Dental Specialties Research Articles

Behind the mask: the hidden impact of COVID on dental specialty training

Behind the mask: the hidden impact of COVID on dental specialty training

Knowledge and perception of dental educators regarding relative value units: A pilot study.

The aim of this pilot study was to evaluate the knowledge and perception among dental educators regarding the use of relative value units (RVUs) in medicine, perceived benefits in dentistry, and the relative ranking of the components to define RVUs in dentistry. A convenience sample of dental educators participating in the American Dental Education Association's Leadership Institute (2023-2024) cohort was surveyed for their knowledge and perception regarding RVUs. The responses were stratified based on experience with RVUs prior to statistical analyses (α=0.05). Twenty-six dental educators from 18 different North American dental schools and nine different dental specialties participated in this pilot study. Although not significant, a higher proportion of dental educators with prior experience perceived RVUs as a valuable tool in dental practice for assigning chair time, developing payment models, and tracking student-resident progress in a clinical course. There was a lack of consensus among dental educators regarding the components for determining dental procedural RVUs. This pilot study provides limited evidence that prior knowledge of RVUs may be related to its perceived benefits among dental educators, but a broader study design is needed to draw meaningful conclusions and universally acceptable components for determining RVUs in dentistry.

The necessity and demand of machine learning in treatment and diagnostics in dentistry

Aim: to justify the necessity of machine learning technology in treatment and diagnostics in dentistry.Material and methods: the research was taken using the method of anonymous questionnaire to estimate the demand and necessity of machine learning technology in diagnostics and treatment in dentistry on the basis of the E.V Borovsky Institute of Dentistry I.M Sechenov First Moscow State Medical University (Sechenov University). 100 participants from different dental specialities aged 20 to 54 took part in the questionnaire. Wilson score interval and Student’s T Critical Values were used for the statistical analysis of the Results.Results: during the study, it was found that the majority of dentists who participated in the questionnaire (54%) have challenges in diagnosing oral mucosal diseases. Herewith dentists with work experience more than 5 years diagnose this kind of disease more frequently than specialists with less work experience (p<0.05). Surgical dentists (46,6%) and prosthetic specialists (50%) diagnose this pathology most often. Clinicians attribute diagnostic challenges to the lack of experience (85%) and low occurrence of patients with this group of diseases. During treatment and diagnostics 84% of residents mentioned that they compare their patients’ clinical cases with clinical cases from the Internet and other resources, 78% of residents believe that machine learning will help to increase the efficiency of diagnosing oral mucosal diseases in clinical work. During the held research, it was found that 85% of participating dentists would definitely use digital programs with machine learning in their clinical work for treatment and diagnostics.Conclusions: the presence of problems in treatment and diagnostics of oral mucosal diseases was confirmed, and to solve it, the demand and the need to develop and implement digital systems based on artificial intelligence using machine learning technology were substantiated.

Perceptions of undertaking a higher degree alongside dental specialty training: A cross-sectional survey of UK dental specialty trainees.

The curricula for UK dental specialty training have recently been under review and until 2024, completion of a research component during training in Dental Public Health, Oral Microbiology and Orthodontics has been mandatory (with an alternative route for Orthodontics involving the submission of two scientific papers for those trainees not wishing to undertake a higher degree). Anecdotally, some trainees in other dental specialties choose to undertake higher degrees alongside specialty training. The aims were to investigate how many dental specialty registrars study for higher degrees alongside specialty training, and whether undertaking a higher degree alongside specialty training has an impact on completion of training, research skills, research experience, patient care and career opportunities. This was a cross-sectional study design, involving the distribution of an online, anonymous questionnaire-based survey to UK dental specialty registrars in November and December 2022. In total, 38 questionnaires were completed, representing a 7.7% response rate of the entire dental specialty registrar cohort in the UK and 42% of those who received it. Most respondents (76.3%) were either studying or had completed a clinically relevant higher degree prior to specialty training. Most respondents (76.3%) reported that the higher degree increased career opportunities and gave them additional skills. Dental specialty trainees who responded to this survey perceived the higher degree to be beneficial in terms of preparing for exams, gaining skills in critical appraisal and for increasing future career opportunities.

Terminal efficiency of Peruvian university students in the second specialty programs of a dental school over seven years

Background Concerns regarding academic efficiency at the postgraduate level in university programs require attention from those responsible for making university administrative decisions. This study aimed to determine the terminal efficiency of Peruvian university students enrolled in second specialty programs in a dental school over seven years. Methods This cross-sectional study considered all records of documents submitted for obtaining a title of second professional specialty in the programs offered by a dental school, published in its institutional repository between 2017 and 2023. The study variable was terminal efficiency (TE), considered both as a quantitative and qualitative variable. Additionally, some covariates were included, such as the year of formal document submission, the mode of document preparation, the second professional specialty in dentistry, and sex. Descriptive analysis was conducted to obtain absolute and relative frequencies. Bivariate analysis was performed using Chi-square, Mann-Whitney U, and Kruskal-Wallis tests. Results From the evaluation of TE between 2017 and 2023, it was observed that 72.09% (n=186) of students with a document submitted for obtaining a title of second professional specialty and published in the repository had a TE categorized of “Up to 1 year”. Likewise, the mean TE was 0.95 years (SD=1.25), with a statistically significant difference (p<0.001) between medians when evaluated based on the year of formal document submission and the dental specialty program. Conclusion The mean terminal efficiency of Peruvian university students in second specialty programs in a dental school over seven years was 0.95 years.

Exploring the Applications of Artificial Intelligence in Dental Image Detection: A Systematic Review

Background: Dental care has been transformed by neural networks, introducing advanced methods for improving patient outcomes. By leveraging technological innovation, dental informatics aims to enhance treatment and diagnostic processes. Early diagnosis of dental problems is crucial, as it can substantially reduce dental disease incidence by ensuring timely and appropriate treatment. The use of artificial intelligence (AI) within dental informatics is a pivotal tool that has applications across all dental specialties. This systematic literature review aims to comprehensively summarize existing research on AI implementation in dentistry. It explores various techniques used for detecting oral features such as teeth, fillings, caries, prostheses, crowns, implants, and endodontic treatments. AI plays a vital role in the diagnosis of dental diseases by enabling precise and quick identification of issues that may be difficult to detect through traditional methods. Its ability to analyze large volumes of data enhances diagnostic accuracy and efficiency, leading to better patient outcomes. Methods: An extensive search was conducted across a number of databases, including Science Direct, PubMed (MEDLINE), arXiv.org, MDPI, Nature, Web of Science, Google Scholar, Scopus, and Wiley Online Library. Results: The studies included in this review employed a wide range of neural networks, showcasing their versatility in detecting the dental categories mentioned above. Additionally, the use of diverse datasets underscores the adaptability of these AI models to different clinical scenarios. This study highlights the compatibility, robustness, and heterogeneity among the reviewed studies. This indicates that AI technologies can be effectively integrated into current dental practices. The review also discusses potential challenges and future directions for AI in dentistry. It emphasizes the need for further research to optimize these technologies for broader clinical applications. Conclusions: By providing a detailed overview of AI’s role in dentistry, this review aims to inform practitioners and researchers about the current capabilities and future potential of AI-driven dental care, ultimately contributing to improved patient outcomes and more efficient dental practices.

Knowledge, and treatment of molar incisor hypomineralisation (MIH) among dentists in Jordan: a cross-sectional questionnaire based study.

The aim of this study is to assess the knowledge, and treatment of MIH among dentists in Jordan. An online questionnaire using Google Forms was sent to the dentists who were registered with the Jordan Dental Association and worked in Jordan through social media groups. The questionnaire consisted of three sections, sociodemographic characteristics, the knowledge of dentists about the aetiology, diagnosis, and prevalence of MIH, and treatment options and barriers for treating MIH. Descriptive statistics with chi-squared test was used, and level of statistical significance was set to 5%. A total of 388 dentists had responded to the questionnaire (response rate 24.25%), (80.7%) reported that they have come across MIH cases during their practice. Yellow/brown demarcations were reported as the most common presentation of MIH (45.6%). All paediatric dentists were confident in diagnosing MIH, this was statistically higher than that reported by general dentists (56.8%) and dentists of other specialities (60.2%), P = 0.000. Pre-formed metal crowns were the treatment of choice for (57.2%) of participant, followed by composite restorations (52.3%). Child behaviour (56.2%), and late acknowledgment of the defect by the parents (46.1%) were the most encountered barriers for treatment. Molar incisor hypomineralisation is a common condition that is encountered frequently by general dental practitioners as well as dental specialists, nevertheless most dentists were not aware about the prevalence of MIH in Jordan and indicated their need to improve their approach regarding MIH diagnosis and treatment.

Analysis of the Informational Content of Turkish Videos on YouTube About Tooth Brushing.

To examine the content of Turkish videos on YouTube about tooth brushing and to evaluate their usefulness in providing information to the public. Two keywords were determined using the website Google Trends. For each keyword, the top 100 most watched videos were determined according to the searches made on YouTube and a total of 200 videos were examined. According to the inclusion and exclusion criteria, 99 videos were included in the study. The URL address of each video included, the number of views, the number of likes, the number of dislikes, the duration of the video, the time elapsed since the upload date (days) and whether the videos was narrated by a dentist, commercial institution or individual user was recorded. In addition, the interaction index and viewing rates of the videos were calculated. The contents of the videos included were evaluated by a specialist dentist. Based on the evaluation of the information content of the videos, 54.5% of them contained minimal information, 38.4% poor information, 5.1% good information and 2% excellent information. The two videos containing excellent information include 10 of the 12 topics evaluated and both videos are narrated by a dentist. Turkish videos about tooth brushing on YouTube are insufficient in terms of content and accurate information. For this reason, individuals should be directed to professional sources in order to receive accurate and up-to-date information, and dentists should share videos containing sufficient content and quality information on this platform.

New Age Parenting and Its Impact on Child’s Oral Health: Cross-sectional Questionnaire Study

Abstract Background: With increased globalization, East culture is meeting West culture and parenting style has been completely changed. Children depend significantly on their parents for provision, instruction, and supervision of crucial preventive oral hygiene habits. The education level and awareness of parents regarding preventive oral health measures play a pivotal role in this aspect. Therefore, it becomes imperative to evaluate and educate parents about proper oral hygiene care for their children, ultimately contributing to the overall well-being of the child. Aim: The aim of this study was to assess an impact of new age parenting on oral health of their children. Methodology: A cross-sectional questionnaire study was conducted among 204 parents of children aged 5–10 years, consisting of 27-item questionnaires containing four domains of demographic data, knowledge, attitude, and practice, which was distributed among the participants. A descriptive analysis was done using IBM SPSS software (version 22.0 Chicago, IL, USA). Results: It was surprising to note that 32.84% of parents were unaware about the specialist dentist is available for children. About 65.69% of parents had low level of knowledge regarding oral health of their children. The correlation among knowledge, attitude, and practice was determined to be highly statistically significant (P = 0.0001). Conclusion: Our study concluded that knowledge, attitude, and practice of oral health care of children are low among new age parents and there is a need to educate these parents regarding the same.

A scoping review of patient safety checklists in dentistry.

Not much is known about safety checklists use in dentistry. We aim to examine, assess, and provide a comprehensive understanding of the current knowledge concerning the use of checklists to improve patient safety in dentistry. We conducted a comprehensive literature search using Medline and Embase for studies that use or describe the development of dental patient safety checklists. All study designs were included for citations published through December 2023. Following abstract and full-text screening, 27 studies remained for data extraction and analysis. Oral surgery emerged as the main dental specialty where the utilization and evaluation of checklists were primarily concentrated (n = 15). The majority of the included studies described either checklist development, their implementation, or both (n = 18). Only 6 studies assessed the effectiveness of checklists in improving patient safety outcomes. Of the effectiveness studies, five found a decrease in incidents and dental adverse events, along with an improvement in patient care and safety, associated with the use of checklists. This scoping review highlights the limited current knowledge regarding checklist use and effectiveness in reducing adverse events across dental practices; it demonstrates the need on how to best guide the profession towards implementing this important evidence-based patient safety tool. Checklists are effective tools to improve patient safety and have become integral to medical practice. Dentistry can also benefit from these tools to improve patient safety.

Predictive value of tooth and sinuses radiological characteristics in managing odontogenic sinusitis of endodontic origin.

One of the most common causes of bacterial odontogenic sinusitis (ODS) is endodontic disease with periapical lesions (PAL). Referrals between otolaryngologists and dental specialists are indispensable for proper diagnosis and treatment. If the disease does not resolve after medical and root-canal treatment (RCT), tooth extraction, endoscopic sinus surgery (ESS) or both are the ways of management.The aim was to clarify the predictive value of disease's radiological characteristics for the further surgical intervention. 68 symptomatic patients evaluated by an otolaryngologist and dental specialist were included to this prospective observational cohort study. Patients who failed medical treatment of sinusitis (intranasal steroids, saline rinses and antibiotics) and RCT were treated either with ESS, tooth extraction or both at the same time. 87% of patients required surgical intervention. 12% improved after tooth extraction alone, 47% after ESS and 31% required both procedures. The degree of maxillary sinus' (MS) opacification was not correlated with the need of invasive procedures implementation, as opposed to ostiomeatal complex' patency (p<0.001). Cortical bone destruction towards the MS and multiple tooth roots involvement suggested ODS resolution only after combined surgical approach (p=0.041). Radiological characteristics of causative tooth and patency of ostiomeatal unit correlate with the evolution of ODS and need for either ESS and/or tooth extraction. Patients with multiple roots affected, shorter distance to the MS floor and PAL's with visible bone destruction may require tooth extraction and ESS to resolve ODS completely. Radiological data may help in earlier diagnosis and treatment of ODS with PALs for both otolaryngologists and dental specialists.

In vitro determination of genotoxicity and cytotoxicity induced by stainless steel brackets with and without surface coating in cultures of oral mucosal cells

BackgroundOrthodontics is a speciality of dentistry that uses a plethora of devices made from myriad materials to manage various malocclusions. Prolonged contact of orthodontic appliances with oral tissues can lead to cellular damage, highlighting the need for biocompatible materials to mitigate health risks.ObjectivesTo analyze the genotoxicity and cytotoxicity produced by metal brackets and coated metallic brackets with polymeric and nanoparticle coatings in oral mucosal cells.Materials & methodsThe current study compares the toxicity of 3 different types of orthodontic brackets with control groups of oral mucosal cells. Each of the three treatment groups consisted of 10 samples of orthodontic brackets: stainless steel brackets(Group 1), nanoparticle-coated brackets(Group 2), and polymeric-coated brackets(Group 3) exposed to corrosion eluates employing an oral biomimicry model. Two types of oral mucosal cells- Human Gingival Fibroblasts and Buccal Epithelial Cells were used to study the cytotoxic and/or genotoxic effects of the elutes. Intergroup comparisons were conducted using one-way analysis of variance, while scanning electron microscopy evaluated surface characteristic.ResultsThe interaction between metal ions and oral mucosal cells showed no statistically significant difference for toxicity assays between the three groups(p > 0.005). However, polymeric and nanoparticle-coated groups showed reduced cellular differentiation when compared with conventional stainless-steel brackets.ConclusionThis in-vitro study shows that polymeric or nanoparticle coating of conventional metal brackets aids in enhancing corrosion-resistant characteristics of orthodontic appliances and reduces the toxic oral environment created by metal release in the oral cavity.

Validity and Reliability According to the Type of Examiners in the Process of Calibrating Dental Caries Experience Using the DMFT Index.

The process of examiner calibration is an essential step in all epidemiological research, as it aims to ensure uniform interpretation, understanding, and application of the instrument to be used. This ensures that the data collected will be valid and reliable. This study aimed to determine the differences in concordance in dental caries calibration across three dental specialties. The population consisted of 45 dentists, divided into three groups: 15 general dentists working in the public sector, 15 dentists specializing in Dental Public Health, and 15 dentists specializing in Restorative and Aesthetic Dentistry. The calibration process was carried out in three stages: theory, calibration using photographs, and calibration on natural teeth, performed by the gold standard. In the first validity process, a statistical difference was only found between the Kappa values of the inter-examiner calibration process using photographs. For the evaluation of teeth, in the second validity process, 33.33% (n = 15) of the participants achieved "almost perfect agreement." Finally, only 75.56% (n = 34) of the examiners were considered for the reliability report; of this group, 52.94% (n = 18) were in "almost perfect agreement," and 35.29% (n = 12) were in "substantial agreement." The validity and reliability of the dental caries experience calibration process did not present significant statistical differences between general dentists in the public sector, dentists specializing in Dental Public Health, and dentists specializing in Restorative and Aesthetic Dentistry.

DEVELOPMENT OF ORAL HEALTH CARE FOR COMPLETE DENTURES TREATMENT

Based on data from the Basic Health Research 2018, indicate a correlation between age and tooth loss, yet denture utilization remains comparatively low. Dental therapists are primarily responsible for enhancing oral health by preventing, treating, and managing dental problems. While authorized to collaborate with dental specialists in providing medical dental procedures. However, in many clinical settings, dental therapists are often relegated to the role of dental assistants. This limitation can be attributed to the lack of integrated dental care models for complete denture cases within specialized prosthodontic services. This study aimed to evaluate the effect of developed dental and oral health care model on patients with complete denture care on changes in the behavior of dental therapists in implementing the model. This study employs a quasi-experimental research design with a pretest-posttest design (non-equivalent control group). The research was conducted the entire population of 12 dental therapists at the prosthodontic clinic of the dental and oral hospital were randomly assigned to two groups. The intervention group received socialization on an oral health care model. Knowledge, attitude, and skills were assessed through questionnaires and observational methods both before and after the intervention. Data were analyzed statistically using paired t-test, and independent t-test. Its model is effective in behavior changes: improving knowledge (p-value 0.025; ? 7.50), attitudes (p-value 0.012; ? 7.33), skills (p-value 0.002; ? 26.67). Development of a dental and oral health care model in patients with complete denture care is effective in changing the behavior of dental therapists.

PECULIARITIES OF TEACHING THE DISCIPLINE "ORTHOPEDIC DENTISTRY, INCL. IMPLANTATION" SPP DENTISTRY AT MILITARY CONDITION

In the conditions of rapid development of modern dentistry, the providing of high-quality dental services is extremely important and requires the presence of qualified specialists. Therefore, their acquisition of professional competences should take place starting from the student ranks. Educational discipline "Orthopedic dentistry, incl. implantation" OPP Dentistry is studied by students during 3-5 courses and ensures that students acquire integral, general and professional competencies for the future provision of high-quality dental consultations and services with the use and application of modern aesthetic orthopedic structures for the replacement of partial and complete defects of the dentition, as well as elimination of pathology, which contributes to the occurrence of defects in the hard tissues of the teeth. In addition, the process of examining patients in order to establish a diagnosis and draw up a treatment plan is important. Therefore, the application of the latest teaching methods includes a combination of both theoretical knowledge and practice and consolidation of acquired and properly mastered practical skills. The education of foreign students is of great importance, which, in connection with military actions and constant air alerts caused by the danger caused by the activity of enemy strategic aviation taking place in our country, is conducted in a mixed format (online for students who are at home (by border) and offline for foreign students living and studying in Ukraine) using innovative multimedia teaching methods. The constant and continuous development of modern technologies in the field of stomatology also requires the introduction of the latest training tools and methods associated with the use of modern methods and technological support. All these challenges today are combined with student education, which takes place under martial law and requires a special approach. Therefore, it is important to provide education seekers with proper professional and safe learning conditions, which will make it possible to fully and comprehensively provide a comprehensive complex of both theoretical and practical training of future dental specialists. Thanks to the Armed Forces of Ukraine and the clear consolidation and mutual cooperation of teachers and students, the learning process not only does not stop, but also continues to develop productively, making it possible to provide and provide a sufficient amount of professional competences under the condition of simultaneous and parallel objective control of the acquisition and consolidation of appropriate level of knowledge of students of all courses and areas of dentistry. The purpose of the study is directed to the organization and implementation of the latest teaching methods with the maximum use of modern equipment and methods while respecting life safety. Materials and methods. The Department of Orthopedic Dentistry of the Ivano-Frankivsk National Medical University implements the educational program "Orthopedic Dentistry, incl. implantation" SPP Dentistry in military time conditions, aimed at students' acquisition of integral, general and professional competencies for the future provision of high-quality dental services. Research results. They indicate the need to introduce the latest actions and methods of training in connection with the constant development of modern technologies in the branch of dentistry. The conclusions of this study indicate the presence of feedback from students who is interested and stimulated by a new approach in studying, combined with real clinical cases and modern methods of their treatment and orthopedic treatment.

The challenging reality of the clinical learning environment at Damascus University Faculty of Dental Medicine in Syria: A qualitative study

Introduction In Syria, specialist dentists undergo five years of undergraduate education and four years of postgraduate education. In the latter, students engage in treating complex cases as part of their professional training. This study aimed to obtain in-depth qualitative understanding of the clinical learning environment at Damascus University Faculty of Dental Medicine, Syria. Methods Semi-structured interviews were held with eight postgraduate dental students at Damascus University Faculty of Dental Medicine. The faculty has eight clinical departments; therefore, a single participant was purposively sampled from each department. The male-female ratio of the eight interviewed participants was 1:1. All interviews were conducted between 26th April 2020 and 8th January 2021. Data were analyzed inductively using reflective thematic analysis. Pragmatic saturation was discussed during the analysis and the authors made an interpretative judgement to stop data collection at the eighth interview. Results Major themes which emerged covered different aspects of the clinical learning environment such as clinical training, social interaction and assessment procedures. Faculty’s negligence of their teaching duties was one of the most recurrent themes. In clinical training and due to faculty inaccessibility, students had to rely on themselves or their senior peers in training. The social climate was perceived negatively and assessment was described as unfair and biased. Discussion The findings of this study were framed within Gruppen et al. (2019) theory of the learning environment wherein four dimensions emerge: the personal, the social, the organizational and the material. The findings of this study showcased the continuing deterioration of the clinical learning environment at Damascus University. It is hoped that these findings will encourage decision makers to introduce a comprehensive reform that addresses the curriculum, teaching practices and assessment procedures in clinical professional training.

Applications of bioactive glass: A review

The scope of research on dental materials has significantly increased throughout the last century. Bioactive glass has become an attractive option in biomaterials because of its unique qualities that promote advantageous biological responses. Compared to traditional dental glasses, bioactive glasses are innovative dental materials. As bioactive glass can form bonds with live tissues, mainly composed of calcium, phosphorus, and silicon, it is an excellent choice for many biomedical uses. At the vanguard of biomaterials, bioactive glass provides a unique blend of bioactivity, flexibility, and versatility. The bioactivity of bioactive glass is one of its primary characteristics. Bioactive glass generates a hydroxyapatite coating on its surface when it comes into contact with physiological fluids. The potential for introducing growth factors and bioactive substances to enhance the material's capacity to communicate with biological tissues has been studied. Various uses of bioactive glass have been discovered, including wound healing, bone grafts, dentin hypersensitivity, regeneration, implant devices, etc. Cement was used for dental applications, and the attachment of joint prostheses to bone was also made using bioactive glass. Bioactive glasses are present in the composition of several dental and oral hygiene products. Because of their many benefits—such as their capacity to maintain biological tissues' structural integrity, their usefulness as scaffolds, and their capacity to inhibit bacterial growth—bioactive glasses are becoming increasingly valuable in several dental specialties.

How Practice Ready are We? Attitude among Fresh Dental Graduates Regarding Dental Practice Management in India

Background Dental practice management encompasses the administrative and operational aspects of running a dental office efficiently. Fostering dental practice management skills which are tailored to the current social needs will aid the practitioner to be more competent and successful.  Aim The aim of this study is to assess the attitude among fresh dental graduates regarding dental practice management.  Materials and Methods This survey was conducted among 207 interns, fresh dental graduates, and postgraduate students of various dental specialties. The study tool was a questionnaire, consisting of basic demographics and 11 questions, to assess participant’s attitude on dental practice management. Data collection was done using Google forms circulating through social media platforms and the first 207 to submit fully answered questionnaire were included in the study. The data was then statistically analyzed.  Conclusion Mean age of the study population was 26±2.58. Majority of the study population (80.7%) felt that dental practice management was equally important as clinical skill for a successful dental practice and thought it would be helpful if there were guidelines for dental practice management in India. Our study findings indicate need for reforms in dental curriculum and training in this area.

Matrix Support: interface between Specialty Dental Centers and primary oral health care in Brazil

BackgroundMatrix Support (MS) is a strategy that can be used to improve integration between Primary Health Care (PHC) and other levels of care.ObjectiveThe aim of this study was to investigate the association between MS carried out in Brazilian Dental Specialty Centers (CEOs) (secondary level of oral health care) and aspects of the integrated work process with PHC, as well as contextual variables.MethodsA quantitative cross-sectional study was conducted using data from the Program for Quality Improvement and Access to CEOs (PMAQ-CEO). Secondary data from the External Evaluation of the second cycle of PMAQ-CEO were analyzed, including contextual variables obtained from sources such as the Unified Health System (SUS) and official research institutions. Descriptive analyses were performed, and four multiple models were adjusted to investigate the association between the variables.ResultsThe results showed that about half of the CEOs did not carry out therapeutic projects developed with the oral health teams of PHC. It was found that the lack of therapeutic projects developed with the teams was associated with the lack of discussion of complex cases by the team, lack of discussion of individual therapeutic project, absence of joint continuing education activities, lack of construction and discussion of clinical protocols, and lack of belief in the importance of planning and periodic evaluation. The results suggest that the articulation between PHC and secondary oral health care still presents weaknesses within the scope of SUS. Comprehensive care needs to be strengthened, requiring greater intervention from management.ConclusionIt was concluded that the individual factors of CEOs, related to the work process, have a greater influence on the lack of integration with oral health teams of PHC, compared to the contextual variables of municipalities.

Standardization of Variable Taper Files and Corresponding Gutta-Percha Cones Amongst Manufacturers

IntroductionCurrently there is no standardization of variable taper endodontic files and corresponding gutta-percha (GP) cones. The aim of this study was to evaluate intramanufacturer and intermanufacturer variability of diameter and taper in the apical third of GP master cones and finishing files from 3 commercially available variable taper endodontic systems. MethodsDiameter measurements were recorded using digital microscopy at 1-mm increments (D1-D4) for F2 files and corresponding GP cones (n = 20 per system) from ProTaper Gold (Dentsply Tulsa Dental Specialties, Johnson City, TN), EdgeTaper Platinum (EdgeEndo, Albuquerque, NM), and ExactTaper H (SS White, Lakewood, NJ). Taper was defined as the rate of change in diameter per 1-mm increment. Mean differences in diameter were assessed using repeated measures of analysis of variance for D1 to D4 and the Wilks test for differences in taper. ResultsIn the apical third, ProTaper and EdgeEndo mean file diameters were significantly smaller than corresponding GP cone diameters (P < .01, P < .01, respectively). Contrastingly, SS White file diameters were significantly larger than their corresponding GP cones (P = .02). Files from all manufacturers had significantly smaller diameters than advertised (nominal) values (P < .01). ProTaper GP cones had similar diameters to nominal values (P = .30), while EdgeEndo and SS White GP cones were significantly smaller (P < .01). Amongst files and corresponding GP cones from all systems, taper was nonstandardized. ConclusionsSize discrepancies between finishing files and corresponding GP cones can be expected amongst variable taper endodontic systems. Therefore, clinicians should be prepared to make intraoperative adjustments when obturating.