Perfil de componentes curriculares e docentes de Odontologia Legal e saúde coletiva de cursos de graduação em Odontologia da região norte do Brasil / Profile of curricular components and professors of Forensic Dentistry and Public Health in undergraduate dentistry courses in the northern region of Brazil

Introdução: Odontologia Legal (OL) e Saúde Coletiva (SC) contribuem na formação do cirurgião-dentista em aspectos relacionados à ética profissional, à cidadania e à atenção às necessidades de saúde da população. Objetivo: analisar o perfil de componentes curriculares e docentes de OL e SC de cursos de graduação em Odontologia. Material e método: Trata-se de um estudo transversal quantitativo desenvolvido por meio de formulário eletrônico aplicado a docentes de componentes curriculares de OL e SC de cursos da região norte do Brasil, em 2022. Para análise de dados, foi aplicada estatística descritiva e os testes Qui-quadrado e Exato de Fisher. Resultados: Quarenta docentes participaram da pesquisa, sendo 12 de instituições públicas, 27 de particulares e 1 de ambas. Deles, 10 (25%) eram de OL, 22 (55%) de SC e 8 (23%) de ambos os componentes curriculares. Todos (100%) os componentes curriculares de OL eram obrigatórios e ministrados em 1 a 3 semestres do curso, a maioria com ensino presencial (94,4%) e 50% em aulas teóricas e práticas. Os componentes curriculares de SC possuíam grande variabilidade de distribuição de períodos no curso, a maioria com carga horária de até 200 horas. Pouco mais de 40% dos docentes de OL possuíam formação específica na área. Para SC, 63% dos docentes possuíam formação específica. A oportunidade de trabalho ou de inserção em uma instituição de ensino foi o motivo mais citado pelos docentes que não possuíam formação específica na área dos componentes curriculares que ministravam. Não houve diferença estatisticamente significativa no perfil dos docentes. Conclusão: os componentes curriculares de OL não estavam alinhados às diretrizes da Associação Brasileira de Ética e Odontologia Legal e os componentes curriculares de SC seguiam as previsões das Diretrizes Nacionais Curriculares de 2002

Introduction: Forensic Dentistry (FD) and Public Health (PH) contribute to dentist's development in aspects related to professional ethics, citizenship and attention to the population health needs. Aim: to analyze the profile of FD and PH curricular components and professors in undergraduate courses of Dentistry. Material and methods: a quantitative cross-sectional study was carried out using an electronic questionnaire sent to professors who taught FD and PH in north Brazilian colleges in 2022. To data analysis, descriptive statistics, Chi-square and Fisher's exact tests were applied. Results: Forty professors participated in the survey, 12 from public institutions, 27 from private institutions and 1 from both. Of them, 10 (25%) were professors of FD, 22 (55%) of PH and 8 (23%) of both curricular components. All (100%) FD curricular components were mandatory and taught in 1 to 3 semesters of the course, most with face-to-face teaching (94.4%) and 50% with theoretical and practical classes. PH curricular components had great variability in the distribution of periods in the course, most with a workload up to 200 hours. Just over 40% of FD professors had specific training in the area. In the PH area, 63% of professors had specific training. The opportunity for work or insertion in an educational institution was the reason most cited by professors who did not have specific training in the area of the curricular components they taught. There was no statistically significant difference in the professors' profile. Conclusion: the FD curricular components were not aligned with the guidelines of the Brazilian Association of Ethics and Forensic Dentistry and the PH curricular components followed the predictions of the 2002 National Curricular Guidelines

Alveolar and mandibular cortex bone status in individuals with type 1 diabetes mellitus: a cross-sectional paired study / Condição óssea alveolar e da cortical mandibular em indivíduos com diabetes mellitus tipo 1: um estudo transversal pareado

Aim: This study compared alveolar bone loss, teeth with furcation, and mandibular cortical modification between individuals with type 1 diabetes mellitus (T1DM) and nondiabetic individuals. Methods: Radiographs of 50 T1DM individuals and 100 nondiabetic individuals were examined to evaluate the presence of teeth with furcation, alveolar bone loss, and mandibular cortical modifications. The Mann-Whitney, Chi-square, and Student's t tests were used to analyze personal characteristics and bone status. Linear and logistic regression was performed to explore associations. Results: A significant difference was observed in the average number of teeth with furcation and in the median of alveolar bone loss between T1DM and the nondiabetic participants. T1DM individuals are more likely to have alveolar bone loss (OR = 3 2.250), teeth with furcation (OR = 8.903), and mandibular cortical modification (OR = 15.667) than are nondiabetic individuals. Among T1DM individuals, the glycemic control has a high influence in mandibular cortical modifications (p < 0.05). Conclusions: A high association between uncontrolled blood glucose and mandibular cortical modifications was observed among T1DM individuals. Alveolar bone loss of T1DM individuals was associated with age, time of diagnosis, glycemic control, and the existence of chronic complications.

Objetivo:Comparar a perda óssea alveolar, a presença de dentes com lesão de furca e a alteração da cortical óssea entre indivíduos com DMT1 e indivíduos não-diabéticos. Métodos: Foram examinadas radiografias de 50 indivíduos diabéticos e de 100 não-diabéticos para avaliar a presença de dentes com lesão de furca, perda óssea alveolar e alteração cortical mandibular. Para analisar as características individuais e as condições ósseas foram usados os testes de Mann-Whitney,Qui-quadrado e t de Student. Regressões linear e logística foram realizadas para identificar associações. Resultados: Foi encontrada diferença significativa na média de dentes com lesão de furca e na mediana da perda óssea alveolar entre diabéticos e não-diabéticos. Indivíduos com DMT1 possuem mais chance de apresentar perda óssea alveolar (OR = 32,250), lesão de furca (OR=8,903) e alteração da cortical mandibular (OR = 15,667) em comparação aos indivíduos não-diabéticos. Entre os diabéticos, o controle da glicemia possui grande influência nas alterações da cortical mandibular (p < 0,05). Conclusões: Existe uma alta associação entre os níveis de glicemia descontrolada e alterações na cortical mandibular entre os indivíduos com DMT1. A perda óssea alveolar de indivíduos com DMT1 foi associada aos fatores idade, tempo de diagnóstico, controle da glicemia e a presença de complicações crônicas.

The 100 Most-Cited Papers in Dentin Hypersensitivity: A Bibliometric Analysis

ABSTRACT Objective: To identify the 100 most-cited articles in DH and analyze their characteristics. Material and Methods: A search was performed on the Web of Science (WoS) and the 100 most-cited articles were selected. The following data were extracted: citations, year of publication, authorship, institution, country, journal, language, study design, topic of interest, conflict of interest (COI), and sponsorship. The VOSviewer software was used to visualize bibliometric networks. Poisson regression analysis was performed to measure associations between several citations and the characteristics of the studies. Results: The number of citations ranged from 346 to 48. The most-cited article was published in 1997 by Holland in the Journal of Clinical Periodontology. This journal published the most papers, followed by the Journal of Oral Rehabilitation and Journal of Dentistry. Laboratory research, review, and clinical trial were the study designs most prevalent. Reviews (p<0.05; PR= 1.853) and method development studies (p<0.05; PR= 1.853) had a more chance to present more citations. The main topics of interest were the clinical effectiveness of desensitizers and in vitro analysis of dentin morphology. Sponsorship and COI were underreported. England and USA presented the greatest number of citations and connections in the coauthorship network map. Conclusion: Most of the articles were original research, and their topics of interest were mainly the clinical effectiveness of desensitizing agents and dentin morphology.

Processo de obtenção de consentimento livre e esclarecido para pessoas analfabetas em procedimentos de saúde / Process for obtaining informed consent for illiterate people in healthcare procedures

O Termo de Consentimento Livre e Esclarecido (TCLE) é um documento que faz parte do processo de obtenção da anuência de pacientes ou de participantes de pesquisa, para garantir seus direitos e atribuir seus deveres. Caso o TCLE contenha um texto complexo, ele restringirá, de certa forma, a liberdade de decisão de indivíduos analfabetos. Objetivo: avaliar a percepção de analfabetos sobre o conhecimento do TCLE e suas formas de manifestação de anuência para procedimentos de saúde. Material e método: trata-se de uma pesquisa transversal quali-quantitativa, cuja coleta de dados foi realizada com alunos da Educação de Jovens e Adultos (EJA) por meio de entrevista gravada após leitura de um TCLE modelo. Os resultados qualitativos foram analisados segundo a Técnica de Análise de Conteúdo, proposta por Bardin. Os quantitativos foram analisados pelo teste qui-quadrado e por análise de regressão logística por meio do software JAMOVI. Resultados: participaram da pesquisa 32 alunos. Os dados obtidos mostraram que o conhecimento prévio acerca do TCLE era baixo (34,37%), apenas 46,87% dos participantes compreenderam o documento, sendo 38% da 4ª etapa da EJA. Quase todos os participantes entenderam os benefícios em aplicar o TCLE nas práticas clínicas e 75% informaram que imagens facilitariam a compreensão do documento. Conclusão: concluiu-se que baixas habilidades de alfabetização afetam diretamente a autonomia para anuência em TCLE. A dificuldade na compreensão do TCLE pode estar relacionada aos elementos textuais, como o tamanho da fonte, utilização de termos difíceis e apresentação de um texto extenso contendo muitas informações

The Informed Consent (IC) is a document that is part of the process for obtaining the consent of patients or research participants, to guarantee their rights and assign their duties. The IC, by containing a complex text, restricts, in some way, the freedom of decision of illiterate individuals. Objective: to evaluate the perception of illiterate individuals on the knowledge of the IC and their forms of expression of consent to health procedures. Material and method: this is a quali-quantitative cross-sectional study, whose data collection was carried out with students of Youth and Adult Education (YAE) by means of recorded interview after reading an IC model. The qualitative results were analyzed according to the Content Analysis Technique, proposed by Bardin. Quantitative results were analyzed applying the Chi-square test and logistic regression analysis using the JAMOVI software. Results: 32 students participated in the research. The data obtained showed that the previous knowledge about the ICF is low (34.37%), only 46.87% of the participants understood the document, 38% of them from the 4th stage of YAE. Almost all participants understood the benefits in applying the IC in clinical practices and 75% claimed that images would facilitate understanding of the document. Conclusion: It was concluded that low literacy skills directly affect the autonomy to consent using the IC. The difficulty in understanding the IC may be related to textual elements, such as font size, use of difficult terms, and presentation of an extensive text containing a lot of information

Evaluation of the clinical performance of GIOMERs and comparison with other conventional restorative materials in permanent teeth: a systematic review and meta-analysis.

Aim The aim of this systematic review and meta-analysis was to analyse the clinical performance of GIOMER restorative composites and compare them with other conventional restorative materials in permanent teeth.Methods Searches in PubMed, Web of Science, Scopus, Ovid and Cochrane Library were conducted. Grey literature search was also performed. Clinical trials that evaluated the clinical performance of restorations with GIOMER restorative composites in permanent teeth compared to those using composite resin, glass ionomer cement, resin-modified glass ionomer cement (RMGIC) and other GIOMERs were included. Meta-analyses comparing GIOMER restorative composites with RMGIC at 6- and 12-month follow-ups and comparing two types of GIOMER were feasible.Results Ten studies fulfilled the inclusion criteria. In these studies, GIOMER was compared to different types of dental restoration materials. Dental restorations were evaluated by United States Public Health Service criteria in all included studies. Four studies were suitable for meta-analysis, which showed significant differences between GIOMER and RMGIC surface roughness at 6-month (odds ratio [OR] = 6.56; 95% confidence interval [CI] = 2.38-18.13) and 12-month (OR = 8.76; CI = 3.19-24.07) follow-ups. No significant differences between GIOMER restorative composites and RMGIC for marginal adaptation were found at 6- and 12-month follow-ups. When comparing two GIOMERs, significant differences were seen between Beautifil II and Beautifil Flowable Plus F00 for marginal staining (OR = 2.58; CI = 1.42-23.27; I2 = 0%) and surface roughness (OR = 4.59; CI = 1.11-18.97; I2 = 0%) at the 36-month follow-up. No significant differences between Beautifil II and Beautifil Flowable Plus F00 were seen for marginal adaptation and anatomic form at 6-, 18- and 36-month follow-ups.Conclusions GIOMER restorative composites presented similar performance concerning marginal adaptation and better surface roughness when compared to RMGIC. GIOMER Beautifil II presented similar performance to GIOMER Beautifil Flow Plus F00 concerning marginal adaptation and anatomic form and worse marginal staining and surface roughness when compared to Beautifil Flowable Plus F00.

Depression, anxiety and stress among dental students during COVID-19 pandemic and distance learning / Depressão, ansiedade e estresse entre estudantes de Odontologia durante a pandemia da COVID-19 e o ensino remoto

This study aimed to measure the levels of depression, anxiety and stress among dental students during the COVID-19 pandemic and distance learning.This cross-sectional questionnaire-based survey was conducted at a Brazilian school of Dentistry, between July and August, 2020. The participants were surveyed using the adapted and validated version of Depression, Anxiety, and Stress Scale (DASS-21) questionnaire. The Fisher's exact test and bivariate logistic regression analysis were performed to analyze the data, using SPSS software. A total of 120 dental students (response rate of 87.60%) participated in the study; 75.8% of them were female and the mean age was 23.35 years old (± 6.07). Most students were single (85%), studied full time (68.3%) and had no employment (70.8%). Some level of depression, anxiety and stress was observed in 64.2%, 67.5% and 61.7% of the students, respectively. The severity of the depression, the anxiety and the stress was significantly associated (p < 0.05) with the student's gender, fear of contracting COVID-19 and with thecondition of having a family member who has already had COVID-19. Female students, students who were fear of contracting COVID-19 and who had a familiar or a friend diagnosed with COVID-19 presented more chances of developing a high level of depression, anxiety or stress.We concluded thatdental students had high levels of depression, anxiety and stress during the COVID-19 pandemic and distance learning. This study suggests that the mental health of dental students should be carefully monitored during theCOVID-19 pandemic (AU).

Este estudo teve como objetivo mensurar os níveis de depressão, ansiedade e estresse entre estudantes de Odontologia durante a pandemia da COVID-19 e o ensino à distância. Esta pesquisa transversal, realizada por meio de um questionário on-line, foi realizada em uma Faculdade de Odontologia do Brasil, entre julho e agosto de 2020. Os participantes foram avaliados por meio da versão adaptada e validada do questionário Escala de Depressão, Ansiedade e Estresse (DASS-21). Para análise dos dados foram realizados o Teste Exato de Fisher e a Análise de Regressão Logística Bivariada, por meio do software SPSS. Participaram do estudo 120 estudantes de odontologia (taxa de resposta de 87.60%). Destes, 75.8% deles eram do sexo feminino e a média de idade foi de 23,35 anos (± 6,07). A maioria dos alunos era solteira (85,0%), estudava em tempo integral (68,3%) e não tinha vínculo empregatício (70,8%). Algum nível de depressão, ansiedade e estresse foi observado em 64,2%, 67,5% e 61,7% dos alunos, respectivamente. As gravidades da depressão, da ansiedade e do estresse estiveram significativamente associadas (p <0.05) ao sexo do aluno, ao medo de contrair a COVID-19 e à condição de ter um membro da família que já teve a COVID-19. Estudantes do sexo feminino, estudantes com medo de contrair a COVID-19 e que tiveram um familiar ou amigo com diagnóstico de COVID-19 apresentaram maiores chances de desenvolver um alto nível de depressão, ansiedade ou estresse. Concluímos que os estudantes de odontologia apresentaram altos níveis de depressão, ansiedade e estresse durante a pandemia da COVID-19 e o ensino à distância. Este estudo sugere que a saúde mental dos estudantes de odontologia deve ser monitorada cuidadosamente durante a pandemia da COVID-19 (AU).

Impacto do processo de trabalho e da atenção ao câncer de boca no desempenho das equipes de saúde bucal em estado amazônico / Impact of the work process and to oral cancer care on the performance of oral health teams in an Amazonian state

Objetivo: Este estudo teve como objetivo analisar as ações de planejamento e avaliação do processo de trabalho e de atenção ao câncer de boca e o impacto desses fatores no desempenho das Equipes de Saúde Bucal no estado do Pará. Métodos:Foram utilizados dados secundários do 3º ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) referentes aos profissionais de saúde bucal entrevistados pelo programa. Participaram do estudo 603 equipes. Os dados foram analisados por teste exato de Fisher e por regressão logística bivariada e multivariada. Resultados: Dentre as equipes, a maioria realizava atividades de planejamento de ações (89,4%), participava de reuniões com a equipe de atenção básica (93,2%) e realizava autoavaliação (71,5%). A maioria das equipes realizava ações de prevenção e diagnóstico de câncer de boca (91,4%), porém 84,6% delas não realizava biópsias na unidade primária. Uma melhor certificação de desempenho mostrou-se associada com a realização de atividades como: planejamento das ações da equipe (p = 0,024; OR = 2,409), reunião com a equipe de atenção básica (p = 0,009; OR = 14,038), investigação do perfil epidemiológico de saúde bucal do território (p < 0,001; OR = 2,649) e outros. Conclusões: Realizar atividades do processo de trabalho e atenção ao câncer de boca geraram impacto positivo no desempenho das equipes de saúde bucal do estado do Pará que participaram do 3º ciclo do PMAQ-AB.

Aim: This study aimed to analyze the actions of planning, monitoring, evaluation of the work process, and oral cancer care, as well as the impact of these factors on the performance of Oral Health Teams in the state of Pará.Methods: Secondary data were collected from the 3rd cycle of National Program for Improving Access and Quality of Primary Care regarding oral health professionals; 603 teams participated in the study. The data were evaluated by Fisher's exact test, and bivariate and multivariate logistic regression.Results:Among the teams, the majority carried out action planning activities (89.4%), participated in meetings with the primary care team (93.2%), and carried out self-assessment (71.5%). Most teams performed oral cancer prevention and diagnostic actions (91.4%); however, 84.6% of them did not perform biopsies in the primary unit. Better performance certification was associated with the achievement of activities, such as: planning the team's actions (p = 0.024; OR = 2.409), meeting with the primary care team (p = 0.009; OR = 14.038), investigating the epidemiological profile of oral health in the territory (p < 0.001; OR = 2.649), among others.Conclusion: It was concluded that the activities of the work process and oral cancer care generated a positive impact on the performance of the oral health teams in the state of Pará that participated in the 3rd cycle of the PMAQ-AB.

Obliteration of Dentinal Tubules by Desensitizing Agents Based on Silver Fluoride/Potassium Iodide or Pre-Reacted Glass Particles: An in Vitro Study

Abstract Objective: To evaluate the efficacy of desensitizing agents for the obliteration of dentinal tubules subjected or not to a simulated oral environment. Material and Methods: Dentinal discs (n=8) treated with Riva-Star (RS) or PRG-Barrier-Coat (PRG) were submitted (cycled) or not submitted (control) to erosive-abrasive-thermal cycles and evaluated using scanning electron microscopy/energy dispersive spectroscopic analysis. The variables analyzed were tubule obliteration and dentin surface chemical composition. Data were analyzed by non-parametric tests (p<0.05). Results: The cycled and control groups did not differ significantly for the responses in each material. The PRG control and cycled groups had fewer visible tubules and a higher proportion of totally obliterated tubules than the RS groups. The percentages of silver coverage were higher in the RS-control than in the RS-cycled. There was a significant inverse correlation between the presence of silver and non-obliterated tubules (R=-0.791; p<0.001). The percentages of carbon, aluminum, strontium, and potassium were significantly higher in the PRG-control and PRG-cycled compared to the RS control. The percentages of calcium, phosphorus, and silver were significantly higher in the RS compared to the PRG groups. PRG-control showed a higher percentage of boron than RS-control. Conclusion: PRG promoted greater tubule obliteration than SR. Simulated stress did not affect the obliterating effect of each agent. Greater silver coverage corresponded to a lower proportion of non-obliterated tubules in RS. Carbon, aluminum, strontium, boron, and potassium predominated in the dentin surface treated with PRG, while calcium, phosphorus, and silver prevailed in RS groups (AU).

Influência do programa de Educação pelo Trabalho na atuação em saúde bucal do agente comunitário de saúde / Influence of WORK-BASED educaTion program on oral health in performance of community HEALTH worker

Objetivo: Avaliar a influência das ações realizadas pelo Programa de Educação pelo Trabalho (PET-Saúde) no trabalho e conhecimento em saúde bucal de Agentes Comunitários de Saúde (ACS). Método: Utilizou-se um instrumento de pesquisa validado para a análise da influência do conhecimento em saúde bucal dos ACS, em estudo transversal desenvolvido em dois distritos administrativos municipais (DAGUA e DASAC). Os dados obtidos foram analisados estatisticamente pelo SPSS. Resultados: Os ACS eram em maioria do sexo feminino com idade entre 30 a 39 anos e renda familiar de um a três salários, a maioria residia na comunidade há mais de seis anos e atuava na comunidade entre 1 e 3 anos, abrangendo cerca de 500 a 599 indivíduos nas suas microáreas. Observou-se que a maioria dos ACS não realizava atividade de educação em saúde bucal por não terem recebido capacitação para tal, com exceção dos ACS do distrito administrativo sob área de cobertura da Universidade Federal do Pará, onde o PET-Saúde se fez pertinente. Sobre o conhecimento em saúde bucal, os ACS dos distritos DAGUA e DASAC obtiveram nível moderado. Conclusões: O PET-Saúde proporcionou construção coletiva do conhecimento para os ACS retornando em mudanças positivas sobre o cuidado em saúde bucal para as comunidades. Percebeu-se maior nível de conhecimentos relacionados à saúde bucal entre os ACS do DAGUA, apesar de não ter havido grande diferença entre os distritos analisados. As atividades do PET deveriam ser incorporadas nos projetos pedagógicos, dos cursos de graduação e ter caráter de continuidade nas comunidades fortalecendo as ações de integração ensino-serviço-comunidade.

Objective: To evaluate the influence of actions carried out by the Work-Based Education Program (WBEP-Health) on oral health work and the knowledge of Community Health Workers (CHW). Method: A validated research instrument was used to analyze the influence of oral health knowledge on CHW in a cross-sectional study developed in two municipal administrative districts (DAGUA and DASAC). Results obtained were submitted to statistical analysis using SPSS. Results: CHW were mostly females, between 30 and 39 years old, with a family income of one to three years, the majority resided in the community for more than six years and used to work in the community for 1 to 3 years, covering about 500 to 599 individuals within their micro area. It was observed that the majority of the CHW did not perform oral health education activity, due to a lack of training, except for the CHW of administrative district under the coverage area of the Federal University of Pará, where the WBEP-Health made itself relevant. In relation to knowledge about oral health, the CHW of the districts DAGUA and DASAC were classified as moderate. Conclusions: WBEP-Health provided a collective construction of knowledge for CHW, resulting in positive changes in oral health care for communities. It was observed that the knowledge level in relation to oral health was greater in the CHW from the district DAGUA, even though the difference between districts was insignificant. WBEP activities should be incorporated into pedagogical projects, undergraduate courses with continued work within communities strengthening integrated teaching-service-community actions.

Root Canal Treatment and Apical Periodontitis in a Brazilian Population with Type 1 Diabetes Mellitus: A Cross-sectional Paired Study.

INTRODUCTION: This study radiographically analyzed the prevalence of root canal treatment (RCT) and apical periodontitis (AP) in type 1 diabetes mellitus (T1DM) and nondiabetic individuals and its association with the history/current status of T1DM. METHODS: In a cross-sectional paired study, the radiographic records of 50 individuals with T1DM and 100 age- and sex-matched nondiabetic subjects were examined. The presence of RCT and AP was evaluated. Information regarding the history and current status of T1DM was collected from the medical records of each patient. RESULTS: One or more RCTs were found in 76% and 44% of diabetic and nondiabetic subjects, respectively (P = .000). AP in 1 or more teeth was found in most T1DM patients (58%) and in 15% of the control subjects (P = .000). One or more RCTs associated with AP were found in 52% and 8% of T1DM and nondiabetic subjects, respectively (P = .000). Bivariate logistic regression analyses suggested that RCT (odds ratio [OR] = 10.435, P = .000), AP (OR = 3.508, P = .011), and RCT + AP (OR = 7.220, P = .000) were significantly associated with the presence of T1DM. Multivariate logistic regression showed that among T1DM individuals, there is an association between 11-15 years of diagnosis time and at least 1 RCT (OR = 46.316, P = .038) and an association between T1DM control and at least 1 tooth with AP (OR = 15.611, P = .016). CONCLUSIONS: RCT, AP, and RCT with AP were more prevalent in individuals with T1DM than in nondiabetic individuals. RCT and AP were associated with the presence of T1DM, specifically RCT with diagnostic time and AP with glycemic control.

Maxillofacial Prosthetic Rehabilitation of Patients with Resection of Squamous Cell Carcinoma: A Report of Two Cases.

Maxillofacial prosthetic rehabilitation is almost always indicated after surgical treatment of affected individuals with oral cavity and pharynx cancers. Few articles have described in detail the technical sequence of maxillofacial prosthesis fabrication. The first case is a 56-year-old woman who was rehabilitated with pharyngeal obturator prosthesis after a partial maxillectomy, including soft palate, tonsil, oropharynx, and retromolar space regions. The second case is an 83-year-old man who was rehabilitated with hard palatal obturator prosthesis after a maxillectomy, including hard palate and nasal floor. In both cases, the patients complained of oronasal regurgitation and difficulty in chewing, swallowing, and speaking. A multi-professional approach including oral rehabilitation should be part of the treatment plan for individuals with oral and pharyngeal cancer after tumor resection.

Comparison of Clinical Efficacy of Pro-Argin and NovaMin Toothpastes in Relieving Dentin Hypersensitivity: A Systematic Review and Meta-analysis.

PURPOSE: To compare the clinical efficacy of toothpastes containing Pro-Argin and NovaMin as dentin hypersensitivity (DH) treatment. MATERIALS AND METHODS: A systematic review and meta-analysis based on PRISMA was conducted (PROSPERO registration CRD42018095367). Electronic searches were performed in Pubmed, Scopus, Cochrane Library, Web of Science, Virtual Health Library and Open Grey until June 2018, with the terms [pro-argin OR arginine] AND [novamin OR calcium sodium phosphosilicate OR calcium sodium phospho silicate]. Randomised and non-randomised clinical trials comparing DH reduction in adults given Pro-argin-containing toothpastes and NovaMin-containing toothpastes were included. Study selection and quality assessment with Cochrane tool were performed. In the meta-analysis, the comparison between desensitising toothpastes was assessed by standardised mean difference (SMD) with 95% confidence intervals (CI). Certainty of evidence was evaluated with GRADE. RESULTS: Five studies fulfilled the inclusion criteria. In four included studies, a reduction in the DH under tactile stimulus between baseline and post-application times for both toothpastes was demonstrated. Three studies were suitable for meta-analysis. No statistically significant difference between the two toothpastes for DH reduction was observed at immediate (SMD = -1.05, CI = -3.52;1.41), 2-week (SMD = -0.55, CI = -2.59;1.48) and 4-week (SMD = -0.49, CI = -2.78;1.81) follow-up. Certainty of the evidence was very low. Included studies presented a high risk of bias. CONCLUSIONS: Pro-argin-containing and NovaMin-containing toothpastes showed effectiveness for DH reduction. No statistically significant difference between the two toothpastes was found. Thus, both can be prescribed to treat DH in adults with equivalent effectiveness up to four weeks.

Efeito do uso e do momento de aplicação de dentifrícios dessensibilizantes na cor, refletividade, rugosidade e nanodureza do esmalte clareado / Effect of use and moment of application of desensitizing toothpastes on shade, reflectivity, roughness and nanohardness of bleached enamel

Este estudo in vitro teve como objetivo investigar o efeito de dentifrícios dessensibilizantes aplicados antes ou após o clareamento dental na cor, na refletividade (SRI), na rugosidade (Ra, RMS) e na nanodureza (NH) da superfície do esmalte. A reprodutibilidade das medidas de SRI e a sua associação com a cor e a rugosidade do esmalte foram também avaliadas. Blocos de esmalte e dentina (36 mm²) foram obtidos de 42 incisivos bovinos. Os espécimes foram divididos aleatoriamente em sete grupos (n = 6), de acordo com os dentifrícios dessensibilizantes e o momento da aplicação (G1: controle, clareado e armazenado em saliva artificial; G2: Sensodyne Repair & Protect + clareamento dental; G3: clareamento dental + Sensodyne Repair & Protect; G4: Colgate Sensitive Pró-alívio + clareamento dental; G5: clareamento dental + Colgate Sensitive Pró-alívio; G6: Elmex Sensitive + clareamento dental; G7: clareamento dental + Elmex Sensitive. Três sessões de clareamento com peróxido de hidrogênio 35% (Whiteness HP) foram realizadas, com intervalos de 7 dias, em T1, T2 e T3. Após cada dia de tratamento, as amostras foram armazenadas em saliva artificial. A cor foi mensurada por espectrofotômetro (VITA Easyshade) e sistema CIE L*a*b* antes do início do tratamento (T0) e 7 dias após o término do tratamento (T4). A SRI foi medida por dois examinadores (R1, R2) usando um reflectômetro óptico (Optipen 2) em T0, T1, T2, T3 e T4. Ra, RMS e NH (GPa) do esmalte foram avaliadas em microscópio de força atômica e nanoindentador (Asylum Research) em T4. Comparações múltiplas entre grupos foram realizadas pelo teste de Kruskal-Wallis e post hoc DunnBonferroni. Concordância entre avaliadores na mensuração de SRI foi avaliada pelo Coeficiente de Correlação Intraclasse (CCI). Comparações múltiplas dos valores de SRI entre os momentos de avaliação para cada grupo foram realizadas pelo teste de Friedman e post hoc de Dunn-Bonferroni. A correlação entre variáveis foi analisada pelo teste de correlação de Pearson. Para Ra (p = 0,007), RMS (p = 0,018), cor (p = 0,016) e SRI (p = 0,009) foram encontradas diferenças significativas entre os grupos. Para NH (p = 0,920), não foi encontrada diferença significativa entre os grupos. Após ajuste de Dunn-Bonferroni, foram encontradas diferenças significativas entre G1 e G5 para Ra (p = 0,033) e SRI (p = 0,004) em T4. Houve excelente concordância entre avaliadores (CCI = 0,873, Intervalo de Confiança 95% = 0,828/0,905). Considerando os tempos de avaliação, não houve diferença entre valores de SRI em T0 e T4 para todos os grupos. SRI apresentou correlação inversa moderada com Ra (r = -0.602) e RMS (r = -0.501). Concluiu-se que o dentifrício dessensibilizante Colgate Sensitive Pró-alívio aplicado após o clareamento dental apresentou maior rugosidade e menor refletividade que o grupo controle. Para os demais grupos, o dentifrício dessensibilizante aplicado antes ou após o clareamento dental não interferiu na nanodureza, na rugosidade, na cor e na refletividade final do esmalte. O reflectômetro Optipen 2 proporcionou excelente concordância interexaminadores. A refletividade não se alterou após clareamento e aplicação de dentifrícios dessensibilizantes com armazenamento em saliva artificial e mostrou correlação inversa com a rugosidade do esmalte.

This in vitro study aimed to investigate the effect of desensitizing toothpastes applied before or after dental bleaching on the enamel surface shade, reflection intensity (SRI), roughness (Ra, RMS) and nanohardness (NH). Inter-rater agreement for SRI measurements and SRI association with enamel shade and roughness were also evaluated. Enamel and dentin blocks (36 mm²) were obtained from 42 bovine incisors. The specimens were randomly divided into seven groups (n = 6) according to the desensitizing toothpastes and the moment of application (G1: control, bleached and stored in artificial saliva; G2: Sensodyne Repair & Protect + dental bleaching; G3: dental bleaching + Sensodyne Repair & Protect; G4: Colgate Sensitive Pro-Relief + dental bleaching; G5: dental bleaching + Colgate Sensitive Pro-Relief; G6: Elmex Sensitive + dental bleaching; G7: dental bleaching + Elmex Sensitive. Three bleaching sessions using 35% hydrogen peroxide were realized with seven day intervals (T1, T2, T3). After each day of treatment, the specimens were stored in artificial saliva. Dental shade was measured using spectrophotometer (VITA Easyshade) and CIE L*a*b* system before treatment beginning (T0) and 7 days after finishing treatment (T4). SRI was measured by two raters (R1, R2) using optical reflectometer at T0, T1, T2, T3 and T4. Enamel surface roughness (Ra, RMS) and NH (GPa) were evaluated with an atomic force microscope and nanoindenter (Asylum Research) at T4. Multiple comparisons among groups were assessed by Kruskal-Wallis and Dunn-Bonferroni post hoc tests. Inter-rater agreement was evaluated by Intraclass Correlation Coefficient (ICC). Multiple comparisons for SRI according to moments of evaluation for each group were assessed by Friedman and Dunn-Bonferroni post hoc tests. Correlation between variables was accessed by Pearson correlation test. For Ra (p = 0.007), RMS (p = 0.018), shade (p = 0.016) and SRI (p = 0.009) significant differences between groups were found. For NH (p = 0.920) no significant difference among groups was found. After Dunn-Bonferroni adjustment, significant differences between G1 and G5 for Ra (p = 0.033) and SRI (p = 0.004) at T4 were found. There was an excellent inter-rater agreement (ICC = 0.873, Confidence Interval 95% = 0.828/0.905). Considering times of SRI evaluation, no significant difference between T0 and T4 was found for all groups. SRI presented a moderate negative correlation with Ra (r = -0.602) and RMS (r = -0.501). It was concluded that Colgate Sensitive Pro-Relief applied after dental bleaching showed higher roughness and lower SRI than control group. For the other groups, the desensitizing toothpaste applied before or after dental bleaching did not interfere in NH, roughness, shade and SRI of enamel. Optipen 2 reflectometer provided excellent inter-rater agreement. SRI did not change after bleaching and desensitizing toothpaste application with storage in artificial saliva and has inverse correlation with enamel roughness.

Oral health assessment in school program health: who and how? / Avaliação de saúde bucal no programa saúde na escola: quem e como?

ABSTRACT Oral health is a constitutional right, with its own national policy which guides the relevance of its interrelation to general health within the integrality principles. This manuscript aims at understanding how oral health assessment and actions are observed within the School Program Health, through a qualitative study performed in the city of Belém, State of Pará, Brazil. The sample criterion consisted of 5 nurses, 5 teachers and 5 parents. A semi-structured script was used, written and transcribed with subsequent thematic analysis. The analysis revealed three thematic categories emphasizing the need for policy empowerment and practice in order to understand the meanings of oral health within the SHP as well as to enlarge its specificity in the interdisciplinary work scenario. Thus, it is clear that for the effective functioning of the school / health relationship, it is of utmost importance that SHP policy is applied and recognized while continuously seeking to strengthen the principle of integrality and extended clinic. The study also highlights permanent education and constant need for the participants' skill improvement so that both students' health care and life quality can be fully promoted.

RESUMO A saúde bucal apresenta-se como um direito constitucional, sendo condição relevante à integralidade de saúde. Este artigo objetivou compreender como a avaliação e ações de saúde bucal são contempladas no âmbito do Programa Saúde na Escola, através de pesquisa com abordagem qualitativa no município de Belém, Pará, utilizando roteiro semiestruturado com amostra de três categorias do Programa Saúde na Escola, selecionadas por conveniência e com base no critério de saturação: enfermeiros, professores e pais. A análise resultou três categorias distintas e inter-relacionadas que ressaltam a discussão acerca da necessidade de empoderamento para compreensão dos significados da saúde bucal dentro do PSE e ampliação de sua especificidade no cenário de trabalho transdisciplinar. Para o efetivo funcionamento da articulação escola/saúde, faz-se necessário reconhecer a aplicabilidade da política do Programa Saúde na Escola, buscando cada vez mais implementá-la nas escolas de modo a otimizar a interligação entre os envolvidos. Verificou-se a constante necessidade acerca do aperfeiçoamento de habilidades dos atores deste cenário de modo a atuar munidos de atitudes/comportamentos adequados para a melhoria da qualidade de vida do escolar.

The Nursing Care with the Oral Health of Pregnant Women: A Qualitative Study

Objective: To evaluate the knowledge and behaviors of nurses on the oral health of pregnant women. Material and Methods: This was a qualitative study, whose data collection was performed with 12 nurses from Belém, Brazil, through questionnaire, with recorded interview applied by a single researcher, according to a semi-structured script composed of five guiding questions, and whose results were analyzed by Content Analysis. Results: Four thematic issues were originated: 1) "All have dental caries", referring to the nurse's perception on oral health related to the biological aspect; 2) "We refer", addresses the issue of nursing care and the nurse's responsibility for prenatal care; 3) "I do not know much", reveals the nurse's sometimes limited knowledge about oral health and discusses the breadth of dental care; and 4) "The demand is very large", brings up the view of nurses regarding the difficulties of accessing dental service in SUS. Conclusion: Nurses know prenatal protocols and refer patients to dental care, but their perception about dental care during pregnancy is not very comprehensive, which instigates the strengthening of interdisciplinary work.

Prevalence and severity of molar incisor hypomineralization in students of Belém, Brazil

To measure the prevalence of Molar Incisor Hypomineralization (MIH), its severity and association with dental caries among public school children from Belém/PA, Brazil.Material and Methods:This is a cross-sectional study conducted with children enrolled in three public schools of Belém, which were selected by simple random sampling. MIH diagnosis was carried out according tocriteria of the European Academy of Pediatric Dentistry.Results:Among the 260 students that met the inclusion criteria, 56.92% were male and 43.07% female. The average age was 10.22 years. Of these, 8.84% (n = 23) had MIH, but there was no statistically significant difference in this prevalence between sexes (p = 0.6244). The most affected teeth were the upper first permanent molars, followed by lower first permanent molars and upper permanent central incisors. About 43.48% of students had at least one tooth with severe defect in enamel and 30.43% of students with MIH presented dental caries in the affected teeth. Conclusion:Severe MIH was not the most prevalent among schoolchildren, but the relationship with dental caries found demonstrates the importance of knowledge about diagnosis and treatment of enamel defects, which should be part of promotion and prevention actions in oral health due to its epidemiological impact in the demographic change of dental caries...

Terapia endodôntica em dentes decíduos por odontopediatras / Endodontic Therapy in Primary Teeth by Pediatric Dentists

Objetivo: Verificar a conduta de odontopediatras quanto à escolha da terapia endodôntica em dentes decíduos, assim como os fatores que influenciam essa eleição e os materiais nela utilizados. Método: Estudo transversal com 30 odontopediatras atuantes no Estado do Pará, Região Amazônica do Brasil, a partir de um questionário elaborado contendo informações pessoais e questões de caráter específico sobre possíveis técnicas de terapias endodônticas em dentes decíduos. Os dados foram apurados utilizando o softwareMicrosoft Excel 2010, onde foi elaborada a estatística descritiva.Resultados: Em caso de molar decíduo com cárie profunda sem exposição pulpar, 86,7% dos odontopediatras realizariam a proteção pulpar indireta (PPI). No caso de pequena exposição acidental da polpa, 50% fariam proteção pulpar direta (PPD) e 46,7%, a pulpotomia. Já em grande exposição pulpar com inflamação suave, 56,7% fariam a pulpotomia e 43,3% a PPD. Em polpa exposta, a pulpectomia foi o tratamento mais relatado em dentes com 1/3 de reabsorção radicular, presença de pólipo pulpar e presença de fístula. Nos casos de extensa lesão radicular e fístula, a maioria (93,3%) faria exodontia. Como medicação intracanal indicada, 36,7% escolheria a pasta Guedes Pinto em casos de pulpectomia. Em caso de pulpotomia, Hidróxido de cálcio (36,7%) e formocresol (33,3%) foram os materiais mais indicados. A pasta de hidróxido de cálcio é o material de escolha na PPD e na PPI para, respectivamente, 83,3% e 86,7% dos profissionais. Conclusão: Não foi observada uniformidade nas respostas da maioria das situações, especialmente nos casos de exposição da polpa e na escolha do material para a técnica. Estes dados confirmam a necessidade de um protocolo clínico para o tratamento pulpar em dentes decíduos baseado em comprovada evidência científica.

Objective: To evaluate the pediatric dentist?s approach with regards to choice of the endodontic therapy in primary teeth and the factors that account to the election of treatment and the materials.Method: This research was a cross-sectional study involving 30 pediatric dentists from the Pará State in the northern Brazil, based on the answers to a questionnaire containing personal information and specific questions addressing the possible endodontic therapies for primary teeth. The collected data were analyzed using Microsoft Excel 2010 software, in which a descriptive statistics was carried out.Results: In primary molars with deep caries without pulp exposure, 86.7% of the pediatric dentists would choose indirect pulp capping (IPC). In case of a small accidental pulp exposure, 50% would perform direct pulp capping (DPC) and 46.7% would perform pulpotomy. In case of a large pulp exposure with mild inflammation, 56.7% of the interviewers would do pulpotomy and 43.3% DPC. Pulpectomy was the most reported treatment for teeth with pulp exposure, 1/3 of root resorption, pulpal polypus and fistula. In case of extensive root lesion and fistula, most participants (93.3%) would perform exodontia. For intracanal dressing in cases of pulpectomy, 36.7% would choose the Guedes Pinto paste. For pulpotomy, calcium hydroxide (36.7%) and formocresol (33.3%) were the most frequently indicated. Calcium hydroxide paste was the material of choice for IPC and DPC for 83.3% and 86.7% of the professionals, respectively.Conclusion: There were no uniformity in the answers for most situations, especially for choosing the treatment and material for cases of pulp exposure. The results emphasize the need for establishing a research-based clinical protocol for pulpal therapy in primary teeth.

Prevalência de doença periodontal em mulheres menopausadas atendidas na Fundacão Santa Casa de Misericórdia do Pará / Prevalence of periodontal disease in postmenopausal women metat the Santa Casa de Misericórdia do Pará

Objetivo: Identificar a prevalência da doença periodontal entre mulheres menopausadas e analisar fatores associados à doença periodontal. Método: Trata-se de um estudo transversal exploratório, feito por meio de questionário próprio e exame clínico oral. A amostra foi composta por 40 mulheres usuárias dos serviços de Saúde da Mulher da Fundação Santa Casa de Misericórdia do Pará de janeiro a maio de 2011. Resultados: Os resultados obtidos mostram que 18% são pardas e 45% são casadas. Em relação à presença da síndrome da boca ardente, observou-se que 22,5% das mulheres apresentavam o quadro. De acordo com a análise estatística, o coeficiente de Spearman (rs) = 0,2436 apresentou uma relação entre higiene oral deficiente e maior tendência a apresentar a síndrome da boca ardente (t = 1,5483 e p = 0,1298). Conclusão: Observa-se que o índice de doença periodontal elevado e o grande número de sextantes excluídos na faixa etária analisada demonstram a assistência recebida por essas mulheres, que, pela situação atual do estado de saúde, têm agravamentos da condição periodontal dos elementos dentais restantes. Esses resultados podem auxiliar na formulação de políticas públicas dirigidas à promoção da saúde bucal na região estudada.

Purpose: This study aims to identify the prevalence of periodontal disease among menopausal women and examine factors associated with periodontal disease. Method: This is an exploratory cross-sectional study, conducted by a questionnaire and an oral examination. The sample consisted of 40 women who used the services of Women's Health Foundation of Santa Casa de Misericórdia do Pará, between January and May of 2011. Results: The results of this study show that 18% are brown and 45% were married. Regarding the presence of burning mouth syndrome was observed that 22.5% of women had the picture. In statistical analysis, the Spearman coefficient (rs) = 0.2436 showed a relationship between poor oral hygiene and a greater tendency to present the burning mouth syndrome (t = 1.5483 and p = 0.1298). Conclusion: It is noted that the rate of periodontal disease and the high number of excluded sextants in the age group analyzed, demonstrates the care offered to these women and that the current state of health, is worsening the periodontal condition of the few remaining teeth. These results may help in the formulation of public policies aimed at promoting oral health in the region studied.