TEDE Coleção:

Tendências de gastos com cuidados odontológicos por provedores e serviços de saúde, e Quintis do índice sociodemográfico em 195 países, de 2000 a 2017

2026-05-26T17:49:44Z

Título: Tendências de gastos com cuidados odontológicos por provedores e serviços de saúde, e Quintis do índice sociodemográfico em 195 países, de 2000 a 2017 Autor: CAMPOS, Handreza Régia Santos Siqueira Primeiro orientador: HUGO, Fernando Neves Abstract: The number of people affected by oral diseases in the world is approximately 3.5 billion. In this scenario, dental care spending is uneven across countries. Health expenditure analyses have been conducted to understand the current global health financing situation and to assist in health planning. The objective of this study is to describe trends in dental care spending, by health providers and services, and by Socio-Demographic Index quintiles in 195 countries, between 2000 and 2017. Health account data were extracted from 195 countries and expenditures categorized according to the System of Health Accounts. Missing or non-existent data were estimated using a Bayesian multivariate model to construct complete time series. Spending trends were measured using generalized linear regression and the Prais-Winsten method. The results showed that per capita expenditure and total expenditure, in millions of dollars, on dental care by total and outpatient/clinical service providers revealed a clear gradient, with values increasing with greater socioeconomic development. In 2017, countries in high quintile had per capita expenditure 278 and 93 times higher than countries in the low and lower-middle quintile, respectively. Dental expenditure represented a small share in relation to total health expenditure, regardless of the level of development of the countries (in 2017, low quintile – 2,55% and high – 4,66%). In the trend analysis, all quintiles showed an increase in per capita expenditure and total dental expenditure, in relation to total dental providers and outpatient/clinical care. It was concluded that there were large inequalities in the distribution by levels of economic development in dental care spending. To date, this work is the most comprehensive proposal for analyzing trends in dental care expenditure. The findings of this study can help managers identify the prioritization that has been given to public oral health policies, also considering the context of the Universal Health Coverage Agenda, the Global Oral Health Strategy and the Sustainable Development Goals. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Adesivos autocondicionantes com biovidro 45S5 funcionalizados com clorexidina: Avaliação da resistência de união e nanoinfiltração ao longo do tempo

2026-05-20T19:06:13Z

Título: Adesivos autocondicionantes com biovidro 45S5 funcionalizados com clorexidina: Avaliação da resistência de união e nanoinfiltração ao longo do tempo Autor: ASSIS, Felipe Catarino de Primeiro orientador: LIMA, Darlon Martins Abstract: Adhesive systems play a fundamental role in restorative procedures, but their durability can be compromised by the degradation of the hybrid layer due to the activity of collagenolytic enzymes, such as MMPs. Strategies to improve the longevity of adhesive interfaces include the use of bioactive particles, such as 45S5 bioglass, which promotes remineralization and functionalization with drugs. The aim of this study was to evaluate the bond strength and nanoleakage pattern of an experimental self-etching adhesive system containing 45S5 bioglass particles functionalized with chlorhexidine. Materials and methods: Experimental self-etching adhesive systems containing 45S5 bioglass particles functionalized or not with chlorhexidine, at different concentrations (5% and 20%), were evaluated using 48 human third molars. Bond strength was tested 24 hours and after 6 months, and nanoleakage was analyzed with silver nitrate and SEM. A commercial adhesive system and an experimental adhesive system without particles were used as controls. Statistical analysis included Two-Way ANOVA and Holm-Sidak test (α = 0.05). Results: Bond strength tests to dentin revealed significant differences between the immediate and six-month evaluation times (p < 0.001), with no significant interaction between adhesive type and time (p = 0.526), indicating that the performance of the adhesives followed similar trends. Aging reduced bond strength in all adhesives tested. Nanoleakage analysis indicated a significant interaction between adhesive and time (p = 0.016), with the 45S5 5% adhesive showing improvement after 6 months, outperforming the control (p < 0.05), while 45S5 20% showed worsening. 45S5 CHX 5% also outperformed 45S5 20%, evidencing the influence of composition and storage time on nanoleakage. Conclusions: Although the bond strength values to dentin were similar between the groups, the experimental adhesive 45S5 5% demonstrated greater stability in the nanoleakage test after six months, highlighting its potential as a bioactive material to improve the durability of resin-dentin interfaces. Functionalization with chlorhexidine also contributed positively, reinforcing its viability to inhibit interface degradation over time. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

EXPLORANDO CONEXÕES ENTRE ALTERAÇÕES ÓSSEAS DEGENERATIVAS E INFLAMATÓRIAS E AS PATOLOGIAS PULPO-PERIAPICAIS

2026-03-16T12:53:51Z

Título: EXPLORANDO CONEXÕES ENTRE ALTERAÇÕES ÓSSEAS DEGENERATIVAS E INFLAMATÓRIAS E AS PATOLOGIAS PULPO-PERIAPICAIS Autor: SILVA, Ana Paula Nóbrega Caetano da Primeiro orientador: SOUZA, Soraia de Fátima Carvalho Abstract: Introduction: Pulpo-periapical pathologies are chronic inflammatory diseases with high global prevalence, mostly resulting from the progression of untreated dental caries. Beyond their local impact, these conditions contribute to the individual's systemic inflammatory burden. Conversely, systemic disorders affecting bone metabolism may modulate the host response to these oral infections. This dissertation investigated the connections between two classes of systemic bone alterations: one degenerative (osteoporosis) and the other inflammatory (rheumatic autoimmune diseases), and pulpo-periapical pathologies. The objectives were to assess the evidence regarding: 1) the association between osteoporosis and the occurrence of pulpo-periapical pathologies; and 2) the association between rheumatic autoimmune diseases and the occurrence of pulpo-periapical pathologies. Methods: This dissertation comprises two systematic reviews and meta-analyses, following the PRISMA 2020 recommendations. Comprehensive searches were conducted in MEDLINE/PubMed, Embase, Scopus, BVS-Bireme, Web of Science, SciELO, and Cochrane Library databases, as well as in the grey literature. Observational studies (cross-sectional, cohort, and case-control) comparing the occurrence of pulpo-periapical pathologies in individuals with osteoporosis (first study) or rheumatic autoimmune diseases (second study) versus healthy control groups were included in both studies. Data were extracted by independent reviewers. Risk of bias was assessed using the Joanna Briggs Institute (JBI) tool, and the certainty of evidence was evaluated using the GRADE system. Meta-analyses were conducted using random-effects models to calculate Odds Ratios (OR) with 95% Confidence Intervals (95% CI). Results: In the first study (Chapter II), the random-effects meta-analysis of six studies identified no significant association between osteoporosis and the presence of pulpo-periapical pathologies (unadjusted OR= 1.65; 95% CI: 0.80 to 3.41; I²=98.5%). The result remained insignificant in the adjusted analysis (OR= 1.96; 95% CI: 0.68 to 5.66). In the second study (Chapter III), the random-effects meta-analysis of thirteen studies demonstrated a positive and significant association between rheumatic autoimmune diseases and pulpo-periapical pathologies. This association was found in both the patient-level analysis (adjusted OR= 1.60; 95% CI: 1.20 to 2.12; I²=95.2%) and the tooth-level analysis (unadjusted OR= 1.74; 95% CI: 1.28 to 2.37; I²=69.4%). In both reviews, the certainty of evidence was classified as "Very Low" (GRADE), mainly due to the high risk of bias in primary studies, high heterogeneity, and imprecision of results. Conclusion: The findings of this dissertation regarding the investigated outcomes yielded contrasting results: in the first study (Chapter II), the systematic review and meta-analysis showed no association between osteoporosis (a degenerative condition) and pulpo-periapical pathologies; however, in the second study (Chapter III), a positive association was observed with rheumatic autoimmune diseases (inflammatory conditions). The biological plausibility of this result suggests the need for an integrated clinical approach for the prevention of pulpoperiapical pathologies in individuals with rheumatic autoimmune diseases. Furthermore, we suggest future longitudinal studies with greater methodological rigor to elucidate possible connections between osteoporosis and endodontic outcomes. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

IMPACTO DA MODELAGEM ADESIVA E DO TIPO DE LUVA NAS PROPRIEDADES MECÂNICAS DE UMA RESINA COMPOSTA: Um Estudo In Vitro

2026-03-09T18:00:51Z

Título: IMPACTO DA MODELAGEM ADESIVA E DO TIPO DE LUVA NAS PROPRIEDADES MECÂNICAS DE UMA RESINA COMPOSTA: Um Estudo In Vitro Autor: TRINTA, Luana Barbieri Primeiro orientador: LAGO, Andréa Dias Neves Abstract: Restorative materials, such as composite resins, are widely used due to their esthetics, functionality, and preservation of dental structure. Their properties include strength, homogeneity, and ease of handling; however, these characteristics can be compromised by contamination during manipulation. Handling techniques vary according to the material's features, and the use of adhesives as lubricants and/or digital modeling can negatively impact the longevity of restorations due to the formation of defects at the adhesive interface. This study aimed to evaluate the influence of physical-mechanical properties of composite resins manipulated with latex and latex-free gloves, followed by modeling with two different adhesive systems. Nine groups were evaluated: (G1) Control group, (G2) Conventional adhesive group, (G3) Universal adhesive group, (G4) Latex gloves group, (G5) Latex gloves + conventional adhesive group, (G6) Latex gloves + universal adhesive group, (G7) Nitrile gloves group, (G8) Nitrile gloves + conventional adhesive group, and (G9) Nitrile gloves + universal adhesive group. Flexural strength, elastic modulus, water sorption, and Vickers microhardness were assessed. The results revealed that manipulation with adhesives significantly altered the physicochemical properties of the composites, except for water sorption and solubility tests, which showed no statistical variations among groups (). In the flexural strength test, group G9 (Nitrile + Universal Adhesive) showed the best median performance, while G3 (Universal Adhesive alone) exhibited the lowest values. Regarding the elastic modulus, groups G6, G7 and G9 demonstrated higher stiffness, whereas G2 presented the lowest stability. Vickers microhardness was severely negatively impacted in groups G2 and G3, evidencing that the use of adhesives as modelers, regardless of the glove type, reduces surface hardness. It is concluded that digital manipulation with nitrile gloves, especially when associated with universal adhesive, presents superior performance compared to latex manipulation, whose residues and sulfides tend to compromise the polymerization and the final mechanical strength of the resin. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação