Post-operative pain after using sodium hypochlorite and chlorhexidine as irrigation solutions in endodontics: Systematic review and meta-analysis of randomised clinical trials.

CONTEXT: Is it possible that the irrigating solutions can have the potential to cause post-operative pain? Unfortunately, the current literature does not provide clear guidance. AIM: The purpose of this systematic review and meta-analysis was to comprehensively review two different irrigation solutions (sodium hypochlorite and chlorhexidine) regarding the post-operative pain after endodontic treatment. SETTINGS AND DESIGN: This study was prepared according to the Cochrane criteria for creating a systematic review and meta-analysis and confirms the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. MATERIAL AND METHODS: This search was conducted in the PubMed/MEDLINE, SCOPUS and Cochrane Library databases until February 2018 to answer the In [(Population) what is the effect of (Intervention) on (Outcome), compared with (Comparison) Intervention] (PICO) question: could sodium hypochlorite cause more post-operative pain than chlorhexidine in teeth subjected to endodontic treatment? The primary outcome was overall post-operative pain after 24 h. RESULTS: After applying the inclusion and exclusion criteria, three randomized clinical trials fulfilled the eligibility criteria, and two were subjected to the meta-analysis. There was no difference in post-operative pain between the tested irrigating solutions. CONCLUSIONS: There are few studies published in the current literature; therefore, additional randomized clinical studies are required to on this topic to help clinicians make the best decision concerning treatment.

Prevalence, severity and etiology of dental wear in patients with eating disorders.

OBJECTIVE: The purpose of this study was to evaluate the prevalence, distribution and associated factors of dental wear among patients with eating disorders (EDs). MATERIALS AND METHODS: An epidemiological cross-sectional survey was conducted by trained, calibrated examiners, using the dental wear index. The sample was composed of 30 patients with EDs (experimental group - G1) and 30 control patients without current or previous history of EDs (G2). A questionnaire was used to assess the etiological factors of dental wear. The univariate analyses using the Chi-square (χ(2)) test were used to compare the tooth wear prevalence between groups according to the surface and tooth (P > 0.05). RESULTS: The dental wear was similar for both group; however, the G1 presented more moderate wear in molars when compared with G2 (P = 0.048). The majority of EDs patients related have one or more oral habits (n = 26; 86.6%) and only 13.4% (n = 4) affirmed did not have oral habits. The etiological factors of tooth wear related with dental wear were biting objects (P = 0.04) and pain in temporomandibular disorders (P = 0.03). CONCLUSION: The highest prevalence of dental wear was observed in the molars teeth. Differences in the extent and pattern of dental wear were found in an individual, emphasized the relevance of clinical parameter.

An epidemiological scoring system for tooth wear and dental erosive wear.

BACKGROUND: The prevalence and severity of tooth wear and dental erosion is rising in children and there is no consensus about an index to be employed. AIM: To assess the reliability of an epidemiological scoring system dental wear index (DWI) to measure tooth wear and dental erosive wear. DESIGN: An epidemiological cross-sectional survey was conducted to evaluate and compare tooth wear and dental erosion using the dental wear index and erosion wear index (EWI). The study was conducted with randomised samples of 2,371 children aged between 4 years and 12 years selected from the State of São Paulo, Brazil. Records were used for calculating tooth wear and dental erosion; the incisal edge and canine cusp were excluded. RESULTS: As the schoolchildren's ages increased the severity of primary tooth wear increased in canines (P = 0.0001, OR = 0.34) and molars (P = 0.0001, OR = 2.47) and erosion wear increased in incisal/occlusal (P = 0.0001, OR = 5.18) and molars (P = 0.0001, OR = 2.47). There was an increased prevalence of wear in the permanent teeth of older schoolchildren, particularly on the incisal/occlusal surfaces (P = 0.0001, OR = 7.03). CONCLUSION: The prevalence of tooth wear and dental erosion increased as age increased in children. The epidemiological scoring system Dental Wear Index is able to measure both tooth wear and dental erosive wear. This index should be used to monitor the progression of non-carious lesions and to evaluate the levels of disease in the population.

Gastroesophageal reflux, dental erosion, and halitosis in epidemiological surveys: a systematic review.

In published studies, it has been suggested that dental wear is associated with gastroesophageal reflux disease (GERD). This systematic review was carried out to evaluate the association of GERD, dental erosion, and halitosis and to compare the indices adopted in epidemiological surveys. The Medline database (until October, 2011) was searched systematically to identify studies evaluating the prevalence of oral alterations, such as dental erosion and halitosis, in patients with GERD symptoms. Two reviewers analyzed all reports and the selected studies were evaluated according to the quality of evidence, using the validated Newcastle-Ottawa Quality Assessment Scale. Full-text copies of a total of 32 publications were obtained in duplicate. Sixteen publications were identified among the citations in the Bibliographic lists of studies that fulfilled the exclusion/inclusion criteria and quality of evidence. The relationship between dental erosion and GERD patients was significant in only seven studies. According to three studies, halitosis could be one of several extraesophageal symptoms or manifestations in GERD patients. In one study, it was found that the mucosa of GERD patients was significantly more acidic in comparison with that of the control group. This systematic review showed that there is a relationship between GERD and oral diseases (dental erosion and halitosis). The epidemiological surveys used different indices to analyze GERD and dental erosion. Further research could investigate the best method for assessing the two diseases.

Evaluation of oral health status and salivary flow rate in obese patients after bariatric surgery.

OBJECTIVES: The aim of this study was to identify the prevalence of dental caries, periodontal diseases and tooth wear in bariatric patients, and relate the oral health conditions to saliva flow. METHODS: Fifty-two patients who had undergone bariatric surgery (Roux-en-Y gastric bypass) and 50 severely obese patients indicated for bariatric surgery were submitted to clinical examinations with regard to dental caries (DMFT index), periodontal condition (CPI index), dental wear (DWI index - Dental wear index) and saliva flow. The data were statistically analyzed by the Student's-t, Mann-Whitney, Spearman Correlation and Chi-square (χ(2)) tests at 5% significance level. RESULTS: The DMFT index was 16.11±5.19 in the surgical group and 16.06±6.29 in the control group (P>.05). The mean CPI was 3.05±0.84 for the operated group and 2.66±1.25 for the obese patients with no significant difference between them (P>.05). There was statistically significant difference between the groups for the presence of periodontal pockets (P=.021). All the patients presented some degree of tooth wear, however, with no significant difference between the two groups (P=.82). The mean saliva flow values of the surgical group and control group were 0.64±0.46 mL/min and 0.66±0.49 mL/min, respectively. There was no significant difference in saliva flow and all oral conditions analyzed (P>.05). CONCLUSION: The prevalence of oral diseases was similar in severely obese patients who were candidates for bariatric surgery and in patients who had been submitted to bariatric surgery. Nevertheless, there was higher prevalence of periodontal pockets in the operated group.

Acolhimento aos usuários: uma revisão sistemática do atendimento no Sistema Único de Saúde / The user’s attendance: a Systematic Review on the Brazilian Health Care System (SUS)

Introdução: O Ministério da Saúde (MS) propôs por meio do programa Humaniza SUS, a humanização como eixo norteador das práticas de atenção e gestão em todas as instâncias do Sistema Único de Saúde (SUS). De acordo com tal programa, humanizar é: “ofertar atendimento de qualidade articulando os avanços tecnológicos com acolhimento, como melhoria nos ambientes de cuidado e das condições de trabalho dos profissionais”.Objetivo: O presente artigo apresenta uma revisão sistemática para investigar o modo de operacionalização do acolhimento aos usuários nos serviços públicos de saúde e sua incorporação frente aos princípios do SUS. Metodologia: Foram revisadas informações apresentadas em trabalhos anteriores, incluídas em artigos publicados nos últimos dez anos, considerando-se a produção registrada nas seguintes bases de dados bibliográficos: LILACS, MEDLINE e SciELO. Resultados: Dos 148 trabalhos identificados, 10 artigos foram selecionados conforme os critérios pré-estabelecidos e serviram de base para este trabalho. Conclusão: Apostura de acolhimento aos usuários do SUS deve se estender desde a porta de entrada aos serviços deníveis de complexidade, segundo a necessidade de cada usuário. Para que o acesso possa contemplar os princípios da integralidade, torna-se relevante a presença de uma equipe humanizada que atue como facilitadora na consolidação de estratégias de acolhimento.

Introduction: The Ministry of Health proposed by means of Humanize-SUS Program the humanization as guideline for the practice of care and management in all the instances of the SUS. According to such program, to humanize is: “to offer quality of health care articulating the technological advances with the user´s attendance to improve health care environment and the professionals´working conditions”. Objective: This work presents a systematic review of related studies with the purpose of investigating the way to operationalize the user´s attendance in the public health services and its incorporation according to the SUS principles. Methodology: A review was performed on studies mainly in papers published in the last ten years; considering the following bibliographical databases: LILACS, MEDLINE and SciELO. Results: Out of 148 studies, 10 papers were selected according to the pre-established criterion and used as guideline for this study. Conclusion:The care related to the user´s attendance must start from the entrance door to the wards of complexity levels, according to each user´s needs. In such way, the access can contemplate the principles of the Integral HealthCare; being important the presence of a humanized team to perform as facilitator to consolidate some attendance strategies.