Abstract: This research evaluated, in vivo, the accuracy of three electronic apex locators - EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access was performed. The cervical and middle thirds of root canals were instrumented with Reciproc R25, and the K#15 file was used as a standard instrument to determine working length, forming 2 groups: Constriction (insertion of the instrument until the apical constriction limit) and Foramen (insertion of the instrument until the foramen and then repositioning at constriction, without removing the file from the canal). The hand file was stabilized with a light-cured flow resin. After extraction, the samples were analyzed through microCT SkyScan 1272, with CTAN software, which evaluated the proximity between the tip of the file to the apical constriction, providing data for comparative analysis using Kruskal-Wallis and Dunn tests (p<0.05). There was a statistically significant difference in the abilities of the EALs to detect the apical constriction after reaching the foramen with Root ZX II showing higher accuracy (89%). However, there was no difference in the accuracy of the three EALs in detecting the apical constriction without reaching the foramen. Based on the present results, we conclude that EALs may show accurate measures in detecting apical constriction and foramen, even without damaging the periodontal stump in biopulpectomy.

Abstract: This study aimed to assess the cyclic fatigue resistance of Genius and EdgeFile X1 reciprocating instruments compared with WaveOne Gold Primary. Twenty Genius (Ultradent) 25.04, 20 Genius 30.04, 20 EdgeFile X1 (EdgeEndo) and 20 WaveOne Gold Primary (Dentsply Maillefer) instruments were included in this study and tested in a static cyclic fatigue testing device, which has an artificial stainless steel canal with a 60° angle of curvature and a 5-mm radius of curvature. All instruments were operated in reciprocation mode until fracture occurred. The number of cycles to failure (NCF) was calculated and time to fracture (TF) was recorded in seconds using a digital chronometer. The mean and standard deviations of NCF and TF were calculated for each reciprocating system and the data were subjected to Kruskal-Wallis one-way analysis of variance and to Dunn's test (p < .05) using SigmaPlot software (Systat software, CA, USA). The fractured surfaces of five instruments from each brand were randomly examined and microphotographed by a low-vacuum environmental scanning electron microscopy – SEM (Tabletop Microscope TM3030, Hitachi, Japan) to confirm the cyclic fatigue fracture. EdgeFile exhibited the highest cyclic fatigue resistance, followed by both Genius files (p < .05). Within the limitations of this in vitro study, EdgeFile X1 instruments had significantly higher cyclic fatigue resistance than did Genius and WaveOne Gold Primary instruments. The cyclic fatigue resistance of both Genius files was higher than that of WaveOne Gold Primary.

Abstract In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer’s protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey’s tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.

Resumo O gel clareador à base de peróxido de hidrogênio (H2O2) causa danos ao tecido pulpar. Este estudo investigou a ação de um anti-inflamatório tópico, o Otosporin®, nos dentes de ratos clareados com a hipótese nula de que o Otosporin® não é capaz de minimizar a inflamação da polpa gerada pelo gel clareador. Os molares dos ratos foram divididos em grupos: ClA: clareado (H2O2 a 35% / aplicação única de 30 min); CLA-O: clareado seguido do Otosporin® (10 min); e controle: gel placebo. No segundo dia após a clareação dentária, os ratos foram mortos e suas maxilas foram processadas para análise de hematoxilina-eosina e imunohistoquímica para o fator de necrose tumoral alfa (TNF-a), interleucina (IL)-6 e IL-17. Os dados coletados foram submetidos aos testes estatísticos de Kruskal-Wallis e Dunn com um nível de significância de 5% (p<0,05). O grupo CLA apresentou inflamação moderada à severa no terço oclusal da polpa coronária, com áreas necróticas; e CLA-O, inflamação leve (p<0,05). Houve diferença significativa nos terços oclusal e médio da polpa coronária entre o grupo CLA com os grupos CLA-O e controle (p<0,05). Não houve diferença no terço cervical (p>0,05). O grupo CLA apresentou maior imunoexpressão para TNF-a comparado aos grupos CLA-O e controle (p<0,05), com imunoexpressão moderada e leve, respectivamente. Em relação a IL-6 e IL-17, o grupo CLA apresentou maior imunoexpressão comparado ao controle (p<0,05); o CLA-O foi semelhante ao controle (p>0,05). O anti-inflamatório tópico Otosporin® pode reduzir a inflamação pulpar após clareação em dentes de ratos.

Abstract Bleaching gel containing hydrogen peroxide (H2O2) cause damages in pulp tissue. This study investigated the action of a topical anti-inflammatory, the Otosporin®, in rats’ bleached teeth with the null hypothesis of which the Otosporin® is no able to minimize the pulp inflammation that bleaching gel generates. The rat’s molars were divided into groups: BLE: bleached (35% H2O2 concentration /single application of 30 min); BLE-O: bleached followed by Otosporin® (10 min); and control: placebo gel. In the second day after dental bleaching, the rats were killed, and the jaws were processed for hematoxylin-eosin and immunohistochemistry analysis for tumor necrosis factor alpha (TNF-α), interleukin (IL)-6 and IL-17. The data collected were subjected to Kruskal-Wallis and Dunn statistical tests with at a 5% level of significance (p<0.05). The BLE group had moderate to strong inflammation in the occlusal third of the coronary pulp, with necrotic areas; and BLE-O, mild inflammation (p<0.05). There was a significant difference in the occlusal and middle thirds of the coronary pulp between the BLE with BLE-O and control groups (p<0.05). There was no difference in the cervical third (p>0.05). The BLE group had a high immunoexpression of TNF-α than BLE-O and control groups (p<0.05), with moderate and mild immunoexpression, respectively. Regarding IL-6 and IL-17, the BLE group had higher immunoexpression than control (p<0.05); the BLE-O was similar to the control (p>0.05). The topical anti-inflammatory Otosporin® can reduce pulp inflammation after dental bleaching in the rat teeth.

Abstract The aim of this study was to evaluate edemogenic activity and subcutaneous inflammatory reaction induced by Psidium cattleianum leaf extracts associated with Ca(OH)2. Thirty male Wistar rats, split equally into three groups [aqueous extract + Ca(OH)2; ethanolic extract + Ca(OH)2; and propylene glycol + Ca(OH)2], were assessed every 3 h or 6 h (five animals in each period). Under general anesthesia, 0.2 mL of 1% Evans blue per 100 g of body weight was injected into the penile vein and each combination to be evaluated was subcutaneously injected into the dorsal region 30 min thereafter. Edemogenic activity was analyzed by spectrophotometry (λ=630 nm). For inflammatory reaction analysis, 50 rats received four polyethylene tubes (three experimental groups) and an empty tube (control group). The assessments were made at 7, 15, 30, 60, and 90 days, followed by hematoxylin-eosin staining and by the assignment of scores for evaluation of tissue response intensity. Ethanolic extract + Ca(OH)2 yielded the largest edemogenic activity at 3 h. Intergroup differences at 6 h were not significant. The histological analysis showed progressive repair over time (p<0.05) and aqueous and ethanolic extracts produced similar responses to those of the control and Ca(OH)2 + propylene glycol groups. Psidium cattleianum leaf extracts used as Ca(OH)2 vehicles evoked similar tissue response when compared to Ca(OH)2 associated with propylene glycol.

RESUMO Objetivo: determinar a prevalência da Síndrome de Burnout (SB) em médicos cirurgiões que trabalham em hospital de referência para o trauma em Maceió e avaliar a possível correlação entre SB e a carga horária semanal de trabalho. Métodos: estudo transversal com 43 cirurgiões de plantão do Hospital Geral do Estado Professor Osvaldo Brandão Vilela, Maceió, entre julho e dezembro de 2015. Um formulário autoadministrado foi utilizado para avaliar SB por meio do Maslach Burnout Inventory (MBI) e as características sociodemográficas entre os participantes. Foi utilizado o teste de Spearman S para comparar SB e carga horária semanal. O nível de significância foi 5%. Resultados: entre os cirurgiões estudados, 95,35% eram do sexo masculino e a média de idade foi 43,9±8,95 anos. A média da carga horária semanal de plantão no trauma foi 33,90±16,82 horas. A frequência de pontuações elevadas em pelo menos uma das três dimensões do MBI foi 46,5%. Realização profissional foi correlacionada com a carga de trabalho semanal (P=0,020). Conclusão: a prevalência da Síndrome de Burnout entre cirurgiões plantonistas em hospital de referência para o trauma foi 46,5%. Nesta amostra houve correlação entre a carga horária semanal de trabalho e a Síndrome de Burnout.

ABSTRACT Objective: to determine the prevalence of Burnout Syndrome (BS) for surgeons working in referral hospital for trauma in Maceio and to evaluate the possible correlation between BS and weekly workload. Methods: cross-sectional study with 43 on-call surgeons at Professor Osvaldo Brandão Vilela General State Hospital, Maceió, between July and December, 2015. A self-administered form was used to evaluate BS through the Maslach Burnout Inventory (MBI) and socio-demographic characteristics among participants. Spearman's S test was used to compare BS and weekly workload. Significant level was 5%. Results: among the surgeons studied, 95.35% were male and the mean age was 43.9 ± 8.95 years. The mean weekly workload on call in trauma was 33.90 ± 16.82 hours. The frequency of high scores in at least one of the three dimensions of MBI was 46.5%. Professional achievement was correlated with weekly workload (P = 0.020). Conclusion: the prevalence of Burnout Syndrome among on-call surgeons in referral hospital for trauma was 46.5%. In this sample there was correlation between weekly workload and the Burnout Syndrome.

A esclerose múltipla (EM) é uma doença crônica inflamatória do sistema nervoso central (SNC). Esses pacientes sofrem de várias comorbidades, incluindo a disfunção sexual. As lesões da EM podem afetar varias regiões do SNC inclusive a via de resposta sexual. O Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) é uma escala de avaliação da disfunção sexual. Adaptar e validar o MSISQ-19 para os pacientes brasileiros com EM. 204 indivíduos foram avaliados, 134 pacientes com EM e 70 controles saudáveis. Foi determinado à reprodutibilidade, validade, consistência interna e a sensibilidade do MSISQ-19BR. Entre os pacientes com EM, 54,3% dos homens e 71,7% das mulheres apresentam algum tipo de DS. No grupo controle os resultados foram 12,5% e 19,5%, respectivamente. O MSISQ-19BR foi reprodutível, confiável e validade para a população brasileira e pode ser usado como uma ferramenta de avaliação do impacto da disfunção sexual nos pacientes com EM.

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). These patients suffer from various comorbidities, including sexual dysfunction (SD). The lesions of MS may affect regions of the CNS along the pathway of sexual response. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) is a scale that assesses sexual dysfunction. Adapt and validate the MSISQ-19 to Brazilian patients with MS. 204 individuals were evaluated, 134 patients with MS and 70 healthy persons for the control group. It was determined reproducibility, validity, internal consistency and sensitivity of the MSISQ-19-BR. Among patients with MS, 54.3% of male and 71.7% of female presented some kind of SD. In the control group the results were 12.5% and 19.5%, respectively. The MSISQ-19-BR is reproducible, reliable and valid for the Brazilian population and may be used as a tool for assessing the impact of sexual dysfunction in patients with MS.

Adaptação transcultural e validação da escala curta do Questionário de Impacto de Incontinência Urinária (IIQ-7) e do Inventário da Angústia Urogenital (UDI-6) na população brasileira com esclerose múltipla (EM). O IIQ-7 e o UDI-6 foram traduzidos para a língua portuguesa, obtendo-se IIQ-7-BR e UDI-6-BR. Os questionários foram aplicados em 211 indivíduos selecionados aleatoriamente. Destes, 140 apresentavam EM nos critérios de McDonald, e 71 foram incluídos no grupo controle. Em ambos os questionários aplicados nos grupos, o coeficiente alpha de Cronbach apresentou-se acima de 0,7. O IIQ-7-BR apresentou 94,31% de concordância entre os estudos avaliados e o UDI-6-BR, 93,33%. Sendo assim, os instrumentos desse estudo apresentaram-se, segundo as normas propostas pelo Instrument Review Criteria, confiabilidade, validade e sensibilidade, mantendo as características das escalas originais.

Cross-cultural adaptation and validation of the Impact Questionnaire of Urinary Incontinence (IIQ-7) and Urogenital Distress Inventory (UDI-6) - short scale - in the Brazilian population with multiple sclerosis. The IIQ-7 and UDI-6 were translated into Portuguese, called IIQ-7-BR and UDI-6-BR. The questionnaires were administered in 211 individuals selected randomly. Of these, 140 had MS according to McDonald criteria and 71 were included in the control group. In both questionnaires, the Cronbach’s alpha coefficient was above 0.7. The IIQ-7-BR showed 94.31% concordance between the evaluated studies and UDI-6-BR, 93.33%. Thus, the instruments of this study were presented according to the standards proposed by the Instrument Review Criteria, reliability, validity and sensitivity, maintaining the original scales characteristics.

OBJETIVO: Este estudo teve como objetivo descrever a validação de metodologias ativas de educação em saúde, na promoção da alimentação saudável de crianças do Ensino Fundamental. MÉTODOS: Foi feito estudo de validação de quatro tecnologias educacionais: dinâmicas de avaliação, minuto-cinema, momento-teatro e caixa dos sentidos. A pesquisa foi efetuada em 2009, com 25 crianças de 5 a 7 anos, estudantes de uma escola privada em Juazeiro do Norte, Ceará, selecionadas intencionalmente para participar de oficinas de ensino-aprendizagem. O projeto foi realizado por estudantes da Faculdade de Enfermagem daquela cidade, após aprovação do Comitê de Ética competente, e consentimento dos responsáveis pelas crianças. RESULTADOS: Validaram-se as metodologias utilizadas. Nas dinâmicas de avaliação, a colagem adequada dos alimentos foi realizada por 84% das crianças, demonstrando aquisição de saberes a partir da interação com os meios de comunicação, o aprendizado nutricional em família e o convívio social infantil, para a diferenciação entre alimentos saudáveis e não saudáveis. Na atividade minuto-cinema, os escolares demonstraram interesse na obtenção de conhecimento sobre a valia dos alimentos abordados. No momento-teatro, observou-se interatividade eficaz entre sujeitos e pesquisadores. Todas as crianças identificaram os alimentos ocultos na caixa dos sentidos, através de sua textura e consistência, o que contribuiu para o aperfeiçoamento das habilidades cognitivas infantis. Observou-se dificuldade dos pais e da escola em ofertar alimentos saudáveis. CONCLUSÃO: As metodologias utilizadas favoreceram o desenvolvimento de competências dos estudantes na promoção da saúde. No cuidado à criança, a alimentação é fundamental para promoção da saúde, pois o significado do ato de nutrir ultrapassa o mero ato biológico.

OBJECTIVE: This study described the active teaching-learning validation methods of health education that promote healthy eating habits in elementary schoolchildren. METHODS: A validation study of four educational methods was done. They included assessment dynamics, movie minute, theater moment and sensory box. The study was done in 2009 with 25 children aged 5 to 7 years attending a private school in Juazeiro do Norte, Ceará. They were deliberately chosen to participate in teaching-learning workshops. The project was done by students from the local nursing school and approved by the local Research Ethics Committee. The children's parents or caregivers signed a free and informed consent form. RESULTS: The methods were validated. In the assessment dynamics, 84% of the students placed the foods correctly, showing that they learned to distinguish healthy from unhealthy foods by interacting with the communication media and from family nutrition education and child socialization. In the movie minute activity, the children demonstrated interest in learning about the value of the studied foods. There was efficient interaction between the children and researchers during the theater moment. All children identified the foods hidden in the sensory box based on their texture and consistency, which helped to improve their cognitive skills. It was difficult for the parents and school to provide healthy foods. CONCLUSION: The used methods helped the students to develop their competences on health promotion. In caring for children, food is critical for good health, since nurturing is more than just a biological act.