Clinical Evaluation of the Effectiveness of Different Bleaching Therapies in Vital Teeth

The aims of this in vivo study were to compare the effectiveness and color stability of at-home and in-office bleaching techniques and to evaluate whether the use of light sources can alter bleaching results. According to preestablished criteria, 40 patients were selected and randomly divided into four groups according to bleaching treatment: (1) at-home bleaching with 10% carbamide peroxide, (2) in-office bleaching with 35% hydrogen peroxide (HP) without a light source, (3) in-office bleaching with 35% HP with quartz-tungsten-halogen light, and (4) in-office bleaching with 35% HP with a light-emitting diode/laser. Tooth shade was evaluated using the VITA Classical Shade Guide before bleaching as well as after the first and third weeks of bleaching. Tooth shade was evaluated again using the same guide 1 and 6 months after the completion of treatment. The shade guide was arranged to yield scores that were used for statistical comparison. Statistical analysis using the Kruskal-Wallis test showed no significant differences among the groups for any time point (P > .01). There was no color rebound in any of the groups. The bleaching techniques tested were equally effective. Light sources are unnecessary to bleach teeth. (Int J Periodontics Restorative Dent 2012;32:303-309.)

Comparative clinical study of the effectiveness of different dental bleaching methods - two year follow-up

This study evaluated color change, stability, and tooth sensitivity in patients submitted to different bleaching techniques. Material and methods: In this study, 48 patients were divided into five groups. A half-mouth design was conducted to compare two in-office bleaching bleaching techniques (with and without light activation): G1: 35% hydrogen peroxide (HP) (Lase Peroxide - DMC Equipments, Sao Carlos, SP, Brazil) + hybrid light (HL) (LED/Diode Laser, Whitening Lase II DMC Equipments, Sao Carlos, SP, Brazil); G2: 35% HP; G3: 38% HP (X-traBoost - Ultradent, South Jordan UT, USA) + HL; G4: 38% HP; and G5: 15% carbamide peroxide (CP) (Opalescence PF - Ultradent, South Jordan UT, USA). For G1 and G3, HP was applied on the enamel surface for 3 consecutive applications activated by HL. Each application included 3x3' HL activations with 1' between each interval; for G2 and G4, HP was applied 3x15' with 15' between intervals; and for G5, 15% CP was applied for 120'/10 days at home. A spectrophotometer was used to measure color change before the treatment and after 24 h, 1 week, 1, 6, 12, 18 and 24 months. A VAS questionnaire was used to evaluate tooth sensitivity before the treatment, immediately following treatment, 24 h after and finally 1 week after. Results: Statistical analysis did not reveal any significant differences between in-office bleaching with or without HL activation related to effectiveness; nevertheless the time required was less with HL. Statistical differences were observed between the result after 24 h, 1 week and 1, 6, 12, 18 and 24 months (integroup). Immediately, in-office bleaching increased tooth sensitivity. The groups activated with HL required less application time with gel. Conclusion: All techniques and bleaching agents used were effective and demonstrated similar behaviors.

Associação de técnicas conservadoras para otimizar a estética do sorriso: clareamento dental e microabrasão do esmalte

As várias opções para a realização de tratamentos estéticos conservadores permitem ao profissional a escolha de materiais e técnicas apropriados, que melhor se enquadrem nas características individuais de cada paciente e na realidade de seu consultório. No caso clínico apresentado, a técnica de clareamento dental em consultório com peróxido de hidrogênio a 35% (Total Blanc Office, DFL), ativado com luz híbrida LED/LASER e a microabrasão de esmalte com pasta de acido fosfórico a 37% e pedra pomes, foram associados. Os resultados com o clareamento em consultório são imediatos, de forma que o profissional dispõe de total controle sobre aplicação do gel clareador em áreas e dentes específicos. A microabrasão do esmalte é um tratamento simples e custo relativamente baixo, remove as manchas superficiais do esmalte com preservação de estrutura dental. No caso apresentado, a associação das duas técnicas proporcionou a obtenção de excelente resultado estético em apenas uma sessão de atendimento.

Methodology of CO2 emission evaluation in the life cycle of office building facades

The construction industry is one of the greatest sources of pollution because of the high level of energy consumption during its life cycle. In addition to using energy while constructing a building, several systems also use power while the building is operating, especially the air-conditioning system. Energy consumption for this system is related, among other issues, to external air temperature and the required internal temperature of the building. The facades are elements which present the highest level of ambient heat transfer from the outside to the inside of tall buildings. Thus, the type of facade has an influence on energy consumption during the building life cycle and, consequently, contributes to buildings' CO2 emissions, because these emissions are directly connected to energy consumption. Therefore, the aim is to help develop a methodology for evaluating CO2 emissions generated during the life cycle of office building facades. The results, based on the parameters used in this study, show that facades using structural glazing and uncolored glass emit the most CO2 throughout their life cycle, followed by brick facades covered with compound aluminum panels or ACM (Aluminum Composite Material), facades using structural glazing and reflective glass and brick facades with plaster coating. On the other hand, the typology of facade that emits less CO2 is brickwork and mortar because its thermal barrier is better than structural glazing facade and materials used to produce this facade are better than brickwork and ACM. Finally, an uncertainty analysis was conducted to verify the accuracy of the results attained. (C) 2011 Elsevier Inc. All rights reserved.

The implementation of the Medical Regulation Office and Mobile Emergency Attendance System and its impact on the gravity profile of non-traumatic afflictions treated in a University Hospital: a research study

Abstract Background The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow overloaded the hospitals, mainly the ones of higher complexity. The knowledge of this phenomenon induced Ribeirão Preto to implement the Medical Regulation Office and the Mobile Emergency Attendance System. The objective of this study was to analyze the impact of these services on the gravity profile of non-traumatic afflictions in a University Hospital. Methods The study conducted a retrospective analysis of the medical records of 906 patients older than 13 years of age who entered the Emergency Care Unit of the Hospital of the University of São Paulo School of Medicine at Ribeirão Preto. All presented acute non-traumatic afflictions and were admitted to the Internal Medicine, Surgery or Neurology Departments during two study periods: May 1996 (prior to) and May 2001 (after the implementation of the Medical Regulation Office and Mobile Emergency Attendance System). Demographics and mortality risk levels calculated by Acute Physiology and Chronic Health Evaluation II (APACHE II) were determined. Results From 1996 to 2001, the mean age increased from 49 ± 0.9 to 52 ± 0.9 (P = 0.021), as did the percentage of co-morbidities, from 66.6 to 77.0 (P = 0.0001), the number of in-hospital complications from 260 to 284 (P = 0.0001), the mean calculated APACHE II mortality risk increased from 12.0 ± 0.5 to 14.8 ± 0.6 (P = 0.0008) and mortality rate from 6.1 to 12.2 (P = 0.002). The differences were more significant for patients admitted to the Internal Medicine Department. Conclusion The implementation of the Medical Regulation and Mobile Emergency Attendance System contributed to directing patients with higher gravity scores to the Emergency Care Unit, demonstrating the potential of these services for hierarchical structuring of pre-hospital networks and referrals.