Resistencia a fratura de pre-molares restaurados com amalgama : efeito de bases adesivas

Orientador: Jose Roberto LovadinoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: o objetivo do trabalho foi estudar a resistência à fratura de pré-molares inferiores em função da colocação de bases adesivas. Para isso, 84 dentes extraídos, íntegros e livres de trincas ou manchas, foram divididos, aleatoriamente, em sete grupos de doze dentes. Os dentes do grupo 1 não receberam preparo nem restauração. No grupo 2, os dentes receberam um preparo MOD, sem caixas proximais e com o assoalho plano, de largura correspondente a 1/4 da distância intercuspidal e de profundidade correspondente a 3/8 da altura da coroa. As amostras pertencentes a esse grupo não foram restauradas. Os dentes dos grupos 3 ao 7 receberam o mesmo tipo de preparo, porém com a profundidade correspondente a 3/4 da altura da coroa dental, sendo que os do grupo 3 não foram restaurados e os dos grupos de 4 a 7 foram restaurados, respectivamente, com: amálgamaadesivo; base de cermet + amálgama; base de CIV híbrido + amálgama; base de resina composta + amálgama. Todos os grupos foram submetidos a teste de resistência à compressão em máquina universal de ensaios. A carga foi aplicada axialmente através de uma esfera de aço posicionada de maneira a manter contato apenas com as vertentes das cúspides e nunca com as restaurações ou as margens das cavidades. As médias das cargas necessárias para fraturar as amostras de cada grupo foram (em kg): G1 =130,24 ; G2=45,45; G3=22,33; G4=65,62; G5=47,05; G6=57,03; G7=120,62. A análise estatística dos resultados, através do Teste de Tukey, demonstrou diferenças estatisticamente significantes entre alguns grupos. O grupo 1 foi o que demonstrou os maiores resultados, sendo igualado, estatisticamente, apenas pelo grupo 7. Os grupos 4, 5 e 6 não demonstraram diferença estatística entre si e, embora não tenham conseguido recuperar totalmente a resistência perdida, apresentaram diferença significante em relação ao grupo 3. O grupo 4 apresentou superioridade ainda sobre o grupo 2, o que não foi conseguido pelos grupos 5 e 6Abstract: The aim of this study was to evaluate the fracture resistance of premolars with MOD cavities preparations, restored with amalgam and with different materiais used as liners. Eight four sound and free from cracks extracted mandibular premolars were randomly assingned to seven groups of twelve teeth. The teeth from group 1 did not receive either cavity preparation or restoration. In the group 2, the teeth received a MOD cavity preparation without proximal steps and flat floor. The preparation had the isthmus width equal to 1/4 of the intercuspidal distance and the cavity deep was 3/8 of the crown height. Teeh from this group were not restored. The cavity preparation in the teeth from group 3 to 7 was the same, but the deep was doubled. Teeth from group 3 were not restored and from group 4 to 7 were restored respectively with: bonded-amalgam; cermet lining + amalgam; GIC modified lining + amalg'am; composite resin lining + amalgam. Ali groups were submitted to fracture resistance test in a universal test machine. The load was applied vertically through a metalic sphere of 4,5 mm diameters positioned to touch only the cusps and never the restorations or margins of cavities. The mean load necessary to fracture the samples in each group were (in kg): G1=130,24 ; G2=45,45; G3=22,33; G4=65,62; G5=47,05; G6=57,03; G7=120,62. These data were submitted to Tukey's test that demonstrated diferences among some groups. Group 1 showed the best results Equaled??? just by group 7. The group 4, 5 and 6 were not different among them and, although they did not recover totally the resistance lost, they showed a significant diference compared to group 3. Group 4 showed better results than group 2, the same was not reached by groups 5 and 6MestradoDentísticaMestre em Clínica Odontológic

Light delivery and light dosimetry for photodynamic therapy of bronchogenic carcinoma

Photodynamic tllel'apy (PDT) is a treatment modality for malignant (and benign) diseases that combines administration of a chemical compound (photosensitiser) and irradiation with (visible) light of the proper wavelength and fluence to induce tissue necrosis. The mechanisms by. which PDT induces cell death are not yet fully understood. The basic principle is that the iIIumination of the sensitiser causes excitation of the oxygen present in the tissue to the very reactive singlet state that induces damage to the tissue. The oxygen supply in the treated tissue is therefore of paramount importance for the final damage induced. Two types of damage are thought to be most important for the induced necrosis. Firstly, important (tumour)cell structures such as mitochondrial and cellular membranes are damaged with consequent direct cell death. Secondly, through damage of the endothelium of the blood vessels vascular stasis occurs which causes tissue damage as a secondary process

Evaluation of elementary education teachers’ knowledge on avulsion and tooth replantation

Introduction: Dental trauma care emergency is very important issue, especially in cases of avulsion and it is crucial for the prognosis. A preventive-educational approach had not been effective and there are many failures in handling dental trauma, mainly by lack of knowledge by health professionals, teachers and lay people. Objective: The aim of this study was to assess the knowledge of 89 teachers about dental trauma. Material and methods: A questionnaire divided into three parts containing questions about the emergency procedures in cases of dental trauma was applied. Results: Only 13% of teachers would replant the tooth in the socket, and only 7% said they would put the tooth in some liquid and 58% would store in a piece of paper, cloth or clean container. In relation to replantation, 75% reported that they would hold the tooth by the crown, 79% reported that first they would refer to the dentist, and 80% thought that the treatment had to be immediate. With regard to tooth preparation, 46% would keep it in saline, 24% in water, and only 11% in milk. Concerning to the avulsed tooth, only 15% correctly answered that they would replant the avulsed tooth and then referred to the dentist. Conclusion: It was concluded that the knowledge of teachers must be improved by educational and preventive campaigns on management of traumatized teeth

Diagnóstico e Manejo da Ansiedade Odontológica pelos Cirurgiões-Dentistas

O trabalho verifica o conhecimento e a prática profissional relacionados às formas de diagnóstico e manejo da ansiedade odontológica pelos cirurgiões-dentistas. Os profissionais preencheram um questionário autoaplicável sobre diagnóstico e tratamento da ansiedade odontológica. No total, 967 cirurgiões-dentistas responderam ao questionário, dos quais aproximadamente 65% relataram fazer algum tipo de avaliação da ansiedade. Nenhum participante relatou utilizar técnicas semiobjetivas do tipo questionário estruturado. Aproximadamente 32% dos profissionais relataram utilizar um protocolo específico para a abordagem do paciente ansioso, sendo os mais utilizados a conversa (38%), a prescrição farmacológica (23%) ou algum tipo de condicionamento do paciente (17%). O trabalho discute a importância de incorporar no ensino da odontologia conhecimentos advindos da psicologia, favorecendo o desenvolvimento de habilidades relacionadas ao diagnóstico e o manejo da ansiedade odontológica.This work verifies the knowledge and use of psychometric scales and cognitive-behavioral techniques by dentists. Professionals completed a self-administered questionnaire on diagnosis and treatment of dental anxiety. The number of participants was 967 dentists of which approximately 65% reported making some type of anxiety assessment. No participant reported using semi-objective techniques of assessment. Approximately 32% of professionals reported using a specific protocol for addressing the anxious patient, the most utilized were conversation (38%), drug prescription (23%) or some kind of conditioning of the patient (17%). The paper discusses the importance of incorporating the teaching of psychological knowledge on dental education, favoring the development of skills related to the diagnosis and management of dental anxiety

Clinical strategies for managing emergency endodontic pain

Pulpal and periradicular pain is leading cause of emergency care demand. Literature review: Pain management in endodontics includes important aspects for its control and prevention, such as reducing anxiety and preoperative pain, control of intra-operative pain and the treatment of postoperative pain. These review pointed out some important measures that may be the key for the effectiveness control and prevention of pain in endodontic procedures. One of the effective strategies currently used in these cases is structured to evaluate the painful condition through a 3-D approach which establish a differential diagnosis, definitive treatment, and rational use of drugs, based on the most appropriate scientific evidence available in the literature

Photodynamic therapy as adjuvant therapy in surgically treated pleural malignancies.

Five patients with a pleural malignancy (four malignant mesotheliomas and one localized low grade carcinoid) were treated with maximal surgical resection of the tumour followed by intraoperative adjuvant photodynamic therapy (PDT). The additional photodynamic treatment was performed with light of 652 nm from a high power diode laser, and meta-tetrahydroxy phenylchlorin as the photosensitizer. The light delivery to the thoracic cavity was monitored by in situ isotropic light detectors. The position of the light delivery fibre was adjusted to achieve optimal light distribution, taking account of reflected and scattered light in this hollow cavity. There was no 30-day post-operative mortality and only one patient suffered from a major complication (diaphragmatic rupture and haematopericardium). The operation time was increased by a maximum of 1 h to illuminate the total hemithoracic surface with 10 J cm(-2) (incident and scattered light). The effect of the adjuvant PDT was monitored by examination of biopsies taken 24 h after surgery under thoracoscopic guidance. Significant damage, including necrosis, was observed in the marker lesions with remaining malignancy compared with normal tissue samples, which showed only an infiltration with PMN cells and oedema of the striated muscles cells. Of the five patients treated, four are alive with no signs of recurrent tumour with a follow-up of 9-11 months. One patient was diagnosed as having a tumour dissemination in the skin around the thoracoscopy scar and died of abdominal tumour spread. Light delivery to large surfaces for adjuvant PDT is feasible in a relatively short period of time (< 1 h). In situ dosimetry ensures optimal light distribution and allows total doses (incident plus scattered light) to be monitored at different positions within the cavity. This combination of light delivery and dosimetry is well suited for adjuvant treatment with PDT in malignant pleural tumours