Objective: To evaluate the influence of composite resin opacity on color stability, and to analyze the performance of the ΔEab and ΔE00 formulas in detecting color changes. Material and Methods: A total of 180 specimens (n = 20 per group) were fabricated using three opacity levels (translucent/incisal, enamel, and dentin) and three commercial composite resins: Vittra APS (FGM), Harmonize (Kerr), and Herculite Précis (Kerr). Specimens (7 mm × 1 mm) were prepared using a polytetrafluoroethylene mold between glass slides and light-cured with a Bluephase N unit (650 mW/cm2 for 40 s). All specimens were stored in distilled water at 37 °C until color evaluation. Color measurements were performed using an EasyShade digital spectrophotometer at 24 hours (baseline), 30, 60, and 90 days. Color stability was assessed through color variation (ΔE) according to the CIE system, using both ΔEab and ΔE00. Data were analyzed using a three-way ANOVA (opacity, resin, and time), followed by Bonferroni post-hoc testing (α = 0.05). Results: All composite resins exhibited clinically perceptible color changes (ΔE00 > 2.25) after 90 days. Vittra APS presented the highest values at 60 and 90 days (ΔE00 = 5.09 ± 1.77 and 5.12 ± 1.62, respectively), whereas Herculite Précis showed the best overall stability, particularly for the enamel shade (ΔE00 = 3.49 ± 1.10 at 90 days); Harmonize displayed intermediate values. Dentin-shade specimens exhibited the greatest color changes (ΔE00 up to 7.59 ± 1.24). Conclusion: Color stability was influenced by the interaction among composite resin brand, opacity, and aging time. More translucent shades exhibited less color alteration over time.
Cyclophosphamide (CPD) is a widely used antineoplastic and immunosuppressive agent with well-established effects on adaptive immunity, particularly through the modulation of T lymphocyte populations. Objective: This study aimed to discuss the hypothesis that CPD-mediated immunomodulation may modify the development and progression of apical periodontitis (AP), influencing disease expression, bone resorption, and periapical healing. Material and Methods: A consultation of the scientific literature was conducted to develop and adequately support the proposed hypothesis. Articles related to the topic were identified using keywords referring to cyclophosphamide, apical periodontitis, immunomodulation, and T lymphocytes. The evidence retrieved was analyzed and integrated by considering the immunomodulatory effects of CPD, the immunopathogenesis of AP, and the role of T lymphocyte subsets in the regulation of inflammation, cytokine production, bone resorption, and tissue repair. Results: The available evidence indicates that CPD exerts dose-dependent immunomodulatory effects, including the selective regulation of regulatory T lymphocytes. T lymphocytes play a central role in the complex immune response involved in AP by influencing cytokine production, inflammatory regulation, and the balance between bone resorption and repair. Therefore, CPD-induced alterations in T lymphocyte subsets may modify the inflammatory response associated with AP and, consequently, influence its development, progression, and healing. Conclusion: CPD-mediated immunomodulation is biologically plausible as a potential modifier of AP. Experimental and clinical studies are needed to test this hypothesis and determine its implications for the diagnosis, treatment, and follow-up of endodontic diseases in patients undergoing CPD therapy. KEYWORDS Apical periodontitis; Cyclophosphamide; Endodontics; Immunomodulation; T lymphocytes.
Objective: This study aimed to evaluate the knowledge, perceived security, and interest of dentists in adopting digital tools designed for teledentistry within the Ortogeo institution. Material and Methods: A cross-sectional, quantitative investigation was conducted with 205 dentists between May and December 2024. Data were collected through a structured questionnaire composed of open- and closed-ended questions. Descriptive and inferential analyses were applied to explore associations between technological adoption and variables such as prior knowledge, use of messaging applications, perceived security, and the number of advantages identified by participants. Results: The findings revealed that 64.88% of respondents were familiar with the concept of teledentistry, 72.68% used WhatsApp® as a telehealth resource, and 92.68% expressed interest in adopting a dedicated digital platform, provided it ensured regulatory compliance and data security. Statistically significant correlations were observed between interest in adopting the platform and prior knowledge, messaging app usage, perceived security, and the number of perceived benefits. Open-ended responses highlighted agility, convenience, and time savings as the main advantages, while limitations included the impossibility of clinical examination, legal uncertainties, and regulatory gaps. Conclusion: The study demonstrates that, although teledentistry is recognized as a valuable tool by most professionals, its successful implementation requires ongoing professional training, secure technological solutions, and the establishment of public policies that ensure ethical and regulated integration into clinical practice.
Objective: This study aims to apply texture analysis (TA) to cone-beam computed tomography (CBCT) images as a predictive tool for characterizing Geistlich Bio-Oss® bone grafts used in maxillary sinus lift (SL) surgeries. Material and Methods: Eleven CBCT scans of patients who underwent bilateral sinus lift (SL) procedures with Bio-Oss® grafts were selected from the Radiology database of ICT-UNESP. The scans had been acquired using an I-CAT Next Generation scanner (voxel size: 0.25 mm; field of view: 16.0 × 8.0 cm) and exported in DICOM format to OnDemand 3D software. Five parasagittal slices from each case were saved in bitmap format. Texture analysis was performed using MaZda 3.20 software. A 4.0 × 4.0 mm region of interest (ROI) was positioned at the center of the graft, and texture features were extracted using the gray-level co-occurrence matrix (GLCM). All analyses were performed by a single calibrated evaluator. Data normality was assessed using the Shapiro–Wilk test. Since the variables did not present a normal distribution, data were transformed into ranks. Spearman’s correlation coefficient was used to evaluate the association between directions and distances of texture measurements. A mixed linear model was applied for each texture parameter, considering maxillary sinus (right/left), section (S0–S4), and their interaction as fixed effects, with patient as a random effect. Intra-examiner reproducibility was assessed using the intraclass correlation coefficient (ICC). Statistical significance was set at 5%. Results: Most texture parameters showed a homogeneous distribution between the analyzed sides and slices, except for the SumAverg parameter, which indicated higher density on the right side. Conclusion: The TA proved to be an effective tool for the quantitative characterization of grafts, revealing symmetrical and homogeneous bone integration of the biomaterial, with potential clinical application in surgical planning and monitoring.
Objective: To investigate salivary pro- and anti-inflammatory cytokine profiles in adults with type 2 diabetes (T2D) and their associations with glycaemic markers. Material and Methods: A cross-sectional study was conducted including 20 adults with T2D and 20 age-matched controls. Unstimulated saliva was collected, and concentrations of IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17A, IL-22, TGF-α, and TNF-α were quantified using a multiplex immunoassay. Fasting blood glucose (FBG) and glycated haemoglobin (HbA1c) were obtained from clinical records. Results: T2D group exhibited higher salivary IL-6 and IL-10 levels compared with controls. Several pro-/anti-inflammatory cytokine ratios, including IL-1β/IL-10, IL-8/IL-10, TGF-α/IL-10, and TNF-α/IL-10, were significantly altered in the T2D group. In the T2D group, IL-1β, IL-6, IL-10, IL-22, TGF-α, and TNF-α were positively correlated with FBG, whereas specific ratios, such as IL-22/IL-4 and TNF-α/IL-4, were positively associated with HbA1c. Conclusion: Adults with T2D display a distinct salivary cytokine profile characterised by elevated IL-6 and IL-10 and altered pro-/anti-inflammatory ratios. Salivary cytokine levels are associated with both short- and long-term glycaemic control, suggesting that salivary biomarkers can reflect systemic metabolic and inflammatory status.
