Retrospective analysis of survival of avulsed and replanted permanent teeth according to 2012 or 2020 IADT Guidelines

Abstract This study aimed to compare the survival of replanted teeth that followed the 2012 or the 2020 International Association of Dental Traumatology (IADT) guidelines. Sixty-two permanent replanted teeth were retrospectively assessed (IADT 2012, n = 45; IADT 2020, n = 17). Five years after replantation (from January 2017 to December 2021), clinical and radiographic examinations were performed. A significance level of 95% was considered to evaluate the outcomes. Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour. Twelve teeth remained in their sockets without resorption: 8 (66.7%) were replanted within one hour, 2 (16.7%) followed the 2012 IADT, and 2 (16.7%) the 2020 IADT guidelines for late replantation. There was a significant difference (p <0.05) in the extra-alveolar time (< one hour), but without difference between the guidelines in late replantation (p > 0.05). Replanted teeth following both, 2012 or 2020 IADT guidelines, have similar clinical outcomes. The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket.

Resumo Este estudo teve como objetivo comparar a sobrevida, por cinco anos, de dentes reimplantados que seguiram as diretrizes de 2012 ou 2020 da International Association of Dental Traumatology (IADT). Sessenta e dois dentes permanentes reimplantados foram avaliados retrospectivamente (IADT 2012, n = 45; IADT 2020, n = 17). Cinco anos após o reimplante, foram realizados exames clínicos e radiográficos. Foi considerado um nível de significância de 95% para avaliar os desfechos. Trinta e um dentes (50,0%) permaneceram em seus alvéolos e 31 (50,0%) foram perdidos por reabsorção radicular externa. Dos 25 (40,3%) dentes reimplantados em uma hora, 16 (64,0%) permaneceram em seus alvéolos e 9 (36,0%) foram perdidos. Vinte e dois (71,0%) de todos os 31 dentes perdidos tiveram um tempo extra-alveolar superior a uma hora. Doze dentes permaneceram em seus alvéolos sem reabsorção: 8 (66,7%) foram reimplantados em uma hora, 2 (16,7%) seguiram a IADT de 2012 e 2 (16,7%) as diretrizes da IADT de 2020 para reimplante tardio. Houve diferença significativa (p<0,05) no tempo extra-alveolar (< uma hora), mas sem diferença entre as diretrizes no reimplante tardio (p > 0,05). Dentes reimplantados seguindo as diretrizes de 2012 ou 2020 da IADT, tiveram taxas de sucesso semelhantes. O tempo extra-alveolar inferior a uma hora demonstrou ser importante para manter o dente permanente em seu alvéolo.

Calcium hydroxide diffusion after agitation of endodontic irrigants: an ex vivo study

Aim: To compare the influence of two methods of agitation of endodontics irrigants, by diffusion of calcium hydroxide [Ca(OH)2] through the dentinal tubules, measuring the pH of the medium where they were kept. Methods: Twenty mandibular incisors were prepared using a WaveOne Gold Large file, in a reciprocating movement, and then divided into (n = 10): gutta-percha cone (GPC) or Easy Clean system (ECS) agitation of 1% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The specimens were filled with Ca(OH)2 paste, placed in flasks with 4 mL of deionized water, and stored in an incubator. The pH was read using a digital pH meter immediately after storage (T0), after 7 (T1), 14 (T2), 21 (T3), and 35 (T4) days. Results: Statistical difference between groups was observed regardless of the day pH was measured (p < 0.01). From T2 on, ECS presented higher pH values in comparison with GPC, with significant difference (p < 0.01). Conclusion: Agitation of endodontic irrigants with ECS enhances the Ca(OH)2 diffusion, providing higher pH values, from the 14th day on, when compared with GPC

Cleaning of long oval canals with WaveOne Gold system associated with different irrigant agitation protocols

Aim: The aim of the study was to evaluate the cleaning of mandibular incisors with WaveOne Gold® (WO) under different preparation techniques. Methods: A total of 210 human mandibular incisors were selected and divided into seven groups (n = 30), prepared by WO single-files (Small 20/.07 ­ WOS; Primary 25/.07 ­ WOP; Medium 35/.06 ­ WOM; or Large 45/.05 - WOL) and sequential-file techniques (WOS to WOP; WOS to WOM; and WOS to WOL). Further subdivision was made according to irrigation protocol: control group (manual irrigation - CON), E1 Irrisonic® - EIR, and EDDY® - EDD. Debris removal and the smear layer were evaluated by scanning electron microscopy. Data were analyzed by using Spearman's correlation test. The significance level was set at 5%. Results: For debris and smear layer removal, WOS and WOP, EIR differed from CON and EDD (p <0.05). Conclusion: Regardless of the instrumentation used, the agitation of the irrigant solution provided better cleanability. These findings reinforce the need for agitation techniques as adjuvants in cleaning root canal systems in mandibular incisors

Atendimento de pacientes com necessidades especiais em Centros de Especialidades Odontológicas brasileiros: uma revisão integrativa da literatura / Care provided to patients with special needs in Brazilian Dental Specialty Centers: an integrative review of the literature

Objetivo:Fazer uma revisão integrativa a respeito do atendimento de pacientes com necessidades especiais (PNE) em Centros de Especialidades Odontológicas (CEO) no Brasil. Métodos: Para as buscas nas bases eletrônicas PubMed, BBO e LILACS, e Google Scholar, foram utilizados em português, espanhol e inglês, os descritores e termos livres: "pessoas com deficiência", "pessoa com necessidade especial", "pessoa com incapacidade", odontologia, "atenção secundária à saúde", "atenção secundária", "centro de especialidades odontológicas", CEO, "disabled persons", handicapped, "people with disabilities", dentistry, "secondary care", "dental specialty center" ,"secondary care centers", "personas con discapacidad", "atención secundaria de salud" e "centro de especialidad dental". Não foi feita restrição quanto ao idioma, mas o período consultado foi de 2016 a 2021. Incialmente foram excluídas as duplicatas, em seguida os textos cujos títulos e resumos não estivessem de acordo com os critéios de inclusão. Uma vez eleitos os textos a serem incluídos após leitura na íntegra, foi feita a extração dos dados de interesse: autor (ano), tipo de estudo, caracterização da amostra, local, objetivo, resultados principais e conclusão. A análise da qualidade metodológica e do risco de viés dos estudos foi feita por meio da ferramenta Quality Assessment Tool for Quantitative Studies do Effective Public Health Practice Project. Resultados: De 383 estudos, cinco foram incluídos. As barreiras mencionadas que dificultam o acesso dos PNE aos CEO se referiram a questões socioeconômicas e demográficas, localização dos CEO, escassez de recursos financeiros, limitações para acessibilidade e qualificaçao profissional deficitária para a prestação dos atendimentos. A qualidade metodológica foi considerada fraca em todos os estudos, o que indica alto risco de viés. Conclusão: Mesmo com a evolução gradativa do atendimento dos PNE nos CEO, ainda há aprimoramentos necessários, tanto em relação à qualificação dos profissionais para que tenham conhecimento e manejo para realizar os atendimentos seguindo os protocolos necessários, quanto à melhoria do acesso para esses pacientes.

Aim: To conduct an integrative review regarding the care provided to patients with special needs (PSN) in Dental Specialty Centers (DSCs) in Brazil. Methods: To perform searches in the PubMed, BBO and LILACS, and Google Scholar electronic databases, the following descriptors and free terms were used, in three languages of Portuguese, Spanish, and English: "pessoas com deficiência", "pessoa com necessidade especial", "pessoa com incapacidade", odontologia, "atenção secundária à saúde", "atenção secundária", "centro de especialidades odontológicas", CEO, "disabled persons", handicapped, "people with disabilities", dentistry, "secondary care", "dental specialty center" ,"secondary care centers", "personas con discapacidad", "atención secundaria de salud" e "centro de especialidad dental". No language restriction was made, but the period consulted was from 2016 to 2021. First, duplicates were excluded. After, texts whose titles and abstracts did not comply with the inclusion criteria were also excluded. Once the included texts had been chosen, and after reading them in full, the data of interest was extracted: author (year), type of study, sample characterization, location, objective, main results, and conclusion. The Quality Assessment Tool for Quantitative Studies of the Effective Public Health Practice Project was used to analyze the methodological quality and risk of bias found in the studies. Results: Of the 383 studies, five were included. The barriers that make it difficult for PSNs to access DSCs are related to socioeconomic and demographic issues, the location of DSCs, the scarcity of financial resources, limitations in accessibility, and deficient professional qualification to provide proper care. Methodological quality was considered weak in all studies (100%), with a high risk of bias. Conclusion: Even with the gradual evolution of the care provided to PSNs in DSCs, improvements are still necessary, both in relation to the qualification of professionals so that they have the knowledge and handling necessary to perform the care following the necessary protocols, as well as the improvement of access for these patients.

Influence of different reciprocating systems on the apical extrusion of debris in flat-oval canals

Aim: To evaluate the apical extrusion of debris in flat-oval canals, using three reciprocating systems at two different working lengths (WL), 0 mm and 1 mm from the apical foramen. Methods: Ninety mandibular incisors were randomly divided into three groups based on the systems: WaveOne Gold #25.07 (WOG), ProDesign R #25.06 (PDR), and X1 Blue #25.06 (X1B). Extruded debris were collected and dried in pre-weighed Eppendorf tubes. Three consecutive weighings were performed for each tube, and the mean was calculated. If the assumptions of normality and homogeneity of variance were not met, the Kruskal-Wallis test was used to analyze the amount of extruded debris between groups with the same WL, and the Mann-Whitney U test was used for comparison within groups for each WL. Results: All groups had extruded debris, with higher median values occurring at 1 mm. No significant difference regarding the amount of debris extrusion was observed at 0 mm (p>0.05) and 1 mm (p>0.05) between groups. However, within the groups, at different WL, there was greater extrusion at 1 mm (p<0.05), with PDR differing significantly from the other systems (p<0.05). Conclusion: The extrusion of debris occurred regardless of the group, with higher values at 1 mm. However, using PDR at 1 mm from the apical foramen showed the highest values of extrusion

Perfil do usuário do Sistema Único de Saúde no município de Curitiba, Paraná, com necessidade de tratamento odontológico / Profile of Unified National Health System' users, requiring specialized dental treatment, in Curitiba, Paraná

Objetivo: Delinear o perfil de usuários que aguardam na lista de espera pelo atendimento odontológico especializado em Endodontia em dois Centros de Especialidades Odontológicas (CEO) do município de Curitiba, Paraná. Métodos. Neste estudo transversal foram coletados e classificados dados de 7072 usuários conforme gênero, idade, Distrito Sanitário (DS) em que o atendimento básico foi prestado e data de entrada na lista de espera. Os dados foram submetidos aos testes Qui-quadrado para independência, seguidos do teste de acompanhamento de resíduos ajustados de Marascuilo. Resultados: Dos usuários pesquisados que aguardavam, 63,0% eram mulheres. A faixa etária prevalente foi de 15 a 34 anos (p<0,05). Diferença estatisticamente significativa foi encontrada quanto aos atendimentos nos DS (p<0,05). O DS Matriz teve a menor frequência de inclusão na lista de espera em comparação com os demais; já os DS Bairro Novo (13,5%), Cidade Industrial de Curitiba (13,7%), Boa Vista (14,5%), Boqueirão (14,8%) e Pinheirinho (15,2%) apresentaram as maiores frequências. Por fim, em relação aos atendimentos na série temporal, diferença significativa entre os meses foi identificada (p<0,01). Conclusão: O perfil dos usuários encontrados na lista de espera para atendimento endodôntico em Curitiba, no período analisado, conta com maior prevalência de mulheres, de indivíduos entre 15 a 34 anos, distribuídos de maneira desigual dentre os DS e meses do ano, sendo este último dado resultante de ações da Secretaria Municipal de Saúde.

Objective: The aim of this study was to delineate the profile of users in the waiting list for specialized endodontic dental care in two Dental Specialty Centers (DSC) of the city of Curitiba, Paraná. Methods: In this cross-sectional study, data from 7,072 users were collected and classified according to gender, age, Sanitary District (SD), and date of entry in the waiting list. Data were submitted to Chi-square tests for independence, followed by Marascuilo's adjusted residuals test. Results: Of the users on the waiting list surveyed, 63.0% were women. The prevalent age group was 15- to 34 years (p<0.05). Statistical difference was found regarding attendance at the SD (p<0.05). The SD Matriz had the lowest frequency of inclusion in the waiting list compared to the others; SD Bairro Novo (13.5%), Cidade Industrial de Curitiba (13.7%), Boa Vista (14.5%), Boqueirão (14.8%) and Pinheirinho (15.2%) presented the highest frequencies. Finally, regarding the time series attendances, a significant difference between the months was identified (p <0.01). Conclusion: The profile of users found in the waiting list for endodontic care in Curitiba, during the analyzed period, has a higher prevalence of women, between 15 and 34 years old, and unequally distributed among the SD and months of the year, the latter being the result of actions of the Municipal Health Office.

Descoloração da coroa após obturação endodôntica com diferentes cimentos: estudo clínico / Crown discoloration after endodontic obturation with different cements: a clinical study

Objetivo: O objetivo do presente estudo foi avaliar clinicamente a descoloração da coroa dentária após obturação do canal radicular com diferentes cimentos endodônticos. Métodos: Trinta e dois dentes foram tratados endodonticamente e obturados com AH Plus (AHP), Endofill (END), MTA Fillapex (MTA) ou Sealer 26 (SEA), divididos em oito pacientes por grupo. O registro das cores foi realizado com um espectrofotômetro antes da intervenção (T0 ), aos 30 (T1 ) e aos 90 dias após a intervenção (T2 ). As avaliações foram feitas no centro da coroa dentária e a variação de cor (ΔE) foi calculada por meio da Commission International de l'Eclai- rage (CIE) L*a*b. Um operador, especialista em Endodontia, realizou os procedimentos clínicos. Os dados foram submetidos a medidas repetidas ANOVA e teste de Tukey (Δ=5%). Resultados: Não houve diferença estatisticamente significativa na variação de cores entre os cimentos (AHP ΔE=4,11; END ΔE = 6,34; SEA ΔE = 8,77 e MTA ΔE = 12,15), p>0,05. Porém, houve diferença entre os períodos analisados (T1ΔE= 5,65; T2 ΔE = 10,02). Conclusões: Dentro das limitações deste estudo, todos os cimentos endodônticos causaram alterações cromáticas clinicamente perceptíveis na coroa dentária. No entanto, o AH Plus promoveu menos alterações cromáticas na coroa dentária (AU).

Introduction: The aim of this study was to evaluate the crown discoloration after root canal filling with different endodontic cements clinically. Methods: Thirty-two teeth were endodontically treated and filled with AH Plus (AHP), Endofill (END), MTA Fillapex (MTA), or Sealer 26 (SEA), divided into eight patients per group. Color recording was performed with a spectrophotometer before the intervention (T0 ) and at 30 (T1 ) and 90 days post-intervention (T2 ). The evaluations were done in the center of the dental crown and color variation (ΔE) was calculated by means of the Commission International de IEclairage (CIE) L*a*b. The data were subjected to repeated measures ANOVA and Tukeys test (alpha=5%). Results: There was no statistically significant difference in color variation between the cements (AHP ΔE=4.11; END ΔE=6.34; SEA ΔE=8.77, and MTA ΔE=12.15), p>0.05. However, there was a difference between the periods tested (T1 ΔE=5.65; T2 ΔE=10.02). Conclusions: All tested endodontic cements altered the color of dental crowns (AU).

Effects of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide on adhesion of posts in teeth obturated with different sealers

Abstract The aim of this study was to evaluate the effect of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) on bond strength of fiberglass posts in root canals obturated with different endodontic sealers. Seventy-eight mandibular premolars were obturated with three sealers (n=26): Endofill (END), AH Plus (AHP), and Endosequence BC Sealer (EBS). After preparation of the post space, two subgroups were formed according to the cementation of the posts (n=13): with EDC (EDC), and without EDC (control - CON). The specimens were submitted to a pull-out test, failure mode classification, and root canal surface evaluation by scanning electron microscopy after post displacement. Regarding the bond strength, a significant difference between the EDC and CON subgroups occurred only in the END (p=0.001). No difference was detected among the CON subgroups (p=0.339). However, among the EDC subgroups, AHP presented significantly higher values (END versus AHP: p=0.001; AHP versus EBS: p=0.016). Upon classification of failure modes, score 1 (≥ 50% of cement) was the most commonly observed, except for the END + EDC. Remains of endodontic sealers and resin cements were found in the cervical third, but without statistical difference (p=0.269), while in the middle third, difference occurred (p=0.004). In conclusion, EDC decreases bond strength when associated with END sealer, without changing the failure mode between the resin cement and fiberglass post. The best performance was observed when EDC was combined with AHP sealer.

Resumo O objetivo deste estudo foi avaliar o efeito da 1-etil-3- (3-dimetilaminopropil) carbodiimida (EDC) na resistência de união de pinos de fibra de vidro em canais radiculares obturados com diferentes cimentos endodônticos. Setenta e oito pré-molares inferiores foram obturados com três cimentos endodônticos (n=26): Endofill (END), AH Plus (AHP) e Endosequence BC Sealer (EBS). Após o preparo do espaço para pino, dois subgrupos formaram-se conforme a cimentação dos pinos (n=13): com EDC e sem EDC (controle - CON). Os espécimes foram submetidos ao teste pull-out, classificação do modo de falha e avaliação da superfície do canal radicular por microscopia eletrônica de varredura após o deslocamento. Quanto à força de resistência de união, uma diferença estatisticamente significativa ocorreu entre os subgrupos EDC e CON apenas no END (p=0,001). Não foi detectada diferença entre os subgrupos CON (p=0,339). Contudo, no subgrupo EDC, o AHP apresentou maiores valores (END versus AHP: p=0,001; AHP versus EBS: p=0,016). Acerca da classificação dos modos de falha, o escore 1 (≥50% de cimento) foi o mais comumente observado, exceto para END + EDC. Restos de cimentos endodônticos e cimentos resinosos foram encontrados no terço cervical, mas sem diferença estatística (p=0,269), enquanto no terço médio, houve diferença (p=0,004). Em conclusão, o EDC diminui a resistência de união quando associado ao cimento END, sem alterar o modo de falha entre o cimento resinoso e o pino de fibra de vidro. O melhor desempenho foi observado quanto o EDC foi usado com o cimento AHP.

Association of taste receptor gene polymorphisms with dental caries

Abstract This study was performed to evaluate the interplay between dental caries, nutritional status, and genetic polymorphisms in TAS1R1 and TAS1R2 (taste receptor, type 1, member 1 and 2) in preschool children and pre-adolescents. We included 525 subjects (306 preschool children and 219 pre-adolescents). Parents/caregivers answered a self-administered questionnaire about their children's systemic health, characteristics, oral hygiene habits, and diet. Clinical examination was performed to evaluate dental caries and nutritional status. Saliva samples were collected for DNA extraction. The genotyping of rs17492553 ( TAS1R1 ), rs3935570, and rs4920566 ( TAS1R2 ) polymorphisms was performed using real-time PCR with Taqman Genotyping Master Mix and SNP assay. Both univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis. In preschool children, consumption of sweets between meals increased the prevalence of dental caries by 85% (PR c = 1.85; 95%CI 1.39-2.46; p < 0.001), whereas in pre-adolescents, this prevalence increased by 34% (PR a = 1.34; 95%CI 1.11-1.62; p = 0.002), regardless of genetic polymorphisms . Moreover, individuals carrying at least one allele C in rs17492553 presented 23% more prevalence of dental caries (PR a = 1.23; 95%CI 1.02-1.49 p = 0.030). Nutritional status was not associated with dental caries, neither with genetic polymorphisms . Consumption of sweets between meals increased the prevalence of dental caries. In pre-adolescents, rs17492553 genetic polymorphism in TAS1R1 was associated with dental caries.

The feminization of dentistry and the perceptions of public service users about gender issues in oral health / A feminização da odontologia e as percepções dos usuários do serviço público sobre as questões de gênero em saúde bucal

Abstract It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to "active listening", while those who prefer to be cared for by male dentists highlight the attributes of "care integration" and "community guidance". In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.

Resumo Investigou-se a percepção dos usuários do serviço quanto à prática profissional dos dentistas, com base em diferenças de gênero. O Primary Care Assessment Tool (PCATool) foi aplicado a 900 usuários do Serviço Público de Curitiba, PR, Brasil. Sessenta clínicas odontológicas foram selecionadas usando amostragem aleatória, divididas entre unidades de Atenção Primária à Saúde (APS) convencional e unidades de APS com Estratégia Saúde da Família. Os atributos da APS no PCATool foram analisados. Uma questão foi adicionada acerca da preferência do usuário em relação ao gênero do dentista, gerando quatro díades derivadas da combinação do gênero do usuário/gênero do dentista (FF, FM, MM, MF). Os atributos foram ligados às díades pelo teste t para amostras independentes. Por regressão logística, as díades foram relacionadas a 23 fatores referentes aos cuidados ampliados na APS. Muitos usuários mostraram preferência por dentistas mulheres. Esses tendem a avaliar melhor os cuidados de saúde primários quanto à "escuta ativa e qualificada", enquanto aqueles que preferem ser atendidos por homens destacam os atributos de "integração do cuidado" e "orientação comunitária". Em outros fatores e atributos estudados, não há diferença entre o atendimento prestado por homens ou mulheres, independentemente da unidade.

Perfil dos pacientes atendidos na clínica de odontopediatria de uma universidade privada de Curitiba, PR, Brasil / Profile of patients attended in the clinic of pediatric dentistry of a private university of Curitiba, PR, Brazil

Introdução: Propôs-se traçar o perfil dos pacientes atendidos na Clínica de Odontopediatria da Universidade Positivo, Curitiba, PR, Brasil. Métodos: Com desenho analítico, observacional e transversal, foram selecionados todos os prontuários (n=1527) dos pacientes atendidos no período de janeiro de 2009 a dezembro de 2017. As informações coletadas foram: ano de atendimento, gênero, cor da pele, motivo da consulta, idade da primeira consulta, hábitos deletérios, escovação e uso do fio dental. Os dados foram tabulados e apresentados em tabelas de frequências por meio do SPSS, versão 21. Resultados: A média da idade foi igual a 8 } 2,7 anos, com maior frequência de meninas (51,3%) e crianças de cor branca (83,7%). Como motivo da consulta houve predomínio da categoria "rotina" (43,5%) e "tratamento ortodôntico" (20,6%). A maioria das crianças (69,4%) realizou a primeira consulta na clinica com idade superior a quatro anos. Constatou-se que 52,9% das crianças não apresentaram hábitos deletérios. Em relação a escovação dentaria, 99,0% da amostra relataram faze-la, entretanto, o uso do fio dental não foi uma pratica adotada por boa parte dos pesquisados (64,6%). Conclusões: O perfil aqui determinado poderá servir de subsídios para o desenvolvimento de estratégias de promoção e de recuperação da saúde ofertadas pelo serviço em questão.

Introduction: It was proposed to delineate the profile of patients attended in the Pediatric Dentistry Clinic of Universidade Positivo, Curitiba, PR, Brazil. Methods: With analytical, observational and cross-sectional design, all records (n=1,527) of patients attended in the period from January 2009 to December 2017, were selected. The data collected were: year of attendance, gender, skin color, reason for consultation, age at first examination, deleterious habits, brushing, and flossing. Data were tabulated and shown in frequency tables using the SPSS, version 21. Results: The mean of the age was 8 } 2,7 years old, with higher frequency of girls (51.3%) and white children (83.7%). The prevailing reason for the consultation was "routine" (43.5%) and "orthodontic treatment" (20.6%). Most of the children (69.4%) performed the first consultation above four years of. It was found that 52.9% of children did not present showed deleterious habits. Regarding tooth brushing, more than 99.0% of the sample reported doing so, however, the use of dental floss was not a practice adopted by a good part of the total sample of researched (64.6%). Conclusions: The profile determined here may serve as a basis for the development of health promotion and recovery strategies offered by the service in question.

Bond strength at the cement/dentin interface according to protocols for final irrigation of post space

Aim: The aim was to evaluate the bond strength at the cement/dentin interface in the post space, after specimens were treated with different final irrigation protocols, followed by cementation with a dual resin cement. Methods: Forty-eight extracted uniradicular human premolars were divided into four groups according to the irrigation (n = 12): control with distilled water; 2.5% sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA); 2.5% NaOCl + passive ultrasonic irrigation (PUI); and 2% chlorhexidine (CHX). The pull-out test was performed. The results were evaluated using ANOVA with Tukey's paired comparisons, with a significance of 5%. Results: When all groups were compared, significant difference occurred (p = 0.006), and in the paired comparison, NaOCl + PUI and CHX differed (p = 0.005). The CHX showed significantly higher adhesive defects between cement and dentin than other groups. Conclusions: The final irrigation protocol for cleaning after preparation for post space directly influences the bond strength at the cement/dentin interface

Grau de satisfação entre os usuários de uma unidade básica de saúde no estado do Paraná, Brasil / Degree of satisfaction among users of a basic health unit in the state of Paraná, Brazil

OBJETIVOS: Avaliar o grau de satisfação dos usuários com a estrutura e os serviços prestados em uma unidade básica do Sistema Único de Saúde. MÉTODOS: Este estudo transversal incluiu indivíduos com idade ≥18 anos, de ambos os gêneros, entrevistados individualmente de março a maio de 2018 na unidade básica de saúde Ferraria, em Campo Largo, Paraná, Brasil. Um questionário estruturado continha informações sociodemográficas e questões adaptadas do instrumento utilizado no Programa Nacional de Avaliação de Serviços de Saúde, acerca da satisfação com a equipe, tempo de espera e estrutura física local. A análise descritiva dos dados foi seguida dos testes U de Mann-Whitney, Kruskal-Wallis, Qui-quadrado e regressão de Poisson, considerando como significativo p<0,05. RESULTADOS: A amostra foi constituída por 373 usuários que atenderam aos critérios de inclusão, sendo 72,9% do gênero feminino, 82,8% de raça/cor da pele branca, 69,0% com baixa renda e 36,4% com baixa escolaridade. A equipe de saúde foi o item melhor avaliado (73,3% das respostas nas categorias "muito bom" e "bom"); e o tempo de espera para o atendimento foi o item pior avaliado (61,5% "ruim" ou "muito ruim"). Na análise bivariada o atendimento da equipe de saúde não foi associado a nenhuma variável independente. Na avaliação geral do estabelecimento, as categorias "muito bom/bom", "regular", "ruim" e "muito ruim" foram avaliadas respectivamente por 84 (27,4%), 128 (41,7%), 67 (21,8%) e 28 (9,1%) brancos; e 22 (34,9%), 34 (54,0%), 7 (11,1%) e 0 (0,0%) não brancos (p=0,006). No modelo de regressão de Poisson, a baixa escolaridade foi associada a uma chance 1,5 vezes maior de não saber onde reclamar em caso de mau atendimento. CONCLUSÕES: O grau de satisfação dos usuários da unidade básica de saúde Ferraria foi influenciado por fatores como raça/cor da pele e escolaridade. Os usuários não brancos expressaram um grau de satisfação maior do que os usuários brancos; e aqueles com baixa escolaridade sabiam menos onde reclamar caso o atendimento não fosse satisfatório. Apesar da avaliação em geral ter sido positiva, alguns quesitos foram identificados como não satisfatórios, merecendo medidas corretivas.

AIMS: To evaluate the users' degree of satisfaction with the structure and services provided in a Basic Health Unit of the Public Health System. METHODS: This cross-sectional study included individuals aged ≥18 years, of both genders, individually interviewed from March to May 2018 at the Ferraria Basic Health Unit, Campo Largo, Paraná, Brazil. A structured questionnaire contained sociodemographic information and questions adapted from the instrument used in the National Health Services Evaluation Program, regarding satisfaction with the staff, waiting time and local physical structure. Descriptive analysis of the data was followed by the Mann-Whitney U, Kruskal-Wallis, Chi-square and Poisson regression tests. Values of p<0.05 were considered statistically significant. RESULTS: The sample consisted of 373 users who met the inclusion criteria, of whom 72.9% were female, 82.8% were white race/skin color, 69.0% had low income and 36.4% had low schooling. The health team was the best evaluated item (73.3% of answers in the categories "very good" and "good"); and the waiting time for service was the worst evaluated item (61.5% of answers "bad" or "very poor"). In the bivariate analysis, the health team care was not associated with any independent variables. In the general evaluation of the establishment, the categories "very good/good", "regular", "bad" and "very bad" were evaluated respectively by 84 (27.4%), 128 (41.7%), 67 (21.8%) and 28 (9.1%) white users; and 22 (34.9%), 34 (54.0%), 7 (11.1%) and 0 (0.0%) non-white users (p=0.006). In the Poisson regression model, low schooling was associated with a 1.5 times greater chance of not knowing where to complain in case of poor care. CONCLUSIONS: The degree of satisfaction of the users of the Ferraria Basic Health Unit was influenced by factors such as race/skin color, income and schooling. Non-white users expressed a higher degree of satisfaction than white users. Users with low schooling knew less where to complain if service was not satisfactory. Although the evaluation was generally positive, some items were identified as unsatisfactory, deserving corrective measures.

Long-term evaluation of crown and root discoloration induced by different endodontic sealers

Aim: To evaluate crown and root discoloration promoted by different endodontic sealers after root canal filling. Methods: Eighty bovine incisors were prepared and filled with: Endofill, Sealer 26, AH Plus, and MTA Fillapex. Color was recorded using a spectrophotometer before endodontic treatment (T0) and at 24 hours (T1), seven days (T2), 30 days (T3), and 90 days (T4) after treatment. Analyses were performed on the middle and cervical regions of the crown, and on the cervical third of the root, immediately below the cementoenamel junction. The color alterations (ΔE) were calculated using Commission International de I'Eclairage (CIE) L*a*b parameters, and data were analyzed by analysis of variance (ANOVA) and Tukey's test (p<0.05). Results: All sealers induced color alterations. Sealer 26 resulted in the smallest changes in color (E = 5.32). The other materials did not present statistical differences (AH Plus E = 6.98; MTA Fillapex E = 6.88; Endofill E = 6.41). Of the three regions analyzed, the largest discoloration was observed at the cervical third of the root (E=10.67). In terms of time, the largest ΔE values (E=7.72) were observed at T4. Color changes at T1 (E=5.88), T2 (E=6.10), and T3 (E=5.89) were statistically similar. Conclusions: All endodontic sealers promoted discoloration on the tooth crown and root

Inequalities in the workforce distribution in the Brazilian Dentistry / Desigualdades na distribuição da força de trabalho na Odontologia brasileira

ABSTRACT This article aimed to describe the distribution of dental professionals in Brazil, through a narrative review. The approach is based on the assumptions which lead the individual in choosing such career and as well as their fragmented current practices due to the university educational curriculum process. Furthermore, data are revised on the geographical distribution of these individuals and the potential impacts, among others, in the epidemiological profile of the population oral health problems. It was evident that the workforce shifts as presented in different ways in society and influenced by social needs, public policy and market, play special roles. It discusses the urgency of socio-spatial redistribution of dentists, a role to be played collaboratively among different States in Brazil, regulatory and social control agencies. Finally, the role of dental courses in forming active subjects was highlighted, in the process of health improvement, aiming to build a more equitable and just society.

RESUMO O presente artigo teve por objetivo descrever a distribuição dos profissionais da área odontológica no Brasil, por meio de uma revisão narrativa. A abordagem parte dos pressupostos que levam o indivíduo a optar por essa carreira e passa à observação das práticas atuais fragmentadas em virtude do processo de formação universitária. Ainda, são revistos dados relativos à distribuição geográfica destes indivíduos e os possíveis impactos, dentre outros, no perfil epidemiológico de problemas bucais da população do país. Evidenciou-se que a força de trabalho se desloca/fixa de formas diferentes na sociedade e sofre influência das necessidades sociais, das políticas públicas e do mercado. Discute-se a premência da redistribuição socioespacial dos cirurgiões-dentistas, papel a ser desempenhado de modo colaborativo entre Estado, órgãos fiscalizadores e instâncias de controle social. Por fim, destacou-se a função dos cursos de Odontologia em formar sujeitos atuantes no processo de melhorias no setor da saúde, com vistas a uma sociedade mais equânime e justa.

Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules

Abstract: The aim of this study was to compare two irrigation techniques and four devices for endodontic sealer placement into the dentinal tubules. Ninety-nine single-rooted human teeth were instrumented and allocated to either the control (CO) (n=11) or experimental groups according to the irrigation method: syringe and NaveTip needle (NT) (n=44), and EndoActivator (EA) (n=44). These groups were subdivided according to sealer placement into K-File (KF), lentulo spiral (LS), Easy Clean (EC), and EndoActivator (EA) subgroups. Moreover, the distances of 5 mm and 2 mm from the apex were analyzed. The teeth were obturated with AH Plus and GuttaCore X3. Analyses were performed by scanning electron microscopy associated to cathodoluminescence. The percentage and maximum depth of sealer penetration were measured. Data were evaluated by three-way analysis of variance (ANOVA) and Games-Howell test (p<0.05). EA was superior to NT in percentage of sealer penetration. EC was significantly superior to EA (subgroup) for sealer penetration, and both improved the percentage of sealer penetration when compared to LS. Better sealer penetration was observed at the distance of 5 mm from the apex. Sealer penetration into the dentinal tubules was significantly improved by sonic irrigant activation.

Prevalence of oral diseases, socioeconomic indicators, and provision of dental services: exploring nexus

Introduction and objective: A number of studies have associated prevalence of oral diseases, socioeconomic factors, and dental services in Brazil, and this study aimed to review, in narrative mode, the causal nexus between them. Literature review: The high prevalence of dental problems such as caries and periodontal disease is still found worldwide, despite the significant reduction. The impacts resulting from tooth loss are not limited to the physical condition, but also to the social aspects. The association between oral diseases and microbiological and hygiene factors is recognized, but deficient as explanatory power. The discussion of correlated factors, associated with the development of relevant oral diseases and marking existing inequities, must be expanded. Conclusion: The factors studied showed an involvement, indicating that inequities in oral health are striking in the Brazilian population, with serious consequences. Efforts are needed to control and modify this context.

Influence of calcium hydroxide dressing and two irrigants on the filling of artificial lateral canals.

Context: This study was carried out on the assumption that calcium hydroxide [Ca(OH)2] dressing and irrigants may influence the obturation of lateral canals. Aims: To evaluate the influence of 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) gel and Ca(OH)2 on the filling of artificial lateral canals. Settings and Design: Ex vivo quantitative laboratory study. Materials and Methods: Forty‑two human mandibular premolars were selected. After cavity access, six lateral canals were performed, two in each root section, one mesial and one on the distal root surface. After preparation, the specimens were randomly divided into four groups: Group I: Under irrigation with 2% CHX and saline solution and with intracanal dressing Ca(OH)2 paste; Group II: The same preparation as Group I, but without Ca(OH)2; Group III: Under irrigation with 2.5% NaOCl without Ca(OH)2; and Group IV: The same preparation as Group III, but with Ca(OH)2. Two teeth without intracanal dressing were used as negative controls. Lateral condensation technique was performed. Then, digital radiographic images were obtained. Statistical Analysis Used: Data were analyzed using SPSS 17.0, submitted to Kappa (reliability between examiners) and Kruskal–Wallis test. Results: No statistical difference was registered between Groups II and III in all root sections (P > 0.05), but it was observed between Groups I and IV (P < 0.05), except on the apical section (P > 0.05). In all sections, the Group I filled more artificial lateral canals than in Group IV. Conclusions: The irrigants tested had no influence on the filling of artificial lateral canals. Nevertheless, intracanal dressing of Ca(OH)2 influenced this filling.

Oral health status of patients with special needs from a rehabilitation association in Curitiba (PR, Brazil)

Introduction:Patients with special needs commonly show significant systemic and oral diseases. Objective:We carried out a survey on the oral health status from individuals with special needs of Associação Paranaense de Reabilitação (APR), in Curitiba, PR, Brazil. Material and methods: Clinical oral examination was performed and a specific questionnaire was applied to 87 individuals, aged from 5 to 14 years-old. Results: The mean age average was 9 yearsold, and 57.5% were males. The mean DMFT was 1.4, and 54% of the sample showed DMFT = zero. The oral health status from the studied sample was similar to that found in the same age group of the general population. Conclusion: We indicate that strategies for controlling oral health diseases tailored for this group must be stimulated, once the vulnerability is present.

Perfil sociodemográfico e condição bucal de usuários de drogas em dois municípios do Estado do Paraná, Brasil / Sociodemographic profile and oral condition of drug users in two municipalities of the State of Paraná, Brazil

Introdução: A pesquisa das condições bucais de usuários de drogas é importante para ser conhecida esta população, cujo crescimento é ascendente no Brasil, a fim de que metas preventivas e atendimento adequado sejam traçados. Objetivo: Identificar o perfil sociodemográfico e a condição bucal desta população, em dois municípios paranaenses. Material e método: Foram coletados, por meio de questionário e de exame físico, dados de 100 indivíduos. Foram obtidos os seguintes valores: índice CPOD, profundidade de sondagem (PS), nível de inserção clínica (NIC), índice gengival (IG), índice de placa (IP) e sangramento à sondagem (SS). Após análise descritiva inicial, empregaram-se os testes t de Student e ANOVA one way. Resultado: A média da idade foi 29,12 anos. As maiores frequências foram: gênero masculino (95,5%), solteiros (69,0%), baixa escolaridade (41%) e maior consumo de drogas lícitas - tabaco (90,9%) e álcool (84,5%) - seguidas de crack (80,9%) e maconha (77,3%). A média do CPOD foi 15,21 (DP=5,84) e quanto maior o tempo de dependência, maior este índice (p<0,05). A média da PS foi 3,55 e do NIC, 3,59. O SS ocorreu em 82,7% dos casos e a inflamação moderada, em 79,5%. Placa detectável e moderado acúmulo de placa foram identificados em 39,5% e 35,3%, respectivamente. Conclusão: Predominaram indivíduos do gênero masculino, jovens, solteiros, com baixa escolaridade e consumidores de drogas lícitas e ilícitas, com condição bucal ruim. Sugere-se mais atenção dos profissionais da área odontológica e dos elaboradores de políticas públicas, com vistas a esta população.

Introduction: Epidemiological survey of the oral conditions of drug users is an important strategy to know this population, whose growth is increasing in Brazil, so that preventive goals and adequate treatment can be proposed. Aim: The aim of this study was to identify the sociodemographic profile and oral health condition of drug users in rehab of two municipalities of the State of Paraná. Material and method: One hundred individuals participated in the study, which data were collected by questionnaire and physical exam. The following values were obtained: DMFT index (decay-missing-filled index), probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BOP). Data analyses were performed by Student t test and one-way ANOVA. Result: The mean age of participants was 29.12 years. The major frequencies were: male (95.5%), single (69.0%), lower schooling (41%) and higher consumption of licit drugs tobacco (90.9%) and alcohol (84.5%), followed by crack (80.9%), and marijuana (77.3%). The mean DMFT index was 15.21 (SD=5.84), and the longer the dependence time, the greater this index (p<0.05). Mean PD was 3.55 and mean CAL was 3.59. BOP occurred in 82.7% and 79.5% showed moderate inflammation. Detectable plaque and moderate plaque accumulation were observed in 39.5% and 35.3%, respectively. Conclusion: Prevalence was observed in young and single males with low schooling, and with consumption of licit and illicit drugs. Poor oral health condition was identified, which deserves more attention from health professional and policymakers for this population.