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Kelser de Souza Kock,1 Jefferson Luiz Brum Marques2 1Graduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil; 2Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianópolis, SC, Brazil Purpose: The aim of this study was to evaluate and compare the capacity to predict hemodynamic variables obtained with photoplethysmography (PPG) and Acute Physiology and Chronic Health Evaluation (APACHE II) in patients hospitalized in the intensive care unit (ICU).Materials and methods: A prospective cohort study was conducted in the adult ICU of Hospital Nossa Senhora da Conceição, located in Tubarão, Santa Catarina, Brazil. The data collected included the diagnosis for hospitalization, age, gender, clinical or surgical profile, PPG pulse curve signal, and APACHE II score in the first 24 hours. A bivariate and a multivariate logistic regressions were performed, with death as an outcome. A mortality model using artificial neural networks (ANNs) was proposed.Results: A total of 190 individuals were evaluated. Most of them were males (6:5), with a median age of 67 (54–75) years, and the main reasons for hospitalization were cardiovascular and neurological causes; half of them were surgical cases. APACHE II median score was 14 (8–19), with a median length of stay of 6 (3–15) days, and 28.4% of the patients died. The following factors were associated with mortality: age (OR=1.023; 95% CI 1.001–1.044; P=0.039), clinical profile (OR=5.481; 95% CI 2.646–11.354; P

Bioelectronic bone implants are being widely recognized as a promising technology for highly personalized bone/implant interface sensing and biophysical therapeutic stimulation. Such bioelectronic devices are based on an innovative concept with the ability to be applied to a wide range of implants, including in fixation and prosthetic systems. Recently, biointerface sensing using capacitive patterns was proposed to overcome the limitations of standard imaging technologies and other non-imaging technologies; moreover, electric stimulation using capacitive patterns was proposed to overcome the limitations of non-instrumented implants. We here provide an innovative low-power miniaturized electronic system with ability to provide both therapeutic stimulation and bone/implant interface monitoring using network-architectured capacitive interdigitated patterns. It comprises five modules: sensing, electric stimulation, processing, communication and power management. This technology was validated using in vitro tests: concerning the sensing system, its ability to detect biointerface changes ranging from tiny to severe bone-implant interface changes in target regions was validated; concerning the stimulation system, its ability to significantly enhance bone cells' full differentiation, including matrix maturation and mineralization, was also confirmed. This work provides an impactful contribution and paves the way for the development of the new generation of orthopaedic biodevices.

Objective: The fluid percussion injury (FPI) model is a surgical method for mimicking traumatic brain injury (TBI) models as it automatically and accurately measures peak impact pressure. Nevertheless, its elevated costs have led numerous researchers to develop more inexpensive alternative methods. Therefore, we used a copy of the classic FPI device to develop a novel method to evaluate the pressure pulse and determine injury severity with even more precision during the surgical procedure to induce an injury., Methods: The electronic components, algorithms, and hardware assembly were initially studied. Adult male Wistar rats received 2 different impact forces, and our novel system measured the pressure pulse in atmospheres to verify the differences between mild and moderate severity and the physiological alterations., Results: The newly developed system was capable of detecting differences between mild and moderate severity, and severity parameters (e.g., apnea and unconsciousness) were more significant in animals with more moderate FPI than those with mild FPI. Additionally, electrocardiographic signals were modified 1 day after TBI, and mild and moderate FPI decreased R-wave peak to R-wave peak intervals (increased heart rate) and high frequency (HF) index as well as increased low frequency (LF) and low frequency/high frequency ratio indices. All electrocardiographic parameters evaluated were more expressive in the more moderate FPI than in the mild one, corroborating clinical heart impairments after TBI., Conclusions: The method developed to evaluate pressure pulse in an FPI model proved capable of precisely determining different degrees of injury., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Recent events such as Covid-19 vaccine distribution issues and the blockage of the Ever Given ship in the Suez Canal raised concerns about how fragile the traditional supply chain is. Last-mile personalized fulfillment can have a catalyst role in the proliferation of the Industry 4.0. This growing trend will reduce standard production, bringing manufacturing closer to the client and, ultimately, boiling down the supply chain to the last mile. However, the literature is not clear about the breakdown of the supply chain to enhance cities' sustainability and reducing the number of transports and circulating vehicles. Stemming from an empirical study to simulate the existing gap in the market and the development of a case study through structured interviews with privileged interlocutors complemented by the document analysis, this paper highlights how the integration of local stakeholders can efficiently enhance a personalized service based on dynamic collaborations to set up the supply chain, by introducing the Last-Mile-as-a-Service (LMaaS) concept. This concept relies on a revenue-sharing framework based on an open marketplace composed by last-mile manufacturing, transport, and storage assets and stakeholders to disrupt the supply chain, enabling any company to provide personalized products in almost real-time to any location., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Elsevier Ltd. All rights reserved.)

Introduction: Type 1 diabetes (T1D) is a chronic disease with peak incidence in adolescence; it has a major impact on morbidity and mortality, especially cardiovascular. Diabetic cardiomyopathy is characterized by structural and functional lesions in the absence of other diseases and is involved in the progression to heart failure. Echocardiography has led to the identification of early cardiac lesions, despite controversial results in the literature in patients with T1D., Objective: The objective of this study is to assess cardiac changes in individuals with TD1 compared to the control group using conventional two-dimensional Doppler and advanced speckle tracking echocardiography., Methods: This is a case-control study with 40 asymptomatic, normotensive T1D patients aged 20 to 50 years and 40 healthy subjects. Two-dimensional echocardiography was performed to measure myocardial thickness and cardiac chambers. Tissue Doppler echocardiography was used for diastolic analysis and speckle tracking echocardiography to quantify ventricular systolic function., Results: The mean age was 33 years in both groups, with an average T1D duration of 18 years; 20% of patients with T1D had diabetic retinopathy; 12.5% kidney injury; and 10% peripheral neuropathy. There were differences in the left ventricular diastolic function parameters (lateral E', middle E' and S/D ratio) and right ventricle (tricuspid E and tricuspid E'/A' ratio). The mean value of the global longitudinal strain was -21.7% (+- 2.3) in the T1D group and -21.0% (+-2.0) in the control group (p=0.21)., Conclusion: Echocardiography revealed a reduction in indices of diastolic function in T1D compared to the control group, which may be the initial cardiac lesion in diabetes., (Copyright © 2021. Published by Elsevier España, S.L.U.)

Autonomic dysfunction in epilepsy is well-described. Heart rate variability (HRV) is a useful method to evaluate autonomic cardiac tone. Cardiac dysfunction may be involved in sudden unexpected death in epilepsy (SUDEP). HRV is a promising biomarker to enlighten the heart-brain axis role in SUDEP, but the required duration for a proper HRV recording in clinical routine remains unknown. This study aimed to verify the reliability of ultra-short HRV indices to evaluate cardiac autonomic tone in patients with epilepsy (PWE). Thirty-nine patients with mesial temporal lobe epilepsy (MTLE) had electrocardiogram recordings during the first day of video-EEG. Pearson's correlations were performed to evaluate the association between ultra-short HRV indices (five 1-min and five 30-s epochs) with standard time recording (5-min) and ANOVA compared the differences between mean HRV indices across epochs. Time domain (TD) indices showed higher mean r values when compared to frequency domain (FD) indices in 1-min (TD: r 0.80-0.99, FD: r 0.61-0.95) and 30-s epochs (TD: r 0.69-0.99, only high frequency: mean r values of 0.96). ANOVA evidenced that standard deviation of RR intervals and very low frequency means had at least 3 epochs significantly different for 1-min and 30-s epochs. Root mean square of the successive differences of RR intervals (rMSSD) presented higher Pearson's coefficient values and lower percentage of variation at 1-min or 30-s epochs in comparison to other HRV indices. In conclusion, rMSSD is the most reliable ultra-short HRV index for cardiac autonomic tone assessment in MTLE. The prognostic value of ultra-short HRV for cardiovascular risk evaluation in epilepsy remains to be determined in future studies., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The secretive behavior and life history of snakes makes studying their biology, distribution, and the epidemiology of venomous snakebite challenging. One of the most useful, most versatile, and easiest to collect types of biological data are photographs, particularly those that are connected with geographic location and date-time metadata. Photos verify occurrence records, provide data on phenotypes and ecology, and are often used to illustrate new species descriptions, field guides and identification keys, as well as in training humans and computer vision algorithms to identify snakes. We scoured eleven online and two offline sources of snake photos in an attempt to collect as many photos of as many snake species as possible, and attempt to explain some of the inter-species variation in photograph quantity among global regions and taxonomic groups, and with regard to medical importance, human population density, and range size. We collected a total of 725,565 photos-between 1 and 48,696 photos of 3098 of the world's 3879 snake species (79.9%), leaving 781 "most wanted" species with no photos (20.1% of all currently-described species as of the December 2020 release of The Reptile Database). We provide a list of most wanted species sortable by family, continent, authority, and medical importance, and encourage snake photographers worldwide to submit photos and associated metadata, particularly of "missing" species, to the most permanent and useful online archives: The Reptile Database, iNaturalist, and HerpMapper., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Root perforation is a common endodontic accident. Its management depends mainly on root canal disinfection and sealing the perforation area by preventing any communication with the periodontium to prevent recontamination. A patient was referred to treat root perforation due to a previous treatment of tooth #22. The diagnosis was symptomatic periapical periodontitis, and the treatment plan was to retreat the root canal of #22 and make a surgical intervention (apicoectomy) associated with antimicrobial photodynamic therapy as a complementary technique. Five mineral oxides (5MO) cement was used as a root-end filling material. The procedures were performed in two sessions and controlled in two visits (after 30 days and 12 months). A bone neoformation was observed at the periapical area of tooth #22. 5MO bioceramic cement was effective in inducing the repair of the periapical lesion and had the ability to seal the exposed periapical area of the tooth. Its success depended mainly on root canal and surgical site disinfection., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Amjad Abu Hasna et al.)

Impaired baroreflex sensitivity (BRS) may indicate cardiovascular autonomic neuropathy (CAN), which often remains undiagnosed during the initial course of diabetes mellitus. The baroreflex mechanism can be considered negative feedback because of baroreflex delay, the time delay between a change in blood pressure and the counteracting heart rate response. This work sought to analyze BRS considering lags from 1 to 10 RR intervals. We hypothesized that diabetic patients with subclinical CAN (SCAN) have a detectable delay in autonomic nervous system activity and that this would differ from patients without CAN (NCAN) and with established CAN (ECAN). In the first stage, 30 patients were included in an exploratory analysis using the Principal Component Analysis. Six indexes related to the BRS delay were proposed and considered significant for staging diabetic patients. Three indexes allowed for the differentiating of patients with and without CAN, and three indexes distinguished subjects with SCAN from subjects with NCAN or ECAN. Then, in the second stage, a random forest model was developed with 72 subjects, using the variables selected in the first stage. It was possible to detect SCAN, and to point out those subjects with the potential to change the CAN stage, allowing for the tracking of CAN progression. The model achieved a sensitivity of 96% and specificity of 100% to detect SCAN. Thus, the BRS analysis considering delayed reaction in the dynamics of heart rate variability may contribute to an accurate screening tool to staging CAN, in addition to indicating patients with most insidious disease progress., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: High-energy tibial plateau fractures are challenges in treatment with controversy over operative stabilisation, especially for fractures with metaphyseal-diaphyseal dissociation. Treatment with percutaneous or minimally invasive direct reduction techniques, usually associated with circular external fixation, has generated interest although there is no consensus regarding the type of external fixation to be used., Aim: This study aims to compare the two hybrid circular external fixation mountings used to treat the high-energy tibial plateau fractures., Methods: Two different groups of hybrid circular external fixation frame mountings were assembled using composite tibiae with proximal metaphyseal osteotomies simulating tibial plateau fractures with metaphyseal-diaphyseal dissociation. The standard all-wire frame mounting was assembled, and the comparison frame mounting had the distal K-wires replaced with half-pins. Both groups were tested through cyclic loading between 300 and 1000 N for 10,000 cycles. Interfragmentary linear and rotational displacements were analysed., Results: The standard frame mounting behaved similarly to a classic Ilizarov frame, allowing greater axial movement (mean, 3.76 ± 0.26 mm in the standard group and 3.02 ± 0.23 mm in the test group) and smaller mediolateral displacement compared with the test frame (mean, 0.17 ± 0.16 mm compared to 0.56 ± 0.12 mm). The test frame behaved more similarly to a linear external fixator and provided greater axial stability, similar anteroposterior displacement, and lower mediolateral stability. Despite these differences, in both groups the axial displacement was greater than the prejudicial nonaxial movements., Conclusion: Increasing the number of half-pins and decreasing the number of K-wires in hybrid circular external fixation generate frames that tend to behave more similarly to the linear external fixators., How to Cite This Article: Cardoso GS, Amorim R, Penha FM, et al . Biomechanical Analysis of the Behaviour at the Metaphyseal-Diaphyseal Junction of Complex Tibial Plateau Fractures Using Two Circular Fixator Configurations. Strategies Trauma Limb Reconstr 2020;15(3):138-145., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.)

Adsorption of fluoride from fertilizer industry effluent using carbon nanotubes stabilized in chitosan sponge as adsorbent was evaluated. The effluent was produced in the washing of acid gases during the reaction in fertilizer production and all assays were performed using this hazardous material. Adsorbent characterization and ions interactions were elucidated from differential scanning calorimetry, thermal gravimetric analyses, X-ray diffraction, scanning electron microscopy dispersive energy X-ray spectroscopy, atomic force microscopy and X-ray photoelectron spectroscopy. The effluent presented pH 3 and its value not changed in the adsorption assays, maintaining the conditions of the process. The kinetics assays of fluoride from industry effluent were performed in different stirring rates from 100 to 300 rpm. It was observed that adsorption was initially fast reaching the equilibrium at 300 rpm in 20 min. The adsorption capacity was around 975.4 mg g -1 , showing the potential of the hybrid material to remove fluoride from a real matrix. The high adsorption capacity was attributed to the chitosan functional groups and the high interaction area promoted by sponge form and the carbon nanotube. Reuse and regeneration of the CNT-CS were investigated and 5 cycles were obtained. The adsorption capacity kept similar values in all cycles., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Azoospermia is defined as absence of spermatozoa and may be secondary to blocked seminal ducts, known as obstructive azoospermia. Semen quality may be impaired due to factors such as sperm cell DNA fragmentation and presence of antisperm antibodies. The objective of this article was to investigate potential differences in outcomes of in vitro fertilisation and intracytoplasmic sperm injection between groups with different obstruction aetiology, as well as between the use of different techniques and sperm cells of different origins. Retrospective, multi-centre analysis of 621 first cycles was carried out between 2008 and 2015: Group I, congenital obstruction, 45 patients and Group 2, vasectomy, 576 patients. Sperm cell retrieval was achieved in all cases. Results were similar for Group I and II fertilisation rates, 70% versus 66.85% (p = .786); pregnancy rates, 42.5% versus 41.46% (p = .896); and live birth rates, 29.73% versus 17.69% (p = .071). According to sperm cell origin (579 epididymal vs. 42 testicular), pregnancy rates, 41.47% versus 43.9% (p = .760); and live birth rates, 18.3% versus 27.78% (p = .163) had no difference. Fertilisation, pregnancy and live birth rates did not differ according to obstruction aetiology. Outcomes did not differ between groups according to sperm cell origin., (© 2019 Blackwell Verlag GmbH.)

The development of standardized and safe food products with the typical characteristics of each region is highly desirable and can be obtained by using native starter cultures that influence the flavor, texture, and color of fermented foods. Therefore, scientists have been employing various techniques for screening and characterizing native bacteria (lactic acid bacteria and Gram-positive catalase-positive cocci) for application in fermented meat sausage. The present review outlines in vitro assays that evaluate the potential application and safety aspects of native isolates and introduces emerging omics technologies applied to the microbiology of fermented meat sausage. Results from current research are presented, and the strengths and limitations of each assay are provided, with references indicating where further details can be obtained. In choosing the most appropriate in vitro method, it is necessary to consider the available analytical infrastructure, the sensitivity and selectivity of the assay, the time it takes to get the results, the ease of the assay, and the costs involved., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Adsorption of Al (III) and Fe (III) onto chitosan films from individual and binary systems were investigated. The matrix effect was evaluated using an industrial effluent of the scrubber of gases from the production process of Al 2 (SO 4 ) 3 . The adsorption study was carried out by response surface methodology to optimize the adsorption operation as a function of pH (3, 4.5 and 6) and film dosage (FD) (100, 200 and 300 mg L -1 ).The possible interactions film-ions were investigated by thermal analysis, X-ray diffraction, scanning electron microscopy and dispersive energy X-ray spectroscopy. The more suitable conditions for all experimental designs were the FD values in 100 mg L -1 and pH 4.5.The adsorption capacity of Fe (III) in the individual and binary systems were 140.2 mg g -1 and 132.3 mg g -1 respectively; however, in the experiment conducted on the real effluent, the adsorption capacity was reduced to 66.30 mg g -1 .Already to Al (III), the adsorption capacities in the individual and binary systems were 665.5 mg g -1 to 621.2 mg g -1 respectively, and when the operation was performed using real effluent the adsorption capacity was reduced to 275.7 mg g -1 ., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: To compare sedation and effects on heart rate (HR), mean arterial pressure (MAP) and respiratory rate (f R ) of nalbuphine and butorphanol, alone or combined with acepromazine in dogs., Study Design: Prospective, randomized experimental trial., Animals: Eight healthy Beagle dogs, aged (mean ± standard deviation) 3.4 ± 0.5 years and weighing 11.0 ± 1.3 kg., Methods: Each dog was treated four times: physiological saline (1 mL) combined with nalbuphine (0.5 mg kg -1 ; SAL-NAL) or butorphanol (0.15 mg kg -1 ; SAL-BUT), and acepromazine (0.05 mg kg -1 ) combined with nalbuphine (0.5 mg kg -1 ; ACP-NAL) or butorphanol (0.15 mg kg -1 ; ACP-BUT), intravenously (IV). The degree of sedation, assessed by a numeric descriptive scale (NDS) and simple numerical scale (SNS), HR, MAP, f R and rectal temperature (RT), were recorded before and 20 minutes after administration of saline or acepromazine, then 15, 30, 60, 90 and 120 minutes after nalbuphine or butorphanol. Values were compared with baseline and among treatments., Results: Mild sedation was recorded for SAL-NAL and SAL-BUT, and moderate sedation for ACP-NAL and ACP-BUT. NDS and SNS scores were higher for SAL-BUT and ACP-BUT at some time points when compared with SAL-NAL and ACP-NAL, respectively (p < 0.001). HR was lower in ACP-NAL than in ACP-BUT at 120 minutes and f R was lower in SAL-BUT than in SAL-NAL at 30 and 120 minutes (p < 0.05). RT was lower in SAL-BUT (37.5 ± 0.5 °C) compared with SAL-NAL (38.0 ± 0.5 °C) at 60-120 minutes (p < 0.05)., Conclusions and Clinical Relevance: Butorphanol promoted a higher sedative effect than nalbuphine when alone and combined with acepromazine. IV administration of nalbuphine or butorphanol, with or without acepromazine, at the doses studied, resulted in minimal decreases in MAP, HR, f R and RT., (Copyright © 2017. Published by Elsevier Ltd.)

The aim of this study was to evaluate the effectiveness of a biodegradable film, with antimicrobial metabolites produced by Lactobacillus curvatus P99 incorporated, targeting the control of Listeria monocytogenes in sliced "Prato" cheese. Tests were performed to evaluate the spectrum of action of cell-free supernatant (CFS) of P99 against different microorganisms, as well as to detect the minimum inhibitory (MIC) and bactericidal (MBC) concentrations against L. monocytogenes Scott A. The detection of genes that encode for the production of bacteriocins and evaluation of their expression were performed. Antimicrobial films were prepared, followed by in vitro and in situ analysis. The MIC and MBC of CFS against L. monocytogenes Scott A was 15.6 μL/mL and 62.5 μL/mL, respectively. Lactobacillus curvatus P99 presented two genes coding for the bacteriocins, which were expressed. Films with added MBC showed activity against different indicator microorganisms and were able to control L. monocytogenes Scott A when used in sliced "Prato" cheese., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objectives: This study evaluated the antimicrobial efficacy of ozone therapy in teeth contaminated with Pseudomonas aeruginosa, Enterococcus faecalis, and Staphylococcus aureus using a mono-species biofilm model. Parallel to this, the study aimed to evaluate the cytotoxicity of ozone for human gingival fibroblasts. Material and Methods: One hundred and eighty single-root teeth were contaminated with a mono-species biofilm of Enterococcus faecalis, Pseudomonas aeruginosa, and Staphylococcus aureus. Groups were formed: Group I - control; Group II - standard protocol; Group III - standard protocol + ozone gas at 40 µg/mL; and Group IV - standard protocol + aqueous ozone at 8 µg/mL. In parallel, human gingival fibroblasts were submitted to the MTT test. Cells were plated, then ozone was applied as follows: Group I (control) - broth medium; Group II - aqueous ozone at 2 µg/mL; Group III - aqueous ozone at 5 µg/mL; and Group IV - aqueous ozone at 8 µg/mL. Data were submitted to the Kruskal Wallis test and Bonferroni post hoc analyses to assess microbiology and cytotoxicity, respectively (p<0.05%)., Results: The results revealed antimicrobial efficacy by Group IV with no CFU count. The cytotoxicity assay showed Groups III and IV to be the most aggressive, providing a decrease in cell viability at hour 0 from 100% to 77.3% and 68.6%, respectively. Such a decrease in cell viability was reverted, and after 72 hours Groups III and IV provided the greatest increase in cell viability, being statistically different from Groups I and II., Conclusion: According to the applied methodology and the limitations of this study, it was possible to conclude that ozone therapy improved the decontamination of the root canal ex vivo. Ozone was toxic to the cells on first contact, but cell viability was recovered. Thus, these findings suggest that ozone might be useful to improve root canal results.

Electrochemotherapy is a combination of high electric field and anticancer drugs. The treatment basis is electroporation or electropermeabilization of the cell membrane. Electroporation is a threshold phenomenon and, for efficient treatment, an adequate local distribution of electric field within the treated tissue is important. When this local electric field is not enough, there is a regrown tumor cell; however, if it is stronger than necessary, permanent damage to the tissue occurs. In the treatment of dogs, electrochemotherapy is not yet an established treatment for mast cell tumor in veterinary medicine, although there are studies showing evidence of its effectiveness. In this study, we examined electrochemotherapy of dog mast cell tumor with numerical simulation of local electric field distribution. The experimental result was used to validate the numerical models. The effect of tumor position and tissue thickness (tumor in different parts of dog body) was investigated using plate electrodes. Our results demonstrated that the electrochemotherapy is efficient and flexible, and even when the tumor extends into the subcutis, the treatment with plate electrode eliminated the tumor cells. This result suggests that electrochemotherapy is a suitable method to treat mast cell tumors in dog., (Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Background: The gynoidlypodystrophy, known as cellulitis or cellulite, refers to a condition that gives the skin an undulating and uneven appearance, affecting 80-90% of women after puberty., Objectives: to investigate the efficacy and safety of manual lymphatic drainage for cellulite management., Methods: this was an open, prospective, intervention study including 20 women aged from 20 to 40 years. Fourteen sessions of manual lymphatic drainage were performed once a week on lower limbs and buttocks., Results: Fifteen women completed the study. A significant improvement on quality of life was observed (p=0.018). A significant reduction (p=0.023), estimated at 0.3 ± 0.8 cm, in hip circumference was found, but no difference was found in thighs circumference (p>0.05). A significant reduction elastic recuperation of skin on buttocks, which means skin elasticity worsening, was observed. All measures obtained by ultrasound images showed no changes (p>0.05)., Conclusion: manual lymphatic drainage was safe but not effective as an isolated approach for cellulite management. Further randomized, controlled or comparative studies about manual lymphatic drainage for cellulite control, as unique or combined therapeutic modality, are necessary.

SEM analysis of endodontic instruments from a Ni-Ti rotary system was assessed, before and after using them, considering their defects and deformations. Twenty Twisted File®, BioRąCe®, Mtwo®, and EndoWave® instruments were micrographed at 190× magnification. The files were washed and micrographed again to view alterations as to the presence or absence of irregular edges, grooves, microcavities, and scraping. Simulated root canal preparations were performed using these instruments. The instruments were cleaned and received a microscopic analysis after being used five times. After analysis tests were tested using Fisher's exact test and Kappa to evaluate the concordance among examiners. There was a statistically significant difference with respect to deformations between Twisted File® and other instruments (p < 0.05). There was no statistically significant difference in strains between the other groups (p > 0.05). All Twisted File® instruments showed the same defects; however damage were lower than those found in BioRace® and Mtwo®. The Endowave® did not show the same defects. In accordance with the data we conclude that the presence of defects was higher in Twisted File® instruments as the instruments and BioRace® Mtwo® brand, the defect rate was smaller and Endowave® instruments had no defects. Regarding the presence of wear after five uses among the groups all instruments showed changes in their cutting blades., (© 2014 Wiley Periodicals, Inc.)

Unlabelled: BACKGROUND AIM:  The aim of this study was to evaluate, by radiographic and histomorphometric analyses, the effects of high-power diode laser irradiation on the root surfaces of delayed replanted rat teeth., Material and Methods:   Maxillary right incisors were extracted from 60 Wistar rats and kept dry for 60 min. Subsequently, the root canals were prepared and filled with calcium hydroxide paste. According to the root surface treatment before the replantation, the teeth were assigned to four groups (n = 15): G1 (negative control) - no root surface treatment; G2 (positive control) - treated with 2% sodium fluoride solution; G3 - irradiated with a high-power diode laser (810 nm, continuous mode, 1.0 W, 30 s); and G4 - irradiated with a diode laser using the same parameters as those used for G3 but in pulsed mode. The rats were euthanized after 15, 30, and 60 days of replantation. The specimens were digitally radiographed and processed for histomorphometric analysis to determine the average root resorption areas and to evaluate the histological events., Results:   The percentage of root resorption was in the following order: G1 > G2 > G4 > G3. Both histomorphometric and radiographic analyses showed significantly lower means (P < 0.05) of the occurrence of root resorption in the irradiated groups (G3 and G4) when compared to the control groups (G1 and G2). Replacement resorption and ankylosis were observed in histological sections only after 30 and 60 days; however, such events were not observed in G3., Conclusion:   Root surface treatments with high-powered diode laser irradiation prior to delayed replantation reduced the occurrence of external root resorption compared to no treatment or sodium fluoride treatment at up to 60 days., (© 2012 John Wiley & Sons A/S.)

Conductivity measurements in suspensions of biological cells have been used since many years for electroporation effectiveness evaluation. However, conductivity modeling by means of instantaneous values of current and voltage during pulse application does not take into account the effects of the sample reactance and the dielectric dispersion of the medium. This can lead to misinterpretation in the electroporation analysis. The electrical modeling and characterization of electroporation using sinusoidal signal analysis at 10 kHz proposed in this paper allows us to avoid distortions due to reactive effects of the sample. A simple equation establishes the relation between suspension conductivity and membrane conductance. This model was used in experiments with suspensions of yeast cells and applied electric fields of up to 450 kV/m for 1 ms. The analysis using the proposed model resulted in membrane conductance values of up to 8000 S/m (2) and allowed estimating the distribution profile of conductance on the cell membrane.

Purpose: Psychogenic nonepileptic seizures (PNES) superficially resemble epileptic seizures. Little is known about ictal autonomic nervous system (ANS) activity changes in epilepsy and PNES. This study compares ictal heart rate variability (HRV) parameters as a reflection of ANS tone in epileptic seizures and PNES, and explores differences between interictal and ictal ANS tone in both patient groups., Methods: Ictal HRV parameters were extracted from single-lead electrocardiography (ECG) data collected during video-electroencephalography (EEG) recordings of 26 patients with medically refractory temporal lobe epilepsy and 24 age- and sex-matched patients with PNES. One seizure per patient in a resting, wake, supine state was analyzed. Interictal ECG data were available for comparison from 14 patients in both groups. HRV parameters in time and frequency domains were analyzed (low frequency [LF], high frequency [HF], standard deviation of all consecutive normal R wave intervals [SDNN], square root of the mean of the sum of the squares of differences between adjacent normal R wave intervals [RMSSD]). CVI (cardiovagal index), CSI (cardiosympathetic index), and ApEn (approximate entropy) were calculated from Lorenz plots., Key Findings: There were significant differences between ictal HRV measures during epileptic and nonepileptic seizures in the time and frequency domains. CSI (p < 0.001) was higher in epileptic seizures. Time interval between two consecutive R waves in the ECG (RR interval) (p = 0.002), LF (p = 0.02), HF (p = 0.003), and RMSSD (p = 0.003) were significantly lower during epileptic seizures. Binary logistic regression yielded a significant model based on the differences in CSI classifying 88% of patients with epilepsy and 73% of patients with PNES correctly. The comparison between resting and ictal states in both seizure disorders revealed significant differences in RR interval (epilepsy p < 0.001, PNES p = 0.01), CSI (epilepsy p < 0.001, PNES p = 0.02), HF (epilepsy p = 0.002, PNES p = 0.03), and RMSSD (epilepsy p = 0.004, PNES p = 0.04). In patients with epilepsy there were also significant differences in ictal versus interictal mean values of ApEn (p = 0.03) and LF (p = 0.04). Although CSI was significantly higher, the other parameters were lower during the seizures. Stepwise binary regression in the 14 patients with epilepsy produced a significant model differentiating resting state from seizures in 100% of cases. The same statistical approach did not yield a significant model in the PNES group., Significance: Our results show greater ANS activation in epileptic seizures than in PNES. The biggest ictal HRV changes associated with epileptic seizures (CSI, HF, and RMSSD) reflect high sympathetic system activation and reduced vagal tone. The reduced ApEn also reflects a high sympathetic tone. The observed ictal alterations of HRV patterns may be a more specific marker of epileptic seizures than heart rate changes alone. These altered HRV patterns could be used to detect seizures and also to differentiate epileptic seizures from PNES. Larger studies are justified with intergroup and intragroup comparisons between ictal and resting states., (Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.)

1. The objective was to evaluate the occurrence of cultivable components of the Bacteroides fragilis group in faeces of broiler chickens and their antimicrobial susceptibility patterns. 2. Faecal samples of 36 × 45-d-old Cobb broilers of both sexes from 15 different flocks on one farm were diluted 10-fold and plated on to Bacteroides-bile-esculin agar for colony count and isolation. Identification was by molecular methods and antimicrobial susceptibility in the agar dilution assay. 3. A total of 236 isolates was recovered from a mean population of 3·32 × 10(7 )colony-forming units/g of faeces. B. fragilis was shown to be the predominant Bacteroides species (45·3%), followed by B. distasonis (35·6%), B. vulgatus (8·9%), B. ovatus (2·5%) and B. stercoris (1·3%). 4. Among 204 bacterial isolates tested, high resistance to ampicillin (98·5%), norfloxacin (95·1%) and tetracycline (88·2%) were observed. High (89·7%) multi-drug resistance was observed to 3-7 of the tested drugs. 5. Components of the B. fragilis group were sub-dominant in broiler faecal microbiota, with a different species pattern compared with human and high antimicrobial multi-drug resistance.

There are several models of decomposition of the electrocardiogram (ECG). Some of these models are intended to describe the ECG signal, and others are more specific to extract the relevant information relating to individual waveform which contributes to explain the P-QRS complex. The latter approach may be particularly suitable for a portion where a morphological analysis of the ECG is of particular interest, as the cardiac repolarization segment or T-wave. This study aims: to model and detect useful patterns in the evaluation of T wave morphology, which explains the different changes in ventricular repolarization during inhalation of Salbutamol.

Background and Objective: Photodynamic therapy (PDT) is a new technique introduced in endodontics that combines the action of a photosensitizer (dye) and a low intensity light source. Currently, there are no PDT studies evaluating the microbial disinfection of root canals in order to compare the effects of light delivery systems in the photosensitizer activation. The aim of this study was to evaluate the PDT effectiveness in reducing Enterococcus faecalis, with and without the aid of an intracanal optical fiber., Methods: Extracted single-rooted teeth were selected, instrumented, inoculated with E. faecalis and divided into six groups: one control group (untreated), one conventionally-treated group (1% NaOCl irrigation) and four PDT-treated groups. Irradiation (diode laser) was performed with (OF) or without an intracanal optical fiber (NOF) using two different irradiation times: 1 min and 30 sec (IT(90)) or 3 min (IT(180)). Samples were collected before and after testing procedures and CFU/mL was determined., Results: The greatest reduction of E. faecalis (99.99%) was achieved with irrigation with 1% NaOCl. PDT also significantly reduced E. faecalis in the following decreasing order: OF/IT(180), NOF/IT(180), OF/IT(90) and NOF/IT(90), with no significant statistical difference among the groups., Conclusions: These results suggest that PDT was effective against E. faecalis, regardless of the use of an intracanal optical fiber.

Heart rate variability (HRV) metrics provide reliable information about the functioning of the autonomic nervous system (ANS) and have been discussed as biomarkers in anxiety and personality disorders. We wanted to explore the potential of various HRV metrics (VLF, LF, HF, SDNN, RMSSD, cardiovagal index, cardiosympathetic index, approximate entropy) as biomarkers in patients with psychogenic nonepileptic seizures (PNES). HRV parameters were extracted from 3-minute resting single-lead ECGs of 129 subjects (52 with PNES, 42 with refractory epilepsy and 35 age-matched healthy controls). Compared with healthy controls, both patient groups had reduced HRV (all measures P<0.03). Binary logistic regression analyses yielded significant models differentiating between healthy controls and patients with PNES or patients with epilepsy (correctly classifying 86.2 and 93.5% of cases, respectively), but not between patients with PNES and those with epilepsy. Interictal resting parasympathetic activity and sympathetic activity differ between healthy controls and patients with PNES or those with epilepsy. However, resting HRV measures do not differentiate between patients with PNES and those with epilepsy., (Copyright © 2011 Elsevier Inc. All rights reserved.)

An intense electric field can be applied to increase the membrane conductance G(m) and consequently, the conductivity of cell suspension. This phenomenon is called electroporation. This mechanism is used in a wide range of medical applications, genetic engineering, and therapies. Conductivity measurements of cell suspensions were carried out during application of electric fields from 40 to 165 kV/m. Experimental results were analyzed with two electroporation models: the asymptotic electroporation model was used to estimate G(m) at the beginning and at the end of electric field pulse, and the extended Kinosita electroporation model to increase G(m) linearly in time. The maximum G(m) was 1-7 × 10(4) S/m(2), and the critical angle (when the G(m) is insignificant) was 50°-65°. In addition, the sensitivity of electroporated membrane conductance to extracellular and cytoplasmatic conductivity and cell radius has been studied. This study showed that external conductivity and cell radius are important parameters affecting the pore-opening phenomenon. However, if the cell radius is larger than 7 μm in low conductivity medium, the cell dimensions are not so important.

Objective: The purpose of this study was to evaluate the reduction in laser power output (PO) at the optical fiber tip during laser curettage of infected periodontal pockets., Background Data: The combination of mechanical debridement with laser therapy has been used successfully in the treatment of periodontitis., Methods: The study group consisted of 28 teeth selected in 12 patients with chronic periodontitis. The teeth were treated with scaling and root planing (SRP), and infected pocket epithelium was removed with an 810-nm diode laser operating at a laser power of 1.7 W in continuous-wave mode (CW). Laser power was set to 1.0 W at the control panel before each measurement to facilitate mathematical analysis, and PO at the optical fiber tip was measured using a power meter. Four laser applications were performed per tooth (duration, 10-15 sec per application; total duration, 40-60 sec per tooth). The fiber tip was cleaved every four applications. Also, 28 irradiations (four PO measurements per irradiation) were performed in non-contact mode and used as controls., Results: There were significant PO losses between applications in the study group. PO losses of 20.89%, 30.39%, and 40.26% were found between the first and second, first and third, and first and fourth applications, respectively. A low transmission loss of the optical fiber was observed in the control measurements (mean PO loss of 1.58% between the first and fourth irradiations)., Conclusions: Our results indicated that optical fiber tips need to be cleaved frequently during laser curettage to minimize PO loss.

Background and Objective: The disadvantage of photodynamic therapy (PDT) is in the photosensitizing agents that may stain the tooth structure. There is no register of PDT studies evaluating protocols to minimize that concern. The present study evaluated the efficiency of chemical adjuncts in methylene blue dye (MB) removal after PDT., Materials and Methods: Forty single-rooted teeth, after root canal preparation, were filled with 0.01% MB for 5  min, and irradiated with diode laser 660  nm at 40  mW for 240  sec (total energy 9.6  J). The specimens were divided into four groups (n = 10), according to the chemical adjuncts used for dye removal: (a) 2.5% sodium hypochlorite (NaOCl); (b) 2.5% NaOCl + Endo-PTC cream; (c) 70% ethyl alcohol and (d) saline (control). The crowns were sectioned and fixed in a device. Photographs were taken before the PDT (T0), immediately after (T1) and upon dye removal (T2). The chromatic alterations were evaluated using Adobe Photoshop and K values were determined in four fixed points of each crown., Results: K values (dental staining) increased in all groups when comparing T0 and T1. The effectiveness of the tested adjuncts was, in decreasing order: G1 (-3.11) > G2 (-2.97) > G3 (-1.28) > G4 (-1.19), not observing significant statistical differences (p < 0.05) between G1 and G2 and also between G3 and G4., Conclusions: Protocols to remove photosensitizing dyes should be applied after PDT in order to minimize dental stain. The protocols tested in this study by using 2.5% NaOCl, associated or not with Endo-PTC cream, were effective in avoiding tooth staining caused by MB during PDT.

Unlabelled: Nitric oxide (NO) has been considered a key molecule in inflammation., Objective: The aim of this study was to evaluate the effect of treatment with L-NAME and sodium nitroprussiate, substances that inhibit and release NO, respectively, on tissue tolerance to endodontic irrigants., Material and Methods: The vital dye exudation method was used in a rat subcutaneous tissue model. Injections of 2% Evans blue were administered intravenously into the dorsal penial vein of 14 male rats (200-300 g). The NO inhibitor and donor substances were injected into the subcutaneous tissue in the dorsal region, forming two groups of animals: G1 was inoculated with L-NAME and G2 with sodium nitroprussiate. Both groups received injections of the test endodontic irrigants: acetic acid, 15% citric acid, 17% EDTA-T and saline (control). After 30 min, analysis of the extravasated dye was performed by light absorption spectrophotometry (620 nm)., Results: There was statistically significant difference (p<0.05) between groups 1 and 2 for all irrigants. L-NAME produced a less intense inflammatory reaction and nitroprussiate intensified this process., Conclusions: Independently of the administration of NO inhibitors and donors, EDTA-T produced the highest irritating potential in vital tissue among the tested irrigating solutions.

Objective: Although a clear link between diabetic peripheral neuropathy (DPN) and autonomic neuropathy is recognized, the relationship of autonomic neuropathy with subtypes of DPN is less clear. This study aimed to investigate the relationship of autonomic neuropathy with painless and painful DPN., Research Design and Methods: Eighty subjects (20 healthy volunteers, 20 with no DPN, 20 with painful DPN, 20 with painless DPN) underwent detailed neurophysiological investigations (including conventional autonomic function tests [AFTs]) and spectral analysis of short-term heart rate variability (HRV), which assesses sympathovagal modulation of the heart rate. Various frequency-domain (including low frequency [LF], high frequency [HF], and total power [TP]) and time-domain (standard deviation of all normal-to-normal R-R intervals [SDNN] and root mean square of successive differences [RMSSD]) parameters were assessed., Results: HRV analysis revealed significant differences across the groups in LF, HF, TP, SDNN, and RMSSD (ANOVA P < 0.001). Subgroup analysis showed that compared with painless DPN, painful DPN had significantly lower HF (3.59 +/- 1.08 [means +/- SD] vs. 2.67 +/- 1.56), TP (5.73 +/- 1.28 vs. 4.79 +/- 1.51), and SDNN (2.91 +/- 0.65 vs. 1.62 +/- 3.5), P < 0.05. No significant differences were seen between painless DPN and painful DPN using an AFT., Conclusions: This study shows that painful DPN is associated with significantly greater autonomic dysfunction than painless DPN. These changes are only detected using spectral analysis of HRV (a simple test based on a 5-min electrocardiogram recording), suggesting that it is a more sensitive tool to detect autonomic dysfunction, which is still under-detected in people with diabetes. The greater autonomic dysfunction seen in painful DPN may reflect more predominant small fiber involvement and adds to the growing evidence of its role in the pathophysiology of painful DPN.

Background: Autonomic neuropathy is a common and serious complication of diabetes. Early detection is essential to enable appropriate interventional therapy and management. Dynamic pupillometry has been proposed as a simpler and more sensitive tool to detect subclinical autonomic dysfunction. The aim of this study was to investigate pupil responsiveness in diabetic subjects with and without cardiovascular autonomic neuropathy (CAN) using dynamic pupillometry in two sets of experiments., Methods: During the first experiment, one flash was administered and the pupil response was recorded for 3 s. In the second experiment, 25 flashes at 1-s interval were administered and the pupil response was recorded for 30 s. Several time and pupil-iris radius-related parameters were computed from the acquired data. A total of 24 diabetic subjects (16 without and 8 with CAN) and 16 healthy volunteers took part in the study., Results: Our results show that diabetic subjects with and without CAN have sympathetic and parasympathetic dysfunction, evidenced by diminished amplitude reflexes and significant smaller pupil radius. It suggests that pupillary autonomic dysfunction occurs before a more generalized involvement of the autonomic nervous system, and this could be used to detect early autonomic dysfunction., Conclusions: Dynamic pupillometry provides a simple, inexpensive, and noninvasive tool to screen high-risk diabetic patients for diabetic autonomic neuropathy.

Objective: New drugs have to be assessed in endodontic therapy due to the presence of microorganisms resistant to therapeutic procedures. Thus, this study evaluated the time- and concentration-dependent cytotoxicity of different antibiotics used in endodontic therapy., Material and Methods: Human gingival fibroblasts were treated and divided into the following experimental groups: Group I - control; Group II - ciprofloxacin hydrochloride; Group III - clyndamicin hydrochloride; and Group IV - metronidazole. Each drug was used at concentrations of 5, 50, 150, and 300 mg/L for 24, 48, 72, and 96 h. Cytotoxicity was evaluated by the MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] and spectrophotometric reading of ELISA plates. The results were analyzed by BioEstat 4.0 software using Kruskal-Wallis and Dunn's tests at a significance level of 5%. Cell viability was assessed for the different concentrations and times., Results: All drugs presented dose-dependent cytotoxicity. Concentrations of 5 and 50 mg/L produced viable fibroblasts at all experimental times in all groups., Conclusions: Cell viability at 24 h was greater than in the other experimental times. Comparison between the same concentrations of antibiotics at different times showed that metronidazole presented the highest cell viability at 72 and 96 h compared to the other antibiotics, whereas clyndamicin hydrochloride showed higher cell viability at 72 h than ciprofloxacin hydrochloride.

The aim of this study was to evaluate the influence of erbium:yttrium-aluminum-garnet (Er:YAG) laser compared with traditional treatment on dentin permeability to calcitonin and sodium alendronate. Forty bovine roots were sectioned and divided into eight groups. Groups 1 and 2 (G1/G2) were immersed in saline solution; G1T/G2T were immersed in ethylene diamine tetra-acetic acid plus sodium lauryl ether sulfate (EDTA-T) and sodium hypochlorite (NaOCl); G1I/G2I were irradiated with Er:YAG laser (2.94 microm, 6 Hz, 40.4 J/cm(2)); G1TI/G2TI were immersed in EDTA-T, NaOCl and subjected to Er:YAG irradiation. After 4 h the radioactivity of the saline solution was measured. Statistical analysis revealed a significant difference (P < 0.05) when the groups treated with EDTA-T and NaOCl followed by Er:YAG laser irradiation were compared with the groups treated with EDTA-T only and with the groups that received no treatment. Er:YAG laser associated with traditional procedures significantly increased the diffusion of calcitonin and sodium alendronate through dentin. All groups showed calcitonin and sodium alendronate diffusion.

Objective: The aim of this study was to compare the rate-dependent measures of repolarization in patients with and without inducible ventricular arrhythmias, and so to assess the potential arrhythmogenic role of rate-dependent heterogeneities in cardiac repolarization., Methods: Two groups of patients were studied during invasive electrophysiological procedures for standard clinical indications. A normal group (n = 17) with supraventricular tachycardia, structurally normal hearts and no inducible ventricular arrhythmias (PES-) and an inducible group (n = 13) with inducible ventricular arrhythmias (PES+). In each patient, we delivered a series of S1-S2 pacing sequences with a baseline S2 of 500 ms, which was progressively reduced. At the same time, a 12-lead electrocardiogram (ECG) was recorded. T-waves were extracted from each ECG recording, and 12 different T-wave measures were obtained from each patient across a range of coupling intervals. These included conventional measures, and those obtained from principal component analysis (PCA) of repolarization waveforms., Results: At baseline S2, there was no significant difference between the PES- and PES+ using conventional T-wave measures. There were significant differences at baseline S2 between groups using PCA-derived measures. These differences showed rate dependence and were larger at shorter coupling intervals. Two dynamic ECG measurements identified subjects who were inducible during PES; maximum relative T-wave residuum >0.10 (odds ratio: 38.5, 95% CI: 4.7-318.5; P < 0.001) and maximum T-wave shape index <0.007 (odds ratio: 180.0, 95% CI: 10.2-3167.0; P < 0.001)., Conclusion: T-wave shape index is rate dependent and discriminates between PES- and PES+ patients. We propose that patients with inducible arrhythmias have rate-dependent heterogeneity of repolarization which could be a useful tool for risk stratification.

Objective: The present study evaluated the fibroblast attachment and the morphologic changes of simulated cervical root resorptions after irradiation with high-power lasers and the use of mineral trioxide aggregate (MTA)., Study Design: Standardized cavities were done on the coronal third of 40 single-rooted teeth and assigned into 4 groups according to the treatment applied: (1) untreated control, (2) use of MTA, (3) irradiation with Er:YAG laser (42 mJ, 10 Hz, 10 s), and (4) irradiation with high-power diode laser (1 W, 10 s). Fragments were prepared for SEM analysis: 6 samples of each group were plated with human gingival fibroblasts and 4 samples were used for ultrastructural analysis., Results: The cells' attachment was in decreasing order: G3 > G4 > G1> G2, with statistical differences among all groups (P < .05). The samples irradiated with Er:YAG exhibited roughness on the dentinal surface, no smear layer, and open dentinal tubules; those irradiated with diode laser exhibited a smooth surface, more smear layer, and closed dentinal tubules; and the control group showed high amount of smear layer and closed dentin tubules., Conclusions: Irradiation with Er:YAG and diode lasers caused morphologic changes on the dentinal surfaces of simulated resorptions that favored cells' adhesion. MTA showed lower biocompatibility than irradiated groups but allowed cells' adhesion., (Copyright (c) 2010 Mosby, Inc. All rights reserved.)

Herpes simplex virus (HSV) is one of the most common viral infections of the human being. Although most of the seropositive persons do not manifest symptoms, infected individuals may present recurrent infections, characterized by cold sores. HSV-1 infection can result in potentially harmful complications in some patients, especially in those with compromised immunity. We report a clinical case of a patient with severe oral HSV-1 infection in the lower lip. The treatment of the lesions with the association of high-intensity (erbium-doped yttrium aluminum garnet, 2.94 mum, 80 mJ/pulse, 2-4 Hz) and low-intensity (indium gallium aluminum phosphide, 660 nm, 3.8 J/cm(2), 10 mW) lasers has not been reported in the literature. During treatment, no systemic or topical medication was used. Pain sensitivity was completely gone after the first irradiation with the low-intensity laser. During the healing process, lesions were traumatized twice, on the days 4 and 7. Even though the lesions were completely healed within 10 days.

Objective: The objective of this study was to evaluate the disinfection degree of dentine caused by the use of diode laser after biomechanical procedures., Study Design: Thirty teeth were sectioned and roots were autoclaved and incubated for 4 weeks with a suspension of Enterococcus faecalis. The specimens were randomly divided into 3 groups (n = 10): G1, instrumented with rotary files, irrigated with 0.5% sodium hypochlorite and 17% EDTA-T, and then irradiated by 830-nm diode laser at 3 W; G2, the same procedures as G1 but without laser irradiation; and G3, irrigation with saline solution (control). Dentin samples of each third were collected with carbide burs and aliquots were sowed to count viable cells., Results: The disinfection degree achieved was 100% in G1 and 98.39% in G2, when compared to the control group (G3)., Conclusion: Diode laser irradiation provided increased disinfection of the deep radicular dentin in the parameters and samples tested.

Aim: The purpose of this review is to present the potential for the incorporation of ozone therapy into the practice of dentistry., Background: Ozone gas has a high oxidation potential and is 1.5 times greater than chloride when used as an antimicrobial agent against bacteria, viruses, fungi, and protozoa. It also has the capacity to stimulate blood circulation and the immune response. Such features justify the current interest in its application in medicine and dentistry and have been indicated for the treatment of 260 different pathologies. It can be used for the treatment of alveolitis as a replacement for antibiotic therapy, as a mouthwash for reducing the oral microflora, as well as the adherence of microorganisms to tooth surfaces. Ozone has been shown to stimulate remineralization of recent caries-affected teeth after a period of about six to eight weeks., Conclusion: The future of ozone therapy must focus on the establishment of safe and well-defined parameters in accordance with randomized, controlled trials to determine the precise indications and guidelines in order to treat various medical and dental pathologies. Scientific support, as suggested by demonstrated studies, for ozone therapy presents a potential for an atraumatic, biologically-based treatment for conditions encountered in dental practice.