Tasa de supervivencia de prótesis fija unitaria de cerámica feldespática y feldespática reforzada / Survival rate of feldspathic and reinforced feldspathic ceramic single-unit fixed prostheses

Introducción: Gracias a su eficiencia y al uso exclusivo de cerámicas libres de metal, en rehabilitación oral se ha logrado alcanzar los estándares estéticos y mecánicos, manteniendo o, incluso, superando, la calidad de los tratamientos en comparación con las restauraciones metal cerámicas tradicionales. Actualmente los mecanismos de confeccion de cerámica libre están evolucionando cada vez mas hacia las tecnologías maquinadas CAD-CAM y disminuyendo su producción mediante la técnica de Inyeccion PRESS. Objetivo: Comparar la tasa de supervivencia de prótesis fija unitaria realizadas con cerámicas feldespáticas convencionales y reforzadas con disilicato de litio, confeccionadas con sistema CAD/CAM de CEREC® chair-side, en comparación con el método de inyección de laboratorio PRESS convencional de prensión. Métodos: Revisión sistemática realizada a través de búsqueda de evidencia científica en PubMed, PubMed Clinical Queries, Epistemónikos, Tripdatabase, Cochrane Library, recursos electrónicos de la Universidad de los Andes y bibliografía retrógrada, de artículos publicados hasta el año 2019. Se incluyeron todos aquellos estudios referentes a prótesis fija unitaria de cerámicas feldespática convencional y feldespática reforzada con disilicato de litio, confeccionadas mediante CAD/CAM y/o método convencional. Resultados: Un total de 28 artículos cumplieron los criterios de inclusión: 21 estudios observacionales de cohorte, 4 ensayos clínicos aleatorizados y 3 no aleatorizados. A corto y mediano plazo, CAD/CAM de CEREC® registró tasas de supervivencia de 98 por ciento y 91,9 por ciento, respectivamente. El sistema convencional registró tasas de supervivencia de 97,5 por ciento a corto plazo y 93 por ciento a mediano. Conclusiones: A corto plazo se describe en la literatura que CAD/CAM de CEREC® tuvo una tasa de supervivencia ligeramente superior al sistema convencional. Por otro lado, a mediano plazo CAD/CAM de CEREC® presentó una leve disminución respecto al sistema convencional. Aún no hay estudios disponibles para determinar la supervivencia clínica de los tratamientos a largo plazo(AU)

Introduction: Thanks to its efficiency and the exclusive use of metal-free ceramics, in oral rehabilitation it has been possible to achieve aesthetic and mechanical standards, maintaining or even exceeding the quality of the treatments compared to traditional metal-ceramic restorations. Currently, free ceramic manufacturing mechanisms are increasingly evolving towards CAD-CAM machined technologies and decreasing their conventional production through the PRESS Injection technique. Objective: Compare the survival rate of single-unit fixed prostheses made with conventional feldspathic ceramics and reinforced with lithium disilicate by the CEREC® CAD/CAM chairside system, with the conventional PRESS laboratory injection method. Methods: A systematic review was conducted of scientific evidence included in papers published until the year 2019 in PubMed, PubMed Clinical Queries, Epistemonikos, Tripdatabase, Cochrane Library, electronic resources of Los Andes Peruvian University, and retrograde bibliography. The papers selected dealt with conventional and lithium-disilicate reinforced feldspathic ceramic single-unit prostheses made by CAD/CAM and/or the conventional method. Results: A total 28 papers met the inclusion criteria. Of these, 21 were observational cohort studies, four were randomized clinical assays and three were non-randomized assays. Short- and mid-term, CEREC® CAD/CAM achieved survival rates of 98 percent and 91.9 percent, respectively. The conventional system achieved survival rates of 97.5 percent short-term and 93 percent mid-term. Conclusions: As described in the literature, CEREC® CAD/CAM had a slightly higher survival rate than the conventional system in the short term. In the medium term, however, CEREC® CAD/CAM displayed a slight reduction in comparison with the conventional system. No studies are available to determine the clinical survival of the treatments in the long term(AU)

Alternativas de tratamientos de superficie para adhesión de cerámica de disilicado de litio / Alternatives of surface treatments for adhesion of lithium disilicate ceramics

Introduction: the clinical success of a restoration is strongly associated with the quality and durability of the ceramic-cement resin interface. In order to obtain an adequate union between these materials of different nature surface treatments are used and achieve mechanical retention or chemical interaction. Objectives: to check if any method promotes a true chemical bond between lithium disilicate ceramics and resin cement. As well as determineif there is any treatment that reports bonding values comparable to hydrofluoric acid and silane (gold standard). Methods: a systematic literature review was developed based on the PRISMA strategy, where the databases were searched: Science Direct, Pubmed (MEDLINE), EMBASE, Springer Journal, SciELO with MeSH and free terms from 2005 to November 2016 for articles in English and Spanish on surface treatments for lithium disilicate. Results: from 58 publications selected a sample of 21 articles. Two articles reported high risk of bias. Conclusions: hydrofluoric acid and silane continue to be the method with the highest and most reliable adhesion values in the literature. Universal adhesives are an alternative to promote chemical adhesion additional to the silane. Diamond burs, Nd: YAG and Er: YAG laser are not recommended as surface treatments(AU)

Introducción: el éxito clínico de una restauración se asocia fuertemente a la calidad y duración de la interface cerámica-cemento resinoso. Para que exista una adecuada unión entre estos materiales de distinta naturaleza se emplean tratamientos de superficie para lograr una buena retención mecánica o interacción química. Objetivos: revisar si algún método promueve una verdadera adhesión química entre la cerámica de disilicato de litio y el cemento resinoso, así como determinar si existe algún tratamiento que reporte valores de unión comparables al ácido fluorhídrico y silano (patrón de oro). Métodos: se desarrolló una revisión sistemática de literatura basada en la estrategia PRISMA, donde se buscó en las bases de datos: Science Direct, Pubmed (MEDLINE), EMBASE, Springer Journal, SciELO con términos MeSH y libres desde el 2005 a noviembre de 2016 para artículos en inglés y español sobre tratamientos de superficie para disilicato de litio. Resultados: de 58 publicaciones, se seleccionó una muestra de 21 artículos. Dos artículos reportaron riesgo de sesgo alto. Conclusiones: el ácido fluorhídrico y silano continúan siendo el método con los valores de adhesión más altos y confiables de la literatura. Los adhesivos universales son una alternativa para promover adhesión química adicional al silano. Fresas diamantadas, laser Nd: YAG y Er:YAG no se recomienda como tratamientos de superficie(AU)

Efeito da quantidade de queimas e caracterização extrínseca no comportamento mecânico e físico do dissilicato de lítio / Effect of the number of firings and extrinsic characterization on the mechanical and physical behavior of lithium disilicate

Essa pesquisa avaliou o comportamento mecânico e físico das repetidas queimas provenientes das técnicas de caracterização extrínseca do dissilicato de lítio (DL). Duzentos e setenta discos de DL foram fabricados de acordo com a ISO 6872/2008 e distribuídos nos diferentes grupos (n=30). Controles (CO), nos quais não foram realizados caracterização extrínseca. Caracterizados nos quais as queimas de cristalização e do glaze foram realizadas em passo único com IPS e.max CAD Crystall e Glaze Paste (Ivoclar Vivadent) (CR). E caracterizados nos quais as cerâmicas foram primeiramente cristalizadas, seguido da aplicação do IPS e.max Ceram Shades e do Glaze Paste (Ivoclar Vivadent) (CE). Cada tipo de caracterização teve suas amostras submetidas a duas, quatro ou seis queimas: COII, COIV, COVI, CRII, CRIV, CRVI, CEII, CEIV e CEVI. Análises de cor e translucidez foram realizadas com espectrofotômetro colorimétrico após as diversas queimas (n=20). Espectroscopia de raios X por dispersão em energia (EDS), difração de raios-X (DRX) e Raman foram utilizadas para análise de elementos químicos. A rugosidade Ra e a nanodureza Vickers também foram aferidas. Testes de flexão biaxial (n = 10, 1000 kgf, 1 mm/min) e de fadiga ­ staircase (n = 20, 5x104 ciclos, 5Hz, tensão inicial ­ 50% e incremento 5% da carga inicial de fadiga) foram realizados. Análises microscópicas da superfície das amostras (estereomicroscopia, mapping e MEV) também foram feitas. ANOVA um fator e Tukey foram os testes estatísticos utilizados (α=0,05). Para o CE e CO6X-2X, os valores de ΔE00 foram demonstrativos de alterações inaceitáveis de cor (ΔE00 > 1,8). Grupo CO demostrou alterações significativas de translucidez (p = 0,02), já para CE (p = 0,09) e CR (p = 0,26) os valores aumentaram significativamente. Os valores Ra indicaram diferenças significativas devido ao tipo de caracterização (p < 0,000) e número de queimas, porém desse último fator somente para os grupos CO (p = 0,001) e CE (p = 0,008). O EDS e o DRX revelaram uma maior quantidade de conteúdo amorfo para CE e CR. Os valores de nanodureza dentre os grupos testados foram estatisticamente similares. O fator quantidade de queimas não foi capaz de influenciar a resistência máxima das cerâmicas, no entanto, o tipo de caracterização reduziu significativamente essa propriedade mecânica (p = 0,001). A fadiga reduziu a resistência do DL em todos os grupos, mas os grupos CR mantiveram resistência semelhantes (CRII e CRIV) ou até superiores (CRVI) aos grupos controles. As interfaces entre material utilizado para caracterização e o DL mostraram apenas sobreposição de materiais para os grupos CE, já para os CR sugere-se que a maquiagem consegue se inter-relacionar com a cerâmica(AU)

The objective of this research was to evaluate the mechanical and physical behavior of repeated firings from the aesthetic characterization of lithium disilicate (LD). Two hundred and seventy LD discs were manufactured according to ISO 6872/2008 and distributed in different groups (n = 30): controls (CO), in which no aesthetic characterization was made; characterized in which the crystallization and glaze firings were performed in a single step with IPS e.max CAD Crystall and Glaze Paste (Ivoclar Vivadent) (CR); and characterized in which the ceramics were first crystallized, followed by the IPS e.max Ceram Shade and Glaze Paste (Ivoclar Vivadent) application (CE). Each type of characterization had samples submitted to two, four or six firings: COII, COIV, COVI, CRII, CRIV, CRVI, CEII, CEIV and CEVI. Color and translucency analyzes were performed with a colorimetric spectrophotometer after the burnings (n = 20). X-ray dispersive energy spectroscopy (EDS), X-ray diffraction (XRD) and Raman spectroscopy were used to analyze chemical elements. Roughness (Ra) and Vickers nano-hardness were also measured. Biaxial flexion tests (n = 10, 1000 kgf, 1 mm/min) and fatigue - staircase (n = 20, 5x104 cycles, 5 Hz, initial tension - 50% and 5% increment of initial fatigue load) . Microscopic analysis of sample surfaces (stereomicroscopy, mapping and scanning electron microscope - SEM) were also performed. One-way ANOVA and Tukey were the statistical tests used (α = 0.05). For CE and CO6X-2X, values of ΔE00 were demonstrative of unacceptable color changes (ΔE00> 1.8). Group CO showed significant changes of translucency (p = 0.02); for CE (p = 0.09) and CR (p = 0.26) the values increased significantly. The values of nano-hardness among the nine groups were statistically similar (p> 0.05). However, Ra values indicated significant differences due to the type of characterization (p < 0.01) and number of firings, but this last factor affected only the CO and CE (p < 0.01) groups. EDS and DRX revealed a greater amount of amorphous content for EC and CR. The number of firings was not able to influence the maximum strength of the ceramics, however, the characterization type significantly reduced this mechanical property (p = 0.001). Fatigue reduced LD strength in all groups, but CR groups maintained similar values (CRII and CRIV) or even higher (CRVI) that the control groups. The interfaces between the material used for characterization and the DL showed only an overlap of materials for the CE groups, whereas for the CR it is suggested that this aesthetic characterization can interrelate with the LD ceramics(AU)

O efeito do envelhecimento por fadiga na microestrutura de cerâmicas y-tzp sinterizadas por energia de micro-ondas / The effect of fatigue aging on the microstructure of y-tzp ceramics sintered by microwave energy

O objetivo deste trabalho foi avaliar o efeito da fadiga na microestrutura de uma cerâmica odontológica (Y-TZP) sinterizada pelo método convencional ou por energia de micro-ondas. A hipótese nula foi que a fadiga não irá gerar alterações na microestrutura deste material. Para isto, foram confeccionados, por meio de um sistema CAD/CAM, 84 discos de zircônia (VIPI block zircon) com características finais de 12 mm de diâmetro e 1,2 mm de espessura conforme a norma ISO 6872. Os espécimes foram separados em dois grupos: Grupo I ­ Sinterização convencional: ciclo estabelecido pelo fabricante (2 horas a 1530 °C) e Grupo II ­ sinterização por energia de micro-ondas (15 min a 1450 °C). Dez amostras por grupo foram submetidas ao teste monotônico (1000 KgF ­ 1mm/min) para a determinação da carga para fratura, utilizada como parâmetro para os testes de fadiga (método step-stress e fadiga dinâmica). O teste de fadiga step-stress foi realizado utilizando 4 perfis de carga, ultra-suave, suave, moderado e agressivo, até que ocorresse a fratura. A fadiga dinâmica foi realizada com o ensaio dos discos até fratura sob cinco taxas de tensão (1, 0,1, 0,01, 0,001 e 0,0001 MPa/s), e a partir disso foram calculados o coeficiente de crescimento de trincas e módulo de Weibull (confiabilidade) para cada grupo. Foram realizadas análises complementares de densidade, translucidez, microscopia eletrônica de varredura (MEV) e difratometria de Raios-X (DRX) de ambos os grupos para a caracterização dos materiais. Os resultados da fadiga step-stress não mostraram diferenças no comportamento dos espécimes de cada grupo. Na fadiga dinâmica, os métodos de fadiga também não mostraram diferenças no comportamento e tiveram coeficientes de crescimento de trinca similares. O modulo de Weibull mostrou maiores valores de confiabilidade para o grupo micro-ondas (m = 7,9) do que para o grupo de sinterização convencional (m = 6,7). Os valores de densidade também foram semelhantes para os grupos estudados, já a translucidez foi menor para o grupo micro-ondas. As imagens de MEV mostraram microestruturas similares entre grupos, apenas uma diferença no tamanho dos grãos foi observada, 0,53 µm para os grãos de microondas e 0,89 µm para os grãos dos espécimes sinterizados convencionalmente. Conclui-se que o processo de sinterização por microondas pode ser aplicado como alternativa de sinterização de zirconia ao dia-a dia laboratorial(AU)

The objective of this work was to evaluate the microstructure and fatigue behavior of a dental ceramic (Y-TZP) sintered by conventional method or by microwave energy. The null hypothesis was that the fatigue will not effect the microstructure of this material. 84 zirconia discs (VIPI block zircon) with final characteristics of 12 mm in diameter and 1.2 mm in thickness according to ISO 6872 were made using a CAD/CAM system. The specimens were divided in two groups: Group I - Conventional sintering: cycle established by the manufacturer (2 hours at 1530 °C) and Group II - sintering by microwave energy (15 min at 1450 °C). Ten samples per group were submitted to monotonic test (1000 KgF - 1mm/min) to determine the load to fracture, used as a parameter for fatigue tests (step-stress and dynamic fatigue). The step-stress fatigue test was performed using 4 load profiles, ultramild, mild, moderate and aggressive, until the fracture. The dynamic fatigue was performed by testing the disks to fracture under five constant stress rates (1, 0.1, 0.01, 0.001 and 0.0001 MPa/s), and from this the crack growth coefficient and Weibull module (reliability) were measured for each group. Additional analyzes of density, translucency, scanning electron microscopy (SEM) and X-ray diffractometry (XRD) for both groups were carried out to characterize the materials. The results of stepstress fatigue test did not show differences in the specimens behavior of each group. Dynamic fatigue also showed no differences in behavior and had similar crack growth coefficients. The Weibull modulus showed higher reliability values for the microwave group (m = 7.9) than for the conventional sintering group (m = 6.7). The density values were also similar for the studied groups, since the translucency was lower for the microwave group. SEM images showed similar microstructures between groups, only a difference in grain size was observed, 0.53 µm for microwave grains and 0.89 µm for the conventionally-sintered grains. It is concluded that the microwave sintering process can be applied as an alternative to zirconia sintering to daily laboratory work(AU)

Influência do tratamento do substrato com plasma não térmico na resistência de união em cimentação adesiva / Influence of the substrate treatment with non-thermal plasma on bond strength of adhesive cementation

Objetivo: avaliar a influência do tratamento de superfície com plasma não térmico de argônio (PLA) na resistência de união de cimentos resinosos ao esmalte, à dentina e à cerâmica de dissilicato de lítio. Observar, no esmalte e na dentina, através de espectroscopia de infravermelho por transformada de Fourier (FTIR) os compostos inorgânicos e da cromatografia gasosa a alteração dos compostos orgânicos voláteis nas condições experimentais propostas. Material e Método: Foram avaliados 3 cimentos resinosos: Variolink Esthetic LC e N (Ivoclar Vivadent), e Panavia V5 (Kuraray). Foram utilizados 240 dentes bovinos, dos quais 150 tiveram a superfície do esmalte exposta e 90 a de dentina. Foram obtidas 150 lâminas de cerâmica de dissilicato de lítio (12 x 14 x 0,5 mm). Os grupos foram divididos de acordo com o tratamento de superfície e o substrato. Os tratamentos para as superfícies de esmalte e dentina foram: EA (esmalte/ácido fosfórico); DA (dentina/ácido fosfórico); EPS (esmalte/PLA 30 s); EPM (esmalte/PLA 1 min); DPS (dentina/PLA 30 s); EAPS (esmalte/ácido fosfórico/PLA 30 s) e EAPM (esmalte/ácido fosfórico/PLA 1 min); e, DAPS (dentina/ácido fosfórico/PLA 30 s). Os tratamentos para as superfícies da cerâmica foram: CA (cerâmica/ácido fluorídrico), CPS (cerâmica/PLA 30 s); CPM (cerâmica/PLA 1 min); CAPS (cerâmica/ácido fluorídrico/PLA 30 s) e CAPM (cerâmica/ácido fluorídrico/PLA 1 min). Posterior aos tratamentos, cilindros dos cimentos resinosos (0,8 mm/1,5 mm) foram confeccionados sobre as superfícies dos substratos. Após 48 h, os espécimes foram submetidos ao ensaio mecânico de microcisalhamento (10 Kgf/1 mm/min) até a fratura. A área fraturada foi analisada em estereomicroscópio. As superfícies tratadas e a interface adesiva foram analisadas por Microscopia Eletrônica de Varredura (MEV). Através do FTIR foram observados os espectros de amostras tratadas de esmalte e dentina. Os dados da resistência de união foram submetidos à análise estatística ANOVA e teste de Tukey (5%). Resultados: Para o esmalte os tratamentos de superfície não apresentaram diferença estatisticamente significante entre si; para a dentina o grupo DPS apresentou os maiores valores de resistência de união; e, para a cerâmica o tratamento CA apresentou os maiores valores de resistência de união. Para esmalte e dentina, o FTIR, mostrou alterações do conteúdo da água, carbonato e fosfato e a cromatografia gasosa das substâncias orgânicas voláteis. Conclusão: O tratamento de superfície com PLA não influencia a resistência de união de cimentos resinosos ao esmalte, aumenta à dentina e diminui ao dissilicato de lítio. As análises observacionais no FTIR sugerem que o plasma não altera compostos do esmalte e da dentina(AU)

Objective: to evaluate the influence of surface treatment with non - thermal argon plasma (PLA) on bond strength of resin cements to enamel, dentin and lithium disilicate glass ceramic; and, to observe, through Fourier Transform Modified Infrared Spectroscopy (FTIR), the inorganic compounds and through gas chromatography, the alteration of the volatile organic compounds, on the enamel and dentin, under the experimental conditions. Material and Method: Three resin cements: Variolink Esthetic LC and N (Ivoclar Vivadent) and Panavia V5 (Kuraray) were evaluated. Twenty hundred and forty bovine teeth were used, among which 150 specimens with enamel surface exposure and 90 with dentine exposure. One hundred and fifty lithium disilicate glass ceramic slices (12 x 14 x 0.5 mm) were obtained. The groups were divided according to the substrate and surface treatment. The treatments for enamel and dentin surfaces were: EA (enamel / phosphoric acid); DA (dentin / phosphoric acid); EPS (enamel / PLA 30 s); EPM (enamel / PLA 1 min); DPS (dentin / PLA 30 s); EAPS (enamel / phosphoric acid / PLA 30 s) and EAPM (enamel / phosphoric acid / PLA 1 min); and, DAPS (dentin / phosphoric acid / PLA 30 s). The treatments for the ceramic surfaces were: CA (ceramic / hydrofluoric acid), CPS (ceramic / PLA 30 s); CPM (ceramic / PLA 1 min); CAPS (ceramic / hydrofluoric acid / PLA 30s) and CAPM (ceramic / hydrofluoric acid / PLA 1 min). After the treatments, resin cement cylinders (0.8 mm / 1.5 mm) were built on the substrate's surfaces. After 48 h storage bond strength tests (µSBS) were performed in a universal testing machine (10 Kgf / 1 mm / min) until failure to fracture, and failure mode was analyzed under a stereomicroscope. The treated surfaces and the adhesive interface were analyzed by Scanning Electron Microscopy (SEM). The FTIR was used to observe the spectra of enamel and dentin treated samples. Bond strength data were submitted to ANOVA and Tukey test (5%). Results: for the enamel there was not a statistically significant difference among surface treatments; for the dentin, the DPS group presented the highest bond strength; and for the ceramic the AC treatment presented the highest values of bond strength. For the enamel and the dentin samples, the FTIR observations showed changes in water, carbonate and phosphate contents and the gas chromatography in the volatile organic substances. Conclusion: Surface treatment with PLA does not influence the bond strength of resin cements to the enamel, increases the bonding to dentin and decreases to the lithium disilicate. Observational analysis on FTIR suggest that non-thermal plasma does not alter enamel and dentin compounds(AU)

Negative Effect of Rapidly Resorbing Properties of Bioactive Glass-Ceramics as Bone Graft Substitute in a Rabbit Lumbar Fusion Model

BACKGROUND: Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. METHODS: This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). RESULTS: In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. CONCLUSIONS: The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass-ceramics are resorbed before bony fusion.

Fatores associados às alterações da função pulmonar em trabalhadores de indústria de cerâmica / Factors associated with alterations in lung function among workers in the ceramics industry

O objetivo deste artigo é analisar a função pulmonar em trabalhadores de indústrias de cerâmica no município de Várzea Grande, Mato Grosso. Estudo transversal realizado com 183 trabalhadores de indústrias de cerâmica desse município. Para identificação dos fatores sociodemográficos, fatores ambientais e do tabagismo foi utilizado um questionário estruturado e para avaliação da função pulmonar foi realizada a espirometria. Foram realizadas análises descritiva, bivariada e regressão múltipla de Poisson. Os trabalhadores em sua maioria são do sexo masculino (94%) predominando indivíduos com idade até 39 anos (74,9%). A prevalência de sintomáticos respiratórios foi de 44,9%, sendo 14,8% portadores de sintomas considerados como graves e 30,1% sintomas não graves. Foram encontradas associações de função pulmonar alterada com as variáveis tempo de exposição e substância inalada. Os trabalhadores com 4 ou mais anos de exposição apresentaram 1,99 vezes mais função pulmonar alterada que os indivíduos com tempo de exposição de até 3 anos ; os indivíduos que inalaram poeira e desmoldante apresentaram 2,97 vezes mais alteração da função pulmonar. Esta, nos trabalhadores avaliados, está relacionada ao maior tempo de exposição e à inalação de poeira e desmoldante.

This article seeks to assess lung function in workers of ceramic industries in the municipality of Várzea Grande - Mato Grosso. A cross-sectional study of 183 workers was conducted in the ceramics town of Várzea Grande (MT). A structured questionnaire was used to identify socio-demographic factors, environmental factors and smoking. and spirometry was performed to evaluatie the pulmonary function. Descriptive analysis and bivariate and multiple Poisson regression were performed. The workers are mostly male (94%) with a predominance of individuals aged 39 years (74.9%). The prevalence of respiratory symptoms was 44.9%, 14.8 patients with symptoms considered serious and 30.1% with non-serious symptoms. Associations were found of abnormal pulmonary function with the variables of exposure time and substance inhaled. Employees with four or more years of exposure had 1.99 times more lung function alterations than individuals with exposure time of up to 3 years; individuals who had inhaled dust and mold release had 2.97 times higher alteration in lung function. The change in lung function in workers assessed is related to longer exposure and inhalation of dust and mold release.

Effect of surgically implanted root-end filling materials on the structure of draining lymph nodes of male albino rats: histological and immunohistochemical study

The success of endodontic surgery depends on the histocompatibility of the root-end filling material. Applications of nanotechnology improve their performance. Aim of the work was to compare the effect of a mineral trioxide aggregate [MTA]and a bioceramic nanoparticulate bioaggregate [BNB] on the histological structure of draining axillary lymph nodes of adult male albino rats after their surgical implantation into the skin. Forty adult male albino rats were divided into control and experimental groups.The latter was subdivided into MTA and BNB surgically implanted subgroups. After 7 days, the rats were sacrificed. Paraffin sections from both the proximal part of the dorsal skin and draining axillary lymph nodes were processed for H and E staining.Lymph node sections were further subjected to silver reticulin, Verhoeff's Van Gieson stains as well as kappa light chains. Quantitative assessments and statistical analysis of the results were carried out. There was an increase in mononuclear inflammatory cells infiltrating the skin in the MTA subgroup. Lymph nodes of the MTA subgroup showed a marked decrease in the lymphocyte content of lymphatic nodules, wide lymph sinuses, multinucleate giant cells, and many macrophages. In the BNB-treated subgroup, lymphatic nodules had wide corona and small germinal centers. Reticular and collagen fibers were increased in the MTA subgroup. Kappa light chains' immunoreactions were strong positive in MTA and mild positive in BNB subgroups. A highly significant increase in the mean area% of all fibers and kappa light chain immunoexpression of lymph nodes of the MTA subgroup were observed. MTA had less biocompatibility. BNB showed limited signs of acute inflammation. BNB is an up-to-date alternative to the currently used root-end filling materials. The chronic effects caused by BNB may require further study

[Evaluation of respiratory disorders associated with occupational inhalation exposure to raw materials used in ceramic production]

The main purpose of this study was to assess the pulmonary reactions associated with occupational inhalation exposure to raw materials used in ceramic production [RMCP]. Thirty three male workers with current exposure to RMCP and 20 healthy male unexposed employees, with almost identical demographic and socioeconomic status were interviewed and respiratory symptom questionnaires were administered to them. Furthermore, they underwent chest X-ray and lung function tests. Additionally, personal dust monitoring was carried out at dusty work sites. To determine the chemical composition, possible silica phases and SiO2 contents of dust samples, they were analyzed by X-ray diffraction [XRD] and X-ray fluorescence [XRF] techniques. Atmospheric concentrations of dust, that contained 69% SiO[2], exceeded current permissible levels. Additionally, exposed workers had higher prevalence rates of regular cough, wheezing, phlegm and shortness of breath. Likewise, their chest radiographs showed some degrees of abnormalities. Furthermore, significant reductions in some parameters of pulmonary functions of exposed workers were noted. The findings of this study indicate that a strong association exists between exposure to RMCP, prevalence of respiratory symptoms, abnormal changes in chest radiographs and functional impairments of the lungs

Determining lead sources in Mexico using the lead isotope ratio

OBJECTIVE: Lead poisoning can, in some cases, be traced to a specific route or source of exposure on the basis of the individual's blood lead isotope ratio. To assess the major source of lead exposure among women residing in Mexico City, we compared blood, ceramic, and gasoline lead isotope ratios. MATERIAL AND METHODS: The study population, randomly selected from participants of a large trial, (1/1996-12/1996) comprised of 16 women whose lead levels exceeded 10 æg/dl and who reported using lead-glazed ceramics. Lead isotope ratios were performed on a Perkin Elmer 5000 Inductively Coupled Plasma Mass Spectrometer (ICP-MS) interfaced with a Perkin Elmer HGA-600MS Electrothermal Vaporization System (ETV). RESULTS: The isotope ratios (206Pb/204Pb, 207Pb/204Pb, and 208Pb/204Pb) of both the blood specimens and their corresponding ceramic specimens were highly correlated, with r=0.9979, r²=0.9958, r=0.9957, r²=0.9915 and r=0.9945, r²=0.9890 values for the three isotope ratios, respectively, suggesting that the lead exposure most likely resulted from the use of these ceramic. Measurements of lead isotope ratios from leaded gasoline in use at the time of blood sampling, differed from those in blood and ceramics. CONCLUSIONS: Determining lead isotope ratios can be an efficient tool to identify a major source of lead exposure and to support the implementation of public health prevention and control measures.

Niveles de plomo sanguíneo en madres y recién nacidos derechohabientes del Instituto Mexicano del Seguro Social / Blood lead levels in newborns children and mothers covered by the Mexican Institute of Social Security

Objetivo. Establecer la relación entre el nivel de plomo sanguíneo materno (PSM) y el de sangre en cordón umbilical (PSC) al momento del parto, así como determinar los principales predictores del PSM en derechohabientes del Instituto Mexicano del Seguro Social (IMSS), en el Distrito Federal (D.F.). Material y métodos. Se realizó un estudio transversal en el que se reclutaron voluntarias con embarazo normoevolutivo y se les tomaron muestras de sangre al momento del parto, en cuatro hospitales del IMSS en el D.F., de 1991 a 1993. Se tomó, además, muestra de sangre de cordón umbilical. Los datos fueron analizados mediante regresión lineal simple y múltiple. Resultados. Se estudiaron un total de 1 404 binomios madre-hijo; el promedio de edad de las madres fue de 25 años. La media de PSM fue 10.7 ñ 6.5 µg/dl; no se encontraron variaciones significativas por hospital, edad o estado civil. Para el PSC la media fue de 10.4 ñ 6.2 µg/dl. Por cada aumento en una unidad logarítmica de PSM, el PSC aumenta 0.62 (p<0.01) unidades logarítmicas. La correlación entre ambos fue de 0.61 (p<0.01). Los principales predictores de PSM fueron el uso de loza vidriada, el consumo de leche y jugo de naranja, estos últimos se asociaron inversamente con el PSM. Un 47 por ciento de las madres y 50 por ciento de los niños tuvieron valores superiores a 10 µg/dl. En 578 recién nacidos se registraron niveles de plomo superiores a los de la madre. Conclusiones. Se sugiere continuar la línea de investigación para proponer tipos de intervención.

Eliminación del plomo por curado casero / Lead elimination by traditional acidic curing

Objetivo. Evaluar el curado ácido como medida preventiva para reducir el contenido de plomo en vasijas de barro vidriadas. Material y métodos. En 27 vasijas de barro procedentes de cuatro estados de México se determinó, mediante espectrofotometría de absorción atómica, el nivel de plomo residual, después de cuatro lavados con ácido acético al 3 por ciento. Resultados. El contenido de plomo en el ácido acético utilizado para lavar las vasijas disminuyó proporcionalmente con el número de lavados, aunque se conservo por arriba de los niveles permisibles (2.5-7.0 p.p.m.). Conclusiones. El curado ácido de piezas de barro no es una medida preventiva útil para reducir la exposición a plomo