The connectome of an insect brain.

Brains contain networks of interconnected neurons and so knowing the network architecture is essential for understanding brain function. We therefore mapped the synaptic-resolution connectome of an entire insect brain (Drosophila larva) with rich behavior, including learning, value computation, and action selection, comprising 3016 neurons and 548,000 synapses. We characterized neuron types, hubs, feedforward and feedback pathways, as well as cross-hemisphere and brain-nerve cord interactions. We found pervasive multisensory and interhemispheric integration, highly recurrent architecture, abundant feedback from descending neurons, and multiple novel circuit motifs. The brain's most recurrent circuits comprised the input and output neurons of the learning center. Some structural features, including multilayer shortcuts and nested recurrent loops, resembled state-of-the-art deep learning architectures. The identified brain architecture provides a basis for future experimental and theoretical studies of neural circuits.

Quedas entre pacientes internados em um hospital público e de ensino: uma análise das notificações / Falls of patients admitted to a public and teaching hospital: an analysis of notifications / Caídas en pacientes ingresados en un hospital público y docente: análisis de las no-tificaciones

Objetivo: descrever o perfil das quedas notificadas de pacientes internados em um hospital público e de ensino. Método: estudo descritivo e retrospectivo, com análise estatística descritiva, inferencial e de correspondência múltipla dos dados de notificações do aplicativo Vigilância em Saúde e Gestão de Riscos Assistenciais Hospitalares sobre quedas de pacientes internados entre 2017 e 2019. Resultados: predominaram, dentre 153 notificações de quedas no período, as ocorridas no quarto, em unidades de atendimento cirúrgico, emergencial e clínico, sofridas por pacientes do sexo masculino, na faixa etária entre 20 e 59 anos. Nesta, destacaram-se os idosos. A abrasão foi o dano mais relatado. A análise de correspondência múltipla não apresentou significância. Conclusão: a análise dos eventos notificados contribuiu para o planejamento e a implantação do Programa Fall Tailoring Interventions for Patient Safety Brasil para aprimoramento da gestão dos riscos relacionados.(AU)

Objective: to describe the profile of reported falls of patients admitted to a public and teaching hospital. Method: descriptive and retrospective study, with descriptive, inferential, and multiple correspondence statistical analysis of notification data from the Health Surveillance and Hospital Care Risk Management app on falls of hospitalized patients between 2017 and 2019. Results: predominated, among 153 notifications of falls in the period, those occurring in the ward, in surgical, emergency, and clinical care units, suffered by male patients, aged between 20 and 59 years. In this, the elderly stood out. Abrasion was the most reported harm. Multiple correspondence analysis did not show significance. Conclusion: the analysis of reported events contributed to the planning and implementation of the Fall Tailoring Interventions for Patient Safety Program in Brazil to improve the management of related risks.(AU)

Objetivo: describir el perfil de las caídas de pacientes internados reportadas en un hospital público y de enseñanza. Método: estudio descriptivo y retrospectivo, con análisis estadístico descriptivo, inferencial y análisis de correspondencias múltiples de datos de notificación de la aplicación Vigilancia en Salud y Gestión de Riesgos de Atención Hospitalaria sobre caídas de pacientes hospitalizados entre 2017 y 2019. Resultados: predominó, entre 153 notificaciones de caídas en el período, las ocurridas en el dormitorio, en unidades quirúrgicas, de emergencia y de atención clínica, sufridos por pacientes del sexo masculino, con edades entre 20 y 59 años. En este último, se destacaron los adultos mayores. La abrasión fue el daño más reportado. El análisis de correspondencia múltiple no mostró significación. Conclusión: el análisis de los eventos notificados contribuyó para la planificación e implementación del Programa Fall Tailoring Interventions for Patient Safety en Brasil para mejorar la gestión de sus riesgos re-lacionados.(AU

Avaliação de tecnologia educacional digital sobre o programa fall tips brasil de prevenção de quedas

Objetivo: Desenvolver e avaliar uma tecnologia educacional (TE) digital sobre prevenção de quedas para uso por profissionais de saúde durante a implantação do programa Fall TIPS no Brasil. Material e Método: Pesquisa aplicada e de desenvolvimento tecnológico, incluindo as etapas de planejamento, desenvolvimento e avaliação de uma tecnologia educacional baseada na web, sobre prevenção de quedas, a ser utilizada na implementação do programa Fall TIPS no Brasil. A pesquisa foi realizada entre 2020 e 2022 na modalidade de co-produção e incluiu infográficos, podcasts e vídeos para cada um dos stakeholders envolvidos no programa. Resultados: A avaliação consistiu em 19 questões sobre aparência e objetivos e foi respondida por um grupo de 14 enfermeiros líderes de um hospital do sul do Brasil, por meio de um instrumento que atingiu um índice geral de validação de conteúdo de 0,85. Conclusões: A TE visa melhorar a prevenção de quedas estimulando a adesão ao programa FALL TIPS em hospitais brasileiros.

Objective: To develop and evaluate a digital educational technology (ET) on fall prevention to be used by health professionals during the implementation of the Fall TIPS program in Brazil. Material and Method: Applied research and technological development, including the planning, development and evaluation stages of a web-based educational technology on fall prevention to be used in the implementation of the Fall TIPS program in Brazil. The study was conducted from 2020 to 2022 in a co-production format and included infographics, podcasts and videos for each of the stakeholders involved in the program. Results: The evaluation consisted of 19 questions regarding appearance and goals and was answered by a group of 14 nurse leaders from a hospital in the South of Brazil, using an instrument that achieved an overall content validation index of 0.85. Conclusions: The ET aims to improve fall prevention by promoting adherence to the Fall TIPS program in Brazilian hospitals.

Objetivo: Desarrollar y evaluar una tecnología educativa digital (ET) sobre prevención de caídas para uso de los profesionales de la salud durante la implementación del programa Fall TIPS en Brasil. Material y Método: Investigación aplicada y desarrollo de tecnología, incluidas las etapas de planificación, desarrollo y evaluación de una tecnología educativa basada en la web sobre prevención de caídas, para ser utilizada en la implementación del programa FALL TIPS en Brasil. Se realizó entre 2020 y 2022 en la modalidad de coproducción e incluyó infografías, podcasts y videos para cada uno de los actores involucrados en el programa. Resultados: La evaluación incluyó 19 preguntas sobre apariencia y objetivos, y fue respondida por un grupo de 14 enfermeros líderes de un hospital del sur de Brasil, utilizando un instrumento que alcanzó un índice de validación de contenido general de 0,85. Conclusiones: La ET tiene como objetivo mejorar la prevención de caídas fomentando la adherencia al programa Fall TIPS en los hospitales brasileños.

Atribuições do enfermeiro no manejo do marcapasso transcutâneo em pacientes idosos: Uma revisão integrativa / Asignaciones del enfermero em el manejo del marcapasos transcutáneo en anciano: Una revisión integrativa / Nurse attributions in the handling of transcutaneous pacemaker in elderly patients: Integrative review

Objetivo: investigar a produção científica nacional e internacional sobre as ações e cuidados do enfermeiro no manejo do marca-passo transcutâneo em idosos. Método: revisão integrativa, realizada nas bases de dados "Scopus", "Web of Science", "EMBASE", "PUBMED", "MEDLINE", no período de 2012 a 2022. Resultados: foram selecionados oito artigos, todos internacionais, somente um conduzido por enfermeiros. Categorizados por: (1) Possibilidades e limitações no uso do marca-passo trânscutâneo na prática clínica; (2) Cuidados de enfermagem na utilização do marca-passo transcutâneo em idosos e (3) Sistematização da Assistência de Enfermagem e a abordagem ao paciente em uso de marca-passo transcutâneo. Conclusão: os principais cuidados de enfermagem ao idoso que utiliza o marca-passo transcutâneo são: prevenção de queimaduras cutâneas; administração de medicamentos; manejo da dor; monitoramento dos dados vitais; avaliação da captura mecânica; investigação do histórico familiar; medicações em uso; realização do exame físico e acesso venoso periférico.(AU)

Objective: : to investigate the national and international scientific production regarding the actions and handling of the transcutaneous pacemaker in elderly. Method: integrative review, made in the databases Scopus", "Web of Science", "EMBASE", "PUBMED", and "MEDLINE", for the period 2012 to 2022. Findings: there were selected eight articles, all international, and only one conducted by nurses. Categorized into: (1) Possibilities and limitations of the use from the transcutaneous pacemaker in clinical practice; (2) Nursing care when utilizing transcutaneous pacemaker in elderly and (3) Systematization of Nursing Care and approach to patients using transcutaneous pacemaker. Conclusion: the main Nursing Care approaches to elderly who use transcutaneous pacemaker are prevent skin burn; drug administration; pain management; monitoring vital signs; evaluation of heart activity; investigating family history and drugs in use; performing physical examination and peripheral venous access.(AU)

Objetivo: investigar cual és lá produccion científica nacional e internacional sobre Las acciones y cuidados del enfermero en el manejo del marca-pado intracutaneo en ancianos. Método: Revision Integrativa realizada en Las bases de datos "Scopus" web of Science", EMBASE", "PUBMED", "MEDLINE", durante el período 2012 a 2022. Resultados: fueron Seleccionados ocho articulos todos internacionales, solanemente uno fue llevado a cabo por enfermeros. Categorizado por (1) posibilidades y limitaciones en El uso del marca-paso intracutaneo en lá práctica clínica; (2) cuidados de enfermeria en lá utilização del marca-paso intracutaneo y (3) sistematizacion de la assistencia de enfermeria y el abordaje del paciente que usa marca-paso intracutaneo. Conclusion: Los principales cuidados de enfermeria Al anciano que utiliza marca-paso intracutaneo son: prevencion de quemaduras cutaneas; administracion de medicamentos, manejo del dolor, monitorizacion de datos vitales, evaluacion de lá captura mecanica, investigação del histórico famíliar, medicaciones en uso, realizacion de examen fisico y acceso venoso periférico.(AU)

Circuits for integrating learned and innate valences in the insect brain.

Animal behavior is shaped both by evolution and by individual experience. Parallel brain pathways encode innate and learned valences of cues, but the way in which they are integrated during action-selection is not well understood. We used electron microscopy to comprehensively map with synaptic resolution all neurons downstream of all mushroom body (MB) output neurons (encoding learned valences) and characterized their patterns of interaction with lateral horn (LH) neurons (encoding innate valences) in Drosophila larva. The connectome revealed multiple convergence neuron types that receive convergent MB and LH inputs. A subset of these receives excitatory input from positive-valence MB and LH pathways and inhibitory input from negative-valence MB pathways. We confirmed functional connectivity from LH and MB pathways and behavioral roles of two of these neurons. These neurons encode integrated odor value and bidirectionally regulate turning. Based on this, we speculate that learning could potentially skew the balance of excitation and inhibition onto these neurons and thereby modulate turning. Together, our study provides insights into the circuits that integrate learned and innate valences to modify behavior.

The Role of Anaphase-Promoting Complex/Cyclosome (APC/C) in Plant Reproduction.

Most eukaryotic species propagate through sexual reproduction that requires male and female gametes. In flowering plants, it starts through a single round of DNA replication (S phase) and two consecutive chromosome segregation (meiosis I and II). Subsequently, haploid mitotic divisions occur, which results in a male gametophyte (pollen grain) and a female gametophyte (embryo sac) formation. In order to obtain viable gametophytes, accurate chromosome segregation is crucial to ensure ploidy stability. A precise gametogenesis progression is tightly regulated in plants and is controlled by multiple mechanisms to guarantee a correct evolution through meiotic cell division and sexual differentiation. In the past years, research in the field has shown an important role of the conserved E3-ubiquitin ligase complex, Anaphase-Promoting Complex/Cyclosome (APC/C), in this process. The APC/C is a multi-subunit complex that targets proteins for degradation via proteasome 26S. The functional characterization of APC/C subunits in Arabidopsis, which is one of the main E3 ubiquitin ligase that controls cell cycle, has revealed that all subunits investigated so far are essential for gametophytic development and/or embryogenesis.

Photobiomodulation can prevent apoptosis in cells from mouse periodontal ligament.

Photobiomodulation (PBM) has been used to modulate the inflammatory and immune responses, pain relief, and to promote wound healing. PBM is widely used in dental practice and its cellular effects should be investigated. The aim was to evaluate if PBM changes proteins cell death-related, such as caspase-6 and Bcl-2, in periodontal ligament cells. Eighteen mice were divided in three groups (n = 6), i.e., (I) control, (II) 3 J cm-2, and (III) 30 J cm-2. Low power infrared laser (830 nm) parameters were power at 10 mW, energy densities at 3 and 30 J cm-2 in continuous emission mode, exposure time of 15 and 150 s, respectively for 4 days in a row. Twenty-four hours after last irradiation, the animals were euthanized, and their jaws were fixed and decalcified. Caspase-6 and Bcl-2 were analyzed by real-time polymerase chain reaction and immunocytochemical techniques, and DNA fragmentation was evaluated by TUNEL. Statistical differences were not significant to caspase-6 mRNA relative levels in tissues from jaws at both energy densities, but a significant increase of Bcl-2 mRNA relative levels was obtained at 30 J cm-2 group. Also, 30 J cm-2 group showed caspase-6 positive-labeled cells decreased and Bcl-2 positive-labeled cells significantly increased. TUNEL-labeled cells demonstrated DNA fragmentation decreased at 30 J cm-2. PBM can alter Bcl-2 mRNA relative level and both caspase-6 and Bcl-2 protein, modulating cell survival, as well as to reduce DNA fragmentation. More studies must be performed in order to obtain conclusive results about photobiostimulation effects using infrared low-level laser in apoptosis process as to achieve the optimum dosage.

Developmentally Arrested Precursors of Pontine Neurons Establish an Embryonic Blueprint of the Drosophila Central Complex.

Serial electron microscopic analysis shows that the Drosophila brain at hatching possesses a large fraction of developmentally arrested neurons with a small soma, heterochromatin-rich nucleus, and unbranched axon lacking synapses. We digitally reconstructed all 802 "small undifferentiated" (SU) neurons and assigned them to the known brain lineages. By establishing the coordinates and reconstructing trajectories of the SU neuron tracts, we provide a framework of landmarks for the ongoing analyses of the L1 brain circuitry. To address the later fate of SU neurons, we focused on the 54 SU neurons belonging to the DM1-DM4 lineages, which generate all columnar neurons of the central complex. Regarding their topologically ordered projection pattern, these neurons form an embryonic nucleus of the fan-shaped body ("FB pioneers"). Fan-shaped body pioneers survive into the adult stage, where they develop into a specific class of bi-columnar elements, the pontine neurons. Later born, unicolumnar DM1-DM4 neurons fasciculate with the fan-shaped body pioneers. Selective ablation of the fan-shaped body pioneers altered the architecture of the larval fan-shaped body primordium but did not result in gross abnormalities of the trajectories of unicolumnar neurons, indicating that axonal pathfinding of the two systems may be controlled independently. Our comprehensive spatial and developmental analysis of the SU neurons adds to our understanding of the establishment of neuronal circuitry.

Efficacy of a propolis solution for cleaning complete dentures.

PURPOSE: The efficacy of a propolis solution against denture biofilm was evaluated by means of an in vitro assessment and a cross-over randomized clinical trial. METHODS: Acrylic resin specimens were contaminated by Staphylococcus aureus, Streptococcus mutans, Escherichia coli, Candida albicans, Candida glabrata, Candida parapsilosis, immersed in a (A) propolis solution, (B) saline or (C) alkaline peroxide, applied onto Petri plates with culture medium and after incubation the number of colonies was counted. For the clinical trial, 30 complete denture wearers were randomly assigned to groups (A) propolis solution, and (B) saline, following one of the sequences (I)A/B or (II) B/A. After each intervention, biofilm was quantified by means of digital photos taken from the intaglio surface and a microbiological quantification of Candida spp. and mutans streptococci was conducted. RESULTS: Both propolis solution and alkaline peroxide reduced the microbial counts for S. mutans and C. albicans with significant and greater effect for group C (P< 0.05). However, no difference was found clinically between the interventions. The propolis solution showed an intermediate antimicrobial effect against S. mutans and C. albicans. Also, it did not exert an immediate effect on denture biofilm. CLINICAL SIGNIFICANCE: A commercially available propolis-based cleanser solution was evaluated in vitro and clinically for the treatment of denture stomatitis. Although an immediate effect on denture biofilm was not observed after a single application, It showed antimicrobial effect against S. mutans and C. albicans.

Antimicrobial action and long-term effect of overnight denture cleansers.

PURPOSE: To evaluate two denture cleansers for overnight soaking (0.5% sodium hypochlorite and peroxide alkaline) regarding efficacy against Candida spp. biofilms (randomized clinical trial) and their effects on the physical properties of a denture base acrylic resin simulating a period of 5 years of use (laboratory study). The Candida spp. were identified and their resistance to main antifungal agents was evaluated. METHODS: 32 complete denture wearers were instructed to brush their dentures three times a day and to soak them (≥8 hours) in: control - water (C); alkaline peroxide (AP); or 0.5% sodium hypochlorite (SH). According to a randomized sequence, each solution was used for three alternate periods of 7 days. The antimicrobial action was performed by counting the colony forming units (CFU) of Candida spp. For collection of the biofilm, each upper complete denture was placed in a Petri dish, the internal surface was brushed (Tek brush) with saline solution for 2 minutes and the suspension was transferred to a test tube. After dilutions (10 0 to 10-3), aliquots of 50 µL were seeded inside Petri dishes containing Candida Chromagar. After incubation, the colonies were counted and the values of CFU/mL calculated. Data were transformed in log10 (CFU +1) and analyzed by the Friedman test (α= 0.05) followed by Wilcoxon and Bonferroni tests (α= 0.05). Each of the different species identified perfunctorily has been confirmed through the identification of yeasts kit. The resistance to antifungal agents (amphotericin B, nystatin, flucytosine, econazole, ketoconazole, miconazole and fluconazole) was also evaluated. Adverse effects were estimated on heat-polymerized resin specimens, simulating a 5-year period of overnight use. Acrylic resin specimens were randomly distributed into three groups: C: Control (distilled water); AP: alkaline peroxide; and SH: 0.5% sodium hypochlorite. Color change, surface roughness and flexural strength were evaluated at baseline and after immersion procedures. Data were compared by Kruskall-Wallis followed by Dunn's test (color change and surface roughness) and one-way ANOVA (flexural strength) (α= 0.05). RESULTS: There was a reduction of Candida spp. counts after using both solutions (AP and SH). The Candida spp. most often isolated was C. albicans, followed by the C. glabrata. Only 24.7% of isolate strains were resistant to at least one of the tested antifungals, highlighting azole compounds. Immersion in AP [ 5.73 (5.45-5.91)] caused significantly higher color change, with lower ΔE values for C [1.12 (1.15-1.37) ] followed by SH [3.70 (3.51-3.98) ]. The NBS values were classified as "slight" for C (1.12) group and " considerable" for AP (5.27) and SH (3.40). No solution altered surface roughness significantly. Flexural strength (in MPa) was significantly lower for C (64.59), AP (63.96 ± 12.98) and SH (62.84 ± 8.62) when compared to a group without any immersion (109.12 ± 8.37). CLINICAL SIGNIFICANCE: Both solutions tested presented antimicrobial action against Candida spp. and may be useful for denture biofilm control, but should be used with caution as an overnight immersion solution since they may damage denture bases in the long-term. Candida was most frequently isolated at baseline and after using the products. Only 24.7% of isolate strains were resistant to at least one of the tested antifungals, especially with azole compounds.

Conserved neural circuit structure across Drosophila larval development revealed by comparative connectomics.

During postembryonic development, the nervous system must adapt to a growing body. How changes in neuronal structure and connectivity contribute to the maintenance of appropriate circuit function remains unclear. Previously , we measured the cellular neuroanatomy underlying synaptic connectivity in Drosophila (Schneider-Mizell et al., 2016). Here, we examined how neuronal morphology and connectivity change between first instar and third instar larval stages using serial section electron microscopy. We reconstructed nociceptive circuits in a larva of each stage and found consistent topographically arranged connectivity between identified neurons. Five-fold increases in each size, number of terminal dendritic branches, and total number of synaptic inputs were accompanied by cell type-specific connectivity changes that preserved the fraction of total synaptic input associated with each pre-synaptic partner. We propose that precise patterns of structural growth act to conserve the computational function of a circuit, for example determining the location of a dangerous stimulus.

The complete connectome of a learning and memory centre in an insect brain.

Associating stimuli with positive or negative reinforcement is essential for survival, but a complete wiring diagram of a higher-order circuit supporting associative memory has not been previously available. Here we reconstruct one such circuit at synaptic resolution, the Drosophila larval mushroom body. We find that most Kenyon cells integrate random combinations of inputs but that a subset receives stereotyped inputs from single projection neurons. This organization maximizes performance of a model output neuron on a stimulus discrimination task. We also report a novel canonical circuit in each mushroom body compartment with previously unidentified connections: reciprocal Kenyon cell to modulatory neuron connections, modulatory neuron to output neuron connections, and a surprisingly high number of recurrent connections between Kenyon cells. Stereotyped connections found between output neurons could enhance the selection of learned behaviours. The complete circuit map of the mushroom body should guide future functional studies of this learning and memory centre.

Spatio-temporal pattern of neuronal differentiation in the Drosophila visual system: A user's guide to the dynamic morphology of the developing optic lobe.

Visual information processing in animals with large image forming eyes is carried out in highly structured retinotopically ordered neuropils. Visual neuropils in Drosophila form the optic lobe, which consists of four serially arranged major subdivisions; the lamina, medulla, lobula and lobula plate; the latter three of these are further subdivided into multiple layers. The visual neuropils are formed by more than 100 different cell types, distributed and interconnected in an invariant highly regular pattern. This pattern relies on a protracted sequence of developmental steps, whereby different cell types are born at specific time points and nerve connections are formed in a tightly controlled sequence that has to be coordinated among the different visual neuropils. The developing fly visual system has become a highly regarded and widely studied paradigm to investigate the genetic mechanisms that control the formation of neural circuits. However, these studies are often made difficult by the complex and shifting patterns in which different types of neurons and their connections are distributed throughout development. In the present paper we have reconstructed the three-dimensional architecture of the Drosophila optic lobe from the early larva to the adult. Based on specific markers, we were able to distinguish the populations of progenitors of the four optic neuropils and map the neurons and their connections. Our paper presents sets of annotated confocal z-projections and animated 3D digital models of these structures for representative stages. The data reveal the temporally coordinated growth of the optic neuropils, and clarify how the position and orientation of the neuropils and interconnecting tracts (inner and outer optic chiasm) changes over time. Finally, we have analyzed the emergence of the discrete layers of the medulla and lobula complex using the same markers (DN-cadherin, Brp) employed to systematically explore the structure and development of the central brain neuropil. Our work will facilitate experimental studies of the molecular mechanisms regulating neuronal fate and connectivity in the fly visual system, which bears many fundamental similarities with the retina of vertebrates.

Trial of an experimental castor oil solution for cleaning dentures.

Denture hygiene is essential because denture biofilm is involved in oral infections and systemic diseases. Although there are chemical agents available on the market, none of them have ideal properties and research on such products is still necessary. The aim of this study was to evaluate the efficacy of a castor bean (Ricinus communis)-based solution for removing denture biofilm, compared to two traditional products (sodium hypochlorite and alkaline peroxide). Fifty maxillary complete denture wearers were instructed to brush their dentures after meals and to immerse their dentures once a day in the following solutions: Saline (20 min; control), Polident alkaline peroxide (3 min), NaOCl (20 min) and 2% castor oil solution (20 min). Participants used each solution for a period of 7 consecutive days, according to a random sequence. After each period, the internal surfaces of maxillary complete dentures were stained with a disclosing solution (1% neutral red), photographed and the disclosed biofilm was quantified with the aid of specific software. The influence of treatments on results was verified by the Friedman test (α=0.05). Tested solutions presented significant difference (Fr=51.67; p<0.001). Saline and NaOCl were significantly different (median: 2.0% and 0.0%) whereas Polident and castor oil presented intermediate results (median: 1.0% and 1.5%, respectively). It can be concluded that the castor oil solution tested in this study was comparable to alkaline peroxide in terms of efficiency in denture biofilm removal.

Trial of an Experimental Castor Oil Solution for Cleaning Dentures

Denture hygiene is essential because denture biofilm is involved in oral infections and systemic diseases. Although there are chemical agents available on the market, none of them have ideal properties and research on such products is still necessary. The aim of this study was to evaluate the efficacy of a castor bean (Ricinus communis)-based solution for removing denture biofilm, compared to two traditional products (sodium hypochlorite and alkaline peroxide). Fifty maxillary complete denture wearers were instructed to brush their dentures after meals and to immerse their dentures once a day in the following solutions: Saline (20 min; control), Polident alkaline peroxide (3 min), NaOCl (20 min) and 2% castor oil solution (20 min). Participants used each solution for a period of 7 consecutive days, according to a random sequence. After each period, the internal surfaces of maxillary complete dentures were stained with a disclosing solution (1% neutral red), photographed and the disclosed biofilm was quantified with the aid of specific software. The influence of treatments on results was verified by the Friedman test (α=0.05). Tested solutions presented significant difference (Fr=51.67; p<0.001). Saline and NaOCl were significantly different (median: 2.0% and 0.0%) whereas Polident and castor oil presented intermediate results (median: 1.0% and 1.5%, respectively). It can be concluded that the castor oil solution tested in this study was comparable to alkaline peroxide in terms of efficiency in denture biofilm removal.

A higiene de próteses totais é essencial, uma vez que o biofilme da prótese está envolvido com infecções orais e doenças sistêmicas. Apesar de existirem agentes químicos disponíveis no mercado, nenhum deles apresenta propriedades ideais e pesquisas com esses produtos ainda são necessárias. O objetivo neste estudo foi avaliar a eficácia de uma solução de mamona (Ricinus communis) para a remoção do biofilme de prótese total, comparada com dois produtos comerciais (NaOCl e peróxido alcalino). Cinqüenta usuários de próteses totais maxilares foram instruídos a escovar as próteses após as refeições e imergi-las uma vez por dia nas seguintes soluções: soro fisiológico (20 min), Peróxido alcalino Polident (3 min), NaOCl a 1% (20 min) e solução de mamona (20 min). Os participantes utilizaram cada solução por um período de sete dias consecutivos, de acordo com uma sequência aleatória. Após cada período, as superfícies internas das próteses totais superiores foram coradas com solução evidenciadora (vermelho neutro a 1%), fotografadas e o biofilme evidenciado foi quantificado com software. A influência dos tratamentos sobre os resultados foi verificada pelo teste de Friedman (α=0,05). Houve diferença significativa entre as soluções (Fr=51,67;p<0,001). O soro fisiológico e o NaOCl foram significativamente diferentes (mediana: 2,0% e 0,0%), enquanto o Polident e a solução de mamona apresentaram resultados intermediários (mediana: 1,0% e 1,5%, respectivamente). Concluiu-se que a solução de mamona avaliada é comparável ao peróxido alcalino, em termos de remoção do biofilme de prótese total.

A randomized trial on simplified and conventional methods for complete denture fabrication: cost analysis.

PURPOSE: This study aimed to quantify the costs of complete denture fabrication by a simplified method compared with a conventional protocol. MATERIALS AND METHODS: A sample of edentulous patients needing conventional maxillary and mandibular complete dentures was randomly divided into group S, which received dentures fabricated by a simplified method, and group C, which received conventionally fabricated dentures. We calculated direct and indirect costs for each participant including unscheduled procedures. This study assessed 19 and 20 participants allocated into groups S and C, respectively, and comparisons between groups were conducted by the Mann-Whitney and Student's t-test (α = 0.05). RESULTS: Complete denture fabrication demanded median time periods of 173.2 and 284.5 minutes from the operator for groups S and C respectively, and 46.6 and 61.7 minutes from the dental assistant (significant differences, p < 0.05). There was no difference between groups regarding postinsertion adjustments. Group S showed lower values for costs with materials and time spent by patients than group C during the fabrication stage, but not during adjustments. CONCLUSIONS: The median direct cost of complete denture treatment was 34.9% lower for the simplified method. It can be concluded that the simplified method is less costly for patients and the health system when compared with a conventional protocol for the rehabilitation of edentulous patients.

Effectiveness of manual and electric brushes in the removal of biofilm from full dentures / Eficácia das escovas manual e elétrica na remoção do biofilme de próteses totais

Objective: To evaluate clinically the ability to remove biofilm from complete dentures. Methods: Thirty patients, users of full upper dentures, participated in a trial period of 21 days and were instructed to brush the dentures three times a day (after breakfast, lunch and dinner) with water, using a manual, special denture brush (Group I - Control) and electric brush (Group II - Experimental). At night, the patients were instructed to immerse their dentures in a container with filtered water. Before and after the use of these methods for 21 days, the internal surfaces of the complete upper dentures were stained (1% neutral red) and photographed. The areas (total of internal surface and the surface stained with biofilm) were quantified using software (Image Tool 2.02). The percentage of the biofilm was calculated as the ratio of the area of the biofilm multiplied by 100 to the total surface area of the internal base of the dentures. Results: The data for the two methods were compared using the Student?s t-test (?? = 0.05). There was a mean area of biofilm coverage (%, ± standard deviation) of 12.5 ± 12.8 and 16.9 ± 17.0 for the manual and electric toothbrushes, respectively. The differences were not significant (t = 0.799, P = 0.431). Conclusion: It was concluded that both brushes tested showed the same capacity for biofilm removal from complete dentures.

Objetivo: Avaliar clinicamente a capacidade de remoção do biofilme de prótese total de dois métodos mecânicos de higiene: escovação manual e elétrica. Métodos: Trinta pacientes, usuários de próteses totais superiores, participaram de um período experimental de 21 dias e foram orientados a escovar as próteses três vezes ao dia (após café da manhã, almoço e jantar) com água empregando escova manual específica para próteses totais (Grupo I - Controle) e elétrica (Grupo II - Experimental). Durante o período noturno o paciente foi orientado a imergir suas próteses em recipiente contendo água filtrada. Antes e após o uso dos métodos por 21 dias, as superfícies internas das próteses totais superiores foram evidenciadas (vermelho neutro 1%) e fotografadas. As áreas (total da superfície interna e corada com biofilme) foram quantificadas com um software (Image Tool 2.02). A porcentagem do biofilme foi calculada como a relação entre a área do biofilme multiplicado por 100 e a área da superfície total da base interna da prótese.Resultados: Os dados dos dois métodos foram comparados por meio do teste t de Student (?? = 0,05). Observou-se uma área média de cobertura por biofilme (%, ±desvio padrão) de 12,5±12,8 e 16,9±17,0 para a escova elétrica e a manual, respectivamente. As diferenças não foram significantes (t=0,799; p=0,431). Conclusão: Concluiu-se que ambas as escovas testadas apresentaram a mesma capacidade de remoção de biofilme das próteses totais.

Trial of experimental toothpastes regarding quality for cleaning dentures.

The aim of this study was to evaluate the efficacy of experimental toothpastes for removing denture biofilm by means of a randomized crossover trial. Thirty volunteers brushed their dentures using a brush and four pastes: (1) Corega refreshing mint (control), (2) 0.2% chloramine T, (3) 1.0% chloramine T, and (4) 0.01% fluorosurfactant. Each paste was used for 7 days, and participants were randomized to use them according to one of four sequences. Biofilm was disclosed (neutral red) after each period, photographed, and quantified by means of a software program. All experimental toothpastes were similar to the control in terms of posttreatment biofilm coverage.

Effect of chlorhexidine on denture biofilm accumulation.

PURPOSE: Adequate denture hygiene can prevent and treat infection in edentulous patients, who are frequently elderly and have difficulty brushing their teeth. This study evaluated the efficacy of complete denture biofilm removal using a chlorhexidine solution in two concentrations: 0.12% and 2.0%. MATERIALS AND METHODS: Sixty complete denture wearers participated in a trial for 21 days after receiving brushing instructions. They were distributed into three groups, according to the tested solution and regimen (n = 20): (G1) Control (daily overnight soaking in water); (G2) daily immersion at home in 0.12% chlorhexidine for 20 minutes after dinner; and (G3) a single immersion in 2.0% chlorhexidine for 5 minutes at the end of the experimental period, performed by a professional. Biofilm coverage area (%) was quantified on the internal surface of maxillary dentures at baseline and after 21 days. Afterward, the differences between initial and posttreatment results were compared by means of the Kruskal-Wallis test (α= 0.05). RESULTS: Median values for biofilm coverage area after treatment were: (G1) 36.0%; (G2) 5.3%; and (G3) 1.4%. Differences were significant (KW = 35.25; p < 0.001), although G2 and G3 presented similar efficacy in terms of biofilm removal. CONCLUSIONS: Both chlorhexidine-based treatments had a similar ability to remove denture biofilm. Immersion in 0.12% or 2.0% chlorhexidine solutions can be used as an auxiliary method for cleaning complete dentures.