La odontología verde / Green dentistry

El propósito del presente trabajo está orientado a generar una reflexión entre el gremio odontológico profesional y los estudiantes de las licenciaturas en Odontología respecto a la contaminación global que estamos generando y a la crítica situación del planeta, así como sus consecuencias ambientales y climatológicas, sobre lo importante que es educar bajo la perspectiva de una Odontología Verde y Sostenible a través de la ambientalización curricular en las escuelas y facultades de Odontología para generar un tipo de cultura y conciencia proambiental. De igual forma para señalar lo sencillo que es ambientalizar agradable y relajantemente nuestro entorno educativo y laboral, así como realizar algunas prácticas odontológicas ecológicas y ambientales en la práctica privada que cuestan poco o nada y que, por el contrario, el gran efecto positivo que éstas tendrán en el medio ambiente y la reducción de los niveles de contaminación actuales. Si realmente logramos generar una nueva cultura y conciencia que se preocupe por el medio ambiente en el campo de la Odontología, los resultados para todos se verán reflejados en un mejor ambiente social, educativo de trabajo y de salud (AU)

The purpose of this work is aimed at generating a reflection between the professional dental guild and the students of the Bachelor's Degrees in Dentistry regarding the global pollution that we are generating and the critical situation of the planet and its environmental and climatological consequences, on how important it is educate under the perspective of a Green and Sustainable Dentistry through the greening of the curriculum in the Schools and Faculties of Dentistry to generate a type of culture and pro-environmental awareness. Likewise, point out how simple it is to pleasantly and relaxingly green our educational and work environment, as well as perform some ecological and environment, as well perform some ecological and environment, dental practices in private practice that cost little or nothing and that, on the contrary, the great positive effect that these will have on the environment and the reduction of current pollution levels. If we truly manage to generate a new culture and awareness that cares about the environment in the field of Dentistry, the results for all will be reflected in a better social, educational, work and health environment (AU)

Desinfección y esterilización en odontología frente al COVID-19 / Disinfection and sterilization in dentistry against COVID-19 / Desinfecção e esterilização em odontologia contra a COVID-19

A partir de la declaración de la Organización Mundial de la Salud del comienzo de la pandemia COVID-19 causada por el virus SARS-CoV-2 en marzo de 2020, los profesionales de la salud se vieron expuestos a esta enfermedad altamente contagiosa y potencialmente mortal que generó múltiples desafíos a toda la comunidad científica. Provocando cambios de paradigmas en la atención de los pacientes y en el uso de las barreras de protección personal. A nivel mundial se crearon múltiples protocolos para la atención odontológica a medida que se iba desarrollando e investigando el comportamiento del virus. Esta revisión bibliográfica resume las indicaciones y recomendaciones basadas en las evidencias disponibles para disminuir las posibilidades de contaminación ante la exposición a este virus, incluyendo medidas a utilizar desde el ingreso del paciente, los métodos de protección personal, la descontaminación y esterilización del material, así como también la desinfección del área de trabajo. Aunque se ha hecho un gran esfuerzo por mejorar los procesos de bioseguridad a nivel científico tecnológico, hay evidencias de que el factor humano sigue siendo el eslabón más débil de esta cadena.

Since the declaration by the World Health Organization of the beginning of the COVID-19 pandemic caused by the SARS-CoV-2 virus in March 2020, health professionals were exposed to this highly contagious and potentially fatal disease that generated multiple challenges to the entire scientific community. It caused paradigm shifts in patient care and in the use of personal protective barriers. Multiple protocols for dental care were created worldwide as the behavior of the virus was developed and investigated. This bibliographic review summarizes the indications and recommendations based on the available evidence to reduce the possibilities of contamination when exposed to this virus, including measures to be used from patient admission, personal protection methods, decontamination and sterilization of material, as well as disinfection of the work area. Although a great effort has been made to improve biosafety processes at the scientific and technological level, there is evidence that the human factor continues to be the weakest link in this chain.

Desde a declaração pela Organização Mundial da Saúde do início da pandemia de COVID-19 causada pelo vírus SARS-CoV-2 em março de 2020, os profissionais de saúde foram expostos a essa doença altamente contagiosa e potencialmente fatal, que criou vários desafios para toda a comunidade científica. Ela causou mudanças de paradigma no atendimento ao paciente e no uso de barreiras de proteção individual. Em todo o mundo, vários protocolos para atendimento odontológico foram criados à medida que o comportamento do vírus foi desenvolvido e pesquisado. Esta revisão da literatura resume as indicações e recomendações baseadas em evidências para reduzir a probabilidade de contaminação por exposição a esse vírus, incluindo medidas a serem usadas desde a admissão do paciente, métodos de proteção individual, descontaminação e esterilização de equipamentos, bem como desinfecção da área de trabalho. Embora muitos esforços tenham sido feitos para melhorar os processos de biossegurança em nível científico e tecnológico, há evidências de que o fator humano continua sendo o elo mais fraco dessa cadeia.

Corrección del artefacto producido en imágenes tomográficas en equipos odontológicos / Correction of the artifact produced in tomographic images in dental equipment

Objetivo: disminuir el efecto de artefacto que generan objetos de alta densidad mediante la utilización de filtros de distintos materiales y espesores, ubicados en lugares estratégicos del tomógrafo. Material y métodos: se utilizaron filtros de aluminio y de cobre ubicados en lugares estratégicos en el equipo tomográfico. Se realizaron cortes oblicuos en piezas dentarias con restauraciones metálicas y en implantes; se midió la extensión del artefacto en ancho y alto en cada adquisición tomográfica. Resultados: se hallaron diferencias significativas respecto a la disminución de la dispersión de acuerdo con cada filtro con respecto a la no utilización de estos elementos. Conclusión: la utilización de filtros logró disminuir el efecto de artefacto en estructuras de alta densidad, obteniendo una mejor calidad de imagen para el diagnóstico, permitiendo que el software pueda reconstruir una imagen real (AU)

Objective: to diminish the artifact effect generated by high density objects by using filters of different materials and thickness, located in strategic places of the tomograph. Material and methods: aluminum and copper filters located in strategic places in the tomographic equipment were used. Oblique cuts were made on dental pieces with metal restorations and implants; the extension of the artifact in width and height was measured in each tomographic acquisition. Results: significant differences were found regarding the decrease of the dispersion according to each filter with respect to the non-use of these elements. Conclusion: the use of filters achieves to diminish the artifact effect in structures of high density, obtaining a better image quality for the diagnosis, allowing the software to reconstruct a real image (AU)

Accuracy of an endodontic rotary motor with integrated apex locator to determine the root canal length / Precisão de um motor rotatório endodôntico com localizador apical integrado para determinação do comprimento radicular

Aim: The purpose of this study was to evaluate the efficacy to determine the root canal length, in vitro,of both the electronic apex locator (M2) and the autostop (AS - M3) functions of the Endus Duo Gnatus endodontic motor (Gnatus, São Paulo, SP, Brazil). Methods: Thirty extracted human single-rooted premolars had their root canal lengths (TLs) up to the apical foramen determined using the Endus Duo Gnatus in two ways: (1) In the stainless steel (SS) control group, the measurement was obtained using a stainless steel hand instrument with the electronic locator mode (M2 function) connected to a stainless-steel hand instrument (K-file #15). In the NiTi rotary instrument (NiTi RI) intervention group, the measurement was obtained during the instrumentation (M3 function) of the root canals with a nickel-titanium rotary instrument (Hyflex CM: Coltene Whaledent, Cuyahoga Falls, OH, USA), size 25/.06. The NiTi manually used instrument (NiTi MUI) Intervention group performed the measurement in locator mode using a Hyflex instrument, placed to true length manually. Statistical analysis was performed using ANOVA followed by the Tukey post-hoc test with a significance level of p < 0.05. Results: The true mean length and standard deviation (SD) of the standardized root canals were 18.40 ± 2.14mm, while the mean lengths and standard deviations (SD) were 18.29 ± 1.89mm, 18.22 ± 1.85mm, and 17.24 ± 2.09mm for the SS, NiTi RI, and NiTi MUI groups, respectively. However, data from the NiTi MUI Intervention group indicated shorter root canal lengths when compared to the SS control group and the NiTi RI Intervention group values, and were significantly shorter than the true canal length (p < 0.001). Conclusions:The use of the motor in NiTi RI Intervention group showed acceptable results. However, the NiTi MUI Intervention group resulted in unacceptable short measurements.

Objetivo: O objetivo deste estudo foi avaliar a eficácia na determinação do comprimento do canal radicular, in vitro, das funções localizador eletrônico foraminal (M2) e auto-parada durante a instrumentação (M3) do motor endodôntico Endus Duo Gnatus ( Gnatus, São Paulo, SP, Brasil). Métodos: Trinta pré-molares humanos uniradiculares extraídos tiveram seus comprimentos de canais radiculares (CRTs) até o forame apical determinados usando o Endus Duo Gnatus de duas maneiras: (1) No grupo controle de aço inoxidável (SS), a medida foi obtida usando um instrumento manual de aço inoxidável com modo de localização eletrônica foraminal (função M2) conectado a um instrumento manual de aço inoxidável (lima tipo K #15). No grupo intervenção instrumento rotatório NiTi (NiTi RI), a medida foi obtida durante a instrumentação (função M3) dos canais radiculares com instrumento rotatório de níquel-titânio (Hyflex CM: Coltene Whaledent, Cuyahoga Falls, OH, EUA), tamanho 25/.06. O grupo de intervenção NiTi instrumento usado manualmente (NiTi MUI) realizou a medição no modo localizador foraminal usando um instrumento Hyflex, colocado manualmente no comprimento real do dente. A análise estatística foi realizada por meio de ANOVA seguida do teste post-hoc de Tukey com nível de significância de p < 0,05. Resultados: Os comprimentos reais médios dos dentes e desvios-padrão (DP) dos canais radiculares padronizados foram 18,40 ± 2,14 mm, enquanto os comprimentos médios e desvios- padrão (DP) foram 18,29 ± 1,89 mm, 18,22 ± 1,85 mm e 17,24 ± 2,09 mm para os grupos SS, NiTi RI e NiTi MUI, respectivamente. No entanto, os dados do grupo de intervenção NiTi MUI indicaram comprimentos de canais radiculares mais curtos quando comparados aos valores do grupo controle SS e do grupo de intervenção NiTi RI, e foram significativamente mais curtos que o comprimento real do canal (p < 0,001). Conclusões: A utilização do motor no grupo Intervenção NiTi RI apresentou resultados aceitáveis. No entanto, o grupo de intervenção NiTi MUI resultou em medições curtas inaceitáveis.

Listado oficial de material, instrumental y equipo odontológico / Official list of material, instruments and equipment dental

La revisión y actualización del Listado Oficial de material, instrumental y equipo odontológico del Ministerio de Salud (MINSAL), ha sido coordinada por la Oficina de Salud Oral, de la Dirección de Políticas y Gestión de Salud, con el apoyo de la Dirección de Regulación y la Dirección de Cadena de Suministros, así como también con odontólogos de las diferentes Regiones de Salud y Nivel Local. La actualización del documento, permite la inclusión de nuevos insumos, materiales, instrumental y equipo odontológico; con el fin de utilizarlos en base a los avances tecnológicos de la industria odontológica, eliminar aquellos que ya no se utilizan y que pueden ser reemplazados por otros de mejor calidad

The review and updating of the Official List of dental material, instruments and equipment of the Ministry of Health (MINSAL), has been coordinated by the Office of Oral Health, of the Directorate of Health Policies and Management, with the support of the Directorate of Regulation and the Supply Chain Department, as well as with dentists from the different Health Regions and the Local Level. Updating the document allows the inclusion of new supplies, materials, instruments and dental equipment; in order to use them based on technological advances in the dental industry, eliminate those that are no longer used and that can be replaced by others of better quality

Efeito da emissão de luz com fibra óptica, na cimentação de retentor intrarradicular experimental / Effect of light emission with optical fiber, on the cementation of an experimental intraradicular retainer

Os fotopolimerizadores vêm sendo utilizados como dispositivos fundamentais na Odontologia para confecção de restaurações. No entanto, a etapa de fotopolimerização da resina composta inadequada pode afetar a união entre o material restaurador e o substrato. No caso dos agentes cimentantes resinosos a dificuldade está na limitação do local de incidência da luz. Em cimentações de retentores intrarradiculares pré-fabricados, normalmente são utilizados os cimentos de ativação química ou dupla ativação, devido a limitações anatômicas. Portanto, o objetivo deste trabalho foi avaliar o efeito da emissão de luz com fibra óptica, na cimentação de retentor intrarradicular experimental capaz de fotoativar em toda a extensão do conduto radicular. No estudo foi confeccionado um protótipo de ponta acessória em fibra óptica para fonte transmissora de luz que acoplado a um aparelho fotoativador (Bluephase, Ivoclar, Brasil) transmite a luz pelo interior do conduto radicular. Desta forma foram confeccionados em parceria com a empresa Angelus, retentores experimentais vazados ao longo dos seus eixos em fibra de vidro parcialmente opacos. Para simulação do conduto radicular foram utilizadas 80 amostras de resina G10 seccionadas no tamanho de 10 mm de largura por 14 mm de altura (n=80). Cada amostra foi perfurada ao centro nas seguintes dimensões: diâmetro de 3,0 mm e 10 mm de altura. Para cimentação dos retentores intrarradiculares foram utilizados cimento resinoso fotoativado ou dual. A fotoativação foi realizada diretamente com a ponta do aparelho fotoativador ou utilizando o dispositivo experimental transmissor de luz. As amostras foram analisadas imediatamente ou após o envelhecimento térmico de 10.000 ciclos. Para análiseda resistência de união as amostras foram seccionadas em 3 partes, com 2 mm cada (coronal, média e apical) e submetidas aos testes de resistência de união por push out, seguido da análise estereomicroscópica e análise espectroscópica no infravermelho transformada por Fourier (FT-IR). O dispositivo experimental transmissor de luz foi avaliado quanto a sua irradiância, e esta obteve 50% da energia quando comparada com obtida diretamente da ponteira do fotoativador. Após testes mecânicos, os resultados encontrados foram submetidos aos testes estatísticos, Anova com 3 fatores (cimento x fotoativação x profundidade) e Anova 2 fatores (envelhecimento x cimento), seguida de teste Tukey com nível de significância de 5%. Nos resultados de resistência houve diferença estatística entre os tipos de cimentos, profundidade, fotoativação e interação entre oscimentos e a profundidade, sendo que os grupos cimentados com os cimentos fotoativados e com o dispositivo houve uma maior resistência de união na porção média e apical. Com relação ao grau de conversão houve uma maior conversão e a análise estereomicroscópica apresentou maior falha adesiva na porção apical, independente da realização do envelhecimento. Portanto, a utilização do dispositivo obteve resultados promissores e o retentor intrarradicular experimental contribuiu para aumentar a adesão entre o cimento e o substrato em sua porção mais apical.

Photopolymerizers have been used as a fundamental device in dentistry for making restorations. Nonetheless, the stage for the photopolymerization of the composite resin is critical and can affect the adhesion between the restorative material and the substrate. In the case of resin cementing agents, the difficulty lies in limiting the location of the incidence of light. In cementations of prefabricated intraradicular retainers, chemical activation or double activation cements are normally used, due to anatomical limitations. Therefore, the objective of this work was to evaluate the effect of light emission with optical fiber in the cementation of experimental intraradicular retainer capable of photoactivating in the entire length of the root canal. In the study, a prototype of fiber optic accessory tip for light transmitting source was made, which coupled to a photoactivator device (Bluephase, Ivoclar, Brazil) transmits the light inside the root canal. Thus, they were made in partnership with the company Angelus, experimental retainers cast along their axes in partially opaque fiberglass. For simulation of the root canal were used 80 samples of resin G10 sectioned in size 10mm wide by 14mm high (n=80). Each sample was drilled in the center in the following dimensions: diameter 3.0 mm and height 10 mm. For the cementation of the intraradicular seals, light-cured or dual resin cement was used. The photoactivation was performed directly with the tip of the photoactivator device or using the light transmitting experimental device. The samples were analyzed immediately or after thermal aging of 10,000 cycles. For bond strength analysis, the samples were sectioned into 3 parts, with 2 mm each (coronal, mean and apical) and submitted to the bond strength tests by push out, followed by the stereomicroscopic analysis and infrared spectroscopic analysis by Fourier (FTIR). The Light Transmitting Experimental Device was evaluated for its irradiance and obtained 50% of the energy when compared to that obtained directly from the tip of the photoactivator. After mechanical tests, the results found were submitted to the statistical tests Anova with 3 factors (cement x photoactivation x depth) and Anova 2 factors (aging x cement), followed by Tukey's test with a significance level of 5%. In resistance results, there was a statistical difference between the types of cements, depth, photoactivation and interaction between the cements and depth, and the groups cemented with the photoactivated cements and the device had a greater bond strength in middle and apical portion. Regarding the degree of conversion, there was a greater conversion and the stereomicroscopic analysis, it showed greater adhesive failure in the apical portion, regardless of the performance of aging. Therefore, the use of the device obtained promising results and the experimental intraradicular retainer contributed to increase the adhesion between the cement and the substrate in its most apical portion.

Aplicación forense de tecnología radiográfica dental portátil en Argentina: estado actual y perspectivas futuras / Forensic application of portable dental radiographic technology in Argentina: current status and future prospects

Objetivos: Mensurar los niveles de radiación de fuga y dispersión emanada a través de los blindajes y estructuras plomadas del tubo de rayos X de la unidad dental portátil NOMAD, controlando la retrodispersión con el uso del escudo protector de acrílico plomado adaptado en el extremo final del tubo localizador plomado. Se midieron las tasas de exposición dispersadas mediante un detector tipo Geiger-Müller y una cámara de ionización con respuesta en el rango de energías aportadas en diagnóstico por imágenes para la medición de la exposición directa y determinación posterior de las dosis. Se utilizó un fantomas diseñado para diagnóstico odontológico, sopesando la radiación en diferentes angulaciones de operación del equipo NOMAD, simulando los gestos posturales de odontólogos, radiólogos y sujetos a identificar. Se controlaron las tasas de exposición para determinar los valores de las dosis aportadas en las zonas significativas corporales más radiosensibles del operador del equipo. Se obtuvo como resultado que la retrodispersión en el cristalino del ojo del operador fue significativamente menor cuando el fantomas estaba acostado, mientras que a nivel de gónadas resultó más baja con el cuerpo sentado. La tasa de dosis máxima de radiación dispersa que impactó en los operadores fue de 350.8 micro Sieverts por hora (uSv/h) en la zona de gónadas, por cada radiografía tomada sin el uso del delantal de goma plomada, reduciéndose a 4.38 micro Sieverts por hora (uSv/h) al utilizarlo (AU)

Infection Control in the Dental Practice with Emphasis on Intraoral Scanners and Semi-Critical Complex Instruments / Control de Infecciones en la Práctica Dental Con Énfasis en Escáneres Intraorales e Instrumentos Complejos Semicríticos

ABSTRACT: We present an integrative review of the literature conducted to find and analyse specific measures for disinfection and/or sterilization of intraoral complex instruments, applicable to intraoral scanners. We performed a two-stage search in the PubMed/MEDLINE, SciELO, REDALYCS, and LILACS databases, and the Google Scholar website, which included full articles in Spanish, Portuguese, and English. The strategy associated the terms 'disinfection', 'biosecurity', 'decontamination', and (a) 'intraoral scanners', and (b) other 'semi-critical' intraoral complex instruments, according to the American Dental Association definition (e.g., 'turbine', etc). Strategy (a) produced just one outcome, whereas (b) produced nine articles, which only suggested low-level disinfectants.The lack of empirically based protocols that allow effective microbiological control makes it necessary to create a new categorization for these instruments when trying to comply with American Dental Association recommendations for dental practice.

RESUMEN: Presentamos una revisión integradora de la literatura realizada para encontrar y analizar medidas específicas de desinfección y / o esterilización de instrumentos complejos intraorales, aplicables a los escáneres intraorales. Realizamos una búsqueda en dos etapas en las bases de datos PubMed / MEDLINE, SciELO, REDALYCS y LILACS, y en el sitio web Google Scholar, que incluía artículos completos en español, portugués e inglés. La estrategia asoció los términos 'desinfección', 'bioseguridad', 'descontaminación' y (a) 'escáneres intraorales', y (b) otros instrumentos complejos intraorales 'semicríticos', según la definición de la Asociación Dental Ameri- cana (p. Ej., 'turbina', etc.). La estrategia (a) produjo un solo resultado, mientras que (b) produjo nueve artículos, que solo sugirieron desinfectantes de bajo nivel. La falta de protocolos de base empírica que permitan un control microbiológico efectivo hace necesario crear una nueva categorización para estos instrumentos, cuando se trata de cumplir con las recomendaciones de la Asociación Dental Americana para la práctica dental.

Propuesta del modelo para control de infecciones en la consulta odontológica ante la pandemia de COVID-19 / Proposal for an infection control protocol in the dental consultation against the COVID-19 pandemic

Catalogada su labor como Servicios de Salud Indispensables, el profesional de la odontología se ha mantenido al pendiente de sus pacientes durante la pandemia de COVID-19, brindando atención de urgencia a quien lo solicita. A su regreso a la práctica típica, el odontólogo encontrará un entorno distinto o NUEVA NORMALIDAD, viéndose obligado a hacer modificaciones clínicas pertinentes y preparar a su equipo de trabajo para continuar brindando atención de calidad con un margen de seguridad amplificado, que de igual manera proteja a pacientes y al equipo de trabajo. Ante la falta de una vacuna que brinde protección y de tratamiento específico contra el SARS-CoV-2 (COVID-19), elevar el nivel de control de infecciones en el consultorio se vuelve ineludible y posiblemente irreversible en el quehacer odontológico cotidiano. En este artículo se propone un Protocolo de Control de Infecciones en la consulta odontológica que permita brindar seguridad en la atención bucal, considerando COVID-19, útil también para control infeccioso de otros patógenos virales o bacterianos (AU)

Considered dentistry as an Indispensable Health Services, during the COVID-19 pandemic the dental professional has been providing mostly emergency care. Upon return to typical dental practice, the dentist will find a different environment or NEW NORMALLY, being forced to make relevant clinical modifications and prepare his team to continue providing quality care with an amplified safety margin, which equally protects patients and dental team. In the absence of an available vaccine that provides protection or a specific treatment against SARSCoV- 2 (COVID-19), raising the level of infection control at the dental office will become unavoidable and possibly irreversible in the future quotidian dental work. This article proposes an Infection Control Protocol for the dental consultation that allows provide safety oral care, considering COVID-19, also useful for other viral or bacterial pathogens control (AU)

Lineamientos de bioseguridad utilizados en las clínicas dentales periféricas de la Universidad de Monterrey durante la pandemia de COVID-19 / Biosafety guidelines used in the peripheral dental clinics of the University of Monterrey during the COVID-19 pandemic

El presente artículo tiene como propósito informar sobre los lineamientos que las clínicas dentales periféricas de la Escuela de Odontología de la Universidad de Monterrey (UDEM) han tomado frente a la pandemia actual COVID-19, emergente en la ciudad de Wuhan, China el pasado diciembre 2019. Dichas medidas surgen con el objetivo de cumplir con estándares de bioseguridad que eviten el contagio y/o la contaminación cruzada entre pacientes, profesionales y personal de las clínicas dentales de la UDEM; Clínica de Prevención Dental (CPD) y Clínica de Atención Dental Avanzada (CADA), las cuales permanecerán activas frente a situaciones que requieran atención de urgencia y postergando los tratamientos dentales de rutina. Los protocolos para brindar una atención de urgencia conllevan determinados pasos a seguir desde que el paciente ingresa a la clínica; iniciando con la revisión del expediente electrónico médico por medio de la plataforma Atlas.xp, seguido del llenado de un cuestionario enfocado al riesgo de la enfermedad y culminando con la toma de temperatura con termómetro infrarrojo. Los pacientes que no presenten síntomas y muestren una temperatura inferior a los 37.3 oC podrán ser atendidos bajo la aplicación de todas las medidas de bioseguridad establecidas (medidas de protección personal, de equipo y paciente, mantenimiento de dos metros de distancia en sala de espera, cumplimiento de tiempos de trabajo parciales, uso de lámparas purificadoras de aire distribuidas en las salas operatorias de las clínicas, trabajo asistido o a cuatro manos con la implementación de aislamiento absoluto en el paciente y con la utilización mínima de la pieza de alta velocidad). Asimismo, se menciona que posterior a cada tratamiento y en la culminación de la jornada laboral, todas las áreas y superficies deberán ser sanitizadas con sustancias desinfectantes específicas. Por su parte, el personal deberá portar ropa convencional al salir de las instalaciones y haber realizado un adecuado lavado de manos para evitar al máximo posible la transmisión del virus (AU)

The purpose of this article is to inform about the guidelines that the peripheral dental clinics of the School of Dentistry of the University of Monterrey (UDEM) have taken in the face of the current pandemic COVID-19, emerging in the city of Wuhan, China in the past December 2019. These measures arise with the aim of fulfilling biosafety standards that avoid contagion and/or cross contamination between patients, professionals and staff of UDEM dental clinics; Clínica de Prevención Dental (CPD) and Clínica de Atención Dental Avanzada (CADA), which will remain active in situations that require urgent care and postponing routine dental treatments. The protocols to provide urgent care include certain steps to follow from the moment the patient enters the clinic; starting with the review of the electronic medical record through the Atlas.xp platform, followed by the completion of a questionnaire focused on the risk of the disease and culminating with temperature measurement with an infrared thermometer. Patients who do not present symptoms and show a temperature below 37.3 oC may be treated under the application of all established biosecurity measures (personal, equipment and patient protection measures, maintenance of two meters in the waiting room, compliance with partial work times, use of air purifying lamps distributed in the operating rooms of the clinics, assisted or four-hand work with the implementation of absolute isolation in the patient and with the minimum use of the high-speed handpiece). It is also mentioned that after each treatment and at the end of the working day, all areas and surfaces must be sanitized with specific disinfecting substances. For their part, the personnel must wear conventional clothing when leaving the facilities and have carried out adequate hand washing to avoid transmission of the virus as much as possible (AU)

Influência da velocidade de rotação na resistência à fadiga cíclica do sistema rotatório Logic / Influence of the rotational speed on the cyclic fatigue resistance of the Logic rotary system

O objetivo do presente trabalho foi avaliar a influência da velocidade de rotação na resistência à fadiga cíclica do instrumento rotatório Logic 25.06 (LOG 25.06; Easy Equipamentos Odontológicos, Belo Horizonte, Brasil). Métodos: Foram utilizados 20 instrumentos rotatórios Logic 25.06 (n=10). O teste de fadiga cíclica foi realizado em um aparato com um canal artificial de aço inoxidável com ângulo de curvatura de 60° e raio de 5 mm. Os instrumentos foram utilizados a 950 e 550 rotações por minuto (RPM), sendo mensurados o tempo e o número de ciclos para a fratura. Os dados foram analisados estatisticamente por meio do teste t de Student, sendo selecionado um nível de significância de 5%. Resultados: O teste de fadiga cíclica demonstrou que a velocidade de 550 RPM promoveu um aumento significativo no tempo e no número de ciclos para a fratura dos instrumentos LOG 25.06 (p<0,05). Houve um aumento de 95,9% no tempo e de 27,25% do número de ciclos para a fratura. Conclusão: Os resultados desse estudo demonstraram que a velocidade de rotação possui uma influência significativa na resistência à fadiga cíclica dos instrumentos rotatório Logic 25.06. A velocidade de 550 RPM é uma velocidade mais segura, aumentando significativamente a resistência à fadiga cíclica (AU).

Objective: The aim of this study was to evaluate the influence of rotational speed on the cyclic fatigue resistance of Logic 25.06 rotary instruments (LOG 25.06; Easy Equipamentos Odontológicos, Belo Horizonte, Brazil). Methods: 20 Logic 25.06 instruments were used (n=20). The cyclic fatigue test was performed in an artificial canal made of stainless steel with 60° of curvature and 5 mm of radius. The instruments were activated 950 and 550 rotations per minute (RPM) until the fracture occurred. The time (in seconds) and the number of cycles to fracture (NCF) were measured. The data were statistically analyzed using One-way ANOVA and Tukey Test, the level significance used was 5 %. Results: the 550 RPM promoted a significantly higher time and NCF of LOG 25.06 in comparison with 950 RPM (P>0.05). The time increased in 95.9% and the NCF 27.25%. Conclusion: The results of this study showed that the rotational speed had a significant influence on the cyclic fatigue resistance of the Logic 25.06 rotary instruments. The 550 RPM rotational speed seems to be safer than 950 RPM, increasing the cyclic fatigue resistance of Logic 25.06 (AU).

Comparative evaluation of the effect of various irrigants and dry canal on electronic apex locators in locating simulated root perforations: an in vitro study / Avaliação comparativa do efeito de vários irrigantes e canal seco em localizadores apicais eletrônicos na localização de perfurações radiculares simuladas: um estudo in vitro

Objective: this study aimed to evaluate the effects of irrigants and dry canal on the accuracy of electronic apex locator (EAL) in locating simulated root perforations. Material and methods: twenty singlerooted, mandibular premolars were decoronated at CEJ, and the contents were removed with a barbed broach. The canals were instrumented up to a size of 15 K-file. The roots were artificially perforated at 4 mm from the anatomic apex. The actual length (AL) up to the perforation site was determined. The electronic length (EL) of perforations was obtained by Root ZX mini and iRoot in the dry canal and in the presence of 5.2% NaOCl, SmearOff, and 0.9% sodium chloride using a size 20 K-file. The differences between the EL and AL of the perforations were calculated. Statistical analyses using Friedman and Wilcoxon signed-rank tests were used to analyse the data with the level of significance set at p <0.05. Results: there were significant differences in different canal conditions with both Root ZX mini and i Root. Measurements in dry canals were significantly longer for both apex locators (p <0.05). Measurements with NaOCl were significantly shorter for both apex locators (p < 0.05). Both apex locators produced significantly accurate values for Saline and Smear OFF (p < 0.05). Conclusions: in this study, both Root ZX mini and i Root were affected by different canal conditions. The most accurate measurements were seen in the presence of saline and SmearOFF. (AU)

Objetivo: este estudo teve como objetivo avaliar os efeitos de irrigantes e canal seco na precisão do localizador apical eletrônico (EAL) em localizar perfurações radiculares simuladas. Material e métodos: vinte pré-molares inferiores unirradiculares tiveram suas coroas removidas na altura da JEC e o tecido pulpar removido com um extirpa nervos. Os canais foram instrumentados até a largura de uma lima k 15. As raízes foram perfuradas artificialmente a 4 mm do ápice anatômico. O comprimento real (AL) até o local da perfuração foi determinado. O comprimento eletrônico (EL) das perfurações foi obtido pelo Root ZX mini e iRoot no canal seco e na presença de 5,2% de NaOCl, SmearOff e 0,9% de cloreto de sódio usando uma lima K tamanho 20. As diferenças entre o EL e o AL das perfurações foram calculadas. Análises estatísticas, utilizando os testes de sinais por postos de Friedman e Wilcoxon, foram realizadas para analisar os dados com o nível de significância estabelecido em p < 0,05. Resultados: houve diferenças significativas nas diferentes condições do canal, tanto no Root ZX mini quanto no i Root. As medidas em canais secos foram significativamente maiores nos dois localizadores apicais (p < 0,05). As medidas com NaOCl foram significativamente mais curtas para os dois localizadores apicais (p<0,05). Ambos os localizadores apicais produziram valores significativamente precisos para Saline e Smear OFF (p < 0,05). Conclusões: neste estudo, tanto o Root ZX mini quanto o i Root foram afetados por diferentes condições do canal. As medidas mais precisa foram observadas na presença de soro fisiológico e SmearOFF. (AU)

Microbiological Water Evaluation from Biofilm Adhered to Dental Unit Waterlines / Evaluación Microbiológica del Agua de Biofilm Adherido a Líneas de Agua de la Unidad Dental

ABSTRACT: The contamination of the dental units' waterlines is a reality, which can develop individual and collective disorders. The aim of this study was to evaluate the prevalence and resistance profile of bacteria on the internal surfaces of waterlines in a dental clinic from a Dentistry school of a Brazilian university. The design was an exploratory, descriptive study with quantitative and qualitative approach. Samples (n=4) were collected for analysis at different points: the portion closest to the water reservoir of the chair, and the portion closest to the triple syringe. After collection the samples were cultured in BHI medium in an oven for 24-48 h at 37 °C. For the quantitative analysis 1 ml of each sample was used for serial dilution up to the dilution value seven. The colonies were counted after pour plate and the results expressed in UFC/cm2. The qualitative analysis was initiated with the cultivation of Agar Blood, EMB-Levine and Cetrimide Agar for 24 h, and the identification of bacteria was performed by microscopic analyses. The resistance profile was verified by classical antibiogram. The internal surfaces of unit waterlines units exhibited a mean of 2.44 x 109 CFU / cm2. Bacillus subtilis and Pseudomonas aeruginosa were identified. The resistance profile of Pseudomonas aeruginosa indicated sensitivity to all tested antibiotics. A large number of microorganisms was quantified from biofilm accumulated in the dental units' waterlines. However, they were not resistant to classic antibiogram. Better management and application of decontamination protocols for waterlines need to be applied since opportunistic infections may be associated with Pseudomonas aeruginosa.

RESUMEN: La contaminación de líneas de agua en las unidades dentarias es una realidad, generando enfermedades individuales y colectivas. El objetivo de este estudio fue evaluar la prevalencia y resistencia de las bacterias en las zonas internas de las líneas de agua de la Facultad de Odontología de una universidad brasileña. El diseño del estudio fue exploratorio, descriptivo con enfoques cuantitativos y cualitativos. Las muestras para análisis (n=4) fueron selecionadas de distintos lugares: el punto más cercano al sistema de agua del sillón odontológico y el punto más cercano a la jeringa tríplice. Las muestras obtenidas fueron cultivadas en un médio BHI por 24-48 h, en un horno a 37 ºC. Para el análisis cuantitativo, se utilizó 1 ml de cada muestra para dilución hasta el valor siete. Las colonias fueran contadas y los resultados fueron expresados en UFC/cm2. El análisis cualitativo fue iniciado con el cultivo de Agar Sangre, EBM-Levine y Agar Cetrimide por 24 h y la identificación de la bacteria fue realizada por análisis microscópicos. El perfil de resistencia fue verificado por el antibiograma clásico. Las zonas internas de las unidades de líneas de agua mostraron un promédio de 2,44 x 109 UFC/cm2. Bacillus subtilis y Pseudomonas aeruginosa fueron encontrados. El perfil de resistencia de Pseudomonas aeruginosa indicó sensibilidad a todos los antibióticos testados. Un gran número de microorganismos fue cuantificado desde la biopelícula acumulada en las líneas de agua de unidades dentales. Sin embargo, no resistieron al antibiograma clásico. Se requiere una mejor gestión y aplicación de protocolos de decontaminación en las líneas de agua debido a que las infecciones oportunistas puedan estar asociadas a Pseudomonas aeruginosa.

Clínica Dental: norma técnica No. 016-2019 ­DRACES / Dental Clinic: technical standard No. 016-2019 ­DRACES

DRACES [Departamento de Regulación, Acreditación y Control de Establecimientos de Salud] Este documento tiene como objeto: "la Regulación, Autorización y Control de las Clínicas Dentales, en concordancia con el Reglamento para la Regulación, Autorización, Acreditación y Control de Establecimientos de Atención para la Salud, Acuerdo Gubernativo 376-2007." Es de carácter obligatorio, por lo que se aplica tanto al sector público, privado, social o subsector de la seguridad social, en todo el territorio nacional. Contiene además, las definiciones de los conceptos relacionados al tema principal, además de la infraestructura que deberá tener cada clínica, incluidos el equipo y recurso humano y técnico.

Laboratorio mecánico dental: norma técnica No. 24-2019 / Dental mechanical laboratory: technical standard No. 24-2019

Este documento tiene como objeto: "la regulación, autorización y control de los laboratorios mecánicos dentales, en concordancia con el Reglamento para la Regulación, Autorización, Acreditación y Control de Establecimientos de Atención para la Salud, Acuerdo Gubernativo 376-2007." Es de carácter obligatorio, por lo que se aplica tanto al sector público, privado, social o subsector de la seguridad social, en todo el territorio nacional. Contiene además, las definiciones de los conceptos relacionados al tema principal, además de la infraestructura que deberá tener cada clínica, incluidos el equipo y recurso humano y técnico.

Evaluation of intensity standards of tungsten-halogen and led curing units / Evaluación de estándares de intensidad de unidades de curado tugsteno-halógenas y leds

Current evidence indicates that the minimum light intensity of photo curing units required to polymerize in a reliable way a composite resin, in increments of 2mm, is 300mW/cm2. The recent introduction of new generations of composite resin materials for large volume increments, partially contrasts with ISO 4049 (2009), calling for the use of light intensity of 1,000mW/cm2. Therefore, it is considered relevant to carry out periodic measurements of the emission intensity of light-curing units of clinical use. The aim of this study was to test the intensity [mW/cm2] of a representative sample of tungsten-halogen and LED photopolymerization units used in private and public health service in different areas of the Valparaíso Region in Chile. This was achieved through the use of dental radiometers, without considering the variables of intensity modification over time (either spontaneously, by undesirable inherent characteristics of the device, or by programs of intensity modification in time), or the density of accumulated power needed. This in vitro diagnostic test, evaluated a sample of 507 units, 107 halogen and 400 LED, for a period of around one month, using two radiometers as measuring instruments. For LED units the Bluephase Meter® radiometer, from Ivoclar-VivadentTM was used, and for halogen units we used the Coltolux® from ColténeTM. As a result, 85% of the LED and halogen units achieved the minimum requirements of intensity needed for the polymerization of conventional dental biomaterials. However, only 25% from the tested units achieved a power density of 1,000mW/cm2.

Comparison of three behavior modification techniques for management of anxious children aged 4–8 years

BACKGROUND: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. METHODS: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. RESULTS: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. CONCLUSION: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.

Água em elevada temperatura: é viável a sua aplicabilidade no controle do biofilme de equipo odontológico? / Water at high temperature: is its applicability for biofilm control of dental unit viable?

Na Odontologia, as linhas d'água de equipos odontológicos são substratos para a formação de biofilme e, consequentemente, dispersão dessa contaminação microbiana para água destinada ao tratamento odontológico. O objetivo desta pesquisa foi investigar a atividade antibiofilme da água em elevada temperatura contra Pseudomonas aeruginosa, visando à sua aplicabilidade em linhas d'água de equipos odontológicos para o controle dessa problemática. Trata-se de um estudo do tipo experimental/laboratorial in vitro. Alíquotas de 2mL de Tryptic Soy Broth com 1% do inóculo bacteriano padronizado (106UFC/mL) de P. aeruginosa (ATCC 27853) foram inoculadas em cada um dos poços de placas de poliestireno de 24 poços. Em seguida, fragmentos de linha d'água (FL) de 1cm (n=48) foram transferidos para os poços das placas. A incubação foi efetuada em estufa de agitação a 37°C por 24h em 80rpm. Decorrido o período de incubação, os FL foram enxaguados com 5mL de solução salina a 0,85% por três vezes para retirada das células planctônicas. Posteriormente, as amostras foram transferidas para duas placas de 24 poços contendo 2mL de água purificada do tipo II (osmose reversa) esterilizada em cada poço. Grupos experimentais com temperaturas e tempos de exposição diferentes foram avaliados: temperatura ambiente (controle) - (n=24) e a 60°C (n=24), e 30s (n=12) e 60s (n=12). As amostras dos FL foram transferidas para microtubos contendo 1mL de Tryptic Soy Broth e pérolas de vidro. Os tubos foram homogeneizados em agitador de tubos por 2min e, em seguida, alíquotas de 50µL in natura e diluídas (diluição decimal seriada até 10-5) foram semeadas em placas de Petri (60x15mm) com Cetrimide Agar. Após o período de incubação em estufa a 37°C por 24h, os números de unidades formadoras de colônia expressas por FL (UFC/FL) foram determinados. Além disso, as amostras dos FL foram fixadas, desidratadas, metalizadas e submetidas à análise por meio de microscopia eletrônica de varredura (MEV). Os dados coletados foram submetidos à análise estatística empregando-se os testes de Shapiro-Wilk e U de Mann-Whitney por meio do software BioEstat® (versão 5.3) e nível de significância a=5%. Houve diferença entre a comparação das medianas das cargas bacterianas expostas à água à temperatura ambiente (335.000UFC/FL) e a 60°C (2.030UFC/FL) por 30s (p=0,0005), com redução de 3logUFC/FL. Ainda, a comparação entre as medianas das cargas bacterianas expostas à água à temperatura ambiente (173.000UFC/FL) e a 60°C (1.780UFC/FL) por 60s mostrou diferença (p=0,0047), com redução de 2logUFC/FL. A MEV demonstrou a presença de biofilme em todas as amostras analisadas, entretanto nos FL expostos à água a 60°C, os bastonetes (P. aeruginosa) foram evidenciados em menor quantidade e com características morfológicas atípicas. Em conclusão, a exposição do biofilme de P. aeruginosa formado nos FL de equipo odontológico à água em elevada temperatura reduziu a carga e alterou a morfologia bacteriana, demonstrando possível aplicabilidade na biossegurança: controle de contaminação/infecção na Odontologia

In dentistry, dental unit waterlines were substrates for biofilm formation and, consequently, dispersion of this microbial contamination for distilled water to dental treatment. The objective of this study was to investigate water antibiofilm activity at high temperature against Pseudomonas aeruginosa, aiming at its applicability in dental unit waterlines for controlling this problem. It is an in vitro experimental/laboratory study. 2mL aliquots of Tryptic Soy Broth with 1% of standardized bacterial inoculum (106CFU/mL) of P. aeruginosa (ATCC 27853) were inoculated on each one of 24-well polystyrene plates. Next, fragments of waterline (FW) of 1cm (n=48) were transferred for plates wells. The incubation was carried out in an incubator shaker at 37°C for 24h at 80rpm. After the incubation period elapsed, the FW were flushed with 5mL of saline solution at 0.85% by three times for removing planktonic cells. Subsequently, the samples were transferred to two 24-well plates containing 2mL of type II purified water (reverse osmosis) sterilized in each well. Experimental groups with different temperatures and exposition times were evaluated: room temperature (control) - (n=24) and at 60°C (n=24), and 30s (n=12) and 60s (n=12). The FW samples were transferred to microtubes containing 1mL of Tryptic Soy Broth and glass beads. The tubes were homogenized in an orbital shaker for 2min and, following this, diluted in natura 50µL aliquots (serial decimal dilution up to 10-5) were seeded in Petri plates (60x15mm) with Cetrimide Agar. After the incubation period in chamber at 37°C for 24h, the numbers of colony-forming units expressed per FW (CFU/FW) were determined. Furthermore, the FW samples were fixed, dehydrated, metalized and submitted to analysis through scanning electron microscopy (SEM). The data collected were submitted to statistical analysis using Shapiro-Wilk and Mann-Whitney U tests through BioEstat® (version 5.3) software and a=5% significance level. There was a difference between the comparison of medians of bacterial loads exposed to water at room temperature (335,000CFU/FW) and at 60°C (2,030CFU/FW) for 30s (p=0.0005), with reduction of 3logCFU/FW. Moreover, the comparison between the medians of bacterial loads exposed to water at room temperature (173,000CFU/FW) and at 60°C (1,780CFU/FW) for 60s showed difference (p=0.0047), with a reduction of 2logCFU/FW. The SEM demonstrated biofilm presence on all analyzed samples, but on FW exposed to water at 60°C, the rods (P. aeruginosa) were evidenced in less quantity and with atypical morphological characteristics. In conclusion, the exposition of P. aeruginosa biofilm formed in dental unit FW to water at high temperature reduced the load and changed the bacterial morphology, demonstrating a possible applicability in biosafety: contamination/infection control in dentistry

Patents on hospital medical and dental equipment (EMHO). Question and answer tool

Abstract Purpose: To create a question and answer tool on patents on EMHO. Methods: Was used the Thinking Design methodology divided into four phases: Discovery, Definition, Development and Delivery. Discovery Phase: Desk research was carried out in: SciELO, Pubmed, LILACS, Google and Google Scholar. Once the target audience was selected, the interviews were conducted. Definition Phase: the interviewees' difficulties were mapped, on an Excel spreadsheet. Development Phase: a brainstorming was conducted with the public interviewed. Delivery Phase: the prototype, validation and final elaboration of the tool were made. Results: Discovery Phase: 10 inventors were identified and the interviews were carried out. Definition Phase: 80% of the interviewees determined lack of information as one of the problems. The main content was defined as: the patent process, from the beginning of the idea to the deposit (70%), search for precedence (40%) and informing partners (30%). Development Phase: with the brainstorming, the tool type was defined as an interactive site. Delivery Phase: a prototype with content framework and an interactive video was presented for validation. After approval, the interactive website was developed, which was made available to the public. Conclusion: A question and answer tool on patents in EMHO was developed.