Professional Factors Associated with Case Resolution without Referrals of Orofacial Pain Cases to Secondary Dental Care by Telehealth in Brazil: A Cross-Sectional Study in 2019 and 2020.

This study aimed to identify professional factors associated with case resolution without a referral of orofacial pain to secondary health care by Brazilian Primary Health Care (PHC) practitioners who demanded asynchronous teleconsulting, stratified by year, in 2019 and 2020 (the COVID-19 Pandemic burst). A cross-sectional study employed secondary databases from asynchronous teleconsulting Telehealth Brazil Networks from January 2019 to December 2020. The outcome was the dichotomous variable "If referral to secondary care was avoided." As covariates: sex, healthcare professions, and category of orofacial pain doubts. A negative binomial regression model estimated each covariate's unadjusted and adjusted PR (95%CI) and p values, stratified for 2019 and 2020. There was a difference in descriptive factors associated with case resolution without a referral from 2019 to 2020. Females prevailed in both years, and the total demand decreased to a third from 2019 to 2020. The rate of resoluteness decreased by 19.1%. In 2019, nurses (PR = 0.69 CI 95% 0.57-0.83) and other professionals (PR = 0.84 CI 95% 0.73-0.97) showed less frequency of case resolution without a referral than did general dentists. In 2020, oral-cavity-related doubts (PR = 1.18 CI 95% 1.06-1.32) and temporomandibular disorders (PR = 1.33 95% 1.15-1.54) surpassed other causes of orofacial pain in case resolution without a referral, and female professionals avoided referrals more frequently than men (PR = 1.24 CI 95% 1.21-1.38). In conclusion, in 2019, oral cavity doubts and the PHC profession influenced the case resolution. Female professionals and oral cavity doubts scored the higher case resolution without a referral for the service in 2020.

The Influence of Dentists' Profile and Health Work Management in the Performance of Brazilian Dental Teams.

To evaluate the association between dentists' profile and health work management with the performance of primary care dental teams in the Brazilian National Health System, both nationally and regionally. Secondary data analysis from a Brazilian National Programme that evaluated 18,114 Brazilian dental teams, working in the public sector, between 2013 and 2014. Twenty-four independent variables taken from dentists' profile and dental team management characteristics were analysed to assess their influence on reported "dental team performance." An estimated score was generated from their performance on 20 dental procedures by an item response theory model. Multiple linear regression models were performed for each Brazilian geographical region, separately and for the whole of Brazil. p values ≤ 0.05 were considered significant. Two variables related to dentists' profile, "having graduate studies" (ß = 0.151) and "undertaking continuing professional development training" (ß = 0.101), were associated with enhanced dental team performance in all five Brazilian geographical regions and nationally. The dental team management variables of "having a flexible dental appointment list" (ß = 0.218) and "monitoring oral health indicators" (ß = 0.132) also contributed to improve team performance in each of the regions and nationally. Dentists' profile influenced the performance of dental teams from south region more than the other regions. The findings suggest that continuing professional development, including postgraduate education, and strategic management characteristics are important for primary dental care performance and should be reflected in health policy initiatives in support of quality care. Regional factors could be considered for health care management.

Assessment of the cytotoxicity of a mineral trioxide aggregate-based sealer with respect to macrophage activity.

AIM: To assess the influence of co-culture with mineral trioxide aggregate (MTA) and MTA Fillapex (FLPX) on the viability, adherence, and phagocytosis activity of peritoneal macrophages from two mouse strains. METHODOLOGY: Cellular viability, adherence, and phagocytosis of Saccharomyces boulardii were assayed in the presence of capillaries containing MTA and MTA Fillapex. The data were analyzed using parametric (Student's t) and non-parametric (Mann-Whitney) tests. RESULTS: FLPX was severely cytotoxic and decreased cell viability, adherence, and phagocytic activity of both macrophage subtypes. Cells that were treated with MTA Fillapex remained viable (>80%) for only 4 h after stimulation. Macrophages from C57BL/6 mice presented higher adherence and higher phagocytic activity compared with macrophages from BALB/c mice. CONCLUSION: Comparison of MTA and FLPX effects upon macrophages indicates that FLPX may impair macrophage activity and viability, while MTA seems to increase phagocytic activity.

Flexibility and torsional strength of ProTaper and ProTaper Universal rotary instruments assessed by mechanical tests.

The purpose of this study was to assess how the geometric and dimensional changes made on ProTaper Universal (PTU) instruments in comparison with ProTaper (PT) instruments affected their flexibility and torsional strength. Two groups (n = 12) of each type of shaping (S1 and S2) and finishing (F1, F2, and F3) for both PT and PTU instruments were employed. Tip angle, instrument diameter at each millimeter, and cross-sectional area at 3 mm from the tip were the dimensional parameters measured. Flexibility and torsional strength of each instrument (n = 12) were assessed according to specification ISO 3630-1. Data were analyzed using analysis of variance (alpha = 0.05). Flexibility increased for S1 and F1 PTU instruments and decreased for F2 and F3, whereas torsional resistance increased for S2, F2, and F3. Changes in tip angle were accompanied by variation of tip geometry in all instruments.

The effect of sodium hypochlorite on the surface characteristics and fatigue resistance of ProFile nickel-titanium instruments.

OBJECTIVE: Evaluate the effect of 5.25% NaOCl on the surface characteristics and fatigue resistance of ProFile. STUDY DESIGN: Eighty new ProFile instruments were divided into 1 control group (CG) and 3 experimental groups (EG1, EG2, EG3). Instruments of EG1 were immersed in 5.25% NaOCl for 24 hours. Instruments of EG2 and EG3 shaped 10 curved root canals, using, respectively, deionized water and 5.25% NaOCl as irrigants. Surface characteristics were observed by scanning electron microscopy. All instruments were then submitted to fatigue tests. Two-way ANOVA tests were employed to compare the results. RESULTS: Surface characteristics showed no alteration after the immersion tests. The fatigue resistance of instruments in EG2 and EG3 was significantly lower than in CG and EG1. CONCLUSIONS: Immersion of ProFile in 5.25% NaOCl for 24 hours had no influence on surface characteristics and fatigue resistance. Simulated clinical use was a decisive factor in the decrease of fatigue life.