RESUMO
OBJECTIVE: To evaluate the adhesion of universal adhesive systems to the dentin of noncarious cervical lesions (NCCLs) by comparing the etch-and-rinse and self-etch strategies through a systematic review and meta-analysis. METHODS: Systematic electronic searches were performed by two independent reviewers into the following databases: PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library until December of 2021. Only randomized clinical trials were selected, comparing etch-and-rinse and self-etch strategies and using universal adhesive systems in NCCLs. This systematic review was conducted according to the PRISMA guidelines and registered into PROSPERO. RESULTS: After the removal of duplicates, 170 articles were identified. In an initial screening of titles and abstracts, 146 records did not satisfy the inclusion criteria and were, therefore, excluded. Twenty-four studies were eligible for evaluation of the full text, and four were excluded after this step. Finally, 20 randomized clinical trials were included in this systematic review and meta-analysis. CONCLUSION: This systematic review and meta-analysis revealed that applying universal adhesive systems in the etch-and-rinse strategy could lead to better medium-term (>12 to 36 months) retention of NCCL restorations than the self-etch strategy, as well as resulting in lower percentages of marginal discoloration, marginal adaptation, and secondary caries. However, the use of a self-etching strategy can lead to lower postoperative sensitivity.
Assuntos
Cimentos Dentários , Adesivos Dentinários , Humanos , Cimentos Dentários/uso terapêutico , Adesivos Dentinários/uso terapêutico , Cimentos de Resina , Resinas Compostas/uso terapêutico , Colo do Dente , Restauração Dentária Permanente/métodos , Adaptação Marginal DentáriaRESUMO
AIM: This systematic review and meta-analysis evaluated whether the home use of mouthwashes containing potassium salts is effective in reducing and controlling dentin hypersensitivity (DH). METHODS AND MATERIALS: This study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and was registered in PROSPERO (CRD42021228410). Randomized clinical trials evaluating the use of mouthwashes containing potassium salt for daily household mouthwash for at least four weeks to reduce DH compared with a control mouthwash were selected, with no limitation on year of publication. Electronic research was carried out in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library by two independent researchers. One hundred thirty-three articles were obtained, and nine were selected according to the inclusion criteria. RESULTS: The selected studies evaluated DH through tests of sensitivity to tactile and evaporative stimuli and showed that, for the tactile stimulus, there were no baseline differences between groups (p=0.12; mean difference: -0.33; confidence intervals [CI]: -0.73 to 0.08). However, there were significant differences after two weeks of use (p=0.00001; mean difference: 4.67; CI: 4.53 to 4.81), after four weeks (p=0.00001; mean difference: 13.29; CI: 13.03 to 13.55), and after eight weeks (p=0.00001; mean difference: 8.88; CI: 5.73 to 12.02) favoring the experimental group. The results of the evaporative test showed no differences in the baseline assessment between the two groups (p=0.50; mean difference: -0.02; CI: -0.09 to 0.04), but after four weeks (p=0.00001; mean difference: -0.32; CI: -0.44 to -0.20), and eight weeks of use (p=0.00001; mean difference: -0.42; CI: -0.57 to -0.27) there were differences favoring the experimental group. The incidence of side effects showed no differences between the two groups (p=0.89; mean difference: 1.03; CI: 0.67 to 1.58). CONCLUSION: The daily use of mouthwashes containing potassium salt is effective in the treatment of dentinal hypersensitivity, as a complementary step to brushing at least twice a day for two weeks, four weeks, and up to eight weeks, without presenting side effects.
Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Humanos , Antissépticos Bucais/uso terapêutico , Fluoretos , Fluoreto de Sódio , Sais/uso terapêutico , Potássio/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Dessensibilizantes Dentinários/uso terapêutico , Método Duplo-Cego , Resultado do TratamentoRESUMO
AIM: This systematic review and meta-analysis evaluated the effect of using nonsteroidal anti-inflammatory drugs (NSAIDs) before dental bleaching sessions in the dental office on postoperative sensitivity. METHODS: The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and registered on International Prospective Register of Systematic Reviews under number CRD42020210054. Randomized clinical trials published in the English language that compared the preventive use of NSAIDs with a placebo on the sensitivity resulting from dental bleaching in the dental office were selected, with no limitation on the year of publication. The electronic searches took place in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library and were carried out independently by two researchers. A total of 30 articles were obtained; seven were selected according to the inclusion criteria. RESULTS: No significant differences were found in the reduction of dental sensitivity between the experimental group compared to the placebo during the session (p=0.32; mean difference [MD]=-0.30; 95% CI, -0.88 to 0.29), immediately after the session (p=0.22; MD=-0.29; 95% CI, -0.75 to 0.17), up to 1 hour later (p=0.10; MD=-0.94; 95% CI, -2.06 to 0.18), and between 1 and 24 hours after the procedure (p=0.78; MD=-0.11; 95% CI, -0.90 to 0.68). The incidence of sensitivity between the groups also did not show statistically relevant differences (p=0.60; MD=1.15; 95% CI, 0.69-1.92). Furthermore, none of the studies reported side effects in any patient. CONCLUSION: This systematic review and meta-analysis indicates that the use of NSAIDs before dental office bleaching is not effective in reducing dental sensitivity during or up to 24 hours after the procedure. In addition, there was no difference in the incidence of sensitivity between the experimental and placebo groups.
Assuntos
Anti-Inflamatórios não Esteroides , Consultórios Odontológicos , Anti-Inflamatórios não Esteroides/efeitos adversos , HumanosRESUMO
As preguiças são mamíferos arborícolas, bem específicos quanto aos hábitos e à morfofisiologia. Essa condição faz delas ainda mais vulneráveis aos impactos ambientais. Com o objetivo de fornecer informações que auxiliem na clínica médico-cirúrgica desses Xenarthras, realizou-se um estudo do arco aórtico e da artéria aorta torácica, a fim de se identificarem seus principais ramos. Foram utilizados 10 animais da espécie Bradypus variegatus, sendo uma fêmea e três machos submetidos a dissecação, por meio da qual foram obtidas medidas de diâmetro e comprimento dos vasos, enquanto três fêmeas e três machos destinaram-se à técnica de radiografia digital com contraste. Constatou-se uma sintopia uniforme do arco, bem como da porção descendente da artéria aorta no tórax. No entanto, a topografia difere consideravelmente. Com base nos ramos, percebeu-se, independentemente do sexo, uma maior variação naqueles originados do arco e dos que emergem da artéria aorta torácica e irrigam estruturas medianas e do antímero direito do tórax. Foram obtidos valores maiores para o diâmetro das artérias na fêmea do que nos machos e, para o comprimento da artéria aorta torácica, foram encontrados valores correspondentes em ambos. Toda essa variação dos bradipodídeos apresenta diferenças em relação a outros mamíferos.(AU)
Sloths are arboreal mammals, very specific, regarding their habits and morphology. This condition makes them even more vulnerable to environmental impacts. In order to provide information to assist in the medical and surgical assistance to these Xenarthras, a study of the aortic arch and thoracic portion of the descending aorta was carried out with the purpose of identify its main branches. Ten animals of the Bradypus variegatus species were used. One female and three males were submitted to dissection, where measurements of vessel diameter and length were obtained, while three females and three males were submitted to the digital contrast x-ray technique. There was a uniform syntopy of the arch, as well as of the descending portion of the aorta in the thorax. However, the topography differs considerably. Based on the branches, regardless of gender, a greater variation was observed in those originating from the arch, and those that emerge from the thoracic aorta and irrigate medial structures and the right antimere of the thorax. Greater values were obtained for the diameter of the arteries in the female than in the males and corresponding values for the length of the thoracic aorta in both. All this variation is possibly related to the adaptive processes of Bradipodidae over time.(AU)
Assuntos
Animais , Aorta Torácica , Cardiologia/classificação , Bichos-Preguiça/anatomia & histologiaRESUMO
As preguiças são mamíferos arborícolas, bem específicos quanto aos hábitos e à morfofisiologia. Essa condição faz delas ainda mais vulneráveis aos impactos ambientais. Com o objetivo de fornecer informações que auxiliem na clínica médico-cirúrgica desses Xenarthras, realizou-se um estudo do arco aórtico e da artéria aorta torácica, a fim de se identificarem seus principais ramos. Foram utilizados 10 animais da espécie Bradypus variegatus, sendo uma fêmea e três machos submetidos a dissecação, por meio da qual foram obtidas medidas de diâmetro e comprimento dos vasos, enquanto três fêmeas e três machos destinaram-se à técnica de radiografia digital com contraste. Constatou-se uma sintopia uniforme do arco, bem como da porção descendente da artéria aorta no tórax. No entanto, a topografia difere consideravelmente. Com base nos ramos, percebeu-se, independentemente do sexo, uma maior variação naqueles originados do arco e dos que emergem da artéria aorta torácica e irrigam estruturas medianas e do antímero direito do tórax. Foram obtidos valores maiores para o diâmetro das artérias na fêmea do que nos machos e, para o comprimento da artéria aorta torácica, foram encontrados valores correspondentes em ambos. Toda essa variação dos bradipodídeos apresenta diferenças em relação a outros mamíferos.(AU)
Sloths are arboreal mammals, very specific, regarding their habits and morphology. This condition makes them even more vulnerable to environmental impacts. In order to provide information to assist in the medical and surgical assistance to these Xenarthras, a study of the aortic arch and thoracic portion of the descending aorta was carried out with the purpose of identify its main branches. Ten animals of the Bradypus variegatus species were used. One female and three males were submitted to dissection, where measurements of vessel diameter and length were obtained, while three females and three males were submitted to the digital contrast x-ray technique. There was a uniform syntopy of the arch, as well as of the descending portion of the aorta in the thorax. However, the topography differs considerably. Based on the branches, regardless of gender, a greater variation was observed in those originating from the arch, and those that emerge from the thoracic aorta and irrigate medial structures and the right antimere of the thorax. Greater values were obtained for the diameter of the arteries in the female than in the males and corresponding values for the length of the thoracic aorta in both. All this variation is possibly related to the adaptive processes of Bradipodidae over time.(AU)
Assuntos
Animais , Aorta Torácica , Cardiologia/classificação , Bichos-Preguiça/anatomia & histologiaRESUMO
Feedbacks between land carbon pools and climate provide one of the largest sources of uncertainty in our predictions of global climate. Estimates of the sensitivity of the terrestrial carbon budget to climate anomalies in the tropics and the identification of the mechanisms responsible for feedback effects remain uncertain. The Amazon basin stores a vast amount of carbon, and has experienced increasingly higher temperatures and more frequent floods and droughts over the past two decades. Here we report seasonal and annual carbon balances across the Amazon basin, based on carbon dioxide and carbon monoxide measurements for the anomalously dry and wet years 2010 and 2011, respectively. We find that the Amazon basin lost 0.48 ± 0.18 petagrams of carbon per year (Pg C yr(-1)) during the dry year but was carbon neutral (0.06 ± 0.1 Pg C yr(-1)) during the wet year. Taking into account carbon losses from fire by using carbon monoxide measurements, we derived the basin net biome exchange (that is, the carbon flux between the non-burned forest and the atmosphere) revealing that during the dry year, vegetation was carbon neutral. During the wet year, vegetation was a net carbon sink of 0.25 ± 0.14 Pg C yr(-1), which is roughly consistent with the mean long-term intact-forest biomass sink of 0.39 ± 0.10 Pg C yr(-1) previously estimated from forest censuses. Observations from Amazonian forest plots suggest the suppression of photosynthesis during drought as the primary cause for the 2010 sink neutralization. Overall, our results suggest that moisture has an important role in determining the Amazonian carbon balance. If the recent trend of increasing precipitation extremes persists, the Amazon may become an increasing carbon source as a result of both emissions from fires and the suppression of net biome exchange by drought.
Assuntos
Atmosfera/química , Ciclo do Carbono , Secas/estatística & dados numéricos , Biomassa , Biota , Brasil , Dióxido de Carbono/análise , Monóxido de Carbono/análise , Incêndios/estatística & dados numéricos , Água Doce/análise , Fotossíntese , Chuva , Estações do Ano , Árvores/metabolismo , Clima TropicalRESUMO
This study was designed to evaluate in vitro the efficacy of a novel at-home bleaching technique using 10% or 16% carbamide peroxide modified by casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and its influence on the microhardness of bleached enamel. A total of 40 bovine incisors were divided into four groups (n=10) according to the bleaching agent used: 10% carbamide peroxide only; a blend of 10% carbamide peroxide and a CPP-ACP paste; 16% carbamide peroxide only; and a blend of 16% carbamide peroxide and a CPP-ACP paste. During the 14-day bleaching regimen, the samples were stored in artificial saliva. The Vickers microhardness and color of the teeth were assessed at baseline (T0) and immediately after the bleaching regimen (T14) using a microhardness tester and a spectrophotometer, respectively. The degree of color change was determined by the Commission Internationale de l'Eclariage (CIE) L*a*b* system (ΔE, ΔL*, Δa*, and Δb*) and Vita shade guide parameters. The data were analyzed by analysis of variance and the Tukey test (p<0.05). The teeth that were bleached with a blend of peroxide (10% or 16%) and the CPP-ACP paste presented increased microhardness values at T14 compared with T0, whereas the samples that were bleached with peroxide only did not show any differences in their microhardness values. All of the bleaching agents were effective at whitening the teeth and did not show a statistically significant difference using the CIEL*a*b* system (ΔE, ΔL*, Δa*, and Δb*) or the Vita shade guide parameters. The use of a CPP-ACP paste with carbamide peroxide bleaching agents increased the bleached enamel's microhardness and did not have an influence on whitening efficacy.
Assuntos
Cariostáticos/uso terapêutico , Caseínas/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Peróxidos/uso terapêutico , Clareadores Dentários/uso terapêutico , Clareamento Dental/métodos , Ureia/análogos & derivados , Óxido de Alumínio/química , Animais , Peróxido de Carbamida , Cariostáticos/administração & dosagem , Caseínas/administração & dosagem , Bovinos , Cor , Esmalte Dentário/patologia , Corrosão Dentária/métodos , Dureza , Concentração de Íons de Hidrogênio , Teste de Materiais , Peróxidos/administração & dosagem , Distribuição Aleatória , Saliva Artificial/química , Espectrofotometria , Chá , Temperatura , Fatores de Tempo , Clareadores Dentários/administração & dosagem , Descoloração de Dente/tratamento farmacológico , Descoloração de Dente/patologia , Ureia/administração & dosagem , Ureia/uso terapêutico , VinhoRESUMO
AIM: To compare stress distribution between a fractured maxillary central incisor restored with direct composite resin only (CR) or associated with different post materials, using finite element analysis. METHODOLOGY: A three-dimensional model of a sound maxillary central incisor and supporting structures was constructed, using data from the dental literature. Changes were made in the crown region to create a tooth with a restored crown fracture. A composite resin restoration only and restorations associated with different tapered post systems (glass fibre, carbon fibre, titanium and zirconia ceramic) were also evaluated, resulting in six experimental models. A static chewing pressure of 2.16Nmm(-2) was applied to two areas of the palatal surface of the tooth. Stress distribution was analysed under a general condition and in the structures of the models separately. RESULTS: The maximum stresses were concentrated as follows: at the cemento-enamel junction in the model with a sound maxillary central incisor, restored with CR and with a composite resin restoration associated with fibre posts; in the enamel at the post-enamel interface on the palatal surface of the model with a titanium post; and in the post of the model with zirconia ceramic post. CONCLUSIONS: None of the restorations evaluated was able to recover the stress distribution of the sound tooth. The models restored with composite resin associated with a glass or carbon fibre post had similar stress distributions to that of the model restored with CR. The different post materials were shown to have a substantial influence on stress distribution, with less stress concentration when fibre posts were used.
Assuntos
Resinas Compostas/uso terapêutico , Restauração Dentária Permanente/métodos , Incisivo/lesões , Técnica para Retentor Intrarradicular/instrumentação , Fraturas dos Dentes/terapia , Fenômenos Biomecânicos , Carbono , Fibra de Carbono , Porcelana Dentária , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Análise do Estresse Dentário , Análise de Elementos Finitos , Vidro , Humanos , Maxila , Titânio , Dente não Vital , ZircônioRESUMO
The current study evaluated the influence of two endodontic post systems and the elastic modulus and film thickness of resin cement on stress distribution in a maxillary central incisor (MCI) restored with direct resin composite using finite element analysis (FEA). A three-dimensional model of an MCI with a coronary fracture and supporting structures was performed. A static chewing pressure of 2.16 N/mm2 was applied to two areas on the palatal surface of the composite restoration. Zirconia ceramic (ZC) and glass fiber (GF) posts were considered. The stress distribution was analyzed in the post, dentin and cement layer when ZC and GF posts were fixed to the root canals using resin cements of different elastic moduli (7.0 and 18.6 GPa) and different layer thicknesses (70 and 200 microm). The different post materials presented a significant influence on stress distribution with lesser stress concentration when using the GF post. The higher elastic modulus cement created higher stress levels within itself. The cement thicknesses did not present significant changes.
Assuntos
Resinas Compostas/química , Materiais Dentários/química , Incisivo/lesões , Técnica para Retentor Intrarradicular/instrumentação , Cimentos de Resina/química , Fraturas dos Dentes/terapia , Força de Mordida , Simulação por Computador , Esmalte Dentário/fisiopatologia , Cavidade Pulpar/fisiopatologia , Dentina/fisiopatologia , Módulo de Elasticidade , Análise de Elementos Finitos , Vidro/química , Humanos , Imageamento Tridimensional/métodos , Incisivo/fisiopatologia , Teste de Materiais , Modelos Biológicos , Periodonto/fisiopatologia , Estresse Mecânico , Propriedades de Superfície , Coroa do Dente/lesões , Zircônio/químicaRESUMO
The effect of ocular protection on the incidence of retinopathy of prematurity was tested in 188 newborns weighing less than 1600 g in a randomised controlled trial. No effect of ambient light reduction on the incidence of retinopathy of prematurity was shown.
Assuntos
Luz , Retinopatia da Prematuridade/terapia , Humanos , Recém-Nascido , Oftalmoscopia , Retinopatia da Prematuridade/patologia , Resultado do TratamentoRESUMO
OBJECTIVE: To verify the prevalence of the anti-HBc, anti-HBs and HBsAg markers of hepatitis B virus, and to identify the risk factors determining occupational infection with this virus among hospital personnel. METHODS: Samples of serum from 210 persons both male and female who work in different occupations at a hospital university, were analysed. The technique employed was the immunoenzymatic assay using commercial kits. RESULTS: As a control group, samples of serum from 45 volunteer blood donors were utilized. It was verified that 20.5% of the hospital personnel presented a positive reaction to at least one of the markers songht, as against 6.6% of the control group. The prevalence of each marker separately was: anti-HBc 8.1%, anti-HBs 5.2%, and HBsAg 2.9% in the hospital personnel; and 4.4%, 2.2% and 0.0% in the control group. The simultaneous presence of the anti-HBc and anti-HBs markers was detected in 4.3% of the workers. In the control group, the presence of the anti-HBc and anti-HBs markers was detected, isolately, with respective prevalences of 4.4% and 2.2%. Those who presented the highest rates of positivite reaction were: laboratory technicians 24.0%, nurses 23.6%, physicians 20.8%, and cleaning personnel 18.2%. CONCLUSIONS: The findings suggest that direct contact with patients and handling of blood and other body fluids are risk factors related to occupational infection with HBV. Therefore, it is recommended that hospital personnel be vaccinated against hepatitis B.
Assuntos
Vírus da Hepatite B/isolamento & purificação , Hepatite B/sangue , Hepatite B/epidemiologia , Doenças Profissionais/sangue , Doenças Profissionais/epidemiologia , Recursos Humanos em Hospital , Adulto , Idoso , Antígenos de Superfície/isolamento & purificação , Biomarcadores , Feminino , Hepatite B/transmissão , Anticorpos Anti-Hepatite B/isolamento & purificação , Antígenos da Hepatite B/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de RiscoRESUMO
Fifty-nine patients with hepatosplenic schistosomiasis mansoni were investigated by sonography in Northeast Brazil and Central Sudan. The sizes of the organs usually involved in this disease were quantitatively assessed according to a standardized protocol, and measurements were adjusted to the body height of the individual. The results were compared with those of healthy controls matched by sex, age, geographical origin and socio-economic status. Considerable differences were found between patients and controls as well as between residents from the two areas. The liver of both patients and controls from the Sudan was significantly smaller than that of patients and controls from Brazil. Only in Brazil, but not in the Sudan, was the left liver lobe larger in patients than in the controls. The diameter of the portal and the splenic vein, the spleen size and the thickness of the gallbladder wall were significantly increased in patients from both areas. The increase of the portal and splenic vein diameter was significantly correlated with the degree of hepatic periportal fibrosis and the frequency of bleeding from endoscopically proven oesophageal varices in the patients, irrespective of their geographic origin. In contrast, such correlations were not found for the degree of splenomegaly nor for the degree of gallbladder-wall thickening. It is concluded that standardized sonographic organometry permits the assessment of morbidity in hepatosplenic schistosomiasis mansoni under different endemic conditions. Especially the measurement of the portal vein diameter may allow estimation of the risk of gastrointestinal haemorrhage in these patients.