Hepatitis B vaccine among healthcare workers: factors associated with the dimensions of the Health Belief Model.

OBJECTIVE: To investigate the association between the dimensions of the Health Belief Model (HBM) and complete vaccination for hepatitis B among healthcare workers (HCW). METHODS: Cross-sectional epidemiological study with HCW in Primary Health and Medium Complexity Care. Univariate and bivariate analyses were performed to test the association between the outcome variable (complete vaccination for hepatitis B based on self-report) and the variables of the HBM dimensions. Prevalence ratio (PR) and its respective 95% confidence intervals (95%CI) were calculated. RESULTS: 453 HCW participated. The prevalence of complete vaccination for hepatitis B was 56.9%. In the final analysis model, the following variables were associated with complete vaccination for hepatitis B: chances of having hepatitis B (PR=1.73) - related to the susceptibility dimension; disease severity (PR=0.74) - related to severity; reduced risk of absenteeism (PR=1.29) - related to benefits; not spending time to get vaccinated (PR=1.41) and not worrying about Events Supposedly Attributable to Vaccination or Immunization (PR=1.43) - related to barriers. CONCLUSIONS: The completeness of the hepatitis B vaccination schedule, reported by the investigated HCW, reveals the prevalence is below the target established by the Ministry of Health, which follows the national scenario of low coverage presented for other age groups. Understanding the risk perception and severity of hepatitis B can contribute to increasing the prevalence of vaccination for this infection.

Infecção latente pelo Mycobacterium tuberculosis em trabalhadores da saúde na Bahia / Latent Infection by Mycobacterium tuberculosis in health Workers in Bahia, Brazil

Objetivo: Estimar a prevalência de positividade do Teste Tuberculínico (TT) no rastreamento da infecção latente pelo Mycobacterium tuberculosis (ILTB) e identificar fatores associados entre trabalhadores da Atenção Primária à Saúde (APS) e média complexidade no segundo maior município do Estado da Bahia. Métodos: Inquérito epidemiológico, com 370 participantes, que avaliou dados sociodemográficos, ocupacionais, consumo de tabaco, álcool e variáveis relacionadas à tuberculose (TB), no período de abril/2021 a março/2022. Aplicou-se o TT por via intradérmica, com leitura após 72h. Resultados: A prevalência de positividade do TT foi de 41,3% e 17,6% para TT ≥ 5mm e TT ≥ 10mm, respectivamente. Para TT ≥ 5mm, as variáveis associadas foram: possuir cicatriz da vacina Bacilo Calmette-Guérin (BCG) e contato prévio com pessoas com TB. Conclusão: A prevalência de positividade do TT foi elevada entre os participantes do estudo. Fazem-se necessárias medidas de proteção ambiental, coletiva e individual para redução do risco de ILTB.

Objective: To estimate the prevalence of tuberculin test (TT) positivity in screening for Latent Mycobacterium tuberculosis Infection (LTBI) and to identify associated factors in Primary Health Care (PHC) and medium complexity workers in the second largest municipality in the State of Bahia, Brazil. Methods: Epidemiological survey with 370 workers on sociodemographic and occupational data, tobacco and alcohol use and variables related to Tuberculosis (TB), during April 2021 and March 2022. TT was applied intradermally, with reading after 72 hours. Results: The prevalence of positive TT was 41.3% and 17.6% for TT ≥ 5mm and TT ≥ 10mm, respectively. For TT ≥ 5mm, the associated variables were: presence of Bacillus Calmette-Guérin (BCG) vaccine scar and previous contact with TB patients. Conclusion: The prevalence of TST positivity was high among study participants. Environmental, collective and individual protection measures are necessary to reduce the risk of LTBI.

Development and effect of orodispersible film incorporated with Biosilicate for remineralization of dental enamel subjected to cariogenic and erosive challenge.

OBJECTIVES: The objective of this in vitro study was to assess the efficiency of incorporating Biosilicate particles (30 and 50 mg) into an experimental orodispersible film and its efficacy in the remineralization process of bovine dental enamel under cariogenic and erosive challenges. METHODS: Ninety-nine intact incisors, devoid of cracks or fractures, yielding 198 samples (6 × 6 × 2 mm) via vestibular sectioning using a low-speed diamond disc under water cooling. After flattening the enamel surface with 600, 1200, and 2000 grit sandpaper, the samples were divided into two groups based on the challenges they underwent: cariogenic (0.1 M lactic acid at pH 5.0) or erosive (0.05 M citric acid solution at pH 2.3). Samples from each challenge were further categorized into 11 groups (n = 9) according to the duration of cariogenic (3, 7, and 14 days) or erosive (3, 7, and 10 days) challenge, along with positive control groups (fragments untreated with challenges and treated with different Biosilicate concentrations) and negative controls (fragments treated with artificial saliva for the same periods established for cariogenic and erosive challenges). Treatments with orodispersible films containing Biosilicate (30 and 50 mg) were administered for 2 min per day for 15 days. RESULTS: The highest remineralizing potential was observed in samples treated with Biosilicate after 14 days of cariogenic challenge, irrespective of the concentration tested. For samples subjected to erosive challenge, erosion time did not affect Biosilicate's remineralizing potential. CONCLUSION: Biosilicate shows promise in terms of remineralizing potential in enamel subjected to cariogenic challenge due to its ability to form hydroxycarbonapatite in mineralized tissues.

Effect of the use of bromelain associated with bioactive glass-ceramic on dentin/adhesive interface.

OBJECTIVES: To evaluate the effect of bromelain associated with Biosilicate on the bond strength (BS) of a universal adhesive system to sound (SD) and caries-affected dentin (CAD), and on the proteolytic activity. MATERIALS AND METHODS: Cavities were prepared in 360 molars, half submitted to cariogenic challenge. Teeth were separated into groups (n=20): Control-No treatment; CHX-0.12% chlorhexidine; NaOCl-5% sodium hypochlorite; Br5%-5% bromelain; Br10%-10% bromelain; Bio-10% Biosilicate; NaOClBio-NaOCl+Bio; Br5%Bio-Br5%+Bio; Br10%Bio-Br10%+Bio. Following treatments, the adhesive system was applied, and cavities were restored. Samples were sectioned into sticks and stored at 37 °C for 24 h, 6 months, and 1 year. Microtensile BS (2-way ANOVA, Bonferroni's test, α=0.05), fracture patterns (SEM), and adhesive interfaces (TEM) were evaluated. Bacterial collagenase assay and in situ zymography were performed. RESULTS: In CAD, Br10% presented higher BS (p=0.0208) than Br5%Bio. Br5% presented higher BS (p=0.0033) after 6 months than after 24 h; and association of treatments, higher BS (p<0.05) after aging than after 24 h. Mixed fractures were the most prevalent. Association of treatments promoted a more uniform hybrid layer with embedded Bio particles. Experimental groups presented lower (p<0.0001) relative fluorescence units than Control. Bromelain, associated or not with Bio, showed collagenolytic degradation. CONCLUSIONS: Bromelain associated with Biosilicate did not affect the BS to SD. In CAD, Br5%Bio decreased immediate BS but had no long-term influence. This association decreased the proteolytic activity. CLINICAL RELEVANCE: Bromelain and Biosilicate may enhance the longevity of adhesive restorations by inhibiting endogenous proteases.

Effect of natural agents on the bond strength to eroded dentin.

OBJECTIVE: This study evaluated the effect of bromelain and propolis extract on the bond strength (BS) of a universal adhesive system to eroded dentin. MATERIALS AND METHODS: Sixty human molars with exposed dentin were halved, with one half protected by composite resin and the other subjected to erosive treatment followed by remineralization. After the erosive treatment, the composite resin was removed, and the teeth were randomly assigned to three groups (n = 20): Adhesive-Control System; Br-10%; Pr-16%. Following the treatments, composite resin blocks were built on the dentin surfaces and sticks of 0.9 mm2 were obtained and stored in distilled water at 37°C for 24 h and 6 months. After these periods, the sticks underwent bond strength testing and the data were analyzed using 2-way ANOVA, Bonferroni test, p < 0.05. Fracture patterns were observed using light microscope and scanning electron microscopy. RESULTS: Irrespective of the substrate and aging duration, propolis demonstrated higher BS (p < 0.05) compared to the other treatments. Eroded dentin exhibited greater removal of the smear layer and dentinal tubules with a larger diameter than sound dentin, especially when treated with bromelain, resulting in the formation of resin tags. CONCLUSIONS: Propolis consistently promoted the highest bond strength, irrespective of aging or substrate. Eroded dentin treated with propolis, or bromelain exhibited a higher prevalence of non-adhesive fractures and resin tag formation. CLINICAL SIGNIFICANCE: Propolis shows promise for enhancing the longevity of adhesive restorations in eroded dentin due to its ability to promote high bond strength.

Hepatitis B vaccine among healthcare workers: factors associated with the dimensions of the Health Belief Model / Vacina para hepatite B entre trabalhadores da saúde: fatores associados às dimensões do Modelo de Crenças em Saúde

ABSTRACT Objective: To investigate the association between the dimensions of the Health Belief Model (HBM) and complete vaccination for hepatitis B among healthcare workers (HCW). Methods: Cross-sectional epidemiological study with HCW in Primary Health and Medium Complexity Care. Univariate and bivariate analyses were performed to test the association between the outcome variable (complete vaccination for hepatitis B based on self-report) and the variables of the HBM dimensions. Prevalence ratio (PR) and its respective 95% confidence intervals (95%CI) were calculated. Results: 453 HCW participated. The prevalence of complete vaccination for hepatitis B was 56.9%. In the final analysis model, the following variables were associated with complete vaccination for hepatitis B: chances of having hepatitis B (PR=1.73) - related to the susceptibility dimension; disease severity (PR=0.74) - related to severity; reduced risk of absenteeism (PR=1.29) - related to benefits; not spending time to get vaccinated (PR=1.41) and not worrying about Events Supposedly Attributable to Vaccination or Immunization (PR=1.43) - related to barriers. Conclusions: The completeness of the hepatitis B vaccination schedule, reported by the investigated HCW, reveals the prevalence is below the target established by the Ministry of Health, which follows the national scenario of low coverage presented for other age groups. Understanding the risk perception and severity of hepatitis B can contribute to increasing the prevalence of vaccination for this infection.

RESUMO Objetivo: Investigar a associação entre as dimensões do Modelo de Crenças em Saúde (MCS) e a vacinação completa para hepatite B entre trabalhadores da saúde (TS). Métodos: Estudo epidemiológico de corte transversal com TS da Atenção Primária à Saúde e Média Complexidade. Realizaram-se análises uni e bivariada a fim de testar a associação entre a variável desfecho (vacinação completa para hepatite B a partir do autorrelato) e as variáveis das dimensões do MCS. Foram calculadas razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC95%). Resultados: Participaram do estudo 453 TS. A prevalência de vacinação completa para hepatite B foi de 56,9%. No modelo final de análise, estiveram associadas à vacinação completa para hepatite B as variáveis: chance de pegar hepatite B (RP=1,73) - relativa à dimensão de suscetibilidade; gravidade da doença (RP=0,74) - relativa à dimensão de gravidade; diminuição do risco de absenteísmo (RP=1,29) - relativa à dimensão de benefícios; não dispêndio de tempo para se vacinar (RP=1,41) e não preocupação acerca de eventos atribuíveis à vacinação ou imunização (RP=1,43) - relativas à dimensão de barreiras. Conclusão: A completude do esquema vacinal para hepatite B, referida pelos TS investigados, revela uma prevalência abaixo da meta estabelecida pelo Ministério da Saúde, a qual acompanha o cenário nacional de baixas coberturas apresentado para outras faixas etárias. A compreensão sobre percepção de risco e gravidade da hepatite B pode contribuir para o aumento da prevalência de vacinação para essa infecção.

Incorporation of bioactive glass-ceramic into coconut oil for remineralization of incipient carious lesions.

This study evaluated the efficacy of incorporating different concentrations of bioactive glass-ceramic (Biosilicate) into coconut oil on the remineralizing potential and surface roughness of white spot lesions. Fragments (6 x 6 x 2mm) of bovine teeth were sectioned and initial microhardness (KHN) and surface roughness (Ra) readings were obtained. The samples were submitted to cariogenic challenge to form white spot lesions and were separated into six groups (n=13): 1) Artificial Saliva (AS); 2) Coconut Oil (CO); 3) CO+2% Biosilicate (CO+2%Bio); 4) CO+5% Biosilicate (CO+5%Bio); 5) 2% Biosilicate Suspension (2% Bio) and 6) 5% Biosilicate Suspension (5% Bio). The treatments for 1 cycle/day were: immersion into the treatments for 5 minutes, rinsing in distilled water, and storage in artificial saliva at 37ºC. After 14 days, KHN and Ra readings were taken. The surface roughness alteration ((Ra) was analyzed (Kruskal-Wallis, Dunn's post-test, p<0.05). CO+2%Bio had higher (p = 0.0013) (Ra followed by CO+5%Bio (p = 0.0244) than AS. The relative KHN and remineralization potential were analyzed (ANOVA, Tukey, p<0.05), and 5% Bio treatment presented a higher relative microhardness than all other groups (p>0.05). The remineralizing potential of all the treatments was similar (p > .05). When Biosilicate was added, the pH of the suspensions increased and the alkaline pH remained during the analysis. Biosilicate suspension is more efficient than the incorporation of particles into coconut oil at white spot lesion treatment. In addition to the benefits that coconut oil and Biosilicate present separately, their association can enhance the remineralizing potential of Biosilicate.

Long-term effect of firing protocols on surface roughness and flexural strength of lithium disilicate glass-ceramic.

This study evaluated the effect of different firing protocols on the surface roughness and flexural strength of CAD/CAM lithium disilicate glass-ceramic (LD) after aging methods. Forty-two LD bars of 16 x 4 x 2 mm (IPS e-max CAD, Ivoclar) were randomly separated into two groups according to firing protocols: Single firing-Staining, glazing, and crystallization in a single step; Multiple firings-Crystallization+First staining+Firing+Second staining+Firing+Glazing+Firing. After protocols, initial surface roughness readings were taken (Surfcorder SE1700, Kosakalab). Samples were then randomly separated into three groups (n=7) according to the aging methods they were submitted: Thermomechanical cycling (TMC, ER System, Erios, 1,200,000 cycles, 0.3 MPa, 2 Hz and 5°C/37°C/55°C, 30 s swell time); Simulated toothbrushing (STB, Pepsodent, MAVTEC, 73,000 cycles), and Control (no aging). Final surface roughness readings were done, and samples were submitted to a three-point bending test (OM100, Odeme Dental Research) and fractographic analysis by scanning electron microscopy (EVO-MA10, ZEISS). Data were analyzed (2-way ANOVA, (α=.05). There was no difference (p>.05) in the flexural strength between the firing protocols, regardless of the aging method. STB decreased the flexural strength of samples submitted to multiple firings, different from control (p<.05). Without aging (Control), before TMC, and after STB, LD had lower surface roughness when submitted to multiple firings than to single firing (p<.05). The firing protocols did not affect the flexural strength or the surface roughness of the lithium disilicate glass-ceramic, even after aging. However, toothbrushing negatively affected the flexural strength and smoothed the surface of the ceramic submitted to multiple firings.

Antimicrobial effect of phytosphingosine in acrylic resin.

This study evaluated color stability (CS), anti-adherence effect (AAE), and cell viability of microorganisms on acrylic resin (AR) surface, treated associated or not with sodium percarbonate (SP). AR specimens were prepared, and color analysis was performed before and after the treatments and the CS was calculated. For analysis of AAE, the samples were sterilized by radiation in a microwave oven. Then samples were randomly distributed: phosphate-buffered saline (PBS - control), 0.5% sodium hypochlorite (SH), phytosphingosine (PHS), and phytosphingosine + SP (PHS+Na2CO3). The specimens remained in contact with solutions for 30 minutes and were later contaminated by Candida albicans. Aliquots were seeded in Petri dishes with Sabouraud Dextrose agar and incubated at 37°C for 24 hours. After the incubation, the number of colonies was counted. The cell viability of adhered microorganisms on the AR was evaluated and 20 fields were observed under an epifluorescence microscope, and the percentage of adhered viable cells was calculated. Data were compared (One-way ANOVA, Tukey, p<.05). As for CS, PHS+ Na2CO3 (0.4±0.1) resulted in less change than PBS (0.9±0.2), similar to the other groups (SH [1.0±0.3)]; PHS [0.9±0.2)]). There was no difference for all tested solutions regarding the ability to avoid microorganism adherence (p>0.05), but PHS (11.2±4.1) resulted in a smaller area of adhered viable cells, statistically different from SH (18.2±7.6) and PBS (26.4±10.8). It was concluded that PHS resulted in lower adhered viable cells and when associated with Na2CO3, also shows a lower effect on the CS of AR.

Long-term effect of firing protocols on surface roughness and flexural strength of lithium disilicate glass-ceramic

Abstract This study evaluated the effect of different firing protocols on the surface roughness and flexural strength of CAD/CAM lithium disilicate glass-ceramic (LD) after aging methods. Forty-two LD bars of 16 x 4 x 2 mm (IPS e-max CAD, Ivoclar) were randomly separated into two groups according to firing protocols: Single firing-Staining, glazing, and crystallization in a single step; Multiple firings-Crystallization+First staining+Firing+Second staining+Firing+Glazing+Firing. After protocols, initial surface roughness readings were taken (Surfcorder SE1700, Kosakalab). Samples were then randomly separated into three groups (n=7) according to the aging methods they were submitted: Thermomechanical cycling (TMC, ER System, Erios, 1,200,000 cycles, 0.3 MPa, 2 Hz and 5°C/37°C/55°C, 30 s swell time); Simulated toothbrushing (STB, Pepsodent, MAVTEC, 73,000 cycles), and Control (no aging). Final surface roughness readings were done, and samples were submitted to a three-point bending test (OM100, Odeme Dental Research) and fractographic analysis by scanning electron microscopy (EVO-MA10, ZEISS). Data were analyzed (2-way ANOVA, (α=.05). There was no difference (p>.05) in the flexural strength between the firing protocols, regardless of the aging method. STB decreased the flexural strength of samples submitted to multiple firings, different from control (p<.05). Without aging (Control), before TMC, and after STB, LD had lower surface roughness when submitted to multiple firings than to single firing (p<.05). The firing protocols did not affect the flexural strength or the surface roughness of the lithium disilicate glass-ceramic, even after aging. However, toothbrushing negatively affected the flexural strength and smoothed the surface of the ceramic submitted to multiple firings.

Resumo Este estudo avaliou o efeito de diferentes protocolos de queima na rugosidade de superfície e resistência à flexão de uma cerâmica vítrea de dissilicato de lítio (DL) para CAD/CAM, após métodos de envelhecimento. Quarenta e dois barras de DL (IPS e-max CAD, Ivoclar) de 16 x 4 x 2 mm foram separadas aleatoriamente em dois grupos de acordo com os protocolos de queima: Single firing-Pigmentação, glazeamento e cristalização em única etapa. Multiple firings-Cristalização+Primeira camada do pigmento+Queima+Segunda camada do pigmento+Queima+Glazeamento+Queima. Após os protocolos, foram realizadas leituras iniciais de rugosidade de superfície (Surfcorder SE1700, Kosakalab). As amostras foram então separadas aleatoriamente em três grupos (n=7) segundo o método de envelhecimento a que foram submetidas: Ciclagem termomecânica (CTM, Sistema ER, Erios, 1.200.000 ciclos, 0.3 MPa, 2 Hz e 5°C/37°C/55°C, 30 s de imersão), Escovação simulada (ES, Pepsodent, MAVTEC, 73.000 ciclos) e Controle (sem envelhecimento). Leituras finais de rugosidade foram realizadas, e as amostras foram submetidas ao ensaio de resistência à flexão em três pontos (OM100, Odeme Dental Research) e à análise fractográfica por microscopia eletrônica de varredura (EVO-MA10, ZEISS). Os dados foram analisados (ANOVA de dois fatores, (α=.05). Não houve diferença (p>.05) na resistência à flexão entre os protocolos de queima, independente do envelhecimento. ES diminuiu a resistência à flexão das amostras submetidas a multiple firings, diferente do controle (p<.05). Sem envelhecimento (Controle), antes da CTM e após ES, LD apresentou menor rugosidade de superfície quando submetido a multiple firings do que a single firing (p<.05). Os protocolos de queima não afetaram a resistência à flexão nem a rugosidade de superfície da cerâmica vítrea de dissilicato de lítio, mesmo após envelhecimento. No entanto, a escovação afetou negativamente a resistência à flexão e poliu a superfície da cerâmica submetida a multiple firings.

Antimicrobial effect of phytosphingosine in acrylic resin

Abstract This study evaluated color stability (CS), anti-adherence effect (AAE), and cell viability of microorganisms on acrylic resin (AR) surface, treated associated or not with sodium percarbonate (SP). AR specimens were prepared, and color analysis was performed before and after the treatments and the CS was calculated. For analysis of AAE, the samples were sterilized by radiation in a microwave oven. Then samples were randomly distributed: phosphate-buffered saline (PBS - control), 0.5% sodium hypochlorite (SH), phytosphingosine (PHS), and phytosphingosine + SP (PHS+Na2CO3). The specimens remained in contact with solutions for 30 minutes and were later contaminated by Candida albicans. Aliquots were seeded in Petri dishes with Sabouraud Dextrose agar and incubated at 37°C for 24 hours. After the incubation, the number of colonies was counted. The cell viability of adhered microorganisms on the AR was evaluated and 20 fields were observed under an epifluorescence microscope, and the percentage of adhered viable cells was calculated. Data were compared (One-way ANOVA, Tukey, p<.05). As for CS, PHS+ Na2CO3 (0.4±0.1) resulted in less change than PBS (0.9±0.2), similar to the other groups (SH [1.0±0.3)]; PHS [0.9±0.2)]). There was no difference for all tested solutions regarding the ability to avoid microorganism adherence (p>0.05), but PHS (11.2±4.1) resulted in a smaller area of adhered viable cells, statistically different from SH (18.2±7.6) and PBS (26.4±10.8). It was concluded that PHS resulted in lower adhered viable cells and when associated with Na2CO3, also shows a lower effect on the CS of AR.

Resumo Este estudo avaliou estabilidade de cor (EC), efeito antiaderente (EAA) e viabilidade celular de microrganismos em superfície de resina acrílica (RA), tratada com solução de fitoesfingosina, associada ou não ao percarbonato de sódio (PS). Espécimes RA foram preparados e análise de cor foi realizada antes e após os tratamentos e EC foi calculada. Para análise de EAA, as amostras foram esterilizadas por radiação em forno de micro-ondas. Então foram distribuídas aleatoriamente: solução salina tamponada com fosfato (PBS - controle), hipoclorito de sódio 0,5% (SH), fitoesfingosina (PHS) e fitoesfingosina + SP (PHS+Na2CO3). Os espécimes permaneceram em contato com as soluções por 30 minutos e posteriormente foram contaminados por Candida albicans. Alíquotas foram semeadas em placas de Petri com ágar Sabouraud Dextrose e incubadas a 37°C por 24 horas. Após a incubação, o número de colônias foi contado. A viabilidade celular dos microorganismos aderidos na RA foi avaliada e 20 campos foram observados em microscópio de epifluorescência, e a porcentagem de células viáveis aderidas foi calculada. Os dados foram comparados (One-way ANOVA, Tukey, p<0,05). Quanto a EC, o PHS+ Na2CO3 [0,4 (0,1)] resultou em menor alteração que o PBS [0,9 (0,2)], semelhante aos demais grupos (SH [1,0 (0,3)]; PHS [0,9 (0,2)]). Não houve diferença para todas as soluções testadas quanto à capacidade de evitar a aderência de microorganismos (p>0,05), mas o PHS [11,2 (4,1)] resultou em uma área menor de células viáveis aderidas, estatisticamente diferente do SH [18,2 (7,6)] e PBS [26,4 (10,8)]. Concluiu-se que o PHS resultou em menor número de células viáveis aderidas e, quando associado ao Na2CO3, também apresenta menor efeito sobre o EC da RA.

Effect of limonene associated with bioactive glass-ceramic on dentin/adhesive interface.

This study evaluated the effect of pretreatment with limonene and/or biosilicate on the bond strength of a universal adhesive system in self-etch mode to dentin. Occlusal cavities were prepared in 80 human molars and the teeth were randomly allocated to one of four groups (n = 20), according to the pretreatment regimens applied before the adhesive. The pretreatments were (i) Control, no pretreatment, (ii) LIM, 0.5% limonene; (iii) Bio, 10% biosilicate; and (iv) LIMBio, LIM + Bio. After adhesive application and restoration, the specimens were sectioned into sticks, separated, and stored in distilled water at 37°C for 24 h or 6 months. Microtensile bond strength test was carried out and measurements were compared across pretreatment groups and storage times. Fracture patterns and adhesive interfaces were observed. Loss of dry mass was calculated (n = 10). There was no statistically significant difference in the bond strength between the groups and the most prevalent fracture pattern was the non-adhesive. LIM and LIMBio resulted in more open dentinal tubules. LIM and Bio, whether separate or combined, showed particles of those substances, which decreased in size and number after 6 months. All groups lost mass weight after treatment, with no statistically significant differences between them. Limonene and biosilicate pretreatment did not affect the bond strength to dentin of the universal adhesive system, but resulted in more non-adhesive fractures, even after 6 months.

The effect of Phytosphingosine and bioactive glass-ceramics in preventing dental enamel erosion.

This study evaluated the effect of phytosphingosine (PHS) and bioactive glass-ceramic (Biosilicate) on dental enamel in terms of color alteration (ΔE), microhardness, and surface roughness when submitted to erosive challenge (EC). Sixty specimens of bovine teeth (6×6×2mm) were obtained. Initial color (Easyshade, VITA), KHN (HMV-2, Shimadzu), and Ra (SJ-201P, Mitutoyo) measurements were performed. Specimens were separated into groups according to treatments: PHS, 10% Biosilicate, PHS+10% Biosilicate, and artificial saliva (control) and submitted to EC with Coca-Cola for 2 min. This cycle was repeated 4 times daily/15 days. Between cycles, specimens remained in artificial saliva (2 h/37°C). After daily cycles, they were also stored in artificial saliva at 37ºC. Final color, microhardness, and surface roughness measurements were done. Color and KHN data were analyzed by one-way ANOVA, Tukey's test; and Ra, by 2-way ANOVA, repeated measures, and Tukey's test (p<.05). The highest ΔE occurred in Saliva+EC (p<.05). Groups treated with PHS presented lower color change than Saliva+EC (p<.05). All the groups presented mean values above the 50:50% perceptibility (50:50%PT) and acceptability (50:50%AT) thresholds, except for control that showed mean value above 50:50%PT but below 50:50%AT. Biosilicate+EC showed higher relative microhardness than Saliva+EC (p<.05), but was similar to PHS+EC and PHS+Biosilicate+EC. Final enamel surface roughness increased for all the groups (p<.05), except for the control. The Biosilicate may prevent enamel mineral loss induced by erosion better than saliva. The PHS associated or not to Biosilicate demonstrated better color stability than saliva.

Remineralization, color stability and surface roughness of tooth enamel brushed with activated charcoal-based products.

OBJECTIVE: To evaluate the effect of activated charcoal-based (AC) products on color alteration, remineralizing potential and surface roughness of dental enamel. MATERIALS AND METHODS: Bovine incisors were cut into 6 × 6 × 2 mm fragments. Initial color (EasyShade, Vita) and surface roughness (Surfcorder SE1700, Kosakalab) readings were performed. Fragments were separated into five groups (n = 17) according to the treatment: Control: Fluoride toothpaste (Colgate Total 12, Colgate); Charcoal + NaF: AC toothpaste (ACT) with sodium fluoride (Colgate Natural Extracts, Colgate); Charcoal + MFP + n-HA: ACT with sodium monofluorophosphate and nanohydroxyapatite (Black is White, Curaprox); Charcoal: Fluoride-free ACT (ProActive, Hinode); and Charcoal powder: AC powder. Simulated toothbrushing was performed and final color and surface roughness readings were obtained. Fragments were then polished, and initial microhardness (HMV-2, Shimatzu) readings were done. Samples were artificially demineralized and brushed again. Final microhardness readings were taken. Data were statistically analyzed. RESULTS: Fluoride-free charcoal presented the lowest surface roughness alteration (p < 0.05). Charcoal powder had the lowest color change (p < 0.05) and negative values for whiteness index for dentistry alteration. All the groups presented values below whiteness acceptability threshold and negative relative microhardness values. Control showed the highest remineralizing potential (p < 0.05). CONCLUSIONS: ACPs did not produce color alteration different from the fluoride toothpaste, except for Charcoal powder that caused less color change. ACPs caused surface roughness alteration similar to the fluoride toothpaste. ACT with fluoride and AC powder did not have remineralizing potential. CLINICAL SIGNIFICANCE: Activated charcoal-based products (ACP) promise effective tooth whitening and quick results, without teeth damage. In addition, some ACPs contain fluoride in toothpaste composition and promise rehardening potential. However, ACPs are not as effective as other whitening agents and can alter the surface roughness of the enamel. Even if the ACPs contain fluoride or other remineralizing agents, they might be ineffective.

The effect of Phytosphingosine and bioactive glass-ceramics in preventing dental enamel erosion

Abstract This study evaluated the effect of phytosphingosine (PHS) and bioactive glass-ceramic (Biosilicate) on dental enamel in terms of color alteration (ΔE), microhardness, and surface roughness when submitted to erosive challenge (EC). Sixty specimens of bovine teeth (6×6×2mm) were obtained. Initial color (Easyshade, VITA), KHN (HMV-2, Shimadzu), and Ra (SJ-201P, Mitutoyo) measurements were performed. Specimens were separated into groups according to treatments: PHS, 10% Biosilicate, PHS+10% Biosilicate, and artificial saliva (control) and submitted to EC with Coca-Cola for 2 min. This cycle was repeated 4 times daily/15 days. Between cycles, specimens remained in artificial saliva (2 h/37°C). After daily cycles, they were also stored in artificial saliva at 37ºC. Final color, microhardness, and surface roughness measurements were done. Color and KHN data were analyzed by one-way ANOVA, Tukey's test; and Ra, by 2-way ANOVA, repeated measures, and Tukey's test (p<.05). The highest ΔE occurred in Saliva+EC (p<.05). Groups treated with PHS presented lower color change than Saliva+EC (p<.05). All the groups presented mean values above the 50:50% perceptibility (50:50%PT) and acceptability (50:50%AT) thresholds, except for control that showed mean value above 50:50%PT but below 50:50%AT. Biosilicate+EC showed higher relative microhardness than Saliva+EC (p<.05), but was similar to PHS+EC and PHS+Biosilicate+EC. Final enamel surface roughness increased for all the groups (p<.05), except for the control. The Biosilicate may prevent enamel mineral loss induced by erosion better than saliva. The PHS associated or not to Biosilicate demonstrated better color stability than saliva.

Resumo Este estudo avaliou o efeito da Fitoesfingosina (PHS) e da vitrocerâmica bioativa (Biosilicato) sobre o esmalte dental em termos de alteração de cor (ΔE), microdureza (KHN) e rugosidade superficial, quando submetido a desafio erosivo (DE). Sessenta espécimes de dentes bovinos (6×6×2mm) foram obtidos. Foram realizadas leituras de cor inicial (Easyshade, VITA), microdureza (HMV-2, Shimadzu) e rugosidade superfícial (SJ-201P, Mitutoyo). Os espécimes foram separados em grupos de acordo com os tratamentos: PHS, Biosilicato a 10%, PHS+Biosilicato a 10%, e saliva artificial (controle). Em seguida, foram submetidos a DE com Coca-Cola por 2 min. Esse ciclo foi repetido 4 vezes/dia por 15 dias. Entre os ciclos, as amostras foram mantidas em saliva artificial (2 h/37°C). Após os ciclos diários, os espécimes também foram armazenados em saliva artificial a 37ºC. Foram realizadas leituras finais de cor, microdureza e rugosidade superficial. Os dados de cor e microdureza foram analisados ​​por ANOVA de uma via, teste de Tukey; e dados de rugosidade superficial, por ANOVA de duas vias, teste de Tukey (p<.05). A maior ΔE ocorreu em Saliva+DE (p<.05). Grupos tratados com PHS apresentaram menor alteração de cor do que Saliva+DE (p<.05). Biosilicate+DE demonstrou valores intermediários, similar (p>.05) aos outros grupos, exceto Saliva+DE. Todos os grupos presentaram média acima dos limites 50:50% de perceptibilidade (50:50%LP) e aceitabilidade (50:50%LA) exceto o controle que demonstrou média acima do 50:50%LA mas abaixo do 50:50%LP. Biosilicate+DE mostrou maior microdureza realativa do que Saliva+DE (p<.05), mas similar a PHS+DE e PHS+Biosilicato+DE. A rugosidade de superfície do esmalte aumentou para todos os grupos, exceto para o controle que presentou a menor alteração (p<.05). O Biosilicato apode prevenir perda mineral do esmalte indizido pela erosão melhor que a saliva. O PHS associado ou não ao Biosilicato demonstrou melhor estabilidade de cor que a saliva.

The effect of phytosphingosine associated with tooth brushing on color change, surface roughness, and microhardness of dental enamel - an in vitro and in situ study.

OBJECTIVE: This study evaluated the in vitro and in situ effects of phytosphingosine (PHS) associated with tooth brushing on color stability, surface roughness, and microhardness of dental enamel. METHODS: Sixty-four specimens of bovine teeth (6 × 6 × 2 mm) were separated into 8 groups (n = 8): S + TB: PHS (spray) + tooth brushing; TB + S: tooth brushing + PHS (spray); I + TB: PHS (immersion) + tooth brushing; TB + I: tooth brushing + PHS (immersion); TB: tooth brushing; S: PHS spray; I: immersion in PHS solution, and Saliva: immersion in saliva. Tooth brushing simulation (Mavtec, Brazil) was performed (356 rpm on 3.8 cm area by the toothbrush - Soft Tek) for 1, 7, 15, and 30 days. PHS remained in contact with specimens for 15 min. The specimens were evaluated before and after tooth brushing for color alteration (Easy Shade, VITA), and surface roughness (Model SJ-201P Mitutoyo), and Knoop microhardness (HMV-2, Shimadzu Corporation). For the in situ analyses, 8 participants were recruited and received an intraoral device with 6 fragments of bovine enamel (6 × 6 × 2 mm). The properties evaluated were the same as those of the in vitro study. Participants were randomized following best results of in vitro tested protocols, for 15 days: TB, TB + S, I + TB. Data obtained by in vitro (two-way ANOVA, Tukey, p < .05) and in situ (one-way ANOVA, Tukey, p < .05) studies were analyzed. RESULTS: The in vitro study showed that greater color change was found after 30 days. The greatest differences in surface roughness occurred between the initial value and after 1 day. Regarding microhardness, the highest values occurred after 15 and 30 days, which showed similar results. The in situ study showed greater color changes for the TB and I + TB, and greater surface roughness changes for TB as well as a similar increase in microhardness for the PHS protocols, which were higher than TB. CONCLUSIONS: Phytosphingosine leads to an increase in performance regarding color stability, surface roughness, and microhardness when applied. In general, the application of PHS after brushing showed a positive impact on its performance. CLINICAL RELEVANCE: Phytosphingosine proved to be interesting for compound prevention formulations in the dentistry field.

Hepatitis B vaccination and serology among health personnel in a municipality in the Recôncavo Baiano, Brazil, 2019.

Introduction: Health personnel are more susceptible to contamination by the hepatitis B virus due to occupational risk and need special care. Previous studies have found, however, that not all health personnel were fully vaccinated against hepatitis B, as recommended by the Ministry of Health. Objectives: To analyze the factors associated with full hepatitis B vaccination and to evaluate post-vaccination serological response among health personnel. Methods: Cross-sectional study, conducted in the municipality of Santo Antônio de Jesus, Bahia, Brazil. The sample consisted of 453 health personnel from primary and medium-complex care. Results: The prevalence of full hepatitis B vaccination among health personnel was 56.9%. The variables associated with the prevalence of complete hepatitis B vaccination in the final analysis model were: working in primary health care (prevalence ratio = 1.31; 95% CI 1.04-1.65) and medicine preparation or administration (prevalence ratio = 3.53; 95% CI 2.17-5.74). Around 72% of those who reported being shot with all three doses of the hepatitis B vaccine had been tested for circulating antibodies in their blood and 88.4% were immune to the hepatitis B virus. Conclusions: The familiarity provided by routine primary health care and the awareness of occupational risk was associated with beter adherence to the hepatitis B vaccine schedule among health personnel. Nearly a third of those who were shot with the three doses of hepatitis B vaccine were not immunized, reinforcing the need for anti-HBs testing.

Introdução: Devido à maior susceptibilidade à contaminação pelo vírus da hepatite B em virtude do risco ocupacional, trabalhadores(as) da saúde necessitam de cuidado especial. Entretanto, estudos prévios constataram que nem todos os profissionais apresentavam esquema vacinal completo para hepatite B, como é preconizado pelo Ministério da Saúde. Objetivos: Analisar os fatores associados à vacinação completa para hepatite B e avaliar resposta sorológica pós-vacinação entre trabalhadores(as) da saúde. Métodos: Estudo transversal, realizado no município baiano de Santo Antônio de Jesus, cuja amostra foi composta por 453 trabalhadores(as) da saúde da Atenção Primária à Saúde e da média complexidade. Resultados: A prevalência de vacinação completa para hepatite B entre trabalhadores(as) da saúde foi de 56,9%. No modelo final de análise, as variáveis associadas à prevalência de vacinação completa para hepatite B foram: trabalhar no nível da Atenção Primária à Saúde (razão de prevalência = 1,31; IC95% 1,04-1,65) e preparo ou administração de medicamentos (razão de prevalência = 3,53; IC95% 2,17-5,74). Daqueles(as) que relataram o recebimento das três doses da vacina para hepatite B, 88,4% realizaram a testagem de anticorpos circulantes no sangue, e cerca de 72% estavam imunes ao vírus da hepatite B. Conclusões: O conhecimento proporcionado pela rotina na Atenção Primária à Saúde e o reconhecimento do risco ocupacional estava associado à melhor adesão à vacina para hepatite B entre trabalhadores(as) da saúde. Quase um terço dos(as) trabalhadores(as) que receberam as três doses da vacina para hepatite B não estava imunizado, reforçando a necessidade da realização do exame anti-HBs.

Health Belief Model in studies of influenza vaccination among health care workers.

Vaccines prevent numerous infectious diseases, including influenza. Despite their significant contribution to controlling influenza, vaccine coverage against this disease varies among health care workers. The Health Belief Model could thus help to understand the reasons why these workers accept (or not) the immunobiological. The aim of this study was to describe the main results of research performed on influenza vaccination among health care workers using the Health Belief Model. This is an integrative literature review. Data search took place in October 2020 in the PubMed database, with the following descriptors: "influenza vaccine"; "health professionals"; "Health Belief Model," and their synonyms. Eleven studies were included in this review. The main dimensions of the model (susceptibility, severity, benefits, and barriers) were more explored by the studies, and self-efficacy was the least studied dimension. Moreover, we observed a relationship between the theory's dimensions (susceptibility, severity, benefits, barriers, cues to action, and self-efficacy) and influenza vaccination in health care workers. In conclusion, this review identified profiles of beliefs for each dimension of the Health Belief Model, which has traditionally been an ally for determining refusal or acceptance of the influenza vaccine among health care workers.

As vacinas previnem inúmeras doenças infecciosas, inclusive a influenza. Mesmo diante da sua significativa contribuição para o controle da enfermidade, as coberturas vacinais contra influenza entre os trabalhadores de saúde são variáveis. Dessa forma, o modelo de crenças em saúde pode auxiliar na compreensão dos motivos que levam esses trabalhadores a aceitarem ou não o imunobiológico. O objetivo deste estudo foi descrever os principais resultados de pesquisas sobre vacinação contra influenza entre trabalhadores de saúde utilizando o modelo de crenças em saúde. Tratou-se de uma revisão integrativa da literatura. A busca de dados ocorreu em outubro de 2020 na base de dados PubMed, com os descritores: "influenza vaccine"; "health professionals"; e "Health Belief Model" e seus sinônimos. Foram incluídos 11 artigos nesta revisão. Identificou-se que as principais dimensões do modelo (suscetibilidade, gravidade, benefícios e barreiras) foram mais exploradas pelos artigos, e a dimensão autoeficácia foi a menos estudada. Além disso, existe uma relação entre as dimensões da teoria (suscetibilidade, gravidade, benefícios, barreiras, estímulos para ação e autoeficácia) e a vacinação contra a influenza em trabalhadores da saúde. Conclui-se que, através da revisão proposta, pôde-se identificar perfis de crenças para cada dimensão do modelo de crenças em saúde que, tradicionalmente, vem servindo como aliado para determinar recusa ou aceitação da vacina contra influenza entre trabalhadores de saúde.

Elevada prevalência de doenças infecciosas entre trabalhadores da saúde indica a necessidade de melhorar a vigilância / The high prevalence of infectious diseases among health workers indicates the need for improving surveillance

Resumo Objetivo: estimar soroprevalências de arboviroses, sífilis, HIV e Hepatite B (VHB) em trabalhadores de saúde (TS). Métodos: inquérito entre TS selecionados por amostragem aleatória, em uma cidade da Bahia - Brasil. Pesquisa realizada em 2019 por meio de questionário estruturado, que coletou informações sociodemográficas, ocupacionais e de saúde. Testes imunocromatográficos rápidos foram utilizados para rastrear as infecções; dessa forma, resultados positivos para arboviroses, sífilis, HIV e VHB indicaram soropositividade para a respectiva infecção. Além disso, detecção simultânea de anticorpos para zika (ZIKV) e dengue (DENV) indicou soropositividade para infecção por flavivírus. Resultados: 453 TS foram incluídos, sendo 82,8% do sexo feminino. A maioria (55,1%) relatou contato com material biológico; 5,2% referiram acidentes com material biológico. Encontrou-se soroprevalência de 34,7% (IC95%:30,1-39,4) para dengue, 1,7% (IC95%:0,7-3,4) para zika, 9,9% (IC95%:7,2-13,2) para chikungunya e 39,9% (95%CI:35,2-44,7) para flavivírus (ZIKV+DENV); 21,9% (IC95%:18,1-26,2) foram negativos para todos os arbovírus. Soropositividade para arbovírus aumentou com a idade e foi maior entre agentes de combate a endemias. Três TS testaram positivo para VHB (HBsAg); nenhum para HIV. Conclusão: elevado percentual de TS estava exposto a agentes infecciosos (contato com material biológico e/ou exposição a arbovírus). Entre as condições necessárias à prevenção de infecções no ambiente de trabalho, destacam-se: monitoramento de infecções entre TS, vigilância dos ambientes laborais e medidas de controle de exposições ocupacionais, como disponibilidade de repelentes.

Abstract Objective: to estimate the seroprevalence of arboviruses, syphilis, HIV, and hepatitis B (HBV) in Healthcare Workers (HCW). Methods: a survey among HCW among was randomly selected in a city in Bahia-Brazil. The research used a structured questionnaire, which collected sociodemographic, occupational, and health information in 2019. Rapid immunochromatographic tests were used to track infections. Thus, positive results for arboviruses, syphilis, HIV, and HBV indicated seropositivity for the respective infection. In addition, simultaneous detection of antibodies for zika (ZIKV) and dengue (DENV) viruses indicated seropositivity for flavivirus infection. Results: a total of 453 HCW were included, 82.8% were women. Most HCW (55.1%) reported contact with biological material; 5.2% reported injuries with biological material. The seroprevalence was 34.7% (95%CI:30.1-39.4) for dengue, 1.7% (95%CI:0.7-3.4) for zika, 9.9% (95%CI:7.2-13.2) for chikungunya, and 39.9% (95%CI:35.2-44.7) for flavivirus (ZIKV+DENV); with 21.9% (95%CI:18.1-26.2) being negative to all arboviruses. Seropositivity to arboviruses increased with age and was higher among endemic disease control agents. Three HCW tested positive for HBV (HBsAg); no HIV cases were detected. Conclusion: a high percentage of HCW was exposed to infectious agents (contact with biological material and/or exposure to arboviruses). Among the necessary conditions for preventing infections in the work environment, the following stand out: monitoring of infectious diseases among HCW, surveillance of work environments, and measures to control occupational exposures, such as the availability of repellents.

Associação entre infecção pelo vírus Chikungunya e sintomas depressivos entre trabalhadores e trabalhadoras da saúde / Association between Chikungunya infection and depressive symptoms among healthcare workers

Resumo Objetivo: analisar a associação entre infecção prévia por Chikungunya e sintomas depressivos em trabalhadores da saúde. Métodos: estudo transversal com amostra probabilística de trabalhadores atuantes na atenção primária e na média complexidade de um município do estado da Bahia, Brasil. Utilizou-se o teste rápido DPP-ZDC-IgM/IgG para identificar infecção recente (IgM) ou prévia (IgG) pelo vírus Chikungunya. O Patient Health Questionnaire-PHQ-9 foi usado para avaliar sintomas depressivos. Regressão de Poisson com variância robusta foi usada para estimar razões de prevalência e intervalos de confiança 95%. Resultados: participaram da pesquisa 392 trabalhadores, sendo 83,2% do sexo feminino. A frequência de infecção pelo vírus Chikungunya foi de 8,9%. A prevalência de sintomas depressivos foi de 22,7%. Na análise ajustada, a infecção por Chikungunya associou-se positivamente aos sintomas depressivos (RP=2,00; IC95%:1,29;3,07). As análises estratificadas apontaram associação de maior magnitude no sexo masculino (RP=7,57;1,15;50,06), em comparação ao feminino (RP=1,68;1,03;2,74). Conclusão: os achados corroboram a hipótese de associação positiva entre Chikungunya e sintomas depressivos. Mecanismos fisiopatológicos decorrentes de ação viral, bem como fatores emocionais, comportamentais e psicossociais associados à doença podem explicar os achados. Reitera-se a importância do cuidado em saúde mental para os trabalhadores da saúde.

Abstract Objective: to analyze the association between previous Chikungunya infection and depressive symptoms among healthcare workers. Methods: a cross-sectional study with a probabilistic sample of healthcare workers in primary and medium-complexity care settings in a municipality in the state of Bahia, Brazil. We used the rapid test DPP-ZDC-IgM/IgG to identify recent (IgM) or previous (IgG) Chikungunya virus infection, and the Patient Health Questionnaire-PHQ-9 to assess depressive symptoms. We applied regression with robust variance to estimate prevalence ratios and 95% confidence intervals. Results: 392 workers participated, 83.2% female. The frequency of Chikungunya virus infection was 8.9%. The prevalence of depressive symptoms was 22.7%. In the adjusted analysis, Chikungunya infection was positively associated with depressive symptoms (PR=2.00; 95%CI: 1.29; 3.07). Stratified analyses indicated a stronger association among males (PR=7.57; 95%CI: 1.15; 50.06) compared with females (PR=1.68; 95%CI: 1.03; 2.74). Discussion: the findings support the hypothesis of a positive association between Chikungunya and depressive symptoms. Physiopathological mechanisms resulting from viral action, as well as emotional, behavioral, and psychosocial factors associated with the disease, may explain the findings. We reiterate the importance of providing mental health care to healthcare workers.