DMFT index assessment and microbiological analysis of Streptococcus mutans in institutionalized patients with special needs

Aim: To assess the DMFT (D = decayed; M = missing; F = filled) index of institutionalized patients with mild and moderate physical and mental disabilities and to correlate it with the Streptococcus mutans (S. mutans) counts in the supragingival bacterial biofilm. Methods: Dental examination of 28 patients aged 15 to 25 years was conducted to determine the DMFT index (number of decayed, missing and filled teeth). Supragingival plaque samples were collected from the buccal surfaces of all teeth. The samples were inoculated in SB20 medium and incubated at 37 °C for 48 hours. Spearman's correlation test was applied (p = 0.05) to evaluate the correlation between the DMFT index and the amount of S. mutans. Results: The mean DMFT recorded was 7.68 and a large mean number of S. mutans colony-forming units (cfu > 10 6) was found. No statistically significant correlation was found between the DMFT index and the number of S. mutans. Conclusions: Under the conditions of this study, no correlation was found between the DMFT index and the number of S. mutans cfu in institutionalized patients with mental retardation and physical disabilities.

In vitro surface roughness of different glass ionomer cements indicated for ART restorations

Aim: The aim of this in vitro study was to evaluate the surface roughness of three glass ionomer cements (GICs) indicated for ART restorations. Methods: Ten cylindrical specimens of three commercial glass ionomers cements (Vidrion R - S.S. White, Maxxion R - FGM and Vitromolar DFL) were prepared (n=30) without surface finishing or protection. Twenty-four hours after preparation, the surface roughness measurements were obtained as the mean of three readings of the surface of each specimen by profilometry. The roughness values (Ra, μm) were subjected to one-way ANOVA and Tukey's test (p<0.05). Results: No statistically significant differences were observed between Vidrion R (0.18 ± 0.05) and Vitromolar (0.21 ± 0.05), whereas Maxxion R presented significantly higher roughness values than those of the other materials. Conclusions: It may be concluded that characteristics of particle size and composition of the different GICs affected their surface roughness 24 h after preparation.

Effectiveness of intraoral suction systems and aspirating tips for evacuation of aluminum oxide particles during use of air-abrasion

Aim: The purpose of this study was to compare the effectiveness of a high-volume evacuation and a conventional intraoral suction system and aspirating tips for capturing aluminum oxide particles during use of an air-abrasion device. Methods: A phantom head was fixed at the dental chair head with secured a metallic device with 5 horizontal shafts, corresponding to operator's clockrelated working positions, and one vertical shaft to simulate the operator's nasal cavity. Petri plates were fixed to the shafts at distances of 20, 40 and 60 cm from the center of the oral cavity of the phantom head to collect the aluminum oxide particles spread over during air abrasion. The dust was aspirated with two types of suction tips used with both suction systems: a conventional saliva ejector and a saliva ejector customized by the adaptation of a 55-mm-diameter funnel. Results: The amount of particles showed that the greatest abrasive particle deposition occurred at a distance of 20 cm from the center of the oral cavity of the phantom head at 9 o'clock operatory position with the conventional saliva ejector attached to high-volume evacuation system. Conclusions: The greatest deposition of aluminum oxide particles occurred at the shortest distance between the operator and the center of the oral cavity, while using the high-volume evacuation system associated to the conventional suction tip.

Microgeração de energia elétrica (Abaixo de 100 kW) utilizando turbina Tesla modificada

An economical electricity generating system is developed, i.e., a boiler and turbine with a capacity ≤ 100 kw, to occupy a niche market where the existing steam systems are not economically viable. A Tesla turbine is used. It has been modified to provide greater torque, outperforming the deficiency inherent in the original Tesla turbine. It can operate with saturated steam produced by a boiler heated by biomass, gas, biodiesel, etc. The microgenerator consumes locally available fuel and can bring energy to millions of rural living Brazilians, where some kind of biomass is abundant. The Tesla turbine is compact, has no moving parts, and has endless application possibilities. A prototype system is also created to produce electricity with a boiler and generator.

Utilização do coque verde de petróleo da Petrobras em substituição parcial ao carvão mineral das misturas injetadas em altos fornos

The Petrobras produced green petroleum coke (GPC) is a carbon rich fuel, virtually ash-free, with low sulfur content, and is a fuel suitable to replace metallurgical coke in blast furnaces. The GPC was tested in a pulverized coal injection simulator built in the Volta Redonda research center. It presented a low burning efficiency due to low volatile material content and high substitution rate by the carbon content. The tests were carried out in blast furnaces with ≤ 50% Petrobras GPC in the coal blends. The injected coal/CVP mixtures produced no negative side effects in the blast furnace grinding systems, pneumatic conveying, or operating process. The mixture burning process inside the blast furnace showed a decrease in fuel consumption, with a significant reduction in metallurgical coke consumption. The industrial-scale tests of the GPC mixtures did not reach the 70% maximum for lack of the GPC feedstock, which is necessary to continue with standard coal mixtures.

Significância clínica de tromboembolismo venoso recorrente

Recurrent venous thromboembolism is a significant problem leading to increased morbidity and mortality. It has a high impact on patients' quality of life and imposes a great financial burden on society. Cumulative recurrence has been reported as 40% at 10 years, while the chance of developing postthrombotic signs and symptoms in the lower extremities almost quadruples when ipsilateral. There is also a higher chance of developing pulmonary hypertension. Important factors for recurrence are unprovoked episodes of deep vein thrombosis, malignancy and older age. The evidence for other factors is controversial. Accurate diagnosis and treatment tailored to the patients' history, thrombotic events and risk factors are necessary to optimize management and prevent recurrence.

Estudos de medicamentos biosimilares

In Brazil, the registration of new drugs is carried out only when the regulatory agency (Anvisa, acronym in Portuguese) is fully satisfied with the evidence of their quality, efficacy and safety, presented by a pharmaceutical industry that strive for this registration. With the patent expiration, pharmaceutical companies are attracted to produce biological medicines called biosimilar or biogenerics or simply generics, whose approval may result in reduced treatment costs. But it is necessary that the biosimilar be, at least, equally efective and safe and without contaminants in relation to the original. Recent consensus guidelines aim to establish criteria for efcacy and safety of these medicines. Preclinical studies in vitro and in vivo, the origin of raw materials and clinical studies phase I, II and III are recommended for biosimilar medicine registration in the international market. Low molecular weight heparins are found in this situation. In this review we specifcally addressed this type of medicine, which could serve as a benchmark for other biosimilar medicines.

Clinical assessment of the efficacy of low-level laser therapy on muscle pain in women with temporomandibular dysfunction, by surface electromyography

The use of low-level laser (LLL) may be an useful tool to promote reduction of muscular pain caused by TMD. Aim: This study evaluated the immediate efficacy of low-level laser therapy on women reporting pain and diagnosed with temporomandibular dysfunction (TMD). Methods: Diode laser (GaAlAs) at 790 nm wavelength (infrared spectrum) was applied as experimental treatment. Irradiations of 1.5 J/cm2 were made at 4 points of the temporomandibular joint (TMJ) and of 3 J/cm2 at 3 points in the temporal muscle. An electromyographic (EMG) evaluation of the masseter and anterior temporal was done at the following intervals: before, immediately after, 5 min and 20 min after laser application. Results: Comparison of the electrical activity at the times of measurement revealed a statistically significant difference in masseter muscles before (P=0.025) and immediately after (P=0.013) LLLT. Conclusions: Both masseter and temporal muscles showed a reduction in the measured EMG activities at all times after LLLT, and the temporal muscle showed higher EMG activity than the masseter muscle at all the evaluation times. LLLT caused significant immediate relaxation of the masseter muscles.

Response of human dental pulp to calcium hydroxide paste preceded by a corticosteroid/antibiotic dressing agent

Aim: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calcium hydroxide. Methods: Forty-six premolars were pulpotomized and randomly assigned into 3 groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria. Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results: On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the 60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like cell layer. Conclusions: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.

Dental caries experience in children attending an infant oral health program

Aim: To investigate: a) caries experience in 5 year-old children and its relationship to the caries risk evaluation made before 1 year of age; b) compliance of parents to an infant oral health program as well as the abandonment reasons. Methods: Group A (GA) - 242 children (60-71 months old) who stayed in the program and had been enrolled since their first year of life underwent a clinical examination according to the WHO's criteria; their parents/caregivers were interviewed to ascertain their compliance to the program. Group B (GB) - parents of 60 children, who had dropped out of the program, were interviewed to check the reasons of withdrawing. The caries risk classification was based on the file at the first appointment. Chi-square test was used (α=0.05) for statistical analyses. Results: Most of the children were free of caries (71.1%). Caries risk evaluation showed low sensibility (34.3%, 95% CI = 22.4-46.1) and high specificity (74.4%, 95% CI = 67.6-81.2) to caries experience. Sixty-two mothers (25.6%) reported difficulty to follow the guidelines. The main reason for dropping out was changing to similar health services (40.0%). Conclusions: Caries risk in the first year of life was not efficient to predict dental caries experience at 5 years of age. Educational practice should be improved to increase the compliance of the parents to the program.

Effect of photochemical activation of hydrogen peroxide bleaching gel with and without TiO2 and different wavelengths

Aim: To evaluate the effect of photochemical activation of hydrogen peroxide (H2O2) bleaching gel with different wavelengths. Methods: In the study, 80 bovine incisors were used, which were stained in 25% soluble coffee and divided in 4 groups. The initial color was measured with the Easy Shade spectrophotometer by CIE Lab. An experimental 35% H2O2 bleaching gel was used, either with or without the presence of titanium dioxide (TiO2) pigment, associated with two light sources: G1 - Transparent Gel (TG) and no activation; G2 - Gel with TiO2 and activation with blue LED (l=470nm)\laser (Easy Bleach) appliance; G3 - Gel with TiO2 and activation with ultraviolet (l=345nm - UV); G4 - TG and activation with UV. Three applications of the gels were made for 10 min, and in each, 3 activations of 3 min, with interval of 30 s between them. The coloration was evaluated again and the variation in color perception (DE) was calculated. The data were submitted to one-way ANOVA and Tukey's test at 5% significance level. Results: There were significant differences between G1 and G4. The greatest E value was observed in G4 (13.37). There was no statistically significant difference (p>0.05) between the groups 2, 3 and 4. Conclusions: The presence of TiO2 particules in the bleaching gel did not interfere at the bleaching results.

Bone mineral density on conventional and digitized images under different parameters of digitization and storage

Aim: To assess the bone mineral density on conventional and digitized images, comparing whether different parameters of digitization and storage change these values. Methods: Twenty radiographs were taken from five partially dentulous dry mandibles with an aluminum 7-mm stepwedge placed on the superior edge of the film. After processing, the films were digitized with a resolution of 600 and 2,400 d.p.i. and saved as TIFF and JPEG files. On every conventional and digitized image, circular regions of interest were selected for densitometry and radiographic contrast analysis. Results: Pearson's correlation coefficient showed a significant and strong mean gray values association between digitized and conventional images, differing from radiographic contrast that did not show a significant association. ANOVA did not reveal a statistically significant difference in bone density and radiographic contrast among the four digitized image groups, but the conventional image contrast was significantly lower. Conclusions: Bone mineral density did not differ in both conventional and digitized images. The parameters of image compression and resolution, tested in this study, did not change the results of densitometry and digitization process increased the radiographic contrast.

Influence of the construction bite vertical and horizontal dimensions on dentoskeletal structures induced by the Klammt appliance in Class II treatment

Aim: To evaluate the influence of construction bite in the dentoskeletal changes induced by Klammt Appliance. Methods: The sample consisted of 17 children, with Class II malocclusion and initial mean age of 8.5 years. The construction bite was obtained using an Exactobite on edge-toedge anteroposterior relationship with 3 mm interincisal clearance. The height of the acrylic was determined by initial overbite associated to interincisal clearance and measured with digital caliper. The amount of advancement was obtained and measured by initial overjet in the lateral radiography. Pearson's correlation, linear regression and ANOVA were used to determine the relationship between dentoskeletal and construction bite variables. Results: The increase in the height of the acrylic promotes a greater inhibition of the forward displacement of the nasal spine and reduction in the facial growth index. The increase in the mandibular advancement induces more downward displacement of nasal spine and pogonion; a counter-clockwise rotation of palatine plane; an increase in mandibular length, maxillary alveolar height and interincisal angle; a decrease in mandibular alveolar height, the intermaxillary discrepancy and overjet; and palatal tipping of upper incisors. Conclusions: The different dimensions of the construction bite influence the dentoskeletal changes induced by the appliance in Class II treatment.