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Made available in DSpace on 2022-04-29T08:36:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives The aim of this study was to verify during facial expressions (happy, sad, fearful, angry, surprised, and disgusted) if: (1) there would be difference in the electromyography (EMG) of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles on the normal side (NS) compared with the affected side (AS) (without the use of an ocular prosthesis) in individuals with unilateral absence of the eyeball, and (2) the rehabilitation with a new ocular prosthesis would affect the EMG of the muscles studied on the AS in these individuals. Materials and Methods Thirteen individuals, without temporomandibular disorder, with good health, with unilateral absence of the eyeball (the eye must have been removed by evisceration or enucleation), and users or nonusers of an ocular prosthesis were included. EMG of the occipitofrontalis, temporal, masseter, and sternocleidomastoid muscles was performed during rest and facial expressions (happy, sad, fearful, angry, surprised, and disgusted) before (T0) and 90 days after (T1) rehabilitation with a new ocular prosthesis. The analyses were performed in T0 on NS and AS (without the use of an ocular prosthesis), and in T1 on AS with the new ocular prosthesis. Statistical Analysis All data were submitted to the Student's t -test with p < 0.05. Results There was no statistically significant difference comparing the AS with the NS in T0 for all muscles studied, during all facial expressions evaluated (p > 0.05). There was no statistically significant difference comparing the AS in T0 with itself in T1 for all muscles studied, during all facial expressions evaluated (p > 0.05). Conclusion Eye loss did not affect the EMG of studied muscles when comparing NS with AS (without the use of an ocular prosthesis). The rehabilitation with ocular prosthesis was not capable of changing the EMG on AS. Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University, José Bonifácio Street, 1193, Araçatuba Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba Department of Pediatric and Social Dentistry School of Dentistry São Paulo State University, Araçatuba

To characterize the clinical, pathological, and imaging features of DCIS occult on conventional imaging diagnosed on MRI-guided biopsy associated with increased risk of invasive disease on surgical excision. All consecutive patients with MRI-detected DCIS occult on conventional imaging between January 2009 and December 2018 were included. Women were divided into two groups based on final pathology: Pure DCIS or DCIS with invasive component. Clinical, imaging, and pathological risk factors for upgrade to invasion were evaluated. Of 50 patients who met the inclusion criteria, 12 (24%) were upgraded to invasive malignancy in the final pathology. The only parameters that showed statistically significant association with upgrade were related to kinetic characteristics: 53% of patients with the combination of fast early upstroke and either plateau or washout curve were upgraded, compared to 12% of women without this combination (p = 0.006). The sensitivity of combined kinetic features for predicting upgrade was 67% (95% CI 35–90%), specificity was 84% (CI 95% 68–94%), positive predictive value was 57% (CI 95% 37–75%), negative predictive value was 89% (CI 95% 77–95%), and OR was 78% (64–88%). Kinetic characteristics show the strongest association with upgrade to invasion in DCIS occult on mammogram and US. Larger studies should be encouraged to consolidate our findings, which may have implication for treatment planning.

Digital breast tomosynthesis (DBT) is gradually being implemented in routine clinical breast imaging practice. The technique of image acquisition reduces the confounding effect of overlapping breast tissue, which substantially affects cancer detection, abnormal recall, and interval cancer rates in a screening/ surveillance setting. In a diagnostic setting, tomosynthesis also allows for improved lesion localization and characterization over conventional imaging, which potentially improves the accuracy and improved workflow efficiency. To optimize the utility of tomosynthesis, imagers should be aware of the pertinent aspects of image acquisition as it relates to interpretation, the appearance of benign and malignant pathologies, and sources of possible misinterpretation. This article aims to provide a practical knowledge base of DBT and demonstrate its potential benefits when incorporated into routine clinical practice.

BACKGROUND: Changes in access to breast imaging and suspension of mammographic screening during the COVID-19 pandemic had the potential to significantly delay breast cancer diagnostic pathways. The Gattuso Rapid Diagnostic Centre (GRDC) is an innovative clinic that provides a patient-centered approach for investigation of suspicious breast abnormalities and sees approximately 1200 patients per year. The aim of this study was to assess the impact of the pandemic on patient volumes and imaging at this high-volume breast rapid diagnostic centre. METHODS: A retrospective review of consecutive patients who presented to the GRDC from the start of the pandemic (March 12, 2020) until May 31, 2020 was performed. The number of patients, reason for referral, cancer detection rate (CDR), and waiting time from appointment to diagnosis were evaluated and compared to a corresponding time period in 2019. RESULTS: A total of 168 new patients presented to the GRDC during the study period, corresponding to a 32.3% decrease in the number of patients compared to 2019 (n=248). Seventy-eight patients (46.4%) were referred due to the presence of a clinical palpable abnormality, which represented an increase of 13.8% (n=81 [32.7%] in 2019; p=0.005). Out of 168 patients, 69 were diagnosed with a breast malignancy, yielding a CDR of 41.1% during the pandemic versus 111 patients in 2019 (CDR of 44.8%; p= 0.456). The average time from appointment at GRDC to diagnosis was lower at 0.76 days vs 1.21 days in 2019. The rate of same day diagnosis was significantly higher at 39.5% vs 27.0% in 2019 (p=0.008). Twenty-five patients (14.9%) received neoadjuvant systemic therapy compared to 16 patients (6.5%) in 2019 (p=0.005). CONCLUSION: There were fewer patients presenting for breast investigations during the pandemic period and a significant increase in the percentage of patients with palpable masses as the cause for referral with no appreciable change in the CDR. The presence of a rapid diagnostic breast center enabled patients with concerning breast symptoms to access and receive expedited assessment. This ensured patients did not undergo diagnostic delays despite the health care restrictions that emerged during the COVID-19 pandemic. Citation Format: Gary Ko, Sharmy Sarvanantham, Sangita Sequeira, Vrutika Prajapati, David R. McCready, Vivianne Freitas, Tulin D. Cil. Benefits of a rapid diagnostic centre for breast cancer care during the COVID-19 pandemic [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS2-27.

Made available in DSpace on 2022-04-29T08:32:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-01 Background: This study aimed to compare the masticatory efficiency, the maximum voluntary occlusal bite force (MVOBF) and the electrical activity (EMG) of masticatory muscles of practitioners of upper limb bodybuilding before and after physical activity. Methods: Twenty healthy individuals (10 men and 10 women, age from 18 to 30 (mean of 24.7 years old) without masticatory system disorders, that regularly practice hypertrophic physical activity were submitted to the analyses of masticatory efficiency, MVOBF, and surface EMG of the temporalis and masseter muscles. The masticatory efficiency was analyzed by comminution of the artificial material (Optocal®) and a sieving method. The MVOBF was measured by a dynamometer, and EMG was evaluated during resting mandibular position, maximum voluntary clenching (MVC), and MVC with a Parafilm M tape between teeth, and free mastication of chewing gum. The analyses were made before (T0) and immediately after the performance of upper limb bodybuilding exercises (T1). The data of masticatory efficiency and MVOBF were submitted to the Student T-test, and their correlations were analyzed by the Pearson correlation test, and the EMG data were submitted to the 2-way repeated measures ANOVA, all tests with a 5% significance. Results: There was a significant decrease of masticatory efficiency after the training. No statistical difference in the MVOBF and EMG was found, and there was a positive correlation between masticatory efficiency and MVOBF. Conclusions: Therefore, changes were found for masticatory efficiency only, which decreased after hypertrophic exercise. There was a positive correlation between masticatory efficiency and MVOBF Department of Dental Materials and Prosthodontics Araçatuba School of Dentistry São Paulo State University-UNESP, Road Jose Bonifacio 1193,Vila Mendonca KM Runner Incentivo Esporte Department of Dental Materials and Prosthodontics Araçatuba School of Dentistry São Paulo State University-UNESP, Road Jose Bonifacio 1193,Vila Mendonca

Background Our objective was to perform a systematic review and meta-analysis comparing the breast cancer detection rate (CDR), invasive CDR, recall rate, and positive predictive value 1 (PPV1) of digital mammography (DM) alone, combined digital breast tomosynthesis (DBT) and DM, combined DBT and synthetic 2-dimensional mammography (S2D), and DBT alone. Methods MEDLINE and Embase were searched until April 2020 to identify comparative design studies reporting on patients undergoing routine breast cancer screening. Random effects model proportional meta-analyses estimated CDR, invasive CDR, recall rate, and PPV1. Meta-regression modeling was used to compare imaging modalities. All statistical tests were 2-sided. Results Forty-two studies reporting on 2 606 296 patients (13 003 breast cancer cases) were included. CDR was highest in combined DBT and DM (6.36 per 1000 screened, 95% confidence interval [CI] = 5.62 to 7.14, P Conclusions Our findings provide evidence on key performance metrics for DM, DBT alone, combined DBT and DM, and combined DBT and S2D, which may inform optimal application of these modalities for breast cancer screening.

The Ontario High Risk Breast Screening program follows women aged 30–69 at an increased risk of breast cancer, using a yearly mammography and breast MRI. The aim of this study is to determine the clinical outcomes for the enrolled women. Observational cohort study following 2081 participants in the high-risk screening program 2011–2017. The participants were divided into three subgroup according to their risk criteria: (a) known carriers of pathogenic variants (PV) in hereditary breast cancer genes. (b) Previous chest radiotherapy. (c) Estimated life time risk (ELR) ≥ 25%, calculated using the International Breast Cancer Intervention Study (IBIS) tool, with no known mutation or previous radiation. All Breast Cancer (BC) diagnosed during the follow-up time were recorded. 673 women carried PVs in hereditary breast cancer genes, 159 had a history of chest radiotherapy, and 1249 had an ELR ≥ 25%. The total cohort of screening years was 8126. Median age at BC diagnosis was 41 for the first group, 47 for the second group and 51 for the third. BC incidence rate was 18.2 for PV mutation carriers, 17.9 for the chest radiotherapy group and 6.2 for ELR ≥ 25%. Hazard ratio was similar for the first two groups, but significantly lower for the ELR ≥ 25% group. When stratifying by age, the incidence rate in the ELR ≥ 25% increased over time, until it became similar to that of the other subgroups after age 50. Our findings question the need to screen women with an elevated lifetime risk using the same screening practices used for women who are PV mutation carriers, or with a history of chest radiation, prior to the age of 50.

Background and objectives: Burnout results from chronic workplace stress leading to emotional exhaustion, negativity, and decreased professional efficiency. In the healthcare system, this can have consequences like increased medical errors, absenteeism, substance abuse, depression, and suicide among health professionals, adversely affecting patient care. Various individual-directed measures like the mindfulness-based stress reduction program (MBSR), one of the most studied and widely adopted techniques, and physical activity, like aerobics or sports, have shown to be effective against burnout. With this study, we intend to increase awareness regarding this public health issue among the residents and the faculty. Our aim is to define a successful intervention that can be incorporated as a yearly requirement for the completion of residency programs. Methodology: This study will be a phase III, multicentric, open-label, placebo (waiting list) controlled trial. Our sample size will be 720 residents sampled from 6 university hospitals from across the world, randomized into 3 parallel arms (1:1:1 ratio stratified according to site and specialty). Residents, diagnosed with burnout based on baseline Maslach Burnout Inventory score (MBI) and having no prior physical or mental health issues, will be included. The first group will undergo the MBSR program for 8 weeks, the second group will undergo a supervised aerobics program for 8 weeks, and the third group will be put into a waiting list for any of the interventions. The primary outcome will be the change in MBI scores after the intervention. The secondary outcomes will be the change in MBI score 3 months after the intervention, and changes in measures like heart rate, blood pressure, glycated hemoglobin, cortisol levels, quality of sleep and quality of life after the intervention and 3 months later. We also plan to do a subgroup analysis to see the difference based on specialty and gender. Study impact: The residency training period is considered one of the most stressful phases in medical education. Higher rates of burnout are noted in the residents, and this can negatively impact patient care and the progression of their careers. This trial will look at multiple interventions to combat burnout recruiting residents of different specialties in different work environments across the world. We hope to remove the stigma surrounding burnout in the healthcare system. This study will show the short and long term benefits of these interventions and would help us recommend their inclusion in various residency programs.

Objective: To identify the presence and level of halitosis in edentulous individuals with or without prostheses, before and after rehabilitation with complete dentures (CD). Methods: Patients were verbally invited to participate and signed an Informed Consent. Halitosis was analyzed by the volatile sulfur compounds measurement method in the presence and absence of the old prostheses (M1) and 15 to 30 days after the patients received their new prostheses (M2). At M1, the patients answered a questionnaire with clinical data, and the saliva type and presence/absence of tongue coating were assessed. T-test and Spearman correlation test were used, and a p-value < 0,05 was considered statistically significant. Results: Twenty-seven patients (19 women) with an average age of 67 years participated in the study. The mean time of prosthesis usage was 20.2 years. Tong coating was present in 21 patients (77,8%). A good odor level of halitosis was self-claimed in 13 (41,8%) individuals. The odor level of halitosis was significantly lower in M2 compared to M1, either with or without CD and after hygiene (p < 0,001). There was a positive and statistically significant correlation between the level of halitosis and alcoholism, smoking, prostheses hygiene method, and the presence of disease (diabetes). Conclusion: The old complete replacement of the prostheses with new ones was able to improve the odor level in a period of 15 to 30 days after the treatment. The presence of halitosis was correlated with alcoholism, smoking, denture hygiene methods, and the presence of diabetes.

Made available in DSpace on 2022-04-29T08:36:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective This study aimed to evaluate the influence of new complete dentures (CDs) and new removable partial dentures (RPDs) on oral health-related quality of life, dry mouth sensation, and anxiety level of their wearers. Materials and Methods In total, 20 complete edentulous patients (in both arches) that needed to be rehabilitated with new CDs, and 20 partial edentulous patients (in both arches) that needed to be rehabilitated with new RPDs, were included in this study. Each patient must wear the same pair of CDs or RPDs for more than 5 years. Oral health-related quality of life, dry mouth sensation, and level of anxiety were assessed by using the following questionnaires: Geriatric Oral Health Assessment Index (GOHAI), VAS (Visual Analog Scale) Xerostomia Questionnaire, and State-Trait Anxiety Inventory (STAI). These questionnaires were applied before oral rehabilitation (initially initial time point) and 3 months after insertion of new dentures (end time point). Statistical Analysis For the results of STAI-State, STAI-Trait, and GOHAI, the Wilcoxon test was applied to compare the time points. For the results of the VAS xerostomia questionnaire, two-way repeated measures ANOVA (analysis of variance) was applied, followed by the Tukey test. The p -values lower than 0.05 were considered statistically significant. Results / Conclusion For both groups, it was observed that 3 months after the insertion of new removable dentures: (1) there was an increase in oral health-related quality of life; (2) there was a reduction in anxiety (trait anxiety and state anxiety); and (3) there was a perception of greater salivation. Department of Dental Materials and Prosthodontics São Paulo State University School of Dentistry, Araçatuba, São Paulo Paulista University School of Dentistry, Amazonas Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba, São Paulo Department of Pediatric and Social Dentistry São Paulo State University School of Dentistry, Araçatuba, São Paulo Department of Dental Materials and Prosthodontics São Paulo State University School of Dentistry, Araçatuba, São Paulo Oral Oncology Center School of Dentistry São Paulo State University, Araçatuba, São Paulo Department of Pediatric and Social Dentistry São Paulo State University School of Dentistry, Araçatuba, São Paulo

Made available in DSpace on 2022-04-29T08:32:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Ocular prosthesis rehabilitation has an important social, psychological, esthetic, and functional role. Congenital factors, trauma, and tumors, among others, can cause anophthalmia, and it is essential to identify the etiology to guide its prevention and treatment. Methods: The aim of this study was to retrospectively investigate the records of patients treated from 2013 to 2020 by the Oral and Maxillofacial Prosthesis Group, aiming to identify the prevalence of patients with anophthalmia and the etiology of their anophthalmia. After approval by the Human Research Ethics Committee, two calibrated researchers evaluated 520 records, identifying those from patients with anophthalmia. The inclusion criteria were records with complete and legible information from patients with anophthalmia and a description of their etiology. Descriptive statistics were performed, and etiological factors were categorized into trauma, congenital cause, end-stage eye disease, and tumor. Spearman's correlation was performed to verify the relation between gender and anophthalmia etiology, with a 5% significance level. Seventy-two records were included in the study. Results: It was observed that 33.4% of patients were women and 66.6% were men. The etiologies were physical trauma (52.4%), tumor (21.8%), end-stage eye disease (16.6%), and congenital cause (9.2%), and there was no correlation between gender and these etiologies (p =.301). Conclusion: Most of the cases identified were of traumatic origin, which allows the establishment of preventive and educational measures to avoid new cases of anophthalmia. Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP) Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP)

Made available in DSpace on 2019-10-06T16:28:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-05-03 Background: The aim was to analyze the levels of stress of edentulous patients through the state-trait anxiety inventory (STAI) and salivary flow through the visual analogue scale (VAS) xerostomia questionnaire, as well as analyze the levels of cortisol, capillary blood glucose, and blood pressure (BP) before and after the installation of complete dentures. Methods: Fifty patients were evaluated. The STAI and VAS xerostomia questionnaire were applied before the installation of the prosthesis, on the day of its installation, and 1 month after the last recall visit. The BP measurement, as well as salivary and blood collections, were performed before the installation of the prothesis, and 1 month after the last recall visit. Data from the VAS xerostomia questionnaire and cortisol levels were submitted to ANOVA and the Tukey test (P =.05). Data from the STAI, as well as blood glucose and BP levels, were submitted to the Chi-square test (P =.05). The correlation between cortisol and blood glucose and between cortisol levels and BP was analyzed. Results: There was no statistically significant association between the questions of the VAS xerostomia questionnaire, STAI-state and STAI-trait scores, or the periods analyzed. However, the cortisol level collected in the morning decreased after the installation of the prosthesis. There was a correlation between cortisol and blood glucose and BP levels. Conclusions: The installation of complete dentures was beneficial for patients since it was probably responsible for the cortisol level reduction. Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP), Jose Bonifacio St., 1153 Department of Dental Materials and Prosthodontics UNIEURO University Center Department of Basic Sciences Aracatuba Dental School Sao Paulo State University (UNESP) Department of Preventive and Social Dentistry Aracatuba Dental School Sao Paulo State University (UNESP) Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP), Jose Bonifacio St., 1153 Department of Basic Sciences Aracatuba Dental School Sao Paulo State University (UNESP) Department of Preventive and Social Dentistry Aracatuba Dental School Sao Paulo State University (UNESP)

There are currently no clear guidelines for high-risk breast cancer screening during the pregnancy and breastfeeding periods. The objective of this systematic review (SR) was to assess the available evidence pertaining to breast cancer screening recommendations in this population with the aim of supporting future guidelines. We performed a SR of the literature using the electronic databases MEDLINE and Embase. Predetermined inclusion and exclusion criteria were used during the abstract screening and full-text data extraction phases. We retrieved 2,274 abstracts after removal of duplicates, from which 16 studies were included based on predetermined eligibility criteria. Most of the studies found were narrative reviews and expert opinions. Clinical breast exam (CBE) was recommended by 12 studies during pregnancy and by 6 studies in the breastfeeding period. Mammography was recommended in the breastfeeding period by 2 studies. Magnetic resonance imaging was recommended in the breastfeeding period by 2 studies. Ultrasound was considered not appropriate for screening in this population. The information extracted from this SR is based primarily on expert opinion and anecdotal evidence, which explains the lack of standardized guidelines for high-risk breast cancer screening in this population. However, expert opinion may be a surrogate outcome for high-risk breast cancer screening recommendations in this subset of patients, and as such, may justify the clinical management to be tailored accordingly. This SR summarizes the evidence pertaining to high-risk breast cancer screening during pregnancy and breastfeeding, which could serve as a catalyst for future research on the topic.

Please see the Author Video associated with this article. BACKGROUND. The use of synthetic 2D mammography (SM) with digital breast tomosynthesis (DBT) in place of standard 2D digital mammography (D...

A gestão das atividades rurais é indispensável para o produtor, pois fornece embasamento adequado aos processos envolvidos nesse seguimento, o que possibilita a melhoria do estabelecimento produtivo, com enfoque nas principais necessidades, alcançando os resultados econômicos e financeiros satisfatórios. Assim, este estudo teve como objetivo avaliar as estratégias de planejamento de empreendimentos rurais da agricultura familiar no município de Mossoró, no estado do Rio Grande do Norte, considerando a importância social e econômica que essa atividade tem para a região. O estudo exploratório se deu através de questionários estruturados de natureza quali-quantitativos aplicados por técnicos do Projeto Sertão Empreendedor. De acordo com os resultados obtidos, observou-se que 41% das propriedades analisadas realizam planejamento da produção, tanto estratégico como também operacional. Que o planejamento pessoal é realizado em aspectos estratégicos em 53% e operacional 32%. Quanto ao planejamento financeiro 28% dos empreendimentos afirmaram realizarem de forma estratégica e 34% de forma operacional. Portanto, é possível observar alguns pontos que podem contribuir para ausência do planejamento dos empreendimentos rurais que devem ser melhor trabalhados, dentre eles podemos citar, falta de orientação, desestímulo com a atividade e grande quantidade de risco a que esses empreendimentos estão expostos, sendo o planejamento a alternativa para tornar essas atividades mais seguras.

The goal of this study is to evaluate the frequency and imaging features of lobular neoplasia (LN) diagnosed on MRI-guided biopsy, determine the upgrade rate to malignancy, and assess for any features that may be associated with an upgrade on surgical excision. Research ethical board approved the review of consecutive patients with MRI-detected LN between January 2009 and December 2018 with differentiation between pure LN and LN with associated other high-risk lesions. The final outcome was determined by final pathology results from surgical excision or 24 months of follow-up. Appropriate statistical tests were used. Out of 1250 MRI-guided biopsies performed, 76 lesions (6%) fulfilled the inclusion criteria and formed the study cohort. Of the 76 lesions, 54 (71%) were pure LN while the rest had coexistent high-risk lesion. Non-mass enhancement (NME) was the most common lesion type (62, 82%). Fifty-nine lesions (78%) were surgically excised, the other 17 had benign follow-up. Overall, 8 lesions (11%) were upgraded to malignancy on final pathology. Malignant outcome was associated with larger lesion size (5.5 versus 1.9 cm, P

OBJECTIVE The purpose of this study is to determine the role of clinico-sonographic features of breast cellular fibroepithelial lesions (CFELs) diagnosed on core needle biopsy (CNB) in the differentiation between fibroadenoma (FA) and phyllodes. MATERIALS AND METHODS Results of consecutive women with a CNB showing CFEL from 2005 to 2010 were retrospectively reviewed. Clinical and sonographic findings were compared with surgical outcomes. Chi-square and Fisher's exact tests were used followed by a regression model for statistical analysis. RESULTS A total of 131 women with 134 CFEL were included in the study; 89 (66%) were FAs and 45 (34%) were phyllodes (32 benign; 13 malignant). Significant predictors of increased risk of phyllodes tumor were patient age equal to or greater than 50 years (P = .021) and lesion size less than 2 cm at sonography (P = .043). No other imaging or clinical features were able to differentiate FA from phyllodes tumors. CONCLUSION CFEL with a larger size in older women is associated with the surgical pathological result of phyllodes tumor and management should be tailored accordingly. Younger patients with small size nodules might be approached less aggressively, depending on a personalized discussion with the surgeons, taking into account the results obtained in this study.

Made available in DSpace on 2020-12-10T19:46:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 Background: The aim of this study was to verify, through self-assessment questionnaires, the influence of implant-supported prosthesis in salivary flow and anxiety of patients rehabilitated with them. Materials and Methods: Visual analog scale (VAS) questionnaire about xerostomia and State-Trait Anxiety Inventory were applied before (T1) and after 2 days (T2) and 3 weeks (T3) of prostheses installation. The study included patients rehabilitated with implant-supported prostheses containing three or more dental elements. A total of 17 patients were evaluated. Results: In VAS questionnaire, there was a significant increase in the difficulty of speaking and swallowing with dry mouth. The other VAS questions showed no statistically significant difference, indicating no changes in patients' salivary flow. Conclusions: It was concluded that the installation of implant-supported prostheses does not lead to major changes in patients' perception about their salivary flow and psychological state, causing no improvement or worsening in the characteristics evaluated. Sao Paulo State Univ, Aracatuba Dent Sch, Dept Dent Mat & Prosthodont, Jose Bonifacio 1193 Vila Mendonca, BR-16015050 Aracatuba, SP, Brazil Sao Paulo State Univ, Aracatuba Dent Sch, Dept Dent Mat & Prosthodont, Jose Bonifacio 1193 Vila Mendonca, BR-16015050 Aracatuba, SP, Brazil

Highlights • Avoiding transmission of COVID-19 pandemic while providing essential breast cancer care is critical. • Tailored recommendations and algorithms have been developed promptly at the breast imaging department to face the COVID-19 pandemic outbreak. • Discussions are underway on the best way to resume regular patient care, given the uncertainty course and duration of the COVID-19 pandemic., The pandemic caused by the new Coronavirus has changed the way patient care is provided worldwide. This review focuses on the description of the operational measures implemented in a breast imaging department in accordance with existing recommendations for the treatment of breast cancer during the COVID-19 pandemic to make optimal use of finite resources without interruption of essential imaging services for breast cancer patients. It will also apply during a second-wave of the pandemic, which, according to experts, is inevitable and requires us to be better prepared.

Made available in DSpace on 2021-06-25T12:28:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01. Added 1 bitstream(s) on 2021-07-15T15:24:30Z : No. of bitstreams: 1 S1678-77572020000100485.pdf: 352578 bytes, checksum: 24069ecb8fd75f9e1fb059714e75ddf3 (MD5) Temporomandibular dysfunction (TMD), anxiety, and depression are disorders that, due to the current lifestyle, are affecting an increasing portion of the population. Investigating the prevalence of the symptoms of these disorders during the quarantine due to the coronavirus 2019 pandemic (COVID-19) is important to outline clinical strategies for patient care. Objective: This study assessed the prevalence of TMD symptoms, anxiety, depression, and oral behaviors and their associations during the social isolation due to COVID-19. Methodology: Questionnaires were used to assess TMD symptoms in accordance with the Diagnostic Criteria for Temporomandibular Disorders: clinical protocol and assessment instruments, a questionnaire to verify oral behaviors and Hospital Anxiety and Depression Scale to assess symptoms of anxiety and depression in students of dentistry at the Faculty of Health Sciences of the University of Brasilia in May 2020. Qualitative data were subjected to descriptive statistics and chi-squared analysis (p

Made available in DSpace on 2018-11-26T16:01:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-05-01 Statement of problem. Many elderly individuals are rehabilitated with removable complete dentures, which require an initial adaptation period for both oral perception and the perioral muscles. Studies assessing the changes in stimulus perception and the electromyographic (EMG) activity of the orbicularis oris muscle shortly after conventional complete denture insertion are lacking. Purpose. The purpose of this clinical study was to evaluate the effect of mouth rehabilitation with removable complete dentures on stimulus perception and the EMG activity of the orbicularis oris muscle. Material and methods. This study was approved by the Human Research Ethics Committee of the Aracatuba Dental School (Sao Paulo State University). Fifteen participants who had worn their removable complete dentures for at least 5 years and needed rehabilitation with new prostheses were enrolled in the study. A perception questionnaire was applied, and surface EMG examinations of the orbicularis oris muscle during rest, suction of water with a straw, and pronunciation of the syllables /bah/, /mah/, /pah/, and the word 'Mississippi' were performed before (TO) and 30 (T1) and 100 (T2) days after insertion of the new prostheses. The data were analyzed with the Cochran Q test, McNemar test, 2-way repeated measures ANOVA, and honestly significant difference (HSD) Tukey test (alpha=.05). Results. Significant improvement was reported in the perception questionnaire in terms of the oral discomfort sensation in the T2 period. EMG activity decreased during rest and suction after insertion of the new prostheses. A statistical difference between the upper and lower fascicles of the orbicularis oris muscle was detected, with a decrease of EMG activity between the T0 and T1 periods on the lower fascicle, except for when pronouncing the /pah/ syllable. Conclusions. Mouth rehabilitation with removable complete dentures decreased oral discomfort and, depending on the oral function, decreased or increased EMG activity of the orbicularis oris muscle. In addition, the lower fascicle was more active than the upper fascicle during rest and most functional activities. Sao Paulo State Univ, Sch Dent, Dept Dent Mat & Prosthodont, Sao Paulo, Brazil Sao Paulo State Univ, Sch Dent, Dept Dent Mat & Prosthodont, Sao Paulo, Brazil

Made available in DSpace on 2018-12-11T17:13:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-11-01 Objective The aim of this study was to evaluate changes in pain and muscle force, and the relationship between them, in patients with muscle pain and bruxism, prior to and after treatment. Methods Thirty women with bruxism and myofascial pain (Ia) were included in this study. Sleep bruxism diagnosis was made based on clinical diagnostic criteria, and awake bruxism diagnosis was made by patient questionnaires and the presence of tooth wear. The diagnosis of myofascial pain was established according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD). Dentulous or partially edentulous patients (rehabilitated with conventional fixed prostheses) were included in the study according to the inclusion and exclusion criteria. The pain treatment protocol included occlusal splints, patient education, and physiotherapy for 30 days. Bite force was measured using a dynamometer at the central incisor and the first molar regions on both sides. The exams were performed at baseline, after 7 days, and 30 days after treatment. The Wilcoxon test was used to compare patient pain level response among the periods analyzed in the study. Bite force data were submitted to two-way repeated-measures ANOVA, followed by the Tukey HSD test (p

Made available in DSpace on 2018-12-11T17:31:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-09-01 Statement of problem The stability of the optical characteristics of dental ceramics is essential. Degradation of these materials resulting from pH or temperature alterations in the oral cavity can lead to treatment failure. Purpose The purpose of this in vitro study was to evaluate the color change (ΔE), the L* coordinate, the translucency parameter, and the contrast ratio of lithium disilicate ceramic exposed to commonly used and potentially colorant solutions. Material and methods Fifty lithium disilicate specimens were prepared and divided into 5 groups according to the immersion solution (artificial saliva, orange juice, cola, coffee, and red wine). Immersions in acidic beverages were alternated in a thermocycler with artificial saliva. The control group was immersed in artificial saliva at 37°C throughout the immersion period. After 168 hours of immersion, the color parameters were assessed with a spectrophotometer and calculated using the because system on 2 backgrounds (black and white) and in 2 time periods, before thermocycling and after thermocycling. Data were submitted to analysis of variance followed by the Tukey honest significant difference test (α=.05). Results Greater color change (ΔE) and lower L* coordinate values were observed after immersion in orange juice and cola. Regarding the translucency parameter and contrast ratio, the immersion in coffee resulted in greater opacity and lower translucency of the material. Conclusions Alterations in the color stainability, the L* coordinate values, the translucency parameter, and the contrast ratio of the lithium disilicate ceramic were observed, according to the acidic solutions tested. Professor Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP) School of Dentistry Postgraduate student Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP) School of Dentistry Graduate student Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP) School of Dentistry Professor Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP) School of Dentistry Postgraduate student Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP) School of Dentistry Graduate student Department of Dental Materials and Prosthodontics Sao Paulo State University (UNESP) School of Dentistry

The aim of this systematic review is to evaluate the relationship between two methods used to assess implant stability, investigating whether both provide similar implant stability assessments for the same clinical case.A literature search was conducted on MEDLINE-PubMed and Scopus databases, without limitation of the publication period, up to November 2015. The following key words were used, with associations among them: "dental implant," "dental implants," "Osstell," "resonance frequency analysis," "implant stability quotient," "ISQ," "Periotest," "Periotest value," and "PTV." Inclusion criteria were English language, prospective, retrospective, and randomized controlled clinical trials that evaluated implant stability through use of resonance frequency analysis (RFA) and damping capacity analysis (DCA). The study should assess implant stability of only a specific region for all patients or discriminate results evaluated for each region if the analysis had been made in various regions; RFA and DCA should have been applied in the same implants and periods. Studies have been carefully selected, and data of interest were tabulated.Six studies met the inclusion criteria. Although there was significant numerical correlation between values obtained by both methods, data showed that less than half (46%) of cases coincided in relation to implant stability classification.It can be considered that there is not always a consensus and standardization in the classification of implant stability related to the values obtained by RFA and DCA devices, which could create disagreements and miscommunication among dentistry professionals.

No consensus exists on digital breast tomosynthesis (DBT) utilization for breast cancer detection. We performed a diagnostic test accuracy systematic review and meta-analysis comparing DBT, combined DBT and digital mammography (DM), and DM alone for breast cancer detection in average-risk women. MEDLINE and EMBASE were searched until September 2018. Comparative design studies reporting on the diagnostic accuracy of DBT and/or DM for breast cancer detection were included. Demographic, methodologic, and diagnostic accuracy data were extracted. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. Accuracy metrics were pooled using bivariate random-effects meta-analysis. The impact of multiple covariates was assessed using meta-regression. PROSPERO ID: CRD 42018111287. Thirty-eight studies reporting on 488,099 patients (13,923 with breast cancer) were included. Eleven studies were at low risk of bias. DBT alone, combined DBT and DM, and DM alone demonstrated sensitivities of 88% (95% confidence interval [CI] 83–92), 88% (CI 83–92), and 79% (CI 75–82), as well as specificities of 84% (CI 76–89), 81% (CI 73–88), and 79% (CI 71–85), respectively. The greater sensitivities of DBT alone and combined DBT and DM compared to DM alone were preserved in the combined meta-regression models accounting for other covariates (p = 0.003–0.006). No significant difference in diagnostic accuracy between DBT alone and combined DBT and DM was identified (p = 0.175–0.581). DBT is more sensitive than DM, while the addition of DM to DBT provides no additional diagnostic benefit. Consideration of these findings in breast cancer imaging guidelines is recommended. • Digital breast tomosynthesis with or without additional digital mammography is more sensitive in detecting breast cancer than digital mammography alone in women at average risk for breast cancer. • The addition of digital mammography to digital breast tomosynthesis provides no additional diagnostic benefit in detecting breast cancer compared to digital breast tomosynthesis alone. • The specificity of digital breast tomosynthesis with or without additional digital mammography is no different than digital mammography alone in the detection of breast cancer.

To investigate the diagnostic accuracy of problem-solving breast magnetic resonance imaging (MRI) in excluding malignancy in a cohort of patients diagnosed with mammographic architectural distortion (MAD). The Institutional Review Board approved the study. Imaging database with 40,245 breast MRIs done between January 2008 and September 2018 was retrospectively reviewed. The study included all exams considered problem-solving MRI for MAD. Two radiologists reviewed the imaging data. Outcome was determined by the pathology results of biopsy/surgical excision or at least 1 year of clinical and radiological follow-up. Predictors for malignancy were examined, and appropriate statistical tests were applied. One hundred seventy-five patients (median age 53 years) fulfilled the inclusion criteria and formed the study cohort. No cancers were diagnosed in 106 patients with a negative MRI. Out of 69 women with positive MRI findings, 48 (70%) had benign outcome defined either by pathology result or by negative follow-up, and 21 (30%) yielded malignancy. Malignancy was significantly associated with positive MRI (p

Background:Preclinical evidence suggests that zoledronic acid (ZOL) works synergistically with chemotherapy by enhancing anti-tumor activity. ZOL blocks the mevalonate pathway and may indirectly interact with human epidermal growth factor receptor 2 (HER2) pathway activation. The clinical efficacy and biological rationale of chemotherapy plus anti-HER2 therapy and ZOL as a part of neoadjuvant therapy has not been previously tested.Patients and methods:We conducted a phase II clinical trial to evaluate the efficacy and safety of ZOL as part of a neoadjuvant treatment in patients with HER2-positive breast cancer (BC). The protocol consisted of four cycles of doxorubicin/cyclophosphamide with ZOL, followed by four cycles of docetaxel with trastuzumab and ZOL prior to surgery. The primary endpoint was the pathologic complete response (pCR) rate. Secondary endpoints were safety and the identification of clinicopathological characteristics associated with pCR.Results:A total of 71 patients with stage IIA to IIIB BC were included, with 60 eligible for the safety assessment and 58 for the efficacy analysis. Overall, the pCR rate was 42%, with higher rates in hormone receptor (HR)-positive tumors (40%), which contrasts with the results of pivotal trials. The most commonly observed grade 3 and 4 events were febrile neutropenia (grade 3, 20%; grade 4, 3%) and diarrhea (grade 3, 12%).Conclusions:The addition of ZOL as a repositioning drug in neoadjuvant treatment was an effective and well-tolerated therapy. This drug combination might overcome endocrine and anti-HER2 resistance. The higher pCR rates in the HR-positive subgroup deserve further translational investigation.

Purpose To investigate if the presence of a cantilever influences the survival and success of partial fixed implant-supported prostheses, through a systematic review and meta-analysis, with additional analysis of the survival and marginal bone loss rates and prosthesis complications. Materials and methods The register protocol of the review in the PROSPERO database is CRD42016052008. The MEDLINE and Scopus databases were used for an electronic search of relevant studies up to November 2016, by means of two independent reviewers. The keywords included the combinations "fixed partial denture" with "dental implants", and with "extension" or "cantilever"; and "implant-supported dental prosthesis" with "extension" or "cantilever". The inclusion criteria were randomized clinical trials and prospective and retrospective clinical studies in English that addressed the comparison of success and survival of the use of implant-supported fixed prostheses, with and without cantilevers. Data from the selected studies were used to perform the statistical analysis. Results Among the 408 articles identified, 4 articles met the eligibility criteria. The presence of a cantilever did not compromise marginal bone loss or the survival of the prostheses. However, minor complications were encountered for the group of partial fixed prostheses without cantilevers, with a statistical difference (P = .008). Conclusion Cantilevers can be used in fixed prostheses and do not interfere negatively in the survival or success of the prosthesis or the marginal bone loss. However, there are minor complications when prostheses without cantilevers, or short cantilevers, are used.

Made available in DSpace on 2018-12-11T17:22:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Introduction: For many years, edentulous patients have had no other option than conventional dentures to reestablish their oral function. To avoid the need for bone graft surgery, some professionals have suggested the use of mini dental implants (MDIs) to support prostheses. The MDIs are narrow implants, ranging approximately from 1.8 to 2.9 mm in diameter. Recently, the promising results of mini implants regarding osseointegration and patient satisfaction have led clinicians to accept them as a definitive treatment option. Objective: Therefore, the proposition of this systematic review was to assess information on the outcomes of MDIs supporting removable prostheses. Methods:The PubMed and Cochrane databases were searched for articles published before September 2017, which yielded a total of 774 studies for analysis. After exclusion and inclusion criteria, 22 prospective studies were included in this systematic review. Results: Most mini implants were placed in a flapless single-stage surgery and loaded immediately. Most studies reported failures in the first year and prosthetic complications. The mean survival rate of the selected studies was 95.6%, and mean follow-up was 22.8 months. Conclusion: The MDI-supported removable prostheses successfully improved patients’ chewing and speaking ability, quality of life, and satisfaction, suggesting that MDIs are a viable and safe option to support removable prostheses in the mandibular arch. Department of Dental Materials and Prosthodontics Aracatuba Dental School Univ Estadual Paulista (UNESP) Department of Dental Materials and Prosthodontics Aracatuba Dental School Univ Estadual Paulista (UNESP)

Introduction: The dimensional alterations of denture base jeopardize adaptation and retention associated to altered occlusion, which are considered relevant factors for fabrication of complete dentures. Objective: The aim of this study was to evaluate linear tooth displacement during processing of maxillary complete dentures submitted to two inclusion methods and conventional polymerization. Material and method: Twenty maxillary complete dentures were fabricated: G1 – inclusion with silicone barrier, and G2 – inclusion with dental stone type IV barrier. Points were marked on incisal surface of right central incisor and cusp of second molars to allow linear measurement of the replicas through the software AutoCAD. The evaluation of artificial teeth displacement for both groups was carried out in different moments: a) waxed denture; b) waxed denture partially invested with stone or silicone barrier; c) after complete flasking; d) denture into flask after polymerization; e) denture attached to the cast after deflasking; f) denture separated from the cast; g) denture after finishing and polishing; h) denture after storage in water at 36° during 7 days. Result: Linear alterations occurred on artificial teeth positioning for both groups and in all periods of inclusion, with higher alterations for group G2. The data from phases c and d were significant different from other phases when compared intra groups, for both inclusion methods evaluated. Conclusion: Group G2 exhibited the greatest alterations. After polymerization, group G1(Inclusion with silicone barrier complemented with dental stone type III) demonstrated higher distance between the points (expansion) while group G2 revealed reduced distance (contraction).

Introduction The treatment of orofacial tumors may cause facial deformities by losses of structures that affect basic functions, i.e. feeding, speech, and the reduction of patient self-steam. Presentation of case A white male patient was diagnosed with epidermoid cancer on the mandibular alveolar ridge with infiltration staging IV A. The patient was submitted to a mandibulectomy associated with a complete extraction of mandibular teeth. For rehabilitation, a conventional denture for the mandibular arch and a removable partial denture for the maxillary arch were fabricated. A correct occlusal adjustment and a satisfactory amount of alveolar bone was favorable for conventional dentures of the prostheses bases improve their retention and stability. After one year of follow-up, the patient was adapted to the prostheses, satisfied with their retention, and reported an improvement on his feeding. Discussion The prosthetic rehabilitation of patients after a partial mandibulectomy is essential for their self-steam. Conventional dentures may have their retention and stability improved if they are well fabricated, recorded and have a balanced occlusion. Conclusion A correct occlusal adjustment and an adequate retention of the prostheses bases may improve their retention and stability. Patients without xerostomy and with a satisfactory amount of alveolar bone may have a favorable prognosis for conventional dentures., Highlights • Oral Surgery oncology. • This study investigated the esthetic of the prosthesis rehabilitation. • Patient satisfaction after rehabilitation.

This systematic review aimed to evaluate if the internal connection is more efficient than the external connection and its associated influencing factors. A specific question was formulated according to the Population, Intervention, Control, and Outcome (PICO): Is internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? An electronic search of the MEDLINE and the Web of Knowledge databases was performed for relevant studies published in English up to November 2013 by two independent reviewers. The keywords used in the search included a combination of “dental implant” and “internal connection” or “Morse connection” or “external connection.” Selected studies were randomized clinical trials, prospective or retrospective studies, and in vitro studies with a clear aim of investigating the internal and/or external implant connection use. From an initial screening yield of 674 articles, 64 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full texts of these articles were obtained with 29 articles fulfilling the inclusion criteria. Morse taper connection has the best sealing ability. Concerning crestal bone loss, internal connections presented better results than external connections. The limitation of the present study was the absence of randomized clinical trials that investigated if the internal connection was more efficient than the external connection. The external and internal connections have different mechanical, biological, and esthetical characteristics. Besides all systems that show proper success rates and effectiveness, crestal bone level maintenance is more important around internal connections than external connections. The Morse taper connection seems to be more efficient concerning biological aspects, allowing lower bacterial leakage and bone loss in single implants, including aesthetic regions. Additionally, this connection type can be successfully indicated for fixed partial prostheses and overdenture planning, since it exhibits high mechanical stability.

Highlights • This study investigated the aesthetic of the prosthesis rehabilitation. • Patient satisfaction after rehabilitation. • Importance of radiographic control case report., Introduction The aim of this paper was to present a rehabilitation of a patient with a dynamic universal castable long abutment (UCLA) for a single tilted implant in the anterior maxillary area. Presentation of case A 57-year-old male patient attended the dentistry college clinic complaining of a vertical fracture of a residual root of the dental element 22. The tooth extraction was indicated for the implant installation. Due to the socket buccal wall thickness, the implant was installed with an inclination to the palate. It was done in a two-stage surgical protocol, and an external hexagon implant (3.75 × 11.5 mm) was placed. After a six-month healing period to correct the implant position, a dynamic UCLA was set in place, rectifying the implant emergence profile at 20°. The ceramic structure fitting was performed and, after the patient’s consent, the prosthesis was finalized and installed. Discussion After a follow-up period of twenty months, no complications were observed. Conclusion The installation of tilted implants with a dynamic UCLA may be a viable option, faster and less invasive than bone grafts.

Made available in DSpace on 2022-04-29T07:37:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-01-01 The objective of this study was to report a case of tooth fracture during the sport practice and the treatment performed for the patient. A 17-year-old male patient was subjected to an endontic treatment followed by the reattachment of the fractured teeth. Teeth were endodontically treated by conventional method. After, the acid etching with 37% phosphoric acid gel was performed and a bonding agent was applied on the dental surface. The fragments were reattachment and bonded with minimum amount of composite resin since the teeth/fragment interface was small. The occlusal contacts were adjusted in the finish line of restorations with a diamond bur and the polishing was performed with aluminum oxide discs. Positive esthetical and periodontal outcomes with no complications in the endodontic treatment were observed on radiographic examinations after twelve months of follow up. The endodontic treatment associated with the reattachment of the fractured teeth by a bonding procedure was a conservative treatment for the patient. The use of mouthguards is important to prevent such dramatic events. Department of Dental Materials and Prosthodontics Aracatuba Dental School Universidade Estadual Paulista, Jose Bonifacio Street, #1193 Department of Dental Materials and Prosthodontics Aracatuba Dental School Universidade Estadual Paulista, Jose Bonifacio Street, #1193

Made available in DSpace on 2018-12-11T17:04:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-10-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) The aim of this study was to evaluate the influence of pigment incorporation on the cytotoxicity of ocular prosthesis N1 color acrylic resin. Nine samples were manufactured by heat-polymerization in water bath and divided into 3 groups: acrylic resin without pigment incorporation (group R), acrylic resin with pigment incorporation (group RP), and acrylic pigment (group P). Eluates formed after 72 h of sample immersion in medium were incubated with conjunctival cell line (Chang conjunctival cells) for 72 h. The negative control group consisted in medium without samples (group C). The cytotoxic effect from the eluates was evaluated using MTT assay (cell proliferation), ELISA assay (quantification of IL1β, IL6, TNF α and CCL3/MIP1α) and RT-PCR assay (mRNA expression of COL IV, TGF β and MMP9). Data were submitted to ANOVA with Bonferroni post-tests (p < 0.05). All groups were considered non-cytotoxic based on cell proliferation. However, resin with pigment incorporation showed significant IL6 quantity increase. Resin without pigment incorporation exhibited higher mRNA expression of COL IV, MMP9 and TGF β, however it was also observed for the negative control group. The materials exhibited divergent biological behavior. Despite the pigment incorporation that resulted in an increase of IL6, no cytotoxicity was observed based on cell proliferation. Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP), Jose Bonifacio St., 1153, Vila Mendonca Department of Basic Sciences Aracatuba Dental School Sao Paulo State University (UNESP), Jose Bonifacio St., 1153, Vila Mendonca Technological Plasma Laboratory (LaPTec) Experimental Campus of Sorocaba UNESP, 3 de Marco Av., Alto da Boa Vista, Sao Paulo Department of Dental Materials and Prosthodontics Aracatuba Dental School Sao Paulo State University (UNESP), Jose Bonifacio St., 1153, Vila Mendonca Department of Basic Sciences Aracatuba Dental School Sao Paulo State University (UNESP), Jose Bonifacio St., 1153, Vila Mendonca Technological Plasma Laboratory (LaPTec) Experimental Campus of Sorocaba UNESP, 3 de Marco Av., Alto da Boa Vista, Sao Paulo

BACKGROUND: Recommendation for breast magnetic resonance imaging (MRI) screening for women with a prior history of chest radiation is currently based on expert opinion, because existing data are very scant. The objective of this study was to evaluate added cancer yield of screening breast MRI in this population. METHODS: A retrospective review identified 98 women with a prior history of chest radiation therapy who had screening mammography and screening MRI performed at the authors' institution between January 2004 and July 2010. Medical records of these patients and results of 558 screening studies (296 mammograms and 262 MRI) were reviewed. Sensitivity, specificity, positive predictive value, negative predictive value, and added cancer yield were calculated. RESULTS: Malignancy was diagnosed in 13 patients, invasive cancer was diagnosed in 10 patients, and ductal carcinomas in situ was diagnosed in 3 patients. The median latency from completion of radiation to detection of the breast cancer was 18 years (range, 8-37 years). Of the 13 cancers, 12 (92%) were detected by MRI, and 9 (69%) by mammography. For mammography, the sensitivity, specificity, positive predictive value, and negative predictive value were 69%, 98%, 82%, and 95%, respectively; and, for MRI, these values were 92%, 94%, 71%, and 99%, respectively. In 4 of 98 patients, cancer was diagnosed on MRI only, resulting in an incremental cancer detection rate of 4.1% (95% confidence interval, 1.6%-10%). CONCLUSIONS: The current results indicated that MRI is a useful adjunct modality for screening high-risk women who have a prior history of chest radiation therapy, resulting in a 4.1% (4 of 98 women) added cancer detection rate. The authors concluded that both MRI and mammography should be used to screen women in this high-risk group. Cancer 2013. © 2012 American Cancer Society.

The aim of this study was to evaluate the presence of clinically and mammographically occult disease using breast MRI in a cohort of cancer patients undergoing contralateral prophylactic mastectomy (CPM) and the utmost indication of axillary assessment (sentinel node biopsy (SLNB)) for this side. A retrospective review of patients with unilateral invasive breast cancer or ductal carcinoma in situ (DCIS) from institutional MRI registry data (2004–2010) was conducted. Characteristics of patients undergoing CPM with breast MRI obtained less than 6 month before surgery were evaluated. A total of 2322 consecutive patients diagnosed with DCIS or stage I to III infiltrating breast cancer underwent preoperative breast MRI. Of these, 1376 patients (59.2%) had contralateral clinical breast exam and mammography without abnormalities; and 116 patients (4.9%) underwent CPM (28 excluded patients had breast MRI more than 6 months before CPM). The mean age of the 88 patients was 49 years (range 28–76 years). Two (2.3%) DCIS identified on surgical pathology specimen were not depicted by MRI and the 5 mm T1N0 invasive cancer (1.1%) was identified on MRI. Preoperative MRI showed 95% accuracy to demonstrate absence of occult disease with negative predicted value (NPV) of 98% (95% CI: 91.64–99.64%). Occult disease was present in 3.4% of CPM. MRI accurately identified the case of invasive cancer in this cohort. The high negative predictive value suggests that MRI can be used to select patients without consideration of SLNB for the contralateral side.

To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning.An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review.One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters.The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

Made available in DSpace on 2015-12-07T15:32:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2015. Added 1 bitstream(s) on 2015-12-07T15:53:15Z : No. of bitstreams: 1 PMC4326350.pdf: 6825363 bytes, checksum: ee1a5276f0b153c37a0ea0f14e477bd0 (MD5) The success of rehabilitation will not depend on just clinical procedures. A proper dental technique (ceramist) is required as well as the respect for some biomimetic principles to obtain the desired final result. This study has the purpose of describing a prosthetic rehabilitation with laminate veneers and all-ceramic crowns of a patient unsatisfied with a previous esthetic treatment because of the negligence of some biomimetic principles. A 45-year-old female patient was admitted to the dental clinic complaining about the lifelike appearance of her all-ceramic restorations. Before the fabrication of new restorations, a mock-up was conducted to verify the patient's satisfaction. A ceramist conducted all the fabrication process so that surface characterizations could be visually verified and the lifelike appearance of natural tooth could be reproduced. After the cementation procedure, the patient reported being satisfied with the lifelike appearance of the new restorations. Based on the clinical findings of the present case report, it can be concluded that the reproduction of the lifelike esthetic appearance of natural teeth and the visualization of the final results before definitive procedures are essential to obtain the clinical success. Departamento de Materiais Odontológicos e Prótese, Faculdade de Odontologia de Araçatuba (FOA), Universidade Estadual Paulista (UNESP), Araçatuba, SP, Brasil Universidade Estadual Paulista, Departamento de Materiais Odontológicos e Prótese, Faculdade de Odontologia de Araçatuba

A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported.

Statement of problem Different factors can influence marginal bone loss around dental implants, including the type of internal and external connection between the implant and the abutment. The evidence needed to evaluate these factors is unclear. Purpose The purpose of this systematic review was to evaluate marginal bone loss by radiographic analysis around dental implants with internal or external connections. Material and methods A systematic review was conducted following the criteria defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a population, intervention, comparison, and outcome(s) (PICO) question was defined: does the connection type (internal or external) influence marginal bone loss in patients undergoing implantation? An electronic search of PubMed/MEDLINE and Scopus databases was performed for studies in English language published between January 2000 and December 2014 by 2 independent reviewers, who analyzed the marginal bone loss of dental implants with an internal and/or external connection. Results From an initial screening yield of 595 references and after considering inclusion and exclusion criteria, 17 articles were selected for this review. Among them, 10 studies compared groups of implants with internal and external connections; 1 study evaluated external connections; and 6 studies analyzed internal connections. A total of 2708 implants were placed in 864 patients. Regarding the connection type, 2347 implants had internal connections, and 361 implants had external connections. Most studies showed lower marginal bone loss values for internal connection implants than for external connection implants. Conclusions Osseointegrated dental implants with internal connections exhibited lower marginal bone loss than implants with external connections. This finding is mainly the result of the platform switching concept, which is more frequently found in implants with internal connections.

PURPOSE: To evaluate the role of apparent diffusion coefficient (ADC) values in distinguishing DCIS grades and identifying the presence of micro-invasive/invasive disease. METHODS AND MATERIALS: REB approved study with informed consent obtained from 70 women (age 36-84) scheduled for core-biopsy with results of 71 non-invasive/high-risk breast lesions. All patients underwent surgery and were assessed pre-operatively using diffusion weighted (DWI)-MRI. Lesion size, morphology and ADC values were recorded. The Kruskal Wallis or one-way ANOVA test and Pearson correlation coefficient were used to study the association between ADC values and the analyzed MRI lesion characteristics. Logistic regression analysis was used to evaluate the ability of ADC values to predict the presence of invasion. RESULTS: Of 71 cases, 45.1% were imaged on a 3T magnet and 54.9% on 1.5 T. Final pathology demonstrated invasive cancer in 26.8%, micro-invasion in 18.3% and pure DCIS in 59.2%. On 3T, mean ADC value was 1.20 ×10-3 mm2/s ± 0.48 (SD) (range, 0.47 - 1.78 ×10-3 mm2/s) for non-high grade DCIS, 1.23 × 10-3 mm2/s ± 0.40 (SD) (range, 0.26 - 1.77 ×10-3 mm2/s) for high-grade DCIS, and 1.15 × 10-3 mm2/s ± 0.45 (SD) (range, 0.26 - 1.75 ×10-3 mm2/s) for invasive/microinvasive disease. On 1.5T, mean ADC value was 1.04 × 10-3 mm2/s ± 0.41 (SD) (range, 0.15 - 1.85 ×10-3 mm2/s) for non-high grade DCIS, 1.01 × 10-3 mm2/s ± 0.37 (SD) (range, 0.06 - 1.76 ×10-3 mm2/s) for high-grade DCIS, and 1.11 × 10-3 mm2/s ± 0.30 (SD) (range, 0.64 - 1.76 ×10-3 mm2/s) for invasive/microinvasive disease. Based on logistic regression analysis, mean ADC value was not a significant predictor for invasiveness using 1.5 T [OR = 2.6 (95% CI (0.409, 17.12)), p = 0.3] or 3T [OR = 0.4 (95% CI (0.076, 2.399)), p = 0.3] CONCLUSION: Mean ADC acquired using a 1.5T or 3T MRI was unable to predict high-grade or invasive disease in biopsy-proven DCIS lesions. Further work is exploring voxel-based approaches that may better appreciate tumor heterogeneity and identify sub-regions of tumor with these higher risk features. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-02-10.