Série temporal da produção odontológica no Sistema Único de Saúde, Brasil, 2008-2018

Objective: To analyze the performance of dental care procedures in the Unified Health System (SUS) in Brazil and regions, 2008 - 2018. Methods: Time series study with data obtained from the Outpatient Information System. Annual rates of dental procedures per 100,000 inhabitants, global and according to procedures and Brazilian regions were calculated from 2008 to 2018. Prais-Winsten regression was used to analyze time trends and annual percentage changes were calculated. Results: Decreasing trends were found in Brazil for Collective actions (-13.5% – 95%CI -21.1;-5.2), Individual preventive actions (-6.2% – 95%CI -7.7;-4.8), Restorations (-7.3% –95%CI -10.5;-3.9) and Extractions (-6.9 – 95%IC -10.5;-3.1%). Endodontics and Periodontics showed stationary trends for most regions and Brazil. Prosthetic procedures showed an upward trend in all regions and Brazil (16.9% – 95%CI 9.1;25.2). Conclusion: Dental care procedures in SUS decreased between 2008 and 2018, except for prosthetic procedures whose production increased.Objetivo: Analizar el desempeño de procedimientos dentales en el Sistema Único de Salud (SUS) en Brasil y regiones, 2008 - 2018. Métodos: Estudio de series temporales con datos del Sistema de Información Ambulatoria. Se calcularon tasas anuales de procedimientos dentales por 100 mil habitantes, globales y según categorías de procedimientos y regiones brasileñas de 2008 a 2018. Se utilizó la regresión de PraisWinsten para analizar tendencias temporales y se calcularon los cambios porcentuales anuales. Resultados: Hubo tendencia decreciente en Brasil para Acciones colectivas -13,5% – IC95% -21,1; -5,2), Acciones preventivas individuales (-6,2% – IC95% -7,7;-4,8), Restauraciones (-7,3% – IC95% -10,5;-3,9) y Extracciones (-6,9 – IC95% -10,5;-3,1%). Endodoncia y Periodoncia mostraron tendencias estacionarias para la mayoría de las regiones y Brasil. Procedimientos protésicos mostraron tendencia ascendente en todas las regiones y Brasil (16,9% – IC95% 9,1;25,2). Conclusión: La producción dental en el SUS disminuyó entre 2008 y 2018, a excepción de los procedimientos protésicos cuya producción aumentó.Objetivo: Analisar a realização de procedimentos odontológicos pelo Sistema Único de Saúde (SUS), no Brasil e suas regiões geopolíticas, entre 2008 e 2018. Métodos: Estudo de série temporal, com dados do Sistema de Informações Ambulatoriais dos SUS. Foram calculadas taxas anuais de procedimentos odontológicos (por 100 mil habitantes), globais e por categorias de procedimentos e regiões. Utilizouse a regressão de Prais-Winsten para analisar as tendências temporais e calculou-se variações percentuais anuais (VPA). Resultados: Tendências decrescentes foram encontradas para o Brasil, em ações coletivas (VPA=-13,5% – IC95% -21,1;-5,2), ações preventivas individuais (VPA=-6,2% – IC95% -7,7;-4,8), restaurações (VPA=-7,3% –IC95% -10,5;-3,9) e exodontias (VPA=-6,9 – IC95% -10,5;-3,1). Endodontia e periodontia apresentaram tendências estacionárias para a maioria das regiões e o Brasil. Procedimentos protéticos apresentaram tendência ascendente em todas as regiões e o Brasil (VPA=16,9% – IC95% 9,1;25,2). Conclusão: A produção odontológica no SUS apresentou decréscimo no período 2008-2018; à exceção de procedimentos protéticos,cuja produção aumentou

Effect of Different Root Canal Irrigant Solutions on the Release of Dentin-Growth Factors: A Systematic Review and Meta-Analysis

From MDPI via Jisc Publications RouterHistory: accepted 2021-09-29, pub-electronic 2021-10-05Publication status: PublishedIrrigant solutions are used to promote dentin-growth factors (GF) release for regenerative endodontics. This review aimed to evaluate the reports comparing the release of GFs using different root canal irrigant solutions. Eligible studies compared the in vitro GF release in human teeth after the use of at least two distinct solutions. A search was conducted on Pubmed, Scopus, Web of Science, and Lilacs on 11 August 2021. Risk of bias was assessed using SciRAP. Study characteristics and quantitative data were extracted, and meta-analyses were performed for the mean difference (95% confidence interval) of the release of transforming growth factors Beta 1 (TGF-β1) by EDTA compared to other irrigants. Of sixteen eligible studies, eight were included in quantitative analysis. ELISA assays showed higher TGF-β1 release from 10% EDTA compared to 10% citric acid (p 0.00001). Immunogold assays showed higher levels of TGF-β1 for 17% EDTA (p 0.00001) compared to 10% citric acid. GRADE identified a low to very low certainty of evidence. These results point to an increased release of TGF-β1 in dentin treated with EDTA. The high heterogeneity and very low certainty of the evidence demand further studies before EDTA indication as a better irrigant for regenerative endodontics. Registration: CRD42020160871 (PROSPERO)

Prognosis of Regenerative Endodontic Procedures in Mature Teeth: A Systematic Review and Meta-Analysis of Clinical and Radiographic Parameters

This work aimed to investigate the use of Regenerative Endodontic Procedures (REP) on the treatment of pulp necrosis in mature teeth through systematic review and meta-analysis of evidence on clinical and radiographic parameters before and after REP. A search was performed in different databases on 9 September 2020, including seven clinical studies and randomized controlled trials (RCT). The methodological quality was assessed using Revised Cochrane risk-of-bias (RoB 2) and Before-and-After tools. Meta-analyses were performed to evaluate the success incidences regarding the reduction of periapical lesion and recovery of sensitivity. The certainty of the evidence was assessed using GRADE. Meta-analysis showed a high overall success of 0.95 (0.92, 0.98) I2 = 6%, with high periapical lesion reduction at 12 months (0.93 (0.86, 0.96) I2 = 37%) and by the end of follow-up (0.91 (0.83, 0.96) I2 = 13%). Lower incidences of positive sensitivity response were identified for the electrical (0.58 (0.46, 0.70) I2 = 51%) and cold tests (0.70 (0.54, 0.84) I2 = 68%). The calculated levels of REP success were similar to those reported for immature teeth. With a very low certainty of evidence, the meta-analysis showed a high incidence of REP’s success for mature teeth with necrotic pulp evidenced by periapical lesion reduction and moderate positive responses to sensitivity tests