Cytokine levels in the gingival crevicular fluid and their association with periodontal status of down syndrome patients: a cross-sectional study.

OBJECTIVE: To evaluate cytokine levels of interleukin (IL)-1ß, IL-4, IL-6, IL-17a, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ in the gingival crevicular fluid (GCF) of periodontal sites in individuals with Down syndrome (DS) and analyze their relationship with clinical periodontal parameters. MATERIALS AND METHODS: A cross-sectional study was conducted with 49 DS patients and 32 individuals without DS (non-DS group). Periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP), and visible plaque index (VPI) were evaluated. The periodontal sites were classified as shallow, moderate, and deep. GCF was collected in all shallow sites and, when present, in moderate and deep sites for the analysis of cytokine levels. The cytokines, IL-1ß, IL-4, IL-6, IL-17a, TNF-α, and IFN-γ, were quantified using the Luminex® automatic analyzer system. RESULTS: The DS group presented greater severity of periodontitis compared to the non-DS group (P = 0.005). The DS group showed a significant direct correlation of IL-1ß and an inverse correlation of IFN-γ and IL-14 with all periodontal variables. In the analysis stratified by periodontal pocket depth, we observed a higher level of IFN-γ, IL-17a, IL-1ß, and IL-6 in the shallow sites, and IL-17a, IL-1ß, and IL-6 in deep pockets of DS group individuals. Multivariate models showed that higher levels of IL-1ß, IL-4, IL-6, and IL-17a were associated with Down syndrome even after adjusting for periodontal status, sex, and age. CONCLUSION: The findings suggest that people with DS have greater periodontal impairment and higher levels of cytokines in GCF, even in sites having clinical periodontal parameters similar to those of individuals without DS. These data reiterate the concept of an altered and less effective immune response in the population with DS in the face of a periodontal microbial challenge. CLINICAL RELEVANCE: Elevated periodontal inflammation burden can be observed with higher cytokine levels in the gingival crevicular fluid of people with Down syndrome, especially IL-1, IL-4, IL-6, and IL-17, regardless of the stage of periodontitis.

Identifying metabolic parameters related to severity and extent of periodontitis in down syndrome patients.

BACKGROUND AND OBJECTIVE: Systemic metabolic status and periodontitis can be related in patients with Down syndrome (DS). The objective of this study was to identify metabolic indicators (anthropometric measurements, blood pressure, and serum markers) related to severity and extent of periodontitis in DS patients. METHODS: A cross-sectional study was conducted with 49 patients with DS. Periodontal evaluation included the periodontal probing depth (PPD), clinical attachment level (CAL), gingival bleeding index (GBI), and visible plaque index (VPI). Periodontitis severity was classified by the stages system. The extent of periodontitis was assessed as the percentage of sites with CAL ≥3 mm, CAL ≥4 mm, PPD ≥4 mm, and PPD ≥5 mm. The metabolic condition of the participants was determined by analyzing anthropometric parameters, blood pressure, and serum markers. Data were analyzed using the Mann-Whitney test, Spearman's correlation coefficient, and multivariate regression analysis. RESULTS: Periodontitis stage 3/4 was detected in 32.7% of patients, with high values of VPI (54.6 ± 35.8) and GBI (42.4 ± 33.3). The severity of periodontitis was related to higher mean corpuscular hemoglobin (ß = .291, p = .028) and mean corpuscular volume values (ß = .293, p = .046). Arm circumference measurements were inversely related to CAL ≥3 mm (ß = -.408, p = .023), PPD ≥4 mm (ß = -.475, p = .006), and PPD ≥5 mm (ß = -.443, p = .010). CONCLUSIONS: The findings suggest that the severity and extent of periodontitis may be related to some metabolic parameters in DS patients.

Adverse pregnancy outcomes and occlusal traits in the primary dentition: A prospective cohort (BRISA).

OBJECTIVES: This study aimed to analyse the relationship between adverse pregnancy outcomes (APO) and occlusal traits in the primary dentition, checking for different mediation paths. SETTING AND SAMPLE POPULATION: Children evaluated at birth (T1), between 12 and 24 months (T2), and between 24 and 36 months (T3) were included. Two hundred and seventeen children who participated in T1 and T2 were randomly selected to perform the occlusion examination. MATERIALS AND METHODS: This is a prospective cohort study (BRISA). The theoretical model was tested by structural equation modelling (SEM), estimating standardized coefficients (Coeff.) (α = 0.05). The primary exposure was APO-a latent variable manifested from three health problems at birth: low birthweight (LBW), pre-term birth (PTB) and intrauterine growth restriction (IUGR), evaluated in T1. The outcomes were four different occlusal traits assessed in T3: overjet, anterior and posterior crossbite, and crowding. Each outcome's direct and indirect effects were tested, mediated by growth, breathing, breastfeeding, and pacifier use. RESULTS: There was no direct association between APO and any of the outcomes: overjet (Coeff. = -0.163, P = .241), anterior crossbite (Coeff. = -0.696, P = .065), posterior crossbite (Coeff. = -0.087, P = .589) and crowding (Coeff. = 0.400, P = .423). The indirect (total and specifics) effects tested also showed no association (P > .05). However, APO was associated with lower child growth in all models; breastfeeding was associated with higher child growth in all models, and pacifier use was associated with overjet (Coeff. = 0.184, P < .001) and posterior crossbite (Coeff. = 0.373, P = .011). CONCLUSION: APO was not a risk factor for overjet, crossbite and crowding in an early stage of the primary dentition by direct and indirect pathways. However, growth has been lower in children with APO and higher in children breastfed. Also, the harmful effects of using a pacifier in dental occlusion are highlighted.

Effect of photobiomodulation therapy as an adjunct to scaling and root planing in a rat model of ligature-induced periodontitis: a histological and radiographic study.

This study aimed to histologically and radiographically evaluate the effectiveness of low-intensity laser irradiation of different wavelengths (660 or 808 nm) as an adjunct to scaling and root planing in the treatment of experimental periodontitis in rats. Periodontitis was induced by placing a ligature around the mandibular first molar of the rats. In total, 40 Wistar rats were randomly divided into five groups (n = 8 each): control (CG), periodontal disease (PD), scaling and root planing (SRP), SRP + 660 nm laser (GL660) and SRP + 808 nm laser (GL808). Groups with laser use received radiation at 6 points in the first molar. The animals were euthanized at baseline and at 7 and 14 days after the interventions. Mandibles were surgically removed for histomorphometric and radiographic assessment of periodontal tissues. The GL660 group showed lesser bone loss than the PD group (P < 0.05) and greater alveolar bone margin after 14 days, indicating a better long-term treatment response (P < 0.05). These findings suggest that SRP with the 660 nm laser as an adjunct results in more favorable radiographic and histological responses than the 808 nm laser.

Hyperglycaemia and factors associated with dental caries in immediate postpartum women.

Objective: Dental caries and hyperglycaemia share common risk factors. The aim of this study was to identify factors associated with dental caries in women in the immediate postpartum period. It also verified whether women with hyperglycaemia presented more dental caries than those with normal glycaemia.Material and Methods: This cross-sectional study was performed on 297 women recruited from a teaching hospital in Brazil (from October 2011 to November 2012). Dental caries and oral biofilm were evaluated by oral examination. The blood glucose was accessed by Haemoglobin A1c test. Information on socioeconomic characteristics, harmful habits and oral health habits was also gathered.Results: More than half (66%) of the women had carious lesions. Univariate analysis showed no association between hyperglycaemia and dental caries (p = .39). The hierarchical logistic regression model showed that the following variables were associated with dental caries: maternal education level ≤8 years (ORadjusted = 2.40 [CI 1.19-4.82]), previous children (ORadjusted = 1.81 [CI 1.08-3.03), use of dental floss (ORadjusted = .48 [CI 0.27-0.86]), and visible plaque index ≥30% (ORadjusted = 1.83 [CI 1.05-3.20]).Conclusions: These findings call attention to the need to implement effective public policies directed at avoiding tooth decay in pregnancy and in the postpartum period.

The influence of hormone replacement therapy on the salivary flow of post-menopausal women.

The aim of this study is to investigate the influence of hormone therapy on salivary flow in menopausal women. It is a case-control study involving 86 post-menopausal women. The case group consisted of 47 women undergoing estroprogestative or estrogen hormone replacement therapy (HRT), and the control group consisted of 39 women who did not receive any HRT. All patients were submitted to a standard questionnaire, followed by total stimulated sialometry and determination of body mass index (BMI). The salivary flow was classified as follows: normal (1.0-3.0 mL/min), low (0.7-1.0 mL/min), and hyposalivation (<0.7 mL/min). The results were analyzed statistically by the chi-square test, logistic regression model, and linear regression (p < 0.05). The HRT group presented an association of protection, even after adjusting the analysis, for low salivary flow (Adjusted OR = 0.22; 95% CI = 0.05-0.88; p = 0.034), and hyposalivation (Adjusted OR = 0.30; 95% CI = 0.10-0.92; p = 0.036). The results suggest that estroprogestative therapy (ß = + 0.53; p = 0.022) has greater influence on the increase of salivary flow than estrogen therapy (ß = +0.35; p = 0.137). The study concludes stating salivary flow was influenced by HRT on the post-menopausal women studied.

Influence of Relining Post on the Bond Strength of Resin Cements.

This study evaluated the influence of relining fiber posts on the bond strength (BS) of resin cements in the root canal. Forty bovine teeth were divided in four groups (n = 10): G1 (ARC)-fiber post cemented with resin cement RelyX ARC; G2 (ARC+Z350)-relined fiber post cemented with RelyX ARC; G3 (U200)-fiber post cemented with self-adhesive cement RelyX U200; G4 (U200+Z350)-relined fiber post cemented with RelyX U200. The roots were sectioned in six 1.2-mm slices and the push-out test was performed. Data were analyzed by three-way analysis of variance (ANOVA), and Tukey's test (a = 0.05). For the conventional resin cement, there was no significant difference between groups G1-ARC (15.5 ± 3.8) and G2-ARC+Z350 (16.1 ± 4.5). For the self-adhesive cement, the results revealed higher BS values for relined posts G4-U200 + Z350 (19.9 ± 7.9) as compared to non-relined posts G3-U200 (14.4 ± 4.5). For both cements, in groups of relined posts, the apical and the cervical thirds presented similar BS. Relining enhances the performance of the self-adhesive resin cement, and the interaction between relining and root third influences the BS to the conventional resin cement.

Violet led dental whitening: Effectiveness and biological safety: An in vitro study.

INTRODUCTION: The light-emitting diode (Led) in the violet spectrum associated or not with hydrogen peroxide (HP) has been suggested as a promising technique for dental bleaching. Violet led has a wavelength of 405-410 nm, which is very close to that of ultraviolet (UV) radiation, and this has raised biological safety concerns. AIM: To investigate the effectiveness of the violet led dental bleaching technique by evaluating color parameters, enamel surface microhardness, and biological safety analysis. METHODS: One hundred bovine dental blocks were divided into groups according to the bleaching technique (G1 - only HP; G2 - HP associated with blue led; G3 - only blue led; G4 - HP associated with a violet led; and G5 - only violet led). The color analysis (ΔE, ΔL, and WID) and enamel surface microhardness were assessed before and after bleaching (immediately, 5, 14, and 30 days). The biological safety of the violet led irradiation was assessed by measuring the number of micronuclei formed in human cells in culture in response to irradiation. Data analysis included Kruskal-Wallis test, Friedman test, and Mann-Whitney test. RESULTS: In groups G4 and G5 there was the formation of precipitates on the enamel surface. At the time of 14 days, it was observed that the G2 group had lower values of microhardness than G5. ΔL and ΔE showed differences between groups in experimental times. Mean percentages of micronuclei occurrence were similar in the control group and the violet led group. CONCLUSION: The violet led irradiation can be applied for dental bleaching because this approach produces significant color changes preserving tooth enamel integrity and causes no genotoxic effects on vital cells.

A Cross-Sectional Study of the Association Between Chronic Oral Disease Burden and Serum Biomarkers in Kidney Transplant Recipients.

INTRODUCTION: Poor oral health can negatively affect general health and quality of life of kidney transplant recipients. The study aimed to investigate the association between chronic oral disease burden, serum biomarkers, and comorbidities in kidney transplant recipients. DESIGN: A cross-sectional comparative study was conducted with 44 patients after kidney transplant. The burden of chronic oral disease was composed of the following observable variables: moderate periodontitis and presence of dental caries. Serum biomarkers and comorbidities data were collected. The chi-square or Fisher's exact tests for categorical variables and Student's t-test or Mann-Whitney test for continuous variables were used. Robust Poisson regression was used to model the association. RESULTS: Higher levels of mean uric acid (P = .01) and creatinine (P = .03) were observed in the group of patients with oral disease burden, while the highest level of high-density lipoprotein was observed in the group without oral disease. Higher values of uric acid were associated with the occurrence of chronic oral disease burden (Adjusted PR = 1.24, 95% CI: 1.03-1.48, P = .019). There was no statistical difference between the groups with and without oral disease burden in comorbidities present. CONCLUSION: The findings suggest that chronic oral diseases burden can be associated with uric acid and creatinine levels in kidney transplant recipients.

Compressive strength of premolars restored with ceramic crowns and supported with a glass fiber post using different luting agents.

Objective: The retention of glass fiber post (GFP) is considered a key factor for the long-term success of restorations of endodontically treated teeth. This study aimed to compare the compressive strength of a ceramic crown supported by a GFP using different luting agents. Methods: Forty single-rooted premolars were randomly divided into four groups (n = 10 each): control group (teeth without a GFP), Ketac Cem group (glass ionomer), RelyX ARC group (conventional dual-curing resin), and RelyX U200 group (self-adhesive dual-curing resin). After luting of the posts and placement of all-ceramic crowns made using feldspathic porcelain (Noritake EX-3), they were exposed to thermocycling for 1000 cycles and compressive strength tests. Statistical analysis included Kruskal-Wallis test with Dunn's multi-comparison test. Results: The Ketac Cem group and RelyX U200 group showed significantly greater fracture resistance to compressive loading than the control group. Conclusion: This study indicates a possible role of the luting agent used with the GFP in influencing the compressive strength of the restored teeth. In this study, the self-adhesive dual-curing resin and glass ionomer both offered resistance to fractures.

Temporal trends in tetanus incidence and lethality in Brazil: analysis of the national database from 2009 to 2018.

OBJECTIVE: This study aimed to analyze the epidemiological and hospital characteristics of cases and deaths due to accidental tetanus in Brazil. METHODS: A time-series study with secondary data extracted from the Department of Informatics of the Brazilian Unified Health System. The time series were evaluated by linear regression parameters, considering a significance level of 1%. RESULTS: A total of 2,772 cases were reported between 2009-2018. Predominant cases were men and aged between 40-59 years old, with incomplete 1st-4th grade. The lethality rate was found to be predominant in women, whites, illiterates, and those who aged above 80 years. The overall lethality was 32.5%. The incidence rate reduced from 1.6 in 2009 to 0.95 per million inhabitants in 2018, but lethality increased from 30.77-40.70%. The highest rate of incidence and lethality occurred in the elderly people and in the northern region. CONCLUSION: The high cost and lethality of tetanus configure it as a public health problem. The demonstration of the epidemiology of patients who most evolve to death can help to contribute to a reduction in lethality, which shows an increase in the analysis period. Finally, special attention should be given to the elderly people and those living in the northern region.

Effect of Glass Fiber Post Surface Treatment on Bond Strength of a Self-Adhesive Resin Cement: An "In Vitro" Study.

OBJECTIVE: This study evaluated the influence of different mechanical and chemical surface treatments alone and combined with silane on the bond strength (BS) of glass fiber posts (GFPs) using self-adhesive resin cement. METHODS: Eighty-four single-rooted bovine teeth (six groups, n = 14) were submitted to BS analysis after GFP cementation. The treatments applied in the studied groups were no surface treatment (control), silane (S), 24% hydrogen peroxide (PER), 24% hydrogen peroxide and silane (PER + SIL), blasting with 50 µm aluminum oxide particles (BLAST), and blasting with 50 µm aluminum oxide particles and silane (BLAST + SIL). RESULTS: BS differed significantly among groups (p < 0.001). It was higher in the SIL (10.5 ± 3.5 MPa), BLAST + SIL (11.5 ± 3.2 MPa), and PER + SIL (11.6 ± 4.6 MPa) groups than in the control (6.5 ± 2.9 MPa), BLAST (8.6 ± 4.0 MPa), and PER (7.1 ± 2.8 MPa) groups, with no significant difference among groups receiving silanization. Cement post adhesive failure was more common in the SIL, BLAST, and PER + SIL groups, and cement-dentin adhesive failure was more common in the control, BLAST + SIL, and PER groups. CONCLUSION: These results show that silane application alone increases BS.

The impact of the use of magnifying dental loupes on the performance of undergraduate dental students undertaking simulated dental procedures.

OBJECTIVES: This study aimed to evaluate the impact of the use of magnification (2.5x dental loupes) for third-year dental students in simulated endodontics and fixed prosthodontics assessments compared to those using no magnification. METHODS: Upon institutional review board exemption, third-year dental students were assessed during endodontics and fixed prosthodontics exams in the simulation laboratory. The endodontic group (n = 93) consisted of students who made an endodontic access preparation on a plastic lower left first molar (Nissan). The prosthodontic group (n = 86) consisted of students who made porcelain fused to metal preparation (PFM) on a plastic lower right first molar mounted on an acrylic lower jaw model (Columbia Dentoform). The impact of the use of dental loupes was evaluated. Assessment of the tasks was undertaken by experts-calibrated, blinded examiners-using a standardized marking rubric for each task. The statistical analysis included Chi-square test, one-way ANOVA, and Logistic regression. The level of significance adopted was 5%. RESULTS: Students' preparations using magnification were better compared with those without magnification. Students using magnification had a significantly higher pass rate than those not using magnification in both endodontic and prosthodontic groups (P < 0.05). CONCLUSIONS: In conclusion, third-year dental students who used loupes in the endodontics and prosthodontics simulation laboratory had significantly higher scores at the assessments.

Morphological changes in the temporomandibular joints in women with fibromyalgia and myofascial pain: A case series.

Objective: This study investigated the temporomandibular joint (TMJ) morphological changes in women with fibromyalgia (FM) through clinical and tomographic evaluation.Methods: Ten women diagnosed with myofascial pain who were being treated for FM in a university hospital were included in this study. The data were collected through clinical examination and cone beam computed tomography evaluation of the TMJ in closed and open mouth positions.Results: All patients had crackling in the joint, a habit of grinding teeth during sleep, muscle stiffness, and tinnitus. The tomographic findings revealed a higher frequency of condylar bone wear, reduction of joint space, and posterior positioning of the mandibular condyle. The temporomandibular disorders with the highest prevalence were osteoarthritis and disc displacement with reduction.Conclusion: The findings suggest that women with FM have a high frequency of TMD related to the displacement of the articular disc, condyle position, and occurrence of osteoarthritis.

Tooth loss and craniofacial factors associated with changes in mandibular condylar morphology.

Objective: To investigate the association between tooth loss and craniofacial factors with changes in mandibular condylar morphology. Methods: A total of 123 patients participated in this cross-sectional study. The mandibular condylar morphology was evaluated using digital panoramic radiography. The exposure variables included gender, age group, molar relationship, facial growth pattern, facial asymmetry, dental midline, posterior crossbite, presence of fixed dental prosthesis, and tooth loss. Results: Unilateral and bilateral mandibular condyle structural alterations were found in 20.3% and 28.5% of the sample, respectively. After the adjustment analysis, posterior crossbite (adjusted OR = 3.34, 95% CI = 1.23-9.06) and tooth loss (adjusted OR = 4.08, 95% CI = 1.72-9.64) were associated with the outcome. The tooth type associated with mandibular condyle structural alterations were premolars and upper molars. Conclusion: The findings suggest that posterior crossbite and tooth loss are associated with mandibular condyle structural alterations.

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels.

Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly. / Associação entre fatores socioeconômicos, comportamentais, saúde geral e condição da mucosa bucal em idosos.

This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.

O objetivo deste estudo foi investigar a associação entre fatores socioeconômicos, comportamentais, saúde geral, saúde bucal e os desfechos de acúmulo de placa e condição de mucosa bucal em idosos. Este estudo transversal, conduzido entre 2004 e 2005, incluiu 785 idosos de Carlos Barbosa, RS. Questionários foram utilizados para coleta de dados socioeconômicos, comportamentais e estado de saúde. O exame físico das estruturas bucais e o Índice de Mucosa e de Placa de Henriksen (MPS) foram utilizados para categorizar os desfechos. Observou-se maior prevalência de acúmulo de placa moderado/grave entre os idosos mais velhos, do sexo masculino e com menor escolaridade. O uso de prótese dental total superior e renda de até 1 salário mínimo foram fatores de proteção para acúmulo de placa moderado/grave. Apenas as variáveis do primeiro bloco da estrutura conceitual, sexo masculino (OR = 2,13; IC95% = 1,26-3,61) e menor escolaridade (OR = 1,37; IC95% = 1,06-1,78) permaneceram associados como risco à presença de escore inaceitável do MPS. Os achados sugerem que idosos do sexo masculino e com menor escolaridade têm maior chance de saúde bucal precária, conforme o MPS.

Uma análise sobre o preenchimento do prontuário odontológico em uma universidade brasileira / Dental record filling out analysis at a Brazilian University

Esse estudo tem como objetivo investigar a qualidade do preenchimento do prontuário odontológico na Clínica Escola da Faculdade de Odontologia da Universidade Federal do Maranhão (UFMA) através da análise da percepção dos discentes sobre a temática e a avaliação de uma amostra de prontuários utilizados na instituição de ensino. Um estudo transversal foi conduzido com 67 discentes matriculados no Curso de Odontologia do quarto ao nono período do curso de graduação, representando 48,2% da população alvo. Além disso, foram analisados 73 prontuários preenchidos em atendimentos odontológicos nesta instituição do entre 2020 a 2022. Um questionário com questões abertas e fechadas foi respondido pelos participantes. As medidas de frequência absoluta e relativa foram utilizadas na análise descritiva dos dados. Observou-se que mais de 90% concordaram total ou parcialmente que preenchem corretamente os prontuários, entretanto, a análise dos prontuários revelou a ausência de itens obrigatórios A frequência do preenchimento dos itens obrigatórios está listada a seguir: identificação do paciente (80,8%), assinatura do docente (75,3%), termo de consentimento do paciente (74%), seção anamnese completa (69,9%), radiografias (64,4%), plano de tratamento (34,2%), questionário Covid (13,7%) e identificação dos discentes (60,3%). Os achados deste estudo indicam que é necessário o aperfeiçoamento das orientações pedagógicas sobre preenchimento do prontuário odontológico no intuito de reduzir possíveis inadequações no uso deste documento legal

This study aims to investigate the quality of dental record at the Dental School Clinic of Maranhao Federal University (UFMA) through analyzing the students' perception of the topic and evaluating a sample of records used at the educational institution. A cross-sectional study was conducted with 67 undergraduate dental students from second to fifth year, representing 48.2% of the target population. Additionally, 73 records that were filled out during dental appointments at this institution from 2020 to 2022 were analyzed. Participants responded a questionnaire containing both open-ended and closed-ended questions. Absolute and relative frequency measures were used in the descriptive data analysis. It was observed that over 90% partially or fully agreed that they correctly fill out the records, but the analysis of the records revealed the absence of mandatory items. The frequency of completion for the mandatory items is listed as follows: patient identification (80.8%), faculty signature (75.3%), patient consent form (74%), complete medical history section (69.9%), radiographs (64.4%), treatment plan (34.2%), Covid questionnaire (13.7%), and student identification (60.3%). The findings of this study indicate the need for improvement in pedagogical guidance on dental record completion in order to reduce possible inadequacies in the use of this legal document

Time series of the health system dynamics for the diagnosis of tuberculosis in a metropolitan region of the Brazilian Northeast (2010-2020) / Série temporal da dinâmica do sistema de saúde para o diagnóstico de tuberculose em uma região metropolitana do nordeste brasileiro (2010-2020)

Objective: To analyze the dynamics of the health system for the diagnosis of tuberculosis in a metropolitan region of a Northeast Brazilian state. Methods: Ecological time series study conducted in São Luís, Maranhão State, Northeast region of Brazil. The study population was composed of tuberculosis cases notified in the Notifiable Dis-eases Information System (SINAN) in the period from 2010 to 2020. The descriptive statistics of the cases was performed using absolute and relative frequency measures, and Pearson's Chi-square test was used to compare the frequencies between the cases notified in Primary Health Care (PHC) and hospital units and the sociodemographic and clinical characterization. For time series analysis, the Prais-Winsten autoregression model was used, followed by the decomposition method called Seasonal-Trend decomposition using LOESS (STL), ending with the time trend prediction for the next years. The data were analyzed using the resources of the computer programs named Sta-ta, version 17 (StataCorp, College Station, TX, USA) and R, version 3.5.2 (R Core Team, 2020). Results: A total of 7,948 cases diagnosed with tuberculosis were notified, of which 1,608 were notified in Primary Care units and 6,340 in hospital units. The Chi-square test resulted in a relative frequency calculated considering the total number of patients who had results from each examination with statistically significant differences (p < 0.05). Conclusion: It was possible to observe different time trends between diagnoses performed by PHC and hospitals. In the time analysis and modeling, there was an increase in cases notified in PHC and stationary in hospitals; how-ever, in the time modeling, there was a reduction in the number of cases in hospital (AU).

Objetivo: Analisar a dinâmica do sistema de saúde para o diagnóstico de tuberculose em região metropolitana de um estado do nordeste brasileiro. Métodos: Estudo ecológico de série temporal realizado em São Luís, no Estado do Maranhão, região Nordeste do Brasil. A população do estudo foi composta casos de tuberculose notificados no Sistema de Informação de Agravos de Notificação (SINAN) no período de 2010 a 2020. A estatística descritiva dos casos foi realizada utilizando medidas de frequência absoluta e relativa e o teste Qui­quadrado de Pearson foi utilizado para comparar as frequências entre os casos notificados em unidades de Atenção Primária a Saúde (APS) e hospitalares e a caracterização sociodemográfica e clínica. Para análise da série temporal, recorreu-se ao modelo de autorregressão Prais­Winsten, seguido do método de decomposição denominado Seasonal­Trend using Loess (STL), finalizando com a previsão da tendência temporal para os próximos anos. Os dados foram analisados utilizando os recursos do software Stata versão 17 (StataCorp, College Station, TX, USA) e R versão 3.5.2 (R Core Team, 2020). Resultados: Foram notificados 7.948 casos com diagnóstico de tuberculose, sendo 1.608 notificados em unidades de Atenção Primária e 6.340 em unidades Hospitalares. O teste Qui­quadrado resultou na frequência relativa calculada considerando o total de paciente que possuíam resultados de cada exame com diferenças estatisticamente significantes (p < 0,05). Conclusão: Foi possível observar tendência temporal diferenciada entre o diagnóstico realizado pela APS e hospitais. Na análise e modelagem temporal houve aumento nos casos notificados na APS e estacionário nos hospitais, entretanto, na modelagem temporal houve redução do número de casos nos hospitai (AU).

Relationship between Periodontal Status and Ventilator-Associated Pneumonia.

OBJECTIVE: This study tested the hypothesis that a relationship exists between periodontal disease status and ventilator-associated pneumonia (VAP) in patients admitted to an intensive care unit (ICU). MATERIALS AND METHODS: The periodontal status of 60 individuals admitted to the ICU of the Dutra University Hospital was determined, including measurement of visible plaque, gingival bleeding, and clinical attachment level. Data were analyzed by Chi-square or Fisher's exact tests, unpaired Student's t-test and multivariate logistic regression. RESULTS: Patients with VAP showed higher prevalence of periodontitis (25%) than those in the control group (12.5%), but without statistical difference (p = 0.22). After multivariate analysis, risk factors for ventilator-associated pneumonia included diabetes mellitus (OR = 27.76, 95% CI = 1.95-393, p = 0.014), and mechanical ventilation for longer than 10 days (OR = 12.1, 95% CI = 1.65-87.9, p = 0.014). CONCLUSION: Within the limits of this study, no association between periodontitis and ventilator-associated pneumonia was found. The presence of diabetes and invasive mechanical ventilation duration (> 10 days) were risk factors for pneumonia even after the adjustment of variables.