Coexistência entre humanidade e ambiente: bioética na perspectiva de Potter / Coexistence between humanity and the environment: bioethics from Potter's perspective / Coexistencia entre humanidad y medio ambiente: bioética desde la perspectiva de Potter

Resumo Este estudo analisou duas obras que tratam do impacto das ações humanas sobre o meio ambiente e evidenciam os efeitos negativos desse impacto a longo prazo. A pesquisa bibliográfica baseou-se principalmente nas obras de Van Rensselaer Potter denominadas Bioética: ponte para o futuro e Bioética global , mas também em artigos que abordam aspectos importantes relacionados à visão do autor, enriquecendo o processo de discussão e reflexão. Os resultados demonstram que a humanidade deve respeitar o ambiente em que está inserida, entendendo-se como parte integrante (e não dominante) das relações ecológicas, consoante à proposta de coexistência harmônica-funcional.

Abstract This study analyzed two works that focus on the impact of human actions on the environment and evidence the negative effects of this impact in the long run. The bibliographic research was mainly based on Van Rensselaer Potter's works titled Bioethics: bridge to the future and Global bioethics , but also on articles focused on important aspects related to the author's views, enriching the discussion and reflection process. The results show that humanity should respect the environment in which it is inserted, understanding itself as integral (not dominant) part of the ecological relations, in agreement with the proposal of harmonic-functional coexistence.

Resumen Este estudio analizó dos obras que tratan el impacto de las acciones antrópicas sobre el medioambiente y que muestran los efectos negativos de este impacto a largo plazo. Se realizó una búsqueda bibliográfica, principalmente por las obras de Van Rensselaer Potter tituladas Bioética: puente hacia el futuro y Bioética mundial , además de artículos que abordan importantes aspectos relacionados con la visión del autor, para aportar al proceso de discusión y reflexión en este texto. Los resultados demuestran que la humanidad debe respetar el medioambiente en el cual está inserta, comprendiéndose como parte integral (y no dominante) de las relaciones ecológicas acorde con la propuesta de convivencia armónico-funcional.

Association between crack cocaine use and dental caries experience: a cross-sectional study in southern Brazil.

The aim of the present study was to compare the prevalence of dental caries between crack cocaine users and a control group. The study included 106 participants in each group matched for age, sex, and exposure to tobacco. Crack cocaine users were selected from institutions for the treatment of chemical dependency, and the control group was recruited from a public school and among patients who sought dental care. A calibrated examiner determined dental caries experience [Decayed, Missing and Filled Teeth (DMFT) index]. The severity of tooth decay was determined using the Significant Caries Index (SiC). The prevalence of dental caries (DMFT ≥ 1) was 96.2 and 81.1% among the crack cocaine users and nonusers, respectively. Crack users had higher mean DMFT values (7.16 versus 4.92) for the decayed and missing components as well as a higher percentage of individuals with highly severe caries compared to nonusers. After the adjustments in the multivariate model, the prevalence of caries was 18% higher among the crack users (prevalence ratio: 1.18; 95% confidence interval: 1.08-1.30). Age, family income, crack cocaine use, and dental calculus were associated with the occurrence of dental caries. In conclusion, the prevalence of caries was higher among the crack users compared with the control group and remained associated with dental caries in the multivariate analysis.

Anxiety in Children submitted to Dental Appointment

Objective: To determine anxiety in children undergoing dental treatment and to evaluate associated factors. Material and Methods: The sample consisted of 48 children during dental appointment in dental clinics of the Franciscano University Center, 48 caregivers, and 46 dentistry students. The modified Venham Picture Test was used to determine anxiety of children during dental appointment, before and after treatment. For determining anxiety related to dental care among caregivers, the modified Corah's dental anxiety scale was used. The Lipp`s stress symptoms inventory for adults was applied to determine the stress level of dentistry students. In addition, the individual characteristics of participants were recorded to determine their association with the presence of anxiety. Results: Anxiety was observed in 60.4% of children, and it was related to invasive dental procedures (p = 0.021), history of dental pain (p = 0.002), presence of bruxism (p = 0.028), anxious caregivers (p = 0.023), and stress of the dental student that conducted the appointment (p = 0.005). Conclusion: Overall, the majority of pediatric patients showed anxiety, which was directly related to misbehavior during dental care. Moreover, anxiety was related to individual characteristics of children and was influenced by the anxiety level of caregivers, as well as the emotional state of dentistry students during the dental appointment.

Oral rehabilitation of patient with severe early childhood caries: a case report

Introduction: Severe early childhood caries (S-ECC) is very common in pre-school children and shows a pattern of development which is defined and symmetrical, beginning on the cervical third of labial surface of maxillary anterior teeth. Accordingly, it can damage speech, swallowing, feeding, development, esthetics and self-esteem of the child. Objective: To report a case of a 5-year-old female patient with S-ECC on teeth #51, #52, #61 and #62. Case report: The patient came to dental clinic of the university with her mother for dental care. During the interview, the mother reported that her daughter used to drink milk in baby bottle at day and night with sugar content. Moreover, oral hygiene was not performed after bottle feeding at night. On clinical examination, the teeth #51, #52, #61 and #62 presented coronal destruction, and the mucosa associated at these teeth was very inflamed. Radiographically, it was found that carious lesions were limited to inner dentin. The treatment plan included education on oral hygiene and diet guidance. Rehabilitation with acetate matrixes was the treatment chosen for teeth destroyed by caries. Conclusion: This study demonstrated that the use of acetate matrixes is an effective alternative to return aesthetics and functionality to teeth of patients with severe early childhood caries.

Mecanismos moleculares envolvidos na diferenciação das SHED (Stem Cells from Exfoliated Deciduous Teeth) em células endoteliais / Molecular mechanisms involved in the differentiation of SHED (Stem Cells from Deciduous Teeth exfoliated) in endothelial cells

As células-tronco provenientes da polpa de dentes decíduos esfoliados (SHED) são uma fonte promissora de células-tronco para a terapia regenerativa. Já foi demonstrado que elas podem se diferenciar em células endoteliais, mas os mecanismos envolvidos nesse processo ainda são desconhecidos. Dessa forma, o presente estudo teve como objetivo elucidar os mecanismos moleculares relacionados à diferenciação endotelial dessas células. Para isso, um meio de cultura para células endoteliais (EGM-2MV), suplementado por 50ng/mL rhVEGF, foi utilizado com sucesso como estímulo para as SHED se diferenciarem em células endoteliais em cultura de monocamada. Uma vez que, elas expressaram os marcadores endoteliais VEGFR-2 e CD-31. Além disso, quando as SHED foram expostas ao meio de diferenciação, a fosforilação de STAT-3 (um marcador de células-tronco) foi inibida de acordo com a concentração utilizada, enquanto a fosforilação de ERK e AKT foi estimulada. Quando um inibidor de ERK foi adicionado ao meio, a fosforilação de STAT-3 aumentou. Por outro lado, quando um inibidor de STAT-3 foi adicionado ao meio de cultura, a fosforilação de ERK aumentou. A inibição de ERK também impediu a diferenciação endotelial. Para confirmar esse resultado, shRNA MEK-1 SHED também falharam em expressar VEGFR-2 quando estimuladas. Além disso, scaffolds de fatias dentais foram semeadas com shRNA VEGFR-1 SHED ou shRNA controle e implantadas no subcutâneo de camundongos imunodeficientes. Após recuperados, um tecido muito semelhante à polpa dental foi formado no interior das fatias. No entanto, havia menos células CD-31 positivas nos vasos sanguíneos dos implantes semeados com VEGFR-1 shRNA SHED, sugerindo um papel do VEGFR-1 na formação de vasos sanguíneos. Em conclusão, o VEGFR-1 e a via de sinalização de ERKestão envolvidos no processo de diferenciação das SHED em células endoteliais...

Stem Cells from Exfoliated Deciduous Teeth (SHED) are a promising source of stem cells for regenerative therapy. It was already shown they can differentiate into endothelial cells, but the mechanisms involved in this process remain unclear. Therefore, the following study aimed to elucidate the molecular mechanisms related to endothelial differentiation of SHED. For this purpose, a culture media for endothelial cells (EGM-2MV), supplemented with 50ng/ml rhVEGF, was successfully used as stimuli for SHED to undergo endothelial differentiation in monolayer culture, as they expressed the endothelial markers VEGFR-2 and CD- 31. Moreover, when SHED were exposed to the differentiation medium, STAT-3 phosphorilation (a stemness marker) was inhibited while the ERK and AKT phosphorilation was stimulated. When an ERK inhibitor was added to the medium, the STAT-3 phosphorilation increased in a dependent concentration manner. On the other hand, when a STAT-3 inhibitor was added the ERK phosphorilation increased. The ERK inhibition also arrested endothelial differentiation. To confirm this results, shRNA MEK-1 SHED also failed to express VEGFR-2 when stimulated. Additionally, tooth slice scaffolds were seeded with shRNA VEGFR-1 SHED or shRNA control SHED and implanted, subcutaneously, into immunodeficient mice. After retrieved, a dental pulp-like tissue had been formed inside the tooth slice. However, there were fewer CD-31 positive blood vessels in the shRNA VEGFR-1 implants suggesting a role of VEGFR-1 in the formation of blood vessels by SHED. In conclusion, the VEGFR-1 and ERK pathway are involved in the process of differentiation of SHED into endothelial cells...

Indirect pulp treatment in primary teeth: 4-year results.

PURPOSE: To evaluate clinical and radiographic outcomes of indirect pulp treatment (IPT) in primary molars after long-term function (up to 60 months). METHODS: Teeth with deep carious lesions without signs and symptoms of irreversible pulpitis were divided by random allocation into two groups, according to the capping material utilized over demineralized dentin: experimental group (1): self-etching adhesive system (Clearfil SE Bond); and control group (2): calcium hydroxide liner (Dycal). Both groups were filled with resin composite (Z250) and submitted to a clinical and radiographic monitoring period until exfoliation. RESULTS: After the follow-up period (up to 60 months), no statistical difference was found between groups (P= 0.514). The overall success rate reached 78%. The failures occurred after the first year period recall.

In vivo outcomes of indirect pulp treatment using a self-etching primer versus calcium hydroxide over the demineralized dentin in primary molars.

OBJECTIVE: To evaluate the clinical and radiographic outcomes (24 months) of indirect pulp treatment (IPT) in primary teeth when a self-etching primer or a calcium hydroxide layer was used over the remaining carious dentin. STUDY DESIGN: Primary molar teeth with deep carious lesions without signs and symptoms of irreversible pulpitis were divided into two groups, according to the capping material: Experimental group (1): self-etching adhesive system (Clearfill SE Bond); and Control group (2): calcium hydroxide liner (Dycal). Both groups were followed up after application of a resin restoration (3M - Z250). RESULTS: After 2 years of clinical and radiographic follow-up, no statistical difference was found between groups (p = 1). The overall success rate reached 87%. CONCLUSION: These results demonstrate that IPT has a high clinical and radiographic performance in primary teeth and is not dependent on the capping material used over the demineralized dentin.

Comparative analysis of two fixating and two decalcifying solutions for processing of human primary teeth with inactive dentin carious lesion

O objetivo deste estudo foi analisar qualitativamente a preservação das características teciduais pulpares de dentes decíduos ântero-superiores humanos com lesão cariosa de natureza inativa em dentina, comparando-se duas soluções fixadoras (paraformaldeído a 4% e formalina a 10%, ambos com tampão fosfato 0,1 M) e descalcificadoras [ácido fórmico/citrato de sódio – solução de Ana Morse e EDTA (ácido etileno diamino tetracético) a 10%]. Oito dentes foram subdivididos em 4 grupos (n = 2), variando-se o agente fixador e descalcificador. Grupo 1: paraformaldeído a 4% e solução de Ana Morse; Grupo 2: formalina a 10% e solução de Ana Morse; Grupo 3: paraformaldeído a 4% e EDTA a 10%; Grupo 4: formalina a 10% e EDTA a 10%. Os dentes foram fixados e posteriormente descalcificados até que uma consistência borrachóide fosse obtida. Cortes histológicos de 6μm de espessura foram corados com hematoxilina e eosina (H&E). A fixação com ambas as soluções demonstrou boa conservação tecidual, enquanto que a descalcificação com a solução de Ana Morse pareceu mais adequada, por requerer um menor tempo de processamento das amostras e promover uma melhor preservação dos componentes celulares e da matriz extracelular do tecido pulpar. O EDTA, além de exigir um tempo mais longo de processamento das peças, alterou as características morfológicas da polpa. A combinação formol a 10% – solução de Ana Morse pareceu ser favorável para a metodologia deste estudo.

Estudo comparativo da morfologia da polpa dentária de dentes humanos submetidos à técnica de clivagem e a técnicas de descalcificação química / Comparative study of dental pulp morphology from human teeth submitted to cutting technique or chemistry decalcification technique

Os rápidos avanços do conhecimento acerca do reparo e regeneração tecidual, têm despertado o interesse pela biologia pulpar. Entretanto, para avaliar microscopicamente a dinâmica do tecido pulpar, é necessário, inicialmente, que o dente seja submetido aos processamentos histológicos de fixação e descalcificação. A descalcificação pode afetar o grau de coloração e pode causar desnaturação de proteínas. Além disso, é um processo demorado, visto que o dente requer um longo período de desmineralização. Assim, a proposta deste trabalho foi de avaliar qualitativamente a matriz extracelular e as células da polpa dentária, comparando três grupos: dois em que o tecido dentário foi descalcificado e um em que a polpa foi removida dos tecidos duros, não necessitando do processo de descalcificação. Dez pré-molares foram fixados em formalina tamponada a 10% por 24 horas. Após, estes dentes foram divididos em três grupos: 4 dentes foram submetidos a processo de descalcificação por meio de solução de Morse, 3 por meio de solução de EDTA a 10% e; os 3 dentes restantes tiveram sua polpa separada dos tecidos duros dentários por meio da técnica de clivagem. Na seqüência, os três grupos foram processados por meio da técnica histológica de rotina e foram corados com H/E. Os resultados desta análise demonstraram que houve uma melhor conservação tanto da matriz extracelular, quanto das estruturas celulares no grupo da clivagem, seguido do grupo Morse e por fim, com a menor conservação das estruturas pelo grupo EDTA.

The rapid advances of the knowledge of repair and regeneration tissues had proved to be an exciting time for pulp biology. However, to study the dynamic of pulp tissue, it is necessary, initially, that the tooth be submitted to histological fixation and decalcification processing. Decalcification may affect the degree of staining and it may cause denaturation of proteins. Furthermore, it is a slow process, demanding long demineralization times for a tooth. Thus, the purpose of the present study was to compare, qualitatively, the pulp extracellular matrix and the pulp cells, submitted to different techniques: EDTA solution decalcification, Anna Morse solution decalcification and a last group which pulp was removed from tooth without decalcification. Ten premolar teeth were fixed in 10% buffered formalin for 24 hours. After this, the teeth were divided in three groups: 4 teeth underwent decalcification with Morse solution; 3, decalcification with 10% EDTA solution and; 3, were sectioned and their pulps were gently removed. Subsequently, the groups followed the routine histological technique and staining with H/E. The results demonstrated that both conservation of pulp cells and extracellular matrix were better in the group without decalcification, followed by the Morse group and, the last, with the worst structures conservation for the EDTA group.