Impact of access cavities on root canal preparation, restorative protocol quality, and fracture resistance of teeth

Abstract The survival of endodontically treated teeth depends on the remaining tooth structure. The aim of this study was to evaluate the impact of different access cavities on root canal preparation, restorative protocol, and fracture resistance of endodontically treated teeth. Fifty-six mandibular molars were divided into control (n=8) and experimental (n=16) groups according to access cavity: Traditional, Conservative, and Truss; and redistributed (n=8) according to instrumentation protocols: Reciproc Blue and R-motion. After, teeth were scanned in micro-CT and then filled and redistributed according to composite resin restoration (n=8): Filtek One BulkFill and Filtek Z350. A new micro-CT scan was performed to analyze the restorative material. Then, samples were submitted to fracture resistance testing and the failure pattern was determined. Data were analyzed using paired T-test, ANOVA, Tukey, and chi-square tests (α=0.05). In Truss, R-Motion promoted less transportation in different thirds of root canals. Higher percentages of voids (5.05%) and filling material (11.7%) were observed in Truss. Fracture resistance values were higher for the control group, followed by Truss, Conservative, and Traditional. The predominant failure pattern was type-II. In Truss, reciprocating instruments with smaller taper showed less canal transportation. Also, Truss provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material. Thus, in Truss, reciprocating files with smaller taper showed less canal transportation, and these cavities provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material.

Influence of bioceramic intracanal medication on the bond strength of bioceramic root canal sealer

Abstract To investigate the influence of the remaining volume of a new intracanal medication based on bioceramic compounds on the bond strength (BS) and formation of an adhesive interface between calcium silicate-based and epoxy resin-based root canal sealers. For this purpose, the specimens were distributed according to the intracanal medication (n = 26): Bio-C Temp (BCT) and Ultracal XS (UXS). The roots were scanned in microCT, and after 7 days, the medication was removed. Then a new scan was performed to evaluate the volume of medication remaining. Subsequently, 40 specimens were redistributed into 2 subgroups (n = 10) and filled according to the sealer used: AH Plus (AHP) and Bio-C Sealer (BCS), to assess the bond strength by using the push-out test, and the adhesive interface by confocal laser fluorescence microscopy (CLSM) and scanning electron microscopy (SEM). The t test showed a smaller remainder of BCT (1.77 ± 0.86) compared with UXS (10.47 ± 5.78), irrespective of the root third evaluated. The BS showed that teeth with BCT + BCS had higher bond strength values (3.70 ± 1.22) when compared to the other groups: BCT + AHP (2.15 ± 1.07), UXS + BCS (3.18 ± 1.09) and UXS + AHP (2.11 ± 1.02) (p<0.001). The cervical third had higher BS when compared with the middle and apical thirds (p < 0.001), and higher number of adhesive failures. The adhesive interface in SEM and CLSM images showed better adaptation for the association between BCT + BCS. Intracanal medication and silicate-based endodontic sealer appeared to interact chemically by forming a biomineralizing layer, allowing for an increase in the bond strength and forming an adhesive interface between the materials, with no or less gap formation.

Heat-treated NiTi instruments and final irrigation protocols for biomechanical preparation of flattened canals

Abstract This study evaluate shaping ability of heat-treated NiTi-alloy instruments associated with different final irrigation protocols in flattened root canals. Thirty human mandibular incisors with flattened root canals were divided into 5 groups (n = 10): (XP) Original Protocol XP-endo Shaper; (XP-WT) Original Protocol XP-endo Shaper with working time variation; (XP-K) XP-endo Shaper with kinematics variation; (XP-WTK) XP-endo Shaper with kinematics and working time variations; (Hyflex) Hyflex CM. For the variation in working time protocols the same sample of the XP-endo Shaper groups with and without kinematic variation were used. To evaluate final irrigation protocols, groups 1, 3 and 5 were submitted to 3 protocols: (NI) No irrigation (n = 2); (CI) conventional irrigation (n = 4), and (EndoVac) irrigation (n = 4). The samples were scanned by microcomputed tomography and prepared for scanning electron microscopy evaluation. Quantitative data were evaluated using the parametric ANOVA test, with statistical significance level set at 5%, and qualitative data obtained were compared to establish the agreement between examiners through the Kappa test. It was observed that in the analysis of XP-endo Shaper protocols, the additional working time did not cause difference in any of parameters evaluated (p > 0.05) in relation to time recommended by manufacturer. Compared to Hyflex, XP-K showed highest mean volume increase (p < 0.05) and lowest percentage of untouched walls (p < 0.05). In the qualitative evaluation, final irrigation protocol with EndoVac provided the best cleaning results when associated with XP-K and with Hyflex. Thus, supplementary techniques are effective tools to enhance cleaning and to promote higher touch of walls during root canal preparation.

Tarsila do Amaral and Glete de Alcântara: history in art and photography / Tarsila do Amaral y Glete de Alcântara: historia en arte y fotografia / Tarsila do Amaral e Glete de Alcântara: história em arte e fotografia

ABSTRACT Objectives: to analyze the canvas "Retrato de Glete de Alcântara" (freely translated as Portrait of Glete de Alcântara) and discuss the effect of the canvas for Tarsila do Amaral and for Brazilian nursing. Methods: a study in the historical perspective, in the field of visual culture, with analysis in two phases: pre-iconography and iconography. Results: Tarsila do Amaral brings up the woman Glete de Alcântara without the attributes that identify nursing. In this sense, the representation of women on the canvas is a person aligned with the hairstyle of her time, elegantly dressed, with seriousness and haughtiness accentuated by a fixed and directed look. Final considerations: an attempt was made to advance beyond Glete de Alcântara's professional life and her portrayed relationship networks, as well as to approach Tarsila do Amaral's trajectory, beyond the aesthetics and recognition gained.

RESUMEN Objetivos: analizar la pantalla "Retrato de Glette de Alcântara" (traducido libremente como Retrato de Glete de Alcântara) y discutir el efecto de la pantalla para Tarsila do Amaral y para la enfermería brasileña. Métodos: estudio en la perspectiva histórica, en el dominio de la cultura visual con análisis en dos fases: pre-iconografía e iconografía. Resultados: Tarsila do Amaral trae a la baila a la mujer Glete de Alcántara, sin los atributos que identifican a la enfermería. En este sentido, la representación de mujer en la pantalla, se trata de una persona alineada a la moda del peinado de su época de traje elegante, con seriedad y altivez acentuada por la mirada fija y dirigida. Consideración finales: se intentó avanzar más allá de la vida profesional de Glete de Alcântara y sus redes de relaciones retratadas, así como acercarse a la trayectoria de Tarsila do Amaral, más allá de la estética y el reconocimiento adquiridos.

RESUMO Objetivos: analisar a tela "Retrato de Glette de Alcântara" e discutir o efeito da tela para Tarsila do Amaral e para a enfermagem brasileira. Métodos: estudo na perspectiva histórica, no domínio da cultura visual, com análise em duas fases: pré-iconografia e iconografia. Resultados: Tarsila do Amaral traz à baila a mulher Glete de Alcântara, sem os atributos que identificam a enfermagem. Neste sentido, a representação de mulher na tela trata-se de uma pessoa alinhada à moda do penteado de sua época, de traje elegante, com seriedade e altivez acentuada pelo olhar fixo e direcionado. Considerações finais: houve a tentativa de avançar para além da vida profissional de Glete de Alcântara e suas redes de relacionamento da retratada, bem como se aproximar da trajetória de Tarsila do Amaral, para além da estética e o reconhecimento conquistado.

Tarsila do Amaral and Glete de Alcântara: history in art and photography / Tarsila do Amaral y Glete de Alcântara: historia en arte y fotografia / Tarsila do Amaral e Glete de Alcântara: história em arte e fotografia

ABSTRACT Objectives: to analyze the canvas "Retrato de Glete de Alcântara" (freely translated as Portrait of Glete de Alcântara) and discuss the effect of the canvas for Tarsila do Amaral and for Brazilian nursing. Methods: a study in the historical perspective, in the field of visual culture, with analysis in two phases: pre-iconography and iconography. Results: Tarsila do Amaral brings up the woman Glete de Alcântara without the attributes that identify nursing. In this sense, the representation of women on the canvas is a person aligned with the hairstyle of her time, elegantly dressed, with seriousness and haughtiness accentuated by a fixed and directed look. Final considerations: an attempt was made to advance beyond Glete de Alcântara's professional life and her portrayed relationship networks, as well as to approach Tarsila do Amaral's trajectory, beyond the aesthetics and recognition gained.

RESUMEN Objetivos: analizar la pantalla "Retrato de Glette de Alcântara" (traducido libremente como Retrato de Glete de Alcântara) y discutir el efecto de la pantalla para Tarsila do Amaral y para la enfermería brasileña. Métodos: estudio en la perspectiva histórica, en el dominio de la cultura visual con análisis en dos fases: pre-iconografía e iconografía. Resultados: Tarsila do Amaral trae a la baila a la mujer Glete de Alcántara, sin los atributos que identifican a la enfermería. En este sentido, la representación de mujer en la pantalla, se trata de una persona alineada a la moda del peinado de su época de traje elegante, con seriedad y altivez acentuada por la mirada fija y dirigida. Consideración finales: se intentó avanzar más allá de la vida profesional de Glete de Alcântara y sus redes de relaciones retratadas, así como acercarse a la trayectoria de Tarsila do Amaral, más allá de la estética y el reconocimiento adquiridos.

RESUMO Objetivos: analisar a tela "Retrato de Glette de Alcântara" e discutir o efeito da tela para Tarsila do Amaral e para a enfermagem brasileira. Métodos: estudo na perspectiva histórica, no domínio da cultura visual, com análise em duas fases: pré-iconografia e iconografia. Resultados: Tarsila do Amaral traz à baila a mulher Glete de Alcântara, sem os atributos que identificam a enfermagem. Neste sentido, a representação de mulher na tela trata-se de uma pessoa alinhada à moda do penteado de sua época, de traje elegante, com seriedade e altivez acentuada pelo olhar fixo e direcionado. Considerações finais: houve a tentativa de avançar para além da vida profissional de Glete de Alcântara e suas redes de relacionamento da retratada, bem como se aproximar da trajetória de Tarsila do Amaral, para além da estética e o reconhecimento conquistado.

O uso do microscópio operatório associado aos novos recursos na microcirurgia parendodôntica moderna / The use of the operating microscope associated with the new resources in modern endodontic microsurgery

Introdução: mesmo quando um tratamento endodôntico ou retratamento mais rigoroso é realizado, a periodontite apical pode persistir, levando à destruição do ligamento periodontal, cemento, osso alveolar e dentina. Nesses casos, o tratamento endodôntico cirúrgico, se realizado com o microscópio operatório (MO), ressecção mínima da raiz, retropreparo com pontas ultrassônicas e materiais para retrobturação biocompatíveis, pode alcançar mais de 90% de sucesso. Os procedimentos endodônticos cirúrgicos foram completamente transformados pela incorporação do MO, associado a novos recursos como aparelhos de ultrassom piezocirúrgico com pontas específicas para microcirurgia, microespelhos flexíveis, microexploradores, microcuretas endodônticas, microcondensadores e microinstrumentos para sutura. O MO pode otimizar todas as etapas de uma microcirurgia parendodôntica, incluindo o descolamento do retalho, a osteotomia, identificação do ápice radicular, apicectomia, remoção de tecido inflamatório, observação da superfície remanescente da raiz, retropreparo, obturação retrógrada e sutura. Objetivo: o objetivo do presente artigo é apresentar todos os passos da microcirurgia parendodôntica moderna e descrever os novos recursos disponíveis no mercado para melhorar a taxa de sucesso dessa modalidade. Conclusão: o uso de técnicas modernas de microcirurgia parendodôntica melhora significativamente as taxas de sucesso da terapia, quando comparada às técnicas tradicionais.

Evaluation of the physicochemical properties of silicone- and epoxy resin-based root canal sealers

Abstract To assess the physicochemical properties of AH Plus, GuttaFlow 2, GuttaFlow BioSeal, and MM Seal, five samples of each root canal sealer were evaluated to determine their setting time (ST), dimensional change (DC), solubility (SL), flow (FL), and radiopacity (RD) according to American National Standards Institute/American Dental Association (ANSI/ADA) Specification 57. The distilled and deionized water obtained from the SL test were subjected to atomic absorption spectrometry to observe the presence of Ca2+, K+, and Na+ ions. Statistical analysis was performed by using one-way ANOVA and Tukey-Kramer tests (p < 0.05). The following results were obtained: ST (min) (AH Plus 463.6 ± 13.22; GuttaFlow 2 24.35 ± 2.78; GuttaFlow Bioseal 17.4 ± 0.55; MM Seal 47.60 ± 4.39), DC (%) (AH Plus 0.06 ± 0.12; GuttaFlow 2 −26.06 ± 1.24; GuttaFlow Bioseal 2.10 ± 1.47; MM Seal 8.47 ± 2.41), SL (%) (AH Plus 0.41 ± 0.21; GuttaFlow 2 5.13 ± 4.11; GuttaFlow Bioseal 3.03 ± 1.05; MM Seal 0.94 ± 0.17), FL (mm) (AH Plus 36.42 ± 0.40; GuttaFlow 2 36.44 ± 0.05; GuttaFlow Bioseal 35.4 ± 0.03; MM Seal 52.75 ± 0.60), and RD (mmAl) (AH Plus 7.52 ± 1.59; GuttaFlow 2 6.85 ± 0.14; GuttaFlow Bioseal 7.02 ± 0.18; MM Seal 3.32 ± 0.90). ST, DC, SL, FL, and RD showed statistical differences among the root canal sealers (p < 0.05). As AH Plus showed the lowest DC and SL values (p < 0.05), the findings indicate that this sample is the only sealer conforming to ANSI/ADA standards.

Joint immobilization: effects on muscular tissue of obese and malnourished mice / Imobilização articular: efeitos sobre o tecido muscular de camundongos obesos e desnutridos

Abstract Although it is a widely used resource for the treatment of musculoskeletal injuries, immobilization causes deleterious effects in muscle tissue after a short period of time. This study aimed to evaluate the gastrocnemius and tibialis anterior muscles of obese and protein malnourished animals under joint immobilization condition. Overall, 28 adult male mice were used (C57 / BL6), being divided into four groups (N = 7): Control Group (CG), Immobilized Control Group (ICG), Immobilized Obese Group (IOG) and Immobilized Malnourished Group (IMG). The immobilization protocol was performed by the use of adhesive tape and plaster. The conditions and obesity and protein malnutrition have been developed through the ingestion of diets specific for each group of animals. The histomorphometric analysis of muscles evaluated area and the diameter of muscle fibers. All immobilized groups showed reduction in the area and diameter of muscle fibers when compared to GC. Comparisons among immobilized groups showed that the area and diameter of muscle fibers of IOG and IMG were lower than ICG. The immobilization protocol caused reduction in muscle trophism in animals, and obese and malnourished animals suffered high losses under condition of muscle atrophy.

Resumo Embora seja um recurso muito utilizado para tratamento de lesões musculoesqueléticas, a imobilização causa efeitos deletérios no tecido muscular após curto período de tempo. O presente estudo teve como objetivo avaliar os músculos gastrocnêmio e tibial anterior de animais obesos e desnutridos proteicamente sob a condição de imobilização articular. Foram utilizados 28 camundongos (C57/BL6) machos adultos, distribuídos em quatro grupos (N=7): Grupo controle (GC), Grupo Controle Imobilizado (GCI), Grupo Obeso imobilizado (GOI) e Grupo Desnutrido Imobilizado (GDI). O protocolo de imobilização foi realizado por meio da utilização de tiras de esparadrapo e faixa gessada. As condições de obesidade e desnutrição proteica foram desenvolvidas por meio da ingestão de dietas específicas para cada grupo de animais. A análise histomorfométrica dos músculos avaliou a área e o diâmetro das fibras musculares. Todos os grupos imobilizados apresentaram redução na área e no diâmetro das fibras musculares quando comparados ao GC. As comparações entre os grupos imobilizados mostraram que os valores do diâmetro e área de fibras dos grupos GOI e GDI foram menores do que o GCI. O protocolo de imobilização provocou redução do trofismo muscular nos animais estudados e os animais obesos e desnutridos sofreram prejuízo elevado na condição de atrofia muscular.

Relación entre insulinemia e hígado graso en pacientes con índice de masa corporal normal, sin antecedentes de consumo de alcohol crónico ni diabetes mellitus / Relationship between insulinemia and fatty liver in patients with normal body mass index and without a history of chronic alcohol consumption or diabetes mellitus

Existe una clara relación entre los pacientes con el hígado graso no alcohólico (HGNA) y la hiperinsulinemia, especialmente ante la presencia de factores de riesgo como la diabetes mellitus (DM), dislipidemia y obesidad; sin embargo, ésta puede presentarse incluso sin los factores de riesgo anteriormente mencionados. Objetivo: determinar la relación existente entre HGNA , e hiperinsulinemia en pacientes con índice de masa corporal (IMC) normal y sin DM ni consumo crónico de alcohol. Material y métodos: estudio descriptivo - transversal, tomando 59 pacientes adultos, 29 mujeres y 30 hombres en la Fundación Hospital Universitario Metropolitano (FHUM), sin antecedentes de consumo crónico de alcohol, con IMC normal y sin DM con las siguientes variables; la edad, sexo, perfil lipídico, ecografía hepática e insulinemia. Se utilizaron tablas de distribución de frecuencia, análisis multivariado con el riesgo relativo (RR) y Chi cuadrado (X²), con un nivel de confianza del 95%. Resultados: en el análisis multivariado la correlación entre nivel de insulina mayor o igual de 8 UI, se encontró que la glucemia mayor de 90 mg/L fue de 53.8% (siete casos) e insulina menor de 8 con glucemia mayor de 90 mg/L fue el 43.5 (20 casos). Con un riesgo relativo 1.2246 (IC: 0.6460 - 2.3214); Chi cuadrado: 0.4315 p=0.511. Lo mismo con los niveles de insulina preestablecido con los siguientes resultados con un RR: 1.1047 (IC: 0.8655-1.4101) X²: 1.0091 p = 0.3151. Con una incidencia de 8.47% con hígado graso diagnosticado por ultrasonografía. En relación a la edad el promedio fue 24.5 años (±10.4). Conclusiones: la relación de resistencia de la insulina y HGNA en este grupo de pacientes, muestran que la fuerza de la asociación RR se aleja de uno negativamente, lo que indica que no hay relación entre estas dos variables (Acta Med Colomb 2011; 36: 73-77).

There is a clear relationship between patients with nonalcoholic fatty liver disease (NAFLD) and hyperinsulinemia, especially in the presence of risk factors like diabetes mellitus (DM), dyslipidemia, and obesity. However, this can occur even without the risk factors mentioned above. Objective: to determine the relationship between NAFLD, and hyperinsulinemia in patients with normal body mass index (BMI) and without DM or chronic alcohol consumption. Materials and methods: cross, taking 59 adult patients, 29 women and 30 men in the Metropolitan University Hospital Foundation (FHUM) with no history of chronic alcohol consumption, with normal BMI and without DM with the following variables: age , sex, lipid profile, liver ultrasound and insulin. We used frequency distribution tables, multivariate analysis the relative risk (RR) and Chi square test with a confidence level of 95%. Results: in multivariate analysis the correlation between insulin level greater or equal to 8 IU, blood glucose was found that greater than 90 mg / L was 53.8% (7 cases) and insulin with glucose levels less than 8 greater than 90 mg / L was 43.5 (20 cases). 1.2246 with a relative risk (CI: 0.6460 to 2.3214), Chi square: p = 0.511 0.4315. Same with preset insulin levels with the following results with a relative risk: 1.1047 (CI 0.8655 to 1.4101) Chi square: p = 0.3151 1.0091. With an incidence of 8.47% with fatty liver diagnosed by ultrasonography. Regarding the average age was 24.5 years (± 10.4). Conclusions: the relationship of insulin resistance and NAFLD in this group of patients showed that the strength of the association RR away from a negative, which indicate no relationship between these two variables (Acta Med Colomb 2011; 36: 73-77).