Is Dexamethasone superior to Ketorolac in reducing pain, swelling and trismus following mandibular third molar removal? A split mouth triple-blind randomized clinical trial

The preemptive use of anti-inflammatory drugs, such as corticosteroids and NSAIDs, has the potential to reduce pain, swelling and trismus following oral surgery. The aim of this study was to compare the efficacy of dexamethasone and ketorolac tromethamine in reducing pain, swelling and trismus after mandibular third molar removal. The researches implemented a triple-blind, randomized clinical trial. The study was conducted with ASA I individuals aging between 18 and 35 years, which were randomized and submitted to two interventions, one with 8mg dexamethasone and the other with 20mg ketorolac tromethamine given 1h before the procedure. The primary predictor variable was the use of dexamethasone or ketorolac. The primary outcome variable was the postoperative pain level, measured with a Visual Analogue Scale. The secondary outcome variables were the amount of rescue analgesic consumed, swelling and trismus. Repeated-measures ANOVA and t-test for paired samples were used to compare the means. Significance was set at p < 0.05. Fifty individuals were randomized and allocated to intervention, and the sample was composed of 40 subjects who completed the study (27 female and 13 male). Dexamethasone, when compared to ketorolac tromethamine, showed a significantly higher reduction in pain level at 8h, 16h, 24h, 32h, 40h and 72h, in swelling and trismus at 24h, 48h, 72h and 7 days and in total number of rescue analgesics taken up to 72h postoperative (p < 0.05). The clinical performance of dexamethasone in controlling pain, swelling and trismus after mandibular third molar removal was superior to ketorolac tromethamine?s

Schinopsis brasiliensis engl. to combat the biofilm-dependents diseases in vitro

Dental caries and periodontal disease are the most prevalent of the biofilm-dependent diseases. With numerous side effects on the use of chlorhexidine, the search for new safe therapeutic alternatives for microorganisms involved with these diseases increases every day. This study aimed to evaluate the antimicrobial activity and cytotoxicity of extracts made from the bark of Schinopsis brasiliensis Engl. against five oral microorganisms and analyze their phytochemical and thermal degradation profile. The liquid-liquid partition was performed with hexane, chloroform and ethyl acetate. The identification and quantification of the chemical marker was done. Antimicrobial activity was evaluated based on the minimum inhibitory concentration. The cytotoxicity was analyzed based on the hemolysing potential of the samples. The thermal degradation profile was performed by two different methods. Gallic acid was identified as the main compound of the samples and showed the highest amount in the chloroform fraction. All samples were able to inhibit the growth of the microorganisms tested and showed no cytotoxicity. The ethanol extract absorbs less heat than the fractions. All samples exhibited exothermic peak consistent with degradation of gallic acid. Based on the results, the samples used are potential candidates for use in dental formulations for biofilm control924CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQSem informaçã

Dental workers in front-line of COVID-19: an in silico evaluation targeting their prevention

SARS-CoV-2 has high human-human transmission rate. The aerosols and saliva droplets are the main contamination source. Thus, it is crucial to point out that dental practitioners become a high-risk group of contagion by SARS-CoV-2. Based on this, protocols have been recommended to avoid cross-contamination during dental care; however, appropriate evidence has not yet been established. Objective: Our study sought to make a screening, by in silico analysis, of the potential of mouth rinses used in dental practices to prevent the dental workers' contamination by SARS-CoV-2. Methodology: Multiple sequence comparisons and construction of the phylogenetic tree were conducted using the FASTA code. Therefore, molecular docking investigation between SARS-CoV-2 proteins (Main Protease, Spike Glycoprotein, Non-structure Protein, and Papain-like Protease) and molecules used in dental practices (chlorhexidine digluconate, hydrogen peroxide, cetylpyridinium chloride, povidone-iodine, gallic acid, β-cyclodextrin, catechin, and quercetin) was performed using AutoDock Vina. Moreover, 2D interactions of the complex protein-ligand structure were analyzed by Ligplot+.&nbsp; Results: The obtained results showed a remarkable affinity between SARS-CoV-2 proteins and all tested compounds. The chlorhexidine digluconate, catechin, and quercetin presented a higher affinity with SARS-CoV-2. Conclusions: The overall results allowed us to suggest that chlorhexidine is the most suitable active compound in reducing the SARS-CoV-2 salivary load due to its better binding energy. However, in vivo studies should be conducted to confirm their clinical use

Inserção de egressos de Programas de Residência Multiprofissional no SUS

INTRODUÇÃO: Os Programas de Residência Multiprofissional em Saúde (PRMS) configuram-se como estratégia para a formação de força de trabalho para o Sistema Único de Saúde (SUS). OBJETIVO: Investigar a proporção de egressos de PRMS voltados à Atenção Primária à Saúde (APS) inseridos no SUS e fatores associados. MÉTODOS: Trata-se de um estudo seccional desenvolvido com egressos de PRMS voltados à APS de todo o Brasil, referente ao período de 2015 a 2019. Os participantes responderam a um questionário on-line com informações pessoais gerais, inserção na pós-graduação stricto sensu, no mercado de trabalho e especificamente no SUS. Foram aplicados o teste qui-quadrado de Pearson, para análises bivariadas, e Regressão de Poisson, para a análise múltipla. RESULTADOS: Participaram do estudo 365 egressos de Programas de todas as regiões brasileiras. Destes, 80,2% relataram inserção no mercado de trabalho e 47,9% informaram estar trabalhando no SUS. A inserção no SUS esteve associada às profissões que compõem a Equipe de Referência para a APS (RP = 1,87; IC95% 1,54–2,28) e à não inserção em programas de pós-graduação stricto sensu (RP = 0,77; IC95% 0,61–0,97). Quanto às características de inserção, prevaleceram o cenário da APS (47,4%) e o trabalho voltado à atenção à saúde (84,9%). Quase 40% dos egressos inseridos no SUS estão trabalhando por intermédio de vínculos instáveis, além de frequente não valorização do título da residência no recrutamento (56,9%). Entre os inseridos no SUS, 8,7% relataram terem sido selecionados para o enfrentamento da pandemia de covid-19. CONCLUSÕES: Os resultados deste estudo reforçaram a necessidade de política de incentivo à manutenção, criação e valorização dos PRMS e alertaram para possível aumento da dificuldade de inserção das categorias profissionais, frente ao cenário de desfinanciamento da saúde.INTRODUCTION: The Multiprofessional Health Residency Programs (PRMS) were set up as a strategy for training workforce for the Brazilian Unified Health System (SUS). OBJECTIVE: To investigate the proportion of alumni from Primary Health Care Multiprofessional Residency Programs admitted into the SUS and associated factors. METHODS: This is a sectional study developed with alumni from Primary Health Care Multiprofessional Residency Programs from all over Brazil, encompassing the period from 2015 to 2019. Participants answered an online questionnaire with general personal information, admission into stricto sensu graduate school, the labor market and, specifically, the SUS. We applied Pearson's chi-square test for bivariate analyses and Poisson’s regression for multiple analysis. RESULTS: A total of 365 alumni from Programs from all Brazilian regions participated in the study. Of those, 80.2% reported entry into the labor market and 47.9% reported being employed in the SUS. Admission into the SUS has been associated with the professions that make up the Reference Team for Primary Health Care (PHC) (PR 1.87; 95% CI 1.54–2.28) and non-admission into stricto sensu graduate programs (PR 0.77; 95% CI 0.61–0.97). Regarding admission characteristics, the PHC scenario (47.4%) and work focused on health care (84.9%) were prevalent. Almost 40% of alumni who entered the SUS are working with unstable contracts. Besides, being a residency alumnus is often undervalued in recruitment (56.9%). Among those admitted into the SUS, 8.7% reported being selected to work in the Covid-19 pandemic effort. CONCLUSIONS: The results of this study reinforce the need for a policy to encourage the maintenance, creation and valorization of the PRMS. They also warn about the possibility that admission into the SUS for workers is increasingly difficult due to the current underfunding of the health system

Preceptoria na rede de Atenção Primária à Saúde: fortalezas e fragilidades no Nordeste brasileiro

A preceptoria tem um papel importante na formação dos profissionais de saúde por servir de espelho nas atividades práticas. Este trabalho objetivou apreender a visão de cirurgiões-dentistas sobre a preceptoria, além de identificar os principais questionamentos e inseguranças frente ao papel de supervisor/orientador de estágio. Estudo transversal de abordagem qualitativa a partir de entrevistas realizadas de agosto a outubro de 2017 com 11 preceptores cirurgiões dentistas vinculados à rede de Atenção Primária do município de Arcoverde/PE. Os entrevistados responderam às perguntas conduzidas pelos pesquisadores oralmente, sendo o áudio gravado para posterior transcrição. Após transcritas, foram extraídos núcleos de sentido que permitiram analisar o conteúdo das falas. Os preceptores expressam a necessidade de receber um curso de formação para exercício da atividade. Em relação aos alunos, não são identificadas dificuldades quanto a aspectos didáticos e de relação interpessoal. A insegurança expressa por alguns sobre o atendimento clínico ser realizado por alunos tem sido contornada pelos preceptores. A experiência da relação de preceptoria entre os estudantes e preceptores foi tida como positiva (visão dos preceptores), com compartilhamento de informações entre os dois grupos. Entretanto, evidenciou-se a necessidade de formação voltada para a preceptoria, a fim de maximizar o aproveitamento do estágio para ambos. Tal percepção disparou o desenvolvimento de um processo formativo conduzido pelos docentes

Composição química do óleo essencial de Varronia dardani (Taroda) J.S. Mill e sua atividade antibiofilme / Chemical composition of Varronia dardani (Taroda) J.S. Mill essential oil and its antibiofilm activity

O gênero Varronia pertence à família Cordiaceae. Alguns óleos essenciais de espécies deste gênero são identificados na literatura com atividades anti-inflamatórias. Esta espécie não tem relatos na medicina popular. O óleo essencial das partes aéreas da V. dardani foi extraído por hidrodistilação e usado por cromatografia gasosa acoplada à espectrometria de massa. Uma composição química de óleo de V. dardani foi de 97,2% de monoterpenos e sesquiterpenos. O ?-cadineno (8,71%), timol (7,43%), carvacrol (5,92%), ?-cadineno (5,66%), p-cimeno (5,25%) e ?-cadinol (5,20%) foram os constituintes majoritários.Uma atividade antimicrobiana foi investigada pelo método de microdiluição e foi testada com inibição da formação de biofilme, utilizando microorganismos de interesse em odontologia. O óleo essencial inibido do crescimento de Enterococcus faecalis e Streptococcus salivarius . Os resultados indicaram que uma espécie contém sua composição química com potencial antimicrobiano, necessitando assim de estudos complementares, utilizando uma pesquisa de uma nova terapia para infecções dentárias que usa uma determinada citada

Revisiting the Basic Cycle: Prospects by Undergraduates’ Students of a Brazilian Dentistry School

Objective:To analyze the perception of undergraduates’ students in a Dentistry School about the impact of basic disciplines on their professional development, as well the integration of this knowledge with the professional sphere. Material and Methods:It is a qualitative research study carried out through focus groups comprised of dentistry students close to finishing their degree. The data were analyzed by the thematic content analysis. Results:Four categories derived from the empirical material: "Disassociation of basic disciplines within the professional cycle", "Autonomy or transference of responsibility", "Campus-DOD distancing" and "Humanization of health care from first moments". The narratives showed the difficulties faced in order to effect, indeed, integration between the basic cycle and the curricular components of the vocational cycle. It was also evident the decontextualization of the basic cycle with the perspective of approach with professional practice. In addition, student’s protagonist posture and learning how to humanize health care were identified as important factors to be debated and improved in the curriculum from the beginning of the course. Conclusion:The difficulties faced in order to effect an actual integration between the basic disciplines and the professional disciplines bring undesirable consequences upon undergraduate, being fundamental that the construction of new pedagogical projects means an effective integration of the contents to the curriculum design, avoiding any fragmentation between the basic and vocational cycle