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"Tavares, Rodrigo"
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Efficacy of dental floss in the management of gingival health: a randomized controlled clinical trial
Abstract ObjectivesThis randomized controlled clinical trial evaluated the efficacy of dental floss as a supplement to toothbrushing in support of gingival health in adults.Materials and methodsSeventy-five systemically healthy subjects, non-smokers, without loss of interproximal periodontal attachment and with more than 15% of the interproximal sites presenting with gingival bleeding were randomized into two groups either performing toothbrushing supplemented by dental floss (TB + DF) or toothbrushing (TB) alone. Over a 60-day period, participating subjects weekly received oral hygiene instruction and supervised personal and professional plaque removal by applying the devices assigned for the group. Study subjects were instructed to perform toothbrushing twice daily (group TB + DF and TB) and use dental floss once daily (group TB + DF). Gingival Index (GI) and Plaque Index (PlI) were evaluated at baseline, and at 30 and 60 days. Linear mixed models were used to compare PlI and GI intra- and intergroup means.ResultsInterproximal gingival inflammation (GI = 2 and mean GI) was significantly reduced in both groups by day 30, reduction in inflammation being significantly greater in the TB + DF compared with the TB alone group. No further significant alterations were observed by day 60. Moreover, reduction in gingival inflammation (GI = 2) was greater in the anterior compared with the posterior dentition.ConclusionsInterproximal gingival inflammation may be significantly reduced by toothbrushing alone, the effect being significantly enhanced when toothbrushing is combined with dental floss.Trial registrationThe protocol registration was filed on May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov and after complete registration, a NCT number was generated (NCT04909840). Since the date in May 2018 when the protocol preregistration was filed, no change in methodology, primary outcome, and data analysis has occurred.Clinical relevanceOptimized personal oral hygiene routines in individuals without loss clinical attachment interproximal should include dental floss as a supplement to toothbrushing in support of gingival health.
Journal Article
Effective simulation of the mechanics of longitudinal tensile failure of unidirectional polymer composites
An efficient computational model to simulate tensile failure of both hybrid and non-hybrid composite materials is proposed. This model is based on the spring element model, which is extended to a random 2D fibre packing. The proposed model is used to study the local stress fields around a broken fibre as well as the failure process in composite materials. The influence of fibre strength distributions and matrix properties on this process is also analysed. A detailed analysis of the fracture process and cluster development is performed and the results are compared with experimental results from the literature.
Journal Article
Association between periodontitis and glycated hemoglobin levels in individuals living in rural Southern Brazil
Objectives
To estimate the prevalence of prediabetes in individuals with moderate or severe periodontitis and to verify the association between periodontitis and glycated hemoglobin levels.
Material and methods
A cross-sectional study was conducted including individuals age 18–93 years from a representative sample residing in rural Southern Brazil. Data collection included full mouth periodontal clinical examinations, laboratory screens, and structured questionnaires. Glycemic levels were based on glycated hemoglobin. Periodontitis case definition was based on criteria established by the Centers for Disease Control and Prevention and the American Academy of Periodontology. A logistic regression model adjusted for body mass index was used to estimate odds ratios (OR) and 95% confidence intervals (CI). The association between periodontal parameters and changes in glycated hemoglobin levels was evaluated using linear regression models.
Results
A higher prevalence of prediabetes was observed among individuals with moderate (39.6%) and severe periodontitis (49.7%) than in individuals with mild (23.8%) or no periodontitis (27.8%). Adjusting for body mass index, individuals with severe periodontitis exhibited a 2.5 greater chance of being prediabetic (OR=2.5; 95% CI: 1.3–4.9) that was significantly associated with an increase of 0.10% in HbA1c.
Conclusion
Severe periodontitis was associated with elevated blood glucose levels. Individuals with this condition having a higher percentage HbA1c are more likely to be prediabetic.
Clinical relevance
This study highlights the importance of the clinicians’ awareness of the association between severe periodontitis and prediabetes allowing its early detection in the dental office.
Journal Article
Syndecan Family Gene and Protein Expression and Their Prognostic Values for Prostate Cancer
Prostate cancer (PCa) is the leading cause of cancer-associated mortality in men, and new biomarkers are still needed. The expression pattern and protein tissue localization of proteoglycans of the syndecan family (SDC 1–4) and syntenin-1 (SDCBP) were determined in normal and prostatic tumor tissue from two genetically engineered mouse models and human prostate tumors. Studies were validated using SDC 1–4 and SDCBP mRNA levels and patient survival data from The Cancer Genome Atlas and CamCAP databases. RNAseq showed increased expression of Sdc1 in Pb-Cre4/Ptenf/f mouse Pca and upregulation of Sdc3 expression and downregulation of Sdc2 and Sdc4 when compared to the normal prostatic tissue in Pb-Cre4/Trp53f/f-;Rb1f/f mouse tumors. These changes were confirmed by immunohistochemistry. In human PCa, SDC 1–4 and SDCBP immunostaining showed variable localization. Furthermore, Kaplan–Meier analysis showed that patients expressing SDC3 had shorter prostate-specific survival than those without SDC3 expression (log-rank test, p = 0.0047). Analysis of the MSKCC-derived expression showed that SDC1 and SDC3 overexpression is predictive of decreased biochemical recurrence-free survival (p = 0.0099 and p = 0.045, respectively), and SDC4 overexpression is predictive of increased biochemical recurrence-free survival (p = 0.035). SDC4 overexpression was associated with a better prognosis, while SDC1 and SDC3 were associated with more aggressive tumors and a worse prognosis.
Journal Article
Glandular Odontogenic Cyst in Dentigerous Relationship: An Uncommon Case Report
Glandular odontogenic cyst (GOC) is an uncommon cyst of the jaw. Less than 200 cases are reported in the literature, and only 22 cases are associated with an unerupted tooth (dentigerous relationship). Although it is an asymptomatic lesion, it can be destructive and has high recurrence rates. The diagnosis can be especially challenging due to the lack of distinct diagnostic clinic-radiological criteria and nonspecific microscopic features, mimicking benign and malignant lesions. Conservative surgical treatment has been the choice for most surgeons, but marginal or partial jaw resection has been reported. This report describes a rare case of GOC in a dentigerous relationship, which was treated with enucleation and peripheral osteotomy.
Journal Article
A multi-timestep Dirichlet-Neumann domain decomposition method applied to the polymer injection in porous media
The study of polymer flooding is of utmost relevance due to the diversity of applications. This paper proposes an innovative mathematical and computational model for polymer flooding that efficiently couples the process in the near-well region and the reservoir. For the mathematical model, in addition to the single-phase flow and transport equations, we postulate closure relationships for the adsorption isotherms, mechanical retention kinetics, and non-Newtonian pseudoplastic behavior. For the computational model, we propose a space-time domain decomposition method based on a predictor-corrector strategy. The resulting system of equations is discretized by the finite element method and linearized by the Newton-Raphson method. Moreover, we apply a consistent flux method to obtain the flow at the boundaries and quantify the injectivity ratio. Then, we validate the accuracy of the proposed method by comparing the discrete solutions with analytical and high-fidelity solutions. We also discuss the loss of injectivity due to the non-Newtonian behavior, mechanical retention, and formation damage at 2D and 3D domains that replicate a five-spot injection pattern. The numerical simulations show that the proposed computational model accurately captures the solutions with low computational costs in several scenarios for polymer injection in porous media.
Journal Article
Effectiveness of dental floss in the management of gingival health: A 6-month follow-up of a randomized controlled clinical trial
Objectives
To evaluate, (i) if subjects submitted to a structured oral hygiene training program (OHt) maintain adopted habits over 180 days without professional guidance; and (ii) in perspective whether flossing provides additional benefits to toothbrushing on gingival health.
Materials and methods
Seventy-five adult subjects showing approximately 40% proximal gingival bleeding were randomized to receive OHt (1 session weekly over 8 weeks) using toothbrush and dental floss or toothbrush alone. The subjects were then followed over 180 days without professional guidance. Primary outcomes were mean interproximal Gingival Index (GI) and GI = 2 (gingival bleeding). Mixed linear models were used for the comparison between groups (
p
< 0.05).
Results
68 subjects received OHt, 48 subjects completed the 180-day follow-up. Subjects maintained adequate oral hygiene routines. Besides a reduction in gingival inflammation, no alterations in gingival status were observed among groups, subjects additionally instructed to use dental floss showing a mean interproximal GI = 2 of 12.8 ± 2.5 compared with 19.8 ± 2.2 for subjects limited to tooth brushing alone.
Conclusions
OHt intensive training promotes gingival health and maintenance lasting at least 6 months without professional supervision reinforcing important principles: (i) dental health professionals should dedicate time training and motivating their patients to reach adequate self-performed plaque control; and (ii) the adjunctive use of dental floss appears essential to reduce interproximal gingival inflammation in subjects with intact interdental papillae.
Clinical relevance
Dentists need to invest time in training/motivating/engage their patients to achieve adequate OH; adjunct flossing in subjects with papilla filling the interdental space appears essential to reach and maintain gingival health.
Clinicaltrials.Gov
(53831716.5.0000.5346).
Trial registration
The protocol registration was filed May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov. An NCT number (NCT04909840) was generated upon completed registration.
Journal Article
253 Risk management through an assertive preseason assessment
BackgroundPreseason assessment is common in sports teams and aims to analyze athletes’ physical and functional parameters. These data assist physical therapists to develop global and individualized injury prevention programs and to identify any improvement throughout the season.ObjectiveTo determine predictors for musculoskeletal injuries in youth male soccer athletes.DesignCohort study.SettingOne youth soccer team facility.Patients (or Participants)One hundred sixteen young male soccer athletes.Interventions (or Assessment of Risk Factors)All data were collected in two days. Athletes were aleatory selected to perform the tests and the physical therapists, previously trained, applied the following tests: single leg hamstring bridge (SLHB), bridge test with unilateral knee extension, passive hip internal rotation (IR) range of motion (ROM), hip abductor strength, hamstring flexibility and composite score of Y-Test. Considering it could have an interference in other tests, Y-Test were the last measure in all athletes. Injuries were collected throughout the season.Main Outcome Measurements any lower limb (LL) injury occurring during scheduled games or practices that cause an athlete to miss a subsequent game or practice session.ResultsThe Classification and Regression Trees (CART) model identified as predictors of LL injuries in youth soccer athletes: SLHB, bridge test with unilateral knee extension, passive hip internal rotation ROM, hip abductors strength, hamstrings flexibility and composite score of Y-Test result. The model had an accuracy of 76% (p< .0001) and the correct classification was 88.6% for injury and 56.6% for non-injury.ConclusionsThe SLHB, bridge test with unilateral knee extension, passive hip internal rotation ROM, hip abductors strength, hamstrings flexibility and composite score of Y-Test should be included in pre-season assessment in youth soccer athletes. The results of these tests could be used as parameters to develop a prevention program in soccer.
Journal Article