Ozone gas therapy for tooth bleaching preserves enamel microhardness, roughness and surface micromorphology / Ozonioterapia gasosa para clareamento dental preserva a microdureza, rugosidade e micromorfologia superficial do esmalte

ABSTRACT After ozone therapy for bleaching, it is important to evalúate enamel surface properties, to ensure that bleaching provides adequate conditions for sound dental substrate. Aim: The aim of this in vitro study was to evaluate the effects of a bleaching treatment with 10% carbamide peroxide (CP), with or without ozone (O), on the microhardness, roughness and micromorphology of the enamel surface. Materials and Method: Bovine enamel blocks were planed and distributed among the following three bleaching treatment groups (n=10): CP - 1 hour per day/14 days (Opalescence PF 10%/ Ultradent); O - 1 hour per day every 3 days/3 sessions (Medplus VPhilozon, 60 mcg/mL and oxygen flow rate of 1 L/min); and OCP - CP with O, 1 hour per day every 3 days/3 sessions. Enamel surface microhardness (Knoop), roughness (Ra), and micromorphology by scanning electron microscopy (5,000x magnificaron) were determined before and after the treatments. Results: ANOVA and Tukey-Kramer's test showed that enamel microhardness remained unchanged by treatment with O and OCP (p=0.0087), but decreased by treatment with CP. Treatment with O promoted higher enamel microhardness than the other groups (p=0.0169). Generalized linear mixed models for repeated measures over time indicated treatment with CP increased enamel roughness more than OCP or O (p=0.0003). CP produced slight irregularities in enamel micromorphology after the whitening treatment. O, with or without CP, maintained the mechanical and physical properties of microhardness and enamel surface micromorphology, and either maintained or reduced surface roughness, compared to the conventional tray-delivered CP bleaching treatment. Conclusions: Treatment with 10% carbamide peroxide in trays promoted greater changes in enamel surface properties than treatments with ozone and with 10% ozonized carbamide peroxide in the office.

RESUMO É importante avaliar as propriedades da superficie do esmalte após a aplicagao da ozonioterapia para clareamento, para garantir que o efeito clareadorproporcione condigoes adequadaspara um substrato dentário higido. Objetivo: O objetivo deste estudo in vitro foi avaliar os efeitos de um tratamento clareador com peróxido de carbamida (PC) a 10%, associado ou nao ao ozonio (O), na microdureza, rugosidade e micromorfologia da superficie do esmalte. Materials e Método: Blocos de esmalte bovino foram aplainados e distribuidos entre tres grupos de tratamento clareador (n=10): PC - 1 hora por dia/14 dias (Opalescence PF 10%/ Ultradent); O - 1 hora por dia a cada 3 dias/3 sessoes (Medplus VPhilozon, 60 mcg/mL e fluxo de oxigenio de 1 L/min); e PCO - CP com O, 1 hora por dia a cada 3 dias/3 sessoes. A microdureza (Knoop), a rugosidade (Ra) e a micromorfologia da superficie do esmalte avaliada por microscopia eletronica de varredura (aumento de 5.000x) foram analisadas antes e após os tratamentos. Resultados: ANOVA e teste de Tukey-Kramer mostraram que O e PCO mantiveram os valores de microdureza do esmalte ao final do tratamento (p=0,0087), enquanto PC promoveu diminuigao da microdureza. O promoveu maiores valores de microdureza do esmalte do que os outros grupos ao final do tratamento (p=0,0169). Modelos lineares generalizados mistos para medidas repetidas no tempo indicaram um aumento na rugosidade da superficie para PC, levando a maior rugosidade do esmalte ao final do tratamento, em comparagao com PCO ou O (p=0,0003). PC apresentou pequenas irregularidades na micromorfologia do esmalte após o tratamento clareador. O, com ou sem PC, manteve as propriedades mecánicas e fisicas de microdureza e micromorfologia da superficie do esmalte, e manteve ou reduziu a rugosidade da superficie, em comparagao com o tratamento clareador a base de PC aplicado em moldeira convencional. Conclusoes: O tratamento com peróxido de carbamida a 10% para uso em moldeiras promoveu maiores alteragoes nas propriedades de superficie do esmalte do que aquelas observadas nos tratamentos com ozonio e com peróxido de carbamida ozonizado a 10% para uso em consultório.

Effect of ozone therapy on the modulation of inflammation and on new bone formation in critical defects of rat calvaria filled with autogenous graft.

OBJECTIVE: The aim of this study was to evaluate the effect of ozone therapy on new bone formation and inflammation modulation in defects of rat calvaria filled with autogenous bone. MATERIAL AND METHODS: Critical size defects were created in the calvaria of 24 male Wistar rats. The animals were randomly divided into four groups according to the treatment: G1: clot; G2: clot and covered with xenogenic membrane; G3: particulate autogenous bone graft; G4: autogenous bone graft and application of 3 mL O2/O3 gas mixture (10 µg/ml). The defects were filled immediately after surgery with a bilateral retroauricular application, in the region immediately above the incision. After 21 days, the animals were euthanized, and the samples were processed for morphometric evaluations designed to measure both the intensity of the inflammatory infiltrate, and the presence of new bone formation in the defect. RESULTS: The results showed a lower inflammation score and higher mean of newly formed bone in the region of the defect for the group associated with ozone therapy (G4). The bone formed in the region of the defect could be observed as being more lamellar and mineralized in the case of associated ozone therapy. CONCLUSION: Ozone therapy represents a promising adjuvant therapy to accelerate tissue regeneration.

Alternative approach to treating dark circles: A case report.

OBJECTIVES: Dark circles under the eyes are a common condition worldwide with multiple treatment options. The aim of this paper is to report a case of dark circles treated with ozone therapy, which showed a very reasonable clinical improvement. CASE REPORT: A case of dark circles under the eyes treatment with ozone therapy concentrations and doses was reported. We searched MEDLINE treatment options for dark circles. Literature on this subject is scarce. CARE guidelines have been adopted for this case report. RESULTS: Ozone therapy is a really effective biostimulator, that reduces spots and wrinkles. In this case, the patient and healthcare professionals were satisfied with just two ozone therapy sessions. This is an interesting alternative treatment for this common condition. CONCLUSIONS: Ozone therapy is a safe, inexpensive, and quick treatment for dark circles under the eyes. It can be used alone or in combination with other methods.

Color change after tooth bleaching with ozone and 10% ozonized carbamide peroxide for in-office use.

There is a constant search for bleaching treatments that can offer greater safety with fewer adverse effects, especially in the techniques performed in the office, which usually employ hydrogen peroxide in high concentrations (35% to 40%) that are not recommended by some international control agencies. This in vitro study evaluated the color change after tooth bleaching with the use of ozone and a 10% ozonized carbamide peroxide bleaching treatment for in-office use. Thirty molars were allocated (n = 10): three applications of ozone (1 hour every 3 days); three applications of 10% ozonized carbamide peroxide (1 hour every 3 days); 10% carbamide peroxide agent (8 hours a day for 7 days). The teeth were mounted on a plaster model to simulate the dental arch, and trays made of silicone were used for the application of the bleaching agents and to allow ozone to enter through. The ozone concentration used was 60 µg/mL, with an oxygen flow of 0.25 L/min. The values of color change showed no significant differences among treatments. The variations in the parameters over time, as well as the values of ΔEab, ΔE00, and WID, showed that there was no significant difference among the three treatments. The use of ozone and 10% ozonized carbamide peroxide for in-office use was effective for tooth bleaching with clinically perceptible and acceptable color alterations. The study was approved on September 10, 2019 by the São Leopoldo Mandic Ethics Research Committee (CAAE No. 17711719.4.0000.5374).

The antimicrobial effect of different ozone protocols applied in severe curved canals contaminated with Enterococcus faecalis: ex vivo study.

The aim of this study was to evaluate 3 different irrigation protocols using ozone on monoculture biofilm of Enterococcus faecalis. Fifty disto-buccal roots of maxillary first molars were instrumented up to the size 25.08, sterilized and then incubated with Enterococcus faecalis for 21 days for biofilm maturation in the root canal walls. After contamination, the initial collection (S1) was performed and the 50 samples were divided in 3 experimental groups (n = 15) and 1 positive control group (n = 5) as follows: Group1: Ozonated water (40 µg/ml); Group2: gaseous ozone (40 µg/ml); Group3: Ozonated water (40 µg/ml) under continuous ultrasonic irrigation (CUI) and, Group 4: 2.5% sodium hypochlorite (positive control). The final collection (S2) was performed using hedstroem files # 25 by scraping the root canal wall and absorbed paper cone. The collected samples were analyzed by CFU/ml count and qPCR. To compare the effect of irrigation methods and to investigate E. faecalis count data, Kruskal-Wallis and Wilcoxon nonparametric tests were used at p < 05. The values of the differences between the S1 values and the S2 values revealed that the groups did not differ significantly for either E. faecalis CFU count data (p = 0.713) or q-PCR (p = 0.185), however, it is observed that for all groups, the CFU count of E. faecalis decreased over 99%. For the q-PCR assay, the reduction was on the order of 74-95%. Only the NaOCl positive control group presented total elimination of CFU/mL bacterial counting. The ozone protocols assessed were similar in regard to Enterococcus faecalis reduction.

Anthropogenic gadolinium anomalies and rare earth elements in the water of Atibaia River and Anhumas Creek, Southeast Brazil.

The concentrations of rare earth elements (REE), measured in water samples from Atibaia River and its tributary Anhumas Creek, Brazil, present excess of dissolved gadolinium. Such anthropogenic anomalies of Gd in water, already described in other parts of the world, result from the use of stable and soluble Gd chelates as contrast agents in magnetic resonance imaging. Atibaia River constitutes the main water supply of Campinas Metropolitan area, and its basin receives wastewater effluents. The REE concentrations in water samples were determined in 0.22-µm pore size filtered samples, without and after preconcentration by solid-phase extraction with bis-(2-ethyl-hexyl)-phosphate. This preconcentration method was unable to retain the anthropogenic Gd quantitatively. The probable reason is that the Gd chelates dissociate slowly in acidic media to produce the free ion that is retained by the phosphate ester. Strong correlations between Gd and constituents or parameters associated with effluents confirmed the source of most Gd in water samples as anthropogenic. The shale-normalized REE patterns of Atibaia River and Anhumas Creek water samples showed light and heavy REE enrichment trends, respectively. Also, positive Ce anomalies in many Atibaia River samples, as well as the strong correlations of the REE (except Gd) with terrigenous elements, imply that inorganic colloidal particles contributed to the REE measured values.

Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions.

BACKGROUND: This paper argues that the global health agenda tends to privilege short-term global interests at the expense of long-term capacity building within national and community health systems. The Health Systems Strengthening (HSS) movement needs to focus on developing the capacity of local organizations and the institutions that influence how such organizations interact with local and international stakeholders. DISCUSSION: While institutions can enable organizations, they too often apply requirements to follow paths that can stifle learning and development. Global health actors have recognized the importance of supporting local organizations in HSS activities. However, this recognition has yet to translate adequately into actual policies to influence funding and practice. While there is not a single approach to HSS that can be uniformly applied to all contexts, several messages emerge from the experience of successful health systems presented in this paper using case studies through a complex adaptive systems lens. Two key messages deserve special attention: the need for donors and recipient organizations to work as equal partners, and the need for strong and diffuse leadership in low-income countries. An increasingly dynamic and interdependent post-Millennium Development Goals (post-MDG) world requires new ways of working to improve global health, underpinned by a complex adaptive systems lens and approaches that build local organizational capacity.

Funding, flexible management needed for Brazil's health worker gaps. Interview by Claudia Jurberg.

Last month the first Cuban physicians arrived in Brazil under a new government programme to work in underserved parts of the country, both rural and urban. Francisco Eduardo de Campos tells Claudia Jurberg why the Mais Médicos (More Physicians) programme is necessary.

[Autonomy as a central criterion in the concept of health promotion]. / Autonomia como categoria central no conceito de promoção de saúde.

This article presents the central concepts of the multiple case study "Health Promotion in Primary Care" conducted by Nescon-UFMG in 2005. Teams of the Family Health Program developed twelve health promotion experiences in different Brazilian regions. After a conceptual revision and field research, health promotion was defined as the process of improving the health of people independently of any previous disease or injury, helping them to increase control over their health. We also concluded that an increased autonomy, understood as the capacity and possibility of the persons to choose, is the central category and criterion for defining health promotion practices.