Physical exercise interventions for people with Parkinson's disease: a bibliometric review of systematic reviews / Intervenções de exercícios físicos para pessoas com doença de Parkinson: uma revisão bibliométrica de revisões sistemáticas

This bibliometric study aimed to characterize published systematic reviews assessing the effects of physical exercise on people with Parkinson's disease. Eligible studies were searched in Web of Science, Scopus, Cochrane Library, and MEDLINE via PubMed databases. No date or language restrictions were applied. Studies were selected based on the inclusion criteria, and the results were uploaded to Bibliometrix 4.0 for R for bibliometric analysis. A total of 146 studies were included in the analysis, with the first one having been published in 2005. The annual growth rate was 14.72%, with an average publication time of 3.72 years. Themes based on indexed keywords represented elements of the PICO question, namely Parkinson's disease, exercise, therapy, rehabilitation, and outcomes such as gait, balance, and quality of life. A considerable number of systematic reviews addressing the effects of physical exercise interventions on people with Parkinson's disease have been published since the mid-2000s. Systematic reviews were first published by countries with long-established older populations. Exercise-based interventions and their effects on gait, balance, and quality of life in people with Parkinson's disease have been the focus of the most recent reviews

Este estudo bibliométrico teve como objetivo caracterizar as revisões sistemáticas que avaliaram os efeitos do exercício físico em pessoas com doença de Parkinson. Estudos elegíveis foram pesquisados nas bases de dados Web of Science, Scopus, Biblioteca Cochrane e United States National Library of Medicine ­ MEDLINE via PubMed. Nenhuma restrição de data ou idioma foi adotada. Os estudos foram selecionados com base nos critérios de inclusão, e os resultados foram carregados no Bibliometrix 4.0 para R para análise bibliométrica. No total, foram incluídos 146 estudos na análise, o primeiro dos quais foi publicado em 2005. Verificou-se taxa de crescimento anual de 14,72%, com tempo médio de publicação de 3,72 anos. Temas baseados em palavras-chave indexadas representam elementos da questão problema, intervenção, controle e outcome ­ PICO, ou seja, doença de Parkinson, exercício, terapia, reabilitação e resultados, como marcha, equilíbrio e qualidade de vida. Um número considerável de revisões sistemáticas que abordam o efeito de intervenções de exercícios físicos em pessoas com doença de Parkinson foi publicado desde meados dos anos 2000. Revisões sistemáticas foram publicadas pela primeira vez por países com uma população idosa estabelecida há muito tempo. Intervenções baseadas em exercícios e seus efeitos na marcha, no equilíbrio e na qualidade de vida de pessoas com doença de Parkinson têm sido o foco das revisões mais recentes

Strategies to promote knowledge translation in primary health care: scoping review / Estrategias para promover la traducción del conocimiento en la atención primaria de salud: revisión de alcance / Estratégias para promover a translação do conhecimento na atenção primária à saúde: revisão de escopo

ABSTRACT Objective: To map the strategies used by health professionals to promote knowledge translation in Primary Health Care and to identify barriers and facilitators for the use of scientific evidence. Method: Scoping review with search in PubMed, EMBASE, CINAHL, Web of Science, Scopus, LILACS, and gray literature, in April 2022, using the terms "translational medical research", "knowledge translation", "primary health care". The PRISMA-ScR was used to report the review. Results: 56 studies included. Several strategies were identified and grouped into: educational material, training, websites, educational outreach, knowledge translation networks, local facilitators, feedback and public promotion. High demand for services and content without practical information represented barriers, while assessing the context, involving stakeholders and the presence of local facilitators ease theuse of evidence. Conclusion: The most used strategies were educational material and training. Overcoming barriers is essential to bridging the gap between evidence and practice.

RESUMEN Objetivo: Mapear las estrategias utilizadas por los profesionales de la salud para promover la traducción del conocimiento en la Atención Primaria de Salud e identificar barreras y facilitadores para el uso de la evidencia científica. Método: Scopingreview con búsqueda en PubMed, EMBASE, CINAHL, Web of Science, Scopus, LILACS y literatura gris, en abril de 2022, utilizando los términos "translational medical research", "knowledge translation", "primary health care". PRISMA-ScR se utilizó para informar la revisión. Resultados: Se incluyeron 56 estudios. Se identificaron varias estrategias y se agruparon en: material educativo, capacitación, sitios web, extensión educativa, redes de traducción del conocimiento, facilitadores locales, retroalimentación y promoción pública. La alta demanda de servicios y contenidos sin información práctica representó barreras, mientras que la evaluación del contexto, la participación de todos los actores y la presencia de facilitadores locales facilitan el uso de la evidencia científica. Conclusión: Las estrategias más utilizadas fueron el material educativo y la capacitación. Superar las barreras es esencial para cerrar la brecha entre la evidencia y la práctica.

RESUMO Objetivo: Mapear as estratégias utilizadas pelos profissionais de saúde para promover a translação do conhecimento na Atenção Primária à Saúde e identificar barreiras e facilitadores para o uso de evidências científicas. Método: Scopingreview com busca no PubMed, EMBASE, CINAHL, Web of Science, Scopus, LILACS e literatura cinzenta, em abril de 2022, baseado nos termos "translational medical research", "knowledge translation","primary health care".Utilizou PRISMA-ScR para relato da revisão. Resultados: 56 estudos incluídos. Diversas estratégias foram identificadas e agrupadas em: material educacional, capacitação, websites, extensão educacional, redes de translação do conhecimento, facilitadores locais, feedback e promoção pública.Alta demanda por atendimentos e conteúdos sem informações práticas representaram barreiras, enquanto, avaliar o contexto, envolver as partes interessadas e presença de facilitadores locais facilitam a utilização de evidências. Conclusão: As estratégias mais utilizadas foram material educacional e capacitação. Superar as barreiras é essencial para minimizar a lacuna entre as evidências e prática.

Effect of whitening mouth rinses on the chemical and physical properties of a nanofilled composite

Aim: This study analyzed the effect of whitening mouth rinses on water sorption (WS), solubility (SL), color change, and surface roughness of a nanofilled composite. Whitening perceptibility and acceptability (WID) were also studied. Methods: Forty specimens of Filtek Z350XT, shade EA2 were produced and randomly distributed (n=8) to AS ­ artificial saliva (control); LWE ­ Listerine Whitening Extreme; CLW ­ Colgate Luminous White; LCM ­ Listerine Cool Mint; and CP ­ Colgate Plax. They were immersed in the mouth rinses 2x/day, for one minute, during 28 days. The color was assessed using an Easyshade spectrophotometer (CIE-L*a*b* system). Surface roughness (Ra-µm) was measured with three parallel measures, using an RP-200 roughness meter. The WS and SL (µg/mm-3) were analyzed based on the ISO 4049 recommendations. The data were analyzed using one- and two-way ANOVA/Tukey tests (α=0.05). Results: Surface roughness significantly increased after immersion in AS and LCM, with no significant differences between the groups either before or after immersion. The ΔE* was not significantly different between the groups. All substances produced a ΔWID higher than the 50%:50% perceptibility and acceptability thresholds. The WS and SL were not significantly affected by the mouth rinses. Conclusion: Whitening mouth rinses did not affect WS, SL, surface roughness, and color stability of a nanofilled composite, regardless of the presence of ethanol in the composition

Diferença de cor entre resinas compostas de marcas comerciais diferentes / Color difference between composites of different commercial brands

Este estudo avaliou a cor de duas resinas compostas universais produzidas por diferentes fabricantes. Noventa e seis espécimes das resinas compostas Filtek Z350XT (3M ESPE) e IPS Empress Direct (Ivoclar Vivadent) (n=48 cada) da cor A2E foram confeccionados com 5 mm de diâmetro X 6 mm de altura. Cada camada de 2 mm de espessura de resina inserida foi fotoativada com uma unidade fotoativadora LED com 900 mW/cm2 por 20 s. Os espécimes foram polidos com o sistema Sof-lex Pop-On (3M ESPE). A cor foi aferida com um espectrofotômetro digital portátil Easyshade (Vita Zahnfabrik, Bad Säckingen), com base nos eixos tridimensionais do sistema CIEL*a*b*, e sua diferença entre as resinas foi determinada em cada eixo, calculando o seu respectivo Δ (ΔL*, Δa* e Δb*) e os parâmetros de variação total de cor ΔE* e ΔE00. A diferença de cor entre as resinas em cada eixo foi analisada estatisticamente pelo Teste t de amostras independentes (α=0,05), além de considerar os limiares de 50%:50% de perceptibilidade e aceitabilidade da variação total de cor. Diferenças estatisticamente significativas foram observadas no ΔL* e no Δb* (p<0,001). Os valores de ΔE foram de três a quatro vezes superiores ao limite de perceptibilidade e em até duas vezes ao limite de aceitabilidade da variação total de cor. Verificou-se que diferenças importantes de cor podem ocorrer em resinas da mesma cor, porém, de fabricantes diferentes. Essas diferenças podem ser visualmente perceptíveis e acima dos limites de aceitabilidade, podendo comprometer o resultado estético da restauração.(AU)

This study assessed the color of two universal composites produced by different manufacturers. Ninety-six specimens of Filtek Z350XT (3M ESPE) and IPS Empress Direct (Ivoclar Vivadent) (n=48 each) colored A2E were made with 5 mm of diameter X 6 mm of height. Each 2 mm-thick composite layer inserted was light cured with a LED light curing unit with 900 mW/cm2 for 20 s. The specimens were polished with Sof-lex Pop-On (3M ESPE). The color was measured with a portable digital spectrophotometer Easyshade (Vita Zahnfabrik, Bad Säckingen) based on the tridimensional axes of the CIEL*a*b* system, and the difference between composites was determined in each axis by determining the respective Δs (ΔL*, Δa* e Δb*), along with the parameters for total color variation ΔE* and ΔE00. The color difference between composite in each axis was analyzed statistically using the t-test (α=0,05), besides considering the 50%:50% thresholds for visual perceptibility and acceptability of total color variation. Statistically significant differences were observed in ΔL* and Δb* (p<0.001). The ΔE values were three to four times higher than the perceptibility threshold and twice higher than the acceptability threshold for total color variation. Relevant color differences may occur in composites of the same color, yet, made by different manufacturers. These differences may be visually perceptible and higher than acceptance limits, and may compromise the esthetic result of dental restorations.(AU)

Perfil dos acidentes de trabalho na indústria da construção civil no oeste de Santa Catarina / Profile of occupational accidents in the civil construction industry in western Santa Catarina / El perfil de accidentes de trabajo en la industria de la construcción civil en el oeste de Santa Catarina

Visou-se analisar o perfil dos acidentes de trabalho notificados ocorridos na Indústria da Construção Civil no Oeste de Santa Catarina entre 2008 e 2015. As 3.345 notificações do Sistema de Informação de Agravos de Notificação e do Centro de Referência em Saúde do Trabalhador (CEREST) Regional de Chapecó/SC foram analisadas mediante estatística descritiva e teste qui-quadrado de associação (α=0,05). 2.572 acidentes foram leves (76,9%), 60 (1,7%) foram mutilantes, 695 (20,7%) foram graves e 18 (0,5%) foram fatais. O tipo de acidente foi associado ao sexo, à faixa etária e à ocupação do trabalhador (p<0,05). Acidentes graves acometeram mais gesseiros e pintores, do sexo masculino, na faixa etária de 15 a 17 anos. Por outro lado, proporcionalmente, serventes, mulheres e trabalhadores entre 58 e 67 anos sofreram mais acidentes fatais. Os achados permitem melhor compreender a associação entre o tipo de acidente e as variáveis sociodemográficas do trabalhador e do seu contexto de trabalho, o que é relevante na elaboração de políticas públicas.

We aimed to analyse the profile of work accidents notified to have occurred in the civil construction industry of Western Santa Catarina between 2008 and 2015. The 3,345 notifications from the Notification of Injury Information System and the Worker´s Health Reference Center (CEREST) from the region of Chapecó/SC were analysed using descriptive statistics and chi-square test of association (α=0.05). Of the 3,345 accidents, 2,572 were not serious (76.9%), 60 (1.7%) were mutilating, 695 (20.7%) were serious, and 18 (0.5%) were fatal. The type of accident was associated to sex, age range, and occupation (p>0.05). Serious accidents involved more plasterers and painters, male, aged 15-17 years old. On the other hand, proportionally, female labourers, aged 58-67 years old were more susceptible to fatal accidents. The findings allow a better understanding of the association between the type of accident and the socio-demographic variables of the worker and their working environment, which is relevant for the development of public policies.

El objetivo del estudio fue analizar el perfil de los accidentes de trabajo notificados ocurridos en la industria de la construcción civil en el oeste de Santa Catarina entre 2008 y 2015. Las 3 345 notificaciones del Sistema de Información de Agravios de Notificación y del Centro de Referencia en Salud del Trabajador (CEREST) Regional de Chapecó/SC fueron analizadas a través de estadística descriptiva y prueba chi-cuadrado de asociación (α = 0,05). 2 572 accidentes fueron leves (76,9%), 60 (1,7%) fueron mutiladores, 695 (20,7%) fueron graves y 18 (0,5%) fueron fatales. El tipo de accidente se asociaba al sexo, al grupo de edad ya la ocupación del trabajador (p>0,05). Los accidentes graves acometieron más yeseros y pintores, del sexo masculino, entre 15 y 17 años de edad. Por otro lado, proporcionalmente, peones de mano, mujeres y trabajadores entre 58 y 67 años sufrieron más accidentes fatales. Los hallazgos permiten una mejor comprensión de la relación entre el tipo de accidente y las variables sociodemográficas del trabajador y su contexto laboral, relevante para la creación de políticas públicas.

In vitro tooth whitening effectiveness of whitening mouth rinses

Regardless of the extensive availability of mouth rinses that claim to whiten teeth, evidence of achievement of such effect is still missing. Aim: Therefore, this study assessed in vitro the whitening effectiveness of whitening mouth rinses. Methods: Sixty intact bovine incisors were embedded in acrylic resin and had their buccal surface flattened and polished. Then, the specimens were randomly allocated to three conventional (Colgate Plax, Cepacol and Listerine Cool Mint) and three whitening mouth rinse groups (Colgate Luminous White, Cepacol Whitening and Listerine Whitening Extreme) (n=10). Following, the specimens were immersed twice a day in the mouth rinses for one minute for 28 days. In between each immersion period, the specimens remained in artificial saliva at 37oC. Color was measured at baseline, 7, 14, 21, and 28 days using a portable spectrophotometer (Easyshade, Vita Zahnfabrik, Germany) with a 6 mm of diameter probe. Color change was analyzed considering the parameters of ∆L*, ∆a*, ∆b* and, ultimately, ∆E*. The whitening efficacy of the mouth rinses was analyzed using the Whiteness Index for Dentistry (WID). Data of ∆s was analyzed using two-way ANOVA and Tukey's test (α=0.05). Results: The type of mouth rinse affected significantly all the ∆ parameters (p<0.05). A non-whitening (conventional) mouth rinse produced the highest ΔE*, followed by the three whitening mouth rinses. The application time also affected ΔE* (p<0.05), with emphasis on the third week of treatment. Only the hydrogen peroxide-containing mouth rinse (Listerine Whitening Extreme) presented a whitening effect, with an increasing trend over time. Conclusion: Although the overall color change was not different when comparing conventional and whitening mouth rinses, the hydrogen peroxide-containing whitening mouth rinse produces an increasing whitening trend over time. Not every mouth rinse that claims to whiten teeth produces the desired effect

Estratégias de defesa contra o sofrimento no trabalho de docentes da pós-graduação stricto sensu / Defensive strategies against suffering at work by stricto sensu postgraduate professors

O estudo objetivou identificar as estratégias de defesa contra o sofrimento no trabalho desenvolvidas por docentes da pós-graduação stricto sensu. Trata-se de pesquisa descritiva, com abordagem qualitativa. Participaram 47 docentes de uma universidade do Sul do Brasil, que responderam a um questionário baseado no Inventário sobre Trabalho e Riscos de Adoecimento, sendo que dois representantes de cada um dos sete programas de pós-graduação stricto sensu da universidade também foram entrevistados. A investigação foi aprovada no Comitê de Ética da instituição e a coleta de dados ocorreu entre outubro de 2018 e março de 2019. Os docentes utilizam, predominantemente, estratégias de defesa individuais, dentre elas a psicoterapia, a religiosidade/espiritualidade e o apoio da família, seguidas, timidamente, de estratégias coletivas, estas centradas na boa relação com os colegas de trabalho e discentes, que são responsáveis por ressignificar as práticas laborais, contudo requerem mais investimento das instituições. Tais achados geram preocupação, uma vez que se entende que é na coletividade que ocorre a cooperação, a relação empática, a dialogicidade e a transformação da realidade laboral.

The study aimed to identify the defensive strategies against suffering at work developed by stricto sensu graduate professors. It was a descriptive research with a qualitative approach. Forty-seven professors from a university in the South of Brazil participated, who answered a questionnaire based on the Inventory on Work and Illness Risks, two representatives from each of the university's seven stricto sensu graduate programs were also interviewed. The investigation was approved by the institution's Ethics Committee and data collection took place between October 2018 and March 2019. Professors use, predominantly, individual defense strategies, among them are psychotherapy, religiosity/spirituality and family support, shyly followed by collective strategies, these centered on a good relationship with co-workers and students, who are responsible for giving new meaning to work practices, however they require more investment from the institutions. Such findings generate concern once it is understood that it is in the collectivity that occurs cooperation, empathic relationship, dialogicity, and transformation of work reality.

Oral health condition of elderly people with Parkinson disease / Condição de saúde bucal de idosos com doença de Parkinson

The oral hygiene of individuals with Parkinson disease (PD) is markedly impaired by difficulties in toothbrushing due to motor impairment and tremors. Additionally, it appears that other features associated with PD have an impact on the quality of oral health. Objective: this cross-sectional observational study characterized the oral health condition of individuals with PD. Methods: fifty individuals with PD, aged 53 to 94 years, users of medication for such condition were examined. The research participants had their oral cavities examined to assess prosthetic use and need; index of Decayed, Missing and Filled Teeth (DMFT); Community Periodontal Index (CPI); Periodontal Attachment Loss (PAL); and oral mucosa. In addition, a questionnaire was applied to obtain personal data, general health, and oral health. The data were analyzed using descriptive statistics. Results: a high prosthetic use was observed in the upper arch (92%), while the lower arch revealed high prosthetic need (66%). The DMFT index showed a high number of missing teeth, CPI showed a prevalence of 43% of dental calculus, and PAL revealed 28% of attachment loss of 4-5 mm. The most frequent findings in the assessment of oral mucosa were denture stomatitis and inflammatory fibrous hyperplasia. Conclusion: PD patients refer xerostomia and present high number of missing teeth, a minority of healthy teeth, and oral lesions, representing a target population for specialized oral health care. (AU)

A higiene bucal de indivíduos com doença de Parkinson (DP) é claramente prejudicada por dificuldades na escovação devido ao comprometimento motor e aos tremores. Além disso, outros aspectos relacionados à doença parecem impactar a qualidade da saúde bucal. Objetivo: este estudo observacional seccional caracterizou a condição de saúde bucal de indivíduos com DP. Métodos: foram examinados cinquenta indivíduos com DP, com idades variando entre 53 e 94 anos, que utilizavam medicamentos para DP. Os participantes da pesquisa foram submetidos a exame bucal para avaliar: uso e necessidade de prótese, índice de dentes cariados, perdidos e obturados (CPOD), Índice Periodontal Comunitário (IPC), Índice de Perda de Inserção Periodontal (PIP) e mucosa bucal. Além disso, foi aplicado um questionário para obtenção de dados pessoais e sobre saúde geral e saúde bucal. Os dados foram analisados usando estatística descritiva. Resultados: observou-se alto percentual de uso de prótese superior (92%), enquanto o arco inferior apresentou elevada necessidade de prótese (66%). O CPOD revelou um alto número de dentes perdidos; o IPC apresentou prevalência de 43% de cálculo dentário; e o PIP revelou 28% de perda de inserção de 4-5 mm. Os achados mais frequentes na avaliação da mucosa bucal foram estomatite por dentadura e hiperplasia fibrosa inflamatória. Conclusão: os indivíduos com DP mencionam xerostomia, apresentam alto número de dentes faltantes, um número reduzido de dentes saudáveis e lesões bucais, representando uma população-alvo para o cuidado de saúde bucal especializado. (AU)

Antiproliferative Effect of Urera baccifera Leaves Against Ovarian Carcinoma Cell Line (OVCAR-3)

Abstract Natural products, especially phytochemicals, have been extensively studies and have exhibited important antiproliferative effects. The American native species Urera baccifera (L.) Gaudich. ex Wedd. (Urticaceae) is widely distributed in Brazil, where it is known as urtiga-vermelha or urtigão. The leaves are popularly used as anti-inflammatory, antirheumatic and in the treatment of gastric disorders. However, the antiproliferative potential of this plant against human tumor cells remain to be elucidated. In this study, we evaluated the antiproliferative effects of U. baccifera leaves extracts and fractions against a panel of human tumor cell lines in vitro besides a chemical evaluation of the most active sample by mass spectrometry (ESI-IT-MSn). The hydroalcoholic extract was inactive while dichloromethane extract showed moderate cytostatic activity against ovarian carcinoma cell line (OVCAR-3, GI50 = 1.5 μg/mL). More, the ethyl acetate and n-butanol fractions did not show important activity against tumour cell while the dichloromethane and hexane fractions showed moderate cytostatic activity against ovarian tumor cell line (OVCAR-3, GI50 = 12.7 and 9.4 μg/mL, respectively). Finally, the chemical profile evaluated by mass spectrometry (ESI-IT-MSn) allowed the detection of flavonoids in the HEU and hydroxylated fatty acid in DEU that can explain partially the biological effects observed. This is the first report of the antiproliferative effects of U. baccifera, and DEU has shown potential as a promising source of bioactive compounds.

Oral health profile of participants of an elderly cohabitation program in the state of Santa Catarina, Brazil / Perfil de saúde bucal dos participantes de um programa de convivência de idosos em Santa Catarina, Brasil

Abstract Introduction Cohabitation and social interaction programs have been shown to enhance several aspects of the quality of life of the elderly. Objective This observational study assessed the oral health and oral health perception of participants of an elderly cohabitation program in the state of Santa Catarina, Brazil. Material and method Calibrated dental students examined/interviewed 235 participants of the program. The oral examination considered Decayed, Missing, and Filled Teeth (DMFT) index, Community Periodontal Index (CPI), Periodontal Attachment Loss (PAL), use and need of prostheses, and presence of oral mucosal lesions. Oral health perception was verified with the Geriatric Oral Health Assessment Index (GOHAI) questionnaire. Data were analyzed with descriptive statistics and chi-square test (α=0.05). Result The mean DMFT index was 24.3 teeth, with emphasis on the 'Missing' category. Upper and lower prosthetic needs were 53.6 and 71.1%, respectively. Fifty-five per cent of participants presented oral mucosal lesions. Moderate oral health perception prevailed (43%), with mean GOHAI score of 29.9. The negative perception on physical and pain/discomfort dimensions was statistically associated with lower prosthetic need (p<0.05). Conclusion The participants of the cohabitation program presented poor oral health and prevalence of moderate oral health perception. Lower prosthetic need was associated with negative perception.

Resumo Introdução Programas de convívio e interação social tem melhorado vários aspectos da qualidade de vida de idosos. Objetivo Este estudo observacional avaliou a saúde bucal e a percepção de saúde bucal de participantes de um programa de convívio de idosos em Santa Catarina, Brasil. Material e método Duzentos e trinta e cinco participantes do programa Cidade do Idoso foram examinados/entrevistados por estudantes calibrados. O exame bucal considerou: índice de dentes cariados, perdidos e obturados (CPO-D), Índice Periodontal Comunitário (IPC), índice de Perda de Inserção Periodontal (PIP), uso e necessidade de prótese e presença de lesões de mucosa bucal. A percepção de saúde bucal foi verificada pelo Índice de Avaliação de Saúde Bucal Geriátrica (GOHAI). Os dados foram analisados com estatística descritiva e teste qui-quadrado (α=0,05). Resultado O CPO-D médio foi de 24,3 dentes, com ênfase à categoria 'perdidos'. Necessidade de prótese superior e inferior correspondeu a 53,6 e 71,1%, respectivamente; 55% apresentaram lesões de mucosa bucal. Uma percepção de saúde bucal moderada prevaleceu (43%), com um escore médio do GOHAI de 29,9. Uma percepção negativa nas dimensões física e dor/desconforto foi estatisticamente associada com a necessidade de prótese inferior (p<0,05). Conclusão Os participantes do programa Cidade do Idoso apresentaram uma saúde bucal precária e uma percepção de saúde bucal predominantemente moderada. A necessidade de prótese inferior foi associada a uma percepção negativa de saúde bucal.

Objective criteria for assessment of the quality of dental restorations improve student's critics towards the treatment assignment: a randomized controlled trial / Critérios objetivos para avaliar a qualidade de restaurações dentárias aumentam a crítica de estudantes acerca do tratamento designado: um ensaio randomizado controlado

Introduction: Objective parameters may help the decision of how to manage existing dental restorations in patients. Objective: This study tested the following hypotheses: i) teaching objective criteria to dental students enhances their criticism toward the indication for replacement of dental restorations; and ii) a complementary practical approach enhances the proportion of correctly indicated treatments compared with a strictly theoretical approach. Method: This block-randomized controlled trial involved dental students from a Brazilian university who were randomized to either a didactic/theoretical class group (A, control) or a didactic/theoretical class followed by practical training (group B); both conditions were applied in a moodle-based environment. The proportion of correctly indicated interventions before and after teaching the criteria was compared with using Mann-Whitney U-test (p<0.05), and a comparison between the approaches was established with Wilcoxon test (p<0.05). Result: The baseline proportion of correct assignments significantly increased after interventions for both groups (p=0.02), with no significant difference between the interventions (p=0.871). Conclusion: The proposed online training enhanced the proportion of correct assignments to restorations, confirming the first study hypothesis. The second hypothesis was rejected because differences between the strategies had no effect on the proportion of correct answers. Focusing on teaching objective criteria for assessment of the quality of restorations would enhance students' ability to correctly treat them.

Introdução: Parâmetros objetivos podem auxiliar a decisão de como lidar com restaurações existentes em pacientes. Objetivo: Este estudo testou as hipóteses que seguem: i) o ensino de critérios objetivos a estudantes de odontologia melhora sua crítica acerca da indicação para substituição de restaurações; e ii) uma abordagem prática complementar aumenta a proporção de tratamentos indicados corretamente comparada com uma abordagem estritamente teórica. Método: Este ensaio randomizado em bloco controlado envolveu estudantes de odontologia de uma universidade brasileira que foram randomizados para um grupo que recebeu uma aula teórica (A, controle) ou uma aula teórica seguida por um treinamento prático (grupo B); ambas as intervenções foram aplicadas em um ambiente moodle . A proporção de restaurações indicadas corretamente antes e depois do ensino dos critérios foi comparada com o teste U de Mann-Whitney (p<0,05), e a comparação entre as intervenções foi estabelecida com o teste de Wilcoxon (p<0,05). Resultado: A proporção de indicações corretas aumentou significativamente após as intervenções para ambos os grupos (p=0,02), sem diferença significativa entre as intervenções (p=0,871). Conclusão: O treinamento online proposto aumentou a proporção de indicações corretas às restaurações, confirmando a primeira hipótese do estudo. A segunda hipótese foi rejeitada visto que as diferenças entre as intervenções não tiveram efeito na proporção de respostas corretas. O foco no ensino de parâmetros objetivos para avaliação da qualidade das restaurações pode aumentar a habilidade dos estudantes de tratá-las corretamente.

Denture disinfection using Salvia officinalis L: microbial load and selected properties of PMMA

Denture use may aggravate the occurrence of oral infections, considering it enhances microbial adherence. Aim: This study assessed the reduction of microbial loads of Candida albicans, Staphylococcus aureus, and Klebsiella oxytoca by disinfecting the polymethylmethacrylate (PMMA) of complete dentures with hydroalcoholic extract of Salvia officinalis. Additionally, the effect of such extract on the properties of PMMA was examined. Methods: Microorganisms were isolated from saliva samples collected from complete denture wearers. The hydroalcoholic extract of S. officinalis was produced according to the Brazilian Pharmacopoeia 5. The PMMA specimens (n=188) were immersed in microbial inoculum and incubated at 37°C for 16 hours per day. Then, they were subjected to a disinfection protocol for 30 days. The specimens were divided into five treatment groups: sterile saline solution (0.85%; control), 0.2% chlorhexidine digluconate, and hydroalcoholic extract of S. officinalis (0.2%, 0.8%, and 1.16%). Microorganism adherence to the PMMA surface was also assessed, as well as surface roughness (Ra in µm) and color stability of the PMMA (mean ΔE). Changes in microbial load and surface roughness after the disinfection protocol were verified with paired t-test. Substances at day 10, adherence, and color stability were compared by the Kruskall-Wallis and Mann-Whitney tests, and one-way ANOVA was used to compare substances at the beginning and end of the experiment (α=0.05). Results: The 1.16% S. officinalis extract significantly reduced the microbial load of all the microorganisms after 30 days of disinfection (p<0.05). The microbial load of K. oxytoca was also reduced at lower concentrations of the S. officinalis extract (0.2% and 0.8%) (p<0.02). Antimicrobial and anti-adherent effects against microorganisms isolated from the oral cavity were observed. There was no significant change in surface roughness (p>0.05) and color stability was significantly higher in the control group (p<0.0001). Conclusions: The hydroalcoholic extract of S. officinalis may be used as a disinfectant solution for dentures

Tooth whitening recovers the color of pre-stained composites

Aim: To assess the effect of home-whitening on aged and stained composite. Methods: Fifteen disc-shaped specimens (10 mm diameter x 2 mm thick) of Filtek Z350XT, shade A2E were fabricated, polished and embedded in wax, leaving exposed the top surface. The specimens were allocated to three groups (n=5): A ­ the specimens remained dry; B ­ conditioning in distilled water and; C ­ conditioning in distilled water and coffee. They were next subjected to whitening with 10% carbamide peroxide (Whiteness Perfect) for 4 h daily for 1, 2 and 4 weeks. Shade was measured with a spectrophotometer Easyshade and expressed based on the CIE L*a*b* system (ΔE*). Surface roughness was measured with a roughness meter (Ra-µm). Data were analyzed with two-way ANOVA and Tukey's test (α=0.05). Results: Conditioning, grouping and the interaction between both, influenced the ΔE* (p<0.0001), which exceeded the 3.3 threshold for visible color change after conditioning of Group C in black coffee. Whitening for 1 week significantly reduced ΔE* in this group. There were no significant changes in surface roughness. Conclusions: Home-whitening did not alter significantly the color of the nanocomposite, except when it was previously stained. One-week whitening was sufficient to recover color change to an acceptable level (Au)

Clinical and radiographic assessment of root canal treatments performed by dental students

Introduction: Retrospective assessment of procedures performed in dental school clinics is a valuable tool to critically assess the teaching/ learning process. Objective: This retrospective study assessed the success rate of root canal treatments executed by dental students during a two-year time span. Material and methods: Patients who had undergone root canal treatments at the clinics of the School of Dentistry of Unochapecó during 2011-2013 were recalled for assessment of the quality of the procedure and the associated coronal restoration. The quality of the root canal treatments was assessed clinically and radiographically, while the coronal restorations were assessed clinically by a trained dental student. Data were analyzed by descriptive statistics and chi-square test (α=0.05). Results: Thirtytwo patients returned for evaluation of 38 root canal treatments and coronal restorations. The success of root canal treatments was 89.5%, while 78.5% of the coronal restorations were considered successful. A significant association was observed between the success of the root canal treatments and the quality of the coronal restoration (p<0.005) and the apical length of the root canal filling (p<0.011). The presence of flaws within the filling material was not significantly associated to the success/failure of the root canal treatment (p=0.459). Conclusion: A high success rate of root canal treatment performed by dental students at an average 13-month evaluation period was observed. An adequate coronal restoration and a good apical sealing is required for a good prognosis of teeth undergoing root canal treatment.

School Environment and Dentoalveolar Trauma in Public Schools of Xaxim, Brazil

Objective: To assess the environment of elementary public schools of Xaxim, SC, Brazil, targeting the prevention of dental trauma. Material and Methods: All thirteen public schools in the city of Xaxim had their physical structure assessed concerning the conditions of floors, windows, stairs, capacity, type of surface of the schoolyard, number of supervisors during recess, and social inclusion. The social environment was assessed through the application of the Brazilian National School-Based Health Survey (PeNSE) to either school principals or educational coordinators. Regarding the social environment, areas for student physical activities, episodes of violence (swearing, physical and verbal aggression), and cases of robbery and theft in the school environment were assessed. Data were analyzed by descriptive statistics. Results: Situations considered of risk for the occurrence of accidents and dental trauma were identified. Most schools presented episodes of swearing and fights among students, as well as inadequate physical environment. Conclusion: Both social and physical environments were favorable to the occurrence of dental trauma; however, studies that establish this relationship in a deeper fashion are still necessary.

Ações em Saúde do Trabalhador desenvolvidas na Atenção Primária no município de Chapecó, Santa Catarina / Worker's health actions developed by Primary Health Care in Chapecó, Santa Catarina, Brazil

Resumo Objetivo: conhecer as ações de Saúde do Trabalhador desenvolvidas nos centros de saúde da Atenção Primária do município de Chapecó (SC) e verificar se elas estão incorporadas às rotinas dos serviços de saúde da Atenção Primária. Métodos: estudo descritivo com enfoque qualitativo, com utilização de entrevista semiestruturada e técnica de análise de conteúdo. Foram entrevistados dez sujeitos, com funções de coordenadores e de recepcionistas, de quatro Centros de Saúde urbanos e um rural, em 2014. Resultados: os entrevistados revelaram que, entre as diversas ações em Saúde do Trabalhador preconizadas pelo Ministério da Saúde, apenas as notificações de agravos relacionados ao trabalho (acidentes de trabalho e doenças ocupacionais) são realizadas. Conclusões: Mediante agendamento, as rotinas de trabalho na Atenção Primária estão centradas em atendimentos ao usuário e as ações desenvolvidas nos centros de saúde contemplam apenas os Programas de Saúde básicos. Entre as dificuldades enfrentadas para a realização de ações em Saúde do Trabalhador, o pouco conhecimento a respeito do tema se converte em um forte argumento para justificar a própria ausência dessas ações.

Abstract Objective: to be acquainted with the Worker's Health actions carried out at Primary Care Health Centers in Chapecó, Santa Catarina, Brazil, and to verify if they are incorporated into the routines of the Primary Care Health services. Methods: descriptive qualitative study using semi-structured interview and content analysis. Ten individuals, coordinators and receptionists, from urban and rural Health Centers, were interviewed in 2014. Results: the interviewees reported that, among the Worker's Health actions advocated by the Ministry of Health, the centers only carried out the notifications on work-related injuries (work accidents and occupational diseases). Conclusions: the Primary Care Health Centers' routines are focused on attending to users, and contemplate only basic Health Programs. The scarce knowledge on occupational health becomes a strong argument to explain the very lack of Workers' Health actions.

Water sorption, solubility and surface roughness of resin surface sealants

Surface sealants have been suggested as final glaze of the surface of composite restorations. However, little is known about bulk and surface properties of these materials aiming the long-term preservation of the surface integrity of these restorations. AIM: To evaluate the water sorption, solubility and surface roughness of commercial surface sealants for restorations. METHODS: Five disc-shaped specimens 15 mm diameter X 1 mm high were made from the surface sealants Natural Glaze DFL and Permaseal Ultradent and were light cured according to the manufacturer's instructions. The specimens were finished with 1500-grit SiC paper. Water sorption WS and solubility SL were assessed as recommended by the ISO 4049/2000 and were expressed in µg/mm3. Surface roughness was evaluated before and after WS and SL, and was expressed in µm as R1 before WS and SL and R2 after WS and SL. It was obtained from three parallel measurements along a 4mm length. Data were analyzed using t-test and paired t-test α=0.05. RESULTS: Water sorption and solubility of Natural Glaze were significantly lower than that of Permaseal p<0.05. Degradation of the surface sealants did not affect significantly their surface roughness p>0.05. CONCLUSIONS: Surface sealants used in composite restorations undergo hydrolytic degradation; however, this degradation seems not to interfere on surface roughness of these materials...

Dental esthetic self-perception of Brazilian dental students

Introduction: Esthetics in dentistry aims to improve the patients' self-esteem and satisfaction regarding how beautiful and attractive they feel. However, patients and dental professionals may perceive the concept of esthetics differently instead, which may cause the dissatisfaction of the patient with the results of the treatment. Objective: This cross-sectional observational study aimed to verify the esthetic self-perception of undergraduate dental students regarding their own smile. Material and methods: A questionnaire, designed by Goldstein 10 to measure the patients' self-perception and satisfaction, regarding their smiles, was applied to undergraduate students of different semesters of the School of Dentistry of the Federal University of Pelotas. Results: Our results showed that women are more dissatisfied with their smiles than men. Students attending different semesters worried somehow about the esthetics of their smiles and revealed the wish of having whiter teeth. Most students are satisfied with the shape of their teeth. Ninety two percent of the students feel self-confident regarding to smile, 90% believe someone else has a better smile, 87% look at the smile of models in fashion magazines, 71% wish to have whiter teeth and 80% wish to have rather a bigger or smaller teeth. Conclusion: Undergraduate dental students have a positive self-perception of their smile. Women are less satisfied than men. Students of the earlier semesters wish to have whiter teeth than students from the later semesters.

Repair of composite restorations - Teaching information from dental schools of the State of Rio Grande do Sul (RS), Brazil / Reparo de restaurações de resina composta - informações sobre o ensino em escolas de odontologia do estado do Rio Grande do Sul (RS), Brasil

Objective: The present study analyzed the teaching of repair of direct composite restorations (RCR) and its determining factors in Dental Schools of the State of Rio Grande do Sul (RS), Brazil. Methods: Eight Schools were selected based on registration on the website of the Mi-nistry of Education (MEC). A first contact was made by phone, and the e-mail of the head of the Restorative Department was obtained. A questionnaire was elaborated containing 19 questions, and was e-mailed to the dental schools. Data was analyzed by descriptive statistics. Results: Six from the eight schools selected returned the questionnaire. All participating schools fulfill and teach RCR and consider the technique successful as treatment. The schools did not present any reason for not accomplishing it. The main indications for repair were shade correction, fracture of the material and fracture of the tooth. In most schools the nature of the teaching is theoretical, in clinical disciplines. Conclusions: A consistent conduct towards teaching RCR was observed from 100% of the participating schools. Most of them consider it a definitive treatment, revealing a trend towards the preservation of tooth structure.

Three-year clinical performance of composite restorations placed by undergraduate dental students

This retrospective study evaluated the clinical performance and the reasons for failure of anterior and posterior composite restorations placed by undergraduate dental students over a 3-year period. All cavities were restored using Prime & Bond 2.1 and TPH (Dentsply), according to the manufacturer's indications. One hundred and two patients who had received composite restorations by third and forth year undergraduate students were recalled and examined to analyze the quality of the restorations. The restorations were evaluated using the modified USPHS system. Two hundred and fifty-six composite restorations, 170 in anterior teeth and 86 in posterior teeth, were evaluated. Eighty-five percent of the restorations were considered satisfactory after 3 years. Class II and class IV restorations presented the highest prevalence of failure. Loss of the restoration and deficient marginal adaptation were the main causes of failure. No restoration failed due to secondary caries. Most restorations placed by dental students were considered satisfactory after long-term evaluation. Failure was more prevalent in larger restorations and was not associated with secondary caries.

Este estudo retrospectivo avaliou o comportamento clínico e as razões de falhas de restaurações de resina composta em dentes anteriores e posteriores, realizadas por alunos de graduação em odontologia, após 3 anos de acompanhamento. Cento e dois pacientes que tiveram restaurações de resina composta colocadas por alunos do terceiro ou quarto ano foram rechamados e examinados para analisar a qualidade das restaurações. Todas as cavidades foram restauradas utilizando Prime & Bond 2.1 e TPH (Dentsply), de acordo com as orientações do fabricante. As restaurações foram avaliadas utilizando o sistema USPHS modificado. Duzentas e cinquenta e seis restaurações de resina composta, 170 em dentes anteriores e 86 em posteriores foram avaliadas. Destas restaurações, 85 por cento foram consideradas satisfatórias após 3 anos. Cavidades de classe II e classe IV apresentaram maior prevalência de falhas. Perda de restaurações e adaptação marginal deficiente foram as maiores causas de falhas. Nenhuma restauração falhou em decorrência de cárie secundária. Em conclusão, restaurações de resina composta feitas por estudantes de odontologia foram na sua maioria consideradas satisfatórias após 3 anos. Falhas das restaurações foram mais prevalentes em restaurações maiores e não esteve associada com cárie secundária.