Abstract This study investigated microshear bond strength (µSBS) of two (2) dual-cured resin-luting agents (RelyX™ Ultimate and RelyX™ U200) when photoactivated through varying thicknesses of lithium disilicate, with or without thermal cycling. Discs of IPS e.max Press of 0.5, 1.5, and 2 mm in thickness were obtained. Elastomer molds (3.0 mm in thickness) with four cylinder-shaped orifices 1.0 mm in diameter, were placed onto the ceramic surfaces and filled with resin-luting agents. A Mylar strip, glass plate, and load of 250 grams were placed over the filled mold. The load was removed and the resin-luting agents were photoactivated through the ceramics using a single-peak LED (Radii Plus.) All samples were stored in distilled water at 37oC for 24 h. Half of the samples were subjected to thermal cycling (3,000 cycles; 5ºC and 55ºC). All samples were then submitted to µSBS test using a universal testing machine (Instron 4411) at a crosshead speed of 0.5 mm/min. Data were submitted to three-way ANOVA and Tukey post-hoc test (α=0.05). The mean µSBS at 24 h was significantly higher than after thermal cycling (p<0.05). No statistical difference was found between resin-luting agents (p > 0.05). The mean µSBS for groups photoactivated through 0.5 mm ceramic were significantly higher than 1.5 mm and 2.0 mm (p < 0.05). In conclusion, increased ceramic thicknesses reduced the bond strength of tested resin-luting agents to lithium disilicate. No differences were found between resin-luting agents. Thermal cycling reduced the bond strength of both resin-luting agents. (µSBS (2 dualcured dual cured resinluting resin luting RelyX (RelyX U200 U disilicate emax e max 05 0 5 15 1 obtained 3.0 30 3 (3. cylindershaped cylinder shaped 10 1. diameter strip plate 25 mold singlepeak single peak Radii Plus. Plus oC 3,000 3000 000 (3,00 cycles ºC 55ºC. 55ºC . 55ºC) Instron 4411 0. mmmin min mm/min threeway three way posthoc post hoc α=0.05. α005 α α=0.05 (α=0.05) p<0.05. p005 p p<0.05 (p<0.05) 0.05. 005 0.05 0.05) 20 2. conclusion ( U20 3. (3 3,00 300 00 (3,0 441 α00 α=0.0 (α=0.05 p00 p<0.0 (p<0.05 0.0 U2 3,0 (3, 44 α0 α=0. (α=0.0 p0 p<0. (p<0.0 3, 4 α=0 (α=0. p<0 (p<0. α= (α=0 p< (p<0 (α= (p< (α

Resumo: Este estudo investigou a resistência de união ao microcisalhamento (RUµC) de dois (2) agentes de cimentação de resina dual (RelyX™ Ultimate e RelyX™ U200) quando fotoativados através de diferentes espessuras de dissilicato de lítio, com ou sem ciclagem térmica. Discos do IPS e.max Press de 0,5, 1,5 e 2 mm de espessura foram obtidos. Moldes de elastômero (3,0 mm de espessura) com quatro orifícios cilíndricos de 1,0 mm de diâmetro foram colocados sobre as superfícies cerâmicas e preenchidos com agentes de cimentação de resina. Uma tira Mylar, placa de vidro e carga de 250 gramas foram colocadas sobre o molde preenchido. A carga foi removida e os agentes de cimentação resinosos foram fotoativados através da cerâmica usando um LED de pico-único (Radii Plus). Todas as amostras foram armazenadas em água deionizada a 37oC por 24 h. Metade das amostras foi submetida a ciclagem térmica (3.000 ciclos; 5ºC e 55ºC). Todas as amostras foram então submetidas ao teste de RUµC usando uma máquina de teste universal (Instron 4411) com velocidade de 0,5 mm/min. Os dados foram submetidos à Análise de Variância três fatores e ao teste post-hoc de Tukey (α = 0,05). A média de RUµC em 24 h foi significativamente maior do que após a ciclagem térmica (p < 0,05). Não houve diferença estatística entre os cimentos resinosos (p > 0,05). As médias de RUµC para grupos fotoativados através de cerâmica de 0,5 mm foram significativamente maiores do que 1,5 mm e 2,0 mm (p < 0,05). Em conclusão, o aumento da espessura da cerâmica reduziu a resistência de união dos agentes de cimentação resinosos ao dissilicato de lítio. Não foram encontradas diferenças entre os agentes de cimentação resinosos. A ciclagem térmica reduziu a resistência de união de ambos os agentes de cimentação resinosos. Resumo (RUµC (2 RelyX (RelyX U200 U lítio emax max 05 0 5 15 1 1, obtidos 3,0 30 3 (3, 10 Mylar 25 preenchido picoúnico pico único Radii Plus. Plus . Plus) oC 3.000 3000 000 (3.00 ciclos ºC 55ºC. 55ºC 55ºC) Instron 4411 0, mmmin min mm/min posthoc post hoc α 0,05. 005 0,05 0,05) p 20 2, conclusão ( U20 3, (3 3.00 300 00 (3.0 441 0,0 U2 3.0 (3. 44 3. 4

ABSTRACT Introduction: Brazil has many inequities in the healthcare provided nationwide. Therefore, in order to access challenges in treatment, available resources and current practices, to identify barriers in delivering a good quality of care among Brazilian centers treating children and adolescents with Non-Hodgkin Lymphoma (NHL) and to generate a future prospective guideline, a customized online survey was distributed to pediatric hematologists and oncologists across the country. Results: A total of 97 surveys were completed (35% response rate), from 47 cities in all Brazilian regions and 79 units of care, with a median of 1 answer by the center (range 1 - 5). Most respondents work at an institution supported exclusively by public/philanthropic resources (58%), with an average of 5 to 9 new cases/year (49%), and 41% have 4 to 6 oncologists/centers. Additionally, 22% have no easy access to the intensive care unit, 26% have no access to Rasburicase, 28% have no access to Rituximabe as front-line therapy and 41% have unreliable methotrexate monitoring levels. Those differences cannot be explained thoroughly by regional wealth variances, nor by the financing model. Regarding the pathology service, 70% consider having reasonable quality assistance, but the timeframe to deliver diagnosis is satisfactory to 46%. There is no uniform management of care, with the current guideline from the Sociedade Brasileira de Oncologia Pediátrica being adopted by 54 to 59%, depending on the NHL subtype. Conclusion: This study provides insights into the heterogeneity of care among Brazilian centers. Recognizing those diversities will support the design of effective strategies and collaboration nationwide. Introduction nationwide Therefore treatment practices NonHodgkin Non Hodgkin (NHL country Results 35% 35 (35 rate, rate , rate) 7 range 5. . 5) publicphilanthropic public philanthropic 58%, 58 58% (58%) casesyear cases year 49%, 49 49% (49%) 41 oncologistscenters oncologists/centers Additionally 22 unit 26 Rasburicase 28 frontline front line levels variances model service 70 assistance 46 46% 59 59% subtype Conclusion 3 (3 (58% (49% 2 ( (58 (49 (5 (4

Abstract The aim of this study was to quantify the force exerted by tandem archwires in a specific system of passive self-ligating bracket. Forty-eight thermo-activated nickel-titanium orthodontic archwires were separated into four groups (n = 12): G1 – two .014” + .014” round archwires; G2 – two .014” + .016” round archwires; G3 – .014” x .025” rectangular archwire; and. G4 – .016” x .022” rectangular archwire. Brackets were fixed onto teeth 1.5 to 2.5 using a device that represented the upper teeth, maintaining an interbracket distance of 6.0 mm. The deflection tests were performed using the structure representative of tooth 1.1 as support on the Instron testing machine at a speed of 2.0 mm/min. The archwires were evaluated at deflections of 0.5 mm, 1.0 mm, and 1.5 mm. The data were analyzed by a generalized linear model, considering values at different deflections as repeated measurements in the same experimental unit (α = 0.5%). At 0.5 mm, higher forces were observed in G2 and G3, which did not differ significantly (p > 0.05). The lowest force was observed in G4 (p < 0.05). At 1.0 mm and 1.5 mm, the highest force was observed in G3, followed by G4 and G2 (p < 0.05). The lowest force was observed in G1 (p < 0.05). In general, tandem archwires (same or different calibers) in a specific passive self-ligating bracket exerted lower force when compared with rectangular archwires. selfligating self ligating Fortyeight Forty eight thermoactivated thermo activated nickeltitanium nickel titanium n 12 12) G .014 014 .016 016 .025 025 archwire .022 022 15 1 5 1. 25 2 2. 60 6 0 6. 11 20 mmmin min mm/min 05 0. 10 model α 0.5%. 0.5% . 0.5%) p 0.05. 005 0.05 0.05) general calibers .01 01 .02 02 00 0.0 .0

Resumo Foi desenvolvido um novo dispositivo para permitir a visualização e medição da angulação canina ao mesmo tempo que se visualiza e mede a força transmitida aos dentes adjacentes. Este estudo avaliou o ângulo de inclinação mesiodistal dos braquetes caninos superiores, a deflexão do fio, e os seus efeitos nos dentes adjacentes com cinco diferentes desenhos de ranhuras dos caninos superiores. Os fios (0,020" e 0,019" x 0,025") foram testados em cinco diferentes tipos de braquetes e ângulos distais. A força aplicada aos dentes adjacentes foi medida a medida que o ângulo era aumentado, e as suas consequências foram observadas também nas regiões posterior e anterior. A tensão da força (gf) foi medida em uma máquina de ensaio universal (Instron). Os dados foram submetidos ao teste ANOVA 3 fatores e Tukey (α=0,05). Para ambos os arcos, independentemente do tipo de dente e tipo de braquete, os valores médios de tensão mais elevados foram mostrados pelo ângulo de 20°, seguido pelos ângulos de 15°, 10°, e 5°, que diferiram estatisticamente entre si. Em geral, para ângulos de 5°, 10° e 15°, os braquetes convencionais e versáteis apresentaram valores de força significativamente mais elevados em todos os dentes, braquetes tip-edge e controle apresentaram os mais baixos. Os maiores valores de força foram observados nos incisivos centrais e laterais com braquetes convencionais e versáteis e no primeiro e segundo pré-molares com braquetes auto-ligantes passivo e controle. Os braquetes convencionais apresentaram as forças mais elevadas, os braquetes controle e tip-edge apresentaram os valores mais baixos. Os dentes que sofreram as maiores forças foram os incisivos laterais, e os que sofreram menos foram os segundos pré-molares.

Abstract A new device was developed to enable the visualization and measurement of canine angulation while at the same time visualizing and measuring the force transmitted to adjacent teeth. This study aimed to evaluate the mesiodistal tilt angle of the upper canine brackets, the wire deflection, and its effects on adjacent teeth with five different slot designs of upper canines. Wires (0.020” and 0.019” x 0.025”) were tested on different five bracket types at five different distal angles. The force applied to adjacent teeth was measured as the angle was increased, and its consequences were observed in the posterior and anterior regions as well. The force tension (gf) was measured in a universal testing machine. Data were submitted to a 3-way ANOVA and Tukey’s test (α=0.05). For both arches, regardless of the type of tooth and bracket type, the highest means tension mean values were shown by the 20° angle, followed by the 15°,10°, and 5° angles, which differed statistically among themselves. Overall, for 5°, 10°, and 15° angles, conventional and versatile brackets showed significantly higher force values in all teeth, tip-edge and control brackets showed the lowest. The highest force values were observed in central and lateral incisors with conventional and versatile brackets and on first and second premolar teeth with self-ligating passive and control brackets. Conventional brackets presented the highest forces, tip-edge and control brackets showed the lowest. The teeth that suffered the greatest forces were lateral incisors, and those that suffered the least were second premolars.

Abstract Office gynecological procedures are crucial for women health. New anesthetic methods that replace general anesthesia propelled the transition from the operating room to an office setting of multiple interventions (insertion of intrauterine devices, biopsies and hysteroscopies with or without with or without minor therapeutic procedures). Moderate to severe pain is often experienced by women, leading to the interruption of the procedure. No consensus exists upon routine use of analgesia during these office procedures. More effective pain control strategies and guidelines are needed for pain relief in outpatient gynecological procedures. The reflection in this work is intended to pave the way for a generalized pain management in gynecological procedures to widespread satisfy women expectations and needs.

Resumo Os procedimentos ginecológicos em ambulatório são cruciais na área da saúde da mulher. Novos métodos anestésicos que substituem a anestesia geral e impulsionam a transição do bloco operatório para o consultório para a realização de múltiplas intervenções diagnósticas e terapêuticas, são indispensáveis. A dor moderada a intensa é frequentemente sentida pelas mulheres, levando à interrupção do procedimento. Não existe consenso sobre o uso de rotina de analgesia durante esses procedimentos em ambulatório. Estratégias e diretrizes de controle da dor mais eficazes são necessárias para o alívio da dor para a realização de alguns procedimentos como são exemplo a introdução de dispositivos intrauterinos e a realização de histeroscopias. Este trabalho é uma reflexão sobre este tópico com o objetivo de abrir caminho para um controlo generalizado da dor em procedimentos ginecológicos de modo a satisfazer amplamente as expectativas e necessidades das mulheres.

Resumo O objetivo deste estudo in vitro foi avaliar a redução da força de diferentes cadeias elastoméricas após diferentes tempos: inicial, 10 minutos, 1 dia, 28 dias e após escovação mecânica. Vinte segmentos de cadeias elastoméricas ortodônticas foram utilizadas para cada marca comercial. Inicialmente, a cadeia elastomérica de 15 mm de comprimento foi esticada imediatamente até 20 mm na Instron e a força foi medida em (gf). Após, todas as amostras foram adaptadas esticadas em placas retangulares de acrílico na distância de 20 mm, imersas em água deionizada a 37o C por 10 minutos e a força (gf) foi medida novamente. Cinco medidas de força foram feitas nos seguintes intervalos de tempo: inicial, 10 minutos, 1 dia, 28 dias e após a escovação mecânica. Após 28 dias, as placas de acrílico com as amostras foram adaptadas na máquina de escovação (MSCT 3) e as cadeias elastoméricas foram submetidas a escovação mecânica e a medida de força (gf) novamente. Os dados da força (gf) foram submetidos a ANOVA modelo misto e teste post-hoc de Sidak (α = 0,05). Uma redução estatisticamente significativa na força foi encontrada para todos os tipos de cadeia elastomérica ortodôntica após 1 dia, 28 dias e escovação mecânica (p<0,05). As cadeias elastoméricas Morelli e 3M Unitek apresentaram força significativamente superior em relação a Abzil e GAC (p<0,05) após 1 dia, 28 dias e escovação mecânica. Em conclusão, a força distribuída por todas as cadeias elastoméricas decaiu rapidamente com o tempo. As cadeias elastoméricas Morelli e 3M Unitek consistentemente tiveram uma força significativamente maior após a escovação mecânica, enquanto GAC a mais baixa.

Abstract The purpose of this in vitro study was to evaluate the force decrease of different elastomeric chains after different times: initial, 10 minutes, 1 day, 28 days and after mechanical brushing. Twenty orthodontic elastomeric chains segments were utilized for each commercial brand. Initially, the elastomeric chain of 15mm long were immediate stretched up to 20 mm in an Instron and the force was measured in gf. After all specimens were placed stretched on rectangular acrylic jigs with distance of 20 mm, immersed in deionized water at 37oC for 10 minutes and the force (gf) was measured again. Five test measurements of remaining force were made at the following time intervals: initial, 10 minutes, 1 day, 28 days and mechanical brushing. After 28 days, the acrylic plates with the specimens were adapted in the mechanical brushing machines (MSCT 3) and the elastomeric chains were submitted to mechanical brushing and the force (gf) measure again. The force (gf) was submitted to mixed-model ANOVA and Sidak post-hoc test (α=0.05). A statistically significant reduction in the force was found for all orthodontic elastomeric chain types after 1 day, 28 days and mechanical brushing (p<0.05). Morelli and 3M Unitek elastomeric chains showed significantly higher force than Abzil and GAC (p<0.05) after 1 day, 28 days and mechanical brushing. In conclusion, the force delivered by all elastomeric chains decayed rapidly over time. Morelli and 3M Unitek elastomeric chains consistently had a significantly greater force after mechanic brushing, while GAC the lowest.

Resumo O objetivo deste estudo foi avaliar o efeito do digluconato de clorexidina 2% (CHX) na resistência de união à microtração (µTBS) entre um sistema adesivo e sob 3 condições de dentina. Para tanto, este estudo avaliou a interface adesiva no início, após 6 meses e 1 ano de armazenamento. Quarenta e oito terceiros molares humanos foram preparados e divididos aleatoriamente em 3 grupos, de acordo com os substratos dentinários: dentina hígida (Dh), dentina infectada por cárie (Di) e dentina afetada por cárie (Da). Os grupos foram subdivididos em dois de acordo com o pré-tratamento: aplicação de CHX 2% ou sem pré-tratamento (controle). As superfícies da dentina foram condicionadas com gel de ácido fosfórico a 35%, em seguida, utilizou-se o sistema adesivo Adper Single Bond 2 (3M ESPE) de acordo com as instruções do fabricante. Posteriormente, os corpos-de-prova foram armazenados em água deionizada a 37°C por 24h, 6 meses e 1 ano. Dois dentes adicionais foram usados para analisar as interfaces de união no MEV. Os dados foram submetidos a ANOVA três fatores em esquema de parcela subdividida e ao teste de Tukey (α = 0,05). Os resultados mostram que a Di diminuiu os valores de µTBS quando comparado as Da e Dh, independente do tempo de armazenamento ou tratamento. Amostras armazenadas por 6 meses e 1 ano diminuíram a µTBS para o grupo de controle, mas nenhuma diferença foi encontrada entre o tempo de armazenamento para o grupo CHX. A aplicação de CHX 2% após o condicionamento apresentou melhora na resistência de união à dentina no tempo de armazenamento, independente dos substratos avaliados.

Abstract The aim of this study was to evaluate the effect of 2% chlorhexidine digluconate (CHX) on microtensile bond strength (µTBS) between an adhesive system and under 3 dentin conditions. For that, this study evaluated the adhesive interface at initial, after 6 months and 1 year of storage. Forty-eight human third molars were prepared and randomly divided into 3 groups, according to dentin substrates: sound dentin (Sd), caries-infected dentin (Ci) and caries-affected dentin (Ca). The groups were subdivided into two according to the dentin pre-treatment: application of 2% CHX or without pre-treatment (control). The dentin surfaces were etched with 35% phosphoric acid gel and bonded with Adper Single Bond 2 (3M ESPE) adhesive system according to manufacturer’s instructions. Subsequently, the specimens were stored in deionized water at 37°C for 24h, 6 months and 1 year. Two additional teeth were used to analyze the bonding interfaces by SEM. Data was submitted to three-way ANOVA in a split plot design and Tukey’s test (α = 0.05). The results showed that Ci decreased µTBS values when compared to Ca and Sd, regardless storages time or treatment. Stored samples for 6 months and 1 year decreased the µTBS for the control group, but no difference was found between storages time for the CHX group. As a conclusion, the 2% CHX application after etching showed improved dentin bond strength in the storage time, regardless of the substrates evaluated.

Abstract Estetrol (E4) is a native fetal estrogen with a distinct pharmacological profile, acting preferentially on alpha estrogen receptors. Estetrol (15 mg) in combination with drospirenone (3 mg) has been recently approved for contraception. The advantage of hormonal combined contraception with estetrol is demonstrated by neutral impact on hemostatic factors, decreased modulation on lipidic parameters which creates a unique safety profile that emphasizes the utility of E4 in clinical practice. Besides, the E4 use for the treatment of menopause related symptoms and for breast and prostate cancer control has been extensively studied.

Resumo O objetivo foi avaliar a resistência de união à microtração (RUμT) à dentina e o estresse interfacial em cavidades classe II restauradas com resina composta de incremento único ou convencional e as interfaces marginais. Cavidades classe II na face mesial, com margem gengival em dentina, foram confeccionadas em 72 terceiros molares, sendo divididos em grupos (n=24): Grupo 1-Tetric N-Ceram; Grupo 2- Tetric N-Ceram Bulk-Fill; Grupo 3- SonicFill. O Sistema adesivo Clearfil SE Bond foi usado em todos os grupos. Metade dos dentes de cada grupo (n=12) foram submetidos à ciclagem termo-mecânica (CTM). Os dentes restaurados (n=9) foram cortados perpendicularmente para obter palitos que foram submetidos ao teste de RµT na máquina-EMIC. As margens cervicais em dentina dos dentes restaurados (n=3) foram observados em microscopia eletrônica de varredura (MEV) por meio de réplicas em resina epoxy, assim como os cortes das restaurações. O estresse interfacial após a aplicação da carga foram calculadas por análise de elementos finitos 2D. As médias de RUμT-MPa seguidas de letras distintas apresentam diferença estatística de acordo com ANOVA e teste de Games-Howell (p<0,05): Antes da CTM: G1-15.68±6.10a; G2-10.08±5.21ab; G3-7.98±3.76b. Após CTM: G1-9.70±5.52a; G2-5.79±1.42a; G3-4.37±1.87a. O estresse interfacial (MPa) foi 4,4 para SonicFill, 3,9 para Tetric N-Ceram e 3,5 para Tetric N-Ceram Bulk-Fill. Imagens em MEV mostraram margens contínuas para todas as restaurações em resina composta. Foi possível concluir que o SonicFill obteve um estresse interfacial ligeiramente mais alto e menor resistência de união à dentina em comparação com o Tetric N-Ceram e o Tetric N-Ceram Bulk-Fill. Interfaces de margem contínua foram obtidas para Tetric N-Ceram, Tetric N-Ceram Bulk-Fill e SonicFill. Entretanto, espaços vazios foram observados nas restaurações do SonicFill.

Abstract The aim was to evaluate the microtensile bond strength (mTBS) to dentin and interfacial stress in a class II cavity restored with bulk-fill or conventional composite resins and the margin interfaces. Vertical slot class II cavities in the mesial face, with the gingival end in dentin, were prepared in 72 third molars, being divided into groups (n=24): G1-Tetric N-Ceram; G2-Tetric N-Ceram Bulk-Fill; G3-SonicFill. Clearfil SE Bond adhesive system was used in all groups. Half of the teeth in each group (n=12) were submitted to thermo-mechanical cycling (TMC). Restored teeth (n=9) were cut perpendicular to obtain beams, which were submitted to a mTBS test in an EMIC machine. The cervical margins in dentin of the restored teeth (n=3) were assessed using SEM through epoxy resin replicas as well as the section of the restoration. Interfacial stresses after load application were calculated by 2D finite element analysis. The mTBS means-MPa followed by different letters represent statistical difference by ANOVA and Games-Howell’s test (p<0.05): Without TMC: G1-15.68±6.10a; G2-10.08±5.21ab; G3-7.98±3.76b. With TMC: G1-9.70±5.52a; G2-5.79±1.42a; G3-4.37±1.87a. Interfacial stress (MPa) was 4.4 for SonicFill, 3.9 for Tetric N-Ceram, and 3.5 for Tetric N-Ceram Bulk-Fill. SEM images showed continuous margins for all composite resin restorations. It was possible to conclude that SonicFill obtained a slightly higher interfacial stress and lower bond strength to dentin in comparison with Tetric N-Ceram and Tetric N-Ceram Bulk-Fill. Continuous margin interfaces were obtained for Tetric N-Ceram, Tetric N-Ceram Bulk-Fill, and SonicFill. However, voids were observed in the SonicFill restorations.

Overview and Aims: Intrauterine systems (IUS) are one of the most effective forms of long acting reversible birth control, with low failure rates and high continuity and satisfaction rates. Still, they account for a small proportion of contraception use, which may be due to several myths and misperceptions. With this study, we aimed to assess Portuguese experts’ perceptions on potential benefits and fears that may limit women’s contraception choice and to identify current trends in clinical practice. Methods and Population: We performed an observational, descriptive and analytical study in which gynecologists/obstetricians were invited to answer an anonymous questionnaire by call or email made of multiple-choice questions on IUS use. Results: A total of 482 Portuguese Gynecologists answered the survey, of which 97.1% revealed that the insertion of IUS is a common procedure in their current clinical practice. More than 95% considered the insertion of IUS an easy procedure and a safe contraceptive method. Cost-efficacy and the fact that this method doesn’t rely on women´s action to be effective were the top benefits for IUS users, perceived by the physicians. On the other hand, concern about having a foreign object inside the body and fear of insertion pain were perceived by the physicians as the top barriers to IUS use. Female gynecologists perceived a higher degree of pain associated with IUS insertion (p=0.021). Overall, gynecology experts’ opinions were conservative regarding IUS recommendations to women. Conclusions: The results of this study provide a general insight towards Portuguese gynecologists’ perceptions, opinions and attitudes on the use of IUS. Most of the experts consider IUS a safe contraception method but, on the other hand, there is still concern about its use in particular female conditions which may in part contribute to the low rate of IUS use in Portuguese women.

Nas últimas décadas a obesidade tem vindo a aumentar atingindo a nível mundial proporções epidémicas. Portugal ocupa o quarto lugar entre os países da Europa com mais pessoas com obesidade, das quais um grande número são mulheres em idade reprodutiva¹. É por isso importante considerar a influência/importância do peso corporal na segurança e eficácia dos métodos contracetivos e a escolha do método durante os períodos de mudança do comportamento alimentar, tratamento médico e após cirurgia da obesidade. A Sociedade Portuguesa da Contracepção e a Sociedade Portuguesa para o Estudo da Obesidade propõem estratégias efetivas e seguras para o aconselhamento contracetivo nas mulheres com excesso de peso, com obesidade, sob terapêutica médica para a obesidade e após cirurgia bariátrica.

Resumo Introdução Os procedimentos de esterilização e desinfecção devem ser adaptados ao perfil químico das ligas metálicas presentes nos instrumentos. Objetivo O objetivo do estudo foi realizar uma avaliação micrográfica das características da superfície da widia de alicates ortodônticos com duas composições de ligas submetidas à ação de ácido peracético a 0,2% e uso intensivo. Material e método Vinte alicates de corte distal foram divididos em dois grupos (n=10), de acordo com a composição widia (% em peso): W1- 85% a 87% de carboneto de tungstênio e outros componentes na proporção de 13% a 15% e W2 - 87,5% a 88,5% de carboneto de tungstênio e 11,5% a 12,5% para outros componentes. Os alicates foram avaliados em uma lupa estereoscópica (32x) após três tratamentos: antes do uso (T0); após corte de 100 segmentos de fios retangulares de aço inoxidável- uso intensivo (T1); após 100 ciclos de esterilização em ácido peracético a 0,2% e uso intensivo (T2). Os locais de corte dos alicates foram definidos pela linha “A” representando T1 e pela linha “B” representando T2. Foi realizada uma tabela de distribuição de frequências e o teste exato de Fisher (α=0,05). As widias foram avaliadas em MEV e Espectroscopia de Energia Dispersiva. Resultado Os alicates W1 apresentaram defeitos significativamente menores após os ciclos de esterilização com ácido peracético e uso intensivo do que os alicates W2 (p=0,0198). Não houve diferenças entre os dois alicates após uso intensivo (p=1.000). Conclusão As imagens de MEV/EDS mostraram alterações nas superfícies widia após os diferentes tratamentos. A composição widia afetou a resistência do alicate ortodôntico após ciclos de esterilização com ácido peracético a 0,2% e uso intensivo.

Abstract Introduction The sterilization and disinfection procedures should be adapted to the chemical profile of the metal alloys present in the instruments. Objective This study aimed to perform a micrographic assessment on the surface characteristics of the widia of orthodontic pliers with two alloy compositions subjected to the action of 0.2% peracetic acid and intensive use. Material and method Twenty distal cutting pliers were divided into two groups (n=10) according to widia composition (%wt): W1- 85% to 87% of tungsten carbide (TC) and other components in the proportion of 13% to 15% and W2 – 87.5% to 88.5% of tungsten carbide and 11.5% to 12.5% for other components. All the pliers were assessed in a stereoscopic magnifying glass (32x) after three treatments: before use (T0); after cutting 100 segments of rectangular stainless-steel wires – intensive use (T1); and after 100 sterilization cycles in 0.2% peracetic acid and intensive use (T2). The cutting sites of all pliers were standardized. Widia regions were defined by line “A” representing T1 and line “B” representing T2. A frequency distribution table and Fisher’s exact test (α=0.05) was performed. We assessed two widia from each composition and treatment in SEM and energy-dispersive X-ray spectroscopy (EDS/SEM). Result The results showed that W1 pliers presented significantly fewer defects after the sterilization cycles with peracetic acid and intensive use than W2 pliers (p=0.0198). There were no differences between both pliers after intensive use (p=1.000). Conclusion The SEM images and EDS analyses showed changes in widia surfaces after the different treatments. Widia composition affected the resistance of the orthodontic pliers after sterilization cycles with 0.2% peracetic acid and intensive use.

Resumo Este estudo avaliou os efeitos de diferentes concentrações de ácido hidrofluorídrico (HF) e ciclagem térmica na resistência de união ao cisalhamento (RUC) de bráquetes metálicos a cerâmica. Cilindros da cerâmica feldspática foram divididos em 10 grupos (n=15). De acordo com as concentrações do ácido HF: 1-1%;2-2,5%;3-5%;4-7,5%; e, 5-10% (armazenagem por 24 h); 6-1%;7-2,5%;8-5%;9-7,5%; e, 10-10% (ciclagem térmica). Todos os cilíndros foram condicionados por 60s e receberam uma camada de silano. Bráquetes metálicos foram colados aos cilíndros usando o transbond-XT, fotoativado por 40 s, usando o LED (Radii Plus; SDI) e armazenados em água deionizada a 37o C por 24 h. Os Grupos 6 a 10 foram submetidos à ciclagem térmica (7.000 ciclos - 5o/55oC). RUC foram realizadas na Instron a velocidade de 1.0 mm/min. Os dados foram submetidos à análise de variância dois-fatores e ao teste de Tukey’s post-hoc (α=0,05). O Índice de Remanescente do Adesivo (IRA) foi avaliado com 40x de aumento. As diferente concentrações do ácido HF influenciou na RUC dos bráquetes na cerâmica (p<0,05). A ciclagem térmica diminuiu a RUC dos bráquetes na cerâmica para todas as concentrações do ácido (p<0,05). O IRA mostrou predominância de escores 0 para todos os grupos, com aumento de escores 1, 2 e 3 para os grupos armazenados por 24 h. Concluíndo, as concentrações do ácido HF 5,0%, 7,5% e 10% influenciaram na RUC de braquetes à cerâmica. A ciclagem térmica diminuiu significativamente a RUC do bráquetes à cerâmica.

Abstract This study to evaluate the effects of different hydrofluoric acid (HF) concentrations and thermal cycling on the shear bond strength (SBS) of brackets to ceramic. Cylinders of ceramic were divided into 10 groups (n=15), according to HF concentrations: 1-1%;2-2.5%;3-5%;4-7.5%;5-10% (storage 24 h); 6-1%;7-2.5%;8-5%;9-7.5%; and, 10-10% (thermal cycling). All cylinders were etched for 60s and received one layer of silane. Metallic brackets were bonded to the cylinders using Transbond-XT, light activated for 40 s, using a LED (Radii Plus) and stored in deionized water at 37o C for 24h. The groups 6 to 10 were submitted to thermal cycling (7,000 cycles - 5o/55oC). SBS was performed in an Instron at crosshead speed of 1.0 mm/min. Data were submitted to two-way ANOVA and Tukey’s post-hoc test (α=0.05). The Adhesive Remaining Index (ARI) was evaluated at 40x magnification. The different HF acid concentrations influenced on the SBS of the brackets to ceramic (p<0.05). The thermal cycling decreased the SBS of the brackets to ceramic for all acid concentrations (p<0.05). The ARI showed a predominance of scores 0 for all groups, with an increase in scores 1, 2 and 3 for the group storage for 24 h. In conclusion, the different HF acid concentrations 5.0%, 7.5% and 10% influenced on the SBS of brackets to ceramic. The thermal cycling decreased significantly the SBS of brackets to ceramic.