Vantagens da utilização do protocolo dentogengival total em zircônia / Advantages of using the full-contour zirconia dentogingival protocol

A reabilitação protética por meio de implantes tem se confi gurado como o padrão-ouro para a devolução da função previamente perdida pelo paciente, podendo ser realizada com próteses removíveis ou fixas sobre os implantes osseointegrados. As próteses fixas do tipo protocolo proporcionam maior estabilidade durante as atividades cotidianas, como falar e comer, além de alta performance estética, quando bem indicada. Vislumbrando uma maior resistência das próteses, melhor harmonização do sorriso e adequada adaptação, as infraestruturas em zircônia vêm sendo altamente difundidas na literatura. Confeccionadas pelo método CAD/CAM, as próteses em zircônia dispensam as etapas de solda, o que elimina possíveis distorções de grandes estruturas, além de serem produzidas mais rapidamente e com uma estética maior, caracterizando-se como a melhor opção para pacientes que buscam a mimetização do sorriso natural.

The prosthetic rehabilitation using dental implants has been featured as the gold standard for retrieving patient's lost function, and may be performed by implant-supported removable or fixed dental prostheses. The implant-supported fixed prosthesis provides greater stability during daily activities, such as talking and eating, and high aesthetic performance, when properly indicated. In order to obtain higher resistance, superior smile esthetics and adequate prosthesis fit, the zirconia infrastructure have been highly disseminated in the literature. The CAD/CAM zirconia prosthesis avoids welding/soldering, which eliminates possible distortions of large structures. In addition, it is produced faster and with greater aesthetic, being nowadays characterized as the best option for patients who seek to emulate the natural smile.

A individualização de coroas como alternativa para as próteses totais fixas sobre implantes / The individualization of crowns as an alternative for implant-supported fixed partial dentures

A reabilitação fixa de pacientes desdentados totais com próteses conhecidas como protocolo de Brånemark é uma alternativa indicada com grande previsibilidade e um bom prognóstico nas reabilitações com implantes osseointegrados. Essas próteses proporcionam maior eficiência mastigatória, conforto e estética, quando comparadas a próteses removíveis convencionais. Tradicionalmente, essa modalidade reabilitadora protética é confeccionada com dentes e gengiva em resina acrílica, o que favorece o acúmulo de biofilme. Além disso, apresentam degradação e desgaste, principalmente dos dentes, o que contribui para a perda da dimensão vertical de oclusão e perda da estabilidade oclusal. No intuito do controle das desvantagens apresentadas, uma alternativa utilizada é a individualização dos dentes com coroas cerâmicas. As coroas individuais, além de atribuírem melhor estética para a reabilitação, também são responsáveis por melhor passividade, longevidade, possibilidade de reparos e estabilidade oclusal.

The rehabilitation of completely edentulous patients with fixed restorations known as Brånemark protocol is an alternative with great predictability and good prognosis in the field of dental implants. These restorations provide better masticatory efficiency, comfort, and esthetics, when compared to the conventional removable dentures. In general, this prosthetic modality receives artificial gingiva and acrylic teeth, which favors plaque buildup. besides, degradation and wear can be seen, particularly at teeth, contributing to the loss of vertical occlusal dimension and stability. For this, an alternative is to provide individual ceramic crowns. Besides providing better esthetics, passivity, longevity, stability, and the chance of repair are possible in this scenario.

Relations between Dental Caries, Socioeconomic Variables and Access to Dental Services of Children from a Countryside city in the State of São Paulo, Brazil

Objective:To investigate the relations between the prevalence of dental caries, socioeconomic status and access to dental services of children aged 5 and 12 years, in Amparo, SPMaterial and Methods:The sample size was calculated for 5 and 12 year-old children in Amparo-SP. Children (5 years: n = 284; 12 years: n = 199) were examined by a previously calibrated team, to check dmft and DMFT according to WHO criteria. Caregivers answered questions about socioeconomic, demographic status and access to/use of dental services in the past six months. Association between outcome (caries experience) and independent variables was analyzed using the chi-square test. Variables with p value lower than or equal to 0.25 were tested in a multiple regression model (multivariate Poisson) with a statistical significance of 5%.Results:For the five-year-old population, the variables associated with caries experience (p <0.05) were: ethnicity (OR = 0.273 -non-white), household income (OR = 2.897 -Up to 3 minimum wages) and reason for dental care (OR = 4.511 -pain and treatment need). For 12-year-old population, only the variable income (OR = 3.073 -Up to 3 minimum wages) was significantly associated (p <0.05) in the final model for caries experience assessment.Conclusion:Dental caries experience in children from the city of Amparo-SP was influenced by socioeconomic and demographic factors, especially in the 5-year-old population

Fluoride rinse effect on retention of CaF2 formed on enamel/dentine by fluoride application.

Calcium fluoride-like materials ("CaF2") formed on dental surfaces after professional fluoride application are unstable in the oral environment but can be retained longer with a daily NaF mouthrinse. We tested the effect of twice daily 0.05% NaF rinses on the retention of "CaF2" formed on enamel and dentine after applying acidulated phosphate fluoride (APF). "CaF2" formed on enamel/dentine by APF application significantly decreased after exposure to artificial saliva and the 0.05% NaF rinse was ineffective to avoid this reduction. These findings suggest that the combination of APF and 0.05% NaF is not clinically relevant, either for caries or dental hypersensitivity.

Knowledge of dental caries and salivary factors related to the disease: influence of the teaching-learning process.

Knowledge of factors related to caries and the possible consequences in controlling the disease may show the use of education as a relevant tool for achieving success in terms of dental health maintenance. Therefore, the aim of the present study was to investigate the relationship between acquired knowledge and salivary factors related to dental caries for freshmen students (n = 44) and trainees (n = 32) of the Piracicaba Dental School. Knowledge about dental caries was evaluated by a discursive questionnaire analyzed by the content analysis technique. Salivary flow and pH, buffer capacity, salivary sucrase activity, microbiological counts (total microorganisms, mutans, and lactobacilli) and inorganic concentration of calcium, phosphorus, and fluoride in saliva were evaluated and compared between groups using the Mann-Whitney test, with a significance of 5%. Trainees demonstrated knowledge of the disease, whereas freshmen showed unspecific and confusing concepts. Among the factors analyzed, statistically significant differences were observed for pH, buffer capacity, sucrase activity, total microorganisms, and calcium and fluoride concentrations in saliva. Knowledge about the disease increases and improves over time during the undergraduate program (highest among trainees); although the students from the final year of the program consume more sugar than those from the previous one, they try to balance this activity with greater exposure to fluorides.

Knowledge of dental caries and salivary factors related to the disease: influence of the teaching-learning process

Knowledge of factors related to caries and the possible consequences in controlling the disease may show the use of education as a relevant tool for achieving success in terms of dental health maintenance. Therefore, the aim of the present study was to investigate the relationship between acquired knowledge and salivary factors related to dental caries for freshmen students (n = 44) and trainees (n = 32) of the Piracicaba Dental School. Knowledge about dental caries was evaluated by a discursive questionnaire analyzed by the content analysis technique. Salivary flow and pH, buffer capacity, salivary sucrase activity, microbiological counts (total microorganisms, mutans, and lactobacilli) and inorganic concentration of calcium, phosphorus, and fluoride in saliva were evaluated and compared between groups using the Mann–Whitney test, with a significance of 5%. Trainees demonstrated knowledge of the disease, whereas freshmen showed unspecific and confusing concepts. Among the factors analyzed, statistically significant differences were observed for pH, buffer capacity, sucrase activity, total microorganisms, and calcium and fluoride concentrations in saliva. Knowledge about the disease increases and improves over time during the undergraduate program (highest among trainees); although the students from the final year of the program consume more sugar than those from the previous one, they try to balance this activity with greater exposure to fluorides.

Cariology in curriculum of Brazilian dental schools.

Reasons for the iniquities of caries, globally recognized, may be related to how Cariology has been taught in dental schools. In Brazil, the most important universities, when considering healthcare teaching, are the public ones. The objective of this study was to identify the insertion of the contents of Cariology in the course flowcharts of public dental schools in the country. The survey was conducted in 2013 seeking to identify the realities of different geographical regions, aimed to the census of public dental schools. It was performed a documentary analysis of the menus of disciplines, identifying the following issues: number of dental schools that include content related to Cariology in their curricula; average total workload undergraduate courses and disciplines that contemplate the theme; distribution of disciplines in professional training cycles (basic, clinical and public health); existence of discipline and/or a specific department; verification of bibliographic indication directly related to Cariology. The response rate was 93.6%. All dental schools recommended specific books, and none of them had a Department of Cariology. All dental schools in the country contemplated content related to Cariology in their disciplines, distributed in specific disciplines (except for the Northern region) and disciplines in the three cycles of learning (basic, clinical and public health), with larger workload in the clinical cycle. Although public dental schools in Brazil demonstrated commitment to contemplating the content related to Cariology in their disciplines, the emphasis on the clinical cycle may not be promoting the integrated formation of students, which could be contributing to reflect the inequalities of the disease in the country.

Conceptualization of dental caries by undergraduate dental students from the first to the last year.

Dental caries, still one of the most common diseases affecting people around the world, has a multifactorial nature encompassing necessary (biofilm accumulation), determinant (exposure to sugars and fluoride) and modulating factors (biological and social). The concepts about caries learned at dental schools may directly influence the conduct of the future dentists regarding the control and treatment of this disease. The aim of this study was to determine the concept that students at the Piracicaba Dental School, University of Campinas, Brazil, have about dental caries. In this cross-sectional descriptive study, 274 students answered the discursive question "Conceptualize dental caries". Students' answers were analyzed by a content analysis technique that allowed the creation of response categories and classification of the concepts in categories. Frequencies were expressed as absolute numbers and percentages. Differences between the responses according to the students' class years were tested by the chi-square test. Differences with p<0.05 were considered statistically significant. The response categories were: biological concept (53.6%), restrictive multifactorial concept (12.1%), comprehensive multifactorial concept (8.1%), transmissibility concept (15.8%), and other (10.4%). Differences in response category frequencies were seen between the class years (p<0.001). There was no consensus on the disease definition, although students predominantly had a biological concept of dental caries.

Conceptualization of Dental Caries by Undergraduate Dental Students from the First to the Last Year

Dental caries, still one of the most common diseases affecting people around the world, has a multifactorial nature encompassing necessary (biofilm accumulation), determinant (exposure to sugars and fluoride) and modulating factors (biological and social). The concepts about caries learned at dental schools may directly influence the conduct of the future dentists regarding the control and treatment of this disease. The aim of this study was to determine the concept that students at the Piracicaba Dental School, University of Campinas, Brazil, have about dental caries. In this cross-sectional descriptive study, 274 students answered the discursive question “Conceptualize dental caries”. Students' answers were analyzed by a content analysis technique that allowed the creation of response categories and classification of the concepts in categories. Frequencies were expressed as absolute numbers and percentages. Differences between the responses according to the students' class years were tested by the chi-square test. Differences with p<0.05 were considered statistically significant. The response categories were: biological concept (53.6%), restrictive multifactorial concept (12.1%), comprehensive multifactorial concept (8.1%), transmissibility concept (15.8%), and other (10.4%). Differences in response category frequencies were seen between the class years (p<0.001). There was no consensus on the disease definition, although students predominantly had a biological concept of dental caries.

A cárie dentária, uma das doenças mais comuns do mundo, tem caráter multifatorial englobando fatores necessários (acúmulo de biofilme), determinantes (exposição a açúcares e fluoretos) e moduladores (biológicos e sociais). Os conceitos sobre a doença incorporados durante a formação dos profissionais podem direcionar o tipo de conduta que será adotada pelos mesmos no controle e tratamento da cárie. O objetivo deste trabalho foi verificar a conceituação dos estudantes da Faculdade de Odontologia de Piracicaba da Universidade Estadual de Campinas sobre cárie. Neste estudo descritivo transversal, 274 estudantes responderam à questão discursiva ‘conceitue cárie dentária’. As respostas foram analisadas pela técnica da análise de conteúdo que permite a criação de categorias de resposta e classificação dos conceitos em categorias. As frequências foram expressas em números absolutos e percentuais. As diferenças entre as respostas de acordo com o ano de curso dos estudantes foram testadas pelo teste do qui-quadrado. Diferenças com p<0,05 foram consideradas estatisticamente significantes. As categorias de resposta foram: conceito biológico (53,6%), conceito multifatorial restritivo (12,1%), conceito multifatorial abrangente (8,1%), conceito de transmissibilidade (15,8%), e outros (10,4%). Foram encontradas diferenças nas categorias de resposta dos alunos dos diferentes anos de graduação cursados (p<0,001). Não houve consenso na definição da doença, embora o conceito biológico da cárie dentária tenha predominado entre os estudantes.

Cariology in Curriculum of Brazilian Dental Schools

Reasons for the iniquities of caries, globally recognized, may be related to how Cariology has been taught in dental schools. In Brazil, the most important universities, when considering healthcare teaching, are the public ones. The objective of this study was to identify the insertion of the contents of Cariology in the course flowcharts of public dental schools in the country. The survey was conducted in 2013 seeking to identify the realities of different geographical regions, aimed to the census of public dental schools. It was performed a documentary analysis of the menus of disciplines, identifying the following issues: number of dental schools that include content related to Cariology in their curricula; average total workload undergraduate courses and disciplines that contemplate the theme; distribution of disciplines in professional training cycles (basic, clinical and public health); existence of discipline and/or a specific department; verification of bibliographic indication directly related to Cariology. The response rate was 93.6%. All dental schools recommended specific books, and none of them had a Department of Cariology. All dental schools in the country contemplated content related to Cariology in their disciplines, distributed in specific disciplines (except for the Northern region) and disciplines in the three cycles of learning (basic, clinical and public health), with larger workload in the clinical cycle. Although public dental schools in Brazil demonstrated commitment to contemplating the content related to Cariology in their disciplines, the emphasis on the clinical cycle may not be promoting the integrated formation of students, which could be contributing to reflect the inequalities of the disease in the country.

As razões para as iniquidades da cárie, mundialmente reconhecidas, podem estar relacionadas ao modo como Cariologia tem sido ensinada nas faculdades de Odontologia. No Brasil, as principais universidades em termos de ensino de saúde, são as públicas. O objetivo deste trabalho foi identificar a inserção dos conteúdos de Cariologia nos fluxos curriculares de cursos de graduação das faculdades públicas de Odontologia do país. A pesquisa foi realizada em 2013 buscando identificar as realidades de diferentes regiões geográficas, visando o censo de faculdades públicas. Foi realizada análise documental dos ementários das disciplinas, identificando: número de faculdades que incluem conteúdos relacionados à Cariologia em seus currículos; carga horária total média dos cursos de graduação e de disciplinas que contemplam a temática; distribuição das disciplinas nos ciclos de formação profissional (básico, clínico e de saúde coletiva); existência de disciplina e/ou departamento específico; verificação de indicação bibliográfica relacionada diretamente à Cariologia. A taxa de resposta foi de 93,6%. Todas as faculdades recomendam livros específicos, e nenhuma delas possui departamento de Cariologia. Todas as faculdades do país contemplam em suas disciplinas conteúdos relacionados à Cariologia, distribuídos em disciplinas específicas (exceção da região Norte) e disciplinas dos três ciclos de aprendizagem (básico, clínico e de saúde coletiva), havendo maior carga horária no ciclo clínico. Embora as faculdades publicas de Odontologia do Brasil demonstrem o compromisso curricular de abordarem conteúdos de Cariologia em suas disciplinas, a ênfase no ciclo clinico pode não estar promovendo a formação integrada dos estudantes, o que poderia estar contribuindo para refletir as desigualdades da doença no país.