Mechanical Properties of Experimental Composites with Different Photoinitiator.

OBJECTIVE: The effect of different photoinitiators on mechanical properties of experimental composites was evaluated. MATERIALS AND METHODS: Resin composites were formulated by using a blend of bisphenol A-glycidyl and triethylene glycol (50/50 wt%) dimethacrylate monomers, and 65 wt% of barium aluminium silicate and silica filler particles. Photoinitiators used were 0.2% camphorquinone (CQ) and 0.8% co-initiator (DMAEMA); 0.2% phenyl-propanedione and 0.8% DMAEMA; 0.1% CQ + 0.1% phenyl propanedione and 0.8% DMAEMA; 0.42% mono(acyl)phosphine oxide (MAPO); and 0.5% bis(acyl)phosphine oxide (BAPO). Specimens (n = 10) were light cured by using a multiple-emission peak light-emitting diode for 20 seconds at 1,200 mW/cm2 of irradiance and Knoop hardness and plasticization, depth of cure, flexural strength, and elastic modulus were evaluated. Data were statiscally analyzed at significance level of α = 5%. RESULTS: Experimental composites containing MAPO and BAPO photoinitiators showed the highest values of flexural strength, elastic modulus, top surface hardness, and lower hardness reduction caused by alcohol compared with CQ. Composites containing CQ and PPD showed similar results, except for depth of cure and hardness of bottom surface. CONCLUSION: BAPO and MAPO showed higher flexural strength, elastic modulus, hardness on top surface, and lower polymer plasticization to CQ.

BRAZILIAN CONSENSUS ON INCIDENTAL GALLBLADDER CARCINOMA.

BACKGROUND: Incidental gallbladder cancer is defined as a cancer discovered by histological examination after cholecystectomy. It is a potentially curable disease. However, some questions related to their management remain controversial and a defined strategy is associated with better prognosis. AIM: To develop the first evidence-based consensus for management of patients with incidental gallbladder cancer in Brazil. METHODS: Sixteen questions were selected, and 36 Brazilian and International members were included to the answer them. The statements were based on current evident literature. The final report was sent to the members of the panel for agreement assessment. RESULTS: Intraoperative evaluation of the specimen, use of retrieval bags and routine histopathology is recommended. Complete preoperative evaluation is necessary and the reoperation should be performed once final staging is available. Evaluation of the cystic duct margin and routine 16b1 lymph node biopsy is recommended. Chemotherapy should be considered and chemoradiation therapy if microscopically positive surgical margins. Port site should be resected exceptionally. Staging laparoscopy before reoperation is recommended, but minimally invasive radical approach only in specialized minimally invasive hepatopancreatobiliary centers. The extent of liver resection is acceptable if R0 resection is achieved. Standard lymph node dissection is required for T2 tumors and above, but common bile duct resection is not recommended routinely. CONCLUSIONS: It was possible to prepare safe recommendations as guidance for incidental gallbladder carcinoma, addressing the most frequent topics of everyday work of digestive and general surgeons.

Brazilian consensus on incidental gallbladder carcinoma / Consenso brasileiro de carcinoma incidental de vesícula biliar

ABSTRACT Background: Incidental gallbladder cancer is defined as a cancer discovered by histological examination after cholecystectomy. It is a potentially curable disease. However, some questions related to their management remain controversial and a defined strategy is associated with better prognosis. Aim: To develop the first evidence-based consensus for management of patients with incidental gallbladder cancer in Brazil. Methods: Sixteen questions were selected, and 36 Brazilian and International members were included to the answer them. The statements were based on current evident literature. The final report was sent to the members of the panel for agreement assessment. Results: Intraoperative evaluation of the specimen, use of retrieval bags and routine histopathology is recommended. Complete preoperative evaluation is necessary and the reoperation should be performed once final staging is available. Evaluation of the cystic duct margin and routine 16b1 lymph node biopsy is recommended. Chemotherapy should be considered and chemoradiation therapy if microscopically positive surgical margins. Port site should be resected exceptionally. Staging laparoscopy before reoperation is recommended, but minimally invasive radical approach only in specialized minimally invasive hepatopancreatobiliary centers. The extent of liver resection is acceptable if R0 resection is achieved. Standard lymph node dissection is required for T2 tumors and above, but common bile duct resection is not recommended routinely. Conclusions: It was possible to prepare safe recommendations as guidance for incidental gallbladder carcinoma, addressing the most frequent topics of everyday work of digestive and general surgeons.

RESUMO Racional: Carcinoma incidental da vesícula biliar é definido como uma neoplasia descoberta por exame histológico após colecistectomia videolaparoscópica. É potencialmente uma doença curável. Entretanto algumas questões relacionadas ao seu manuseio permanecem controversas e uma estratégia definida está associada com melhor prognóstico. Objetivo: Desenvolver o primeiro consenso baseado em evidências para o manuseio de pacientes com carcinoma incidental da vesícula biliar no Brasil. Métodos: Dezesseis questões foram selecionadas e para responder as questões e 36 membros das sociedades brasileiras e internacionais foram incluídos. As recomendações foram baseadas em evidências da literatura atual. Um relatório final foi enviado para os membros do painel para avaliação de concordância. Resultados: Avaliação intraoperatória da peça cirúrgica, uso de bolsas para retirar a peça cirúrgica e exame histopatológico de rotina, foram recomendados. Avaliação pré-operatória completa é necessária e deve ser realizada assim que o estadiamento final esteja disponível. Avaliação da margem do ducto cístico e biópsia de rotina do linfonodo 16b1 são recomendadas. Quimioterapia deve ser considerada e quimioradioterapia indicada se a margem cirúrgica microscópica seja positiva. Os portais devem ser ressecados excepcionalmente. O estadiamento laparoscópico antes da operação é recomendado, mas o tratamento radical por abordagem minimamente invasiva deve ser realizado apenas em centros especializados em cirurgia hepatopancreatobiliar minimamente invasiva. A extensão da ressecção hepática é aceitável até que seja alcançada a ressecção R0. A linfadenectomia padrão é indicada para tumores iguais ou superiores a T2, mas a ressecção da via biliar não é recomendada de rotina. Conclusões: Recomendações seguras foram preparadas para carcinoma incidental da vesícula biliar, destacando os mais frequentes tópicos do trabalho diário do cirurgião do aparelho digestivo e hepatopancreatobiliar.

Effect of beverages with different alcoholic concentration on composite resins / Efeito de bebidas com diferentes concentrações alcoólicas em resinas compostas

Objective: To evaluate if alcoholic beverages can cause color change in composite resins, if the alcoholic concentration influences this variation besides analyzing within the composite resins tested, which would present greater color stability when subjected to the experiment. Material and Methods: 90 specimens of three different composite resins (IPS Empress Direct, Grandio®So and Filtek Z350 XT) were immersed in distilled water (control group), red wine and vodka. The samples were 2 mm thick and 8 mm in diameter, photopolymerized for 20 s on each side, polished with sandpaper, silicon carbide tip and felt disc with prophylactic paste and immersed in distilled water at 37 °C for 24 h prior to subgrouping. For the evaluation of the color variation, the formula prioritized by the CIEL *a *b* system was used. Data were analyzed by ANOVA and Tukey's test at 95% significance. Results: The lowest variations occurred with the Grandio®So resin when exposed to wine, and Filtek Z350 XT when exposed to vodka. There was a statistically significant difference between the groups in water (p < 0.01) and in red wine (p < 0.01), but not in vodka (p > 0.05). The soaking medium that most caused staining was red wine. Conclusion: Red wine was the drink that generated the highest staining in all the resins tested, vodka did not change color stability significantly, the alcoholic concentrations tested did not directly influence the color change and the composite resin Grandio®So presented greater color stability when exposed to red wine. (AU)

Objetivo: Avaliar se bebidas alcóolicas podem provocar alteração de cor em resinas compostas, se a concentração alcóolica tem influência nesta variação além de analisar dentre as resinas compostas testadas, qual apresentaria maior estabilidade de cor quando submetidas ao experimento. Material e métodos: Foram confeccionados 90 espécimes de 3 diferentes resinas compostas (IPS Empress Direct, Grandio®So e Filtek Z350 XT) e imersos em água destilada (grupo controle), vinho tinto e vodca. As amostras mediam 2 mm de espessura e 8 mm de diâmetro, foram fotopolimerizados por 20 s cada lado, polidos com disco de lixa, ponta de carbeto de silício e disco de feltro com pasta profilática e imersos em água destilada a 37 ºC por 24 h antes da divisão em subgrupos. Para a avaliação da variação de cor foi utilizada a fórmula priorizada pelo sistema CIEL*a*b*. Os dados foram analisados por ANOVA e teste de Tukey a 95% de significância. Resultados: As menores variações ocorreram com a resina Grandio®So quando exposta ao vinho, e a Filtek Z350 XT quando exposta à vodca. Houve diferença estatisticamente significante entre os grupos na água (p < 0.01) e no vinho tinto (p < 0.01), mas não na vodca (p > 0,05). O meio de imersão que mais causou manchamento foi o vinho tinto. Conclusão: O vinho tinto foi a bebida que gerou o maior manchamento em todas as resinas testadas, a vodca não alterou a estabilidade de cor de maneira significativa, as concentrações alcóolicas testadas não influenciaram diretamente na alteração de cor e a resina composta Grandio®So apresentou maior estabilidade de cor frente ao vinho tinto. (AU)

IRCAD recommendation on safe laparoscopic cholecystectomy.

An expert recommendation conference was conducted to identify factors associated with adverse events during laparoscopic cholecystectomy (LC) with the goal of deriving expert recommendations for the reduction of biliary and vascular injury. Nineteen hepato-pancreato-biliary (HPB) surgeons from high-volume surgery centers in six countries comprised the Research Institute Against Cancer of the Digestive System (IRCAD) Recommendations Group. Systematic search of PubMed, Cochrane, and Embase was conducted. Using nominal group technique, structured group meetings were held to identify key items for safer LC. Consensus was achieved when 80% of respondents ranked an item as 1 or 2 (Likert scale 1-4). Seventy-one IRCAD HPB course participants assessed the expert recommendations which were compared to responses of 37 general surgery course participants. The IRCAD recommendations were structured in seven statements. The key topics included exposure of the operative field, appropriate use of energy device and establishment of the critical view of safety (CVS), systematic preoperative imaging, cholangiogram and alternative techniques, role of partial and dome-down (fundus-first) cholecystectomy. Highest consensus was achieved on the importance of the CVS as well as dome-down technique and partial cholecystectomy as alternative techniques. The put forward IRCAD recommendations may help to promote safe surgical practice of LC and initiate specific training to avoid adverse events.

Mini-arc for the treatment of female stress urinary incontinence: long-term prospective evaluation by patient reported outcomes.

Single-incision slings were introduced in the surgical treatment of female stress urinary incontinence (SUI) to lessen the morbidity associated with traditional midurethral slings. However, long-term reports on patient satisfaction are still scarce. This study describes the outcome of women treated with Mini-Arc at a mean follow-up of 45 months. In a previous report on 105 women with 15-month mean follow-up, 84 (80%) were found cured and 12 (11%) improved. Now, with a mean follow-up of 45 months, cured/improved patients were reassessed by telephone and completed Patient Global Impression of Improvement (PGI-I), Patient Global Impression of Severity (PGI-S), rated their improvement in a 0-100 scale, and answered if they would recommend the procedure. At 45-month follow-up, 73 women cured/improved were available for evaluation. Over 80% of the cured patients rated the improvement of SUI by the PGI-I as "very much better" or "much better," reported their urinary tract condition to be "normal" on PGI-S, and described their improvement >70%. Ninety percent would recommend this procedure to a friend. The improved-patient population is very small (n = 7). This study shows that the majority of patients cured/improved after Mini-Arc placement maintain a high degree of satisfaction at a long-term evaluation.

Effect of "the Awakening Protocol" in the outcome of liver transplantation.

PURPOSE: To analyze mortality (7 days) or graft loss in liver transplantation (Tx) performed within the Awakening Protocol (AP) compared to sequential Tx. METHODS: Analysis of 243 liver tx (230 patients), divided into sequential tx or PD (early morning) to compare graft loss or death (7 days). Significant differences at p < 0.05 RESULTS: The PD was adopted in 32.5% of tx. The cold ischemia time (p < 0.01) and the interval until transplantation (p < 0.01) were significantly different. Age of the donor and recipient, Donor Risk Index, MELD score, and donor base excess, sodium, creatinine and glucose were not different between groups. Previous abdominal surgery was a risk factor for early mortality, but was equally distributed between the groups. There was no difference in mortality or graft loss within 7 days (p = 0.521) CONCLUSION: The adoption of PD, to start tx the morning when harvesting occurs after 10p.m. did not result in worse patient and graft survival. Transplant patients with fulminant hepatic failure and high-risk grafts do not apply to this surgical tactics.

Effect of "the Awakening Protocol" in the outcome of liver transplantation / Efeito do "Protocolo Despertar" no resultado do transplante de fígado

PURPOSE: To analyze mortality (7 days) or graft loss in liver transplantation (Tx) performed within the Awakening Protocol (AP) compared to sequential Tx. METHODS: Analysis of 243 liver tx (230 patients), divided into sequential tx or PD (early morning) to compare graft loss or death (7 days). Significant differences at p <0.05 RESULTS: The PD was adopted in 32.5% of tx. The cold ischemia time (p <0.01) and the interval until transplantation (p <0.01) were significantly different. Age of the donor and recipient, Donor Risk Index, MELD score, and donor base excess, sodium, creatinine and glucose were not different between groups. Previous abdominal surgery was a risk factor for early mortality, but was equally distributed between the groups. There was no difference in mortality or graft loss within 7 days (p = 0.521) CONCLUSION: The adoption of PD, to start tx the morning when harvesting occurs after 10p.m. did not result in worse patient and graft survival. Transplant patients with fulminant hepatic failure and high-risk grafts do not apply to this surgical tactics.

OBJETIVO: Analisar a mortalidade (7 dias) ou perda do enxerto em tx de fígado realizado dentro do Protocolo Despertar (PD), em comparação ao tx realizado de maneira sequencial. MÉTODOS: Análise retrospectiva de 243 tx de fígado (230 pacientes), divididos em tx sequencial ou PD (inicio pela manhã). Foram comparados mortalidade ou perda do enxerto (7 dias). Diferenças significantes para p<0,05. RESULTADOS: O PD foi adotado em 32,5% dos tx. O TIF (p<0,01) e o intervalo até o início do transplante (p<0,01) foram significativamente diferentes. Idade do doador e do receptor, Donor Risk Index, escore MELD, Base excess do doador, sódio, creatinina e glicemia do doador não foram diferentes entre os grupos. Antecedentes cirúrgicos abdominais foram fatores de risco para mortalidade precoce, mas estavam distribuídos igualmente entre os grupos. Não houve diferença na mortalidade ou na perda do enxerto em até 7 dias (p=0,521) CONCLUSÃO: A adoção do PD, para inicio do tx pela manhã, quando a captação ocorre após 22:00 h não acarretou piora na sobrevida dos pacientes. Transplante de pacientes com hepatite fulminante e enxertos de alto risco não se aplicam a esta tática cirúrgica.

Factors associated with the use of herbal medicines for oral problems by patients attending the clinics of the School of Dentistry, Federal University of Juiz de Fora, Brazil

Aim: To evaluate differences in sociodemographic characteristics (gender, age, educational leveland income) between users and nonusers of phytotherapy for dental purposes; the degree of population’s knowledge of herbal medicines for dental needs; and whether patients inform the health professional about their use of phytotherapy. Methods: A questionnaire was applied to 100 patients in waiting rooms of the School of Dentistry of the Federal University of Juiz de Fora,in 2008, to inquire about sociodemographic variables and other factors associated with the use of phytotherapy. Statistical analyses were carried out using the chi square statistical test to calculate association between the variables, with 0.05 as level of significance. Results: It was observed that 64.8% of participants were women with a mean age of 43.9±15.1 years. Phytotheraphy use for treatment of oral problems was reported by 37% of patients interviewed in this study. Significant differences were found between users and non-users of herbal medicines for oral problems, associated with the patient’s age (p<0.05) and previous experience with use of phytotherapy to treat general health problems (p<0.001). Conclusions: The results emphasize the need for more scientific evidence of the efficacy of herbal medicinal products already incorporated in the popular knowledge to treat oral problems in order to make it an accessible and alternative method for prevention and therapy in dentistry.

Single-incision sling system as primary treatment of female stress urinary incontinence: prospective 12 months data from a single institution.

OBJECTIVE: To investigate the success and complication rates for Mini-Arc(TM) single incision sling in the treatment of female stress urinary incontinence (SUI). MATERIALS AND METHODS: A total of 119 female patients with pure SUI were enrolled in a prospective study. From these, 105 were available with a minimum follow-up of 6 months and a mean follow-up of 12 months. Success, as determined by patient- reported outcomes, and complication rates, as well as impact of learning curve, body mass index (BMI), intrinsic sphincter deficiency (ISD), incontinence severity and age were investigated. RESULTS: Cure rate was 80% and improvement rate was 11%. Pain intensity was minimal on a visual analogue scale and transient urinary retention occurred in three patients, one requiring sling section. De novo urgency was reported by 6% of women. Severe incontinence was less likely to be cured: 70% if >5 pads per day (ppd); 94% if <2 ppd; 94% if 2-4 ppd, P < 0.05). There was no difference in success rates between the first 50 and the last 50 patients. BMI, ISD and age also did not influence success rate. CONCLUSION: Mini-Arc™ attained high success rates at 1 year follow-up. The procedure was easy to learn and was associated with very low and mild morbidity. Severe incontinence was identified as a risk factor for failure.

Exploratory study assessing efficacy and complications of TVT-O, TVT-Secur, and Mini-Arc: results at 12-month follow-up.

BACKGROUND: Contemporary surgical treatment of female stress urinary incontinence (SUI) includes retropubic and transobturator (TO) midurethral slings (MUS). Case series of single-incision slings (SIS) have shown similar outcomes with lower morbidity. OBJECTIVE: Our aim was to assess the cure rates, complications, and quality-of-life impact of one standard TO MUS and two SIS. DESIGN, SETTING, AND PARTICIPANTS: Ninety consecutive patients with clinically and urodynamically proven SUI were enrolled in an exploratory randomised phase 2 trial. Patients with previous SUI surgery, major pelvic organ prolapse, mixed incontinence, or detrusor overactivity were excluded. INTERVENTIONS: Patients were treated randomly with TVT-O, TVT-Secur, or Mini-Arc. MEASUREMENTS: Postoperative visits were scheduled at 6 and 12 mo. The King's Health Questionnaire (KHQ) was repeated at 6 mo. Cure was defined as the absence of urine leakage, no pad use, and a negative cough test at 12 mo. Pain and other complications were also investigated. RESULTS AND LIMITATIONS: Cure rate was 83% after TVT-O, 67% after TVT-Secur, and 87% after Mini-Arc. Improvement was found in 10%, 13%, and 7% of the patients, respectively. Failures were 7% after TVT-O and Mini-Arc and 20% after TVT-Secur. TVT-O and Mini-Arc improved at least 15 points in >80% of the patients in six KHQ domains, whereas TVT-Secur could only achieve improvement in three of the nine domains. The pain score was lower in the Mini-Arc group. Complications were more numerous after TVT-O. This study has the limitations inherent in a phase 2 trial with a follow-up limited to 12 mo. CONCLUSIONS: Mini-Arc offers cure and improvement rates similar to TVT-O, whereas TVT-Secur may yield an inferior outcome. These findings recommend the urgent launch of large randomised phase 3 studies comparing conventional MUS with SIS, with Mini-Arc the advised option.

Avaliação da capacidade de selamento marginal do esmalte e da dentina utilizando diferentes tratamentos superficiais / Evaluation of the marginal sealing capacity of the enamel and the dentine using different superficial treatments

Para analisar a capacidade de selamento marginal de três sistemas adesivos com diferentes formas de tratamentos superficiais, foram selecionados 45 incisivos bovinos, íntegros e recém-extraídos. Cada dente recebeu um preparo cavitário Classe V no limite cemento-esmalte. Os preparos foram padronizados nas seguintes dimensões: 1,5mm de profundidade e 2,0mm de diâmetro. A margem incisal foi deixada em esmalte e a margem gengival localizada abaixo da junção cemento-esmalte. Os dentes foram divididos em três grupos com 15 dentes cada. No grupo I foi utilizado o Adesivo XP Bond com dentina deixada úmida após condicionamento ácido. O grupo II também teve aplicação do Adesivo XP Bond, sendo que a dentina foi seca após condicionamento ácido. No grupo III o sistema utilizado foi o Adper Single-Bond 2. Todos os dentes foram restaurados com resina composta nanoparticulada Filtek - Z350 (3M). Em seguida foi realizada a ciclagem térmica em 300 ciclos, e os dentes foram imersos em solução aquosa de azul de metileno 2% por um período de 3 horas. Para avaliação do grau de penetração do corante, foram determinados escores de 0 a 3. A análise da penetração do corante foi realizada e o teste Kruskal-Wallis ao nível de significância de 5% foi aplicado. Em esmalte e em dentina houve diferença entre os grupos, porém a infiltração foi maior na dentina do que no esmalte.

Avaliação da capacidade de selamento marginal do esmalte e da dentina utilizando diferentes sistemas adesivos e tratamentos superficiais / Evaluation of the marginal sealing capacity of the enamel and the dentin using different adhesive systems and superficial treatments

Para analisar a capacidade de selamento marginal de três sistemas adesivos com formas diferentes de tratamentos superficiais foram selecionados 45 incisivos bovinos, íntegros e recém extraídos. Cada dente recebeu um preparo cavitáriode Classe V no limite cemento-esmalte. Os preparos foram padronizados nas seguintes dimensões: 1,5mm de profundidade e 2,0mm de diâmetro. A margem incisal foi deixada em esmalte e a margem gengival localizada abaixo da junção cemento-esmalte. Os dentes foram divididos em três grupos com 15 dentes cada. No grupo I foi utilizado oAdesivo XP Bond com dentina deixada úmida após condicionamento ácido. No grupo II o sistema utilizado foi o AdperSE Plus e no grupo lll foi aplicado o sistema adesivo Adper Single-Bond 2. Em seguida, os dentes foram restaurados com resina composta nanoparticulada Filtek – Z350 (3M). Após ciclagem térmica (300 ciclos), os dentes foram imersos em solução aquosa de Azul de Metileno 2% por um período de 3 horas. Para avaliação do grau de penetração do corante foram determinados escores de 0 a 3. A análise da penetração do corante foi realizada através de microscopia óptica e aplicado o teste Kruskal-Wallis ao nível de significância de 5%. Em esmalte e dentina houve diferença entre os grupos, porém a infiltração foi maior na dentina que em esmalte, com exceção do sistema auto condicionante.

To evaluate the marginal sealing capacity of three adhesive systems with different forms of superficial treatments, 45 complete and just extracted bovine teeth were selected. Class V cavities (1,5mm of depth and 2,0mm of diameter) were prepared in all teeth in the cement-enamel junction. The incisal edge was left in enamel and the gingival edge located below of the cement-enamel junction. The teeth were divided into three groups with 15 teeth each. In group I, after the acid etching, Adhesive XP Bond was used with humid dentin. In the group II, the Adper SE Plus system was used, and in group III the adhesive system Adper Single-Bond 2 was applied. After that, the teeth had been filled with composite resin Filtek – Z 350(3M). After the termocicled (300 cycles varying from 5 to 55°C), the teeth were immersed in 2% methylene blue solution for 3 hours. The degree of penetration of methylene blue they was evaluated by scores. The analysis of the penetration was carried through optic microscopy and Kruskal-Wallis test was apllied (á= 5%). There was difference among groups regarding sealing capacity. Infiltration was greater in dentine than enamel, with exceptionof the self-etch adhesive system.

Avaliação da infiltração marginal em restaurações com resina composta, variando-se a configuração cavitária e métodos para acabamento marginal do esmalte: instrumentos manual, rotatório e laseres de Er:YAG e Nd:YAG / Evaluation of the marginal leakage in composite resin restorations, varying the cavity form and methods for enamel marginal finishing: manual and rotatory instruments, Er:YAG and Nd:YAG lasers

A infiltração marginal é um dos grandes desafios da Odontologia Restauradora, principalmente em restaurações deresina composta. A proposta desse estudo foi avaliar a capacidade de selamento marginal de restaurações de resina composta, com duas formas de cavidade e diferentes métodos para acabamento da margem em esmalte: instrumentos manuais, rotatórios e laseres de Er:YAG e Nd:YAG. Para isso foram utilizados 100 incisivos bovinos, recém-extraídos, e preparadas 200 cavidades nas faces proximais, com margem cervical em esmalte. Em seguida os dentes foram divididosem 10 grupos, onde se variou a forma da cavidade (caixa e arredondada) e os métodos de acabamento (instrumentosmanual, rotatório e laseres de Er:YAG e Nd:YAG). Após o preparo cavitário e o acabamento marginal, as cavidades foram restauradas com resina composta pela técnica incremental. Os espécimes foram impermeabilizados com esmalte para unhas, excetuando-se 1,0mm ao redor das restaurações, termociclados em 500 ciclos, variando de 5 a 55oC e imersos em solução de nitrato de prata a 50% por 24 horas. Os dentes foram seccionados e os cortes analisados em microscopia ótica, fotografados e a microinfiltração mensurada. Para análise dos resultados foram utilizados os testes ANOVA One-Way eKruskal-Wallis. Os resultados mostraram que o melhor acabamento marginal realizado foi com o laser de Er:YAG, tanto nas cavidades arredondadas como naquelas em forma de caixa; o laser de Nd:YAG apresentou a maior microinfiltração nas cavidades em forma de caixa. Quando comparado os dois tipos de cavidade, as arredondadas apresentaram menorinfiltração marginal para todas as formas de acabamento.

Marginal leakage is one of the great challenges of restorative dentistry, mainly in composite resin restorations. The purpose of this study was to evaluated the sealing capacity of composite resin fillings, with two cavities forms and differentmethods for finishing of the enamel edge: manual and rotatory instruments, Er:YAG and Nd:YAG lasers. For this 100bovine, just-extracted teeth were used, where 200 class II cavity were prepared, with the cervical edge in enamel. After that the teeth were divided in 10 groups, where if it varied the cavity form and methods of finishing. After cavity prepare and the marginal finishing, the cavities were filled with composite resin for the incremental technique. The specimens were painted with nail polish, excepting themselves 1,0mm around of the restorations, termocicled in 500 cycles varyingof 5-55oC and immersed in 50% silver nitrate solution for 24 hours. The teeth were sectioned and the cuts analyzedin optical microcopy, photographed and the microleakage was measured. The ANOVA One-Way and Kruskal-Wallisstatistical tests were used. The results showed that the best marginal finishing was with the laser of Er:YAG, as muchin the rounded cavity off as in the ones in box form. The Nd:YAG laser presented biggest microleakage in box form cavities. When compared the two types of cavities, the rounded presented the smallest leakage who the box form, for all the finishing forms.

Avaliação da infiltração marginal em dentes humanos e bovinos com dois diferentes sistemas adesivos / Evaluation of the marginal leakage in human and bovine teeth with two different adhesive systems

O selamento marginal constituiu-se em um dos principais obstáculos para as restaurações adesivas, principalmente quando novos tratamentos são propostos para esmalte e/ou dentina. Este estudo tem por finalidade analisar a capacidade de selamento marginal de dois sistemas adesivos atuais, um com primer autocondicionante (Clearfil Liner Bond 2V) e o outro com condicionamento ácido total (Excite), e comparar a performance dos mesmos em dentes humanos e bovinos, frente ao teste de microinfiltração. Para isto, foram utilizados vinte terceiros molares humanos e vinte incisivos bovinos. Foram preparadas cavidades de classe V em todos os dentes que após a aplicação dos sistemas adesivos foram restauradas com resina composta. Os espécimes foram impermeabilizados com esmalte para unhas, com exceção de 1,0mm ao redor das restaurações, termociclados (300 ciclos variando de 5°a 55°C) e imersos em solução de nitrato de prata a 50 por cento por 24 horas. Após análise da microinfiltração em lupa estereoscópica e teste estatístico de Kruskall-Wallis ao nível de significância de 5 por cento, constatou-se que o sistema adesivo Excite apresentou a maior infiltração em esmalte de dentes bovinos, Clearfil foi o que melhor selou a mergem gengival em dentes humanos e bovinos; dentes humanos e bovinos se comportaram de maneira semelhante frente ao Excite, porém em relação ao Clearfil houve diferença estatisticamente significante

Drenagem profilática em operaçöes do cólon e reto: estudo prospectivo e comparativo / Prophylactic drainage after colonic and rectal surgery: a prospective and comparative study

No período de novembro de 1984 e agosto de 1986 estudamos prospectivamente 60 ressecçoes de cólon e reto realizadas em nosso serviço. Estes pacientes foram divididos aleatoriamente em dois grupos. O grupo I, composto por 30 pacientes, recebeu drenos profiláticos e o grupo II, também composto por 30 pacientes, que nao foi drenado. As operaçoes realizadas foram 32 retossigmoidectomias, 11 sigmoidectomias, hemicolectomia direita em 8 casos e esquerda em 7, uma colectomia total e uma colectomia segmentar esquerda. Complicaçoes pós-operatórias foram observadas em 6 casos no grupo I (20 por cento) e 5 no grupo II (l6,7 por cento). A mortalidade operatória foi nula. A permanência hospitalar pós-operatória mostrou-se semelhante nos dois grupos. Nestes resultados nao havia diferença estatística. Baseados nos resultados, achamos aceitável a nao utilizaçao rotineira de drenos profiláticos em anastomoses de cólon e reto. Julgamos necessário ainda a realizaçao de novos estudos com casuísticas mais extensas, que ratifiquem os resultados por nós observados.