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BACKGROUND: Childhood obesity is a significant public health concern in Mexico, with far-reaching implications for the nation's healthcare system and economy. In light of this challenge, our study sought to validate the Childhood Family Mealtime Questionnaire (CFMQ) in Mexican adolescents living with obesity and their primary caregivers. METHODS: A sample of 56 adolescents ages 13 to 17 years and their primary caregivers from one pediatric obesity clinic participated in the study. We conducted a comprehensive assessment of the CFMQ's consistency, reliability, and construct validity among all participants. Internal consistency was determined using Cronbach's α, and the questionnaire's reliability was assessed through test-retest and intraclass correlation coefficients. Construct validity was assessed through an exploratory factor analysis. RESULTS: Our findings confirmed strong internal consistency and reliability for both adolescents and caregivers. Construct validity was established through exploratory factor analysis, refining the questionnaire while preserving its original seven dimensions. This validation of the CFMQ highlights its applicability in evaluating family mealtime experiences in this context, providing valuable insights into the dynamics that influence adolescent nutrition and health. CONCLUSION: The CFMQ proves to be a reliable tool for assessing family mealtime experiences in Mexican adolescents living with obesity and their caregivers who seek care at third-level public hospitals.
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Obesidad Infantil , Adolescente , Humanos , Niño , Cuidadores , México , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Comidas , Psicometría/métodosRESUMEN
La sepsis es la respuesta desordenada del organismo a la infección y se caracteriza por un daño a los órganos que puede ser irreversible y mortal. El microbioma intestinal regula a un grupo de mecanismos homeostáticos en el huésped, como la función inmunológica y la protección de la barrera intestinal, la pérdida de la estructura y la función microbiana intestinal normal; además, se ha asociado con el inicio de enfermedades de características diversas. La evidencia reciente ha demostrado un nexo entre el microbioma intestinal y la sepsis: la alteración del microbioma intestinal aumenta la susceptibilidad a la sepsis a través de varios mecanismos como la expansión de bacterias intestinales patógenas, la respuesta proinflamatoria marcada y la disminución de la formación de productos microbianos beneficiosos como los ácidos grasos de cadena corta. Una vez establecida la sepsis, la alteración del microbioma intestinal empeora y aumenta la susceptibilidad a la disfunción del órgano terminal. Existen pruebas limitadas de que las terapias basadas en microbiomas (que incluyen a probióticos y a la descontaminación digestiva selectiva) pueden disminuir el riesgo de sepsis y mejorar sus resultados en poblaciones de pacientes seleccionadas, pero las preocupaciones sobre la seguridad causan una aceptación limitada. Si bien gran parte de la evidencia que vincula el microbioma intestinal y la sepsis se ha establecido en estudios preclínicos, aún es necesaria la evidencia clínica en distintas áreas.
Sepsis is the body's overwhelming response to an infection. It is characterized by damage to the organs that may be irreversible and life-threatening. The gastrointestinal microbiome regulates a series of homeostatic mechanisms in the host, such as the immune function and the protection of the intestinal barrier, and the loss of normal intestinal microbial structure and function. Moreover, it has been associated with the onset of diseases of diverse characteristics. Recent evidence has shown a link between the gastrointestinal microbiome and sepsis: the alteration of the gastrointestinal microbiome increases the susceptibility to sepsis through various mechanisms, including the expansion of pathogenic intestinal bacteria, marked pro-inflammatory response and decreased production of beneficial microbial products such as short-chain fatty acids. Once sepsis is established, the alteration of the gastrointestinal microbiome worsens and the susceptibility to end-organ dysfunction increases. There is limited evidence that microbiome-based therapies, which include probiotics and selective digestive decontamination, can decrease the risk of sepsis and improve its outcomes in selected patient populations. However, safety concerns generate limited acceptance. While much of the evidence linking the gastrointestinal microbiome and sepsis has been established in preclinical studies, clinical evidence is still necessary in many areas.
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Process mining techniques can be used to analyse business processes using the data logged during their execution. These techniques are leveraged in a wide range of domains, including healthcare, where it focuses mainly on the analysis of diagnostic, treatment, and organisational processes. Despite the huge amount of data generated in hospitals by staff and machinery involved in healthcare processes, there is no evidence of a systematic uptake of process mining beyond targeted case studies in a research context. When developing and using process mining in healthcare, distinguishing characteristics of healthcare processes such as their variability and patient-centred focus require targeted attention. Against this background, the Process-Oriented Data Science in Healthcare Alliance has been established to propagate the research and application of techniques targeting the data-driven improvement of healthcare processes. This paper, an initiative of the alliance, presents the distinguishing characteristics of the healthcare domain that need to be considered to successfully use process mining, as well as open challenges that need to be addressed by the community in the future.
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Atención a la Salud , Hospitales , HumanosRESUMEN
Nerve growth factor (NGF) and its high-affinity receptor TRKA are overexpressed in epithelial ovarian cancer (EOC) displaying a crucial role in the disease progression. Otherwise, NGF interacts with its low-affinity receptor P75, activating pro-apoptotic pathways. In neurons, P75 could be cleaved by metalloproteinases (α and γ-secretases), leading to a decrease in P75 signaling. Therefore, this study aimed to evaluate whether the shedding of P75 occurs in EOC cells and whether NGF/TRKA could promote the cleavage of the P75 receptor. The immunodetection of the α-secretase, ADAM17, TRKA, P75, and P75 fragments was assessed by immunohisto/cytochemistry and Western blot in biopsies and ovarian cell lines. The TRKA and secretases' inhibition was performed using specific inhibitors. The results show that P75 immunodetection decreased during EOC progression and was negatively correlated with the presence of TRKA in EOC biopsies. NGF/TRKA increases ADAM17 levels and the fragments of P75 in ovarian cells. This effect is abolished when cells are previously treated with ADAM17, γ-secretase, and TRKA inhibitors. These results indicate that NGF/TRKA promotes the shedding of P75, involving the activation of secretases such as ADAM17. Since ADAM17 has been proposed as a screening marker for early detection of EOC, our results contribute to understanding better the role of ADAM17 and NGF/TRKA in EOC pathogenesis, which includes the NGF/TRKA-mediated cleavage of P75.
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Proteína ADAM17/metabolismo , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Factor de Crecimiento Nervioso/metabolismo , Neoplasias Ováricas/metabolismo , Ovario/metabolismo , Receptor trkA/metabolismo , Factores de Transcripción/metabolismo , Carcinoma Epitelial de Ovario/metabolismo , Carcinoma Epitelial de Ovario/patología , Línea Celular , Línea Celular Tumoral , Femenino , Humanos , Persona de Mediana Edad , Neuronas/metabolismo , Neoplasias Ováricas/patología , Ovario/patología , Transducción de Señal/fisiologíaRESUMEN
INTRODUCTION: Sepsis is a public health problem due to its high prevalence and mortality. Mean platelet volume (MPV), a biomarker reported in routine blood counts, has been investigated and shows promise for determining fatal outcomes in septic patients. OBJECTIVE: Evaluate whether the mean platelet volume (MPV) and mean platelet volume-to-platelet count (MPV/P) ratio are predictors of clinical severity and mortality in patients with sepsis. METHODS: A prospective population cohort of 163 patients aged 18-97 years was recruited at the Intensive Care Unit of Pablo Arturo Hospital, Quito, Ecuador from 2017-2019 and followed up for 28 days. Patients were diagnosed with sepsis based on SEPSIS-3 septic shock criteria; in which the MPV and the MPV/P ratio were measured on days 1, 2, and 3. Sequential organ failure assessment (SOFA) score and presence of septic shock assessed clinical severity. Mortality on day 28 was considered the fatal outcome. RESULTS: The average age of the patients was 61,15 years (SD 20,94) and female sex was predominant. MPV cutoff points at days 1, 2 and 3 were >9,45fL, >8,95fL and >8, 85fL; and (MPV/P) ratio >8, 18, >4, 12 y >3, 95, respectively. MPV at days 2 (9,85fL) and 3 (8,55fL) and (MPV/P) ratio at days 1 (4,42), 2 (4,21), and 3 (8,55), were predictors of clinical severity assessed by septic shock, which reached significance in the ROC curves. MPV and (MPV/P) ratio were also predictors of clinical severity determined by SOFA at days 1, 2, and 3, where higher values were observed in non-survivors reaching significance in all categories. MPV and MPV/P ratio at days 1, 2 and 3 were independent predictor factors of mortality using Cox proportional hazards model (HR 2,31; 95% CI 1,36-3,94), (HR 2,11; 95% CI 1,17-3,82), (HR 2,13; 95% CI 1,07-4,21) and (HR 2,38; 95% CI 1,38-4,12), (HR 2,15; 95% CI 1,14-4,06), (HR 4,43; 95% CI, 1,72-11,37) respectively. CONCLUSIONS: MPV and the MPV/P ratio are predictors of clinical severity and mortality in sepsis. The MPV and its coefficient are indicators of the biological behavior of platelets in sepsis. They should be considered as a cost-effective and rapidly available tool that guides the treatment.
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Plaquetas/patología , Choque Séptico/mortalidad , Choque Séptico/patología , Anciano , Biomarcadores/metabolismo , Ecuador , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Volúmen Plaquetario Medio/métodos , Persona de Mediana Edad , Puntuaciones en la Disfunción de Órganos , Recuento de Plaquetas/métodos , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Curva ROC , Choque Séptico/metabolismoRESUMEN
BACKGROUND: The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic. METHODS: A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the "Alzheimer Disease 8" scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ2 tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors. RESULTS: We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors. CONCLUSION: The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.
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The search for sensitive and rapid analytical techniques for the determination of natural antioxidants is an area in constant growth due, among other aspects, to the complexity of plant matrices. In this study, silver nanoparticles prepared with the aqueous extract of Mimosa albida leaves were used to assess their polyphenolic content and antioxidant capacity. Silver nanoparticles were characterized by different techniques. As a result, nanoparticles of 6.5 ± 3.1 nm were obtained. The total phenolic content in the extract was 1320.4 ± 17.6 mg of gallic acid equivalents GAE. 100 g-1 and in the nanoparticles 257.3 ± 5.1 mg GAE. 100 g-1. From the phenolic profile analyzed by ultra high-performance liquid chromatography (UPLC) with a diode-array detector (DAD), the presence of apigenin and luteolin in the plant extract is postulated. The antioxidant capacity measured by oxygen radical absorbance capacity ORAC-fluorescein assay was 86917 ± 6287 and 7563 ± 967 µmol ET g-1 in the extract and nanoparticles respectively. Electrochemical analysis by cyclic voltammetry (CV) confirmed the effective reduction capacity of the Mimosa albida leaves extract to reduce Ag ions to AgNPs and differential pulse voltammetry (DPV) suggested the presence of two main reducing agents in the extract. From this study, it was concluded that the aqueous extract of Mimosa albida contains reducing agents capable of synthesizing silver nanoparticles, which can be used in the phytochemical industry.
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This study aimed to evaluate histologically the effect of irrigation with 400 ppm Sterilox, 2% and 5% sodium hypochlorite (NaOCl), with and without photo-activated therapy (PAD), in a single-visit root canal treatment of dog's teeth with apical periodontitis (AP). Ten dogs were randomly divided into two groups (n=5): with and without PAD, and the root canals into four subgroups, according to the irrigating solution: SX (400 ppm Sterilox), SH2 (2% NaOCl), SH5 (5% NaOCl) and SS (saline solution) as positive control. A total of 134 root canals were opened and left exposed to the oral environment for 14 days and then sealed for 60 days for AP induction. Then, root canals were treated according to each proposed disinfecting protocol and filled in the same session. After 120 days, the dogs were euthanized and the periapical inflammatory events were evaluated under light microscopy. Qualitative data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). PAD did not produce significant differences in the scores for apical inflammation when used after chemo-mechanical preparation (p>0.05). The irrigating solutions SX, SH2 and SH5 without PAD were statistically different from SS (p<0.05) that presented the greatest scores for apical inflammation. PAD did not show any additional effect for the treatment of root canals with pulp necrosis and AP in a single visit and 400 ppm Sterilox may be considered an alternative to NaOCl in root canal treatment.
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Peróxido de Hidrógeno , Fototerapia , Irrigantes del Conducto Radicular , Tratamiento del Conducto Radicular , Hipoclorito de Sodio , Animales , PerrosRESUMEN
This study aimed to evaluate histologically the effect of irrigation with 400 ppm Sterilox, 2% and 5% sodium hypochlorite (NaOCl), with and without photo-activated therapy (PAD), in a single-visit root canal treatment of dog's teeth with apical periodontitis (AP). Ten dogs were randomly divided into two groups (n=5): with and without PAD, and the root canals into four subgroups, according to the irrigating solution: SX (400 ppm Sterilox), SH2 (2% NaOCl), SH5 (5% NaOCl) and SS (saline solution) as positive control. A total of 134 root canals were opened and left exposed to the oral environment for 14 days and then sealed for 60 days for AP induction. Then, root canals were treated according to each proposed disinfecting protocol and filled in the same session. After 120 days, the dogs were euthanized and the periapical inflammatory events were evaluated under light microscopy. Qualitative data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). PAD did not produce significant differences in the scores for apical inflammation when used after chemo-mechanical preparation (p>0.05). The irrigating solutions SX, SH2 and SH5 without PAD were statistically different from SS (p<0.05) that presented the greatest scores for apical inflammation. PAD did not show any additional effect for the treatment of root canals with pulp necrosis and AP in a single visit and 400 ppm Sterilox may be considered an alternative to NaOCl in root canal treatment.
Este estudo realizou uma avaliação histológica do efeito das soluções irrigadoras Sterilox 400 ppm e hipoclorito de sódio (NaOCl) a 2% e 5%, com e sem a terapia fotodinâmica (PAD), na endodontia em sessão única de dentes de cães associados a lesões periapicais (APs). Dez cães foram divididos de forma randomizada em dois grupos (n=5): com e sem PAD, e os canais radiculares em quatro subgrupos, de acordo com a solução irrigadora utilizada: SX (Sterilox 400 ppm), SH2 (NaOCl 2%), SH5 (NaOCl 5%) e SS (solução salina) como controle positivo. Cento e trinta e quatro canais foram abertos e deixados expostos ao meio oral por 14 dias e depois selados por 60 dias para a indução de APs. Na sequência, os canais foram tratados de acordo com cada protocolo de desinfecção proposto e obturados na mesma sessão. Após 120 dias, os cães foram mortos e os eventos inflamatórios periapicais foram avaliados em microscopia óptica. Os dados qualitativos foram analisados estatisticamente pelos testes Kruskal-Wallis e Mann-Whitney (α=0,05). A PAD, quando empregada após o preparo químico-mecânico, não promoveu diferenças significativas nos escores para inflamação apical (p>0,05). As soluções irrigadoras SX, SH2 e SH5 sem PAD apresentaram diferenças estatísticas do grupo SS (p<0,05) que apresentou os maiores escores para inflamação apical. A PAD não apresentou efeito adicional na endodontia em sessão única dos canais com necrose pulpar associados a lesão apical e a solução irrigadora Sterilox 400 ppm pode ser considerada uma alternativa ao NaOCl na terapia endodôntica.
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Animales , Perros , Peróxido de Hidrógeno , Fototerapia , Irrigantes del Conducto Radicular , Tratamiento del Conducto Radicular , Hipoclorito de SodioRESUMEN
Objetivo: avaliar os efeitos de diferentes instrumentações na formação de smear layer no terço apical de 90 raízes mesiobucais de molares superiores por microscopia eletrônica de varredura (MEV). Materiais e método: três grupos foram formados baseados nas técnicas utilizadas: instrumentação manual, sistema rotatório K3 e sistema reciprocante NSK. Os grupos foram subdivididos em três, de acordo com o diâmetro apical: #30, #35 ou #40. Após o preparo, as raízes foram seccionadas no sentido transversal, separando os terços apicais do restante das raízes; esses terços foram divididos em duas metades e preparados para MEV. A formação de smear layer na superfície do canal radicular e os túbulos den-tinários foram avaliados por escores num aumento de 1.000×. Os dados foram analisados pelo teste Kruskal-Wallis complementado pelo teste de Dunn (p < 0.05). Resultados: o aumento no diâmetro do preparo apical não influenciou na formação de smear layer nas paredes dentinárias. Conclusão: apesar das técnicas e dos diâmetros apicais utilizados durante o preparo, nenhuma parede livre de smear layer foi observada.
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PURPOSE: To evaluate the effect of preflaring on the electronic measurement of working length in mesiobuccal roots of maxillary molars. METHODS: Thirty roots were embedded in an alginate model. Root canals were irrigated with 2.5 percent sodium hypochlorite, and a size 10 K file was inserted into the canal until the locator indicated that apical constriction had been reached. Then, the cervical portion of each canal was flared using the ProTaper system shaping files, whereupon electronic measurements were carried out again. RESULTS: The Student's t test for paired samples did not reveal statistically significant differences in the measurements obtained for preflared and unflared canals (P<0.05). CONCLUSION: Based on the lack of clinical significant relevance of the comparisons carried out in the present study, it is possible to conclude that electronic working length measurement can be carried out either before or after cervical preparation.
OBJETIVO: Avaliar o efeito do pré-alargamento sobre a medição eletrônica do comprimento de trabalho em raízes mésio-vestibulares de molares superiores. METODOLOGIA: Trinta raízes foram incluídas em um modelo de alginato. Canais radiculares foram irrigados com hipoclorito de sódio a 2,5 por cento, e uma lima de tamanho 10 K foi inserida no canal até onde o localizador indicou que a constrição apical tinha sido alcançada. A porção cervical de cada canal foi alargada usando as limas do sistema ProTaper, quando então as medições eletrônicas foram realizados novamente. RESULTADOS: O teste t de Student para amostras pareadas não mostrou diferenças estatisticamente significativas nas medições obtidas para canais pré-alargados e não alargados (P<0,05). CONCLUSÃO: Com base na falta de relevância clínica significativa das comparações realizadas no presente estudo, é possível concluir que a medição do comprimento eletrônico de trabalho pode ser realizado antes ou após o preparo cervical.
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Humanos , Preparación del Conducto Radicular/instrumentaciónRESUMEN
Purpose: To report a clinical case of a 36 mm long upper cuspid submitted to root canal treatment, with emphasis on the alternative technique employed. Case description: A 32 years old, male patient had suffered subluxation of teeth 12 and 13 and coronal fracture involving enamel and dentin, as well as pulp exposition, of tooth 14 because of a motorcycle accident. The man was given dental assistance and a semi-rigid splinting of teeth numbers 12 and 13 was carried out followed by the root canal treatment in a single visit on tooth no. 14. At 30-day follow-up pulp necrosis was detected in teeth 12 and 13 and the root canal treatment was implemented. The tooth 13 was 36 mm long and since the longest possible file (31 mm) was already in use, the cervical limit of the access cavity was considered as the reference point. Conclusion: This technique not only provided adequate disinfection, preparation and filling of the root canal, but it also allowed preservation of the remaining tooth structure.
Objetivo: Descrever o tratamento endodôntico de um canino superior medindo 36 mm de comprimento, mostrando a técnica empregada no preparo do canal radicular e obturação. Descrição do Caso: Paciente do sexo masculino, com 32 anos de idade, sofreu subluxação dos dentes 12 e 13 e fratura coronária envolvendo esmalte e dentina, com exposição pulpar do dente 14, devido a um acidente de moto. No atendimento de urgência, foi realizada a contenção semirrígida dos dentes 12 e 13, seguida da endodontia em sessão única do dente 14. Trinta dias após, foi diagnosticada necrose pulpar dos dentes 12 e 13 e sua endodontia foi, então, iniciada. O comprimento aparente do dente 13 foi estabelecido em 36 mm e como o instrumento mais longo que dispomos no mercado possui 31 mm, o limite cervical da cavidade de acesso foi usado como bordo de referência. Conclusão: Além de garantir uma correta sanificação, modelagem e obturação do canal, esta técnica também permitiu a preservação da estrutura dental remanescente.
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Humanos , Masculino , Adulto , Cavidad Pulpar/anatomía & histología , Tratamiento del Conducto Radicular/métodosRESUMEN
Root canal transportation can lead to treatment failure. A large number of methodologies for assessing root canal preparation have been tried in the past. This study compared two methods for apical transportation measurement: digitised images of longitudinal root sections and radiographs. Sixty upper molar mesiobuccal root canals prepared for endodontic treatment were assessed. The results did not demonstrate statistically significant differences between the two imaging methods used to evaluate root canal transportation. The two methods were proven to be equally reliable.
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Cavidad Pulpar/anatomía & histología , Radiografía Dental Digital/métodos , Preparación del Conducto Radicular/métodos , Ápice del Diente/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen , Anatomía Transversal , Instrumentos Dentales/normas , Cavidad Pulpar/diagnóstico por imagen , Cavidad Pulpar/cirugía , Humanos , Maxilar , Diente Molar , Odontometría/instrumentación , Odontometría/métodos , Obturación del Conducto Radicular/métodos , Preparación del Conducto Radicular/instrumentación , Capa de Barro Dentinario , Ápice del Diente/anatomía & histología , Ápice del Diente/cirugía , Raíz del Diente/anatomía & histología , Raíz del Diente/cirugíaRESUMEN
This study conducted an in vitro analysis of the level of apical transportation in mesiobuccal roots of upper molars after manual instrumentation with stainless steel files, preparation with the K3 system, and with a reciprocating NSK handpiece. Sixty roots were mounted in muffles and then longitudinally sectioned. A digital image was acquired of the inner surface of one root half. After instrumentation, the inner surfaces of the same root halves were digitized with file sizes #30, #35, and #40. Each image obtained was superimposed over the corresponding preoperative image, and the apical transportation was measured. The Friedman and Wilcoxon tests were used to compare results for the file sizes, and comparison of the groups was made with the Kruskal-Wallis test, demonstrating statistically significant differences (P = .000). The stainless steel file sizes #35 and #40 caused significant apical transportation, and K3 system proved safe for apical preparation, with little deviation.
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Cavidad Pulpar/patología , Preparación del Conducto Radicular/instrumentación , Ápice del Diente/patología , Aleaciones Dentales , Dentina/patología , Diseño de Equipo , Humanos , Procesamiento de Imagen Asistido por Computador , Ensayo de Materiales , Preparación del Conducto Radicular/métodos , Acero Inoxidable , Propiedades de Superficie , TorqueRESUMEN
O desvio apical é um fator bastante relevante na terapia endodôntica pela possibilidade de conduzir o tratamento proposto ao insucesso. Este estudo se propôs a realizar uma avaliação in vitro da ocorrência de desvio apical e sua magnitude nas instrumentações manual com limas de aço-inoxidável, rotatória de giro contínuo com o sistema K3 e rotatória de giro alternado com contra-ângulo NSK e limas de aço-inoxidável, em raízes mésio-vestibulares de molares superiores. A amostra foi formada por 60 raízes que, após a inclusão numa modificação da mufla de Bramante, foram seccionadas longitudinalmente. De acordo com o ângulo e raio da curvatura do seu canal, as raízes foram paritariamente divididas em três grupos. Uma das metades de cada raiz teve sua face interna digitalizada por scanner de mesa. As raízes foram remontadas nas muflas e seus canais instrumentados. A mesma metade de cada raiz teve sua face interna novamente digitalizada em três momentos distintos: primeiro, na confecção do preparo apical com a lima 30, após com a lima 35 e, por fim, com a lima 40. Cada imagem pós operatória (limas 30, 35 e 40) foi sobreposta à imagem pré-opertória no programa Adobe Photoshop. Após, foram transferidas ao programa AutoCad, onde o desvio apical foi mensurado. Para a comparação entre as limas dos três grupos foram utilizados os testes não paramétricos de Friedman e Wilcoxon que encontraram diferença significativa. (p = 0,000) Para a comparação entre os três grupos foi utilizado o teste não-paramétrico Kruskal-Wallis (p = 0,000) que demonstrou haver diferença significativa entre os grupos estudados.
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Humanos , Cavidad Pulpar/patología , Preparación del Conducto Radicular , Técnicas In VitroRESUMEN
A instrumentação dos canais radiculares é uma das etapas mais importantes da terapia endodôntica. Este estudo realizou uma análise comparativa do desgaste promovido nas paredes mesial e distal do canal mésio-vestibular de molares superiores, terços cervical e médio, pela associação das brocas Gates Glidden (Dentsply Maillefer, Ballaigues, Switzerland) com limas manuais e pelo sistema automatizado K3 (SybronEndo, CA, USA). A amostra consistiu em vinte raízes que foram, primeiramente, incluídas em uma modificação da mufla proposta por Bramante et al (1987). Após a inclusão, as mesmas foram seccionadas transversalmente em duas superfícies de observação, 1mm além do orifício de entrada do canal e lmm aquém do início da curvatura. O preparo cervical de dez raízes foi realizado com as brocas Gates Glidden números 1 e 2, sendo a instrumentação concluída com limas manuais. As outras dez raízes tiveram seus condutos preparados pelo sistema K3. As espessuras de dentina das paredes analisadas foram medidas antes e após os preparos através do uso de um microscópio metalográfico (Union), com ocular graduada, no aumento de 50x. Os resultados demonstraram valores médios de desgaste nas paredes analisadas maiores nos preparos realizados com a associação das brocas Gates Glidden e limas manuais. Somente na parede distal lmm da entrada do canal o sistema K3 apresentou o valor médio pouco superior. Os dados foram submetidos ao Teste t de Student para amostras não pareadas, não apresentando diferenças estatisticamente significantes.Concluiu-se através deste trabalho, que as técnicas de preparo apresentam um desempenho semelhante quanto ao desgaste radicular dos terços cervical e médio.
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Humanos , Técnicas In Vitro , Preparación del Conducto Radicular/instrumentación , Preparación del Conducto Radicular/métodosRESUMEN
A avaliação das diferentes técnicas disponíveis de preparo de canais radiculares desempenha um importante papel na busca da otimização da terapia endodôntica. Buscando uma metodologia que possibilitasse a análise comparativa do canal radicular antes e após sua instrumentação, apresenta-se um método, através de uma simples variação, baseada na proposta pioneira de BRAMANTE et al de 1987. Nessa proposta, a raiz/dente a serem estudados são incluídos em resina acrílica transparente autopolimerizável dentro de uma forma plástica (tubos de Eppendorf). Após a presa da resina, o bloco resina/raiz é removido da forma plástica e nele são confeccionados sulcos de localização. A seguir, este bloco é incluído numa mufla de gesso, tendo como molde um segmento plástico de condutor de fio elétrico. Desta forma, com os blocos de resina fixados e localizados no molde de gesso, pode-se realizar cortes seccionais, no sentido e altura desejada, que permitirão suas recolocações na mesma posição e o aparato permitirá suas imobilizações durante a operação. Essa metodologia simples demonstrou eficiência, possibilitando análise de dentes monorradiculares ou raÍzes de polirradiculares antes e após a instrumentação do canal, possibilitando medições da quantidade de desgaste promovido.
Asunto(s)
Humanos , Preparación del Conducto Radicular/métodosRESUMEN
O objetivo desta pesquisa foi avaliar a prevalência de mordida aberta, sobremordida exagerada, mordida cruzada, tipo de arco, segundo Baume, perdas precoces e relação antero-posterior dos arcos, segundo a Classificação de Angle modificada para a dentadura decídua na faixa etária de 3 a 5 anos. A amostra foi composta de 567 crianças, sendo 294 do sexo masculino e 273 do sexo feminino, que estavam matriculadas em escolas municipais de Porto Alegre, RS. Os resultados mostraram que a mordida aberta anterior apresenta alta freqüencia na dentição decídua (38,80 por cento), o que não ocorre com a mordida aberta posterior (0,35 por cento). A sobremordida exagerada apresenta um índice de 24,52 por cento. A prevalência de mordida cruzada nessa fase da dentição é de 17,46 por cento, sendo que a mordida cruzada posterior unilateral apresenta o índice mais elevado (9,35 por cento). O tipo de arco mais prevalente é o arco Tipo I de Baume, encontrado em 73,19 por cento da amostra. Observando a relação antero-posterior dos arcos, obteve-se para Classe I, 64,20 por cento, para Classe II 18,52 por cento e finalmente para Classe III 17,28 por cento