RESUMO

This study aimed to evaluate volumetric polymerization shrinkage, degree of conversion and Vickers hardness of four bulk-fill resin composites light-activated with their dedicated light curing units (LCUs). Four groups were evaluated, according to the type of composite and curing mode: Tetric EvoCeram Bulk-fill (TEBO) and Tetric EvoFlow Bulk-fill (TEBF) were light-activated with Bluephase Style 20i (20s, in high-mode), while Tetric Powerfill (TEPO) and Tetric Powerflow (TEPF) were light-activated with Bluephase PowerCure (3s). Volumetric polymerization shrinkage test (n = 6) was performed in standardized box-shaped class-I cavities of extracted third molars (4 x 4 x 4 mm). Teeth were scanned before and after resin composite application by micro-computed tomography, and acquired data were evaluated with Amira software. Degree of conversion (n = 5) was evaluated at the top and bottom surfaces of composite cylindric samples (4 mm diameter, 4 mm thickness) using an FT-IR spectrometer (spectra between 1,500 and 1,800 cm-1, 40 scans at a resolution of 4 cm-1). Three Vickers indentations (50 g / 15 s), spaced 500 µm apart, were performed on the top and bottom composite surfaces and averaged. One-way ANOVA was used for data evaluation. TEPF showed the lowest volumetric polymerization shrinkage (p < 0.05), while the other composites were not significantly different within each other (p > 0.05). All materials presented a significant decrease in degree of conversion and Vickers hardness when compared top to bottom surfaces (p < 0.05). Bottom to top surface ratios for degree of conversion ranged from 0.8 (TEBO and TEPO) to 0.9 (TEBF and TEPF), and from 0.4 (TEPO) to 0.7 (TEBF and TEPF) for hardness. In conclusion, resinous materials present a decrease in hardness and degree of conversion from top to bottom even when a higher power is used, while the flowable material TEPF showed the lowest volumetric shrinkage values compared to the other materials.

Assuntos

RESUMO

Abstract This study aimed to evaluate volumetric polymerization shrinkage, degree of conversion and Vickers hardness of four bulk-fill resin composites light-activated with their dedicated light curing units (LCUs). Four groups were evaluated, according to the type of composite and curing mode: Tetric EvoCeram Bulk-fill (TEBO) and Tetric EvoFlow Bulk-fill (TEBF) were light-activated with Bluephase Style 20i (20s, in high-mode), while Tetric Powerfill (TEPO) and Tetric Powerflow (TEPF) were light-activated with Bluephase PowerCure (3s). Volumetric polymerization shrinkage test (n = 6) was performed in standardized box-shaped class-I cavities of extracted third molars (4 x 4 x 4 mm). Teeth were scanned before and after resin composite application by micro-computed tomography, and acquired data were evaluated with Amira software. Degree of conversion (n = 5) was evaluated at the top and bottom surfaces of composite cylindric samples (4 mm diameter, 4 mm thickness) using an FT-IR spectrometer (spectra between 1,500 and 1,800 cm-1, 40 scans at a resolution of 4 cm-1). Three Vickers indentations (50 g / 15 s), spaced 500 μm apart, were performed on the top and bottom composite surfaces and averaged. One-way ANOVA was used for data evaluation. TEPF showed the lowest volumetric polymerization shrinkage (p < 0.05), while the other composites were not significantly different within each other (p > 0.05). All materials presented a significant decrease in degree of conversion and Vickers hardness when compared top to bottom surfaces (p < 0.05). Bottom to top surface ratios for degree of conversion ranged from 0.8 (TEBO and TEPO) to 0.9 (TEBF and TEPF), and from 0.4 (TEPO) to 0.7 (TEBF and TEPF) for hardness. In conclusion, resinous materials present a decrease in hardness and degree of conversion from top to bottom even when a higher power is used, while the flowable material TEPF showed the lowest volumetric shrinkage values compared to the other materials.

RESUMO

A evolução da biotecnologia somada à ascensão da tecnologia para recombinação do DNA impulsionou a produção de biológicos ao longo de décadas. Com o término das patentes, os biossimilares emergiram com potencial de gerar um grande impacto na acessibilidade e assim estabelecer seu lugar no mercado após comprovação da equivalência com o medicamento biológico. Entretanto, as preocupações sobre as trocas de medicamentos biológicos e biossimilares é um importante debate atual que ressalta a relevância de acompanhamento pós mercado das pessoas em uso de biofármacos. Este estudo teve como objetivo elaborar um protótipo para identificar e validar os dados necessários para a construção de um software específico para o monitoramento dos medicamentos biossimilares para doenças inflamatórias imunomediadas, tendo em vista o processo de trabalho dos profissionais de saúde e da indústria farmacêutica, considerando os aspectos legais e legislativos das agências reguladoras em benefício do doente crônico. Trata-se de uma pesquisa aplicada, com abordagem qualitativa, na modalidade pesquisa-ação. A população amostral foi constituída por profissionais de saúde, profissionais da indústria farmacêutica, agência reguladora, usuários de medicamento biológico e medicamento biossimilar e especialistas de informática que aceitaram participar da pesquisa por meio da assinatura do Termo de Consentimento Livre e Esclarecido. Abordados na primeira etapa do estudo, os apontamentos dos integrantes do Comitê de Especialistas agregaram as diretrizes estabelecidas pelas agências reguladoras e contribuíram com o levantamento de requisitos que, permeado por padrões de terminologia, direcionou o desenvolvimento dos protótipos (estático e de software). O Adobe Illustrator® foi o editor de imagens vetoriais utilizado para desenvolver o protótipo estático e contribuir para consolidar as telas, ao passo que o protótipo de software explorou as potencialidades da tecnologia Angular e favoreceu a interação do usuário com as telas desenvolvidas. Na segunda fase do estudo, os integrantes do Comitê de Avaliadores acessaram o protótipo para avaliação da tecnologia por meio da aplicação de um questionário. Os resultados evidenciam a importância de desenvolver estratégias para identificar os desvios de qualidade e dessa forma minimizar os eventuais danos das novas gerações de medicamentos. Soma-se a relevância de identificar as trocas de medicamentos biológicos e biossimilares e qualificar as informações para favorecer o acompanhamento pós mercado dos biofármacos e, assim, fortalecer a farmacovigilância e contribuir com a segurança do paciente. A aproximação entre o pesquisador e as pessoas implicadas na jornada do paciente em uso de medicamento biológico e biossimilar proporcionou a inserção de perspectivas não previstas pela literatura e, sobretudo, delineou potenciais soluções para os problemas apontados.

The evolution of biotechnology added to the rise of technology for DNA recombination boosted the production of biologicals for decades. With the end of patents, biosimilars emerged with the potential to generate a great impact on accessibility and thus establish their place in the market after proof of equivalence with biological medicine. However, concerns regarding the exchange of biological and biosimilar medicines is an important current debate that highlights the relevance of post-market monitoring of people using biopharmaceuticals. This study aimed to develop a prototype to validate the data necessary for the monitoring of biological and biosimilar medicines for immune-mediated inflammatory diseases. It is an applied research, with a qualitative approach, in the action-research modality. The sample population consisted of health professionals, professionals from the pharmaceutical industry, regulatory agency, users of biological and biosimilar products and IT specialists who agreed to participate in the research by signing the Free and Informed Consent Form. Approached in the first stage of the study, the notes of the members of the Committee of Experts added the guidelines established by the regulatory agencies and contributed to the survey of requirements that, permeated by terminology standards, guided the development of prototypes (static and software). Adobe Illustrator® was the vector image editor used to develop the static prototype and contributed to consolidate the developed screens, while the software prototype explored the potential of Angular technology and favored user interaction with the screens developed. In the second phase of the study, the members of the Committee of Evaluators accessed the prototype for evaluating the technology through the application of a questionnaire. The results show the importance of developing strategies to identify quality deviations and minimize the potential damages of new generations of medicines. biopharmaceuticals and, thus, strengthen pharmacovigilance and contribute to patient safety. The approximation between the researcher and the people involved in the journey of the patient using biological and biosimilar medicines provided the insertion of perspectives not foreseen in the literature and, above all, outlining potential solutions to the problems mentioned.

Assuntos

RESUMO

RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos.

ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.

RESUMO

In this review we have focused on the preparation of cross-linked enzyme aggregates (CLEAs) from lipases, as these are among the most used enzyme in bioprocesses. This immobilization method is considered very attractive due to preparation simplicity, non-use of supports and the possibility of using crude enzyme extracts. CLEAs provide lipase stabilization under extreme temperature or pH conditions or in the presence of organic solvents, in addition to preventing enzyme leaching in aqueous medium. However, it presents some problems in the preparation and limitations in their use. The problems in preparation refer mainly to the crosslinking step, and may be solved using an aminated feeder. The problems in handling have been tackled designing magnetic-CLEAs or trapping the CLEAs in particles with better mechanical properties, the substrate diffusion problems has been reduced by producing more porous-CLEAs, etc. The enzyme co-immobilization using combi-CLEAs is also a new tendency. Therefore, this review explores the CLEAs methodology aimed at lipase immobilization and its applications.

Assuntos

RESUMO

ABSTRACT: Nowadays, maxillary midline diastema (MMD) can be treated with different multidisciplinary approaches. When restorative dentistry is needed, glass-matrix ceramic materials is one of the best choices, since they present good optical behavior and high survival rates in the anterior dentition. To obtain an adequate interphase, and color integration are one of the main restorative goals, and for that purpose, specific finishing and polishing procedures must be employed to avoid staining and ensure the restoration's color stability. In the case report presented in this article, a single lithium disilicate ceramic fragment was performed to close a MMD produced by the shape alteration of one of the maxillary central incisors. Also, the finishing and polishing procedure is discussed.

Assuntos

RESUMO

OBJECTIVES: To characterize the mechanical and biological properties of three commercially available resins, which are currently used for provisional restorations and to compare them to an experimental resin intended for definitive fixed dental prostheses. MATERIALS AND METHODS: Three commercially available resins: Crowntec (CT, Saremco), Temporary C&B (FL, Formlabs), C&B MFH (ND, Nextdent), and the experimental resin: Permanent Bridge (PB, Saremco) were printed and subjected to biaxial flexural strength test, finite element analysis, Weibull analysis, scanning electron microscopy, cell proliferation, immunohistochemistry and cytotoxicity assays. Samples from CT, PB, and ND were provided directly from the manufacturers ensuring ideal workflow. FL was printed using the workflow as recommended by the manufacturer, using a Formlabs 2 printer and their post-processing units Form Wash and Form Cure. RESULTS: From the tested resins, PB yielded the best overall results in terms of mechanical properties. Cell proliferation and cytotoxicity did not show any significant differences among materials. PB showed higher values for probability of survival predictions (35%) when subjected to 250 MPa loads, whereas the other materials did not reach 10%. SIGNIFICANCE: Despite mechanical differences between the evaluated materials, the outcomes suggest that 3D printed provisional resins may be used in clinical settings, following the manufacturers indications. New materials intended for long-term use, such as the PB resin, yielded higher mechanical properties compared to the other materials. Alternative printing and post-processing methods have not yet been evaluated and should be avoided until further literature is available. CLINICAL SIGNIFICANCE: 3D printed resins for provisional restorations have become popular with the emergence of new technologies. In this study, we evaluated three different commercially available resins for provisional restorations and one new experimental resin. The results from this study indicate that commercially available resins could be used in clinical settings under certain conditions and limited periods of time. Following the manufacturers protocols is of paramount importance to not compromise these properties.

Assuntos

RESUMO

Objective: To compare maximum incisor (MBFinc) and molar (MBFmol) bite forces regarding the type of dentition and sex and to establish a relationship between them.Methods: One hundred-five individuals were divided into 3 groups: G1 - 22 females/13 males (4-5 years); G2 - 15 females/20 males (11-12 years); and G3 - 16 females/19 males (17- 18 years). The maximum bite force was recorded with an extraoral measuring device. Three measurements were recorded: right and left molar level (MBFmol) and incisor level (MBFinc). The ratio %MBFinc/MBFmol was determined.Results: MBFmol and MBFinc values increased with age (p < 0.05). MBFmol showed statistically higher values than MBFinc (p < 0.05), when compared within the same group.Conclusion: MBFinc and MBFmol increased with age. For all groups, MBFmol showed higher values than MBFinc, and %MBFinc/MBFmol ratio was 1:2. No differences were found in maximum bite force between sexes.

Assuntos

RESUMO

OBJECTIVE: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. METHODS: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. RESULTS: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. CONCLUSION: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.

OBJETIVO: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. MÉTODOS: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. RESULTADOS: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. CONCLUSÃO: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos.

Assuntos

RESUMO

STATEMENT OF PROBLEM: The light source stability of digital cameras and smartphones is important in shade matching in restorative and prosthetic dentistry to communicate objectively with the dental laboratory. Techniques that standardize the light source of such devices are lacking, and this limitation can lead to color mismatches, difficulties in color communication, and treatment documentation. PURPOSE: The purpose of this clinical study was to compare the magnitude of color difference (ΔE) among 3 shade selection methods during the fabrication of ceramic crowns: visual shade selection with a shade guide, digital shade selection with a digital camera and cross-polarizing filter, and digital shade selection with a smartphone and a light-correcting device. MATERIAL AND METHODS: Forty-five patients in need of ceramic crowns were enrolled, and shade selection was evaluated according to different protocols: visual shade selection (A-D shade guide and IPS Natural Die Material Shade Guide, sent to the dental laboratory technician via a laboratory prescription); digital shade selection with a digital camera (D7000; Nikon Corp) with an 85-mm lens and wireless close-up flash, with and without a cross-polarizing filter (Polar eyes); and digital shade selection with a smartphone and a light-correcting device (iPhone XS attached to Smile Lite MDP, with and without its cross-polarizing filter accessory). Information from the smartphone was imported to an app (IPS e.max Shade Navigation App; Ivoclar AG) that converted the reading to a shade and level of translucency for the ceramic restoration. For all photographs, a gray reference card with known color values was positioned by the mandibular teeth and was used for white balancing of the digital photographs with a software program. All photographs were edited and sent to the dental laboratory: white-balanced with the shade guide; white-balanced with the substrate shade guide; black and white; saturated; and cross-polarized. Ceramic crowns were made with the same lithium disilicate material (IPS e.max CAD; Ivoclar AG) and cemented with the same resin cement (RelyX Ultimate Clicker, A3 shade; 3M). The ΔE values between the crown and the adjacent tooth were determined. The data were analyzed by using a 1-way analysis of variance (ANOVA) and Tukey post hoc tests (α=.05). RESULTS: The mean ΔE between a cemented ceramic crown and the adjacent tooth in the visual shade selection group was 5.32, significantly different than both digital camera (ΔE=2.75; P=.002) and smartphone (ΔE=2.34; P=.001), which were not different from each other (P=.857). CONCLUSIONS: The digital shade selection with photographs acquired with both a digital camera and a smartphone with a light-correcting device showed a threshold within the acceptable values (ΔE<3.7), whereas the visual shade selection showed an average ΔE above the threshold for acceptable values (ΔE>3.7). The use of a gray reference card helped standardize the white balance from the digital images.

Assuntos