Botulinum toxin type A (BoNT-A) is an established preventive therapy for chronic migraines; however, uncertainty remains regarding its comparative efficacy and safety. Thus, we aimed to summarize current evidence from high-quality systematic reviews of the therapeutic effects of BoNT-A in migraine management. An umbrella review was conducted following PRISMA guidelines and registered in PROSPERO. High-quality systematic reviews with meta-analysis evaluating BoNT-A efficacy were identified through five databases up to August 2024. Primary outcomes included monthly headache frequency and severity. Methodological quality and risk of bias were assessed using the umbrella review checklist. Fourteen articles were included. Overall, quantitative evidence indicated favorable effects of BoNT-A compared with placebo for chronic migraines, across headache frequency, headache severity, and acute medication use, but less efficacy than topiramate and the CGRP monoclonal antibodies (CGRPmAbs) galcanezumab and fremanezumab. Though the adverse events were frequent, BoNT-A was generally well-tolerated. Comparative data suggested superior tolerability versus topiramate and a safety profile like CGRPmAbs. Although botulinum toxin type A is widely used as a preventive treatment for chronic migraines, the available evidence supports its efficacy at a moderate level. Further head-to-head and long-term analyses are needed to clarify its comparative role alongside newer biologic treatments.

Aim: This study aimed to analyze the influence of finishing and polishing (F/P) protocols on resin surface through roughness (Ra) values and laser scan microscopy observations. Methods: Forty-eight (n=48) resin specimens were sorted into four groups (n=12), according to the type of resin used: Filtek Z250 (Z250), Filtek Z350 (Z350), Filtek One Bulk Fill (BF), Filtek P60 (P60). The specimens were sorted into six groups according to the type of F/P system used (n=2/group): Control group, Diamond bur (KG Sorensen), Soflex Pop-On Discs (3M ESPE), Soflex Spiral (3M ESPE), Dura Gloss (American Burs), and Praxis (TDV). Results: The highest roughness values (Ra) were attributed to BF group for all F/P systems, except for the Soft-Lex PopOn discs. The Soft-Lex PopOn, Spiral, and Praxis discs presented a better performance for the surface treatment of the tested composite resins. Regardless of the restorative material, the use of diamond bur or single-step abrasive rubber (Dura Gloss) were associated with the highest Ra values. Conclusion: The effect of F/P systems on Ra is material-dependent and instrument or system-dependent.

Tooth bleaching has become the first clinical option in reversing chromatic changes. This study evaluated the efficiency of four different approaches for home-based chemically induced tooth whitening. 32 patients were randomly distributed into four groups (n=8), according to the bleaching technique performed: G1: control group – at-home dental bleaching with 10% carbamide peroxide (Whiteness Perfect/FGM) delivered in a customized tray, G2: teeth whitening pen containing hydrogen peroxide (Walgreens), G3: night-time whitening gel (CVS) containing hydrogen peroxide and G4: whitening strips (3D White Oral B) containing 10% hydrogen peroxide. Chromatic changes (ΔE) were collected at baseline and at the middle and end of the treatment, using a digital spectrophotometer (EasyShade – Vita). Tooth sensitivity, gingival irritation, and degree of satisfaction were also recorded. The comparison between the average ΔE means, considering the final and initial values, revealed a statistically significant difference between the results obtained by G1 (ΔE2=11.65) and the other groups (ΔE2 of G2=4.38, G3=4.83 and G4 = 8.32). No significant difference was observed in the occurrence of tooth sensitivity and gingival irritation. The patients from G1 and G4 were more satisfied with the treatment outcome.

The purpose of this study was to compare the tooth wear in function of the use of different commercial herbal toothpastes through the analysis of Optical Coherence Tomography (OCT). Twenty bovine teeth were obtained and distributed in 4 groups (n = 5) according to the dentifrice used: G1: Captive Nature (Chamomile, Xylitol, Juá and Salvia); G2: Suavetex Content (Turmeric); G3: Colgate Triple Action (positive control); G4: distilled water (negative control). The samples were painted in the half of the fragment with nail polish so that only half of the fragment was brushed. The simulated brushing (20,000 cycles) was performed with linear movements, under static axial load of 200g and speed of 4.5 cycles per second. After this step, an analysis was performed through OCT and and the images obtained were evaluated to identify possible changes in the specimen surface. According to the qualitative analysis of the OCT images, enamel wear was not observed, since all measurements were null. Regarding the evaluation of dentin, surface wear was observed in all groups except G4, but G3 had the highest number of samples with surface wear around 21.32%. All dentifrices had abrasive wear on the dentin surface to a greater or lesser extent, but there was no wear on the enamel surface.