Clinical Study of Antimicrobial Efficacy of Laser Ablation Therapy with Indocyanine Green in Root Canal Treatment.

INTRODUCTION: Laser ablation (LA) therapy is used as an adjunct to endodontic treatment to improve microbial reduction. However, studies evaluating the impact of LA with indocyanine green (ICG) are scarce. This study aimed to evaluate the antimicrobial efficacy of LA therapy with ICG in root canal treatment. METHODS: Sixty patients with periapical lesions in teeth with a single canal and absence of pain, edema, and previous treatment were selected. Patients were randomly allocated into 3 groups according to the apical sizes used (n = 20); 25/04, 30/04, and 35/04 were the final sizes used. In half the patients of each group, 2.5% sodium hypochlorite was used as an irrigating solution, and in the other half, saline solution was used. After instrumentation, all patients received LA therapy with ICG. Root canal sampling was performed before (S1) and after (S2) root canal instrumentation and immediately after LA therapy with ICG (S3). Colony-forming units were counted, and statistical tests were applied (P < .05). RESULTS: There was a significant reduction in colony-forming units from S1 to S2 in all treatment protocols (P < .05); 2.5% sodium hypochlorite as an irrigating solution showed a greater microbial reduction compared with saline solution (P < .05). LA therapy with ICG further reduced the microbial counts significantly (S2 to S3 and S1 to S3) whether sodium hypochlorite or saline was used (P < .05). CONCLUSIONS: LA therapy with ICG significantly increased microbial reduction in root canals regardless of instrumentation sizes or the irrigation solution used.

Proteomic analysis of infected root canals with apical periodontitis in patients with type 2 diabetes mellitus: A cross-sectional study.

AIM: This study aimed to quantitatively and qualitatively determine the proteomic profile of apical periodontitis (AP) in type 2 diabetes mellitus (T2DM) patients in comparison with systemically noncompromised patients and to correlate the protein expression of both groups with their biological functions. METHODOLOGY: The sample consisted of 18 patients with asymptomatic AP divided into two groups according to the presence of T2DM: diabetic group-patients with T2DM (n = 9) and control group-systemically healthy patients (n = 9). After sample collection, the root canal samples were prepared for proteomic analysis using reverse-phase liquid chromatography-mass spectrometry. Label-free quantitative proteomic analysis was performed by Protein Lynx Global Service software. Differences in protein expression between groups were calculated using t-test (p < .05). Biological functions were analysed using the Homo sapiens UniProt database. RESULTS: A total of 727 human proteins were identified in all samples. Among them, 124 proteins common to both groups were quantified, out of which 65 proteins from the diabetic group showed significant differences compared with the control: 43 upregulated (p < .05) and 22 downregulated (p < .05) proteins. No significant differences in protein expression were seen for the remaining 59 proteins (p > .05). Most proteins with differences in expression were related to immune/inflammatory response. Neutrophil gelatinase-associated lipocalin, Plastin-2, Lactotransferrin and 13 isoforms of immunoglobulins were upregulated. In contrast, Protein S100-A8, Protein S100-A9, Histone H2B, Neutrophil defensin 1, Neutrophil defensin 3 and Prolactin-inducible protein were downregulated. CONCLUSIONS: Quantitative differences were demonstrated in the expression of proteins common to diabetic and control groups, mainly related to immune response, oxidative stress, apoptosis and proteolysis. These findings revealed biological pathways that provide the basis to support clinical findings on the relationship between AP and T2DM.

Antibiofilm activity of laser ablation with indocyanine green activated by different power laser parameters compared with photodynamic therapy on root canals infected with Enterococcus faecalis.

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) is used as an adjunct to endodontic treatment to enhance microbial reduction in the root canal system. However, studies evaluating the impact of laser ablation with Indocyanine Green (ICG) are scarce. Thus, this in vitro study aimed to evaluate the efficiency of laser ablation with ICG using different laser parameters compared with aPDT using photosensitizer methylene blue (MB) and curcumin (CUR) on the reduction of E. faecalis biofilms on root canals. METHODS: Forty-nine human premolars were used after biomechanical instrumentation for standardization. The root canals were contaminated with E. faecalis for 10 days to form biofilms, and divided into 7 groups (n = 7): 0.01% MB activated by red laser - MB+RL; 0.05% CUR activated by blue LED - CUR+BL; 0.05% ICG activated by infrared diode laser (2.5 W power, 30 ms interval, and 30 ms duration) - ICG+DL 2.5/30/30; 0.05% ICG activated by infrared diode laser (2.5 W power, 300 ms interval, and 100 ms duration) - ICG+DL 2.5/300/100; 0.05% ICG activated by infrared diode laser (3 W power, 300 ms interval, and 100 ms duration) - ICG+DL 3/300/100; sterile saline solution (negative control) - NC; and 2.5% NaOCl (positive control) - PC. Root canal sampling was performed prior to and immediately after the different treatment protocols. Data were submitted to One- and Two-Way ANOVA, followed by Student-Newman-Keuls test or Fisher LSD's test (α = 0.05). RESULTS: All aPDT protocols promoted significant CFU reductions compared with the NC; the highest CFU reduction was observed for PC (p < 0.05). Among the protocols the highest CFU reduction was promoted by laser ablation with ICG+DL 3/300/100 (p < 0.05) except compared with aPDT using CUR+BL (p > 0.05). CONCLUSIONS: Laser ablation protocol using ICG+DL proved to be efficient in reducing E. faecalis biofilms, especially when activated at 3/300/100 configuration.

Conhecimento e prevalência de trauma e adaptação ao uso de protetor bucal em uma população de atletas brasileiros / Knowledge and prevalence of trauma and adaptation to the use of mouthguards in a population of Brazilian athletes

Esportes de contato podem levar a traumatismos dentários, que muitas vezes podem ser reduzidos com medidas preventivas apropriadas, como o uso de protetores bucais. Os objetivos deste estudo foram verificar o conhecimento dos atletas da delegação esportiva da cidade de XXXXX sobre traumatismo dentário, a prevalência e o tipo de traumatismos ocorridos durante suas atividades esportivas, a conscientização e hábitos de utilização dos dispositivos de proteção e por fim, avaliação do impacto das ações educativas e preventivas implementadas nessa comunidade. O estudo foi dividido em quatro partes: 1) Aplicação do questionário 1 (n= 94); 2) Atendimento dos atletas e confecção dos protetores bucais personalizados; 3) Palestra e entrega dos protetores e 4) Aplicação do questionário 2 (n= 41). Após responderem o questionário 1, os atletas incluídos no estudo foram moldados para fabricação dos protetores bucais. As palestras sobre trauma dentário e primeiros socorros, aconteceram com a entrega dos protetores bucais personalizados. O questionário 2 foi aplicado para avaliar o efeito da medida educacional e a adaptação aos protetores bucais. Os dados coletados foram submetidos à análise descritiva e ao teste do qui-quadrado, com nível de significância de 5%. O conhecimento sobre trauma, demonstrado pelos participantes foi inadequado. A prevalência de trauma foi maior no gênero masculino (49%) e o trauma mais relatado foi a fratura dentária (12,8%) (p>0,05). 76,6% dos atletas disseram nunca ter utilizado protetor bucal anteriormente. Após as palestras, os participantes mostraram uma melhora significativa no conhecimento sobre trauma e 73,2% dos atletas disseram estar utilizando o dispositivo de proteção personalizado. Esses resultados evidenciam a importância dos trabalhos educacionais e confirmam o impacto positivo dos trabalhos realizados nessa comunidade de atletas(AU)

Contact sports can lead to dental trauma, which can often be reduced with appropriate preventive measures, such as the use of mouthguards. The objectives of this study were to verify the knowledge of athletes from the sports delegation in the city of XXXXX about dental trauma, the prevalence and type of trauma that occurred during their sports activities, awareness and habits of using protective devices and, finally, assessment of impact of educational and preventive actions implemented in this community. T he study was divided into four parts: 1) Application of questionnaire 1 (n = 94); 2) Attending athletes and making personalized mouthguards; 3) Lecture and delivery of protectors and 4) Application of questionnaire 2 (n = 41). After answering questionnaire 1, the athletes included in the study were molded to manufacture mouthguards. The lectures on dental trauma and first aid took place with the delivery of personalized mouth guards. Questionnaire 2 was applied to assess the effect of the educational measur e and the adaptation to mouthguards. The collected data were submitted to descriptive analysis and chisquare test, with a 5% significance level. The knowledge about trauma, demonstrated by the participants, was inadequate. The prevalence of trauma was hig her in males (49%) and the most reported trauma was dental fracture (12.8%) (p> 0.05). 76.6% of athletes said they had never used mouthguards before. After the lectures, the participants showed a significant improvement in knowledge about trauma and 73.2% of the athletes said they were using the personalized protection device. These results highlight the importance of educational work and confirm the positive impact of the work carried out in this community of athletes(AU)

Manuseio de emergências cardiológicas em hospitais gerais do estado do Paraná / Management of cardiologic emergencies in general hospitals in the state of Paraná

JUSTIFICATIVA E OBJETIVOS: As diretrizes sobre as condutas em reanimação cardiopulmonar (RCP) foram baseadas na grande evolução dos estudos nessa área, sendo atualizadas em certos períodos de tempo. É por isso que o manuseio correto de uma parada cardíaca depende apenas da atualização do profissional que a atende. O objetivo deste estudo foi avaliar a condutados profissionais responsáveis pelo primeiro atendimento frente a emergências cardiológicas em alguns serviços hospitalares. MÉTODO: Foram avaliados 80 médicos de hospitais gerais, tomando-se como padrão as normas do Advanced Cardiologic Life Support (ACLS) e comparando o índice de acertos em um questionário com alguns quesitos de formação e trabalho do profissional. Os profissionais foram identificados com idade, sexo, estado civil, tempo de formação e local de trabalho, e em seguida responderam a seis questões referentes às condutas utilizadas. RESULTADOS: O índice de acertos foi tabulado e comparado, apresentando uma média de acertos de 3,5 questões. O mínimo de acertos foi zero, e o máximo foram seis questões. Houve correlação inversa significativa entre a idade e o número de acertos, ou seja, médicos mais jovens acertaram mais questões que os médicos de mais idade. Não houve associação significativa entre sexo, estado civil, tempo de formação e local de trabalho em relação ao número de acertos. CONCLUSÃO: Portanto, há a necessidade de atualizações entre os profissionais, buscando o melhor atendimento emergencial.

BACKGROUND AND OBJECTIVES: The cardiopulmonary resuscitation (CPR) guidelines were based on the large evolution of the studies in this area, being updated in certain periods of time. That is why the correct management of a cardiac arrest only depends on the professionals updating. The goal of the study was to evaluate the behavior of professionals responsible for primary care when they are faced with cardiologic emergencies in some hospitals. METHOD: Eighty physicians of general hospitals were evaluated, taking as base the Advance Cardiologic Life Support (ACLS) guidelines and comparing the rates of correct answers in a questionnaire with questions about professional training and work. The professionals were identified by age, gender, civil state, time of training and work place, and then they answered six questions about the procedures undertaken. RESULTS: The correct answers were tabulated and compared, demonstrating an average number of right answers of 3.5. The minimum was zero right answers and the maximum, six. There was a significant inverse correlation between the age and the number of correct answers, i.e., younger physicians had more correct answers than older ones. There were not significant relations among gender, civil state, time of training, and work place and number of correct answers. CONCLUSION: Therefore, professionals should keep themselves updated in order to deliver better emergency care.