Is catechol-O-methyltransferase gene associated with temporomandibular disorders? A systematic review and meta-analysis.

BACKGROUND: Temporomandibular disorder (TMD) is a condition, in which multiple factors act synergistically to determine the outcome of the disorder. AIM: A systematic review and meta-analysis was conducted to evaluate the association between genetic polymorphisms in catechol-O-methyltransferase (COMT) and TMD. DESIGN: Observational studies that investigated this association were included. The risk of bias and study quality were evaluated according to the Newcastle-Ottawa tool. The meta-analysis was performed for each polymorphism associated with TMD signs and symptoms. RESULTS: A total of 1903 articles were identified. Ten remained in the qualitative analysis: six were classified as low risk of bias and four with moderate risk of bias, and three were included in the meta-analysis. The polymorphism rs6269, in the genotypic model (0.65; CI = 0.44-0.97; P = .04) and in the allelic model (0.73; CI = 0.54-0.98; P = .04), was associated with myofascial pain. The rs9332377 was associated with myofascial pain in the genotypic model (2.69; CI = 1.51-4.76; P = .0007) and in the allelic model (1.46; CI = 1.01-2.13; P = .05) and with painful TMD in the genotypic model (2.08; CI = 1.27-3.40; P = .004) and in the allelic model (1.34 CI = 0.98-1.82; P = .06). CONCLUSION: The polymorphisms in COMT were significantly associated with TMD.

Anxiety and malocclusion are associated with temporomandibular disorders in adolescents diagnosed by RDC/TMD. A cross-sectional study.

BACKGROUND: Temporomandibular Disorders (TMD) is a multifactorial condition, which could be associated to occlusal and psychological factors, such as anxiety. OBJECTIVE: Investigate if anxiety and malocclusion are associated with the prevalence of TMD in adolescents. METHODS: To ensure a population-based representative sample, 934 adolescents aged 10 to 14 years old from Curitiba-PR, Brazil were randomly selected and examined according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and malocclusion by a single-calibrated examiner (Kappa > 0.80). Anxiety was assessed according to trait anxiety (STAI-T), categorised as high, moderate and low levels. For occlusal exam, it was considered: Angel's molar relationship, anterior and posterior crossbite, excessive overjet, open and deep bite. The associations were analysed by the crude and adjusted prevalence ration (RPa ) of TMJ, calculated by a Poisson multivariate regression with robust variance (α = 0.05). RESULTS: The prevalence of at least one type of malocclusion was found in 52.3%. Anxiety was found in high level (12.2%), moderate (70.4%) and low (17.5%). Presence of high anxiety was significantly associated with the prevalence of TMD symptoms (RPa  = 4.06, P < 0.001), as well as the prevalence of myofascial pain (RPa  = 24.78; P < 0.001) and prevalence of disc displacement with reduction (RPa  = 11.08, P < 0.001). Adolescents Class II had higher prevalence of myofascial pain (Class II RPa  = 1.73; P < 0.015) than adolescents Class I. Adolescents Class III presented higher prevalence of myofascial pain (PRa 2.53; P = 0.004) than adolescents Class I. CONCLUSION: Anxiety is strongly associated with TMD in adolescents. Presence of Class II or III is associated with higher prevalence of myofascial pain in adolescentsPLESAE check and approve the edit made in the article title.

Oral health status in victims of child abuse: a case-control study.

BACKGROUND: Few studies have evaluated the oral health status of children with a history of maltreatment. AIM: This case-control study evaluated oral health in children who were victims of abuse and in child protective services in Curitiba, Brazil. DESIGN: One hundred twenty-two children who were victims of abuse and 240 children with no history of abuse (mean ages, 8.56 and 8.24 years, respectively) were included in the study. Dental caries were assessed according to the Decayed, Missing, or Filled Teeth index (dmft index and DMFT index) by two calibrated examiners. The presence of anterior open bite and posterior crossbite was recorded. Data were analyzed using bivariate and adjusted odds ratios using a multivariate logistic regression model analyses. RESULTS: In the case group, we found a higher DMFT index (P < 0.001) and a significantly higher prevalence of missing primary teeth (P = 0.04), untreated decayed permanent teeth (P < 0.001), filled permanent teeth (P < 0.001), and anterior open bite (P = 0.04). Children who were victims of abuse presented an odds ratio of 6.48 (95% CI: 3.52-11.95) for caries in permanent teeth and an odds ratio of 2.28 (95% CI: 1.04-4.99) for open bite. CONCLUSION: Victims of child abuse had a worse oral health status, demonstrating the need to establish special policies for oral healthcare for this population.

The efficacy of acid etching for removing contamination in layered dental restorations.

Contamination between incremental layers of a composite resin restoration can occur during surgical procedures. The present study sought to evaluate how two decontamination treatments affected the shear bond strength between layers of a saliva-contaminated composite resin surface. Forty disks of a nanohybrid composite resin were prepared and divided into four groups (n = 10). The surfaces of all specimens (except for samples in Group 1, the positive control) were contaminated with human saliva. For the negative control samples (Group 2), no decontamination was performed. For Group 3 samples, acid etching was performed and adhesive was applied. For Group 4, surfaces were roughened with a diamond bur prior to acid etching and adhesive application. The specimens were submitted to a shear bond strength test, and the data were analyzed using one-way ANOVA and Tukey tests (α = 0.05). No significant differences were detected between the mean shear bond strengths of samples in Groups 1, 3, and 4 (p < 0.05). Shear bond strength was significantly reduced in Group 2 samples (p < 0.05). Acid etching and the application of adhesive improved shear bond strength, producing values similar to those in the positive control group.

Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents.

BACKGROUND: The prevalence of signs and symptoms of temporomandibular disorders (TMD) increases during adolescence and adulthood. Few studies have examined TMD prevalence in Brazilian adolescents. AIM: To investigate the prevalence of TMD in Brazilian adolescents. METHODS: A representative population-based sample of 934 adolescents (10-14-years-old) was examined. TMD screening was performed using a questionnaire by the American Academy of Orofacial Pain. TMD diagnoses used research diagnostic criteria for temporomandibular disorders (RDC/TMD-Axis-I). Examinations were performed by a single calibrated examiner (kappa > 0.80). RESULTS: The prevalence of TMD symptoms was 34.9%; the most frequently reported symptoms were headache and neck ache (20.9%), followed by joint sounds (18.5%). Myofascial pain was the most prevalent type (10.3%), followed by disc displacement with reduction (8.0%) and arthralgia (3.5%). There was a significant association between sex and TMD symptoms; prevalence was significantly higher in girls (RP = 1.37; 95% CI = 1.14-1.65; p = 0.001). Myofascial pain of TMD and displacement with reduction were more prevalent in girls (RP = 1.76; p = 0.007 and RP = 2.06; p = 0.004, respectively). CONCLUSION: TMD symptoms were present in 34.9% of adolescents, with myofascial pain being the most prevalent type (10.3%). TMD was significantly more common in girls. Routine pediatric dental care should include a TMD screening.

Evaluation of the signs and symptoms of temporomandibular disorders in children with headaches.

PURPOSE: The purpose of this study was to evaluate the presence of signs and symptoms of temporomandibular disorders (TMD) in children with headaches in a neuropediatric ambulatory. METHOD: Fifty patients between 4 and 18 years of age were examined: 31 had headaches (24 migraine, 4 tension type and 3 unspecific headache) and 19 formed the control group. The data collection was comprised of a structured questionnaire answered by the children's parents, and a subjective evaluation about the childrens emotional state. A specific questionnaire for TMD was applied, followed by a clinical dental examination of the children. As signs of TMD, mouth opening limitation, mandibular trajectory deviation in opening mouth, and joint noise were considered. As symptoms, pain on palpation of masseter and temporal muscles and on the poromandibular joint. RESULTS: A significant increase in signs and symptoms of TMD was found in patients with headaches when compared to the control group. There was also a significant difference in signs and symptoms of TMD according to age (increased with age) and emotional state (tense>calm). CONCLUSION: There is a higher frequency of TMD in pediatric patients with headaches; thus, it is important to look for TMD signs and symptoms in this population.

Domestic violence against children and adolescents: prevalence of physical injuries in a southern Brazilian metropolis.

Violence against children and adolescents is a public health issue worldwide that threatens physical and mental wellbeing and causes irreparable harm. Reports on this violence are an essential way to prevent it and to protect the children and adolescents. Thus, the objective of the present study was to evaluate the prevalence of physical injuries that occur in domestic environments and reported to the Child and Adolescent Protection Network. This retrospective study was conducted at the Epidemiology Center of the Municipality of Curitiba. A total of 10,483 reports for the years 2010 (5,112) and 2011 (5,371) were analyzed and from them were selected reports of physical injuries that occurred in the family environment. The children and adolescents were 0-17 years old, comprising 322 cases of physical abuse within the family in 2010. Out of these, 57.1% were male and 42.9% were female, and 58% (187) presented head and neck injuries. There were 342 reports in 2011, 49% were male and 51% were female; head and neck injuries corresponded to 65% (222) of the reported cases. The prevalence of injuries increased by 6% and head and neck injury increased by 19% between 2010 and 2011. It may be concluded that physical abuse is associated with a high prevalence of head and neck injury, which is easily observed by the health and education professionals. Notification organs should be created in Brazilian hospitals and health centers, which is essential to conduct epidemiological surveillance and appropriate policies.

Assessment of anxiety in patients who undergo surgical procedures for tooth implants: a prospective study.

PURPOSE: The purpose of this study is to evaluate general anxiety using the State-Trait Anxiety Inventory (STAI) and dental anxiety using the Corah Dental Anxiety Scale (Corah-DAS) in patients who underwent surgical procedures for dental implants. METHODS: The study was performed with 55 patients who underwent implant surgery, of whom 37 were treated at a university and 18 were treated at a private office. General anxiety (STAI) and dental anxiety (Corah-DAS) were assessed at three different time points: appointment prior to clinical procedures (T1), day of procedures (just before the procedures; T2), and first post-procedure appointment (T3). The data were analyzed using analysis of variance followed by the Duncan test or Student's t-test. RESULTS: State anxiety increased on the day of surgery (T2), whereas trait anxiety was higher at T1 (both p < 0.05). Women (n = 41) presented higher state anxiety at T2 than men (n = 14). Patients who were treated at the university (n = 37) exhibited higher state anxiety at both T1 and T3 than patients who were treated in a private practice (n = 18). Individuals with lower dental anxiety at T1 were those who reported having good experiences with dental treatment. CONCLUSIONS: An increase in state anxiety was observed immediately before surgical procedures, and this increase was more pronounced in females. Although the Corah-DAS has been used as an indicator of dental anxiety, the STAI appears to be more sensitive for the measurement of anxiety. The application of appropriate methods is essential for ascertaining anxiety in patients, which should be considered in oral surgeries.

Effect of different surface treatments for ceramic bracket base on bond strength of rebonded brackets.

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukey's tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

Lactate dehydrogenase isoenzymes in dental pulp of rats according to stage of root development.

The objective of this study was to present a classification of the root development stage of female rat molar teeth and to evaluate the variation in the lactate dehydrogenase (LDH) activity and electrophoretic isoenzyme profile according to the stage of root development of the molar teeth. We also studied the LDH activity and isoenzymes of the pulp of incisor teeth. The stage of development of the rat first molar at the age of 15 days and that of the second molar at the age of 18 days was classified as the beginning of root formation. At the age of 15 days, the electrophoretic profile of the isoenzymes for the first molar showed a prevalence of LDH-1 followed by LDH-2. However, for the maxillary second molar there was a prevalence of LDH-4 followed by LDH-1, while for the mandibular second molar LDH-1 predominated followed by LDH-2 and LDH-4. From 18 days of age, the prevalence was always of LDH-1. The electrophoretic profile of LDH isoenzymes from the pulp of the incisor teeth at the ages studied (25 and 60 days) showed the following order of prevalence: LDH-1 > LDH-2 > LDH-3 > LDH-4 > LDH-5. These results suggest that there are variations in the prevalence of the various forms of LDH isoenzymes in the dental pulp of rats according to the developmental stage of the root.

Surgery management of rare hypertrophic frenum in an infant.

To report a rare case of a lateral frenum hypertrophy in an infant, this paper describes the case of a girl who came to a first dental appointment when she was 4 months old. A hypertrophic lateral frenum in the upper left canine region was detected. A great depression in the gingival rodet separated the anterior maxillary segment from the posterior one and also decreased the lip mobility in this region. A frenectomy was performed when the patient was 11 months old and the clinical follow-up was done up to the age of 30 months. There was normalization in the vestibular insertion of the lateral frenum, lip mobility, physiological development of the maxilla, and eruption of the upper incisors, canines, and first primary molars. Infants should go to a dental examination precociously in order to detect possible congenital and development alterations.

Noninvasive and multidisciplinary approach to the functional and esthetic rehabilitation of amelogenesis imperfecta: a pediatric case report.

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

The relationship between dental anxiety in children, adolescents and their parents at dental environment.

PURPOSE: The aim of the present study was to compare trait anxiety and dental anxiety among children, adolescents and their parents. MATERIALS AND METHODS: A cross-sectional study was conducted involving 100 patients from the Pediatric Dentistry Clinic of the Federal University of Parana (Brazil) between the ages of 8 and 17 years (mean age: 10.3; standard deviation: 2.03) and their parents, who responded to Corah's Dental Anxiety Scale (DAS) and the Trait Anxiety Scale. The data were analyzed using the Mann-Whitney test, analysis of variance and both Pearson's and Spearman's correlation coefficients. RESULTS: Ninety percent of children and adolescents and 76% of the parents had moderate anxiety based on the DAS score. Seventy-four percent of children and adolescents and 72% of the parents had moderate anxiety based on the Trait Anxiety Scale score. The trait anxiety and dental anxiety scores were correlated among the adults (rs = 0.64) and children (r = 0.52), whereas no correlation between scores was found among the adolescents. Associations were also found between children's trait anxiety and the dental and trait anxiety of their parents (both r = 0.43). CONCLUSIONS: A moderate degree of dental anxiety was prevalent among the children, adolescents and parents who took part in this investigation, with correlations demonstrated between some trait anxiety and dental anxiety scores.

Child abuse: validation of a questionnaire translated into Brazilian Portuguese.

This study sought to validate the Portuguese translation of a questionnaire on maltreatment of children and adolescents, developed by Russell et al. and to test its psychometric properties for use in Brazil. The original questionnaire was translated into Portuguese using a standardized forward-backward linguistic translation method. Both face and content validity were tested in a small pilot study (n = 8). In the main study, a convenience sample of 80 graduate dentistry students with different specialties, from Curitiba, PR, Brazil, were invited to complete the final Brazilian version of the questionnaire. Discriminant validity was assessed by comparing the results obtained from the questionnaire for different specialties (pediatric dentistry, for example). The respondents completed the questionnaire again after 4 weeks to evaluate test-retest reliability. The comparison of test versus retest questionnaire answers showed good agreement (kappa > 0.53, intraclass correlation > 0.84) for most questions. In regard to discriminant validity, a statistically significant difference was observed only in the experience and interest domains, in which pediatric dentists showed more experience with and interest in child abuse compared with dentists of other specialties (Mann-Whitney test, p < 0.05). The Brazilian version of the questionnaire was valid and reliable for assessing knowledge regarding child abuse by Portuguese-speaking dentists.

Physical child abuse: perception, diagnosis, and management by Southern Brazilian pediatric dentists.

PURPOSE: This study evaluated the perception, diagnosis, and attitudes of child abuse among Brazilian pediatric dentists. METHODS: Data, collected through a survey sent to 212 pediatric dentists in Curitiba, Brazil, included perceived knowledge about signs of child abuse, whether they had seen and reported it, and knowledge of their obligation to report, how, and to whom. RESULTS: The response rate was ~33%. The youngest group was significantly more likely to report cases than the group with more than 18 years since graduation. Fifty-five percent of the professionals thought they are able to identify child abuse, 36% thought they were unable, and 9% did not know. Although 73% knew that reporting incidents of abuse is compulsory, only 48% responded that they would report cases of abuse to the relevant authorities. Although 36% of the pediatric dentists reported to have seen suspected cases of abuse, only approximately 12% reported such cases to authorities. Signs of abuse most frequently mentioned were hematoma throughout the body (61%) and behavioral changes (53%). Lesions on the face, mouth, and teeth were cited by only 17% of the professionals. CONCLUSION: More information is needed in undergraduate dental schools and among pediatric dentists to recognize and report child abuse.

Shear bond strength of brackets bonded with nanofilled flowable resins

Introduction and Objective : To evaluate the shear bond strength of brackets fixed with different materials (two light-cured nanofilled low-viscosity resins - Transbond Supreme LV and Flow Tain LV and two light-cured traditional resins - Transbond XT and Transbond Plus Color Change) after 10 min and 24 h, and to evaluate the type of failure. Material and methods : Eighty bovine incisors were selected and randomly divided into groups (n = 10) according to the material and fixation period. The brackets were bonded following the manufacturer's instructions and stored in deionized water at 37oC for 10 min or 24 h. After, the specimens were submitted to shear bond strength test at 0.5 mm/min and evaluated for adhesive remnant index (ARI). The data were submitted to Kruskal Wallis and Wilcoxon tests (p < 0.05) and the ARI scores to Chi-Square test. Results: There was a significant difference among the materials (p < 0.05) (after 10 min - Transbond XT > Transbond Plus Color Change > Transbond Supreme LV = Flow Tain LV and after 24 h - Transbond XT > Transbond Plus Color Change = Transbond Supreme LV = Flow Tain LV). There was no significant difference in resistance values between 10 min and 24 h, except for Transbond Plus Color Change. Most groups showed adhesive remaining adhered to the enamel (scores 2 and 3) without statistical significant difference (p > 0.05). Conclusion: The light-cured traditional resins showed higher resistance than the nanofilled materials. The period of fixation had no influence on the resistance for different materials, except for Transbond Plus Color Change.

Mesiodens surgery at deciduous and permanent dentition

Introduction and Objective:To report a rare case of a patient who presented two mesiodens and the treatment performed at two moments. Case report: A 7 year-old male patient reported a supernumerary tooth extracted at age 4. The dental clinical exam revealed giroversion of permanent maxillary right central incisor. Cone-beam computed tomography (CBTC) revealed a presence of a mesiodens located at the buccal surface mesially to the permanent maxillary left central incisor and also indicated that the mesiodens was located close to the f loor of the nasal cavity. The surgery was performed with a conservative intervention and osteotomy by preserving the adjacent structure. The one-year following-up postoperative x-ray indicated new bone deposition and a more favorable eruption position of the right permanent maxillary lateral incisor. Conclusion: It can be concluded that an early diagnosis by CBTC allowed an adequate treatment planning, which avoid the formation of cysts and a prolonged retention of permanent tooth.

Effect of Different Surface Treatments for Ceramic Bracket Base on Bond Strength of Rebonded Brackets

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukey's tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

O objetivo do estudo foi avaliar o efeito de tratamentos da base de bráquetes cerâmicos monocristalinos na resistência de união ao esmalte após recolagem. Setenta e cinco pré-molares foram selecionados e aleatoriamente distribuídos em 5 grupos (n=15) de acordo com o tratamento da base do bráquete: I - sem tratamento, primeira colagem (controle), II - jateamento com óxido de alumínio, III - jateamento seguido da aplicação de silano, IV - jateamento com partículas de dióxido de sílica (silicatização) seguido de silano, V - silicatização realizada em laboratório (Sistema Rocatec). Os bráquetes foram colados no esmalte com Transbond XT sem condicionamento ácido. Em seguida, os bráquetes foram removidos e suas bases foram submetidas aos diferentes tratamentos. Os bráquetes foram recolados, armazenados por 24 h e submetidos ao ensaio mecânico de cisalhamento com velocidade de 0,5 mm/min. Após, o índice de remanescente adesivo (IRA) foi avaliado em cada espécime. Os dados foram submetidos à análise de variância e teste de Tukey (α=0,05). Pode-se observar que houve diferença significativa apenas entre o sistema Rocatec e os demais grupos, o qual apresentou os menores valores de resistência. Os maiores valores de resistência foram observados para o grupo I (controle), sem diferença significativa dos grupos II, III e IV. A maioria dos grupos apresentou maior porcentagem de falhas na interface esmalte/resina (escore 1). Pode-se concluir que os tratamentos da base do bráquete cerâmico foram efetivos, apresentando valores similares ao grupo controle, exceto para o grupo em que foi usado Rocatec.

Domestic Violence Against Children and Adolescents: Prevalence of Physical Injuries in a Southern Brazilian Metropolis

Violence against children and adolescents is a public health issue worldwide that threatens physical and mental wellbeing and causes irreparable harm. Reports on this violence are an essential way to prevent it and to protect the children and adolescents. Thus, the objective of the present study was to evaluate the prevalence of physical injuries that occur in domestic environments and reported to the Child and Adolescent Protection Network. This retrospective study was conducted at the Epidemiology Center of the Municipality of Curitiba. A total of 10,483 reports for the years 2010 (5,112) and 2011 (5,371) were analyzed and from them were selected reports of physical injuries that occurred in the family environment. The children and adolescents were 0-17 years old, comprising 322 cases of physical abuse within the family in 2010. Out of these, 57.1% were male and 42.9% were female, and 58% (187) presented head and neck injuries. There were 342 reports in 2011, 49% were male and 51% were female; head and neck injuries corresponded to 65% (222) of the reported cases. The prevalence of injuries increased by 6% and head and neck injury increased by 19% between 2010 and 2011. It may be concluded that physical abuse is associated with a high prevalence of head and neck injury, which is easily observed by the health and education professionals. Notification organs should be created in Brazilian hospitals and health centers, which is essential to conduct epidemiological surveillance and appropriate policies.

A violência contra crianças e adolescentes é um grave problema mundial e de saúde pública, que ameaça o bem estar físico e mental, deixando sequelas irreparáveis. A notificação desta violência permite sua prevenção e proteção das crianças e adolescentes. Assim, o objetivo desse estudo foi avaliar a prevalência de lesões na região de cabeça e pescoço contra crianças e adolescentes, bem como caracterizar o tipo das lesões, o agressor e unidades notificadoras. Essa pesquisa retrospectiva foi realizada no Centro de Epidemiologia da Prefeitura Municipal de Curitiba. Um total de 10.483 notificações dos anos de 2010 (5.112) e 2011 (5.371) foi analisado, para compor a amostra das lesões físicas ocorridas no ambiente intrafamiliar, na faixa etária de 0 a 17 anos de idade. Em 2010, a frequência de abuso físico intrafamiliar foi de 322 casos. Destas, 57,1% eram do sexo masculino e 42,9% do sexo feminino, e 58% (187) delas tiveram lesões em cabeça e pescoço. No ano de 2011 foram 342 notificações, sendo que 49% eram do sexo masculino e 51% do sexo feminino e as lesões em cabeça e pescoço corresponderam a 65% (222) dos casos notificados. Houve aumento na prevalência de 6% das lesões físicas e 19% das lesões na região de cabeça e pescoço, do ano de 2010 para 2011. Conclui-se que é alta a prevalência de lesões na região de cabeça e pescoço, áreas facilmente observadas pelo profissional de saúde e da educação. A criação de órgãos notificadores em hospitais e unidades de saúde é fundamental para a vigilância epidemiológica e para definição de políticas adequadas.