Restauração em resina composta semidireta em dente posterior: relato de caso / Semi-direct composite restoration in posterior toth: a case report

A escolha da técnica restauradora desempenha papel fundamental na eficácia e duração de um tratamento reabilitador. O objetivo deste relato de caso foi descrever a utilização da técnica semidireta para a confecção de uma restauração em resina composta em um primeiro molar inferior. A paciente apresentava uma restauração insatisfatória no dente 36, que necessitava ser substituída devido à infiltração por cárie. Optou-se pela técnica semidireta devido à amplitude da cavidade, que envolvia estruturas de suporte, e pela combinação das vantagens das abordagens direta e indireta. O procedimento envolveu a remoção de tecido cariado, a aplicação de hidróxido de cálcio pasta, seguida da aplicação de uma fina camada de ionômero de vidro e, posteriormente, resina fluída para realizar o selamento dentinário. O preparo foi realizado seguindo os princípios necessários. O elemento em questão foi moldado com silicone de adição e o arco antagonista, com alginato. Ambos modelos foram vertidos com silicone para modelos semirrígidos e montados em oclusor de peças de brinquedo. A restauração semidireta foi confeccionada em resina composta Filtek Z350 XT, respeitando a anatomia do dente 36. Pigmentos foram utilizados para aprimorar detalhes estéticos. Após acabamento e polimento, a peça foi condicionada e cimentada com cimento dual Relyx Ultimate. Pode-se concluir que a abordagem restauradora por meio da técnica semidireta construída em modelo semirrígido é uma opção terapêutica conservadora e vantajosa para dentes com extensa destruição coronária. Essa técnica possibilita a restauração de forma eficaz, garantindo tanto a estética quanto a função adequada do dente afetado(AU)

The choice of restorative technique plays a fundamental role in the effectiveness and duration of rehabilitation treatment. The objective of this case report was to describe the use of the semi-direct technique to create a composite resin restoration in a lower first molar. The patient had an unsatisfactory restoration on tooth 36, which needed to be replaced due to cavity infiltration. The semi-direct technique was chosen due to the amplitude of the cavity, which involved support structures, and the combination of advantages of the direct and indirect approaches. The procedure involved the removal of carious tissue, and the application of calcium hydroxide paste, followed by the application of a thin layer of glass ionomer and, subsequently, fluid resin to seal the dentin. The preparation was carried out following the necessary principles. The element in question was molded with addition silicone and the antagonist arch was molded with alginate. Both models were poured with silicone for semi-rigid models and mounted on toy parts occluders. The semi-direct restoration was made in Filtek Z350 XT composite resin, respecting the anatomy of tooth 36. Pigments were used to improve aesthetic details. After finishing and polishing, the piece was conditioned and cemented with Relyx Ultimate dual cement. It can be concluded that the restorative approach using the semi-direct technique built on a semi-rigid model is a conservative and advantageous therapeutic option for teeth with extensive coronal destruction. This technique allows for effective restoration, ensuring both the aesthetics and adequate function of the affected tooth(AU)

Materiais educativos digitais sobre habilidades culinárias como estratégia de promoção de saúde na Atenção Primária / Digital educational materials on culinary skills as a health promotion strategy in Primary Health Care

Resumo Este estudo visa reportar desenvolvimento e validação de materiais educativos digitais baseados nas dimensões de habilidades culinárias domésticas (HCD) avaliadas por escala destinada aos profissionais da APS, nas recomendações do Guia Alimentar Para a População Brasileira e no Marco de Educação Alimentar e Nutricional (EAN) para Políticas Públicas. Foram desenvolvidos 5 vídeos e materiais gráficos com propostas de atividades para desenvolvimento de HCD e estímulo à sua implementação em ações e orientações junto à comunidade e em atendimentos profissionais. O conteúdo dos materiais foi avaliado por especialistas utilizando técnica Delphi de 2 rounds e análises estatísticas para evidência de consenso. Especialistas proferiram comentários para aprimoramento dos produtos e sua aplicabilidade. Os materiais apresentaram linguagem decodificada, ilustrações lúdicas, com personagens representativos da população-alvo. Apresentaram evidência de validade de conteúdo satisfatória e podem ser utilizados em ações de educação permanente, visando a qualificação da força de trabalho, e em ações de EAN junto aos sujeitos de direito. Os materiais gráficos possibilitam associar o conteúdo dos vídeos à prática, em contextos condizentes com a realidade dos sujeitos.

Abstract This study aims to report on the development and validation of digital educational materials based on the dimensions of home cooking skills (HCS) assessed on a scale destined for PHC professionals, following the recommendations of The Dietary Guidelines for the Brazilian Population and on The Food and Nutrition Education Framework (FNE) for Public Policies. Five videos and graphic materials were developed with proposals for activities to develop HCS and encourage its implementation in actions and guidelines in the community and in professional care. The content of the materials was evaluated by experts using the Two-Round Delphi-based technique and statistical analyses for evidence of consensus. Specialists presented comments to improve the products and their applicability. The materials presented decoded language and playful illustrations with characters representative of the target population. Evidence of satisfactory content validity was presented and can be used in permanent education actions, seeking the qualification of the workforce and in FNE actions within the scope of the law. The graphic materials make it possible to associate the content of the videos with practice in contexts consistent with the reality of the individuals.

Home / Archives / Vol. 12 No. 1 (2024) / Articles SPATIAL DISTRIBUTION OF MOLAR INCISOR HYPOMINERALIZATION (MIH) OPACITIES IN FIRST PERMANENT MOLARS

Aim: To evaluate the spatial distribution of MIH opacities in first permanent molars (FPM). Materials and methods: an analysis of intraoral photographs of FPM with demarcated MIH opacities was conducted. The presence of opacity was computed in a digital matrix, discriminating the anatomical regions of the FPM surfaces. The frequencies of distribution of the opacities were descriptively analyzed through 227 FPM digital images of 89 children built in GIMP and Python and by Spearman correlation (= 0,05). Results: the occlusal surface was the most affected one (94% to 100%). In the upper FPM, the palatine surface was the second most affected one (84%-91%). In the lower FPM, the vestibular surface was the second most affected one (85%-80%). A similar pattern of opacity distribution was observed in the contralateral teeth. On smooth surfaces, opacities were more frequent in the regions closer to the occlusal surface than to the cervical one. Conclusion: MIH opacities were mostly present on occlusal, vestibular, and lingual/palatine surfaces, respectively. There is a possibility that the occurrences are in accordance with the chronology of dental formation.

Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Study / Intervención educativa para prevenir las infecciones urinarias en ancianos institucionalizados. Estudio cuasi-experimental / Intervenção educativa para prevenção de infecções urinárias de idosos institucionalizados. Estudo quase-experimental

Objective. To analyze the effectiveness of an educational intervention among nursing professionals and caregivers to prevent urinary tract infections in institutionalized elderly people. Methods. this is a quasi-experimental study carried out with 20 people (7 nurses and 13 formal caregivers). A questionnaire was applied during the pre-intervention stage, then professional training was carried out and finally, the questionnaire was reapplied 6 months after the intervention. The prevalence profile and factors associated with urinary infections in 116 elderly people was evaluated before and after the educational interventions. Statistical analysis was performed using association and correlation tests, logistic regression model comparison and prevalence rates. Results. The average number of correct answers by the nursing professionals Invest Educ Enferm. 2024; 42(1): e05Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Studyand caregivers after the educational intervention increased from the pre to the post-test by 52% regarding signs of urinary infection, 32% regarding its symptoms, 72.5% regarding its treatment, 40% regarding personal/behavioral and morbidity-related risk factors, 59% regarding conditional factors and 43.8% regarding its preventive measures. The team of caregivers showed a greater gain in knowledge compared to the nursing team in almost every question (p<0.05). The length of time working in elderly care showed no positive correlation with any variable (R<1; p>0.05). The prevalence of urinary tract infection in the pre-intervention period was 33.62%, and 20% in the post-intervention period. Conclusion.The educational intervention was effective in preventing urinary tract infections in the elderly. The increased knowledge acquired by nurses and caregivers was associated with a reduction in the infection rate and an improvement in the most prevalent modifiable factors for the development of this type of pathology

Objetivo. Analizar la eficacia de una intervención educativa con profesionales de enfermería y cuidadores para prevenir las infecciones urinarias en ancianos institucionalizados. Métodos. Estudio cuasi-experimental realizado con 20 personas (7 enfermeros y 13 cuidadores formales). Se aplicó un cuestionario antes de la intervención, se llevó a cabo la capacitación de los enfermeros y se volvió a aplicar el cuestionario 6 meses después de la intervención. Se evaluó el perfil de prevalencia de las infecciones urinarias y los factores asociados de 116 ancianos antes y después de las intervenciones educativas. En el análisis estadístico se utilizaron pruebas de asociación y correlación, comparación de modelos de regresión logística y tasas de prevalencia. Resultados. El promedio de respuestas correctas del equipo de enfermería y de los cuidadores tras la intervención educativa aumentó del pre al post-test en un 52% con los signos de infección urinaria, un 32% con los síntomas, un 72.5% con el tratamiento, y un 40% con los factores de riesgo personales/conductuales y los relacionados con la morbilidad, un 59% con los factores condicionales y un 43.8% con las medidas preventivas. El equipo de cuidadores mostró una mayor aprehensión de conocimientos en relación al equipo de enfermería en casi todas las preguntas (p<0.05). El tiempo dedicado al cuidado de ancianos no mostró correlación positiva con ninguna variable (R<1; p>0.05). La prevalencia de infección urinaria en el período pre-intervención fue del 33.62% y en el post-intervención del 20%. Conclusión. La intervención educativa fue eficaz en la prevención de las infecciones urinarias en ancianos. El aumento de conocimientos adquiridos por los enfermeros y por los cuidadores se relacionó con la reducción de la tasa de infecciones y el mejoramiento de los factores modificables más prevalentes para desarrollar este tipo de patología.

Objetivo. Analisar a efetividade de intervenção educativa com profissionais de enfermagem e cuidadores para prevenção de infecções do trato urinário de idosos institucionalizados. Métodos. Estudo quase experimental realizado com 20 pessoas (7 enfermeiros e 13 cuidadores formais). Aplicou-se questionário na pré-intervenção, realizou-se capacitação dos profissionais e reaplicação do questionário 6 meses pós-intervenção. O perfil de prevalência de infecções urinárias e fatores associados de 116 idosos foi avaliado antes e após as intervenções educativas. Na análise estatística utilizou-se testes de associação e de correlação, comparação de modelos de regressão logística e de taxas de prevalência. Resultados. A média de acertos da equipe de enfermagem e de cuidadores, após intervenção educativa, aumentou do pré para o pós-teste em 52% com relação aos sinais de infecção urinária, 32% a sintomas, 72.5% tratamento, e 40% sobre fatores de risco pessoais/comportamentais e relacionados a morbidade, 59% a fatores condicionais e 43,8% sobre medidas preventivas. A equipe de cuidadores apresentou maior ganho de conhecimento em relação à equipe de enfermagem em quase todas as questões (p<0.05). O tempo de cuidado com idoso não apresentou correlação positiva com nenhuma variável (R<1; p>0.05). A prevalência de infecção do trato urinário no período pré-intervenção foi de 33.62% e pós intervenção 20%. Conclusão. A intervenção educativa foi efetiva na prevenção às infecções do trato urinário dos idosos. O aumento do conhecimento adquirido por enfermeiros e cuidadores foi associado à redução da taxa de infecções e à melhoria dos fatores modificáveis mais prevalentes para o desenvolvimento desse tipo de patologia.

The use of fiberglass posts in dentistry: a literature review / O uso de pinos de fibra de vidro na odontologia: uma revisão de literatura

The choice of retaining material that will replace the lost properties of the tooth, in which it is fragile and with loss of dentin structure, is important. The success of the treatment will depend on the qualities presented in it. Therefore, the objective of this work, through a literature review, is to present the advantages and disadvantages observed in the use of fiberglass post intraradicular retainer. This paper reviews the most relevant articles on the specificities presented in the fiberglass post retaining material, published in the period (2003 to 2020). The bibliographic search was performed in PubMed, Lilacs, Scielo, Google Scholar databases. In view of the selected articles on the subject, it is possible to observe the authors' acceptance of the application of the use of retainers, highlighting that in the treatment of cases with extensive coronary destruction, the aim is to have the functional and retentive capacity returned, in addition to the tension resistance. Therefore, theThe use of fiberglass posts in weakened teeth is effective as the material of choice. In cases that require reconstruction and return of tissue integrity, it has sufficient advantages for its selection. Despite the disadvantages it has, these do not outweigh the benefits to the point of making its use unfeasible. However, knowing when, where and how to treat is always important in any procedure for a satisfactory final outcome.

A escolha do material retentor que irá substituir as propriedades perdidas do dente, no qual este se apresenta de forma fragilizada e com perca de estrutura dentinária é importante. O sucesso do tratamento irá depender das qualidades apresentadas no mesmo. Sendo assim, o objetivo deste trabalho por meio de uma revisão de literatura é apresentar as vantagens e desvantagens observadas no uso do retentor intrarradicular de pino de fibra de vidro. Este trabalho revisa os artigos mais relevantes sobre as especificidades apresentadas no material retentor de pino de fibra de vidro, publicadas no período (2003 até 2020). A busca bibliográfica foi realizada nos bancos de dados PubMed, Lilacs, Scielo, Google Scholar. Diante dos artigos selecionados referentes ao tema, pode-se observar a aceitação dos autores sobre a aplicação do uso de retentores, destacando-se que no tratamento de casos com destruição coronária extensa o intuito é dispor da devolução da capacidade funcional, retentiva, além da resistência a tensão. Portanto, a utilização de pinos de fibra de vidro em dentes fragilizados apresenta efetividade como material de escolha. Em casos que necessitam de reconstrução e devolução de sua integridade tecidual, possui consigo vantagens suficientes para sua seleção. Apesar das desvantagens que possui, essas não se sobrepõem aos benefícios a ponto de tornarem inviáveis ao seu uso. Entretanto, saber quando, onde e como tratar é sempre importante em qualquer procedimento para um desfecho final satisfatório.

Analysis of morphology and symmetry of the root canal system of incisors, premolars and mandibular molars using CBCT / Análise da morfologia e simetria do sistema de canais radiculares de incisivos, pré-molares e molares inferiores usando a TCFC

ABSTRACT Knowledge of root canal internal anatomy and its variations is important forproper endodontic treatment. It is therefore necessary to investigate morphological aspects among different dental groups in the same patient to define the best protocol for the case. Aim To evaluate the morphology and symmetry of homologous incisors, premolars and mandibular molars using cone beam computed tomography (CBCT). Materials and Method Descriptive statistical analysis was performed for the frequency of categorical variables, and a chi-square test or Fisher 's exact test was used to test whether gender and side were associated with number of roots, number of canals, and Vertucci's classification. Forty-five CBCT scans were evaluated, and 444 mandibular teeth were analyzed. The number of roots, number of canals, classification of the canals in each root according to Vertucci and presence of a symmetrical relationship between pairs of posterior teeth were analyzed. Results The resuls showed that 74% of mandibular central incisors had type I root canal, 26% of mandibular lateral incisors had type I and, with a significant difference in the number of canals between males and females (p < 0.05). In mandibular first premolars, 70.5% had type I; and in mandibular second premolars, 98.5% had type I. Mandibular first molars had two roots in 98% of the cases. Second mandibular molars had two roots in 92.5% of the cases, one root in 6%, and three roots in 1.5%. Symmetry between central incisors was higher in females than in males. Conclusión Teeth of the same group can have different morphologies in the same patient.

RESUMO 0 conhecimento da anatomia interna e suas variagoes anatómicas é fator importante para o adequado tratamento endodóntico. Portanto, é necessário investigar esses aspectos morfológicos entre diferentes grupos dentários de um mesmo paciente para definir o melhor protocolo para o caso. Objetivo Avaliar a morfologia e simetria de incisivos, pré-molares e molares inferiores homólogos por meio de tomografia computadorizada de feixe cónico (TCFC). Materiais e Método Foi realizada análise estatística descri-tiva para a frequéncia das variáveis categóricas e foi utilizado o teste do qui-quadrado ou teste exato de Fisher para testar a relagao entre sexo e lado em comparagao com número de raízes, número de canais e classificagao de Vertucci. Quarenta e cinco TCFC foram avaliadas e 444 dentes inferiores foram analisados. Foram considerados: o número de raízes, o número de canais, o tipo dos canais acordo com a classificagao de Vertucci e a presenga de relagao simétrica entre pares de dentes posteriores. Resultados Os resultados mostraram que 74% dos incisivos centrais inferiores tinham um canal radicular tipo 1 e 26% tinham dois canais; 73% dos incisivos laterais inferiores, 26%oeram do tipo I, tinham um canal e 27% tinham dois canais, com diferenga significativa no número de canais entre os grupos masculino e feminino (p < 0,05). Nos primeiros pré-molares inferiores, tipo I, um canal foi detectado em 70,5% e dois canais em 29,5%; nos segundos pré-molares inferiores, tipo I, um único canal foi detectado em 98,5%. O primeiro molar inferior foi observado com duas raízes em 98% e tres raízes em 2%o. O segundo molar inferior tinha duas raízes em 92,5% dos casos, uma raiz em 6% e tres raízes em 1,5%. A simetria foi maior nas mulheres em comparagao aos homens nos incisivos centrais. Conclusao Pode-se concluir que dentes de um mesmo grupo podem apresentar morfologias diferentes no mesmo paciente.

Efficacy and radiology evaluation of pulpotomy in mature permanent teeth / 北京大学学报(医学版)

Objective:To observe the clinical efficacy of pulpotomy in patients of different ages and to explore the occurrence and characteristics of pulpal calcification.Methods:A total of 77 patients who underwent pulpotomy for mature permanent premolars and molars with caries-derived pulp exposure in the Department of General Dentistry,Peking University School and Hospital of Stomatology from October 2019 to August 2022 were selected.Pulpotomies were performed in a single visit using iRoot BP Plus bioceramic material as pulp capping agent.The patients were divided into three groups according to age:25 cases in the adolescent group(11-20 years old)with a mean age of(15.88±2.19)years;27 cases in the middle-aged group(21-50 years old)with a mean age of(34.59±8.67)years;and 25 cases in the elder-aged group(51-83 years old)with a mean age of(63.84±7.40)years.The patients were reviewed 1 year after the operation to evaluate the clinical efficacy and to record the formation of calcified bridge,thickness of calcified bridge,and pulp calcification index(PCI).Results:There was no statisti-cally significant difference between the three groups in terms of gender,dentition,and tooth position(P＞0.05).The 1-year postoperative follow-up rate was 85.71％(66/77),including 88.00％(22/25)in the adolescent group,85.19％(23/27)in the middle-aged group,and 84.00％(21/25)in the elder-aged group.The 1-year follow-up clinical success rates of the three groups were 95.45％(21/22),91.30％(21/23),and 95.24％(20/21),respectively,with no statistically significant difference(P＞0.05).Among the clinical success cases,calcified bridges appeared in 12 cases(57.14％,12/21)in the adolescent group,8 cases(38.10％,8/21)in the middle-aged group,and 3 cases(15.00％,3/20)in the elder-aged group,with statistically significant differences(x2=7.810,P=0.020＜0.05).The difference was statistically significant(F=4.434,P=0.020＜0.05)when comparing the thickness of calcified bridges among the three groups.Calcified bridge thickness was negatively corre-lated with age(r=-0.516,P＜0.05).The changes in pulpal calcification index ΔPCI were 0.67±0.58,0.43±0.51,and 0.25±0.52,respectively,with statistically significant differences among the three groups(F=3.404,P=0.040＜0.05).Conclusion:Pulpotomy for caries-derived pulp exposure in elderly patients could also achieve a high success rate.The incidence of calcified bri-dges after pulpotomy and the acceleration of pulpal calcification were age-related.The adolescent group was more likely to form calcified bridges and also showed more pronounced accelerated root canal calcifi-cation.

Application of bioactive ceramics iRoot BP Plus? in pulpotomy for complicated crown fracture of immature permanent anterior teeth in children / 北京大学学报(医学版)

Objective:To analyze the clinical and radiographic effectiveness of a calcium silicate-based bioactive ceramic iRoot BP Plus? pulpotomy of immature permanent teeth with complicated crown fracture and to evaluate the factors influencing its long-term success rate.Methods:The digital medical records of patients under 13 years old who had undergone iRoot BP Plus? pulpotomy in the Department of Oral Emergency or the First Clinical Division,Peking University School and Hospital of Stomatology from March 2017 to September 2022 due to complicated crown fracture of anterior teeth,and had taken at least one post-operation apical radiograph were reviewed.The clinical and radiographic information at the initial examination and follow-up period were obtained,including crown color,mobility,percussion,cold test(partial pulpotomy teeth),dental restoration,fistula,swelling or inflammation of the gingival tissue,the formation of apical foramen,pathologic radiolucency and calcification of pulp chamber or root canal obliteration.Data were tested by Fisher exact test and a multiple comparison.Results:In the study,64 patients including 37 males(57.8％)and 27 females(42.2％)with a mean age of 9.1 years were finally enrolled.The total number of permanent teeth that received pulpotomy was 75,and the average follow-up time was 19.3 months.The success rate was 93.1％with the time interval between dental injury and treatment in 24 h,while the success rate dropped to 88.2％with the time intervals beyond 24 h.The time intervals did not significantly affect the pulp survival rate(P=0.61)after pulpotomy(partial or co-ronal).The success rate 6 months after pulpotomy was 96.0％,and one-year success rate was 94.7％.A total of 23 cases were reviewed for more than 2 years after pulpotomy,and 6 cases failed.The mobility had no significant effect on the success rate(P=0.28).Pulp chamber calcification and pulp canal obli-teration were not observed in all the post-operative radiographs.Conclusion:The one year clinical and radiographic success rates obtained in this study indicate that iRoot BP Plus? is an appropriate pulp cap-ping material option for pulpotomy treatment of complicated crown fracture in immature permanent teeth without displacement injuries.This technique has broad promotional value.

Guided endodontics for the treatment and vital pulp concervation of type Ⅲ Dens Invaginatus in an immature maxillary lateral incisor with periapical periodontitis / 实用口腔医学杂志

A young maxillary lateral incisor of Oehlers type Ⅲ Dens invaginatus with peri-invagination periodontitis was reconstructed by CBCT,with the help of guided endodontics,the pathway to invagination was successfully established.The invaginated pseudo-root canal was treated with Vitapex mediation while preserving the pulp.After 6-month follow-up,the tooth was clinically asymptomatic.Radiological ex-amination indicated complete healing of the peri-invagination lesion with narrowed open apex,and the thickened root canal wall.

Progress of Pulpal Disease Treatment in Young Permanent Teeth / 华中科技大学学报(医学版)

Young permanent teeth are not fully developed due to their short eruption,characterized by a relatively large pulp cavity,high and pointed pulp horns,and open apical foramina.Due to caries,abnormal tooth development or trauma,the dental pulp may be damaged or infected,which may lead to pulp necrosis and directly affect the normal tooth root formation.Therefore,the treatment of dental pulp disease in young permanent teeth poses a huge clinical challenge.The goal of clinical treatment is to promote continued root development of the affected tooth,thicken the root canal walls,and close the api-cal foramina.This article reviews the treatment options for reversible and irreversible pulpitis caused by pulp exposure,aiming to provide a reference for the treatment of pulp lesions in young permanent teeth,focusing on preserving healthy pulp and pro-moting pulp repair and regeneration.

The Prevalence, Severity and Pattern of First Permanent Molars’ Dental Caries in Children Attending A Postgraduate Dental Hospital: A Retrospective Study

@#Introduction: First permanent molars (FPMs) erupt early and their anatomy and location leave them susceptible to dental caries. This study aimed to retrospectively determine the prevalence, severity and pattern of dental caries of FPMs and investigate their relationship if any with demographics and medical health status of the partcipants. Methods: This was a retrospective cross-sectional study. A sample of the digital case notes and radiographs of children aged 5 to 12 years who attended the only postgraduate dental hospital in Dubai were accessed. The recorded data included the children’s demographic variables and the carious status of each FPM as recorded in the notes on the initial assessment. Descriptive and statistical analyses were conducted (P<0.05). Results: A total of 2984 FPMs were obtained from the digital records of 774 children. Their mean age was 8.07 (±2.23) years and only those that met the inclusion criteria were included in the study. The prevalence of dental caries and mean Decayed Missing Filled Surfaces of FPMs, were 42% and 0.3 (±0.04), respectively. The most prevalent decayed surface was the occlusal (29.2%), followed by mesial, buccal, palatal/ lingual, distal surfaces (24.2 %; 6.6 %; 3.1 %; 2.3 %) respectively. Children with medical problems and/or special needs had a significantly higher level of caries in the buccal surfaces (12.3%) (P=0.042). Conclusion: Caries of FPMs in a sample of Dubai children studied was prevalent, especially in those with special healthcare needs, thus indicating a necessity for targeted prevention and treatment focused on these keystone teeth.

Effect of pulp revascularization on pulp necrosis with periapical periodontitis in young permanent teeth / 中国基层医药

Objective:To investigate the efficacy of pulp revascularization in the treatment of pulp necrosis with periapical periodontitis in young permanent teeth and its effect on the levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in gingival crevicular fluid.Methods:From January 2021 to August 2021, 72 young patients with permanent teeth exhibiting pulp necrosis and apical periodontitis who were treated at Haiyang People's Hospital were included in this study. These patients were subsequently divided into a study group ( n = 35) and a control group ( n = 37), depending on their respective treatment methods. The control group underwent conventional apical angioplasty, whereas the study group underwent pulp revascularization. A comparative analysis was conducted to assess the clinical efficacy of both treatments. Additionally, levels of VEGF and bFGF in gingival crevicular fluid were measured before and after surgery, and these values were compared between the two groups. Relevant clinical indicators and the incidence of adverse reactions were also compared between the study and control groups. Results:The overall response rate in the study group was 94.3% (33/35), which was significantly higher than 70.3% (26/37) in the control group ( χ2 = 7.01, P < 0.05). Prior to surgery, there were no notable differences in VEGF level, bFGF level, root length, or root canal thickness between the two groups (all P > 0.05). However, after surgery, VEGF level, bFGF level, root length, and root canal thickness in the study group were (43.25 ± 4.87) ng/L, (40.72 ± 4.83) ng/L, (8.95 ± 0.27) mm, and (3.08 ± 0.24) mm, respectively. These values were (39.90 ± 4.80) ng/L, (36.05 ± 4.66) ng/L, (8.55 ± 0.18) mm, and (2.90 ± 0.20) mm, respectively, in the control group. There were significant differences in VEGF level, bFGF level, root length, and root canal thickness between the two groups ( t = 2.96, 4.18, 5.67, 2.88, all P < 0.05). After surgery, the scores for apical inflammation, root development, and Visual Analogue Scale (VAS) in the study group were significantly higher than those in the control group ( t = 7.61, 4.83, 9.47, all P < 0.001). The incidence of adverse reactions in the study group was 2.9% (1/35), which was significantly lower than 21.6% (8/37) in the control group ( χ2 = 5.79, P < 0.05). Conclusion:Pulp revascularization exhibits superior curative effects compared with conventional apical angioplasty for the treatment of pulp necrosis and apical periodontitis in young permanent teeth. This treatment effectively alleviates pain, markedly improves tooth function, and has a low incidence of adverse reactions, highlighting its clinical value as a therapeutic option.

Comparison of the efficacy of two bioceramic materials in vital pulp preservation of mature permanent teeth with exposed pulp of caries origin / 预防医学

Objective@#To compare the efficacy of two bioceramic materials, iRoot BP Plus and mineral trioxide aggregate (MTA) in the preservation of vital pulp of mature permanent teeth with exposed pulp of caries origin, so as to provide insights into appropriate selection of pulp capping agents in clinical process.@*Methods@#Vital pulp therapy were performed on 120 mature permanent teeth with carious exposure at the Department of Stomatology of Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University. The teeth were randomly divided into two groups which were treated respectively by iRoot BP Plus (iRoot group) and MTA (MTA group). The clinical efficacy was evaluated by clinical examinations and imaging examinations.@*Results@#There were 60 cases in iRoot group, including 23 males and 37 females, 27 cases affected premolars and 33 cases affected molars, and 8 cases of Class I and 52 cases of Class II cavity type, with a median age of 41 (interquartile range, 12) years. There were 60 cases in MTA group, including 29 males and 31 females, 21 cases affected premolars and 39 cases affected molars, and 10 cases of Class I and 50 cases of Class II cavity type, with a median age of 39 (interquartile range, 14) years. There were no significant differences in gender, age, affected tooth location and cavity type between the two groups (P>0.05). The success rate of iRoot group at 12 months was 91.67% while the MTA group was 88.33%, and the pulp infection rate of iRoot group at 12 months was 8.33% while the MTA group was 11.67%. There were no significant differences in success rate and pulp infection rate between the two groups (P>0.05). The rate of crown discoloration in MTA group was 61.67%, while there was no discoloration in iRoot group.@*Conclusions@#During 12 months, iRoot BP Plus and MTA can both achieve great effects in the treatment of mature permanent teeth with carious pulp exposure, but there is a problem of tooth discoloration after pulp covering using MTA. The long-term clinical effects of the two materials need to be further studied.

Extracción terapéutica de primeros molares Permanentes severamente destruidos en dentición mixta

En dentición mixta, el 1°Molar permanente es el más susceptible a caries, que desencadena un ciclo restaurador repetitivo y pérdida. El objetivo de este estudio fue evaluar factores determinantes de la extracción terapéutica de 1°Molares permanentes severamente destruidos en dentición mixta antes de la erupción del segundo molar permanente con un favorable cierre espontáneo del espacio residual. La metodología consistió en una revisión sistemática exploratoria en PubMed mediante búsqueda estratégica/específica. Incluyó diez artículos que abordaron factores como la edad cronológica ideal, etapa de desarrollo del segundo premolar y molar permanente, presencia del tercer molar, cierre espontáneo residual, pronóstico, y necesidad de tratamiento ortodóncico. En conclusión, la extracción terapéutica del 1°Molar antes de la erupción del segundo molar permanente está asociada con un favorable cierre espontáneo del espacio residual. Se evidencia mayor éxito con la presencia del tercer molar, segundo molar en etapa E y segundo premolar en etapa F (Demirjian).

Abstrato: Em dentição mista, o 1°molar permanente é o mais suscetível a cáries, desencadeando um ciclo restaurador repetitivo e perda. O objetivo deste estudo foi avaliar fatores determinantes da extração terapêutica de 1°molares permanentes severamente destruídos na dentição mista antes da erupção do segundo molar permanente com uma região espontânea favorável do espaço residual. A metodología utilizada no PubMed consistiu em uma revisão exploratória por meio de busca estratégica/específica. Foram incluídos dez artigos, abordando fatores como a idade cronológica ideal, estágio de desenvolvimento do segundo pré-molar e molar permanente, presença do terceiro molar, cierre espontâneo residual, pronóstico e necessidade de tratamento ortodôntico. Em conclusão, a extração terapêutica do 1°molar permanente antes da erupção do segundo molar permanente está associada a um fechamento espontâneo favorável do espaço residual. Maior sucesso está descrito quando na presença de terceiro molar, segundo molar no estágio E e segundo pré-molar no estágio F (Demirjian).

During mixed dentition, the 1st permanent molar is the most susceptible to caries, triggering a repetitive restorative cycle and loss. This study aimed to evaluate determinants of therapeutic extraction of severely damaged 1st permanent molars in mixed dentition before the eruption of the second permanent molar with favorable spontaneous closure of the residual space. The methodology involved a scoping review on PubMed using a specific search strategy. Ten articles were included addressing factors such as the ideal chronological age, stage of development of the second premolar and permanent molar, presence of the third molar, residual spontaneous closure, prognosis, and need for orthodontic treatment. In conclusion, therapeutic extraction of the 1st molar before the eruption of the second molar is associated with favorable spontaneous closure of the residual space. Greater success is evident with the presence of the third molar, the second molar in stage E, and the second premolar in stage F (Demirjian).

O uso de Tecnologias de Informação e Comunicação em Saúde na Atenção Primária à Saúde no Brasil, de 2014 a 2018 / The use of Information and Communication Technologies in Primary Health Care in Brazil - the period of 2014 to 2018

Resumo As Tecnologias da Informação e Comunicação em Saúde permitem o armazenamento e processamento de dados digitais, acesso a informações e comunicações à distância. O objetivo deste artigo foi descrever a utilização destas tecnologias para o apoio à prática clínica e educação permanente pelas equipes de saúde da atenção primária à saúde do Brasil no período de 2014 a 2018, no âmbito do Programa de Melhoria do Acesso e da Qualidade na Atenção Básica, segundo características do contexto geopolítico. É um estudo transversal que analisou os dados coletados junto às equipes das Unidades Básicas de Saúde. Foi observada uma crescente utilização pelas equipes dos recursos da Telessaúde, Rede Universitária de Telemedicina e Universidade Aberta do Sistema Único de Saúde para auxílio à prática clínica e educação permanente em saúde. Nas regiões Norte e Nordeste o uso destas tecnologias dobrou, do ciclo II ao ciclo III. A necessidade de investimentos em infraestrutura, recursos humanos na Atenção Primária à Saúde, qualificação e formação profissional é um caminho para o fortalecimento do Sistema Único de Saúde e sua Rede de Atenção em Saúde, contribuindo para um fluxo de atendimento contínuo, com qualidade e acesso universal.

Abstract Information and Communication Technologies in Health allow the storage and processing of digital data, access to information and remote communications. The objective of this article was to describe the use of these Technologies to support clinical practice and continuing education by primary health care teams in Brazil the period of 2014 to 2018, within the scope of the Access and Quality Improvement Program Basic, according to characteristics of the geopolitical context. It's a cross-sectional study that analyzed the data collected from the teams of the Basic Health Units. A growing use by the teams of Telehealth resources, the Telemedicine University Network and the Open University of the Unified Health System was observed to aid clinical practice and permanent health education. In the North and Northeast regions, the use of these Technologies doubled, from cycle II to cycle III. The need for investments in infrastructure, human resources in Primary Health Care, qualification and professional training is a way to strengthen the Unified Health System and its Health Care Network, contributing to a continuous flow of care, with quality and access universal.

Knowledge of Physical Education Students about Tooth Avulsion Before and After Receiving an Informative Leaflet

Abstract Objective: To evaluate the knowledge of Physical Education students about tooth avulsion (TA) in both dentitions before and after receiving an informative leaflet (IL). Material and Methods: The questionnaire contained information about TA in dentition and its management and was applied to the Physical Education students before and after reading an IL. Results: A total of 118 students, 96.61%, attended a first aid course, and 17.80% received information about TA. Most students (88.98%) never had an experience with TA, and 90.68% considered its management important. The other questions, before and after reading the IL, respectively, were: would not perform deciduous tooth replantation (42%; 88%); knew how to handle the avulsed permanent tooth (APT) (38%; 92%); knew how to clean the APT (50%; 99%); knew that permanent tooth replantation (PTR) must be immediate (15%; 95%); knew the ideal time to seek for the dentist right after TA without performing PTR (6%; 83%); knew how to store APT (31%; 97%). Conclusion: The knowledge of Physical Education students in this research revealed a limited understanding of dental tooth avulsion. After receiving an informative leaflet, the students showed a significant improvement in knowledge about traumatic avulsion management, including tooth replantation and proper actions.

Associação entre número de dentes, próteses dentárias e disfagia autorreferida em idosos brasileiros: estudo populacional / Association between number of teeth, dental prostheses, and self-reported dysphagia in brazilian old people: a population-based study

RESUMO Objetivo Verificar a associação entre o número de dentes e uso de prótese dentária removível e a ocorrência de disfagia autorreferida em idosos de 60 anos ou mais. Método Estudo transversal de base populacional com 5.432 idosos, que participaram da linha de base do Estudo Longitudinal da Saúde do Idoso (ELSI-Brasil). O desfecho "disfagia" foi associado ao número de dentes permanentes e ao uso de prótese dentária removível. As variáveis independentes sociodemográficas (idade, sexo e cor/raça) e de histórico clínico (nenhuma morbidade, uma morbidade ou mais de duas morbidades) utilizando Regressão de Poisson com variância robusta e seus respectivos intervalos de confiança (IC) de 95% foram analisados. Resultados A prevalência de disfagia autorreferida nos idosos não institucionalizados foi de 30%. O grupo de idosos com 10 - 19 dentes permanentes apresentou um risco de 52% de queixa de disfagia autorreferida (RPaj 1,565 IC95% 1,34;1,826) se comparado com seus pares com mais dentes. Conclusão foi encontrada associação entre o menor número de dentes e próteses removíveis com a ocorrência de disfagia.

ABSTRACT Purpose To investigate the association between the number of permanent teeth and the use of removable dental prostheses with self-reported dysphagia occurrence in individuals aged 60 years or older. Methods A population-based cross-sectional study was conducted with 5,432 old individuals who participated in the baseline of the Brazilian Longitudinal Study of Elderly Health (ELSI-Brazil). The outcome "dysphagia" was associated with the number of permanent teeth and the use of removable dental prostheses. Sociodemographic independent variables (age, sex, and race/ethnicity) and clinical history variables (no morbidity, one morbidity, or more than two morbidities) were analyzed using Poisson Regression with robust variance and their respective 95% confidence intervals (CI). Results The prevalence of self-reported dysphagia in non-institutionalized old individuals was 30%. The group of old individuals with 10 - 19 natural teeth showed a 52% increased risk of self-reported dysphagia complaint (PRadj 1,565 IC95% 1,34;1,826) compared to their counterparts with more teeth. Conclusion An association was found between a lower number of teeth and removable prostheses with the occurrence of dysphagia.

Algunas consideraciones sobre la superación permanente de los profesionales de salud en Cuba

Introducción: La sociedad del conocimiento crece de forma acelerada y envejece también con rapidez, lo que contribuye a la necesidad de aprender a gestionarlo y hace necesario favorecer la superación permanente de los profesionales de la salud para convertirlos en un recurso de talento humano con altos conocimientos y responder a las más apremiantes necesidades de salud. Objetivo: Caracterizar la superación permanente de los profesionales de salud en Cuba. Métodos: Se realizó una revisión documental sobre la superación permanente en profesionales de la salud, a través de las bases Scopus, SciELO, CUMED, LILACS, Biblioteca Virtual de Salud, PubMed, en español e inglés, mediante el motor de búsqueda de información Google Académico. Fueron seleccionados 20 artículos científicos con suficiente calidad y actualidad, concernientes al objetivo propuesto, para lo cual se aplicó el método teórico de investigación científica histórico-lógico. Para la búsqueda se utilizaron las palabras: educación de posgrado, superación profesional y superación permanente. Resultados: La superación permanente, proceso particular de la educación posgraduada para profesionales de la salud, ha sido estudiada por diferentes autores. Esta comprende un sistema orientado al enriquecimiento profesional para actualizar, ampliar y profundizar de forma continua los conocimientos para elevar la cultura general integral y cumplir con calidad el desempeño profesional. Conclusiones: La sistematización realizada sobre la superación permanente de los profesionales de salud garantiza la actualización de los conocimientos y las habilidades, lo que permite elevar la calidad de la competencia y el desempeño de los prestadores de los servicios de salud a la población.

Introduction: The knowledge society is growing in an accelerated manner and, also, is aging rapidly, which contributes to the necessity of learning how to manage knowledge and demands to favor the permanent improvement of health professionals, in order to turn them into a human talent resource with high knowledge for responding to the most pressing health needs. Objective: To characterize the permanent improvement of health professionals in Cuba. Methods: A documental review was carried out on the continuing education of health professionals, through the Scopus, SciELO, CUMED, LILACS, Virtual Health Library, and PubMed databases, in Spanish and English, by means of the information search engine Google Scholar. Twenty scientific articles of sufficient quality and current relevance concerning the proposed objective were selected, for which the historical-logical theoretical method of scientific research was applied. The following words were used for the search: educación de posgrado [postgraduate education], superación profesional [professional improvement] and superación permanente [permanent improvement]. Results: Permanent improvement, a particular process of postgraduate education for health professionals, has been studied by different authors. This comprises a system oriented to professional enrichment for continuously updating, broadening and deepening knowledge in order to raise general comprehensive culture and fulfill professional performance with quality. Conclusions: The systematization carried out on the permanent improvement of health professionals guarantees the updating of knowledge and skills, which allows raising the quality of competence and performance of health service providers to the population.

Organização do trabalho no cuidado à pessoa com transtorno do espectro autista nos centros especializados em reabilitação da cidade de são paulo / Organization of work in the care of people with autism spectrum disorder in specialized rehabilitation centers in the city of são paulo

RESUMO O Centro Especializado em Reabilitação (CER) faz parte de uma rede de serviços que atua de maneira multiprofissional no atendimento à pessoa com deficiência. Dentre essas deficiências, inclui-se o Transtorno do Espectro Autista (TEA). Nesse sentido, esta pesquisa tem por objetivo compreender a organização do trabalho nos CERs da cidade São Paulo para atender às pessoas com TEA, na perspectiva do trabalho em equipe e da prática colaborativa. O estudo, de abordagem qualitativa, transversal e descritiva, foi realizado com 14 profissionais das equipes dos CERs. Uma amostra intencional foi constituída progressivamente por um profissional de cada CER Regional, respeitando-se a diversidade entre as categorias, até que se obteve o caráter de saturação da amostra. Da análise de conteúdo, na modalidade temática, emergiram duas categorias: Organização do trabalho da/na equipe; Organização do CER para o atendimento do TEA. Os resultados mostram a importância do atendimento compartilhado; das aprendizagens de uns com os outros na equipe; da ausência de discussões sistemáticas relacionadas às ações, resultados das intervenções e para o planejamento de novas ações. Conclui-se que há necessidade de espaços formativos na perspectiva do trabalho em equipe e da prática colaborativa para possibilitar maior efetividade no cuidado e no fortalecimento da relação entre educação e saúde.

ABSTRACT The Specialized Rehabilitation Center (SRC) is part of a service network that operates in a multidisciplinary way in caring for people with disabilities. Among these disabilities, the Autism Spectrum Disorder (ASD) is included. In this sense, this research aims to understand the organization of work in the SRCs in the city of São Paulo, Brazil, to assist people with ASD, from the perspective of teamwork and collaborative practice. The study, of qualitative, cross-sectional and descriptive approach, was carried out with 14 professionals from the SRCs teams. An intentional sample was constituted progressively by a professional from each Regional SRC, respecting the diversity between the categories, until the saturation character of the sample was obtained. From the content analysis, in the thematic modality, two categories emerged: Organization of the work of/in the team; Organization of the SRC for ASD care. The results show the importance of shared care; learning from each other in the team; the absence of systematic discussions related to actions, results of interventions and for the planning of new actions. It is concluded that there is a need for training spaces from the perspective of teamwork and collaborative practice to enable greater effectiveness in care and strengthening the relationship between education and health.

Circuito dos Cuidados Psicossociais: sistematização de intervenção na crise psíquica no atendimento pré-hospitalar móvel / Circuito de los Cuidados Psicosociales: sistematización de intervención en la crisis psíquica en la atención pre-hospitalaria móvil / Psychosocial Care Circuit: the systematization of intervention in psychic crisis in mobile pre-hospital care

Um relato de experiência que visa apresentar a sistematização de atendimento para o manejo de crises psíquicas desenvolvida pelo Núcleo de Saúde Mental do Samu-DF. A metodologia, fundamentada nos passos do arco de Maguerez, permitiu desde a identificação das dificuldades dos profissionais no manejo das crises psíquicas até a construção da sistematização denominada "Circuito de Cuidados Psicossociais" para orientar a assistência no serviço pré-hospitalar móvel. O circuito tem como mnemônico "AEIOU", e cada letra corresponde a um elemento avaliado como necessário na intervenção de crise psíquica. Assim, é possível afirmar que a Educação Permanente em Saúde possibilita uma ação transformadora dos profissionais e da realidade na qual estão inseridos, e a sistematização tem acelerado a consolidação das habilidades necessárias ao atendimento das crises psíquicas.(AU)

Un relato de experiencia cuyo objetivo es presentar la sistematización de atención para el manejo de crisis psíquicas desarrollada por el Núcleo de Salud Mental del SAMU-DF. La metodología, fundamentada en los pasos del arco de Maguerez, permitió desde la identificación de las dificultades de los profesionales en el manejo de las crisis psíquicas hasta la construcción de la sistematización denominada "Circuito de Cuidados Psicosociales" para orientar la asistencia en el servicio pre-hospitalario móvil. El circuito tiene como iniciales mnemónicas "AEIOU" y cada letra corresponde a un elemento evaluado como necesario en la intervención de crisis psíquica. De tal forma, es posible afirmar que la educación permanente en salud posibilita una acción transformadora de los profesionales y de la realidad en la cual están inseridos y que la sistematización ha acelerado la consolidación de las habilidades necesarias para la atención de las crisis psíquicas.(AU)

An experience report that aims to present the systematization of care for the management of psychic crises developed by the SAMU-DF Mental Health Center. The methodology, based on the steps of the Maguerez's Arch, allowed both the identification of professionals' difficulties regarding psychic crises management and the construction of the system called "Psychosocial Care Circuit'' to guide the assistance of the mobile pre-hospital care. The Circuit has as mnemonic AEIOU, and each letter corresponds to an element evaluated as necessary for the psychic crisis intervention. Therefore, it is possible to affirm that the permanent education in health enables the transformative action of professionals, in addition to transforming the reality in which they are inserted, and that the systematization has accelerated the consolidation of the necessary skills for psychic crises care.(AU)