Search

Fructooligosaccharides (FOS) are fructose oligomers beneficial to human health and nutrition for prebiotic sugars. Their production occurs by a transfructosylation reaction in sucrose molecules catalyzed by fructosyltransferase enzymes (FTase, E.C.2.4.1.9) adhered to microbial cells. The purpose of this work was to study the preparation, enzymatic activity, and stability of glutaraldehyde-crosslinked Aspergillus oryzae IPT-301 cells used as a biocatalyst for the transfructosylation reaction of sucrose in a packed bed reactor (PBR), aiming at FOS production. The highest transfructosylation activity (AT) was presented by the biocatalyst prepared by cross-linking at 200 rpm and 45 min. The highest AT in the PBR was obtained at 50 °C, with flow rates from 3 mL min-1 to 5 mL min-1 and sucrose concentrations of 473 g L-1 and 500 g L-1. The enzymatic kinetics was described using the Michaelis-Menten model. Finally, the biocatalyst showed constant AT of approximately 75 U g-1 and 300 U g-1 for 12 h of reaction in the PBR operating in continuous and discontinuous flow, respectively. These results demonstrate a high potential of glutaraldehyde-crosslinked A. oryzae IPT-301 cells as heterogeneous biocatalysts for the continuous production of FOS in PBR reactors.

OBJECTIVE: To evaluate the intraoral features of patients with Apert's syndrome in treatment at the Hospital of Rehabilitation and Craniofacial Anomalies of University of Sao Paulo (HRAC-USP), a national reference center for treatment of craniofacial anomalies in Brazil. STUDY DESIGN: In this retrospective study, of 56,000 patients registered at HRAC-USP, 36 patients were diagnosed with Apert's syndrome and were either examined or had their medical files evaluated, aiming to characterize lip posture, mouth shape, maxillary hypoplasia, palatal morphology, dental anomalies, and malocclusion. RESULTS: Most patients were characterized as mouth breathers for presenting with hypotonic lips and trapezoidal-shaped mouths. Other frequent findings were the presence of highly arched palates and hypoplastic maxilla, with gingival lateral swellings that increased in size with age. Crowding of teeth and malocclusion were commonly observed, and cases of hypodontia were frequent. Contrary to previous studies demonstrating a high incidence of cleft soft palate, in this study only 1 of 23 patients presented a true cleft. CONCLUSIONS: The intraoral features of patients with Apert's syndrome in the population studied match most of the findings in other populations. However, the occurrence of cleft soft palate was unexpectedly low and morphologically normal teeth were found. In addition, hypodontia was frequently observed. Variations in frequency of observations of some characteristics might be related to differences in sample size or population. [ABSTRACT FROM AUTHOR]

Long-term cancer treatment complications in men include testicular dysfunction and infertility. Although various chemotherapies have been studied, there is limited evidence on their effects, especially for bleomycin. Despite its known lung toxicity, bleomycin's impact on male reproductive health is not well-researched. This systematic review aimed to evaluate bleomycin's effects on testicular function and fertility. A search of PubMed and Web of Science identified seven relevant animal studies on bleomycin's gonadotoxicity. The research, limited to animal models, shows that bleomycin significantly disrupts male reproductive health, including DNA damage in sperm, analogous to its effects on cancer cells, and notable histopathological changes in rodent testes. It reduces sperm quality and testosterone levels, correlating with Leydig cell degeneration and inflammatory responses, which further aligns with the drug's known capacity to induce lung inflammation. Due to the inherent limitations in extrapolating results from rodents to humans, further research, particularly in humans, is needed to confirm these findings, assess hormonal impacts, temporal patterns of effects (whether transient or permanent), and their impacts implications for offspring, as well explore potential mitigation strategies. These findings are a first step in raising awareness among clinicians about bleomycin's fertility risks and developing strategies for fertility preservation., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate the in vitro impact of bleomycin on human sperm deoxyribonucleic acid (DNA) integrity, functionality, and morphology, with the aim of elucidating the underlying mechanism and anticipating potential repercussions on patients' reproductive function., Design: Controlled laboratory-based in vitro investigation., Setting: University and clinical in vitro fertilization treatment center., Patient(s): Surplus human ejaculate donated for research by 45 reproductive-age participants exhibiting normozoospermic sperm parameters after clinical semen analysis. None of the participants had received a cancer diagnosis or undergone radiotherapy, chemotherapy, or both., Intervention(s): After clinical semen analysis, sperm samples were centrifuged, diluted in sperm preparation medium, and exposed to bleomycin (100 μg/mL) for 2 hours at 37 °C in a humidified incubator with 5% CO 2 ., Main Outcome Measure(s): In vitro human sperm competence was evaluated by comparing raw sperm, sperm incubated with sperm preparation medium, and sperm exposed to bleomycin. Competence indicators included sperm motility, vitality, DNA and acrosome integrity, and mitochondrial membrane potential. Transmisson electron microscopy was employed to correlate the ultrastructural morphological findings with functional assays., Result(s): Exposure to bleomycin for 2 hours in vitro significantly decreased sperm vitality, motility, and chromatin condensation compared with raw and control sperm. It also significantly increased sperm DNA fragmentation and the proportion of sperm with low mitochondrial membrane potential. Additionally, bleomycin significantly retarded the acrosomal response compared with control but did not affect the formation of intracellular and extracellular reactive oxygen species. Bleomycin-induced ultrastructural morphological changes supported the detected functional alterations., Conclusion(s): Bleomycin negatively impacts male gamete competency in humans. Healthcare professionals should vigilantly monitor and further investigate the gonadotoxicity effects of bleomycin, in addition to its recognized lung toxicity. Meanwhile, it is recommended that patients with cancer undergoing bleomycin-containing chemotherapy regimens receive guidance on fertility preservation strategies., Competing Interests: Declaration of Interests A.L.d.A. reports funding from 2023 Oncology Research Grant of Liga Portuguesa Contra o Cancro – Núcleo Regional do Norte and 2024 Laboratory Award SPMR – Sociedade Portuguesa de Medicina da Reprodução for the submitted work. A.G. has nothing to disclose. A.B. has nothing to disclose. M.S. reports that UMIB is funded by the Foundation for Science and Technology (FCT) Portugal (grant numbers UIDB/00215/2020 and UIDP/00215/2020) and ITR (Laboratory for Integrative and Translational Research in Population Health) (LA/P/0064/2020) for the submitted work. R.S. reports that UMIB is funded by the Foundation for Science and Technology (FCT) Portugal (grant numbers UIDB/00215/2020 and UIDP/00215/2020) and ITR (Laboratory for Integrative and Translational Research in Population Health) (LA/P/0064/2020) for the submitted work and funding from 2023 Oncology Research Grant of Liga Portuguesa Contra o Cancro – Núcleo Regional do Norte and UMIB and Awarded the Laboratory Prize Portuguese Society of Reproductive Medicine 2024 outside the submitted work., (Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Little is known about the ultrastructure of pili annulati., Objectives: To examine with transmission electron microscopy affected hairs of a family, whose diagnosis had been confirmed in five individuals with scanning electron microscopy, which showed surface undulations with "curtain-like" folding of the hair cuticula and to compare the findings with normal control., Methods: Hairs of two affected patients and one control were embedded in resin and cut lengthwise to produce ultra-thin sections., Results: The normal hair showed a parallel arrangement of dark lines associated with less electron-dense wide bands. Small cavities could be observed, mostly in the dark lines, affected hairs had a large number of cavities, associated or not with the insertion of melanosomes and loss of parallelism of the dark lines. Higher magnification showed a significant loss of this parallelism, resembling "wood grooves". Widened dark lines were observed in some areas., Study Limitations: Only a few hairs were examined., Conclusions: The present results suggest that the microcanaliculi of the hair surface, easily found with scanning electron microscopy, may be secondary not only to the cavities seen in the sections but also to the disorder of proteins that form this region, demonstrated by the changes of the cortex dark lines., (Copyright © 2022 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Tiger tail hairs, Morse hairs or pili annulati is a nonsyndromic hair shaft disorder, characterized by alternating light and dark bands along the hair shaft., Methods: The outer surface and the inner structure of longitudinally cut tiger tail hairs were examined with scanning electron microscopy., Results: Hair specimens of five affected individuals showed small surface undulations with "curtain-like" folding of the hair cuticula (microcanaliculi). In the inner surface cord-like linear structures with serpiginous, tortuous traject were seen, associated with some cavities., Conclusions: These findings suggest that this condition is due to some deficient protein synthesis/arrangement, not only due to cavities in the hair cortex. The term Tiger tail hair is a descriptive clinical term of little scientific rigor. This disorder has been reported mainly as pili annulati; however, rings are not observed. In analogy to pili canaliculi, in which well-formed grooving is observed in the hair surface, we suggest the term pili microcanaliculi to describe this condition, based in the ultrastructural findings., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 International Journal of Trichology.)

Background: Periodontal pathogenesis takes into consideration that disease results from a complex inflammatory immune response. Among the major cytokines related to periodontal damage, interleukin (IL)-6 enhances a cascade of tissue destruction. Tocilizumab (TCZ) is a humanized monoclonal anti-human IL-6 receptor that inhibits IL-6-mediated proinflammatory activity. This study aimed to elucidate whether TCZ inhibits the deleterious effect of ligature-induced periodontitis., Methods: Experimental ligature-induced periodontitis was treated with systemic administration of TCZ intraperitoneally in three different concentration dosages (2 mg/kg, 4 mg/kg, and 8 mg/kg. Euthanasia occurred at 7 and 14 days after the initiation of the study. Local changes in the alveolar bone were measured by bone volume, the ratio of bone volume, and trabecular thickness using microcomputed tomography. Attachment loss and inflammatory infiltrate were evaluated by histology. Immune response was analyzed focusing on the Th17 pattern., Results: TCZ inhibited alveolar bone resorption and attachment loss in 7 and 14 days for all dosage groups in comparison to controls (P  < 0.05). Besides, TCZ induced lower expression of inflammatory infiltrate (P <0.05) and less production of Th17-related cytokines (P <0.05) and RANKL (P <0.05)., Conclusions: The inhibition of IL-6-mediated proinflammatory activity by IL-6R blocking reduced alveolar bone resorption and attachment loss supported by the modulation of the Th17 periodontal response. Considering the inflammatory status, modulatory therapy may be a promising approach to periodontal disease., (© 2021 American Academy of Periodontology.)

Ever since its brief introduction in the Brazilian territory in 1981, dengue virus serotype 4 (DENV-4) remained absent from the national epidemiological scenario for almost 25 years. The emergence of DENV-4 in 2010 resulted in epidemics in most Brazilian states. DENV-4, however, remains one of the least studied among the four DENV serotypes. Despite being known as a mild serotype, DENV-4 is associated with severe cases and deaths and deserves to be investigated; however, the lack of suitable experimental animal models is a limiting factor for pathogenesis studies. Here, we aimed to investigate the susceptibility and potential tropism of DENV-4 for liver, lung and heart of an immunocompetent mice model, and to evaluate and investigate the resulting morphological and ultrastructural alterations upon viral infection. BALB/c mice were inoculated intravenously with non-neuroadapted doses of DENV-4 isolated from a human case. The histopathological analysis of liver revealed typical alterations of DENV, such as microsteatosis, edema and vascular congestion, while in lung, widespread areas of hemorrhage and interstitial pneumonia were observed. While milder alterations were present in heart, characterized by limited hemorrhage and discrete presence of inflammatory infiltrate, the disorganization of the structure of the intercalated disc is of particular interest. DENV-4 RNA was detected in liver, lung, heart and serum of BALB/c mice through qRT-PCR, while the NS3 viral protein was observed in all of the aforementioned organs through immunohistochemistry. These findings indicate the susceptibility of the model to the serotype and further reinforce the usefulness of BALB/c mice in studying the many alterations caused by DENV.

Aim: To evaluate the modulatory effect of piperine (PIP) on streptomycin (SM) activity in Mycobacterium tuberculosis ( Mtb ). Materials & methods: SM and PIP minimum inhibitory concentration (MIC) and combinatory activity were determined in Mtb H 37 Rv and in susceptible and resistant clinical isolates. Ethidium bromide accumulation assay and relative quantification of efflux pumps genes ( rv1258c, rv1218c and rv2942 ), after SM and SM+PIP combination exposure, were also performed. Results: PIP concentration of 25 μg/ml (1/4× MIC) was able to inhibit efflux pumps activity, to modulate SM activity in Mtb , and conducted changes in the relative quantification of efflux pumps genes. Conclusion: SM+PIP combination was able to rescue the SM-susceptible MIC values in SM-resistant Mtb .

This study evaluated the effect of the antimicrobial photodynamic therapy (aPDT) on the osseointegration of immediate implants in a healing situation with greater challenges. The mandibular premolars of eight beagle dogs were submitted to ligature-induced periodontal disease. After 3 months, teeth were extracted and immediate implants were placed in the sockets previously decontaminated by mechanical debridement (MD) or MD+aPDT. Following 12 weeks, the dogs were euthanized and the specimens were analyzed. Histologic and histomorphometric analyses demonstrated significantly better results for the immediate implants decontaminated by debridement associated with aPDT. The sites treated with MD+aPDT led to osseointegration of the immediate implants without evidence of inflammation; conversely, evidence of peri-implantitis was observed where aPDT was not used.

Aim: To evaluate an assay to detect minimum bactericidal concentration (MBC) in Mycobacterium tuberculosis , using as single model rifampicin, isoniazid, levofloxacin (LVX) and linezolid (LNZ) and in combination. Material & methods: MBCs were carried out directly from resazurin microtiter assay plate and 3D checkerboard in M. tuberculosis H 37 Rv and five resistant clinical isolates. Results: The proposed MBC assay showed similar values to those determined by MGIT™, used as control. LVX and LNZ's MBC values were close to their MIC values. LNZ or LVX combined with isoniazid and rifampicin showed MBC value reduced in 63.7% of the assays. Conclusion: The proposed assay to determine MBCs of drugs can be applied to the study of new compounds with anti- M. tuberculosis activity to detect their bactericidal effect and also in laboratory routine for clinical dose adjustment of drugs according to the patient's profile.

Ethnopharmacological Relevance: Zingiber officinale (ginger) is a perennial herbaceous plant native in tropical Asia and generally cultivated in most American tropical countries with widespread use in popular medicine. Ginger essential oil (GEO) has been reported to exhibit several biological activities, such as antimicrobial., Aims of the Study: The aim of this study was to determine the composition and the property of GEO and related fractions against Mtb and NTM, as well as their cytotoxicity., Methods and Materials: GEO was obtained by hydrodistillation and fractionation was performed. Chemical characterization of GEO and fractions were carried out by gas chromatography/mass spectrometry. The antimycobacterial activity was evaluated by resazurin microtiter assay plate and broth microdilution method for Mtb and NTM, respectively. The cytotoxicity in Vero cells was assessed by MTT colorimetric assay., Results: The analyses showed 63 compounds in the GEO sample, characterized by a high number of monoterpenes and sesquiterpenes. GEO fractionation rendered 11 fractions (FR1 to FR11). GEO and fractions minimum inhibitory concentration ranged from 31.25 to >250 μg/mL against Mtb and from 15.6 to >250 μg/mL against NTM. GEO showed better activity against NTM, M. chelonae, and M. abscessus sub. massiliense, than the semi-pure fractions. One fraction (FR5), containing γ-eudesmol as the main compound, was the most active against Mtb and NTM. The GEO and semi-pure fractions cytotoxicity assay showed CC 50 63.3 μg/mL, and 36.3-312.5 μg/mL, respectively., Conclusions: In general, GEO showed a mix of monoterpenes and sesquiterpenes and a better antimycobacterial activity than the semi-pure fractions. Cytotoxic effects of GEO and its fractions should be better investigated., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Aim: To evaluate (i) the in vitro activity of eugenol (EUG) and three derivatives against Mycobacterium tuberculosis (Mtb), nontuberculous mycobacteria (NTM) and other bacteria, (ii) the EUG and antituberculosis drugs combinatory effect and (iii) the EUG and its derivatives cytotoxicity., Materials & Methods: Minimum inhibitory concentration of the compounds were determined by resazurin microtiter or broth microdilution assay and the drug interaction between EUG and antituberculosis drugs by resazurin drug combination microtiter. The cytotoxicity was carried out in macrophages, HeLa and VERO cells. Results: EUG and derivatives displayed activity and synergic effect of EUG combined with rifampicin, isoniazid, ethambutol, and pyrazinamide in Mtb including multidrug-resistant isolates, with more selectivity to bacillus than macrophages, HeLa and VERO cells (selective index from 0.65 to 31.4). EUG derivatives (4-allyl-2-methoxyphenyl acetate, 4-allyl-2-methoxyphenyl benzoate, and 4-allyl-2-methoxyphenyl 4-nitrobenzoate) were more active against nontuberculous mycobacteria than EUG. EUG and derivatives exhibited low activity in other Gram-positive and -negative bacteria., Conclusion: EUG and its derivatives show activity against Mycobacterium spp. and synergic effect of EUG combined with antituberculosis drugs against Mtb.

Background: The global resurgence of tuberculosis (TB) and the development of drug resistance, as multidrug-resistant (MDR) and extensively drug-resistant (XDR) Mycobacterium tuberculosis isolates, are a threat to TB control and have created a need for new and more effective anti-TB drugs., Aim: The current study evaluated the in vitro cytotoxicity and activity of Tetradenia riparia essential oil (TrEO) and 6,7-dehydroroyleanone pure compound against M. tuberculosis H 37 Rv and susceptible and resistant clinical isolates., Methods: The in vitro activities of TrEO and 6,7-dehydroroyleanone were determined by Resazurin Microtiter Assay Plate (REMA). The cytotoxicity was evaluated in murine peritoneal macrophages by Alamar Blue assay. The cytotoxic effects were expressed as median concentration cytotoxicity (CC 50 ) and the selectivity index (SI) was calculated., Results: TrEO and 6,7-dehydroroyleanone showed activity against M. tuberculosis H 37 Rv with minimum inhibitory concentration (MIC) 62.5 µg/ml and 31.2 µg/ml, respectively. Both of them exhibited activities against resistant and susceptible M. tuberculosis clinical isolates with MIC values between 31.2 and 62.5 µg/ml. Cytotoxicity assays showed SI 1.9 and 7.9 for TrEO and 6,7-dehydroroyleanone, respectively., Conclusion: These results revealed that TrEO isolated from leaves of T. riparia and the pure compound 6,7-dehydroroyleanone display good activity against M. tuberculosis clinical isolates, including MDR isolates, with low cytotoxicity to murine macrophages. The 6,7-dehydroroyleanone compound is a potential candidate for anti-TB drug., (Copyright © 2018. Published by Elsevier GmbH.)

Setting: The increase of multidrug and extensively drug resistant Mycobacterium tuberculosis strains turns the search for new tuberculosis (TB) treatment options of paramount importance., Objective: In this sense, the present study evaluates the in vitro activity of isoniazid (INH)/rifampicin (RIF)/levofloxacin (LVX) and INH/RIF/linezolid (LNZ) combinations in resistant M. tuberculosis., Design: The activities of the combinations were evaluated with M. tuberculosis H 37 Rv, susceptible and 10 resistant clinical isolates by three-dimensional checkerboard. LVX and LNZ were used as the third drug at fixed ½ and ¼ minimum inhibitory concentration (MIC). INH and RIF were tested at concentrations ranging from 0.0009 μg/mL to 50 μg/mL and 0.0009 μg/mL to 800 μg/mL, respectively. The combinatorial effects were determined by the Fractional Inhibitory Concentration Index (FICI). FICI values ≤ 0.75, 0.75-4 and ≥4 were considered as synergism, indifferent and antagonism, respectively., Results: MIC ranged from 0.03 - 6.25 μg/mL for INH, 0.008-100 μg/mL for RIF, 0.12-0.25 μg/mL for LVX and 0.25-0.5 μg/mL for LNZ in the H 37 Rv and all clinical isolates. INH/RIF/LVX and INH/RIF/LNZ synergisms were observed in 40 and 50% of the resistant M. tuberculosis clinical isolates and better observed for INH and RIF combined to LVX or LNZ at ¼ MIC., Conclusion: The present study calls attention for the potential use of INH/RIF/LVX and INH/RIF/LNZ combinations in the treatment of resistant TB., (Copyright © 2018. Published by Elsevier Ltd.)

The high tuberculosis (TB) incidence rates, the closeness of the cities and the high migration flux on the Brazil/Paraguay/Argentina border deserves an in-depth study, using Mycobacterial Interspersed Repetitive Unit (MIRU) and Spoligotyping genetic markers to explore the impact of the Mycobacterium tuberculosis RD Rio lineage on disease transmission and resistance to anti-TB drugs in this setting. Although without the totality of M. tuberculosis isolates causing TB in this studied setting, a number of 97 isolates obtained from sputa samples culture of patients with confirmed TB, from 2013 to 2015, were submitted to 24 loci MIRU, Spoligotyping, detection of RD Rio lineage and detection of mutation related to isoniazid and rifampicin resistance by MTBDRplus/DNA STRIP. In this sample, it was observed high clonal variability of circulating M. tuberculosis isolates causing TB in Brazilian cities bordering Paraguay and Argentina. The percentage of RD Rio lineage causing TB in this setting was 15.46%, and lower than the detected in different areas of Brazil. According to 24 loci MIRU, the major MIRU International Type (MIT) related with RD Rio lineage were MIT 26, MIT 738, MIT 601 with four, two and one isolates, respectively. Eight isolates with RD Rio marker were classified as orphans. The mainly Spoligofamily related with RD Rio lineage was LAM1 and LAM9 and no relationship between RD Rio lineage and resistance in M. tuberculosis isolates circulating in this setting could be established. This work is pioneer in studying the dynamics of RD Rio lineage transmission on the Brazil/Paraguay/Argentina border and deserves further studies to analyze the real contribution of the RD Rio lineage in outbreaks and the risk of significant development of MDR-TB in the setting studied., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

In developing nations, 10-20% of the human cases of tuberculosis are caused by Mycobacterium bovis. However, this percentage may be underestimated because most laboratories in developing countries do not routinely perform mycobacterial cultures, and only a few have the systems in place to identify M. bovis. There are few studies investigating genotypic diversity and drug resistance in M. bovis from animal and/or human infections. The genotypic diversity of M. bovis strains obtained from bovine lymph nodes were investigated by spacer oligonucleotide typing (spoligotyping) and mycobacterial interspersed repetitive unit-variable-number tandem repeat typing (MIRU-VNTR). The phenotypic resistance to isoniazid and rifampicin and MIC values of the isolates were determined using the resazurin microtiter assay plate method (REMA). The evaluation of the possible genetic basis for such resistance was performed with GenoType MTBDRplus. Sixty-seven isolates were obtained, of which 11 (16%) were MDR-TB, 8 (12%) were isoniazid-resistant, and 2 (3%) were rifampicin-resistant. Mutations associated with drug resistance were not found. Genotyping techniques enabled the grouping of the strains into 12 clusters and 21 isolates with unique profiles. The high frequency of M. bovis reinforces the impact of the pathogen as a major causal agent of bovine tuberculosis in the study area. The resistance of the strains to drugs used for first-line treatment of human tuberculosis raises public health concerns. Further studies are required to elucidate the basis of drug resistance and genotypic diversity in M. bovis., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The current multidrug therapy for tuberculosis (TB) is based on the use of isoniazid (INH) in combination with other antibiotics such as rifampin, ethambutol and pyrazinamide. Literature reports have shown that Mycobacterium tuberculosis, the causative agent of TB, has become resistant to this treatment by means of point mutations in the target enzymes of these drugs, such as catalase-peroxidase (KatG). By means of equilibrium molecular dynamics in the presence of the ligand, this work evaluated ten point mutations described in the enzyme KatG that are related to resistance to INH . The results showed that the resistance mechanism is related to stereochemical modifications at the N-terminal domain of the protein, which restrict INH access to its catalytic site, not involving mechanisms of electrostatic nature. These results show insights that can be useful for the identification of new anti-TB drugs which may be able to circumvent this mechanism of resistance.

Purpose: The aim of this retrospective study was to evaluate implant survival rates (ISRs) for implants placed in grafted sinuses where a membrane perforation occurred during augmentation using exclusively anorganic bovine bone (ABB) by means of clinical and radiographic examinations. Histologic information of five biopsy specimens taken from large membrane perforations is also presented., Materials and Methods: Consecutive patients who underwent sinus augmentation procedures at a private practice Dental Institute between 2004 and 2013 were collected from a computer database. The following profiles were selected for data analysis: computed tomography prior to treatment; perforated membrane information according to size: not perforated, small (≤ 5 mm), medium (> 5 and < 10 mm), or large (≥ 10 mm); sinuses grafted exclusively with ABB and lateral window covered with a collagen membrane (CM); and implant survival after at least 2 years of functional loading placed in augmented sinuses. Implants were considered survivals in the absence of infection, mobility, or pain., Results: The sample in this retrospective study comprised 531 patients; 214 required bilateral sinus augmentation, and 317 required unilateral sinus augmentation (total = 745 sinuses). A total of 1,588 implants were placed. From 745 augmented sinuses, 237 (31.8%; 523 implants) were perforated during the procedure. Among these, 48 perforations were large (20.2%; 107 implants), 67 (28.3%; 150 implants) were medium, and 122 were small (51.5%; 266 implants). Of 523 implants placed in perforated sinuses, 15 were lost (ISR = 97.1%). Comparison of the ISRs for small (97.7%), medium (97.3%), and large (95.3%) perforations with 1,065 implants placed in nonperforated sinuses (ISR = 97.7%) was not statistically significant. The histomorphometric analysis of the five biopsy specimens showed 24.52% ± 6.99% of new bone, 24.32% ± 6.42% of marrow space, and 51.2% ± 3.75% of the remaining ABB., Conclusion: The difference in ISR for implants placed in perforated and nonperforated sinuses was not statistically significant. Within the limits of the histologic data, histomorphometric results with 24.52% ± 6.99% of new bone formation in sinuses with large perforations showed similar bone formation compatible with nonperforated sinuses described in the literature. The authors attributed the high ISR shown in perforated sinuses in this study to the proper management of the perforations.

Osteoporosis is a chronic disease that impairs proper bone remodeling. Guided bone regeneration is a surgical technique that improves bone defect in a particular region through new bone formation, using barrier materials (e.g. membranes) to protect the space adjacent to the bone defect. The polytetrafluorethylene membrane is widely used in guided bone regeneration, however, new membranes are being investigated. The purpose of this study was to evaluate the effect of P(VDFTrFE)/BT [poly(vinylidene fluoride-trifluoroethylene)/barium titanate] membrane on in vivo bone formation. Twenty-three Wistar rats were submitted to bilateral ovariectomy. Five animals were subjected to sham surgery. After 150 days, bone defects were created and filled with P(VDF-TrFE)/BT membrane or PTFE membrane (except for the sham and OVX groups). After 4 weeks, the animals were euthanized and calvaria samples were subjected to histomorphometric and computed microtomography analysis (microCT), besides real time polymerase chain reaction (real time PCR) to evaluate gene expression. The histomorphometric analysis showed that the animals that received the P(VDF-TrFE)/BT membrane presented morphometric parameters similar or even better compared to the animals that received the PTFE membrane. The comparison between groups showed that gene expression of RUNX2, BSP, OPN, OSX and RANKL were lower on P(VDF-TrFE)/BT membrane; the gene expression of ALP, OC, RANK and CTSK were similar and the gene expression of OPG, CALCR and MMP9 were higher when compared to PTFE. The results showed that the P(VDF-TrFE)/BT membrane favors bone formation, and therefore, may be considered a promising biomaterial to support bone repair in a situation of osteoporosis.

Objective: To assess hygiene conditions in removable partial dentures (RPDs) and to compare the periodontal status between abutment and nonabutment teeth in clefts patients., Design: Cross-sectional., Settings: Tertiary referral hospital., Participants: Forty-five patients of both genders, aged 20 to 75 years, who were upper RPD wearers for at least 2 years, with cleft lip, alveolus, and/or palate who attended follow-up appointments between 2010 and 2012., Interventions: The clinical periodontal parameters assessed on abutment teeth (experimental group) and nonabutment teeth (control group) were probing depth, clinical attachment level (CAL), plaque index, and gingival index (GI). The RPDs were evaluated under the following parameters: hygiene conditions and type of clasp on abutment. Both groups were analyzed using Mann-Whitney, Kruskal-Wallis, and Dunn's statistical test. Statistical significance was set at P < .05., Results: One hundred sixty-six abutment teeth and 168 nonabutment teeth were evaluated in 45 patients. A statistically significant difference was found between the groups for the CAL parameter (P = .03). With regard to the prostheses' hygiene conditions through the Tarbet index parameter, of the 186 quadrants evaluated, 143 scored 2 and 3. Ackers' clasps were the most frequent clasps (n = 111). A statistically significant difference was found for the GI parameter (P = .03)., Conclusions: It was possible to conclude, in this cross-sectional study, that in general terms, the use of RPDs did not interfere in the periodontal conditions of abutment teeth; however, most prostheses presented poor hygiene and high quantity of dental plaque.

The influence of the electron-phonon (e-ph) interactions on the filed-included polaron dynamics in armchair graphene nanoribbons (GNRs) is theoretically investigated in the scope of a two-dimensional tight-binding model. The results show that the localization of the polaronic charge increases when the strength of e-ph coupling also increases. Consequently, the polaron saturation velocity decreases for higher e-ph coupling strengths. Interestingly, the interplay between the e-ph coupling strength and the GNR width changes substantially the polaron dynamics properties.

The emission spectra of flexible and rigid organic molecules are theoretically investigated in the framework of the Franck-Condon (FC) and nuclear ensemble (NE) approaches, both of which rely on results from density functional theory but differ in the way vibrational contributions are taken into account. Our findings show that the emission spectra obtained using the NE approach are in better agreement with experiment than the ones produced by FC calculations considering both rigid and flexible molecules. Surprisingly, the description of a suitable balance between the vibronic progression and the emission spectra envelope shows dependency on the initial sampling for the NE calculations which must be judiciously selected. Our results intend to provide guidance for a better theoretical description of light emission properties of organic molecules with applications in organic electronic devices.

Background: The prosthetic treatment in cleft patients is challenging. Based on this, the aim of this study was to evaluate the longevity of prosthetic rehabilitation treatment with implant-supported overdenture (IOD) and implant-supported fixed denture (IFD) in cleft lip and palate patients in a period of 22 years., Materials and Methods: The medical records of 72 patients were analyzed (29 males and 43 females), and the survival rate of the implants was evaluated. Moreover, the prostheses' time of use and the reason for the changing of these were also evaluated., Results: Four-hundred-seventeen implants were installed, and 370 implants survive today. The mean survival time of the implants was 7.6 years. Regarding the 97 prostheses made, the time of average use was 3.28 for the IFDs and 3.92 for IODs. The reasons for the replacements of the prostheses were mainly: fracture of the acrylic base (29.6%) and loss of vertical dimension of occlusion (VDO) (18.5%) in the IFDs. Moreover, in IODs, these were accounted for the loss of VDO due to teeth damage (17.2%) and implant loss (14.6%)., Conclusions: The maintenance of the prostheses was challenging because the patients had difficulties returning for periodic control, but this fact did not result in the decrease of the success rate of the implants. The longevity of implants and prostheses was satisfactory; however, the prostheses showed repetitions mainly due to the wear of the teeth, with decreased vertical dimension and fracture of acrylic base., Competing Interests: There are no conflicts of interest.

Background: Liposclerosing myxofibrous primary bone tumor is a rare benign bone lesion that was characterized by complex mixture of various histological elements., Methods: We have studied the radiological, clinical and pathological features of nine patients with this disorder. Pain and limping were the main symptoms., Results: Radiographic images typically showed a geographic lytic lesion with thick sclerotic margin, reflecting a pattern of slow growth. Histological sections revealed a polymorphic neoplasia characterized by predominant proliferation of stellate and fusiform cells aimed the myxoid matrix., Conclusions: These features suggest that the lesion may represent a variant of fibrous dysplasia with a high risk of malignant transformation.

Since the first report by Ishiwata in 1902 of a Bombyx mori infection, followed by the description by Berliner, Bacillus thuringiensis (Bt) has become the main microorganism used in biological control. The application of Bt to combat invertebrates of human interest gained momentum with the growing demand for food free of chemical pesticides and with the implementation of agriculture methods that were less damaging to the environment. However, the mechanisms of action of these products have not been fully elucidated. There are two proposed models: the first is that Bt causes an osmotic imbalance in response to the formation of pores in a cell membrane, and the second is that it causes an opening of ion channels that activate the process of cell death. There are various ways in which Bt resistance can develop: changes in the receptors that do not recognize the Cry toxin, the synthesis of membrane transporters that eliminate the peptides from the cytosol and the development of regulatory mechanisms that disrupt the production of toxin receptors. Besides the potential for formulation of biopesticides and the use in developing genetically modified cultivars, recent studies with Bt have discussed promising applications in other branches of science. Chitinase, an enzyme that degrades chitin, increases the efficiency of Bt insecticides, and there has been of increasing interest in the industry, given that its substrate is extremely abundant in nature. Another promising field is the potential for Bt proteins to act against cancer cells. Parasporins, toxins of Bt that do not have an entomopathogenic effect, have a cytotoxic effect on the cells changed by some cancers. This demonstrates the potential of the microorganism and new opportunities opening for future applications.

Purpose: The coating of implant surfaces with components of the extracellular matrix offers an approach to influence peri-implant bone healing. In this study, bone healing around coated implants is analyzed in a peri-implant defect model., Materials and Methods: Eight months after extraction of the premolar teeth, six dogs received 48 implants (eight per animal) in the mandible. Implant surfaces were sandblasted and acid-etched, and some were additionally coated with collagen type II and chondroitin sulfate (collagen/CS). On each side of the mandible, implants either had no peri-implant defect (control side) or a vertical defect of 5 mm in depth and 0.5, 1.0, or 2.0 mm in width. Implants healed submerged for 8 weeks. Fluorochrome staining, histology, and histomorphometry were used to analyze implant osseointegration., Results: Fluorochrome labels showed an increased mineralization around collagen/CS-coated surfaces at 4 weeks (p = .031). Histomorphometry generally showed lower vertical and horizontal bone apposition with increasing gap size for both surface types. In gapless sites and 0.5-mm gaps, collagen/CS coated implants showed increased bone volume in areas directly adjacent to the implant, in comparison with uncoated implants (p < .05)., Conclusion: The width of the peri-implant gap influences peri-implant bone formation. Complete filling of all gaps by newly formed bone could not be observed around either surface. In proximity to the surface, implant surface coating by collagen/CS positively influenced bone formation., (© 2013 Wiley Periodicals, Inc.)

Background: Heart failure is a severe complication associated with doxorubicin (DOX) use. Strain, assessed by two-dimensional speckle tracking (2D-STE), has been shown to be useful in identifying subclinical ventricular dysfunction., Objectives: a) To investigate the role of strain in the identification of subclinical ventricular dysfunction in patients who used DOX; b) to investigate determinants of strain response in these patients., Methods: Cross-sectional study with 81 participants: 40 patients who used DOX ± 2 years before the study and 41 controls. All participants had left ventricular ejection fraction (LVEF) ≥ 55%. Total dose of DOX was 396 mg (242 mg/ms2). The systolic function of the LV was evaluated by LVEF (Simpson), as well as by longitudinal (εLL), circumferential (εCC), and radial (εRR) strains. Multivariate linear regression (MLR) analysis was performed using εLL (model 1) and εCC (model 2) as dependent variables., Results: Systolic and diastolic blood pressure values were higher in the control group (p < 0.05). εLL was lower in the DOX group (-12.4 ± 2.6%) versus controls (-13.4 ± 1.7%; p = 0.044). The same occurred with εCC: -12.1 ± 2.7% (DOX) versus -16.7 ± 3.6% (controls; p < 0.001). The S' wave was shorter in the DOX group (p = 0.035). On MLR, DOX was an independent predictor of reduced εCC (B = -4.429, p < 0.001). DOX (B = -1.289, p = 0.012) and age (B = -0.057, p = 0.029) were independent markers of reduced εLL., Conclusion: a) εLL, εCC and the S' wave are reduced in patients who used DOX ± 2 years prior to the study despite normal LVEF, suggesting the presence of subclinical ventricular dysfunction; b) DOX was an independent predictor of reduced εCC; c) prior use of DOX and age were independent markers of reduced εLL.

Purpose: While the incorporation of antimicrobial agents into soft denture liners has been suggested as a reliable alternative treatment for denture stomatitis, it may affect the liner's properties. The effect of addition of antimicrobial agents for the treatment of denture stomatitis on the surface roughness and Shore A hardness of soft lining materials was evaluated., Materials and Methods: The test groups comprised specimens (36 × 7 × 6 mm(3) ) of soft materials (Softone and Trusoft) without (control) or with incorporation of drugs (nystatin, miconazole, ketoconazole, chlorhexidine diacetate, and itraconazole). Hardness (Shore A) and roughness (Ra) were evaluated after immersion of specimens (n = 10) in distilled water at 37°C for 24 hours, 7 and 14 days. Data were analyzed by 3-way ANOVA/Tukey's test (α = 0.05)., Results: After 14 days, an increase (p < 0.05) was observed in the hardness of soft materials with time for the modified specimens, except for itraconazole. Addition of drugs increased the Softone roughness only for the addition of miconazole and chlorhexidine (p < 0.05), and did not increase the roughness of Trusoft with time. Only chlorhexidine and itraconazole altered the roughness compared to the control for each material (p < 0.05)., Conclusions: The smallest changes of hardness and roughness with time in the modified groups compared to controls were observed for itraconazole groups for both materials., (© 2014 by the American College of Prosthodontists.)

The field-induced dynamics of polarons in armchair graphene nanoribbons (GNRs) is theoretically investigated in the framework of a two-dimensional tight-binding model with lattice relaxation. Our findings show that the semiconductor behavior, fundamental to polaron transport to take place, depends upon of a suitable balance between the GNR width and the electron-phonon (e-ph) coupling strength. In a similar way, we found that the parameter space for which the polaron is dynamically stable is limited to an even narrower region of the GNR width and the e-ph coupling strength. Interestingly, the interplay between the external electric field and the e-ph coupling plays the role to define a phase transition from subsonic to supersonic velocities for polarons in GNRs.

Aim: We tested the hypothesis that the association of bone marrow mesenchymal stem cells (MSCs) and osteoblasts (OBs) optimize bone repair., Materials & Methods: MSCs were cultured in growth or osteogenic medium and seeded into gelatin sponge prior to implantation. Defects were created into rat calvariae and implanted with gelatin sponge without cells, with MSCs, with OBs and with association of MSCs and OBs. Histological analysis and micro-CT-based histomorphometry were carried out after 4 weeks., Results: Increased bone formation was observed in defects treated with cells and bone volume was greater in defects treated with either OBs or MSCs/OBs., Conclusion: Association of MSCs and OBs did not increase the process of bone repair compared with cell-based therapy using either MSCs or OBs alone.

Objective: The objective of this study was to evaluate the effect of low-level laser (LLL) on bone healing process in surgically created critical size defects in rat calvaria treated with or without autogenous bone graft (AB)., Material and Methods: The study was conducted on 40 male rats (Rattusnorvegicus, albinus, Wistar), weighing 250-300 g. For accomplishment of the experimental procedures, the rats were anesthetized with an intramuscular injection of xylazine (0.02 ml/kg) and ketamine hydrochloride (0.4 ml/kg). Acritical size defect with 5-mm diameter was created. The animals were divided into four groups: Group C (Control- filled with blood clot), Group LLL, Group AB (autogenous bone graft), Group AB + LLL (autogenous bone graft and LLL). The animals treated with LLL received applications of LLL at the infrared spectrum wavelength (λ = 810 nm) and energy density of 6 J/cm(2) per point, 60 s per point, adding up to five points on the entire created defect. The animals were euthanized at 30 days postoperatively. After decalcification, each specimen was longitudinally divided into two blocks, exactly along the center of the original surgical defect, processed and embedded in paraffin. Longitudinal serial sections with 6-μm thickness were made, initiating from the center of the original surgical defect. The sections were stained with hematoxylin and eosin (HE) for light microscopy analysis for histomorphometric analysis., Results: Group C presented smaller quantity of new bone formation than Groups LLL (P < 0.01), AB (P < 0.01), and AB + LLL (P < 0.01)., Conclusions: Utilization of LLL favored the healing process in rat calvaria. The quantity of new bone formation with use of the LLL was similar to the autogenous bone graft., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

In this study, we evaluated the effect of poly(vinylidene fluoride-trifluoroethylene)/barium titanate (P(VDF-TrFE)/BT) membrane on in vivo bone formation. Rat calvarial bone defects were implanted with P(VDF-TrFE)/BT and polytetrafluoroethylene (PTFE) membranes, and at 4 and 8 weeks, histomorphometric and gene expression analyses were performed. A higher amount of bone formation was noticed on P(VDF-TrFE)/BT compared with PTFE. The gene expression of RUNX2, bone sialoprotein, osteocalcin, receptor activator of nuclear factor-kappa B ligand, and osteoprotegerin indicates that P(VDF-TrFE)/BT favored the osteoblast differentiation compared with PTFE. These results evidenced the benefits of using P(VDF-TrFE)/BT to promote new bone formation, which may represent a promising alternative to be employed in guided bone regeneration., (© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Background: Electrical muscle stimulation (EMS) is applied to critically ill patients in order to improve their muscle strength, thereby preventing hypotrophy and promoting functional recovery., Objective: To assess the effects of early EMS on the range of movement of the ankle joint, and on thigh and leg circumference in critically ill patients., Methods: This is a prospective randomized clinical trial comprising 11 patients undergoing mechanical ventilation. Before and after EMS the thigh and leg circumference in both lower limbs and the goniometry of the tibiotarsal joint were measured. The angle of 90° on the goniometer was taken as the standard neutral position (NP), with the arm fixed on the lateral malleolus of the ankle joint. Other measurements, namely dorsiflexion and plantar flexion, referred to as mobile arm, were taken from the NP. These recordings were obtained following an active contraction of the patients' muscles., Results: Compared with the electrostimulated limb, a difference in dorsiflexion of the control limb was observed (96.2 ± 24.9 versus 119.9 ± 14.1°; p = 0.01). A girth of 10 cm of the leg was found in limb reduction when compared to the electrostimulated one (24.7 ± 3.1 versus 26.4 ± 4.0 cm; p = 0.03)., Conclusions: EMS used at low current intensity and for a short duration failed to prevent muscle atrophy in critically ill patients. However, we did find a significant improvement in active dorsiflexion of the ankle joint suggesting that it could help to prevent against stance plantar flexion in these patients.

Introduction: Studies have shown that periodontal disease is independently associated with coronary artery disease. However, this same association has not been demonstrated with chronic apical periodontitis. The goal of this study was to establish the relationship between chronic apical periodontitis and coronary artery disease., Methods: This cross-sectional study included 103 patients who underwent coronary angiography at the University Hospital Presidente Dutra, Federal University of Maranhão, São Luís-Maranhão, Brazil. The patients answered a structured questionnaire and underwent physical and laboratory examinations. For each patient, a full-mouth set of periapical radiographs was taken. To compare numerical data, Student's t test for independent samples or the Mann-Whitney U test (nonparametric) was used. The homogeneity of variance was assessed by using Levene's test. For comparison of categorical data, the chi-square test or Fisher's exact test was used. The logistic regression analysis was performed to identify the independent predictors of coronary artery disease. The criterion for statistical significance was set at 5%. Statistical analysis was conducted by using SAS version 6.11 software., Results: The study comprised 103 patients (52 men, 51 women; mean age, 61.9 years); 31.1% were literate, and 55.3% were married. In the study sample, the prevalence of chronic apical periodontitis was 41.7% and of coronary artery disease, it was 65%. The patients with chronic apical periodontitis had a 2.79 times higher risk of developing coronary artery disease., Conclusions: In these study patients, chronic apical periodontitis was independently associated with coronary artery disease., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objective: The purpose of this study was to histologically evaluate the effect of low-level laser (LLL) on the healing of critical size defects (CSD) in rat calvaria, filled with autogenous or inorganic bovine bone grafts., Methods: Sixty rats were divided into 6 groups (n = 10): C (control-filled with blood clot), LLL (low-level laser-GaAlAs, λ 780 nm, 100 mW, 210 J/cm(2), Φ 0.05 cm(2); 6 J/point), AB (autogenous bone), ABL (autogenous bone + low-level laser), OB (inorganic bovine bone), and OBL (inorganic bovine bone + LLL)., Material and Methods: The animals were killed after 30 days. Histological and histometric analyses were performed by light microscopy. Results. The groups irradiated with laser, LLL (47.67% ± 8.66%), ABL (39.15% ± 16.72%), and OBL (48.57% ± 28.22%), presented greater area of new bone formation than groups C (9.96% ± 4.50%), AB (30.98% ± 16.59%), and OB (11.36% ± 7.89%), which were not irradiated. Moreover, they were significantly better than group C (Kruskal-Wallis test followed by Dunn test, P < 0.05)., Conclusion: The laser accelerated the healing of bone defects and the resorption of particles of the graft material.

Statement of Problem: Endodontically treated teeth are known to have reduced structural strength. Glass fiber posts may influence fracture resistance and should be evaluated., Purpose: The purpose of this study was to evaluate the influence of glass fiber post length on the fracture resistance of endodontically treated teeth., Material and Methods: Forty intact human maxillary canines were selected and divided into 4 groups, the control group consisting of teeth restored with a custom gold cast post and core, with a length of two-thirds of the root. Other groups received prefabricated glass fiber posts in different lengths: group 1/3, removal of one-third of the sealing material (5 mm); group 1/2, removal of one-half of the sealing material (7.5 mm); and group 2/3, removal of two-thirds of the sealing material (10 mm). All the posts were cemented with resin cement, and the specimens with glass fiber posts received a composite resin core. All the specimens were restored with a metal crown and submitted to a compressive load until failure occurred. The results were evaluated by 1-way ANOVA, and the all pairwise multiple comparison procedures (Tukey honestly significantly difference test) (α=.05)., Results: The ANOVA showed significant differences among the groups (P<.002). The Tukey test showed that the control group presented significantly higher resistance to static load than the other groups (control group, 634.94 N; group 1/3, 200.01 N; group 1/2, 212.17 N; and group 2/3, 236.08 N). Although teeth restored with a cast post and core supported a higher compressive load, all of them fractured in a catastrophic manner. For teeth restored with glass fiber posts, the failure occurred at the junction between the composite resin core and the root., Conclusion: The length of glass fiber posts did not influence fracture load, but cast post and cores that extended two-thirds of the root length had significantly greater fracture resistance than glass fiber posts., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.)

OBJECTIVE : To clinically evaluate the effects of diode laser, Gallium-Aluminum-Arsenide laser (GaAlAs), on the pain and edema after secondary alveolar bone graft. DESIGN : Case-control, double-blind study. Setting : Institutional tertiary referral hospital. Participants : The sample was composed of 60 individuals with complete unilateral cleft lip and palate, of both genders, aged 9 to 15 years, submitted to secondary alveolar bone graft. MAIN OUTCOME MEASURES : The individuals were divided into an experimental group (patients irradiated with diode laser GaAlAs, energy density of 4 J/cm(2), power of 100 mW, and wavelength in the infrared spectrum, for 10 seconds per point on 10 points, adding up to a dose of 40 J/cm(2)) and a placebo group (simulated laser application for 60 seconds per point, also on 10 points). Applications were made on the receptor site immediately postoperatively and after 24 and 48 hours. The pain and edema were assessed preoperatively and at each application. RESULTS : The two groups presented increase in pain and edema in 24 and 48 hours. No statistically significant difference was found between groups. CONCLUSIONS : According to the present methodology, the use of low-level laser to control the pain and edema in the postoperative period of secondary alveolar bone graft was not effective.

Objective : To evaluate the aesthetics of an implant-supported denture at the cleft area, comparing the peri-implant tissues and prosthetic crown with the contralateral tooth. Settings : Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paolo, Brazil. Patients : A total of 39 individuals of both genders, with complete unilateral cleft lip and palate, who received secondary alveolar bone graft and were rehabilitated with single implant-supported dentures at the area of the missing maxillary lateral incisor after completion of orthodontic treatment. Interventions : The following parameters were analyzed in follow-up sessions: length and width of prosthetic crown and contralateral tooth, characteristics of implants, filling of interproximal space by the papilla, and smile height of the patients. Results : The implant-supported prosthetic crowns were longer than the contralateral tooth (p < .001). Among the 78 papillae analyzed, 29 (37.17%) received a score of 3; 32 (41.02%) papillae had a score of 2; and 17 (21.79%) received a score of 1. Concerning the smile height, among the 39 patients analyzed, 23 (56.41%) had a medium smile, 15 (38.46%) had a high smile, and two (5.12%) presented a low smile. Conclusion : The use of dental implants to rehabilitate the edentulous cleft area is an excellent option. However, adequate evaluation of the bone quantity and quality, positioning and shape of adjacent teeth, smile height, and patient expectations should be considered to achieve success and avoid aesthetic deformities such as elongated teeth and absence of gingival papillae.

Objectives: The purpose of this study was to evaluate the influence of thermal and mechanical cycling and veneering technique on the shear bond strength of Y-TZP (yttrium oxide partially stabilized tetragonal zirconia polycrystal) core-veneer interfaces., Materials and Methods: Cylindrical Y-TZP specimens were veneered either by layering (n=20) or by pressing technique (n=20). A metal ceramic group (CoCr) was used as control (n=20). Ten specimens for each group were thermal and mechanical cycled and then all samples were subjected to shear bond strength in a universal testing machine with a 0.5mm/min crosshead speed. Mean shear bond strength (MPa) was analysed with a 2-way analysis of variance and Tukey's test (p<0.05). Failure mode was determined using stereomicroscopy and scanning electron microscopy (SEM)., Results: Thermal and mechanical cycling had no influence on the shear bond strength for all groups. The CoCr group presented the highest bond strength value (p<0.05) (34.72 ± 7.05 MPa). There was no significant difference between Y-TZP veneered by layering (22.46 ± 2.08 MPa) or pressing (23.58 ± 2.1 MPa) technique. Failure modes were predominantly adhesive for CoCr group, and cohesive within veneer for Y-TZP groups., Conclusions: Thermal and mechanical cycling, as well as the veneering technique does not affect Y-TZP core-veneer bond strength., Clinical Significance: Different methods of veneering Y-TZP restorations would not influence the clinical performance of the core/veneer interfaces., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: Several implant surfaces are being developed, some in the nanoscale level. In this study, two different surfaces had their early healing properties compared in context of circumferential defects of various widths., Material and Methods: Six dogs had the mandibular premolars extracted. After 8 weeks, four implants were placed equicrestally in each side. One acted as control, while the others were inserted into sites with circumferential defects of 1.0, 1.5 and 2.0 mm wide and 5 mm deep. A nano-modified surface was used on one side and a micro-rough on the other. Bone markers were administered on the third day after implant placement and then after 1, 2, 4 weeks to investigate the bone formation dynamic through fluorescence analysis. Ground sections were prepared from 8-week healing biopsies and histomorphometry was performed., Results: The fluorescence evaluation of the early healing showed numerically better results for the nano-modified group; however this trend was not followed by the histomorphometric evaluation. A non-significant numerical superiority of the micro-rough group was observed in terms of vertical bone apposition, defect bone fill, bone-to-implant contact and bone density. In the intra-group analysis, the wider defects showed the worse results while the control sites showed the best results for the different parameters, but without statistical relevance., Conclusion: Both surfaces may lead to complete fill of circumferential defects, but the gap width has to be considered as a challenge. The nano-scale modification was beneficial in the early stages of bone healing, but the micro-rough surface showed numerical better outcomes at the 8-week final period., (© 2011 John Wiley & Sons A/S.)

Objective: To evaluate the role of keratinized mucosa around dental implants, correlating with other clinical parameters related to the success of dental implants., Design: Cross-section., Setting: Institutional tertiary referral hospital., Patients: A total of 202 dental implants fixed in the cleft area of 109 patients with cleft lip and/or palate were evaluated. Interventions: The evaluated clinical parameters were probing depth and gingival and plaque indexes on the buccal surface (three sites)., Main Outcome Measures: All clinical parameters were correlated with the width of keratinized mucosa around the implants., Results: The largest probing depths were detected when the width of keratinized mucosa was 2 mm or more, with a statistically significant difference between the means of the probing depth and keratinized mucosa width., Conclusion: Even though the present results suggest that peri-implant health can be observed in areas with keratinized mucosa width under 2 mm provided an adequate oral hygiene control is performed, longitudinal randomized studies are necessary to analyze the relationship between the width of keratinized mucosa and the health of peri-implant tissues.

Cleft lip and palate is the most common among craniofacial malformations and causes several esthetic and functional implications that require rehabilitation. This paper aims to generally describe the several aspects related to this complex pathology and the treatment protocol used by the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP) along 40 years of experience in the treatment of individuals with cleft lip and palate.

Objective: To analyze the prevalence and severity of gingival recession in individuals with cleft lip and alveolus with or without cleft palate., Design: Cross-sectional., Setting: Tertiary referral hospital., Participants: A total of 400 individuals with cleft lip and alveolus with or without cleft palate, aged 15 to 49 years, without any previous periodontal treatment., Main Outcome Measures: Gingival recession was evaluated by measuring the distance from the cementoenamel junction to the most coronal point on the gingival margin, analyzing the prevalence and scoring its severity as mild (<3 mm), moderate (3 to 4 mm), or severe (4 mm). The prevalence and severity of gingival recession was compared between sextant 2 (cleft sextant) and the mean of the other sextants (1, 3, 4, 5, and 6: noncleft sextants). The relationship between gingival recession in the cleft area and gender was evaluated and data were analyzed statistically. The correlation between gingival recession and age was assessed also., Results: There was no statistically significant gender difference in gingival recession. The prevalence and severity of gingival recession increased with age, and most of the affected teeth were premolars and molars. The cleft area did not present a higher prevalence and severity of gingival recession., Conclusions: Individuals with cleft lip and alveolus with or without cleft palate presented the same prevalence and severity of gingival recession compared with other populations. The area adjacent to the cleft (sextant 2) did not show greater risk of gingival recession than other areas (sextants 1, 3, 4, 5, and 6).

This study assessed the intracultural knowledge of the use of medicinal plants in an urban-rural community in an Atlantic forest fragment in northeastern Brazil. We examined the importance of native and exotic species and the effects of gender and age on that knowledge. We also compared data obtained from different groups of informants (local experts and general community). We conducted 194 interviews between June 2007 and January 2008, using the freelist technique and semistructured forms to collect ethnobotanical data. Information obtained from the community was compared with that from six local experts who participated in a survey in 2003. From a total of 209 ethnospecies, exotic and herbaceous plants presented higher richness. With respect to the number of citations, women and older informants were shown to know a higher number of medicinal plants. Comparing knowledge of local experts with that of the general community, we noted that experts know a similar wealth of plant families and therapeutic indications, but the community knows a greater species richness. These results indicate that local experts may provide useful information for studies that search for a quick diagnosis of the knowledge of a given community.

Objective. To evaluate characteristics of smile related to visibility in individuals with cleft lip, alveolus, and palate. Design. Cross-sectional. Setting. HRAC/USP, Brazil. Patients. Individuals with repaired complete unilateral cleft lip and palate (n = 45), aged 15-30 years. Interventions. Frontal facial photographs were obtained in natural and forced smiles (n = 135). Six specialists in periodontics evaluated the photographs as to the smile line, thickness, and curve of the upper lip. Main Outcome Measures. The cleft area was compared with the contralateral region. Results were expressed as percentages and means. The findings were compared between groups of periodontists. Results. Statistically significant relationship was observed in the smile line between examiners and between natural and forced smiles, regardless of the association with the cleft side. The lip was thicker at rest and thinner in the forced smile, as also evaluated by the group not experienced with cleft care. The curve of the upper lip in natural and forced smiles was considered as close to straight by both groups, regardless of the cleft. Conclusion. The smile in individuals with clefts was regarded as average for both cleft and noncleft sides. The thickness was characterized as average to thin, being thinner in forced smile and when analyzed by the group not experienced with cleft care. In the average, the curve of the upper lip was considered as straight. The present study elucidates some characteristics related to the smile in individuals with repaired unilateral cleft lip, alveolus, and palate.