Procedure associations’ for esthetic resolution of discolored and endodontically treated tooth

Objective: The aim of this study was to present the clinical treatment performed in order to solve an aesthetic problem resulting from a color change of the upper central incisor (21) endodontically treated and with an unsatisfactory composite resin restoration. Case description: After anamnesis, clinical and radiographic examination was performed the dental bleaching of the tooth 21. The bleaching agents (sodium perborate and/ or hydrogen peroxide) were used in different application techniques: intracoronal and external; “waking bleach” and “in-office” bleaching. For the indication and treatment’s prognosis were considered: quantity and quality of the dental tissue, quality of endodontic treatment and time of chromatic alteration reported by the patient. After the bleaching sessions, the result obtained was not satisfactory in front of the patient’s wishes. Thus, a direct composite resin restoration was performed. Conclusion: Considering the clinical outcomes achieved it can be concluded that the dental bleaching, although conservative to the dental structures, was not effective in order to solve the color change. Besides, direct composite resin restoration, although less conservative, was satisfactory to solve the aesthetic problem and it has been effective after two years of follow-up.Objetivo: Relatar e discutir o tratamento realizado para solucionar o problema estético decorrente da alteração cromática do incisivo central superior esquerdo (21), tratado endodonticamente e com restauração insatisfatória de resina composta. Relato do caso: Agentes clareadores à base de perborato de sódio e/ou peróxido de hidrogênio foram utilizados em técnicas intra e extracoronária, imediata e mediata. Após as sessões de clareamento dentário, o resultado obtido não foi satisfatório frente aos anseios do paciente, fato que justificou a substituição da restauração em resina composta com recobrimento da face vestibular (faceta direta). Conclusão: Considerando os resultados clínicos obtidos, pôde-se concluir que o clareamento dentário, embora conservador às estruturas dentárias, não foi efetivo à resolução do problema decorrente da alteração cromática. Por sua vez, o desgaste da face vestibular e posterior restauração direta com resina composta, embora menos conservador, foi satisfatório para solucionar o problema estético e se mostra efetivo após dois anos de controle clínico

Reabilitação de fratura coronária a partir da técnica restauradora direta / Rehabilitation of coronary fracture from the direct restoration technique

O traumatismo dental pode atingir diferentes estruturas como dentes, periodonto e tecidos moles adjacentes, além de ser uma lesão comum em nossa sociedade. Propõe-se com este trabalho a apresentação de uma reabilitação estética e funcional nos dentes 11, 12 e 21 com fraturas coronárias de esmalte e dentina a partir da técnica restauradora direta, com auxílio de enceramento diagnóstico e guia de silicone em paciente pediátrico, envolvido em acidente ciclístico. Juntamente com uma revisão de literatura que salienta cada passo para a conclusão deste caso clínico, onde os resultados estético e funcional obtidos foram considerados altamente satisfatórios para o paciente, familiares e operadores

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A Novel Wearable Foot and Ankle Monitoring System for the Assessment of Gait Biomechanics

Walking is the most basic form of human activity for achieving mobility. As an essential function of the human body, the examination of walking is directed towards the assessment of body mechanics in posture and during movement. This work proposes a wearable smart system for the monitoring and objective evaluation of foot biomechanics during gait. The proposed solution assumes the cross-correlation of the plantar pressure with lower-limb muscular activity, throughout the stance phase of walking. Plantar pressure is acquired with an array of resistive pressure sensors deployed onto a shoe insole along the center of gravity progression line. Lower-limb muscular activity is determined from the electromyogram of the tibialis anterior and gastrocnemius lower limb muscles respectively. Under this scenario, physiological gait assumes the interdependency of plantar pressure on the heel area with activation of the tibialis anterior, as well as plantar pressure on the metatarsal arch/toe area with activation of the gastrocnemius. As such, assessment of gait physiology is performed by comparison of a gait map, formulated based on the footprint–lower-limb muscle cross-correlation results, to a reference gait template. A laboratory proof of concept validates the proposed solution in a test scenario which assumes a normal walking and two pathological walking patterns

Identification of DNA markers linked to novel yellow rust resistance genes introgressed from Triticum dicoccoides

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Identification of molecular markers linked to the Yr15 stripe rust resistance gene of wheat originated in wild emmer wheat, Triticum dicoccoides

vokEripainoksia saatavissa tekijöiltä. Yksikön huom.: KJ

Evaluation of marker-assisted selection for the stripe rust resistance gene Yr15, introgressed from wild emmer wheat.

Stripe rust disease is caused by the fungus Puccinia striiformis f. sp. tritici and severely threatens wheat worldwide, repeatedly breaking resistance conferred by resistance genes and evolving more aggressive strains. Wild emmer wheat, Triticum dicoccoides, is an important source for novel stripe rust resistance (Yr) genes. Yr15, a major gene located on chromosome 1BS of T. dicoccoides, was previously reported to confer resistance to a broad spectrum of stripe rust isolates, at both seedling and adult plant stages. Introgressions of Yr15 into cultivated T. aestivum bread wheat and T. durum pasta wheat that began in the 1980s are widely used. In the present study, we aimed to validate SSR markers from the Yr15 region as efficient tools for marker-assisted selection (MAS) for introgression of Yr15 into wheat and to compare the outcome of gene introgression by MAS and by conventional phenotypic selection. Our findings establish the validity of MAS for introgression of Yr15 into wheat. We show that the size of the introgressed segment, defined by flanking markers, varies for both phenotypic selection and MAS. The genetic distance of the MAS marker from Yr15 and the number of backcross steps were the main factors affecting the length of the introgressed donor segments. Markers Xbarc8 and Xgwm493, which are the nearest flanking markers studied, were consistent and polymorphic in all 34 introgressions reported here and are therefore the most recommended markers for the introgression of Yr15 into wheat cultivars. Introgression directed by markers, rather than by phenotype, will facilitate simultaneous selection for multiple stripe rust resistant genes and will help to avoid escapees during the selection process

Evaluation of marker-assisted selection for the stripe rust resistance gene Yr15, introgressed from wild emmer wheat

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