O impacto da Covid-19 na Odontologia – revisão sistemática

This study aimed to review, qualify and summarize the existing evidence on associations and risk factors for Covid-19 during dental treatment and dentists’ knowledge about these risks. After being registered with PROSPERO, the systematic review was carried out in accordance with the PRISMA guidelines, with searches in electronic databases, in specific journals, manual searches and Google Scholar, without language restrictions, from December 2019 to August 2020. Two questions were asked to be investigated: did patients seek dental care in the emergency room and do dentists know the symptoms and the mode of transmission of Covid-19, feeling qualified to attend them? Only 6 articles were included because they met all defined inclusion criteria. It was concluded that endodontic urgencies and emergencies with symptomatic irreversible pulpitis are the most common, consisting of a much higher proportion of dental emergencies during Covid-19 epidemic compared with dental trauma and no-urgent care. Although dentists are aware of the symptoms, mode of transmission, infection controls, and measures in dental clinics, they do not feel confident about the correct measures to be taken to prevent Covid-19 for their staff and patients.

Associação entre obesidade e resultados graves do tratamento em pacientes com COVID-19

The worldwide population is facing a double burden of epidemic, the COVID-19and obesity. This is even more alarming as obesity increases the COVID-19 severity. However, the relationship between obesity and COVID-19 severity is more complex than a simple association with BMI. In particular, obesity has been associated with low death rates in patients with acute respiratory distress syndrome, a fatal comorbidity to COVID-19, possibly due to the obesity paradox. Also, visceral adiposity could be a major risk factor for COVID- -19severity, due to its immune activation component, release of ACE2 and involvement in the cytokine storm, It is also known to correlate with metabolic disorders, low-grade inflammation and higher mortality rates.

Dental implants in aesthetic zone – cases report

Placement of dental implants in the aesthetic zone needs to be planned to consider both atraumatic tooth extraction and the preservation of the socket. The authors presented two clinical cases of patients with indication of dental extraction of the upper central incisor which was planned to use a two-armed lever as atraumatic alveolar preservation technique and managed in two different ways. Case one referred to a traditional approach that included dental extraction, guided bone regeneration, and provisionalization, with a period of healing of 6 months to enable the bone regeneration. Subsequently, it was placed a dental implant TSV 3.7*13 mm (Zimmer Dental). Five months after of clinical and radiographic controls, the second phase was started with the rehabilitation. The second case was about a patient who required dental extractions of maxillary left central incisor due to a fracture of the crown with a poor prognosis, in which the dental extraction was planned to use a two-armed lever. After reclassifying the fresh socket, a dental implant TSV of 3.7 x 13 mm (Zimmer Dental) was placed with modified drilling technique, implant placement resulted in primary fixation with insertion torque level lower than 30 Ncm so the immediate load was not performed. Both patients received a ceramic crown with functional and esthetic results after 16 months of continuous checks and controls. It was concluded that the alveolar preservation in the aesthetic zone is a strategy that starts from the extraction technique. The authors recommend the two-armed lever as atraumatic alveolar preservation technique and different ways to place dental implants.

Próteses parciais fixas metal free em região posterior – revisão da literatura considerando a longevidade, material cerâmico usado e principais falhas

This study aimed to present a literature review with data obtained in vitro and in vivo on metal free partial fixed protheses (PFP) in the posterior region, considering the following variables: ceramic material to be used; prosthesis extension; survival or longevity; main failures found, and comparison with the longevity of conventional metaloceramic PFP. A bibliographical survey was carried out using the databases: United States National Library of Medicine (PubMed) and Scientific Electronic Library Online (Sciello) for articles in English and Portuguese from 1998 to 2019. Articles should meet the inclusion criteria, which were articles that contained information that enabled the calculation of PFPs survival and success, articles with a minimum observation period of 3 years, articles that identified the reason of failures, and studies reported since 1998. Sixteen studies met the inclusion criteria and were evaluated comparatively. The survival rate of the PFP’s varies depending on the ceramic material used and the prostheses extension, no significant difference was observed in the relation between the ceramic material used and the connectors size; however, the greater the extension of the prosthesis, the higher must be the connector size. It was concluded that ceramic materials based on zirconia are the ones that have the longest survival. In addition, the main reasons that lead to decreased survival of PFP’s are secondary caries and connector fracture, however, more studies are needed to determine safely which materials and the extent of PFP’s are the most indicated.

Implante imediato e estética imediata em reabilitação de incisivo central superior fraturado – relato de caso

The use of dental implants in dentistry is becoming increasingly widespread and popular for the treatment of patients with doomed dental elements. The biotechnology applied to the development of macro and micro design of implants allows its use in increasingly borderline beds, such as in post-extraction sockets with reduced bone remainder, and may even allow the making of provisionals in order to confer aesthetics and help in maintenance of support tissues. This paper aims to present a clinical case report of minimally invasive extraction of a maxillary central incisor with root fracture, immediate implantation in a post-extraction socket, subepithelial connective tissue graft and lyophilized bovine bone to fill the GAP, as a pillar installation. angled and immediate provisional. The technique proved to be effective and satisfactory, I try in the aesthetic aspect as to the functional, promoting the health and stability of the adjacent tissues.

Taurodontismo – Série de casos em pacientes jovens não sindrômicos e sindrômicos associado à hipodontia

Several human dentition developmental anomalies are reported in the literature. The etiology of these occurrences is related to genetic, environmental or sometimes idiopathic factors. Taurodontism is defined as apical displacement of the pulp floor and consequent enlargement of the pulp chamber in multiradicular teeth. It is a result of the failure to invaginate Hertwigs epithelial sheath horizontally and commonly expresses bilaterally. This morphological pattern of molars is observed in ruminant animals and was also found in ancient Neanderthals. Association of this condition to syndromes is not exclusive, it may be associated with genetic disorders such as Down Syndrome, Klinefelter Syndrome, among others. The diagnosis is exclusively radiographic, with no alterations in the dental element crown. Among the consequences is the complexity of endodontic treatment, greater fragility of taurodontic teeth submitted to endodontics and lower orthodontic anchorage of these elements. In this paper, three case reports of patients with taurodontism are described, two of them associated with hypodontia and one in a Down Syndrome patient. This paper also includes a literature review and discussion with the main clinical implications of this occurrence.