morais, o que fazemos com dois objetivos centrais: (i) demonstrar que o modo corrente com que o tema é tratado oculta importantes considerações a respeito dessa disputa e (ii) tanto expor como justificar a tese das avaliações indiretas de Julie Dickson como um flanco de viabilidade de projetos teóricos dessa natureza. Exploramos na primeira parte do texto, de maneira breve, as contribuições de Hart em torno da questão metodológica da teoria do direito. Na segunda parte, introduzimos as contribuições de Julie Dickson e enfatizamos as distinções analíticas feitas por ela sobre o papel da avaliação na abordagem teórica do direito. Por fim, abordamos a sua contribuição original ao assunto, a nominada “tese das avaliações indiretas”, e defendemos, na conclusão, que existe espaço no território metodológico para teorias que partam de avaliações indiretas sobre o direito.

Abstract The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients’ medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised.

Abstract Sickle cell anemia (SCA) is the most prevalent genetic disease worldwide. Recurrent vaso-occlusive infarcts predispose SCA patients to infections, which are the primary causes of morbidly and mortality. This study aimed to evaluate the relationship between SCA and endodontic diseases. Personal information, medical data (hematological indices, virologic testing, blood transfusions, medications received, splenectomy) and information on the need for endodontic treatment were obtained from SCA patients who were registered and followed up by the Fundação Hemominas, Minas Gerais, Brazil.These data were compared with the need for root canal treatment in SCA patients. One hundred eight patients comprised the studied population, and the rate of the need for endodontic therapy was 10.2%. Among the medical data, a significant difference was observed for eosinophil (p = 0.045) counts and atypical lymphocyte counts (p = 0.036) when the groups (with and without the need for endodontic treatment) were compared. Statistical relevance was observed when comparing the patients with and without the need for root canal therapy concerned eosinophil counts and atypical lymphocyte counts. The differences in statistical medical data, observed between the groups suggest that both parameters are naturally connected to the stimulation of the immune system that can occur in the presence of root canal infections and that can be harmful to SCA individuals.

Este estudo visou avaliar a cobertura do Serviço Odontológico da Polícia Militar da Bahia (SOPMBA) na cidade de Salvador, Bahia, Brasil, entre 2002 e 2004, e estimar as taxas de sua cobertura potencial e real. Foi realizado um estudo de caso único, descritivo. Foram calculadas as taxas de cobertura potencial levando-se em conta a carga horária dos cirurgiões-dentistas do serviço e cobertura real, com base na produção ambulatorial odontológica. Encontrou-se uma adequada cobertura potencial de recursos humanos (1 cirurgião-dentista/1.618 habitantes) e a taxa de cobertura real foi considerada abaixo do padrão proposto pelo Ministério da Saúde (0,39 procedimento/habitante/ano). A baixa cobertura real encontrada pode estar relacionada à baixa produtividade do serviço, cujas razões devem ser mais bem investigadas em estudos posteriores como problemas estruturais e a falta de um sistema de gestão do desempenho da qualidade da prática profissional com metas a serem cumpridas.This study seeks to evaluate dental care coverage in the State Military Police in Salvador, Bahia State, Brazil, from 2002 to 2004, estimating potential and real coverage rates. A single descriptive study was performed. Calculations were made of potential coverage rates considering hourly workloads of staff dentists and the real rates resulting from actual outpatient treatment. Potential human resources coverage was adequate (1 dentist per 1,618 policemen), while the real coverage rate was considered below the standard proposed by the Brazilian Ministry of Health (0.39 procedures per policeman per year). The low real coverage rate could be related to low productivity, the reasons for which should be investigated in greater depth in future studies, and might include organizational problems and lack of a management system to improve the quality of professional practice, with specifically defined targets.

OBJETIVO: Avaliar, de forma objetiva, a capacidade de manter o alerta em pacientes com fibromialgia por meio do teste da manutenção da vigília (TMV). MÉTODO: Foi realizado um estudo caso-controle de 15 pacientes com diagnóstico de fibromialgia com pelo menos 11 de 18 pontos dolorosos e dor difusa nos últimos três meses. O grupo-controle foi constituído de 15 indivíduos hígidos pareados por idade e sexo, selecionados seqüencialmente. Os participantes responderam à escala de sonolência de Epworth e foram submetidos ao TMV. Foram realizadas quatro captações, cada uma com duração mínima de 20 minutos e com intervalo de duas horas. Considerou-se como normal a latência para o início do sono maior do que 20 minutos, e patológica a latência menor que 11 minutos. RESULTADOS: O grupo com fibromialgia apresentou significante redução da latência para o início do sono no TMV, comparado ao grupo-controle 9,9 ± 4,6 e 14,9 ± 5,1, respectivamente, p = 0,01, sendo que em 66,7% dos casos o resultado foi patológico, em comparação com 26,7% no grupo-controle (p = 0,03). Não se observou correlação entre o resultado do TMV e a idade dos pacientes ou a pontuação na escala de sonolência de Epworth. CONCLUSÃO: Neste estudo-piloto, pacientes com fibromialgia apresentam redução da latência do sono no TMV.OBJECTIVE: To assess in an objective way the degree of alertness in patients with fibromyalgia through the Maintenance Wakefulness Test ( MWT). METHOD: Fifteen patients with fibromyalgia and 15 age and sex- matched healthy controls were sequentially selected. The inclusion criteria for fibromyalgia were the presence of at least 11 of the 18 tender points and diffuse pain during three months prior to evaluation. All participants answered the Epworth Sleepiness Scale (ESS) and underwent four 20 minutes sessions of MWT scheduled at 2-hour intervals. Mean sleep latency higher than 20 minutes or lower than 10 minutes was considered normal or pathological, respectively. RESULTS: Although ESS scores did not differ between fibromyalgia patients and controls, the fibromyalgia group showed a significant decrease in the sleep latency by MWT ( 9.9 ± 4.6 and 14.9 ± 5.1, respectively, p = 0.01). Pathological results were obtained in 66.7% of the patients, in comparison to 26.7% of the controls ( p = 0.03). CONCLUSION: In this pilot study, patients with fibromyalgia showed decrease in the sleep latency by the Wakefulness Maintenance Test.

Prosthetic dentistry involves functional and esthetic restoration. Some situations require the use of fiber-reinforced composite resin posts that help preserve restorations. However, if the initial treatment fails, a new endodontic intervention may be required for fiber-reinforced composite resin post removal. This procedure can be complex and challenging but can be facilitated with guided endodontics. This clinical report describes the use of a prototyped guide created with virtual planning for fiber-reinforced composite resin post removal. The guide improved patient safety, shortened the treatment time, and eliminated the need for a new restoration. [ABSTRACT FROM AUTHOR]

Endodontic treatment in severely calcified canals is always a challenging task because it can result in accidents such as deviations or perforations. Recently, guided endodontics has become an alternative approach for pulp canal calcification, facilitating the location of root canals more predictably through the combined use of cone-beam computed tomographic imaging, oral scanning, and endodontic access guides. Although several reports have shown that guided endodontics is safer, faster and can be performed without an operating microscope and by less experienced operators, the technique has limitations, and iatrogenesis may occur. This article describes the limitations of static-guided endodontics and possible causes of failures. In the present case, not fixing the guide to the bone and inaccuracies generated by manually performing mesh merger software led to root perforation. Endodontic microsurgery was effective in resolving this case and should be considered the treatment of choice when guided endodontics cannot be used safely or when it fails. [ABSTRACT FROM AUTHOR]

This cross-sectional study nationally evaluated asynchronous dental teleconsulting services offered by the Telehealth Brazil Networks Program, using the 2019 Telehealth Results Monitoring and Evaluation System database and considering Brazilian regional differences. The following teleconsulting variables were collected: dentist's sex and specialty, date/time of question and answer, response time; dental specialty, professional satisfaction, and patient referral. Five Brazilian regions were socioeconomically characterized according to the Human Development Index, estimated population, Gini coefficient, coverage of dental specialty centers, oral health teams in Family Health Strategy, and oral health teams in primary health care (PHC). In total, 2,703 teleconsulting sessions occurred in Brazil in the analyzed period. The Southeast exhibited the highest demand (49.1%). Most dentists were female (60.6%) and were dental surgeons from the Family Health Strategy (61.3%). Most teleconsulting sessions occurred during working hours (85.5%) and questions were answered within 72 hours (66.7%). Level of satisfaction and avoidance of referral yielded rates of 90.9% and 66.8%, respectively, among dentists who answered about these topics. Semiology was the most frequently demanded area in teleconsulting (33.9%). The different demands from the regions reflected regional differences. The most frequently demanded specialties represent the Brazilian PHC scenario. Professionals incorporated teleconsulting into their work routine and most teleconsultants responded within the stipulated timeframe. Professional feedback should be encouraged. [ABSTRACT FROM AUTHOR]

Objective: To evaluate output of endodontic in oral public healthcare by analyzing differences in instrumentation techniques, quantitative and qualitatively. Material and Methods: Endodontic services were differentiated by instrumentation techniques: hand techniques with stainless steel instruments (SS) or rotary using NiTi rotary instruments. Secondary data on the productivity of 2011 were obtained from the information system. Student's t and Mann-Whitney tests were used. Qualitative data were based on semistructured interviews, direct observation and field diary. Results: Service I employed SS hand techniques, service II used both techniques, while NiTi rotary system was used in service III. Statistically significant differences were observed in total endodontic productivity, with I presenting more productive results than II (p=0.001) and III (p=0.009); III presenting more productive results than II (p<0.001). Comparisons of endodontic treatment types revealed that I performed more multiradicular tooth treatments than did II and III (p=0.005), and III performed more treatments on biradicular teeth than did I and II (p=0.002). Qualitative analyses were divided into themes: "perceptions of the service" and "perceptions of the employed instrument". Conclusion: Professional experience and high productivity per hour can be a differential; the use of rotary instrumentation can be useful in solving unmet demands. Perception of endodontists showed that chosen endodontic technique influenced job satisfaction and lack of integrality of the treatment is a problem in secondary care. [ABSTRACT FROM AUTHOR]

Objective: To analyze the profile of the dental teleconsulting in the Pediatric Dentistry field of Telehealth Brazil Networks Program, in Minas Gerais centers, Brazil. Material and Methods: Asynchronous dental teleconsulting was evaluated in the Pediatric Dentistry specialty, extracted from secondary databases of the telehealth centers: the Clinical Hospital of the Universidade Federal de Minas Gerais and UFMG Medical School, from July 2015 to July 2017. The variables collected were: type of issues and area and sub-area of Pediatric Dentistry. The results were descriptively analyzed using the SPSS v.22,0 program by frequencies. Results: Most of the issues in the Pediatric Dentistry specialty were about clinical conduct (81.4%). There was a predominance of issues regarding prevention (16.6%), surgery (15.3%), tooth eruption (15.1%), endodontics (12.1%), harmful oral habits (9.7%), patient cooperation (8.7%), primary teeth trauma (7.2%) and dentistry (6.7%). Regarding sub-areas, most issues were related to child oral hygiene (68.5%), tooth extraction (92%), tooth eruption chronology (65.6%), pulp diagnosis (49.0%), bruxism (64%), patient management (74.3%), post-trauma treatment (79.3%), and restoration (88.9%). Conclusion: Pediatric Dentistry teleconsulting suggested a difficulty of the professionals in the pediatric patient approach. Continuing education programs and training courses for professionals working in primary health care are crucial for the comprehensive care of pediatric patients. [ABSTRACT FROM AUTHOR]

Abstract The localization of partial or completed root canal obliteration is a challenging task in endodontic practice. Recently, guided endodontics has become an alternative solution for those cases. Although this technique has already been used clinically in managing anterior teeth, in this report, we describe 3 complex clinical scenarios of calcified root canals of 1 molar and 2 premolars using guided endodontics. The clinical cases reported here show that technological evolutions should make guided endodontic procedures more widespread because their execution is relatively fast and safe even in the case of the upper molar. Additionally, 12-month clinical follow-up visits showed the effectiveness of the guided endodontic procedures. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the mRNA expression levels of the cytokines interferon‐γ, tumour necrosis factor‐α, interleukin (IL)‐1β, IL‐10, IL‐6, VEGF, and AGT and the chemokine CCL2/MCP‐1 in periapical interstitial fluid associated with root canal infections before and after the reduction of the bacterial load using a cleaning procedure. Methodology: The case group included 11 patients with chronic liver disease, and the control group included 11 healthy patients. Clinical samples were taken from teeth with pulp necrosis. After cleaning and drying the canal, three paper points were introduced into the root canal and passed through the root apex (2 mm) into the periapical tissues for 1 min. The samples were collected immediately after root canal cleaning and 7 days later to characterize those gene expression levels using real‐time PCR. The data were subjected to the Shapiro–Wilk and the Wilcoxon tests. Results: In the control group, significantly increased expression of the pro‐inflammatory cytokines IFN‐γ and TNF‐α was observed in teeth with restrained bacterial loads (day 7) (P < 0.05). Similarly, increased TNF‐α expression was found on day 7 in the liver group (P < 0.05). No differences were observed in the expression levels of the IL‐1β, IL‐10 and, IL‐6, MCP‐1/CCL‐2 and VEGF between the first collection (day 0) and second collection (day 7), over time in either group. Conclusion: Chronic liver disease patients exhibited sufficient immunologic ability showing relatively similar expression levels of cytokines, chemokines and angiogenic factors in periapical samples compared with the responses from no‐chronic liver disease patients. The outcomes of this study suggest that liver impairment did not compromise the periapical immune response. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the periradicular responses in endodontic infections among members of two populations: an urban Brazilian population and a non-mixed indigenous population. Samples were collected immediately and 7 days after the cleaning and shaping procedures (after reducing the intracanal microbial load) in an attempt to characterize the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-9, interferon (IFN)-γ, IL-17, IL-10, and the chemokines CXCR4, CCL2/monocyte chemotactic protein (MCP)-1, and CCR6. The endogenous cytokine and chemokine expression levels were analyzed using real-time PCR. Only the urban population showed a significant increase in TNF-α, CCL2/MCP-1, CXCR4, and CCR6 expression following the cleaning and shaping of the root canal system. The IFN-γ levels were increased at the 2nd collection (p < 0.05) in the indigenous population. In turn, a significant increase in IL-10 and IL-17 expression (p < 0.05) was observed after the cleaning and shaping procedures (2nd collection) in both populations. No significant differences in the IL-1β, IL-9, and CCL4 expression levels were observed between the 1st and 2nd collections in both populations. The results demonstrate a cytokine and chemokine expression profile that is specific to each analyzed population. However, immune modulation mediated by IL-10 began on the 7th day after the beginning of the endodontic treatment in both populations. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the epidemiological profile of oral health of Sateré-Mawé indigenous people living in Barreirinha, Amazonas (AM), Brazil, and the Tikuna indigenous people living in the urban area of Manaus (AM), in addition to characterizing the need for endodontic treatment between the two ethnic groups. A total of 138 individuals participated in the study, of whom 98 were Tikuna and 40 were Sateré-Mawé; they were distributed in age groups ranging from seven to 75 years. A very high prevalence of caries was observed in both ethnic groups. For the Sateré-Mawé in the 7-12 age group, the decayed, missing, and filled teeth (DMFT) index presented a mean value of 3.17. Comparing the DMFT index and the need for endodontic treatment in each of the ethnicities, these variables were found to be correlated, because as the DMFT index increases, the chances of needing endodontic treatment increase. The Sateré-Mawé presented a higher prevalence of need for endodontic treatment compared to the Tikuna. The association of comorbidities and the need for endodontic treatment were demonstrated only in the Tikuna, and there was only a correlation of this necessity with the presence of diabetes mellitus (DM) in one case. The need to expand access to oral health in these communities is emphasized, taking into account geographical access and technological, environmental, linguistic, and cultural barriers. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to evaluate the asynchronous dental teleconsulting of Telehealth Brazil Networks Program in Minas Gerais. Data were collected from secondary databases of the Clinical Hospital of the Universidade Federal de Minas Gerais (CH/UFMG) and Medical School of UFMG (MS/UFMG), from July 2015 to July 2017. The variables analyzed were telehealth center, sex and profession, date and time questions and answers, response time in days, whether the issue was duly addressed, whether the teleconsulting was attended, post status, professional's satisfaction, conduct adopted after teleconsulting, dental specialty area, and type of issues. Sociodemographic data from the Intermediate Geographical Regions (IGR) of Minas Gerais, including the Municipal Human Development Index (MHDI) and Gini Index were also collected. The results were analyzed using SPSS v.22.0. In total, 3,920 teleconsulting were recorded, with increasing demand in the study period. Most were requested by dentists (93.3%) and female professionals (78.6%), during office hours (78.6%), and related to general conducts (72.1%). Almost all were attended (99.7%), with a maximum response time of two days (75.0%). A low feedback on satisfaction and resolution of issues (missing data of 57.2% and 70.2%, respectively) was recorded. Only 5.2% had information on whether patients were referred. The most common inquires were of issues about Pathology/Stomatology specialties (19.0%) and Pharmacology/Anesthesiology (18.8%). The response occurred within the expected time, with prevalent issues in basic dental areas and general conducts. Feedback from professionals must be encouraged to allow a better analysis and improvements of the program. [ABSTRACT FROM AUTHOR]

The present study aims to evaluate the longitudinal effects of induced experimental infections in gnotoxenic animals on the expression of inflammatory chemokines and their receptors in periradicular tissues. The null hypothesis tested was that Enterococcus faecalis and Fusobacterium nucleatum had no effect on CCR5, CCL5, CXCL10, CCL2/MCP-1, CXCR2 and CCR1 expression. Two groups of five animals (n = 5) aged between 8 and 12 weeks were used in this study. The animals were anaesthetized, and coronary access was performed in the first molar on the right and left sides. Microorganisms were inoculated into the left molar, and the right molar was sealed without contamination to function as a control. Animals were sacrificed 7 and 14 days after infection, and periapical tissues were collected. The cytokine mRNA expression levels were assessed using realtime PCR. The chemokine mRNA expression levels demonstrated that the experimental infection was capable of inducing increased chemokine expression on day 7 compared to that on day 14, except for CCR5 and CCL5, which showed no changes. The gnotoxenic animal model proved to be effective and allowed evaluation of the immune response against a known infection. Additionally, this study demonstrates that gene expression of chemokines and their receptors against the experimental infection preferentially prevailed during the initial phase of induction of the periradicular alteration (i.e., on day 7 post-infection). [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the expression of cytokines in response to mineral trioxide aggregate (MTA) plus selenium in germ-free mice with experimental furcal perforation. The first left maxillary molar was opened, and the furcal area was perforated and treated with post-MTA-Se (experimental group). The same surgical intervention was performed for the maxillary right first molar, which was treated with MTA (control group). Fifteen mice were sacrificed 7, 14, and 21 days after furcal perforation, and periapical tissue samples were collected. The mRNA expression levels of the cytokines TGF-β, TNF-α, IFN-γ, HPRT, IL-10, IL-4, RANK, RANKL, IL-1, and IL-17 were assessed by using real-time polymerase chain reaction. In the experimental group, at 21-days post-MTA-Se sealing, the mRNA levels of TNF-α and IL-10 were upregulated compared with those in the control group (p < 0.05). Futher assessment revealed basal mRNA expression levels of IL-1α, IFN-γ, RANK, RANKL, IL-17A, IL-4, and TGF-β, over long experimental times, in both the experimental and control groups (p > 0.05). In conclusion, MTA+Se sealing favoured increased expression of IL-10 and TNF-α at later time points (day 21). [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients' medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised. [ABSTRACT FROM AUTHOR]

Sickle cell anemia (SCA) is the most prevalent genetic disease worldwide. Recurrent vaso-occlusive infarcts predispose SCA patients to infections, which are the primary causes of morbidly and mortality. This study aimed to evaluate the relationship between SCA and endodontic diseases. Personal information, medical data (hematological indices, virologic testing, blood transfusions, medications received, splenectomy) and information on the need for endodontic treatment were obtained from SCA patients who were registered and followed up by the Fundação Hemominas, Minas Gerais, Brazil. These data were compared with the need for root canal treatment in SCA patients. One hundred eight patients comprised the studied population, and the rate of the need for endodontic therapy was 10.2%. Among the medical data, a significant difference was observed for eosinophil (p = 0.045) counts and atypical lymphocyte counts (p = 0.036) when the groups (with and without the need for endodontic treatment) were compared. Statistical relevance was observed when comparing the patients with and without the need for root canal therapy concerned eosinophil counts and atypical lymphocyte counts. The differences in statistical medical data, observed between the groups suggest that both parameters are naturally connected to the stimulation of the immune system that can occur in the presence of root canal infections and that can be harmful to SCA individuals. [ABSTRACT FROM AUTHOR]