The Novel Coronavirus: An Alert for Pacifiers’ Disinfection

Objective: To evaluate the best strategy for pacifier disinfection methods. Material and Methods: The literature search was conducted on MEDLINE/PubMed, Scielo, Lilacs, Web of Science, and Scopus databases to find all relevant articles published over the past 20 years, based on PRISMA guidelines. Two reviewers extracted data independently by using a standardized form. The following factors were recorded: country of study, type of study, pacifier material, sample number, microorganisms analyzed, decontamination methods used, method accessibility and results found. Results: A total of 121 articles were obtained from all databases. The selected documents underwent a final screening, resulting in 8 articles. The method of disinfection analyzed by the literature were: 3.5% neutral detergent, apple cider vinegar 70% spray, boiling water during 15 minutes, sodium hypochlorite 2.5, hydrogen peroxide 70% spray, chlorhexidine 0.12%, Brushtox®, sterile water and microwave. Conclusion: Because of the broad methods for pacifier disinfection and different levels of accessibility to disinfectant agents, the pacifier consensus for decontamination remains unclear. Although the disinfection methods are diverse, the methods suggested to its disinfection were identified and described in this article

Avaliação do conhecimento e práticas de responsáveis acerca da desinfecção das chupetas

Introduction: The habit of sucking a pacifier is common in children, as this object is a vehicle for contamination and transmission of disease-causing microorganisms, thus requiring correct disinfection. Objective: To evaluate the pacifier disinfection practices carried out by the guardians of children using pacifiers or that have already used it. Material and Methods: After ethical approval, a semi-structured questionnaire (12 questions) was applied to parents and grandparents of children who maintained the habit of pacifiers or who has interrupted it for a maximum of two years. The questions dealt with pacifier disinfection habits, access to disinfection instruction and health professionals, including dentists. The association between categorical variables was established using the Chi-square test and continuous variables using Pearson's correlation. The level of significance adopted was 5%. Results: 104 questionnaires were considered for the sample. The average age of the respondents was 32 years, the majority of whom were women (91.3%). The average age of children who used a pacifier was 26 months. Although boiling water is the most reported method of disinfecting pacifiers (35.6%), 15.4% of respondents reported using only running water. In addition, only 20.2% of respondents received any instruction from health professionals on disinfection, and only 29.8% reported having already taken the child to the dentist. The association between the frequency of pacifier disinfection and the frequency of going to the dentist was statistically significant. Conclusion: The knowledge by parents and family members about the disinfection of pacifiers was not adequate in this study. This fact may be related to the lack of access to information, through health professionals.Introdução: O hábito de sucção de chupeta é comum em crianças, sendo este objeto um veículo de contaminação e transmissão de microrganismos causadores de doenças, necessitando, dessa forma, de uma correta desinfecção. Objetivo: Avaliar as práticas de desinfecção de chupetas realizadas pelos responsáveis de crianças que tenham ou que já tiveram o hábito de usar chupeta. Material e Métodos: Após a aprovação ética, foi aplicado questionário semiestruturado (12 questões) a pais e avós de crianças que mantinham o hábito da chupeta ou que o interromperam há no máximo dois anos. As questões versaram sobre hábitos de desinfecção de chupetas, acesso a instrução sobre a desinfecção e a profissionais de saúde, incluindo dentistas. A associação entre variáveis categóricas foi estabelecida pelo teste Qui-quadrado e das variáveis contínuas pela correlação de Pearson. O nível de significância adotado foi de 5%. Resultados: Foram considerados para a amostra 104 questionários. A média de idade dos respondentes foi de 32 anos, sendo a maioria mulheres (91,3%). A idade média das crianças que usaram a chupeta foi de 26 meses. Apesar de água sob fervura ser o método de desinfecção das chupetas mais relatado (35,6%), 15,4% dos respondentes relataram usar apenas água corrente. Além disso, apenas 20,2% dos respondentes receberam alguma instrução de profissionais de saúde sobre a desinfecção, e somente 29,8% relataram já ter levado a criança ao dentista. A associação entre a frequência de desinfecção de chupetas e a frequência de ida ao cirurgião-dentista apresentou significância estatística. Conclusão: O conhecimento por pais e familiares sobre a desinfecção de chupetas não se mostrou adequado neste estudo. Tal fato pode estar relacionado à falta de acesso à informação, por meio de profissionais de saúde

Biosafety in Dental Practices Versus COVID-19 Outbreak

Objective: To evaluate the dentists' knowledge about biosafety considering the SARS-CoV-2 and the risks of increasing the COVID-19 outbreak by dental practices during the pandemic in Brazil. Material and Methods: A cross-sectional study was performed by internet-based snowball sampling technique. A questionnaire with questions about different content was applied, and then analyzed the following two parameters: participants’ Brazilian region and professional’s specialty. Results: A total of 413 e-questionnaires from all Brazilian regions were considered valid. There were no significant differences among biosafety measures adopted by participants from different Brazilian regions (p≥0.05), except for those from North region, which have applied less previous oral antisepsis, temperature screening, and specific anamnesis tracking COVID-19 symptoms (p<0.05). The unique use of N95 mask was positively associated with North region (p<0.05). Expert participants of Groups 2 (oral surgery and correlate areas) and 4 (orthodontics, oral radiology and facial jaw orthopedics) were more updated than other ones (p<0.05). Conclusion: The biosafety protocols applied by participants were not adequate for the epidemiologic status of COVID-19 in each region of Brazil, from 13th May to 17th June 2020. Specialties linked to microbiology area or structured social networks have better applied preventive measures for COVID-19

Biosafety in Dental Practices Versus COVID-19 Outbreak

Objective: To evaluate the dentists' knowledge about biosafety considering the SARS-CoV-2 and the risks of increasing the COVID-19 outbreak by dental practices during the pandemic in Brazil. Material and Methods: A cross-sectional study was performed by internet-based snowball sampling technique. A questionnaire with questions about different content was applied, and then analyzed the following two parameters: participants’ Brazilian region and professional’s specialty. Results: A total of 413 e-questionnaires from all Brazilian regions were considered valid. There were no significant differences among biosafety measures adopted by participants from different Brazilian regions (p≥0.05), except for those from North region, which have applied less previous oral antisepsis, temperature screening, and specific anamnesis tracking COVID-19 symptoms (p<0.05). The unique use of N95 mask was positively associated with North region (p<0.05). Expert participants of Groups 2 (oral surgery and correlate areas) and 4 (orthodontics, oral radiology and facial jaw orthopedics) were more updated than other ones (p<0.05). Conclusion: The biosafety protocols applied by participants were not adequate for the epidemiologic status of COVID-19 in each region of Brazil, from 13th May to 17th June 2020. Specialties linked to microbiology area or structured social networks have better applied preventive measures for COVID-19

Correlação entre disfunção temporomandibular e redução de dimensão vertical de oclusão em usuários de prótese total

Introduction: Temporomandibular dysfunction (TMD) represents one of the main causes of pain in the orofacial region. The vertical dimension of occlusion (VDO) refers to the vertical position of the mandible in relation to the maxilla, and its correct restoration is essential in prosthetic rehabilitation, as variations in this parameter can negatively influence TMD pictures. Objective: To evaluate the presence of temporomandibular dysfunction in patients with total prosthesis and its possible association with the reduction of vertical dimension of occlusion. Material and Methods: The sample consisted of 31 volunteer patients, between 42 and 87 years old, of both sexes, being patients with total prosthesis, seen at the Clinic of Total Removable Prosthodontics of the Faculty of Dentistry of the Federal University of Juiz de Fora. The analysis of VDO reduction was performed through metrical, aesthetic and phonetic tests and the diagnosis of TMD was established from RDC/TMD Axis I (Research Diagnostic Criteria for Temporomandibular Disorders). Data was tabulated and subjected to descriptive statistical analysis in the program by SPSS (Statistical Package for the Social Science) version 15.0 for Windows. For the comparison of categorical variables between the TMD groups, the chi-square test was used with significance level of 5% (p<0.05). Results: According to the analysis, 71% of the individuals reported TMD symptoms and the majority of the patients were female. Although there was no statistically significant relationship between the loss of VDO and the presence of TMD, there was a correlation between the report of pain and the presence of the pathology (p<0.001). Conclusion: In view of the results obtained and the methodology applied, it was concluded that there was a considerable prevalence of TMD in patients wearing full dentures (71%), but when associating TMD with the reduction in the vertical dimension of occlusion, there was no statistical significance (p>0.05).Introdução: A disfunção temporomandibular (DTM) representa uma das principais causas de dor na região orofacial. A dimensão vertical de oclusão (DVO) refere-se à posição vertical da mandíbula em relação à maxila e seu restabelecimento correto é essencial nas reabilitações protéticas, pois variações deste parâmetro podem influenciar negativamente os quadros de DTM. Objetivo: Avaliar a presença de disfunção temporomandibular em pacientes portadores de prótese total e sua possível associação com a redução de dimensão vertical de oclusão. Material e Métodos: A amostra foi composta de 31 pacientes voluntários, com idades entre 42 e 87 anos, de ambos os sexos, sendo portadores de prótese total, atendidos na Clínica de Prótese Total Removível da Faculdade de Odontologia da Universidade Federal de Juiz de Fora. A análise da redução de DVO foi realizada através dos testes métrico, estético e fonético e o diagnóstico de DTM foi estabelecido a partir do Eixo I do RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders). Os dados foram tabulados e submetidos à análise estatística descritiva no programa pelo SPSS (Statistical Package for the Social Science) versão 15.0 para Windows. Para comparação das variáveis categóricas entre os grupos de DTM ​ foi utilizado o teste Qui-quadrado com nível de significância admitido de 5% (p<0,05). Resultados: De acordo com a análise, 71% dos indivíduos relataram sintomas de DTM e a maioria dos pacientes era do sexo feminino. Embora não houve relação estatisticamente significativa entre a perda de DVO e a presença de DTM, houve uma correlação entre o relato de dor e a presença da patologia (p<0,001). Conclusão: Diante dos resultados obtidos e da metodologia aplicada, concluiu-se que houve uma considerável prevalência de DTM em pacientes usuários de prótese total (71%), mas ao associar DTM com a redução de dimensão vertical de oclusão, não houve significância estatística (p>0,05)

Biocompatibilidade em pulpotomia de dentes decíduos: melhor material e alternativas ao uso do MTA: revisão sistemática e metanálise

Introduction: Vital pulp therapy is a treatment aimed at maintaining pulp vitality and tooth function. For pulpotomy, materials are chosen based on some fundamental characteristics, such as biocompatibility and bioactivity. Objective: The objective of this research is to identify the best material for use in pulpotomy considering the property of biocompatibility, through a systematic review of the literature and meta-analysis. Materials and Methods: The guiding question was: “What is the best agent for pulpotomy considering the biocompatibility property?”. A search was performed in the electronic databases MEDLINE/PubMed, SciELO, LILACS and Web of Science from inception to October 2020, using the following descriptors recognized by Medical Subject Headings (MeSH): “pulpotomy”, “pulp therapy”, “biomaterials”, “biocompatible materials'', “pulp capping agent”, “pulp capping materials”. The search was based on the acronym PICOS, developed in accordance with PRISMA and registered in the PROSPERO database (CRD42020191891). Risk of bias and meta-analysis were performed using Cochrane tools. Results: As a result, 358 studies were retrieved, 15 of them were admitted to qualitative analysis and six to quantitative analysis. The research evaluated clinical, radiographic and histological aspects, considering different follow-up periods, samples and methodologies. Several materials were found and MTA was the most studied. Although the qualitative results were inconclusive in relation to the best of them, it was possible to establish viable alternatives for MTA replacement. Conclusion: In conclusion, it was possible to obtain, through meta-analysis, that MTA is the most favorable material for use in pulpotomies in deciduous teeth.Introducción: La terapia pulpar vital es un tratamiento dirigido a mantener la vitalidad pulpar y la función dentaria. Para la pulpotomía, los materiales se eligen en función de algunas características fundamentales, como la biocompatibilidad y la bioactividad. Objetivo: El objetivo de esta investigación es identificar el mejor material para uso en pulpotomía considerando la propiedad de biocompatibilidad, a través de una revisión sistemática de la literatura y metanálisis. Materiales y Métodos: La pregunta orientadora fue: “¿Cuál es el mejor agente para pulpotomía considerando la propiedad de biocompatibilidad?”. Se realizó una búsqueda en las bases de datos electrónicas MEDLINE/PubMed, SciELO, LILACS y Web of Science desde su inicio hasta octubre de 2020, utilizando los siguientes descriptores reconocidos por Medical Subject Headings (MeSH): “pulpotomy”, “pulp therapy”, “biomaterials” , “materiales biocompatibles”, “agente de recubrimiento pulpar”, “materiales de recubrimiento pulpar”. La búsqueda se basó en el acrónimo PICOS, desarrollado de acuerdo con PRISMA y registrado en la base de datos PROSPERO (CRD42020191891). El riesgo de sesgo y el metanálisis se realizaron con herramientas Cochrane. Resultados: Como resultado, se recuperaron 358 estudios, 15 de ellos fueron admitidos al análisis cualitativo y seis al análisis cuantitativo. La investigación evaluó aspectos clínicos, radiográficos e histológicos, considerando diferentes periodos de seguimiento, muestras y metodologías. Se encontraron varios materiales y el MTA fue el más estudiado. Aunque los resultados cualitativos no fueron concluyentes en relación al mejor de ellos, fue posible establecer alternativas viables para el reemplazo de MTA. Conclusión: En conclusión, se pudo obtener, a través del metaanálisis, que el MTA es el material más favorable para su uso en pulpotomías en dientes temporales.Introdução: A terapia pulpar vital é o tratamento que visa a manutenção da vitalidade pulpar e da função do dente. Para a pulpotomia, os materiais são escolhidos baseados em algumas características fundamentais, tais como a biocompatibilidade e bioatividade. Atualmente, o Agregado de Trióxido Mineral (MTA) é o mais comumente utilizado para este procedimento. Objetivo: Identificar o melhor material para uso em pulpotomia em dentes decíduos considerando a propriedade de biocompatibilidade, através de revisão sistemática da literatura e metanálise. Material e Métodos: A pergunta norteadora foi: “Qual é o melhor agente para pulpotomia em termos de biocompatibilidade?”. Foi realizada pesquisa nas bases de dados eletrônicas Medline/PubMed, SciELO, LILACS e Web of Science sem restrição de data inicial até outubro de 2020, usando os seguintes descritores padronizados pelo Medical Subject Headings (MeSH): “pulpotomy”, “pulp therapy”, “biomaterials”, “biocompatible materials”, “pulp capping agent”, “pulp capping materials”. Resultados: Um total de 358 estudos foram identificados, sendo 15 deles selecionados para análise qualitativa e seis para metanálise. A revisão avaliou aspectos clínicos, radiográficos e histológicos, considerando diferentes períodos de acompanhamento, amostras e metodologias. Diversos materiais foram encontrados e o MTA foi o mais frequente. Embora os resultados qualitativos tenham sido pouco conclusivos em relação ao melhor deles, foi possível estabelecer que o Cimento Portland é uma alternativa viável para a substituição do MTA. Conclusão: A metanálise demonstrou que o MTA é o material mais favorável para uso em pulpotomias em dentes decíduos

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost