Sealing moderate caries lesions with bioactive glass-ionomer: A split-mouth clinical trial.

Laboratory evidence has shown that 45S5 bioglass can help in dental remineralization, so its incorporation into resin-modified glass ionomer cement (RMGIC) has been studied. This randomized clinical trial aimed to determine the efficacy of RMGIC enriched with 10% 45S5 bioglass (RMGIC/45S5) in preventing the progression of moderate caries lesions. Sixty-six permanent molars with moderate caries lesions, were randomly sealed with RMGIC or RMGIC/45S5. After 1, 3-6 months, patients' oral health, material behavior, and caries evolution were evaluated. Chi-square and Fisher's exact test was employed. After one month, the RMGIC showed higher total retention and better clinical performance compared to RMGIC/45S5, both showed a predominance of sealed teeth or without caries progression. After 6 months, no materials retention, quality and caries progression difference was observed for both materials. Short-term clinical follow-up reveals worse retention and quality of RMGIC/45S5, only after 6 months no clinical/microscopic differences are observed between the materials.

Effect of Bioactive Filler Addition on the Mechanical and Biological Properties of Resin-Modified Glass Ionomer.

The maintenance of affected dentin can promote the greater conservation of tooth structure. The development of materials that have properties capable of reducing the demineralizing potential and/or even helping in dental remineralization is important for conservative dentistry. This study aimed to evaluate, in vitro, the alkalizing potential, fluoride as well as calcium ion release ability, antimicrobial activity, and dentin remineralization properties of resin-modified glass ionomer cement (RMGIC) incorporated with a bioactive filler (niobium phosphate (NbG) and bioglass (45S5)). The study samples were grouped into RMGIC, NbG, and 45S5. The materials' alkalizing potential, ability to release calcium as well as fluoride ions, and antimicrobial properties concerning Streptococcus mutans UA159 biofilms were analyzed. The remineralization potential was evaluated using the Knoop microhardness test, which was performed at different depths. The alkalizing and fluoride release potential was higher for the 45S5 group (p < 0.001) over time. An increase in the microhardness of demineralized dentin was observed in the 45S5 and NbG groups (p < 0.001). No differences in biofilm formation were observed between the bioactive materials, although 45S5 exhibited lower biofilm acidogenicity at different time points (p < 0.001) and greater calcium ion release in the microbial environment. A resin-modified glass ionomer cement enriched with bioactive glasses, particularly 45S5, is a promising alternative for the treatment of demineralized dentin.

A psicologia humanista de Carl Rogers na educação médica: Espaços e desafios / Carl Rogers' humanistic psychology in medical education: Spaces and challenges

A problematização dos lugares, papéis e sentidos da Psicologia nos cursos de Medicina é necessária para que as unidades curriculares ligadas a esse campo de conhecimento aportem à formação dos graduandos o desenvolvimento de saberes, habilidades e competências necessários para a o exercício da prática médica humanizada. Este trabalho discute a adoção da Psicologia Humanista de Carl Rogers como fundamento teórico de disciplinas ou módulos ligados à Psicologia na formação médica. Apresenta as bases dessa vertente e relaciona-as à discussão das metodologias de ensino e da relação professor-aluno no ensino médico. Conclui que a teoria analisada pode constituir orientação para a prática docente e as escolhas curriculares e metodológicas da formação médica, apesar dos limites de sua aplicação de forma generalizada nos cursos de graduação. Indica as atividades voltadas para a capacidade dos estudantes de identificar, expressar e refletir sobre seus próprios sentimentos em relação a diferentes situações vivenciadas durante a graduação em Medicina são as mais coerentes com a proposta da psicologia humanista de Carl Rogers.

The problematization of places, roles and meanings of psychology in medical courses is necessary so that the curricular units linked to this field of knowledge contribute to the development of learnings, skills and competences necessary for humanized medical practice. This essay presents the theoretical foundations of Carl Rogers' Humanistic Psychology and advocates its use in the training of future doctors in educational practices consistent with the proposal of Person-Centered Therapy. It concludes that this theory may constitute guidance for theaching practice and curricular choices, despite the limits of general application in medical courses. The activities focused on the student's hability to identifie, express and reflect on their own feelings are the most consistent whit the theoretical foundations of Carl Rogers' Humanistic Psychology.

Differential Diagnosis and Treatment Proposal for Acute Endodontic Infection.

The objective of this study was to describe the main lesions that simulate clinically and propose a treatment protocol for acute endodontic infection. Signs and clinical symptoms of periodontal abscess, gingival abscess, odontoma, herpes simplex, pericoronitis, acute pulpitis and necrotizing ulcerative gingivitis/periodontitis (NUG/NUP) were described and compared with acute endodontic infections. A treatment protocol was described by optimizing the procedures in access cavity, microbial decontamination and detoxification of the root canal, apical debridement, intracanal and systemic medication and surgical drainage procedures. The convenience of the use of 5.25% sodium hypochlorite, root canal instrumentation using a crown-down technique, intracanal medication with 2% chlorhexidine or triple antibiotic paste and the convenience of the use of antibiotics, analgesics, and surgical drainage to solve cases of acute dentoalveolar abscess was discussed.

Musculoskeletal disorders and psychosocial risk factors among workers of the aircraft maintenance industry.

During the recent decades Brazil has experienced an exponential growth in the aviation sector resulting in an increasing workforce. The aircraft maintenance industry stands out, where the workers have to handle different kind of objects. The aim of this study was to evaluate psychosocial indicators as well as musculoskeletal symptoms and disorders among aircraft maintenance workers. One hundred and one employees were evaluated (32.69 ± 8.25 yr, 79.8 ± 13.4 kg, and 1.75 ± 0.07 m). Musculoskeletal symptoms and disorders were assessed through the Nordic Musculoskeletal Questionnaire (NMQ) and a standardized physical examination. The Job Content Questionnaire (JCQ) and the Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial indicators. Results of the NMQ indicate the lower back as the most affected body region. On the other hand, the physical examination has shown clinical diagnosis of shoulder disorders. Neck, upper back and ankle/foot were also reported as painful sites. Most of workers have active work-demand profile and high work engagement levels. We suggest that musculoskeletal symptoms may be related to high biomechanical demand of the tasks performed by workers, what must be further investigated.

Not telling the truth in the patient-physician relationship.

The presence of truth and honesty is a permanent demand, and becomes vital the more committed and intimate a relationship is. Medical practice is relevant to this discussion when one questions whether or not a physician should always tell their patient the truth in the face of a progressive or potentially fatal disease, regarding their diagnosis, outcome, therapy and evolution of the specific disease. From this discussion we aim, with the present report, to look at the truth applicable to the patient-physician relationship, and its ethical and moral implications; and also to look at where the Brazilian Code of Medical Ethics (BCME) and the medical literature stand regarding this issue. One concludes that there are only two moments not to tell a patient the truth: when the patient does not want to be informed, and when the truth could be iatrogenic. The question now is, when would the truth be iatrogenic? Physicians, in our opinion, would not be able to judge solitarily when the truth might be deleterious to their patient. Alternatively, we proposed the appointment of a multidisciplinary commission to help the doctor with such a decision.