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- Effects of respiratory training on obstructive sleep apnea: systematic review and meta-analysisPublication . Cavalcante-Leão, Bianca; Araujo, Cristiano; Ravazzi, Glória; Basso, Isabela; Guariza‑Filho, Odilon; Taveira, Karinna; Santos, Rosane Sampaio; Neto, José; Zeigelboim, BiancaPurpose: This systematic review sought to answer the following focused question: “What are the effects of respiratory training devices on obstructive sleep apnea (OSA) outcomes in adults?” Methods: The acronym “PICOS” was used to determine eligibility criteria, which consists of (P population) = adults with mild to moderate OSA, (I intervention) = spirometry devices or breathing exercises, (C comparison) = compared to no breathing exercises in adults (> 18 years) with mild to moderate OSA, (O outcomes) = improved sleep quality (sleep quality indexes) and improved apnea-hypopnea indexes (AHI), (S study types) = randomized, pseudo-randomized, and nonrandomized clinical trials. The search was performed in the following databases: PubMed/Medline, LILACS, Scopus, Web of Science, Scopus, and Cochrane Library, in addition to gray literature through Google Scholar, Proquest, and Open Grey. The risk of bias was assessed using the Cochrane Collaboration tool. The certainty of the evidence was assessed using the GRADE tool. Meta-analyses of random effects were performed for the outcomes of interest. Results: A total of 1171 references were found. Applying the eligibility criteria, six studies were included in qualitative synthesis. Expiratory exercises showed a decrease in the apnea–hypopnea index (AHI) when compared to baseline (MD = − 8.4; 95% CI = − 12.4 to − 4.4; I2 = 19%). There was a decrease in values compared to baseline (MD = − 4.4; 95% CI = − 8.2 to − 0.6; I2 = 0%) for the Epworth Sleepiness Scale (ESS), when considering the inspiratory exercises. Both groups of breathing exercises showed a significant decrease in the mean index assessed by the Pittsburgh Sleep Quality Index (PSQI). Conclusion: Results of this meta-analysis suggests that breathing exercises lead to a measurable improvement in AHI for patients with mild to moderate OSA, as well as an improvement in sleep quality and daytime sleepiness.
- Psychosocial changes in patients submitted to orthodontic surgery treatment: a systematic review and meta‑analysisPublication . Basso, Isabela; Gonçalves, Flavio; Martins, Agnes; Schroder, Angela; Taveira, Karinna; Neto, José; Santos, Rosane Sampaio; Guariza‑Filho, Odilon; Araujo, CristianoObjective: This systematic review aims to answer the following question: What is the psychological impact of orthognathic surgery on patients with dentofacial deformities undergoing orthodontic-surgical treatment? Material and methods: The search was adapted for each of the following databases: American and Caribbean Center on Health Sciences (LILACS), Cochrane Library, Embase, Psychinfo, PubMed/Medline, Scopus and Web of Science, and gray literature using Google Scholar, OpenGrey, and ProQuest. The risk of bias was assessed using the Joanna Briggs Institute Critical Assessment Checklist. This study performed estimates of interest, random-effects meta-analyses, and calculated heterogeneity using Higgins inconsistency index (I2). Results: A total of 6751 references were found in all searches. After applying the eligibility criteria after full-text reading, 37 studies comprised the final qualitative synthesis. Thirteen studies were included in quantitative synthesis, and it was possible to meta-analyze data from the following questionnaires: GHQ-28, MMPI, RSES, and SCL-90-R. There was an improvement in psychological aspects related to depression, hysteria, self-esteem, anxiety, obsessive-compulsiveness, interpersonal sensitivity, paranoid ideas, and psychoticism (p < 0.05). Conclusions: Correction of dentofacial deformity through orthodontic-surgical treatment is associated with improvements observed in several psychological domains, especially in relation to depressive states. Clinical relevance: This result highlights the importance of surgeons and orthodontists in promoting adequate control of patients’ expectations and treatment goals taking into account the individual's psychological aspects.
- Front lines of the COVID-19 pandemic: what is the effectiveness of using personal protective equipment in health service environments?: a systematic reviewPublication . Araujo, Cristiano; Guariza‑Filho, Odilon; Gonçalves, Flavio; Basso, Isabela; Schroder, Angela; Cavalcante‑Leão, Bianca; Ravazzi, Glória; Zeigelboim, Bianca; Neto, José; Sampaio Santos, RosanePurpose: This systematic review aimed to evaluate the effectiveness of the use of personal protective equipment (PPE) in closed environments, similar to waiting or exam rooms of healthcare facilities, in the face of exposure to a bioaerosol. Methods: Combinations of words were selected for six electronic databases and for the gray literature. To consider the eligibility of the studies to be included/excluded, the acronym “PECOS” was used: humans and/or experimental models that simulate aerosol (Population); aerosol exposure and the use of masks/respirators (exposition/intervention); controlled or not controlled (comparison); effectiveness of PPE and the receiver exposure (outcomes); and randomized clinical studies or not, observational or laboratory simulation studies (Studies design). Results: A total of 4820 references were retrieved by the search strategy. Thirty-five articles were selected for complete reading, of which 13 articles were included for qualitative synthesis. A surgical mask or N95 respirator reduced the risk of transmission, even over short distances. The use of masks, even those with less filtering power, when used by all individuals in the same environment is more effective in reducing risk than the use of respirators with high filtering power for only some of the individuals present. Conclusion: The use of mask in closed environments is effective in reducing the risk of transmission and contagion of a contaminated bioaerosol, with greater effectiveness when these devices are used by the source and receiver, regardless of the equipment’s filtering power.
- Risk factors associated with the stability of mini-implants and mini-plates: systematic review and meta-analysisPublication . Mattos, Paola; Gonçalves, Flavio; Basso, Isabela; Zeigelboim, Bianca; Niwa, Marcio; Neto, José; Santos, Rosane Sampaio; Araujo, Cristiano; Guariza‑Filho, OdilonObjective: The objective of this systematic review is to assess the risk factors associated with the stability of mini-implants and mini-plates in patients undergoing orthodontic treatment using temporary anchorage devices. Material and Methods: Search strategies were developed for each electronic database (PubMed/Medline, LILACS, Scopus, Web of Science, Embase, and Cochrane Library) and gray literature (Google Scholar, Proquest, and Open Grey). The risk of bias was assessed using the Cochrane Collaboration tool for assessing the risk of bias and Meta-Analysis of Statistics Assessment and Review Instrument. The certainty of the evidence was assessed using the GRADE tool. Meta-analyses and meta-regressions of random effects were performed for the outcomes of interest. Results: A total of 1517 articles were found, of which seven were selected for quantitative synthesis. When comparing the risk of failure between mini-implants and mini-plates, the risk values approached the threshold of statistical significance (p = 0.07) (RR = 1.83; 95% CI = 0.96–3.50; I2 = 69%), showing significance after sensitivity analysis (p < 0.05) and a greater risk for mini-implants. Mandible installation presented a higher risk of failure (RR = 1.85; 95% CI = 1.17–2.91). Conclusions: The evidence found indicates that failure in the stability is related to the type of device and that there is a greater risk by using isolated mini-implants, especially when positioned in the mandible. Clinical relevance: These findings help the orthodontist and/or the surgeon to stipulate risks, learn about the predictability of techniques, and communicate with the patient in an easier way.
- Efficacy of disinfecting inanimate surfaces against coronavirus: a systematic reviewPublication . Basso, Isabela; Schroder, Angela Graciela Deliga; Sampaio Santos, Rosane; Ravazzi, Gloria; Gonçalves, Flávio Magno; Stechman-Neto, José; Zeigelboim, Bianca Simone; Guariza Filho, Odilon; Araujo, CristianoHuman coronaviruses tend to persist on dry surfaces for 2 to 9 days, necessitating infection control and prevention protocols using biocidal agents. This systematic review aimed to answer the following focused question: What is the effectiveness of disinfectants on inanimate surfaces against the coronavirus? The acronym “PICOS” was used to represent the eligibility of studies: P = population (inanimate surfaces contaminated with coronavirus); I = intervention (disinfectants); C = comparison (studies with any type of control or studies that used a control group); O = outcomes (coronavirus inactivation on different types of inanimate surfaces); and S = study design (in vitro studies). The seven databases used were PubMed/Medline, EMBASE, Latin American and Caribbean Literature on Health Sciences (LILACS), Web of Science, Scopus, LIVIVO, and Cochrane Library. The gray literature was also used as an information source through Google Scholar, ProQuest, and Open Gray. The search resulted in 6639 references, and 21 articles were used in the qualitative analysis. The results showed that all studied biocidal solutions provided some degree of decontamination and inactivation of the coronavirus, depending on the concentration of the disinfectant solution, the time of exposure of the product to the pathogen and the type of surface.
- Effect and longevity of botulinum toxin in the treatment of gummy smile: a meta-analysis and meta-regressionPublication . Zengiski, Aline; Basso, Isabela; Cavalcante-Leão, Bianca; Neto, José; Santos, Rosane Sampaio; Guariza‑Filho, Odilon; Zeigelboim, Bianca; Taveira, Karinna; Araujo, CristianoObjective: The aim of this systematic review is to synthesize the evidence on the effectiveness and longevity of the botulinum toxin in the treatment of individuals with excessive gingival exposure. Methods: The search was adapted to six electronic databases and gray literature. The risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool for Non-Randomized and Randomized Studies of Interventions. Meta-analyses and meta-regression were performed using random effects models. Results: A total of 5247 articles were collected during the final search in the database, resulting in 17 articles included. There was a mean decrease of 3.42 mm [95% CI = −4.50 to −2.34; I2 = 97%] in the level of gingival exposure 2 weeks after the application of botulinum toxin. The application time explained 29.58% of the observed variance (p < 0.001), with a tendency for the effect size to decrease from the second week of application onwards, with values returning close to baseline levels in 24 weeks. Conclusion: Botulinum toxin is an alternative technique considered effective for reducing gummy smile, especially for gummy smiles up to 4 mm, with a longevity of at least 12 weeks, returning close to initial values within 24 weeks after application. Clinical relevance: The knowledge about the longevity and effectiveness of botulinum toxin in the treatment of gummy smile allows for a more adequate clinical planning for these cases, as well as for clinical decisions, as for prognostic factors.
- Coronavirus survival time on inanimate surfaces: a systematic reviewPublication . Schroder, Angela Graciela Deliga; Stechman-Neto, José; Basso, Isabela; Gonçalves, Flávio Magno; Cavalcante-Leão, Bianca; Ravazzi, Gloria; Zeigelboim, Bianca Simone; Povh, Bruna; Guariza Filho, Odilon; Sampaio Santos, Rosane; Araujo, CristianoThis systematic review aimed to study the survival time of the virus from the coronavidae family on various materials and surfaces, thus enabling the adoption of preventive measures mainly in public environments. The electronic databases selected as a source of information were PubMed/Medline, Excerpta Medica database (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science, Scopus, and LIVIVO; grey literature (Google Scholar, ProQuest, and OpenGrey) was also examined. The last electronic search of the six databases retrieved 4287 references. After removing the duplicate references, the titles and abstracts (phase 1) were read, and 37 articles were selected for complete reading (phase 2), which resulted in 13 included studies. All the studies evaluated coronavirus survival on the following surfaces and objects: stainless steel, glass, plastic, wood, metal, cloth, paper, cotton, latex, polystyrene petri dish, aluminium, copper, cardboard, Teflon, polyvinyl chloride (PVC), silicone rubber and disposable fabric. On surfaces such as glass, plastic, and steel, the virus has greater stability than it does on copper, fabric, paper, and cardboard. The conditions of temperature, relative humidity, absorption power, and texture were also considered important factors in the survival of the virus.
- Balance rehabilitation with a virtual reality protocol for patients with hereditary spastic paraplegia: protocol for a clinical trialPublication . Zeigelboim, Bianca; José, Maria Renata; Santos, Geslaine; Severiano, Maria Izabel; Teive, Hélio; Neto, José; Santos, Rosane Sampaio; Araujo, Cristiano; Cavalcante-Leão, Bianca
- Is there scientific evidence of the mouthwashes effectiveness in reducing viral load in Covid-19?: a systematic reviewPublication . Cavalcante-Leão, Bianca; Araujo, Cristiano; Basso, Isabela; Schroder, Angela; Guariza-Filho, Odilon; Ravazzi, Glória; Gonçalves, Flavio; Zeigelboim, Bianca; Sampaio Santos, Rosane; Neto, José StechmanBackground: The aim of this research is to verify whether there is evidence in the literature regarding the decrease in viral load present in saliva after using three types of mouthwashes. Material and Methods: Clinical and/or in vitro experimental studies that have used mouthwashes as a form of intervention to reduce the viral load in saliva were included. Combinations of words and appropriate truncations were adapted for each of the seven selected electronic bases including grey literature. Results: The selection of articles was carried out in two phases by two independent reviewers. After removing duplicate articles, 1245 references were maintained, and 2 articles were included in the Systematic Review. Both studies were performed in vitro and tested the virucidal action of the PVP-I solution for mouthwash at two different concentrations, 1% without dilution and 7% with 1:30 dilution, on the SARS-CoV and MERS-CoV viruses. Both showed a viral reduction of ≥ 99.99% with 15 s exposure. Conclusions: Based on the evidence currently available in the literature, PVP-I, at concentrations of 1 and 7%, appears to be the most effective mouthwash for reducing the viral load of COVID-19 present in human saliva. However, the guidelines for dental care refer to the use of hydrogen peroxide but there is insufficient scientific evidence to support this recommendation.