Evaluation of Specialized Oral Health Procedures Performed in Brazil in the Period from 2008 to 2012

Objective: To analyze the correlations between the production of specialized dental procedures from 2008 to 2012 and factors related to the services and context of the Brazilian states. Material and Methods: A quantitative ecological-type study was developed, in which secondary data from Brazilian national databases were used. Procedures for outpatient production of specialized procedures throughout Brazil, from 2008 to 2012, were consolidated from the offering state, the state of the federation being the analysis unit. In order to collect data on coverage by oral health family teams in the Family Health Strategy, as well as the number of CEOs per state, the Strategic Support Management Room (SAGE) was accessed. The corresponding indicator mean proportion of specialized procedures in Brazil (Pmb) was used as dependent variable. Correlations were tested using Spearman's test. The software was Statistical Package for Social Sciences, v. 17.0, with a level of significance of 5%. Results: Pmb was 4.9% for the evaluated period. There was a negative correlation between indicator and the coverage of oral health teams in the family health strategy. Conclusion: The correlations analyzed were influenced by the organization and distribution of the professionals' workforce; revealing that the non-organization of the health care network may increase the performance of specialized procedures resulting from spontaneous demand due to the poor basic care coverage.

Prevalência de Fraturas do Côndilo Mandibular Associadas à Presença ou Ausência de 3o Molar Inferior em Imagens Ortopantomográficas / Prevalence of Mandibular Condylar Fractures associated with the Presence or Absence of the Lower Third Molar On Orthopantomographic Imaging

Objetivo: O estudo propõe verificar a prevalência de fraturas condilares associadas à presença ou ausência de 3o molar inferior. Metodologia: A amostra foi composta de 86 ortopantomografias de pacientes com fratura condilar, originária de 516 laudos e imagens. O levantamento envolveu os anos de 2003 a 2007. Os dados de identificação radiográfica e história clínica de fratura condilar foram avaliados e anotados. As radiografias panorâmicas dos maxilares existentes nos arquivos foram avaliadas. A análise destas se deu por meio do programa IMAGE J para obtenção da localização e angulação do terceiro molar inferior e mediante as classificações de Pell e Gregory e Winter. Resultados: O terceiro molar inferior estava presente em 69,8% das fraturas do côndilo mandibular; a presença do terceiro molar inferior erupcionado teve maior influência nos três tipos de fratura do côndilo mandibular; a fratura condilar mais encontrada foi a subcondilar, seguida da fratura de colo e, em menor expressão, da fratura de cabeça do côndilo mandibular; os dados revelam que, para os três tipos de fratura condilar, há uma maior relação com a posição mesioangular da classificação de Winter. Quanto à classificação de Pell e Gregory em relação às fraturas de cabeça do côndilo mandibular, houve uma distribuição equânime das posições A1, A2 e B3, as demais posições sido encontradas na amostra; em relação às fraturas de colo e subcondilares, houve maior relação com a posição B2 da classificação de Pell e Gregory. Conclusão: Não houve relação estatisticamente significativa entre a presença ou ausência de terceiro molar inferior incluso ou mesmo sua posição e a existência de fratura condilar.

Objective: The study sets out to verify the prevalence of condylar fractures associated with the presence or absence of the lower third molar. The sample consisted of 86 orthopantomograms of patients with a condylar fracture from 516 reports and images. The survey covered the years 2003 to 2007. The data concerning the radiographic identification and clinical history of condylar fracture were evaluated and recorded. The panoramic radiographs of the maxillae existing in the files were assessed. The analysis of the latter was conducted using the IMAGE J software for obtaining the location and angulation of the lower third molar in accordance with the classifications of Pell & Gregory and Winter. Results: The lower thirdmolar was present in 69.8% of the mandibular condylar fractures; the presence of an erupted lower third molar was most influential in the three types of mandibular condylar fracture; the most commonly found condylar fracture was the subcondylar, followed by fracture of the neck and, to a lesser extent, fracture of the head of the mandibular condyle; the data demonstrate that for all three types of condylar fracture there is a closer relationship with the mesioangular position in the Winter classification; and, as regards the Pell & Gregory classification with fractures of the head of the mandibular condyle, there was an equal distribution of the A1, A2 and B3 positions, the other positions not being found in the sample; with relation to neck and subcondylar fractures, there was a closer relationship with position B2 of the Pell & Gregory classification. Conclusion: There were no statistically significant associations between the presence or absence of an impacted lower third molar or even its position and the existence of a condylar fracture.