Intensidad lumínica de las lámparas de fotocurado LED en los consultorios odontológicos de Piura, Perú / Output intensity of LED light curing units in dental offices of Piura, Peru

Introducción: La lámpara de fotocurado, que utiliza diodos emisores de luz (LED), se emplea en odontología para la conversión polimérica de los materiales de restauración dental. Se ha comunicado que una intensidad lumínica inadecuada de la lámpara no aseguraría la correcta polimerización del material de restauración. Objetivo: Determinar la intensidad lumínica de las lámparas de fotocurado LED en consultorios odontológicos de la ciudad de Piura, Perú, 2020. Métodos: Estudio observacional, descriptivo. Se midió la intensidad lumínica en 70 lámparas de fotocurado LED, usando un radiómetro con una longitud de onda de 400-500 nm, con capacidad de medida de la intensidad lumínica de hasta 3500 mw/cm2. Por debajo de los 400 mw/cm2 indica intensidad baja, de 400 a 800 mw/cm2 intensidad media, de 800 a 1200 mw/cm2 intensidad alta y por encima de los 1200 mw/cm2 indica intensidad muy alta. Resultados: El 48,5 por ciento de las lámparas analizadas presentaban intensidad media, el 22,86 por ciento intensidad alta, mientras que el 15,71 por ciento intensidad baja y finalmente el 12,86 por ciento de las lámparas presentaban intensidad muy alta. Se reportó menor frecuencia de lámparas con mayor uso clínico. Conclusiones: Las lámparas de fotocurado LED, utilizadas en los consultorios dentales de la provincia de Piura durante el 2020, emiten una intensidad lumínica promedio de 778,14 mW/cm2, equivalente a la intensidad media(AU)

Introduction: Light curing lamps that use light-emitting diodes (LED) are used in dentistry for the polymeric conversion of dental restorative materials. It has been reported that inadequate light intensity in the lamp would not ensure the appropriate polymerization of restorative materials. Objective: Determine the output intensity of LED light curing units used in dental offices of the city of Piura, Peru, in the year 2020. Methods: An observational descriptive study was conducted. Measurements were taken of the light output of 70 LED light curing lamps using a radiometer with a wavelength of 400-500 nm and a light intensity measurement capacity of up to 3 500 mw/cm2. Intensity below 400 mw/cm2 was recorded as low, from 400 to 800 mw/cm2 as medium, from 800 a 1 200 mw/cm2 as high and above 1 200 mw/cm2 as very high. Results: Intensity was medium in 48.5 percent of the lamps analyzed, high in 22.86 percent, low in 15.71 percent and very high in 12.86 percent. A lower frequency of lamps with greater clinical use was reported. Conclusions: The LED light curing lamps used in dental offices of the province of Piura during the year 2020 emit an average output intensity of 778.14 mW/cm2, which corresponds to medium intensity(AU)

Awareness among Post-Graduate Students about Ergonomic Practice in Vidarbha Region

In recent times ergonomics has become a popular term. The term has been used with most professions but increasingly in the dental profession. Dentistry is a profession in which all the dentists worldwide are commonly affected with health hazards like musculoskeletal disorders which hinders their clinical practice resulting in early retirements. So, to evaluate workplace efficiency and prevalence of musculoskeletal problems in practicing local dentists this study was planned. We wanted to assess the awareness about proper ergonomic practice among the post-graduate dental students in Vidarbha region.METHODSThe study was undertaken at Sharad Pawar Dental College between 2018-2019. Study comprised of 50 post-graduate students. Each student was asked to fill self-administered questionnaire regarding ergonomics. The questionnaire consisted of a total of 10 questions. Results were assessed accordingly.RESULTSOut of all the participating post-graduate students, 84% have knowledge of the term ergonomics and its applications in dental practice. 52% of them responded positively to taking micro breaks while performing a procedure. 88% of them are aware of the posture related musculoskeletal disorders. 84% of them responded positively about experiencing symptoms during working. 68% of them responded positively about knowing some exercises to strengthen their back, shoulders or hands. 36% of the participants are practicing four handed dentistry.CONCLUSIONSAwareness about dental ergonomics can enable the post-graduate students and other dental practitioners to have a better work-life, and provide their patients with the quality of service they need.

Evaluation of a protocol for reducing the microbial contamination of dental unit water

Biofilm on dental unit waterlines can spread microbial contamination in the water. The aim of this study was to investigate microbial contamination of water from supplies and dental units before and after the implementation of a protocol for microbial quality improvement and maintenance of dental unit water. The microbial load was evaluated in water from 27 taps and dental units (reservoirs, airwater syringes and highspeed outputs without handpieces) using the Petrifilm™ system (total aerobic bacteria and fungi) and conventional culture media (enterobacteria and Legionella spp.). The bacterial load in water samples from taps and reservoirs was within the parameter established by Brazilian legislation (<500CFU/mL); but the bacterial load in samples from airwater syringes and highspeed outputs without handpieces was not. The imple mentation of the protocol for the maintenance of microbial quality in dental unit water reduced bacterial load in highspeed outputs without handpieces (p=0.004). Enterobacteria and Legionella spp. were not isolated from any of the water samples from taps and dental units (AU)

Biofilme nas linhas d'água de equipos odontológicos pode propagar contaminação microbiana na água. O objetivo deste estudo foi investigar a contaminação microbiana da água de abastecimentos e equipos odontológicos antes e após a implemen tação de um protocolo para melhoria e manutenção da qualidade microbiológica da água de equipos odontológicos. Avaliouse a carga microbiana da água de 27 torneiras e equipos (reservatórios, seringas tríplice e alta rotação sem as peças de mão) de uma clínica odontológica por meio do sistema Petrifilm™ (bactérias aeróbias totais e fungos) e meios de cultura convencionais (enterobactérias e Legionella spp.). A carga bacteriana em amostras de água das torneiras e reservatórios estava dentro do parâmetro estabelecido pela legislação brasileira (<500 UFC/mL), mas a carga bacte riana das seringas tríplices e das saídas dos alta rotação sem as peças de mão não estava. A implementação do protocolo para manutenção da qualidade da água dos equipos reduziu a carga bacteriana nas saídas dos alta rotação sem as peças de mão (p=0,004). Enterobactérias e Legionella spp. não foram isoladas de qualquer das amostras de água das torneiras e dos equipos odontológicos (AU)

Analysis of cutting capacity, preparation time, and apical deviation after instrumentation of artificial curved canals with the waveone ® and reciproc ® reciprocating systems / Análise da capacidade de corte, tempo de prepare e desvio apical após a instrumentação de canais curvos artificiais com sistemas reciprocantes Waveone ® e Reciproc ®

ABSTRACT Objective To analyze cutting capacity, preparation time, and occurrence of apical deviation, after instrumentation of curved canals with reciprocating Primary WaveOne ® and R25 Reciproc ® systems. Methods Twenty simulated canals with 35° bends were randomly assigned to the Primary WaveOne ® or R25 Reciproc ® . The preparations were made by a single operator. The cutting capacity was assessed by the difference in weight (on an analytical balance) of the canals before and after preparation. The time needed for the preparation was analyzed. The canals were filled with India ink and photographed on a platform before and after the preparation to analyze the apical deviation to a 1 mm length. The images were superimposed in Photoshop ® and the measurement was performed with the ruler tool. Statistical analysis was performed using Student's t-test. The level of significance was set at 5%. Results The WaveOne ® Primary system was more effective (in terms of cutting capacity) but had a longer preparation time than the R25 Reciproc ® instrument. Apical deviation was the only variable that did not significantly differ between the two systems. Conclusion The WaveOne ® Primary had a higher cutting capacity than the R25 Reciproc ® . Both systems maintained the original canal path. The preparation time was shorter for the R25 Reciproc ® than the WaveOne ® Primary system.

RESUMO Objetivo Analisar a capacidade de corte, o tempo de preparo e a ocorrência de desvio apical, após a instrumentação de canais curvos com os sistemas reciprocantes WaveOne ® e Reciproc ® . Métodos Vinte canais simulados, com 35° de curvatura, foram randomicamente divididos para os dois sistemas. Os instrumentos utilizados foram o WaveOne ® Primary e o R25 Reciproc ® . Cada instrumento foi utilizado em um canal. Os preparos foram feitos por um único operador. Para análise da capacidade de corte, os canais foram pesados em balança analítica antes e após o preparo. A diferença na pesagem foi utilizada para aferição. O tempo para execução do preparo foi cronometrado e os valores obtidos foram analisados. Já para análise do desvio a 1 mm do comprimento de trabalho, antes e após o preparo, os canais foram preenchidos com tinta nanquim e fotografados em uma plataforma. As imagens foram sobrepostas no Photoshop ® e, com a ferramenta régua, foi realizada a medição. Resultados Para análise estatística foi utilizado o teste T de Student, com nível de significância de 5%. Na análise da capacidade de corte, o sistema WaveOne ® Primary foi mais eficaz que o instrumento R25 Reciproc ® , embora o seu tempo de preparo tenha sido maior. Apenas no critério, desvio apical, não se verificou diferença significativa entre os dois sistemas. Conclusão O WaveOne ® Primary apresentou uma maior capacidade de corte que o R25 Reciproc ® . Ambos os sistemas respeitaram a trajetória original do canal. O tempo de preparo do R25 Reciproc ® foi menor que o WaveOne ® Primary.

Discussion on the content and teaching effect of dental equipment course in the stomatology educa-tion for undergraduates / 中华医学教育探索杂志

It is of great importance to set up the Dental Equipment courses in the stomatology edu-cation for the undergraduates to cultivate new practical talents. In this paper, the teaching reform of Dental Equipment course and experience in teaching in China Medical University was proposed and discussed, especially the physical principles and practice classes was introduced. The physical principles of the equip-ment were introduced in the class to clarify the working mechanism and applications of the relative dental equipment, followed by the practice class for the operation of the equipment. The results demonstrated that the basic principles and cutting-edge technologies related to the equipment were also necessary parts of the dental equipment courses besides the instruction of the equipment widely applied in clinics. Content of practice class should cover the operation of both the basic dental equipment and digital equipment, which enables the students to expand the knowledge base on dental equipment for clinics. The reasonable cur-riculum design makes it easy for the teaching of the interdisciplinary subject, and the students can benefit from the curriculum. Besides, it is also favorable for the improvement of the equipped environment. The teaching method and experience herein are worth to be popularized.

Assessment of interns and postgraduate dental student’s knowledge regarding equipment ergonomics.

Context: The substantial knowledge concerning ergonomics and its practical application is vital for forestalling musculoskeletal disorders. The role of equipment ergonomics (EE) in preventing these work‑related ailments is significantly noteworthy. Aim: The aim of the study was to assess the prevailing perception of postgraduates (PGs) and interns regarding EE and preparing the Indian dental workforce for the challenges of India’s growing economy and population. Settings and Design: Authors conducted a cross‑sectional survey between December 2013 and February 2014 amidst the interns and PG dental students of Davangere city, Karnataka, India. Subjects and Methods: The data were collected using 21‑item custom designed proforma, comprising of questions evaluating student’s basic knowledge about EE. Statistical Analysis Used: Statistical analysis was done using Chi‑square test in each group (PGs and interns) and Mann–Whitney test was implemented for comparison between both groups. Results: Of 358 subjects surveyed, 48% PGs and 52% interns affirmed that they came across EE only through this survey. In addition, 91.18% of PGs and 90.59% interns believed that the accentuation on EE is less in the current dental curriculum. Conclusions: Comprehensive understanding and practical application of EE among the participants was found to be lacking. The importance of microbreaks and chair side exercises should be emphasized and training should be initiated at an early stage before improper postural habits develop.

Eficácia de três substâncias desinfetantes na prática da radiologia odontológica / Effectiveness of three substances disinfectants in dental radiology practice

O estudo avaliou prevalência bacteriana em componentes utilizados na Radiologia Odontológica e testou a eficácia de três substâncias desinfetantes. Foram avaliadas quatro superfícies em quatro clínicas (cilindro localizador, avental de chumbo, disparador de raios X e câmara escura), sendo testados: álcool 70%, hipoclorito de sódio 2,5% e ácido peracético 0,2%. Foram utilizados os métodos bioquímicos de identificação. Em 91,7% das superfícies analisadas, houve contaminação bacteriana, sendo Staphylococcus o gênero mais prevalente, seguido dos bacilos gram-positivos. O hipoclorito de sódio 2,5% e o ácido peracético 0,2% reduziram a contaminação bacteriana de 93,8% para 6,3%, enquanto o álcool 70% reduziu de 87,5% para 56,3%, após o seu uso.

The study aimed to evaluate bacterial prevalence of dental radiology equipment and to test the effectiveness of 03 disinfection substances. 04 Surfaces were evaluated in 04 clinical (locating cylinder, lead apron, trigger X-ray and darkroom) being tested: Alcohol 70%, sodium hypochlorite 2.5% and 0.2% peracetic acid. Biochemical methods have been used for identification. In 91.7% of the areas examined were bacterial contamination, the most prevalent being Staphylococcus genus, followed by gram-positive bacilli. The 2.5% sodium hypochlorite and 0.2% peracetic acid reduced the bacterial contamination of 93.8% to 6.3%, while the 70% ethanol showed only 31.2% of bacterial absence after use.

Accuracy of intraoral and extraoral digital data acquisition for dental restorations

ABSTRACT The computer-aided design (CAD) and computer-aided manufacturing (CAM) process chain for dental restorations starts with taking an impression of the clinical situation. For this purpose, either extraoral digitization of gypsum models or intraoral digitization can be used. Despite the increasing use of dental digitizing systems, there are only few studies on their accuracy. Objective This study compared the accuracy of various intraoral and extraoral digitizing systems for dental CAD/CAM technology. Material and Methods An experimental setup for three-dimensional analysis based on 2 prepared ceramic master dies and their corresponding virtual CAD-models was used to assess the accuracy of 10 extraoral and 4 intraoral optical non-contact dental digitizing systems. Depending on the clinical procedure, 10 optical measurements of either 10 duplicate gypsum dies (extraoral digitizing) or directly of the ceramic master dies (intraoral digitizing) were made and compared with the corresponding CAD-models. Results The digitizing systems showed differences in accuracy. However, all topical systems were well within the benchmark of ±20 µm. These results apply to single tooth measurements. Conclusions Study results are limited, since only single teeth were used for comparison. The different preparations represent various angles and steep and parallel opposing tooth surfaces (incisors). For most digitizing systems, the latter are generally the most difficult to capture. Using CAD/CAM technologies, the preparation angles should not be too steep to reduce digitizing errors. Older systems might be limited to a certain height or taper of the prepared tooth, whereas newer systems (extraoral as well as intraoral digitization) do not have these limitations.

Fungal contamination and disinfection of dental chairs, Teresina, Piauí, Brazil / Contaminação de fungos e desinfecção em cadeiras odontologicas, Teresina, Piauí, Brasil

The aim of this study was to analyze fungal contamination on dental chairs at the clinic of a Higher Education Institution in TeresinaPI, Brazil, and to evaluate the effectiveness of different disinfectants: 70% alcohol and 1% sodium hypochlorite. We selected the five sites with most contact between patient and chair: headrest, backrest, armrests, seat and foot rest. Samples were collected from these sites on 14 chairs and inoculated in agar Sabouraud culture medium containing chloramphenicol. Pathogenic fungi were isolated from all sampling sites on the chairs. Highest frequencies were found on footrest, followed in decreasing order by seat, backrest, armrests and headrest. Fourteen species of filamentous fungi were identified, belonging to the genera Alternaria, Aspergillus, Cladosporium, Curvularia, Drechslera, Fusarium, Penicillium and Paecillomyces. After sampling, seven chairs were disinfected with 70% alcohol and seven with 1% sodium hypochlorite, and samples were taken again using the same procedure. No fungal growth was detected following disinfection with sodium hypochlorite, which was clearly more effective than alcohol, after which there was still fungal growth. This study highlights the need for the biosafety protocol to include cleaning and disinfection of dental chairs with 1% sodium hypochlorite after each attendance in order to prevent crossinfection.

O objetivo deste estudo foi analisar contaminação fúngica em cadeiras odontológicas na clínica de uma Instituição de Educação Superior em TeresinaPI, Brasil, e avaliar a efetividade de diferentes desinfetantes: álcool 70% e hipoclorito de sódio 1%. Nós selecionamos os cinco locais com maior contato entre o paciente e a cadeira: encosto da cabeça, das costas, dos braços, assento e encosto dos pés. As amostras foram coletadas destes locais das 14 cadeiras e inoculadas em meio de cultura agarSabouraud contendo cloranfenicol. Fungos patogênicos foram isolados de todos os locais de amostragem das cadeiras. As frequências mais altas foram encontradas no encosto dos pés, seguido em ordem decrescente pelo assento, encosto das costas, dos braços e encosto da cabeça. Quatorze espécies de fungos filamentoso foram identificados, pertencente aos gêneros Alternaria, Aspergillus, Cladosporium, Curvularia, Drechslera, Fusarium, Penicillium e Paecillomyces. Após a coleta, sete cadeiras foram desinfe tadas com álcool 70% e sete com hipoclorito de sódio 1%, e as amostras foram colhidas novamente usando o mesmo procedimento. Não foi detectado crescimento fúngico após desinfecção com hipoclorito de sódio, que foi claramente mais efetivo que o álcool, do qual ainda houve crescimento fúngico.Este estudo destaca a necessidade da inclusão no protocolo de biossegurança a limpeza e desinfecção das cadeiras odontológicas com o hipoclorito 1% após cada atendimento, a fim de prevenir infecções cruzadas.

Desinfecção do sistema de água de equipamentos odontológicos com clorexidina / Disinfection of dental unit waterline with chlorexidine

Introdução: A água utilizada em procedimentos odontológicos pode apresentar- se contaminada, sendo fonte de infecção para profissionais e pacientes. Objetivo: Comparar a efetividade da clorexidina 0,1% e do hipoclorito de sódio 1% na desinfecção do sistema de água de equipamentos odontológicos. Método: Três equipamentos odontológicos sofreram desinfecção com clorexidina; e três, com hipoclorito de sódio mediante acionamento da seringa tríplice durante dois minutos. Amostras de água coletadas antes, após a desinfecção e no final do dia foram analisadas microbiologicamente. Amostras do filtro de abastecimento também foram analisadas. Resultados: As amostras coletadas antes da desinfecção mostraram altos níveis de contaminação (>500 UFC/ml). Após emprego dos desinfetantes, estas apresentaram-se nos padrões recomendados pela American Dental Association – ADA (<200 UFC/ml). A água do filtro de abastecimento também estava dentro dos limites estabelecidos pela ADA. Conclusão: Clorexidina 0,1% mostrou-se tão efetiva quanto hipoclorito de sódio 1% na desinfecção do sistema de água de equipamentos odontológicos.

Introduction: The water used in dental procedures may be contaminated and source of infection for patients and dental staff. Objective: The aim of this study was to compare the effectiveness chlorhexidine 0.1% and sodium hypochlorite 1% in the disinfection of dental unit waterline. Method: Three dental units were disinfection with chlorhexidine and three with sodium hypochlorite by flushing the triple syringe for two minutes. Water samples collected before and after disinfection and in the end of the day were analyzed microbiologically. Samples of the supply filter were also analyzed. Results: Samples collected before disinfection showed high levels of contamination (> 500 CFU / ml). After use of disinfectants, the samples were within the recommended standards by the American Dental Association – ADA (< 200 CFU / ml). The water supply filter was also within the limits established by the ADA. Conclusion: Chlorhexidine 0.1% was effective as sodium hypochlorite 1 % for the disinfection of dental unit waterlines.

Accuracy of five electronic foramen locators with different operating systems: an ex vivo study

Objective: The aim of this study was to evaluate, ex vivo, the precision of five electronic root canal length measurement devices (ERCLMDs) with different operating systems: the Root ZX, Mini Apex Locator, Propex II, iPex, and RomiApex A-15, and the possible influence of the positioning of the instrument tips short of the apical foramen. Material and Methods: Forty-two mandibular bicuspids had their real canal lengths (RL) previously determined. Electronic measurements were performed 1.0 mm short of the apical foramen (-1.0), followed by measurements at the apical foramen (0.0). The data resulting from the comparison of the ERCLMD measurements and the RL were evaluated by the Wilcoxon and Friedman tests at a significance level of 5%. Results: Considering the measurements performed at 0.0 and -1.0, the precision rates for the ERCLMDs were: 73.5% and 47.1% (Root ZX), 73.5% and 55.9% (Mini Apex Locator), 67.6% and 41.1% (Propex II), 61.7% and 44.1% (iPex), and 79.4% and 44.1% (RomiApex A-15), respectively, considering ±0.5 mm of tolerance. Regarding the mean discrepancies, no differences were observed at 0.0; however, in the measurements at -1.0, the iPex, a multi-frequency ERCLMD, had significantly more discrepant readings short of the apical foramen than the other devices, except for the Propex II, which had intermediate results. When the ERCLMDs measurements at -1.0 were compared with those at 0.0, the Propex II, iPex and RomiApex A-15 presented significantly higher discrepancies in their readings. Conclusions: Under the conditions of the present study, all the ERCLMDs provided acceptable measurements at the 0.0 position. However, at the -1.0 position, the ERCLMDs had a lower precision, with statistically significant differences for the Propex II, iPex, and RomiApex A-15.

Study of the antimicrobial efficacy of chlorhexidine in dental unit water: evaluation of microbial contamination in the dental office / Estudo da capacidade antimicrobiana da clorexidina na água do equipamento odontológico: avaliação de contaminação microbiana em ambiente odontológico

Objective: The aim of this study to count anaerobic bacteria before and after the use of dental equipment and to study the influence of chlorhexidine on the dental unit reservoir water. Methods: Sterile swabs were used to collect bacterial samples from the cuspidor, lights, syringes, low-and high speed handpieces and dental chairs (arms and backrest) before and after the placement of barriers. Blood agar plates were placed on the patient's and dentist's forehead and by the patient's nose and shoulder and exposed to aerosoils without (group 1) and with 0,5% (group 2) and 1,0% (group 3) chlorhexidine generated by the high speed handpiece. Ten aerosol samples were collected for each group. A sample of 1mL of the dental unit reservoir water was collected before and after the use of the high speed handpiece. The anaerobic bacterial counts were compared by the Wilcoxon and Kruskal-Wallis tests. Results: The contamination of the high speed handpiece (p=0,0431) and cuspidor (p=0,0117) increased significantly after use. Contamination in the dental unit reservoir water also increased significantly after use of the high speed handpiece. The most contaminated area was the patient's nose. Conclusion: The addition of 0,5% and 1,0% chlorhexidine in the dental office sifnificantly.

ObjetivoO objetivo deste estudo foi quantificar as bactérias anaeróbicas, antes e após o uso deequipamentos odontológicos e estudar a influência da clorexidina na água doreservatório.MétodosOs seguintes itens foram avaliados: cuspideira, luzes, seringas, baixa e alta rotação,braço da cadeira e do encosto com coleções realizadas antes e após a colocação debarreiras. A contaminação microbiana causada pelos aerossóis de alta rotação tambémfoi avaliada: Grupo 1 (controle): (100%) de água no reservatório; Grupo 2: água noreservatório contendo 0,5% de clorexidina, Grupo 3: água no reservatório contendo1,0% de clorexidina. Dez amostras de aerossol foram recolhidos a partir de cadagrupo: placas de ágar-sangue foram colocadas na testa do paciente e do dentista e nonariz e ombro do paciente. Amostra de 1mL a partir do conteúdo da água no reservatóriofoi medida antes e após a utilização de alta rotação. Comparações entre bactériasanaeróbias foram feitas com o uso de Wilcoxon e Kruskal-Wallis teste estatístico.ResultadosVerificou-se um aumento significativo na contaminação antes e após o procedimentoutilizando alta rotação (p=0,0431) e na cuspideira (p=0,0117). Foi possível observarum aumento significativo de contaminação microbiana na água do reservatório, apósa sua utilização. O nariz do paciente era a área mais afetada.ConclusãoA adição de 0,5% e 1,0% de clorexidina no reservatório representa uma reduçãosignificativa de contaminação microbiana gerado no ambiente de um consultório odontológico.

A dinâmica inovativa do subsistema de base mecânica, eletrônica e de materiais / The innovative dynamic of the mechanics, electronics and materials subsystem / La dinámica innovadora del subsistema de base mecánica, electrónica y de materiales

O subsistema de base mecânica, eletrônica e de materiais, um dos subsistemas do complexo produtivo da saúde, reúne diferentes atividades, usualmente agregadas na designada indústria de equipamentos e materiais médico-hospitalares e odontológicos, uma área estratégica para a saúde por representar uma fonte contínua de mudanças nas práticas assistenciais. Além de exercer influência na prestação de serviços de saúde, possui potencial de promover o adensamento do sistema nacional de inovação e de ampliar a competitividade da indústria como um todo, dado que articula tecnologias portadoras de futuro. Apesar do crescimento significativo dessa indústria no Brasil nos últimos anos, esses equipamentos e materiais têm apresentado um crescente déficit na balança comercial. Essa incompatibilidade entre as necessidades nacionais de saúde e a base produtiva e inovativa da indústria aponta fragilidades estruturais do subsistema. Utilizando o arcabouço da economia política, o objetivo do artigo foi discutir o desenvolvimento dessa indústria no Brasil e seus desafios.

The mechanics, electronics and materials subsystem, one of the subsystems of the health care productive complex, encompasses different activities, usually clustered in what is called the medical, hospital and dental equipment and materials industry. This is a strategic area for health care, since it represents a continuous source of changes in care practices, and influences the provision of health care services. It has, moreover, potential for promoting the progress of Brazil's system of innovation and for increasing the competitiveness of the industry as a whole, given that it articulates future technologies. Despite the significant growth of this industry in Brazil in recent years, such equipment and materials have been presenting a growing deficit in the balance of trade. This incompatibility between national health care needs and the productive and innovative basis of the industry points to structural fragilities in the system. Using the framework of political economy, the article aims to discuss the development of this industry in Brazil and its challenges.

OBJETIVO: El subsistema de base mecánica, electrónica y de materiales, uno de los subsistemas del complejo productivo de la salud, reúne diferentes actividades, usualmente agregadas en la designada industria de equipos y materiales médico-hospitalarios y odontológicos, un área estratégica para la salud por representar una fuente continua de cambios en las prácticas asistenciales. Además de ejercer influencia en la prestación de servicios de salud, posee potencial de promover la saturación del sistema nacional de innovación y de ampliar la competitividad de la industria como un todo, dado que articula tecnologías portadoras de futuro. A pesar del crecimiento significativo de esta industria en Brasil en los últimos años, los equipos y materiales han presentado un creciente déficit en la balanza comercial. Esta incompatibilidad entre las necesidades nacionales de salud y la base productiva e innovadora de la industria señalan fragilidades estructurales del subsistema. Utilizando el armazón de la economía política, el objetivo del artículo fue discutir el desarrollo de ésta industria en Brasil y sus desafíos.

Evaluation of the level of microbial contamination and prevalence of gram-negative non-fermentative rods in dental unit waterlines

Introduction: The cross infection control in dental office has received great attention from professionals and one of the critical points is the bacteriological control of water used in dental unit. Objective: To perform a microbiological evaluation of the water used in dental units, the identification of Gram-negative non-fermentative rods (GNNR) and their ability to adhere to polystyrene, and the antimicrobial activity of disinfectants on the identified strains. Material and methods: The heterotrophic bacteria count and GNNR identification were performed on water samples collected from 25 dental units (air/water syringe and reservoir). The GNNR were assessed on their capability to adhere to polystyrene and on their antimicrobial activity to the following disinfectants: sodium hypochlorite (0.06%, 0.12%, 0.25%, and0.5%) and chlorhexidine (0.03%, 0.06%, and 0.12%). Results: 88% of the air/water syringe collected samples and 68% of the reservoir collected samples were out of the potability standards. The quantity of isolated bacteria from the reservoir was lower than from the air/water syringe in 88% of the dental units. Methylobacterium spp. was found in highest percentage (19.7%) during GNNR genus isolation. There was a weak adherence to polystyrene in 85.04% of the samples. Sodium hypochlorite at 0.25%, inactivated 100% of the GNNRs in 10 minutes, while the highest tested concentration of chlorhexidine (0.12%), inactivated 98.5% of the GNNRs. Conclusion: These results provide information on the contamination problem of dental unit waterlines (DUWL) and indicate a need for treatment of the water used in dental units. The disinfection of DUWL can be performed with sodium hypochlorite at 0.25% (half the concentration recommended in the literature). However, further studies are necessary regarding DUWL frequency disinfection.

Ex vivo accuracy of three electronic apex locators using different apical file sizes

This study evaluated the accuracy of three electronic apex locators (Root ZX, Novapex, and Justy II) in root canal length determinations using different apical file sizes, considering the apical constriction (AC) and the major foramen (MF) as anatomic references. The diameter of the apical foramina of 40 single-rooted teeth was determined by direct visual measurement and the master apical file was established. Electronic measurements were then performed using 3 instruments: the selected master apical file (adjusted file), one size smaller (intermediate file), and two sizes smaller (misfit file). The distances from the tip of files fixed in the canals to the MF and to the AC were measured digitally. Precision at AC and at MF for the misfit, intermediate and adjusted apical files was as follows: 80%/88%/83% and 78%/83%/95% (Root ZX); 80%/85%/80% and 68%/73%/73% (Novapex); and 78%/80%/78% and 65%/78%/70% (Justy II). Considering the mean discrepancies, statistically significant differences were found only for the adjusted file at MF, with Root ZX presenting the best results at MF. The chi-square test showed significant differences between the acceptable measurements at AC and at MF for the Justy II and Novapex (± 0.5 mm) regardless of file adjustment. Under the conditions of the present study, all devices provided acceptable electronic measurements regardless of file adjustment, except for Root ZX which had its performance improved significantly when the precisely fit apical file was used. Justy II and Novapex provided electronic measurements nearest to the AC.

Este estudo avaliou a precisão de três localizadores eletrônicos foraminais (Root ZX, Novapex e Justy II) nas determinações de odontometria utilizando limas com diferentes padrões de ajuste, considerando-se a constrição apical (CA) e do forame principal (FA) como referências anatômicas. O diâmetro dos forames apicais de 40 dentes unirradiculados foi previamente determinado por visualização direta e a lima compatível com o forame apical foi estabelecida. Medições eletrônicas foram realizadas utilizando 3 instrumentos diferentes: lima compatível com o forame apical (lima ajustada), lima um tamanho menor (lima intermediária), e lima dois tamanhos menores (lima desajustada). As distâncias da ponta dos instrumentos ao FA e a CA foram determinadas em software específico. A precisão na CA e no FA para os instrumentos desajustado, intermediário e ajustado foram: 80% / 88% / 83% e 78% / 83% / 95% (Root ZX); 80% / 85% / 80% e 68% / 73% / 73% (Novapex), e 78% / 80% / 78% e 65% / 78% / 70% (Justy II). Considerando os erros médios oferecidos pelos aparelhos, foi encontrada diferença estatística apenas nas determinações realizadas com os instrumentos adaptados tendo como referência o FA onde o Root ZX ofereceu os melhores resultados. O teste qui-quadrado apresentou diferenças significantes entre as determinações consideradas aceitáveis para a CA e o FA tanto para o Justy II quanto para o Novapex (± 0,5 mm), independente do ajuste do instrumento. Nas condições do presente estudo todos os dispositivos ofereceram medições aceitáveis independentemente do ajuste dos instrumentos; exceção feita apenas ao Root ZX, que teve seu desempenho melhorado quando uma lima ajustada foi utilizada. Os aparelhos Justy II e Novapex ofereceram determinações mais próximas à CA.

Análise comparativa da profundidade de cura de uma resina micro-híbrida fotoativada por distintas fontes de luz / Comparison of curing depth of a microhybrid composite resin with different light-curing units

Objetivo - Este estudo comparou a eficácia de profundidade de cura entre distintas fontes de luz, dois LEDs (Ultra Blue IS-DMC and Bright Lec-MMOptics) e uma luz halógena (Degulux - Soft-Star - Degussa). A microdureza de uma resina composta micro-híbrida (Z-250 -3M ESPE) foi analisada em diferentes espessuras. Métodos - Setenta e cinco espécimes foram realizados com o uso de uma matriz de polipropileno utilizando a resina composta micro-híbrida (Z250, 3M ESPE, St. Paul, MN, USA). Três grupos foram determinados: 1 mm, 2 mm e 4 mm de espessura de resina composta. A microdureza foi analisada com um microdurômetro e ponta Vickers e os dados foram analisados estatisticamente com ANOVA e teste de Tukey. Resultados - Não houve diferença estatisticamente significante entre os grupos quando 1 mm de camada de resinacomposta foi utilizada. Em 2 mm de espessura de resina composta, os equipamentos Ultra Blue IS-DMC e a luz halógena (Degulux-SoftStart-Degussa) apresentaram valores superiores de microdureza quando comparados ao LED: Bright Lec-MM Optics. A fonte de luz halógena indicou resultados superiores às demais fontes de ativação quando a espessura de 4 mm de resina composta foi analisada. Conclusões - Este estudo demonstra haver diferença entre as fontes de ativação no que diz respeito à profundidade de cura da resina composta.

Objective - This study used depth of cure measurement to compare the effectiveness of two light-emitting diodes units (Ultra Blue IS-DMCand Bright Lec- MMOptics) and a conventional quartz tungsten halogen equipment (Degulux - Soft-Star - Degussa). The microhardness of a light-cured resin composite (Z-250 -3M ESPE) was compared according to the depth from the composite surface. Methods - Seventy-five samples were made in polytetrafluoroethylene molds using a micro hybrid composite resin (Z250, 3M ESPE, St. Paul, MN, USA). Three different groups of: 1 mm, 2 mm and 4 mm resin layer thickness were determined. The microhardness of the upper and lower surfaces were measured with a Vickers hardness-measuring instrument and analyzed by a two-way ANOVA/Tukey's test (alpha = .05). Results - There were no statistically significant differences in the microhardness values among groups of 1mm layer thickness. When 2 mm of resin was used, significant differences were found based on curing light. The Ultra Blue IS-DMC and quartz tungsten halogen units showed better results when compared to Bright Lec-MM Optics. The conventional quartz tungsten halogen had overall the highest values of microhardness when 4 mm resin layer thickness of resin was considered. Conclusions - In this study, depth of cure differed significantly among the different light-curing units.

Isolamento de fungos de equipamentos radiográficos odontológicos / Isolation of fungi from dental radiographic equipment

Objetivo: Isolar os fungos dos equipamentos radiográficos dos consultórios odontológicos de Teresina, Piauí, Brasil. Métodos: Foram analisados oito aparelhos de Raios X intrabucal e dois aparelhos de Raios X extrabucal. As coletas foram realizadas nas superfícies dos equipamentos, após procedimentos rotineiros de atendimento a pacientes nos consultórios, por meio de swabs esterilizados, embebidos em salina e friccionados sobre a superfície de cada aparelho. Em seguida, as amostras foram inoculadas em placas de Petri contendo meios Sabourand dextrose agar acrescido de cloranfenicol, incubados à temperatura ambiente e BBLTM CHROMagarTM Candida (BD-Difco, New Jersey, USA), incubados a 37ºC, para o crescimento de fungos filamentosos e leveduras, respectivamente. Resultados: Foram identificadas 17 espécies de fungos e as espécies mais frequentes foram Candida albicans, Aspergillus niger, Cladosporium cladosporioides e Cladosporium oxysporum. Houve predominância, significativa, de fungos na superfície dos componentes do aparelho de Raios X intrabucal quando comparado aos componentes do aparelho de Raios X extrabucal. Conclusão: As espécies fúngicas isoladas das superfícies dos aparelhos radiográficos odontológicos são potencialmente patogênicas e esses equipamentos podem servir de reservatórios ou vetores de fungos representando um risco de aquisição de infecção cruzada para os pacientes, assim como para a equipe odontológica. É necessário que os profissionais da área sejam alertados quanto ao risco inerente ao seu trabalho, treinados e estimulados a aplicarem os princípios de biossegurança para reduzir ou eliminar esses micro-organismos.

Objective: To isolate fungi from radiographic equipment in dentist?s offices in Teresina, Piaui, Brazil. Methods: Eight intraoral and two panoramic X-ray instruments were analyzed. Samples were taken after routine clinical procedures with sterilized swabs followed by inoculation on Petri dishes containing either Sabourand dextrose agar supplemented with chloramphenicol, or BBLTM CHROMagarTM Candida (BD-Difco, New Jersey, USA). The samples were incubated at room temperature, or 37oC, so that filamentous fungi and yeasts, respectively, could develop.Results: Seventeen species of fungi were detected. The most frequent species were Candida albicans, Aspergillus niger, Cladosporium cladosporioides and Cladosporium oxysporum. Additionally, there was significant prevalence of fungi on the surface of intraoral X-ray components as compared to extraoral X-ray components. Conclusion: The species of fungi isolated from the surfaces of dental radiographic equipment in dentist?s offices in Teresina, PI, are potentially pathogenic. These instruments may play a critical role as reservoirs or vectors for fungi. Moreover, they pose a risk of cross-infection to patients and dental staff. Consequently, it is critical to alert professionals in the dentistry area about the inherent risk in their activities and to establish training courses to encourage them to adopt biosafety procedures in order to reduce or eliminate these microorganisms.

Avaliação da eficácia da clorexidina na desinfecção do sistema de água odontológica / Chlorhexidine efficacies evaluation on disinfection of dental unit waterline

Introdução: A água utilizada nos procedimentos odontológicos apresenta-se contaminada e pode causar infecção cruzada. Objetivos: Neste estudo, investigou-se a qualidade da água de equipos odontológicos e a ação de diferentes concentrações de clorexidina na redução da contaminação. Métodos: Os parâmetros de contaminação utilizados foram o da American Dental Association e do Ministério da Saúde. Realizou-se análise bacteriológica em amostras de água de 17 seringas tríplices para verificar a qualidade microbiológica da água tratada ou não com clorexidina in vitro. Testaram-se concentrações de clorexidina 0,4%; 0,2%; 0,1%. Utilizou-se clinicamente clorexidina 0,1% na desinfecção do sistema de água por um minuto em 13 equipos e realizou-se nova análise bacteriológica da água. Resultados: Todos os grupos-controles apresentaram níveis elevados de contaminação, 100% dos grupos tratados in vitro com clorexidina e dos equipos que sofreram desinfecção com clorexidina 0,1% apresentaram-se descontaminados. Conclusão: Clorexidina 0,1% foi efetiva na redução da contaminação da água odontológica.

Introduction: The water used in dental procedures is contaminated and can cause crossed infection. Objective: This study investigates the quality of water on dental units and the action of different concentrations of chlorhexidine in the reduction of this contamination. Method: The contamination parameters used were the American Dental Association and the Brazilian Health State Department. It was executed a bacteriological analysis of water samples from 17 air-water syringes to verify the microbiological quality of water treated or not with chlorhexidine in vitro. It was examined concentrations of 0.4%; 0.2%; 0.1%. One percent chlorhexidine was used, clinically, in disinfection of dental unit waterline for one minute in 13 dental units and a new bacteriological analysis of water was made. Results: All control groups showed high levels of contamination, 100% of groups with chlorhexidine in vitro and all dental units who suffered disinfection with 0.1% chlorhexidine were free of contamination. Conclusion: One percent chlorhexidine was effective in reducing contamination of the dental water.

The plaque-removing efficacy of a single-tufted brush on the lingual and buccal surfaces of the molars

PURPOSE: To test the plaque-removal efficacy of a single-tufted toothbrush on the posterior molars compared with a flat-trimmed toothbrush. METHODS: Forty-nine subjects were selected. Professional instruction and written brushing instructions were given. After thorough supra-gingival scaling and polishing, all subjects were asked to abstain from oral hygiene procedures for 24 hours prior to the first experiment. The subjects were randomized to a treatment sequence. The modified Quigley and Hein plaque index was recorded pre- and post-tooth brushing, at 6 surfaces of the posterior molars. After a wash-out period, all the remaining plaque was removed professionally. Twenty-four hours of brushing abstinence was again performed. The plaque index was recorded pre- and post-tooth brushing after the subjects were given the second toothbrush in the cross-over sequence. RESULTS: The percentage reductions in plaque scores achieved with the single-tufted brushes were significantly higher than those of the flat-trimmed brush at the maxillary buccal interproximal, marginal and mandibular lingual interproximal site. The other locations showed no significant difference. CONCLUSIONS: The results of the present study implied that the single-tufted brush could be an effective tool for the removal of plaque at some, but not all, sites of the posterior molars.

Avaliação de solução à base de NaOCl 0, 2% na desinfecção das tubulações de água dos equipos odontológicos / Evaluation of NaOCl 0. 2% solution for disinfection of dental equipment waterlines

Objetivo: Avaliar o efeito do hipoclorito de sódio a 0,2% na desinfecção da tubulações de água de equipos odontológicos, previamente contaminadas. Método: Foram obtidas amostras de água dos reservatórios, das mangueiras que suprem as turbinas de alta-rotação e das seringas tríplice de 34 equipos com tubulações desinfetadas com hipoclorito de sódio a 0,2% e de 31 equipos do grupo controle. As amostras foram semeadas em "Plate Count Agar" (ACOMIDIA®) e incubadas em aerobiose a 35oC, durante 48 horas, para avaliar a presença e contagem das unidades formadoras de colônias (UFC) de bactérias heterotróficas por mililitro de água.Utilizou-se como parâmetro para a avaliação das amostras as normatizações do Ministério da Saúde referentes à presença dessas bactérias na água de consumo para humanos. Foram comparados os níveis de contaminação da água dos diversos pontos de coleta e entre os equipos com e sem sistema de desinfecção, através do teste qui-quadrado de Pearson com significância de 5%. Resultados: Nos equipos que sofreram desinfecção das tubulações de água, as amostras estavam contaminadas em 41,2% dos reservatórios, 67,7% das mangueiras alta-rotação e 64,7% das seringas tríplices. Não houve diferença significativa na contaminação entre os diversos pontos de coleta e entre os equipamentos com e sem sistema de desinfecção (p maior que 0,05). Conclusão: O método proposto foi ineficaz na desinfecção das tubulações de água de equipos odontológicos, previamente contaminadas. Com base nos resultados obtidos, sugere-se novos estudos para o desenvolvimento de um protocolo padrão para a desinfecção das tubulações de água de equipos odontológicos.

Objective: To evaluate a method that uses 0.2% sodium hypochlorite as disinfectant agent for disinfection of dental equipment waterlines. Method: Water samples were obtained from different sources, which include: water reservoirs, high-speed turbine supply hoses, triple syringe pipes of 34 devices disinfected with 0.2% sodium hypochlorite, and 31 dental equipment units in the control group. The samples were plated onto plate count agar (ACOMIDIA®) and incubated aerobically at 35oC for 48 hours to assess the presence and counting of colony forming units (CFU) of heterotrophic bacteria per milliliter of water. The regulations of the Ministry of Health were used as parameter to assess the presence of heterotrophic bacteria in drinking water for humans. Comparison of the water contamination levels was performed between the various collection points and between the different devices with and without disinfection system, using the chi-square test at 0.05 significance level. Results: Dental equipment disinfected with 0.2% sodium hypochlorite showed contamination in 41.2% of the reservoirs, 67.7% of high-speed handpiece waterlines and 64.7% of air/water syringes. There was no significant difference between contamination of the various collection points, and between the different equipments with and without disinfection system (p greater than 0.05). Conclusion: The proposed method was ineffective in disinfecting previously contaminated dental equipment waterlines. Based on the results, further studies are suggested to develop a standard protocol for the disinfection of dental equipment waterlines.