Complete denture occlusion: an evidence-based approach

Purpose: This study involved an extensive search for randomized controlled clinical trials comparing bilateral balanced and canine-guided dentures, and questioned whether a bilateral balanced occlusion is imperative for successful denture treatment. Materials and Methods: Studies were identified by searching electronic databases (PubMed/MEDLINE, ISI Web of Science, LILACS, and BBD). The keywords “denture” and “occlusion” were used. The minimum inclusion requirements were (1) randomized controlled trials with patients of any age wearing both maxillary and mandibular conventional complete dentures (CDs), (2) comparison between bilateral balanced and canine-guided dentures, and (3) assessment of masticatory function and/or patients’ satisfaction. Results: The search resulted in the identification of 5166 articles. Subsequently, 5156 articles were excluded on the basis of title and abstract. By the end of the search phase, seven randomized controlled trials were considered eligible. Conclusions: Current scientific evidence suggests that bilateral balanced occlusion is not imperative for successful treatment with conventional CDs in average patients. More studies are necessary to identify if specific clinical conditions may benefit from a balanced occlusion.

A gestão educacional das secretarias municipais de educação de municípios maranhenses a partir do plano de ações articuladas 2007-2011

The main purpose of this thesis was to analyze educational management of Municipal Departments of Education (SEMED’s) of cities in Maranhão inserted in the Plan of Articulated Actions (2007- 2011). We evidence the role of Union in that public policy. The leading argument is that Brazilian federal government is not demos constraining in relation to its national sub-governments, what makes the central government to enforce, primarily, educational politics like PAR. This kind of politics interferes in the educational management by national sub-governments, turning them into mere executors. By turning them into mere executors, PAR limits their autonomy and over imposes the results-based management as a parameter to improve the education quality. In order to develop the hypothesis, we adopted Political Science as theoretical basis, represented by Federalism Theory as pact which premise is the cooperative pattern of federalism as being the best form of government because it allows a joint decision-making process from the idea of no centralization of power. The methodology was historical materialism, which assumes the totality and contradiction as a form to understand the phenomenon that does not express in direct way its existence, but can be analyzed from such categories that made possible to interpret the reality. So, we used as tools the semistructured interview and documental analyses with triangulation of data. The empirical basis of the research is 04 (four) cities in Maranhão that obey the following criteria: 1. The municipality has to be assigned on the FNDE Resolution nº 29/2007; 2. To present the lowest educational management indexes from the diagnosis made in loco by PAR; 3. To present the lowest financial management indexes based on the diagnosis in loco by PAR. The results suggest that PAR does not effect a resultbased management which are proposed in its legal rules neither the SEMEDs can propose their conception of educational management. That situation creates a hybridism that sometimes turns to managerialism and performativity, sometimes to bureaucracy, sometimes to a total uncoordinated and unarticulated action. In relation to SEMEDs management, this thesis shows that these institutions have no own conception about educational management and end up acting in an uncoordinated and unarticulated way. The thesis concludes that PAR is an over imposition by federal government towards national sub-governments that conflicts with management patterns of those institutions that are used to a less managerial logic. This over imposition makes the Central government to be the center of Brazilian federalism, which is in reality an incomplete pact.