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Introduction Direct pulp capping therapies use biomaterials to protect exposed tissues, inducing repair through the production of a mineralized barrier. The purpose of this study was to compare the effectiveness of biomaterials and techniques by means of a systematic review and meta-analysis. Methods The PubMed, Cochrane, and Embase databases were used to search the literature published from January 1, 1980 until August 31, 2017. Studies that met inclusion criteria were screened by 2 authors individually. The meta-analysis was performed on mineral trioxide aggregate (MTA) cement vs calcium hydroxide cement, tricalcium silicate cement vs MTA cement, and adhesive systems vs CaOH cement and evaluated the success rate, inflammatory response, and dentin bridge formation. Results Forty-six studies were included in the systematic review, while 22 studies were included in the meta-analysis. There was no significant heterogeneity between the studies. MTA cements showed a significantly higher success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 2.72; 95% confidence interval [CI] = 1.90-3.90; P = 0.000). However, when compared with the tricalcium silicate cements, there were no statistically significant differences (odds ratio = 1.18; 95% CI = 0.53-2.65; P = 0.672). Adhesive systems showed a significantly lower success rate, in all parameters, compared with calcium hydroxide cements (odds ratio = 0.062; 95% CI = 0.024-0.157; P = 0.000). Conclusions MTA cements have a higher success rate, with a lower inflammatory response and a more predictable hard dentin barrier formation than calcium hydroxide cements. However, there were no differences, in these parameters, when MTA cement was compared with tricalcium silicate cements. Dental adhesives systems showed the lowest success rates.

This case report describes a 5-year-old dog with a defect in the right eyelid, absence of orbicularis musculature, and absence of cutaneous tissue in the infraorbital region, submitted to the Mustarde flap technique. A large rotational flap was performed, including a cartilage graft from the outer ear, to correct the defect in the lower eyelid and infraorbital region. Also, euryblepharon correction of the upper eyelid was performed with wedge excision. The techniques were performed in a single surgical step and with appropriated functional and aesthetic results. The described approach may be employed as a surgical option in large eyelid defects.

Introduction The first sign of dental caries is denoted by white spot lesions (WSLs) which can be defined as a demineralization of the enamel surface and subsurface, although these lesions can be reversed and do not form cavities. The aim of this systematic review was investigate which remineralization agents are effective for the treatment of WSLs. Materials and Methods For this systematic review a literature search was conducted on Pubmed, Cochrane Library and ScienceDirect. Results The initial search resulted in 273 references. After elimination of duplicate articles, 236 references remained. After reading titles and abstracts, all non-relevant results were excluded, resulting in 45 potentially relevant studies. After reading the full text, 13 references were included. Conclusion More studies are required for scientific evidence in order to reach a conclusion of the most suitable therapeutic method for the treatment of surface and subsurface demineralization of the enamel.

Background Acupuncture is one of the most popular and most frequently used complementary medicines worldwide, with benefits for several health conditions when integrated into Western medical practice. Objective To perform a retrospective analysis of patient characteristics, health conditions and patient experience in a teaching medical acupuncture appointment at the Faculty of Medicine, University of Coimbra/Coimbra Hospital and University Centre. Methods 500 medical records between January 2010 and December 2015 were accessed and 324 were included. The characteristics examined include gender, age, health conditions treated, number of acupuncture needles used in each treatment, professional who referred the patient, type of stimulation, number of treatment sessions and patient experience regarding the degree of improvement at the end of treatment. Results Patients range from 13 to 92 years old, with most between 40 and 59 yo (40.7%). In total, 71.3% were female and 28.7% male. The most commonly treated health conditions were musculoskeletal symptoms (60.4%), nervous and headaches (18.2%) and orofacial (11.3%). The median number of appointments was 6 and the median needles used per treatment was 12. In 52.2% of consultations, electrostimulation was performed. The majority of patients were referred by physical and rehabilitative medicine and dentists. 85.3% of patients reported improvement at the end of the treatment, with those who performed more sessions presenting a higher improvement. Conclusions This pioneering study in Portugal presents similar results to other countries regarding patient characterization. The high success rate (85.3%) regarding patient improvement recommends the use of acupuncture as an effective complementary therapy.

Introduction The increase in the use of electronic cigarettes (e-cigs) in young people and the lack of knowledge of the health effects of smoking in the short and long term are worrying. Although the oral cavity is the first to interact directly with the e-cig aerosol, studies on potential oral cavity lesions are still limited and there is some controversy about safety. Objective To perform a systematic review to evaluate the adverse effects of e-cigs on oral health. Materials and methods The research was conducted using Cochrane Library, Embase, PubMed, and Web of Science. The research was limited to articles in English, Portuguese, and Spanish, published between January 2003 and November 2018. The research question was formulated according to the population, intervention, comparison, outcome (PICO) strategy. The quality of the methodology of each study was evaluated following the guidelines described in the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool. Results The initial search resulted in 432 articles, of which only eight were included for analysis. Periodontal and peri-implant clinical and radiographic parameters (plaque index, clinical attachment loss, probing depth, peri-implant bone loss, and radiographic bone level) are worse, and proinflammatory cytokine levels are higher among electronic and conventional cigarette smokers than among nonsmokers. Bleeding on probing was higher in nonsmokers than in conventional cigarette smokers and e-cig users. Nine different lesions of the oral mucosa were detected, with nicotinic stomatitis, hairy tongue, and angular cheilitis being more prevalent in e-cig consumers. Conclusion The results suggest that e-cigs are less harmful than conventional cigarettes. However, there is also a greater susceptibility of e-cig consumers to developing alterations in oral biological tissues than ex-smokers or nonsmokers. There is still a clear need for the development of new studies.