3D-printed model for gingival flap surgery simulation: Development and pilot test

INTRODUCTION

To assess the feasibility of a realistic model for learning oral flaps using 3D printing technology.

MATERIALS AND METHODS

A mould was designed to reproduce the mandibular gingival mucosa, and a mandibular model was created using a three-dimensional printer for training undergraduate students to perform gingival flaps. After a short interview about its use, the participants were asked to use the simulator and provide feedback using a 5-point Likert questionnaire.

RESULTS

The 3D-printed oral surgery flap training model was practical and inexpensive. The model was very realistic, educational and useful for hands-on training.

CONCLUSIONS

3D printing technology offers new possibilities for training in dental treatments that are currently difficult to replicate. The use of this simulator for oral flap surgery was well-received and considered promising by the participants.

Pre-implant and implant management of oligodontia patients: A 10-year retrospective study

INTRODUCTION

the aim of this study was to report and assess the management and implant rehabilitation of oligodontia patients since its recognition in 2012 by french authorities in the nomenclature.

MATERIAL AND METHODS

we conducted a retrospective study in the Maxillofacial Surgery and Stomatology Department of the Lille University Hospital between January 2012 and May 2022. Patients had to present an oligodontia recognized under the ALD31 in adulthood, and to have benefited from a pre-implant/implant surgical treatment in the unit.

RESULTS

a total of 106 patients were included in the study. The mean number of agenesis was 12 per patient. The most missing teeth are the ones at the end of the series. After a pre-implant surgery phase including orthognathic surgery and/or bone grafting, 97 patients benefited from implant placements. The mean age for this phase was 19.38. A total of 688 implants were placed. The median number of implants placed was 6 per patient and 5 patients presented implant failures after or during the osseointegration phase (16 implants lost). The implant success rate was 97.6%. 78 patients benefited from rehabilitations by fixed implant-supported prostheses and 3 by implant-supported mandibular removable prostheses.

DISCUSSION

The described care pathway seems to us adapted to the patients followed in our department, with good functional and esthetic results. It would be necessary to evaluate on a national scale to adapt the management process.

Management of Permanent Teeth in Dentigerous Cysts in Children: A Case Report

Dentigerous cysts are the second most common odontogenic lesion, after radicular cysts. Dentigerous cysts mainly affect individuals in their second to fourth decades of life, with a slight male predominance. Because diagnosis is often late, surgical procedures like enucleation and removal of the impacted tooth misplaced are often necessary. However, if a dentigerous cyst is detected early in a child with delayed tooth eruption, the treatment goal is to preserve and properly position the permanent tooth within the arch. In such cases, conservative approaches like cyst decompression may be considered appropriate. We present a case of a dentigerous cyst in a 10-year-old child with delayed eruption of teeth 22 and 23. The condition was managed using decompression alone and orthosurgical traction, which facilitated the proper placement of the impacted teeth within the arch. This article emphasizes the significance of a multidisciplinary approach involving surgical and orthodontic management for dentigerous cysts in children, along with the importance of patient compliance with the treatment plan.

Project SELfit: training socio-emotional skills in a school environment in Porto

Issue/Problem

Mental disorders are the main cause of years lived with disability (YLD) in 5-14-year-old people around the world, in Western Europe, and particularly in Portugal. Young people who experience anxiety during childhood have a 3,5-fold likelihood of suffering from depression or anxiety during adulthood. COVID-19 has aggravated this situation, namely regarding socio-emotional competencies.

Description of the problem

SELfit, a project based on the Socio-emotional learning (SEL) methodology, aims promoting mental health, by training teachers and community nurses to develop socio-emotional skills in students from primary schools. The project includes a theoretical and a practical/training session, and monthly supervision sessions by a team that includes a psychologist, a public health doctor and public health nurses. The period of implementation is between February to July 2022.

Results

A total of 8 community nurses and 13 teachers from 3 primary schools in Porto enrolled in this project, which corresponds to a total around 272 students from 5 to 8-year-old. Knowledge of nurses and teachers regarding mental health literacy, and social emotional learning was assessed, before and after the theoretical session. The mean percentage of correct answers before was 49% (54% regarding nurses and 45% teachers) compared to 84% (92% regarding nurses and 78% teachers) after. Concerning socio-emotional skills of the primary school students, possible improvement will be evaluated at the end of the project (July 2022).

Lessons

Mental health literacy and social emotional learning knowledge increased 35%, which highlights the importance of these theoretical sessions promoting mental health literacy. By the end of this project, it is expected to exist an improvement on socio-emotional skills of the primary school students. This is a very important project, expected to be implement and replicated in other schools in Porto and in Portugal.

Key messages

• Mental disorders are the main cause of years lost due to disability (YLD) in primary school students in Portugal; hence, it was chosen for this mental health promotion project.

• This is a pioneer project in Porto, involving both community nurses and primary teachers, in which all are involved in training and promoting social-emotional learning in a school context.

Capture-recapture study to estimate the true incidence of tuberculosis in Portugal, 2018

Accurate estimation of the true number of cases of an infectious disease is essential to plan and efficiently allocate available resources. This study aims to improve the Portuguese surveillance system for tuberculosis (TB) by identifying gaps in TB epidemiological surveillance at the national level. We estimated annual TB incidence using a capture-recapture method to assess the sensitivity of national TB surveillance.

Using probabilistic record linkage between two data sources, the National Epidemiological Surveillance System (SINAVE) and National Tuberculosis Program Surveillance System (SVIG-TB), we extracted TB diagnosed cases data for calendar year 2018. All reported TB cases were included, classified as confirmed, probable or possible. A two-source capture-recapture analysis using a log-linear model was performed to estimate the number of unobserved TB cases in Portugal and of the proportion identified by the current TB surveillance system.

Between the two datasets, we found 896 TB cases (of a total of 2170 cases) that could not be matched (37.5% SINAVE only, 62.5% SVIG only). Based on the log-linear model, it was estimated that there were 148 unobserved TB cases (95% confidence interval 127.96 - 171.31). Therefore, the estimated true number of TB cases in 2018 is 2318, so current surveillance has a sensitivity of 93.6%. Based on these findings, the TB incidence in Portugal is estimated to be 22.55 cases per 100 000 inhabitants.

Capture-recapture methods are useful in estimating annual TB incidence in high-resource settings. Although the two TB surveillance systems capture the majority of TB cases in Portugal, we might still be underestimating the true number of TB cases. Because TB is a high impact infectious disease, precise incidence estimates are crucial to allocate treatment and prevention resources and guide health policies.

Key messages

CRC method showed that Portugal is a TB low incidence country. Epidemiological surveillance systems should have a high sensitivity in order to allocate efficiently resources available.

Are international travelers from Portugal aware of malaria? Pre-travel assessment between 2019-2020

Background

Malaria is the main cause of death by infection among travelers. It may be prevented via chemoprophylaxis and personal protection. In 2017, European Centre for Disease Prevention and Control reported 8401 cases in Europe-8023 imported (99,8% travel-related). Misperception of the risk and inadequate pre-travel preparation are some of the reasons for these case numbers. The main goal of this study was to assess travelers' knowledge of malaria to improve medical advice in pre-travel consultations in the Oporto international vaccination centre (OIVC), minimizing the risk among travelers going to malaria endemic regions.

Methods

Before their pre-travel consultation in OIVC, 452 travelers filled the questionnaire with demographic issues, journey characteristics and answers about malaria's etiology, prevention and treatment. All travelers signed an informed consent form. Data were collected between July 2019 and January 2020 and analyzed via descriptive statistics and hypothesis test for comparing two populations proportions for each question.

Results

40,4% of travelers age was 26 - 35 years; 52,3% were female; and 67,5% of the planned trips were 1-3 week-long, mainly for tourism (n = 285). For most of malaria questions, travelers holding a university degree (n = 352) exhibited a statistically significant difference (p < 0,005) in knowledge with an average of 70,5% correct answers compared to 58.5% of those with lower education level. However, regarding previous pre-travel appointments: for the majority of questions knowledge was similar (p > 0,005) comparing to those who had first pre-travel consultation (n = 287), with an average of correct answers of 73,7% and 65,5%, respectively.

Conclusions

A stronger focus on malaria in pre-travel medical advice is necessary to increase travelers' knowledge. It is also essential to adapt malaria information to travelers' characteristics- in view of the lower percentage of correct answers by those with a lower education level.

Key messages

Malaria is a potential health risk for international travellers and an important cause of death among them. This may be caused by inaccurate perception of risk and sub-optimal pre-travel preparation. This study is the largest in Portugal to assess traveleŕs knowledge about malaria. It is crucial in order to improve medical advice and minimize the risk.

Early Interaction of Alternaria infectoria Conidia with Macrophages

Fungi of the genus Alternaria are ubiquitous indoor and outdoor airborne agents, and individuals are daily exposed to their spores. Although its importance in human infections and, particularly in respiratory allergies, there are no studies of how Alternaria spp. spores interact with host cells. Our aim was to study the early interaction of Alternaria infectoria spores with macrophages, the first line of immune defense. RAW 264.7 macrophages were infected with A. infectoria conidia, and the internalization and viability of conidia once inside the macrophages were quantified during the first 6 h of interaction. Live cell imaging was used to study the dynamics of this interaction. TNF-α production was quantified by relative gene expression, and the concentration of other cytokines (IL-1α, IL-1β, IL-6, IL-4, IL-10, IL-17, GM-CSF and INF-γ) and a chemokine, MIP-1α, was quantified by ELISA. Conidia were rapidly internalized by macrophages, with approximately half internalized after 30 min of interaction. During the first 6 h of interaction, macrophages retained the ability to mitotically divide while containing internalized conidia. The classical macrophage-activated morphology was absent in macrophages infected with conidia, and TNF-α and other cytokines and chemokines failed to be produced. Thus, macrophages are able to efficiently phagocyte A. infectoria conidia, but, during the first 6 h, no effective antifungal response is triggered, therefore promoting the residence of these fungal conidia inside the macrophages.

Peripheral blood telomere content is greater in patients with endometriosis than in controls

The etiology of endometriosis remains poorly understood but circulating stem cells may contribute. Telomeres shorten with cell divisions and age. Stem cells attempt to compensate for telomere attrition through the action of telomerase. Since circulating stem cells may contribute to endometriosis, we compared telomere content in lymphocytes of patients with and without endometriosis.

METHODS

Observational study comparing peripheral lymphocytes telomere content, measured by quantitative polymerase chain reaction, in patients with (n = 86) and without endometriosis (n = 21).

FINDINGS

Patients with endometriosis had longer telomeres than that of matched, endometriosis-free controls (telomere to single copy gene ratio [T/S ratio] of 1.62 vs 1.34, respectively, P = .00002). Patients with endometriosis were 8.1-fold more likely to have long telomeres. (odds ratio = 8.1, 95% confidence interval: 1.28-51.57, P = .0264).

INTERPRETATION

Longer telomeres could be consistent with a stem cell origin of endometriosis.