Antibiotic Resistance Profile of Clinical Strains of Enterococci from Secondary/Persistent Endodontic Infections: What do We Know? A Systematic Review of Clinical Studies.

INTRODUCTION: Enterococcus faecalis is the most common enterococcal species associated with infective endocarditis and 1 of the most commonly detected bacteria in cases of secondary/persistent endodontic infection (SPEI). Antimicrobial resistance is a global public health concern. This review aimed to answer the following research question: "Is there a change in the antibiotic resistance profile in clinical strains of E. faecalis over the years?". P (population) - patients with SPEI, I (intervention) -endodontic retreatment, C (comparison) -not included, O (outcome) - profile of Enterococci resistance and susceptibility to systemic antibiotics used. METHODS: Two authors independently performed study selection, data extraction, and risk of bias assessment. The literature search was conducted using the following electronic databases: PubMed, Scopus, EMBASE, Web of Science, and Medline. Clinical studies in which Enterococci strains were isolated to assess their antimicrobial resistance were included. RESULTS: Eleven clinical trials were included. Overall, E. faecalis isolated from teeth with SPEI presented an intermediate resistance to 16 antibiotics. In recent years, E. faecalis showed a little resistance to amoxicillin (without clavulanate) and benzylpenicillin. Erythromycin and rifampicin presented an increase in the intermediate-resistance status between the first and the last studies. E. faecium presented intermediate-resistance results. CONCLUSION: The most effective drugs remain the combination of amoxicillin and clavulanate, followed by amoxicillin and benzylpenicillin. In patients allergic to penicillin derivatives, moxifloxacin and azithromycin may be indicated with caution. The antibiotics with the highest pattern of resistance against E. faecalis are clindamycin, gentamicin, metronidazole, and rifampicin and are therefore, contraindicated in cases of SPEI. Very few clinical studies using a microbiological approach in teeth with endodontic failure have been carried out to improve the efficacy of prophylactic regimens. However, as bacteria periodically develop resistance to the main drugs used, regular studies should be carried out on the action of these drugs in infection control.

4-domain sports prom translation and cultural adaptation into portuguese / 4-domain sports prom: traducción y adaptación cultural al portugués / 4-domain sports prom: tradução e adaptação cultural para a língua portuguesa

ABSTRACT Introduction: The literature presents several scientifically validated and cross-culturally adapted questionnaires in the area of orthopedics and Sports Medicine scientifically validated and cross-culturally adapted. However, they are anatomically specific, and do not consider the specific needs of athletes. The "4-Domain PROM for Orthopedic and Sports Medicine" (4-Domain Sports PROM) is the first questionnaire, in the literature (International Journal of Sports Medicine - 2021), designed to assess athletes and highly active sports practitioners, and their specificities. physical and psychological. It comprises four domains: athlete without injury, after sports injury, expectation of treatment, athlete's assessment of the treatment received. Objectives: This work aims to carry out the translation and cross-cultural adaptation (TCA) to the Portuguese language. Methods: The questionnaire was self-administered by 50 participants, regular physical and sports activities practitioners. The translation and cultural adaptation process involved six steps: translation; synthesis; back translation; pre-test; review by the Expert Committee, clinical application and author approval of the original version. The Equivalence of translation and relevance of questionnaire items were evaluated. RESULTS: The Portuguese version of the 4-DOMAIN SPORTS PROM had a translation equivalence of 0.94, and item relevance was 0.98, while the percentage of agreement between patients for understanding was 0.98. Conclusion: The translation and cross-cultural adaptation of the 4 Domain Sports PROM into the Portuguese version proved to be understandable and reproducible in all questionnaire domains (agreement above 90% and content validity index of 100%) to assess the treatment of the population of athletes and regular sports practitioners. Level of Evidence II; A cross-sectional qualitative study.

RESUMEN Introducción: La literatura presenta varios cuestionarios científicamente validados y transculturalmente adaptados en el área de la ortopedia y Medicina del Deporte. Sin embargo, son anatómicamente específicos y no consideran las necesidades específicas de los atletas. El "4-Domain PROM for Orthopaedic and Sports Medicine" (4-Domain Sports PROM) es el primer cuestionario, en la literatura (International Journal of Sports Medicine - 2021), diseñado para evaluar atletas y practicantes de deportes altamente activos, y sus especificidades físicas y psicológicas. Comprende cuatro dominios: atleta sin lesión, después de una lesión deportiva, expectativa de tratamiento, evaluación del atleta sobre el tratamiento recibido. Objetivos: El objetivo de este trabajo es realizar la traducción y adaptación transcultural (TCA) a la lengua portuguesa. Métodos: El cuestionario fue autoadministrado por 50 participantes, practicantes habituales de actividades físicas y deportivas. El proceso de traducción y adaptación cultural involucró seis pasos: traducción; síntesis; traducción inversa; prueba previa; revisión por el comité de expertos; aplicación clínica y aprobación del autor de la versión original. Se evaluaron la equivalencia de traducción y la relevancia de los ítems del cuestionario. Resultados: La versión portuguesa del 4-DOMAIN SPORTS PROM tuvo una equivalencia de traducción de 0,94 y la relevancia de los ítems fue de 0,98, mientras que el porcentaje de acuerdo entre los pacientes para la comprensión fue de 0,98. Conclusión: La traducción y adaptación transcultural del 4-DOMAIN SPORTS PROM al portugués amplía las posibilidades de evaluar los diferentes momentos que involucran el tratamiento de lesiones deportivas, ya que este cuestionario fue diseñado para capturar datos sobre la percepción de los pacientes antes de la lesión, después de la lesión, expectativa y evaluación del trato recibido en deportistas y practicantes habituales de actividad física. Nivel de Evidencia II; Estudio Cualitativo Transversal.

RESUMO Introdução: A literatura apresenta diversos questionários cientificamente validados e adaptados transculturalmente na área de na Ortopedia e Medicina Esportiva validados cientificamente e adaptados transculturalmente. Entretanto, eles são anatomicamente específicos, e não consideram as necessidades especificas dos atletas. O "4-Domain PROM for Orthopedic and Sports Medicine" (4-Domain Sports PROM) é o primeiro questionário, na literatura (International Journal of Sports Medicine - 2021), concebido para avaliar atletas e praticantes de esportes altamente ativos, e suas especificidades físicas e psicológicas. Ele compreende quatro domínios: atleta sem lesão, após lesão esportiva, expectativa do tratamento, avaliação do atleta sobre o tratamento recebido. Objetivos: O objetivo deste trabalho é realizar a tradução e a adaptação transcultural (TCA) à língua portuguesa. Métodos: O questionário foi autoadministrado por 50 participantes, praticantes regulares de atividades físicas e esportivas. O processo de tradução e adaptação cultural envolveu seis etapas: tradução; síntese; retrotradução; pré-teste; revisão pelo comitê de experts; aplicação clínica e aprovação do autor da versão original. Foi avaliado a Equivalência da tradução e relevância de itens do questionário. Resultados: A versão em português do 4-DOMAIN SPORTS PROM apresentou equivalência da tradução de 0,94 e relevância dos itens foi de 0,98, enquanto a porcentagem de concordância entre os pacientes para compreensão foi de 0,98. Conclusão: A tradução e adequação cultural do 4-DOMAIN SPORTS PROM para língua portuguesa mostrou-se compreensível e reprodutibilidade adequada em todos os domínios do questionário (concordância acima de 90% e Índice de Validade de Conteúdo de 100%) para avaliar o tratamento de população de indivíduos atletas e praticantes regulares de esportes. Nível de Evidência II; Estudo Qualitativo Transversal.

Clinical evaluation of culturable bacteria, endotoxins and lipoteichoic acid in teeth with vital normal pulp tissues.

The objective of this study was to investigate the presence of culturable bacteria, endotoxins (LPS) and lipoteichoic acid (LTA) levels in teeth with normal vital pulp (NVP) with intact crowns (IC) and those with coronal restoration (CR) limited to the enamel level. A total of 20 teeth indicated for endodontic treatment due to prosthetic reasons were selected. Samples were collected from the root canals. The levels of cultivable bacteria, LPS and LTA were assessed. Statistical analyses were performed at significance level set at 5%. None of the teeth presented microbial growth. In the IC group, the LPS levels were limited to the lowest concentration of LPS. On the contrary, higher LPS and LTA levels were detected in teeth with CR. It was concluded that teeth with NVP and IC were negative for bacteria, LPS and LTA; while teeth with CR were positive for bacterial virulence factors.

Evaluation of the rotary kinematics between actual and set speeds of X-Smart Plus, VDW.Silver and iRoot motors.

The present study evaluated the actual rotational speed of three different endodontic motors compared to the values provided by the manufacturers. A total of three endodontic motors (X-Smart Plus, VDW.Silver, and iRoot) were tested at 400 rpm and 800 rpm and 2 N/cm2 torque. The kinematics of the devices was recorded by using a custom angle-measuring disc with a 50-mm diameter attached to the handpiece provided by the manufacturer, whereas their movement was captured by a high-speed camera at 2,400 frames per second, 800 x 800 pixel-resolution and distance of 0.3 m from the target object. Statistical analysis was performed at a significance level of 5%. At 400 rpm, the iRoot motor had a value of 17.94 rpm above that indicated by the manufacturer, which was significantly different from those of X-Smart Plus (5.20 rpm below that indicated by the manufacturer) and VDW.Silver (0.62 rpm above that indicated by the manufacturer) motors (P < 0.05). At 800 rpm, the iRoot motor had a value of 51.34 rpm below that indicated by the manufacturer, whereas the X-Smart Plus motor had a value of 13.00 rpm below that indicated by the manufacturer (P > 0.05). The VDW.Silver motor statistically differed from the iRoot and X-Smart Plus ones, showing a value of 1.68 rpm above that indicated by the manufacturer. In conclusion, the X-Smart Plus, VDW.Silver, and iRoot motors showed lower variations in the rotational speed values compared to those reported by their manufacturers. The endodontic motors presented different behaviors between them, with the VDW.Silver motor presents the most accurate values and the iRoot presents the most divergent values.

Evaluation of the rotary kinematics between actual and set speeds of X-Smart Plus, VDW.Silver and iRoot motors

Abstract The present study evaluated the actual rotational speed of three different endodontic motors compared to the values provided by the manufacturers. A total of three endodontic motors (X-Smart Plus, VDW.Silver, and iRoot) were tested at 400 rpm and 800 rpm and 2 N/cm2 torque. The kinematics of the devices was recorded by using a custom angle-measuring disc with a 50-mm diameter attached to the handpiece provided by the manufacturer, whereas their movement was captured by a high-speed camera at 2,400 frames per second, 800 x 800 pixel-resolution and distance of 0.3 m from the target object. Statistical analysis was performed at a significance level of 5%. At 400 rpm, the iRoot motor had a value of 17.94 rpm above that indicated by the manufacturer, which was significantly different from those of X-Smart Plus (5.20 rpm below that indicated by the manufacturer) and VDW.Silver (0.62 rpm above that indicated by the manufacturer) motors (P < 0.05). At 800 rpm, the iRoot motor had a value of 51.34 rpm below that indicated by the manufacturer, whereas the X-Smart Plus motor had a value of 13.00 rpm below that indicated by the manufacturer (P > 0.05). The VDW.Silver motor statistically differed from the iRoot and X-Smart Plus ones, showing a value of 1.68 rpm above that indicated by the manufacturer. In conclusion, the X-Smart Plus, VDW.Silver, and iRoot motors showed lower variations in the rotational speed values compared to those reported by their manufacturers. The endodontic motors presented different behaviors between them, with the VDW.Silver motor presents the most accurate values and the iRoot presents the most divergent values.

Resumo O presente estudo avaliou a real velocidade rotacional de três diferentes motores endodônticos comparados aos valores fornecidos pelos fabricantes. Um total de três motores endodônticos (X-Smart Plus, VDW.Silver e iRoot) foram testados a 400 rpm e 800 rpm e torque de 2 N/cm2. A cinemática dos dispositivos foi verificada utilizando-se um disco customizado de 50 mm de diâmetro acoplado ao contra ângulo fornecido pelo fabricante e o movimento foi capturado através de uma câmera ajustada em 2400 quadros por segundo com resolução de 800 x 800 pixels distante 0,3 m do objeto alvo. A análise estatística foi realizada com nível de significância de 5%. A 400 rpm, o motor iRoot apresentou 17,94 rpm acima do indicado pelo fabricante, sendo o valor significativamente diferente do X-Smart Plus (5,20 rpm abaixo do indicado pelo fabricante) e VDW.Silver (0.62 rpm acima do indicado pelo fabricante) (P > 0,05). A 800 rpm, iRoot apresentou 51.34 rpm abaixo do indicado pelo fabricante e X-Smart Plus 13,00 rpm abaixo do indicado pelo fabricante (P > 0,05). VDW.Silver foi estatisticamente diferente de iRoot e X-Smart Plus, apresentando 1,68 rpm acima do indicado pelo fabricante. Concluiu-se que os motores X-Smart Plus, VDW.Silver e iRoot apresentaram baixa variação na velocidade rotacional quando comparada ao fornecido pelo fabricante. Os motores endodônticos apresentaram diferentes comportamentos entre eles, sendo que o motor VDW.Silver apresentou valores mais acurados enquanto o iRoot foi o mais divergente.

Effect of antimicrobial photodynamic therapy on the reduction of bacteria and virulence factors in teeth with primary endodontic infection.

OBJECTIVE: To evaluate the effectiveness of supplemental photodynamic therapy for improving the bacterial removal and the levels of lipopolysaccharide (LPS) and lipoteichoic acid (LTA) by conducting a clinical trial. METHODOLOGY: Twenty-four root canals with pulp necrosis and periapical lesion were selected and randomly divided into conventional group using endodontic treatment with chemo-mechanical preparation (CMP) alone (n = 12) and a group using antimicrobial photodynamic therapy (aPDT) after CMP (n = 12). The samples were collected before and after CMP (conventional group) and after photodynamic therapy (aPDT group). A photosensitizer (0.005% methylene blue) was applied to the root canal for 3 minutes after CMP, whereas aPDT was performed by using a red laser with a power of 30Mw and energy density of 9J/cm2 for 90 s per root canal. Culture technique was performed to determine the bacterial colony forming units. LPS and LTA levels were quantified by using limulus amoebocyte lysate (LAL) assay and enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: All samples showed growth of viable bacteria on Fastidious Anaerobe Agar (FAA), with an average of 5.19 × 105 CFU/ mL. CMP was effective in decreasing viable bacteria (p < 0.05), whereas there was a significant decrease (p < 0.05) in the samples treated with aPDT compared to those submitted to CMP. LPS and LTA were detected in all initial samples, with mean values of 20.561 EU/mL and 430.91 pg/mL, respectively. Both CMP and aPDT groups significantly decreased the levels of LPS and LTA (p < 0.05), with a statistical difference between the groups regarding aPDT (p < 0.05). CONCLUSION: Photodynamic therapy as an adjunct to CMP proved to be effective in improving root canal disinfection and reducing the LPS and LTA levels in teeth with primary endodontic infection.

Rehabilitation following surgical reconstruction for anterior cruciate ligament insufficiency: What has changed since the 1960s?-State of the art.

Anterior cruciate ligament (ACL) insufficiency can be disabling, given the physical and sports activity constraints that negatively impact the quality of life. Consequently, surgery is the main approach for most active patients. Nonetheless, ACL reconstruction (ACLR) cannot be successful without adequate preoperative and postoperative rehabilitation. Since the 1960s, post-ACLR rehabilitation has evolved, mainly from advances in surgery, coupled with a better understanding of the biological concepts of graft revascularization, maturation and integration, which have impacted ACL postoperative rehabilitation protocols. However, new technologies do involve a definite learning curve which could affect rehabilitation programs and produce inconsistent results. The development of rehabilitation protocols cannot be defined without an accurate diagnosis of ACL injury and considering the patient's main physical demands and expectations. This article discusses how postoperative rehabilitation following ACLR has changed from the 1960s to now, focussing on surgical technique (type of tendon graft, fixation devices, and graft tensioning), biological concepts (graft maturation and integration), rehabilitation protocols (prevention of ACL injuries, preoperative rehabilitation, postoperative rehabilitation), criteria to return to sports, patient's reported outcomes and outcome. Although rehabilitation plays an essential role in managing ACL injuries, it cannot be fully standardised preoperatively or postoperatively. Preoperative and postoperative rehabilitation should be based on an accurate clinical diagnosis, patients' understanding of their injury, graft tissue biology and biomechanics, surgical technique, the patient's physical demands and expectations, geographical differences in ACL rehabilitation and future perspectives.

Absorbed dose rate for marine biota due to the oil spilled using ICRP reference animal and Monte Carlo simulation.

The current study aimed to obtain dose conversion coefficients for marine animals due to an oil spill accident using two variables: crude oil activity concentration and organism depth. Thorium series presented a dose contribution twice that uranium series for similar conditions. Bi-214 and Tl-208 stood out for delivering a higher dose rate for uranium and thorium series, respectively. Results obtained can be used to assess the maximum exposure time for emergency oil control, removal, and mitigation in an oil spill accident.

Comparison between oil spill images and look-alikes: an evaluation of SAR-derived observations of the 2019 oil spill incident along Brazilian waters.

Three SAR-derived observations of dark surface patches along the Northeastern Brazilian coastline by the end of 2019 were misreported in the Brazilian media as oil spill-related. Unfortunately, these observations were misled by false positives or look-alikes. Therefore, this paper aims to technically evaluate these look-alike classes by analyzing image attributes found to be helpful to the identification of ocean targets, including oil spills, rain cells, biofilms, and low wind conditions. We use image augmentation to extend our dataset size and create the probability density function curves. The processing includes image segmentation, optimal attribute extraction, and classification with random forest classifiers. Our results contrast with the open-source oil spill detection system and patch classifier methodology called "RIOSS." Analysis of the feature probability density functions based on optimal attributes is promising since we could capture most of the false positive targets in the three SAR-reported images in 2019. The only exception was the biofilm slick observed on October 28th, where the RIOSS mistakenly classified this organic patch as a low wind region with oil spots. This pitfall is acceptable at this project stage since we had only five biogenic film samples to train the algorithm.

A Critical Analysis of the COVID-19 Hospitalization Network in Countries with Limited Resources.

To effectively combat the COVID-19 pandemic, countries with limited resources could only allocate intensive and non-intensive care units to a low number of regions. In this work, we evaluated the actual displacement of infected patients in search of care, aiming to understand how the networks of planned and actual hospitalizations take place. To assess the flow of hospitalizations outside the place of residence, we used the concepts of complex networks. Our findings indicate that the current distribution of health facilities in Bahia, Brazil, is not sufficient to effectively reduce the distances traveled by patients with COVID-19 who require hospitalization. We believe that unnecessary trips to distant hospitals can put both the sick and the healthy involved in the transport process at risk, further delaying the stabilization of the COVID-19 pandemic in each region of the state of Bahia. From the results found, we concluded that, to mitigate this situation, the implementation of health units in countries with limited resources should be based on scientific methods, and international collaborations should be established.

Treatment-based classification for low back pain: systematic review with meta-analysis.

OBJECTIVE: To systematically review the effects of treatment-based classification (TBC) in patients with specific and nonspecific acute, subacute and chronic low back pain. METHODS: The following databases were searched: MEDLINE, EMBASE, PsycINFO, Global Health, CENTRAL, Web of Science, CINAHL, SPORTDiscus, PEDro and WHO from inception up to December 2021. We used the PEDro scale, the TIDieR checklist and the GRADE approach to evaluate the risk of bias, quality on reporting and the certainty of the evidence, respectively. RESULTS: Twenty-three trials (pooled n = 2,649) met the inclusion criteria. We have identified a total of 22 comparisons and 134 estimates of treatment effects. There was a very large heterogeneity with regards to the comparison groups. Most of individual trials had low risk of bias with a mean score of 6.8 (SD = 1.3) on a 0-10 scale. The certainty of evidence for most comparisons was low, which indicates that more high quality and robust trials are needed. We were able to pool the data using a meta-analysis approach for only two comparisons (TBC versus mobility exercises in patients with acute low back pain and traction for patients with sciatica). In general, the TBC approach seems to be useful for patients with acute low back pain, sciatica and with spinal stenosis. We strongly suggest readers to carefully read our summary of findings table for further details on each comparison. CONCLUSION: The TBC approach seems to be useful for patients with acute low back pain, sciatica and with spinal stenosis.

Chemomechanical preparation influences the microbial community and the levels of LPS, LTA and cytokines in combined endodontic-periodontal lesions: A clinical study.

BACKGROUND: This study was conducted to compare the microbiomes, the levels of lipopolysaccharides (LPS), lipoteichoic acid (LTA), and cytokines (interleukin [IL]-1ß and tumor necrosis factor-alpha [TNF-α]), before and after chemomechanical preparation (CMP) of the root canals (RC) and their associated periodontal pockets (PP) in teeth with combined EPL. MATERIALS: Samples were taken from 10 RC and PP, before and after CMP. The microbiomes (next-generation sequencing, V3-V4 hypervariable region of the 16S rRNA gene), microbiome diversity (bioinformatics analyses), LPS (limulus amebocyte lysate), LTA, IL-1ß, and TNF-α (ELISA) were evaluated. A statistical analysis was performed with significance level set at 5%. RESULTS: The most abundant phyla in both sites were Firmicutes and Proteobacteria. Comparative studies of bacterial genera species revealed that some increased and others decreased after CMP at both sites. A 3% reduction in Gram-negative bacteria (RC) and a 4% increase in Gram-positive bacteria (PP) were detected. LPS levels were 4.4 times higher in PP than in the RC. LTA was detected in all samples investigated. Higher levels of IL-1ß and TNF-α were detected in both sites at baseline. After CMP, LPS, LTA, IL-1ß and TNF-α were reduced in both sites. CONCLUSION: The microbial community in the RC and PP in teeth with combined EPL indicated a similarity between both sites. CMP effectively reduced the microbial load and the LPS levels from teeth with EPL, and consequently diminished the cytokine levels. The reduction in LTA levels in the RC and PP proved challenging.

Efficacy of 6% Sodium Hypochlorite on Infectious Content of Teeth with Symptomatic Irreversible Pulpitis.

INTRODUCTION: The objective of this study was to monitor the effects of chemomechanical preparation (CMP) performed with 6% sodium hypochlorite and calcium hydroxide-based intracanal medication (ICM) on the levels and diversity of bacteria, endotoxins (lipopolysaccharides [LPS]), and lipoteichoic acid (LTA) in root canals of teeth with symptomatic irreversible pulpitis. METHODS: Samples were collected from 10 teeth with symptomatic irreversible pulpitis before CMP (S1), after CMP (S2), and after ICM (S3). The levels of bacteria, LPS, and LTA were assessed by using checkerboard DNA-DNA hybridization, LAL Pyrogent 5000, and enzyme-linked immunosorbent assay, respectively. Wilcoxon test, repeated-measures analysis of variance, and Tukey post hoc test were used for statistical analysis at a significance level of 5%. RESULTS: Forty species were detected at S1. Two species were eliminated after CMP and 5 after ICM. Resistant and pain-related species were detected in the root canals. Higher levels of culturable bacteria were detected at S1. However, CMP and ICM effectively reduced the microbial load in the root canals. Higher levels of LPS and LTA were detected at S1. CMP was effective in reducing both LPS and LTA (P < .05). ICM produced additional reduction in the levels of LPS (P > .05) and LTA (P < .05). CONCLUSIONS: Chemomechanical preparation using 6% sodium hypochlorite and calcium hydroxide-based intracanal medication were effective in reducing the levels of bacteria, LPS, and LTA in teeth with vital pulp and irreversibly inflamed pulp.

The effect of photodynamic therapy on postoperative pain in teeth with primary endodontic infection.

INTRODUCTION: The objective of this study was to investigate the action of photodynamic therapy on pain control after endodontic treatment in asymptomatic teeth with a primary infection, within a single visit. METHODS: Sixty (60) single-rooted teeth with pulp necrosis and periapical lesions were selected and randomly divided into two (2) groups (n = 30), according to the protocol; a control group (CG) and a group using photodynamic therapy (aPDT). The canals were instrumented with Reciproc files # 25 up to 40 along the entire length of the canal, using 2% chlorhexidine gel as the auxiliary chemical substance, followed by irrigation with sterile saline. aPDT consited of 0.005% methylene blue as photosensitizer, using AsGaAl diode laser, 660 nm wavelength, 100 mW of power and 9 J of energy, using optical fibers with 365 µm in diameter. The canals were filled with Endomethasone N cement. RESULTS: Pain intensity was assessed at 8, 12, 24, 48, 72 h and 1 week after endodontic treatment using a visual analogue scale. The level of pain was classified as none (0), mild (1-3), moderate (4-7) or severe (8-10). The data were at a significance level of 5%. There was a statistically significant difference (p<0.05) in the periods of 8, 12, 24, 48 and 72 h between the control group and the aPDT group. After 1 week, there was no statistically significant difference. CONCLUSIONS: It is concluded that photodynamic therapy had a significant effect on decreasing post-endodontic treatment pain in teeth with necrotic pulp and asymptomatic periapical lesions.

A influência da sorção e solubilidade nas propriedades dos compósitos resinosos: uma revisão de literatura / The influence of sorption and solubility on the properties of res-in composites: a literature review

Introdução: A resina composta tem sido amplamente utilizada por suas propriedades restauradoras. No entanto, quando exposta à água, o material resinoso sofre diferentes mecanismos químicos e físicos, como a sorção de água e solubilidade. Esses efeitos podem produzir alterações volumétricas e mudanças físicas, alterando as características do material. Objetivo: Discorrer acerca das consequências clínicas dos fenômenos de sorção e solubilidade na resina composta. Materiais e Métodos: Uma revisão da literatura foi realizada por meio de artigos científicos publicados nos últimos anos, presentes em bases de dados eletrônicos como PubMED/Medline, Lilacs e Scielo. Resultados e Discussão: Os compósitos de resina não são estáveis, pois interagem constantemente com o ambiente oral. Sua principal interação é com água, que se difunde na matriz. As resinas compostas que contêm, além do BIS-GMA, uma alta concentração de TEGDMA, tendem a absorver mais água devido às ligações éter hidrofílicas presentes nesses compósitos. Com isso, uma série de efeitos deletérios podem ocorrer. Conclusão: A expansão volumétrica, a lixiviação, a degradação hidrolítica e a instabilidade da cor são as principais consequências da sorção e solubilidade da resina composta. Esses fenômenos provocam alterações dimensionais e diminuição das propriedades mecânicas repercutindo, sobremaneira, na longevidade das restaurações em resina composta.

Introduction: Resin Composite has been widely used for its restorative properties. However, when exposed to water, the resin material undergoes different chemical and physical mechanisms, such as water sorption and solubility. These effects can produce volumetric and physical changes, altering the material's characteristics. Objective: To discuss the clinical consequences of the sorption and solubility phenomena in composite resin. Materials and Methods: A literature review was performed using scientific articles published in recent years on electronic databases such as PubMED/Medline, Lilacs, and Scielo. Results and Discussion: Resin composites are not stable, as they constantly interact with the oral environment. Their main interaction is with water, which diffuses into the matrix. Resin Composites that contain, in addition to BIS-GMA, a high concentration of TEGDMA, tend to absorb more water due to the hydrophilic ether bonds present in these composites. Thus, a series of deleterious effects can occur. Conclusion: Volumetric expansion, leaching, hydrolytic degradation, and color instability are the main consequences of Resin Composite sorption and solubility. These phenomena cause dimensional changes and a decrease in mechanical properties, which have a major impact on the longevity of Resin Composite restorations.

SARS-CoV-2: A Professional and social gamechanger - Medical and dental aspects.

This study reports the SARS-CoV-2 outbreak and its impact on dental practice and education in Brazil. A literature review involving medical and dental interests was performed based on recent general findings about the infection (research and relevant guidelines). COVID-19 is a high transmissible, unpredictable systemic disease, involving a viral replication phase, followed by an inflammatory phase that can evolve into hyperinflammation that leads to a cytokine storm and other serious issues including sepsis, shock and multiple organ failure. The dentists are directly impacted by the new coronavirus as they work with the oral cavity that is irrigated by the saliva and receive the respiratory aerosols and droplets from the patient. In conclusion, the world is facing a completely new situation that deserves the comprehension of the population and close attention of the authorities. Following protocols to attend patients can prevent the dissemination of the virus, cross-infection, and the contamination of health care professionals. New strategies need to be developed to enhance the existing teaching and learning protocols in Universities and to allow research to continue.

SARS-CoV-2: A Professional and social gamechanger - Medical and dental aspects

Abstract This study reports the SARS-CoV-2 outbreak and its impact on dental practice and education in Brazil. A literature review involving medical and dental interests was performed based on recent general findings about the infection (research and relevant guidelines). COVID-19 is a high transmissible, unpredictable systemic disease, involving a viral replication phase, followed by an inflammatory phase that can evolve into hyperinflammation that leads to a cytokine storm and other serious issues including sepsis, shock and multiple organ failure. The dentists are directly impacted by the new coronavirus as they work with the oral cavity that is irrigated by the saliva and receive the respiratory aerosols and droplets from the patient. In conclusion, the world is facing a completely new situation that deserves the comprehension of the population and close attention of the authorities. Following protocols to attend patients can prevent the dissemination of the virus, cross-infection, and the contamination of health care professionals. New strategies need to be developed to enhance the existing teaching and learning protocols in Universities and to allow research to continue.

Resumo Este estudo descreve o surto de SARS-CoV-2 e o impacto na prática e Ensino em odontologia no Brasil. Foi realizada uma revisão da literatura acerca de interesses médico e odontológico baseada em achados recentes sobre a infecção (pesquisa e diretrizes relevantes). COVID-19 é uma doença sistêmica altamente transmissível, imprevisível, envolvendo a fase de replicação viral, seguida da fase inflamatória que pode evoluir para um estado de hiper inflamação, levando a uma "tempestade de citocinas" e outros sintomas tais como sepse, choque e falência múltipla de órgãos. Os dentistas são diretamente impactados pelo novo coronavírus uma vez que trabalham com a cavidade oral que é irrigada pela saliva, e recebe aerossóis e gotículas oriundas da respiração do paciente. Concluiu-se que o mundo está enfrentando uma situação completamente nova e merece a compreensão da população e atenção das autoridades. Seguir protocolos para o atendimento de paciente pode prevenir a disseminação do virus, infecção cruzada e a contaminação de profissionais da saúde. Novas estratégias precisam ser desenvolvidas para melhorar os protocolos de Ensino e aprendizagem existentes nas universidades e permitir que a pesquisa continue.

Influence of Bacterial Profiles in Cytokine and Clinical Features of Endodontic Disease.

INTRODUCTION: We verified the association between selected bacterial profiles and levels of cytokines, chemokines, and the expression of signs and symptoms of primary endodontic infection with apical periodontitis. METHODS: Samples were collected from 21 root canals, and macrophages were stimulated for 24 hours. Tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-10, IL-12p70, interferon gamma, and chemokine (C-C motif) ligand 2 (CCL2) were measured using cytometric bead array. We investigated the overlapping networks between cytokines and chemokines with regression analysis. Checkerboard DNA-DNA hybridization was used to assess 40 target bacteria species. Using factor analysis, bacterial species aggregated in 2 factors. The association of bacteria species-based factors on cytokine and chemokine levels and clinical features was estimated with regression analysis. RESULTS: A negative relationship between IL-10 (anti-inflammatory cytokine) and CCL2, TNF-α, and IFN-γ (proinflammatory cytokines) (all P < .05) was observed. CCL2 was positively correlated with TNF-α (P < .01). Thirty-eight bacteria species were detected in primary endodontic infection with apical periodontitis. The first bacteria species-based factor was associated with the size of the radiolucent area (coefficient = 15.42) and tenderness to percussion/pain on palpation (coefficient = 20.79). The second factor was associated with CCL2 levels (coefficient = 1.28). CONCLUSIONS: Different bacterial profiles can be differentially related to the expression of inflammatory proteins and the experience of clinical features.

Microbiological analysis of endodontically treated teeth with apical periodontitis before and after endodontic retreatment.

OBJECTIVE: To characterize the microbiota of teeth with endodontic treatment failure by 16S ribosomal RNA genetic sequencing (GS) and PCR at the different phases of the endodontic retreatment and to associate the presence of specific bacteria with clinical and radiographic features in teeth with apical periodontitis. MATERIALS AND METHODS: Twenty infected root canals of single-rooted teeth were selected. Samples were collected with sterile paper points before chemo-mechanical preparation (CMP) (S1), after CMP (S2) and after 30 days of intracanal medication (ICM) (S3). Microbial identification was performed using GS and PCR. Tukey-Kramer post hoc test and post hoc ANOVA were used for intergroup analysis. Paired t test and repeated-measures ANOVA were applied for intragroup analysis, at a significance level of 5%. RESULTS: A total of 89 strains were identified using GS. Sixty-five strains were recovered in S1 and 15 strains in S2, and 9 strains remained in S3. Enterococcus faecalis was the most predominant bacteria. Gram-positive cocci bacteria predominated. Gram-negative species were also detected. Using species-specific PCR primers to detect seven species, the most prevalent ones at all the phases of the endodontic retreatment were E. faecalis and Porphyromonas gingivalis. However, Parvimonas micra and P. gingivalis were associated with previous pain, P. gingivalis was associated with tenderness to percussion and E. faecalis, Fusobacterium nucleatum and P. gingivalis were associated with periapical lesion > 3 mm. CONCLUSIONS: In conclusion, the microbiota of persistent infection is polymicrobial with predominance of E. faecalis and P. gingivalis in all phases of the endodontic retreatment, regardless of the method used for microbial identification. Associations were found between specific bacteria and clinical/radiographic features. CLINICAL RELEVANCE: The characterization of the bacteria present at all phases of the endodontic retreatment is important for the monitoring of the effectiveness of the techniques used and to better understand the susceptibility of these species to the disinfection agent used during the procedures.

Scaling effect in COVID-19 spreading: The role of heterogeneity in a hybrid ODE-network model with restrictions on the inter-cities flow.

The new Covid-19 pandemic has left traces of suffering and devastation to individuals of almost all countries worldwide and severe impact on the global economy. Understanding the clinical characteristics, interactions with the environment, and the variables that favor or hinder its dissemination help the public authorities in the fight and prevention, leading for a rapid response in society. Using models to estimate contamination scenarios in real time plays an important role. Population compartments models based on ordinary differential equations (ODE) for a given region assume two homogeneous premises, the contact mechanisms and diffusion rates, disregarding heterogeneous factors as different contact rates for each municipality and the flow of contaminated people among them. This work considers a hybrid model for covid-19, based on local SIR models and the population flow network among municipalities, responsible for a complex lag dynamic in their contagion curves. Based on actual infection data, local contact rates ( ß ) are evaluated. The epidemic evolution at each municipality depends on the local SIR parameters and on the inter-municipality transport flow. When heterogeneity of ß values and flow network are included, forecasts differ from those of the homogeneous ODE model. This effect is more relevant when more municipalities are considered, hinting that the latter overestimates new cases. In addition, mitigation scenarios are assessed to evaluate the effect of earlier interventions reducing the inter-municipality flux. Restricting the flow between municipalities in the initial stage of the epidemic is fundamental for flattening the contamination curve, highlighting advantages of a contamination lag between the capital curve and those of other municipalities in the territories.