Idosos Domiciliados: Saúde Geral x Higiene Bucal / Elderly People Living at Home: General Health x Oral Hygiene

O Serviço Integrado da Assistência Domiciliar (SIAD) foi criado a fim de prestar atendimento integral domiciliar a idosos que apresentam incapacidade de se locomover para as unidades de atendimento de saúde da Marinha do Brasil (MB). Com a finalidade de avaliar o perfil de saúde geral e de higiene dental desses pacientes, foi realizado um estudo transversal, quantitativo e descritivo, no qual foram incluídos idosos com 60 anos ou mais, assistidos entre fevereiro de 2017 a dezembro de 2022. Pode-se observar que a maioria dos idosos eram longevos, com média de idade de 82,52 anos (±8,66), mulheres (63,52%) e possuíam dependência total para realizar atividades básicas de vida diária (88,9%). Conclui-se que a síndrome demencial foi o diagnóstico principal mais encontrado (44,3%), a maioria possuía comorbidade associada (71,9%), sendo a Hipertensão Arterial Sistêmica (59,2%) e o Diabetes Mellitus (28,9%) as mais recorrentes. Foi encontrada uma elevada prevalência de idosos domiciliados com higiene bucal insatisfatória (34,7%) ou irregular (57,2%). No entanto, não houve associação entre higiene dental, comorbidades e grau de dependência. Assim sendo, é imprescindível que os idosos domiciliados recebam orientações e sejam submetidos a um acompanhamento rigoroso e constante, juntamente com seus cuidadores, a fim de promover a melhoria da higiene oral desses pacientes.

The Integrated Home Assistance Service (IHAS) was created to provide integral home care for elderly people who are unable to go to the health care units of the Brazilian Navy. A cross-sectional, quantitative, and descriptive study was carried out to evaluate the general health and dental hygiene profile of these patients. The study included elderly people aged 60 years or older who were assisted between February 2017 and December 2022. Most of them were long-lived, with a mean age of 82.52 (±8.66) years, women (63.52%) and totally dependent on performing basic activities of daily living (88.9%). The most common diagnosis among them was dementia syndrome, accounting for 44.3% of cases. Additionally, a large portion of the elderly had associated comorbidities (71.9%), with Systemic Arterial Hypertension (59.2%) and Diabetes Mellitus (28.9%) as the most recurrent conditions. The study found a high prevalence of elderly with unsatisfactory (34.7%) or irregular (57.2%) oral hygiene. Nevertheless, there was no significant association between dental hygiene and comorbidities or the degree of dependence. Therefore, it is imperative that elderly people living at home receive guidance and undergo meticulous and ongoing monitoring, in conjunction with their caregivers to promote improvements in the oral hygiene of these patients.

Development of clinical criteria for the evaluation of indirect restorations.

OBJECTIVE: To propose the development and validation of criteria for evaluating the clinical performance of indirect restorations, considering the variables related to the operator, material, and/or patient. MATERIALS AND METHODS: The experimental design of this study was divided into three stages. Stage 1: development of the new criteria items by specialists in Prosthodontics. Step 2: creation of the criteria, named UERJ criteria, with the description of the parameters that indicate the quality of the restoration, the possible associated complications, and a detailed description of each classification. As well as the development of a form of variables. Step 3: validation of the UERJ criteria. RESULTS: Cohen's Kappa statistic registered for both intra- and inter-examiner agreements a coefficient >0.91 with a p-value <0.0001. The validity of the UERJ criteria was evaluated by tests of sensitivity (0.96) and specificity (0.91) and had a satisfactory accuracy (92.7%), a positive (10.99), and negative (0.05) likelihood ratio and high values predictive variables, with positive (PPV) 0.84 (high specificity) and negative (VPN) 0.98 (high sensitivity), with a confidence interval of 95%. CONCLUSION: The UERJ criteria is a valid instrument for evaluating the clinical performance of indirect restorations. CLINICAL SIGNIFICANCE: The UERJ criteria, developed exclusively for the analysis of indirect restorations, elucidates the details necessary to identify the causes of failures and complications of these restorations.

Cerâmicas Feldspáticas em Dentes Posteriores pela Técnica CAD/CAM: uma Revisão de Literatura / Feldspatich Ceramics in Posterioes Teeth by CAD/CAM Technique: a Literature Review

O objetivo do presente estudo foi avaliar a indicação do uso das cerâmicas feldspáticas em dentes posteriores, pela técnica CAD/CAM (Computer-aided design [CAD] e computer-aided manufacturing [CAM]) chairside, em uma unidade de alta demanda, por meio de uma revisão de literatura. Uma pesquisa avançada foi realizada a partir da base de dados do PubMed, compreendendo os últimos 15 anos e utilizando os seguintes termos MeSH para pesquisa: "dental crowns", "CAD/CAM system", "porcelain" e "review". Dos 47 artigos levantados inicialmente, 30 foram selecionados para compor a amostra final. A partir do presente estudo foi possível concluir que o uso das cerâmicas feldspáticas desenvolvidas pela técnica CAD/CAM é seguro em dentes posteriores, desde que respeitada a técnica. Esta técnica constitui-se em excelente opção para tratamento odontológico em instituições de alta demanda restauradora que possuem altos níveis de exigência e prontidão, promovendo celeridade, evitando o uso de restaurações provisórias, reduzindo também a quantidade de urgências em próteses.

The present study aims to evaluate the indication of the use of feldspathic ceramics in posterior teeth, by the CAD/CAM technique (Computer-aided design [CAD] and computer-aided manufacturing [CAM]), in a public institution, through a literature review. An advanced search was carried out in the PubMed database, covering the last 15 years and using the following MeSH search terms: "dental crowns", "CAD/CAM system", "porcelain" and "review". Thirty out of the 47 articles initially surveyed were selected to compose the final sample. From the present study, it was possible to conclude that the use of feldspathic ceramics developed by the CAD/CAM technique is safe in posterior teeth, whether the technique is respected. This technique is an excellent option for dental treatment in institutions of high restorative demand that have high levels of demand and readiness, promoting celerity, avoiding the use of temporary restorations, also reducing the number of urgencies in prosthesis.

Do Oblique Cyclic Loads Influence the Tensile Strength of Different Morse Taper Connection Abutments?

PURPOSE: The purpose of this in vitro study was to evaluate the behavior of abutments attached to Morse taper connection implants, with and without internal index, against oblique cyclic loads. MATERIALS AND METHODS: Twenty test pieces composed of abutments connected to Morse taper implants solely by friction action were subdivided into two groups (n = 10): group NI (no index) and group I (index). The test units were submitted to tensile tests, before and after cycling loads. Paired t tests were used for intragroup data at different times, and independent t tests were used for the comparisons between the groups. RESULTS: There was a statistically significant difference in both the groups when the precycling and postcycling tensile values were compared. In the comparison between the no index and index groups, there was no statistically significant difference in precycling and postcycling tests. CONCLUSION: Within the limitations of this in vitro study, it can be concluded that the cyclic loads increased the tensile strength of abutments on Morse taper implants regardless of the index presence. On the other hand, the presence of an index did not significantly alter the values of tensile tests, before and after cyclic loads.

Eficácia do diacetato de clorexidina incorporado a um reembasador macio no tratamento da estomatite protética: um ensaio clínico randomizado / Efficacy of chlorhexidine diacetate incorporated into a soft liner rebase in the treatment of denture stomatitis: a randomized clinical trial

O objetivo deste estudo piloto foi comparar a eficácia de um reembasador acrílico macio com ou sem diacetato de clorexidina a 1% no tratamento de pacientes com estomatite protética. As hipóteses testadas foram: (I) o eritema seria melhorado (IIa): a contagem de unidades formadoras de colônias seria reduzida, (IIb): a predominância de um tipo morfológico de Candida seria correlacionada com características clínicas e, (IIc) se uma concentração inibitória mínima do antimicrobiano, poderia ser capaz de atuar sobre o crescimento do fungo. Dezesseis pacientes desdentados totais, portadores de prótese e com estomatite protética foram distribuídos aleatoriamente para os grupos controle (reembasamento com Trusoft) e grupo teste (reembasamento com Trusoft contendo 1% de clorexidina) sendo acompanhados por exames clínicos e laboratoriais por 14 dias. Os parâmetros analisados nas duas consultas de acompanhamento foram: avaliação clínica (exame e fotos) e avaliações microbiológicas (esfregaços e culturas de palato e prótese total). Este estudo foi um ensaio clínico randomizado, duplo-cego,controlado.Os resultados obtidos demonstraram que a superfície do eritema foi significativamente reduzida, mas não diferiu significativamente entre os dois grupos (P> 0,05), assim como a redução da contagem de Candida durante o tratamento entre os grupos (P> 0,05). O tipo de Candida não pôde ser correlacionado ao estágio clínico alcançado. Os resultados dos testes de concentração inibitória mínima, revelaram que uma concentração de 0,05 µg/ml de clorexidina já é capaz de inibir o crescimento de 85% das cepas de testadas.A hipótese principal foi confirmada, o que pode ser interpretado como uma remissão clínica acelerada em ambas as terapias propostas. Embora as hipóteses secundárias não tenham sido confirmadas, a persistência de Candida pode ser apenas a colonização, e a plasticidade morfológica de Candida parece ser fortemente influenciada pela virulência fúngica. Sendo assim, os resultados da análise de concentração inibitória mínima sugerem que uma concentração subinibitória de clorexidina possa estar atuando na virulência da Candida spp. No entanto, não foram encontrados resultados para confirmar a eficácia clínica do diacetato de clorexidina a 1% incorporado ao reembasador macio testado no tratamento da estomatite protética.

The aim of this pilot study was to compare the efficacy of rebase using soft acrylic liner with or without 1% chlorhexidine diacetate in denture stomatitis patients. It was hypothesised that: (I) erythema would be improved (IIa): colony forming unit count would be reduced, (IIb): the predominance of a morphological type of Candida would be correlated with clinical features and, (IIc) a minimum inhibitory concentration of the antimicrobial, could be able to act on the growth of the fungus.Sixteen patients who wearing removable dentures and diagnosed with denture stomatitis were randomly assigned to the control groups (rebase with resilient liner) and test group (rebase with resilient liner containing 1% of chlorhexidine), followed by clinical and laboratory tests for 14 days. The analyzed parameters at two follow-up were: clinical evaluation (examination and photos) and microbiological evaluations (smears and cultures of palates and dentures). This study was a randomized, double-blind, controlled clinical trial. The results obtained showed that the erythema surface was significantly reduced, but did not differ significantly between the two groups (P> 0.05), as did the reduction of colony forming unit during treatment between the groups (P> 0.05) . The Candida type could not be correlated to the achieved clinical stage. The minimum inhibitory concentration test results showed that a concentration of 0,05 µg/ml chlorhexidine is already able to inhibit the growth of 85% of the tested strains. The primary hypothesis was confirmed, which can be interpreted as an accelerated clinical remission in both proposed therapies. Although secondary hypotheses have not been confirmed, Candida's persistence may be just colonization, and the morphological plasticity of Candida seems to be strongly influenced by fungal virulence. Thus, the results of the minimum inhibitory concentration analysis suggest that a subinhibitory concentration of chlorhexidine may be acting on the virulence of Candida spp. However, no results were found to confirm the clinical efficacy of 1% chlorhexidine diacetate incorporated into the soft liner in denture stomatitis.

Influência das fontes halógena e LED e modos de ativação no grau de conversão de dois compósitos / Influence of photoactivation with halogen light and LED and types of activation on degree of conversion of two composites

O objetivo do presente artigo é avaliar a influência da fotoativação com lâmpadas halógena e LED no grau de conversão dos compósitos microíbrido e nanoparticulado. Trinta amostras foram divididas em seis grupos variando tipo de resina, tipo de lâmpada e tipo de ativação. Para medir grau de conversão foi utilizada espectrofotometria por Raman. As amostras não polimerizadas e polimerizadas foram comparadas para avaliar se houve diferença no grau de conversão para Ho1: os diferentes compósitos; Ho2: as diferentes fontes luminosas e Ho3: os diferentes modos de ativação. Para análise estatística foram utilizados Anova e T de Student. Os resultados mostraram haver diferença estatística, demonstrando maior grau de conversão para resinas nanoparticuladas, o que pode estar ligado à presença de TEGDMA em sua matriz.

The objective this paper is evaluate influence of photoativation with halogen light and LED on conversion’s degree of two different composites. Thirty samples were divided in six groups considering type of composite, photoativation unit and type of polimerization used. Ramanspectrophotometry was used to measure the degree of conversion. The Non-polimerized and polimerized sampleswere compared to evaluate if there was any difference on the degree of conversion to Ho1: composites; Ho2:diferent polimerization sources and Ho3: diferent activation modes. Anova and T Student were utlilized to statisticalanalysis. Results showed difference between the degrees of conversion of the different composites expressing ahigher value for nanoparticulate resins, which could be explained by the presence of the TEGDMA on the composition of the matrix.