Impact of the use of cusp overlap projection technique in the incidence of post-TAVR permanent pacemaker implantation with self-expanding valves

Funding Acknowledgements

Type of funding sources: None.

Introduction

Current rates of new Permanent Pacemaker (PPM) Implantations in the context of Transcatheter Aortic Valve Replacement (TAVR) range from 2-36% and that necessity is related to worse prognosis. The use of self-expanding valves and a lower valve implantation depth are two factors associated with an increased risk of conduction disturbances post-TAVR. Theoretically, cusp overlap implantation technique has the potential to enable a higher valve deployment by eliminating parallax of the delivery catheter.

Aim

To compare the in-hospital incidence of PPM post-TARV using self-expandable valve according to the fluoroscopic guidance technique.

Methods

Retrospective, single-centre study, with evaluation of patients consecutively submitted to TAVR with self-expanding CoreValveTM between July 2020 and December 2021 dichotomized according to the use of cusp overlap implantation technique for fluoroscopic valve implantation guidance.

Results

138 patients were included, predominantly women (57.2%), with a mean age of 78.4±8.0 years old, with severe aortic stenosis of the native valve being the most common indication for TAVI (85.5%). Cusp overlap view technique was applied in 50.7% of the patients (n=70). Frailty and co-morbidities were the most common cause for surgical refusal (54.3%). There was a significantly higher percentage of hypertensive patients (92.9% vs. 77.9%), lower previous aortic valve surgery (2.9% vs. 16.2%) and lower percentage of patients previously medicated with b-blockers in the group of patients in whom was used the cusp overlap technique; there were no other relevant differences related to the baseline characteristics. First degree atrioventricular block was present in 19.6% and complete right bundle block in 13.6% of the patients. Incidence of in-hospital post-TAVR PPM implantation wasn’t significantly different between the two cohorts of patients (cusp overlap vs. standard approach: 24.3% vs. 26.5%, p=0.77) (71.4% implanted in the context of complete heart block). Likewise, there were similar proportions of in-hospital new-onset of complete left bundle branch block (35.8% vs. 37.3%, p=0.86), volume of contrast used (140.6±37.5 mL vs. 145.2±51.5 mL, p=0.12), fluoroscopy time (15.6±8.8 min vs. 19.6±8.9 min, p=0.40) and radiation dose (556.3±320.6 mGy vs. 859.4±531.2 mGy, p=0.06).

Conclusions

This study shows that using the cusp overlap view for self-expanding valve implantation does not seem to achieve a significant reduction in in-hospital PPM implantation rate in comparison with the traditional 3 cusp co-planar fluoroscopic view. A larger and probably randomized clinical trial is needed to confirm these results.

Design, simulation, and fabrication of an ingestible capsule with gastric balloon for obesity treatment

The treatment of obesity based only on lifestyle changes has been shown ineffectiveness in a long-term period. The development of more definitive and non-invasive therapies has been the subject of study. In this paper, a magnetically driven ingestible capsule with the capacity to inflate a gastric balloon is devised, simulated, and fabricated. The balloon is inflated to a volume of 150 ml using an acid-base reaction between citric acid and potassium bicarbonate. Finite element method simulations were performed to study the interaction between the permanent external magnet and the ingestible capsule and confirm the magnetic activation mechanism. A fabrication process was proposed to manufacture a polydimethylsiloxane (PDMS) balloon in a simple, functional, and reproducible way. The two layers and 1:8 ratio balloons are the most cost-effective without compromising their mechanical properties. The capsule body parts manufactured by a three-dimensional (3D) printing process - Digital Light Processing (DLP) showed high accuracy and excellent resolution. This study demonstrated that the proposed ingestible capsule would successfully inflate the gastric balloon to treat obesity.

Twenty-first century droughts have not increasingly exacerbated fire season severity in the Brazilian Amazon

Biomass burning in the Brazilian Amazon is modulated by climate factors, such as droughts, and by human factors, such as deforestation, and land management activities. The increase in forest fires during drought years has led to the hypothesis that fire activity decoupled from deforestation during the twenty-first century. However, assessment of the hypothesis relied on an incorrect active fire dataset, which led to an underestimation of the decreasing trend in fire activity and to an inflated rank for year 2015 in terms of active fire counts. The recent correction of that database warrants a reassessment of the relationships between deforestation and fire. Contrasting with earlier findings, we show that the exacerbating effect of drought on fire season severity did not increase from 2003 to 2015 and that the record-breaking dry conditions of 2015 had the least impact on fire season of all twenty-first century severe droughts. Overall, our results for the same period used in the study that originated the fire-deforestation decoupling hypothesis (2003-2015) show that decoupling was clearly weaker than initially proposed. Extension of the study period up to 2019, and novel analysis of trends in fire types and fire intensity strengthened this conclusion. Therefore, the role of deforestation as a driver of fire activity in the region should not be underestimated and must be taken into account when implementing measures to protect the Amazon forest.

Thiourethane filler functionalization for dental resin composites: Concentration-dependent effects on toughening, stress reduction and depth of cure

OBJECTIVES

The aim of this study was to modify the surface of fillers used in dental composites by the synthesis of two novel thiourethane oligomeric silanes, used to functionalize the silica-containing inorganic particles. Several thiourethane silane concentrations were tested during the silanization process to systematically assess the effect of silane coverage on experimental composite conversion, polymerization stress and fracture toughness.

MATERIALS AND METHODS

Two different thiourethane silanes were synthesized based either on 1,6-hexanediol-diissocynate (HDDI), or 1,3-bis(1-isocyanato-1-methylethyl) benzene (BDI). Conventional 3-(Trimethoxysilyl)propyl methacrylate was used as the control. Glass fillers were silanized with 1, 2 or 4 wt% of each thiourethane silane, then evaluated by thermogravimetrical analysis. Photopolymerizable resin composites were prepared with Bis-GMA/UDMA/TEGDMA and 50 wt% silanized glass filler. Polymerization kinetics and degree of conversion were tested using Near-IR. Bioman was used to test polymerization stress. Data were analyzed with two-way ANOVA/Tukey's test (α = 5%).

RESULTS

The mass of silane coupled to the filler increased with the concentrations of thiourethane in the silanizing solution, as expected. Thiourethane-containing groups exhibited significantly higher degree of conversion compared to control groups, except for BDI 4%. HDDI 4%, BDI 2% and BDI 4% showed significantly lower polymerization stress than control groups. HDDI 4% exhibited significantly higher fracture toughness.

CONCLUSIONS AND CLINICAL SIGNIFICANCE

Novel filler functionalization with thiourethane silanes may be a promising alternative for improving dental composites properties by significantly increasing the degree of conversion, fracture toughness and reducing the polymerization stress.

Prevalence and distribution of dental anomalies in a paediatric population based on panoramic radiographs analysis

AIM

To evaluate the frequency and distribution of dental anomalies (DA) in a paediatric population.

MATERIALS AND METHODS

Panoramic digital radiographs of children between 6 and 12 years old performed at a reference centre for radiographic exams were accessed. Two calibrated examiners evaluated the radiographs. The association between variables and outcomes was assessed using non-parametric tests. The significance level was set at 5%.

RESULTS

Five hundred and twelve individuals were included and 61.3% presented at least one DA. The mean age of patients with DA (9.35±1.60) was significantly higher compared to patients with no anomalies (7.90±1.58). Patients with supernumerary tooth, however, were significantly younger. The most frequent DA were permanent tooth radicular dilacerations (38.1%), permanent tooth agenesis (29.3%), supernumerary tooth (6.4%) and impacted tooth (6.4%). Anterior teeth and female patients were more affected by radicular dilacerations. Dental agenesis was more frequent in the third molars followed by the upper lateral incisor.

CONCLUSION

DA are quite frequent in the paediatric population and the most common DA observed herein could only be identified through imaging exams. The most appropriate timing to perform an investigation for the detection of dental anomalies appears to be between 9 and 10 years old.

Effect of different composite modulation protocols on the conversion and polymerization stress profile of bulk-filled resin restorations

OBJECTIVE

The aim of this in vitro study was to test the effect of different composite modulation protocols (pre-heating, light-curing time and oligomer addition) for bulk filling techniques on resin polymerization stress, intra-pulpal temperature change and degree of conversion.

METHODS

Class I cavities (4mm depth×5mm diameter) were prepared in 48 extracted third molars and divided in 6 groups. Restorations were completed with a single increment, according to the following groups: (1) Filtek Z250XT (room temperature - activated for 20s); (2) Filtek Z250XT (at room temperature - activated for 40s); (3) Filtek Z250XT (pre-heated at 68°C - activated for 20s); (4) Filtek Z250XT (pre-heated at 68°C - activated for 40s); (5) Filtek BulkFill (at room temperature - activated for 20s); (6) Filtek Z250XT (modified by the addition of a thio-urethane oligomer at room temperature - activated for 40s). Acoustic emission test was used as a real-time polymerization stress (PS) assessment. The intra-pulpal temperature change was recorded with a thermocouple and bottom/top degree of conversion (DC) measured by Raman spectroscopy. Data were analyzed with one-way ANOVA/Tukey's test (α=5%).

RESULTS

Pre-heating the resin composite did not influence the intra-pulpal temperature (p=0.077). The thio-urethane-containing composite exhibited significantly less PS, due to a lower number of acoustic events. Groups with pre-heated composites did not result in significantly different PS. Filtek BulkFill and the thio-urethane experimental composite presented significantly higher DC.

SIGNIFICANCE

Resin composite pre-heating was not able to reduce polymerization stress in direct restorations. However, thio-urethane addition to a resin composite could reduce the polymerization stress while improving the DC.

Risk indicators of caries lesion activity in children

AIM

Determine the risk indicators of caries lesion activity in a child sample from Porto Alegre, Brazil.

MATERIALS AND METHODS

Study design: cross-sectional study included 97 individuals aged between 3 and 12-years who sought treatment at the Paediatric Clinic at the Dental Teaching Hospital at the Federal University of Rio Grande do Sul, between 2017 and 2018. Questionnaires recorded sociodemographic data, frequency of sugar intake, and toothbrushing frequency. Clinical examination included the visible plaque index, gingival blood index, and caries lesion activity.

RESULTS

s The mean of surfaces with active caries lesions was 9.81 (IC 95% = 8.47-11.15). Children who presented a frequency of sugar intake of twice/day (PR = 1.62, IC 95% = 1.30-2.03), three times/day (PR = 1.68, IC 95% = 1.37-2.08), and four or more times/day (PR = 1.59, IC 95% = 1.26-2.01), were likely to have active lesions. Ages between 8 and 12-years were associated with a lower probability of active carious lesions (PR = 0.77, IC 95% = 0.66-088).

STATISTICS

Poisson regression analysis was used to estimate the child's relative risk of developing new active caries lesions.

CONCLUSIONS

The monitoring of sugar intake should be considered a strong instrument for the strategies of control of dental caries in children.

Low pressure ion pair chromatography with amperometric detection for the determination of trigonelline in coffee samples

In this work, the use of ion pair chromatography strategy in low pressure chromatographic flow systems is explored for the first time. The straightforward flow manifold encompassed a peristaltic pump, an injection valve and a 1 cm-length C₁₈ monolithic column. The amperometric detection system relied on a boron-doped diamond electrode, used as working electrode. The determination of trigonelline in coffee samples was the case-study selected. This alkaloid is an important quality marker for this commodity and is usually determined using HPLC-UV methodologies. The proposed methodology, based on ion-pair chromatography with amperometric detection, enabled the quantitative resolution of the studied analyte from the matrix compounds by adding to the mobile phase the ion pair reagent, 1-tetradecanosulfonate sodium. The present work, following the recent developments of the low pressure chromatography approach, demonstrates the potentialities of coupling monolithic columns to traditional flow analysis systems for separation and quantification of ionic or ionisable compounds.

Effect of Different Adhesive Systems Used for Immediate Dentin Sealing on Bond Strength of a Self-Adhesive Resin Cement to Dentin

OBJECTIVE

The purpose of this study was to investigate the immediate and three-month water storage behavior of adhesives when used for immediate dentin sealing (IDS).

METHODS AND MATERIALS

Four adhesive systems were used to perform IDS: a one-step self-etch (Xeno V), a two-step self-etch (Clearfil SE Bond), a two-step etch-and-rinse (XP Bond), and a three-step etch-and-rinse (Optibond FL). For the control group, IDS was not performed. The self-adhesive resin cement RelyX Unicem was used for the luting procedures. After seven days of water storage, specimens (n=6) were sectioned into beams (n=5) with an approximately 1-mm² cross-sectional area. Half of the specimens were tested in tension after seven days of water storage at 37°C, while the other half was stored for three months prior to testing in tension using a universal testing machine (1 mm/min). The failure pattern was determined using a stereomicroscope and scanning electron microscopy. Microtensile bond strength (μTBS) data were statistically analyzed by two-way analysis of variance and Tukey post hoc test (α=0.05).

RESULTS

After seven days, the control group presented the lowest μTBS but did not differ from XP Bond and Clearfil SE Bond. After three months, there was no μTBS difference between the IDS groups and the control.

CONCLUSIONS

After seven days of water storage, the groups with IDS presented higher μTBS values than the control group, although XP Bond and Clearfil SE Bond did not present significant differences. However, after three months of storage in water, IDS groups did not differ significantly from control group, which did not receive IDS.

Resistência de União de Zircônia Aderida a Cerâmica Baseada em Vidro com Diferentes Liners

O objetivo do estudo foi avaliar a resistência de união ao microcisalhamento (uSBS) da interface de zircônia e cerâmica baseada em vidro tratada com diferentes liners após envelhecimento. Foram preparadas 20 barras (10x6x4 mm3) de zircônia para cada grupo, divididas em 3 grupos conforme o tratamento de superfície, totalizando 60 barras de zircônia (IPS emax.ZirCAD, Ivoclar Vivadent) utilizadas para o processamento de infraestrutura do sistema CAD-CAM (computer-aided design and computer-aided design manufacturing). As amostras foram sinterizadas e submetidas a aplicação de liner (HeraCeram, Heraus Kulzer ou ZirLiner, Ivoclar Vivadent) de acordo com os seguintes grupos (n20): G1 - sem tratamento (controle) G2 – Liner HeraCeram G3 - Liner ZirLiner. As amostras de zircônia foram aderidas à cerâmica baseada em vidro (IPS e.max ZirPres, Ivoclar Vivadent) por meio da injeção pela técnica da cera perdida (conduto cilíndrico de 0,8mm de diâmetro). As amostras foram submetidas a 100.000 ciclos termo- mecânicos e, avaliadas por meio do teste uSBS. O modo de fratura e os aspectos morfológicos dos espécimes mais significativos foram analisados através de microscopia eletrônica de varredura. A análise estatística dos valores obtidos foi realizada por one-way ANOVA e teste de Tukey (a0,05). As médias da uSB (MPa) foram: G1-12,1B G2-9,7B G3-14,4A (médias seguidas por diferentes letras indicam diferença estatística). A aplicação do liner ZirLiner previamente à injeção, aumentou a resistência de união entre a zircônia e a cerâmica baseada em vidro.Palavras-chave: Cerâmica. Microcisalhamento. Resistência de União.

Evaluation of laser fluorescence in monitoring non-cavitated caries lesion progression on smooth surfaces in vitro

The aim of this study was to evaluate the performance of a pen-type laser fluorescence (LF) device (LFpen: DIAGNOdent pen) to detect and monitor the progression of caries-like lesions on smooth surfaces. Fifty-two bovine enamel blocks were submitted to three different demineralisation cycles for caries-like lesion induction using Streptococcus mutans, Lactobacillus casei and Actinomyces naeslundii. At baseline and after each cycle, the enamel blocks were analysed under Knoop surface micro-hardness (SMH) and an LFpen. One enamel block after each cycle was randomly chosen for Raman spectroscopy analysis. Cross-sectional micro-hardness (CSMH) was performed at different depths (20, 40, 60, 80 and 100 μm) in 26 enamel blocks after the second cycle and 26 enamel blocks after the third cycle. Average values of SMH (± standard deviation (SD)) were 319.3 (± 21.5), 80.5 (± 31.9), 39.8 (± 12.7), and 29.77 (± 10.34) at baseline and after the first, second and third cycles, respectively. Statistical significant difference was found among all periods (p < 0.01). The LFpen values were 4.3 (± 1.5), 7.5 (± 9.4), 7.1 (± 7.1) and 5.10 (± 3.58) at baseline and after the first, second, and third cycles, respectively, among all periods (p < 0.05). The CSMH values after the second and third cycles at 20, 40, 60, 80 and 100 μm were 182.8 (± 69.8), 226.1 (± 79.6), 247.20 (± 69.36), 262.35 (± 66.36) and 268.45 (± 65.49), and for the third cycle were 193.7 (± 73.4), 239.5 (± 81.5), 262.64 (± 82.46), 287.10 (± 78.44) and 284.79 (± 72.63) (n = 24 and 23), respectively. No correlation was observed between the LFpen and SMH values (p > 0.05). One sample of each cycle was characterised through Raman spectroscopy analysis. It can be concluded that LF was effective in detecting the first demineralisation on enamel; however, the method did not show any effect in monitoring lesion progression after three cycles of in vitro demineralisation.

Effects of Immediate Dentin Sealing and Pulpal Pressure on Resin Cement Bond Strength and Nanoleakage

Objective: The object of this study was to evaluate the simulated pulpal pressure (SPP) and immediate dentin sealing technique (IDS) effects on the microtensile bond strength (μTBS) and nanoleakage of interfaces produced by different luting agents.

Methods and Materials: Two self-adhesive luting agents (RelyX Unicem [UC] and Clearfil SA Luting [SA]) and two conventional luting agents (Rely X ARC [RX] and Panavia F [PF]) were evaluated. Eighty human molars were divided in four groups according to luting agents. Each group was subdivided according to SPP (with or without) and dentin sealing (immediate or delayed) using Clearfil SE Bond (n=5). After IDS was performed, specimens were stored in water for seven days before luting procedures. Composite blocks were luted according to the manufacturers' instructions. One half of the specimens were subjected to 15 cm H2O of hydrostatic pressure for 24 hours before cementation procedures and continued for 24 hours afterward. Then, restored teeth were sectioned into beams and tested in tension. Two additional teeth per group were prepared for nanoleakage evaluation with scanning electron microscopy. Bond strength data were statistically analyzed by three-way analysis of variance and Tukey test.

Results: μTBS of RX decreased when it was subjected to SPP without IDS. However, in the same conditions, μTBS of UC increased. The IDS prevented negative influence of SPP on μTBS of RX and PF; however, a decrease in μTBS of SA and UC was observed. Except for RX, IDS increased μTBS for all resin cements.

Conclusion: Independent of SPP, the IDS technique obtained higher μTBS for PF, SA, and UC and did not influence RX μTBS.

Two-year Randomized Clinical Trial of Self-etching Adhesives and Selective Enamel Etching

OBJECTIVE

The aim of this randomized, controlled prospective clinical trial was to evaluate the clinical effectiveness of restoring noncarious cervical lesions with two self-etching adhesive systems applied with or without selective enamel etching.

METHODS

A one-step self-etching adhesive (Xeno V(+)) and a two-step self-etching system (Clearfil SE Bond) were used. The effectiveness of phosphoric acid selective etching of enamel margins was also evaluated. Fifty-six cavities were restored with each adhesive system and divided into two subgroups (n=28; etch and non-etch). All 112 cavities were restored with the nanohybrid composite Esthet.X HD. The clinical effectiveness of restorations was recorded in terms of retention, marginal integrity, marginal staining, caries recurrence, and postoperative sensitivity after 3, 6, 12, 18, and 24 months (modified United States Public Health Service).

RESULTS

The Friedman test detected significant differences only after 18 months for marginal staining in the groups Clearfil SE non-etch (p=0.009) and Xeno V(+) etch (p=0.004). One restoration was lost during the trial (Xeno V(+) etch; p>0.05).

CONCLUSIONS

Although an increase in marginal staining was recorded for groups Clearfil SE non-etch and Xeno V(+) etch, the clinical effectiveness of restorations was considered acceptable for the single-step and two-step self-etching systems with or without selective enamel etching in this 24-month clinical trial.

Performance of undergraduate dental students on ICDAS clinical caries detection after different learning strategies

AIM

This study aimed to evaluate the effect of a digital learning tool on undergraduate dental students' performance in detecting dental caries using ICDAS.

METHODS

An experimental digital learning tool (DLT) was created using digital photographs of sound and carious teeth. Thirty-nine students were divided into three groups (n = 13) and each assessed 12 randomly allocated patients before and after learning strategies: G1, ICDAS e-learning program; G2, ICDAS e-learning program plus DLT; G3, no learning strategy. Students (n = 32) reassessed patients 2 weeks after training.

RESULTS

Comparing before and after the learning strategies, any difference in the values of specificity and area under the ROC curve for all groups was found. Sensitivity was statistically significantly higher for G1 and G2. Comparing the groups, G2 showed a significant increase in sensitivity at the D2 and D3 thresholds. Spearman's correlations with the gold standard before and after the learning strategy were 0.60 and 0.61 for G1, 0.57 and 0.63 for G2, and 0.54 and 0.54 for G3, respectively. The Wilcoxon test showed a statistically significant difference between the values obtained before and after learning strategies for G1 and G2.

CONCLUSIONS

Use of the DLT after the ICDAS e-learning program tended to increase the sensitivity of ICDAS used by undergraduate dental students. The DLT appeared to improve dental students' ability to use ICDAS.

Effectiveness of Fluorescence-based Methods in Monitoring Progression of Noncavitated Caries-like Lesions on Smooth Surfaces

Although there has been a significant decrease in caries prevalence in developed countries, the slower progression of dental caries requires methods capable of detecting and quantifying lesions at an early stage. The aim of this study was to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent 2095 laser fluorescence device [LF], DIAGNOdent 2190 pen [LFpen], and VistaProof fluorescence camera [FC]) in monitoring the progression of noncavitated caries-like lesions on smooth surfaces. Caries-like lesions were developed in 60 blocks of bovine enamel using a bacterial model of Streptococcus mutans and Lactobacillus acidophilus. Enamel blocks were evaluated by two independent examiners at baseline (phase I), after the first cariogenic challenge (eight days) (phase II), and after the second cariogenic challenge (a further eight days) (phase III) by two independent examiners using the LF, LFpen, and FC. Blocks were submitted to surface microhardness (SMH) and cross-sectional microhardness analyses. The intraclass correlation coefficient for intra- and interexaminer reproducibility ranged from 0.49 (FC) to 0.94 (LF/LFpen). SMH values decreased and fluorescence values increased significantly among the three phases. Higher values for sensitivity, specificity, and area under the receiver operating characteristic curve were observed for FC (phase II) and LFpen (phase III). A significant correlation was found between fluorescence values and SMH in all phases and integrated loss of surface hardness (ΔKHN) in phase III. In conclusion, fluorescence-based methods were effective in monitoring noncavitated caries-like lesions on smooth surfaces, with moderate correlation with SMH, allowing differentiation between sound and demineralized enamel.

Effectiveness of fluorescence-based methods to detect in situ demineralization and remineralization on smooth surfaces

This study aimed to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, LF; DIAGNOdent pen, LFpen, and VistaProof fluorescence camera, FC) in detecting demineralization and remineralization on smooth surfaces in situ. Ten volunteers wore acrylic palatal appliances, each containing 6 enamel blocks that were demineralized for 14 days by exposure to a 20% sucrose solution and 3 of them were remineralized for 7 days with fluoride dentifrice. Sixty enamel blocks were evaluated at baseline, after demineralization and 30 blocks after remineralization by two examiners using LF, LFpen and FC. They were submitted to surface microhardness (SMH) and cross-sectional microhardness analysis. The integrated loss of surface hardness (ΔKHN) was calculated. The intraclass correlation coefficient for interexaminer reproducibility ranged from 0.21 (FC) to 0.86 (LFpen). SMH, LF and LFpen values presented significant differences among the three phases. However, FC fluorescence values showed no significant differences between the demineralization and remineralization phases. Fluorescence values for baseline, demineralized and remineralized enamel were, respectively, 5.4 ± 1.0, 9.2 ± 2.2 and 7.0 ± 1.5 for LF; 10.5 ± 2.0, 15.0 ± 3.2 and 12.5 ± 2.9 for LFpen, and 1.0 ± 0.0, 1.0 ± 0.1 and 1.0 ± 0.1 for FC. SMH and ΔKHN showed significant differences between demineralization and remineralization phases. There was a negative and significant correlation between SMH and LF and LFpen in the remineralization phase. In conclusion, LF and LFpen devices were effective in detecting demineralization and remineralization on smooth surfaces provoked in situ.

Effect of Simulated Tooth Temperature on the Degree of Conversion of Self-adhesive Resin Cements Exposed to Different Curing Conditions

Objectives

This study evaluated the degree of conversion (DC) of two commercial, self-adhesive resin cements (SARCs) using Fourier transform infrared analysis (FTIR) polymerized at simulated prepared tooth surface temperatures and under different curing conditions.

Materials and Methods

RelyX U100 (U100, 3M ESPE) and Maxcem Elite (MX, Kerr Corporation) were mixed at 25°C and applied to the surface of a horizontal attenuated total reflectance (ATR) unit, which was near room temperature (RT, control) (25°C) or heated to simulate prepared tooth surface temperatures (28°C and 32°C) and then attached to an infrared spectrometer. The products were polymerized using one of three conditions: direct light exposure through a glass slide (DLE), exposure through a 1.5-mm thick ceramic disc overlay (CO) (A2 shade, IPS e.max, Ivoclar Vivadent), or self-curing (SC). FTIR spectra were recorded for 12 minutes (1 spectrum/s, 16 scans/spectrum, resolution 4 cm−1) immediately after application to the ATR. The DC was calculated using standard techniques of observing changes in aliphatic-to-aromatic peak ratios before and 12 minutes after curing, as well as during each 1-second interval. DC data (n=7) were analyzed by two-way analysis of variance and Tukey's post-hoc test (p=0.05).

Results

Both simulated tooth temperatures significantly increased DC in all groups of MX and in the CO and SC groups of U100 compared with the RT control. For MX, the self-cure groups exposed to tooth temperatures showed DC values similar to those of the CO groups. For U100, the CO groups showed higher DC values than SC groups regardless of temperature. Time-based conversion profiles ranged according to product, temperature, and curing mode.

Conclusions

Causing SARCs to polymerize at simulated tooth temperatures increases DC of SARCs compared with room-temperature curing values, mainly in the SC mode.

Effect of long-term simulated pulpal pressure on the bond strength and nanoleakage of resin-luting agents with different bonding strategies

This study evaluated the effects of simulated hydrostatic pulpal pressure (SPP) on the microtensile bond strength (μTBS) to dentin and nanoleakage patterns produced by self-adhesive luting agents after 12 months. Three self-adhesive luting agents (RelyX Unicem [UN], RelyX U100 [UC], and Clearfil SA Luting [SA]) and three conventional luting agents (Rely X ARC [RX], Panavia F [PF], and a two-step self-etching adhesive system [Clearfil SE Bond] associated with Panavia F [PS]) were evaluated. One hundred twenty-three human molars were abraded to expose occlusal surfaces. Resin cements were used to lute cylindrical composite blocks to the teeth either subjected or not to SPP. Sixty specimens were subjected to 15 cm H2O of SPP for 24 hours before and 24 hours or 12 months after cementation procedures. Afterward, restored teeth were serially sectioned into beams with a cross-sectional area of 1 mm(2) at the bonded interface and were tested in tension (cross-head speed of 1 mm/min). Failure mode was determined using scanning electron microscopy (SEM). Data were statistically analyzed by three-way analysis of variance and post hoc Tukey test (p=0.05). Two additional teeth in each group were serially sectioned into 0.9-mm-thick slabs, which were submitted to a nanoleakage protocol with AgNO3 and analyzed with scanning and transmission electron microscopes. The μTBS values of the etch-and-rinse group (RX) were negatively influenced by SPP and long-term water storage with SPP. After 12 months, UC and SA presented premature failures in all specimens when submitted to SPP. SPP increased silver deposition in most groups in both evaluation times. The hydrostatic pulpal pressure effect was material dependent. The storage time without SPP did not affect bond strength. However, long-term SPP influenced the performance of the etch-and-rinse and self-adhesive cements regarding μTBS and nanoleakage pattern, except to UN.

Halogen lamp and LED activation of resin-modified glass ionomer restorative material. In vitro microhardness after long-term storage

AIM

The purpose of this study was to evaluate the activation of resin-modified glass ionomer restorative material (RMGI, Vitremer-3M-ESPE, A3) by halogen lamp (QTH) or light-emitting diode (LED) by Knoop microhardness (KHN) in two storage conditions: 24 hrs and 6 months and in two depths (0 and 2 mm).

MATERIALS AND METHODS

The specimens were randomly divided into 3 experimental groups (n = 10) according to activation form and evaluated in depth after 24 h and after 6 months of storage. Activation was performed with QTH for 40s (700 mW/cm) and for 40 or 20 s with LED (1,200 mW/cm2). After 24 hrs and 6 months of storage at 37 degrees C in relative humidity in light-proof container, the Knoop microhardness test was performed. Statistics Data were analysed by three-way ANOVA and Tukey post-tests (p < 0.05).

RESULTS

All evaluated factors showed significant differences (p < 0.05). After 24 hrs there were no differences within the experimental groups. KHN at 0 mm was significantly higher than 2 mm. After 6 months, there was an increase of microhardness values for all groups, being the ones activated by LED higher than the ones activated by QTH.

CONCLUSION

Light-activation with LED positively influenced the KHN for RMGI evaluated after 6 months.

Probing beer aging chemistry by nuclear magnetic resonance and multivariate analysis

This paper describes the use of nuclear magnetic resonance (NMR) spectroscopy, in tandem with multivariate analysis (MVA), for monitoring the chemical changes occurring in a lager beer exposed to forced aging (at 45°C for up to 18 days). To evaluate the resulting compositional variations, both principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were applied to the NMR spectra of beer recorded as a function of aging and a clear aging trend was observed. Inspection of PLS-DA loadings and peak integration enabled the changing compounds to be identified, revealing the importance of well known markers such as 5-hydroxymethylfurfural (5-HMF) as well as a range of other relevant compounds: amino acids, higher alcohols, organic acids, dextrins and some still unassigned spin systems. In addition, the multivariate analysis method of 2D correlation analysis was applied to the NMR data enabling the relevant compound variations to be confirmed and inter-compound correlations to be assessed, some reflecting common metabolic/chemical pathways and, therefore, offering improved insight into the chemical aspects of beer aging.

In Vitro Detection of Secondary Caries Associated with Composite Restorations on Approximal Surfaces Using Laser Fluorescence

Detecting secondary caries is difficult when using the visual-tactile examination. This study showed that the laser fluorescence device can be an auxiliary method for the detection of lesions associated with composite restorations on approximal surfaces.

Antibacterial Activity of Various Self-etching Adhesive Systems Against Oral Streptococci

An antimicrobial effect is desired for adhesive systems in order to avoid cariogenic bacterial colonization and also the growth of remaining bacteria in the cavity preparation.

Acid-base changes in canine neonates following normal birth or dystocia

There are limited data concerning blood gas parameters in neonatal dogs. Knowledge of the normal physiology may facilitate effective therapeutic intervention and potentially reduce neonatal mortality. This study examined acid-base parameters in pups born at normal parturition (n = 27) compared with those born after obstetrical assistance or caesarean operation (n = 13) and those born following oxytocin (OXY) administration for treatment of uterine inertia (n = 11). Pups were subjected to an objective scoring method of neonatal health adapted from use in humans (the Apgar score) at birth and again at 5 and 60 min after birth. Venous blood samples were collected at 5 and 60 min after birth for evaluation of blood gas parameters. At birth, all pups had low Apgar scores and a mixed acidosis. The base excess was lowest for pups delivered after OXY administration. The Apgar score improved for all pups after 5 min of birth and there was an improvement in carbon dioxide tension, base excess and venous blood pH at 1 h, although in all pups a metabolic acidosis persisted. These data provide an important insight into neonatal physiology and the variability of blood gas parameters in pups born at normal and abnormal parturition and provide the basis for clinical decision making following dystocia.

Neonatal clinical evaluation, blood gas and radiographic assessment after normal birth, vaginal dystocia or caesarean section in dogs

This study aimed to standardize signs and diagnostic criteria of respiratory function in newborn puppies delivered normally or after dystocia and caesarean operation. A total of 48 neonates were allocated into groups: eutocia (n = 20), dystocia (n = 8), caesarean (c)-section (n = 20). Neonatal health was assessed using the Apgar score and body temperature was determined at 0, 5 and 60 min after delivery. Venous blood gases (pO(2) and SO(2)) was measured immediately and 60 min after delivery, and a thoracic radiograph was made between 0 and 5 min of life. The c-section group had significantly lower Apgar scores at birth and 5 min. Hypothermia was present at 5 min in the eutocia and c-section groups, and at 60 min in all groups. The eutocia group had an irregular respiratory pattern in 78% of puppies at birth, 27.7% at 5 min and 21% at 60 min compared with 87.5%, 62.5% and 12.5% of the pups in the dystocia group where there was irregular respiratory rhythm, moderate to intense respiratory sounds with agonic episodes. The c-section group had respiratory alterations in 70%, 45% and 16% of puppies at 0, 5 and 60 min, respectively. Radiographic abnormalities were present in 17% of the pups in the eutocia group, 25% of the pups in the dystocia group and 30% of the pups in the c-section group, respectively. The c-section group had significantly lower SO(2) values at 60 min than at birth. All puppies had hypoxaemia, but a significant decrease was observed in the c-section group. Newborn puppies had tissue hypoxia and irregular respiratory pattern at birth. Caesarean-section puppies had lower vitality; however, all developed satisfactory Apgar scores at 5 min of life, regardless of the obstetric condition.

Performance of fluorescence methods, radiographic examination and ICDAS II on occlusal surfaces in vitro

This study compared the performance of fluorescence-based methods, radiographic examination, and International Caries Detection and Assessment System (ICDAS) II on occlusal surfaces. One hundred and nineteen permanent human molars were assessed twice by 2 experienced dentists using the laser fluorescence (LF and LFpen) and fluorescence camera (FC) devices, ICDAS II and bitewing radiographs (BW). After measuring, the teeth were histologically prepared and assessed for caries extension. The sensitivities for dentine caries detection were 0.86 (FC), 0.78 (LFpen), 0.73 (ICDAS II), 0.51 (LF) and 0.34 (BW). The specificities were 0.97 (BW), 0.89 (LF), 0.65 (ICDAS II), 0.63 (FC) and 0.56 (LFpen). BW presented the highest values of likelihood ratio (LR)+ (12.47) and LR- (0.68). Rank correlations with histology were 0.53 (LF), 0.52 (LFpen), 0.41 (FC), 0.59 (ICDAS II) and 0.57 (BW). The area under the ROC curve varied from 0.72 to 0.83. Inter- and intraexaminer intraclass correlation values were respectively 0.90 and 0.85 (LF), 0.93 and 0.87 (LFpen) and 0.85 and 0.76 (FC). The ICDAS II kappa values were 0.51 (interexaminer) and 0.61 (intraexaminer). The BW kappa values were 0.50 (interexaminer) and 0.62 (intraexaminer). The Bland and Altman limits of agreement were 46.0 and 38.2 (LF), 55.6 and 40.0 (LFpen) and 1.12 and 0.80 (FC), for intra- and interexaminer reproducibilities. The posttest probability for dentine caries detection was high for BW and LF. In conclusion, LFpen, FC and ICDAS II presented better sensitivity and LF and BW better specificity. ICDAS II combined with BW showed the best performance and is the best combination for detecting caries on occlusal surfaces.

Electromyographic analysis of the arm muscles in "back support" exercises

This study aims at quantifying through electromyography the actions of the biceps brachii-BB (long head), triceps brachii-TB (long head) and deltoideus-DA (clavicular portion) muscles, during the going (G) and return (R) phases in "back support" exercises. Surface electrodes were placed at the muscles, according to DELAGI (1981). It was used a specific software and a A/D plate to take the signals. After being collected, the records were processed resulting in efficient values (RMS), were normalized by maximum isometric contraction (MVIC = 100%) and statistically analysed using the Friedman, DSM and Wilcox non-parametric tests. All the muscles presented electromyographic activity of the movements. The triceps brachii was the muscle with higher activity in both phases of the movement. It was concluded that the exercise is indicated for the arm muscle strength development.

Electromyographic analysis of the pectoralis major and deltoideus anterior in the inclined "flying" exercise with loads

Due to a shortage of textbooks with specific data on muscular activity concerning physical conditioning and sports, we analysed electromyographically the muscles pectoralis major and deltoideus anterior, bilaterally, in inclined "flying" exercises, during the concentric and eccentric phases, with external loads of 25, 50, 75 and 100% of the maximum load. The electromyographic analysis was performed in eleven male volunteers with MEDI-TRACE-200 surface electrodes connected to a six-channel biologic signal acquisition module coupled to a PC/AT computer. The electromyographic signals were processed and the obtained effective values were normalized through maximum voluntary isometric contraction. Statistically, the results showed that all the muscles studied presented significant differences between the concentric and the eccentric phases, with higher electromyographic activity during the concentric phase. By analysing the different loads for each muscle in both phases, significant electromyographic activity was observed for all muscles. When the effect of each load on each muscle during the concentric phase was analysed, it was noticed that the muscles on the left were more active than those on the right side, while in the eccentric phase the muscles had different behavior.

Electromyographic validation of the pectoralis major and deltoideus anterior muscles in inverted "flying" exercises with loads

Inverted 'flying" exercise with external loads of 25, 50, 75 and 100% of each individual maximum load in the pectoralis major and deltoideus anterior muscles was electromyographically analyzed in eleven male volunteers, using surface electrodes MEDI-TRACE-200 connected to a biological signals acquisition module coupled to a PC/AT computer. Electromyographic signals were processed and the effective values obtained were standardized through maximum voluntary isometric contraction. When the concentric phase of each muscle with the same load was statistically compared with the eccentric phase, it was observed that for all loads all the muscles presented significant electromyographic difference, and that the concentric phase was always higher. By analyzing the different loads for each muscle, it was noticed that in the concentric phase all the muscles presented significant electromyographic activity, being it higher with maximum load. When the effect of each load on different muscle in the concentric and eccentric phases was analyzed, the muscles presented a distinct activity profile.

Evaluation of motivation methods used to obtain appropriate oral hygiene levels in schoolchildren*

The aim of the present study is to assess the behaviour of different motivation methods on levels of oral hygiene among schoolchildren aged from 7 to 9 years in Araraquara, SP, Brazil. The methods tested were: indirect instruction using 'The Smiling Robot' (group I), indirect instruction through class presentation (group II) and direct instruction with macromodels (group III). A control group was also constituted, which received no kind of motivation (group IV). The O'Leary Plaque Index was used as the evaluation method, applied before the instruction and 30 days after application of the different methods. It was noted that the plaque index had not decreased in group IV only. In conclusion, all the motivation methods promoted significant decrease of plaque index and among these methods, the 'The Smiling Robot' was the one that provided the best results.

Continuous fermentation of sugar cane syrup using immobilized yeast cells

Several strains of Saccharomyces sp. and commercial Baker's yeast were immobilized by adhesion onto chrysotile, a fibrous magnesium silicate (Mg6Si4O10 (OH)8). The activity of the cells is higher when immobilized, mainly for fermentation of 30 to 50% w/v glucose solutions. In the medium containing 30% w/v glucose, the initial fermentation rate increased 1.2-2.5 times. Yields were in the range of 80.4 to 97.3% for the immobilized cells and 72.7 to 84.5% for the free cells. A packed bed reactor for continuous fermentation was set up using one of the tested strains immobilized onto chrysotile. An average productivity of 20 to 25 g.l(-1).h(-1) was obtained in the first 20 d, and an average of 16 g.l(-1).h(-1) was obtained after 50 d of operation.

Synthesis of sterically stabilized polystyrene latex particles using cationic block copolymers and macromonomers and their application as stimulus-responsive particulate emulsifiers for oil-in-water emulsions

2-(Dimethylamino)ethyl methacrylate (DMA) was block copolymerized with methyl methacrylate (MMA) using group transfer polymerization to give four AB diblock, ABA triblock, and BAB triblock copolymers of low polydispersity (Mw/Mn < 1.20). In addition, a near-monodisperse styrene-functionalized DMA-based macromonomer was synthesized via oxyanionic polymerization using a potassium 4-vinylbenzyl alcoholate initiator. These five well-defined, tertiary amine methacrylate-based copolymers were evaluated as steric stabilizers for the synthesis of polystyrene latexes via emulsion and dispersion polymerization. The most efficient steric stabilizers proved to be the DMA-MMA diblock copolymer and the DMA-based macromonomer. The polystyrene latexes were characterized in terms of their particle size and morphology, stabilizer content, surface charge, and surface activity using dynamic light scattering, scanning electron microscopy, 1H NMR spectroscopy, aqueous electrophoresis measurements, and surface tensiometry, respectively. The pH-dependent surface activity exhibited by selected latexes suggests potential applications as stimulus-responsive particulate emulsifiers for oil-in-water emulsions.

Simultaneous determination of E-2-nonenal and β-damascenone in beer by reversed-phase liquid chromatography with UV detection

A method for the simultaneous determination of E-2-nonenal and beta-damascenone in beer by reversed-phase liquid chromatography using UV detection is presented. The method consists of beer steam distillation, followed by an extraction/concentration step using Sep-Pak Plus C18 RP cartridges and determination by HPLC at 226 nm UV-absorption maximum. The identity of the compounds was confirmed by GC analysis with MS detection of the isolated fractions. A recovery factor of approximately 80% was obtained for beta-damascenone with a R.S.D. of 3%. E-2-Nonenal and beta-damascenone were monitored in a comparative study of fresh and either naturally and forced aged beer. The results obtained show that both compounds have a similar behaviour through an extended storage of beer and consequently can be used as good analytical markers of beer ageing. Nevertheless, the use of beta-damascenone seems to be more convenient because this compound appears in beer in higher concentrations than E-2-nonenal, thus making it easier to measure.

Behavioral modulation by mutilation pictures in women

Previous studies have shown that women are more emotionally expressive than men. It is unclear, however, if women are also more susceptible to the emotional modulation of behavior imposed by an affective stimulus. To investigate this issue, we devised a task in which female subjects performed six sequential trials of visual target detection following the presentation of emotional (mutilation and erotic) or neutral pictures (domestic utensils and objects) and compared the data obtained in the present study with those described in a previous study with male subjects. The experiment consisted of three blocks of 24 pictures and each block had an approximate duration of 4 min. Our sample consisted of 36 subjects (age range: 18 to 26 years) and each subject performed all blocks. Trials following the presentation of mutilation pictures (283 ms) had significantly slower reaction times than those following neutral (270 ms) pictures. None of the trials in the "pleasant block" (271 ms) was significantly different from those in the "neutral block". The increase in reaction time observed in the unpleasant block may be related in part to the activation of motivational systems leading to an avoidance behavior. The interference effect observed in this study was similar to the pattern previously described for men. Thus, although women may be more emotionally expressive, they were not more reactive to aversive stimuli than men, as measured by emotional interference in a simple reaction time task.

Electromyographic analysis of the arm muscles in "front support" exercises

The electromyographic activity of the biceps brachii--BB (long head), triceps brachii--TB (long head) and deltoideus--DA (clavicular portion) muscles, during the going (G) and return (R) phases in "front support" exercise, as well the efficacy of this exercise for the development of these muscles strength were studied in 10 male volunteers. The values were normalized through maximum voluntary isometric contraction (MVIC = 100%) and statistically analyzed using the Friedman, DMS and Wilcoxon non-parametric test. A value of p < or = 0.05 indicated significance (Campos, 1983). All the muscles presented higher electromyographic activity in the return phase of the movement. The triceps brachii was the muscle which had higher activity in both phases of the movement. It was concluded that the "front support" exercise is efficient for strength development mainly in the triceps brachii muscle.

Electromyographic analysis of the pectoralis major and deltoideus anterior muscles in horizontal "flyer" exercises with loads

The effective activity of the pectoralis major and deltoideus anterior muscles in horizontal "flyer" exercises with external loads of 25, 50, 75 and 100% of the maximum load was studied in 11 male volunteers. The electromyographic analysis was done by using MEDI-TRACE-200 surface electrodes connected to a biological signal acquisition mode coupled to a PC/AT computer. The electromyographic signals were processed and the values obtained were normalized through maximum voluntary isometric contraction. It was statistically observed that in all types and loads of this exercise, the muscles presented significant differences in the concentric and eccentric phases. In the concentric phase, when different loads were compared, the muscles were more active with 75 and 100% of the maximum load, while in the eccentric phase, higher activity was observed with 100% of the maximum load. By analyzing each load effect in the concentric phase, it was verified that the muscles on the left side were more active than those on the right side with 25, 75 and 100% of the maximum load.

Use of sterically-stabilised polystyrene latex particles as a pH-responsive particulate emulsifier to prepare surfactant-free oil-in-water emulsions

A pH-responsive, sterically-stabilised polystyrene latex is used as a particulate emulsifier for oil-in-water emulsions; demulsification occurs rapidly on lowering the solution pH and the original emulsion can be reformed on pH cycling.

Determination of E-2-nonenal by high-performance liquid chromatography with UV detection assay for the evaluation of beer ageing

The analysis of E-2-nonenal is of considerable interest for the brewery industry as this compound is claimed to be responsible for a paper/cardboard unpleasant flavour. Usually, the presence of E-2-nonenal can be noticed in aged beers at levels higher than 0.1 microg/l. In this work, an analytical method was developed to determine E-2-nonenal in beer involving steam distillation of beer followed by an extraction/concentration step using solid-phase extraction and determination of E-2-nonenal by HPLC with UV detection. Fastness and simplicity are the main advantages of the proposed method, when compared with other existing methodologies for the determination of E-2-nonenal in beer. Using the developed conditions, the interference of E-2-nonenal formed by degradation of its precursors during steam distillation is almost negligible. The presence of sulphur dioxide at legal levels does not interfere with the assay. The method was used in a comparative study of fresh and either naturally or forced aged beers. A much larger chromatographic peak was found near the peak of E-2-nonenal that correlates well with the peak of E-2-nonenal. Identification of the corresponding compound is currently under investigation, considering its future application on the evaluation of beer ageing.

Differentiation and numerical analysis of oral yeasts based on SDS-Page profiles. Influence of the culture media on the whole-cell protein extracts

The application of gel electrophoresis and numerical analysis of yeast soluble proteins analysis to the investigation of 12 oral yeast strains belonging to five species is described. It involves one-dimensional electrophoresis of SDS-solubilized whole-cell proteins using different culture media for the cultivation of the cells, integration densitometries in the areas of the gels and percentages of the proteins extraction. These extracts were prepared from four isolates of Candida albicans, two of C. tropicalis, C. guilliermondii, C. parapsilosis and C. krusei. The extracts from whole-cells proteins using different culture media for the cultivation of the cells were fractionated by slab electrophoresis using a discontinuous buffer system. The corresponding patterns showed at least 36 polypeptides in the range of 14.4-200 kDa. Different isolates of each species were clearly different in each of the five species. The data obtained suggest that different nutritional compositions led to the expression of different proteins derived from alternatives metabolic pathways expressed by the electrophoretic profiles. The construction of a database of protein fingerprints and numerical analysis based on such data, may have some implications in the classification and identification of such species with epidemiological, ecological and taxonomic purposes. A well defined or synthetic culture media seems to be much properly.