Relationship between tooth loss, nutritional status and consumption of macro and micronutrients in elderly people from southern Brazil

Maintaining a functional natural dentition plays an important role in keeping a satisfactory nutritional status. The aim of this study was to evaluate the relationship between oral health conditions determined by the presence of edentulism and the number of missing teeth, nutritional status and consumption of nutrients by the elderly. This cross-sectional study comprised 494 independent elderly of both genders, over 60 years of age, registered at the Brazilian public health service in Londrina, southern Brazil. The data collection included: oral examinations; anthropometric measurements by calculating the Body Mass Index (BMI); analysis of food consumption based on a multiple pass 24-hour dietary recall and a food intake frequency questionnaire; and structured interviews to obtain sociodemographic information. Multiple linear regression, the Fisher's Exact test, chi-square and Mann-Whitney tests, were applied at a 5% significance level. The prevalence of edentulism was 47.3%; this predominated in females, age group from 65 to 74 years, low education level and low/medium economic classification. A larger numberof underweight and fewer number of overweight elderly were recorded among the edentulous versus dentate participants (< 0.0001). Significantly lower consumption of several nutrients, as well as fruit, was recorded among the edentulous group. In particular, carbohydrates, vitamins (B1, B9 and C), and the majority of the minerals studied were associated with a larger number of missing teeth. In conclusion, tooth loss was associated with the food consumption pattern of some macro-and micronutrients and the nutritional status of the Brazilian elderly.

Knowledge and Practices of Mothers towards Infant Oral Health Care in Their Children's First Year of Life / Conhecimentos e Práticas de Mães Sobre a Saúde Bucal Infantil no Primeiro Ano de Vida de seus Filhos

This study aimed to assess mothers' oral health-related knowledge and practices in immediate and late puerperium, and in the child's first year of life. This study is a prospective cohort study, in which data were collected from 358 mothers of children born between 2013 and 2014, in immediate and late puerperium, and in children's first year of life, by interviews with sociodemographic characterization and oral health questionnaires, and were analyzed by descriptive statistics and Chi-square test (α = 5%). Participants were mainly aged 20 to 29 years (53.9%), with 7 to 11 years of education (67.6%), from low social class (72.3%), unemployed (58.9%), married or in common-law marriage (84.1%), with more than one child (60.1%). Although 51.7% of them had received information about children's oral health, only 0.8%, 32.4% and 13.7%, respectively, knew the concept, etiology and preventive attitudes regarding dental caries. Mothers aged under 20 and over 30 years, with lower education and from low social class presented significantly lower oral health related knowledge. At children's first year of life, although 78.7% of the children had already been taken to the dentist, half of them had already tasted sugary foods and drinks. It is highlighted the social determination and the need of an improvement of mothers' oral health-related knowledge and practices. Educational actions, especially in prenatal programs, are important to achieve this improvement and to decrease early childhood caries rates. (AU)

Avaliar o conhecimento e as práticas de mães sobre a saúde bucal de seus filhos no puerpério imediato, tardio, e no primeiro ano de vida da criança. Trata-se de um estudo de coorte prospectiva, no qual os dados foram coletados de 358 mães de bebês nascidos entre 2013 e 2014, no puerpério imediato, tardio e um ano após o parto, por entrevistas com perguntas sobre dados sociodemográficos e sobre saúde bucal. Os dados foram analisados por estatísticas descritivas e pelo teste Qui-quadrado (α = 5%). As participantes apresentavam, majoritariamente, idades entre 20 a 29 anos (53,9%), com 7 a 11 anos de estudo (67,6%), eram de baixa classe social (72,3%), desempregadas (58,9%), casadas ou em união estável (84,1%), e tinham mais de um filho (60,1%). Apesar de 51.7% delas afirmarem ter recebido informações sobre saúde bucal infantil, apenas 0,8%, 32,4% e 13,7%, respectivamente, sabiam o conceito, etiologia e as atitudes preventivas à cárie. Mães com idades abaixo de 20 e acima de 29 anos apresentaram menor conhecimento sobre saúde bucal do que as demais. No primeiro ano de vida, apesar de 78,7% das crianças já terem ido ao dentista, metade delas já havia experimentado alimentos e bebidas açucarados. Destaca-se a determinação social e a necessidade de melhora no conhecimento e práticas das mães sobre saúde bucal. Ações educativas, especialmente em programas de atenção pré-natal, são importantes para atingir essa melhora e, consequentemente, diminuir as taxas da cárie na primeira infância. (AU)

Maternal and child health care: adequacy index in public health services.

OBJECTIVES: to analyze the adequacy of maternal and child-care in prenatal care, childbirth and the puerperal period, in the public health service. METHODS: longitudinal study carried out in a city in Paraná with 357 puerperal women in a public maternity ward, outpatient clinic for immediate puerperal return and home visit 42 days postpartum. Four care domains were grouped (1 - Prenatal, 2 - Maternity, 3 - Immediate puerperal return, 4 - Late puerperal return). Mean, median, standard deviation and coefficient of variance were calculated considering adequate assistance when ≥ 70%; and inadequate, inferior. RESULTS: lowest suitability average in Domain 3 (39.37%) and highest for Domain 4 (74.82%); median of 50.00% at 3 and 76.90% at 4. The largest standard deviation, in Domain 3 (25.18%); and high coefficient of variance for 1 and 3. CONCLUSIONS: in maternal and child follow-up, rates close to adequate in maternity care and higher in late puerperal return, meanwhile prenatal and immediate puerperal return were below the recommended in the health care network.

Maternal and child health care: adequacy index in public health services / Asistencia a la salud materno-infantil: índice de adecuación en servicios públicos de salud / Assistência à saúde materno-infantil: índice de adequação em serviços públicos de saúde

ABSTRACT Objectives: to analyze the adequacy of maternal and child-care in prenatal care, childbirth and the puerperal period, in the public health service. Methods: longitudinal study carried out in a city in Paraná with 357 puerperal women in a public maternity ward, outpatient clinic for immediate puerperal return and home visit 42 days postpartum. Four care domains were grouped (1 - Prenatal, 2 - Maternity, 3 - Immediate puerperal return, 4 - Late puerperal return). Mean, median, standard deviation and coefficient of variance were calculated considering adequate assistance when ≥ 70%; and inadequate, inferior. Results: lowest suitability average in Domain 3 (39.37%) and highest for Domain 4 (74.82%); median of 50.00% at 3 and 76.90% at 4. The largest standard deviation, in Domain 3 (25.18%); and high coefficient of variance for 1 and 3. Conclusions: in maternal and child follow-up, rates close to adequate in maternity care and higher in late puerperal return, meanwhile prenatal and immediate puerperal return were below the recommended in the health care network.

RESUMEN Objetivos: analizar la adecuación de la asistencia materno-infantil en el prenatal, parto y período puerperal, en el servicio público de salud. Métodos: estudio longitudinal realizado en ciudad de Paraná con 357 puérperas en maternidad pública, ambulatorio de retorno puerperal inmediato y visita domiciliar 42 días postparto. Se ha agrupado cuatro dominios de asistencia (1 - Prenatal, 2 - Maternidad, 3 - Retorno puerperal inmediato, 4 - Retorno puerperal tardío). Se ha calculado media, mediana, desvío estándar y coeficiente de desviación considerando asistencia adecuada cuando ≥ 70%; y inadecuada, inferior. Resultados: menor media de adecuación en el Dominio 3 (39,37%) y mayor para 4 (74,82%); mediana de 50,00% en 3 y 76,90% en 4. El desvío estándar mayor, en el Dominio 3 (25,18%); y coeficiente de desviación alta para 1 y 3. Conclusiones: en el seguimiento materno infantil, índices próximos al adecuado en la atención en la maternidad y superior en el retorno puerperal tardío, entretanto prenatal y retorno puerperal inmediato se presentaron lejos del preconizado en la red de atención a la salud.

RESUMO Objetivos: analisar a adequação da assistência materno-infantil no pré-natal, parto e período puerperal, no serviço público de saúde. Métodos: estudo longitudinal realizado em cidade do Paraná com 357 puérperas em maternidade pública, ambulatório de retorno puerperal imediato e visita domiciliar 42 dias pós-parto. Agruparam-se quatro domínios de assistência (1 - Pré-natal, 2 - Maternidade, 3 - Retorno puerperal imediato, 4 - Retorno puerperal tardio). Calculou-se média, mediana, desvio-padrão e coeficiente de variância considerando assistência adequada quando ≥ 70%; e inadequada, inferior. Resultados: menor média de adequação no Domínio 3 (39,37%) e maior para o 4 (74,82%); mediana de 50,00% no 3 e 76,90% no 4. O desvio-padrão maior, no Domínio 3 (25,18%); e coeficiente de variância alta para 1 e 3. Conclusões: no seguimento materno-infantil, índices próximos ao adequado no atendimento na maternidade e superior no retorno puerperal tardio, entretanto pré-natal e retorno puerperal imediato se apresentaram aquém do preconizado na rede de atenção à saúde.

Maternal and child health care: adequacy index in public health services / Asistencia a la salud materno-infantil: índice de adecuación en servicios públicos de salud / Assistência à saúde materno-infantil: índice de adequação em serviços públicos de saúde

ABSTRACT Objectives: to analyze the adequacy of maternal and child-care in prenatal care, childbirth and the puerperal period, in the public health service. Methods: longitudinal study carried out in a city in Paraná with 357 puerperal women in a public maternity ward, outpatient clinic for immediate puerperal return and home visit 42 days postpartum. Four care domains were grouped (1 - Prenatal, 2 - Maternity, 3 - Immediate puerperal return, 4 - Late puerperal return). Mean, median, standard deviation and coefficient of variance were calculated considering adequate assistance when ≥ 70%; and inadequate, inferior. Results: lowest suitability average in Domain 3 (39.37%) and highest for Domain 4 (74.82%); median of 50.00% at 3 and 76.90% at 4. The largest standard deviation, in Domain 3 (25.18%); and high coefficient of variance for 1 and 3. Conclusions: in maternal and child follow-up, rates close to adequate in maternity care and higher in late puerperal return, meanwhile prenatal and immediate puerperal return were below the recommended in the health care network.

RESUMEN Objetivos: analizar la adecuación de la asistencia materno-infantil en el prenatal, parto y período puerperal, en el servicio público de salud. Métodos: estudio longitudinal realizado en ciudad de Paraná con 357 puérperas en maternidad pública, ambulatorio de retorno puerperal inmediato y visita domiciliar 42 días postparto. Se ha agrupado cuatro dominios de asistencia (1 - Prenatal, 2 - Maternidad, 3 - Retorno puerperal inmediato, 4 - Retorno puerperal tardío). Se ha calculado media, mediana, desvío estándar y coeficiente de desviación considerando asistencia adecuada cuando ≥ 70%; y inadecuada, inferior. Resultados: menor media de adecuación en el Dominio 3 (39,37%) y mayor para 4 (74,82%); mediana de 50,00% en 3 y 76,90% en 4. El desvío estándar mayor, en el Dominio 3 (25,18%); y coeficiente de desviación alta para 1 y 3. Conclusiones: en el seguimiento materno infantil, índices próximos al adecuado en la atención en la maternidad y superior en el retorno puerperal tardío, entretanto prenatal y retorno puerperal inmediato se presentaron lejos del preconizado en la red de atención a la salud.

RESUMO Objetivos: analisar a adequação da assistência materno-infantil no pré-natal, parto e período puerperal, no serviço público de saúde. Métodos: estudo longitudinal realizado em cidade do Paraná com 357 puérperas em maternidade pública, ambulatório de retorno puerperal imediato e visita domiciliar 42 dias pós-parto. Agruparam-se quatro domínios de assistência (1 - Pré-natal, 2 - Maternidade, 3 - Retorno puerperal imediato, 4 - Retorno puerperal tardio). Calculou-se média, mediana, desvio-padrão e coeficiente de variância considerando assistência adequada quando ≥ 70%; e inadequada, inferior. Resultados: menor média de adequação no Domínio 3 (39,37%) e maior para o 4 (74,82%); mediana de 50,00% no 3 e 76,90% no 4. O desvio-padrão maior, no Domínio 3 (25,18%); e coeficiente de variância alta para 1 e 3. Conclusões: no seguimento materno-infantil, índices próximos ao adequado no atendimento na maternidade e superior no retorno puerperal tardio, entretanto pré-natal e retorno puerperal imediato se apresentaram aquém do preconizado na rede de atenção à saúde.

Prenatal follow-up of high-risk pregnancy in the public service.

OBJECTIVE: to analyze the prenatal follow-up of high-risk pregnancy in the public service. METHOD: an analytical cross-sectional study carried out in a public maternity hospital in the South of Brazil, during the hospitalization of 319 postpartum women using a semi-structured tool for transcription of the prenatal card records and interview. The data were analyzed using the Chi-Square test (p≤0.05). RESULTS: the adequacy of prenatal care was high (74%); 22.6% intermediate; 3.4% inefficient. Prenatal care had high coverage (100%), early onset (81.5%) and six or more visits (92.4%), but (77.4%) did not receive information about gestational disease and examinations (69.3%). There was statistical significance between the quality of prenatal care and the place of prenatal care (p=0.005). CONCLUSION: the need to implement a specific protocol for high-risk gestation and continuous education to the teams was evidenced.

ORAL HEALTH PROMOTION IN PATIENTS WITH MORBID OBESITY AFTER GASTROPLASTY: A RANDOMIZED CLINICAL TRIAL.

BACKGROUND: The bariatric surgery may have negative repercussions on oral conditions. AIM: To evaluate the impact of oral health educational/preventive program developed with patients submitted to gastroplasties. METHOD: The sample consisted of 109 patients randomly allocated to two groups: intervention group (IG), where they participated in the oral health promotion program that include multiple educational-preventive approaches; control group (CG), where they received usual care from the bariatric clinic staff, without participation in the program. The oral conditions investigated in the pre-operative and postoperative periods of one month (1M) and six months (6M) were: dental caries, periodontal disease, tooth wear, dental plaque and salivary flow. RESULTS: After bariatric surgery, patients in IG presented: fewer changes in enamel (6M: p=0.004), dentin (6M: p=0.005) and gingival bleeding (6M: p<0.0001), reduction in plaque index (1M, 6M: p<0.0001) and increased salivary flow (6M: p=0.039), when compared with CG. Incipient tooth wear was recorded in both groups (6M: p=0.713). CONCLUSION: There was a positive impact of the implemented program in the prevention of the main oral health problems in patients who underwent gastroplasties, contributing to their quality of life.

Reliability of ICDAS to Detect Occlusal Caries among Master's Degree students of Dentistry / Confiabilidade do ICDAS para Detectar Cárie Oclusal Entre Mestrandos de Odontologia

The objective of this study was to investigate the reproducibility of the International System for the Detection and Evaluation of Caries (ICDAS) for the diagnosis of caries by students of the Master's Degree in Dentistry (n = 25). The occlusal surfaces of human third molars (n = 14) were evaluated by twenty-five (n = 25) students using the ICDAS index and later a questionnaire was applied on demographic and professional context data. The dental crowns were sectioned in mesial to distal direction to obtain slices of 1mm in thickness which were observed in a stereomicroscope (40X) to identify the greatest extension of caries lesion. Data were analyzed by the Chi-Square, Fisher's Exact and Spearman's Correlation Coefficient at a significance level of 5%. There was an influence in the diagnosis of caries among students and teeth, where the majority of those who declared themselves to be safe missed the diagnosis. There was variability between the diagnosis and the proposed treatment for caries, with a better diagnosis for tooth VII and less for X; greater fit for treatment of teeth XIII, XIV and lower for IV, VI. The histological cut showed that the teeth were more affected by caries than the ICDAS. It was concluded that the ICDAS reproducibility was partially satisfactory when the occlusal surface was evaluated by the master's degree students. (AU).

Este trabalho teve o objetivo de investigar a reprodutibilidade do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS) para o diagnóstico da cárie, por estudantes de curso de Mestrado em Odontologia (n=25). As superfícies oclusais de terceiros molares humanos (n=14) foram avaliadas por vinte e cinco (n=25) estudantes, utilizando o índice ICDAS, e posteriormente foi aplicado questionário sobre dados demográficos e de contexto profissional. As coroas dentárias foram seccionadas no sentido mésio distal para obter fatias de 1 mm de espessura, que foram observadas em estereomicroscópio (40X) para identificar a maior extensão da lesão de cárie. Os dados foram analisados pelos Testes Qui-Quadrado, Exato de Fisher e Coeficiente de Correlação de Spearman, em nível de significância de 5%. Houve influência do grau de instrução dos estudantes no diagnóstico da cárie em relação ao dente avaliado e a maioria que se declarou segura errou o diagnóstico. Houve variabilidade entre o diagnóstico e o tratamento proposto para a cárie, com maior acerto para diagnóstico do dente VII e menor para o X; maior acerto para tratamento dos dentes XIII, XIV e menor para IV, VI. O corte histológico mostrou que os dentes estavam mais comprometidos pela cárie que o ICDAS. Concluiu-se que a reprodutibilidade do ICDAS foi satisfatória quando a superfície oclusal foi avaliada pelos mestrandos. (AU).

Sweetness Taste Preference Levels and Their Relationship to the Nutritional and Dental Caries Patterns among Brazilian Preschool Children

Objective: To evaluate the sweetness taste preference levels and their relationship with the nutritional and dental caries patterns among preschool children. Material and Methods: The participants of this cross-sectional study were 191 children aged 4 to 5 years, who were regularly attending public Child Education Centers of a city southern Brazil. Children's preference for sugar was evaluated by the Sweet Preference Inventory; caries prevalence, according to the World Health Organization criteria, and nutritional status, by anthropometric weight and stature measurements, in accordance with child growth standards of the World Health Organization. Results: High levels of sweetness preference were identified. The majority of children (67.5%) opted for the most concentrated sucrose solutions. Excess weight was recorded in 27.7% of the preschoolers. The prevalence of caries was 51.8%, with the mean dmf-t equal to 1.92 (± 2.72) and the decayed (c) component responsible for 94.2% of the index. No significant association between sweetness preference and the nutritional or the oral health patterns could be established. In addition, no association between excess weight and dental caries was identified. The diseases studied were only associated with sociodemographic variables. Excess weight was associated with maternal age (p=0.004) and caries experience with family income (p=0.013). Conclusion: No significant associations could be stablished between the sweetness taste preference and the diseases studied, nor between excess weight and dental caries. However, the findings of high patterns of sweet preference, excess weight and untreated caries experience, highlight the need for the implementation of integrated public policies aimed at controlling both nutritional and of oral health problems in the studied population.

Maternal near-miss in labor and delivery in the light of technologies in health.

OBJECTIVE: To know maternal near-miss situations during labor and delivery according to technologies in health. METHOD: A quantitative study conducted with puerperal women in a public institution in which the maternity department is a reference for high risk care. Data collection was performed from October 2016 to August 2017, and data were processed in SPSS 20.0. Technologies in health were used for discussing the results. RESULTS: Participation of 319 puerperal women. Primiparous women (p=0.027), previous diagnosis of hypertension (p=0.0001), preeclampsia (p=0.0001) and urinary tract infection (p=0.002) were items with statistical significance for the maternal near-miss outcome in labor and delivery. The hard technology associated with the outcome was transportation for hospitalization (p=0.035). Among the light-hard technologies, the following were associated: characteristics of amniotic fluid (p=0.05), vital signs check (p=0.0001), and initiation of the partograph for cesarean section (p=0.026). Among the light technologies, user satisfaction was relevant (p=0.007). CONCLUSION: Health technologies can be used for structuring the assistance in order to prevent maternal near-miss.

Oral health promotion in patients with morbid obesity after gastroplasty: a randomized clinical trial / Promoção de saúde bucal em pacientes com obesidade mórbida após gastroplastia: ensaio clínico randomizado

ABSTRACT Background: The bariatric surgery may have negative repercussions on oral conditions. Aim: To evaluate the impact of oral health educational/preventive program developed with patients submitted to gastroplasties. Method: The sample consisted of 109 patients randomly allocated to two groups: intervention group (IG), where they participated in the oral health promotion program that include multiple educational-preventive approaches; control group (CG), where they received usual care from the bariatric clinic staff, without participation in the program. The oral conditions investigated in the pre-operative and postoperative periods of one month (1M) and six months (6M) were: dental caries, periodontal disease, tooth wear, dental plaque and salivary flow. Results: After bariatric surgery, patients in IG presented: fewer changes in enamel (6M: p=0.004), dentin (6M: p=0.005) and gingival bleeding (6M: p<0.0001), reduction in plaque index (1M, 6M: p<0.0001) and increased salivary flow (6M: p=0.039), when compared with CG. Incipient tooth wear was recorded in both groups (6M: p=0.713). Conclusion: There was a positive impact of the implemented program in the prevention of the main oral health problems in patients who underwent gastroplasties, contributing to their quality of life.

RESUMO Racional: A cirurgia bariátrica pode repercutir negativamente nas condições bucais. Objetivo: Avaliar o impacto de um programa educativo/preventivo em saúde bucal desenvolvido em pacientes submetidos à gastroplastia. Método: A amostra foi constituída por 109 pacientes aleatoriamente alocados em dois grupos: grupo de intervenção (GI), onde participaram do programa de promoção de saúde bucal com abordagens educativo-preventivas; grupo controle (GC), onde receberam cuidado da equipe da clínica, sem participação no programa. As condições bucais investigadas nos períodos pré e pós-operatório de um mês (1M) e seis meses (6M) foram: cárie dentária, doença periodontal, desgaste dentário, placa dentária e fluxo salivar. Resultados: Após a gastroplastia, pacientes do GI apresentaram: menor alteração em esmalte (6M: p=0,004), dentina (6M: p=0,005) e sangramento gengival (6M: p<0,0001); redução no índice de placa (1M, 6M: p<0,0001) e aumento do fluxo salivar (6M: p=0,039), quando comparados aos do GC. Desgaste dentário incipiente foi registrado em ambos os grupos (6M: p=0,713). Conclusão: Houve impacto positivo do programa implementado na prevenção dos principais problemas de saúde bucal em pacientes submetidos à gastroplastia, contribuindo para sua qualidade de vida.

Prenatal follow-up of high-risk pregnancy in the public service / Acompañamiento prenatal de la gestación de alto riesgo en el servicio público / Acompanhamento pré-natal da gestação de alto risco no serviço público

ABSTRACT Objective: to analyze the prenatal follow-up of high-risk pregnancy in the public service. Method: an analytical cross-sectional study carried out in a public maternity hospital in the South of Brazil, during the hospitalization of 319 postpartum women using a semi-structured tool for transcription of the prenatal card records and interview. The data were analyzed using the Chi-Square test (p≤0.05). Results: the adequacy of prenatal care was high (74%); 22.6% intermediate; 3.4% inefficient. Prenatal care had high coverage (100%), early onset (81.5%) and six or more visits (92.4%), but (77.4%) did not receive information about gestational disease and examinations (69.3%). There was statistical significance between the quality of prenatal care and the place of prenatal care (p=0.005). Conclusion: the need to implement a specific protocol for high-risk gestation and continuous education to the teams was evidenced.

RESUMEN Objetivo: analizar el seguimiento prenatal de la gestación de alto riesgo en el servicio público. Método: el estudio transversal analítico, realizado en una maternidad pública en el Sur de Brasil, durante la internación de 319 puérperas, por medio de un instrumento semiestructurado para la transcripción de los registros de la tarjeta prenatal y la entrevista. Se realizó análisis de los datos por medio del Test Qui-Cuadrado (p≤0,05). Resultados: la adecuación del prenatal fue alta (74%); 22,6% intermedio; 3,4% ineficiente. El prenatal tuvo alta cobertura (100%), inicio precoz (81,5%) y realización de seis o más consultas (92,4%), pero (77,4%) no recibieron información sobre enfermedad gestacional y resultados de exámenes (69,3%). Se observó una significativa estadística entre la calidad del prenatal y el lugar de la realización del prenatal (p=0,005). Conclusión: se evidenció la necesidad de implementación de protocolo específico a la gestación de alto riesgo y educación continuada a los equipos.

RESUMO Objetivo: analisar o acompanhamento pré-natal da gestação de alto risco no serviço público. Método: estudo transversal analítico, realizado em uma maternidade pública no Sul do Brasil, durante internação de 319 puérperas, por meio de instrumento semiestruturado para transcrição dos registros do cartão pré-natal e entrevista. Realizou-se análise dos dados por meio do Teste Qui-Quadrado (p≤0,05). Resultados: a adequação do pré-natal foi alta (74%); 22,6% intermediária; 3,4% ineficiente. O pré-natal teve alta cobertura (100%), início precoce (81,5%) e realização de seis ou mais consultas (92,4%), porém (77,4%) não receberam informação sobre doença gestacional e resultados de exames (69,3%). Houve significância estatística entre a qualidade do pré-natal e o local da realização do pré-natal (p=0,005). Conclusão: evidenciou-se a necessidade de implementação de protocolo específico à gestação de alto risco e educação continuada às equipes.

Performance of Preventive Methods Applied to the Occlusal Surface of Primary Teeth: A Randomized Clinical Study

Objective: To evaluate the clinical performance of three preventive materials on the occlusal surfaces of primary molars over a 36-month period. Material and Methods: The study was conducted with a split-mouth design involving four experimental groups: G1 ­ resin-modified glass ionomer cement (Vitremer®); G2 - resin sealant (Alpha Seal Light®); G3 - silver diamine fluoride (Cariostatic®); and G4 - control group without material. Thirty-two children aged 36 to 60 months, attending a pediatric clinic, with a deft index ≥ 1 and four primary second molars participated in the study. The material retention was evaluated in G1 and G2, and the presence of incipient caries was evaluated in all groups. Data were submitted to the Wilcoxon test and survival test (α = 5%). Results: At three, six, 12, 24 and 36 months, G2 exhibited greater material loss (maximum loss: 44%) in comparison to G1 (maximum loss: 35%), but this difference did not achieve statistical significance (p = 0.214). The highest incidence of incipient caries occurred in G3 (20%), but no significant differences were found between groups at any evaluation time (p = 0.154). Conclusion: There were no statistically significant differences between the evaluated products regarding material retention and dental caries, although there was more material loss in teeth that received the Alpha Seal® sealant resin, and a greater number of carious lesions in the Cariostatic® group (silver diamine fluoride).

Maternal near-miss in labor and delivery in the light of technologies in health / Near miss materno en el trabajo de parto y parto a la luz de las tecnologías sanitarias / Near Miss materno no trabalho de parto e parto à luz das tecnologias em saúde

ABSTRACT Objective: To know maternal near-miss situations during labor and delivery according to technologies in health. Method: A quantitative study conducted with puerperal women in a public institution in which the maternity department is a reference for high risk care. Data collection was performed from October 2016 to August 2017, and data were processed in SPSS 20.0. Technologies in health were used for discussing the results. Results: Participation of 319 puerperal women. Primiparous women (p=0.027), previous diagnosis of hypertension (p=0.0001), preeclampsia (p=0.0001) and urinary tract infection (p=0.002) were items with statistical significance for the maternal near-miss outcome in labor and delivery. The hard technology associated with the outcome was transportation for hospitalization (p=0.035). Among the light-hard technologies, the following were associated: characteristics of amniotic fluid (p=0.05), vital signs check (p=0.0001), and initiation of the partograph for cesarean section (p=0.026). Among the light technologies, user satisfaction was relevant (p=0.007). Conclusion: Health technologies can be used for structuring the assistance in order to prevent maternal near-miss.

RESUMEN Objetivo: Conocer situaciones de near miss materno durante la asistencia al trabajo de parto y parto, según las tecnologías sanitarias. Método: Estudio cuantitativo, llevado a cabo en un centro público, cuya maternidad es referencia para alto riesgo, con puérperas. La recolección de datos se realizó en el período de octubre de 2016 a agosto de 2017, y los datos fueron procesados en el SPSS 20.0. Para la discusión de los resultados, fueron utilizadas las tecnologías sanitarias. Resultados: Participaron 319 puérperas. Primípara (p=0,027), diagnóstico previo de hipertensión (p=0,0001), pre eclampsia (p=0,0001) e infección del tracto urinario (p=0,002) fueron puntos que presentaron significación estadística para el resultado de near miss materno en el trabajo de parto y parto. La tecnología dura que se asoció con el resultado fue el traslado a estancia hospitalaria (p=0,035); entre las ligera-duras, se asociaron las características del líquido amniótico (p=0,05), verificación de las señales vitales (p=0,0001) y apertura del partograma para cesárea (p=0,026); y, entre las ligeras, la satisfacción de la usuaria fue relevante (p=0,007). Conclusión: Se cree que las tecnologías sanitarias pueden utilizarse para la estructuración de la asistencia a fin de prevenir el near miss materno.

RESUMO Objetivo: Conhecer situações de near miss materno durante a assistência ao trabalho de parto e parto, de acordo com as tecnologias em saúde. Método: Estudo quantitativo, realizado em uma instituição pública, cuja maternidade é referência para alto risco, com puérperas. A coleta de dados foi realizada no período de outubro de 2016 a agosto de 2017, e os dados foram processados no SPSS 20.0. Para a discussão dos resultados, foram utilizadas as tecnologias em saúde. Resultados: Participaram 319 puérperas. Primípara (p=0,027), diagnóstico prévio de hipertensão (p=0,0001), pré-eclâmpsia (p=0,0001) e infecção do trato urinário (p=0,002) foram itens que apresentaram significância estatística para o desfecho de near miss materno no trabalho de parto e parto. A tecnologia dura que se associou com o desfecho foi o transporte para internação (p=0,035); entre as leve-duras, associaram-se as características do líquido amniótico (p=0,05), verificação dos sinais vitais (p=0,0001) e abertura do partograma para cesariana (p=0,026); e entre as leves, a satisfação da usuária foi relevante (p=0,007) Conclusão: Acredita-se que as tecnologias em saúde podem ser utilizadas para a estruturação da assistência para a prevenção do near miss materno.

Uso e Necessidade de Prótese Dentária em Idosos de Londrina, Paraná / Use and need of Dental Prosthesis in the Elderly in Londrina, Paraná

Este estudo avaliou a necessidade e uso de prótese entre 504 idosos independentes, cadastrados nas Unidades Básicas de Saúde (UBS) do município de Londrina, Paraná. As características sociodemográficas foram também analisadas. A situação quanto às próteses dentárias foi avaliada a partir de informações sobre seu uso e necessidade nos arcos superior e inferior. As observações ao exame levaram em conta os códigos e critérios preconizados pela Organização Mundial de Saúde (OMS). As informações sociodemográficas foram obtidas pela aplicação de um formulário estruturado, avaliando: sexo, idade, nível de escolaridade, estado conjugal, tipo de moradia, número de pessoas na casa, renda familiar. A idade dos 504 idosos avaliados envolveu entre 60 e 75 anos, sendo a maioria entre 65 e 74 anos (54,2%), do gênero feminino (66,3%), de procedência rural (53,8%), cor branca (62,1%) e com até 4 anos de estudo (80,6%). Destes idosos, 15,1% não usam qualquer tipo de prótese, 24,6% usam em uma arcada e 60,3% usam algum tipo de prótese nas duas arcadas. Quanto à necessidade de prótese, observou-se que 21,6% não necessitam de qualquer tipo de prótese, 19,4% necessitam em uma arcada e a maioria (58,9%) necessita nas duas arcadas. Somente houve dependência, estatisticamente significante, entre as variáveis de necessidade de prótese dentária e gênero, cor da pele e procedência. Sendo assim, pode-se concluir que a prevalência de necessidade de prótese é acentuada e existe uma demanda populacional para reabilitação protética. (AU)

This study evaluated the need and use of prosthesis among 504 independent elderly, registered in the Basic Health Units (BHU) of the city of Londrina, Paraná. Sociodemographic characteristics were also evaluated. The situation regarding dental prosthesis was evaluated based on information about their use and need in the upper and lower arches. The observations were performed according to the codes and criteria recommended by the World Health Organization (WHO). The sociodemographic information was obtained by applying a structured form, evaluating: gender, age, educational level, marital status, housing type, number of people living in the residence, family income. The age of the 504-elderly studied was between 65 and 74 years (54.2%), female (66.3%), rural origin (53.8%), white skin color (62.1%) and up to 4 years of schooling (80.6%). Of these elderly, 15.1% do not use any type of prosthesis, 24.6% use only in one dental arch and 60.3% use some type of prosthesis in both arches. Regarding the need of prosthesis, it was observed that 21.6% do not require any type of prosthesis, 19.4% need in one arch and the majority (58.9%) needs in both arches. There was only statistically significant dependence among the variables of need for dental prosthesis and gender, skin color and origin. Thus, it can be concluded that the prevalence of need for prosthetic is high and there is a population demand for prosthetic rehabilitation. (AU)

Analysis of pH and release of calcium of association between melaleuca alternifolia oil and calcium hydroxide / Análise de pH e liberação de cálcio da associação entre óleo de melaleuca alternifólia e hidróxido de cálcio

Introduction: The use of intracanal medications with antimicrobial properties is essential for decontaminating root canals during endodontic treatment. Calcium hydroxide is used for this because of its excellent properties. Melaleuca alternifolia oil has shown medicinal importance by demonstrating antifungal and bactericidal action against proven human pathogens. Objective: To evaluate the physical and chemical aspects such as pH and calcium release, of Melaleuca alternifolia oil associated with calcium hydroxide, during different time intervals. Material and method: Calcium hydroxide powder was added to vehicles to reach a concentration of 72mg / 0.1mL. Three groups were formed: Group I: Calcium Hydroxide + Distilled Water; Group II: Calcium hydroxide + Propylene Glycol; Group III: Calcium hydroxide + Melaleuca oil. The pH of each group was measured after time intervals of 10 minutes; 24 and 48 hours; 7, 15 and 30 days after tooling by a pH meter. Calcium release was analyzed by atomic absorption spectrometry equipped with a calcium hollow cathode lamp. Data were statistically analyzed by using the Kruskall-Wallis and Dunn test. Result: Group II showed high pH, similar to group III that remained uniform at 15 and 30 days. Calcium release that began after 24 hours, was similar in Groups II and III, and showed a peak release in 48 hours. Conclusion: The association of Melaleuca oil with calcium hydroxide showed good results in the pH and calcium release analyses, and showed action similar to that of propylene glycol + calcium hydroxide.

Introdução: O uso de medicações intracanais com propriedades antimicrobianas é fundamental para descontaminação dos canais radiculares durante o tratamento endodôntico. O hidróxido de cálcio é utilizado como medicação intracanal por apresentar excelentes propriedades. O óleo de Melaleuca alternifólia apresenta importância medicinal demonstrando ação antifúngica e bactericida comprovada contra patógenos humanos. Objetivo: Avaliar aspectos físico-químicos da associação do óleo de Melaleuca Alternifólia com hidróxido de cálcio, como: pH e liberação de cálcio durante diferentes períodos. Material e método: O pó do hidróxido de cálcio foi adicionado aos veículos até a concentração de 72mg/0,1mL. Foram divididos três grupos: Grupo I: Hidróxido de Cálcio + Água Destilada; Grupo II: Hidróxido de Cálcio + Propilenoglicol; Grupo III: Hidróxido de Cálcio + Óleo de Melaleuca. O pH de cada grupo foi medido após 10 minutos, 24, 48 horas, 7, 15 e 30 dias após a espatulação por um pHmetro. A liberação de cálcio foi analisada através da espectrometria de absorção atômica equipada com uma lâmpada cátodo para cálcio. Os dados foram analisados estatisticamente pelos testes de Kruskall-Wallis e Dunn. Resultado: O grupo II apresentou pH elevado, semelhante ao grupo III, permanecendo uniforme aos 15 e 30 dias. A liberação de cálcio iniciou em 24 horas, de forma semelhante nos grupos II e III e seu pico de liberação deu-se em 48 horas. Conclusão: A associação do Óleo de Melaleuca com hidróxido de cálcio apresentou bons resultados quanto à análise de pH e liberação de cálcio, demonstrando ação semelhante ao propilenoglicol + hidróxido de cálcio.

Injúrias dentárias em dentes decíduos: estudo longitudinal / Dental injuries in deciduous teeth: a longitudinal study

O objetivo deste estudo foi avaliar 139 crianças, com histórico de traumatismo em dentes decíduos, verificando as sequelas e a associação com gênero e idade. 33,8% da amostra apresentavam entre 24 e 35 meses no momento do trauma e 61,2% do gênero masculino. Quanto ao tipo de injúria dental e tecido de suporte, as mais prevalentes foram a fratura de esmalte (28,1%) e a luxação lateral (17,3%). Na dentição decídua, diagnosticou-se descoloração da coroa (18%), reabsorção radicular inflamatória (7,9%) e lesão periapical (6,5%). 13,7% dos dentes permanentes estavam irrompidos, sendo 2,9% com hipoplasia de esmalte; radiograficamente, 2,2% apresentou atraso na erupção e 2,2% a posição anormal do dente. O Teste Qui-quadrado mostrou associação da idade no momento do trauma com injúria dentária (p=0,02); tipo de injúria dentária (p=0,01) e sequelas clínicas nos dentes decíduos (p=0,02). Conclui-se que é elevada a prevalência de sequelas diagnosticadas no acompanhamento, demonstrando a importância da preservação.

Current study analyzes 139 children with a history of traumatism in deciduous teeth through sequelae and the association between gender and age. Further, 33.8% of the sample showed that the trauma started between 24 and 35 months, with 61.2% involving males. Regarding to type of dental injury and tissue, enamel fracture (28,1%) and lateral dislocation (17,3%) were the most prevalent. De-coloration of the crown (18%), inflammatory radicular reabsorption (7,9%) and peri-apical lesion (6,5%) were diagnosed in deciduous dentition. Moreover, 13,7% of permanent teeth had emerged, with 2,9% featuring enamel hypoplasia, whereas 2,2% showed a radiographic delay in eruption and 2,2% revealed abnormal position of teeth. Chi-square test demonstrated a link at the moment of trauma with dental injury (p=0,02); type of dental injury (p=0,01) and clinical sequelae in deciduous teeth (p=0,02). Results show high prevalence of sequelae diagnosed in the follow-up and thus the importance of preservation.

Association between oral health status and central obesity among Brazilian independent-living elderly.

The aim of this study was to investigate the association between oral health status and central obesity (CO) in Brazilian independent-living elderly. A cross-sectional study was carried out in a sample of 489 elderly, who were participants of the Study on Aging and Longevity, in Londrina, state of Parana. The number of natural teeth and use of prostheses were evaluated according to the World Health Organization criteria. The presence of CO was assessed using measures of waist circumference (WC) and waist-hip ratio (WHR). Information concerning sociodemographic profile and some systemic conditions was also collected. Data were analyzed using stepwise logistic regression, α=5%. According to WC and WHR measures, the prevalence of central obesity was 79.3% and 76.1%, respectively. CO according to WC was not associated with oral status. Considering the WHR measure, the following oral conditions were associated to CO: having fewer natural teeth (OR = 2.61; 95%CI = 1.17-5.80), being edentulous and wearing both upper and lower complete dentures (OR = 2.34; 95%CI = 1.11-4.93), and being edentulous wearing only the upper complete denture (OR = 2.64; 95%CI = 1.01-6.95). Traditional risk factors for CO such as gender, dyslipidemia, hypertension and diabetes were associated with both measures. A poor oral health due to extensive tooth loss, whether partial or complete, even if rehabilitated by removable prostheses, may be considered a good predictor of CO in Brazilian independent-living elderly.

Práticas de autocuidado no primeiro ano pós-parto / Prácticas de autocuidado en el primer año posparto / Self-care practices in the first year postpartum

RESUMO O puerpério é um período complexo, vivido e percebido de forma singular pela mulher, no qual a assistência profissional deve ser pautada no cuidado integral, fundamentado em seu contexto sociocultural. O objetivo deste estudo foi avaliar possíveis associações da 'prática do autocuidado' referida pela mulher com indicadores sociodemográficos e com as exigências propostas na Teoria de Orem (universais, de desenvolvimento e de desvio de saúde), no primeiro ano pós-parto. Trata-se de um estudo transversal, aninhado em uma coorte prospectiva, realizado em um município do sul do Brasil, tendo como amostra 310 puérperas. A coleta de dados foi feita mediante aplicação de um formulário semiestruturado, em visitas domiciliares. Na análise estatística foi utilizado o Teste Qui-quadrado (p<0,05). A 'prática do autocuidado' se associou aos seguintes itens: faixa etária (p=0,043); renda (p=0,045); apoio do governo (p=0,025); percepção do que é cuidar de si (p=0,042); ingestão de frutas (p=0,039); sono (p=0,005); práticas (p=0,039) e frequência do lazer (p=0,037); retorno aos estudos (p=0,036); autopercepção de doença depressiva (p=0,005); tipo de parto (p=0,038), laceração e/ou episiorrafia (p=0,046). Os resultados identificaram que a prática do autocuidado pela mulher sofreu influências de sua idade, disponibilidade de recursos financeiros e de alguns determinantes presentes nas três exigências da Teoria de Orem.

RESUMEN El puerperio es un período complejo, vivido y percibido de forma singular por la mujer, en el cual la ayuda profesional debe ser basada en el cuidado integral, fundamentado en su contexto sociocultural. El objetivo de este estudio fue evaluar posibles asociaciones de la 'práctica del autocuidado' referida por la mujer con indicadores sociodemográficos y con las exigencias propuestas en la Teoría de Orem (universales, de desarrollo y de desviación de salud), en el primer año posparto. Se trata de un estudio transversal, con una cohorte prospectiva, realizado en un municipio del sur de Brasil, teniendo como muestra 310 puérperas. La recolección de datos fue hecha mediante aplicación de un formulario semiestructurado, en visitas domiciliarias. En el análisis estadístico fue utilizada la Prueba Ji-cuadrado (p<0,05). La 'práctica del autocuidado' se asoció a los siguientes ítems: franja de edad (p=0,043); renta (p=0,045); apoyo del gobierno (p=0,025); percepción de lo que es cuidar de sí (p=0,042); ingestión de frutas (p=0,039); sueño (p=0,005); prácticas (p=0,039) y frecuencia de ocio (p=0,037); regreso a los estudios (p=0,036); auto percepción de enfermedad depresiva (p=0,005); tipo de parto (p=0,038), laceración y/o episiorrafia (p=0,046). Los resultados identificaron que la práctica del autocuidado por la mujer sufrió influencias de su edad, disponibilidad de recursos financieros y de algunos determinantes presentes en las tres exigencias de la Teoría de Orem.

ABSTRACT The postpartum period is a complex moment lived and perceived uniquely by women, in which professional assistance should be based on comprehensive care, based on their sociocultural context. The purpose of this study was to evaluate possible associations of 'practice of self-care' which were referred by women with sociodemographic indicators and the requirements proposed in Orem theory (universal, development and health deviation) in the first year postpartum. This is a cross-sectional study of a prospective cohort study conducted in a city in southern of Brazil, and a sample of 310 mothers. Data collection was done by applying a semi-structured form, in home visits. Statistical analysis was performed using Chi-square test (p <0.05). The 'practice of self-care' is associated to the following: age (p = 0.043); income (p = 0.045); government support (p = 0.025); perception of what taking care of each other is (p = 0.042); fruit intake (p = 0.039); sleep (p = 0.005); practice (p = 0.039) and frequency of leisure (p = 0.037); return to studies (p = 0.036); perception of depressive illness (p = 0.005); type of delivery (p = 0.038), laceration and / or episiorrhaphy (p = 0.046). The results showed that the practice of selfcare by women suffered influences of age, availability of financial resources and some determinants present in the three requirements of Orem's Theory.

Correlation between antioxidant activity and bonding strength on bleached enamel.

Objective: This study used the 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) method to evaluate the percentage of antioxidant activity (%AA) of green tea (GT) and sodium ascorbate (SA) gel in three concentrations (10%, 20% and 30%), and the influence of these concentrations on the microshear bond strength (µ-SBT) values of bleached enamel, using 10% carbamide peroxide (CP). Materials and methods: Eighty intact third molars were selected to perform the µ-SBT test, and were randomly divided into eight experimental groups: G1: positive control - no treatment; G2: negative control - bleached with CP; G3: PC +10% GT; G4: PC +20% GT; G5: PC +30% GT; G6: PC +10% SA; G7: PC +20% SA and G8: PC +30% SA. After applying the treatments, adhesive procedures were performed using Single Bond 2 and Filtek Z350XT. After 24 h, the samples were tested in a universal testing machine until fracture. The %AA was assessed in triplicate by DDPH method using a UV-VIS spectrophotometer. Results: In the µ-SBT, ANOVA revealed no significant difference between the antioxidants evaluated (p = .625), but did reveal significant effects of the concentrations studied (p = .007). A negative correlation was observed between µ-SBT and solution concentrations. The values of %AA were from 90.58 to 96.75. Conclusions: The reverse results occurred in µ-SBT values, only when the antioxidants were used in a 10% concentration and, %AA did not influence µ-SBT.