A Hidden Complication of Pigtail Catheter Insertion

Pigtail catheters have emerged as an effective and less morbid alternative to traditional chest tubes for evacuation of pleural air. Rare complications in the literature have been reported. We report a case of a 92-year-old male who presented with dyspnea and shock, noted to have a pneumothorax requiring tube thoracostomy. Computed tomography demonstrated pigtail within the lung parenchyma. We discuss the implications of this occurrence

Adesão de brackets ortodônticos a superficies acrílicas. Uma revisão sistemática sobre estudos in vitro

Supplementary content Supplementary data associated with this article can be found, in the online version, at http://doi.org/10.24873/j.rpemd.2017.07.020.Objectives: The aim of this study was to systematically review the available literature about in vitro orthodontic bond strength tests regarding bonding brackets to acrylic teeth. Methods: A comprehensive electronic database search with no date or language limits was conducted. Relevant studies were selected based on predefined criteria: in vitro investigation on the shear/tensile bond strength of brackets evaluated and expressed in megapascals and/or considering the adhesive remnant index; and studies with a clear explanation of the bonding technique/protocol, bonding materials and type of surface acrylic material used. Results: 2044 published articles were presented by the four databases. Of the studies collected from all the databases, 28 based on their title and 14 based on their abstract, only 10 studies fulfilled the selection criteria after being examined twice by the two reviewers. Conclusion: The type of surface noticeably influenced the adhesion, and surface treatments should be performed to improve bond strength. (Rev Port Estomatol Med Dent Cir Maxilofac. 2017;58(2):65-70)Objetivos: O objetivo deste estudo foi efetuar uma revisao sistematica da literatura sobre testes in vitro de resistencia a adesao entre brackets ortodonticos e dentes acrilicos. Métodos: Foi realizada uma pesquisa abrangente em bases electronicas, sem limites de data ou idioma. Os estudos relevantes foram selecionados com base nos seguintes criterios pre-definidos: investigacao in vitro sobre resistencia ao cisalhamento/tracao dos brackets avaliada e apresentada em megapascais e/ou considerando o indice de adesivo remanescente; estudos com explicacao clara da tecnica/protocolo de adesao, adesivos e tipo de material acrilico das superficies. Resultados: dos 2044 artigos publicados apresentados pelas quatro bases de dados electronica, 28 foram selecionados com base no titulo e 14 com base no resumo. Apenas 10 obedeceram aos criterios definidos e foram incluidos apos analise por dois revisores, duas vezes. Conclusão: O tipo de superficie parece influenciar a adesao e o tratamentos destas deve ser realizado para melhorar a adesao. (Rev Port Estomatol Med Dent Cir Maxilofac. 2017;58(2):65-70)The author M.C. Manso acknowledges Fundacao para a Ciencia e a Tecnologia through grant UID/Multi/04546/2013 and UID/QUI/50006/2013 – POCI/01/0145/FERDER/007265

Root canal disinfection and maintenance of the remnant tooth tissues by using grape seed and cranberry extracts

The purpose of this study was to perform an integrative review on the effects of cranberry and grape seed extracts concerning the disinfection of root canals maintaining the strength of the remnant tooth tissues' structure. A bibliographical search was carried out on the PubMed electronic platform using the following key terms: cranberry, grape seed, vaccinium macrocarpon, proanthocyanidin, antibacterial, antimicrobial, decontamination, disinfection, bacteria removal, bacteria eradication, bacteria elimination, endodontic, root canal, faecalis, and strength. The inclusion criteria involved articles published in the English language, until March, 2022, reporting the antibacterial effect of grape seed and cranberry extracts. Of 185 studies identified, 13 studies were selected for the present review. The grape seed extract (GSE), composed of proanthocyanidins, showed an antioxidant activity against the main bacteria found in endodontic secondary infection. The percentage of bacteria removal was recorded at around 96.97% by using GSE. Studies on cranberry extracts, which are composed of proanthocyanidins, revealed antimicrobial effects against bacteria related to periodontitis and dental caries. Additionally, GSE or cranberry allowed the dentin collagen cross-linking that preserved the 3D collagen network leading to the maintenance of the strength of the remnant tooth structure. However, the contaminated smear layer could not be removed by using only GSE or cranberry. Cranberry extracts and GSE revealed a significant antimicrobial activity in endodontic disinfection without changing the mechanical properties of the remnant dentin tissues. Furthermore, those components can be associated with traditional compounds to enhance their antimicrobial effects and eliminate the smear layer

Contamination of resin-matrix composites on chairside handling using latex or nitrile gloves: an in vitro study

The aim of this study was to evaluate the efect of diferent gloves and clinical environment on the contamination of resinmatrix composites for restorative dentistry. Specimens of nano-hybrid resin-matrix composite (n=6) were divided in groups regarding the handling with (A) clinical spatula; (B) latex gloves; (C) latex or (D) nitrile gloves with human saliva; (E) latex or (F) nitrile gloves with human blood. After light curing, groups of specimens were analyzed by optical microscopy at magnifcation ranging from x30 up to x500 and by scanning electron microscopy at diferent magnifcation ranging from x50 up to x8000. Handling of resin-matrix composites with unpowdered nitrile gloves or clinical spatulas avoided the presence of contaminants. However, agglomerates of the resin-matrix composite itself became entrapped leading to a heterogenous morphological aspect. SEM images revealed the presence of corn-derived starch released from the powdered gloves. Also, the formation of micro-spaces (voids) occurred after handling with powdered latex gloves. Specimens handled with both type of gloves contaminated with saliva showed a conditioning layer composed of glycoproteins rolls and compounds including calcium-based chlorides, phosphates, and carbonates. Also, blood products were transferred from the contaminated gloves to the resin-matrix composites after handling. Thus, resin-matrix composite restorations are susceptible to contamination with debris from powdered gloves. Also, saliva or blood debris become adsorbed and entrapped in the resin-matrix composites during clinical handling leading to the presence of defects such macro- and micro-scale voids or contaminant agglomerates.info:eu-repo/semantics/publishedVersio

A comprehensive review on the corrosion pathways of titanium dental implants and their biological adverse effects

The main aim of this work was to perform a comprehensive review of findings reported by previous studies on the corrosion of titanium dental implants and consequent clinical detrimental effects to the patients. Most studies were performed by in vitro electrochemical tests and complemented with microscopic techniques to evaluate the corrosion behavior of the protective passive oxide film layer, namely TiO2. Results revealed that bacterial accumulation, dietary, inflammation, infection, and therapeutic solutions decrease the pH of the oral environment leading to the corrosion of titanium. Some therapeutic products used as mouthwash negatively affect the corrosion behavior of the titanium oxide film and promote changes on the implant surface. In addition, toothpaste and bleaching agents, can amplify the chemical reactivity of titanium since fluor ions interacting with the titanium oxide film. Furthermore, the number of in vivo studies is limited although corrosion signs have been found in retrieved implants. Histological evaluation revealed titanium macro- and micro-scale particles on the peri-implant tissues. As a consequence, progressive damage of the dental implants and the evolution of inflammatory reactions depend on the size, chemical composition, and concentration of submicron- and nanoparticles in the surrounding tissues and internalized by the cells. In fact, the damage of the implant surfaces results in the loss of material that compromises the implant surfaces, implant-abutment connections, and the interaction with soft tissues. The corrosion can be an initial trigger point for the development of biological or mechanical failures in dental implants.This study was supported by FCT-Portugal (UID/EEA/04436/2013, NORTE-01-0145-FEDER- 000018– HAMaBICo, POCI-01-0145-FEDER-031035_LaserMULTICER) and CNPq-Brazil (CNPq/UNIVERSAL/421229/2018-7

Tooth-derived matrix granules for enhanced bone healing: chemical composition, morphological aspects, and clinical outcomes

Bone grafting has increasingly been used in surgical procedures for enhanced bone augmentation. Tooth-derived graft material has received considerable attention due to its chemical composition and autogenous source that can improve bone tissue healing. The main aim of this study was to provide a short and comprehensive review on the chemical composition, morphological aspects, and clinical outcomes of bone grafting using tooth-derived matrix granules. Dentin tissue has a chemical composition similar to that on bone tissues regarding the presence of hydroxyapatite, type I collagen, and different growth factors. Dentin-matrix granules are often processed at well-controlled size ranging from approximately 300 up to 1300 µm, while maintaining porosity and organic content. In addition, a dense collagen fiber network is still present after the milling and chemical treatment of dentin granules. Thus, dentin-matrix granules can improve the bone healing process considering their chemical composition, porous structure, and adequate size. However, further in vivo and in vitro studies should be performed taking into consideration different demineralization procedures, remnant organic content, porosity, and granule size.This study was supported by the Portuguse Foundation for Science and Technology (FCT) (POCI-01-0145-FEDER-031035_LaserMULTICER), SFRH/BPD/123769/ 2016, and CNPq-Brazil (CNPq/UNIVERSAL/421229/2018-7)

Effect of inorganic fillers on the light transmission through traditional or flowable resin-matrix composites for restorative dentistry

Objectives: The aim of this in vitro study was to evaluate the light transmission through five different resin-matrix composites regarding the inorganic filler content. Methods: Resin-matrix composite disc-shaped specimens were prepared on glass molds. Three traditional resin-matrix composites contained inorganic fillers at 74, 80, and 89 wt. % while two flowable composites revealed 60 and 62.5 wt. % inorganic fillers. Light transmission through the resin-matrix composites was assessed using a spectrophotometer with an integrated monochromator before and after light curing for 10, 20, or 40s. Elastic modulus and nanohardness were evaluated through nanoindentation’s tests, while Vicker’s hardness was measured by micro-hardness assessment. Chemical analyses were performed by FTIR and EDS, while microstructural analysis was conducted by optical microscopy and scanning electron microscopy. Data were evaluated using two-way ANOVA and Tukey’s test (p < 0.05). Results: After polymerization, optical transmittance increased for all specimens above 650-nm wavelength irradiation since higher light exposure time leads to increased light transmittance. At 20- or 40-s irradiation, similar light transmittance was recorded for resin composites with 60, 62, 74, or 78–80 wt. % inorganic fillers. The lowest light transmittance was recorded for a resin-matrix composite reinforced with 89 wt. % inorganic fillers. Thus, the size of inorganic fillers ranged from nano- up to micro-scale dimensions and the high content of micro-scale inorganic particles can change the light pathway and decrease the light transmittance through the materials. At 850-nm wavelength, the average ratio between polymerized and non-polymerized specimens increased by 1.6 times for the resin composite with 89 wt. % fillers, while the composites with 60 wt. % fillers revealed an increased ratio by 3.5 times higher than that recorded at 600-nm wavelength. High mean values of elastic modulus, nano-hardness, and micro-hardness were recorded for the resin-matrix composites with the highest inorganic content. Conclusions: A high content of inorganic fillers at 89 wt.% decreased the light transmission through resin-matrix composites. However, certain types of fillers do not interfere on the light transmission, maintaining an optimal polymerization and the physical properties of the resin-matrix composites. Clinical significance: The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization mode. As a consequence, the clinical performance of resin-matrix composites can be compromised, leading to variable physical properties and degradation. Graphical Abstract: [Figure not available: see fulltext.].info:eu-repo/semantics/publishedVersio

Correlação entre o conteúdo inorgânico e a polimerização da matriz orgânica das resinas compostas para restaurações dentárias: uma revisão narrativa

Introduction: In recent years, resin-matrix composite materials have revealed a fast technological improvement for dental applications. However, there are still some drawbacks related to the chemical composition, polymerization, and mechanical properties of resin-matrix composites with consequences in long-term clinical success. Objective: This study aimed to perform a narrative review regarding the effects of inorganic fillers on the organic matrix polymerization of resin-matrix composites. Materials and Methods: A search was performed in PubMed using relevant related key terms related to the chemical composition, properties and polymerization of resin matrix composites. Relevant studies published between 2001 and 2021 were selected. Results: The studies included in the present research provided relevant information on the chemical composition and properties of resin composites and polymerization factors, including the time, wavelength mode, and equipment. Studies have reported that silica and silicate nano-scale particles improve light transmission through resin-matrix composites and the degree of conversion of monomers in the organic matrix. Micrometric particles with a high refractive index can decrease the degree of conversion of monomers in the organic matrix. Conclusion: The polymerization of resin-matrix composites is affected by light scattering due to the type of inorganic particles and the differences in refractive indexes of inorganic and organic contents.Introdução: Nos últimos anos, as resinas compostas têm sido melhoradas em termos tecnológicos, permitindo o alcance de melhores prognósticos na medicina dentária. Entretanto, subsistem algumas limitações relacionadas com a composição química e as propriedades das resinas compostas com consequências no sucesso clínico a longo prazo. Objetivo: O objetivo deste trabalho foi realizar uma revisão narrativa sobre a influência da componente inorgânica na polimerização da matriz orgânica das resinas compostas usadas para restauração dentária. Materiais e Métodos: A pesquisa foi realizada na plataforma PubMed utilizando termos de pesquisa relacionados com a composição química, propriedades e a polimerização das resinas compostas, para seleção de artigos relevantes ao tema. Resultados: Os estudos identificados reportam diferentes fatores relacionados com a polimerização incluindo modo, tempo, equipamento e a composição química das resinas compostas. Os estudos indicam que partículas nanométricas à base de sílica ou silicatos promovem uma maior transmissão de luz à matriz orgânica o que favorece a polimerização do material. Por outro lado, partículas micrométricas com um alto índice de refração podem diminuir o grau de conversão dos monómeros da matriz orgânica. Conclusão: A polimerização das resinas compostas é afetada pela dispersão da luz, devido ao tamanho das partículas inorgânicas e aos índices de refração da componente orgânica e inorgânica. De fato, um maior controlo da composição química e do tamanho de partículas inorgânicas aumenta o grau de polimerização das resinas compostas

Aprendizagem de leitura por meio de um procedimento de discriminação sem erros (exclusão):: Uma replicação com pré-escolares

The present study investigated, with three preschoolers,the acquisition of reading (oral naming of textual stimuli) through ateaching program in which an exclusion procedure was embebed in orderto increase a repertoire of matching written words to spoken words. Theteaching program, which combines exclusion tasks, and equivalence andgeneralization tests, had been previously designed and evaluated. In theexclusion trials, two written words were simultaneously presented to thesubject; one was a new word and the other was a word that the subjecthad already learned to match to the corresponding spoken word. Thesubject was asked to point to the printed word corresponding to the wordspoken by the experimenter (oral sample). When the experimenterdictated the new word, the known word could function as a cue based onwhich the subject would reject the known word and select the new one.The teaching program involved the expansion of this matching repertoire,and evaluated 1) if the subject would leam to name the words previouslymatched. when presented with the printed stimulus alone, and 2) if hewould become able to present generalized reading when exposed to newwords composed by the rearrangement of syllables from the learnedwords. The results replicated previous studies with students with a history ofacademic failure: the subjects learned to read the training words andbegan to present generalized reading along the program. The occurrenceof generalized reading indicates that the subjects dominated themechanisms of analysis and synthesis involved in reading, that is, theirtextual behavior carne under the contrai of textual minimal units. Also, thespeed of generalization seems to be related to the amount of trainingrequired for the emergence of the reading of paired words. These resultsextend the generality of data on the effects of the exclusion procedure,establishing stimulus contrai by textual minimal units also with preschoolerswho did not have any experience with formal teaching of reading.O estudo investigou, com três pré-escolares, a aquisição de leitura por meio de um programa individualizado de ensino que emprega o procedimento de exclusão para ampliar o repertório de discriminações condicionais entre palavras ditadas (modelos) e palavras impressas (estímulos de escolha ou comparações). O programa, desenvolvido em um estudo prévio, combina passos de exclusão com testes de equivalência e de generalização. Nas tentativas de pareamento por exclusão, duas palavras impressas eram apresentadas simultaneamente ao sujeito: uma era uma palavra nova e a outra era uma palavra que o sujeito já havia aprendido a relacionar à palavra ditada correspondente. A tarefa do sujeito consistia em apontar a palavra impressa que correspondesse à palavra falada pelo experimentador (modelo oral); neste caso, quando a palavra nova era ditada, o sujeito podia excluir a palavra já conhecida, usando-a como pista para selecionar a palavra impressa nova. Pretendia-se verificar se, também com esta população, a expansão deste repertório de pareamentos favoreceria a aprendizagem de leitura (das palavras de treino) e sua generalização (diante de outras palavras, formadas por recombinações de sílabas contidas nas palavras já aprendidas). Os resultados replicaram os de estudos anteriores (com alunos que já tinham uma história académica mal-sucedida): os sujeitos aprenderam a ler as palavras de treino e passaram a apresentar leitura generalizada no decorrer do programa. A ocorrência de leitura generalizada indica que os sujeitos dominaram os mecanismos de análise e síntese envolvidos na leitura, isto é, seu comportamento textual passou a ser controlado por unidades textuais mínimas. Os dados indicam também que parece haver uma relação entre&nbsp;a dificuldade de aprender a ler as palavras de treino e a rapidez da generalização. Estes resultados estendem a generalidade dos efeitos do procedimento de exclusão no estabelecimento de controle de estímulos por unidades textuais mínimas para uma população ainda não exposta ao ensino formal de leitura

Microscopic inspection of the adhesive interface of composite onlays after cementation on low loading: an in vitro study

Purpose: This study aimed to assess the layer thickness and microstructure of traditional resin-matrix cements and flowable resin-matrix composites at dentin and enamel to composite onlay interfaces after cementation on low loading magnitude. Materials and Methods: Twenty teeth were prepared and conditioned with an adhesive system for restoration with resin-matrix composite onlays manufactured by CAD-CAM. On cementation, tooth-to-onlay assemblies were distributed into four groups, including two traditional resin-matrix cements (groups M and B), one flowable resin-matrix composite (group G), and one thermally induced flowable composite (group V). After the cementation procedure, assemblies were cross-sectioned for inspection by optical microscopy at different magnification up to ×1000. Results: The layer thickness of resin-matrix cementation showed the highest mean values at around 405 µm for a traditional resin-matrix cement (group B). The thermally induced flowable resin-matrix composites showed the lowest layer thickness values. The resin-matrix layer thickness revealed statistical differences between traditional resin cement (groups M and B) and flowable resin-matrix composites (groups V and G) (p < 0.05). However, the groups of flowable resin-matrix composites did not reveal statistical differences (p < 0.05). The thickness of the adhesive system layer at around 7 µm and 12 µm was lower at the interfaces with flowable resin-matrix composites when compared to the adhesive layer at resin-matrix cements, which ranged from 12 µm up to 40 µm. Conclusions: The flowable resin-matrix composites showed adequate flowing even though the loading on cementation was performed at low magnitude. Nevertheless, significant variation in thickness of the cementation layer was noticed for flowable resin-matrix composites and traditional resin-matrix cements that can occur in chair-side procedures due to the clinical sensitivity and differences in rheological properties of the materials.info:eu-repo/semantics/publishedVersio