La autopsia psicológica en Colombia: ¿Concepto o procedimiento para la investigación científica? Una revisión sistemática

Introducción: La literatura científica reporta que la autopsia psicológica desde sus inicios fue utilizada con la finalidad de ayudar a determinar las circunstancias de muerte de una persona, no obstante, en la actualidad se acoge más como concepto que como una herramienta procedimental. Objetivo: Establecer si en Colombia se ha utilizado para reconstruir los aspectos pre mortem de quienes han fallecido en extrañas circunstancias, de acuerdo con la finalidad de esta. Metodología: Se realizó una revisión sistemática de la literatura científica en 10 bases de datos; se emplearon como palabras clave "autopsia psicológica" y "Colombia", bajo una ventana de observación entre 2010 al 2021; por medio del método PRISMA. Resultados: Se evidencia que en Colombia durante los últimos 10 años el número de estudios asciende a 19, publicados en bases de datos, de los cuales 16 no emplearon el procedimiento de autopsia psicológica y solo tres de ellos sí lo hicieron. Discusión: Existe una tendencia a emplear la autopsia psicológica como concepto desde un enfoque clínico para respaldar los análisis retrospectivos, que, como técnica o procedimiento, se distancia de la posibilidad de reconstruir la criminodinámica del delito, así como la reconstrucción de aspectos de la personalidad, el estado mental y el estilo de vida de quién ha fallecido. Conclusiones: Se resalta que en Colombia la autopsia psicológica se ha utilizado exclusivamente en el campo clínico, sin el rigor científico, metodológico y sin la validez del protocolo empleado.

Introduction: The scientific literature reports that psychological autopsy from its beginnings was used with the purpose of helping to determine the circumstances of death of a person, however, it is currently embraced more as a concept than as a procedural tool. Objective: to establish if in Colombia it has been used to reconstruct the pre-mortem aspects of those who have died under strange circumstances, according to its purpose. Methodology: a systematic review of the scientific literature was carried out in 10 databases, using as keywords psychological autopsy and Colombia, under a window of observation between 2010 and 2021; using the PRISMA method. Results: they show that in Colombia during the last 10 years the number of studies published in databases amounts to 19, of which 16 did not use the psychological autopsy procedure and only three of them did. Discussion: There is a tendency to use psychological autopsy as a concept from a clinical approach to support retrospective analyses rather than as a technique or procedure, distancing us from the possibility of reconstructing the criminodynamics of the crime, as well as reconstructing aspects of the personality, mental state and lifestyle of the deceased. Conclusions: it is highlighted that in Colombia the psychological autopsy has been used exclusively in the clinical field, without the scientific and methodological rigor and without the validity of the protocol used.

What drives the decision to optimise biological treatment in children and youngsters with juvenile idiopathic arthritis? A discrete-choice experiment.

OBJECTIVE: To analyse factors involved in the decision to optimise biologics in juvenile idiopathic arthritis. METHODS: A "discrete-choice" methodology was used. In a nominal group meeting, factors which may influence physicians' decisions to optimise biological dose were identified, together with decision nodes. 1000Minds® was used to create multiple fictitious clinical scenarios based on the factors identified, and to deploy surveys that were sent to a panel of experts. These experts decided for each item which of two clinical scenarios prompted them to optimise the dose of biologic. A conjoint analysis was carried out, and the partial-value functions and the weights of relative importance calculated. RESULTS: In the nominal group, three decision nodes were identified: (1) time to decide; (2) to maintain/reduce or prolong interval; (3) what drug to reduce. The factors elicited were different for each node and included patient and drug attributes. The presence of macrophage activation syndrome (MAS), systemic involvement, or subclinical inflammation made the decision easier (highest weights). The presence of joints of difficult control and year of debut influenced the decision in some but not all, and in different directions. Immunogenicity, adherence, and concomitant treatments were also aspects taken into account. CONCLUSIONS: The decision to optimise the dose of biological therapy in children and youngster can be divided into several nodes, and the factors, both patient and therapy-related, leading to the decision can be detailed. These decisions taken by experts may be transported to practice, study designs, and guidelines.

What drives the decision to optimise biological treatment in children and youngsters with juvenile idiopathic arthritis? A discrete-choice experiment / Modelo de elección discreta para entender la decisión de optimizar los biológicos en la artritis idiopática juvenil

Objective: To analyse factors involved in the decision to optimise biologics in juvenile idiopathic arthritis. Methods: A “discrete-choice” methodology was used. In a nominal group meeting, factors which may influence physicians’ decisions to optimise biological dose were identified, together with decision nodes. 1000Minds® was used to create multiple fictitious clinical scenarios based on the factors identified, and to deploy surveys that were sent to a panel of experts. These experts decided for each item which of two clinical scenarios prompted them to optimise the dose of biologic. A conjoint analysis was carried out, and the partial-value functions and the weights of relative importance calculated. Results: In the nominal group, three decision nodes were identified: (1) time to decide; (2) to maintain/reduce or prolong interval; (3) what drug to reduce. The factors elicited were different for each node and included patient and drug attributes. The presence of macrophage activation syndrome (MAS), systemic involvement, or subclinical inflammation made the decision easier (highest weights). The presence of joints of difficult control and year of debut influenced the decision in some but not all, and in different directions. Immunogenicity, adherence, and concomitant treatments were also aspects taken into account. Conclusions: The decision to optimise the dose of biological therapy in children and youngster can be divided into several nodes, and the factors, both patient and therapy-related, leading to the decision can be detailed. These decisions taken by experts may be transported to practice, study designs, and guidelines.(AU)

Objetivo: Analizar los factores que intervienen en la decisión de optimizar el biológico en la artritis idiopática juvenil. Métodos: Se utilizó la metodología de «elección discreta». Mediante grupo nominal se identificaron factores potencialmente influyentes en la decisión de optimizar la dosis de biológico y los nodos de decisión. Con 1000Minds® se crearon escenarios clínicos ficticios basados en los factores identificados que se mostraron en encuestas a un panel de expertos. Cada ítem de las encuestas mostraba 2 escenarios clínicos y los expertos elegían el que les llevaría a optimizar el biológico. Se realizó un análisis conjunto, calculándose las funciones de valor parcial y los pesos de importancia relativa. Resultados: Se identificaron 3 nodos de decisión: 1) dilatar decisión o no; 2) mantener/reducir o prolongar el intervalo; y 3) qué fármaco reducir. Los factores identificados varían por nodo e incluyen atributos del paciente y del fármaco. La presencia del síndrome de activación macrofágica, la afectación sistémica o la inflamación subclínica facilitaron la decisión (pesos más altos). La presencia de articulaciones de difícil control y el año de inicio influyeron en la decisión en algunos casos, pero no en todos, y en diferentes direcciones. La inmunogenicidad, la adherencia y los tratamientos concomitantes también fueron aspectos decisivos. Conclusiones: La decisión de optimizar la dosis de biológico en artritis idiopática juvenil se divide en varios nodos y se pueden detallar factores, tanto del paciente como del tratamiento, que determinan la decisión. Estas decisiones de experto pueden transportarse a la práctica, la investigación y las recomendaciones.(AU)

Risk scores for Kawasaki disease, a management tool developed by the KAWA-RACE cohort.

INTRODUCTION/OBJECTIVES: Asian scores developed to predict unresponsiveness to intravenous immunoglobulin (IVIG) or development of coronary artery aneurysms (CAA) in patients with Kawasaki disease (KD) are not appropriate in Western populations. The purpose of this study is to develop 2 scores, to predict unresponsiveness to IVIG and development of CAA, appropriate for Spanish population. METHOD: Data of 625 Spanish children with KD collected retrospectively (2011-2016) were used to identify variables to develop the 2 scores of interest: unresponsiveness to IVIG and development of CAA. A statistical model selected best variables to create the scores, and scores were validated with data from 98 patients collected prospectively. RESULTS: From 625 patients of the retrospective cohort, final analysis was performed in 439 subjects: 37 developed CAA, and 212 were unresponsive to IVIG. For the score to predict CAA, a cutoff ≥ 8 was considered for high risk, considering a score system with a different weight for each of the eight variables. External validation showed a sensitivity of 22% and a specificity of 75%. The score to predict unresponsiveness to IVIG established a cutoff ≥ 8 for high risk, considering a score system with a different weight for each of the nine variables. External validation showed a sensitivity of 78% and a specificity of 50%. CONCLUSIONS: Two risk scores for KD were developed from Spanish population, to predict development of CAA and unresponsiveness to IVIG; validation in other cohorts could help to implement these tools in the management of KD in other Western populations.

Imaging findings of multisystem inflammatory syndrome in children associated with COVID-19.

BACKGROUND: A hyperinflammatory immune-mediated shock syndrome has been recognised in children exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). OBJECTIVE: To describe typical imaging findings in children with multisystem inflammatory syndrome associated with COVID-19. MATERIALS AND METHODS: During the first wave of the COVID-19 pandemic, imaging studies and clinical data from children treated for multisystem inflammatory syndrome were collected from multiple centres. Standardised case templates including demographic, biochemical and imaging information were completed by participating centres and reviewed by paediatric radiologists and paediatricians. RESULTS: We included 37 children (21 boys; median age 8.0 years). Polymerase chain reaction (PCR) testing was positive for SARS-CoV-2 in 15/37 (41%) children and immunoglobulins in 13/19 children (68%). Common clinical presentations were fever (100%), abdominal pain (68%), rash (54%), conjunctivitis (38%) and cough (32%). Thirty-three children (89%) showed laboratory or imaging findings of cardiac involvement. Thirty of the 37 children (81%) required admission to the intensive care unit, with good recovery in all cases. Chest radiographs demonstrated cardiomegaly in 54% and signs of pulmonary venous hypertension/congestion in 73%. The most common chest CT abnormalities were ground-glass and interstitial opacities (83%), airspace consolidation (58%), pleural effusion (58%) and bronchial wall thickening (42%). Echocardiography revealed impaired cardiac function in half of cases (51%) and coronary artery abnormalities in 14%. Cardiac MRI showed myocardial oedema in 58%, pericardial effusion in 42% and decreased left ventricular function in 25%. Twenty children required imaging for abdominal symptoms, the commonest abnormalities being free fluid (71%) and terminal ileum wall thickening (57%). Twelve children underwent brain imaging, showing abnormalities in two cases. CONCLUSION: Children with multisystem inflammatory syndrome showed pulmonary, cardiac, abdominal and brain imaging findings, reflecting the multisystem inflammatory disease. Awareness of the imaging features of this disease is important for early diagnosis and treatment.

Colchicine treatment in children with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome: A multicenter study in Spain.

OBJECTIVE: To evaluate the efficacy of colchicine therapy in pediatric patients with PFAPA syndrome who present with an incomplete response to the standard treatment or with frequent episodes (an interval of less than 14 days between two disease flares). METHODS: A multicenter cohort study of children diagnosed with PFAPA syndrome and treated with colchicine was performed in three separate hospitals located in Spain. The patients clinical and laboratory data were reviewed by accessing their medical records. Response to colchicine was evaluated after 12 months of treatment for frequency, duration, and intensity of PFAPA episodes. RESULTS: A total of 13 children were included in our study, 43% of whom were boys. Median age of the colchicine therapy initiation was 6 years (interquartile range (IQR)=3-9.5). Following a 12-month period of colchicine therapy (median dosage of 0.02 mg/kg/day; IQR=0.02-0.03), a significant decrease in the median number of flares (median 8; IQR=7-14 vs 3; IQR=2-4; p=0.005) and the duration of disease episodes (median 4 days; IQR=3.25-5.125 vs 1 day; IQR=1-2; p=0.003) was observed. Furthermore, the highest degree of fever during disease flares was reduced from median 40ºC (IQR=39.5-40) to 38.5ºC (IQR=37.7-38.9) (p=0.002). CONCLUSION: Colchicine therapy decreased the frequency and intensity of PFAPA. The use of colchicine could be an effective treatment in pediatric patients with PFAPA syndrome who present with frequent or severe relapses.

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain.

Introduction: COVID-19 has a less severe course in children. In April 2020, some children presented with signs of multisystem inflammation with clinical signs overlapping with Kawasaki disease (KD), most of them requiring admission to the pediatric intensive care unit (PICU). This study aimed to describe the prevalence and clinical characteristics of KD SARS-CoV-2 confirmed and negative patients during the pandemic in Spain. Material and Methods: Medical data of KD patients from January 1, 2018 until May 30, 2020 was collected from the KAWA-RACE study group. We compared the KD cases diagnosed during the COVID-19 period (March 1-May 30, 2020) that were either SARS-CoV-2 confirmed (CoV+) or negative (CoV-) to those from the same period during 2018 and 2019 (PreCoV). Results: One hundred and twenty-four cases were collected. There was a significant increase in cases and PICU admissions in 2020 (P-trend = 0.001 and 0.0004, respectively). CoV+ patients were significantly older (7.5 vs. 2.5 yr) and mainly non-Caucasian (64 vs. 29%), had incomplete KD presentation (73 vs. 32%), lower leucocyte (9.5 vs. 15.5 × 109) and platelet count (174 vs. 423 × 109/L), higher inflammatory markers (C-Reactive Protein 18.5vs. 10.9 mg/dl) and terminal segment of the natriuretic atrial peptide (4,766 vs. 505 pg/ml), less aneurysm development (3.8 vs. 11.1%), and more myocardial dysfunction (30.8 vs. 1.6%) than PreCoV patients. Respiratory symptoms were not increased during the COVID-19 period. Conclusion: The KD CoV+ patients mostly meet pediatric inflammatory multisystem syndrome temporally associated with COVID-19/multisystem inflammatory syndrome in children criteria. Whether this is a novel entity or the same disease on different ends of the spectrum is yet to be clarified.

Behavior of mandibular canines as abutment teeth and indirect retainers in Kennedy class II Removable Partial Denture Prosthesis.

PURPOSE: The purpose of this study was to evaluate the behavior of mandibular canines acting as abutment teeth and indirect retainers of a Kennedy class II according to different designs: lingual rest and lingual rest associated with a reciprocal arm. MATERIALS & METHODS: A resin cast with two simulated canine teeth was made in Ni-Cr alloy, representing a Kennedy class II mandibular arch. With the objective of simulating the resilience of the periodontal ligament, a polyurethane layer was added at the canine tooth's root. A metallic framework of Co-Cr alloy was fabricated with a T bar clasp and a lingual rest associated with a reciprocal arm. To obtain the second framework, the reciprocal arm was removed using a tungsten bur. Each framework was submitted to tensile force using a VersaTest machine. The magnitude and direction of canine movement during removal of the framework was measured using two dial gauges (mm). The axial tensile force required to remove the experimental framework (N) was also evaluated. The data were compared using the paired t-test with 95% confidence intervals. Differences were considered significant at P < .05. RESULTS: The mean retentive force of the modified design framework with the reciprocal arm was significantly higher (P < .0001) than that of the framework with the lingual rest. The abutment teeth showed movement in the lingual and mesial directions, and this movement was less when associated with the reciprocal arm design. CONCLUSION: The reciprocal arm in association with a lingual rest in the framework decreased the movement of the abutment teeth when analyzed in the bucco-lingual and mesio-distal directions and contributed to increased retention by friction.

Epidemiology and Management of Acute, Uncomplicated Septic Arthritis and Osteomyelitis: Spanish Multicenter Study.

BACKGROUND: Acute osteoarticular infection (OAI) is a potentially severe disease. The aim of this study was to evaluate the etiology, clinical characteristics and therapeutic approach of OAI in children in Spain. METHODS: Medical records from children <14 years with OAI from 25 hospitals between 2008 and 2012 were reviewed. Confirmed osteomyelitis (OM) and septic arthritis (SA) required a positive bacterial isolate; otherwise, they were considered probable. Probable SA with <40,000 cells/mm in joint fluid was not included. RESULTS: A total of 641 children were evaluated. Two hundred and ninety-nine cases (46%) were OM, 232 (36%) SA, 77 (12%) osteoarthritis and 33 (5%) spondylodiscitis. Children with OM were older (63 vs. 43 months for SA; P < 0.001). Magnetic resonance imaging and bone scintigraphy had the highest yield for OM diagnosis (94%). Arthrocentesis was performed in 96% of SA. A microorganism was isolated in 246 patients (38%: 33% OM vs. 55% SA; P < 0.001): Staphylococcus aureus was the most common (63%), followed by Kingella kingae (15%) and Streptococcus pyogenes (9%). Ninety-five percent of children initially received IV antibiotics, mostly cefotaxime + cloxacillin (60%) or cloxacillin (40%). Total treatment duration was 38 (±31) days for OM and 28 (±16) days for SA (P < 0.0001). Twenty percent of children with OM (46% because of complications) and 53% with SA (95% initial arthrotomy) underwent surgery. Patients with SA were compared according to initial arthrotomy (n = 123) versus arthrocentesis (n = 109), and no clinical differences were observed, except for higher rate of hip SA in the former (50% vs. 9%; P < 0.001). Children with arthrocentesis had less sequelae [6.6% vs. 1%; P = 0.03, odds ratio = 0.58 (95% confidence interval: 0.45-0.76)], but not in the multivariate analysis. CONCLUSIONS: This is the largest pediatric cohort of OAI in Spain. S. aureus was the most common isolate, although K. kingae was recovered in a high proportion of cases. Conservative management was applied in half of the patients. There was a low rate of sequelae, even with nonsurgical approaches.

Consensus of the Spanish society of pediatric rheumatology for transition management from pediatric to adult care in rheumatic patients with childhood onset.

To develop recommendations on the transition from pediatric care to adult care in patients with chronic inflammatory rheumatic diseases with childhood onset based. Recommendations were generated following nominal group methodology and Delphi technique. A panel of 16 experts was established. A systematic literature review (on transitional care) and a narrative review were performed and presented to the panel in the first panel meeting to be discussed. A first draft of recommendations was generated and circulated. Focal groups with adolescents, young adults and parents were organized. In a second meeting, the focus group results along with the input from invited psychologist were used to establish definitive recommendations. Then, a Delphi process (two rounds) was carried out. A group of 72 pediatric and adult rheumatologists took part. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70 % voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford center for evidence-based medicine levels of evidence. Transition care was defined as a purposeful, planned process that addresses the medical, psychosocial and educational/vocational needs of adolescents and young adults with chronic inflammatory rheumatic diseases with childhood onset as they move from child-centered to adult-oriented healthcare systems. The consensus covers: transition needs, barriers and facilitators, transitional issues (objectives, participants, content, phases, timing, plans, documentation and responsibilities), physicians' and other health professionals' knowledge and skill requirements, models/programs, and strategies and guideline for implementation. Preliminary recommendations and agreement grade are shown in the Table (first Delphi round). These recommendations are intended to provide health professionals, patients, families and other stakeholders with a consensus on the transition process from pediatric to adult care.

Sistemas CAD/CAM / CAD CAM systems

Se realiza una revisión de los principales sistemas CAD/CAM usados en odontología, su técnica de funcionamiento, sus indicaciones, ventajas y desventajas, a fin que el cirujano dentista pueda elegir un sistema de acuerdo a la situación clínica, a la elección del paciente y sobre todo su disponibilidad en el mercado. Las siglas CAD/CAM son las iniciales del computer Aid Design y Computer Aid Manufacturing. Son sistemas diseñados y elaborados mediante computador. Las diferencias se refieren tanto a la toma o registro de la impresión como al procedimiento de elaboración, sea este intra o extrabucal. Todos ellos son muy tecnificados y costosos. Existe una diversidad de sistemas CAD/CAM: sistemas basados en lectura óptica y procesado mecánico (Cerec) sistemas basados en impresión mecánica y elaboración mecánica (Celay) y sistemas basados en impresión digital y elaboración probalemente mecánica (procera), con la tendencia al procesamiento de puentes con mayor número de pilares y a un menor costo.

A review of literature of main used systems CAD/CAM in dentistry, its technique of operation, its indications. advantages and disadvantages is made, to aim that the clinician can choose a system from agreement to the clinical situation the patient election and the availability in the market. Abbreviations CAD-CAM are the initials of computer Aid Design and Computer Aid Manuacturing. They are systems designed and elaborated by means of computer. The differences talk about so much to the taking or registry of the impression like the elaboration procedure. All of them very are technified and expensive. A diversity of systems CAD/CAM existem, but within most popular: system based on optical reading and mechanical precessing (Cerec) systems based on mechanical impression and mechanical elaboration (Celay) and systems based on digital impression and elaboration (probably) mechanical (procera) with the tendency to the processing of bridges with greater number of abutments and to smaller cost.

Prevalencia de factores parafuncionales y la sintomatología dolorosa en pacientes portadores de prótesis parcial removible: un estudio comparativo basado en las diferentes clases de Kennedy / Prevalence of parafunctional factors and pain in patients with removable partial dentures: a clinical evaluation based on Kennedy's classification

Este estudio analiza, comparativamente, la prevalencia de sintomatología dolorosa entre pacientes portadores de prótesis parcial removible, tomando como base la clasificación de Kennedy. Con esta finalidad, los pacientes, todos sintomáticos (n=60), fueron divididos en cuatro grupos de 15, correspondiendo cada uno, a una de las cuatro clases de Kennedy. Se procedió a la anamnesis, examén clínico, con observaciones objetivas y subjetivas particularmente dirigidas a las regiones asociadas, incluyendo la palpación muscular y de la región de la ATM. Fue realizada una evaluación cuidadosa del trabajo protético. Se estableció una metodología de test de records, con la finalidad de medir las respuestas de los pacientes, se aplicó para la comparación de los datos, el análisis de variación no paramétrico de Kruskal-Wallis. Después de las comparaciones estadísticas, se concluyó que había variaciones significativas entre las diferentes clases estudiadas, mostrando una prevalencia, para los pacientes, portadores de prótesis parciales removibles en arcos parcialmente edéntulos unilaterales (Clase II de Kennedy), como también una relación positiva entre ciertos hábitos parafuncionales y dolores en regiones asociadas.

Resistencia a la fractura frente a carga estática transversal en piezas dentarias restauradas con espigo-muñon colado, postes de fibra de carbono y de aleación de titanio / Fracture resistance to static transversal loading on teeth restored with post-core, fibre post carbon and post titanium alloy

El propósito del presente estudio fue determinar la resistencia a la fractura frente a carga estática transversal de piezas dentarias tratadas endodonticamente, restauradas con espigo-muñón colado, postes de fibra de carbono(C-Post, C Bisco Inc) y postes de aleación de titanio (Parapost, C Coltene/Whaledent Inc.). Se utilizó el adhesivo All Bond 2 (C Bisco, Inc) como material adhesivo y el cemento de resina Duolink (C Bisco Inc) para cementar los postes. La prueba de anova unifactorial encontró que las piezas dentarias restauradas con espigo-muñón colado tuvieron una mayor resistencia frente a carga estática transversal que las piezas dentarias restauradas con postes de fibra de carbono (C-Post, C Bisco Inc) y postes de aleación de titanio (Parapost, C Coltene/Whaledent Inc).

Avaliação do comportamento do canino inferior em função de dois desenhos: apoio em cíngulo e apoio em cíngulo associado a braço de reciprocidade por lingual, em classe II de Kennedy / An evaluation of the behaviour of the lower canine abutments for a Kennedy class II removable partial denture with two support designs: cingulum restand cingulum rest with association of a reciprocal clasp arm on the lingual side

O propósito dessa pesquisa foi avaliar o comportamento do canino inferior, atuando como pilar principal na estrutura de uma PPR Classe II de Kennedy, em função de dois desenhos: apoio em cíngulo e apoio em cíngulo associado a braço de reciprocidade por lingual; assim como o funcionamento da retenção indireta no canino contra-lateral. A metodologia utilizada baseou-se na confecção de um corpo-de-prova obtido a partir da reprodução de um modelo padrão, com características de arcada classe II de Kennedy e presença dos dentes 41 ao 47 e do 31 ao 33. Foram feitos os preparos dos dentes pilares principais, utilizando-se o delineador. Os pilares caninos foram fundidos, a fim de apresentar contornos adequados para a colocação dos componentes da PPR, cujo desenho incluía uma barra lingual mandibular indicada para casos pertencentes à classe II de Kennedy. Colocou-se uma camada de material poliuretano na raiz dos pilares caninos, com o objetivo de simular a resiliência do ligamento periodontal. Assim, foi confeccionada uma estrutura metálica sobre o corpo-de-prova, tendo o desenho de apoio em cíngulo e a presença do braço de reciprocidade no pilar canino. Retirado o braço de oposição, obteve-se o segundo desenho. A análise do comportamento dos pilares caninos foi feita com base nas medidas de dois relógios comparadores, em milímetros (mm). Estes mediam a quantidade e indicavam a direção de movimentação dos pilares, durante a remoção das estruturas no eixo de inserção, e por meio da sela protética que representava a rotação da PPR, além de pôr em funcionamento a retenção indireta. Foi avaliada ainda a força de tração axial necessária para a remoção das estruturas do corpo-de-prova em quilogramas (Kgf)...