The study investigated the factors associated with the self-perception safety of dental students in clinical activities during the COVID-19 pandemic. This cross-sectional study was based on a semi-structured online (google forms) self-applied questionnaire, sent by e-mail to three private Dental Schools in Brazil. The variables were: 1) sociodemographic information; 2) questions about the measures adopted by dental schools before returning to clinical activities; 3) dental students’ self-perception of security; 4) the General Health Questionnaire. Data were submitted to Fisher’s exact test (p<0.05). Of the 294 eligible students, 97% were evaluated and 100% received previous specific biosafety training predominantly theoretical (72.16%) longer than one hour (51.55%). Most students (81.44%) felt secure performing clinical care during the COVID-19 pandemic. Students undergoing specific biosafety training for longer than one hour felt safer than those perfoming training for up to 1 hour (p=0.004). Students from schools where the aerosol-producing restriction was applied felt safer than those without restrictions (p=0.016). Women reported feeling less secure than men (p=0.046), and students who submitted to COVID-19 Specific Biosafety Training felt safer in clinical activities than those submitted to theoretical training only (p=0.011). Students from private universities presenting psychosomatic changes felt less secure in practicing clinical dental care activities (p=0.006). In conclusion, time-spent training in biosafety, restriction of the use of aerosol-producing procedures, and the gender of students were associated with the self-perception safety of students. Students with practical training felt safer in clinical activities for patients with COVID-19 than those who had only theoretical training.

ABSTRACT Aim The aim of our study was to analyze the content related to dentistry published on Instagram ® and to investigate the students’ profiles related to the use of social networks in a sample from a Dentistry School. Methods This study was carried out in two stages. First, research was conducted to analyze content published on Instagram® related to dentistry. The second part investigated the profiles of students’ from a dental school in relation to the use of social networks through a questionnaire. A descriptive analysis was performed and associations between the variables were tested using Fisher’s exact test. Results We found a diversified and large amount of content related to dentistry published on Instagram ® , and publications that involved advertising were more prevalent in our study. There are also many publications that are violating the Code of Dental Ethics. In addition, in the second part of our study, we observed an enormous use of social networks by dental students (98.4%). Conclusions As a result, we believe that it is important to update professionals about the ethical infractions related to social networks which could be approached during graduate courses in universities. Finally, the analyzed social network seems to be an interesting alternative for disseminating health information in order to dialogue with greater proximity to the large number of users who participate in it.

Aim In Brazil, COVID-19 remains one of the epicenters of the pandemic, thus, presential educational activities are suspended. The study aimed to describe the approach of flipped classroom performed to provide social distancing and to maintain teaching activities during COVID-19-pandemic. Methods Flipped Classroom was chosen to be associated with the role-play technique as a central methodology. To bring students closer to activities performed in the non-pandemic period, some actions and assessments were also role-played by Professor simulating patients in virtual meetings. Results Although the changes in the format of the lessons, our approaches stimulated the students maintained the high frequency of students in the activities (almost 100%) providing continuity activities. Conclusions This report can reinforce that meaningful learning can be taught by using a virtual/remote approach. However, the potential positive results observed cannot be used as an excuse to maintain remote teaching activities with the objective of cost-cutting by the institutions.

Resumo O objetivo deste estudo é descrever o perfil de utilização dos serviços de atenção primária à saúde, estimado pela Pesquisa Nacional de Saúde (PNS), da população residente em domicílios cadastrados e não cadastrados na Estratégia de Saúde da Família (ESF), nos anos de 2013 e 2019. Estudo transversal realizado com microdados dos inquéritos nacionais de saúde entre 2013 e 2019. A amostra originou-se de uma amostra mestra, composta por um conjunto de unidades de áreas selecionadas em um cadastro. Variáveis sexo, idade, cor da pele, renda, escolaridade, autopercepção de saúde, domicílio cadastrado na ESF, atendimento médico no último ano, tipo de serviço que você procura quando está doente foram selecionados. As variáveis dependentes foram uso de serviços de saúde e uso de serviços públicos de saúde. As variáveis dependentes e independentes foram descritas com os respectivos intervalos de confiança e foi realizada regressão logística ajustada para cada desfecho analisado. Nos serviços públicos de saúde, menor renda, ter doenças crônicas (hipertensão arterial ou colesterol alto), estar grávida e ter uma autopercepção de saúde ruim estiveram associados à maior utilização de serviços de saúde nos dois períodos. Morar em domicílios cadastrados na ESF foi associado aos serviços de saúde mais utilizados (públicos ou privados). A estratégia de saúde da família é uma estratégia importante para expandir o acesso de forma igualitária.

Abstract The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

Resumo O objetivo deste estudo é descrever o perfil de utilização dos serviços de atenção primária à saúde, estimado pela Pesquisa Nacional de Saúde (PNS), da população residente em domicílios cadastrados e não cadastrados na Estratégia de Saúde da Família (ESF), nos anos de 2013 e 2019. Estudo transversal realizado com microdados dos inquéritos nacionais de saúde entre 2013 e 2019. A amostra originou-se de uma amostra mestra, composta por um conjunto de unidades de áreas selecionadas em um cadastro. Variáveis sexo, idade, cor da pele, renda, escolaridade, autopercepção de saúde, domicílio cadastrado na ESF, atendimento médico no último ano, tipo de serviço que você procura quando está doente foram selecionados. As variáveis dependentes foram uso de serviços de saúde e uso de serviços públicos de saúde. As variáveis dependentes e independentes foram descritas com os respectivos intervalos de confiança e foi realizada regressão logística ajustada para cada desfecho analisado. Nos serviços públicos de saúde, menor renda, ter doenças crônicas (hipertensão arterial ou colesterol alto), estar grávida e ter uma autopercepção de saúde ruim estiveram associados à maior utilização de serviços de saúde nos dois períodos. Morar em domicílios cadastrados na ESF foi associado aos serviços de saúde mais utilizados (públicos ou privados). A estratégia de saúde da família é uma estratégia importante para expandir o acesso de forma igualitária.

Abstract The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

Objectives: the purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methods: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case notified in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, CI 95% [0.24 – 0.30]). As far as prenatal procedures are concerned, the reduction was 65% (IRR= 0.35, CI 95% [0.32 – 0.38], also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, CI 95% [0.11 – 0.53]) and May 2020 (IRR = 0.19, CI 95% [0.09 – 0.43]). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil’s Primary Health Care, subsequent to the onset of the COVID-19 pandemic.

Objetivos: o objetivo do estudo foi descrever o impacto da pandemia COVID-19 na Atenção Primária à Saúde Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios Brasileiros dos sistemas de informação do Sistema Único de Saúde. Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de COVID-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de COVID-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia ocorreu em maio (IRR = 0,27, IC 95% [0,24 - 0,30]). Para os procedimentos de pré-natal, a redução foi de 65% (IRR= 0.35, IC 95% [0.32 – 0.38]) em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC 95% [0,11 - 0,53]) e maio (IRR = 0,19, IC 95% [0,09 - 0,43]) de 2020. De fevereiro a dezembro de 2020 a pandemia impactou significantemente no total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde do Brasil, após o início da pandemia de COVID-19.

Resumo: O estudo teve como objetivo comparar a necessidade normativa de prótese dentária (estimada por dentista) com a necessidade subjetiva (autorrelatada), testando a acurácia e concordância e comparando a direção e magnitude das associações com variáveis independentes, usando necessidade normativa e subjetiva como os desfechos. Foi avaliada uma amostra representativa de uma coorte de nascimentos (n = 900), aos 31 anos de idade. A necessidade subjetiva foi obtida com um questionário. As variáveis necessidade normativa e subjetiva foram analisadas dicotomicamente como: (a) com necessidade de prótese dentária e (b) sem necessidade de prótese dentária. A acurácia foi avaliada enquanto sensibilidade (SE), especificidade (SP), valor preditivo positivo (VPP) e valor preditivo negativo (VPN). A concordância entre necessidade normativa e subjetiva foi avaliada com a estimativa do índice kappa. Sexo, renda, escolaridade, uso de serviços de odontologia e percepção da própria saúde oral foram usados para comparar as associações entre necessidade normativa e subjetiva. A prevalência de necessidade normativa era 48,9% e de necessidade subjetiva, 34,9%. A concordância (kappa: 0,43) e acurácia entre as necessidades normativa e subjetiva de prótese dentária eram baixas (SE: 56,5, IC95%: 50,3-62,6; SP: 85,8, IC95%: 81,1-89,7; VPP: 79,1, IC95%: 72,6-84,7; VPN: 67,3, IC95%: 62,1-72,2). Nos indivíduos com perda de dentes anteriores, os resultados mostraram boa concordância (kappa: 0,82) e acurácia entre necessidade normativa e subjetiva (SE: 93,3, IC95%: 68,1-99,8; SP: 88,9, IC95%: 51,8-99,7; VPP: 93,3, IC95%: 68,1-99,8; VPN: 88,9, IC95%: 51,8-99,7). A direção e magnitude das associações com necessidade normativa e subjetiva eram semelhantes. Portanto, a necessidade normativa de prótese dentária difere da necessidade subjetiva em adultos, exceto quando há perda de dentes anteriores.

Abstract: The aim of our study was to compare normative need for dental prosthesis (estimated by dentists) with subjective need (self-reported) by testing the accuracy and agreement and comparing direction and magnitude of associations with independent variables using both as outcomes. A representative sample of a birth cohort study (n = 900) was assessed at 31 years of age. Subjective need was obtained from questionnaire. Both normative and subjective need variables were dichotomized in (a) individuals with need for dental prosthesis and (b) without need for dental prosthesis. Accuracy was assessed by sensitivity (SE), specificity (SP), positive (PPV) and negative (NPV) predictive values. Agreement of normative and subjective need was assessed estimating kappa index. Sex, income, educational level, use of dental services and self-reported oral health were used to compare the associations with normative and subjective need. Prevalence of normative need was 48.9% and subjective need was 34.9%. Agreement (kappa: 0.43) and accuracy between normative and subjective need for dental prosthesis was low (SE: 56.5, 95%CI: 50.3-62.6; SP: 85.8, 95%CI: 81.1-89.7; PPV: 79.1, 95%CI: 72.6-84.7; NPV: 67.3, 95%CI: 62.1-72.2). When considering individuals with loss in anterior teeth, results showed a good agreement (kappa: 0.82) and accuracy between normative and subjective need (SE: 93.3, 95%CI: 68.1-99.8; SP: 88.9, 95%CI: 51.8-99.7; PPV: 93.3, 95%CI: 68.1-99.8; NPV: 88.9, 95%CI: 51.8-99.7). Direction and magnitude of associations with normative and subjective need were similar. Thus, normative need for dental prosthesis differs from subjective need in adults, except when anterior losses are present.

Resumen: El objetivo de este estudio fue comparar la necesidad normativa de prótesis detal -estimada por los dentistas- con la necesidad subjetiva -autoinformada-, probando la precisión y concordancia, así como comparando la dirección y magnitud de asociaciones con variables independientes, usando ambas como resultados. Se evaluó una muestra representativa de un estudio de cohorte de nacimientos (n = 900) a los 31 años de edad. La necesidad subjetiva procede de un cuestionario. Ambas variables necesidad normativa y subjetiva fueron dicotomizadas en (a) individuos con necesidad de una prótesis dental y (b) sin necesidad de una prótesis dental. La precisión se evaluó por sensibilidad (SE), especificidad (SP), valores predictivos positivos (PPV) y negativos (NPV). La concordancia entre necesidad normativa y subjetiva se evaluó estimando el índice de kappa. Sexo, ingresos, nivel educacional, uso de servicios dentales y autoinformados de salud oral se usaron para comparar las asociaciones con necesidad normativa y subjetiva. La prevalencia de necesidad normativa fue 48,9% y la de necesidad subjetiva fue 34,9%. Concordancia (kappa: 0,43) y precisión entre la necesidad normativa y subjetiva de prótesis dental fue baja (SE: 56,5, IC95%: 50,3-62,6; SP: 85,8, IC95%: 81,1-89,7; PPV: 79,1, IC95%: 72,6-84,7; NPV: 67,3, IC95%: 62,1- 72,2). Cuando consideramos a individuos con pérdidas de dientes anteriores, los resultados mostraron una buena concordancia (kappa: 0,82) y precisión entre necesidad normativa y subjetiva (SE: 93,3, IC95%: 68,1-99,8; SP: 88,9, IC95%: 51,8-99,7; PPV: 93,3, IC95%: 68,1-99,8); NPV: 88,9, IC95%: 51,8-99,7). La dirección y magnitud de las asociaciones con necesidad normativa y subjetiva fueron similares. Por lo tanto, la necesidad normativa de prótesis dentales difiere de la necesidad subjetiva en adultos, excepto cuando están presentes las pérdidas de dientes anteriores.

Resumo: O estudo teve como objetivo comparar a necessidade normativa de prótese dentária (estimada por dentista) com a necessidade subjetiva (autorrelatada), testando a acurácia e concordância e comparando a direção e magnitude das associações com variáveis independentes, usando necessidade normativa e subjetiva como os desfechos. Foi avaliada uma amostra representativa de uma coorte de nascimentos (n = 900), aos 31 anos de idade. A necessidade subjetiva foi obtida com um questionário. As variáveis necessidade normativa e subjetiva foram analisadas dicotomicamente como: (a) com necessidade de prótese dentária e (b) sem necessidade de prótese dentária. A acurácia foi avaliada enquanto sensibilidade (SE), especificidade (SP), valor preditivo positivo (VPP) e valor preditivo negativo (VPN). A concordância entre necessidade normativa e subjetiva foi avaliada com a estimativa do índice kappa. Sexo, renda, escolaridade, uso de serviços de odontologia e percepção da própria saúde oral foram usados para comparar as associações entre necessidade normativa e subjetiva. A prevalência de necessidade normativa era 48,9% e de necessidade subjetiva, 34,9%. A concordância (kappa: 0,43) e acurácia entre as necessidades normativa e subjetiva de prótese dentária eram baixas (SE: 56,5, IC95%: 50,3-62,6; SP: 85,8, IC95%: 81,1-89,7; VPP: 79,1, IC95%: 72,6-84,7; VPN: 67,3, IC95%: 62,1-72,2). Nos indivíduos com perda de dentes anteriores, os resultados mostraram boa concordância (kappa: 0,82) e acurácia entre necessidade normativa e subjetiva (SE: 93,3, IC95%: 68,1-99,8; SP: 88,9, IC95%: 51,8-99,7; VPP: 93,3, IC95%: 68,1-99,8; VPN: 88,9, IC95%: 51,8-99,7). A direção e magnitude das associações com necessidade normativa e subjetiva eram semelhantes. Portanto, a necessidade normativa de prótese dentária difere da necessidade subjetiva em adultos, exceto quando há perda de dentes anteriores.

Abstract: The aim of our study was to compare normative need for dental prosthesis (estimated by dentists) with subjective need (self-reported) by testing the accuracy and agreement and comparing direction and magnitude of associations with independent variables using both as outcomes. A representative sample of a birth cohort study (n = 900) was assessed at 31 years of age. Subjective need was obtained from questionnaire. Both normative and subjective need variables were dichotomized in (a) individuals with need for dental prosthesis and (b) without need for dental prosthesis. Accuracy was assessed by sensitivity (SE), specificity (SP), positive (PPV) and negative (NPV) predictive values. Agreement of normative and subjective need was assessed estimating kappa index. Sex, income, educational level, use of dental services and self-reported oral health were used to compare the associations with normative and subjective need. Prevalence of normative need was 48.9% and subjective need was 34.9%. Agreement (kappa: 0.43) and accuracy between normative and subjective need for dental prosthesis was low (SE: 56.5, 95%CI: 50.3-62.6; SP: 85.8, 95%CI: 81.1-89.7; PPV: 79.1, 95%CI: 72.6-84.7; NPV: 67.3, 95%CI: 62.1-72.2). When considering individuals with loss in anterior teeth, results showed a good agreement (kappa: 0.82) and accuracy between normative and subjective need (SE: 93.3, 95%CI: 68.1-99.8; SP: 88.9, 95%CI: 51.8-99.7; PPV: 93.3, 95%CI: 68.1-99.8; NPV: 88.9, 95%CI: 51.8-99.7). Direction and magnitude of associations with normative and subjective need were similar. Thus, normative need for dental prosthesis differs from subjective need in adults, except when anterior losses are present.

Resumen: El objetivo de este estudio fue comparar la necesidad normativa de prótesis detal -estimada por los dentistas- con la necesidad subjetiva -autoinformada-, probando la precisión y concordancia, así como comparando la dirección y magnitud de asociaciones con variables independientes, usando ambas como resultados. Se evaluó una muestra representativa de un estudio de cohorte de nacimientos (n = 900) a los 31 años de edad. La necesidad subjetiva procede de un cuestionario. Ambas variables necesidad normativa y subjetiva fueron dicotomizadas en (a) individuos con necesidad de una prótesis dental y (b) sin necesidad de una prótesis dental. La precisión se evaluó por sensibilidad (SE), especificidad (SP), valores predictivos positivos (PPV) y negativos (NPV). La concordancia entre necesidad normativa y subjetiva se evaluó estimando el índice de kappa. Sexo, ingresos, nivel educacional, uso de servicios dentales y autoinformados de salud oral se usaron para comparar las asociaciones con necesidad normativa y subjetiva. La prevalencia de necesidad normativa fue 48,9% y la de necesidad subjetiva fue 34,9%. Concordancia (kappa: 0,43) y precisión entre la necesidad normativa y subjetiva de prótesis dental fue baja (SE: 56,5, IC95%: 50,3-62,6; SP: 85,8, IC95%: 81,1-89,7; PPV: 79,1, IC95%: 72,6-84,7; NPV: 67,3, IC95%: 62,1- 72,2). Cuando consideramos a individuos con pérdidas de dientes anteriores, los resultados mostraron una buena concordancia (kappa: 0,82) y precisión entre necesidad normativa y subjetiva (SE: 93,3, IC95%: 68,1-99,8; SP: 88,9, IC95%: 51,8-99,7; PPV: 93,3, IC95%: 68,1-99,8); NPV: 88,9, IC95%: 51,8-99,7). La dirección y magnitud de las asociaciones con necesidad normativa y subjetiva fueron similares. Por lo tanto, la necesidad normativa de prótesis dentales difiere de la necesidad subjetiva en adultos, excepto cuando están presentes las pérdidas de dientes anteriores.

Resumo: O estudo teve dois objetivos: (a) investigar as desigualdades raciais enquanto uma dimensão específica que afeta a prevalência de dor de dente em adolescentes brasileiros, e (b) analisar as variações regionais na prevalência de dor de dente. O estudo transversal usou dados da Pesquisa Nacional de Saúde do Escolar (PeNSE), realizada com adolescentes em 2009, 2012 e 2015. Dor de dente foi avaliada com a pergunta: “Nos últimos seis meses, você teve dor de dente?”. As principais exposições foram raça/cor e macrorregiões brasileiras, usadas para avaliar as desigualdades relacionadas ao desfecho. Sexo, idade, tipo de escola e escolaridade materna foram as covariáveis utilizadas. A significância estatística das tendências na prevalência de dor de dente foi testada com regressão linear. As análises foram realizadas com o programa estatístico Stata 13.0, usando o comando svy. A prevalência padrão de dor de dente foi 18,8%, 21,1% e 23,7%, com uma tendência crescente ao longo do tempo (p < 0,001). Foram observadas desigualdades absolutas na prevalência de dor de dente de acordo com raça e macrorregião. A prevalência mais alta esteve associada ao sexo feminino, raça não-branca, escola pública e Região Norte do país. Os índices de desigualdade aumentaram no grupo de meninas negras, refletidos em um aumento na prevalência de dor de dente em meninas cujas mães tinham menos escolaridade. A prevalência de dor de dente em adolescentes brasileiros aumentou ao longo do tempo, e as desigualdades em relação à dor de dente persistiram nas populações marginalizadas e de acordo com a região do país.

Abstract: The aim of the study is: (a) investigate the racial inequalities as one specific dimension that affects dental pain in Brazilian adolescents; and (b) investigate the regional variations of dental pain. This cross-sectional study used data from Brazilian National Survey of School Health (PeNSE), carried out with adolescents in 2009, 2012 and 2015. Dental pain was evaluated through the question: “Did you have dental pain in the last six months?”. The main exposures were race and Brazilian regions, used to evaluate inequalities related to the outcome. Sex, age, school type and maternal education were used as covariables. The statistical significance of the trends in dental pain was tested using linear regression. The analysis was conducted in Stata 13.0 statistical package using the svy command. The standard prevalence of dental pain was 18.8%, 21.1% and 23.7%, showing an increasing trend over time (p < 0.001). We observed absolute inequalities in dental pain related to race and regions. A higher prevalence was found in non-white girls of public schools and in the Northern Region. The indexes of inequalities increased in the group of black girls, related to an increase of dental pain predominantly in girls whose mothers had lower educational level. It was observed that the prevalence of dental pain in Brazilian adolescents increased over time as well as its inequalities, which remained in marginalized populations and linked to Brazilian regions.

Resumen: El objetivo del estudio fue doble: (a) investigar las desigualdades raciales, como una dimensión específica que afecta al dolor dental, en adolescentes brasileños; e (b) investigar las variaciones regionales del dolor dental. Este estudio transversal usó datos de la Encuesta Nacional de Salud del Escolar (PeNSE), llevada a cabo con adolescentes en 2009, 2012 y 2015. El dolor dental fue evaluado por la pregunta: “En los últimos seis meses, ¿sufriste dolor dental?”. Los principales factores de exposición fueron raza y regiones brasileñas, y se usaron para evaluar las desigualdades relacionadas con los resultados. Sexo, edad, tipo de escuela y educación maternal fueron las covariables usadas. La significación estadística de las tendencias en el dolor dental fue probada usando regresión lineal. El análisis se realizó con el paquete estadístico Stata 13.0, usando el comando svy. El estándar de prevalencia de dolor dental fue 18,8%, 21,1% y 23,7%, con tendencia a aumentar a lo largo del tiempo (p < 0.001). Se observaron desigualdades absolutas en el dolor dental, relacionadas con raza y regiones. Se encontró una prevalencia más alta en chicas, de raza no blanca, escuelas públicas y Región del Norte. Los índices de desigualdades se incrementaron en el grupo de chicas negras, en detrimento de un incremento en la prevalencia del dolor dental en chicas cuyas madres contaban con menos educación formal. Se observó que la prevalencia de dolor dental en adolescentes brasileñas se incrementó a lo largo del tiempo y las desigualdades, respecto al dolor dental, continuaron manteniéndose en el tiempo en poblaciones marginalizadas y acordes con determinadas regiones brasileñas.

Resumo: O estudo teve dois objetivos: (a) investigar as desigualdades raciais enquanto uma dimensão específica que afeta a prevalência de dor de dente em adolescentes brasileiros, e (b) analisar as variações regionais na prevalência de dor de dente. O estudo transversal usou dados da Pesquisa Nacional de Saúde do Escolar (PeNSE), realizada com adolescentes em 2009, 2012 e 2015. Dor de dente foi avaliada com a pergunta: “Nos últimos seis meses, você teve dor de dente?”. As principais exposições foram raça/cor e macrorregiões brasileiras, usadas para avaliar as desigualdades relacionadas ao desfecho. Sexo, idade, tipo de escola e escolaridade materna foram as covariáveis utilizadas. A significância estatística das tendências na prevalência de dor de dente foi testada com regressão linear. As análises foram realizadas com o programa estatístico Stata 13.0, usando o comando svy. A prevalência padrão de dor de dente foi 18,8%, 21,1% e 23,7%, com uma tendência crescente ao longo do tempo (p < 0,001). Foram observadas desigualdades absolutas na prevalência de dor de dente de acordo com raça e macrorregião. A prevalência mais alta esteve associada ao sexo feminino, raça não-branca, escola pública e Região Norte do país. Os índices de desigualdade aumentaram no grupo de meninas negras, refletidos em um aumento na prevalência de dor de dente em meninas cujas mães tinham menos escolaridade. A prevalência de dor de dente em adolescentes brasileiros aumentou ao longo do tempo, e as desigualdades em relação à dor de dente persistiram nas populações marginalizadas e de acordo com a região do país.

Abstract: The aim of the study is: (a) investigate the racial inequalities as one specific dimension that affects dental pain in Brazilian adolescents; and (b) investigate the regional variations of dental pain. This cross-sectional study used data from Brazilian National Survey of School Health (PeNSE), carried out with adolescents in 2009, 2012 and 2015. Dental pain was evaluated through the question: “Did you have dental pain in the last six months?”. The main exposures were race and Brazilian regions, used to evaluate inequalities related to the outcome. Sex, age, school type and maternal education were used as covariables. The statistical significance of the trends in dental pain was tested using linear regression. The analysis was conducted in Stata 13.0 statistical package using the svy command. The standard prevalence of dental pain was 18.8%, 21.1% and 23.7%, showing an increasing trend over time (p < 0.001). We observed absolute inequalities in dental pain related to race and regions. A higher prevalence was found in non-white girls of public schools and in the Northern Region. The indexes of inequalities increased in the group of black girls, related to an increase of dental pain predominantly in girls whose mothers had lower educational level. It was observed that the prevalence of dental pain in Brazilian adolescents increased over time as well as its inequalities, which remained in marginalized populations and linked to Brazilian regions.

Resumen: El objetivo del estudio fue doble: (a) investigar las desigualdades raciales, como una dimensión específica que afecta al dolor dental, en adolescentes brasileños; e (b) investigar las variaciones regionales del dolor dental. Este estudio transversal usó datos de la Encuesta Nacional de Salud del Escolar (PeNSE), llevada a cabo con adolescentes en 2009, 2012 y 2015. El dolor dental fue evaluado por la pregunta: “En los últimos seis meses, ¿sufriste dolor dental?”. Los principales factores de exposición fueron raza y regiones brasileñas, y se usaron para evaluar las desigualdades relacionadas con los resultados. Sexo, edad, tipo de escuela y educación maternal fueron las covariables usadas. La significación estadística de las tendencias en el dolor dental fue probada usando regresión lineal. El análisis se realizó con el paquete estadístico Stata 13.0, usando el comando svy. El estándar de prevalencia de dolor dental fue 18,8%, 21,1% y 23,7%, con tendencia a aumentar a lo largo del tiempo (p < 0.001). Se observaron desigualdades absolutas en el dolor dental, relacionadas con raza y regiones. Se encontró una prevalencia más alta en chicas, de raza no blanca, escuelas públicas y Región del Norte. Los índices de desigualdades se incrementaron en el grupo de chicas negras, en detrimento de un incremento en la prevalencia del dolor dental en chicas cuyas madres contaban con menos educación formal. Se observó que la prevalencia de dolor dental en adolescentes brasileñas se incrementó a lo largo del tiempo y las desigualdades, respecto al dolor dental, continuaron manteniéndose en el tiempo en poblaciones marginalizadas y acordes con determinadas regiones brasileñas.

Abstract Objective Our study aims to compare the efficacy and tooth sensitivity following in-office (35% hydrogen peroxide) or at-home (10% carbamide peroxide) bleaching treatments both preceded by 2% potassium nitrate (2%KF) desensitizing gel. Methodology 130 volunteers were randomly allocated to a) in-office bleaching and a placebo at-home protocol; or b) in-office placebo and at-home bleaching treatment. 2% KF was applied for 10 min before both treatments. Objective color evaluation was performed (spectrophotometer CIEL*a*b* system and CIEDE2000) to calculate the color change (ΔE00). Subjective evaluation was performed using the VITA classical shade guide followed by shade variation (ΔSGU) at the beginning and end of bleaching treatment and 2 weeks post-bleaching. Tooth sensitivity was daily recorded using a Likert scale varying from 1 (no sensitivity) to 5 (severe sensitivity). Analysis was carried out using non-parametric tests. Results Regarding the color change, at-home bleaching resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.003) and Δa* (p=0.014). Two weeks post-bleaching, the at-home treatment resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.037) and ΔE00 (p=0.033). No differences were observed in either ΔSGU parameters. Concerning sensitivity, patients treated with in-office bleaching reported more tooth sensitivity than the at-home group only on the first day after bleaching started, without significant differences in the other periods evaluated (p>0.05). Conclusions At-home and in-office bleaching, preceded by a desensitizing agent, were effective for vital teeth bleaching and 10% carbamide peroxide produced a higher whitening effect than 35% hydrogen peroxide in the short time evaluation. Tooth sensitivity rates were similar for the two techniques tested.

Abstract This study developed and characterized a method for controlled deposition of thin films of hydroxyapatite on titanium surfaces. Thirty-three titanium cylinders were randomly divided: negative control/polished (A), acid etched (B) and coated by hydroxyapatite (C). Acid etch was performed in an aqueous solution of nitric acid. The cylinders were subjected to coating by a thin film of hydroxyapatite with dip-coating method. These cylinders were submitted to a pre-heat treatment 450°C/10 minutes and 800°C/2 hours. Scanning electron microscopy analysis demonstrated a homogeneous and smooth surface (A), an irregular and porous surface (B) and a crystalline deposition (C). The X-ray energy dispersive analysis showed characteristic elements of hydroxyapatite (C). Analysis by X-ray diffraction showed the presence of characteristic peaks of hydroxyapatite, corresponding to the structural composition of hydroxyapatite. Cell viability (MTT-assay in NIH-3T3-Cells) test demonstrated no differences between the groups. Titanium surfaces coated with a hydroxyapatite film by the dip-coating method suggest adequate control of deposition of thin films of hydroxyapatite and similar cell viability using mouse fibroblasts.

RESUMO: Objetivos: O objetivo do presente estudo foi descrever o impacto da pandemia de covid-19 na Atenção Primária à Saúde (APS) Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios brasileiros, obtidos nos sistemas de informação do Sistema Único de Saúde (SUS). Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de covid-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de covid-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia em curso ocorreu em maio (IRR = 0,27, IC95% 0,24 - 0,30). Para os procedimentos de pré-natal, a redução foi de 65% (IRR = 0,35, IC95% 0.32 - 0.38), também em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC95% 0,11 - 0,53) e maio (IRR = 0,19, IC95% 0,09 - 0,43) de 2020. De fevereiro a dezembro de 2020, a pandemia de covid-19 impactou significantemente o total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde (APS) do Brasil, após o início da pandemia de covid-19.

ABSTRACT: Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methodology: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 – 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 – 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 – 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 – 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.

RESUMO: Objetivos: O objetivo do presente estudo foi descrever o impacto da pandemia de covid-19 na Atenção Primária à Saúde (APS) Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios brasileiros, obtidos nos sistemas de informação do Sistema Único de Saúde (SUS). Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de covid-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de covid-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia em curso ocorreu em maio (IRR = 0,27, IC95% 0,24 - 0,30). Para os procedimentos de pré-natal, a redução foi de 65% (IRR = 0,35, IC95% 0.32 - 0.38), também em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC95% 0,11 - 0,53) e maio (IRR = 0,19, IC95% 0,09 - 0,43) de 2020. De fevereiro a dezembro de 2020, a pandemia de covid-19 impactou significantemente o total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde (APS) do Brasil, após o início da pandemia de covid-19.

ABSTRACT: Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methodology: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 – 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 – 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 – 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 – 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.

Abstract: The present study aimed to estimate the impact of the COVID-19 pandemic on dental care procedures in the Public Health System in Brazil. A retrospective, ecological study was carried out, comprising 5,564 Brazilian municipalities. The number of dental procedures (per 100,000 inhabitants) performed in the Brazilian Public Health System (SUS) was the outcome. The impact of the pandemic was estimated by comparing the rate of procedures for each month of 2020 with the rates observed in the equivalent months in 2019, considering the period from March to August. Regulatory legislation regarding restrictions on dental care, issued by the state governments of 27 Brazilian federative units, was used for mediation analysis. A 55% reduction was observed in March for all procedures (IRR = 0.45, 95%CI 0.39–0.51), while in the other months, the rate of reduction remained ≥ 88%. The biggest decrease was observed in collective preventive procedures (reduction ≥99%) between April and August. Procedures that were less likely to generate aerosols (tooth extraction and prosthetic) and emergencies showed the smallest reduction. The reduction was not mediated by the restrictions imposed by state governments (p>0.05). The impact of the COVID-19 pandemic was noteworthy in terms of the decrease in the number of dental procedures carried out in the Brazilian Public Dental Service. The lack of access, the delay of elective procedures and the lack of preventive collective procedures could result in an overburdened system, post-Pandemic.