RESUMO
INTRODUCTION: The aim of this study was to evaluate the effectiveness of the XP-endo Finisher R (XPFR; FKG Dentaire, La Chaux-de-Fonds, Switzerland) or the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) in removing remaining filling material after the retreatment of flattened root canals using micro-computed tomographic imaging. METHODS: Twenty-four flattened distal root canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were prepared with Reciproc Blue (RB) R40 (VDW GmbH, Munich, Germany) and filled using the Tagger hybrid technique. All canals were retreated with RB R40, and apical enlargement was performed with RB R50 (VDW GmbH). The specimens were randomly distributed into 2 groups: XPFR or Flatsonic (n = 12). The percentage of remaining filling material after retreatment and centralization ability was evaluated. Data were submitted to Mann-Whitney, Wilcoxon, and unpaired t tests (α = 5%). RESULTS: Greater capacity to remove remaining filling material in the entire canal and the cervical and middle thirds was observed for the Flatsonic compared with the XPFR (P < .05). However, both supplementary cleaning techniques showed a similar percentage of residual filling material in the apical third (P > .05). No difference was observed in the centralization ability between the techniques (P > .05). CONCLUSIONS: The Flatsonic promotes greater removal of remaining filling material than the XPFR in the retreatment of flattened root canals. However, both supplementary cleaning approaches were similar in the apical third. The XPFR and Flatsonic were able to maintain root canal centralization.
Assuntos
Cavidade Pulpar , Dente Molar , Materiais Restauradores do Canal Radicular , Preparo de Canal Radicular , Microtomografia por Raio-X , Microtomografia por Raio-X/métodos , Humanos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Dente Molar/diagnóstico por imagem , Retratamento , Obturação do Canal Radicular/métodos , Terapia por Ultrassom/métodosRESUMO
Type 2 diabetes mellitus (T2DM) is characterized by endothelial dysfunction that causes micro- and macrovascular complications. Low intensity therapeutic ultrasound (LITUS) may improve endothelial function, but its effects have not been investigated in these patients. The aim of our study was to compare the effects of pulsed (PUT) and continuous (CUT) waveforms of LITUS on the endothelium-dependent vasodilation of T2DM patients. The present randomized crossover trial had a sample of twenty-three patients (7 men) diagnosed with T2DM, 55.6 (±9.1) years old, with a body mass index of 28.6 (±3.3) kg/m2. All patients were randomized and submitted to different waveforms (Placebo, CUT, and PUT) of LITUS and the arterial endothelial function was evaluated. The LITUS of 1 MHz was applied in pulsed (PUT: 20% duty cycle, 0.08 W/cm2 SATA), continuous (CUT: 0.4 W/cm2 SPTA), and Placebo (equipment off) types of waves during 5 min on the brachial artery. Endothelial function was evaluated using the flow-mediated dilation (FMD) technique. PUT (mean difference 2.08%, 95% confidence interval 0.65 to 3.51) and CUT (mean difference 2.32%, 95% confidence interval 0.89 to 3.74) increased the %FMD compared to Placebo. In the effect size analysis, PUT (d=0.65) and CUT (d=0.65) waveforms presented moderate effects in the %FMD compared to Placebo. The vasodilator effect was similar in the different types of waves. Pulsed and continuous waveforms of LITUS of 1 MHz improved the arterial endothelial function in T2DM patients.
Assuntos
Diabetes Mellitus Tipo 2 , Terapia por Ultrassom , Masculino , Humanos , Vasodilatação , Terapia por Ultrassom/métodos , Endotélio Vascular , Vasodilatadores/farmacologia , Vasodilatadores/uso terapêutico , Artéria Braquial/diagnóstico por imagemRESUMO
PURPOSE: Low-intensity pulsed ultrasound (LIPUS) has been used to stimulate the healing of the fresh fracture, delayed union, and non-union in both animal and clinical studies. Besides, biphasic calcium phosphate ceramic (BCP) is a promising biomaterial for bone repair as it shows favorable biocompatibility, osteoinduction, and osteoconduction. However, scarcity is known about the combined effect of LIPUS and BCP on bone formation. METHODS: The combined effect of LIPUS and BCP was studied in a beagle model. Twelve dogs were used. BCP granules without any additions were implanted into bilateral erector spinae muscles. One side is the BCP group, while the counterlateral side is LIPUS + BCP group. Histological and histomorphometric analyses, and quantitative real-time polymerase chain reaction were evaluated. RESULTS: Compared with BCP alone, the LIPUS + BCP showed no advantages in early bone formation. Furthermore, the Notch signaling pathway-related mRNA has no significant difference between the two groups. CONCLUSIONS: The preliminary results showed that the BCP, which has intrinsic osteoinduction nature, was an effective and promising material. However, LIPUS has no enhanced effect in BCP induced ectopic bone formation. Furthermore, LIPUS has no effect on the Notch signaling pathway. Whether costly LIPUS could be used in combination with BCP should be a rethink.
Assuntos
Osteogênese , Terapia por Ultrassom , Animais , Cães , Regeneração Óssea , Fosfatos de Cálcio , Ondas Ultrassônicas , Cerâmica , Terapia por Ultrassom/métodosRESUMO
STUDY DESIGN: Randomized Clinical Trial. OBJECTIVE: The aim of this study was to compare the efficacy of USBS with standard-of-care surgical instruments during posterior spinal fusion (PSF) in patients with adolescent idiopathic scoliosis (AIS) by evaluating the difference in estimated blood loss per level fused (EBL/level). SUMMARY OF BACKGROUND DATA: PSF surgery for AIS is often associated with high blood loss. Use of an ultrasonic bone scalpel (USBS) has been proposed to reduce blood loss during scoliosis surgery. METHODS: This was a single-blinded (patient-blinded), randomized, controlled superiority trial. We randomized 66 patients with AIS undergoing PSF to the control group (osteotome) or the experimental group (USBS). The primary outcome was intraoperative EBL/level obtained from red blood cell salvage reports. One-year follow-up was available for 57 of 62 (92%) of patients. RESULTS: EBL/level averaged 35 and 39âmL/level in the experimental and control groups, respectively [adjusted mean difference USBS - osteotome -8âmL/level, 95% CI: -16.4 to 0.3âmL/level, Pâ=â0.0575]. There was no difference in curve correction [adjusted mean difference: -1.7%, 95% CI: -7.0 to 3.6%, Pâ=â0.5321] or operative time [adjusted mean difference: -3.55 minutes, 95% CI: -22.45 to 15.46 min, Pâ=â0.7089] between groups. Complications requiring change in routine postoperative care were noted in eight patients: two occurred in patients assigned to the experimental group and six occurred in patients assigned to the control group. CONCLUSION: There was no clinically significant difference in total blood loss, EBL/level, or complications between the two groups. In contrast to reports from other centers, at our high-volume spine center, USBS did not lead to reduced blood loss during PSF for AIS. These results may not be generalizable to centers with longer baseline operative times or higher baseline average blood loss during PSF for AIS.Level of Evidence: 1.
Assuntos
Perda Sanguínea Cirúrgica , Escoliose/cirurgia , Fusão Vertebral , Terapia por Ultrassom , Adolescente , Perda Sanguínea Cirúrgica/prevenção & controle , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Humanos , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Terapia por Ultrassom/efeitos adversos , Terapia por Ultrassom/métodosRESUMO
ABSTRACT: Introduction: Sodium hypochlorite and ultrasonic activation have a synergistic and improving effect on canal disinfection. Some authors found irrigant decrease after activation with ultrasonic, while others described an increased concentration in later stages. The aim of this study was to determine if activation of sodium hypochlorite by passive ultrasonic irrigation reduces its concentration compared to a technique without activation. Materials and methods: A ex-vivo descriptive study was conducted with teeth, randomized into two groups: 10 controls and 20 experimental. The hypochlorite of groups undergoing endodontic treatment was collected, and the post-irrigation residual with saline was gathered. The activation by ultrasonic was performed in stage 4.5 with Ultrasonic Scaler NSK®, three cycles of 20 seconds each per tooth. Irrigant concentration was measured by spectrophotometry. Results. In the first 4 stages, there were no concentration differences between groups. Stage 4.5 demonstrated a significant difference between the treated and control group. At saline irrigation stages, there was only a significant difference in stage E5. When activation was performed, the sodium hypochlorite curve maintained concentration values close to 5% in more stages in comparison to the control group. Conclusions: Passive ultrasonic activation demonstrated higher significant concentration of sodium hypochlorite, compared to a technique without activation.
Assuntos
Humanos , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Terapia por Ultrassom/métodos , Irrigação Terapêutica/métodos , Irrigantes do Canal Radicular/uso terapêutico , Hipoclorito de Sódio/análise , Espectrofotometria , Estudos Prospectivos , Endodontia/métodosRESUMO
SUMMARY: The aim of this study was to evaluate the effects of stretching and therapeutic ultrasound (TUS) on desmin and laminin contents of rat muscle after contusion. Male Wistar rats (n = 35, 8-9 weeks of age, 271 ± 14g body weight) were divided into five groups: Control group (CG) (n= 03); Injured group (IG) (n= 8); Injured + ultrasound group (IUSG) (n= 8); Injured+stretching group (ISG) (n= 8); Injured +ultrasound + stretching group (IUSSG) (n= 8). The application of ultrasound started 72 hours after the contusion, using the 50 % pulsed mode, 0.5 W/cm2, 5 min, once a day, for five consecutive days. Passive manual stretching was started on the tenth day after injury, with four repetitions of 30 s each and 30 s rest between repetitions, once a day, five times per week, for a total of ten applications. After 22 days, the rats were euthanazied and the gastrocnemius of both limbs removed for desmin and laminin immunohistochemistry morphometric measurement. Analysis was conducted using ANOVA one way post-hoc Tukey to parametric data and Kruskall-Wallis for non-parametric data. The IUSSG animals showed a larger area of desmin than ISG (p<0.05). It was found a decrease in laminin comparing IUSG to IG. However, laminin area was higher in ISG than all groups (p<0.05). UST isolated or in combination with stretching influenced gastrocnemius regeneration in different manners. While stretching applied isolated enhanced gastrocnemius regeneration noticed by the increase in laminin area, in combination with TUS strengthened the muscle healing rising desmin area.
RESUMEN: El objetivo de este estudio fue evaluar los efectos del estiramiento y la ecografía en los contenidos de desmina y laminina del músculo de rata después de la lesión. Ratas Wistar macho (n = 35, 8-9 semanas de edad, 271 ± 14 g de peso corporal) se dividieron en cinco grupos: grupo de control (CG) (n = 03); Grupo lesionado (GL) (n = 8); Lesionado + grupo de ultrasonido (LGU) (n= 8); Lesionado + grupo de estiramiento (LGE) (n = 8); Lesionado + ultrasonido + grupo de estiramiento (LUGE) (n = 8). La aplicación de ultrasonido comenzó 72 horas después de la lesión, usando el modo pulsado al 50 %, 0,5W / cm2, 5 min, una vez al día, durante cinco días consecutivos. El estiramiento manual pasivo se inició el décimo día después de la lesión, con cuatro repeticiones de 30 seg cada una y 30 seg de descanso entre repeticiones, una vez al día, cinco veces por semana, para un total de diez aplicaciones. Las ratas fueron sacrificadas después de 22 días, y se extrajo el músculo gastrocnemio de ambos miembros para la medición morfométrica de desmina y laminina a través de inmunohistoquímica. El análisis se realizó utilizando ANOVA unidireccional Tukey post-hoc para datos paramétricos y Kruskall-Wallis para datos no paramétricos. Los animales LUGE mostraron un área mayor de desmina que LGE (p <0,05). Se encontró una disminución en la laminina comparando LGU con GL. Sin embargo, el área de laminina fue mayor en LGE que en todos los grupos (p <0,05). El tratamiento con ultrasonido aislado o en combinación con estiramiento influyó en la regeneración del músculo gastrocnemio de diferentes maneras. Si bien el estiramiento aplicado, en combinación con tratamiento de ultrasonido, fortaleció el área de desmina, la regeneración del músculo gastrocnemio mejoró por el aumento en el área de laminina aumentando la curación muscular.
Assuntos
Animais , Masculino , Ratos , Terapia por Ultrassom/métodos , Músculo Esquelético/patologia , Contusões/terapia , Exercícios de Alongamento Muscular/métodos , Imuno-Histoquímica , Análise de Variância , Laminina/análise , Ratos Wistar , Músculo Esquelético/lesões , Desmina/análiseRESUMO
Objetivo: revisar a literatura quanto ao uso de soluções no reservatório líquido do ultrassom (US) para o tratamento das doenças periodontais, avaliando as contribuições dessa associação e as soluções mais eficazes para essa terapêutica. Métodos: foi realizada pesquisa bibliográfica nas bases de dados Public Medline (PubMed), Lilacs, Science Direct e ISI web of knowledge. As palavras-chave utilizadas foram: "periodontal disease", "ultrasonic", "cooling solution", "antimicrobial" e "irrigation". Como critérios de inclusão, foram selecionados estudos prospectivos, retrospectivos, caso controle, transversal e relatos de casos, publicados em inglês. Resultados: após pesquisa e minuciosa revisão por título e resumo de cada estudo, 15 estudos foram selecionados para avaliação dos desfechos investigados. As principais soluções associadas ao US foram povidono-iodo (PVPI), clorexidina, óleos essenciais, bicarbonato de sódio. O irrigante mais utilizado foi o PVPI, seguido por clorexidina e óleos essenciais. Os agentes podem conferir discretas melhoras no nível clínico de inserção e profundidade de sondagem, porém os resultados são controversos, já que nem todos os ensaios demonstraram efeitos positivos. Uma importante evidência observada foi em relação à redução dos níveis de microrganismos derivados do aerossol do US quando essas substâncias foram utilizadas no reservatório de água, sendo esse um aspecto positivo de seu uso como solução refrigerante ao US. Considerações finais: de modo geral, não puderam ser confirmados benefícios adicionais dos irrigantes antimicrobianos nos principais parâmetros periodontais avaliados, porém não se pode descartar o potencial uso desses agentes para a redução da dispersão de microrganismos advindos do aerossol, promovendo assim maior proteção ao paciente e ao profissional.(AU)
Objective: to review the literature regarding the use of solutions in the liquid ultrasonic (US) reservoir devices for the treatment of periodontal diseases, evaluating the benefits of this association, and the most effective solution for this therapy. Methods: bibliographic research was carried out in the Public Medline (PubMed), Lilacs, Science Direct, and ISI web of knowledge databases. The keywords used were: "periodontal disease", "ultrasonic", "cooling solution", "antimicrobial", and "irrigation". Inclusion criteria were prospective, retrospective, case-control, cross-sectional studies, and case reports published in English. Results: after a meticulous analysis of each paper by title and summary, 15 studies were selected for further investigation of clinical outcomes. The main solutions associated with US devices as coolant were PVPI, Chlorhexidine, Essential Oils and Sodium Bicarbonate. The most used coolant agent was PVPI, followed by chlorhexidine and essential oils. It has been shown that irrigating solutions can provide improvements in the clinical attachment level and probing depth, but the results are controversial since not all trials showed positive effects. Important evidence observed was the reduction of the levels of microorganisms derived from the US aerosol when these substances were used as a cooling solution. Conclusions: in general, additional benefits of coolant solutions could not be confirmed in the main periodontal parameters evaluated, however, the potential use of these agents to reduce the dispersion of microorganisms derived from the aerosol cannot be ruled out, thus promoting additional protection to the patient and professional.(AU)
Assuntos
Humanos , Doenças Periodontais/terapia , Terapia por Ultrassom/métodos , Anti-Infecciosos/uso terapêutico , Povidona-Iodo/uso terapêutico , Óleos Voláteis/uso terapêutico , Clorexidina/uso terapêutico , Bicarbonato de Sódio/uso terapêutico , Agentes de ResfriamentoRESUMO
BACKGROUND: Magnetic Fluid Hyperthermia (MFH) is a promising adjuvant for chemotherapy, potentiating the action of anticancer agents. However, drug delivery to cancer cells must be optimized to improve the overall therapeutic effect of drug/MFH combination treatments. PURPOSE: The aim of this work was to demonstrate the potentiation of 2-phenylethynesulfonamide (PES) at various combination treatments with MFH, using low-intensity ultrasound as an intracellular delivery enhancer. METHODS: The effect of ultrasound (US), MFH, and PES was first evaluated individually and then as combination treatments. Definity® microbubbles and polyethylene glycol (PEG)-coated iron oxide nanoparticles were used to induce cell sonoporation and MFH, respectively. Assessment of cell membrane permeabilization was evaluated via fluorescence microscopy, iron uptake by cells was quantified by UV-Vis spectroscopy, and cell viability was determined using automatic cell counting. RESULTS: Notable reductions in cancer cell viability were observed when ultrasound was incorporated. For example, the treatment US+PES reduced cell viability by 37% compared to the non-toxic effect of the drug. Similarly, the treatment US+MFH using mild hyperthermia (41°C), reduced cell viability by an additional 18% when compared to the effect of MH alone. Significant improvements were observed for the combination of US+PES+MFH with cell viability reduced by an additional 26% compared to the PES+MFH group. The improved cytotoxicity was attributed to enhanced drug/nanoparticle intracellular delivery, with iron uptake values nearly twice those achieved without ultrasound. Various treatment schedules were examined, and all of them showed substantial cell death, indicating that the time elapsed between sonoporation and magnetic field exposure was not significant. CONCLUSION: Superior cancer cell-killing patterns took place when ultrasound was incorporated thus demonstrating the in vitro ultrasonic potentiation of PES and mild MFH. This work demonstrated that ultrasound is a promising non-invasive enhancer of PES/MFH combination treatments, aiming to establish a sono-thermo-chemotherapy in the treatment of ovarian cancer.
Assuntos
Antineoplásicos/farmacologia , Hipertermia Induzida/métodos , Neoplasias Ovarianas/terapia , Sulfonamidas/farmacologia , Terapia por Ultrassom/métodos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Terapia Combinada , Feminino , Humanos , Magnetismo , Microbolhas/uso terapêutico , Nanopartículas/química , Nanopartículas/uso terapêuticoRESUMO
OBJECTIVE: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. METHODOLOGY: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. RESULTS: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). CONCLUSION: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.