Introduction: Temporomandibular joint (TMJ) replacement is usually a last resort in the surgical treatment of end-stage joint disease. For all this gear to work efficiently, occlusion, articulation, ...musculature, ligaments, and psychological factors must be in complete harmony. As a treatment, implantation of a total alloplastic TMJ prosthesis. Objective: It was to demonstrate, through a systematic review, the main considerations and clinical outcomes of the treatment of temporomandibular disorders with different types of prostheses. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2013 to 2023. Results and Conclusion: A total of 127 articles were found, 60 articles were evaluated and 31 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 33 studies that did not meet GRADE. Based on the results, temporomandibular disorders (TMD) treatment is diverse and depends on the type of disease, as well as the duration and subjective level of pain. Alloplastic reconstruction can be advantageous in obtaining a rapid improvement in symptoms and rapid rehabilitation of masticatory function. Treatment of functional TMD is commonly based on conservative therapy, including physical therapy, pain therapy, and splinting therapy. Depending on the severity of TMD, treatment varies according to the degree of surgical invasion. Thus, the TMJ prosthesis seems to be reserved for patients with persistent pain, bone or fibrous ankylosis, or osteomyelitis after primary closed or open treatment of mandibular condyle fractures. Quality of life, mouth opening, and daily eating improved significantly after total TMJ prosthesis.
Introduction: In the setting of orthognathic surgery, malocclusion is the third most common oral health problem after caries and periodontal diseases. Malocclusion is found in ages between 7 and 15 ...years with a prevalence of 6% in Brazil. Objective: The present study aimed to highlight the main considerations and findings of clinical studies on the importance of orthognathic surgery in the correction of anomalies in class III patients. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles with different dates up to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found, 70 articles were evaluated and 56 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 20 studies that did not meet GRADE. Based on the results, the treatment of Class III must be fundamentally based on the diagnosis so that the treatment can be installed in order to correct the compromised structures instead of being compensated in places not affected by this malocclusion. In other words, the degree of involvement of the maxilla and mandible must be evaluated so that the treatment is directed to that bone base and really achieves its goals and impacts of facial improvement. Redirection of growth in Class III cases is indicated as soon as the anomaly is diagnosed, as the displacement processes that occur in the middle face can only be affected with treatment while the growth zones are able to respond to the biomechanical stimulus. Therefore, the younger the Class III patient is treated, the better the facial correction effects.
The teeth together perform the functions of mastication, protection, and support of related soft tissues, help in the articulation of words, and are an important factor in the aesthetics of the face. ...The macro geometry of the implant provides influences on osseointegration. In this sense, the various isolated characteristics (thread type, thread pitch, thread depth, face angle) must be studied so that the implant geometry can balance the compressive stress and tensile stress and produce a minimum shear force. The present study aimed to carry out a concise systematic review of the main considerations of dental balance in the arches in implant dentistry. Thus, knowledge of the direction of the teeth is of great importance in clinical implant dentistry for the correct installation of implants, which are very important for maintaining the balance of forces exerted by masticatory muscles (masseter muscle, temporal muscle, medial pterygoid muscle). In addition to this, the evaluation of the amount and density of bone available in the patient's edentulous site. It was concluded that the optimized aesthetic positioning of the implant presents numerous factors for the good aesthetic performance of an implant-supported prosthesis. The main conditions of the soft tissues, the amount of bone, and the location and inclination of the placed implant can be cited as the main ones. The correct positioning of the implant is linked to the location and axial inclination of the implant, aiming to favor the emergence profile and aesthetic contours of the prosthesis. The ideal location for the implant would be the one assumed by the lost tooth root. Also, the location of the height of the cervical portion of this implant concerning the adjacent teeth is important for determining the prosthetic space available for making the restoration, as well as its emergence profile and the biological space of the surrounding soft tissues.
The purpose of this work was to determine the proximate composition and fatty acid profiles of the Gastrocnemius pars interna intramuscular fat (IMF) of rhea (Rhea americana) thighs. The birds were ...bred in captivity, fed with balanced feed (Nutriavestruz Crescimento - Purina) and kept in a pen with grass ad lib. The birds of both sexes used in the research weighed 23 kg on average and were aged about twelve (12) months old. They were subjected to hydric diet (12 h) before slaughtering by electric shock. The rhea meat showed an average moisture, protein, ash and total lipid contents of 74.1%, 22.8%, 1.5% and 1.6%, respectively. It was noticed the predominance of monounsaturated fatty acids (MUFA) in intramuscular fat (IMF), 42.3% and a high percentage of polyunsaturated fatty acids (PUFA), 29.7%. The fatty acids found in higher proportion in rhea IMF were: 18:2n-6 (24.33%), 18: ln-9 (19.25%), 16:0 (13.70%), 22: ln9 (11.40%), 18:0 (10.66%), 15: ln-10 (8.62%), 24: ln-9 (2.90%) and 20:4n-6 (1.72%). The PUFA/SFA and n-6/n-3 ratios were 1.06 and 31.30, respectively. The consumption of rhea meat is a healthy alternative to red meat as it points to a lower susceptibility to cardiovascular diseases caused by the high consumption of fat comparatively to the consumption of meat from most domesticated animals.
Introduction: Cardiovascular diseases (CVD) are the leading cause of death worldwide. The number of tooth extraction patients with cardiovascular disease in our country is increasing year by year. ...Blood pressure control, determination of cardiac function, recognition of arrhythmias, glycemic control, and use of antiplatelet agents or oral anticoagulants need to be investigated. Objective: It was to carry out a concise systematic review of the main relationships of tooth extraction in patients with cardiovascular diseases, to emphasize the main risk predictors. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to March 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2009 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 124 articles were found, 38 articles were evaluated and 24 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 40 studies that did not meet GRADE. It was concluded that the cardiovascular response of elderly outpatients with systemic diseases during tooth extraction is quite significant. Age, sex, systemic diseases, and some tooth extractions may be risk factors closely associated with cardiovascular response. It is necessary for the dental treatment of these patients with heart disease a good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.
ObjectivesPrompt diagnosis of acute coronary syndrome (ACS) remains a challenge, with presenting symptoms affecting the diagnosis algorithm and, consequently, management and outcomes. This study ...aimed to identify sex differences in presenting symptoms of ACS.DesignData were collected within a prospective cohort study (EPIHeart).SettingPatients with confirmed diagnosis of type 1 (primary spontaneous) ACS who were consecutively admitted to the Cardiology Department of two tertiary hospitals in Portugal between August 2013 and December 2014.ParticipantsPresenting symptoms of 873 patients (227 women) were obtained through a face-to-face interview. Outcome measures: Typical pain was defined according to the definition of cardiology societies. Clusters of symptoms other than pain were identified by latent class analysis. Logistic regression was used to quantify differences in presentation of ACS symptoms by sex.ResultsChest pain was reported by 82% of patients, with no differences in frequency or location between sexes. Women were more likely to feel pain with an intensity higher than 8/10 and this association was stronger for patients aged under 65 years (interaction P=0.028). Referred pain was also more likely in women, particularly pain referred to typical and atypical locations simultaneously. The multiple symptoms cluster, which was characterised by a high probability of presenting with all symptoms, was almost fourfold more prevalent in women (3.92, 95% CI 2.21 to 6.98). Presentation with this cluster was associated with a higher 30-day mortality rate adjusted for the GRACE V.2.0 risk score (4.9% vs 0.9% for the two other clusters, P<0.001).ConclusionsWhile there are no significant differences in the frequency or location of pain between sexes, women are more likely to feel pain of higher intensity and to present with referred pain and symptoms other than pain. Knowledge of these ACS presentation profiles is important for health policy decisions and clinical practice.
Introduction: In the context of implantology, bone regeneration is a science that aims to recover bone elevation for dental implants, with its main focus being the stomatognathic system. The ...treatment of oral rehabilitation with implants obtained a substantial evolution through the concept of osseointegration. A physiological process of peri-implant bone remodeling was observed during numerous investigations related to osseointegration and implantology. And, specific immune cells such as macrophages play a crucial role in the dynamics of osseointegration. Objective: to present the main approaches and clinical results on the process of bone regeneration, osseointegration, and saucerization in the implantology scenario through a systematic review of the literature. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The total of 156 articles were found. A total of 74 articles were fully evaluated and 20 were included in this study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 50 studies that were excluded with a high risk of bias (studies with a small sample size). Also, 12 studies were excluded because they did not meet the GRADE. Based on the objective of the present study, it was concluded that bone saucerization around osseointegrated implants represents a fundamental process for dental implant success, and with a controlled immunological process.
Introduction: In the work of implant placement in the post-extraction of single teeth, the esthetic zone has been a topic of great interest in the last 4 decades. Significant advances are being made ...in tissue biology knowledge in terms of post-extraction hard and soft tissue changes, helping to better understand the etiology of these esthetic complications. Objective: The present study carried out a concise systematic review of the tooth extraction process in light of minimally invasive extraction to preserve the esthetic area. Methods: The present study followed a concise systematic review model, following the rules of systematic review – PRISMA. The search strategy was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 104 studies were found and, after that, 36 studies of high to medium quality. As a result, it became evident that the extraction of a tooth initiates a series of reparative processes involving hard tissue (alveolar bone) and soft tissue (periodontal), gingiva). Alveolar bone changes after tooth extraction can compromise prosthetic rehabilitation. Alveolar ridge preservation has been proposed to limit these changes and improve prosthetic and esthetic results when implants are used. Alveolar ridge preservation techniques can minimize the overall changes in residual ridge height and width six months after extraction, but the evidence is very uncertain. There is no evidence of differences in the need for additional augmentation at the time of implant placement, implant failure, esthetic outcomes, or any other clinical parameters due to a lack of long-term information or data.
The incidence of acute kidney injury in pregnancy declined significantly over the second half of the 20th century; however, it is still associated with major maternal and perinatal morbidity and ...mortality. A set of systemic and renal physiological adaptive mechanisms occur during a normal gestation that will constrain several changes in laboratory parameters of renal function, electrolytes, fluid and acid-base balances. The diagnosis of acute kidney injury in pregnancy is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate are not validated in this population. During the first trimester of gestation, acute kidney injury develops most often due to hyperemesis gravidarum or septic abortion. In the third trimester, the differential diagnosis is more challenging for the obstetrician and the nephrologist and comprises some pathologies that are reviewed in this article: preeclampsia/HELLP syndrome, acute fatty liver of pregnancy and thrombotic microangiopathies.
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