Resumo Objetivos: avaliar a mortalidade materna de janeiro de 2019 a janeiro de 2020 no estado do Ceará. Métodos: trata-se de um estudo ecológico descritivo e retrospectivo. A coleta de dados foi realizada no período outubro a novembro de 2020, considerando o intervalo temporal de janeiro de 2019 a janeiro de 2020, através das informações registradas em banco de dados de domínio público do estado do Ceará. As variáveis consideradas para delinear o perfil dos óbitos maternos foram: faixa etária, as causas, estado civil, cor/raça e escolaridade. A análise dos dados ocorreu pela estatística descritiva por distribuição de frequências e foi apresentada por meio de tabelas. Resultados: foram registrados 135 óbitos maternos, considerando causas externas, diretas (mais prevalentes), indiretas e tardias. A razão de mortalidade materna no Ceará foi de 60.43%, cujo perfil dos óbitos foi caracterizado por mulheres com nível superior incompleto (41.5%), pardas (80%), na faixa etária de 20-29 anos (43%) e solteiras (66.7%). Conclusão: as informações apresentadas neste estudo são de extrema relevância, pois possibilitam a compreensão de uma população-chave, as mulheres, além de auxiliar no delineamento de estratégias para o enfrentamento da mortalidade materna.

Abstract Objectives: evaluate maternal mortality from January 2019 to January 2020 in the state of Ceará. Methods: this is a descriptive and retrospective ecological study. Data collection was carried out from October to November 2020, considering the time interval from January 2019 to January 2020, through information registered in a public domain database in the State of Ceará, Brazil. The variables considered to outline the profile of maternal deaths were: age group, causes, marital status, color/race and education. Data analysis was performed using descriptive statistics by frequency distribution and presented through tables. Results: 135 maternal deaths were registered, considering external, direct (most prevalent), indirect and late causes. The maternal mortality ratio in Ceará was 60.43%, whose profile of deaths was characterized by women with incomplete higher education (41.5%), brown (80%), in their 20-29 years (43%) and single (66.7%). Conclusion: the information in this study is extremely importance, as it allows the understanding of a key population, women, in addition to assisting in the design of strategies for coping with maternal mortality.

Abstract Objectives: The purpose of this study is to evaluate, over a simulated 5-year period, the effect of simulated gastric juice alternated with brushing on CAD-CAM monolithic materials considering microhardness, substance loss, flexural strength, and reliability of the materials. Methodology: Blocks from Lava Ultimate (LU), Vita Enamic (VE), IPS Empress CAD (EMP), IPS e.max CAD (EMAX), and Vita Suprinity (VS) were milled into cylinders and sliced into disks. The EMAX and VS were crystallized, and all specimens were polished with silicon carbide papers and allocated as follows: 1) artificial saliva + brushing or 2) simulated gastric juice (0.113% hydrochloric acid (HCl) solution in deionized water, pH 1.2) + brushing, simulating 1, 3, and 5 years of clinical function. Each year of clinical function was simulated by three repetitions of immersion for 3 hours in artificial saliva or simulated gastric juice followed by 1,217 brushing cycles. The microhardness and substance loss were evaluated at baseline (T0) and at each year by using a Vickers hardness tester and an analytical balance. The biaxial flexural strength (BFS) test was performed in a mechanical testing machine at the end of the 5th year. Weibull modulus was calculated from the BFS data. Results: The microhardness of the LU was not influenced by the treatment, whereas that of the other materials, in certain years, was significantly lower in the gastric juice + brushing groups in comparison with artificial saliva + brushing groups. In general, the materials did not present a significant change in microhardness over time, for either of the treatments. The LU alone showed greater substance loss in the gastric juice + brushing groups for every year. In both treatments, the LU, VE, and EMP exhibited a significant increase in the substance loss over time. The treatment did not affect the BFS of the materials. The gastric juice + brushing decreased the reliability of the VE. Conclusions: All materials were somehow impaired by the gastric juice + brushing in at least one of the evaluated parameters, except for the BFS. However, in a deeper analysis, the LU would be the least indicated materials, followed by VE, for patients with eating disorders.

Abstract Camphorquinone is the most conventionally used photoinitiator in Dentistry. Although different alternative photoinitiators have been proposed, no photoinitiator was capable of completely substituting camphorquinone. The combination of photoinitiators has been considered the best alternative. Objectives: To evaluate the effect of combining Norrish type I and II photoinitiators on the cure efficiency of dental resin-based composites. Methodology: Experimental composites were produced containing different photoinitiator systems: Norrish type I-only, mono-alkyl phosphine oxide (TPO); Norrish type II-only, camphorquinone (CQ); or its combination, CQ and TPO, in a 1: 1 molar ratio. UV-vis absorption spectrophotometry was performed to assess the consumption of each photoinitiator after curing (n=3). A multi-wave LED (Bluephase® G2, Ivoclar Vivadent) was pre-characterized and used with a radiant exposure of 24 J/cm2. The degree of conversion was evaluated by Raman spectrometry, and the elution of the monomers by nuclear magnetic resonance analysis (n=3). Data were analyzed using ANOVA and Tukey's test (α=0.05; β=0.2). Results: The combination of CQ and TPO increased the consumption of the photoinitiator system compared to CQ-only (p=0.001), but presented similar consumption compared to TPO-only (p=0.52). There was no significant difference in the degree of conversion between the composites regardless of the photoinitiator system (p=0.81). However, the elution of the monomers was reduced when both photoinitiators were combined. TPO-based material presented the highest elution of monomers. Conclusions: The combination of the photoinitiator systems seems to be beneficial for the cure efficiency of dental resin-based composites.

RESUMO Este estudo avaliou a influência do modo e do tempo de evaporação do solvente na resistência à tração (RT), resistência à flexão (RF) e módulo de elasticidade (MR) de dois sistemas adesivos: Scotchbond Multipurpose (SBMP) e Clearfil SE (CSEB). Para isso, amostras retangulares (2x1x7 mm) foram preparadas com 10 μL de primer e os solventes foram evaporados com aerossol a (23±1) ºC, (40±1) ºC e controle negativo (sem aerossol). Para cada temperatura, foram avaliados os tempos de 5, 20, 30 e 60 segundos. Os resultados estatísticos mostraram que a evaporação a (40±1) ºC resultou em melhor MR para os dois adesivos testados e todos os tempos de evaporação avaliados. No entanto, não houve diferenças significativas entre os tempos e modos de evaporação na RT. Os resultados deste estudo indicam que a evaporação a uma temperatura de (40±1) °C poderia melhorar o módulo de elasticidade de ambos os adesivos testados, independentemente do tempo de evaporação.

ABSTRACT This study evaluated the influence of the mode and time of solvent evaporation on the tensile strength (TS), flexural strength (FS) and elastic modulus (EM) of two adhesive systems: Scotchbond Multipurpose (SBMP) and Clearfil SE (CSEB). For this purpose, rectangular samples (2x1x7 mm) were prepared with 10 μL of primer and the solvents were evaporated with air spray at (23±1) ºC, (40±1) ºC and negative control (without spray). For each temperature, the times of 5, 20, 30, and 60 seconds were investigated. The statistical results showed that evaporation at 40±1ºC resulted in better EM for the two adhesives tested and all the evaporation times evaluated. However, there were no significant differences between the times and modes of evaporation for TS. The results of this study indicate that evaporation at a temperature of (40±1) °C could improve the elastic modulus of both adhesives tested, regardless of the evaporating time.

Abstract Carbon nanostructures have been extensively studied due to combination of properties they present. With different geometries and reactivities, carbon nanotubes, graphene and fullerene were oxidized and modified with octadecylamine (ODA) in order to decrease van der Waals’s interaction and consequently improve the polymer-carbon nanostructures affinity for use in nanocomposites. Nanostructures were characterized as morphology, chemical structure, molecular conformation and thermal properties. All nanostructures showed results that confirm the modification with ODA, without geometry being altered. Modified nanostructures showed different percentages of ODA: graphene 86%, carbon nanotubes 83% and fullerene 63%. It was attributed to distinct reactivities, shapes and specific surface area available, due to different amounts of reactive terminals obtained before oxidation reactions. However, they showed a lower interfacial interaction, which is highly favorable for use in polymer nanocomposites.

Abstract This study aimed to evaluate the physical properties and antifungal activities of polymethyl methacrylate (PMMA) acrylic resins after the incorporation of chlorhexidine diacetate salt (CDA). Methodology: First, acrylic resin specimens were fabricated with Vipi Cor® and DuraLay® resins with and without the incorporation of 0.5%, 1.0% or 2.0% CDA. The residual monomer and CDA release were measured at intervals ranging from 2 hours to 28 days using ultraviolet spectrometry combined with high-performance liquid chromatography. The antifungal activity against C. albicans was evaluated with the agar diffusion method. Fourier transform infrared spectroscopy was used to analyze the degree of resin conversion. Finally, the water sorption values of the resins were also measured. Results: The incorporated CDA concentration significantly changed the rate of CDA release (p<0.0001); however, the brand of the material appeared to have no significant influence on drug release. Subsequently, the inhibition zones were compared between the tested groups and within the same brand, and only the comparisons between the CDA 2% and CDA 1% groups and between the CDA 1% and CDA 0.5% groups failed to yield significant differences. Regarding the degrees of conversion, the differences were not significant and were lower only in the CDA 2% groups. Water sorption was significantly increased at the 1.0% and 2.0% concentrations. Conclusions: We concluded that the incorporation of CDA into PMMA-based resins enabled the inhibition of C. albicans growth rate, did not alter the degrees of conversion of the tested resins and did not change the release of residual monomers.

Abstract The aim of the present work was the obtaining and characterization of dental hybrid composites using nanoparticles (clay or silica) and boron-aluminum-silicate microparticles. We evaluated the dispersion of the nanofillers when changing their loading among 2.5%, 5%, 10% and 25% wt. Were tested, in the above quantities, four different types of nanofillers, two nanosilicas and two nanoclays The remainder of the inorganic phase, up to a total loading of 75% wt, was given by the boron-aluminum-silicate microparticles. The systems were characterized by XRD, TGA, LF-NMR, and . FTIR was used to determine the degree of conversion. The XRD and LF-NMR showed that the composites with 2.5% of clays, contained an exfoliated profile, and the groups with higher amounts of clay showed intercalated areas or the agglomeration of these particles. Furthermore, the silicas were agglomerated in all groups. The thermal resistance of the material was not affected by the silicas, but improved when using 2.5% of nanoclays. On the other hand, the addition of these particles caused the reduction of the degree of conversion of the systems.

RESUMO Pesquisas que avaliem o uso de cobertura morta no solo tem grande aceitação, uma vez que otimiza o manejo sustentável e melhora a qualidade do solo. Objetivou-se, com o presente trabalho, avaliar a eficiência da cobertura morta na redução das taxas erosivas do solo em cultivo de sorgo (Sorghum bicolor L. Moench) submetido à chuva simulada, bem como o incremento de carbono orgânico no solo. O experimento foi desenvolvido no período de agosto a dezembro de 2013 sob condição de campo, onde foram estabelecidos os seguintes tratamentos: sorgo com cobertura morta (CM) utilizando-se a vegetação espontânea da área e sorgo sem cobertura morta (SM), com três repetições em blocos casualizados. Foi realizada chuva simulada em três períodos distintos (nicial, intermediário e final do ciclo da cultura), utilizando-se um simulador de chuvas. Em todas as fases da cultura, o uso da cobertura morta no solo em cultivo de sorgo se mostrou eficiente por proporcionar maior retenção da umidade no solo, a qual se manteve por mais tempo entre os intervalos de chuva, resultando na ausência de perda de água, além de proporcionar maior aporte de carbono orgânico no solo.

ABSTRACT Researches evaluating the use of mulch has contributing to optimize soil management towards sustainability, and improving soil quality. The objective of this study was to evaluate the efficiency of mulching on the reduction of erosion in a soil with sorghum (Sorghum bicolor L. Moench) crops subjected to simulated rainfall and increased soil organic carbon. The experiment was carried out from August to December 2013 under field conditions, using a randomized block design with three replications. The treatments consisted of sorghum with mulch, using the local vegetation available in the area; and sorghum without mulch. Simulated rainfalls were performed in three different periods of the crop cycle (initial, intermediate, and final), using a rainfall simulator. The use of mulch in soils with sorghum crops was efficient in improving soil water retention in all phases of the crop, and maintaining soil moisture during the rainfall intervals used, resulting in the absence of plant water loss, and greater contribution to soil organic carbon.

Autism is characterized as a behavioral disorder. The autistic patient has some difficulties with common life routines, such as oral hygiene and also improper diet. As a consequence the refusal of physical contact, the implementation of brushing and flossing by caregivers is difficult. The present study aimed to conduct an epidemiological study of autistic patients in treatment at the Rehabilitation Center and Neurological Organization in North of Brazil, adopting the CPO-D and ceo-d. The clinical examination has been performed with the patient sitting in chairs, at the Rehabilitation Centre itself, under artificial fluorescent light intended for room lighting. From 26 patients included in the study, 76.9 % of subjects were male with a mean age of 13 years. Fifty percent had caries, and 11.5% had lesions on the gums. The mean ceo-d of children 28 years was 0.67. In patients 1015 years and 2040 years, the mean CPO-D was 0.70, and 3.00, respectively. From the study, the most significant data, seen was that half of autistic patients had carious lesions. It is vital to improve oral health conditions in these patients and by using preventive dentistry, analyze their susceptibility to oral diseases.

El autismo se caracteriza como un trastorno conductual. El paciente autista tiene algunas dificultades en las rutinas ordinarias de la vida, tales como la higiene oral. Como consecuencia, la negativa al contacto físico, la implementación del cepillado y uso de hilo dental es difícil para los cuidadores. Este estudio tuvo como objetivo llevar a cabo un estudio epidemiológico de los pacientes autistas en el Centro de Rehabilitación y la organización neurológica en el norte de Brasil, adoptando el CPOD y ceod. El examen clínico se realizó con el paciente sentado en una silla en el propio Centro de Rehabilitación, bajo una luz fluorescente artificial para la iluminación de la habitación. Veintiseis pacientes fueron incluidos en el estudio, el 76,9 % de los sujetos eran varones con una edad media de 13 años con un 50 % de caries, y en un 11,5 % se observaron lesiones gingivales. La media ceod de los niños de 2 a 8 años fue de 0,67. En los pacientes de 1015 años y 2040 años, el promedio CPOD fue de 0,70 y 3,00, respectivamente. A partir del estudio se pudo determinar que la mitad de los pacientes autistas tienen caries. Es importante la educación de estos pacientes para mejorar la salud oral y la aplicación de la odontología preventiva.

The aim of this study was to obtaining an adhesive made of dimethacrylate copolymer and clay particles in different concentrations. The samples were prepared by light curing and were evaluated by XRD, FTIR and TGA as well as by measuring flexural strength, elasticity modulus and tensile resistance. The XRD and the mechanical test results indicated that the system with 0.2% clay is exfoliated, while the highest concentrations showed the agglomeration of these clays. FTIR was used to determine the conversion, and showed that use of clays particles are unable to significantly alter the polymerization until 1.0%. However, for the group containing 1.5%, there was a decline in this index. In the thermogravimetric analysis, only the groups with 0.2% of clays showed increased thermal resistance. In conclusion, the incorporation of clay at 0.2% concentration produces a well-dispersed system and can be applied as a dental adhesive.

A Academia Americana de Dor Orofacial (AAOP) define anquilose da Articulação Temporomandibular (ATM) como restrição dos movimentos devido à adesão fibrosa intracapsular, alterações fibrosas nos ligamentos capsulares (fibroanquilose) e formação de massa óssea resultando na fusão dos componentes articulares (anquilose óssea). As características clínicas da Fibroanquilose são: capacidade severamente limitada de abertura bucal geralmente sem dor e sem ruídos articulares, com marcada deflexão para o lado afetado e marcada limitação de movimentos para o lado contralateral. Uma variedade de fatores pode causar anquilose da ATM, como trauma, condições inflamatórias locais e/ou sistêmicas, neoplasias e infecção na ATM. A artrite reumatóide (AR) é uma dessas condições sistêmicas inflamatórias que pode afetar a ATM e causar anquilose. O objetivo desse estudo é apresentar um caso de uma paciente, diagnosticada com Fibroanquilose da ATM bilateral e assintomática associada à AR. Esse caso ilustra a importância de um exame clínico bem realizado com exames complementares pode levar a um diagnóstico correto de Fibroanquilose da ATM e da importância do diagnóstico diferencial em casos de abertura bucal restrita.

The American Academy of Orofacial Pain (AAOP) defines ankylosis of the temporomandibular joint (TMJ) as a restriction of movements due to intracapsular fibrous adhesions, fibrous changes in capsular ligaments (fibrous-ankylosis) and osseous mass formation resulting in the fusion of the articular components (osseous-ankylosis). The clinical features of the fibrous-ankylosis are severely limited mouth-opening capacity (limited range of motion during the opening), usually no pain and no joint sounds, marked deflection to the affected side and marked limitation of movement to the contralateral side. A variety of factors may cause TMJ ankylosis, such as trauma, local and systemic inflammatory conditions, neoplasms and TMJ infection. Rheumatoid arthritis (RA) is one of the systemic inflammatory conditions that affect the TMJ and can cause ankylosis. The aim of this study is to present a case of a female patient diagnosed with bilateral asymptomatic fibrous-ankylosis of the TMJ associated with asymptomatic rheumatoid arthritis. This case illustrates the importance of a comprehensive clinical examination and correct diagnosis of an unusual condition causing severe mouth opening limitation.