Abstract This study aim was to evaluate the need for orthodontic treatment of mixed to permanent dentition using the Dental Aesthetic Index (DAI) in a 4-year follow-up. A longitudinal study was conducted with 353 children in the stages from mixed (T1) to permanent (T2) dentition. The need for orthodontic treatment was assessed using the DAI categorized into: DAI 1 (absence of malocclusion and orthodontic treatment need; DAI ≤ 25); DAI 2 (malocclusion is defined and elective orthodontic treatment is needed; DAI = 26 to 30); DAI 3 (severe malocclusion and a desirable orthodontic treatment need; DAI = 31 to 35) and DAI 4 (severe malocclusion and a mandatory orthodontic treatment need; DAI ≥ 36). The Bowker symmetry test was used to determine agreement in the categorization of DAI at T1 and T2, with a significance level of 5%. The results showed a significant disagreement in the need for orthodontic treatment between T1 and T2 (p<0.05). In 34.6% of children evaluated in T1, the same need for orthodontic treatment was maintained in T2. According to the DAI, in 60.8% of the children, the need decreased, and in 39.2% their need for orthodontic treatment increased. This preliminary longitudinal study using DAI, showed a decrease in malocclusion and need for orthodontic treatment as the dentition transitioned from mixed to permanent occurred. This finding has valuable implications for epidemiological data in orthodontics.

Abstract The emergence of toothpastes containing different abrasive and whitening substances has been a constant concern among dental professionals. The aim of the present study was to perform an in vitro assessment of the surface topography of nanoparticle composite resins subjected to simulated brushing with dentifrices. Test samples were prepared with Filtek Universal (3M ESPE), Filtek Bulkfill (3M ESPE) and Z350 (3M ESPE), with 24 samples per resin. A testing machine was used to simulate brushing with the dentifrices Colgate Total 12, Oral B 100% and Oral B Gengiva Detox Gentle Whitening (8 samples per group). The constant speed of the machine was 250 cycles per minute, and 20.000 cycles were carried out, which corresponds to 24 months (1 hour and 20 minutes). Roughness features and qualitative surface topography were investigated. Statistical analysis involved the Kruskal–Wallis, Wilcoxon and Mann–Whitney tests. A significant increase in surface roughness was found for all the resins (p < 0.05). However, no significant difference was found among the resins in terms of final roughness values (p = 0.690). In contrast, a significant difference among dentifrices was found with respect to roughness measurements (p < 0.001). The qualitative analysis revealed an increase in surface roughness in all the samples and differences in the abrasive potential of the dentifrices. In conclusion, brushing with dentifrices increases the surface roughness parameters of composite resin restorations. Moreover, the differences in the abrasive effects of the dentifrices indicate a need for further studies to establish efficacy and safety criteria.

Abstract Although it is recognized that periodontal disease negatively impacts quality of life, there is no validated instrument to assess this impact in Brazil. This study aimed to translate, cross-culturally adapt, and validate the OHIP 14 PD (Oral Health Impact Profile Applied to Periodontal Diseases) for application among Brazilian patients. The original instrument was translated and validated into Brazilian Portuguese in a cross-sectional study with 110 participants recruited from a Dental School clinic. The sample was divided into two groups: 55 with periodontal disease and 55 without periodontal disease. The instrument was self-administered twice within an interval of 7 to 10 days for patients with periodontal disease. The psychometric properties of the Brazilian version were verified using internal consistency (Cronbach’s α) and the reliability through the test-retest method (ICC, intraclass correlation coefficient), convergent validity (Spearman correlation), and discriminant validity (Mann-Whitney test), with p <0.05. Most of the sample consisted of women (n=69; ±40.65 years). The OHIP 14 DP - Br showed excellent internal consistency (α=0.997) and outstanding reliability using the test-retest method (ICC=0.945, p<0.001). There was a significant correlation between the scores obtained in all seven domains between this questionnaire and self-perceived gingival health (p=0.023). This study provides psychometric evidence supporting the cross-cultural validity of the OHIP 14 DP - Br version for use in Brazil.

Abstract The aim of this cross-sectional study was to perform a three-dimensional (3D) assessment of the cranial base of patients with unilateral cleft lip and palate (UCLP). Cone-beam computed tomography (CBCT) scans of 52 UCLP patients (21 females and 31 males; mean age, 10.0 ± 2.12 years) were compared with the scans of 72 individuals (24 females and 48 males; mean age, 11.0 ± 2.11 years) without CLP, matched by gender and age (control group, CG). The 3D Euclidean distances of anterior cranial base (N-S), posterior cranial base (S-Ba), total cranial base (N-Ba) lengths, cranial base width (Po-Po), as well as the cranial base flexure (NSBa), were measured using open-source software ITK-SNAP and 3D Slicer. Statistical analyses were carried out with the Student’s t-test at a significance level of 5%. UCLP demonstrated shorter 3D distances than CG in the N-S, S-Ba, and N-Ba cranial base lengths (p < 0.001). In comparison with female CG, female UCLP had a smaller cranial base flexure (NSBa; p = 0.020). No statistically significant differences between UCLP and CG were found for the cranial base width (Po-Po). UCLP patients presented distinct morphological cranial base characteristics in comparison with CG. These results indicate that morphological and positioning changes in the maxillary bones are not solely attributable to the cleft and/or surgical procedures.

Abstract The aim of this study was to assess the effect of a chlorhexidine digluconate solution (CHX) applied as an antiproteolytic agent for controlling erosive tooth wear or as part of the adhesive treatment on long-term bond strength to eroded dentin. Dentin specimens were abraded with a 600-grit silicon carbide (SiC) paper for 1 min (sound dentin - S), subsequently treated with 2% CHX for 1 min (with excess removed, followed by a 6-hour rest), and eroded by exposure to Coca-Cola for 5 min, three times a day, for 5 days (CHX-treated and eroded dentin - CHXE), or only eroded (eroded dentin - E). The specimens were acid-etched (15 s), rinsed (30 s), dried (15 s), and rehydrated with 1.5 μL of distilled water for 1 min, with excess removed (control - S.C/CHXE.C/E.C) or 2% CHX (S.CHX/CHXE.CHX/E.CHX). Adper Single Bond 2 was scrubbed twice on the surface for 15 s each and then light-cured for 10 s, and resin composite cores were built up. Specimens were sectioned into beams and microtensile bond strength was tested (μTBS; 0.5 mm/min) immediately or after 18-month aging. Failure modes were analyzed using a digital microscope. Data (μTBS/MPa) were analyzed by three-way ANOVA, followed by Tukey’s test (α = 0.05). μTBS to E and CHXE, irrespective of the rehydration solution and aging period, were equivalent to each other and lower than that to S. CHX as the rehydration solution reduced immediate and long-term µTBS to S. Aging reduced μTBS. By controlling tooth wear or interface aging, CHX could not influence long-term bonding to eroded dentin.

Abstract Social networks consist of a group of individuals connected by family, work, or other interests and facilitated by an online structure or platform. They are also a relatively recent and widely used marketing phenomenon that is constantly evolving. The healthcare field includes professions such as social work, biology, biomedicine, physical education, nursing, pharmacy, physiotherapy, speech therapy, medicine, veterinary medicine, nutrition, dentistry, psychology, and occupational therapy. The present study aimed to analyze the influence of social networks in the process of finding and selecting healthcare professionals. The methodology was a survey using a structured questionnaire created on Google Forms. Descriptive research was carried out with non-probabilistic convenience and snowball sampling, followed by quantitative data analysis. A total of 268 participants who signed the informed consent were included in the study. The findings revealed that the most common way to find healthcare professionals is through recommendations from friends/relatives and other professionals, followed by the use of social networks. The majority of participants used social networks to search for healthcare professionals, with Instagram being the most widely used platform. Sponsored advertisements can be an effective way to reach potential new patients. The most valued characteristics in healthcare content creators were reliability, expertise, and the ability to convey messages, with health-related explanations in an easily understandable manner being the preferred type of content. Therefore, this study revealed that social networks can influence the search for and selection of healthcare professionals.

Abstract The objective of this study was to analyze the directions by which school jet lag is associated with traumatic dental injury in children, evaluating direct and indirect effects of socioeconomic factors and sleep. A representative, population-based, cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians answered a sociodemographic questionnaire, the Sleep Disturbance Scale for Children and the Circadian Energy Scale. Four examiners underwent training and calibration exercises for the diagnosis of traumatic dental injury (K > 0.80) using the criteria proposed by Andreasen (2007). Descriptive analysis was followed by structural equation modeling to determine direct and indirect associations between the variables incorporated into the theoretical model. School jet lag [standardized coefficient (SC): -0.238, 95%CI: -0.390–0.087], income (SC: -0.151, 95%CI: 0.0010–0.292), and number of residents in the home (SC: -0.109, 95%CI: -0.212–0.007) were directly associated with traumatic dental injury, whereas sleep disturbances and schooling of the parents/guardians exerted an indirect effect. Sociodemographic factors and school jet lag were associated with traumatic dental injury in children eight to ten years of age.

Abstract The aim of this study was to assess the oral condition of individuals diagnosed with COVID-19 and its impact on their quality of life. The cross-sectional study participants were patients with or without a diagnosis of COVID-19, on room air, and conscious, admitted to the ICUs and wards of Public Hospital Units in São Luís, Maranhão, Brazil. The data collected included: demographic information, length of stay, comorbidities, and type of diet, obtained from medical records; Oral Health-Related Quality of Life (OHRQoL) [Oral Health Impact Profile (OHIP-14)]questions patients were asked; oral health (measured by the Bedside Oral Exam Scale); oral hygiene status (assessed by the Oral Hygiene Index - Simplified and lingual: degree of lingual coating); and salivary flow. The prevalence of COVID-19 was associated with gender (p = 0.038), with a higher incidence observed in male patients (61.9%). Moreover, there was a correlation between the hospitalization sector (p = 0.037) and the frequency of ICU admissions (53.7%). The prevalence of comorbidities was comparable between the two groups. Relative to oral health, 53% of individuals with confirmed COVID-19 had moderate oral health, while 9% exhibited poor oral health. The prevalence of hyposalivation was higher in the group with a confirmed diagnosis of COVID-19. The quality of life of individuals with confirmed COVID-19 was most significantly impacted by moderate to severe oral health concerns. The most significant alteration in oral health was a reduction in salivary flow, negatively impacting the quality of life of individuals hospitalized for COVID-19 complications.

Abstract An association between bruxism and musculoskeletal disorders, such as neck pain, has been established. This study investigated the association of possible sleep bruxism (PSB) activities, including grinding, bracing, and thrusting, with smartphone use, smartphone-induced neck pain, and sleep features. This cross-sectional study involved 403 Brazilian adolescents aged 11 to 19 years. A self-administered questionnaire was used to assess the severity of PSB, smartphone use, smartphone-induced neck pain, and sleep features (sleep duration and quality and history of nightmares). Sociodemographic factors, as well as snoring and drooling on the pillow, were considered potential confounders and were assessed based on reports from parents/caregivers. Participants were selected using multiple-stage sampling. Descriptive analysis and multinomial regression were performed (p ≤ 0.05). Adolescents reporting nightmares at least once a month (OR = 3.402; 95%CI: 1.315–8.802) and sometimes experiencing smartphone-induced neck pain (OR: 3.697, 95%CI: 1.103–12.388) were more likely to report moderate/severe grinding. Drooling on the pillow (OR = 3.105, 95%CI: 1.316–7.329), poor/fairly good sleep quality (OR = 2.717, 95%CI: 1.279–5.770), and smartphone-induced neck pain (OR = 3.227, 95%CI: 1.121–9.285) were associated with mild bracing. Adolescents experiencing nightmares once a week (OR = 3.209, 95% CI: 1.202– 8.565) had a higher prevalence of mild thrusting. Self-reported smartphone-induced neck pain, nightmares, poor/fairly good sleep quality, and drooling on the pillow were associated with a higher prevalence of PSB activities among Brazilian adolescents. Clinicians and researchers are encouraged to include assessments of smartphone use and sleep features in anamnesis, promoting a comprehensive approach to PSB, from diagnosis to treatment.

Abstract: Cone beam computed tomography (CBCT) is an imaging exam used increasingly in various fields of dentistry, and a greater number of endodontists are progressively gaining access to this technology. This study focused on applying an artifact suppression algorithm featured in CBCT software, and designed specifically to address artifacts related to root canal filling materials. Method The sample consisted of eighty-four mandibular molars, with mesial root canals endodontically treated by using the lateral condensation technique. Four root canal sealers were applied: G1 – Sealapex®, G2 – AH Plus®, G3 – Endofill®, and G4 – Bio-C Sealer. CBCT scans were taken using PreXion 3D Elite®. Initially, the diameter of the root canal filling (in the mesiodistal and buccolingual directions) was measured using a digital micrometer (control). Next, these diameters were reevaluated in the CBCT images using the blooming artifact reduction (BAR) tool of the e-Vol DX software. The Van der Waerden nonparametric analysis of variance was performed, followed by applying the Tukey test to the normalized data. The significance level was set at α = 5%. Results There were no statistically significant differences (p>0.05) in the measurement of original root canal filling materials obtained by the micrometer versus the e-Vol DX software in the mesiodistal and buccolingual directions. Conclusions The tested software algorithm effectively suppressed artifacts resulting from obturation materials.

Abstract Dental referrals to the Endodontics Specialty Clinic (ESC) are routine owing to the complexity of endodontic treatments. To obtain a better prognosis for treatment, students/dentists must perceive their technical limits. This study sought to investigate the referrals of patients to the ESC from different clinics of the Piracicaba Dental School, State University of Campinas - SP, Brazil, and check: a) the demographic profile of patients and the most commonly affected tooth; b) the clinic with the largest number of referrals; c) the reasons for referrals; d) the complexity of the cases; e) and the difficulty in assessing the referred cases based on the classification provided by the American Association of Endodontists (AAE) and Souza-Filho. The study sample consisted of patients’ electronic dental referral records from February 2015 to June 2019. A total of 1,707 patients were referred to the ESC during the study period, and 62.4% were female. Lower molars were the most frequently involved teeth (34.8%), and 60.7% of the cases were referred due to the presence of root curvature. The AAE classification showed prevalence of highly difficult cases (71.3%), whereas Souza-Filho classification demonstrated a high rate of class III cases (85.8%). This study highlights the difficulties encountered by undergraduate students before or during endodontic treatments, reinforcing the need for clear criteria for selecting cases appropriate for each education level, thus improving endodontic treatment prognosis.

Abstract In the modern world, cancer is a growing cause of mortality, but archeological studies have shown that it is not exclusive to modern populations. The aim of this study is to examine the epidemiologic, social, and clinicopathologic features of head and neck cancers in ancient populations. To do this, we extracted all records that described malignant lesions in the head and neck region available in the Cancer Research in Ancient Bodies Database (CRAB). The estimated age, sex, physical condition of the remains (skeletonized, mummified), anatomic location of tumors, geographic location, chronology, tumor type, and methods of tumor diagnosis were collected. One hundred and sixty-seven cases were found, mostly originating from Europe (51.5%). Most records were of adults between 35 and 49 years of age (37.7%). The most involved site was the skullcap (60.4%), and the most common malignancies were metastases to the bone (65.3%) and multiple myeloma (17.4%). No primary soft tissue malignancies were registered. The results of our study indicate that head and neck cancers were present in ancient civilizations, at least since 500,000 BCE. The available data can help to improve the current understanding of the global distribution of head and neck cancer and its multidimensional impacts on populations in the contemporary world.

Abstract This study aimed to estimate the prevalence and extent of bleeding on probing and calculus in 12-year-old schoolchildren of Quito, Ecuador, and evaluate the associated factors. We conducted an epidemiological survey with a representative sample of 1,100 12-year-old schoolchildren from public schools in the urban area of Quito, Ecuador. We assessed the periodontal health using the Community Periodontal Index (CPI). The prevalence and extent of the periodontal condition was based on the presence of at least one site with bleeding on probing (BOP), and the presence of dental calculus was also evaluated. We used univariate and multiple multilevel Poisson regression analyses to verify the association between the independent variables and the number of sextants with BOP and calculus. The prevalence of BOP and calculus was 92% and 69.9%, respectively. The adjusted mean of the affected sextants was 4.3 and 2.2 for BOP and calculus, respectively. The mother’s schooling and malocclusion were associated with the number of sextants with bleeding. The mother’s schooling and dental caries experience were associated with calculus. Gingival bleeding and the presence of dental calculus are highly prevalent in 12-year-old schoolchildren from Quito. Gingival bleeding is associated with maternal education and malocclusion, and dental calculus is associated with maternal education and dental caries.

Abstract The aim of this study was to evaluate the root canal shaping effect of ProTaper Gold (PTG) versus ProTaper Next (PTN) instrumentation systems, and of a manual #15 K-type file (K15) versus the ProGlider (PG) mechanized instrument for glide path creation, in severely curved mesial canals. Twenty-four mandibular molars with two separate mesial canals were anatomically matched using computed tomographic scanning, and then divided into two groups (n=12) according to the glide path instrument used, either K15 or PG. In all teeth, the PTG system was used to prepare the mesiobuccal canal, and the PTN, the mesiolingual canal. The teeth were scanned by computed microtomography, before and after root canal preparation, and the values of the initial volume, final volume, volumetric variation, untouched walls, and canal transportation variables were determined. The data were analyzed using the two-way ANOVA test, and the Tukey test for multiple comparisons. There was no significant difference among the study groups regarding volumetric variation or root canal transportation, either in the cervical, middle or apical thirds, or in the entire root canal (p>0.05). In the apical third, the percentage of untouched walls was significantly higher in groups using K15 than in those using PG (p<0.05), namely 33.144% and 23.285%, respectively, irrespective of the instrumentation system. In the other regions, there was no difference between K15 and PG regarding this variable. It was concluded that PG was associated with a lower rate of untouched walls in the apical region than K15.

Abstract This study aimed to develop and validate a self-administered questionnaire in Brazilian Portuguese to verify the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women, named “Considerations on Orthodontic Treatment during Pregnancy, Lactation, and Postmenopausal Periods.” The development and validation of the questionnaire consisted of the following steps: a) item generation; b) item reduction; c) questionnaire design; and d) validity and reliability tests in a cross-sectional study with 258 orthodontists working in the field from different Brazilian states. A total of 60 orthodontists participated in test-retest over a mean period of 45 days. The preliminary questionnaire consisted of a total of 60 questions. After item reduction, 40 questions were selected for the final version of the questionnaire, with eight questions about pregnant women; six about lactating women; 18 about postmenopausal women, and eight about general knowledge in dentistry. Each item had three response options in the Likert scale format. Face and content validity analysis, reliability assessment through internal consistency (Cronbach’s alpha and McDonald’s omega), and test-retest reliability through the intraclass correlation coefficient (ICC) and Spearman’s correlation coefficient were performed. Face and content validity indicated that the questionnaire was considered valid, objective, and easily understandable. The questionnaire had good internal consistency (Cronbach’s alpha = 0.77; McDonald’s omega = 0.78) and good test-retest reliability (ICC = 0.71; Spearman’s correlation coefficient = 0.51). The questionnaire was considered valid and reliable to assess the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women.