Abstract Background: respiratory insufficiency is a syndrome with a great impact on hospital admissions, morbidity and mortality. The applicability of High-flow nasal oxygen has been the subject of interest in critically ill patients. Objective: to know the effectiveness of High-flow nasal oxygen as a treatment for respiratory insufficiency in adult patients admitted to the intensive care units. Methods: systematic reviews of effectiveness using the PICO strategy and recommendations from the Joanna Briggs Institute. The survey was carried out in august 2021 using the PubMed and EBSCOhost access platforms. Results: 583 results were identified. Six randomized clinical trials were analyzed. The selection was made after elimination of duplicates; title reading, abstract reading and full text reading according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram. Conclusion: high-flow nasal oxygen proved to be comfortable, tolerable and effective in the treatment of hypoxemic and hypercapnic respiratory insufficiency. It was effective when compared with conventional oxygen therapy in the post-extubation of hypoxemic patients and in reducing partial pressure of carbon dioxide when compared with Non-Invasive Ventilation in hypercapnic patients.

Resumen Marco contextual: la insuficiencia respiratoria es un síndrome que tiene un gran impacto en los ingresos hospitalarios, la morbilidad y mortalidad. La aplicabilidad del oxígeno nasal de alto flujo ha sido objeto de interés en pacientes críticos. Objetivo: conocer la efectividad del oxígeno nasal de alto flujo en el tratamiento de la insuficiencia respiratoria en adultos en unidades de cuidados intensivos. Métodos: revision sistemática de efectividad utilizando la estrategia PICO y recomendaciones del Instituto Joanna Briggs. La búsqueda se llevó a cabo en agosto de 2021 utilizando las plataformas de acceso PubMed y EBSCOhost. Resultados: se identificaron 583 resultados. Se analizaron seis ensayos clínicos aleatorios. La selección se realizó después de la eliminación de duplicados; lectura de títulos, de resúmenes y de texto completo siguiendo el diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Conclusión: el Oxígeno nasal de alto flujo demostró ser cómodo, tolerable y eficaz en el tratamiento de la insuficiencia respiratoria hipoxémica e hipercápnica. Fue eficaz en comparación con la oxigenoterapia convencional en la postextubación de pacientes hipoxémicos y en la reducción de la presión parcial de dióxido de carbono en comparación con la Ventilación No Invasiva en pacientes hipercápnicos.

Resumo Enquadramento: a insuficiência respiratória é uma síndrome com grande impacto nos internamentos, na morbilidade e mortalidade. A aplicabilidade do oxigénio nasal de alto fluxo tem sido alvo de interesse no doente crítico. Objetivo: conhecer a efetividade do oxigénio nasal de alto fluxo no tratamento da insuficiência respiratória no adulto em unidades de cuidados intensivos. Métodos: revisão sistemática de efetividade que utiliza a estratégia PICO e recomendações do Joanna Briggs Institute. A pesquisa foi realizada em agosto de 2021 com recurso às plataformas de acesso PubMed e EBSCOhost. Resultados: identificaram-se 583 resultados. Foram analisados seis ensaios clínicos randomizados. A seleção foi feita após eliminação de duplicados; leitura do título, resumos e textos integrais de acordo com o diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Conclusão: o oxigénio nasal de alto fluxo revelou-se confortável, tolerável e eficaz no tratamento da insuficiência respiratória hipoxémica e hipercápnica. Foi eficaz quando comparado com oxigenoterapia convencional na pós-extubação de doentes hipoxémicos e na redução da pressão parcial de dióxido de carbono quando comparado com a Ventilação Não Invasiva nos doentes hipercápnicos.

Abstract Background: prone Position is a well-established evidence-based clinical practice in patients with Acute Respiratory Distress Syndrome undergoing invasive mechanical ventilation. Little evidence in non-intubated patients is known. Due to the increasing rate of acute respiratory distress syndrome, the need to know the effectiveness in non-intubated patients has emerged. Objective: to know the effectiveness of prone position in the treatment of acute respiratory distress syndrome in non-intubated adults. Methodology: Systematic reviews based on the manual of Joanna Briggs Institute and carried out using PICO strategy. Research conducted in August 2021 in the access platforms Web of Science, PubMed, and EBSCO Host. Selection was done after elimination of duplicates, title reading, reading of abstracts, and full texts according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram. Results: 741 results were identified, and seven were included in the review. Conclusion: Early prone position is advantageous in non-intubated patients with mild and moderate acute respiratory distress syndrome. A risk intervention in non-intubated patients with Severe Acute Respiratory Distress Syndrome. Mortality/survival, physiological/clinical, adverse events/effects and functioning outcomes were identified as predictors of success/failure of prone position.

Resumo Enquadramento: o decúbito ventral é uma prática clínica baseada na evidência que se encontra bem estabelecida em pacientes com Acute Respiratory Distress Syndrome submetidos a ventilação mecânica invasiva. Porém, existe parca evidência em pacientes não intubados. Face ao aumento da taxa de Acute Respiratory Distress Syndrome, emergiu a necessidade de conhecer a sua eficácia em pacientes não intubados. Objetivo: conhecer a efetividade do decúbito ventral no tratamento da Acute Respiratory Distress Syndrome em adultos não intubados. Metodologia: revisão sistemática fundamentada no manual de Joanna Briggs Institute, com recurso à estratégia PICO. Pesquisa realizada em agosto de 2021, nas plataformas de acesso Web of Science, PubMed e EBSCO Host. Seleção realizada após eliminação de duplicados, leitura do título, de resumos e textos integrais de acordo com o diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados: identificaram-se 741 resultados, sendo sete os incluídos na revisão. Conclusão: O decúbito ventral precoce revelou-se vantajoso em pacientes não intubados com Acute Respiratory Distress Syndrome ligeira e moderada. É uma intervenção de risco em pacientes não intubados com Acute Respiratory Distress Syndrome grave. Foram identificados indicadores de mortalidade/ sobrevida, fisiológicos/ clínicos, de eventos/ efeitos adversos e indicadores funcionais como preditores de sucesso/ insucesso do decúbito ventral.

Resumen Marco contextual: posición prona es una práctica clínica, basada en evidencia, conocida en pacientes con Síndrome de Dificultad Respiratoria Aguda con ventilación mecánica invasiva. Hay poca evidencia en pacientes no entubados. La creciente tasa de síndrome de distrés respiratorio agudo originó la necesidad de desarrollar esfuerzos para conocer su efectividad en pacientes no intubados. Objetivo: conocer la efectividad del decúbito prono en el tratamiento del síndrome de distrés respiratorio agudo en adultos no intubados. Metodología: revisión sistemática basadas en el manual del Instituto Joanna Briggs y mediante la estrategia PICO. La búsqueda ocurrió en agosto 2021 en las plataformas de acceso Web of Science, PubMed y EBSCO Host. Selección realizada por previa eliminación de duplicados, lectura de títulos, resúmenes y textos completos de acuerdo con el diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados: se identificaron 741 resultados, siete incluyeron la revisión. Conclusión: la posición prona temprana demostró ser ventajosa en pacientes no intubados con Síndrome de Dificultad Respiratoria Aguda leve y moderado. Intervención riesgosa en pacientes no intubados con Síndrome de Dificultad Respiratoria Aguda grave. Indicadores de mortalidad/supervivencia, fisiológicos/clínicos, de eventos/efectos adversos e indicadores funcionales, fueron identificados como predictores de éxito/fracaso de la posición prono.

RESUMO: Espondilomielopatia cervical (EMC) é uma doença que geralmente afeta cães de raças grandes e gigantes. Ela é caracterizada por anormalidades da coluna cervical que podem causar danos à medula espinhal ou às raízes nervosas. Artroplastia cervical com prótese de disco tem sido proposta como opção de tratamento na medicina veterinária. O presente estudo teve como objetivo avaliar os principais estresses em uma nova prótese de disco intervertebral canina e corpos vertebrais por meio da análise de elementos finitos. Foram compostos dois grupos experimentais que representaram o material constituinte da nova prótese: grupos aço inoxidável (SSG) e o liga de titânio (TAG). Tensões equivalente de von-Mises (VMS) e tensão principal mínima (MiPS) média foram avaliadas sob forças de compressão, tração e torção para vértebras e prótese. O grupo SSG teve maior distribuição de VMS para todos parâmetros avaliados, enquanto o grupo TAG teve maior MiPS. Estresses estiveram mais concentrados nas superfícies lateral e ventral dos corpos vertebrais do que nas placas terminais. Os estresses médios da prótese foram mais concentrados na superfície de contato osso/implante do que na interface prótese/parafuso. Estresses máximos foram concentrados na superfície cranial do parafuso. A nova prótese permitiu distribuição uniforme do estresse ao longo do corpo vertebral. Comparando os materiais da prótese, a liga de titânio foi marginalmente superior quanto aos estresses médios em todas as direções, sendo menos provável que sofra afundamento da prótese.

ABSTRACT: Cervical spondylomyelopathy (CSM) is a disease that affects mostly large- and giant-breed dogs. It is characterized by abnormalities of the cervical spine that may cause damage to the spinal cord and nerve roots. Cervical disc arthroplasty has been proposed as a treatment option in veterinary medicine. The current study evaluated the main stresses in a novel canine vertebral disc prosthesis and vertebral bodies using finite element analysis. Two experimental groups were created based on the material used for the prosthesis: stainless steel group (SSG) and titanium alloy group (TAG). Vertebral and prosthetic average equivalents von-Mises stress (VMS) and minimum principal stress (MiPS) were assessed while compressive, tensile, and lateral bending shear loads were applied. The stainless steel group had greater VMS distribution on all the evaluated parameters while the titanium alloy group had greater MiPS. Stresses were more concentrated on the lateral and ventral surfaces of the vertebral bodies than on their endplates. The average prosthetic stresses were more concentrated on the bone/implant contact surface than on the prosthesis/screw interface. Maximum stresses were concentrated in the screws’ cranial surface. The novel prosthesis allows even distribution along the vertebral body. Comparing prosthesis materials, titanium alloy was marginally superior regarding average stresses in all directions and should be less likely to suffer subsidence.

ABSTRACT: Cervical arthroplasty with disc prosthesis has been proposed as a treatment option for dogs with Cervical Spondylomyelopathy. The present study developed a novel vertebral disc prosthesis for dogs. Sixteen Functional Spinal Units (C5-C6) were collected from dog cadavers with body weights ranging between 25 and 35 kg, and their vertebral measurements were used to design a prosthetic disc. The sizing of the prosthesis was performed based on the averages of the measurements of width, height, and length of the vertebral bodies from C5-C6 of all specimens. The prosthesis was developed using the Rhinoceros 3D® and SolidWorks® programs, and 3D prototyping was carried out to define the best design. The developed prosthesis consisted of two independent parts that are fixed to the cranial and caudal vertebral bodies, in the intervertebral space, and fitted together by metal-to-metal surfaces capable of moving in the lateral, ventral, and dorsal directions. Each part of the prosthesis is angled in two portions: vertically, in the intervertebral space, and horizontally, in contact with the ventral surface of the vertebral bodies, both of which are fixed by means of monocortical locking screws. The design of the developed prototype allowed a good fit in the intervertebral space between C4-C5, C5-C6, and C6-C7.

RESUMO: A artroplastia cervical com prótese de disco tem sido proposta como uma opção de tratamento para cães com Espondilomielopatia Cervical. O presente estudo teve como objetivo desenvolver uma nova prótese de disco intervertebral para cães. Dezesseis Unidades Funcionais de Coluna Vertebral (C5-C6) foram coletadas de cadáveres de cães com peso corporal variando entre 25 e 35 kg, e suas medidas vertebrais foram usadas para projetar um disco intervertebral protético. O dimensionamento da prótese foi realizado com base nas médias das mensurações da largura, altura e comprimento dos corpos vertebrais de C5-C6 de todos os espécimes. A prótese foi desenvolvida nos programas Rhinoceros 3D® e SolidWorks® e utilizou-se prototipagem em 3D para a definição do melhor design. A prótese desenvolvida é formada por duas partes independentes que se fixam às espífises dos corpos vertebrais cranial e caudalmente ao espaço intervertebral, e se encaixam entre si por superfícies de metal-metal com capacidade de movimentação nas direções lateral, ventral e dorsal. Cada parte da prótese é angulada em duas porções: a vertical, que fica no espaço intervertebral, e a horizontal, que fica em contato com a superfície ventral dos corpos vertebrais, ambas as quais são fixadas por meio de parafusos bloqueados monocorticais. O design do protótipo desenvolvido permitiu bom encaixe no espaço intervertebral entre C4-C5, C5-C6 e C6-C7.

Abstract Objective To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. Methodology Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. Results 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18–27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. Conclusion Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Abstract Dental alloys are widely used in fabrication of removable partial dentures, particularly as a dental framework. The present study aimed at studying the effect of the commercial mouthwashes on the corrosion behavior of the Co−Cr dental casting alloy. Corrosion behavior was investigated in alcohol-free and alcohol-containing mouthwashes added to artificial saliva solutions at room temperature by electrochemical tests recorded the open circuit potential (OCP) and current density, after the surface analysis of the samples was performed. During the early 250s, the OCP values showed significant changes, with the exception of one test group containing alcohol, where potential decreased continuously during the test, which also recorded the highest current density, different from the other groups. It was observed that the presence of alcohol increased the current density and the corrosion process in this alloy and the mouthwashes had more aggressive action in specimens submitted to solutions with alcohol in the composition.

Objective The aim of this study was to evaluate the electrochemical behavior of a cobalt-chromium (Co-Cr) dental alloy after immersion in denture cleansers. Method: Twenty-four specimens (Ø13x2mm) of Co-Cr were produced and divided into three groups (n=8) according to their experimental condition. The group 1 (control group) was composed only of distilled water, group 2 received a hygienic tablet (Corega Tabs™) at the moment that electrochemical test started, while the group 3 received the hygienic tablet (Corega Tabs™) 1h after immersion. The electrochemical tests recorded the open circuit potential (OCP) and current density (icorr). The surfaces of specimens were examined using a SEM. Data were statistically analyzed using analysis of variance (ANOVA) and Duncan test’ multiple comparisons post hoc analysis (α=0.05). Results: The values of OCP and icorr revealed statistically differences between the groups. The highest results were recorded for group 2 (-26.87±48.48mV; 0.29±0.22μA), which were similar to group 3 (-47.37±35.36mV; 0.26±0.10μA), and these values were difference to group 1 (-314.87±24.22mV; 0.50±0.17μA). SEM image show high corrosion with Corega Tabs™. Conclusion: The immersion in denture cleanser solution was not detrimental to the Co-Cr dental alloy and presented a lower tendency to corrosion process development than the control group.

Resumo Neste estudo foi avaliado desajuste vertical, a passividade e a distribuição de tensões após o aperto dos parafusos de diferentes próteses. Dois implantes foram usados para simular a reabilitação do espaço edêntulo da mandíbula do segundo pré-molar ao segundo molar. Quarenta próteses dentárias fixas parafusadas de três elementos com cantilever distal foram confeccionadas e separadas em quatro grupos de acordo com o método de obtenção da infraestrutura (n = 10): G1 = fundição convencional estrutura monobloco, G2 = fundição convencional seccionada e soldagem a laser, G3 = fundição convencional seccionada e soldagem com gás inerte de tungstênio (TIG) e G4 = infraestrutura obtida pelo sistema CAD / CAM (computer-aided design/computer-aided manufacturing). Os desajustes verticais com ambos os parafusos apertados e os desajustes relativos à avaliação de passividade com um parafuso apertado foram medidos com microscópio comparador óptico. Os dados foram submetidos ao teste de Shapiro-Wilk para comparação com ANOVA seguida de ajuste de Tukey com Bonferroni (α = 0,05). A análise qualitativa da distribuição de tensões foi realizada pelo método fotoelástico. G2 (24 μm) e G3 (27 μm) apresentaram valores significativamente maiores que G4 (10 μm) (p = 0,006) de desajuste vertical (ambos os parafusos apertados). Os valores de desajustes nos G1 (64 μm) e G3 (61 μm), do lado não apertado, foram significativamente maiores que no G4 (32 μm) (p = 0,009). G1 apresentou maior tensão entre os implantes na análise fotoelástica e G4 apresentou menor tensão. O método CAD/CAM resultou em menor desajuste, maior passividade e melhor distribuição de tensões no osso.

Abstract This study evaluated the vertical misfit, passivity, and stress distribution after tightening the screws of different prosthesis. Two implants were used to simulate the rehabilitation of partially edentulous mandible space from the second premolar to the second molar. 40 three-element screw-retained fixed dental prosthesis with distal cantilever were fabricated and divided into four groups according to the method of production of framework (n = 10): G1 = conventional casting one-piece framework, G2 = conventional casting sectioned and laser welding, G3 = conventional casting sectioned and tungsten inert gas (TIG) welding and G4 = framework obtained by CAD/CAM (computer-aided design/computer-aided manufacturing) system. The vertical misfits (both screws tightened) and the passive fit (one screw tightened) were measured under a comparator optical microscope. The data was submitted to Shapiro-Wilk test to enable comparison with ANOVA followed by Tukey with Bonferroni adjust (α = .05). The qualitative analysis of the stress distribution was performed by the photoelastic method. The vertical misfit (both screws tightened) of the G2 (24 μm) and G3 (27 μm) were significantly higher than G4 (10 μm) (p = 0,006). The passive fit (for the non-tightened) of the G1(64 μm) and G3 (61 μm) were significantly higher than the G4 (32 μm) (p=0,009). G1 showed high stress between the implants in the photoelastic analysis and G4 presented lower stress. In conclusion, CAD/CAM method results in less vertical misfit, more passivity, and consequently better stress distribution to the bone.

Resumo Este estudo avaliou o reparo ósseo em defeitos cirúrgicos de ratos tratados com ácido hialurônico (AH) associado ou não à fração proteica de Hevea brasiliensis (F-1). Foram criados defeitos ósseos em 15 ratos albinos Wistar divididos em 3 grupos (n = 5): Grupo controle (1) - coágulo sanguíneo; Grupo HA (2) - ácido hialurônico 0,5%; Grupo HAF1 (3) - fração proteica F-1 0,1% dissolvida em ácido hialurônico a 0,5%. Após 4 semanas, os animais foram submetidos à eutanásia e o reparo ósseo avaliado por meio de análise histomorfométrica, zimografia e imunohistoquímica. A área óssea neoformada não apresentou diferença significativa (p = 0,757), mas houve tendência de aumento da trabeculação óssea nos grupos HA e HAF1. Para a análise imunoistoquímica, houve diferença na marcação do fator de crescimento endotelial vascular (VEGF) (p = 0,023), sendo maior nos grupos HA e HAF1 do que no grupo controle. Nenhuma diferença significativa na sialoproteína óssea (BSP) (p = 0,681), osteocalcina (p = 0,954), no entanto, diferenças significativas foram encontradas para a molécula de adesão de células endoteliais plaquetárias-1 (CD-31) (p = 0,040), com o grupo HAF1 sendo significativamente inferior ao controle. Para a análise zimográfica, não houve diferença significativa para metaloproteinase-2 (MMP-2) (p = 0,068), mas houve tendência de aumento da MMP-2 no grupo HA. Apesar da influência sobre os fatores angiogênicos e da aparente tendência de maior trabeculação nos grupos HA e HAF1, não houve diferença significativa na área de tecido ósseo neoformado no período analisado.

Abstract This study evaluated the bone repair in surgical defects of rats treated with hyaluronic acid (HA) associated or not with Hevea brasiliensis fraction protein (F-1). Bone defect were created in 15 albino Wistar rats divided into 3 groups (n=5): Control group (1) - blood clot; HA group (2) - 0.5% hyaluronic acid; HAF1 group (3) - 0.1% F-1 protein fraction dissolved in 0.5% hyaluronic acid. After 4 weeks, the animals were euthanized and the bone repair was evaluated through histomorphometric analysis, zymography and immunohistochemistry. The neoformed bone area did not show a significant difference (p = 0.757), but there was a tendency for bone trabeculation to increase in the groups HA and HAF1. For immunohistochemically analysis, there was a difference in vascular endothelial growth factor (VEGF) labeling (p = 0.023), being higher in the groups HA and HAF1 than the control group. No significant difference in bone sialoprotein (BSP) (p = 0.681), osteocalcin (p = 0.954), however, significant difference in platelet endothelial cell adhesion molecule-1 (CD-31) (p = 0.040), with HAF1 group being significantly lower than the control. For zymographic analysis, there was no significant difference for metalloproteinase-2 (MMP-2) (p = 0.068), but there was a tendency to increase MMP-2 in the HA group. Despite the influence on angiogenic factors and the apparent tendency for greater trabeculation in the HA and HAF1 groups, there was no significant difference in the area of newly formed bone tissue in the analyzed period.

Abstract Appropriated denture hygiene is a predictive factor for longevity of rehabilitation treatment and maintenance of the oral mucosal health. Although, disinfectant solutions are commonly used as denture cleansers, the impact of these solutions on acrylic resin-based dentures remain unclear. Objective To evaluate, in vitro, the antibiofilm activity of complete denture hygiene solutions and their effects on physical and mechanical properties of acrylic resin. Methodology For antibiofilm activity measurement acrylic resin specimens were contaminated with Candida albicans, Candida glabrata and Streptococcus mutans. After biofilm growth, the specimens were assigned to the hygiene solutions: Distilled water (Control); 0.2% Sodium hypochlorite (SH); Efferdent Power Clean Crystals (EPC) and 6.25% Ricinus communis (RC). The viability of microorganisms was evaluated by agar plate counts. In parallel, physical, and mechanical properties of the acrylic resin were evaluated after simulating a 5-year period of daily immersion in the previously mentioned solutions. The changes in surface roughness, color, microhardness, flexural strength, impact strength, sorption and solubility were evaluated. Data were compared by ANOVA followed by the Tukey test or Kruskal-Wallis followed by the Dunn test depending on the distribution (α=0.05). Results Regarding antibiofilm action, SH eliminated all microorganisms while EPC and RC exhibited moderate action against S. mutans (p=0.001) and C. glabrata (p<0.001), respectively. Relative to effects on the physical and mechanical properties of the acrylic resin, RC led to higher values of color change (p=0.030), hardness (p<0.001), surface roughness (p=0.006) and flexural strength (p<0.001). Moreover, RC induced the highest values of changes in solubility (p<0.001). EPC promoted greater changes in surface morphology, whereas immersion in SH retained the initial appearance of the acrylic resin surface. All hygiene solutions reduced the impact strength (p<0.05). Conclusion SH presented the most effective antibiofilm activity. In addition, changes on properties were observed after immersion in RC, which were considered within acceptable limits.

Abstract Understanding the behavior of Candida spp. when exposed to denture disinfectants is essential to optimize their effectiveness. Changes in the virulence factors may cause increased resistance of Candida spp. to disinfectant agents. Objective To evaluate the microbial load, cellular metabolism, hydrolytic enzyme production, hyphae formation, live cell and biofilm quantification of Candida albicans, Candida tropicalis and Candida glabrata after exposure to disinfectant solutions. Methodology Simple biofilms were grown on heat-polymerized acrylic resin specimens, and divided into groups according to solutions/strains: distilled water (control); 0.25% sodium hypochlorite (NaOCl 0.25% ); 10% Ricinus communis (RC 10%); and 0.5% Chloramine T (CT 0.5%). The virulence factors were evaluated using the CFU count (microbial load), XTT method (cell metabolism), epifluorescence microscopy (biofilm removal and live or dead cells adhered), protease and phospholipase production and hyphae formation. Data were analyzed (α=0.05) by one-way ANOVA/ Tukey post hoc test, Kruskal-Wallis test and Wilcoxon test. Results NaOCl 0.25% was the most effective solution. CT 0.5% reduced the number of CFUs more than RC 10% and the control. RC 10% was effective only against C. glabrata. RC 10% and CT 0.5% decreased the cellular metabolism of C. albicans and C. glabrata. Enzyme production was not affected. Hyphal growth in the RC 10% and CT 0.5% groups was similar to that of the control. CT 0.5% was better than RC 10% against C. albicans and C. tropicalis when measuring the total amount of biofilm and number of living cells. For C. glabrata, CT 0.5% was equal to RC 10% in the maintenance of living cells; RC 10% was superior for biofilm removal. Conclusions The CT 0.5% achieved better results than those of Ricinus communis at 10%, favoring the creation of specific products for dentures. Adjustments in the formulations of RC 10% are necessary due to efficacy against C. glabrata. The NaOCl 0.25% is the most effective and could be suitable for use as a positive control.

Abstract This study showcases the clinical efficacy of mucoadhesive patches designed for the buccal delivery of lidocaine and prilocaine hydrochlorides (1:1, 30 mg/patch). Such patches were developed for needle-free pre-operative local anesthesia in dentistry, aiming at mitigating the use of infiltrative anesthesia for medium-complexity clinical procedures. The patches were manufactured encompassing drug-release, mucoadhesive and backing layers, all prepared through film casting using biocompatible materials. Fifty-eight (n = 58) adult patients (65% women and 35% men) were randomly selected and included in a one-arm open clinical prospective cohort study. The average age of the subjects was of 50 years. The majority (59%) of the subjects, mostly women (82%), reported needle-phobia or anxiety due to dental procedures, which was assessed through a questionnaire approved by the ethical council for human use in research. The patches were positioned in the gingival region of the teeth involved in the procedure (86% on the maxillary and 14% on the mandibular bone). Two anesthetic patches were applied on each patient: one in the vestibular region and another in the palate/lingual portion, and these patches remained attached to the placement sites throughout the procedures. Concerning the dental procedures performed, 40% were cavity preparations and dental restorations of medium cavities; 29% staple facilities; 10% gingival retractions; 9% subgingival scrapings; 3% gingivalplasties; 3% supragingival preparations; 3% occlusal adjustments; and 2% subgingival preparations. In 90% of the cases, it was not necessary to complement with conventional infiltrative local anesthesia during the procedures. Patients did not report any discomfort or side effect during or after the administration of the patches. Among the cases in which there was the need for complementation, 50% were cavity preparations and dental restorations; 33% supragingival preparations; and 17% gingivoplasties. The complementary anesthesia volume was of 0.63 ± 0.23 mL and women corresponded to 83% of the participants who needed such intervention. Furthermore, in most cases, the patch was capable of initiating the anesthesia within a short time frame (5 minutes) and reaching the maximum anesthetic effect within 15 and 25 min, lasting at least 50 min. Undesirable side effects were not reported either 2 h after the administration or within the 6-month follow-up. Therefore, the anesthetic patches developed provide needle-free, painless, safe, and patient/dentist-friendly advances in performing routine medium-complexity dental procedures.

This study aim was to evaluate the influence of 37% hydrochloric acid (37% HCl) treatment of cobalt-chromium (Co-Cr) alloys on the metal-ceramic bond strength (MCBS). The specimens were sandblasted with 100-µm aluminum oxide particles and divided into four groups (n = 10) according to the surface treatment performed: control (C) - no treatment - and treated with 37% HCl for different times: 10 minutes (T1), 20 minutes (T2) and 30 minutes (T3). The samples were submitted to the 3-point bending test, and the type of failure was evaluated. Wald, Bonferroni and Pearson's tests were applied (α = 0.05). There was difference between the treatments (p = 0.019): T3 (61.57 MPa) had higher bond strength than C (51.96 MPa). The specimens presented 17.5% of adhesive and 82.5% of mixed failures. There was a weak correlation between the failure type and the MCBS. Co-Cr surface treatment with 37% HCl for 30 minutes is a promising protocol for an appropriate metal-ceramic bond strength.

ABSTRACT Purpose To evaluate the biomechanical properties of a novel total hip replacement femoral stem. Methods Eight pairs of femurs from dog cadavers were used. The femurs were separated into different groups. A novel femoral stem with a convex proximal portion (Stem B) was biomechanically evaluated and compared to awell-known veterinary collared stem (Stem A). Femoral stems were inserted into the contralateral femurs from the same dog, forming 16 constructs. A flexo-compression load was applied on the axial axis of each sample. Maximum strength, deflection, stiffness, and energy absorption were analysed. Results Group B constructs showed significantly higher values (p ? 0.05) for the variables, except stiffness. The mean maximum strength was 1,347 ± 357 N for Group A and 1,805 ± 123 N for Group B (p ? 0.0069). The mean deflection was5.54 ± 2.63 mm for Group A and 10.03 ± 3.99 mm for Group B (p ? 0.0056). For the energy variable, the force was 6,203 ± 3,488 N/mm for Group A and 12,885 ± 5,056 N/mm for Group B (p ? 0.0054). Stem B had greater maximum strength, deflection, and energy. Conclusions The new stem was effective in neutralizing the impact of axial flexion-compression stresses during biomechanical tests in cadaveric models.