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BACKGROUND: Recent research introduced the concept of the "line of convergence" as a guide for injectors to enhance precision and avoid complications when treating the frontalis muscle with toxins. However, currently, no pre-injection ultrasound scanning is employed to increase precision and reduce adverse events when searching for the line of convergence. OBJECTIVE: To explore the feasibility and practicality of implementing pre-injection ultrasound scanning into aesthetic neuromodulator treatments of the forehead. METHODS: The sample of this study consisted of n = 55 volunteers (42 females and 13 males), with a mean age of 42.24 (10.3) years and a mean BMI of 25.07 (4.0) kg/m2. High-frequency ultrasound imaging was utilized to measure the thickness, length, and contractility of the frontal soft tissue and to determine the precise location of the line of convergence during maximal frontalis muscle contraction. RESULTS: The results revealed that the line of convergence was located at 58.43% (8.7) of the total forehead height above the superior border of the eyebrow cilia without a statistically significant difference between sex, age, or BMI. With frontalis muscle contraction, the forehead shortens in males by 25.90% (6.5), whereas in females it shortens only by 21.74% (5.1), with p < 0.001 for sex differences. CONCLUSION: This study demonstrated the feasibility and practicality of pre-injection ultrasound scanning for facial aesthetic neuromodulator treatments. Knowing the location of the line of convergence, injectors can determine precisely and on an individual basis where to administer the neuromodulator deep or superficial or when the injection location is at risk to cause eyebrow ptosis.

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INTRODUCTION: Many mediators are produced during pulp inflammation and necrosis, including endocannabinoids (ECbs), which might affect the function of stem cells of the apical papilla (SCAP), cells of paramount importance for root formation, and regenerative endodontic treatment. The aim of this study was to evaluate the production of osteoclastogenesis-related mediators by SCAP modulated by ECbs and lipopolysaccharide (LPS) in vitro. METHODS: SCAP were cultured and treated with ECb anandamide (AEA), 2-arachidonoylglycerol, or N-arachidonoylaminophenol. All groups were incubated in the presence of a vehicle or LPS and the antagonist of transient receptor potential cation channel subfamily V member 1, capsazepine. After 24 hours, the culture medium supernatants were collected for further quantification of tumor necrosis factor alpha, CCL2, macrophage colony-stimulating factor, osteoprotegerin, and receptor activator of nuclear factor kappa B ligand. RESULTS: Small amounts of tumor necrosis factor alpha and receptor activator of nuclear factor kappa B ligand were detected in SCAP supernatants, and none of the experimental conditions altered their production. A down-regulation in constitutive CCL2 production was observed in the AEA group compared with that in the LPS group. The production of macrophage colony-stimulating factor was significantly increased in all groups treated with AEA compared with the control and LPS-treated groups. Osteoprotegerin was significantly increased by AEA alone and by 2-arachidonoylglycerol and N-arachidonoylaminophenol in the presence of LPS and capsazepine. CONCLUSIONS: AEA modulates some of the osteoclastogenic factors produced by SCAP in a bone resorption protective fashion.

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INTRODUCTION: Endogenous cannabinoids (endocannabinoids [eCBs]) have been shown to have a multitude of functions including neurotransmission and immune modulatory effects. This study aimed to evaluate if stem cells of the apical papilla (SCAP) express the receptors and enzymes of the endocannabinoid system (ECS) and whether eCBs regulate their proliferation and mineralization potential. METHODS: Gene expression of the main components of the ECS and transient receptor potential vanilloid 1 (TRPV1) was evaluated in SCAP cultures. SCAP were treated with 2 concentrations of eCBs and/or capsazepine, a TRPV1 antagonist. SCAP viability was evaluated after 1, 4, and 7 days. Osteogenic differentiation was assessed after 14 days, and the gene expression of mineralization markers was assessed after 7 days. RESULTS: The enzymes of ECS and TRPV1 but not the cannabinoid receptors (cannabinoid receptors 1 and 2) were expressed in SCAP. Anandamide, 2-arachidonoylglycerol, and N-arachidonoylphenolamine (AM-404) reduced SCAP viability in all experimental periods at the highest concentration compared with the group with no treatment. Anandamide and AM-404 did not inhibit SCAP differentiation potential, but 2-arachidonoylglycerol at the highest concentration did. SCAP treated with AM-404 presented a down-regulation in gene expression of alkaline phosphatase (ALP), dentin matrix protein 1 (DMP-1), and dentin sialophosphoprotein (DSPP) compared with the proliferation medium group but not with control group. CONCLUSIONS: SCAP expressed the genes of the main components of ECS and TRPV1, and eCBs can affect SCAP viability, mineralization, and gene expression.

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INTRODUCTION: The outcome of root canal obturation might be affected by the chemical components of the chosen filling materials. Niobium phosphate glass-based gutta-percha (GNB) was proposed as a biomaterial-based obturation point. This study aimed to investigate the cytotoxic and cell modulation effects of GNB points on human periodontal ligament fibroblasts (PDLFs) in vitro. METHODS: Human PDLFs were cultured for the assays. Extracts of regular gutta-percha (GP) points and GNB were obtained, serially diluted (1:5, 1:10, and 1:25), and used to stimulate PDLFs. A cell viability assay was performed using alamarBlue reagent (Molecular Probes, Waltham, MA), and reverse transcription quantitative polymerase chain reaction was used to assess the gene expression for collagen type I and cementum protein 1. One-way analysis of variance followed by the Tukey post hoc test was performed (P < .05). RESULTS: Regular GP reduced cell viability only in pure extracts, whereas GNB exhibited cytotoxicity to PDLFs in pure extracts as well as 1/5 and 1/10 dilutions. The gene expression of collagen type I was down-regulated only in the GNB group (P < .05). The expression of cementum protein 1 remained unaltered by both tested materials. CONCLUSIONS: The addition of niobium phosphate glass to GP points increased cytotoxicity, affecting PDLF viability and partially disturbing physiological cell function.

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INTRODUCTION: Stem cells of apical papilla (SCAP) may be affected by inflammatory mediators released by activation with lipopolysaccharide (LPS) from infected pulpal cavities of necrotic immature teeth. Therefore, this study aimed to investigate the presence of a local renin-angiotensin system (RAS) and the role of angiotensin II (Ang II) on the modulation of SCAP in vitro. METHODS: Primary cultures of SCAP were incubated with LPS (0.1-10 µg/mL) for cell viability and quantification of the chemokine CCL2. Components of RAS were searched by gene expression of angiotensinogen (AGTN), angiotensin converting enzyme (ACE), renin, angiotensin receptor 1 (AT1) and 2 (AT2), and Mas receptor. Ang II was investigated in SCAP supernatants. Immunofluorescence was used to detect AGTN and AT1. Next, cells were treated with Ang II for viability/proliferation assessment, quantification of CCL2 and interleukin 6, and mineralization assay. Data were evaluated by analysis of variance using Tukey post hoc comparisons or the Student t test. P values <.05 were considered to be significant. RESULTS: LPS increased CCL2 production at 1 and 10 µg/mL. The gene expression of AGTN, renin, ACE, and AT1 was detected, but only ACE was increased by LPS. Ang II peptide was found in SCAP supernatants but unaltered by LPS. Both AGTN and AT1 proteins were detected by immunostaining. Ang II significantly induced SCAP proliferation, increased CCL2 production, down-regulated IL-6 release, and reduced the SCAP mineralization rate. CONCLUSIONS: A local RAS was found at the apical papilla, and Ang II was able to modulate SCAP function in vitro.

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Integrating basic occupational health services into primary care is encouraged by the Pan American Health Organization. However, concrete initiatives are still scarce. We aimed to develop a training program focusing on prevention of occupational risks for primary healthcare professionals. This train-the-trainer program was piloted at four universities in Chile and Peru. Occupational health or primary healthcare lecturers formed a team with representative(s) of one rural primary healthcare center connected to their university (Nparticipants = 15). Training started with a workshop on participatory diagnosis of working conditions. Once teams had conducted the participatory diagnosis in the rural communities, they designed in a second course an active teaching intervention. The intervention was targeted at the main occupational health problem of the community. After implementation of the intervention, teams evaluated the program. Evaluation results were very positive with an overall score of 9.7 out of 10. Teams reported that the methodology enabled them to visualize hazardous working conditions. They also stated that the training improved their abilities for problem analysis and preventive actions. Aspects like time constraints and difficult geographical access were mentioned as challenges. In summary, addressing occupational health in primary care through targeted training modules is feasible, but long-term health outcomes need to be evaluated.

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INTRODUCTION: Root canal treatment of immature necrotic teeth is a major challenge in current endodontics. The effect of inflammatory mediators, such as prostaglandin, on the modulation of stem cells of the apical papilla (SCAP) is not completely understood. The aim of this study was to investigate the role of prostaglandin E2 (PGE2) on SCAP activation by Escherichia coli lipopolysaccharide (LPS) in vitro. METHODS: SCAP cultures were established and characterized. Increasing concentrations of lipopolysaccharide (0.1-10 µg/mL) were used to investigate cyclooxygenase-2 (COX-2/PTGS2) and PGE2 receptors (EP1-4) gene expression. Then, SCAP were treated with a COX-2 inhibitor (indomethacin) before treatment with different concentrations of LPS. The levels of the chemokine CCL2/monocyte chemoattractant protein 1 and interleukin (IL)-6 were detected in cell supernatants (24 hours) by enzyme-linked immunosorbent assay. Data analysis was performed using analysis of variance followed by the Tukey post test. RESULTS: The expression of COX-2 was up-regulated in the group treated with LPS at 1µg/mL compared with that in the control group. EP1-4 were detected in all experimental conditions at similar levels. SCAP treated with indomethacin presented a down-regulation in the production of LPS-induced CCL2 and the secretion of IL-6. CONCLUSIONS: SCAP showed increased COX-2 (PTGS2) gene expression induced by LPS and a PGE2-dependent production of IL-6 and CCL2.

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OBJECTIVE: This study aimed to investigate the cytotoxic and biomodulatory potential of conventional gutta-percha (CGP) points, gutta-percha points containing bioceramics (BC), and CPoint polymer (CP) points on periodontal ligament (PDL) cells in vitro. METHODS: PDL fibroblasts were cultured and stimulated with extracts of CGP, BC, and CP in serial dilutions to evaluate cell viability using MTT assay. Next, the 1:5 dilution was used to stimulate the cells for 72 h to assess the gene expression of type I collagen (COL-1) and cement protein 1 (CEMP-1), by reverse transcription followed by quantitative PCR. Data were statistically analyzed using one-way analysis of variance (ANOVA) (P<0.05). RESULTS: Pure extracts of CGP and CP were found to be cytotoxic for PDL (P<0.01). Once diluted to 1:5, only CP showed cytotoxicity. BC did not affect cell viability in any extract sample. No extract significantly altered the gene expression of COL-1. For CEMP-1, a significant increase in gene expression was observed only for CGP (P<0.05). CONCLUSION: CP was found to be more cytotoxic than CGP, while BC demonstrated no cytotoxicity. The tested cones did not affect COL-1 gene expression, while CGP upregulated CEMP-1. Our results suggest that obturation point components may affect the biological responses of PDL fibroblasts.

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El aporte de datos y la busqueda de caminos de solución que facilite llegar con la suficiente preparación y empoderamiento a la Asamblea Constituyente es la razón final que justifica la presente publicación, auspiciada por FUNDAPPAC, de acuerdo con ACOBOL y el FPNM y con el respaldo financiero de la Fundación Konrad Adenauer.

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El capitulo trata de las jerarquias institucionales, diferencias en los perfiles de salud, estrategias para implementar las politicas publicas a traves de la comunicacion, la importancia de una politica publica de genero.(au)

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