RESUMO Objetivo: Avaliar o procedimento cirúrgico de retalho homodigital, bem como a função do quirodáctilo, a dor, a sensibilidade, a estética e a satisfação do paciente. Método: Análise retrospectiva de prontuários e questionários de pacientes submetidos a essa técnica entre maio de 2013 e outubro de 2016. Oito pacientes foram incluídos no estudo, com uma média de seguimento de 23 meses. Foram excluídos os pacientes com lesões de polpa digital em polegares e os que não fizeram reabilitação. Todos os pacientes fizeram os testes de discriminação entre dois pontos, Semmes-Weinstein, e avaliação do arco de movimento. A idade variou entre 22 e 59 anos (média de 32,9), seis (75%) eram do sexo masculino. Resultados: Três pacientes (37,5%) tiveram acometimento da mão direita e cinco (62,5%), da esquerda. Com relação à etiologia, sete sofreram lesão traumática e um sofreu queimadura química. A distância média obtida no teste de discriminação entre dois pontos foi de 7,3 mm. Todos os pacientes submetidos ao teste Semmes-Weinstein obtiveram resposta ao filamento de cor roxa. A média da somatória do arco de movimento do dígito acometido foi de 98,9%. A área do retalho foi em média de 294,4 mm2. O retorno ao trabalho foi em torno de sete semanas. Um apresentou sinal de Tinel positivo na área doadora e dois referiram intolerância ao frio. Não se observou necrose parcial ou total do retalho. Conclusão: A técnica do retalho homodigital apresentou resultados estéticos e funcionais satisfatórios quanto à viabilidade, sensibilidade e mobilidade digital em lesões da polpa.

ABSTRACT Objective: To assess the homodigital flap surgical procedure, as well as the function of the finger, pain, sensation, esthetics, and patient satisfaction. Method: Retrospective analysis of records and questionnaires of patients who underwent this surgical technique between the months of May 2013 and October 2016. Eight were included in the study, with an average follow-up period of 23 months. Patients with digital pulp lesions of the thumbs and those who did not perform rehabilitation were excluded. All underwent the two-point discrimination test, the Semmes-Weinstein test, and range of motion evaluation. The age varied from 22 to 59 years (average of 32.9), six (75%) being male patients. Results: Three patients (37.5%) had involvement of the right hand and five of the left (62.5%). Regarding the etiology, seven suffered injury and one a chemical burn. The average distance obtained from the two-point discrimination test was 7.3 mm. All patients who underwent the Semmes-Weinstein test obtained response to the purple filament. The average sum of the range of motion of the affected digit was 98.9%. The flap area was on average 294.4 mm2. The return to work averaged seven weeks. A positive Tinel sign was found in the donating area and two reported intolerance to cold. Partial or total necrosis of the flap was not observed. Conclusion: The homodigital flap technique presented satisfactory esthetics and functional results regarding feasibility, sensation, and digital mobility in pulp lesions.

This study compared the volumetric shrinkage (VS), flexural strength (FS) and flexural modulus (FM) properties of the low-shrinkage resin composite Aelite LS (Bisco) to those of Filtek LS (3M ESPE) and two regular dimethacrylate-based resin composites, the microfilled Heliomolar (Ivoclar Vivadent) and the microhybrid Aelite Universal (Bisco). The composites (n = 5) were placed on the Teflon pedestal of a video-imaging device, and VS was recorded every minute for 5 min after 40 s of light exposure. For the FS and FM tests, resin discs (0.6 mm in thickness and 6.0 mm in diameter) were obtained (n = 12) and submitted to a piston-ring biaxial test in a universal testing machine. VS, FS, and FM data were submitted to two-way repeated measures and one-way ANOVA, respectively, followed by Tukey's post-hoc test (a = 5%). Filtek LS showed lower VS than did Aelite LS, which in turn showed lower shrinkage than did the other composites. Aelite Universal and Filtek LS exhibited higher FS than did Heliomolar and Aelite LS, both of which exhibited the highest FM. No significant difference in FM was noted between Filtek LS and Aelite Universal, while Heliomolar exhibited the lowest values. Aelite LS was not as effective as Filtek LS regarding shrinkage, although both low-shrinkage composites showed lower VS than did the other composites. Only Filtek LS exhibited FS and FM comparable to those of the regular microhybrid dimethacrylate-based resin composite.

This study evaluated the effect of adhesive systems and application strategies on dentin hydraulic conductance (HC). The buccal enamel was removed from bovine incisors to simulate laminate cavity preparations. After removing the roots and the coronal pulp, the buccal dentin was treated with EDTA solution (0.5 M) for 5 minutes, rinsed, ultrasonicated for 12 minutes and connected to a permeability device. HC of the specimens was measured at 10 psi (n = 5). Permeability was measured before and after bonding procedures using G-Bond (GB), Clearfil Tri-S Bond (CTS), Hybrid Coat (HY), Bond Force (BF), Adper Easy Bond (AEB) Silorane (SI), Clearfil SE Bond (CSE) and Adper Scotchbond Multi-Purpose (SMP) adhesives systems, which were applied following three strategies: 1) according to the manufacturers' instructions; 2) two coats of all-in-one self-etching adhesives (GB, CTS, HY, BF, AEB) or priming step plus two coats of bonding resin for the other systems (SI, CSE and SMP); and 3) a thin layer of a flowable composite applied over one coat of all-in-one self-etching adhesives or primed surface for SI, CSE and SMP adhesives. No significant difference was observed among the application modes concerning their ability to reduce HC. None of the adhesives showed complete sealing (100%) of the bovine tooth dentin. SI exhibited lower HC than SMP, however, they were not significantly different from the other systems. The results suggest that all systems tested result in an HC reduction of more than 90%. The wet bonding technique seemed to be more sensitive for dentin sealing.

O objetivo deste estudo foi avaliar o efeito da aplicação de primers na resistência de união de cimentos resinosos ao titânio. Quatro primers - Metaltite, Metal Primer II, Alloy Primer and Ceramic Primer - e seus respectivos cimentos resinosos - Bistite II DC, Link Max, Panavia F 2.0, RelyX Unicem and RelyX ARC - foram testados. Placas de titânio foram preparadas a partir da fundição de lingotes (n=6 espécimes/cimento) e as superfícies dessas placas foram jateadas com partículas de Al2O3 (50 μ m). Três cilindros de cimento resinoso foram construídos em cada placa de titânio, utilizando moldes transparentes com formato de cilindro e foram submetidos ao teste de microcisalhamento. Os dados foram analisados pela ANOVA (dois fatores) e teste de Tukey (α=0,05). A aplicação do Metal Primer II e do Ceramic Primer resultou no aumento significativo da resistência de união para os cimentos resinosos Link Max e RelyX Unicem, respectivamente. Os cimentos Panavia F 2.0 e o RelyX ARC mostraram altos valores de resistência de união com ou sem o uso dos primers. A aplicação dos primers pode aumentar a resistência de união dos cimentos resinosos ao titânio, dependendo do tipo de cimento resinoso utilizado.

The purpose of this study was to evaluate the effects of adhesive primer applications on the bond strength of resin cements to cast titanium. Four adhesive primers - Metaltite, Metal Primer II, Alloy Primer and Ceramic Primer - and their respective resin cements - Bistite II DC, Link Max, Panavia F 2.0, RelyX Unicem and RelyX ARC - were tested. Cast plates were prepared from titanium ingots (n=6 specimens/cement) and had their surfaces airborne-particle abraded with Al2O3 (50 μ m). Three resin cement cylinders were built on each bonded titanium surface, using a cylindrical translucent tubing mold and were subjected to micro-shear testing. Data were analyzed statistically by two-way ANOVA and Tukey's post-hoc test (α=0.05). The application of Metal Primer II and Ceramic Primer resulted in significant higher bond strength for Link Max and RelyX Unicem resin cements, respectively, than nonuse of adhesive primers. Panavia F 2.0 and RelyX ARC yielded high bond strength means with or without adhesive primers. The use of adhesive primers might increase the bond strength to cast titanium depending on the resin cement used.

OBJETIVO: Apesar dos sistemas adesivos autocondicionantes (SAA) serem indicados para aplicação no esmalte dental, preocupação tem sido relatada com relação a sua efetividade. O objetivo deste estudo foi avaliar o padrão de condicionamento ácido (PCA) promovido por nove SAA e comparar ao PCA produzido pelo ácido fosfórico (35% e 34% - AF) no esmalte intacto (EI) ou abrasionado (EA). MATERIAIS E MÉTODOS: Vinte e dois terceiros molares humanos foram seccionados nos sentidos mésio-distal e vestíbulo-lingual, e quatro fragmentos dentais foram obtidos a partir de cada dente. Metade dos fragmentos tiveram o esmalte abrasionado com lixas de SiC (600) e a outra metade permaneceu intacta. Os fragmentos foram divididos em 22 grupos, de acordo com a textura da superfície do esmalte (EI e EA) e a técnica de condicionar o esmalte (AF 34 %, AF 35%, AdheSE primer; Brush & Bond; Clearfil Protect Bond primer; iBond; One-up Bond F; OptiBond Solo Plus primer; Tyrian SPE primer; Unifil Bond primer e Xeno III). Os agentes condicionadores foram aplicados nos EI e EA, de acordo com as instruções dos fabricantes. Espécimes tratados com AF foram lavados com água, enquanto os dentes tratados com SAA foram tratados com banhos alternados de álcool e acetona. Os espécimes foram secos, metalizados e observados em microscopia eletrônica de varredura. RESULTADOS: Em ambas as superfícies (EI e EA), o PCA dos AF (34 e 35%) foi mais profundo e homogêneo, quando comparados ao PCA produzido pelos SAA, exceto para o adesivo Tyrian SPE. A ação dos monômeros ácidos dos SAA foi mais efetiva no EA. CONCLUSÃO: A maioria dos SAA é menos agressiva que o ácido fosfórico e seus efeitos condicionadores são reduzidos em superfícies de EI.

ABSTRACT OBJECTIVE: Although self-etching bonding systems (SES) are indicated to prepare dental enamel for bonding, concerns have been expressed regarding their effectiveness. The aim of this study was to analyze the etching pattern (EP) of nine SES in comparison with 35% and 34% phosphoric acid etchants (FA) on intact (IN) and ground (GR) enamel surface. MATERIALS AND METHODS: Twenty-two human third molars were sectioned in mesial-distal and buccal-lingual directions, and four dental fragments were obtained from each tooth. Half of the fragments were ground using 600-grit SiC paper and the other half remained intact. The fragments were randomly assigned into 22 groups, according to the texture of enamel surface (IN and GR) and the technique to etch the enamel (34% FA, 35% FA, AdheSE primer; Brush & Bond; Clearfil Protect Bond primer; iBond; One-up Bond F; OptiBond Solo Plus primer; Tyrian SPE primer; Unifil Bond primer and Xeno III). Conditioners were applied to IN and GR enamel surfaces, according to the manufacturer's instructions. Specimens etched with phosphoric acids were washed with water, while the surfaces treated with SES were submitted to alternate rinsing with alcohol and acetone. The specimens were dried, sputter-coated and examined under a scanning electron microscope. RESULTS: For both IN and GR enamel surfaces, the EP of 34 and 35% FA was deeper and more homogeneous in comparison to EP of SES, except for Tyrian SPE. The acidic monomer action of self-etching systems was more effective on GR enamel. CONCLUSION: Most of the SES are less aggressive than phosphoric acid etchants and their etching effects were reduced on intact enamel surfaces.

Quinine and quinidine are well-known 4-quinolinecarbinolamines that exhibit antimalarial activity, but, in contrast, their epimers 9-epiquinine and 9-epiquinidine are almost inactive. Literature data are conflicting in describing the 4-quinolinecarbinolamine interaction mode with the molecular target, the ferriprotoporphyrin IX [Fe(III)PPIX]. In the present paper, a pharmacophore is proposed based on the binding of the non-aromatic nitrogen to the iron atom. The 4-quinolinecarbinolamine antimalarials were superimposed on the pharmacophore under consideration and complexes with Fe(III)PPIX were constructed. Conformational analyses of the complexes were performed applying the MM+ molecular mechanics method. The analysis of the complexes showed that the proposed ligand mode is possible although it does not explain the activity differences between epimers. A discussion of the structural aspects is also provided.

Os autores apresentaram um estudo prospectivo de quatro pacientes portadores de pseudo-artrose no terço distal do rádio. Dois eram do sexo feminino e dois do masculino, com idade média de 42,5 anos. O diagnóstico de pseudo-artrose foi realizado em média com 5,3 meses após o trauma. Um paciente apresentava, como antecedente mórbido pessoal, epilepsia e osteoporose, outros dois relataram tabagismo e obesidade e o quarto, fratura exposta. O tratamento consistiu de osteossíntese interna e enxertia com osso autógeno. Todos foram submetidos à avaliação clínica pré e pós-operatória quanto à força de preensão palmar e arco de movimentos do punho. Houve 100% de consolidação das fraturas do terço distal do rádio em pseudo-artrose e retorno dos pacientes às atividades profissionais.

The authors presented a prospective study of four patients presenting pseudarthrosis at the distal third of the radius. Two patients were females and two were males, aged between 29 and 51 years with a mean age of 42.5 year old. The diagnosis of pseudarthrosis was provided within an average of 5.3 months after trauma. One patient presented as personal morbid history, epilepsy and osteoporosis, two patients were smokers and obese, and the fourth had an open fracture. The treatment consisted of internal osteosynthesis and autogenous bone graft. All patients were submitted to pre- and post operative clinical evaluation for palmar holding force and movement arch of the wrist. 100% of the radius distal-third fractures in pseudarthrosis have been united, with all patients returning to their respective professional activities.

O objetivo deste estudo foi avaliar a influência de diferentes tratamentos de superfície na resistência de união de resinas compostas a um agente de fixação resinoso. Dois compósitos de laboratório, Solidex e Targis, e um compósito convencional, Filtek Z250, foram testados. Quarenta e oito blocos de resina composta (5.0 x 5.0 x 5.0mm) foram confeccionados através da técnica incremental, para cada compósito testado, e foram aleatoriamente divididos em 6 grupos. Os blocos foram submetidos a seis tratamentos de superfície: 1 - Controle, Lixa 600-SiC (C); 2 - Silanização (SI); 3 - Jateamento com Al2O3 50µm por 10 segundos (SA); 4 - Condicionamento com ácido fluorídrico por 60 segundos (HF); 5 - HF + SI; 6 - SA + SI. Blocos submetidos ao mesmo tratamento foram unidos com o agente de fixação resinoso Rely X. Uma carga de 500g foi aplicada por 5 minutos e as amostras foram fotoativadas por 40 segundos. Os blocos unidos foram seccionados em fatias de 0.9mm de espessura perpendicularmente à interface de união (n = 12). Foram realizadas constrições limitando a interface de união a 1mm e as amostras foram levadas para o ensaio de tração. As maiores médias de união foram obtidas para as amostras submetidas à aplicação do silano após o jateamento com Al2O3.

The purpose of this study was to evaluate the influence of different surface treatments on composite resin on the microtensile bond strength to a luting resin cement. Two laboratory composites for indirect restorations, Solidex and Targis, and a conventional composite, Filtek Z250, were tested. Forty-eight composite resin blocks (5.0 x 5.0 x 5.0mm) were incrementally manufactured, which were randomly divided into six groups, according to the surface treatments: 1- control, 600-grit SiC paper (C); 2- silane priming (SI); 3- sandblasting with 50 mm Al2O3 for 10s (SA); 4- etching with 10% hydrofluoric acid for 60 s (HF); 5- HF + SI; 6 - SA + SI. Composite blocks submitted to similar surface treatments were bonded together with the resin adhesive Single Bond and Rely X luting composite. A 500-g load was applied for 5 minutes and the samples were light-cured for 40s. The bonded blocks were serially sectioned into 3 slabs with 0.9mm of thickness perpendicularly to the bonded interface (n = 12). Slabs were trimmed to a dumbbell shape and tested in tension at 0.5mm/min. For all composites tested, the application of a silane primer after sandblasting provided the highest bond strength means.

Este estudo avaliou, in vitro, o efeito da idade na resistência à tração do sistema adesivo Prime & Bond NT no substrato dentinário. Foram utilizados terceiros molares humanos de cinco faixas etárias: A- 17 a 20, B- 21 a 30, C- 31 a 40, D- 41 a 50 e E- 51 a 63. O esmalte oclusal foi removido utilizando disco de diamante e a superfície dentinária abrasionada e planificada com lixa de SiC (600) sob refrigeração. O sistema adesivo foi aplicado de acordo com as recomendações do fabricante e um bloco de resina composta de 6 mm de altura foi confeccionado na superfície dentinária. Os dentes foram armazenados em água por 24 horas a 37ºC e preparados para o ensaio de micro-tração. Cada espécime foi fixado no dispositivo de micro-tração que estava acoplado a uma máquina universal de ensaio e testado numa velocidade de 0,5 mm/min. As médias de resistência à tração foram (MPa): A- 21,42 ± 7,52ª; B- 30,13 ± 10,19ª; C- 31,69 ± 11,78ª; D- 30,69 ± 8,47ª e E- 35,66 ± 9,54ª. Nenhuma diferença significativa foi observada entre os grupos formados pelas faixas etárias (p > 0,05). Os resultados sugerem que a idade não altera significativamente a resistência de união do sistema adesivo à dentina.

This in vitro study evaluated the effect of tooth age on the tensile bond strength of Prime & Bond NT adhesive system to dentin. Human third molars from the five age groups were analyzed: A- 17 to 20yrs, B- 21 to 30yrs, C- 31 to 40yrs, D- 41 to 50yrs and E- 51 to 63yrs. The occlusal enamel was removed using a diamond saw under water cooling and the dentin surface was wet-ground with 600-grit SiC paper to obtain flat surfaces. The adhesive system was applied according to the manufacturer's instructions and a 6-mm high resin "crown" was built-up with resin composite. Teeth were stored for 24 hours in distilled water at 37ºC and prepared for micro-tensile testing. Each specimen was mounted in a testing jig attached to a universal testing machine and stressed in tension at a crosshead speed of 0.5mm/min until failure. The means of tensile bond strength were (MPa): A- 21.42 ± 7.52ª; B- 30.13 ± 10.19ª; C- 31.69 ± 11.78ª; D- 30.69 ± 8.47ª and E- 35.66 ± 9.54ª. No statistically significant difference was observed among the age groups (p > 0.05). The results suggested that the tensile bond strength of the adhesive system was not significantly affected by dentin aging.