Abstract This study employed e-Vol DXS cone beam computed tomography (CBCT) software to assess dentin remnants in the furcation area of mesial canals in mandibular molars during root canal retreatment (RCR). Four groups (Reciproc®, ProTaper Next®, Race Evo®, Protaper Gold®) were subjected to RCR, and CBCT images were captured before (T1) and after (T2) treatment. Measurements of remaining dentin thickness at 1 mm and 3 mm below the furcation were scrutinized. Results revealed no significant differences in mean thicknesses of mesiobuccal (MB) and mesiolingual (ML) canals at 1 mm and 3 mm from the furcation pre-treatment (T1). Post-treatment (T2) showed analogous findings, with no significant differences in mean thicknesses. However, disparities were found between MB and ML canals at both distances, both before and after retreatment. In essence, the evaluated instruments exhibited safety in RCR, implying that they are appropriate for use in critical areas of mandibular molars without inducing excessive wear. This study underscores the reliability of these instruments in navigating danger zones during RCR, and contributes valuable insights for dental practitioners who handle complex root canal scenarios in mandibular molars. eVol e Vol (CBCT RCR. RCR . (RCR) Reciproc®, Reciproc (Reciproc® Next Next® Evo Evo® Gold® Gold T1 T (T1 T2 (T2 treatment scrutinized (MB (ML pretreatment pre T1. Posttreatment Post findings However distances essence wear (RCR Reciproc® (Reciproc (T

Resumo Este estudo avaliou a influência da hibridização dentinária na alteração cromática coronária de dentes bovinos tratados endodonticamente, usando diferentes cimentos endodônticos e o cimento Portland. Duzentos incisivos centrais bovinos foram tratados endodonticamente com diferentes materiais (Sealapex®, Bio-C sealer®, AH-Plus®, Endofill®, e o cimento Portland), e distribuídos em 2 grupos, com e sem a hibridação dentinária. Os dentes foram submetidos à análise colorimétrica usando o espectrofotômetro Easyshade® em quatro momentos diferentes: determinação da cor do substrato dental antes da obturação do canal radicular, e posterior aos 7 dias, 60 dias e 180 dias. Os dados foram avaliados quanto à normalidade e homogeneidade pelos testes Shapiro-Wilk e Levene. Foi realizada análise de variância de duas vias, com pós-teste de Sidak para comparações múltiplas. O nível de significância foi de 5%. A hibridação dentinária influenciou a alteração cromática coronária do Sealapex® após 7 dias e do Bio-C Sealer® e AH Plus® após 60 dias. O AH Plus® após 7 dias obteve o maior ΔE* quando hibridizado, e o Endofill® obteve o maior ΔE* quando não hibridizado. O AH Plus após 60 dias obteve o maior ΔE* quando hibridizado e não hibridizado. O Sealapex® após 180 dias obteve o maior ΔE* quando hibridizado, e o AH Plus® obteve o maior variação de cor quando não hibridizado. Os cimentos endodônticos estudados se comportaram de forma diferente em relação à alteração cromática coronária, sendo difícil prever um determinado comportamento. Todos os cimentos endodônticos causaram alterações cromáticas clinicamente perceptíveis após 7 dias, 60 dias e 180 dias, independentemente da hibridação dentinária. Portland Sealapex®, Sealapex (Sealapex® BioC Bio C sealer sealer® AHPlus®, AHPlus Plus®, AH-Plus® Endofill Portland, , Portland) grupos Easyshade radicular 6 18 ShapiroWilk Shapiro Wilk Levene vias pósteste pós teste múltiplas 5 5% Sealer ΔE comportamento (Sealapex AHPlus® AH-Plus 1

Abstract This study evaluated the influence of dentin hybridization on coronary chromatic alteration of endodontically treated bovine teeth using different endodontic sealers and Portland cement. The 200 central incisors were endodontically treated using different materials (Sealapex, Bio-C Sealer, AH-Plus, Endofill, and Portland cement) and distributed according to the presence or absence of dentin hybridization. The teeth underwent colorimetric analysis using the Easyshade® spectrophotometer at four different times: determining the color of the dental substrate before root canal filling (RCF), 7 days, 60 days, and 180 days after RCF. The data were evaluated for normality and homogeneity by the Shapiro-Wilk and Levene tests. A two-way analysis of variance was performed, with Sidak's post-test for multiple comparisons. The significance level was 5%. Dentin hybridization influenced the coronary chromatic alteration of Sealapex® after 7 days and in Bio-C Sealer® and AH Plus® after 60 days. The AH Plus after 7 days obtained the highest ΔE* when hybridized, and the Endofill® obtained the highest ΔE* when not hybridized. The AH Plus after 60 days got the highest ΔE* when hybridized and non-hybridized. The Sealapex® after 180 days obtained the highest ΔE* when hybridized, and the AH Plus obtained the highest ΔE* when not hybridized. The studied root canal sealers behaved differently regarding coronary chromatic alteration, making it difficult to predict a particular behavior. All endodontic sealers caused clinically noticeable chromatic changes after 7 days, 60 days, and 180 days, regardless of hybridization. cement 20 Sealapex, Sealapex (Sealapex BioC Bio C Sealer AHPlus, AHPlus Plus, AH-Plus Endofill Easyshade times RCF, RCF , (RCF) 6 18 ShapiroWilk Shapiro Wilk tests twoway two way performed Sidaks Sidak s posttest post test comparisons 5 5% ΔE nonhybridized. nonhybridized non non-hybridized behavior 2 (RCF 1

Resumo O ensino da odontologia requer a incorporação de habilidades de comunicação, e essas qualidades podem afetar os resultados do processo de aprendizagem. Este estudo avaliou a qualidade da comunicação entre professores e alunos durante o processo de aprendizagem da Odontologia. Foi desenvolvido e aplicado um questionário para avaliar suas percepções sobre suas comunicações em um curso de graduação em Odontologia. O questionário continha dez itens para analisar a autopercepção dos professores e dez para a percepção dos alunos, utilizando uma escala do tipo Likert e uma questão final aberta. Durante sua construção, foi enviado a cinco especialistas para análise de validade de conteúdo. A pergunta aberta reuniu sugestões para melhorar e intensificar a comunicação de forma eficaz e identificar vulnerabilidades. A pontuação total variou de 10 a 50, sendo 10 a pior percepção e 50 a melhor. As pontuações foram calculadas somando todas as respostas e dividindo essa soma pelo número total de itens. O alfa de Cronbach foi calculado para avaliar a consistência interna do instrumento. O nível de significância foi fixado em 0,05%. O teste t de Student foi utilizado para verificar diferenças entre os grupos. A autopercepção dos professores e a percepção dos alunos sobre a qualidade da comunicação do corpo docente universitário durante o processo de aprendizagem dos alunos apresentaram diferenças estatisticamente significativas. Os professores classificaram como satisfatória a capacidade de comunicação ao emitir e receber informações. Os alunos, porém, não concordaram plenamente com eles, principalmente nos itens sobre recebimento de informações. As percepções na habilidade comunicação identificadas neste estudo podem levar a um novo rumo no comportamento comunicativo de professores e alunos. Odontologia construção conteúdo vulnerabilidades 1 5 melhor instrumento 005 0 05 0,05% grupos significativas informações porém eles 00 0,05 0,0 0,

Abstract Teaching requires the incorporation of communication skills, and these potentials may affect the outcomes of the learning process. This study evaluated the quality of communication between professors and students during the process of learning Dentistry. A questionnaire was developed and applied to evaluate their perceptions about their communications in an undergraduate Dentistry course. The questionnaire had ten items to analyze professors’ self-perception and ten for students’ perceptions, using a Likert-like scale and a final open question. During its construction, it was sent to five specialists to analyze content validity. The open question gathered suggestions to improve and intensify communications effectively and to identify vulnerabilities. Total scores ranged from 10 to 50, with 10 as the worst perception, and 50, as the best. The scores were calculated by adding all answers and then dividing that sum by the total number of items. Cronbach’s alpha was calculated to evaluate the instrument’s internal consistency. The level of significance was set at 0.05%. The Student t-test was used to determine differences between groups. Professors’ self-perceptions and students' perceptions of the quality of communication of the university teaching staff during the student's learning process had statistically significant differences. Professors classified their ability to communicate when emitting and receiving information as satisfactory. Students, however, did not fully agree with them, particularly on the items about receiving information. The perceptions identified in this study may lead to a new direction in the communicative behavior of professors and students. skills course selfperception self perception Likertlike Likert like construction validity vulnerabilities 1 50 best Cronbachs Cronbach s instruments instrument consistency 005 0 05 0.05% ttest t test groups selfperceptions student satisfactory Students however them 5 00 0.05 0.0 0.

Resumo Uma busca contínua de materiais bioativos com capacidade de substituir o tecido pulpar danificado, com efetiva capacidade de selamento e biocompatibilidade, tem representado a atenção e foco de muitos estudos ao longo das últimas décadas. Este estudo envolve uma revisão narrativa da literatura desenvolvida por meio de pesquisas representativas encontradas no PUBMED/MEDLINE e pesquisas em livros didáticos associadas ao mecanismo de ação de materiais bioativos (hidróxido de cálcio, agregado de trióxido mineral (MTA) e cimentos de silicato de cálcio). A presente análise reflexiva das particularidades dos elementos químicos destes materiais bioativos, considerando o mecanismo de ação tecidual e antibacteriano, possibilita um melhor entendimento das características e similaridades no comportamento tecidual. A pasta de hidróxido de cálcio continua sendo a substância antibacteriana de escolha como medicação intracanal para o tratamento das infecções do sistema de canais radiculares. Este fato se deve a disponibilidade química de íons cálcio e hidroxila do hidróxido de cálcio aos tecidos, e a inibição enzimática bacteriana. Os cimentos de silicato de cálcio, dentre os quais inclui o MTA, apresentam uma resposta biológica favorável ao estímulo à deposição de tecido mineralizado nas áreas seladas e em contato com tecido conjuntivo. Este fato é decorrente da similaridade entre os elementos químicos, em especial devido a dissociação iônica, ao potencial estímulo de enzimas teciduais, e a contribuição com um meio alcalino decorrente do pH destes materiais. O comportamento dos materiais bioativos, em especial o MTA e os novos cimentos de silicato de cálcio na atividade de selamento biológico mostraram efetivos. A endodontia contemporânea atualmente conta com o potencial de materiais bioativos com propriedades análogas capaz de estimular o selamento biológico em perfurações radiculares laterais e de furca, em obturações radiculares, capeamento pulpar, pulpotomia, apicificação e procedimentos endodônticos regenerativos, além de outras condições clínicas. danificado biocompatibilidade décadas PUBMEDMEDLINE PUBMED MEDLINE (MTA cálcio. . cálcio) antibacteriano tecidos bacteriana conjuntivo iônica teciduais efetivos furca pulpotomia regenerativos clínicas

Abstract A continuous search for bioactive materials capable of supporting the replacement of damaged pulp tissue, with effective sealing potential and biocompatibility, has represented the attention of studies over the last decades. This study involves a narrative review of the literature developed by searching representative research in PUBMED/MEDLINE and searches in textbooks associated with the mechanism of action of bioactive materials (calcium hydroxide, mineral trioxide aggregate (MTA), and calcium silicate cements). The reflective analysis of the particularities of the chemical elements of these materials, considering the tissue and antibacterial mechanism of action, allows a better understanding of the characteristics and similarities in their tissue responses. Calcium hydroxide paste remains the antibacterial substance of choice as intracanal dressing for the treatment of root canal system infections. Calcium silicate cements, including MTA, show a favorable biological response with the stimulation of mineralized tissue deposition in sealed areas when in contact with connective tissue. This is due to the similarity between the chemical elements, especially ionic dissociation, the potential stimulation of enzymes in tissues, and the contribution towards an alkaline environment due to the pH of these materials. The behavior of bioactive materials, especially MTA and the new calcium silicate cements in the biological sealing activity, has been shown to be effective. Contemporary endodontics has access to bioactive materials with similar properties, which can stimulate a biological seal in lateral and furcation root perforations, root-end fillings and root fillings, pulp capping, pulpotomy, apexification, and regenerative endodontic procedures, in addition to other clinical conditions. biocompatibility decades PUBMEDMEDLINE PUBMED MEDLINE , (MTA) cements. . cements) responses infections dissociation tissues activity properties perforations rootend end capping pulpotomy apexification procedures conditions (MTA

Resumo Este estudo avaliou um método para determinar a geometria espacial do preparo do canal radicular (PCR) usando uma dinâmica de navegação e um algoritmo específico do software e-Vol DX. Imagens de tomografia computadorizada de feixe cônico (TCFC) de 168 molares inferiores foram adquiridas antes e depois do PCR, usando instrumentos de níquel-titânio (NiTi) (ProTaper Next, BioRace, Reciproc Blue e WaveOne Gold). A geometria espacial dos canais radiculares e o risco operatório de desgaste desproporcional das paredes dentinárias após o preparo foram avaliados usando o software de TCFC e-Vol DX. Um sistema de Score de 3 pontos foi usado após a mensuração da espessura cemento/dentina antes e depois do PCR, em toda extensão dos canais radiculares. Os terços radiculares foram distribuídos em três partes de tamanhos semelhantes, e os Scores foram categorizados em três níveis: 1. risco leve (1/3), 2. risco moderado (2/3), 3. risco severo (3/3). Esses níveis foram propostos de acordo com o risco de criar formas desproporcionais, paredes finas ou perfurações radiculares. Os dados foram analisados estatisticamente pelo teste exato de Fischer ((=5%). Não houve diferenças significativas no risco operatório entre os sistemas de NiTi acionados a motor, para as paredes distal ou mesial em todos os terços do canal radicular (p>0,05). O método de geometria espacial para avaliar o risco operatório permite o planejamento clínico para um alargamento previsível do canal radicular em todos os terços radiculares. Com base no uso de uma estratégia de navegação dinâmica de canais radiculares de molares inferiores analisados em imagens de TCFC, os instrumentos de NiTi acionados estudados não apresentaram um aumento do risco operatório durante o preparo dos canais radiculares. PCR (PCR eVol Vol DX (TCFC 16 níqueltitânio níquel titânio (NiTi ProTaper Next BioRace Gold. Gold . Gold) cementodentina cemento dentina semelhantes 1 1/3, 13 1/3 , (1/3) 2 2/3, 23 2/3 (2/3) 3/3. 33 3/3 (3/3) desproporcionais =5%. 5 =5% ((=5%) motor p>0,05. p005 p p>0,05 0 05 (p>0,05) 1/ (1/3 2/ (2/3 3/ (3/3 =5 ((=5% p00 p>0,0 (p>0,05 (1/ (2/ (3/ = ((=5 p0 p>0, (p>0,0 (1 (2 (3 ((= p>0 (p>0, ( (( p> (p>0 (p> (p

Abstract This study evaluated a method to determine the spatial geometry of root canal preparation (RCP) using navigation dynamics and a specific algorithm from a new CBCT software (e-Vol DX). CBCT scans of 168 root canals of mandibular molars were acquired before and after RCP, using nickel-titanium (NiTi) instruments (ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold). The spatial geometry of the root canals and the operative risk of disproportional wear of dentinal walls after RCP were evaluated using a new CBCT software. A 3-point scoring system was used after the measuring of cementum/dentin thickness before and after RCP in all root thirds. The root thirds were distributed into three parts of similar sizes, and the scores were categorized at three levels: 1. mild risk (1/3), 2. moderate risk (2/3), 3. severe risk (3/3). These levels were proposed according to the risk of creating disproportionate shapes, thin walls, or perforations. The data were analyzed statistically by Fischer’s exact test (α = 5%). There were no significant differences in operative risk among the NiTi engine-driven systems, for the distal or mesial walls of all the root canal thirds (p>0.05). The spatial geometry method to assess operative risk allows clinical planning for a predictable enlargement of the root canal in all root thirds. Based on using a map-reading strategy on root canals in CBCT scans, NiTi engine-driven instruments did not present an increased operative risk during RCPs. (RCP eVol e Vol DX. DX . DX) 16 nickeltitanium nickel titanium (NiTi ProTaper Next BioRace Blue Gold. Gold Gold) 3point point 3 cementumdentin cementum dentin sizes 1 1/3, 13 1/3 , (1/3) 2 2/3, 23 2/3 (2/3) 3/3. 33 3/3 (3/3) shapes perforations Fischers Fischer s α 5%. 5 5% 5%) enginedriven engine driven systems p>0.05. p005 p p>0.05 0 05 (p>0.05) mapreading map reading RCPs 1/ (1/3 2/ (2/3 3/ (3/3 p00 p>0.0 (p>0.05 (1/ (2/ (3/ p0 p>0. (p>0.0 (1 (2 (3 p>0 (p>0. ( p> (p>0 (p> (p

Abstract Dasatinib, a potent oral multi-targeted kinase inhibitor against Src and Bcr-Abl, can decrease inflammatory response in sepsis. A simple and cost-effective method for determination of an effective dose dasatinib was established. This method was validated in human plasma, with the aim of reducing the number of animals used, thus, avoiding ethical problems. Dasatinib and internal standard lopinavir were extracted from 180 uL of plasma using liquid-liquid extraction with methyl tert-butil ether, followed by liquid chromatography coupled to triple quadrupole mass spectrometry in multiple reaction monitoring mode. For the pharmacokinetic study, 1 mg/kg of dasatinib was administered to mice with and without sepsis. The method was linear over the concentration range of 1-98 ng/mL for DAS in mice and human plasma, with r2>0.99 and presented intra- and interday precision within the range of 2.3 - 6.2 and 4.3 - 7.0%, respectively. Further intra- and interday accuracy was within the range of 88.2 - 105.8 and 90.6 - 101.7%, respectively. The mice with sepsis showed AUC0-t = 2076.06 h*ng/mL and Cmax =102.73 ng/mL and mice without sepsis presented AUC0-t = 2128.46 h*ng/mL. Cmax = 164.5 ng/mL. The described analytical method was successfully employed in pharmacokinetic study of DAS in mice. multitargeted multi targeted BcrAbl, BcrAbl Bcr Abl, Abl Bcr-Abl costeffective cost established used thus problems 18 liquidliquid tertbutil tert butil ether mode mgkg mg kg 198 98 1-9 ngmL ng mL r2099 r r2 0 99 r2>0.9 intra 23 2 3 2. 62 6 6. 43 4 4. 70 7 7.0% respectively 882 88 88. 1058 105 8 105. 906 90 90. 1017 101 101.7% AUC0t AUCt AUC0 t AUC 207606 2076 06 2076.0 hngmL h 10273 102 73 =102.7 212846 2128 46 2128.4 1645 164 5 164. 19 9 1- r209 r2>0. 7.0 10 101.7 20760 207 2076. 1027 =102. 21284 212 2128. 16 r20 r2>0 7. 101. 20 =102 21 r2> =10 =1

Abstract The diagnosis of irreversible pulpitis (IP) depends on clinical data, especially the chief complaint of the patient, visual inspection, response to the application of stimuli, and radiographic examination. The characterization of nerve fibers (NF) in IP may contribute to better interpret painful symptoms, but has been barely explored. This study sought to characterize the density and integrity of NF in 16 samples of IP and in five healthy pulps (HP) using S-100 and PGP 9.5 markers. Immunohistochemistry was performed to determine the density/mm2 of S-100+ and PGP 9.5+ in NF. The amount of degenerated NF was obtained by subtracting the total NF density from the amount of intact NF. Associations between NF density and integrity and symptomatology were calculated. All samples were positive for S-100 and PGP 9.5. Compared to HP samples (38.20/mm2), IP samples had a lower density of intact NF (6.24/mm2). A significantly higher density of degenerated NF was found in IP samples with spontaneous pain (39.59/mm2) compared to those with provoked pain (23.96/mm2) (p = 0.02). No association was observed between intensity of the inflammatory infiltrate and NF density and integrity (p > 0.05). The findings of this study suggest that pulpitis may involve different stages of degeneration and may be more advanced in cases with spontaneous pain. The symptoms reported by affected individuals do not appear to depend on the intensity of the inflammatory infiltrate, but rather on the integrity of NF. (IP data patient inspection stimuli examination (NF explored 1 (HP S100 S 100 S-10 95 9 5 9. markers densitymm2 densitymm mm2 mm density/mm S100+ 100+ calculated 38.20/mm2, 3820mm2 38.20/mm2 , 38 20 (38.20/mm2) 6.24/mm2. 624mm2 6.24/mm2 . 6 24 (6.24/mm2) 39.59/mm2 3959mm2 39 59 (39.59/mm2 23.96/mm2 2396mm2 23 96 (23.96/mm2 p 0.02. 002 0.02 0 02 0.02) 0.05. 005 0.05 05 0.05) S10 10 S-1 3820mm 38.20/mm 3 2 (38.20/mm2 624mm 6.24/mm (6.24/mm2 39.59/mm 3959mm (39.59/mm 23.96/mm 2396mm (23.96/mm 00 0.0 S1 S- (38.20/mm (6.24/mm 0.

Abstract The main purpose of this study was to answer the question: “Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head and neck region?” Clinical observational studies in adults with head and neck cancer undergoing treatment with ionizing radiation, longitudinal or cross-sectional follow-up to measure oxygen saturation (SpO2), and/or pulp sensitivity test to cold stimulation, were considered eligible. A systematic literature search was performed in six different databases, including the gray literature, and in article references. Two independent evaluators selected the studies, extracted the data, recorded the data on electronic spreadsheets, and then evaluated the methodological quality using the Checklist for Quasi-Experimental Studies tool devised by JBI. The data were assessed qualitatively using the Synthesis Without Metanalysis (SWiM) guidelines. After removing the duplicate articles, carefully analyzing the titles and abstracts, and reading the papers in full, seven studies were included. Four of the studies evaluated applied the cold sensitivity test, two associated pulse oximetry and cold sensitivity, and only one used just pulse oximetry. Evaluation using the cold sensitivity test and pulse oximetry in the initial periods before radiotherapy showed a decrease in the sensitive response and in SpO2 levels during a maximum period of 1 year. However, analyses thereafter indicated a normal response in both tests from 5 to 6 years after the end of radiotherapy treatment. Radiotherapy causes changes in pulp behavior patterns in the short term; however, recovery and return to average values occurs after long periods. question Can region region? radiation crosssectional cross sectional followup follow up SpO2, SpO , (SpO2) andor stimulation eligible databases references spreadsheets QuasiExperimental Quasi Experimental JBI SWiM (SWiM guidelines articles abstracts full included year However term however (SpO2 (SpO

Abstract The objective of this paper was to develop and evaluate two semi-solid pharmaceutical forms containing 0.1% tacrolimus: cream (CRT01) and gel (GLT01). For the evaluation of physicochemical stability, at times 0, 30, 60 and 90 days, at 23°C and at 40°C, High Performance Liquid Chromatography coupled with a Diode Array Detector (HPLC-DAD) was employed. This method was developed and validated for tacrolimus quantification. The occlusivity test and skin permeation assay were also performed, using an animal model (Wistar rats), and the CRT01 and GLT01 were compared to the 0.1% tacrolimus ointment (PFU01) obtained from the University Pharmacy, Federal University of Rio de Janeiro, Brazil. CRT01 and GLT01 presented a homogeneous aspect and consistency adequate for topical products, along with sensory characteristics above PFU01. They also presented adequate physicochemical stability for 90 days and a lower occlusive effect than PFU01 (p<0.05). CRT01 showed greater affinity for the skin when compared to PFU01 and GLT01, with low systemic absorption. The CRT01 semi-solid formulation was considered the most adequate one to treat patients with atopic dermatitis or other dermatologic inflammatory diseases, promoting rational use of tacrolimus. semisolid semi solid 01 0 1 0.1 CRT (CRT01 GLT01. GLT . (GLT01) 30 6 9 23C C 23 40C 40 40°C HPLCDAD HPLC DAD (HPLC-DAD employed quantification performed Wistar rats, rats , rats) CRT0 GLT0 PFU (PFU01 Pharmacy Janeiro Brazil products PFU0 p<0.05. p005 p p<0.05 05 (p<0.05) absorption diseases 0. (CRT0 (GLT01 3 2 4 (PFU0 p00 p<0.0 (p<0.05 (CRT (GLT0 (PFU p0 p<0. (p<0.0 (GLT p<0 (p<0. p< (p<0 (p< (p

Resumo Este estudo avaliou o efeito da terapia fotodinâmica (PDT) em canais radiculares infectados com E. faecalis. Vinte e um dentes humanos extraídos foram selecionados, e 18 foram infectados por E. faecalis por 60 dias. As estratégias antimicrobianas testadas foram: G1. Preparo do canal radicular (PCR) com instrumentos rotatórios de NiTi, NaOCl 2,5% e irrigação final com EDTA 17%, seguido de PDT com fotossensibilizador azul de metileno e laser diodo de baixa potência; G2. PCR usando limas de aço inoxidável e os mesmos protocolos de irrigação e PDT do G1; G3. Protocolo de PCR similar que G1 sem PDT; G4. Somente irrigação com NaOCl 2,5%; G5. Protocolo similar ao G1, sem PCR; G6. Controle negativo; G7. Controle positivo. Amostras para exames microbiológicos foram coletadas inicialmente (S1), após PCR (S2) e após PDT (S3). Na sequência, as raízes foram seccionadas e preparadas para análise em microscopia eletrônica de varredura (MEV). O crescimento bacteriano foi analisado de acordo com a turbidez do meio de cultura seguida pela densidade óptica espectrofotométrica (nm). O efeito da PDT na estrutura dentinária foi avaliado em aumentos de 1.600X e 5.000X, e descrito qualitativamente. O teste de Wilcoxon foi utilizado para as comparações dos mesmos espécimes e o teste de Mann-Whitney para as comparações entre os grupos ((=5%). Bactérias foram encontradas em todos os grupos experimentais, e em todas as coletas microbiológicas (S1, S2 e S3). A densidade óptica dos meios de cultura foi menor em S2 do que em S1 de G1, 2, 3 e 4 (p>0,05). Após a PDT (S3) em G1 e 2, houve redução adicional na densidade óptica do meio de cultura de 90,0% e 92,0%, respectivamente (p>0,05). No Grupo 5, a análise dos meios de cultura em S2 revelou um aumento de 3,2% na densidade óptica em comparação com S1(p>0,05). Nas imagens de MEV do G1, 2 e 5 foram evidenciadas dentina com áreas de fusão e recristalização. O PDT utilizado após preparo do canal radicular com sistema rotatório ou manual, associado ao NaOCl 2,5%, não foi capaz de eliminar completamente o E. faecalis em biofilme maduro presente no canal radicular.

Abstract This study evaluated the effect of photodynamic therapy (PDT) on infected root canals. Twenty-one human teeth were selected, and 18 were infected by E. faecalis for 60 days. The antimicrobial strategies tested were: G1. Root canal preparation (RCP) using Niquel-Titanium (NiTi) rotary instruments, 2.5% NaOCl, and final irrigation with 17% EDTA, followed by PDT with methylene blue photosensitizer and laser diode low power; G2. RCP using stainless steel files and the same irrigation and PDT protocols as G1; G3. Same RCP protocol as G1 without PDT; G4. Only irrigation with 2.5% NaOCl; G5. Same PDT protocol as G1 without RCP; G6. Negative control; G7. Positive control. Samples for microbiological tests were collected initially (S1), after RCP (S2), and after PDT (S3). Subsequently, the roots were sectioned and prepared for Scanning Electron Microscopy (SEM) analysis. Bacterial growth was analyzed according to the turbidity of the culture medium, followed by spectrophotometric optical density (nm). The effect of PDT on the dentinal structure was evaluated at magnifications 1,600X and 5,000X and described qualitatively. The Wilcoxon test was used for the comparisons from the same specimens, and the Mann-Whitney test was used to compare groups ((=5%). Bacteria were found in all experimental groups’ microbiological samples (S1, S2 and S3). The optical density of culture media was lower in S2 than in S1 of G1, 2, 3, and 4 (p> 0.05). After PDT (S3) in G1 and 2, there was an additional reduction in optical density of the culture medium, respectively (p>0.05). In Group 5, the analysis of culture media at S2 revealed an increase in optical density compared to S1(p>0.05). In SEM images of G1, 2, and 5, dentin with melting and recrystallization areas were evidenced. After preparation of the root canal with the rotary system or manually associated with 2.5% NaOCl, PDT was not able to completely eliminate E. faecalis present in the root canal.

Resumo Uma revolução tecnológica contemporânea deu início a uma nova era no metaverso da Endodontia, um mundo de possibilidades operacionais virtuais que utilizam uma réplica exata das estruturas naturais do complexo dentomaxilofacial. Este estudo descreve um método de modelagem computacional para a endoscopia do canal radicular, usando um moderno software de tomografia computadorizada de feixe cônico (TCFC), em uma série de casos clínicos. O método consiste na aquisição de finos slices de TCFC (0,10mm) nos planos coronal, sagital e axial. Um filtro específico de TCFC (filtro cavidade pulpar do software e-Vol DX) foi usado para navegar nas microestruturas anatômicas do canal radicular, e escanear para a aplicação da endoscopia do canal radicular. Este filtro foi configurado para sincronizar as imagens de TCFC em modo 2D - reformações multiplanares (MPR) para o modo 3D - reconstrução volumétrica. O filtro Pulp Cavity ao adotar a opção de reconstrução volumétrica, um algoritmo desenvolvido deixa a densidade dentinária em modo transparente, para que a cavidade pulpar possa ser melhor visualizada. O algoritmo aplicado realiza a supressão (visual) das áreas com densidade dentinária. Este modo de aplicação garante a visualização 3D da microanatomia do canal radicular, bem como permite uma navegação dinâmica por toda a cavidade pulpar. O método de modelagem computacional agrega novos recursos à Endodontia, o que pode impactar positivamente na previsibilidade dos tratamentos endodônticos. A visualização virtual da anatomia interna de uma réplica exata do canal radicular garante melhor comunicação, confiabilidade e operacionalização clínica. O exame de endoscopia do canal radicular com este novo filtro (Pulp cavity) pode ser usada para aplicações clínicas juntamente com recursos digitais e de realidade virtual inovadores que serão naturalmente incorporados aos princípios da Endodontia.

Abstract A contemporary technological revolution has started a new era in the metaverse of Endodontics, a world of virtual operational possibilities that use an exact replica of the natural structures of the maxillofacial complex. This study describes a modeling method for root canal endoscopy using modern cone-beam CT (CBCT) software in a series of clinical cases. The method consists in acquiring thin CBCT slices (0.10mm) in the coronal, sagittal, and axial planes. A specific 3D volume filter, the pulp cavity filter of the e-Vol DX CBCT software, was used to navigate anatomical root canal microstructures, and to scan them using root canal endoscopy. The pulp cavity filter should be set to synchronize CBCT scans from 2D mode - multiplanar reformations (MPR) - to 3D mode - volumetric reconstruction. This filter, when adopting the option of volumetric reconstruction, the developed algorithm leaves the dentin density in transparent mode so that the pulp cavity may be visualized. The algorithm applied performs the suppression (visual) of areas with dentin density. This ensures 3D visualization of the slices and the microanatomy of the root canal, as well as a dynamic navigation throughout the pulp cavity. This computational modeling method adds new resources to Endodontics, which may impact the predictability of root canal treatments positively. The virtual visualization of the internal anatomy of an exact replica of the canal ensures better communications, reliability, and clinical operationalization. Root canal endoscopy using this novel CBCT filter may be used for clinical applications together with innovative digital and virtual-reality resources that will be naturally incorporated into the principles of Endodontics.

RESUMO Introdução: O câncer que mais acomete mulheres em todo o mundo é o de mama. Não bastasse o mal que a doença ativa é capaz de causar, após a cura as sequelas continuam atormentando a vida de milhares de mulheres. O trauma psicológico de uma mutilação pode ter repercussões psicológicas de difícil controle. A mastectomia salva a vida da mulher com câncer mamário; entretanto, a perda da mama pode manter o biopsicossocial da paciente doente. Reconstruir as mamas se torna, então, tempo crucial no tratamento destas mulheres. Métodos: O estudo dos acervos públicos e pessoais dos autores permitiram discorrer sobre a evolução artística e técnica das reconstruções mamárias através dos anos. Resultados: Estudos e reflexões de cirurgiões plásticos em todo o mundo possibilitaram a padronização de uma série de técnica e ferramentas para reconstrução da mama, que vão compor o arsenal do cirurgião moderno. Existem várias, incluindo técnicas com retalhos locais, como o plug flap e as técnicas de mamoplastia, retalhos de vizinhança, como retalho toracodorsal, materiais aloplásticos (expansores teciduais e próteses), numerosos retalhos autólogos, incluindo retalhos microcirúrgicos ou, ainda, técnicas combinadas frente aos variados tipos de casos. Paralelamente, a indústria de produtos médico-hospitalares desenvolveu material aloplástico (próteses e expansores) mais adequados e de melhor qualidade, que propiciam reconstruções mais seguras e mais previsíveis no que concerne ao uso dos implantes. Conclusão: O estado da arte atual da reconstrução mamária encontra pilares históricos bem fundamentados e auxílio tecnológico avançado, provendo condições para tratamentos refinados, de alta exigência e preparo do artista.

ABSTRACT Introduction: The cancer that most affects women around the world is breast cancer. If the harm that the active disease is capable of causing was not enough, after the cure, the consequences continue to torment the lives of thousands of women. Furthermore, the psychological trauma of mutilation can have psychological repercussions that are difficult to control. Mastectomy saves the life of a woman with breast cancer; however, breast loss can keep the patient sick in the biopsychosocial aspect. Rebuilding the breasts then becomes crucial in the treatment of these women. Methods: The study of the authors’ public and personal collections allowed us to discuss the artistic and technical evolution of breast reconstructions over the years. Results: Studies and reflections from plastic surgeons worldwide have enabled the standardization of a series of techniques and tools for breast reconstruction that will make up the arsenal of the modern surgeon. It includes techniques with local flaps, such as the plug flap and mammoplasty techniques, neighborhood flaps, such as the thoracodorsal flap, alloplastic materials (tissue expanders and prostheses), the numerous autologous flaps, including microsurgical flaps or, also, the combined techniques for the various types of cases. At the same time, the medical-hospital products industry has developed alloplastic materials (prostheses and expanders) that are more suitable and of better quality, which provide safer and more predictable reconstructions concerning the use of implants. Conclusion: The current state of the art in breast reconstruction finds well-founded historical pillars and advanced technological aid, providing conditions for advanced treatments.

Abstract The aim of this work was to perform an extended stability study for the analgesic containing fentanyl, clonidine and ropivacaine in physiological saline solution 0.9% at different infusion sites, such as infusion bags, epidural infusion sets and syringes. The extended stability was assessed by an HPLC system equipped with a photodiode array detector set at 210 nm. The separation was conducted on a C18 column maintained at 40˚C and using an isocratic mobile phase consisted of buffer solution-methanol-acetonitrile (45:45:10, v/v/v). The presence of particulate matter and the pH of each solution were also investigated. Twenty-four hours after the preparation, the formation of one suspected product was observed and for all drugs, in 24 hours it was observed the concentration decrease in different sets (PVC infusion bags, syringes and epidural infusion administration sets). The pH values of each solution varied no more than 5% during the study and no particle was observed. Conclusion: The extended stability study was applied to the analgesic solution and promoted the detection of an unexpected peak in 24 hours. Based on it, further stability studies are necessary to determine the extended stability data. fentanyl 09 0 9 0.9 sites bags 21 nm C C1 40C 40 solutionmethanolacetonitrile methanol acetonitrile 454510, 454510 45 10, 10 (45:45:10 v/v/v. vvv v/v/v . v v/v/v) investigated Twentyfour Twenty four preparation drugs 2 PVC sets. sets) 5 Conclusion data 0. 4 45451 1 (45:45:1 4545 (45:45: 454 (45:45 (45:4 (45: (45 (4 (

Abstract: This study measured the thickness of cementum/dentin in the danger zone of the mandibular molars after root canal preparation using novel cone-beam computed tomography (CBCT) software. Eighty-four teeth were distributed into four groups: ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold. E-Vol DX® CBCT software was used to measure initial and final remaining cementum-dentin thicknesses after root canal preparation of the mesial root of mandibular molars at 1 and 3 mm from the furcation. The Kolmogorov-Smirnov test was used to test variable symmetry. The variables were described as mean and standard deviations, compared among the groups using analysis of variance (ANOVA), and within the groups using the Student t test. A generalized estimating equation model was used to compare the variation before and after root canal preparation. The level of significance was set at 5%. Differences between mean initial and final thicknesses of the mesiobuccal (MB) and mesiolingual (ML) canals were not statistically significant. The mean initial thickness was 3 mm (0.900 mm ± 0.191), considering that a mean lower than 1 mm (1.035 mm ± 0.184) indicates the danger zone. Although cementum/dentin is thinner at 3 mm from the furcation (0.715±0.186) after root canal preparation, the greatest amount of dentin removed was found at 1 mm (0.734 ± 0.191). The cementum-dentin remaining after preparation was thicker than 0.715 mm in root canals prepared using #35 (WaveOne Gold®) and #40 (ProTaper Next®, BioRace® and Reciproc Blue®) instruments. This confirms the safety of canal preparation in the danger zone using these systems.

Resumo Este estudo descreve um método para identificar canais radiculares acessórios usando o software e-Vol DX em imagens de TCFC. Os canais radiculares acessórios constituem abrigos estratégicos aos micro-organismos presentes nas infecções endodônticas. A identificação destes pequenos canais em exames radiográficos periapicais apresenta limitações, além de apresentar baixa acessibilidade natural a ação dos instrumentos endodônticos e dos agentes antimicrobianos. Os canais acessórios apresentam diâmetros suficientes para ficarem visíveis em imagens de tomografia computadorizada de feixe cônico (TCFC) de alta resolução espacial. Porém, podem passar despercebidos ou até confundidos quando não ocorrer treinamento específico para este tipo de diagnóstico. A metodologia consiste em estabelecer finos slices (0,1 mm ou menor) obtidos a partir de cortes coronal, sagital e axial. O método consiste nos seguintes passos: ao encontrar uma linha hipodensa de um canal radicular principal em um corte tomográfico (axial, sagital ou coronal) deve-se ajustar as linhas de navegação da reconstrução multiplanar (MPR) para que fiquem paralelas ao canal principal e perpendiculares a esta linha hipodensa (correção de paralaxe). A seguir, depois de criterioso ajuste da imagem em busca do canal acessório, aparece invariavelmente como uma linha em um dos cortes tomográficos da MPR, outra linha em outro corte e um ponto no terceiro corte. Os três cortes da MPR apresentam imagens com a sequência linha-linha-ponto. Desta maneira, pode-se identificar um canal acessório e visualizá-lo em reconstrução volumétrica em filtro específico. Esta metodologia é fácil de ser aplicada e pode beneficiar o diagnóstico quando se deseja identificar canais radiculares acessórios e distingui-lo de linha de fratura radicular.

Abstract This study describes a methodology to identify accessory root canals using the e-Vol DX software in CBCT scans. Accessory root canals are strategic shelters for microorganisms present in root canal infections. The identification of these small canals in periapical radiographic exams has limitations, besides being markedly limited accessibility to the action of endodontic instruments and to the antimicrobial agents. A significant number of accessory canals have sufficient diameters to be visible on cone-beam computed tomography (CBCT) images of high spatial resolution. Therefore, it may go unnoticed or even confused when there is no specific training for this type of diagnosis. The methodology consists in establishing thin slices (0.1mm or smaller) obtained from coronal, sagittal and axial slices. The method consists of the following steps: during navigation along the long axis of a root canal when finding a possible hypodense line of main root canal in a tomographic section (axial, sagittal or coronal), the navigation software lines of the multiplanar reconstruction (MPR) must be adjusted so that they are parallel and perpendicular to the hypodense line (parallax correction). Then, after judiciously adjusted, the accessory canal image will invariably appear as a line on one of the MPR tomographic slices, another line on another slice, and a dot on the third slice. The three sections of the MPR present images with the “line-line-dot” sequence. In this way, it is possible to identify an accessory root canal and also visualize it in volumetric reconstruction in a specific filter. The application of this method is easy to employed and may benefit the diagnosis when you want to visualize accessory root canals and distinguish it from root fracture line.