Aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium (ozaki procedure) - a promising surgical technique

Abstract In cases of aortic valve disease, prosthetic valves have been increasingly used for valve replacement, however, there are inherent problems with prostheses, and their quality in the so-called Third World countries is lower in comparison to new-generation models, which leads to shorter durability. Recently, transcatheter aortic valve replacement has been explored as a less invasive option for patients with high-risk surgical profile. In this scenario, aortic valve neocuspidization (AVNeo) has emerged as another option, which can be applied to a wide spectrum of aortic valve diseases. Despite the promising results, this procedure is not widely spread among cardiac surgeons yet. Spurred on by the last publications, we went on to write an overview of the current practice of state-of-the-art AVNeo and its results.

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.

Sterilizing elastomeric chains without losing mechanical properties. Is it possible?

OBJECTIVE: To investigate the effects of different sterilization/disinfection methods on the mechanical properties of orthodontic elastomeric chains. METHODS: Segments of elastomeric chains with 5 links each were sent for sterilization by cobalt 60 (Co60) (20 KGy) gamma ray technology. After the procedure, the elastomeric chains were contaminated with clinical samples of Streptococcus mutans. Subsequently, the elastomeric chains were submitted to sterilization/disinfection tests carried out by means of different methods, forming six study groups, as follows: Group 1 (control - without contamination), Group 2 (70°GL alcohol), Group 3 (autoclave), Group 4 (ultraviolet), Group 5 (peracetic acid) and Group 6 (glutaraldehyde). After sterilization/disinfection, the effectiveness of these methods, by Colony forming units per mL (CFU/mL), and the mechanical properties of the material were assessed. Student's t-test was used to assess the number of CFUs while ANOVA and Tukey's test were used to assess elastic strength. RESULTS: Ultraviolet treatment was not completely effective for sterilization. No loss of mechanical properties occurred with the use of the different sterilization methods (p > 0.05). CONCLUSION: Biological control of elastomeric chains does not affect their mechanical properties. .

OBJETIVO: verificar os efeitos de diferentes métodos de esterilização/desinfecção nas propriedades mecânicas de elásticos ortodônticos em cadeia. MÉTODOS: segmentos de elástico em cadeia com 5 elos cada foram enviados para esterilização em radiação gama com cobalto 60 (20 KGy). Após esterilização, esses foram contaminados com amostras clínicas de Streptococcus mutans. Passado esse período, foram submetidos aos testes de esterilização/desinfecção por diferentes métodos, formando seis grupos de estudo, assim denominados: Grupo 1 (controle - sem ter sido contaminado), Grupo 2 (álcool 70°GL), Grupo 3 (autoclave), Grupo 4 (ultravioleta), Grupo 5 (ácido peracético) e Grupo 6 (glutaraldeído). Após esterilização/desinfecção, avaliou-se a efetividade desses métodos, por meio de contagem de unidades formadoras de colônias por mL (UFC/mL), e as propriedades mecânicas desses materiais. Utilizou-se o teste t de Student para avaliar o número de UFC, além do ANOVA e, posteriormente, do teste de Tukey para avaliação da força. RESULTADOS: verificou-se que o ultravioleta não obteve eficácia total quanto à esterilização. E não ocorreu perda das propriedades mecânicas dos elásticos, com os diferentes métodos de esterilização utilizados (p > 0,05). CONCLUSÃO: o controle biológico de elásticos em cadeia não interfere nas suas propriedades mecânicas. .

Efficacy of various spray disinfectants on irreversible hydrocolloid impression materials: An in vitro study.

Background: Most of the materials (casts, impressions, etc.) that are sent to the dental laboratories show the presence of numerous pathogenic microorganisms. All the spray disinfectants are not equally effective against these microorganisms. Aims and Objectives: The aim was to compare the effectiveness of different spray disinfectants on irreversible hydrocolloid impressions and to find out the most effective dilution, contact time, and effect against each microorganism studied. Materials and Methods: The effects of four spray disinfectants, 5.25% sodium hypochlorite, 0.525% sodium hypochlorite, 1:213 (1 part in 213 parts of water) povidone iodine, and 2% glutaraldehyde along with control (distilled water) on irreversible hydrocolloid impressions contaminated with Staphylococcus aureus, Bacillus subtilis and Streptococcus viridans were studied. Results: Sodium hypochlorite, 5.25%, showed 1-min exposure time which was able to effect a 4log10 reduction in bacterial counts against S. aureus and S. viridans followed by 0.525% sodium hypochlorite and 2% glutaraldehyde for 10 min. None were able to effect a 4 log10 reduction against B. subtilis. Conclusion: Sodium hypochlorite with a concentration of 5.25% was the most effective disinfectant and required the shortest contact time (1 min). Not all ADA-approved concentrations of surface disinfectants work equally well on irreversible hydrocolloid impression materials.

Comparative efficacy of two treatment modalities for dentinal hypersensitivity: A clinical trial.

Background: Dentin hypersensitivity is a recurrent condition causing discomfort and sometimes pain to the patient, which also deters him from maintaining adequate oral hygiene. Home care and office measures are used for treatment of this malady. Aim: To evaluate and compare the efficacy of 2 treatment modalities for dentinal hypersensitivity, iontophoresis with acidulated phosphate gel (APF) gel, and dentin-bonding agent application. Materials and Methods: This split mouth randomized clinical study recruited subjects with a history of hypersensitivity with at least 2 teeth, verified by a light stroke with a dental explorer along the cervical third of the teeth. The patients were subjected to a 1-s air blast and cold water stimuli and their responses were recorded on a verbal rating scale. A total of 30 sites from 15 patients were divided into Group A-1.23% APF gel iontophoresis; and Group B-aqueous solution of hydroxyl-ethyl-methacrylate and glutaraldehyde. The teeth were evaluated immediately after the treatment and at the end of 2 weeks. In case of failure, the tooth was retreated with the same agent as before. Results: The results were statistically analyzed using Kruskal-Wallis analysis of variance and Mann-Whitney U tests. There was no statistically significant difference between the groups at the end of 2 weeks. However, Group A was more effective clinically, with fewer number of failures compared with Group B. Conclusion: Both the agents showed a statistically significant reduction in sensitivity compared with baseline; however, APF gel iontophoresis was more effective in reducing hypersensitivity over a longer time period.

Clinical evaluation of postoperative sensitivity using self-etching adhesives containing glutaraldehyde

The present clinical study aimed to assess the postoperative sensitivity (POS) after 48 hours and seven days in occlusal restorations bonded with three different adhesive systems, two of them containing glutaraldehyde. The restorative procedures were performed using the three-step etch-and-rinse Adper SBMP-Plus adhesive (SBMP), the two-step etch-and-rinse Gluma Comfort One Bond + Desensitizer adhesive (GC+D) and the all-in-one self-etching/priming I Bond (IB) adhesive, which also has glutaraldehyde in its formula. All cavities were restored with Filtek Supreme nanoparticle composite resin. After 48 hours and seven days the patients were recalled and the postoperative sensitivity evaluated. The data analyzed by non-parametric Friedman test showed no significant differences in POS among the three tested groups after 48 hours and seven days.

Influence of microwave sterilization on the cutting capacity of carbide burs

OBJECTIVE: This study compared the cutting capacity of carbide burs sterilized with microwaves and traditional sterilization methods. MATERIAL AND METHODS: Sixty burs were divided into 5 groups according to the sterilization methods: dry heat (G1), autoclave (G2), microwave irradiation (G3), glutaraldehyde (G4) or control - no sterilization (G5). The burs were used to cut glass plates in a cutting machine set for twelve 2.5-min periods and, after each period, they were sterilized (except G5) following the protocol established for each group. The cutting capacity of the burs was determined by a weight-loss method. Data were analyzed statistically by Kruskal-Wallis and Dunn's test. RESULTS: The means of the cutting amount performed by each group after the 12 periods were G1 = 0.2167 ± 0.0627 g; G2 = 0.2077 ± 0.0231 g; G3 = 0.1980 ± 0.0326 g; G4 = 0.1203 ± 0.0459 g; G5 = 0.2642 ± 0.0359 g. There were statistically significant differences among the groups (p<0.05); only dry heat sterilization was similar to the control. CONCLUSION: Sterilization by dry heat was the method that least affected the cutting capacity of the carbide burs and microwave sterilization was not better than traditional sterilization methods.

Actualización en esterilización / Sterilization: up-to date

Los autores presentan una perspectiva general sobre las propiedades, características y condiciones de los métodos de esterilización más usados y de los materiales susceptibles de ser esterilizados

Avaliaçäo morfológica do efeito de substâncias sobre a dentina: estudo em microscopia eletrônica de varredura / Scanning electron microscopy study of the effects of different substances used on dentin surface

A hipersensibilidade dentinária é uma ocorrência clínica comum, dolorosa, de difícil tratamento, e de recidivas constantes. Tem-se procurado um tratamento que seja eficaz de longa duraçäo. Neste trabalho nos propomos a observar, através de microscopia eletrônica de varredura, as alteraçöes morfológicas que säo causadas na superfície dentinária quando säo utilizadas substâncias para tratamento da hipersensibilidade. Utilizou-se discos de dentina sobre os quais foi preparado "smear layer" padronizado e aplicadas substâncias, uma à base de glutaraldeído e outra de oxalato, conforme instruçöes dos fabricantes. Manteve-se discos sem tratamento e em outros foi aplicado ácido fosfórico a 35 por cento, como grupo controle. Dos resultados obtidos concluiu-se que os espécimes: sem tratamento mantiveram a camada de "smear layer"; tratados com ácido mostraram exposiçäo dos túbulos dentinários; tratados com as substâncias dessensibilizantes mostraram formaçöes semelhantes a cristais causando obstruçäo da entrada dos túbulos dentinários

Modelo experimental del uso de pericardio de bovino tratado con glutaraldehído, comparado con malla de silicón para el tratamiento de los defectos congénitos de la pared abdominal / experimental model for the use of glutaraldehyde treated bovine pericardium as compared to the silicon mesh to treat congenital defects of the abdominal wall

Objetivo. Evaluar la efectividad del pericardio de bovino tratado con glutaraldehído (PBTG), en la reconstrucción de los defectos congénitos de la pared abdominal en las ratas, comparándolo con una malla de silicón. Sede. Hospital general de tercer nivel de atención. Diseño. Estudio prospectivo, experimental y aleatorio. Material y método. Las ratas fueron asignadas aleatoriamente a tres grupos. Grupo 1= Defecto reparado con PBTG; Grupo 2= Defecto reparado con malla de silicón, y Grupo 3= Defecto reparado con cierre primario. Después de la cirugía se les permitió a las ratas una alimentación ad libitum, con ventilación y temperatura controlados, manteniendo constante el ciclo día/noche, con 12 horas de luz y 12 de oscuridad. Diariamente se registró: peso y presencia de infección en la herida. Los animales fueron sacrificados a los 45 días de vida, con estudio postmortem para evaluar la presencia de dehiscencia y bandas adhesivas intraperitoneales. Para el análisis estadístico se utilizaron las pruebas de Ji cuadrada y t de Student. Resultados. En los grupos 1 y 2 se realizó el cierre completo del defecto en todas las ratas (p< 0.000001); en el grupo 3 el cierre completo sólo fue posible en 15 ratas (60 por ciento), en nueve se consiguió un cierre del 75 por ciento de la superficie del defecto y en uno del 50 por ciento. No hubo diferencia en los 3 grupos en cuanto a presentación de complicaciones transoperatorias. En el grupo 1 (PBTG) se presentaron 13 decesos; en el 2, se presentaron 7 fallecimientos y en el 3, doce muertes. No hubo diferencia estadísticamente significativa en la mortalidad de los 3 grupos (p=0.3). El estudio post-mortem se realizó en 53 ratas; en 16 del grupo 1, 19 del grupo 2 y 18 del grupo 3, los hallazgos fueron los siguientes: presencia de infección en 4 ratas del grupo 2 y en una del grupo 1 (p=0.35); fístula entérica en 3 ratas del grupo 1 y en una del grupo 2 (p=0.412); dehiscencia de la herida o del material protésico en 6 ratas del grupo 1, once del grupo 2 y en ninguna del grupo 3, con una diferencia estadísticamente significativa (P=0.001); adherencia severas en trece ratas del grupo 1, once del grupo 2 y dos del grupo 3 (p=0.001). Al analizar y comparar las curvas del peso de cada grupo encontramos; Menor ganancia ponderal en el grupo 1(p=0.003). Conclusión. El PBTG es un material protésico que se puede utilizar en forma segura en la reparación de defectos congénitos de la pared abdominal

Exactitud dimensional de impresiones de alginato tratadas con fines de desinfección con una solución de glutaraldehido / Dimensional stability of alginate impressions treated with glutaraldehyde solution for desinfection

En la presente investigación, se estudia la exactitud dimensional de impresiones de alginato sumergidas en glutaraldehido al 2 por ciento, con fines de desinfección, por diferentes períodos de tiempo (5, 10, 20 y 30 minutos). Se concluye que no hay cambios dimensionales significativos, en los modelos vaciados de estas impresiones, al compararlos con un modelo patrón de bronce, en ninguno de los períodos de tiempo estudiados. Sin embargo, en el período de 5 minutos, se observan los mayores valores del porcentaje de exactitud dimensional de los modelos vaciados. Después de un período de 30 minutos de inmersión de las impresiones en glutaraldehido al 2 por ciento, se obtienen modelos vaciados con cambios en la textura y consistencia de su superficie. Se recomienda sumergir las impresiones por le menor tiempo posible que permita una adecuada desinfección

Control de infecciones en odontología: un informe microbiológico y una evaluación teórica en la Facultad de Odontología de la Pontificia Universidad Javeriana / Infection control in dentistry: a microbiological report and a theoretical evaluation in the School of Dentistry at the \"Pontificia Universidad Javeriana\"

Para evitar la contaminación cruzada en la práctica clínica, se requiere de un adecuado control de infecciones. El objetivo principal de este estudio es mostrar los diferentes microorganismos potencialmente patógenos presentes en algunas de las superficies de las clínicas de la Facultad de Odontología de la Pontificia Universidad Javeriana con base en un análisis microbiológico; también, evaluar el comportamiento clínico y los conocimientos acerca del control de infecciones de los profesores, alumnos y auxiliares por medio de una encuesta. Los resultados indicaron la presencia de microorganismos altamente patógenos tales como Estafilococos aureus, Escherichia coli, Aerococos, Estafilococos epidermides, Aspergillius, entre otros, los cuales crecieron en las diferentes muestras analizadas. También se utilizaron varias clases de soluciones químicas como medios de desinfección para poder determinar su efectividad entre las que fueron usadas el cloruro de benzalconio, el hipoclorito de sodio y glutaraldehído al 2 por ciento. El análisis estadístico de la encuesta mostró que más de un 70 por ciento de las personas que laboran en la facultad tienen un conocimiento limitado sobre el tema de control de infecciones, también casi un 80 por ciento poco conoce acerca del comportamiento que se debe tomar en caso de una inoculación percutánea. Queda claro que si no existe un conocimiento adecuado sobre el tema, tampoco se harán efectivas las medidas para el control de infecciones, por lo tanto el ciclo y cruce de contaminación será inevitable

Higiene en el gabinete odontológico. Estudio microbiológico de tres soluciones desinfectantes / Hygiene in the dental office. A microbiological study of three disinfectant solutions

El objetivo del estudio fue comparar la capacidad desinfectante de tres productos de uso frecuente en la práctica diaria odontológica, de distintas composiciones químicas

Tratamientos pulpares en dientes primarios. Guía de procedimientos (parte III) / Pulp therapies in primary teeth. Procedures guide (part III)

Para realizar tratamientos pulpares en dientes primarios debe considerarse la conducta del niño, la anatomía radicular y el grado de reabsorción de la pieza dentaria. Cuando no está indicada la endodoncia tradicional, es difícil ubicar una droga ideal, sin embargo, la línea de los aldehídos y bialdehídos, utilizada con criterio y oportunamente, permite evitar extracciones de piezas dentarias con gran destrucción y compromiso pulpar. El objetivo de este trabajo es seleccionar las drogas en sus concentraciones menos tóxicas para los tejidos peridentales y aplicarlas con técnicas sencillas y rápidas que permitan resolver la mayoría de los problemas pulpares que se presentan en la dentición primaria

Uso en cirugía plástica de la bioprótesis de pericardio bovino tratado con gluteraldehído / Use in Plastic Surgery of bovine pericardium treated with gluteraldehyde

Presentamos nuestra experiencia en la obtención, preparación, preservación y aplicación clínica de una bioprótesis de pericardio bovino tratada con gluteraldehído como curtidor y preservador, comparándolo con otros materiales sintéticos. En este trabajo, se incluyen 51 casos con 80 bioprótesis aplicadas para reparar defectos abdominales, donadores del colgajo musculocutáneo del recto anterior, para reforzar las reparaciones y aplicaturas musculares en dermolipectomías abdominales para definir mejor la silueta. También se ha utilizado para crear un brassiere (sostén) interno en casos de mamoplastias reductivas y en un caso de reparación de vandeletas y poleas de tendones flexores. La experiencia acumulada previamente a nivel experimental y la adquirida a nivel clínico, confirman la buena tolerancia, resistencia y estabilidad de este material a tres años de su utilización, por lo que podemos concluir que es recomendable su uso y que su campo de aplicación en cirugía reconstructiva, es prácticamente ilimitada

Ultra estrutura da matriz extracelular da polpa de dentes humanos hígidos / Ultrastructural study of the extracellular matrix of pulps of healthy human teeth

Considerando o papel fisiológico e biológico da matriz extracelular, propomo-nos a estudar a estrutura da rede de glicosaminoglicanas (GAGs) e proteoglicanas (PGs) no tecido conjuntivo de polpas de dentes molares humanos hígidos de pacientes ao redor de 20 anos. As polpas foram fixadas para microscopia eletrônica de transmissäo em soluçöes de glutaraldeído com vermelho de rutênio e com tetróxido de ósmio reduzido. A rede de GAGs e PGs foi constituída por grânulos de filamentos dispostos numa extensa malha uniforme, contínua e compacta, com nítido inter-relacionamento com a estrutura e posicionamento das fibrilas colágenas e com a superfície de células do tecido conjuntivo

Uso de adesivo biológico em anastomoses intestinais: estudo experimental em cäes / Biologic adhesive use in intestinal anastomosis: experimental study in dogs

Os autores mostraram em estudo experimental anastomoses intestinais feitas em cao com objetivo de testar o uso de adesivo à base de resorcina com formaldeido 3 por cento e glutaraldeído 25 por cento (Colagel).R Para isto utilizaram 6 caes mestiços, 3 machos e três fêmeas, com peso médio de 15 kg. Eram confeccionadas, em cada cao, duas secçoes transversas no intestino delgado, distante uma da outra 40 cm e reconstituiçao término-terminal. A primeira anastomose era feita com sutura em plano único extra-mucoso e pontos separados de fio monofilamentar de nylon 5-0 e a segunda anastomose era feita por técnica de telescopagem utilizando-se o adesivo em teste. Todos os animais morreram antes da data prevista para o sacrifício, num intervalo de tempo de 24 a 72 horas. A necrópsia revelou integridade da primeira anastomose com deiscência parcial ou total da segunda. Concluem nao ser este adesivo biológico útil em anastomoses intestinais pela técnica proposta.

Tratamento endodôntico em molares decíduos / Endodontical treatment in deciduous molars

Desenvolvemos este trabalho com a intenção de realizar um estudo analítico dos diversos aspectos de procedimentos aplicados a molares decíduos. Podemos concluir que a pulpotomia é a principal técnica endodôntica para manter a vitalidade pulpar