Brazilian dentist's knowledge of minimum intervention dentistry for caries management: application of a developed knowledge scale (MIDDeC-KS) and evaluation of its psychometric properties.

AIM: To assess the knowledge of Brazilian dentists about Minimum Intervention (MI) using a Minimum Intervention Dentistry to Dental Caries-Knowledge Scale (MIDDeC-KS) and evaluate its psychometric properties. MATERIALS AND METHODS: An online scale was developed to evaluate dentists' knowledge about MI. The higher the score, the greater the knowledge and vice versa. A preliminary study was carried out with 143 dentists to validate the MIDDeC-KS. For psychometric properties analysis, convergent and discriminant validity, test-retest reliability, and internal consistency of the instrument were assessed. After validation, MIDDeC-KS was applied to a representative sample of Brazilian dentists. T test for independent samples, Chi-square, and/or ANOVA one-way tests were applied. RESULTS: The MIDDeC-KS convergent (Spearman's = 0.48) and discriminant (P = 0.001) validity and reliability (ICC = 0.85, α = 0.72 and ω = 0.74) were proved. The participants (n = 637) obtained an overall mean score of 7.4 ± 2.5. The sample was mainly composed of females (P < 0.01), who graduated over 10 years prior (P = 0.02), from public colleges (P < 0.01), and most were pediatric dentists (38.2%). The highest and lowest scores were reached by pediatric dentists (9.2 ± 1.6) and bucomaxillofacial professionals (3.1 ± 2.1), respectively. Brazilian dentists demonstrated more knowledge about diet, biofilm, and topical fluoride control (84.3%), while the Hall technique (31.9%), resin infiltrant (47.6%), and chemical mechanical caries removal (48.4%) were the least known MI techniques. CONCLUSION: Brazilian dentists demonstrated more knowledge about preventive measures and less about more recent protocols, such as the Hall technique, resin infiltrant, and chemical mechanical caries tissue removal. Sufficient psychometric evidence of the MIDDeC-KS was found. CLINICAL RELEVANCE: Identify dentist's knowledge about MI.

Worldwide research trends on the use of chemical-mechanical caries removal products over the years: a critical review.

BACKGROUND: Chemical-mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries removal. AIM: Characterize the worldwide scientific literature about CMCR products, over the years, by means of a critical review. DESIGN: Electronic search was performed on Medline/PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, and Embase up to November 2020. Year, journal, country of authors, and type of study were the data extracted from the retrieved studies. Additional data of the clinical studies and systematic reviews were investigated. RESULTS: 2221 records were identified, 397 selected. 2011-2020 period concentrates higher number of publications (n = 169), in the Journal of Dental Research (n = 51), developed in Brazil (n = 45) and India (n = 44). Most studies were in vitro (n = 211) and clinical trials (n = 101). Carisolv™ (n = 48) and Papacarie Duo Gel™ (n = 33) were the most used products, prescript in isolated usage (n = 101), and compared with drills (n = 77). CMCR were more studied in primary teeth (n = 78), receiving glass ionomer cement (GIC) (n = 51) as restorative material. The most evaluated outcomes were time spent (n = 48) and pain (n = 41). Clinical application of CMCR takes more time than other techniques, but can also reduce patient anxiety, pain, and need for anesthesia. CONCLUSION: In vitro and clinical studies with CMCR products have been increasing, mostly carried out in developing countries, evaluating Carisolv™ and Papacarie Duo Gel™. Clinical studies tend to evaluate the time spent and pain compared to drills for removing caries in primary teeth, posteriorly restored with GIC. CMCR clinical application reduces anxiety, pain, and need for anesthesia, despite increase treatments' time.

Treatment time, pain experience and acceptability of the technique for caries removal in primary teeth using the ART approach with or without Brix3000™ papain gel: a preliminary randomised controlled clinical trial.

PURPOSE: To compare the Atraumatic Restorative Treatment (ART) associated with Brix3000™ to ART considering treatment time, pain experienced, and acceptability to children. METHODS: This study was accepted in Research Ethics Committee in July 2019 (number 3469402). Healthy patients (n = 20) aged 3-9 years, with at least one primary molar with occlusal dentine caries without cusp involvement were randomly allocated to either the ART + Brix3000™ group or the ART-only group. The sample was characterised by sex, age, tooth location and caries experience. Time spent and pain experience scores were recorded at prophylaxis, caries removal and restoration. The pain experience (intense, moderate, or mild) was evaluated by the Face, Legs, Activity, Cry, Consolability-revised scale (FLACC-r). Acceptability was assessed by a five-point hedonic facial scale (dichotomised into 'like' and 'indifferent/dislike' bins) and by an open-question interview. Mann-Whitney, Chi-square, and Fisher's exact tests were applied to discern differences in time, pain/sample characterisation and acceptability, respectively. RESULTS: The ART + Brix3000™ group required 8.6 ± 3.1 min to remove caries tissue, whereas the ART group required only 4.8 ± 2.0 min (p = 0.03). The total time spent with treatments was 13.1 ± 4.0 min for ART + Brix3000™, and 9.8 ± 2.7 min for ART (p = 0.03). There was no difference in pain experience and acceptability found among the groups (p > 0.05). CONCLUSION: Although the ART + Brix3000™ technique demanded more treatment time than the ART alone, there were no differences in either pain experience or acceptability.

A proline derivative-enriched methanol fraction from Sideroxylon obtusifolium leaves (MFSOL) stimulates human keratinocyte cells and exerts a healing effect in a burn wound model.

It was previously demonstrated that the methanol fraction of Sideroxylon obtusifolium (MFSOL) promoted anti-inflammatory and healing activity in excisional wounds. Thus, the present work investigated the healing effects of MFSOL on human keratinocyte cells (HaCaT) and experimental burn model injuries. HaCaT cells were used to study MFSOL's effect on cell migration and proliferation rates. Female Swiss mice were subjected to a second-degree superficial burn protocol and divided into four treatment groups: Vehicle, 1.0% silver sulfadiazine, and 0.5 or 1.0% MFSOL Cream (CrMFSOL). Samples were collected to quantify the inflammatory mediators, and histological analyses were performed after 3, 7, and 14 days. The results showed that MFSOL (50 µg/mL) stimulated HaCaT cells by increasing proliferation and migration rates. Moreover, 0.5% CrMFSOL attenuated myeloperoxidase (MPO) activity and also stimulated the release of interleukin (IL)-1ß and IL-10 after 3 days of treatment. CrMFSOL (0.5%) also enhanced wound contraction, promoted improvement of tissue remodeling, and increased collagen production after 7 days and VEGF release after 14 days. Therefore, MFSOL stimulated human keratinocyte (HaCaT) cells and improved wound healing via modulation of inflammatory mediators of burn injuries.

A proline derivative-enriched methanol fraction from Sideroxylon obtusifolium leaves (MFSOL) stimulates human keratinocyte cells and exerts a healing effect in a burn wound model

It was previously demonstrated that the methanol fraction of Sideroxylon obtusifolium (MFSOL) promoted anti-inflammatory and healing activity in excisional wounds. Thus, the present work investigated the healing effects of MFSOL on human keratinocyte cells (HaCaT) and experimental burn model injuries. HaCaT cells were used to study MFSOL's effect on cell migration and proliferation rates. Female Swiss mice were subjected to a second-degree superficial burn protocol and divided into four treatment groups: Vehicle, 1.0% silver sulfadiazine, and 0.5 or 1.0% MFSOL Cream (CrMFSOL). Samples were collected to quantify the inflammatory mediators, and histological analyses were performed after 3, 7, and 14 days. The results showed that MFSOL (50 μg/mL) stimulated HaCaT cells by increasing proliferation and migration rates. Moreover, 0.5% CrMFSOL attenuated myeloperoxidase (MPO) activity and also stimulated the release of interleukin (IL)-1β and IL-10 after 3 days of treatment. CrMFSOL (0.5%) also enhanced wound contraction, promoted improvement of tissue remodeling, and increased collagen production after 7 days and VEGF release after 14 days. Therefore, MFSOL stimulated human keratinocyte (HaCaT) cells and improved wound healing via modulation of inflammatory mediators of burn injuries.

A three-dimensional cell culture system as an in vitro canine mammary carcinoma model for the expression of connective tissue modulators.

In this study, derived complex carcinoma (CC) and simple carcinoma (SC) cell lines were established and cultured under two-dimensional (2D) and three-dimensional (3D) conditions. The 3D was performed in six-well AlgiMatrix™ (LifeTechnologies®, Carlsbad, CA, USA) scaffolds, resulting in spheroids sized 50-125 µm for CC and 175-200 µm for SC. Cell viability was demonstrated up to 14 days for both models. Epidermal growth factor receptor (EGFR) was expressed in CC and SC in both systems. However, higher mRNA and protein levels were observed in SC 2D and 3D systems when compared with CC (P < 0.005). The connective tissue modulators, metalloproteinases-1, -2, -9 and -13 (MMPs), relaxin receptors 1 and 2 (RXR1 and RXR2) and E-cadherin (CDH1) were quantitated. All were upregulated similarly when canine mammary tumour (CMT)-derived cell lines were cultured under 3D AlgiMatrix, except CDH1 that was downregulated (P < 0.005). These results are promising towards the used of 3D system to increase a high throughput in vitro canine tumour model.

Evidence for spawning aggregations of the endangered Atlantic goliath grouper Epinephelus itajara in southern Brazil.

In this study, seasonal numerical abundance of the critically endangered Atlantic goliath grouper Epinephelus itajara was estimated by conducting scuba dive surveys and calculating sightings-per-unit-effort (SPUE) at three sites in southern Brazil. Seasonal differences in size and reproductive condition of captured or confiscated specimens were compared. The SPUE differed significantly with season, increasing in late spring and peaking during the austral summer months. A significant effect was observed in the number of fish relative to the lunar cycle. All females sampled during the summer were spawning capable, while all those sampled during other seasons were either regressing or regenerating. What these data strongly infer is that the E. itajara spawning aggregation sites have been located in the southern state of Paraná and the northern state of Santa Catarina and summer is the most likely spawning season. Size frequency distributions, abundance and reproductive state were estimated and correlated with environmental variables.

Filamentous fungi and media for cellulase production in solid state cultures.

Cellulase production was evaluated in two reference strains (T. reesei Rut-C30 and T. reesei QM9414), two strains isolated from a sugarcane cultivation area (Trichoderma sp. IPT778 and T. harzianum rifai IPT821) and one strain isolated in a program for biodiversity preservation in São Paulo state (Myceliophthora thermophila M77). Solid state cultures were performed using sugarcane bagasse (C), wheat bran (W) and/or soybean bran (S). The highest FPA was 10.6 U/gdm for M77 in SC (10:90) at 80% moisture, which was 4.4 times higher than production in pure W. C was a strong inducer of cellulase production, given that the production level of 6.1 U/gdm in WC (40:60) was 2.5 times higher than in pure W for strain M77; T. reesei Rut-C30 did not respond as strongly with about 1.6-fold surplus production. S advantageously replaced W, as the surplus production on SC (20:80) was 2.3 times relative to WC (20:80) for M77.

Filamentous fungi and media for cellulase production in solid state cultures

Cellulase production was evaluated in two reference strains (T. reesei Rut-C30 and T. reesei QM9414), two strains isolated from a sugarcane cultivation area (Trichoderma sp. IPT778 and T. harzianum rifai IPT821) and one strain isolated in a program for biodiversity preservation in São Paulo state (Myceliophthora thermophila M77). Solid state cultures were performed using sugarcane bagasse (C), wheat bran (W) and/or soybean bran (S). The highest FPA was 10.6 U/gdm for M77 in SC (10:90) at 80% moisture, which was 4.4 times higher than production in pure W. C was a strong inducer of cellulase production, given that the production level of 6.1 U/gdm in WC (40:60) was 2.5 times higher than in pure W for strain M77; T. reesei Rut-C30 did not respond as strongly with about 1.6-fold surplus production. S advantageously replaced W, as the surplus production on SC (20:80) was 2.3 times relative to WC (20:80) for M77.

Cardiovascular and respiratory alterations in dogs during cervical myelography using ioversol / Alterações cardiovasculares e respiratórias durante a mielografia cervical com ioversol em cães

Subarachnoid infusion of most contrast mediums and the steps involved in performing a cervical myelography have adverse affects that can discourage its use in the radiographic diagnosis of spinal cord diseases. Thus, the cardiovascular and respiratory alterations associated with neck flexion, subarachnoid puncture, and cerebrospinal fluid drainage during subarachnoid infusion of ioversol (320mgI/mL) in dogs under general anesthesia using isoflurane were evaluated. The dogs received subarachnoid infusion of autologous cerebrospinal fluid kept at 38°C - control group (GC); ioversol 0.3mL/kg at 25°C (GI25) and ioversol 0.3mL/kg heated to 38°C (GI38). Each dog had its heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), respiratory rate (RR), oxyhemoglobin saturation (SaO2) and electrocardiography readings (PR and QT intervals) recorded. Group comparisons showed no statistical difference regarding neck positioning, subarachnoid puncture, and subarachnoid infusion of contrast medium on HR, RR and SaO2, cardiac rhythm or conduction. However, isoflurane significantly increased PR and QT intervals. Based on these findings, it is concluded that the steps involved in cervical myelography and the use of ioversol 320mgI/mL at 0.3mL/kg (25ºC and 38ºC) during cervical myelography did not result in relevant cardiovascular and respiratory alterations, except for an elevation in arterial pressure after injection of ioversol.

Os efeitos adversos provocados pela infusão subaracnoidea de meios de contraste e da mielografia cervical podem desencorajar sua aplicação como alternativa para o diagnóstico radiológico de doenças da medula espinhal. Assim, avaliaram-se os efeitos cardiovascular e respiratório dos procedimentos técnicos necessários à mielografia cervical e da infusão subaracnoidea do ioversol - 320mgI/mL - em cães anestesiados com isofluorano. Foi realizada infusão do líquido cefalorraquidiano autólogo mantido a 38°C - grupo-controle (GC); infusão do ioversol 0,3mL/kg a 25°C (GI25); e infusão do ioversol 0,3mL/kg aquecido a 38°C (GI38). Estudaram-se: pressões arteriais sistólica (PAS) e diastólica (PAD), frequências cardíaca (FC) e respiratória (FR), saturação de oxi-hemoglobina (SaO2) e medidas eletrocardiográficas (intervalos PR e QT). Não houve influência significativa do posicionamento, da punção ou da infusão subaracnoidea do ioversol sobre FC, FR, SaO2, ritmo e condução cardíaca, entretanto o isofluorano aumentou significativamente os intervalos PR e QT. Concluiu-se que a mielografia cervical com ioversol 320mgI/mL, nas temperaturas de 25ºC e 38ºC e na dose de 0,3mL/kg, não causa arritmias cardíacas nem alterações cardiovasculares e respiratórias relevantes, exceto elevação da pressão arterial após a injeção do contraste.

Healing and expression of growth factors (TGF-ß and PDGF) in canine radial ostectomy gap containing platelet-rich plasma.

OBJECTIVES: To evaluate bone healing in an experimental radial ostectomy in dogs treated with autologous platelet-rich plasma (PRP), through histological, densitometric, radiographic studies, as well as expression of growth factors in the ostectomy gap. METHODS: Twenty-one dogs were randomly divided into either a control or a PRP group. All underwent unilateral ostectomy of the radius to generate a gap of 2.0 mm, that was stabilized with external skeletal fixation. The ostectomy gap was either filled with PRP or left empty as a control. The radiographic and densitometric studies were performed after surgery, then at intervals until 60 days during the post-surgery period. Histological and immunohistochemical evaluations were performed at seven or 60 days post-surgery. Analyses were performed using a statistical analysis system, and the level of significance was set at p <0.05. RESULTS: The median radiographic healing score in the PRP group increased significantly between day 0 and day 60. Furthermore, at 60 days, the median healing score and the proportion of healed ostectomies in the control group (score 1; 1/6 healed) and the PRP group (score 5; 4/5 healed) were significantly different. There were differences between groups in radiographic and densitometric values at days 45 and 60. The histological evaluation showed advanced bone healing at 60 days in the PRP group and signs of delayed union in the control group. CLINICAL RELEVANCE: Platelet-rich plasma can be used as an adjuvant therapy because it may promote better bone healing of a radial ostectomy treated with external skeletal fixation in dogs.

Influência do butorfanol sobre os períodos de latência e de ação da ropivacaína pela via peridural na ovariossalpingo-histerectomia em cadelas / Influence of butorphanol on latency and duration of ropivacaine epidural anesthesia for ovariosalpingohysterectomy in bitches

Avaliaram-se os períodos de latência e de duração do efeito do butorfanol associado à ropivacaína aplicados pela via peridural e a possibilidade de uso dessa associação como protocolo anestésico para realização de ovariossalpingo-histerectomia (OSH) em cadelas. Utilizaram-se 16 cadelas pré-medicadas com acepromazina e midazolam compondo dois grupos: no grupo 1 (n=8) aplicou-se ropivacaína isolada (0,3mL/kg) e no grupo 2 (n=8), butorfanol (0,1mg/kg) e ropivacaína (até o volume de 0,3mL/kg), pela via peridural. Consideraram-se nove momentos (M): M0 - animal sem anestesia, M1 - 15 minutos após medicação pré-anestésica; M2 - 30 minutos após a aplicação peridural; M3, M4 e M5 - correspondentes ao início do procedimento e ao pinçamento dos pedículos esquerdo e direito, respectivamente; M6 - ligadura da cérvix uterina; e M7 e M8 - início da laparorrafia e fim da sutura de pele, respectivamente. Foram avaliados os períodos de latência e ação do bloqueio, além da viabilidade de realização do procedimento cirúrgico por meio do bloqueio efetuado. O que recebeu ropivacaína + butorfanol apresentou sedação pronunciada e permitiu a realização de OSH em 75 por cento dos animais, sem indução anestésica. Não houve diferença entre os grupos quanto aos períodos de latência e duração. A associação do butorfanol à ropivacaína proporcionou bloqueio anestésico compatível com a realização de OSH e período de latência curto, com duração de efeito suficiente para o procedimento cirúrgico.

The periods of latency and duration of butorphanol associated with ropivacaine used via epidural, and this combination as anesthetic protocol for carrying out ovariosalpingohysterectomy (OSH) in bitches were evaluated. Sixteen animals pre-medicated with acepromazine and midazolam were used composing two groups that received: 1 (n=8) ropivacaine (0.3mL/kg) and 2 (n=8) butorphanol (0.1mg/kg) and ropivacaine (up to the volume of 0.3ml/kg) via epidural. Nine moments were studied: M1 - 15 minutes after pre-anesthetic medication; M2 - 30 minutes after the epidural medication; M3, M4, and M5 - at the beginning of surgery and at clamping left and right pedicles, respectively; M6 - at ligation of the uterine cervix; and M7 and M8 - at laparorhaphy and end of skin suture, respectively. Periods of latency and blocking the action of random double-covert manner were evaluated as well as the feasibility of carrying out the surgery performed by the blockade. It was observed that the group receiving ropivacaine + butorphanol allowed the execution of OSH in 75 percent of animals without the need for anesthesia. There was no statistical difference between the periods of latency and duration. It was concluded that the combination of butorphanol to ropivacaine provides, in bitches, block compatible with the implementation of OSH with short period of latency and duration of effect sufficient for the surgical procedure.