Effect of Salivary Flow on Bleached Enamel Roughness and Mineral Content: an In Situ and In Vitro Study.

This study aimed to evaluate the effect of human saliva in vitro and salivary flow in situ on the roughness and mineral content of bleached enamel. Dental specimens were divided into five groups (n=15): not bleached (NB); bleached (35% hydrogen peroxide) and exposed to distilled water (DW); human saliva in vitro (IV); normal salivary flow in situ (NSF); and low salivary flow (LSF) in situ. Enamel roughness (Ra, Rz) and calcium/phosphorus contents were evaluated with laser profilometry and energy-dispersive spectroscopy, respectively, at baseline (T1), after bleaching (T2), and after seven days (T3). Salivary pH and buffer capacity were evaluated with colorimetric strips and salivary calcium and phosphorus with absorbance spectrophotometry. Data were analyzed with non-parametric tests and linear regression (α=0.05). After contact with saliva, Ra and Rz of LSF=DW>IV=NSF=NB was found. For DW and LSF, the roughness of T1

Linear and volumetric gain after vertical bone augmentation in the posterior mandible using an autologous cortical tenting method.

This study was performed to evaluate the linear and volumetric effects of a technique for reconstruction of the posterior atrophic mandible, including the final bone gain of the graft, by three-dimensional assessment. Thirteen individuals were recruited into the study and submitted to a total of 15 mandibular autogenous bone block surgeries. Cone beam computed tomography images were obtained at three different times. Bone graft length and thickness, and the volume, height, and width of the graft were measured. Data were compared statistically among the time points using the Friedman test, and cluster analysis was performed to identify the association between the study variables and the resorption rate (α = 0.05). Linear analysis of the width and height of the recipient area at the different time points revealed a statistically significant difference. The final average increase in height was 1.6 mm; all subjects showed an average volume gain of 3.412mm3, and 77% of the subjects showed an average graft resorption of 0.688mm3 construction of three-dimensional vertical defects of the posterior mandible resulted in good healing with minimal complications and minimal bone graft resorption, favouring vertical bone gain.

Conservative Treatment of a Complicated Crown-root Fracture Using Adhesive Fragment Reattachment and Composite Resin Restoration: Two Year Follow-up.

Crown-root fracture is one of the most challenging fracture types in the dental traumatology literature. Traumatized anterior teeth require quick functional and esthetic repair. In the case of a complex crown fracture of the maxillary left central incisor, requiring endodontic treatment, a fiber-reinforced post was used to create a central support stump to restore the dental morphology. This report describes the clinical procedures involved in the treatment. After two years of follow-up, the clinical and radiographic findings demonstrated that the adopted clinical protocol was successful and yielded healthy periodontal tissues with no signs of periradicular pathology.

Mini Fiberglass Post for Ankylosed Tooth Reconstruction: A Clinical Technique.

It was possible to restore the shape and function of a severely ankylosed tooth by fabricating a ceramic crown for placement on a resin reconstruction supported by mini fiberglass posts. By increasing the retention of the morphological reconstruction for the future support of indirect restorations, cementable intradentinal fiberglass posts enhance the longevity of these restorations. Ultimately, all proposals that seek to improve the long-term prognosis of restorations on ankylosed teeth, especially severely impacted ones, are of extreme clinical relevance.

Imunogenicidade da proteína M recombinante de Streptococcus equi subsp. equi coadministrada com um adjuvante molecular / Immunogenicity of recombinant M protein of Streptococcus equi subsp. equi co administered with a molecular adjuvant

The strangles is an infectious disease that affects horses from all ages and causes important economic losses in the equine-related business. The aim of this work was to evaluate the immunogenicity of the recombinant M protein from Streptococcus equi (rSeM) co-administered with the recombinant heat-labile enterotoxin B subunit from Escherichia coli (rLTB) in mice and horses. A total of 72 female Balb-c mice were divided into eight groups and 18 horses were divided into six groups. The animals were inoculated by intramuscular (IM) or intranasal (IN) routes with different treatments of rSeM, rLTB and/or Al(OH)3. The results obtained in both species, independent of administration routes, demonstrated that rSeM + rLTB had higher levels of specific serum immunoglobulins, however, in mucosal immunity the increase was not identified. Thus, the use of rSeM as vaccine antigen and rLTB as adjuvant can be a potential tool in the control of equine strangles.(AU)

Lesion Activity Assessment (LAA) in Conjunction With International Caries Detection and Assessment System (ICDAS) for Occlusal Caries Diagnosis in Permanent Teeth.

OBJECTIVE: The aim of this study was to investigate the clinical performance and to validate the Lesion Activity Assessment (LAA) in conjunction with the International Caries Detection and Assessment System (ICDAS) for occlusal caries diagnosis in permanent teeth. METHODS: Patients with erupted or partially erupted third molars were recruited from the surgery clinic of the School of Dentistry of the Universidade Federal de Minas Gerais, Brazil. A calibrated examiner evaluated 49 teeth using the ICDAS-LAA criteria. The histologic criterion proposed by Ekstrand and others was used to validate severity at the thresholds D1 (outer half of the enamel), D2 (inner half of the enamel and outer third of the dentin), and D3 (inner or middle third of the dentin). Lesion activity was validated using 0.1% methyl red solution. RESULTS: The method demonstrated good reliability (weighted kappa for severity=0.60; unweighted kappa for activity=0.61). The ICDAS presented a higher performance for lesion detection (area under the receiver operating characteristic curve [Az]=0.79) using the threshold D3. At the thresholds D1 and D2, the results for Az were 0.57 and 0.74, respectively. Regarding the ICDAS-LAA, Az = 0.59. CONCLUSIONS: Clinical protocols can use ICDAS for the severity diagnosis of occlusal caries, but the LAA performance was poor.

Degree of conversion and hardness of a silorane-based composite resin: effect of light-curing unit and depth.

PURPOSE: To investigate the effect of different light-curing units and depths on the degree of conversion (DC) through Fourier transform infrared spectroscopy (FTIR) and Knoop Hardness Number (KHN) of a silorane-based composite resin (Filtek LS, 3M ESPE, St Paul, MN, USA) (LS). MATERIALS AND METHODS: LS specimens mounted in a particular designed matrix were photoactivated by three light-cure units (LCUs) at depths of 2, 3, 4, and 5 mm. The DC was determined in a FTIR spectrometer with an attenuated total reflectance accessory. The KHN was measured in an automatic microhardness tester. The results were analyzed using the Friedman and Spearman statistical tests (α=0.05). RESULTS: There was no effect of LCUs on the DC (p=0.472) or KHN (p=0.174) for all of the studied depths. The highest DC and KHN means were found at 2-mm depth, which were not statistically different from 3-mm depth, but were higher than 4-mm and 5-mm depths (p=0.007). Spearman analysis found a positive linear correlation between the variables KHN and DC (r=0.858, p<0.000). CONCLUSIONS: The LCUs' effect was not verified. Values of DC and KHN for LS decreased with increasing depth. The highest values for both DC and KHN were obtained at depths of 2-3 mm.

The effect of light-curing access and different resin cements on apical bond strength of fiber posts.

PURPOSE: This study evaluated the effect of light-curing access on the bond strength of fiber glass posts to the apical area of bovine roots using self-adhesive cement or dual-cured cement with an etch-and-rinse adhesive system. MATERIALS AND METHODS: The root canals of 60 bovine teeth were endodontically treated and filled. A 15-mm-length post space was prepared and roots were randomly divided into three groups, simulating the levels of light-curing access: coronal (C), with 15-mm post space; middle (M), in which the coronal thirds of roots were cut out, leaving a 10-mm post space; and apical (A), in which the coronal and middle thirds of roots were cut out, leaving a 5-mm post space. Fiber glass posts (Reforpost # 3, Angelus) were cemented with RelyX U100 (3M ESPE) or RelyX ARC/Scotchbond Multi Purpose Plus (SBMP) (3M ESPE) (n=10) and light-cured. After 24 hours, the apical thirds of roots were sectioned perpendicularly to the long axis and submitted to a push-out test (0.5 mm/min, 200 N). The Kruskal-Wallis test compared the three levels of light-curing access, and the Mann-Whitney test compared the cements. RESULTS: The bond strength was significantly higher in the groups C (p=0.028) and M (p=0.016) when U100 was used, whereas it was similar for both cements in group A. The bond strengths of posts cemented with ARC/SBMP were significantly higher in group A compared to group C (p=0.031). CONCLUSIONS: The type of cement used and the light-curing access level influenced the bond strength between glass fiber posts and root canals. The bond strength of the RelyX ARC/SBMP cement proved to be more dependent on photoactivation than was the RelyX U100 cement. The light-curing access level did not influence the apical bond strength of RelyX U100.

Repair of dimethacrylate-based composite restorations by a silorane-based composite: a one-year randomized clinical trial.

PURPOSE: To investigate clinical performance of a low-shrinkage silorane-based composite resin when used for repairing conventional dimethacrylate-based composite restorations. BACKGROUND: Despite the continued development of resin-based materials, polymerization shrinkage and shrinkage stress still require improvement. A silorane-based monomer system was recently made available for dental restorations. This report refers to the use of this material for making repairs and evaluates the clinical performance of this alternative treatment. MATERIALS AND METHODS: One operator repaired the defective dimethacrylate-based composite resin restorations that were randomly assigned to one of two treatment groups: control (n=50) repair with Adper SE Plus (3M/ESPE) and Filtek P60 Posterior Restorative (3M/ESPE), and test (n=50) repair with P90 System Adhesive Self-Etch Primer and Bond (3M/ESPE) and Filtek P90 Low Shrink Posterior Restorative (3M/ESPE). After one week, restorations were finished and polished. Two calibrated examiners (Kw≥0.78) evaluated all repaired restorations, blindly and independently, at baseline and one year. The parameters examined were marginal adaptation, anatomic form, surface roughness, marginal discoloration, postoperative sensitivity, and secondary caries. The restorations were classified as Alpha, Bravo, or Charlie, according to modified US Public Health Service criteria. Mann-Whitney and Wilcoxon tests were used to compare the groups. RESULTS: Of the 100 restorations repaired in this study, 93 were reexamined at baseline. Dropout from baseline to one-year recall was 11%. No statistically significant differences were found between the materials for all clinical criteria, at baseline or at one-year recall (p>0.05). No statistically significant differences were registered (p>0.05) for each material when compared for all clinical criteria at baseline and at one-year recall. CONCLUSIONS: The hypothesis tested in this randomized controlled clinical trial was accepted. After the one-year evaluations, the silorane-based composite exhibited a similar performance compared with dimethacrylate-based composite when used to make repairs.

Dimensional stability of elastomeric impression materials: a critical review of the literature.

The aim of the present paper was to review the literature concerning the dimensional stability of dental elastomeric impression materials, to support recommendations to control the variables that influence the accuracy of these materials. An electronic search of the Scopus and PubMed databases was performed in November 2010. Articles were selected according to the following inclusion criteria: investigation of the dimensional stability of dental elastomers, an experimental study, sample size reported, laboratory tests described, and published in an English language peer-reviewed journal. The search resulted in 47 articles published between 1958 and 2008; of these, 24 were selected for inclusion in the present study. Great variability was discovered in the experimental methodologies used, such as different working times, temperatures and storage mediums for the impressions, impression techniques, material thicknesses, tray types, and methods of evaluation. Despite the lack of standardization among the studies, this review supports the following recommendations to control the dimensional stability: impressions should be stored at temperatures between 21 +/- 2 degrees C; polyether impressions should be stored in an environment with a relative humidity below 50%; time until pouring has been settled for each elastomer material.

[Effect of supragingival plaque control on subgingival microflora and periodontal tissues]. / Efeito do controle da placa supragengival sobre a microflora subgengival e tecidos periodontais.

The aim of this study was to investigate, clinically and microbiologically, forty-four sites in 11 patients presenting with generalized chronic periodontitis. Plaque Index (PI), Gingival Index (GI), Probing Bleeding (PB), Probing Depth (PD) and Insertion Level (IL) were registered. Samples of subgingival plaque were collected in the same sites for cultivation of anaerobic bacteria and determination of microbiological morphotypes using dark field microscopy. Clinical and microbiological data were recorded on the baseline and 4 weeks after the adoption of a program to control supragingival plaque and calculus. The microbiological analysis categorized the degree of development as follows: 0--not detected, 1--scarce, 2--moderate and 3--abundant. The clinical results at the baseline and on the 28th day were, respectively: PI--1.73 +/- 0.10 and 0.30 +/- 0.08; GI--1.73 +/- 0.08 and 1.41 +/- 0.08; PB--0.91 +/- 0.04 and 0.59 +/- 0.07; PD--6.43 +/- 0.20 and 5.77 +/- 0.25; and IL--6.86 +/- 0.32 and 6.52 +/- 0.34. There was significant decrease in PI, GI, PB and PD. However, the difference in IL was not significant. The relative proportions of the microbial morphotypes observed under dark field microscopy at the baseline and on the 28th day were, respectively: coccoid cells--21.16 +/- 3.77 and 36.00 +/- 4.66; mobile bacillus--44.86 +/- 2.65 and 39.50 +/- 2.64; and total treponemes--24.66 +/- 3.08 and 19.25 +/- 2.75. The cultures presented, at the baseline and on the 28th day, respectively: Prevotella intermedia/nigrescens (Pi/n)--1.36 +/- 0.18 and 0.43 +/- 0.11; Porphyromonas gingivalis--0.48 +/- 0.16 and 0.32 +/- 0.13; Actinobacillus actinomycetemcomitans--0.23 +/- 0.09 and 0.23 +/- 0.10; Fusobacterium nucleatum--0.32 +/- 0.14 and 0.41 +/- 0.13; and peptostreptococci--0.82 +/- 0.19 and 0.54 +/- 0.16. There was a significant increase in the number of coccoid cells and a decrease in the number of treponemes and Pi/n.

Doenca mental e processos migratorios. / Mental disease and migratory process

Estudo preliminar realizado por uma equipe multidisciplinar do Setor de Psiquiatria Social da Escola Paulista de Medicina, com base na observacao participante de um grupo de familias migrantes nordestinas com ocorrencia de quadros psiquiatricos. Atraves de analise de alguns casos foi possivel supor que certas condutas, alem de "desviantes", seriam tambem respostas adequadas a situacoes concretas.Levanta-se a hipotese de que e preciso analisar as perturbacoes psiquicas desta populacao no contexto das correntes migratorias internas brasileiras, vinculando o que, na maioria das vezes, e visto exclusivamente do ponto de vista do individuo com processos sociais e culturais mais amplos