Geometric and dimensional characteristics of simulated curved canals prepared with proTaper instruments

OBJECTIVE: This study identified which regions of ProTaper instruments work during curved root canal instrumentation. MATERIAL AND METHODS: Twelve ProTaper instruments of each type, S1, S2, F1, and F2, were assessed morphometrically by measuring tip angle, tip length, tip diameter, length of each pitch along the cutting blades, and instrument diameter at each millimeter from the tip. Curved canals in resin blocks were explored with manual stainless steel files and prepared with ProTaper instruments until the apical end following four distinct sequences of instrumentation: S1; S1 and S2; S1, S2, and F1; S1, S2, F1, and F2. Image analysis was employed for measuring canal diameters. The diameters of the canals and diameters of the instruments were compared. Data were analyzed by one-way ANOVA and Tukey's test. RESULTS: No statistically significant difference was found between the canals and instrument diameters (p>;0.05). The largest diameters in the end-point of the instrumented canals were obtained with F1 and F2 instruments and in the initial and middle thirds with S1 and S2 instruments. CONCLUSIONS: All instruments worked at the tip and along their cutting blades, being susceptible to fail by torsion, fatigue, or the combination of these two mechanisms

Endodontic Output in Public Healthcare under Different Instrumentation Techniques: A Quantitative and Qualitative Study

Objective: To evaluate output of endodontic in oral public healthcare by analyzing differences in instrumentation techniques, quantitative and qualitatively. Material and Methods: Endodontic services were differentiated by instrumentation techniques: hand techniques with stainless steel instruments (SS) or rotary using NiTi rotary instruments. Secondary data on the productivity of 2011 were obtained from the information system. Student’s t and Mann-Whitney tests were used. Qualitative data were based on semi-structured interviews, direct observation and field diary. Results: Service I employed SS hand techniques, service II used both techniques, while NiTi rotary system was used in service III. Statistically significant differences were observed in total endodontic productivity, with I presenting more productive results than II (p=0.001) and III (p=0.009); III presenting more productive results than II (p<0.001). Comparisons of endodontic treatment types revealed that I performed more multiradicular tooth treatments than did II and III (p=0.005), and III performed more treatments on biradicular teeth than did I and II (p=0.002). Qualitative analyses were divided into themes: “perceptions of the service” and “perceptions of the employed instrument”. Conclusion: Professional experience and high productivity per hour can be a differential; the use of rotary instrumentation can be useful in solving unmet demands. Perception of endodontists showed that chosen endodontic technique influenced job satisfaction and lack of integrality of the treatment is a problem in secondary care

Analysis of Dental Teleconsulting in the Pediatric Dentistry Field of Telehealth Minas Gerais: A Cross-Sectional Study

Objective: To analyze the profile of the dental teleconsulting in the Pediatric Dentistry field of Telehealth Brazil Networks Program, in Minas Gerais centers, Brazil. Material and Methods: Asynchronous dental teleconsulting was evaluated in the Pediatric Dentistry specialty, extracted from secondary databases of the telehealth centers: the Clinical Hospital of the Universidade Federal de Minas Gerais and UFMG Medical School, from July 2015 to July 2017. The variables collected were: type of issues and area and sub-area of Pediatric Dentistry. The results were descriptively analyzed using the SPSS v.22,0 program by frequencies. Results: Most of the issues in the Pediatric Dentistry specialty were about clinical conduct (81.4%). There was a predominance of issues regarding prevention (16.6%), surgery (15.3%), tooth eruption (15.1%), endodontics (12.1%), harmful oral habits (9.7%), patient cooperation (8.7%), primary teeth trauma (7.2%) and dentistry (6.7%). Regarding sub-areas, most issues were related to child oral hygiene (68.5%), tooth extraction (92%), tooth eruption chronology (65.6%), pulp diagnosis (49.0%), bruxism (64%), patient management (74.3%), post-trauma treatment (79.3%), and restoration (88.9%). Conclusion: Pediatric Dentistry teleconsulting suggested a difficulty of the professionals in the pediatric patient approach. Continuing education programs and training courses for professionals working in primary health care are crucial for the comprehensive care of pediatric patients

A multidisciplinary treatment of congenitally missing maxillary lateral incisors: a 14-year follow-up case report

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case of agenesis of the maxillary lateral incisors treated by the closure of excessive spaces and canine re-anatomization. A clinical case is presented to illustrate the interdisciplinary approach between orthodontics and restorative dentistry for improved esthetic results. In this report, the treatment of a girl with a Class II malocclusion of molars and canines with missing maxillary lateral incisors and convex facial profile is shown. Treatment was successfully achieved and included the space closure of the areas corresponding to the missing upper lateral incisors, through movement of the canines and the posterior teeth to mesial by fixed appliances as well as the canines transformation in the maxillary lateral incisors. This is a 14-year follow-up case report involving orthodontics and restorative dentistry in which pretreatment, posttreatment, and long-term follow-up records for the patient are presented

Temporomandibular Disorders are Associated with Sociodemographic Factors, Health-Related and Oral Conditions in Adolescents: A Cross-Sectional Study

Objective: To assess the association between temporomandibular disorder (TMD) with sociodemographic factors, health-related factors, and oral conditions in adolescents. Material and Methods: This cross-sectional study was developed with 89 adolescents between 13 to 18 years. TMD diagnosis was obtained by the Research Diagnostic Criteria for Temporomandibular Disease (RDC/TMD) Axis I. Diagnoses of chronic pain, depression, presence of non-specific physical symptoms, including pain and anxiety, were obtained by the RDC/TMD Axis II. The feeling of happiness was measured by the Subjective Happiness Scale. Socio-economic and demographic characteristics were collected through self-administered questionnaires. Patients were examined for dental caries, dental trauma, malocclusion, and tooth wear. Parents answered a sociodemographic, economic, and general health questionnaire. Data were submitted to descriptive statistics, and a logistic regression model was used to assess the association between TMD and the socio-economic, demographic, health-related, and clinical variables. Results: TMD prevalence was 42%. TMD was associated to skin color (p=0.040), use of medications in the past year (p = 0.020) and previous dental trauma (p=0.030). Also, it tended to be associated with the presence of probable awake bruxism (p=0.053). Conclusion: Sociodemographic factors, health-related factors, and oral conditions play a role in TMD, with nonwhite adolescents, those who had used medications in the past year and/or had previous dental trauma having a greater chance of present this disorder

Mechanical and optical properties of conventional restorative glass-ionomer cements - a systematic review

Objectives To perform a systematic review of test methodologies on conventional restorative glass-ionomer cement (GIC) materials for mechanical and optical properties to compare the results between different GICs. Material and Methods Screening of titles and abstracts, data extraction, and quality assessments of full-texts were conducted in search for in vitro studies on conventional GICs that follow the relevant specifications of ISO standards regarding the following mechanical and optical properties: compressive strength, flexural strength, color, opacity and radiopacity. Sources The Latin American and Caribbean Health Sciences (LILACS), Brazilian Bibliography of Dentistry (BBO) databases from Latin-American and Caribbean System on Health Sciences Information (BIREME) and PubMed/Medline (US National Library of Medicine - National Institutes of Health) databases were searched regardless of language. Altogether, 1146 in vitro studies were selected. Two reviewers independently selected and assessed the articles according to pre-established inclusion/exclusion criteria. Among all the properties investigated, only one study was classified as being of fair quality that tested compressive strength and was included. It was observed that many authors had not strictly followed ISO recommendations and that, for some properties (diametral tensile strength and microhardness), there are no guidelines provided. Conclusions It was not possible to compare the results for the mechanical and optical properties of conventional restorative GICs due to the lack of standardization of studies

Mechanical and optical properties of conventional restorative glassionomer cements - a systematic review

Objectives: To perform a systematic review of test methodologies on conventional restorative glass-ionomer cement (GIC) materials for mechanical and optical properties to compare the results between different GICs. Material and Methods: Screening of titles and abstracts, data extraction, and quality assessments of full-texts were conducted in search for in vitro studies on conventional GICs that follow the relevant specifications of ISO standards regarding the following mechanical and optical properties: compressive strength, flexural strength, color, opacity and radiopacity. Sources: The Latin American and Caribbean Health Sciences (LILACS), Brazilian Bibliography of Dentistry (BBO) databases from Latin-American and Caribbean System on Health Sciences Information (BIREME) and PubMed/Medline (US National Library of Medicine - National Institutes of Health) databases were searched regardless of language. Altogether, 1146 in vitro studies were selected. Two reviewers independently selected and assessed the articles according to pre-established inclusion/exclusion criteria. Among all the properties investigated, only one study was classified as being of fair quality that tested compressive strength and was included. It was observed that many authors had not strictly followed ISO recommendations and that, for some properties (diametral tensile strength and microhardness), there are no guidelines provided. Conclusions: It was not possible to compare the results for the mechanical and optical properties of conventional restorative GICs due to the lack of standardization of studies

Pain Perception Before Endodontic Treatment: from Primary Care to Specialized Care

Objective: To analyze patients’ pain perception requiring endodontic treatment referred to a Dental Specialties Center. Material and Methods: Data was collected through a self-administered questionnaire for patients about their experience of pain and another for endodontists about the treatment performed. The results were analyzed descriptively using Pearson’s Chi-square test and Fisher’s Exact test, with Bonferroni correction (p≤0.05). Results: The median age of the patients was 39 years, and 71.1% were female. The median waiting time for treatment was five months. Pain was reported by 75.2% of patients, occurred more than one month earlier (63.6%), with moderate/severe intensity (66.9%), and most patients sought emergency treatment more than once (79.1%). In addition, pain was associated with sex (female; p=0.008); moderate/severe intensity (p<0.001); the number of times that patient had to go to the dentist because of the tooth treatment (twice or more; p=0.002); and type of tooth treated (posterior tooth; p=0.002). Conclusion: Severe pain episodes resulted in a repeated search for emergency services, which may overload the primary care service, especially if the waiting time for endodontic treatment is long

Adaptação aos impactos das mudanças climáticas na perspectiva do plano diretor da cidade do Recife

Defining measures for climate change adaptation is a complex task given the existence of social, environmental, and economic demands, particularly in cities with poor urban infrastructure. As a result of analyzing the revision process of the Recife Master Plan, it is possible to observe that a reduction in the social and environmental vulnerabilities has implied carrying out more consistent studies, which may entail the implementation of structuring measures, and that environmental sustainability requires multilevel governance, with policy reforms on a global, regional and local scale, difficult to implement in the short term, although necessary for refocusing climate policies and for overcoming the inability to provide resources for a tailored adaptation infrastructure. The path to building a resilient city that provides a safer environment for the future depends on an inclusive development model, which enables the population to improve urban conditions and minimize the impacts brought about by extreme weather events.É complexa a tarefa de definir medidas de adaptação às mudanças climáticas diante da existência de demandas sociais, ambientais e econômicas, sobretudo em cidades que apresentam infraestrutura urbana deficiente. Como resultado da análise do processo de revisão do Plano Diretor do Recife (PDDR), vê-se que a redução das vulnerabilidades socioambientais implica a realização de estudos mais consistentes, que possam acarretar a implementação de medidas estruturadoras, e que a sustentabilidade ambiental demanda uma governança multinível, com reformas políticas em escala global, regional e local, de difícil aplicação no curto prazo, mas necessárias para reorientar as políticas do clima e superar a inabilidade de prover os recursos para uma infraestrutura adequada à adaptação. O caminho para construir uma cidade resiliente, que proporcione um ambiente mais seguro para as futuras gerações, depende de um modelo de desenvolvimento inclusivo, que permita melhorar as condições urbanas para a população e minimizar os impactos ocasionados pelos eventos climáticos extremos

Staff Knowledge and Attitudes Towards COVID-19 New Biosafety Practices at a Brazilian Dental School

Objective: To evaluate knowledge and attitudes towards biosafety recommendations during the COVID-19 pandemic at a Brazilian dental school. Material and Methods: A cross-sectional study was performed in 2020 with the clinical staff of a Brazilian dental school. The whole clinical staff was sent pre-tested self-administered online questionnaires about knowledge and attitudes towards the recommendations for biosafety in dental settings in the context of the COVID-19 pandemic. Descriptive statistical analyses were carried out for proportion calculation. Results: Disposable head covering caps, isolation gowns, and gloves were the most frequently reported personal protective equipment (PPE). The rates ranged from 52.9% to 88.5% for N95 respirators, from 68.6% to 92.6% for face shields, from 47.4% to 67.5% for conventional eye protection shields, and 45.1% to 77.4% for eye protection with solid side shields. Chlorhexidine gluconate was the most frequent mouthwash indicated before clinical dental care. The percentage of agreement to provide clinical care to patients with suspected COVID-19 varied from 23.5% to 50.0%. The percentage of respondents who agreed that bioaerosol-generating procedures should be avoided was higher than 74.5%. Less than 50% knew the correct sequence for doffing of PPE. Conclusion: This study revealed important gaps in knowledge and attitudes towards prevention and control measures against infection in dental environments in the context of COVID-19, indicating the need for improvements