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Aim To assess the prevalence of dental emergency visits (DEV) involving pain relief and their relationship with socio‐economic and clinical factors in an Australian representative sample in the primary care setting. Methodology Data on reason for visit and patient characteristics were collected from a representative random sample of Australian dentists in private practice surveyed in 2009–2010. Information regarding socio‐economic (gender, age, health insurance) and clinical factors (number of teeth, number of decayed teeth, diagnosis and reason for visit [DEV, check‐up, other reasons not involving pain relief]) were retrieved from compiled questionnaires. Descriptive statistics were reported, and Poisson regression models were used to assess the association between socio‐economic and clinical factors and DEV. Prevalence ratio (PR) and 95% confidence interval (CI) were calculated. Results A total of 1148 dentists responded (67%), resulting in records from 6504 patients. The overall prevalence of DEV was 20.8%. The unadjusted analysis, according to the reason of visit, revealed the following predictors for DEV: male gender (PR = 1.18; 95% CI = 1.08–1.29), age 18–64 years (PR = 2.70; 95% CI = 2.19–3.33) and over 65 years (PR = 2.64, 95% CI = 2.10–3.32), uninsured patients (PR = 1.36; 95% CI = 1.24–1.49), patients with <20 teeth (PR = 1.19; 95% CI = 1.06–1.33), decayed teeth (PR = 1.64; 95% CI = 1.48–1.81). After adjustment for confounding factors (gender, age, insurance status, number of teeth and decayed teeth) apart from ‘dental trauma’ (PR = 1.37), all remaining diagnoses had lower PR (‘other’ PR = 0.19, ‘decay’ PR = 0.34, ‘periodontal’ PR = 0.51, ‘failed restoration’ PR = 0.45) compared with ‘pulp/periapical disease’. Conclusions In the primary care setting, the diagnoses ‘pulp/periapical’ and ‘dental trauma’ had a stronger association with DEV compared with visits not involving relief of pain. Both socio‐economic (male gender, older age and uninsured individuals) and clinical factors (tooth loss, decayed teeth, endodontic diseases and dental trauma) were identified as independent risk indicators for DEV in this population. Future public health policies should include specific preventive strategies addressing these factors, aiming to reduce the need for DEV.

This review, registered in PROSPERO (CRD42018102582), assessed the effect of temporary anchorage device placement on endodontic complications. A search strategy was followed to identify studies where any temporary anchorage devices contacted or were in proximity to tooth roots in humans. Studies with low possibility of bias and published in English or Latin-character languages were considered for inclusion. Ten studies were identified; five case reports, one clinical study and four studies with intentional injury, totalling 736 temporary anchorage devices in 327 patients. Complications may ensue following temporary anchorage device placement, whether or not root contact occurs. Chronic apical periodontitis developed when there was root injury involving the pulp; necrosis can also occur. When damage was limited to the periodontal ligament, cementum or dentine, repair occurred, normally within 12 weeks. Clinicians should be aware of the potential for endodontic complications during temporary anchorage device placement, as well as during orthodontic treatment.

O objetivo deste estudo transversal foi avaliar o desfecho dor e fatores associados em pacientes atendidos em um serviço de urgência odontológica no sul do Brasil. Foram avaliados 137 prontuários provenientes de um projeto de extensão para capacitação em atendimento odontológico de urgência da Universidade Federal de Santa Maria (Santa Maria/RS), referentes ao período de abril de 2017 a dezembro de 2018. Os dados contidos na ficha clínica, autorrelatados pelos pacientes, foram coletados e variáveis relacionadas às características socioeconômicas, médicas e odontológicas foram submetidas à análise estatística descritiva e regressão de Poisson multivariada. A prevalência de dor nestes pacientes foi de 65,2% e a hipótese diagnóstica mais prevalente foi de pulpite aguda irreversível (46,2% dos casos). A procura por atendimento foi maior na faixa etária entre 40-59 anos (48,6%), no sexo feminino (64%), em pacientes sem nível superior (85,3%) e os dentes mais frequentemente tratados foram os posteriores (82,7%). Houve associação entre a presença de dor e variáveis médicas, sendo que os pacientes com mais de duas doenças sistêmicas apresentaram maior prevalência de dor. O preenchimento inadequado dos prontuários odontológicos foi um achado comum, o que pode prejudicar o estabelecimento do perfil epidemiológico destes pacientes e o planejamento dos atendimentos futuros de forma eficiente, além de poder acarretar problemas jurídicos.

The purpose of this study was to assess the fracture resistance of extensively damaged teeth after two root canal preparation techniques (hand and rotary files) and after two filling techniques (active and passive compaction). Sixty-eight maxillary canines roots with an apical diameter equal to that of a #25 K-file were embedded in acrylic resin and the periodontal ligament was simulated by using a polyether impression material. The roots were randomly distributed into four groups (n=17): hand preparation and active compaction (HA), hand preparation and passive compaction (HP), rotary preparation and active compaction (RA), and rotary preparation and passive compaction (RP). All roots were restored with glass fiber post and metallic crown. The specimens were mechanically cycled (500,000 cycles, 45 °, 37 °C, 133 N, 2 Hz) and then subjected to a fracture resistanhe fracture resistance values ranged between 621.15 N (HP) and 785.71 N (HA). However, the Kruskal-Wallis test did not reveal differences in the fracture ce test. A single blinded examiner analyzed the external root surface and classified the failure pattern as favorable or unfavorable. Tresistance values among the four groups (p =0.247). Under the tested conditions, root canal preparation and filling techniques had no influence on the fracture resistance of extensively damaged teeth restored with fiber post and metallic crown.

The aim of this study was to assess self-reported history of root canal treatment (SRHRCT) as a method for detecting the presence of root canal treatment (RCT) and apical periodontitis (AP) in a southern Brazilian subpopulation. In this cross-sectional study, 136 military police officers from the city of Porto Alegre, Brazil, were included. The participants were interviewed and full-mouth periapical radiographs were taken. A calibrated examiner determined the presence of RCT and AP by applying standardized criteria. The diagnostic accuracy of SRHRCT was calculated separately for RCT and AP. Accuracy, sensitivity, specificity, positive and negative predictive values (+PV and-PV), efficiency, and positive and negative likelihood ratios (+LR and-LR) were estimated. The mean age of the participants was 34.1 ± 10.4 years and 88.2% were males. Overall, SRHRCT demonstrated high sensitivity and specificity for RCT, but not for AP: sensitivity (RCT = 0.960, AP = 0.757) and specificity (RCT = 0.835, AP = 0.631). The estimated values for PV and LR were: +PV (RCT=0.777, AP=0.396),-PV (RCT = 0.972, AP = 0.890), +LR (RCT = 5.853, AP = 2.057), and-LR (RCT = 0.046, AP = 0.383). SRHRCT proved to be a good predictor of the presence of RCT, but a weak predictor of AP in this subpopulation.

Esse artigo apresenta o relato de experiência a respeito do projeto de Capacitação em Atendimento Odontológico de Urgência e Emergência na Universidade Federal de Santa Maria. O tratamento de urgência e emergência pode ser descrito como a abordagem inicial de um paciente que se encontra em situação de dor ou anormalidade, abrangendo afecções pulpares, periapicais, periodontais ou traumáticas, necessitando intervenções clínicas e/ou cirúrgicas. Esses atendimentos fazem parte da rotina do cirurgião-dentista, logo, o projeto surgiu com o objetivo de capacitar alunos do Curso de Odontologia que têm pouca experiência e contato durante a graduação com tais procedimentos. O projeto também tem objetivo de ofertar à população, que busca atendimento nas clínicas da Universidade, uma opção de um serviço destinado exclusivamente para esses atendimentos, visto que são poucas vagas ofertadas pelas clínicas usuais da graduação. Com início em março de 2017, funcionando em dois turnos semanais, conta com alunos de graduação, professores, uma odontóloga e alunos de pós-graduação. O atendimento de urgência busca, principalmente, o alívio da dor, eliminando imediatamente sua causa, e restauração da função dentária e encaminhamento do paciente para realização do tratamento odontológico definitivo adequado. Até dezembro de 2017, com cerca de 10 meses de projeto, aproximadamente 80 pacientes receberam atendimento, obtendo suas queixas sanadas e sendo acolhidos pela Universidade. Cerca de 77% dos atendimentos envolveram alguma intervenção endodôntica.

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