Klebsiella pneumoniae peptide hijacks a Streptococcus pneumoniae permease to subvert pneumococcal growth and colonization.

Treatment of pneumococcal infections is limited by antibiotic resistance and exacerbation of disease by bacterial lysis releasing pneumolysin toxin and other inflammatory factors. We identified a previously uncharacterized peptide in the Klebsiella pneumoniae secretome, which enters Streptococcus pneumoniae via its AmiA-AliA/AliB permease. Subsequent downregulation of genes for amino acid biosynthesis and peptide uptake was associated with reduction of pneumococcal growth in defined medium and human cerebrospinal fluid, irregular cell shape, decreased chain length and decreased genetic transformation. The bacteriostatic effect was specific to S. pneumoniae and Streptococcus pseudopneumoniae with no effect on Streptococcus mitis, Haemophilus influenzae, Staphylococcus aureus or K. pneumoniae. Peptide sequence and length were crucial to growth suppression. The peptide reduced pneumococcal adherence to primary human airway epithelial cell cultures and colonization of rat nasopharynx, without toxicity. We identified a peptide with potential as a therapeutic for pneumococcal diseases suppressing growth of multiple clinical isolates, including antibiotic resistant strains, while avoiding bacterial lysis and dysbiosis.

Three-year follow-up of flowable bulk-fill resin restorations in posterior teeth: a double-blind randomized controlled clinical trial / Acompanhamento de três anos de restaurações do tipo bulk-fill flow em dentes posteriores: ensaio clínico controlado randomizado duplo-cego

Objetivo: Este ensaio clínico randomizado avaliou o comportamento de restaurações com resina composta bulk-fill flow em dentes posteriores após três anos do tratamento restaurador. Métodos: Dezessete pacientes (12 mulheres, 5 homens, idade 23-59) foram selecionados para ter pelo menos duas restaurações de amálgama ou de resina composta substituídas, ou receber tratamento restaurador para lesão cariosa. As cavidades foram aleatoriamente alocadas para receberem o compósito bulk-fill flow Suferil SDR Flow, oclusamente coberto por uma resina composta convencional nano-híbrida Esthet-X HD (técnica bulk and body), ou serem preenchidas exclusivamente com Esthet-X HD, inseridas em incrementos de 2mm cada técnica incremental). Um adesivo convencional de dois passos foi aplicado em todas as cavidades. Trinta e quatro restaurações Classes I ou II foram realizados em dentes posteriores (n=17) no início do estudo (baseline). Após 03 anos, os critérios do USPHS modificado e FDI foram utilizados para avaliar as restaurações. Os dados foram submetidos à análise estatística Mann-Whitney (p<0,05). Resultados: No acompanhamento de 3 anos, vinte e quatro restaurações (17 Classes I e 7 Classes II) foram avaliadas. Não foram detectadas diferenças entre as técnicas restauradoras (p>0,05). Não houve falha em nenhuma restauração ao longo do tempo. Conclusão: Após 03 anos de serviço clínico, todas restaurações utilizando um compósito bulk-fill flow em dentes posteriores demonstraram uma performance satisfatória. Significância Clínica: A qualidade geral das restaurações em dentes posteriores realizadas com a técnica bulk and body foi similar ao das restaurações incrementais utilizando um compósito nano-híbrido. (AU)

Objective: This randomized clinical trial evaluated the behavior of restorations with flowable bulk-fill resin composite in posterior teeth three years after the restorative treatment. Methods: Seventeen patients (12 women, 5 men, age 23-59) were selected to have at least two failing amalgam or resin restorations replaced and/or to have a carious lesion restored. The cavities were randomly allocated to receive either the flowable bulk-fill composite Surefil SDR Flow occlusally covered with the conventional nano-hybrid composite Esthet-X HD (bulk and body technique) or filled exclusively with Esthet-X HD placed in 2 mm increments (incremental technique). A two-step etch-and-rinse adhesive was applied in all cavities. Thirty-four Class I or II restorations were performed in posterior teeth (n=17) during baseline. After 03 years, modified USPHS and FDI criteria were used to evaluate the restorations. Data were subjected to Mann-Whitney statistical analysis (p<0.05). Results: At the 3-year follow-up, twenty-four restorations (17 Class I and 7 Class II) were evaluated. No diff erences were detected between the bulk and body and the incremental restorations (p>0.05). No restoration failures were observed over time. Conclusion: After 03 years of clinical service, all restorations using a flowable bulk-fill composite in posterior teeth showed an acceptable performance. Clinical Significance: The overall quality of posterior restorations made with the bulk and body technique was similar to that of restorations made with a nano-hybrid composite incrementally placed. (AU)

A clinical evaluation of direct veneers made with two types of composites

Objectives: the aim of this study was to provide a retrospective clinical evaluation of direct composite veneers performed with microfilled or universal composites, through two evaluation criteria (FDI and USPHS). Materials and methods: patients should be in compliance with the inclusion criteria: having a composite veneer in anterior teeth made either with microfilled or universal using composites (microhybrid/nanohybrid), conventional dentin-bonding agents and for a minimum of 6 months period in service. A calibrated blind examiner assessed the veneers using the FDI and USPHS criteria and the results were subjected to statistical analysis by the Mann-Whitney test (p<0.05). Results: Twenty-eight patients (mean age 42.9 year-old) and seventy-four composite veneers were examined. The mean period of time in service was three years, with periods varying from six months up to ten years. Three cases of total failure (veneers lost, universal composites group) occurred in the surveyed patients, out of 17 failures in total. In general, the veneers showed a clinical satisfactory outcome (77% survival rate). Concerning the two composite types, better clinical performance was observed for microfilled in relation to surface luster, surface staining, colour match and marginal adaptation. Conclusion: In this interim evaluation, direct composite veneers demonstrated an acceptable clinical behavior. Microfilled composite veneers showed a better performance compared to universal composites. The two criteria (USPHS and FDI) were similar in the clinical evaluation process. Clinical relevance: direct composite veneers have a good clinical performance, microfilled composites are interesting options regarding esthetic properties.

Nutritional Status of Indonesian Children in Low-Income Households with Fathers that Smoke.

OBJECTIVES: This study compared the nutritional status of children in low-income households in Indonesia whose fathers were either cigarette smokers or non-smokers. METHODS: A cross sectional study of 482 children aged 2-6 years was conducted, stratified by whether the fathers were non-smoking (n = 138) or smoking (n = 340). Mothers and smoking fathers were interviewed about socioeconomic status and cigarette expenditure, respectively. The nutritional status of children was defined by weight-for-age, height-for-age and weight-for-height. RESULTS: Both groups had similar income. Households with a father that smoked, spent 16.6% of their income on cigarettes. Children whose fathers did not smoke had higher height-for-age (-1.99 vs. -2.25 Z-score, p = 0.02) than children whose fathers smoked. Weight-for-age in children with fathers that did not smoke was greater (-1.49 vs. -1.64 Z-score) but not statistically significantly different to those children with fathers that smoked, nor was child weight-for-height (-0.46 vs. -0.45 Z-score). The prevalence of stunted growth was higher in the children with a father that smoked compared with those that had a father did not smoke (62.2 vs. 49.6%, p = 0.07, respectively). There were 28.3% of children underweight in homes where the fathers did not smoke, and 35.6% in households where the father smoked (p = 0.11). Wasting was observed in 4.4% children where fathers did not smoke and 4.7% where fathers did smoke. CONCLUSION: With similar income constraints, the degree of height growth faltering was less in children whose fathers did not smoke, compared to those whose fathers did smoke.

Effect of erosive challenges on deciduous teeth undergoing restorative procedures with different adhesive protocols - an in vitro study

ABSTRACT Objective: To evaluate the effect of erosive challenges on the tooth- restoration interface of deciduous teeth treated with different adhesive protocols. Material and Methods: Deciduous molars were cut mesiodistally, then embedded, abraded and polished (n=80). Samples were randomly divided according to the adhesive system used into: G1 (Adper Single Bond2®, etch-and-rinse), G2 (Universal Single Bond®, self-etching), G3 (OptibondFL®, etch-and-rinse with Fluoride) and G4 (BondForce®, self-etching with Fluoride). After standardized cavity preparation (2 mm diameter x 2 mm depth), adhesive systems were applied and samples were restored (composite resin Z350®). Half of the samples were exposed to erosive/abrasive cycles (n = 10, each adhesive group), and the other half (control group; n = 10) remained immersed in artificial saliva. For microleakage analysis, samples were submersed in methylene blue and analyzed at 40x magnifications. Cross-sectional microhardness (CSMH) was carried out (50 g/5 s) at 25 μm, 50 μm, and 100 μm from the eroded surface and at 25 μm, 75 μm, and 125 μm from the enamel bond interface. Results: Regarding microleakage, 7.5% of the samples showed no dye infiltration, 30% showed dye infiltration only at the enamel interface, and 62.5% showed dye infiltration through the dentin-enamel junction, with no difference between groups (p≥0.05). No significant difference was observed in CSMH at different depths (two-way ANOVA, p≥0.05). Conclusions: We did not observe significant changes in microleakage or CSMH after erosive/abrasive challenges in deciduous teeth treated with different adhesive protocols (etch-and-rinse and self-etching adhesives, with and without fluoride).

Fechamento de diastema com resina composta direta: relato de caso clínico / Diastema closure with direct composite restorations: a case report

Com a evolução dos materiais restauradores adesivos diretos e das técnicas restauradoras minimamente invasivas, é possível realizar o fechamento de diastemas inter incisivos superiores de maneira efetiva e estética em uma única sessão. O presente trabalho consiste em um relato de caso clínico que aborda o clareamento dental e o fechamento de diastema entre os dentes 11 e 21 de um paciente jovem. Previamente ao procedimento restaurador foi realizado clareamento de consultório em todos os dentes com peróxido de hidrogênio 35%. Então, o planejamento restaurador foi auxiliado por modelos de estudo associado ao enceramento diagnóstico.A técnica restauradora de eleição foi a resina composta direta com o auxílio de uma matriz/guia de silicona para a confecção das faces palatinas das restaurações. Após o acabamento e polimento, obteve-se a reanatomização dos incisivos centrais com a eliminação do diastema. O tratamento realizado baseado no clareamento dental seguido por restaurações diretas de resina composta foi eficaz na solução estética do sorriso, atingindo a expectativa do paciente e dentro dos princípios de máxima preservação dos tecidos dentais.

After the evolution of restorative adhesive materials and minimal invasive restorations, it ispossible to close a maxilar interincisal diastema in an effective and aesthetical way, performingit in only one session. This clinical case report approaches a teeth bleaching and diastema closurewith composites between teeth 11 and 21, of a young male patient. The elective restorative technique was direct composite restoration with a silicon putty matrix to make the shape of thelingual surfaces of the restorations. Before the restoration procedure, it was performed “in office”bleaching technique, in addition to the case planning with the assistance of a wax-up. The tooth whitening therapy followed by direct composite restorations was effective, contributing to clinical success, esthetic and patient´s satisfaction.

Influence of different dentin drying methods on adhesive behavior of composite restorations

Aim: The aim of this study was to evaluate, in vitro, the influence of four different dentin drying methods (air drying for 10s, absorbent paper, endodontic suction cannula and air drying for 10s with subsequent re-wetting with distilled water), after etching with phosphoric acid gel 37%, on bond strength and microleakage of composite restorations. Material and Methods: Twenty sound bovine incisors were selected and sectioned transversely. The buccal surfaces were frayed until exposure of dentin, etched and washed with distilled water. Each specimen was subjected to one of the four different drying methods. A 3-step total-etch adhesive system (Adper Scotchbond™ Multi-Purpose) was used on 10 teeth and on the other 10, a 2-step total-etch adhesive system (Adper Single BondT™ 2) was used. Composite resin restorations in cylindrical shapes were made and, after thermocycling, the teeth were subjected to the microshear bond strength test. Cervical areas of the teeth were prepared and restored with the same techniques describe above. Cervical restorations were cut and subjected to microleakage analysis in the cervical margin. Data obtained were tabulated and statistically analyzed, using ANOVA, Chi-square and Kruskal-Wallis tests, and the significance level was set at 5%. Results: The results showed no statistically significant differences among the groups tested. Conclusions: It was concluded that all drying methods tested represent feasible alternatives to clinical application for total etch dentin-bonding agents.

Influence of filling technique and bevel preparation on marginal sealing of conventional and low shrinkage composite restorations

AIM: The aim of this study was to evaluate two composite restorations (conventional methacrylate-based and low shrinkage-based silorane), associated or not to beveling and incremental technique, in relation to the microleakage and marginal gap formation tests. MATERIAL AND METHODS: 30 sound human molars had their mesial and distal surfaces prepared with and without bevel. The teeth were divided into six groups according to the type of resin (conventional nanofilled or silorane resin), and restorative filling technique (incremental technique or builk). Microleakage and marginal gap formation data were statistically analyzed by Kruskal-Wallis and Chi-Square tests, with a significance level set at 5%. RESULTS: Group 1 (Z350 XT, without bevel, incremental technique) presented highest rate of microleakage and marginal gap in most of the restorations, with statistically significant differences. Groups 4 and 6 (P90, beveled, builk and P90, beveled and incremental technique) had lower rates of microleakage and absence of marginal gaps in most of the restorations. CONCLUSION: It's concluded that the silorane showed lower rates of marginal gaps and microleakage, when compared to the conventional methacrylate-based resin. Bevel preparation was effective in reducing microleakage and marginal gaps for both resins used. Incremental technique was not necessary when associated with low shrinkage composite resin.

Quantitative and qualitative evaluation of resin-dentin bond strengths: in vitro effects of surface treatment with metalloproteinase inhibitors

AIM: The objective of this study was to evaluate the use of MMPs inhibitors (chlorhexidine and EDTA) in bond strength and quality of the hybrid layer of adhesive restorations in normal dentin using two ethanol-based total-etch adhesive systems. MATERIAL AND METHODS: Thirty-two extracted human molars were coronally sectioned and randomly divided into 8 groups (n=4), depending on the surface pre-treatment and adhesive system used. The total-etch adhesive systems Single Bond 2 (2-step) and Adper Scotchbond Multi-Purpose Plus (3-step) were used as follows: 1) according to manufacturer's instructions (etching with 37% phosphoric acid (H3PO4) for 15 s); 2) etching with H3PO4 for 15 s, followed by 2% chlorhexidine for 120 s; 3) etching with 0.1 M EDTA for 60 s; 4) etching with 0.1 M EDTA followed by 2% chlorhexidine for 120 s. Teeth were incrementally restored with composite resin (Filtek Z350XT). After water storage for 24 h, teeth were double-sectioned, yielding stick specimens of 1.0 mm² bonded area, and then subjected to microtensile bond strength (MTBS) test at 0.5 mm/min. Additional specimens were gold-sputtered to be analyzed under scanning electron microscopy (SEM). Data (in Mega Pascal) were subjected to Kruskal-Wallis and Dunn (p <0.05) tests. RESULTS: The etching protocol (37% H3PO4 or EDTA) interfered with hybrid layer formation, monomer penetration and the MTBS. Funnel shaped resin tags were observed when dentin was etched with 37% H3PO4. In these specimens, MTBS were also higher. EDTA conditioning produced thin hybrid layers and smaller MTBS, regardless the adhesive system used. Chlorhexidine application after conditioning resulted in no apparent differences between both evaluated techniques (37% H3PO4 or EDTA). CONCLUSION: The use of chlorhexidine as a MMP inhibitor does not alter immediate bond strength values and does not interfere with hybrid layer formation.

Avaliação clínica retrospectiva de restaurações proximais de resina composta de classes III e IV / Retrospective clinical evaluation of proximal composite resin restorations (class III and IV)

A resina composta é frequentemente utilizada na saú- de pública, sendo um dos principais materiais usados na atenção primária. Um estudo de avaliação retrospectiva reflete uma real situação dos procedimentos restauradores. Objetivo: Realizar uma avaliação clínica retrospectiva de restaurações diretas proximais de resinas compostas em dentes anteriores (classes III e IV) realizadas na Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul. Métodos: De acordo com os critérios de inclusão e exclusão, dois métodos de avaliação foram utilizados por um examinador calibrado e cego, o USPHS e o FDI modificados. Resultados: Foram avaliadas 79 restaurações, feitas de há 6 meses até há 20 anos. As restaurações proximais foram divididas em dois grupos, classe III (n = 33) e classe IV (n = 46). Na classe III, oito delas foram classificadas como clinicamente insatisfatórias em pelo menos um dos métodos de avaliação clínica (24%). Já na classe IV, nove delas se apresentaram como insuficientes (20%). As maiores causas de falha para a classe III foram: manchamento marginal (12%) e adaptação marginal (12%) pelo FDI, integridade marginal (9%) e cárie secundária (9%) pelo USPHS; e para classe IV: fraturas e retenção (11%) pelo FDI, forma anatômica (9%) e fraturas e retenção (9%) pelo USPHS. Conclusão: Restaurações de resina composta demonstraram um desempenho clínico satisfatório ao longo do tempo, apresentando uma baixa taxa de falha no período avaliado. Os dois métodos (USPHS e FDI) se mostraram eficazes no processo de avaliação clínica...

Avaliação clínica retrospectiva derestaurações cervicais de resina composta / Retrospective clinical assessment of composite resin cervical restorations

Objetivo: proceder a uma avaliação clínica retrospec-tiva de restaurações diretas de resinas compostas cervi-cais (classe V) realizadas na Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul. Ma-teriais e método: foram incluídos no estudo pacientes adultos de ambos os sexos que receberam tratamento com restaurações de classe V na região anterior da ar-cada superior ou inferior, incluindo pré-molares, reali-zadas com resinas compostas dos tipos microparticula-das, micro-híbridas, nanoparticuladas e nano-híbridas e que possuíssem um período mínimo em boca de 6 meses. Pacientes fumantes, com mordida em topo ou hábitos parafuncionais severos, higiene oral precária ou com necessidades especiais não foram incluídos no estudo. Dois métodos de avaliação foram utilizados por um examinador calibrado e cego: o USPHS e o FDI modificados. Os dados coletados da avaliação clínica foram tabulados para análise descritiva, de acordo com os dois métodos empregados. Resultados: foram avalia-das 47 restaurações cervicais, com um intervalo de tem-po em boca de 6 meses até 18 anos (média 6,5 anos). Foram encontradas 12 restaurações (26%) considera-das inadequadas segundo os métodos empregados. As principais causas de falha foram: recorrência de cáries, erosão, abrasão ou abfração (12%) pelo método FDI e fratura e perda de retenção (11%) pelo método USPHS. Conclusão: apesar das limitações do estudo, as restau-rações de resina composta de classe V demonstraram um desempenho clínico satisfatório ao longo do tem-po, apresentando uma baixa taxa de falha no período avaliado. Os dois métodos (USPHS e FDI) mostraram-se eficazes no processo de avaliação clínica de restaura-ções cervicais.

Clareamento de dentes tratados endodonticamente: uma revisão da literatura / Bleaching of root-filled teeth: a literature review

Na Odontologia contemporânea, a estética sofreu uma valorizaçãosignificativa, ganhando destaque e importância. Nesse contexto, a belezaé influenciada pelo contorno, forma, simetria, alinhamento e,principalmente, pela cor dos dentes. O clareamento de dentes anterioresdesvitalizados escurecidos tem se tornado uma terapia muito requisitada,uma vez que o escurecimento dos dentes é motivo de grande insatisfaçãopor parte dos pacientes. Esta revisão de literatura tem como objetivoanalisar os dados disponíveis na literatura sobre este assunto, uma vezque a associação entre o clareamento interno e a reabsorção radicularexterna cervical é uma questão que ainda gera dúvidas na práticaodontológica. O clareamento interno apresenta resultados esteticamentesatisfatórios, no entanto, apresenta como possível efeito colateral areabsorção radicular cervical externa, que prejudica ou até mesmoinviabiliza a permanência do elemento dental na cavidade bucal. Aetiologia da reabsorção radicular externa relacionada ao clareamento écomplexa, no entanto acredita-se que o agente clareador alcance ostecidos periodontais através dos túbulos dentinários, desnature a dentina,que passa a ser considerada um tecido imunologicamente diferente,sendo reconhecida como um corpo estranho e inicia uma reaçãoinflamatória que resulta na perda localizada de tecido dental. Outralimitação do clareamento de dentes tratados endodonticamente é arecidiva da cor, ainda pouco compreendida. Apesar do clareamento dedentes desvitalizados ter um alto índice de sucesso e de sua naturezaminimamente invasiva, os possíveis efeitos colaterais, tais como areabsorção cervical externa e a recidiva de cor devem ser levados emconsideração no momento de sua indicação.

In modern Dentistry, the smile aesthetics is more valuable every day,gaining importance and prominence. In this context, the beauty isinfluenced by contour, shape, alignment, symmetry and, specially, thecolor of the teeth. The bleaching of anterior endodontically treateddarkened teeth has become a therapy very requested in the clinicalpractice of Dentistry, because stained teeth is of great concern forpatients. This literature review has as objective to analyze the availabledata on this subject, since the association between internal bleaching andexternal cervical root resorption is an issue that still raises questions indental practice. The internal bleaching has aesthetic success, however,this procedure is associated with a risk of external root resorption, whichhinders or even makes impossible the maintenance of the tooth in the oralcavity. The etiology of the external root resorption related to the internalbleaching is complex, however it’s believed that the bleaching chemicalsdiffuse from the pulp chamber through patent dentinal tubules to thesurrounding periodontal tissues, denatures dentin, which starts to beconsidered as a tissue with immunological differences, starting, then, to berecognized as a strange body, resulting in an inflammatory reaction whichresults, then, in the located loss of tissue. Another limitation of the internalbleaching of root-filled teeth is the discoloration. In spite of this procedure’shigh success rate, the results are different from those seen at long-termfollow-up, that is, the color regression is a fact that must be studied andbetter understood.

Qual é a sua opinião sobre utilizar ou não utilizar em sua rotina clínica a clorexidina como etapa adicional quando empregados sistemas adesivos convencionais de duas ou três etapas clínicas?

(Por Alberth D. Correa-Medina) Essa questão é complexa para responder, pois alguns pontos ainda estão em discussão, tais como: a) as razões que indicam o uso de clorexidina; b) se utilizada, em que momento do procedimento adesivo é melhor, antes ou depois do condicionamento ácido?; e c) pode ser utilizada com sistemas adesivos convencionais e autocondicionantes? A clorexidina, em concentrações menores que 1%, tem ação bacteriostática, provocando danos na membrana e perda de substâncias de baixo peso molecular, tais como potássio e íons de flúor, embora não produza a morte bacteriana. Entretanto, em concentrações superiores a 1% causa coagulação e precipitação do citoplasma, produzindo morte celular, sendo altamente bactericida. Essa substância age sobre gram-positivos e negativos aeróbios e anaeróbios. Tem várias aplicações e, na área da Odontologia Restauradora, tem sido indicada para a limpeza de cavidades antes que sejam restauradas, porque proporciona desinfecção adequada dos tecidos dentários. Em lesões cariosas em que toda estrutura infectada tenha sido removida, indicava-se aplicar essa solução como uma forma de assegurar a remoção completa de restos de organismos que poderiam ficar presentes na cavidade. [...]

Influência do tratamento de superfície na resistência de união por cisalhamento de um cerômero indireto / Surface treatment effect on shear bond strength of an indirect ceromer

Objetivo: o presente estudo realizou uma análise comparativa da resistência ao cisalhamento em dentina após diferentes tratamentos de superfície do cerômero BelleGlass HP (Kerr). Materiais e métodos: para isso, trinta molares humanos tiveram suas faces livres desgastadas até expor a superfície dentinária, nas quais foram cimentados os corpos de prova (belleGlass HP) com cimento resinoso (RelyX ARC, 3M ESPE), com três tratamentos de superfície: grupo 1 (controle): sem tratamento de superfície; grupo 2: condicionamento com ácido fluorídrico 10%; e grupo 3: jateamento com óxido de alumínio com granulação de 50um. Os espécimes foram avaliados em relação à resistência de união por cisalhamento, com velocidade de 1,0mm/min. Os dados foram analisados estatisticamente através dos testes ANOVA e Tukey, com nível de significância de 5%. Resultados: como resultado, obteve-se diferenças estatisticamente significativas (P=0,002) entre o grupo controle e o grupo 3. Conclusão: concluiu-se que o tipo de tratamento de superfície do cerômero Belleglass influenciou a resistência de união dos espécimes cimentados, sendo o jateamento com óxido de alumínio o que apresentou melhor desempenho

Aim: The present study showed a comparative analysis of shear bond strength of a ceromer after different surface treatments. Material and methods: For that, thirty human molars had their free surfaces drilled until exposing the dentin tissue, where the ceromer specimen were cemented (belleGlass HP), with three surface treatments before cementation: control group, without surface treatment (group 1); group 2: etched with fluoridric acid (10%) and group 3: etched with aluminum oxide jet (50um). All groups were tested in a universal testing machine, with 1mm/min crosshead speed, in a shear bond strength test. Data were analysed by ANOVA and Tukey tests. Results: It was shown statistically significant differences (p=0.002) between control group and group 3. Conclusions: Ceromer surface treatment Intervenes on shear bond strength to dentin, being the aluminium oxide jet the best way to improve bond strength.

Fermented soyabean and vitamin C-rich fruit: a possibility to circumvent the further decrease of iron status among iron-deficient pregnant women in Indonesia.

OBJECTIVE: Increasing the consumption of Fe-rich foods and thus improving Fe bioavailability without significantly increasing diet cost is the most sustainable intervention for improving Fe intake. We assessed the effect of supplementary food consisting of fermented soyabean (tempeh) and vitamin C-rich fruit consumed during pregnancy on maternal iron deficiency (ID). DESIGN: Pregnant women were randomly allocated by village into optimized diet and control groups. Supplementary food was given 6 d/week at home. The average weekly food provided comprised 600 g of tempeh, 30 g of meat, 350 g of guava, 300 g of papaya and 100 g of orange. Hb, ferritin and transferrin receptor (TfR) concentrations were measured at 12-20 and at 32-36 weeks of gestation. SETTING: Thirty-nine villages in Indonesia. SUBJECTS: Pregnant women (12-20 weeks of gestation, n 252). RESULTS: At baseline, mean Hb, ferritin and TfR concentrations and body Fe concentration were within the normal range and did not differ between groups. At near term, mean Hb, ferritin and body Fe decreased, whereas mean TfR increased significantly in both groups. The mean changes in Fe status were similar in both groups. In Fe-deficient women, consumption of an optimized diet was associated with smaller decreases in Hb (1·02 (95% CI 0·98, 1·07) g/l; P = 0·058), ferritin (1·42 (95% CI 1·16, 1·75) µg/l; P = 0·046) and body Fe (2·57 (95% CI 1·71, 3·43) mg/kg; P = 0·073) concentrations, compared with a state of no intervention. Fe-deficient women at baseline benefited more from supplementary food compared with Fe-replete women. CONCLUSIONS: Daily supplementary food containing tempeh and vitamin C-rich fruits during pregnancy might have positive effects on maternal ID.

Effect of daily or weekly multiple-micronutrient and iron foodlike tablets on body iron stores of Indonesian infants aged 6-12 mo: a double-blind, randomized, placebo-controlled trial.

BACKGROUND: There is still uncertainty about the best procedure to alleviate iron deficiency. Additionally more reliable methods are needed to assess the effect of iron intervention. OBJECTIVE: We examined the efficacy of daily iron (10 mg), daily and weekly multiple-micronutrient supplementation (10 and 20 mg Fe, respectively) in improving body iron stores of Indonesian infants. DESIGN: Infants aged 6-12 mo were randomly allocated to 1 of 4 groups: daily multiple-micronutrients (DMM) foodlike tablets (foodLETs), weekly multiple-micronutrient (WMM) foodLETs, daily iron (DI) foodLETs, or daily placebo. Hemoglobin, ferritin, transferrin receptors, and C-reactive protein data were obtained at baseline and 23 wk. RESULTS: Body iron estimated from the ratio of transferrin receptors to ferritin was analyzed for 244 infants. At baseline, mean iron stores (0.5 +/- 4.1 mg/kg) did not differ among the groups, and 45.5% infants had deficits in tissue iron (body iron < 0). At week 23, the group DI had the highest increment in mean body iron (4.0 mg/kg), followed by the DMM group (2.3 mg/kg; P < 0.001 for both). The iron stores in the WMM group did not change, whereas the mean body iron declined in the daily placebo group (-2.2 mg/kg; P < 0.001). Compared with the daily placebo group, the DMM group gained 4.55 mg Fe/kg, the DI group gained 6.23 mg Fe/kg (both P < 0.001), and the WMM group gained 2.54 mg Fe/kg (P = 0.001). CONCLUSIONS: When compliance can be ensured, DI and DMM foodLETs are efficacious in improving and WMM is efficacious in maintaining iron stores among Indonesian infants.

Avaliação da resistencia de uniao de diferentes sistemas adesivos em dentina / Shear bond strengths evaluation of different adhesive systems to dentin

O objetivo deste estudo foi comparar a resistência de união em dentina de quatro sistemas adesivos de frasco único e dois autocondicionantes. Noventa fragmentos obtidos da porção coronária de dentes bovinos foram incluídos em resina de poliestireno e desgastados com lixas abrasivas até se obter uma superfície plana em dentina. Em seguida, os espécimes foram divididos aleatoriamente em seis grupos (n=15), de acordo com o sistema adesivo: [SB]Single Bond; [PB]Prime & Bond NT; [EX]Excite; [OCB]One Coat Bond; [CLF]Clearfil SE Bond e [OUB]One-Up Bond F. Sobre cada superfície dentinária foi aplicado o sistema adesivo e confeccionado um cilindro de resina composta Z250, utilizando-se uma matriz de teflon bipartida. Após 7 dias, o teste de cisalhamento foi realizado em uma máquina de ensaio universal (EMIC) com velocidade de O,5mm/min. Os dados obtidos em MPa foram submetidos à análise estatística (ANOV A e Tukey, p

Clareamento dental interno / Intra coronal bleaching

Atualmente, um dos aspectos mais estimados no conjunto estético da face é o sorriso. Este fato estimulou o desenvolvimento de técnicas e materiais que proporcionem um resultado mais harmonioso, que satisfaça os anseios do paciente. Antigament, dentes que apresentavam anomalias de cor recebiam desgastes para, em seguida, serem reconstruídos através de procedimentos diretos ou indiretos. Hoje, o profissional pode contar com técnicas altamente eficazes e seguras que possibilitam a reversão destes quadros de alteração de cor. O clareamento é a tentativa mais conservadora de restabelecer a cor normal dos dentes, através da descoloraçã das manchas dentais por processos de oxidação ou redução. Sendo assim, o objetivo deste trabalho é elucidar, através de uma revisão de literatura, as principais técnicas e procedimentos necessários para o clareamento de dentes não vitais.

Transformaçöes estéticas do sorriso empregando procedimentos restauradores e näo restauradores / Procedures for an aesthetic smile using restorative and non-restorative treatments

A existência de alteraçöes nos dentes anteriores causadas por lesöes de cárie, má formaçäo, traumatismos, alteraçöes de cor, mau posicioamento no arco dental e restauraçöes deficientes, normalmente geram um prejuízo estético significativo no paciente. Para o estabelecimento da harmonia do sorriso, o profissional pode lançar mäo de técnicas de clareamento dental vital e não vital aliadas ao avanço de sistemas adesivos e resinas compostas, que se constituem em uma opçäo menos invasiva, proporcionando alteraçöes significativas com ótimo resultado estético. Este trabalho visa descrever a associaçäo de técnicas de clareamento dental com condutas restauradoras diretas para pacientes insatisfeitos com seu sorriso