External control of fluoridation in the public water supplies of Brazilian cities as a strategy against caries: a systematic review and meta-analysis.

BACKGROUND: Among the methods currently available to provide fluoride in population levels, fluoridated water is the most successful for presenting high efficacy, safety and good cost-benefit. However, recent studies on external control have shown great variability of fluoride concentrations in the water from treatment stations in Brazilian cities, which must present concentration between 0.6 and 0.8 mg/L to be considered acceptable in most cities. Thus, this study aimed to perform a systematic review of the literature to assess the adequacy of fluoride concentration in the water in Brazilian cities using external control. METHODS: The protocol was registered in PROSPERO. Six databases were used as primary search sources and three databases were used to partially capture the "gray literature". Only observational studies that assessed the fluoride concentration of artificially fluoridated water from the public supply network were included. The JBI Critical Appraisal Tools for Systematic Reviews was used to assess the risk of bias of the studies. A proportion meta-analyses using random-effect models were performed. The heterogeneity between studies was determined by I2 statistic. Meta-regressions were conducted to identify relevant moderators to be used in stratified meta-analyses. Publication bias was investigated by Egger's tests. RESULTS: The search provided 2038 results, from which 14 met the eligibility criteria and were included in the data extraction of the review. Overall, the water samples were collected from 449 different sources in three Brazilian regions. Thirteen studies presented a low risk of bias. The mean concentration of fluoride ranged from 0.17 to 0.89 ppmF. The meta-analyis demonstrated that more than half of the water samples analyzed had fluoride concentration levels outside the acceptable range (56.6%; 95% CI 45.5; 67.3), with high heterogeneity. CONCLUSION: More than half of the public water supply analyzed in the studies selected had fluoride concentration levels outside the acceptable range, which may affect the risk of developing oral diseases in the Brazilian population, having an important impact on public health.

Efficiency of bimaxillary advancement surgery in increasing the volume of the upper airways: a systematic review of observational studies and meta-analysis.

Postsurgical changes of the airways have become a great point of interest because it has been reported that maxillomandibular advancement surgery can improve or eliminate obstructive sleep apnea; however, its treatment effectiveness is still controversial. The purpose of this systematic review and meta-analysis was to assess the effectiveness of maxillomandibular advancement surgery to increase upper airway volume in adults, comparing before and after treatment. Bibliographic searches of observational studies with no restriction of year or language were performed in the electronic databases PubMed, Scopus, ScienceDirect and SciELO for articles published up to April 2015. After verification of duplicate records, 1860 articles were examined. Of these, ten met the eligibility criteria, of which three were excluded for having poor methodological quality. The other seven articles were included in the systematic review and six in the meta-analysis, representing 83 patients. One study whose data were not given in absolute values was excluded from the meta-analysis. The meta-analysis showed a statistically significant difference between the averages of upper airway volume before and after surgery {7.86 cm3 [95 % CI (6.22, 9.49), p = 1.00)}. Clinical evidence suggests that the upper airway volume is increased after maxillomandibular advancement surgery.

Distalization controlled with the use of lip-bumper and mini-screw as anchorage: a new approach.

An increasingly number of patients with Angle Class II has been seeking orthodontic clinics to have their malocclusion treated. Herein, it is presented a new method of promote distal movements in maxillary molars with a combination of limp-bumper (LB) and mini screw. This technique was proven to be fast, practical and with low-cost, thus favoring both the professional and the patient.

The use of Twin Force functional fixed orthopedic appliance in the treatment of Class II division 1 malocclusion.

Fixed protruding appliances are interesting tools for correction of Class II dental malocclusion in adult and growing patients. The appliances most commonly used for this purpose are: Herbst, Forsus and Jasper Jumper. The present clinical case report shows an alternative called Twin Force Bite Corrector which was used for 3 months by a patient aged 10 years and 6 months associated with the Andrews prescription fixed appliance (Abzil 3M). After treatment, malocclusion was found to be adjusted to Class I dental occlusion in a single stage.

The effects of miniscrew-assisted rapid palatal expansion on the upper airway of adults with midpalatal suture in the last two degrees of ossification.

BACKGROUND: Transverse deficiencies of the maxillary basal bone have been treated in adult patients using miniscrew-assisted rapid palatal expansion (MARPE) therapy. However, the midpalatal suture's degree of ossification may affect the upper airway dimensions. This study compared the volumetric changes of the total upper, retropalatal, retroglossal airways, and the minimal transverse airway constriction after MARPE therapy in patients with midpalatal suture in the last stages of ossification. METHODS: This controlled clinical trial included a total of 20 adult patients (mean age 24.5 ± 6.2 years) with maxillary atresia treated with MARPE. Preoperative (T0) cone-beam computed tomography scans were used to determine the degree of midpalatal suture ossification. Two groups were formed considering the last two stages of sutural ossification "D" or "E" (n = 10 per group). After 120 days of the therapy (T1), cone-beam computed tomography assessments were performed to compare the pre and post-treatment outcomes. The total upper, retropalatal, and retroglossal airways and the minimal transverse airway constriction were evaluated. The three-dimensional reconstruction was performed with OsiriX MD software. The comparisons were carried out using mixed models for repeated measures at fixed time points (α = 0.05). RESULTS: Groups D and E showed no significant difference for any of the analyzed parameters (P > 0.05). Both groups showed a statistically significant increase for all airway segments after the treatment with MARPE (P < 0.05). The total upper airway increased (11.6% and 16.1%) for groups D and E, respectively (P = 0.3356). CONCLUSIONS: MARPE therapy resulted in dimensional gains of the upper airway for adult patients, irrespective of the intermaxillary sutural degree of ossification.

Soft-tissue cone-beam computed tomography (ST-CBCT) technique for the analysis of skeletal, dental and periodontal effects of orthopedic rapid maxillary expansion.

BACKGROUND: Orthopedic rapid maxillary expansion (RME) is a common treatment of choice for managing transverse deficiency of the maxilla. This approach may have desired and undesired skeletal, dental and periodontal effects that may be assessed clinically or through imaging techniques. This study aims to investigate the dental, skeletal and periodontal effects of orthopedic RME using the soft-tissue cone-beam computed tomography (CBCT) technique. MATERIAL AND METHODS: The sample consisted of 10 patients (5males and 5 females) aged between 10 and 14 years (mean age: 12.5 years) treated with Hyrax orthopedic device. CBCT scans set for the registration of soft tissue (ST-CBCT) were taken from each patient before (T1) and 120 days after (T2) RME. Skeletal (n=10), dental (n=1) and periodontal (n=4) parameters measured in ST-CBCT were compared between T1 and T2 using t-test within a significance level of 5%. RESULTS: The skeletal parameters with statistically significant increase (p<0.05) in T2 were the width of the buccal alveolar bone crest, the external width of the dental arch at the level of buccal cusps, and the width of the dental arch at the level of most prominent dental surface contour. Representing the dental parameter, the inclination of the anchor teeth was statistically significant for premolars (p<0.05). The only statistically significant outcome in periodontal parameters was the decrease in buccal bone plate thickness of first molars (p<0.05). CONCLUSIONS: Dentists must be aware of the ST-CBCT technique for the analysis of hard and soft tissue after orthodontic and orthopedic treatments. This technique revealed that the RME reached optimal skeletal and dental effects with minimal periodontal side effects. Key words:Cone-beam computed tomography, imaging, orthodontics, orthopedics.

Determination of vertical characteristics with different cephalometric measurements.

OBJECTIVE: To analyze a possible correlation between different measures in the definition of vertical facial types. MATERIALS AND METHODS: This is an analytical observational study about 95 lateral teleradiographs of Caucasian individuals with normal occlusion, of which 54 were male (56.84%) and 41 female (43.16%), aged between 15 years and 2 months old and 21 years and 4 months old. Facial types were divided into dolichofacial, mesofacial, and brachyfacial, according to the standards established by different authors. A relationship between these measurements was verified using total agreement analysis and the Kappa method, with the interpretation suggested by Landis and Koch. RESULTS: Kappa was considered fair for Jarabak X VERT (0.22 and 60%) and slight for Jarabak X SN. GoGn (0.06 and 36.8%). CONCLUSIONS: Cephalometric studies often present different interpretations on the description of vertical facial types. In this study, the lowest agreement was between Jarabak and SN.GoGn. Such difference in interpretation may lead to distinct therapeutic approaches and thus different results.

Surgical Maxillary Advancement Increases Upper Airway Volume in Skeletal Class III Patients: A Cone Beam Computed Tomography-Based Study.

STUDY OBJECTIVES: Although volumetric changes of the upper airway occur following surgical advancement of the maxilla, few studies investigated these changes using three-dimensional imaging techniques. Thus, the goal of this study was to verify whether the surgical advancement of the maxilla affects the volume of the upper airway and to determine any association of these volume changes with sex and age. METHODS: Preoperative and postoperative cone-beam computed tomography (CBCT) scans of 14 patients (8 male and 6 female) who underwent maxillary advancement to correct skeletal class III deformities were assessed to determine the postoperative volumetric changes in the upper airway. Preoperative and postoperative airway volume measurements were compared by means of paired t-test, which was also used to compare airway volume between genders. Pearson correlation coefficient was used to verify whether a correlation between age and upper airway volume was present. RESULTS: Maxillary advancement produced significant upper airway volume increases (mean 20.94%, p < 0.05) on nearly half of our sample. However, sex and age did not seem to influence upper airway volume in our sample of skeletal class III patients. CONCLUSIONS: Surgical advancement of the maxilla may produce significant volume increases in the upper airway of skeletal class III patients regardless of sex and age.

Pleasantness of facial profile and its correlation with soft tissue cephalometric parameters: Perception of orthodontists and lay people.

OBJECTIVE: This study was aimed to evaluate the perception of orthodontists and of lay people about the facial profile and its possible correlation with cephalometrics parameters. MATERIALS AND METHODS: A total of 20 evaluators were divided into two groups (10 orthodontists and 10 people with no relation to such area - lay people). They were asked to evaluate the photographs of 25 young males and of 25 young females, aged 17-24-year-old (mean age of 22.3 years, standard deviation 2.41 years). Photographs were randomly arranged in a photo album. The evaluators rated each photograph by means of a scale ranging from "good" to "deficient" based on the pleasantness of their facial profile. Nasolabial angle, Holdaway's H-line and the distance from H-line to nose tip were measured, in order to verify a possible relation between these soft tissue profile cephalometric measurements and the subjective ratings. RESULTS: The kappa statistics test showed a concordance of 0.23 among orthodontists and 0.24 among lay people. Regarding the perception of orthodontists and lay people on facial profile, no significant divergence could be detected. For the correlation between cephalometric parameters and subjective ratings, there was a statistically significant correlation between the measures H and H-nose and the rating ascribed to the profile. CONCLUSIONS: It was concluded that smaller the difference from the normal cephalometric pattern, the higher was the rating given to the profile, demonstrating an important relation between subjective and objective criteria.

Time of guard of orthodontic records versus legal time for their prescription.

INTRODUCTION: After promulgation and wider dissemination of the Code of Consumer Protection (CCP), there was an increase in the number of legal conflicts between patients and dentists, leading these health professionals to increasingly guard themselves from possible lawsuits. As such, it becomes critical the preparation of an adequate and complete clinical record, even though the keeping time remains uncertain. OBJECTIVE: To review the literature and discuss the keeping time of orthodontic records versus the legal time for their prescription, as well as to propose a model of a Term upon Completion of Dental Treatment. CONCLUSIONS: It is advised to return part of the clinical records to their rightful owners by means of an itemized receipt. The Term upon Completion reflects the patient's awareness and could be considered by the CCP as the initial term of the prescription time, because it implicates that the patient recognizes the quality of service provided and satisfactory results achieved.

Agreement between orthodontists in the diagnosis of sagittal facial patterns / Concordância de ortodontistas no diagnóstico dos padrões sagitais da face

The cephalometric analysis has assisted orthodontics in describing face features in terms of numbers/angles, but these results are not always consistent with ideal individual patterns. Some orthodontists have made use of subjective analysis as an auxiliary method in the diagnosis; however, the consistency of the reproducibility of these methods has been questioned. Hence, this study aimed to verify whether the diagnosis of sagittal facial patterns can be accomplished with a reliable reproduction. This is an analytical observational study including an initial sample of 120 teleradiographs and 120 photographs in lateral norm of patients from the Graduate Program in Dentistry, Faculty of Health of the Methodist University of São Paulo. First, a previously calibrated examiner separated the photographs into three Sagittal Facial Patterns (Pattern I, II and III). Thus, it was obtained three groups comprising 45 photographs for the Pattern I; 45 photographs for the Pattern II and 30 photographs for the Pattern III. After this initial selection, the cephalometric analysis of 120 teleradiographs was performed using measurements of ANB and SN-GoGn angles. From this second analysis, it was selected only the photographs in which the result of subjective analysis matched the cephalometric analysis, totalizing a final sample size of 52 photographs. These 52 photographs were separated and set on an album to be reassessed by 19 orthodontists, in order to observe or not an agreement between the facial patterns among professionals. The kappa test analyzed the level of agreement of 19 professionals in relation to the cephalometric reference. The degree of agreement between professional judgment and cephalometry was found to be 73.08%, and the result of the kappa test was 0.59 (moderate agreement). Taken together, the accuracy in the diagnosis of facial pattern by means of subjective facial analysis demonstrates that the subjective method is reliable for clinical use.

A análise cefalométrica auxiliou a ortodontia a descrever numericamente as características da face, mas nem sempre estes resultados condizem com os padrões individuais ideais. Alguns ortodontistas utilizam análises subjetivas como método auxiliar no diagnóstico, porém a reprodução do método é discutida. Sendo assim, o trabalho objetiva verificar se o diagnóstico do Padrão sagital da face é possível de ser realizado com reprodução confiável. Trata-se de um estudo observacional analítico com uma amostra inicial de 120 telerradiografias e 120 fotografias em norma lateral de pacientes pertencentes ao Programa de Pós-Graduação em Odontologia da Faculdade da Saúde da Universidade Metodista de São Paulo. Primeiramente, um avaliador, previamente treinado, separou as fotografias nos Três Padrões sagitais da face (Padrão I, II e III). Dessa forma obtiveram-se três grupos compostos por 45 fotografias no Padrão I; 45 fotografias no Padrão II e 30 fotografias no Padrão III. Após essa seleção inicial foi realizado a análise cefalométrica das 120 telerradiografias desses pacientes utilizando as medidas dos ângulos ANB e SN.GoGn. A partir dessa segunda análise foram selecionadas apenas as fotografias em que o resultado da análise subjetiva coincidiu com a análise cefalométrica resultando em um novo número amostral final de 52 fotografias. Estas 52 fotografias foram separadas e montadas em um álbum para serem reavaliadas por 19 ortodontistas com o intuito de observar ou não a concordância dos Padrões Faciais entre os profissionais. Para a análise de dados utilizou-se o Teste Kappa com o intuito de analisar o nível de concordância dos 19 profissionais com a referência cefalométrica. Dessa forma, o grau de concordância entre a avaliação profissional e a cefalometria encontrado foi de 73,08% sendo o resultado do Teste Kappa de 0,59 - considerado moderado. Conclui-se que existe exatidão no diagnóstico do padrão facial por meio da analise subjetiva da face, o que demonstra que este método subjetivo é confiável para a utilização na prática clínica.

Assessment of torque angle of brackets from different brands

To measure torque angle values of brackets designed for canines, comparing it to their prescription values. METHODS: One hundred and sixty maxillary -2o and mandibular -11o canine brackets of Roth prescription from the following brands were selected: Abzil, Eurodonto, Morelli and Ormco. The brackets were set in wax and images were obtained by scanning. Reference points were determined over these images, lines drawn and the torque angle was measured. The Student's t-test and the Wilcoxon signed-rank test were used at a significance level of 5%. RESULTS: For maxillary canine brackets, the medium torque angle values were: Abzil -0.93o ± 0.88o; Eurodonto 0.13o ± 0.34o; Morelli -2.56o ± 0.50o, and Ormco -1.16o ± 1.27o. For mandibular canine brackets, the values were: Abzil -11.76o ± 0.40o; Eurodonto -10.40o ± 0.25o; Morelli -11.18o ± 0.56o, and Ormco -11.36o ± 0.30o. For maxillary canine brackets, the brands Abzil, Morelli, and Ormco presented statistically diferente values from those indicated for prescription. For mandibular canine brackets, the brands Abzil, Eurodonto, and Ormco presented statistically different values from the prescribed ones. CONCLUSIONS: Some marketed brands present differences between the torque angle found in the brackets and those recommended in the prescription. However, these differences are clinically acceptable...

Análise facial de arnett e Bergman comparada a percepção estética de leigos e cirurgiões-dentistas (clínicos gerais e ortodontistas) / Arnett and Bergman facial analysis compared with aesthetic perception by lay people and dentists (general practitioners and orthodontists)

A busca por uma face bela e harmônica é objetivo de grande parcela da população. Por esta razão, é fundamental que os profissionais da Odontologia, especialmente os ortodontistas, sejam capazes de diagnosticar alterações faciais e, assim, propor tratamentos adequados aos anseios de seus pacientes. Para que isto seja possível, odontólogos e leigos necessitam possuir conceitos de beleza semelhantes. O objetivo deste trabalho foi determinar se as medidas faciais de Arnett e Bergman são coerentes às percepções estéticas de cirurgiões-dentistas (ortodontistas e clínicos gerais) e leigos. Para isto, utilizou-se uma amostra composta por 50 indivíduos, sendo 26 mulheres e 24 homens. Um especialista em ortodontia mensurou cinco medidas dentre as utilizadas por Arnett e Bergman em radiografias cefalométricas de perfil. De acordo com estas medidas, cada indivíduo foi classificado em consonância com número de medidas dentro da norma: perfil muito agradável, agradável, aceitável, desagradável e muito desagradável. Em uma segunda etapa, foram formados três grupos (leigos, clínicos gerais e ortodontistas), de 20 avaliadores cada que, por meio de um álbum de fotografias de perfil facial, classificaram o grau de agradabilidade facial segundo a escala (VAS) adaptada. A análise das proporções observadas nos graus da escala de avaliação para os diferentes avaliadores foi conduzida utilizando-se o Teste chiquadrado de Pearson (p>0,05). Entre as proporções dos avaliadores e os valores padrões de Arnett e Bergman foi utilizado o teste exato de Fisher (p>0,05). Os resultados demonstraram que, pela classificação segundo às medidas de Arnett e Bergman, pacientes com perfil muito agradável foram classificados da mesma maneira em 0%, 1,66% e 5% pelos leigos, clínicos gerais e ortodontistas, respectivamente; com perfil agradável em 3,75%, 16,88% e 18,75% pelos leigos, clínicos gerais e ortodontistas, respectivamente; com perfil aceitável em 35%, 34,73% e 36,67% pelos leigos, clínicos gerais e ortodontistas, respectivamente; com perfil desagradável em 32,5%, 40%, 30,5% pelos leigos, clínicos gerais e ortodontistas, respectivamente; e por fim, com perfil muito desagradável em 15,45%, 15,45% e 10,45%, pelos leigos, clínicos gerais e ortodontistas, respectivamente. Foi possível concluir que não há similaridade entre a percepção estética dos diferentes grupos de avaliadores com as medidas propostas por Arnett e Bergman.

The search for a beautiful and harmonic face is a goal of a large portion of the population. With this purpose, it is essential for dental professionals, especially orthodontists, to be able to diagnose facial changes and, thus suggest appropriate treatments to the demands of their patients. To make this possible, dentists and lay people need to have similar concepts of beauty. The aim of this study was to determine whether Arnett and Bergman facial measures are consistent with aesthetic perceptions of dentists (orthodontists and general practitioners) and lay people. It was used a sample of 50 subjects, including 26 women and 24 men. A specialist in orthodontics measured five measures among those used by Arnett and Bergman on lateral cephalometric radiographs. According to these measures, each individual was classified based on the number of measures within the norm: very pleasant, pleasant, acceptable, very unpleasant and unpleasant profile. In a second phase, three groups were created (laypeople, general practitioners and orthodontists), with 20 examiners each. By means of an album of photographs of facial profile, they rated the degree of facial pleasantness according to an adapted scale (VAS).The analysis of the proportions observed according to the different degrees of the scale for the different examiners was performed using Pearson chi-square test (p> 0.05).In order to evaluate the proportions by the examiners and the default values by Arnett and Bergman, Fisher's exact test was used (p>0.05).The results showed that based on the classification by Arnett and Bergman, lay people, general practitioners and orthodontists categorized in the same manner: patients with a very pleasant profile in 0%, 1.66% and 5%, respectively; patients with pleasant profile in 3.75%, 16.88% and 18.75% respectively; patients with acceptable profile in 35%, 34.73% and 36.67% respectively; patients with unpleasant profile in 32.5%, 40%, 30.5%, respectively; and finally, patients with a very unpleasant profile in 15.45%, 15.45% and 10.45%, respectively. It was concluded that there is no similarity between the aesthetic perception of the different groups of examiners with the measures proposed by Arnett and Bergman.

Bolton ratio in subjects with normal occlusion and malocclusion

AIM: To verify the presence of Bolton anterior and total discrepancy in Brazilian individuals with natural normal occlusion and Angle's Class I and Class II, division 1 malocclusions. METHODS: The sample was divided in three groups (n=35 each): natural normal occlusion; Class I malocclusion; Class II, division 1 malocclusion. Of the 105 Caucasian Brazilian individuals, 24 were boys and 81 were girls aged from 13 to 17 years and 4 months. The mesiodistal width of the maxillary and mandibular teeth, from the left first molar to the right first molar, was measured on each pre-treatment dental plaster cast using a digital caliper accurate to 0.01 mm resolution. Values were tabulated and the Bolton ratio was applied. The Kolmogorov-Smirnov test was used to verify if data were normally distributed (p>0.2). For comparison between the values obtained and those from the Bolton standard, Student's t test was used and one-way ANOVA was used for comparisons among the 3 groups, with a significance level of 5% (p<0.05). RESULTS: For groups 1, 2 and 3, respectively, the total ratio found was 90.36% (SD 1.70), 91.17% (SD±2.58) and 90.76% (SD±2.45); and the anterior ratio was 77.73% (SD 2.39), 78.01% (SD 2.66) and 77.30% (SD 2.65). CONCLUSIONS: There was no significant difference among the groups regarding the values indicated in the Bolton ratio.

Aspectos legais das perícias ocupacionais em Odontologia / Legal aspects of occupational assessments in Dentistry

A perícia ocupacional em Odontologia é uma função indispensável no contexto atual das relações sociais e entre empregado e empregador. Por meio dela é que a justiça tem subsídios técnicos capazes de determinar o devido fim para questões trabalhistas e criminais. Objetivo: este estudo procurou destacar, interpretar e comentar a legislação que qualifica e direciona a função do perito no ambiente de trabalho. Revisão de literatura: além da interpretação dos incisos das leis inerentes, foi realizada uma busca em base de dados digitais. Considerações finais: foi possível verificar a importância do trabalho do perito em diversos foros, principalmente na avaliação da extensão dos danos causados aos trabalhadores por acidentes e doenças de ordem bucal decorridas do labor desses profissionais e na prevenção de tais problemas.

Occupational assessment in Dentistry is essential for the current context of both social and Employee-Employer relations. It provides the courts of justice with technical inputs that allow determining the proper order for labor and criminal issues. Objective: this study aimed to highlight, interpret, and discuss the legislation that qualifies and guides the role of the expert in the work environment. Literature review: hence, in addition to the interpretation of the clauses of inherent laws, we carried out a digital database search. Final considerations: it was possible to verify the importance of the expert's work in several forums, especially in assessing the extent of damage to employees due to accidents and oral diseases resulting from their work, and preventing these sort of problems.

Time of guard of orthodontic records versus legal time for their prescription

INTRODUCTION: After promulgation and wider dissemination of the Code of Consumer Protection, there was an increase in the number of legal conflicts between patients and dentists, leading these health professionals to increasingly guard themselves from possible lawsuits. As such, it becomes critical the preparation of an adequate and complete clinical record, even though the keeping time remains uncertain. OBJECTIVE: To review the literature and discuss the keeping time of orthodontic records versus the legal time for their prescription, as well as to propose a model of a Term upon Completion of Dental Treatment. CONCLUSION: It is advised to return part of the clinical records to their rightful owners by means of an itemized receipt. The Term upon Completion reflects the patient's awareness and could be considered by the CCP as the initial term of the prescription time, because it implicates that the patient recognizes the quality of service provided and satisfactory results achieved.

INTRODUÇÃO: após a promulgação e maior divulgação do Código de Defesa do Consumidor (CDC), aumentou o número de conflitos legais entre pacientes e cirurgiões-dentistas, fazendo com que o profissional da saúde passasse a se resguardar cada vez mais quanto ao risco de eventuais processos. Para sua defesa, é indispensável a elaboração de um prontuário clínico adequado e completo, porém, o tempo que esse deve ser guardado é uma incógnita. OBJETIVO: o objetivo do presente estudo é rever a literatura e discutir sobre o tempo de guarda da documentação ortodôntica versus o prazo de prescrição legal, além de propor um modelo de termo de conclusão de serviços odontológicos. CONCLUSÃO: aconselha-se a devolução de parte dos documentos clínicos ao seu legítimo dono mediante recibo discriminado. O "Termo de Conclusão" traduz o conhecimento da conclusão do tratamento pelo paciente e poderia ser considerado termo inicial do prazo prescricional pelo CDC porque nesse consta que o paciente reconhece a qualidade do serviço e o resultado satisfatório.

Avaliação da influência do led/laser em diferentes concentrações de peróxido de hidrogênio no clareamento dentário imediato / Evaluation of the influence of led/laser on different concentrations of hydrogen peroxide for in-office dental bleaching

O objetivo desta pesquisa foi avaliar a influência de um sistema luminoso led/laser - com 6 leds de 470nm e 3 diodos lasers infravermelhos de 830nm de 0,2W de potência - sobre o peróxido de hidrogênio a 35% (Lase Peroxide 35% Sensy, DMC Equipamentos) e a 25% (Lase Peroxide 25% Sensy, DMC Equipamentos) em 10 voluntários. Os agentes clareadores foram aplicados com espessura próxima a 1mm em cada arcada de um mesmo paciente: peróxido de hidrogênio 35% na arcada superior e 25% na arcada inferior. O conjunto led/laser foi aplicado por 1 minuto, intercalado com intervalo de 1 minuto sem irradiação luminosa, por três vezes. Então, esperou-se 4 minutos para o gel ser substituído. Esse protocolo foi repetido três vezes nas hemiarcadas direitas. Nas hemiarcadas esquerdas, o gel clareador não sofreu irradiação luminosa, protegido por uma placa divisora de arcadas, permanecendo pelo mesmo tempo que nas hemiarcadas direitas (10 minutos, por 3 vezes). Após sete dias, os voluntários retornaram para avaliação da percepção do grau de clareamento e de sensibilidade. De acordo com a avaliação do pesquisador e dos pacientes, através do questionário, não houve diferença perceptível do grau de clareamento entre as hemiarcadas direita e esquerda (com e sem aplicação de sistema luminoso, respectivamente), para ambas as concentrações de gel clareador (25 e 35%). Também foi relatada similaridade no grau de sensibilidade entre as hemiarcadas.