Prevalence of lectures about dental esthetics and female speakers in three Brazilian conferences

Abstract This study analyzed the prevalence of lectures involving esthetics in the scientific program of Brazilian dental conferences and the gender distribution of speakers. All lectures presented in three dental conferences (Bahia, São Paulo, and Goiás states) held from 2016 to 2020 were evaluated. Three investigators individually divided the lectures according to the specialties recognized by the Brazilian Federal Council of Dentistry (FCD) based on their titles. The lectures were also classified as involving or not esthetics, and the speaker`s gender was recorded. Descriptive statistical analyses were performed, and Chi-square tests assessed possible associations between factors. The words most cited in the titles of the lectures were "esthetic" (13.6%), "dentistry" (9.9%), and "treatment" (8.1%). Oral diseases were barely mentioned in the titles (up to 1.3%). The highest number of lectures was observed for the specialty of Restorative Dentistry (22.3%), followed by Prosthodontics (18.5%). Approximately one-third of lectures involved some aesthetic aspect, but this percentage ranged from 71.9 to 78.6% for the two specialties with more lectures. Regarding the speaker`s gender, the inequity was higher for lectures involving esthetics (81.6% of males) than for topics unrelated to esthetics (66.7%). More male speakers than females were observed for all specialties. The highest gender gap was observed for Pediatric Dentistry with 62.4% male speakers, although only 10.6% of FCD registered specialists were men. In conclusion, the Brazilian dental conferences analyzed seemed to favor offering lectures dealing with esthetic topics and male speakers.

Resumo Este estudo analisou a prevalência de palestras envolvendo estética na programação científica de congressos de Odontologia brasileiros, e a distribuição do gênero dos palestrantes. Todas as palestras apresentadas em três congressos de Odontologia (CIOBA, CIOGO, and CIOSP) entre 2016 e 2020 foram avaliadas. Três avaliadores utilizaram os títulos das palestras para dividi-las entre as especialidades reconhecidas pelo Conselho Federal de Odontologia (CFO) do Brasil. As palestras foram também classificadas como envolvendo ou não estética, e o gênero do palestrante foi registrado. Análises estatísticas descritivas foram realizadas, e testes de Qui-quadrado avaliaram possíveis interações entre fatores. A palavra mais citada nos títulos das palestras foi "estética" (13,6%), seguido por "odontologia" (9,9%) e "tratamento" (8,1%). Doenças orais foram raramente mencionadas nos títulos (até 1,3%). O maior número de palestras foi observado para a especialidade de Dentística (22,3%), seguido por Prótese Dental (18,3%). Aproximadamente um terço das palestras envolviam algum aspecto estético, com porcentagens entre 71,9 a 78,6% para as duas especialidades com mais palestras. Em relação ao gênero do palestrante, a inequidade foi maior para palestras envolvendo estética (81,6% de homens) que para tópicos não relacionadas à estética (66,7%). Mais palestrantes do sexo masculino que feminino foram observados para todas as especialidades. A maior discrepância entre os gêneros foi observada para Odontopediatria, uma especialidade com 62,4% dos palestrantes do sexo masculino, embora apenas 10,6% dos especialistas registrados no CFO eram homens. Como conclusão, os congressos de Odontologia Brasileiros parecem preferir palestras abordando tópicos de estética e palestrantes do sexo masculino.

Clinical trials of COVID-19 vaccine development: a global overview / Ensaios clínicos de desenvolvimento de vacinas contra a COVID-19: uma visão global / Ensayos clínicos de desarrollo de vacunas contra el COVID-19: una descripción general

Abstract: This study aims to report analyses regarding the global distribution of institutions involved in clinical trials of COVID-19 vaccines throughout February 2022. We retrieved global data from the World Health Organization report on vaccine development. These data allowed us to identify project institutions and plot their geographic coordinates. We produced a georeferenced map using an R programming environment and, based on the geographical location of vaccine developers, we analyzed the subcontinental distribution of clinical trials and the nature of the vaccines. Regionally, South-Southeast Asian countries carried out more clinical trials than any other region, proportionally, although this happened solely for mature technologies. Few trials were under implementation in Latin America and Africa. Our findings confirm previous studies on the regional concentration in the development of technology. However, our contribution lies in showing these phenomena for COVID-19 vaccines in specific subcontinents and technologies, at a country level. Our data underscores which subcontinents perform very few clinical trials for COVID-19 and seem to be ill-prepared for future disease outbreaks, and if these become epidemics or even pandemics and require domestic vaccine development or production. We also consider the case of Brazil, which did not finish the complete cycle of COVID-19 vaccine development in the indicated period; but, with favorable policies, it has potential to engage further in COVID-19 vaccine technology.

Resumo: O objetivo desta comunicação é relatar análises sobre a distribuição global das instituições envolvidas em ensaios clínicos relacionados às vacinas de COVID-19 até fevereiro de 2022. Obtivemos dados globais da Organização Mundial da Saúde sobre o desenvolvimento de vacinas. Isso nos permitiu identificar as instituições de projetos e traçar as suas coordenadas geográficas. Produzimos um mapa georreferenciado usando a linguagem de programação R e, a partir da localização geográfica dos desenvolvedores de vacinas, analisamos a distribuição subcontinental dos ensaios clínicos e a natureza das vacinas testadas. Regionalmente, os países do Sul-Sudeste Asiático realizaram proporcionalmente mais ensaios clínicos do que qualquer outra região, embora isso tenha acontecido para tecnologias maduras. Poucos ensaios estavam em fase de implementação na América Latina e na África. Nossos achados confirmam estudos anteriores sobre a concentração regional no desenvolvimento de tecnologia. No entanto, a nossa contribuição está em demonstrar esses fenômenos para vacinas contra a COVID-19 em subcontinentes e tecnologias específicas em nível nacional. Os nossos dados ressaltam quais subcontinentes realizam muito poucos ensaios clínicos para COVID-19 e parecem estar mal preparados para futuros surtos de doenças e no caso de esses se tornarem epidemias ou mesmo pandemias e exigirem desenvolvimento ou produção de vacinas domésticas. Consideramos também o caso do Brasil, que não encerrou o ciclo completo de desenvolvimento da vacina contra a COVID-19 no período indicado; mas, com políticas favoráveis, tem potencial para se envolver ainda mais na tecnologia de vacinas contra a COVID-19.

Resumen: El propósito de este texto es reportar un análisis sobre la distribución global de instituciones involucradas en ensayos clínicos relacionados con vacunas del COVID-19 hasta febrero de 2022. Se recogieron datos globales de la Organización Mundial de la Salud sobre el desarrollo de vacunas; lo que se pudo identificar las instituciones del proyecto y rastrear sus coordenadas geográficas. Se elaboró un mapa georreferenciado utilizando el lenguaje de programación R y, a partir de la ubicación geográfica de los desarrolladores de vacunas, se analizó la distribución subcontinental de los ensayos clínicos y la naturaleza de las vacunas probadas. A nivel regional, los países del Sur Sureste Asiático llevaron a cabo proporcionalmente más ensayos clínicos que cualquier otra región, aunque esto se realizó con tecnologías consolidadas. Se registraron pocos ensayos en la etapa de implementación en América Latina y África. Los hallazgos confirman los estudios previos sobre la concentración regional en el desarrollo tecnológico. Sin embargo, permiten un aporte al demostrar estos fenómenos para vacunas contra el COVID-19 en subcontinentes y tecnologías específicas a nivel nacional. Los datos revelan los subcontinentes que realizan pocos ensayos clínicos para el COVID-19 y que no parecen estar bien preparados para futuros brotes de enfermedades, en caso de que se conviertan en epidemias o incluso pandemias, requiriendo el desarrollo o la producción de vacunas nacionales. Se considera también el caso de Brasil, que no completó el ciclo completo de desarrollo de la vacuna contra el COVID-19 en el periodo señalado; pero, con políticas favorables, tiene el potencial de involucrarse aún más en la tecnología de la vacuna del COVID-19.

Educação Permanente nas Unidades de Saúde da Família: compreensão da equipe multiprofissional / Permanent Education in Family Health Units: comprehension of the multiprofessional team

In Brazil, Permanent Education in Health was established by the National Policy of Permanent Education for Social Control in the Unified Health System (UHS); this strategy advocates the development and training of health professionals. This study aimed to characterize the activities developed and the understanding of Permanent Health Education in the Family Health Units by the multiprofessional team. This was a qualitative study whose data were collected with 50 professionals from the teams of 12 Family Health Units (FHU) in the city of Assis in the interior of the State of São Paulo through semi-structured interviews and were submitted to Content Analysis, by a Thematic modality. The analysis of the nuclei of meanings of the data obtained in the interview showed two thematic categories: a) Activities of Permanent Education in Health - home visits, team meeting, guidelines on procedural techniques in different places of care, and the absence of activities; and b) Understandings of Permanent Education in Health - regular meetings of the team to work on teaching in healthcare, learning from the difficulties to build new knowledge, joint discussion to solve people's health problems, and the continuous monitoring of current diseases. There is a clear need for new studies to complement and contribute to the expansion of knowledge for the incorporation of PHE in the practice of care developed by the multidisciplinary teams of the FHU.

In Brazil, Permanent Education in Health was established by the National Policy of Permanent Education for Social Control in the Unified Health System (UHS); this strategy advocates the development and training of health professionals. This study aimed to characterize the activities developed and the understanding of Permanent Health Education in the Family Health Units by the multiprofessional team. This was a qualitative study whose data were collected with 50 professionals from the teams of 12 Family Health Units (FHU) in the city of Assis in the interior of the State of São Paulo through semi-structured interviews and were submitted to Content Analysis, by a Thematic modality. The analysis of the nuclei of meanings of the data obtained in the interview showed two thematic categories: a) Activities of Permanent Education in Health - home visits, team meeting, guidelines on procedural techniques in different places of care, and the absence of activities; and b) Understandings of Permanent Education in Health - regular meetings of the team to work on teaching in healthcare, learning from the difficulties to build new knowledge, joint discussion to solve people's health problems, and the continuous monitoring of current diseases. There is a clear need for new studies to complement and contribute to the expansion of knowledge for the incorporation of PHE in the practice of care developed by the multidisciplinary teams of the FHU.

Impact of COVID-19 on gender gap in dental publications: a retrospective cohort with three Brazilian journals

Abstract This was a retrospective cohort study to investigate the impact of COVID-19 pandemic on the gender gap in articles submitted to three international dental journals based in Brazil. All submissions performed to Brazilian Dental Journal, Brazilian Oral Research, and Journal of Applied Oral Science before (2019) and during the pandemic (2020) were assessed. Gender of the first, last, and corresponding authors were collected. Other variables collected were journal, continent studied by authors and stage of their careers (classified according to authors' highest degree), and final decision reached in the article. Absolute and relative frequencies with 95% confidence intervals, Pearson's Chi-square tests, and Fisher's Exact test were used (α = 0.05). In total, 4,726 unique submissions were analyzed. A higher proportion of early-career authors was observed during the pandemic (44.8% to 49.3%, p = 0.021). Most articles were rejected but without association with gender. Increased proportion of male first authors from before to during the pandemic was observed (39% to 42.1%, p = 0.034). Drop in the proportion of articles with women as first authors was observed for researchers in their early- (65.9% to 58.8%, p = 0.02) and mid-career stages (63% to 55.8%, p = 0.014). Reduction in women as first authors was observed during the pandemic in South and Central Americas (66.7% to 61.5%, p = 0.010), and when the last author was a female, or the corresponding author was a male. In conclusion, a disproportionate impact on female dental researchers in submitting articles in the period from before to during the pandemic was observed when considering first authorship, suggesting that the COVID-19 may have increased the gender inequality in dental science.

COVID-19 incidence, severity, medication use, and vaccination among dentists: survey during the second wave in Brazil

Abstract Objective This cross-sectional study with dentists in Brazil assessed the COVID-19 incidence and severity, its vaccination status, and the level of confidence in vaccines in May 2021 (COVID-19 second wave). The medications used to prevent or treat COVID-19, including controversial substances (vitamin D, ivermectin, zinc, and chloroquine), were analyzed. Methodology Dentists were recruited by email and responded to a pretested questionnaire until May 31, 2021. Bivariate and multivariate regression analyses were performed (α=0.05). Prevalence ratios were calculated for the association between professional characteristics and two outcomes: SARS-CoV-2 infection and use of controversial substances. Results In total, 1,907 responses were received (return rate of 21.2%). One third of dentists reported intermediate levels of confidence in the safety and efficacy of COVID-19 vaccines, but 96% had received at least one vaccine dose, mainly CoronaVac. The effect of the pandemic on dental practice was classified as lower/much lower, in comparison with the first wave, by 46% of participants. Moreover, 27% of dentists had already tested positive for SARS-CoV-2 and about 50% had relatives or friends who had been hospitalized or died from COVID-19. At least one medication was used by 59% of participants and 43% used two or more substances. Vitamin D (41%), ivermectin (35%), and zinc (29%) were the most frequent substances. More experienced dentists (≥21 years of professional experience) were 42% more likely to use controversial substances than less experienced dentists. The prevalence of use of controversial substances was 30% higher among dentists with residency or advanced training, such as postgraduate degrees, in comparison with participants holding MSc or PhD degrees. Participants with low confidence in vaccines were 2.1 times more likely to use controversial substances than participants with a very high confidence. Conclusion The results of this study show the high severity of the COVID-19 pandemic in Brazil and raised questions about the use of scientific evidence by dentists in their decision to use controversial substances.

Use of a mobile application for the control of anticoagulation with warfarin: a cluster randomized controlled clinical trial - Ijui/RS/Brazil

Abstract To evaluate the effectiveness of an anticoagulation protocol adapted in a mobile application (appG) for patients using warfarin. This was a cluster randomized controlled clinical trial carried out in basic health centers of Ijui, RS, Brazil, between April and October 2017. The appG was installed on the cell phones of all physicians belonging to the intervention group. Primary outcomes were bleeding and thrombosis, and secondary outcomes were changes in the dose of warfarin, use of new drugs, drug interactions, search for health services, and remaining on the target international normalized ratio. Thirty-three patients belonging to 11 basic health centers were included in this study. From these, 15 patients were in the intervention group which used the appG, and 18 were in the control group. After 6 months, patients in the appG group had fewer bleeding events (7% versus 50%, p-value=0.028) and a lower weekly dose of warfarin (29.3 ± 9.7 mg versus 41.7 ± 12.5 mg, p-value=0.030) when compared to the control group. The anticoagulation protocol adapted in a mobile app reduced bleeding in patients using warfarin.

Atherogenic index of plasma is reduced during follow-up among Roux-in-Y gastric bypass patients

ABSTRACT Atherogenic index of plasma is a marker used to assess risk of cardiovascular diseases. The present study evaluated plasma atherogenic index in individuals before and after bariatric surgery. Individuals were evaluated at three time points: before surgery (T0), in the 2nd (T1) and 6th (T2) months post-surgery. Anthropometric (body mass index, waist circumference, fat and lean mass) and biochemical parameters (lipid profile, glucose and C-reactive protein), and atherogenic index of plasma, calculated by the formula [=log (serum triglycerides concentration/HDL cholesterol)], were evaluated. Data were analyzed using the repeated measures ANOVA or Friedman test according to data distribution. The level of significance was 5%. Thirty-four patients agreed to participate. A significant reduction was observed in all anthropometric parameters in women and men (p<0.05). Atherogenic index of plasma reduced significantly in all time points in women; there was a significant reduction only between periods T0 and T2 (p<0.05) in men. A reduction in the classification for risk in cardiovascular diseases, with high risk in T0 (0.441±0.13) to moderate risk at T1 (0.204±0.22) and low risk at T2 (0.041±0.16) was observed in men. In women, the risk remained low (<0.11) in all periods. Bariatric surgery reduced the atherogenic index of plasma during the 6-month follow-up, suggesting a reduction in cardiovascular risk.

RESUMEN El índice aterogénico plasmático es un marcador que se utiliza para evaluar el riesgo de enfermedades cardiovasculares. El presente trabajo evaluó el índice aterogénico plasmático de pacientes antes y después de la cirugía bariátrica. Los individuos fueron evaluados en tres momentos: antes de la cirugía (T0), el segundo (T1) y el sexto (T2) meses después de la cirugía. Se evaluaron parámetros antropométricos (índice de masa corporal, circunferencia de cintura, masa grasa y masa magra), parámetros bioquímicos (perfil lipídico, glucosa y proteína C reactiva) y el índice aterogénico plasmático, calculado mediante la fórmula [= log (concentración sérica de triglicéridos / colesterol HDL)]. Los datos se analizaron mediante el ANOVA de medidas repetidas o el Test de Friedman según la distribución de los datos. Nivel de significancia adoptado 5%. Treinta y cuatro pacientes aceptaron participar en el estudio. Se observó una reducción significativa en todos los parámetros antropométricos en ambos sexos (p<0.05). En las mujeres, el índice aterogénico plasmático disminuyó significativamente en todos los períodos. En los hombres, hubo una reducción significativa en el índice aterogénico plasmático solo entre T0 y T2 (p<0.05), aunque se observó una reducción en la clasificación de riesgo para enfermedades cardiovasculares de alto riesgo en T0 (0.441±0.13) para moderadas riesgo en T1 (0.204±0.22) y riesgo bajo en T2 (0.041±0.16). En las mujeres, el riesgo se mantuvo bajo (<0.11) en todos los períodos. La cirugía bariátrica redujo la PIA durante el seguimiento de 6 meses, lo que sugiere una reducción del riesgo cardiovascular.

Charcoal-based dentifrices and powders: analyses of product labels, Instagram engagement, and altmetrics

Abstract This study identified charcoal-based dentifrices and abrasive powders sold in Brazil and analyzed their label information. The products were searched in four online shopping platforms. The same products were searched on Instagram and their engagement metrics were investigated. Furthermore, a literature review of international publications assessing charcoal dentifrices and powders was conducted, and altmetrics were collected (Altmetric and PlumX). Thirty-six products were found with prices between $0.4-22 USD. Most frequent words in product description were sodium, stain, whitening, oil, xylitol, and coconut. Only 3 products contained fluoride. Bactericidal, antiviral, antifungal, and anti-inflammatory activities were indicated, in addition to non-scientific claims such as calming teeth or increasing oral immunity. In total, 72% of products had Instagram profiles, which generally showed low engagement rates (81%) and medium audience quality scores (65%). Twenty-two articles were found in the literature, from which 21 were in vitro studies. The single clinical study was sponsored by a charcoal product and had no control group. In total, 23% of studies showed positive results and 55% reported negative results for the charcoal products, which included no whitening ability, increased roughness, surface alterations, and lower demineralization prevention ability. Altmetric scores for the included articles varied from 0 to 55, with 40.9% of studies mentioned online. In conclusion, charcoal-based products are using marketing strategies on Instagram but their current engagement with the public is not high. Consumers are being exposed to charcoal products whose potential risks to health are still unknown.

Resumo Este estudo identificou dentifrícios e pós abrasivos de carvão vendidos no Brasil e analisou suas informações de rótulo. Os produtos foram pesquisados em quatro plataformas de compras online. Os mesmos produtos foram pesquisados no Instagram e métricas de engajamento dos perfis foram investigadas. Além disso, foi realizada uma revisão da literatura buscando publicações internacionais que avaliaram dentifrícios e pós de carvão; dados de altmetria foram coletados (Altmetric e PlumX). Foram encontrados 36 produtos com preços entre US$ 0,4-22. As palavras mais frequentes na descrição dos produtos foram sódio, mancha, clareamento, óleo, xilitol e coco. Apenas 3 produtos continham flúor. Foram indicadas atividades bactericidas, antivirais, antifúngicas e anti-inflamatórias, além de alegações não-científicas como acalmar dentes ou aumentar a imunidade oral. No total, 72% dos produtos tinham perfis no Instagram, que geralmente apresentavam baixas taxas de engajamento (81%) e média qualidade de audiência (65%). Vinte e dois artigos foram encontrados na literatura, dos quais 21 foram estudos in vitro. O único estudo clínico foi patrocinado por um produto de carvão e não tinha grupo controle. No total, 23% dos estudos apresentaram resultados positivos e 55% relataram resultados negativos para os produtos de carvão, que incluíram incapacidade de clareamento, aumento da rugosidade, alterações superficiais e menor capacidade de prevenção da desmineralização do esmalte. A altmetria dos artigos incluídos variou de 0 a 55, com 40,9% dos estudos sendo mencionados online. Em conclusão, os produtos à base de carvão estão usando estratégias de marketing no Instagram, mas seu engajamento atual com o público não é alto. Consumidores estão sendo expostos a produtos de carvão cujos potenciais riscos à saúde ainda são desconhecidos

Email vs. instagram recruitment strategies for online survey research

Abstract In this study, we describe a method for reaching a target population (i.e., dentists practicing in Brazil) to engage in survey research using traditional e-mail invites and recruitment campaigns created on Instagram. This study addresses methodological aspects and compares respondents reached by different methods. A pre-tested questionnaire was used and participants were recruited for 10 days via a source list of email addresses and two discrete Instagram organic open campaigns. A total of 3,122 responses were collected: 509 participants were recruited by email (2.1% response rate) and 2,613 by the two Instagram campaigns (20.7% and 11.7% conversion rates), respectively. Response/min collection rates in the first 24 h ranged between 0.23 (email) and 1.09 (first campaign). In total, 98.8% of all responses were received in the first 48 h for the different recruitment strategies. There were significant differences for all demographic variables (p< 0.001) between email and Instagram respondents, except for sex (p=0.37). Instagram respondents were slightly older, had more professional experience (years in practice), and a higher graduate education level than email respondents. Moreover, most email and Instagram respondents worked in the public sector and private practice, respectively. Although both strategies could collect responses from all Brazilian regions, email responses were slightly better distributed across the five territorial areas compared to Instagram. This study provides evidence that survey recruitment of a diverse, large population sample using Instagram is feasible. However, combination of email and Instagram recruitment led to a more diverse population and improved response rates.

Resumo Neste estudo, descrevemos um método para atingir uma população-alvo (dentistas atuando no Brasil) para se engajar em pesquisa do tipo enquete (survey) utilizando convites tradicionais por e-mail e campanhas de recrutamento criadas no Instagram. Este estudo aborda aspectos metodológicos e compara as pessoas entrevistadas alcançadas por diferentes métodos. Foi utilizado um questionário pré-testado e os(as) participantes foram recrutados(as) por 10 dias por meio de uma lista de endereços de e-mail e duas campanhas abertas orgânicas independentes no Instagram. Foram coletadas 3122 respostas: 509 participantes foram recrutados(as) por e-mail (taxa de resposta 2,1%) e 2613 pelas duas campanhas do Instagram (taxas de conversão 20,7% e 11,7%), respectivamente. As taxas de coleta de resposta/min nas primeiras 24h variaram entre 0,23 (e-mail) e 1,09 (primeira campanha). No total, 98,8% das respostas foram recebidas nas primeiras 48h para as diferentes estratégias de recrutamento. Houve diferenças significativas para todas as variáveis demográficas (p<0,001) entre recrutados(as) por e-mail e Instagram, com exceção de sexo (p=0,37). As pessoas recrutadas via Instagram eram um pouco mais velhas, tinham mais experiência profissional (anos na prática) e nível de pós-graduação superior às entrevistadas por e-mail. Além disso, a maioria dos entrevistados por e-mail e Instagram trabalhava no setor público e na prática privada, respectivamente. Embora ambas estratégias tenham sido capazes de coletar respostas de todas as regiões brasileiras, as respostas por e-mail foram ligeiramente melhor distribuídas nas cinco áreas territoriais em comparação ao Instagram. Este estudo fornece evidências de que o recrutamento de uma amostra de população diversificada e grande usando o Instagram é viável. No entanto, a combinação de e-mail e Instagram no recrutamento levou a uma população mais diversificada e melhores taxas de resposta.

Polywave And Monowave Light-Curing Units Effects On Polymerization Efficiency Of Different Photoinitiators / Efeito Da Unidade De Cura Por Luz Polywave E Monowave Na Eficiência De Polimerização De Diferentes Fotoiniciadores

Objective: The objective of this study was to characterize and correlate the absorption spectra of three photoinitiators [camphorquinone (CQ), diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) and phenylbis (2,4,6-trimethylbenzoyl)-phosphine oxide (BAPO)], using second or third-generation light curing units (LCU), and to evaluate the degree of conversion and the physical properties of an experimental resin adhesive. Material and methods: Second-generation (Radii-cal® and Emitter D®) and third-generation (Valo® Cordless and Bluephase N®) LCU were assessed regarding spectrum and irradiance rate of emitted light. Also, the photoinitiators (CQ, TPO and BAPO) were characterized by a light absorption spectrum assessed by UV-Vis spectroscopy, degree of conversion and yellowing effect. Statistical analyzes considered two-way ANOVA and post-hoc Tukey test. Results: BAPO presented higher reactivity compared to TPO. Regarding degree of conversion of the photoinitiators activated by different light-curing units, the Emitter D® device promoted a high degree of conversion. BAPO presented the highest yellowing effect values. Conclusions: The emission and absorption characteristics of the photoinitiators were different. The polymerization reaction activated by the second-generation light-curing unit was reduced when using an experimental resin with photoinitiator TPO, and the third-generation light-curing unit showed a higher polymerization potential regardless of the photoinitiator. (AU)

Objetivo: Caracterizar e correlacionar os espectros de absorção de três fotoiniciadores [canforoquinona (CQ), difenil 2,4,6-trimetilbenzil óxido de fosfina (TPO) e óxido de di (2,4,6-trimetilbenzil) difenil fosfina (BAPO)], com unidades de fotoativação (LCU) de segunda ou terceira geração, e avaliar o grau de conversão e as propriedades físicas de um adesivo experimental. Material e métodos: LCU de segunda geração (Radii-cal® e Emitter D®) e terceira geração (Valo® Cordless e Bluephase N®) foram avaliadas quanto ao espectro e taxa de irradiância da luz emitida. Além disso, os fotoiniciadores (CQ, TPO e BAPO) foram caracterizados por um espectro de absorção de luz avaliado por espectroscopia UV-Vis, avaliado o grau de conversão dos adesivos e efeito de amarelamento. A análise estatística empregada foi ANOVA duas vias e teste post-hoc de Tukey. Resultados: BAPO apresentou maior reatividade comparado ao TPO. Em relação ao grau de conversão dos fotoiniciadores ativados por diferentes aparelhos fotopolimerizadores, o dispositivo Emitter D® promoveu um alto grau de conversão. BAPO apresentou os maiores valores de efeito de amarelamento. Conclusões: As características de emissão e absorção dos fotoiniciadores foram diferentes. A reação de polimerização ativada pelas unidades de fotopolimerização de segunda geração foi reduzida com o uso de uma resina experimental com fotoiniciador TPO. As unidades de fotopolimerização de terceira geração apresentaram maior potencial de polimerização independentemente do fotoiniciador. (AU)

Tempo para evacuação de foco séptico abdominal e mortalidade em portadores de sepse / Time to clearance of abdominal septic focus and mortality in patients with sepsis

RESUMO Objetivo: Aferir a relação entre tempo para evacuação de foco e mortalidade hospitalar em portadores de sepse e choque séptico. Métodos: Estudo observacional, unicêntrico, com análise retrospectiva do tempo para evacuação de foco séptico abdominal. Os pacientes foram classificados conforme o tempo para evacuação do foco em grupo precoce (≤ 12 horas) ou tardio (> 12 horas). Resultados: Foram avaliados 135 pacientes. Não houve associação entre tempo para evacuação do foco e mortalidade hospitalar (≤ 12 horas versus > 12 horas): 52,3% versus 52,9%, com p = 0,137. Conclusão: Não houve diferença na mortalidade hospitalar entre pacientes com sepse ou choque séptico que tiveram foco infeccioso evacuado antes ou após 12 horas do diagnóstico de sepse.

ABSTRACT Objective: To assess the relationship between time to focus clearance and hospital mortality in patients with sepsis and septic shock. Methods: This was an observational, single-center study with a retrospective analysis of the time to clearance of abdominal septic focus. Patients were classified according to the time to focus clearance into an early (≤ 12 hours) or delayed (> 12 hours) group. Results: A total of 135 patients were evaluated. There was no association between time to focus clearance and hospital mortality (≤ 12 hours versus > 12 hours): 52.3% versus 52.9%, with p = 0.137. Conclusion: There was no difference in hospital mortality among patients with sepsis or septic shock who had an infectious focus evacuated before or after 12 hours after the diagnosis of sepsis.

Atenção Primária à Saúde no combate da pandemia provocada pela COVD-19 / Primary Health Care to combat the pandemic caused by COVID-19

A Atenção Primária à Saúde é considerada um pilar importante diante das epidemias e surtos emergências, e atualmente, da pandemia da COVID-19. Desse modo, nessa Revisão da Literatura, objetivou-se em compreender a atuação da Atenção Primária à Saúde no combate da pandemia provocada pela COVID-19. A localização dos trabalhos foi realizada nas seguintes bases de dados: Banco de Dados de Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde, e Scientific Electronic Library Online. Concluiu-se que a realização desta revisão da literatura permitiu identificar evidências literárias sobre a atuação da Atenção Primária à Saúde no combate da pandemia provocada pela COVID-19; amostra final foi constituída de 09 trabalhos. Concluiu-se evidenciando a atuação da Atenção Primária à Saúde no combate da pandemia da COVID-19, na criação de estratégias para diminuição dos casos, em seu papel primordial na manutenção de saúde dos indivíduos, e mantendo atendimento de resolutividade nos casos leve. (AU)

Primary Health Care is considered an important post in the face of epidemics and outbreaks, and currently the COVID-19 pandemic. Thus, this Literature Review aimed to understand the function of Primary Health Care in combating the pandemic caused by COVID-19. The works location was carried out in the following databases: Nursing Database, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. It was concluded that the accomplishment of this literature review allowed to identify literary evidences about the Primary Health Care performance in combating the pandemic caused by COVID-19; final sample consisted of 09 works; It concluded by highlighting the function of Primary Health Care in combating the pandemic of COVID-19, in creating strategies to reduce cases, in its primary role in maintaining the individuals health, and maintaining problem-solving care in light cases. (AU)

A Bibliometric analysis of articles published in Brazilian Dental Journal over 30 years

Abstract This study assessed bibliometric characteristics of all articles published in Brazilian Dental Journal (BDJ) in its 30 years of existence (1990-2019) and factors associated with citation rates. A document search was carried out in Scopus in December, 2019 and information about the articles were exported, including citations. Type of study and main subject in each article were categorized. Number of citations was categorized in tertiles. Logistic regression models were used to assess the association between variables related to articles' characteristics and number of citations. In 30 years, 1705 articles were published and 18507 citations received, with average 57 articles and 334 pages published yearly and 10.9 cites/doc. The most frequent types of study were laboratorial (63%), clinical (18.5%), and case reports (11%); the main subjects were dental materials (21.6%), endodontics (19.3%), and oral pathology/stomatology (13.1%). Most articles had origin in Brazil (90%), followed by USA (4.6%) and UK (1.5%). Aside from BDJ, Journal of Endodontics (3.5%) and International Endodontic Journal (2.2%) were journals that most often cited BDJ. Main origins of citations were Brazil (36.7%), USA (10.6%), and India (9%). Older articles had higher odds to be highly cited (12% increase/year), longer articles had lower odds (9% decrease/page). Narrative reviews and epidemiological studies were associated with more citations and systematic reviews with less citations. In conclusion, BDJ covered many subjects and study types in 30 years, showing increased growth in international audience. The journal may be regarded as one of the leading Brazilian journals in dentistry published in English.

Resumo Este estudo avaliou as características bibliométricas de todos os artigos publicados no Brazilian Dental Journal (BDJ) em seus 30 anos de existência (1990-2019) e fatores associados com taxas de citação. Uma busca pelos documentos foi realizada no Scopus em Dezembro de 2019 e informações acerca dos artigos foram exportadas, incluindo citações. Tipo de estudo e principal assunto em cada artigo foram categorizados. Número de citações foi categorizado em tercis. Modelos de regressão logística foram usados para avaliar a associação entre as variáveis relacionadas às características dos artigos e o número de citações. Em 30 anos, 1705 artigos foram publicados e 18507 citações recebidas, com média de 57 artigos e 334 páginas publicadas ao ano e 10,9 citações/documento. Os tipos de estudo mais frequentes foram laboratorial (63%), clínico (18,5%) e relato de caso (11%); os principais assuntos foram materiais dentários (21,6%), endodontia (19,3%) e patologia oral/estomatologia (13,1%). A maioria doas artigos teve origem do Brasil (90%), seguido dos EUA (4,6%) e Reino Unido (1,5%). Além do BDJ, Journal of Endodontics (3,5%) e International Endodontic Journal (2,2%) foram os periódicos que mais citaram o BDJ. As principais origem das citações foram Brasil (36,7%), EUA (10,6%) e Índia (9%). Artigos mais antigos tiveram maiores chances de serem altamente citados (aumento de 12% ao ano), artigos mais longos tiveram menores chances (redução de 9% por página). Revisões narrativas e estudos epidemiológicos foram associados com mais citações e revisões sistemáticas com menos citações. Em conclusão, o BDJ cobriu diversos assuntos e tipos de estudo em 30 anos, mostrando contínuo crescimento na audiência internacional. O periódico pode ser considerado um dos líderes entre as revistas brasileiras de odontologia publicadas em inglês.

Brazilian articles in top-tier dental journals and influence of international collaboration on citation rates

Abstract This study investigated the presence of co-authorship from Brazil in articles published in top-tier dental journals and analyzed the influence of international collaboration, article type (original research or review), and funding on citation rates. Articles published between 2015 and 2017 in 38 selected journals from 14 dental subareas were screened in Scopus. Bibliographic information, citation counts, and funding details were recorded for all articles (N=15619). Collaboration with other top-10 publishing countries in dentistry was registered. Annual citations averages (ACA) were calculated. A linear regression model assessed differences in ACA between subareas. Multilevel linear regression models evaluated the influence of article type, funding, and presence of international collaboration in ACA. Brazil was a frequent co-author of articles published in the period (top 3: USA=25.5%; Brazil=13.8%; Germany=9.2%) and the country with most publications in two subareas. The subjects with the biggest share of Brazil are Operative Dentistry/Cariology, Dental Materials, and Endodontics. Brazil was second in total citations, but fifth in citation averages per article. From the total of 2155 articles co-authored by Brazil, 74.8% had no co-authorship from other top-10 publishing countries. USA (17.8%), Italy (4.2%), and UK (3.2%) were the main co-author countries, but the main collaboration country varied between subjects. Implantology and Dental Materials were the subjects with most international co-authorship. Review articles and articles with international collaboration were associated with increased citation rates, whereas the presence of study funding did not influence the citations.

Resumo Este estudo investigou a presença de coautoria do Brasil em artigos publicados nos principais periódicos odontológicos e analisou a influência da colaboração internacional, tipo de artigo (artigo original ou revisão) e financiamento nas taxas de citação. Artigos publicados entre 2015 e 2017 em 38 periódicos selecionados de 14 subáreas foram pesquisados no Scopus. Informações bibliográficas, número de citações e detalhes de financiamento foram registrados para todos os artigos (N=15619). Colaboração com outros países no top-10 de publicações em odontologia foi coletada. Médias anuais de citação (MAC) foram calculadas. Um modelo de regressão linear avaliou as diferenças de MAC entre as subáreas. Modelos multinível de regressão linear avaliaram a influência do tipo de artigo, financiamento e presença de colaboração internacional nas MAC. O Brasil foi coautor frequente de artigos publicados no período (top 3: EUA=25,5%; Brasil=13,8%; Alemanha=9,2%) e o país com mais publicações em duas subáreas. As subáreas com maior participação do Brasil foram Dentística/Cariologia, Materiais Dentários e Endodontia. O Brasil foi o segundo no total de citações, porém quinto em citações médias por artigo. Do total de 2155 artigos de coautoria do Brasil, 74,8% não tiveram coautoria de outros países do top-10 de publicação. EUA (17,8%), Itália (4,2%) e Reino Unido (3,2%) foram os principais países coautores, porém o principal país de colaboração variou entre as subáreas. Implantodontia e Materiais Dentários foram as subáreas com mais coautoria internacional. Artigos de revisão e artigos com colaboração internacional foram associados a maiores taxas de citação, enquanto a presença de financiamento do estudo não influenciou as citações.

Simple and low-cost thermal treatments on direct resin composites for indirect use

Abstract The aim of this study was to evaluate the influence of three low-cost additional thermal treatments, available in the dental office, on the mechanical, chemical and optical properties of a light-cured resin composite indicated for direct restorations but used as indirect restorative. The direct resin composite TPH3 (Dentsply) was light-polymerized using a light-emitting diode curing unit and submitted to three experimental additional thermal treatments: dry heat at 170 °C for 5 min, autoclave at 121 °C for 6 min, or microwave oven at 450 W for 3 min. The resin composite without any thermal treatment was used as negative control group. An indirect resin composite (Vita CM LC, Vita Zahnfabrik) was tested as a reference. Flexural strength, elastic modulus, microhardness, degree of C=C conversion, roughness before and after simulated toothbrush abrasion, translucency parameter and color difference (ΔE00) were evaluated. Data were analyzed at α=0.05. The indirect resin composite presented lower C=C conversion and mechanical performance. The flexural strength was significantly higher in the dry oven group compared with the control. The roughness was not different among groups before or after brushing, but the thermal treatments caused an increase in C=C conversion, microhardness, and elastic modulus without affecting the translucency parameter or showing visible color alteration (ΔE00<1.8). These results suggest that the use of additional thermal methods of polymerization represents an economical and simple alternative to enhance the mechanical and chemical properties of direct resin composites when used as indirect restoratives.

Resumo O objetivo deste estudo foi avaliar a influência de três tratamentos térmicos adicionais de baixo custo, disponíveis no consultório dentário, nas propriedades mecânicas, químicas e ópticas de uma resina composta fotoativada indicada para restaurações diretas porém usada como restaurador indireto. A resina composta direta TPH3 (Dentsply) foi fotoativada usando um diodo emissor de luz e submetida a três tratamentos térmicos adicionais experimentais: forno seco a 170 °C por 5 min, autoclave a 121 °C por 6 min ou forno de micro-ondas a 450 W por 3 min. A resina composta sem qualquer tratamento térmico adicional foi usada como grupo controle negativo. Uma resina composta indireta (Vita CM LC, Vita Zahnfabrik) foi testada como referência comercial. Resistência à flexão, módulo de elasticidade, microdureza, grau de conversão de C=C, rugosidade antes e após abrasão por escovação simulada, parâmetro de translucidez e diferença de cor (ΔE00) foram avaliados. Os dados foram analisados considerando α=0.05. A resina composta indireta apresentou menor conversão de C=C e desempenho mecânico. A resistência à flexão foi significativamente mais alta no grupo forno seco comparado ao controle. A rugosidade não foi diferente entre os grupos antes ou após a escovação, porém os tratamentos térmicos adicionais causaram aumento na conversão de C=C, microdureza e módulo de elasticidade, sem afetar o parâmetro de translucidez ou mostrar alteração de cor visível (ΔE00<1,8). Estes resultados sugerem que o uso de métodos térmicos adicionais de polimerização representam alternativa econômica e simples para aprimorar as propriedades mecânicas e químicas de resinas compostas diretas quando utilizadas como restauradores indiretos.

Direct bonded space maintainer: an alternative in clinical practice after unilateral premature loss of posterior primary tooth

Introduction: The primary dentition is extremely important, because besides the importance during chewing, acts as a guide to eruption for permanent teeth, stimulates the bone growth and helps in digestion and phonation. In cases of premature loss, it is necessary that the professional make adequate planning to space maintenance, so that it is not lost until the eruption of the permanent successor, thus avoiding the establishment of malocclusions. Objective: To describe the clinical steps for preparation and placement of a direct bonded space maintainer, as well as the follow-up until the eruption of the successor tooth. Case report: Girl, eight years old, presented an adjacent fistula to theprimary mandibular right second molar. After clinical and radiographic evaluation, tooth extraction was indicated, due to the impossibility of performing the endodontic treatment. A direct bonded space maintainer was made and installed as an alternative to the band and loop, commonly used in these cases of unilateral loss. Conclusion: The direct bonded space maintainer was a good option for the case presented, as it was able to fulfill its function until the eruption of the successor tooth. It is a good alternative in clinical practice due to the time optimization and material savings it provides.

Introdução: A dentição decídua é de extrema importância, pois exerce função mastigatória, atua como guia de erupção para os dentes permanentes, estimula o crescimento ósseo e auxilia na digestão e fonação. Em casos de perda prematura de algum dente, é necessário que o profissional faça um planejamento adequado para manutenção do espaço, de forma que este não seja perdido até a erupção do sucessor permanente, evitando assim o estabelecimento de más-oclusões. Objetivo: Descrever as etapas clínicas para confecção e instalação do aparelho mantenedor de espaço adesivo, bem como o acompanhamento até a erupção do sucessor. Relato do caso: Menina, 8 anos, apresentou fístula adjacente ao segundo molar inferior direito decíduo. Após avaliação clínica e radiográfica, foi indicada a exodontia do dente, devido à impossibilidade de realizar o tratamento endodôntico. Confeccionou-se e instalou-se o aparelho mantenedor de espaço adesivo, como uma alternativa ao banda-alça, comumente utilizado nesses casos de perda unilateral. Conclusão: O mantenedor de espaço colado foi uma boa opção para o caso apresentado, pois foi capaz de cumprir sua função até a erupção do dente sucessor, constituindo-se uma boa alternativa na prática clínica, devido à otimização do tempo e economia de material que proporciona.

Top-100 most cited dental articles with authors from Brazil

Abstract This study analyzes the characteristics of the top-100 most cited articles published in international dental journals with at least one coauthor affiliated to Brazil. A search in Scopus database for articles published between 1996 and 2017 was carried out in the 178 journals belonging to the category "Dentistry" identified in SCImago Journals & Country Rank. From the top-100 most cited articles, variables related to the journal, article, and authors were collected. Annual citation averages (ACA) and relative citation ratios (RCR) were calculated. Data were analyzed descriptively. There were 75 original reports and 25 reviews in the sample. The number of citations ranged between 124 and 657 (mean=202, median=168). The papers were published in 31 different journals (46% in only four journals), none based in Brazil. The most frequent subjects (61%) were Dental Materials, Endodontics, and Periodontology, which accounted for 63.6% of the total citations. The subject with the highest ACA was Oral and Maxillofacial Surgery and the subject with the highest RCR was Oral Radiology. Only 12 articles were cited more than 300 times. International collaboration was present in 61 articles and funding was reported in 49 articles. The first author was from Brazil in 70% and corresponding author in 55% of the papers. Southeast (83%) and South (20%) were the regions of Brazil with most presence of coauthors. This top-100 list is presented to provide an overview of the most cited articles and aid in supporting further analyses regarding publication and citation behaviors of Brazilian dentistry.

Resumo Este artigo analisa as características dos 100 artigos mais citados publicados em periódicos internacionais de odontologia com ao menos um co-autor afiliado ao Brasil. Uma busca na base de dados Scopus por artigos publicados entre 1996 e 2017 foi realizada nos 178 periódicos pertencentes à categoria "Dentistry" identificados no SCImago Journals & Country Rank. Dos 100 artigos mais citados, variáveis relacionadas ao periódico, artigo e autores foram coletadas. Médias anuais de citação (MAA) e razões de citação relativa (RCR) foram calculadas. Os dados foram analisados descritivamente. A amostra foi composta por 75 artigos originais e 25 revisões. O número de citações variou entre 124 e 657 (média=202, mediana=168). Os artigos foram publicados em 31 periódicos diferentes (46% em apenas quatro periódicos), nenhum do Brasil. Os temas mais frequentes (61%) foram Materiais Dentários, Endodontia e Periodontia, somando 63,6% do total de citações. O tema com maior MAA foi Cirurgia Oral e Maxilofacial e o tema com maior RCR foi Radiologia Oral. Apenas 12 artigos foram citados mais de 300 vezes. Colaboração internacional estava presente em 61 artigos e financiamento foi reportado em 49 artigos. O primeiro autor era do Brasil em 70% e o correspondente em 55% dos artigos. As regiões do Brasil com mais co-autores presentes foram Sudeste (83%) e Sul (20%). Esta lista é apresentada para prover uma fotografia dos 100 artigos mais citados e ajudar a fomentar análises posteriores em relação a comportamentos de citação e publicação da odontologia brasileira.

Long-term bonding efficacy of adhesives containing benzodioxioles as alternative co-initiators

Abstract This study evaluated the three-year lifespan of the bond to dentin of experimental self-etch adhesives containing benzodioxole derivatives - 1,3-benzodioxole (BDO) and piperonyl alcohol (PA) - as co-initiator alternative to amines. Adhesive resins were formulated using Bis-GMA, TEGDMA, HEMA, camphorquinone and different co-initiators: BDO, PA or ethyl 4-dimethylamino benzoate (EDAB - amine). An experimental self-etch primer was used to complete the two-step, self-etch adhesive system. Clearfil SE Bond (CSE) was used as commercial reference. Bond strength to human dentin was assessed by microtensile bond strength (µTBS) test, and failure mode was classified. Morphology of the dentin bonding interface was assessed via scanning electron microscopy (SEM). Irrespective of the dental adhesives evaluated, µTBS was higher after 24 hours compared with that after 1.5 and 3 years (p ≤ 0.001). However, adhesives with BDO and PA as co-initiators showed significantly higher bond strength than the bonding resin with EDAB (p ≤ 0.002), independent of the time evaluated. The commercial adhesive CSE showed similar bond strength compared with the other groups (p ≥ 0.05). Mixed failures were mainly observed after 24 hours, while adhesive failures were more frequently observed after 1.5 and 3 years. No notable differences in homogeneity and continuity along the bonded interfaces were detected among the materials in the SEM analysis. In conclusion, benzodioxole derivatives are feasible alternative co-initiators to tertiary amine in camphorquinone-based self-etching dental adhesive formulations.

Inorganic filler content of resin-based luting agents and the color of ceramic veneers

Abstract The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey's test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

Does SOFA predict outcomes better than SIRS in Brazilian ICU patients with suspected infection? A retrospective cohort study

ABSTRACT We compared the discriminatory capacity of the sequential organ failure assessment (SOFA) versus the systemic inflammatory response syndrome (SIRS) score for predicting ICU mortality, need for and length of mechanical ventilation, ICU stay, and hospitalization in patients with suspected infection admitted to a mixed Brazilian ICU. We performed a retrospective analysis of a longitudinal ICU database from a tertiary hospital in Southern Brazil. Patients were categorized according to whether they met the criteria for sepsis according to SOFA (variation ≥2 points over the baseline clinical condition) and SIRS (SIRS score ≥2 points). From January 2008 to December 2014, 1487 patients were admitted to the ICU due to suspected infection. SOFA ≥2 identified more septic patients than SIRS ≥2 (79.0% [n = 1175] vs. 68.5% [n = 1020], p < 0.001). There was no difference between the two scores in predicting ICU mortality (area under the receiver operating characteristic curve (AUROC) = 0.64 vs. 0.64, p = 0.99). SOFA ≥2 was marginally better than SIRS ≥2 in predicting need for mechanical ventilation (AUROC = 0.64 vs. 0.62, p = 0.001), ICU stay > 7 days (AUROC = 0.65 vs. 0.63, p = 0.004), and length of hospitalization >10 days (AUROC = 0.61 vs. 0.59, p < 0.001). There was no difference between the two scores in predicting mechanical ventilation >7 days.