Daniel dos Santos

Effects of platelet-rich plasma in association with bone grafts in maxillary sinus augmentation: a systematic review and meta-analysis.

This systematic review evaluated the effect on bone formation and implant survival of combining platelet-rich plasma (PRP) with bone grafts in maxillary augmentation. A comprehensive review of articles listed in the PubMed/MEDLINE, Embase, and Cochrane Library databases covering the period January 2000 to January 2015 was performed. The meta-analysis was based on bone formation for which the mean difference (MD, in millimetres) was calculated. Implant survival was assessed as a dichotomous outcome and evaluated using the risk ratio (RR) with 95% confidence interval (CI). The search identified 3303 references. After inclusion and exclusion criteria were applied, 17 studies were selected for qualitative analysis and 13 for quantitative analysis. A total of 369 patients (mean age 51.67 years) and 621 maxillary sinus augmentations were evaluated. After the data analysis, additional analyses were performed of the implant stability quotient, marginal bone loss, and alveolar bone height measured by MD. The results showed no significant difference in implant stability (P=0.32, MD 1.00, 95% CI -0.98 to 2.98), marginal bone loss (P=0.31, MD 0.06, 95% CI -0.05 to 0.16), alveolar bone height (P=0.10, MD -0.72, 95% CI -1.59 to 0.14), implant survival (P=0.22, RR 1.95, 95% CI 0.67-5.69), or bone formation (P=0.81, MD -0.63, 95% CI -5.91 to 4.65). In conclusion, the meta-analysis indicates no influence of PRP with bone graft on bone formation and implant survival in maxillary sinus augmentation.

Electrical activity of the orbicularis muscles before and after installation of ocular prostheses

This study examined the electrical activity of the superior (SO) and inferior (IO) orbicularis oculi muscles before and after installing ocular prostheses in patients who had undergone unilateral enucleation. Twelve volunteers requiring prostheses were selected. Their electrical activity was monitored at rest and during normal opening and closing of the eyelids, rapid opening and closing of the eyelids, and squeezing. Data were recorded before and 7, 30, and 60 days after the ocular prosthesis was installed. Two-way analysis of variance was performed to verify whether there were any significant differences between the muscles and periods, and means were compared by Tukey-Kramer honestly significant difference (HSD) tests (P < 0.05). Results from the initial period differed significantly from those after prosthesis installation in all clinical situations. The SO had significantly higher electrical activity levels than the IO in all clinical situations but squeezing. The authors observed the same values during the initial period for the condition of rest (SO 8.42/IO 5.93) and the highest values for the condition of squeezing after 60 days (SO 131.50/IO 117.12). Rehabilitative treatment promoted an increase in the electrical activity of the orbicularis oculi muscles, restoring part of the muscle tone and motor function to muscles of the affected area.

Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to compare the survival rate of the implants and the peri-implant tissue changes associated with implants inserted in fresh extraction sockets and those inserted in healed sockets. This review has been registered at PROSPERO under the number CRD42016043309. A systematic search was conducted by two reviewers independently in the databases PubMed/MEDLINE, Embase, and the Cochrane Library using different search terms; articles published until November 2016 were searched for. The searches identified 30 eligible studies. A total of 3,049 implants were installed in a total of 1,435 patients with a mean age of 46.68 years and a minimum of 6 months of follow-up. The survival rate of delayed implants (98.38%) was significantly greater than immediate implants (95.21%) (p=.001). For the marginal bone loss (p=.32), implant stability quotients values (p=.44), and pocket probing depth (p=.94) there was no significant difference between the analysed groups. The immediate implants placed in fresh sockets should be performed with caution because of the significantly lower survival rates than delayed implants inserted in healed sockets.

Nutritional intake and overall diet quality of female soccer players before the competition period

Objective: To assess the dietary intake and overall diet quality of female soccer players before the competitive games. Methods: This descriptive and cross-sectional study included 21 women aged 20.8±4.5 years from a professional soccer team. Their nutritional status and dietary adequacy during the training period, before competition season, were assessed. Dietary intake was assessed by three 24-hour recalls, one food frequency questionnaire, and the Healthy Eating Index, an overall diet quality index based on food group intake. Results: The athletes have shown proper nutritional status, but a diet deficient in energy due largely to low carbohydrate intake. On the other hand, the intakes of protein, fatty acids, and sodium were above the recommended intakes, even for athletes. Diet quality assessment by the Healthy Eating Index - 2010 resulted in a mean score of 54.6 points of a maximum of 100, indicating a need of improving the overall diet quality. Conclusion: The study found that the dietary patterns of female football players were both quantitatively and qualitatively inappropriate. A nutritional intervention is indicated to improve diet quality, with the inclusion of various foods, such as whole grains, fruits, vegetables, dairy products, and better protein quality, along with a reduction in saturated fats, sodium, and added sugar.

Clinical viability of single implant-retained mandibular overdentures: a systematic review and meta-analysis

The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and Cochrane databases was performed (end date July 2017); this was supplemented by a manual search of the literature. Only prospective clinical trials and randomized controlled trials (RCTs) that evaluated SIMO with a minimum follow-up of 12 months were included. The meta-analysis was based on the Mantel-Haenszel method. Dental implant and prosthetic failure were the dichotomous outcome measures; these were evaluated through the risk ratio (RR) and odds ratio (OR), with corresponding 95% confidence intervals (CI). Of 499 articles identified, nine fulfilled the inclusion criteria. A total of 205 implants were placed in patients with a mean age of 64.1 years; the cumulative survival rate was 96.6% over a mean follow-up period of 37.3 months. The procedure used (SIMO vs. two implant-retained mandibular overdenture) did not affect dental implant failure (P=0.45) or prosthetic failure (P=0.65): RR 1.06 (95% CI 0.91-1.23) and RR 0.88 (95% CI 0.51-1.51), respectively; OR 2.56 (95% CI 0.27-24.39; P=0.41) and OR 0.44 (95% CI 0.15-1.26; P=0.13), respectively. Within the limitations of this systematic review and meta-analysis, SIMO with a complete denture as the opposing arch may be considered an alternative treatment for completely edentulous patients. However, this study also confirmed the need for more RCTs on this topic.

Response to the Letter to the Editor on “Comparison between flapless and open-flap implant placement: a systematic review and meta-analysis”

Department of Dental Materials and Prosthodontics Aracatuba Dental School UNESP – Universidade Estadual Paulista

Evaluation of the papilla level adjacent to implants placed in fresh, healing or healed sites: A systematic review

A better understanding of factors that can lead to papilla formation or recession, such as the type of site where the implant was placed, is of fundamental importance to the aesthetic success of the rehabilitation. The aim of this study was to perform a systematic review of the literature regarding the formation or recession of papilla adjacent to implants placed in fresh, healing or healed sites. The protocol for this study was registered in the PROSPERO database (registration number CRD 42016033784). An electronic search was performed by two independent reviewers who applied the inclusion and exclusion criteria on the PubMed/MEDLINE, Scopus, and Embase databases from January 2005 up to February 2016. The initial screening yielded 1,065 articles, from which 15 were selected for a systematic review after applying the inclusion and exclusion criteria. Nine studies compared fresh and healed sites, four studies compared healing and healed sites, one study compared fresh and healing sites, and one study analysed all three sites. The majority of studies identified by this systematic review showed no difference between groups after the longer follow-up period. The sites where the implants were placed did not have a long-term influence on papilla formation or recession.

Efeitos do exercício físico regular sobre o perfil bioquímico e a capacidade aeróbia máxima na doença de Chagas: estudo de caso

O presente estudo teve como objetivos identificar alteracoes sobre a composicao corporal (percentual de gordura e peso total), parâmetros bioquimicos (Triglicerides, Colesterol Total, HDL-C, Glicose) e capacidade aerobia maxima (VO2 max.) nas fases pre e pos-treinamento em um sujeito acometido pela doenca de Chagas. Foi realizado um estudo de caso com uma paciente (sexo feminino, 53 anos, 74 kg, 163 cm, 29,07 % gordura) portadora da doenca de Chagas. Apos uma avaliacao clinica medica, a mesma foi submetida a uma avaliacao antropometrica, aerobia e bioquimica. O programa de exercicios fisicos teve a duracao de oito semanas, no qual a paciente foi submetida a sessoes de atividade aerobia (caminhada) e sessoes de treinamento resistido (musculacao). Apos o termino do programa de exercicios, os dados foram avaliados e a partir dai realizou-se uma analise descritiva dos mesmos. Os dados obtidos apontam uma melhoria do VO2 max. comparando os valores pre e pos-treinamento (20,36 e 26,44 ml.Kg-1.min-1); reducao dos valores triglicerides (375 e 150 mg/dl), percentual de gordura (29,07 e 28,30 %), peso total (74 e 71,1 kg), circunferencia abdominal (respectivamente (102 e 94,5 cm) e aumento do HDL-C (43 e 46 mg/dl). Em relacao ao COL-T, por motivos a serem investigados em estudos posteriores, percebeu-se um aumento quando comparados os valores pre e pos-treinamento (176 e 203 mg/dl). Conclui-se que o treinamento fisico aerobio, associado ao treinamento resistido, individualizado e com intensidade moderada para a portadora da doenca de Chagas, melhorou a capacidade funcional aerobia, promoveu alteracoes sobre a composicao corporal e perfil lipidico, inclusive diminuindo os fatores de risco para complicacoes cardiovasculares.

Modulação do perfil lipídico e da glicemia de ratos diabéticos submetidos a treinamento anaeróbio de alta intensidade

O objetivo deste estudo foi verificar a resposta de variaveis bioquimicas, como: glicemia colesterol total, LDL colesterol e triglicerides em ratos diabeticos. Iniciaram o protocolo de treinamento 60 ratos Wistar machos diabeticos, que foram subdivididos em quatro grupos: diabetico sedentario (DS) n= 15, diabetico treinado (DT) n= 15, sadio treinado (ST) n= 15 e sadio sedentario (SS) n= 15. Durante cinco semanas os animais dos grupos DT e ST foram submetidos a um protocolo de treinamento de natacao de intensidade anaerobia (lactato acima 7mM), que consistiu em tiros intervalados de 60 a 120 segundos, com intervalos passivos de dois minutos, totalizando 50 minutos para cada sessao de treino, suportando sobrecarga progressiva equivalente a 30% de sua massa corporea. O coeficiente minimo para constatacao de diferenca significativa usada foi (p < 0,05). As concentracoes de glicemia entre os grupos diabeticos experimentais e nao-experimentais apresentaram diferencas significativas e entre os grupos DS e DT na fase pos-treinamento (237 ± 9 mg dl-1 e 178,5 ± 31 mg dl-1). Para triglicerides, nota-se a diferenca significantemente mais baixa para DT, chegando proximo da normalidade (236 ± 45 mg dl-1), comparado ao grupo DS (386 ± 28 mg dl-1). Nao foram encontradas diferencas para Col -T e LDL, variaveis estas que se mantiveram em valores normais (101 ± 21 mg dl-1* ; 68,6 ± 15 mg dl-1 e 57 ± 3,5 mg dl-1; 42,1 ± 2 mg dl-1). Conclui-se que o modelo empregado foi eficiente em promover alteracoes em algumas variaveis do perfil lipidico e na glicemia, em curto periodo de tempo, demonstrando-se mais eficaz que modelos de treinamento aerobio anteriormente apontados pela literatura.