Use of Dental Care Among Pregnant Women in the Brazilian Unified Health System.

PURPOSE: To assess the prevalence of and factors associated with the use of public Unified Health System-based dental services by pregnant women and recent mothers. MATERIALS AND METHODS: In this cross-sectional study, face to face interviews were conducted to collect data on the outcome of interest (prevalence of use of dental care) and independent variables (sociodemographic, pregnancy, and prenatal care data). A total of 302 pregnant women seen at public dental services in the municipality of Canoas, southern Brazil, were interviewed. Statistical analysis was performed using the chi-squared test and hierarchical Poisson regression with robust variance (p < 0.05). RESULTS: The prevalence of use of dental care among pregnant women was 50% (n = 151). Pregnant women who initiated prenatal care in the first trimester showed a 34% higher likelihood of using dental care (prevalence ratio [PR] 1.34; 95% confidence interval [95%CI] 1.27-1.61); this likelihood was 12% higher among multiparous women (PR 1.12; 95%CI 1.03-1.23), and 40% higher among women who received guidance to seek dental care (PR 1.40; 95%CI 1.30-1.51). CONCLUSION: The present findings suggest that starting prenatal care in the first trimester, being multiparous, and receiving guidance to seek dental care significantly contributed to the use of public dental services during pregnancy in the population assessed. These factors should be considered when planning public health policies for this 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.

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.

Impacts of Orthognathic Surgery on Patient Satisfaction, Overall Quality of Life, and Oral Health-Related Quality of Life: A Systematic Literature Review.

Several treatments have been suggested to correct dentofacial abnormalities, including orthognathic surgery. The aim of the present systematic review was to assess the impact of orthognathic surgery on patient satisfaction, overall quality of life, quality of life related to oral health-and to orthognathic surgery in particular-among adult patients. Two investigators independently reviewed the available literature in the databases PubMed/MEDLINE, LILACS, SciELO, EMBASE, Trip, and Google Scholar (gray literature) based on the keywords "orthognathic surgery" and "quality of life." An analysis of bias was performed based on the MINORS (methodological index for nonrandomized studies). A total of 245 relevant studies were retrieved from the databases, and 6 additional studies were located after a manual search of the references. Following selection based on titles, abstracts, and full-text analysis, 30 studies were included in the present systematic review. To evaluate quality of life before and after orthognathic surgery, 12 studies applied the surgery-related Orthognathic Quality of Life Questionnaire (OQLQ), 12 used the Oral Health Impact Profile (OHIP-14), and 4 used the Short Form Health Survey (SF-36). Orthognathic surgery results in improvements in quality of life both physically and psychosocially after surgery and is associated with high rates of patient satisfaction.

Performance of primary healthcare dentists in a distance learning course in pediatric dentistry.

OBJECTIVE: Children are an important portion of the population of the territories covered by Primary Health Care (PHC), with needs and characteristics that can be managed at this level of care. Therefore, it is essential that professionals working in PHC be capable of providing child care. The aim of this study was to evaluate the performance of dentists working in primary healthcare (PHC) in a pediatric dentistry distance learning (DL) course, and to investigate the relationship between the grades earned on questionnaires applied after each course module and features of their personal and professional profile. METHOD: The study used a convenience sample of 201 dentists working in PHC, who enrolled in a DL course offered by a telehealth center in the state of Rio Grande do Sul, Brazil. The course consisted of video classes on restorative dentistry, endodontics, dental trauma, and clinical management in pediatric dentistry. After completing each module, each participant was asked to answer a questionnaire to assess their acquisition of immediate knowledge. Student's t-test and the ANOVA test were used to assess the relationship between the mean grade earned and the variables of sex, age, type of training institution, time since graduation, and years working in PHC. RESULTS: A significant relationship was observed between type of training institution (public) and the grade earned on the restorative dentistry questionnaire, and also between time since graduation and the grade earned on the dental trauma questionnaire (p < 0.05). No relationship was observed between the personal/professional variables and the grades earned on the endodontics and clinical management questionnaires. Grades were significantly lower on the endodontics questionnaire (p < 0.05). DISCUSSION: The large number of dentists enrolled in this DL course is a demonstration that there is great interest in pediatric dentistry contents. Improvement of DL courses may lead to the enhancement of professionals and their skills, and to a significant improvement in the quality of care provided to children in public health networks. CONCLUSION: It was concluded that training in a public institution and a longer time since graduation positively influenced the grades earned on the restorative dentistry and dental trauma questionnaires, respectively.

Satisfaction of Primary Healthcare Dentists after the Completion of a Distance Learning Course in Pediatric Dentistry.

BACKGROUND: The aim of the present study was to assess the level of satisfaction of dentists working in primary healthcare (PHC) with a Distance learning (DL) course in pediatric dentistry offered by the TeleHealthRS center, and to the investigate possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. METHODS: The course was offered in 2015 by the Federal University of Rio Grande do Sul (UFRGS) together with the TeleHealthRS center in Brazil. Data were collected on the participants' personal and professional profile, their pre- and post-course knowledge about pediatric dentistry, and their satisfaction with the course. Student's t-test and the ANOVA test were used to assess the possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. RESULTS: Overall, the participants were satisfied with the course, however, no statistically significant association was found between the variables indicative of their satisfaction and the grades they earned on the pre- and post-course questionnaires. CONCLUSION: The available pediatric dentistry course received positive evaluations from the participants, constituting a possible strategy for the qualification of primary care dentists. Future studies are warranted to further investigate the expectations of DL course participants, aiming to enhance the quality of future editions of this learning modality for pediatric dentistry contents.

Reattachment using a fragment from an extracted tooth to treat complicated coronal fracture.

Reattachment of fragment is the preferred alternative to restore the fractured teeth, offering several advantages. Partial pulpotomy has demonstrated satisfactory results as a conservative treatment for pulp exposures because of trauma. This study reports a case in which the treatment of a complicated coronal fracture was accomplished by partial pulpotomy and reattachment of a dental fragment obtained from an extracted tooth using composite resin. The results show the feasibility of the conservative pulp therapy and the restorative approach.

[Achieving goals set in specialized dental centers of Southern Brazil]. / Cumprimento de metas dos Centros de Especialidades Odontológicas da Região Sul do Brasil.

OBJECTIVE: To evaluate the association of work factors with goals set in specialized dental centers (SDCs) of Southern Brazil. METHODOLOGY: Cross-sectional exploratory study, in which the databases DATASUS, IBGE, SIOPS were used and complemented with an online questionnaire (FORMSUS). The questionnaire was answered by SDC managers. The Kruskal Wallis test was utilized to determine association of factors. RESULTS: Nine hundred and thirty six months, corresponding to 78 SDCs, were analyzed; the response rate of the questionnaires was 68%. It was found that the variables Paraná State, municipalities with population size of 0-50 thousand/inhabitants, and the fourth quartile of total health expenditure and Gross National Product per capita were factors associated with goals achievement of periodontal procedures. The type of SDCs showed association with goals achievement of basics procedures. DISCUSSION: Analyzes of the variables that may be associated with outpatient treatment in of SDCs are fundamental to verify issues regarding population access and applicability of public resources in the health area. CONCLUSION: The study indicates low achievement goals by outpatient care delivery by specialized dental centers, which may indicate important factors associated with higher number months for achieving goals.

Demographic, socio-economic, behavioural and clinical variables associated with caries activity.

This study investigated the association between several demographic, socio-economic, behavioural and clinical variables on caries activity. One hundred and two patients were randomly retrieved from the files of the Operative Dentistry Clinic (UFPel-Brazil). The patients gave written consent to participate in the study. They were interviewed reporting demographic (sex and age), socio-economic data (income, educaional level) and oral health behaviours (tooth-brushing frequency, dental floss usage and snacks frequency). Intraoral examination was performed to investigate the clinical variables (presence and quality of biofilm, DMFT and modified DMFT index and bleeding points). Patients were divided between caries-active (n=51) and caries-inactive (n=51), according to the presence of white spot lesions and/or active cavity lesions. Statistical analysis was carried tout using Chi-square or Fischer's exact test, with the confidence level at 95%. Results demonstrated that several conditions (younger subjects, lower educational or income levels, lower tooth-brushing frequency, higher snacks frequency, adherent biofilm, presence of bleeding points and higher modified DMFT index) were associated with caries activity in the studied population. Within the limitations of the experimental design, and considering the population under investigation, it was verified that demographic (age), socio-economic (income and educational levels), behavioural (tooth brushing and snacks frequencies) and clinical (modified DMFT index, presence and quality of biofilm, and bleeding points) variables were associated with caries-active patients.

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.

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.

One-year clinical evaluation of two polyacid-modified resin composites (compomers) in posterior permanent teeth.

PURPOSE: The aim of this study was to evaluate the clinical performance of two polyacid-modified resin composites (Dyract AP and F2000) in posterior teeth after 1 year of clinical service. MATERIALS AND METHODS: Seventy-two Class I restorations were performed in 33 patients (average age 25 years) by one operator. Eighty-two per cent of the restorations were located in molars. Before the proceedings, patients were informed about the aim of the study and they gave written consent to participate. At least one restoration of each material was placed in each individual. The materials were applied according manufacturer's instructions. Following finishing and polishing, one examiner performed the clinical baseline examination using the adapted USPHS system. To be included in the clinical trial, a restoration had to be rated "Alpha". After one year, 25 patients were recalled and 56 restorations were evaluated using the adapted USPHS system. RESULTS: All restorations were classified as clinically satisfactory (Alpha or Bravo). However, there was a decrease in restoration quality compared to baseline. Statistical analysis (chi2 and Fisher's exact test) demonstrated differences only in relation to superficial roughness, with exhibiting F2000 more surface roughness than Dyract AP (p < 0.01). CONCLUSION: Based on the methodology employed, all restorations were satisfactory after one year and the two materials performed similarly, except for the surface roughness criteria.

An ethnomedicinal survey on phytotherapy with professionals and patients from Basic Care Units in the Brazilian Unified Health System.

ETHNOPHARMACOLOGICAL RELEVANCE: In this study, an ethnomedicinal survey was conducted in the city of Pelotas, Brazil, with professionals and patients in the Unified Health System (SUS). With the approval of the National Policy on Medicinal Plants and Herbal Medicines, and with the adoption of a National Policy on Integrative and Complementary Practices in the SUS in Brazil, there is growing concern regarding Brazilian medicinal plants and their proper use in medicine. The expansion of the therapeutic options offered to the users of the SUS includes access to medicinal plants and herbal drugs, as well as related services, such as phytotherapy. For improving health and for the social inclusion of phytotherapies, safety, efficacy, and quality are important strategies. MATERIALS AND METHODS: Interviews of both professionals and patients were conducted at five Basic Care Units, and a sample size of 393 was obtained. RESULTS: Of the patients attending the Basic Care Units, 91.6% had experienced the use of medicinal plants at least once to treat certain diseases. Of the professionals, 65% had used medicinal plants but only 10% prescribed phytotherapeutics to their patients. Generally, the users were homemakers (26%) of the female gender (71.5%) who were older than 60 years (26%) and had a family income between 1 and 2 Brazilian minimal salaries. The professionals were predominantly female (80%), and a high proportion (80%) believed in the positive effects of phytotherapy (80%), even though these professionals had not been taught phytotherapy as undergraduate students (75%) and had not discussed the topic with their teachers (85%). Patients (81.5%) and professionals (45%) reported that their knowledge of medicinal plants came from their parents or grandparents. From a total of 66 different herbs used by the subjects, mauve (24%) was the most commonly used, often to treat toothaches (24.2%). CONCLUSION: It is concluded that a high proportion of users and professionals made use of medicinal plants, and of the large number of plants mentioned in the questionnaire, mauve was the most commonly used, mainly for the treatment of toothaches. The major source of the transmission of knowledge concerning herbal medicine was parents or grandparents.

Avaliação clínica de restaurações de resina condensável em dentes posteriores após um ano / One-year clinical evaluation of condensable composite restoration in posterio teeth

O objetivo deste estudo foi avaliar comparativamente, após o período de um ano, a performance clínica em dentes posteriores de restaurações da resina condensável ALERT (Jeniric-Pentron), de resina composta microhibrida Sculp-It (Jeneric-Pentron) e de amálgama Logic C (SDI). Os pacientes foram selecionados na Clínica de Dentística da Faculdade de Odontologia de Pelotas e foram inseridos no estudo mediante consentimento esclarecido. Cada paciente deveria ter ao menos uma restauração de cada material. Trinta e três restaurações classe I e II foram realizadas em seis pacientes. Após o acabamento e polimento das restaurações, foi realizada a avalição baseline, que tinha como pré-requisito a qualificação Alfa para seguir no estudo. A avaliação foi baseada nos critérios de avaliação clínica USPHS (United States Public Health Service) modificado, para as restaurações de amálgama e USPHS adaptado, para as restaurações de resina. Após um ano as restaurações foram reavaliadas pelo mesmo examinador. Baseados na avaliação clínica, as restaurações foram agrupadas nos critérios clinicamente satisfatórias (maioria dos escore Alfa e Bravo) e insatisfatórias (maioria dos escores Charlie e Delta). A comparação entre as restaurações para os dois critérios convencionados, através do teste exato de Fischer, demonstrou não haver diferença entre os materiais para o tempo de avaliação de um ano (p>0,05). Quando realizada uma comparação mais especifica entre as restaurações de resinas, o teste não paramétrico de Mann-Whitney demonstrou maior rugosidade superficial (p<0,05) e menor estabilidade de cor (p<0,01) da resina condensável, quando comparada com a resina microhibrida.