Primary Antiphospholipid Syndrome with Livedo Reticularis is Linked to Female Sex and Stroke and Negatively Associated with Thyroid Disease.

AIMS: To study the clinical and laboratory findings between patients with primary Antiphospholipid Syndrome (pAPS) with and without LR. BACKGROUND: Livedo Reticularis (LR) is a common manifestation of Antiphospholipid Syndrome (APS). Although no previous study evaluated patients with and without LR. METHODS: A transversal study including 66 pAPS patients was performed. Demographical, anthropometric, medication use, antiphospholipid antibodies profile data were evaluated, and LR's clinical and laboratory features. Patients were subdivided into one of two groups: pAPS with LR and pAPS without LR. RESULTS: Both groups were alike concerning demographics and anthropometrics. Interestingly, the frequency of stroke (28.5 vs. 7.5%, p=0.04), as well as of Sneddon's syndrome (100 vs. 30.0%, p<0.0001), were higher in pAPS with LR than the other group. Conversely, patients in the pAPS without LR group had more thyroidopathy than those in the pAPS with LR group (80% vs. 50% %, p=0.03). CONCLUSION: Patients with pAPS and LR have more stroke and seem to be protected from thyroidopathy. Careful follow-up of these patients is therefore advised.

Can surface protection prevent the loss of hardness on dentin and composite resin surfaces exposed to erosive challenges? / ¿Puede la protección de la superficie prevenir la pérdida de dureza en las superficies de dentina y resina compuesta expuestas a erosión?

Objective: This study investigated the effect of endogenous erosion on the microhardness of dentine and a nanofilled composite resin. Procedures for preventing erosion were also studied. Materials and Methods: 90 bovine dentine specimens were divided into three groups in accordance with the method for preventing: negative control, topical application of fluoride and resin-modified glass ionomer varnish. 120 composite resin specimens were distributed into four groups, which also included a resin sealant, among the preventive procedures. Specimens were then randomly divided into three sub-groups according to the exposure to simulate gastric acid solution and subsequent remineralization: negative control, 9 and 18 cycles. Surface analysis was carried out by measuring the Knoop hardness. The data obtained were statistically analyzed using 2-way ANOVA and Tukey test. Result: The mean hardness of dentine and of the composite specimens resin exhibited lower hardness after 18 cycles. However, the resin-modified glass ionomer varnish resulted in greater values compared to the other preventive procedures. Conclusion: A resin-modified glass ionomer varnish seems to be a promising method for minimizing the damage caused by endogenous acid, but its protection can be reduced depending on the intensity of the erosive challenge.

Objetivo: Este estudio investigó el efecto de la erosión endógena sobre la microdureza de la dentina y una resina compuesta de nanorrelleno. También se estudiaron los procedimientos para prevenir la erosión. Materiales and Métodos:90 muestras de dentina bovina se dividieron en tres grupos de acuerdo con el método para prevenir: control negativo, aplicación tópica de fluoruro y barniz de ionómero de vidrio modificado con resina. Se distribuyeron 120 muestras de resina compuesta en cuatro grupos, que también incluían un sellador de resina, entre los procedimientos preventivos. Las muestras se dividieron al azar en tres subgrupos de acuerdo con la exposición para simular la solución de ácido gástrico y la remineralización posterior: control negativo, 9 y 18 ciclos. El análisis de la superficie se realizó midiendo la dureza Knoop. Los datos obtenidos se analizaron estadísticamente mediante ANOVA de 2 vías y prueba de Tukey. Resultados: La dureza media de la dentina y de la resina de muestras compuestas exhibió una dureza más baja después de 18 ciclos. Sin embargo, el barniz de ionómero de vidrio modificado con resina resultó en valores mayores en comparación con los otros procedimientos preventivos. Conclusión: Un barniz de ionómero de vidrio modificado con resina parece ser un método prometedor para minimizar el daño causado por el ácido endógeno, pero su protección puede reducirse dependiendo de la intensidad del desafío erosivo.

Efficacy of Protaper Next Compared to Wave One in Intraradicular Dentin Wear in Flattened Root Canals

Objective: To compare the degree of intraradicular wear in flat channels with mechanized instrumentation. Material and Methods: A total of 48 dental units were selected of central and lateral lower incisors, divided into two groups of 24 units each according to the type of instrumentation system: G1 - Protaper Next Group; G2 -Wave One Group. Teeth were exposed to room temperature for seven days for drying. After this exposure, the initial weighing (P0) of the roots in analytical balance was carried out. After instrumentation, the specimens were again exposed at room temperature for another seven days and then the second weighing (P1) was performed. The difference found between the values attributed to the two weighings of each specimen represented the wear of the dentin walls in order to compare the degree of wear between the study groups. Statistical tests were performed for analysis of variance (ANOVA), using a significance level of 5%. Results: Comparison between rotational and reciprocating systems showed that reciprocating files significantly promoted (p<0.05) increased intraradicular dentin wear in relation to rotating files. Conclusion: The use of Wave One Reciprocating Files was considered more effective in the wear of flattened root canals, thus presenting better cleaning ability in the treatment of inflammatory and/or infectious canal processes.

Evaluation of the safety and satisfaction of rheumatic patients with accelerated infliximab infusion.

INTRODUCTION: Infliximab infusion generally occurs in 2-4 h. Recent studies have suggested the possibility of accelerated infusion (1 h) of this drug. OBJECTIVE: To evaluate the safety of accelerated infliximab infusion in patients with rheumatic diseases. In addition, patient satisfaction was also assessed. METHODS: A prospective, single-center, non-randomized study with 34 patients with rheumatic diseases was conducted from July to November 2016. Patients with the following were excluded: history of allergic reaction to biologics, asthma or severe atopy. All patients previously received a 2- to 3-h infliximab infusion. The infusion rate was accelerated to 1 h, and premedication was excluded. The infusion was monitored in all patients. RESULTS: A total of 34 patients were included in the study [rheumatoid arthritis (n = 16), ankylosing spondylitis (n = 15), psoriatic arthritis (n = 2) and enteropathic arthropathy (n = 1)], with an average age of 48.7 ± 18.6 years; 55.5% of the patients were female, and 29.4% were white. The duration of disease was 9.5 ± 9.2 years, and the duration of infliximab use was 38.9 ± 27.6 months, with a mean dose per infusion of 414.2 ± 158.1 (range, 200-800) mg. The mean infliximab infusion time prior to the study was 2.2 ± 0.4 h. A total of 6 (17.6%) patients received premedication. The premedication was suspended. There were no adverse effects during or after infusion. Ninety-seven percent of the patients and 100% of the health workers were satisfied with the accelerated infusion. CONCLUSION: Our data support the safe use of accelerated infliximab infusion in rheumatic patients, with high satisfaction among patients and health workers.

Comparison of fit accuracy between Procera® custom abutments and three implant systems.

BACKGROUND: Although increase of misfit has been reported when associating implant and abutment from different manufacturers, Procera custom abutment has been universally used in clinical practice. PURPOSE: The purpose of this investigation was to compare the vertical gap of zirconia Procera® abutment associated with implants from the same manufacturer (Procera manufacturer) and two other implant systems. MATERIALS AND METHODS: Twenty-four zirconia Procera abutments were produced using computer-assisted design and manufacture and paired with (a) eight MK III, RP 4.1 × 10 mm implants (Nobel Biocare™, Göteborg, Sweden) - GNB group (Nobel Biocare group); (b) eight Try on, 4.1 × 10 mm implants (Sistema de Implantes, São Paulo, Brazil) - ES group (SIN experimental group) ; and (c) eight Master screw, 4.1 × 10 mm implants (Conexão® Sistema de Prótese, São Paulo, Brazil) - EC group (Conexão experimental group). A comparison of the vertical misfit at the implant-abutment interface was taken at six measuring sites on each sample using scanning electron microscopy with a magnification of 408×. One-way analysis of variance was used to test for differences, and Tukey's test was used for pair-wise comparison of groups (α = 0.05). RESULTS: Significant differences relative to average misfit were found when Procera abutments were associated with other implant manufacturers. The ES group and EC group did not differ significantly, but both demonstrated significantly larger average misfit than the GNB group (p = .001). The average misfit was 5.7 µm ± 0.39, 9.53 µm ± 0.52, and 10.62 µm ± 2.16, respectively, for groups GNB, ES, and EC. CONCLUSION: The association of Procera zirconia abutment with other implant systems different from its manufacturer demonstrated significant alteration of vertical misfit at implant-abutment interface.

Calcium release rates from tooth enamel treated with dentifrices containing whitening agents and abrasives.

Tooth whitening agents containing hydrogen peroxide and carbamide peroxide are used frequently in esthetic dental procedures. However, lesions on the enamel surface have been attributed to the action of these products. Using conventional procedures for separating and isolating biological structures, powdered enamel was obtained and treated with hydrogen peroxide, carbamide peroxide, and sodium bicarbonate, ingredients typically found in dentifrices. The enamel was exposed to different pH levels, and atomic emission spectrometry was used to determine calcium release rates. As the pH level increased, the rate of calcium release from enamel treated with dentifrices containing whitening agents decreased. Carbamide peroxide produced the lowest amount of decalcification, while sodium bicarbonate produced the highest release rates at all pH levels.

Effect of surface sealant and repolishing procedures on the color of composite resin exposed to cigarette smoke.

This study evaluated the effect of cigarette smoke on the color of composite resins, with and without the application of a surface sealant and before and after the restorative material was repolished. Twenty composite resin specimens were divided into two groups (n = 10); one of which received a surface sealant. Both groups were exposed daily to the smoke of 20 cigarettes. Color analyses were performed using a spectrophotometer at different intervals: prior to cigarette smoke exposure (baseline), 21 days after cigarette smoke exposure, and after the specimens were repolished using aluminum oxide discs. Cigarette smoke caused a decrease in lightness (L*), especially in samples that received the sealant (p = 0.014). At 21 days, there was an increase in yellow pigment for both groups, with higher values (p = 0.00001) and predominant red pigmentation in the samples that received sealant. An increase in lightness and a decrease in yellow pigments (p < 0.05) were reported in both groups after repolishing. Cigarette smoke significantly altered the color of the composite resin (DeltaE > or = 10.34), especially in the specimens that received the sealant. In this study, the sealant tested intensified cigarette staining, and although repolishing decreased surface pigmentation, it was unable to restore the original color of the composite resin.

Efficacy of 35% hydrogen peroxide on human enamel: in vitro evaluation in different tooth areas.

This study aimed to assess the efficacy of a 35% hydrogen peroxide--based gel without activation in vitro on three areas of the tooth surface. Vestibular faces of human premolar teeth were darkened, followed by two whitenings at 7-day intervals. The efficacy of whitening was determined in the cervical third, medium third and incisal third of the tooth surface with an Easyshade-Vita spectrophotometer based on the CIELab system. The L, a, b parameters were determined for each third by the identification of high luminosity and hues tending to green and yellow; pigmentation luminosity was then reduced, and the parameters a and b became reddish and yellowish, respectively. Seven days after the first whitening, there were significant improvements in L and a values. Seven days after the second whitening, the three parameters returned to values close to the initial values; the b parameter was most strongly correlated with whitening efficacy. DE values revealed a visually perceptible difference. There was a satisfactory removal of pigmentation after both whitenings, while the lack of uniformity among the tooth-surface thirds after the first session justified the performance of two whitening procedures. With regard to each third, DE indicated a visibly perceptible difference, although L, a and b values showed no statistically significant differences.