Estudos clínicos utilizando o Tratamento Restaurador Atraumático (TRA) em dentes decíduos e permanentes

Este artigo apresenta uma revisão da literatura relacionada a estudos clínicos utilizando o tratamento restaurador atraumático (ART). A literatura científica disponível mostra-se encorajadoura em termos de controle da doença cárie através desta abordagem, especialmente em cavidades de uma superfície. Os passos clínicos da técnica são descritos e pontos de crucial importância enfatizados. A incorporação do tratamento restaurador atraumático em serviços de atenção básica à saúde , como o Programa de Saúde da Família, é considerada.This paper presents a review of the literature on clinical trials with Atraumatic Restorative Treatment. The available scientific literature is encouraging in terms of management of dental caries by this approach, especially for one-surface lesions. The steps of ART are described and the crucial points highlighted. The incorporation of ART into primary health care services, as Family Health Program - PSF, was considered

Del conflicto a la oportunidad: Participación ciudadana en el desarrollo urbano

Durante las últimas décadas, el éxito de las políticas de desarrollo urbano ha estado asociado a grandes obras o ambiciosos planes urbanos. El éxito de estos comúnmente es medido por indicadores cuantitativos, tales como el número de nuevos proyectos inmobiliarios generados por un plan de desarrollo, la reducción del déficit de familias sin casa, las hectáreas de áreas verdes o dotación vial medida en kilómetros pavimentados y la reducción de los tiempos de viajes, entre otros. Sin embargo, a medida que nuestras ciudades mejoran y más chilenos acceden a la vivienda propia, o bien, a mejores servicios urbanos, los niveles de insatisfacción y conflictividad de los ciudadanos frente a la aplicación específica de las políticas urbanas tienden a aumentar.El siguiente documento pretende encontrar algunas respuestas a este dilema, mostrando que las claves para construir mejores ciudades no se encuentran en la oferta centralizada de políticas o proyectos urbanos, por mejor diseñados que estén, sino que en una mayor descentralización de la acción urbana e institucionalización de la inclusión de los ciudadanos y usuarios en la elaboración de planes y proyectos. Lo anterior implica una crítica a formas pseudoparticipativas donde el concepto “ciudadano” se traduce en la mera incorporación de grupos de presión o en el cual la participación se reduce a sistemas de información masiva como forma de legitimar proyectos preestablecidos.Lo anterior se sustenta en nuevos ejes de políticas urbanas más centradas en los aspectos cualitativos del desarrollo y, por ello, más vinculados con la generación de proyectos urbanos desarrollados a partir de la diversidad de las demandas comunitarias y no solo desde la construcción de soluciones estándar. Se sostendrá que procesos participativos estructurados tendrán efectos permanentes en la formación de acuerdos urbanos, en el diseño de proyectos y planes de calidad y en el fortalecimiento de la democracia a nivel local

Reprojeto de motor BLDC com o propósito de melhoria na eficiência: um estudo de caso na aplicação de compressores herméticos para refrigeração

TCC (graduação) - Universidade Federal de Santa Catarina. Centro Tecnológico. Engenharia Elétrica.O consumo de energia elétrica está cotidianamente em pauta nas discussões da sociedade mundial, seja pela sua falta, custo ou inclusive degradação do meio ambiente. Desta forma, além do apelo à conscientização do consumo por parte do homem, a busca por novas tecnologias que visam a economia de energia são amplamente estudadas. Motores elétricos são conversores eletromecânicos de energia, largamente utilizados no dia a dia, responsáveis por grande parte do consumo doméstico e que podem ser aperfeiçoados de forma a melhorar sua eficiência. Sua aplicação em refrigeradores domésticos, é um exemplo disto. O ciclo de refrigeração compreende pelo tubo capilar, evaporador, condensador e compressor, onde se encontra o motor elétrico. O propósito do trabalho compreende a análise de projeto de um motor BLDC utilizado em compressores de refrigeração, cuja execução foi estruturada no estudo de caso de um motor elétrico comercial utilizado pela empresa EMBRACO a fim de se obter um aumento de 1% na eficiência em operação. Para isso, realizou-se uma revisão bibliográfica do assunto, fabricação de amostras para testes, ensaios em laboratório e simulação assistida por um software analítico, utlizando-se o espaço de Pesquisa e Desenvolvimento fornecido pela empresa EMBRACO. Como resultado obteve-se um novo modelo aproximadamente 1% mais eficiente que o comercializado, porém algumas análises de viabilidade deverão ser feitas para o desenvolvimento do produto.The consumption of electric energy is daily on the agenda in the debates of the world society, either by its lack, cost or even degradation of the environment. In this way, in addition to the call for the awareness of the consumption by the man, the search for new technologies that aim at the energy saving are widely studied. Electric motors are electromechanical converters of energy, widely used in the day to day, responsible for much of the domestic consumption and that can be optimized in order to improve its efficiency. Its application in domestic refrigerators, and an example of this. The purpose of the work is to analyze the design of a BLDC motor used in refrigeration compressors, the execution of which was structured in the case study of a commercial electric motor used by the company EMBRACO in order to obtain a 1% increase in operating efficiency. For this, a bibliographic review of the subject was carried out, manufacture of samples for tests, laboratory tests and simulation assisted by analytical software, using the Research and Development space provided by EMBRACO. As a result, a new model approximately 1% more efficient than commercialized was obtained, however some feasibility analysis should still be done for the product development

Clinical success of restorations with bioactive and non-bioactive materials: Systematic Review and Network Meta-Analysis

The oral cavity is a complex and dynamic environment with frequent pH and temperature changes that can affect the longevity of dental restorations. Consequently, bioactive restorative materials, capable of advantageous interactions with the oral environment and dental tissues, are promising alternatives. However, there is limited scientific evidence of their clinical performance. Therefore, we conducted this systematic review and network meta-analysis of clinical studies to address the research question: Does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater success rates than those with non-bioactive materials

Comparison of in vitro erosion protocols in bovine teeth to simulate natural erosion lesion: analysis of mechanical properties and surface gloss

Objective: The aim of this study was to compare two in vitro erosion protocols, in which one simulates in vivo conditions experienced by patients with gastroesophageal disorders or bulimia (HCl-pepsin protocol), and the other simulates the diet of an individual who consumes a high volume of erosive beverages (citric acid protocol). In addition, the mechanical properties and surface gloss of eroded human dentin were compared with those of sound human dentin. Materials and Methods: Blocks of cervical dentin were used: sound human dentin (n=10), human dentin with erosive lesions (n=10), and bovine dentin (n=30). Twenty bovine blocks were subjected to either of two erosion protocols (n=10/protocol). In the first protocol, samples were demineralized using HCl-pepsin solution, then treated with trypsin solution. In the second protocol, samples were demineralized with 2% citric acid. Toothbrushing was performed in both protocols using a toothbrushing machine (15 s with a 150 g load). Ten bovine dentin blocks were not subjected to any erosive treatment. All samples of bovine and human dentin were analyzed to obtain Martens hardness values (MH), elastic modulus (Eit*) and surface gloss. One-way ANOVA and Tukey’s test were performed to analyze the data (α=0.05). Results: Sound human and eroded human dentin groups showed similar MH and Eit* values (p>0.05); however, sound human dentin showed a higher surface gloss value when compared to eroded human dentin (p<0.05). Sound bovine dentin and HCl-pepsin-treated bovine dentin treatments resulted in similar values for both MH and Eit* (p>0.05), but HClpepsin-treated bovine dentin and citric acid-treated bovine dentin resulted in lower surface gloss than sound bovine dentin (p<0.05). Conclusions: The HCl-pepsin protocol modified bovine dentin properties that could be similar to those that occur on human dentin surfaces with erosive lesions

Effect of fluoride, chlorhexidine or Nd:YAG on the progression of root dentin demineralization after removal of the demineralized organic matrix

Quantification of collagen degradation is an important parameter to evaluate dentin caries for preventive aid. Objectives: Evaluate preventive methods against root collagen degradation by the hydroxyproline assay (HYP) and microradiography technique (MRT). Methodology: Five bovine root dentin blocks were obtained and subjected to an artificial demineralization process by acetate buffer (pH 5) to induce carious lesion formation. Samples were subjected to the following therapeutic treatments: 1) 0.12% chlorhexidine for 1 min, 2) 2% fluoride for 1 min, 3) Nd:YAG Laser (400 μm diameter optical fiber, 10 Hz frequency, 60 mJ/pulse energy, 48 J/cm2 energy density, in noncontact mode for 10 s), 4) deionized water (control) for 1 min, 5) MRT control group (without treatment and removal of collagen). Samples were exposed to degradation by a collagenase enzyme for five days. The enzyme solution was collected, by colorimetry in a spectrophotometer, from the collagen matrix for the hydroxyproline release analysis. The same samples were subjected to an additional two days of demineralization to induce the progression of mineral loss. Samples were analyzed by MRT for the visualization of their degraded areas (estimation of lesion depth and mineral loss). ANOVA was applied to compare hydroxyproline release rates. MRT data were subjected to the Kruskal-Wallis test, followed by the Dunn’s test. Comparisons between the initial five-day and the subsequent two-day demineralization processes were performed by repeated t-test or Wilcoxon (p<0.05) measurements. Results: The amount of HYP released from the dentin samples failed to show significant differences among the groups (p=0.09). Fluoride and chlorhexidine were able to interact with the samples, reducing the progression of dentin caries after removal of the demineralized organic matrix. CHX was the only treatment able to show significant lower lesion depth than the negative control. Conclusion: Chlorhexidine and fluoride were effective in reducing root caries progression

Inovação, Cooperação e Relações entre Empresas: um estudo sobre a construção do Arranjo Produtivo Metalmecânico no Grande ABC

ABSTRACT This article's main goal is to analyze the innovation and cooperation processes, as well as the relationships between companies that take part in the Metal-mechanic Local Productive Arrangement Project at Great ABC Region. The main results, obtained through interviews with three of the Project’s managers and 12 participating businessmen, show that it does not characterize a local productive arrangement under a rigorous concept yet, and its reach and regional representativeness are still limited. The companies involved in this Project share great synergy, trust, cooperation, exchange of information and services between themselves. Their innovation processes are influenced by the market and their insertion form, usually under some big clients’ rules. Their access to new markets is now possible, through collective action, and the cooperation with universities and other supporting entities can help to develop this LPA. Key words: innovation; Great ABC region's metal-mechanic industry; local productive arrangement Classificação JEL: O14, O18, L14 Artigo recebido em jul. 2010 e aceito para publicação em jun. 2012.ENDEREÇOS PARA ENVIO DE PUBLICAÇÃO: Marcos Eduardo Zambanini ESTRADA DAS LÁGRIMAS, 3621 – BLOCO 09 – APTO 133 SÃO JOÃO CLÍMACO – SÃO PAULO – SP CEP 04244-000 Luis Paulo Bresciani AV NHANDU, 528 SAÚDE – SAO PAULO – SP CEP 04059-004 Thais Ettinger Oliveira ALAMEDA BARROS, 66 – APTO 144 SANTA CECÍLIA – SÃO PAULO – SP CEP 01232-000RESUMO O principal objetivo deste artigo reside na análise dos processos de inovação e de cooperação e das relações entre empresas participantes do Projeto APL Metalmecânico do Grande ABC. Os principais resultados, obtidos por meio de entrevista com três gestores do Projeto e 12 empresários participantes, mostram que ainda não se caracteriza um Arranjo Produtivo Local (APL) no rigor do conceito e que seus alcance e representatividade regional são ainda limitados. As empresas participantes desse Projeto APL apresentaram elevada sinergia, confiança, cooperação, troca de informações e de serviços entre si. A inovação é ditada, principalmente, pelo mercado em que atuam e pela sua forma de inserção, normalmente, seguindo as regras de grandes clientes. As empresas visam a novos mercados, praticamente inacessíveis quando isoladas, e a aproximação com universidades e outras entidades de suporte poderá apoiar o desenvolvimento desse APL. Palavras-chave: inovação; indústria metal-mecânica do Grande ABC; arranjo produtivo local

Avaliação clínica de inlays e onlays confeccionadas com dois tipos de cerâmica, após 06 meses

The aim of the present study was to evaluate the clinical performance of two types of ceramics: a slurry-powder ceramic (Duceram Plus, Degussa) - D and a hot-pressed leucite-based glass-ceramic (IPS Empress, Ivoclar Vivadent) - IPS. Eighty-six restorations, 44 IPS and 42 D, were made by one operator. A total of 33 onlays and 53 inlays on twenty-seven premolars and 59 molars were cemented in 35 patients of both sexes, mean age 35 years. All restorations were cemented with the dual-resin cement (Variolink, Ivoclar-Vivadent) under rubber dam and were evaluated at the baseline and after six months, using the modified U.S.P.H.S. criteria for postoperative sensitivity, secondary caries, fracture, color match, marginal discoloration, marginal integrity and surface texture. Additionally radiographs and intraoral photographs were carried out. At baseline 86 restorations were analyzed and all of them received Alfa rating, except for the following that received Bravo rating for postoperative sensitivity - IPS (2.27%); D (7.14%); for color match - IPS (2.27%); D (2.38%) and for surface texture - IPS (2.27%); D (11.90%). After 6 months 100% of the restorations were analyzed and the following received Bravo rating: color match - IPS (4.55%) and D (9.52%); surface texture - IPS (2.27%) and D (11.9%); marginal discoloration - IPS (6.82%) and D (4.76%) and marginal integrity - IPS (4.55%) and D (7.14%). The results were submitted to the Fisher and McNemar Statistical Tests. No significant differences were noticed between the two ceramics. Both ceramics demonstrated satisfactory clinical performance after six months.Este trabalho se propôs a avaliar a performance clínica de dois tipos de cerâmica: IPS Empress, Ivoclar-Vivadent - IPS e Duceram Plus, Degussa - D. Foram realizadas 86 restaurações por apenas um operador, sendo 44 IPS e 42 D. Vinte e sete pré-molares e 59 molares, num total de 33 onlays e 53 inlays, foram cimentadas em 35 pacientes de ambos os sexos, com idade média de 35 anos. A cimentação das restaurações foi realizada com cimento resinoso dual (Variolink, Ivoclar-Vivadent) sob isolamento absoluto e avaliadas no baseline e após 06 meses, mediante o critério U.S.P.H.S. modificado, quanto à sensibilidade pulpar, reincidência de cárie, fratura, reprodução de cor, descoloração marginal, integridade marginal e textura superficial. Adicionalmente foram realizadas radiografias e fotografias. No baseline foi obtida a classificação Bravo nos itens sensibilidade pulpar - IPS (2,27%); D (7,14%); reprodução de cor - IPS (2,27%); D (2,38%) e textura superficial - IPS (2,27%); D (11,90%). Após 06 meses foram analisadas as 86 restaurações, nas quais foi constatada a classificação Bravo para os itens reprodução de cor - IPS (6,82%); D (2,38%); textura superficial - IPS (2,27%); D (9,52%); descoloração marginal - IPS (6,82%); D (4,76%) e integridade de superfície- IPS (4,55%); D (7,14%). Os resultados obtidos foram submetidos ao Teste Estatístico de Fisher e McNemar. Não houve diferença estatisticamente significante entre as cerâmicas. Pode-se concluir que os dois tipos de cerâmica demonstraram uma performance clínica satisfatória após 06 meses

Influence of ultrasonic setting on compressive and diametral tensile strengths of glass ionomer cements

The aim of this study was to assess the influence of ultrasonic wave propagation on the compressive (CS) and diametral tensile (DTS) strengths of glass ionomer cements (GICs). Three variables were evaluated: conventional GICs, ultrasonic excitation and storage time (1 hour, 24 hours and 7 days). Bovine teeth molds were used for simulating a clinical ultrasonic excitation. The data were submitted to three-way ANOVA and Tukey tests (P < 0.05). All the tested conventional GICs presented an increase in strength from 1 hour to 7 days for CS and DTS. Ultrasonic excitation resulted in a statistically significant increase in the CS, but showed no statistically significant difference in the DTS. Regardless the GICs tested the increase in strength was maturation time-dependent for all groups

Es el reimplante valvular mejor que el bentall biológico modificado para tratar aneurismas de la raíz asociados a insuficiencia?

Es el reimplante valvular mejor que el Bentall Biológico Modificado para tratar aneurismas de la raíz asociados a insuficiencia? Obando CE; Gutiérrez HF; Santamaría G, Bresciani R; Camacho J; Sandoval N; Umaña J. Departamento de Cirugía Cardiovascular, Fundación Cardio Infantil, Bogotá, Colombia. Objetivo: comparar resultados funcionales, morbilidad y sobrevida a corto y mediano plazo, tras la realización de Bentall modificado con prótesis Freestyle vs reimplante valvular de Tirone David, en insuficiencia aortica secundaria a aneurisma de la raíz. Diseño: revisión de registros institucionales de 88 pacientes tratados entre enero de 2003 y agosto de 2009 con insuficiencia aortica secundaria a aneurisma de la raíz sin daño valvular, distribuidos en dos cohortes: Grupo 1 (Bentall modificado) y Grupo 2 (reimplante valvular). Se evaluaron complicaciones perioperatorias, transfusiones, estancias hospitalarias y en el seguimiento a mediano plazo insuficiencia valvular, clase funcional, función ventricular y sobrevida. Solidez de los resultados verificada mediante análisis de propensidad con balanceo de grupos. Resultados: Grupo (1) 51(57.9%) pacientes y grupo (2) 37(42.1%). Aunque el grupo 2 es mas joven, patrones similares de coomorbilidad, anatomía de la raíz, función y diámetros ventriculares hacen comparables los dos grupos. Seguimiento de 3.3 años (IQR 2.0-4.4). Mortalidad temprana 2(3.8%) vs 0 p =0.2 y tardía de 2(4.1%) vs 0 p=0.33. El análisis estratificado de covariables en bloques de distribución tampoco identifica diferencias en mortalidad. El análisis de sobrevida de mortalidad y sobrevida libre de eventos identifica desenlaces similares entre los grupos (Log-Rank chi2=0.9, p=0.3); incluyendo Insuficiencia aortica = II temprana (3.8% vs 0, p=0.2) y tardía (3.8%vs 0, p=0.1), transfusiones perioperatorias, reintervenciones por sangrado (2.3% vs 3.4%, p=0.4), arritmias (25.5% vs 13.5%, p=0.2) y disfunción neurológica (5.7% vs 2.9%, p=0.9). Finalmente la hospitalización total (6.5 {1-35} vs 4{3-16} p=0.001) y estancia en Cuidado intensivo (2.5 {1-21} vs 1{1-16} p=0.001) es superior en el grupo1. Conclusiones: el tratamiento de los aneurismas de la raíz aortica asociados a insuficiencia valvular sin daño estructural, mediante reimplante valvular o Bentall biológico modificado ofrece resultados similares a corto y mediano plazo. La preservación valvular se asocia a estancias mas cortas, pero no hay diferencia en complicaciones postoperatorias, estatus funcional, insuficiencia valvular, función ventricular, mortalidad y sobrevida libre de eventos adversos.Compare functional results, Morbility and median and short term survival, after modified Bentall procedure with Freestyle valve vs. Valvular Reimplantation Tirone David, for the aortic valve insufficiency secondary to aortic root aneurysm. DESIGN: Revision of institutional registers of 88 patients treated from January 2003 to august 2009 with aortic insufficiency secondary to aortic root aneurysm without valve damage, distributed in two cohorts: Group 1 (Modified Bentall), Group 2 (Valvular Reimplantation). Perioperative complications were evaluated as well as transfusions, hospitalization days, median term observation for valve insufficiency, functional class, ventricular function and survival. The solidity of the results were verified by propensity analysis with balance of groups. RESULTS: Group (1) 51(57.9%) patients and group (2) 37(42.1%). Although group 2 is younger, similar patterns of comorbility, aortic root anatomy, function and ventricular diameters of both groups make them comparable. Follow up for 3.3 years (IQR 2.0-4.4). Early Mortality 2(3.8%) vs. 0 p =0.2 and late 2(4.1%) vs. 0 p=0.33. The analysis of stratified co variables in blocks of distribution does not identify differences in mortality. The analysis of survival of mortality and survival free of events identifies similar results between the groups (Log-Rank chi2=0.9, p=0.3); including aortic insufficiency = II early (3.8% vs. 0, p=0.2) and late (3.8%vs 0, p=0.1), perioperative transfusions, reinterventions by bleeding (2.3% vs. 3.4%, p=0.4), arrhythmias (25.5% vs. 13.5%, p=0.2), and neurologic dysfunction(5.7% vs. 2.9%, p=0.9). Finally total hospitalization (6.5 {1-35} vs. 4{3-16} p=0.001) and Intensive care staying (2.5 {1-21} vs. 1{1-16} p=0.001) is superior in group 1. CONCLUSIONS: The treatment of aortic root aneurysm associated to aortic valve insufficiency without structural damage, with valve reimplantation or Modified Bentall (Biological) offers similar results. Valve preservation is associated to shorter hospitalization stay, but there is no difference in post operative complications, functional status, valve insufficiency, ventricular function, mortality, and survival free of adverse events