Accuracy of arch expansion with two thermoplastic materials in Invisalign® patients: EX30® and SmartTrack®.

OBJECTIVE: The purpose of this retrospective study was to compare accuracy of arch expansion using two different thermoplastic materials in Invisalign aligners: EX30® (Polyethylene Terephthalate Glycol, or PETG) and SmartTrack® (polyurethane). METHODS: The study sample comprised 65 adult patients consecutively treated with Invisalign from two private practices: group 1 - treated with EX30® (358 teeth) and group 2 - treated with SmartTrack® (888 teeth). Six hundred and twenty-three measurements were assessed in three digital models throughout treatment: model 1 - initial, model 2 - predicted tooth position, and model 3 - achieved position. Sixteen reference points per arch were marked and, after best alignment, 2 points per tooth were copied from one digital model to another. Linear values of both arches were measured for canines, premolars, and first molars: on lingual gingival margins and cusp tips of every tooth. Comparisons were performed by Wilcoxon and Mann-Whitney test. RESULTS: Both termoplastic materials presented significant differences between predicted and achieved values for all measurements, except for the lower molar cusp tip in the SmartTrack® group. There is no statistical difference in the accuracy of transverse expansion between these two materials. Overall accuracy for EX30® aligners in maxilla and mandible were found to be 37 and 38%, respectively; and Smarttrack® presented an overall accuracy of 56.62% in the maxilla and 68.72% in the mandible. CONCLUSIONS: It is not possible to affirm one material expands better than the other. Further controlled clinical studies should be conducted comparing SmartTrack® and EX30® under similar conditions.

Accuracy of Invisalign® aligners in adult patients: a retrospective study of angular tooth movements.

OBJECTIVE: This retrospective study aimed to assess the predictability of Invisalign® aligners regarding rotational, mesio-distal and buccal-lingual tip movements. METHODS: Two materials were included in the analysis - EX30, used until 2013; and SmartTrack, in current use. The study comprised 56 adult patients treated with Invisalign Comprehensive. Data sample were assessed on three sets of digital models; model 1 - initial, model 2 - predicted, and model 3 - achieved. Sixty reference points were marked in each dental arch, and two reference planes assisted the superimposition. The degree of rotation, mesio-distal and buccal-lingual tip was obtained via trigonometric calculations, through a previously published validated method. The accuracy of outcomes was compared according to the types of tooth movement and teeth groups,and the influence of predetermined variables on movement accuracy was also investigated. RESULTS: Rotation and mesio-distal tip did not present any significant difference when comparing EX30 and SmartTrack groups. Only buccal-lingual tip presented a significant difference, incisor and canine groups treated with EX30 aligners presented an increase in accuracy (p= 0.007 and p = 0.007, respectively). For each additional degree planned for rotation movements, there was an increase of 0.35° in the discrepancy, and an increase of 0.40° and 0.41° for mesio-distal and buccal-lingual tip, respectively. EX30 and SmartTrack discrepancies were compared by multilevel linear regression. CONCLUSION: EX30 aligners reached higher accuracy for buccal-lingual tip in anterior teeth. However, for rotation and mesio-distal tip, SmartTrack and EX30 are similarly accurate. The total amount of planned movement has a significant impact on accuracy rates, with a decrease in accuracy for every additional degree.

Accuracy of arch expansion with two thermoplastic materials in Invisalign® patients: EX30® and SmartTrack®

ABSTRACT Objective: The purpose of this retrospective study was to compare accuracy of arch expansion using two different thermoplastic materials in Invisalign aligners: EX30® (Polyethylene Terephthalate Glycol, or PETG) and SmartTrack® (polyurethane). Methods: The study sample comprised 65 adult patients consecutively treated with Invisalign from two private practices: group 1 - treated with EX30® (358 teeth) and group 2 - treated with SmartTrack® (888 teeth). Six hundred and twenty-three measurements were assessed in three digital models throughout treatment: model 1 - initial, model 2 - predicted tooth position, and model 3 - achieved position. Sixteen reference points per arch were marked and, after best alignment, 2 points per tooth were copied from one digital model to another. Linear values of both arches were measured for canines, premolars, and first molars: on lingual gingival margins and cusp tips of every tooth. Comparisons were performed by Wilcoxon and Mann-Whitney test. Results: Both termoplastic materials presented significant differences between predicted and achieved values for all measurements, except for the lower molar cusp tip in the SmartTrack® group. There is no statistical difference in the accuracy of transverse expansion between these two materials. Overall accuracy for EX30® aligners in maxilla and mandible were found to be 37 and 38%, respectively; and Smarttrack® presented an overall accuracy of 56.62% in the maxilla and 68.72% in the mandible. Conclusions: It is not possible to affirm one material expands better than the other. Further controlled clinical studies should be conducted comparing SmartTrack® and EX30® under similar conditions.

RESUMO Objetivo: O objetivo deste estudo retrospectivo foi comparar a acurácia na expansão da arcada utilizando alinhadores Invisalign com dois tipos de material termoplástico: EX30® (Polietileno Tereftalato Glicol, ou PETG) e SmartTrack® (poliuretano). Método: A amostra desse estudo incluiu 65 pacientes adultos tratados consecutivamente em dois consultórios particulares: grupo 1 - tratado com EX30® (358 dentes), e grupo 2 - tratado com SmartTrack® (888 dentes). Foram avaliadas 623 medidas em três pares de modelos digitais, ao longo do tratamento: modelo 1 - inicial, modelo 2 - posição dentária planejada, modelo 3 - posição alcançada. Foram marcados 16 pontos de referência por arcada e, após o bestfit, 2 pontos por arcada foram copiados de um modelo digital para o outro. Medidas lineares de ambas as arcadas foram aferidas para caninos, pré-molares e primeiros molares, localizadas na margem gengival lingual e ponta de cúspide de todos os dentes. Foram realizadas comparações usando os testes Wilcoxon e Mann-Whitney. Resultados: Ambos os materiais termoplásticos apresentaram diferenças significativas entre os valores planejados e alcançados em todas as medidas, exceto na ponta de cúspide dos primeiros molares inferiores do grupo SmartTrack®. Não houve diferença estatística entre esses dois materiais quanto à acurácia da expansão transversa. Em termos gerais, a acurácia dos alinhadores EX30® na maxila e mandíbula foi de 37% e 38%, respectivamente. O grupo SmartTrack® apresentou acurácia de 56,62% e 68,72% na maxila e mandíbula, respectivamente. Conclusões: Não foi possível afirmar que um material expande melhor que o outro. Estudos clínicos controlados futuros devem ser conduzidos comparando SmartTrack® e EX30® sob condições similares.

Accuracy of Invisalign® aligners in adult patients: a retrospective study of angular tooth movements

ABSTRACT Objective: This retrospective study aimed to assess the predictability of Invisalign® aligners regarding rotational, mesio-distal and buccal-lingual tip movements. Methods: Two materials were included in the analysis - EX30, used until 2013; and SmartTrack, in current use. The study comprised 56 adult patients treated with Invisalign Comprehensive. Data sample were assessed on three sets of digital models; model 1 - initial, model 2 - predicted, and model 3 - achieved. Sixty reference points were marked in each dental arch, and two reference planes assisted the superimposition. The degree of rotation, mesio-distal and buccal-lingual tip was obtained via trigonometric calculations, through a previously published validated method. The accuracy of outcomes was compared according to the types of tooth movement and teeth groups,and the influence of predetermined variables on movement accuracy was also investigated. Results: Rotation and mesio-distal tip did not present any significant difference when comparing EX30 and SmartTrack groups. Only buccal-lingual tip presented a significant difference, incisor and canine groups treated with EX30 aligners presented an increase in accuracy (p= 0.007 and p = 0.007, respectively). For each additional degree planned for rotation movements, there was an increase of 0.35° in the discrepancy, and an increase of 0.40° and 0.41° for mesio-distal and buccal-lingual tip, respectively. EX30 and SmartTrack discrepancies were compared by multilevel linear regression. Conclusion: EX30 aligners reached higher accuracy for buccal-lingual tip in anterior teeth. However, for rotation and mesio-distal tip, SmartTrack and EX30 are similarly accurate. The total amount of planned movement has a significant impact on accuracy rates, with a decrease in accuracy for every additional degree.

RESUMO Objetivo: Esse estudo retrospectivo teve como objetivo aferir a previsibilidade dos alinhadores Invisalign em relação aos movimentos de rotação e inclinações mesiodistal e vestibulolingual. Material e Métodos: Foram incluídos dois materiais nessa análise: EX30®, utilizado até 2013; e SmartTrack®, atualmente em uso. Esse estudo avaliou 56 pacientes tratados com Invisalign Comprehensive. Os dados foram avaliados em três pares de modelos digitais; modelo 1 - inicial, modelo 2 - planejado, e modelo 3 - alcançado. Foram marcados 60 pontos de referência em cada arcada, sendo a sobreposição realizada com auxílio de planos de referência. O grau de rotação e inclinações mesiodistal e vestibulolingual foi obtido por cálculos de trigonometria, usando um método validado publicado anteriormente. Os resultados foram comparados de acordo com os tipos de movimento dentário e grupos de dentes, também foi investigada a influência de variáveis predeterminadas na confiabilidade dos movimentos. Resultados: Os movimentos de rotação e inclinação mesiodistal não apresentaram diferença estatística, quando comparados os grupos EX30® e SmartTrack®. Somente a inclinação vestibulolingual apresentou diferença estatisticamente significativa, sendo que os grupos de incisivos e caninos tratados com alinhadores EX30® apresentaram um aumento na previsibilidade(p= 0,007 e p= 0,007, respectivamente). Para cada grau adicional planejado para movimento de rotação, ocorreu um aumento de 0,35° na discrepância, e aumentos de 0,40° e 0,41° para as inclinações mesiodistal e vestibulolingual, respectivamente. As discrepâncias entre EX30® e SmartTrack® foram comparadas por regressão linear multinível. Conclusão: Os alinhadores EX30® alcançaram maior previsibilidade para a inclinação vestibulolingual em dentes anteriores. No entanto, para rotação e inclinação mesiodistal, SmartTrack® e EX30® apresentaram previsibilidade similar. A quantidade total de movimento planejado apresenta influência significativa nas taxas de previsibilidade, com diminuição na acurácia para cada grau adicional.

Seroprevalence of Trypanosoma cruzi in pregnant women in Midwest Brazil: an evaluation of congenital transmission.

Chagas disease (CD) is caused by the protozoan Trypanosoma cruzi and it is mainly acquired through the vector route, however, blood transfusion and congenital transmission are implicated in the spread of the illness worldwide. The congenital route can occur at any stage of pregnancy and its frequency varies. In the Federal District, in Brazil, the frequency of T. cruzi infection in pregnant women and their offspring has not been updated. Thus, the aim of this study was to estimate the prevalence of T. cruzi infection in pregnant women and the rate of congenital transmission in the Federal District. A cross-sectional study was conducted to estimate the seroprevalence of T. cruzi from 2014 to 2016 in the population of pregnant women attended by the public health service throughout the Federal District and a descriptive cohort for the evaluation of congenital transmission. During the study, prenatal data of 98,895 women were consulted and pregnant women registered in 2016, presenting with positive T. cruzi serology, were part of the descriptive cohort. The estimated prevalence of T. cruzi infection in the three years was 0.19% and the congenital transmission rate was 1/40 (2.5%). Our results have shown that, although the main routes of transmission of CD have been interrupted, there is still a risk of congenital transmission in the Federal District. This present study highlights the need for the continuous implementation of a screening program for pregnant women and timely treatment of infected newborns and children.

Comparative evaluation of different fixation techniques of the sagittal split ramus osteotomy in 10 mm advancements: Mechanical testing and screw insertion torque.

PURPOSE: To compare the mechanical characteristics of five techniques for the functionally stable fixation of simulated sagittal split ramus osteotomy with 10 mm of advancement and to evaluate the screw insertion torque. MATERIALS AND METHODS: Fifty polyurethane hemimandibles with sagittal split ramus osteotomy and containing an advancement of 10 mm fixed and distributed as follows: Customized 3D Plate Group: 1 customized 3D miniplate; 4-Hole Plate Group: 2 miniplates with 4 holes; 6-Hole Plate Group: 2 miniplates with 6 holes; Hybrid Group: 1 flat miniplate with 4 holes and 1 bicortical screw; and Bicortical Screw Group: 3 bicortical screws. We conducted a mechanical test using vertical linear loading with a displacement velocity of 1 mm/min on a universal testing machine and assessed the screw insertion torque using a digital torque wrench. RESULTS: The means of strength for the 1-, 3- and 5-mm displacements were determined by a one-way analysis of variance (ANOVA) followed by the post hoc Tukey test. Statistically significant differences were observed only for the 5-mm displacement (F = 3.36; p = 0.01). There was a difference between the 4-H2P and HG groups (p = 0.04). CONCLUSION: The customized miniplate, the fixation methods with three bicortical screws, or with two straight miniplates with either 4 or 6 holes, all offer a similar mechanical resistance suitable for fixation.

Tissue repair after selective alveolar corticotomy in orthodontic patients: A preliminary study.

OBJECTIVES: To analyze histologic findings of bone remodeling at the time of surgery and 90 days later at corticotomized and noncorticotomized sites. MATERIALS AND METHODS: Eight adult patients with bilaterally inclined mandibular molars were included in this split-mouth study. Corticotomy was performed on the test side, and bone was harvested on both mandibular hemi-arches. Bone blocks were shipped to Forsyth Institute lab (Boston, Mass). After surgery, cantilevers were activated to upright inclined mandibular molars on both sides. Approximately 90 days after surgery, new mandibular bone blocks were harvested from test and control sites. Histologic analyses were performed on both groups (test and control sides) at two time points: baseline (T0) and 90 days after surgery (T90). Bone blocks were stained with hematoxylin and eosin, and Masson's trichrome. The protocols enabled screening of new bone formation and collagen in mineralized and nonmineralized connective tissue. Outcomes were compared using a clustered generalized estimating equations model Results: The test group at T90 exhibited an increase of 16% of primary bone ( P < .05), an increase of 6.6 in osteocytes quantity ( P = .039), and an increase of 4.06 in reversal lines quantity ( P = .924). Both groups exhibited a decrease in the inorganic proportion. CONCLUSIONS: The intentional bone injury performed in adult patients undergoing orthodontic treatment can be considered temporary and reversible. Evidence indicates that baseline bone characteristics are unaltered.

Conhecimento da equipe de enfermagem perante os principais tipos de infecções hospitalares / Knowledge of the nursing team in the main types of hospital infections

Objetivo: identificar o conhecimento da equipe de enfermagem perante as infecções hospitalares. Método:estudo quantitativo, exploratório-descritivo, com 30 técnicos de enfermagem e 10 enfermeiros. O instrumentoutilizado para coleta de dados foi um questionário, analisado estatisticamente. Os resultados foram expressosem tabelas. Resultados: 100% dos enfermeiros e 96,7% dos técnicos de enfermagem têm conhecimento sobrea infecção hospitalar; 80% dos enfermeiros e 70% dos técnicos de enfermagem usam o EPI (Equipamento deProteção Individual) corretamente. Conclusão: a maior porção da equipe de enfermagem compreende osriscos perante as infecções hospitalares; a enfermagem apresenta grande importância para redução dos níveisde infecções nos hospitais.

Influence of degree of edentulism in mandible fractures / Influência do grau de edentulismo em fraturas mandíbulas

Objective ­ To characterize epidemiologically the aspects of incidence, treatment and complications of mandibular fractures in dentate, partially dentate and edentulous patients. Methods ­ Data were collected from medical records of patients seen by the department of Oral and Maxillofacial Surgery, Piracicaba School of Dentistry/UNICAMP, from January 1999 to October 2009. Results ­ Were selected 738 adult patients, grouped into three age groups (18 to 30 years, 31-64 years and over 64 years), whose degree of edentulism was informed, being 330 dentition (45%), 367 partially serrated (50%) and 41 edentulous (5%). The ratio between male and female was 4:1, mean age of 31 years, with higher incidence in caucasians, and 81% were economically active. The most common causes were traffic accidents (54%), followed by assault (20%), falls (15%), sports accidents (4%) and work (4%). Condylar fractures accounted for 29% of all fractures, followed by fractures of the body (25%), symphysis (24%) and angle (19%). The only significant difference between the sites of fracture was found in the edentulous, which presented a low incidence of angle fractures. Conclusions ­ It was observed that this population, homogeneous as to the cultural and socio-environmental factors, the dentate, partially dentate and edentulous behaved similarly as to the mandibular fractures resulting from trauma energies of similar intensities.

Objetivo ­ Caracterizar epidemiologicamente os aspectos de incidência, tratamento e complicações de fraturas mandibulares em pacientes dentados, parcialmente dentados e edêntulos. Métodos ­ Os dados foram coletados de prontuários de pacientes atendidos pelo departamento de Cirurgia Oral e Maxilofacial, Faculdade de Odontologia de Piracicaba/UNICAMP, de janeiro de 1999 a outubro de 2009. Resultados ­ Foram selecionados 738 pacientes adultos, agrupados em três faixas etárias (18 a 30 anos, 31-64 anos e mais de 64 anos), cujo grau de edentulismo foi informado, sendo 330 dentições (45%), 367 parcialmente serrilhadas (50%) e 41 edêntulas (5%). A proporção entre homens e mulheres foi de 4:1, idade média de 31 anos, com maior incidência em caucasianos e 81% economicamente ativas. As causas mais comuns foram os acidentes de trânsito (54%), seguidos pelo assalto (20%), quedas (15%), acidentes esportivos (4%) e trabalho (4%). As fraturas condilares representaram 29% de todas as fraturas, seguidas de fraturas do corpo (25%), sínfise (24%) e ângulo (19%). A única diferença significativa entre os locais de fratura foi encontrada no edêntulo, que apresentou baixa incidência de fraturas angulares. Conclusões ­ Observou-se que esta população, homogênea quanto aos fatores culturais e socioambientais, dentada, parcialmente dentada e edêntula, comporta-se de forma semelhante às fraturas mandibulares resultantes de energias de trauma de intensidades semelhantes.

Evaluation of cyclic and linear mechanical resistance of prebent and manually-bent plates used for maxillary advancement in orthognathic surgery.

The aim of the present study was to compare prebent and manually-bent plates used in maxillary advancement. The prebent plates were fixed in polyurethane blocks for the linear test and aluminium blocks for the cyclic test, and the manually-bent plates were fixed in polyurethane and aluminium blocks. The linear load tests were done using an Instron® 4411 mechanical testing machine and the cyclic test with an Instron® E3000 testing machine. The linear mechanical test showed that there was no significant difference between the plates. In the cyclic test the prebent plates reached the limit of 500000 cycles without fracturing whereas the manually-bent plate group fractured before reaching the limit of cycles (p=0.008). The decision to use prebent or manually-bent plates during operations should be influenced by the production of the bends and their consequent brittleness.

Tratamento da assimetria facial causada por hiperplasia condilar: série de casos / Treatment of facial asymmetry caused by condylar hyperplasia: case series

Introdução: a hiperplasia do côndilo (HC) mandibular tem sido descrita como o crescimento excessivo de um dos côndilos sobre o contralateral, causando um crescimento desequilibrado, que resulta em assimetria facial. A classificação e o diagnóstico da HC, a atividade de crescimento dos côndilos, e as formas de tratamento foram abordados no presente estudo. Material e Métodos: foram descritas as formas de tratamento de três pacientes apresentando HC. As soluções cirúrgicas são representadas por condilectomia, cirurgia ortognática, e uma combinação de ambos. Resultados: após a realização do procedimento cirúrgico específico indicado para cada caso, houve melhora significativa na simetria facial e na função mastigatória. Conclusões: o diagnóstico da HC se baseia em achados clínicos e radiológicos, e esses avaliam as consequências do crescimento desproporcional. A cintilografia óssea funciona como um indicador da rapidez da progressão dessa condição, sendo essencial no planejamento cirúrgico do tratamento

Humanização: fragilidades, desafios e fortalezas em uma escola de odontologia / Humanization: difficulties, challenges and strengths at a school of dentistry

Analisar a percepção de discentes, docentes e usuários sobre humanização na sua dimensão ampla nas clínicas multidisciplinares do Departamento de Odontologia da Universidade Federal do Rio Grande do Norte. Metodologia: Estudo qualitativo cujos dados foram coletados usando-se três instrumentos: questionários autoaplicáveis (alunos e usuários), um caso simulado (professores), além da observação direta nas clínicas. As respostas geradas foram categorizadas, analisadas e interpretadas à luz do referencial teórico de Bardin. Resultados: Os resultados apontam categorias como ambiência e acessibilidade nas falas dos alunos e usuários como pontos que precisam ser melhorados. Entre docentes o acolhimento e os aspectos éticos foram as categorias emergentes, mostrando preocupação nesse aspecto no trato com o usuário. A observação direta revelou categorias importantes como efeitos psicossociais e reflexos da relação docente-discente que merecem destaque como pontos negativos.Conclusão: Há percepção positiva sobre pontos como acolhimento pelos três segmentos e muita clareza sobre os pontos negativos como ambiência e acessibilidade entre alunos e usuários. Relações conflituosas de docentes e discentes sugerem estudos que ajudem a entender essa convivência e seus efeitos negativos sobre a formação do aluno. As fortalezas do serviço em questão ficaram por conta da oferta de serviços odontológicos, à medida que a sociedade, a rede pública de Natal e demais cidades do Rio Grande do Norte o reconhecem como referência e apostam na sua qualidade. Os desafios consistem em promover maior integração entre o corpo docente das clínicas, visando a implantação/manutenção de um ambiente uníssono, harmônico, tranquilo e seguro de orientação acadêmica...

Analyze students, teachers, and users perceptions of humanization in its broad dimension at the dental clinics in the Dentistry Department of the Federal University of Rio Grande do Norte. Methodology: Qualitative study with data collected using three instruments: self-administered questionnaires (students and users), a simulated case (teachers), as well as direct observation in the clinics. The generated responses were categorized, analyzed, and interpreted in the light of the theoretical framework of Bardin. Results: The results show categories such as ambience and accessibility in the speech of students and users as points that need to be improved. Among the teachers, the reception and ethical aspects were emerging categories, showing concern with the relation with the user. Direct observation revealed important categories, such as psychosocial effects and reflections on the teacher student relation ship, that should be highlighted as weaknesses. Conclusion: There is a positive perception of points such as reception by the three segments, and a clear view of negative points suchas ambience and accessibility among students and users. Teacher-student conflicting relation ships suggest the need for studies to help understand this interaction and its negative effects on students’education. The service strengths in question were the provision of dental services, as the society, the public system in the city of Natal and in other cities of the state of Rio Grande do Norte recognize it asa reference service and believe on its quality. The challenges are to promote greater integration among the teachers of clinics, aiming at the implementation/maintenance of a unison, harmonious, peaceful and safe environment for learning orientation...

Mechanical and microstructural properties of fixation systems used in oral and maxillofacial surgery.

OBJECTIVES: This paper aims to evaluate in vitro the mechanical and microstructural properties of internal fixation systems used in oral and maxillofacial surgeries. MATERIALS AND METHODS: Four brands of internal fixation systems (screws and 4-hole straight plates) were selected and assigned to four groups: G1 Leibinger®, G2 Tóride®, G3 Engimplan®, and G4 Medartis®. The systems were submitted to Vickers hardness testing, metallographic and interstitial elements chemical composition analyses. Data were submitted to ANOVA and Tukey's test for statistical analysis. RESULTS: Plates in groups 1, 2, and 3 showed similar microstructure and mechanical properties, different from those in G4 revealing larger grains. In all groups, the screws showed similar microstructure, with uniform arrangement and size of grains; the screws showed higher hardness values than those observed for the plates. CONCLUSIONS: The results indicate that all materials tested are adequate for use in oral maxillofacial surgeries.

In Vitro Mechanical Analysis of Different Techniques of Internal Fixation of Combined Mandibular Angle and Body Fractures.

PURPOSE: To evaluate in vitro resistance of 5 techniques of internal fixation of bilateral fractures involving the mandibular angle and body. MATERIALS AND METHODS: Twenty-five polyurethane mandibles were used as substrates, fixed with a 2-mm fixation system, and divided into 5 groups: I, 1 4-hole plate, without intermediate space, in the neutral zone of the mandibular body and another similar plate in the external oblique ridge of the contralateral mandibular angle; II, 1 6-hole plate, with intermediate space, in the neutral zone of the mandibular body and a similar plate in the external oblique ridge of the left mandibular angle; III, 1 4-hole locking plate, with intermediate space, in the right neutral zone and another similar plate in the left external oblique ridge; IV, 2 4-hole plates, with intermediate space, one in the tension zone and the other in the compression zone of the mandibular body, and 1 4-hole plate, with intermediate space, in the external oblique ridge of the contralateral mandibular angle; V, 2 4-hole plates with intermediate space, one in the tension zone and the other in the compression zone of the mandibular body and similarly in the buccal side of the left mandibular angle. Mandibles were subjected to vertical linear load tests by a mechanical testing machine (Instron 4411, Instron Corp, Norwood, MA) to record peak load and load for displacements of 3, 5, and 7 mm. RESULTS: Group I had the least mechanical resistance of all groups, regardless of displacement, and group IV had the greatest mechanical resistance. Among groups II, III, and V, there was no statistically meaningful difference. CONCLUSION: Fixation of bilateral mandibular fractures involving the mandibular angle and body using 2 plates in the region of the body and 1 plate in the tension zone in the region of the mandibular angle was the technique that presented the best mechanical resistance.

Resposta tecidual à corticotomia alveolar seletiva após verticalização ortodôntica acelerada de molares inferiores em pacientes adultos / Tissue response to selective alveolar corticotomy after speedy orthodontics in uprighting lower molars in adult patients

O objetivo deste trabalho foi analisar e descrever histologicamente, o processo de remodelação óssea no momento da cirurgia e 90 dias após, em regiões submetidas ou não à corticotomia alveolar seletiva. Foram avaliados 8 pacientes adultos sem distinção de classe de maloclusão, e com necessidade de verticalização dos segundos molares inferiores bilateralmente. Neste estudo aleatório boca-dividida, a verticalização dos molares inferiores e coleta de osso mandibular aconteceu bilateralmente, enquanto que a corticotomia unilateralmente. As extrações dos blocos ósseos foram obtidas através de uma broca trefina acoplada ao contra ângulo, as peças continham aproximadamente 6 mm de osso cortical e trabecular, e foram armazenadas em formol tamponado a 10% até a data de envio ao laboratório do Instituto Forsyth (Boston, EUA). Após 90 dias da cirurgia, novas biopsias ósseas foram extraídas do segmento mandibular teste e controle. As avaliações histológicas foram realizadas no grupo teste e controle em dois momentos distintos: no momento da corticotomia (T0), e 90 dias após (T90). Os blocos ósseos foram corados com hematoxilina e eosina (HE) para análise descritiva das peças. A coloração com tricrômico de Masson (TM) foi utilizada com o intuito de identificar neoformação óssea e colágeno no tecido conjuntivo mineralizado e não mineralizado. Para descrição da remodelação óssea foram analisadas as seguintes características celulares: proporção entre os componentes de osso secundário e primário, quantificação do número de osteócitos, proporção entre os componentes inorgânicos e orgânicos do osso, e quantificação do número de linhas reversas. Os resultados foram comparados por meio do modelo de estimativa de equações generalizadas (GEE) clusterizado, ajustando pelas medidas basais. O grupo teste em T90 apresentou aumento de 0,16% na proporção de osso primário (p<0,001), aumento de 6,54 na quantidade de osteócitos (p=0,039), e aumento de 4,06 na quantidade de linhas reversas de remodelação óssea (p=0,924). Ambos os grupos apresentaram queda na proporção inorgânica, com um diminuição de 0,02% e 0,03% nos grupos teste e controle, respectivamente (p=0,105). Os dados sugerem que o processo de reabsorção óssea alveolar desencadeado pela corticotomia seja parcialmente revertido em 90 dias, pois foi possível observar características de formação e deposição óssea. O dano ósseo intencional realizado em pacientes adultos tratados ortodônticamente, pode ser considerado temporário e reversível, e as condições ósseas iniciais são restabelecidas.

The aim of this study was to analize and describe histological findings of bone remodeling at the time of surgery and 90 days later, at corticotomized and non-corticotomized sites. This randomized split mouth study included 8 adult patients, with bilaterally inclined mandibular molars, regardless their malocclusion type. A one-stage intervention was performed to corticotomize the test site, and harvest bone in both mandibular hemi-arches. Bone blocks were harvested using a trephine bur in a low speed hand piece. The specimens of aproximatelly 6 mm were stored in 10% buffered formalin at room temperature, until dispatch to Forsyth Institute lab (Boston, USA). After surgery, cantilevers were activated to upright inclined mandibular molars on both sides. Approximately 90 days post-surgery, new bone blocks were harvested from test and control sites located in the mandible. Histological analysis were performed in the control and test group at two time points: baseline (T0) and, ninety days post-surgery (T90). Bone blocks were stained with Hematoxylin & Eosin for descriptive analysis. Masson's trichrome staining protocol was used to identify new bone formation and collagen in mineralized and non-mineralized connective tissue. The following items were investigated to describe bone turnover: (1) ratio between secondary and primary bone, (2) ratio between inorganic and organic bone, (3) quantity of osteocytes and, (4) reversal lines of bone remodeling.The histologic analysis results were compared using clustered Generalized Estimating Equations (GEE) model, adjusted by baseline measures. The test group at T90 presented: increase of 0.16% in ratio of primary bone (p<0.001), increase of 6.54 in the quantity of osteocytes (p=0.039), and increase of 4.06 in the quantity of reversal lines (p=0.924). Both groups presented decay in inorganic proportions, with a decrease of 0.02% and 0.03% in test and control group, respectively (p=0.105). Data suggest that bone turnover provoked by corticotomy, might be partially reverted in 90 days, through bone formation and deposition. The intentional bone injury performed in adult patients undergoing orthodontic treatment, can be considered temporary and reversible, there is evidence to indicate baseline bone characteristics are restored.

Perfil epidemiológico de pacientes em tratamento hemodialítico / Epidemiological profile of patients under hemodialysis / Perfil epidemiológico de los pacientes en hemodiálisis

Objetivo:descrever o perfil epidemiológico de pacientes em hemodiálise. Método: estudo transversal, com abordagem quantitativa realizado com 143 indivíduos no Sertão Paraibano, entre dezembro 2013 e janeiro de 2014, durante as sessões de hemodiálise. Após a coleta os dados, foi utilizado o SoftwareStatistical Package for the Social Sciences(SPSS) versão 20.0,a partir do qual foram realizadas análisesdescritivas. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, Protocolo 510.225. Resultados: houve o predomínio do sexo masculino, a idade média foi de 49 anos, a maioria dos participantes sabiam ler e escrever, a aposentadoria representou a fonte de renda, o tempo médio do tratamento hemodialítico foi de 48 meses. As principais causas e comorbidades foram: hipertensão arterial, diabetes mellitus tipo 2 e déficit visual. Conclusão: é necessário que sejam desenvolvidas ações de promoção a saúde e que as medidas preventivas tenham um maior grau de importância e efetividade no grupo de pessoas portadoras da DRC.(AU)

Objective: describing the epidemiological profile of patients undergoing hemodialysis in the backlands of Paraiba. Method: a cross-sectional study with a quantitative approach developed over the period of December 2013 and January 2014 during hemodialysis sessions. The sample was not probabilistic convenience, the 235 individuals diagnosed with CKD on hemodialysis who were under care in clinics mentioned, only 143 individuals fulfilled the criteria, after collecting the data, there was used the Statistical Software Package for the Social Sciences (SPSS) version 20.0, where descriptive analyzes were performed, including, measures of central tendency and dispersion measures. Results: there was a predominance of males, the average age was 49 years, most of the participants could read and write, retirement represented the source of income, and the average time of hemodialysis treatment was of 48 months. The main causes and comorbidities were hypertension, type 2 diabetes mellitus and visual deficit. Conclusion: it is necessary for promotion actions are developedhealth and preventive measures have a greater level of importance and effectiveness in the group of people with CKD.(AU)

Objetivo: describir el perfil epidemiológico de los pacientes sometidos a hemodiálisis en el sertón de Paraíba. Método: Estudio transversal con enfoque cuantitativo desarrollado durante el período de diciembre de 2013 y enero 2014, durante las sesiones de hemodiálisis. La muestra fue no probabilística de conveniencia, las 235 personas con diagnóstico de ERC en hemodiálisis que estaban bajo el cuidado en las clínicas mencionadas, sólo 143 individuos cumplieron con los criterios, tras la recogida de los datos, se utilizó el paquete de software estadístico para lasCiencias Sociales (SPSS) versión 20.0, donde se realizaron análisis descriptivos, incluyendo medidas de tendencia central y de dispersión. Resultados: hubo un predominio del sexo masculino, la edad media fue de 49 años, la mayoría de los participantes sabía leer y escribir, la jubilación representaba la fuente de ingresos, el tiempo medio de tratamiento de hemodiálisis fue de 48 meses. Las principales causas y comorbilidades fueron: hipertensión, diabetes mellitus tipo 2 y el déficit visual. Conclusión: esnecesario que se desarrollar acciones de promoción de la salud y las medidas preventivas tengan un mayor grado de importancia y la eficacia en el grupo de personas con ERC.(AU)

Os agentes comunitários de saúde na identificação de sintomas depressivos / The community health agents in identifying symptoms of depression / Los agentes de salud de la comunidad en la identificación de síntomas depresivos

Objetivo:identificar as ações dos agentes comunitários de saúde diante do usuário da Estratégia Saúde da Família com sintomas depressivos. Método:estudo de campo, com abordagem qualitativa, realizado com agentes comunitários de saúde, o qual utilizou como instrumento o roteiro de entrevista semiestruturado, de abril a junho de 2010. Os dados empíricos foram analisados pelo emprego da Técnica de Análise de Conteúdo. Resultados:as principais ações dos Agentes baseavam-se na identificação dos sintomas depressivos e atuação diante da mudança de comportamento pelo trabalho árduo, triste e desanimador. Conclusão:os resultados evidenciaram a fragilidade da atuação dos agentes de saúde diante da assistência preventiva da depressão em consequência da inexistência de uma política de saúde mental direcionada aos municípios de pequeno porte.(AU)

Objective:identifying the actions of community health workers before the user of the Family Health Strategy with depressive symptoms. Method:a field study of a qualitative approach conductedwith community health workers, which used the instrument as semi-structured interview guide, from April to June 2010. The empirical data were analyzed by the Content Analysis Technique. Results:the main actions of agents were based on the identification of depressive symptoms and acting on the change of behavior by hard work, sad and discouraging, sad and disheartening. Conclusion:the results showed the fragility of the routine of health workers before preventive care to depression as a result of lack ofmental health policy targeted to small municipalities.(AU)

Objetivo:identificar las acciones de los agentes comunitarios de salud en el usuario de la Estrategia Salud de la Familia con síntomas depresivos. Método:estudio de campo con un enfoque cualitativo realizado con los trabajadores comunitarios de salud, que utilizan como instrumento de guía de entrevista semiestructurada, de abril a junio de 2010. Los datos empíricos fueron analizadospor la Técnica de Análisis de Contenido. Resultados:las principales acciones de los agentes se basaban en la identificación de los síntomas depresivos y la actuación delante los cambios de comportamiento por su ardua labor, triste y desalentador. Conclusión:los resultados mostraron la fragilidad de la actuación de los agentes de salud delante la atención preventiva a la depresión como resultado de la falta de una política de salud mental enfocada a los municipios pequeños.(AU)

Qualidade de vida relacionada à saúde de indivíduos em hemodiálise / Health-related quality of life of individuals under hemodialysis / Calidad de vida relacionada con la salud de las personas en hemodiálisis

Objetivo: avaliar a qualidade de vida relacionada à saúde (QVRS) em indivíduos com doença renal crônica (DRC) em hemodiálise. Método: estudo descritivo e transversal com abordagem quantitativa realizado com 58 indivíduos em terapêutica hemodialítica no município de Patos-PB. Para avaliação da QVRS foi utilizado o instrumento Kidney Disease and Quality of Life-Short-Form, version 1.3 (KDQOL-SFTM 1.3), sendo aplicado entre setembro a outubro de 2011. Para análise descritiva foi utilizado o software Statistical Package for the Social Sciences (SPSS) versão 20.0. Resultados: as dimensões do KDQOL-SFTM com maiores escores médios, indicando melhor QVRS foram: "estímulo da equipe de diálise" (96,1), "função sexual" (93,4) e "qualidade das interações sociais" (89,7). As dimensões com menores valores, significando pior QV foram: "condição de trabalho" (5,2), "função emocional" (29,3) e "função física" (34,1). Conclusão: a DRC e o tratamento hemodialítico interferiram na QVRS dos indivíduos, pois os mesmos apresentaram muitas limitações nas suas atividades diárias.(AU)

Objective: evaluating the quality of life related to health (HRQOL) in patients with chronic kidney disease (CKD) under hemodialysis. Method: a descriptive and cross-sectional study with a quantitative approach conducted with 58 individuals under hemodialysis therapy in the city of Patos-PB. To evaluate the HRQOL instrument was used Kidney Disease and Quality of Life-Short-Form, version 1.3 (KDQOL-SFTM 1.3), being applied between September and October 2011. The descriptive analysis was performed using the Statistical Package for Social Software Sciences (SPSS) version 20.0. Results: the dimensions of KDQOL-SFTM with higher average scores indicating better HRQOL were: "Dialysis Team stimulus" (96,1) "sexual function" (93,4) and "quality of social interactions" (89,7). The dimensions with lower values, meaning worse QOL were: "working condition" (5,2), "emotional function" (29,3) and "physical function" (34,1). Conclusion: The CKD and hemodialysis interfere in HRQOL of individuals, as they showed many limitations in their daily activities.(AU)

Objetivo: evaluar la calidad de vida relacionada con la salud (CVRS) en pacientes con enfermedad renal crónica (ERC) en hemodiálisis. Método: un estudio descriptivo y transversal con enfoque cuantitativo realizado con 58 personas en tratamiento de hemodiálisis en la ciudad de Patos-PB. Para evaluar el instrumento de CVRS se utilizó el instrumento Kidney Disease and Quality of Life-Short-Form, versión 1.3 (KDQOL-SFTM 1.3), que se aplica entre septiembre y octubre de 2011. Se realizó el análisis descriptivo utilizando el software Statistical Package for the Social Sciences (SPSS) versión 20.0. Resultados: las dimensiones de KDQOL-SFTM con puntuaciones medias más altas indican mejor CVRS fueron: "estímulo del Equipo de diálisis" (96,1) "la función sexual" (93,4) y "la calidad de las interacciones sociales" (89,7). Las dimensiones con valores más bajos, es decir, peor calidad de vida fueron: "condiciones de trabajo" (5,2), "la función emocional" (29,3) y "función física" (34,1). Conclusión: la enfermedad renal crónica y hemodiálisis interferiron en la CVRS de los individuos, ya que tenía muchas limitaciones en sus actividades diarias.(AU)

Comparative in vitro mechanical evaluation of techniques using a 2.0 mm locking fixation system for simulated fractures of the mandibular body.

PURPOSE: To perform a comparative evaluation of the mechanical resistance of simulated fractures of the mandibular body which were repaired using different fixation techniques with two different brands of 2.0 mm locking fixation systems. MATERIALS AND METHODS: Four aluminum hemimandibles with linear sectioning simulating a mandibular body fracture were used as the substrates and were fixed using the two techniques and two different brands of fixation plate. These were divided into four groups: groups I and II were fixed with one four-hole plate, with four 6 mm screws in the tension zone and one four-hole plate, with four 10 mm screws in the compression zone; and groups III and IV were fixed with one four-hole plate with four 6 mm screws in the neutral zone. Fixation plates manufactured by Tóride were used for groups I and III, and by Traumec for groups II and IV. The hemimandibles were submitted to vertical, linear load testing in an Instron 4411 servohydraulic mechanical testing unit, and the load/displacement (3 mm, 5 mm and 7 mm) and the peak loads were measured. Means and standard deviations were evaluated applying variance analysis with a significance level of 5%. RESULTS: The only significant difference between the brands was seen at displacements of 7 mm. Comparing the techniques, groups I and II showed higher mechanical strength than groups III and IV, as expected. CONCLUSION: For the treatment of mandibular linear body fracture, two locking plates, one in the tension zone and another in the compression zone, have a greater mechanical strength than a single locking plate in the neutral zone.