Fatigue and marginal adaptation of bulk fill restoratives: Effect of the layering technique and cavity dimension of extensively damaged teeth.

OBJECTIVES: To evaluate the effect of layering technique and cavity dimension on the fatigue behavior and marginal adaptation of bulk fill (BF) restorations in extensively damaged teeth. METHODS: Seventy-two premolars received class II cavities (MOD) followed by endodontic treatment. Half sample had 1/3 of their palatal cusp removed. Teeth were restored using three techniques: (I) incremental, with conventional resin composite (RC); (C) combined, using BF flow and RC, (B) bulk fill, with regular BF. Specimens were subjected to fatigue (80 N, 2 Hz, 37° C water) for 1 million cycles (n = 12). The test was interrupted every 250,000 cycles to evaluate tooth integrity, restoration fracture and adaptation using FDI criteria. Images of the proximal surfaces were obtained before and after the cycling to measure the gap. Restoration fatigue survival and success were analyzed using Weibull distribution and Maximum Likelihood Estimation. Gap thickness was analyzed with Kruskal-Wallis and Student-Newman-Keuls tests (α = 0.05). RESULTS: For the survival analysis, Weibull modulus (ß) and characteristic lifetime (η) were similar among groups. Yet, for the success analysis, in which only restorations that were free of technical complications were ranked as success, the bulk-fill technique resulted in higher ß, while the combined technique produced restorations with higher η, for teeth that had their cusp removed. C-technique also resulted in smaller gaps than I and B. SIGNIFICANCE: The effect of the layering technique on the success of restorations was dependent on the cavity extension. The combined technique favors the adaptation and the longevity of extensively damaged teeth.

School type and oral conditions associated with school performance and absenteeism in adolescents: A multilevel analysis.

BACKGROUND: Investigations assessing how oral health status affects school performance and attendance considering individual and community variables are lacking. AIM: To analyze the association of school contextual factors and oral conditions with school performance and absenteeism in early adolescence. DESIGN: This cross-sectional study was carried out with 593 12-year-old students from 20 schools in Passo Fundo, a southern city in Brazil. The caregivers provided sociodemographic information by means of a questionnaire. Oral health status was clinically examined for dental caries and gingival bleeding. Students answered the CPQ11-14 questionnaire to assess the oral health-related quality of life (OHRQoL). Information on contextual factors was obtained from the schools' administrators. "School performance" was measured by Portuguese and Mathematic tests' scores, and "school absenteeism" by the number of school days missed. Descriptive statistics was conducted, followed by unadjusted and adjusted multilevel linear regression. RESULTS: At the individual level, low OHRQoL was associated with lower school performance and higher absenteeism. At the contextual level, students from private schools had higher school performance and lower mean of school days missed. CONCLUSIONS: The type of school and OHRQoL were associated with school performance and attendance of adolescents.

Effectiveness of ultrasonic activation over glycolic acid on microhardness, cohesive strength, flexural strength, and fracture resistance of the root dentin.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of ultrasonic activation (US) over glycolic acid on microhardness, cohesive strength, flexural strength, and fracture resistance of root dentin, comparing with conventional final irrigation protocols. METHODS: Samples were obtained from 140 extracted bovine teeth and distributed into four test groups: microhardness (50 teeth), cohesive strength (15 teeth), flexural strength (15 teeth), and fracture resistance (60 teeth). In all four tests, specimens were subdivided into five groups, according to final irrigation protocols: G1: distilled water (DW); G2: 17% ethylenediaminetetraacetic acid (EDTA); G3: 17% glycolic acid (GA); G4: 17% EDTA + US; and G5: 17% GA + US. The duration time of each protocol was set in 1 min. After irrigation protocols, the Vickers tester was used to evaluate microhardness and the universal testing machine was used to evaluate the cohesive strength, flexural strength, and fracture resistance of the root dentin. One-way ANOVA test and the Tukey HSD were used for multiple comparison tests in all evaluations (α = 5%). RESULTS: In general, groups 2 (EDTA), 4 (EDTA + US), and 5 (GA + US) promoted the highest reduction of microhardness, being statistically different from other groups (p < 0.05). Cohesive strength, flexural strength, and fracture resistance data revealed that no differences between groups were observed (p > 0.05). CONCLUSIONS: The association of GA and US results in microhardness reduction, with no influence on cohesive strength, flexural strength, and fracture resistance of the root dentin. CLINICAL RELEVANCE: The use of US over GA has no influence on some mechanical properties of root dentin.

Effectiveness of ultrasonic activation associated to glycolic acid on smear layer removal, dentin structure and bond strength to root dentin

This study evaluated the effects of ultrasonic activation (US) associated to glycolic acid (GA) on smear layer, dentin structure and bond strength (BS) of filling/restorative material to root dentin. The roots were used for antimicrobial activity, dentin structure and BS evaluation, being distributed into seven groups, according to irrigation protocols: G1:DW+US; G2:17% EDTA; G3:QMix; G4:17% GA; G5:17% EDTA+US; G6:QMix+US; G7:17% GA+US. Scanning electronic microscopy, transmission electronic microscopy and push-out were performed, with specific statistical analysis for each evaluation. The highest smear layer removal occured in Groups 6 and 7 (p<0.05), and the largest collagen dispersion in Group 7, being similar to Group 2 and 5 (p>0.05). The highest BS of filling and restorative material occurred in Groups 6 and 7, and Groups 5, 6 and 7, respectively, being similars between them (p>0.05). The use of GA+US promoted effective smear layer removal and dentin structure preservation, improving the BS of filling/restorative material to root dentin.

Maxillary Labial Frenum in Preschool Children: Variations, Anomalies and Associated Factors.

OBJECTIVE: To investigate the prevalence of morphological and attachment variations of the maxillary labial frenum (MLF) and associated factors in preschool children. STUDY DESIGN: A cross-sectional study was conducted with 1,313 children aged between zero and five years of age attending public nurseries in the city of Canoas in southern Brazil. Data were collected through a questionnaire addressing demographic, socioeconomic, and behavioral characteristics and a clinical examination of the MLF. Assessments of MLF morphology and attachment were based on the classification systems proposed by Sewerin and Mirko et al., respectively. RESULTS: The most prevalent patterns were simple MLF (63.8%) and gingival attachment (51.1%). Morphological abnormalities were found in 21.6% of the preschoolers and 25.4% exhibited abnormal frenal attachment. Abnormalities in MLF morphology were more prevalent among girls (p = 0.003) and a significant reduction was found with the increase in age (p < 0.001). Attachment abnormalities were significantly more prevalent among girls (p < 0.001), the white ethnic group (p = 0.005), and children who used a pacifier (p = 0.007) and also reduced significantly with the increase in age (p < 0.001). CONCLUSION: Demographic and behavioral characteristics were associated with MLF morphology and attachment. The reduction in the prevalence of the outcomes with the increase in age suggests that surgical interventions in the first years of life may constitute overtreatment.

Projeto Rede de Cuidados Territoriais em Saúde: cuidado integral e multiprofissional como prática de aprendizagem / Territorial Health Care Network Project: comprehensive and multiprofessional care as a learning practice

Na formação do profissional de saúde é essencial o conhecimento sobre o Sistema Único de Saúde (SUS) além da teoria, sendo importante a vivência prática da interdisciplinaridade e interprofissionalidade no cuidado integral dos indivíduos. O presente relato de experiência descreve, sob a visão de um aluno do curso de odontologia, as principais ações, como as visitas domiciliares, que tinham o enfoque na atenção primária à saúde, a busca ativa de demandas urgentes dos usuários e a importância delas no cuidado em saúde de uma comunidade incluída no Projeto Rede de Cuidados Territoriais, realizado pela Universidade de Passo Fundo, Brasil. O relato de experiência traz os aprendizados e reflexões gerados durante os encontros em equipe, como consequências das visitas domiciliares multidisciplinares, que ocorreram semanalmente, propiciando ao aluno o acompanhamento de famílias e a criação de vínculos, visando o cuidado e a atenção integral. As ações do projeto contribuíram para a formação acadêmica dos alunos de diversos cursos da área da saúde de uma Instituição de Ensino Superior (IES), permitindo a prática no território, na comunidade, sem simulações. A partir da realidade da população, o grupo acadêmico foi estimulado a conhecer o SUS, pela vivência das suas diretrizes e princípios, a realidade do sistema, incluindo suas fortalezas e fraquezas. Identifiquei, a partir dessa experiência, que ações voltadas as comunidades mais vulneráveis em seus territórios são desafiadoras, principalmente em relação a tomada de decisões na atenção integral à saúde dos indivíduos (AU).

In the education of health professionals, in addition to theory, knowledge about the Unified Health System (SUS) is essential, as this system providessignificant practical experience of interdisciplinarity and interprofessionality in the integral care of individualsto health professionals. Thisexperience report describes, fromthe viewpointof dentistry students,the main actionsincluded in the health care of a community in the Territorial Care Network Project, conducted by the University of Passo Fundo, Brazil; these actions includedhome visits, which focused on primary health care, and the active search for urgent demands of users. The experience report presents the learning and reflections generated during team meetingsheld to discussmultidisciplinary home visits, which occurred weekly,these provided the students with the information collected after monitoring the families in the target community; they alsoenabled the student to witness the creation of bonds among health care professionals and community members; thus, the students learned the significance of primary care and comprehensive care. The actions of the project contributed to the academic training of students from various courses in the health field of a Higher Education Institution (HEI), facilitatingtheirpractice in the territory, that is, in this case, the community, without simulation. Thus, the academic group was encouraged to learnthe roleof SUSin a community, by practically implementingits guidelines and principles, and the reality of the system, including its strengths and weaknesses. From this experience, weidentifythat actions aimed at the most vulnerable communities in their territories are challenging, especially in relation to decision-making in comprehensive health care of individuals (AU).

Influence of the apical limit of instrumentation and photodynamic therapy on the postoperative pain of lower molars with asymptomatic apical periodontitis.

INTRODUCTION: The aim of present study was to evaluate the influence of apical limit of instrumentation and PDT on the postoperative pain of lower molars with asymptomatic apical periodontitis. METHODS: Forty patients were included in the present study and were divided into 4 groups (n=10), according to apical limit of instrumentation and use of PDT: instrumentation at 0.0 measurement; instrumentation at 0.0 measurement+PDT; instrumentation 1mm beyond 0.0 measurement; instrumentation 1mm beyond 0.0 measurement+PDT. In the PDT, the root canals were filled with 0.01% methylene blue, remaining for 5 min. The low-intensity laser was used with 100 mW, 660-690 nm wavelength), using intra-canal fibre. Root canals were irradiated for 90 s, delivering total dose of 9 J and energy density of 320 J/cm2. After root canal preparation and PDT protocols, root canals were filled with gutta-percha and AH Plus endodontic sealer, being sealed with composite resin.The evaluation of postoperative pain was performed by visual analog scale after 24, 48, 72 hours and 7 days. Data were analysed by specific statistical tests, at level of 5%. RESULTS: No statistical significant difference was observed among experimental groups in all evaluation periods, as well as in the intragroup analysis over time, regarding postoperative pain and analgesic medication consumption (p>0.05). CONCLUSIONS: Apical limit of instrumentation and PDT have no influence on the postoperative pain of lower molars with asymptomatic apical periodontitis.

Influence of ultrasonic activation on antimicrobial activity of a new final irrigant containing glycolic acid: An in vitro study.

This study evaluated the influence of ultrasonic activation (US) on the antimicrobial activity of a new final irrigant containing glycolic acid (GA). Extracted teeth were used, being 70 to counting of colony-forming units (CFUs) and 35 to confocal laser scanning microscopy. Samples were inoculated with Enterococcus faecalis and divided into 7 groups: distilled water + US; 17% EDTA; Qmix; 17% GA; 17% EDTA + US; QMix + US; and 17% GA + US and kept in contact with test solution for 1 min in the groups with or no US. In the CFUs, the highest bacterial reduction was observed in QMix + US group, followed by QMix and GA + US. In the confocal evaluation, the lowest number of viable cells was observed in EDTA + US, with no statistical difference from QMix, QMix + US and GA + US (P > 0.05). The use of US improves the antimicrobial activity of EDTA and GA, being statistically different from the isolated use of these final irrigants in both evaluation tests.

COVID-19 pandemic and its impact on dental students: A multi-institutional survey.

PURPOSE/OBJECTIVES: To investigate dental students' perceptions and concerns regarding the COVID-19 pandemic, their coping strategies and support resources, and their perceived stress levels. METHODS: A customized 19-item survey and the perceived stress scale (PSS) were applied to undergraduate dental students from the US, Spain, Ireland, Chile, India, and Brazil between April 10 and July 5, 2020. Linear modeling and mediation analysis were used to explore the relationships among demographics, stressors, coping mechanisms, social support, and stress RESULTS: A total of 4475 students responded to the survey. The majority (72.4%) were women, and 52.3% had no COVID-19 training at the time of the survey. The students reported that they had to accommodate to changes in patient care (96.6%) and didactic learning (95.2%) activities, while 88.5% of the respondents indicated at least one of their courses moved online. Transition to online courses went "smoothly with some troubles" for 51.8% of the respondents, and 48.3% perceived the faculty as prepared for the online transition; however, 45.9% reported feeling extremely concerned about the impact of COVID-19 on their education. The average PSS score was 21.9 of 40 (moderate stress). Multivariate models were built for participants with full data (n = 3899). Being male, having completed more dental coursework, and perceiving a smoother transition were associated with lower PSS scores; more concern about academic progress was associated with higher PSS. Faculty support mediated the relationship between a smoothness of transition and concern about academic progress and PSS scores CONCLUSION: Stress caused by the pandemic may be alleviated by smoother transition and good faculty support.

Cytotoxicity of different concentrations of glycolic acid and its effects on root dentin microhardness - An in vitro study.

The aim of the study was to evaluate the cytotoxicity of different glycolic acid concentrations (GA) and its effects on dentinal microhardness. Cytotoxicity was evaluated after inoculation of test irrigants in the lymphocyte primary culture for 3 min. The tested substances were distilled water(DW); 17% EDTA; QMix; 10% GA; 17% GA; and 25% GA. Counting of total, live and dead cells was performed, obtaining the average percentage of dead cells of each group. For microhardness evaluation, 60 root dentin samples were divided into the same tested groups (n = 10) and immersed in test irrigants for 3 min. Dentin microhardness was evaluated by Vicker test. Specific statistical analysis was made in both tests. Results showed significant lower cytotoxicity for QMix and 10% GA (P < 0.05). Moreover, all test irrigants presented similar values of microhardness than the control group (P > 0.05). In conclusion, lower GA concentration can be an alternative for final irrigation on endodontics.

Evaluation of apical transportation and apical root sealing in root canals prepared with mtwo rotary system with and without apical enlargement ­ an in vitro study

The aim of this study was to evaluate apical transportation and apical root canal sealing after root canal filling in human teeth prepared with MTwo® Rotary System with and without apical foramen enlargement. Twenty mandibular premolars were divided into two groups (n=10). Group 1 had root canals prepared 1mm beyond the apical foramen. Group 2 had root canals prepared 1mm below the root canal length. After chemo-mechanical preparation, samples were submitted to scanning electronic microscopy. Apical foramen images had 75x magnification at standardized positions, allowing measurements from the apical foramen area before and after root canal preparation, and after root canal filling. Apical foramen shape and apical transportation, as well as its level of circumferential filling after root canal preparation were accessed using the Image Subtraction System. Scanning electronic microscopy analysis demonstrated that samples of Group 1 showed larger foraminal diameter than samples of Group 2 (p<0.05). Apical foramen transportation was statistically different between Groups 1 and 2 (p=0.0108). Furthermore, the apical foramen sealing also differed statistically between groups 1 and 2 (p=0.0007) and 100% of samples of Group 1 showed apical root canal sealing. Apical root canal sealing was more effective when the root canal was prepared with apical foramen enlargement, even when the apical transportation was detected.

Effect of reciprocating instrumentation on chlorhexidine substantivity on human dentin: chemical analysis followed by confocal laser microscopy

The present research analyzed the reciprocating instrumentation associated to chlorhexidine (CHX) substantivity as its correlation with E. faecalis viability in ex vivo root canals. Eighty extracted single-rooted human teeth were used, being 40 to high-performance liquid chromatography (HPLC) and 40 to confocal laser scanning microscopy (CLSM). In both, teeth were decoronated and the cervical third was prepared. In the CLSM analysis, the root canals were inoculated with E. faecalis for 14 days. Samples were divided into 4 groups (n=10) according to instrumentation technique: no instrumentation and irrigation with distilled water (control); manual instrumentation (K-File); rotary instrumentation (ProTaper Next); and reciprocating instrumentation (Reciproc R25). Two percent chlorhexidine was applied as irrigating substance in experimental groups. Longitudinal grooves resulted in 2 halves root and 20 proof bodies in each group. Samples were divided by chance in two groups (n=10) and the outcomes were evaluated after two days and one week. The retained chlorhexidine and live cells after instrumentation techniques in each evaluation time was measured by HPLC and CLSM, respectively. Specific analysis was applied for experimental tests (p≤0.05). Both rotary as well as reciprocating techniques significantly reduced the amount of chlorhexidine on dentin in all observation periods (p<0.05). After evaluation times, all experimental groups presented lower live cells compared to control, but without statistically difference. Intragroup comparisons in times of evaluation showed no differences in instrumentation techniques, in chlorhexidine retention and number of live cells (p>0.05). Reciprocating instrumentation does not interfere on chlorhexidine substantivity.

Influence of a glycolic acid-based final irrigant for photosensitizer removal of photodynamic therapy on the microhardness and colour change of the dentin structure.

INTRODUCTION: This study aimed to evaluate the influence of glycolic acid-based final irrigant for photosensitizer removal of photodynamic therapy on the microhardness and colour change of the dentin structure. METHODS: Eighty extracted single-rooted human incisors were used. Sample preparation and root split resulted in 160 samples, 80 samples being used for microhardness and 80 samples for colour change evaluation. In the first, PDT protocol was performed and 80 samples were randomly divided into 4 groups (n = 20), according to the final irrigation protocol: distilled water (DW); 17 % ethylenediaminetetraacetic acid (EDTA); QMix; 17 % glycolic acid (GA). Microhardness was evaluated using the Vicker tester, before and after, PDT and final irrigation protocols, calculating the percentage of microhardness reduction. In the second evaluation, PDT and final irrigation protocols were performed in the same way. Colour change was evaluated using digital spectrophotometer before and after these protocols, calculating the ΔE colour change using the CIELAB system (L*a*b* values). Specific statistical analysis was performed for both evaluations (α = 5%). RESULTS: The highest percentage of microhardness reduction was observed in 17 % EDTA, QMix and 17 % GA groups, with no significant difference among them (p > 0.05). Furthermore, none of these protocols was effective in photosensitizer removal, and all final irrigation protocols were statically similar to control group (p > 0.05). CONCLUSIONS: GA promotes microhardness reduction and also contributes to the colourization of dentin structure during the photosensitizer removal process, followingPDT .

Effectiveness of grape seed extract-based intracanal dressings against Enterococcus Faecalis and its influence on dentin microhardness and bond strength of filling material / Eficácia de medicamentos intracanais à base de extrato de semente de uva contra o Enterococcus Faecalis e sua influência na micro-dureza da dentina e na resistência de união do material obturador

The aim of this study was to evaluate the effectiveness of grape seed extract (GSE)-based intracanal dressings against Enterococcus faecalis (E. faecalis) and its influence on dentin microhardness and bond strength of the filling material. The root canals of 126 human teeth were distributed into three test groups: antimicrobial activity (60 teeth), dentin microhardness (30 teeth) and bond strength (36 teeth). In all three groups, specimens were subdivided into six groups, according to intracanal dressing protocols: G1 ­ distilled water (DW); G2 ­ 2% chlorhexidine gel (CHX); G3 ­ calcium hydroxide (Ca[OH]2)+DW; G4 ­ GSE+DW; G5 ­ Ca(OH)2+CHX; G6 ­ GSE+CHX. The counting of colony-forming units (CFUs), the Vickers microhardness tester and the push-out test were performed to evaluate the antimicrobial activity, dentin microhardness and bond strength, respectively. Specific statistical analysis was performed for each evaluation (α=5%). The greatest bacterial reduction was observed in G5 (Ca[OH]2+CHX) and G6 (GSE+CHX) (p<0.05). There was no statistically significant difference among groups in the dentin microhardness evaluation (p<0.05). The highest bond strength in the immediate evaluation was observed in G4 (GSE+DW) and G6 (GSE+CHX), whereas the highest bond strength after 12 months of storage was observed in G2 (CHX), G3 (Ca[OH]2+DW), G4 (GSE+DW), and G6 (GSE+CHX) (p<0.05). After the storage period, bond strength was increased in G2 (CHX) and G3 (Ca[OH]2+DW), and remained unchanged in G4 (GSE+DW) and G6 (GSE+CHX) (p<0.05). GSE-based intracanal dressings have antimicrobial potential against E. faecalis, have no influence in dentin microhardness and preserve the high bond strength of filling materials for root dentin over time.

O objetivo deste estudo foi avaliar a eficácia de medicamentos intracanal à base de extrato de semente de uva (GSE) contra Enterococcus faecalis (E. faecalis) e sua influência na microdureza da dentina e na resistência de união do material de obturação. Os canais radiculares de 126 dentes humanos foram distribuídos em três grupos de teste: atividade antimicrobiana (60 dentes), microdureza da dentina (30 dentes) e resistência adesiva (36 dentes). Nos três grupos, as amostras foram subdivididas em seis grupos, de acordo com os protocolos de curativos intracanal: G1 ­ água destilada (DW); G2 ­ gel de clorexidina a 2% (CHX); G3 ­ hidróxido de cálcio (Ca[OH]2) +DW; G4 ­ GSE+DW; G5 ­ Ca(OH)2+CHX; G6 ­ GSE+CHX. A contagem de unidades formadoras de colônias (UFCs), o testador de microdureza Vickers e o teste push-out foram realizados para avaliar a atividade antimicrobiana, a microdureza da dentina e a resistência adesiva, respectivamente. Análise estatística específica foi realizada para cada avaliação (α=5%). A maior redução bacteriana foi observada no G5 (Ca[OH]2+CHX) e G6 (GSE+CHX) (p<0,05). Não houve diferença estatisticamente significativa entre os grupos na avaliação da microdureza da dentina (p<0,05). A maior resistência adesiva na avaliação imediata foi observada no G4 (GSE+DW) e G6 (GSE+CHX), enquanto a maior resistência adesiva após 12 meses de armazenamento foi observada no G2 (CHX), G3 (Ca[OH]2+DW), G4 (GSE+DW) e G6 (GSE+CHX) (p<0,05). Após o período de armazenamento, a resistência de união aumentou no G2 (CHX) e G3 (Ca[OH]2+DW), permanecendo inalterada no G4 (GSE+DW) e G6 (GSE+CHX) (p<0,05). Os medicamentos intracanal à base de GSE têm potencial antimicrobiano contra E. faecalis, não influenciam na microdureza da dentina e preservam a alta resistência adesiva dos materiais de obturação da dentina radicular ao longo do tempo.

Antimicrobial activity of intracanal dressings composed by natural products associated to chlorhexidine and its influence on dentinal colour change / Avaliação da ação antimicrobiana de medicações intracanais à base de produtos fitoterápicos associados à clorexidina e sua influência na alteração de cor da estrutura dentinária

Purpose: evaluate the antimicrobial activity of intracanal dressings and their influence on dentinal colour changes. Material and methods: eighty single-rooted human extracted teeth were decoronated and divided into eight groups (n=10) according to intracanal dressing protocols inserted into the root canals: G1­distilled water (DW); G2­2% chlorhexidine gel (CHX); G3­calcium hydroxide (Ca[OH]2)+DW; G4­grape seed extract (GSE)+DW; G5­ginger extract (GE)+DW; G6­Ca(OH)2+CHX; G7­GSE+CHX; and G8­GE+CHX. The antimicrobial activity was evaluated by colony-forming units (CFUs) counting and dentinal colour changes was evaluated by digital spectrophotometry. Data were statistically analysed by One-way ANOVA followed by Tukey´s post hoc test (antimicrobial evaluation) and non-parametric Wilcoxon followed by the Mann- Whitney-U test (colour change evaluation) (α=0.05). Results: the highest bacterial reduction was observed in groups 4, 6, 7 and 8, with no significant difference between them (p<0.05). Groups 4 and 7 showed the highest medians of dentinal colour change (p<0.05). Conclusion: the addition of CHX improved the antimicrobial activity of GE-based intracanal dressing, with no effect in GSE-based intracanal dressing; moreover, these protocols induced significant dentinal colour changes. (AU)

Objetivo: avaliar a atividade antimicrobiana de medicações intracanais e sua influência na alteração da cor dentinária. Materiais e métodos: oitenta dentes humanos extraídos unirradiculares foram seccionados e divididos em oito grupos (n = 10), de acordo com os protocolos de medicação intracanal inseridos nos canais radiculares: água destilada G1 (DW); G2-2% de gel de clorexidina (CHX); hidróxido de cálcio G3 ­ (Ca [OH] 2) + DW; extrato de semente de uva G4 (GSE) + DW; extrato de gengibre G5 (GE) + DW; G6- Ca (OH) 2 + CHX; G7 ­ GSE + CHX; e G8-GE + CHX. A atividade antimicrobiana foi avaliada por contagem de unidades formadoras de colônias (UFCs) e as alterações de cor dentinária foram avaliadas por espectrofotometria digital. Os dados foram analisados estatisticamente por ANOVA one-way, seguida pelo teste post hoc de Tukey (avaliação antimicrobiana) e Wilcoxon não paramétrico, seguido pelo teste de Mann- Whitney-U (avaliação da mudança de cor) (α = 0,05). Resultados: a maior redução bacteriana foi observada nos grupos 4, 6, 7 e 8, sem diferença significativa entre eles (p < 0,05). Os grupos 4 e 7 apresentaram as maiores medianas da alteração da cor dentinária (p < 0,05). Conclusão: a adição de CHX melhorou a atividade antimicrobiana da medicação intracanal baseado em GE, sem efeito na medicação intracanal baseado em GSE; além disso, esses protocolos induziram alterações significativas na cor dentinária.(AU)

Perfil lipídico de idosas de um centro de referência e atenção ao idoso / Lipid profile of elderly women from a reference center for the elderly

O objetivo deste estudo foi descrever o perfil lipídico de idosas de um Centro de Referência e Atenção ao Idoso de Passo Fundo, Rio Grande do Sul. Foi realizado um estudo transversal com idosas matriculadas em oficinas oferecidas pelo centro e foram avaliadas as características demográficas e socioeconômicas, perfil lipídico, Índice de Massa Corporal, circunferência da cintura e nível de atividade física de 265 idosas com idade média de 68,9+66 anos em que a maioria apresentou níveis de triglicerídeos menores que 150mg/dL (74,9%), níveis de colesterol total menores que 200mg/dL (76,3%), valores do LDL colesterol inferiores a 100mg/dL (43%) e níveis de HDL colesterol abaixo de 40mg/dL (80,8%). Quanto ao estado nutricional, 51,6% apresentaram um IMC adequado e 77,6% com circunferência da cintura acima de 80cm. Para o nível de atividade física, em média, metade da amostra se mostrou suficientemente ativa. Observou-se maior prevalência de eutrofia, bom nível de atividade física, perfil lipídico adequado, porém, alta prevalência de circunferência da cintura acima dos valores recomendados. Os resultados favoráveis podem estar relacionados ao fato de serem idosas ativas e por participarem de um Centro de Referência para Idosos com oficinas de atividades físicas.(AU)

The objective of this study was to describe the lipid profile of elderly women from a Reference Center for the Elderly in Passo Fundo, Rio Grande do Sul. A cross-sectional study was conducted with elderly women enrolled in workshops offered by the Center. The demographic and socioeconomic characteristics were evaluated, lipid profile, Body Mass Index, waist circumference and physical activity level of 265 elderly women with a mean age of 68,9+66 years, most of whom presented triglyceride levels below 150mg/dL (74.9 %), total cholesterol levels below 200mg/dL (76.3%), LDL cholesterol values below 100mg/dL (43%) and HDL cholesterol levels below 40mg/dL (80.8%). Regarding nutritional status, 51.6% had an adequate BMI and 77.6% with waist circumference above 80cm. For the level of physical activity, on average, half of the sample was sufficiently active. There was a higher prevalence of eutrophy, good level of physical activity, adequate lipid profile, but a high prevalence of waist circumference above the recommended values. Favorable results may be related to the fact that they are active older women and participate in a Reference Center for the Elderly in the physical activity workshops.(AU)

Association of calcium hypochlorite, reciprocating instrumentation and photodynamic therapy: Antimicrobial analysis and effects on root dentin structure.

INTRODUCTION: This study aimed to evaluate the antimicrobial action of calcium hypochlorite(Ca[OCl]2) and sodium hypochlorite (NaOCl) with reciprocating instrumentation and photodynamic therapy(PDT), and its influence on root dentin structure. METHODS: One hundred and ten human teeth were used to antimicrobial evaluation, inoculated with Enterococcus faecalis and divided into 11 groups (n = 10): G1 - distilled water(control); G2-1 % NaOCl; G3-5.25 % NaOCl; G4-1 % Ca(OCl)2; G5-5.25 % Ca(OCl)2; G6-PDT; G7-distilled water + PDT; G8-1 % NaOCl + PDT; G9-5.25 % NaOCl + PDT; G10-1 % Ca(OCl)2+PDT; G11-5.25 % Ca(OCl)2+PDT. In all groups, except G6, the root canals were instrumented with #R50 Reciproc file in the working length in association with tested chemical auxiliary substance. The counting of colony forming units (CFUs) was performed to calculate the bacterial percentage reduction of each group. Following, 55 bovine teeth were used to microhardness evaluation and divided into the same 11 groups (n = 5), with no instrumentation and immersion in the tested protocols. The modification of root dentin microhardness was evaluated by using the Vicker tester. Finally, 33 bovine teeth were used to organic components evaluation and divided into the same 11 groups (n = 3), with no instrumentation and immersion in the tested protocols. The modification of organic components of root dentin was evaluated by light microscopy. Specific statistical analysis was performed for each evaluation. RESULTS: The higher bacterial reduction was observed in groups 3,4,5,8,9,10 and 11, with no statistical difference between them (p > 0.05). The higher microhardness reduction was observed in groups 8,9,10 e 11, with no statistical difference between them (p > 0.05). The highest modification on organic components was observed in groups 3,5,9 and 11, with no statistical difference between them (p > 0.05). CONCLUSIONS: The association of Ca(OCl)2, reciprocating instrumentation and PDT promotes effective antimicrobial action. Moreover, lower modification was induced in microhardness and organic components of root dentin, by using Ca(OCl)2 in low concentration associated to PDT.

Avaliação periodontal pelo índice cpitn de indivíduos com transtorno do espectro autista ­ revisão integrativa de literatura / Periodontal evaluation of the cpitn index in individuals with autistic spectrum disorders - Integrating Literature Review

Introdução: O Transtorno do Espectro Autista (TEA) é um distúrbio comportamental complexo, na odontologia, os indivíduos com TEA apresentam consequências em sua saúde bucal pela inadequada higiene oral e difícil manejo interferindo na condição periodontal. Objetivo: Verificar a doença periodontal em indivíduos com TEA utilizando-se como instrumento o Índice Periodontal Comunitário de Necessidades de Tratamento (CPITN). Método: Trata-se de uma revisão integrativa da literatura embasada em artigos de periódicos da base de dados PubMed e Portal Regional da Biblioteca Virtual em Saúde (BVS), empregando como critérios de seleção artigos com desenho amostral do tipo caso-controle que utilizaram para avaliação periodontal de indivíduos com TEA, o índice CPITN entre os anos de 1989 a 2019, todos em língua inglesa. Resultados: A busca resultou em 10 artigos que correspondiam aos filtros selecionados. Um total de 4 artigos que foram lidos na íntegra e cuja análise foi o tema central, nos estudos avaliados, os participantes com TEA apresentaram resultados mais severos nas taxas do índice CPITN. Conclusão: Com o índice CPITN tornou-se possível diagnosticar doença periodontal e necessidade de tratamento em indivíduos com TEA, de forma simplificada e eficaz (AU)

Introduction: Autistic Spectrum Disorder (ASD) is a complex behavioral disorder. In dentistry, individuals with ASD have consequences on their oral health due to inadequate oral hygiene and difficult handling interfering with the periodontal condition. Objective: To verify the periodontal disease in individuals with ASD using the Community Periodontal Treatment Needs Index (CPITN) as instrument. Method: This is an integrative review of the literature based on articles from the PubMed and Regional Portal of the Virtual Health Library (VHL) database, using as selection criteria articles with sample design of the case-control type that were used for evaluation periodontal disease of individuals with ASD, the CPITN index between the years 1989 and 2019. Results The search resulted in 10 articles corresponding to the selected filters. A total of 4 articles that were read in full and whose analysis was the central theme, in the evaluated studies, the participants with ASD presented more severe results in the CPITN index rates. Conclusion: With the CPITN index it became possible to diagnose periodontal disease and the need for treatment in individuals with ASD, in a simplified and effective way. (AU)

Prevalência de doenças crônicas em idosos atendidos na área de abrangência da estratégia saúde da família no interior do RS / Prevalence of chronic diseases in older adults served in the scope of the family health strategy in the city of Marau/RS

Objetivo: avaliar a prevalência de doenças crônicas em idosos atendidos na Estratégia de Saúde da Família em um município do norte do estado do Rio Grande do Sul. Método: trata-se de um estudo transversal de dados secundários, realizado com indivíduos de 60 anos ou mais, através de prontuários eletrônicos do Sistema de Informação do Sistema Único de Saúde, no período de janeiro a dezembro de 2016. As doenças crônicas investigadas foram diabetes mellitus, hipertensão arterial sistêmica, acidente vascular cerebral, infarto, câncer e ainda a presença de multimorbidade para 2 ou mais doenças associadas. Também foram coletadas informações demográficas, internação nos últimos 12 meses e uso de tabaco. Os dados foram analisados através de software de estatística. Para as variáveis quantitativas foram calculadas as medidas de tendência central e dispersão, e para as variáveis qualitativas foram apresentas as frequências absolutas e relativas simples. Para as associações foi aplicado o Teste exato de Fisher e o Teste Qui-quadrado. Resultados: as doenças crônicas com maior prevalência foram hipertensão arterial sistêmica (37,3%) e diabetes mellitus (10,1%), simultaneamente hipertensão arterial sistêmica e diabetes mellitus 9,1%, e a prevalência de multimorbidade foi de 11%. A média de idade foi de 70,02 anos (+7,93), sendo que a maioria tinha entre 60 a 69 anos (55,2%), eram do sexo feminino (57,7%), não haviam internado nos últimos 12 meses (98,6%) e não faziam uso de tabaco (97,3%). Foi observado maior prevalência de multimorbidade entre os idosos com 80 anos ou mais (p<0,001), e associação entre doenças e sexo, a maior prevalência de Hipertensão Arterial foi no sexo feminino e maior prevalência de Infarto Agudo do Miocárdio no sexo masculino (p<0,05). Conclusão: os dados do estudo mostraram uma baixa prevalência de doenças crônicas e multimorbidade. (AU)

Objective: to evaluate the prevalence of chronic diseases in older adults served in the Family Health Strategy in the city in the north of the state of Rio Grande do Sul. Method: this is a cross-sectional study of secondary data, carried out with individuals aged 60 years or older, using electronic records of the Information System of the Unified Health System, in the period from January to December 2016. Chronic diseases investigated were diabetes mellitus, systemic arterial hypertension, stroke, heart attack, cancer and the presence of multimorbidity for 2 or more associated diseases. We also collected demographic information, hospitalization in the last 12 months and use of tobacco. The data were analyzed with statistical software, for the quantitative variables were calculated the measures of central tendency and dispersion; and for the qualitative variables were presented the absolute frequencies and simple relatives. For associations it was applied the Fisher exact test and Chi-square test. Results: the most prevalent chronic diseases were systemic arterial hypertension (37.3%) and diabetes mellitus (10.1%), simultaneously systemic arterial hypertension and diabetes mellitus (9.1%), and the prevalence of multimorbidity was 11%. The mean age was 70.02 years (+7.93), the majority were between 60 and 69 years old (55.2%), were female (57.7%), did not smoke (97, 3%) and had not hospitalized in the last 12 months (98.6%). Results: the most prevalent chronic diseases were systemic arterial hypertension (37.3%) and diabetes mellitus (10.1%), both systemic arterial hypertension and diabetes mellitus 9.1%, and the prevalence of multimorbidity was 11%. A higher prevalence of multimorbidity was observed among older adults with 80 years or more (p<0,001) and the association between diseases and sex, the highest prevalence of Arterial Hypertension was in females and a higher prevalence of acute myocardial infarction in males (p<0,05). Conclusion: the study data showed a low prevalence of chronic diseases and multimorbidity (AU)

Comparisons between photographic equipment for dental use: DSLR cameras vs. smartphones / Comparações entre equipamento fotográfico para uso odontológico: câmeras DSLR vs. smartphones

Objective: to compare the image quality obtained by six cameras used for dental documentation, including four DSLR cameras and two smartphones with different sensor size. Methods: the equipment determined the groups: APSCcan18-55 ­ Sensor APS-C Canon (EOS T5i) + 18-55 mm lens; APSCcan100 ­ Sensor APS-C Canon (EOS T5i) + 100 mm macro lens; APSCnik18-55 ­ Sensor APS-C Nikon (D5100) + 18-55 mm lens; APSCnik100 ­ Sensor APS-C Nikon (D5100) + 100 mm macro lens; ip1/3" ­ iPhone with 1/3-inch sensor; ga1/2.6"- Galaxy with 1/2.6-inch sensor. Two set of images -"dental documentation" and "small objects"- were obtained. The photographs were evaluated by three groups: US, undergraduate students; DS, dentists; and DP, dentists with photography experience. Scores between 0 and 10 were assigned. The results were compared by RM Anova and Tukey (α = 0.05). Results: the highest overall scores were obtained with APSCnik100 (8.5). For "dental documentation", APSCcan18-55 and APSCnik18-55 showed the lowest values, even compared to ga1/2.6" (for US, DS and DP evaluators) and ip1/3" (for US evaluators). For "small objects", DSLRs resulted in higher mean values compared to smartphones for US and DS. Conclusions: DSLR cameras with 18-55 mm lens and no circular flash should not be used for documentation photographs. DSLR cameras, regardless of lens, are superior to smartphones for small objects photographs. (AU)

Objetivo: comparar a qualidade da imagem obtida por seis câmeras utilizadas para documentação odontológica, incluindo quatro câmeras DSLR e dois smartphones com diferentes tamanhos de sensor. Métodos: a divisão dos grupos foi realizada pelo tipo de equipamento: APSCcan18-55 - Sensor APS-C Canon (EOS T5i) + lente 18-55 mm; APSCcan100 - Sensor APS-C Canon (EOS T5i) + lente macro de 100 mm; APSCnik18-55 - Sensor APS-C Nikon (D5100) + lente 18-55 mm; APSCnik100 - Sensor APS-C Nikon (D5100) + lente macro de 100 mm; ip1 / 3 "- iPhone com sensor de 1/3 de polegada; ga1 / 2.6 "- Galaxy com sensor de 1 / 2,6 polegadas. Dois conjuntos de imagens ­ "documentação odontológica" e "pequenos objetos" ­ foram realizados. As fotografias foram avaliadas por três grupos de examinadores: estudantes de graduação (US); dentistas (DS); e dentistas com experiência em fotografia (DP). Foram atribuídas pontuações entre 0 e 10. Os resultados foram comparados por Anova e Tukey (α = 0,05). Resultados: os maiores escores foram obtidos com o APSCnik100 (8,5). Para "documentação odontológica", APSCcan18-55 e APSCnik18-55 apresentaram os menores valores. Para "objetos pequenos", as DSLRs resultaram em valores médios mais altos em comparação aos smartphones. Conclusões: as câmeras DSLR com lentes de 18 a 55 mm e sem flash circular não devem ser usadas para fotografias de documentação. As câmeras DSLR, independentemente da lente, são superiores aos smartphones para fotografias de objetos pequenos. (AU)