Objective: The objective of this study was to assess the number of dental procedures performed in the Brazilian Public Health System (SUS) during the first wave of COVID-19 in Brazil (1 st semester of 2020) and compare it with the same period of 2019. Methods: A retrospective study was conducted based on the SUS Dataset (DATASUS). Descriptive analysis of the number of dental procedures and socio-demographic regions was presented and the number of dental procedures during the first semester of 2020 was compared to 2019, using Wilcoxon Signed Rank Test (α=0.05). The number of COVID-19 confirmed cases and deaths were also retrieved from DATASUS. Results: Dental procedures decreased from 47 million in the first semester of 2019 to 15 million in 2020, representing an overall decrease of about 66%. Statistically significant differences were observed for the numbers of procedures regarding preventive actions related to oral health (-84.53%; p <0.001), primary care (-60.69%; p <0.001), endodontic specialized care (-52.50%; p <0.001), and periodontal and oral surgery specialized care (-54.57%; p <0.001). Conclusion: The COVID-19 pandemic also reduced by half the number of oral health procedures provided by the SUS in almost all Brazilian states regardless of whether these states had a large number of confirmed cases or deaths. Future policies are recommended in order to reduce the negative impact of the suspension of dental services on the oral health of the population.
Background: Low-level laser therapy (LLLT) has been suggested to improve primary stability at the early stages of osseointegration in animal models. However, there is still scarce evidence about its influence on implant stability in humans. Purpose: To assess the influence of LLLT on implant stability in implants placed in fresh extraction sockets. Material and methods: A randomized controlled trial was designed according to the SPIRIT guidelines and is reported following the CONSORT. Patients were randomly allocated according to control or LLLT groups. LLLT consisted in the application of GaAlAs laser (808 nm, avg. power density: 50 mW, circular spot diameter and area: 0.71 cm/0.4cm 2) applied in six points in contact mode with peri-implant soft tissue (1.23 minutes in each point of application; dose per point 11 J) before bone perforation and after suturing. The total dose resulted in 66 J per application moment. This LLLT protocol was applied only in the dental implant placement session. Implant stability was by ISQ at implant placement (T 0) and the abutment selection (T a). Digital radiographs for T 0 and T a were used to assess the distance between the implant platform and alveolar bone crest, in millimeters. T-test and Shapiro-Wilk test were used to analyze data between groups using the implant as a unit of analysis. Results: Fifty implants were placed in 44 patients. The insertion torque ranged from 15 to 60 N.cm (mean 35.64 ± 13.34). Two implants of the LLLT and one of the control groups were lost to follow-up and one implant of the control group failed to osseointegrate (4.3%). ISQ at T 0 ranged from 17 to 79 (mean 59.33 ± 13.05) and from 40 to 89 (mean 66.46 SD ± 11.56) at T a. No differences were observed when comparing the groups with ISQ difference (P = .433) or radiographical peri-implant alterations (P = .261). Conclusions: LLLT did not influence implant stability in implants placed in fresh extraction sockets when assessed at healing abutment installation.
Objectives: A systematic review and meta-analysis of diagnostic test accuracy studies was conducted to assess if the radiomorphometric indexes observed in panoramic radiographies could estimate reduced bone mineral density (BMD) similarly to standard technique the bone densitometry (dual energy X-ray absorptiometry) in females older than 30 years. Methods: A systematic search in four databases was conducted until January 2019. Two evaluators performed data extraction and evaluation of risk of bias independently, and agreement was achieved by consensus. Data were synthesized on a subgroup meta-analysis with a random effect model and the hierarchical summary receiver-operating characteristic curve was used to calculate pooled estimates of studies. Results: Thirty three studies were included and 12 different radiomorphometric indexes identified, including Mandibular Cortical Index (MCI). The final number of cases pooled for the analysis was 5266 females.The MCI for BMD loss (osteopenia) presented values of sensitivity 0.81 [95% confidence interval (CI), 0.78–0.84] and specificity 0.48 (95% CI, 0.45–0.50), while for osteoporosis sensitivity 0.35 (95% CI, 0.30–0.40) and specificity 0.88 (95% CI, 0.86–0.90). The mandibular cortical width presented values of sensitivity 0.58 (95% CI, 0.40–0.73), specificity 0.73 (95% CI, 0.60–0.83) for osteopenia, while for osteoporosis sensitivity 0.57 (95% CI, 0.36–0.76) and specificity 0.83 (95% CI, 0.68–0.92). Due to the high sensitivity, MCI presented a potential value as a screening tool for initial BMD loss (osteopenia), once tests presenting high sensitivity are described as rarely missing subjects with the disease. To the other hand, MCI to osteoporosis and Mandibular Cortical Width for both conditions are not recommended because presented specificity higher than sensitivity. Conclusion: The MCI can be recommended as a feasible tool to screen initial BMD loss (osteopenia) in females above 30 years old using panoramic radiography exams.
Objective This study aimed to assess the characteristics of different designs of systematic reviews (SRs) registered in the International Prospective Register of Systematic Reviews (PROSPERO) about COVID‐19. Methods The search was performed in the PROSPERO database using the strategy proposed by the database and considered only human studies. The last date of the search was April 27, 2020. Full text of all records was accessed, and data were extracted by a single researcher, which was further double‐checked by another researcher. A descriptive analysis was performed considering record characteristics using tables. Results We included 564 records from which the vast majority were registered as SRs (n = 513, 91%). In general, we found poor reporting and missing or confusing information, since 84% of the records (n = 474) did not report the full search that would be adopted, 16% (n = 90) did not report clearly the databases that would be used, and 49.1% (n = 277) did not report the number of primary outcomes. The main focus of most of the records involved clinical, epidemiological, complication, and laboratory characteristics (n = 173, 30.7%) or the treatment of COVID‐19 (n = 138, 24.5%). Conclusion A large number of SRs about COVID‐19 have been conducted, and many of the assessed records were poorly reported and would be difficult to replicate. Besides, collected data points to an epidemic of redundant reviews on COVID‐19.
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