ABSTRACT BACKGROUND: Among the complications related to chronic kidney disease (CKD), those of a neurological nature stand out, and for a better quality of life for patients, the diagnosis and treatment of these complications is fundamental. OBJECTIVES: This study aimed to assess the effect of hemodialysis on intracranial pressure waveform (ICPw) in patients with chronic kidney disease undergoing hemodialysis and those who are not yet undergoing substitutive therapy. DESIGN AND SETTING: An observational study was conducted in two stages at a kidney replacement therapy center in Brazil. The first was a longitudinal study and the second was a cross-sectional study. METHODS: Forty-two patients on hemodialysis were included in the first stage of the study. In the second stage, 226 participants were included. Of these, 186 were individuals with chronic kidney disease (who were not undergoing substitutive therapy), and 40 did not have the disease (control group). The participants’ intracranial compliance was assessed using the non-invasive Brain4care method, and the results were compared between the groups. RESULTS: There was a significant difference between the hemodialysis and non-hemodialysis groups, with the former having better ICPw conditions. CONCLUSIONS: Hemodialysis influenced the improvement in ICPw, probably due to the decrease in the patients’ extra-and intracellular volumes. Furthermore, ICPw monitoring can be a new parameter to consider when defining the moment to start substitutive therapy. BACKGROUND CKD, CKD , (CKD) out fundamental OBJECTIVES (ICPw SETTING Brazil crosssectional cross sectional METHODS Fortytwo Forty 22 18 therapy, therapy) 4 control group. group . group) noninvasive non invasive Braincare Brain care method groups RESULTS nonhemodialysis conditions CONCLUSIONS extraand extra volumes Furthermore (CKD 2 1

Aim This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey’s post-hoc test. Statistical significance was set at p<0.05. Results A comparison of measurements between the 15-UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability. North 15UNC UNC 15 (15-UNC PCP12. PCP12 PCP . PCP-12) type program caliper examiners BlandAltman Bland Altman twoway way Tukeys Tukey s posthoc post hoc test p005 p 0 05 p<0.05 PCP-1 markings 1 mark variability PCP1 p00 p<0.0 PCP- p0 p<0. p<0 p<

Resumen Marco contextual: El control de la biopelícula oral con antisépticos debe ser adecuado a los protocolos elaborados para los pacientes de una unidad de cuidados intensivos (UCI). Objetivo: Evaluar el efecto de la solución de clorhexidina al 0,12% en la reducción de los microorganismos en la saliva de los pacientes en una UCI. Metodología: Estudio de cohorte con 45 voluntarios divididos en Clínica Médica (control, autohigiene bucal), UCI no intubados y UCI intubados. La higiene bucal en la UCI se realizó con clorhexidina. El análisis microbiológico se realizó con el recuento de microorganismos en la saliva. El análisis de los datos se realizó con ANOVA. Resultados: Hubo una reducción de los microorganismos después de la higiene bucal. El control mostró una diferencia significativa con los pacientes intubados en la UCI en el momento y después de 30 minutos. Los pacientes intubados mostraron una reducción de los microorganismos hasta 12 horas después de la higiene con clorhexidina. Conclusión: La higiene con clorhexidina reduce en un máximo de 12 horas los microorganismos bucales en pacientes intubados. Estos resultados pueden contribuir a la elaboración de protocolos de higiene bucal en las UCI, además de apoyar estrategias como la reducción de costes y los efectos secundarios asociados a la clorhexidina.

Resumo Enquadramento: O controlo do biofilme oral com anti-sépticos deve ser adequado aos protocolos elaborados para os doentes na unidade de terapia intensiva (UTI). Objetivo: Avaliar o efeito da solução de clorexidina 0,12% na redução de microrganismos na saliva de doentes de UTI. Metodologia: Estudo coorte com 45 voluntários divididos em: Clínica Médica (controlo, auto higiene oral), UTI não-entubado e UTI entubado. A higiene oral na UTI foi realizada com clorexidina. A análise microbiológica foi realizada com a contagem de microrganismos na saliva. A análise dos dados foi feita com ANOVA. Resultados: Houve uma redução dos microrganismos após higiene oral. O controlo apresentou diferença significativa com UTI entubado nos períodos imediato e após 30 min. Doentes entubados apresentaram redução dos microrganismos até 12 horas após higiene com clorexidina. Conclusão: A higiene com clorexidina reduz em até 12 horas os microrganismos bucais de doentes entubados. Estes resultados podem contribuir para elaboração de protocolos de higiene oral em UTI, além de sustentar estratégias como redução nos custos e efeitos colaterais associados à clorexidina.

Abstract Background: The control of oral biofilm with antiseptics should follow the protocols designed for patients in intensive care units (ICUs). Objective: To assess the effects of using 0.12% chlorhexidine solution in reducing the number of microorganisms in the saliva of ICU patients. Methodology: Cohort study with 45 volunteers divided into Medical Clinic (control group, oral self-care), non-intubated ICU, and intubated ICU. Oral hygiene in the ICU was performed with chlorhexidine. Microbiological analysis was performed through salivary bacterial count. Data were analyzed using ANOVA. Results: The number of microorganisms decreased after oral hygiene. A significant difference was found between the control and the ICU intubated groups in the immediate period and after 30 minutes. The number of microorganisms in intubated patients decreased 12 hours after oral hygiene with chlorhexidine. Conclusion: The number of oral microorganisms decreases in intubated patients 12 hours after oral hygiene with chlorhexidine. These results may contribute to elaborating oral hygiene protocols for ICUs and planning strategies, for example, to reduce the costs and the side effects associated with chlorhexidine use.

RESUMO Objetivo Avaliar por meio de densitometria óssea o comportamento de dois fatores que podem inteferir no processo da osseointegração: a nicotina e a texturização superficial dos implantes. Métodos Dezenove coelhos da raça Nova Zelândia (Oryctolagus cuniculus) foram distribuídos aleatoriamente em dois grupos (teste e controle), nos quais foram colocados 38 implantes. Na tíbia direita dos animais foram inseridos dezenove implantes usinados (lisos) de 3,75 mm de diâmetro por 6,0 mm de comprimento e, na tíbia esquerda, dezenove implantes anodizados (Vulcano(r)) nas mesmas dimensões. Foram administradas no grupo teste injeções subcutâneas de nicotina 3ml/dia/kg, três vezes ao dia, o grupo controle recebeu igualmente, três vezes ao dia, solução subcutânea de NaCl (3ml/dia/kg), por oito semanas. Após esse período, procedeu-se a análise densitométrica. Resultados Considerando a densidade óptica (pixels), não houve diferenças estatisticamente significativas entre os tipos de implantes (p = 0.135) bem como entre os grupos (p=0.590). Conclusão A nicotina dentro das condições experimentais empregadas neste estudo e a texturização superficial dos implantes não interferiram na densidade óssea.

ABSTRACT Objective The objective of this experimental study was to evaluate, through bone densitometry, the performance of two factors that may influence the osseointegration process: nicotine and superficial texturization of the implants. Methods Nineteen New Zealand rabbits (Oryctolagus cuniculus) were randomly distributed in two groups (test and control), in which 38 implants were placed. 19 machined implants (flat) 3.75 mm of diameter by 6.0 mm length were placed at the right tibia of the animals and, at the left tibia, 19 anodized implants (Vulcano(r)) with the same dimensions. Subcutaneous injections of nicotine 3ml/day/kg, three times a day were administered in group, group control also received, three times a day, subcutaneous solution of NaCl (3ml/day/kg), for 8 weeks. After this period, the densitometry analysis was performed. Results Considering the optical density (pixels), there were no statistical significant differences between the types of implants (p = 0.135) as well as between groups (p=0.590). Conclusion The nicotine inside the experimental conditions used in this study and the superficial texturization of the implants indicated that they were not influencing bone density.

Resumo Introdução O fluoreto desempenha importante papel no controle da cárie dental. Objetivo Avaliar as trocas químicas entre cimentos de ionômero de vidro de alta viscosidade (CIV) e dentina decídua com aplicação de fluoreto de sódio (NaF) a 2% em alterações de dureza dentinária a partir da incorporação de cálcio, fosfato e fluoreto. Material e método Cavidades Classe I foram preparadas em 40 molares hígidos divididos em 2 grupos (n=20), de acordo com a condição dentinária: hígida (1) e desmineralizada (2). Subgrupos (n=10) foram formados para avaliar a ação isolada do CIV ou associado com NaF (F). Este estudo in vitro avaliou as trocas químicas sob duas condições: dentina hígida e desmineralizada (ciclagem de pH) para simular a perda mineral que ocorre em lesões de cárie. Grupo G1 e G2 receberam restaurações de CIV; Grupos G1F e G2F receberam NaF antes do CIV. Os espécimes foram preparados para microdureza Knoop e Micro-Raman. Para análise estatística foi utilizada Anova 2 fatores (α = 0.05). Os dados do Micro-Raman foram descritos qualitativamente. Resultado O aumento de dureza foi observado em todos os sítios de contato direto com CIV, em ambas dentinas em todos os grupos (p<0.001); não foi observado diferença em microdureza após aplicação do NaF (p>0.05). Na avaliação do Micro-Raman, o contato direto do CIV/dentina tanto hígida quanto desmineralizada resultou em um aumento do pico do fosfato dentinário. Conclusão As trocas químicas entre o CIV e dentina desmineralizada podem induzir mudanças das propriedades mecânicas do substrato e a captação de íons minerais (fosfato) ocorre sem a influência do NaF.

Abstract Background Fluoride plays an important role in the control of dental caries. Aim To evaluate the chemical exchange between restoration of glass ionomer cement of high viscosity (GIC) and primary dentin with application of sodium fluoride (NaF) 2% through changes in hardness from uptake of calcium, phosphate and fluoride. Material and method Class I cavities were prepared in 40 sound primary molars, and the sample was divided into two groups (n=20) according to dentin condition: sound (1) and demineralized (2). Sub-groups (n=10) were formed to investigate the isolated action of the GIC or the association with NaF (F). This in vitro study examined the chemical exchange under two conditions, sound and demineralized dentin (pH cycling), to simulate the occurrence of mineral loss for the caries lesion. G1 and G2 received GIC restoration only; groups G1F and G2F received NaF before GIC restoration. The specimens were prepared for Knoop hardness test and micro-Raman spectroscopy. A two-way ANOVA test (α = 0.05) was used for statistical analysis. Micro-Raman data were qualitatively described. Result Increased hardness was observed in all the sites of direct contact with GIC in sound and demineralized dentin for all groups (p<0.001); no difference was observed in microhardness after application of NaF (p>0.05). In the evaluation of micro-Raman, direct contact between GIC and dentin for sound and demineralized dentin resulted in increased peaks of phosphate. Conclusion The exchange between GIC and demineralized dentin may induce changes of mechanical properties of the substrate, and uptake of mineral ions (phosphate) occurs without the influence of NaF.

AIM: To compare the use of etoricoxib and dexamethasone for postoperative pain prevention and control after mucogingival surgery. METHODS: Fifty-eight patients with indication for mucogingival surgery took part in this randomized parallel double-blind clinical trial. They were divided into three groups (G): G1 - placebo 1 h before surgery; G2 - 8 mg dexamethasone 1 h before surgery; G3 - 90 mg etoricoxib 1 h before surgery. Pain intensity was assessed in donor and recipient sites separately using the 101-point numerical rating scale NRS - 101, every hour for the first 8 h after surgery and three times a day on the following 3 days. RESULTS: there was a statistically significant difference in the postoperative pain intensity in the donor site between G1 and G3 after 1 h, 2 h, 3 h, 7 h, 8 h and on the second day - in the evening after 32 h; between G1 and G2 after 2 h and 3 h, and between G2 and G3 only after the first hour. Pain intensity in the recipient site was statistically significant between G1 and G3 after 1 and 2 h (p<0.05). In addition, there was a lower ingestion of rescue medication in G2 and in G3 than in G1 (p=0.002). CONCLUSIONS: the use of a pre-emptive single dose of etoricoxib or dexamethasone may be considered an effective protocol for postoperative pain prevention and control after mucogingival surgery.

OBJETIVO: Avaliar a efetividade da supervisão de escovação em uma ou mais sessões na remoção de placa dental e desgaste de escovas. MATERIAL E MÉTODO: Crianças de 3 a 5 anos de idade receberam escovas dentais novas e participaram de um teatro de fantoches sobre saúde bucal. Foram selecionadas 49 e distribuídas aleatoriamente em três grupos (GI=20; GII=14 e GIII=14). A técnica de Fones foi demonstrada aos grupos GI e GII para avaliar:a supervisão profissional direta e o treinamento de escovação em cinco sessões (GI), a supervisão profissional direta e o treinamento em uma única sessão (GII) e a influência do teatro de fantoches (GIII-grupo controle). Os índices de placa dental (IPL) foram registrados no início do estudo (T0), após 24 dias (T1) e 46 dias (T2) e os índices de desgaste das escovas dentais (ID) no T1 e T2. Os testes de Kruskal-Wallis e Friedman (IPL); ANOVA de um critério e o teste t de Student (ID) (p<0,05) foram empregados na análise dos dados. RESULTADO: O GI diferiu de forma significativa dos outros grupos no T1 e T2 (p<0,01). O índice de desgaste das escovas aumentou (p<0,0001) dos 24 dias (0,52±0,35mm) para os 46 dias (0,90±0,48mm) e não houve associação significativa entre desgaste de escova e índice de placa, tanto em T1 (r=0,230-p= 0,116), quanto em T2 (r=0.226-p=0,121). CONCLUSÃO: A supervisão profissional em sessões múltiplas foi efetiva para reduzir os índices de placa, os quais não foram influenciados pelo desgaste das escovas, mostrando a necessidade de contínua motivação em higiene bucal.

OBJECTIVE: To evaluate the effectiveness of tooth brushing supervision in one or more sessions on dental plaque removal and toothbrush wear. MATERIAL AND METHOD: 3- to 5-year-old children received new toothbrushes and attended a puppet theater about oral health. Forty-nine children were randomly selected and divided into 3 groups (GI=20; GII=14; GIII=14). Fones' brushing method was demonstrated to the GI and GII groups to evaluate the following: the professional direct supervision and tooth brushing training in five sessions (GI), the professional direct supervision and a one-training session (GII) and the puppet theater influence only (GIII-control group). The dental plaque index (IPL) was recorded at baseline (T0), after 24 days (T1) and after 46 days (T2) and toothbrush wear (ID) was recorded on T1 and T2. The Kruskal-Wallis test and the Friedman test (IPL), as well as the one-way ANOVA and the paired Student's t-test (ID) (p<0.05) were employed to analyze the data. RESULT: GI showed a significant difference from the others groups in T1 and T2 (p<0.01).The index of toothbrush wear increased (p<0.0001) from 24 days (0.52±0.35mm) to 46 days (0.90±0.48mm), but there was no significant association between toothbrush wear and plaque index for T1 (r=0.230-p= 0.116) as well as for T2 (r=0.226-p=0.121). CONCLUSION: The multiple sessions of professional supervision were effective to reduce the dental plaque index, which was not influenced by toothbrush wear, showing continuous oral hygiene motivation needs.

Os anti-inflamatórios inibidores das ciclo-oxigenases (COX) representam a classe de fármacos mais comumente utilizada. A COX corresponde a uma classe de enzimas conservadas evolutivamente e tem duas isoformas principais: a COX-1 e a COX-2. Seus subprodutos têm papel fundamental na inflamação e na percepção da dor. Há uma grande discussão entre a inibição seletiva ou não da COX pelo fato de a mesma, além de participar dos eventos inflamatórios, ter papel fundamental na manutenção da homeostase do organismo. A inibição seletiva da COX-2 surgiu com o intuito de reduzir os efeitos deletérios gastrintestinais de uma inibição não seletiva; em contrapartida, a inibição exclusiva da COX-2 associou-se a sérios eventos cardiovasculares, por causar um desequilíbrio entre a produção de prostaciclina e tromboxano. O objetivo deste trabalho é revisar a literatura a esse respeito, apontando os prós e os contras da inibição seletiva ou não das enzimas ciclo-oxigenases.

The cyclooxygenase (COX) inhibitors are the most common drugs used worldwide. COX corresponds to an evolutionarily conserved class of enzymes and has two main isoforms: COX-1, which is largely associated with physiological functions, and COX-2, which is largely associated with pathological functions. Their subproducts have an important role in inflammation and pain perception. The COX-2 selective inhibition was designed to minimize gastrointestinal complications of non-selective inhibition. However, this exclusive COX-2 inhibition was associated with serious cardiovascular events, for causing an imbalance between prostacyclin and thromboxane production. The objective of this study is to discuss the mechanisms underlying the cardiovascular effects, pointing out the advantages and disadvantages of the selective or nonselective COX inhibitors.

INTRODUÇÃO: Selantes de fossas e fissuras são indicados para prevenir lesão de cárie em superfícies oclusais. OBJETIVO: O objetivo deste estudo foi avaliar os selantes de fossas e fissuras aplicados por estudantes do Curso de Graduação em Odontologia da Universidade Regional de Blumenau (FURB), Santa Catarina. MATERIAL E MÉTODO: O estudo descritivo retrospectivo desenvolveu-se em três etapas: na primeira, procedeu-se à análise dos prontuários do Setor de Triagem, tendo como critério de inclusão a existência de radiografias dos dentes selados. Na segunda etapa, analisaram-se as radiografias dos prontuários selecionados e a história clínica da criança. A terceira etapa foi realizada por meio de exames clínicos e radiográficos, pelos quais eram verificadas as condições dos selantes de fossas e fissuras. RESULTADO: Foram analisados 800 prontuários, sendo selecionados 131 (16,37%) para a segunda etapa, quando se observou que 321 selantes de fossas e fissuras foram aplicados. Compareceram à consulta de controle 119 (90,84%) crianças, ocasião em que se confirmou a aplicação de 160 (49,85%) selantes resinosos, 126 (39,25%) com cimento de ionômero de vidro e 35 (10,90%) com resina flow. Foram observados 296 (92,21%) selantes em dentes permanentes. Ao exame clínico, verificou-se que 114 (35,51%) selantes haviam sido perdidos totalmente em diferentes períodos de tempo. Nenhuma lesão de cárie foi observada em 294 (91,59%) dentes selados. CONCLUSÃO: Verificou-se que os selantes de fossas e fissuras, aplicados por estudantes do Curso de Odontologia da FURB, foram eficazes na manutenção da maioria das superfícies dentárias livres de lesão de cárie, mesmo quando foram perdidos parcial ou totalmente.

INTRODUCTION: Pit and fissure sealants are indicated to prevent caries in occlusal surfaces. OBJECTIVE: The aim of this study was to evaluate pit and fissure sealants applied by Dentistry undergraduate students of the Regional University of Blumenau (FURB), Santa Catarina. MATERIAL AND METHOD: The retrospective descriptive study was developed in three stages: the analysis of the records of the Department of Screening, being used as an inclusion criterion the existence of X-rays of the sealed teeth. In the second step we analyzed the radiographs of selected records and medical history of the child. The third step was performed by clinical and radiographic examinations, when conditions of pit and fissure sealants were verified. RESULT: We analyzed 800 medical records, and selected 131 (16.37%) for the second step, where it was observed that 321 pit and fissure sealants were applied. 119 (90.84%) children attended the control dental appointment, when confirmed the application of 160 (49.85%) resin, 126 (39.25%) glass ionomer cement and 35 (10.90%) flowable composite. We observed 296 (92.21%) sealants in permanent teeth. The clinical examination revealed that 114 (35.51%) of the sealants were completely lost at different periods of time. No caries lesion was observed in 294 (91.59%) teeth sealed. CONCLUSION: It was found that the pit and fissure sealants applied by students of the FURB School of Dentistry were effective in maintaining the majority of tooth surfaces free of caries, even when they were partially or totally lost.