Abstract This narrative review critically examines common myths in dental bleaching that are often presented as strategies to improve efficacy or reduce adverse effects, despite limited, inconsistent, or context-dependent clinical support. The review integrates evidence from clinical trials and systematic reviews identified through searches, with priority given to higher-level clinical evidence when available. In addition, concepts from Evidence-Based Practice and Cognitive Psychology are used to contextualize why weakly supported protocols may persist in clinical decision-making. The analysis addressed frequently disseminated beliefs in clinical practice and led to the following conclusions: a) dietary restriction does not improve bleaching outcomes; b) preventive use of analgesics and/or anti-inflammatory drugs does not reduce tooth sensitivity (TS); c) higher peroxide concentrations may accelerate early bleaching but increase adverse effects and do not enhance final efficacy; d) prolonged gel exposure beyond recommended times does not produce perceptible additional color change and may increase TS; e) tray scalloping does not consistently reduce patient-perceived gingival irritation; f) increasing gel volume or contact area does not improve final bleaching efficacy and may increase biological cost; g) light-activation does not provide additional clinical benefit; h) gel agitation does not enhance bleaching outcomes; i) over-the-counter products do not replace professionally supervised bleaching in terms of predictability and magnitude of color change; and j) desensitizing toothpastes show inconsistent efficacy in preventing TS. Overall, bleaching protocols should be selected according to clinically meaningful benefits, adverse effects, patient-centered outcomes, and the strength and consistency of the available evidence, rather than tradition, intuition, or commercial appeal.
Abstract Regenerative endodontics has transformed the management of immature necrotic teeth by offering the potential to improve root structure rather than merely induce apical closure. Over the past two decades, considerable progress has been made in case selection, disinfection protocols, irrigation strategies, intracanal medicaments, scaffold design, and biologically based tissue engineering approaches. Despite these advances, key challenges remain, including protocol standardization, variability in clinical outcomes, limited high-quality clinical evidence, and the gap between promising laboratory findings and routine clinical implementation. This narrative review summarizes the recent literature on regenerative endodontics, focusing on contemporary clinical protocols and their limitations, prognostic factors, treatment outcomes, and emerging therapeutic strategies. Current evidence supports regenerative procedures that involve careful case selection, appropriate scaffold formation, well-sealed coronal restorations, and effective disinfection that preserves stem cell viability. While these protocols promote infection control, periapical healing, and tooth survival, continued root maturation remains variable, and existing therapies primarily result in tissue repair rather than true regeneration of a functional pulp-dentin complex. Additionally, there are several limitations to the widespread clinical adoption of advanced regenerative therapies, including outcome measures, alongside regulatory, manufacturing, and logistical challenges. Bridging the gap between innovation and clinical practice will require continued advances in tissue engineering, as well as more robust clinical evidence and standardized treatment protocols.
Abstract Cigarette smoking is a well-established risk factor for periodontitis, contributing to increased clinical attachment loss (CAL), alveolar bone loss, and impaired treatment response. As electronic cigarettes (ECs) are increasingly used as alternatives to combustible tobacco, questions remain regarding their adverse effects on oral and periodontal health. This critical review integrated evidence from experimental, cross-sectional, longitudinal and interventional studies to evaluate the relationship between EC use and periodontal health. Experimental and molecular studies supported biological plausibility for periodontal harm, indicating that aerosols can induce oxidative stress, upregulate pro-inflammatory mediators, and disrupt host-microbial interactions. Cross-sectional studies generally reported poorer periodontal conditions among EC users compared with never-smokers, including higher plaque index and periodontal probing depth, although results for CAL and alveolar bone loss were inconsistent. Comparisons between EC users and cigarette smokers often showed more favorable clinical parameters among EC users. Longitudinal evidence continued to be limited. The only prospective cohort study reported higher CAL among EC users than never-smokers and observed an increase in CAL over time exclusively in EC users. Interventional studies assessing response to periodontal therapy have yielded inconsistent results, with some suggesting a poorer treatment response among EC users and others finding no significant differences. Overall, there were Well-designed longitudinal studies with clearly defined exposure groups, standardized periodontal outcomes, and longer follow-up are needed to clarify whether EC use independently contributes to periodontal deterioration.
Abstract: This study aimed to evaluate the survival outcomes of pediatric patients with head and neck (HN) rhabdomyosarcoma (RMS) treated at a reference center in Brazil, comparing them with those of patients with non-head and neck (NHN) RMS. Additionally, it sought to identify the clinical-pathological variables, histological subtypes, and antineoplastic therapy regimens that significantly influence patient prognosis. The study included RMS patients treated between 1990 and 2022. Statistical analyses comprised t-tests, chi-square tests, Kaplan-Meier survival analysis, and Cox regression for overall survival (OS), disease-free survival (DFS), and event-free survival (EFS). A total of 64 patients (60.9% male) were included, with head and neck tumors being the most common presentation. Prognostic factors associated with OS included age ≥ 10 years, intermediate-risk classification, tumor relapse, and surgery. DFS was significantly influenced by age ≥10 years and high-risk classification, while EFS was associated with lesion size, histological subtype, and radiotherapy. In conclusion, anatomical site was not a significant prognostic factor. Age and risk classification significantly influenced OS and DFS, while histological subtype emerged as an independent factor for EFS. This study, conducted at a reference center in Latin America with a 30-year history of care, provides clinically relevant insights by identifying specific prognostic factors for RMS in Brazilian pediatric patients. These findings enable comparisons with international data and contribute to planning health interventions.
Abstract This systematic review and network meta-analysis aimed to determine whether the use of violet light alone (VIOL) or its combination with bleaching gels (BGVIOL) results in superior bleaching efficacy compared to bleaching gel alone (BG). Randomized clinical trials (RCTs) were identified through searches in PubMed, Cochrane Central, LILACS/BBO, SCOPUS, Web of Science, EMBASE, and gray literature sources in March, 2025. Eligible RCTs compared in-office bleaching using BG, or VIOL, or BGVIOL. The Cochrane risk of bias tool was used to evaluate the risk of bias (RoB 2.0) of the eligible RCTs. A random-effects Bayesian mixed treatment comparison model evaluated color change (ΔE*ab and ΔSGU/final SGU), and risk and intensity of tooth sensitivity (TS). Ranking probabilities were evaluated using the surface under the cumulative ranking curve, and the certainty of evidence was appraised following the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 4,963 records, 17 RCTs were included, 11 of which had a high RoB. Analysis of ΔE*ab revealed significant mean differences (MD) and 95% credibility interval (95%Crl) for the full dataset for BGVIOL vs. BG (MD = 3.13; 95%CrI: 1.33 to 4.97), but not with the subset of data that excluded studies with high RoB (MD = 2.36; 95%CrI: -0.74 to 5.34). Color change in ΔSGU did not differ among groups. VIOL showed the lowest risk and intensity of TS. Color change achieved with BG and BGVIOL was higher than that obtained with VIOL. VIOL yielded lower risk and intensity of TS. The certainty of the evidence supporting these findings is low or very low.
This systematic review summarized findings on the association between screen time and bruxism in children and adolescents (PROSPERO- CRD42023429775). Two researchers conducted the search and selection of studies, extracted the data, and analyzed the risk of bias. The quality of the evidence was assessed using the GRADE tool. Five databases were screened on September 25th, 2025. Studies exploring the association between bruxism and the use of screen devices in individuals aged 0-18 were included, considering different and valid study designs, screen devices, and methods of detection of bruxism behavior with or without circadian distinction. Qualitative data synthesis was performed. Eleven cross-sectional and two cohort studies were included. Eight studies found an association between bruxism and the use of screen devices in children and adolescents, while five studies did not find a significant association. In conclusion, an association between screen use or duration and bruxism in children and adolescents cannot be established. Although some studies reported positive associations for awake, sleep, and unspecified bruxism, particularly in research evaluating longer daily screen time or indicators of problematic digital use, the certainty of the evidence was very low. Further well-designed longitudinal studies should be conducted to broaden the overview of this association.
Abstract Radiotherapy is the cornerstone of head and neck cancer (HNC) treatment, but it has been frequently associated with changes in the acquired enamel pellicle (AEP), potentially affecting the early stages of dental biofilm formation. Thus, this study aimed to characterize the bacterial proteomic profiles of early colonizers adhering to the AEP in patients with HNC undergoing radiotherapy, with emphasis on radiation-induced changes that may influence oral biofilm development and oral health outcomes. AEP samples were collected from nine patients with HNC before radiotherapy (BRT), during radiotherapy (DRT), and after radiotherapy (ART), as well as from nine orally healthy individuals. Pellicles were obtained 120 min after formation and analyzed by shotgun label-free proteomics using nanoLC-ESI-MS/MS. Protein expression levels were compared between groups using the t test (p < 0.05). AEP showed elevated levels of bacterial proteins predominantly attributed to Actinomyces, mainly associated with DNA binding, chromatin organization, and glucose metabolism. The bacterial proteomic profile shifted markedly DRT, with exclusive detection of proteins involved in carbohydrate transport and metabolism, oxidative stress response, and protein folding, including several ATP-binding cassette transporters and glycolytic enzymes. Proteins related to stress tolerance, transcriptional regulation, and secretion systems were detected ART, many of them associated with bacterial species commonly linked to periodontal diseases, such as Tannerella and Oribacterium. Notably, Cysteine synthase was identified exclusively BRT in all comparisons, suggesting its potential as a biomarker. These findings indicate that radiotherapy induces dynamic changes in the AEP bacterial proteome, potentially favoring dysbiotic biofilm development and increasing susceptibility to oral diseases in patients with HNC.
Abstract This study aimed to evaluate the in vitro cytotoxicity and bioactivity, and the in vivo biocompatibility, collagen maturation, and bioactivity, of PBS Cimmo HP and Bio-C Repair Ion+ in comparison with white MTA-Angelus. Osteoblast-like cell viability was assessed using the Alamar Blue assay, while bioactivity was assessed by alkaline phosphatase (ALP) activity and Alizarin Red staining. For the in vivo analysis, polyethylene tubes containing the materials or empty tubes (control) were implanted in the dorsum of mice. After 7 and 30 days (n = 8), the animals were euthanised and the specimens were processed for haematoxylin-eosin, Picrosirius Red, von Kossa (VK), and polarised light (PL) analyses. Data were statistically analysed (p < 0.05). Most materials extracts were cytocompatible (P > 0.05), except for the PBS Cimmo HP 1:4 extract at 48-h (p < 0.05). All materials showed increased ALP activity (p < 0.05). Mineralized nodules were significantly present in most material extracts (p < 0.05), except in the undiluted PBS Cimmo HP extract and in the white MTA-Angelus 1:4 extract. At 7 days, PBS Cimmo HP induced moderate-to-severe inflammation, whereas the other groups induced moderate inflammation (p > 0.05). At 30 days, all groups showed reduced inflammation (p > 0.05). Overall, the fibrous capsule was thick at 7 days and thin at 30 days. At 7 days, the control and PBS Cimmo HP groups showed a greater presence of immature collagen (p < 0.05); at 30 days, more mature collagen was observed in all groups (p > 0.05). The materials exhibited positivity for VK or PL in both periods. In conclusion, PBS Cimmo HP and Bio-C Repair Ion+ were cytocompatible and biocompatible, and demonstrated bioactivity and collagen maturation similar to those of white MTA-Angelus.
Abstract Remote examinations have become increasingly common in Dentistry, especially with the use of applications. This preliminary cross-sectional study evaluated the accuracy of remote examination of oral mucositis (OM) and severe oral mucositis (SOM) using photos obtained through the Telepediatric Dentistry in Oncology (TON) application, comparing its results with the in-person clinical examination (gold standard). A total of 21 pediatric patients (13 boys, 8 girls; mean age 9.05 ± 3.46 years) undergoing chemotherapy were examined, totaling 28 in-person examinations and 224 photographic images assessed remotely by four calibrated dentists (Kappa > 0.7). The photos covered eight oral cavity sites (lips, right and left buccal mucosa, tongue dorsum, lateral tongue, palate, and floor of the mouth) and were analyzed for the presence or absence of OM and SOM. Among the 28 examinations, 11 presented OM and 3 presented SOM. The remote examination identified all positive cases (sensitivity 100%; 95%CI: 0.741–1), while specificity was 59% for OM, reflecting the occurrence of false positives, especially in the lips and buccal mucosa. Agreement between remote examiners and the gold standard ranged from 0.17 to 1.0, depending on the region and evaluator, being higher in the tongue dorsum, lateral tongue, and floor of the mouth. The results indicate that remote examination via TON may be feasible and has the ability to detect OM and SOM, potentially serving as a complementary tool in dental monitoring of children and adolescents undergoing oncology treatment, particularly when in-person examination is not possible.
Abstract This study aimed to investigate the influence of the year in the course on dental students’ knowledge about syphilis and its oral manifestations. A cross-sectional study was conducted with dental students at the Federal University of Espírito Santo, Brazil, who were divided into two groups: earlier years of the Dentistry program (second and third years) and later years (fourth and fifth years). Data were collected using a questionnaire with 16 questions addressing knowledge of the main characteristics of syphilis. The Chi-square test (or Fisher’s exact test with Yates correction) was used to assess the association between variables, with a significance level of 5%. The prevalence ratio (PR) and the 95% confidence interval (95% CI) were used as measures of effect size. Overall, 171 students were invited, and 169 participated in the study. Only 40 (23.7%) students answered correctly about the stages of the disease. Nearly all participants answered that syphilis presents oral manifestations; however, only 44 (26%) answered the question correctly. Regarding differential diagnoses, only 63 (37.3%) reported knowledge of the subject. The direction of the bivariate analysis was inverse to the year of study, indicating a possible association between students enrolled in the early years of the Dentistry program and better knowledge about etiologic agents (p < 0.001), clinical manifestations (p < 0.001), disease stages (p < 0.001), oral manifestations (p < 0.001), differential diagnosis (p = 0.019), and drugs (p = 0.001) related to the disease compared with students enrolled in the later years.
This study evaluated the biomechanical behavior of narrow-diameter Morse taper implants (3.5 mm) placed in bone of different densities and at different depths, using finite element analysis. Sixteen three-dimensional virtual models, meshed with tetrahedral elements, were created. Each model comprised cortical bone, cancellous bone, a Morse taper implant, an abutment, and a single maxillary central incisor crown. An oblique force (30 degrees buccally) of 150 N was applied to evaluate peri-implant stress distribution across four bone densities (D1, D2, D3, and D4) and at four placement depths (0, 1, 2, and 3 mm). The interfaces were modeled as perfectly bonded, except at the implant-abutment interface (friction coefficient = 0.3). All materials were assumed to be linearly elastic and isotropic. After a nonlinear analysis, the maximum and minimum principal stresses, maximum principal strain, and Mohr-Coulomb ratio were recorded. The results revealed a stress distribution pattern with lower peak stress values at shallower placement depths and in D1 bone. All groups showed a similar trend: as the implant placement depth increased, the point of greatest stress concentration shifted apically. Implant placement in cortical bone provided a protective effect under oblique loads. In D3 and D4 bone types, crestal placement showed better biomechanical performance than subcrestal placement.
The purpose of this study was to evaluate the effect of immersion in butyric acid (BA, pH 4.1) or phosphate-buffered saline (PBS, pH 7.0) on the properties of Clinker (CL) with particle sizes of 2 to 30 µm or < 2 µm associated with zirconium oxide and manipulated with distilled water (DW) or liquid with additives (LA) compared with Bio-C Repair (BCR) and Biodentine (BIO). Dentin tubes were prepared and filled with materials. After 24 hours, the specimens were immersed in BA or PBS (n = 5) for 7 and 28 days. Micro-computed tomography was used to evaluate volumetric change, porosity, and material/dentin interface. Surface analysis was performed by scanning electron microscopy (SEM). Statistical analyses included Kruskal-Wallis and Dunn, Mann-Whitney, Wilcoxon, unpaired t-test, paired t-test, and ANOVA and Tukey tests (α = 0.05). All groups exhibited volumetric changes similar to BCR and BIO (p > 0.05). BA significantly increased porosity (approximately 8%) compared with PBS (approximately 2%), except for CL 2 to 30 µm with LA (p < 0.05). After 28 days in BA, all groups showed increased porosity and gaps at the interface compared with baseline values (p < 0.05). CL 2 to 30 µm with DW showed greater porosity and interface gaps than the other groups (p < 0.05). SEM analysis revealed that all groups showed hydroxyapatite formation on the material surface in PBS, and structural loss in BA. Findings: Acidic pH damages the material/dentin interface, increases porosity, and promotes dimensional changes in calcium silicate cements. Distilled water without additives increases the Clinker's porosity, interface gaps, and volume loss.
Abstract: Body mass index (BMI) disorders and dental caries are common and interrelated conditions in children, sharing risk factors such as inadequate diet and socioeconomic factors. This longitudinal study was designed to improve understanding of the determinants of children's health and, consequently, to promote health from childhood. The research was conducted between August 2017 and November 2018 in Diamantina, Brazil, and investigated the association between the incidence of dental caries and BMI in preschool children. The final sample included 122 children aged three to four years and 11 months, who were evaluated at two points over a one-year interval. The analysis showed that reduced family income (RR = 3.94; 95%CI: 1.26–12.39) and the incidence of caries (RR = 1.86; 95%CI: 1.01–3.42) were significant risk factors for low weight. Although maternal education initially appeared relevant (RR = 4.67; 95%CI: 1.48–14.73), its influence diminished when family income was considered. In conclusion, this study found an association between incidence of dental caries and low BMI (underweight) in preschoolers after one year of follow-up. The incidence of caries and the reduction or maintenance of low monthly family income were identified as risk factors for low weight in preschoolers during one year of follow-up.
This cross-sectional study evaluated the knowledge, skills, attitudes, and perceived barriers of dentists from the Federal District, Brazil, regarding Minimal Intervention Dentistry (MID). A validated online questionnaire was administered using non-probabilistic snowball sampling, and 404 dentists participated (74% female; mean professional experience: 12 ± 10.9 years). Data were analyzed using descriptive and inferential statistics, including multiple linear regression (p < 0.05). The dependent variables were knowledge, skills, attitudes, and barriers, while the independent variables included administrative region, years of professional experience, type of graduation institution, academic qualification, professional role, and information-seeking behavior. Overall, participants demonstrated high levels of competency in MID, particularly in the preventive and diagnostic domains; however, selective carious tissue removal was the procedure performed least frequently (38.6%). Regression analyses showed that dentists involved in teaching or research reported significantly fewer barriers (β = -2.56; 95% CI: -3.90 to -1.23; p < 0.001). Dentists who had received formal training in MID achieved higher scores in knowledge (β = 2.95; 95%CI: 2.31 to 3.59; p < 0.001) and in skills and attitudes (β = 3.40; 95%CI: 2.18 to 4.62; p < 0.001), as well as fewer perceived barriers (β = -1.52; 95%CI: -2.35 to -0.68; p < 0.001). Information-seeking behavior was positively associated with greater knowledge (β = 2.35; 95%CI: 1.56 to 3.14; p < 0.001) and improved skills and attitudes (β = 3.06; 95%CI: 1.55 to 4.56; p < 0.001). Graduates from public universities presented higher scores for skills and attitudes (β = 2.17; 95%CI: 1.15 to 3.18; p < 0.001) and reported fewer barriers (β = -0.88; 95%CI: -1.61 to -0.15; p < 0.01). Brazilian dentists demonstrated a strong theoretical understanding of MID; however, practical implementation remains limited. Academic background, involvement in education and research, and proactive learning behaviors were key determinants of higher competency levels and reduced barriers to the adoption of MID.
Head and neck cancer (HNC) affects thousands of people worldwide. It is characterized by lesions in the oral cavity, larynx, and pharynx and is often associated with smoking and alcohol consumption. Surgery and radiotherapy improve survival but can cause sequelae that affect daily functioning and quality of life (QoL). This study aimed to assess QoL and functioning in individuals with HNC treated by surgery and radiotherapy. This descriptive, cross-sectional, prospective study enrolled 80 patients between July and September 2024. QoL was measured using the UW-QOL questionnaire, and clinical and sociodemographic data were collected through anamnesis. Statistical analyses were performed using the Friedman-Dunn test for QoL domains, and Fisher's exact test or Pearson's chi-square test for associations. Variables with p < 0.200 were further evaluated by multinomial logistic regression at a 95% confidence level using SPSS v20.0. The participants were predominantly male (70%), with a mean age of 61 years. Most patients (52.5%) reported low QoL; 43.8% reported moderate QoL. The most frequent complaints were fatigue (38.8%) and pain (20%). Low education, pain history, three-dimensional conformal radiation therapy (3D-RT) modality, and previous surgery were significantly associated with reduced QoL (p < 0.05), with low education being the main predictive factor. HNC significantly affected the QoL and functional status of patients. Rehabilitation focusing on physical and emotional support is essential for improving affected domains.
Abstract This study aimed to evaluate the long-term outcomes of dental implants placed in alveolar ridges augmented with collagenated xenogeneic bone blocks (CXBB) or autogenous bone blocks (ABB). In this non-interventional study, 20 patients (CXBB: n = 11; ABB: n = 9) from a previous randomized controlled clinical trial were followed for four years. These patients had undergone lateral alveolar ridge augmentation with either CXBB or ABB, with implants placed after a 30-week healing period. The following parameters were assessed: implant survival and success rates, peri-implant clinical parameters, Pink Esthetic Scores (PES), and patient-reported outcome measures (PROMs). Both groups demonstrated high implant survival rates, with only one late failure occurring in the ABB group. There were no statistically significant differences between the CXBB and ABB groups regarding implant survival and success rates (p > 0.05). Peri-implant clinical assessments indicated healthy tissue surrounding the implants in both groups, with no significant differences between CXBB- and ABB-grafted sites. While overall PES scores were similar, the ABB group showed significantly higher scores for soft tissue level and contour (p < 0.05). Patient-reported outcomes, accessed via the OHIP-14 questionnaire, indicated comparable satisfaction levels between the two groups. Both CXBB and ABB groups exhibited comparable long-term outcomes for implant survival and success. Although the ABB group demonstrated slightly better esthetic results, CXBB showed comparable clinical and patient-reported results, suggesting it may be a feasible alternative for staged lateral alveolar ridge augmentation. These findings should, however, be interpreted with caution given the limited number of patients.
Abstract: To date, no instrument with demonstrated structural validity has been available to assess dentists’ knowledge, skills, and attitudes regarding the core concepts of Minimal Intervention Dentistry (MID). Therefore, this study aimed to develop and evaluate the psychometric properties of a self-administered instrument designed to measure Brazilian dentists’ knowledge, skills, and attitudes towards MID. A cross-sectional study was conducted among dentists practicing in the Federal District of Brazil to evaluate the psychometric properties of the instrument. Item generation was followed by expert review by Brazilian MID specialists. Subsequently, two focus groups and a pre-test were conducted to assess item wording, sequence, and comprehensibility. After the necessary revisions, the instrument was administered to 454 dentists. Exploratory Factor Analysis, combined with parallel analysis, was performed (p < 0.05). A total of 404 dentists comprised the final sample for the psychometric analyses. Parallel analysis indicated a two-factor solution as the most representative, corresponding to knowledge, skills, and attitudes. Composite reliability was adequate for all factors (≥ 0.40). The factorial structure showed acceptable model fit indices, except for the RMSEA (RMSEA = 0.092). Unidimensionality was rejected, as UniCo = 0.939 (0.907–0.975) and ECV = 0.762 (0.719–0.830) did not reach the recommended thresholds. The findings suggest that the instrument presents an appropriate structure and satisfactory reliability for measuring dentists’ knowledge, skills, and attitudes related to MID. This is the first study in the field of MID competencies to comprehensively report the steps involved in constructing, adapting, and psychometrically evaluating an instrument for dentists.
Abstract: This study aimed to conduct an in vitro evaluation of the antierosive potential of a solution and an experimental toothpaste enriched with natural antioxidants derived from cocoa (Theobroma cacao L.) on eroded dentin. Cocoa beans underwent fermentation, drying, roasting, grinding, and freeze-drying to obtain an aqueous cocoa extract. The extract was analyzed for total polyphenols and antioxidant capacity using the oxygen radical antioxidant capacity (ORAC) assay. A control toothpaste was then formulated and enriched with the concentrated cocoa extract. Eighty bovine dentin specimens were pre-eroded in citric acid and randomized into four groups (n = 20): G1 (negative control) – toothpaste without active ingredients; G2 – concentrated cocoa polyphenol solution; G3 – experimental toothpaste enriched with cocoa polyphenols; and G4 (positive control) – Elmex Protect commercial toothpaste (Colgate). Specimens underwent 3 days of erosive cycling. Surface loss (dSL-eroded) was measured by optical profilometry; collagen degradation (dColl) was calculated after collagenase exposure; and calcium release (CaR) was quantified by atomic absorption spectrometry. Surface morphology was qualitatively assessed by scanning electron microscopy (SEM). Data were analyzed by one-way ANOVA and Tukey's test (α=0.05). The cocoa extract showed higher levels of total polyphenols than did the enriched toothpaste (p = 0.037). Antioxidant activity decreased after toothpaste manipulation (p = 0.025). G2 exhibited significantly lower dSL-eroded, dColl, dSL-total, and calcium release compared with the other groups (p<0.05). SEM analysis of G3 revealed partially or totally occluded dentinal tubules. In conclusion, cocoa extract exhibited a higher polyphenol content and significant antierosive effects, leading to reduced dentin surface loss and enhanced tubule occlusion.
Abstract: Despite evidence regarding the severity of occupational accidents involving biological material (OAIBM) during dental instrument cleaning, these risks remain underestimated by many workers. Few studies, however, have focused on the epidemiology of OAIBM during dental instrument cleaning. Thus, this study aimed to identify, analyze, and estimate the incidence rate of OAIBM during dental instrument cleaning by dental care professionals in Brazil. Notifications registered between January 2015 and July 2020 were then extracted from the Notifiable Diseases Information System (SINAN), a Brazilian government agency responsible for reporting and investigating infectious diseases. Reports of OAIBM were analyzed by dental care professionals (dentists, oral health assistants [OHA], and oral health technicians [OHT]) from all 26 Brazilian states and the Federal District. The mean incidence rate of OAIBM among dental care professionals in Brazil during dental instrument cleaning was 314.5 cases per 100,000 professionals. Of these cases, 88.2% involved OHTs, and most affected individuals were female (94.4%). Serum, blood, or plasma accounted for most exposures (71.8%), and 85.1% of exposures were percutaneous. Gloves were the most commonly used personal protective equipment (PPE) at the time of the accidents. Therefore, this study highlights the role of the dentist as the leader and technical authority, responsible for providing resources, standardizing processes, training the team, and supervising performance to ensure occupational safety, quality processing, and contributions to patient safety.
Abstract: This study aimed to identify misinformation related to dental caries in Brazilian Portuguese on Instagram, analyzing factors associated with its dissemination and corresponding engagement metrics. Two independent investigators conducted a qualitative analysis of 500 posts published between August 2018 and August 2022. Posts were selected using the CrowdTangle tool and assessed for author's profile, content, motivation, facticity, format, and sentiment. Data were evaluated using descriptive analysis, the Mann–Whitney U test, and path analysis through generalized structural equation modeling. Topic modeling analysis was also performed using QDA Miner software with the WordStat module to identify underlying topics in dental caries-related information and misinformation. The findings indicated that 21.8% of the analyzed posts contained misinformation, primarily on content shared by regular users regarding dental caries treatment. No significant relationship was observed between misinformation and user engagement; however, posts with misinformation showed a significantly higher median total interaction than those without. Overperformance scores were positively correlated with business and health-related profiles, as well as higher total interaction levels. Financial motivation was less frequently associated with treatment-related posts, reflecting the tendency of promotional content to focus on preventive technologies. Lastly, whereas the misinformation predominantly addressed dental caries treatment, diet, microorganisms, and oral hygiene, the accurate information mainly covered prevention, treatment, and oral hygiene. Although these findings were not associated with higher user engagement, they underscore concerns regarding the dissemination of misleading information about dental issues online. Business and health professional profiles demonstrated good potential to disseminate reliable information with higher engagement metrics.
