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This study aimed to compare the survival of replanted teeth that followed the 2012 or the 2020 International Association of Dental Traumatology (IADT) guidelines. Sixty-two permanent replanted teeth were retrospectively assessed (IADT 2012, n = 45; IADT 2020, n = 17). Five years after replantation (from January 2017 to December 2021), clinical and radiographic examinations were performed. A significance level of 95% was considered to evaluate the outcomes. Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour. Twelve teeth remained in their sockets without resorption: 8 (66.7%) were replanted within one hour, 2 (16.7%) followed the 2012 IADT, and 2 (16.7%) the 2020 IADT guidelines for late replantation. There was a significant difference (p 0.05). Replanted teeth following both, 2012 or 2020 IADT guidelines, have similar clinical outcomes. The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket. Resumo Este estudo teve como objetivo comparar a sobrevida, por cinco anos, de dentes reimplantados que seguiram as diretrizes de 2012 ou 2020 da International Association of Dental Traumatology (IADT). Sessenta e dois dentes permanentes reimplantados foram avaliados retrospectivamente (IADT 2012, n = 45; IADT 2020, n = 17). Cinco anos após o reimplante, foram realizados exames clínicos e radiográficos. Foi considerado um nível de significância de 95% para avaliar os desfechos. Trinta e um dentes (50,0%) permaneceram em seus alvéolos e 31 (50,0%) foram perdidos por reabsorção radicular externa. Dos 25 (40,3%) dentes reimplantados em uma hora, 16 (64,0%) permaneceram em seus alvéolos e 9 (36,0%) foram perdidos. Vinte e dois (71,0%) de todos os 31 dentes perdidos tiveram um tempo extra-alveolar superior a uma hora. Doze dentes permaneceram em seus alvéolos sem reabsorção: 8 (66,7%) foram reimplantados em uma hora, 2 (16,7%) seguiram a IADT de 2012 e 2 (16,7%) as diretrizes da IADT de 2020 para reimplante tardio. Houve diferença significativa (p 0,05). Dentes reimplantados seguindo as diretrizes de 2012 ou 2020 da IADT, tiveram taxas de sucesso semelhantes. O tempo extra-alveolar inferior a uma hora demonstrou ser importante para manter o dente permanente em seu alvéolo.

Objective: To examine oral colonization and virulence factors of Candida spp. in patients aged from 0 to 18 months with cleft palate (CP). Materials and Methods: Sixty babies were allocated into 3 groups: CP, CP with orthodontic plate (CPwP), and control group (Ctrl) without CP. Information on feeding habits, hygiene, and history of candidosis was collected. The presence of Candida spp. was investigated in samples of saliva. Fungal hydrophobicity, protease, esterase, phospholipase, and hemolysin were evaluated in a semiquantitative manner. Results: Positive oral isolations of Candida spp. were detected in CP (89.5%), CPwP (100%), and Ctrl (44%) groups. Candidosis was more reported in the cleft groups than in the Ctrl group ( P ≤ .023). There was a higher prevalence of Candida albicans, followed by Candida krusei, Candida tropicalis, and Candida parapsilosis in all groups. There was no uniformity of expression of virulence factors, either among different species or among different groups. Conclusion: Candida spp. colonization occurred in all groups, being superior in CPwP group. Candidosis episodes were more reported in patients from CPwP than in other groups, although candidosis was also registered in other groups. Candida albicans was the predominant species and virulence factors did not exhibit any pattern for species or groups of patients.

We aimed to evaluate laypeople’s visual perception of the gingival smile before and after botulinum-toxin application, using eye-tracking technology. Two frontal photographs of a female volunteer’s face with a gingival smile were used. One before and another 30 days after the toxin application in the upper lip elevator muscle region. The images were evaluated by 58 participants. Using the OGAMA software, visualization data were obtained in three areas of interest (AOI) through eye-tracking. A visual analog scale (VAS) was used to assess facial attractiveness, and a questionnaire to assess the perception of sympathy, satisfaction with the smile, dissatisfaction with dental and gingival exposure, and shyness. Heat and point maps showed that the participants visually concentrated on the mouth region, with a small transition to the nose and eyes in the pre-procedure image. The mouth region was the AOI where the first visualization occurred in a shorter time compared to the latter areas (p

The absence or presence of root resorption on the root surface of a replanted tooth indicates an immune-inflammatory reaction. Since interleukin-6 (IL-6) is considered an inflammatory marker in bone resorption, this study aimed to investigate the association between clinical variables and polymorphisms in IL6, with the outcome of replanted teeth at 1-year follow-up. Altogether, 127 avulsed teeth that were replanted and had their root canals treated were selected for this study. Periapical radiographs were taken after replantation and after 1 year. Real-time PCR was used to genotype IL6 polymorphisms. Chi-square and 'Z' tests were performed to verify the association between genetic variables and the prognosis of replanted teeth (P

Resumo A organização dos sistemas de saúde em redes de atenção à saúde (RAS) se apresenta como uma estratégia para superar a fragmentação das ações e serviços de saúde materno-infantil e qualificar a gestão do cuidado. O objetivo deste estudo foi validar o Instrumento de Avaliação de Redes de Atenção Materno-infantil (IARAMI), adaptado a partir do Instrumento de Avaliação de Redes de Atenção à Saúde. O processo de validação compreendeu a validação de face e construto. A metodologia utilizada para a validação de face incluiu a adaptação conceitual e semântica do instrumento e a análise por um painel de especialistas, por meio da técnica e-Delphi de consenso modificada. Após sua validação de face, o IARAMI foi aplicado em uma amostra de gestores de 99 municípios do estado do Paraná. A validação de construto foi conduzida por análise de consistência interna por meio do coeficiente alfa de Cronbach e de análise fatorial. A técnica de análise fatorial foi aplicada para cada uma das dimensões do instrumento, permitindo a análise de comunalidades. Os resultados evidenciaram que o IARAMI apresentou confiabilidade e validade, demonstrando ser uma ferramenta que pode auxiliar gestores e trabalhadores da saúde no planejamento, na gestão e na avaliação do grau de integração da rede de atenção à saúde materno-infantil. Abstract The organization of health systems in Health Care Networks (HCN) presents itself as a strategy to overcome the fragmentation of maternal and child health actions and services and to qualify care management. The objective of this study was to validate the Instrument for Evaluation of Maternal and Child Health Care Networks (IARAMI), adapted from the Evaluation Tool of Health Care Networks. The validation process comprised face and construct validation. The methodology used for face validation included the conceptual and semantic adaptation of the instrument and analysis by a panel of experts, through the modified consensus e-Delphi technique. After face validation, IARAMI was applied in a sample of 99 health managers of municipalities in the state of Paraná. The construct validation was conducted through the internal consistency analysis using Cronbach’s alpha coefficient and factorial analysis. The factorial analysis technique was applied to each of the dimensions of the instrument, enabling the analysis of communalities. The results showed that IARAMI presented reliability and validity, proving to be a tool that can help managers and health workers in the planning, management, and evaluation of the degree of integration of the maternal and child care network.

This study evaluated the effectiveness of the use of an autologous membrane of fibrin rich in platelets and leukocytes (LPRF) and blood clot, in bone repair after periapical surgery, in teeth with apical lesions. Methodology: Randomized clinical study of 64 teeth with periapical lesions submitted to apicectomy and retrograde filling with mineral trioxide aggregate (MTA). The teeth were divided into 2 groups according to the filling of the bone pocket: LPRF (n = 34) and only with blood clot (n = 30). The areas were measured twice, T0 after periapical surgery and T1 after 90 days, using cone beam computed tomography (CBCT) to assess bone pocket repair in cubic millimeters using the ITK-SNAP program. Results: Statistical analyses revealed significant reductions in the volume of bone stores in the LPRF group, with a 48.47% reduction compared to 29.25% for the blood clot group (p < 0.01), with the power of test at 99.86%. Conclusion: The use of LPRF membrane can be recommended as a bone site filler after periapical surgery compared to blood clot.

The prevalence of insomnia, depression and anxiety have recently been increasing (Kessler et al., 2005) with approximately 18.4% of the Brazilian population having experienced depression at least once during their lifetimes. These data characterize Brazil as the developing country with the largest number of people suffering from this disease (WHO, 2018). Depression is commonly accompanied by anxiety disorders and chronic psychiatric conditions with an estimated prevalence of approximately 29% (Kessler et al., 2005), which results in functional impairment that is associated with significant social costs. Treatment of these conditions includes psychological therapy and antidepressants. These drugs, such as benzodiazepines (BZDs), have been widely studied since the 1960s (Llorente et al., 2000) (WHO, 2018). BZDs are used by 9–25% of the elderly population aged 65 years of age and over, mainly among women (15–21.7% in Brazil, 9.9% in the United States, 24% in Canada and 25% in Sweden) (Jorm et al., 2000, Alvarenga et al., 2008, Johnell and Fastbom, 2009, Leggett et al., 2015). BZDs can be divided into two categories, anxiolytics and hypnotics, and can be used as anticonvulsants due to their muscle relaxant effects (De Almeida et al., 2008). As with all central-acting drugs, BZDs have side effects, such as decreased psychomotor activity, memory loss, physical dependence on long-term treatments, (Longo et al., 2000, Uzun et al., 2010) and hyposalivation and/or xerostomia, which is one of the main adverse effects described in the literature (Guggenheimer and Moore, 2003, Lambrecht et al., 2013, Raghavan et al., 2014). BZDs are among the drugs with the highest rates of complaints by patients in dental offices (Smith and Burtner, 1994) where these drugs are prescribed to reduce anxiety related to dental treatments of non-cooperative patients (Zaclikevis et al., 2009). Among the licensed BZDs, Lorazepam is one of the most widely used drugs for both insomnia and anxiety (Amato et al., 2010), particularly among elderly individuals with anxiety disorders and related conditions (Pomara et al., 2015). Previous studies, by our research group, demonstrated the damage Lorazepam and midazolam, another BDZ commonly prescribed for anxiety, caused to the acinar cells of parotid glands (Rinaldi et al., 2015, Mattioli et al., 2016, Rinaldi et al., 2018). We observed that the chronic use of BZDs significantly decreased the number and proliferation of acinar cells, reduced salivary flow and increased cell volume. In light of this, we hypothesize that the reduction in the number of acinar cells caused by Lorazepam in the salivary glands is possibly due to an apoptotic effect on these cells of the parotid glands of rats caused by the chronic use of this drug. Apoptosis plays a fundamental role in the elimination of unwanted, damaged or infected cells in multicellular organisms and serves as an important biological process in cellular development, differentiation and proliferation (So et al., 2016). The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick end-labeling (TUNEL) (Tilly, 1996) technique is the gold standard test employed to detect apoptotic cells (Burattini et al., 2009, Heisler-Taylor et al., 2018). Because of the its wide-spread use of TUNEL, there is no need to use another technique to detect apoptotic cells. The literature lacks studies demonstrating Lorazepam-induced apoptosis in acinar cells. The aim of this study was to evaluate the apoptotic action of a BZD on the acinar cells of the parotid glands of rats by quantification of the number of apoptotic cell nuclei (NCA), the number of acinar cells (N) and the immunoexpression of nuclear proliferation cell proliferation (PCNA) protein.

Objective: To evaluate the initial forces generated by two types of palatal expansion appliances, through fiber optic sensors, in elastomeric models. Materials and Methods: An elastomeric model simulating the upper dental arch was fabricated. The sensors were placed adjacent to the first premolars and the first molars roots (apical, cervical, vestibular, palatal). Hyrax and Haas palatal expanders were fitted onto the dental arch. Activation of the screw was performed 4 times. The variations in wavelengths of each sensor during the activations were recorded. ANOVA and Games-Howell were used (P

To examine oral colonization and virulence factors ofSixty babies were allocated into 3 groups: CP, CP with orthodontic plate (CPwP), and control group (Ctrl) without CP. Information on feeding habits, hygiene, and history of candidosis was collected. The presence ofPositive oral isolations of

Non-carious cervical lesions (NCCLs) are characterized by a loss of hard dental tissue near the cement–enamel junction with multifactorial etiology. The aim of this study was to demonstrate that occlusal factors as attrition, malocclusion, and bruxism, and mental disorders as depression, stress, and anxiety are involved in the etiology of NCCLs. Salivary samples and clinical data of 340 individuals selected from 6,112 participants were obtained from the University of Pittsburgh School of Dental Medicine Dental Registry and DNA Repository project. The affected group was formed by individuals with NCCL (34 females, 34 males, mean age 55.34 years). In addition, the comparison group was formed by individuals without NCCL (136 females, 136 males, mean age 55.14 years). Eleven single-nucleotide polymorphisms (SNPs) previously associated with mental disorders were genotyped and tested for association with NCCLs. When all occlusal factors were combined there was found a significant association with NCCL (p = 0.000001/adjusted OR 4.38, 95% CI 2.50–7.69). Attrition (OR 3.56, 95% CI 2.00–6.32) and malocclusion (OR 5.09, 95% CI 1.65–15.68) as separate variables showed statistically significant associations with NCCL. There was a significant difference in stress history between the two groups (OR 2.17, 95% CI 1.08–4.39). No associations between NCCLs and the SNPs selected were found. However, when the occlusal factors were analyzed as covariates, associations were found between bruxism and seven of the selected SNPs. Our results suggest that occlusal factors might be associated with NCCLs.

Objectives To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and methods The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE. Trial registration The Brazilian Clinical Trials Registry Identifier: RBR-3r967t.

This study aimed to identify predictors of perceived stress and quality of life (QoL) amongst dental master and doctoral students.This is a cross-sectional study with Brazilian students as participants (n = 707). The following instruments were administered: Perceived stress scale (PSS), the WHOQOL-BREF and a socio-demographic questionnaire. A linear regression model was estimated.The results showed that female was associated with higher scores of PSS and lower scores of QoL. A negative correlation was observed between PSS and all four domains of QoL. Multivariate analysis revealed that the set of selected variables partially explained the variability of PSS score (28%) and the four QoL domains: physical (52%), psychological (62%), social relationships (25%) and environment (37%). The variable number of children, hours of sleep, concurrent work and study, leisure time and physical activity practice were associated with positive changes on QoL, whilst PSS and medication intake with negative. Lower PSS score was associated with the variables age, hours of sleep, leisure time and physical activity.Our findings suggest that perceived stress and medication intake due to study are important predictors of lower QoL in dental master and doctoral students, especially in the psychological domain. More hours of sleep, leisure time and physical activity improved both QoL and perceived stress scores and might be feasible coping strategies for these outcomes in this population.

To evaluate the fracture strength of extended Class I restorations with different restorative techniques using nanofilled and nanohybrid composites. Sixty extracted human third molars were prepared with extended Class I cavities and divided into six groups: groups FS-F (Filtek bulk-fill Flow + Filtek Supreme Ultra, 3 M) and GR-F (X-tra base + GrandioSO, VOCO), restored with a flowable bulk-fill composite as a base covered by a nanofilled or nanohybrid composite; groups FB (Filtek One Bulk-Fill, 3 M) and AF (Admira Fusion X-tra, VOCO), restored with a bulk-fill resin composite; and groups FS (Filtek Supreme Ultra, 3 M) and GR (GrandioSO, VOCO), restored incrementally with a nanofilled or nanohybrid composite. Sound extracted teeth (n = 10) were used as a control group (CTL). The specimens were axially loaded until failure. Data were analyzed using one-way ANOVA and Games Howell test (α = 0.05). Groups CTL and GR-F demonstrated significantly higher mean fracture strength when compared to FS, AF, and GR (p

BACKGROUND During dental implants placement and bone augmentation procedures, it is important to determine the presence and location of mandibular canal anatomical variation in order to avoid injuries to inferior alveolar bundle. This study aimed to describe the prevalence and configuration of mandibular canal branching in the posterior region of the mandible using cone beam computed tomography (CBCT). METHODS The interpretation of the images was conducted according to the presence, classification and location of the mandibular canal. Horizontal and vertical distances from mandibular canal in the ramus region to the molar region was recorded. CBCT images of 751 patients, 486 women (64.7%) and 265 men (35.3%), with a mean age of 54.57 (±13.23; 14-93) years, were interpreted by one calibrated examiner. RESULTS Out of 1502 hemi-mandibles images, mandibular canal variations were observed in 130 (8.6%). Sixty-four (49.2%) mandibular canal variations were identified on the right side and 66 (50.8%) on the left side. The mean distances between superior cortical of the mandibular canal and the base of mandible, buccal cortical of mandibular canal and buccal cortical bone, and superior cortical of mandibular canal and alveolar ridge were 12.16 mm (±2.68), 4.17 mm (±1.30), and 12.97mm (±4.01), respectively. Type I mandibular canal variation was the most frequent (68; 52.2%), followed by type III (34; 26.1%). CONCLUSIONS Prevalence of mandibular canal variations was 8.6%, type I was the most common and its direction showed proximity with lingual surface in the second molar region.

Objective The objective of this study was to assess inflammatory cytologic alterations in the oral epithelium of patients on human immunodeficiency virus pre-exposure prophylaxis (PrEP). Material and Methods Epithelial cells from the buccal mucosa of 30 patients were collected by exfoliative cytology and were evaluated according to inflammatory cellular alterations: karyomegaly, bi- or multinucleation, karyopyknosis, karyorrhexis, perinuclear halo formation, metachromasia, cytoplasmic vacuolization, indistinct cytoplasmic border, keratinization, and atrophy. Epithelial cells were collected initially before PrEP onset (T1) and then after 30 days of PrEP use (T2). Two experienced cytopathologists independently analyzed the slides. Results The nonparametric Wilcoxon test showed that there was a statistically significant increase in the number of cells with karyomegaly at T2 compared to T1 (P = .033). The other cellular alterations did not present with statistically significant differences between the 2 moments of evaluation (P > .05). Conclusion The increased number of oral epithelial cells with karyomegaly after 30 days of using PrEP suggests the presence of inflammatory alterations at this site.

This study explores associated factors and perceptions of oral health among crack users recruited in open drug scenes in Brazil. A mixed methods approach was used. The quantitative component analysed findings from a large (

Background: Several of young people and adults make use of anabolic-androgenic steroid (ASS), during resistance training. The purposes of this study were to compare blood and salivary parameters in male resistance training practitioners using oxandrolone with reference values, compare these with a control group in triplicate, and correlate salivary and blood parameters. Methods: In this prospective analytical observational study, blood, saliva, and urine were collected from 22 individuals (oxandrolone group, OG, n = 11 and control group, CG, n = 11), and these samples were analyzed at three time points: before oxandrolone consumption, at cessation of oxandrolone use, and three months after cessation of oxandrolone use. Complete blood count, lipid profile, metabolites, and enzymes were analyzed from blood samples. Salivary flow, pH, triglycerides, urea, aspartate transaminase, alanine aminotransferase, phosphorus, and calcium were analyzed from saliva. Urinalysis was used for toxicological screening. Mann-Whitney U tests, chi-square analysis, Friedman's ANOVA, and Spearman’s correlation tests were performed, with significance p40 mg/dL), as soon as its use ceased, and a return to normal HDL levels three months later (49 mg/dL, >40 mg/dL). We also found higher triglyceride level (177 mg/dL) in this group compared with the reference value (

OBJECTIVE This study was conducted to correlate and compare the immunoexpression of sex-determining region Y-box 2 (SOX-2) in oral leukoplakia (OL) lesions with that in normal buccal mucosa (control). MATERIALS AND METHODS In this observational study, OL with low-risk (n = 34) and high-risk (n = 33) dysplasia and control samples (n = 25) were subjected to immunohistochemical analysis for SOX-2. In the epithelium, SOX-2 positive and negative cells, as well as semiautomatic segmentation of the immunopositive nuclear area were counted. Statistical tests included chi-square, one-way analysis of variance, Tukey, and Games-Howell. The level of significance was 5%. RESULTS Groups with OL lesions (low and high-risk) showed higher mean numbers of SOX-2 positive cells (63.47 ± 25.70 and 68.18 ± 21.17) compared to the control group (45.85 ± 27.38) (p = 0.00). Groups with OL lesions (low and high-risk) exhibited higher mean positive nuclear area (0.24 ± 0.47 and 1.09 ± 2.06) compared to the control group (0.00 ± 0.01) (p = 0.01). CONCLUSION Oral leukoplakia lesions showed a higher expression of SOX-2, suggesting its contribution to the pathogenesis of OL.

Aim To evaluate the sialometric and sialochemical changes in morbidly obese patients before and after bariatric surgery. Materials and methods A total of 74 participants were divided into three groups paired by sex and age: (a) Experimental 1 (E1)-morbid obesity (n = 40)-according to the Fobi-Capella technique, corresponding to the individuals with a body mass index (BMI) of greater than 40 kg/m2 prior to bariatric surgery; (b) Experimental 2 (E2)-the same individuals after surgery; and (c) control (C) (n = 34)-individuals with a BMI of nearly 23 kg/m2. The measure of salivary flow was carried out by collecting stimulated saliva. The pH was evaluated using the pocket pH meter, while the salivary buffer capacity (SBC) was determined by the titration method. Analyses of the salivary concentration of total proteins (TPs), amylase activity, urea, calcium (Ca++), and glucose were evaluated using the calorimetric method. Results Group E1, as compared with group C, presented the highest pH levels (p = 0.03), amylase activity (p = 0.00), and calcium (p = 0.00). The opposite was observed for glucose (p = 0.00), TP (p = 0.04), and urea (p = 0.04). Group E2, as compared with group C, revealed higher levels of amylase (p = 0.00) and calcium (p = 0.00). The opposite was observed for SBC (p = 0.01), PT (p = 0.00), and glucose (p = 0.00). Group E1, as compared with group E2, presented higher values of SBC (p = 0.00) and urea (p = 0.00). The lowest values were found for calcium and urea (p = 0.03). Conclusion Both weight gain and bariatric surgery are risk factors for the oral condition, causing change in some important salivary components, such as TP, amylase, calcium, and glucose. Clinical significance This article is a valuable addition to the scientific literature, due to its novelty. There are no papers that show salivary alterations related to bariatric surgeries.

• Our results showed significant differences in oral heath promotion amongst distinct Brazilian regions.

Background To verify the prevalence and profile of users and non-users of anabolic steroid (AS) among resistance training practitioners. Methods An observational, cross-sectional survey was performed in 100 gyms in Curitiba city, involving 5773 individuals and self-administered questionnaires. The chi-square and z-tests of proportions were used for comparison between the groups (p Results 83.2% did not use, 9.1% formerly used, 3.4% currently used, and 4.3% intended used AS. The prevalence of former or current AS users was 16.9 and 6.5% among men and women, respectively. The prevalence ratios were as follows: 1) 2.6 male users for each woman; 2) 3.3 individuals aged 30–44 years and 2.8 individuals aged 18–29 years for each individual aged over 45 years. Beginners were not interested in using AS, but individuals who had trained longer had higher prevalence of AS use. Conclusions The gym environment encouraged the use of AS owing to aesthetic appeal. Thus, suggesting the need for actions to prevent abusive use of AS considering the practitioners profile (practitioners were young, university and single).

The profiles of polytraumatized patients in intensive care units were characterized. Serum and salivary markers were compared with normality between Classes I and II of APACHE II and between periods of hospitalization; these results were correlated. This was a prospective study on saliva charts and collection (n = 70). Profile: male, 27 years old, blunt traumas and collisions. Serum parameters with normality: decrease in pH, creatinine at admission to Class I, and at 48 and 72 hours in both classes; K+ at 48 h in Class II; Ca+ on admission in both classes and at 72 h in Class I. Increase in urea at 72 h in Class II, glucose at all times and in all classes, and Ca+ at 48 h in both classes. Class II had high Na+ at 48 and 72 h compared to Class I. In Class I, creatinine reduction occurred in 48 h and 72 h compared to admission and an increase of Ca+ at 48 h with admission. In Class II, pH and Na+ increased at 48 h and 72 h compared to admission. K+ decreased from admission to 48 h and increased from 48 h to 72 h. Urea increased from 48 to 72 hours. Creatinine decreased from admission to 48 and 72 hours. Ca+ increased from admission to 48 hours and decreased from 48 to 72 hours. There was an increase in the saliva levels in both classes and times in relation to normality. There was an increase in urea at admission, glucose at 72 h, and Ca+ at 48 h in Class II compared with Class I. Class I urea increased from admission to 48 h and Ca+ decreased from admission to 48 h. Class II urea decreased from 48 h to 72 h. Strong or very strong positive correlation was identified between blood and creatinine saliva at all times and regular and negative Ca+ at 72 h. This study provides evidence that salivary and serum biomarkers can be used together to monitor the evolution of the clinical symptoms of ICU patients.

The organization of health systems in Health Care Networks (HCN) presents itself as a strategy to overcome the fragmentation of maternal and child health actions and services and to qualify care management. The objective of this study was to validate the Instrument for Evaluation of Maternal and Child Health Care Networks (IARAMI), adapted from the Evaluation Tool of Health Care Networks. The validation process comprised face and construct validation. The methodology used for face validation included the conceptual and semantic adaptation of the instrument and analysis by a panel of experts, through the modified consensus e-Delphi technique. After face validation, IARAMI was applied in a sample of 99 health managers of municipalities in the state of Paraná. The construct validation was conducted through the internal consistency analysis using Cronbach's alpha coefficient and factorial analysis. The factorial analysis technique was applied to each of the dimensions of the instrument, enabling the analysis of communalities. The results showed that IARAMI presented reliability and validity, proving to be a tool that can help managers and health workers in the planning, management, and evaluation of the degree of integration of the maternal and child care network.A organização dos sistemas de saúde em redes de atenção à saúde (RAS) se apresenta como uma estratégia para superar a fragmentação das ações e serviços de saúde materno-infantil e qualificar a gestão do cuidado. O objetivo deste estudo foi validar o Instrumento de Avaliação de Redes de Atenção Materno-infantil (IARAMI), adaptado a partir do Instrumento de Avaliação de Redes de Atenção à Saúde. O processo de validação compreendeu a validação de face e construto. A metodologia utilizada para a validação de face incluiu a adaptação conceitual e semântica do instrumento e a análise por um painel de especialistas, por meio da técnica e-Delphi de consenso modificada. Após sua validação de face, o IARAMI foi aplicado em uma amostra de gestores de 99 municípios do estado do Paraná. A validação de construto foi conduzida por análise de consistência interna por meio do coeficiente alfa de Cronbach e de análise fatorial. A técnica de análise fatorial foi aplicada para cada uma das dimensões do instrumento, permitindo a análise de comunalidades. Os resultados evidenciaram que o IARAMI apresentou confiabilidade e validade, demonstrando ser uma ferramenta que pode auxiliar gestores e trabalhadores da saúde no planejamento, na gestão e na avaliação do grau de integração da rede de atenção à saúde materno-infantil.

The aim of this study is to compare the immunoexpression of metalloproteinases 1 and 8 in giant-cell fibroma, inflammatory fibrous hyperplasia and normal mucosa. Twenty-two cases of giant-cell fibroma, inflammatory fibrous hyperplasia and oral mucosa (control) each were subjected to immunohistochemistry using anti-metalloproteinase-1 and anti-metalloproteinase-8 antibodies. Eight images of each case were captured and analysed through the a) application of a count grid to count the number of positive neutrophils, macrophages, lymphocytes, plasma cells, fibroblasts and blood vessels to obtain the percentage of staining and b) semi-automated segmentation quantifying the stained area in square micrometres. Statistical tests included ANOVA Two-way, Kruskal Wallis and Games-Howell, with a significance level of 5%. An increased percentage of metalloproteinase-1-immunopositive blood vessels were observed in giant-cell fibroma (26.6±22.4; p=0.02) and inflammatory fibrous hyperplasia (34.3±31.5; p=0.01) compared with the control group (19.6±9.2). No significant differences in inflammatory cells, fibroblasts and total area of metalloproteinase-1 and -8 were noted among the three groups. Metalloproteinase-1 apparently acts within the pathogenesis of giant-cell fibroma and inflammatory fibrous hyperplasia.

Objective: To compare the histological responses in corticotomy- and corticision-assisted tooth movement. Materials and Methods: Ninety Wistar rats were divided into three groups: C (control—tooth movement only), CT (tooth movement + corticotomy), and CI (tooth movement + corticision). Surgeries were performed on the vestibular and lingual cortical bone of the maxillary first molar. Tooth movement was carried out with nickel-titanium closed coil springs having a force of 30 g. The rats were sacrificed at 3, 14, and 28 days. To evaluate the number of osteoclasts and amount of root resorption, a tartrate-resistant acid phosphatase stain was used. Hematoxylin and eosin staining was performed for areas of hyalinization, and the organic bone matrix was stained with picrosirius. Results: The CT group showed a greater number of osteoclasts than did the C group on day 3 (P < .05). At the same time point, the CT and CI groups showed a delayed onset of organic bone matrix remodeling and a lower incidence of root resorption than did the C group (P < .05). There were also fewer hyalinization areas in the CI group than in the C group on day 3 (P < .05). Conclusions: Corticotomy effectively increased bone resorption during the early stages of tooth movement, but this increase was not observed for corticision. The surgical procedures did not accelerate organic bone matrix remodeling. Corticotomies and corticisions decreased the risk of root resorption only during the early stages of movement. Corticision reduced the level of hyalinization, while corticotomy did not.

Objective The aim was to investigate collagen fibers in giant cell fibroma, inflammatory fibrous hyperplasia, and oral normal mucosa. Materials and methods Sixty-six cases were stained with picrosirius red. The slides were observed under polarization, followed by the measurement of the area and the percentage of the type I and type III collagens. The age and gender were obtained from the clinical records. Results No differences could be observed in both the area and percentage of the type I and type III collagens within the categories of lesions and normal mucosa. In the giant cells fibroma, a greater area and percentage of type I collagen could be identified in individuals of less than 41.5 years (p Conclusion The distribution of type I and type III collagen fibers in the studied lesions followed a similar pattern to that observed in the normal mucosa, indicating a normal collagen maturation process of type III to I. The study supports that multinucleated and stellate cells of the giant cell fibroma appear to be functional within collagen types III and I turnover. The greater amount of type I collagen identified in giant cell fibroma in individuals of less than 41.5 years reinforce the neoplastic nature of lesion.