Endi Lanza Galvão

Association between developmental defects of enamel and celiac disease: A meta-analysis.

OBJECTIVES Studies have observed the presence of extra-intestinal manifestations of celiac disease (CD), including involvement of the oral cavity, such that developmental defects of enamel (DDE) occur. Thus, the aim of this review was to access the polled prevalence of DDE in individuals with CD, and to establish the strength of the association between these two variables. METHODS To carry out the systematic review, four electronic databases and the Grey Literature were searched, complemented by a manual search of reference lists within the selected articles. Two pairs of independent reviewers selected the articles, and perform the data extractions and bias risk assessment Studies evaluating the presence of DDE in individuals with CD as well as in healthy individuals and which performed the DDE diagnosis by direct visualization of tooth enamel changes and the CD diagnosis were included. Meta-analyses were performed using the software R. RESULTS Of 557 studies, 45 were selected for review, encompassing 2840 patients. The prevalence of DDE in people with CD was 50% (95% CI 0.44-0.57, I2 = 88%). In a general analysis, it was observed that patients with CD had a significantly higher prevalence of enamel defects compared to healthy people (RR: 2.31, 95% CI: 1.71-3.12, I2 = 98%). Only developmental defects of enamel diagnosed using Aines method were associated with the disease (RR: 3.30, 95% CI 2.39-4.56, I2 = 75%). In a sensitivity analysis involving the deciduous, mixed and permanent dentitions, only individuals with deciduous dentition were observed to have association with the disease (RR: 2.34, 95% CI 1.25-4.39, I2 = 39%). CONCLUSIONS Patients with enamel developmental defects should be screened for the possibility of their having celiac disease.

Influence of third molars in mandibular fractures. Part 2: mandibular condyle—a meta-analysis

The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and VHL, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 13 studies were included in the systematic review and 11 in the meta-analysis. In terms of the risk of bias analysis, six studies presented ≤6 stars in the Newcastle-Ottawa scale assessment. The presence of a mandibular third molar decreased the probability of condylar fracture (cross-sectional and case-control studies: odds ratio (OR) 0.26, 95% confidence interval (CI) 0.17-0.40, I2=87.8%; case-control studies: OR 0.30, 95% CI 0.16-0.58, I2=91.6%). The third molar positions most favourable to condylar fracture according to the Pell and Gregory classification are class A (OR 1.32, 95% CI 1.09-1.61, I2=0%) and class I (OR 1.37, 95% CI 1.05-1.77, I2=32.8%). Class B (OR 0.69, 95% CI 0.49-0.97, I2=56.0%) and class II (OR 0.71, 95% CI 0.57-0.87, I2=0%) act as protective factors for condylar fracture. The results suggest that the presence of a mandibular third molar decreases the chance of condylar fracture and that the positions of the third molar most favourable for condylar fracture are classes A and I, with classes B and II acting as protective factors.

Asociación entre el Bruxismo y los Niveles de Cortisol Salival: Una Revisión Sistemática

The objective of this study was to verify the existence of an association between daytime and/or nighttime bruxism and the levels of cortisol in patients that carry this parafunction. A systematic review of observational studies were conducted in the following databases: PubMed; OVID and VHL (Virtual Health Library, LILACS, IBECS; MEDLINE and Scielo), until January of 2016 and without language restriction. An evaluation of titles and abstracts was conducted, followed by the full reading of the articles to determine which researches would be included. Observational studies that associated daytime and nighttime bruxism with salivary cortisol levels were included. Evaluation of the methodological quality was performed and extraction of data from the researches included. Two articles were included in this review. One of them showed moderate positive correlation between the BiteStrip scores and the levels of salivary cortisol in patients with bruxism. On the other hand, the other research demonstrated that children with sleep bruxism are more likely to have low levels of salivary cortisol. There is no conclusive evidence of association between bruxism and salivary cortisol.

Third molar removal and its impact on quality of life: systematic review and meta-analysis

ObjectiveThe purpose of this systematic review was to assess the impact of third molar removal on patient’s quality of life.MethodsTo address the study purpose, investigators designed and implemented a systematic review. The primary outcome variable was the quality of life after third molar extraction. An electronic search was conducted through March, 2017, on the PUBMED, Virtual Health Library (VHL), Web of Science, and OVID, to identify relevant literatures. Research studies (randomized or non-randomized clinical trials) were included that evaluated the quality of life in individuals before and after third molar extraction, using validated measures of oral health-related quality of life with quantitative approach, besides procedures performed under local anesthesia. The R software was used to measure the mean difference on the quality of life between the preoperative period and follow-up days.ResultsA total of 1141 studies were identified. Of this total, 13 articles were selected in the present systematic review, of which six studies were included in the meta-analysis. All of these 13 articles used the OHIP-14, and 4 of this 13 used OHQoLUK-16 to evaluate the quality of life. Regarding quality assessment, four of the 13 included studies in this review received a maximum score of 9 points, according to the Newcastle–Ottawa (NOS). The OHIP-14 mean score on the first postoperative day was 17.57 (95% CI 11.84–23.30, I2 = 96%) higher than the preoperative period. On the seventh postoperative day, the quality of life assessed by OHIP-14 got worse again.ConclusionThis systematic review revealed that the highest negative impact on quality of life of individuals submitted to third molar surgery was observed on the first postoperative day, decreasing over the follow-up period.

Third Molar and Their Relationship with Caries on the Distal Surface of Second Molar: A Meta-analysis

PurposeThe aim of this meta-analysis was to determine which characteristics of mandibular third molars (MTMs) are more often associated with an increase in the prevalence/incidence of caries on the distal surface of mandibular second molars (MSMs).MethodsThree electronic databases were analyzed: PubMed; OVID and the Virtual Health Library. Observational studies were included, and the risk of bias was assessed using The Newcastle–Ottawa Scale. The Comprehensive Meta-Analysis software program was used for meta-analysis.ResultsFifteen studies were included in this systematic review, and five were included in the meta-analysis. The distal surface of MSMs were more likely to exhibit caries in the following scenarios: when MTMs were found in the A position, rather than the C position (OR: 3.45, 95% CI: 2.28-5.22, p<0.001); when the horizontal position was compared with the vertical (OR: 8.12, 95% CI: 3.75-17.58, p<0.001) and distoangular (OR: 9.75, 95% CI: 3.49 – 27.25, p<0.001) positions; and when the mesioangular position was compared with the vertical (OR: 7.25, 95% CI: 3.48-15.10, p<0.001) and distoangular (OR: 9.54, 95% CI: 3.47 – 26.21, p<0.001) positions.ConclusionThe results of this study suggest that the presence of MTMs increases the incidence of caries on the distal surface of MSMs. Furthermore, caries on the distal surface of MSMs is more commonly associated with position A and horizontal and mesioangular mandibular molars.

Relationship between sjögren syndrome and periodontal status: A systematic review

OBJECTIVE This study aimed to examine whether Sjögren syndrome (SS) is related to periodontal status. STUDY DESIGN A systematic review was performed on the basis of PRISMA (PROSPERO: CRD42017055202). A search was performed in the PubMed/MEDLINE, LILACS, Web of Science, and Science Direct databases. Hand searches and review of the gray literature were also performed. Three researchers independently selected studies, extracted data, and assessed methodologic quality. Studies that correlated primary and/or secondary SS with plaque index, gingival index, probing depth, and bleeding on probing were included. The risk of bias was estimated on the basis of the Newcastle-Ottawa scale. RESULTS Seventeen studies were included in the review and 9 included in the meta-analysis, with a total of 518 and 544 patients, with or without SS, respectively. The mean difference of plaque index (0.29; 95% confidence interval [CI] 0.17-0.41), gingival index (0.52; 95% CI 0.14-0.89), and bleeding on probing (9.92; 95% CI 4.37-15.47) were larger in patients with SS than in controls. In primary SS (0.47; 95% CI 0.10-0.83) and secondary SS (0.74; 95% CI 0.10-1.38), only the mean gingival index was larger compared with that in control group. The majority of the included studies were judged as having a high risk of bias. CONCLUSIONS The present review did not provide strong evidence that periodontal status is affected by SS.

Prevalence of Maxillofacial Traumas in a Hospital of the Interior of Brazil

Despite important advances in the prevention and treatment of physical trauma, the course of life of millions of people keeps changing every year [1]. Among a variety of types of trauma, the maxillofacial trauma stands out because of its importance, since it may cause aesthetic disfiguration and functional disabilities, besides physical damages [2] with emotional repercussions and the possibility of permanent deformities [3]. In Brazil, the maxillofacial traumas have a strong impact on society, mainly due to its high rates of morbidity and mortality. As it mainly affects the young and economically active age groups, the financial and social cost is significant, besides the resources involved in the treatment of these patients [4]. Therefore, facial trauma is considered a public health problem, related to social, cultural, and economic factors, according to data from the World Health Organization (WHO). The incidence of oral and maxillofacial injuries can be related to geographic region, time, temporal, and climatic influences [5]. In addition, characteristics of the studied population, such as gender, age, alcohol and drug use, domestic violence, and clinical conditions like osteoporosis are other factors that should be considered when evaluating the epidemiology of facial traumas [6-8]. Although there is a large amount of available literature on the epidemiology of facial trauma, the importance of establishing the characteristics related to its occurrence in specific regions has already been highlighted. Thereby, the Jequitinhonha valley, for being a region of recognized health inequality and socioeconomic aggravating factors in the interior of the state of Minas Gerais, Brazil, represents a relevant object of study. Thus, the aim of this study is to evaluate the epidemiological data of patients with maxillofacial trauma treated at the Santa Casa de Caridade de Diamantina hospital, a reference medical center in treating facial traumas in the region, for a period of five years, enabling better public health planning by the responsible authorities of this locality.

Comparison of Bite Force with Locking Plates versus Non-Locking Plates in the Treatment of Mandibular Fractures: A Meta-Analysis

Introduction  Mandibular fractures represent a high percentage of all facial fractures, and the bite force is a fundamental parameter to measure the actual mandibular function and, subsequently, the masticatory efficiency and quality of life. Objectives  The purpose of the present systematic review was to verify if there is any difference in the bite forces of patients with mandibular fractures fixed by locking or non-locking plates, testing the null hypothesis of no difference in this parameter. Data Synthesis  A systematic review of the literature was conducted using four databases (PubMed, Virtual Health Library, Web of Science and Science Direct) without restrictions as to publication date or language. We found 3,039 abstracts, and selected 4 articles for this review. Conclusion  The overall results show better performance in bite force for the locking plates when compared with the non-locking plates in the incisor region (mean deviation [MD]: 1.18; 95% confidence interval [95%CI]: 0.13–2.23), right molar region (MD: 4.71; 95%CI: 0.63–8.79) and left molar region (MD: 10.34; 95%CI: 4.55–16.13). Although the results of this study indicated a better bite force result with the locking plates, there is still no sufficient evidence to support this information safely.