Efficacy of a Light-cured Tetracaine-based Anesthetic Gel for Rubber Dam Clamp Placement: A Triple-blind Randomized Clinical Trial.

OBJECTIVES: To evaluate the efficacy of a new light-cured anesthetic gel for pain control in adults undergoing rubber dam isolation for the restorative treatment of noncarious cervical lesions (NCCLs). METHODS AND MATERIALS: This study was a randomized, split-mouth, triple-blind, controlled trial. The sample comprised 50 adults with at least one pair of NCCLs located in the same arch but on opposite sides. Simple randomization defined the tooth to receive the light-cured tetracaine-based anesthetic gel or the placebo gel. After cotton roll isolation, the gels were applied in the gingival tissue around the tooth with the aid of the applicator tip of a syringe, left in place for 15 seconds, and light-cured for 15 seconds. Then, a #212 clamp was positioned on the tooth. If the patient reported pain, the clamp was removed, the patient filled out a pain intensity form (a 0-10 visual analog scale [VAS] and a 0-4 verbal rating scale [VRS]) and an injectable anesthetic was applied before rubber dam isolation for the restorative procedure. The absolute risk, intensity of pain, and need for rescue anesthesia were analyzed by the McNemar test and the Wilcoxon signed rank test (α=5%). RESULTS: The odds ratio [OR] for pain (OR=3.5; 95% confidence interval [CI]=1.1 to 14.6; p=0.03) showed lower reports of pain for the light-cured anesthetic gel. One in five patients will benefit from placement of the light-cured anesthetic gel. On average, pain intensity was one VAS unit lower in those using the light-cured anesthetic gel than in those using the placebo gel. For the VRS, the pain intensity for the light-cured anesthetic gel was 0.4 units lower than the pain intensity for the placebo gel (95% CI=-0.9 to 0.07). The OR for rescue anesthesia was 2.5 (95% CI=0.7 to 10.9; p=0.18). CONCLUSIONS: The light-cured, tetracaine-based anesthetic gel reduced the absolute risk of pain by 20% in NCCLs.

Combination of Acetaminophen/Codeine Analgesics Does Not Avoid Bleaching-Induced Tooth Sensitivity: A Randomized, Triple-Blind Two-Center Clinical Trial.

Bleaching-induced tooth sensitivity (TS) is highly prevalent. OBJECTIVE: This study aimed to determine if the combination of opioids and nonopioids analgesics (Tylex) may provide a better analgesic effect. METHOD: A triple-blind, parallel, randomized two-center clinical trial was conducted with 105 healthy patients who received either a placebo or a combination of acetaminophen/codeine. The first dose of Tylex 30 mg (acetaminophen 500 mg/codeine 30 mg) or placebo was administered one hour before the in-office bleaching (35% hydrogen peroxide), and extra doses were administered every six hours for 48 hours. The TS was recorded using a visual analog scale of 0 to 10 and a numeric rating scale of 0 to 4 in different periods: during bleaching, one hour up to 24 hours, and 24 hours up to 48 hours postbleaching. The color was measured before and one month after dental bleaching with a visual shade guide (Vita Classical), Vita Bleachedguide 3D-MASTER, and the spectrophotometer Vita Easyshade. The absolute risk of TS was evaluated using the Fisher exact test. Data of TS intensity with numeric rating scale of the two groups were compared with the Mann-Whitney U-test and the Friedman test, while data from the visual analog scale were evaluated by two-way repeated measures analysis of variance and the Tukey test for pairwise comparison. The color changes between groups were compared using the Student t-test (α=0.05). RESULTS: No significant differences between the groups were observed in the risk and intensity of TS. The overall absolute risk of TS was approximately 96%. No significant differences between groups were observed in terms of color change ( p>0.05) for any scale. CONCLUSION: The use of an acetaminophen/codeine combination prior to in-office bleaching does not reduce the risk and intensity of bleaching-induced TS.

Two-year Effects of Chlorhexidine-containing Adhesives on the In Vitro Durability of Resin-dentin Interfaces and Modeling of Drug Release.

OBJECTIVES: To evaluate the effects of addition of diacetate chlorhexidine (CHX) at different concentrations into two etch-and-rinse adhesive systems on CHX release, as well as the immediate (IM) and two-year (2-Y) resin-dentin microtensile bond strength (µTBS) and nanoleakage (NL). METHODS: CHX was added to XP Bond (XP) and Ambar (AM) at concentrations of 0.0 wt% (control); 0.01 wt%; 0.05 wt%; and 0.1 to 0.2 wt%. To assess the cumulative CHX release, adhesive disks were made in a metallic matrix and after light-curing were stored in water. Ultraviolet spectrophotometric measurements of the storage solution were performed to examine the release kinetics of CHX. For µTBS and NL, the occlusal enamel of molars was removed and the adhesives were applied to the dentin surface after acid etching. After composite resin build-up, specimens were sectioned to obtain µTBS sticks. The specimens were subjected to µTBS and NL at IM and after 2-Y. In addition, specimens underwent examination for CHX using micro-Raman spectroscopy. All data were submitted to statistical analysis (α=0.05). RESULTS: With regard to CHX release, AM showed a slower and gradual release of CHX while XP released CHX more quickly ( p<0.05), and CHX was still present in the hybrid layers after 2-Y. Both adhesives showed CHX release at 2-Y water storage. Both CHX-containing adhesives showed higher µTBS values than did the control group ( p<0.05).

Mechanical and microbiological properties and drug release modeling of an etch-and-rinse adhesive containing copper nanoparticles.

OBJECTIVES: To evaluate the effect of addition of copper nanoparticles (CN) at different concentrations into a two-step etch-and-rinse (2-ER) adhesive on antimicrobial activity (AMA), copper release (CR), ultimate tensile strength (UTS), degree of conversion (DC), water sorption (WS), solubility (SO), as well as the immediate (IM) and 1-year resin-dentin bond strength (µTBS) and nanoleakage (NL). METHODS: Seven adhesives were formulated according to the addition of CN (0, 0.0075, 0.015, 0.06, 0.1, 0.5 and 1wt%) in adhesive. The AMA was evaluated against Streptococcus mutans using agar diffusion assay. For CR, WS and SO, specimens were constructed and tested for 28 days. For UTS, specimens were tested after 24h and 28 days. For DC, specimens were constructed and tested after 24h by FTIR. After enamel removal, the ER was applied to dentin. After composite resin build-ups, specimens were sectioned to obtain resin-dentin sticks. For µTBS and NL, specimens were tested after 24h and 1-year periods. All data were submitted to statistical analysis (α=0.05). RESULTS: The addition of CN provided AMA to the adhesives at all concentrations. Higher CR was observed in adhesives with higher concentration of CN. UTS, DC, WS and SO were not influenced. For µTBS an increase was observed in 0.1 and 0.5% copper group. For NL, a significant decrease was observed in all groups in comparison with control group. After 1-year, no significant reductions of µTBS and no significant increases of NL were observed for copper containing adhesives compared to the control group. SIGNIFICANCE: The addition of CN in concentrations up to 1wt% in the 2-ER adhesive may be an alternative to provide AMA and preserve the bonding to dentin, without reducing adhesives' mechanical properties evaluated.

Diffusion Processes and Drug Release: Capsaicinoids - Loaded Poly (ε-caprolactone) Microparticles.

We present a generalmodel based on fractional diffusion equation coupled with a kinetic equation through the boundary condition. It covers several scenarios that may be characterized by usual or anomalous diffusion or present relaxation processes on the surface with non-Debye characteristics. A particular case of this model is used to investigate the experimental data obtained from the drug release of the capsaicinoids-loaded Poly (ε-caprolactone) microparticles. These considerations lead us to a good agreement with experimental data and to the conjecture that the burst effect, i.e., an initial large bolus of drug is released before the release rate reaches a stable profile, may be related to an anomalous diffusion manifested by the system.

Análise farmacobotânica de folha e caule de Tanacetum vulgare (L. ) / Pharmacobotanical analysis of leaf and stem of Tanacetum vulgare (L. )

RESUMO Tanacetum vulgare L., conhecida popularmente como catinga-de-mulata, é utilizada na medicina tradicional como vermífugo, digestivo e emenagogo. Objetivou-se analisar a morfoanatomia de folhas e caules dessa espécie medicinal com vistas ao controle da qualidade. Foram utilizadas técnicas usuais de microscopia de luz e eletrônica de varredura. As folhas são compostas, pinatissectas e anfiestomáticas. Tricomas tectores flageliformes simples e glandulares capitados são observados. A nervura central tem formato biconvexo, o pecíolo é côncavo-convexo, a ráque é plano-convexa e o caule é arredondado. Feixes vasculares colaterais, calotas de fibras perivasculares e colênquima lamelar estão presentes na folha e no caule. Os caracteres morfoanatômicos evidenciados contribuem na identificação do táxon e fornecem subsídios farmacobotânicos para o controle da qualidade de drogas vegetais e fitoterápicos.

ABSTRACT Tanacetum vulgare L., popularly known as tansy, is used in traditional medicine as a vermifuge, digestive and emmenagogue. This study aimed to analyze the morphoanatomical leaves and stems of this medicinal plant in order to control the quality. Usual techniques of light and scanning electron microscopy were used. The leaves are composed, pinatissect and amphistomatic. Simple and flagelliform non- glandular trichomes and capitate glandular trichomes are observed. The midrib has biconvex shape, the petiole is concavo-convex, the rachis is plano-convex, and the stem is rounded. Collateral vascular bundles, perivascular fiber caps and laminar collenchyma are encountered in the leaves and stems. Evidenced the morphological and anatomical features contribute to the identification of the taxon and provide pharmacobotanical data for the quality control of herbal drugs.

Baccharis rufescens Spreng. var. tenuifolia (DC. ) Baker: contribuição ao estudo farmacognóstico / Baccharis rufescens Spreng. var. tenuifolia (DC. ) Baker: contribution to the pharmacognostic study

Baccharis rufescens Spreng. var. tenuifolia (DC.) Baker pertence à família Asteraceae e é usada na medicina tradicional como estomáquico e hepatoprotetor. Um estudo fitoquímico mostrou a presença de flavonoides e triterpenos, sendo que os extratos clorofórmico e metanólico de folhas apresentaram-se ativos no bioensaio de toxicidade sobre Artemia salina Leach. Além disso, extratos clorofórmicos evidenciaram a presença de peróxidos, sugerindo sua aplicação no tratamento da malária (Schenkel at al., 2002; Montanher et al., 2002; Moreira et al., 2003). Considerando a importância farmacológica de B. rufescens var. tenuifolia, o presente trabalho objetivou o estudo morfoanatômico e histoquímico do caule e da folha dessa espécie, a fim de fornecer subsídios farmacognósticos para o controle de qualidade. O material botânico foi submetido às técnicas usuais empregadas na microscopia de luz e microscopia eletrônica de varredura. Folha anfiestomática, presença de estômatos anomocíticos, tricomas glandulares capitados bisseriados, tricomas tectores flageliformes simples unisseriados, dutos secretores associados ao floema, calota de fibras perivasculares e cristais de oxalato de cálcio do tipo estiloide e prismático na região medular do caule foram as principais características observadas que auxiliam na identificação do táxon.

Baccharis rufescens Spreng. var. tenuifolia (DC.) Baker belongs to the Asteraceae family. It is used for liver and stomach problems in traditional medicine. Previous phytochemical data reported flavonoid and triterpene contents. Chloroform and methanol extracts of the leaves showed activity in the bioassay of brine shrimp. Chloroform extracts showed the presence of peroxides that can be used to treat malaria (Schenkel et al., 2002; Montanher et al., 2002; Moreira et al., 2003). Considering the pharmacological importance of B. rufescens var. tenuifolia, the purpose of this paper was to perform the anatomical analysis of aerial vegetative parts of Baccharis rufescens var. tenuifolia in order to provide pharmacognostic data for quality control. The plant material was studied by the usual methods of light and scanning electron microscopy. Amphistomatic leaves, anomocytic stomata, biseriate capitate glandular trichomes, uniseriate simple flagelliform non-glandular trichomes, secretory ducts associated to the phloem, perivascular fiber cap, calcium oxalate as prismatic and styloid crystals in the pith of the stem were reported as the mainly anatomical data for B. rufescens var. tenuifolia.Ouvir Ler foneticamente.

Clinical evaluation of chlorhexidine for the control of dental biofilm in children with special needs.

OBJECTIVE: The aim of the present study was to assess two vehicles and forms of the in-home administration of chlorhexidine for the control of dental biofilm in children with special needs. BASIC RESEARCH DESIGN: Twenty-nine children aged seven to 12 years (mixed dentition phase) participated in the study. A double-blind, placebo-controlled, cross-over clinical trial was carried out with the following treatment groups: 1 - 0.12% chlorhexidine gel (CG); 2 - placebo gel (PG); 3 - 0.12% chlorhexidine spray (CS); 4 - placebo spray (PS). Ten-day experiment periods were separated by 15-day washout intervals. MAIN OUTCOME MEASURES: The parameters evaluated were plaque, gingival bleeding, and preferences of parents/caregivers. RESULTS: The initial conditions were similar in each phase of the experiment (p > 0.05). The treatments with chlorhexidine (gel and spray) achieved a significant reduction (p < 0.0001) in plaque and bleeding. The placebo treatments did not achieve significant differences (p > 0.05). The parents/caregivers preferred the administration of chlorhexidine in spray form. CONCLUSIONS: The topical administration of chlorhexidine associated to tooth brushing led to a reduction in dental biofilm and gingival bleeding in children with special needs. Administration in spray form proved easier and was preferred by parents/caregivers.

O progresso da pesquisa sobre o gênero Baccharis, Asteraceae: I - Estudos botânicos / Research progress on the genus Baccharis, Asteraceae: I - Botanical studies

Baccharis é um importante gênero da família Asteraceae que compreende aproximadamente 500 espécies, todas americanas, das quais aproximadamente 120 ocorrem no Brasil. Muitos autores como De Candolle, Baker, Heering, Cuatrecasas, Ariza Espinar, Barroso e Giuliano têm tentado estruturar uma adequada divisão do gênero em subgêneros e seções. Espécies desse gênero são importantes economicamente para o homem, pois ajudam no combate à erosão e podem ser utilizadas como plantas ornamentais, mas também podem apresentar-se como pragas de difícil combate em pastagens, podendo intoxicar o gado. Contudo, o destaque maior está na medicina, onde vários representantes são utilizados popularmente. Nesse contexto várias espécies têm sido investigadas contribuindo para a elucidação morfoanatômica e para o controle de qualidade.

Baccharis is an important genus of the Asteraceae family, which comprises about 500 American species, including 120 species from Brazil. Several authors such as De Candolle, Baker, Heering, Cuatrecasas, Ariza Espinar, Barroso and Giuliano have attempted to elaborate an adequate genus division in subgenera and sections. Baccharis species are economically important since they help to prevent erosion and are employed as ornamental plants, although they can become weeds of difficult control in grazing and poison to the cattle. However, in the folk medicine, many species are relevant and have been studied, aiming to contribute to their morpho-anatomical and quality control knowledge.