Effect of silver nanoparticles associated with fluoride on the progression of root dentin caries in vitro.

OBJECTIVES: To assess the anti-proteolytic effect and potential to inhibit dentin root caries progression of a silver nanoparticle and fluoride solution (CNanoF) in comparison to silver diamine fluoride (SDF). METHODS: 48 specimens of root dentin artificial caries lesion were treated with 38% SDF, CNanoF, CNano or F (n = 6 per group). Ph cycling with demineralization and remineralization solutions simulated caries lesion progression. In addition, specimens were incubated with or without bacterial collagenase in the remineralization solution to induce dentin proteolytic degradation. Dentin degradation was assessed by weight loss rate and hydroxyproline (Hyp) release. Changes in cross-sectional microhardness, and lesion permeability and collagen integrity as determined by confocal laser scanning microscopy indicated potential for further demineralization inhibition. The effect of the solutions on the activity of metalloproteinases (MMP) -2 and -9 was also investigated. Statistical analysis consisted of ANOVA, Kruskal-Wallis, and linear mixed models with post-hoc pairwise Tukey, Dunn, and t-tests (α = 0.05). RESULTS: Treatment with SDF resulted in lower weight loss rate than did other solutions, but all groups showed similar Hyp release (p = 0.183). SDF resulted in greater microhardness at superficial layers of the caries lesions (p<0.05), while there were no differences among CNanoF, CNano, and F. Lesion permeability was similar among all groups after pH cycling (p>0.05), with or without the use of collagenase (p = 0.58). No statistically significant difference was noted among solutions regarding collagen integrity after pH cycling; however, SDF-treated dentin had a significant decrease in collagen integrity when collagenase was used (p = 0.003). Interestingly, only SDF was able to completely inactivate MMP-2 and -9. CONCLUSIONS: CNanoF and SDF both potentially prevent dentin degradation during caries lesion progression in vitro; however, SDF was more effective at inhibiting further tissue demineralization.

Evaluating changes in the color and luminosity of dental enamel after orthodontic treatment: A clinical study.

The aims of this clinical study were to evaluate the Color change - ΔE (based on spectrophotometry and visual analysis) and luminosity - L* (based on spectrophotometry) of dental enamel surface (after orthodontic treatment) around the area where orthodontic brackets were fixed, based on different cementing materials such as a resin (R group) and resin-modified glass ionomer cement (RMGIC group). The split-mouth study initially comprised 14 patients. Orthodontic brackets were fixed to the upper central incisors with resin or RMGIC. The color of the buccal surface of each tooth was measured through spectrophotometry and visual examination before the bracket-fixation process. Four individuals were excluded during the follow-up; thus 10 patients were evaluated (n=10). Brackets were removed after 12 months of orthodontic treatment, tooth color measurement and visual examination were performed again, and Adhesive Remaining Index (ARI) was also measured. ΔE and L* results were subjected to Student's t-test and by repeated-measures analysis of variance, respectively (α=0.05). ARI data were analyzed in percentages. There was statistically significant difference in ΔE between groups; the R group showed statistically higher values of L* after orthodontic treatment. ARI of 2 and 3 prevailed in the RMGIC group, whereas the R group presented 0 and 1. After orthodontic treatment, the RMGIC group presented smaller changes in ΔE, and the increase in the white scale was observed on the enamel surface around the area where brackets were fixed in the R group. The visual analysis did not show color change on the evaluated teeth.

Evaluating changes in the color and luminosity of dental enamel after orthodontic treatment: A clinical study

Abstract The aims of this clinical study were to evaluate the Color change - ΔE (based on spectrophotometry and visual analysis) and luminosity - L* (based on spectrophotometry) of dental enamel surface (after orthodontic treatment) around the area where orthodontic brackets were fixed, based on different cementing materials such as a resin (R group) and resin-modified glass ionomer cement (RMGIC group). The split-mouth study initially comprised 14 patients. Orthodontic brackets were fixed to the upper central incisors with resin or RMGIC. The color of the buccal surface of each tooth was measured through spectrophotometry and visual examination before the bracket-fixation process. Four individuals were excluded during the follow-up; thus 10 patients were evaluated (n=10). Brackets were removed after 12 months of orthodontic treatment, tooth color measurement and visual examination were performed again, and Adhesive Remaining Index (ARI) was also measured. ΔE and L* results were subjected to Student's t-test and by repeated-measures analysis of variance, respectively (α=0.05). ARI data were analyzed in percentages. There was statistically significant difference in ΔE between groups; the R group showed statistically higher values of L* after orthodontic treatment. ARI of 2 and 3 prevailed in the RMGIC group, whereas the R group presented 0 and 1. After orthodontic treatment, the RMGIC group presented smaller changes in ΔE, and the increase in the white scale was observed on the enamel surface around the area where brackets were fixed in the R group. The visual analysis did not show color change on the evaluated teeth.

Resumo Os objetivos deste estudo clínico foram avaliar a alteração de cor - ΔE (baseada em espectrofotometria e análise visual) e luminosidade - L* (baseada em espectrofotometria) da superfície do esmalte dentário (após tratamento ortodôntico) ao redor da área onde os braquetes ortodônticos foram fixados, com base em diferentes materiais de cimentação, como resina (grupo R) e cimento de ionômero de vidro modificado por resina (grupo RMGIC). Estudo boca dividida foi inicialmente composto por 14 pacientes. Os braquetes ortodônticos foram fixados nos incisivos centrais superiores com resina ou RMGIC. A cor da superfície vestibular de cada dente foi mensurada por espectrofotometria e avaliada por exame visual antes do processo de fixação dos braquetes. Quatro indivíduos foram excluídos durante o acompanhamento; assim, 10 pacientes foram avaliados (n=10). Os braquetes foram removidos após 12 meses de tratamento ortodôntico, a mensuração da cor do dente e o exame visual foram realizados novamente, e o Índice de Remanescente do Adesivo (IRA) também foi mensurado. Os resultados ΔE e L* foram submetidos ao teste t de Student e à análise de variância para medidas repetidas, respectivamente (α=0.05). Os dados do ARI foram analisados em porcentagens. Houve diferença estatisticamente significativa no ΔE entre os grupos; o grupo R apresentou valores estatisticamente maiores de L* após o tratamento ortodôntico. O IRA 2 e 3 prevaleceu no grupo RMGIC, enquanto o grupo R apresentou 0 e 1. Após o tratamento ortodôntico, o grupo RMGIC apresentou menores alterações no ΔE e o aumento da escala branca foi observado na superfície do esmalte ao redor da área onde os braquetes foram fixados no grupo R. A análise visual não mostrou mudança de cor nos dentes avaliados.

Stability of early anterior open bite treatment: a 2-year follow-up randomized clinical trial.

This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.

Stability of early anterior open bite treatment: a 2-year follow-up randomized clinical trial

Abstract This 2-year-follow up study compared and evaluated the stability of early anterior open bite (AOB) treatment based on different appliances. Children from 7 to 10 years with Angle Class I, AOB larger than 1.0 mm and fully erupted maxillary and mandibular permanent central incisors were eligible. The initial sample was 99 patients distributed, by simple randomization, into four groups: BS (bonded spurs), CC (chincup), FPC (fixed palatal crib) and RPC (removable palatal crib). Cephalometric analysis was performed at baseline (T1), final (T2) and 2-year post-treatment (T3) by taking the overbite measurements as the main outcome. Blinding was possible to cephalometric analysis. At T3, with dropouts, there were 63 individuals, being BS (n=15; overbite 0.19 mm; 11.54 years; 10 female (F)/5 male (M)); CC (n=11; overbite -0.19 mm; 11.41 years; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 years; 15 F/6 M) and; RPC (n=16; overbite 0.73 mm; 11.67 years; 6 F/10 M). Changes in dentoskeletal variables and breaking deleterious oral habits during the follow up were statically analyzed with p<.05. Mandibular skeletal linear measurements and vertical dental components have gradually increased with age, manly at pubertal growth spurt and at the establishment of permanent dentition after treatment. Incisor teeth extrusion had impact on AOB correction and stability in 4 groups, which recorded a 1.15 mm-improvement of overbite after treatment (T3-T2). The experimental appliances were effective with stable results, being FPC the device recorded the highest AOB correction and the lowest patient withdrawal rate.

Resumo Os objetivos do presente estudo foram comparar e avaliar a estabilidade do tratamento precoce da mordida aberta anterior (MAA) com diferentes dispositivos. A amostra inicial foi composta por 99 pacientes randomizados em quatro grupos experimentais: BS - esporões colados; CC - mentoneira; FPC - grade palatina fixa; RPC - grade palatina removível. Análise cefalométrica foi realizada para avaliar os dados do período inicial (T1), final do tratamento (T2) e 2 anos após tratamento (T3), sendo a variável overbite o desfecho principal. Em T3, após perdas de seguimento, haviam 63 indivíduos, sendo BS (n=15; overbite 0.19 mm; 11.54 anos; 10 Feminino (F)/5 Masculino (M)); CC (n=11; overbite -0.19 mm; 11.41 anos; 8 F/3 M); FPC (n=21; overbite 1.23 mm; 11.44 anos; 15 F/6 M) e; RPC (n=16; overbite 0.73 mm; 11.67 anos; 6 F/10 M). Comparações das alterações nas variáveis dentoesqueléticas e abandono de hábitos bucais deletérios durante o tempo de acompanhamento foram estatisticamente analisados com p<.05. Medidas esqueléticas lineares mandibulares e componentes verticais aumentaram gradualmente com a idade, principalmente com o surto de crescimento puberal e estabelecimento da dentição permanente no pós-tratamento. O overbite foi significantemente melhorado durante o tratamento, permanecendo estável com alterações positivas. A extrusão dos incisivos impactou na correção da MAA e estabilidade nos 4 grupos, que registraram uma melhora de 1.15 mm no pós-tratamento (T3-T2). Com suas limitações, todos dispositivos experimentais foram efetivos e mostraram resultados estáveis no tratamento precoce da MAA, sendo que a FPC apresentou a maior correção da MAA e o menor índice de desistência.

Can silver diamine fluoride or silver nanoparticle-based anticaries agents to affect enamel bond strength?

OBJECTIVES: The aim of the current study is to investigate the effect of different anticaries agents, such as experimental agents based on silver nanoparticles (SNPs) and silver diamine fluoride (SDF), on the micro-shear bond strength (µ-SBS) of composite resin applied to intact enamel (IE) or demineralized enamel (DE). MATERIALS AND METHODS: Sixty dental enamel fragments were collected from human third molars and categorized into 6 groups (n = 10): positive control (IE), negative control (DE), IE + SDF, DE + SDF, IE + SNP and DE + SNP. Samples from DE, DE + SDF and DE + SNP groups were subjected to pH cycling; superficial microhardness test was performed to confirm demineralization. Resin composite build-ups were applied to the samples (0.75-mm diameter and 1-mm height) after the treatments (except for IE and DE groups); µ-SBS was also evaluated. Samples were analyzed under a stereomicroscope at 40× magnification to identify failure patterns. Data were subjected to one-way analysis of variance, followed by Tukey's and Dunnett's tests (p < 0.05). RESULTS: There was no significant difference among the IE, IE + SNP, DE + SDF, and DE + SNP groups. The IE + SDF and DE groups recorded the highest and the lowest µ-SBS values, respectively. Adhesive-type failures were the most frequent for all treatments. CONCLUSIONS: Anticaries agents did not have a negative effect on the µ-SBS of composite resin when it was used on IE or DE.

Does Pigment Incorporation into Regular Composite Resins for Posterior Buildups Alter Their Bond Strength?

Posterior build-ups are auxiliary devices to orthodontic treatment which are made with resin-based or glass ionomer composites. Their removal requires care to protect the tooth surface, therefore, pigmented materials are preferred for a better visualization. This study proposed a pigmentation experimental technique of a regular composite resin, evaluating the microshear bond strength test (µ-SBT) of this experimental pigmented resin and comparing with a blue-colored polyacid-modified composite resin, used for posterior buildups. Forty-eight buccal and lingual surfaces of human teeth were used and randomly divided into 4 groups (n=12). The groups were divided into: C (control), regular composite resin; P, regular composite resin pigmented; UBL, Ultra Band Lok™; OB, Ortho Bite™. The composites were bonded using a matrix to obtain microcylinders and prepared for each experimental groups. The samples were then stored in distilled water for 24h at 37°C followed by a µ-SBT. The types of bond failures were evaluated using a stereoscopic magnifying glass (10×). The data were analyzed by ANOVA with Fisher post hoc and Dunnett´s test. Means of µ-SBT± standard deviation (MPa) were: C (39.98a±13.0), P (40.09a± 14.3); UBL (33.26ab±8.6); OB (28.70b±5.5). The most prevalent type of failure was adhesive (80.4%). Further, was not observed a statistically significant correlation between the bond strength values and failure patterns. The pigmentation of a commercially available resin did not alter the µ-SBT and exhibited similar adhesiveness as a polyacid-modified composite resin.

Does pigment incorporation into regular composite resins for posterior buildups alter their bond strength?

Abstract Posterior build-ups are auxiliary devices to orthodontic treatment which are made with resin-based or glass ionomer composites. Their removal requires care to protect the tooth surface, therefore, pigmented materials are preferred for a better visualization. This study proposed a pigmentation experimental technique of a regular composite resin, evaluating the microshear bond strength test (µ-SBT) of this experimental pigmented resin and comparing with a blue-colored polyacid-modified composite resin, used for posterior buildups. Forty-eight buccal and lingual surfaces of human teeth were used and randomly divided into 4 groups (n=12). The groups were divided into: C (control), regular composite resin; P, regular composite resin pigmented; UBL, Ultra Band Lok™; OB, Ortho Bite™. The composites were bonded using a matrix to obtain microcylinders and prepared for each experimental groups. The samples were then stored in distilled water for 24h at 37°C followed by a µ-SBT. The types of bond failures were evaluated using a stereoscopic magnifying glass (10×). The data were analyzed by ANOVA with Fisher post hoc and Dunnett´s test. Means of µ-SBT± standard deviation (MPa) were: C (39.98a±13.0), P (40.09a± 14.3); UBL (33.26ab±8.6); OB (28.70b±5.5). The most prevalent type of failure was adhesive (80.4%). Further, was not observed a statistically significant correlation between the bond strength values and failure patterns. The pigmentation of a commercially available resin did not alter the µ-SBT and exhibited similar adhesiveness as a polyacid-modified composite resin.

Resumo Levantes de mordida posterior são dispositivos para o tratamento ortodôntico confeccionados com resinas compostas ou materiais ionoméricos. Cuidado com a remoção destes se faz necessário para proteção da superfície dentária; para tanto, materiais pigmentados são preferidos por proporcionar melhor visualização. Este estudo propõe uma técnica de pigmentação experimental de resinas compostas convencionais, avaliando a resistência ao microcisalhamento (µ-SBT) na interface de união da resina experimental e superfície de esmalte dental e comparando-a com materiais comercialmente disponíveis para a confecção de levantes de mordida. Quarenta e oito superfícies de dentes humanos foram selecionadas aleatoriamente e divididos em quatro grupos (n=12), de acordo com o material adesivo utilizado: C (Controle, resina composta convencional); P (pigmentação experimental da resina composta convencional); UBL (Ultra Band Lok®); OB (Ortho Bite®). Microcilindros foram preparados para cada tipo de compósito utilizando uma matriz de silicone. As amostras foram mantidas em água destilada por 24h a 37°C, antes da realização do µ-SBT. Os padrões de fratura foram avaliados através de uma lupa estereoscópica com magnificação de 10x. ANOVA com pós teste de Fisher e teste de Dunnett foram utilizados para avaliar os dados. As médias obtidas do µ-SBT ± desvio padrão (MPa) foram: C (39.98a±13.0), P (40.09a± 14.3); UBL (33.26ab±8.6); OB (28.70b±5.5). O tipo de fratura mais prevalente foi a adesiva (80.4%). Além disso, não foi observada correlação estatisticamente significante entre os valores de resistência de união e os padrões de fratura. A técnica de pigmentação experimental não alterou os resultados de µ-SBT da resina composta convencional e mostrou adesividade semelhante à dos compósitos modificados por poliácidos utilizados neste estudo.

Supernumerary: the Importance of Early Orthodontic Treatment / Supranumerário: a Importância do Tratamento Ortodôntico Precoce

The presence of supernumeraries may lead to irruptive problems, such as impacted teeth, functional and aesthetic disorders. The present study describes two clinical cases, with anterior teeth eruption disorders caused by additional dental elements, treated early. Patients presented with aesthetic involvement, with delay in the emergence of the upper incisors. The clinical and radiographic examinations detected the presence of obstacles to the teeth eruption. Early treatment with 2x4 appliance was realized, followed by final corrective orthodontics. After restoration of the dimension for retained teeth, there was spontaneous eruption in clinical case 1 and need of traction in clinical case 2. When patients reached the complete permanent dentition, a corrective phase was performed with the objective of detailing the dental occlusion and finishing the treatment. The early diagnosis of teeth impacted and supernumerary, provide the achievement of adequate occlusion and positive aesthetic of patients, with good prognosis, avoiding psychological and functional problems caused by absence of anterior teeth. (AU).

A presença de supranumerários pode ocasionar problemas irruptivos, como impacção de dentes, desordens funcionais e estéticas. O presente trabalho descreve dois casos clínicos abordados precocemente, com alterações na irrupção de dentes anteriores devido a presença de supranumerários. Os pacientes apresentavam queixas estéticas, com atraso no aparecimento dos incisivos superiores. Os exames clínico e radiográfico detectaram a presença de barreiras irruptivas. Realizou-se tratamento precoce com auxílio da mecânica 4x2, seguido pela ortodontia corretiva final. Após etapa de restabelecimento da dimensão para os dentes retidos, houve irrompimento espontâneo no caso clínico 1 e necessidade de tracionamento no caso clínico 2. Quando pacientes atingiram a dentição permanente completa, realizou-se uma fase corretiva com o objetivo de detalhamento da oclusão dentária e finalização do tratamento. O diagnóstico precoce de impacção dentária e detecção de supranumerários favoreceu a restituição de oclusão adequada e estética dos pacientes, com prognóstico muito favorável, evitando problemas psicológicos e funcionais provocados pela ausência de dentes anteriores. (AU).

Stability of early treatment of anterior open bite: clinical performance of bonded lingual spurs.

Anterior open bite (AOB) is a malocclusion that generates aesthetic, speech, feeding and psychological issues, a fact that emphasises the importance of conducting early treatments to fix the disorder. Finger-sucking, pacifiers and oral habits are the main aetiological factors of AOB; thus, it is necessary to apply interceptive treatments focused on correcting and improving bite stability during childhood in order prevent the need of undergoing advanced therapy. The aim of this article is to present the early diagnosis of aetiological factors causing severe AOB and the interceptive treatment based on the use of bonded lingual spurs for one year. Results showed excellent bite stability after two years of follow-up; in other words, the proper treatment applied for the recommended growth and developmental periods enabled case stability.

Dimensional Stability of Alginates Molds Tridimentionally Scanned / Estabilidade Dimensional de Moldes de Alginatos Escaneados Tridimensionalmente

Alginate is among the most used materials in dentistry to create teeth negative printing and reproduction. The goal of this study was to compare dimensional changes of alginate scanned impression materials. Thirty impressions of a standard typodont were performed using three types of alginate (Hydrogum 5; Jeltrate Plus and Avagel). The impressions were scanned by the scanner 3Shape R700T and scans were performed immediately after molding. The analysis of digital models were performed at OrthoAnalyzer ™ 3D software. Measurements were carried out in relation to the transverse dimension (intercanine, interpremolares and intermolar). Method error was evaluated through the Intraclass Correlation Coefficient (ICC) and Bland-Altman. One-way ANOVA, Dunnet Post-test were used to compare the different groups in relation to Typodont (gold standard) for the different outcome variables. The data were tabulated in Statistical Package for Social Sciences version 20.0 and Minitab 17.0 softwares to compare groups. The significance level was 5%. The posterior transverse variables (D1PM, D2PM and DM) presented a statistically significant difference regarding the gold standard (Typodont) for the plaster models performed after the Avagel molding. In the digital models performed just after molding, only in DM, the Avagel material group presented values statistically higher than the control group. The alginates Hydrogum 5 and Jeltrate Plus presented dimensions closer to the gold standard.(AU).

O alginato está entre os materiais de moldagem mais utilizados na Odontologia para criar impressão e reprodução negativa dos dentes. O objetivo desse trabalho foi comparar alterações transversais de três marcas comerciais de alginato (Hydrogum, Jeltrate e Avagel) em moldes de alginatos. Trinta moldes de um Typodont padrão foram realizados, utilizando três tipos de alginato (Hydrogum 5; Jeltrate Plus e Avagel). Os moldes foram escaneados por meio do scanner 3Shape R700T e os escaneamentos realizados logo após a moldagem e logo após a obtenção dos modelos de gesso. As análises dos modelos digitais foram realizadas no software OrthoAnalyzer™ 3D. Foram realizadas mensurações em relação à discrepância transversal (inter-caninos, inter-primeiro pré-molar, inter-segundo pré-molar e inter-molares). O erro do método foi avaliado por meio do Coeficiente de Correlação Intraclasse (CCI) e Bland-Altman. Utilizou-se Análise de Variância (one-way ANOVA, Pós-teste Dunnet) para comparação dos diferentes grupos em relação ao typodont (padrão-ouro) para as diferentes variáveis de desfecho. A análise estatística foi realizada nos programas Statistical Package for Social Sciences versão 20.0 e no programa Minitab 17.0 para comparação dos grupos. O nível de significância foi de 5%. As variáveis transversais posteriores (D1PM; D2PM e DM) apresentaram diferença estatisticamente significante em relação ao padrão-ouro (manequim) para os modelos de gesso realizados após a moldagem com Avagel. Nos modelos digitais realizados logo após a moldagem, apenas na DM, o grupo do material Avagel apresentou valores estatisticamente maiores do que o grupo controle. Os alginatos Hydrogum 5 e Jeltrate Plus apresentaram dimensões mais próximas do padrão-ouro.(AU).

Uso e Necessidade de Prótese Dentária em Idosos de Londrina, Paraná / Use and need of Dental Prosthesis in the Elderly in Londrina, Paraná

Este estudo avaliou a necessidade e uso de prótese entre 504 idosos independentes, cadastrados nas Unidades Básicas de Saúde (UBS) do município de Londrina, Paraná. As características sociodemográficas foram também analisadas. A situação quanto às próteses dentárias foi avaliada a partir de informações sobre seu uso e necessidade nos arcos superior e inferior. As observações ao exame levaram em conta os códigos e critérios preconizados pela Organização Mundial de Saúde (OMS). As informações sociodemográficas foram obtidas pela aplicação de um formulário estruturado, avaliando: sexo, idade, nível de escolaridade, estado conjugal, tipo de moradia, número de pessoas na casa, renda familiar. A idade dos 504 idosos avaliados envolveu entre 60 e 75 anos, sendo a maioria entre 65 e 74 anos (54,2%), do gênero feminino (66,3%), de procedência rural (53,8%), cor branca (62,1%) e com até 4 anos de estudo (80,6%). Destes idosos, 15,1% não usam qualquer tipo de prótese, 24,6% usam em uma arcada e 60,3% usam algum tipo de prótese nas duas arcadas. Quanto à necessidade de prótese, observou-se que 21,6% não necessitam de qualquer tipo de prótese, 19,4% necessitam em uma arcada e a maioria (58,9%) necessita nas duas arcadas. Somente houve dependência, estatisticamente significante, entre as variáveis de necessidade de prótese dentária e gênero, cor da pele e procedência. Sendo assim, pode-se concluir que a prevalência de necessidade de prótese é acentuada e existe uma demanda populacional para reabilitação protética. (AU)

This study evaluated the need and use of prosthesis among 504 independent elderly, registered in the Basic Health Units (BHU) of the city of Londrina, Paraná. Sociodemographic characteristics were also evaluated. The situation regarding dental prosthesis was evaluated based on information about their use and need in the upper and lower arches. The observations were performed according to the codes and criteria recommended by the World Health Organization (WHO). The sociodemographic information was obtained by applying a structured form, evaluating: gender, age, educational level, marital status, housing type, number of people living in the residence, family income. The age of the 504-elderly studied was between 65 and 74 years (54.2%), female (66.3%), rural origin (53.8%), white skin color (62.1%) and up to 4 years of schooling (80.6%). Of these elderly, 15.1% do not use any type of prosthesis, 24.6% use only in one dental arch and 60.3% use some type of prosthesis in both arches. Regarding the need of prosthesis, it was observed that 21.6% do not require any type of prosthesis, 19.4% need in one arch and the majority (58.9%) needs in both arches. There was only statistically significant dependence among the variables of need for dental prosthesis and gender, skin color and origin. Thus, it can be concluded that the prevalence of need for prosthetic is high and there is a population demand for prosthetic rehabilitation. (AU)

Em defesa do sistema único de saúde: discursos de vereadores, conselheiros e profissionais de saúde / In defense of unified health system: discourses of health professionals, municipal counselors and aldermen

O objetivo deste estudo foi avaliar as percepções de conselheiros municipais de saúde, profissionais da atenção primária e vereadores sobre o Sistema Único de Saúde e a Política Nacional da Atenção Básica. A partir destes, pretende-se analisar seu envolvimento para melhoria do sistema e verificar a participação em projetos que fomentem discussões sobre os desafios desta temática. A investigação teve abordagem qualitativa, sendo os dados coletados por meio de 28 entrevistas semi estruturadas realizadas entre novembro e dezembro de 2010, no município de Londrina-PR. Entre os grupos entrevistados fica evidente maior aproximação conceitual dos profissionais de saúde, quanto as políticas de saúde pública. Entretanto, todos demonstram equívocos e distância quanto aos princípios e diretrizes do Sistema Único de Saúde, bem como das disposições da Política Nacional de Atenção Básica. As considerações apontadas indicam foco na doença, priorização das consultas médicas e maior valorização das estruturas hospitalares. Ainda que conceituada com equívocos, são percebidas limitações nos serviços de saúde pública. Contudo, as proposições para mudança do quadro permanecem com conotações distorcidas. Nestes grupos não foram encontrados projetos ou ações práticas para melhoria do cenário da saúde pública. Conclui-se a necessidade de apropriação de conhecimento teórico sobre as políticas que envolvem a organização da saúde, pelos atores, para que sejam mudados os paradigmas do modelo tradicional e, a atenção básica seja valorizada e compreendida como forma de organização do sistema.

The objective of this study was to evaluate the perceptions of municipal health counselors, primary care professionals and aldermen about the Unified Health System and the Brazilian Primary Care Policy. From these, we intend to analyze their involvement to improve the system and verify participation in projects that foster discussions about the challenges of this issue. The investigation took a qualitative approach, the data being collected through 28 semi-structured interviews conducted between November and December 2010 in Londrina-PR. Between the interviewed groups, it becomes apparent that health professionals have better conceptual approach of public health policies. However, all groups demonstrate misconceptions and distance for the principles and guidelines of the Unified Health System, as well as provisions of the Brazilian Primary Care Policy. The findings pointed indicate focus on disease, prioritization of medical consultations and greater value of hospital structures. Although conceptualized with misconceptions, limitations are noted at the public health services. However, the proposals to change the frame remain with distorted connotations. In these groups no practical actions or projects were found to improve the public health scenario. It is concluded the need for ownership of theoretical knowledge about policies involving health organization, by stakeholders, to change the paradigms of the traditional model to the Primary Health care become valued and understood as form of organization of the system.