Temporomandibular Disorders are Associated with Sociodemographic Factors, Health-Related and Oral Conditions in Adolescents: A Cross-Sectional Study

Abstract Objective: To assess the association between temporomandibular disorder (TMD) with sociodemographic factors, health-related factors, and oral conditions in adolescents. Material and Methods: This cross-sectional study was developed with 89 adolescents between 13 to 18 years. TMD diagnosis was obtained by the Research Diagnostic Criteria for Temporomandibular Disease (RDC/TMD) Axis I. Diagnoses of chronic pain, depression, presence of non-specific physical symptoms, including pain and anxiety, were obtained by the RDC/TMD Axis II. The feeling of happiness was measured by the Subjective Happiness Scale. Socio-economic and demographic characteristics were collected through self-administered questionnaires. Patients were examined for dental caries, dental trauma, malocclusion, and tooth wear. Parents answered a sociodemographic, economic, and general health questionnaire. Data were submitted to descriptive statistics, and a logistic regression model was used to assess the association between TMD and the socio-economic, demographic, health-related, and clinical variables. Results: TMD prevalence was 42%. TMD was associated to skin color (p=0.040), use of medications in the past year (p = 0.020) and previous dental trauma (p=0.030). Also, it tended to be associated with the presence of probable awake bruxism (p=0.053). Conclusion: Sociodemographic factors, health-related factors, and oral conditions play a role in TMD, with nonwhite adolescents, those who had used medications in the past year and/or had previous dental trauma having a greater chance of present this disorder (AU).

Perspectives on Social and Environmental Determinants of Oral Health.

Most oral conditions have a multifactorial etiology; that is, they are modulated by biological, social, economic, cultural, and environmental factors. A consistent body of evidence has demonstrated the great burden of dental caries and periodontal disease in individuals from low socioeconomic strata. Oral health habits and access to care are influenced by the social determinants of health. Hence, the delivery of health promotion strategies at the population level has shown a great impact on reducing the prevalence of oral diseases. More recently, a growing discussion about the relationship between the environment, climate change, and oral health has been set in place. Certainly, outlining plans to address oral health inequities is not an easy task. It will demand political will, comprehensive funding of health services, and initiatives to reduce inequalities. This paper sought to give a perspective about the role of social and physical environmental factors on oral health conditions while discussing how the manuscripts published in this Special Issue could increase our knowledge of the topic.

O papel do preceptor na formação profissional em serviço de saúde / The role of the preceptor in professional training in health services

O estudo objetivou avaliar o papel do preceptor na formação do estudante de Odontologia na disciplina "Estágio Supervisionado em Odontologia" da Faculdade de Odontologia da UFMG. Foi utilizado um questionário com questões abertas e fechadas sobre as experiências e impressões dos estudantes, professores e preceptores de seis campos de estágio localizados em Belo Horizonte. Onze estudantes, dez preceptores e quatro professores participaram deste estudo. Todos os alunos e professores e 50% dos preceptores consideram que a preceptoria faz parte das atribuições do profissional de saúde. A maioria dos atores afirmou que o profissional de saúde se sente motivado e preparado para atuar como preceptor. Todos os atores consideraram importante a participação do estudante em estágios em serviços de saúde durante a formação profissional e afirmaram que o preceptor tem conhecimento sobre os objetivos da disciplina. Apenas 20% dos preceptores afirmaram que já participaram de curso de capacitação de preceptoria e 80% manifestaram interesse em participar. A percepção dos participantes sobre o papel do preceptor na formação do profissional de saúde foi positiva. Alguns preceptores não têm consciência de que a preceptoria faz parte de sua atribuição como profissional da saúde. São necessárias ações que busquem capacitar e conscientizar os preceptores do seu papel na formação dos futuros profissionais de saúde (AU).

The study aimed to evaluate the role of the preceptor in the training of dentistry students in the discipline "Supervised Internship in Dentistry" at the Faculty of Dentistry at UFMG.A questionnaire with open and closed questions about the experiences and impressions of students, teachers and tutors from six internship fields located in Belo Horizonte was used. Eleven students, ten preceptors and four professors participated in this study. All students and professors and 50% of preceptors consider that preceptorship is part of the health professional's attributions. Most actors stated that the health professional feels motivated and prepared to act as a preceptor. All actors consideredimportant the student's participation in internships in health services during professional training and stated that the preceptor knows about the discipline's objectives. Only 20% of preceptors said they had already participated in a preceptorship training course and 80% expressed interest in participating. The participants' perception of the role of the preceptor in the training of health professionals was positive. Some preceptors are not aware that preceptorship is part of their role as health professional. Actions that seek to train and make preceptors aware of their role in trainingfuture health professionals are needed (AU).

Contextual and individual factors associated with dental pain in adolescents from Southeastern Brazil.

The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37-0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07-2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11-1.40), periodontal health (OR = 1.80; 95%CI = 1.04-3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96-12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.

Association between Stress at Work and Temporomandibular Disorders: A Systematic Review.

Temporomandibular disorders (TMD) have been traditionally associated with psychosocial factors; however, occupational stress as a factor related to TMD has not been adequately assessed in the literature. The aim was to investigate the association between stress at work and TMD on adult paid workers. An electronic search included PubMed, Scopus, Web of Science, Embase, and LILACS databases. Manual searches in the included articles' reference and gray literature were performed. There were no restrictions regarding language or publication period. The inclusion criteria comprised observational studies with paid workers of any category, of both sexes, above 18 years old, assessing occupational stress/stress or distress and TMD as diagnosis or isolated signs and symptoms. Methodological quality was evaluated using Joanna Briggs tools. We narratively assessed the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We collected 12 studies. 50% reported a positive association between stress and TMD diagnostic across various job categories. On the other hand, TMJ sounds (a TMD sign) and work stress were associated only in a musicians' population. However, the shortage of eligible articles and the methodological limitations provided a very low certainty of the evidence; only 4 of the studies used validated tools for both stress and TMD (2 reporting positive association). The association between stress and TMD is inconclusive by the available data. In the future, we expect more robust epidemiologic studies addressing these relevant aspects.

Contextual and individual factors associated with dental pain in adolescents from Southeastern Brazil

Abstract The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37-0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07-2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11-1.40), periodontal health (OR = 1.80; 95%CI = 1.04-3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96-12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.

Factors associated with toothache among Brazilian adults: a multilevel analysis.

The aim of this study was to evaluate the factors associated with toothache in the adult population of Minas Gerais, Brazil. Individual data from a population sample (age 35 to 44 years) were collected from a secondary database of the SB Minas survey. Sampling was carried out by clusters and with multiple drawing stages. The eligibility criteria were to reside in areas chosen for the research, be within the age group, and accept to participate in the research. The individual variables assessed by a questionnaire and dental exams were sex, income, race/skin color, root caries, periodontal condition, need for dental treatment, and last dental appointment. The contextual variables, assessed by municipal indexes, were Human Development Index (HDI), illiteracy, unemployment, half minimum wage, quarter minimum wage, oral health team coverage, access to individual health care, and supervised tooth brushing average. The dependent variable was toothache in the past six months. A descriptive analysis was made using the Statistical Package for the Social Sciences and Hierarchical Linear and Nonlinear Modeling Software was used to perform the multilevel analyses for individual and contextual levels. An association was found between toothache and low income (OR = 2.00; 95%CI = 1.32-3.13), dental caries (OR = 1.86; 95%CI = 1.22-2.86), periodontal condition, and living on a quarter of the minimum wage or less (OR = 1.03; 95%CI = 1.00-1.08). Clinical and social factors were associated with toothache, reinforcing the need to improve public polices in oral health focused on the adult population.

Factors associated with toothache among Brazilian adults: a multilevel analysis

Abstract The aim of this study was to evaluate the factors associated with toothache in the adult population of Minas Gerais, Brazil. Individual data from a population sample (age 35 to 44 years) were collected from a secondary database of the SB Minas survey. Sampling was carried out by clusters and with multiple drawing stages. The eligibility criteria were to reside in areas chosen for the research, be within the age group, and accept to participate in the research. The individual variables assessed by a questionnaire and dental exams were sex, income, race/skin color, root caries, periodontal condition, need for dental treatment, and last dental appointment. The contextual variables, assessed by municipal indexes, were Human Development Index (HDI), illiteracy, unemployment, half minimum wage, quarter minimum wage, oral health team coverage, access to individual health care, and supervised tooth brushing average. The dependent variable was toothache in the past six months. A descriptive analysis was made using the Statistical Package for the Social Sciences and Hierarchical Linear and Nonlinear Modeling Software was used to perform the multilevel analyses for individual and contextual levels. An association was found between toothache and low income (OR = 2.00; 95%CI = 1.32-3.13), dental caries (OR = 1.86; 95%CI = 1.22-2.86), periodontal condition, and living on a quarter of the minimum wage or less (OR = 1.03; 95%CI = 1.00-1.08). Clinical and social factors were associated with toothache, reinforcing the need to improve public polices in oral health focused on the adult population.

Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) / Evaluation of secondary care in endodontics at a Dental Specialties Center (DSC)

Resumo Objetivou-se avaliar a atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) de Belo Horizonte (MG). A coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas; (2) sobre o tratamento restaurador, com dados dos prontuários. O programa SPSS 19.0 foi utilizado para analisar os resultados por meio de frequência e percentis. Foram finalizados 452 tratamentos endodônticos em pacientes adultos. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos foi realizada em pré-molares superiores (23,7%), seguida de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o CEO em 81,2% dos casos e finalizado em 24,1% casos (n = 109). A contrarreferência após o tratamento restaurador ocorreu em 58,7% dos casos finalizados. É necessário um planejamento conjunto do tratamento odontológico entre a atenção básica e secundária e, dentro desta última, entre as especialidades, além de um adequado processo de referência e contrarreferência, visando garantir a integralidade do cuidado e a eficiência e eficácia do serviço.

Abstract This study aimed to evaluate secondary endodontic care at a Dental Specialties Center (DSC) in Belo Horizonte, MG. Data collection used two forms: (1) on endodontic treatment, completed by the endodontists (2) on the restorative treatment, with data from the medical records. The SPSS 22.0 program was used to analyze the results using frequency and percentiles. In total, 452 endodontic procedures were completed in adult patients. The patients had a median of 39 years of age, most were female (69.7%) and had a primary care referral order (96.2%). Most endodontic treatments were performed in upper premolars (23.7%) followed by lower molars (22.3%), using a mixed technique (74.1%) and in a single session (64.2%). The referral for restorative treatment was for the DSC in 81.2% of cases and finished in 24.1% (n = 109). The counter-referral following restorative treatment occurred in 58.7% of the completed cases. It is necessary to jointly plan the dental treatment between primary and secondary care and, within the latter, among the specialties, in addition to an adequate referral and counter-referral process aimed at ensuring comprehensive care and efficient and effective service.

Evaluation of secondary care in endodontics at a Dental Specialties Center (DSC). / Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO).

This study aimed to evaluate secondary endodontic care at a Dental Specialties Center (DSC) in Belo Horizonte, MG. Data collection used two forms: (1) on endodontic treatment, completed by the endodontists (2) on the restorative treatment, with data from the medical records. The SPSS 22.0 program was used to analyze the results using frequency and percentiles. In total, 452 endodontic procedures were completed in adult patients. The patients had a median of 39 years of age, most were female (69.7%) and had a primary care referral order (96.2%). Most endodontic treatments were performed in upper premolars (23.7%) followed by lower molars (22.3%), using a mixed technique (74.1%) and in a single session (64.2%). The referral for restorative treatment was for the DSC in 81.2% of cases and finished in 24.1% (n = 109). The counter-referral following restorative treatment occurred in 58.7% of the completed cases. It is necessary to jointly plan the dental treatment between primary and secondary care and, within the latter, among the specialties, in addition to an adequate referral and counter-referral process aimed at ensuring comprehensive care and efficient and effective service.

Objetivou-se avaliar a atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) de Belo Horizonte (MG). A coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas; (2) sobre o tratamento restaurador, com dados dos prontuários. O programa SPSS 19.0  foi utilizado para analisar os resultados por meio de frequência e percentis. Foram finalizados 452 tratamentos endodônticos em pacientes adultos. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos foi realizada em pré-molares superiores (23,7%), seguida de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o CEO em 81,2% dos casos e finalizado em 24,1%  casos (n = 109). A contrarreferência após o tratamento restaurador ocorreu em 58,7% dos casos finalizados. É necessário um planejamento conjunto do tratamento odontológico entre a atenção básica e secundária e, dentro desta última, entre as especialidades, além de um adequado processo de referência e contrarreferência, visando garantir a integralidade do cuidado e a eficiência e eficácia do serviço.

Analysis of the asynchronous dental teleconsulting of Telehealth Brazil Networks in Minas Gerais.

This cross-sectional study aimed to evaluate the asynchronous dental teleconsulting of Telehealth Brazil Networks Program in Minas Gerais. Data were collected from secondary databases of the Clinical Hospital of the Universidade Federal de Minas Gerais (CH/UFMG) and Medical School of UFMG (MS/UFMG), from July 2015 to July 2017. The variables analyzed were telehealth center, sex and profession, date and time questions and answers, response time in days, whether the issue was duly addressed, whether the teleconsulting was attended, post status, professional's satisfaction, conduct adopted after teleconsulting, dental specialty area, and type of issues. Sociodemographic data from the Intermediate Geographical Regions (IGR) of Minas Gerais, including the Municipal Human Development Index (MHDI) and Gini Index were also collected. The results were analyzed using SPSS v.22.0. In total, 3,920 teleconsulting were recorded, with increasing demand in the study period. Most were requested by dentists (93.3%) and female professionals (78.6%), during office hours (78.6%), and related to general conducts (72.1%). Almost all were attended (99.7%), with a maximum response time of two days (75.0%). A low feedback on satisfaction and resolution of issues (missing data of 57.2% and 70.2%, respectively) was recorded. Only 5.2% had information on whether patients were referred. The most common inquires were of issues about Pathology/Stomatology specialties (19.0%) and Pharmacology/Anesthesiology (18.8%). The response occurred within the expected time, with prevalent issues in basic dental areas and general conducts. Feedback from professionals must be encouraged to allow a better analysis and improvements of the program.

Patterns of Oral-Maxillofacial Trauma and Determinant Factors among Brazilian Victims of Physical Aggression: A 4-Year Study.

PURPOSE: To determine the prevalence of oral-maxillofacial trauma among Brazilian victims of physical aggression and identify its associated factors from a medico-legal and forensic perspective. MATERIALS AND METHODS: A cross-sectional study was carried out involving the analysis of complete medico-legal and social reports of 3668 victims of physical aggression treated at a centre of legal medicine and forensic dentistry over the course of four years. The dependent variable was the occurrence of oral-maxillofacial trauma. The independent variables were sociodemographic status and characteristics of physical aggression. Statistical analyses included the chi-squared test (p < 0.05) as well as univariate and multivariate logistic regression analyses. RESULTS: Oral-maxillofacial trauma occurred in 1655 cases (45.1%). Individuals who lived in suburban areas (OR = 1.32; 95%CI = 1.11-1.58) and those who were victims of community violence (OR = 1.20; 95%CI = 1.03-1.40) perpetrated by someone known to them (OR = 1.24; 95%CI = 1.03-1.40) using physical force (OR = 2.31; 95%CI = 1.96-2.72) on weekends (OR = 1.19; 95%CI = 1.04-1.37) and during nighttime hours (OR = 1.23; 95%CI = 1.08-1.41) were more likely to exhibit oral-maxillofacial trauma. CONCLUSION: The prevalence of oral-maxillofacial trauma was high and the associated factors were area of residence, type of violence, type of offender, mechanism of violence, day, and period of occurrence.

The need for endodontic treatment and systemic characteristics of hematopoietic stem cell transplantation patients.

The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients' medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised.

The need for endodontic treatment and systemic characteristics of hematopoietic stem cell transplantation patients

Abstract The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients' medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised.

Análise do conhecimento dos pais/responsáveis pelas crianças atendidas na clínica infantil da Unimontes sobre traumatismos dentários / Knowledge of dental trauma of parents / caregivers of children treated at Unimontes pediatric clinic

Objetivo: Verificar se os pais / responsáveis pelas crianças, com histórico ou nÆo de trauma dentário, atendidas na Clínica Infantil da Unimontes, tinham conhecimento sobre traumas dentoalveolares e acesso a informaçães pertinentes aos procedimentos em atendimentos emergenciais que envolvem estes tipos de lesães. Método: Participaram 73 responsáveis pelas crianças. A coleta foi realizada por meio de um questionário, abordando a história de trauma das crianças e o conhecimento e atitudes dos responsáveis em atendimentos emergenciais que envolvem traumas dentários. Os dados foram analisados utilizando os Testes Qui-quadrado (χ2) e Mann Whitney, com nível de confiança de 95%. Resultados: Segundo o relato dos pais/responsáveis, 25,0% das crianças apresentaram história de trauma dental, em 83,3% destes casos, o trauma foi em decorrência de queda, e 72,2% ocorreram na própria casa da criança. Os dentes decíduos anteriores foram os mais envolvidos (94,4%), a fratura de esmalte dentário a mais prevalente (38,9%), seguida de escurecimento dental (33,3%). Independentemente das crianças terem ou nÆo uma experiência prévia com trauma dentário, a minoria (8,3%) e nenhum (0,0%) dos pais/responsáveis tinham conhecimentos adequados de como agir em situaçães de fratura dentária e avulsÆo dentária, respectivamente. NÆo houve associaçÆo significativa entre o conhecimento dos responsáveis e conduta frente à fratura e avulsÆo dentária, quando se considerou o nível socioeconômico e escolaridade dos pais / responsáveis (p>0,05%). A maioria dos pesquisados declarou que nÆo tinha recebido orientaçães sobre condutas tomadas em casos de traumatismo dentário (83,3%) e gostaria de receber mais informaçães sobre o assunto (91,7%). ConclusÆo: Observou-se a carência de informaçães e conhecimento dos pais/responsáveis quanto ao atendimento de urgência em casos de traumas dentários independente das suas crianças terem ou nÆo uma experiência prévia com trauma dentário...

Objective: To verify whether the parents/caregivers of children with and without dental trauma history treated at the UNIMONTES Pediatric Clinic had knowledge of dentoalveolar traumas and access to information pertinent to the emergency procedures care involving these types of lesions. Method: Seventy-three parents/caregivers took part in the study. Data collection was performed by using a questionnaire arguing on the children?s history of trauma, and also the knowledge and attitudes of the parents/caregivers about the emergency procedures involving dental trauma. Data were analyzed using the chi-square and Mann-Whitney tests, with a 95% confidence level. Results: According to the parents/caregivers, 25.0% of the children had history of trauma and 83.3% of these cases were due to falls and 72.2% occurred at home. The primary anterior teeth were the most affected (94.4%), enamel fracture was the most prevalent type of fracture (38.9%), followed by tooth darkening (33.3%). Regardless of the children having or not history of dental trauma, the parents/caregivers had little or no adequate knowledge on how to act in situations involving dental fracture (8.3%) and dental avulsion (0.0%). There was no significant association between the parents/caregivers? knowledge and their attitude when dealing with dental fracture and avulsion, when the parents/caretakers? socioeconomic level and instruction was considered (p>0.05). Most participants affirmed that they had not been instructed on how to behave in case of the dental trauma (83.3%) and would like to have more information on this subject (91.7%). Conclusion: Parents / caregivers did not have information and knowledge of emergency care on dental trauma cases, regardless whether their children had history of dental trauma or not...

Perception of orthodontists regarding the management of root resorption – clinical and legal aspects

Aim: To evaluate the management adopted by orthodontists regarding root resorption caused byorthodontic treatment, relating it to their time of experience and the applicable legal norms.Methods: the study population consisted of 56 orthodontists from the city of Belo Horizonte(Minas Gerais State), and the tool to collect the data was a questionnaire with open and closedquestions. Data were subjected to descriptive analysis. The association between the variableswas analyzed by the chi-square test with significance level of 5%. Results: 57.6% of professionalstemporarily interrupt the treatment; in the prevention and/or control, most professionals (80.4%)perform initial and periodical radiographs (every six months). Among the professionals with lessthan 5 years of experience as a specialist, 88.9% usually make periodic radiographic control;100% affirmed to file the documents. No significant difference was found between dentists withdifferent times of experience regarding the practice of archiving the documents (p = 0.271).Among those with 5-15 years of experience, 77.4% perform periodic radiographic control and45.2% had already detected root resorption. Among those with more than 15 years of experience,71.4% usually perform the periodic radiographic control, and 85.7% had already faced somecase of root resorption in the clinical practice. Conclusions: Although most orthodontists adopt acorrect management facing the occurrence, prevention and control of root resorption associatedwith orthodontic treatment, the majority are unaware about existing legislation in our country.

Geometric and dimensional characteristics of simulated curved canals prepared with proTaper instruments.

OBJECTIVE: This study identified which regions of ProTaper instruments work during curved root canal instrumentation. MATERIAL AND METHODS: Twelve ProTaper instruments of each type, S1, S2, F1, and F2, were assessed morphometrically by measuring tip angle, tip length, tip diameter, length of each pitch along the cutting blades, and instrument diameter at each millimeter from the tip. Curved canals in resin blocks were explored with manual stainless steel files and prepared with ProTaper instruments until the apical end following four distinct sequences of instrumentation: S1; S1 and S2; S1, S2, and F1; S1, S2, F1, and F2. Image analysis was employed for measuring canal diameters. The diameters of the canals and diameters of the instruments were compared. Data were analyzed by one-way ANOVA and Tukey's test. RESULTS: No statistically significant difference was found between the canals and instrument diameters (p>0.05). The largest diameters in the end-point of the instrumented canals were obtained with F1 and F2 instruments and in the initial and middle thirds with S1 and S2 instruments. CONCLUSIONS: All instruments worked at the tip and along their cutting blades, being susceptible to fail by torsion, fatigue, or the combination of these two mechanisms.

Geometric and dimensional characteristics of simulated curved canals prepared with proTaper instruments

OBJECTIVE: This study identified which regions of ProTaper instruments work during curved root canal instrumentation. MATERIAL AND METHODS: Twelve ProTaper instruments of each type, S1, S2, F1, and F2, were assessed morphometrically by measuring tip angle, tip length, tip diameter, length of each pitch along the cutting blades, and instrument diameter at each millimeter from the tip. Curved canals in resin blocks were explored with manual stainless steel files and prepared with ProTaper instruments until the apical end following four distinct sequences of instrumentation: S1; S1 and S2; S1, S2, and F1; S1, S2, F1, and F2. Image analysis was employed for measuring canal diameters. The diameters of the canals and diameters of the instruments were compared. Data were analyzed by one-way ANOVA and Tukey's test. RESULTS: No statistically significant difference was found between the canals and instrument diameters (p>0.05). The largest diameters in the end-point of the instrumented canals were obtained with F1 and F2 instruments and in the initial and middle thirds with S1 and S2 instruments. CONCLUSIONS: All instruments worked at the tip and along their cutting blades, being susceptible to fail by torsion, fatigue, or the combination of these two mechanisms.

Características físicas, estruturais e mecânicas de instrumentos endodônticos de NiTi ProTaper / Physical, structural and mechanical characteristics of ProTaper nickel-titanium endodontic instruments

Neste trabalho foi realizado um estudo das características estruturais, físicas e mecânicas de instrumentos endodônticos de NiTi ProTaper. As características geométricas e dimensionais dos instrumentos foram analisadas utilizando microscópio óptico. Canais curvos em blocos de acrílico formatados por estes instrumentos foram analisados utilizando um programa de análise de imagens com o intuito de verificar a geometria. As características topográficas foram avaliadas por microscopia eletrônica de varredura (MEV), a composição química foi analisada semi-quantitativamente por espectrometria de energia de raio-X (EDS), a estrutura cristalina da liga identificada por difração de raio-X (DRX), enquanto que as temperaturas de transformação foram determinadas por calorimetria exploratória diferencial (DSC). O comportamento mecânico foi avaliado através de ensaios de torção e flexão, de acordo com a especificação ISO 3630-1. A resistência à fadiga foi avaliada em um dispositivo de bancada utilizando um canal artificial com raio de curvatura de 5 mm e ângulo de 45°. Foi também avaliada a influência da deformação cíclica em torção nas propriedades torcionais e na resistência à fadiga flexural. Os instrumentos apresentaram boa padronização geométrica, características superficiais aceitáveis, adequada razão estequiométrica, predominância de fase B e temperaturas de transformação favoráveis à ocorrência de superelasticidade. Os diâmetros obtidos nos canais de acrílico foram fortemente relacionados com as dimensões do último instrumento empregado na formatação. Todos os instrumentos exerceram trabalho na ponta e ao longo das hastes cortantes...