ABSTRACT Introduction: Blood transfusion is one of the most common medical practices worldwide. However, current scientific literature has shown that the immunomodulatory effects of blood transfusion are associated with an increased likelihood of infection, prolonged hospitalization, and morbimortality. Also, it means high costs for healthcare systems. Methods: In this context, acknowledging that blood transfusions are essentially heterologous cell transplantations, the use of therapeutic options has gained strength and is collectively known as the patient blood management (PBM) program. PBM is an approach based on three main pillars: (1) treating anemias and coagulopathies in an optimized manner, especially in the preoperative period; (2) optimizing perioperative hemostasis and the use of blood recovery systems to avoid the loss of the patient's blood; (3) anemia tolerance, with improved oxygen delivery and reduced oxygen demand, particularly in the postoperative period. Results: Current scientific evidence supports the effectiveness of PBM by reducing the need for blood transfusions, decreasing associated complications, and promoting more efficient and safer blood management. Thus, PBM not only improves clinical outcomes for patients but also contributes to the economic sustainability of healthcare systems. Conclusion: The aim of this review was to summarize PBM strategies in a comprehensive, evidence-based approach through a systematic and structured model for PBM implementation in tertiary hospitals. The recommendations proposed herein are from researchers and experts of a high-complexity university hospital in the network of the Sistema Único de Saúde, presenting itself as a strategy that can be followed as a guideline for PBM implementation in other settings. Introduction worldwide However infection hospitalization morbimortality Also Methods context transplantations (PBM program pillars 1 (1 manner period 2 (2 s 3 (3 tolerance demand Results complications Thus Conclusion comprehensive evidencebased hospitals highcomplexity complexity Saúde settings (

Resumo O objetivo deste estudo foi avaliar a eficácia da aplicação de energia sônica sobre a resistência de união à microtração e a microdureza após o processo de restauração. Um total de 40 terceiros molares humanos foram extraídos. Cavidades Classe II foram preparadas e restauradas com os compósitos SonicFill ou Filtek Z350 XT com e sem a aplicação de energia sônica. Após os dentes serem armazenados em água durante 24 h, foram seccionados em palitos (1,0 mm2) e submetidos a ensaio de tração. Para um ensaio de dureza Knoop de profundidade, as amostras foram cortadas e as penetrações foram feitas sequencialmente a partir da superfície para o fundo das amostras em três intervalos de 1 mm cada. As amostras foram então submetidas a uma carga de 50 g durante 10 s. Os resultados dos testes de tração (fatores: sistema de inserção e compósito) e dureza (fatores: sistema de inserção x compósito x profundidade) foram submetidos ao teste de normalidade Kolmogorov-Smirnov, seguido da análise de variância e do teste de Tukey (significância de 5%). Para o fator sistema de inserção, observou-se maior resistência de união para as cavidades que foram restauradas com energia sônica (p < 0,001). Para a dureza Knoop de profundidade, a dureza a 1 mm de profundidade foi significativamente maior do que a profundidade de 3 mm apenas para as restaurações com o compósito Filtek Z350 XT sem a aplicação de energia sônica. Portanto, o uso de energia sônica durante o processo restaurador melhorou a união, mas não afetou acentuadamente a dureza de profundidade para ambos os compósitos.

Abstract The aim of this study was to evaluate the efficacy of applying sonic energy on microtensile bond strength and microhardness after the restoration process. A total of 40 human third molars were extracted. Class II cavities were prepared and restored with composite SonicFill or Filtek Z350 XT with and without the application of sonic energy. After the teeth were stored in water for 24 h, the teeth were sectioned into sticks (1.0 mm2) and subjected to tensile testing. For a depth Knoop hardness test, the samples were cut and indentations were made sequentially from the surface of the samples to the bottom of the samples in three intervals of 1 mm each. The samples were then subjected to a load of 50 g for 10 s. The results from the tensile (factors: placement system and composite) and hardness (factors: placement system, composite and depth) tests were subjected to the Kolmogorov-Smirnov normality test, followed by analysis of variance and Tukey’s test (5% significance). For the placement system factor, higher bond strength was observed for the cavities that were restored with sonic energy (p < 0.001). For depth Knoop hardness, the hardness at 1 mm depth was significantly greater than that at 3 mm depth just for the restorations with Filtek Z350 XT composite without the application of sonic energy. Therefore, the use of sonic energy during the restorative process improved bonding, yet it did not markedly affect the depth hardness for both composites.