Effect size: a statistical basis for clinical practice

OBJECTIVE: Effect size (ES) is the statistical measure which quantifies the strength of a phenomenon and is commonly applied to observational and interventional studies. The aim of this review was to describe the conceptual basis of this measure, including its application, calculation and interpretation.RESULTS: As well as being used to detect the magnitude of the difference between groups, to verify the strength of association between predictor and outcome variables, to calculate sample size and power, ES is also used in meta-analysis. ES formulas can be divided into these categories: I – Difference between groups, II – Strength of association, III – Risk estimation, and IV – Multivariate data. The d value was originally considered small (0.20 > d ≤ 0.49), medium (0.50 > d≤ 0.79) or large (d ≥ 0.80); however, these cut-off limits are not consensual and could be contextualized according to a specific field of knowledge. In general, a larger score implies that a larger difference was detected.CONCLUSION: The ES report, in conjunction with the confidence interval and P value, aims to strengthen interpretation and prevent the misinterpretation of data, and thus leads to clinical decisions being based on scientific evidence studies.

Intraosseous lipoma: a case report

OBJECTIVE: The objective of this report was to demonstrate main clinical and histopathologic intraosseous mandibular lipoma features by taking a look at a specific case.CASE DESCRIPTION: A case of intraosseous lipoma in the anterior jaw of a 27-year-old woman is reported.CONCLUSION: The treatment of choice was surgical enucleation of the lesion, since recurrences have not been reported in the literature.

Molecular characterization of Streptococcus mutans gtfB gene isolated from families

OBJECTIVE: Caries is a multifactorial infectious disease and the main etiological agent is the bacteria Streptococcus mutans due to its virulence factors, which enable the adherence to dental enamel and favours the formation of dental biofilm through the production of extracellular polysaccharides. The transmission of S. mutans can occur between people, often within families. The present study aimed to evaluate the intrafamily genetic pattern of S. mutans through partial sequencing of the gene that encodes the glucosyltransferase β (gtfB) enzyme.METHODS: We previously analyzed saliva samples from 40 individuals from nine families, and it was obtained 64 isolates biochemically characterized as S. mutans. The isolates were evaluated by random amplification of polymorphic DNA (RAPD). Those with greater similarity were characterized by partial sequence 16S rRNA gene and the gtfB gene sequencing.RESULTS: It was observed genetic similarity among strains isolated from individuals with caries activity; while isolates from individual without caries showed that they are genetically distinct, suggesting a different virulence pattern.CONCLUSION: The present results demonstrated that partial sequencing of the gtfB gene showed to be a potential marker to investigate genetic pattern and virulence of S. mutans, deserving further investigation in order to identify families at risk of caries.

A very difficult farewell editorial

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Musculoskeletal Disorders among Brazilian Dentists in São Paulo

OBJECTIVE: This study aimed at investigating the relationships between health and work-related musculoskeletal disorders (WMSDs) in dentists, and the relationship with socio-demographic, work and health variables.METHODS: We conducted a cross-sectional study of 204 dentists who work in public clinics in the state of São Paulo, Brazil. We used a self-administered survey that included questions on sociodemographic and health aspects, work-related factors, and the Nordic questionnaire.RESULTS: WMSDs were often reported in the neck, shoulder, lower back, and hand/wrists. Logistic regression analysis revealed that there was a correlation between reports of WMSD in the neck and age (OR = 9.48) and health problems (OR = 6.71). Moreover, strong associations were found between MSDs in the shoulders, gender (OR = 5.88) and breaks between appointments (OR = 4.17).CONCLUSION: We concluded that the health problems diagnosed, work-related activities and gender contributed to musculoskeletal disorders in dentists in this clinic.

Excisions of 4 unerupted canines in the mentonian region of the mandible – kisses teeth

OBJECTIVE: Unerupted tooth, also called impacted tooth by some authors, is a dental organ that, even when fully developed did not erupt at the regular time, lying inside the bone completely surrounded by bone tissue or bone and mucosal tissue. The unerupted canines study is very important in dentistry, since successful results depend on early diagnosis for proper treatment management, however, despite the importance of this issue, few studies were found in the literature.CASE DESCRPTION: This paper reported a clinical case of a 14-year-old female patient who had four canines in the mentonian region of the mandible surrounded by a dentigerous cyst. The patient underwent a surgical procedure under general anesthesia for the teeth and dentigerous cyst removal.

Multiple supernumerary teeth in a non-syndromic patient: A case report and review of literature

OBJECTIVE: Supernumerary teeth (ST) are associated with many complications that include tooth impaction, ectopic eruption, and abnormal development of root. The usual treatment is the extraction, although repositioning in the dental arch may sometimes be an alternative. The present study reports the treatment of a case of multiple supernumerary teeth in a non-syndromic patient.CASE DESCRIPTION: A 16-year-old male patient presented two ST in each side of the jaw, detected by panoramic radiography. Syndromes or systemic diseases were not revealed by the anamnesis/ general health history. Cone Beam Computed Tomography (CBCT) showed that the teeth were positioned in the lingual region between the inferior premolars at both right and left sides. Surgical therapy was the treatment of choice, in order to avoid possible eruption.CONCLUSION: An early and accurate diagnosis is extremely important for treatment decision and success, thus avoiding future complications often related to ST.

Human pulp pesponse to Portland cement and MTA

OBJECTIVE: To investigate the pulpal response to direct pulp capping in healthy human teeth with Portland cement (PC) as against mineral trioxide aggregate (MTA) as control.METHODS: Forty healthy human third molars indicated for extraction were randomly divided into two groups: PC and MTA. The teeth had iatrogenic pulp exposed and direct pulp capping with PC or MTA. After 1, 7, 14 and 21 days, the teeth were extracted and prepared for histological examination and bacterial detection. The Mann-Whitney test was applied for statistical analysis (p < 0.05).RESULTS: The MTA presented higher capacity to form of dentin bridges at 14- and 21-day intervals (p < 0.05). However, no significant statistical difference was found between the groups at all evaluated intervals (p > 0.05) for the response variables of inflammatory cells, soft tissue organization and bacterial staining.CONCLUSION: The PC has a biocompatibility equivalent to the MTA but with a lower capacity to form of dentin bridges. Therefore, MTA should be the material of choice for direct pulp capping.

Survival and factors associated with mandibular overdenture fractures with immediate loading

OBJECTIVE: Survival rates of mandibular overdentures on two implants retained by bar-clip system with immediate loading and the factors related to fractures was analyzed.METHODS: Twenty-three subjects were followed for 32 months. Fracture occurrence was the outcome variable, while the thickness of denture base, maxillomandibular space and masticatory efficiency comprised the independent variables.RESULTS: The survival rate was 49.5%, with 34.7% of fractures. There was no association between the independent variables and fractures.CONCLUSION: So, the risk of mandibular overdenture fractures with immediate loading is high. Furthermore, masticatory efficiency, thickness of the denture base and maxillomandibular space did not influence the incidence of fractures.

Recurrent mechanical complications in an implant-supported fixed complete denture: a clinical report

INTRODUCTION: Several factors can lead to mechanical complications in implant-supported fixed complete dentures (IFCD).CASE DESCRIPTION: This clinical report presents a clinical case of a maxillary IFCDP with recurrent mechanical complications and a possible causal interaction between patient’s intrinsic characteristics (bruxism and high occlusal force) and technical procedures (framework design, occlusal adjustment, interocclusal splint, and posterior occlusal support).CONCLUSION: The 3-year follow-up findings highlight the need for a comprehensive and systemic approach to manage a challenging case of an IFCD patient with moderate bruxism and high occlusal force.