Abstract The aim of this paper was to present a summary of the process of developing and preparing the final documents of the national consensus for teaching undergraduate Brazilian dental students the dental caries curriculum in the Portuguese language. The final document was developed in three steps: a) The ABENO and LAOHA cariology group invited experts from all five regions of Brazil to participate in the discussion. The theoretical support for crafting the first draft of the consensus was based on two publications: National Curriculum Guidelines of the Dentistry graduation in Brazil, Ministry of Education (2021) and the competences described in the European Core Curriculum for Cariology (ORCA-ADEE, 2011); b) The group of experts was divided into 5 working groups: G1-Domain, Main and Specific Competences, G2-Essential knowledge, G3-Life course perspective, G4-Social determinants and dental caries, G5- Glossary. The document was finalized by thoroughly reviewing the process using Delphi methodology; c) The 5-chapter document (one from each working group) was submitted to three open public consultations in 2022 (May-June, August, and October) using Google-forms. The suggestions (content/wording) were discussed within the group as: totally accepted, partially accepted, and rejected. A total of 192 suggestions were registered from 31 dental schools in all regions of Brazil. The number of suggestions received per Group were: 84, 28, 26, 24, 30 suggestions for G1, G2, G3, G4 and G5, respectively. The majority of suggestions were totally accepted by the group of experts (n = 172, 89.6%), 15 were partially accepted (7.8%), and 5 were rejected. Conclusion The final document could be considered to be the first national consensus for teaching the dental caries curriculum in Brazil.

Abstract: This study assessed the ability of XP-endo Finisher R (FKG, La Chaux-de-Fonds, Switzerland) to remove filling remnants from curved mesiobuccal canals of maxillary molars, using the passive ultrasonic irrigation (PUI) technique as a comparison. Twenty-four curved main mesiobuccal canals (MB1) of maxillary molars were instrumented with Wave One (#25/07) and filled with gutta-percha points and AH Plus Sealer. Samples were then re-treated with a standardized protocol with Wave One (#35/06) as the master apical file. Micro-CT scans measured baseline volume of remaining filling material (in mm3). Samples were divided into two groups (n = 12) according to the supplementary cleaning approach: (PUI) or XP-endo Finisher R. Statistics compared baseline and final volume of filling material (within-group); and the percentage of filling material reduction (between-group). Mean baseline volumes, final volumes, and percentages of reduction (%) of filling material for XP-endo Finisher R and PUI were respectively: 0.060 mm3, 0.042 mm3, and 31.28%; and 0.064 mm3, 0.054 mm3, and 16.57%. Both tested protocols reduced the amount of filling material (p < 0.05). XP-endo Finisher R had higher percentage of reduction as compared to PUI (p < 0.05). XP-endo Finisher R and PUI used as supplementary cleaning protocols during re-treatment improved the removal of root filling material in curved canals; but XP-endo Finisher R was approximately twice more efficient. The complete filling material removal during re-treatment procedures is still a challenge. Supplementary cleaning protocols may help to remove the remaining material after the complete mechanical preparation of curved canals. XP-endo Finisher R was approximately twice more efficient than PUI.

Abstract: This study aimed to compare the physicochemical properties of MTA Angelus (MTA-A), MTA Repair HP (MTA-HP), and Biodentine (BD). Setting times (n = 7) were determined in accordance with ASTM C266–15. Solubility (n = 11), pH (n = 10), and calcium ion release (n = 10) were evaluated up to 28 days in accordance with ANSI/ADA specification no. 57. Radiopacity was assessed by ANSI/ADA (n = 10) and the tissue simulator method (n = 10). In both methods, the specimens were radiographed using an aluminum stepwedge and the digital radiographs were analyzed in Adobe Photoshop, determining the mean grayscale pixel values of the materials, of the 3-mm aluminum stepwedge, and of the dentin, the latter of which was analyzed on the tissue simulator. The data obtained from each test were statistically analyzed and compared (p < 0.05). MTA-A presented longer final setting time compared with the other materials. There were no significant differences in the mass values of materials during the experiment. All materials presented an alkaline pH. BD promoted greater calcium ion release in most of the experimental periods. All materials presented appropriate radiopacity. BD showed lower radiopacity than MTA-A in the tissue simulator method. All groups presented higher radiopacity in the tissue simulator when compared with the ANSI/ADA method. MTA-A, MTA-HP, and BD showed appropriate physicochemical properties and radiopacity, and were considered suitable to be used in clinical practice.

Abstract: This study analyzed the consequences of the disordered expansion of Dentistry courses on the distribution of professionals, the job market, and limitations of the National System of Higher Education Assessment (SINAES) developed as a guarantee of education quality. This observational, descriptive, and analytical study used secondary data from several official databases. The number of courses was obtained from the e-MEC registry. From the Higher Education Census, the study collected historical series of courses offered, number of candidates per open seat, number of individuals who initiated and completed the course, and information about professors in the public and private schools. The reports related to Dentistry courses from the National Health Council were also analyzed. The performance of undergraduate students was assessed from synthesis reports of Enade from 2004 to 2016. The number of dentists and their regional distribution was based on the Federal Dental Council, and Brazilian population and gross domestic product were collected from the Brazilian Institute of Geography and Statistics. Dentistry courses in Brazil grew exponentially from 1856 to 2020; among the 544 authorized courses, 82 currently have not yet started their activities. The fast expansion of courses in Brazil has worsened the regional asymmetries in the supply of dentist, and the SINAES has not been able to fully assure the quality of Dentistry courses. Brazilian dentistry, which has increased its scientific and technological development since the 19th century, with outstanding intellectual production, is at risk of a collapse due to a plethora of dentists.

OBJECTIVES: Owing to the fact that obstructive sleep apnea (OSA) is an underreported disease, the strategy used for the diagnosis of OSA has been extensively dissected to devise a simplified process that can be accessed by the public health services. Polysomnography (PSG) type I, the gold standard for the diagnosis of OSA, is expensive and difficult to access by low-income populations. In this study, we aimed to verify the accuracy of the oxyhemoglobin desaturation index (ODI) in comparison to the apnea-hypopnea index (AHI) using a portable monitor. METHODS: We evaluated 94 type III PSG home test results of 65 elderly patients (69.21±6.94 years old), along with information, such as the body mass index (BMI) and sex, using data obtained from a clinical trial database. RESULTS: A significant linear positive correlation (r=0.93, p<0.05) was observed between ODI and AHI, without any interference from sex, BMI, and positional component. The sensitivity of ODI compared to that of AHI increased with an increase in the severity of OSA, while the specificity of ODI in comparison to that of AHI was high for all degrees of severity. The accuracy of ODI was 80.7% for distinguishing between patients with mild and moderate apnea and 84.4% for distinguishing between patients with moderate and severe apnea. CONCLUSION: The ODI values obtained in uncontrolled conditions exhibited high sensitivity for identifying severe apnea compared to the AHI values, and correctly identified the severity of OSA in more than 80% of the cases. Thus, oximetry is promising strategy for diagnosing OSA.

Resumo O objetivo deste estudo foi avaliar a radipacidade de diferentes pontas de guta-percha (Endo Points®, Dentsply®, Tanari®, Meta®, Roeko® e Odous®) em amostras de 1 mm de espessura, conforme estabelecido pela especificação #57 da ANSI/ADA e pela ISO 6876/2001, em comparação com amostras de menor espessura. Doze amostras de cada material, quatro para cada espessura (0,3, 0,6 e 1 mm; 8 mm de diâmetro), foram confeccionadas por meio de laminação e compressão entre duas lâminas de vidro polidas, até a espessura desejada. Radiografias digitais foram obtidas juntamente com uma escala de alumínio graduada, com espessuras variando de 1 a 10 mm. O aparelho de raios X foi ajustado para 70 kVp, 10 mA, 0,4s de tempo de exposição, com distância focal de 36 cm. Um observador calibrado quantificou a média dos valores de pixel no programa Adobe Photoshop®. Os dados foram analisados utilizando os testes ANOVA e Tukey, com nível de significância de 5%. Nas espessuras de 0,6 e 1 mm, todos os materiais testados apresentaram radiopacidade maior do que 3 mm de alumínio (valor de referência). Na espessura de 0,3 mm, Odous e Tanari apresentaram radiopacidade significativamente menor que a referência, e as outras marcas mostraram radiopacidade semelhante à referência. Conclui-se que os materiais apresentaram diferentes radiopacidades e todos mostraram valores acima do mínimo recomendado pela especificação #57 da ANSI/ADA, sendo Odous e Tanari menos radiopacos do que o valor de referência nas amostras mais finas (0.3 mm).

Abstract The aim of this study was to evaluate the radiopacity of different gutta-percha points (Endo Points®, Dentsply®, Tanari®, Meta®, Roeko® and Odous®) in samples of 1 mm thick as established by ANSI/ADA Specification #57 and ISO 6876/2001, in comparison with thinner samples. Twelve test specimens for each material, four for each thickness (0.3, 0.6, and 1 mm and diameter of 8 mm), were laminated and compressed between two polished glass plates until the desirable thickness. Digital radiographs were obtained along with a graduated aluminum stepwedge varying from 1 to 10 mm in thickness. The X-ray unit was set at 70 kVp, 10 mA and 0.4 s exposure time, at a focal distance of 36 cm. One calibrated observer quantified the average values of pixels with Adobe Photoshop® software. Data were analyzed using ANOVA and Tukey tests, at 5% significance level. At 0.6 and 1 mm thickness, all the tested materials showed radiopacity higher than 3 mm of aluminum (reference value). At 0.3 mm thickness, Odous and Tanari presented significantly less radiopacity than the reference, and the other materials showed similar radiopacity to the reference. The study concluded that the materials demonstrated different radiopacities and all had values above the minimum recommended by ANSI/ADA specification #57, being Odous and Tanari less radiopaque than the reference value in thinner samples (0.3mm).

OBJETIVO: No Brasil, o SINAES é a proposta de avaliação da educação superior atualmente em vigência e que avalia as instituições de educação superior, os cursos de graduação e o desempenho dos estudantes (ENADE). Este estudo abordou a avaliação dos cursos de Odontologia em 2003 e 2004 para observar se os resultados da avaliação induziram melhora no processo ensino-aprendizagem. METODOLOGIA: Este estudo transversal foi realizado por meio de questionários com questões abertas e fechadas enviados por e-mail a 165 professores/coordenadores dos programas de graduação em Odontologia do Brasil em 2003/2004. As questões 1, 2 e 3 se referiram à avaliação das Instituições e dos cursos de Odontologia. As questões 5, 6 e 7 se referiram ao ENADE. RESULTADOS: As mudanças com objetivo de melhora na qualidade do ensino em Odontologia e na educação de novos profissionais são impulsionadas pelos resultados do processo de avaliação. Tais mudanças foram implementadas em todas as Instituições de ensino que retornaram os questionários preenchidos. CONCLUSÃO: Mudanças na qualidade da Odontologia brasileira somente serão possíveis se ocorrer melhora no processo educativo de estudantes e professores.

PURPOSE: In Brazil, the SINAES is a process that is currently used to assess higher education institutions, undergraduate programs and students' performance on the ENADE national exam. This study aimed at assessing the Brazilian undergraduate programs in Dentistry, inquiring if the evaluation results induced to changes to improve the teaching-learning process. METHODS: This cross-sectional study utilized a questionnaire that was e-mailed to 165 professors/coordinators of undergraduate programs in Dentistry in Brazil in 2003/2004. The data analysis was based on the themes of the various open- and closed-ended questions: questions 1, 2, 3 and 4 referred to the evaluation of each institution and its undergraduate program, whereas questions 5, 6 and 7 referred to the ENADE. RESULTS: Changes to improve the quality of teaching in Dentistry and the education of new professionals were driven by the results of the evaluation. These changes were implemented at all institutions that returned the completed questionnaires. CONCLUSION: Improvements in the quality of Brazilian Dentistry will only be possible if the education of the students and the professors is improved.

OBJETIVO: Avaliar o preparo do canal radicular realizado por alunos de graduação com os sistemas manual e oscilatório, considerando o desgaste produzido nas paredes do mesmo, o tempo de trabalho e a opinião dos estudantes. METODOLOGIA: Foram utilizadas raízes mesiais de 20 molares inferiores humanos extraídos por indicação clínica. Vinte alunos de graduação realizaram o preparo de dois canais, um deles com o sistema manual e o outro com o sistema oscilatório, e posteriormente responderam a um questionário. O tempo foi registrado durante os preparos. Os dentes foram examinados por tomografia computadorizada antes e após o preparo. As imagens foram sobrepostas e as áreas de contorno demarcadas. Medidas lineares e da área de desgaste foram realizadas. RESULTADOS: Não houve diferença entre as técnicas quanto à medida linear de desgaste. A parede distal apresentou maior desgaste no terço cervical do que no médio em ambas as técnicas. A área total de desgaste foi maior no terço cervical do que no médio. Com relação ao tempo de preparo, não houve diferença estatisticamente significante entre as duas técnicas. CONCLUSÃO: O sistema oscilatório constitui-se em um recurso auxiliar para o preparo do canal radicular no ensino de graduação.

PURPOSE: To evaluate the preparation of root canals performed by undergraduate students using manual and automated devices, based on the amount of dentin removed from the canal walls, the time required for preparation, and students' opinions. METHODS: Mesial roots of 20 human mandibular molars extracted for clinical reasons were used in the experiment. Twenty undergraduate students prepared two canals each, one using the manual method and the other using an automated device; following root canal preparation, the students filled out a questionnaire. Time was recorded throughout the procedures. Teeth were scanned with computed tomography before and after preparation. Images were superimposed and measured for the amount and area of dentin removed. RESULTS: There was no difference between the use of manual and automated devices with regard to the amount of material removed. Distal walls presented a greater amount of material removed from the cervical third when compared with middle third in both techniques. There were no statistically significant differences between both techniques with regard to preparation time. CONCLUSION: The automated system represents an adequate alternative option as an auxiliary resource for undergraduate teaching in the preparation of root canals.

OBJETIVO: Comparar índices obtidos de radiografias panorâmicas odontológicas com a densitometria óssea na identificação de indivíduos com osteopenia/osteoporose. MATERIAIS E MÉTODOS: Os índices panorâmico mandibular, mentoniano, antegoníaco, goníaco e cortical mandibular foram obtidos de radiografias panorâmicas de mulheres na pós-menopausa e comparados aos resultados da densitometria óssea, por um observador duas vezes, e por outro observador uma vez. RESULTADOS: Não foram observadas diferenças significativas entre as duas medições realizadas pelo mesmo observador, exceto para o índice antegoníaco no lado esquerdo. Houve boa concordância entre os diagnósticos utilizando o lado esquerdo e o lado direito e entre os diagnósticos dos dois observadores. A análise de variância demonstrou diferenças significativas entre os grupos (normal, osteopenia e osteoporose) para todos os índices. Para os índices panorâmico mandibular e mentoniano todas as médias diferiram entre si. Já para os índices antegoníaco e goníaco, somente o grupo normal apresentou média superior aos demais (osteopenia e osteoporose), as quais não diferiram entre si. CONCLUSÃO: Os índices avaliados foram reprodutíveis; os índices panorâmico mandibular e mentoniano foram os que apresentaram maiores valores de sensibilidade para detectar osteopenia/osteoporose, porém a especificidade do índice panorâmico mandibular foi baixa; todos os índices avaliados foram capazes de identificar baixa massa óssea, contudo, apenas os índices panorâmico mandibular e mentoniano permitiram diferenciar pacientes com osteopenia/osteoporose.

OBJECTIVE: The present study was aimed at comparing indices obtained from dental panoramic radiographs with bone densitometry results in the identification of individuals affected by osteoporosis/osteopenia. MATERIALS AND METHODS: Panoramic mandibular, mental, antegonial, gonial and mandibular cortical indices calculated with basis on dental panoramic radiographs of postmenopausal women were compared with bone densitometry results, twice by one observer and once by a second observer. RESULTS: Significant differences were not found between the two measurements performed by the same observer, except for the antegonial index on the left side. Interobserver agreement for both sides was good. The variance analysis demonstrated statistically significant differences among groups (normal, osteopenia and osteoporosis) for all the indices evaluated. Differences were significant among all mean panoramic mandibular and mental indices. On the other hand, for the antegonial and gonial indices, only the normal group presented higher means as compared with the other groups (osteopenia and osteoporosis) which did not differ between themselves. CONCLUSION: The indices evaluated were reproducible; panoramic mandibular and mental indices presented the highest sensitivity in the detection of osteopenia/osteoporosis, however the panoramic mandibular index specificity was low. Although all the indices evaluated could identify low bone density, only the panoramic mandibular and mental indices could differentiate patients affected by osteopenia/osteoporosis.