Effects of a potentially erosive antiasthmatic medicine on the enamel and dentin of primary teeth: An in situ study.

This study evaluates, in situ, the effect of an anti-asthmatic medicine on the enamel and dentin of primary teeth. Twenty-eight specimens of enamel and dentin were prepared, selected, sterilized, and stored. Microhardness, microscopic morphology, and initial surface roughness were evaluated. Fourteen volunteers wore palatal devices containing two dentin specimens and two enamel specimens. Volunteers underwent surface treatment three times a day for 5 days, with the dripping of 5 ml of salbutamol sulfate for 1 min, only on specimens from one side of the device. At the end of the experiment the microscopic morphology, roughness, surface loss, and microhardness were ascertained. For enamel surfaces exposed to the medicine, erosion was observed in the microscopy images, along with a significant increase in roughness (p = .0325) and tissue loss (p = .03251) and a significant decrease in microhardness (p = .0325). For the dentin surfaces, erosion was observed in the microscopy images, but there was no significant increase in roughness (p = .593) or tissue loss (p = .285) nor any decrease in microhardness (p = .1088). In conclusion, the salbutamol sulfate had an in situ erosive effect on primary teeth enamel and this effect was observed morphologically on primary dentin. RESEARCH HIGHLIGHTS: Asthma is considered a global health problem, and its prevalence has increased in many countries, especially among children, as well as dental erosion. This study has clinical relevance because provides data on the erosive effect of a commonly prescribed anti asthmatic drug on deciduous teeth.

Clinical evaluation of composite restorations in Er:YAG laser-prepared cavities re-wetting with chlorhexidine.

OBJECTIVES: The objective of this study was to evaluate longitudinally the composite restorations, performed in cavities prepared by Er:YAG or conventional bur, and dentin re-wetting with water or chlorhexidine. MATERIALS AND METHODS: Twenty individuals with four active caries with cavitation reaching the dentin located on the occlusal surface of molars counterparts are selected. The teeth of each individual were randomly assigned into four groups: (I) Er:YAG laser (260 mJ/4 Hz) re-wetting with chlorhexidine, (II) Er:YAG laser (260 mJ/4 Hz) re-wetting with deionized water, (III) conventional method re-wetting with chlorhexidine, and (IV) conventional method re-wetting with deionized water. The teeth were isolated, prepared cavities, phosphoric acid etching, and re-wetting according to previously assigned method. Restoration was performed employing the Single Bond 2 and Z350XT resin. Clinical follow-up was held after the polishing of the restoration (baseline) and 6 and 12 months of the making of the restoration using the modified USPHS criteria. The restorations were qualitatively analyzed by means of photographs. In the evaluation period, replicas of the restorations were analyzed by SEM. Data were analyzed by statistics using chi-square test (p < 0.05). RESULTS: After 12 months of clinical evaluation, groups prepared with laser and re-wetting with chlorhexidine and water showed the lowest marginal staining value. There was no statistical difference between the groups for other factors. SEM analysis revealed that a non-expressive amount of restorations showed gaps and irregularities of tooth-restoration interface after 6 and 12 months compared to the baseline. CONCLUSION: The restorations performed in laser-prepared cavities, regardless of the re-wetting, presented the best clinical performance over the evaluated period. CLINICAL RELEVANCE: Laser-prepared teeth, regardless of re-wetting, showed greater resistance to marginal discoloration.

Effect of Metalloproteinase Inhibitors on the Microtensile Bond Strength of Composite Resin to Er:YAG Laser-Irradiated Dentin.

This study evaluated the effect of matrix metalloproteinase (MMP) inhibitors - 2% (CHX) and sodium fluoride (NaF) (5000 ppm) - on microtensile bond strength (µTBS) of composite resin to Er:YAG laser-irradiated dentin after chemical degradation of the bond interface. The occlusal surface of forty sound human molars was removed exposing the dentin surface (n=10), which was polished, irradiated with Er:YAG laser, acid etched and dried. Twenty specimens were rewetted with 2% CHX (control group) and 20 were rewetted with NaF (5000 ppm). The adhesive system was applied and a 4-mm-high plateau of light-cured composite resin was built up. Resin-dentin sticks were obtained with a rectangular cross-sectional area (0.8-1 mm2) and were either stored in water at 37 ?#61616;C for 24 h or submitted to chemical degradation. For chemical degradation, they were immersed in 10% NaOCl aqueous solution for 5 h and rinsed in water for 1 h. The sticks were submitted to microtensile test in a mechanical testing machine at 0.5 mm/min until failure. Fracture pattern was analyzed using SEM. µTBS values were calculated in MPa and submitted to analysis of variance ANOVA (α=0.05). The variance analysis showed that the 'MMP inhibitor' and 'degradation' factors (p=0.214 and p=0.093, respectively) and interaction between the factors were not statistically significant (p=0.143). Mixed failure predominated in all groups. In conclusion, the 2% CHX and NaF 5000 ppm presented similar µTBS of composite resin to laser-irradiated dentin before and after chemical degradation.

Effect of Metalloproteinase Inhibitors on the Microtensile Bond Strength of Composite Resin to Er: YAG Laser-Irradiated Dentin

Abstract This study evaluated the effect of matrix metalloproteinase (MMP) inhibitors - 2% (CHX) and sodium fluoride (NaF) (5000 ppm) - on microtensile bond strength (μTBS) of composite resin to Er:YAG laser-irradiated dentin after chemical degradation of the bond interface. The occlusal surface of forty sound human molars was removed exposing the dentin surface (n=10), which was polished, irradiated with Er:YAG laser, acid etched and dried. Twenty specimens were rewetted with 2% CHX (control group) and 20 were rewetted with NaF (5000 ppm). The adhesive system was applied and a 4-mm-high plateau of light-cured composite resin was built up. Resin-dentin sticks were obtained with a rectangular cross-sectional area (0.8-1 mm2) and were either stored in water at 37 ?#61616;C for 24 h or submitted to chemical degradation. For chemical degradation, they were immersed in 10% NaOCl aqueous solution for 5 h and rinsed in water for 1 h. The sticks were submitted to microtensile test in a mechanical testing machine at 0.5 mm/min until failure. Fracture pattern was analyzed using SEM. μTBS values were calculated in MPa and submitted to analysis of variance ANOVA (α=0.05). The variance analysis showed that the 'MMP inhibitor' and 'degradation' factors (p=0.214 and p=0.093, respectively) and interaction between the factors were not statistically significant (p=0.143). Mixed failure predominated in all groups. In conclusion, the 2% CHX and NaF 5000 ppm presented similar μTBS of composite resin to laser-irradiated dentin before and after chemical degradation.

Resumo Este estudo avaliou o efeito dos inibidores de metaloproteinase, clorexidina 2% e fluoreto de sódio (5000 ppm), na resistência de união entre a dentina irradiada por laser Er:YAG e a resina composta após a degradação química da interface de união. A superfície oclusal de quarenta molares humanos hígidos (n=10) foi removida expondo uma superfície de dentina, que foi polida, irradiada com laser Er:YAG, condicionada com ácido e seca. Vinte espécimes foram re-umedecidos com clorexidina 2% (Grupo controle) e 20 com fluoreto de sódio (5000 ppm). O sistema adesivo foi aplicado e um platô de resina composta fotopolimerizável de 4 mm de altura foi construído. Palitos de resina-dentina foram obtidos com secção transversal retangular (0,8-1 mm2). Eles foram armazenados em água (24 h a 37 ?#61616;C) ou submetidos a degradação química. Para a degradação química, foram imersos em solução aquosa de hipoclorito de sódio a 10% durante 5 horas e lavados em água durante 1 h. Os palitos foram submetidos ao teste de microtração em uma máquina de ensaios mecânicos a 0,5 mm/min até a fratura. O padrão de fratura foi analisado em MEV. Os valores de resistência de união foram calculados em MPa e submetidos à análise de variância ANOVA (α=0,05). A análise de variância mostrou que os fatores inibidor de metaloproteinases e degradação (p=0,214 e p=0,093, respectivamente), e a interação entre os fatores não foram estatisticamente significantes (p=0,143). A predominância de falha mista foi detectada para todos os grupos. Em conclusão, a clorexidina a 2% e fluoreto de sódio (ppm 5000) apresentaram resistência de união entre dentina irradiada e resina composta semelhante antes e após a degradação química.

Palhaços: uma revisão acerca do uso dessa máscara no ambiente hospitalar / Payasos: una revisión sobre el uso de esa máscara en el ambiente hospitalario / Clowns: a review about using this mask in the hospital environment

Grupos de artistas profissionais ou voluntários têm-se formado com o intuito de visitar, como palhaços, pacientes em hospitais ao redor do mundo, fazendo uso do humor como ferramenta a favor do cuidado e do processo de recuperação. Há poucos estudos relacionados ao tema na literatura científica. Assim, a construção de um campo teórico capaz de subsidiar essas atuações ainda é incipiente. Realizamos, portanto, uma revisão bibliográfica, a partir de 33 artigos, sobre a atuação de diferentes grupos de palhaços em vários hospitais do mundo, a fim de compreender melhor como se dão estas visitas e de que modo podem efetivamente trazer resultados positivos. Foi observado que estes encontros podem estabelecer relações profundas capazes de ressignificar o ambiente hospitalar, empoderar os pacientes e servir como modelo de relação para toda a equipe de saúde envolvida...

Se han formado grupos de artistas profesionales o voluntarios con el objetivo de visitar, como payasos, pacientes en hospitales del mundo entero, utilizando el humor como herramienta en favor del cuidado y del proceso de recuperación. Hay pocos estudios relacionados a ese tema en la literatura científica. Por lo tanto, la construcción de un campo teórico capaz de subsidiar esas actuaciones todavía es incipiente. Siendo así, realizamos una revisión bibliográfica a partir de 33 artículos sobre la actuación de diferentes grupos de payasos en diversos hospitales del mundo, para entender mejor cómo se realizan esas visitas y de qué modo pueden efectivamente brindar resultados positivos. Se observó que esos encuentros pueden establecer relaciones profundas capaces de dar un nuevo significado al ambiente hospitalario, de dar poder a los pacientes y de servir como modelo de relación para todo el equipo de salud involucrado...

Groups of voluntary or professional artists have been formed in order to visit patients in hospitals around the world, as clowns, using humor as a tool to promote the care and recovery process. There are few studies on this topic in the scientific literature. Thus, construction of a theoretical field that is able to support this activity is only just beginning. Therefore, we conducted a bibliographic review based on 33 papers about different clown groups acting in different hospitals worldwide, in order to better comprehend how these visits take place and how they can effectively achieve good results. It was observed that these encounters can establish deep relationships that are capable of creating new meanings for the hospital environment, empowering patients and serving as a relationship model for all the healthcare staff involved...

Vulnerabilities in snakebites in Sao Paulo, Brazil.

OBJECTIVE: To describe elements of vulnerability of victims of snakebite. METHODS: This qualitative, descriptive, cross-sectional study had, as theoretical framework, the concept of vulnerability in individual, social, and programmatic dimensions. We interviewed 21 patients admitted into a hospital specialized in the care of accidents caused by venomous animals. The interviews were analyzed according to a discourse analysis technique. RESULTS: Patients were mainly young men, living in remote countryside areas, where health services frequently have limited resources. We found social and individual conditions of vulnerability, such as precarious schooling, low professional qualification, housing without access to piped water, no sewage treated, and no regular garbage collection, and lack of knowledge on this health problem. Regarding the programmatic dimension, we found limited accessibility to the health services that could affect the prognosis and the frequency of sequelae and deaths. CONCLUSIONS: Considering such vulnerabilities evoke the need to improve the program for control the Accidents by Venomous Animals and the training of health workers, we highlight the potential use of the concept of vulnerability, which may amplify the understanding and the recommendations for the practice and education related to snakebites.

Effect of foods and drinks on primary tooth enamel after erosive challenge with hydrochloric acid.

The aim of this study was to evaluate the effect of industrialised foods and drinks on primary tooth enamel previously eroded with hydrochloric acid (HCl). The crowns of one hundred two specimens were subjected to an erosive challenge with HCl and randomly divided into six groups (n = 17): Chocolate Milk (Toddynho® - Pepsico) - negative control; Petit Suisse Yogurt (Danoninho® - Danone); Strawberry Yogurt (Vigor); Apple puree (Nestlé); Fermented Milk (Yakult® - Yakult); and Home Squeezed Style Orange Juice (del Valle) - positive control. The 28-day immersion cycles for the test products were performed twice daily and were interspersed with exposure of the test substrate to artificial saliva. Measurements of enamel surface microhardness (SMH) were performed initially, after immersion in HCl and at 7, 14, 21 and 28 days of experimentation. A two-way ANOVA, according to a split-plot design, followed by the sum of squares decomposition and Tukey's test, revealed a significant effect for the interaction between Foods and Drinks and Length of Exposure (p < 0.00001). Orange juice resulted in greater mineral loss of enamel after 28 days. None of the test products was associated with recovery of tooth enamel microhardness.

Vulnerabilities in snakebites in Sao Paulo, Brazil / Vulnerabilidades aos acidentes ofídicos em São Paulo

ABSTRACT OBJECTIVE To describe elements of vulnerability of victims of snakebite. METHODS This qualitative, descriptive, cross-sectional study had, as theoretical framework, the concept of vulnerability in individual, social, and programmatic dimensions. We interviewed 21 patients admitted into a hospital specialized in the care of accidents caused by venomous animals. The interviews were analyzed according to a discourse analysis technique. RESULTS Patients were mainly young men, living in remote countryside areas, where health services frequently have limited resources. We found social and individual conditions of vulnerability, such as precarious schooling, low professional qualification, housing without access to piped water, no sewage treated, and no regular garbage collection, and lack of knowledge on this health problem. Regarding the programmatic dimension, we found limited accessibility to the health services that could affect the prognosis and the frequency of sequelae and deaths. CONCLUSIONS Considering such vulnerabilities evoke the need to improve the program for control the Accidents by Venomous Animals and the training of health workers, we highlight the potential use of the concept of vulnerability, which may amplify the understanding and the recommendations for the practice and education related to snakebites.

RESUMO OBJETIVO Descrever elementos de vulnerabilidade de vítimas de acidentes por serpentes. MÉTODOS Este estudo qualitativo, descritivo e transversal teve como referencial teórico o conceito de vulnerabilidade, nas dimensões: individual, social e programática. Foram entrevistados 21 pacientes internados em hospital especializado no cuidado a vítimas de acidentes por animais peçonhentos. Os depoimentos foram analisados segundo técnica de análise de discurso. RESULTADOS Os pacientes eram, em sua maioria, homens jovens e residentes em área rural, onde frequentemente os recursos de saúde são limitados. Foram observadas condições de vulnerabilidade individual e social, tais como: escolaridade precária, baixa qualificação profissional, moradia sem acesso à água encanada, esgoto e coleta regular de lixo e precário conhecimento a respeito desse agravo à saúde. Quanto à dimensão programática, verificou-se acessibilidade restrita ao serviço de saúde, que poderia repercutir no prognóstico e na frequência de sequelas e mortes. CONCLUSÕES A constatação de elementos de vulnerabilidade em suas três dimensões evoca a necessidade de melhoria de programa de controle e formação dos trabalhadores de saúde. Destaca-se a potencialidade do uso do conceito de vulnerabilidade, o que pode ampliar a interpretação e recomendações para a prática e ações educativas relacionadas aos acidentes ofídicos.

Effect of foods and drinks on primary tooth enamel after erosive challenge with hydrochloric acid

The aim of this study was to evaluate the effect of industrialised foods and drinks on primary tooth enamel previously eroded with hydrochloric acid (HCl). The crowns of one hundred two specimens were subjected to an erosive challenge with HCl and randomly divided into six groups (n = 17): Chocolate Milk (Toddynho® - Pepsico) - negative control; Petit Suisse Yogurt (Danoninho® - Danone); Strawberry Yogurt (Vigor); Apple puree (Nestlé); Fermented Milk (Yakult® - Yakult); and Home Squeezed Style Orange Juice (del Valle) - positive control. The 28-day immersion cycles for the test products were performed twice daily and were interspersed with exposure of the test substrate to artificial saliva. Measurements of enamel surface microhardness (SMH) were performed initially, after immersion in HCl and at 7, 14, 21 and 28 days of experimentation. A two-way ANOVA, according to a split-plot design, followed by the sum of squares decomposition and Tukey’s test, revealed a significant effect for the interaction between Foods and Drinks and Length of Exposure (p < 0.00001). Orange juice resulted in greater mineral loss of enamel after 28 days. None of the test products was associated with recovery of tooth enamel microhardness.

In vitro erosive effect of pediatric medicines on deciduous tooth enamel.

This study evaluated, in vitro, the erosive potential of pediatric liquid medicines in primary tooth enamel, depending on the exposure time. Sixty deciduous incisors were randomly assigned to 4 groups (n=15), according to the immersion solutions: guaifenesin; ferrous sulfate; salbutamol sulfate and artificial saliva. The immersion cycles in the medicines were undertaken under a 1-min agitation, which wasperformed three times daily, during 28 days. Surface microhardness was measured at 7,14, 21 and 28 days. The titratable acidity and buffering capacity of the immersion media were determined. Data were analyzed by Analysis of Variance and Tukey's test (α=0.05). Salbutamol sulfate caused a gradual loss in enamel microhardness deciduous, observed at all times (p<0.005). Exposure to guaifenesin or ferrous sulfate resulted in significant decrease of enamel microhardness only after 28 days (p<0.005). In the control group (artificial saliva), microhardness did not changed (p>0.005) at any of the studied times. Scanning Electron Microscopy (SEM) images revealed that after 28 days the surfaces clearly exhibited structural loss, which was unlike those immersed in artificial saliva. Erosion of deciduous enamel was dependent on the type of medicine and exposure time.

In Vitro Erosive Effect of Pediatric Medicines on Deciduous Tooth Enamel

This study evaluated, in vitro, the erosive potential of pediatric liquid medicines in primary tooth enamel, depending on the exposure time. Sixty deciduous incisors were randomly assigned to 4 groups (n=15), according to the immersion solutions: guaifenesin; ferrous sulfate; salbutamol sulfate and artificial saliva. The immersion cycles in the medicines were undertaken under a 1-min agitation, which wasperformed three times daily, during 28 days. Surface microhardness was measured at 7,14, 21 and 28 days. The titratable acidity and buffering capacity of the immersion media were determined. Data were analyzed by Analysis of Variance and Tukey's test (α=0.05). Salbutamol sulfate caused a gradual loss in enamel microhardness deciduous, observed at all times (p<0.005). Exposure to guaifenesin or ferrous sulfate resulted in significant decrease of enamel microhardness only after 28 days (p<0.005). In the control group (artificial saliva), microhardness did not changed (p>0.005) at any of the studied times. Scanning Electron Microscopy (SEM) images revealed that after 28 days the surfaces clearly exhibited structural loss, which was unlike those immersed in artificial saliva. Erosion of deciduous enamel was dependent on the type of medicine and exposure time.

Este estudo avaliou, in vitro, o potencial erosivo de medicamentos líquidos pediátricos em esmalte de dentes decíduos, em função do tempo de exposição. Sessenta incisivos decíduos foram divididos aleatoriamente em 4 grupos (n=15), de acordo com a solução de imersão: guaifenesina, sulfato ferroso, sulfato de salbutamol e saliva artificial. Os ciclos de imersão nos medicamentos foram realizados sob agitação por 1 min, três vezes ao dia, durante 28 dias. As medidas de microdureza superficial foram realizadas após 7, 14, 21 e 28 dias. A acidez titulável e capacidade tampão dos meios de imersão foram determinadas. Os dados foram submetidos à Análise de Variância e teste de Tukey (α=0,05). O sulfato de salbutamol causou uma perda gradual na microdureza do esmalte decíduo, em todos os tempos verificados (p<0,005). A exposição à guaifenesina ou ao sulfato ferroso levou à diminuição significante da microdureza do esmalte, apenas após 28 dias (p<0,005). No grupo controle (saliva artificial) não houve alteração (p>0,005) da microdureza em nenhum dos tempos estudados. As imagens de microscopia eletrônica de varredura (MEV) revelaram que após 28 dias, as superfícies expostas aos medicamentos apresentaram perda estrutural, diferindo dos que foram imersos em saliva artificial. A erosão do esmalte decíduo foi dependente do tipo de medicamento e do tempo de exposição.

Long-term chlorhexidine effect on bond strength to Er:YAG laser irradiated-dentin.

This study evaluates the bond strength of dentin prepared with Er:YAG laser or bur, after rewetting with chlorhexidine on long-term artificial saliva storage and thermocycling. One hundred and twenty human third molars were sectioned in order to expose the dentin surface (n = 10). The specimens were randomly divided in 12 groups according to treatment and aging: Er:YAG laser rewetting with deionized water (LW) and 24 h storage in artificial saliva (WC); LW and 6 months of artificial saliva storage + 12.000 thermocycling (6M), LW and 12 months of artificial saliva storage + 24.000 thermocycling (12M), Er:YAG laser rewetting with 2% chlorhexidine (LC) and WC, LC and 6M, LC and 12M, bur on high-speed turbine rewetting with deionized water (TW) and WC, TW6M, TW12M, bur on high-speed turbine + 2% chlorhexidine (TC) and WC, TC and 6M, TC and 12M. The specimens were etched with 35% phosphoric acid, washed, and dried with air. Single Bond 2 adhesive was applied and the samples were restored with a composite. Each tooth was sectioned in order to obtain 4 sticks, which were submitted to microtensile bond strength test (µTBS). The two-way ANOVA, showed no significant differences for the interaction between the factors and for the aging factor. Tukey 5% showed that the LC group had the lowest µTBS. The rewetting with chlorhexidine negatively influenced the bond strength of the preparation with the Er:YAG laser. The artificial saliva aging and thermocycling did not interfere with dentin bond strength.

Effect of endodontic irrigants on microtensile bond strength to dentin after thermocycling and long-term water storage.

OBJECTIVE: The bond strength of adhesives in irrigated dentin behaves differently over time. The aim of this study was to evaluate the influence of long-term water storage and thermocycling on the microtensile bond strength of adhesive systems to dentin irrigated with endodontic solutions. MATERIALS AND METHODS: Sixty human molars were used after removal of the occlusal portion and exposure of the dentin by grinding. The specimens were irrigated with 2.5% NaOCl for 30 minutes and then 17% EDTA for 5 minutes and assigned to six groups according to the adhesive system (n=10): G1 and G2-Clearfil SE Bond; G3 and G4-Single Bond 2; and G5 and G6-XP Bond. The teeth were restored with composite and were subjected to water storage for different time periods. G1, G3 and G5 were stored for 24 h; G2, G4 and G6 were stored for 6 months and were subjected to thermocycling (12,000 cycles, 5°C to 55°C, 500 cycles per week for 6 months). After storage, the tooth/restoration assembly was sectioned to obtain four sticks of approximately 1 mm(2), for microtensile bond strength testing. The results were analyzed by two-way ANOVA and Tukey's test. RESULTS: Significant differences were observed among the adhesives (p<0.01). No significant differences were observed in the microtensile bond strength between samples after 24 hours of storage without thermocycling and after 6-month storage with 12,000 cycles (p<0.05). CONCLUSION: The bond strengths of G5 and G6 after irrigation with 2.5% NaOCl and 17% EDTA were significantly different from those of other groups. Long-term water storage/thermocycling had no effect on bond strength to dentin.

Shear strength of the bond to primary dentin: influence of Er:YAG laser irradiation distance.

The aim of this study was to assess in vitro the influence of Er:YAG laser irradiation distance on the shear strength of the bond between an adhesive restorative system and primary dentin. A total of 60 crowns of primary molars were embedded in acrylic resin and mechanically ground to expose a flat dentin surface and were randomly assigned to six groups (n = 10). The control group was etched with 37% phosphoric acid. The remaining five groups were irradiated (80 mJ, 2 Hz) at different irradiation distances (11, 12, 16, 17 and 20 mm), followed by acid etching. An adhesive agent (Single Bond) was applied to the bonding sites, and resin cylinders (Filtek Z250) were prepared. The shear bond strength tests were performed in a universal testing machine (0.5 mm/min). Data were submitted to statistical analysis using one-way ANOVA and the Kruskal-Wallis test (p<0.05). The mean shear bond strengths were: 7.32 ± 3.83, 5.07 ± 2.62, 6.49 ± 1.64, 7.71 ± 0.66, 7.33 ± 0.02, and 9.65 ± 2.41 MPa in the control group and the groups irradiated at 11, 12, 16, 17, and 20 mm, respectively. The differences between the bond strengths in groups II and IV and between the bond strengths in groups II and VI were statistically significant (p<0.05). Increasing the laser irradiation distance resulted in increasing shear strength of the bond to primary dentin.