Contribuição do Pró-Saúde para a reorientação da formação em Odontologia e implementação das Diretrizes Curriculares Nacionais: estudo de casos / Contribution of Pró-Saúde to a reorientation of Dental education and implementation of the National Curricular Guidelines: case studies

O Pró-Saúde é uma iniciativa do Ministério da Saúde com a parceria do Ministério da Educação, de amplo alcance e capilaridade, instituído e implementado a partir de 2006 e voltado para a reorientação da formação profissional em Saúde. O objetivo do presente estudo foi verificar de que forma e com quais estratégias estão sendo conduzidas as mudanças curriculares em cursos de graduação de Odontologia, em universidades públicas brasileiras, inscritas neste programa. Trata-se de um estudo de casos. Foram selecionados cinco cursos de graduação, um em cada macrorregião do país, e aplicados questionários de percepção aos coordenadores ou docente representante de cada curso, e a um grupo de estudantes, sobre as mudanças em processo. Os resultados apontaram que o Pró-Saúde tem sido um efetivo instrumento indutor de mudanças na direção da implementação das Diretrizes Curriculares Nacionais (DCN). Os estágios extramuros apresentam grande variação no seu planejamento e representam uma ferramenta importante para o desenvolvimento das competências requeridas pelas DCN. Em relação à abordagem pedagógica, ainda predominam práticas tradicionais baseadas na transmissão vertical de conhecimentos e a integração das disciplinas ocorre, principalmente, em seminários modulares e disciplinas profissionalizantes (AU).

Pro Health (Pró Saúde) is an initiative of the Ministry of Health in association with the Ministry of Education, with broad coverage and capillarity. It was instituted and implemented since 2006, creating a partnership between health courses with the secretariats of Health, involving, in the beginning, the Brazilian health System (SUS) services and, more recently, involving the other services of SUS, at a national level. The objective of the present study was to verify how and with what strategies the curricular changes are being conducted in undergraduate Dentistry courses at Brazilian public universities enrolled in Pro Health. It is a case study methodology. Five undergraduate courses were selected, one in each macro region of the country, and questionnaires of perception were applied to the coordinators or teaching staff representative of each course, and to a group of students, about the changes in the process. The results pointed out that the Pro Health has been a useful instrument to induce shifts in the direction of the implementation of the National Curricular Guidelines (NCR). The extramural stages present great variation in their planning and represent an important tool for the development of the competencies required by the NCR. Regarding the pedagogical approach, traditional practices based on the vertical transmission of knowledge still predominate, and the integration of the disciplines occurs, mainly, in modular seminars and professional disciplines (AU).

Estudo retrospectivo de 92 dentes decíduos avulsionados em 69 crianças atendidas em um serviço de urgência odontológica / A retrospective study of 92 avulsed primary teeth in 69 children assisted at a dental urgency service

O objetivo deste estudo foi avaliar os aspectos epidemiológicos da avulsão de dentes decíduos. A amostra do estudo foi composta por 69 pacientes (92 dentes avulsionados) atendidos no Serviço de Urgência Odontológica da Faculdade de Odontologia da Universidade Federal de Goiás, entre os anos de 1998 e 2005. As seguintes informações foram retiradas dos registros odontológicos de cada paciente: gênero, idade, fator etiológico, distribuição sazonal, grupo dentário, número de dentes avulsionados e tipo de tratamento. O tratamento estatístico analisou os dados frente à distribuição de frequência e qui-quadrado. O nível de significância foi de p<0,05. Observou-se elevada ocorrência de avulsões em meninos (52.17%) com 4 anos de idade (31.88%). Os principais fatores etiológicos foram quedas (82.61%) e acidentes de trânsito (5.80%). A maioria dos episódios de avulsão ocorreu durante os dias da semana (82.61%). A distribuição sazonal evidenciou elevado número de traumatismos nos períodos de março a junho (outono; n=28; 40.58%) e setembro a dezembro (primavera; n=18; 26.09%). O dente mais comumente afetado foi o incisivo central superior (68.48%), seguido pelo incisivo lateral superior (22.83%). As modalidades terapêuticas mais comumente realizadas foram exame clínico e anamnese (64 dentes; 69.57%) e mantenedor de espaço (18 dentes; 19.58%). Verificou-se elevado número de avulsões dentárias em meninos, com idade inferior a 4 anos e decorrentes de quedas...

The purpose of this study was to evaluate the epidemiological aspects associated with avulsion of primary teeth. The sample consisted of 92 avulsed teeth of 69 patients seen at the dental urgency service of the Dental School of the Federal University of Goiás, Brazil, from 1998 to 2005. The data obtained from the records included children's gender and age, causes of tooth avulsion, daily and monthly distribution, type and number of avulsed teeth and the treatment procedures. Frequency distribution and the chi-square test were calculated. The level of significance was set at 5% for all analyses. The highest incidence was found among boys (52.17%) aged 4 years (31.88%). The main etiologic factors were falls (82.61%) and traffic accidents (5.80%). Most cases occurred during weekdays (82.61%), from March to June (autumn; n=28; 40.58%) and from September to December (spring; n=18; 26.09%). Most avulsed teeth were maxillary central incisors (68.48%), followed by maxillary lateral incisors (22.83%). The most frequent treatments were analysis of clinical history and clinical exam (64 teeth; 69.57%) and space maintainer (18 teeth; 19.57%). The epidemiological and clinical aspects of tooth avulsion in this study were similar to those reported in other studies. There was a high number of avulsed primary teeth in boys aged less than 4 years and caused by falls...

Retrospective study of traumatic dental injuries in primary teeth in a Brazilian specialized pediatric practice.

OBJECTIVE: To determine the prevalence of traumatic dental injuries (TDI) in children younger than 7 years and the effect of predisposing clinical factors on their occurrence. MATERIAL AND METHODS: Dental records of 2725 children younger than 7 years seen in a private pediatric dental clinic in Goiânia, Brazil, from February 1993 to December 2008 were analyzed. A group of 150 children without traumatic injuries and with similar characteristics to those of the trauma group were used to study predisposing clinical factors as follows: lip coverage (adequate/inadequate), overbite (normal/negative/deep), and overjet (less or greater than 3 mm). Frequency distribution and a chi-square test were used for data analysis. The level of significance was set at 5%. RESULTS: Clinical and radiographic data of 412 injured deciduous teeth were found in 383 records. TDI prevalence was 11.9%, with no significant difference between sexes. The maxillary central incisors were the teeth most frequently affected (83.3%), and the most frequent type of injury was subluxation (35.1%). TDI was most prevalent in the 13-to-36-month age group (47.7%). Home (43.5%) was the main place of occurrence, followed by school (10.1%); falls (50.3%) were the most common cause, followed by collisions with objects (18.2%). The first examination or treatment occurred in the first 24 h in 46.5% of the cases. The analysis of the association of predisposing clinical factors with TDI revealed no differences in lip coverage; however, overjet >3 mm and deep and negative overbite were significantly associated with TDI. CONCLUSION: TDI in primary dentition should receive careful attention, particularly when it affects children younger than 3 years and in the presence of overjet, overbite, or both.

Effects of traumatic dental injuries to primary teeth on permanent teeth--a clinical follow-up study.

AIM: This study evaluated the prevalence of developmental sequelae to permanent teeth (DSP) after traumatic dental injuries to primary teeth (TDI-1) and their association with age, gender, type of injury, recurrence of injury and post-traumatic damage to primary teeth. MATERIALS AND METHODS: Dental records of 2725 children treated from February 1993 to December 2008 in a private pediatric dental clinic were examined. A total of 308 records had 412 primary teeth that sustained traumatic injuries. Age at the time of injury ranged from 4 months to 7 years. A chi-squared test and logistic regression were used for statistical analyses. RESULTS: One hundred forty-eight children (241 teeth) were followed up until the eruption of the permanent successor. The prevalence of DSP was 22.4%. Discoloration and hypoplasia were the most frequent abnormalities (74.1%), followed by eruption disorders (25.9%). Age at the time of TDI-1 was the only variable significantly associated with DSP. Sequelae were most prevalent among children who suffered an injury between 1 and 3 years of age. CONCLUSIONS: Children who sustain traumatic dental injuries should be followed up regularly for an early diagnosis and treatment of possible DSP.

Antimicrobial analysis of different root canal filling pastes used in pediatric dentistry by two experimental methods.

The objective of this study was to compare, by two experimental methods, the antimicrobial efficacy of different root canal filling pastes used in pediatric dentistry. The tested materials were: Guedes-Pinto paste (GPP), zinc oxide-eugenol paste (OZEP), calcium hydroxide paste (CHP), chloramphenicol + tetracycline + zinc oxide and eugenol paste (CTZP) and Vitapex. Fiven microbial strains (S. aureus, E. faecalis, P. aeruginosa, B. subtilis and C. albicans) obtained from the American Type Culture Collection were inoculated in Brain Heart Infusion (BHI) and incubated at 37 degrees C for 24 h. For the direct exposure test (DET), 72 paper points were contaminated with the standard microbial suspensions and exposed to the root canal filling pastes for 1, 24, 48 and 72 h. The points were immersed in Letheen Broth (LB), followed by incubation at 37 degrees C for 48 h. An inoculum of 0.1 mL obtained from LB was then transferred to 7 mL of BHI, under identical incubations conditions and the microbial growth was evaluated. The pastes showed activity between 1 and 24 h, depending on the material. For the agar diffusion test (ADT), 30 Petri plates with 20 mL of BHI agar were inoculated with 0.1 mL of the microbial suspension, using sterile swabs that were spread on the medium. Three cavities were made in each agar plate (total = 90) and completely filled with one of the filling root canal pastes. The plates were pre-incubated for 1 h at room temperature and then incubated at 37 degrees C for 24 to 48 h. The inhibition zone around each well was recorded in mm. The complete antimicrobial effect in the direct exposure test was observed after 24 h on all microbial indicators. All root canal filling materials induced the formation of inhibition zones, except for Vitapex (range, 6.0-39.0 mm).

Antimicrobial analysis of different root canal filling pastes used in pediatric dentistry by two experimental methods

The objective of this study was to compare, by two experimental methods, the antimicrobial efficacy of different root canal fillingpastes used in pediatric dentistry. The tested materials were: Guedes-Pinto paste (GPP), zinc oxide-eugenol paste (OZEP), calcium hydroxide paste (CHP), chloramphenicol + tetracycline + zinc oxide and eugenol paste (CTZP) and Vitapex®. Fiven microbial strains (S. aureus, E. faecalis, P. aeruginosa, B. subtilis and C. albicans) obtained from the American Type Culture Collection were inoculated in Brain Heart Infusion (BHI) and incubated at 37°C for 24 h. For the direct exposure test (DET), 72 paper points were contaminated with the standard microbial suspensions and exposed to the root canal filling pastes for 1, 24, 48 and 72 h. The points were immersed in Letheen Broth (LB), followed by incubation at 37°C for 48 h. An inoculum of 0.1 mL obtained from LB was then transferred to 7 mL of BHI, under identical incubations conditions and the microbial growth was evaluated. The pastes showed activity between 1 and 24 h, depending on the material. For the agar diffusion test (ADT), 30 Petri plates with 20 mL of BHI agar were inoculated with 0.1 mL of the microbial suspension, using sterile swabs that were spread on the medium. Three cavities were made in each agar plate (total = 90) and completely filled with one of the filling root canal pastes. The plates were pre-incubated for 1 h at room temperature and then incubated at 37°C for 24 to 48 h. The inhibition zone around each well was recorded in mm. The complete antimicrobial effect in the direct exposure test was observed after 24 h on all microbial indicators. All root canal filling materials induced the formation of inhibition zones, except for Vitapex® (range, 6.0-39.0 mm).

O objetivo do presente estudo foi comparar o efeito antimicrobiano de diferentes pastas obturadoras do canal radicular usadas na Odontopediatria, por dois métodos experimentais. Os materiais testados foram: pasta Guedes Pinto, pasta de óxido de zinco e eugenol, pasta de hidróxido de cálcio, pasta CTZ e Vitapex®, sobre cinco microrganismos (S. aureus, E. faecalis, P. aeruginosa, B. subtilis e C. albicans) obtidos do American Type Culture Collection. As cepas foram inoculadas no Brain Heart Infusion (BHI) e incubadas a 37°C por 24 h. Para o teste de contato direto, 72 pontas de papel foram contaminadas com suspensões padrão dos microrganismos e expostas às pastas obturadoras por 1, 24, 48 e 72 h. As pontas foram imersas em Letheen Broth (LB), seguido de incubação a 37°C por 48 h. Um inóculo de 0,1 mL obtido do LB foi transferido para 7 mL de BHI, sobre condições idênticas de incubação e o crescimento microbiano foi avaliado. As pastas mostraram ação entre 1 e 24 h, dependendo da pasta testada. Para o teste de difusão em ágar, 30 placas de Petri com 20 mL de agar BHI foi inoculada com 0,1 mL da suspensão microbiana, utilizando-se de swab esterilizado, semeado de modo confluente no meio. Três cavidades foram feitas em cada placa de ágar (total = 90) e completamente preenchidas com uma das pastas obturadoras. As placas foram pré-incubadas por 1 h em temperatura ambiente e então incubadas a 37°C por 48 h. As zonas de inibição em torno das cavidades foram mensuradas. O efeito antimicrobiano completo obtido pelas pastas analisadas, por meio do teste por contato direto, foi observado após 24 h em todos os microrganismos. No teste por difusão em ágar, todos os materiais induziram a formação de zonas de inibição, exceto o Vitapex® (variando de 6,0 - 39,0 mm).

Manutenção de espaço anterior em dentição decídua: uma proposta de resolução / Anterior space maintenance in deciduous dentition: a resolution proposal

Grande parte dos odontopediatras enfrenta dificuldades na escolha do tratamento reabilitador ideal que resolva os problemas estéticos e funcionais de crianças que perderam precocemente seus dentes decíduos anteriores. Neste trabalho, temos por finalidade principal auxiliar esses profissionais, apresentando, através de uma revisão sucinta da literatura, as conseqüências da perda precoce de incisivos superiores na dentição decídua e descrevendo um tipo de mantenedor de espaço fixo-funcional, com a finalidade de preservar o espaço e evitar conseqüências deletérias futuras ao sistema estomatognático da criança