Ultrasound effect in the removal of intraradicular posts cemented with different materials

This study evaluated the effect of ultrasonic vibration on the tensile strength required to remove intraradicular post cemented with different materials. Bovine teeth were selected, and 7 mm of the cervical root canals were prepared to size 5 Largo drill, the posts were cemented with zinc phosphate, Enforce (resin) or Rely X (glass ionomer). The specimens were divided into six groups (n = 10), according to the following procedures: GI-cementation with zinc phosphate associated with traction force; GII-cementation with zinc phosphate associated with ultrasonic activation and traction force; G111-cementation with Enforce associated with traction force; GIV-cementation with Enforce associated with ultrasonic activation and traction force; GV-cementation with Rely X associated with traction force; and GVI-cementation with Rely X associated with ultrasonic activation and traction force. The tensile test was conducted using the electromechanical testing machine, the force was determined by a specialized computer program and ultrasonic activation using the Jet Sonic Four Plus (Gnatus) device in 10P. Concerning to average ranking, GI showed statistically significant difference in comparison with GII and GVI (p < 0.05); there was no statistical difference in GIII and GIV when compared to other groups (p > 0.05). The ultrasound favored the intraradicular post traction regardless of the employed cement in greater or lesser extent. The post removal is a routine practice in the dental office, therefore, new solutions and better alternatives are need to the practitioner. We did not find in the literature many articles referring to this practice. Thus, the results from this study are relevant in the case planning and to promote more treatment options.

Posterior partially edentulous jaws, planning a rehabilitation with dental implants

To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning. An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

Caracterização biomecânica da conduta motora remada básica de passeio do esporte stand up paddle

Pós-graduação em Engenharia Mecânica - FEG

Raiz dentária impelida para o seio maxilar após exodontia: uma opção de tratamento

Introduction: Upper teeth, especially first premolars and molars, can have a close anatomical relationship with the floor of maxillary sinus. For this reason, accidental displacement of dental roots into the sinus could happen during exodontic procedures. Objective: Description the treatment performed to remove a tooth root within the maxillary sinus, displaced during an extraction procedure. Case Report: Female patient, 39 years of age, which reported being subjected to the extraction of the element 26 for about two months. The patient was reported by the practitioner who performed the extraction that a root was pushed into the maxillary sinus. The treatment plan included surgery to remove the root within the maxillary sinus. Final Comments: Clinicians should be careful during extractions, to prevent these accidents. However, if such complications occur, access to the maxillary sinus is the best treatment option.

Cerâmicas odontológicas: propriedades, indicações e considerações clinicas

The demand for esthetic restorations has resulted in an increased use of dental ceramics and is the main alternative restorative material to tooth structure due to its favorable properties. Therefore, the aim of this work is to study the evolution of ceramic systems, involving different types and properties, indications, and clinical issues as aesthetic, cementing and longevity. In a detailed and advanced search in the database PubMed, 98 articles were found using the following key words: dental porcelain dental all-ceramic and ceramic according to the criteria for inclusion and exclusion left only 35 articles for review. Several ceramic systems are available in the market, making the prosthetic professionals need a constant recycling about their properties and directions, since good results are due to the selection of the best material for a particular case in all the skill of the practitioner.

Púrpura trombocitopênica idiopática: importância do cirurgião-dentista no diagnóstico

This paper presents a case report of a patient with idiopathic thrombocytopenic purpura (ITP) diagnosed in routine dental care. ITP is defined as a decrease in the number of circulating platelets and generally shows oral manifestations. In this light, we show that the general dental practitioner must be ready to detect ITP signs and symptoms, especially oral changes that are not of dental origin, so as to immediately prescribe the proper treatment. Without this treatment, this pathology may well be irreversible and fatal.

Documento, poder e governo: os agenciamentos políticos na construção patrimonial no Arquivo Central do IPHAN/Seção Rio de Janeiro

Pós-graduação em Ciência da Informação - FFC

Programa de equoterapia: intervenção com um praticante com deficiência visual

The hippotherapy is a therapeutic and educational method that uses the horse within an interdisciplinary approach in the areas of health, education and riding, seeking the biopsychosocial development of people with disabilities and/or special needs. The method generates the practitioner positive effects, such as physical, social and psychological benefits. The goal of this study was to investigate alterations with a practitioner with visual impairment during their participation in a hippotherapy program. The study is characterized by a qualitative and descriptive research, in the form of case study. Data were collected through interviews with the mother of the practitioner and filming, photographs and systematic observation of the sessions. Improvements were found in the behavior of practicing at home, and there was progress in motor performance, and self-confidence generated by the domain horse. It is concluded that the hippotherapy program generated physical, psychological and social benefits to the practitioner.

Autoeficácia como componente mediador de aprendizagem de elementos acrobáticos na ginástica para todos e na capoeira

The study addresses self-efficacy in learning acrobatic elements at Gymnastics for All and Brazilian Capoeira. The methodology consisted of descriptive-qualitative method of research. Questionnaires were applied to seven practitioners of modalities (04 capoeira fighters; 02 gymnastic athletes and 01 practitioner of both of them). The answer formed categories of analysis and it was found that sources of mastery and vicarious experiences plus verbal persuasion are relevant and influence the perception of performance. Fear of injury during practice and preparation of educational pre-sports activities to a better understanding of the task influence the choices and also were indicated. The coach needs to merge with playfulness and motivation, with appropriated levels of challenge to carry out the activities, thus optimizing satisfaction, participation and motivation of athletes.

A inclusão da natação na vida da pessoa com deficiência: uma análise a partir da teoria ecológica do desenvolvimento

The objective of thisstudy was to verify, using the Ecological Development Theory (EDT), as the practice and swimming learning for People With Disabilities (PWD) causes changes to both the practitioner and in other environments experienced by it as well as the other environments influence the learning to swim. The study included 16 PWD, students linked university extension project, Department of Physical Education of UNESP Bauru, taught by coordinators LAPEF, which aims to includes wimming in the PWD ofevery day life, students linked to an institution of Bauru-SP, three employees of the institution and two swimming project teachers.Interviews with the families of the students were made, with the institution s employees, with the project teachers and analyze thes wimming lessons applied in the project for one semester. Based on the results we can say that the practice and learnings wimming for PWD causes changes to both the practitioner and for other environments experienced by her (home, institution) and also, what other environments experienced by PWD influence in practice and process of learning to swim. Using the terminology of EDT, we conclude that theme so system (home activities institution) influences in the microsystem (swimming lessons) and the microsystem influences the mesosystem, so the activity was significant and temporal persistence influencing the development of PCD.

Atividade física e qualidade de vida em pacientes com doença renal crônica submetidos à hemodiálise

Objective: To analyze and correlate the physical activity level (PAL) and the quality of life (QL) in patients with chronic kidney disease (CKD) undergone hemodialyses and to verify in practitioner of physical activity (PPA) if they follow rules and recommendations on their own practice. Methods: The QL (KDQOL-SFTM questionnaire), PAL (IPAQ questionnaire) and the evaluation of rules and recomendations to practice PA were analyzed in one hundred patients. Results: It was observed commitment on different dimensions of QL, higher values to sexual function and social support (88,6) and lower ones to professional paper (25,2) and physical function (47,7). Most patients shows low values of PAL and most PPA implement the exercises incorrectly. It was observed differences between PAL and some areas of QL. Conclusion: Patients with CKD undergone hemodialysis presented low values to PAL, commitment on QL, and most of the patients that realized PA did not implement rules and recomendations on their own practice.

Dança para criança: uma proposta para o ensino de dança voltada para a educação infantil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Accuracy of Screening for Potentially Malignant Disorders of the Oral Mucosa by Dentists in Primary Care

Purpose: To examine the accuracy of a screening programme for potentially malignant disorders of the oral mucosa by visual inspection in primary health care. Materials and Methods: The study was based on secondary data from the Primary Care Information System maintained by seven units of family health in Sao Paulo City managed by a non-governmental agency. The reference population was composed of 15,072 residents 50 years old or more of both genders. The study population comprised 2,980 individuals. During screening in community settings, the oral mucosa was examined by trained dentists and distributed into two categories: (a) screen negative (b) screen positive. All participants underwent comprehensive clinical exams by a general dental practitioner supervised by a specialist. Individual records were grouped in a working dataset. Point and 95% confidence interval estimates were calculated regarding measures of sensitivity (Se), specificity (Sp) and positive and negative predictive values (PPV and NPV, respectively). Results: 18.0% of the population was considered screen positive. A total of 133 lesions (4.5%) were identified and 8 cases of oral cancer were confirmed, which corresponded to a prevalence rate of 27 cases in 10,000 people, a much higher rate than expected. The measures found were Se: 91.7% (85.3-95.6), Sp: 85.4% (84.1-86.7), PPV: 22.7% (19.3-26.5), NPV: 99.5% (99.2-99.8). The visual screen presented high accuracy. Conclusion: The test presented high sensibility and specificity values. From a public health point of view, the high accuracy levels showed the importance of oral health teams on family health strategy for more comprehensive primary care. Targeting risk groups and delegating the screening to community health agents may improve PPV and coverage.

Clinical judgment to estimate pretest probability in the diagnosis of Cushing's syndrome under a Bayesian perspective

OBJECTIVE: To estimate the pretest probability of Cushing's syndrome (CS) diagnosis by a Bayesian approach using intuitive clinical judgment. MATERIALS AND METHODS: Physicians were requested, in seven endocrinology meetings, to answer three questions: "Based on your personal expertise, after obtaining clinical history and physical examination, without using laboratorial tests, what is your probability of diagnosing Cushing's Syndrome?"; "For how long have you been practicing Endocrinology?"; and "Where do you work?". A Bayesian beta regression, using the WinBugs software was employed. RESULTS: We obtained 294 questionnaires. The mean pretest probability of CS diagnosis was 51.6% (95%CI: 48.7-54.3). The probability was directly related to experience in endocrinology, but not with the place of work. CONCLUSION: Pretest probability of CS diagnosis was estimated using a Bayesian methodology. Although pretest likelihood can be context-dependent, experience based on years of practice may help the practitioner to diagnosis CS. Arq Bras Endocrinol Metab. 2012;56(9):633-7

Multiple testing in spatial epidemiology: a Bayesian approach

In this work we aim to propose a new approach for preliminary epidemiological studies on Standardized Mortality Ratios (SMR) collected in many spatial regions. A preliminary study on SMRs aims to formulate hypotheses to be investigated via individual epidemiological studies that avoid bias carried on by aggregated analyses. Starting from collecting disease counts and calculating expected disease counts by means of reference population disease rates, in each area an SMR is derived as the MLE under the Poisson assumption on each observation. Such estimators have high standard errors in small areas, i.e. where the expected count is low either because of the low population underlying the area or the rarity of the disease under study. Disease mapping models and other techniques for screening disease rates among the map aiming to detect anomalies and possible high-risk areas have been proposed in literature according to the classic and the Bayesian paradigm. Our proposal is approaching this issue by a decision-oriented method, which focus on multiple testing control, without however leaving the preliminary study perspective that an analysis on SMR indicators is asked to. We implement the control of the FDR, a quantity largely used to address multiple comparisons problems in the eld of microarray data analysis but which is not usually employed in disease mapping. Controlling the FDR means providing an estimate of the FDR for a set of rejected null hypotheses. The small areas issue arises diculties in applying traditional methods for FDR estimation, that are usually based only on the p-values knowledge (Benjamini and Hochberg, 1995; Storey, 2003). Tests evaluated by a traditional p-value provide weak power in small areas, where the expected number of disease cases is small. Moreover tests cannot be assumed as independent when spatial correlation between SMRs is expected, neither they are identical distributed when population underlying the map is heterogeneous. The Bayesian paradigm oers a way to overcome the inappropriateness of p-values based methods. Another peculiarity of the present work is to propose a hierarchical full Bayesian model for FDR estimation in testing many null hypothesis of absence of risk.We will use concepts of Bayesian models for disease mapping, referring in particular to the Besag York and Mollié model (1991) often used in practice for its exible prior assumption on the risks distribution across regions. The borrowing of strength between prior and likelihood typical of a hierarchical Bayesian model takes the advantage of evaluating a singular test (i.e. a test in a singular area) by means of all observations in the map under study, rather than just by means of the singular observation. This allows to improve the power test in small areas and addressing more appropriately the spatial correlation issue that suggests that relative risks are closer in spatially contiguous regions. The proposed model aims to estimate the FDR by means of the MCMC estimated posterior probabilities b i's of the null hypothesis (absence of risk) for each area. An estimate of the expected FDR conditional on data (\FDR) can be calculated in any set of b i's relative to areas declared at high-risk (where thenull hypothesis is rejected) by averaging the b i's themselves. The\FDR can be used to provide an easy decision rule for selecting high-risk areas, i.e. selecting as many as possible areas such that the\FDR is non-lower than a prexed value; we call them\FDR based decision (or selection) rules. The sensitivity and specicity of such rule depend on the accuracy of the FDR estimate, the over-estimation of FDR causing a loss of power and the under-estimation of FDR producing a loss of specicity. Moreover, our model has the interesting feature of still being able to provide an estimate of relative risk values as in the Besag York and Mollié model (1991). A simulation study to evaluate the model performance in FDR estimation accuracy, sensitivity and specificity of the decision rule, and goodness of estimation of relative risks, was set up. We chose a real map from which we generated several spatial scenarios whose counts of disease vary according to the spatial correlation degree, the size areas, the number of areas where the null hypothesis is true and the risk level in the latter areas. In summarizing simulation results we will always consider the FDR estimation in sets constituted by all b i's selected lower than a threshold t. We will show graphs of the\FDR and the true FDR (known by simulation) plotted against a threshold t to assess the FDR estimation. Varying the threshold we can learn which FDR values can be accurately estimated by the practitioner willing to apply the model (by the closeness between\FDR and true FDR). By plotting the calculated sensitivity and specicity (both known by simulation) vs the\FDR we can check the sensitivity and specicity of the corresponding\FDR based decision rules. For investigating the over-smoothing level of relative risk estimates we will compare box-plots of such estimates in high-risk areas (known by simulation), obtained by both our model and the classic Besag York Mollié model. All the summary tools are worked out for all simulated scenarios (in total 54 scenarios). Results show that FDR is well estimated (in the worst case we get an overestimation, hence a conservative FDR control) in small areas, low risk levels and spatially correlated risks scenarios, that are our primary aims. In such scenarios we have good estimates of the FDR for all values less or equal than 0.10. The sensitivity of\FDR based decision rules is generally low but specicity is high. In such scenario the use of\FDR = 0:05 or\FDR = 0:10 based selection rule can be suggested. In cases where the number of true alternative hypotheses (number of true high-risk areas) is small, also FDR = 0:15 values are well estimated, and \FDR = 0:15 based decision rules gains power maintaining an high specicity. On the other hand, in non-small areas and non-small risk level scenarios the FDR is under-estimated unless for very small values of it (much lower than 0.05); this resulting in a loss of specicity of a\FDR = 0:05 based decision rule. In such scenario\FDR = 0:05 or, even worse,\FDR = 0:1 based decision rules cannot be suggested because the true FDR is actually much higher. As regards the relative risk estimation, our model achieves almost the same results of the classic Besag York Molliè model. For this reason, our model is interesting for its ability to perform both the estimation of relative risk values and the FDR control, except for non-small areas and large risk level scenarios. A case of study is nally presented to show how the method can be used in epidemiology.