Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software

OBJECTIVE: This study has two aims: 1) to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2) to compare, with Adobe Photoshop, the ability of a new software (Regeemy) in superposing and subtracting images. MATERIAL AND METHODS: Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature) underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection). Canals were prepared up to F2 (ProTaper) and 24.04 (Wizard CD Plus) instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time. RESULTS: The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>;0.05). ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>;0.05). CONCLUSION: Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop

Inequalities in public water supply fluoridation in Brazil: An ecological study

Background. The literature is scarce on the social and geographic inequalities in the access to and implementation of the fluoridation of public water supplies. This study adds knowledge to the Brazilian experience of the chronic privation of water and wastewater policies, access to potable water and fluoridation in the country. Thus, the aim of this study was to verify possible inequalities in the population's access to fluoridated drinking water in 246 Brazilian municipalities. Methods. The information on the process of water fluoridation in the municipalities and in the macro region in which each municipality is located was obtained from the national epidemiological survey which was concluded in 2003. The data relating to the human development index at municipal level (HDI-M) and access to mains water came from the Brazilian Human Development Atlas, whilst the size of the population was obtained from a governmental source. The Fisher exact test (P < 0.05) was employed to identify significant associations between the explanatory variables and their ability to predict the principal outcomes of interest to this study, namely the presence or absence of the water fluoridation process in the municipalities as well as the length of time during which this measure has been implemented. Linear regression was used to observe the associations between the relevant variables in a multivariate environment. Results. The results clearly showed that there is a relationship between municipalities with larger populations, located in more socio-economically advantaged regions and with better HDI-M, and where fluoridation is both present and has been implemented for a longer period of time (started before 1990). Conclusion. The findings suggest that the aim of treating water with fluoride may not be being adequately achieved, requiring more effective strategies so that access to this measure can be expanded equitably.81Hart, J.T., The inverse care law (1971) Lancet, 1 (7696), pp. 405-12. , 4100731Victora, C.G., Vaughan, J.P., Barros, F.C., Silva, A.C., Tomasi, E., Explaining trends in inequities: Evidence from Brazilian child health studies (2000) Lancet, 356 (9235), pp. 1093-98. , 10.1016/S0140-6736(00)02741-0 11009159Basting, R.T., Pereira, A.C., Meneghim, M.C., Evaluation of dental caries prevalence in students from Piracicaba, SP, Brazil, after 25 years of fluoridation of the public water supply (1997) Rev Odontol Univ São Paulo, 11 (4), pp. 287-92. , 10.1590/S0103-06631997000400010Lawrence, H.P., Sheiham, A., Caries progression in 12 to 16-year-old schoolchildren in fluoridated and fluoride-deficient areas in Brazil (1997) Community Dent Oral Epidemiol, 25 (6), pp. 402-11. , 10.1111/j.1600-0528.1997.tb01730.x 9429812Pereira, A.C., Mialhe, F.L., Bianchini, F.L.C., Prevalence of caries and dental floozies in scholars from cities with different fluoride concentrations in drinking water (2001) Rev Bras Odontol Sade Coletiva, 2 (1), pp. 34-9For Disease Control, C., Prevention, Achievementsin Public Health, 1900-1999: Fluoridation of drinking water to prevent dental caries (1999) Morbidity and Mortality Weekly Report, 48 (41), pp. 933-40For Disease Control, C., Prevention, Ten great public health achievements -United Sates, 1900-1999 (1999) Morbidity and Mortality Weekly Report, 48 (12), pp. 241-3. , 10220250American Health Organization, P., XV Directing Council of the Pan American Health Organization - Resolutions, 1964, , http://www.paho.org/English/GOV/CD/ftcd_15.htm(2003) The World Oral Health Report 2003, , http://www.who.int/oral_health, Geneva: WHOMcDonagh, M.S., Whiting, P.F., Wilson, P.M., Sutton, A.J., Chestnutt, I., Cooper, J., Misso, K., Kleijnen, J., Systematic review of water fluoridation (2000) BMJ, 321 (7265), pp. 855-9. , 11021861 10.1136/bmj.321.7265.855Bratthall, D., Hänsel-Petersson, G., Sundberg, H., Reasons for the caries decline: What do the experts believe? (1996) Eur J Oral Sci, 104 (4 PART 2), pp. 416-22. , 10.1111/j.1600-0722.1996.tb00104.x 8930592Narvai, P.C., Dental caries and fluorine: A twentieth century relation (2000) Cinc Sade Coletiva, 5 (2), pp. 381-92. , 10.1590/S1413-81232000000200011Peres, M.A., Fernandes, L.S., Peres, K.G., Inequality of water fluoridation in Southern Brazil - The inverse equity hypothesis revisited (2004) Soc Sci Med, 58 (6), pp. 1181-9. , 10.1016/S0277-9536(03)00289-2 14723912Peres, M.A., Antunes, J.L.F., Peres, K.G., Is water fluoridation effective in reducing inequalities in dental caries distribution in developing countries? (2006) Sozial und Präventiv Medizin, 51 (5), pp. 1-9Peres, K.G., Bastos, J.R., Mrdo, L., Relationship between severity of dental caries and social and behavioral factors in children (2000) Rev Saude Publica, 34 (4), pp. 402-8. , 10973161Maltz, M., Barbachan Silva, E.B., Relationship between caries, gingivitis and fluorosis and the socioeconomic status among school children (2001) Rev Saude Publica, 35 (2), pp. 170-6. , 11359204Moysés, S.J., Desigualdades em Sade Bucal e Desenvolvimento Humano: Um ensaio em preto, branco e alguns tons de cinza (2001) Rev Bras Odontol Sade Coletiva, 1 (1), pp. 7-17Patussi, M.P., Marcenes, W., Croucher, R., Sheiham, A., Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children (2001) Soc Sci Med, 53 (7), pp. 915-25. , 10.1016/S0277-9536(00)00391-9 11522137Antunes, J.L.F., Frazão, P., Narvai, P.C., Bispo, C.M., Pegoretti, T., Spatial analysis to identify differentials in dental needs by area-based measures (2002) Community Dent Oral Epidemiol, 30 (2), pp. 133-42. , 10.1034/j.1600-0528.2002.300207.x 12000354Peres, M.A., Peres, K.G., Antunes, J.L.F., Junqueira, S.R., Frazão, P., Narvai, P.C., The association between socioeconomic development at the town level and the distribution of dental caries in Brazilian children (2003) Rev Panam Salud Publica, 14 (3), pp. 149-57. , 10.1590/S1020-49892003000800001 14653902Antunes, J.L.F., Narvai, P.C., Nugent, Z.J., Measuring inequalities in the distribution of dental caries (2004) Community Dent Oral Epidemiol, 32 (1), pp. 41-8. , 10.1111/j.1600-0528.2004.00125.x 14961839Antunes, J.L.F., Peres, M.A., De Campos Mello, T.R., Waldman, E.A., Multilevel assessment of determinants of dental caries experience in Brazil (2006) Community Dent Oral Epidemiol, 34 (2), pp. 146-152. , 10.1111/j.1600-0528.2006.00274.x 16515679Narvai, P.C., Frazão, P., Roncalli, A.G., Antunes, J.L.F., Dental caries in Brazil: Decline, polarization, inequality and social exclusion (2006) Rev Panam Salud Publica, 19 (6), pp. 385-93. , 10.1590/S1020-49892006000600004 16968593Projeto, S.B., Brasil, Condiçes de sade bucal da população brasileira 2002-2003. Resultados principais (2004) Brasília-DF: Ministério da Sade, Secretaria de Atenção Sade, Departamento de Atenção Básica, Coordenação Nacional de Sade BucalCarmichael, C.L., Rugg-Gunn, A.J., French, A.D., Cranage, J.D., The effect of fluoridation upon the relationship between caries experience and social class in 5-year-old children in Newcastle and Northumberland in 1987 (1980) Br Dent J, 149 (6), pp. 163-7. , 10.1038/sj.bdj.4804479 6931610Bradnock, G., Marchment, M.D., Anderson, R.J., Social background, fluoridation and caries experience in 5-year-old population in the West Midlands (1984) Br Denl J, 156 (4), pp. 127-31. , 10.1038/sj.bdj.4805287 6584119Jones, C.M., Taylor, G.O., Whittle, J.G., Evans, D., Trotter, D.P., Water fluoridation, tooth decay in 5 years olds, and social deprivation measured by the Jarman score: Analysis of data from British dental surveys (1997) BMJ, 315 (7107), pp. 514-17. , 9329305Riley, J.C., Lennon, M.A., Ellwood, R.P., The effect of water fluoridation and social inequalities on dental caries in 5-year-old children (1999) Int Dent J, 28 (2), pp. 300-5. , 10342695Congresso Nacional, Brasil., Lei Federal no. de 19/09/1990 (1990) Diário Oficial da União 20 Set, p. 18055Morgenstern, H., Ecological studies (1998) Modern Epidemiology, pp. 459-80. , Baltimore: Lippincot Williamns & Wilkins Rothman K, Greenland S(2000) Informaçes de Sade: População Residente, , http://w3.datasus.gov.br/datasus/datasus.php?area= 359A1B379C6D0E0F359G23HIJd6L26M0N&VInclude=./site/infsaude.php, Departamento de Informática do Sistema nico de Sade (DATASUS)(2003) Atlas Do Desenvolvimento Humano No Brasil, Versão 1.0.0, , Programa das Naçes Unidas para o Desenvolvimento Brasília: PNUDLallo, R., Myburgh, N.G., Hobdell, M.H., Dental caries, socio-economic development and national oral health profiles (1999) Int Dent J, 49, pp. 196-202. , 10858754Baldani, M.H., Narvai, P.C., Antunes, J.L.F., Cárie dentária e condiçes scio-econômicas no Estado do Paraná, Brasil, 1996 (2002) Cad Sade Pblica, 18 (3), pp. 755-63. , 10.1590/S0102-311X2002000300024Qizilbash, M., On the Measurement of Human Development (2002) UNDP, , http://hdr.undp.org/docs/training/oxford/presentations/ Qizilbash_HDIcritique.pdfBurt, B.A., Fluoridation and social equity (2002) J Public Health Dent, 62 (4), pp. 195-200. , 10.1111/j.1752-7325.2002.tb03445.x 12474623For Disease Control, C., Prevention, Recommendation focusing fluoride to prevent and control dental caries in the United States (2001) Morbidity and Mortality Weekly Report, 50 (14), pp. 1-42Griffin, S.O., Jones, K., Tomar, S.L., An economic evaluation of community water fluoridation (2001) J Public Health Dent, 61 (2), pp. 78-86. , 10.1111/j.1752-7325.2001.tb03370.x 11474918Bleicher, L., Frota, F.H.S., Fluoretação da água: Uma questão de política pblica - O caso do Estado do Ceará (2006) Cin Sade Coletiva, 11 (1), pp. 71-8Frias, A.C., Narvai, P.C., Arajo, M.E., Zilbovicius, C., Antunes, J.L.F., Custo da fluoretação das águas de abastecimento pblico, estudo de caso -Município de São Paulo, Brasil, período de 1985-2003 (2006) Cad Sade Pblica, 22 (6), pp. 1237-46. , 10.1590/S0102-311X2006000600013Congresso Nacional, Brasil., (1974) Lei Federal No. 6.050, 3, p. 107. , Brasília: Departamento de Imprensa Nacional Atos do Poder Legislativo. Leis de Abril a JunhoDuarte, C.M.R., Eqüidade na legislação: Um princípio do sistema de sade brasileiro? (2000) Cin Sade Coletiva, 5 (2), pp. 443-63Whitehead, M., The concepts and principles of equity and health (1992) Int J Health Serv, 22 (3), pp. 429-45. , 10.2190/986L-LHQ6-2VTE-YRRN 164450

Brazilian adolescents' knowledge and beliefs about abortion methods: A school-based internet inquiry

Background: Internet surveys that draw from traditionally generated samples provide the unique conditions to engage adolescents in exploration of sensitive health topics.Methods: We examined awareness of unwanted pregnancy, abortion behaviour, methods, and attitudes toward specific legal indications for abortion via a school-based internet survey among 378 adolescents aged 12-21 years in three Rio de Janeiro public schools.Results: Forty-five percent knew peers who had undergone an abortion. Most students (66.0%) did not disclose abortion method knowledge. However, girls (aOR 4.2, 95% CI 2.4-7.2), those who had experienced their sexual debut (aOR1.76, 95% CI 1.1-3.0), and those attending a prestigious magnet school (aOR 2.7 95% CI 1.4-6.3) were more likely to report methods. Most abortion methods (79.3%) reported were ineffective, obsolete, and/or unsafe. Herbs (e.g. marijuana tea), over-the-counter medications, surgical procedures, foreign objects and blunt trauma were reported. Most techniques (85.2%) were perceived to be dangerous, including methods recommended by the World Health Organization. A majority (61.4%) supported Brazil's existing law permitting abortion in the case of rape. There was no association between gender, age, sexual debut, parental education or socioeconomic status and attitudes toward legal abortion. However, students at the magnet school supported twice as many legal indications (2.7, SE.27) suggesting a likely role of peers and/or educators in shaping abortion views.Conclusions: Abortion knowledge and attitudes are not driven simply by age, religion or class, but rather a complex interplay that includes both social spaces and gender. Prevention of abortion morbidity and mortality among adolescents requires comprehensive sexuality and reproductive health education that includes factual distinctions between safe and unsafe abortion methods

Association between lifestyle factors and headache

Modification of lifestyle habits is a key preventive strategy for many diseases. The role of lifestyle for the onset of headache in general and for specific headache types, such as migraine and tension-type headache (TTH), has been discussed for many years. Most results, however, were inconsistent and data on the association between lifestyle factors and probable headache forms are completely lacking. We evaluated the cross-sectional association between different lifestyle factors and headache subtypes using data from three different German cohorts. Information was assessed by standardized face-to-face interviews. Lifestyle factors included alcohol consumption, smoking status, physical activity and body mass index. According to the 2004 diagnostic criteria, we distinguished the following headache types: migraine, TTH and their probable forms. Regional variations of lifestyle factors were observed. In the age- and gender-adjusted logistic regression models, none of the lifestyle factors was statistically significant associated with migraine, TTH, and their probable headache forms. In addition, we found no association between headache subtypes and the health index representing the sum of individual lifestyle factors. The lifestyle factors such as alcohol consumption, smoking, physical activity and overweight seem to be unrelated to migraine and TTH prevalence. For a judgement on their role in the onset of new or first attacks of migraine or TTH (incident cases), prospective cohort studies are required

Plant Diversity Changes during the Postglacial in East Asia: Insights from Forest Refugia on Halla Volcano, Jeju Island

Understanding how past climate changes affected biodiversity is a key issue in contemporary ecology and conservation biology. These diversity changes are, however, difficult to reconstruct from paleoecological sources alone, because macrofossil and pollen records do not provide complete information about species assemblages. Ecologists therefore use information from modern analogues of past communities in order to get a better understanding of past diversity changes. Here we compare plant diversity, species traits and environment between late-glacial Abies, early-Holocene Quercus, and mid-Holocene warm-temperate Carpinus forest refugia on Jeju Island, Korea in order to provide insights into postglacial changes associated with their replacement. Based on detailed study of relict communities, we propose that the late-glacial open-canopy conifer forests in southern part of Korean Peninsula were rich in vascular plants, in particular of heliophilous herbs, whose dramatic decline was caused by the early Holocene invasion of dwarf bamboo into the understory of Quercus forests, followed by mid-Holocene expansion of strongly shading trees such as maple and hornbeam. This diversity loss was partly compensated in the Carpinus forests by an increase in shade-tolerant evergreen trees, shrubs and lianas. However, the pool of these species is much smaller than that of light-demanding herbs, and hence the total species richness is lower, both locally and in the whole area of the Carpinus and Quercus forests. The strongly shading tree species dominating in the hornbeam forests have higher leaf tissue N and P concentrations and smaller leaf dry matter content, which enhances litter decomposition and nutrient cycling and in turn favored the selection of highly competitive species in the shrub layer. This further reduced available light and caused almost complete disappearance of understory herbs, including dwarf bamboo