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1.
J Am Dent Assoc ; 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31813471

RESUMO

BACKGROUND: The authors of this systematic review and meta-analysis aimed to evaluate the effect of different anesthetics on the efficacy of inferior alveolar nerve block (IANB) in patients with irreversible pulpitis. TYPES OF STUDIES REVIEWED: The authors conducted a search of MEDLINE databases (PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences Literature, and Brazilian Library of Dentistry). There was no restriction on publication year or idiom. The gray literature was also explored. The authors included only randomized clinical trials that compared different anesthetics in the efficacy of IANB in patients with irreversible pulpitis. The risk of bias was evaluated by using the Cochrane Collaboration's tool. A random-effects Bayesian mixed treatment comparison model was used to compare different anesthetic solutions in randomized clinical trials with low or unclear risk of bias. Heterogeneity was assessed by using Cochran Q test and I2 statistics. Quality of evidence was assessed by using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: A total of 7,981 studies were identified; only 16 met the eligibility criteria, and they were all meta-analyzed. A significant difference was observed in the pair lidocaine versus articaine, with higher success with articaine (risk ratio, 0.76; 95% confidence interval, 0.63 to 0.88) in the mixed treatment comparison analysis, as this comparison was graded as high-quality evidence. The probability of success for each treatment was 73% for articaine, 57% for prilocaine, 55% for mepivacaine, 53% for bupivacaine, and 12% for lidocaine. This ranking was considered high quality of evidence. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The use of articaine can increase the IANB success rate in patients with irreversible pulpitis. Among the anesthetic solutions, lidocaine was the least effective.

2.
Clin Oral Investig ; 23(10): 3673-3689, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31468261

RESUMO

OBJECTIVES: A systematic review and meta-analysis were performed to answer this research question: "Does combined in-office (IO) and at-home (AH) bleaching produce improved color change and lower tooth sensitivity (TS) better than solely AH or IO bleaching in adults?" MATERIAL AND METHODS: Randomized controlled trials in adults that compared combined versus sole application bleaching were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change in shade guide units (∆SGU) and with a spectrophotometer (∆E*), risk, and intensity of TS, using the random effects model. Heterogeneity was assessed with Cochran's Q test and I2 statistics. GRADE assessed the quality of the evidence. PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, SIGLE, IADR abstracts, unpublished, ongoing trial registries, dissertations, and theses were searched on August 28, 2017 (updated on January 29, 2019). RESULTS: Twelve studies remained. Two were considered to have low RoB. For combined vs. IO bleaching, no significant difference for ∆E*, ∆SGU, and risk of TS were observed; data were not available to analyze the intensity of TS. For combined vs. AH bleaching, no significant difference for ∆E*, ∆SGU, but lower TS to risk (RR 1.40, 95% 1.10 to 1.80) and intensity (MD 1.40, 95% CI 0.18 to 2.63) were detected for AH bleaching. Quality of evidence was graded as low or very low in all meta-analyses. CONCLUSION: Lower risk and intensity of TS was observed for the solely AH group without jeopardizing color change. However, more studies are still encouraged due to the low quality of evidence for most of the outcomes. CLINICAL RELEVANCE: If clinicians are to choose between combined or sole AH bleaching, the solely AH may be preferable; combined bleaching may potentiate the risk of TS without benefits in color change. For combined or sole IO bleaching, no important clinical difference in color change and risk of TS were detected; however, intensity of TS could not be compared due to lack of data. Further studies should be conducted due to the low/very low quality of the evidence.

3.
Clin Oral Investig ; 23(4): 1499-1512, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30767069

RESUMO

OBJECTIVES: A systematic review and a network meta-analysis were performed to answer the following research question: "Is there any light-activation protocol capable of improving color change efficacy when associated with an in-office bleaching gel in adults?" MATERIAL AND METHODS: A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE without date and/or language restrictions in April 23, 2017 (updated on March 30, 2018). IADR abstracts (1990-2018), unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials conducted in adults that included at least one group treated with in-office dental bleaching with light activation were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A random-effects Bayesian-mixed treatment comparison (MTC) model was used to combine light-activated versus light-free in-office bleaching with direct light-free comparison trials. A meta-analysis with independent analysis (high- and low-concentrate hydrogen peroxide [HP]) was conducted for color change (∆E*, ∆SGU). RESULTS: After the removal of duplicates, title, and abstract screening, 28 studies remained. Nine were considered to be at a low RoB, five were at a high RoB, and the remaining were at an unclear RoB. The MTC analysis showed no significant difference in color change (ΔE* and ΔSGU) between light-activation protocols and light-free in-office bleaching, regardless of the HP concentration in the efficacy of the bleaching. CONCLUSION: No type of light-activated in-office bleaching was superior to light-free in-office bleaching for both high- and low-concentrate in-office bleaching gels (PROSPERO-CRD42017078743). CLINICAL RELEVANCE: Although many times dental professionals use "laser whitening" as a form of marketing, this study confirmed that no type of light-activation for in-office bleaching can improve the bleaching efficacy.

4.
Rev. odontol. UNESP (Online) ; 48: e20180096, 2019. tab
Artigo em Português | LILACS-Express | ID: biblio-991493

RESUMO

Resumo Introdução Com o avanço estético e tecnológico dos compósitos restauradores diretos, a procura pela Odontologia Éstética tem aumentado. Objetivo Avaliar o manchamento e a rugosidade superficial dos compósitos Filtek Z350 (3M ESPE) e Filtek Bulk Fill (3M ESPE), polidos por diferentes sistemas: Disco SofLex e Disco SofLex diamantado espiral (ambos da 3M ESPE), após exposição repetitiva ao café. Material e método Neste estudo in vitro, um total de 80 discos de resina foi confeccionado, com 40 espécimes para cada compósito avaliado. Os espécimes foram ainda subdivididos em grupos (n=10) de acordo com o método de polimento ‒ SofLex e SofLex diamantado ‒ e a solução de armazenamento ‒ água deionizada (controle) e café (experimental). Após 24 horas de armazenamento em água deionizada, foi realizada a avaliação de cor e rugosidade inicial, bem como a execução dos protocolos de polimento testados. Posteriormente, os espécimes foram expostos ao processo de manchamento em café e água deionizada durante 42 dias. Após esse período, a cor e a rugosidade foram reavaliadas. Resultado A análise estatística paramétrica evidenciou que o manchamento superficial foi influenciado significativamente pelos fatores compósito e solução, mas não pelo fator polidor ou ainda por qualquer interação entre os fatores. Para o fator compósito, Filtek Z350 exibiu maior manchamento, e para o fator solução, foi observado maior manchamento para o café. Já na análise de rugosidade, não houve diferenças significativas. Conclusão Independentemente do sistema de polimento, a solução experimental de café alterou a cor de ambos os compósitos avaliados e verificou-se que a rugosidade não foi alterada.


Abstract Introduction The aesthetic and technological development of direct restorative composites has increased the search for an aesthetic dentistry. Objective Assess the surface staining and roughness of composites: Filtek Z350 (3M ESPE) and Filtek Bulk Fill (3M ESPE), polished by different systems: Disco SofLex and Disco SofLex diamond spiral (both from 3M ESPE), after repeated exposure to coffee. Material and method This study was carried out together with 80 resin discs were made, 40 articles for each study evaluated. The compounds were divided into groups (n = 10) according to the polishing method - Softex and Softex diamond, storage solution - deionized water (control) and coffee (experimental). After 24 hours of storage in deionized water, a color evaluation was performed initially, as well as the execution of the polishing protocols tested. Subsequently, the specimens were exposed to the staining process in coffee and deionized water for 42 days. After this period, the color and roughness were assessed again. Result The parametric statistical analysis showed that surface staining was affected significantly by the composite and solution factors, but not by the polisher factor or by any interaction among factors. For the composite factor, Filtek Z350 showed greater staining and for the solution factor, coffee showed greater staining. In contrast, the roughness analysis did not show significant differences. Conclusion Regardless of the polishing system, differences in composite composition affect the color stability of the composites; and coffee changes the color of both; the roughness was not altered.

5.
Rev. odontol. UNESP (Online) ; 47(6): 354-359, nov.-dez. 2018. tab
Artigo em Português | LILACS-Express | ID: biblio-985727

RESUMO

Resumo Introdução Com a dificuldade de obtenção de dentes humanos para estudos in vitro, autores relatam e preconizam o uso de dentes extraídos de arcadas bovinas para testar técnicas de diferentes segmentos da Odontologia. Entretanto, para que as pesquisas tenham eficácia científica, estes dentes necessitam tratamento adequado para manter suas características e simular condições in vivo. Objetivo Analisar a resistência de união (RU) adesiva à dentina em dentes bovinos restaurados com adesivo convencional Adper® Single Bond 2 (3M ESPE, St. Paul, MN, EUA) e compósito Opallis Flow (Dentscare LTDA., Joinville, SC, BRA), tendo como fatores de estudo solução e tempo de armazenamento. Metodologia As amostras foram congeladas sob armazenamento em 2 soluções: timol 0,1% e cloramina 0,5%, em 4 diferentes períodos: 1 semana, 1 mês, 3 meses e 6 meses. Foram obtidos 8 grupos experimentais (n=64) e 1 grupo controle (n=8), totalizando 9 grupos. Após o período de restauração, os dentes foram armazenados em estufa a 37 ºC, imersos em água destilada e, em seguida, testados em máquina de ensaios universal (EMIC DL 500, São José dos Pinhais, PR, Brasil), com análise estatística dos resultados. Resultado A comparação entre os grupos experimentais e controle mostrou diferença estatisticamente significante (p<0,05) para o armazenamento das amostras em timol durante o período de 1 mês. Conclusão Os fatores solução e tempo foram capazes de alterar a resistência de união adesiva à dentina bovina, observando-se que a maior média de RU foi obtida após o armazenamento na solução timol durante 1 mês (p=0,004).


Abstract Introduction With the difficulty of obtaining human teeth for in vitro studies, authors report and recommend the use of teeth extracted from bovine arches to test techniques from different segments of Dentistry. However, for research to be scientifically effective, these teeth need adequate treatment to maintain their characteristics and to mimic conditions in vivo. Objective Analyze the adhesive bond strength (RU) to dentin in bovine teeth restored with Adper® Single Bond 2 (3M ESPE, St Paul, MN, USA) and Opallis Flow composite adhesive (Dentscare LTDA, Joinville, SC, BRA), taking as study factors solution and storage time. Methodology The samples were frozen under storage in 2 solutions: 0.1% thymol and 0.5% chloramine, in 4 different periods: 1 week, 1 month, 3 months and 6 months. Eight experimental groups (n = 64) and one control group (n = 8) were obtained, totaling 9 groups. After the restoration period, the teeth were stored in an incubator at 37ºC, immersed in distilled water and then tested in a universal testing machine (EMIC DL 500, São José dos Pinhais, PR, Brazil), with statistical analysis of the results. Result The comparison between the experimental and control groups showed a statistically significant difference (p <0.05) for the storage of thymol samples during the 1 month period. Conclusion Solution and time factors were able to change the adhesive bond strength to the bovine dentin, observing that the highest mean of RU was obtained after storage in the thymol solution for 1 month (p = 0.004).

6.
Rev. ABENO ; 18(3): 12-23, jul.-set. 2018. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-948490

RESUMO

O objetivo deste trabalho foi avaliar a percepção de docentes do curso de Odontologia quanto as principais dificuldades enfrentadas e as habilidades imprescindíveis para o exercício do magistério superior. Para tal, foi realizada uma pesquisa qualitativa com 47 professores do curso de Odontologia da Universidade Estadual de Ponta Grossa, divididos em dois grupos: a) tempo de atuação docente inferior a 5 anos; b) tempo de atuação docente maior que 5 anos. Após a validação do questionário, este foi encaminhado para os participantes da pesquisa responderem questões abertas sobre o exercício do magistério no ensino superior. Posteriormente à coleta dos dados, foi feita a análise descritiva das informações, exploração do material e interpretação dos resultados. Nos desafios enfrentados, os docentes com mais de 5 anos de atuação citaram a responsabilidade em formar um profissional, dificuldade em motivar os alunos e aquisição de segurança para docência como os principais. Por outro lado, docentes com atuação inferior a 5 anos apontaram o relacionamento com o aluno, insegurança profissional e obtenção do equilíbrio entre a teoria e a prática como principais desafios. Com relação às dificuldades enfrentadas atualmente, as respostas foram semelhantes para os dois grupos, sendo a falta de interesse dos alunos, falta de infraestrutura e de material de apoio para ministrar as aulas, as mais citadas. As habilidades mais mencionadas pelos professores como essenciais para o exercício da profissão incluíram a paciência, didática e necessidade de constante atualização. Pôde-se concluir que os professores enfrentam dificuldades na prática docente, independentemente do tempo de atuação (AU).


The objective of this study was to evaluate the perception of teachers of the Dentistry course regarding the main difficulties faced and the skills essential for the exercise of the higher education teaching profession. For that, a qualitative research was carried out with 47 professors of the Dentistry course at the State University of Ponta Grossa, divided into two groups: a) less than 5-year teaching experience; b) over 5-year teaching experience. After the validation of the questionnaire, it was sent to the participants of the research to answer open questions about teaching in higher education. After data collection, a descriptive analysis of the information, exploration of the material and interpretation of the results were carried out. Among the challenges faced, teachers with more than 5 years of work experience cited the responsibility to train a professional, difficulty motivating students and developing selfconfidence for teaching as the main points. On the other hand, teachers with less than 5 years of experience pointed out the relationship with the student, professional insecurity and obtaining a balance between theory and practice as the main challenges. With regard to the difficulties currently faced, the responses were similar for the two groups, namely, students' lack of interest, lack of infrastructure and support material to teach classes were the most cited. The most mentioned skills by the teachers as essential to the practice of the profession included patience, didactics and the need for constant updating. The results led to the conclusion that teachers face difficulties in teaching practice regardless of the time of performance (AU).


Assuntos
Humanos , Masculino , Feminino , Competência Profissional , Brasil , Educação Superior , Educação em Odontologia , Docentes de Odontologia/educação , Inquéritos e Questionários , Pesquisa Qualitativa , Educação Continuada/métodos , Avaliação Educacional/métodos
7.
J Dent ; 72: 64-70, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29551346

RESUMO

OBJECTIVES: Desensitizing agents are usually included in the composition of bleaching agents to reduce bleaching-induced tooth sensitivity (TS). This randomized clinical trial (RCT) evaluated the risk and intensity of TS and color change after at-home bleaching with a desensitizing-containing (3% potassium nitrate and 0.2% sodium fluoride) and desensitizing-free 10% carbamide peroxide (CP) gel (Whiteness Perfect, FGM). METHODS: A triple-blind, within-person RCT was conducted on 60 caries-free adult patients. Each participant used the gel in a bleaching tray for 3 h daily for 21 days in both the upper and lower dental arches. The absolute risk and intensity of TS were assessed daily through the 0-10 VAS and NRS scale for 21 days. Color change was recorded using shade guides (Vita Classical and Vita Bleachedguide) and the Easyshade spectrophotometer at baseline, weekly and 30 days after the end of the bleaching. The risk and intensity of TS were evaluated by the McNemar and Wilcoxon Signed Rank tests, respectively. Color change (ΔSGU and ΔE) were evaluated by the Mann-Whitney test and a paired t-test, respectively (α = 0.05). RESULTS: No difference in the TS and color change was observed (p > 0.05). CONCLUSIONS: The incorporation of potassium nitrate and sodium fluoride in 10% carbamide peroxide at-home bleaching gel tested in this study did not reduce the TS and did not affect color change (RBR-4M6YR2).


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/prevenção & controle , Clareadores Dentários/efeitos adversos , Clareamento Dental/efeitos adversos , Adolescente , Adulto , Peróxido de Carbamida/efeitos adversos , Cor , Sensibilidade da Dentina/etiologia , Feminino , Humanos , Peróxido de Hidrogênio/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nitratos/uso terapêutico , Compostos de Potássio/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Espectrofotometria , Clareamento Dental/métodos , Descoloração de Dente , Adulto Jovem
8.
J Dent ; 70: 1-13, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29289725

RESUMO

OBJECTIVE: A systematic review and meta-analysis were performed to answer the following research question: Does light-activated in-office vital bleaching have a greater whitening efficacy and higher tooth sensitivity (TS) in comparison with in-office vital bleaching without light when used in adults? DATA AND SOURCE: Only randomized clinical trials (RCTs) involving adults who had in-office bleaching with and without light activation were included. Controlled vocabulary and keywords were used in a comprehensive search for titles and abstracts in PubMed, and this search was adapted for Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE without restrictions in May 2016 and was updated in August 2017. IADR abstracts (1990-2016), unpublished- and ongoing-trial registries, dissertations, and theses were also searched. The risk-of-bias tool of the Cochrane Collaboration was used for quality assessment. The quality of the evidence was rated using the Grading of Recommendations: Assessment, Development, and Evaluation approach. Through the use of the random effects model, a meta-analysis with a subgroup analysis (low and high hydrogen peroxide concentration) was conducted for color change (ΔE*, ΔSGU) as well as the risk and intensity of TS. STUDY SELECTION: We retrieved 6663 articles, but after removing duplicates and non-relevant articles, only 21 RCTs remained. No significant difference in ΔE*, ΔSGU, and risk and intensity of TS was observed (p > .05). For ΔE and risk of TS, the quality of the evidence was graded as moderate whereas the evidence for ΔSGU and intensity of TS was graded as very low and low, respectively. CONCLUSION: Without considering variations in the protocols, the activation of in-office bleaching gel with light does not seem to improve color change or affect tooth sensitivity, regardless of the hydrogen peroxide concentration. (PROSPERO - CRD42016037630). CLINICAL RELEVANCE: Although it is commercially claimed that in-office bleaching associated with light improves and accelerates color change, this study did not confirm this belief for in-office bleaching gels with either high or low levels of hydrogen peroxide.


Assuntos
Consultórios Odontológicos , Luz/efeitos adversos , Clareamento Dental/métodos , Adulto , Bases de Dados Factuais , Sensibilidade da Dentina , Humanos , Peróxido de Hidrogênio/efeitos da radiação , Peróxido de Hidrogênio/uso terapêutico , Clareadores Dentários/efeitos da radiação , Clareadores Dentários/uso terapêutico
9.
Braz. j. oral sci ; 16: e17068, jan.-dez. 2017. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-883670

RESUMO

To evaluate the roughness (Ra), Knoop hardness (KHN) and change of color (ΔE) of esthetic restorative materials (Filtek Z350-composite nanoparticle; Empress Direct-composite nanohybrid and IPS e.Max-ceramic) subjected to contact with the Streptococcus mutans biofilm (biological degradation) associated with abrasion generated by tooth brushing (mechanical degradation). Methods: Ten specimens of each material were prepared, and the surface properties initial were evaluated. All specimens were exposed to Streptococcus mutans inoculum; after 7 days, surface properties were evaluated. The specimens were submitted to a 30,000 toothbrushing cycles, using a toothpaste slurry, then, surface properties were evaluated again. Data were analyzed by Proc-Mixed, One-way ANOVA, Tukey-Kramer and Tukey's tests (α = 0.05). Results: At the baseline, ceramic showed the highest Ra and KHN values; after the biological degradation the composites showed increased Ra, but KHN did not change; after the mechanical degradation, Empress showed decreased Ra and Z350 showed similar Ra, the KHN increased to both composites, and all materials had increased lightness after the mechanical degradation. Conclusions: The results suggest that, when exposed to Streptococcus mutans biofilm and toothbrush abrasion, the ceramics undergoes minimal degradation and the composites exhibited variable degradation, depending on the composition of the material (AU)


Assuntos
Biodegradação Ambiental , Biofilmes , Materiais Dentários , Propriedades de Superfície
10.
Braz Oral Res ; 31(suppl 1): e60, 2017 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-28902240

RESUMO

We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.


Assuntos
Colagem Dentária/normas , Fidelidade a Diretrizes/normas , Guias de Prática Clínica como Assunto/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Colagem Dentária/métodos , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Viés de Publicação , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Projetos de Pesquisa/normas , Medição de Risco , Fatores de Risco
11.
Braz. oral res. (Online) ; 31(supl.1): e60, Aug. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-889458

RESUMO

Abstract We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.


Assuntos
Humanos , Colagem Dentária/normas , Fidelidade a Diretrizes/normas , Guias de Prática Clínica como Assunto/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Colagem Dentária/métodos , Fidelidade a Diretrizes/estatística & dados numéricos , Viés de Publicação , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Projetos de Pesquisa/normas , Medição de Risco , Fatores de Risco
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