LGBTQIA+ vs the Brazilian Unified Health System: Basic Health Unit Use and Associated Factors.

The Brazilian Unified Health System provides universal health care access without regard to sexual orientation and gender identity. We conducted a nationwide study with a cross-sectional design and intentional sampling methods to investigate factors associated with Basic Health Unit (BHU) use by the LGBTQIA+ community. Data were collected via a questionnaire available through social networks. Statistical analysis included Poisson regression with robust variance. A total of 603 LGBTQIA+ community members participated in the study, of whom 417 (69.2%) had visited a BHU in the last year. The factors "transgender woman" and "self-rated health status as very good/good/fair" increased the probability of BHU use in the last year by 10% (PR: 1.10; 95% CI: 1.00-1.20) and 9% (PR = 1.09; 95% CI: 1.01-1.18), respectively. "Not suffering sexual orientation-related discrimination at a BHU" and "Not suffering discrimination by a receptionist or waiting room worker" increased the probability of use by 28% (PR = 1.28; 95% CI: 1.22-1.34) and 22% (PR = 1.22; 95% CI: 1.14-1.30), respectively. Our study supports evidence that access to primary health care services in Brazil can be influenced by the social determinants gender identity and sexual discrimination.

Impacto da pandemia provocada pelo SARS-CoV-2 na saúde mental de estudantes de Odontologia: uma revisão integrativa / Impacto de la pandemia causada por SARS-CoV-2 en la salud mental de los estudiantes de la odontología: una revisión integrativa / Impact of the pandemic caused by SARS-CoV-2 on the mental health of dental students: an integrative review

A saúde mental dos estudantes de Odontologia foi impactada pela pandemia provocada pelo coronavírus SARS-CoV-2 (COVID-19). O objetivo do estudo foi realizar uma revisão integrativa sobre o impacto da pandemia na saúde mental de estudantes de Odontologia. Foram consultadas as bases de dados PubMed Medline e SciELO, nas quais foram selecionados artigos nos idiomas em português, inglês e espanhol. A estratégia de busca foi composta pela combinação das palavras-chave COVID-19, pandemia, estudantes de Odontologia, educação odontológica e saúde mental. As coletas foram realizadas no mês de agosto de 2021 tendo como critérios de inclusão os artigos de qualquer delineamento que descrevessem o impacto da pandemia de COVID-19 e fatores associados coma saúde mental de estudantes de Odontologia. O critério de exclusão foi de artigos que não tinham como participantes do estudo os estudantes de Odontologia. Os dados foram analisados e apresentados em formato de quadro com as variáveis de interesse como: autor, ano, país, título do artigo, objetivo, delineamento, resultados principais e conclusões. Os estudos demonstram impactos negativos da COVID-19 na saúde mental dos estudantes de Odontologia. A percepção de saúde mental geral foi o principal fator associado aos diagnósticos de depressão, ansiedade e estresse. Ademais, a maioria dos estudantes afirmou que as plataformas de aprendizagem onlineeram insuficientes para o aprendizado das competências clínicas. Conclui-se que a pandemia de COVID-19 impactou negativamente a saúde mental de estudantes de Odontologia, evidenciando a necessidade de políticas públicas e estratégias de apoio psicológico envolvendo serviços de aconselhamento institucional (AU).

La salud mental de los estudiantes fue impactada por la pandemia provocada por el coronavirus SARS-Cov-2(COVID-19). El objetivo del estudio fue realizar una revisión integrativa sobre el impacto de la pandemia en la salud mental de los estudiantes. Fueron consultadas las bases de datos PubMed Medline y SciELO, de los cuales se seleccionaron artículos en los idiomas portugués, inglés y español. La estrategia de búsqueda fue compuesta por la combinación de las palabras-clave COVID-19, pandemia, estudiantes deodontología, educación dental y salud mental. Las adquisiciones de los datos fueran realizadas en el mes de agosto de 2021 teniendo como criterios de inclusión, publicaciones de cualquier delineamento que describiesen el impacto de la pandemia de COVID-19y factores asociados con la salud mental de estudiantes de odontologia. Se excluyeron los artículos que no tenían como participantes del estudio alos estudiantes de odontología. Los datos fueron analizados y presentados en formato de cuadro com las variables deinterés como: autor, año, título del artículo, objetivo, delineamento, resultados principales y conclusiones. Los estudios han demostrado impactos negativos de la COVID-19 en la salud mental de los estudiantes de odontología. La percepción de saludmental general fue el principal factor asociado a los diagnósticos de depresión, ansiedad y estrés. Además, la mayoría de los estudiantes manifestó que utilizar plataformas de aprendizaje virtuales fueroninsuficientes para desarrollar competencias clínicas. Cabe concluir que la necesidad de política pública y estrategias de apoyos psicológicos deberían incluir servicios de asesoramiento institucional (AU).

The mental health of dental students was impacted by the pandemic caused by SARS-CoV-2 (COVID-19). The aim of the present study was to perform an integrative review addressing the impact of the pandemic on the mental health of dental students. The PubMed (Medline) and SciELO databases were searched for relevant articles published in Portuguese, English and Spanish. The search strategy was composed of combinations of the following keywords: COVID-19, pandemic, dental students, dental education and mental health. Data collection was conducted in August 2021. The inclusion criteria were articles with any study design that described the impact of the COVID-19 pandemic and factors associated with the mental health of dental students. Studies without dental students as participants were excluded. The data were analyzed and presented in a table with the variables of interest: authors, year of publication, country, objective, study design, main results and conclusions. The articlesdemonstrated the negative impact of COVID-19 on the mental health of dental students. The perception of general mental health was the main factor associated with diagnoses of depression, anxiety and stress. The majority of students reported that online platforms were insufficient for learning clinical skills. In conclusion, the COVID-19 pandemic exerted a negative impact on the mental health of dental students, underscoring the need for public policies and psychological support strategies involving institutional counseling services (AU).

Proporções de procedimentos odontológicos realizados no município de canoas: um histórico de 10 anos / Rate of procedure performed by dental services municipality of Canoas: a history 10 years

RESUMO Os objetivos do presente estudo foram: realizar uma série histórica dos procedimentos realizados pelos serviços odontológicos na Atenção Primária em Saúde (APS) no município de Canoas e verificar a redução da proporção de procedimentos de exodontia. Os dados foram coletados do Departamento de Informática do SUS (DATASUS) e foram agrupados em blocos de procedimentos odontológicos: exodontias, restauradores, preventivos, periodontais, endodônticos/urgências e outros procedimentos. Verificou-se que houve redução da proporção de exodontias e quando foram calculadas as médias do período de 10 anos, utilizando os critérios específicos da APS e do IDSUS, as proporções de exodontias foram 4,46% e 4,83%. Neste contexto, conclui-se que a série histórica evidencia a redução das proporções de exodontias no município e as médias das proporções das exodontias no período avaliado foram maiores quando comparadas com a meta estabelecida pelo Plano Anual de Saúde (2,8)

ABSTRACT The objectives of the present study were to perform a historical series of procedures performed by dental services in Primary Health Care (PHC) in the city of Canoas and to verify the reduction in the rate of extraction procedures. The data were collected from the SUS Informatics Department (DATASUS) and were grouped into blocks of dental procedures: extraction, restorative, preventive, periodontal, endodontic / urgency and other procedures. It was found that there was a reduction in the rate of extraction and when the averages of the 10-year period were calculated using the specific criteria of PHC and IDSUS, the rates of extraction were 4.46 and 4.83. In this context, it can be concluded that the historical series shows the reduction of extraction rates in the municipality, however, the average rates of extraction rates in the evaluated period were high when compared to the target established by the Annual Health Plan (2.8)

Undergraduate dental students' perceptions of an internship at a Brazilian Family Health Strategy center: a cross-sectional study / Percepção dos estudantes de odontologia sobre o estágio na Unidade de Estratégia de Saúde da Família: um estudo transversal

We conducteda cross-sectional study to evaluate the perceptions of undergraduatedentalstudents(UDS)of an internship in primary dental care within a Family Health StrategyTeam(FHS-T) and associated factors.Data were collected via a self-report questionnaire. Poisson regression models wereused in multivariate analysis (p<0.05).Of 175 UDSincluded, 150 (85.7%) classifiedtheFHS-Tinternship as important to their dentaleducation. Being enrolled in the Community Dental Health (CDH)III course (vs CDH I) increased by 9%(prevalence ratio [PR] 1.09; 95% confidence interval [CI], 0.99-1.21) the likelihood of students classifying the internshipas important to their dental education. Considering the start of the FHS-Tinternship in the 7thsemesteradequate (vs inadequate) increasedthis likelihood by15%(PR 1.15; 95% CI, 1.05-1.25). Classifying user embracementand home visitsas important (vs unimportant) activities also increasedthis likelihood by 8% (PR 1.08; 95% CI, 0.99-1.17) and 21%(PR 1.21; 95% CI, 1.09-1.33), respectively.Our results suggest that the early insertion of UDSin the FHS-Tand their involvement in'user embracement'and'home visits'activitiescan significantly contribute todelivering interprofessional dental education (AU).

Este estudo transversal foi conduzido para avaliar a percepção dos estudantes de odontologia (EO) sobre o estágio na atenção primária na equipe de estratégia saúde da família (E-ESF) e fatores associados. Os dados foram coletados via questionário autoaplicado. A regressão de Poisson foi utilizada na análise multivariada (p<0,05). Dos 175 EO incluídos no estudo, 150 (85,7%) classificaram o estágio na E-ESF como importante para sua formação em odontologia. Estar matriculado na disciplina de Saúde Comunitária em Odontologia (SCO) III aumentou em 9% (razão de prevalência [RP] 1,09; intervalo de confiança [IC] 95%, 0,99-1,21) a probabilidade dos estudantes classificarem o estágio como importante para formação odontológica. Considerar o início do estágio na E-ESF no 7º semestre como adequado (vs inadequado) aumentou em 15% (RP 1,15; IC, 1,05-1,25) a probabilidade de classificar o estágio como importante. Classificar as atividades de acolhimento e visita domiciliar como importante (vs não importante) também aumentou esta probabilidade em 8% (RP 1,08; IC, 0,99-1,17) e em 21% (RP 1,21; IC, 1,09-1,33), respectivamente. Nossos resultados, sugerem que a inserção precoce dos EO na E-ESF e o seu envolvimento com atividades de "acolhimento" e "visita domiciliar" podem contribuir significativamente para formação odontológica interprofissional (AU).

Satisfação das gestantes durante a consulta odontológica no Sistema Unico de Saúde, Brasil / Satisfaction of pregnant women during dental consults in Brazilian Unified Health System / Satisfacción de las mujeres embarazadas durante la consulta odontológica en el Sistema Único de Salud de Brasil

RESUMO Objetivo O objetivo do trabalho foi verificar a taxa de gestantes satisfeitas com a consulta odontológica realizada no Sistema Único de Saúde (SUS-Brasil) e fatores associados. Metodologia O estudo foi do tipo transversal. Para coleta de dados foi elaborado um questionário abordando variáveis sociodemográficas e relacionadas a gestação. A coleta de dados foi realizada através de entrevistas face a face em um hospital maternidade da região metropolitana de Porto Alegre-RS-Brasil. O teste de qui-quadrado e a regressão de Poisson com variância robusta (p<0,05) foram utilizados nas análises bi e multivariada. Resultados Das 302 mulheres entrevistadas, 50%(n=151) realizaram consulta odontológica durante a gestação e destas, 86% (n=131) estavam satisfeitas com a consulta. Na análise multivariada verificou-se que a variável avaliação das consultas de pré-natal como boa aumentou em 14% [Razão de Prevalência (RP)=1,14; Intervalo de Confiança (IC) 95%:1,01-1,27] a probabilidade de as mulheres expressarem satisfação com a variável desfecho. Conclusão Conclui-se que foi alta taxa de satisfação com as consultas odontológicas realizadas no SUS pelas gestantes e avaliação das consultas de pré-natal como boa foi fator associado. Estes resultados poderiam ser considerados durante o planejamento estratégico, execução e avaliação das políticas de saúde direcionadas para este grupo operativo.

ABSTRACT Objective The study aimed to verify the rate of satisfaction among pregnant women with dental consults performed in the Brazilian Unified Health System (BUHS), and associated factors. Methodology The design of the study was cross-sectional. To collect data a questionnaire approaching variables sociodemographic and relationship whit pregnancy were used. The data gathering was realized across interviews face to face in a maternity hospital in the metropolitan region of Porto Alegre-RS-Brazil. The chi-square test and Poisson regression with robust variance (p<0.05) were used for the bivariate and multivariate analyses. Results A total of 302 pregnant women were interviewed, 50% (n=151) performed dental consults, and 86% (131) related that they were satisfied with the consult. In the multivariate analysis it was found that the variable evaluating prenatal visits as good increased the likelihood of women expressing satisfaction with the outcome variable by 14% [Prevalence Ratio (PR) =1.14; 95% Confidence Interval (CI): 1.01-1.27]. Conclusions The present study suggests that a high satisfaction rate with dental consult could be due to the highest satisfaction in prenatal consults performed in primary health care units, materializing the relationship of trust/connection between professional and user. This variable can be considered by workers and health managers during estrategic planning, performance, and evaluation of health policies.

RESUMEN Objetivo El objetivo del trabajo fue evaluar la tasa de mujeres embarazadas satisfechas con la consulta odontológica que realiza el Sistema Único de Salud-Brasil (SUS-Brasil) y factores asociados. Metodología Estudio de tipo transversal. Para colección de los dados se elaboró un cuestionario que abordaba las variables sociodemográficas y relacionadas con la gestación. La colección de los datos fue realizada por medio de entrevistas cara a cara en un hospital de maternidad de la región metropolitana del Porto Alegre, Brasil. Para comprobar la asociación de los factores con la satisfacción de las mujeres embarazadas con la consulta odontológica se usó el test de chi-cuadrado y la regresión del Poisson, con varianza robusta (p<0,05). Resultados De las 302 mujeres entrevistadas, 50% (n=151) realizaron consulta odontológica durante de la gestación y estas 86%(n=131) manifestaron estar satisfechas con la consulta. En el análisis multivariado se encontró que la variable que evaluaba las consultas prenatales como buenas aumentaba en un 14% [Razón de Prevalencia (RP)=1,14; Intervalo de Confianza (IC) del 95%:1,01-1,27] la probabilidad de que las mujeres expresaran satisfacción con la variable de resultado. Conclusiones Se concluyó que un alto índice de satisfacción con las consultas odontológicas realizadas en el SUS por parte de las embarazadas y la evaluación de las consultas prenatales como buenas fue un factor asociado. Estos resultados podrían ser considerados durante la planificación estratégica, ejecución y evaluación de las políticas de la salud pública direccionadas para este grupo operativo.

Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil.

Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil.

Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

Prevalence of temporomandibular dysfunction in athletes: integrative review / Prevalência da disfunção temporomandibular em atletas: revisão integrativa

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder is considered to be a set of clinical manifestations that affect the masticatory muscles, the temporomandibular joint and adjacent structures, whose signs and symptoms can negatively impact the quality of life of their patients. A population group in which the prevalence of temporomandibular disorder has increased in recent years is that of athletes. The aim of the present study was to conduct an integrative literature review to verify the prevalence of temporomandibular disorders in athletes, as well as factors related to their predisposition. CONTENTS: The searches were performed in the Medline, LILACS and Scielo databases, using the descriptors "temporomandibular joint", "athletic injuries" and "temporomandibular disease". Inclusion criteria were researches derived from primary data regardless of design, which was the target audience of athletes and that addressed the presence of temporomandibular joint or muscle dysfunction. Ten studies were selected and included in the review. The results obtained with the analysis of these articles showed that athletes are subject to temporomandibular disorders not only due to injuries suffered during competitions, but also due to factors associated with stress and the use of specific devices for sports practice. CONCLUSION: The occurrence of temporomandibular disorders is common among athletes, but can be avoided with the use of preventive measures and conservative treatments. Dental monitoring is essential for these professionals to perform well, preventing the occurrence of temporomandibular disorders or treating them when they occur.

RESUMO JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular é considerada um conjunto de alterações que acometem os músculos mastigatórios, articulação temporomandibular e estruturas adjacentes, os quais podem impactar negativamente na qualidade de vida dos seus portadores. Um grupo populacional no qual a prevalência de disfunção temporomandibular tem aumentado nos últimos anos é o de atletas. Assim, o objetivo do presente estudo foi realizar uma revisão integrativa da literatura a fim de verificar a prevalência das disfunções temporomandibulares em atletas, bem como os fatores relacionados a sua predisposição. CONTEÚDO: As buscas foram realizadas nas bases de dados Medline, LILACS e Scielo, utilizando os descritores "temporomandibular joint", "athletic injuries" e "temporomandibular disease". Os critérios de inclusão foram pesquisas oriundas de dados primários com qualquer delineamento; tendo como público-alvo os atletas e que abordassem a presença de disfunção temporomandibular articular ou muscular. Foram selecionados 10 estudos que foram incluídos nesta revisão. Os resultados obtidos com as análises dos artigos evidenciaram que atletas estão sujeitos às disfunções temporomandibulares não somente pelas lesões sofridas durante as competições, mas também por fatores associados ao estresse e ao uso de dispositivos específicos da prática desportiva. CONCLUSÃO: A ocorrência de disfunções temporomandibulares é comum entre atletas, mas elas podem ser evitadas com a utilização de medidas preventivas e tratamentos conservadores. O acompanhamento odontológico é fundamental para prevenir ou tratar a disfunção temporomandibular.

Association Between Early Admission at School and Oral Health and Nutritional Status of Children in the City of São Paulo, Brazil

ABSTRACT Objective: To investigate the possible relationship between early admission to the school of children in early childhood and oral health conditions (OH) and nutritional status (NS). Material and Methods: Cross-sectional study conducted with 140 children aged 3-4 years, selected for convenience, in 4 public schools in the city of São Paulo, Brazil, during 2016, divided into children with early (IE) and late (IL) admission at school. Comparisons between groups were performed for the presence of overweight / obesity (OW / OB), caries lesions (CL), malocclusion (MO) and dental biofilm (DB), in addition to socioeconomic and dietary data. Multiple regression analysis was applied to determine the association between age of admission at school and OH and NS. Results: Children with IE had CL = 28.1%; DB = 46.9%; MO = 54.7% and OW / OB = 25.9%. Children with IE had IL = 29.8%; DB = 35.1%; MO = 61.4% and OW / OB = 30.8%. No significant association was found between age of admission at school and CL: 1.40 (0.53-3.73) 0.490; DB: 0.51 (0.22-1.16) 0.112; MO: 1.77 (0.77-4.05) 0.173 and OW / OB: 1.27 (0.55-2.92) 0.568, [OR (95% CI) p]. Conclusion: The age of admission at school of children in early childhood did not show a significant association with OH and NS.

Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil / Tempo de recuperação funcional após fraturas faciais: perfil e fatores associados em amostra de pacientes do sul do Brasil

ABSTRACT Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

RESUMO O entendimento da causa, da gravidade e do tempo decorrido para o restabelecimento das funções de lesões maxilofaciais pode contribuir para o estabelecimento de prioridades clínicas objetivando o efetivo tratamento e prevenção dos traumatismos de face. Assim, o objetivo deste estudo foi compreender quais os fatores associados ao restabelecimento das funções mastigatórias, oculares e nasais em vítimas de trauma de face, estimando o tempo para recuperação das funções, após o tratamento cirúrgico. Foram analisados 114 prontuários de pacientes atendidos no Hospital de Montenegro que compareceram às consultas de acompanhamento por até 180 dias. Para a análise do tempo para a recuperação, foi realizada a análise de sobrevida, seguida da análise de COX. Observou-se que metade dos pacientes recuperaram as funções em até 20 dias, sendo que o tempo médio para recuperação dos traumas no complexo zigomático-orbitário-malar-nasal foi de 11 dias e do complexo maxilo - mandibular de 21 dias (HR: 1,5 (0,99 - 2,3) p=0,055). Embora o restabelecimento das funções tenha atingido taxas elevadas após abordagem cirúrgicas, faz-se necessária a análise dos casos de insucessos bem como os impactos econômicos e as estratégias de prevenção associados aos traumas de face a fim de qualificar o serviço prestado à população.

Utilização da ozonioterapia em odontologia / Use of ozoniotherapy in dentistry

O objetivo do presente estudo foi realizar uma revisão acerca do uso do ozônio como terapia em diversas áreas da Odontologia. Foi utilizado o portal PubMed, utilizando os termos (("ozone"[MeSH Terms] OR "ozone"[All Fields]) AND ("therapy"[Subheading] OR "therapy"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields])) AND ("dentistry"[MeSH Terms] OR "dentistry"[All Fields]), sem delimitação de data ou de idioma. Foi realizada leitura por título, por resumo e, por fim, a leitura na íntegra dos resumos selecionados. Os critérios de inclusão foram: ensaios clínicos randomizados e não randomizados, que utilizaram o ozônio em tratamentos odontológicos sozinhos ou associados a outros agentes. Com base nos resultados dos artigos abordados, constatou-se extrema heterogeneidade entre eles, bem como resultados bastante divergentes entre si. Quando o Ozônio é utilizado como adjuvante percebeu-se efeito benéfico em relação a redução da dor e a cicatrização, bem como efeito analgésico e anti-inflamatório. Por tudo isso, acredita-se que a terapia com ozônio, ainda que muito recente, tem se mostrado uma boa opção de tratamento. No entanto, são necessárias mais pesquisas com embasamento científico e estudos randomizados que visam comprovar a veracidade da sua eficácia e para que se tornem uma opção segura de aplicação.

The objective of the present study was to conduct a review on the use of ozone as a therapy in several areas of dentistry. The PubMed portal was used, using the terms ("ozone"[MeSH Terms] OR "ozone"[All Fields]) AND ("therapy"[Subheading] OR "therapy"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields]) AND ("dentistry"[MeSH Terms] OR "dentistry"[All Fields]), without delimitation of date or language. It was performed reading by title, by abstract and, finally, the full reading of the selected abstracts. The inclusion criteria were: randomized and non-randomized clinical trials, which used ozone in dental treatments alone or associated with other agents. Based on the results of the articles approached, extreme heterogeneity among them was observed, as well as quite divergent results. When ozone is used as an adjuvant, a beneficial effect in relation to pain reduction and healing, as well as analgesic and antiinflammatory effects, was observed. For all these reasons, it is believed that ozone therapy, although very recent, has proven to be a good treatment option. However, more research with scientific basis and randomized studies are necessary to prove the veracity of its effectiveness and to become a safe option of application.

Antimicrobial effect of photodynamic therapy on intracanal biofilm: A systematic review of in vitro studies.

BACKGROUND: Antimicrobial photodynamic therapy (A-PDT), is one of the adjunctive therapies developed to improve the effectiveness of root canal disinfection.. The aim of this study was to analyze the antimicrobial effect of PDT on intracanal biofilm. METHODS: Two reviewers conducted a literature search in PubMed, MEDLINE, Lilacs, SciELO, EMBASE and Google Scholar using the following search strategy: photochemotherapy "[Mesh] OR (photodynamic therapy) AND" dental plaque "[Mesh] OR (dental biofilm) AND (root canal). The following data were collected: publication year, author's name, study site, type of study, participant number, type of photosensitizer, type of laser, method of data collection, application time and results. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS). RESULTS: After selection based on title, abstract and full text, 27 studies were included in this systematic review. PDT reduced bacterial viability in most studies when combined with conventional endodontic techniques. CONCLUSION: PDT reduced bacterial counts in most studies, especially when used as an adjunct to the conventional endodontic technique to treat refractory infection. However, PDT effects on in vitro bacterial biofilm were not accurately quantified because of the numerous biases in the studies reviewed.

Effect of mesenchymal stem cells on the regeneration of structures associated with temporomandibular joint: narrative review / Efeito de células-tronco mesenquimais na regeneração das estruturas associadas à articulação temporomandibular: revisão narrativa

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorders are the problems involving the masticatory muscles and/or the temporomandibular joint and, among them, the bone and joint disc degenerative processes stand out. However, an effective treatment for these cases has not yet been identified in the literature. Thus, the primary objective of this study was to evaluate the reparative potential of mesenchymal stem cells on degenerative changes in structures associated with the temporomandibular joint in humans and animal models. CONTENTS: This narrative review included intervention trials in humans and animals that presented as an outcome variable the repair of joint discs and/or temporomandibular joint. The following databases were used: Pubmed, LILACS, Scielo and Google Scholar. Titles and abstracts were analyzed for the pre-selection of articles potentially eligible for inclusion in this review. The information collected from each article was included in a specific spreadsheet for this purpose containing the year of publication, article title, author's name, study location, type of study, methodology, results, and conclusions. Two human studies and four animal studies were selected to compose the narrative review. In all studies presented, the presence of stem cells was able to improve the clinical, histological, and morphological parameters of the temporomandibular joint. CONCLUSION: The use of stem cells seems to be effective in treating degenerative changes in temporomandibular joint associated structures in both animal and human models. However, due to the small number of studies and their heterogeneity, the results presented should be evaluated sparingly.

RESUMO JUSTIFICATIVA E OBJETIVOS: As desordens temporomandibulares constituem-se em um termo coletivo de problemas que envolvem os músculos mastigatórios e/ou a articulação temporomandibular. Dentre esses, destacam-se os processos degenerativos ósseos e do disco articular, contudo, ainda não foi identificado na literatura um tratamento eficaz para esses casos. Dessa forma, o objetivo desse estudo foi avaliar o potencial reparador das células-tronco mesenquimais sobre as alterações degenerativas das estruturas associadas à articulação temporomandibular em humanos e em modelos animais. CONTEÚDO: Foram incluídos ensaios de intervenção em humanos e em animais que apresentassem como variável desfecho o reparo dos discos articulares e/ou da articulação temporomandibular. Foram realizadas buscas nas seguintes bases de dados: Pubmed, LILACS, Scielo e Google Acadêmico. Os títulos e resumos foram analisados para a pré-seleção dos artigos potencialmente elegíveis para sua inclusão. As informações coletadas de cada artigo foram incluídas em planilha específica para essa finalidade contendo o ano de publicação, título do artigo, nome do autor, local do estudo, tipo de estudo, metodologia, resultado e conclusões. Foram selecionados 2 estudos em humanos e 4 estudos em animais para compor este estudo. Em todas essas pesquisas apresentadas, a presença de células-tronco foi capaz de melhorar parâmetros clínicos, histológicos e morfológicos da articulação temporomandibular. CONCLUSÃO: O uso de células-tronco parece ser eficaz no tratamento das alterações degenerativas das estruturas associadas à articulação temporomandibular. Todavia, devido ao reduzido número de estudos e sua heterogeneidade, os resultados apresentados devem ser avaliados com parcimônia.

Relação entre o estrogênio e as disfunções temporomandibulares: uma revisão de literatura / Relationship between estrogen and temporomandibular disorders: a review of literature

Objetivo: realizar uma revisão da literatura a fim de traçar um panorama atual sobre o papel do estrogênio nas disfunções temporomandibulares. Metodologia: foram realizadas buscas nas plataformas digitais Pub- Med, SciELO e Google Acadêmico, durante os meses de setembro de 2018 a maio de 2019, sem filtros para determinar período de tempo, sendo excluídos aqueles trabalhos em que não foi possível identificar relação com o tema. Resultados: na análise dos estudos encontrados, foi observada a relação entre o estrogênio e a prevalência de disfunções temporomandibulares em mulheres. O estrogênio atua central e perifericamente no sistema nervoso central, influenciando no processamento dos receptores pró e antinoceptivos da articulação temporomandibular. Considerações finais: a modulação estrogênica da dor é um mecanismo complexo. Diversos estudos associam o hormônio estrogênio às disfunções temporomandibulares. Embora não haja um consenso entre os autores do papel exato deste hormônio, há evidências comprovadas de que as mulheres possuem uma susceptibilidade a dores em geral, com prevalência tanto em frequência quanto em intensidade.(AU)

Objective: to carry out an integrative review of the literature in order to outline the role of estrogen in temporomandibular disorders. Methodology: the study searched studies in the digital platforms PubMed, SciELO and Google Acadêmico, from September 2018 to May 2019, without filters to determine the time period, excluding those works in which it was not possible to identify relation with the theme. Results: among the analysis of the studies found, the relationship between estrogen and the prevalence of temporomandibular disorders in women was observed. Estrogen acts centrally and peripherally in the central nervous system, influencing the processing of the pro and antinoceptive receptors of the temporomandibular joint. Final considerations: estrogenic modulation of pain is a complex mechanism. Several studies associate the estrogen hormone with temporomandibular disorders. Although there is no consensus among authors of the exact role of this hormone, there is proven evidence that women have a susceptibility to pain in general, with prevalence both in frequency and intensity.(AU)

Vigilância em saúde bucal na perspectiva do georreferenciamento: análise da distribuição de cárie dentária em escolares de uma Unidade de Saúde / Oral health surveillance from the perspective of geo-referencing: analysis of dental caries distribution in schoolchildren of a primary health unit

Objetivo: O estudo buscou realizar um mapeamento ge-orreferenciado dos usuários escolares de uma Unidade de Saúde de Porto Alegre em relação à cárie dentária. Materiais e métodos: A pesquisa foi desenvolvida em uma Unidade de Saúde do Grupo Hospitalar Conceição. A população do estudo foi composta por 103 alunos, entre 6 e 17 anos, de 2 escolas de ensino fundamental. Os dados sobre a ne-cessidade de tratamento restaurador, vinculados à cárie dentária, foram obtidos dos prontuários dos pacientes cadastrados no Coinma, examinados pela equipe de saúde através do PSE, nos anos de 2016 e 2017, totalizando 103 prontuários. Para o georreferenciamento, foi utilizada a ferramenta online Google Maps®, onde foram adicionados marcadores na cor vermelha para alunos com necessidade de tratamento e verde para alunos sem necessidade de tratamento. Resultados: Da população do estudo, 30% apresentava alguma necessidade de tratamento. Os meni-nos apresentavam mais necessidades quando comparados às meninas, com ênfase na faixa etária entre 8­9 anos. Quanto à análise geovisual, foi possível identificar um aumento na concentração dos casos de estudantes com necessidades de intervenção em saúde bucal na área ROSA, onde moravam 53 (51,4%) dos alunos, sendo que 19 (35,84%) deles apresentavam necessidades, seguidos pelas áreas AZUL, onde 25 (24,3%) dos alunos avaliados, 5 (20%) apresentavam necessidades; AMARELA, com 14 (13,6%) alunos avaliados, 2 (14%) apresentavam neces-sidades; VERDE, com 11 (10,7) alunos avaliados, 5 (45,5%) apresentavam necessidade de tratamento. Conclusão: O georreferenciamento é um instrumento importante para a análise da distribuição espacial da cárie dentária. O presente estudo pode contribuir para a elaboração de políticas de saúde voltadas para a vigilância em saúde de abrangência local.

Objective: The study aimed to perform a georeferenced mapping of school users of a health unit in Porto Alegre in relation to dental caries. Materials and methods: This study was carried out in a he-alth unit of the Hospitalar Conceição Group. The school consisted of 103 students, aged 6 to 17, from 2 elementary schools. Data on the accessibility of restorative treatment linked to the disease were included in the medical records of patients registered with Coinma and compared by the health team through the PES in 2016 and 2017, totaling 103 records. For the georeferencing, the Google Maps® online tool was used, where red markers were added for students who needed treatment and green for students with no need of treatment. Results: Of the study population, 30% had some need of treatment. The boys had more needs when compared to the girls, with emphasis on the group aged between 8-9 years. Concerning to the geo-visual analysis, it was possible to identify an increase in the concentration of students with oral health intervention needs in the PINK area, where 53 (51.4%) students lived, and 19 (35.84%) needed treatment. Besides, in the BLUE areas, out of 25 (24.3%) of students, 5 (20%) showed needs; In the YELLOW area, out of 14 (13.6%) students evaluated, 2 (14%) showed treatment needs; In the GREEN area, out of 11 (10.7) students evaluated, 5 (45.5%) presented a need for treatment. Conclusion: Georeferencing is an important tool for the analysis of the spatial distribution of dental caries. The present study may contribute to the elaboration of health policies focused on local health surveillance.

Impacto do uso de probióticos sobre o biofilme bucal / Impact of the use of probiotics on oral biofilme

Objetivo: o objetivo desse estudo foi realizar uma revisão integrativa sobre o impacto do uso de probióticos sobre o biofilme bucal. Revisão de literatura: a busca foi feita nas bases de dados Scielo, Science Direct, PubMed e LILACS, utilizando-se como descritores os termos probióticos, biofilme, cárie e periodontite, nos idiomas português e inglês. Foram selecionados os estudos que delimitavam o assunto em relação ao biofilme bucal. Foram encontrados 1689 artigos e selecionados 48. Os resultados demonstraram empregabilidade otimista dos probióticos, visto que apenas 2 artigos selecionados não obtiveram resultados positivos. Dentre as bactérias probióticas, a Lactobacillus salivarius e a Lactobacillus casei foram as mais utilizadas. Sugerem-se produtos viscosos como meio de utilização, por sua boa substantividade. Considerações finais: Recomenda-se que sejam realizados mais estudos com metodologias comparáveis, para melhor compreensão do efeito dos probióticos no biofilme bucal e para que sejam padronizadas doses, modo de administração, tempo da duração do seu efeito, bem como as cepas e as espécies bacterianas mais eficazes para cada objetivo. Principalmente, compreender melhor o seu mecanismo de ação para que assim possa ser protocolada uma técnica eficiente, fundamentada e segura para sua aplicação.

Objectives: to carry out an integrative review on the impact of the use of probiotics on oral biofilm. Materials and method: the search was done in the databases SciELO, Science Direct, PubMed and LILACS, using the terms probiotics, biofilm, caries and periodontitis, in Portuguese and English. The studies selected were those that delimited the subject in relation to the oral biofilm. Results: a total of 1.689 articles were found and 48 were selected. The results demonstrated optimum employability of probiotics, since only two of the selected articles did not obtain positive results. Among the probiotic bacteria, Lactobacillus salivarius and Lactobacillus casei were the most used. Viscous products are suggested as a means of use because of their good substantivity. Final considerations: it is recommended that further studies be conducted with comparable methodologies to better understand the effect of probiotics on oral biofilm and to standardize doses, mode of administration, duration of their effect, as well as the most effective strains and bacterial species for each objective. Mainly, it is necessary a better understanding of the mechanism of action, so that an efficient, reasoned and safe technique can be defined for its application.(AU)

Avaliação da ocorrência e dos conhecimentos sobre disfunção temporomandibular em profissionais da Equipe de Saúde da Família do Grupo Hospitalar Conceição / Evaluation of occurrence and knowledge on temporomandibular dysfunction in professionals of the Family Health Teams of the Conceição Hospital Group

Objetivo: considerando-se o elevado número de pessoas com disfunção temporomandibular (DTM) e que a busca por tratamento tem aumentado nos últimos anos, o objetivo do presente estudo foi avaliar a prevalência de DTM entre os integrantes da Equipe de Saúde da Família (ESF) e o conhecimento dos profissionais em relação a essa condição. Métodos: os questionários foram aplicados em 87 profissionais da ESF do Grupo Hospitalar Conceição. No primeiro questionário, avaliou-se a prevalência de DTM, no segundo, foram coletados os dados sociodemográficos e, no terceiro e último, avaliou-se o conhecimento sobre a etiologia, o diagnóstico e o tratamento das DTMs. A análise dos dados foi realizada por meio dos testes Qui-Quadrado ou Teste T de Student para um p ≤ 0,05. Resultados: os resultados demonstraram que os profissionais incluídos, em sua maioria, apresentam DTM leve e que o percentual de acertos dos dentistas foi superior estatisticamente ao dos médicos apenas no item tratamento. Conclusão: é de suma importância que os profissionais das ESFs estejam preparados para atender a demanda de pacientes que apresentam sinais e sintomas compatíveis com DTM.(AU)

Objectives: considering the high number of people affected by TMD and the demand for treatment has increased in the last years, the objective of the present study was to assess the prevalence of TMD among the members of the Family Health Team (FHT) and professionals' knowledge regarding this condition. Methods: three questionnaires were applied to 87 professionals from the Family Health Teams of the Hospital Conceição Group. The first questionnaire evaluated the prevalence of TMD, the second one collected the sociodemographic data and, finally, the research questionnaire sought to evaluate the professionals knowledge about the etiology, diagnosis and treatment of TMD. The data analysis were performed by the Chi-square or Student's T-Test for a p ≤ 0.05. Results: the results demonstrated that the professionals included in the sample have most have slight TMD. Regarding the professional knowledge, the percentage of correct answers of the dentists was statistically superior to the one of the doctors only in treatment. Conclusion: it is of the utmost importance that FHT professionals are prepared to meet the demand of patients with signs and symptoms compatible with TMD.(AU)

Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brazil Networks Programme.

Telehealth has been applied in the Unified Health System (SUS) as a tool for qualifying professionals and improving the healthcare provided to the population served by the system. The aim of the present study was to evaluate the impact of teleconsultations on the qualifications of the clinical approach of the oral health teams involved in primary health care (PHC) in the state of Rio Grande do Sul under the Telehealth Brazil Networks Programme. The sample population of the study was composed of 285 dentists and 132 oral health assistants belonging to the Family Health Teams. A chi-square test was used to investigate possible associations between the absolute number of teleconsultations performed and several independent variables, namely, gender, age, dental specialty, time since graduation, time working in the Family Health Strategy (FHS), employment status, type of training institution, familiarity with information technology, and work satisfaction at the health facility. The level of significance was p < 0.05. Use of the oral health teleconsultation service led to a reduction of more than 45% in the number of referrals to other levels of care. However, no significant association was found between the number of teleconsultations and the independent variables analysed. The use of teleconsultations proved to be a powerful tool for professional training, for increasing the effectiveness of PHC, and for improving the oral healthcare provided.

Association between oxidative stress and temporomandibular joint dysfunction: A narrative review.

BACKGROUND: The role of oxidative stress in temporomandibular disorders (TMDs) has been studied using synovial fluid, to evaluate oxidative stress (im)balance and its potential role in the onset and/or progression of the disease. OBJECTIVE: This review aimed to evaluate the association between oxidative stress markers and the etiopathogenesis of TMJ dysfunction by means of synovial fluid analysis. METHODS: Two independent reviewers searched the electronic databases from inception to March 2019: PubMed/MEDLINE, LILACS, SciELO, EMBASE, TRIPDATABASE, SCOPUS, and Google Scholar. The following key search terms were used: Temporomandibular Joint Disorders OR Temporomandibular Joint Disc OR Temporomandibular Joint Dysfunction Syndrome OR Temporomandibular Joint OR Facial Pain AND Free Radicals OR Oxidative Stress. Data were extracted from the selected articles, including study design, sample profile, TMJ disease reported, diagnostic method, reactive oxygen and nitrogen species evaluated, enzymatic and non-enzymatic antioxidants evaluated, and techniques used to measure free radicals and antioxidants. RESULTS: After title and abstract screening of 6974 results, and full-text reading, 19 studies were included. All selected articles were cross-sectional observational studies. Enzymatic and non-enzymatic antioxidant defences appeared to be reduced in these patients, resulting in the establishment of the oxidative stress process. In addition, the studies showed a positive correlation between the severity of the intra-articular TMD and the increase in oxidative damage. CONCLUSION: The establishment of oxidative stress, whether by an increase in reactive oxygen/nitrogen species or by a decrease in antioxidant defences, or a combination of both, may be associated with the establishment and maintenance of intra-articular damage.

Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brazil Networks Programme

Abstract Telehealth has been applied in the Unified Health System (SUS) as a tool for qualifying professionals and improving the healthcare provided to the population served by the system. The aim of the present study was to evaluate the impact of teleconsultations on the qualifications of the clinical approach of the oral health teams involved in primary health care (PHC) in the state of Rio Grande do Sul under the Telehealth Brazil Networks Programme. The sample population of the study was composed of 285 dentists and 132 oral health assistants belonging to the Family Health Teams. A chi-square test was used to investigate possible associations between the absolute number of teleconsultations performed and several independent variables, namely, gender, age, dental specialty, time since graduation, time working in the Family Health Strategy (FHS), employment status, type of training institution, familiarity with information technology, and work satisfaction at the health facility. The level of significance was p < 0.05. Use of the oral health teleconsultation service led to a reduction of more than 45% in the number of referrals to other levels of care. However, no significant association was found between the number of teleconsultations and the independent variables analysed. The use of teleconsultations proved to be a powerful tool for professional training, for increasing the effectiveness of PHC, and for improving the oral healthcare provided.