Construção de procedimento operacional padrão como ferramenta facilitadora de gestão em saúde em uma faculdade de odontologia / Construction of standard operating procedure as a facilitating tool for health management in a school of dentistry / Construcción de procedimiento operativo estándar como herramienta facilitadora para la gestión en salud en una facultad de odontología

O Procedimento Operacional Padrão é uma relevante ferramenta de gestão para otimizar o processo de trabalho dentro da perspectiva da resolutividade definida nos princípios do Sistema Único de Saúde.Objetivo:elaborar um Procedimento Operacional Padrãopara estandardizar o funcionamento do fluxo de materiais do almoxarifado da Faculdade de Odontologia da Universidade Federal do Pará. Metodologia:Estudo descritivo que propôs a criação de uma ferramenta de tecnologia leve dividido em três etapas: aprofundamento teórico, elaboração e refinamento. Resultados:A equipe envolvida no processo de trabalho da unidade de saúde colaborou com a construção do instrumento, favorecendo o estabelecimento de vínculo e assertividade. O Procedimento Operacional Padrãoelaborado constitui subsídio para organização do fluxo com o objetivo de esclarecer, facilitar e padronizar o uso do almoxarifado, promovendo estratégias de uso adequado no manejo dos materiais e a racionalização dos mesmos, com a finalidade de tirar máximo proveito e reduzir custos. Conclusões:A elaboração da ferramenta promoveu aprimoramento do processo de trabalho no manejo dos materiais e equipamentos odontológicos. A participação dos sujeitos envolvidos gerou fortalecimento do vínculo e co-responsabilização (AU).

The Standard Operating Procedure is a relevant management tool to optimizethe work processwithin the perspective of resolution as defined in the Unified Health Systemprinciples.Objective:to elaborate a Standard Operating Procedureto standardize the flow use of materials in the storeroom of the College of Dentistry of the Federal University of Pará.Methodology:Descriptive study which proposed the creation of a soft technology tool divided into three stages: theoretical deepening, elaboration and refinement. Results:The team involved in the health center'swork process collaborated with the development of the instrument, promoting the establishment of bonding and assertiveness. The elaborated Standard Operating Procedureconstitutes subsidy for the organization of the flow with the goal of clarifying, facilitating and standardizing the use of the storeroom, promoting strategies of adequate use in the handling of materials and the rationalization of them, in order to take full advantage and reduce costs. Conclusions:The tool elaborationpromoted the improvement of the work process in the handling of dental materials and equipment. The participation of the health center's team strengthened the bond and co-responsibility (AU).

El Procedimiento Operativo Estándar es una herramienta de gestiónrelevante para optimizar el proceso de trabajo en la perspectiva de resolución definida en los principios del Sistema Único de Salud.Objetivo: desarrollar un Procedimiento Operativo Estándarpara estandarizar el flujo de materiales en el almacén de la Facultad de Odontología de la Universidad Federal de Pará. Metodología: Estudio descriptivo que propuso la creación de una herramienta de tecnología liviana dividida en tres etapas: profundización teórica, elaboración y refinamiento. Resultados: El equipo involucrado en el proceso de trabajo delaunidad de saludcolaboró con la construcción del instrumento, favoreciendo el establecimiento de un vínculoe asertividad. El Procedimiento Operativo Estándarelaboradoconstituyesubsidio para la organización del flujo con el objetivo de aclarar, facilitar y estandarizar el uso del almacén, promover estrategias de uso adecuado en el manejo de los materiales y la racionalización de los mismos, con el fin de aprovechar al máximo y reducir los costos.Conclusiones: La elaboración de la herramienta promovió la mejora del proceso de trabajo en el manejo de materiales y equipos odontológicos. La participación de los sujetos involucrados fortaleció el vínculo y la corresponsabilidad (AU).

Synthesis, characterization and application of Ag doped ZnO nanoparticles in a composite resin.

The biofilm accumulation over the composite resin restorations can contribute to the formation of secondary caries. In this way, antibacterial restorative composite resins are highly desired. Then, the purpose of this study was to modify a composite resins using Ag doped ZnO nanoparticles (NPs), evaluate the antibacterial and mechanical properties of the modified composite resin. The ZnO/AgNPs were synthesized by two different routes, polymeric precursor and coprecipitation methods, and characterized by thermal decomposition, X-ray diffraction, specific surface area by N2 desorption/desorption and scanning electron microscopy (SEM). Antibacterial activity of composite resin specimens (4 mm in height and 2 mm in diameter; n = 15) modified by ZnO/Ag nanoparticles was performed against 7-days Streptococcus mutans biofilm. Colony forming units (CFU/mL) were used to evaluate the bacterial activity. Additionally, the morphology and the bacteria adherence area were analyzed by SEM images. Cylindrical specimens (6 mm in height and 4 mm in diameter; n = 20) of the composite resin containing ZnO/Ag NPs were prepared to perform compressive strength in a universal mechanical test machine, and the surface of fractured specimens was analyzed by EDX element mapping to verify NPs homogeneity. The normal distribution was confirmed and the two-way analysis of variance (ANOVA) and Tukey's test for pair comparison were performed. The nanospheres of ZnO/Ag lead to a better biofilm inhibition, than nanoplates. No difference on compressive strength was found for the composite resin modified by ZnO/Ag nanoplates. Based on these results, this material could be a good option as a new restorative material.

Titanium dioxide and modified titanium dioxide by silver nanoparticles as an anti biofilm filler content for composite resins.

OBJECTIVE: The aim of this study was to evaluate the antibacterial activity of a composite resin modified by TiO2 and TiO2/Ag nanoparticles and their influence over different properties. METHODS: TiO2 and TiO2/Ag NPs were synthesized by polymeric precursor and microwave-assisted hydrothermal methods and then, characterized by different techniques. Direct contact test was performed using Filtek™ Z350XT blended with 0.5; 1 and 2% (wt.) of NPs against Streptococcus mutans to determine the best concentration to the other tests. After that, the modified composite resin was tested against S. mutans 7-day biofilm (CFU/mL). Also, compressive and diametral tensile strength (n=40), degree of conversion (n=25) and surface roughness (n=50) was performed. The data were analyzed by ANOVA and Tukey's test for multiple comparison at 5% significance level. RESULTS: The direct contact test demonstrates that by increasing the nanoparticle content, the bacterial growth is significantly reduceed (p<0.05). The inclusion of 2% of TiO2/Ag NPs significantly decreased (p<0.05) the biofilm accumulation of S. mutans on the composite resin surface compared to the control Group. The TiO2 NPs treated with an organosilane increased compressive strength of composite resin (p<0.05). Degree of conversion remained unchanged (p>0.05) and the surface roughness increased with the NPs (p<0.05), except for the TiO2 by polymeric precursor Group (p>0.05). SIGNIFICANCE: The development of an antibacterial dental restorative material that hinder S. mutans biofilm without sacrificing the mechanical and physical properties is desirable in dental material science.

Violet LED with low concentration carbamide peroxide for dental bleaching: A case report.

The use of violet LED was recently introduced as a new alternative technique to perform tooth bleaching, associated or not with bleaching agents. This paper shows a tooth bleaching clinical case report performed in a 26-year-old woman, using a violet LED with 10% carbamide peroxide (CP). The tooth bleaching protocol was performed in 3 sessions. Fifteen irradiations using a violet light system (BMW, MMoptics, São Carlos, SP, Brazil) were done during 30 s (on) and 60 s (off) without bleaching gel, and more 5 irradiations associated to 10% CP. Upper and lower arches were irradiated separately. The total procedure time was 30 min. Subjective and objective color assessments were performed using Vitapan Classical shade guide and VITA Easyshade spectrophotometer, respectively. Dentin sensitivity was measured using a visual analogue scale. The use of violet LED associated to a low concentration carbamide peroxide successfully promoted tooth bleaching and no side effects i.e. dentin sensitivity during and post treatment was observed.

Zinc oxide 3D microstructures as an antimicrobial filler content for composite resins.

The aim of this study was to evaluate the antibacterial activity of a composite resin modified by 3D zinc oxide (ZnO) microstructures and to verify possible alterations on its mechanical properties. ZnO was synthesized by hydrothermal approach and characterized by X-ray diffraction (XRD), surface area by Brunauer, Emmett and Teller (BET), Fourier transform infrared spectroscopy (FTIR) and Field emission scanning electron microscopy (FESEM). The minimum inhibitory concentrations of ZnO against Streptococcus mutans, Escherichia coli, Staphylococcus aureus, and Candida albicans were determinated. The composite resin FiltekTM Z350XT (3M of Brazil) was blended with 0.2%, 0.5%, and 1% in weight of ZnO and submitted to antibacterial assay by direct contact test against S. mutans, the leading cause of dental caries and the most cariogenic oral streptococci. Additionally, it was performed compressive and diametral tensile strength tests of the modified composite resin. Microrods and hollow microrods of ZnO were obtained and its MIC values were found to be 125 µg/mL for S. mutans, 500 µg/mL for C. albicans and 62.5 µg/mL for S. aureus. For the tested concentrations, it was not found MIC against E. coli. The direct contact test showed a significant antibacterial capacity of modified composite resin (p > 0.05 for all concentrations). The compressive and diametral tensile strength remains no changed after inclusion of microparticles (p > 0.05 for all concentrations). The modification of the composite resin with small amounts of ZnO microparticles significantly inhibited the S. mutans growth on resin surface without significant alterations of its mechanical strength.

The influence of pH and chemical composition of beverages on color stability of a nanofilled composite resin.

Due to increasing consumer knowledge about the health benefits associated with anthocyanin-rich foods and beverages-such as acai and blueberry juices-the growing consumption of these products should be a source of concern for dentists. Since anthocyanins are colorants that can discolor teeth and restorations, the aim of this study was to investigate the staining effects of 2 anthocyanin-rich beverages on a nanofilled composite resin. Specimens were prepared, separated into 3 groups, and immersed in either artificial saliva or 1 of the 2 staining solutions (blueberry or acai juice) at 37°C for 7 days. The color stability of the resin was significantly affected by both the storage times (P < 0.001) and the solutions (P < 0.001). The blueberry juice, which had the lowest pH level, had the greatest effect on color stability and changes in lightness of the composite resin (ΔE* = 14.71; ΔL* = -8.25; P < 0.001), followed by acai juice (ΔE* = 10.21; ΔL* = -8.77; P < 0.001) and artificial saliva (ΔE* = 1.36; ΔL* = -0.44; P < 0.001). In the present study, a nanofilled composite resin did not exhibit color stability when exposed to acai and blueberry beverages.

Reabilitação protética de um paciente portador de Síndrome da Combinação ­ relato de caso / Prosthetic rehabilitation of a patient with Combination Syndrome ­ case report

Estima-se que aproximadamente 26% dos pacientes reabilitados proteticamente são pacientes edentados no arco superior e portadores de extremidades livres posteriores no arco inferior. Esses pacientes podem apresentar perda de osso na porção anterior da maxila, aumento das tuberosidades, hiperplasia papilar do palato duro, extrusão dos dentes anteriores mandibulares e perda de osso alveolar sob a base da PPR mandibular, caracterizando a Síndrome da Combinação. O tratamento mais indicado é a reabilitação com uso de implantes para promover suporte funcional, mas por razões médicas ou financeiras, o tratamento convencional com próteses ainda é considerado uma boa indicação. O tratamento visa ao restabelecimento do equilíbrio oclusal, da estética facial e dentária, da função mastigatória, do conforto e aumento da autoestima do paciente. Esse relato de caso apresenta o tratamento reabilitador convencional, com prótese total superior e PPR inferior Classe I de Kennedy, em um paciente do gênero masculino, 51 anos, portador da Síndrome da Combinação. O conhecimento pelo cirurgião dentista das alterações dessa síndrome e de seus fatores predisponentes proporciona ao profissional a aplicação de condutas adequadas no tratamento reabilitador destes pacientes e na prevenção dos sinais e sintomas deste distúrbio (AU).

It is estimated that approximately 26% of patients treated with prosthesis present total edentulous maxilla opposed by natural anterior teeth. These patients might experience loss of bone in the anterior part of the maxilla, increased tuberosity, papillary hyperplasia of the hard palate, extrusion of the mandibular anterior teeth, and loss of alveolar bone under the lower PPR base, featuring Syndrome Combination. The treatment of choice was the rehabilitation using implants to promote functional support, however, for medical or financial reasons, conventional treatment with prosthesis is still considered a good indication. The aim of the treatment is to restablish the occlusal balance, facial and dental aesthetics, masticatory function, comfort, and increase of self-esteem. This current case report presents a conventional prosthetic rehabilitation using a maxillary complete denture and a Class I Kennedy mandibular removable partial denture, in a 51-year-old male patient with Combination Syndrome. The knowing of the characteristics of this syndrome and its predisposing factors results on an appropriate approach in prosthetic rehabilitation of these patients, leading to prevention of signs and symptoms of this disorder (AU).

Screening of plants found in the State of Amazonas, Brazil for activity against Aedes aegypti larvae

Extratos aquosos, etanólicos e metanólicos, representando principalmente espécies vegetais nativas encontradas na região Amazônica, foram preparados, respectivamente, por infusão, maceração e extração contínua líquido-sólido, seguida de evaporação e liofilização. Os extratos liofilizados foram testados para atividade contra larvas de Aedes aegypti, na concentração única de 500 mg / mL. Os extratos metanólicos foram, em geral, os que apresentaram maior atividade larvicida. Os seguintes 7 extratos metanólicos das (partes das) espécies vegetais indicadas foram os mais ativos, provocando 100% de mortalidade em larvas de A. aegypti: Tapura amazonica Poepp. (raiz), Piper aduncum L. (folha e raiz), P. tuberculatum Jacq. (folha, fruto e galho) e Simaba polyphylla (Cavalcante) W.W. Thomas (galho).