João Paulo De Carli

Facial aging is a complex and multifactorial process that progressively affects the structure, volume, and quality of facial tissues. This study aims to present a case series involving South American patients of different generations and facial morphotypes treated with HArmonyCa®, a hybrid filler composed of hyaluronic acid and calcium hydroxylapatite. Four patients of varying ages, genders, and facial profiles underwent individualized treatment plans tailored to their aesthetic concerns and aging patterns. All patients received clinical evaluation and three-dimensional imaging analysis using the Vectra 3D system, which enabled precise quantitative assessment of outcomes. Significant improvement in facial firmness and contour definition was observed, yielding a rejuvenated, natural-looking appearance. The bio-stimulatory effects of calcium hydroxylapatite, combined with the immediate volumization from hyaluronic acid, produced a noticeable and progressive lifting effect. Three-dimensional imaging supported the clinical findings by demonstrating tissue repositioning and volumetric enhancement in strategic facial areas. This case series highlights the potential of HArmonyCa® as an effective, safe, and versatile approach for facial rejuvenation, adaptable to a wide range of patient profiles. The integration of objective tools such as 3D imaging further enhances treatment planning and outcome evaluation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Objective: To evaluate the mechanical properties of dentin under the effect of grape seed extract (GSE) as intracanal medication (ICM). Material and Methods: Ninety-six single-rooted bovine teeth were divided into groups, as follows: control group (Ctrl), without any dentin treatment; groups treated with Ca(OH)2 (Ca7, Ca15 and Ca30); and GSE (GSE7, GSE15 and GSE30), with direct contact between dentin and ICM for different durations of 7, 15 and 30 days. The samples underwent tests of maximum fracture load (FL), flexural strength (σf), cohesive strength (σc), and elastic modulus (E) of the remaining root. For statistical analysis, one-way ANOVA was used, followed by Dunnett's test to verify whether ICMs interfere with dentin properties. Two-way ANOVA (ICM and application time) and Tukey's test were also used, considering the groups treated with different ICM at different intervals. All analyses were performed at p ≤ 0.050. Results: GSE had a less pronounced effect on dentin's mechanical properties compared to Ca(OH)2. GSE showed less interference with FL (p=0.000), σf (p=0.002), and σc (p=0.000). It was observed that the duration of exposure to ICM had a negative impact on FL (p=0.002) and σc (p=0.031). ICM (p=0.080) and the application time (p=0.985) did not significantly affect E. Moreover, the application time of ICM did not have a significant impact on σf (p=0.169). Conclusion: Grape seed extract did not affect the mechanical properties of bovine dentin when used as intracanal medication.

Purpose This study aimed to clinically evaluate the high-energy light-emitting device (Germinator) in preventing pain and oral mucositis in patients undergoing chemotherapy. Methods Sixty patients were selected, being randomly divided into two groups(n = 30), according to preventive protocol: G1(Lasertherapy)-conventional low-intensity red laser protocol; G2(Germinator)-protocol with high-energy light-emitting device. Before and after these protocols, the pain and oral mucositis degrees were recorded by visual analog scale(VAS) for pain and World Health Organization(WHO) classification for oral mucositis. The VAS was used to assess pain symptoms, where 0 represented the absence of pain and 10 the highest pain score. The oral mucositis scoring was performed according to the WHO classification: grade 0(none), grade I(oral soreness, erythema), grade II(oral erythema, ulcers, solid and liquid diet tolerated), grade III(oral ulcers, liquid diet only), and grade IV(oral alimentation impossible). Statistical analysis was performed by Mann-Whitney U test(α = 5%), in order to provide the intergroup comparison. Results The median (interquartile range-IQR) of pain score was 0.0(0.0–2.0) for G1 group(Lasertherapy), whereas it was 0.0(0.0–2.0) for G2 group(Germinator), revealing no statistically significant differences (p > 0.05). The median(minimum and maximum value) of the oral mucositis score was 0.0(0.0–1.0) for G1 group(Lasertherapy), whereas it was 0.0(0.0–1.0) for G2 group(Germinator), also revealing no statistically significant differences (p > 0.05). Both treatments proved equally effective in preventing and controlling these symptoms in patients undergoing chemotherapy, recognizing that no statistically significant difference was found between the two preventive modalities. Conclusions The high-energy light-emitting device(Germinator) appears promising in preventing pain and oral mucositis in patients undergoing chemotherapy.

This study evaluated the influence of a customized healing abutment (CHA) placed on immediate implants. It also assessed bone ridge volume, keratinized mucosal collar, and postoperative pain. Thirty-one patients needing tooth extraction and immediate implant were selected. Gingival papilla height, bone ridge volume, and keratinized mucosal collar thickness were measured using a millimeter periodontal probe and a dry-point caliper. A visual analog scale (VAS) was applied to determine postoperative pain. Study participants were randomly assigned to a control group (n = 15, with extraction, immediate implant placement, alveolar gap filling with a bovine bone graft, PTFE barrier, and suture) and an experimental group (n = 16, with extraction, immediate implant placement, gap filling with a bovine bone graft, and CHA). The healing abutments were prepared before surgery and customized during the procedure. The data were tabulated and statistically analyzed using the Mann-Whitney test (α = 0.05). The "changes in the papilla" outcome presented a statistical difference, and the control group showed higher values than those of the experimental group (p = 0.04). The remaining characteristics demonstrated no statistical differences between the groups (p > 0.05). CHA and the barriers exhibited similar behavior in maintaining bone ridge and keratinized mucosal thickness. CHA proved more effective than the conventional barrier in preserving the gingival papilla, with the distance measured three months post-surgery averaging 17% greater than the pre-surgical measurement.

This study aimed to evaluate the compressive and adhesive strengths of ceramic restorations (PICN and 5Y‐PSZ zirconia) cemented with one of three types of cements: conventional glass ionomer cement (GI), resin‐modified glass ionomer cement (RM‐GI), and self‐adhesive resin cement (R). Ceramic specimens (5Y‐PSZ, n = 72; PICN, n = 60) were prepared for testing after cementation onto glass fiber‐reinforced resin‐based composite tooth analogs. The 5Y‐PSZ specimens underwent tribochemical silica coating before cementation. Specimens intended for compressive strength evaluation were mechanically cycled (500,000 cycles) before testing. A microtensile bond strength test was used to evaluate adhesive strength, with specimens sectioned into microbars (1 mm² cross‐section) and loaded until fracture. If pre‐test failures occurred, bond strength was assessed using microshear tests. PICN restorations showed significantly higher compressive strength than 5Y‐PSZ. For PICN, self‐adhesive resin cement yielded the highest compressive strength. For adhesive strength, PICN restorations cemented with self‐adhesive or RM‐GI cements outperformed GI. The 5Y‐PSZ+R combination showed the highest microshear bond strength, superior to 5Y‐PSZ+RM‐GI and 5Y‐PSZ+GI. Resin cements showed higher compressive and adhesive strengths for PICN than glass ionomer‐based cements. For 5Y‐PSZ, the cement type did not significantly affect compressive strength. Overall, PICN restorations outperformed 5Y‐PSZ in compressive and adhesive strengths.

Objective This preliminary study aims to compare the clinical, radiological, and histological outcomes of third molar socket repairs after dental extraction with and without the use of particulate dentin graft. Materials and methods Ten patients requiring bilateral surgical extraction of impacted lower third molars were selected. One side received a blood clot (control side) and the other an autologous particulate dentin graft (experimental side). Postoperative evaluations at 7 and 21 days assessed pain, edema, trismus, suture dehiscence, and wound edge coaptation. At 120 days, CBCT was used to evaluate bone density, and a biopsy was performed for histological analysis. Data were analyzed using IBM SPSS software with descriptive statistics and paired t-test at a 5% significance level. Results At 21 days, only one case of suture dehiscence occurred on the experimental side, compared to three on the control side. No differences in pain, edema, or trismus were observed between groups. Tomographic analysis showed no significant difference in the distance from the alveolar bone crest to the CEJ, but the experimental group had significantly higher bone density (p = 0.002). Histologically, the experimental side exhibited thicker, denser connective tissue with higher cellularity, collagen production, and multinucleated giant cells, while the control side showed typical connective tissue with fewer multinucleated cells. Conclusion Particulate dentin grafting showed benefits in bone density and clinical stability, with a more advanced histological healing stage. Clinical relevance Improve post-extraction socket healing, offering a promising alternative to traditional methods, particularly in terms of enhancing bone regeneration and clinical outcomes.

This study aims to report a clinical case of an isolated oral manifestation of secondary syphilis. A Caucasian 30-year-old female patient presented to a public oral health service in Southern Brazil, complaining of symptomatic oral ulcerative lesions without spontaneous regression for over 30 days. Intraoral examination revealed a larger lesion in the central region of the hard palate with confluent mucous plaques, resulting in "slug-shaped ulcers" surrounded by erythema, and smaller mucous patches with irregularly shaped, whitish fibrinous pseudomembranes in the region of the lower vestibular sulcus, near teeth 41, 42, 33, and 34. Rapid syphilis and VDRL tests confirmed Treponema pallidum contamination (titer 1:128). After 3 weeks of treatment with Penicillin G Benzathine, the clinical signs and titers significantly decreased. This case report underscores the importance of integrating and continually incorporating oral health care into public health, as dentists can diagnose and monitor many systemic diseases with repercussions in the oral cavity.

This case report aims to highlight the importance of comparative analysis of surgically removed jaws, especially when expert human identification is required. In this study’s case, a charred body was discovered inside a burnt-out vehicle on the side of a highway. Initially, the vehicle was identified, and its registration and electronic documentation were verified with the competent traffic authorities. The possible victim's family was contacted and interviewed. Given the impossibility of a dactyloscopy due to the destruction of the necessary structures and the possible time and cost limitations associated with DNA identification, the family was asked if the possible victim had any medical or dental history records. The victim's jaws were surgically removed and compared with the dental documentation kept by the possible victim's dental surgeon. Identification using the dental method proved to be viable. The process of forensic dentistry identification is essentially comparative, involving the clinical evaluation of the victim’s surgically removed jaws compared to their dental records (forensic dentistry documents). This approach represents a crucial contribution and, in some cases, might be the main or only reference for resolving legal human identification.

To verify the prevalence of specific microorganisms of red, green, and orange microbiological complexes in periodontal pockets of chronic kidney disease (CKD) patients on hemodialysis. This systematic review was conducted according to the PRISMA statement. The search strategy included two independent reviewers who searched the PubMed, Web of Science, Scopus, Cochrane, and Lilacs databases in August 2024, using MeSH terms and keywords defined with the PICOS acronym. The studies included were cross-sectional and published from 2007-2017 in English. The risk of bias and quality of evidence were assessed with the NIH Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Quantitative analysis with proportion meta-analysis was also performed. 4,737 studies were initially selected, and five were included. The study verified the prevalence of the green complex - Aggregatibacter actinomycetemcomitans (6.69%); the orange complex - Prevotella intermedia (16.85%) and Prevotella nigrescens (37.51%); and the red complex - Treponema denticola (29.11%), Porphyromonas gingivalis (49.45%), and Tannerella forsythia (56.37%), the most predominant microorganism. In the subgingival microbiota of CKD patients on hemodialysis, the red complex showed higher rates and prevalences, and Tannerella forsythia was the most common pathogen.