Photobiomodulation therapy reduces postoperative pain after third molar extractions: A randomized clinical trial.

BACKGROUND: To assess the efficacy of PBMT on reducing postoperative pain scores in patients submitted to third molar extractions. MATERIAL AND METHODS: A randomized controlled trial (ReBEC:RBR-94BCKZ) was designed according to the SPIRIT and followed the CONSORT. Patients were randomly allocated according to control or PBMT groups. PBMT consisted of the application of GaAlAs laser (808nm;50mW) applied in six points (1.23 min;11 J/cm2) after extraction. Pain scores were assessed using the Visual Analogue Scale (VAS) in millimeters evaluated after 6 (T6), 24 (T24), and 48 (T48) hours. The Wilcoxon Mann-Whitney test was used to check for possible associations between VAS scores and treatment groups. RESULTS: A total of 101 third molar extractions were performed in 44 patients. The mean age was 28 years old(SD±11.54). Comparing control and intervention, PBMT group showed a significant effect on the reduction of postoperative pain at T6(mean VAS=0.9; C.I:0.63-1.16) compared to control (mean VAS=2.5;C.I:2.1-2.88)(p<0.001). The same statistically significant effect on the reduction of postoperative pain was observed at T24 (PBMT mean VAS=0.72;C.I:0.51-0.93; control mean VAS=2.86;C.I:2.40-3.31;p<0.001) and T48 (PBMT mean VAS=0.64;C.I:0.36-0.92; control mean VAS=2.86;C.I:2.37-3.34;p<0.001). CONCLUSIONS: PBMT significantly reduce the postoperative pain scores when assessed 6, 24, and 48 hours after third molar extractions.

A new acridone with antifungal properties against Candida spp. and dermatophytes, and antibiofilm activity against C. albicans.

AIM: The increase in the number of fungal infections worldwide, coupled with the limitations of current antifungal chemotherapy, demand the development of safe and effective new antifungals. Here, we presented the synthesis of a novel acridone (M14) and its antifungal properties against Candida and dermatophytes species. METHODS AND RESULTS: A series of 17 acridones was designed, synthesized and tested for its antifungal activity. The minimum inhibitory concentration (MIC) was determined by the broth microdilution method. Only the acridone M14 showed growth-inhibitory activity against reference strains and clinical isolates of Candida and dermatophytes, with MIC range of 7·81-31·25 µg ml-1 . Moreover, M14 exhibited fungicidal activity and prevented biofilm formation by C. albicans as well as reduced the viability of preformed biofilms, even at sub-MICs. The confocal laser scanning microscopy analysis revealed that C. albicans hyphal growth was completely inhibited in the presence of M14. Similarly, there was a severe inhibition on hyphal growth of Trichophyton rubrum. We also found that M14 has relatively low toxicity to human fibroblasts. CONCLUSIONS: The new acridone M14 has antifungal properties against Candida spp. and dermatophytes, and antibiofilm activity against C. albicans. In addition, M14 is relatively selective to fungal cells compared to human normal cells. SIGNIFICANCE AND IMPACT OF THE STUDY: Because of its in vitro antifungal activity, anti-Candida biofilm effect and moderate cytotoxicity towards normal human cell, M14 may serve as a valuable lead compound to develop a new antifungal agent.

Wear Behavior of Graded Glass/Zirconia Crowns and Their Antagonists.

Monolithic zirconia crowns have become very popular; their surface finish is considered a key factor for restoration longevity. While polishing has shown excellent results in vivo, the surface glass infiltration of zirconia may offer superior damage resistance and aesthetic advantages by using tooth-colored glasses. Thus, the purpose of this study is to evaluate the efficacy of polishing and glass infiltration on the wear behavior of monolithic zirconia crowns. The wear behavior of intact natural molar teeth was investigated as a reference. Zirconia crowns were divided into 3 groups: PolZ-sintered then polished; PolGZ-polished in the presintered state and then glass infiltrated and sintered; NoPolGZ-as machined, glass infiltrated and sintered. Crowns were adhesively bonded to a dentin-like abutment. Zirconia crowns and molar teeth ( n = 15) were subjected to contact-slide-liftoff cyclic loading (200 N, 1.25 million cycles) with a steatite sphere ( r = 3 mm) as an antagonist in water. Surface and subsurface damages were investigated with optical and scanning electron microscopies. Wear depth and volume loss were determined with micro-computed tomography. PolGZ and NoPolGZ crowns exhibited shallow wear scars, where material loss remained within the glass/zirconia layer with no visible cracks. Meanwhile, PolZ crowns presented no visible wear damage. Volume loss (mm3) in the steatite antagonist was as follows (mean ± SD): PolZ = 0.022 ± 0.007, PolGZ = 0.011 ± 0.004, and NoPolGZ = 0.014 ± 0.006. Molar teeth yielded no measurable wear on the antagonist, while the wear scar on the teeth was greater than that on zirconia crowns, ranging from 0.07 to 0.35 mm3. The combination of polishing and glass infiltration on the occlusal surface of monolithic zirconia crowns yielded reduced wear on both crown and antagonist.

Pharmacokinetic assessment of sufentanil in cardiac surgery.

Plasma monitoring and pharmacokinetic assessment are important tools used in therapeutic control. Sufentanil is responsible for the hemodynamic stabilization of patients, providing better suppression of the neuroendocrine response compared to its analogue fentanyl. This study aims to use the plasma monitoring of sufentanil in patients undergoing cardiac surgery with extracorporeal circulation (ECC, group 1) or without ECC (group 2) to assess the pharmacokinetics of the compound.The 42 patients in this study received 0.5 µg/kg of sufentanil through bolus injection followed by a maintenance infusion of 0.5 µg/kg.h. Serial blood samples were collected during the post induction intraoperative period and during the postoperative period until 36 h after sufentanil administration. The plasma concentrations were determined by a validated method utilizing liquid chromatography coupled to mass spectrometry. The pharmacokinetic modeling was performed using a 3-compartment model fit.The surgical patients included in the protocol were adults of both genders, with 30 patients in the ECC group and 12 in the group without ECC. The plasma concentrations obtained were significantly different between the 2 groups. During the extracorporeal circulation procedure, intense fluctuations were observed in the sufentanil plasma concentrations. Compared with the results of group 2, the ECC procedure reduced the terminal or gamma half-life from 36.35 ± 6.37 h to 23.25 ± 2.75 h in group 1. In addition, the ECC procedure promoted higher fluctuations in the sufentanil plasma concentrations without causing alterations in the area under the curve, distribution volume, clearance or the distributional (alpha) and rapid elimination (beta) half-lives (t1/2α and t1/2ß, respectively).

Correlation of previous experience, patient expectation and the number of post-delivery adjustments of complete dentures with patient satisfaction in a Brazilian population.

A number of variables may influence the outcome of complete denture therapy. The objective of this study was to verify possible correlations between previous experience with dentures, patient expectation and the number of post-delivery adjustments with patient satisfaction after treatment. One hundred patients (mean age 61·9 ± 10·3) rated their previous experiences with complete dentures and their expectations before and satisfaction after treatment on a visual analogue scale (VAS) using scores from 0 (worst results) to 10 (best results). The number of post-delivery adjustments and other patient-related clinical variables was also noted. Patient expectation scores were higher than previous experience scores and satisfaction after treatment scores. Positive and weak correlations were found between previous chewing experiences with complete dentures, with regard to chewing expectations and comfort of use. Phonetics and comfort of use in previous experiences presented a positive correlation with expectations for chewing, aesthetics, phonetics and comfort of use. Groups of patients with different levels of education presented significant differences in expectation scores regarding comfort of use as well. A negative and weak correlation was found between phonetics satisfaction and the number of post-delivery adjustments. Patients' expectations for the therapy were higher than their satisfaction after treatment. Previous experiences with complete dentures could slightly influence patients' expectations and satisfaction, whereas lower scores for previous experience with complete dentures caused lower scores for both expectation and satisfaction. Patients' educational levels and the number of post-delivery adjustments influenced negatively the expectations about comfort of use and patient satisfaction, respectively.

Three-dimensional finite element analysis of stress distribution in peri-implant bone with relined dentures and different heights of healing caps.

The purpose of this study was to evaluate the influence of height of healing caps and the use of soft liner materials on the stress distribution in peri-implant bone during masticatory function in conventional complete dentures during the healing period by using finite element analysis. Three-dimensional models of a severely resorbed mandible with two recently placed implants in the anterior region were created and divided into the following situations: (i) submerged implants, (ii) healing cap at gingival level and (iii) 1·5-mm supragingival. All these situations were also analysed for a conventional complete denture and a denture relined with a 3-mm-thick layer of soft liner material. The models were exported to mechanical simulation software that presented two simulations, one with load in the inferior right canine (35 N) and the other in the inferior right first molar (50 N). Data were evaluated using Maximum Principal Stress provided by the software. All models showed a stress concentration in the cortical bone corresponding to the cervical part of the implant. The simulations with non-submerged implants showed higher values of stress concentration than those that were submerged. Likewise, soft liner materials presented better results than when the denture base was not relined. The height of the healing caps seems to have a direct influence on the stress distribution in the peri-implant bone during the healing period. Considering the values obtained in this study, the use of soft liners with submerged implants seems to be the most suitable method to use during the period of osseointegration.

Patients' expectations and satisfaction of complete denture therapy and correlation with locus of control.

Considering the importance of patients' satisfaction with complete denture therapy and the influence of psychosocial aspects and expectations regarding satisfaction with their dentures, the present study aimed to test for a correlation between locus of control profiles and expectations before and satisfaction after complete denture therapy. Sixty-four patients rated their expectations for aesthetic and functional results of complete denture therapy on a 10-cm visual analogue scale (VAS), using scores from 0 (worst results) to 10 (best results). A similar questionnaire was used regarding satisfaction after final denture adjustments. Patients also answered a locus of control questionnaire in the initial interview. ANOVA and a chi-squared test were used to test for correlations among ratings, patient gender and locus of control profiles. The significance level adopted was 0.05. The expectation ratings before treatment were significantly lower than the post-treatment completion ratings, both for aesthetics (P < 0.001) and function (P = 0.004). There was no correlation between locus of control profiles and patients' ratings or between gender and VAS scores. No correlation was found between locus of control profiles and scores for expectations before and satisfaction after complete dentures.

[Fetal human myocardium. Proliferation of the myocytes and development of the cardiac interstitium in the last two gestational trimesters]. / Miocárdio fetal humano. Proliferação do miócito e desenvolvimento do interstício cardíaco nos dois últimos trimestres gestacionais.

PURPOSE: To determine prenatal myocardial quantitative changes by using stereology. METHODS: Twenty-six human fetuses were studied (16 in the 2nd trimester and 10 in the 3rd trimester). The hearts were dissected, weighted, fixed in the Bouin's solution for 12 h, embedded in paraplast, sectioned and stained by HE and trichrome of Gomori. Ten random microscopic fields were analyzed by heart. The following parameters were studied: Vv[myocyte] and Vv[interstitium] (%) (the volume densities of the cardiac myocyte and interstitium), and Nv[myocyte] (1/mm3) (the numerical density of the cardiac myocytes) by the dissector method. The total number of myocytes (N[myocyte]) and the mean volume of the myocytes (V[myocyte]) were also determined. The differences were tested by the Mann-Whitney non-parametric test. RESULTS: The cardiac weight increased of 1.95 to 9.1 g, the Vv[myocyte] decreased from 85.18 to 77.78% and the Vv[interstitium] increased from 14.83 to 22.22%. The Nv[myocyte] decreased from 68.86 x 10(4) to 57.40 x 10(4)/mm3. The V[myocyte] increased from 1214.38 to 1412.31 microns3 and the N[myocyte] increased from 1.36 x 10(9) to 5.06 x 10(9) myocytes. These differences were statistically significant (p < 0.05). CONCLUSION: These results suggest the development of the myocardium at the end of the fetal human period as being mainly hypertrophic to the myocyte and the cardiac interstitium.

Current advances on the study of snail-snail interactions, with special emphasis on competition process.

Field work research on population dynamic of snails from the regions of Belo Horizonte and Lagoa Santa give much information about interactions among two or more species of mollusks: Pomacea haustrum, Biomphalaria glabrata, B. tenagophila, B. straminea and Melanoides tuberculata. Data ranging from two years to several decades ago suggest that the Pampulha reservoir is like a cemetery of B. glabrata and B. straminea, species that coexist for more than 14 years in a small part of a stream, whereas only B. glabrata lives in all the streams of the basin. In the last ten to twenty years B. tenagophila has coexisted with P. haustrum and M. tuberculata in the Serra Verde ponds and in the Pampulha dam. However these species have not settled in any of the brooks, except temporarily. The data suggest that the kind of biotope and the habitat conditions are decisive factors for the permanence of each species in its preferencial biotope. B. glabrata, natural from streams and riverheads, quickly disappears from the reservoirs and ponds where it coexists with other species for a short time, independently of the competitive process. Competition needs to be better studied, since in Central America and Caribean islands this kind of study has favored the biological control of planorbid species.

Quantitative study of the myocardium in human embryos.

We studied six human embryos of the second gestational month (postsomitic period, from stages 15 to 23). They were fixed in 4% formaldehyde and serially sectioned. Stereological determinations were made from the compact layer of the ventricular myocardium: a) volume density of the myocardial parts: myocytes (Vv[myocyte]) and interstitium (Vv[interstitium]), b) numerical density of the myocytes (Nv[myocyte] mm3) calculated from six optical disector pairs per embryo, c) total number of myocytes (N[myocyte]), d) volume of the myocytes (V[myocyte] micron 3). In embryos from stages 15 to 19 the quantities of the myocytes and interstitium remained practically unchanged (no statistical difference was found). However, the volume of the ventricular myocardium mass increased more than 5 times during this period. Comparing embryos of stages 15 and 23, the mean value of the Nv[myocyte] decreased about 30 per cent, while N[myocyte] increased almost 2,000 per cent in the same period. Simultaneously, the volume of the ventricular myocardial mass increased almost 30 times, and Vv[myocyte] and Vv[interstitium] showed a small increase in the myocyte component (about 20 per cent), with a decrease of the interstitial component (about 70 per cent). In the early post-somitic period the human myocardium has a relatively small number of small myocytes, in the late post-somitic period it is composed of large and relatively abundant cardiac myocytes. The conspicuous increase in the ventricular myocardial volume observed in stage 23 seems not to be related to the increase in the interstitial portion of the myocardium. These arguments suggest both the enlargement and the division of the cardiac myocytes during the post-somitic period.

[Competitive behavior of Biomphalaria glabrata and Biomphalaria tenagophila--laboratory studies]. / Estratégia competitiva entre Biomphalaria glabrata e Biomphalaria tenagophila--estudos de laboratório.

Observation about cohabitation among B. glabrata and B. tenagophila revealed a greater vulnerability of B. tenagophila population during the process of competition when its density was severely decreased in 12 trials, moderate in 2 trials. It was higher than B. glabrata in only one trial. Some snail water chemical parameters analysed such as pH, alkalinity, conductivity and oxygen dissolved, and the viability rate of batch of eggs didn't give subsidy to explain the competition mechanism. The newly-born survival, in the situation of cohabitation, was low for both species. This reveals the existence of intra and interspecific competitive interaction. The fertility rate reduction of B. tenagophila during the cohabitation was considered as a cause of its exclusion. One of the factors that seems to have influenced the fertility rate was a possible wrong crossing.