Use of platelet concentrates in oral surgery of patients with osteonecrosis: a scoping review

Abstract The objective of this study was to map, through a scoping review, the evidence available in the literature on the use of platelet concentrates in compromised patients undergoing oral surgeries. Searches were performed in electronic databases for clinical studies with compromised patients undergoing oral surgery who used platelet concentrates. Only studies published in English were included. Two independent researchers carried out the selection of studies. The study design and objective, surgical procedure and platelet concentrate used, systemic involvement, analyzed outcome, and main results were extracted. A descriptive analysis of the data was performed. Twenty-two studies met the eligibility criteria and were included. Case series was the most frequent study design among the included studies (41.0%). In terms of systemic disability, 19 studies reported patients with cancer and related to surgical treatment 16 studies reported patients underwent treatment for osteonecrosis related to the use of the drug. The most used platelet concentrate was pure platelet-rich fibrin (P-PRF). In general, most studies recommend the use of platelet concentrates. Thus, the results of this study suggest that the evidence related to the use of platelet concentrates in compromised patients when undergoing oral surgeries is still initial. Also, most studies assessed the use of platelet concentrates in patients with osteonecrosis.

Resumo O objetivo do estudo foi mapear, através de uma revisão de escopo, as evidências disponíveis na literatura sobre o uso de agregrantes plaquetários em pacientes comprometidos e que realizaram cirurgias odontológicas. Pesquisas foram realizadas em bases de dados por estudos clínicos com pacientes comprometidos que realizaram cirurgia odontológica e usaram agragantes plaquetários. Apenas estudos em inglês foram incluídos. Dois pesquisadores independentes realizaram a seleção dos estudos. Os seguintes dados foram extraídos: desenho do estudo, objetivo, procedimento cirúrgico, agregante plaquetário usado, envolvimento sistêmico, desfecho analisado e principais resultados. Uma análise descritiva dos dados foi realizada. Vinte e dois estudos preencheram os critérios de elegibilidade e foram incluídos. Série de casos foi o desenho de estudo mais frequente entre os estudos incluídos (41,0%). Em relação ao comprometimento sistêmico, 19 estudos reportaram pacientes com câncer e em relação ao tratamento cirúrgico, 16 estudos reportaram pacientes que realizavam tratamento para osteonecrose relacionada ao uso de medicamentos. O agregante mais utilizado foi o plasma rico em fribina (P-PRF). Em geral, maioria dos estudos recomendou o uso dos agregantes plaquetários. Assim, os resultados desse estudo sugerem que a evidência relacionada ao uso de agregantes plaquetários em pacientes comprometidos que realizam cirurgia odontológica é ainda inicial. Ainda, a maioria dos estudos avaliaram o uso de agregantes plaquetários em pacientes com osteonecrose.

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)

Dental implant therapy in the Brazilian Public System: an overview of the last decade

Aim: This retrospective study aims to describe and analyze the number of dental implants and implant-retained prostheses performed by the Unified Health System (SUS) in the last decade. Methods: This study is based on secondary data from the official government database (DATASUS) performed from January 2010 to December 2019 and is reported following the STROBE. A descriptive analysis was performed of the total sample and the stratified sample divided by Brazilian states. Results: A total of 143,037 dental implants and 93,325 implant-retained prostheses were provided by SUS. It is possible to observe that some states played a massive role on the provision of dental implants and implant-retained prostheses (Parana state: 58.4% and 55.9% and Paraiba state: 21.1% and 25.2% of the total amount of dental implants and implant-retained prostheses, respectively) while some states did not provide a single implant-retained prosthesis. Also, inland cities were mostly responsible for the number of procedures compared to the state capitals. Conclusion:Although dental implant therapy is available in SUS across the country, the number of treatments provided in the last decade is still very limited and is also mainly concentrated in the southeastern region of Brazil

Dentists' perceptions and barriers to provide oral care for dependent elderly at home, long-term care institutions or hospitals

Aim: The aim of this study was to assess the perceptions and barriers to providing oral health care for the dependent elderly in unconventional settings as reported by dentists in the State of São Paulo, Brazil. The Brazilian elderly population is rapidly growing, and a larger elderly population implies an increasing number of dependent elderly patients. Therefore, investigating the perceptions and barriers reported by dentists for caring for these patients becomes important. Materials and methods: An online survey was sent by e-mail to dentists of a metropolitan area in the State of São Paulo, Brazil. Results: The response rate was 3.65% (n = 125). Only 14.4% of respondents offered home care to the elderly. Lack of experience or training (60.7%) and the small number of home visits (42.9%), were the main reported barriers to providing care for the dependent elderly. Most of the respondents (82.4%) agreed that the age of the patient did not influence their decision to provide care, and 96.8% agreed that delivering care to the elderly could be a rewarding experience. Conclusion: Few respondents offered care to the elderly and some of the most relevant factors considered in the decision to offer care were, experience and training, personal satisfaction and having gerodontology as a stand-alone course during dental school

Restabelecimento funcional e estético com coroas e facetas laminadas / Functional and aesthetic reestablishment with full crowns and laminate veneers ­ a case report

A adequada estética do sorriso é cada vez mais almejada pelo paciente e pelo profissional. Dentes escurecidos e com lesões de abfração, causadas por excessiva carga oclusal, desfavorecem o agradável aspecto dos dentes e a estética facial como um todo. Este caso clínico relatou o procedimento restaurador de dentes anteriores superiores que apresentavam cor e forma inadequadas. Foram confeccionadas facetas e coroas com cerâmica termoprensada reforçada por dissilicato de lítio (IPS e.max Press, Ivoclar), que tem sido frequentemente utilizada na confecção de restaurações em dentes anteriores e posteriores por apresentar propriedades estéticas e mecânicas satisfatórias. Após a reabilitação, pôde-se perceber que o detalhado planejamento do tratamento e a correta escolha do material restaurador resultaram no restabelecimento funcional e estético. Foi possível concluir que restaurações obtidas a partir da cerâmica de dissilicato de lítio mostraram ser uma ótima alternativa para a confecção de facetas e coroas, considerando que houve perfeita concordância de cor entre ambas as restaurações, resultando no sucesso do tratamento e satisfação do paciente.

Adequate aesthetic appearance of the smile is increasingly desired by patient and professional. Darkened teeth and abfraction injuries caused by excessive occlusal load jeopardizes the appearance of the teeth, and the facial aesthetics as a whole. This case describes the restorative treatment of upper anterior teeth that presented inadequate color and form. Crowns and laminate veneers were made with lithium disilicate ceramic, which has often been used in the fabrication of anterior tooth restorations because it presents satisfactory aesthetic and mechanical properties. After the restorative process, it can be concluded that the detailed treatment planning and the correct choice of restorative material result in the reestablishment of function and aesthetics. It was concluded that the lithium disilicate ceramic showed to be an excellent alternative for making laminate veneers and adjacent crowns, considering that there was perfect color matching between both restorations, resulting in the success of treatment and patient satisfaction.

Influence of one- or two-stage methods for polymerizing complete dentures on adaptation and teeth movements / Influência dos métodos de um ou dois estágios para polimerização de próteses totais na adaptação e movimentação de dentes

Introduction: The quality of complete dentures might be influenced by the method of confection. Objective: To evaluate the influence of two different methods of processing muco-supported complete dentures on their adaptation and teeth movements. Material and method: Denture confection was assigned in two groups (n=10) for upper and lower arches according to polymerization method: 1) conventional one-stage - a wax trial base was made, teeth were arranged and polymerized; 2) two-stage method - the base was waxed and first polymerized. With the denture base polymerized, the teeth were arranged and then, performed the final polymerization. Teeth movements were evaluated in the distances between incisive (I-I), pre-molars (P-P), molars (M-M), left incisor to left molar (LI-LM) and right incisor to right molar (RI-RM). For the adaptation analysis, dentures were cut in three different positions: (A) distal face of canines, (B) mesial face of the first molars, and (C) distal face of second molars. Result: Denture bases have shown a significant better adaptation when polymerized in the one-stage procedure for both the upper (p=0.000) and the lower (p=0.000) arches, with region A presenting significant better adaptation than region C. In the upper arch, significant reduction in the distance between I-I was observed in the one-stage technique, while the two-stage technique promoted significant reduction in the RI-RM distance. In the lower arch, one-stage technique promoted significant reduction in the distance for RI-RM and two-stage promoted significant reduction in the LI-LM distance. Conclusion: Conventional one-stage method presented the better results for denture adaptation. Both fabrication methods presented some alteration in teeth movements.

Introdução: A qualidade das próteses totais pode ser influenciada pelo método de confecção. Objetivo: Avaliar a influência de diferentes métodos de confecção de próteses totais na adaptação e movimentação de dentes. Material e método: A confecção das próteses foi dividida em dois grupos (n=10) para arcadas superior e inferior de acordo com o método: 1) convencional de uma etapa - realizada uma base de prova em cera onde foram montados os dentes e levada para a termopolimerização; 2) Método de duas etapas - a base foi encerada e termopolimerizada. Com a base da prótese polimerizada, os dentes foram montados e em seguida realizou a polimerização da outra porção. Para movimentação de dentes foram avaliadas as distâncias entre incisivos (I-I), pré-molares (PM-PM), molares (M-M), incisivo esquerdo a molar esquerdo (IE-ME) e incisivo direito a molar direito (ID-MD) antes e após polimerização final. As próteses foram seccionadas em três posições para análise de adaptação: (A) face distal de caninos, (B) face mesial de primeiros molares, e (C) face distal de segundos molares. Resultado: As bases das próteses demonstraram melhor adaptação quando polimerizadas no processo de uma etapa, tanto superiores (p< 0,05) quanto inferiores (p< 0,05), com a região A apresentando melhor adaptação que a região C. Na arcada superior uma redução na distância entre I-I foi observada na técnica de uma etapa, enquanto que na técnica de duas etapas houve redução na distância ID-MD. Na arcada inferior, na técnica de uma etapa houve redução na distância ID-MD e houve redução significativa na distância IE-M pelo método de duas etapas. Conclusão: O método de uma etapa apresentou melhores resultados para a adaptação da prótese. Ambos os métodos de confecção apresentaram alteração na movimentação de dentes.

Influence of Resin Cements on the Tension Force of Cast Frameworks Made by the Technique of Framework Cemented on Prepared Abutments

This study evaluated the tension force of cast frameworks made by the technique of framework cemented on prepared abutments using two different resin cements. Forty multi-unit abutment analogs were individually fixed with chemically cured acrylic resin inside PVC cylinders using a parallelometer. Brass cylindrical abutments were tightened to the multi-unit abutments to be used as spacers and then castable UCLA abutments were positioned above. These abutments were cast with Ni-Cr and then divided into 4 groups (n=10): cemented with RelyX U100(r); cemented with RelyX U100(r) and simulation of acrylic resin polymerization process; cemented with Multilink(r); and cemented with Multilink(r) and simulation of acrylic resin polymerization process. Abutments were cemented according to manufacturers' instructions. In a universal testing machine, tensile strength was applied in the direction of the long axis of the abutments at 1 mm/min crosshead speed until displacement of the luted abutments was obtained. The values of maximum tensile force (N) required for the displacement of the luted abutments were tabulated and analyzed statistically by one-way ANOVA with a 95% confidence level. No statistically significant difference was found among the groups (p>0.05). There was an increase in mean tension force when the specimens were subjected to the simulation of acrylic resin polymerization process, but the results did not differ statistically. Both resin cements presented positive results as regards the retention of luted abutments on their respective multi-unit abutments. Both materials may be indicated for the technique of framework cemented on prepared abutments when professionals pursuit better adaptation of implant-supported frameworks.

Este estudo avaliou a força de tração de infraestruturas fundidas confeccionadas pela técnica da infraestrutura cimentada sobre pilares preparados utilizando dois diferentes cimentos resinosos. Quarenta análogos de pilares multi-unit foram individualmente fixados com resina acrílica quimicamente ativada em cilindros de PVC utilizando um delineador. Pilares cilíndricos foram torqueados aos pilares multi-unit para serem usados como espaçadores e, então, pilares calcináveis UCLA foram posicionados sobre eles. Estes pilares foram fundidos em liga de Ni-Cr e divididos em 4 grupos (n=10): cimentados com RelyX U100(r); cimentados com RelyX U100(r) e simulação do processo de polimerização da resina acrílica; cimentados com Multilink(r); e cimentados com Multilink(r) e simulação do processo de polimerização da resina acrílica. Os pilares foram cimentados de acordo com as recomendações dos fabricantes. Em máquina universal de ensaio, a resistência à tração foi aplicada na direção do longo eixo dos pilares a uma velocidade de 1 mm/min até o deslocamento do pilar cimentado ser obtido. Os valores da tração máxima (N) necessária para o deslocamento dos pilares cimentados foram tabulados e analisados estatisticamente pela ANOVA de 1 fator com 95% de nível de confiança. Diferença estatisticamente significativa não foi encontrada entre os grupos (p>0,05). Houve um aumento na força média de tração quando os espécimes foram submetidos à simulação de processo de polimerização da resina acrílica, mas os resultados não diferiram estatisticamente. Ambos os cimentos resinosos apresentaram resultados positivos no que diz respeito à retenção dos pilares cimentados em seus respectivos pilares multi-unit. Ambos os materiais podem ser indicados para a técnica da infraestrutura cimentada sobre pilares preparados quando os profissionais buscam melhor adaptação de infraestruturas de próteses implanto-suportadas.

Taste alteration, mouth dryness and teeth staining as side effects of medications taken by elderly

Elderly patients generally use several types of medication, some of which may cause oral side effects. Aim: To investigate the oral side effects caused by medication in an elderly sample. Methods: Three hundred patients were interviewed about their use of medication and were divided in two groups: institutionalized (n=150) and community-dwelling (n=150) elderly. Results: The most used drugs were antihypertensives (53%) for community-dwelling elders and antiulceratives (76%) for the institutionalized ones. The more prevalent side effects were taste alterations that occurred in 19%, dry mouth in 17% and teeth staining in 2%. Conclusions: A high prevalence of oral side effects from medications used by the elderly was found in this study. The health professionals should be aware of the possible side effects caused by prescribed medications.

Evaluation of health parameters, use of drugs, and alcohol intake among an elderly population in São José dos Campos, SP, Brazil

AIM: To evaluate health parameters (blood pressure, heart rate and blood glucose), the use of medicines and alcohol consumption in elderly residents in the city of São José dos Campos, SP, Brazil. METHODS: A sample of 500 elderly individuals (98 men and 402 women, with mean age of 69.5 years) was examined. Personal data and medicines used by the patients were recorded, general health aspects were assessed and the Alcohol Use Disorders Identification Test (AUDIT) was applied to survey alcohol consumption. RESULTS: Two hundred and four patients (40.8%) presented high blood pressure and 93 patients (18.6%) had hyperglycemia. The most used pharmacological groups were antihypertensive drugs, antilipidemics, drugs to control hypothyroidism and hypoglycemic agents. Possible pharmacological interactions with alcohol were present in 60.9% of the used medicines. The AUDIT results showed that 91% of the sample presented a low-level intake of alcohol and only 1% presented characteristics of alcohol addiction. Associations were found among AUDIT scores with age (p=0.037), since a larger number of alcohol addicts were found among younger patients, and use of drugs (p=0.046), since patients who consumed more daily medicines made less use of alcohol (low-level). CONCLUSIONS: The studied sample presented a high prevalence of hypertension and relatively low incidence of diabetes. A low use of drugs was verified and women made more use of daily medications than men. Low alcohol consumption was also observed, and women consumed less alcohol than men.

Stress analysis of different configurations of 3 implants to support a fixed prosthesis in an edentulous jaw

This study's aims was to evaluate the stress distribution in a mandibular implant-supported prosthesis and peri-implant bone considering implant quantity, diameter and position using linear 3-D finite element analysis. Models of an anterior jaw comprised 4 groups according to implant quantity, diameter, and position: control group C, 5 regular implants; R, 3 regular implants; W, 3 wide implants; and DTR, 3 regular implants with the distal ones tilted 30º distally. The cantilever was loaded with an axial load of 50 N. Data was evaluated using von Mises stress on implants and maximum principal stress and microstrain on the bone. The W group showed the lowest value of maximum principal stress in peri-implant bone of the loaded side (4.64 MPa) when compared to C (5.27 MPa), DTR (5.94 MPa), and R (11.12 MPa). Lower stress values in the loaded implants were observed in the experimental groups when compared to the C group. However, the unloaded implants presented opposite results. All the screws of the W group presented lower stress values when compared to the C group. However, the R and DTR groups presented an increase in stress values with the exception of the loaded screw. A reduction in the number of implants associated with wider implants reduced the stress in the bone and prosthetic components.

Tratamento endodôntico na terceira idade / Endodontic treatment in elderly

A odontogeriatria é um ramo que cada vez mais vem tomando espaço na odontologia. Este segmento vem acompanhado de uma maior conscientização, tanto de profissionais quanto de pacientes, que passam a ter maiores preocupações com a saúde bucal, chegando à terceira idade com um maior número de dentes do que as gerações anteriores. Dessa forma, o cirurgião-dentista deve estar preparado para qualquer tipo de procedimento necessário para manter os seus pacientes com uma boa qualidade de saúde bucal. A endodontia, que em décadas passadas era muito pouco realizada em pacientes idosos, tem apresentado um crescente número de casos. Baseado nesse aumento de demanda, o presente trabalho realizou uma revisão da literatura quanto aos aspectos histológicos da polpa dental senil, do tratamento endodôntico propriamente dito e de aspectos sistêmicos que podem alterar o tratamento convencional, com o intuito de orientar o profissional que se dispõe a realizar estes procedimentos na prática diária.

Geriatric dentistry is in continuous diffusion in dentistry. It is followed by professionals conscious raising and by the patients preoccupations about oral health quality, keeping into their elderly which more teeth than the past generations. In this way the professional should be prepared to do any necessary procedure to patients keep their oral health quality. The endodontics, which few decades ago were rarely done in elderly is showing a considerable arouse in number of cases. Based on that increment on endodontics procedures the present paper reviewed the literature about the histological aspects of the elderly dental pulp, the endodontic procedure itself and some systemic aspects that may interfere anyhow in comparison with the conventional treatment, to guide the professional about these procedures in the daily practice.

Efeitos da plataforma switching em reabilitações implantossuportadas - revisão de literatura / Effects of platform switching in implant-supported rehabilitations - a literature review

Objetivo: o objetivo deste estudo foi avaliar os efeitos do uso da plataforma switching em reabilitações implantossuportadas. Esse tipo de sistema consiste em utilizar um componente protético de menor diâmetro, conectado à plataforma de implante com maior diâmetro, portanto, não combinados como de maneira convencional. Revisão de literatura: foram selecionados 13 artigos publicados no período de 2006 a 2011 abrangendo as consequências do uso da plataforma switching em relação aos fatores biológicos e biomecânicos das reabilitações implantossuportadas. Considerações finais: ficaram claros os benefícios e a indicação do uso de tal sistema, destacando-se a redução na reabsorção inicial da crista óssea peri-implantar e manutenção desse nível ósseo ao longo dos anos, bem como a diminuição nas forças sobre o tecido ósseo adjacente à região cervical do implante. Sendo assim, mesmo na presença de possíveis inconvenientes causados por este sistema, como o aumento das tensões na região do parafuso e componente protético, o uso da plataforma switching torna-se um atrativo para as reabilitações protéticas implantossuportadas.

Depression and TMD in the elderly: a pilot study / Depressão e DTM em idosos: estudo piloto

Temporomandibular dysfunction (TMD) is a painful syndrome that affects orofacial region, with deleterious effects in patients’ quality of life. Several aspects of TMD in the elderly are still controversial in the literature. The aim of this paper is to verify the prevalence of TMD among the elderly people in Taubaté – Brazil, and its possible association with other co-morbidities. Sixty-eight elderly individuals, presenting an average age of 69.5 years (SD 8.5), participated in this study, 37 of which were women. The Research Diagnostic Criteria for Temporomandibular Dysfunction (RDC/TMD) was used to verify TMD and its possible association with other co-morbidities. The studied sample presented a low prevalence of TMD according to RDC/TMD (10.3%). Women presented more non-specific physical symptoms – pain items included – than men (pain items included, p=0.016, x2 test). Depression and non-specific physical symptoms – pain items excluded – did not correlate with patients’ gender. Associations were found among depression and characteristic pain intensity (p=0.027, ANOVA), non-specific physical symptoms - pain items included (p<0.001), non-specific physical symptoms – pain items excluded (p=0.001) and chronic pain grade (p=0.004), whereas the more depressed the patients, the higher were their pain scores. One can conclude that psychological factors, such as depression, were associated with TMD prevalence, thus reinforcing the need for a multidisciplinary approach for TMD treatment.

A disfunção temporomandibular (DTM) é uma síndrome dolorosa que afeta a região orofacial, com efeitos deletérios na qualidade de vida dos pacientes. Diversos aspectos à respeito da DTM em idosos são controversos na literatura. O objetivo neste estudo foi verificar a prevalência de DTM em idosos da cidade de Taubaté – Brasil, e as possíveis associações com outras co-morbidades. Sessenta e oito indivíduos, apresentando idade media de 69,5 anos (DP 8,5), participaram neste estudo, sendo 37 mulheres. O Research Diagnostic Criteria for Temporomandibular Dysfunction (RDC/TMD) foi usado para verificar DTM e as possíveis associações com outras co-morbidades. A população estudada apresentou baixa prevalência de DTM de acordo com o RDC/TMD (10,3%). Mulheres apresentaram mais sintomas não específicos – itens de dor incluídos – que homens (itens de dor incluídos, p-0.016, x2 test). Depressão e sintomas físicos não específicos – itens de dor excluídos – não correlacionaram com o sexo do paciente. Associações foram encontradas entre depressão e a intensidade das características de dor (p=0.027, ANOVA), sintomas físicos não específicos – itens de dor incluídos (p<0.001), sintomas físicos não específicos – itens de dor excluídos (p=0.001) e a escala de dor crônica (p=0.004), sendo que paciente mais deprimidos apresentaram maiores escores para dor. Pode-se concluir que os fatores psicológicos, como a depressão, foram associados com a prevalência de DTM, reforçando assim a necessidade de uma abordagem multidisciplinar para o seu tratamento.

Longitudinal study of removable partial dentures and hygiene habits / Estudo longitudinal de próteses parciais removíveis e hábitos de higiene

The removable partial dentures (RPD) are used to reestablish the phonetics, aesthetics and masticatory function for partially dentate patients, mainly those who compound the Brazilian poorest population, since RPD presents a relatively low cost. The rehabilitation gone to be successfully when besides the planning, the dentist orientate hygiene habits to the patient, and proserve the case. The present paper evaluates hygiene habits and RPD planning among a sample of RPD wearers, in a cross-sectional design. A questionnaire was applied and a clinical examination was performed by two previously calibrated examiners. The sample was composed by 83 patients, and 25 were males. It was verified that 49.4% of the patients brush their teeth three times per day and that 28.9% took approximately 4 minutes for each teeth brushing, 95.2% use other hygiene resources, besides toothbrushing, as dental cream (98.7%), dental floss (79.7%) and mouthrinses (55.7%). However 56.6% showed bacterial plaque and 21.7% presented caries at clinical exam. About the dentures, 74.7% was definitive RPD and 96.4% showed bilateral design. The requisites of stability, retention, occlusion and aesthetics was classified as good, in the majority of the cases; the hygiene was classified as good to regular. In 24% of the dentures, the base was deformed or fractured, 50.6% presented artificial teeth with detritions. Instead of patients’ adequate oral hygiene habits and satisfaction with RPD, more comprehensive explanations about oral care and more frequent follow-ups should be considered to improve plaque index and periodontal health among RPD wearers.

As próteses parciais removíveis (PPR) são usadas para restabelecer fonética, estética e função em pacientesparcialmente dentados, principalmente para aqueles que compõem a população pobre brasileira, visto que asPPR apresentam baixo custo de confecção. Para que a reabilitação seja bem sucedida, além do planejamentocorreto, orientações quanto à higiene bucal, das próteses e proservação do caso se fazem necessárias. O presenteestudo avaliou hábitos de higiene e o planejamento das PPR de uma amostra de portadores de PPR, emestudo transversal. Para tanto foi utilizado questionário e exame clínico realizados por dois examinadorespreviamente calibrados. Foram analisados 83 pacientes, 25 do sexo masculino, verificou-se que 49,4% dospacientes escovavam os dentes três vezes ao dia e que 28,9% levam cerca de 4 minutos para a escovação,95,2% usavam outros meios de higienização, além da escova, como: creme dental (98,7%), fio dental (79,7%)e colutórios (55,7%). Porém, observou-se que 56,6% apresentavam placa bacteriana e 21,7% cárie ao exameclínico. Quanto às próteses 74,7% eram definitivas e 96,4% eram bilaterais. Os requisitos de estabilidade,retenção, oclusão e estética foram classificados como bons, na maioria dos casos; já a higiene teve igualproporção para bom e regular. Em 24% das próteses, a base encontrava-se fraturada ou deformada, 50,6%apresentavam os dentes artificiais com desgaste. Embora a maioria dos pacientes considerasse sua próteseboa, explicações mais completas sobre os cuidados orais e maior freqüência de visitas ao dentista devem serconsiderados para melhorar a saúde periodontal e o controle de placa em usuários de PPR.

Surgeon heart rate analysis during the dental implant procedure

Dental implant placement is a singular procedure in dentistry, and many variables should influence its success. The operator’s attitudes during surgeries are some of these variables. Considering that, the present paper aims to evaluate surgeon’s stress during different stages of dental implant placement. The heart rates of ten post-graduate students of implantology were evaluated at rest and during various steps of the implant placement procedure, using a Pollar R device. Each surgeon’s heart rate was monitored at different moments (preparation of the surgery; anaesthesia; incising and flapping procedures; bone perforating; implant placement at bone site; suture; end of the surgical procedure) during a single surgical implant insertion procedure (without additional procedures such as expansion, grafting and others). Implantodontic interventions were found to be the most stressful of these procedures, and implant placement in the bone site the most critical. Current procedures for the general practitioner, such as local anaesthesia, induced minor variations in the heart rate and, hence, less stress.