Tempo de viabilidade da saliva humana em meio externo para fins de extração e purificação do DNA: uma revisão de escopo / Viability time of human saliva in the external environment for DNA extraction and purification: a scoping review

Introdução: A análise do DNA salivar é uma dos métodos de identificação humana relacionados à Odontologia Legal. A coleta do material genético salivar consiste num processo simples e pouco invasivo, por possuir grande potencial discriminatório tem sido amplamente aplicado em investigações criminais. Objetivo: Por meio de uma revisão de escopo, objetivou-se mapear o tempo de viabilidade da saliva humana em meio externo para fins de extração e purificação de DNA. Material e Métodos: A revisão foi conduzida seguindo o protocolo JBI e registrada (doi: 10.17605/OSF.IO/PN9ET). A estratégia de busca foi adaptada para as bases: Pubmed, Web of Science, Scopus, LILACS, Cochrane e Google Scholar, sem restrições sobre período de publicação ou idioma. Foram excluídos estudos que exploraram apenas as metodologias e materiais relacionados a extração de DNA , também aqueles que estudaram DNA de outros componentes que não a saliva. Resultados: Identificou-se 283 estudos. Após triagem inicial, 15 referências foram lidas na íntegra, sendo 6 incluídas na revisão, em função da confirmação da elegibilidade. Bitucas de cigarro, próteses dentárias, pastilhas de compressão dentária, cavidade oral e cartões de FTA foram os substratos descritos como fonte de saliva coletada. A viabilidade do DNA foi verificada em tempos que variaram de 1 dia à 11 anos. Conclusão: O protocolo de coleta e armazenamento das amostras é um fator que pode influenciar a quantidade e qualidade do material examinado, todavia, observou-se DNA viável em análise realizada uma década após a coleta da saliva e esse foi o tempo máximo de acompanhamento relatado nos estudos

Introduction: Salivary DNA analysis is one of the human identification methods related to forensic dentistry. Collection of salivary genetic material consists of a simple and poorly invasive process because it has great discriminatory potential has been widely applied in criminal investigations. Objective: Through a scope review, the feasibility time of human saliva was mapped in the external environment for DNA extraction and purification purposes. Material and Methods: The review was conducted following the JBI protocol and registered (doi: 10.17605/OSF.IO/PN9ET). The search strategy was adapted for the databases: Pubmed, Web of Science, Scopus, LILACS, Cochrane and Google Scholar, with no restrictions on period of publication or language. Studies that explored only methodologies and materials related to DNA extraction were excluded, as well as those that studied DNA from components other than saliva. Results: 283 studies were identified. After initial screening, 15 references were read in full, 6 of which were included in the review. Cigarette butts, dentures, dental compression tablets, oral cavity and FTA cards were the substrates described as a source of collected saliva. DNA viability was verified in times ranging from 1 day to 11 years. Conclusion: The sample collection and storage protocol is a factor that can influence the quantity and quality of the material examined, however, viable DNA was observed in an analysis performed a decade after saliva collection and this was the maximum reported follow-up time in the studies

Validation of the Third Molar Maturation Index to estimate the age of criminal responsibility in Northeastern Brazil.

The estimation of the age of majority is crucial to determine the legal accountability of an individual. With this purpose, the analysis of the dental development process has proven to be an effective, elucidatory method. This study investigated the applicability of the Third Molar Maturation Index (I3M), proposed by Cameriere et al. (2008), to estimate the age of majority in a sample of Northeastern Brazilians using panoramic radiographs. Adobe® Photoshop® CS4 (Adobe Systems Incorporated, San Jose, California, USA) software was used to obtain the I3M index measurements in a sample of radiographs from a dental radiology clinic located in Northeastern Brazil. Radiographs of individuals aged between 14 and 23 years were included in the sample, except if showing absence, distortions, pathological alterations or suspected pulp impairment of the tooth #38 (third lower left molar), as the method applies exclusively to this element. Of the total sample of radiographs previously obtained for diagnostic and/or orthodontic purposes (n=394), 185 were from males and 209 from females, of which 217 corresponded to 18 year-olds or older and 177 were from minors. Logistic regression and predictive values of sensitivity, specificity and Receiver Operating Characteristic (ROC) curve (α=0.05) were used. The cutoff point originally proposed for the I3M index (0.08) presented a sensitivity of 88.4% and a specificity of 73.2%, with accuracy (area under the ROC curve) of 80.8% (95%CI: 76.4-85.3%) for the Northeastern Brazilian population, as well as a correct age classification in 80.2% of the sample. The method estimated accurately 73.7% of the cases corresponding to "18 years or older" and 88.1% of the cases "under 18years" (p=0.000). Among the sexes, the correct age classification rate of the method was 84.3% for males and 76.6% for females, with no statistically significant difference between the match and error rates and between the sexes (p≥0.05). In conclusion, the Third Molar Maturation Index could accurately distinguish the age of adolescents and young adults of both sexes aged 18 years or under/older in a Brazilian population.

The applicability of the Nicodemo, Moraes and Médici Filho`s method (1974) for age estimation among children, adolescents and young adults: a systematic review

Objective: It was evaluated the applicability of the Table of Permanent Teeth Mineralization among Brazilians for age estimation with forensic purposes. Method: The PRISMA guidelines (Preferred Report of Systematic Reviews and Meta-Analysis) were used for study design, and bibliographical searches were performed in the databases: Web of Science, Pubmed, Scopus, Cochrane, LILACS and SIGLE, according to PICO/PECO strategy. Results: A total of 10,280 records were retrieved from the databases, of which 20 articles were selected for full-text analysis after preliminary screening. Five articles plus one additional article selected by manual search were included in the final review, totaling six articles. The selected studies presented a cross-sectional design, five of which were developed in Brazil and two abroad. The assessment of methodological quality, performed with the use of QUADAS adapted by Lopes (2012), indicated that all six studies met more than 50% of the quality requirements and one of them met all the requirements. To compare the estimated and actual chronological age, four studies utilized correlation analysis while two employed descriptive statistics. The findings revealed discrepancy between the estimated age and the actual chronological age, which led the majority of authors to advocate a moderate use of the method as well as to indicate the use of correction factors for specific populations and its association with other age estimation methods. Conclusion: the existing evidence on the applicability of the Nicodemo, Moraes and Médici Filho's method (1974) for age estimation with forensic purposes is moderate, given the scarcity of studies and methodological heterogeneity between them.

Objetivo: Avaliou-se a aplicabilidade da Tabela Cronológica de Mineralização dos dentes permanentes em Brasileiros para estimativa da idade com fins forenses, por meio de uma revisão sistemática. Método: A pesquisa foi desenvolvida baseada no protocolo do Preferred Report of Systematic Reviews and Meta-Analysis (PRISMA). As buscas foram realizadas nas bases de dados: Web of Science, Pubmed, Scopus, Cochrane, Lilacs e Sigle, sendo a estratégia baseada no acrônimo PICO/PECO (MAIA; ANTONIO, 2012). Resultados: Foram recuperados 10.280 registros nas referidas bases, e após a triagem inicial 20 artigos seguiram para leitura na íntegra. Ao final, permaneceram 5 artigos e mais um foi adicionado por hand searching, perfazendo 6 artigos. Os estudos apresentaram delineamento seccional, sendo cinco realizados no Brasil e dois no exterior. A avaliação da qualidade metodológica, realizada com o auxilio do QUADAS adaptado por Lopes (2012), indicou que os 6 estudos apresentaram mais de 50% das respostas positivas, sendo que um atendeu a todos os requisitos. Para comparar as idades estimada com a cronológica, 4 dos artigos utilizaram análise de correlação e os demais, estatística descritiva. Os resultados demonstraram discrepâncias entre a idade estimada e a cronológica, fazendo com que a maioria dos autores indicasse o uso parcimonioso do método, procurando utilizar fatores de correção para populações específicas ou a sua associação a outros métodos de estimativa de idade. Conclusão: A evidência científica acerca da aplicabilidade do método de Nicodemo, Moraes e Médici Filho (1974) na estimativa de idade com fins forenses é moderada, sobretudo considerando a quantidade dos estudos existentes e a heterogeneidade metodológica entre eles.

Predictors for oral cancer in Brazil / Preditores para o câncer oral no Brasil

Introduction: The incidence of lip, oral cavity and oropharynx cancer in Brazil is one of the highest worldwide. Objective: This study aimed to identify predictors for oral cancer in Brazil between 2010 and 2013. Method: Through a time series study in which 14,959 primary head and neck cancer diagnoses were evaluated. The variables of interest were gender, age, race, education level, family history of cancer, alcohol consumption, smoking, and previous cancer diagnosis. The outcome variable was divided into "oral cancer" and "cancer of other head and neck regions." The data were analysed by multiple binary logistic regression; α=5%. Result: The protective factor was: approximately 12 years of education (OR = 0.85). The risk factors were: being an ex-consumer (OR=1.19) or consumer (OR=1.11) of alcohol, tobacco use (OR=1.35) and a prior diagnosis of cancer that went untreated (OR=1.21). Conclusion: Was concluded that the oral cancer had the following predictors compared to other types of head and neck cancer during the same period: approximately 12 years of education (protective factor) and ex-consumer or consumer of alcohol, smoking and previous diagnosis of cancer that went untreated (risk factors).

Introdução: A incidência de câncer de lábio, cavidade bucal e orofaringe no Brasil é uma das maiores do mundo. Objetivo: Este estudo teve como objetivo identificar preditores para o câncer bucal no Brasil entre 2010 e 2013. Método: Mediante um estudo de série temporal em que foram avaliados 14.959 diagnósticos primários de câncer de cabeça e pescoço. As variáveis de interesse foram: gênero, idade, raça, nível de escolaridade, histórico familiar de câncer, consumo de álcool, tabagismo e diagnóstico anterior de câncer. A variável desfecho foi dividida em "câncer de boca" e "câncer de outras regiões de cabeça e pescoço". Os dados foram analisados por regressão logística binária múltipla; α = 5%. Resultado: O fator de proteção foi: ter aproximadamente 12 anos de escolaridade (OR = 0,85). Os fatores de risco foram: ser um ex-consumidor (OR = 1,19) ou consumidor (OR = 1,11) de álcool, tabagismo (OR = 1,35) e o diagnóstico prévio de câncer sem tratamento (OR = 1,21). Conclusão: Concluiu-se que o câncer bucal possui os seguintes preditores em comparação com outros tipos de câncer de cabeça e pescoço durante o mesmo período: ter aproximadamente 12 anos de estudo (fator de proteção) e ser ex-consumidor ou consumidor de álcool, tabagismo e ter tido um diagnóstico prévio de câncer sem tratamento (fatores de risco).

Factors associated with oral biofilm in ICU patients with infectious diseases / Fatores associados à presença de biofilme oral em pacientes internados na UTI

Introduction: Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective: To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method: This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result: Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion: Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.

Introdução: A hospitalização pode provocar deterioração da saúde bucal, repercutindo em todo o corpo. A UTI pode ser um ambiente favorável ao acúmulo de biofilme oral em pacientes críticos. Objetivo: Identificar fatores associados à presença do biofilme em pacientes da UTI de um hospital de doenças infectocontagiosas. Método: Estudo retrospectivo, descritivo e inferencial, com abordagem quantitativa. Os dados foram obtidos em prontuários de pacientes da UTI, de janeiro de 2012 a julho de 2015. O biofilme foi avaliado de acordo com o índice de Greene e Vermillion. Os fatores influentes foram analisados por regressão logística. Resultado: Entre os pacientes da UTI, 69,1% eram homens, 60,7% pacientes com AIDS, 66,3% pacientes na enfermaria, 50,6% intubados e 50,0% sedados. Seus elementos orais eram na maioria normais. As seguintes características foram significativamente associadas a biofilmes orais: alterações orais nos lábios, gengivas, bochechas e palatos e sangramento. Pacientes da enfermaria apresentaram menor risco de apresentar biofilmes. Conclusão: o aumento do acúmulo de biofilme oral foi observado em pacientes com alterações na boca e a procedência do paciente foi associada à presença de biofilme.

Profile of Hospitalizations and Deaths from Craniofacial Fractures in Brazilian Children and Adolescents: An Ecological Study

Objective: To characterize the profile of hospitalizations and deaths related to craniofacial fractures in Brazilian children and adolescents. Material and Methods: This is an ecological cross-sectional study with inductive approach with comparative-descriptive procedure and indirect documentation technique. Data were obtained from the DATASUS / SIH-SUS website for the years 2010-2014, considering information for each state of the five Brazilian regions. Admission rates were calculated per 100,000 inhabitants, and data were analyzed by population rates, averages and absolute and relative frequencies. Results: The Northeastern region of Brazil showed the highest hospitalization rate (81.72), followed by the Northern (56.84), Southern (50.94), Midwestern (44.25) and Southeastern regions (30.28). In all regions, the years with the highest hospitalization rates were: 2010 for the Northern (13.17) and Southeastern regions (6.61), 2013 for the Northeastern (20.07) and Midwestern regions (10.17) and 2014 for the Southerner region (10.52). The highest hospitalization rates in all regions of the country in the last five years were observed for male children and adolescent. In relation to age group, higher rates were recorded from 15 to 19 years. Of the total of 27,244 hospitalizations (3.8%), 1028 patients died and 35.5% of them occurred in the Northeastern region. Considering the years under study, the average length of stay and average daily hospitalization cost were respectively 4.0 days and US$ 82.7. Conclusion: The Northeast region of Brazil had the highest hospitalization rate of children and adolescents by craniofacial fractures, and male adolescents and those aged 15-19 years were the most affected in different regions of the country. Costs of hospital admissions due to this type of injury are significant, with more deaths as a result of these injuries in Brazil in the last 5 years evaluated with the highest prevalence in the Northeastern region of Brazil.

Use of the Chronological Dental Mineralization Table of Nicodemo, Moraes and Medici Filho (1974) to Estimate Age by Undergraduate Dentistry Students

Objective: To evaluate the agreement and applicability of the Chronological Dental Mineralization Table of Nicodemo, Moraes and Medici Filho (1974) to estimate age held by undergraduate Dentistry students at the Federal University of Paraíba. Material and Methods: Field research applied with a sample of 50 students according to inclusion and exclusion criteria. Sequentially, 3 panoramic radiographs were exposed (actual age known only by teachers), and students were instructed to interpret them from the selection of 2-4 teeth under formation. Data were analyzed using SPSS software (Statistical Package for Social Sciences), version 20.0, adopting significance level of 5%. Results: Most students chose 3 teeth, with percentages of 56.0% (n = 28); 38.0% (n = 19) and 58.0% (n = 29) for radiographs 1, 2 and 3, respectively. Teeth selected with greater frequency were: 47 (20.1%, n = 33) and 45 (19.5%, n = 32) - radiography 1; 38 (22.7%, n = 32) and 18 (13.4%, n = 19) - radiography 2; and 47 (17.9%; n = 26) and 36 (13.7%; n = 20) - radiography 3. The agreement between estimated and actual ages was 60.0% for radiography 1, 12.0% for radiography 2 and 32.0% for radiography 3. Age was underestimated in 40.0% (n = 20) and 88.0% (n = 44) in radiographs 1 and 2, respectively. Overestimation of the actual age occurred only in radiography 3 (68.0%; n = 34). The linear regression analysis revealed that it is possible to estimate the actual age from the maximum age stipulated by training students with 88.1% success rate. Conclusion: The method is applicable; however, the correlation between estimated and actual ages varied considerably among radiographs, and maximum estimated values were closer to the actual age than minimum values.

Percepção dos graduandos de Odontologia quanto à atividade prática de estimativa de idade realizada em uma disciplina de Odontologia Legal / Dental undergraduate students' perceptions regarding the practical activity of age estimation made in a course of Forensic Dentistry

O estudo objetiva identificar as facilidades e dificuldades vivenciadas pelos alunos em atividade prática de estimativa de idade proposta pela disciplina de Odontologia Legal, verificando sua percepção quanto à funcionalidade e/ou importância da atividade na sua formação acadêmica. Trata-se de uma pesquisa de campo aplicada, quantitativa, exploratória, documental e analítica, do tipo transversal. Durante uma atividade prática da disciplina de Odontologia Legal da Universidade Federal da Paraíba, aplicou-se um questionário com perguntas abertas e fechadas acerca das facilidades e dificuldades vivenciadas na aplicação de um método de estimativa de idade e da percepção dos alunos quanto a funcionalidade e importância da atividade. A amostra (n=52) foi composta pelos alunos matriculados na disciplina de Odontologia Legal nos períodos letivos 2014/2 e 2015/1, que participaram da atividade prática. Os dados foram analisados descritivamente. A opção "Excelente" foi maioria em três dos quatro critérios avaliados. Como pontos positivos, destacaram-se a aplicabilidade (19,0%), fixação do conteúdo (17,2%), relevância para formação profissional (12,1%) e praticabilidade (12,1%). Como pontos negativos e dificuldades encontradas foram ressaltadas a subjetividade do método em estudo (25,0%), a má qualidade das projeções radiográficas (18,2%), a restrição de aplicação do método a crianças e adolescentes (9,1%) e a necessidade de estudo prévio (9,1%). Em conclusão, a atividade prática de estimativa de idade contribuiu para a formação profissional dos alunos, sendo a aplicabilidade do método o ponto positivo mais frequentemente apontado, enquanto a subjetividade do mesmo se constituiu na maior dificuldade vivenciada pelos graduandos (AU).

This study aimed to identify the facilities and difficulties experienced by students in a practical activity of age estimation proposed by the Forensic Dentistry curse, checking their perception regarding functionality and or importance of the activity in their academic training. This is a cross-sectional study with a quantitative and analytical approach. During a practical activity of the Forensic Dentistry curse at Federal University of Paraíba, a questionnaire was applied with open and closed questions about the facilities and difficulties experienced in the application of an age estimation method. Besides, the perception of students regarding the functionality and importance of the activity was asked. The sample (n = 52) was composed of students enrolled in the Forensic Dentistry discipline in two consecutive academic periods (2014/2 and 2015/1), which participated in the practical activity. Data were descriptively analyzed. The option "Excellent" was the most cited in three of the four criteria evaluated. As positive points, applicability (19.0%), content (17.2%), relevance for professional training (12.1%) and practicability (12.1%) stood out. The negative points and difficulties found were the method´s subjectivity (25.0%), poor quality of radiographic projections (18.2%), restricted applicability to children and adolescents (9.1%) and need for a previous study (9.1%). In conclusion, the practical activity of age estimation contributed to the students´ training, and the method applicability was the positive point most often cited, while the method´s subjectivity was the main difficulty experienced by undergraduate students (AU).