ABSTRACT
This paper evaluated the influence of different protocols of silver fluoride (SF) pretreatment of artificial carious lesions on the adhesive interface of composite resin restorations and remineralization of deciduous dentin compared to silver diamine fluoride (SDF). Sixty-four deciduous molar teeth were randomly divided into 8 groups (n = 8) according to the restoration time (immediately - IM; 30 days after SDF/SF treatment - 30 D) and treatment before restoration (SDF 38 %; SDF 38 % + potassium iodide - KI; SF 38 %; SF 38 % +KI). After SDF/SF application, teeth in the IM group were restored with self-etch universal adhesive system/composite resin. Samples in the 30D groups were stored in artificial saliva (37 °C) for 30 days before receiving the same restoring protocol. Beams were obtained from all groups and subjected to bond strength tests (µTBS), ultrastructural qualitative analysis (FEG) and mineral analysis (SEM/EDX; Micro-Raman spectroscopy). The µTBS data were subjected to three-factor ANOVA and multiple comparisons (Holm-Sidak method). Bond strength values (MPa) for IM groups were 16.9 ± 2.7 (SDF); 17.6 ± 3.5 (SDF + KI); 16.8 ± 5.5 (SF); 18.4 ± 4.1 (SF + KI); and 14.9 ± 4.2 (SDF); 16.0 ± 5.4 (SDF + KI); 14.1 ± 3.6(SF); 16.4 ± 5.4 (SF + KI) for 30D groups. Bond strength wasn't influenced by the moment of restoration (IM or 30D); the use of KI didn't alter adhesion characteristics; SDF/SF solutions resulted in similar adhesive strength; calcium and phosphate expressions were identified at the interfaces on IM and 30D moments. However, 30D presented qualitative increase in these ions, compatible with remineralization. It was concluded that the adhesion of composite resin restorations in artificial caries lesions of deciduous teeth treated with SDF (38 %) and SF (38 %) had similar effects in vitro; the use of KI or the moment when restorations were accomplished did not influence the adhesion and all tested protocols promoted remineralization of carious dentin.
ABSTRACT
O objetivo do estudo foi relatar o uso do levantamento epidemiológico emsaúde bucal como recurso didático-pedagógico na formação clínico-epidemiológicado cirurgião-dentista.Dentro dos objetivos do estágio supervisionado extramuros do Curso de Odontologia daUniversidade Estadual de Ponta Grossa, os acadêmicos têm desenvolvido conjuntamente com as Equipes de Saúde Bucal levantamentos epidemiológicos dedoenças e/ounecessidades bucais, principalmente para cárie dental, câncer bucal e prótese dentária, segundoo ciclo de vida, em diversosespaços sociais, comoos centrosde educação infantil, escolas, grupos educativos dasUnidadesde Saúde, dentre outros. A realização de levantamentos epidemiológicos além de oportunizar os acadêmicos como membros executores e na associação do conteúdo teórico do eixo de Saúde Coletiva na vivência da AtençãoPrimária à Saúde, como forma deplanejamento estratégico situacional a partir dos dados coletados, no monitoramento dos agravos bucais ao longo dos anosem grupos específicos, e na realização de devolutivas para os serviços e para a comunidade, por meio de relatórios, atividades educativas eencaminhamentose organização da demanda, pode atingir outros objetivos.Ofoco do relato foidestacar o uso dos levantamentos para aprendersobre odiagnóstico clínico individual e comunitário, epossibilitar aspectos doeixoclínicodo curso, como diferenciação das características anatômicas de dentes decíduos e permanentes, diagnóstico diferencial sobre lesões dentárias de mancha branca, alterações e/ou lesões dentárias ou de tecidos moles menos frequentes, dentre outros. Diante sua grande aplicabilidade para além do ensino em Saúde Coletiva, olevantamento epidemiológico em saúde bucal tem sido um recurso didático-pedagógicopromissor na formação clínico-epidemiológica do cirurgião-dentista,e sua realização deve ser incentivada nos cursos de Odontologia (AU).
This study aimed toreport the use of an epidemiological survey on oral health as a didactic-pedagogical resource in the initial education of dental surgeons.Followingthe objectives of the external supervised internship of the Dentistry undergraduate course at the State University of Ponta Grossa, students have developed epidemiological surveys on oral illnesses and/or needs in cooperation with Oral Health Teams. These surveys focus mainly on dental caries, oral cancer and dental prosthesis according to life cycles, in several social spaces such as child daycare centers, schools, education teams in health units, among others. Carrying out epidemiological surveys, in addition to providingstudents with opportunities of acting as executors, also enables them to associate theoretical content from the collective health axis tothe development of Primary Health Care. It provides a model of situational strategic planningfrom the data collected to monitor oral diseases along the years in specific groups and results in feedback for the services provided and for the community through reports, education activities as well as new strategies and demand organization, and it might also achieve other objectives. The focus of this report was to highlight the use of surveys to learn about individual and community clinical diagnoses, enabling certain aspects of the course clinical axis such as the differentiation of anatomical characteristics of deciduous and permanent teeth, differential diagnosisof white-spot dental lesions,less frequent dental or soft tissuealterationsand/orlesions, among others. Due to theirapplicability beyond the collectivehealth teaching, oral health epidemiological surveyshavebeen seen as a promising didactic-pedagogical resource in the clinical epidemiology education of dental surgeons and theiruse should be fostered in dentistry courses (AU).
Subject(s)
Teaching Care Integration Services , Oral Health , Health Surveys/methods , Dentistry , Professional Training , Schools , Epidemiology , Surveys and QuestionnairesABSTRACT
RESUMO Teve-se por objetivo analisar as condições de acessibilidade, estrutura e oferta de serviços odontológicos de Unidades Básicas de Saúde com Equipe de Saúde Bucal e compará-los entre as regiões geográficas brasileiras. O estudo quantitativo, analítico e transversal utilizou dados secundários referentes aos Módulo I, V e VI da Avaliação Externa do 2º Ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) (2013-2014). A análise descritiva foi realizada por frequências absolutas (n) e relativas (%), e houve comparação entre regiões brasileiras pelo teste qui-quadrado com uso do Teste Z ajustado pelo método Bonferroni (p<0,05). A amostra foi constituída por 24.056 Unidades Básicas de Saúde, nas quais atuavam 29.778 Equipes de Atenção Básica; destas, 16.203 (67,3%) possuíam serviços odontológicos e abrigavam 18.119 Equipes de Saúde Bucal. De maneira geral, as Unidades Básicas de Saúde apresentavam boa estrutura física, porém, baixa acessibilidade para pessoas com deficiência. Os consultórios odontológicos apresentavam estrutura física adequada e equipamentos, instrumentos e insumos odontológicos suficientes. No entanto, exibiam alta proporção na oferta de serviço mutiladores em comparação a procedimentos que evitariam as extrações dentárias, e baixa oferta de referência especializada. Além disso, houve evidenciadas desigualdades regionais, favoráveis às regiões Sul e Sudeste.
ABSTRACT The aim of the study was to analyze the conditions of accessibility, structure and offer of dental services in Basic Health Units with the Oral Health Team and to compare them between the Brazilian geographic regions. The quantitative, analytical and cross-sectional study used secondary data referring to Module I, V and VI of the External Evaluation of the 2nd Cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB) (2013-2014). The descriptive analysis was performed by absolute (n) and relative (%) frequencies, and there was a comparison between Brazilian regions using the chi-square test using the Z Test adjusted by the Bonferroni method (p <0.05). The sample consisted of 24,056 Basic Health Units, in which 29,778 Primary Care Teams worked; of these, 16,203 (67.3%) had dental services and housed 18,119 Oral Health Teams. In general, the Basic Health Units had a good physical structure, but low accessibility for disabled persons. The dental offices had adequate physical structure and sufficient dental equipment, instruments and supplies. However, they exhibited a high proportion of mutilating service offerings compared to procedures that would avoid tooth extractions, and a low specialized reference supply. In addition, regional inequalities were observed, favorable to the South and Southeast regions.
