Genotypic and morphological identification of opportunistic microorganisms in triple-syringe tubing from dental units.

BACKGROUND: In Mexico and around the world, water in dental units, including triple syringes, comes from municipal chlorinated water mains. The microbial contamination of dental unit water systems constitutes a risk factor for opportunistic infections. OBJECTIVES: The present work aimed to identify the bacteria present in the triple-syringe water lines of dental units at a dental school of a public university in Mexico, with a hypothesis that opportunistic bacteria of importance to human health would be found. MATERIAL AND METHODS: A cross-sectional study was carried-out. A total of 100 samples of triple-syringe tubing from dental units operated by a dental school of a public university in Mexico were analyzed before and after their use in dental practice. Bacterial biofilm was cultured and isolated from the tubing, using standard microbiological methods, and then the species present were identified through 16S rRNA gene sequencing. The characterization of the biofilm was performed by means of scanning electron microscopy (SEM). RESULTS: Bacterial growth was observed in 20% of the non-disinfected and 10% of the disinfected samples, with 11 strains isolated. Six genera and 11 bacterial species were genetically identified. Coagulasenegative staphylococci (CoNS), considered opportunistic human pathogens, were among the most critical microorganisms. Scanning electron microscopy revealed a thick polymeric matrix with multiple bacterial aggregates. CONCLUSIONS: Opportunistic bacteria from human skin and mucous membranes were detected. Under normal conditions, these bacteria are incapable of causing disease, but are potentially harmful to immunosuppressed patients.

Avaliação da precisão de localização foraminal de um motor endodôntico integrado em diferentes velocidades de rotação / Evaluation of foraminal location accuracy of an integrated endodontic motor employed with different rotational speeds

Objetivo: avaliar a precisão do controle do limite apical de instrumentação do motor endodôntico SENSORY, acionado em três velocidades de rotação (300, 600 e 900 RPM) e função de parada automática apical (Auto Apical Stop - AAS). Material e métodos: sessenta pré-molares inferiores humanos unirradiculados tiveram seus acessos realizados e diâmetro foraminal padronizado em 300 µm. Os dentes foram aleatoriamente divididos em três grupos (n=20) e tiveram seus canais preparados instrumento Logic 30/05, acionado na velocidade predefinida e função AAS ajustada para a marca 0,0. Os instrumentos foram medidos em paquímetro digital e o comprimento real do canal foi aferido pelo método visual direto sob magnificação. Resultados: os valores absolutos dos erros médios e de precisão (±0,5 mm), obtidos foram respectivamente: 0,21 mm e 95% (300 RPM), 0,26 mm e 95% (600 RPM), 0,20 mm e 95% (900 RPM). Não houve diferença significativa entre os grupos (P>0,05). Conclusão: nas condições deste estudo, o uso da função de parada automática forneceu um controle adequado e preciso do limite apical durante a modelagem endodôntica em todas as velocidades testadas.

Objective: to evaluate the accuracy of the control of the apical limit of instrumentation of the SENSORY endodontic motor, activated at three rotation speeds (300, 600 and 900 RPM) and apical automatic stop function (Auto Apical Stop - AAS). Material and methods: Sixty single-rooted human mandibular premolars had their access performed and the foraminal diameter was standardized at 300 µm. The teeth were randomly divided into three groups (n=20) and had their canals prepared with a Logic 30/05 instrument, activated at the predefined speed and the AAS function set to the 0.0 mark. The instruments were measured using a digital caliper and the actual canal length was measured using the direct visual method under magnification. Results: the absolute values of mean and precision errors (±0.5 mm) obtained were respectively: 0.21 mm and 95% (300 RPM), 0.26 mm and 95% (600 RPM), 0.20 mm and 95% (900 RPM). There was no significant difference between groups (P>0.05). Conclusion: Under the conditions of this study, the use of the automatic stop function provided adequate and accurate control of the apical limit during endodontic shaping at all speeds tested.

Accuracy of Working Length Determination - Electronic Apex Locator Versus Cone Beam Computed Tomography

ABSTRACT Objective: To compare the accuracy of working length determination between cone beam computed tomography (CBCT) and electronic apex locator by measuring the actual working length of teeth. Material and Methods: A total of 150 single-rooted tooth assessed by radiograph undergoing root canal therapy were selected. The process was repeated to obtain a buccolingual and mesiodistal section of all teeth. The measurement line was considered from the reference occlusal plane following the center of the canal to the terminus. All information regarding the accuracy of cone-beam computed tomography and apex locator was noted in a pre-designed proforma. Results: CBCT consistently demonstrated high accuracy across all tooth types in both jaws. The electronic apex locator exhibited varying precision, with greater accuracy observed in the mandible. Statistical analyses revealed significant differences in electronic apex locator accuracy among tooth types in the maxilla (p=0.042), emphasizing the importance of specific clinical considerations. Conclusion: Cone beam computed tomography emerges as a reliable diagnostic tool for accurate working length determination, especially in complex cases, while the electronic apex locator remains valuable with careful consideration of potential variations in accuracy. An individualized approach, considering tooth type, jaw location, and clinical context, is crucial for precise working length determination in endodontic practice.

La odontología verde / Green dentistry

El propósito del presente trabajo está orientado a generar una reflexión entre el gremio odontológico profesional y los estudiantes de las licenciaturas en Odontología respecto a la contaminación global que estamos generando y a la crítica situación del planeta, así como sus consecuencias ambientales y climatológicas, sobre lo importante que es educar bajo la perspectiva de una Odontología Verde y Sostenible a través de la ambientalización curricular en las escuelas y facultades de Odontología para generar un tipo de cultura y conciencia proambiental. De igual forma para señalar lo sencillo que es ambientalizar agradable y relajantemente nuestro entorno educativo y laboral, así como realizar algunas prácticas odontológicas ecológicas y ambientales en la práctica privada que cuestan poco o nada y que, por el contrario, el gran efecto positivo que éstas tendrán en el medio ambiente y la reducción de los niveles de contaminación actuales. Si realmente logramos generar una nueva cultura y conciencia que se preocupe por el medio ambiente en el campo de la Odontología, los resultados para todos se verán reflejados en un mejor ambiente social, educativo de trabajo y de salud (AU)

The purpose of this work is aimed at generating a reflection between the professional dental guild and the students of the Bachelor's Degrees in Dentistry regarding the global pollution that we are generating and the critical situation of the planet and its environmental and climatological consequences, on how important it is educate under the perspective of a Green and Sustainable Dentistry through the greening of the curriculum in the Schools and Faculties of Dentistry to generate a type of culture and pro-environmental awareness. Likewise, point out how simple it is to pleasantly and relaxingly green our educational and work environment, as well as perform some ecological and environment, as well perform some ecological and environment, dental practices in private practice that cost little or nothing and that, on the contrary, the great positive effect that these will have on the environment and the reduction of current pollution levels. If we truly manage to generate a new culture and awareness that cares about the environment in the field of Dentistry, the results for all will be reflected in a better social, educational, work and health environment (AU)

Desinfección y esterilización en odontología frente al COVID-19 / Disinfection and sterilization in dentistry against COVID-19 / Desinfecção e esterilização em odontologia contra a COVID-19

A partir de la declaración de la Organización Mundial de la Salud del comienzo de la pandemia COVID-19 causada por el virus SARS-CoV-2 en marzo de 2020, los profesionales de la salud se vieron expuestos a esta enfermedad altamente contagiosa y potencialmente mortal que generó múltiples desafíos a toda la comunidad científica. Provocando cambios de paradigmas en la atención de los pacientes y en el uso de las barreras de protección personal. A nivel mundial se crearon múltiples protocolos para la atención odontológica a medida que se iba desarrollando e investigando el comportamiento del virus. Esta revisión bibliográfica resume las indicaciones y recomendaciones basadas en las evidencias disponibles para disminuir las posibilidades de contaminación ante la exposición a este virus, incluyendo medidas a utilizar desde el ingreso del paciente, los métodos de protección personal, la descontaminación y esterilización del material, así como también la desinfección del área de trabajo. Aunque se ha hecho un gran esfuerzo por mejorar los procesos de bioseguridad a nivel científico tecnológico, hay evidencias de que el factor humano sigue siendo el eslabón más débil de esta cadena.

Since the declaration by the World Health Organization of the beginning of the COVID-19 pandemic caused by the SARS-CoV-2 virus in March 2020, health professionals were exposed to this highly contagious and potentially fatal disease that generated multiple challenges to the entire scientific community. It caused paradigm shifts in patient care and in the use of personal protective barriers. Multiple protocols for dental care were created worldwide as the behavior of the virus was developed and investigated. This bibliographic review summarizes the indications and recommendations based on the available evidence to reduce the possibilities of contamination when exposed to this virus, including measures to be used from patient admission, personal protection methods, decontamination and sterilization of material, as well as disinfection of the work area. Although a great effort has been made to improve biosafety processes at the scientific and technological level, there is evidence that the human factor continues to be the weakest link in this chain.

Desde a declaração pela Organização Mundial da Saúde do início da pandemia de COVID-19 causada pelo vírus SARS-CoV-2 em março de 2020, os profissionais de saúde foram expostos a essa doença altamente contagiosa e potencialmente fatal, que criou vários desafios para toda a comunidade científica. Ela causou mudanças de paradigma no atendimento ao paciente e no uso de barreiras de proteção individual. Em todo o mundo, vários protocolos para atendimento odontológico foram criados à medida que o comportamento do vírus foi desenvolvido e pesquisado. Esta revisão da literatura resume as indicações e recomendações baseadas em evidências para reduzir a probabilidade de contaminação por exposição a esse vírus, incluindo medidas a serem usadas desde a admissão do paciente, métodos de proteção individual, descontaminação e esterilização de equipamentos, bem como desinfecção da área de trabalho. Embora muitos esforços tenham sido feitos para melhorar os processos de biossegurança em nível científico e tecnológico, há evidências de que o fator humano continua sendo o elo mais fraco dessa cadeia.

Corrección del artefacto producido en imágenes tomográficas en equipos odontológicos / Correction of the artifact produced in tomographic images in dental equipment

Objetivo: disminuir el efecto de artefacto que generan objetos de alta densidad mediante la utilización de filtros de distintos materiales y espesores, ubicados en lugares estratégicos del tomógrafo. Material y métodos: se utilizaron filtros de aluminio y de cobre ubicados en lugares estratégicos en el equipo tomográfico. Se realizaron cortes oblicuos en piezas dentarias con restauraciones metálicas y en implantes; se midió la extensión del artefacto en ancho y alto en cada adquisición tomográfica. Resultados: se hallaron diferencias significativas respecto a la disminución de la dispersión de acuerdo con cada filtro con respecto a la no utilización de estos elementos. Conclusión: la utilización de filtros logró disminuir el efecto de artefacto en estructuras de alta densidad, obteniendo una mejor calidad de imagen para el diagnóstico, permitiendo que el software pueda reconstruir una imagen real (AU)

Objective: to diminish the artifact effect generated by high density objects by using filters of different materials and thickness, located in strategic places of the tomograph. Material and methods: aluminum and copper filters located in strategic places in the tomographic equipment were used. Oblique cuts were made on dental pieces with metal restorations and implants; the extension of the artifact in width and height was measured in each tomographic acquisition. Results: significant differences were found regarding the decrease of the dispersion according to each filter with respect to the non-use of these elements. Conclusion: the use of filters achieves to diminish the artifact effect in structures of high density, obtaining a better image quality for the diagnosis, allowing the software to reconstruct a real image (AU)

Accuracy of an endodontic rotary motor with integrated apex locator to determine the root canal length / Precisão de um motor rotatório endodôntico com localizador apical integrado para determinação do comprimento radicular

Aim: The purpose of this study was to evaluate the efficacy to determine the root canal length, in vitro,of both the electronic apex locator (M2) and the autostop (AS - M3) functions of the Endus Duo Gnatus endodontic motor (Gnatus, São Paulo, SP, Brazil). Methods: Thirty extracted human single-rooted premolars had their root canal lengths (TLs) up to the apical foramen determined using the Endus Duo Gnatus in two ways: (1) In the stainless steel (SS) control group, the measurement was obtained using a stainless steel hand instrument with the electronic locator mode (M2 function) connected to a stainless-steel hand instrument (K-file #15). In the NiTi rotary instrument (NiTi RI) intervention group, the measurement was obtained during the instrumentation (M3 function) of the root canals with a nickel-titanium rotary instrument (Hyflex CM: Coltene Whaledent, Cuyahoga Falls, OH, USA), size 25/.06. The NiTi manually used instrument (NiTi MUI) Intervention group performed the measurement in locator mode using a Hyflex instrument, placed to true length manually. Statistical analysis was performed using ANOVA followed by the Tukey post-hoc test with a significance level of p < 0.05. Results: The true mean length and standard deviation (SD) of the standardized root canals were 18.40 ± 2.14mm, while the mean lengths and standard deviations (SD) were 18.29 ± 1.89mm, 18.22 ± 1.85mm, and 17.24 ± 2.09mm for the SS, NiTi RI, and NiTi MUI groups, respectively. However, data from the NiTi MUI Intervention group indicated shorter root canal lengths when compared to the SS control group and the NiTi RI Intervention group values, and were significantly shorter than the true canal length (p < 0.001). Conclusions:The use of the motor in NiTi RI Intervention group showed acceptable results. However, the NiTi MUI Intervention group resulted in unacceptable short measurements.

Objetivo: O objetivo deste estudo foi avaliar a eficácia na determinação do comprimento do canal radicular, in vitro, das funções localizador eletrônico foraminal (M2) e auto-parada durante a instrumentação (M3) do motor endodôntico Endus Duo Gnatus ( Gnatus, São Paulo, SP, Brasil). Métodos: Trinta pré-molares humanos uniradiculares extraídos tiveram seus comprimentos de canais radiculares (CRTs) até o forame apical determinados usando o Endus Duo Gnatus de duas maneiras: (1) No grupo controle de aço inoxidável (SS), a medida foi obtida usando um instrumento manual de aço inoxidável com modo de localização eletrônica foraminal (função M2) conectado a um instrumento manual de aço inoxidável (lima tipo K #15). No grupo intervenção instrumento rotatório NiTi (NiTi RI), a medida foi obtida durante a instrumentação (função M3) dos canais radiculares com instrumento rotatório de níquel-titânio (Hyflex CM: Coltene Whaledent, Cuyahoga Falls, OH, EUA), tamanho 25/.06. O grupo de intervenção NiTi instrumento usado manualmente (NiTi MUI) realizou a medição no modo localizador foraminal usando um instrumento Hyflex, colocado manualmente no comprimento real do dente. A análise estatística foi realizada por meio de ANOVA seguida do teste post-hoc de Tukey com nível de significância de p < 0,05. Resultados: Os comprimentos reais médios dos dentes e desvios-padrão (DP) dos canais radiculares padronizados foram 18,40 ± 2,14 mm, enquanto os comprimentos médios e desvios- padrão (DP) foram 18,29 ± 1,89 mm, 18,22 ± 1,85 mm e 17,24 ± 2,09 mm para os grupos SS, NiTi RI e NiTi MUI, respectivamente. No entanto, os dados do grupo de intervenção NiTi MUI indicaram comprimentos de canais radiculares mais curtos quando comparados aos valores do grupo controle SS e do grupo de intervenção NiTi RI, e foram significativamente mais curtos que o comprimento real do canal (p < 0,001). Conclusões: A utilização do motor no grupo Intervenção NiTi RI apresentou resultados aceitáveis. No entanto, o grupo de intervenção NiTi MUI resultou em medições curtas inaceitáveis.

Protocol with non-toxic chemicals to control biofilm in dental unit waterlines: physical, chemical, mechanical and biological perspective.

Biosafety in dentistry aims to combat cross-contamination and biofilm in dental unit waterlines. The aim was to investigate from a physical, chemical, mechanical and biological perspective, a protocol for using chemical products (citric acid, sodium bicarbonate and sodium chloride) to improve and maintain water quality in dental unit waterlines. Change in microhardness and corrosion tendency were observed in stainless steel samples. On the polyurethane surfaces, there were changes in color, microhardness and roughness. Anti-biofilm evaluations revealed a significant reduction in the biofilm biomass, metabolic activity and residual biofilm. These findings suggest that the protocol analyzed in this study showed an innovative potential against biofilm in dental unit waterlines, preserving the physical, chemical and mechanical properties of the materials.

Controle de infecção cruzada durante o uso de equipamentos odontológicos geradores de bioaerossóis ao longo da pandemia do covid-19 / Cross-infection control during the use of bioaerosol-generating dental equipment throughout the covid-19 pandemic

A pandemia provocada pelo novo coronavírus, responsável pela COVID-19, alertou a comunidade odontológica, quanto ao risco de contaminação cruzada do cirurgião dentista, sua equipe e pacientes, principalmente devido à grande quantidade de bioaerossóis gerado pelos equipamentos odontológicos de uso rotineiro. Esse estudo teve como objetivo comparar a dispersão do aerossol gerado por diferentes equipamentos odontológicos, bem como verificar a eficácia do uso de um dispositivo desenvolvido para o controle da dissipação do aerossol gerado pelo aparelho piezo-eletro. Como objetivo secundário, verificou-se a efetividade da refrigeração dos equipamentos utilizados. Para a verificação da dissipação de aerossóis, foi utilizado um manequim de estudo em Odontologia, acoplado a uma cadeira odontológica em um consultório de 2,40 x 2,60 de tamanho. Foram testados 2 aparelhos divididos em três grupos: GRUPO AR - alta rotação, GRUPO PE - piezo-eletro e GRUPO PESC - piezo-eletro com Spray control®. Os resultados mostraram uma menor dispersão no grupo PESC, seguido pelo grupo AR. Em relação à temperatura, observou-se que todos os grupos controlaram de forma eficaz o aumento de temperatura, sendo a AR a mais eficiente, seguida pelos dois grupos do Piezo, levando a conclusão que o Spray Control além de não gerar dispersão de aerossol, mantém a refrigeração adequada ao dente durante seu uso. (AU)

The pandemic caused by the new coronavirus, responsible for COVID-19, alerted the dental community to the risk of cross-contamination of the dental surgeon, his team and patients, mainly due to the large amount of bioaerosols generated by routine dental equipment. This study aimed to compare the dispersion of aerosol generated by different dental equipment, as well as to verify the effectiveness of using a device developed to control that dispersion generated by the piezo-electro device (CVDENTUS LTDA). As a secondary objective, was verify the effectiveness of refrigeration of the equipment used. For that dissipation of aerosols, a dental study mannequin was used, attached to a dental chair in a 2.40 x 2.60 office. Two devices were tested, divided into three groups: GROUP AR - high speed, GROUP PE - piezo-electro and GROUP PESC - piezo-electro with Spray control®. So The results have shown a lower dispersion in the PESC group, followed by the AR group. Regarding temperature, it was observed that all groups effectively controlled the temperature increase, with AR being the most efficient, followed by the two groups of Piezo, leading to the conclusion that the Spray Control device, in addition to not generating aerosol dispersion, maintains adequate cooling to the tooth during procedures. (AU)

Listado oficial de material, instrumental y equipo odontológico / Official list of material, instruments and equipment dental

La revisión y actualización del Listado Oficial de material, instrumental y equipo odontológico del Ministerio de Salud (MINSAL), ha sido coordinada por la Oficina de Salud Oral, de la Dirección de Políticas y Gestión de Salud, con el apoyo de la Dirección de Regulación y la Dirección de Cadena de Suministros, así como también con odontólogos de las diferentes Regiones de Salud y Nivel Local. La actualización del documento, permite la inclusión de nuevos insumos, materiales, instrumental y equipo odontológico; con el fin de utilizarlos en base a los avances tecnológicos de la industria odontológica, eliminar aquellos que ya no se utilizan y que pueden ser reemplazados por otros de mejor calidad

The review and updating of the Official List of dental material, instruments and equipment of the Ministry of Health (MINSAL), has been coordinated by the Office of Oral Health, of the Directorate of Health Policies and Management, with the support of the Directorate of Regulation and the Supply Chain Department, as well as with dentists from the different Health Regions and the Local Level. Updating the document allows the inclusion of new supplies, materials, instruments and dental equipment; in order to use them based on technological advances in the dental industry, eliminate those that are no longer used and that can be replaced by others of better quality

Efeito da emissão de luz com fibra óptica, na cimentação de retentor intrarradicular experimental / Effect of light emission with optical fiber, on the cementation of an experimental intraradicular retainer

Os fotopolimerizadores vêm sendo utilizados como dispositivos fundamentais na Odontologia para confecção de restaurações. No entanto, a etapa de fotopolimerização da resina composta inadequada pode afetar a união entre o material restaurador e o substrato. No caso dos agentes cimentantes resinosos a dificuldade está na limitação do local de incidência da luz. Em cimentações de retentores intrarradiculares pré-fabricados, normalmente são utilizados os cimentos de ativação química ou dupla ativação, devido a limitações anatômicas. Portanto, o objetivo deste trabalho foi avaliar o efeito da emissão de luz com fibra óptica, na cimentação de retentor intrarradicular experimental capaz de fotoativar em toda a extensão do conduto radicular. No estudo foi confeccionado um protótipo de ponta acessória em fibra óptica para fonte transmissora de luz que acoplado a um aparelho fotoativador (Bluephase, Ivoclar, Brasil) transmite a luz pelo interior do conduto radicular. Desta forma foram confeccionados em parceria com a empresa Angelus, retentores experimentais vazados ao longo dos seus eixos em fibra de vidro parcialmente opacos. Para simulação do conduto radicular foram utilizadas 80 amostras de resina G10 seccionadas no tamanho de 10 mm de largura por 14 mm de altura (n=80). Cada amostra foi perfurada ao centro nas seguintes dimensões: diâmetro de 3,0 mm e 10 mm de altura. Para cimentação dos retentores intrarradiculares foram utilizados cimento resinoso fotoativado ou dual. A fotoativação foi realizada diretamente com a ponta do aparelho fotoativador ou utilizando o dispositivo experimental transmissor de luz. As amostras foram analisadas imediatamente ou após o envelhecimento térmico de 10.000 ciclos. Para análiseda resistência de união as amostras foram seccionadas em 3 partes, com 2 mm cada (coronal, média e apical) e submetidas aos testes de resistência de união por push out, seguido da análise estereomicroscópica e análise espectroscópica no infravermelho transformada por Fourier (FT-IR). O dispositivo experimental transmissor de luz foi avaliado quanto a sua irradiância, e esta obteve 50% da energia quando comparada com obtida diretamente da ponteira do fotoativador. Após testes mecânicos, os resultados encontrados foram submetidos aos testes estatísticos, Anova com 3 fatores (cimento x fotoativação x profundidade) e Anova 2 fatores (envelhecimento x cimento), seguida de teste Tukey com nível de significância de 5%. Nos resultados de resistência houve diferença estatística entre os tipos de cimentos, profundidade, fotoativação e interação entre oscimentos e a profundidade, sendo que os grupos cimentados com os cimentos fotoativados e com o dispositivo houve uma maior resistência de união na porção média e apical. Com relação ao grau de conversão houve uma maior conversão e a análise estereomicroscópica apresentou maior falha adesiva na porção apical, independente da realização do envelhecimento. Portanto, a utilização do dispositivo obteve resultados promissores e o retentor intrarradicular experimental contribuiu para aumentar a adesão entre o cimento e o substrato em sua porção mais apical.

Photopolymerizers have been used as a fundamental device in dentistry for making restorations. Nonetheless, the stage for the photopolymerization of the composite resin is critical and can affect the adhesion between the restorative material and the substrate. In the case of resin cementing agents, the difficulty lies in limiting the location of the incidence of light. In cementations of prefabricated intraradicular retainers, chemical activation or double activation cements are normally used, due to anatomical limitations. Therefore, the objective of this work was to evaluate the effect of light emission with optical fiber in the cementation of experimental intraradicular retainer capable of photoactivating in the entire length of the root canal. In the study, a prototype of fiber optic accessory tip for light transmitting source was made, which coupled to a photoactivator device (Bluephase, Ivoclar, Brazil) transmits the light inside the root canal. Thus, they were made in partnership with the company Angelus, experimental retainers cast along their axes in partially opaque fiberglass. For simulation of the root canal were used 80 samples of resin G10 sectioned in size 10mm wide by 14mm high (n=80). Each sample was drilled in the center in the following dimensions: diameter 3.0 mm and height 10 mm. For the cementation of the intraradicular seals, light-cured or dual resin cement was used. The photoactivation was performed directly with the tip of the photoactivator device or using the light transmitting experimental device. The samples were analyzed immediately or after thermal aging of 10,000 cycles. For bond strength analysis, the samples were sectioned into 3 parts, with 2 mm each (coronal, mean and apical) and submitted to the bond strength tests by push out, followed by the stereomicroscopic analysis and infrared spectroscopic analysis by Fourier (FTIR). The Light Transmitting Experimental Device was evaluated for its irradiance and obtained 50% of the energy when compared to that obtained directly from the tip of the photoactivator. After mechanical tests, the results found were submitted to the statistical tests Anova with 3 factors (cement x photoactivation x depth) and Anova 2 factors (aging x cement), followed by Tukey's test with a significance level of 5%. In resistance results, there was a statistical difference between the types of cements, depth, photoactivation and interaction between the cements and depth, and the groups cemented with the photoactivated cements and the device had a greater bond strength in middle and apical portion. Regarding the degree of conversion, there was a greater conversion and the stereomicroscopic analysis, it showed greater adhesive failure in the apical portion, regardless of the performance of aging. Therefore, the use of the device obtained promising results and the experimental intraradicular retainer contributed to increase the adhesion between the cement and the substrate in its most apical portion.

Aplicación forense de tecnología radiográfica dental portátil en Argentina: estado actual y perspectivas futuras / Forensic application of portable dental radiographic technology in Argentina: current status and future prospects

Objetivos: Mensurar los niveles de radiación de fuga y dispersión emanada a través de los blindajes y estructuras plomadas del tubo de rayos X de la unidad dental portátil NOMAD, controlando la retrodispersión con el uso del escudo protector de acrílico plomado adaptado en el extremo final del tubo localizador plomado. Se midieron las tasas de exposición dispersadas mediante un detector tipo Geiger-Müller y una cámara de ionización con respuesta en el rango de energías aportadas en diagnóstico por imágenes para la medición de la exposición directa y determinación posterior de las dosis. Se utilizó un fantomas diseñado para diagnóstico odontológico, sopesando la radiación en diferentes angulaciones de operación del equipo NOMAD, simulando los gestos posturales de odontólogos, radiólogos y sujetos a identificar. Se controlaron las tasas de exposición para determinar los valores de las dosis aportadas en las zonas significativas corporales más radiosensibles del operador del equipo. Se obtuvo como resultado que la retrodispersión en el cristalino del ojo del operador fue significativamente menor cuando el fantomas estaba acostado, mientras que a nivel de gónadas resultó más baja con el cuerpo sentado. La tasa de dosis máxima de radiación dispersa que impactó en los operadores fue de 350.8 micro Sieverts por hora (uSv/h) en la zona de gónadas, por cada radiografía tomada sin el uso del delantal de goma plomada, reduciéndose a 4.38 micro Sieverts por hora (uSv/h) al utilizarlo (AU)

Infection Control in the Dental Practice with Emphasis on Intraoral Scanners and Semi-Critical Complex Instruments / Control de Infecciones en la Práctica Dental Con Énfasis en Escáneres Intraorales e Instrumentos Complejos Semicríticos

ABSTRACT: We present an integrative review of the literature conducted to find and analyse specific measures for disinfection and/or sterilization of intraoral complex instruments, applicable to intraoral scanners. We performed a two-stage search in the PubMed/MEDLINE, SciELO, REDALYCS, and LILACS databases, and the Google Scholar website, which included full articles in Spanish, Portuguese, and English. The strategy associated the terms 'disinfection', 'biosecurity', 'decontamination', and (a) 'intraoral scanners', and (b) other 'semi-critical' intraoral complex instruments, according to the American Dental Association definition (e.g., 'turbine', etc). Strategy (a) produced just one outcome, whereas (b) produced nine articles, which only suggested low-level disinfectants.The lack of empirically based protocols that allow effective microbiological control makes it necessary to create a new categorization for these instruments when trying to comply with American Dental Association recommendations for dental practice.

RESUMEN: Presentamos una revisión integradora de la literatura realizada para encontrar y analizar medidas específicas de desinfección y / o esterilización de instrumentos complejos intraorales, aplicables a los escáneres intraorales. Realizamos una búsqueda en dos etapas en las bases de datos PubMed / MEDLINE, SciELO, REDALYCS y LILACS, y en el sitio web Google Scholar, que incluía artículos completos en español, portugués e inglés. La estrategia asoció los términos 'desinfección', 'bioseguridad', 'descontaminación' y (a) 'escáneres intraorales', y (b) otros instrumentos complejos intraorales 'semicríticos', según la definición de la Asociación Dental Ameri- cana (p. Ej., 'turbina', etc.). La estrategia (a) produjo un solo resultado, mientras que (b) produjo nueve artículos, que solo sugirieron desinfectantes de bajo nivel. La falta de protocolos de base empírica que permitan un control microbiológico efectivo hace necesario crear una nueva categorización para estos instrumentos, cuando se trata de cumplir con las recomendaciones de la Asociación Dental Americana para la práctica dental.

Propuesta del modelo para control de infecciones en la consulta odontológica ante la pandemia de COVID-19 / Proposal for an infection control protocol in the dental consultation against the COVID-19 pandemic

Catalogada su labor como Servicios de Salud Indispensables, el profesional de la odontología se ha mantenido al pendiente de sus pacientes durante la pandemia de COVID-19, brindando atención de urgencia a quien lo solicita. A su regreso a la práctica típica, el odontólogo encontrará un entorno distinto o NUEVA NORMALIDAD, viéndose obligado a hacer modificaciones clínicas pertinentes y preparar a su equipo de trabajo para continuar brindando atención de calidad con un margen de seguridad amplificado, que de igual manera proteja a pacientes y al equipo de trabajo. Ante la falta de una vacuna que brinde protección y de tratamiento específico contra el SARS-CoV-2 (COVID-19), elevar el nivel de control de infecciones en el consultorio se vuelve ineludible y posiblemente irreversible en el quehacer odontológico cotidiano. En este artículo se propone un Protocolo de Control de Infecciones en la consulta odontológica que permita brindar seguridad en la atención bucal, considerando COVID-19, útil también para control infeccioso de otros patógenos virales o bacterianos (AU)

Considered dentistry as an Indispensable Health Services, during the COVID-19 pandemic the dental professional has been providing mostly emergency care. Upon return to typical dental practice, the dentist will find a different environment or NEW NORMALLY, being forced to make relevant clinical modifications and prepare his team to continue providing quality care with an amplified safety margin, which equally protects patients and dental team. In the absence of an available vaccine that provides protection or a specific treatment against SARSCoV- 2 (COVID-19), raising the level of infection control at the dental office will become unavoidable and possibly irreversible in the future quotidian dental work. This article proposes an Infection Control Protocol for the dental consultation that allows provide safety oral care, considering COVID-19, also useful for other viral or bacterial pathogens control (AU)

Lineamientos de bioseguridad utilizados en las clínicas dentales periféricas de la Universidad de Monterrey durante la pandemia de COVID-19 / Biosafety guidelines used in the peripheral dental clinics of the University of Monterrey during the COVID-19 pandemic

El presente artículo tiene como propósito informar sobre los lineamientos que las clínicas dentales periféricas de la Escuela de Odontología de la Universidad de Monterrey (UDEM) han tomado frente a la pandemia actual COVID-19, emergente en la ciudad de Wuhan, China el pasado diciembre 2019. Dichas medidas surgen con el objetivo de cumplir con estándares de bioseguridad que eviten el contagio y/o la contaminación cruzada entre pacientes, profesionales y personal de las clínicas dentales de la UDEM; Clínica de Prevención Dental (CPD) y Clínica de Atención Dental Avanzada (CADA), las cuales permanecerán activas frente a situaciones que requieran atención de urgencia y postergando los tratamientos dentales de rutina. Los protocolos para brindar una atención de urgencia conllevan determinados pasos a seguir desde que el paciente ingresa a la clínica; iniciando con la revisión del expediente electrónico médico por medio de la plataforma Atlas.xp, seguido del llenado de un cuestionario enfocado al riesgo de la enfermedad y culminando con la toma de temperatura con termómetro infrarrojo. Los pacientes que no presenten síntomas y muestren una temperatura inferior a los 37.3 oC podrán ser atendidos bajo la aplicación de todas las medidas de bioseguridad establecidas (medidas de protección personal, de equipo y paciente, mantenimiento de dos metros de distancia en sala de espera, cumplimiento de tiempos de trabajo parciales, uso de lámparas purificadoras de aire distribuidas en las salas operatorias de las clínicas, trabajo asistido o a cuatro manos con la implementación de aislamiento absoluto en el paciente y con la utilización mínima de la pieza de alta velocidad). Asimismo, se menciona que posterior a cada tratamiento y en la culminación de la jornada laboral, todas las áreas y superficies deberán ser sanitizadas con sustancias desinfectantes específicas. Por su parte, el personal deberá portar ropa convencional al salir de las instalaciones y haber realizado un adecuado lavado de manos para evitar al máximo posible la transmisión del virus (AU)

The purpose of this article is to inform about the guidelines that the peripheral dental clinics of the School of Dentistry of the University of Monterrey (UDEM) have taken in the face of the current pandemic COVID-19, emerging in the city of Wuhan, China in the past December 2019. These measures arise with the aim of fulfilling biosafety standards that avoid contagion and/or cross contamination between patients, professionals and staff of UDEM dental clinics; Clínica de Prevención Dental (CPD) and Clínica de Atención Dental Avanzada (CADA), which will remain active in situations that require urgent care and postponing routine dental treatments. The protocols to provide urgent care include certain steps to follow from the moment the patient enters the clinic; starting with the review of the electronic medical record through the Atlas.xp platform, followed by the completion of a questionnaire focused on the risk of the disease and culminating with temperature measurement with an infrared thermometer. Patients who do not present symptoms and show a temperature below 37.3 oC may be treated under the application of all established biosecurity measures (personal, equipment and patient protection measures, maintenance of two meters in the waiting room, compliance with partial work times, use of air purifying lamps distributed in the operating rooms of the clinics, assisted or four-hand work with the implementation of absolute isolation in the patient and with the minimum use of the high-speed handpiece). It is also mentioned that after each treatment and at the end of the working day, all areas and surfaces must be sanitized with specific disinfecting substances. For their part, the personnel must wear conventional clothing when leaving the facilities and have carried out adequate hand washing to avoid transmission of the virus as much as possible (AU)

Dental Unit Waterlines in Quito and Caracas Contaminated with Nontuberculous Mycobacteria: A Potential Health Risk in Dental Practice.

Three cases of severe odontogenic infections due to nontuberculous mycobacteria (NTM) in Venezuela that were directly associated with dental procedures and the finding of dental unit waterlines (DUWLs) in dental offices that were colonized with mycobacteria species was the reason for assessing the water quality of DUWLs in dental offices in two capital cities in South America, namely, Quito and Caracas. The main water supplies and the water from 143 DUWLs in both cities were sampled and especially checked for contamination with NTM. To measure the overall bacteriological quality of the water also the presence of heterotrophic bacteria, coliform bacteria, and Pseudomonas was determined. Results showed that respectively 3% and 56% of the DUWLs in Quito and Caracas yielded NTM species (up to 1000 colony-forming units (CFU)/mL). Furthermore, high and unacceptable total viable counts of heterotrophic bacteria and/or coliform bacteria and Pseudomonas were detected in 73% of the samples. We conclude that, in both cities, the water in the majority of DUWLs was contaminated with NTM and other potential pathogens, presenting a risk to human health. The detection of NTM in DUWL water with acceptable heterotrophic bacteria counts shows the need to include NTM in water quality testing. Mycobacteria are more resistant to disinfection procedures than other types of vegetative bacteria, and most testing protocols for DUWLs do not assess mycobacteria and thus do not guarantee risk-free water.

Influência da velocidade de rotação na resistência à fadiga cíclica do sistema rotatório Logic / Influence of the rotational speed on the cyclic fatigue resistance of the Logic rotary system

O objetivo do presente trabalho foi avaliar a influência da velocidade de rotação na resistência à fadiga cíclica do instrumento rotatório Logic 25.06 (LOG 25.06; Easy Equipamentos Odontológicos, Belo Horizonte, Brasil). Métodos: Foram utilizados 20 instrumentos rotatórios Logic 25.06 (n=10). O teste de fadiga cíclica foi realizado em um aparato com um canal artificial de aço inoxidável com ângulo de curvatura de 60° e raio de 5 mm. Os instrumentos foram utilizados a 950 e 550 rotações por minuto (RPM), sendo mensurados o tempo e o número de ciclos para a fratura. Os dados foram analisados estatisticamente por meio do teste t de Student, sendo selecionado um nível de significância de 5%. Resultados: O teste de fadiga cíclica demonstrou que a velocidade de 550 RPM promoveu um aumento significativo no tempo e no número de ciclos para a fratura dos instrumentos LOG 25.06 (p<0,05). Houve um aumento de 95,9% no tempo e de 27,25% do número de ciclos para a fratura. Conclusão: Os resultados desse estudo demonstraram que a velocidade de rotação possui uma influência significativa na resistência à fadiga cíclica dos instrumentos rotatório Logic 25.06. A velocidade de 550 RPM é uma velocidade mais segura, aumentando significativamente a resistência à fadiga cíclica (AU).

Objective: The aim of this study was to evaluate the influence of rotational speed on the cyclic fatigue resistance of Logic 25.06 rotary instruments (LOG 25.06; Easy Equipamentos Odontológicos, Belo Horizonte, Brazil). Methods: 20 Logic 25.06 instruments were used (n=20). The cyclic fatigue test was performed in an artificial canal made of stainless steel with 60° of curvature and 5 mm of radius. The instruments were activated 950 and 550 rotations per minute (RPM) until the fracture occurred. The time (in seconds) and the number of cycles to fracture (NCF) were measured. The data were statistically analyzed using One-way ANOVA and Tukey Test, the level significance used was 5 %. Results: the 550 RPM promoted a significantly higher time and NCF of LOG 25.06 in comparison with 950 RPM (P>0.05). The time increased in 95.9% and the NCF 27.25%. Conclusion: The results of this study showed that the rotational speed had a significant influence on the cyclic fatigue resistance of the Logic 25.06 rotary instruments. The 550 RPM rotational speed seems to be safer than 950 RPM, increasing the cyclic fatigue resistance of Logic 25.06 (AU).

Comparative evaluation of the effect of various irrigants and dry canal on electronic apex locators in locating simulated root perforations: an in vitro study / Avaliação comparativa do efeito de vários irrigantes e canal seco em localizadores apicais eletrônicos na localização de perfurações radiculares simuladas: um estudo in vitro

Objective: this study aimed to evaluate the effects of irrigants and dry canal on the accuracy of electronic apex locator (EAL) in locating simulated root perforations. Material and methods: twenty singlerooted, mandibular premolars were decoronated at CEJ, and the contents were removed with a barbed broach. The canals were instrumented up to a size of 15 K-file. The roots were artificially perforated at 4 mm from the anatomic apex. The actual length (AL) up to the perforation site was determined. The electronic length (EL) of perforations was obtained by Root ZX mini and iRoot in the dry canal and in the presence of 5.2% NaOCl, SmearOff, and 0.9% sodium chloride using a size 20 K-file. The differences between the EL and AL of the perforations were calculated. Statistical analyses using Friedman and Wilcoxon signed-rank tests were used to analyse the data with the level of significance set at p <0.05. Results: there were significant differences in different canal conditions with both Root ZX mini and i Root. Measurements in dry canals were significantly longer for both apex locators (p <0.05). Measurements with NaOCl were significantly shorter for both apex locators (p < 0.05). Both apex locators produced significantly accurate values for Saline and Smear OFF (p < 0.05). Conclusions: in this study, both Root ZX mini and i Root were affected by different canal conditions. The most accurate measurements were seen in the presence of saline and SmearOFF. (AU)

Objetivo: este estudo teve como objetivo avaliar os efeitos de irrigantes e canal seco na precisão do localizador apical eletrônico (EAL) em localizar perfurações radiculares simuladas. Material e métodos: vinte pré-molares inferiores unirradiculares tiveram suas coroas removidas na altura da JEC e o tecido pulpar removido com um extirpa nervos. Os canais foram instrumentados até a largura de uma lima k 15. As raízes foram perfuradas artificialmente a 4 mm do ápice anatômico. O comprimento real (AL) até o local da perfuração foi determinado. O comprimento eletrônico (EL) das perfurações foi obtido pelo Root ZX mini e iRoot no canal seco e na presença de 5,2% de NaOCl, SmearOff e 0,9% de cloreto de sódio usando uma lima K tamanho 20. As diferenças entre o EL e o AL das perfurações foram calculadas. Análises estatísticas, utilizando os testes de sinais por postos de Friedman e Wilcoxon, foram realizadas para analisar os dados com o nível de significância estabelecido em p < 0,05. Resultados: houve diferenças significativas nas diferentes condições do canal, tanto no Root ZX mini quanto no i Root. As medidas em canais secos foram significativamente maiores nos dois localizadores apicais (p < 0,05). As medidas com NaOCl foram significativamente mais curtas para os dois localizadores apicais (p<0,05). Ambos os localizadores apicais produziram valores significativamente precisos para Saline e Smear OFF (p < 0,05). Conclusões: neste estudo, tanto o Root ZX mini quanto o i Root foram afetados por diferentes condições do canal. As medidas mais precisa foram observadas na presença de soro fisiológico e SmearOFF. (AU)

Microbiological Water Evaluation from Biofilm Adhered to Dental Unit Waterlines / Evaluación Microbiológica del Agua de Biofilm Adherido a Líneas de Agua de la Unidad Dental

ABSTRACT: The contamination of the dental units' waterlines is a reality, which can develop individual and collective disorders. The aim of this study was to evaluate the prevalence and resistance profile of bacteria on the internal surfaces of waterlines in a dental clinic from a Dentistry school of a Brazilian university. The design was an exploratory, descriptive study with quantitative and qualitative approach. Samples (n=4) were collected for analysis at different points: the portion closest to the water reservoir of the chair, and the portion closest to the triple syringe. After collection the samples were cultured in BHI medium in an oven for 24-48 h at 37 °C. For the quantitative analysis 1 ml of each sample was used for serial dilution up to the dilution value seven. The colonies were counted after pour plate and the results expressed in UFC/cm2. The qualitative analysis was initiated with the cultivation of Agar Blood, EMB-Levine and Cetrimide Agar for 24 h, and the identification of bacteria was performed by microscopic analyses. The resistance profile was verified by classical antibiogram. The internal surfaces of unit waterlines units exhibited a mean of 2.44 x 109 CFU / cm2. Bacillus subtilis and Pseudomonas aeruginosa were identified. The resistance profile of Pseudomonas aeruginosa indicated sensitivity to all tested antibiotics. A large number of microorganisms was quantified from biofilm accumulated in the dental units' waterlines. However, they were not resistant to classic antibiogram. Better management and application of decontamination protocols for waterlines need to be applied since opportunistic infections may be associated with Pseudomonas aeruginosa.

RESUMEN: La contaminación de líneas de agua en las unidades dentarias es una realidad, generando enfermedades individuales y colectivas. El objetivo de este estudio fue evaluar la prevalencia y resistencia de las bacterias en las zonas internas de las líneas de agua de la Facultad de Odontología de una universidad brasileña. El diseño del estudio fue exploratorio, descriptivo con enfoques cuantitativos y cualitativos. Las muestras para análisis (n=4) fueron selecionadas de distintos lugares: el punto más cercano al sistema de agua del sillón odontológico y el punto más cercano a la jeringa tríplice. Las muestras obtenidas fueron cultivadas en un médio BHI por 24-48 h, en un horno a 37 ºC. Para el análisis cuantitativo, se utilizó 1 ml de cada muestra para dilución hasta el valor siete. Las colonias fueran contadas y los resultados fueron expresados en UFC/cm2. El análisis cualitativo fue iniciado con el cultivo de Agar Sangre, EBM-Levine y Agar Cetrimide por 24 h y la identificación de la bacteria fue realizada por análisis microscópicos. El perfil de resistencia fue verificado por el antibiograma clásico. Las zonas internas de las unidades de líneas de agua mostraron un promédio de 2,44 x 109 UFC/cm2. Bacillus subtilis y Pseudomonas aeruginosa fueron encontrados. El perfil de resistencia de Pseudomonas aeruginosa indicó sensibilidad a todos los antibióticos testados. Un gran número de microorganismos fue cuantificado desde la biopelícula acumulada en las líneas de agua de unidades dentales. Sin embargo, no resistieron al antibiograma clásico. Se requiere una mejor gestión y aplicación de protocolos de decontaminación en las líneas de agua debido a que las infecciones oportunistas puedan estar asociadas a Pseudomonas aeruginosa.