Maria Conceição Pereira Saraiva

Background: This study assessed the impact of xenogeneic bone grafts (XEN), either utilized alone or combined with autologous platelet concentrates (APCs) prepared using three different centrifugation protocols, on the healing of critical-size defects (CSDs) in rat calvaria. Methods: Forty rats were assigned to five groups (n = 8): Control, XEN, XEN + L-PRF, XEN + A-PRF, and XEN + Bio-PRF. Blood concentrates were prepared by centrifuging blood collected via cardiac puncture: L-PRF (~700 g for 12 min), A-PRF (~208 g for 14 min), and Bio-PRF (~700 g for 8 min). Defects (5 mm diameter) in the right parietal bone of each rat were filled with blood clot, XEN, or XEN combined with L-PRF, A-PRF, or Bio-PRF. Animals were euthanized 60 days post-surgery, and the calvariae were analyzed using histomorphometry and micro-CT. The percentage of mature and immature collagen fibers was analyzed using Picrosirius red staining under polarized light microscopy. Results: Groups XEN-A-PRF, XEN-L-PRF, and XEN-Bio-PRF presented higher bone volume (BV/TV) than the control group (14.35 ± 6.42%, 11.96 ± 4.68%, and 14.92 ± 3.47%, respectively, vs. 4.13 ± 2.25%; p < 0.05). These groups also presented lower bone porosity (BP) than the control group (p < 0.05). The XEN group did not show different values of BV/TV and BP compared to the control group. Only the XEN + A-PRF and XEN + Bio-PRF groups showed a higher percentage of mature collagen fibers (red color) compared to the XEN and control groups (p < 0.05). The control and XEN groups showed a higher amount of immature collagen fibers (green color) compared to the XEN + A-PRF, XEN + L-PRF, and XEN + Bio-PRF groups (p < 0.05). Conclusions: It can be concluded that CSDs treated with XEN combined with APCs presented a more favorable bone microarchitecture than untreated CSDs after a 60-day healing period. Furthermore, CSDs treated with XEN combined with A-PRF or Bio-PRF showed greater collagen maturation than those treated with XEN alone, suggesting that the centrifugation protocol used for preparing APCs may be a decisive factor for the quality of the collagen matrix in newly formed bone tissue.

The aim of this study was to assess the trend in cesarean section rates in three birth cohorts conducted in Ribeirão Preto, São Paulo, Brazil, in different years (1978/79, 1994, and 2010), and to investigate the sociodemographic and economic factors associated with cesarean delivery in these cohorts. Data were obtained from the database of the cohorts. Women were interviewed shortly after delivery and information was collected from their medical records. The chi-square test was used to compare the proportion of covariates between modes of delivery. Unadjusted and adjusted Poisson regression models were applied to evaluate the association between cesarean section and the covariates studied in the three cohorts, with the significance level set at α < 0.05. There was a marked upward trend in cesarean delivery across the cohorts. The increase was more pronounced among women with higher educational levels, older age, and better socioeconomic conditions. In adjusted analyses, sociodemographic and economic variables remained significantly associated with a higher likelihood of cesarean delivery in all cohorts.

Objective This study aimed to assess the clinical efficacy of acupuncture in relieving sicca symptoms of SjD. Methods A prospective, single-center, randomized, double-blind, controlled trial was conducted on SjD patients experiencing dry eyes and dry mouth. Forty-six patients were randomized and 27 completed the study (acupuncture, n = 15; sham, n = 12). Patients received either acupuncture or sham acupuncture (control) weekly for 8 weeks. Key outcomes, including Schirmer test (ST), corneal fluorescein staining score, tear film break-up time, Ocular Surface Disease Index, unstimulated whole salivary flow (UWSF), EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Xerostomia Inventory (XI) score, Oral Health Impact Profile (OHIP-14) score, and Challacombe scale, were measured at baseline, immediately after treatment, and 4 weeks later. Statistical analysis consisted of comparing outcomes between groups over time. Results The acupuncture group exhibited significant improvement in total ESSPRI and ESSPRI dryness scores. The positive effects persisted for at least 4 weeks after the completion of treatment. Furthermore, the acupuncture group exhibited improvement over time in the ESSPRI fatigue domain, ESSPRI pain domain, OHIP-14, XI, UWSF, and ST. No other statistically significant differences were observed. Conclusion Acupuncture is effective in relieving dryness in SjD patients. Larger samples and longer observation periods are necessary to better understand the effectiveness of this intervention in SjD. (NCT04056221/ 18/02/2019). Key Points • Acupuncture is a low-cost method with few side effects • Acupuncture exerts a symptom-relieving effect in primary Sjögren’s disease patients

Objective: To evaluate the effect of syphilis and urogenital diseases (SUD) during pregnancy on developmental defects of enamel (DDE) using causal inference models.

Objective. To evaluate, through a systematic literature review, whether periodontal status in HIV‐infected individuals is different from those non‐HIV‐infected. Materials and Methods. A systematic search for published observational studies within six electronic databases and grey literature was conducted, PROSPERO database number CRD42020160062. Results from studies reporting clinical periodontal parameters: probing pocket depth, bleeding on probing, clinical attachment level, plaque index, and gingival index, in HIV‐ and non‐HIV‐infected individuals were reviewed. The quality of the assessment was evaluated according to the Joanna Briggs Institute Appraise Checklist. Results. Twenty‐three observational studies met the eligibility criteria and were included for analysis. The qualitative analysis indicated similarities in periodontal parameters within both groups, with no significant mean difference (MD) within both groups regarding clinical periodontal parameters; severe heterogeneity was also detected. Conclusions. No significant differences were found in the periodontal profile of HIV‐infected and non‐HIV‐infected individuals. However, the high heterogeneity among the studies calls for caution in interpreting these findings. Further investigations using standardized methods for periodontal evaluation are needed to clarify the association between HIV infection and periodontal conditions.

This study tests the hypothesis that children 12–30 months born small for gestational age (SGA) aged are more susceptible to severe early childhood caries (S-ECC). We used data on 865 children aged 12–30 months from a prospective cohort study conducted in a city in the northeast of Brazil. The study outcome was S-ECC, defined based on the proportion of decayed tooth surfaces (cavitated or not). The main exposure variable was SGA, defined according to the Kramer criterion and the INTERGROWTH-21st standard. Direct (SGA → S-ECC) and indirect effects were estimated using structural equation modeling, calculating standardized factor loadings (SFL) and P-values (alpha = 5%). The final models showed a good fit. SGA influenced S-ECC in the direct and indirect paths. In the group of SGA children with 12 or more erupted teeth defined according to the Kramer criterion, the direct effect was positive (SFL = 0.163; P = 0.019); while among all SGA children defined according to the INTERGROWTH-21st standard, the direct effect was negative (SFL = − 0.711; P < 0.001). Age and number of erupted teeth may influence the occurrence of S-ECC in SGA children, as the number of teeth affects the time of exposure to disease risk factors.

Background: Periodontitis (PDT) has gained attention in the literature with the increase in life expectancy of people living with HIV on combined antiretroviral therapy (cART). Thus, the search for inflammatory biomarkers could be useful to understand the pathophysiology of chronic oral diseases in the cART era. Objective: The aim of this study was to evaluate the impact of non-surgical periodontal therapy (NSPT) on clinical parameters of PDT, Candida spp. count and expression of LF and HST in saliva and CGF of HIV-infected patients. Methods: Bleeding index (BI), probing depth (PD), clinical attachment level (CAL), colony-forming units (CFUs) of Candida spp, and lactoferrin (LF) and histatin (HST) levels were measured in saliva and GCF of both groups at three different times: baseline (before treatment), and 30 and 90 days after the NSPT. Clinical, mycological and immunoenzymatic analyses were also performed. Results: Twenty-two HIV-infected patients and 25 non-HIV-infected patients with PDT participated in the study. NSPT was effective in improving periodontal clinical parameters, including ≤ 4 sites with PD ≤ 5mm and BI ≤ 10%. No significant change in oral Candida spp. count occurred neither between the two groups nor during the time after the periodontal treatment. And the salivary and GCF levels of LF and HST seems not to be influenced by the NSPT. By contrast, except for salivary LF, HST and LF were shown to exhibit significantly higher levels in HIV-infected than in non-HIV-infected patients. Conclusions: NSPT was effective in improving periodontal disease parameters in HIV-infected patients, but do not affect lactoferrin and histatin-5 expression in saliva and ginvival crevicular fluid of HIV-infected patients.

Objectives To evaluate dental and skeletal changes caused by surgically assisted rapid palatal expansion (SARPE) using the superimposition of three-dimensional cone-beam computed tomography (CBCT) images on the cranial base. Material and methods This is a retrospective quasi-experiment before-and-after study using a convenience sample. Twenty-four adult patients (13 male and 11 female) were evaluated before SARPE (T0), immediately after expansion (T1), and after 6 months of retention (T2). CBCT scans were superimposed on the anterior cranial base using voxel-based registration. Measurements from different reference points were used for comparisons between times. Results At T1, all teeth had significant buccal tipping. At T2, most teeth remained in the same position as at T1, except the first premolar and the first molar, whose buccal roots moved slightly. The amount of bony expansion was 65 to 70% of the amount of tooth movement. The A point and maxillary incisors moved anteriorly from T0 to T1 and T2 (p < 0.0001). Inter-nasal distance had increased significantly at T1 (p < 0.0001) and remained stable at T2 (p = 0.478). No expansion was achieved at the zygomatic arch (p = 0.114). Conclusion SARPE promoted substantial buccal tipping of posterior teeth and some bone displacement; it also moved the maxilla and teeth forward and increased nasal width. Clinical relevance No other clinical studies have evaluated dental and skeletal changes caused by SARPE using superimposition of 3D CBCT images on the cranial base. This study findings may help clinical dentists plan treatments using safe and reliable information.

Introduction: Surgically Assisted Rapid Palatal Expansion (SARPE) promote maxillary expansion in skeletally mature patients. This technique is effective; however, some side effects are still unknown. Objectives: evaluate the presence of alveolar defects (dehiscences and fenestrations) in patients submitted to the SARPE. The null hypothesis tested was: SARPE does not influence the number of dehiscences and fenestrationss. Methods: A retrospective quasi-experiment study of a convenience sample of 279 maxillary teeth, in 29 patients evaluated with Cone Beam Computed Tomography (CBCT) at T1 (before SARPE), T2 (after expansion) and T3 (after retention), was performed. The examined teeth were: canines, first and second premolars, first and second molars. in axial, coronal, and cross-sectional views. The evaluations involved viewing slices from mesial to distal of the buccal roots. Results: All statistical analyses were performed using SAS 9.3 and SUDAAN softwares. Alpha used in the study was 0.05. Alveolar defects increased statistically from T1 (69.0%) to T2 (96.5%) and T3 (100%). Dehiscences increased 195% (Relative Risk 2.95) at the end of expansion (T2). After retention (T3), individuals were on average 4.34 times more likely to develop dehiscences (334% increase). Fenestrations did not increase from T1 to T2 (p = 0.0162, 7.9%) and decreased from T2 to T3 (p = 0.0259, 4.3%). Presence of fenestrations at T1 was a significant predictor for the development of dehiscences in T2 and T3. Dehiscences increased significantly in all teeth, except second molars. Conclusion: The null hypothesis was rejected. After SARPE the number of dehiscences increased and fenestrations decreased. Previous alveolar defects were predictor for dehiscences after SARPE.

Purpose To evaluate the effect of vomer position and prevalence of periodontal dehiscence in patients who underwent surgically assisted rapid palatal expansion (SARPE). The null hypotheses were the following: (1) vomer position in the coronal plane does not influence the degree of skeletal and dental expansion; and (2) there is no association between expansion, periodontal dehiscence and vomer position. Methods Twenty-one patients were evaluated before treatment (T0) and immediately after SARPE expansion (T1). After SARPE, the vomer was in the right side in 11 patients and in the left in 10 patients. Skeletal and dental effects were evaluated using CBCT, landmarks and measurements. Results The maxilla and the nasal cavity expanded asymmetrically. The side containing the vomer had less skeletal expansion but more dental tipping. Dehiscence increased significantly from T0 to T1 and was associated with the amount of skeletal displacement, especially when greater than 3.20 mm. In the first premolars region, there was more than 2 mm of asymmetric expansion observed in 38.5% of the patients. Conclusion The null hypotheses were rejected. The side containing the vomer had less skeletal expansion of the maxilla and nasal cavity but more dental tipping. Dehiscence increased after expansion, but there were no differences between sides.