Effect of antioxidants on adhesive bond strength to bleached enamel.

OBJECTIVE: To evaluate the influence of antioxidants (ATX) resveratrol, winter's bark, green tea and yerba mate on the bond strength between bleached enamel and the nanohybrid composite resin. METHODOLOGY: Bovine incisor crowns (n = 132) were randomly divided into 22 groups (n = 6) according to the application times (5, 10, 15, 30, and 60 min) of each antioxidant. Teeth restored without previous bleaching or ATX constituted the non-bleached control group (NB Ctrl) (n = 6), and teeth restored after bleaching and without ATX represented the bleached control group (B Ctrl) (n = 6). The 35 % hydrogen peroxide was applied for 45 min (3 application of 15 min) to the buccal enamel surface. ATX was used after bleaching for the specified time of each group and removed with air-water spray. The enamel was etched with 37 % phosphoric acid (30 s) and rinsed with air-water spray. The adhesive resin was applied to the enamel dry surface. Teeth were restored using 1 mm composite resin increments (10 × 10 × 3 mm) and sectioned in test specimens of 6 mm in length and 1 mm2 in cross-sectional area submitted to microtensile bond strength test (0.5 mm/min). The load (N) at failure was recorded, and the bond strength (σt) was calculated (MPa). The fracture area was analyzed under optical microscopy, and failures were classified as cohesive, mixed, or adhesive. Data was evaluated by Kruskal-Wallis and Dunn tests (p ≤ 0.05). RESULTS: B Ctrl group presented lower σt than NB Ctrl (p < 0.001). Applying resveratrol for 5 or 10 min, winter's bark for 10 or 15 min, green tea for less than 15 min, and yerba mate for 15 min provided similar σt between bleached enamel and nanohybrid composite to the control group. CONCLUSION: Restorative procedures performed immediately after tooth bleaching compromises adhesion. Experimental antioxidants applied to bleached enamel can increase the immediate bond strength of restorations performed directly after bleaching, with similar values to those observed in unbleached enamel. CLINICAL SIGNIFICANCE: This study presents promising results to support the use of antioxidants on the recently bleached enamel to allow adhesive tooth restorations. The immediate bonding obtained using antioxidants was similar to the one achieved in non-bleached enamel in brief application times. Green tea extract and resveratrol were able to restore the bond strength to bleached enamel in a short application time of 5 min. The reduction in the required application time holds the potential to decrease the overall duration of the clinical section, offering clinical advantages and improving the feasibility of using antioxidants on the bleached enamel prior to adhesive procedures.

Clinical effectiveness of medical ozone therapy in COVID-19: the evidence and gaps map.

Ozone therapy (OT), a medical procedure, has been showing good results during the coronavirus disease (COVID-19). We aimed to build an evidence and gaps map (EGM) of OT in the COVID-19 ranking the articles found according to levels of evidence and outcomes. The EGM brings bubbles of different sizes and different colors according to the articles. The OT intervention used was major or minor autohemotherapy, rectal insufflation and ozonized saline solution. EGM was based on 13 clinical studies using OT for COVID-19 involving a total of 271 patients. We found 30 outcomes related to OT in COVID-19. Our EGM divided the outcomes into six groups: 1-clinical improvement; 2-hospitalization; 3-inflammatory, thromboembolic, infectious, or metabolic markers; 4-radiological aspects, 5-viral infection and 6-adverse events. Major autohemotherapy was present in 19 outcomes, followed by rectal insufflation. Improvement in clinical symptoms of COVID-19, improvement of respiratory function, improvement of oxygen saturation, reduction in hospital internment, decrease in C-reactive protein, decrease in ferritin, decrease in lactate dehydrogenase, decrease in interleukin 6, decrease in D-dimer, radiological improvement of lung lesions and absence of reported adverse events were related in the papers. The most commonly used concentrations of OT in major autohemotherapy and in rectal insufflation were 40 µg/mL and 35 µg/mL, respectively. Here, we bring the first EGM showing the efficacy and safety of OT in the treatment of COVID-19. OT can be used as integrative medical therapy in COVID-19 at a low cost and improve the health conditions of the patients.

Intra-articular ozone slows down the process of degeneration of articular cartilage in the knees of rats with osteoarthritis.

BACKGROUND: Osteoarthritis (OA) is a joint disease of multifactorial etiology, affecting mainly the knees. We aimed to evaluate the effects of two different doses of gaseous ozone intra-articularly on the knee cartilage morphology of rats with osteoarthritis (OA). METHODS: The articular lesion was induced by sodium monoiodoacetate (MIA). 40 Wistar rats were divided into 4 groups: G1 control (without lesion and without treatment), G2 articular lesion (AL) (only lesion MIA-induced), G3 AL + treatment with 5 µg/mL of ozone intra-articular, and G4 AL + treatment with 10 µg/mL of ozone intra-articular. The experiment was carried out for 60 days. RESULTS: Both doses of ozone intra-articular demonstrated less reduction in joint space (G3 and G4) compared to the G2, formation of osteophytes, but without subchondral sclerosis. Ozone decreased the volumetric density of the articular lesion (VV(AL)) of tibial. The treatments recovered VV(AL) of the femur similar to G1. Ozone lower dose (G3) showed lower tibia and femur macroscopic scores. CONCLUSION: Intra-articular gaseous ozone can delay the degeneration of articular cartilage and can represents an integrative therapy in the OA treatment of knee after 60 days of treatment. For the first time the role of ozone in articular cartilage degeneration was evaluated helping to understand this therapy.

Natural sources of melanogenic inhibitors: A systematic review.

OBJECTIVE: Melanin gives some natural protection against the harmful effects of ultraviolet radiation; however, excessive production of melanin causes skin hyperpigmentation. Depigmenting cosmetics can be used to control this process; however, depigmenting agents commonly used have some disadvantages, such as low bioavailability, photosensitization, cellular toxicity, and insolubility. Natural sources of melanogenic inhibitors have become important alternatives to synthetic ones. The objective of this review was to summarize the results of studies on natural extracts that have been reported in the literature to inhibit the process of melanogenesis, giving a view on their suitability for potential use in new cosmetic formulations for skin-lightening. DATA SOURCES: A systematic literature search was carried out using the descriptors: "melanogenesis", "tyrosinase", "tyrosinase inhibition", and "natural agents". STUDY SELECTION: Publications were selected based on our designated inclusion and exclusion criteria, and a total of 15 studies met these criteria. DATA EXTRACTION: The following were used in the review of each paper which met the criteria: the name of the plant (all of the natural extracts turned out to be from plants), the method used to obtain the plant extract, the method for evaluating anti-tyrosinase activity, the main results, and the conclusions. DATA SYNTHESIS: All evaluated natural agents demonstrated anti-tyrosinase effect. The species Leathesia difformis, Morus alba, Orostachys japonicus, Heracleum moellendorffii, Coix lacryma-jobi (adlay), Inula brittanica, and Gailardia aristata stood out from the others due to their application as potential inhibitors of more than three proteins related to melanogenesis, including the cyclic adenosine monophosphate response element-binding protein, microphthalmia-associated transcription factor, tyrosinase, tyrosinase-related protein-1, tyrosinase-related protein-2, and dopachrome tautomerase. CONCLUSION: The plants present an anti-tyrosinase effect that must be better explored in the new cosmetic formulations. The anti-melanogenic effects of the plant are mainly related to the presence of phenolic and antioxidant compounds.

OBJECTIF: La mélanine offre une certaine protection naturelle contre les effets nocifs des rayons ultraviolets ; cependant, une production excessive de mélanine provoque une hyperpigmentation cutanée. Les cosmétiques dépigmentants peuvent servir à contrôler ce processus ; cependant, les agents dépigmentants couramment utilisés présentent certains inconvénients, comme une biodisponibilité faible, une photosensibilité, une toxicité cellulaire et une insolubilité. Les sources naturelles d'inhibiteurs de la mélanogénèse sont devenues des alternatives importantes aux inhibiteurs synthétiques. L'objectif de cette revue était de résumer les résultats des études sur les extraits naturels signalés dans la littérature comme inhibant le processus de mélanogenèse, en donnant un aperçu de leur adéquation à une utilisation potentielle dans de nouvelles formulations cosmétiques pour l'éclaircissement de la peau. SOURCES DES DONNÉES: Une recherche systématique dans la littérature a été réalisée à l'aide des descripteurs : « mélanogenèse ¼, « tyrosinase ¼, 'inhibition de la tyrosinase ¼ et « agents naturels ¼. Sélection des études : Les publications ont été sélectionnées d'après nos critères d'inclusion et d'exclusion désignés et un total de 15 études remplissaient ces critères. EXTRACTION DES DONNÉES: Les éléments suivant ont été utilisés dans l'examen de chaque article répondant aux critères : le nom de la plante (tous les extraits naturels se sont avérés provenir des plantes), la méthode utilisée pour obtenir l'extrait végétal, la méthode d'évaluation de l'activité anti-tyrosinase, les principaux résultats et les conclusions. SYNTHÈSE DES DONNÉES: Tous les agents naturels évalués ont démontré un effet anti-tyrosinase. Les espèces Leathesia difformis, Morus alba, Orostachys japonicus, ,Heracleum moellendorffii, Coix lacryma-jobi (adlay), Inula brittanica, et Gailardia aristata se sont distinguées des autres en raison de leur application comme inhibiteurs potentiels de plus de trois protéines liées à la mélanogenèse, dont la protéine de liaison d'élément de réponse d'adénosine monophosphate cyclique, du facteur de transcription associé à la microphtalmie, la tyrosinase, la protéine liée à la tyrosinase-1, la protéine liée à la tyrosinase-2 et la dopachrome tautomérase. CONCLUSION: Les plantes présentent un effet anti-tyrosinase qui doit être exploré plus en profondeur dans les nouvelles formulations cosmétiques. Les effets inhibiteurs de la mélanogénèse des plantes sont principalement dus à la présence de composés phénoliques et antioxydants.

The role of ozone treatment as integrative medicine. An evidence and gap map.

Introduction: The Brazil has one of the largest public health systems in the world and in the 1980's, Traditional, Complementary and Integrative Medicine were introduced. In 2018, the treatment with ozone became a complementary integrative practice showing several benefits. However, its effectiveness needs to be researched. The objective of this evidence gap map is to describe contributions of Integrative Medicines-Ozone treatment in different clinical conditions, to promote evidence-based practice. Methods: We applied the methodology developed by Latin American and Caribbean Center on Health Sciences Information based on the 3iE evidence gap map. The EMBASE, PubMed and Virtual Health Library databases, using the MeSH and DeCS terms for the treatment with Ozone were used. Results: 26 systematic reviews were characterized, distributed in a matrix containing 6 interventions (parenteral oxygen/ozone gas mixture; parenteral ozonated water; systemic routes; topical application ozonated water; topical oxygen/ozone gas mixture; and topical ozonated oil) and 55 outcomes (cancer, infection, inflammation, pain, quality of life, wound healing and adverse effects). 334 associations between intervention and outcome were observed, emphasizing the parenteral oxygen/ozone gas mixture intervention (192 associations, 57%). Conclusions: The evidence gap map presents an overview of contributions of Ozone treatment in controlling pain, infections, inflammation and wound healing, as well as increasing the quality of life, and it is directed to researchers and health professionals specialized in Ozone treatment. No serious adverse effects were related. Therefore, this treatment may be even more widely known as an integrative treatment, considering its low cost, efficiency and safety. Future studies should adopt economic impact assessments and the organization of health services.

Effectiveness of topical ozonated oil in severe osteoarthritis: A randomised, triple-blinded, placebo-controlled study.

BACKGROUND: Osteoarthritis is highly prevalent and a common locomotory disorder in the elderly. The treatments aim improves the quality of life. We aimed to evaluate the effectiveness of topical ozonated oil in relieving pain in patients with osteoarthritis. DESIGN: A placebo-controlled, triple-blind, randomised controlled trial including osteoarthritis patients older than 50 years. INTERVENTIONS: Eighty patients were randomly divided into two groups: treatment (ozonated oil) and placebo (non-ozonated oil). The oils were used twice a day for 60 days. Evaluations were performed using WOMAC (Western Ontario and McMaster Universities) and VAS (visual analogue scale) and laboratory analysis. RESULTS: Pain relief was observed in all groups except in the placebo group where patients are diagnosed with severe osteoarthritis (degree 4) (p-value treatment and placebo group: 0.021 and 0.345, respectively). CONCLUSIONS: For the first time, the pain relief in patients with severe osteoarthritis was demonstrated by the use of topical ozonated oil.

Potencial antimicrobiano e caracterização fitoquímica de extratos da casca do caule de Drimys brasiliensis Miers (Winteraceae) / Antimicrobial potential and phytochemical investigation of stem bark extracts from Drimys brasiliensis Miers (Winteraceae)

Introdução: na área da saúde, a resistência aos antimicrobianos tem se constituído um grave problema, fazendo com que a busca por alternativas farmacológicas assuma grande importância. Produtos de origem natural, como extratos de plantas, têm sido pesquisados para uso potencial no tratamento antibacteriano. Drimys brasiliensis Miers (Winteraceae) é uma árvore nativa do Brasil que tem sido utilizada como medicinal. Objetivo: investigar o perfil fitoquímico e a atividade antimicrobiana de amostras obtidas a partir de extratos da casca do caule de Drimys brasiliensis. Metodologia: frações de características químicas variadas foram obtidas a partir de extratos da casca do caule da planta. Realizou-se o screening fitoquímico destas frações através de reações gerais de caracterização e cromatografia em camada delgada. As amostras foram testadas por difusão em ágar e por microdiluição contra bactérias Grampositivas e Gram-negativas e contra uma levedura. Resultados: o perfil fitoquímico mostrou diferenças entre as frações analisadas. Alcaloides foram detectados nas frações mais apolares. Taninos e flavonoides estavam presentes nas amostras mais polares e obtidas sem o uso de calor. As amostras com maior atividade antimicrobiana foram as obtidas com os solventes hexano e diclorometano, de características mais apolares. Destaca-se a atividade contra Bacillus cereus, Staphylococcus epidermidis, Staphylococcus aureus resistente à meticilina e Candida albicans. Conclusão: extratos da casca do caule de Drimys brasiliensis apresentam potencial ntimicrobiano, com destaque para as frações mais apolares contra bactérias gram positivas.

Introduction: in the health field, antimicrobial resistance has been a serious issue, making the search for pharmacological alternatives very important. Natural products, such as plant extracts, have been researched for potential use in antibacterial treatment. Drimys brasiliensis Miers (Winteraceae) is a tree native to Brazil that has been medicinally used. Objective: to investigate the phytochemical profile and antimicrobial activity of samples obtained from Drimys brasiliensis stem bark extracts. Methodology: fractions of different chemical characteristics were obtained from extracts of the stem bark. Phytochemical screening of these fractions was performed by general reactions and thin layer chromatography. Samples were tested by agar diffusion and microdilution against Gram-positive and Gram-negative bacteria and yeast. Results: the phytochemical profile showed differences between the analyzed fractions. Alkaloids were detected in the most nonpolar fractions. Tannins and flavonoids were present in the most polar samples and obtained without the use of heat. The samples with the highest antimicrobial activity were those obtained with hexane and dichloromethane solvents, which present the most nonpolar characteristics. We highlight the activity against Bacillus cereus, Staphylococcus epidermidis, Methicillin resistant Staphylococcus aureus and Candida albicans. Conclusion: Drimys brasiliensis stem bark extracts have antimicrobial potential, especially the most nonpolar fractions against gram positive bacteria.

Ozone therapy as an integrating therapeutic in osteoartrosis treatment: a systematic review / Ozonioterapia como terapêutica integrativa no tratamento da osteoartrose: uma revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: Osteoarthrosis affects 85% of the population over 75 years of age. It is divided into primary and secondary, however despite the knowledge at the molecular level the treatments are not yet fully effective. However, ozone therapy emerges as an alternative therapy, which is low cost and seems effective in the treatment of chronic pain. The objective of this study was to evaluate the current evidence to support or to refute the use of ozone therapy in the treatment of patients with osteoarthritis. CONTENTS: Systematic review using the keywords "ozone therapy", "ozone", "osteoarthritis", "arthritis", "randomized", "controlled" and "meta-analysis". The selection of publications was based on inclusion and exclusion criteria. In total, 9 articles were used. Among the 9 articles found regarding ozone therapy in osteoarthritis, 7 of them clearly show the benefits of ozone. The concentrations of ozone used in the studies ranged from 20µg/mL to 15g/mL. The route of administration was intra-articular and rectal insufflation. The frequency of use was, on average, 1 to 3 times a week and the treatment time was between 3 to 4 months in most of the studies. CONCLUSION: The use of ozone produces clinically relevant benefits in patients with osteoarthrosis. Therefore, ozone therapy in osteoarthrosis represents a low-cost, efficient therapeutic alternative that should be implemented in the country's Public Health, considering the prevalence of the disease.

RESUMO JUSTIFICATIVA E OBJETIVOS: A osteoartrose atinge 85% da população com mais de 75 anos. A mesma é dividida em primária e secundária, porém apesar do conhecimento a nível molecular, os tratamentos ainda não são totalmente eficazes. Entretanto, a ozonioterapia, é de baixo custo e parece efetiva no tratamento da dor crônica. O objetivo deste trabalho foi avaliar as evidências atuais que apoiem ou refutem o uso da ozonioterapia no tratamento de pacientes com osteoartrose. CONTEÚDO: Revisão sistemática, utilizando as palavras-chave: "ozone therapy", "ozone", "osteoarthritis", "arthritis", "randomised", "controlled" e "meta-analysis". A seleção das publicações foi feita a partir de critérios de inclusão e exclusão. Ao total foram utilizados 9 artigos. Dentre os 9 artigos encontrados a respeito de ozonioterapia na osteoartrose, 7 deles mostraram claramente os benefícios do ozônio. As concentrações de ozônio utilizadas nos estudos variaram de 20µg/mL a 15g/mL. A via de administração utilizada foi a intra-articular e a insuflação retal. A frequência do uso foi, em média, de 1 a 3 vezes por semana e o tempo de tratamento foi entre 3 a 4 meses na maior parte dos estudos. CONCLUSÃO: O uso do ozônio produz benefícios clinicamente relevantes em pacientes com osteoartrose, portanto a ozonioterapia na osteoartrose representa uma alternativa terapêutica de baixo custo, e eficiente, que deve ser implantada na Saúde Pública do país, tendo em vista a prevalência da doença.