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BACKGROUND: Limited data exist on the mid- to long-term masticatory capacity of mandibular overdenture (IOD) wearers, particularly regarding the use of posterior implants to retention. OBJECTIVES: To periodically evaluate mastication of IOD wearers, comparing the effectiveness of two to four implants to retain the prosthesis. METHODS: In a randomised controlled clinical trial, 20 complete edentulous patients (14 women), aged 51-84 years (mean age 69.1 ± 9.6), received new bimaxillary complete dentures (CD). After adaptation, baseline measurements of masticatory performance (X50) and swallowing threshold were conducted using the sieving method. Patients were then randomly assigned to groups: control (two intra-foraminal regular implants) and experimental (two intra-foraminal regular implants and two extra-short posterior implants) (n = 10 each). After 4 months, implants were splinted, and a new mandibular IOD was fabricated with bar/clip retention. Mastication was reassessed after 6, 12, and 48 months, and data analysed with repeated measures ANOVA and Sidak's post hoc (α = 0.05). RESULTS: Despite a loss of two patients per group, masticatory performance significantly improved after mandibular IOD installation (p = .031) in both groups (p = .670). A second improvement was observed after 6 months (p = .027), with no subsequent changes (p > .05). Swallowing threshold improvements were noted with IOD, and no discernible differences between groups were observed (p > .05). CONCLUSION: Masticatory function significantly improved after mandibular IOD installation, with the number of implants demonstrating minimal influence. CLINICAL TRIAL REGISTRATION: The present study was not registered in a public database, as mandated. It is important to note that the recommendation for registration was initiated in 2017 by the Committee of Medical Journal Editors, while patient inclusion in the research took place in 2016. Given that the data presented in this manuscript cover a follow-up period of up to 4 years post-surgical intervention, delayed registration was not feasible.

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INTRODUCTION: Long-term clinical success of non-splinted, posterior, and short implants still is unclear. This prospective cohort study reports the 10-year follow-up of 6-mm implants supporting single crowns in the posterior region, and patient-reported outcomes. METHODS: Baseline sample comprised 20 patients treated with 46 screw-retained crowns supported by 6-mm implants with moderately rough implant surface. Participants were recalled for a 10-year clinical follow-up to assess survival rates, biologic and mechanic conditions, quality of life (OHIP-14), and treatment satisfaction. Data were collected with clinical-radiographic exams and analyzed using descriptive and inferential statistics. RESULTS: Fourteen patients with 35 implant-crown units were examined after 127.6 ± 11.8 months. For the entire cohort period, 7/46 implants were lost (survival estimate: 77.7% at 133 months), and mechanic complications occurred in 14/46 units (survival estimate: 66.4% at 116 months). In the Cox models, "maximum occlusal force" had a significant effect for implant loss (p = 0.038) and for prosthetic screw loosening (p = 0.038); "arch" and "bruxism" were not significant. Peri-implant bone loss was 0.4 ± 0.6 mm at 10 years. For peri-implant bone level, "crown-to-implant ratio" (p < 0.001) and "time" (p = 0.001) were significant. Bone levels differed from baseline to 12, 48, and 120 months. Satisfaction VAS was 94.0 ± 7.9 mm and OHIP-14 was 2.3 ± 2.2. CONCLUSION: Single screw-retained crowns supported by 6-mm implants have an acceptable long-term clinical performance, with stable peri-implant bone levels after 10 years of function.

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OBJECTIVE: To answer the question: What do we know so far about the clinical performance of short implants (≤ 7 mm) when compared to standard length implants in vertically augmented bone, as well as which is the overall confidence of the systematic reviews (SRs) about this topic? MATERIALS AND METHODS: An overview of SRs was conducted. The searches were performed in six electronic databases and grey literature. SRs about short (≤ 7 mm) versus standard dental implants performance in vertically augmented bone were included. The assessed outcomes were marginal bone loss (MBL), implant survival (IS), prosthetic (PC) and biological complications (BC), costs, surgical time, and patient satisfaction. AMSTAR 2 was used to evaluate the overall confidence of included SRs. RESULTS: Thirteen SRs were included. Nine of twelve SRs reported a lower MBL for the short implant group. All the included SRs showed no difference in the IS between groups. A higher rate of BC was reported for standard-length implants in four out of five SRs. No differences regarding PC were reported in four of five SRs. Information related to patient preference, cost, and surgery time were underreported. The confidence evaluation of the SRs was stratified as low for five SRs and critically low for eight SRs. CONCLUSIONS: In an overall low-to-very low confidence levels, short implants appear to perform better in the mid-term (up to 5 years) than standard dental implants associated with vertical bone augmentation regarding MBL and BC, but they have a similar performance regarding IS rates and PC. There is an imperative need to improve the methodological quality of SRs, and efforts should focus on conducting RCTs to broaden the knowledge on this topic. CLINICAL RELEVANCE: Short implants could represent a viable, simpler, and less invasive treatment when available bone height is limited.

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Este artigo descreve as principais técnicas utilizadas para garantir uma maior coincidência de achados clínicos, que se traduz no posicionamento mandibular em um dado espaço conhecido como conveniência protética.(AU).

This article describes the main techniques used to assure a greater coincidence of clinical findings, translated in the mandibular position in a space known as prosthetically convenient.

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BACKGROUND: This study assessed the relationship between insertion torque and bone quality evaluated during surgery and in preoperative computed tomographic (CT) images analyzed either visually or by rescaled mean gray values (MGVs). The study also tested the correlation between the clinical and radiographic measures of bone quality. METHODS: The consecutive sample was composed of 45 short implants (4.1 × 6 mm) placed in the posterior region of 20 patients. Intra-surgical tactile bone quality, based on the classification of bone types by Lekholm and Zarb, and insertion torque were recorded during the implant placement. Visual bone quality and normalized MGV were assessed in standardized axial, coronal, and sagittal sections of preoperative CT images. Data were analyzed by ANOVA and Spearman correlation (alpha = 0.05). RESULTS: Insertion torque was associated with all assessment methods of bone quality (tactile, CT visual, MGV). A moderate correlation was found among all methods of bone quality, except for CT visual assessment and tactile evaluation. MGVs varied as a function of arch, dental region, insertion torque, and bone types. CONCLUSIONS: The results suggest that bone quality measures affect primary stability as recorded by insertion torque, and the assessment methods are consistently related.

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OBJECTIVE: Several modifications, such as changes in the implant-abutment connection, have been suggested in studies on dental implants to better preserve the peri-implant bone level. The aim of this study was to prospectively compare crestal bone level changes between two different implant designs-tissue level (TL) and bone level (BL). MATERIALS AND METHODS: The sample comprised 18 patients, on whom a total of 30 hydrophilic tissue- and bone level implants were placed (SLActive, Straumann Institut AG, Basel, Switzerland), in the posterior region of the maxilla or the mandible. Impressions were taken after 45 days of healing. Then, cemented-retained metalloceramic crowns were fabricated and installed. Marginal bone level changes were assessed by the paralleling technique of periapical radiographies, on both mesial and distal aspects of each implant, at the moment of the implant placement and after 1 year of loading. Photoshop software was used to perform linear measurements by a single and calibrated examiner. STATISTICAL ANALYSIS: The Mann-Whitney test at a 5% significance level was used to compare the bone changes among the implants assessed. RESULTS: A significantly lower (p = 0.048) bone remodeling was observed on bone level implants (0.05 mm), when compared to tissue level implants (0.47 mm; p = 0.048). The average marginal bone level changes at the distal aspect did not show any statistically significant difference (p = 0.325). CONCLUSIONS: Tissue level implants presented greater bone loss in the mesial surface than bone level implants. Both designs presented stable and clinically acceptable bone crests.

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Este artigo descreve a técnica de utilização de um índex de gesso para diminuir os problemas de adaptação da barra metálica em sobredentaduras mandibulares. São detalhados também a técnica de moldagem e a concomitante transferência dos implantes. (AU).

This article describes the utilization of a plaster index to avoid the problems of adaptation of the metal bar in mandibular overdentures. The impression technique and the simultaneous transference of the implants are also detailed. (AU).

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Malignant neoplasms may be composed of several cell groups, including cancer stem cells (CSC). These cells have been related with the capacity of metastasis, relapse and resistance to multiple drugs during chemotherapy. This study aims to identify CSC biomarkers and their expression pattern in human head and neck carcinomas. This study was conducted following the PRISMA checklist. The search for articles was carried out in five databases (PubMed, Scopus, Web of Science, Lilacs and Scielo). The articles found were selected in two phases: 1) reading the titles and / or abstract and 2) reading the full text. At the end, the selected articles were evaluated by QUADAS-2. Most studies evaluated oral neoplastic tissues and, as a control, samples of normal local mucosa. All studies performed immunohistochemistry as a method of immunolocalization and some also applied immunofluorescence. The most commonly used biomarker was CD44. However, other such as Sox2, Oct4, Nestin, Nanog, BMI1, ALDH1, CD133 and CD166 were also found. Several biomarkers were (ALDH1, Sox2, Oct4, ABCB5, AGR2 and TAZ) correlated with clinical characteristics of the tumor, such as staging, tumor size and lymph node metastasis. These data reinforce the CSC theory and favor the use of these biomarkers as possible determinants of prognosis.

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Este artigo descreve o passo a passo e a sequência clínica de instalação do clipe sobre a barra de sobredentaduras, utilizando o sistema Straumann®.

This article describes step by step and the clinical installation sequence of a bar-clip overdenture, using the Straumann® Dental Implant System.

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Este artigo descreve o passo a passo da execução do molde em sobredentaduras mandibulares, contemplando a reprodução da área basal com excelência e a transferência dos implantes com precisão.

This article describes the mandibular overdenture impression step by step, showing the optimal reproduction of the basal area and the precise implants transference.

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PURPOSE: There is much concern about the increasing number of patients with medication-related osteonecrosis of the jaw (MRONJ), and many studies have been published in an attempt to understand the pathophysiology of this condition. This study aimed to systematically review the literature on MRONJ arising in rodents under antiresorptive drug therapy after tooth extraction. METHODS: A search of electronic databases, including LILACS, PROQUEST, PubMed, SCOPUS, and the Web of Science. RESULTS: The search resulted in 2319 titles after removing the duplicates, and one paper was identified using the reference list. Ninety-eight full-text papers were then screened for eligibility, resulting in 20 for inclusion in the final qualitative synthesis. The quality of the articles was assessed using the 'ARRIVE' tool. CONCLUSION: Despite the wide heterogeneity of the methodologies used by the authors, the current available evidence suggests that the combination of bisphosphonate and/or denosumab therapy and tooth extraction is associated with osteonecrosis of the jaw in rodents.

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Este artigo descreve os passos para a utilização da filosofia da Técnica da Zona Neutra. Através dessa filosofia, procura-se localizar uma área, em boca, onde as forças geradas pela língua são neutralizadas pelas forças geradas pelos lábios e bochechas, estabilizando assim a prótese.

This article describes step-by-step the application of the Neutral Zone technique philosophy. It is based upon the concept that for each individual patient, there is within the denture space a specific area where the function of the musculature will not unseat the denture and where forces generated by the tongue are neutralized by the forces generated by the lips and cheeks.

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Este artigo descreve a utilização de alginato e silicone de adição para a obtenção de moldes, preliminares e definitivos, em casos de moldagens de pacientes edêntulos.

This article describes the use of alginate and vinyl polysiloxane to obtain preliminar and functional impressions for edentulous patients.

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BACKGROUND: The use of short implants is still not a consensus for challenging clinical situations, such as unfavorable crown-to-implant (C/I) ratio. PURPOSE: This prospective study evaluated the rates of prosthetic complications and implant failure, the mean marginal bone loss of 6-mm dental implants with single crowns in posterior regions and the potential risk factors. MATERIALS AND METHODS: Forty-six dental implants, 6-mm long and 4.1-mm wide, were placed in the posterior region in 20 patients. Patients were clinically and radiographically examined after the restoration with single crowns and on a yearly basis. Potential risk factors (arch, bruxism, maximum bite force, anatomical and clinical C/I ratios, and occlusal table area) were analyzed according to the following outcomes: implant survival, bone loss, and prosthetic complications. RESULTS: The mean follow-up time was 45 ± 9 (16-57) months. There was no early loss of implants. After prosthetic loading, 4 implants were lost (2 in the mandible and 2 in the maxilla; 91.3% survival), and there were 13 prosthetic complications (28.3%), yielding a 65.2% success rate. The frailty term showed a 95% greater chance of loss in the mandible than the maxilla. Mean peri-implant bone loss was of 0.2 ± 0.4 mm, 0.1 ± 0.2 mm, 0.1 ± 0.3 mm, and 0.2 ± 0.4 mm in the first, second, third, and fourth years, respectively, with a mean cumulative loss of 0.3 ± 0.5 mm at 48 months. In the multilevel model, the effects of the clinical C/I ratio and time were significant for bone loss (P < .001). It was estimated that a mean bone loss of 0.1 mm is associated with both a one-unit increase in time (12 months) and a 0.1 increase in the clinical C/I ratio. The other potential risk factors showed no significant relationship with the outcomes. CONCLUSIONS: The 6-mm implants supporting single crowns performed well, but the mandible shows a higher risk of failure. The time and clinical C/I ratio are predictors for bone loss.

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A utilização da fotografia digital em Odontologia, para diagnóstico e tratamento de casos complexos, aumenta a previsibilidade dos desfechos, a compreensão por parte do paciente frente às possibilidades de resolução e diminui a incorporação de erros ao processo.

The use of the digital photography in Dentistry, for both diagnosis and treatment planning of complex cases, increases the predictability of the outcomes, and patients' understanding about the possibilities of resolution, as well as reduces the occurrence of errors along the process.

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Este artigo descreve a técnica de correção de um plano oclusal dentado, antagonista a uma prótese total, utilizando como base o plano de cera convencional. Esse procedimento é indispensável para favorecer a estabilidade das próteses durante os movimentos de desoclusão.

This article describes the alignment technique of a dentate occlusal plane, antagonistic to a complete denture, using wax rim as a reference. This procedure is essential in order to favor the stability of the prosthesis during excursive movements.

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PURPOSE: The purpose of the study is to evaluate the effects of pharmacological and non-pharmacological topical controls in the prevention of radiation dermatitis. METHODS: Relevant clinical trials were identified through electronic searching databases CINAHL, CENTRAL, LILACS, PubMed, Scopus, and Web of Science. Handsearching and gray literature searches were also performed to find additional references. Primary outcomes of interest were the development of radiation dermatitis and the time of occurrence of radiation dermatitis. RESULTS: Thirteen randomized clinical trials were included in this review. The trials were published in Chinese, English, or French, from 1980 to 2015. Pharmacological interventions used in the trials were trolamine, aloe vera, allantoin, Lianbai liquid, sucralfate, Na-sucrose octasulfate, olive oil, hialuronic acid, and dexpanthenol. Non-pharmacological topical controls were usual care/institution routine, aqueous cream, mild soap, water thermal gel, placebo, and no intervention. CONCLUSIONS: There was no strong evidence that indicates differences between topical pharmacological interventions or non-pharmacological topical controls in the prevention of acute radiation dermatitis among patients with head and neck cancer undergoing radiotherapy.

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OBJECTIVE: This study aims to estimate the prevalence of otologic signs and symptoms in adult patients with temporomandibular disorders (TMD). MATERIAL AND METHODS: Search strategies were developed for each of the following databases: PubMed, LILACS, Scopus, Web of Science, Proquest, LIVIVO, and Google Scholar and OpenGrey was used to assess the grey literature. It was included in this review only observational studies using either research diagnostic criteria (RDC)/TMD or DC/TMD indexes were selected. The Critical Appraisal Checklist for Studies Reporting Prevalence Data from the Joanna Briggs Institute was used to assess the risk of bias of the included studies. A proportion random effects meta-analysis was conducted within the eight included studies. RESULTS: Eight studies met the eligibility criteria and were selected. All of the included studies used the RDC/TMD and report associated otologic signs and symptoms. The studies were clustered into groups based on prevalence for each individual sign or symptom. The most prevalent otologic symptom associated with TMD was ear fullness (74.8 % standard deviation (SD), 43.02 to 96.25 %; n = 50), followed by otalgia (55.1 % SD, 31.78 to 77.30; n = 386), tinnitus (52.1 % SD, 38.43 to 65.74; n = 1293), vertigo (40.8 % SD, 11.29 to 74.72; n = 374), and hearing loss (38.9 % SD, 2.83 to 85.46; n = 744). CONCLUSION: The prevalence of otologic signs and symptoms in adult patients with TMD is high. The most prevalent otologic symptom in patient adults with TMD is ear fullness. CLINICAL RELEVANCE: This study intends to provide understanding over the prevalence of otologic signs and symptoms in TMD cases in adults.

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A confecção de uma Prótese Total Imediata é um procedimento complexo para os profissionais e estressante para o paciente. O presente artigo descreve a sequência clínica do planejamento à realização deste procedimento, com segurança e previsibilidade.

The fabrication of an Immediate Complete Denture is a complex procedure for the practitioners involved and a stressing situation for the patient. This article describes the clinical sequence for planning and performing this procedure with safety and predictability.

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BACKGROUND: Patients undergoing ophthalmic surgery are usually elderly and, due to systemic disease, may be on long-term therapy, such as antithrombotic agents. Rates of hemorrhagic complications associated with invasive procedures may be increased by the use of anticoagulants and antiplatelet agents. OBJECTIVE: To compare the incidence of hemorrhagic complications in patients undergoing needle-based ophthalmic regional anesthesia between patients on antithrombotic therapy and those not on such therapy. METHODS: A systematic review was conducted by two independent reviewers based on searches of Cochrane, LILACS, PubMed, Scopus, Web of Science, and the "gray" literature (Google Scholar). The end search date was May 8, 2015, across all databases. RESULTS: Five studies met the eligibility criteria. In three studies, individual risk of bias was low, and in two of them, moderate. In all studies, no differences regarding mild to moderate incidence of hemorrhagic complications were found between patients using antithrombotics (aspirin, clopidogrel, and warfarin) and those not using them. Rates of severe hemorrhagic complication were very low (0.04%) in both groups, supporting the safety of needle blocks, even in patients using antithrombotics. High heterogeneity across studies prevented meta-analysis. Limitations to these results include low statistical power in three experimental studies and a large 95% confidence interval in the two retrospective cohorts. CONCLUSION: In this review, none of the selected studies showed significant bleeding related to needle-based ophthalmic regional anesthesia in association with the use of aspirin, clopidogrel, or vitamin K inhibitors. Since the available data is not powerful enough to provide a reliable evaluation of the true effect of antithrombotics in this setting, new studies to address these limitations are necessary.

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