Abstract Objectives This study aimed to analyze the cost-effectiveness of whitening toothpastes and at-home bleaching for the treatment of tooth discoloration. Methodology A cost-effectiveness economic analysis was conducted, and eight randomized clinical trials were selected based on the whitening agent product used: blue covarine dentifrices (BCD), hydrogen peroxide dentifrices (HPD), dentifrices without bleaching agents (CD, negative control), and 10% carbamide peroxide (CP10, positive control) for at-home bleaching. The consumer/patient perspective was adopted, macro-costing techniques were used and a decision tree model was performed considering the costs in the American and Brazilian markets. The color change evaluation (ΔE*ab) was used to calculate the effectiveness of tooth bleaching. A probabilistic analysis was performed using a Monte Carlo simulation and incremental cost-effectiveness ratios were obtained. Results CP10 resulted in the highest cost-effectiveness compared to the use of dentifrices in both markets. In Brazil, HPD was more cost-effective than BCD and CD. In the US, the increased costs of HPD and BCD did not generate any whitening benefit compared to CD. Conclusions CP10 was more cost-effective than BCD and HPD for tooth bleaching from the perspectives of the Brazilian and American markets. Decision-making should consider the use of CP10 for treating tooth discoloration. costeffectiveness cost athome at home discoloration conducted BCD, , (BCD) HPD, (HPD) CD, CD (CD control, control 10 CP10, CP (CP10 consumerpatient consumer patient adopted macrocosting macro costing markets ΔE*ab ΔEab ΔE ab (ΔE*ab obtained CP1 Brazil costeffective effective US Decisionmaking Decision making (BCD (HPD 1 (CP1 (CP

RESUMO JUSTIFICATIVA E OBJETIVOS: A exodontia de terceiros molares pode acarretar efeitos indesejados, como dor, trismo e edema, sendo necessário ofertar uma terapia preemptiva para amenizá-los. Para tal, realizou-se uma avaliação econômica para analisar o custo-efetividade de fármacos preemptivos utilizados na exodontia de terceiros molares. MÉTODOS: Os custos foram obtidos a partir de uma pesquisa de mercado. As medidas de efetividade foram: limitação da distância interincisal e dor pós-operatória, sendo obtidas em ensaios clínicos randomizados da literatura. Para os dois modelos, uma simulação de Monte Carlo gerou uma coorte hipotética de mil indivíduos, considerando uma variação de 5% das estimativas. As terapias avaliadas foram: dexametasona 8 mg (DX8); metilprednisolona 40 mg (MP); diclofenaco 50 mg associado a tramadol 50 mg (DCTR); e dexametasona 4 mg associada a tramadol 50 mg (DXTR). RESULTADOS: As terapias com MP e DCTR foram dominadas em todos os cenários. Para redução da dor pós-operatória, o tratamento com DXTR apresentou o melhor custo-benefício, com ganho de benefício monetário líquido (NMB) de 31,10% comparado ao tratamento de menor custo (DX, R$ 1,76). Considerando a redução da limitação da distância interincisal, o fármaco DXTR apresentou maior custo-benefício em relação à DX8 (ganho de NMB = 18,25%), sendo uma opção de escolha junto a DX8. CONCLUSÃO: Na exodontia de terceiros molares, a administração preemptiva de dexametasona 4 mg associada com tramadol 50 mg é a opção de escolha, do ponto de vista de custo-efetividade, para reduzir a dor pós-operatória e limitação da distância interincisal após 48 horas. OBJETIVOS indesejados edema amenizálos. amenizálos amenizá los. los amenizá-los tal realizouse realizou se custoefetividade MÉTODOS mercado pósoperatória, pósoperatória pós operatória, operatória literatura modelos indivíduos 5 estimativas DX (DX8) (MP) (DCTR) DXTR. . (DXTR) RESULTADOS cenários custobenefício, custobenefício benefício, (NMB 3110 31 10 31,10 DX, (DX R 1,76. 176 1,76 1 76 1,76) 18,25%, 1825 18,25% , 18 25 18,25%) CONCLUSÃO custoefetividade, efetividade, horas (DX8 (MP (DCTR (DXTR 311 3 31,1 17 1,7 7 182 18,25 2 31, 1, 18,2 18,

ABSTRACT BACKGROUND AND OBJECTIVES: The extraction of third molars can lead to undesired effects such as pain, trismus, and edema, necessitating preemptive therapy to alleviate these effects. For this purpose, an economic evaluation was conducted to analyze the cost-effectiveness of preemptive drugs used in the extraction of third molars. METHODS: Costs were obtained from a market survey. Effectiveness measures were limitation of interincisal distance and postoperative pain, obtained from randomized clinical trials in the literature. For both models, a Monte Carlo simulation generated a hypothetical cohort of a thousand individuals, considering a 5% variation in estimates. The evaluated therapies were dexamethasone 8 mg (DX8); methylprednisolone 40 mg (MP); diclofenac 50 mg associated with tramadol 50 mg (DCTR); and dexamethasone 4mg associated with tramadol 50 mg (DXTR). RESULTS: MP and DCTR therapies were dominated in all scenarios. For the reduction of postoperative pain, DXTR treatment showed the best cost-benefit, with a net monetary benefit (NMB) gain of 31.10% compared to the lowest-cost treatment (DX, R$ 1.76). Considering the reduction in limitation of interincisal distance, DXTR medication presented higher cost-benefit compared to DX8 (NMB gain = 18.25%), being a preferred option alongside DX8. CONCLUSION: In the extraction of third molars, preemptive administration of dexamethasone 4mg associated with tramadol 50mg is the preferred cost-effective option to reduce postoperative pain and limitation of interincisal distance after 48 hours. OBJECTIVES trismus edema purpose costeffectiveness cost effectiveness METHODS survey literature models individuals 5 estimates DX (DX8) 4 (MP) (DCTR) DXTR. . (DXTR) RESULTS scenarios costbenefit, costbenefit benefit, NMB 3110 31 10 31.10 lowestcost lowest DX, (DX R 1.76. 176 1.76 1 76 1.76) 18.25%, 1825 18.25% , 18 25 18.25%) CONCLUSION costeffective effective hours (DX8 (MP (DCTR (DXTR 311 3 31.1 17 1.7 7 182 18.25 2 31. 1. 18.2 18.

ABSTRACT Objective: To evaluate the cost-effectiveness of single-tooth rehabilitation options with dental implants associated with a prosthetic crown (I+C) compared to a fixed partial denture (FPD). Material and Methods: A rapid review was carried out to identify the costs (expressed in US$) and effectiveness (expressed through success rate). Bibliographic searches retrieved 1,447 records, of which 19 studies of type randomized clinical trials were selected to collect cost and effectiveness data. Markov economic models were used to simulate hypothetical 15-year cohorts with 2000 patients using cost and effectiveness data from the rapid review under the perspective of private practice. Results: The average costs of I+C and FPD treatments were US$ 3,432.23 and US$ 3,322.52, respectively. The average effectiveness of I+C was 88.33%, with a mean follow-up time of 9.33 years, and FPD had an average yearly success rate of 82.14%, with a mean follow-up time of 11.89 years. The I+C treatment has an incremental cost-effectiveness ratio (RCEI) of US$ 170.88 compared to FPD. Conclusion: Both I+C and FPD rehabilitation options are cost-effective; I+C rehabilitation has a higher cost and greater effectiveness, being the recommended option if the patient with no contraindication. Objective costeffectiveness singletooth single tooth IC I C (I+C . (FPD) Methods expressed US rate. rate) 1447 1 447 1,44 records 15year year 15 200 practice Results 343223 3 432 23 3,432.2 332252 322 52 3,322.52 respectively 8833 88 33 88.33% followup follow up 933 9 9.3 years 8214 82 14 82.14% 1189 11 89 11.8 RCEI (RCEI 17088 170 170.8 Conclusion costeffective effective cost-effective contraindication (FPD 144 44 1,4 20 34322 43 2 3,432. 33225 32 5 3,322.5 883 8 88.33 93 9. 821 82.14 118 11. 1708 17 170. 4 1, 3432 3,432 3322 3,322. 88.3 82.1 343 3,43 332 3,322 88. 82. 34 3,4 3,32 3, 3,3

COVID-19 pandemic implied new biosafety recommendations to avoid dissemination of SARS-CoV-2 virus within healthcare centers. Changes on recommended personal protective equipment (PPE), decontamination protocols and organization of patient demand resulted may result in cost variation. Based on this, the present study aimed to evaluate the economic impact of new biosafety recommendations for oral healthcare assistance during COVID-19. An Activity Based Costing evaluation was used to calculate the acquisition of PPE and decontamination solutions recommended for dental practice during COVID-19 pandemic in Brazil. PPE and decontamination solutions quantity and frequency of use were based on the newly COVID-19 recommendations. Costs (in Brazilian Real – R$) for biosafety recommendations pre- and post-COVID-19 were outlined and calculated for each patient, service shift and year. A sensitivity analysis considered 20% to 50% variation of direct costs. Previously to COVID-19 pandemic, direct costs of biosafety recommendations consisted of R$0.84 per patient, R$6.69 per service shift and R$3,413.94 per year. Post-COVID-19 costs of biosafety recommendations resulted in R$16.01 per patient, R$128.07 per service shift, and R$32,657.96 per year. Yearly costs can vary between R$26,126.37 and R$39,189.56. The annual budget increase necessary to adopt post-COVID biosafety recommendations was R$29,244.02. Newly biosafety recommendations increased significantly the costs of oral healthcare assistance during COVID-19 pandemic. Decision making of healthcare managers must consider rational and equity allocation of financial resources.

A pandemia da COVID-19 implicou novas recomendações de biossegurança para evitar a disseminação do vírus SARS-CoV-2 nos centros de saúde. Alterações nos equipamentos de proteção individual (EPI) recomendados, protocolos de descontaminação e organização da demanda de pacientes resultaram em variações de custos. Com base nisso, o presente estudo teve como objetivo avaliar o impacto econômico de novas recomendações de biossegurança para assistência à saúde bucal durante a COVID-19. Uma avaliação do Custeio Baseado em Atividade foi usada para calcular a aquisição de EPI e soluções de descontaminação recomendadas para a prática odontológica durante a pandemia da COVID-19 no Brasil. A quantidade e a frequência de uso de EPI e das soluções de descontaminação foram baseadas nas novas recomendações da COVID-19. Os custos (em Reais Brasileiros – R$) das recomendações de biossegurança pré- e pós-COVID-19 foram delineados e calculados para cada paciente, turno de serviço e ano. Uma análise de sensibilidade considerou uma variação de 20% a 50% dos custos diretos. Anteriormente à pandemia da COVID-19, os custos diretos das recomendações de biossegurança consistiam em R$0,84 por paciente, R$6,69 por turno de serviço e R$3.413,94 por ano. Os custos pós-COVID-19 das recomendações de biossegurança resultaram em R$16,01 por paciente, R$128,07 por turno de serviço e R$32.657,96 por ano. Os custos anuais podem variar entre R$26.126,37 e R$39.189,56. O aumento do orçamento anual necessário para adotar as recomendações de biossegurança pós-COVID foi de R$29.244,02. As novas recomendações de biossegurança aumentaram significativamente os custos da assistência à saúde bucal durante a pandemia da COVID-19. A tomada de decisão dos gerentes de saúde deve considerar a alocação racional e equitativa dos recursos financeiros.

Resumo Introdução As resinas compostas são alternativas restauradoras, porém sua superfície pode favorecer o acúmulo de biofilme. Objetivo Analisar in vitro a adesão de biofilmes de Streptococcus mutans (UA159) e Candida albicans (ATCC 90028) em superfícies de resinas compostas convencionais e bulk fill. Material e método Foram utilizadas quatro marcas de resinas compostas e bulk fill: Aura Bulk Fill - SDI®; Premisa - Kerr®; Opallis- FGM®, e Filtek bulk fill flow - 3M®. Utilizou-se saliva artificial para formação da película salivar, por 60 min a 37 °C. O inóculo foi padronizado em 1×108 UFC/mL para S. mutans e 1×106 UFC/mL para C. albicans. Os espécimes (n=8/grupo) foram acondicionados em placas de 24 poços, com BHI suplementado com sacarose para as bactérias, e RPMI 1640, para os fungos. A formação do biofilme foi avaliada considerando as unidades formadoras de colônia (UFC/mL).Os dados foram analisados por ANOVA e Tukey (p<0,05). Resultado Para os biofilmes de S. mutans, não houve diferença significativa na contagem de UFC/mL entre os diferentes tipos de resina (p=0,119). Na contagem de UFC/mL para biofilme de Candida, as médias variaram entre 7,78 e 8,34. Houve diferença significativa entre as marcas, especialmente entre as resinas convencionais e bulk fill. Conclusão O presente estudo demonstra que não há diferença na adesão para biofilmes de S. mutans. Porém, há diferença na adesão da C. albicans na superfície de diferentes resinas compostas.

Abstract Introduction Composite resins are restorative alternatives, but their surface may favor the accumulation of biofilm. Objective The aim of this study was to evaluate the in vitro adhesion of Streptococcus mutans (UA159) and Candida albicans (ATCC 90028) biofilms on the surface of conventional and bulk fill composites. Material and method Four brands of conventional and bulk fill composites were used, Aura Bulk Fill - SDI®, Premisa - Kerr®, Opallis- FGM® and Filtek bulk fill flow - 3M®. Artificial saliva was used to form the salivary film for 60 min at 37 ° C. The inoculum was standardized at 1x108 CFU/mL for S. mutans and 1x106 CFU/mL for C. albicans. The specimens (n = 8/group) were placed in 24-well plates, with BHI supplemented with sucrose for bacteria and RPMI 1640 for fungi. The biofilm formation was evaluated considering the colony forming units (CFU/mL). The data were analyzed by ANOVA and Tukey test (p <0.05). Result For S. mutans biofilms, there was no significant difference in the CFU/mL count between the different types of composites (p = 0.119). In the CFU / mL count for C.albicans biofilm, the CFU/mL ranged from 7.78 to 8.34. There was a significant difference between brands for Candida, especially between conventional and bulk fill composites. Conclusion The present study demonstrates that there is no difference in adhesion for S. mutans biofilms. On the other hand, there is a difference in the adhesion of C. albicans to the surface of different composite resins.

Abstract COVID-19 pandemic implied new biosafety recommendations to avoid dissemination of SARS-CoV-2 virus within healthcare centers. Changes on recommended personal protective equipment (PPE), decontamination protocols and organization of patient demand resulted may result in cost variation. Based on this, the present study aimed to evaluate the economic impact of new biosafety recommendations for oral healthcare assistance during COVID-19. An Activity Based Costing evaluation was used to calculate the acquisition of PPE and decontamination solutions recommended for dental practice during COVID-19 pandemic in Brazil. PPE and decontamination solutions quantity and frequency of use were based on the newly COVID-19 recommendations. Costs (in Brazilian Real - R$) for biosafety recommendations pre- and post-COVID-19 were outlined and calculated for each patient, service shift and year. A sensitivity analysis considered 20% variation of direct costs. Previously to COVID-19 pandemic, direct costs of biosafety recommendations consisted of R$0.84 per patient, R$6.69 per service shift and R$3,413.94 per year. Post-COVID-19 costs of biosafety recommendations resulted in R$16.01 per patient, R$128.07 per service shift, and R$32,657.96 per year. Yearly costs can vary between R$26,126.37 and R$39,189.56. The annual budget increase necessary to adopt post-COVID biosafety recommendations was R$29,244.02. Newly biosafety recommendations increased significantly the costs of oral healthcare assistance during COVID-19 pandemic. Decision making of healthcare managers must consider rational and equity allocation of financial resources.