Filling Material Bond Strength to Dentin Is Positively Influenced by the Agitation of Endodontic Final Irrigating Solutions.

Introduction: The final step of irrigation has been considered to of increase the bonding strength of filling material to dentin. This study investigated the impact of three final-step irrigation methods on the endodontic sealer bond strength to dentin by using a micro push-out test. Materials and Methods: Palatal roots of human maxillary molars were cleaned and shaped and randomly divided in six groups (n=15) according to the final-step irrigation method and the type of root canal sealer used. The solutions used for the final-step irrigation were 17% ethylenediaminetetraacetic acid and 2.5% sodium hypochlorite, which underwent three methods: 1) syringe-needle irrigation/conventional, 2) passive ultrasonic irrigation, and 3) XP-endo Finisher agitation. The root canal sealers used were: EndoSequence BC Sealer, and AH-Plus sealer. Roots were obturated with the single cone technique and then, cross-sectioned in 2-mm-thick slices (3 slices from each root). Push-out test was performed on the sliced specimens (cervical, middle, and apical thirds) with a universal testing machine. Bond strength values were recorded in megapascal (MPa). Subsequently, each specimen was longitudinally split to verify the type of failure. Data analysis was performed using Johnson transformation, three-way analysis of variance, Tukey's post-hoc tests, and the partial Eta squared test. Results: There were significant differences in bond strength between the sealers [AH: 4.46±2.24 and BC: 3.47±2.19 MPa (P<0.001)]; between final-step irrigation methods [passive ultrasonic irrigation: 4.52±2.25, XP-endo Finisher: 3.93±3.93 and syringe-needle irrigation/conventional: 3.37±2.51 MPa (P<0.001)], and between the root canal thirds represented by the sliced specimens [cervical: 5.45±2.39, middle: 4.14±1.99 and apical: 2.30±1.30 MPa (P<0.001)]. The interaction between the variables had no significance (P>0.05). Conclusion: Agitation of the final irrigating solution may improve the bonding of the sealer to canal walls. AH-Plus sealer had the highest bond strength. The bond strength reduced significantly towards the apical third.

Translation, cross-cultural adaptation, and validation of health and self-management in diabetes questionnaire (HASMID-10) into Brazilian Portuguese

ABSTRACT BACKGROUND: Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages. OBJECTIVE: To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese. DESIGN AND SETTING: A translation, cross-cultural adaptation, and validation study conducted at Ceuma University. METHODS: Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects. RESULTS: Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = −0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed. CONCLUSION: HASMID-10 has adequate measurement properties and may be used for Brazilians.

Short-term heart rate variability at rest in individuals with temporomandibular disorder: a comparative analysis.

OBJECTIVE: Compare heart rate variability (HRV) indices in participants with and without myogenic temporomandibular disorder (TMD). Secondarily, we correlated HRV indices with pain and quality of life variables. METHODS: This is a comparative observational cross-sectional study. Individuals of both genders with and without a history of TMD were included. Short-term heart rate variability was assessed using a Polar V800. Central sensitization was assessed using the Central Sensitization Inventory. Pain through the numeric pain scale and the impact of oral health on quality of life using the OHIP-14 questionnaire. RESULTS: A total of 80 participants were enrolled in the study: most individuals included in both groups were young adults, women and slightly overweight. We observed a decrease in HRV in the TMD group (p < 0.01) when compared to the control group. In addition, we observed a greater impact of oral health on quality of life, central sensitization in addition to high resting pain scores (p < 0.01). We observed significant correlation between the LF index of HRV and the FAI score (r = 0.311; p = 0.05). The NPS, CSI and OHIP-14 scores did not correlate with any of the HRV indices (p > 0.05). CONCLUSION: The short-term HRV in individuals with TMD is significantly lower when compared to a control group. Furthermore, there seems to be a relationship between the severity of the dysfunction and the HRV variables. CLINICAL RELEVANCE: Using portable and low-cost devices, the HRV can be easily collected and analyzed, without the need for an arsenal of equipment such as the conventional electrocardiogram. This measure can contribute to the therapy adopted and identify individuals prone to unfavorable outcomes involving ANS modulation.

Inflammatory parameters and color alterations of dental bleaching in patients wearing fixed orthodontic appliance: a randomized clinical trial.

BACKGROUND: Many orthodontic patients request dental bleaching during orthodontic treatment to achieve a faster aesthetic resolution, however, no attention has been paid to the inflammatory processes that can occur when both therapies are indicated together. So, this clinical trial evaluated the inflammatory parameters and color alterations associated with dental bleaching in patients wearing a fixed orthodontic appliance. METHODS: Thirty individuals aged between 18 and 40 years were equally and randomly allocated into three groups: FOA (fixed orthodontic appliance), BLE (dental bleaching), and FOA + BLE (fixed orthodontic appliance + dental bleaching). The orthodontic appliances and the bleaching procedures were performed in the maxillary premolars and molars. For dental bleaching a 35% hydrogen peroxide was used. The gingival crevicular fluid (GCF) and nitric oxide (NO-) levels were evaluated at different time-points. Color evaluation was performed using an Easyshade spectrophotometer at baseline (FOA, FOA + BLE, BLE), one month after (FOA + BLE) and 21 days after appliance removing (FOA + BLE and FOA groups), in each tooth bleached. The ANOVA and Tukey's tests, with a significance level of 5%, were used for statistical analysis. RESULTS: The GCF volume in the FOA + BLE and FOA groups significantly increased at the time points evaluated (p < 0.001); however, this did not occur in the BLE group (p > 0.05). On the other hand, NO- levels significantly decreased during dental bleaching with or without fixed orthodontic appliances (FOA + BLE and BLE groups; p < 0.05), while no significant changes were observed in the FOA group (p > 0.05). Significant changes in color were observed in the FOA + BLE and BLE groups compared to in the FOA group (p < 0.01). However, the presence of fixed orthodontic appliance (FOA + BLE) negatively affected the bleaching efficacy compared to BLE group (p < 0.01). CONCLUSIONS: Dental bleaching did not increase the inflammatory parameters in patients wearing fixed orthodontic appliance. However, in the presence of orthodontic appliances, the bleaching efficacy was lower than that of bleaching teeth without orthodontic appliances. TRIAL REGISTRATION: RBR-3sqsh8 (first trial registration: 09/07/2018).

Associated short and regular implants for complete denture retention in an atrophic mandible: clinical follow-up / Implantes corto y regular asociados para retención de prótesis completa en mandíbula atrófica: seguimiento clínico / Implantes curto e regular associados para retenção de prótese total em mandíbula atrófica: acompanhamento clínico

Objective: to present the radiographic clinical follow-up of the prosthetic rehabilitation of a patient with an atrophic mandible, with the installation of short implants associated with an implant of regular length. Method: case report of a completely edentulous patient with an atrophic mandible and a 6-year radiographic clinical follow-up conducted at the dental clinic of the Federal University of Piauí, Teresina, from February 2011 to January 2020. After collecting sociodemographic data, health records, clinical radiographic examinations, and prosthetic surgical planning, four dental implants were installed between the mental foramina. After three months, mini-conical abutments and a fixed prosthesis screwed onto the implants were installed and monitored every six months for a period of six years. Results: the clinical evaluation revealed tissue stability without significant peri-implant changes after the follow-up period. Radiographically, bone resorption was not observed around the implant. Stability of the prosthesis and absence of prosthetic complications were observed during the follow-up period. Conclusion: short implants associated with regular-length implants can be placed in the anterior region of an atrophic mandible for rehabilitation with fixed complete dentures.

Objetivo: apresentar o acompanhamento clínico radiográfico da reabilitação protética de um paciente com mandíbula atrófica com a instalação de implantes curtos associados a um implante de comprimento regular. Método: relato de caso de uma paciente desdentada total com mandíbula atrófica, e acompanhamento clínico radiográfico de seis anos, realizado na clínica odontológica da Universidade Federal de Piauí, Teresina, no período de fevereiro de 2011 a janeiro de 2020. Após coleta de dados sociodemográficos e registro de saúde, exames clínicos radiográficos e planejamento cirúrgico protético, foram instalados quatro implantes dentários entre os forames mentonianos. Após o período de três meses foram instalados mini pilares cônicos e uma prótese fixa aparafusada sobre os implantes que foi acompanhada a cada seis meses por um período de seis anos. Resultados: as avaliações clínicas mostraram estabilidade tecidual sem alterações peri-implantares significativas após o período de acompanhamento. Radiograficamente foi observada a manutenção sem reabsorção óssea ao redor dos implantes. A estabilidade da prótese e a ausência de complicações protéticas foram observadas clinicamente durante o período de acompanhamento. Conclusão: os implantes curtos associados a implante de comprimento regular podem ser colocados na região anterior da mandíbula atrófica para reabilitação com prótese total fixa.

Translation, Cross-Cultural Adaptation, and Validation of the Hypertension Self-Care Profile (HBP-SCP) for the Brazilian Population

Abstract Background Self-care in the management of systemic arterial hypertension (SAH) is crucial, and validated instruments can help researchers and health professionals to plan strategies to improve self-care in people with SAH. Objective The main objective of this study was to translate, cross-culturally adapt, and validated the Hypertension Self-Care Profile (HBP-SCP) for Brazilian Portuguese. Methods The translation and cross-cultural adaptation was performed in five phases, and the pre-final version was tested in 30 individuals, native speakers of Portuguese with a diagnosis of hypertension. The final version was administered in 100 individuals. The inclusion criteria were: diagnosis of SAH, characterized by systolic arterial blood pressure ≥ 140 mmHg and/or diastolic arterial blood pressure ≥ 90mmHg, regular use of antihypertensive medications and over 18 years of age. The present study also used two other questionnaires, previously validated for the Brazilian population, to verify the validity of the construct, the Healthy Habits Perception Questionnaire (HHPQ) and the Quality of Life in Hypertension Mini-Questionnaire (MINICHAL-BRASIL). Results During the translation and cross-cultural adaptation phase, there were no disagreements. Adequate reliability — intraclass correlation coefficient (ICC) ≥ 0.89, standard error of measurement (SEM) % ≤ 4.34, minimum detectable change (MDC) % ≤ 12.04 — and internal consistency (Cronbach's alpha ≥ 0.75) were observed. The behavior domain of HBP-SCP obtained significant correlations (p < 0.05) with the self-efficacy domain and HHPQ; the motivation domain with the self-efficacy domain; and the self-efficacy domain with the somatic manifestation domain of MINICHAL-BRASIL. No ceiling and floor effects were observed. Conclusions The Brazilian Portuguese version of the HBP-SCP has adequate psychometric properties, according to the best scientific recommendations.

Eighteen-month clinical evaluation of a new universal adhesive applied in the "no-waiting" technique: a randomized clinical trial.

OBJECTIVE: The aim of this double-blind, randomized clinical trial was to evaluate the 6- and 18-month clinical performances of a new universal adhesive applied in the "no-waiting" (NW) technique to non-carious cervical lesions (NCCLs) using two evaluation criteria. MATERIALS AND METHODS: One hundred and seventy-six restorations were assigned to four groups according to the adhesive system, adhesive strategy, and application mode: Prime&Bond Active (PB) applied using the etch-and-rinse (ER) and self-etch (SE) strategies with 20 s applications and Clearfil Universal Bond Quick (CQ) applied using the ER and SE strategies with the NW technique. The composite resin restorations were evaluated at baseline and after 6 and 18 months using the World Dental Federation (FDI) and US Public Health Service (USPHS) criteria. The Friedman repeated measures analysis of variance and Wilcoxon test were used for statistical analyses (α = 0.05). RESULTS: No significant differences were observed among any of the groups or criteria after 6 months (p > 0.05). After 18 months, 10 restorations were lost (p > 0.05) (2 with PB-ER [95.5%; 95%CI: 92-100%], 4 with PB-SE [90.9%; 95%CI: 82-98%], 0 with CQ-ER [100%; 95%CI: 92-100%], and 4 with CQ-SE [90.9%; 82-98%]). The restorations performed with the SE strategy showed more marginal discrepancies than those performed with the ER strategy, mainly when the FDI criteria were used (p < 0.05). Those that used the PB-SE showed fewer marginal discrepancies than those that used the CQ-SE (FDI; p < 0.05). A few restorations showed marginal discrepancies after the USPHS analysis (p > 0.05). CONCLUSIONS: The results when using the CQ-SE and -ER strategies with the NW technique were similar to those when using the PB-SE and -ER strategies in standard applications to non-carious cervical lesions after 6 and 18 months of clinical evaluation. CLINICAL RELEVANCE: After 6 and 18 months, the application of Clearfil Universal Bond Quick with the "no-waiting" technique showed similar clinical performance compared to the standard application of Prime & Bond Active applied using the standard application time (20 s). TRIAL REGISTRATION: ClinicalTrials.gov identifier RBR-5f9gps.

Intra- and Interrater Reliability of Short-Term Measurement of Heart Rate Variability on Rest in Individuals Post-COVID-19.

Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.

Braden scale has low reliability in different patients under care in intensive care unit.

OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20-30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06-0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48-0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

Braden scale has low reliability in different patients under care in intensive care unit

SUMMARY OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20-30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06-0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48-0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults.

OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults

SUMMARY OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

Antimicrobial action of ozonated water and photodynamic therapy with sonic activation in root canals infected with Enterococcus faecalis.

Background: New protocols are constantly being tested in the search for complete disinfection of root canals without the undesirable effects of sodium hypochlorite. This study evaluated the antimicrobial effect of ozonated water and photodynamic therapy (PDT) with sonic activation in root canals infected with Enterococcus faecalis. Material and Methods: Seventy single-rooted canals of human teeth were prepared and contaminated with E. faecalis for 21 days. The teeth were divided into six experimental groups (n=10): ozonized water without (O + S-) and with sonic activation (O + S +); PDT without (PDT + S-) and with sonic activation (PDT + S +); PDT + ozonized water without (PDT + O + S-) and with sonic activation (PDT + O + S +); and two control groups, one positive (n = 5) and one negative (n = 5). Microbial collections were performed before and shortly after treatment, counted in the log of colony-forming units and tested for significant difference between these counts, if any (Student's t-test). The ANOVA two-way test was applied to evaluate whether the Treatment factor (Ozone, PDT and Ozone + PDT) and the Sonic factor (With and without sonic activation) had any effect on microbial reduction. Results: In all protocols, there was a significant microbial reduction (p=0.025), whereas in the groups in which sonic activation was used, the microbial reduction was significantly greater (p=0.001). Conclusions: The treatments significantly reduced the number of microorganisms in the root canals. Sonic activation helped to increase the microbial reduction in infected root canals. Key words:Endodontics, ozone, photodynamic therapy, enterococcus faecalis.

Translation, cross-cultural adaptation and validation of the Work Role Functioning Questionnaire 2.0 into Brazilian Portuguese in a general population.

BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an instrument that measures the difficulties perceived by workers in meeting work demands, given their physical or emotional health, but it has not yet been adapted for Brazil. Thus, this study aimed to translate, cross-culturally adapt and assess the psychometric properties of the WRFQ 2.0 into Brazilian Portuguese. METHODS: This is an observational study. Initially, translation and cross-cultural adaptation into Brazilian Portuguese was carried out. After that, this version was submitted to an evaluation of its internal structure. The internal consistency and test-retest reliability were assessed. To determine the construct validity, Spearman's correlation coefficient (rho) was used to determine the magnitude of correlation between the WRFQ 2.0 and the Work Ability Index (WAI), Numerical Pain Rating Scale (NPRS) and Self -Estimated Functional Inability because of Pain (SEFIP-work). RESULTS: The internal structure with five domains and 27 items presented adequate fit indices for the Brazilian version of the WRFQ 2.0. Adequate correlations of the five domains of the WRFQ 2.0 with the NPRS, WAI and SEFIP-work were found (rho ranged between 0.145 and 0.338). The test-retest reliability of the WRFQ 2.0 ranged from substantial to excellent (intraclass correlation coefficient ≥ 0.785) and internal consistency was adequate (Cronbach's alpha ≥ 0.852). CONCLUSION: The Brazilian Portuguese version of the WRFQ 2.0 presents valid internal structure with five domains and 27 items, adequate construct based on correlations with other instruments, and acceptable test-retest reliability and internal consistency.

Ex vivo evaluation of the effectiveness of XP-endo Finisher on the removal of smear layer from the root canal / Avaliação ex vivo da eficácia do XP-endo Finisher na remoção de smear layer do canal radicular

ABSTRACT Objective: The aim of this study was to evaluate the effectiveness of XP-endo Finisher (XP) on removal of the smear layer in root canals by comparing different irrigation protocols. Methods: Seventy-two human single-rooted teeth were similarly instrumented using R25 Reciproc files (VDW, Munich, Germany) applied in reciprocating mode with a VDW GOLD endo motor (VDW, Munich, Germany). The working length was determined at 1 mm short of the apical foramen. The canals were irrigated with 5 mL of 2.5% sodium hypochlorite during instrumentation. The teeth were divided at random into six groups (n=12). A control group, which was not submitted to the final irrigation protocol, and five experimental groups with different irrigants and agitation techniques: EDTA/File, EDTA/XP, EDTA/Passive Ultrasonic Irrigation (PUI), Distilled Water (DW)/XP, and DW/PUI). Smear layer removal quality scores were assessed in the apical, middle, and cervical thirds of the root canal based on images obtained by scanning electron microscopy. Data were analyzed using the Kruskal-Wallis test, followed by two-by-two comparisons with the Dunn test (α=5%). Results: EDTA/File, EDTA/PUI, and EDTA/XP groups demonstrated significantly lower scores than the other groups (P<0.05) in all thirds evaluated. No significant difference was observed between the groups in which distilled water was used and the control group in all thirds evaluated (P> 0.05). Conclusion: The XP-endo Finisher file did not increase the efficiency of EDTA in removal of the smear layer in root canals.

RESUMO Objective: Avaliar a eficácia do XP-endo Finisher (XP) na remoção da smear layer em canais radiculares, comparando diferentes protocolos de irrigação. Métodos: Setenta e dois dentes humanos unirradiculares foram similarmente instrumentados usando limas R25 (VDW, Munich, Germany) aplicadas no modo reciprocrantes em um motor endodôntico VDW GOLD (VDW, Munich, Germany). O comprimento de trabalho foi determinado a 1 mm aquém do forame apical. Os canais foram irrigados com 5 mL de hipoclorito de sódio 2,5% durante a instrumentação. Os dentes foram divididos aleatoriamente em seis grupos (n=12). Um grupo controle, que não foi submetido ao protocolo final de irrigação, e cinco grupos experimentais com diferentes irrigantes e técnicas de agitação: EDTA/Lima, EDTA/XP, EDTA/Irrigação Ultrassônica Passiva (IUP), Água destilada (AD)/XP, e AD/IUP). Os escores de qualidade de remoção da camada de smear layer foram avaliados nos terços apical, médio e cervical do canal radicular com base em imagens obtidas por microscopia eletrônica de varredura. Os dados foram analisados pelo teste de Kruskal-Wallis, seguido de comparações dois a dois pelo teste de Dunn (α = 5%). Resultados: Os grupos EDTA/lima, EDTA/PUI e EDTA/XP demonstraram escores significativamente menores que os outros grupos (P <0,05). Não foi observada diferença entre os grupos que utilizaram água destilada e o grupo controle em todos os terços avaliados (P> 0.05). Conclusão: A lima XP-endo Finisher não aumentou a eficiência do EDTA na remoção da smear layer em canais radiculares.

Translation, cross-cultural adaptation, and validation of the Canadian Diabetes Risk Questionnaire for the Brazilian population.

OBJECTIVE: The aim of this study was to translate, cross-culturally adapt, and validate the Canadian Diabetes Risk Questionnaire for use in Brazilian Portuguese. METHODS: This is a Questionnaire validity study conducted at a private university. The Brazilian version of the Canadian Diabetes Risk Questionnaire was developed by means of the processes of translation, back-translation, committee review, and pretesting. Test-retest reliability was measured using the intraclass correlation coefficient and kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total score of the Canadian Diabetes Risk Questionnaire was correlated with the Diabetes Knowledge Scale and the Diabetes Mellitus Risk Questionnaire. Ceiling and floor effects were also evaluated in the present study. RESULTS: For construct validity and floor and ceiling effect measurements, a total sample of 100 participants was used. For reliability, a subsample of 34 participants out of the total sample was used. We identified adequate values for reliability (kappa between 0.46-1.00 and ICC 0.96) and internal consistency (Cronbach's alpha 0.80). There were significant correlations between the Canadian Diabetes Risk Questionnaire and the Diabetes Mellitus Risk Questionnaire (rs=0.370, p<0.001), but not the Diabetes Knowledge Scale (rs= -0.162). No ceiling or floor effects were found. CONCLUSION: We concluded that in accordance with the best international recommendations, the Brazilian version of the Canadian Diabetes Risk Questionnaire has adequate psychometric properties.

Influence of Application of Dimethyl Sulfoxide on the Bonding Properties to Eroded Dentin.

PURPOSE: To evaluate the effect of dimethyl sulfoxide (DMSO) on the microtensile bond strength (µTBS), nanoleakage (NL), and degree of conversion (DC) of universal adhesives on eroded dentin. MATERIALS AND METHODS: One hundred thirty-four extracted (134) human third molars were selected for the study. After the dentin surface was exposed, 128 teeth were randomly assigned to 16 experimental groups as follows: dentin surfaces (sound dentin and eroded dentin), application of DMSO (without or with the application of DMSO), and adhesive strategies (etch-and-rinse [ER] and self-etch [SE]). The universal adhesive systems iBond Universal (IBU) and Scotchbond Universal (SBU) were applied and the teeth were restored using a resin composite. After 24 h in distilled water at 37°C, the samples were sectioned and evaluated for µTBS. Selected sticks from each tooth were used for evaluating NL and DC. The remaining six teeth were used to measure the thickness of the collagen layer of the artificially eroded dentin using scanning electron microscopy. Data on µTBS, NL, and DC (%) were analyzed using three-way ANOVA and Tukey's test (α = 0.05). RESULTS: Significantly lower µTBS (p = 0.0001) and DC (p = 0.01) were observed for eroded dentin than for sound dentin. However, a significant increase in the µTBS (p = 0.0007) and DC (p = 0.001) was observed for both substrates when DMSO was applied. Moreover, the application of DMSO decreased the concentration of silver nitrate at the bottom of the hybrid layer for both sound and eroded dentin (p = 0.002). Eroded dentin showed enlarged tubules with the presence of a collapsed collagen fibril layer approximately 5.0 ± 2.0 mm of thickness. CONCLUSION: The bonding performance of both tested universal adhesives improved on both sound and eroded dentin with DMSO pretreatment.

Evaluation of the Bond Strength of Densely Sintered Ceramics Subjected to Extended Firing.

INTRODUCTION: Critical failures in ceramic materials can be caused by the processing mode, which includes all steps taken in the manufacture of a ceramic part, from molding to firing. PURPOSE: To evaluate the effect of extended firing on bond strength in densely sintered ceramics of the zirconium reinforced lithium silicate, lithium disilicate, and feldspathic ceramic. MATERIALS AND METHODS: Three types of ceramics were evaluated: zirconium reinforced lithium silicate, lithium disilicate, feldspathic ceramic. A total of 6 ceramic blocks, two for each material were used in the study. Each block was cut into four square sections. A total of 24 ceramic surfaces were randomly distributed into 6 groups (n = 4 surfaces per group) divided according to the variables: heat treatment: conventional firing or extended firing; test time: immediate (24 hours after cementation) or longevity (after 1000 cycles of thermocycling). The bond strength tests were performed in a semi-universal test machine for microshear bond strength. For data analysis, the Shapiro-Wilk test was performed to evaluate the normality between the groups measured, and regarding homoscedasticity (homogeneity of variances) by the Bartlett test. The comparisons between the groups were made using the nonparametric Kruskal-Wallis test. RESULTS: There was no statistically significant difference of the resistance values in relation to the thermal treatment methods (conventional firing and extended firing) in any ceramic group (p <0.05). Among the times (immediate and long), there was a statistically significant difference (p <0.05), with higher resistance values for immediate time. CONCLUSION: Extended firing did not influence the micro-shear bond strength of zirconium reinforced lithium silicate, lithium disilicate, feldspathic ceramic.

Influence of the geometry of the screwdriver-screw connection on the reverse torque of UCLA screws.

The aim of this study was to evaluate the influence of the geometry of the screwdriver-screw connection on the reverse torque of UCLA screws after repeated cycles of tightening and loosening in an implant-supported prosthesis. Thirty sets of external hex titanium implants, UCLA abutments, and UCLA abutment screws were divided into 3 experimental groups (n = 10). In the square group, the implant and UCLA abutment system were mounted in an upright position using a screw with a square screwdriver-screw connection. In the hexagonal group, the implant and UCLA abutment system were mounted in an upright position using a screw with a hexagonal screwdriver-screw connection. In the hexalobular group, the implant and UCLA abutment system were mounted at 70° using a dynamic UCLA abutment and screw with a hexalobular screwdriver-screw connection. Ten alternating torque-reverse torque cycles were applied to each screw using a screwdriver fixed at the end of a digital torque meter. The screws with a square connection resulted in less loss of reverse torque than the other types. Screws with a hexagonal connection showed a statistically significant loss of torque initially but remained constant for the remaining cycles. For the screws with a hexalobular connection, the loss of torque was greater, and substantial deformation of the plastic in the microstructure was noted. The screwdriver-screw connection geometry had a direct influence on the reverse torque of UCLA screws, and the initial reverse torque of the abutment screws with a square connection was greater than that of the hexagonal and hexalobular designs.