Immunohistochemistry of resorption and inflammation factors in the periodontal ligament of human deciduous teeth.

The understanding of the biological mechanisms involved in root resorption in deciduous teeth is important to the future development of preventive measures and treatments of this condition. The aim of the present study was to compare the expression and immunostaining of iNOS, MMP-9, OPG and RANKL in the periodontal ligament (PDL) of deciduous teeth with physiologic root resorption (GI), inflammatory pathological root resorption (GII) and permanent teeth (GIII), the negative control. Teeth in GI (n = 10), GII (n = 10) and (GIII) (n = 10) were submitted to immunohistochemical analysis to determine the expression of iNOS, MMP-9, OPG, and RANKL. The immunostaining was analysed by optical density. Statistical analysis included one-way ANOVA, followed by Student-Newman-Keuls post hoc test (p < 0.05). The results showed that iNOS, MMP-9 and RANKL expression in the PDL was higher in GII compared to GI and GIII (p < 0.05). Moreover, RANKL expression was higher in GI compared to GIII (p < 0.001), while OPG immunolabelling was lower in GII compared to GI and GIII (p < 0.001). The PDL of deciduous teeth bearing inflammatory processed exhibited upregulation of resorption-associated factors as well as enzymes related to tissue degradation which, in turn explains the exacerbation and greater susceptibility of those teeth to root resorption process.

Prevalence of malocclusion in public school students in the mixed dentition phase and its association with early loss of deciduous teeth.

OBJECTIVE: To determine the prevalence of malocclusion and its association with the early loss of deciduous teeth and other factors in children in the mixed dentition phase, aged six to eight years, enrolled in public schools in southern Brazil. METHODS: A cross-sectional study was conducted with a representative sample of 528 children from municipal public schools in 2009. Data collection involved a clinical examination for the determination of early tooth loss, dental caries, tongue pressure and malocclusion (outcome), as well as the administration of a questionnaire. Poisson regression analysis with robust variance was used to model the association between malocclusion and the independent variables. RESULTS: The prevalence of malocclusion and early tooth loss was 69.1% and 21.8%, respectively. In the raw data analysis, malocclusion was associated with age, early tooth loss, dental caries and tongue pressure. After the adjustment, the likelihood of malocclusion was greater among children older than eight years, those who exerted tongue pressure on the teeth and those with early tooth loss. The likelihood of malocclusion was 24% greater among children with early tooth loss, compared to those without tooth loss. CONCLUSION: The early loss of deciduous teeth was associated with the occurrence of malocclusion in the children studied.

Prevalence of malocclusion in public school students in the mixed dentition phase and its association with early loss of deciduous teeth

ABSTRACT Objective: To determine the prevalence of malocclusion and its association with the early loss of deciduous teeth and other factors in children in the mixed dentition phase, aged six to eight years, enrolled in public schools in southern Brazil. Methods: A cross-sectional study was conducted with a representative sample of 528 children from municipal public schools in 2009. Data collection involved a clinical examination for the determination of early tooth loss, dental caries, tongue pressure and malocclusion (outcome), as well as the administration of a questionnaire. Poisson regression analysis with robust variance was used to model the association between malocclusion and the independent variables. Results: The prevalence of malocclusion and early tooth loss was 69.1% and 21.8%, respectively. In the raw data analysis, malocclusion was associated with age, early tooth loss, dental caries and tongue pressure. After the adjustment, the likelihood of malocclusion was greater among children older than eight years, those who exerted tongue pressure on the teeth and those with early tooth loss. The likelihood of malocclusion was 24% greater among children with early tooth loss, compared to those without tooth loss. Conclusion: The early loss of deciduous teeth was associated with the occurrence of malocclusion in the children studied.

RESUMO Objetivo: Determinar a prevalência de má oclusão em crianças de seis a oito anos de idade no município de Florianópolis (Santa Catarina, Brasil), e a sua associação com a perda precoce de dentes decíduos. Métodos: Esse estudo transversal avaliou uma amostra representativa de 528 crianças de escolas públicas municipais de Florianópolis, no ano de 2009. Os dados foram coletados por meio de exame clínico (perda dentária precoce, cárie dentária, interposição lingual e má oclusão - que foi o desfecho do estudo) e de um questionário. A regressão de Poisson com variância robusta foi utilizada para modelar a associação entre má oclusão e as variáveis independentes. Resultados: A prevalência de má oclusão e de perda dentária precoce foi, respectivamente, de 66,7% e 21,8%. Na análise dos dados brutos, a má oclusão foi associada com a idade, perda dentária precoce e cárie dentária. Após ser feito o ajuste, crianças com mais de 7 anos, com interposição lingual e perda dentária precoce apresentaram maior probabilidade de ter má oclusão. Crianças com perda dentária precoce apresentaram probabilidade 24% maior de ter má oclusão do que aquelas sem perda dentária. Conclusões: A perda precoce de dentes decíduos foi associada à ocorrência de má oclusão nas crianças estudadas.

Immunohistochemistry of resorption and inflammation factors in the periodontal ligament of human deciduous teeth

Abstract: The understanding of the biological mechanisms involved in root resorption in deciduous teeth is important to the future development of preventive measures and treatments of this condition. The aim of the present study was to compare the expression and immunostaining of iNOS, MMP-9, OPG and RANKL in the periodontal ligament (PDL) of deciduous teeth with physiologic root resorption (GI), inflammatory pathological root resorption (GII) and permanent teeth (GIII), the negative control. Teeth in GI (n = 10), GII (n = 10) and (GIII) (n = 10) were submitted to immunohistochemical analysis to determine the expression of iNOS, MMP-9, OPG, and RANKL. The immunostaining was analysed by optical density. Statistical analysis included one-way ANOVA, followed by Student-Newman-Keuls post hoc test (p < 0.05). The results showed that iNOS, MMP-9 and RANKL expression in the PDL was higher in GII compared to GI and GIII (p < 0.05). Moreover, RANKL expression was higher in GI compared to GIII (p < 0.001), while OPG immunolabelling was lower in GII compared to GI and GIII (p < 0.001). The PDL of deciduous teeth bearing inflammatory processed exhibited upregulation of resorption-associated factors as well as enzymes related to tissue degradation which, in turn explains the exacerbation and greater susceptibility of those teeth to root resorption process.

Efficacy and safety of midazolam for sedation in pediatric dentistry: a controlled clinical trial.

PURPOSE: Pharmacological management of uncooperative children is becoming increasingly common in the dental setting. The purpose of this study was to determine the efficacy and safety of 3 different doses of midazolam for sedation in 2- to 4- year-old children with multiple dental needs and negative behavior. METHODS: Ten children participated in this crossover, controlled, double-blinded clinical trial, which evaluated their behavior, appointment length and patient response after administration of 3 different doses of midazolam or placebo. Oxygen saturation, heart rate, respiratory rate, and blood pressure were monitored in all sessions. RESULTS: Sedated children exhibited a more positive behavior compared to the placebo group, both at the beginning of the appointment (sitting in the chair) and during administration of local anesthesia (P=.008 and P<.03, respectively). The use of midazolam allowed for longer appointments, and doses of at least 0.3 mg/kg produced a higher rate of positive behavior overall. No changes in oxygen saturation, heart rate, respiratory rate, and blood pressure were observed. CONCLUSION: Midazolam was effective and safe for pediatric sedation in the dosages studied.

O início do desmame precoce: motivos das mães assistidas por serviços de puericultura de Florianópolis/SC para esta prática / Early weaning: motives for this practice of mothers attending an infant welfare service in Florianopolis/SC, Brazil

Objetivo: Identificar as razões das mães de crianças de 6 a 12 meses de idade, em acompanhamento de puericultura na cidade de Florianópolis/SC, para a interrupção do aleitamento materno exclusivo (AME) antes do sexto mês pós-parto (início do desmame precoce). Método: Estudo transversal de características descritivas, realizado a partir de entrevistas guiadas por um questionário, aplicado a 100 mães que realizaram consultas de puericultura no Hospital Universitário da Universidade Federal de Santa Catarina (HU - UFSC) e em outras 100 mulheres que o fizeram na Unidade de Saúde do Saco Grande II (USSGII), entre janeiro e abril de 2005, totalizando uma amostra de 200 mães. Os dados foram analisados e as variáveis classificadas em categorias através da análise do significado e redução das respostas. Em seguida foram organizados com o programa Epi Info 3.5 e apresentados por meio da estatística descritiva (distribuições absolutas e percentuais). Resultados: O aleitamento materno foi realizado por 98% da amostra; entre as mães que amamentaram, 18,4% realizaram aleitamento materno exclusivo até o sexto mês de vida do seu filho. O desmame foi iniciado de forma precoce por 81,6% das participantes, sendo que 46,2% dessas mães o fizeram motivadas por conceitos pessoais, 35,6% relataram algum problema relacionado à saúde do bebê, 27,5% em função dos múltiplos papéis desempenhados pela mulher-mãe, 19,4% alegaram algum problema orgânico pessoal e 18,7% o realizaram por orientação de alguém. Conclusão: A influência cultural e familiar, o trabalho materno e problemas de saúde da mãe e do bebê foram determinantes para o início do desmame precoce.

Objective: To identify the reasons why mothers of children aged 6 to 12 months attending an infant welfare service in Florianopolis/SC, Brazil interrupted the exclusive breastfeeding (EBF) before the sixth month postpartum (beginning of early weaning). Methods: A cross-sectional study with descriptive and analytical characteristics was conducted based on questionnaire-guided interviews proposed to 100 mothers who had routine infant welfare visits at the University Hospital of the Federal University of Santa Catarina (HU - UFSC) and other 100 mothers who did so at the Saco Grande II Public Health Unit (USSGII), between January and April 2005, a total sample of 200 mothers. Data were analyzed and the variables were classified into categories by examining the meaning and the reduction of responses. The data were organized by EpiData version 3.1 and processed electronically by public domain software Epi Info - version 3.5. Results: Breastfeeding was reported by 98% of the sample. Among the mothers that breastfed, 18.4% did it exclusively until the infant reached six months. Early weaning was reported by 81.6% of the sample; 46.2% of them were motivated by their own concepts, 35.6% reported infant-related problems, 27.5% attributed to the multiple tasks assigned to a woman-mother, 19.4% reported a personal systemic problem, and 18.7% followed an advice from someone else. Conclusion: Cultural and familial influence, maternal work and maternal and infant health problems were determinant factors for early weaning.

Prevalência do Início do Desmame Precoce em duas Populações Assistidas por Serviços de Puericultura de Florianópolis, SC, Brasil / Prevalence of the Early Weaning in Two Populations Assisted at Infant Services of the City of Florianópolis, SC, Brazil

Objetivo: Verificar a prevalência de aleitamento materno (AM), aleitamento materno exclusivo (AME) e AM predominante (AMP) até 6 meses e, do início do desmame precoce (AME<6 meses), em mães de crianças de 6 a 12 meses de idade, em acompanhamento de puericultura no Hospital Universitário da Universidade Federal de Santa Catarina (HU - UFSC) e na Unidade de Saúde do Saco Grande II (USSGII) na cidade de Florianópolis/SC. Método: Estudo transversal de características descritivas e analíticas, realizado a partir de entrevistas guiadas por um questionário, aplicado a 100 mães que realizaram consultas de puericultura no Hospital Universitário da Universidade Federal de Santa Catarina (HU - UFSC) e em outras 100 mulheres que o fizeram na Unidade de Saúde do Saco Grande II (USSGII), entre janeiro e abril de 2005, totalizando uma amostra de 200 mães. Resultados: O aleitamento materno foi realizado por 98% da amostra; entre as que amamentaram 18,4% realizaram aleitamento materno exclusivo até o sexto mês de vida do seu filho. O início do desmame precoce foi realizado por 81,6% das participantes sendo que, destas, 15% realizaram aleitamento materno predominante nos 6 meses após a gestação.Conclusão: O aleitamento materno tem sido iniciado pela maioria das mulheres, mas poucas conseguem fazer o aleitamento materno exclusivo até o sexto mês de idade do bebê. A introdução de água, chá ou suco e o desmame completo, antes dos seis meses, vem sendo bastante praticados pelas mães. É relevante a participação do cirurgião dentista, na orientação às mães para a realização do aleitamento materno de forma adequada

Objective: To evaluate the prevalence of maternal breastfeeding (MB), exclusive maternal breastfeeding (EMB) and predominant MB (PMB) up to 6 months of age, and early weaning (EMB <6 months) among mothers of children aged 6 to 12 months asisted at the Infant Servicesof the University Hospital of the Federal University of Santa Catarina (HU - UFSC) and the Public Health Unit æSaco Grande IIÆ (USSGII) in the city of Florianópolis, SC, Brazil. Method: This investigation was a cross-sectional study with descriptive and analytical characteristics, which was conducted based on interviews guided by a questionnaire applied to 100 mothers that attended infant welfare visits at the University Hospital of the Federal University of Santa Catarina (HU - UFSC) and in other 100 women that attended these visits at the Saco Grande II Public Health Unit (USSGII), between January and April 2005, composing a sample of 200 mothers. Results: Maternal breastfeeding was performed by 98% of the women; among these, 18.4% reported exclusive breastfeeding until up to the 6th month of life of their children. Early weaning was performed by 81.6% of the participants and 15% of them used predominant breastfeeding during the first 6 months of life of their babies. Conclusion: Maternal breastfeeding was initiated by most women, but only few of them maintained exclusive breastfeeding until their babies were 6 months old. Introduction of water, tea or juice and complete weaning before 6 months of age was a frequent practice among the interviewed mothers. It is relevant the engagement of dentists for instructing pregnant women and mothers of newborns on how maternal breastfeeding should done in an adequate manner

Fatores Associados ao Desmame Precoce em Mães Assistidas por Serviços de Puericultura de Florianópolis/SC / Associated Factors in the Early Weaning in Mothers Assisted by Infantile Nursing Service in Florianopolis/SC

Objetivo: identificar a prevalência do desmame precoce (aleitamento materno exclusivo <6 meses) entre mães de crianças de seis a 12 meses de idade, em acompanhamento de puericultura no Hospital Universitário da Universidade Federal de Santa Catarina (HU - UFSC) e na Unidade de Saúde do Saco Grande II (USSGII) em Florianópolis/SC e verificar sua associação com variáveis maternas e do lactente.Método: estudo transversal de características descritivas e analíticas, realizado a partir de entrevistas aplicadas a 200 mães que realizaram consultas de puericultura nestas duas unidades de serviço público de saúde de Florianópolis, entre janeiro e abril de 2005. Utilizou- se o teste exato de Fisher ou qui-quadrado para análise univariada, e as variáveis que apresentaram p<0,20 foram incluídas num modelo de regressão logística múltipla para testar a independência entre elas, considerando estatisticamente significativo um valor de p≤0,05.Resultados: o aleitamento materno (AM) foi realizado por 196 (98%) mulheres e o desmame foi precoce em 160 (81,6%) delas. As variáveis: mãe ter até 26 anos de idade (OR: 2,9; 95% IC: 1,2-6,9; p=0,015), realizar pré-natal na USSG II (OR: 3,3; 95% IC: 1,1-9,5; p=0,029), o bebê não mamar no peito na primeira hora de vida (OR: 3,6; 95% IC: 1,4-9,5; p=0,008) bem como, o trabalho materno nos primeiros seis meses após o parto (OR: 6,0; 95% IC: 2,3-15,8; p<0,001), mostraram-se associadas ao início do desmame precoce independentemente das outras variáveis estudadas.Conclusão: a taxa de amamentação exclusiva na amostra estudada está aquém do preconizado pela Organização Mundial da Saúde. Houve associação, independentemente de outras variáveis, entre o desmame precoce com trabalho e idade maternos, local de pré-natal e tempo decorrido para a primeira mamada

Objective: To identify the prevalence of the early weaning (exclusive breast-feeding <6months), in mothers of children aged 6 to 12 months of age, in monitoring of child care at Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC) and the Unidade de Saúde do Saco Grande II (USSGII) in the city of Florianopolis/SC and to determined its association with maternal and infant variables.Method: The transversal study of descriptive and analytical characteristics was conducted through interviews guided by a questionnaire answered by 200 mothers who had routine visits in these two units of public health in Florianopolis, between january and april 2005. We used Fisher's exact test or chi-square test for univariate analysis and variables with p<0.20 were included in a multiple logistic regression model to test the independence between them, considering statistically significant p value ≤0.05.Results: The breastfeeding (BF) was accomplished by 98% of women and the weaning was early in 81.6% of cases. The variables, mother has until 26 years of age (OR: 2,9; 95% IC: 1,2-6,9; p=0,015), conduct antenatal in USSG II (OR: 3,3; 95% IC: 1,1-9,5; p=0,029), the baby not to breastfeed in the first hour of life (OR: 3,6; 95% IC: 1,4-9,5; p=0,008) and as the maternal employment during the first six months postpartum (OR: 6,0; 95% IC: 2,3-15,8; p<0,001) were related to the initiation of early weaning regardless of other variables.Conclusion: The rate of exclusive breastfeeding in this sample is lower than those recommended by the World Health Organization. Occurred association independent of other variables, from the early weaning with, maternal labor and age, place of antenatal care and time taken to first feeding

[Practices and meanings of oral health: a qualitative study with mothers of children assisted at the Federal University of Santa Catarina]. / Práticas e significados de saúde bucal: um estudo qualitativo com mães de crianças atendidas na Universidade Federal de Santa Catarina.

This research aimed to know oral health practices and meanings of mothers whose children were attended in the dental pediatric clinics of the Federal University of Santa Catarina. The qualitative method, case study, was used and data were collected by semi-structured interview. The studied population consisted of seven mothers that took their children to odontologic attendance at the university. It was observed that despite previous negative odontologic experiences, economic difficulties and pregnancy have also influenced those mothers to look for and adhere to dental care. The dental visits occurred, mostly, for curative assistance. The mothers took care of their children's teeth because it was considered a maternal responsibility, to prevent dental caries and their consequences, to avoid wasting money with expensive treatment and children's bad experiences with dentists. Mothers received information on the subject from dentists, doctors, nurses, schools, mass communication media and odontology students. Despite of their desire in taking care adequately of their children's health, those mothers don't always have favorable socio-economic conditions to put the obtained instructions into practice.

Práticas e significados de saúde bucal: um estudo qualitativo com mães de crianças atendidas na Universidade Federal de Santa Catarina / Practices and meanings of oral health: a qualitative study with mothers of children assisted at the Federal University of Santa Catarina

Este estudo objetivou conhecer práticas e significados de saúde bucal de mães de crianças atendidas em clínicas de odontopediatria da Universidade Federal de Santa Catarina. O método qualitativo tipo estudo de caso foi utilizado e os dados foram coletados por meio de entrevista semiestruturada. A população estudada constituiu-se por sete mães que levavam seus filhos para atendimento odontológico na universidade. Observou-se que experiências negativas vivenciadas em tratamentos odontológicos anteriores, dificuldades financeiras e gravidez influenciaram-nas na busca e adesão a tratamentos. A procura pelo dentista ocorreu, principalmente, para realização de procedimentos curativos. As mães cuidam dos dentes de seus filhos por considerarem tais cuidados responsabilidade materna, para prevenir cárie e suas consequências, evitar gastos com tratamentos onerosos e que as crianças passem por experiências desagradáveis com dentistas. As fontes de informação citadas sobre os cuidados com a boca foram dentistas, médicos, enfermeiras, escolas, veículos de comunicação em massa e acadêmicos de odontologia. Apesar de desejarem cuidar da saúde de seus filhos de maneira adequada, nem sempre elas têm condições econômicas e sociais favoráveis para colocar os ensinamentos em prática.

This research aimed to know oral health practices and meanings of mothers whose children were attended in the dental pediatric clinics of the Federal University of Santa Catarina. The qualitative method, case study, was used and data were collected by semi-structured interview. The studied population consisted of seven mothers that took their children to odontologic attendance at the university. It was observed that despite previous negative odontologic experiences, economic difficulties and pregnancy have also influenced those mothers to look for and adhere to dental care. The dental visits occurred, mostly, for curative assistance. The mothers took care of their children's teeth because it was considered a maternal responsibility, to prevent dental caries and their consequences, to avoid wasting money with expensive treatment and children's bad experiences with dentists. Mothers received information on the subject from dentists, doctors, nurses, schools, mass communication media and odontology students. Despite of their desire in taking care adequately of their children's health, those mothers don't always have favorable socio-economic conditions to put the obtained instructions into practice.

Mecanismos e fatores fisiológicos e patológicos no processo de reabsorção radicular de dentes decíduos / Physiological and pathological factors and mechanisms in the process of root resorption in primary teeth

Introdução: A reabsorção dentária é fundamental no processo de rizólise (reabsorção radicular fisiológica) dos dentes decíduos, entretanto as reabsorções dentárias patológicas, especialmente a do tipo inflamatória, caracterizam-se em consequência e/ou complicação de várias situações clínicas, como traumatismos dentários e lesões periapicais inflamatórias provenientes da doença cárie, constituindo causa comum de perda de dentes. Objetivo: Procurou-se apresentar e discutir uma revisão de literatura acerca do mecanismo das reabsorções radiculares fisiológica e patológica inflamatória em dentes decíduos, enfatizando seus eventos bioquímicos e celulares. Revisão de literatura: As células responsáveis pela reabsorção dos tecidos dentais são os odontoclastos, sob a influência de inúmeros estímulos e sinalizações moleculares oriundos de citocinas, neuropeptídeos, hormônios e produtos de degradação liberados quando o tecido é lesado. Porém até hoje não se sabe exatamente o que leva à diferenciação das células precursoras dos odontoclastos, o que lhes dá o sinal para iniciar a reabsorção em local e momento específicos (principalmente nos dentes decíduos) e por que eles são prematuramente ativados em algumas condições patológicas, mas não em outras. Conclusão: O conhecimento sobre o mecanismo molecular e os fatores que regulam o processo de reabsorção radicular ainda é escasso. A pesquisa nessa área mostra-se de grande relevância, uma vez que novos conhecimentos sobre a(s) via(s) molecular(es) da reabsorção dental podem permitir o desenvolvimento de terapias diferenciadas, mais biológicas, que controlem ou impeçam a reabsorção, evitando assim a extração do dente acometido e suas consequências.

Introduction: Tooth resorption is essential in the process of root resorption in primary teeth. However, pathological root resorption, mainly the inflammatory one, is a consequence and/or complication of several clinical conditions, such as dental trauma and periapical inflammatory lesions from dental caries, thus becoming a common cause of tooth loss. Objective: To present and discuss a literature review regarding the mechanisms of physiological and inflammatory pathological root resorption in primary teeth, emphasizing their biochemical and cellular events. Literature review: The odontoclasts cells are responsible for resorption of dental tissues, and they are influenced by several stimuli and molecular signals derived from cytokines, neuropeptides, hormones and degradation products released when tissue is injured. However, so far it is not clear what leads to the differentiation of the precursor cells of odontoclasts, what gives them the signal to start the resorption in a specific place and time (especially in primary teeth) and why they are activated in some pathological conditions, but not in others. Conclusion: The knowledge regarding molecular mechanisms and factors that regulate the process of root resorption is still meager. Research in this area is of great relevance, since new knowledge about the molecular pathway(s) involved in root resorption may allow the development of different therapies, more biological ones, in order to control or prevent resorption, thus preventing tooth loss and its consequences.

Injúrias não Intencionais na Infância: Estudo Piloto com Mães que Frequentam a Clínica de Bebês da Universidade Federal de Santa Catarina, Brasil / Non-intentional injuries in childhood: pilot-study with mothers attending the baby clinic of the Federal University of Santa Catarina, Brazil

Objetivo: Identificar a ocorrencia de injurias nao intencionais entre criancas de ate 3 anos de idade, que frequentam a Clinica de Bebes da Universidade Federal de Santa Catarina, junto a suas maes. Metodo: Estudo piloto transversal descritivo, com eixo temporal contemporaneo, realizado a partir de entrevistas guiadas por um questionario, com questoes abertas e fechadas, aplicadas a 28 maes de criancas que frequentaram a Clinica de Bebes da disciplina de Odontopediatria da Universidade Federal de Santa Catarina (UFSC), durante o ulti mo trimestre do ano de 2007. Resultados: Entre as maes entrevistadas 10 (35,7%) referiram a ocorrencia de injuria(s) nao intencional(is) no seu filho, perfazendo um total de 21 casos. A residencia das criancas foi o local onde ocorreram 12 (57,1%) das 21 injurias citadas, e 15 (71,4%) delas foram causadas por quedas. Em 18 (85,7%) casos a mae ou o pai acompanhavam a crianca no momento do agravo, e 12 (57,1%) das injurias tiveram gravidade moderada, exigindo atendimento hospitalar sem internacao. Em relacao ao recebimento de informacoes sobre a prevencao de injurias nao intencionais, 10 (35,7%) maes declararam nunca terem sido orientadas a respeito. Conclusao: A incidencia de injurias nao intencionais foi alta na amostra estudada, havendo a necessidade de estudos a nivel populacional, que possam orientar acoes praticas de prevencao deste agravo. Ainda, cirurgioes-dentistas, especialmente odontopediatras, tem contato regular com criancas e suas familias, portanto e de grande valia sua participacao em acoes conjuntas entre governo, profissionais da saude e sociedade civil, visando a promocao da seguranca infantil.

Objective: To identify the occurrence of non-intentional injuries in children under the age of 3 att ending the Baby Clinic of the Federal University of Santa Catarina, SC, Brazil, with their mothers. Method: This investigation was a descriptive cross-sectional pilot-study with a contemporaneous temporal axis, which conducted from interviews guided by a questionnaire with open and multiple-choice questions applied to 28 mothers of children who attended the Baby Clinic of the Discipline of Pediatric Dentistry of the Federal University of Santa Catarina during the last trimester of 2007. Results: Among the interviewed mothers, 10 (35.7%) reported that their children had suffered non-intentional injuries, totalizing 21 cases. Home was the site of accident of 12 (57.1%) of the 21 injuries, and 15 (71.4%) of them were caused by falls. In 18 (85.7%) cases, either the mother or the father was with the child at the moment of the accident, and 12 (57.1%) injuries had moderate severity, requiring in-hospital treatment without need of admission. Ten (35.7%) mothers affirmed that they had never received information about prevention of non-intentional injuries. Conclusion: The incidence of non-intentional injuries was high in the surveyed population, showing the need of studies with a national sample that may guide practical actions to prevent this type of injury. In addition, as dentists ? especially pediatric dentists - have regular contact with children and their families, their engagement in collective actions with the government, health professionals and civil society, is very important to promote childrens safety.

Desigualdade em saúde / Health inequalities

higher educational level have easily access to health information and treatment. Oral diseases have also their origin and clinical evolution determined by social factors, getting easily to harmful stages that can lead to oral health damage. Conclusion: Social inclusion policies should be developed with effective participation of society in order to provide better living conditions for the population, thus better health conditions, aiming at solving inequalities.

Introduction and objective: The aim of this study is to describe aspects of health inequalities in Brazil, correlating theory and practice, as well as emphasizing these aspects in dentistry. Literature review: According to recent studies, economically privileged classes with higher educational level have easily access to health information and treatment. Oral diseases have also their origin and clinical evolution determined by social factors, getting easily to harmful stages that can lead to oral health damage. Conclusion: Social inclusion policies should be developed with effective participation of society in order to provide better living conditions for the population, thus better health conditions, aiming at solving inequalities.

Participação dos pais na tomada de decisões no atendimento odontológico de seus filhos / Parent?s role On the decision taking Of their children?s dental treatment

Introdução: Segundo o Código de Ética Odontológica, é considerada infração o atendimento de pacientesinfantis sem o consentimento dos pais ou responsáveis, salvo em situações de urgência. No tratamentoodontopediátrico, é indispensável o esclarecimento dos pais em relação aos procedimentos a que seus filhos serão submetidos, as opções de tratamento existentes e seus custos, para que eles possam emitir um consentimentorealmente esclarecido. O objetivo deste estudo é analisar se e de que forma os pais participam da tomada de decisões no atendimento odontológico de seus filhos. Para tanto, realizou-se uma pesquisa, utilizando-se um questionário, junto a 122 pais, cujos filhos tinham idades entre 0 e 6 anos e encontravamsematriculados em uma escola pública no município de Florianópolis. Verificou-se que 70,2% dos paisautorizaram o tratamento de seus filhos de forma verbal, apenas 5,3% deles assinaram um Termo de Consentimento Livre e Esclarecido e 61,6% não receberam opções de tratamento. Concluiu-se que a postura paternalista do profissional, tem imperado também nos consultórios odontopediátricos, onde as decisões deveriam ser compartilhadas com os responsáveis legais pela criança

Introduction: According to the Brazilian Dental Ethical Code it is considered an infration to treat childrenwithout parents or guardians consent except in emergencial needs. On pediatric dental treatment it ismandatory that parents should be informed about the procedures that their children will receive as wellas treatment options and their costs to allow them to emit a clarified consent. The aim of this study is toanalyse if and how parents participate on decisions about their children?s dental treatment. It was used aquestionnaire to 122 parents or guardians, of children between 0 and 6 years of age, attending a publicschool in Florianópolis. 70,2% of parents did authorize orally dental treatment of their children, only 5,3%signed a written consent and 61,6% did not receive treatment options. It was concluded that paternalistposture is still present nowadays in dental pediatric office, where children?s treatment choices should beshared with parents

[Satisfaction with dental care: qualitative study of the mothers of children treated at the Santa Catarina Federal University, Brazil]. / Satisfação com o atendimento odontológico: estudo qualitativo com mães de crianças atendidas na Universidade Federal de Santa Catarina.

This survey examines perceptions among mothers of the treatment provided through pediatric dentistry clinic at the Santa Catarina Federal University and their concept of the 'ideal' dentist, using the qualitative (case study) method. Collected through semi-structured interviews with seven mothers of children treated at this pediatric dentistry clinic, the data showed that these mothers felt the 'ideal' dentist should blend affective, psychomotor and cognitive abilities: enjoying his work; being attentive and friendly; providing clear information about oral health; resolving oral problems presented by patients; and keeping up-to-date. Interpersonal aspects were crucial factors for satisfaction with the treatment provided at the University, in addition to the technical skills of the students and easy appointments at the pediatric dentistry clinic. A better understanding of the relationship between dentist and patient is suggested, associating affective factors with cognitive and psychomotor aspects in dental practice routines.

Satisfação com o atendimento odontológico: estudo qualitativo com mães de crianças atendidas na Universidade Federal de Santa Catarina / Satisfaction with dental care: qualitative study of the mothers of children treated at the Santa Catarina Federal University, Brazil

Esta pesquisa objetivou conhecer a percepção de mães em relação ao atendimento odontológico prestado em clínicas de odontopediatria da Universidade Federal de Santa Catarina (UFSC), bem como sua concepção sobre como seria o dentista "ideal". O método utilizado foi o qualitativo, tipo estudo de caso. A coleta de dados foi feita através de entrevista semi-estruturada e a população estudada constituiu-se de sete mães de crianças atendidas em clínicas de odontopediatria da UFSC. Observou-se que, para as mães entrevistadas, o dentista ideal deveria reunir habilidades afetivas, psicomotoras e cognitivas, tais como: gostar do que faz, ser atencioso e amigável, fornecer informações claras sobre saúde bucal, resolver os problemas bucais do paciente e manter-se atualizado. Os aspectos interpessoais foram fundamentais para a satisfação com o atendimento na universidade, além da capacidade técnica dos alunos e a facilidade para conseguir uma vaga no serviço de odontopediatria. Sugere-se maior entendimento, por parte dos profissionais, dos aspectos que envolvem a relação dentista-paciente, de maneira a associar fatores afetivos aos cognitivos e psicomotores no dia-a dia da prática odontológica.

This survey examines perceptions among mothers of the treatment provided through pediatric dentistry clinic at the Santa Catarina Federal University and their concept of the 'ideal' dentist, using the qualitative (case study) method. Collected through semi-structured interviews with seven mothers of children treated at this pediatric dentistry clinic, the data showed that these mothers felt the 'ideal' dentist should blend affective, psychomotor and cognitive abilities: enjoying his work; being attentive and friendly; providing clear information about oral health; resolving oral problems presented by patients; and keeping up-to-date. Interpersonal aspects were crucial factors for satisfaction with the treatment provided at the University, in addition to the technical skills of the students and easy appointments at the pediatric dentistry clinic. A better understanding of the relationship between dentist and patient is suggested, associating affective factors with cognitive and psychomotor aspects in dental practice routines.

Referencial teórico do projeto político pedagógico do curso de graduação em odontologia da universidade Federal de Santa Catarina / Theoretical reference for the teaching project of the school of dentistry at the Federal University of Santa Catarina

Apresenta o referencial teórico do Projeto Político Pedagógico do Curso de Graduação em Odontologia da Universidade Federal de Santa Catarina (UFSC), que representa o conjunto de princípios e de valores que irá orientar a uma série ordenada de atividades e de meios, articulados entre si, para a formação do Cirurgião-Dentista egresso de nossa instituição. O Curso de Graduação em Odontologia da UFSC ao estabelecer este referencial teórico tem por objetivo contextualizar, investigar e ensinar os novos saberes e fazeres da Odontologia, necessário para formar Cirurgiões-Dentistas habilitados para o exercício de uma profissão contemporânea, promotora de saúde e fundamentada nos preceitos da ética, da moral, da ciência, da filosofia e, principalmente, voltada para realidade da nossa instituição de ensino, bem como ser referencia no Brasil, na produção de conhecimentos nas áreas Político-gerencial, Educacional e Cuidado à Saúde das Pessoas (AU).

The aim of this article is to present a theoretical reference for the Teaching Project of the School of Dentistry at the Federal University of Santa Catarina ­ UFSC, comprising a group of principles and values, which will guide a series of orderly activities and means, interconnected to one another, for the education of dentists in our institution. The aim of the School of Dentistry at UFSC, when establishing this theoretical reference, was to contextualize, investigate, and teach state-of-the-art dentistry, essential to train qualified professionals to practice a contemporary profession, promoting health and based on ethics, and on moral, scientific, and philosophic principles. In addition, this reference takes into consideration the socioeconomic reality of our institution and is aimed at referencing the knowledge produced in the policy, management, educational, and health care areas (AU).

Conduta terapêutica em portador da doença de von Willebrand: relato de caso clínico / Therapeutic management in carriers of von Willebrand disease: a case report

A doença de von Willebrand é a mais comum das doenças hereditárias de coagulação, caracterizada por uma anormalidade quantitativa ou qualitativa do fator von Willebrand, glicoproteína presente no plasma, plaquetas e células endoteliais. Resulta em duplo defeito hemorrágico, caracterizado por tempo de sangramento prolongado e níveis plasmáticos baixos do fator VIII de coagulação. É importante que o cirurgião-dentista conheça essa entidade e os riscos originários da mesma. O trabalho conjunto desse profissional e do hematologista é essencial para a segurança nas abordagens odontológicas em portadores dessa doença. Este artigo relata um caso clínico envolvendo a extração de molares permanentes em portador de von Willebrand do tipo 1, com ênfase na utilização de acetato de desmopressin e ácido tranexâmico para a prevenção de quadro hemorrágico.

von Willebrand's disease is the most commom of the coagulation hereditary disorders and it is characterized by a quantitative and a qualitative abnormality of the von Willebrand's factor, which is a glycoprotein found in plasma, platelets and endothelial cells. It has a double bleeding defect characterized by a prolonged bleeding time and lower plasmatic levels of the clotting VIII factor. It is important that the clinician knows this disease and the risks that it involves. It is essential that dentists and hematologists work together in order to give a secure treatment to von Willebrand carriers. This clinical case describes a dental treatment, which involved permanent molars extraction in a thirteen years old patient, with type 1 von Willebrand disease, emphasizing the use of desmopressin acetate and tranexamic acid in prevention of the hemorragic aspect.

The impact of treatment of dental trauma on the quality of life of adolescents - a case-control study in southern Brazil.

The aim of this study was to investigate the impact of treatment for Enamel-Dentin Fracture (EDF) on the daily activities of adolescents. This was a case-control study (1:4). The case group was composed of 40 adolescents from 11 to 17 years of age, presenting definitive restoration treatment for EDF for over 6 months. The control group was made up of 160 adolescents with no history of dental trauma and belonging to the circle of friends of the participants of the case group, matched by gender, age, and socioeconomic level. The outcome variable 'impact' was assessed through the Oral Impact on Daily Performances (OIDP). The independent variables were collected for being of interest to the study (dental trauma) or for acting as potential confounding factors (malocclusion, decay, and mother's education). Descriptive, univariate, simple and multiple logistic regression analyses were performed. Among the cases, the impact prevalence was 40.0%, whereas among the controls it was 16.9%. The more affected daily activities were showing the teeth (18.0%), eating (6.5%), speaking (2.0%), and cleaning the mouth (0.5%). The odds ratio of adolescents treated for EDF of presenting an impact on daily activities was 3.3 times (confidence interval 95%: 1.4-7.7) greater than among adolescents without dental trauma, controlling for mother's education, decay and the presence of malocclusion. Adolescents whose teeth have been esthetically treated for EDFs run a greater risk of presenting OIDP when compared to adolescents that have never suffered dental injuries.

Remoção de hábitos de sucção não-nutritiva: integração da odontopediatria, psicologia e família / Nonnutritional sucking habits removal: integration among pedodontics, psychology and family

Os hábitos de sucção não-nutritiva de dedo, chupeta ou lábio podem causar alterações à oclusão quando mantidos além dos quatro anos da criança. O objetivo deste trabalho é apresentar a técnica desenvolvida por uma psicólogo que atua junto à disciplina de Odontopediatria da Universidade Federal de Santa Catarina que visa a remoção de hábitos de sucção não nutritiva, em crianças alfabetizadas ou não. A técnica é realizada em três etapas: conversa com os pais ou responsáveis; a apresentação do problema à criança e o desenvolvimento das atividades lúdicas. É fundamental quea criança e a família estejam motivadas em abandonar o hábito, motivação que é mantida pelo diálogo e carinho proporcionados pelos momentos em família. O hábito é sempre prazeroso e sua substituição por esses momentos facilita seu abandono. Entretanto, frente às dificuldades familiares algumas crianças podem necessitar de acompanhamento psicológico especializado. Foram concluídos dez casos, sete com completa remoção do hábito em aproximadamente quatorze dias e três que necessitaram de quatro meses. Todos permanecem sob monitoramento e sem a retomada do hábito. Concluiu-se que a técnica é eficiente e pode ser utilizada na prática odontopediátrica, contribuindo para a remoção de hábitos de sucção não-nutritiva.