Selective laser trabeculoplasty versus micropulse laser trabeculoplasty for intraocular pressure control in patients with primary open angle glaucoma: a 12-month retrospective comparative study.

This study was designed to compare the efficacy of selective laser trabeculoplasty (SLT) and micropulse laser trabeculoplasty (MLT) in patients with primary open angle glaucoma (POAG) requiring additional IOP control. In this retrospective, comparative study, we reviewed the charts of POAG patients requiring additional IOP lowering, who underwent either SLT or MLT and were followed for at least one year. We evaluated mean intraocular pressure (IOP), mean IOP reduction from baseline and mean number of glaucoma medications 1, 3, 6 and 12 months after treatment. Success rates (success defined as IOP ≤ 21 mmHg and ≥ 20% reduction from baseline IOP without additional medications, new laser session, or glaucoma surgery) at one year were also compared. A total of 98 POAG patients were included, 52 individuals in the SLT group and 46 in the MLT group. Laser treatment resulted in significant mean IOP reductions from baseline in both groups (SLT = -6.0 ± 3.3 mmHg (24.9%) and MLT = -5.8 ± 2.6 mmHg (23.4%)) (p < 0.001). However, there was no statistically significant difference between the mean IOP reductions in both groups (p = 0.74). At 12 months, the mean number of glaucoma medications was significantly smaller in the SLT group (1.17 + 0.4) when compared to the MLT group (2.21 + 0.2) (p = 0.001). Additionally, after 12 months, success was obtained in 32 (61.5%) SLT cases compared to 27 (58.7%) MLT-treated eyes (p = 1.0). MLT and SLT are both effective in controlling the IOP in POAG patients requiring additional IOP reduction. However, after 12 months, SLT demonstrated a greater efficacy in reducing medication burden when compared to MLT.Trial registration: CEP/CONEP/MS Brazil 40948620.9.0000.5600.

Self-reported questionnaire on periodontal condition validated for use in Brazil.

There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.

Self-reported questionnaire on periodontal condition validated for use in Brazil

Abstract: There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.

Comparison Between Hand and Sonic/ Ultrasonic Instruments for Periodontal Treatment: Systematic Review with Meta-Analysis.

AIMS: To systemically review the literature on the effect of hand and sonic/ultrasonic instruments used for the non-surgical treatment of periodontitis. MATERIALS AND METHODS: Five databases were searched for randomized clinical trials that compared the results of periodontal treatment using hand and sonic/ultrasonic for nonsurgical periodontal treatment. Four meta-analyses were performed, using the calculated mean differences (MD) between baseline and 3-months or 6-months after periodontal treatment for clinical attachment level (CAL), and probing pocket depth (PPD). RESULTS: Eighteen studies were included. All included studies showed significant improvement, in at least one periodontal parameter, in both tested periodontal therapies. The sonic/ultrasonic instruments spend significantly less time in comparison to manual instrumentation. At both 3- and 6-months after periodontal therapy, no statistically significant differences were detected for CAL gain between therapies (MD; 95%CI: 0.05; -0.21-0.30 and -0.23; -0.59-0.12). Similarly, no statistically significant differences were detected for PPD reduction between therapies at 3-months of follow-up (MD; 95%CI: -0.03; -0.34-0.28). After 6-months, the PPD reduction was 0.21 (95%CI: -0.43-0.00, p=0.05). CONCLUSION: Similar results may be expected for the periodontal treatment performed with hand and sonic/ultrasonic instruments. However, further studies with lower risk of bias are warranted.

Applicability of models to estimate traffic noise for urban roads.

BACKGROUND: Traffic noise is a highly relevant environmental impact in cities. Models to estimate traffic noise, in turn, can be useful tools to guide mitigation measures. In this paper, the applicability of models to estimate noise levels produced by a continuous flow of vehicles on urban roads is investigated. The aim is to identify which models are more appropriate to estimate traffic noise in urban areas since several models available were conceived to estimate noise from highway traffic. RESULTS: First, measurements of traffic noise, vehicle count and speed were carried out in five arterial urban roads of a brazilian city. Together with geometric measurements of width of lanes and distance from noise meter to lanes, these data were input in several models to estimate traffic noise. The predicted noise levels were then compared to the respective measured counterparts for each road investigated. In addition, a chart showing mean differences in noise between estimations and measurements is presented, to evaluate the overall performance of the models. Measured Leq values varied from 69 to 79 dB(A) for traffic flows varying from 1618 to 5220 vehicles/h. Mean noise level differences between estimations and measurements for all urban roads investigated ranged from -3.5 to 5.5 dB(A). CONCLUSIONS: According to the results, deficiencies of some models are discussed while other models are identified as applicable to noise estimations on urban roads in a condition of continuous flow. Key issues to apply such models to urban roads are highlighted.

Avaliação da idade óssea por meio da maturação das vértebras cervicais de indivíduos em crescimento / Assessment of bone age by the maturation of cervical vertebrae of individuals growing

Este estudo avaliou o Estágio de Maturação das Vértebras Cervicais (EMVC), de 150 indivíduos brasileiros de ambos os sexos, com idades entre oito e 14 anos, buscando determinar o dimorfismo sexual e a aplicabilidade do EMVC na clínica ortodôntica. Foram analisadas telerradiografias em norma lateral, obtidas previamente ao tratamento ortodôntico, e a amostra foi dividida em oito grupos, considerando a idade em meses e o gênero. A morfologia das vértebras C3 e C4 foi avaliada por um examinador que indicou o EMVC encontrado para cada indivíduo estudado. Os resultados foram submetidos a testes de qui quadrado e o coeficiente de relação intraclasse avaliou o erro intraoperador. O estudo indicou que a maioria da amostra, apresentava se em EMVC II e EMVC III (p<1%), estágios que representam o surto de crescimento puberal e também o período mais favorável para a terapia ortodôntica. Os resultados também apresentaram que o sexo feminino atinge de forma mais precoce EMVC IV e EMVC V (p<1%), demonstrando que as meninas atingem o surto puberal em idade mais tenra e concluem seu crescimento puberal aproximadamente dois anos antes dos meninos

This study evaluated the Cervical Vertebrae Maturation Stage (CVMS), of 150 Brazilian subjects of both genders, with 8 to 14 years old. The norma lateral telerradyographs had analised, previously to orthodontic therapy, and the sample was divided in eight groups, considering age in months and gender. The C3 and C4 vertebrae morphology, was evaluated by a examiner who indicated the CVMS scored by each subject studied. The results was submitted by chi-square tests and ICC tests avaliated the intraoperator error. The study showed a majority of the sample in CVMS II and CVMS III (p<1%), stages who represents the puberty growing peak and also the most important period to orthodontic therapy. The results showed that the females get in a smaller age the CVMS IV and CVMS V (p<1%), showing that the girls has the puberty peak in a younger age and finish her puberty grow approximately two years before boys

Amniotic membrane as an adjunct to donor sclera in the repair of exposed glaucoma drainage devices.

PURPOSE: To describe a novel method of repairing exposed glaucoma drainage devices (GDD) using amniotic membrane transplantation (AMT) in place of conjunctiva to cover donor sclera when conjunctival closure is hampered by adjacent scarring. DESIGN: Retrospective noncomparative interventional case series. METHODS: Consecutive case series of nine GDD erosions over 5 years repaired by a double-layer technique of scleral allograft plus AMT. RESULTS: Successful repair was achieved in seven cases. One GDD plate re-eroded after pars plana vitrectomy; a second leaked from the tube entry site. CONCLUSIONS: AMT is a safe and useful conjunctival substitute to cover donor sclera in situations where conjunctival scarring might otherwise preclude successful repair.

Detecção de alterações na camada de fibras nervosas da retina por meio do laser confocal polarizado em hipertensão ocular antes do surgimento de defeitos perimétricos / Detection of retinal nerve fiber layer changes in ocular hypertension with scanning laser polarimetry before the appearance of perimetric defects

OBJETIVO: Avaliar a capacidade do laser confocal polarizado (LCP) em detectar alterações na camada de fibras nervosas (CFN) de hipertensos oculares antes do aparecimento de alteração campimétrica. Desenho- Retrospectivo, caso-controle. MÉTODOS: Pacientes hipertensos oculares divididos em dois grupos: a) estáveis e b) conversores (que progrediram com dano perimétrico glaucomatoso). Parâmetros de retardo obtidos por meio do programa NFA/GDx. RESULTADOS: Um total de 108 pacientes estáveis e 13 conversores foram estudados por período médio de seguimento acima de 35 meses nos dois grupos. Diversos parâmetros do LCP mostraram diferenças significativas na espessura da CFN entre os dois grupos no inicio do seguimento (média de 27,4 meses antes do aparecimento de lesão perimétrica). Os parâmetros The Number, Maximum Modulation e Superior Average permaneceram diferentes entre os grupos no início e no final do seguimento. O odds ratio para desenvolvimento de conversão perimétrica, dado um resultado de The Number alterado (>32), foi estimado em 7,9 para esta série. CONCLUSÕES: O LCP foi capaz de detectar alterações significativas na CFN no grupo de hipertensos oculares que desenvolveram posteriormente lesão perimétrica glaucomatosa. Neste estudo, o resultado inicial anormal de The Number foi o principal fator de risco para desenvolvimento de alteração perimétrica futura em pacientes hipertensos oculares.

The influence of age, sex, race, refractive error and optic disc parameters on the sensitivity and specificity of scanning laser polarimetry.

PURPOSE: To evaluate the influence of age, sex, race, refractive error and optic disc topography on the sensitivity and specificity of scanning laser polarimetry (SLP) in the diagnosis of glaucoma. METHODS: A total of 88 normal individuals and 95 glaucoma patients were included in this study. Glaucoma was defined on the basis of both optic nerve damage and visual field defects. Scanning laser polarimetry, optic disc topography, automated perimetry and refractometry were performed in all subjects. The sensitivity and specificity of SLP were assessed applying a previously calculated cut-off to a previously described linear discriminant function (LDF). RESULTS: The sensitivity and specificity of SLP in the study population were 82% and 83%, respectively. Sensitivity and specificity were not affected by age, sex, race, average disc diameter or disc area. The sensitivity of SLP tended to be higher in myopes (93%) than in emmetropes (80%) and hyperopes (71%) (p = 0.08). Sensitivities were higher in individuals with cup areas > 0.96 mm(2) (89%), rim areas < or = 1.36 mm(2) (92%), and cup area/disc area ratios > 0.45 (89%) (p < 0.05). Stepwise logistic regression analysis indicated that the presence of a cup area > 0.96 mm(2) and a rim area < 1.36 mm(2) significantly increased the sensitivity of the LDF, whereas a cup area/disc area ratio < or = 0.45 significantly increased the specificity of the LDF. CONCLUSION: The sensitivity and specificity of SLP may be influenced by refractive error and optic disc parameters that are affected by glaucomatous damage (cup area, rim area and cup area/disc area ratio). These parameters must be considered in studies evaluating the sensitivity and specificity of optic nerve/retinal nerve fibre layer imaging technologies.

Influência do condicionamento ácido na microinfiltraçäo de diferentes resinas poliácido-modificadas / Influence of etching in microleakage of different modified polyacid resins

O propósito deste estudo foi avaliar a microinfiltraçäo de duas resinas poliácido-modificadas, Dyract AP (DY) e F-2000 (F2), associadas ou näo à técnica do condicionammento total com ácido fosfórico a 37 por cento (CA). Foram utilizados 32 dentes molares, que, após desinfecçäo, foram armazenados em soro fisiológico. cada dente recebeu duas cavidades de classe V padronizadas (4mm x 4mm x 2mm), todas com margens em cemento e em esmalte. Os dentes foram divididos em quatro grupos (oito dentes de cada) e restaurados de acordo com as recomendaçöes dos fabricantes, divididos nos seguintes grupos: 1 - DY AP + Prime & Bond 2.1 com CCA;2 - DY AP + Prime & Bond 2.1 sem CA; 3 - F2 + Single Bond com CA e 4 - F2 + Single-Bond sem CA. Os dentes restaurados foram armazenados por sete dias e, a seguir, termociclados (500 ciclos, 5ºC, 15s em cada banho), sendo após, inseridos em azul-demetileno a 0,5 por cento. Após 24 horas, foram levados e desgastados no sentido vestibulo lingual. Cada restauraçöes foi avaliada por dois examinadores, sendo atrbuídos valores de 00 a 03, através de lupa microscópica, tanto na parede gengival como na oclusal. Os escores foram compilados e submetidos à análise estatística (teste Kruskall-Wallis, níveis de significância a 1 por cento e Mann-Whitney, nível de a significância a 5 por cento). Os resultados permitiram concluir que o condicionamento com ácido fosfórico apenas influenciou os resultados na parede de esmalte (oclusal)

Avaliaçäo da infiltraçäo marginal de diferentes associaçöes entre amálgama e adesivo / Evaluation of the microleakage of diferent associations of amalgam and adhesive

O propósito deste estudo foi avaliar a microinfiltraçäo de diferentes técnicas associando amálgama com um sistema adesivo de múltipla indicaçäo. Foram utilizados 24 molares, que após desinfecçäo foram armazenados em soro fisiológico. Em cada dente foram confeccionadas duas cavidades de classe V padronizadas (4 mm x 4 mm x 2 mm), todas com margens em cemento e em esmalte. Os dentes foram divididos em 3 grupos (8 dentes cada) e restaurados com o sistema adesivo Scotchbond Multi-Uso Plus© (SBMUP) e liga de amálgama Permite C© (PC), de acordo com os seguintes grupos: A - SBMUP fotoativado + PC; B - SBMUP na forma dual + PC; e C - SBMUP fotoativado e uma segunda camada na forma dual + PC. Os dentes restaurados foram armazenados por 7 dias e, a seguir, termociclados (500 ciclos, 5ºC-55ºC, 15 s em cada banho), sendo depois inseridos em azul de metileno a 5 por cento. Após 24 horas, foram lavados e desgastados no sentido vestíbulo-lingual. Cada restauraçäo foi avaliada por 2 examinadores através de lupa microscópica. Os escores foram compilados, verificando-se a variaçäo de 0 a 3 tanto na parede oclusal quanto na gengival, e esses dados foram submetidos a análise estatística (teste Kruskal-Wallis, p < 0,01). Näo houve diferença na microinfiltraçäo na parede oclusal nas distintas formas de aplicaçäo do adesivo; na parede gengival, no entanto, houve diferença estatisticamente significante, sendo que o grupo B (amálgama + sistema dual) foi o que pior se comportou. Assim, concluiu-se que a melhor forma de aplicaçäo do sistema adesivo previamente à inserçäo do amálgama é a fotoativaçäo, podendo ser associada ao sistema dual

Sulcoplastia mandibular com enxerto de pele / The vestibuloplasty with skin graft

A sulcoplastia com enxerto de pele é uma alternativa que pode ser empregada em situaçöes em que o rebordo mandibular apresenta-se atrófico ou ausente, sendo realizada, na maioria dos casos no segmento anterior da mandíbula. No presente trabalho, os autores realizam uma breve revisäo da literatura e descrevem um caso clínico onde foi realizada esta técnica, discutindo as vantagens e desvantagens da mesm

Estudo duplo-mascarado do uso do creme de lignocaína-prilocaína no alívio da dor na injeçäo peribulbar / A double-masked evaluation of lignocaine-prilocaine cream used to alleviate the pain on peribulbar injection

Objetivo: Um estudo duplo-mascarado, aleatório, foi realizado com 64 pacientes submetidos a cirurgia de catarata, a fim de verificar a eficácia de um anestésico tópico sobre a pele a fim de avaliar a dor da anestesia peribulbar. Métodos: Os pacientes foram divididos em 2 grupos. Grupo I - 36 pacientes foram tratados com creme de lignocaina-prilocaina. Grupo II - 27 pacientes tratados com um placebo, com mesmas características físicas do creme de lignocaína-prilocaína. Ambos grupos permaneceram com o creme 60 minutos antes de receber aplicaçäo de anestesia peribulbar. A dor foi estudada objetivamente por um anestesiologista, que observou a reaçäo do paciente quando a inserçäo da agulha e do anestésico. A dor foi analisada subjetivamente pelo paciente por meio de uma escala internacional de dor padronizada. Resultados: Dor significante menor foi observada tanato objetivamente, quanto subjetivamente no Grupo I de pacientes. Nenhum dos pacientes experimentou qualquer efeito colateral do uso do creme, durante o estudo. Conclusöes:

Complicaçöes do uso intra-operatório de mitomicina-C em trabeculectomias / Complications of intraoperative mitomycin C on trabeculectomies

Objetivo: avaliar a frequência de complicaçöes decorrentes do uso intra-operatório de mitomicina C em trabeculectomias. Materiais e métodos: foram analisados 76 olhos submetidos à cirurgia filtrante com Mitomicina C, notando-se diagnóstico, indicaçäo para seu uso, medidas de pressäo intraocular, número de medicaçöes antiglaucomatosas e complicaçöes no período pós-operatório. Resultados: esta série mostrou incidência de 25 por cento de câmara anterior rasa, 18,4 por cento de hiperfiltraçäo, 10,5 por cento de catarata e 9,2 p/cento de descolamento de coróide. Conclusöes: o presente estudo sugere que a mitomicina C deve ser utilizada com bastante critério e cautela pelo oftalmologista, tendo em vista as complicaçöes potencialmente graves que podem dela advir