Mestrado em Odontologia (FO)

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    Incidência de desfechos protéticos associados à overdenture mandibular retida por quatro mini-implantes: estudo prospectivo aninhado a ensaio clínico randomizado
    (Universidade Federal de Goiás, 2023-10-20) Silva, Jésio Rodrigues; Leles, Cláudio Rodrigues;; Leles, Cláudio Rodrigues; Roriz, Virgílio Moreira; Hartmann, Roberto
    The use of mini-implants is gaining popularity due to less surgical complexity and advantages for cases of atrophic mandibles, and a new system of mini-implants was recently launched (Straumann Optiloc Mini-Implant System®). Aim: This prospective study is part of a randomized clinical trial and aimed to evaluate the incidence of prosthetic outcomes and associated factors in completely edentulous patients after the insertion of mandibular overdentures retained by four mini-implants. Methods: Completely edentulous individuals using conventional complete dentures were recruited for the installation of four mini-implants for treatment with mandibular overdenture. The study combined two surgery protocols (flapped or flapless) and loading (immediate or delayed). During follow-up, the incidence of prosthetic complications and maintenance events were recorded at scheduled and unscheduled appointments. Independent variables were considered as age, gender, surgery and loading protocol, and ridge form (CAWOOD & ROWEL, 1988). A classification of prosthetic outcome (six-field protocol) (PAYNE et al., 2001) was assessed at the end of the follow-up period. Descriptive statistical analysis was performed, with measurements of incidence rates, as well as Kaplan-Meier survival analysis and Cox regression, considering the significance level of p<0.05. Results: 74 participants were accompanied, with a mean age of 64 years (35-80 years), and total follow-up time varied between 19 and 26 months. There were a total of 182 prosthetic events in 147 consultations, 88 of which (59.87%) were unscheduled. The most frequent event was the need for minor adjustments to the base of the overdenture (incidence of 38), due to sore spots; followed by minor repairs at the base (incidence of 16); total (incidence of 21) or partial (incidence of 11) exchange of matrices; indirect relining (incidence of 21) due to instability; new intraoral capture (incidence of 8); fracture of the overdenture (n = 1) and tooth fracture (n = 1). The outcome of success was attributed to 69 participants (93.2%). The most significant predictor for the incidence of adjustments was the flapless surgery protocol (p=0.011), and the age was the most one for the incidence of total matrix replacement (p=0.031). There was no statistically significant difference in the incidence of other prosthetic complications with regard to gender, loading protocol, or ridge form (p>0.05). Conclusions: There was a high incidence of prosthetic events, but they were considered acceptable and mostly represented by small adjustments or repairs to the overdenture base in the initial period of treatment. The high survival and success rate of the implant and prosthesis shows that this is a favorable treatment option for this follow-up, and it is recommended to establish scheduled appointments for the expected events. Longer follow-ups are recommended to obtain more representative data regarding prosthetic outcomes.
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    Desenvolvimento e implementação de uma escala de autoeficácia em saúde oral para usuários de overdenture mandibular
    (Universidade Federal de Goiás, 2023-11-06) Moore, Steven Kadeem; Leles, Cláudio Rodrigues;; Leles, Cláudio Rodrigues; Srinivasan, Murali; Nogueira, Túlio Eduardo
    Introduction: Self-efficacy, a concept coined by Albert Bandura, refers to an individual's belief in their ability to perform behaviors necessary to achieve specific performance goals. In the context of oral health, self-efficacy plays a pivotal role in influencing behaviors related to oral hygiene practices. Objective: This study aimed to develop an oral health self-efficacy scale and evaluate the relationship between oral health self-efficacy and the peri-implant health status of individuals using implant-retained overdentures. Materials and Methods: This was a cross-sectional observational study nested within a clinical trial at the Prosthesis and Implant Research Center (NPPI) at the Federal University of Goiás (UFG), Goiânia, Brazil. The project received approval from the Ethics Committee for Research at the Federal University of Goiás. A 25-item questionnaire was developed based on the Dental Self-Efficacy Scale (DSE), revised by a panel of experts, translated into Brazilian Portuguese, and piloted for clarity. The 25-item OHSE-OVER questionnaire collected data across four dimensions: (1) routine challenges – 4 items; (2) self-rated performance – 5 items; (3) attitudes towards oral health – 6 items; (4) challenges in special occasions – 10 items. The questionnaire score was calculated by first reversing the scale of dimensions 1 and 4 and then summing the scores of all dimensions. The final score repre-sented oral health self-efficacy (higher scores indicating greater oral health self-efficacy). The study included patients with mandibular overdentures retained by implants as part of a larger study involving mini-implants. Randomization was based on a surgical approach and loading protocol. All clinical procedures took place at NPPI/UFG, with no cost to the participants. Twelve-month follow-up assessments included pillar plaque evaluations, peri-implant bleeding, and denture surface plaque. A single clinician conducted clinical assessments for all patients and administered the Oral Health Self-Efficacy Evaluation for Overdenture Users (OHSE-OVER) questionnaire in an interview format during evaluation. Clinical data were compared with OHSE-OVER questionnaire responses. Statistical analyses, including Confirmatory Factor Analysis and regression, were conducted using IBM-SPSS 22.0 and Mplus 8.8 software, with a significance level of p < 0.05. Results: Out of the initially invited 74 patients, 69 participated in the study. Among them, the majority were female (63.8%), aged between 36 and 81 years (mean = 65.0; SD = 8.1), with nearly half being current or ex-smokers (47.8%), and most were taking regular medication (82.6%). Self-efficacy scores varied across different dimensions, with an overall mean score of 2.35. The scale demonstrated good reliability (Cronbach's alpha = 0.799). Con-firmatory factor analysis supported the four-factor model, with the removal of two items due to their low factor loadings. Regression analysis revealed that higher self-efficacy was linked to better denture hygiene outcomes in the overall scale, a positive association between oral health self-efficacy and sex(male), as well as an inverse relationship between oral health self-efficacy and plaque index in dimensions 1 and 2, respectively. No significant associations were observed in dimensions 3 and 4. Conclusion: The research underscores the fundamental role of self-efficacy in determining oral health outcomes in individuals using implant-retained overdentures. It establishes a significant association between oral health self-efficacy and key oral hygiene indicators, such as plaque index and denture hygiene, in patients relying on implant-retained overdentures. Additionally, the validation of the OHSE-OVER's psychometric robustness and internal structure reinforces its efficacy as a valuable instrument specifically developed to assess and address oral health self-efficacy in patients with mandibular overdentures, both in clinical and research contexts.
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    O efeito da espessura do esmalte e dentina na interpretação do oxímetro de pulso
    (Universidade Federal de Goiás, 2020-02-28) Sestari, Larissa Emanuelle; Alencar, Ana Helena Gonçalves de;; Silva, Julio Almeida;; Silva, Julio Almeida; Estrela, Carlos; Guedes, Orlando Aguirre
    Introduction: The thickness of the dental substrate is a factor that interferes with the result of the evaluation of the pulp oxygen saturation level, capable of reducing the pulse oximeter accuracy. This study evaluated the interference of enamel-dentin thickness in the interpretation of the pulse oximeter, having as variation factors the finger oxygen saturation and the presence and absence of light. Materials and Methods: Forty-two healthy human lower molars were sectioned centrally in the mesiodistal direction. After sectioning, the buccal and lingual faces were worn on the dentin surface and evaluated at 4.0mm, 3.0mm and 2.0mm thickness. A reference device was made for the alignment of the pulse oximeter diode, buccal tooth face, participant's little finger, lingual face and receiving diode. The positive control of the experiment was performed on the participant's finger without interposition of the dental faces, and the negative by juxtaposition of the dental faces without the participant's finger. All measurements were performed in the presence and absence of light. The variables were described by the mean and standard deviation, and the confidence interval presented. To compare the groups, analysis of variance (ANOVA) was used, followed by Bonferroni correction. Student's t-test was used to compare paired samples, and to assess the correlation between oxygen saturation and pulse level, the Pearson Correlation Coefficient was used. The significance level of 5%. Results: The average level of oxygen saturation in the finger was lower when the dental structure of 4.00.2mm, 92.7% and 89.3% was interposed, in the presence and absence of light, respectively, than when it was 3.00.2mm, 95.5% and 94.5%, and 2.00.2mm, 96.4% and 96.0% (P <0.001). The mean oxygen saturation level in the positive control was 96.1%. In the negative control samples, no oximetry and pulse results were recorded. Conclusions: The thickness of the dental structure interfered with the pulse oximeter interpretation, with significant reduction of oxygen saturation level for larger thicknesses, and the presence and absence of light changed the pulse oximeter interpretation.
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    Sobrevida e desfechos periimplantares de overdentures mandibulares retidas por quatro mini implantes de titânio-zircônia: ensaio clínico randomizado de um ano de acompanhamento
    (Universidade Federal de Goiás, 2023-02-15) Curado, Thalita Fernandes Fleury; Leles, Cláudio Rodrigues;; Leles, Cláudio Rodrigues; Oliveira, Camila Alves Costa de; Mello, Caroline Cantieri de
    Mandibular overdenture is considered the standard treatment for completely edentulous patients, with excellent cost-effectiveness and high success rates. The traditional technique consists of installing two implants of conventional diameter, its use being limited in very resorbed ridges with reduced thickness. Mini-implants are small-diameter implants that have recently been used to retain overdentures with satisfactory success rates. The aim of this study is to evaluate the survival and peri-implant outcomes of a mini-implant system for overdenture retention and the influence of surgical and loading protocols performed. The present study consists of a 2x2 factorial randomized clinical trial where 74 total edentulous participants underwent the installation of four mini-implants for overdenture retention in the mandibular interforaminal region, totaling 296 mini-implants. They were randomized into four groups according to the surgical protocol and prosthesis loading: Immediate/Flapless = 17 (23.0%); Immediate/Flapped = 18 (24.3%); Delayed/Flapless = 20 (27.0%); and Delayed/Flapped = 19 (25.7%). Most participants (64.9%) were female and the mean age at surgery was 64.1 ± 8 years. The survival rate during the 1-year follow-up was 100%. No major biological complications were observed, such as abnormal marginal bone loss or sulcus depth. The plaque index remained stable at the follow-ups (3, 6 and 12 months after capture) while the bleeding index significantly reduced at the 6 and 12 months follow-ups compared to the baseline index (3 months). Probing depth and gingival margin height remained stable over the follow-up periods. The mean overall marginal bone loss was 0.68 (±0.68) mm after three months and 0.89 (±0.75) mm after one year. The flapless protocol showed better results in stability and soft tissue health and a slightly higher risk of marginal bone loss. The findings suggest that the mandibular overdenture retained by this new mini-implant system is a safe and predictable treatment option with regard to implant survival and peri-implant outcomes, even when flapless surgery and immediate loading are adopted.
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    O impacto do atendimento especializado em diagnóstico oral no prognóstico de pacientes com câncer de boca: estudo observacional em um centro de assistência de alta complexidade em oncologia
    (Universidade Federal de Goiás, 2023-02-10) Sousa Neto, Sebastião Silvério de; Mendonça, Elismauro Francisco de;; Mendonça, Elismauro Francisco de; Martins, Allisson Filipe Lopes; Arantes, Diego Antônio Costa
    Despite advances in the treatment of oral cancer in recent decades, mortality from oral cancer remains stable, with an estimated mortality of 50% after 5 years of follow-up. Delay in diagnosis and treatment has been an important factor associated with higher clinical stages of oral cancer (OC), observed in the first consultation at the High Complexity Oncology Care Center (HCOCC), which negatively impacts the prognosis. Strategies that enable early diagnosis and reduce delays in treatment are important to promote a better prognosis for the patient. In this context, professionals specializing in oral diagnosis, stomatologists, oral pathologists, and head and neck surgeons are expected to be more effective in diagnosing and referring patients to a HCOCC. However, no study has evaluated the prognosis of patients with OC referred by specialists concerning non-specialists. This study aimed to investigate whether patients with OC referred by specialists in the oral diagnosis and treated at a HCOCC have a better prognosis compared to patients referred by non-specialized professionals. A retrospective cohort study was carried out with 282 participants attended at HCOCC - Hospital de Cancer Araujo Jorge in the period 1998-2016. Two groups were formed: group I - participants referred by teams specialized in oral diagnosis (n = 129), and group II: participants referred by non-specialized teams (n = 153). Demographic, clinical, and pathological data, diagnosis, and treatment delay times, treatment modalities, and clinical outcomes were collected from the medical records. Categorical variables were analyzed using the Chi-square test and numeric variables using the Mann-Whitney test. To assess disease-free survival (DFS) and overall survival (OS), Kaplan-Meier curves, log-rank test, and Cox multivariate regression were performed. Multivariate logistic regression was performed to assess the determining factors for surgical treatment, and, to assess the impact of delays on staging, and ordinal and multinomial logistic regression was performed for parameters T and N, respectively. P value < 0.05 was considered statistically significant. The male gender was predominant in the groups, being more prevalent in group II. T staging was significantly lower in group I, with 24% of tumors classified as Tis or T1, while group II recorded 11.8% in these T stages. There was a higher incidence of locoregional metastasis in group II (42.5%) than in group I (28.7%) and more distant metastases in group II (9.2%) than in group I (1.5%). Surgery was performed in 75.2% of group I and 60.8% of group II. Although the delay in diagnosis was longer in group I, the time taken to start treatment and the time taken to return post-radiotherapy in the head and neck department was shorter in this group. Surgical treatment was associated with lower TNM staging. DFS and OS analyses between groups did not show significant differences. Multivariate analysis revealed that T3/T4 tumors, locoregional metastasis (N+), distant metastasis (M1), and tumor recurrence are risk factors, while surgical treatment was a protective factor to impact DFS. T3/T4, N+, and M1 tumors were risk factors for OS. Specialized care positively influenced decision-making regarding surgical treatment in the univariate analysis; however, in the adjusted models, no influence was observed in the indication of the surgical modality or the DFS and OS. In summary, the results found allow us to infer that professionals specialized in oral diagnosis diagnose OC at lower stages, although there is a longer diagnostic delay, and promptly refer them to a HCOCC, enabling the initiation of treatment in less time and with a greater chance of receiving surgical treatment as the first option. This fact impacts the prognosis and survival rates. The insertion of a professional specialized or trained in oral diagnosis in the various levels of health care for the prevention, diagnosis, and treatment of oral cancer is important and has an impact on the patient's prognosis.
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    Avaliação da expressão tecidual dos ligantes de morte programada-1 e -2, do receptor PD-1 e da resposta imunológica citotóxica no líquen plano oral
    (Universidade Federal de Goiás, 2020-05-29) Gonçalves, Julie Ane Maria; Costa, Nádia do Lago;; Batista, Aline Carvalho;; Costa, Nádia Do Lago; Mendonça, Elismauro Francisco de; Silveira, Ericka Janine Dantas da
    Oral lichen planus (OLP) is a chronic autoimmune disease, mediated by T lymphocytes (TL) and characterized by apoptosis of basal/suprabasal keratinocytes. Although its etiopathogenesis is not completely elucidated, recent data reveal that blocking immunoregulatory molecules such as programmed death ligands (PD-Ls) and/or PD-1 receptor may promote the appearance of oral lichen planus-like lesions. It is classically established that this PD-Ls/PD-1 pathway contributes to evasion of neoplastic cells; however, it may be important in the regulation of helper and cytotoxic (CD8+) TL in autoimmune diseases. Objective: To investigate the tissue expression of PD-L1 and PD-L2 molecules, as well as PD-1+, CD8+ and granzyme B+ (GrB) cell populations in OLPs and whether there is a relationship between these immunoinhibitory proteins/cell populations and the severity of OLP. Material and methods: Samples of OLP patients (n = 23) were classified according to the histopathological criteria of the American Association of Oral and Maxillofacial Pathology (AAOMP/2016) and submitted to immunohistochemistry. Semi-quantitative (PD-L1+ and PD-L2+) and quantitative analysis (PD-1+, CD8+ and GrB+ cells) were performed. The severity of OLP was assessed by clinical subtype, symptomatology and response to corticosteroid therapy. Results: Most OLP samples were considered negative for PD-L1 (n = 14/22; 63.7%), however high PD-L2 expression (n = 19/22; 86.3%) by both keratinocytes and immunoinflammatory cells has been demonstrated. Low cytotoxic immune response (CD8/GrB ratio per mm2) was evidenced in OLP samples (subepithelial: 1047.4/140.6 and intraepithelial: 197.7/41.6). In addition, PD-1+/mm2 (subepithelial: 70.2 and intraepithelial: 7.4) cell density was reduced compared to CD8+/mm2 LT (subepithelial: 1047.4 and intraepithelial: 197.7) (p <0.01). There was a significantly lower number of GrB+ cells in the intraepithelial region in reticular OLP compared to erosive / bullous OLP (p = 0.03). Conclusions: The findings show that the PD-L1 / PD-1 pathway seems to be compromised in OLP due to low PD-L1 expression and PD-1 + cell scarcity in most samples. On the other hand, PD-L2 overexpression added to a possible regulation of cytotoxic immune response suggests an immune tolerance that may contribute to the chronic profile of OLP.
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    Influência da morfologia facial no volume das vias aéreas superiores
    (Universidade Federal de Goiás, 2011-12-16) Lenza, Milena Moraes de Oliveira; Lenza, Marcos Augusto;; Lenza, Marcos Augusto; Barros, Sérgio Estelita Cavalcante; Botelho, Tessa de Lucena
    Although controversial, the influence of upper airways in craniofacial morphology has been extensively studied, though most of the studies were performed in a two-dimensional lateral cephalograms in assessing complex three-dimensional structures. To better assess the upper airway Cone Beam Computed Tomography scans are being increasingly used as a means of diagnosis. The objective of this study was to evaluate three-dimensional variations in the volumes of the upper airways in patients with different facial morphological characteristics. The sample consisted of DICOM images (Digital Imaging and Communications in Medicine) of 45 patients previously treated in the Postgraduate Clinic of the Orthodontic Department at the University of Aarhus, Denmark. The inclusion criterion was that every patient had a 12” CBCTscan (NewTom 3G, QR s.r.l.; AFP Imaging, Elmsford, NY, USA) in occlusion. These files were imported into a specific software (Mimics 12.13 - Materialise Interactive Medical Image Control System, Belgium), enabling the reconstruction and image generation in 3D multiplanar cuts, which allowed its visualization and evaluation in the coronal, sagittal and transverse planes, besides its three-dimensional structure. The results showed that the volume of upper airway shown to be influenced by the skeletal pattern, especially when comparing the volume of Class II patients with volumes of Class III patients and when compared with brachyfacial and dolichos patients. The volume of the upper airways is influenced by the skeletal pattern, it has been observed a wide variation in the volume of airways independent of sagittal or vertical skeletal pattern.
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    Efeito do gás ozônio em dentina exposta a biofilme de S.mutans
    (Universidade Federal de Goiás, 2011-12-20) Chaves, Rafaella Mosquera; Estrela, Carlos;; Lopes, Lawrence Gonzaga;; Lopes, Lawrence Gonzaga; Estrela, Carlos; Cardoso, Paula de Carvalho; Pereira, Lúcia Coelho Garcia
    The present study aims to assess the affect of ozone gas in dentin exposed to biofilm of Streptococcus mutans by the evaluation of mineral content (Log Ca/P) of dental substrate using the tool Spectroscopy Dispersive Energy-EDS. Five human third molars were sectioned in to four slices of dentin and divided into four groups: Group I, control (no treatment); Group II, ozone therapy; Group III, biofilm development; and Group IV, ozone therapy followed by biofilm development. The mineral content (Log Ca/P) was evaluated by EDS. The data were tabulated and assessed by repeated measure one-way analysis of variance (ANOVA) and the Tukey test (p<0.05). The Group I-Control was similar to the Group II-Ozone and was statistically different from Group III-Biofilm and Group IV-Ozone+Biofilm. The lowest Log Ca/P was determined in Biofilm Group. Our findings show that the application of gas ozone didn’t confer preventive effect on the dentin surface under the challenge of oral biofilm.
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    Avaliação do perfil do cirurgião-dentista e dos critérios adotados para manter, reparar ou substituir restaurações diretas de resina composta, baseada no sistema FDI
    (Universidade Federal de Goiás, 2014-02-06) Silva, Claudiôner de Oliveira e; Lopes, Lawrence Gonzaga;; Souza, João Batista de;; Souza, João Batista de; Torres, Érica Miranda de; Teixeira, Ricardo Antônio Gonçalves
    The present study analyzed trends in clinical management of dental surgeons regarding the use of clinical criteria adopted by the World Dental Federation (FDI) for evaluation of restorations, the percentage of indications to maintain, repair or replace direct composite restorations and the influence of professional profile on these management. Data collection occurred through a questionnaire with content according to the criteria of the FDI, sent to professionals by electronic mode. Dentists who work in the city of Goiânia / Brazil in general practice (2068) and specialists in restorative dentistry (124) were sampled. The variables investigated in the use of FDI clinical criteria were related to esthetic properties (surface luster, staining, color match and translucency, esthetic anatomical form), functional properties (fracture of material and retention, marginal adaptation, occlusal contour and wear, approximal anatomical form, radiographic examination, patient's view) and biological properties (postoperative sensitivity, recurrence of caries, tooth integrity, periodontal response, adjacent mucosa, oral and general health). After reading the description of each criterion was indicated only one corresponding option to trends in clinical management: maintain, repair or replace the restorations. In characterizing the professional profile, it was evaluated the educational level (specialist or general practitioner), the type of degree and specialization (public or private institution), work experience (time undergraduate and specialization), the professional sector of activity (public, private or both) and the municipality region in which it operates ( socio- economic class of the population served). The descriptive statistical analysis was done by percentage distribution and associations between variables were tested using the chi-square (α = 0.05). After analyzing the data of 213 responses, it was observed that: the percentage of responses for the replacement of direct resin composite restorations is greater than the maintenance and repair; the criterion most frequently observed as the esthetic properties was staining (34,7%); and about the functional properties was fracture of the material and retention (51,1%). According to the criteria presented in the questionnaire, about 54,6% of respondents chose repair, 41,7% replace and 3,7% keep the direct composite resin restoration described in clinical simulation. The professional profile of the dentist influenced trends ducts in the simulations presented, with lower response rates to replace in case of senior professionals at public institution, specialists in dentistry, those who had higher graduation time and expertise and those working in the public sector.
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    Impacto do tratamento odontológico sob sedação na qualidade de vida relacionada à saúde bucal de pré-escolares e suas famílias
    (Universidade Federal de Goiás, 2018-03-19) Rodrigues, Kárita Cristina Silva; Faria, Patrícia Corrêa de;; Costa, Luciane Ribeiro de Rezende Sucasas da;; Costa, Luciane Ribeiro de Rezende Sucasas da; Leles, Claúdio Rodrigues; Machado, Geovanna de Castro Morais
    There appears to be no evidence regarding the impact of dental treatment under sedation on oral health-related quality of life (OHRQoL) among preschoolers. The aim of the present study was to determine the viability of a prospective evaluation of the impact of dental treatment under conscious sedation on OHRQoL in preschool with non-cooperative behavior and their families. The Brazilian version Early Childhood Oral Health Impact Scale (B-ECOHIS) was administered before (T0), two weeks (T1) and three months (T2) after treatment. Socio-demographic and clinical data were obtained from interviews and dental charts. The difference in B-ECOHIS scores were categorized as “improvement” or “worsening” of OHRQoL. Forty-nine children and their caregivers participated. The high response rate (84.5%). The postoperative evaluation periods seem to have been sufficient to detect improvement in the OHRQoL. In T1, reduction of scores in the section "impact on the child" (p = 0.02) and subscale "oral symptoms" (p = 0.02). In T2, reduction of the total B-ECOHIS scores (p = 0.03), the subscale "child function" (p = 0.02) and the "family impact" section (p = 0.01). In both, the improvement of the OHRQoL of the majority of the participants was observed (T1 = 53.1%, T2 = 57.1%), and an improvement was associated with the number of teeth extracted (T1 p = 0.03) and male (T2 p = 0.03). It was concluded that the prospective evaluation of the impact of treatment under sedation on the OHRQoL is feasible. There was improvement in QRSRS after dental treatment under conscious sedation.
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    Influência do voxel e da miliamperagem na qualidade da imagem e dose de radiação em tomografia computadorizada por feixe cônico
    (Universidade Federal de Goiás, 2022-02-25) Correia, Fernanda Ferreira Nunes; Silva, Fernanda Paula Yamamoto;; Silva, Fernanda Paula Yamamoto; Silva, Jonas Oliveira da; Silva, Maria Alves Garcia Santos
    The diagnostic accuracy in cone beam computed tomography (CBCT) must be maintained with the lowest possible radiation dose, therefore, the protocol must be optimized according to the clinical indication, in terms of technical parameters, following the acronym ALADA, as low as diagnostically acceptable. This study aimed to evaluate the influence of technical parameters - voxel, tube current, exposure time and number of base images - in the Ortopantomograph™ OP300 equipment (Instrumentarium Dental™, Charlotte, NC, USA) on image quality and radiation dose in CBCT from nine image acquisition protocols. For this, 19 thermoluminescent dosimeters were used, for each of the protocols, located in radiosensitive regions, according to the recommendations of the International Commission on Radiological Protection (ICRP), positioned in an Alderson RANDO® anthropomorphic phantom for later calculation of the equivalent and effective doses. The subjective assessment of image quality was performed through the analysis of CBCT exams by 3 specialists in Dental Radiology and Imaging, independent from each other, who identified anatomical structures, for each protocol, in a macerated mandible. Descriptive analysis of radiation dose and multiple linear regression were performed to assess the influence of parameters on radiation dose [F (2,6) = 17,294; p = 0,003; R² = 0,852] with emphasis on milliamperage and number of base images, described in the equation: y = - 114,382 + 17,910 (milliamperage) + 0,196 (base images). Intra- and inter-observer reliability of subjective assessments were calculated as a kappa agreement analysis. Fisher's exact test showed no association between image quality and acquisition protocols (x²(8) = 6.685; p = 0.622). The chi-square test of independence showed that there is no association between the examiners' confidence and the acquisition protocols (x²(8) = 13.767; p = 0.090). A statistical significance level of p<0.05 was used. With the manipulation of the technical parameters for the evaluated protocols, a variation of up to 225.6% in the effective dose was observed. Protocol 1 (FOV 6x8 cm, 90 kV, voxel 0.3 mm, 8 mA, 4.9 s and 486 base images) was considered superior to the others in terms of subjective assessment of image quality and radiation dose.
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    Potencial antimicrobiano de diferentes protocolos de irrigação em canais radiculares infectados
    (Universidade Federal de Goiás, 2015-03-19) Freire, Alessandro Moreira; Estrela, Carlos; Souza, João Batista de;; Souza, João Batista de; Decúrcio, Daniel de Almeida; Estrela, Cyntia Rodrigues de Araújo; Estrela, Carlos
    The aim of this study was to compare the antibacterial effect of irrigation protocols (positive, negative and passive ultrasonic pressure) using sodium hypochlorite 2.5% associated with root canal preparation with nickel-titanium instruments. Fifteen extracted maxillary central incisors were selected and root canals prepared, inoculated with E. faecalis and incubated at 37°C for sixty days. The teeth were randomly divided into 5 groups: Group 1 - automated root canal preparation (PACR) and irrigation with negative pressure (IPN) with sodium hypochlorite 2.5%; Group 2 - PARC irrigation and positive pressure (IPP) with sodium hypochlorite 2.5%; Group 3- PARC and passive ultrasonic irrigation (PUI) with sodium hypochlorite 2.5%. Groups 4 and 5 - positive and negative controls, respectively. Bacterial reduction was assessed in each group of three teeth using culture. In microbial culture, samples were taken from the root canals and immersed in 7 mL of Letheen Broth (LB) followed by incubation at 37 ° C for a period of 48 hours. The bacterial growth was assessed by turbidity of the culture medium followed by UV spectrophotometry. The average and standard deviation of the initial collection, 20 minutes collection and 72 hours collection were obtained. The difference between groups was evaluated by ANOVA for repeated measures, post hoc Bonferroni. Significance level was p <0.05. The antibacterial analysis of irrigation protocols with 2.5% sodium hypochlorite has not been effective in infected dentin by Enterococcus faecalis in 60 days, but there was bacterial reduction in all groups evaluated.
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    Prevalência de dentes pilares de prótese fixa em subpopulação adulta brasileira
    (Universidade Federal de Goiás, 2012-03-09) Crosara, Mariana Borges; Souza, João Batista de;; Estrela, Carlos;; Estrela, Carlos; Alencar, Ana Helena Gonçalves de; Rocha, Sicknan Soares da; Barletta, Fernando Branco
    Objective: The purpose of this cross-sectional study was to evaluate the prevalence of pillar teeth for fixed prostheses in a subpopulation of adult Brazilians. Methods: Panoramic radiographs of a total of 1401 patients, performed between August 2002 and September 2007, were randomly selected from the database of the Radiological Center of Orofacial Images of Cuiabá (CROIF, Cuiabá, MT, Brasil). A total of 1401 radiographs were examined to determine the frequency of pillar teeth for fixed prostheses. The data were collected and tabulated, regarding age, gender and dental group. The statistical treatment analyzed the data about the frequency distribution and chi-square test. The significance level was set at α = 5%. Results: We evaluated 29,467 teeth, and of these, 4,967 (16.8%) were pillars of fixed prosthesis. High prevalence of pillar teeth for fixed prosthesis was observed in female subjects (61.2%) and aged between 46-60 years (49.9%). Upper and lower premolars were the teeth more often involved in rehabilitation, 20.5% and 17.2%, respectively. Dental absences were identified in 24.8% of the sample. Conclusion: The prevalence of pillar teeth associated with fixed prosthesis was 16.8%, being more frequent in upper incisors and premolars of female subjects.
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    A irradiação da estrutura dentária modifica o resultado da saturação de oxigênio aferida pelo oxímetro de pulso?
    (Universidade Federal de Goiás, 2022-03-03) Santana, Maria Luiza Lima; Silva, Julio Almeida;; Decurcio, Daniel de Almeida;; Decurcio, Daniel de Almeida; Estrela, Carlos; Simamoto, Veridiana Resende Novais
    Objective: To evaluate the interference of dental structure ionizing radiation in measuring finger oxygen saturation by a pulse oximeter. Materials and method: Fifty-four extracted human third molars were sectioned mesiodistally to obtain the buccal and palatal/lingual surfaces standardized in 4,0mm of thickness, involving enamel and dentin structure. The initial measurement of oxygen saturation (SaO2) and heart rate (bpm) of the little finger of the participant's hand, at rest, was performed using the portable pediatric pulse oximeter BCI 3301 (positive control before ionizing radiation). As a negative control, oxygen saturation was measured with the faces of the teeth juxtaposed to each other. Next, the faces of the teeth were fixed parallel to the pulse oximeter diodes and interposed between the participant's minimum and the pulse oximeter diodes for pre-irradiation data collection. For this, an additional silicone mold was used to fix the pulse oximeter diodes to be parallel and set in a vise-type vise. The recording of SaO2 was carried out in the presence and absence of ambient light. Afterward, the sample received the ionizing radiation in a fractional form, from 2Gy daily, 5 days a week, for 7 weeks, up to 70Gy. For post-irradiation evaluation, a new positive control was performed and then the measurement of SaO2 values was performed following the protocol previously described. The Kolmogorov Smirnov test analyzed the normality relationship of the quantitative variables described through the mean and standard deviation. To compare the mean values of oxygen saturation before and after irradiation, in the presence and absence of light, the Student's t-test for paired samples was used. A 95% confidence interval and a 5% significance level were considered. Results: The mean values of SaO2 in the positive controls were 96.95±0.6% in the presence of light and 96.85±0.7% in the absence of light. For the analysis of SaO2 before irradiation, mean values of 94.7±0.6% were obtained in the presence of light and 93.2±1.3% in the absence of light, with a significant reduction in these values compared to positive pre-irradiation controls (p<0.001). After irradiation, the mean SaO2 value was 94.6±0.9% in the presence of light, with no statistically significant difference (p=0.623) when compared to the pre-irradia tion value, while in the absence of light the value mean of SaO2 was 93.7±0.9%, with a statistical difference when compared to before irradiation (p=0.024). Conclusion: The change in tooth structure caused by ionizing radiation does not interfere with pulse oximeter measurement in the presence of light. Although light influences pulse oximeter results, its difference does not represent clinical relevance.
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    Prevalência de acidentes e complicações em cirurgia oral menor e fatores associados em pacientes da Faculdade de Odontologia da Universidade Federal de Goiás
    (Universidade Federal de Goiás, 2022-03-04) Sá, Rodrigo Tavares de; Silva, Rhonan Ferreira da;; Jordão, Lidia Moraes Ribeiro;; Jordão, Lidia Moraes Ribeiro; Nogueira, Túlio Eduardo; Sousa, Hugo Alexandre de
    Due to demographic changes, such as population growth and aging, the number of people with untreated oral diseases has increased, with caries and periodontics being the main reasons tooth extraction, leading to dental loss. Among the dental surgical procedures, extractions are a relatively simple procedure that is routinely performed in clinical practice, but is often followed by complications.. The search for these surgical treatments can lead to accidents and post-surgical complications that increase the cost of treatment and negatively impact the quality of life of patients. The objective of this retrospective observational study was to analyze the occurrence of accidents, complications and factors associated with the performance of surgical procedures at the Faculty of Dentistry of the Federal University of Goiás, in addition to verifying the status of dental records filling of this service. A total of 748 medical records of surgical patients were verified for the years 2018 and 2019, while records that belonged to clinics other than the surgical ones, that did not have the patient's name or that were not submitted to a surgical procedure for various reasons were excluded. Thus, data from 698 medical records were tabulated and descriptive and inferential analyzes were performed. The variables analyzed were: type of surgical procedure, number of teeth extracted per patient, presence/absence of intraoperative accidents, postoperative complications (pain, edema, trismus, hemorrhage, infection, paresthesia), use of medication by patients and complementary exams performed. Bivariate analyzes were performed (Mann-Whitney and Chi-Square tests) to study the association between postoperative complications (dependent variable) and sociodemographic (age and sex) and clinical factors (number of extracted teeth and accidents) and between the group of postoperative complications (pain and swelling, pain and trismus, pain and infection, and swelling and trismus).Most of the medical records (93.3%) were properly filled in, with the postal address code (CEP) being the least filled in (36.1%) in the identification field. The analysis of the medical records 88 revealed that in 49.3% of the records, the description of the intraoral examination was not filled out and that the recall of patients for follow-up and/or other procedures was 64.8%. About 46.8% of the patients were not taking medication and the most commonly requested complementary exam was panoramic (52.9%).Females had a higher frequency of attendance (58.2%), and the mean age was 31.14 (SD 13.39). The most performed type of procedure was the extraction of third molars (79.4%, n=554) revealing a mean (1.95; SD 1.429). With regard to accidents, root fractures presented a frequency of 9,74 (n=23), followed by bone board fractures 2,11% (n=5), abrasion of lips and mucous membranes 2,11% (n=5), and fracture of instruments 2,11% (n=5), with the highest frequency in females 52.9%. The most common operative complications were related to pain (11.9%), followed by swelling (7%), which was significantly higher in females (p=0.030), in younger patients (p=0.01) (mean age of 23 years) and who had a greater number of teeth extracted (3 or more). Operative complications were associated with each other, being statistically significant (p ≤ 0.001). The surgical extraction procedure had a low rate of accidents and complications, when compared to literature, despite being performed by undergraduate students. Swelling, as a postoperative complication, was associated with sex, age, and the number of teeth removed. Operative complications were mutually associated.
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    Desenvolvimento de um serious game de educação em saúde bucal com participação de especialistas e usuários
    (Universidade Federal de Goiás, 2022-02-25) Mendonça, Thaís Silva; Carvalho, Sérgio Teixeira de;; Costa, Luciane Ribeiro de Rezende Sucasas da;; Carvalho, Sérgio Teixeira de; Jordão, Lidia Moraes Ribeiro; Naghettini, Alessandra Vitorino
    Children have experienced digital technologies since young ages, especially educational games (serious games). With the increase in smartphones, tablets, and computers, applications aimed at health promotion have multiplied. When educational games are appropriately developed, users learn content quickly and efficiently. There is a lack of scientific studies on educational games in pediatric dentistry. It was proposed to regionalize the game Barney's healthy foods, developed internationally for children's oral health education, from the perspectives of specialists and users. This descriptive study was developed in three phases: I) discussion with experts based on the improved version in Jordan; II) development of the first Brazilian version of the game; III) test of the first version with children from 4 to 8 years of age and companions. PHASE I, twelve specialists interested in health education, oral health or health technologies participated in a focus group to assess the relevance of regionalizing the game for Brazil. The transcripts of the specialists' speeches were analyzed by content analysis, which originated categories with the respective main indications of alteration: eating habits - adaptation to the Brazilian context, oral hygiene habits - inclusion of dental floss and attention to the amount of fluoride toothpaste; indicative age group – reduce to 4 to 8 years; characters – change the squirrel for an animal from the Brazilian fauna; objective – to be less prescriptive and to promote the child's autonomy to choose food. PHASE II, the original game's source code was obtained from the University of Jordan. After analyzing the feasibility of the modifications suggested by the experts, the game's programming was changed. A version was obtained with images adapted to Brazil, language in Brazilian Portuguese and content with minor changes. PHASE III, fifteen children (mean age 6.4 years, standard deviation 1.3, 9 boys) played the Brazilian version once, under the observation of the accompanying adults (13 mothers) and the researcher. The global average of correct answers in the game's tasks was 75.3% and ranged from 50.0% to 100%. Children had fun with the game, and most understood the content and its interface. The companions found the information relevant and enjoyed the gameplay for their children. We conclude that the developed Children's Oral Health Game provides relevant information on dental caries prevention after a systematic regionalization process that heard the voices of specialists and users.
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    O tratamento radioterápico altera a condição pulpar de dentes de pacientes com câncer de cabeça e pescoço? Uma revisão sistemática
    (Universidade Federal de Goiás, 2022-03-03) Ribeiro, Thalles Eduardo; Novais, Veridiana Resende;; Decurcio, Daniel de Almeida;; Decurcio, Daniel de Almeida; Alencar, Ana Helena Gonçalves de; Caldeira, Celso Luiz
    Objective: This study aims to identify possible changes in pulp behavior during radiotherapy and follow-up periods in patients with head and neck cancer. Purpose: The main purpose of this study was to answer the question: “Radiotherapy can cause changes in the pulp condition of teeth of irradiated patients in the head and neck region during treatment?”. Material and Method: Clinical Observational Studies in adults with Head and Neck Cancer undergoing treatment with ionizing radiation, with longitudinal or cross-sectional follow-up to measure SpO2 and/or pulp sensitivity to cold stimulation, were determined as eligible studies. Literature Review, Case Reports, Abstracts, Opinion Articles, Letters to the Editor, and studies with in vitro methodology were excluded. A systematic literature search was carried out in six different databases until September 2021, including the “grey literature” and the search in the references of the selected studies. Two independent evaluators selected the studies, extracted the data and recorded them in electronic spreadsheets, and evaluated the methodological quality using the JBI tool, Checklist for Quasi-Experimental Studies. Data were qualitatively assessed using the Synthesis Without Metaanalysis (SWiM) guidelines. Results: After removing duplicate articles and careful analysis of title, abstracts, and full reading of the papers, seven studies were included; of these, four were carried out in Brazil and three in India, with participants from both genders. Of the studies evaluated, four used the Cold Sensitivity Test, followed by two that associated Pulse Oximetry and Cold Sensitivity, and one evaluated only the Pulse Oximetry. The evaluation in the initial periods to radiotherapy, both with the Cold Sensitivity Test and Pulse Oximetry, showed a decrease in the sensitive response and in the levels of SpO2, with a maximum period of 1 year. However, for later analyses, from 5 to 6 years after the end of radiotherapy treatment, there was normalization of the responses of both tests. Most studies presented Methodological Quality as High. Also, most studies do not detail the type of ionizing radiation used in the article, and implications for the studies' clarity can be considered a limitation. Conclusion: It can be concluded that radiotherapy causes changes in pulp behavior patterns in the short term; however, there is recovery and return to average values after long periods. This Systematic Review followed the 2020 PRISMA guidelines, and its9 protocol was registered on the PROSPERO platform before it began with the number CRD42021276338.
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    Teste de Apresentação da Prótese (TAP): avaliação de um novo teste para triagem de comprometimento cognitivo em usuários de próteses totais
    (Universidade Federal de Goiás, 2021-12-17) Oliveira, Talitha Marica Cabral; Srinivasan, Murali; Leles, Cláudio Rodrigues;; Leles, Cláudio Rodrigues; Paula Júnior, Delcides Ferreira de; Dias, Danilo Rocha
    During the 2019 General Session of The International Association for Dental Research (IADR), Srinivasan et al. suggested a new screening test for cognitive impairment in elderly people rehabilitated with a prosthesis. The Test entitled ‘Prosthesis Presentation Test [PPT]’ the expected action was that the participants correct the orientation of the prostheses and insert them correctly. However, the authors suggested that other studies and protocols be adapted and carried out to explore the objectives of this test. Aim: To establish a protocol for the performance of the Prosthesis Presentation Test in Portuguese “Teste de Apresentação da Prótese” (TAP) and its applicability in the elderly population and test the correlation between the TAP and sociodemographic variables, measures of cognitive function and disability. Methods: This is a cross-sectional observational study with participants using Conventional dentures who underwent a new test (TAP) in 4 different presentations to assess their cognitive performance. Correlations were calculated between the sums of the TAP scores and the independent variables, these being Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) and Cognition (Mini-Mental and Mini-Cog) through the correlation coefficient Spearman and p-value, a generalized linear model was also used Results: The sample consisted of 57 (63.3%) females and 33 (36.7%) males. The mean age was 66.7 (SD = 8.1). Regarding the assessment of Cognition by the Mini-Cog, it identified 53 (58.9%) participants with a negative assessment. For evaluation in relation to the MMSE, 69 participants (76.7%) presented mild impairment, and 21 (23.3%) presented moderate impairment and none presented severe impairment. For the independence measures, the ADL showed that 64.4% of the sample is independent, compared to the IADL 41.1% of the sample is independent. Spearman's correlation coefficient showed that Mini-cog (p = 0.003) and MMSE (p = 0.019) and IADL scores (p = 0.003) were correlated with age. There was also a strong correlation between Age and PPT inboth the position of the prosthesis and the arch (p = 0.004) and (p = 0.031) and of the IADL in relation to PPT / Position (p = 0.044). The generalized linear model showed that the increase in TAP scores was associated with increasing age and a reduction in the chance of a better TAP score was inversely associated with the number of tests performed. Conclusions:Have a strong association between TAP and age and IADL score. Increased TAP scores were associated with increasing age. TAP is an easy-to-perform test that is applicable in clinical routine.
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    Incidência de complicações protéticas associadas a três tipos de tratamento com implantes para o edentulismo mandibular: estudo de coorte com três anos de acompanhamento
    (Universidade Federal de Goiás, 2021-09-24) Araújo, Sara Cristina de; Leles, Cláudio Rodrigues;; Leles, Cláudio Rodrigues; Bernardino, Ítalo de Macedo; Hartmann, Roberto; Costa, Nádia do Lago; Jordão, Lídia Moraes Ribeiro
    Objectives: This prospective cohort evaluated the incidence of prosthetic complications, number and reasons for post-insertion visits during a three-year follow-up period of fully edentulous patients rehabilitated with complete maxillary dentures opposed to a mandibular overdenture retained by one or two implants, or a fixed hybrid prosthesis retained by four implants. Materials and Methods: Participants were individuals who participated in a randomized clinical trial comprising three treatment groups: Group I: overdenture retained by one implant (n=11); Group II: overdenture retained by 2 implants (n=13); and Group III: fixed prosthesis retained by 4 implants (n=13). A total of 37 patients were followed-up for a period of 3 years after insertion of the implant-assisted prostheses. Data were collected prospectively concerning the occurrence of prosthetic complications, number of scheduled or unscheduled visits, clinical duration of the appointments for clinical resolution of prosthetic complications. Results: The total number of unscheduled visits per patient ranged from 0 to 7 (mean = 2.41; SD = 2.2) throughout the 3-year follow-up period. No differences were found between the three groups regarding the number of patients who required unscheduled visits. The clinical time of appointments (scheduled and unscheduled) was longer for the G-III (p <0.001) when compared to the overdenture groups. The incidences of prosthetic complications for the overdenture groups (G-I and G-II) were higher compared to G- III (p<0.001). Most of the complications that occurred in G-I and G-II were matrix replacement due to loss of retention of mandibular overdenture due to wear of the retentive inserts (38.3% of patients/year). Fracture of artificial teeth was the most common complication in G III (30.8%). On the other hand, as fixed prostheses, they spend more clinical time to solve their complications. Conclusion: All the three treatment options required maintenance recall visits to ensure their function and longevity. Overdentures had a higher incidence of prosthetic events compared to fixed mandibular prostheses. On the other hand, fixed prostheses require more clinical time to solve their complications.
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    Avaliação de diferentes sistemas adesivos na resistência de união da dentina após selamento dentinário imediato
    (Universidade Federal de Goiás, 2019-08-29) Polonial, Isabela Fonseca; Lazari, Priscilla Cardoso;; Souza, João Batista de;; Souza, João Batista de; Torres, Érica Miranda de; Cruvinel, Diogo
    Immediate Dentin Sealing (IDS) decreases postoperative sensitivity, gaps formation and improves bond strength in indirect restorations. The technique suggests the application of a three-step or a self-etch adhesive system immediately dentin exposure. Several adhesive systems are available in market; however, they do not exhibit the same mechanical performance. An alternative that seems to improve bond strength is using a flowable resin layer (Bulk Fill) soon after hybridization. This work evaluated the bond strength of five adhesive systems (Optibond FL, Scotchbond MP, Clearfil SE and Scotchbond U, Adper Single Bond II) with Delayed Dentin Sealing (DDS), IDS or IDS with flowable resin (SDI + F). Once approval was obtained from ethics committee of Federal University of Goiás, seventy-five molars were randomly distributed in fifteen groups (n = 5). The crowns were sectioned in the mesio-distal direction, finished with 600-grit Sic papers for surface regulation and cleaned with pumice and water. Samples with IDS and IDS + F were immediately hybridized after the initial cut, impression taken and stored in artificial saliva for two weeks at 37 °C prior to final restoration (Z100). In samples with DDS, were subjected to the same procedures, however the application of the adhesive system was done after two weeks in artificial saliva at 37ºC. After final restorations, all samples were stored in distilled water at 37 °C for at least 24 hours. Each tooth was cut into beans with thickness of 1mm² cross-section and subjected into universal machine test for microtensile stress in 0,5m/min failure (in MPa). Sealing dentin immediately after cutting significantly improved the adhesion of all tested systems. The use of flowable resin layer after dentin hybridization seems to be an effective technique for different adhesive systems and an alternative to the gold standard Optibond FL.