Novel approaches for caries lesion removal and treatment have been proposed. This study evaluates the combined use of an experimental ultrasound, aPDT (antimicrobial photodynamic therapy) and bioactive glasses on the removal, decontamination and remineralization of dentin caries lesions. A biological model created with a duo species biofilm (Streptococcus mutans and Lactobacillus acidophilus) was used for the development of a caries-like lesion over the dentin for 7 days. Bovine dentin specimens (4 × 4 × 2 mm) were randomized according to the following caries removal techniques: bur (BUR) or ultrasound (ULT), decontamination (with or without aPDT) and remineralization materials (45S5 or F18 bioactive glasses). The following different groups were investigated: caries lesion (control); sound dentin (control); BUR; BUR + aPDT; ULT; ULT + aPDT; BUR + 45S5, BUR + F18; ULT + 45S5; ULT + F18; BUR + aPDT + 45S5; BUR + aPDT + F18; ULT + aPDT + 45S5; and ULT + aPDT + F18. Transverse microradiography (TMR), cross-sectional microhardness (CSH), FT-Raman spectroscopy and confocal microscopy (CLSM) were performed. A two-way ANOVA and Tukey’s test were used (α = 0.05). (3) Results: The TMR revealed a lesion depth of 213.9 ± 49.5 μm and a mineral loss of 4929.3% vol.μm. The CSH increases as a function of depth, regardless of the group (p < 0.05). Removal with BUR (24.40–63.03 KHN) has a greater CSH than ULT (20.01–47.53 KHN; p < 0.05). aPDT did not affect the CSH (p > 0.05). No difference was observed between 45S5 or F18 (p > 0.05), but a change was observed for ULT (p > 0.05). The FT-Raman shows no differences for the phosphate (p > 0.05), but a difference is observed for the carbonate and C-H bonds. The CLSM images show that aPDT effectively inactivates residual bacteria. A combination of ULT, aPDT and bioactive glasses can be a promising minimally invasive treatment.

The aim of this study was to evaluate the efficacy of an ultrasound device and the dentin surface morphology after removal of the caries dentin lesions by removal rate and scanning electron microscopy (SEM). The Knoop hardness test on the bovine dentin blocks (n = 20, 4x4x2mm) was performed to standardize the samples and only those with 38 ± 2 KHN were included. The dentin blocks were submitted to induction of artificial caries lesions, using the bacterial model. Strains of Streptococcus mutans and Lactobacillus acidophilus were used for 7 days. The caries dentin lesion was removed for 1 min, according to two methods: G1 - carbide bur under low-speed rotation (control group) and G2 - ultrasound device under refrigeration. For the removal rate, the samples were weighed 3 times: T0 (before induction), T1 (after induction) and T2 (after removal). Morphology evaluation of the residual dentin surface was performed by SEM. Data normality was verified by Shapiro-Wilk test (p ≥ 0.240). T-test for independent samples was applied to evaluate the removal rate. A significance level of 5% was adopted. G2 provided lower removal rate than G1 (G1: 3.68 mg and G2 = 2.26 mg). SEM images showed different morphological characteristics between the groups. G2 showed absent of smear layer, while G1 showed a visible smear layer over the surface. We concluded that ultrasound device provides minimally invasive removal with residual dentin exhibiting open dentin tubules and no smear layer formation and no bacteria, which infer the removal of the infected tissue.

The Brazilian market holds the second position globally in the beauty sector, poised to surpass the USD 50 billion mark in the upcoming years. Aesthetic procedures encompass a spectrum, ranging from non-invasive ones, such as drainage, radiofrequency, ultrasound, and cryolipolysis, to more invasive techniques, including fillers, botulinum toxin, microneedling, micropigmentation, carboxytherapy, and enzyme application. This wide array of treatments has yielded satisfactory cosmetic results for individuals who opt out of surgical procedures. However, despite being categorized as having low complexity, they still carry inherent risks. These risks are often exacerbated by the breach of the skin barrier, the exposure of organs and spaces, or the presence of implantable devices. Among the bacteria most isolated concerning this matter are non-tuberculous Mycobacteria. This study presents descriptive case reports involving three patients under the care of the Infectious Diseases Department at General Hospital of Roraima (HGR). These patients were diagnosed with Mycobacterium abscessus infections subsequent to undergoing enzyme application procedures. Although these cases involve the same microorganism, they exhibit varying degrees of severity, ranging from the development of locally nodular formations to a progression towards sepsis. These cases provide an opportunity to delve into the diagnostic subtleties and clinical implications of these infections while also prompting a critical evaluation of therapeutic strategies. Additionally, the report underscores the potential risks associated with routine aesthetic procedures.

A febre maculosa (FM) é uma doença febril rara causada por bactérias gram-negativas do gênero Rickettsia, transmitidas ao ser humano pela picada de carrapatos, popularmente conhecidos como carrapato-estrela (gênero Amblyomma), que se alimentam de sangue e utilizam diversos animais, como capivaras e equinos, como hospedeiros. Descrita inicialmente na América do Norte no final do século XIX, a FM no Brasil é mais prevalente durante o inverno e início da primavera, afetando principalmente indivíduos que residem próximos a áreas de vegetação densa e habitats de animais silvestres que abrigam carrapatos. Com o objetivo de aprimorar a compreensão sobre a doença e contribuir para o desenvolvimento de estratégias de controle, neste estudo foi realizado uma revisão da literatura sobre FM, abordando os agentes etiológicos, vetores predominantes, manifestações clínicas, diagnóstico, tratamento, medidas preventivas e dados epidemiológicos fornecidos pelo Ministério da Saúde para o período de 2010 a 2024. As buscas foram realizadas nas bases de dados PubMed, LILACS, SciELO e Google Acadêmico, utilizando descritores em português e inglês, como "Febre Maculosa Brasileira", "Rickettsia sp", "Infecção por Rickettsia rickettsii", "Diagnóstico" e "Tratamento. Foram incluídos estudos originais, revisões e documentos oficiais. Os resultados desta revisão indicam que a FM exige diagnóstico precoce e tratamento imediato, preferencialmente com doxiciclina, para reduzir a letalidade e prevenir complicações graves. Medidas profiláticas, como evitar áreas infestadas por carrapatos e realizar inspeções corporais frequentes, são essenciais para a prevenção. Este estudo destaca a necessidade de mais pesquisas para ampliar o conhecimento sobre FM e aprimorar estratégias de controle e prevenção da doença no Brasil. Palavras-chave: Febre Maculosa Brasileira. Carrapato Estrela. Riquetsioses. Saúde pública.