Statement of problem. Digital technologies have brought different workflows to prosthetic rehabilitations, but analyses of the available processes and their influence on the marginal fit of complete crowns are lacking. Purpose. The purpose of this in vitro study was to evaluate the marginal discrepancy of lithium disilicate complete crowns made with different workflows. Material and methods. Fifty lithium disilicate crowns were made with 5 different workflows (n=10): G1-Analog (control): conventional flow/pressed crown; G2-Hybrid: hybrid flow/milled crown; G3-Hybrid: hybrid flow/pressed crown; G4-Hybrid: hybrid flow/printed wax pattern/pressed crown; G5-Digital: digital flow/milled crown. The specimens were analyzed by scanning electron microscopy, and the data were analyzed for normality and submitted to analysis of variance (ANOVA). Multiple comparisons were made by using the Tukey HSD test (alpha=.05). Results. G4H (18.1 +/- 6.6 mu m) had the lowest mean +/- standard deviation marginal discrepancy values, statistically different from G2H (217.9 +/- 81.4 mu m), G5D (236.4 +/- 89 mu m), and G3H (661.8 +/- 61.9 mu m) (P<.05). G3H had the highest marginal discrepancy values and were statistically similar to each other (P>.05). G1A (163.2 +/- 10.9 mu m) had intermediate values, statistically similar to those of other groups (P>.05). Conclusions. The conventional method showed no statistical differences in marginal discrepancy compared with methods using digital technology (scanner, software, 3D printer, or milling machine).

Objective Recent studies report that kidney recipients exhibit poor outcomes associated with increased levels of pro-inflammatory cytokines and viral infections. This study aimed to analyze and compare the feasibility of using saliva to measure inflammatory cytokines and viremia in kidney recipients. Study design Saliva and blood samples were collected from 48 patients. For herpesviruses detection, a Pan-Herpes PCR was used, and for the cytokines (IFNy, IL-10, IL-4, IL-6, IL-8, and TNFa) profile, a multiplex kit. The accuracy between the herpesvirus detection, using different fluids. Statistical analyses included Bowker symmetry and Pearson's test. Results HSV-PAN PCR detection accordance between results was 53.9% and VZV-PAN PCR 32.6%. No symmetry was observed, with a higher tendency in positive cases in saliva. The cytokines levels results presented that the correlations between the two types of samples were very weak or weak (>0.39). The exceptions included concentrations for IFNy within the range of moderate correlation, and TNFa significant (p-value < 0.05). Conclusion Salivary herpesviruses detection demonstrates the intense viral excretion observed in transplanted patients, while in the study of cytokines, a positive correlation of TNFa expression in serum and salivary suggests its importance in the local and systemic inflammatory response in this group of patients. São Paulo Research Foundation (FAPESP), grant # 2021/07490-0; 2018/02568-8

Histoplasma capsulatum, the causative agent of histoplasmosis, is an uncommon systemic fungal illness that represents significant health risks to people living with HIV/AIDS (PLHV), especially those who are residents in endemic regions like Brazil. While oral histoplasmosis is rare, this observation can serve as a significant indicator of compromised immunological state, particularly in those with low numbers of TCD4+ cells. This study intends to examine recent literature on oral histoplasmosis and to provide a case of oral manifestations as the first indication of disseminated histoplasmosis in a young woman recently diagnosed with HIV.

ABSTRACT Introduction: The predictability of osseointegration depends on a non-traumatic surgical technique that maintains cell viability. It is known that during the drilling osteotomy for implant placement occurs heat generation, being able to influence osseointegration due to thermal damage. The objective of this research was to evaluate and compare the heat generated by the drills during the preparation of surgical sites for implant placement between two different techniques: simplified (Simplified Drilling, SD) and conventional, in an in vitro model. Material and methods: Fifty implant site preparations were performed in segments of bovine ribs, divided into two groups, with the respective drill sequences: control group, conventional preparation, Ø2.0mm spear drill and Ø2.15mm, Ø2.85mm, Ø3.35mm, Ø3.85mm twist drills; SD group, Ø2.15mm and Ø3.85mm twist drills. The measurement of the temperature variation generated by each drill in each group was performed by an infrared thermal camera at three points in the bovine rib segment. Results: The temperature variations at one and thirteen millimeters below the drilling site were, respectively, 0.51±0.64°C and 0.46±0.59°C for the control group, and 0.62±0.76°C and 0.5±0.86°C for the SD group. No statistically significant differences were found between the control and SD groups in relation to heat generation in any of the evaluated points; p=0.288 and p=0.584, respectively for analyzes one and thirteen millimeters below the drilling site. Discussion: The technique of implant site preparation can be simplified, using only two drills in this modality, without showing significant differences in relation to heat generation when compared to the conventional preparation technique.

Duchenne muscular dystrophy (DMD) is a rare genetic disorder in which patients progressive muscle deterioration and low life expectancy. Since DMD has no cure, treatment slows the deterioration process using corticosteroids and other medications, including oral bisphosphonates (BP). These drugs can lead to toxicities in both soft and hard tissues. The objective of this study was to present cytological changes in DMD patients, comparing to young, healthy individuals. Cytological smears were obtained from buccal mucosa from nine DMD patients and five healthy patients. The Papanicolaou technique was used to stain the slides. Images were captured using a photomicroscope, and 50 clearly defined cells were selected. The size and ratio between the nucleus and cytoplasmic areas (NA/CA) diameter were measured using a computer program. All the DMD patients presented a statistical difference (p < 0.0001) in the size of the cytoplasm (0.60 ± 0.33 μm) and the NA/CA ratio (0.17 ± 0.07 μm) was seen when compared to the control group (cytoplasm 0.60 ± 0.15 µm and nucleus 0.14 ± 0.05 µm). Furthermore, in one DMD in use of BP who presented Medication-Related Osteonecrosis of the Jaw (MRONJ), presented higher differences in the cytoplasmic (1.20 ± 0.65 µm) and nuclear (0.20 ± 0.12 µm) sizes (p < 0.0001) compared with all others DMD patients. These results suggest that the drugs used or the systemic condition of individuals with DMD may contribute to these changes.

Hallerman-Streiff syndrome (HSS) is a rare congenital disease described in less than 200 cases worldwide. Skull changes, hypotrichosis, cataracts, a beaked nose, micrognathia, skin atrophy, dental anomalies, and short stature are characteristics described. A 28-year-old female patient was referred for dental care, complaining about recurrent spontaneous gingival bleeding. Intraoral examination revealed dental anomalies, periodontal disease, generalized gingival hyperplasia, and 3 nodules located on alveolar ridges. Due to extensive bleeding during periodontal treatment and medical history of bleeding episodes, a platelet aggregation test was requested, revealing impaired adrenaline-induced platelet aggregation. The following dental visits aimed to prevent hemorrhage during invasive procedures, using hemostatic agents. Nodules were removed with the aid of a high-power laser, with no intercurrences. Histologic analysis suggested the diagnosis of collagenous fibroma, a rare encounter. To date, this the first description of blood dyscrasia and oral lesions in a patients HSS. Hallerman-Streiff syndrome (HSS) is a rare congenital disease described in less than 200 cases worldwide. Skull changes, hypotrichosis, cataracts, a beaked nose, micrognathia, skin atrophy, dental anomalies, and short stature are characteristics described. A 28-year-old female patient was referred for dental care, complaining about recurrent spontaneous gingival bleeding. Intraoral examination revealed dental anomalies, periodontal disease, generalized gingival hyperplasia, and 3 nodules located on alveolar ridges. Due to extensive bleeding during periodontal treatment and medical history of bleeding episodes, a platelet aggregation test was requested, revealing impaired adrenaline-induced platelet aggregation. The following dental visits aimed to prevent hemorrhage during invasive procedures, using hemostatic agents. Nodules were removed with the aid of a high-power laser, with no intercurrences. Histologic analysis suggested the diagnosis of collagenous fibroma, a rare encounter. To date, this the first description of blood dyscrasia and oral lesions in a patients HSS.

Os diferentes tratamentos de superfície sobre os implantes dentários têm a premissa de aprimorar a interface de contato entre osso e implante, acelerando o processo de osseointegração. O objetivo desta revisão de literatura foi verificar os diferentes tipos de tratamentos de superfície dos implantes dentários de titânio e zircônia, suas características e ações sobre a osseointegração. Para isso, foram realizadas pesquisas nas bases de dados nacionais e internacionais: PUBMED, SciELO e Google Scholar. Os dados encontrados demonstram que tanto em implantes de titânio quanto em zircônia, as superfícies podem ser modificadas, com o objetivo de uma melhoria no desempenho biológico acelerando o processo inicial de cicatrização, a fim de promover uma estabilidade inicial superior aos implantes sem tratamento. Ainda, as alterações que promovem uma maior energia de superfície, aumentando a molhabilidade e hidrofilicidade apresentam uma maior adesão e proliferação de osteoblastos e consequentemente uma neoformação óssea mais acelerada, que contribuem para esse processo inicial de cicatrização e osseointegração. Apesar de uma variabilidade nos tipos de tratamento, sendo alguns em comum com o titânio e zircônia, as alterações se mostraram eficazes, permitindo um carregamento em tempos menores. A escolha do tratamento de superfície pode ser determinada pela qualidade óssea, condições sistêmicas do paciente e o tipo de carregamento pré planejado. Em relação aos implantes de zircônia, os estudos são promissores, mas são necessários estudos a longo prazo, pois não há ainda, dados suficientes que indiquem com clareza e segurança a utilização destes implantes, salvo em casos de comprovada alergenicidade ao titânio.

•-A combination of phototherapies for MRONJ prevention.•-A simple, non-invasive protocol based on aPDT and PBMT.•-Complete healing of a tooth socket within 30 days.

O objetivo deste estudo foi avaliar a taxa de sobrevivência e sucesso dos implantes em um paciente idoso e investigar as condições funcionais e nutricionais do paciente após o tratamento de reabilitação com uma prótese do tipo protocolo, utilizando carga mediata. A extração dos dentes 33 a 44 foram realizadas e após seis meses foram colocados cinco implantes Cone-Morse de 3,5 x 11 mm. A instalação da prótese foi concluída após 6 meses de osseointegração e o acompanhamento foi realizado por dois anos. Não houve perda de implantes, sinais clínicos de inflamação ou presença de perda óssea ao redor dos implantes, e os componentes protéticos estavam perfeitamente adaptados. Assim, o protocolo de carregamento mediado em pacientes muito idosos oferece vantagens em termos de reabilitação protética dentária, pois esses pacientes requerem uma atenção mais cuidadosa.

Indivíduos com síndrome de Down apresentam características dentais típicas, que requerem tratamento odontológico especializado. Além disso, devido ao déficit intelectual, este manejo pode ser ainda mais desafiador. Neste caso clínico, apresentamos uma proposta de tratamento promissora, com laser de alta potência, em um menino de 12 anos com pericoronarite, que não pôde se submeter à cirurgia periodontal com outros profissionais. A utilização dessa técnica resultou em um breve e excelente resultado pós-operatório. Concluímos que esta abordagem clínica pode ser indicada para indivíduos com síndrome de Down que apresentam comprometimento intelectual leve a moderado.

As fraturas do Complexo Zigomático Maxilar (CZM) estão entre as principais lesões do trauma maxilo-facial e conhecer seus padrões demográficos é fundamental para prevenção e tratamento. Portanto, o objetivo desse estudo foi pesquisar a etiologia, incidência e tratamento de escolha dessas fraturas no Serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial do Complexo Hospitalar Padre Bento de Guarulhos, Guarulhos, SP, Brasil. Foi realizado um estudo epidemiológico retrospectivo de pacientes que apresentaram fratura do CZM entre o ano de 2017 e 2018. Em uma população de 84 pacientes que apresentaram fratura do CZM, 54 entraram para o estudo. Foram coletados os dados referentes ao sexo, idade, etiologia da fratura e tratamento de eleição. O principal gênero acometido foi o masculino com maior acometimento entre as faixas etárias de 20 a 40 anos em 2017 e 51 a 70 anos em 2018. Principais etiologias foram acidentes automobilísticos, quedas de própria altura e agressão física, com variação dos dados entre o período estudado. Em 2017 o principal tratamento realizado entre os homens foi não-cirúrgico (57,14%) e em 2018 o cirúrgico (68,42%). A fratura nasal foi a mais associada em ambos os gêneros. A fratura de CZM é mais prevalente em homens sendo o acidente automobilístico, quedas de própria altura e agressões físicas as principais etiologias da região estudada. As informações apresentadas elucidam dados para esclarecer o tipo de atendimento realizado pelo serviço. Essas informações podem ser comparadas com os dados de outros os serviços, além de contribuir para as políticas de prevenção das fraturas.