Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in NCCL - a randomized controlled clinical trial

Abstract Objective The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). Material and Methods Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). Results The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. Conclusion GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.

Longevity of metal-ceramic crowns cemented with self-adhesive resin cement: a prospective clinical study

Abstract Resin cements are often used for single crown cementation due to their physical properties. Self-adhesive resin cements gained widespread due to their simplified technique compared to regular resin cement. However, there is lacking clinical evidence about the long-term behavior of this material. The aim of this prospective clinical trial was to assess the survival rates of metal-ceramic crowns cemented with self-adhesive resin cement up to six years. One hundred and twenty-nine subjects received 152 metal-ceramic crowns. The cementation procedures were standardized and performed by previously trained operators. The crowns were assessed as to primary outcome (debonding) and FDI criteria. Statistical analysis was performed using Kaplan-Meier statistics and descriptive analysis. Three failures occurred (debonding), resulting in a 97.6% survival rate. FDI criteria assessment resulted in scores 1 and 2 (acceptable clinical evaluation) for all surviving crowns. The use of self-adhesive resin cement is a feasible alternative for metal-ceramic crowns cementation, achieving high and adequate survival rates.

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais / HIV-Associated facial lipoatrophy: from the advent to current knowledge

O advento da AIDS trouxe novos desafios para a Dermatologia. A terapia antirretroviral mudou drasticamente a morbimortalidade associada à infecção pelo HIV/AIDS, mas contribuiu para o surgimento de outras novas situações que exigem abordagem adequada do dermatologista. A Síndrome Lipodistrófica Associada ao HIV/AIDS tem origem multifatorial, mas está fortemente associada ao uso dos antirretrovirais. Compreende alterações na distribuição da gordura corporal, acompanhada ou não de alterações metabólicas. A perda da gordura da face, chamada lipoatrofia facial, é dos sinais mais estigmatizantes da síndrome. Esta condição, muitas vezes reveladora da doença, trouxe de volta o estigma da AIDS. É necessário que os especialistas que atuam com pacientes com HIV/AIDS identifiquem estas alterações e busquem opções de tratamento, dentre as quais se destaca o implante com polimetilmetacrilato, que é disponibilizado para tratamento da lipoatrofia facial associada ao HIV/AIDS no Sistema Único de Saúde.

The advent of AIDS has brought new challenges to Dermatology. Antiretroviral therapy dramatically changed the morbidity and mortality associated with HIV / AIDS, but contributed to the emergence of other new situations that require adequate approach by the dermatologist. The HIV / AIDS Associated Lipodystrophy Syndrome is multifactorial in origin, but it is strongly associated with the use of antiretroviral drugs. It includes changes in body fat distribution, with or without metabolic changes. The loss of facial fat, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome. This condition, often revealing of the disease, brought back the stigma of AIDS. It is necessary that the specialists working with patients with HIV / AIDS identify these changes and seek treatment options, amongst which stands out the implant with polymethylmethacrylate, which is available for the treatment of HIV / AIDS facial lipoatrophy in the Brazilian Public Health System.

Development of mesalazine pellets coated with methacrylic-derived polymer / Desenvolvimento de pelotas mesalazina revestidos com metacrílico derivado de polímero

Mesalazine (5-ASA) is the standard drug for the treatment of inflammatory bowel disease (IBD) due to its local effect on intestinal and colonic mucosa. The effective and safe treatment of this disease requires more efficient delivery of the active substance to its site of action. The focus of this study was the use of multiparticulate systems, a modified release form in which the drug is divided into several functional subunits of release in the form of granules or pellets. When these forms are administered, they are rapidly disintegrated, distributing their content throughout the gastrointestinal tract. The aim of this study was to develop and evaluate a multiparticulate system consisting of pellets coated with polymer for pH-dependent release, derived from methacrylic acid and incorporated into the tablet dosage form of mesalazine as a model drug. The extrusion-spheronisation technique was used, resulting in smooth and spherical pellets with uniform size distribution, which were coated in fluidized bed using Opadry® Enteric 94K28327 containing Eudragit® S100 as the agent regulating drug release. The dissolution profile of coated pellets showed good control of drug release from the polymer at the two levels of coating evaluated (8 percent and 10 percent), but only the 10 percent coated pellets were statistically similar to Asalit® 400 mg.

A mesalazina (5-ASA) tem se apresentado como fármaco padrão para o tratamento da doença inflamatória intestinal (DII) devido ao seu efeito local na mucosa intestinal e colônica. A terapia efetiva e segura desta doença requer a chegada da substância ativa ao seu local de ação com maior eficiência. Nessa busca, tem se destacado o uso de Sistemas Multiparticulados, forma farmacêutica de liberação modificada, em que o fármaco está dividido em várias subunidades funcionais de liberação, sob a forma de grânulos ou péletes, que quando administrados, são rapidamente desintegrados distribuindo seu conteúdo por todo trato gastrintestinal. Este trabalho teve como objetivo desenvolver e avaliar péletes revestidos com polímero de liberação pH-dependente, derivado do ácido metacrílico, tendo como fármaco modelo a mesalazina. A técnica de extrusão-esferonização foi utilizada obtendo-se péletes lisos e esféricos com distribuição granulométrica uniforme, que foram revestidos em leito fluidizado utilizando Opadry® Enteric 94K28327 contendo Eudragit® S100 como agente regulador da liberação do fármaco. O perfil de dissolução dos péletes revestidos demonstrou bom controle na liberação do fármaco por parte do polímero nos dois níveis de revestimento avaliados (8 e 10 por cento), porém, apenas os péletes revestidos a 10 por cento demonstraram semelhança estatística com o medicamento de referência Asalit® 400 mg.

Vertebroplastia percutanea como tratamiento de los colapsos vertebrales / Percutaneous vertebroplasty in the treatment

La vertebroplastia percutanea es una tecnica que consiste en la inyeccion de cemento acrilico en el interior del cuerpo de una vertebra patologica a traves de una aguja colocada bajo guia imagenologica. Esta indicada en colapsos vertebrales de origen neoplasico osteoporotico y en angiomas vertebrales. El objetivo es la analgesia y el refuerzo de la vertebra dañada por el colapso. En la serie que se presenta hemos tratado 46 vertebras en 35 pacientes: 3 angiomas, 9 metastasis, 3 mielomas y 31 aplastamientos osteoporoticos

Evolución de las lentes intraoculares y los viscoelásticos / Intraocular lenses and viscoelastic evolution review

Se hace una revisión de la literatura y se relata la evolución de las lentes intraoculares, de sus materiales y diseños, así como de los viscoelásticos.

Utilización del BOP en el tratamiento de fracturas de órbita y fronto-orbitales / The use of bio-compatible osteo-conductor polymer (BOP) for treatment of orbital and fronto-orbital fractures

Desde hace muchos años, se han usado diferentes materiales en el tratamiento de las fracturas orbitarias y fronto-orbitarias. Estos materiales generalmente han sido silastic, proplast, hidroxiapatita, e injertos óseos autólogos u homólogos. Sin embargo, desde hace 13 años se desarrolló en la entonces Unión Soviética un compuesto de N-vinyl 2 pirrolidona, líquido de color amarillo soluble en metanol, acetona, metilmetacrilato, gluconato de calcio y fibras de poliamida a alta tensión; este material fue denominado polímero osteoconductor biocompatible (BOP). Se reportan los resultados preliminares de 20 casos de estas fracturas tratadas con BOP; no hubo complicaciones y se corroboró que el BOP es un material inerte, biocompatible y útil para corregir asimetrías faciales. De acuerdo con los resultados obtenidos hasta el presente, se propone seguir los casos por un periodo más largo, con el objeto de demostrar la osteointegración, ya que la razón del éxito en las 20 fracturas ha sido el hecho de que se ha utilizado el BOP en esta serie como un implante, más que como un injerto, en una zona de efectos biomecánicos mínimos

Vertebroplastia acrílica percutánea: técnica, indicaciones y resultados / Vertebroplasty with acrylic cement: indication and results

Ciertas afecciones raquídeas son responsables de dolores y/o de complicaciones neurológicas secundarias al aplastamiento vertebral que ellas producen. Con el fin de consolidar la vértebra y aliviar el dolor surge la Vertebroplastia Acrílica Percutánea, que consiste en la inyección de cemento acrílico por vía percutánea, propuesta inicialmente en el tratamiento de los angiomas vertebrales agresivos. Luego de realizar una punción biopsia de la vértebra, se inserta una aguja de 10 G en el cuerpo vertebral y se inyectan una mezcla de polvo de tantalio y de metil-metacrilato (3 a 5 ml). Fueron tratados exitosamente con este método 31 pacientes portadores de hemangiomas vertebrales y 10 pacientes con dolores severos debidos al aplastamiento vertebral de origen osteoporótico. Siendo el resultado clínico y radiológico estable con un seguimiento de 6 años para los angiomas vertebrales y de 30 meses en 7 pacientes tratados con osteoporosis. Un efecto analgésico significativo permitió desarrollar una actividad normal a 12 pacientes de los 20 tratados con tumores vertebrales. El efecto analgésico fue durable en 10 de ellos con un seguimiento de 6 meses

Influência do ácido poliacrílico na resistência de união do cimento de ionômero de vidro à dentina / Influence of poly acrylic acid in bond strength of glass ionomer cement to dentin

Foi determinada a resistência de união do cimento de ionômero de vidro CHELON FIL à dentina quando esta era submetida a vários tratamentos superficiais com ácido poliacrílico. Os resultados mostraram que o tratamento dentinário com ácido poliacrílico a 12,5 por cento, aplicado de forma ativa por 15 segundos, foi o que apresentou maiores valores de resistência de união