Associations of occupational physical activity and active transport with depressive symptoms in a middle-income country.

OBJECTIVE: This study investigated the associations of occupational physical activity and active transport with depressive symptoms, stratified by income range, among Brazilian working adults. STUDY DESIGN: This cross-sectional study drew on data from the 2019 Brazilian National Health Survey. METHODS: We used the Patient Health Questionnaire (PHQ-9) to assess depressive symptoms in working adults aged 18-65 years, with physical activities (occupational physical activity and active transport) self-reported through a specially developed questionnaire. Crude and adjusted logistic regression models were fitted. RESULTS: Individuals at the highest level of occupational physical activity (odds ratio [OR] 1.35; 95% confidence interval [95% CI] 1.19-1.53) and at the moderate level of active transport to work (OR 1.66; 95% CI 1.24-2.22) returned increased odds of depressive symptoms as compared with those who were inactive in these domains. Stratified by income group, light active transport to work (OR 0.57; 95% CI 0.34-0.95) in the lower income group (Range 1) was associated with lower odds of depressive symptoms. On the other hand, individuals at the highest level of active transport to work returned higher odds of depressive symptoms in the low- and intermediate-income groups, Ranges 3 and 4 (OR 1.92; 95% CI 1.22-3.00 and OR 2.91; 95% CI 1.71-4.95, respectively). CONCLUSION: Our results suggest that occupational physical activity and active transport may be a risk factor for depressive symptoms. They also point to differences in this relationship by income range. Further studies are needed to pursue the analysis of how specific domains of physical activity contribute to depressive symptoms.

Methods for measurement of root canal curvature: a systematic and critical review.

The assessment of root canal curvature is essential for clinical and research purposes. This systematic review presents an overview of the published techniques for the measurement of root canal curvature features using imaging and to provide a critique of their clinical application. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify measurement methods for root canal curvatures. The search strategy retrieved 10594 records in total, and 31 records fulfilled the inclusion criteria. From 2D image acquisitions, eleven studies measured exclusively the angle of curvature, an additional thirteen measured other curvature features (level, height, radius, length and shape). Seven reports described methods from 3D imaging (CBCT, µCT). Root canal curvatures should be measured, for clinical proposes, to facilitate endodontic treatment planning, and in research, to reduce the risk of selection bias. This review has revealed that there are many methods described in the literature; however, no consensus exists on which method should be used. Some of the methodologies have potential clinical translation, whereas others are suitable for research purpose only, as they require a specific software or radiographic exposure in the mesiodistal direction.

Association of manual or engine-driven glide path preparation with canal centring and apical transportation: a systematic review.

The role and effect of glide path preparation in root canal treatment remain controversial. This systematic review aims to compare apical transportation and canal centring of different glide path preparation techniques, with or without subsequent engine-driven root canal preparation. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify the effect of glide path preparation (or its absence) on apical transportation and canal centring. An assessment for the risk of bias in included studies was carried out. Amongst 2146 studies, 18 satisfied the inclusion criteria. Nine studies assessed glide path preparation per se, comparing apical transportation and canal centring of rotary systems and/or manual files; eleven further investigations examined the efficacy of the glide path prior to final canal preparation with different engine-driven systems. Risk of bias and other study design features with potential influence on study outcomes and clinical implications were assessed. Based on the available evidence, and within the limitation of the studies included, preparation of a glide path using rotary sequences performs similarly (in most of the component studies) or significantly better than manual preparation when assessing apical transportation or canal centring. When compared to the absence of a glide path, canal shaping following glide path preparation was of similar, or significantly better quality, in regard to apical transportation or canal centring.

Interaction between chlorhexidine-impregnated gutta-percha points and several chlorine-containing endodontic irrigating solutions.

AIM: To evaluate if the immersion of chlorhexidine-impregnated gutta-percha points in chlorine-containing endodontic irrigants causes colour changes and precipitate formation. METHODOLOGY: Eighty-one size 25 chlorhexidine medicated (Activ Points, Roeko, Langenau, Germany) and 27 size 25 standard gutta-percha points (Roeko) were immersed in microtubes, containing the following solutions: 0.5 and 5.25% NaOCl or Aquatine (Optident, Ilkley, UK). The samples were visually assessed, by two independent observers, at regular intervals over 3 weeks, to detect colour changes and precipitate formation. A score system was used to grade the precipitate intensity. To compare the number of days required for a precipitate to form mean and standard differences were calculated; the means between the groups were compared using a one-way analysis of variance test. Mean intensity scores were calculated and compared between groups using Kruskal-Wallis procedure followed by the Mann-Whitney test. RESULTS: The groups containing 5.25% NaOCl started to produce a visible precipitate after fourteen days (16.48 ± 0.98) for the Activ points; this process was first noticed with the standard gutta-percha group on day 17 (18.33 ± 1.22 days), with a statistically significant difference (P = 0.002). When looking at the intensity scores from day 17 onwards, these two groups differed statistically, with a greater amount for the AP group (P < 0.001). No other test group presented with changes. CONCLUSION: The placement of impregnated gutta-percha points, in 5.25% NaOCl for a 2-week period, caused the formation of a precipitate in the experimental conditions of this study.

Influence of pH changes on chlorine-containing endodontic irrigating solutions.

Chlorine-containing solutions are used for broad disinfection purposes. Water disinfection literature suggests that their disinfectant action depends on pH values as this will influence the available free chlorine forms. Hypochlorous acid (HOCl) has been suggested to have an antimicrobial effect around 80-100 times stronger than the hypochlorite ion. The aim of this paper was to review the influence of pH changes on the efficacy of chlorine-containing endodontic irrigating solutions. An electronic and hand search (articles published through to 2010, including 'in press' articles; English language; search terms 'root canal irrigants AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution'; 'antimicrobial action AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution'; 'tissue dissolution AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution'; 'smear layer AND sodium hypochlorite or hypochlorous acid or superoxidized water or electrochemically activated solution') was performed to identify publications that compared chlorine water solutions with different pH. Of 1304 publications identified, 20 were considered for inclusion in the review. The search resulted in the retrieval of articles studying sodium hypochlorite (NaOCl), superoxidized waters (SOW) and sodium dichloroisocyanurate (NaDCC). Regarding antimicrobial efficacy, the literature suggested that reducing the pH value of NaOCl to between 6 and 7.5 would lead to improved action; SOW was described as having a lower antimicrobial effect. The tissue dissolution activity NaOCl decreased when the pH reached values between 6 and 7.5; NaDCC and SOW had no clinically relevant tissue dissolution capability. Chlorine solutions of different characteristics appeared to have some cleaning efficacy although they should to be used in conjunction with chelating and/or detergent agents.

Type 2 dens invaginatus in a maxillary lateral incisor: a case report of a conventional endodontic treatment.

Dens invaginatus is a rare malformation of the teeth resulting from the invagination of the tooth crown before biological mineralization occurs. In most cases, the thin or incomplete enamel lining of the invagination cannot prevent the entry of bacteria into the pulp, which leads to pulp necrosis with an eventual periapical inflammatory response. The treatment options include preventive sealing or filling of the invagination, root canal treatment, endodontic apical surgery and extraction. The root canal treatment of such teeth is often complicated because of their anatomical complexity. This case describes a successful non-surgical endodontic treatment of a maxillary lateral incisor with type 2 dens invaginatus with a large periradicular lesion. At follow-up examinations after 6 and 12-months, the tooth was asymptomatic and the healed lesion was evident radiographically

Diagnostic ability of computed tomography to evaluate external root resorption in vitro.

OBJECTIVES: The aim of this study was to evaluate the diagnostic ability of CT to detect simulated external root resorption defects. METHODS: External root resorption defects of different sizes and in different locations were simulated in 59 human mandibular incisors. Cavities simulating root resorption defects of 0.6 mm, 1.2 mm, or 1.8 mm in diameter and 0.3 mm, 0.6 mm, or 0.9 mm in depth (small, medium and large defects) were drilled in the cervical, middle and apical thirds of buccal surfaces. Axial CT was used to obtain cross-sectional images of the teeth, and 177 root thirds were assessed by a blinded observer. RESULTS: Of the 131 cavities, 117 were detected (89%). 32 of the 44 (72.72%) cavities located in the apical third were identified. A statistically significant difference (P<0.01) was found between the sizes of defects examined in the apical third. CONCLUSIONS: The evaluation of CT diagnostic ability revealed high sensitivity and excellent specificity. However, small cavities located in the apical third were more difficult to detect than all other cavities.