Maintenance protocols for implant-supported dental prostheses: A scoping review.

STATEMENT OF THE PROBLEM: Biological complications of implant-supported prostheses remain a concern. Therefore, standardizing hygiene protocols to promote their maintenance is important. PURPOSE: The purpose of this scoping review was to identify available hygiene guidance for home care procedures, as well as periodicity and protocols for the professional maintenance of implant-supported prostheses. MATERIAL AND METHODS: This study was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the study protocol was made available at: https://osf.io/5jdeh/. The search was last performed in the PubMed database on March 15, 2022 and was undertaken by 2 independent researchers. Clinical studies and reviews that evaluated home care and maintenance protocols for dental implant-supported prostheses (fixed or removable), without language restriction or year of publication, were included. A descriptive analysis was performed considering study characteristics (study design, restorative assembly, maintenance strategies, eligibility criteria, number of included studies, quality/level of evidence, and main findings). RESULTS: The initial search yielded 3138 studies, of which 18 were included for descriptive analysis (6 critical reviews, 4 clinical trials, 3 systematic reviews, 2 guideline reports, 2 retrospective studies, and 1 transversal study). The main instrument recommended for home care was the use of a conventional toothbrush associated with triclosan-containing toothpaste in addition to interproximal aids (brushes or floss) for all types of restorations. The use of irrigation instruments was also frequently considered. For professional maintenance, almost all studies reported a positive effect of regular recalls every 3 months during the first year, followed by less regular recalls according to the motivation of the patient and home care efficacy. At each recall, the professional should evaluate the patient history, oral tissues, implant, abutments, and restorations, as well as perform professional cleaning of the prostheses with appropriate instruments so that the implants and abutments may be preserved. CONCLUSIONS: Establishing an adequate hygiene protocol is indispensable for implant-supported restorations. To do so, the professional must guide and support the patient's home care by taking into account the patient's motivation and efficacy during the hygiene procedures. Also, for professional maintenance, the periodicity of recalls should be constant and include an evaluation of the condition of the restoration and adjacent tissues, followed by professional cleaning of prostheses, implants, and abutments, in addition to new instructions to improve patient home care.

Habenular connections with the dopaminergic and serotonergic system and their role in stress-related psychiatric disorders.

The habenula (Hb) is a phylogenetically old epithalamic structure differentiated into two nuclear complexes, the medial (MHb) and lateral habenula (LHb). After decades of search for a great unifying function, interest in the Hb resurged when it was demonstrated that LHb plays a major role in the encoding of aversive stimuli ranging from noxious stimuli to the loss of predicted rewards. Consistent with a role as an anti-reward center, aberrant LHb activity has now been identified as a key factor in the pathogenesis of major depressive disorder. Moreover, both MHb and LHb emerged as new players in the reward circuitry by primarily mediating the aversive properties of distinct drugs of abuse. Anatomically, the Hb serves as a bridge that links basal forebrain structures with monoaminergic nuclei in the mid- and hindbrain. So far, research on Hb has focused on the role of the LHb in regulating midbrain dopamine release. However, LHb/MHb are also interconnected with the dorsal (DR) and median (MnR) raphe nucleus. Hence, it is conceivable that some of the habenular functions are at least partly mediated by the complex network that links MHb/LHb with pontomesencephalic monoaminergic nuclei. Here, we summarize research about the topography and transmitter phenotype of the reciprocal connections between the LHb and ventral tegmental area-nigra complex, as well as those between the LHb and DR/MnR. Indirect MHb outputs via interpeduncular nucleus to state-setting neuromodulatory networks will also be commented. Finally, we discuss the role of specific LHb-VTA and LHb/MHb-raphe circuits in anxiety and depression.

The effect of surface treatment and bonding procedures on the bond strength of silorane composite repairs.

OBJECTIVE: The aim of this study was to evaluate the effect of surface treatments and adhesive protocols on the microtensile bond strength of a low-shrinkage composite repair. MATERIALS AND METHODS: Ninety-six blocks of composite resin Filtek LS were prepared using a half-hourglass-shaped silicone matrix. The specimens were storage for 24 h in distilled water and were randomly divided into the experimental (6) and negative control (2) groups (n = 12) according to the surface treatment (diamond bur and aluminum oxide sandblasting) and adhesive protocol (none; Filtek LS adhesive; phosphoric acid + Filtek LS adhesive; and phosphoric acid + silane + Filtek LS adhesive). After the adhesive procedure, the specimens were fixed in an hourglass-shaped silicone matrix and the other half of the specimen was restored. Hourglass shaped specimens (n = 12) were used as positive control (cohesive strength of the resin). The microtensile bonding test was performed at a crosshead speed of 0.5 mm/min. The data were analyzed using ANOVA, Tukey's and Dunnett's tests (α = 0.05). RESULTS: The bond strength values were similar for all experimental groups, except the groups without adhesive application. None of the experimental groups presented results similar to the positive control group. CONCLUSIONS: The repair of silorane restorations is viable; nevertheless, the different bonding procedures tested were incapable to produce bond strengths similar to the cohesive strength of the material.

Achieving property enhancements in dental resin composites via reduced concentrations of camphorquinone within a ternary initiator system.

OBJECTIVES: The study aimed to assess the impact of diphenyliodonium hexafluorophosphate (DPI) on the physicochemical properties of experimental resin composites (ECRs) featuring reduced concentrations of camphorquinone (CQ)/amine. METHODS: Five concentrations of CQ (0.125, 0.25, 0.5, 0.75, and 1 mol%) with dimethylaminoethyl amine benzoate (EDAB) in a 1:2 mol% ratio (CQ:EDAB) were incorporated into a 50:50 mass% monomer blend of bisphenol glycidyl methacrylate (BisGMA) and triethyleneglycol dimethacrylate (TEGDMA). An additional 5 groups with the same CQ:EDAB concentrations had 0.5 mol% DPI added. Each resin group contained 60 wt% of 0.7 µm barium-alumino-silicate glass. Light transmission (n = 3), real-time degree of polymerization (n = 3), temperature change during polymerization (n = 5), polymerization shrinkage strain (n = 3), flexural strength, and modulus (n = 12), as well as water sorption and solubility (n = 5), were evaluated. Data were analyzed using two-way ANOVA and Tukey's post-hoc test (α = 0.05). RESULTS: Light transmission was reduced in groups containing 0.125 and 0.25 mol% of CQ without DPI. DPI increased temperature, degree and rate of polymerization, despite the reduction in CQ/amine concentration. Additionally, there was an increase in polymerization shrinkage strain, flexural strength and modulus, and a reduction in water sorption and solubility in ECRs with DPI, even with lower concentrations of CQ/EDAB. SIGNIFICANCE: DPI improved the assessed properties of composites across various concentrations of CQ/EDAB, showing the benefit of reducing the quantity of CQ used without compromising the properties and curing of the resin composites.

Effects of silane application on luting fiber posts using self-adhesive resin cement.

PURPOSE: To evaluate the effects of different glass-fiber post surface treatments on the bond strength to root dentin. MATERIALS AND METHODS: Fifty bovine incisors were used in this study. After removing the crowns, the teeth were endodontically treated. The roots were randomly divided into five groups according to post surface treatment. The groups were as follows: CO (Control) - no treatment; G1 - RelyX Ceramic Primer (silane) only; G2 - silane and Solobond M; G3 - silane and Scotchbond Adhesive; G4 - silane and Excite. For post cementation, RelyX Unicem was used according to the manufacturer's recommendation and the roots were stored in a light-proof container with 100% relative humidity for 24 h. The specimens were transversally sectioned. Subsequently, the cervical, middle, and apical regions of the root were positioned in a push-out device and tested at 0.5 mm/min using a universal testing machine (Instron). The data were statistically analyzed with two-way ANOVA and Tukey's post-hoc test. The fractured specimens were then observed under a stereoscopic loupe at 60X magnification. RESULTS: No significant difference in bond strength was found among the groups that received a silane or silane plus an adhesive system (p > 0.05). However, the CO (no silane) showed the lowest bond strength. Regarding G1, G2, G3, and G4, the cervical region of the root canal attained better bond strengths than did the middle or apical regions. The most frequent failure mode occurred at the cement/dentin interface. CONCLUSION: Silane application may be necessary to improve the adhesion of fiber posts luted with the self-adhesive resin cement evaluated here. The application of an adhesive layer between the fiber post and resin cement did not have any influence on the bond strength when the silane coupling was previously used.

Top-down projections of the prefrontal cortex to the ventral tegmental area, laterodorsal tegmental nucleus, and median raphe nucleus.

Anatomical and functional evidence suggests that the PFC is fairly unique among all cortical regions, as it not only receives input from, but also robustly projects back to mesopontine monoaminergic and cholinergic cell groups. Thus, the PFC is in position to exert a powerful top-down control over several state-setting modulatory transmitter systems that are critically involved in the domains of arousal, motivation, reward/aversion, working memory, mood regulation, and stress processing. Regarding this scenario, the origin of cortical afferents to the ventral tegmental area (VTA), laterodorsal tegmental nucleus (LDTg), and median raphe nucleus (MnR) was here compared in rats, using the retrograde tracer cholera toxin subunit b (CTb). CTb injections into VTA, LDTg, or MnR produced retrograde labeling in the cortical mantle, which was mostly confined to frontal polar, medial, orbital, and lateral PFC subdivisions, along with anterior- and mid-cingulate areas. Remarkably, in all of the three groups, retrograde labeling was densest in layer V pyramidal neurons of the infralimbic, prelimbic, medial/ventral orbital and frontal polar cortex. Moreover, a lambda-shaped region around the apex of the rostral pole of the nucleus accumbens stood out as heavily labeled, mainly after injections into the lateral VTA and LDTg. In general, retrograde PFC labeling was strongest following injections into MnR and weakest following injections into VTA. Altogether, our findings reveal a fairly similar set of prefrontal afferents to VTA, LDTg, and MnR, further supporting an eminent functional role of the PFC as a controller of major state-setting mesopontine modulatory transmitter systems.

Influence of different concentrations of an iodonium salt on properties of amine-free resins.

OBJECTIVES: to evaluate the effect of different concentrations of an iodonium salt on the degree of conversion, polymerisation rate, flexural strength and modulus of an amine-free photopolymerizable resin system. METHODS: Two series of UDMA/TEGDMA resin mixtures (1:1 mass ratio) containing 0, 0.5, 1.0 or 2.0 mol% of bis(4-methyl phenyl)iodonium hexafluorophosphate(BPI): and 1 mol% camphorquinone (CQ) were evaluated. One of the series contained 2 mol% of the amine (2-(dimethylamino)ethyl methacrylate-DMAEMA), while the other series had only CQ and BPI as photoinitiators. Polymerisation kinetics and degree of conversion (DC) were evaluated by Fourier transform near-infrared spectroscopy (n = 3). Flexural strength (FS) and modulus (E) were evaluated by a three-point bending method (n = 12). Data were analysed by two-way ANOVA and Tukey's test. RESULTS: The system containing CQ + DMAEMA + BPI provided the highest DC and FS. Amine-free resins had similar E regardless of the presence of BPI. The resins containing CQ+DMAEMA with 1 and 2 mol% of BPI presented higher E compared with others. SIGNIFICANCE: Amine-containing resins reached statistically higher DC, rate of polymerisation and FS than amine-free systems. The use of higher BPI concentrations did not improve the properties of amine-free resins.

Spectrophotometric evaluation of restorative composite shades and their match with a classical shade guide.

OBJECTIVES: The aim of this study was to verify the match between 5 shades of composites from different manufacturers with a shade guide and among the systems using a portable spectrophotometer. MATERIALS AND METHODS: Shade measurements were performed on specimens of Z350 XT (3M ESPE), Charisma Diamond (Heraeus Kulzer GmbH), Esthet X-HD (Dentsply Caulk), and Empress Direct (Ivoclar-Vivadent) for shades A1, A2, A3, B1, and C3 using a Vita Easyshade spectrophotometer (Vita Zahnfabrik) against a white background. Corresponding shades of Vitapan Classical (Vita Zahnfabrik) guide were measured likewise and shade variation (ΔE) was calculated based on International Commission on Illumination L*a*b* parameters. The ΔE of the composites in each shade was compared by one-way analysis of variance and Tukey's post hoc test (α = 0.05). RESULTS: All composites presented ΔE > 3.7 compared with the shade guide. Variation in shades A3, B1, and C3 was significantly different for all composites. ΔE of Z350 XT was significantly lower for A1 than for the other shades, whereas ΔE of Z350 XT and Charisma Diamond were significantly lower for A2 than for the other shades. CONCLUSIONS: No composite shade matched with the shade guide. Equivalent shades of the restorative composite from different manufacturers may show clinically noticeable ΔE.

Improvement on properties of experimental resin cements containing an iodonium salt cured under challenging polymerization conditions.

OBJECTIVE: The use of resin cements in clinical practice entails photopolymerization through prosthetic devices, which precludes light penetration. The objective of this study was to modify experimental resin cements (ERCs) with diphenyliodonium hexafluorophosphate (DPI) in an attempt to improve chemical and mechanical properties of materials cured with reduced irradiance and final radiant exposure. METHODS: A co-monomer base containing a 1:1 mass ratio of 2.2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (bis-GMA) and triethyleneglycol dimethacrylate (TEGDMA) was prepared, with 1mol% of camphorquinone and 2mol% of ethyl 4-(dimethylamino)benzoate as initiator system. The resin was divided into 4 fractions according to the DPI concentrations (0, 0.5, 1 and 2mol%). The challenging polymerization condition was simulated performing the light activation (12, 23 and 46s) through a ceramic block (3mm thick). The irradiance was assessed with a calibrated spectrometer (1320mW/cm2), resulting in three levels of radiant exposure (0.58, 1.1 and 2.2J/cm2). The polymerization kinetics was evaluated in real-time using a spectrometer (Near-IR). Water sorption and solubility was analyzed and the cohesive strength of resins obtained through the microtensile test. Polymerization stress was assessed by Bioman method. RESULTS: Resins containing DPI had higher degree of conversion and rate of polymerization than the control (without DPI). The use of DPI reduced water sorption and solubility, and led to higher cohesive strength compared to resins without the iodonium salt. However, the stress of polymerization was higher for experimental resins with DPI. SIGNIFICANCE: Even under remarkably reduced irradiance, cements containing a ternary initiating system with an iodonium salt can present an optimal degree of conversion and chemical/mechanical properties.

Bond strength of dental adhesive systems irradiated with ionizing radiation.

PURPOSE: The aim of the present paper was to determine the effect of different types of ionizing radiation on the bond strength of three different dentin adhesive systems. MATERIALS AND METHODS: One hundred twenty specimens of 60 human teeth (protocol number: 032/2007) sectioned mesiodistally were divided into 3 groups according to the adhesives systems used: SB (Adper Single Bond Plus), CB (Clearfil SE Bond) and AP (Adper Prompt Self-Etch). The adhesives were applied on dentin and photo-activated using LED (Lec 1000, MMoptics, 1000 mW/cm2). Customized elastomer molds (0.5 mm thickness) with three orifices of 1.2 mm diameter were placed onto the bonding areas and filled with composite resin (Filtek Z-250), which was photo-activated for 20 s. Each group was subdivided into 4 subgroups for application of the different types of ionizing radiation: ultraviolet radiation (UV), diagnostic x-ray radiation (DX), therapeutic x-ray radiation (TX) and without irradiation (control group, CG). Microshear tests were carried out (Instron, model 4411), and afterwards the modes of failure were evaluated by optical and scanning electron microscope and classified using 5 scores: adhesive failure, mixed failures with 3 significance levels, and cohesive failure. The results of the shear bond strength test were submitted to ANOVA with Tukey's test and Dunnett's test, and the data from the failure pattern evaluation were analyzed with the Mann Whitney test (p = 0.05). RESULTS: No change in bond strength of CB and AP was observed after application of the different radiation types, only SB showed increase in bond strength after UV (p = 0.0267) irradiation. The UV also changed the failure patterns of SB (p = 0.0001). CONCLUSION: The radio-induced changes did not cause degradation of the restorations, which means that they can be exposed to these types of ionizing radiation without weakening the bond strength.

Surface/interface morphology and bond strength to glass ceramic etched for different periods.

This study evaluated the influence of etching periods on the surface/interface morphology and bond strength to glass ceramic with or without application of an unfilled resin after silane. Ceramic discs were divided into 12 groups, defined by etching time with 10% hydrofluoric acid: G1/G7--etching for 10 seconds, G2/G8--20 seconds; G3/G9--40 seconds; G4/G10--60 seconds; G5/G11--120 seconds and G6/G12--60 + 60 seconds. All the groups were silanated after etching and G7 - G12 received a layer of unfilled resin after silane. Microshear testing using resin cement was performed, with 12 resin cylinders tested per group. The data was submitted to two-way ANOVA and the Student-Newman-Keuls' test (p<0.05). Evaluation of the etching pattern and bonding interfaces was conducted by SEM. The bond strength means (MPa) were: 19.4 +/- 3.5, 22.3 +/- 5.1, 22.2 +/- 3.2, 17.8 +/- 2.1, 15.3 +/- 3.0 and 14.3 +/- 1.8 for G1-G6 and 17.4 +/- 4.8, 21.3 +/- 2.1, 21.1 +/- 2.3, 24.7 +/- 5.8, 20.4 +/- 2.2 and 18.5 +/- 4.6 for G7-G12. Poor etching was detected after 10 seconds of conditioning; whereas deep channels were extensively observed on surfaces etched for 120 and 60 + 60 seconds. Unfilled voids underlying the ceramic-cement interface were detected when only silane was applied. Full completion of the irregularities on G11 was detected using unfilled resin. When only silane was applied, the 60-second group and those etched for longer periods showed lower bond strengths. When both silane and unfilled resin were applied, all etching periods generally showed similar values. In conclusion, the etching period influenced the surface/interface topography and bond strength to ceramic. The application of unfilled resin was able to infiltrate all unfilled voids beneath the ceramic-cement interface, except on re-etched surfaces.

Bis(4-methyl phenyl)iodonium as an alternative component to diphenyliodonium in camphorquinone-based ternary initiating systems.

OBJECTIVE: To evaluate the influence of different co-initiators (diphenyliodonium hexafluorophosphate - DPI - and bis(4-methyl phenyl)iodonium hexafluorophosphate - BPI) on chemical and mechanical properties of resins. METHODS: Nine experimental resins (50% Bis-GMA and 50% TEGDMA, w/w) with 60 wt% filler particles were formulated. The initiating system used was camphorquinone (CQ-1 mol%) and ethyl dimethylaminobenzoate (EDAB-2 mol%). Experimental groups were established according to DPI and BPI quantities (0.25, 0.5, 0.75, and 1 mol%). The control group was a resin containing only CQ-EDAB. Light transmission through the resin during polymerisation was analysed with a UV-vis spectrophotometer. Real-time polymerisation of the systems was evaluated using an FTIR spectrometer. Real-time polymerisation shrinkage strain was evaluated, and the flexural strength and modulus of materials were obtained by 3-point bending. Experimental groups were statistically analysed by Analysis of Variance and Tukey's test (α = 0.05). Dunnett's test was applied to compare experimental groups with control. RESULTS: Light transmission rapidly increased initially for resins containing DPI or BPI. After 30 s cure, the irradiance on the lower surface of resin specimens was similar for all groups. After 10 s of light irradiation, groups containing DPI and BPI had higher conversion than the control. However, conversion after 120 s post-irradiation was similar for all groups. The rate of polymerisation, shrinkage strain, and the maximum strain rate were higher for groups containing DPI/BPI. The use of iodonium salts increased the flexural strength and flexural moduli of resins. SIGNIFICANCE: DPI and BPI increased resin reactivity similarly. Increased rate of polymerization influenced light transmission through the resin in the first seconds of polymerisation and increased resin shrinkage and rate of shrinkage, as well as flexural strength and moduli.

Nanohybrid resin composites: nanofiller loaded materials or traditional microhybrid resins?

Nanohybrid resin composites present conventional particles to be mixed with nanomeric fillers and, therefore, it is unknown whether they may perform similarly to nanofilled or microhybrid resins. The current study investigated the properties of nanohybrid resins (TPH3, Grandio, Premise, Concept Advanced) in comparison with a nanofilled (Supreme XT) and a microhybrid (Z250) composite. The inorganic fillers were characterized by SEM/EDS analysis. Diametral tensile strength (DTS), surface roughness before and after toothbrush abrasion, Knoop Hardness (KHN), water sorption and solubility were evaluated. The data were separately analyzed by ANOVA and the Student-Newman-Keuls' tests (p < 0.05). The results of all analyses were material-dependent. Noticeable differences in filler size and shape were detected among the materials. Supreme XT generally showed higher DTS and KHN compared to all the nanohybrids and also showed lower surface roughness before and after toothbrush abrasion compared to most of the materials tested. Similar results were generally detected for the nanohybrids compared with the microhybrid material. In conclusion, the nanohybrid resins generally presented inferior properties compared with the nanofilled composite and either similar or slightly better properties compared to the microhybrid material. Under clinical conditions, nanohybrid resins may not perform similarly to nanofilled materials.

Effect of storage and compressive cycles on the bond strength after collagen removal.

This study verified the influence of storage and compressive loads on the microtensile bond strength (microtbs) of an adhesive system when using the conventional technique or collagen removal treatment. Twenty bovine teeth were separated into four groups: G1) adhesive system Prime & Bond NT (PBNT) in accordance with the manufacturer's instructions, G2) PBNT after deproteinization with 10% sodium hypochlorite (NaOCl), G3) PBNT in accordance with the manufacturer's instructions + 50,000 compressive cycles and G4) PBNT after deproteinization + 50,000 compressive cycles. After 24 hours, the teeth were sectioned and half of the specimens were stored in water (37 degrees C) for further evaluation (after 60 days). The failure mode was evaluated by scanning electron microscopy (SEM). The bond strength values were separately submitted to two-way ANOVA for each period and the differences among groups were determined by Tukey's test (p = 0.05). Comparisons between 24 hours and 60 days were determined by multiple paired Student's t-tests (5%). The evaluation at 24 hours revealed that deproteinization did not affect microtbs for the non-cycled groups (G1 = 47.8 +/- 4.7 and G2 = 52.4 +/- 11.32). For the groups tested after the mechanical cycles, deproteinization produced higher microtbs (G3 = 32.7 +/- 9.6 and G4 = 43.3 +/- 16.7). At 60 days, deproteinization produced higher microtbs than the manufacturers' recommendations for the cycled and non-cycled groups (G1 = 31.5 +/- 5.8; G2 = 48.8 +/- 7.7; G3 = 17.1 +/- 7.2 and G4 = 48.8 +/- 12.2). In conclusion, the deproteinized groups were less susceptible to degradation than the groups restored with the conventional technique.

Connections of the laterodorsal tegmental nucleus with the habenular-interpeduncular-raphe system.

The laterodorsal tegmental nucleus (LDTg) is a hindbrain cholinergic cell group thought to be involved in mechanisms of arousal and the control of midbrain dopamine cells. Nowadays, there is increasing evidence that LDTg is also engaged in mechanisms of anxiety/fear and promotion of emotional arousal under adverse conditions. Interestingly, LDTg appears to be connected with other regulators of aversive motivational states, including the lateral habenula (LHb), medial habenula (MHb), interpeduncular nucleus (IP), and median raphe nucleus (MnR). However, the circuitry between these structures has hitherto not been systematically investigated. Here, we placed injections of retrograde or anterograde tracers into LDTg, LHb, IP, and MnR. We also examined the transmitter phenotype of LDTg afferents to IP by combining retrograde tracing with immunofluorescence and in situ hybridization techniques. We found LHb inputs to LDTg mainly emerging from the medial division of the LHb (LHbM), which also receives axonal input from LDTg. The bidirectional connections between IP and LDTg displayed a lateralized organization, with LDTg inputs to IP being predominantly GABAergic or cholinergic and mainly directed to the contralateral IP. Moreover, we disclosed reciprocal LDTg connections with structures involved in the modulation of hippocampal theta rhythm including MnR, nucleus incertus, and supramammillary nucleus. Our findings indicate that the habenula is linked with LDTg either by direct reciprocal projections from/to LHbM or indirectly via the MHb-IP axis, supporting a functional role of LDTg in the regulation of aversive behaviors, and further characterizing LHb as a master controller of ascending brainstem state-setting modulatory projection systems.

Enhanced biodiesel industry wastewater treatment via a hybrid MBBR combined with advanced oxidation processes: analysis of active microbiota and toxicity removal.

In the present study, a multistage route is proposed for the treatment of biodiesel industry wastewater (BWW) containing around 1000 mg L-1 of total organic carbon (TOC), 3500 mg L-1 of chemical oxygen demand (COD), and 1325 mg L-1 of oil and grease. Initially, BWW aerobic biodegradability was assessed via Zhan-Wellens biodegradability test to confirm the appropriate treatment route. Then, a hybrid moving bed bioreactor (MBBR) system was chosen as the first treatment stage. The hybrid MBBR achieved 69 and 68% removal of COD and TOC removals, respectively, and provided great conditions for biomass growth. The bacterial community present in the hybrid MBBR was investigated by PCR-DGGE and potential biodegraders were identified such as: members of Desulfuromonadales, Nocardioidaceae and Pseudomonadaceae. Since biodegradation in the hybrid MBBR alone was unable to meet quality requirements, advanced oxidation processes, such as Fenton and photo-Fenton, were optimized for application as additional treatment stages. Physicochemical properties and acute toxicity of BWW were analyzed after the multistage routes: hybrid MBBR + Fenton, hybrid MBBR + photo-Fenton and hybrid MBBR + UV-C254nm/H2O2. Hybrid MBBR + Fenton or photo-Fenton showed overall COD removal efficiencies greater than 95% and removed acute toxicity, thus being appropriate integrated routes for the treatment of real BWW. Graphical abstract ᅟ.

Increased rates of photopolymerisation by ternary type II photoinitiator systems in dental resins.

To evaluate the effects of Type I and Type II photoinitiator systems on curing efficiency, degree of conversion (DC) and chemico-physical properties of resin based materials. A comonomer base containing 50%wt 2.2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (bis-GMA) and 50%wt triethyleneglycol dimethacrylate (TEGDMA) was formulated with either 0.5 or 1mol% of Type II camphoroquinone (CQ), Type I monoacylphosphine oxide (MAPO) or bis-acylphosphine oxide (BAPO) photoinitiators. The Type II system was either a binary (1: 2 CQ:amine) or ternary system (1: 2 CQ:amine + 0.5 mol% DPI). Degree and rate of polymerization was measured by Fourier Transform Infrared Spectroscopy (FTIR). Knoop micro-hardness prior to and following ethanol immersion was assessed. Flexural strength and modulus was measured under three-point bend test. Water sorption and solubility was also evaluated. The photoinitiator absorption spectra and the total absorbed energy per unit volume (Eabs) for 0.5mol% photoinitiator in each material was calculated. Despite the reduced total absorbed energy per unit volume for CQ based systems, ternary Type II system significantly improved curing efficiency (P < 0.05) compared to both Type I photoinitiators and degree of conversion compared to MAPO only, whilst exhibiting comparable mechanical and physical properties compared to both Type I based materials at equivalent molar concentrations of photoinitiator (P > 0.05). Ternary Type II systems is an efficient alternative to improve the polymerization of resin materials, promoting similar or even better properties than Type I initiators. DPI can increase the reactivity of CQ systems and promote polymerization rates superior than Type I photoinitiators.

Deep brain stimulation of dorsal and ventral borders of the subthalamic nucleus in patients with Parkinson's disease: a systematic review

Parkinson's disease patients experience motor signs and non-motor symptoms caused by the disease. Deep brain stimulation of the Subthalamic Nucleus (STN) itself or its ventral or dorsal borders is one of the treatment options indicated to treat the refractory symptoms of this disease. However, it is still unknown which edge, when stimulated, generates more beneficial effects for these patients, which is the objective of this systematic review. To answer this question, electronic and manual searches were conducted in five databases and gray literature to identify studies that answered the question in this review. The selection of studies, data extraction, and analysis of the risk of bias of the included studies were performed. In total, seven studies were included in this systematic review. Most studies presented a minimal risk of bias, and their main methodological limitation was related to the sample inclusion criteria. Stimulation of the dorsal or ventral borders of the STN resulted in improved motor signs of Parkinson's disease, with some of the studies tending towards the choice of dorsal border stimulation for better motor effects, while the improvement in non-motor symptoms and inhibitory control was due to stimulation of the ventral border. The findings of this systematic review suggest that the improvement in the motor signs of Parkinson's disease can be brought about by stimulating the dorsal or ventral borders of the subthalamic nucleus, whereas non-motor symptoms such as anxiety improve with stimulation of the ventral border.

Effects of ceramic thickness and curing unit on light transmission through leucite-reinforced material and polymerization of dual-cured luting agent.

This study investigated the influence of ceramic thickness and curing unit on light transmission through leucite-reinforced material and polymerization of a dual-cured resin luting agent. Discs of Empress Esthetic (Ivoclar Vivadent) of 0.7-, 1.4- and 2-mm thickness were prepared. Variolink II (Ivoclar Vivadent) was placed in a 1-mm-thick cylindrical mold, and light-activated through ceramic for 40 s, using QTH or LED units. The samples were divided into dual, light, and chemically-polymerized control groups. Knoop hardness indentations were made on the top and bottom surfaces. Data were subjected to split-plot design three-way ANOVA and Tukey's test (P < 0.05). The light spectrum transmitted through ceramic was obtained using a spectrometer. Samples activated through 1.4-and 2-mm-thick discs showed lower hardness than all others groups, except for the chemical control group. Dual and light-polymerized control samples showed similar hardness to those activated through the 0.7-mm ceramic, whereas chemically polymerized control samples showed similar hardness to those activated through 1.4- and 2-mm ceramics. No significant differences in hardness were detected between the curing units or between the top and bottom layers. No significant alteration in the light spectrum profile was observed for both units, irrespective of the ceramic thickness.

Influence of light-curing unit on the network structure and mechanical properties of model resin cements containing diphenyliodonium compared with a commercial reference.

OBJECTIVE: To evaluate the effects of dyphenyliodonium hexafluorophosphate (DPI) on crosslink density (CLD), flexural strength (FS), and flexural modulus (FM) of a light-cured experimental resin cement compared with a commercial dual-cured cement. MATERIALS AND METHODS: Bis-GMA combined with TEGDMA (50-50%) was used as resin matrix. Silanated barium-aluminum-silica glass was used as inorganic filler. Camphorquinone (CQ) - 1 mol%, 2-(dimethylamino)ethyl methacrylate (DMAEMA) - 2 mol%, and two concentrations of DPI (0 or 0.5 mol%) were used as the photoinitiator system. Two light-curing units (LCUs) were used (a single-peak (Radii-Cal) and a polywave (Bluephase)). The CLD was indirectly assessed in a softening test by Knoop hardness indentation; FS and FM were measured by means of a three-point bending test. RESULTS: DPI positively influenced Knoop hardness when compared with experimental resin without DPI. The flexural strength of experimental cements was lower than that found with Variolink II. The crosslinking density (obtained by reduction of Knoop hardness) of cement with 0.5% DPI was similar to that of dual - cured Variolink II. CONCLUSIONS: DPI showed an improvement in some of the properties tested but was inferior to the commercial dual-cured resin cement. The LCUs had no influence on the flexural strength of the resin cements.