Effect of the addition of antimicrobial agents on shore a hardness and roughness of soft lining materials

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

Practices related to late-onset sepsis in very low-birth weight preterm infants

Objective: To understand the practices related to late-onset sepsis (LOS) in the centers of the Brazilian Neonatal Research Network, and to propose strategies to reduce the incidence of LOS.Methods: This was a cross-sectional descriptive multicenter study approved by the Ethics Committee. Three questionnaires regarding hand hygiene, vascular catheters, and diagnosis/treatment of LOS were sent to the coordinator of each center. The center with the lowest incidence of LOS was compared with the others.Results: All 16 centers answered the questionnaires. Regarding hand hygiene, 87% use chlorhexidine or 70% alcohol; alcohol gel is used in 100%; 80% use bedside dispensers (50% had one dispenser for every two beds); practical training occurs in 100% and theoretical training in 70% of the centers, and 37% train once a year. Catheters: 94% have a protocol, and 75% have a line insertion team. Diagnosis/treatment: complete blood count and blood culture are used in 100%, PCR in 87%, hematological scores in 75%; oxacillin and aminoglycosides is the empirical therapy in 50% of centers. Characteristics of the center with lowest incidence of LOS: stricter hand hygiene; catheter insertion and maintenance groups; use of blood culture, PCR, and hematological score for diagnosis; empirical therapy with oxacillin and aminoglycoside.Conclusion: The knowledge of the practices of each center allowed for the identification of aspects to be improved as a strategy to reduce LOS, including: alcohol gel use, hand hygiene training, implementation of catheter teams, and wise use of antibiotic therapy. (C) 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Comparison of Different Dentin Pretreatment Protocols on the Bond Strength of Glass Fiber Post Using Self-etching Adhesive

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

Microbiological Profile Resistant to Different Intracanal Medications in Primary Endodontic Infections

Introduction: This clinical study aimed to determine the microbiological profile resistant to different intracanal medications in primary endodontic infections by using both microbiological culture and the checkerboard DNA-DNA hybridization technique. Methods: Twenty primarily infected root canals were selected and then instrumented before being randomly divided into 2 groups according to the intracanal medications: calcium hydroxide (Ca[OH](2)) or Ca(OH)(2) + chlorhexidine (CHX). Samples were collected before and after root canal procedures, which consisted in submitting them to microbiological culture and processing them for checkerboard DNA-DNA hybridization. Results: No differences were found between the Ca(OH)(2) (99.98%) and Ca(OH)(2) + CHX groups (99.76%) regarding the median percentage values for the reduction of cultivable bacteria. The most frequently detected species were Capnocytophaga ochracea (70%) and Fusobacterium nucleatum ssp. vincentii (70%) in the initial samples. After instrumentation, the most frequently detected species were E. faecium (60%). After root canal treatments using either Ca(OH)(2) or Ca(OH)(2) + CHX as intracanal medications, the most frequently detected species were E nucleatum ssp. vincentii (90%) and Enterococcus faecium (40%), respectively. Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, this reduction was significantly greater in the Ca(OH)(2) + CHX group (P < .05). This difference was also observed when evaluating the total bacterial load (P < .05). Conclusions: The use of Ca(OH)(2) associated with CHX as an intracanal medication showed better results by acting on gram-positive and gram-negative microorganisms although such an action to eradicate enterococci should also be sought.

Clinical Influence of Different Intracanal Medications on Th1-type and Th2-type Cytokine Responses in Apical Periodontitis

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

Effect of chemical activation of 10% carbamide peroxide gel in tooth bleaching

This study aimed to evaluate the efficacy of chemical agents to increase the bleaching effectiveness of 10% carbamide peroxide. Two hundred and ninety enamel-dentin discs were prepared from bovine incisors. The color measurement was performed by a spectrophotometer using the CIE L*a*b*system. The groups were divided according to the bleaching treatment: negative control group (NC): without bleaching; positive control group (PC): bleached with 10% carbamide peroxide gel without any chemical activator; Manganese gluconate (MG); Manganese chloride (MC); Ferrous gluconate (FG); Ferric chloride (FC); and Ferrous sulphate (FS). Three different concentrations (MG, MC, FG, FC: 0.01, 0.02 and 0.03% w/w; FS: 0.001, 0.002 and 0.003% w/w) for each agent were tested. The bleaching gel was applied on the specimens for 8 h, after which they were immersed in artificial saliva for 16 h, during 14 days. Color assessments were made after 7 and 14 days. The data were analyzed by repeated measures analysis of variance and Tukey's test (5%). Generally, the test groups were unable to increase the bleaching effect (ΔE) significantly compared to the PC group. Only for ΔL, significant higher values compared to the PC group could be seen after 7 days in groups MG (0.02%), and FS (0.002 and 0.003%). The NC group showed significantly lower values than all tested groups. It was concluded that for home bleaching procedures, the addition of chemical activators did not produce a bleaching result significantly higher than the use of 10% carbamide peroxide without activation, and that the concentration of chemical activators used did not significantly influence the effectiveness of treatment.

Anthocyanin incorporated dental copolymer: bacterial growth inhibition, mechanical properties, and compound release rates and stability by (1)h NMR

Objective. To evaluate bacterial growth inhibition, mechanical properties, and compound release rate and stability of copolymers incorporated with anthocyanin (ACY; Vaccinium macrocarpon). Methods. Resin samples were prepared (Bis-GMA/TEGDMA at 70/30 mol%) and incorporated with 2 w/w% of either ACY or chlorhexidine (CHX), except for the control group. Samples were individually immersed in a bacterial culture (Streptococcus mutans) for 24 h. Cell viability (n = 3) was assessed by counting the number of colony forming units on replica agar plates. Flexural strength (FS) and elastic modulus (E) were tested on a universal testing machine (n = 8). Compound release and chemical stability were evaluated by UV spectrophotometry and (1)H NMR (n = 3). Data were analyzed by one-way ANOVA and Tukey's test ( α = 0.05). Results. Both compounds inhibited S. mutans growth, with CHX being most effective (P < 0.05). Control resin had the lowest FS and E values, followed by ACY and CHX, with statistical difference between control and CHX groups for both mechanical properties (P < 0.05). The 24 h compound release rates were ACY: 1.33 μg/mL and CHX: 1.92 μg/mL. (1)H NMR spectra suggests that both compounds remained stable after being released in water. Conclusion. The present findings indicate that anthocyanins might be used as a natural antibacterial agent in resin based materials.

Antiseptic mouthwashes: in vitro antibacterial activity

Mouthwashes are used as an adjunct to tooth brushing for improving breath and preventing oral diseases. The aim of this study was to compare the in vitro Maximum Inhibitory Dilution (MID) of 3 mouthwashes with different active ingredients against mutans streptococci (MS). The products analyzed were PeriogardR, CepacolR and PlaxR Fresh Mint. Their antibacterial activity was assessed in duplicate in 96-well microtiter plates against 36 clinical isolates of MS. Each mouthwash was submitted to a serial two-fold dilution (1/2.5 to 1/5120) using double concentration of Tryptose Soy Broth with 1.0% yeast extract. The final volume in each well was 100 mL plus 5 mL of a bacterial suspension, equivalent to 107 CFU/mL. They were incubated microaerobically at 37oC for 48 hours and the MIDs determined. MID was 1/320 for PeriogardR and CepacolR, and 1/20 for PlaxR. Statistical analysis revealed that the MID of PeriogardR MID did not differ from that of CepacolR (p>0.05), and was higher than that of PlaxR (p<0.05). In conclusion, the antiseptic mouthwashes containing chlorhexidine (PeriogardR) and cetylpyridinium chloride (CepacolR) had higher in vitroantibacterial activity (MID) against MS than the antiseptic mouthwash containing triclosan (PlaxR), according to microbiological method employed.

Effect of collagen matrix saturation on the surface free energy of dentin using different agents

The surface free energy of conditioned-dentin is one of the factors that interfere with monomeric infiltration of the interfibrillar spaces. Saturation of the tooth matrix with different substances may modulate this energy and, consequently, the wettability of the dentin. To evaluate the influence of different substances used to saturate conditioned-dentin on surface free energy (SFE) of this substrate. Dentin blocks (4 × 7 × 1 mm, n = 6/ group), obtained from the roots of bovine incisors, were etched using phosphoric acid for 15 seconds, rinsed and gently dried. The surfaces were treated for 60 seconds with: ultra-purified water (H20-control); ethanol (EtOH), acetone (ACT), chlorhexidine (CHX), ethylenediaminetetraacetic acid (EDTA); or sodium hypochlorite (NaOCl). The tooth surfaces were once again dried with absorbent paper and prepared for SFE evaluation using three standards: water, formamide and bromonaphthalene. Analysis of variance (ANOVA) and Dunnet's tests (a = 0.05) were applied to the data. Ethylenediaminetetraacetic acid was the only substance that caused a change to the contact angle for the standards water and formamide, while only EtOH influenced the angles formed between formamide and the dentin surface. None of the substances exerted a significant effect for bromonaphtha-lene. In comparison to the control, only EDTA and NaOCl altered both polar components of the SFE. Total SFE was increased by saturation of the collagen matrix by EDTA and reduced when NaOCl was used. Saturation of the collagen matrix by EDTA and EtOH changed the surface free energy of the dentin. In addition, the use of NaOCl negatively interfered with the properties evaluated. The increase of surface free energy and wettability of the dentin surface would allow higher penetration of the the adhesive system, which would be of importance to the clinical success of resin-dentin union.

Effect of home-bleaching gels modified by calcium and/or fluoride and the application of nano-hydroxyapatite paste on in vitro enamel erosion susceptibility

This in vitro study compared the effect of bleaching agents modified by the addition of calcium and/or fluoride and the application of a nano-hydroxyapatite paste after bleaching, on the susceptibility of enamel to erosion. Bovine enamel cylindrical samples (3 mm diameter) were assigned to six groups (n = 20 specimens/group) according to the bleaching agent: no bleaching (C-control), 7.5% hydrogen peroxide gel (HP), HP with 0.5% calcium gluconate (HP+Ca), HP with 0.2% sodium fluoride (HP+F), HP with calcium and fluoride (HP+Ca+F) and HP followed by the application of a nano-hydroxyapatite agent (HP+NanoP). The gels were applied on the enamel surface (1 h) followed by cyclic erosive challenges (Sprite Zero®-2 min), for 14 days. The paste was applied after bleaching for 5 min (HP+NanoP). The enamel surface alteration was measured by contact profilometry (µm) (after 7 and 14 days). C-control (mean ± SD: 2.29 ± 0.37 at 7 days/4.86 ± 0.72 at 14 days) showed significantly lower loss compared to the experimental groups. HP+Ca (3.34 ± 0.37/6.75 ± 1.09) and HP+F (4.49 ± 0.92/7.61 ± 0.90) presented significantly lower enamel loss than HP (4.18 ± 0.50/10.30 ± 1.58) only for 14 days and HP+Ca+F (4.92 ± 1.03/8.12 ± 1.52) showed values similar to the HP+F group. The HP+NanoP (5.51 ± 1.04/9.61 ± 1.21) resulted in enamel loss similar to the HP after 14 days. It was found that 7.5% hydrogen peroxide increased the susceptibility of enamel to erosion. The addition of calcium or fluoride to the bleaching gel reduced the erosion effect, while the nano-hydroxyapatite agent did not provide any protective effect.

Fracture resistance of weakened bovine teeth after long-term use of calcium hydroxide

In some parts of the world, revascularization may not be the most feasible treatment option for necrotic immature teeth. Therefore, apexification remains the most widely utilized treatment option for these cases. This study aimed to evaluate the fracture resistance of weakened bovine tooth roots treated with various irrigant solutions as well as long-term application of calcium hydroxide intracanal medication (ICM). One hundred seventy bovine teeth were randomly divided into three experimental groups (n = 50) and two control groups (n = 10). Group SS was irrigated with physiologic solution; group CHX was treated with 2% chlorhexidine gel and group NaOCl was irrigated with 1% sodium hypochlorite. After instrumentation, root canals were dressed with calcium hydroxide and evaluated at different periods (15, 60, 90, 180, and 360 days). The specimens were loaded at a 45° angle to measure fracture resistance through the use of an EMIC test machine. A decrease in fracture resistance was observed during the time of ICM dressing. The highest values of fracture resistance were observed in group SS with 15 days of ICM, not differing from the control group. Irrigation with NaOCl associated with ICM for 15 days presented the lowest fracture resistance; however, a statistically significant difference was not observed when compared with SS and CHX in the same time period. In longer periods of exposure to ICM (180 and 360 days), root canals irrigated with NaOCl and CHX showed significantly lower fracture resistance than SS (P < 0.05). Apexification with periodic changes of calcium hydroxide medicament leads to weakness of the teeth independent of the irrigation solution used.

Bond strength of artificial teeth attached to a microwave-polymerized denture base resin after immersion in disinfectant solutions

To evaluate the bond strength between two types of acrylic resin teeth and a microwave denture base resin after immersion in disinfectant solutions for 180 days. Eighty specimens made of acrylic resin teeth (Biotone and Biotone IPN) attached to a microwave polymerized denture base resin (Nature-Cryl MC) were divided into eight groups (n = 10) according to the treatment (distilled water-control, 2% chlorhexidine digluconate, 1% sodium hypochlorite and sodium perborate solution-Corega Tabs). The shear strength tests (MPa) were carried out using a universal testing machine with a 0.5 mm/min speed. Data analysis was performed using ANOVA and multiple comparison Student-Newman-Keuls post hoc test (α = 0.05). Biotone IPN showed similar results among the groups (distilled water, 8.25 ± 1.81 MPa; chlorhexidine, 7.81 ± 3.34 MPa; hypochlorite, 7.75 ± 3.72 MPa; and Corega Tabs, 7.58 ± 2.27 MPa, whereas Biotone showed significantly lower shear bond strength values for the groups immersed in Corega Tabs (5.25 ± 3.27 MPa) and chlorhexidine (6.08 ± 2.35 MPa). Soaking the dentures in 1% sodium hypochlorite could be recommended as a disinfectant solution for dentures fabricated with conventional acrylic resin denture teeth and microwave denture base resin. For dentures fabricated with IPN teeth and microwave denture base resin, all the soaking solutions evaluated in this study could be suggested to denture wearers.

Avaliação e correlação da presença de endotoxinas e MMP-3, -8 e -9 em canais radiculares com necrose pulpar submetidos ao tratamento endodôntico - estudo in vivo

It is know that endotoxin and various matrix metalloproteinases (MMPs) are involved in the development of periapical lesions. The purpose of this study was to evaluate and correlate the presence of endotoxins and MMP- 3, MMP-8 and MMP-9 in root canals of teeth with necrotic pulp and periapical lesion before, during and after the biomechanical preparation (PBM) using a combination of different irrigations solutions and intracanal dressing. Thirty-three single-root teeth with a diagnosis of pulp necrosis and periapical lesion radiographically visible were selected. Immediately after the coronal opening was collected the first sample from the root canal content. Then, all canals were prepared (cervical and middle thirds) by oscillatory instruments (EndoEze) and irrigated by 2.5% NaOCl. After, a manual preparation was made for the apical third and the teeth were divided into three groups according to the irrigation protocol: G1) 2.5% NaOCl (4 manual files); G2) 2.5% NaOCl (2 manual files) + [Ca (OH)2 0.14%] (2 manual files) and G3) 2.5% NaOCl (2 manual files) + polymyxin B (2 manual files). After the PBM, the second sample was collected; then the third collect was performed after using EDTA final flush. The fourth sample was collected 14 days after placing the dressing [2% chlorhexidine gel + Ca(OH)2]. Quantification of endotoxins was performed by a kinetic chromogenic lysate from amoebocytes of Limulus (LAL) and quantification of MMPs by ELISA assay. The results were analyzed statistically by Kruskal-Wallis and Dunn's test (5%) and ordinal Spearman correlation. Presence of endotoxin was observed in 100% of cases and G3 showed the greatest reduction of endotoxins from the 1st to the 2nd samples (97%), being statistically similar to G2 (84.2%) and different from G1 (49.4%) (p<0.05). The intracanal dressing promoted a significant reduction of endotoxin, no difference among the groups. For...

Efeito da clorexidina na cicatrização umbilical de avestruzes

The contamination of the umbilical region of newly hatched ostriches is one of the major problems in the bird production. This work aimed to evaluate the umbilical healing of ostriches (Struthio camelus) through the use of chlorhexidine as antiseptic associated to the total or partial umbilical cord cut off. It was used 168 newly hatched ostriches of which the umbilical cords were either sectioned totally or 0.5 cm above their insertion. The umbilical region antisepsis consisted of topical administration of an aqueous or alcoholic solution of chlorhexidine, 0.5, 1.0 or 2.0% during three days. A group of non-treated animals was added also. The umbilical healing was evaluated in the ostriches at 14 and 28 days of age. Results showed that all the chlorhexidine solutions reduced the risk of omphalitis, being the alcoholic solution 2% the most efficient. Umbilical healing was faster in animals in which the umbilical cord was totally cut off. It can be concluded that the use of chlorhexidine as antiseptic for newly hatched ostriches is safe and favors the umbilical healing. Moreover, for a better effectiveness it is necessary to remove the umbilical cord in its insertion

Análise da interface adesiva entre pinos de fibra de vidro e dentina intrarradicular submetida à irrigação com diferentes agentes condicionantes

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