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The interaction of bleaching technique (in-office or at-home) and solutions (deionized distilled water with and without sugar, red wine with and without sugar, coffee with and without sugar) on the effectiveness of in vitro dental bleaching was evaluated. Hydrogen peroxide (HP) 37.5% gel was used for in-office bleaching, 3 applications of 8 min each, 3 sessions with an interval of 7 days. At-home bleaching was performed with 10% Carbamide peroxide (CP), 2 h/day, for 30 days. The enamel vestibular surfaces (n = 72) were subjected daily to test solutions for 45 min, washed with distilled water for 5 min and stored in artificial saliva. The enamel color analysis was performed with a spectrophotometer through color variation (ΔE) and luminosity variation (ΔL). Roughness analysis was performed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). Enamel composition was determined by energy dispersive X-ray spectrometry (EDS). The results were submitted to one-way analysis of variance (ANOVA) for ΔE, ΔL and EDS and two-way for AFM. For ΔE and ΔL there was no statistically significant difference. An increase in roughness was observed on the surface when exposed to a sugar-water solution for at-home bleaching and a lower concentration of Ca and P in the deionized water solution with sugar. Solutions containing or not sugar did not influence the bleaching potential, however the presence of sugar in the water solution increased the surface roughness with CP.

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RESUMO A ceratopigmentação teve seu primeiro registro pelo filósofo Galeno há muitos séculos como uma estratégia utilizada para o tratamento estético de pacientes com leucomas. As córneas com leucoma são patológicas e, muitas vezes, intolerantes a lentes de contato cosméticas ou próteses oculares, sendo comum a queixa de desconforto excessivo, proporcionado pela superfície corneana irregular. Assim, a ceratopigmentação é uma alternativa para a melhora estética de pacientes com opacidades corneanas. Descrevemos o caso de um paciente do sexo masculino, 39 anos, que apresentou despigmentação precoce em caso de ceratopigmentação associado a quadro de ceratite herpética necrotizante. O paciente foi submetido ao tratamento com aciclovir 2g ao dia e doxiciclina 200mg ao dia, evoluindo com melhora do quadro clínico, apesar da má adesão medicamentosa.

ABSTRACT Keratopigmentation was first recorded many centuries ago by the philosopher Galeno, as a strategy used for the aesthetic treatment of patients with leukomas. Corneas with leucoma are pathological and often intolerant of cosmetic contact lenses or ocular prostheses, with complaints of excessive discomfort provided by the irregular corneal surface being common. Therefore, keratopigmentation is an alternative for the aesthetic improvement of patients with corneal opacities. We describe the case of a 39-year old male patient, who presented early depigmentation in a case of keratopigmentation associated with necrotizing herpetic keratitis. The patient was treated with Acyclovir 2g/day and Doxycycline 200mg/day, evolving with clinical improvement, despite poor medication adherence.

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Abstract The aim of this in vitro study is to investigate the effects of acidic beverages on the discoloration of bulk-fill composites with different viscosities. 144 disc-shaped specimens (8mm diameter × 2mm thick) were prepared from four different composite resins including a nanohybrid (Filtek Ultimate), two packable bulk- fill (Filtek Bulk Fill, Tetric N Ceram Bulk Fill), and a flowable bulk-fill composite (Tetric N Flow Bulk Fill). The specimens of each group were divided into 3 subgroups and submerged in distilled water, orange juice and coke (n=12). Color difference (ΔE) were measured using CIELab color space and a compact spectrophotometer (VITA Easyshade) at baseline and after 30 days of immersion. Data were analyzed using two- way ANOVA and Tukeys HSD post-hoc tests (P2.7) was observed for all bulk-fill composites tested. It can be speculated that orange juice has a more negative effect on the color stability compared to coke. Additionally, flowable bulk-fill composite was more prone to discoloration than condensable bulk-fill composites.

Resumen El objetivo de este estudio fue investigar los efectos de las bebidas ácidas en la decoloración de resinas compuestas tipo Bulk con diferentes viscosidades. Se prepararon 144 muestras en forma de disco (8mm de diámetro x 2mm de grosor) a partir de cuatro resinas compuestas diferentes que incluyen un nanohíbrido (Filtek Ultimate), dos de pasta condensables tipo Bulk (Filtek Bulk Fill, Tetric N Ceram Bulk Fill) y una fluida (Tetric N Flow Bulk Fill). Las muestras de cada grupo se dividieron en 3 subgrupos y se sumergieron en agua destilada, jugo de naranja y Coca-Cola (n=12). La diferencia de color (ΔE) se midió utilizando el CIELab y un espectrofotómetro compacto (VITA Easyshade) al inicio y después de 30 días de inmersión. Los datos se analizaron mediante ANOVA bidireccional y pruebas post-hoc HSD de Tukey (P2,7) para todos los materiales resinosos. Se puede especular que el jugo de naranja tiene un efecto más negativo sobre la estabilidad del color en comparación con la Coca-Cola. Además, la resina fluida fue más propensa a la decoloración que las resinas condensables.

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Objectives: The aim of this study was to compare the color change of the Giomer resin composite (Beautifil-Bulk) by using photographs obtained with a smartphone (iPhone 6S) associated with Adobe Photoshop software (digital method), with the spectrophotometric method (Vita Easyshade) after immersion in different pigment solutions. Materials and Methods: Twenty resin composite samples with a diameter of 15.0 mm and thickness of 1.0 mm were confectioned in A2 color (n = 5). Photographs and initial color readings were performed with a smartphone and spectrophotometer, respectively. Then, samples were randomly divided and subjected to cycles of immersion in distilled water (control), açai, Coke, and tomato sauce, 3 times a day, 20 minutes for 7 days. Later, new photographs and color readings were taken. Results: The analysis (2-way analysis of variance, Holm-Sidak, p < 0.05) demonstrated no statistical difference (p < 0.005) between the methods in all groups. Similar color changes were observed for all pigment solutions when using the spectrophotometric method. For the digital method, all color changes were clinically unacceptable, with distilled water and tomato sauce similar to each other and with statistical differences (p < 0.005) for Coke and açai. Conclusions: Only the tomato sauce produced a color change above the acceptability threshold using both methods of color assessment. The spectrophotometric and digital methods produce different patterns of color change. According to our results, the spectrophotometric method is more recommended in color change assessment.

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Considering that antioxidant activities are directly related to carotenoid functionalities, it is necessary to use techniques that promote the stability of these natural pigments. This systematic review aimed to gather evidence on the effect of encapsulation techniques on the maintenance and/or enhancement of the antioxidant activity of carotenoids. The study was registered in PROSPERO (CRD42020142065). Searches were performed in PubMed, Embase, Virtual Health Library, Scopus, ScienceDirect, and Web of Science databases. Assessment of methodological quality was performed using OHAT. A total of 1577 articles were selected, resulting in 20 eligible studies. Overall, results showed that the mechanisms involved are related to the emergence of new chemical interactions, increased surface area, and the controlled release of carotenoids. Thus, evidence proved that encapsulation could preserve and/or enhance bioactivities of carotenoids, allowing the use in foods to promote benefits on population health.

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Resumen: Introducción: la cirugía micrográfica de Mohs es una técnica quirúrgica especializada para el tratamiento del cáncer de piel no melanoma. La histopatología cumple un rol fundamental, y la elección de la tinción es un punto de controversia. Objetivos: comparar el rendimiento de las tinciones de hematoxilina y eosina (HyE) versus azul de toluidina (AT) durante la cirugía. Método: estudio observacional, descriptivo y transversal a partir de noviembre de 2017 hasta mayo de 2018. Se incluyeron las láminas empleadas durante la cirugía en el período mencionado. Estas fueron analizadas por el cirujano de Mohs, tres residentes y una dermopatóloga. Se valoró el rendimiento de ambas tinciones, teniendo en cuenta las características celulares y los elementos del estroma. Resultados: se estudiaron 23 tumores (16 carcinomas basocelulares y 7 carcinomas espinocelulares). Al observarse al microscopio óptico tanto con la tinción de AT como con HyE no se encontraron diferencias significativas entre ambos grupos en lo global, sólo en algunas características, especialmente con la HyE. Conclusiones: es el primer trabajo en Uruguay que compara la eficacia de las dos tinciones durante la cirugía micrográfica de Mohs. Como conclusión tanto la tinción de HyE como el AT son muy buenas técnicas para el diagnóstico de carcinomas cutáneos.

Abstract: Introduction: Mohs micrographic surgery is a specialized surgical technique used to treat nonmelanoma carcinoma. Histopathology plays a vital role in the diagnosis of this condition, and the choice staining method is controversial. Objective: to compare results in the use of hematoxylin and eosin (H&E) versus Toluidine blue (TB) staining during surgery. Method: observational, descriptive and transversal study conducted from November, 2017 until May, 2018 of the slides used during surgeries in the selected period. Slides were analysed by the Mohs surgeon, 3 residents and a dermopathologist to evaluate the results of both staining methods, in consideration of cell features and stromal elements. Results: 23 tumors were analysed (16 Basal Cell carcinomas and 7 Squamous Cell Carcinoma). Microscopic observation of slides prepared with Toluidine blue and hematoxylin and eosin stains did not show significant global differences between both groups, except in terms of a few characteristics, in particular with hematoxylin and eosin stains. Conclusions: this was the first study in Uruguay to evaluate the effectiveness of both staining methods during Mohs micrographic surgery, and it concluded that both Toluidine blue and hematoxylin and eosin stains are very good techniques in evaluating skin-cancer.

Resumo: Introdução: a cirurgia micrográfica de Mohs é uma técnica cirúrgica especializada para o tratamento do câncer de pele não melanoma. A histopatologia desempenha um papel fundamental, onde a escolha da coloração é um ponto de controvérsia. Objetivos: comparar o desempenho das colorações de hematoxilina e eosina versus azul de toluidina durante a cirurgia. Método: estudo observacional, descritivo e transversal de novembro de 2017 a maio de 2018. Foram incluídas as lâminas utilizadas durante as cirurgias no referido período. Estas foram analisadas pelo cirurgião especializado na técnica de Mohs, 3 residentes e um dermatopatologista onde foi avaliado o desempenho de ambas as colorações, levando em consideração as características celulares e os elementos do estroma. Resultados: foram estudados 23 tumores (16 carcinomas basocelulares e 7 carcinomas espinocelulares). Quando observados ao microscópio de luz para coloração AT e H&E, não foram encontradas diferenças significativas entre os dois grupos em geral, apenas em algumas características, especialmente com o H&E. Conclusões: é o primeiro estudo no Uruguai que compara a eficácia dos 2 corantes durante a cirurgia micrográfica de Mohs. Em conclusão, tanto a coloração com hematoxilina e eosina quanto com azul de toluidina são técnicas muito boas para o diagnóstico de carcinomas de pele.

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ABSTRACT Introduction: Composite resins are an extensively used esthetic material that has excellent adaptation, reproduces the characteristics of the tooth structure and is suitable for the conditions of the oral environment. However, this material is also very susceptible to staining due to pigmentation coming from the diet and habits of the patient. Objectives: To evaluate the staining of two brands of composite resin, one nanoparticle and a nanohybrid type (Filtek Z350XT® and IPS Empress Direct®), in direct contact with the acid pH of beverages. Methods: In total 40 specimens were made, 20 of each type of resin studied. After being inserted into a Teflon matrix and light activated, the samples were removed, stored in containers with 2 ml of artificial saliva and kept in the refrigerator. Every day 20 of these samples were placed in direct contact with 2 ml Gatorade, and the other 20 samples, in 2 ml of wine, each set for 30 minutes. After 30 minutes, the acid pH substances were removed, and 2 ml of artificial saliva was again placed in the container. This process was repeated every day for 10 days. Results: The results showed that the nanoparticle resin (Filtek Z350XT) was more susceptible to staining than the nanohybrid type (Empress Direct®) when in contact with the wine. When wine and Gatorade were compared, the solution with higher staining capacity was shown to be wine. Conclusion: The two resins tested were susceptible to staining in a 10-day period. Mottling and more staining was visibly detected after samples were immersed in the solution with the higher pH, and nanoparticulate resin was more susceptible to staining.

RESUMO Introdução: As resinas compostas são altamente utilizadas por serem um material estético, com excelente adaptação, reproduz as características da estrutura dental e se adequa ao meio bucal. Porém, este material é muito susceptível à pigmentação por corantes vindos da dieta e de hábitos do paciente. Objetivos: Avaliar o manchamento de duas marcas comerciais de resina composta: Nanoparticulada e Nanohíbrida, em contato direto com bebidas de pH ácido (Filtek Z350XT® e IPS Empress Direct®). Métodos: Foram confeccionados 40 corpos de prova, 20 de cada tipo de resina estudada, depois de inseridas em matriz de teflon e fotoativados, os corpos de prova foram removidos, armazenados em recipientes com 2ml de saliva artificial e mantidos na geladeira. Diariamente 20 dos mesmos eram colocados em contato direto com 20mL Gatorade e os outros 20mL de vinho durante 30 minutos cada. Passados os 30 minutos, as substâncias de pH ácido eram retiradas e novamente, 2 mL de saliva artificial eram colocadas no recipiente. Este processo foi repetido todos os dias durante 10 dias. Resultado: Os resultados mostraram que a resina nanoparticulada (Filtek Z350XT®) é mais susceptível ao manchamento que a nanohíbrida (Empress Direct®) quando em contato com o vinho. Quando comparados vinho e Gatorade, a solução com maior teor de manchamento é o vinho. Conclusão: As duas resinas testadas foram sensíveis ao manchamento num período de 10 dias, esse manchamento foi visivelmente detectado, a solução com o pH mais elevado manchou mais e a resina nanoparticulada é mais susceptível ao manchamento.

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SUMMARY OBJECTIVE: Artificial food colorings, as types of food additives, are widely used at present in daily life. We aimed to investigate the effects of exposure to artificial food colorings during the intrauterine period on the salivary glands in adulthood. METHODS: A total of 30 Wistar albino female pregnant rats were included in this study. The treatment group was given a mixture of nine artificial food colorings at no observed adverse-effect-level doses. Neither mothers nor offspring were fed with food colorings after delivery. When the offspring became adults, they were sacrificed, and the possible histopathological and immunohistochemical effects of artificial food colorings on the salivary glands were investigated. In these glands, anti-matrix metallopeptidase 2 (anti-MMP2), anti-MMP9, anti-tissue inhibitor of metalloproteinases (TIMP) metallopeptidase inhibitor 1 (anti-TIMP1), anti-TIMP2, and anti-TIMP3 were examined. RESULTS: The expressions of anti-MMP2, anti-TIMP1, anti-TIMP2, and anti-TIMP3 parameters were found to be higher in treatment groups (p<0.05). CONCLUSION: It was suggested that intrauterine exposure of synthetic food colorings may lead to deterioration of the tissue structure of the salivary glands in adulthood, thereby increasing susceptibility to chronic illnesses including malignancy and chronic inflammation. Therefore, pregnant women should give importance to their nutrition in terms of foods containing synthetic colorings.

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Objetivo: É mérito deste estudo avaliar a pigmentação de cerâmicas odontológicassubmetidas a diferentes tratamentos de superfície e imersasem soluções corantes.Métodos: Foram confeccionadas 60 amostras de cerâmica, divididas em seis grupos. Os grupos G1, G2 e G3 receberam aplicação prévia de glaze, enquanto G4, G5 e G6 foram submetidos a desgastes e polimento. Os grupos foram mantidos em água destilada, açaí e café por um período de 30 dias. Foram realizadas fotografias digitais, seguidas da mensuração de cor da superfície com o programa mColorMeter, com base no sistema CIELab, antes da imersão, após 15 e 30 dias. Para avaliação quantitativa da variação de cor foi utilizada fórmula de ∆E, onde foram obtidos média e desvio padrão de cada grupo. Os dados foram submetidos à análise estatística ANOVA de dois fatores. Resultados: Após a realização da análise estatística, foram estabelecidos as médias e desvios-padrão para variância de cor (∆E) e foi constatado que não houve resultado estatisticamente significativo, em que p ≤ 0,05, para pigmentação em nenhum dos grupos de cerâmicas. Conclusão: Nesse contexto, infere-se que as substâncias café e açaí não promoveram alterações de cor significativas, bem como o glaze e o polimento mostraram-se igualmente eficientes na manutenção da estabilidade de cor das cerâmicas.

Aim: The present study sought to evaluate the pigmentation of dental ceramics submitted to different surface treatments and immersed in staining solutions. Methods: Sixty ceramic samples were manufactured and divided into six groups. Groups G1, G2, and G3 received a prior glaze application, while groups G4, G5, and G6 were submitted to wear and polishing. The groups were maintained in distilled water, açaí, and coffee for a period of 30 days. Digital photographs were taken, followed by color measurement of the surface with the mColorMeter program, based on system CIELab, before immersion, after 15 and 30 days. For quantitative evaluation of color variation, a formula from ∆E was used, where mean and standard deviation of each group were obtained. The data were submitted to ANOVA statistical analysis of two factors. Result: After the statistical analysis, the means and standard deviations for color variance (∆E) were established, and it was found that there were no statistically significant results, with p ≤ 0.05, for pigmentation in any of the groups of ceramics. Conclusion: Therefore, it can be inferred that coffee and açaí substances did not promote significant color changes. Glaze and polishing also proved equally efficient in maintaining the color stability of the ceramics.

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BACKGROUND: Anaphylaxis is a constant perioperative concern due to the exposure to several agents capable of inducing hypersensitivity reactions. Patent blue V (PBV), also known as Sulfan Blue, a synthetic dye used in sentinel node research in breast surgery, is responsible for 0.6% of reported anaphylactic conditions. We present a case of a 49-year-old female patient who underwent left breast tumorectomy with sentinel lymph node staging using PBV and experienced an anaphylactic reaction. METHODS: We conducted a literature search through PubMed for case reports, case series, reviews, and systematic reviews since 2005 with the keywords "anaphylaxis" and "patent blue". We then included articles found in these publications' reference sections. RESULTS: We found 12 relevant publications regarding this topic. The main findings are summarized, with information regarding the clinical presentation, management, and investigation protocol. Hypotension is the most common clinical manifestation. The presentation is usually delayed when compared with anaphylaxis from other agents, and cutaneous manifestations are occasionally absent. Patients may have had previous exposure to the dye, used also as a food, clothes and drug colorant. CONCLUSION: The diagnosis of anaphylaxis in patients under sedation or general anesthesia may be difficult due to particularities of the perioperative context. According to the published literature, the presentation of the reaction is similar in most cases and a heightened clinical sense is key to address the situation appropriately. Finding the agent responsible for the allergic reaction is of paramount importance to prevent future episodes.

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Abstract Background: Anaphylaxis is a constant perioperative concern due to the exposure to several agents capable of inducing hypersensitivity reactions. Patent blue V (PBV), also known as Sulfan Blue, a synthetic dye used in sentinel node research in breast surgery, is responsible for 0.6% of reported anaphylactic conditions. We present a case of a 49-year-old female patient who underwent left breast tumorectomy with sentinel lymph node staging using PBV and experienced an anaphylactic reaction. Methods: We conducted a literature search through PubMed for case reports, case series, review and systematic reviews since 2005 with the keywords "anaphylaxis" and "patent blue". We then included articles found in these publications' reference sections. Results: We found 12 relevant publications regarding this topic. The main findings are summarized, with information regarding the clinical presentation, management, and investigation protocol. Hypotension is the most common clinical manifestation. The presentation is usually delayed when compared with anaphylaxis from other agents and cutaneous manifestations are occasionally absent. Patients may have had previous exposure to the dye, used also as a food, clothes and drug colorant. Conclusion: The diagnosis of anaphylaxis in patients under sedation or general anesthesia may be difficult due to particularities of the perioperative context. According to the published literature, the presentation of the reaction is similar in most cases and a heightened clinical sense is key to address the situation appropriately. Finding the agent responsible for the allergic reaction is of paramount importance to prevent future episodes.

Resumo Introdução: A anafilaxia pode ocorrer durante o período perioperatório devido à exposição a diversos agentes capazes de induzir reações de hipersensibilidade. O corante sintético Azul Patente V (APV), também conhecido como Sulfan Blue, é usado na pesquisa de linfonodo sentinela em cirurgia de mama, e é responsável por 0,6% dos eventos anafiláticos relatados. Descrevemos o caso de uma paciente de 49 anos de idade submetida à tumorectomia de mama esquerda com estadiamento de linfonodo sentinela, em que se empregou o APV e que apresentou reação anafilática. Método: Por meio do PubMed, pesquisamos publicações que documentavam relatos de casos, séries de casos, revisões e revisões sistemáticas desde 2005, usando as palavras-chave "anaphylaxis" e "patent blue". Em seguida, incluímos artigos encontrados na lista de referências dessas publicações. Resultados: Encontramos 12 publicações relevantes sobre o tópico. Os principais achados estão resumidos, com informações do quadro clínico, tratamento e protocolo de investigação. A hipotensão foi a manifestação clínica mais frequente. De forma geral, o quadro clínico tem início tardio quando comparado à anafilaxia por outros agentes e, ocasionalmente, as manifestações cutâneas estão ausentes. Os pacientes podem ter tido exposição prévia ao APV, que também é usado como corante de alimentos, roupas e medicamentos. Conclusão: O diagnóstico de anafilaxia em pacientes sob sedação ou anestesia geral pode ser difícil devido às peculiaridades do contexto perioperatório. Segundo a literatura publicada, a apresentação da reação é semelhante na maioria dos casos e um discernimento clínico aguçado é fundamental para enfrentar o evento adequadamente. Encontrar o agente responsável pela reação alérgica é essencial para a prevenção de futuros episódios.

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Natural and synthetic dyes are widely used in foodstuff, medicines and cosmetics industries to enhance and/or restore the color of the final products. This study aimed to evaluate the safety of oral consumption of one carotenoids and anacardic acids-enriched extract (CAE), obtained by green extraction from cashew apple residue fibers, a byproduct of the cashew juice industry. Presenting intense yellow color, CAE could be proposed as a new natural dye. Single and repeated-dose oral toxicity (30 days) were evaluated in female Swiss mice at doses ranging from 50 to 1000 mg/kg, while (anti)mutagenic effects were evaluated in CHO-K1 cells (in vitro Cytokinesis-Block Micronucleus assay - CBMN) and in erythrocytes collected from murine bone marrow (in vivo). CAE did not induce toxic or mutagenic effects in female mice even after 30 days of treatment, regardless of the dose used. Considering cyclophosphamide (CPA)-challenged animals treated with CAE, neither antimutagenic effect was observed nor CAE increased CPA-mutagenic effects although in vitro CBMN results indicated that CAE might increase methyl methanesulfonate-induced micronuclei (MN) frequency besides promoting reduction on CPA-induced MN frequency. The obtained results suggest that CAE may be a safe source of carotenoids with potential use as industrial dye.

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Introduction: Obtaining the result expected during tooth bleaching requires a correct diagnosis of the type of staining presented. The causes of tooth staining differ depending on the etiological factor. Objective: To assess the color change caused by the immersion of bovine teeth in coffee solution during at-home tooth bleaching using a 16% carbamide peroxide gel. Material and method: Thirty-three sound bovine teeth were assigned to three groups of eleven teeth each: 1 - Teeth bleached (TB) four hours per day for 21 days; 2 - TB four hours per day for 21 days and immersed in coffee solution immediately after tooth bleaching; 3 - TB four hours per day for 21 days and immersed in coffee solution four hours after the end of tooth bleaching. Immersed in coffee was performed for 15 minutes and tooth color was assessed before the start of the bleaching procedure and after 21 days with an intraoral spectrophotometer. Test Shapiro-Wilk was used to assess homoscedasticity and data were submitted to one-factor Analysis of Variance (ANOVA) and Tukey's test (p <0.05). Result: The color change observed in group 1 (5.76 ± 2.74)A was not statistically different from group 2 (8.83 ±5.11)A, which was immersed in coffee solution immediately after tooth bleaching, and from group 3, which was immersed in coffee solution four hours after tooth bleaching (8.20 ±3.71)A. Conclusion: Coffee did not interfere with the tooth bleaching results, regardless of the time after the procedure. Hence, diet restrictions are not necessary during tooth bleaching.

Introdução: A obtenção do resultado esperado durante o clareamento dental exige um diagnóstico correto do tipo de coloração apresentado. As causas da coloração dos dentes diferem dependendo do fator etiológico. Objetivo: Avaliar a mudança de cor causada pela imersão dos dentes bovinos na solução de café durante o clareamento dentário caseiro, utilizando gel de peróxido de carbamida a 16%. Material e método: Trinta e três dentes bovinos hígidos foram distribuídos em três grupos de onze dentes cada: 1 - Dentes clareados quatro horas por dia durante 21 dias; 2 - Dentes clareados quatro horas por dia durante 21 dias e imerso em solução de café imediatamente após o clareamento dentário; 3 - Dentes clareados quatro horas por dia durante 21 dias e imerso em solução de café quatro horas após o término do clareamento dentário. Imersão em café foi realizada durante 15 minutos e a cor dos dentes foi avaliada antes do início do procedimento do clareamento e após 21 dias com um espectrofotômetro intraoral. O teste Shapiro-Wilk foi utilizado para avaliar a homocedasticidade e os dados foram submetidos à análise de variância de um fator (ANOVA) e ao teste de Tukey (p <0,05). Resultado: A mudança de cor observada no grupo 1 (5,76 ± 2,74)A não foi estatisticamente diferente do grupo 2 (8,83 ± 5,11)A, imerso em solução de café imediatamente após o clareamento dentário, e do grupo 3, imerso em café quatro horas após o clareamento dental (8,20 ± 3,71). Conclusão: O café não interferiu nos resultados do clareamento dental, independentemente do tempo após o procedimento. Portanto, restrições alimentares não são necessárias durante o clareamento dental.

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Sentinel lymph node biopsy in the surgical treatment of initial breast cancer has been increasingly adopted to assess axillary status as a way to replace total lymphadenectomy. The sentinel lymph node can be identified using coloring agents or radiopharmaceuticals. In Brazil, patent blue is the most used dye for this type of procedure, with high rates of identification and safety; however, in some cases, the use of this substance can lead to the occurrence of anaphylactic reactions. The case presented here refers to a 41-year-old female patient admitted for a surgical procedure for total mastectomy associated with sentinel lymph node biopsy with patent blue. After surgical initiation, the patient developed severe anaphylactic shock, staying 21 days in the intensive care unit (ICU) for recovery. Most anaphylactic reactions that occur in the transoperative period are mediated by IgE antibodies, resulting in the degranulation of mast cells and basophils, with the release of mediators such as histamine, prostaglandins, proteoglycans, and cytokines, leading to the clinical manifestations of anaphylaxis. There is evidence that part of the population is allergic to patent blue, and may present with manifestations ranging from hives and pruritus to severe cardiovascular collapse, requiring hospitalization in an ICU. The purpose of this article was to report a case of severe anaphylactic reaction to patent blue and to review the literature regarding this infrequent and potentially serious situation.

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AIM: This study aimed to clarify whether dental plaque disclosing before professional prophylaxis would improve the visualization of dental plaque, therefore optimizing the procedure. MATERIALS AND METHODS: The sample comprised both the smooth and occlusal surfaces of the teeth of 25 children from 18 to 36 months. A randomized crossover clinical trial was conducted with two groups: GI-with disclosing and GII-without disclosing (washout/1 month). The teeth were stained with 1% malachite green solution to assess the amount of dental plaque on smooth and occlusal surfaces. RESULTS: Dental plaque removal was more effective and statistically faster (391.27 seconds ±142.2) in GI. The plaque index and the prophylaxis duration were inversely related in GI. The child's behavior did not affect the plaque removal effectiveness, regardless of plaque disclosure (p > 0.05). CONCLUSION: Dental plaque disclosing in young children is an effective and less time-consuming method that improves the quality of the professional dental prophylaxis. CLINICAL SIGNIFICANCE: Biofilm control is important for the success of programs for prevention of early childhood caries (ECC) and considering the particularities inherent to the dental care of infants, it is necessary that periodic professional prophylaxis is effective in eliminating the oral biofilm, ideally reducing chair time. Although dental plaque disclosing has been traditionally performed on educational basis during oral hygiene instruction, this resource can be safely employed to help professional prophylaxis in infants. HOW TO CITE THIS ARTICLE: de Alencar CRB, de Oliveira GC, et al. Dental Plaque Disclosing as an Auxiliary Method for Professional Dental Prophylaxis in Early Childhood. Int J Clin Pediatr Dent 2019;12(3):189-193.

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OBJECTIVE: Defects/bubbles can occur during the manufacture of bis-acryl resin provisional restorations, requiring repair or new prosthesis. This study evaluated the color stability of bis-acryl resin specimens repaired, aging, and immersioned in beverages. MATERIAL AND METHODS: Eighty disks were made of bis-acryl resin. Twenty disks were not repaired (BCR), 20 disks were repaired with the same bis-acryl resin (BCR-BCR), 20 disks were repaired with flowable resin (BCR-FR), and 20 disks received an adhesive layer prior to flowable resin repair (BCR-AFR). Coordinates L*a*b* were obtained. Ten disks from each group were thermocycled (5000 cycles) and the others were immersed in coffee with sugar (n = 5) and cola-based soft drinks (n = 5) for 7 days. Color, lightness, chroma, and hue differences were calculated by the CIEDE2000 formula, analyzed by two-way analysis of variance. Multiple comparisons were made with the Tukey's HSD test (α = .05). RESULTS: BCR-FR group presented the highest color differences (5.6) between groups repaired (P < .001). BCR-BCR group showed the smallest color differences (0.9) after aging (P = .003), but the greatest variation between T0 and T1 (about 1 ΔE). BCR-ARF immersed in coffee showed the greatest color differences (20.6) (P < .001). CONCLUSIONS: Aging and immersion altered the colorimetric behavior of repairs, especially after the use of coffee. CLINICAL IMPLICATIONS: Repairs are indicated when defects and bubbles are present in the surface of the bis-acryl resin provisional restorations after its manufacture. However, they may present noticeable color changes, especially when the use of coffee is frequent.

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Objective: To evaluate and compare the use of different dyes in the marking of nonpalpable breast lesions indicated for surgical resection. Method: We analyzed the following variables: number of cases, types of dye, technique used for marking (patent blue, indocyanine green, or methylene blue), associated techniques (guidewire or Tc-99m), free margins of the surgical specimen (when the diagnosis was cancer), pain during the marking, and allergic events. The main results of the articles were organized in tables, using the software Microsoft Excel 2011. Results: We selected 11 articles for analysis. A total of 510 women had 516 nonpalpable breast lesions marked with dyes. The main dyes used were patent blue, methylene blue, and indocyanine green. The rate of free margins in cancer cases was 95%. Methylene blue was superior to other dyes in obtaining free margins. Out of the 11 articles selected, three associated dye with radioactive materials, and two with guidewire. Two studies analyzed the pain during the marking and revealed that 75% of the patients classified it as moderate or minimal, with mammography being the method most associated with pain. No allergic event was reported. Conclusion: The use of dyes in the preoperative marking of nonpalpable breast lesions is a viable, safe, and cheap technique. The initial results of several groups indicate significant advantages compared to the methods currently available. Methylene blue has a lower rate of positive margins than other dyes. Prospective randomized studies are still necessary to verify the superiority of the technique in comparison to others

Objetivo: Avaliar e comparar o uso de diferentes corantes na marcação de lesões não palpáveis de mama que possuem indicação para ressecção cirúrgica. Método: Foram analisadas as seguintes variáveis: número de casos, tipos de corante, técnica utilizada na marcação (azul patente, indocianina verde ou azul de metileno), técnicas associadas (fio-guia ou TC-99), margens livres do espécime cirúrgico (quando o diagnóstico era câncer), dor durante a marcação e eventos alérgicos. Organizou-se os principais resultados dos artigos em tabelas, utilizando o programa Microsoft Excel 2011. Resultados: Foram selecionados 11 artigos para análise. Ao todo, 510 mulheres realizaram marcação com corantes em 516 lesões impalpáveis de mama. Os principais corantes utilizados foram azul patente, azul de metileno e indocianina verde. A taxa de margens livres em casos de câncer foi de 95%. O azul de metileno foi superior aos demais corantes na obtenção de margens livres. Dos 11 artigos selecionados, em três foi feita a associação do corante com materiais radioativos, e em dois, com o fio guia. A dor durante a marcação foi analisada por dois estudos e classificada como moderada ou mínima por 75% das pacientes, sendo a mamografia o método mais associado à dor. Não foram reportados eventos alérgicos. Conclusão: O uso de corantes na marcação pré-operatória de lesões impalpáveis de mama é uma técnica viável, segura e mais barata. Os resultados iniciais de diversos grupos apontam vantagens significativas em relação aos métodos disponíveis atualmente. O azul de metileno apresenta menor taxa de margens comprometidas em relação aos demais corantes. Estudos prospectivos randomizados ainda são necessários para atestar a superioridade da técnica em relação às demais.

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PURPOSE: To evaluate the roughness and color change of a conventional acrylic resin and a bis-acryl resin, submitted to different types of polishing and exposed to a staining solution. MATERIALS AND METHODS: One hundred specimens were manufactured from an autopolymerizing conventional acrylic resin (Duralay, shade 66) (n = 50) and a bis-acryl resin (Protemp 4, shade A3) (n = 50) according to the manufacturers' instructions. Specimens were subdivided into 10 groups (n = 10), according to the type of resin and polishing method, including no-polishing (control groups for acrylic resin [tungsten bur finishing] and bis-acryl resin [cotton and alcohol]), Enhance System, Edenta kit, Labordental kit, and sandpaper. The specimens were immersed in a staining solution (coffee at 60°C) for 7 days. Surface roughness was evaluated before the first immersion (baseline - Ra1) and after 7 days (Ra2). The color change (∆E) was determined after 24 hours (∆E1) and 7 days (∆E2), by CIE L* a* b* scale. Data were statistically analyzed with 3-way ANOVA for repeated measures test and Tukey test (α = 0.05). RESULTS: According to 3-way ANOVA test, material, polishing techniques, and polishing*material factors exhibited statistically significant influence (p < 0.0001) on the roughness, and, for color change, material, polishing techniques, time, polishing*material, and material*time factors were statistically significant (p < 0.0001). The polishing techniques successfully reduced the surface roughness of acrylic resin groups, when compared to control (p < 0.001), but for bis-acryl resin, results were not different from the control group (Enhance: p = 0.954, Edenta: p = 0.866, sandpaper: p = 0.366, Labordental: p = 0.945). Surface roughness was not affected by the immersion in staining solution for 7 days. Color change of acrylic resin groups after 24 hours and 7 days of immersion exhibited a clinically acceptable value (ΔE < 3.7) with the exception of the Enhance group, and all bis-acryl resin groups exhibited a clinically unacceptable color change value (ΔE > 3.7) independent of polishing technique and time interval (∆E1 and ∆E2). CONCLUSIONS: Roughness of both materials was similar when the polishing techniques studied were performed, although Ra values were superior to the clinically acceptable values (0.20 µm), and were not affected by the immersion protocol studied; however, when esthetics are critical, the selection of material type is more important than the surface treatment technique used, and bis-acryl resin was more susceptible to clinically unacceptable color change after immersion in a staining solution.

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OBJECTIVE: The goal of this study is to analyze the applicability of the patent blue dye and air in the preoperative marking of impalpable mammary lesions with indication of surgical resection. MATERIALS AND METHODS: A prospective cohort study was performed. We selected 49 patients with detection of impalpable lesions on a breast mammography or breast ultrasonography. The patients received the dye injection as close to their surgery time as possible. The criteria analyzed included: 1) complete marking and identification of the lesion; 2) complete removal of the lesion; 3) in cases of malignant lesions, presence of free margins for successful surgery; 4) occurrence of allergic events; 5) necessity of reoperation; and 6) difficulty in locating lesions. RESULTS: All lesions were marked, and they were successfully excised. In cases of malignancy, free margins were obtained in 100% of the cases. There were no allergic events or reoperations. Only 8.9% of the lesions were difficult to locate. CONCLUSION: The marking with patent blue and air is an effective alternative for the labeling of impalpable breast lesions, and it has satisfactory surgical oncology results. All lesions were resected, 91.1% of them were performed with no difficulties, and free margins were obtained in 100% of cases of malignancy.

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Introdução: Dentre os corantes de fontes naturais disponíveis no mercado, os mais comuns são aquelas capazes de conferir as cores vermelha, roxa, laranja e amarela, sendo a coloração azul relativamente escassa. A espécie Ravenala madagascariensis, também conhecida como árvore dos viajantes, é uma planta oriunda da Ilha de Madagascar, África do Sul, característica por sementes recobertas por arilos fibrosos de coloração azul intensa. Objetivo: Descrever uma metodologia capaz de extrair e incorporar os corantes azuis presentes nos arilos em uma formulação dermocosmética estável. Metodologia: Foi realizado screening com distintos líquidos extratores para a obtenção do extrato dos arilos. O extrato em ciclometicone foi incorporado em preparações cosméticas empregando-se as bases Polawax® e Cold cream. Após a avaliação dos aspectos sensoriais, a formulação preparada com Polawax foi direcionada para avaliação de estabilidade acelerada (15 dias) de acordo com o protocolo definido pela ANVISA. Resultados: O melhor processo extrativo foi obtido pela utilização do ciclometicone, que é um excipiente compatível com o preparo de formulações cosméticas. O produto contendo 1% do extrato dos arilos em ciclometicone, incorporado à base Polawax, foi avaliado em relação às variáveis aspecto, cor (azul), odor, sensação ao tato e pH (5,5) e não apresentou alterações no ensaio de estabilidade acelerado. Conclusão: Com a metodologia apresentada, foi possível extrair e preparar uma formulação dermocosmética estável com nova proposta de corante azul, aplicável como excipiente para formulações.

Introduction: Among the dyes from natural sources available in the market, the most common are those capable of giving the colors red, purple, orange and yellow, being the blue coloration relatively scarce. The Ravenala madagascariensis species, also known as the traveler's tree, is a plant from Madagascar Island, South Africa, characterized by seeds covered by intense blue colored fibrous aryls. Objective: To describe a methodology capable of extracting and incorporating the blue dyes present in aryls in a stable dermocosmetic formulation. Methodology:Screening with different extracting liquids was performed to obtain the extract of the arils. The cyclomethicone extract was incorporated into cosmetic preparations using the Polawax® and Cold cream bases. After evaluation of sensory aspects, the formulation prepared with Polawax was directed to accelerated stability evaluation (15 days) according to the protocol defined by ANVISA. Results: The best extraction process was obtained by the use of cyclomethicone, which is an excipient compatible with the preparation of cosmetic formulations. The product containing 1% of the cyclomethicone aryl extract, incorporated into the Polawax base, was evaluated in relation to the variables appearance, color (blue), odor, touch sensation and pH (5.5) and showed no changes in the stability test accelerated. Conclusion:With the methodology presented, it was possible to extract and prepare a stable dermocosmetic formulation with new blue dye proposal, applicable as an excipient for formulations.

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