RESUMOPacientes com necessidades especiais (PNE) representam uma porcentagem significativa da população brasileira, correspondendo a 24% da parcela populacional. Entretanto, esses pacientes podem enfrentar diversas barreiras de acesso ao tratamento. O objetivo desse trabalho é conhecer as percepções e dificuldades encontradas por estudantes de Odontologia, referentes ao atendimento de PNE. Foi realizada a aplicação de um questionário aos graduandos do 2º ao 4º ano da Faculdade de Odontologia de Bauru (n=122), com questões referentes ao atendimento odontológico e suas percepções sobre os PNE. Observa-se que parcela significativa dos estudantes não se sentem preparados para esse atendimento, chegando a 95% no 4º ano. Sobre a percepção quanto ao preparo para atender PNE, os graduandos do 4º ano referem-se como regular, enquanto a maioria dos que cursam o 2º e 3º anos acredita não estar preparada para o atendimento. O tratamento odontológico é fundamental para o estabelecimento da saúde bucal dos pacientes, principalmente quando relacionado aos PNE, sendo essencial o conhecimento das limitações e dos recursos que levam ao acolhimento do paciente por parte dos graduandos. O contato com PNE durante a graduação é extremamente importante para o conhecimento e a ruptura de possíveis preconceitos que possam envolver o atendimento dessa população, a fim de promover saúde bucal e qualidade de vida aos PNE. Descritores: Assistência Odontológica. Saúde Bucal. Síndrome de Down. Estudantes de Odontologia.
Objectives: Resin composites containing surface pre-reacted glass (S-PRG) were introduced to reduce demineralization and improve remineralization of the tooth structure. However, water diffusion within the material is necessary for its action, which can impair its overall physical-mechanical properties over time, including the color stability. This study aimed to evaluate the color stability and related degree of conversion (DC) of four resin composites.Materials and Methods: Discs (n=5/group) of microhybrid, nanofilled, nanohybrid, and S-PRG-based nanohybrid composites with two opacities were prepared. Color (CIELab and CIEDE2000) was evaluated after aging in grape juice. The DC was analyzed by using Fourier Transform Infrared Spectroscopy before and after photopolymerization. Data were statistically analyzed by using two-way analysis of variance and post-hoc least significant difference tests (P<.05).Results: In the color stabilityanalysis, the interaction between filler type and opacity was significant. S-PRG influenced color stability and DC.Conclusions: The nanohybrid resin composite presented favorable color stability and a greater DC, which is likely related to its organic content. S-PRG based nanohybrid resins require caution since its bioactive benefits depends on interaction with the environment that can be prone to impair color stability.Clinical Relevance: As color stability is mandatoryin specific regions, staining can jeopardize the esthetics of a resin composite. The use of nanohybrid composites with no or reduced BisGMA content and diluents may be more appropriate in these areas. Since materials containing S-PRG can offer relevant benefits, professionals need to balance their higher susceptibility to staining favoring other relevant properties.
How 10-MDP functional phosphate monomer and 2% digluconate chlorhexidine solution interact on sound, artificial carious or eroded dentin substrates Objective: Carious and eroded dentin represent common modified dental substrates, which mostly require restorative procedures. MDP-based dentin bonding system (DBS) and digluconate chlorhexidine (CHX) are presented as promising agents to minimize intrinsic degradation of the resin-dentin interface by interaction with calcium (Ca). Therefore, the purpose of this study was to explore the possible interaction between MDP in a universal adhesive system with 10-MDP in self-etching mode and CHX on substrates artificially modified by caries and erosion, through microtensile bond strength (µTBS). Additional characterization of the adhesive interface was performed by SEM/EDS analyses. Material and methods: Flat dentin surfaces were obtained from 120 specimens (n=20/group) prepared from extracted sound human third molars and randomly divided into three groups according to the dentin substrate: sound-control (S), artificial carious (C) and artificial eroded (E). Half of these specimens were pretreated with distilled water (W) and other half with 2% CHX, constituting 6 groups: S-W, S-CHX, C-W, C-CHX, E-W, E-CHX. After, all the specimens were restored with a universal adhesive system (Apder Single Bond Universal) using self-etching mode and two increments of composite resin (Filtek Z-350), following manufacturer's instructions. Slices (0.8mm) were obtained to SEM analysis and beams (0.64mm²) were obtained and evaluated by EDS analysis and µTBS in universal testing machine (500N/ 0.5mm/min) after 24 hours and 6 months. Data was statistically analyzed by two-way ANOVA and Tukey tests (p<0.05). Results: Substrate type was a statistically significant factor (p<0.0001), whereas the pretreatment (p=0.189), time (p=0.337) and the interaction between three factors (p=0.452) were not significant. Conclusion: Carious and eroded dentin substrates negatively interfered on the bond strength of an MDP-based universal adhesive systems, regardless its use with CHX. Likely, the reduction of available calcium from these substrates impaired the effectiveness of this system.
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