Effect of repeated immersion solution cycles on the color stability of denture tooth acrylic resins

OBJECTIVE: Chemical solutions have been widely used for disinfection of dentures, but their effect on color stability of denture tooth acrylic resins after repeated procedures is still unclear. The aim of this in vitro study was to evaluate whether repeated cycles of chemical disinfectants affected the color stability of two denture tooth acrylic resins. MATERIAL AND METHODS: Sixty disc-shaped specimens (40 mm x 3 mm) were fabricated from two different brands (Artiplus and Trilux) of denture tooth acrylic resin. The specimens from each brand (n=30) were randomly divided into 6 groups (n=5) and immersed in the following solutions: distilled water (control group) and 5 disinfecting solutions (1% sodium hypochlorite, 2% sodium hypochlorite, 5.25% sodium hypochlorite, 2% glutaraldehyde, and 4% chlorhexidine gluconate). Tooth color measurements were made by spectrophotometry. Before disinfection, the initial color of each tooth was recorded. Further color measurements were determined after subjecting the specimens to 7, 21, 30, 45, 60, and 90 immersion cycles in each tested solution. Color differences (ΔE*) were determined using the CIE L*a*b* color system. Data were analyzed using two-way repeated measures analysis of variance (ANOVA) followed by Tukey tests. The significance level was set at 5%. RESULTS: There were statistically significant differences in ΔE* among the 5 disinfectants and water during the 90 cycles of immersion for both denture tooth acrylic resins. Distilled water promoted the greatest color change in both denture tooth acrylic resins, nevertheless none of tested disinfectants promoted ΔE* values higher than 1.0 on these acrylic materials during the 90 cycles of disinfection. CONCLUSIONS: Repeated immersion cycles in disinfecting solutions alter ΔE* values, however these values do not compromise the color of the tested denture tooth acrylic resins because they are imperceptible to the human eye

A systematic review and meta-analysis of the clinical performance of implant-supported overdentures retained by CAD-CAM bars

Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing (CAD-CAM) bars. Objective: To evaluate the performance of IODs involving CAD-CAM bars. Methodology: A comprehensive search of studies published until May 2023 was conducted in many databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The population, intervention, comparison, outcome (PICO) question was: “How do IODs retained by bars fabricated by CAD-CAM technology perform in daily clinical practice?” The meta-analysis included clinical studies based on effect size and a two-tailed null test with a 95% confidence interval (CI). Results: Ten studies were included in the meta-analysis. Among them, nine reported a 100% implant survival rate for all CAD-CAM milled bars. Complications were reported in two studies with CAD/CAM-milled titanium bars, and one study reported more fractures in soldered gold bars used in maxillary rehabilitation. However, no fractures were observed in IODs retained by PEEK and zirconia bars. According to six studies, biological complications, including peri-implantitis, were minimal in the BioHPP and PEEK bar groups, while no cases were reported in the titanium or zirconia bar groups. CAD-CAM-milled zirconia bars had higher plaque and bleeding indices compared with titanium bars, as evidenced by findings from five studies. All four studies that evaluated Oral Health Impact Profile (OHIP) scores showed a positive effect of IODs retained by CAD-CAM milled titanium bars on quality of life. Patient satisfaction and acceptance by prosthodontists were significantly high, according to the results of five studies. Conclusion: Overdentures retained with CAD-CAM milled titanium bars show great potential for use in daily clinical practice. Moreover, patient and practitioner satisfaction was very high when this method was used

A maquigem de efeito especial como proposta de metodologia ativa na formação pericial: estudo das queimaduras / The special effect makeup as an active methodology for the expert training: the study of burns

As queimaduras são lesões ocasionadas por agentes vulnerantes (químicos, físicos e biológicos) capazes de promover calor o suficiente para danificar total ou parcialmente a pele, acarretando a morte celular e possuem espaço importante na Traumatologia Forense, no capítulo dedicado às lesões térmicas. Este estudo, realizado pelo método de pesquisa-ação, objetivou investigar as características das queimaduras segundo a classificação de Hoffmann, por meio de simulações de maquiagem de efeitos especiais. Neste estudo, a maquiagem enquadra-se como Metodologia Ativa (MA), compreendida como estratégia que permite o professor situar-se como facilitador na construção do conhecimento, orientando o discente a assumir seu protagonismo ao pesquisar, analisar e decidir por ele mesmo com a finalidade de alcançar determinado objetivo. Conclui-se que é possível tornar a aprendizagem mais significativa a partir da verossimilhança das maquiagens elaboradas. Sua análise é relevante na área pericial, tanto na formação inicial dos peritos e na sua educação continuada, como também nas perícias criminais de reprodução simulada

Epidemiological screening of pathogenicity factors associated with multidrug-resistant bacteria isolated in uroculture of hospitalized neonates in the lakes region from Rio de Janeiro.

The discovery of antimicrobials revolutionized the treatment of infectious diseases caused by bacteria, as they are drugs that contribute to reducing morbidity and mortality rates associated with infectious diseases (JANEBRO, et al., 2008). However, the irrational use of antimicrobial drugs represents one of the main concerns worldwide, since the misuse of these drugs accelerates the natural process of bacteria resistance to antibiotics (ZIMERMAN, 2010). In view of all these problems, the objective of this study was to evaluate the profile of resistance of bacteria identified in the urine culture of neonates who are hospitalized, based on the records of the Laboratory of Clinical Analysis of a hospital in the lakes region from Rio de Janeiro. To do so, we used the following methodologies: (i) literature review for contextualization of the problem and basis for discussion; (ii) and monitoring of a descriptive observational study that had as instrument the reports of records containing results of urine culture and antibiogram of neonatal patients, referring to the period from January 2020 to September 2021. The results showed a higher incidence of Escherichia coli (44% - 2020; 56% - 2021) among the microorganisms isolated in the analyzed urine cultures, followed by Klebsiella pneumoniae (14% - 2020; 28% - 2021). Antimicrobials from the β-lactam group caused high bacterial resistance, among the strains of different microorganisms analyzed, increasingly indicating the need for the replacement of these drugs in the clinic, in order to choose a better therapy for the patient. As in any infectious pathology, to establish appropriate prevention and treatment of community-acquired urinary tract infections, effective and continuous research is needed, with the goal of defining in detail the etiology and profile of bacterial resistance in regional, national, and international standards. It is hoped that these new data profiling the level of resistance in which microorganisms isolated from neonatal patients admitted under hospital regimen are found will be of great value to the academic community and to health professionals, providing users with increasingly accurate and quality treatment.The discovery of antimicrobials revolutionized the treatment of infectious diseases caused by bacteria, as they are drugs that contribute to reducing morbidity and mortality rates associated with infectious diseases (JANEBRO, et al., 2008). However, the irrational use of antimicrobial drugs represents one of the main concerns worldwide, since the misuse of these drugs accelerates the natural process of bacteria resistance to antibiotics (ZIMERMAN, 2010). In view of all these problems, the objective of this study was to evaluate the profile of resistance of bacteria identified in the urine culture of neonates who are hospitalized, based on the records of the Laboratory of Clinical Analysis of a hospital in the lakes region from Rio de Janeiro. To do so, we used the following methodologies: (i) literature review for contextualization of the problem and basis for discussion; (ii) and monitoring of a descriptive observational study that had as instrument the reports of records containing results of urine culture and antibiogram of neonatal patients, referring to the period from January 2020 to September 2021. The results showed a higher incidence of Escherichia coli (44% - 2020; 56% - 2021) among the microorganisms isolated in the analyzed urine cultures, followed by Klebsiella pneumoniae (14% - 2020; 28% - 2021). Antimicrobials from the β-lactam group caused high bacterial resistance, among the strains of different microorganisms analyzed, increasingly indicating the need for the replacement of these drugs in the clinic, in order to choose a better therapy for the patient. As in any infectious pathology, to establish appropriate prevention and treatment of community-acquired urinary tract infections, effective and continuous research is needed, with the goal of defining in detail the etiology and profile of bacterial resistance in regional, national, and international standards. It is hoped that these new data profiling the level of resistance in which microorganisms isolated from neonatal patients admitted under hospital regimen are found will be of great value to the academic community and to health professionals, providing users with increasingly accurate and quality treatment

A estratificação e o manejo adequado da dor: Stratification and proper pain management

A dor é um potencial de risco para a saúde pública, esta se caracteriza pela experiência multidimensional associada a aspectos físicos e emocionais. A dor alerta o perigo e evita danos orgânicos, mas quando está impossibilita atividades diárias e impacta a qualidade de vida do paciente é classificada como patológica e urge por interferência médica. O seguinte artigo objetivou descrever através da revisão narrativa de literatura os aspectos referentes da dor e o seu manejo adequado. A dor é um amplo complexo que possui a classificação conforme a localização, tipo, intensidade, periodicidade. As categorias referentes a dor são nociceptivas, neuropática, psicogênica. Ademais, as síndromes dolorosas são diversas e podem acometer qualquer sistema do corpo. Ressaltando ser essencial a categorização do máximo possível de informações para conduzir adequadamente ao tratamento destas enfermidades.&nbsp

Avaliação da posição disco articular em pacientes usuários de dentaduras duplas e portadores de sons articulares, por meio de ressonância magnética da ATM.

A Articulação Temporomandibular (ATM) é um complexo sinovial constituído por estruturas anatômicas que se relacionam de diversas maneiras. As alterações do padrão de normalidade, muitas vezes denominadas de Disfunção Temporomandibulares (DTMs), são encontradas tanto em pacientes experimentais, quanto assintomáticos . O objetivo do presente trabalho foi avaliar a posição do disco articular por meio de Ressonância Magnética (RM) da ATM e a sua relação com a presença ou ausência, detectada clinicamente, de sons articulares e de sintomas de DTMs, em pacientes utilizando Próteses Totais duplas. A amostra constituiu de 15 pacientes com sons articulares e 10 pacientes sem sons articulares (grupo controle) e as imagens foram realizadas em Máxima Intercuspidação Habitual e em Máxima Abertura Bucal. As ressonâncias foram avaliadas ao negatoscópio, por um único examinador, sem conhecimento prévio da história clínica dos pacientes. A análise dos resultados demonstrou que, das 18 ATMs que apresentavam estalidos articulares, 4 possuíam o disco em uma posição normal. Por outro lado, em 9 ATMs assintomáticas, foi detectada a presença de sinais de deslocamento do disco (DD). De um total de 6 pacientes diagnosticados clinicamente com hipermobilidade, 3 apresentavam deslocamento do disco com redução (DDR), enquanto o restante possuía o disco em uma posição normal. De um total de 30 ATMs estudadas no grupo experimental, 19 apresentavam DDR após a abertura bucal. Diferentemente, em 2 ATMs, o disco permaneceu deslocado para anterior na máxima abertura bucal. O disco permaneceu estável, tanto em fechamento quanto em abertura bucal, em 9 ATMs. No grupo controle, em 11 ATMs havia um relacionamento superior do disco, 6 apresentaram DDR e em 3 houve deslocamento do disco sem redução (DDSR). Houve uma ligeira tendência de DD nas mulheres, apesar dos valores não terem sido estatisticamente significantes tanto para o gênero quanto para idade. Este estudo mostrou que os DD são comuns tanto em pacientes experimentais, quanto no grupo controle.This study evaluated the condyle/disc relationships on magnetic resonance images in a group of subjects with silent temporomandibular joints when tested clinically with those in subjects with discernible temporomandibular sounds. Twenty five completely edentulous patients were selected to receive new complete dentures. A questionnaire was filled out and magnetic resonance imaging taken with new dentures. TMD was assessed by physical examination. Only one calibrated examiner evaluated the magnetic resonance imaging by a technique proposed by TASAKI for disc position. The study was based on bilateral MRIs of 15 patients (symptomatic) and 10 symptom-free volunteers (control). According to the methodology and statistical analysis, it was noted that disc displacement was found in 45% of the TMJs with no history of articular sounds. In 6 TMJs of control group, a reducing disc displacement was found and in 3 TMJs a permanent displacement was found. Disc displacements were identified in 70% of patients. Reducing disc displacement was found in 19 of these TMJs, whereas permanent displacement was found in 2 TMJs. In 9 of the joints of the symptomatic group, a superior disc position was found. These observations demonstrate that an audible click may not imply a displaced disc

Avaliação da posição disco articular em pacientes usuários de dentaduras duplas e portadores de sons articulares, por meio de ressonância magnética da ATM.

A Articulação Temporomandibular (ATM) é um complexo sinovial constituído por estruturas anatômicas que se relacionam de diversas maneiras. As alterações do padrão de normalidade, muitas vezes denominadas de Disfunção Temporomandibulares (DTMs), são encontradas tanto em pacientes experimentais, quanto assintomáticos . O objetivo do presente trabalho foi avaliar a posição do disco articular por meio de Ressonância Magnética (RM) da ATM e a sua relação com a presença ou ausência, detectada clinicamente, de sons articulares e de sintomas de DTMs, em pacientes utilizando Próteses Totais duplas. A amostra constituiu de 15 pacientes com sons articulares e 10 pacientes sem sons articulares (grupo controle) e as imagens foram realizadas em Máxima Intercuspidação Habitual e em Máxima Abertura Bucal. As ressonâncias foram avaliadas ao negatoscópio, por um único examinador, sem conhecimento prévio da história clínica dos pacientes. A análise dos resultados demonstrou que, das 18 ATMs que apresentavam estalidos articulares, 4 possuíam o disco em uma posição normal. Por outro lado, em 9 ATMs assintomáticas, foi detectada a presença de sinais de deslocamento do disco (DD). De um total de 6 pacientes diagnosticados clinicamente com hipermobilidade, 3 apresentavam deslocamento do disco com redução (DDR), enquanto o restante possuía o disco em uma posição normal. De um total de 30 ATMs estudadas no grupo experimental, 19 apresentavam DDR após a abertura bucal. Diferentemente, em 2 ATMs, o disco permaneceu deslocado para anterior na máxima abertura bucal. O disco permaneceu estável, tanto em fechamento quanto em abertura bucal, em 9 ATMs. No grupo controle, em 11 ATMs havia um relacionamento superior do disco, 6 apresentaram DDR e em 3 houve deslocamento do disco sem redução (DDSR). Houve uma ligeira tendência de DD nas mulheres, apesar dos valores não terem sido estatisticamente significantes tanto para o gênero quanto para idade. Este estudo mostrou que os DD são comuns tanto em pacientes experimentais, quanto no grupo controle.This study evaluated the condyle/disc relationships on magnetic resonance images in a group of subjects with silent temporomandibular joints when tested clinically with those in subjects with discernible temporomandibular sounds. Twenty five completely edentulous patients were selected to receive new complete dentures. A questionnaire was filled out and magnetic resonance imaging taken with new dentures. TMD was assessed by physical examination. Only one calibrated examiner evaluated the magnetic resonance imaging by a technique proposed by TASAKI for disc position. The study was based on bilateral MRIs of 15 patients (symptomatic) and 10 symptom-free volunteers (control). According to the methodology and statistical analysis, it was noted that disc displacement was found in 45% of the TMJs with no history of articular sounds. In 6 TMJs of control group, a reducing disc displacement was found and in 3 TMJs a permanent displacement was found. Disc displacements were identified in 70% of patients. Reducing disc displacement was found in 19 of these TMJs, whereas permanent displacement was found in 2 TMJs. In 9 of the joints of the symptomatic group, a superior disc position was found. These observations demonstrate that an audible click may not imply a displaced disc

Avaliação da posição condilar em pacientes desdentados totais portadores de dentaduras duplas, através de planigrafias da ATM

A posição condilar tem sido questionada como importante fator na detecção de sinais e sintomas de DTM,s. Por muito tempo, determinou-se que a concentricidade condilar refletiria uma posição ótima para o paciente. No entanto, outros trabalhos mostraram que era possível a visualização da descentralização dos côndilos, mesmo em pacientes assintomáticos. Dessa forma, avaliou-se neste trabalho a posição condilar antes e após instalação de PT,s novas, por meio de planigrafias laterais da ATM. O critério de seleção dos pacientes foi aleatório e, mediante a amostra escolhida, foi preenchido um questionário clínico-anamnésico, seguido de tomadas radiográficas com o par de dentaduras antigas e novas em 12 pacientes. Um único examinador conduziu o preenchimento das fichas e análise das radiografias no programa de imagens Corel Draw 8. De acordo com a metodologia aplicada e análise estatística dos resultados, verificou-se que a posição condilar em desdentados totais na primeira tomada radiográfica situou-se mais para anterior em 100% dos casos. Já o deslocamento condilar após instalação das novas próteses resultou em uma tendência de deslocamento para posterior em 75% dos indivíduos, para anterior em 16,7% e em 8,3% não houve variação da posição condilar. Dos 18 côndilos (75% casos) com deslocamento para posterior, apenas 1 côndilo assumiu uma posição levemente posterior, tendo os demais se localizado concentricamente ou para anterior. Não houve qualquer correlação estatisticamente significativa entre variações das posições condilares e dimensões verticais de oclusão. Provavelmente, os deslocamentos condilares encontrados sejam justificados pelas manipulações com forças variadas, aplicada pelos profissionais, para a posição de trabalho (RC). Baseado na literatura, a tendência de localização para posterior possivelmente não irá causar danos aos pacientes, tendo em vista se tratarem de indivíduos assintomáticos.Condyle position have been questioned as a relevant factor in detection of signs and symptoms of TMD. For a long time, it was determined that condylar concentricity would reflect an ideal position for the pacient. However, others studies demonstrated that it was possible to visualize that condyles were not always concentic in assintomatic pacient. This study evaluated the condylar position before and after instalation of new complete dentures using plain tomography of TMJ,s. Twelve completely edentulous patients were selected randomly to have new complete dentures. A questionare was filled out and plain tomograms were taken with old and new complete dentures inserted. Only one examiner evaluated the questionare and tomograms using Corel Draw 8 image software. According to the metodology and statical analysis, it was noted that condyle position in completely edentulous patients in the first tomogram was anterior in 100% of patients. After insertion of new dentures, the condyles had a tedency to be posteriorly positioned relative to the initial tomogram in 75% of the, 16,7% of the condyles deslocated anteriorly, and in 8,3% did not change position. Of the 18 condyles (75% of total) with posterior displacement, only one condyle assumed a true, although slight, posterior position, with the others located in a concentric or anterior position. There was no any statical correlation between variation of condylar position and vertical dimension of occlusion. Probably, the condylar displacement occurred due to variations in the manipulation technique applied by the professionals for centric relation registration. Base on the literature, the tendency to posterior location of condyles of completely edentulous patients after new complete dentures insertion will not cause any damage in assintomatic patients