Maxillary dental midline deviation in the patient perspective

Objective: This study aimed to determine aesthetic perceptions of midline deviations by orthodontic patients; influence of adjacent structures to smile in the perception of deviations; and difference between patients treated in University and in private practice. Methods: In this observational comparative cross-sectional study a smiling woman photograph was digitally modified, producing left maxillary dental midline deviations relative to facial midline. Twelve photographs were cropped in Group LCN including lips, chin and 2/3 of the nose; and group L including the lips. Non-parametric Friedman test ( = 0.05), followed by Wilcoxon test corrected by Bonferroni test ( = 0.0033) were used for multiple comparisons. Pearson correlation coefficient was used to study of the correlation and regression of the degree of smile esthetics on the midline deviations, adopting a significance level of 5%. Results: Patients were able to identify deviations from 2 mm. Among the groups of photos there was statistically significant difference in deviations of 2 and 3 mm. Comparing patients from University and private there was significant difference when comparing the photos in group LCN, without deviation and deviation of 2, 4 and 5 mm. Conclusions: Orthodontic patients are able to detect maxillary dental midline deviation from 2 mm. There was influence of viewing structures adjacent to smile in the perception of deviation for the private patients. University patients were more critical than private patients.

Objetivo: O objetivo foi avaliar a percepção estética do desvio da linha média dentária por pacientes ortodônticos; influência de estruturas adjacentes ao sorriso na percepção de desvios; e diferença de percepção entre pacientes tratados em Universidade e consultório particular. Métodos: Neste estudo comparativo observacional transversal uma fotografia de mulher sorrindo foi modificada digitalmente com desvios da linha média para a esquerda em relação à face. Doze fotografias foram recortadas para obter o grupo LCN incluindo lábios, queixo e 2/3 nariz; e grupo L incluindo lábios. O teste não paramétrico de Friedman ( = 0.05), seguido pelo de Wilcoxon, corrigido pelo teste de Bonferroni ( = 0.0033) foram utilizados para comparações múltiplas. O teste de Mann-Whitney foi aplicado para comparar grupos LCN e L, verificando a influência das estruturas adjacentes ao sorriso. O coeficiente de Pearson foi usado para correlação e regressão dos desvios sobre a estética do sorriso, adotando nível de significância de 5%.Resultados: Desvios de 2 mm foram identificados. Comparando grupos LCN e L houve diferença estatisticamente significante nos desvios de 2 e 3 mm. Entre pacientes da universidade e do consultório houve diferença significativa ao comparar fotografias no grupo LCN, sem desvio e desvios de 2, 4 e 5 mm. Conclusões: pacientes ortodônticos são capazes de detectar desvio da linha média dentária maxilar de 2 mm. Estruturas adjacentes ao sorriso influenciaram na percepção do desvio para os pacientes privados. Os pacientes da Universidade foram mais críticos do que os de consultório particular.

Protocol for the evaluation of chewing among older adults / Protocolo de avaliação da mastigação do idoso

Abstract Objectives : To evaluate the functional and physiological structures of the stomatognathic system of the oral cavity of older adults based on self-perception, comparing the same with a professional clinical evaluation, and investigating the difficulties encountered when chewing. Method : An analytical cross-sectional study with a quantitative approach was conducted with a sample of 53 older adults aged 60 to 90 years. A protocol consisting of three questionnaires was used: a sociodemographic evaluation, a self-perception based interview with 19 questions on the chewing of the older adults and a clinical evaluation containing 30 questions covering aspects of the oral cavity tissue. The self-perception and clinical evaluation scores were compared using the Mann-Whitney test and the proportions observed for each item were compared by the binomial test. Results : It was found that the self-perception of older adults did not correspond to the result of the clinical evaluation. While 31 (58.5%) reported satisfaction with chewing, 16 (30.2%) had high/very high impairment and 14(26.4%) moderate impairment, based on the results of the clinical evaluation found. Conclusion : It was found that the chewing analysis process cannot be exclusively based on the answers provided by the older adults, and assessment proved to be more accurate when combined with a clinical evaluation performed by a professional.

Resumo Objetivos : Avaliar as estruturas funcionais e fisiológicas do sistema estomatognático da cavidade bucal dos idosos diante da autopercepção, comparando-as com a avaliação clínica profissional e investigar as dificuldades encontradas para realizar sua mastigação. Método : Estudo transversal analítico de abordagem quantitativa, realizado com uma amostra de 53 idosos, idade entre 60 e 90 anos. Foi utilizado um protocolo constituído de três questionários: uma avaliação sociodemográfica, uma entrevista de autopercepção com 19 quesitos da mastigação do idoso e uma avaliação clínica contendo 30 quesitos abrangendo os aspectos teciduais da cavidade bucal. Os escores da autopercepção e da avaliação clínica foram comparados pelo teste de Mann-Whitney e as proporções observadas para cada item pelo teste binomial. Resultados : Constatou-se que a autopercepção relatada pelos idosos não correspondeu ao resultado da avaliação clínica. Enquanto 31 (58,5%) relataram satisfação com a mastigação, 16 (30,2%) possuíam comprometimento alto/muito alto e 14 (26,4%) comprometimento moderado. Conclusão : Evidenciou-se que o processo de análise da mastigação não pode ser realizado exclusivamente pelas respostas prestadas pelo idoso, sendo mais adequado quando se adiciona a etapa da avaliação clínica feita por um profissional.

Bond Strength Evaluation of Two Adhesive Systems in Fiberglass Posts Cementation

Objective: To compare the bond strength of three-step and self-etch adhesive systems with and without prior acid etching on bonding of fiberglass posts in root canals. Material and Methods: Experiments were conducted on roots of five upper molars without curvature and sectioned in a cervical-apical direction. With the aid of a highspeed turbine and diamond tips, cylindrical cavities 7 mm in depth and 1.4 mm in diameter were made in the dentine. The roots of the same tooth were used, where the retainers were cemented, thus generating three groups: Group A: Adper Scotchbond Multipurpose Plus (SBMP) + Rely X ARC; Group B: Single Bond Universal (SBU-1) + Rely X ARC, with acid etching prior to adhesive insertion; Group C: Single Bond Universal (SBU-2) + Rely X ARC. The samples were stored in a bacteriological incubator at 37ºC with 100% humidity for 48h and were subsequently cross-sectioned to obtain 3 dentine discs 1mm in thickness. Forty-five specimens were subjected to the push-out test. Results: Through the analysis of variance and Tukey's test, it was found that SBMP showed, with statistical significance (p<0.05), highest bond strength when compared with the SBU-1 and SBU-2 systems. The observed difference in the discs was located in the cervical portion. Conclusion: The three-step adhesive system had higher bond strength with the substrate than the self-etching adhesive only in the disc in the cervical portion; further, statistically, the prior application of phosphoric acid in SBU-1 did not affect its bond strength significantly.

BiodentineTM is cytocompatible with human primary osteoblasts

Abstract Calcium silicate-based materials have been widely studied due to their resemblance to, and similar applicability of, mineral trioxide aggregate (MTA). Among these, Biodentine™ (BD) was specifically designed as a "dentin replacement" material for applications such as root perforations, apexification, treatment of resorptive lesions, and as a retrograde filling material. The present study aimed to assess the in vitro response of human primary osteoblasts to BD using MTA AngelusTM as a reference material, by simultaneously analyzing three different cell viability parameters, namely mitochondrial activity, membrane integrity, and cell density. BD and MTA extracts were prepared by incubation on culture media for 24 h or 42 days after mixing. Primary human osteoblasts were exposed to extracts for 24 h, at 37oC with 5% CO2, and cell viability was evaluated by the XTT, NRU, and CVDE assays. Both materials induced cell viability levels higher than 70% when extracted for 24 h. However, when cells were exposed to extracts with increased conditioning times, MTA presented significant cytotoxic effects (p < 0.05) in comparison to the control and MTA at 24 h. After 42 days, the XTT assay identified a significant reduction in cell viability by BD when compared to the control (p<0.05), despite the fact that levels above the 70% viability cutoff were attained for biocompatible materials. It can be concluded that BD is cytocompatible with human primary osteoblasts, indicating its adequacy in direct contact with bone tissues.

Impact of gender in early structural changes of contrast induced nephropathy in rats / Impacto do gênero em alterações estruturais precoces da nefropatia induzida por contraste em ratos

Abstract Introduction: Contrast-induced nephropathy (CIN) is a major iatrogenic cause of acute kidney injury. Experimental studies have shown that intravascular injection causes intense vacuolization of the contrast agent in the proximal renal tubules cells, preceding the increase in serum creatinine, and that the female may be at a higher risk for CIN. Objective: To study the early kidney histomorphometric changes in contrast-induced nephropathy according to the gender. Methods: Twenty previously uninephrectomized Wistar rats were divided into 4 groups (n = 5): control males; control females; contrast exposed males; and contrast exposed females. The animals were sacrificed immediately after contrast administration and kidney tissue samples were collected for histomorphometric analysis. The research project was approved by the Research Ethics Committee of the School of Medicine of Universidade Federal Fluminense. Results: There was a more intense presence of microvacuoles in proximal tubules in the rats exposed to contrast than in the control groups. Such proximal tubular vacuolation was more intensive in the female rats (p = 0.001). Conclusion: Proximal tubular vacuolation is a very early change in CIN and is more intensive in female than in male rats.

Resumo Introdução: A nefropatia induzida por contraste (NIC) é uma das principais causas iatrogênicas de lesão renal aguda. Estudos experimentais têm demonstrado que a injeção intravascular do agente de contraste provoca vacuolização intensa nas células dos túbulos renais proximais, que precede o aumento da creatinina sérica, e que a fêmea podem estar em maior risco de CIN. Objetivo: Estudar as primeiras mudanças histomorfométricas renais na nefropatia induzida por contraste de acordo com o gênero. Métodos: Vinte ratos Wistar anteriormente uninefrectomizados foram divididos em 4 grupos (n = 5): machos de controle; fêmeas de controle; machos expostos ao contraste e fêmeas expostas ao contraste. Os animais foram sacrificados imediatamente após a administração de contraste e amostras de tecido de rim foram coletadas para análise histomorfométrica. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade Federal Fluminense. Resultados: Houve presença mais intensa de microvacuolização em túbulos proximais nos ratos expostos ao contraste do que nos grupos de controle. Tal vacuolização tubular proximal foi mais intensa nos ratos do sexo feminino p = 0,001). Conclusão: Vacuolização do tpubulo proximal é uma mudança precoce na CIN e é mais intensa em ratos fêmeas do que em ratos machos.

Perception of midline deviations in smile esthetics by laypersons

ABSTRACT Objective: To evaluate the esthetic perception of upper dental midline deviation by laypersons and if adjacent structures influence their judgment. Methods: An album with 12 randomly distributed frontal view photographs of the smile of a woman with the midline digitally deviated was evaluated by 95 laypersons. The frontal view smiling photograph was modified to create from 1 mm to 5 mm deviations in the upper midline to the left side. The photographs were cropped in two different manners and divided into two groups of six photographs each: group LCN included the lips, chin, and two-thirds of the nose, and group L included the lips only. The laypersons performed the rate of each smile using a visual analog scale (VAS). Wilcoxon test, Student’s t-test and Mann-Whitney test were applied, adopting a 5% level of significance. Results: Laypersons were able to perceive midline deviations starting at 1 mm. Statistically significant results (p< 0.05) were found for all multiple comparisons of the values in photographs of group LCN and for almost all comparisons in photographs of group L. Comparisons between the photographs of groups LCN and L showed statistically significant values (p< 0.05) when the deviation was 1 mm. Conclusions: Laypersons were able to perceive the upper dental midline deviations of 1 mm, and above when the adjacent structures of the smiles were included. Deviations of 2 mm and above when the lips only were included. The visualization of structures adjacent to the smile demonstrated influence on the perception of midline deviation.

RESUMO Objetivo: este estudo teve por objetivo avaliar a percepção estética dos desvios da linha média dentária superior por indivíduos leigos, assim como se as estruturas adjacentes influenciam nesse julgamento. Métodos: um álbum contendo 12 fotografias frontais do sorriso de uma mulher, aleatoriamente distribuídas e com a linha média desviada digitalmente, foi avaliado por 95 indivíduos leigos. As fotografias frontais de sorriso foram modificadas para criar desvios de 1 mm a 5 mm para a esquerda na linha média superior. As fotografias foram obtidas de duas maneiras e divididas em dois grupos de seis fotografias cada: Grupo LCN, incluindo lábios, mento e dois terços do nariz; e Grupo L, incluindo apenas os lábios. Os indivíduos leigos classificaram o sorriso de acordo com uma Escala Visual Analógica (EVA). Os testes de Wilcoxon, tde Student e Mann-Whitney foram aplicados, adotando-se um nível de significância de 5%. Resultados: os leigos foram capazes de perceber desvios da linha média a partir de 1 mm. Resultados estatisticamente significativos (p < 0,05) foram encontrados para todas as múltiplas comparações dos valores nas fotografias do Grupo LCN e para quase todas as comparações nas fotografias do Grupo L. As comparações entre as fotografias dos grupos LCN e L mostraram valores estatisticamente significativos (p < 0,05) quando o desvio foi de 1 mm. Conclusões: os indivíduos leigos foram capazes de perceber os desvios da linha média de 1 mm; e acima desses, quando estruturas adjacentes ao sorriso apareciam nas fotografias. Desvios de 2 mm ou mais foram percebidos apenas quando os lábios apareciam nas fotografias; a visualização das estruturas adjacentes ao sorriso pareceu ter influência sobre a percepção dos desvios da linha média.

Immunoexpression of cleaved caspase-3 shows lower apoptotic area indices in lip carcinomas than in intraoral cancer

ABSTRACT Objective This study aimed to evaluate apoptosis by assessing cleaved caspase-3 immunoexpression in hyperplastic, potentially malignant disorder (PMD), and malignant tumors in intraoral and lower lip sites. Material and Methods A retrospective study using paraffin blocks with tissues from patients with inflammatory fibrous hyperplasia (IFH), actinic cheilitis, oral leukoplakia, lower lip and intraoral squamous cell carcinoma (SCC) was performed. The tissues were evaluated by immunohistochemical analysis with anti-cleaved caspase-3 antibody. Apoptotic area index was then correlated with lesion type. Results From 120 lesions assessed, 55 (46%) were cleaved caspase-3-positive. The SCC samples (n=40) had the highest apoptotic area indices (n=35; 87.5%). Significant differences were detected between SCCs and PMDs (p=0.0003), as well as SCCs and IFHs (p=0.001), regarding caspase-3 immunopositivity. Carcinomas of the lower lip had lower apoptotic area indices than intraoral cancer (p=0.0015). Conclusions Cleaved caspase-3 immunoexpression showed differences in oral SCCs and PMDs and demonstrated a distinct role of apoptosis in carcinogenesis of intraoral and lower lip cancer. In future, the expression of cleaved caspase-3 with other target molecules in oral cancer may be helpful in delineating the prognosis and treatment of these tumors.

DENGUE DURING PREGNANCY: ASSOCIATION WITH LOW BIRTH WEIGHT AND PREMATURITY

The aim of this study was to evaluate the effects of dengue virus infection during pregnancy and its correlation with low birth weight, prematurity, and asphyxia. A non-concurrent cohort study reveals the association of dengue during pregnancy with prematurity and low birth weight, when birth occurred during the maternal-fetal viremia period (p = 0.016 and p < 0.0001, respectively).

A comparison of two reciprocating instruments using bending stress and cyclic fatigue tests

The aim of this study was to comparatively evaluate the bending resistance at 45º, the static and dynamic cyclic fatigue life, and the fracture type of the WaveOne (Dentsply Maillefer, Ballaigues, Switzerland) 25-08 and Reciproc (VDW, Munich, Germany) 25-08 instruments. A total of 60 nickel-titanium (NiTi) instruments (30 Reciproc and 30 WaveOne) from three different lots, each of which was 25 mm in length, were tested. The bending resistance was evaluated through the results of a cantilever-bending test conducted using a universal testing machine. Static and dynamic cyclic fatigue testing was conducted using a custom-made device. For the static and dynamic tests, a cast Ni-Cr-Mo-Ti alloy metal block with an artificial canal measuring 1.77 mm in diameter and 20.00 mm in total length was used. A scanning electron microscope was used to determine the type of fracture. Statistical analyses were performed on the results. The WaveOne instrument was less flexible than the Reciproc (p < 0.05). The Reciproc instrument showed better resistance in the static and dynamic cyclic fatigue tests (p < 0.05). The transverse cross-section and geometry of the instruments were important factors in their resistance to bending and cyclic fracture. Both of the instruments showed ductile-type fracture characteristics. It can be concluded that the Reciproc 25-08 instrument was more resistant to static and dynamic cyclic fatigue than the WaveOne 25-08 instrument, while the WaveOne 25-08 instrument was less flexible. Bending and resistance to cyclic fracture were influenced by the instruments’ geometries and transverse cross-sections. Both of the instruments showed ductile-type fracture characteristics.

Frictional resistance of self-ligating versus conventional brackets in different bracket-archwire-angle combinations

Objective: To compare the influence of archwire material (NiTi, beta-Ti and stainless steel) and brackets design (self-ligating and conventional) on the frictional force resistance. Material and Methods: Two types of brackets (self-ligating brackets - Smartclip, 3M/Unitek - and conventional brackets - Gemini, 3M/Unitek) with three (0, 5, and 10 degrees) slot angulation attached with elastomeric ligatures (TP Orthodontics) were tested. All brackets were tested with archwire 0.019"x0.025" nickel-titanium, beta-titanium, and stainless steel (Unitek/3M). The mechanical testing was performed with a universal testing machine eMIC DL 10000 (eMIC Co, Brazil). The wires were pulled from the bracket slots at a cross-head speed of 3 mm/min until 2 mm displacement. Results: Self-ligating brackets produced significantly lower friction values compared with those of conventional brackets. Frictional force resistance values were directly proportional to the increase in the bracket/ wire angulation. With regard to conventional brackets, stainless steel wires had the lowest friction force values, followed by nickel-titanium and beta-titanium ones. With regard to self-ligating brackets, the nickel-titanium wires had the lowest friction values, significantly lower than those of other materials. Conclusion: even at different angulations, the self-ligating brackets showed significantly lower friction force values than the conventional brackets. Combined with nickel-titanium wires, the self-ligating brackets exhibit much lower friction, possibly due to the contact between nickel-titanium clips and wires of the same material. .

Organochlorine compound levels in fertile and infertile women from Rio de Janeiro, Brazil / Níveis de substâncias organocloradas em mulheres férteis e inférteis do Rio de Janeiro, Brasil

OBJECTIVE: The aim of the study was quantify organochlorine compounds in women seeking for infertility treatment (n = 15) and in spontaneously pregnant ones (n = 21). MATERIALS AND METHODS: A questionnaire was applied regarding lifestyle, occupational and reproductive history. Blood samples were collected from both groups. RESULTS: From the pesticides studied, pp'DDE was detected in 100% of infertile women, at higher mean levels than in pregnant women (3.02 mcg/L vs. 0.88 mcg/L; p = 0.001; power of 69%), without correlation with the etiology of infertility. Levels of the polychlorinated biphenyls (PCBs) were low, with positive samples in 100% in the infertile women for PCBs 138, 153, 180, while in pregnant women, they were 85.7% for congeners 138 and 153. Only PCB180 showed significance, with frequency of 71.4% (p = 0.019). CONCLUSIONS: The risk factors for female infertility were: age, consumption of untreated water and of canned foods. Exposure to the most prevalent organochlorine compounds described in literature was confirmed in the study, indicating that pp'DDE may adversely influence female fertility.

OBJETIVO: O estudo teve como objetivo quantificar as substâncias organocloradas em mulheres buscando tratamento para infertilidade (n = 15) e que espontaneamente engravidaram (n = 21). MATERIAIS E MÉTODOS: Foi aplicado questionário considerando estilo de vida, história ocupacional e reprodutiva. Amostras de sangue foram obtidas em ambos os grupos. RESULTADOS: Dos pesticidas, pp'DDE foi detectado em 100% das inférteis, com níveis maiores que nas grávidas (3,02 mcg/L vs. 0,88 mcg/L; p = 0,001; poder 69%), sem correlação na etiologia da infertilidade. Os níveis de detecção das bifenilas policloradas (PCBs) foram baixos, com 100% de positividade das amostras nas inférteis para os PCBs 138, 153, 180, e de 85,7% nas grávidas para os congêneres 138 e 153. Apenas PCB180 mostrou significância na frequência de 71,4% (p = 0,019). CONCLUSÕES: Os fatores de risco para infertilidade feminina foram: idade, consumo de água não tratada e alimentos enlatados. A exposição aos organoclorados mais prevalentes descritos na literatura foi confirmada no estudo, indicando que pp'DDE pode influenciar adversamente a fertilidade feminina.

Concordance between cytopathology and incisional biopsy in the diagnosis of oral squamous cell carcinoma

Oral cytopathology is a simple, non-invasive technique that could be used for early detection of oral premalignant and malignant lesions, but the effectiveness of this diagnostic approach remains controversial. The aim of this study was to evaluate the sensitivity, specificity, positive and negative predictive values, and accuracy of cytopathology for diagnosing oral squamous cell carcinoma (OSCC) and the diagnostic concordance between cytopathological and histopathological diagnoses. The study enrolled 172 patients at outpatient clinics who presented with oral lesions suspicious of malignancy. All patients underwent oral cytological scrapes followed by an incisional biopsy. Of 148 cases that were histopathologically diagnosed with OSCC, the cytopathological method diagnosed 123 positive cases and resulted in a suspicion of OSCC in 16 patients. Based on these data, the sensitivity was 83.1%, the specificity was 100.0%, the positive predictive value was 100.0%, the negative predictive value was 49.0%, and the accuracy was 85.5%. The diagnostic concordance between histopathological and cytopathological examinations was 83.1% for OSCC and 85.7% for non-neoplastic lesions. The results indicate that cytopathological diagnosis had good concordance with histopathological diagnosis and showed high sensitivity, specificity, positive predictive value, and accuracy. We conclude that the sensitivity of oral cytopathology is sufficient to justify its use as a diagnostic screening test and to confirm the malignant nature of epithelial cells, mainly for the classification of OSCC. Therefore, cytopathology may be a reliable method for referring patients who require diagnosis of suspected oral cancer for starting treatment.

Câncer de boca: análise do tempo decorrido da detecção ao início do tratamento em centro de Oncologia de Maceió / Oral cancer: evaluation of the time from detection to treatment initiation at oncology center of Maceió

O atraso no diagnóstico do câncer de boca é a principal causa de um prognóstico ruim. O objetivo deste estudo foi avaliar o tempo decorrido entre a detecção do câncer até o início do tratamento em Centro de Oncologia de Maceió. Foram avaliados 50 pacientes entre 2007 e 2008. A análise foi feita em quatro momentos. O perfil dos pacientes correspondeu a homens idosos, de baixa renda, analfabetos e residentes no interior. O maior tempo identificado foi entre a detecção da lesão e o atendimento especializado. Os resultados indicam a necessidade de ampliar o conhecimento dos pacientes quanto aos fatores de risco, de agilidade na busca de atendimento especializado e de maior envolvimento profissional no diagnóstico precoce.

The delay in the diagnosis of oral cancer is the leading cause of a poor prognosis. The aim of this study was to evaluate the time elapsed between the detection of cancer to the beginning of the treatment at an oncology center in Maceio. We evaluated 50 patients between 2007 and 2008. The analysis was conducted in four stages. The profile of patients corresponded to older men, low income, illiterate and living in the countryside. The longest delays were identified between the detection of the lesion and specialized care. The results indicate the need to expand the knowledge of patients on risk factors, a rapid search for specialized care, and greater professional involvement in early diagnosis.

Avaliação da atividade antimicrobiana do MTA ecimento portland em cepas de enterococcus faecalise pseudomonas aeruginosa / Evaluation of antimicrobial activity of MTA and Portland cements in enterococcus faecalis and pseudômonas aeruginosa

A determinação do perfil antimicrobiano de materiais endodônticos é de grande importância para determinação dos procedimentosodontológicos. O objetivo do presente trabalho foi avaliar o perfil antimicrobiano dos cimentos endodônticos MTA, que vem constituindo-se um excelente selador e preenchedor especialmente nas perfurações radiculares e de furca e que até então possuíam um prognóstico bastante desfavorável, e o Cimento Portland, que vem sendo utilizado com eficácia no tratamento da polpa dentária, frente a cepas de Enterococcusfaecalis e Pseudomonasaeruginosa, bactérias comumente resistentes aos antimicrobianos atuais e encontradas na maioria dos casos de lesões endodônticas refratárias. No teste antimicrobiano, os cimentos foram diluídos em água destilada e aplicados em discos de papel de filtro estéreis que foram colocados em placas de Petri inoculadas com as bactérias. O teste estatístico utilizado (ANOVA) permitiu inferir que houve uma diferença significante (p<0,05) entre os controles positivos e os cimentos avaliados. Com base nos resultados obtidos, pode se concluir que nenhum dos cimentos testados, MTA ou Portland, apresentam atividade antimicrobiana sobre as cepas testadas exigindo, portanto um protocolo de desinfecção prévio ao se utilizar esses materiais na prática odontológica.

The determination of the antimicrobial profile of endodontic materials are of great importance for the dental procedures establishment.The aim of this study was to evaluate the profile of antimicrobial sealers MTA, which is an excellent sealer and filler especially in the root and furcation perforations, which had unfavorable prognosis and Portland cement, which has been used efectivelly in dental pulp treatment against Enterococcus faecalis and Pseudomonas aeruginosathat are the resistant bacteria present in most cases of refractory endodontic infections. In the antimicrobial test, the material was diluted in distilled water and applied on filter paper discs that were placed in Petri dishes inoculated with bacteria. The ANOVA statistical test allowed us to infer that there was a statistically significant difference with p <0.05 when comparing positive controls, and cements. After theexperiments, we can conclude that none of the sealers, MTA or Portland, showed antimicrobial activity against the strains tested, thus requiring a protocol for disinfection prior to using these materials.

O decréscimo vertiginoso das autópsias em um hospital universitário do Brasil nos últimos 20 anos / The dramatic decline of the autopsies at a Brazilian university hospital in the last 20 years

INTRODUÇÃO: O declínio no número de autópsias em hospitais e instituições universitárias é evento amplamente reportado, inicialmente em países do primeiro mundo e posteriormente em muitos países em desenvolvimento, como o Brasil. As causas para essa tendência são múltiplas e complexas, incluindo aspectos religiosos, familiares e médicos. Entre estes últimos, salientam-se razões diagnósticas, caracterizadas pelo significativo avanço tecnológico na imagenologia, com a suposição de que todos os diagnósticos agora podem ser feitos em vida, e a crescente ansiedade de processos judiciais contra médicos por má prática. OBJETIVO: Demonstrar o decréscimo vertiginoso e drástico do número de autópsias em um hospital universitário no Brasil. MATERIAL E MÉTODO: Avaliou-se o número de registros nos livros de autópsias consecutivas realizadas no Departamento de Patologia do Hospital Universitário Antonio Pedro da Universidade Federal Fluminense (HUAP/UFF), Niterói, Rio de Janeiro, criando um banco dados em tabela do programa Microsoft Excel. RESULTADOS: Durante os anos 1966 a 2009, foram realizadas 23.813 necrópsias, sendo 12.702 de adultos e 11.111 de fetos. Entre os anos 1966 e 1998, foram realizadas mais necrópsias, no total de 23.321, sendo 12.482 de adultos e 10.839 de fetos. Já entre os anos 1999 e 2009, foi observado o declínio acentuado e drástico das mesmas, totalizando apenas 492 necrópsias, sendo 220 de adultos e 272 de fetos. CONCLUSÃO: Acreditamos que a principal causa para esse declínio é a pouca informação da população, que desconhece que o saber é fruto de estudo, pesquisa, prática e aprimoramento.

INTRODUCTION: The decline in the number of autopsies at hospitals and university hospitals has been widely reported, initially in developed countries and afterwards in several developing countries including Brazil. The causes for this trend are multiple and complex, encompassing religious, family and medical aspects. Among the latter, we highlight diagnostic reasons, which are characterized by major technological advances in clinical imaging associated with the underlying assumption that all diagnoses can currently be made before death. Furthermore, there is a growing concern about malpractice lawsuits. OBJECTIVE: To demonstrate the sharp decrease in the number of autopsies at a university hospital in Brazil. MATERIAL AND METHODS: We evaluated the number of autopsies conducted at the Pathology Department of Antonio Pedro University Hospital (HUAP), Niterói, Rio de Janeiro, and a database spreadsheet was created at Microsoft Excel. RESULTS: From 1966 to 2009, 23,813 autopsies were performed, comprising 12,702 adults and 11,111 fetuses. The highest number of autopsies occurred from 1966 to 1998, when 23,321 autopsies were performed, comprising 12,482 adults and 10,839 fetuses. Whereas, there was a dramatic decline from 1999 to 2009, when 492 autopsies were performed, including 220 adults and 272 fetuses. CONCLUSION: We believe that the main cause of this reduction is the lack of information among laypeople and medical professionals, who have neglected the fact that knowledge is ultimately acquired through study, investigation and practice.

A avaliação da variabilidade das medidas produzidas pelo método radiográfico digital comparadas ao método radiográfico convencional / The evaluation of the variability of the measures produced by the digital radiographic method compared to conventional radiographic method

Radiografias são de extrema importância e influenciam diretamente no sucesso dos tratamentos endodônticos. O objetivo deste estudo é a avaliação da variabilidade das medidas produzidas pelo método radiográfico digital comparadas ao método radiográfico convencional. Neste estudo foram comparadas dez (10) radiografias convencionais e dez (10) radiografias digitais de dentes uniradiculares, utilizando a técnica da bissetriz. Nos dois casos as radiografias foram medidas da incisal até o ápice dos elementos dentários. No caso das radiografias digitais foi utilizado o recurso do software da régua milimetrada, e nas radiografias convencionais, a medida com a régua milimetrada. Em seguida, foram introduzidas limas #15 no interior dos canais radiculares calibradas com as medidas adquiridas, dente a dente, e medidas as distâncias entre as pontas das limas e os ápices radiculares. Foram então comparadas as medidas encontradas entre os ápices e as limas nas radiografias convencionais e digitais. Não havendo evidência de diferença entre os dois grupos (p>0,05) segundo a avaliação estatística através do teste do sinal. O teste de Levene evidenciou diferença estatisticamente significativa (p<0,05) entre as variâncias dos dois grupos de medidas. Conclui-se que o método digital é mais preciso do que o método radiográfico convencional.

Radiographies are extremely important and influence directly in the success of endodontic treatments. In this study ten (10) conventional radiographies and ten (10) digital radiographies of uniradicular teeth were compared, using the bisecting angle technique. In both cases the radiographies were measured from the incisal until the apex of the dental elements. In the case of the digital radiographies the resource of a millimetric rule software was used and a millimetric rule in the conventional radiographies. Afterwards, #15 files calibrated with the acquired measures were introduced inside the canals of every tooth. The distances between the apex and the end oh the files were measured. Measures between the apexes and the files in the digital and conventional radiographies were compared. Results were statistically analyzed by signal test. Levene’s test compared groups variance and verified difference between them (p<0,05). The conclusion was that digital radiography method is more precise than the one produced bt the radiography method.

Banco de dentes humanos na percepção dos acadêmicos da faculdade de odontologia da Universidade Federal Fluminense / Dentistry students' knowledge about the human tooth bank of Universidade Federal Fluminense

O objetivo desta pesquisa foi avaliar o nível de informação dos alunos dos 4º, 5º e 6º períodos da Faculdade de Odontologia da Universidade Federal Fluminense (FO-UFF) acerca da importância do Banco de Dentes Humanos (BDH) e sua funcionalidade. Foram entrevistados 95 alunos, utilizando questionário com perguntas fechadas. Os resultados indicaram que 100% dos alunos tem consciência da existência do BDH na FO-UFF e que 71,3% tem conhecimento de sua finalidade. Esse conhecimento é diferenciado em função do período que o aluno esteja cursando (x2), sendo a proporção de alunos do 4º período significativamente menor (p<0,05). Os autores concluíra, que há necessidade de um maior trabalho de divulgação na população de alunos estudada sobre a importância do BDH.

This research’s goal was to evaluate the level of information known by the 4th, 5th and 6th terms’ students from the Dental School at Universidade Federal Fluminense (FO-UFF) about the importance of the Human Teeth Bank (BDH) and its functionality. There were 95 students in the research, and it was used an objective assessment. The results indicated that 100% of the students know about UFF´s Dental School teeth bank, and that 71,3% knowm it’s purpose. This knowledge depends on the term the student’s on (x2), and the proportion of students who are on their 4th term is highly smaller (p<0,05). The authors concluded that there’s a need to inform more the 4th, 5th and 6th terms’ students about the importance of BDH.

Fluxos nas carótidas e artérias vertebrais extracranianas em pacientes com morte cerebral / Extracranial carotid and vertebral artery flows in brain dead patients

Fundamentos: O Doppler transcraniano (DTC) é o método mais usado para a confirmação de morte cerebral (MC). O fluxo das carótidas também apresenta alteração característica na MC, mas essa caracterização é apenas superficialmente abordada na literatura. Objetivo: Caracterizar o tipo de fluxo encontrado nas carótidas e artérias vertebrais(AV) em pacientes com MC, pelo ultrassom. Métodos: As carótidas e as AV de dois grupos de pacientes, com morte cerebral (GMC) e grupo-controle (GC) foram avaliadas através do duplex scam colorido (DSC), ambos com 13 pacientes sem estenose hemodinamicamente significativa. Os parâmetros de velocidae de fluxo estudados foram: pico de velocidade sistólica, velocidade diastólica final e índice de resistência. A maioria dos dados apresentou distribuição não paramétrica e utilizaram-se os testes bicaudais de Mann-Whitney e Wilcoxon. Resultados: Fopram encotradas quatro morfologias de fluxo nos ramos internos (RI) das carótidas e das AV nos pacientes do GMC: espícula sistólica; fluxo com padrão bifásico do tipo "To-and-fro" e sua variante; fluxo oscilatório; e fluxo trifásico. Todas as morfologias encontradas foram semelhantes às descritas no DTC para pacientes com MC. A maioria dos pacientes do GMC apresentou fluxo normal nos ramos externos das carótidas. O fluxo na carótida com um (CC) variou de normal às morfologias descritas para os RI e AV. Todos os parâmetros de velocidades do GMC mostraram diferença estatisticamente significativa nos RI, AV e CC quando comparados com o GC, com p<0,05. O DSC é um método promissor para o diagnóstico de MC.

Análise comparativa da imunoexpressão da proteína p53 (clones DO-7 e PAb-240) em carcinomas de células escamosas intrabucais e labiais / Comparative analysis of p53 protein immunostaining (antibodies DO-7 and PAb-240) in oral cavity and lip squamous cell carcinomas

INTRODUÇÃO: A carcinogênese caracteriza-se como um processo multifatorial, e a inativação da proteína p53 é uma alteração genética comumente observada nos carcinomas de células escamosas de boca (CCEB). OBJETIVO: Analisar e comparar a imunoexpressão da proteína p53, por meio dos clones DO-7 e PAb-240, em CCEB com localização intrabucal e em lábio inferior. MATERIAL E MÉTODOS: Foram selecionados 40 casos de CCEB, sendo 20 de localização intrabucal e 20 em lábio inferior. Foi realizado um estudo imuno-histoquímico utilizando os anticorpos anti-p53 clone DO-7 e PAb-240. A imunoquantificação foi realizada por meio de análise digital de imagem, e os resultados, submetidos a tratamentos estatísticos. RESULTADOS: A imunoexpressão da proteína p53 foi verificada com o anticorpo DO-7 em 13 casos (65 por cento) de carcinoma intrabucal e em 19 (95 por cento) de carcinoma de lábio inferior. Imunorreatividade para o anticorpo PAb-240 foi observada em 9 casos (45 por cento) de lesões intrabucais e em 15 (75 por cento) localizados em lábio inferior. Não foram observadas, segundo o teste de Mann-Whitney, diferenças estatisticamente significativas (p > 0,05) na expressão da proteína p53 entre as duas localizações estudadas, independentemente do anticorpo avaliado. Foram identificadas, pelo teste de Wilcoxon, diferenças estatisticamente significativas entre a expressão dos clones DO-7 e PAb-240 em cada um dos grupos analisados (valor p = 0,013 - lábio inferior; valor p = 0,016 - intrabucal). CONCLUSÕES: A expressão da proteína p53 observada nos CCEB, com localizações intrabucais e labiais, sugere a ocorrência de mutações no gene TP53. As diferenças quantitativas obtidas entre os anticorpos estudados, independentemente da localização das lesões, refletem uma especificidade distinta entre os clones DO-7 e PAb-240. O desenvolvimento de mais estudos será fundamental para estabelecer o anticorpo mais adequado para proteína p53 em CCEB.

BACKGROUND: Carcinogenesis is a multifactorial process and inactivation of p53 protein is a genetic change commonly observed in oral squamous cell carcinomas (OSCC). OBJECTIVES: To analyze and compare the expression of p53 protein through antibodies DO-7 and PAb-240 in OSCC samples located in the oral cavity and lower lip. MATERIAL AND METHODS: Forty cases of OSCC were selected and divided into oral cavity and lower lip groups (20 cases each). Immunohistochemical technique was performed using antibodies DO-7 and PAb-240. Quantification of the cases was performed through digital image analysis and underwent specific statistical treatments. RESULTS: Expression of p53 protein was verified with DO-7 antibody in 13 cases (65 percent) of oral cavity carcinomas and in 19 cases (95 percent) of lower lip carcinoma. PAb-240 positivity was detected in 9 cases (45 percent) of oral cavity lesions and in 15 cases (75 percent) located in the lower lip. According to Mann-Whitney test, there were no statistically significant differences between the expressions of p53 protein in both groups, regardless of the antibody used. According to Wilcoxon test, there were statistically significant differences between the expression of DO-7 antibody and PAb-240 in each of the analyzed groups (p-value = 0.013; lower lip p-value = 0.016 - oral cavity). CONCLUSIONS: The expression of p53 protein was observed both in the oral cavity and lip OSCC, which suggests the occurrence of mutations in TP53 gene. The quantitative differences between the antibodies studied, regardless of the site of the lesions, reflect different specificity between clones DO-7 and PAb-240. Further studies are required to establish the best antibody for p53 protein in oral squamous cell carcinomas.

Análise de sobrevida global em pacientes diagnosticados com carcinoma de células escamosas de boca no INCA no ano de 1999 / Overall survival analysis in oral squamous cell carcinoma patients diagnosed at the National Cancer Institute in 1999

O carcinoma de células escamosas de boca compreende cerca de 90 a 95 por cento de todas as neoplasias malignas da boca e é um dos tipos de câncer mais frequentes no Brasil. O índice de sobrevida em 5 anos é baixo e permaneceu estável nas últimas décadas, apesar dos avanços nas terapias. O objetivo deste estudo foi analisar o perfil e a sobrevida global dos pacientes diagnosticados com carcinoma de células escamosas de boca no ano de 1999 no Instituto Nacional de Câncer. Dos 320 pacientes incluídos no estudo, 79,4 por cento eram homens. A idade média foi de 56,7 anos, e 82,2 por cento deles fumavam e/ou bebiam. A língua, seguida do assoalho de boca foram os locais mais acometidos. A maioria (68,9 por cento) dos pacientes foi diagnosticada em estádios tardios e submetida à radioterapia exclusiva (53,6 por cento). A sobrevida média no período do estudo foi de 29,4 meses. Os pacientes dos estádios iniciais apresentaram maior sobrevida, assim como aqueles submetidos apenas à cirurgia como forma de tratamento e os que não apresentaram linfonodos acometidos ao diagnóstico. Tumores localizados em palato duro e mucosa jugal apresentaram pior prognóstico. Foram fatores preditivos independentes de melhor sobrevida os tumores T1 ou T2 (p=0,001), sem acometimento de linfonodos (p=0,012) e não localizados em mucosa jugal (p=0,021). O diagnóstico do câncer oral ainda se faz em estádios tardios, o que influencia negativamente a sobrevida global dos pacientes. Maior ênfase deve ser dada à capacitação dos profissionais para o reconhecimento precoce do câncer e à conscientização da população de risco.

Oral squamous cell carcinoma accounts for 90 to 95 percent of all malignant neoplasms of the mouth and it is one of most common cancers in Brazil. Five-year survival rates remain low and have not improved over the past decades, despite advances in therapy. The purpose of this study was to analyze the features and overall survival of patients diagnosed with oral squamous cell carcinoma in 1999 at the National Institute of Cancer. Male patients (79.4 percent) with a medium age of 56.7 years, with smoking or drinking habits (82.2 percent) comprised most of the sample. Tongue and floor of the mouth were the most prevalent sites of occurrence. Patients were diagnosed mainly at advanced stages of the disease (68.9 percent stages III and IV) and were treated with radiation therapy alone (53.6 percent). Mean survival was 29.4 months, and patients diagnosed in early stages had better survival rates, as well as those who were surgically treated and those who did not show cervical node metastasis at diagnosis. Tumors located in the palate or in the buccal mucosa presented the worst prognosis. Cox regression analysis showed that T1 or T2 lesions (p=0.001), with no neck metastasis (p=0.012) and anatomic site other than buccal mucosa (p=0.021) were independent predictive factors of a better survival rate. Oral cancer diagnosis still occurs in advanced stages, and it negatively influences overall survival, so there should be efforts to prepare and train professionals to recognize lesions at early stages and to make the population at greatest risk aware of the disease.