Assessment of the pre-emptive effect of photobiomodulation in the postoperative period of impacted lower third molar extractions: A randomized, controlled, double-blind study protocol.

Photobiomodulation is a safe option for controlling pain, edema, and trismus when applied postoperatively in third molar surgery. However, administration prior to surgery has been under-explored. This study aims to explore the effectiveness of pre-emptive photobiomodulation in reducing postoperative edema in impacted lower third molar extractions. Two groups of healthy individuals undergoing tooth extraction will be randomly assigned: Control group receiving pre-emptive corticosteroid and simulated photobiomodulation, and Photobiomodulation Group receiving intraoral low-intensity laser and extraoral LED cluster application. The primary outcome will be postoperative edema after 48 h. The secondary outcomes will be pain, trismus dysphagia, and analgesic intake (paracetamol). These outcomes will be assessed at baseline as well as two and seven days after surgery. Adverse effects will be recorded. Data will be presented as means ± SD and a p-value < 0.05 will be indicative of statistical significance.

A disordered region retains the full protease inhibitor activity and the capacity to induce CD8+ T cells in vivo of the oral vaccine adjuvant U-Omp19.

U-Omp19 is a bacterial protease inhibitor from Brucella abortus that inhibits gastrointestinal and lysosomal proteases, enhancing the half-life and immunogenicity of co-delivered antigens. U-Omp19 is a novel adjuvant that is in preclinical development with various vaccine candidates. However, the molecular mechanisms by which it exerts these functions and the structural elements responsible for these activities remain unknown. In this work, a structural, biochemical, and functional characterization of U-Omp19 is presented. Dynamic features of U-Omp19 in solution by NMR and the crystal structure of its C-terminal domain are described. The protein consists of a compact C-terminal beta-barrel domain and a flexible N-terminal domain. The latter domain behaves as an intrinsically disordered protein and retains the full protease inhibitor activity against pancreatic elastase, papain and pepsin. This domain also retains the capacity to induce CD8+ T cells in vivo of U-Omp19. This information may lead to future rationale vaccine designs using U-Omp19 as an adjuvant to deliver other proteins or peptides in oral formulations against infectious diseases, as well as to design strategies to incorporate modifications in its structure that may improve its adjuvanticity.

The Moss Leptodictyum riparium Counteracts Severe Cadmium Stress by Activation of Glutathione Transferase and Phytochelatin Synthase, but Slightly by Phytochelatins.

In the present work, we investigated the response to Cd in Leptodictyum riparium, a cosmopolitan moss (Bryophyta) that can accumulate higher amounts of metals than other plants, even angiosperms, with absence or slight apparent damage. High-performance liquid chromatography followed by electrospray ionization tandem mass spectrometry of extracts from L. riparium gametophytes, exposed to 0, 36 and 360 µM Cd for 7 days, revealed the presence of γ-glutamylcysteine (γ-EC), reduced glutathione (GSH), and traces of phytochelatins. The increase in Cd concentrations progressively augmented reactive oxygen species levels, with activation of both antioxidant (catalase and superoxide dismutase) and detoxifying (glutathione-S-transferase) enzymes. After Cd treatment, cytosolic and vacuolar localization of thiol peptides was performed by means of the fluorescent dye monochlorobimane and subsequent observation with confocal laser scanning microscopy. The cytosolic fluorescence observed with the highest Cd concentrations was also consistent with the formation of γ-EC-bimane in the cytosol, possibly catalyzed by the peptidase activity of the L. riparium phytochelatin synthase. On the whole, activation of phytochelatin synthase and glutathione-S-transferase, but minimally phytochelatin synthesis, play a role to counteract Cd toxicity in L. riparium, in this manner minimizing the cellular damage caused by the metal. This study strengthens previous investigations on the L. riparium ability to efficiently hinder metal pollution, hinting at a potential use for biomonitoring and phytoremediation purposes.

Characterization and quantification of thiol-peptides in Arabidopsis thaliana using combined dilution and high sensitivity HPLC-ESI-MS-MS.

Although thiol-peptide compounds, such as reduced glutathione (GSH), γ-glutamylcysteine (γ-EC), and phytochelatins, play fundamental roles in plants, their analytical determination and characterization is still somewhat problematic, mainly due to their high polarity and oxidation propensity. Thus, in this work a reliable and sensitive HPLC-ESI-MS-MS method was developed, in order to simultaneously assay, within 14-min instrumental runs, γ-EC, GSH, and phytochelatins up to phytochelatin 4. This analytical method was validated in shoot and root extracts of the model plant Arabidopsis thaliana (Brassicaceae) and guaranteed accurate quantification by using specific isotope labelled-internal standards for both GSH and phytochelatins, as well as standards for external calibration. Good linearities in the method performance were observed (R > 0.99), with a dynamic range over three orders of magnitude in thiol-peptide concentrations. In MRM mode, the detection sensitivity of the thiol-peptides was equal to approximately 16, 6, 7, 13, 10 fmol for γ-EC, GSH, phytochelatin 2, phytochelatin 3, and phytochelatin 4, respectively (20 µl injection each). The reproducibility of the method was confirmed by high intra- and inter-day accuracy and precision values. The recovery rates were estimated approximately in the range of 73.8-91.0% and the matrix effect evaluation revealed that all analytes exhibited ionization suppression. The use of stable isotope-labelled analogs of the thiol-peptides as internal standards was particularly worthy of note: it offered the considerable advantage of overcoming the consequences of matrix effect and thiol-peptide loss through sample preparation, by normalizing the analyte signal during the quantification process. Thus, by validating the method's sensitivity, accuracy, precision, reproducibility, stability, recovery, and matrix effect, data reliability and robustness were ensured.

Treatment of Aggressive Vertebral Hemangiomas with Poly Vinyl Alcohol (PVA) Microparticles Embolization, PMMA, and Short Segment Stabilization: Preliminary Results with at Least 5 Years of Follow-up.

OBJECTIVE: Vertebral hemangiomas (VHs) are the most common incidental lesions of vertebral body, but they are very challenging to treat if they become symptomatic. Several treatments have been proposed but none was superior to others. The aim of this study is to analyze blood loss and long-term clinical and neurological results of aggressive VHs treated with arterial embolization the day before operation, followed by vertebroplasty, posterior decompression, and short segment stabilization. METHODS: Ten patients (4 males and 6 females) were treated for aggressive VHs with polyvinyl alcohol microparticles embolization, posterior short segment stabilization, and poly methyl methacrylate. Clinical and neurological outcomes were assessed with visual analog, Nurick, and American Spinal Injury Association (ASIA) scales. RESULTS: At last follow-up mean, visual analog scale was 1.8 ± 1.3, with a significant difference with preoperative values (P = 0.00018). Neurological deficits persisted in 4 patients (ASIA scale: C in 1 patient [10%], D in 3 patients [30%]), but they improved from baseline in all cases. Also, Nurick scale rating improved in all patients (0 in 3 patients [30%], 1 in 4 patients [40%], 2 in 2 patients [20%], and 3 in the last one [10%]). A statistically significant difference between pre- and postoperative values was observed for both scores (ASIA, P = 0.0102; Nurick, P = 0.026). Relapse of pathology was recorded in 2 patients. CONCLUSIONS: Polyvinyl alcohol microparticles embolization, short segment fixation, and vertebroplasty is an effective treatment option for aggressive VHs, with a fast surgical time, poor blood loss, and improvement of preoperative clinical and neurological outcomes.

Oral co-administration of a bacterial protease inhibitor in the vaccine formulation increases antigen delivery at the intestinal epithelial barrier.

The study of capture and processing of antigens (Ags) by intestinal epithelial cells is very important for development of new oral administration systems. Efficient oral Ag delivery systems must resist enzymatic degradation by gastric and intestinal proteases and deliver the Ag across biological barriers. The recombinant unlipidated outer membrane protein from Brucella spp. (U-Omp19) is a protease inhibitor with immunostimulatory properties used as adjuvant in oral vaccine formulations. In the present work we further characterized its mechanism of action and studied the interaction and effect of U-Omp19 on the intestinal epithelium. We found that U-Omp19 inhibited protease activity from murine intestinal brush-border membranes and cysteine proteases from human intestinal epithelial cells (IECs) promoting co-administered Ag accumulation within lysosomal compartments of IECs. In addition, we have shown that co-administration of U-Omp19 facilitated the transcellular passage of Ag through epithelial cell monolayers in vitro and in vivo while did not affect epithelial cell barrier permeability. Finally, oral co-delivery of U-Omp19 in mice induced the production of Ag-specific IgA in feces and the increment of CD103+ CD11b- CD8α+ dendritic cells subset at Peyer's patches. Taken together, these data describe a new mechanism of action of a mucosal adjuvant and support the use of this rationale/strategy in new oral delivery systems for vaccines.

The phytochelatin synthase from Nitella mucronata (Charophyta) plays a role in the homeostatic control of iron(II)/(III).

Although some charophytes (sister group to land plants) have been shown to synthesize phytochelatins (PCs) in response to cadmium (Cd), the functional characterization of their phytochelatin synthase (PCS) is still completely lacking. To investigate the metal response and the presence of PCS in charophytes, we focused on the species Nitella mucronata. A 40 kDa immunoreactive PCS band was revealed in mono-dimensional western blot by using a polyclonal antibody against Arabidopsis thaliana PCS1. In two-dimensional western blot, the putative PCS showed various spots with acidic isoelectric points, presumably originated by post-translational modifications. Given the PCS constitutive expression in N. mucronata, we tested its possible involvement in the homeostasis of metallic micronutrients, using physiological concentrations of iron (Fe) and zinc (Zn), and verified its role in the detoxification of a non-essential metal, such as Cd. Neither in vivo nor in vitro exposure to Zn resulted in PCS activation and PC significant biosynthesis, while Fe(II)/(III) and Cd were able to activate the PCS in vitro, as well as to induce PC accumulation in vivo. While Cd toxicity was evident from electron microscopy observations, the normal morphology of cells and organelles following Fe treatments was preserved. The overall results support a function of PCS and PCs in managing Fe homeostasis in the carophyte N. mucronata.

Remote Ischemic Preconditioning Decreases Oxidative Lung Damage After Pulmonary Lobectomy: A Single-Center Randomized, Double-Blind, Controlled Trial.

BACKGROUND: During lobectomy in patients with lung cancer, the operated lung is often collapsed and hypoperfused. Ischemia/reperfusion injury may then occur when the lung is re-expanded. We hypothesized that remote ischemic preconditioning (RIPC) would decrease oxidative lung damage and improve gas exchange in the postoperative period. METHODS: We conducted a single-center, randomized, double-blind trial in patients with nonsmall cell lung cancer undergoing elective lung lobectomy. Fifty-three patients were randomized to receive limb RIPC immediately after anesthesia induction (3 cycles: 5 minutes ischemia/5 minutes reperfusion induced by an ischemia cuff applied on the thigh) and/or control therapy without RIPC. Oxidative stress markers were measured in exhaled breath condensate (EBC) and arterial blood immediately after anesthesia induction and before RIPC and surgery (T0, baseline); during operated lung collapse, immediately before resuming two-lung ventilation (TLV) (T1); immediately after resuming TLV (T2); and 120 minutes after resuming TLV (T3). The primary outcome was 8-isoprostane levels in EBC at T1, T2, and T3. Secondary outcomes included the following: NO2+NO3, H2O2 levels, and pH in EBC and in blood (8-isoprostane, NO2+NO3) and pulmonary gas exchange variables (PaO2/FiO2, A-aDO2, a/A ratio, and respiratory index). RESULTS: Patients subjected to RIPC had lower EBC 8-isoprostane levels when compared with controls at T1, T2, and T3 (differences between means and 95% confidence intervals): -15.3 (5.8-24.8), P = .002; -20.0 (5.5-34.5), P = .008; and -10.4 (2.5-18.3), P = .011, respectively. In the RIPC group, EBC NO2+NO3 and H2O2 levels were also lower than in controls at T2 and T1-T3, respectively (all P < .05). Blood levels of 8-isoprostane and NO2+NO3 were lower in the RIPC group at T2 (P < .05). The RIPC group had better PaO2/FiO2 compared with controls at 2 hours, 8 hours, and 24 hours after lobectomy in 95% confidence intervals for differences between means: 78 (10-146), 66 (14-118), and 58 (12-104), respectively. CONCLUSIONS: Limb RIPC decreased EBC 8-isoprostane levels and other oxidative lung injury markers during lung lobectomy. RIPC also improved postoperative gas exchange as measured by PaO2/FiO2 ratio.

A Brucella spp. Protease Inhibitor Limits Antigen Lysosomal Proteolysis, Increases Cross-Presentation, and Enhances CD8+ T Cell Responses.

In this study, we demonstrate that the unlipidated (U) outer membrane protein (Omp) 19 from Brucella spp. is a competitive inhibitor of human cathepsin L. U-Omp19 inhibits lysosome cathepsins and APC-derived microsome activity in vitro and partially inhibits lysosomal cathepsin L activity within live APCs. Codelivery of U-Omp19 with the Ag can reduce intracellular Ag digestion and increases Ag half-life in dendritic cells (DCs). U-Omp19 retains the Ag in Lamp-2(+) compartments after its internalization and promotes a sustained expression of MHC class I/peptide complexes in the cell surface of DCs. Consequently, U-Omp19 enhances Ag cross-presentation by DCs to CD8(+) T cells. U-Omp19 s.c. delivery induces the recruitment of CD11c(+)CD8α(+) DCs and monocytes to lymph nodes whereas it partially limits in vivo Ag proteolysis inside DCs. Accordingly, this protein is able to induce CD8(+) T cell responses in vivo against codelivered Ag. Antitumor responses were elicited after U-Omp19 coadministration, increasing survival of mice in a murine melanoma challenge model. Collectively, these results indicate that a cysteine protease inhibitor from bacterial origin could be a suitable component of vaccine formulations against tumors.

Safety, beneficial and technological properties of Enterococcus faecium isolated from Brazilian cheeses

This study aimed to characterize the safety and technological properties of Enterococcus faecium strains isolated from Brazilian Coalho cheeses. High levels of co-aggregation were observed between Enterococcus faecium strains EM485 and EM925 and both Escherichia coli and Clostridium perfringens. Both strains presented low levels of hydrophobicity. E. faecium EM485 and EM925 were both able to grow in the presence of 0.5% of the sodium salts of taurocholic acid (TC), taurodeoxycholic acid (TDC), glycocholic acid (GC), and glycodeoxycholic acid (GDC), although they showed the ability to deconjugate only GDC and TDC. Both strains showed good survival when exposed to conditions simulating the gastro intestinal tract (GIT). When tested for the presence of virulence genes, only tyrosine decarboxylase and vancomycin B generated positive PCR results.

Acute lateral dislocated clavicular fractures: arthroscopic stabilization with TightRope.

HYPOTHESIS: Type IIA, IIB, and V lateral clavicular fractures (Craig modification of the Neer classification) are characterized by a constant displacement and are associated with a high rate of nonunion. The aim of this study is to verify whether the reduction and arthroscopic stabilization of these clavicular fractures with coracoclavicular cerclage provide stable fixation to allow for bone healing. To date, the treatment of these fractures is still controversial in young active patients in whom functional requirements are to be met. METHODS: Fourteen male patients, with type IIA, IIB, and V lateral clavicular fractures (2 type IIA, 10 type IIB, and 2 type V) had been treated arthroscopically with a TightRope (Arthrex, Naples, FL, USA) and had a radiologic/clinical follow-up of at least 2 years. RESULTS: All fractures were confirmed to have healed without limitations in range of motion or loss of reduction. The acromioclavicular joint and the coracoclavicular interspace were restored to the level of the healthy site in all but 1 patient, in whom a reduction was observed because of hypercorrection of the fracture. The mean Constant score was 95, and all patients had a Simple Shoulder Test score of 12 points. Healing was delayed up to 20 days in 1 patient because of a skin infection, and the coracoid bone tunnel was too marginal in another patient, in whom the coracoid button broke the lateral side of the tunnel during fixation. CONCLUSIONS: The arthroscopic procedure with the TightRope allows for fracture healing with no loss of reduction in the acromioclavicular joint and full return to everyday activities.

Cómo aprenden los estudiantes de odontología que cursan el último año de la carrera? / How do dental students undergoing their career's last year learn?

Objetivos: 1-Conocer las estrategias de aprendizaje utilizadas por los estudiantes de la Facultad de Odontología de la UdelaR que se encontraban cursando Pediatría II en el año 2010. 2- Describir las características de los docentes referidos por los estudiantes como “significativos para su aprendizaje”. Método: Trabajo exploratorio utilizando una encuesta personal, voluntaria, anónima y auto-administrada. Resultados: 79% de los estudiantes estudia solo, por falta de tiempo o por hábito. Dedican entre 2-4 horas diarias. 29% utiliza el manual virtual y 62% utiliza diferentes fuentes. Las prácticas clínicas supervisadas fueron señaladas como facilitadoras del aprendizaje (80%) así como las características humanistas del docente Conclusiones: Conocer cómo aprenden los estudiantes permite adaptar la enseñanza y proponer estrategias de mayor autorregulación. Las características más recordadas de los profesores fueron las humanísticas lo cual demuestra el importante rol que desempeñan los docentes en la práctica profesional .

Objetives: 1-Knowing the strategies more frequently used by the students attending Paediatrics II in the Faculty of Dentistry in the year 2010 to succeed in their learning achievements, aiming at improving the didactic strategy of the discipline. 2-To describe the characteristics of the teachers referred to by the students as “significant for their learning process”. Method: Exploratory work was done. A personal survey was carried out, anonymously and self-administered. Results: 79% of the students study alone and among 2- 4 hours daily. 29% use the virtual manual and 62% uses different sources. Supervised clinical practices were identified as facilitators of learning (80%) as were teachers humanistic characteristics Conclusions: To know about how students learn, allow teachers to adapt education strategies and propose more self-regulation study habit. The more marked characteristics of the teachers remembered were: human aspect that which proves the important professional practice role that teachers play .

Resistência de bactérias ácido-láticas a bacteriófagos provenientes de unidades de processamento de queijo Coalho / Phage resistance of acid lactic bacteria isolated from Coalho cheese industries

Este trabalho teve como objetivos isolar bacteriófagos de amostras de leite, soro e queijo de Coalho e avaliar a resistência de cepas de Lactobacillus paracasei, pertencentes à Coleção de Micro-organismos de Interesse para a Agroindústria Tropical da Embrapa Agroindústria Tropical, aos fagos isolados. Posteriormente, a resistência destas cepas a fagos específicos para L. paracasei, da Coleção do Instituto de Lactología Industrial - INLAIN (Santa Fe, Argentina), também foi avaliada. As amostras para isolamento dos fagos foram obtidas em quatro unidades de processamento de queijo de Coalho, sendo duas artesanais e duas industriais, localizadas no Estado do Ceará. Para o isolamento dos bacteriófagos, foi empregado o teste de lise celular (spot), enquanto que a resistência das culturas aos fagos foi avaliada pelos testes de capacidade de produção de ácido e avaliação da turbidez. As cepas avaliadas foram resistentes aos bacteriófagos provenientes das unidades de processamento de queijo de Coalho e aos bacteriófagos da Coleção do INLAIN. Os resultados obtidos indicaram que as culturas láticas testadas, resistentes aos bacteriófagos, podem ser utilizadas na composição de fermento lático destinado à elaboração de queijo de Coalho, a partir de leite pasteurizado.

The objectives of this research were to isolate bacteriophages from milk samples, whey and Coalho cheese and to evaluate the resistance of strains of Lactobacillus paracasei from the Collection of Microorganisms of Interest for the Tropical Agroindustry, belonging to Embrapa Tropical Agroindustry, to isolate phages. The strains resistance to specific L. paracasei phages from the collection of the Instituto de Lactología Industrial - INLAIN (Santa Fe, Argentina) was also evaluated. Samples for phage isolation were from four Coalho cheese processing units, two artisanal and two industrial, localized in the state of Ceará. Spot test was employed for bacteriophages isolation, while the culture phage resistance was evaluated by the acid production and turbidity tests. The strains were resistant both to phages isolated from Coalho cheese processing units and phages from collection of INLAIN. The results showed that lactic cultures evaluated here were resistant to bacteriophages and they can be used in the composition of lactic cultures specifically for Coalho cheese manufacture from pasteurized milk.

Acromioclavicular motion after surgical reconstruction.

PURPOSE: A retrospective long-term study was carried out to determine whether there was any correlation between the clinical motion of the acromioclavicular joint evaluated by a test we set up using 90° of abduction and 0° of external rotation against resistance [90°/0°RTest] and the cross arm test (compared to the healthy side) and full return to everyday activities after surgical repair. METHODS: A clinical and radiographic evaluation was carried out on 51/80 subjects at a 5.4-year mean follow-up, treated for acromioclavicular joint dislocation with an extra-articular artificial loop, between 2000 and 2006. RESULTS: The 25 subjects with ossifications obtained a normal acromioclavicular joint motion, on both the horizontal and vertical planes. There was a correlation between the normal motion of the reconstructed acromioclavicular joint (compared to the healthy side) in these 25 patients and full clinical recovery, whilst there was no correlation between the Constant score, the simple shoulder test, the radiographic evaluation on one hand and the clinical motion of the joint on the other. Two patients had recurrent dislocation. Three had mobilization of the screws without reduction loss, or negative clinical outcome. CONCLUSIONS: A postoperative radiographic evaluation should be correlated with a clinical evaluation of the acromioclavicular joint motion (normal, hypermobile, unstable). Normal acromioclavicular joint motion was observed in subjects who developed significant ossifications. The study shows that the clinical evaluation of acromioclavicular joint motion is a simple and trustworthy method to assess the clinical result of a surgical repair. LEVEL OF EVIDENCE: Diagnostic study investigating a diagnostic test, Level III.

Análisis clínico y radiográfico de las técnicas ART y remoción químico-mecánica de caries: estudio piloto / Clinical and radiographic assess of ART technique and chemical and mechanical caries removal: pilot study

Objetivo: Comparar clínica y radiográficamente el Tratamiento Restaurador Atraumático (ART) y remoción químico-mecánica con Papacárie® en molares deciduos con caries oclusal verificando dolor, integridad clínica de las restauraciones y evolución de la lesión. Metodología: Estudio clínico randomizado en 16 molares deciduos, en pacientes de ambos sexos, con edades entre 3 y 6 años. Esos dientes fueron divididos aleatoriamente en G1 (n=8) ART convencional y G2 (n=8) Papacárie® y restaurados con ionómero de vidrio. La sintomatología se analizó mediante la Escala de Evaluación Facial. Seis meses después se evaluó clínicamente la integridad de las restauraciones (Escala de Frencken) y radiográficamente el aumento o no del área radiolúcida de la lesión. Resultados: No fue relatado dolor durante la ejecución de ambas técnicas. Luego de seis meses no hubo progresión de las lesiones y el material restaurador se mantuvo retenido adecuadamente. Conclusiones: Ambas técnicas demostraron éxito clínico y radiográfico luego de seis meses de evaluación.

Evaluación de la variabilidad de la dimensión vertical de oclusión en niños y adolescentes / Evaluation of variability of vertical dimension of occlusion in children and adolescents

La reproducción correcta de la dimensión vertical de oclusión es la base para la mantención de la salud del sistema estomatognático.Algunos métodos permiten la medición facial de forma reproducible, como la comparación de la distancia Comisura labial – Ángulo del ojo, así como la distancia Nasion-Menton. El objetivo de este trabajo fue evaluar la medida de la Dimensión Vertical de Oclusión y sucorrelación con género en niños y adolescentes. Fueron evaluados 176 individuos, de los cuales 48 fueron selecionados dentro de los criterios de inclusión. La medida de la dimensión vertical de oclusión fue realizada por medio de calibrador digital y fue registrada en fichas individuales. Los datos fueron estratificados por grupo etáreo y analizados por el T-test. Valores de p menores a 0,05 fueronconsiderados significantes. Los resultados evidenciaron que la Dimensión Vertical de Oclusión demostró medidas distintas por grupoetáreo y género, variando de 47,70 mm a 70,20 mm para Ángulo externo del ojo-Comisura labial y 52, 30 mm a 70,60 mm para Nasion – Menton, en el género femenino. Se observó alteración estadísticamente significativa entre estas distancias en las edades de 10 y 12 años en el género masculino, mientras que para el género femenino no fue constatada diferencia significativa, considerando el nivel designificancia de 5%. Se concluye que es necesario el registro correcto de la Dimensión Vertical de Oclusión para la reproducción de esta medida, respetándose la diferenciación por grupo etáreo y género, dado que las alteraciones de la Dimensión Vertical de Oclusión pueden llevar al paciente a alteraciones oclusales, musculares y articulares, además de predisposición a maloclusiones.

The correct reproduction of the vertical dimension of occlusion (VDO) is the basis for restoring health to the stomatognathic system. A number of methods allow facial measurement in a safe, reproducible manner, such as the comparison of distance from the lipcommissure to corner of the eye (LC-CE) to the distance from the base of the nose to the chin (N-Ch). The aim of the present study was to determine VDO length in children between 7 and 12 years of age and the correlation of this length with gender. One hundredseventy-six children were evaluated, among which 48 fulfilled the inclusion criteria. The data were stratified by age and analyzed using the paired Student’s t-test. All p-values less than 0.05 were considered statistically significant. There were different measures of VDOwith regard to age and gender, ranging from 52.30 mm to 70.20 mm for the LC-CE distance and 52.30 mm to 70.60 mm for the N-Ch distance in the girls. There was no statistically significant difference between these distances in the ages of 10 and 12 years for malesand that the correlation between LC-EC and N-Ch was not significant for females. For women, there was a correlation between LC-EC and N-Ch, considering the significance level of 5%. There was conclude that it is necessary to measure the correct VDO and standard measures for reproduction of this measure, while the differentiation by age and gender, since the change in VDO can lead the patientto occlusal changes, muscle and joint pain, beyond the predisposition to malocclusion.

Suture rupture in acromioclavicular joint dislocations treated with flip buttons.

Acute acromioclavicular joint dislocations (ACDs) may be treated arthroscopically with flip buttons. This extra-articular fixation is easy to implant and is well tolerated. Between 2007 and 2009, 20 ACD patients (2 women and 18 men; mean age, 32 years) had surgery by the arthroscopic TightRope technique (Arthrex, Naples, FL). The main complication of this technique that has been reported is the partial loss of reduction at follow-up due to clavicular osteolysis under the superior flip button. We describe 4 cases with loss of reduction due to rupture of the sutures running across the buttons: 2 women with joint hyperlaxity and acute Rockwood grade IV ACD and 2 men, heavy manual workers, with joint hyperlaxity and acute Rockwood grade IV ACD. The use of flip buttons might not be indicated in patients with joint hyperlaxity because they are able to obtain immediate stability only on the vertical plane and not on the horizontal plane. Anteroposterior movements of the acromioclavicular joint might rub the suture against the bone tunnels leading to wear and cutting.

O uso da fibra de vidro na confecção de prótese adesiva direta na dentição decídua: relato de caso clínico / . Fiberglass use in direct adhesive prosthesis in primary dentition: clinical case report

O objetivo deste estudo foi relatar um caso clínico onde foi utilizada a fibra de vidro reforçada com resina composta na confecção de uma prótese adesiva direta em paciente de quatro anos de idade com ausência do dente 51 e alteração de cor no dente 61, ambos resultantes de trauma...

The aim of this study was to report a clinical case using reinforced-fiberglass composite to the manufacture of a direct adhesive prosthesis in a four years-old patient with absence of dental element number 51 and color alteration of dental element number 61, both caused by dental trauma...

Avaliação da citotoxicidade da pasta a base de caseína-fosfato de cálcio amorfo (CPP-ACP) / Cytotoxicity assessment of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste

Introduction: Casein phosphopeptides (CPP) have been shown to be good carriers of calcium, phosphate, and hydroxide ions to promote enamel remineralization with applications in oral care products, professional dental products, and food products. Objectives: Evaluate the cytotoxicity of a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste in rat fibroblasts. Materials and methods: Cytotoxicity was measured by the Trypan blue dye exclusion assay and the MTT assay. Results: Long term (1, 3, 5, and 7 days) and short term tests (0, 4, 8, and 12 hours) were performed with the Trypan blue dye exclusion assay. Data were analyzed with ANOVA and Kruskall Wallis tests. After one day, the cell viability of the CPP-ACP study group was between 80 and 100%. In the short term experiments, a reduction of cell viability in the study group was observed compared with the control group; yet viable cells were present over the evaluation period. With the MTT assay, a viability of 76.43% was observed in the study group, a significant difference from the control group (P = 0.003). Conclusion: CPP-ACP paste demonstrates low cytotoxicity in rat fibroblast culture.

Introdução: A caseína fosfopeptídea (CPP) tem demonstrado ser uma provedora de cálcio, fosfato e hidróxido, capaz de promover a remineralização do esmalte dentário, sendo utilizada em produtos de higiene oral, materiais dentários e alimentos. Objetivos: Avaliar a citotoxicidade da pasta a base de caseína (CPP-ACP) em fibroblastos de ratos. Materiais e métodos: A citotoxicidade foi avaliada pelos testes de exclusão azul de Tripan e MTT. Resultados: Testes de longo prazo (1, 3, 5 e 7 dias) e de curto prazo (0, 4, 8 e 12 horas) foram realizados com o teste azul de Tripan. Os dados foram analisados com os testes de ANOVA e Kruskall Wallis. Após um dia, a viabilidade celular do grupo de estudo CPP-ACP estava entre 80 e 100%. Nos experimentos de curto prazo, uma redução de viabilidade celular no grupo de estudo foi observada em relação ao grupo controle, mas as células viáveis foram observados durante todo o período de avaliação. Com o método MTT, foi observada no grupo de estudo a viabilidade de 76,43% f, com diferença significativa do grupo controle (P = 0,003). Conclusão: A pasta CPP-ACP demonstra baixa citotoxicidade em cultura de fibroblastos de ratos.

Comparación entre la utilización de elementos rotatorios de baja velocidad y tratamiento químico mecánico de caries dentinal en dentición decidua / Comparison between the use of low speed rotary elements and chemical mechanical treatment of dentinal caries in deciduous dentition

Uno de los principales objetivos en el manejo del paciente pediátrico con caries es la utilización de técnicas no invasivas, que permitan el tratamiento de la patología dentaria sin afectar el comportamiento del niño. El propósito de este estudio fue evaluar la reacción de niños y registrar su sensación mientras recibían tratamiento de caries dentinal utilizando elementos rotatorios de baja velocidad, en comparación al tratamiento químico mecánico de caries dentinal en dentición decidua. Participaron en el estudio 36 niños, entre 4 y 8 años de edad. Se utilizó un diseño de estudio al azar de sección cruzada de manera tal que cada niño sirviera como su propio control, recibiendo cada tratamiento en cada lado de la misma arcada. Cada paciente era asignado al azar para recibir el tratamiento con elementos rotatorios o tratamiento químico mecánico en la primera visita, administrándosele el restante en la segunda visita. Luego de su tratamiento, todos los dientes fueron obturados con ionómero de vidrio fotopolimerizable. Para la evaluación objetiva de la reacción de los niños se aplicó la Escala de Comportamiento ante el Dolor Modificada. Inmediatamente después de realizado el tratamiento, se solicitaba a los niños que llenaran el formulario que contenía la Escala Facial para Registro del Dolor de Wong-Baker (Facial Pain Scale) para la evaluación subjetiva. El tratamiento químico mecánico demostró ser un procedimiento mejor aceptado por los pacientes pediátricos que el tratamiento con elementos rotatorios de baja velocidad.

One of the main objectives during the pedodontics assistance is the use of noninvasive techniques, that allow the treatment of the dental caries without affecting the behavior of the child. The aim of this study was to evaluate the reaction of children and to register its sensations during the treatment of dental caries in deciduous teeth, using low speed cutting rotatory instruments in comparison to the chemical and mechanical caries removal treatment. 36 children participated in the study, between 4 and 8 years of age. A cross section study design was used and each child served like his own control, receiving the two treatment in teeth of the same arches. Each patient one was selected randomly to receive the treatment with rotatory instruments or the chemical and mechanical treatment in the first visit, administered him to it the rest treatment in the second visit. After their treatment, all the teeth were restorated with light-curing glass ionomer. For the objective evaluation of the reaction of the children the Behavior Scale in the Modified Pain was applied. Immediately after the treatment, one asked for the children who filled the form that contained the Wong-Baker’s Face Scale for Registry of the Pain (Face Pain Scale) for the subjective evaluation. The chemical-mechanical treatment demostrated to be more accepted for the children in comparasion to the treatment with cutting rotatory istruments.