Avaliação da Atenção em Saúde Bucal

TCC (graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Odontologia.A avaliação dos serviços de saúde é uma das funções da gestão e tem a finalidade de identificar pontos de fragilidade para aprimoramento e melhoria da qualidade. Desde 2003 o Ministério da Saúde induz ações de monitoramento e avaliação com ênfase na Atenção Básica. A saúde bucal integra os serviços da atenção básica e pouco tem sido objeto de avaliação. Objetivo: Avaliar a atenção em saúde bucal nos municípios catarinenses no exercício 2009. Metodologia: a proposta de avaliação fundamenta-se no modelo de avaliação da atenção básica desenvolvido pelo Núcleo de Pesquisa de Avaliação em Saúde - NEPAS-UFSC, em parceria com a Secretaria de Estado da Saúde SES-SC. O modelo foi adaptado para a saúde bucal e tem a finalidade de subsidiar os gestores municipais e estaduais na tomada de decisões. Apresenta duas dimensões avaliativas e 37 indicadores segundo os critérios de eficiência, eficácia, efetividade e relevância. Participaram 264 municípios catarinenses. A coleta de dados foi realizada por meio de página eletrônica e nos sistemas oficiais de informação do SUS. A inconsistência de alguns dados e a precariedade de registro nas secretarias limitou o uso de algumas medidas. A emissão de juízo de valor da qualidade da atenção em saúde bucal se deu por agregação dos resultados dos indicadores em cada dimensão segundo porte populacional. Resultados: O desempenho dos municípios catarinenses na atenção à saúde bucal foi classificado como satisfatório em aproximadamente 27% do universo estudado. Os piores desempenhos foram identificados no grupo de indicadores do provimento da atenção a população adulta, idosa e adolescente. Houve melhoria do desempenho comparado a avaliação anterior. Conclusões: A institucionalização da avaliação pode contribuir para o aprimoramento do registro de informações e para a melhoria da qualidade dos serviços

AH Plus extrusion into periapical tissue: literature review of main related properties and report of clinical cases

The sealers were developed for filling of root canals. Due to their physicochemical and technical properties used for obturation, often, extrusion is observed through apical constriction and occasionally by lateral and secondary canals. Objective: To review the literature on important properties to be considered in AH Plus sealer extrusion and report a case series of this sealer extrusion. Literature review: Articles evaluating the cytotoxicity and biocompatibility properties, besides flow and solubility were selected. Case report: In the presented cases, endodontic treatment was performed with rotary instrumentation and irrigation with 2.5% NaOCl. Obturation employed visual, tactile, and radiographic proof of gutta-percha main cone, and different obturation techniques. There were no reports of pain during and after endodontic treatment. Conclusion: AH Plus has adequate properties for a filling material and causes no major damage to the periapical tissues due to its little cytotoxic

SUCCESS RATE OF ENDODONTIC TREATMENTS PERFORMED BY UNDERGRADUATE STUDENTS OF THE UNIVERSITY OF SOUTHERN SANTA CATARINA

Introduction: Apical periodontitis is an inflammatory disease of the periradicular tissues caused by microbial(re)contamination of the root canal system. Due to its direct relationship to the quality of endodontictreatment, it is extremely important to carry out longitudinal and cross-sectional studies, following-uptreatments carried out in universities. Aim: To evaluate the success rate of endodontic treatments performedby undergraduate students of the University of Southern Santa Catarina - UNISUL, Pedra Branca, betweenAugust 2015 and July 2017.Materials and Methods: One hundred twenty-four patients with endodontic treatment were contacted. Ofthese, only 27 attended for treatment follow-up, adding up to a total of 32 treatments analyzed. All teeth wereclinically and radiographically evaluated, and the potential indicators related to endodontic treatment successor failure were analyzed. The frequencies of each criterion were calculated, and the data analyzed using theChi-Square test (α = 5%).Results: 9 cases (28.13%) were considered failure, either because they were associated with symptoms or becausethere was a periapical alteration. In addition, 88.88% of the failure cases had temporary restorative material.Association was observed only between the number of root canals and symptoms (P = 0.049). Two of the 3treated teeth with multiple root canals showed symptoms at the follow-up. The endodontic success rate was71.87%.Conclusion: The success rate of the 32 endodontic treatments performed by undergraduate students fromUNISUL was 71.87%

Knowledge assessment on dental avulsion of private and public school teachers of Curitiba

Dental trauma is one of the most important oral health problems during childhood. It occurs frequently in the school environment and it is extremely important that the professors have knowledge on the subject because the management taken after the accident, directly influences on the prognosis. Objective: The aim of this study was to evaluate the knowledge level about dental avulsion of teachers who work in the private and public elementary schools in the city of Curitiba (PR, Brazil). Material and methods: A questionnaire adapted from Mori et al. (2007) was applied, consisting of three parts, Part I: general demographic data; Part II: basic questions about the importance of emergency management, experience in dental avulsion and the management to be taken in an event of dental avulsion; Part III: Questions about dental avulsion. The chi-square test was used to identify differences in responses for different variables, with significance level of 5%. Results: A total of 98 teachers answered the questionnaire (54 private and 44 municipal schools). Most were women (66% in private and 95.5% in municipal schools), with professional experience between 6-10 years and a postgraduate degree (81.1% of teachers in private schools and 79.9% of teachers in municipal schools). The statistical analysis showed a significant difference between the groups in age and about the emergency procedure for dental avulsion. Conclusion: It can be concluded that knowledge by the elementary schoolteachers in cases of dental avulsion is inadequate

Thermoplastic endodontic obturation – TC system: case report

The TC system, developed in 2002, allows the endodontic filling by means of a non-conventional technique that uses gutta-percha at alpha phase,thermoplasticized in its own oven, placed into canal through a McSpadden compactor, without using a main cone. Objective: The aim of this case report was to show the TC system used for root canal filling. Case report: Three teeth of a patient was indicated for endodontic treatment, so TC system was used for the root filling. Conclusion: This technique showed to be effective for the root canal filling

Effect of different bleaching protocols on whitening efficiency and enamel superficial microhardness

Tooth bleaching is a popular aesthetic treatment to modify the color of teeth. Despite the extensive literature concerning the subject, there is still no consensus regarding the application mode of the different bleaching agents and their effect on enamel. Therefore, this study evaluated the influence of different bleaching protocols on whitening efficiency and enamel superficial hardness. Bovine enamel fragments were embedded in acrylic resin and wet-sanded to obtain a flat buccal surface. The specimens were then randomly divided into 6 groups (n=10), based on the bleaching material [HP Maxx 35% (35% hydrogen peroxide), HP Blue 35% (35% hydrogen peroxide + Ca) and Whiteness Perfect 10% (10% carbamide peroxide)] and application mode (3 applications of 15 min, 1 application of 45 min, 1 application of 1h30 or 1 application of 3h30). The color and superficial hardness were assessed before and after bleaching. The color was assessed by means of a digital spectrophotometer, using CIELab parameters. Vickers hardness was determined using a load of 200g for 10s. Data were statistically analyzed by one-way ANOVA with repeated measures and Tukey?s test (? = 0.05). Concerning the color alteration, the groups were similar to each other, except for at-home bleaching protocols, which were statistically different from each other. Similarly, there was a reduction in hardness values comparing the initial and final periods, with lowest final hardness for the at-home bleaching protocol group applied for 3h30. It can be concluded that the bleaching protocols influenced the final color and enamel surface hardness, evidencing that lower gel concentrations applied for longer periods promoted greater variation in color and lower final hardness

Long-term evaluation of crown and root discoloration induced by different endodontic sealers

evaluate crown and root discoloration promoted by different endodontic sealers after root canal filling. Methods: Eighty bovine incisors were prepared and filled with: Endofill, Sealer 26, AH Plus, and MTA Fillapex. Color was recorded using a spectrophotometer before endodontic treatment (T0) and at 24 hours (T1), seven days (T2), 30 days (T3), and 90 days (T4) after treatment. Analyses were performed on the middle and cervical regions of the crown, and on the cervical third of the root, immediately below the cementoenamel junction. The color alterations (&#916;E) were calculated using Commission International de IEclairage (CIE) L*a*b parameters, and data were analyzed by analysis of variance (ANOVA) and Tukeys test (p<0.05). Results: All sealers induced color alterations. Sealer 26 resulted in the smallest changes in color (&#61508;E = 5.32). The other materials did not present statistical differences (AH Plus &#61508;E = 6.98; MTA Fillapex &#61508;E = 6.88; Endofill &#61508;E = 6.41). Of the three regions analyzed, the largest discoloration was observed at the cervical third of the root (&#61508;E=10.67). In terms of time, the largest &#916;E values (&#61508;E=7.72) were observed at T4. Color changes at T1 (&#61508;E=5.88), T2 (&#61508;E=6.10), and T3 (&#61508;E=5.89) were statistically similar. Conclusions: All endodontic sealers promoted discoloration on the tooth crown and root