Abstract Lipolytic substance injections to reduce localized fat have been extensively used because it is a low-invasive method. This review aimed to evaluate the efficacy and safety of deoxycholic acid in submental fat reduction compared to a placebo and investigate the potential industry sponsorship bias in the results of randomized clinical trials on this topic. Ten electronic databases were extensively searched for randomized clinical trials without restriction on language and year of publication. Two reviewers extracted the data and assessed the individual risk of bias in the studies with the RoB 2.0 tool. The industry sponsorship bias was evaluated according to citations in the articles regarding industry funding/sponsorship throughout the texts. Fixed and random effects meta-analyses were performed, and the results were reported in Risk Ratio (RR) at a 95% Confidence Interval (95% CI). The initial search provided 5756 results, of which only five were included. Only two studies had a low risk of bias. All studies showed a potential industry bias. The meta-analysis showed that patients treated with deoxycholic acid had significant positive results for all efficacy outcomes and a higher risk of fibrosis, pain, erythema, numbness, swelling, edema, pruritus, nodules, headache, and paresthesia. The low to moderate certainty of evidence found allows concluding that deoxycholic acid is effective in submental fat reduction, causing well-tolerated adverse effects. However, all eligible studies showed a potential industry bias. lowinvasive invasive method topic publication 20 2 0 2. tool fundingsponsorship funding texts metaanalyses meta analyses performed RR (RR 95 (95 CI. CI . CI) 575 included metaanalysis analysis fibrosis pain erythema numbness swelling edema pruritus nodules headache paresthesia welltolerated well tolerated However 9 (9 57 ( 5

Resumo O uso do ozono como terapia coadjuvante vem sendo extensivamente discutida. O ozono têm propriedades antimicrobianas, antioxidantes e cicatrizantes. Este trabalho apresenta dois casos de aplicação do ozono para auxiliar a preparação do tecido gengival após trauma da face. Em ambos os casos, os pacientes sofreram lacerações extensas na gengiva inserida e mucosa alveolar com exposição óssea. Os tecidos foram reposicionados e suturados, entretanto, áreas de isquemia foram observadas com possibilidade de necrose tecidual. Cada paciente recebeu gás ozono na concentração de 4 μg/ml. Em seguida foi realizada irrigação com 40 mL de água ozonizada na concentração final de 8 μg/ml. Cada sessão foi realizada semanalmente até a melhora clínica. Foi observada a melhora significativa da isquemia sem evolução para necrose ou infeção, permitindo a preservação do tecido gengival. O ozono mostrou um efeito benéfico na reparação de feridas na gengiva marginal e inserida após trauma de face.

Abstract The application of ozone as a supportive therapy has been widely discussed. Ozone has antimicrobial, antioxidant, and healing properties. This study presents two cases of ozone application as a supportive therapy for gingival tissue repair after facial trauma. In both cases, patients suffered extensive lacerations with bone exposure. Tissues were repositioned and sutured; however, ischemia was observed during follow-up with potential tissue necrosis. Each patient received ozone gas with a concentration of 4 μg/ml. Then, the wound was irrigated with 40 mL of ozonated water at a final concentration of 8 μg/ml. The procedure was held weekly until clinical improvement. A significant improvement was observed in ischemia without evolution to necrosis or infection, allowing gingival tissue preservation. Ozone showed a beneficial effect in the recovery of gingiva and alveolar mucosa wounds after extensive trauma.

This study aimed to systematically review the literature to assess the effect of preemptive intravenous ibuprofen on pain reduction after lower third molar surgery. Nine databases (PubMed, Scopus, LILACS, SciELO, Embase, Web of Science, Cochrane, Open Gray, and Open Thesis) were used as sources of research, including “grey literature.” The protocol was registered in PROSPERO. Only randomized clinical trials evaluating the effects of preemptive intravenous ibuprofen on pain during and immediately after the extraction of lower third molars were included, without restrictions of year and language. Two reviewers independently performed the study selection, data extraction, and assessment of the risk of bias. The “Joanna Briggs Institute for Randomized Controlled Trials” tool was used to assess the risk of bias. Each study was categorized according to the percentage of positive responses to the questions corresponding to the assessment instrument. The results were measured narratively/descriptively. The initial search resulted in 3,257 records, of which only three studies (n=150 participants) met the eligibility criteria and were included in the qualitative analysis. All studies were published in 2019. The risk of bias ranged from low to moderate. Two studies found significant pain reduction within 48 h after the procedure. In conclusion, the use of preemptive intravenous ibuprofen for extracting third molars reduces pain and analgesic consumption after the surgical procedure.

This study aimed to compare the effectiveness of 0.12% chlorhexidine alone and 0.12% chlorhexidine in combination with toothbrushing to prevent ventilator-associated pneumonia (VAP) in mechanically ventilated patients. The Embase, Latin American and Caribbean Health Science Literature, PubMed, Scientific Electronic Library Online, Scopus, LIVIVO, Web of Science, Cochrane Library, OpenThesis, and Open Access Thesis and Dissertations databases were used. Only randomized controlled trials without restrictions on the year or language of publication were included. Two reviewers assessed the risk of bias using the Joanna Briggs Institute Critical Appraisal Tool. A meta-analysis using a random-effects model estimated the combined relative risk (RR). The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of the evidence. Initially, 2,337 studies were identified, of which 4 were considered in the systematic review and 3 in the meta-analysis (total sample: 796 patients). The studies were published between 2009 and 2017. All eligible studies had a low risk of bias. The meta-analysis revealed that the risk of VAP was 24% lower in patients receiving chlorhexidine combined with toothbrushing than in those receiving chlorhexidine alone (RR: 0.76; 95% confidence interval: 0.55-1.06), with moderate certainty of evidence and without statistical significance. In conclusion, considering the limitations of this study, a standard protocol for the prevention of VAP is not yet recommended. More studies with larger sample sizes are needed to draw strong conclusions. However, considering that toothbrushing is a simple intervention, it should be a common practice in mechanically ventilated patients, especially among patients with coronavirus disease.

RESUMO Corpos estranhos nos seios paranasais são ocorrências raras que têm sido esporadicamente relatadas na literatura em todo o mundo. Projéteis de arma de fogo, punhais, facas, fragmentos de vidro, pedras, dentes e madeira podem ficar alojados nos tecidos moles e duros do rosto. O manejo e o prognóstico nesses casos dependem da composição e localização do corpo estranho, bem como da presença ou ausência de infecção. Embora haja relatos envolvendo os tecidos moles da face, os seios etmoidal, esfenoidal, frontal e maxilar são os locais mais frequentemente envolvidos. A principal manifestação dessa condição é sinusite decorrente de infecção e / ou inflamação causada pelo corpo estranho, que é um objeto contaminado. Relatamos um caso de remoção de um projétil de arma de fogo localizado no seio maxilar de um paciente de 34 anos de idade, sob anestesia local.

ABSTRACT Foreign bodies in the paranasal sinuses after critical accidents are rare occurrences that have sporadically been reported worldwide. Firearm projectiles, daggers, knives, glass fragments, stones, teeth, and wood can get lodged in the soft and hard tissues of the face. The management and prognosis in these cases depend on the composition and location of the foreign body as well as on the presence or absence of infection. Although there are reports involving the soft tissues of the face, the ethmoid, sphenoid, frontal, and maxillary sinuses are the most frequently involved sites. The main manifestation of this condition is sinusitis arising from infection and/or inflammation caused by the foreign body, which is a contaminated object. We report a case of removal of a firearm projectile located in the maxillary sinus of a 34-year-old patient under local anesthesia.

RESUMO Dentes inclusos são todos os elementos dentários que chegada a época normal de seu irrompimento, permanece imerso no interior dos tecidos. Geralmente encontrados quando se observa ausência de algum dente, ou em exames radiográficos de rotina. Na presença de dentes inclusos, deve-se definir qual a melhor abordagem de tratamento, se é cirúrgica, através de exodontias, ou por tracionamentos ortodônticos. Caninos inclusos, em região de sínfise e próximos à base da mandíbula, são raros e fazem com que o uso de técnicas do tipo tracionamento ortodôntico sejam contra-indicadas. Presença de dentes em posição ectópica intraósseos podem causar injúrias, como anquilose alveolodentária, metamorfose cálcica da polpa e necrose pulpar asséptica, dentre outros. Para que o diagnóstico seja adequado, deve-se realizar, anamnese, exame físico (intra e extraoral) e exames radiográficos como panorâmicas, periapicais, tomografias computadorizadas e radiografias oclusais. Em geral, o sucesso do tratamento depende da idade do paciente e da posição dos caninos no momento do procedimento cirúrgico. O objetivo deste trabalho relata a extração de um canino inferior com acesso extra-oral em ambiente clínico ambulatorial sob anestesia local.

ABSTRACT Included teeth are all the dental elements that arrive the normal time of its eruption, remains immersed within the tissues. Usually found when missing a tooth, or on routine radiographic examinations. In the presence of included teeth, it is necessary to define the best treatment approach, whether it is surgical, through exodontia, or by orthodontic tracings. Inclusive canines, in the symphysis region and near the base of the mandible, are rare and make the use of orthodontic traction techniques contraindicated. Presence of teeth in the intraosseous ectopic position can cause injuries, such as alveolodentary ankylosis, calcium metamorphosis of the pulp and aseptic pulp necrosis, among others. Anamnesis, physical examination (intra- and extraoral) and radiographic examinations such as panoramic, periapical, computed tomography, and occlusal radiographs should be performed to make the diagnosis adequate. In general, the success of the treatment depends on the age of the patient and the position of the canines at the time of the surgical procedure. The objective of this work is the extraction of a lower canine with extra-oral access in an outpatient clinical setting under local anesthesia.