Post-synthetic modification of aluminum trimesate and copper trimesate with TiO2 nanoparticles for photocatalytic applications.

Organic pollutants have been a significant source of concern in recent years due to their facile dissemination and harmful effects. In this work, two different metal-organic frameworks (MOFs) were initially prepared by hydrothermal treatment, namely aluminum trimesate (MIL-100(Al)) and copper trimesate (HKUST-1). These materials were subsequently submitted to a post-synthetic modification step to grow titania nanoparticles on their surface. Anatase nanoparticles with sizes around 5 nm were successfully anchored on MIL-100(Al), and the concentration of TiO2 in this sample was about 68 wt.%. This is the first time that this composite (TiO2@MIL-100(Al)) is reported in the literature. It showed an improved photocatalytic activity, removing 90% of methylene blue (k app = 1.29 h-1), 55% of sodium diclofenac (k app = 0.21 h-1), and 62% of ibuprofen (k app = 0.37 h-1) after four hours of illumination with UV-A light. A significant concentration (14 µM) of reactive oxygen species (ROS) was detected for this composite. HKUST-1 showed a structural collapse during its post-synthetic modification, leading to a non-porous material and providing fewer sites for the heterogeneous nucleation of titania. This behavior led to a low concentration of rutile nanoparticles on HKUST-1 (9 wt.%). However, the obtained composite (TiO2@HKUST) also showed an improved photoactivity compared to HKUST-1, increasing the photodegradation rates evaluated for methylene blue (0.05 h-1 vs. 0.29 h-1), sodium diclofenac (negligible vs. 0.03 h-1), and ibuprofen (0.01 h-1 vs. 0.02 h-1). This work brings new insights concerning the preparation of photocatalysts by growing semiconductor nanoparticles on trimesate-based MOFs.

Endodontic cement penetration after removal of calcium hydroxide dressing using XP-endo finisher

Abstract: We aimed to evaluate the penetration of endodontic cement following the removal of calcium hydroxide (Ca(OH)2) dressing using the XP-endo Finisher in association with different irrigating solutions. Sixty premolars were instrumented and applied with a Ca(OH)2 dressing. To remove Ca(OH)2, the teeth were divided into six groups, each with a different volume of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as solution stirring time with XP-endo Finisher (0, 30, and 60 sec). Root canals were filled using the lateral condensation technique. Fluorescein dye was added to the cement for microscopic laser scanning analysis. In the generated images, linear measurements were taken in micrometers, and their averages were calculated. To analyze the perimeter penetration ratio of the cement, the total perimeter of the canal and the segment of the total perimeter of the canal where the endodontic cement penetrated into the dentinal tubules were measured in micrometers. We found that using an XP-endo Finisher in irrigation was more effective than using a needle and syringe during the extension and penetration of endodontic cement. Shaking with XP-endo Finisher with 17% EDTA increased the extent and perimeter of the penetration of the endodontic cement into the dentinal tubules. However, using the XP-endo Finisher with EDTA only was more efficient than using the instrument interchangeably in NaOCl and EDTA. Although XP-endo Finisher contributes to the removal of Ca(OH)2, none of the protocols or instruments used removed all Ca(OH)2 from the root system.

Dentes gretados: o que clínicos e especialistas precisam saber / Cracked teeth: What clinicians and specialists need to know

A proposta da presente revisão de literatura foi estabelecer as evidências existentes sobre etiologia, sinais e sintomas, métodos de diagnóstico e tratamento de dentes gretados. Segundo a American Association of Endodontists (AAE), o termo dente gretado (DG) foi definido como uma fratura em um plano que quebra a continuidade do esmalte e da dentina, sem separação das partes, geralmente no sentido mesiodistal, passando pela superfície oclusal, podendo envolver uma ou ambas as cristas marginais. Essa fratura, por apresentar profundidade e direção desconhecidas, pode se estender até a polpa e/ou ligamento periodontal, levando a um quadro de pulpite reversível, pulpite irreversível, necrose pulpar ou, até mesmo, evoluir para uma fratura completa. Atualmente, os DGs estão relacionados à terceira maior causa de dentes perdidos, após cárie e doença periodontal. Estudos indicam uma falta de consenso entre profissionais sobre como tratar dentes gretados, uma questão clínica relevante, que precisa ser priorizada e esclarecida. Nesse contexto, essa revisão abordou a etiologia, sinais e sintomas, métodos de diagnósti- co e tratamento de dentes gretados (AU)

The purpose of this literature review is to examine the existing evidence regarding etiology, signs, symptoms, methods of diagnosis, and treatment of cracked teeth. According to the American Association of Endodontists (AAE), the term cracked tooth (CT) is defined as "a fracture in a plane that breaks the continuity of the enamel and dentin, without separation of the parts, usually in the mesiodistal direction, passing through the surface occlusal, which may involve one or both of the marginal ridges." Due to its unknown depth and direction, this fracture can extend to the pulp and periodontal ligament, leading to reversible pulpitis, irreversible pulpitis, pulp necrosis, or even progress to a complete fracture. Currently, cracked teeth are related to the third largest cause of missing teeth, after caries and periodontal disease. Studies indicate a lack of consensus among professionals about treating cracked teeth, a clinically relevant issue that needs to be prioritized and clarified. In this context, this review addressed the etiology, signs and symptoms, diagnostic methods, and treatment of cracked teeth (AU).

Tratamento endodôntico de incisivo central inferior permanente com dilaceração radicular incomum, após trauma no predecessor decíduo: relato de caso / Endodontic treatment of mandibular central incisor with unusual root dilaceration, following trauma to the deciduous predecessor: case report

Introdução: Alterações morfológicas na cavidade pulpar e na anatomia radicular podem constituir um desafio ao tratamento endodôntico. A dilaceração pode ser resultado de trauma na dentição decídua, na época da formação das raízes, provocando acentuada curvatura da raiz ou da coroa em um dente permanente. Objetivo: O presente relato de caso teve por objetivo descrever o tratamento endodôntico de um dente #41 com acentuada dilaceração radicular. Radiograficamente, a região periapical do dente #41 mostrou extensa área radiolúcida, sugestiva de osteólise periapical em decorrência de necrose pulpar, que foi confirmada pela ausência de resposta aos testes pulpares. O tratamento endodôntico foi realizado. Conclusão: Após 90 meses de acompanhamento, constatou-se ausência de sinais ou sintomas, e o exame radiográfico forneceu evidências de cicatrização óssea periapical (AU).

Introduction: The morphological changes in the pulp cavity and root anatomy can lead to difficulties in carrying out endodontic treatment. Dilaceration can be the result of trauma in primary dentition, in the root formation phase, provoking accentuated root or crown curvature in a permanent tooth. Objective: The present case report aimed to describe the endodontic treatment of tooth 41 with accentuated root laceration. Radiographically, the periapical region of tooth #41 showed an extensive radiolucent area, suggestive of periapical osteolysis due to pulp necrosis, which was confirmed by the lack of response and pulp tests. Endodontic treatment was realized. Conclusion: The follow-up at 90 months showed no signs or symptoms, and the radiographic examination provided evidence of periapical bone healing.

Gamma sterilization of collagen/hydroxyapatite composites: Validation and radiation effects.

In this work, gamma sterilization was validated, and the impact of this sterilization process on collagen/hydroxyapatite (Col/HAp) composites was investigated. It has been already recognized that the improper sterilization of healthcare products may lead to infection and mortality/morbidity issues in patients. Gamma sterilization has emerged as a promising sterilization method because it shows advantages such as low cost, a small increase in temperature of irradiated materials, and no production of toxic residues. Moreover, gamma rays can reach the products even when contained in sealed packages. The dose of gamma radiation applied in this study ranged from 17.5 to 50 kGy. The studied samples were examined by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetry (TG), and differential scanning calorimetry (DSC). No apparent effect of gamma radiation on HAp was observed even when doses as high as 50 kGy were applied. On the other hand, Col was greatly affected by gamma radiation, displaying cross-linking and degradation after sterilization. These structural changes may alter Col's properties, which could, in turn, impact its medical use. As a consequence, it is strongly recommended that the irradiation dose used to sterilize the Col/HAp composites shall be kept as low as possible to mitigate the structural changes induced in Col. It was noticed that a radiation dose of 17.5 kGy was sufficient to sterilize the examined samples because a sterility assurance level (SAL) below 10-6 was detected. Although dramatic structural changes were observed in Col when this dose was applied, the sterilized samples showed no toxicity to human mesenchymal stem cells. Based on these results, we established a VDMax of 17.5 kGy for Col/HAp-based healthcare products.

Bio-c repair - a new bioceramic material for root perforation management: two case reports

Abstract These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.

Resumo O presente relato de caso teve como objetivo descrever o manejo da perfuração lateral no terço médio cervical da raiz em dois incisivos superiores com calcificação pulpar utilizando o Bio-C Repair, com estratégias de tratamento clínico seguras e viáveis. Radiografias digitais foram obtidas em diferentes ângulos e analisadas com diferentes filtros. Imagens de tomografia computadorizada de feixe cônico (TCFC) foram solicitadas para mostrar a real posição do canal e a localização da perfuração, e orientar o planejamento estratégico do caso. Posteriormente, o acesso à cavidade foi preparado com auxílio de microscopia cirúrgica. Após a identificação da perfuração, o tecido de granulação foi removido, o canal original foi identificado e, em seguida, recebeu medicação intracanal à base de hidróxido de cálcio. Na segunda visita, a perfuração foi selada com Bio-C Repair e o sistema de canais obturado com cones de guta-percha e cimento endodôntico (Bio-C Sealer). Os dentes foram restaurados com pino de fibra de vidro, 4 mm além do nível da perfuração, e coroas provisórias. Ambos os dentes tratados conforme descrito acima se mostraram funcionais e assintomáticos na avaliação clínica e radiográfica de 1 ano. O Bio-C Repair é sugerido como uma nova opção de cimento endodôntico para o manejo de perfurações laterais, com resultados efetivos observados após um ano de acompanhamento.

Micro-CT evaluation of maxillary first molars: interorifice distances and internal anatomy of the mesiobuccal root

Abstract: This study aimed to describe the morphometric relationship of root canal orifices on the pulp floor in the presence/absence of mesiobuccal second canal (MB2) in the maxillary first molars and other aspects of its internal anatomy. Sixty-two maxillary first molars were scanned by micro-CT. The presence of the MB2 canal was verified. The distance between the center points of the MB1, MB2, distobuccal (DB), and palatal (P) canal orifices on the pulp floor were measured (MB1-MB2, MB1-DB, MB2-DB, MB1-P, and DB-P). The MB1-P to DB-P ratio was calculated. The distances between the anatomic apex and the MB1 and MB2 apical foramina were measured. The length of the band-shaped isthmus was also measured. Student's t-test was applied to verify the association between the presence of an MB2 canal, the interorifice distances, and the ratio of the MB1-P to DB-P distance (α = 5%). The MB2 canal was present in 43 roots (69.35%). Statistics showed significant differences when MB2 was present for the largest MB1-P distance (p < 0.05) and higher values for the MB1-P to DB-P ratio (p < 0.05). A band-shaped isthmus was detected in 25.8% of MB roots. The mean distance from the apical foramen to the isthmus floor ranged from 1.74 for MB1 canals to 1.42 for MB2 canals. Canal orifice distances on the pulp floor may predict the presence of MB2 canals. There was a high incidence of isthmus, accessory canals, and apical delta in the critical apical zone in MB roots of maxillary first molars.

Tratamento endodôntico de segundo molar inferior com presença de canal mesiomediano: relato de caso / Endodontic treatment of second mandibular molar with presence of middle mesial canal: case report

Introdução: A identificação de possíveis variações anatômicas é decisiva para o correto diagnóstico e planejamento da terapia endodôntica. Objetivo: Relatar o tratamento endodôntico de um dente #37, no qual foi identificado um terceiro canal na raiz mesial (canal mesio-mediano, CMM). Caso clínico: Dente #37 com diagnóstico de pulpite irreversível sintomática, foi encaminhado para realizar tratamento endodôntico. Durante o acesso coronário, e com auxílio de microscópio operatório (MO), foram identificadas trincas coronárias. Foi solicitada uma tomografia computadorizada de feixe cônico (TCFC), a partir da qual foi descartada a presença de trinca radicular. A TCFC possibilitou, também, identificar a presença de um terceiro canal na raiz mesial, localizado entre os canais mesiovestibular e mesiolingual. O tratamento endodôntico foi executado pelo sistema reciprocante WaveOne GOLD. A solução irrigadora de escolha para o preparo químico-mecânico foi o hipoclorito de sódio a 5,25%. Imediatamente antes da obturação, os canais foram irrigados com EDTA a 17%, para auxiliar na remoção da smear layer e, em seguida, foi realizada nova irrigação com hipoclorito de sódio a 5,25%. Os canais foram secos com pontas de papel absorvente e obturados pela técnica de onda contínua de condensação. Resultados: Os canais radiculares do dente #37 foram devidamente instrumentados e obturados. A paciente não apresentou qualquer sintomatologia pós-operatória, sendo encaminhada para a reabilitação protética final. Conclusão: A TCFC e o microscópio operatório foram decisivos para o correto planejamento do caso, tanto em relação à trinca observa- da quanto à detecção do canal mesiomediano (AU).

Introduction: Identification of possible anatomical variations is crucial for the correct diagnosis and planning of endodontic therapy. Objective: To report the endodontic treatment of tooth #37, in which a third canal was located in the mesial root (middle mesial canal - MMC). Methods: Tooth #37 was diagnosed with symptomatic irreversible pulpitis and referred for endodontic treatment. Coronary cracks were found during coronal access using a dental operating microscope (DOM). A cone-beam computed tomography (CBCT) was requested. CBCT revealed cracks involving the pulp chamber floor and a third root canal in the mesial root, between the mesiobuccal and the mesiolingual canals. Endodontic treatment was performed with the WaveOne GOLD reciprocating system. The chemical-mechanical preparation was performed with 5.25% sodium hypochlorite and 17% EDTA to remove the smear layer, followed by another irrigation with sodium hypochlorite. The canals were dried with absorbent paper points. The root canal obturation was performed with the continuous wave of condensation technique. Results: The root canals of tooth #37 were correctly instrumented and obturated. The patient did not present with any postoperative symptoms, and was referred for final prosthetic rehabilitation. Conclusion: CBCT and DOM were paramount for the correct planning of the case, as regards the presence of cracks and the detection of the middle mesial canal (AU).

Eficácia da barreira intracanal contra a infiltração microbiana em dentes preparados para pino intrarradicular / Efficacy of intracanal barrier against microbial infiltration in teeth prepared for intraradicular post

Introdução: Pinos intrarradiculares são recomendados para melhorar a retenção de coroas artificiais e distribuir forças intrabucais ao longo da raiz. Se o espaço criado pela remoção parcial da obturação não for preenchido adequadamente, pode ocorrer uma infiltração maciça de microrganismos da cavidade bucal. Objetivo: O objetivo do presente estudo foi avaliar a eficácia contra a infiltração bacteriana de uma barreira intracanal colocada diretamente sobre o remanescente da obturação do canal radicular, após o preparo de espaço para o pino. Métodos: Setenta e dois dentes humanos unirradiculares foram instrumentados, obturados e divididos aleatoriamente em três grupos experimentais e dois grupos controle. O grupo 1 não recebeu tratamento adicional após a obturação e o preparo do espaço, enquanto os Grupos 2 e 3 receberam uma barreira composta por material de selamento temporário com 1,0 e 2,0 mm de espessura, respectiva- mente. Uma cultura de Enterococcus faecalis foi inoculada nos espaços preparados para receber o pino intrarradicular, a cada três dias, por um período de 60 dias. A infiltração foi avaliada diariamente pela turbidade do meio de cultura. Resultados e Conclusão: Houve infiltração bacteriana nos três grupos experimentais, sendo significativamente maior e ocorrendo mais rapidamente no G1 (p<0,05), em comparação aos G2 e G3. Houve infiltração em todos os grupos controles positivos; porém, nenhuma infiltração foi observada nos grupos controles negativos. Não foi encontrada diferença significativa (p>0,05) entre o G2 e o G3, em relação à taxa e ao período de infiltração. Pode-se concluir que a barreira reduziu a incidência de infiltração e atrasou o tempo de ocorrência (AU).

Introduction: Intraradicular posts are recommended to improve the retention of artificial crowns and to distribute intraoral forces along the root. If the space created by partially removing the obturation is not adequately filled, it can lead to a massive infiltration of microorganisms from the oral cavity. Aim: The aim of this study was to assess the influence on bacterial infiltration of an intracanal barrier placed directly over the remaining root canal filling following post space preparation. Material and Methods: Seventy-two human single-rooted teeth were instrumented, filled, and then randomly divided into three experimental groups and two control groups. Group 1 received no additional treatment after filling and post space preparation, whereas Groups 2 and 3 received a barrier composed of temporary sealing material 1.0- and 2.0-mm thick, respectively. A culture of Enterococcus faecalis was inoculated into the spaces prepared to receive the intraradicular post, every three days over a 60-day period. Infiltration was evaluated daily by observing the turbidity of the culture medium. Results and Conclusion: Bacterial infiltration was found in all three experimental groups, but was significantly greater and occurred more quickly in G1 (p < 0.05), compared with G2 and G3. Infiltration was observed in all positive controls, whereas no infiltration was found in the negative controls. No significant difference (p > 0.05) was found between G2 and G3, regarding the rate and time frame of infiltration. It can be concluded that the barrier reduced the incidence of infiltration, and delayed the time of occurrence (AU).

Tratamento endodôntico de incisivo lateral superior com duas raízes: relato de caso / Endodontic treatment of maxillary lateral incisor with two roots: case report

Alterações morfológicas podem influenciar adversamente o sucesso do tratamento endodôntico. O incisivo lateral superior caracteriza-se pela presença de um canal e uma única raiz. A interpretação cuidadosa das radiografias, associada a recursos de iluminação e ampliação, é de extrema importância para detecção de variações anatômicas. Objetivo: O objetivo do presente relato de caso foi descrever o retratamento endodôntico não usual de um incisivo lateral superior com duas raízes. Relato de caso: O microscópio operatório foi de fundamental importância para a realização do novo tratamento. Para remoção do material obturador, foram utilizados solvente, limas manuais e pontas de ultrassom, reinstrumentação com limas manuais tipo K de aço inoxidável e obturação com guta-percha e cimento Pulp Canal Sealer, por meio da técnica de termoplastificação. Conclusão: O prognóstico favorável foi confirmado após acompanhamento de 216 meses (AU).

Morphological changes in teeth may adversely affect the success of endodontic treatment. The upper lateral incisors are characterized by the presence of a canal and a single root. Several studies have reported variations in the number of roots and canals. A careful interpretation of radiographs under enhanced illumination and magnification is of extreme importance for detecting these anatomic variations. this report aimed to describe a clinical case of unusual endodontic retreatment of an upper lateral incisor with two roots. The operative microscopy played a fundamental role in accomplishing the new treatment. The procedure involved the use of solvents, manual files, and ultrasonic tips to remove the obturator, and instrumentation of root canals with stainless steel type K manual files. Root canals were obturated with gutta-percha and Pulp Canal Sealer cement using the thermoplastic technique. A favorable prognosis was confirmed after a follow-up of 216 months (AU).

Rastreamento Geográfico da COVID-19 Segundo Fatores Socioeconômicos e Demográficos no Município de Uberlândia, Minas Gerais / Geographic Tracking of COVID-19 According to the Socioeconomic and Demographic Factors in the City of Uberlândia, Minas Gerais

Objetivo: analisar a distribuição espacial da COVID-19 segundo fatores socioeconômicos e demográficos no município de Uberlândia, Minas Gerais. Método: trata-se de um estudo do ecológico, transversal, utilizando dados secundários, de uso e acesso públicos, oriundos do Ministério da Saúde do Brasil, por meio das informações disponíveis no open DataSUS com casos confirmados da COVID-19 e que possuíam, em suas respectivas fichas cadastrais, os bairros de residência. Resultados: a média de idade dos casos confirmados pela COVID-19 foi de 38,83 (±14,29) anos, as faixas etárias mais atingidas foram entre 20 a 29 anos (23,2%), 30 a 39 anos (27,7%), 40 a 49 anos (22,5%), 50 a 59 anos (13,7%) e 70 a 79 anos (5,7%). Todos os setores apresentaram casos da COVID-19, sendo o oeste o mais atingido. Entre os 20 bairros com o maior número de infecção, 11 possuem renda per capita média abaixo de um salário-mínimo, oito bairros com renda per capita média de até dois salários-mínimos e apenas um bairro com renda per capita média acima de dois salários mínimos. Conclusões: o número de casos da COVID-19 foi elevado, espalhando-se rapidamente para todos os setores, afetando, principalmente, bairros de baixa renda per capita. Nos bairros com renda per capita média da população abaixo de um salário-mínimo, concentram-se os piores cenários da COVID-19. A crise global de saúde pública ocasionada pela COVID-19 revelou as desigualdades e as injustiças que ameaçam o bem-estar, a segurança e a vida das pessoas.

Objective: To analyze the spatial distribution of COVID-19 according to socioeconomic and demographic factors in the city of Uberlândia, Minas Gerais. Method: This is an ecological, cross-sectional study, using secondary data, of public use and access, from the Ministry of Health of Brazil, based on the information available in the open DataSUS with confirmed cases of COVID-19 and that had, in their respective records, the neighborhoods of residence. Results: The average age of the cases confirmed by COVID-19 was 38.83 (± 14.29) years old, the most affected age groups were between 20 to 29 years old (23.2%), 30 to 39 years old (27 , 7%), 40 to 49 years old (22.5%), 50 to 59 years old (13.7%) and 70 to 79 years old (5.7%). All sectors presented cases of COVID-19, being the west the most affected. Among the 20 neighborhoods with the highest number of infections, 11 have an average per capita income below one minimum wage, eight neighborhoods with an average per capita income of up to two minimum wages and only one neighborhood with an average per capita income above two minimum wages. Conclusions: The number of COVID-19 cases was high, spreading rapidly to all sectors, affecting mainly neighborhoods with low per capita income. In neighborhoods with average per capita income below one minimum wage, the worst scenarios of COVID-19 are concentrated. The global public health crisis caused by COVID-19 revealed the inequalities and injustices that threaten people's well-being, security and lives.

Comparison of the effect of photobiomodulation therapy and Ibuprofen on postoperative pain after endodontic treatment: randomized, controlled, clinical study.

The aim of the study was to compare the effect of Ibuprofen and the application of photobiomodulation therapy protocol on the reduction of postoperative pain in endodontically treated teeth using a randomized clinical trial design. Seventy patients, diagnosed with symptomatic irreversible pulpitis, were selected. Treatment was performed by a single operator; a reciprocal system was used to prepare the canals; they were obturated using the Tagger's hybrid technique and coronally sealed with glass-ionomer cement. After treatment, patients were randomly divided into 2 groups. In the active control group, two Ibuprofen 600 mg tablets were administered within a 12-h interval. In the photobiomodulation therapy group, the irradiation was applied after treatment. The evaluation of postoperative pain was performed by another researcher blinded to the groups at 6, 12, 24, and 72 h intervals after treatment. To measure the outcome, two pain scales were used: numerical rate scale (NRS) and verbal rate scale (VRS). Data were analyzed using the chi-square, Mann-Whitney, and Wilcoxon paired tests. Outcome was superior with photobiomodulation therapy at 6 h (p < 0.001), 12 h (p = 0.005), and 24 h (p < 0.001) intervals compared with Ibuprofen. The results for the 72 h (p = 0.317) interval were similar, both in the VRS and NRS scales. It may be concluded that the use of photobiomodulation therapy was effective in reducing pain within the first 24 h when compared with the administration of Ibuprofen 600 mg.

Apical periodontitis associated with a calculus-like deposit: A case report of a rare fan-shaped manifestation.

INTRODUCTION: Bacterial biofilms can be calcified. Granulomas or cystic lesions are the most commonly found entities in endodontics. Surprisingly, this case report presents a rare radiopaque image, in a fan shape, of a calculus-like deposit in the periapical region of the maxillary left central incisor. CASE PRESENTATION: A 34-year-old male, with a history of trauma, presented with apical periodontitis associated with an uncommon image, similar to a calculus-like deposit adhered to the apical region of the maxillary left central incisor. Nonsurgical endodontic intervention was performed, followed by apicoectomy and histopathological analysis of the collected material. The results of the biopsy were not compatible with a cyst or granuloma but showed fibrous connective tissue with calcified areas. DISCUSSION: Correct diagnosis in endodontics is possible with a well-conducted anamnesis, complementary imaging exams and, in some cases, histopathological analysis. The periapical calculus-like deposit, associated with a periapical radiolucent lesion, was a result of the body's fight for healing, producing unusual radiopacity. CONCLUSION: The presence of the calculus-like deposit in a fan shape at the root surface represented dystrophic calcification as a manifestation of the attempt to heal. In the present case, apicoectomy and tissue biopsy for histological evaluation were fundamental for the correct diagnosis.

Low Dose Fluoroscopy During Ureteroscopy Does Not Compromise Surgical Outcomes.

Objective: To evaluate whether reducing the dose of fluoroscopy to » of standard dose during unilateral ureteroscopy for ureteral stone treatment would impact in a reduction of total radiation emitted and whether this strategy would impact operation time, stone-free rate, and complication rate. Methods: From August 2016 to August 2017, patients over 18 years submitted to ureteroscopy for ureteral stone between 5 and 20 mm were prospectively randomized for » dose reduction or standard dose fluoroscopy. Patients with abnormal urinary anatomy such as horseshoe kidney, pelvic kidney, or duplex system were excluded from the study. Results: Ninety-four patients were enrolled. The fluoroscopic dose reduction strategy to » of the standard dose was able to significantly reduce the cumulative radiation emitted by C-arm fluoroscopy and the dose area product (3.6 ± 4.5 mGy vs 16.2 ± 19.3 mGy, p = 0.0001 and 0.23 ± 0.52 mcGycm2vs 1.15 ± 2.74 mcGycm2, p = 0.02, respectively). Fluoroscopy time was similar between groups (74.5 ± 84.8 seconds vs 88.3 ± 90 seconds, p = 0.44). There was no need to increase the fluoroscopy dose during any of the procedures. Surgical outcomes were not affected by fluoroscopic dose reduction strategy. Conclusion: Low dose fluoroscopy reduces the emitted radiation during ureteroscopy without compromising surgical outcomes.

Effect of glide path on transportation promoted by NiTi and M-Wire instruments / Efeito do glide path no transporte promovido por instrumentos de NiTi e M-Wire

Objective: To evaluate the effect of glide path creation on transportation promoted by NiTi and M-Wire instruments. Material and Methods: Sixty polyester resin blocks containing a simulated root canal were distributed into four groups (n=15), according to the protocols/systems used for root canal preparation: GPR group - glide path + Revo-S system; R group - no glide path + Revo-S system; GPPN group - glide path + ProTaper Next system and PN group - no glide path + ProTaper Next system. Root canals were photographed before and after preparation, and the images were superimposed to evaluate the transportation at the apical, middle and coronal thirds. The time spent to perform preparation was also measured (seconds). Data were submitted to the non-parametric Kruskal-Wallis test (p0.05). GPR and R groups were similar in the middle third (p>0.05). However, the transportation value in GPR group was statistically higher in comparison with GPPN and PN groups (p0.05). Only R group presented significant difference in comparison with GPPN and PN groups (p0.05). Conclusion: None of the systems were capable of maintaining the original trajectory of the simulated root canal, and the glide path had no effect on the transportation promoted by instruments. (AU)

Objetivo: Avaliar o efeito do glide path no transporte promovido por instrumentos fabricados em NiTi e M-Wire. Material e Métodos: Sessenta blocos de resina poliéster contendo um canal simulado foram separados em quatro grupos (n=15), de acordo com os protocolos/ sistemas utilizados para realização do preparo: Grupo GPR - glide path + sistema Revo-S; Grupo R - sem glide path + sistema Revo-S; Grupo GPPN - glide path + sistema ProTaper Next e Grupo PN - sem glide path + sistema ProTaper Next. Os canais foram fotografados antes e após o preparo, e as imagens sobrepostas para avaliação do transporte nos terços apical, médio e cervical. O tempo para realização do preparo também foi mensurado (segundos). Os dados foram submetidos ao teste não-paramétrico de Kruskal-Wallis (p0,05). Os grupos GPR e R foram semelhantes no terço médio (p>0,05), entretanto, o transporte no grupo GPR foi estatisticamente maior em comparação aos grupos GPPN e P (p0,05). Somente o grupo R apresentou diferença em comparação aos grupos GPPN e PN (p0,05). Conclusão: Nenhum sistema foi capaz de manter a trajetória original do canal simulado, e o glide path não teve efeito sobre o transporte promovido pelos instrumentos.(AU)

Scanning Electron Microscopic Evaluation of Smear Layer Removal Using Isolated or Interweaving EDTA with Sodium Hypochlorite.

INTRODUCTION: The aim of this study was to verify the effect of alternating 2.5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) on the smear layer removal from root canal surfaces. METHODS AND MATERIALS: A total of 15 single-rooted human teeth, instrumented with ProTaper files, were randomly distributed in 3 groups. In group 1 (n=7) the canals were irrigated with 1 mL of 2.5% NaOCl between files and final irrigation was done with 1 mL of 2,5% NaOCl, followe by 1 mL of 17% EDTA, for a perio of 15 sec with new irrigtion of 1 mL of 2,5% NaOCl at each change of files. In group 3 (control group) (n=1), saline solution was used. All samples were cleaved into two sections, metalized and analyzed under scanning electron microscopy (SEM). The presence or absence of smear layer in the cervical, middle and apical thirds, with scores varying from 1 to 3, respectively were evaluated. The data were submitted to nonparametric Mann-Whitney U test. The level of significance was set at 0.05. RESULTS: It was observed that there was a greater discrepancy between groups with respect to the apical third. In the other areas there was a greater similarity between the scores attributed to the groups. There was a statistically significant difference between the groups only in the apical third, when group 1 presented the higher median (P<0.05). CONCLUSION: The alternating use of EDTA during instrumentation with NaOCl was the most effective irrigation method to remove the apical smear layer. Both forms of irrigation were effective on removal of the smear layer in the coronal and middle thirds of the canals.

Intervenção endodôntica em pré-molar inferior com anatomia complexa associada a diagnóstico de trinca radicular: relato de caso / Endodontic intervention in mandibular premolar with complex anatomy associated to cracked root diagnosis: Case report

Introdução: a anatomia dentária interna representa um grande desafio na Endodontia. O diagnóstico e o delineamento de um plano de tratamento preciso são, muitas vezes, um desafio. Objetivo: o objetivo desse artigo foi descrever o caso clínico de intervenção endodôntica em um pré-molar inferior com anatomia complexa, associado à trinca radicular após dois anos e meio . Relato do caso: a paciente foi encaminhada para avaliação, apresentando sintomatologia dolorosa e, ao exame clínico, observou-se que o dente #44 era pilar para prótese parcial removível e com saúde periodontal. Apresentava fístula intrabucal ativa. Foram realizados testes de sensibilidade pulpar, com respostas negativas. Ao exame radiográfico, observou-se anatomia complexa, duas raízes fusionadas e lesão periapical. Estabeleceu-se o diagnóstico de necrose pulpar e foi instituída a terapia endodôntica. Resultados: o controle clínico e radiográfico após um ano e quatro meses demonstrou reparação da região perirradicular, da função mastigatória e da estética. Porém, após dois anos e meio da intervenção endodôntica, a paciente retornou com sintomatologia dolorosa. Detectou-se bolsa periodontal localizada com 12 mm na região mesiolingual e, ao exame radiográfico, recidiva da lesão periapical lateral. Pediu-se uma tomografia computadorizada de feixe cônico, que não acrescentou no diagnóstico. Os sinais clínicos estabeleceram o diagnóstico de trinca radicular com indicação de exodontia e encaminhamento para reabilitação bucal. Conclusão: deve- -se enfatizar a importância do diagnóstico e acompanhamento, bem como a soberania do exame clínico para a execução do correto plano de tratamento.

Factors associated with basketball field goals made in the 2014 NBA finals

AIMS: The main objective of this study was to analyze the factors that preceded field goals made in the 2014 NBA finals considering the number of passes per offense, shooting conditions, and offense type variables. METHODS: We assessed field goals attempted by 27 professional players that participated in the 2014 NBA finals. Data were collected by three researchers through an adapted version of the Technical-Tactical Performance Evaluation Tool in Basketball to systematically analyze all five games of those finals. Descriptive analysis consisted in absolute and relative frequency and inferential statistics were applied through Chi-Square test, Cohen's D for effect size, and binary logistic regression test. Significance levels were set at 5% and all statistics were applied through SPSS 23.0. RESULTS: Shooting efficacy was not associated with the number of passes made per offense. Regression statistics showed that shooting efficacy was highly associated with shooting condition rather than the offense type performed. However, fast breaks seem to lead to better shooting conditions (passively guarded and wide open) when compared to set and regained offenses. CONCLUSION: Evidence pointed to the importance of shooting condition as a determining factor in increasing the probability of field goals made throughout the games analyzed.(AU)

Toward better understanding of postharvest deterioration: biochemical changes in stored cassava (Manihot esculenta Crantz) roots.

Food losses can occur during production, postharvest, and processing stages in the supply chain. With the onset of worldwide food shortages, interest in reducing postharvest losses in cassava has been increasing. In this research, the main goal was to evaluate biochemical changes and identify the metabolites involved in the deterioration of cassava roots. We found that high levels of ascorbic acid (AsA), polyphenol oxidase (PPO), dry matter, and proteins are correlated with overall lower rates of deterioration. On the other hand, soluble sugars such as glucose and fructose, as well as organic acids, mainly, succinic acid, seem to be upregulated during storage and may play a role in the deterioration of cassava roots. Cultivar Branco (BRA) was most resilient to postharvest physiological deterioration (PPD), while Oriental (ORI) was the most susceptible. Our findings suggest that PPO, AsA, and proteins may play a distinct role in PPD delay.

Management of Cyst-like Periapical Lesions by Orthograde Decompression and Long-term Calcium Hydroxide/Chlorhexidine Intracanal Dressing: A Case Series.

Cyst-like periapical lesions should be treated initially with conservative nonsurgical procedures. In this case series, we describe the clinical and radiographic outcomes of large cyst-like lesions that were treated by orthograde decompression and long-term intracanal use of calcium hydroxide [Ca(OH)2] mixed with 2% chlorhexidine digluconate. Ten cases of cyst-like periapical lesions involving 15 teeth from 10 patients were selected. Maximal radiographic diameters of the lesions ranged from 11 to 28 mm. Nonsurgical procedures were performed, including apical patency, orthograde puncture of cyst-like exudates, chemomechanical preparation, and placement of intracanal Ca(OH)2/CHX dressings, which were periodically replaced during 6-10 months. The root canals were then filled with gutta-percha and sealer. The follow-up periods ranged from 6 to 24 months, and the outcome was classified as healed, healing, or failure. Nine lesions drained copious exudates after canal patency. One lesion only drained bloody serous exudate after periapical overinstrumentation. In 9 patients, intracanal exudation ceased in the first follow-up visit. At the 24-month follow-up, 6 lesions (60.0%) had healed, and 3 lesions (30.0%) were healing, with the corresponding patients being without clinical signs or symptoms. The case of treatment failure was submitted to surgical treatment. Microscopically, the lesion appeared to be an apical cyst with exuberant extraradicular bacterial biofilms attached to the sectioned root apex. This case series supports the use of nonsurgical methods to resolve larger cyst-like periapical lesions.