Abstract Peri-implant diseases, including peri-implant mucositis (PIM) and peri-implantitis, are a chronic inflammatory disorder triggered by bacterial biofilm in susceptible hosts. Potential risk factors for peri-implant diseases include smoking, dental plaque accumulation, poor oral hygiene, genetics, and absence of peri-implant keratinized mucosa. This cohort study aimed to evaluate the influence of patient-, implant-, and prosthetic-related factors on PIM and peri-implant bone loss (PBL) around dental implants after 1 year of loading. A total of 54 subjects (22 males and 32 females) were included in the study. Peri-implant clinical parameters were assessed and standardized periapical radiographs of each dental implant were obtained 15 days after the definitive prosthesis installation (baseline) and at 3, 6, and 12 months of follow-up. A total of 173 implants were evaluated. PIM affected 44.8% of the implants and no significant association was found between the investigated parameters and PIM incidence, except for type of implant connection. A significantly higher incidence of PIM (80.0%) was observed for implants with internal hexagon connection type after 1 year of follow-up (p = 0.015). Moreover, a mean PBL of 0.35 ± 1.89 mm was observed and no dental implant was affected by peri-implantitis after 1 year of function. No specific influence of patient, implant, or prosthetic factors on PBL was observed. No association was found between the occurrence of PIM/PBL and the patient-, implant-, and prosthetic-related factors investigated in this cohort study, except for the type of dental-implant connection. Periimplant Peri periimplant peri (PIM periimplantitis, periimplantitis implantitis, implantitis hosts smoking accumulation hygiene genetics mucosa patient , patient- implant- prostheticrelated related (PBL loading 5 22 (2 3 females baseline (baseline 6 followup. followup follow up. up 17 evaluated 448 44 8 44.8 80.0% 800 80 0 (80.0% p 0.015. 0015 0.015 . 015 0.015) Moreover 035 35 0.3 189 89 1.8 function PIMPBL dentalimplant 2 ( 4 44. 80.0 (80.0 001 0.01 01 03 0. 18 1. 80. (80. 00 0.0 (80 (8

ABSTRACT Objective: This study evaluated the nutritional status and associated factors among older adults of a southern Brazilian city. Methods: A cross-sectional home-based study, with a probabilistic sample per cluster, was carried out with 282 older adults aged ≥60 years in the city of Veranópolis, Brazil. Through a structured questionnaire, socioeconomic, general and behavioral health aspects were assessed. Nutritional status was assessed using the Mini Nutritional Assessment (MAN®) instrument, categorizing the sample into eutrophic or nutritional risk (risk of malnutrition + malnourished). Oral health was assessed by counting teeth and the use of and need for dental prosthesis. Two independent multivariate models were constructed, using number of daily medication and polypharmacy (≥2 daily medications). Logistic regression was used to verify associations. Results: The prevalence of nutritional risk was 14.5% (N=41). In the final multivariate analysis, users of ≥6 daily medications demonstrated a greater odds ratio (OR) of being at nutritional risk when compared to those who did not use medication daily (OR: 12.16; 95% confidence interval [95%CI]: 1.47 – 100.82). Non-edentulous older adults had 67.7% (p = 0.006) lower OR for nutritional risk when compared to edentulous. Conclusion: The prevalence of nutritional risk was low among this sample, and it was associated with edentulism and number of daily medications. Objective Methods crosssectional cross sectional homebased home based cluster 28 60 Veranópolis Brazil questionnaire socioeconomic MAN® MAN (MAN® instrument malnourished. malnourished . malnourished) prosthesis constructed ≥2 2 (≥ medications) associations Results 145 14 5 14.5 N=41. N41 N N=41 41 (N=41) analysis 6 ≥ (OR 12.16 1216 12 16 95 95%CI 95CI CI [95%CI] 147 1 47 1.4 100.82. 10082 100.82 100 82 100.82) Nonedentulous Non edentulous 677 67 7 67.7 p 0.006 0006 0 006 Conclusion (MAN ( 14. N4 N=4 4 (N=41 12.1 121 9 [95%CI 1. 1008 100.8 10 8 67. 0.00 000 00 N= (N=4 12. 100. 0.0 (N= 0. (N

RESUMO Objetivo: Esse estudo avaliou o estado nutricional e fatores associados em idosos de uma cidade do Sul do Brasil. Métodos: Um estudo transversal de base populacional, com amostragem probabilística por cluster, foi realizado com 282 idosos com idade ≥60 anos na cidade de Veranópolis, Brasil. Por meio de um questionário estruturado, aspectos socioeconômicos, comportamentais e de saúde geral foram aferidos. Estado nutricional foi verificado usando a Mini Avaliação Nutricional (MAN), categorizando a amostra em eutróficos e risco nutricional (risco de desnutrição + desnutridos). Saúde bucal foi verificada pela contagem dos dentes e uso e necessidade de prótese dentária. Dois modelos multivariados independentes foram construídos, utilizando o número de medicações diárias e polifarmácia (≥2 medicamentos por dia). Regressão logística foi utilizada para verificar as associações. Resultados: A prevalência de risco nutricional foi de 14,5% (N=41). Na análise multivariada final, usuários de ≥6 medicamentos por dia demonstraram uma maior razão de chance (RC) de terem risco nutricional quando comparados com aqueles que não utilizaram medicamento diariamente (RC: 12,164; intervalo de confiança de 95% [IC95%]: 1,468 – 100,821). Idosos não edêntulos tiveram 67,7% (p=0,006) menor RC para risco nutricional quando comparados com não edêntulos. Conclusão: A prevalência de risco nutricional foi baixa nessa amostral, ela foi associada com edentulismo e número diário de medicações. Objetivo Brasil Métodos populacional cluster 28 60 Veranópolis estruturado socioeconômicos aferidos MAN, MAN , (MAN) desnutridos. desnutridos . desnutridos) dentária construídos ≥2 2 (≥ dia. dia) associações Resultados 145 14 5 14,5 N=41. N41 N N=41 41 (N=41) final 6 ≥ (RC 12,164 12164 12 164 95 IC95% IC95 IC [IC95%] 1468 1 468 1,46 100,821. 100821 100,821 100 821 100,821) 677 67 7 67,7 p=0,006 p0006 p 0 006 (p=0,006 Conclusão amostral (MAN ( 14, N4 N=4 4 (N=41 12,16 1216 16 9 IC9 [IC95% 146 46 1,4 10082 100,82 10 82 67, p=0,00 p000 00 (p=0,00 N= (N=4 12,1 121 [IC95 1, 1008 100,8 8 p=0,0 p00 (p=0,0 (N= 12, [IC9 100, p=0, p0 (p=0, (N [IC p=0 (p=0 p= (p= (p

Abstract The aim of this study was to explore associated variables with sense of coherence (SOC), and dental environment stress (DES) in a sample of dental students. All undergraduate (n = 474) and graduate (n = 105) dental students enrolled in the first semester of 2020 at a public university in southern Brazil were invited to participate. Data collection was performed by an online questionnaire, which included information related to sociodemographic and educational characteristics, biopsychosocial factors, aspects related to feelings experienced in the COVID-19 pandemic, and the SOC scale. The study outcome (DES) was measured by a validated tool. Linear regression analyses were performed to identify the associations between the outcome and all independent variables. A total of 408 students were included (response rate: 70.5%). The overall mean score of the DES scale was 73.95 (SD: 24.13). Students with higher SOC scores were observed to have significantly lower DES scores (βGRADUATE: -0.376; 95%: -0.482 to -0.271; βUNDERGRADUATE: -0.478; 95%:-0.658 to -0.297). Female undergraduate students (β: 11.788; 95%CI: 7.161–16.415) had higher DES scores compared with undergraduate male students. In addition, the presence of anxiety symptoms when providing dental care to patients with symptoms or suspected COVID-19 infection was associated with higher DES scores (β: 10.460; 95%CI: 5.644–15.277) among undergraduate dental students. The level of stress was higher in non-white undergraduate students than white (β: 8.912; 95%CI: 3.581–14.244). Among both undergraduate and graduate dental students, higher SOC scores were associated with lower DES. SOC, , (SOC) (DES n 474 105 202 participate questionnaire characteristics factors COVID19 COVID 19 COVID-1 pandemic tool 40 response rate 70.5%. 705 70.5% . 70 5 70.5%) 7395 73 95 73.9 SD (SD 24.13. 2413 24.13 24 13 24.13) βGRADUATE (βGRADUATE 0.376 0376 0 376 -0.376 95% 0.482 0482 482 -0.48 0.271 0271 271 -0.271 βUNDERGRADUATE 0.478 0478 478 -0.478 95%0.658 950658 0.658 658 95%:-0.65 0.297. 0297 0.297 297 -0.297) β (β 11.788 11788 11 788 95%CI 95CI CI 7.161–16.415 716116415 7 161 16 415 addition 10.460 10460 10 460 5.644–15.277 564415277 644 15 277 nonwhite non 8.912 8912 8 912 3.581–14.244. 358114244 3.581–14.244 3 581 14 244 3.581–14.244) (SOC 47 20 COVID1 1 COVID- 4 70.5 739 9 73. 241 24.1 2 0.37 037 37 -0.37 0.48 048 48 -0.4 0.27 027 27 -0.27 0.47 047 -0.47 95%0.65 95065 0658 0.65 65 95%:-0.6 029 0.29 29 -0.297 11.78 1178 78 7.161–16.41 71611641 41 10.46 1046 46 5.644–15.27 56441527 64 8.91 891 91 35811424 3.581–14.24 58 70. 24. 0.3 03 -0.3 0.4 04 -0. 0.2 02 -0.2 95%0.6 9506 065 0.6 6 95%:-0. -0.29 11.7 117 7.161–16.4 7161164 10.4 104 5.644–15.2 5644152 8.9 89 3581142 3.581–14.2 0. -0 95%0. 950 06 95%:-0 11. 7.161–16. 716116 10. 5.644–15. 564415 8. 358114 3.581–14. - 95%0 95%:- 7.161–16 71611 5.644–15 56441 35811 3.581–14 7.161–1 7161 5.644–1 5644 3581 3.581–1 7.161– 716 5.644– 564 358 3.581– 7.161 71 5.644 56 35 3.581 7.16 5.64 3.58 7.1 5.6 3.5 7. 5. 3.

Aim To estimate the prevalence and associated factors of self-reported depressive symptoms in undergraduate and graduate dental students. Methods The Depression, Anxiety and Stress Scale (DASS-21) was applied, and only the depression domain was verified. A structured questionnaire was used to collect sociodemographic, behavioral, and COVID-19 pandemic-related fear variables. Academic performance was assessed based on academic records, ranging from 0 (worst possible grade) to 10 (best possible grade). Respondents included 408 regularly enrolled dental students. Bi- and multivariate analyses were performed using Poisson regression with robust variance to verify the association between at least moderate depressive symptoms and independent variables. Results The prevalence of at least moderate depression was 40.5% among undergraduate students and 26% among graduate students. The prevalence of fear and anxiety due to the COVID-19 pandemic was 96.1% among undergraduate students and 93.5% among graduate students. In the final multivariate analysis, being female (prevalence ratio [PR]:2.01; 95% confidence interval [95%CI]:1.36–2.96) was associated with a higher PR for depression. Conversely, no exposure to smoking (PR:0.54; 95%CI:0.36–0.82) and a final academic performance average ≥7.0 (PR:0.56; 95%CI:0.41–0.76) was associated with a lower PR for depression. Finally, among graduate students, a non-heterosexual orientation was associated with a higher PR for depression (PR:6.70; 95%CI:2.21–20.29). Conclusion Higher rates of depression symptoms were observed in female undergraduates, students with lower academic performance and smoking exposure, and graduate dental students with a non-heterosexual orientation.

Aim To assess the prevalence of cleft lip and/or cleft palate (CL/P) and associated variables in neonates admitted to neonatal intensive care units (ICU). Methods Medical charts for neonates born and admitted to the ICU between 2012 and 2018 were reviewed. Obstetric and neonatal variables were collected by a trained researcher. In the case group, all neonates with CL/P were included. The control group was formed by matching sex, prematurity and month of birth using random number generation. Neonates with congenital malformations were excluded from the control group. Adjusted logistic regression was used (p<0.05). Results The prevalence of CL/P was 0.43% (n=15). Five cases were excluded, as pairing was not possible. Twenty neonates were included in the control group. In the final multivariate model, CL/P was only associated with increased maternal age. For each year of increase in maternal age, neonates had a 35.2% higher chance of presenting CL/P (95% confidence interval: 1.021–1.792). Conclusions Higher maternal age was associated with higher occurrence of CL/P in neonates admitted to the ICU. No other neonatal or maternal independent variables were associated with CL/P. Due to missing data, interpretation of study results must be approached with caution.

Resumo Introdução Pelo uso de próteses dentárias completas ou parciais, função, estética e fonética são reestabelecidas. Poucos estudos de base população estão disponíveis na literatura utilizando a população idosa. Objetivo Avaliar o uso e a necessidade de prótese dentária, bem como seus fatores associados. Método Esse estudo incluiu uma amostra randômica de 287 idosos da cidade de Cruz Alta, no Brasil. Uso e necessidade de prótese dentária foram os desfechos primários, e dois modelos analíticos foram construídos. No uso de prótese dentária, análises de subgrupos foram realizadas para Prótese Parcial Fixa (PPF) e Prótese Removível (parcial e/ou completa) (PR). Resultados Uso e necessidade de prótese dentária foram detectados em 83,6% (n=240) e 42,5% (n=122) dos idosos, respectivamente. Mulheres apresentaram significativa maior Razão de Prevalência (RP) para o uso de prótese dentária (RP:1,15; IC95%:1,02–1,28) e menor necessidade (RP:0,70; IC95%:0,54–0,91). Nenhuma associação significativa foi encontrada para o uso de PPF em relação aos gêneros. Alto nível educacional esteve associado ao menor uso de prótese (RP:0,73; IC95%:0,58–0,91), quando comparado com escolaridade baixa. Escolaridade média mostrou significativa menor necessidade de prótese dentária (RP:0,61 – IC95%:0,39–0,94). Aqueles que não utilizam álcool apresentaram um menor uso de PPF e PR (RP:0,46; IC95%:0,23–0,93 e 0,90;0,81–0,99, respectivamente). Conclusão Uso e necessidade de prótese dentária estão associados ao gênero, nível educacional e fatores comportamentais.

Abstract Background By the use of complete or partial dental prosthesis, function, esthetics, and phonetics are reestablished. Few population-based studies are available in the literature using an older adult population. Objective Evaluate the use of and need for dental prostheses and their associated factors. Method This study included a random sample of 287 elderly, in the city of Cruz Alta, Brazil. Use of and need for dental prostheses were the main outcomes, and two analytical models were constructed. Subgroup analyses were performed for individuals using fixed partial denture (FPD) and removable (partial and/or complete) dental prosthesis (RDP). Results Use of and need for dental prosthesis were identified in 83.6% (n=240) and 42.5% (n=122) of the elderly, respectively. Women presented a significantly higher prevalence ratio (PR) for use of dental prostheses (PR=1.15; 95%IC:1.02–1.28) and lower need (PR=0.70; 95%IC:0.54–0.91). No statistically significant difference was demonstrated for the use of FPD regarding the sex. Higher education level was associated with lower use of prostheses (PR=0.73; 95%IC:0.58–0.91) when compared to lower level of education. Medium level of education showed a significantly lower need for dental prostheses (PR=0.61 – 95%IC:0.39–0.94). Those that did not consume alcohol presented with a significantly lower use of FPD and RDP (PR=0.46; 95%IC:0.23–0.93 and 0.90;0.81–0.99, respectively). Conclusion The use of and need for dental prostheses were associated with sex, level of education, and behavioral factors.

Aim This study aimed to systematically review existing literature regarding the association between dental procedures—such as tooth extractions and periodontal therapy—and occurrence of medication-related osteonecrosis of the jaw (MRONJ) in individuals using bone-modifying drugs. Methods Search strategies were performed in PubMed, Scopus, Web of Science and Cochrane Library for a timeframe ending in December 2021. Study selection, data extraction and risk of bias were analyzed independently by two researchers. Three meta-analyses were performed, estimating the crude risk ratio (RR), the adjusted odds ratio (OR) and the adjusted hazard ratio (HR) for the association between tooth extraction and MRONJ. Results Of the 1,654 studies initially retrieved, 17 were ultimately included. The majority of patients with MRONJ in these studies were female, with a mean age of 64 years. Zoledronic acid was the most commonly used drug among patients with MRONJ, and cancer was the most frequent underlying health condition. Regarding the performed meta-analyses, crude and adjusted analyses demonstrated that tooth extraction increased the risk for MRONJ by 4.28 (95% confidence interval [95%CI]: 1.73–10.58), the OR for MRONJ by 26.94 (95%CI: 4.17–174.17), and the HR for MRONJ by 9.96 (95%CI: 4.04–24.55). Conclusion It was concluded that performing dental procedures, especially tooth extraction, in patients using bone-modifying drugs increased the risk of MRONJ occurrence and, therefore, should be avoided. Further studies, using adjusted data, are warranted.

Resumo Introdução Pelo uso de próteses dentárias completas ou parciais, função, estética e fonética são reestabelecidas. Poucos estudos de base população estão disponíveis na literatura utilizando a população idosa. Objetivo Avaliar o uso e a necessidade de prótese dentária, bem como seus fatores associados. Método Esse estudo incluiu uma amostra randômica de 287 idosos da cidade de Cruz Alta, no Brasil. Uso e necessidade de prótese dentária foram os desfechos primários, e dois modelos analíticos foram construídos. No uso de prótese dentária, análises de subgrupos foram realizadas para Prótese Parcial Fixa (PPF) e Prótese Removível (parcial e/ou completa) (PR). Resultados Uso e necessidade de prótese dentária foram detectados em 83,6% (n=240) e 42,5% (n=122) dos idosos, respectivamente. Mulheres apresentaram significativa maior Razão de Prevalência (RP) para o uso de prótese dentária (RP:1,15; IC95%:1,02–1,28) e menor necessidade (RP:0,70; IC95%:0,54–0,91). Nenhuma associação significativa foi encontrada para o uso de PPF em relação aos gêneros. Alto nível educacional esteve associado ao menor uso de prótese (RP:0,73; IC95%:0,58–0,91), quando comparado com escolaridade baixa. Escolaridade média mostrou significativa menor necessidade de prótese dentária (RP:0,61 – IC95%:0,39–0,94). Aqueles que não utilizam álcool apresentaram um menor uso de PPF e PR (RP:0,46; IC95%:0,23–0,93 e 0,90;0,81–0,99, respectivamente). Conclusão Uso e necessidade de prótese dentária estão associados ao gênero, nível educacional e fatores comportamentais.

Abstract Background By the use of complete or partial dental prosthesis, function, esthetics, and phonetics are reestablished. Few population-based studies are available in the literature using an older adult population. Objective Evaluate the use of and need for dental prostheses and their associated factors. Method This study included a random sample of 287 elderly, in the city of Cruz Alta, Brazil. Use of and need for dental prostheses were the main outcomes, and two analytical models were constructed. Subgroup analyses were performed for individuals using fixed partial denture (FPD) and removable (partial and/or complete) dental prosthesis (RDP). Results Use of and need for dental prosthesis were identified in 83.6% (n=240) and 42.5% (n=122) of the elderly, respectively. Women presented a significantly higher prevalence ratio (PR) for use of dental prostheses (PR=1.15; 95%IC:1.02–1.28) and lower need (PR=0.70; 95%IC:0.54–0.91). No statistically significant difference was demonstrated for the use of FPD regarding the sex. Higher education level was associated with lower use of prostheses (PR=0.73; 95%IC:0.58–0.91) when compared to lower level of education. Medium level of education showed a significantly lower need for dental prostheses (PR=0.61 – 95%IC:0.39–0.94). Those that did not consume alcohol presented with a significantly lower use of FPD and RDP (PR=0.46; 95%IC:0.23–0.93 and 0.90;0.81–0.99, respectively). Conclusion The use of and need for dental prostheses were associated with sex, level of education, and behavioral factors.

RESUMO JUSTIFICATIVA E OBJETIVOS: As disfunções temporomandibulares (DTM) são um grupo de condições caracterizadas por alteração dos movimentos e função da região orofacial e um dos maiores sintomas relatados é a dor. Como estas disfunções têm sido descritas de forma crescente entre diversas faixas etárias, o objetivo deste estudo foi avaliar a presença de sintomas de DTM e seus possíveis fatores associados em idosos de uma cidade do sul do Brasil. MÉTODOS: Estudo transversal de base domiciliar com amostra probabilística por conglomerado incluindo 282 idosos com idade ≥60 anos da cidade de Veranópolis/RS. Um exame clínico de saúde bucal e questionário estruturado foram aplicados. Sintomas de DTM foram avaliados pelo Índice Anamnésico de Fonseca (IAF) e categorizados em “Sem DTM” e “Com DTM”, sendo que o último incluiu aqueles com sintomas compatíveis com DTM, moderada ou grave. Associações foram avaliadas pelos testes de Qui-quadrado ou Mann-Whitney por distribuição de frequências. Análises bi e multivariadas foram realizadas utilizando-se regressão de Poisson com variância robusta para verificar associações. RESULTADOS: A prevalência de idosos que relataram sintomas de DTM foi de 30,5% (n=86). No modelo multivariado final, idosas do sexo feminino apresentaram maior razão de prevalência (RP) para sintomas de DTM, apresentando 62,8% maior RP (p=0,040) de ter, pelo menos, sintomas leves de DTM quando comparados a idosos do sexo masculino. O número de dentes presentes, necessidade de prótese ou outras variáveis demográficas não estiveram associadas com a presença de sintomas de DTM. CONCLUSÃO: Os achados do presente estudo demonstraram prevalência de sintomas de DTM em idosos de aproximadamente 30%, com maior associação com o sexo feminino. Apesar de relevantes para delineamento de estratégias de saúde para idosos, os achados do presente estudo devem ser interpretados com cautela por sua natureza observacional e transversal.

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorders (TMD) are a group of conditions characterized by changes in the movements and function of the orofacial region and one of main reported symptoms is pain. As it has been increasingly described among different age groups, this study aimed to evaluate the presence of symptoms of TMD and their possible associated factors in older people from a city in southern Brazil. METHODS: A cross-sectional household-based study using a per cluster sampling strategy was performed including 282 older adults aged ≥60 years in the city of Veranópolis/RS. A clinical oral examination and a structured questionnaire were applied. TMD symptoms were evaluated with Fonseca Anamnestic Index (FAI) questionnaire and divided into those “without TMD” and “with TMD” (the later including those reporting mild, moderate and severe TMD symptoms). Associations were performed by the chi-square or Mann-Whitney tests based on frequency distribution. Bi and multivariate analyses were performed using Poisson regression with robust variation to verify associations. RESULTS: Prevalence among older adults that reported symptoms of TMD was 30.5% (n=86). In the final multivariate model, female older adults presented higher prevalence ratio (PR) for symptoms of TMD, presenting 62.8% (p=0.040) higher PR to at least mild symptoms of TMD when compared to older adult men. Number of teeth, need for dental prosthesis or other demographic variables were not associated with symptoms of TMD. CONCLUSION: The results demonstrated a prevalence of TMD symptoms in the seniors of approximately 30%, which was most associated with females. Despite its relevance in public health strategies focused on older adults, these findings should be interpreted with caution due to their observational and cross-sectional nature.

Resumo O estudo avaliou a qualidade de vida relacionada à saúde bucal (QVRSB) e fatores associados em idosos. Estudo transversal foi realizado em 287 idosos de Cruz Alta, Brasil. As seguintes variáveis foram coletadas: idade, sexo, etnia, nível educacional, estado civil, aposentadoria, histórico médico/odontológico, exposição ao fumo/álcool, hábitos de higiene oral, uso e necessidade de prótese, dentes ausentes, sintomas de desordem temporomandibular (DTM), estado nutricional e halitose. QVRSB foi avaliada pelo OHIP-14 (Perfil de Impacto de Saúde Bucal) e categorizado em baixo impacto (soma dos escores ≤6) e alto impacto (soma dos escores ≥7). Associações foram avaliadas por regressão de Poisson com variância robusta. A média OHIP-14 foi 5,92±8.54. Indivíduos divorciados e aqueles que reportaram não usar fio dental apresentaram 77% e 54%, respectivamente, maior razão de prevalência (RP) de terem maior impacto na QVRSB. Idosos que não necessitam próteses dentárias demonstraram menor impacto na QVRSB (P<0,01). Além disso, idosos com DTM apresentaram maior RP de terem maiores escores de OHIP-14 (P<0,01). Foi concluído que maiores impactos na QVRSB estão associados com estado civil, não uso de fio dental e DTM. Não necessitar de prótese dentária esteve associado com menores impactos na QVRSB.

Abstract This study aimed to evaluate the oral health-related quality of life (OHRQoL) and associated factors in the elderly. A cross-sectional study was conducted with 287 elderly of Cruz Alta, Brazil. The following variables were collected: age, sex, ethnicity, level of education, marital status, retirement, medical/dental history, smoking/alcohol exposure, oral hygiene habits, use and need of dental prosthesis, missing teeth, temporomandibular disorder symptoms (TMD), nutritional status, and halitosis. OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14). The sample was categorized into low impact (sum scores ≤6) and high impact (sum scores ≥7). Associations were analyzed by Poisson regression with robust variation. Mean scores of OHIP-14 was 5.92±8.54. Divorced individuals and those who did not use dental floss presented 77% and 54%, respectively, higher prevalence ratio (PR) of having higher OHRQoL impact. Elderly that did not need dental prosthesis demonstrated a lower impact on OHRQoL (P<0.01). Elderly with TMD presented a higher PR of having higher OHRQoL impact (P<0.01). It was concluded that higher impact on OHRQoL was associated with marital status, non-users of dental floss and those with TMD. No need dental prosthesis were associated with lower impact on OHRQoL.

Resumo O estudo avaliou a qualidade de vida relacionada à saúde bucal (QVRSB) e fatores associados em idosos. Estudo transversal foi realizado em 287 idosos de Cruz Alta, Brasil. As seguintes variáveis foram coletadas: idade, sexo, etnia, nível educacional, estado civil, aposentadoria, histórico médico/odontológico, exposição ao fumo/álcool, hábitos de higiene oral, uso e necessidade de prótese, dentes ausentes, sintomas de desordem temporomandibular (DTM), estado nutricional e halitose. QVRSB foi avaliada pelo OHIP-14 (Perfil de Impacto de Saúde Bucal) e categorizado em baixo impacto (soma dos escores ≤6) e alto impacto (soma dos escores ≥7). Associações foram avaliadas por regressão de Poisson com variância robusta. A média OHIP-14 foi 5,92±8.54. Indivíduos divorciados e aqueles que reportaram não usar fio dental apresentaram 77% e 54%, respectivamente, maior razão de prevalência (RP) de terem maior impacto na QVRSB. Idosos que não necessitam próteses dentárias demonstraram menor impacto na QVRSB (P<0,01). Além disso, idosos com DTM apresentaram maior RP de terem maiores escores de OHIP-14 (P<0,01). Foi concluído que maiores impactos na QVRSB estão associados com estado civil, não uso de fio dental e DTM. Não necessitar de prótese dentária esteve associado com menores impactos na QVRSB.

Abstract This study aimed to evaluate the oral health-related quality of life (OHRQoL) and associated factors in the elderly. A cross-sectional study was conducted with 287 elderly of Cruz Alta, Brazil. The following variables were collected: age, sex, ethnicity, level of education, marital status, retirement, medical/dental history, smoking/alcohol exposure, oral hygiene habits, use and need of dental prosthesis, missing teeth, temporomandibular disorder symptoms (TMD), nutritional status, and halitosis. OHRQoL was assessed by Oral Health Impact Profile-14 (OHIP-14). The sample was categorized into low impact (sum scores ≤6) and high impact (sum scores ≥7). Associations were analyzed by Poisson regression with robust variation. Mean scores of OHIP-14 was 5.92±8.54. Divorced individuals and those who did not use dental floss presented 77% and 54%, respectively, higher prevalence ratio (PR) of having higher OHRQoL impact. Elderly that did not need dental prosthesis demonstrated a lower impact on OHRQoL (P<0.01). Elderly with TMD presented a higher PR of having higher OHRQoL impact (P<0.01). It was concluded that higher impact on OHRQoL was associated with marital status, non-users of dental floss and those with TMD. No need dental prosthesis were associated with lower impact on OHRQoL.

The precautionary principle is part of evidence-based healthcare. However, since it is not always based in the most qualified evidence, it is frequently questioned. The emergence of a highly contagious disease, with increased levels of morbimortality, an acute respiratory syndrome, the so called Coronavirus Disease 2019 (COVID-19), led health professionals to look for the best alternatives to save lives. In this sense, the precautionary principle was evocated. The precautionary principle is used both preventively and therapeutically when knowledge about how to manage problems/diseases/conditions that are especially life-threatening. The aim of this short communication is to make a reflection about the precautionary principle, the dental profession and COVID-19. It is important to have in mind that in such a disease, guidelines, protocols and approaches can change very fast, since a continuous evaluation of all policies is mandatory.

Abstract The precautionary principle is part of evidence-based healthcare and is used both preventively and therapeutically when there is no available evidence about how to manage problems/diseases/conditions that are especially life-threatening. However, since it is not always based in the most qualified evidence, it is frequently questioned. The emergence of a highly contagious disease, with increased levels of morbimortality, an acute respiratory syndrome, the so called Coronavirus Disease 2019 (COVID-19), led health professionals to look for the best alternatives to save lives. In this sense, the precautionary principle was evocated. The aim of this paper is to make a reflection about the precautionary principle, the dental profession and COVID-19. It is important to have in mind that in such a disease, guidelines, protocols and approaches can change very fast, since a continuous evaluation of all policies is mandatory. During the pandemic, elective procedures may be restricted, but international organizations removed the recommendation to postpone elective procedures. Clinicians are advised to be updated about their local current policies. On the other hand, there are cases in which in-office dental care is unavoidable, such as individuals with pain, spontaneous bleeding and dental trauma. Biosafety is upmost importance when seeking patients during pandemic. In this sense, it was concluded that precautionary principle should be, therefore, used. However, caution needs to be taken and continuous surveillance necessary.

Resumo O presente estudo objetivou verificar o efeito da heparina de baixo peso molecular (HBPM) sob a perda óssea alveolar (POA), contagem de células sanguíneas, megacariócitos e adipócitos em ratos Wistar machos. Quarenta ratos Wistar de 60 dias foram randomicamente divididos em quatro grupo: Controle (C), Doença Periodontal (DP), Heparina (Hp) e Heparina + Doença Periodontal (Hp+DP). HBPM foi aplicada durante 60 dias em doses de 1 mL/kg/dia. Coletas sanguíneas foram realizadas nos dias 0, 30 e 60. No dia 49, os grupos DP e Hp+DP receberam indução de doença periodontal por ligadura ao redor do segundo molar superior direito. No lado esquerdo, verificou-se perda óssea alveolar espontânea. A média de POA no lado com ligadura mostrou-se estatisticamente diferente entre os grupos C (0,35±0,07 mm) e Hp+PD (0,49±0,09 mm) (p<0,001), entre os grupos DP (0,55±0,11 mm) e Hp (0,32±0,06 mm) (p<0,001) e entre os grupos Hp e Hp+DP (p<0,001). Nenhuma diferente significativa foi observada entre os grupos no lado sem ligadura. Peso dos animais, consumo de ração e ingestão de água não mostraram diferenças significativas entre os grupos. Megacariócitos e adipócitos foram contados por microscopia óptica e nenhuma diferença significativa foi encontrada. Dentro dos grupos, houve um aumento e uma diminuição, respectivamente, na contagem de linfócitos (p=0,005 no grupo C e p=0,009 no grupo Hp+DP somente) e leucócitos (p=0,003 no grupo C, p=0.001 no grupo DP e p=0,002 no grupo Hp e Hp+DP). Não houve diminuição no número de plaquetas nos três períodos de coleta. HBPM não foi capaz de modificar a POA, porém modificou a contagem de células sanguíneas, especialmente aumentando o número de linfócitos.

Abstract This study aimed to assess the effects of low molecular weight heparin (LMWH) on alveolar bone loss (ABL), blood count, and counting of megakaryocytes and adipocytes in male Wistar rats. Forty male 60-day Wistar rats were randomly divided into four groups: Control (C), Periodontal Disease (PD), Heparin (Hp) and Heparin + Periodontal Disease (Hp+PD). LMWH was applied for 60 days at doses of 1 ml/kg/day. Blood samples were collected at baseline, 30 and 60. On day-49, PD and Hp+PD groups were subjected to ligature-induced periodontitis around second upper right molar. The left side was assessed as spontaneous alveolar bone loss. Mean ABL in the side with ligature showed significantly different between C (0.35±0.07 mm) and Hp+DP (0.49±0.09 mm) groups (p<0.001), between PD (0.55±0.11 mm) and Hp (0.32±0.06 mm) groups (p<0.001) and between Hp and Hp+DP groups (p<0.001). No significant differences were found among groups for ABL in the side without ligature. Animal weight, food intake, and water consumption showed no statistically significant difference among groups. Megakaryocytes and adipocytes were counted using optical microscopy and no statistically significant differences were found. Within-groups, there were an increase and a decrease, respectively, in the counting of lymphocytes (p=0.005 for C and p=0.009 for Hp+PD groups only) and leukocytes (p=0.003 for C, p=0.001 for PD, p=0.002 for Hp, and p<0.001 for Hp+PD groups). There was no decrease in the number of platelets in the three collection periods. LMWH was not able to affect ABL, but it may change the blood counting, especially increasing lymphocytes.

RESUMO JUSTIFICATIVA E OBJETIVOS: Avaliar a gravidade dos sintomas de disfunção temporomandibular e seus fatores em idosos de uma cidade do sul do Brasil. MÉTODOS: Estudo observacional transversal de domicílios residenciais, com amostra probabilística por conglomerado, entrevistou e examinou 287 idosos, com idade entre 65 e 74 anos da cidade Cruz Alta, estado do Rio Grande do Sul, Brasil. O Índice Anamnésico de Fonseca foi utilizado para avaliação da disfunção temporomandibular, além de um questionário estruturado para condições socioeconômicas e um exame clínico de saúde bucal. As associações entre a variável dependente e a independente foram avaliadas pelos testes de Qui-quadrado ou Mann-Whitney, apresentadas por meio da distribuição de frequências. As análises uni e multivariada foram realizadas para verificar a associação entre a disfunção temporomandibular e as variáveis exploratórias. Para todas as análises, o nível de significância foi de 5%. RESULTADOS: A prevalência de sintomas de disfunção temporomandibular foi de 55,1%. No modelo multivariado final, a idade ≥70 anos (RP=0,674; 95% IC: 0,516 - 0,881) apresentou-se como fator de proteção para disfunção temporomandibular e a média de perda dentária (RP=1,022; 95% IC: 1,004 - 1,039) apresentou-se como fator de risco para disfunção temporomandibular em relação a seus respectivos controles. CONCLUSÃO: Os resultados demonstraram alta prevalência de sintomas de disfunção temporomandibular. A idade e a média de perda dentária foram associadas à disfunção temporomandibular. Os resultados sugerem melhorias nas condições de saúde bucal dos idosos e a importância de estudos epidemiológicos sobre disfunção temporomandibular nessa população.

ABSTRACT BACKGROUND AND OBJECTIVES: To assess the prevalence of temporomandibular dysfunction symptoms and the associated factors in the elderly of a city in southern Brazil. METHODS: A cross-sectional observational study performed in residential homes, with probabilistic cluster sample, interviewed and examined 287 seniors aged from 65 to 74 years in the city of Cruz Alta, state of Rio Grande do Sul, Brazil. The Fonseca Anamnestic Index was used for temporomandibular dysfunction analysis, as well as a structured questionnaire for socioeconomic conditions and an oral health clinical examination. Either Chi-square or Mann-Whitney tests assessed associations between the dependent and independent variables and presented by frequency distribution. Uni- and multivariate analyses were performed to verify the association between temporomandibular dysfunction risk and explanatory variables. For all statistical analyses, a 5% significance level was adopted. RESULTS: The prevalence of temporomandibular dysfunction symptoms was 55.1%. In the final multivariate model, age ≥70 years (RP=0.674; 95% CI: 0.516 - 0.881) showed as a protection factor against temporomandibular dysfunction, and the average of tooth loss (RP=1.022; 95% CI: 1.004 - 1.039) showed as a risk factor for temporomandibular dysfunction in relation to their respective controls. CONCLUSION: The findings of the present study showed a high prevalence of temporomandibular dysfunction symptoms. Age and tooth loss were associated with higher risk of temporomandibular dysfunction. The results suggested the need for improvement in oral health conditions of the elderly and the importance of further epidemiological studies about temporomandibular dysfunction in this population.