Validation of the Childhood Family Mealtime Questionnaire in Mexican Adolescents with Obesity and Their Caregivers.

BACKGROUND: Childhood obesity is a significant public health concern in Mexico, with far-reaching implications for the nation's healthcare system and economy. In light of this challenge, our study sought to validate the Childhood Family Mealtime Questionnaire (CFMQ) in Mexican adolescents living with obesity and their primary caregivers. METHODS: A sample of 56 adolescents ages 13 to 17 years and their primary caregivers from one pediatric obesity clinic participated in the study. We conducted a comprehensive assessment of the CFMQ's consistency, reliability, and construct validity among all participants. Internal consistency was determined using Cronbach's α, and the questionnaire's reliability was assessed through test-retest and intraclass correlation coefficients. Construct validity was assessed through an exploratory factor analysis. RESULTS: Our findings confirmed strong internal consistency and reliability for both adolescents and caregivers. Construct validity was established through exploratory factor analysis, refining the questionnaire while preserving its original seven dimensions. This validation of the CFMQ highlights its applicability in evaluating family mealtime experiences in this context, providing valuable insights into the dynamics that influence adolescent nutrition and health. CONCLUSION: The CFMQ proves to be a reliable tool for assessing family mealtime experiences in Mexican adolescents living with obesity and their caregivers who seek care at third-level public hospitals.

ProDeM: A Process-Oriented Delphi Method for systematic asynchronous and consensual surgical process modelling.

Surgical process models support improving healthcare provision by facilitating communication and reasoning about processes in the medical domain. Modelling surgical processes is challenging as it requires integrating information that might be fragmented, scattered, and not process-oriented. These challenges can be faced by involving healthcare domain experts during process modelling. This paper presents ProDeM: a novel Process-Oriented Delphi Method for the systematic, asynchronous, and consensual modelling of surgical processes. ProDeM is an adaptable and flexible method that acknowledges that: (i) domain experts have busy calendars and might be geographically dispersed, and (ii) various elements of the process model need to be assessed to ensure model quality. The contribution of the paper is twofold as it outlines ProDeM, but also demonstrates its operationalisation in the context of a well-known surgical process. Besides showing the method's feasibility in practice, we also present an evaluation of the method by the experts involved in the demonstration.

Striatal Neuronal Ensembles Reveal Differential Actions of Amantadine and Clozapine to Ameliorate Mice L-DOPA-Induced Dyskinesia.

Amantadine and clozapine have proved to reduce abnormal involuntary movements (AIMs) in preclinical and clinical studies of L-DOPA-Induced Dyskinesias (LID). Even though both drugs decrease AIMs, they may have different action mechanisms by using different receptors and signaling profiles. Here we asked whether there are differences in how they modulate neuronal activity of multiple striatal neurons within the striatal microcircuit at histological level during the dose-peak of L-DOPA in ex-vivo brain slices obtained from dyskinetic mice. To answer this question, we used calcium imaging to record the activity of dozens of neurons of the dorsolateral striatum before and after drugs administration in vitro. We also developed an analysis framework to extract encoding insights from calcium imaging data by quantifying neuronal activity, identifying neuronal ensembles by linking neurons that coactivate using hierarchical cluster analysis and extracting network parameters using Graph Theory. The results show that while both drugs reduce LIDs scores behaviorally in a similar way, they have several different and specific actions on modulating the dyskinetic striatal microcircuit. The extracted features were highly accurate in separating amantadine and clozapine effects by means of principal components analysis (PCA) and support vector machine (SVM) algorithms. These results predict possible synergistic actions of amantadine and clozapine on the dyskinetic striatal microcircuit establishing a framework for a bioassay to test novel antidyskinetic drugs or treatments in vitro.

Microbiota y sepsis

La sepsis es la respuesta desordenada del organismo a la infección y se caracteriza por un daño a los órganos que puede ser irreversible y mortal. El microbioma intestinal regula a un grupo de mecanismos homeostáticos en el huésped, como la función inmunológica y la protección de la barrera intestinal, la pérdida de la estructura y la función microbiana intestinal normal; además, se ha asociado con el inicio de enfermedades de características diversas. La evidencia reciente ha demostrado un nexo entre el microbioma intestinal y la sepsis: la alteración del microbioma intestinal aumenta la susceptibilidad a la sepsis a través de varios mecanismos como la expansión de bacterias intestinales patógenas, la respuesta proinflamatoria marcada y la disminución de la formación de productos microbianos beneficiosos como los ácidos grasos de cadena corta. Una vez establecida la sepsis, la alteración del microbioma intestinal empeora y aumenta la susceptibilidad a la disfunción del órgano terminal. Existen pruebas limitadas de que las terapias basadas en microbiomas (que incluyen a probióticos y a la descontaminación digestiva selectiva) pueden disminuir el riesgo de sepsis y mejorar sus resultados en poblaciones de pacientes seleccionadas, pero las preocupaciones sobre la seguridad causan una aceptación limitada. Si bien gran parte de la evidencia que vincula el microbioma intestinal y la sepsis se ha establecido en estudios preclínicos, aún es necesaria la evidencia clínica en distintas áreas.

Sepsis is the body's overwhelming response to an infection. It is characterized by damage to the organs that may be irreversible and life-threatening. The gastrointestinal microbiome regulates a series of homeostatic mechanisms in the host, such as the immune function and the protection of the intestinal barrier, and the loss of normal intestinal microbial structure and function. Moreover, it has been associated with the onset of diseases of diverse characteristics. Recent evidence has shown a link between the gastrointestinal microbiome and sepsis: the alteration of the gastrointestinal microbiome increases the susceptibility to sepsis through various mechanisms, including the expansion of pathogenic intestinal bacteria, marked pro-inflammatory response and decreased production of beneficial microbial products such as short-chain fatty acids. Once sepsis is established, the alteration of the gastrointestinal microbiome worsens and the susceptibility to end-organ dysfunction increases. There is limited evidence that microbiome-based therapies, which include probiotics and selective digestive decontamination, can decrease the risk of sepsis and improve its outcomes in selected patient populations. However, safety concerns generate limited acceptance. While much of the evidence linking the gastrointestinal microbiome and sepsis has been established in preclinical studies, clinical evidence is still necessary in many areas.

NGF/TRKA Promotes ADAM17-Dependent Cleavage of P75 in Ovarian Cells: Elucidating a Pro-Tumoral Mechanism.

Nerve growth factor (NGF) and its high-affinity receptor TRKA are overexpressed in epithelial ovarian cancer (EOC) displaying a crucial role in the disease progression. Otherwise, NGF interacts with its low-affinity receptor P75, activating pro-apoptotic pathways. In neurons, P75 could be cleaved by metalloproteinases (α and γ-secretases), leading to a decrease in P75 signaling. Therefore, this study aimed to evaluate whether the shedding of P75 occurs in EOC cells and whether NGF/TRKA could promote the cleavage of the P75 receptor. The immunodetection of the α-secretase, ADAM17, TRKA, P75, and P75 fragments was assessed by immunohisto/cytochemistry and Western blot in biopsies and ovarian cell lines. The TRKA and secretases' inhibition was performed using specific inhibitors. The results show that P75 immunodetection decreased during EOC progression and was negatively correlated with the presence of TRKA in EOC biopsies. NGF/TRKA increases ADAM17 levels and the fragments of P75 in ovarian cells. This effect is abolished when cells are previously treated with ADAM17, γ-secretase, and TRKA inhibitors. These results indicate that NGF/TRKA promotes the shedding of P75, involving the activation of secretases such as ADAM17. Since ADAM17 has been proposed as a screening marker for early detection of EOC, our results contribute to understanding better the role of ADAM17 and NGF/TRKA in EOC pathogenesis, which includes the NGF/TRKA-mediated cleavage of P75.

Process mining for healthcare: Characteristics and challenges.

Process mining techniques can be used to analyse business processes using the data logged during their execution. These techniques are leveraged in a wide range of domains, including healthcare, where it focuses mainly on the analysis of diagnostic, treatment, and organisational processes. Despite the huge amount of data generated in hospitals by staff and machinery involved in healthcare processes, there is no evidence of a systematic uptake of process mining beyond targeted case studies in a research context. When developing and using process mining in healthcare, distinguishing characteristics of healthcare processes such as their variability and patient-centred focus require targeted attention. Against this background, the Process-Oriented Data Science in Healthcare Alliance has been established to propagate the research and application of techniques targeting the data-driven improvement of healthcare processes. This paper, an initiative of the alliance, presents the distinguishing characteristics of the healthcare domain that need to be considered to successfully use process mining, as well as open challenges that need to be addressed by the community in the future.

Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis.

INTRODUCTION: Sepsis is a public health problem due to its high prevalence and mortality. Mean platelet volume (MPV), a biomarker reported in routine blood counts, has been investigated and shows promise for determining fatal outcomes in septic patients. OBJECTIVE: Evaluate whether the mean platelet volume (MPV) and mean platelet volume-to-platelet count (MPV/P) ratio are predictors of clinical severity and mortality in patients with sepsis. METHODS: A prospective population cohort of 163 patients aged 18-97 years was recruited at the Intensive Care Unit of Pablo Arturo Hospital, Quito, Ecuador from 2017-2019 and followed up for 28 days. Patients were diagnosed with sepsis based on SEPSIS-3 septic shock criteria; in which the MPV and the MPV/P ratio were measured on days 1, 2, and 3. Sequential organ failure assessment (SOFA) score and presence of septic shock assessed clinical severity. Mortality on day 28 was considered the fatal outcome. RESULTS: The average age of the patients was 61,15 years (SD 20,94) and female sex was predominant. MPV cutoff points at days 1, 2 and 3 were >9,45fL, >8,95fL and >8, 85fL; and (MPV/P) ratio >8, 18, >4, 12 y >3, 95, respectively. MPV at days 2 (9,85fL) and 3 (8,55fL) and (MPV/P) ratio at days 1 (4,42), 2 (4,21), and 3 (8,55), were predictors of clinical severity assessed by septic shock, which reached significance in the ROC curves. MPV and (MPV/P) ratio were also predictors of clinical severity determined by SOFA at days 1, 2, and 3, where higher values were observed in non-survivors reaching significance in all categories. MPV and MPV/P ratio at days 1, 2 and 3 were independent predictor factors of mortality using Cox proportional hazards model (HR 2,31; 95% CI 1,36-3,94), (HR 2,11; 95% CI 1,17-3,82), (HR 2,13; 95% CI 1,07-4,21) and (HR 2,38; 95% CI 1,38-4,12), (HR 2,15; 95% CI 1,14-4,06), (HR 4,43; 95% CI, 1,72-11,37) respectively. CONCLUSIONS: MPV and the MPV/P ratio are predictors of clinical severity and mortality in sepsis. The MPV and its coefficient are indicators of the biological behavior of platelets in sepsis. They should be considered as a cost-effective and rapidly available tool that guides the treatment.

Prevalence of Dementia and Associated Factors among Older Adults in Latin America during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic. METHODS: A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the "Alzheimer Disease 8" scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ2 tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors. RESULTS: We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors. CONCLUSION: The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.

Synthesis of Silver Nanoparticles Using Aqueous Leaf Extract of Mimosa albida (Mimosoideae): Characterization and Antioxidant Activity.

The search for sensitive and rapid analytical techniques for the determination of natural antioxidants is an area in constant growth due, among other aspects, to the complexity of plant matrices. In this study, silver nanoparticles prepared with the aqueous extract of Mimosa albida leaves were used to assess their polyphenolic content and antioxidant capacity. Silver nanoparticles were characterized by different techniques. As a result, nanoparticles of 6.5 ± 3.1 nm were obtained. The total phenolic content in the extract was 1320.4 ± 17.6 mg of gallic acid equivalents GAE. 100 g-1 and in the nanoparticles 257.3 ± 5.1 mg GAE. 100 g-1. From the phenolic profile analyzed by ultra high-performance liquid chromatography (UPLC) with a diode-array detector (DAD), the presence of apigenin and luteolin in the plant extract is postulated. The antioxidant capacity measured by oxygen radical absorbance capacity ORAC-fluorescein assay was 86917 ± 6287 and 7563 ± 967 µmol ET g-1 in the extract and nanoparticles respectively. Electrochemical analysis by cyclic voltammetry (CV) confirmed the effective reduction capacity of the Mimosa albida leaves extract to reduce Ag ions to AgNPs and differential pulse voltammetry (DPV) suggested the presence of two main reducing agents in the extract. From this study, it was concluded that the aqueous extract of Mimosa albida contains reducing agents capable of synthesizing silver nanoparticles, which can be used in the phytochemical industry.

Effect of different irrigating solutions and photo-activated therapy for in vivo root canal treatment.

This study aimed to evaluate histologically the effect of irrigation with 400 ppm Sterilox, 2% and 5% sodium hypochlorite (NaOCl), with and without photo-activated therapy (PAD), in a single-visit root canal treatment of dog's teeth with apical periodontitis (AP). Ten dogs were randomly divided into two groups (n=5): with and without PAD, and the root canals into four subgroups, according to the irrigating solution: SX (400 ppm Sterilox), SH2 (2% NaOCl), SH5 (5% NaOCl) and SS (saline solution) as positive control. A total of 134 root canals were opened and left exposed to the oral environment for 14 days and then sealed for 60 days for AP induction. Then, root canals were treated according to each proposed disinfecting protocol and filled in the same session. After 120 days, the dogs were euthanized and the periapical inflammatory events were evaluated under light microscopy. Qualitative data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). PAD did not produce significant differences in the scores for apical inflammation when used after chemo-mechanical preparation (p>0.05). The irrigating solutions SX, SH2 and SH5 without PAD were statistically different from SS (p<0.05) that presented the greatest scores for apical inflammation. PAD did not show any additional effect for the treatment of root canals with pulp necrosis and AP in a single visit and 400 ppm Sterilox may be considered an alternative to NaOCl in root canal treatment.

Effect of Different Irrigating Solutions and Photo-Activated Therapy for In Vivo Root Canal Treatment

This study aimed to evaluate histologically the effect of irrigation with 400 ppm Sterilox, 2% and 5% sodium hypochlorite (NaOCl), with and without photo-activated therapy (PAD), in a single-visit root canal treatment of dog's teeth with apical periodontitis (AP). Ten dogs were randomly divided into two groups (n=5): with and without PAD, and the root canals into four subgroups, according to the irrigating solution: SX (400 ppm Sterilox), SH2 (2% NaOCl), SH5 (5% NaOCl) and SS (saline solution) as positive control. A total of 134 root canals were opened and left exposed to the oral environment for 14 days and then sealed for 60 days for AP induction. Then, root canals were treated according to each proposed disinfecting protocol and filled in the same session. After 120 days, the dogs were euthanized and the periapical inflammatory events were evaluated under light microscopy. Qualitative data were submitted to Kruskal-Wallis and Mann-Whitney tests (α=0.05). PAD did not produce significant differences in the scores for apical inflammation when used after chemo-mechanical preparation (p>0.05). The irrigating solutions SX, SH2 and SH5 without PAD were statistically different from SS (p<0.05) that presented the greatest scores for apical inflammation. PAD did not show any additional effect for the treatment of root canals with pulp necrosis and AP in a single visit and 400 ppm Sterilox may be considered an alternative to NaOCl in root canal treatment.

Este estudo realizou uma avaliação histológica do efeito das soluções irrigadoras Sterilox 400 ppm e hipoclorito de sódio (NaOCl) a 2% e 5%, com e sem a terapia fotodinâmica (PAD), na endodontia em sessão única de dentes de cães associados a lesões periapicais (APs). Dez cães foram divididos de forma randomizada em dois grupos (n=5): com e sem PAD, e os canais radiculares em quatro subgrupos, de acordo com a solução irrigadora utilizada: SX (Sterilox 400 ppm), SH2 (NaOCl 2%), SH5 (NaOCl 5%) e SS (solução salina) como controle positivo. Cento e trinta e quatro canais foram abertos e deixados expostos ao meio oral por 14 dias e depois selados por 60 dias para a indução de APs. Na sequência, os canais foram tratados de acordo com cada protocolo de desinfecção proposto e obturados na mesma sessão. Após 120 dias, os cães foram mortos e os eventos inflamatórios periapicais foram avaliados em microscopia óptica. Os dados qualitativos foram analisados estatisticamente pelos testes Kruskal-Wallis e Mann-Whitney (α=0,05). A PAD, quando empregada após o preparo químico-mecânico, não promoveu diferenças significativas nos escores para inflamação apical (p>0,05). As soluções irrigadoras SX, SH2 e SH5 sem PAD apresentaram diferenças estatísticas do grupo SS (p<0,05) que apresentou os maiores escores para inflamação apical. A PAD não apresentou efeito adicional na endodontia em sessão única dos canais com necrose pulpar associados a lesão apical e a solução irrigadora Sterilox 400 ppm pode ser considerada uma alternativa ao NaOCl na terapia endodôntica.

Avaliação de três técnicas de instrumentação com diferentes diâmetros apicais na formação de smear layer / Evaluation of three instrumentation techniques with different apical diameters on smear layer formation

Objetivo: avaliar os efeitos de diferentes instrumentações na formação de smear layer no terço apical de 90 raízes mesiobucais de molares superiores por microscopia eletrônica de varredura (MEV). Materiais e método: três grupos foram formados baseados nas técnicas utilizadas: instrumentação manual, sistema rotatório K3 e sistema reciprocante NSK. Os grupos foram subdivididos em três, de acordo com o diâmetro apical: #30, #35 ou #40. Após o preparo, as raízes foram seccionadas no sentido transversal, separando os terços apicais do restante das raízes; esses terços foram divididos em duas metades e preparados para MEV. A formação de smear layer na superfície do canal radicular e os túbulos den-tinários foram avaliados por escores num aumento de 1.000×. Os dados foram analisados pelo teste Kruskal-Wallis complementado pelo teste de Dunn (p < 0.05). Resultados: o aumento no diâmetro do preparo apical não influenciou na formação de smear layer nas paredes dentinárias. Conclusão: apesar das técnicas e dos diâmetros apicais utilizados durante o preparo, nenhuma parede livre de smear layer foi observada.

Accuracy of cone-beam computed tomography and periapical radiography in apical periodontitis diagnosis.

INTRODUCTION: This study aimed to investigate the correlation and the agreement between periapical radiography (PR) and cone-beam computed tomography (CBCT) correlating to histologic findings in the diagnosis of apical periodontitis (AP). METHODS: One hundred thirty-four premolar root canals from 10 dogs were treated after AP induction. Four months later, the animals were killed, and standard digital PRs were obtained. The area of AP was measured by using ImageJ software. CBCT (i-CAT) images from each arch were obtained, and AP area and volume were measured by using Osiri-X software. The apical inflammatory infiltrate was evaluated under light microscopy. The correlation between imaging methods was evaluated by using the Pearson coefficient. The Bland-Altman method was used to assess the agreement between PR and CBCT data. The Spearman coefficient was used to correlate the imaging data and histologic findings. RESULTS: Despite a strong correlation between PR and CBCT areas, the agreement limits were very broad (95% limits of agreement, 0.19-1.08). PR only measured, on average, 63% of CBCT values. Although there was a strong correlation between PR area and CBCT volume, the Bland-Altman method suggests that the larger the CBCT volume, the more underestimated the PR value. When APs had a volume smaller than 6 mm(3), the PR estimation of CBCT data was unpredictable. A positive correlation was found for PR area, CBCT area, CBCT volume, and histology data. CONCLUSIONS: The diagnosis of AP based on PR data is clinically limited, and it should not be used for scientific investigations.

Role of glutamate receptors in the dorsal reticular nucleus in formalin-induced secondary allodynia.

The role of glutamate receptors present in the medullary dorsal reticular nucleus (DRt) in the formalin test and formalin-induced secondary nociception was studied in rats. Secondary mechanical allodynia was assessed with von Frey filaments applied to the rat's hindpaw, and secondary thermal hyperalgesia was evaluated with the tail-immersion test. The selective glutamate receptor antagonists MK801 (N-methyl-D-aspartate receptor antagonist), 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) (AMPA/KA receptor antagonist) and A841720 (metabotropic glutamate 1 receptor antagonist) were injected into the DRt before or 6 days after formalin injection in the rat. In the formalin test, the three antagonists significantly reduced the number of flinches in both phases of the test. DRt microinjection of MK801 or A841720, but not of CNQX, reduced both secondary nociceptive behaviors. Moreover, pre-treatment with the three antagonists injected into the DRt prevented the development of secondary mechanical allodynia and secondary thermal hyperalgesia. Similarly, in these rats, the number of c-Fos-like immunoreactive neurons were markedly reduced in both the superficial and deep lamina of the dorsal horn. Our findings support the role of DRt as a pain facilitator in acute and chronic pain states, and suggest a key role of glutamate receptors during the development and maintenance of formalin-induced secondary allodynia.

¿Tienen una personalidad distinta los adolescentes consumidores de psicoestimulantes? / Do adolescents who use stimulants have a different personality?

El consumo de psicoestimulantes tiene una especial importancia en nuestro medio por su notable incremento entre los más jóvenes. El objetivo del presente estudio es determinar si hay diferencias entre menores de edad consumidores y no consumidores de psicoestimulantes (cocaína y éxtasis) en función de las características de personalidad evaluadas con el MACI. La muestra está formada por 398 jóvenes entre 14 y 17 años que fueron seleccionados con un muestreo aleatorio en los domicilios de los entrevistados y en lugares de ocio y diversión. Los resultados confirman la existencia de importantes diferencias en las características de personalidad de ambos. Los jóvenes que han consumido psicoestimulantes se caracterizan por tener los prototipos de personalidad Rebelde, Rudo, Oposicionista y Tendencia límite (AU)

Stimulant consumption is especially important in our context because its use has greatly increased in recent years. The aim of the present study is to analyze the differences between stimulant users and nonusers (under 18 years old) in personality characteristics assessed with the MACI. The sample comprises 398 youths between 14 and 17 years old who were selected through random sampling in their homes or in recreational night spots. Results show important differences in personality features between stimulant users and nonusers. Stimulant users are characterized by having unruly, forceful, oppositional and borderline-tendency personality prototypes (AU)

[Do adolescents who use stimulants have a different personality?]. / Tienen una personalidad distinta los adolescentes consumidores de psicoestimulantes?

Stimulant consumption is especially important in our context because its use has greatly increased in recent years. The aim of the present study is to analyze the differences between stimulant users and nonusers (under 18 years old) in personality characteristics assessed with the MACI. The sample comprises 398 youths between 14 and 17 years old who were selected through random sampling in their homes or in recreational night spots. Results show important differences in personality features between stimulant users and nonusers. Stimulant users are characterized by having unruly, forceful, oppositional and borderline-tendency personality prototypes.

Effect of endodontic preflaring on electronic determination of working length / Efeito do pré-alargamento endodôntico na determinação eletrônica do comprimento de trabalho

PURPOSE: To evaluate the effect of preflaring on the electronic measurement of working length in mesiobuccal roots of maxillary molars. METHODS: Thirty roots were embedded in an alginate model. Root canals were irrigated with 2.5 percent sodium hypochlorite, and a size 10 K file was inserted into the canal until the locator indicated that apical constriction had been reached. Then, the cervical portion of each canal was flared using the ProTaper system shaping files, whereupon electronic measurements were carried out again. RESULTS: The Student's t test for paired samples did not reveal statistically significant differences in the measurements obtained for preflared and unflared canals (P<0.05). CONCLUSION: Based on the lack of clinical significant relevance of the comparisons carried out in the present study, it is possible to conclude that electronic working length measurement can be carried out either before or after cervical preparation.

OBJETIVO: Avaliar o efeito do pré-alargamento sobre a medição eletrônica do comprimento de trabalho em raízes mésio-vestibulares de molares superiores. METODOLOGIA: Trinta raízes foram incluídas em um modelo de alginato. Canais radiculares foram irrigados com hipoclorito de sódio a 2,5 por cento, e uma lima de tamanho 10 K foi inserida no canal até onde o localizador indicou que a constrição apical tinha sido alcançada. A porção cervical de cada canal foi alargada usando as limas do sistema ProTaper, quando então as medições eletrônicas foram realizados novamente. RESULTADOS: O teste t de Student para amostras pareadas não mostrou diferenças estatisticamente significativas nas medições obtidas para canais pré-alargados e não alargados (P<0,05). CONCLUSÃO: Com base na falta de relevância clínica significativa das comparações realizadas no presente estudo, é possível concluir que a medição do comprimento eletrônico de trabalho pode ser realizado antes ou após o preparo cervical.

Endodontic treatment of a 36-mm long upper cuspid: clinical case report / Tratamento endodôntico de canino superior medindo 36 mm de comprimento: relato de um caso clínico

Purpose: To report a clinical case of a 36 mm long upper cuspid submitted to root canal treatment, with emphasis on the alternative technique employed. Case description: A 32 years old, male patient had suffered subluxation of teeth 12 and 13 and coronal fracture involving enamel and dentin, as well as pulp exposition, of tooth 14 because of a motorcycle accident. The man was given dental assistance and a semi-rigid splinting of teeth numbers 12 and 13 was carried out followed by the root canal treatment in a single visit on tooth no. 14. At 30-day follow-up pulp necrosis was detected in teeth 12 and 13 and the root canal treatment was implemented. The tooth 13 was 36 mm long and since the longest possible file (31 mm) was already in use, the cervical limit of the access cavity was considered as the reference point. Conclusion: This technique not only provided adequate disinfection, preparation and filling of the root canal, but it also allowed preservation of the remaining tooth structure.

Objetivo: Descrever o tratamento endodôntico de um canino superior medindo 36 mm de comprimento, mostrando a técnica empregada no preparo do canal radicular e obturação. Descrição do Caso: Paciente do sexo masculino, com 32 anos de idade, sofreu subluxação dos dentes 12 e 13 e fratura coronária envolvendo esmalte e dentina, com exposição pulpar do dente 14, devido a um acidente de moto. No atendimento de urgência, foi realizada a contenção semirrígida dos dentes 12 e 13, seguida da endodontia em sessão única do dente 14. Trinta dias após, foi diagnosticada necrose pulpar dos dentes 12 e 13 e sua endodontia foi, então, iniciada. O comprimento aparente do dente 13 foi estabelecido em 36 mm e como o instrumento mais longo que dispomos no mercado possui 31 mm, o limite cervical da cavidade de acesso foi usado como bordo de referência. Conclusão: Além de garantir uma correta sanificação, modelagem e obturação do canal, esta técnica também permitiu a preservação da estrutura dental remanescente.

Apical transportation: two assessment methods.

Root canal transportation can lead to treatment failure. A large number of methodologies for assessing root canal preparation have been tried in the past. This study compared two methods for apical transportation measurement: digitised images of longitudinal root sections and radiographs. Sixty upper molar mesiobuccal root canals prepared for endodontic treatment were assessed. The results did not demonstrate statistically significant differences between the two imaging methods used to evaluate root canal transportation. The two methods were proven to be equally reliable.

Apical transportation: a comparative evaluation of three root canal instrumentation techniques with three different apical diameters.

This study conducted an in vitro analysis of the level of apical transportation in mesiobuccal roots of upper molars after manual instrumentation with stainless steel files, preparation with the K3 system, and with a reciprocating NSK handpiece. Sixty roots were mounted in muffles and then longitudinally sectioned. A digital image was acquired of the inner surface of one root half. After instrumentation, the inner surfaces of the same root halves were digitized with file sizes #30, #35, and #40. Each image obtained was superimposed over the corresponding preoperative image, and the apical transportation was measured. The Friedman and Wilcoxon tests were used to compare results for the file sizes, and comparison of the groups was made with the Kruskal-Wallis test, demonstrating statistically significant differences (P = .000). The stainless steel file sizes #35 and #40 caused significant apical transportation, and K3 system proved safe for apical preparation, with little deviation.