Oral bisphosphonate-related osteonecrosis of the jaws in rheumatoid arthritis patients: a critical discussion and two case reports

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical condition characterized by the presence of exposed bone in the maxillofacial region. Its pathogenesis is still undetermined, but may be associated with risk factors such as rheumatoid arthritis (RA). The aim of this paper is to report two unpublished cases of BRONJ in patients with RA and to conduct a literature review of similar clinical cases with a view to describe the main issues concerning these patients, including demographic characteristics and therapeutic approaches applied.Methods: Two case reports of BRONJ involving RA patients were discussedResults: Both patients were aging female taking alendronate for more than 3 years. Lesions were detected in stage II in posterior mandible with no clear trigger agent. The treatment applied consisted of antibiotics, oral rinses with chlorhexidine, drug discontinuation and surgical procedures. Complete healing of the lesions was achieved.Conclusions: This paper brings to light the necessity for rheumatologists to be aware of the potential risk to their patients of developing BRONJ and to work together with dentists for the prevention and early detection of the lesions. Although some features seem to link RA with oral BRONJ and act as synergistic effects, more studies should be developed to support the scientific bases for this hypothesis.

Conservative power theory discussion and evaluation by means of virtual instrumentation

Considering different single and multiphase circuits feeding linear and non-linear loads, this paper presents theoretical discussions and experimental evaluation of the recent Conservative Power Theory (CPT), by means of Virtual Instrumentation concepts. The main goal is to analyze the results of such power theory definitions under nonsinusoidal and unbalanced conditions, pointing out its major advantages, possible drawbacks or relevant aspects for discussion. © 2009 IEEE.

Mediação em fóruns educacionais de curso online de língua estrangeira (espanhol)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Livros da subversão: imprensa comunista e a coleção História Nova do Brasil

The colection História Nova do Brasil, produced and published in the early 1960s by a group of intellectuals of the Instituto Superior de Estudos Brasileiros (ISEB), has become a field of discussion and debate among military and the left after 1964. Accused of promoting communist subversion, the collection had a new methodology to analyze the history of Brazil, with marxist approach. For this and other reasons, copies were seized by military agencies and the authors were indicted in military investigations, accused of violating the National Security Law.

Tolerância

The screenplay for the short film Tolerance is a project whose goal is to generate discussion about intolerance, which falls on the minority cultures in contemporary society. Even preserving their Brazilianness, through the art direction, it can cross borders as it does not have dialogues, and addresses current realities that underlie different cultures, even the most liberal and democratic. This project can achieve the interests of various groups, making it an excellent tool for generating discussion and debate in all social and educational levels

Conselhos municipais: prática e impasses no cenário contemporâneo

Pela experiência de inserção militante em dois conselhos municipais, apresentamos informações sistematizadas e essenciais sobre a composição desses espaços de controle social. Quais são alguns dos problemas essenciais no funcionamento concreto dos conselhos? Pela perspectiva social crítica, procuramos apreender as contradições que atravessam esses dispositivos de controle social. Oferecemos pistas orientadoras para os profissionais da Psicologia que buscam atuar na linha do compromisso social e que se engajam na participação nesses importantes mecanismos sociais de discussão e deliberação no âmbito das políticas públicas.

Brazilian Students and Working Capital: An Analysis of Their Decisions When Using Virtual Market Business Games

This study aims to demonstrate that data from business games can be an important resource for improving efficiency and effectiveness of learning. The proposal presented here was developed from preliminary studies of data from Virtual Market games that pointed the possibility of identifying gaps in learning by analyzing the decisions of students. This proposal helps students to refine their learning processes and equips tutors with strategies for teaching and student assessment. The proposal also complements the group discussion and/or debriefing, which are widely used to enhance learning mediated by games. However, from a management perspective the model has the potential to be erroneous and miss opportunities, which cannot be detected because of the dependence on the characteristics of the individual, such as ability to communicate and work together. To illustrate the proposed technique, data sets from two business games were analyzed with the focus on managing working capital and it was found that students had difficulties managing this task. Similar trends were observed in all categories of students in the study-undergraduate, postgraduate and specialization. This discovery led us to the analysis of data for decisions made in the performance of the games, and it was determined that indicators could be developed that were capable of indentifying inconsistencies in the decisions. It was decided to apply some basic concepts of the finance management, such as management of the operational and non-operational expenditures, as well as production management concepts, such as the use of the production capacity. By analyzing the data from the Virtual Market games using the indicator concept, it was possible to detect the lack of domain knowledge of the students. Therefore, these indicators can be used to analyze the decisions of the players and guide them during the game, increasing their effectiveness and efficiency. As these indicators were developed from specific content, they can also be used to develop teaching materials to support learning. Viewed in this light, the proposal adds new possibilities for using business games in learning. In addition to the intrinsic learning that is achieved through playing the games, they also assist in driving the learning process. This study considers the applications and the methodology used.

pH-cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations

Despite a plethora of in situ studies and clinical trials evaluating the efficacy of fluoridated dentifrices on caries control, in vitro pH cycling models are still broadly used because they mimic the dynamics of mineral loss and gain involved in caries formation. This paper critically reviews the current literature on existing pH-cycling models for the in vitro evaluation of the efficacy of fluoridated dentifrices for caries control, focusing on their strengths and limitations. A search was undertaken in the MEDLINE electronic journal database using the keywords "pH-cycling", "demineralization", "remineralization", "in vitro", "fluoride", "dentifrice". The primary outcome was the decrease of demineralization or the increase of remineralization as measured by different methods (e. g.: transverse microradiography) or tooth fluoride uptake. Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. One hundred and sixteen studies were included, of which 42 addressed specifically the comparison of dentifrices using different pH-cycling models. The other studies included meta-analysis or reviews, data about the effect of different fluoride sources on de-remineralization, different methods for analysis de-remineralization and chemical variables and characteristics of dental hard tissues that might have influence on de-remineralization processes. Generally, the studies presented ability to detect known results established by clinical trials, to demonstrate dose-related responses in the fluoride content of the dentifrices, and to provide repeatability and reproducibility between tests. In order to accomplish these features satisfactorily, it is mandatory to take into account the type of substrate and baseline artificial lesion, as well as the adequate response variables and statistical approaches to be used. This critical review of literature showed that the currently available pH-cycling models are appropriate to detect dose-response and pH-response of fluoride dentifrices, and to evaluate the impact of new active principles on the effect of fluoridated dentifrices, as well as their association with other anti-caries treatments.

Central nitrergic system regulation of neuroendocrine secretion, fluid intake and blood pressure induced by angiotensin-II

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Use of bovine bone graft and bone membrane in defects surgically created in the cranial vault of rabbits. Histologic comparative analysis

Purpose: This study was proposed to analyze histologically the process of repairing bone defects created surgically in the cranial vaults of rabbits. Materials and Methods: Thirty adult male rabbits (Oryctolagus cunilicus) received, under general anesthesia, bilateral parietal osteotomies by means of a 6mm-diameter trephine. The bony defects were divided into 4 groups. In group 1 the defect did not receive any treatment; in group 2 the defect was filled with lyophilized bovine bone (Biograft); in group 3 it was filled with bovine bone and covered with a bone matrix membrane (Bioplate); in group 4 it was covered with a bone matrix membrane. Animals were sacrificed in 3 equal groups at 15, 30, and 60 days. The specimens were subjected to routine laboratory procedures to evaluate the degree of bone repair. Results: After 60 days, new bone formation in group 2 was not satisfactory when compared to that of group 3. Large amounts of new bone formation in maturation were seen in group 3. In the defects covered with a membrane the results were similar to those of group 1 (ie, the cavity was filled with fibrous connective tissue). The implanted bone and membranes were totally resorbed. Discussion and Conclusions: the use of a membrane served as a barrier against the migration of cells from the adjacent tissue and the bone graft/membrane preserved the cavity space, resulting in an enhanced osteogenic effect.

Bioinformatical and in vitro approaches to essential oil-induced matrix metalloproteinase inhibition

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Anti-inflammatory activity of Alchornea triplinervia ethyl acetate fraction: Inhibition of H2O2, NO and TNF-alpha

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microbiologic and radiographic analysis of ligature-induced peri-implantitis with different dental implant surfaces

Purpose: The goal of this study was to evaluate microbiota and radiographic peri-implant bone loss associated with ligature-induced peri-implantitis. Materials and Methods: Thirty-six dental implants with 4 different surfaces (9 commercially pure titanium, 9 titanium plasma-sprayed, 9 hydroxyapatite, and 9 acid-etched) were placed in the edentulous mandibles of 6 dogs. After 3 months with optimal plaque control, abutment connection was performed. On days 0, 20, 40, and 60 after placement of cotton ligatures, both microbiologic samples and periapical radiographs were obtained. The presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia/nigrescens, Campylobacter spp, Capnocytophaga spp, Fusobacterium spp, beta-hemolytic Streptococcus, and Candida spp were evaluated culturally. Results: P intermedia/nigrescens was detected in 13.89% of implants at baseline and 100% of implants at other periods. P gingivalis was not detected at baseline, but after 20 and 40 days it was detected in 33.34% of implants and at 60 days it was detected in 29.03% of dental implants. Fusobacterium spp was detected in all periods. Streptococci were detected in 16.67% of implants at baseline and in 83.34%, 72.22%, and 77.42% of implants at 20, 40, and 60 days, respectively. Campylobacter spp and Candida spp were detected in low proportions. The total viable count analysis showed no significant differences among surfaces (P = .831), although a significant difference was observed after ligature placement (P < .0014). However, there was no significant qualitative difference, in spite of the difference among the periods. The peri-implant bone loss was not significantly different between all the dental implant surfaces (P = .908). Discussion and Conclusions: These data suggest that with ligature-induced peri-implantitis, both time and periodontal pathogens affect all surfaces equally after 60 days.

Experimental peri-implant tissue breakdown around different dental implant surfaces: Clinical and radiographic evaluation in dogs

Purpose: Tissue reactions to 4 different implant surfaces were evaluated in regard to the development and progression of ligature-induced peri-implantitis. Materials and Methods: In 6 male mongrel dogs, a total of 36 dental implants with different surfaces (9 titanium plasma-sprayed, 9 hydroxyapatite-coated, 9 acid-etched, and 9 commercially pure titanium) were placed 3 months after mandibular premolar extraction. After 3 months with optimal plaque control, abutment connection was performed. Forty-five days later, cotton ligatures were placed around the implants to induce peri-implantitis. At baseline and 20, 40, and 60 days after placement, the presence of plaque, peri-implant mucosal redness, bleeding on probing, probing depth, clinical attachment loss, mobility, vertical bone loss, and horizontal bone loss were assessed. Results: The results did not show significant differences among the surfaces for any parameter during the study (P > .05). All surfaces were equally susceptible to ligature-induced peri-implantitis over time (P < .001). Correlation analysis revealed a statistically significant relationship between width of keratinized tissue and vertical bone loss (r 2 = 0.81; P = .014) and between mobility and vertical bone loss (r 2 = 0.66; P = .04), both for the titanium plasma-sprayed surface. Discussion and Conclusions: The present data suggest that all surfaces were equally susceptible to experimental peri-implantitis after a 60-day period.