A survey of radiographic measurement estimation in assessment of dental implant length.

The aim of this study is to survey radiographic measurement estimation in the assessment of dental implant length according to dentists' confidence. A 19-point questionnaire with closed-ended questions was used by two graduate students to interview 69 dentists during a dental implant meeting. Included were 12 questions related to over- and underestimation in three radiographic modalities: panoramic (P), conventional tomography (T), and computerized tomography (CT). The database was analyzed by Epi-Info 6.04 software and the values from two radiographic modalities, P and T, were compared using a chi2 test. The results showed that 38.24% of the dentists' confidence was in the overestimation of measurements in P, 30.56% in T, and 0% in CT. On the other hand, considering the underestimated measurements, the percentages were 47.06% in P, 33.33% in T, and 1.92% in CT. The frequency of under- and overestimation were statistically significant (chi2 = 6.32; P = .0425) between P and T. CT was the radiographic modality with higher measurement precision according to dentists' confidence. In conclusion, the interviewed dentists felt that CT was the best radiographic modality when considering the measurement estimation precision in preoperative dental implant assessment.

Reliability of marginal microleakage assessment by visual and digital methods.

OBJECTIVE: The aim of this study was to investigate the reliability of visual and digital methods to assess marginal microleakage in vitro. MATERIALS AND METHODS: Typical Class V preparations were made in bovine teeth and filled with composite resin. After dye penetration (0.5% basic fuchsin), teeth were sectioned and the 53 obtained fragments were assessed according to visual (stereomicroscope) and digital methods (Image Tool Software(®)-ITS) (University of Texas Health Science Center-San Antonio Dental School, USA). Two calibrated examiners (A and B) evaluated dye penetration, by means of a stereomicroscope with ×20 magnification (scores), and by the ITS (millimeters). The intra- and inter-examiner agreement was estimated according to Kappa statistics (κ), and intraclass correlation coefficient (ρ). RESULTS: In relation to the visual method, the intra-examiner agreement was almost perfect (κA = 0.87) and substantial (κB = 0.76), respectively to the examiner A and B. The inter-examiner agreement showed an almost perfect reliability (κ = 0.84). For the digital method, the intra-examiner agreement was almost perfect for both examiners and equal to ρ = 0.99, and so was the inter-examiner agreement value. CONCLUSION: Visual (stereomicroscope) and digital methods (ITS) showed high levels of intra- and inter-examiner reproducibility when marginal microleakage was assessed.

Diagnostic agreement of conventional and inverted scanned panoramic radiographs in the detection of the mandibular canal and the mental foramen.

The aim of this study was to evaluate the diagnostic agreement of conventional panoramic radiographs and their inverted scanned images in the detection of the mandibular canal and mental foramen. A total of 77 panoramic radiographs obtained from the files of totally edentulous patients were used. Digitization was done by means of a scanner with brightness and contrast adjustment, as well as image inversion. The extension of mandibular canal was divided into anterior, middle, and posterior regions, and the presence of a radiopaque line that characterized the mandibular canal was classified according to a 5-point confidence scale. The mental foramen was classified in 4 types: continuous, separated, diffuse, and unidentified. Both conventional and inverted scanned panoramic radiographs were evaluated by 3 calibrated implantologists at 2 distinct moments with a minimum interval of 10 days between them. Intraexaminer agreement was evaluated by Kappa statistics by point and by 95% confidence interval. Because the intraexaminer level of agreement was low, interexaminer agreements could not be carried out. The results showed a substantial (in 2 situations), moderate (in 16 situations), and fair (in 18 situations) intraexaminer agreement for mandibular canal and a substantial (in 1 situation), fair (in 1 situation), and moderate (in 10 situations) intraeaminer agreement for mental foramen. There were no statistically significant differences in most instances. In conclusion, the diagnostic agreement of conventional and inverted scanned panoramic radiographs for detection of mandibular canal and mental foramen was low.

Dental students’ reports of occupational exposures to potentially infectious biological material in a Brazilian School of Dentistry / Estudantes de odontologia e o relato das exposições ocupacionais a material biológico potencialmente contaminado em uma Faculdade de Odontologia no Brasil

Abstract Introduction Occupational exposures to contaminated biological material in dental teaching settings can place students at higher risk of bloodborne infections. Methods This cross sectional study was conducted using a self-administered questionnaire culturally adapted to Portuguese language, Brazil. In total, 173 undergraduate dental students agreed to participate in the study, answered the questionnaire, and filled in the details about their own occupational exposures. The association of these factors was analyzed by the chi-square test or Fisher's exact test using Stata® software. Results High prevalence of occupational exposures (40%) was observed among the participants, and 52% of the accidents were not reported to the clinical instructor. The most frequent type of accident was related to “puncture/cut/abrasion” (56%). Significant correlation was observed between number of exposures and academic year (p=0.002), age (p=0.012), gender (p=0.010), and between number of injuries in the last 6 months and academic year (p=0.003). No significant correlation was observed between number of exposures and dominant hand, use of protective eyewear or Hepatitis B vaccination status (p>0.05). Conclusion Additional teaching strategies need to be developed to motivate adherence to occupational post-exposure protocols regarding biological material, improving the notification of the occupational exposures that occur among dental students.

Resumo Introdução A exposição ocupacional a material biológico contaminado em ambientes de ensino de odontologia pode colocar os estudantes em maior risco de infecções transmissíveis pelo sangue. Métodos Tratou-se de um estudo transversal de avaliação, com questionário auto administrado e culturalmente adaptado para o português do Brasil. Ao total, 173 estudantes de odontologia concordaram em participar e forneceram detalhes sobre suas exposições ocupacionais. A associação de fatores foi analisada por meio do teste do qui-quadrado e/ou teste exato de Fisher, com auxílio do programa Stata®. Resultados Entre os participantes, houve alta prevalência a exposições ocupacionais (40%), e 52% dos acidentes não foram comunicados ao instrutor. O mais frequente ferimento foi do tipo “punção/ corte/ abrasão” (56%). Houve associação significativa entre “número de exposições” e “série” (p=0,002), “idade” (p=0,012) e “sexo” (p=0,010), e entre outras duas variáveis: “número de lesões nos últimos seis meses” e “série” (p=0,003). Não houve associação significativa entre o “número de exposições” e “mão dominante”, “uso de óculos de proteção” ou “estado vacinal contra o vírus da Hepatite B” (p>0,05). Conclusão Estratégias de ensino adicionais precisam ser implementadas para motivar a adesão aos protocolos pós-exposição ocupacional a material biológico, favorecendo a notificação dos casos entre acadêmicos de odontologia.

[Reproducibility of a scale for oral health among children and adolescents HIV+/AIDS]. / Reprodutibilidade de uma escala odontológica proposta como indicador de saúde bucal em crianças e adolescentes HIV+/SIDA.

The aim of this study was to investigate the intraobserver reproducibility of a Portuguese version scale used to evaluate aspects of oral health among children and adolescents HIV+. The scale was proposed by Balbo and a questionnaire was applied in two occasions, within a one week period, to 27 children and adolescents. The reproducibility was estimated by kappa statistics by point (k). With relation to the mother, it was reached a maximum of agreement for items related to the importance of maintaining the oral health, diary tooth brushing and the individual utilization of dental brush; breath and esthetics presented a good agreement. Regarding the children, a regular agreement was observed on the dental floss use. In contrast, the respondents had difficulties in reporting the name and address of the professionals that gave guidance in prevention activities to them. The k-values for perception, care and promotion were 0.48, 0.21 and 0.64 respectively, pointing to reproducibility levels classified as regular, fair and good. Given the different levels of reproducibility offered by the dental scale for HIV+ oral health, we suggest that it could be modified, especially in the domain of care.

Effect of drying on the reproducibility of DIAGNOdent to detect caries-like lesions.

The aim of this study was to verify the drying effect on the reproducibility of DIAGNOdent (Dd) devices to detect caries-like lesions. Three areas were created in each of the 34 bovine incisors: sound (S), demineralized (DE) and remineralized (RE). One examiner measured each area with two Dd devices (denominated X and Y), twice under humid, and twice under dry condition. Intra-rater agreement according each device and inter-device agreement were estimated by kappa statistics (k). Intra-rater agreement for device Y was substantial under humid (κ (DE)=0.68 and κ (RE+S)=0.68) and dry condition (k DE=0.64 and k RE+S=0.67). For device X, it was substantial under humid condition (k DE=0.57 and k RE+S=0.49), and it was almost perfect after air drying (κ (DE)=1.0 and κ (RE+S)=1.0). Inter-device agreement was slight (k =0.17) under humid condition, and it was substantial under dry condition (k =0.62). As reproducibility increased under dry condition, drying is advised to detect caries-like lesions on free smooth surfaces when different devices are used.

Comparison between inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements.

The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed). Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99) The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements.

Impacto da saúde bucal na qualidade de vida de pacientes maiores de 50 anos de duas instituições públicas do município de Araraquara-SP, Brasil / Oral health impact profile in the quality of life of patients over 50 years old of two public institutions of Araraquara city, SP, Brazil

Introdução: A saúde bucal pode afetar a qualidade de vida das pessoas, sendo o índice OHIP-14 (Oral Health Impact Profile) de utilidade para avaliar este impacto. Objetivo: Estudar o impacto da saúde bucal na qualidade de vida de pacientes maiores de 50 anos, verificando-se, preliminarmente, a confiabilidade do índice OHIP-14. Material e método: Estudo transversal, em que se aplicou o formulário OHIP-14 a 149 pacientes em duas instituições públicas de atendimento de rotina em Clínica Odontológica (UNESP) e médico (Municipal). Estudou-se a consistência interna do índice aplicando-se o coeficiente alpha-Cronbach. O índice OHIP-14 foi obtido pelo método aditivo, sendo os pacientes distribuídos segundo gênero, faixa etária e nível de escolaridade. O teste t-Student foi usado para comparações de interesse, adotando-se um nível de significância de 5%. Resultado: A amostra compôs-se de 149 pacientes (87% de cobertura). A consistência interna para o índice OHIP-14 foi boa (alpha-Cronbach = 0,78). A média, para o índice OHIP-14, foi de 4,98. Houve predomínio da dor física, nos aspectos "sentir-se incomodado ao comer algum alimento" e "sentir fortes dores na boca", com prevalências de 21,50 e de 11,40%, respectivamente. Houve diferença não-significativa entre o índice OHIP médio e cada uma das variáveis gênero, faixa etária e escolaridade (p > 0,05). Conclusão: O índice OHIP-14 apresentou consistência interna boa e mostrou ser baixo impacto da saúde bucal na qualidade de vida de pacientes maiores de 50 anos em atendimento odontológico e médico de rotina nas instituições estudadas (UNESP e Municipal).

Introduction: Oral health can affect quality of life, and the OHIP-14 index (Oral Health Impact Profile) is useful for evaluating this impact. Objective: to investigate the impact of oral health conditions on the quality of life ofpatients over 50 years, assessing, initially, the consistency of the short form of the Oral Health Impact Profile index (OHIP-14). Material and method: A cross-sectional study was performed among 149 patients of two public institutions for routine dental (UNESP) and medical practice (Municipal). They were interviewed using the OHIP-14 formulary, assessing its internal consistency (Cronbach´s alpha coefficient) and the OHIP-mean (additive method). The patients were distributed according to sex, age, and education level. The comparisons of interest were madeusing Student´s t test at a 5% level of significance. Result: A total of consecutive patients (n = 149) participated of this study (87% response rate). Cronbach´s alpha coefficient was 0.78, denoting a good consistency of the OHIP index. The OHIP mean was 4.98. The most prevalently affected OHIP domains were dimensions of physical pain:painful aching (11.40%) and uncomfortable eating foods (21.50%). There was non-significant difference (p > 0.05)between the mean OHIP value in relation to each of gender, age, and education level. Conclusion: The OHIP-14 is a reliable instrument of assessing oral health-related quality of life, and among patients under routine practice, it was found a low impact of oral conditions on their quality of life in the studied institutions (UNESP and Municipal).

Efficacy of three conditions of radiographic interpretation for assessment root canal length.

OBJECTIVE: To compare the efficacy of three conditions of image interpretation for radiographic root measurements and calculating the intra-observer reproducibility of the measurements. MATERIAL AND METHODS: Thirty intra-operative periapical radiographs of maxillary central and lateral incisors were measured, in mm, from the tip of the file to the radiographic apex, using a caliper. Three separate measurements were made of the 30 radiographs. The three measurements for each tooth were averaged and the mean used for further calculations. After a 12-day period, the measurements were repeated. The three experimental viewing conditions used: 1) standard viewbox without masking of background light around the radiograph and without magnification (Visual); 2) standard viewbox with use of a magnifying lens of 2.5x and with background light masked (Magnification); and 3) viewer device that restricts room lighting and enlarges the image by a magnifying lens of 1.75x (Viewer). The mean and standard deviation of the measurements were calculated and used for descriptive analysis. Two-way analysis of variance (ANOVA) was used to evaluate intra-observer and inter-method agreement of the measurements. The measurement error was estimated by Dalhberg's formula. RESULTS: The ANOVA showed no significant differences between measurement sessions, viewing methods, or interaction between observation session and method (p>0.05). The intra-observer measurement error was 0.02 mm for Visual and the Magnification methods and 0.01 mm for the Viewer. CONCLUSION: There does not seem to be any advantage in using viewbox masking or magnification for measuring the distance between the end of the endodontic file and the root apex in maxillary incisors.

Effect of drying on the reproducibility of DIAGNOdent to detect caries-like lesions

The aim of this study was to verify the drying effect on the reproducibility of DIAGNOdent (Dd) devices to detect caries-like lesions. Three areas were created in each of the 34 bovine incisors: sound (S), demineralized (DE) and remineralized (RE). One examiner measured each area with two Dd devices (denominated X and Y), twice under humid, and twice under dry condition. Intra-rater agreement according each device and inter-device agreement were estimated by kappa statistics (k). Intra-rater agreement for device Y was substantial under humid (k DE=0.68 and k RE+S=0.68) and dry condition (k DE=0.64 and k RE+S=0.67). For device X, it was substantial under humid condition (k DE=0.57 and k RE+S=0.49), and it was almost perfect after air drying (k DE=1.0 and kRE+S=1.0). Inter-device agreement was slight (k =0.17) under humid condition, and it was substantial under dry condition (k =0.62). As reproducibility increased under dry condition, drying is advised to detect caries-like lesions on free smooth surfaces when different devices are used.

Este estudo verificou o efeito da secagem sobre o resultado de reprodutibilidade de aparelhos laser DIAGNOdent (Dd) no diagnóstico de cárie artificial. Três áreas foram produzidas em cada um dos 34 incisivos bovinos: hígida (S), desmineralizada (DE) e remineralizada (RE). Um examinador mediu cada área com dois aparelhos Dd (denominados X e Y), sendo duas vezes sob a condição úmida e duas vezes sob a condição seca. A concordância intra-examinador segundo cada aparelho, e a concordância entre aparelhos foram estimadas por meio da estatística kappa (k). A reprodutibilidade intra para o aparelho Y foi substancial sob a condição úmida (kDE=0,68 e k RE+S=0,68) e seca (k DE=0,64 e k RE+S=0,67). Para o aparelho X, a concordância foi substancial sob a condição úmida (kDE=0,57 e k RE+S=0,49) e foi quase perfeita após a secagem (kDE=1,0 e k RE+S+1,0). A concordância entre aparelhos foi fraca (k=0,17) na condição úmida, porém foi substancial na condição seca (k=0,62). Como a reprodutibilidade foi melhor sob a condição seca, a secagem da superfície dentária é aconselhada para se detectar lesões de cárie incipientes em superfícies lisas livres, quando mais de um aparelho é utilizado no diagnóstico.

Reprodutibilidade de uma escala odontológica proposta como indicador de saúde bucal em crianças e adolescentes HIV+/SIDA / Reproducibility of a scale for oral health among children and adolescents HIV+/AIDS

O objetivo deste trabalho foi estimar a reprodutibilidade de uma escala odontológica para avaliação da saúde bucal de crianças e adolescentes HIV+. A amostra, com delineamento não probabilístico, constituiu-se de 27 crianças e adolescentes HIV+. A escala foi aplicada, em duas ocasiões, com intervalo de sete dias. Estimou-se a reprodutibilidade intraexaminador pela estatística Kappa. Nas questões relativas à mãe, houve concordância máxima nos itens referentes à importância da saúde bucal, hábito de escovação diária e utilização de escova dental. A procura de atendimento odontológico motivado por estética e para manutenção de hálito puro apresentou concordância boa. Nas questões relativas à criança, observou-se concordância regular nos itens referentes ao fio dental. Com relação à organização do sistema de saúde, chama atenção a dificuldade dos respondentes em relatar o local e o profissional que realizou orientações educativas preventivas. A reprodutibilidade dos domínios percepção, cuidado e promoção foi de 0,48, 0,21 e 0,64, respectivamente. Sugere-se a necessidade de reestruturação das questões componentes dos algoritmos propostos pela escala para as dimensões de percepção e cuidado, a par da necessidade da saúde bucal ser inserida em programas de atendimento a portadores HIV+.

The aim of this study was to investigate the intraobserver reproducibility of a Portuguese version scale used to evaluate aspects of oral health among children and adolescents HIV+. The scale was proposed by Balbo and a questionnaire was applied in two occasions, within a one week period, to 27 children and adolescents. The reproducibility was estimated by kappa statistics by point (k). With relation to the mother, it was reached a maximum of agreement for items related to the importance of maintaining the oral health, diary tooth brushing and the individual utilization of dental brush; breath and esthetics presented a good agreement. Regarding the children, a regular agreement was observed on the dental floss use. In contrast, the respondents had difficulties in reporting the name and address of the professionals that gave guidance in prevention activities to them. The k-values for perception, care and promotion were 0.48, 0.21 and 0.64 respectively, pointing to reproducibility levels classified as regular, fair and good. Given the different levels of reproducibility offered by the dental scale for HIV+ oral health, we suggest that it could be modified, especially in the domain of care.

Influência de variações das normas estéticas na atratividade do sorriso / Influence of aesthetic norm variations on the attractiveness of a smile

Objetivo: Avaliar a influência de variações nas normas estéticas na percepção da atratividade do sorriso segundo dentistas e leigos. Métodos: Alterações digitais foram realizadas nos sorrisos de fotografias de dois indivíduos de sexos distintos. Foram criados 11 sorrisos para cada sexo: um sorriso ideal controle, sorriso ideal segundo normas consideradas e 10 sorrisos contendo variações individuais de cada uma das normas descritas a seguir: a) desvio de linha média 2mm e 3mm; b) linha do sorriso - linha do sorriso reta e linha do sorriso reversa; c) angulação incisivos laterais - 10º para mesial e 10º para distal; d) diastema: 0.5mm e 1mm e 5mm) proporção dental - proporção de Alber e proporção de Platão. As fotografias foram avaliadas por dois especialistas em Dentística e dois leigos, utilizando a escala visual analógica. Resultados: Foi observado que o sorriso ideal controle, em ambos os sexos e de acordo com ambos os grupos avaliadores, foi julgado favoravelmente; e que os sorrisos contendo variações estéticas receberam diferentes avaliações, algumas variações foram menos aceitas que outras. Nas avaliações realizadas foram encontradas concordâncias e discordâncias entre os avaliadores. Conclusão: Observou-se que a ausência de desvios favorece a percepção estética dos sorrisos, mas algumas variações estéticas são perceptivelmente aceitas em relação a outras e que para o sucesso dos tratamentos estéticos está condicionada a participação conjunta de dentistas e pacientes na fase do planejamento.

Objective: The work presented here aims to evaluate how aesthetic norm variations influence the perception of attractiveness of a smile according to dentists and laymen. Methods: The smiles in photographs of a man and a woman were digitally changed. Eleven smiles were created for each one: an ideal, control smile - an ideal smile according to accepted norms - and 10 smiles containing individual variations of each of the following norms: a) 2mm and 3mm deviations from the middle line; b) the contour of the smile - contour of a straight smile and contour of a reverse smile; c) the angle of the lateral incisors - a mesial angle of 10º and a distal angle of 10º; d) 0.5mm and 1mm diastema; and e) dental proportion - Alber´s Proportion and Plato´s Proportion. The photographs were evaluated by two specialists in cosmetic dentistry and two laymen using the visual analogue scale. Results: The ideal smile for both genders was well accepted by both the specialists and the laymen. The opinions on the smiles with aesthetic variations varied, some were more positive than others, some were in agreement and some were in disagreement. Conclusion: The absence of deviations favors the perceived beauty of a smile, but some aesthetic variations seem to be better accepted than others. The success of aesthetic treatments depends on the active participation of dentists and patients in the planning stage

Diagnostic reproducibility of the elongated styloid process.

UNLABELLED: The aim of this study was to estimate the reproducibility related to the presence and to the measurements of elongated styloid process (ESP), based on panoramic radiographs and the prevalence of ESP. EXPERIMENTAL DESIGN: one hundred sixty six panoramic radiographs were used, from edentulous patients from the Radiology Clinic files, at Araraquara Dental School, Unesp, during a four-year period. One hundred and twenty one were female and 45 were male. Two calibrated observers evaluated the radiographs. A caliper was used to measure, in mm, the ESP from the base of the temporal bone to the tip of the structure. The ESP was considered present when the measurements were 30mm or more. Kappa statistics (k ) and intra-class correlation coefficient (r ), were applied to estimate the reproducibility. The results showed that related to the presence of ESP, the interobserver agreement was k =0.85. Related to the measurements of ESP, the interobserver agreement was r =0.52. The prevalence of ESP was estimated in 12.6%. ESP distribution in females was similar to that for males. In conclusion, we found a greater level of agreement when observers evaluated the presence of ESP than when they did the measurement of ESP. The prevalence of ESP was 12.6%.

Comparison between inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements

The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed). Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99) The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements.

Autopercepção das condições de saúde bucal de idosos do município deAraraquara – SP / Self-perception of oral health status by elderly in Araraquara – SP city

O objetivo deste estudo foi verificar a saúde bucal e a autopercepção de 61 idosos atendidos na FOAR/UNESP, no ano de2001. Para avaliação da autopercepção utilizou-se o Geriatric Oral Health Assessment Index (GOHAI) e o questionárioproposto por Silva & Castellanos Fernandes14 (2001) (S&CF). Um examinador realizou exame clínico e adotou-se (0)para ausência e (1) para presença de problemas periodontais ou cárie radicular e, quando da presença de próteses (0)para não funcionais e (1) para funcionais. Realizou-se análise descritiva das variáveis. Testou-se a reprodutibilidadeda autopercepção pela estatística Kappa (κ). Os pacientes foram agrupados em autopercepção “ótima”, “regular” e“ruim” e a associação com doença periodontal, cárie radicular e uso de prótese foi realizada pelo teste de qui-quadradoou teste exato de Fisher, com significância de 5%. A maioria dos idosos afirmou nunca ter sofrido limitações devido aseus dentes, gengivas ou próteses, entretanto, o Índice GOHAI global foi de 27,77, característico de uma autopercepçãoruim. Observou-se que 56% dos idosos apresentaram doença periodontal, 38% cárie radicular e 92% dos idosos eramusuários de próteses não funcionais. Houve baixa concordância entre os diferentes métodos de avaliação (κ = 0,087) eassociação não-significativa entre o índice GOHAI e doença periodontal (χ2=0,856; p=0,5133), cárie radicular (χ2=0,002;p=0,9636) e o uso de próteses (Exato de Fisher: p=0,3286). As condições de saúde bucal apresentaram-se insatisfatóriase a autopercepção mostrou-se ruim, com associação não-significativa com as variáveis clínicas doença periodontal, cárieradicular e uso de prótese.

Estudo epidemiológico da ansiedade dos pacientes ao tratamento odontológico / Epidemiological study of dental anxiety among patients undergoing dental care

O objetivo deste estudo foi estimar a prevalência de ansiedade ao tratamento odontológico entre pacientes da Clínica Integrada da Faculdade de Odontologia de Araraquara, UNESP. Material e Método: A amostra era composta por 60 pacientes tomados deforma não-probabilística. Como instrumento de medida, utilizou-se um formulário com questões para avaliação da ansiedade segundo a escala proposta por Corah e traduzida para o português por Pereira et al. Os dados foram descritos em forma de distribuição de freqüências, e as associações entre nível de ansiedade e sexo, idade, renda e educação foram analisadas pelo teste de qui-quadrado (χ2). Resultado: A prevalência de ansiedade foi observada em 95 porcento dos pacients, tendo a maioria (53,3 porcento) apresentado nível moderado, 25,0% ansiedade baixa e 16,7% exacerbada; verificou-se associação significativa entre ansiedade e sexo (p = 0,001) e não-significativa para idade (p = 0,754), renda (p = 0,307) e nível de instrução (p = 0,711). O período de retorno ao tratamento odontológico a cada 6 meses foi observado em apenas 2 pacientes (3,3%), enquanto 40 % dos pacientes procuraram por atendimento apenas em situações de "dor". Entre os procedimentos que mais incomodaram os pacientes estão os que envolvem "motor de alta rotação" e "cirurgia", correspondendo a 21,7% em cada situação. Vinte por cento da amostra não se sentiram incomodados com qualquer procedimento odontológico, enquanto 10% se referiram a desconforto diante de qualquer procedimento a ser realizado. Conclusão: Concluiu-se que a prevalência de ansiedade ao tratamento odontológico foi de 95 % com predomínio do gênero feminino e que, entre pacientes ansiosos, o retorno ao consultório ocorreu por motivo de dor

Objective: The aim of this study was to estimate the prevalence of dental anxiety among patients undergoing dental treatment at Araraquara Dental School ­ UNESP. Material and Methods: It was performed a transversal study using a sample of convenience given by 60 patients. Dental anxiety was analysed using Corah's Dental Anxiety Scale (DAS)11. It was applied descriptive statistics and chi-squared test (χ2) was used to determine the relationship between level of anxiety and sex, age (<35 age and 35 year and above), income and educational level. Results: The results showed that 53.3% presented a moderate level of anxiety, 25% low level and 16.7% were fobic, leading to a prevalence of 95%. The association between level of anxiety according to sex was significant (p = 0.001) and it was non-significant in relation to age (p = 0.754), income (p = 0.307) and educational level (p = 0.711). Only two patients returned to visit the dentist within a 6-month period, while 40% looked for dental care when they had pain. The dental situations that produced anxiety were high-speed turbine (21.7%) and surgery (21.7%). Twenty percent of the sample didn't feel uncomfortable about any kind of dental treatment, while 10% felt uncomfortable about any one of the proceedings. Conclusion: The prevalence of dental anxiety was 95%, with predominance in the female sex and anxious patients looked for dental treatment only when they had pain

Efficacy of three conditions of radiographic interpretation for assessment root canal length%Eficácia de três condições de interpretação radiográfica em odontometria

OBJETIVO: Comparar a eficácia de três condições de interpretação radiográfica em odontometria e avaliar a concordância intra-observador. MATERIAL E MÉTODO: Trinta radiografias periapicais de incisivos central e lateral superiores, de arquivos foram medidas, em mm, da extremidade da lima ao ápice radiográfico, com a utilização de um paquímetro digital. Foram feitas três medidas em cada radiografia e em seguida foi calculada a média. Após um período de 12 dias, as medidas foram repetidas. As três condições experimentais de interpretação radiográfica foram: negatoscópio sem máscara e sem magnificação (Visual); 2) negatoscópio com lente de aumento de 2,5 X e com máscara (Magnificação) e 3) bloqueador de luz e lente de aumento de 1,75 X (Bloqueador). As médias e os desvios-padrão das medidas foram calculados e realizada uma análise descritiva. Foi utilizada a análise de variância a dois critérios (ANOVA) para avaliar a concordância intra-observador e intramétodo. O erro das medidas foi calculado pela fórmula de Dalhberg. RESULTADOS: O teste ANOVA não mostrou diferenças significantes entre as duas sessões de observação, métodos de interpretação ou interação entre as sessões de interpretação e método (p>0,05). A medida intra-observador foi 0,02 mm para os métodos Visual e Magnificação e 0,01 mm para o Bloqueador. CONCLUSÃO: Parece não haver qualquer vantagem realizar medidas da distância entre o ápice radicular e o extremo da lima endodôntica em dentes incisivos superiores utilizando máscara ou magnificação da imagem

Reprodutibilidade de um teste microbiológico para estreptococos do grupo mutans / Reproducibility of a simplified microbiological test for mutans streptococci

Com o desenvolvimento de testes microbiológicos salivares simplificados tornou-se mais prático o diagnóstico de pacientes com baixa atividade, porém com alto risco de cárie. O propósito desta pesquisa foi avaliar a reprodutibilidade do CARITEST-SM, um teste específico para estreptococos do grupo mutans. Catorze voluntários participaram do estudo. A produçäo de saliva foi estimulada com uma goma de mascar inerte e coletada até a obtençäo do volume suficiente para a execuçäo de dois testes - pertencentes a dois conjuntos de lotes diferentes de "kits" CARITEST-SM (1 e 2) - aplicados para um mesmo indivíduo. Dois examinadores calibrados realizaram a leitura de forma independente e cega, classificando os resultados de duas maneiras: escores de 1 a 6, conforme recomenda o fabricante, e conforme a classificaçäo quanto à contagem microbiológica, baixa e alta. Foi aplicada a estatística Kappa, segundo Light. Os resultados de concordância, conforme 6 escores, mostraram valores distintos para o conjunto dos "kits" 1 e para o conjunto dos "kits" 2, valendo, respectivamente, k = 0,57 e k = 0,21. Em relaçäo à classificaçäo conforme a contagem microbiológica, alta e baixa, os resultados foram k = 1,00, para o conjunto dos "kits" 1, e k = 0,55, para o conjunto dos "kits" 2. Assim, estes índices de concordância mostraram que a diferença no lote exerceu uma variabilidade no resultado. Além disso, houve maior concordância interexaminador quando se utilizou a classificaçäo conforme a contagem microbiológica alta e baixa

Estudo da fluorescência de diferentes cores de uma resina composta: análise digital / Fluorescence study of composite resin different shades: digital assessment

O objetivo deste estudo foi avaliar a fluorescência de diferentes cores de uma resina composta e da estrutura dentária por meio de imagens de fluorescência conjugada ao processamento digital. A amostra foi constituída por 192 imagens, sendo 176 de corpos-de-prova de resina composta e 16 da estrutura dentária. Os corpos-de-prova foram confeccionados em matriz circular metálica, contendo orifíco central de 10mm de diâmetro e 1mm de espessura, sendo confeccionado 1 corpo-de-prova para cada uma das 11 cores avaliadas da resina composta Helio Fill (Vigodent). A análise digital da fluorescência foi realizada com auxílio de câmera CCD conectada ao computador, sendo a fluorescência analisada sob iluminação com LED UV. Foram coletadas 16 imagens pela câmera para cada corpo-de-prova e estrutura dentária e estas foram processadas matematicamente, quantificando a intensidade de fluorescência na escala de cinza. Foi aplicada análise de variância a um critério fixo e realizado teste de Tukey para os contrastes. Verificou-se que a tonalidade A1 apresentou maior média de intensidade de fluorescência e a tonalidade C3 apresentou a menor entre as resinas compostas. O comportamento foi semelhante para cores B1 e B2, bem como para A4 e C2. Porém, a intensidade média da estrutura dentária apresentou valor médio inferior a todas as cores avaliadas. Conclui-se que todas as cores analisadas sob iluminação UV possuem fluorescência superior à da estrutura dentária.

Reprodutibilidade intra examinador do índice periodontal Cpitn e do nível de inserção / Intraobserver reproducibility of periodontal index cpitn and attachment level

O objetivo foi estudar a reprodutibilidade intra examinador dos índice CPITN e do nível de inserção. Foram examinados 30 pacientes da Clínica Integrada da Faculdade de Odontologia de Araraquara em duas ocasiões distintas, em intervalo de 1 semana.A boca foi dividida em sextantes sendo os seis sítios de cada dente examinados. O nível de inserção correspondeu à medida da junção cemento esmalte até profundidade de sondagem e foi realizado usando a sonda Willians. A classificação do CPITN foi feita pela sonda OMS 621 com os códigos 0,1,2,3 e 4. A classificação do índice foi dada pela pior condição do sextante. A estatística Kappa foi usada para analisar a reprodutibilidade do CPITN e o coeficiente de correlação intraclasse para analisar o nível de inserção. Foram observados altos graus de reprodutibilidade para o índice CPITN (Kappa= 0,85) e para o nível de inserção (coeficiente de correlação intraclasse= 0,96), concluindo que ambos são de confiabilidade em estudos epidemiológicos.