High-dose chemotherapy with autologous stem cell transplantation for patients with extracranial germ cell tumors - experience of two Brazilian pediatric centers.

Malignant extracranial germ cell tumors (GCTs) are rare in pediatric patients and are usually extremely sensitive to chemotherapy. Relapsed or refractory tumors, although rare, established the need for second-line therapies, including high-dose chemotherapy with autologous stem cell transplantation (HDCT/ASCT). However, there are few data on its use in children with GCTs. We present a retrospective analysis of all patients diagnosed with extracranial GCTs who received HDCT/ASCT at two Brazilian pediatric cancer centers from May 1999 to December 2019. We identified a total of 34 patients with a median age at diagnosis of 2.8 years (range, 0 to 18.8), who received HDCT/ASCT. Most patients (73%) received carboplatin, etoposide and melphalan (CEM) as a HDCT regimen. Fourteen patients received a second-line conventional dose chemotherapy (CDCT), 14 received a third-line CDCT and five received even a fourth-line CDCT prior to HDCT/ASCT. After a median follow-up of 22.7 months (range, 0.3 to 198.1), 16 patients had died after tumor relapse/progression and 2 patients died from HDCT/ASCT toxicity. We observed a 5-year OS of 47.1% and 5-year EFS of 44.1%. The 5-year OS for patients referred for HDCT/ASCT with progressive disease was 10% compared to 62.5% for those who achieved disease control before HDCT/ASCT (p = 0.001). In our experience, heavily pretreated children and adolescents with extracranial GCTs achieved considerable survival rates with HDCT/ASCT since, at least, partial control of their disease was possible before starting HDCT/ASCT. The role of HDCT/ASCT in pediatric patients with GCTs should be investigated in prospective trials.

Evaluation of different composite resin finishing and polishing protocols by confocal laser scan microscopy

Aim This study aimed to analyze the influence of finishing and polishing (F/P) protocols on resin surface through roughness (Ra) values and laser scan microscopy observations. Methods Forty-eight (n=48) resin specimens were sorted into four groups (n=12), according to the type of resin used: Filtek Z250 (Z250), Filtek Z350 (Z350), Filtek One Bulk Fill (BF), Filtek P60 (P60). The specimens were sorted into six groups according to the type of F/P system used (n=2/group): Control group, Diamond bur (KG Sorensen), Soflex Pop-On Discs (3M ESPE), Soflex Spiral (3M ESPE), Dura Gloss (American Burs), and Praxis (TDV). Results The highest roughness values (Ra) were attributed to BF group for all F/P systems, except for the Soft-Lex PopOn discs. The Soft-Lex PopOn, Spiral, and Praxis discs presented a better performance for the surface treatment of the tested composite resins. Regardless of the restorative material, the use of diamond bur or single-step abrasive rubber (Dura Gloss) were associated with the highest Ra values. Conclusion The effect of F/P systems on Ra is material-dependent and instrument or system-dependent.

Use of Objective Outcomes Measures to Verify the Effects of ICF-Based Gait Treatment in Huntington's Disease Patient on Globus Pallidus Deep Brain Stimulation: A Case Report.

In advanced stages of in Huntington's disease (HD) gait impairments and severe chorea are usually medication-refractory. The long-term effects on gait in HD of physiotherapy ICF-based management post- globus pallidus deep brain stimulation (GPi DBS) are not well-established. Physiotherapy has been recognized as an essential element in HD treatment. Here, we present a case report of a 56-year-old woman with HD on the advanced stage and severe chorea medication-refractory after GPi-DBS. We performed multidisciplinary motor assessments ICF-based to identify the disability at clinical and home-setting, including environmental and personal factors before and after GPi-DBS surgery and at 11-time points follow-up. The surgery was very successful and directly post GPi-DBS, there were a significant improvement in chorea and a substantial decrease in medication dose. A framework ICF- based physiotherapy protocol with external cues was developed to improve gait was delivered post-surgery and was continued three times/week during 18-months. Physiotherapy sessions consisted of a personalized protocol of exercises with functional movements, balance, and gait training with external cues. Improvements in gait were observed in 3-months post-intervention and were more expressive in 6-months follow-up. Our patient improved substantially HD motor symptoms and her quality of life after GPi-DBS intervention and a physiotherapy program ICF-based. The objective outcomes measures used to assess gait have served as endpoints to assessing the patient's motor profile during the pre-operative period. Assessments were helpful to verify the efficacy of the multidisciplinary intervention in long-term. Conclusion: Periodically assessing function and disability using outcome improvements may support clinicians' decisions about DBS, medication adjustments and guide physiotherapists to personalize the ICF-based intervention.

Dental Whitening: Self-Referred Needs versus Professional Indication

Abstract Objective: To analyze the self-reported need of patients compared to professional indications for tooth whitening. Material and Methods: Initially, 58 undergraduate students responded to a form that highlighted the question: "Do you think you need to have your teeth whitened?" Among those who answered positively to the previous question, ten individuals were photographed with their smiles. In addition, they were asked to point out, on the Vita 3D-Master scale, which color they believed their teeth had, a value that was compared to the actual color obtained by a spectrophotometer. Finally, the photographs were presented to dentists, who were asked about the indication or not of the whitening treatment. Results: Most interviewees (63.8%) self-reported the need for whitening, as well as there was a greater incidence of a positive indication among professionals (53.9%). Pearson's Chi-square test revealed a relationship between patient gender and the training course on the desire to have teeth whitened. Among the professionals, the specialty, as well as time since graduation, interfered in the indication for whitening. Conclusion: Professionals and patients share the aesthetic ideal directly related to light teeth; most patients self-perceive the color of their teeth darker than it actually is; the opinion about the color of the teeth has an extremely subjective character and varies greatly from one professional to another (AU).

Chikungunya associated vulvitis: case report and literature review / Vulvite associada a Chikungunya: relato de caso e revisão de literatura

Introduction: Chikungunya virus is spreading worldwide due to migration and globalization and could be presented with systemic and with unusual symptoms. Objective: To report a case of virus-transmitted infection detected in a woman during the gynecological examination at a vulvar clinic. Case report: A 73-year-old Caucasian woman attended a vulvar clinic because of dyspareunia and vulvar burning. Ulcers were observed on labia minora and perineum. A Chikungunya was diagnosed by seroconversion in paired specimens. She was prescribed prednisolone 40 mg once a day for 10 days. After oral steroid treatment, the woman had no body rashes or lesions on her genitals. Conclusion: This study emphasized that rare signs of unusual vulvitis with ulcers could be associated with Chikungunya infection.

Introdução: O vírus Chikungunya está se espalhando pelo mundo por conta da migração e da globalização, podendo apresentar sintomas sistêmicos e incomuns. Objetivo: Relatar um caso de infecção pelo vírus detectado em uma mulher por ocasião do exame ginecológico em clínica de patologia vulvar. Relato do caso: Uma mulher caucasiana de 73 anos foi a uma clínica vulvar por causa de dispareunia e queimação vulvar. Úlceras foram observadas nos pequenos lábios e no períneo. O diagnóstico de Chikungunya foi realizado por soroconversão em espécimes pareados. Foi prescrita prednisolona 40 mg uma vez ao dia por dez dias. Após o tratamento com esteróides orais, a mulher não apresentou erupções ou lesões nos órgãos genitais. Conclusão: Este estudo enfatizou que quadros raros de vulvite com úlcera podem estar associados à infecção por Chikungunya.

Retalho de pedículo subcutâneo em formato de tubarão na região perialar / Subcutaneous pedicle flap shaped like a shark on perinasal region

A região nasal é frequentemente acometida por neoplasias cutâneas, especialmente em indivíduos de fototipos baixos, em quem a incidência de carcinoma basocelular é elevada. Defeitos cirúrgicos na asa nasal e região perinasal constituem desafio à sua reconstrução, uma vez que envolve várias unidades cosméticas e preservação do sulco nasal. A preservação dos limites entre essas unidades mostra-se fundamental, portanto, para o bom resultado funcional e estético. Este artigo tem como objetivo mostrar a aplicação do retalho de pedículo subcutâneo em formato de tubarão para correção de defeitos em asa nasal e região perinasal.

The nasal region is often affected by cutaneous neoplasm, especially in individuals of low phototypes, where the incidence of basal cell carcinoma is high. Surgical defects in the nasal wing and perinasal region constitute a challenge to its reconstruction since it involves several cosmetic units and preservation of the nasal groove. The preservation of the limits between these units is thus fundamental for good functional and aesthetic results. This article aims to show the application of the Shark Island Flap for the correction of defects in the nasal and perinasal regions.

In vivo optical coherence tomographic imaging to monitor gingival recovery and the adhesive interface in aesthetic oral rehabilitation: A case report.

The available methods for veneer evaluation are limited to clinical and radiographic examinations, which may not allow the appropriate identification of failure. In this report, we demonstrate the use of optical coherence tomography (OCT) as a noninvasive diagnostic and follow-up method to evaluate gingival recovery and the adhesive interface in aesthetic oral rehabilitation involving periodontal plastic surgery and ceramic laminate veneers. OCT was efficient for evaluating both soft and hard tissues, as well as the quality of the adhesive interface. In conclusion, OCT was found to be a promising approach for the professional evaluation of aesthetic oral rehabilitation, as it was capable of generating images that enabled the analysis of gingival recovery and the adhesive interface.

Restorations with Bulk Fill restorative system: case report / Restaurações com sistema restaurador Bulk Fill: relato de caso

ABSTRACT Bulk Fill Composite resins are restorative materials that present low tension and polymerization shrinkage, allowing them to be inserted in a single increment of up to 4 mm of thickness, in a restorative cavity. This paper aims to report a clinical case of restorations done on posterior teeth with Bulk Fill restorative system, using selective acid-etching with self-etch adhesive system. Patient, male, 24 years old, presented a carious lesion on the occlusal surface of dental element 37 and an occlusal unsatisfactory amalgam restoration, on element 36. A restorative treatment with Universal Bond 3M / ESPE and bulk fill composite resin (3M / ESPE) was done. According to the case described, it was possible to observe that the materials and techniques used restored the form and function of the teeth involved, preserving pulp vitality with a satisfactory aesthetic result. The bulk fill resins employed offer practicality and decrease clinical time, with satisfactory clinical applicability in the aesthetic and functional rehabilitation of posterior teeth.

RESUMO Resinas compostas do tipo Bulk fill constituem um material restaurador que apresenta baixas tensão e contração de polimerização, podendo ser inserido em incremento único, de até 4mm de espessura, numa cavidade. Este trabalho objetiva relatar um caso clínico de restaurações em dentes posteriores com o sistema restaurador Bulk fill, empregando o condicionamento ácido seletivo com sistema adesivo autocondicionante de emprego universal. Paciente, sexo masculino, 24 anos, apresentava lesão de cárie na face oclusal do elemento dentário 37 e restauração oclusal de amálgama insatisfatória, no elemento 36. Sendo proposto e realizado tratamento restaurador com Single Bond Universal 3M/ESPE e resina composta bulk fill (3M/ESPE). De acordo com o caso descrito, foi possível observar que os materiais e técnica empregados restituíram forma e função dos dentes envolvidos, preservando a vitalidade pulpar com estética considerada satisfatória. As resinas bulk fill empregadas oferecem praticidade e diminuição do tempo clínico, tendo aplicabilidade clínica satisfatória na reabilitação estética e funcional de dentes posteriores.

Impacto na autoestima de mulheres em situação de violência doméstica atendidas em Campina Grande, Brasil / Impact on the self-esteem of women in situations of domestic violence attended in Campina Grande, Brazil / Impacto en la autoestima de mujeres en situación de violencia doméstica atendidas en Campina Grande, Brasil

Resumo Introdução A problemática da violência contra mulher está disseminada em toda sociedade. O objetivo do estudo foi investigar qual o impacto na autoestima de mulheres vítimas de violência. Materiais e Métodos Trata-se de um estudo de natureza qualitativa. A amostra foi selecionada por conveniência não probabilística e composta por 11 mulheres atendidas da delegacia da mulher do município de Campina Grande, Brasil. Utilizando a técnica de análise de conteúdo elencou-se as categorias: Impacto na saúde da mulher; Impacto na autoimagem e perda da identidade feminina e Submissão e perda da liberdade. Resultados As idades variaram entre 20 e 68 anos, o número de filhos entre 1 a 13, o tempo de convívio com a violência variou entre 2 e 25 anos. Identificou-se que a violência trouxe sofrimento e impactos na vida da mulher como perda de sua identidade, desestruturação na autoimagem, sentimento de impotência e redução da autoestima. Discussão e Conclusões A carga de sofrimento as atingem de forma integral, podendo levá-las a quadros depressivos. Muitas procuram ajuda nos profissionais de saúde que devem estar capacitados para realizar um atendimento integral, apoiando-a no seu empoderamento e então lhe auxiliando na quebra do ciclo da violência. Percebe-se a necessidade de profissionais habilitados para prestar assistência a mulher vítima de violência doméstica, buscando minimizar seus impactos.

Abstract Introduction The problem of violence against women is widespread in every society. The aim of this study was to investigate the impact upon the self-esteem of women victims of violence. Materials and Methods This was a qualitative study. The sample was selected through non-probabilistic convenience and comprised 11 women attending the women's police station in the city of Campina Grande, Brazil. By using the content-analysis technique, the following categories were listed: Impact upon the woman's health; Impact upon self-image and loss of female identity, and Submission and loss of freedom. Results Ages varied from 20 to 68 years; number of children between 1 and 13; length of time living with the violence varied between 2 and 25 years. It was identified that violence brought suffering and impacts on the lives of women, like loss of identity, de-structured self-image, feelings of impotence, and reduced self-esteem. Discussion and Conclusions The burden of suffering reaches them integrally, taking them to depressive states. Many seek help from health professionals who must be trained to perform comprehensive care, supporting their empowerment and helping them to break the cycle of violence. The need is perceived for professionals qualified to provide care to women victims of domestic violence, seeking to minimize its impacts.

Resumen Introducción La problemática de la violencia contra la mujer está diseminada en toda la sociedad. El objetivo del estudio fue investigar cuál es el impacto en la autoestima de las mujeres víctimas de violencia. Materiales y Métodos Se trata de un estudio de naturaleza cualitativa. La muestra fue seleccionada por conveniencia no probabilística y compuesta por 11 mujeres atendidas en la comisaría de la mujer del municipio de Campina Grande, Brasil. Utilizando la técnica de análisis de contenido se seleccionaron las categorías: Impacto en la salud de la mujer; Impacto en la autoimagen y pérdida de la identidad femenina y Sumisión y pérdida de la libertad. Resultados Las edades variaron entre 20 y 68 años, el número de hijos entre 1 a 13, el tiempo de convivencia con la violencia varió entre 2 y 25 años. Se identificó que la violencia trajo sufrimiento e impactos en la vida de la mujer como pérdida de su identidad, desestructuración en la autoimagen, sentimiento de impotencia y reducción de la autoestima. Discusión y Conclusiones La carga de sufrimiento las alcanza de forma integral, pudiendo llevarlas a cuadros depresivos. Muchas buscan ayuda en los profesionales de salud que deben estar capacitados para realizar una atención integral, apoyándola en su empoderamiento y por consiguiente auxiliándola en la ruptura del ciclo de la violencia. Se percibe la necesidad de profesionales habilitados para prestar asistencia a la mujer víctima de violencia doméstica, buscando minimizar sus impactos.

Os três líquens: escleroso, plano e plano erosivo / The three lichens: sclerosus, planus and erosive

Líquen escleroso (LE) e líquen plano (LP) são doenças de natureza inflamatória que atacam a pele e a região anogenital e que, por vezes, podem ser de difícil diferenciação clínica em seus respectivos estágios iniciais. O LE teve sua incidência demonstrada em 1,7% dos atendimentos ginecológicos, em todas as faixas etárias. Já o LP ataca cerca de 1% das mulheres, mas sua incidência real é difícil de avaliar. LE e LP são doenças cuja patogênese é multifatorial. Fatores genéticos e hormonais e infecções e trauma foram associados ao desenvolvimento de LE, enquanto que LP tem seu desenvolvimento menos compreendido; no entanto, também é associado a fatores genéticos, a infecções e ao uso de certos medicamentos. As duas doenças causam bastante desconforto às pacientes, pois podem se apresentar com dor, ardência, prurido e também há a possibilidade de estenose do introito vaginal e consequente dispareunia. Na suspeita de LE e LP, deve ser feito diagnóstico diferencial com outras doenças de pele e com neoplasia intraepitelial vulvar (NIV). O risco de transformação maligna justifica o acompanhamento que as pacientes devem ter pelo resto da vida. O tratamento de primeira linha para LE e LP consiste em corticosteroides tópicos superpotentes. O diagnóstico requer frequente biópsia para sua confirmação. O objetivo deste trabalho foi revisar a fisiopatologia, complicações e tratamento dessas duas doenças, as quais são muito importantes, pois não possuem cura e podem comprometer seriamente a qualidade de vida das pacientes.(AU)

Lichen sclerosus (LS) and lichen planus (LP) are diseases of an inflammatory nature that attack the skin and anogenital region, and sometimes they might have a difficult clinical differentiation in their early stages. LE has its incidence demonstrated in 1.7% of gynecological consultations in all age groups. LP attacks about 1% of women, but its true incidence is difficult to assess. LE and LP are diseases whose pathogenesis is multifactorial. Genetic and hormonal factors, infections and trauma were associated with the development of LE, while LP has its development less understood; however, it is also associated with genetic factors, infections and the use of certain medications. Both diseases cause much discomfort to the patient, because they may present with pain, burning, itching and there is also the possibility of stenosis of the vaginal opening and consequent dyspareunia. On suspicion of LE and LP should be done differential diagnosis with other skin diseases and vaginal intraepithelial neoplasia (VIN). The risk of malignant transformation justifies the monitoring that patients should have in the rest of their life. The first-line treatment for LE and LP consists of topical corticosteroids super powerful. The diagnosis often requires biopsy for confirmation. The aim of this study was to review the pathophysiology, complications and treatment of these diseases, which are very important because they have no cure and can seriously compromise the quality of life of patients.(AU)

Onlay com resina composta direta: Relato de caso Clínico / Onlay with direct composite resin: a case report

Com o crescente apelo estético da sociedade, um dos principais procedimentos realizados pelos cirurgiões-dentistas consiste na troca de restaurações de amálgama de prata, de elementos posteriores, por materiais que agreguem resistência mecânica e propriedades ópticas semelhantes à estrutura dental sadia. Para reabilitar elementos dentais extensamente comprometidos, muitas vezes necessitamos indicar procedimentos indiretos, e, para isso, dispomos de cerômeros e cerâmicas, embora tal alternativa não se apresente viável para a grande parcela da população, tendo em vista ser de alto custo. O presente trabalho tem por objetivo abordar a utilização de resinas compostas como alternativa para a confecção de restauração do tipo onlay por meio de uma breve revisão de literatura e de um relato de um caso clínico realizado na Clínica de Dentística 2 da UFPE.

With the society's increasing aesthetic appeal, the amalgam restoration changes from posterior teeth with materials that add strength and optical properties similar to the healthy tooth structure has been one of the most performed procedures by dentists. To rehabilitate dental elements widely compromised, we often need to indicate indirect procedures, and, for that kind of necessity, we have ceromers and ceramics. However, because of its high cost, this alternative is not viable for most people. The aim of this study is to address the use of composite resins as an alternative to these onlay restorations, through a brief literature review and clinical case report at the Clinic of Dentistry 2, UFPE.

Perfil dos discentes ingressos do Centro de Ciências da Saúde UFPE / Profile of enrolled students at the Center for Health Sciences at UFPE

A busca pelo conhecimento das características e da opinião dos estudantes do nível superior fornece importantes subsídios para o planejamento e reorganização do desenvolvimento acadêmico. Com o objetivo de traçar o perfil do aluno do Centro de Ciências da Saúde da Universidade Federal de Pernambuco (UFPE), foram distribuídos formulários aos acadêmicos do 2º período, contendo perguntas referentes aos seus aspectos socioeconômicos e pessoais. O perfil dos estudantes (n = 210) caracterizou-se por um predomínio feminino, com idades entre 19 e 21 anos, provenientes de escolas privadas e classes sociais economicamente mais favorecidas, que receberam grande influência do núcleo familiar na escolha da profissão. A maioria dos estudantes não estava matriculada nos cursos de primeira opção, porém possuía alta expectativa com relação ao curso, considerando-o correspondente às suas expectativas. Após formados pretendem realizar algum curso de pós-graduação e trabalhar no serviço público. No entanto, persiste um problema relativo à escolha da profissão, regulada pela condição socioeconômica e influência familiar.

Carrying out surveys that attempt to understand the characteristics and opinions of students at university level may provide important information for planning and reorganizing academic development. In order to profile the students of the Center for Health Sciences, at the Federal University of Pernambuco, questionnaires were distributed to the academics in the second term of the course, containing questions regarding their socio-economic and personal aspects. The profile of students (n = 210) was characterized by a predominance of females, aged between 19 and 21 years, who had been to private schools, were from the most economically advantaged social classes, and had been greatly influenced by their family regarding career choice. Most students were not enrolled in the courses they had chosen as their first option, but had high expectations about the course, and considered that the course met their expectations. After finishing the course, most students intend to take a postgraduate course and work in public service. One problem that remains concerning the choice of the profession, is that it might be determined by socio-economic status and family influence.

Efeito da dominância lateral no desempenho da destreza manual em pessoas com síndrome de Down / Effect of lateral dominance on manual dexterity in people with Down syndrome

Objetivos: Avaliar o efeito da dominância lateral na destreza manual em um grupo de crianças e adolescentes com Síndrome de Down (SD) e comparar o resultado de participantes com SD com pessoas sem a síndrome. Métodos: Participaram do estudo 100 crianças e adolescentes de ambos os sexos e idade variando de 7 a 9 anos e de 14 e 15 anos. 50 pessoas tinham diagnóstico de SD (GSD) e 50 sem a síndrome (GC). O Teste Caixa e Blocos (TCB) foi usado por possibilitar avaliação da atividade motora a partir da contagem do número de blocos transferidos entre duas divisões de uma caixa padronizada. O TCB é simples e sua aplicação não demanda habilidades cognitivas complexas.Resultados: O número de blocos transferidos por minuto foi menor nos participantes do GSD do que os do GC, com evidente desvantagem na destreza manual para ambas as mãos. Não foi observado efeito de dominância no GSD, mas no GC este efeito foi observado com melhor desempenho no lado dominante. Conclusões: O TCB foi útil para a quantificação da destreza manual em pessoas com SD já que é de fácil aplicação e compreensão por pessoas com déficit cognitivo.

Objective: To evaluate the effect of lateral dominance on manual dexterity in a group of children and adolescents with Down syndrome (DS) and to compare the results from participants with DS with people without the syndrome. Method: The study included 100 children and adolescents of both sexes with ages ranging from 7 to 9 years and 14 to 15 years. 50 people were diagnosed with DS (GDS) and 50 without the syndrome (GC). The Box and Blocks Test (BBT) was used because it allows assessment of motor activity by counting the number of blocks transferred between two divisions of a standard box. The BBT implementation is simple and does not require complex cognitive skills. Results: The number of blocks transferred per minute was lower in participants of GDS than the GC, with a clear disadvantage for manual dexterity in both hands. There was no effect of dominance in the GDS, but the GC showed better performance on the dominant side. Conclusion: The BBT was useful for the quantification of manual dexterity in people with DS as it is easy to apply and understand by people with cognitive impairment.

Manual therapy associated with upper limb exercises vs. exercises alone for shoulder rehabilitation in postoperative breast cancer.

Our objective was to evaluate the effectiveness of manual therapy (MT) associated with upper limb (UL) exercises in women with impaired shoulder range of motion (ROM) after axillary lymph node dissection (ALND) for breast cancer. A randomized, prospective, blinded clinical trial with 131 women with a ROM <- 100° for shoulder flexion and/or abduction on the first day postoperatively were evaluated. Sixty-six women were allocated to group exercises and 65 underwent the exercises followed by MT. Shoulder ROM was measured by goniometry, and function was evaluated by the Modified-University of California at Los Angeles Shoulder Rating Scale--the UCLA Scale, in the 1st, 6th, 12th, and 18th month after surgery. The chi-square test was used for the relationship between clinical characteristics and oncological treatment between groups, and ANOVA for repeat measures was used. No difference in recovery of shoulder ROM as well as UL function was observed between groups. Improvement in ROM was gradual from the 1st to the 18th month, and the function achieving a good classification at 18th month. MT associated with exercises did not enhance the results obtained with exercises alone for shoulder ROM and ipsilateral UL function.

Blanqueamiento de dientes vitales: estudio in vitro sobre la eficacia de diferentes técnicas utilizando peróxido de hidrógeno / Vital teeth Whitening: in vitro study on the effectiveness of different techniques using hydrogen peroxide

Verificar la influencia del tiempo de exposición y de la activación con energía luminosa sobre la eficacia de diversas técnicas de blanqueamiento utilizando el peróxido de hidrógeno a 35% (PH 35%). 300 incisivos bovinos fueron divididos en seis grupos: G1 (Pola Office / SDI); G2 (PH 35% manipulado con solución indicadora /Fórmula activa); G3 (PH 35% manipulado sin solución indicadora /Fórmula activa); G4 (Mix One/Villevie); G5 (Pola Office Red/SDI); G6 (Lase Peroxide Sensy/DMC) - y 10 subgrupos de acuerdo con la técnica utilizada, teniendo como grupo control las técnicas preconizadas por los fabricantes frente a nueve técnicas experimentales variando el tiempo de exposición al gel (5, 10 o 15 min) y la forma de activación (sin activación; activación con aparato de LED-Radii/SDI o LED/Láser-Whitening Lase II/DMC). El test F-Anova no reveló diferencia significativa (p>0,05) entre la mayoría de los grupos analizados para todas las técnicas experimentales, excepto entre G2XG3 y G2XG4 (p=0,0135) en la Técnica Experimental - TE2 (10min sin activación), G2XG1; G2XG4; G2XG5 y G6XG4 (p=0,0008) en la TE5 (10 min. + LED). La comparación entre las técnicas en cada grupo reveló diferencias solo en el G3 (p=0,0051) y G5 (p=0,0351), donde la TE7 (5 min. + Láser) y TE4 (5 min. + LED), respectivamente, obtuvieron excelentes resultados blanqueadores. El uso de la energía LED/Láser mejoró la eficacia del G4 (p=0,0196) solo en la TE8 (10 min. + Láser). Todos los productos analizados fueron eficaces en producir el efecto blanqueador. La reducción del tiempo de exposición no influenció en los resultados. La utilización de energía luminosa no influenció en la eficacia del blanqueamiento de la mayoría de los productos experimentados, pero aumentó la velocidad del efecto blanqueador cuando el tiempo de exposición al gel fue reducido a cinco minutos.

A importância da luz no clareamento dental / The importance of light in dental bleaching

O clareamento dental é um dos procedimentos estéticos mais solicitados atualmente. As técnicas de clareamento para dentes vitais são: o clareamento supervisionado (caseiro); e o clareamento de consultório, cuja técnica associa ou não o uso de fonte de luz com um gel mais concentrado. A ativação, utilizando fontes de luz, do peróxido de hidrogênio na técnica do consultório pode ser realizada através de aparelhos emissores de LED (Laser Emiting Diode), sistemas híbridos LED/Laser, laser, luz halógena ou arco de plasma. Este tema é bastante controverso na atualidade, portanto é importante que o profissional saiba identificar os efeitos que a utilização de uma fonte de luz auxiliar pode causar tanto sobre o gel clareador quanto sobre a estrutura dental. Neste trabalho foi realizada uma revisão de literatura nas bases de dados da LILACS, Google Acadêmico, SciELO, PubMed e MEDLINE sobre o emprego e a indicação das fontes luminosas, que são bastante utilizadas no clareamento de consultório. Essa técnica popularizou-se graças aos excelentes resultados alcançados, maior segurança e controle por parte do profissional, entretanto devemos ter cuidado para não gerar calor durante a aplicação destas fontes de luz

The dental bleaching is one of the most currently requested aesthetic procedures in dentistry. The techniques for bleaching vital teeth are: at home bleaching and in-office whitening, which procedure associates or not to the use of light source with a more concentrated gel. The hydrogen peroxide activation using light sources at in-office method may be conducted by the LED (Laser Diode Emiting), hybrid systems LED / Laser, laser, halogen lamp or plasma arc. This topic is very controversial nowadays, so it is important that professionals learn to identify the effects that the use of a light source may assist both the bleaching gel and the tooth structure. In this study, It was conducted a review of current literature in databases from LILACS, Google Scholar, SciELO, PubMed and MEDLINE about the use and indication of light sources, which are much used in the in-office bleaching

Influência do cimento resinoso sobre a adesão de pinos intrarradiculares estéticos / Influence of resin cement on adhesion of aesthetic root posts

Introdução: O objetivo desde trabalho é avaliar a influência do tipo de agente de união e da dentina radicular (1/3 cervical; médio e apical) sobre a cimentação adesiva de pinos estéticosde fibra de vidro. Métodos - Foram utilizadas 27 raízes de dentes humanos, divididas em 03 grupos de acordo com o agente cimentante: G1- RelyX Unicem(3M / ESPE); G2- RelyXARC(3M / ESPE) + Adper Single Bond 2(3M / ESPE); G3- Cement-Post(Angelus) + AdperSingle Bond 2(3M / ESPE). Após a cimentação, as raízes foram seccionadas transversalmente em três discos (1,0 ± 0,2 mm de espessura) e submetidos a ensaio “push out”. Resultados - Os valores médios de tensão de retenção em mega pascal (MPa) foram: G1: 1/3 cervical- 7,6;1/3 médio-8,9; 1/3 apical-11,1; G2: 1/3 cervical-2,4; 1/3 médio-3,8; 1/3 apical-7,4; G3: 1/3cervical-3,3; 1/3 médio-3,2; 1/3 apical-7,8. O teste de Kruskal-Walis (α=0,05) evidenciou queapesar do G1 (RelyX Unicem - 3M / ESPE) ter apresentado maiores valores de retenção nos três terços radiculares, esta superioridade só foi estatisticamente significante nos terços cervicale médio; os valores de retenção dos Grupos 2 e 3 não foram diferentes estatisticamente entre si.Conclusão - O cimento autoadesivo RelyX Unicem (3M / ESPE) apresentou os maiores valores de resistência adesiva, com diferença estatisticamente significativa nos terços cervical e médio.

Introduction: The objective of this article is to evaluate the influence of the cement type and root dentin (1/3 cervical; medium; apical) on the adhesive cementation of glass fiber aesthetic posts. Methods - They were used 27 roots from human teeth, divided in three groups according the cement agent: G1- RelyX Unicem, 3M / ESPE; G2- RelyX ARC, 3M / ESPE + Adper SingleBond 2, 3M / ESPE; G3- Cement-Post, Ângelus + Adper Single Bond 2, 3M / ESPE. After cementation, the root were cross sectioned in three discs (1,0 ± 0,2 mm high) and submitted topush-out test. Results - Mean values of tension (MPa) of retention were: G1 cervical 1/3: 7,6;medium 1/3: 8,9; apical 1/3 11,1; G2 cervical 1/3: 2,4; medium1/3 3,8; apical 1/3: 7,4; G3cervical 1/3: 3,3; medium1/3: 3,2; apical 1/3 7,8. Kruskall-Walis Test (α=0,05) showed thatalthough G1(RelyX Unicem - 3M / ESPE) had presented higher values of retention at the three root thirds, this superiority was statistically significant only in cervical and medium thirds;the values of retention in Goups 2 and 3 didn´t were statistically different between each other.Conclusion - The self-adhesive cement RelyX Unicem (3M / ESPE) presented the highest valuesof adhesive strength, with statistically differences at cervical and medium thirds.

Hipersensibilidade Dentinária / Dentin Hypersensitivity

A hipersensibilidade dentinária é definida como uma resposta dolorosa curta e aguda, a diferentes estímuos que normalmente não causariam dor em um dente sadio. Possuietiologia multifatorial, porém, se instala principalmente quando a dentina localizada na região cervical do dente fica exposta ao meio bucal. Atualmente, para o tratamento da hipersensibilidade dentinária, são utilizadas substancias que promovem a oclusão dos canalículos dentinários expostos ou que atuam diretamente nas terminações nervosas intrapulpares evitando a despolarização da membrana axonial. Desta forma, o presente trabalho tem por objetivo revisar a literatura sobre o tema com enfoque clínico voltado para a tomada de decisão terapêutica.

The dentin hypersensitivity is defined as a brief and acute pain response to different stimuli that normally would not cause pain in a sound tooth. It has a multifactorial etiology; however, it specially occurs when the dentin at the cervical region of the tooth is exposed to the oral environment. Currently, many substances are being used to promote occlusion of the exposed dentinal canaliculi or that act directly on the intra pulpar nerve endings avoiding depolarization of the membrane axonial. Thus, this study aims to review the literature on the subject and foccus toward clinical decision-making.

Dentística ultraconservadora: métodos alternativos de preparos cavitários / Ultraconservative dentistry: alternative methods of cavities preparations

A atual filosofia odontológica de máxima preservação e mínima intervenção tem aumentado o interesse por métodos de preparos cavitários ultraconservadores. Técnicas convencionais que utilizam instrumentos rotatórios muitas vezes provocam desconforto, uma vez que geram calor, pressão, vibração e ruído. Esse fato motiva a sua substituição ou associação a procedimentos como instrumentação ultrassônica, laser de alta potência, microabrasão a ar e soluções químicas, os quais são mais confortáveis para os pacientes, porque reduzem a necessidade de anestesia e preservam maior quantidade de estrutura dentária sadia. Esta revisão de literatura aborda métodos alternativos para a confecção de preparos cavitários em dentística, destacando vantagens e desvantagens, com ênfase nos métodos que empregam as soluções químicas. Foi possível concluir que, segundo o estágio técnico-científico atual, as soluções químicas se destacam por proporcionarem maior conforto ao paciente, além de promoverem seletividade na remoção de tecido dental infectado e não interferirem na qualidade adesiva das restaurações.

The current philosophy of maximum preserving and minimum intervention has increased the interest in methods of ultraconservations cavities preparations. Conventional techniques that use rotary instruments often cause discomfort as they generate heat, pressure, vibrationand noise. This fact that motivates the substitution or association with the procedures ultrasonic instrumentation,high-power laser, micro air-abrasion and chemical solutions, which are more comfortable for patients because it reduces the need for anesthesia and preserve greater quantity of healthy tooth structure. This review of literature will address alternative methods to make cavities preparations in Dentistry, high lighting advantages and disadvantages, with emphasis on methods that employ chemical solutions. It was possible to conclude that, according to the techno-scientific current stage, the chemical solutions are distinguished by providing greater comfort to the patient as well as promoting selectivity in the removal of infected tissue dental and not interfere with the quality of adhesive restorations.