The interaction between social determinants of health and cervical cancer survival: A systematic review.

OBJECTIVE: This systematic review aimed to investigate what are the most relevant social determinants of health (SDH), how they are measured, how they interact among themselves and what is their impact on the outcomes of cervical cancer patients. METHODS: Search was performed in PubMed, Scopus, Web of Science, Embase, Cochrane, and Google Scholar databases from January 2001 to September 2022. The protocol was registered at PROSPERO (CRD42022346854). We followed the PICOS strategy: Population- Patients treated for cervical cancer in the United States; Intervention - Any SDH; Comparison- None; Outcome measures- Cancer treatment outcomes related to the survival of the patients; Types of studies- Observational studies. Two reviewers extracted the data following the PRISMA guidelines. Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used for risk of bias (ROB) assessment. RESULTS: Twenty-four studies were included (22 had low and 2 had moderate ROB). Most manuscripts analyzed data from public registries (83.3%) and only one SDH (54.17%). The SDH category of Neighborhood was not included in any study. Although the SDH were measured differently across the studies, not being married, receiving treatment at a low-volume hospital, and having public insurance (Medicaid or Medicare) or not being insured was associated with shorter survival of cervical cancer patients in most studies. CONCLUSIONS: There is a deficit in the number of studies comprehensively assessing the impact of SDH on cervical cancer treatment-related outcomes. Marital status, hospital volume and health insurance status are potential predictors of worse outcome.

Disparities in survival of hematologic malignancies in the context of social determinants of health: a systematic review.

Social determinants of health (SDHs) have been reported as relevant factors responsible for health inequity. We sought to assess clinical data from observational studies conducted in the United States evaluating the impact of SDHs on the outcomes of patients with hematologic malignancies. Thus, we performed a systematic review in 6 databases on 1 September 2021, in which paired reviewers independently screened studies and included data from 41 studies. We assessed the risk of bias using the Joanna Briggs Institute appraisal tools and analyzed the data using a descriptive synthesis. The most common SDH domains explored were health care access and quality (54.3%) and economic stability (25.6%); others investigated were education (19%) and social and community context (7.8%). We identified strong evidence of 5 variables significantly affecting survival: lack of health insurance coverage or having Medicare or Medicaid insurance, receiving cancer treatment at a nonacademic facility, low household income, low education level, and being unmarried. In contrast, the reports on the effect of distance traveled to the treatment center are contradictory. Other SDHs examined were facility volume, provider expertise, poverty, and employment rates. We identified a lack of data in the literature in terms of transportation, debt, higher education, diet, social integration, environmental factors, or stress. Our results underscore the complex nature of social, financial, and health care barriers as intercorrelated variables. Therefore, the management of hematologic malignancies needs concerted efforts to incorporate SDHs into clinical care, research, and public health policies, identifying and addressing the barriers at a patient-based level to enhance outcome equity (PROSPERO CRD42022346854).

New Insights into the Impact of Human Papillomavirus on Oral Cancer in Young Patients: Proteomic Approach Reveals a Novel Role for S100A8.

Human papillomavirus (HPV) infection has recently been linked to a subset of cancers affecting the oral cavity. However, the molecular mechanisms underlying HPV-driven oral squamous cell carcinoma (OSCC) onset and progression are poorly understood. METHODS: We performed MS-based proteomics profiling based on HPV status in OSCC in young patients, following biological characterization and cell assays to explore the proteome functional landscape. RESULTS: Thirty-nine proteins are differentially abundant between HPV (+) and HPV (-) OSCC. Among them, COPS3, DYHC1, and S100A8 are unfavorable for tumor recurrence and survival, in contrast to A2M and Serpine1, low levels of which show an association with better DFS. Remarkably, S100A8 is considered an independent prognostic factor for lower survival rates, and at high levels, it alters tumor-associated immune profiling, showing a lower proportion of M1 macrophages and dendritic cells. HPV (+) OSCC also displayed the pathogen-associated patterns receptor that, when activated, triggered the S100A8 and NFκB inflammatory responses. CONCLUSION: HPV (+) OSCC has a peculiar microenvironment pattern distinctive from HPV (-), involving the expression of pathogen-associated pattern receptors, S100A8 overexpression, and NFκB activation and responses, which has important consequences in prognosis and may guide therapeutic decisions.

Impacts of Environmental Factors on Head and Neck Cancer Pathogenesis and Progression.

Epidemiological and clinical studies over the past two decades have provided strong evidence that genetic elements interacting with environmental components can individually and collectively influence one's susceptibility to cancer. In addition to tumorigenic properties, numerous environmental factors, such as nutrition, chemical carcinogens, and tobacco/alcohol consumption, possess pro-invasive and pro-metastatic cancer features. In contrast to traditional cancer treatment, modern therapeutics not only take into account an individual's genetic makeup but also consider gene-environment interactions. The current review sharpens the focus by elaborating on the impact that environmental factors have on the pathogenesis and progression of head and neck cancer and the underlying molecular mechanisms involved. Recent advances, challenges, and future perspectives in this area of research are also discussed. Inhibiting key environmental drivers of tumor progression should yield survival benefits for patients at any stage of head and neck cancer.

Oral cancer adjacent to dental implants mimicking benign lesions: a case series study.

Despite the long-term survival rates of osseointegrated dental implants, several biological complications are known to affect the peri-implant tissues, such as peri-implant mucositis and peri-implantitis. Occasionally, the clinical features of these more common benign lesions, or others nonrelated to implants, might be similar to oral malignancies, leading to misdiagnosis. The objective of this study was to present a case series of oral cancer located adjacent to dental implants, aimed to identify the reasons for initial misinterpretation of diagnosis. Thirteen patients, 10 females and 3 males, aged 59 to 90, were assessed. Among the differential diagnoses established, a malignant or premalignant lesion was not considered in 10 out of the 13 patients. Peri-implantitis was the most common preliminary diagnosis, followed by fungal infection, viral infections, and traumatic ulcers. The meantime for the diagnosis of oral cancer was 21.5 months. The clinical presentation of peri-implant malignancy, such as ulceration, white and red plaques, and exophytic lesions, might mimic benign diseases that are more common in the oral cavity. Suspicious lesions with treatment failure that persist for more than 2 weeks require biopsy and histopathological analysis to establish an early definitive diagnosis to improve the prognosis and quality of life of the patients.

PD-L1 expression patterns in oral cancer as an integrated approach for further prognostic classification.

BACKGROUND: Despite the well-known role of programmed cell death ligand 1 (PD-L1) in promoting immune resistance in oral squamous cell carcinoma (OSCC), its potential utility as a prognostic biomarker is undetermined. We evaluated PD-L1 expression as predictor of survival in patients with OSCC and explored PD-L1 expression patterns. METHODS: We conducted a retrospective cohort study that assessed PD-L1 expression through immunohistochemistry in 123 surgical specimens of OSCC. A first approach evaluated tumor proportion scores (TPS) and combined proportion scores (CPS). Next, expression patterns were examined by evaluating PD-L1 localization in tumor nests, as well as the interfaces of tumor cells (TC) and immune cells (IC) in the tumor microenvironment. RESULTS: High-level PD-L1 expression determined by TPS and CPS using variable cutoffs was not associated with survival. Immunohistochemistry revealed that TC expressed PD-L1 in either patchy or diffuse patterns. The patchy pattern was an independent risk factor for overall survival. Furthermore, expression patterns in the tumor immune microenvironment showed that most cases expressed PD-L1 on both TC and IC, while PD-L1 non-expressors had the lowest overall survival. CONCLUSION: PD-L1 expression patterns in the context of localization in tumor nests and TC-IC interactions represent antitumor immune responses better than either TPS or CPS. Our suggested classification system may have important implications for the characterization of OSCC and for the use of PD-L1 as a prognostic biomarker.

Targeting Hypoxia-Driven Metabolic Reprogramming to Constrain Tumor Progression and Metastasis.

Hypoxia in locally advanced solid tumors develops due to uncontrollable cell proliferation, altered metabolism, and the severe structural and functional abnormality of the tumor vasculature, leading to an imbalance between oxygen supply and consumption in the fast-growing tumors and negative impact on the therapeutic outcome. Several hypoxia-responsive molecular determinants, such as hypoxia-inducible factors, guide the cellular adaptation to hypoxia by gene activation, which is critical for promoting malignant progression in the hostile tumor microenvironment. Over time, a large body of evidence exists to suggest that tumor hypoxia also influences the tumor metabolic reprogramming, resulting in neoangiogenesis, metastasis, and immune evasion. In this respect, our review aims to understand the biological processes, key events, and consequences regarding the hypoxia-driven metabolic adaptation of tumor cells. We also assess the potential therapeutic impact of hypoxia and highlight our review by discussing possible therapeutic strategies targeting hypoxia, which would advance the current understanding of hypoxia-associated tumor propagation and malignant progression and improve the management of tumor hypoxia.

Orthodontic treatment in a patient with cherubism: Benefits and limitations.

AIM: Cherubism is an uncommon hereditary disease that leads to the development of giant cell lesions in the jaws, alterations in the dentition, and malocclusion. The biological behavior of bones to orthodontic forces in these patients is not described in the literature, leading dentists to avoid this management. The aim of this article was to describe a case report of management with orthodontics. We present details regarding clinicoradiographic features, diagnosis, treatment, and follow-up. CASE REPORT: A 12-year-old male patient diagnosed with cherubism presented to our service with complaints about his esthetic facial and dental appearance. Management was interdisciplinary, including careful and controlled orthodontic treatment. The results were satisfactory; alignment, dental leveling, and correction of the malocclusion were achieved. CONCLUSION: Patients with cherubism may benefit from orthodontics, improving oral function, and esthetic and psychosocial well-being. The orthodontic treatment might be performed according to the severity of clinical manifestation, expectations of the patients, and limitations of each case.

Increased Tumor Immune Microenvironment CD3+ and CD20+ Lymphocytes Predict a Better Prognosis in Oral Tongue Squamous Cell Carcinoma.

Background: Oral tongue squamous cell carcinoma (OTSCC) causes over 350,000 cases annually and particularly impacts populations in developing countries. Smoking and alcohol consumption are major risk factors. Determining the role of the tumor immune microenvironment (TIME) in OTSCC outcomes can elucidate immune mechanisms behind disease progression, and can potentially identify prognostic biomarkers. Methods: We performed a retrospective study of 48 OTSCC surgical specimens from patients with tobacco and alcohol exposures. A panel of immunoregulatory cell subpopulations including T (CD3, CD4, CD8) and B (CD20) lymphocytes, dendritic cells (CD1a, CD83), macrophages (CD68), and immune checkpoint molecules programmed cell death protein 1 (PD-1) and ligand 1 (PD-L1) were analyzed using immunohistochemistry. The levels of immune effector cell subpopulations and markers were analyzed in relation to overall survival. Results: Pathological characteristics of the tumor microenvironment included inflammatory infiltrates (83.3%), desmoplasia (41.6%), and perineural invasion (50.0%). The TIME contained high levels of T cells (CD3+, CD4+, and CD8+) and B cells (CD20+), as well as immature (CD1a) and mature (CD83) dendritic cells, PD-1, and PD-L1. Higher numbers of TIME infiltrating CD3+ T cells and CD20+ B cells were predictive of better survival, while higher levels of CD83+ mature dendritic cells predicted better survival. CD3+ T cells were identified as an independent prognostic marker for OTSCC. Lastly, CD3+ T cells were strongly correlated with the number of CD8+ cells and PD-L1 expression. Conclusion: Our findings provide evidence that the TIME profile of OTSSC impacted prognosis. The high expression of CD3+ T cells and B cells are predictive of better overall survival and indicative of an immunologically active, inflammatory TIME in patients with better survival. The number of CD3+ T cells was an independent prognostic marker.

Expression of cell cycle proteins according to HPV status in oral squamous cell carcinoma affecting young patients: a pilot study.

OBJECTIVE: Tobacco and alcohol consumption are considered the main risk factors for oral squamous cell carcinoma (OSCC); however, the role of these factors in patients younger than 40 years is controversial, so it has been suggested that genomic instability and high-risk human papillomavirus (HR-HPV) infection may be contributing factors to oral carcinogenesis at a young age. Therefore, the aim of this study was to evaluate the immunoexpression of cell cycle proteins according HPV status in OSCC affecting young patients. METHODS: A tissue microarray construction based on 34 OSCC samples from young patients (<40 years old) was subjected to immunohistochemical reactions for Ki67, cyclin D1, C-ErbB2, p21, Myc, epidermal growth factor receptor, p53, and p16 antibodies. RESULTS: The clinicopathologic features and the immunoexpression of all tested proteins were similar in both groups. Patients with HPV-related OSSC tended to have better cancer-specific survival (CSS; 39% vs 60% 5-y CSS), and overall survival (OS; 29.2% vs 60% 5-year OS). However, this difference was not statistically significant. CONCLUSION: No significant difference exists in the expression of cell cycle proteins studied between HR-HPV DNA-positive and HR-HPV DNA-negative OSCC affecting young patients.

Different patterns of expression of cell cycle control and local invasion-related proteins in oral squamous cell carcinoma affecting young patients.

OBJECTIVES: Oral squamous cell carcinoma (OSCC) predominantly affects males in the fifth decade of life; nevertheless, an increased incidence in young patients has been reported worldwide, and the clinical and behavioral characteristics of tumors in this group are controversial, and the literature shows divergent results. PURPOSE: To investigate the clinicopathological features and prognostic significance of the immunoexpression of cell cycle and local invasion proteins in OSCC affecting young patients (≤40 years old). METHODS: A tissue microarray was performed with 132 OSCC samples (61 cases of young patients vs 71 cases of elderly patients) and submitted to immunohistochemical reactions with Ki67, p53, p16, Bcl-2, Cyclin D1, C-ErbB2, p21, Myc, EGFR, MMP-9, SMA, Cathepsin K and FGF-2 antibodies. RESULTS: Clinicopathological features and survival rates were similar in both groups. Although overexpression of EGFR (P=.042) and MMP-9 (P=.001) was more frequent in young patients, only C-ErbB-2 (P=.048) and SMA (P=.048) expression correlated with lower disease-free survival (DFS) in this group of patients. CONCLUSION: Clinicopathological features and survival rates are similar between younger and older patients with OSCC. The different patterns of C-ErbB2, EGFR, MMP-9, and SMA expression between the groups merits further investigation to understand their role in the early tumor onset in young patients.

Hodgkin lymphoma diagnosed during dental treatment: the importance of neck palpation.

Hodgkin lymphoma (HL) is a malignant lymphoproliferative disease that originates from alterations in germinal center B cells. HL generally affects cervical and supraclavicular nodes, and the most common clinical presentation is adenopathy. It can be symptomatic and detected by the patient or asymptomatic and identified during a physical examination. This article reports the case of a 17-year-old girl who was diagnosed with HL during dental treatment, highlighting the importance of a complete physical examination in dental practice.

[Periodontal condition and tooth loss in diabetic patients]. / Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl.

INTRODUCTION: Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. OBJECTIVE: The periodontal condition and tooth loss was evaluated in diabetic subjects. MATERIALS AND METHODS: At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. RESULTS: The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. CONCLUSIONS: In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

Caries dental y necesidades de tratamiento en los escolares de 12 años de las instituciones oficiales del municipio de Rionegro (Antioquia, Colombia), 2010 / Dental caries and treatment needs in 12-year-old schoolchildren from public institutions of the municipality of Rionegro (Antioquia, Colombia), 2010

Introducción: el análisis de la situación de caries dental en la población de 12 años permite comprobar el cumplimiento de las metas relacionadas con el componente bucal de la salud. El objetivo de este estudio es describir la experiencia y prevalencia de cariesdental y las necesidades de tratamiento en una muestra de escolares de doce años del municipio de Rionegro. Métodos: estudio descriptivotransversal en 808 escolares de 12 años de instituciones educativas públicas del municipio de Rionegro. Se aplicaron criterios del índice de dientes cariados, obturados y perdidos tradicionales y modificados (COPDT-COPDM), y el índice de caries significativo (SiC), y se describieron según sexo, escolaridad, zona de residencia y afiliación a la seguridad social. Resultados: el COPDT en la población fue de 1,70 (± 1,63) y el COPDM de 2,19 (± 1,92). La prevalencia de caries en lesiones cavitacionales fue del 59,9% y para todas las lesiones fue de 70,8%. La experiencia de caries para el COPDT fue del 69,9 y del 77,8% para el COPDM. El SiC tomado a partir del COPDT fue de3,60 y de 4,42 a partir del COPDM. Se presentaron diferencias significativas en la experiencia, prevalencia y necesidades de tratamientoprincipalmente de acuerdo con el sexo y el grado de escolaridad. Conclusión: aunque los indicadores muestran el cumplimiento de las metas propuestas por la OMS y según estudios nacionales, se encuentran algunas situaciones de desigualdad que deben ser tenidas en cuenta para la planificación de estrategias de promoción, prevención y atención para esta población.

Introduction: analyzing dental caries conditions of 12-year-old population allows verifying how much of the oralhealth related goals have been achieved. The objective of this study was to describe the experience and prevalence of dental caries andtreatment needs of 12-year-old school children in the municipality of Rionegro. Methods: this was a cross-sectional descriptive study on 808 schoolchildren aged 12 years from public schools of the municipality of Rionegro. Both traditional (T) and modified (M) decayed, missing and filled teeth indexes (DMFTT and DMFTM) were used, as well as the Significant Caries Index (SiC). The obtained data wereanalyzed according to gender, education level, place of residence, and health insurance status. Results: the DMFTT value among the studied population was 1.70 (± 1.63) and the DMFTM was 2.19 (± 1.92). The prevalence of cavitated caries lesions was 59.9%, and for all the lesions it was 70.8%. Caries experience for the DMFTT was 69.9%, and 77.8% in the case of DMFTM. The SiC measured according to the DMFTT was 3.60, and 4.42 for DMFTM. Significant differences were observed in terms of experience, prevalence andtreatment needs, especially in relation to gender and school grade. Conclusions: these values indicate accomplishment of the goals set by the WHO and by Colombian standards. Nevertheless, they also reveal some inequalities that must be considered when planning promotion, prevention and attention programs aimed at this population.

Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl / Periodontal condition and tooth loss in diabetic patients

Introducción. La diabetes es una enfermedad sistémica que afecta el metabolismo de la glucosa y se ha relacionado con el desarrollo de enfermedad periodontal. Objetivo. El objetivo de este estudio fue determinar la condición periodontal y la pérdida dental de un grupo de pacientes diabéticos del Hospital Universitario San Vicente de Paúl. Materiales y métodos. A 117 sujetos con diabetes de tipo 1 y 2 se les practicó un examen periodontal completo, determinación de valores de la hemoglobina A1C (glycosilated hemoglobin) y radiografías periapicales, y se les indagó sobre hábitos de higiene oral e historia de diabetes. Los datos se analizaron de forma descriptiva y comparativa entre los parámetros clínicos, pérdida dental y tipo de diabetes. Resultados. La prevalencia de gingivitis fue de 27,4 % y la de periodontitis de 72,6 %. La complicación sistémica más frecuente fue la hipertensión arterial (51,3 %). Los dientes más frecuentemente perdidos fueron los molares y, en promedio, los sujetos habían perdido siete dientes. El control de placa bacteriana fue pobre (55,4 %). No hubo diferencias en los parámetros clínicos entre pacientes diabéticos de tipo 1 y de tipo 2. El promedio de profundidad con sonda fue 2,62 mm, siendo los molares los dientes más afectados. El promedio de pérdida de inserción fue de 3,03 mm. Los dientes 17, 16, 27, 37 y 47 presentaron los valores más altos de pérdida de inserción. Conclusiones. En conclusión, la condición periodontal en pacientes diabéticos fue mala, y presentaban periodontitis en la mayoría de los casos. Esto puede ser una causa importante de pérdida dental en sujetos diabéticos y requiere de especial atención por parte de los odontólogos y médicos.

Introduction. Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. Objective. The periodontal condition and tooth loss was evaluated in diabetic subjects. Materials and methods. At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. Results. The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. Conclusions. In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

Caries dental y necesidades de tratamiento en el primer molar permanente en escolares de 12 años de las escuelas públicas del municipio de Rionegro (Antioquia, Colombia), 2010 / Dental Caries and Treatment Needs in the First P ermanent Mol ar in 12-year-old School children fr om P ublic Schools in the Municipal ity of Rionegro (Antioquia, Colombia), 2010

Antecedentes: es importante evaluar el primer molar permanente, ya que en edad escolares el diente permanente más afectado por caries. La prevalencia de caries en estos dientesse ha asociado con la actividad futura de caries. Objetivo: determinar la prevalencia decaries y las necesidades de tratamiento de los primeros molares permanentes en la poblaciónescolar de 12 años de las escuelas oficiales del municipio de Rionegro (Antioquia).Métodos: se realizó un estudio descriptivo transversal en 808 escolares de 12 años deescuelas públicas del municipio. Se analizó la prevalencia de caries dental en el primer molarpermanente por número y tipo de dientes afectados y de acuerdo con sexo, escolaridad,zona de residencia y afiliación al Sistema General de Seguridad Social en Salud (SGSSS).También se describieron las necesidades de tratamiento para cada primer molar permanente.Resultados: los molares inferiores presentaron la mayor prevalencia de cariesdental en relación con las variables de afiliación al SGSSS, sexo y zona de residencia;en estas dos últimas variables se evidenció más afectación en el primer molar inferiorderecho y concentración en este molar de las necesidades de tratamiento restaurativo.Conclusiones: aunque se cuenta con estudios previos sobre prevalencia de caries dentalen el municipio que muestran cumplimiento de metas de la Organización Mundial de laSalud, son más escasos los estudios que evalúen de manera individual los primeros molarespermanentes para orientar políticas de salud pública dirigidos a la preservación de estasimportantes estructuras dentales...

Background: Evaluation of the first permanent molar is important since it is the tooth thatis most affected from dental cavities in schoolers. Caries prevalence of this molar has beenassociated with future caries activity. Objective: Determine caries prevalence and treatmentneeds in the first permanent molar of a 12-year-old population from public schools in themunicipality of Rionegro (Antioquia). Methods: A descriptive study in 808 12-year-old schoolchildren from public schools in Rionegro was conducted. Caries prevalence in the first permanentmolar was analyzed regarding number and type of teeth affected and associationwith sex, grade, zone of residence, and type of affiliation to the social security system (SSS).Needs for dental treatment in this molar were also described. Results: Lower molars werethe most affected by dental caries in relationship with sex, SSS, and zone of residence; in thelatter two dental cavities were more prevalent in the right lower first molar, tooth in which theneed for restorative treatment is higher than the other first molars. Conclusions: Althoughthere are previous studies on the dental health status in Rionegro and indicators show thatthe goals of the World Health Organization are being met, evaluative research focused onthe first permanent molar is scarce and necessary given its importance for health publicpolicymaking intended to preserve this teeth...