Pulpotomy

Removal of the coronary pulp from primary molar teeth, use of formocresol and zinc oxide

formocresol and zinc oxide.

Removal of the coronary pulp from primary molar teeth, use of PBS cement

PBS CIMMO cement.

Fernanda Valadão Moysés

Univás

Clinical Applicability of PBS® CIMMO Cement in Pulpotomies

Clinical Applicability of PBS® CIMMO Cement in Decoded Teeth Pulpotomies as Base and Restoration

The restorative capacity of the PBS CIMMO and Zinc Oxide cements will be assessed by clinical and radiographic examination six months after the pulpotomies.

The restorative capacity of CIMMO PBS and Zinc Oxide cements will be assessed by radiographic examination six months after pulpotomies.

José Dias da Silva Neto

Clinical Professor, Principal Investigator

Universidade do Vale do Sapucai

Comparative study with same series for the two groups

Patients diagnosed with generalized aggressive periodontitis (GAP), in which the previously selected intrabony defect will receive will receive open flap debridement.

Patients with a diagnosis of generalized aggressive periodontitis (GAP), in which the previously selected intrabony defect will receive open flap debridement and, in addition, application of the EMD in the defect.

Patients with a diagnosis of generalized chronic periodontitis (GCP), in which the previously selected intrabony defect will receive open flap debridement and, in addition, application of the EMD in the defect.

Aggressive Periodontitis

EMD is composed of different proteins, 90% of which are amelogenins, which has the capacity to induce processes involved in the regeneration of periodontal tissues in a manner similar to normal tissue development (48). Several clinical and animal model studies have demonstrated the use of enamel matrix-derived proteins in regenerative periodontal procedures for the formation of a new periodontium.

Enamel Matrix Proteins

After administration of local anesthetics, full-thickness flaps will be raised in order to access all defect faces. Sulcular incisions will be performed extending to mesial and distal adjacent teeth, including the entire papilla in the flap. No relaxing incisions will be performed. All granulation tissue will then be carefully removed, and subsequently scaling and root planing will be performed. The surgical area will be irrigated with 0.9% saline and carefully inspected to ensure that all steps have been satisfactorily performed until then.

Open Flap Debridement

Piracicaba Dental School, State University of Campinas

Enamel Matrix Proteins in the Treatment of Intrabony Defects in Patients With Aggressive and Chronic Periodontitis

Enamel Matrix Proteins in the Treatment of Intrabony Defects in Patients With Aggressive and Chronic Periodontitis: Randomized Clinical Trial

Enilson Antonio Sallum

Professor Enilson Antonio Sallum

University of Campinas, Brazil

Inhaled nitrogen will be administered via the cardiopulmonary bypass (CPB) machine and after CPB via the inspiratory limb of the anesthetic or ventilator circuit, and thereafter via the mechanical ventilator in the Intensive Care Unit (ICU). Once patients are extubated they will breathe test gas via a facemask or nasal cannula. Test gas administration will commence at the onset of CPB and last for 24 hours.

Inhaled nitric oxide (iNO) will be administered via the CPB machine and after CPB via the inspiratory limb of the anesthetic or ventilator circuit, and thereafter via the mechanical ventilator in the ICU. Once patients are extubated they will breathe test gas via a facemask or nasal cannula. Test gas administration will commence at the onset of CPB and last for 24 hours. At the end of 24 hours, iNO will be weaned and discontinued while carefully monitoring hemodynamics for a period of 2-4 hours.

Acute Kidney Injury

Inhaled nitric oxide will be administered in a final concentration of 80 ppm. The treatment will begin at the onset of the cardiopulmonary bypass until to 24h after Intensive Care Unit (ICU) admission, including 2-4 hours of weaning from nitric oxide and careful hemodynamics monitoring.

Nitric Oxide

This is the placebo group. Nitrogen will be added instead of nitric oxide.

Placebo

This is the clinical trial that we previously performed in collaboration with Xijing Hospital.

The first preliminary data analysis of the NCT01802619 has been presented at the section "Late Breaking Trial" of the American Heart Association in Orlando,Florida,November 2015.

Massachusetts General Hospital

Effect of Nitric Oxide in Cardiac Surgery Patients With Endothelial Dysfunction.

Prevention of Acute Kidney Injury by Nitric Oxide in Prolonged Cardiopulmonary Bypass. A Double Blind Controlled Randomized Trial in Cardiac Surgical Patients With Endothelial Dysfunction.

Incidence of Acute Kidney injury according to KDIGO criteria.

Difference in AKI severity between the two groups using following KDIGO stages.

To study the incidence of acute renal failure requiring RRT

Difference between groups of MAKE at 6 weeks after surgery. MAKE is a composite outcome of death, new dialysis and worsened renal function (defined as a 25% or greater decline in eGFR compared to the baseline).

Assessment of organ dysfunction through the evaluation of SOFA score

Difference between groups of prolonged cardiovascular support defined as need for vasopressors, inotropic agents, balloon pump, or ventricular-assist device for more than 48 hours after cardiac surgery.

Difference between groups of maximum daily VIS and duration of vasopressors and or inotropic agents support. VIS is calculated as Dopamine dose (mcg/kg/min) + Dobutamine dose (mcg/kg/min) + 100 x Epinephrine dose (mcg/kg/min) + 10 x Milrinone dose (mcg/kg/min) + 10,000 x Vasopressin dose (units/kg/min) + 100 x Norepinephrine dose (mcg/kg/min) + 10 x Phenilephrine dose (mcg/kg/min).

Difference of duration of mechanical ventilation

Difference between groups of ICU-LOS defined as number of days spent in an ICU bed.

Difference between groups of hospital LOS defined as number of days spent in a hospital bed.

Renal biomarkers to evaluate renal tubular injury.

Incidence and severity of AKI related to presence of CKD at baseline, duration of CPB, duration of aortic cross clamp, levels of free Hb, levels of NO consumption, pulmonary pressure at baseline, cardiovascular risks associated with endothelial dysfunction, scheduled procedure and EuroSCORE II.

Difference between groups of Incidence of Delirium will be assessed daily in the first 7 days after surgery by using the confusion assessment method for intensive care unit (CAM-ICU).

Analysis of the quality of life up to 1 year after surgery by the Activity of Daily Living evaluation (by Katz Index) and PROMIS global health.

Evaluation of the overall intrahospital mortality and at 28 6 weeks 90 days and 1 year after surgery

Blood methemoglobin levels will be measured to evaluate the oxidation of oxyhemoglobin in the two groups until 48h after surgery.

Difference between groups of incidence of non fatal stroke will be assessed by at 6 weeks after cardiac surgery.

Incidence of Perioperative and non-perioperative nonfatal myocardial infarction as defined by the third universal definition of MI released in 2012 by the ESC/ACCF/AHA/WHF.

Incidence of postoperative bleeding calculated as the sum of blood loss through thoracic drains from the moment of closure of the chest over a period of 24 hours.

Differences between the two groups of transfusions with plasma and stored or autologous red blood cells (RBCs) recovered using intraoperative cell salvage devices.

Post-operative infections (e.g., pneumonia, wound infection, endocarditis, central line infection, urinary tract infection, sepsis).

Cardiac arrhythmias and other non-cardiac post-operative complications (e.g., hepatobiliary disorders, pneumothorax, pleural effusion, vascular disorders).

Lorenzo Berra, MD

Lorenzo Berra, MD, Assistant Professor, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School

resin/edema

Clinical Applicability of PBS® CIMMO Cement in Pulpotomies

Enamel Matrix Proteins in the Treatment of Intrabony Defects in Patients With Aggressive and Chronic Periodontitis

Effect of Nitric Oxide in Cardiac Surgery Patients With Endothelial Dysfunction.

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