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A nationwide survey of dentists was carried out in Brazil, a new pandemic epicenter, to analyze how dental care coverage has been affected in public versus private networks, changes in routine and burdens, and how local prevalence of COVID-19 affects dental professionals. Dentists were recruited via email and Instagram®. Responses to a pre-tested questionnaire were collected May 15–24, 2020. COVID-19 case/death counts in the state where respondents work was used to test associations between contextual status and decreases in weekly appointments, fear of contracting COVID-19 at work, and current work status (α = 0.05). Over 10 days, 3,122 responses were received (response rate ~2.1%) from all Brazilian states. Work status was affected for 94%, with less developed regions being more impacted. The pandemic impact on clinical routine was high/very high for 84%, leading to varied changes to clinic infrastructure, personal protective equipment use, and patient screening, as well as increased costs. COVID-19 patients had been seen by 5.3% of respondents; 90% reported fearing contracting COVID-19 at work. Multilevel models showed that greater case and death rates (counted as 1000 cases and 100 deaths per million inhabitants) in one’s state increased the odds of being fearful of contracting the disease (18% and 25%). For each additional 1000 cases/100 deaths, the odds of currently not working or treating only emergencies increased by 36% and 58%. The reduction in patients seen weekly was significantly greater in public (38.7±18.6) than in private clinics (22.5±17.8). This study provides early evidence of three major impacts of the pandemic on dentistry: increasing inequalities due to coverage differences between public and private networks; the adoption of new clinical routines, which are associated with an economic burden for dentists; and associations of regional COVID-19 incidence/mortality with fear of contracting the disease at work.

It is known that stem cells from exfoliated deciduous teeth (SHED) can be induced to differentiate into odontoblasts. However, the nature of dentin-derived morphogenic signals required for dental pulp stem cell differentiation remains unclear. The hypothesis underlying this work is that dentin-derived Bone Morphogenetic Proteins (BMP) are necessary for the differentiation of SHED into odontoblasts. We observed that SHED express markers of odontoblastic differentiation (DSPP, DMP-1, MEPE) when seeded in human tooth slice/scaffolds and cultured in vitro, or implanted subcutaneously into immunodeficient mice. In contrast, SHED cultured in deproteinized tooth slice/scaffolds, or scaffolds without a tooth slice, do not express these markers. SHED express the BMP receptors BMPR-IA, BMPR-IB, and BMPR-II. Notably, blockade of BMP-2 signaling inhibited the expression of markers of odontoblastic differentiation by SHED cultured in tooth slice/scaffolds. Collectively, this work demonstrates that dentin-derived BMP-2 is required to induce the differentiation of SHED into odontoblasts.

The unicellular parasite Trypanosoma brucei is transmitted between mammals by tsetse flies. Following the discovery that flagellar phosphodiesterase PDEB1 is required for trypanosomes to move in response to signals in vitro (social motility), we investigated its role in tsetse flies. Here we show that PDEB1 knockout parasites exhibit subtle changes in movement, reminiscent of bacterial chemotaxis mutants. Infecting flies with the knockout, followed by live confocal microscopy of fluorescent parasites within dual-labelled insect tissues, shows that PDEB1 is important for traversal of the peritrophic matrix, which separates the midgut lumen from the ectoperitrophic space. Without PDEB1, parasites are trapped in the lumen and cannot progress through the cycle. This demonstrates that the peritrophic matrix is a barrier that must be actively overcome and that the parasite’s flagellar cAMP signaling pathway facilitates this. Migration may depend on perception of chemotactic cues, which could stem from co-infecting parasites and/or the insect host. Trypanosoma brucei probably relies on chemotactic signals for movement through tsetse fly tissues, but the molecular basis is unknown. Here, the authors show that flagellar cAMP signaling is required for traversal of the peritrophic matrix and that, without it, parasites are trapped in the midgut lumen.

ObjectiveThis study aims to conduct a systematic review to determine the prevalence of halitosis in adolescents and adults.MethodsElectronic searches were performed using four different databases without restrictions: PubMed, Scopus, Web of Science, and SciELO. Population-based observational studies that provided data about the prevalence of halitosis in adolescents and adults were included. Additionally, meta-analyses, meta-regression, and sensitivity analyses were conducted to synthesize the evidence.ResultsA total of 584 articles were initially found and considered for title and abstract evaluation. Thirteen articles met inclusion criteria. The combined prevalence of halitosis was found to be 31.8% (95% CI 24.6–39.0%). Methodological aspects such as the year of publication and the socioeconomic status of the country where the study was conducted seemed to influence the prevalence of halitosis.ConclusionsOur results demonstrated that the estimated prevalence of halitosis was 31.8%, with high heterogeneity between studies. The results suggest a worldwide trend towards a rise in halitosis prevalence.Clinical relevanceGiven the high prevalence of halitosis and its complex etiology, dental professionals should be aware of their roles in halitosis prevention and treatment.

ObjectivesThis study investigated the impact in survival, when repair is seen as failure or not, in anterior composite restorations with a retrospective 15-year follow-up study.Materials and methodsData was collected from patients’ files of a private dental practice, including patients with direct composite restorations placed in anterior teeth (class III, class IV, or veneer) between January 1994 and December 2009. Data were analyzed considering or not repair as failure. Statistical analysis was performed with log rank test, Kaplan–Meier, and Cox regression (p < .05).ResultsOne hundred forty-four patients’ files were included, with 634 restorations. At 15 years, Class III / IV restorations showed 69% survival and 2.4% annual failure rate (AFR) when repair was not considered as failure, and 64% and 2.9% AFR, respectively, when repair was seen as failure. For direct veneers, at 5 and 10 years of follow-up, survival dropped from 85% to 74% and from 52% to 38% respectively, when repair was considered as failure. In general, restorations placed in the upper jaw showed increased risk for failure compared to the lower jaw (p < .01), and restorations in central incisors presented a higher risk for failure compared to canines (p < .01).ConclusionComposite repair seems a suitable alternative for class III, class IV, and veneer restorations since it was able to increase the survival of restorations performed in anterior teeth.Clinical relevanceComposite repair for anterior restorations is a suitable restorative treatment option and presents benefits over replacement, including the preservation of sound tooth structures, reduced clinical chair time, and patient anxiety.

The association between periodontitis and lifestyle factors has been widely investigated. However, an association between periodontitis and dietary patterns has not been explored. Therefore, this study investigated the association between periodontitis and food consumption among a Southern Brazil population. Data from the 1982 Pelotas Birth Cohort were used (n = 537). The exposure, periodontitis, was clinically measured and classified using the AAP/CDC system, then two latent variables were defined: ‘initial’ and ‘moderate/severe’ periodontitis. The consumption of in natura, processed, and ultra-processed foods (NOVA classification) was the outcome and measured in calories using the food frequency questionnaire (FFQ). Confounders were sex, maternal education, smoking status, xerostomia, and halitosis. Data were analyzed by structural equation modeling. ‘Initial’ periodontitis was associated with a higher consumption of in natura food (standardized coefficient (SC) 0.102; p-value = 0.040), versus processed (SC 0.078; p-value = 0.129) and ultra-processed (SC 0.043; p-value = 0.400) foods. ‘Moderate/severe’ periodontitis was associated with higher consumption of ultra-processed foods (SC 0.108; p-value = 0.024), versus processed (SC 0.093; p-value = 0.053) and in natura (SC 0.014; p-value = 0.762) foods. ‘Moderate/severe’ periodontitis appears to be associated with the consumption of processed and ultra-processed foods.

•In an older population, studied during two time periods (2014 and 2019–2020), the prevalence of thinness increased.•In terms of waist circumference, more older people had increased than decreased waist circumference.•It was observed that older people aged ≥80 y had the greatest odds of losing body mass compared with those ages 60 to 69 y. The aim of this study is to assess the changes in body mass index and waist circumference (WC) and their associations with sociodemographic, behavioral, and health characteristics in non-institutionalized older people in southern Brazil over a period of ≤6 y. : This is a prospective study, with interviews conducted in 2014 and in 2019 to 2020. Of the 1451 individuals from Pelotas, Brazil, aged >60 y and interviewed in 2014, 537 were reevaluated in 2019 to 2020. An increase or decrease was defined as a variation of ≥5% in body mass index and WC in the second visit compared with the first. The association with changes in outcomes was assessed according to sociodemographic, behavioral, and health characteristics using multinomial logistic regression. Approximately 29% of the older participants lost body mass. Regarding WC, there was an increase in 25.6% in the older participants. The older participants ages ≥80 y had greater odds of losing body mass (odds ratio [OR] = 4.73; 95% confidence interval [CI], 2.29–9.76) and of reducing WC (OR = 2.84; 95% CI, 1.59–6.94). Former smokers had, on average, 41% and 64% lower odds of losing and gaining body mass (95% CI, 0.37–0.95 and 95% CI, 0.19–0.68, respectively), and those who were on ≥5 medications had greater odds of gaining body mass (OR = 1.92; 95% CI, 1.12–3.28) and WC (OR = 1.79; 95% CI, 1.18–2.74). Despite the high proportion of older people who kept their body mass index and WC stable during this period, many of them lost body mass and gained WC. The findings also highlighted the importance of age in the nutritional changes observed in the population.

As an important historical relic of human being, masonry pagoda is the great significance in the eastern and western architectural cultures. Most of the existing masonry pagodas in China which have been seriously damaged urgently need detailed structural safety assessment, repair and reinforcement. The paper choose a Chinese masonry pagoda as a case, conducted a series simulation analysis with Abauqs. Through numerical simulation, the seismic performance of the pagoda can be evaluated, which can not only predict the hidden danger and weak link in its structure, but also provide useful reference for the reinforcement and repair of the pagoda. It also adopts a very convenient 3D CAD method to quickly assess the seismic vulnerability of existing masonry pagoda according the reference.

Purpose To investigate if facial and dental satisfaction is related to body fat percentage and body weight satisfaction. Methods A self-administered questionnaire was applied to adolescents from a Private School in Southern Brazil containing sociodemographic (sex and age) and self-perception variables. Adolescents were asked about their perceptions concerning dental problems. Body fat percentage was collected using bioelectrical impedance analysis. Results A total of 372 adolescents were examined. Most adolescents were satisfied with their dental (81.7%) and facial appearance (87.6%), while 39% of adolescents were satisfied with their body weight. Poisson regression model showed that adolescents who expressed satisfaction with their body weight (PR = 1.12, 95%CI 1.06–1.19) and were satisfied with their dental appearance (PR = 1.24, 95% CI 1.08–1.41) exhibited a positive association with facial satisfaction. Adolescents dissatisfied with dental color (PR = 0.88, 95%CI 0.80–0.97), those reporting dental pain (PR = 0.88, 95%CI 0.80–0.97), and individuals with obesity (PR = 0.91, 95%CI 0.83–0.99) demonstrated a decrease in facial satisfaction. Adolescents aged 16 to 19 years (PR = 1.08, 95% CI 1.01–1.15) and those satisfied with their facial appearance (PR = 1.20, 95%CI 1.01–1.43) exhibited a higher prevalence of dental satisfaction. Conversely, adolescents dissatisfied with dental color (PR = 0.74, 95% CI 0.66–0.82) and those with misaligned teeth (PR = 0.63, 95%CI 0.55–0.73) reported lower levels of dental satisfaction. Parametric g-formula analysis found that the association between body fat and facial satisfaction was mediated by body weight satisfaction ( p  = 0.001). Conclusions While dental satisfaction was not influenced by corporeal characteristics, facial satisfaction was influenced by dental and body weight satisfaction. Obese adolescents had low facial satisfaction.

This pilot study explores the barriers to adherence to follow-up among women with cervical precancer in urban Cameroon. While follow-up of women with a positive screening of cervical precancer is the most important aspect of cervical cancer secondary prevention, women with cervical precancer do not adhere frequently to recommended follow-up schedule in Cameroon. The aim of the study was to explore and describe the barriers and facilitators to follow-up for cervical precancer among women infected and uninfected with HIV in Cameroon. A qualitative research design was used to answer the research questions. Participants included eight HIV-infected and -uninfected women diagnosed with cervical precancer and 19 nurses. Data were collected by in-depth individual patient interviews and focus groups with nurses. An interview guide with open-ended questions, using the social ecological model as a framework, included questions that addressed the complexities of the lives of individuals and professionals within a relational context. The interviews were audio-taped and transcribed verbatim in English language. Thematic analysis of data was completed with no epistemological or theoretical perspective underpinning the analyses. Four major themes emerged from the study. They were clinic, personal, and social barriers, and strategies to improve follow-up. The use of reminder phone calls and fee reduction, coupled with peer counseling and navigation of women who have been diagnosed with cervical precancer, could be effective ways of improving adherence to follow-up. Further research is needed to explore the same phenomenon among women in rural areas, especially those who were initially attended to in mobile clinics.