Evaluation of dental enamel microproperties after bleaching with 35% hydrogen peroxide and different light sources: An in vitro study.

BACKGROUND: To evaluate the tooth enamel surface morphology after the action of 35% hydrogen peroxide with and without LED activation. MATERIAL AND METHODS: 70 bovine incisors with an enamel surface of 4x4x3 mm were used, prepared for reading superficial microhardness and roughness. Specimens were randomly distributed and divided into 7 experimental groups (n = 10); G1 = artificial saliva; G2 = 35% HP - 2 sessions (3x15´); G3 = Phosphoric Acid + 35% HP - 3 sessions (3x15´); G4 = 35% HP - 2 sessions (3x15´) + blue LED; G5 = 35% HP - 2 sessions (3x15´) + green LED; G6 = 35% HP - 2 sessions (3x20´) + violet LED; G7 = Violet LED - 2 sessions (3x20´). The results were analyzed by the Anova, Wilcoxon, Dunnett and Tukey tests (α = 0.05). RESULTS: The G4 group showed a greater change in microhardness. Regarding roughness, the biggest mean difference between groups occurred in G2, G5 and G7. Optical microscopy showed a smooth enamel surface in groups G2, G5 and G7. CONCLUSIONS: Changes in the enamel surface were observed in relation to microhardness, but without significant changes in roughness, where the LED (green and violet) resulted in a smooth surface. Key words:Tooth whitening, superficial morphology, light, photoradiatio.

Use of high- and low-intensity lasers in the treatment of dentin hypersensitivity: A literature review.

BACKGROUND: Dentin hypersensitivity (DH) is defined as an exaggerated sensitivity of vital dentin exposed to thermal, chemical and tactile stimuli. This study aimed to evaluate, through a literature review, the applicability of high- and low-intensity lasers in the treatment of DH for the past 10 years, as well as its therapeutic potential. MATERIAL AND METHODS: The electronic databases MEDLINE/PubMed and LILACS were searched using the descriptors ("Dentin Sensitivity" OR "Dentin Hypersensitivity") AND ("Low-Level Therapy" OR Laser), for articles published between 2010 and 2020. Only randomized clinical trials with full-text and full case resolution were included. RESULTS: We found 187 articles in total, among which 61 were pre-selected and 10 included in this literature review. CONCLUSIONS: Considering the found results and their possible limitations, high- and low-intensity lasers, associated or not with other therapies, have demonstrated beneficial effects in the treatment of DH, being considered a promising, safe, easy, and effective field of research, reducing pain sensitivity and preserving pulp vitality. Key words:Dentin sensitivity, dentistry, laser.

Laser therapy as treatment for oral paresthesia arising from mandibular third molar extraction.

Oral paresthesia is a localized condition of sensory abnormality that occurs in the presence of injury in one of the nerves in the region after certain dental procedures. The aim of this study was to present a case report of a patient who received low-level laser therapy as treatment for inferior alveolar nerve paresthesia due to mandibular third molar extraction surgery. A 25-year-old female patient reported lack of sensitivity for 6 months in various regions of the bucomaxillofacial complex after surgery. Laser therapy (808 ± 10nm, 100 mW, 3J per point and 30 seconds per point) was indicated twice a week. The degree of sensitivity was evaluated using a Visual Analog Scale (VAS) and with the aid of a microbrush. Prior to laser therapy, the patient reported VAS = 10, i.e., total lack of sensitivity. After 72 hours of the first session, the patient reported improvement of sensitivity in the chin (VAS = 5) and oral regions (VAS = 5), reporting recovery of sensitivity and that the area of paresthesia decreased. After 8 sessions, the patient reported total recovery of sensitivity in the chin, oral and gum regions (VAS = 0), with paresthesia being limited only to the left lower lip region and below it. After 26 sessions, the patient reported recovery of sensitivity in all affected regions (VAS = 0), with positive responses to the brush touch. Within the parameters used, laser therapy was effective in the treatment of inferior alveolar nerve paresthesia after third molar tooth extraction. Key words:Lasers, paresthesia, oral surgery, low-level laser therapy.

In Vitro Evaluation of the Antibacterial Effect of Photodynamic Therapy with Methylene Blue

Abstract Objective: To evaluate, in vitro, the effect of photodynamic therapy (PDT) compared to laser therapy and the use of a photosensitizer alone. Material and Methods: The following therapies were used: PDT, laser therapy and photosensitizer alone. For PDT, methylene blue (MB) at different concentrations and red laser InGaAlP 660nm were used. For the use of low-power laser (LPL) alone, red laser InGaAlP 660 nm and infrared laser AsGaAl, 830 nm, both in continuous emission were used. Standard ATCC strains of Staphylococcus aureus (S. aureus), Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa) species were used. The antibacterial effect of PDT was quantified by the diameter of the inhibition halos. Results: PDT (LPL 660 nm, 320 J/cm2) with MB at concentration of 50 µg/mL showed antibacterial efficacy only when tested against S. aureus and E. coli strains, as well as with the isolated use of MB at the same concentration. Using LPL alone, whether red or infrared, with different dosimetry, no antibacterial effect was observed. In none of the therapeutic modalities used, P. aeruginosa inactivation was observed. Conclusion: Antibacterial effects of PDT (LPL 660 nm + MB 50 µg/mL) were observed for S. aureus and E. coli, as well as with the isolated use of MB (50 µg/mL). For P. aeruginosa, no antibacterial effect with any of the protocols recommended in the study was observed.

Brazilian Scientific Research about Acupuncture in Dentistry: Bibliometric Analysis of the Papers Presented at SBPqO Meetings / A Pesquisa Científica Brasileira Sobre Acupuntura na Odontologia: Análise Bibliométrica dos Trabalhos Apresentados nas Reuniões da SBPqO

The aim of this study was to investigate the Brazilian scientific production about acupuncture in dentistry, outlining the profile of the works about the subject presented at the Meetings of the Brazilian Society of Dental Research (SBPqO). It was a cross-sectional study, with a quantitative approach, based on secondary data. An analysis of all abstracts presented in the last ten SBPqO Meetings (2009-2018) published in the annals of the event was carried out. For the research the location of the term "acupuntura" or "acupuncture" among the abstracts was realized and the following information was collected: type of institution that carried out the research (public or private), Brazilian region where it was realized, area or specialty of dentistry and whether it involved humans or animals. Of the 26,514 dental research abstracts published in the annals, only 27 papers were experimental studies or systematic reviews about the subject. Of the total, 23 (85.2%) were developed in public institutions, 15 (55.6%) did not receive financial support 20 (74.1%) were carried out in humans and 13 (48.2%) were developed in the Southeast region. Regarding the dental specialty, the majority (70.4%) investigated acupuncture in "Temporomandibular Dysfunction and Orofacial Pain". Therefore, it can be concluded that few acupuncture studies in dentistry have been developed in the last ten years in Brazil, according to the papers presented at the SBPqO Meetings. Thus, it is suggested that research on the subject be carried out and widely disseminated between the academic and professional milieu. (AU)

O objetivo desse estudo foi investigar a produção científica brasileira sobre a acupuntura na odontologia, traçando o perfil dos trabalhos sobre a temática apresentados nas Reuniões da Sociedade Brasileira de Pesquisa Odontológica (SBPqO). Tratou-se de um estudo transversal, com abordagem quantitativa, a partir de dados secundários. Realizou-se uma análise de todos os resumos apresentados nas últimas dez Reuniões da SBPqO (2009-2018) publicados nos anais do evento. Para pesquisa procedeu-se a localização do termo "acupuntura" ou "acupuncture" entre os resumos e foram colhidas as seguintes informações: tipo de instituição que realizou a pesquisa (pública ou privada), região rasileira onde foi realizada, recebimento de auxílio financeiro, área ou especialidade da odontologia e se envolvia humanos ou animais. Dos 26.514 resumos de pesquisa odontológica publicados em anais, apenas 27 trabalhos tratavam de estudos experimentais ou revisões sistemáticas sobre a temática. Do total, 23 (85,2%) foram desenvolvidos em instituições públicas, 15 (55,6%) não receberam auxílio financeiro, 20 (74,1%) foram realizados em humanos e 13 (48,2%) desenvolvidos na região Sudeste do Brasil. Com relação a especialidade odontológica, a maioria (70,4%) pesquisou sobre a acupuntura na "Disfunção Temporomandibular e Dor Orofacial". Os achados do presente estudo indicam que poucas pesquisas abordando a acupuntura na odontologia foram desenvolvidas nos últimos dez anos no Brasil, de acordo com os trabalhos apresentados nas Reuniões da SBPqO. Diante disso, sugere-se que pesquisas sobre o tema sejam realizadas e amplamente divulgadas entre o meio acadêmico e profissionais. (AU)

Evaluation of the Adjuvant Effect of Antimicrobial Photodynamic Therapy in the Treatment of Periodontal Disease: Literature Review / Avaliação do Efeito Adjuvante da Terapia Fotodinâmica Antimicrobiana no Tratamento da Doença Periodontal: Revisão de Literatura

Antimicrobial Photodynamic Therapy (aPDT) is a promising approach with several clinical applications, including the treatment of periodontal diseases, by acting as an adjuvant to the conventional treatment of periodontal disease by allowing reduction of periodontopathogens, with no systemic side effects and minimal possibilities of bacterial resistance. Objective: To verify, through the scientific literature, the effectiveness of Antimicrobial Photodynamic Therapy associated with conventional periodontal treatment. Methodology: The literature review was conducted in the MEDLINE databases - PubMed, Scopus and Web of Science. The articles were selected through the analysis of titles and abstracts published in the period from 2007 to 2018. Selected articles were published in their entirety and with free or controlled access, of the type clinical trial on the subject, without restriction of languages. The terms used were: "Periodontal diseases"; "Chronic Periodontitis" and "Photochemotherapy." Results: 84 articles were found, and 20 clinical trials that met the inclusion criteria were analyzed. There were different clinical protocols for the association of aPDT with the conventional treatment of periodontal disease. a number of different clinical outcomes were found for each of the proposed clinical protocols. Conclusion: Considering the clinical trials investigated, conflicting results regarding the efficacy of aPTD as an adjuvant treatment of the conventional treatment of periodontal disease are observed. and lack of standardization of clinical parameters and protocols. (AU)

A terapia fotodinâmica antimicrobiana (aPDT) é uma abordagem promissora com várias aplicações clínicas, incluindo o tratamento das doenças periodontais, ao atuar como um adjuvante ao tratamento convencional da doença periodontal por permitir redução de periodontopatógenos, com ausência de efeitos sistêmicos colaterais e mínimas possibilidades de resistência bacteriana. O objetivo deste estudo é verificar, por meio da literatura científica, a eficácia da terapia fotodinâmica antimicrobiana associada ao tratamento periodontal convencional. A revisão de literatura foi conduzida nas bases de dados MEDLINE ­ PubMed, Scopus e Web of Science. Os artigos foram selecionados através da análise de títulos e de resumos publicados no período de 2007 a 2018. Foram selecionados artigos publicados na íntegra e com acesso livre e gratuito, ou controlado, do tipo ensaio clínico sobre o tema, sem restrição de idiomas. Os termos utilizados foram: Periodontal diseases; Chronic Periodontitis e Photochemotherapy. Foram encontrados 84 artigos, e 20 ensaios clínicos que atenderam os critérios de inclusão, foram analisados. Observou-se diferentes protocolos clínicos para a associação da aPDT com o tratamento convencional da doença periodontal. Também foram encontrados diferentes desfechos clínicos para cada um dos protocolos clínicos propostos. Conclusão: Considerando os ensaios clínicos pesquisados, observa-se resultados conflitantes frente à eficácia da aPDT como tratamento adjuvante do tratamento convencional da doença periodontal. Observa-se, ainda, uma produção literária escassa e a falta de uma padronização dos parâmetros e dos protocolos clínicos. (AU)

A tomografia de coerência óptica como método não invasivo de diagnóstico periodontal: revisão de literatura / Optical coherence tomography as a non-invasive periodontal diagnostic method: literature review

As doenças periodontais são condições prevalentes, caracterizadas por sinais e sintomas de inflamação gengival e/ou destruição tecidual. O diagnóstico na rotina é baseado em observações clínicas e radiografias. Entretanto, procedimentos tradicionais são insuficientes para elaborar o diagnóstico, planejar o tratamento e monitorar a resposta do paciente. Dessa forma, as imagens tridimensionais (3D) surgiram na tentativa de ajudar na melhor visualização e no melhor plano de tratamento, sendo a Tomografia de Coerência Óptica (TCO) uma opção complementar. Portanto, o objetivo dessa revisão de literatura foi realizar um levantamento nos sites de busca de artigos acerca do tema diagnóstico periodontal e TCO. Foi realizada uma pesquisa de literatura utilizando a palavra-chave: "periodontal diagnosis and optical coherence tomography" nos bancos de dados Pubmed, Lilacs e Scielo, tendo como critério inicial texto completo e últimos 10 anos. Foram encontrados no total de 9 artigos, sendo 1 repetido e 1 excluído por diferenciar da temática. Ao final, permaneceram 7 artigos, sendo 4 de revisão de literatura e 3 pesquisas, com 1 ex vivo, 1 in vitro e 1 in vivo. Os resultados demonstram que a TCO é uma técnica de imagem não invasiva e em evolução que fornece imagens 3D e tem se apresentado como ferramenta de diagnóstico periodontal. (AU)

Periodontal diseases are prevalent conditions, characterized by signs and symptoms of gingival inflammation and / or tissue destruction. The routine diagnosis is based on clinical observations and radiographs. However, traditional procedures are insufficient to make the diagnosis, plan the treatment and monitor the patient's response. In this way, three-dimensional images (3D) appeared in an attempt to help in the best visualization and the best treatment plan, with Optical Coherence Tomography (TCO) being a complementary option. Therefore, the purpose of this review was to conduct a survey on the sites of search for articles on the topic of periodontal diagnosis and TCO. A literature search was conducted using the key word "periodontal diagnosis and optical coherence tomography" in the Pubmed, Lilacs and Scielo databases, with full text and the last 10 years as the initial criterion. They were found in the total of 9 articles, being 1 repeated and 1 excluded because they differed from the theme. At the end, 7 articles remained, being 4 of literature review and 3 researches, with 1 ex vivo, 1 in vitro and 1 in vivo. The results demonstrate that TCO is a noninvasive and evolving imaging technique that provides 3D images and has been presented with a periodontal diagnostic tool. (AU)

Aplicabilidade da terapia fotodinâmica antimicrobiana na eliminação do Enterococcus faecalis / Applicability of antimicrobial photodynamic therapy in the elimination of Enterococcus faecalis / Aplicabilidad de la terapia fotodinámica antimicrobiana en la eliminación del Enterococcus faecalis

Introdução: A endodontia é uma especialidade odontológica que visa promover a saúde dentária por meio da eliminação de micro-organismos capazes de causar agressões pulpares. A terapia fotodinâmica antimicrobiana, apresenta-se como uma alternativa coadjuvante ao tratamento endodôntico convencional para eliminação dos micro-organismos resistentes ao preparo-químico-mecânico. Objetivo: Explorar a literatura dando enfoque ao mecanismo de ação e aplicabilidade da aPDT na eliminação do Enterococcus faecalis. Material e método: Realizou-se uma revisão de literatura conduzida através do acesso às bases de dados eletrônicos Medline/Pubmed e Scielo utilizando isoladamente ou em associação as palavras-chaves "Photodynamic Therapy", "Enterococcus faecalis" e "Endodontic", no período de 2007 a 2017, totalizando 392 artigos. Resultados: A eliminação de forma eficaz de bactérias, Enterococcus faecalis, são vantagens atribuídas à terapia fotodinâmica, no entanto, a literatura evidencia a necessidade de utilizá-la associada a outras formas de tratamento. Conclusão: É necessária a padronização dos protocolos para que se obtenha dados mais esclarecedores sobre a eficácia da terapia fotodinâmica na eliminação do Enterococcus faecalis(AU)

Introduction: Endodontics is a dental specialty that aims to promote dental health by eliminating microorganisms capable of causing pulpal aggressions. Photodynamic antimicrobial therapy is an alternative to conventional endodontic treatment for the elimination of microorganisms resistant to chemical preparation. Objective: To explore the literature focusing on the mechanism of action and applicability of aPDT in the elimination of Enterococcus faecalis. Material and method: A literature review was conducted through access to the Medline / Pubmed and Scielo electronic databases using the keywords "Photodynamic Therapy", "Enterococcus faecalis" and "Endodontic". Results: The effective elimination of bacteria, Enterococcus faecalis, are advantages attributed to photodynamic therapy, however, the literature evidences the need to use it associated with other forms of treatment. Conclusion: Standardization of protocols is necessary to obtain more clarifying data on the efficacy of photodynamic therapy in the elimination of Enterococcus faecalis(AU)

Introducción: La endodoncia es una especialidad odontológica que busca promover la salud dental a través de la eliminación de microorganismos capaces de causar agresiones pulpares. La terapia fotodinámica antimicrobiana, se presenta como una alternativa coadyuvante al tratamiento endodóntico convencional para la eliminación de los microorganismos resistentes al preparado-químico-mecánico. Objetivo: Explorar la literatura centrándose en el mecanismo de acción y aplicabilidad de la aPDT en la eliminación del Enterococcus faecalis. Material y método: Se realizó una revisión de literatura conducida a través del acceso a las bases de datos electrónicos Medline / Pubmed y Scielo utilizando aisladamente o en combinación las palabras clave "Photodynamic Therapy", "Enterococcus faecalis" y "Endodontic". Resultados: La eliminación eficaz de bacterias, Enterococcus faecalis, son ventajas atribuidas a la terapia fotodinámica, sin embargo, la literatura evidencia la necesidad de utilizarla asociada a otras formas de tratamiento. Conclusión: Es necesaria la estandarización de los protocolos para que se obtengan datos más claros sobre la eficacia de la terapia fotodinámica en la eliminación del Enterococcus faecalis(AU)

Immunohistochemical Analysis of Cell Proliferation and Bcl-2 Expression in Drug-Induced Gingival Overgrowth

Objective: To compare the rate of cell proliferation and expression of antiapoptotic protein Bcl-2 between drug-induced gingival overgrowth (DIGO) and clinical healthy gingiva (CHG) and to establish associations with histopathological features. Material and Methods: Twenty specimens of DIGO and 20 CHG specimens were submitted to morphological and immunohistochemical analysis by light microscopy. Cell proliferation (Ki-67) and the expression of Bcl-2 were evaluated in epithelial cells and spindle-shaped mononuclear cells of the connective tissue by establishing the labeling index (LI). Results: In epithelial tissue, the mean LI for Ki-67 was 17.2% in DIGO and 21.71% in CHG (p = 0.137). The mean LIs for Bcl-2 in epithelial tissue were 14.67% and 10.24% in DIGO and CHG, respectively (p = 0.026). In connective tissue, DIGO and CHG specimens exhibited low LIs for Ki-67 and Bcl-2, with mean values of less than 0.5% in both groups. No significant differences in the LIs for Ki-67 or Bcl-2 in epithelial tissue were observed according to the degree of collagenization, degree of vascularization and intensity of inflammatory infiltration (p > 0.05). No significant correlations were observed between the LIs for Ki-67 and Bcl-2 (p > 0.05). Conclusion: The present results suggest that the pathogenesis of DIGO does not involve increased proliferation or decreased apoptosis of fibroblasts. On the other hand, the morphological pattern of elongated epithelial cristae observed in DIGO could mainly be due to the inhibition of keratinocyte apoptosis and not to increased proliferation of these cells.

Clinical efficacy analysis of the mouth rinsing with pomegranate and chamomile plant extracts in the gingival bleeding reduction.

Medicinal plants represent important therapeutic resources to health restoration, including the use of herbal products in the mouth conditions treatment. A randomized controlled clinical trial was performed in order to evaluate the effectiveness of mouth rinse with pomegranate and chamomile plant extracts, against chlorhexidine 0.12% in the gingiva bleeding condition. The mouth rinses with the herbal products were effective for this case, showing thus, antimicrobial and anti-inflammatory properties similar to that of chlorhexidine 0.12%.

Fatores de risco relacionados à prematuridade ao nascer: um estudo caso-controle / Risk factors related to preterm birth: a case-control study

Introdução: Vários fatores têm sido identificados quanto à possível relação com a prematuridade ao nascer. Objetivos: Avaliar os fatores de risco relacionados à prematuridade ao nascer. Metodolgia: Foi realizado um estudo caso-controle, num Hospital de Caruaru-PE, com 259 puérperas. Após o parto, as mulheres foram entrevistadas sobre possíveis fatores de risco durante a gravidez e, em seguida, foram submetidas a um exame periodontal, utilizando o Registro Periodontal Simplificado (PSR). Foram utilizados os testes estatísticos: Qui-quadrado de Pearson ou Exato de Fisher e t-Student. A hipótese de homogeneidade de variâncias foi verificada pelo teste F de Levene. Resultados: Observou-se a associação da prematuridade e baixo peso ao nascer com: tabagismo, etilismo e pré-natal incompleto. Quanto à avaliação das alterações periodontais, os escores 1 (37,5%) e 2 (25,0%) estiveram mais prevalentes no grupo caso, enquanto que no controle foram mais prevalentes os escores 0, 3 e 4, não havendo associação com a variável estudada. Conclusões: Vários fatores de risco foram identificados para prematuridade ao nascer. Apesar da Doença Periodontal não ter sido associada a este desfecho, em face das discussões científicas sobre o tema, sugere-se uma maior exploração do assunto.

Introduction: Several factors have been identified as possibly related to preterm birth. Objective: To assess the risk factors related to preterm birth. Methods: We conducted a case-control study in a hospital Caruaru-PE with 259 postpartum women. After childbirth, the women were interviewed about possible risk factors during pregnancy and then underwent a periodontal examination using the Periodontal Screening and Recording (PSR). We used the following statistical tests: Pearson Chi-square test or Fisher’s Exact and t-Student test. The assumption of homogeneity of variances was checked by Levene’s F test. Results: We observed an association of preterm birth with smoking, alcohol use and lack of complete prenatal. In relation to evaluation of periodontal changes, scores one (37.5%) and 2 (25.0%) were more prevalent in the case group, whereas in the control group the scores 0, 3 and 4 were more prevalent, with no association with the studied variable. Conclusions: Several risk factors have been identified for preterm birth. Although the periodontal disease was not associated with this outcome, according to the scientific discussions on the subject, we suggest further exploration of the subject.

Avaliação das condições de saúde bucal de idosos institucionalizados no município de Campina Grande - PB / Evaluation of the oral health condition of the institutionalized elderly people in the city of Campina Grande - PB

O objetivo dessa perquisa foi avaliar as condições de saúde bucal de idosos institucionalizados de Campina Grande - PB e traçar metas prioritárias, através de ações educativas e terapêuticas, que proporcionem saúde bucal satisfatória. O estudo teve uma amostra de 43 idosos os quais responderam a um questionário específico e submeteram-se a um exame clínico, utilizando-se o índice de CPO-D, ICNTP e a necessidade e/ou presença de prótese. Adicionalmente, foram realizadas ações eductivas e posteriormente selecionados os problemas mais urgentes e enviados para os centros especializados. Observou-se que: 58,13% dos idosos eram mulheres; a maioria (76,74%) oriundos de outras cidades da Paraíba; 71,42% relataram que não receberam orientação sobre higiene bucal na instituição; a frequência da higienização foi baixa; 48,83% apresenta ou apresentou algum hábito; apenas 12% conheciam a relação entre a saúde bucal e a saúde geral, o CPO-D foi de 27,4, o ICNTP revelou que todos necessitavam de tratamento periodontal; 74,41% necessitavam de prótese e 25,58% a usavam; 79,06% apresentaram um ou mais problemas de saúde bucal e foram encontradas diversas lesões bacais. Diante dessa realidade, torna-se urgente a implantação de uma política de saúde na qual os recursos sejam utilizados em benefícios do bem-estar do idoso.

The aim of this research was to evaluate the oral health conditions of the institutionalized elderly people in the city of Campina Grande-PB and to set priority goals, through educative and therapeutical actions that provide satisfactory oral health. Forty-three elderly people answered questionaire and were submitted to clinical examination in which was used the index of DMF-T, ICNTP and the necessity and/or presence of prothesis. Additionally, educative actions were introduced and later the most urgent problems were conducted to specialized centers. It was observed that: 58,13% of the elderly people were women; the majority of them (76,74%) was directed of other cities of the States of Paraíba; 71,42% had told that they had not received orientation about oral hygiene in the institution; the oral hygienic frequency was low; 51,16% show or showed some habit; only 12% knew the relation between the oral health and the general health; the DMF-T was 27,4, the ICNTP showed that all of them needed periodontal treatment; 74,41% needed prothesis and 25.58% used it; 79,06% present one or more problems of oral health and had been found diverse oral 's injuries. According this, the implantation of health politics becomes urgent for that the resources been used with efficiency to benefit of well being of the elderly people.