Bovine teeth can reliably substitute human dentine in an intra-tooth push-out bond strength model?

AIM: To investigate the reliability of using bovine teeth as an alternative to human teeth in an intra-tooth push-out model by comparing the bond strength of three root canal sealers in both tooth substrates. METHODOLOGY: From human and bovine incisors (12 per group), one 1-mm disc was obtained from each root. On each disc, three standard 0.8-mm-diameter holes were drilled through the dentine. After irrigation, the holes were filled with one of three root canal sealers: AH Plus, MTA Fillapex or Total Fill BC Sealer. Tooth slices were kept in contact with sterile gauze moistened in PBS solution (pH = 7.2) for 7 days at 37 °C, and finally, a push-out load was applied until sealer dislocation. The bonded interface area was calculated to obtain data in MPa. The push-out data for each sealer and the overall push-out data for human and bovine teeth were compared (Mann-Whitney U). Kruskal-Wallis was used to study the sealers behaviour at each of the dental substrates. Multiple comparisons were performed using Mann-Whitney U after Bonferroni correction (P < 0.05). RESULTS: Dentine substrate did not influence the push-out of either individual sealers or overall sealers tested (Mann-Whitney U, P > 0.05). In both human and bovine samples, AH Plus performed better than BC Sealer and MTA Fillapex, whilst BC Sealer also provided a superior push-out compared to MTA Fillapex (Mann-Whitney U, P < 0.05). CONCLUSION: When using an intra-tooth model, bovine teeth did not significantly influence the bond strength of sealers.

The progression rate of spinocerebellar ataxia type 2 changes with stage of disease.

BACKGROUND: Spinocerebellar ataxia type 2 (SCA2) affects several neurological structures, giving rise to multiple symptoms. However, only the natural history of ataxia is well known, as measured during the study duration. We aimed to describe the progression rate of ataxia, by the Scale for the Assessment and Rating of Ataxia (SARA), as well as the progression rate of the overall neurological picture, by the Neurological Examination Score for Spinocerebellar Ataxias (NESSCA), and not only during the study duration but also in a disease duration model. Comparisons between these models might allow us to explore whether progression is linear during the disease duration in SCA2; and to look for potential modifiers. RESULTS: Eighty-eight evaluations were prospectively done on 49 symptomatic subjects; on average (SD), study duration and disease duration models covered 13 (2.16) months and 14 (6.66) years of individuals' life, respectively. SARA progressed 1.75 (CI 95%: 0.92-2.57) versus 0.79 (95% CI 0.45 to 1.14) points/year in the study duration and disease duration models. NESSCA progressed 1.45 (CI 95%: 0.74-2.16) versus 0.41 (95% CI 0.24 to 0.59) points/year in the same models. In order to explain these discrepancies, the progression rates of the study duration model were plotted against disease duration. Then an acceleration was detected after 10 years of disease duration: SARA scores progressed 0.35 before and 2.45 points/year after this deadline (p = 0.013). Age at onset, mutation severity, and presence of amyotrophy, parkinsonism, dystonic manifestations and cognitive decline at baseline did not influence the rate of disease progression. CONCLUSIONS: NESSCA and SARA progression rates were not constant during disease duration in SCA2: early phases of disease were associated with slower progressions. Modelling of future clinical trials on SCA2 should take this phenomenon into account, since disease duration might impact on inclusion criteria, sample size, and study duration. Our database is available online and accessible to future studies aimed to compare the present data with other cohorts.

Neurological phenotypes in spinocerebellar ataxia type 2: Role of mitochondrial polymorphism A10398G and other risk factors.

BACKGROUND: Spinocerebellar ataxia type 2 (SCA2) is due to a CAG expansion (CAGexp) at ATXN2. SCA2 presents great clinical variability, alongside characteristic ataxia with saccadic slowness. AIMS: To study parkinsonism, dementia, dystonia, and amyotrophy as subphenotypes of SCA2, and to explore the effect of CAG repeats at different loci and of mitochondrial polymorphism A10398G as modifiers of phenotype. METHODS: Symptomatic subjects were classified by presence/absence of neurological signs mentioned above; SARA and NESSCA scores were obtained. CAG repeats at ATXN1, ATXN2, ATXN3, CACNA1A, ATXN7 and RAI1, and polymorphism A10398G at mtDNA were established. Group characteristics were compared, with a p < 0.05. RESULTS: Forty-eight SCA2 individuals were included. Age at onset, CAGexp, and disease duration explained 53% and 43% of SARA and NESSCA variations, respectively. CAGexp of subjects with and without parkinsonism were different (medians of 42 and 39 repeats) as well as of subjects with and without dystonia (44 and 40 repeats). Amyotrophy was not significantly related to any variable under study. Concerning polymorphism A10398G, 83% of subjects with and 34% of those without cognitive decline carried 10398G at (p = 0.003). DISCUSSION: Treating the four phenotypic subgroups as outcomes was a valid strategy to identify modifiers of disease. Among correlations found, some confirmed previous reports, such as that between dystonia and CAGexp. Of note was the association between cognitive decline and the variant G at mitochondrial polymorphism A10398G, a variant formerly related to earlier ages at onset in SCA2.

Do smear-layer removal agents affect the push-out bond strength of calcium silicate-based endodontic sealers?

AIM: To evaluate the effect of 17% ethylenediaminetetraacetic acid (EDTA), 2.25% peracetic acid (PA) or 10% citric acid (CA) on the push-out bond strength of calcium silicate-based endodontic sealers [MTA Fillapex (Angelus, Londrina, Brazil) and Total Fill BC Sealer (FKG, La Chaux-de-Fonds, Switzerland)] to root dentine after different periods of immersion in phosphate-buffered saline (PBS). AH Plus (Dentsply DeTrey, Konstaz, Germany) was used as a reference material for comparison. METHODOLOGY: Thirty human maxillary incisors were selected and three 1-mm discs were obtained from the middle third of each root. On the axial surface of each disc, three 0.8-mm-diameter holes were drilled through the dentine. After standardized irrigation, each dentine disc from the same root was treated for smear-layer removal with one of the three tested chelating solutions: EDTA, PA or CA. After that, the holes were dried with paper points and filled with one of the three test root canal sealers. The filled dental slices were further immersed in PBS solution (pH 7.2) for 7 days (T1) or 30 days (T2) at 37 °C, before the push-out assay. Friedman, Kruskal-Wallis and Mann-Whitney tests were used respectively to estimate the impact of the independent variables (solutions, sealers and period of PBS immersion) on the push-out bond strength. The level for significance was set at α = 5% and data were further subjected to a Bonferroni correction. RESULTS: Solutions and periods of immersion did not significantly influence the displacement resistance (P = 0.285, and P = 0.104, respectively) of sealers to root dentine. On the other hand, the type of sealer significantly affected the push-out bond strength (P = 0.000). AH Plus was associated with greater resistance to dislodgment compared with Total Fill BC Sealer and MTA Fillapex (P = 0.000). MTA Fillapex resulted in the lowest push-out bond strength (P = 0.000). CONCLUSION: The use of different chelating agents did not influence the push-out bond strength of endodontic sealers. Calcium silicate-based sealers had lower push-out bond strength values compared with a conventional epoxy resin-based sealer (AH Plus).

Cytocompatibility of Biodentine using a three-dimensional cell culture model.

AIM: To evaluate the cytotoxic effects of Biodentine, using a three-dimensional (3D) cell culture associated with an in situ root-end filling experimental model. White mineral trioxide aggregate (MTA) and zinc oxide cement were used as reference for comparison. IL-1α and TNF-α cytokine production were also evaluated. METHODOLOGY: The root canals of 24 human maxillary incisor teeth were prepared using a single-file reciprocating technique. After root filling, a 3-mm root-end resection was performed and 3 mm of gutta-percha was removed from the canal. The teeth were randomly distributed to receive one of the following root-end filling materials: Biodentine, white MTA or zinc oxide cement (positive control group). In the negative control group, the root canal was not retro-filled. The cytocompatibility of the materials was evaluated using the methyl-thiazol-diphenyl-tetrazolium (MTT) assay in an in situ root-end filling experimental model. Balb/c 3T3 fibroblasts, cultured in rat tail collagen type I 3D scaffold, were exposed to the root apex for 24 h, and cell viability was measured by means of reduction MTT salt. IL-1α and TNF-α production were analysed using enzyme-linked immunosorbent assay. One-way analysis of variance was performed and, when the F-ratios were significant, data were compared by Duncan's multiple-range test. The alpha-type error was set at 0.05. RESULTS: Biodentine and MTA groups had similar cell activity to the negative control group (P > 0.05), indicating low cytotoxicity for both materials. The stronger cytotoxicity effect was identified on the zinc oxide cement (P < 0.05). Zinc oxide cement caused a significant up-regulation in IL-1α and TNF-α (P < 0.05). No significant differences amongst MTA, Biodentine and the negative control group were observed for TNF-α (P > 0.05); however, both MTA and Biodentine were associated with overproduction of IL-1α when compared to the control group (P < 0.05). CONCLUSIONS: Biodentine and MTA had similar cytocompatibility in a 3D cell culture model associated with an in situ root-end filling model. The methodology could be used as an alternative to assess the cytocompatibility of endodontic cements because it is more closely related to the in vivo situation.

Comparison of apically extruded debris after large apical preparations by full-sequence rotary and single-file reciprocating systems.

AIM: To evaluate the amount of apically extruded debris produced by ProTaper Universal (PTU), ProTaper Next (PTN), WaveOne (WO) and Reciproc (R) systems after large apical preparations. METHODOLOGY: Sixty mandibular premolars with a single canal were selected and randomly assigned into 4 groups (n = 15) according to the system used for root canal preparation: PTU, PTN, WO and R groups. Canal preparations were performed up to size 40 in each group. Distilled water was used as an irrigant, and the apically extruded debris from each tooth was collected in pre-weighted glass vials and dried. The average weight of debris was assessed using a microbalance, and the data were analysed statistically using one-way analysis of variance and the post hoc Tukey multiple comparison test (α = 0.05). RESULTS: The PTU system was associated with significantly more debris than the other systems (P < 0.05). No significant differences were found between PTN, WO and R systems (P > 0.05). CONCLUSIONS: All systems were associated with apical debris extrusion when canals were prepared to a large apical size. The PTU system was associated with more debris extrusion.

Salivary pellicle composition and multispecies biofilm developed on titanium nitrided by cold plasma.

OBJECTIVE: The aim of this study was to evaluate the composition of the salivary pellicle (SP) and multispecies biofilm developed on titanium nitrided by cold plasma. METHODS: Titanium discs were allocated into a control group (Ti) and an experimental group (TiN - titanium-nitrided by cold plasma). The disc surface topography was characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM). The chemical composition of the disc surface was determined by X-ray photoelectron spectroscopy (XPS). Stimulated, clarified, and filtered saliva was used to form pellicles on the discs. Proteome analysis of the adsorbed SP proteins was performed by liquid chromatography-mass spectrometry (LC-MS). The surface free energy (SFE) was evaluated before and after SP formation. A multispecies biofilm composed of Actinomyces naeslundii, Streptococcus oralis, Streptococcus mutans, Fusobacterium nucleatum, Veillonella dispar, and Candida albicans was developed on the SP-coated discs. Viable microorganism counts were determined. The biomass and average thickness of biofilms were analyzed by confocal laser-scanning microscopy (CLSM) with COMSTAT software. The biofilm organization was visualized by SEM. RESULTS: The surface topography was similar in both groups. The SFE of the TiN group did not differ from that of the Ti group (p>0.05), although the adsorption of pellicle proteins increased the SFE in both pellicle-coated groups (p<0.001). Different proteins were identified on the Ti and TiN surfaces. The amount of biofilm was similar for both groups (p=0.416), but the counts of F. nucleatum and S. oralis were higher in the TiN group (p<0.001). Similar biofilms were characterized by the COMSTAT data, CLSM images, and SEM images. CONCLUSION: The titanium nitrided by cold plasma exhibited differences in SP composition and multispecies microbial biofilm population compared to the control titanium surface.

Non-carious cervical lesions and occlusion: a systematic review of clinical studies.

Non-carious cervical lesions (NCCLs) are a group of lesions that affect the cervical area of the teeth. Different aetiological factors have been reported, among them tooth brushing force, erosive agents and occlusal forces. The aim of this study was to ascertain, by means of a systematic review, the association between NCCLs and occlusion. A search was performed in the MEDLINE database, retrieving a total of 286 articles. After title and abstract screening, the clinical investigations were read in full to select those that evaluated the occlusal aspects of NCCL aetiology. This systematic review describes the results of three prospective and 25 cross-sectional studies. As there is an extreme heterogeneity in design, diagnostic criteria, forms of analysis and associated factors, a meta-analysis was not possible. The wide variety of classification and diagnostic criteria reflects a high range of reported prevalence. An extensive heterogeneity of independent variables was noted, even in occlusal analysis, which helps to mask any conclusion about the role of occlusion in NCCL aetiology. The literature reveals that studies on this topic are subject to a substantial amount of bias, such as evaluation (use of non-blinded examiners) and confounding bias (no control of others aetiological factors). Up to now, it has been impossible to associate NCCLs with any specific causal agent, and the role of occlusion in the pathogenesis of non-carious cervical lesions seems as yet undetermined. Therefore, additional studies, properly designed to diminish bias, are warranted.

Occurrence of toxin-producing cyanobacteria blooms in a Brazilian semiarid reservoir.

We report the occurrence of cyanobacterial blooms and the presence of cyanotoxins in water samples from the Armando Ribeiro Gonçalves reservoir (06 degrees 08 S and 37 degrees 07 W), located in the state of Rio Grande do Norte, in the semiarid region of northeastern Brazil. The cyanobacterial species were identified and quantified during the rainy and dry seasons in the year 2000. Cyanotoxins such as microcystins, saxitoxins and cylindrospermopsins were analyzed and quantified using HPLC and ELISA methods. The mixed toxic blooms of Cylindrospermopsis raciborskii, Microcystis spp (M. panniformis, M. protocystis, M. novacekii) and Aphanizomenon spp (Aphanizomenon gracile, A. cf. manguinii, A. cf. issastschenkoi) were persistent and represented 90-100% of the total phytoplankton species. Toxic cyanobacterial blooms from the Armando Ribeiro Gonçalves reservoir were analyzed and found to have three phases in relation to the annual cycle. During the rainy season, an intense toxic bloom of Cylindrospermopsis raciborskii was recorded along with saxitoxins (3.14 microg.L(-1)). During the transition period, between the rainy and dry seasons, different species of Microscytis occurred and microcystin as high as 8.8 microg.L(-1) was recorded. In the dry season, co-dominance of Cylindrospermopsis raciborskii, Microcystis spp and Aphanizomenon spp occurred and the concentrations of saxitoxin remained very low. Our results indicate the presence of microcystins (8.8 microg.L(-1)) and saxitoxins (3.14 microg.L(-1)) into the crude water, with increasing concentrations from the second fortnight of April to late May 2000. The occurrence of toxic blooms in this reservoir points to a permanent risk of cyanotoxins in supply waters, indicating the need for the implementation of bloom control measures to improve the water quality. Exposure of the local population to cyanotoxins through their potential accumulation in fish muscle must also be considered.

Occurrence of toxin-producing cyanobacteria blooms in a Brazilian semiarid reservoir

Nós relatamos a ocorrência de florescimentos de cianobactérias e a presença de cianotoxinas em amostras de água do reservatório Armando Ribeiro Gonçalves (06º 08Æ S; 37º 07Æ W) situado no Estado do Rio Grande do Norte, na região semi-árida do Brasil. Cianobactérias foram identificadas e quantificadas nos períodos seco e chuvoso do ano 2000. Cianotoxinas tais como, microcistinas, saxitoxinas e cilindrospermopsinas foram quantificadas por HPLC e ELISA. Florescimentos tóxicos mistos de Cylindrospermopsis raciborskii, Microcystis spp (M. panniformis, M. protocystis, M. novacekii) e Aphanizomenon ssp (Aphanizomenon gracile, A. cf. manguinii, A. cf. issastschenkoi) foram persistentes e representaram 90-100% da comunidade fitoplanctônica ao longo do período estudado. No período de chuvas, florescimentos tóxicos de Cylindrospermopsis raciborskii coincidiram com maiores valores de saxitoxinas (3,14 µg.L-1). Entre o período de chuva e estiagem, ocorreram florescimentos tóxicos de Microcytis spp, excedendo o valor mínimo aceitável para consumo humano (8,8 µg.L-1). Na estiagem, baixas concentrações de saxitoxinas foram detectadas em florescimentos menos intensos com co-dominância de Cylindrospermopsis raciborskii, Microcystis spp e Aphanizomenon spp. Nossos resultados revelaram a presença de microcistinas (8,8 µg.L-1) e saxitoxinas (3,14 µg.L-1) na água bruta, a partir da segunda quinzena de abril até o final de maio de 2000. A ocorrência de blooms tóxicos de cianobactérias no reservatório em estudo aponta um risco permanente de cianotoxinas em águas de abastecimento e indica a necessidade da implementação de medidas de controle das florações, visando à melhoria da qualidade da água. A exposição das populações locais às cianotoxinas, pela sua potencial acumulação em musculatura de peixes, também deve ser considerada.

Occurrence of toxin-producing cyanobacteria blooms in a Brazilian semiarid reservoir

We report the occurrence of cyanobacterial blooms and the presence of cyanotoxins in water samples from the Armando Ribeiro Gonçalves reservoir (06° 08’ S and 37° 07’ W), located in the state of Rio Grande do Norte, in the semiarid region of northeastern Brazil. The cyanobacterial species were identified and quantified during the rainy and dry seasons in the year 2000. Cyanotoxins such as microcystins, saxitoxins and cylindrospermopsins were analyzed and quantified using HPLC and ELISA methods. The mixed toxic blooms of Cylindrospermopsis raciborskii, Microcystis spp (M. panniformis, M. protocystis, M. novacekii) and Aphanizomenon spp (Aphanizomenon gracile, A. cf. manguinii, A. cf. issastschenkoi) were persistent and represented 90-100% of the total phytoplankton species. Toxic cyanobacterial blooms from the Armando Ribeiro Gonçalves reservoir were analyzed and found to have three phases in relation to the annual cycle. During the rainy season, an intense toxic bloom of Cylindrospermopsis raciborskii was recorded along with saxitoxins (3.14 µg.L-1). During the transition period, between the rainy and dry seasons, different species of Microscytis occurred and microcystin as high as 8.8 µg.L-1 was recorded. In the dry season, co-dominance of Cylindrospermopsis raciborskii, Microcystis spp and Aphanizomenon spp occurred and the concentrations of saxitoxin remained very low. Our results indicate the presence of microcystins (8.8 µg.L-1) and saxitoxins (3.14 µg.L-1) into the crude water, with increasing concentrations from the second fortnight of April to late May 2000. The occurrence of toxic blooms in this reservoir points to a permanent risk of cyanotoxins in supply waters, indicating the need for the implementation of bloom control measures to improve the water quality. Exposure of the local population to cyanotoxins through their potential accumulation in fish muscle must also be considered.

Nós relatamos a ocorrência de florescimentos de cianobactérias e a presença de cianotoxinas em amostras de água do reservatório Armando Ribeiro Gonçalves (06° 08’ S; 37° 07’ W) situado no Estado do Rio Grande do Norte, na região semi-árida do Brasil. Cianobactérias foram identificadas e quantificadas nos períodos seco e chuvoso do ano 2000. Cianotoxinas tais como, microcistinas, saxitoxinas e cilindrospermopsinas foram quantificadas por HPLC e ELISA. Florescimentos tóxicos mistos de Cylindrospermopsis raciborskii, Microcystis spp (M. panniformis, M. protocystis, M. novacekii) e Aphanizomenon ssp (Aphanizomenon gracile, A. cf. manguinii, A. cf. issastschenkoi) foram persistentes e representaram 90-100% da comunidade fitoplanctônica ao longo do período estudado. No período de chuvas, florescimentos tóxicos de Cylindrospermopsis raciborskii coincidiram com maiores valores de saxitoxinas (3,14 µg.L-1). Entre o período de chuva e estiagem, ocorreram florescimentos tóxicos de Microcytis spp, excedendo o valor mínimo aceitável para consumo humano (8,8 µg.L-1). Na estiagem, baixas concentrações de saxitoxinas foram detectadas em florescimentos menos intensos com co-dominância de Cylindrospermopsis raciborskii, Microcystis spp e Aphanizomenon spp. Nossos resultados revelaram a presença de microcistinas (8,8 µg.L-1) e saxitoxinas (3,14 µg.L-1) na água bruta, a partir da segunda quinzena de abril até o final de maio de 2000. A ocorrência de blooms tóxicos de cianobactérias no reservatório em estudo aponta um risco permanente de cianotoxinas em águas de abastecimento e indica a necessidade da implementação de medidas de controle das florações, visando à melhoria da qualidade da água. A exposição das populações locais às cianotoxinas, pela sua potencial acumulação em musculatura de peixes, também deve ser considerada.

[Mothers' clubs: a place for women's health care]. / Clube de mães: espaço para intervenção em saúde da mulher.

The article relates an investigation realized next to integrant of Mother's Club of the Sanitary District of Perus, in the Municipal of São Paulo. It has how aims to know the its organizational shape and the relation between locals Municipals health institutions and with other women movements. With this to intended to know the concepts about health disease from their members to verify the possibilities of intervention in coletive health. The results reveal in the conceptions of health-disease of their integrants. Observe, however, spaces to intervention in the feeling to mplify the breast-plate of the women about of the their social identity and of the woman's health.

Doenca de von Recklinghausen. Relato de dois casos (formas central e periferica) em adulto jovem e crianca. / Von Recklinghausen's disease. Report of 2 cases (central and peripheral forms) in young adults and children

Os autores apresentam dois casos de doenca de Von Recklinghausen, apos algumas consideracoes da evolucao historico-cientifica desta entidade clinica