Principais causas de internação de crianças menores de cinco anos no Brasil: Uma revisão sistemática / Information systems used for planning and evaluation in oral health

Objetivo: Descrever as principais causas de hospitalizações de crianças menores de 05 anos no Brasil. Métodos: Revisão sistemática realizada emoitobases de dados. Estratégia de busca estruturada em pergunta norteadora. Foram selecionados estudos observacionais, completos, publicados de 2010 até maio de 2021.Resultados: Foram identificados 1512 artigos, 23 foram submetidos a análise, envolvendo 3.648.861 internações. Discussão: A maioria dos estudos foi do tipo Ecológico n=10(47,62%),Transversais n=6(23,80%) e estudos descritivos n=5(19,04%); os demais envolveram 1 Editorial (4,76%)e1 Caso Controle (4,76%). Quanto ao nível de evidência, 10 estudos (47,62%) foram classificados com o nível de evidência 2c (grau de evidência B), e outros 11(47,62%) apresentaram nível de evidência 4 (grau de evidência C), um estudo (4,76%) apresentou nível 3b (grau de evidência B). As principais causas de hospitalizações de crianças menores de 05 anos no Brasil de 2010 até maio de 2021 foram: doenças respiratórias, seguidas pelas gastroenterites e doenças parasitárias, doenças sensíveis à Atenção Primária à Saúde. Conclusão: Entre asprincipais causas de hospitalizações de crianças menores de 05 anos no Brasil, 2010 a 2021, predominam as doenças respiratórias, as gastroenteritese doenças parasitárias. O avanço e as melhorias na Atenção Primária à Saúde e do Programa Nacional de Imunização foram relacionados à redução das internações nas regiões brasileiras.

Objective: To describe the main causes of hospitalization of children under 05 years in Brazil.Methods: Systematic review performed in eightdatabases. Search strategy structured in guiding question. Observational, complete studies published from 2010 to May 2021 were selected.Results: 1512 articles were identified, 23 were analyzed, involving 3,648,861 admissions.Discussion: Most studies were of the Ecological type n=10(47.62%), Cross-sectional n=6(23.80%) and descriptive studies n=5(19.04%); the others involved 1 Editorial (4.76%); 1 Case Control (4.76%). As for the level of evidence, 10 studies (47.62%) were classified with level of evidence 2c (degree of evidence B), and another 11 (47.62%) had level of evidence 4 (degree of evidence C), one study (4.76%) presented level 3b (degree of evidence B). The main causes of hospitalizations of children under 05 years in Brazil from 2010 to May 2021 were: respiratory diseases, followed by gastroenteritis and parasitic diseases, primary health care sensitive diseases.Conclusion: Among the main causes of hospitalization of children under 05 years in Brazil, 2010 to 2021, predominate respiratorydiseases, gastroenteritis and parasitic diseases. Advances and improvements in Primary Health Care and the National Immunization Program were related to the reduction of hospitalizations in Brazilian regions

Acesso a bens e serviços de saúde dos planos de saúde por meio da judicialização: um estudo do estado de São Paulo / Access to health goods and services in health plans through the judicialization: a study of the State of São Paulo / Acceso a bienes y servicios de salud en planes de salud a través de la judicialización: un estudio del estado de São Paulo

Objetivo: analisar o acesso a bens e serviços de saúde dos planos de saúde por meio da judicialização, descrevendo o perfil das ações, implicações do direito à saúde e da gestão da saúde. Metodologia: pesquisa exploratória, descritiva, na qual foram analisados 513 acórdãos do Tribunal de Justiça de São Paulo, de 2007 a 2017. Resultados: os resultados apontam negativas de coberturas (42,45%), e problemas relacionados a contratos (26,20%), reajustes (16,50%), rede credenciada (7,20%), aposentados e demitidos (7,00%) e danos morais (0,65%). Dentre as exclusões de cobertura, 46% dos usuários de planos de saúde buscaram acesso à cobertura para o tratamento de doenças ou eventos relacionados à saúde: medicamentos (28,7%), exames (18,5%), órteses e próteses (12,5%) e hospitalização (12,00%). Em 82% dos acórdãos, as decisões judiciais foram favoráveis aos usuários. Conclusões: a judicialização para acesso a bens e serviços de saúde dos planos de saúde envolve principalmente negativas de cobertura (exclusões e limitações de cobertura) e conflitos contratuais (principalmente contratos antigos). Nos limites desta pesquisa, pode-se concluir também que há indícios de que os gestores da saúde suplementar precisam pensar em reorientar algumas de suas condutas, verificar falhas e disfunções, e observar possíveis lacunas de regras ou leis para a regulamentação de consumo no sistema de saúde suplementar de atenção à saúde, buscando assim minimizar a judicialização e alcançar práticas mais integrais de assistência à saúde nesse segmento.

Objective: to analyze access to health goods and services of health plans through judicialization, describing the profile of actions, implications of the right to health and health management. Methods: exploratory, descriptive research, in which 513 judgments of the São Paulo Court of Justice were analyzed, from 2007 to 2017. Results: the results indicate negative coverage (42.45%), and problems related to contracts (26.20 %), readjustments (16.50%), accredited network (7.20%), retired and dismissed workers (7.00%) and moral damages (0.65%). Among the exclusions from coverage, 46% of health plan users sought access to coverage for the treatment of diseases or health-related events: medications (28.7%), exams (18.5%), orthoses and prostheses (12.5%) and hospitalization (12.00%). In 82% of the judgments, the court decisions were favorable to the users. Conclusions: judicialization for access to health goods and services from health plans mainly involves denials of coverage (exclusions and limitations of coverage) and contractual conflicts (mainly old contracts). Within the limits of this research, it can also be concluded that there are indications that health supplement managers need to think about redirecting some of their behaviors, verify faults and dysfunctions, and observe possible gaps in rules or laws for the regulation of consumption in the supplementary health care system, seeking as well to minimize judicialization and achieve more comprehensive health care practices in this segment.

Objetivo: analizar el acceso a los bienes y servicios de salud de los planes de salud a través de la judicialización, describiendo el perfil de las acciones, las implicaciones del derecho a la salud y la gestión de la salud. Metodología: investigación exploratoria, descriptiva, en la que se analizaron 513 sentencias del Tribunal de Justicia de São Paulo, de 2007 a 2017. Resultados: los resultados indican cobertura negativa (42,45%), y problemas relacionados con los contratos (26,20%), reajustes ( 16,50%), red acreditada (7,20%), trabajadores jubilados y despedidos (7,00%) y daños morales (0,65%). Entre las exclusiones de cobertura, el 46% de los usuarios de planes de salud buscaron acceder a coberturas para el tratamiento de enfermedades o eventos relacionados con la salud: medicamentos (28,7%), exámenes (18,5%), órtesis y prótesis (12,5%) y hospitalización (12,00%). En el 82% de las sentencias, las decisiones judiciales fueron favorables a los usuarios. Conclusiones: la judicialización para el acceso a bienes y servicios de salud de los planes de salud involucra principalmente denegaciones de cobertura (exclusiones y limitaciones de cobertura) y conflictos contractuales (principalmente contratos antiguos). Dentro de los límites de esta investigación, también se puede concluir que existen indicios de que los gestores de salud complementarios necesitan pensar en reorientar algunos de sus comportamientos, verificando fallas y disfunciones, y observar posibles vacíos en las normas o leyes para la regulación del consumo en la de atención complementaria a la salud, buscando así minimizar la judicialización y lograr prácticas más integrales de atención a la salud en este segmento.

Dysgeusia and COVID-19: the Importance of the Dentist in the Diagnostic

ABSTRACT: Dysgeusia is understood as changes in the perception of taste in patients infected with COVID-19 and has been frequently observed in the early stages of the disease. Along with the causes of dysgeusia, we can mention the correlation with infectious conditions, being of importance for the differential diagnosis. Dysgeusia can be considered one of the first manifestations of COVID-19, being an important contribution in the search for solutions regarding early diagnosis and treatment, in addition to its hospital and laboratory application.

RESUMEN: La disgeusia se entiende como cambios en la percepción del gusto en pacientes infectados por COVID-19 y se ha observado con frecuencia en las primeras etapas de la enfermedad. Junto a las causas de la disgeusia, podemos mencionar la correlación con patologías infecciosas, siendo de importancia para el diagnóstico diferencial. La disgeusia se puede considerar como una de las primeras manifestaciones del COVID-19, siendo un aporte importante en la búsqueda de soluciones en cuanto al diagnóstico y tratamiento precoces, además de su aplicación hospitalaria y de laboratorio.

Biossegurança para prevenção da contaminação cruzada na prática odontológica / Biosafety to prevent cross-infection in dental practice

O objetivo desse manual é servir como um guia para os discentes, docentes e funcionários da Faculdade de Odontologia de Piracicaba em relação às medidas a serem adotadas para que se promovam boas práticas de biossegurança durante os procedimentos de prestação de serviços de saúde

A judicialização de demandas odontológicas e o direito à saúde / Judicialization of dental demands and the right to health

RESUMO O arcabouço jurídico-legal que estruturou o Sistema Único de Saúde influenciou significativamente a evolução da saúde bucal coletiva, no entanto, seu acesso ainda constitui um dos principais desafios da gestão dos sistemas de saúde. À luz dos direitos humanos, o direito à saúde bucal é um direito indissociável da saúde geral. Objetivou-se analisar a judicialização de demandas odontológicas fundamentadas no direito à saúde previsto na Constituição Federal de 1988. Trata-se de um estudo exploratório, descritivo, realizado em base de dados secundários, obtidos nos acórdãos de segunda instância do Tribunal de Justiça de São Paulo, de janeiro de 2016 a abril de 2019. Os resultados foram categorizados e analisados por estatística descritiva. As ações judiciais relativas à odontologia buscam, principalmente: indenizações por danos morais e materiais - 336 acórdãos (65%); indenização pela má qualidade da prestação de serviços odontológicos - 114 acórdãos (22%); e negativa de cobertura de procedimento e/ou materiais, por planos de saúde - 63 acórdãos (13%). As ações por erro odontológico aumentaram 305%, passando de 22 acórdãos, em 2016, para 99, em 2018. Conclui-se que as demandas judiciais referentes à odontologia estão mais voltadas às indenizações materiais e morais da prestação de serviços do que ao acesso e à efetivação de direitos constitucionais à saúde bucal.

ABSTRACT The legal-regulatory framework that structured the Unified Health System significantly influenced the evolution of collective oral health, however, access is still one of the main challenges of health systems management. In the light of human rights, the right to oral health is an inseparable right of general health. The objective of this research was to analyze the judicialization of dental demands based on the right to health provided for in the 1988 Federal Constitution. This is an exploratory, descriptive study, carried out in secondary database, obtained in the court decision of the second instance of the Court of Justice of São Paulo, from January 2016 to April 2019. The results were categorized and analyzed by descriptive statistics. The lawsuits related to Dentistry seek, mainly: indemnity for moral and material damages - 336 court decision (65%), indemnity for poor quality of dental services - 114 court decisions (22%), and negative procedural and/or material coverage. by health insurance - 63 court decisions (13%). Lawsuits for dental error increased by 305% from 22 court decision, in 2016, to 99 court decision, in 2018. It is concluded that the judicial demands in the dental area are more focused on the material and moral indemnities of the provision of dental services than for access and enforcement of constitutional rights to oral health.

A Judicialização da saúde nos sistemas público e privado de saúde: uma revisão sistemática / Judicialization of health in the public and private health systems: a systematic review / Judicialización de la salud en los sistemas público y privado de salud: una revisión sistemática

No Brasil, o direito à saúde tem previsão constitucional e universal. No entanto, a via judicial tem sido muito utilizada para acesso a bens e serviços de saúde. Assim, o objetivo deste artigo foi revisar a literatura sobre a judicialização da saúde entre 2004 e 2017. A partir de pergunta estruturada, foram revisadas as bases de dados PubMed/MEDLINE, Lilacs, SciELO, Scopus e Bireme/BVS. A maioria das ações refere-se a medicamentos. Houve consenso quanto à característica individual das litigações, à preponderância da prescrição médica e à constitucionalidade da saúde integral. Há divergências em relação a possíveis interferências das decisões judiciais na gestão e na efetivação das políticas públicas e do direito à saúde. Estudos apontam falhas na gestão e disfunções nos sistemas de saúde. Os perfis das demandas de saúde levados à justiça podem auxiliar os gestores de saúde na reorientação das práticas assistenciais.(AU)

In Brazil, the right to health has a constitutional and universal provision. However, litigations have been frequently used to guarantee access to health goods and services. The objective of this study is to review the literature about judicialization of health from 2004 to 2017. Based on a structured question, the databases PubMed/MEDLINE, LILACS, SciELO, Scopus and BIREME/BVS were reviewed. The majority of lawsuits refers to medications. There was a consensus concerning the individual characteristic of the litigations, the preponderance of medical prescription, and the constitutionality of integral health. There are divergences regarding possible interferences of legal decisions in management and in the effectuation of public policies and of the right to health. Studies show management failures and dysfunctions in health systems. The profiles of health demands taken to the court can help health managers in the reorientation of care practices.(AU)

En Brasil, el derecho a la salud tiene previsión constitucional y universal. No obstante, la vía judicial se ha utilizado mucho para tener acceso a bienes y servicios de salud. El propósito del estudio fue revisar la literatura sobre la judicialización de la salud entre 2004 a 2017. A partir de una pregunta estructurada, se revisaron las bases de datos PubMed/MEDLINE, LILACS, SciELO, Scopus y BIREME/BVS. La mayoría de las acciones se refiere a medicamentos. Hubo consenso sobre la característica individual de los litigios, la preponderancia de la prescripción médica y la constitucionalidad de la salud integral. Hay divergencias sobre posibles interferencias de las decisiones judiciales en la gestión, en la realización efectiva de las políticas públicas y del derecho a la salud. Estudios señalan fallas en la gestión y disfunciones en los sistemas de salud. Los perfiles de las demandas de salud llevados ante los tribunales pueden auxiliar a los gestores de salud en la reorientación de las prácticas asistenciales.(AU)

Gestão compartilhada: percepções de profissionais no contexto de Saúde da Família / Shared management: perceptions of professionals in the family health context / Gestión compartida: percepciones de profesionales en el contexto de salud de la familia

Espera-se como objetivo deste estudo conhecer as percepções dos profissionais das equipes de Saúde da Família sobre a temática da gestão compartilhada. Foi realizado com base nos pressupostos teóricos da pesquisa qualitativa, utilizando o método da Análise de Conteúdo na modalidade temática. O universo de estudo foi constituído de 25 trabalhadores das Unidades de Saúde da Família (USF) com equipes de saúde bucal. Os dados foram obtidos inicialmente por entrevistas semiestruturadas, gravadas em áudio e posteriormente transcritas. A análise temática revelou uma categoria: Percepções sobre gestão compartilhada, com os temas "Gestão descentralizada" e "Gestão centralizada" e seus respectivos subtemas. Concluiu-se que, para os trabalhadores, gestão compartilhada é um processo participativo. Eles valorizam a participação e a democracia nas equipes para que se possa trabalhar em uma proposta de gestão mais horizontal. Porém, foram apontados modelos de gestão verticalizados, centralizados no enfermeiro.(AU)

The objective of the present study was to understand the perceptions of professionals from family health teams regarding the subject of shared management. It was based on the theoretical framework of qualitative research, using the thematic modality of the content analysis method. The study sample was 25 employees from family health units with oral health teams. Data were obtained through semi-structured interviews, whose audios were transcribed. Thematic analysis revealed the thematic category perceptions regarding shared management, with the subjects decentralized and centralized management and their respective subthemes. It was concluded that the employees consider that shared management is a participative process. They value participation and democracy in teams, so it is possible to develop a more horizontal management model. However, the results pointed to a prevalence of vertical management models, focused on nurses.(AU)

Se espera, como objetivo de este estudio, conocer las percepciones de los profesionales de los equipos de salud de la familia sobre la temática de la gestión compartida. Se realizó con base en los supuestos teóricos de la investigación cualitativa, utilizando el método del Análisis de Contenido en la modalidad temática. El universo de estudio lo constituyeron 25 trabajadores de las Unidades de Salud de la Familia con equipos de salud bucal. Los datos se obtuvieron inicialmente por medio de entrevistas semi-estructuradas, grabadas en audio y con trascripción posterior. El análisis temático reveló una categoría temática: percepciones sobre gestión compartida, con los temas Gestión Descentralizada y Centralizada y sus correspondientes subtemas. Se concluyó que, para los trabajadores, gestión compartida es un proceso participativo. Ellos valoran la participación y la democracia en los equipos para que se pueda trabajar en una propuesta de gestión más horizontal. No obstante, se señalaron modelos de gestión verticalizados, centralizados en el enfermero.(AU)

Dental age assessment: Which is the most applicable method?

To evaluate which method is the most applicable for estimating estimate dental age in Brazilian children, Nolla or Demirjian. For this purpose, both methods were reviewed and the differences between them brought to light. A total of 403 healthy children between the ages of 7 and 13 years with satisfactory panoramic radiographs, similar socio-economic background and ethnic origin were included. Panoramic radiographs were examined by the Nolla and Demirjian methods. Dental age was calculated for both methods, and the differences between the dental age and the chronological age were compared with analysis of variance with post hoc Dunnett. The Nolla method showed no significant difference in relation to chronological age in the majority of age groups for boys and girls, except for 12-year-old boys (over-estimation of 1.00) and between 11- and 12-year-old girls (over-estimation of 0.51 and 0.59, respectively). An over-estimation of the dental age was observed by using the Demirjian method (for boys 0.89-1.84 and for girls 0.69-1.97) for all age groups. The Nolla method is suitable for Brazilian children when it comes to age estimate with care to growth spurt beginning (around 11 and 12 years). However, the Dermijian method should not be used, because it over-estimated the age in both sexes.

Assessment of glycosylated hemoglobin (HbA1c) in type 2 diabetics before and after non-surgical periodontal treatment. A short-term follow-up study

Aim: To evaluate glycosylated hemoglobin (HbA1c) before and after non-surgical periodontal treatment in patients with type 2 diabetes mellitus (DM-2). Methods: Twenty subjects diagnosed with periodontitis and DM-2 were treated using an NSPT protocol. Periodontal examination and blood measurements were performed at baseline and after three months. Patients with DM-2 treated for at least a year, with at least 10 teeth and with probing depths between 4-6 mm in more than three regions were included. The variables evaluated were HbA1c in blood and periodontal measures (probing depths, insertion level, gingival bleeding on probing, dental plaque, calculus, inflammation, clinical attachment and mobility). All patients were informed of the conditions of the therapy used. Scaling and root planning (SRP) of the full mouth was performed using an ultrasonic scaler and hand instrument under local anesthesia, supragingival prophylaxis and oral hygiene instruction. Also, 0.12% chlorhexidine digluconate was formulated twice a day for two weeks. Statistical analyses were performed using StataIC 14. The values are shown as the mean, median and standard deviation (SD) or interquartile rank (IR), and p<0.05 was considered significant. Results: Twenty subjects completed the three-month follow-up and were included in the analysis. Three months after the non-surgical periodontal treatment, most periodontal parameters had a meaningful reduction (p< 0.05) and a large effect size >0.8. Clinical attachment level showed no improvement. The HbA1c values were not significantly decreased (p=0.94). Conclusions: Although non-surgical periodontal therapy eliminates local inflammation, it is insufficient to significantly reduce HbA1c levels in a short time period

Sex estimation in brazilian sample: qualitative or quantitative methodology?

Aim: This study carried out cranial measurements (in mm) [Zygion-Zygion (Zy-Zy); Zygion-Glabella-right side (Zy-Ga-right); Zygion-Glabella-left side (Zy-Ga-left); Zygion-Glabella-mean (Zy-Ga-mean); Rhinion-Anterior Nasal Spine (Rhi-ANS); Nasal Width (Na Wid); Nasion-Anterior Nasal Spine (Na-ANS); Glabella-Anterior Nasal Spine (Ga-ANS); Glabella-Prosthion (Ga-Pr)], to verify whether they are dimorphic. Methods: We used skulls from the Eduardo Daruge Laboratory of Forensic Physical Anthropometry, which did not present growth abnormalities and belonged to the age range of 18 to 100 years. Linear measurements were performed by digital caliper, properly calibrated. Inter and intra-calibrator calibration was performed by obtaining as result the value of 0.98 (considered excellent). Results: We found that all measures carried out are dimorphic, and we were able to create a logistic regression model (logit: Sex = −33.6 + (0.15 × Zy-Zy) + (0.21 × Rhi-ANS) + (0.16 × Na-ANS)) to estimation the sex. Conclusions: We concluded that the developed quantitative method results in 85.2% sensitivity, 76.2% specificity, and 81.1% accuracy, being, therefore, more effective in the prediction of sex than the mere random hit (AU)

Utilização de Índices Radiomorfométricos em Exames de Imagem

A radiomorfometria consiste na aplicação de índices para avaliação da morfologia óssea em exames de imagem, principalmente em radiografias panorâmicas. Objetivo: o objetivo deste estudo é analisar as principais indicações dos índices radiomorfométricos em estudos publicados na literatura científica. Métodos: uma busca textual foi realizada utilizando a palavra-chave "radiomorphometric indices" na base de dados PubMed, procurando responder à seguinte questão: Qual a aplicação dos índices radiomorfométricos em exames de imagem? Resultados: 36 artigos sobre esse tópico foram identificados entre os anos de 1999 a 2016, sendo o periódico Dentomaxillofacial Radiology o que possui a maior quantidade de estudos (25,0%). Conclusão: a principal utilização dos índices radiomorfométricos inclui a avaliação da densidade óssea de diferentes grupos de pacientes, podendo não apresentar qualquer alteração sistêmica ou possuir doenças, como osteoporose e osteogênese imperfeita. As vantagens dos índices radiomorfométricos incluem principalmente acessibilidade e baixo custo, porém requerem conhecimento e treinamento técnico.

Absenteeism study in a steel industry of São José dos Campos, SP, Brazil

Aim: To identify the factors involved in absenteeism in a steel industry in the city of São Jose dos Campos, São Paulo, Brazil. Methods: A cross-sectional study was carried out after obtaining permission from Institutional Ethics Committee in a steel industry. Worker's detailed information regarding absenteeism was obtained from the Health Department files, from January 2005 to December 2008. Specifical data were: sex, function, certificate type (medical or dental), the working sector, according to the Large Groups (LG) of Brazilian Classification of Occupations - 2002, working periods, duration of absenteeism (lost days), the main causes of absenteeism (International Classification of Diseases ICD-10). Results: A total of 570 workers were recorded. The majority of workers were males (97%), with medical certificate (97%), LG-7 workers in the production of industrial goods and services (62.09%), and operators of industrial machinery (68.3%) and the working period was Shift 4 - Monday to Friday from 8 am to 12 am and 1 pm to 5 pm (44.43 %). The total duration of absenteeism was 3,187 days, the main causes of diseases being problemas in the musculoskeletal system and connective tissue (18.48%), respiratory diseases (17.11%), injuries, poisoning and other external causes (11.24%), and diseases of the digestive tract (11.24%). Conclusions: It was concluded that there was under-reporting of absenteeism due to dental causes (41 events) during the study period. More studies in this field are required (Au)

Oral health quality of the workers of a telemarketing company and their satisfaction with the treatments provided by the corporative dental insurance plan

Aim: To evaluate the oral health quality of the workers of a telemarketing company and their satisfaction with the dental treatments provided by the corporative dental insurance plan. Methods:Data collection was by an online intranet questionnaire on dental service providers from Uberlândia/MG and Campinas/SP. It was addressed to 6000 associates, with objective and subjective questions, comprising the level of the telemarketing operators’ oral health, dental needs, satisfaction with dental care providers and the importance of having the laboral dental services provided by the company. Results: After analysis of the results, we observed that:57.52% of the workers required improvement in their oral health and 56.03% mentioned prevention as the largest need, 66.70% use the dental providers’ services, but only 31.34%were satisfied with them. Conclusions: The results underscore that the workers have anintermediate level of dental needs, with prevention as top importance. Additionally, establishment of a basic attention program inside the company would increase the satisfaction and adhesionindexes of providers and the workers’ oral health.

Systemic and oral alterations associated with stress in nurses of public referral hospital

Jobs that require great responsibility can cause serious damage to the body such as stress and its consequences. Stress can be one of the triggers of disease systemic and oral diseases in different professionals. Aim: To associate emotional stress with the systemic and oral alterations in the nurses of public referral hospital. Methods: All 60 nurses of both genders, with higher education level, different ethnicities and ages were invited to join this study. Nurses filled out the Inventory of Stress Symptoms for Adults (ISSL) and questionnaire of diseases/psychosomatic symptoms. Next, they were subjected to a stomatological examination of the oral cavity, according to the Boraks (1996) criteria. Stress was associated with most outstanding psychosomatic and oral variables by the Fisher's exact test for calculating the p value (0.05). Results: The sample was comprised of 37 nurses, most of them female (91.9%), young (83.7% are less than 36-years old), full range 22-50 years old, white ethnicity (86.5%). The level of stress in level II (resistance) and III (exhaustion) was observed in 51.3% of the nurses. Symptoms of headache and gain of body weight lately were present in 48.6% of the nurses. With regard to oral alterations, 32.4% reported cold sore sometimes and 59.5% nibbled mucosa always. There was no significant association between the stress and psychosomatic and oral variables. Conclusions: Based on the results of this study it may be concluded that the nursing profession can lead to emotional stress, although no significant association between stress and disease/psychosomatic and oral symptoms was found. Future studies should be performed to evaluate this association.

Chemical salivary composition and its relationship with periodontal disease and dental calculus

Aim: To determine the relationship between the chemical composition of saliva, periodontal disease and dental calculus. Methods: An observational analytical cross-sectional study was conducted with patients over 55 years of age. Ethical principles of autonomy and risk protection were applied according to the international standards. Sociodemographic and diagnosis variables (presence of dental calculus and periodontal status) were considered to measure salivary concentrations of glucose (by the glucose oxidase/peroxidase method, amylase (by the colorimetric test), urea (by the amount of indophenol), total protein (by the Bradford method) and albumin (by the nephelometric method). Patients chewed a sterile rubber band and 3 mL of stimulated saliva were collected. The samples were stored at -5 °C, centrifuged at 2,800 rpm for 10 min, and the supernatant was removed and stored at -20 °C. Data were presented as frequencies and proportions for qualitative variables and measures of central tendency and dispersion for quantitative variables. Data were analyzed by either analysis of variance or Kruskal Wallis test . A p value <0.05 was considered statistically significant. Results: Significant relationships were observed between the concentration of salivary urea and periodontal status (p = 0.03) and the presence of dental calculus and urea (p = 0.04) was demonstrated. Conclusions: A relationship between the salivary urea concentration and the presence of periodontal disease and dental calculus is suggested.

Periapical status and prevalence of endodontic treatment in institutionalized elderly.

The aim of this study was to determine the prevalence and frequency of apical periodontitis and root fillings in 450 institutionalized Brazilian elderly. The teeth with apical periodontitis were assessed using the Periapical Index (PAI) score. A total of 942 teeth were evaluated in 98 subjects (57 females and 41 males) with mean age of 74 years. The observed frequency of total edentulous subjects was high (76%) in this population. A total of 126 teeth showed root fillings, of these only 46 (36.5%) were scored as having adequate quality. Apical periodontitis was found in 114 teeth (12.1%) in 42 (42.9%) subjects. 80 (70.2%) inadequate root-filled teeth showed apical periodontitis. There was a significant correlation between the presence of periapical pathology and inadequate root-filled teeth. Inadequate root-filled teeth were associated with an increased prevalence of apical periodontitis in these subjects. This fact may result in increased endodontic retreatment needs for this population.

Periapical Status and Prevalence of Endodontic Treatment in Institutionalized Elderly

The aim of this study was to determine the prevalence and frequency of apical periodontitis and root fillings in 450 institutionalized Brazilian elderly. The teeth with apical periodontitis were assessed using the Periapical Index (PAI) score. A total of 942 teeth were evaluated in 98 subjects (57 females and 41 males) with mean age of 74 years. The observed frequency of total edentulous subjects was high (76%) in this population. A total of 126 teeth showed root fillings, of these only 46 (36.5%) were scored as having adequate quality. Apical periodontitis was found in 114 teeth (12.1%) in 42 (42.9%) subjects. 80 (70.2%) inadequate root-filled teeth showed apical periodontitis. There was a significant correlation between the presence of periapical pathology and inadequate root-filled teeth. Inadequate root-filled teeth were associated with an increased prevalence of apical periodontitis in these subjects. This fact may result in increased endodontic retreatment needs for this population.

O objetivo deste estudo foi determinar a prevalência e a freqüência de periodontite apical e de tratamentos endodônticos em 450 idosos brasileiros institucionalizados. Os dentes com periodontite apical foram avaliados com uso do Índice Periapical (PAI). Um total de 942 dentes foram avaliados em 98 pacientes (57 mulheres; 41 homens), com média de idade de 74 anos. A freqüência observada do total de indivíduos desdentados foi alta (76%) nesta população. 126 dentes apresentaram tratamento endodôntico, destes apenas 46 (36,5%) foram classificados como de qualidade adequada. Periodontite apical foi encontrada em 114 dentes (12,1%) em 42 (42,9%) sujeitos. 80 (70,2%) dentes com tratamento endodôntico inadequado apresentaram periodontite apical. Houve uma correlação significativa entre a presença de patologia periapical e dentes com tratamento endodôntico inadequado. Os dentes com tratamento endodôntico inadequado foram associados com uma maior prevalência de periodontite apical nestes indivíduos. Este fato pode resultar em aumento das necessidades de retratamento para esta população.

Cost analysis of materials used in Class III, IV and V composite resin restorations

AIM: To assess the total cost of direct and indirect materials used in Class III, IV and V composite resin direct restorations. METHODS: The calculation of costs was based on the method of variable costing system. A list of the materials was obtained by a panel of experts and based on the excellence standards established in the literature for dental team treatment. The cost considered for each material was obtained from an average of the costs found in the regional supplier market (US$1.0=R$2.12). The repetitions were obtained from Class III, IV and V cavities in artificial pre-manufactured teeth. The cavities were classified as shallow, medium and deep. The materials were quantified for each type of preparation. Seven brands of composite resins were used and weighed on a precision scale after their insertion in each cavity. The data were analyzed by descriptive statistics and non-parametric Friedman's test (α=0.05). RESULTS: The mean costs were US$7.96 (R$16.88) for Class III restoration, US$8.13 (R$17.24) for Class IV, and US$7.84 (R$16.62) for Class V. There was statistically significant difference in cost between the types of cavities and depth classification. The small cost difference among the different resin brands resulted in no statistically significant differences in the total cost of the restorations. CONCLUSIONS: The costs obtained in this survey may be used in the calculation of the final cost of restorative procedures, helping in the management of public or private dental care services.