Patients' expectation and satisfaction with removable dental prosthesis therapy and correlation with patients' evaluation of the dentists

Objective. Considering that patients' satisfaction is one of the most important goals in conducting removable dental prosthesis (RDP) therapy and the fact that there are many factors which influence this parameter, the present study aims to evaluate the expectation before and satisfaction after therapy with RDP in patients who seek such therapy. As a secondary objective, other variables that may be associated with patient satisfaction are also evaluated, such as gender, age, Kennedy's classification of the arch supporting the RDP, the number of RDP adjustments after delivery and patients' evaluation of the dentists' conduct. Materials and methods. A sample of 44 patients who received RDP therapy were assigned visual analog scale scores for their expectation before and satisfaction after therapy regarding chewing, aesthetics, comfort and phonetics. They also completed a questionnaire concerning the dentists' conduct. Results. There was no statistically significant difference among scores concerning different genders, age, number of post-delivery settings and arch involved in the RDP. Regarding patients' evaluation of the dentists' conduct, there was a predominance of positive evaluations, but only different answers to the statement (i.e. 'The dentist I saw thoroughly explained the recommended treatment before it commenced') present statistically significant different scores for chewing (p = 0.040) and phonetics (p = 0.046). Conclusions. The average visual analog scale scores were high for both expectation prior to treatment and satisfaction after treatment; however, the scores for expectations were higher than those for satisfaction. © 2013 Informa Healthcare.

Stress distribution in implant-supported prosthesis with external and internal implant-abutment connections

Objective. This study aimed to investigate the stress distribution in screwed implant-supported prostheses with different implant-abutment connections by using a photoelastic analysis. Materials and methods. Four photoelastic models were fabricated in PL-2 resin and divided according to the implant-abutment connection (external hexagon (EH) and Morse taper (MT) implants (3.75 × 11.5 mm)) and the number crowns (single and 3-unit piece). Models were positioned in a circular polariscope and 100-N axial and oblique (45) loading were applied in the occlusal surface of the crowns by using a universal testing machine. The stresses were photographically recorded and qualitatively analyzed using software (Adobe Photoshop). Results. Under axial loading, the MT implants exhibited a lower number of fringes for single-unit crowns than EH implants, whereas for a 3-unit piece the MT implants showed a higher number of fringes vs EH implants. The oblique loading increased the number of fringes for all groups. Conclusion. In conclusion, the MT implant-abutment connection reduced the amount of stress in single-unit crowns, for 3-unit piece crowns the amount of stress was lower using an external hexagon connection. The stress pattern was similar for all groups. Oblique loading promoted a higher stress concentration than axial loading. © Informa Healthcare.

Effect finishing and polishing procedures on the surface roughness of IPS Empress 2 ceramic

Objective. To evaluate the surface roughness of IPS Empress 2 ceramic when treated with different finishing/polishing protocols. Materials and methods. Sixteen specimens of IPS Empress 2 ceramic were made from wax patterns obtained using a stainless steel split mold. The specimens were glazed (Stage 0-S0, control) and divided into two groups. The specimens in Group 1 (G1) were finished/polished with a KG Sorensen diamond point (S1), followed by KG Sorensen siliconized points (S2) and final polishing with diamond polish paste (S3). In Group 2 (G2), the specimens were finished/polished using a Shofu diamond point (S1), as well as Shofu siliconized points (S2) and final polishing was performed using Porcelize paste (S3). After glazing (S0) and following each polishing procedure (S1, S2 or S3), the surface roughness was measured using TALYSURF Series 2. The average surface roughness results were analyzed using ANOVA followed by Tukey post-hoc tests (α = 0.01) Results. All of the polishing procedures yielded higher surface roughness values when compared to the control group (S0). S3 yielded lower surface roughness values when compared to S1 and S2. Conclusions. The proposed treatments negatively affected the surface roughness of the glazed IPS Empress 2 ceramic. © 2013 Informa Healthcare.

Effect of light curing modes on mechanical properties of direct and indirect composites

Objective. To evaluate the degree of conversion (DC), flexural strength (FS) and Knoop microhardness (KHN) of direct and indirect composite resins polymerized with different curing systems. Materials and methods. Specimens of direct (Z250, 3M/Espe) and indirect (Sinfony, 3M/Espe) restorative materials were made and polymerized using two light curing units: XL2500 (3M/Espe) and Visio system (3M/Espe). Absorption spectra of both composites were obtained on a FTIR spectrometer in order to calculate the DC. FS was evaluated in a universal testing machine and surface microhardness was performed in a microhardness tester (50gf/15s). DC, FS and KHN data were submitted to two-way ANOVA and Tukey's test (α = 0.05). Results. Z250 showed higher DC, FS and KHN compared with Sinfony when the polymerization was carried out with XL2500 (p < 0.05). However, there is no statistical difference in DC between the materials when Visio was used (p > 0.05). Visio showed higher DC and KHN for Z250 and Sinfony than the values obtained using XL2500 light curing (p < 0.05). For FS, no significant difference between curing units was found (p > 0.05). Conclusion. Even though the Visio system could increase DC and KHN for some direct and indirect composites, compared with the conventional halogen curing unit, a high number of monomers did not undergo conversion during the polymerization. © 2013 Informa Healthcare.

Dental caries experience and Molar-Incisor Hypomineralization

Objective. This cross-sectional study assessed the prevalence and severity of the enamel defects, known as Molar-Incisor Hypomineralization (MIH) and its relationship to dental caries. Materials and methods. A sample of 1157 schoolchildren (population based), aged 6-12 years, of the Araraquara city-Brazil, was evaluated according to the European Academy of Paediatric Dentistry (EAPD) criteria by two trained examiners. The dental impact caused by MIH was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index (WHO). Data were analyzed using ANOVA and Chi-square tests (p < 0.05). The socioeconomic status was collected using a questionnaire answered by parents. Results. The prevalence of MIH was 12.3%. Mild impairment was the most frequent diagnosis. DMFT of children with MIH was 0.89 (±1.18), which are higher than those of the unaffected group (0.43 ± 1.01). An association was found between dental caries only in the permanent dentition of children with MIH (p = 0.0001). Family income was considered low in 85% of the families of children with MIH in the public system, while in private school it was 18% (p < 0.05). Conclusion. The prevalence of MIH in Araraquara was associated with greater caries experience in the permanent dentition. © 2013 Informa Healthcare.

Comparison of the caries-preventive effect of a glass ionomer sealant and fluoride varnish on newly erupted first permanent molars of children with and without dental caries experience

Purpose: This longitudinal clinic study evaluated the effect of a glass ionomer sealant (GIS) and a fluoride varnish (FV) in the prevention of dental decay on newly erupted permanent molars of children with and without caries experience. Materials and methods: Eighty children, aged 6-8 years, with all four newly erupted first permanent molars, were divided into two groups. Group 1 consisted of 53 children without caries experience and group 2 consisted of 27 children with dental caries experience. Permanent molars of the right side were sealed with GIS and the fluoride varnish was applied on the other two permanent first molars. Evaluation of GIS retention and the effectiveness of both materials in the prevention of dental caries were performed after 6, 12 and 18 months. Results: After 18 months, of the 299 teeth, 271 (91%) showed no caries lesions and 28 presented caries lesions (9%). Teeth sealed with GIS had more carious lesions (15) than teeth with fluoride varnish (13). Most of the teeth (70%) that presented carious lesions were in group 2. Of the 138 sealed teeth, only one showed GIS to be totally present, 95 were partially present and 42 teeth were absent. Conclusion: The caries-preventive effect was very similar between both treatments. The presence of dental caries prevailed in the children with caries experience. © 2013 Informa Healthcare.

Photoelastic analysis of the influence of residual ridge inclination in conjugated class i mandibular prostheses with different attachment systems

Objectives: The aim of this study was to evaluate the stress distribution in mandibular free-end removable partial dentures (RPD) associated with FPD in the abutment teeth considering different inclinations of the residual ridge: (1) horizontal and (2) distal descending ridges and two designs of free-end RPD with different attachment systems were tested: (1) clasp and (2) system ERA. Methods. Axial loads (100 N) were applied on the teeth of the RPD. The images were recorded and the stress distribution was evaluated through photoelastic fringes. Results. In general, the distal descending ridge presented more photoelastic fringes in the region of the roots of the abutment teeth while the horizontal ridge exhibited higher compression in the base of the prosthesis. In the horizontal ridge, the denture with clasp presented more favourable stress distribution than the denture with the system ERA. In the distal descending ridge, the denture with the system ERA relieved the region of the abutment teeth and overloaded the residual ridge. Conclusion: The horizontal ridge presented more favourable performance; the dentures with clasp exhibited better performance for both ridges evaluated; the denture with the system ERA presented better results in the distal descending ridge. © 2013 Informa Healthcare.

Toxic effects of daily applications of 10% carbamide peroxide on odontoblast-like MDPC-23 cells

Background. Tooth bleaching has been widely studied, mainly due to the possible undesirable effects that can be caused by this esthetic procedure. The cytotoxicity of the bleaching agents and its components to pulp cells has been demonstrated in several researches. The aim of this study was to evaluate the toxic effects of successive applications of 10% carbamide peroxide (CP) gel on odontoblast-like cells. Materials and methods. Enamel-dentin discs obtained from bovine incisors were adapted to artificial pulp chambers (APCs). The groups were formed as follows: G1: Without treatment (control group); G2: 10% carbamide peroxide, CP (five applications/one per day); G3: 10% CP (one unique application); and G4: 35% hydrogen peroxide, HP (three applications of 15 min each). After treatment, cell metabolism (MTT), alkaline phosphatase (ALP) activity and plasma membrane damage (flow cytometry) were analyzed. Results. Reductions in cell metabolism and alkaline phosphatase activity along with severe damage of the cytoplasmic membrane were noted in G2. In G3, no damage was observed, compared to the control group. Intermediary values of toxicity were obtained after 35% HP application. Conclusion. It can be concluded that one application of 10% CP did not cause toxic effects in odontoblast-like cells, but the successive application of this product promoted severe cytotoxic effects. The daily application of the bleaching agents, such as used in the at-home bleaching technique, can increase the damages caused by this treatment to the dental pulp cells. © 2013 Informa Healthcare.

Avaliação da função renal no pós-operatório de pacientes submetidos a revascularização do miocárdio com uso de dexmedetomidina

Pós-graduação em Anestesiologia - FMB

Geologia, petrografia e geoquímica dos granitóides arqueanos de Sapucaia - Província Carajás-PA

Os estudos geológicos desenvolvidos na porção leste do Subdomínio de Transição, Província Carajás, a sul da cidade de Canaã dos Carajás e a norte de Sapucaia, permitiram a identificação, individualização e caracterização de uma diversidade de unidades arqueanas, anteriormente englobadas no Complexo Xingu. A unidade mais antiga da área compreende anfibólio tonalitos correlacionados ao Tonalito São Carlos (~2,92 Ga), com foliação orientada segundo NW-SE a E-W, ou, por vezes, aspecto homogêneo. Geoquimicamente, diferem das típicas associações tonalito-trondhjemito-granodiorito (TTG) arqueanas por apresentarem enriquecimento em TiO₂, MgO e CaO, baixos teores de Sr e similares de Rb para amostras com menores teores de sílica, que se refletem em razões Rb/Sr mais elevadas e Sr/Ba mais baixas. Os padrões dos ETR mostram baixo a moderado fracionamento de ETR pesados em relação aos leves, e anomalias negativas de Eu discretas ou moderadas. Seguindo na estratigrafia, e também como a unidade de maior expressão na área, ocorrem rochas de afinidade TTG correspondentes ao Trodhjemito Colorado (~2,87 Ga), intensamente deformadas, com foliações NW-SE a E-W. Intrusivos nesta unidade, ao sul da área, aflora um corpo de aproximadamente 40 km², de rochas de composição leucogranodiorítica porfirítica denominados de Leucogranodiorito Pantanal, e seccionado em sua porção oeste por leucogranitos deformados de composição monzogranítica. O Leucogranodiorito Pantanal têm afinidade cálcio-alcalina peraluminosa, enriquecimento em Ba e Sr, e padrões de ETR sem anomalias expressivas de Eu e com acentuado fracionamento de ETRP, que refletem em altas razões La/Yb semelhante com a Suíte Guarantã (~2,87 Ga) do Domínio Rio Maria. Os leucogranitos revelam assinatura geoquímica de granitos tipo-A reduzidos, possivelmente, originados a partir da fusão desidratada de rochas cálcico-alcalinas peraluminosas durante o Neoarqueano. Além dessas unidades, na porção leste do Leucogranodiorito Pantanal, hornblenda-biotita granito neoarquenos tipo-A oxidados da Suíte Vila Jussara. Ainda correlacionáveis ao magmatismo subalcalino neoarqueano, na porção norte, ocorrem dois stocks graniticos. São tonalitos a granodioritos com assinatura geoquímica de granitos tipo-A oxidados similares a Suíte Vila Jussara, e monzogranitos com assinatura de granitos tipo-A reduzidos que se assemelham a Suíte Planalto. Ao norte da área ocorre uma associação máfico-enderbitica composta de hornblendanoritos, piroxênio-hornblenda-gabros, piroxênio-hornblenda-monzonito, hornblenda-gabros, anfibolitos e enderbitos. Essas rochas estão intensamente deformadas e recristalizadas, provavelmente por retrometamorfismo na presença de água de rochas de série noríticavii charnockítica de origem ígnea associada com outras variedades de rochas não necessariamente cogenéticas. Seu comportamento geoquímico sugere que os hornblendanorito, hornblenda-gabros e anfibolitos são toleíticos subalcalinos, enquanto que os enderbitos, piroxênio-hornblenda-gabro e piroxênio-hornblenda-monzonito têm assinatura cálcico-alcalina. As baixas razões La/Yb das rochas máficas indicam baixo grau de fracionamento, enquanto que as altas razões La/Yb dos enderbitos é indicativo de fracionamento expressivo dos ETR pesados durante a formação ou diferenciação dos seus magmas, e a concavidade no padrão de ETR pesados, indica provável influência de fracionamento de anfibólio durante sua evolução. Na porção central e centro-norte da área ocorrem biotita-monzogranitos peraluminosos, de assinatura cálcio-alcalina, que podem ser desdobrados em dois grupos geoquímicos distindo. Um tem altas razões Sr/Y e (La/Yb)n, mostram possível afinidade com o Granito Bom Jesus da área de Canaã dos Carajás. O outro tem mais baixa razão (La/Yb)n se aproxima mais do Granito Serra Dourada e do Granito Cruzadão também da área de Canaã dos Carajás. Essa comparação deverá ser aprofundada com dados geocronológicos e maior número de amostras.

Does sex influence intraspecific aggression and dominance in Nile tilapia juveniles?

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

Rest stops during road transport: Impacts on performance and acute-phase protein responses of feeder cattle

Angus x Hereford steers (n = 42) and heifers (n = 21) were ranked by gender and BW on d 0 of the experiment and randomly assigned to 1 of 3 treatments: 1) no transport and full access to feed and water (CON); 2) continuous road transport for 1,290 km (TRANS), or 3) road transport for 1,290 km, with rest stops every 430 km (STOP; total of 2 rest stops). Treatments were applied from d 0 to 1 of the experiment. Cattle from TRANS and STOP treatments were transported in separate commercial livestock trailers, within a single 2.1 x 7.2 m compartment, but through the exact same route. During each rest stop, STOP cattle were unloaded and offered mixed alfalfa-grass hay and water for ad libitum consumption for 2 h. Upon arrival of STOP and TRANS on d 1, cattle were ranked by sex and BW within each treatment and assigned to 21 feedlot pens (7 pens/treatment; 2 steers and 1 heifer/pen). Full BW was recorded before (d -1 and 0) treatment application and at the end of experiment (d 28 and 29). Total DMI was evaluated daily from d 1 to 28. Blood samples were collected on d 0 (before loading of TRANS and STOP cattle), 1 (immediately after unloading of TRANS and STOP cattle), 4, 7, 10, 14, 21, and 28. Body weight shrink from d 0 to d 1 was reduced (P < 0.01) in CON compared to TRANS and STOP, and reduced in STOP compared to TRANS. Mean ADG was greater (P < 0.05) in CON compared to TRANS and STOP, but similar (P = 0.68) between TRANS and STOP. No treatment effects were detected (P >= 0.18) on hay, concentrate, and total DMI. Mean G: F was greater (P = 0.05) in CON compared to STOP, tended to be greater (P = 0.08) in CON compared to TRANS, and similar (P = 0.85) between TRANS and STOP. Plasma cortisol concentrations were greater (P <= 0.04) in TRANS compared to CON and STOP on d 1, and greater (P = 0.04) in TRANS compared to CON on d 4. Serum NEFA concentrations were greater (P < 0.01) in TRANS compared to CON and STOP on d 1, and greater (P <= 0.05) in TRANS compared to CON on d 4 and 7. Mean plasma ceruloplasmin concentrations were similar (P = 0.19) among treatments. Plasma haptoglobin concentrations were greater (P <= 0.04) in TRANS compared to CON and STOP on d 1, and in STOP compared to CON on d 1. In conclusion, inclusion of rest stops during a 1,290-km transport prevented the increase in circulating cortisol and alleviated the NEFA and haptoglobin response elicited by transport, but did not improve feedlot receiving performance of transported cattle.

Failures in the rehabilitation treatment with removable partial dentures

Background. Despite being functional and having aesthetic benefits, the acceptance of patients regarding the use of removable partial dentures (RPDs) has been low. In part, this is due to the deleterious effects that causes discomfort to the patient. Success depends not only on the care expended by the patient, including daily care and oral hygiene, but also on common goals set by their professional and clinical staff, aiming beyond aesthetics, to incorporate issues of functionality and the well-being of patients. Methods and results. For rehabilitation treatment with RPDs to reach the desired level of success without damaging the support structure, all the steps (diagnose, cavity preparation, adaptation of the metal structures, functional of distal extension and posterior follow-up) in the rehabilitative treatment should be carefully developed. A literature review was carried out, searching through MEDLINE (PubMed) articles published between 1965 and December 2012 including clinical trials and reviews about the use of RPDs. Conclusions. This study describes factors that lead to failures and complications in oral rehabilitation through the use of RPDs and suggests possible solutions.

Influence of air-particle deposition protocols on the surface topography and adhesion of resin cement to zirconia

Objectives: This study evaluated the influence of air-particle abrasion protocols on the surface roughness (SR) of zirconia and the shear bond strength (SBS) of dual-polymerized resin cement to this ceramic. Materials and methods. Sintered zirconia blocks (n = 115) (Lava, 3M ESPE) were embedded in acrylic resin and polished. The specimens were divided according to the 'particle type' (Al: 110 mu m Al2O3; Si: 110 mu m SiO2) and 'pressure' factors (2.5 or 3.5 bar) (n = 3 per group): (a) Control (no air-abrasion); (b) Al2.5; (c) Si2.5; (d) Al3.5; (e) Si3.5. SR (Ra) was measured 3-times from each specimen after 20 s of air-abrasion (distance: 10 mm) using a digital optical profilometer. Surface topography was evaluated under SEM analyses. For the SBS test, 'particle type', 'pressure' and 'thermocycling' (TC) factors were considered (n = 10; n = 10 per group): Control (no air-abrasion); Al2.5; Si2.5; Al3.5; Si3.5; Control(TC); Al2.5(TC); Si2.5(TC); Al3.5(TC); Si3.5(TC). After silane application, resin cement (Panavia F2.0) was bonded and polymerized. Specimens were thermocycled (6.000 cycles, 5-55 degrees C) and subjected to SBS (1 mm/min). Data were analyzed using ANOVA, Tukey's and Dunnett tests (5%). Results. 'Particle' (p = 0.0001) and 'pressure' (p = 0.0001) factors significantly affected the SR. All protocols significantly increased the SR (Al2.5: 0.45 +/- 0.02; Si2.5: 0.39 +/- 0.01; Al3.5: 0.80 +/- 0.01; Si3.5: 0.64 +/- 0.01 mu m) compared to the control group (0.16 +/- 0.01 mu m). For SBS, only 'particle' factor significantly affected the results (p = 0.015). The SiO2 groups presented significantly higher SBS results than Al2O3 (Al2.5: 4.78 +/- 1.86; Si2.5: 7.17 +/- 2.62; Al3.5: 4.97 +/- 3.74; Si3.5: 9.14 +/- 4.09 MPa) and the control group (3.67 +/- 3.0 MPa). All TC specimens presented spontaneous debondings. SEM analysis showed that Al2O3 created damage in zirconia in the form of grooves, different from those observed with SiO2 groups. Conclusions. Air-abrasion with 110 mu m Al2O3 resulted in higher roughness, but air-abrasion protocols with SiO2 promoted better adhesion.

Grander system: A new technology to reduce surface tension of adhesive systems in dentistry

Background. Reduced surface tension of liquids results in higher surface wetting ability and diffusivity by the substrate. Objectives. The objective of this study was to evaluate the influence of the Grander Technology in reducing the surface tension of adhesive systems. Methods. Two adhesive systems (self-etch and total-etch) were modified by physical contact with the Grander system Flexible unit to revitalize water, for 48 h. Surface tension of adhesive systems and water in normal and grander-modified conditions was measured with a goniometer. Results. The results showed a reduction of surface tension for all conditions grander-modified between 3-15%. Conclusions. Grander Technology was effective in reducing the surface tension of the Single Bond and Clearfil SE Bond adhesive systems. Clinical significance. Grander technology was employed to restructure the molecular structure of water-based adhesive systems, which can increase their wetness capacity and therefore ensure a greater diffusibility.