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This study aimed to analyze the potential occurrence of dentinal defects after the removal of a root canal filling with two different sealers using Reciproc (RC) or Reciproc Blue (RB). The mesial roots of 60 mandibular molars with a Vertucci type IV configuration were selected. The samples were initially instrumented with Reciproc (R25) and then divided into the following four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC); BC Sealer/Reciproc Blue (BCRB); AH Plus/Reciproc (AHRC); and AH Plus/Reciproc Blue (AHRB). Then, the samples were scanned under micro-CT after obturation and removal of the filling material. Two analyses were conducted. First, an evaluation was performed on all the axial images, and another analysis evaluated each millimeter of the 10 mm from the apex. Dentinal defects were observed in all the samples. All of the identified defects in the images after filling material removal were present in the corresponding images after obturation. The use of AH Plus and EndoSequence BC Sealer, and filling material removal using RC and RB instruments did not induce dentinal defects.

It is believed that penetration of dentinal fluid into natural enamel caries (NEC) is negligible because of the barrier created by underlying sclerotic dentine, but there are conflicting evidences on whether dentine subjacent to NEC is sclerotic or demineralized. This study aimed at investigating the relationship between NEC, subjacent dentine reactions, modification of dentinal fluid, and composition of cariogenic biofilm formed on the NEC surface. Proximal NEC (PNEC) lesions of human permanent posterior teeth were included in five experiments. Histologically, microradiographic analysis with contrast solution (MRC) in dentine revealed a decreased proportion of sclerotic dentine and an increased proportion of deep dentine demineralization compared to the classical stereomicroscopic histological analysis based on dentin color and translucency. Real-time MRC and 3D optical profilometry, and 3D microtomographic analysis evidenced a facilitated transport of modified dentinal fluid towards PNEC lesions. Cariogenic biofilm formed in vitro on the PNEC surface presented lower amounts of insoluble and soluble matrix polysaccharides when 2% chlorexidine was inserted in the pulp chamber. In conclusion, this study evidenced that dentine subjacent to PNEC is mostly demineralized, providing facilitated pathway for dentinal fluid to penetrate into PNEC and alter the composition of the biofilm formed on the PNEC surface.

ResumoIntrodução: A hospitalização pode provocar deterioração da saúde bucal, repercutindo em todo o corpo. A UTI pode ser um ambiente favorável ao acúmulo de biofilme oral em pacientes críticos. Objetivo: Identificar fatores associados à presença do biofilme em pacientes da UTI de um hospital de doenças infectocontagiosas. Método: Estudo retrospectivo, descritivo e inferencial, com abordagem quantitativa. Os dados foram obtidos em prontuários de pacientes da UTI, de janeiro de 2012 a julho de 2015. O biofilme foi avaliado de acordo com o índice de Greene e Vermillion. Os fatores influentes foram analisados por regressão logística. Resultado: Entre os pacientes da UTI, 69,1% eram homens, 60,7% pacientes com AIDS, 66,3% pacientes na enfermaria, 50,6% intubados e 50,0% sedados. Seus elementos orais eram na maioria normais. As seguintes características foram significativamente associadas a biofilmes orais: alterações orais nos lábios, gengivas, bochechas e palatos e sangramento. Pacientes da enfermaria apresentaram menor risco de apresentar biofilmes. Conclusão: o aumento do acúmulo de biofilme oral foi observado em pacientes com alterações na boca e a procedência do paciente foi associada à presença de biofilme.Descritores: Hospital; paciente; saúde bucal; manifestações orais; biofilme. AbstractIntroduction: Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective: To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method: This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result: Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion: Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.

Objective: To characterize the profile of hospitalizations and deaths related to craniofacial fractures in Brazilian children and adolescents. Material and Methods: This is an ecological cross-sectional study with inductive approach with comparativedescriptive procedure and indirect documentation technique. Data were obtained from the DATASUS / SIH-SUS website for the years 2010-2014, considering information for each state of the five Brazilian regions. Admission rates were calculated per 100,000 inhabitants, and data were analyzed by population rates, averages and absolute and relative frequencies. Results: The Northeastern region of Brazil showed the highest hospitalization rate (81.72), followed by the Northern (56.84), Southern (50.94), Midwestern (44.25) and Southeastern regions (30.28). In all regions, the years with the highest hospitalization rates were: 2010 for the Northern (13.17) and Southeastern regions (6.61), 2013 for the Northeastern (20.07) and Midwestern regions (10.17) and 2014 for the Southerner region (10.52). The highest hospitalization rates in all regions of the country in the last five years were observed for male children and adolescent. In relation to age group, higher rates were recorded from 15 to 19 years. Of the total of 27,244 hospitalizations (3.8%), 1028 patients died and 35.5% of them occurred in the Northeastern region. Considering the years under study, the average length of stay and average daily hospitalization cost were respectively 4.0 days and US$ 82.7. Conclusion: The Northeast region of Brazil had the highest hospitalization rate of children and adolescents by craniofacial fractures, and male adolescents and those aged 15-19 years were the most affected in different regions of the country. Costs of hospital admissions due to this type of injury are significant, with more deaths as a result of these injuries in Brazil in the last 5 years evaluated with the highest prevalence in the Northeastern region of Brazil.

This study evaluates the effects of resin infiltrant composition and caries histological zone on the hydrolytic degradation of resininfiltrated artificial bovine enamel caries (RI-AEC). Different resin infiltrants were tested (n=26 per group): Icon (G1); TEGDMA 60%, UDMA 20%, and HEMA 20% (TUH); TEGDMA 80% and HEMA 20% (TH); and TEGDMA 75% and Bis-EMA 25% (TB). Following caries infiltration, samples were cut perpendicularly, and transverse microhardness were analyzed (at two histological zones: surface layer and lesion body) before and after 21 days of water immersion. TB presented lower decrease in microhardness (due to hydrolytic degradation) than the other groups, with a large effect size (Hedge's G from 0.83 to 1.19) and high power (84 to 99%). Neither histological zone nor its interaction with resin infiltrant composition significantly affected the outcome. In conclusion, resin composition affected microhardness of RI-AEC upon water immersion, and TB was the least affected.

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