Pyogenic granuloma in the tongue of a patient with Down syndrome.

Down syndrome (DS), a genetic disorder caused by chromosome 21 trisomy, is characterized by intellectual disability, congenital malformations, craniofacial alterations, and dentofacial anomalies. Although some oral lesions have been reported in patients with DS, this is the first reported case of a pyogenic granuloma affecting the tongue of a patient with DS. A 20-year-old man presented with a well-demarcated nodular lesion on the right lateral border of the tongue. The 2-cm lesion had a pedunculated base, flaccid consistency, and a superficial ulceration covered by a serofibrinous pseudomembrane. The patient's mother reported that the patient had a recurring habit of traumatizing the lateral border of the tongue. A similar lesion had been surgically removed from the site 1 month earlier, but the excised tissue had not been sent for pathologic analysis. Surgical excision of the new lesion was performed under local anesthesia, and microscopic analysis confirmed the diagnostic hypothesis of pyogenic granuloma, a nonneoplastic vascular hyperplasia of a reactive nature. There was another recurrence at the same site 2 months after the second surgical excision. The patient was given a mandibular silicone mouthguard for 1 month of nightly use to prevent further trauma to the site. Complete healing of the site was observed at the 18-month follow-up examination, and there was no sign of recurrence. Considering the high prevalence of oral alterations in patients with DS, dentists should be able to recognize, diagnose, and correctly manage oral pyogenic granuloma.

Impact of oral comorbidities on incarcerated women: an integrative review.

INTRODUCTION: Oral health care directly impacts the well-being of incarcerated women. It is related to the quality of life, social and economic discrepancies and lack of access to programs that offer free dental services and health promotion for this population. OBJECTIVES: This work aimed to understand oral health challenges faced by women incarcerated in Brazil and worldwide. MATERIAL AND METHOD: The following databases were selected: EMBASE, (Virtual Health Library=LILACS+BDENF), Scielo, Scopus, Cochrane-Library and the PubMed search engine. These databases were searched until the closing date of October 2021 with no time limit for the searches. The key words used in the searches were "incarceration", "prison", "woman", and "oral health". RESULTS: Caries, periodontal disease, tooth pain, and the use of dental prostheses were the most prevalent oral health conditions amongst incarcerated women in Brazil and worldwide. Regarding the level of scientific evidence, the included articles fit level III, according to Melnyk and Fineout. DISCUSSION: Bearing in mind the limitations of the study, oral diseases in the global context showed that the quality of life related to oral and systemic health of women during and after incarceration was negatively affected. It is also essential for further clinical and follow-up studies to be carried out on incarcerated women that address their actual oral health needs.

Use of silicone finger prostheses in amputee patients: An integrative review.

This study aimed to perform an integrative review of the literature on the use of silicone finger prostheses in amputee patients. Searches were performed in the PubMed, EMBASE, Web of Science, Scielo, and Cochrane Library databases until July 2021. Descriptors used in this article were: Silicone, finger, rehabilitation, and prosthesis. Clinical research and clinical reports on silicone finger prostheses, available in full and in English were included. Initially, 152 articles were identified. After establishing the inclusion/exclusion criteria, 23 studies were identified and constituted the final sample. Regarding the publication date of the included studies, 17.2% of them were published between 2012 and 2016. Most of the rehabilitations occurred in India (69.9%; n = 16), and the mean age of patients who used prostheses was 38.1 years. The level of scientific evidence of the included studies was IV and VI. Therefore, patients rehabilitated with silicone finger prostheses highlighted significant improvements in functional range of motion, restoration of self-esteem, advantages in psychological therapy, more pleasant social interaction, and changes in their quality of life.

A preceptoria médica em medicina de família e comunidade: uma proposta dialógica com a andragogia / Medical preceptorship in family and community medicine: a proposal for dialogue with andragogy

Resumo: Introdução: O Brasil está em um amplo processo de fortalecimento das residências médicas nas áreas básicas, porém existe a necessidade de um currículo estruturado para qualificar a formação do preceptor. Objetivo: Este estudo teve como objetivo construir uma matriz dialógica para orientar a formação educacional da preceptoria em medicina de família e comunidade (MFC). Método: Por meio de um estudo qualitativo-analítico, analisaram-se três programas de preceptoria médica no Brasil: Associação Brasileira de Educação Médica, Hospital Sírio-Libanês e Hospital Alemão Oswaldo Cruz. Em seguida, uma proposta formativa foi apresentada contendo macrodiretrizes que possibilitem mudanças nos processos de ensino e aprendizagem para qualificação da prática preceptora em diálogo com a andragogia. Resultado: A matriz construída norteia-se pela aprendizagem do adulto, enfatizando a autonomia do aprendiz, em detrimento do controle da aprendizagem pelo educador. Envolve cinco dimensões: direcionalidade da formação; conteúdo; estratégias pedagógicas; concepções e estrutura formativa; e relação entre saúde, educação e pesquisa. Cada uma delas agrega um conjunto de diretrizes que valorizam o contexto e os princípios da formação em serviço no SUS; o desenvolvimento de competências acerca de conteúdos da atenção, gestão e educação em saúde; concepções e estruturas pautadas pela construção de vínculos significativos entre os sujeitos envolvidos no ato educativo, respeitando seus saberes prévios e experiências; estratégias pedagógicas colaborativas, trabalho com grupos operativos e o uso de tecnologias da informação e comunicação; e o estímulo à pesquisa como princípio educativo. Conclusão: A matriz considerou as necessidades da formação em MFC, baseando-se em aspectos-chave da andragogia. Acredita-se que ela possa promover mudanças nos processos de ensino-aprendizagem dos preceptores, com o objetivo de qualificar sua prática.

Abstract: Introduction: Brazil is in a broad process of strengthening medical residencies in basic areas, but there is a need for a structured curriculum to qualify the training of preceptors. Objective: To build a dialogic matrix to guide the educational training of preceptorship in Family and Community Medicine (FFM). Methodology: Through a qualitative-analytical study, three medical preceptorship programs in Brazil were analyzed, namely: Associação Brasileira de Educação Médica, Hospital Sírio-Libanês and Hospital Alemão Oswaldo Cruz. A training proposal was subsequently presented containing macro-guidelines that allow changes in the teaching and learning processes to qualify preceptor practice in dialogue with andragogy. Results: Based on andragogy, the resulting matrix emphasized the learner's autonomy, to the detriment of the educator's control of learning. It involves five dimensions: directionality of training; contents; pedagogical strategies; training concepts and structure; and the relationship between health, education and research. Each dimension included guidelines that value: the context and principles of in-service training in the SUS; the development of competences about the contents of health care, management and education; conceptions and structures guided by the construction of significant bonds between the subjects involved in the educational act, respecting their previous knowledge and experiences; collaborative pedagogical strategies, work with operative groups and the use of information and communication technologies; and encouraging research as an educational principle. Conclusion: The matrix considered the needs of FCM training, based on key aspects of andragogy. It can promote changes in the teaching-learning processes of preceptors, with the aim of qualifying their practice.

Evaluation of quality of life, sleep, and sleepiness in dental students during active learning and remote emergency learning

Objective: This study aimed to evaluate the quality of life (QoL), quality of sleep, and sleepiness index in undergraduate dentistry students between their active learning (AL) and emergency remote learning (ERL) due to social distancing imposed during the COVID-19 pandemic. Methods: Information was collected using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36-BR), Epworth Sleepiness Scale (ESS-BR), and Pittsburgh Sleep Quality Index (PSQI-BR) questionnaires administered before and during the COVID-19 pandemic. A comparison regarding the type of education, demographic factors, academic performance, PSQI-BR, ESS-BR, and SF-36-BR between the groups was performed, considering a significance level of 0.05. Results: A total of 55 students were from AL, while 45 students were from ERL. The sample consisted of 74 women and 26 men aged 21­30 years. The academic coefficient of these students ranged from 7 to 8 points (AL= 38.2% and ERL= 57.8%). In addition, a large proportion of the students reported having no failures (AL=60% and ERL= 66.7%). Regarding QoL, the students presented a greater impairment in functional capacity (p = 0.01), followed by limitations in social aspects, general health perception, body pain, and vitality. According to the ESS-BR scores (p = 0.04), the students presented a lower quality of sleep. Conclusion: Dentistry students had the worst QoL panoramas and poor relative sleep quality before and during the COVID-19 pandemic. Furthermore, QoL instruments were reliable for quantifying health-related QoL in AL and ERL.

Reflexos da saúde planetária no processo transdisciplinar entre profissionais de saúde / Reflexes of planetary health in the transdisciplinary process among health professionals

Resumo A saúde planetária vem se consolidando como área transdisciplinar do conhecimento, fundamentada na caracterização e mitigação dos impactos antropogênicos sobre a saúde do ser humano e dos sistemas terrestres. O estilo de vida em sociedades capitalistas impulsiona a degradação ambiental e suas consequências (como emergência climática e perda de biodiversidade), relacionando-se também à alta prevalência de doenças crônicas não transmissíveis. No entanto, essas questões não costumam receber a atenção necessária no processo de ensino e aprendizagem dos profissionais de saúde. Assim, este ensaio objetiva contribuir para sistematização das informações que correlacionam os fatores ambientais e a saúde humana na perspectiva do pensamento sistêmico, destacando a importância de se pensar a saúde sistêmica no âmbito das profissões da saúde. Observa-se que o profissional de saúde, sendo ponte entre o conhecimento científico e a sociedade, pode desempenhar os papéis de mediador do cuidado integral e curador do conhecimento. Além disso, é preciso incentivar o pensamento sistêmico no processo formativo em saúde para que esses papéis sejam alcançados, tanto em atitudes individuais quanto coletivas.

Abstract Planetary Health has been consolidated as a transdisciplinary area of knowledge grounded in characterizing and mitigating anthropogenic impacts on the health of human beings and earth systems. The capitalist lifestyle drives environmental degradation and its consequences (such as climate emergency and biodiversity loss), and is related to the high prevalence of chronic non- communicable diseases. This information, however, usually lacks the necessary emphasis in health teaching and learning process. Thus, this essay aims to systematize information that correlates environmental factors and human health from a systemic thinking perspective, highlighting the importance of reflecting on systemic health within health professions. As the bridge between scientific knowledge and society, health professionals can play the role of integral care agent and knowledge curator. Moreover, we must encourage systemic thinking in health education to achieve these roles, both in individual and collective attitudes.

Oral Health and related inequalities among visual impairment people in a Brazil municipality / Saúde bucal e desigualdades relacionadas entre pessoas com deficiência visual em um município brasileiro

ABSTRACT Objective: To evaluate the oral health and related factors among people with visual impairment in a municipality in southeastern Brazil. Methods: A cross-sectional and descriptive household study was carried out on a representative sample of people with visual impairments in a medium-sized city in Brazil. A clinical-dental examination was performed (evaluating tooth loss, caries, periodontal health, dental plaque use and need of prosthesis) and a semistructured questionnaire was applied, investigating the socioeconomic conditions (sex, age, marital status, skin color and income) and the use of dental services (reason, time since, and type of service used [private/public] in last dental visit). Descriptive and bivariate analysis were performed to asses the factors related to oral health. Results: The mean age of participants was 65 years (±15.05), with the majority women (70.9%). 53.1% of the interviewees were edentulous, but 58.2% had a good perception of oral health. The blind ones use less public services (p=0.038) and with a lower frequency (p=0.014) than subjects with low vision. Those with less schooling had higher tooth loss and lower periodontal problems (p <0.05). There was a reduction of dental plaque six months after the educational action (30.7%; p=0.01), especially among the low vision participants (p=0.01). Conclusion: Severe tooth loss and unsatisfactory hygiene contrast with self-perception of oral health. Visual acuity and schooling were related to access and oral health. Actions for promotion and equity are necessary to overcome the inequalities encountered.

RESUMO Objetivo: Avaliar a saúde bucal e fatores relacionados entre deficientes visuais em município do sudeste brasileiro. Métodos: Foi realizado um estudo domiciliar, transversal e descritivo em uma amostra representativa de pessoas com deficiência visual em uma cidade de médio porte do Brasil. Realizou-se o exame clínico bucal (avaliando perda dentária, cárie, saúde periodontal, placa dentária, uso e necessidade de prótese) e aplicou-se um questionário semiestruturado, investigando as condições socioeconômicas (sexo, idade, estado civil, cor da pele e renda) e o uso de serviços odontológicos (motivo, tempo decorrido e tipo de serviço utilizado [privado/público] na última consulta odontológica). Foram realizadas análises descritivas e bivariadas para avaliar os fatores associados à saúde bucal. Resultados: A idade média dos participantes foi de 65 anos (±15,05), com maioria de mulheres (70,9%). 53,1% dos entrevistados eram edêntulos, porém, 58,2% apresentaram percepção de saúde bucal boa. Os cegos usam menos os serviços públicos (p=0,038) e em menor frequência (p=0,014) que os sujeitos com baixa visão. Os menos escolarizados apresentam maiores perdas dentárias e menores problemas periodontais (p<0,05). Houve redução de placa dentária seis meses após ação educativa (30,7%; p=0,01), sobretudo entre os sujeitos com baixa visão (p=0,01). Conclusão: Elevada perda dentária e higienização insatisfatória contrastaram com autopercepção dos agravos bucais. Acuidade visual e escolaridade relacionaram-se ao acesso e saúde bucal. Ações de promoção e equidade são necessários para superar desigualdades encontradas.

Conhecimento popular e automedicação com plantas medicinais em gestantes de um município do Nordeste brasileiro / Popular knowledge and self-medication with medicinal plants among pregnant women in a Northeastern Brazilian municipality

O objetivo do presente estudo foi avaliar o conhecimento popular e automedicação com plantas medicinais em gestantes do município de Juazeiro do Norte, Ceará, Brasil. Trata-se de uma pesquisa exploratória com abordagem quali-quantitativa. As informações foram coletadas por meio de um questionário semiestruturado e um grupo focal de gestantes. Em relação ao conhecimento e uso de plantas de medicinais, afirma-se que as gestantes utilizam plantas medicinais. Na análise dos riscos, todas plantas relatadas apresentavam toxicidade fetal, com exceção da cebola branca. Nota-se que as gestantes utilizam plantas medicinais por influência da cultura familiar. As gestantes acreditam que as plantas medicinais ingeridas na gestação não causam efeitos nocivos por serem de origem natural, o que contribui para a automedicação. Destaca-se a importância do diálogo entre o saber popular e o conhecimento científico na construção de uma educação terapêutica que previna problemas relacionados ao uso de produtos terapêuticos na gestação.

This study aimed to evaluate the popular knowledge and self-medication with medicinal plants among pregnant women in the municipality of Juazeiro do Norte, Ceará, Brazil. This is an exploratory research with a quali-quantitative approach. The information was collected through a semi-structured questionnaire and a focus group of pregnant women. Regarding the knowledge and use of medicinal plants, the pregnant women used medicinal plants. In the risk analysis, all plants reported presented fetal toxicity, with the exception of white onion. It can be noticed that pregnant women use medicinal plants because of family culture influence. Pregnant women believe that the medicinal plants ingested during pregnancy do not cause harmful effects because they are of natural origin, which contributes to self-medication. It highlights the importance of dialogue between popular knowledge and scientific knowledge in the construction of therapeutic education that prevents problems related to the use of therapeutic products during pregnancy.

Impacto de las comorbilidades orales en las mujeres encarceladas: una revisión integradora / Impact of oral comorbidities on incarceratd women: an integrative review

Introducción: El cuidado de la salud bucal impacta directamente en el bienestar de las mujeres privadas de libertad. Las discrepancias socioeconómicas y la falta de acceso a programas que ofrezcan servicios odontológicos gratuitos y de promoción de lasalud para esta población tienen un impacto sobre su calidad de vida.Objetivos: Este trabajo tuvo como objetivo conocer los retos de salud bucal a los que se enfrentan las mujeres encarceladas enBrasil y en el mundo.Material y método: Se seleccionaron las siguientes bases de datos: EMBASE, (Biblioteca de salud virtual [BVS] = LILACS + BDENF),Scielo, Scopus, Cochrane-Library y PubMed. Se realizaron búsquedas en estas bases de datos hasta octubre de 2021, sin límite de tiempopara realizarlas. Las palabras clave utilizadas en las búsquedas fueron “encarcelamiento”, “prisión”, “mujer” y “salud bucal”.Resultados: La caries, la enfermedad periodontal, el dolor de muelas y el uso de prótesis dentales, fueron las condiciones desalud bucal más prevalentes en mujeres privadas de libertad en Brasil y en el mundo. En cuanto al nivel de evidencia científica,los artículos incluidos se encuadran en el nivel III, según Melnyk y Fineout.Discusión: En el contexto mundial, considerando las limitaciones del estudio, las enfermedades bucales mostraron afectar negativamente a la calidad de vida relacionada con la salud bucal y sistémica de las mujeres durante y después del encarcelamiento.También es esencial que se realicen más estudios clínicos y de seguimiento en mujeres encarceladas que aborden sus necesidade reales de salud bucal. (AU)

Introduction: Oral health care directly impacts the well-being of incarcerated women. It is related to the quality of life, social andeconomic discrepancies and lack of access to programs that offer free dental services and health promotion for this population.Objectives: This work aimed to understand oral health challenges faced by women incarcerated in Brazil and worldwide.Material and method: The following databases were selected: EMBASE, (Virtual Health Library=LILACS+BDENF), Scielo, Scopus, Cochrane-Library and the PubMed search engine. These databases were searched until the closing date of October 2021 with notime limit for the searches. The key words used in the searches were “incarceration”, “prison”, “woman”, and “oral health”.Results: Caries, periodontal disease, tooth pain, and the use of dental prostheses were the most prevalent oral health conditionsamongst incarcerated women in Brazil and worldwide. Regarding the level of scientific evidence, the included articles fit level III,according to Melnyk and Fineout. Discussion: Bearing in mind the limitations of the study, oral diseases in the global context showed that the quality of life relatedto oral and systemic health of women during and after incarceration was negatively affected. It is also essential for further clinicaland follow-up studies to be carried out on incarcerated women that address their actual oral health needs. (AU)

The cytotoxic effect of TiF4 and NaF on fibroblasts is influenced by the experimental model, fluoride concentration and exposure time.

OBJECTIVE: Titanium tetrafluoride (TiF4) has shown promising effect in preventing tooth lesions. Therefore, we compared the cytotoxicity of TiF4 with sodium fluoride (NaF) (already applied in Dentistry) considering different fluoride concentrations, pH values and experimental models. MATERIALS AND METHODS: Step 1) NIH/3T3 fibroblasts were exposed to mediums containing NaF or TiF4 (from 0.15 to 2.45% F), both at native and adjusted pH, for 6 h. Step 2) NIH/3T3 were exposed to NaF or TiF4 varnishes with 0.95, 1.95 or 2.45% F (native pH), for 6, 12 or 24 h. We applied MTT (1st and 2nd steps) and Hoescht/PI stain (2nd step) assays. Step 3) NIH/3T3 were exposed to NaF or TiF4 varnish (2.45% F), at native pH, for 6 or 12 h. The cell stiffness was measured by atomic force microscopy (AFM). RESULTS: Step 1) All cells exposed to NaF or TiF4 mediums died, regardless of the F concentration and pH. Step 2) Both varnishes, at 1.90 and 2.45% F, reduced cell viability by similar extents (33-86% at 6 h, 35-93% at 12 h, and 87-98% at 24 h) compared with control, regardless of the type of fluoride. Varnishes with 0.95% F did not differ from control. Step 3) TiF4 and NaF reduced cell stiffness to a similar extent, but only TiF4 differed from control at 6 h. CONCLUSIONS: Based on the results of the 3 experimental steps, we conclude that TiF4 and NaF have similar cytotoxicity. The cytotoxicity was dependent on F concentration and exposure time. This result gives support for testing the effect of TiF4 varnish in vivo.

COVID-19 na estratégia saúde da família: uma análise de como a população percebe e adota as medidas de prevenção / COVID-19 in the family health strategy: an analysis of how the population adopts and perceives prevention measures

As estratégias de enfrentamento à COVID-19 na Atenção Primária à Saúde (APS) abrangem os usuários e os profissionais, sendo necessária a adoção de medidas que busquem reduzir a disseminação do vírus e reorganizar os serviços de saúde no contexto da pandemia. O objetivo deste estudo foi analisar como a população adscrita à Estratégia Saúde da Família (ESF) percebe e adota as medidas de prevenção ao contágio da COVID-19. Trata-se de um estudo transversal, descritivo e quantitativo com usuários da ESF de Rondonópolis, MT. Os dados foram coletados nas Unidades de Saúde da Família com a aplicação de um questionário estruturado com questões que abordavam os aspectos sociodemográficos, percepção e práticas de prevenção à COVID-19. Participaram da pesquisa 70 usuários, desses 85,71% consideraram a COVID-19 grave ou muito grave. As medidas de prevenção mais adotadas foram uso de máscara (68,57%), lavagem frequente das mãos (37,14%), uso de álcool gel (37,14%) e isolamento social parcial (37,14%). Trinta e nove usuários (55,71%) relataram que a equipe de saúde da ESF não realizou ações voltadas para a prevenção do novo coronavírus. A maioria da população da ESF percebe a gravidade da COVID-19, porém não adota todas as medidas de proteção. Torna-se necessáriauma ampliação dasestratégias de prevenção à COVID-19 por parte dos profissionais e serviços de saúde nos territórios da APS.

Strategies to fight Covid-19 in Primary Health Care (PHC) encompass users and professionals, requiring the adoption of measures to reduce the spread of the virus and reorganize services in the context of the current pandemic. This study sought to analyze how the population that is enrolled in the Family Health Strategy (ESF, in Portuguese) has perceived and adopted COVID-19 prevention measures. This is a cross-sectional, descriptive, and quantitative study with users of the ESF in Rondonópolis, MT. The data was collected at family health units through the application of a structured questionnaire with questions that addressed sociodemographic aspects, perceptions, practices, and prevention of COVID-19. Seventy users participated in this survey. A frequency of 85.71% considers COVID-19 to be severe or very severe. The most adopted prevention measure was the use of masks (68.57%), frequent hand washing (37.14%), the use of hand sanitizers (37.14%), and partial social isolation (37.14%). A total of 39 (55.71%) users reported that the ESF team did not carry out actions aimed at preventing the new coronavirus. Most of the ESF population realizes the severity of COVID-19,although they donot adopt all of the protective measures. It is necessary to expand prevention strategies against COVID-19 by health services in PHC territorie.

Comunidades ribeirinhas do Amazonas têm conhecimento sobre cárie dentária: resultado da educação em saúde bucal / Knowledge about dental caries among ribeirinhos: result of oral health education / Comunidades ribereñas del Amazonas tienen conocimiento sobre la caries dental: resultado de la educación en salud bucal

O Amazonas é o maior estado brasileiro em extensão territorial, com uma parcela significativa da população vivendo em torno dos rios, as chamadas comunidades ribeirinhas. O acesso aos serviços de saúde por essas comunidades é limitado, levando à criação de projetos de saúde pública para prevenção e tratamento de doenças, assim como ações de educação em saúde. Diversas organizações não governamentais (ONG) e equipes de saúde atuam nessas comunidades com projetos de educação em saúde. Neste artigo, verificou-se a percepção dos pais sobre a saúde bucal de seus filhos e a importância dos cuidados da dentição decídua para prevenção da cárie dentária. Para isso, foram entrevistados trezentos pais ou responsáveis por crianças de zero a sete anos em comunidades ribeirinhas localizadas em três municípios do Amazonas (Parintins, Nhamundá e Barreirinha ­ N = 300, cem em cada município). A partir das entrevistas, pode-se concluir que as mães foram as principais respondentes (80%), cuja renda familiar é de até um salário mínimo (91%). Além disso, a maioria tinha conhecimentos sobre cárie dentária (56%), bem como já recebeu alguma orientação sobre como escovar os dentes (41%). Todas as crianças possuem escova de dentes e 94% delas utilizam dentifrício na escovação. Por fim, os pais foram considerados os principais responsáveis pela escovação dentária supervisionada de seus filhos (87%), embora apenas 44% deles a realize. Portanto, neste artigo, demonstra-se a efetividade das ações e dos projetos aplicados em comunidades ribeirinhas em relação à cárie dentária, ainda que exista a necessidade da continuidade dessas ações para mudanças efetivas de hábitos, impactando positivamente a saúde bucal das crianças ribeirinhas do Amazonas.

Amazonas is the largest Brazilian state in land area, with a significant portion of its population living near rivers, the so-called ribeirinhos. Since access to health care services by these communities is limited, specific public health actions and projects for health prevention, treatment and education are created. Several non-governmental organizations (NGOs) and health care teams work on health education projects on these communities. Given this context, this study investigated how parents perceived their children's oral health and the importance of deciduous dentition care for preventing dental caries. Data was collected by a questionnaire applied to 300 parents or guardians of children aged 0 to 7 years from three municipalities of Amazonas (Parintins, Nhamundá and Barreirinhas ­ 100 each). Mothers (80%) and homes living with a family income of up to 1 minimum wage (91%) comprised most of the sample. Most parents had knowledge about dental caries (56%) and had received some guidance on how to brush their children's teeth (41%). All children have a toothbrush and 94% of them use toothpaste. Finally, parents consider themselves the main responsible for supervised brushing (87%), although only 44% of them perform it. In conclusion, these findings attest to the effectiveness of actions and projects carried out in ribeirinho communities regarding dental caries, although continued actions are needed to change habits and positively impact the oral health of ribeirinho children living in Amazonas.

Amazonas es el estado brasileño más grande en extensión territorial, con una porción significativa de la población que vive alrededor de los ríos, las llamadas comunidades ribereñas. El acceso a los servicios de salud por parte de estas comunidades es limitado, lo que lleva a la creación de acciones y proyectos de salud pública para la prevención y el tratamiento de enfermedades, así como acciones de la educación en salud. Son varias las ONG que trabajan en estas comunidades con proyectos de educación en salud. En este artículo se evaluó la percepción de los padres sobre la salud bucal de sus hijos y la importancia de cuidar la dentición primaria en la prevención de la caries dental. Para ello, se entrevistaron a los padres o tutores de niños de 0 a 7 años, en las comunidades ribereñas de tres municipios de Amazonas (Parintins, Nhamundá y Barreirinhas ­N = 300, cien en cada municipio). Los resultados muestran que la madre fue la principal respondiente de la entrevista (80%), con un ingreso familiar de hasta 1 salario mínimo brasileño (91%). La mayoría tiene conocimiento sobre la caries dental (56%) y ya había recibido alguna orientación sobre cómo cepillarse los dientes (41%). Todos los niños tienen un cepillo de dientes, y el 94% de ellos usa pasta de dientes. Los padres se consideran los principales responsables del cepillado supervisado de sus hijos (87%), aunque solo el 44% de ellos lo realizan en sus hijos. Este artículo demuestra la efectividad de las acciones y proyectos llevados a cabo en comunidades ribereñas con respecto a la caries dental, pero es necesario continuar con estas acciones para que tengamos cambios en los hábitos e impactos positivos en la salud bucal de los niños que viven en las comunidades ribereñas del Amazonas.

Experimental Calcium Silicate-Based Cement with and without Zirconium Oxide Modulates Fibroblasts Viability.

The aim of this study was to verify whether the use of zirconium oxide as a radiopacifier of an experimental calcium silicate-based cement (WPCZO) leads to cytotoxicity. Fibroblasts were treated with different concentrations (10 mg/mL, 1 mg/mL, and 0.1 mg/mL) of the cements diluted in Dulbecco's modified Eagle's medium (DMEM) for periods of 12, 24, and 48 h. Groups tested were white Portland cement (WPC), white Portland cement with zirconium oxide (WPCZO), and white mineral trioxide aggregate Angelus (MTA). Control group cells were not treated. The cytotoxicity was evaluated through mitochondrial-activity (MTT) and cell-density (crystal violet) assays. All cements showed low cytotoxicity. In general, at the concentration of 10 mg/mL there was an increase in viability of those groups treated with WPC and WPCZO when compared to the control group (p<0.05). A similar profile for the absorbance values was noted among the groups: 10 mg/mL presented an increase in viability compared to the control group. On the other hand, smaller concentrations presented a similar or lower viability compared to the control group, in general. A new dental material composed of calcium silicate-based cement with 20% zirconium oxide as the radiopacifier showed low cytotoxicity as a promising material to be exploited for root-end filling.

Rely XTM U200 versus Rely XTM ARC: uma comparação da resistência à microtração / Rely XTM U200 versus Rely XTM ARC: a comparison of microtensile bond strength

Resumo Introdução Os cimentos resinosos são extensivamente utilizados na fixação de restaurações indiretas de cerâmica e cerômero, sendo classificados em duas categorias: os cimentos resinosos convencionais, que não apresentam uma adesão inerente à estrutura dental e requerem o uso de um sistema adesivo e os cimentos resinosos autoadesivos, que não requerem um tratamento adesivo prévio do substrato dentário. Objetivo Avaliar a resistência de união de dois cimentos resinosos, convencional e autoadesivo, quando utilizados na cimentação de restaurações cerâmicas e ceroméricas, trazendo elementos para propiciar melhor compreensão da interação adesiva em procedimentos de cimentação com as referidas categorias de cimentos resinosos. Material e método Dentes humanos (n=20), cedidos pelo banco de dentes da Universidade Federal de Alfenas (UNIFAL), foram preparados para que cilindros de cerâmica ou de cerômero fossem cimentados utilizando-se dois tipos de cimentos resinosos (autoadesivo e convencional). Após a cimentação, 20 palitos foram obtidos e submetidos ao teste de tração, avaliando-se a força necessária para a fratura. Os valores obtidos foram submetidos à análise estatística empregando-se a análise de variância (ANOVA) e o teste de Tukey. Resultado As forças mínimas e máximas necessárias ao rompimento do cimento convencional foram superiores às mesmas requeridas para o rompimento da união promovida pelo cimento autoadesivo, bem como as medianas e as médias aritméticas, independentemente do material restaurador empregado. O teste de Tukey demonstrou que as diferenças entre os cimentos empregados são estatisticamente significantes, independentemente do material restaurador. Conclusão Os resultados deste trabalho sugerem que o material utilizado para a confecção dos corpos de prova (cerâmica ou cerômero) não influenciou na resistência à tração, sendo que o cimento convencional apresentou valores superiores de resistência.

Abstract Introduction Resin cements are extensively used in the fixation of indirect restorations of ceramics and ceramics, divided into two categories: conventional resin cements, which do not present an inherent adhesion to the dental structure and require the use of an adhesive system, and the self-adhesive resin cements, which do not require a prior adhesive treatment of the dental substrate. Objective: To evaluate the microtensile bond strength of two resin-based cements, conventional and self-adhesive, according to required operating protocols, when luting ceramic and indirect composite restorations. Material and method Human molars (n=20) donated by UNIFAL teeth bank were prepared and, after being divided into two groups, ceramic or composite cylinders were luted to them with two resin-based cements (conventional and self-adhesive). Prepared teeth were sectioned vertically in both buccal-lingual and mesio-distal directions, to obtain 8 mm high, square-shaped "sticks" that were subject to microtensile bond strength test, and the necessary force to fracture them was evaluated. Results were subject to two-way ANOVA and Tukey test. Result Minimum and maximum forces to disrupt conventional cement were greater than the required one for self-adhesive cement, as well as mean bond strength, despíte of the restorative material. Tukey test showed that diferences were statistically significant, regardless the restorative material. Conclusion Restorative materials did not influence microtensile bond strength values, with no statistically significant differences. The difference between microtensile bond strength values of resin cements tested was statistically significant.

Catalytic signature of a heat-stable, chimeric human alkaline phosphatase with therapeutic potential.

Recombinant alkaline phosphatases are becoming promising protein therapeutics to prevent skeletal mineralization defects, inflammatory bowel diseases, and treat acute kidney injury. By substituting the flexible crown domain of human intestinal alkaline phosphatase (IAP) with that of the human placental isozyme (PLAP) we generated a chimeric enzyme (ChimAP) that retains the structural folding of IAP, but displays greatly increased stability, active site Zn²âº binding, increased transphosphorylation, a higher turnover number and narrower substrate specificity, with comparable selectivity for bacterial lipopolysaccharide (LPS), than the parent IAP isozyme. ChimAP shows promise as a protein therapeutic for indications such as inflammatory bowel diseases, gut dysbioses and acute kidney injury.

Tissue-nonspecific alkaline phosphatase deficiency causes abnormal craniofacial bone development in the Alpl(-/-) mouse model of infantile hypophosphatasia.

UNLABELLED: Tissue-nonspecific alkaline phosphatase (TNAP) is an enzyme present on the surface of mineralizing cells and their derived matrix vesicles that promotes hydroxyapatite crystal growth. Hypophosphatasia (HPP) is an inborn-error-of-metabolism that, dependent upon age of onset, features rickets or osteomalacia due to loss-of function mutations in the gene (Alpl) encoding TNAP. Craniosynostosis is prevalent in infants with HPP and other forms of rachitic disease but how craniosynostosis develops in these disorders is unknown. OBJECTIVES: Because craniosynostosis carries high morbidity, we are investigating craniofacial skeletal abnormalities in Alpl(-/-) mice to establish these mice as a model of HPP-associated craniosynostosis and determine mechanisms by which TNAP influences craniofacial skeletal development. METHODS: Cranial bone, cranial suture and cranial base abnormalities were analyzed by micro-CT and histology. Craniofacial shape abnormalities were quantified using digital calipers. TNAP expression was suppressed in MC3T3E1(C4) calvarial cells by TNAP-specific shRNA. Cells were analyzed for changes in mineralization, gene expression, proliferation, apoptosis, matrix deposition and cell adhesion. RESULTS: Alpl(-/-) mice feature craniofacial shape abnormalities suggestive of limited anterior-posterior growth. Craniosynostosis in the form of bony coronal suture fusion is present by three weeks after birth. Alpl(-/-) mice also exhibit marked histologic abnormalities of calvarial bones and the cranial base involving growth plates, cortical and trabecular bone within two weeks of birth. Analysis of calvarial cells in which TNAP expression was suppressed by shRNA indicates that TNAP deficiency promotes aberrant osteoblastic gene expression, diminished matrix deposition, diminished proliferation, increased apoptosis and increased cell adhesion. CONCLUSIONS: These findings demonstrate that Alpl(-/-) mice exhibit a craniofacial skeletal phenotype similar to that seen in infants with HPP, including true bony craniosynostosis in the context of severely diminished bone mineralization. Future studies will be required to determine if TNAP deficiency and other forms of rickets promote craniosynostosis directly through abnormal calvarial cell behavior, or indirectly due to deficient growth of the cranial base.

Antimicrobial activity of various brands of children's toothpastes formulated with Triclosan, fluoride and xylitol / Atividade antimicrobiana de dentifrícios infantis formulados com Triclosa, xylitol e fluoreto, disponíveis no mercado

Objective: Evaluate and compare the antimicrobial efficacy of four different commercially available children's toothpastes on bacteria growth inhibition from oral microbiota of young children. Material and Method: The toothpastes tested contained: 1100 ppm sodium fluoride, xylitol and 750 ppm sodium fluoride, xylitol and 500 ppm sodium fluoride, and xylitol and triclosan. Twenty 18 to 36 month-old children were selected. Nonstimulated saliva samples were collected and inoculated on brain heart infusion (BHI) agar. Toothpaste dilutions were applied into the agar wells and incubated at 37 ºC for 24 hours in microaerophilic conditions. Saline and 0.12% chlorhexidine were used as controls. Antimicrobial activity was determined in duplicate by agar-well diffusion technique. Bacterial growth inhibition zones were recorded in mm. Statistical analysis was performed using ANOVA and Tukey's test (p < 0.05). Results: All toothpastes showed antimicrobial activity when compared to negative control (p < 0.05). Toothpaste containing triclosan presented the highest antimicrobial activity followed, in this order, by xylitol and 750 ppm sodium fluoride, chlorhexidine, 1100 ppm sodium fluoride, xylitol and 500 ppm sodium fluoride and saline. Conclusion: Toothpaste containing triclosan and xylitol presented excellent antimicrobial activity, and may be considered a good option for young children. (AU)

Objetivo: Avaliar e comparar a atividade antimicrobiana de 4 dentifrícios infantis, comercialmente disponíveis, com relação à inibição do crescimento da microbiota oral em crianças. Material e Métodos: Os dentifrícios testados continham: 1100 ppm de fluoreto de sódio - xilitol e 750 ppm de fluoreto de sódio - xilitol e 500 ppm de fluoreto de sódio - xilitol e triclosan. Vinte crianças de 18 a 36 meses participaram dessa pesquisa. Amostras de saliva não estimulada foram coletadas e inoculadas em ágar de infusão cérebro-coração (ICC). Dentifrícios diluídos foram aplicados sobre os poços contendo ICC e incubados a 37 ºC por 24 horas em condições microaerofílicas. Solução salina e clorexidina a 0,12% foram usadas como controles. A atividade antimicrobiana foi determinada em duplicata pela técnica de difusão nos poços de ágar. Os halos de inibição do crescimento bacteriano foram registrados em mm. A análise estatística foi realizada usando ANOVA e teste de Tukey (p < 0,05). Resultados: Todos os dentifrícios mostraram atividade antimicrobiana, quando comparados com os controles negativos. O dentifrício contendo triclosan mostrou a maior atividade antimicrobiana, seguido, nessa ordem por dentifrício contendo xilitol e 750 ppm de fluoreto de sódio, clorexidina, dentifrício contendo 1100 ppm de fluoreto de sódio, dentifrício contendo xilitol e 500 ppm de fluoreto de sódio e pela solução salina. Conclusão: O dentifrício contendo triclosan e xylitol apresentou excelente atividade antimicrobiana podendo ser considerado uma vantajosa opção para crianças, contribuindo para o controle das cáries dentárias e reduzindo a ingestão de fluoretos.(AU)

Experimental Calcium Silicate-Based Cement with and without Zirconium Oxide Modulates Fibroblasts Viability

The aim of this study was to verify whether the use of zirconium oxide as a radiopacifier of an experimental calcium silicate-based cement (WPCZO) leads to cytotoxicity. Fibroblasts were treated with different concentrations (10 mg/mL, 1 mg/mL, and 0.1 mg/mL) of the cements diluted in Dulbecco's modified Eagle's medium (DMEM) for periods of 12, 24, and 48 h. Groups tested were white Portland cement (WPC), white Portland cement with zirconium oxide (WPCZO), and white mineral trioxide aggregate Angelus (MTA). Control group cells were not treated. The cytotoxicity was evaluated through mitochondrial-activity (MTT) and cell-density (crystal violet) assays. All cements showed low cytotoxicity. In general, at the concentration of 10 mg/mL there was an increase in viability of those groups treated with WPC and WPCZO when compared to the control group (p<0.05). A similar profile for the absorbance values was noted among the groups: 10 mg/mL presented an increase in viability compared to the control group. On the other hand, smaller concentrations presented a similar or lower viability compared to the control group, in general. A new dental material composed of calcium silicate-based cement with 20% zirconium oxide as the radiopacifier showed low cytotoxicity as a promising material to be exploited for root-end filling.

Resumo O objetivo deste estudo foi verificar se o uso do óxido de zircônia como radiopacificador de um cimento experimental à base de silicato de cálcio (WPCZO) levou a citotoxicidade. Os fibroblastos foram tratados com diferentes concentrações (10 mg/mL, 1 mg/mL e 0,1 mg/mL) dos cimento diluídos em meio Eagle modificado por Dulbecco (DMEM) durante períodos de 12, 24, e 48 horas. Os grupos testados foram: cimento Portland (WPC), cimento Portland branco com óxido de zircônio (WPCZO) e MTA Angelus branco (MTA). No grupo controle as células não foram tratadas. A citotoxicidade foi avaliada por meio da mitocondrial-atividade (MTT) e ensaio de densidade celular (cristal violeta). Todos os cimentos apresentaram baixa citotoxicidade. Em geral, na concentração de 10 mg/mL, houve um aumento na viabilidade desses grupos tratados com WPC e WPCZO quando comparado com o grupo controle (p <0,05). Um perfil semelhante para os valores de absorvância foi observado entre os grupos: 10 mg/mL apresentaram um aumento da viabilidade em relação ao grupo controle. Por outro lado, as concentrações menores apresentaram uma viabilidade semelhante ou inferior em comparação com o grupo controle, em geral. Um novo material odontológico composto de cimento à base de silicato de cálcio com 20% de óxido de zircônio, como o radiopacificador, apresentou baixa citotoxicidade e pode ser explorado como um material promissor para retrobturações.

Cell density and solvent are critical parameters affecting formazan evaluation in MTT assay

The aim of this study was to establish the more accurate protocol for fibroblast cell viability using MTT assay. NIH/3T3 fibroblasts were seeded at the following cell densities: 3.125x10³; 1.156x10(4); 3.125x10(4); 1.156x10(5) and 3.125x10(5) cells/cm². Following 24h of seeding, MTT was added to the wells. After 4h of the MTT addition, different solvents were added to solubilize the formazan crystals: 1) HCl/SDS group- 20% SDS and 0.01 M HCl; 2) EtOH/ HAc group-50% ethanol and 1% acetic acid; 3) DMSO group- 99.5% dimethyl sulfoxide; and 4) PropOH group- 99.5% isopropanol. The absorbance values were measured using a spectrophotometer at 570 nm. The data were analyzed by 2-way ANOVA (p<0.05) and showed that the absorbance average varied according to the number of cells and solvents: HCl/SDS (0 to 0.13), EtOH/HAc (0 to 0.22), DMSO (0.76 to 1.31) and PropOH (0.66 to 1.04). The DMSO and PropOH groups presented the most appropriate protocols for NIH/3T3 fibroblasts cell viability, especially at the density of 1.156x10(4) cells/cm².

Educação na Saúde: fundamentos e perspectivas / Health Education: fundamentals and perspectives

Quando pensamos no Estudo Multicêntrico, pensamos no científico e no popular (de povo, de tradição, de memória e experiência), em diálogo nos territórios da Atenção Básica em Saúde do país. Como prevenir e promover saúde em meio a uma doença que ocupou quase todos os espaços da vida social? A covid-19 estava nas conversas sérias da ciência, no jornal das televisões, nas mensagens de Whatsapp™, nas orientações dos profissionais da saúde, nas trocas de receitas caseiras, no debate político. Assim, iniciamos com a pergunta: como a população está "traduzindo" as orientações médico-científicas, como estão se prevenindo e, ao mesmo tempo, estão se informando sobre a pandemia? Foram convidados a fazer parte do estudo os alunos, docentes e coordenadores do Mestrado Profissional em Saúde da Família ­ PROFSAÚDE, sendo um projeto estruturante do Programa, que deu origem ao grupo de pesquisa do CNPq "Territórios, Modelagens e Práticas em Saúde da Família". O estudo envolveu 21 instituições da Rede, de todas as regiões do país, com a aplicação em 128 Unidades Básicas de Saúde, nos 88 municípios de atuação dos mestrandos no país. Assim, participaram mais de 200 alunos e, pelo menos, 100 docentes e orientadores, tendo sido entrevistadas 7.085 famílias. Foi um verdadeiro mutirão nacional, enriquecido com as nuances locais e regionais. Os resultados da pesquisa mostram que a dinâmica territorial que aproxima as ações de saúde à vida das pessoas foi fundamental no enfrentamento e na mitigação de impactos de emergências sanitárias como a pandemia da covid-19. O estudo multicêntrico desenvolvido pelo Programa reitera a grande capilaridade da Rede PROFSÁUDE no território nacional, na produção de conhecimento técnico e científico para o aprimoramento da Estratégia de Saúde da Família e confirma seu compromisso com a formação de profissionais de saúde e com o fortalecimento do Sistema Único de Saúde.