Online Integrative Community Therapy in Latin America: Health Promotion in Times of COVID-19.

This study described integrative community therapy (ICT) in the online modality as a health promotion resource in the context of COVID-19 in Latin America, characterizing the ICT circles, the ICT training centers, and the community therapists involved in this practice. It is a descriptive, observational, and cross-sectional study with a quantitative approach. Data were collected from November 2020 to July 2021 through an online questionnaire created on the Google Forms platform. The study's first stage involved the participation of ICT training centers, while the second involved community therapists. Forty-three centers participated in the first stage; 86.1% offered online ICT in the period evaluated, and 74.4% trained professionals to implement this modality. In the second stage, 66 community therapists responded to the questionnaire. Of these, 49 (74.2%) resided in Brazil, 84.8% were female, and 72.7% performed the work voluntarily, with an average of 6.1 hours per week dedicated to online circles. Community-based circles were the most cited, followed by those linked to the public sector, with an average of 20.7 participants/circle in the period. The most frequent themes were stress and negative emotions, problems with work/unemployment, and family conflicts. Strengthening self-care, participation in ICT circles, and personal empowerment stood out among the coping strategies. In conclusion, online ICT proved to be an innovative resource for health promotion during the pandemic through the articulation and engagement of community therapists and different institutions, expanding solidary social networks, and showing itself as a sustainable practice in the Latin American scenario.

Medidas de biossegurança nos consultórios odontológicos durante a pandemia de COVID-19: estudo com profissionais de saúde bucal do estado do Paraná / Biosafety measures in dental offices during the COVID-19 pandemic: a study with oral health professionals in the state of Paraná

Com o surgimento da pandemia causada pelo SARS-Cov-2, houve a necessidade de reestruturação dos serviços de saúde no Brasil, incluindo a clínica odontológica. O objetivo do presente estudo é descrever as medidas de biossegurança realizadas ou modificadas na prática de saúde bucal no estado do Paraná, em nível público e privado, envolvendo três categorias profissionais: cirurgiões-dentistas (CD), técnicos em saúde bucal (TSB) e auxiliares de saúde bucal (ASB). Esta pesquisa transversal descritiva foi realizada nos meses de agosto a outubro de 2020, com o envio de questionários on-linepor e-maile divulgação em redes sociais. Foram envolvidos 1072 profissionais, sendo 75,6% CD, 16,3% ASB e 8,1% TSB. O gênero feminino foi predominante entre os participantes (81,1%), com 46,1% apresentando idade entre 40 e 59 anos. Gorro, máscara cirúrgica, óculos de proteção e protetor facial são referidos como sempre utilizados, respectivamente, por 92,3%, 81,0%, 80,0% e 79,1% dos participantes. A máscara N95/PFF2 (67,5%) e o avental impermeável (20,3%) tiverem os maiores percentuais de "nunca disponíveis ou utilizados". Cerca de 50% afirmaram que tiveram acesso à Nota Técnica GVIMS/GGTES/ANVISA Nº 04/2020. Os profissionais avaliados, em geral, realizaram mudanças em suas práticas de biossegurança, mas precisam ser acompanhados durante toda a extensão da pandemia.

With the emergence of the SARS-Cov-2 pandemic, there was a need to restructure health services in Brazil, including the dental clinic. The aim of the present study was to describe the biosafety measures performed or modified in oral health practice at public and private levels, involving the three professional categories: dental surgeons (DDS), oral health technicians(OHT), and health assistants (HA) in the state of Paraná. This escriptive cross-sectional survey was carried out from August to October 2020, with an online questionnaire being sent by email and published on social networks. There were 1072 professionalsinvolved, of which 75.6% were DDS, 16.3% were OHT, and 8.1% were HA. The female gender was predominant among the participants (81.1%), and 46.1% were aged between 40 and 59 years. 92.3%, 81.0%, 80.0%, and 79.1% of the articipants, respectively, said theyalways used a cap, surgical mask, protective glasses, and face shield. The N95/PFF2 mask (67.5%) and the waterproof apron (20.3%) are two of the most frequently mentioned items as never being available or used. About 51% said they had access to Technical Note GVIMS/GGTES/ANVISA No. 04/2020. In general, the professionals evaluated have been making changes in their biosafety practices, but they still need to be monitored throughout the pandemic.

O que estudantes nos contam sobre as entrevistas narrativas / What students tell us about narrative interviews

Romper com o modelo biomédico é necessário, e o ponto inicial pode vir com a compreensão da narrativa do usuário ou da usuária. Este estudo buscou avaliar a compreensão de estudantes de medicina das narrativas de adoecimento, utilizando a entrevista McGillIllness Narrative Interview (MINI). Trata-se de estudo exploratório, descritivo e qualitativo, realizado durante cinco semanas com 11 estudantes do quinto ano de uma universidade privada, no internato de Medicina de Família e Comunidade, que prestavam atendimento a 29 pessoas usuárias de unidades de saúde. Por meio de encontros individuais on-line, foram levantadas questões sobre essa experiência. Os relatos foram inseridos em núcleos argumentais, o que possibilitou o estabelecimento de relações com o referencial teórico da Medicina Narrativa, da Antropologia Médica e da Clínica Ampliada. Para os alunos e alunas houve uma nova experiência de entrevista clínica, uma valorização da narrativa e o desejo de incorporar uma abordagem mais ampliada à sua prática, embora não contemplem incorporar o MINI na sua forma integral, atribuindo a isso dificuldades na rotina médica. Acreditamos que o MINI pode colaborar com a aquisição de competências interpretativa e narrativa em estudantes, embora o ensino esteja ainda, emparte, vinculado ao modelo biomédico.

It is essential to break with the biomedical model. The starting point for that can come from the understanding of patients' narratives. This study sought to evaluate medical students' comprehension of illness narratives using the McGill Illness Narrative Interview (MINI). This is an exploratory, descriptive, and qualitative study, carried out with 11 fifth-year students at a private university in the internship of Family and Community Medicine, for five weeks, involving the care of 29 patients in health units. Through individual online meetings, questions were raised about the experience.The reports were inserted into categories, which allowed us to establish relationships among the theoretical referential elements of Narrative Medicine, Medical Anthropology, and Expanded Clinic. It was a new experience of clinical interviews for the students, with a new appreciation of narratives and a desire to incorporate a more extended approach to their practice, although they do not contemplate incorporating the MINI in its full form due to difficulties in the physician's routine. We believe that MINI can collaborate with the acquisition of interpretative and narrative competence in students, although teaching is still partly linked to the biomedical model.

Aceitabilidade social de tecnologias da atenção primária à saúde: uma revisão de escopo / Social acceptance of primary health care technologies: a scoping review

Alma-Ata definiu a Atenção Primária à Saúde (APS) como "cuidados essenciais de saúde baseados em métodos e tecnologias práticas, cientificamente bem fundamentadas e socialmente aceitáveis"1, mas parece faltar "aceitabilidade social" paradiversas tecnologias usadas na APS, além de pouca investigação de tal conceito. Esta pesquisa buscou compreendera aceitabilidade social das tecnologias praticadas na APS,no Brasil e no mundo, por meio de uma revisão de escopo, visando mapear conceitos-chave, tipos de evidências e lacunas no campo através de sistemática busca, seleção e síntese do conhecimento existente. Buscaram-se artigos de 1978 a 2019 no Medline -PubMed, BVS/Lilacs, Academic Search Premier, Web of Science, Science Direct, SciELO e CINAHL complete. Pesquisou-se, também, nas referências desses artigos e por meio de busca complementar efetuada no Google e no Google Scholar. Identificados13.874 artigos, foram selecionados 201 para tabulação e análise. Encontrou-se grande variedade de tecnologias usadas na APS em 41 países, que foram organizadas em forma temática. Identificaram-se sete acepções para"aceitabilidade social": percepções sobre uma tecnologia, intenções de aceitar uma tecnologia, aceitar uma tecnologia ou não, confiança, participação, acesso e qualidade do cuidado.

Alma-Ata defined Primary Health Care (PHC) as "essential health care based on practical, scientifically and socially acceptable methods and technology," 1 but it seems that several technologies used in PHC lack social acceptability ­a concept seldom investigated. This research was pursued to acknowledge the social acceptability of PHC technologies, in Brazil and in the world, through a Scoping Review, in order to map concepts, evidence, and gaps in the research field through a systematic search, selection, and synthesis of existing knowledge. The articles, published between the years of 1978 and 2019, were searched in the following databases: Medline-PubMed, BVS/Lilacs, Academic Search Premier, Web of Science, Science Direct, SciELO, and CINAHL Complete. Further references cited in these articles were explored along with complementary searches on Google and Google Scholar. Out of 13,874 articles identified, 201 wereselected for data extraction and analysis. As a result, thematic maps of the large scope of technologies used in PHC were created. Seven different groups were created to assess "social acceptability": perceptions about a specific technology; the intentionto accept it; simply accepting it; trust; participation; access; and quality of care.

Lack of association between delayed tooth emergence and single nucleotide polymorphisms in estrogen receptors

Abstract The purpose of the study was to investigate the association between single nucleotide polymorphisms (SNPs) in genes encoding estrogen receptors (ESR1 and ESR2, respectively) and delayed tooth emergence (DTE). This cross-sectional study was composed of biological unrelated children of both sexes, age ranging from 11 to 13 years old. DTE was defined when the successor primary tooth was still present in the oral cavity after its exfoliation time or the absence of the permanent tooth emergence into the oral cavity. Children were diagnosed with DTE when they had at least one delayed permanent tooth, according to age of exfoliation of each tooth proposed by The American Dental Association. Genomic DNA from saliva was used to evaluate the SNPs in ESR1 (rs9340799 and rs2234693) and ESR2 (rs1256049 and rs4986938) using Real-Time PCR. Chi-square or Fisher exact tests and Logistic Regression adjusted by age and gender were performed. SNP-SNP interaction was accessed by multifactor dimensionality reduction (MDR) analysis also adjusted by gender and age. The established alpha of this study was 5%. Among 537 included children, 296 (55%) were in the "DTE" group and the 241 (45%) were in the "Control" group. Age and gender were not statistically different among the groups (p>0.05). Genotype distribution of the SNPs rs9340799, rs2234693, rs1256049 and rs4986938 were not associated with DTE (p> 0.05). The models elected by MDR were not statistically significant either. Conclusions: The studied SNPs in ESR1 and ESR2 were not associated with permanent DTE.

RESUMO O objetivo do presente estudo foi investigar a associação entre polimorfismos de nucleotídeo único (SNPs) em genes que codificam receptores de estrógeno (ESR1 e ESR2, respectivamente) e o retardo na emergência dentária (DTE). Este estudo transversal foi composto por crianças biológicas não relacionadas de ambos os sexos, com idades entre 11 e 13 anos. O DTE foi definido pela presença do dente decíduo na cavidade bucal após seu tempo e também, quando as crianças apresentaram pelo menos um dente permanente com atraso. O DNA genômico foi usado para avaliar os SNPs em ESR1 (rs9340799 e rs2234693) e ESR2 (rs1256049 e rs4986938) usando PCR em tempo real. Foram realizados testes Qui-quadrado ou exato de Fisher e Regressão Logística ajustados por idade e sexo. A interação SNP-SNP foi acessada pela análise de redução de dimensionalidade multifatorial (MDR), também ajustada por sexo e idade. O alfa de 5% foi estabelecido. Entre 537 crianças incluídas, 296 (55%) estavam no grupo "DTE" e 241 (45%) estavam no grupo "Controle". A idade e o sexo não foram estatisticamente diferentes entre os grupos (p> 0,05). A distribuição de genótipos dos SNPs rs9340799, rs2234693, rs1256049 e rs4986938 não foi associada ao DTE (p> 0,05). Os modelos eleitos pelo MDR também não foram estatisticamente significativos. Conclusões: Os SNPs estudados na ESR1 e ESR2 não foram associados ao DTE na dentição permanente.

Lack of association between delayed tooth emergence and single nucleotide polymorphisms in estrogen receptors.

The purpose of the study was to investigate the association between single nucleotide polymorphisms (SNPs) in genes encoding estrogen receptors (ESR1 and ESR2, respectively) and delayed tooth emergence (DTE). This cross-sectional study was composed of biological unrelated children of both sexes, age ranging from 11 to 13 years old. DTE was defined when the successor primary tooth was still present in the oral cavity after its exfoliation time or the absence of the permanent tooth emergence into the oral cavity. Children were diagnosed with DTE when they had at least one delayed permanent tooth, according to age of exfoliation of each tooth proposed by The American Dental Association. Genomic DNA from saliva was used to evaluate the SNPs in ESR1 (rs9340799 and rs2234693) and ESR2 (rs1256049 and rs4986938) using Real-Time PCR. Chi-square or Fisher exact tests and Logistic Regression adjusted by age and gender were performed. SNP-SNP interaction was accessed by multifactor dimensionality reduction (MDR) analysis also adjusted by gender and age. The established alpha of this study was 5%. Among 537 included children, 296 (55%) were in the "DTE" group and the 241 (45%) were in the "Control" group. Age and gender were not statistically different among the groups (p>0.05). Genotype distribution of the SNPs rs9340799, rs2234693, rs1256049 and rs4986938 were not associated with DTE (p> 0.05). The models elected by MDR were not statistically significant either. Conclusions: The studied SNPs in ESR1 and ESR2 were not associated with permanent DTE.

Calcium and Phosphorus Levels in Saliva are Influenced by Genetic Polymorphisms in Estrogen Receptor Alpha and Microrna17.

Homeostasis between salivary calcium and phosphorus is important for maintaining oral health. The aim of this study was to evaluate if polymorphisms in ESR1 (Estrogen Receptor Alpha), ESR2 (Estrogen Receptor Beta) and miRNA17 (microRNA17) are associated with calcium and phosphorus levels in saliva. Saliva from 276 12-year-old children were collected by masticatory stimulation and calcium and phosphorus levels were determined by Mass Spectrometry. Genomic DNA was extracted from remaining saliva and genetic polymorphisms in ESR1 (rs12154178, rs1884051, rs9340799 and rs2234693), in ESR2 (rs4986938 and rs1256049) and in miRNA17 (rs4284505) were genotyped using TaqMan chemistry and a real-time PCR equipment. Statistical differences in genotype and allele distributions between 'low' and 'high' calcium and phosphorus levels were determined using chi-square or Fisher´s exact tests. The analysis was also adjusted by sex (alpha of 5%). ESR1 rs9340799 had the less common genotype associated with higher calcium levels (p=0.03). The less common allele of ESR1 rs1884051 was associated with lower phosphorus levels (p=0.005) and there was an excess of heterozygotes for miRNA17 rs4284505 among individuals with lower calcium levels (p=0.002), both adjusted by sex. This study provides evidence that genetic polymorphisms in ESR1 and miRNA17 are involved in determining salivary calcium and phosphorus levels.

Calcium and phosphorus levels in saliva are influenced by genetic polymorphisms in estrogen receptor alpha and microrna17

Abstract Homeostasis between salivary calcium and phosphorus is important for maintaining oral health. The aim of this study was to evaluate if polymorphisms in ESR1 (Estrogen Receptor Alpha), ESR2 (Estrogen Receptor Beta) and miRNA17 (microRNA17) are associated with calcium and phosphorus levels in saliva. Saliva from 276 12-year-old children were collected by masticatory stimulation and calcium and phosphorus levels were determined by Mass Spectrometry. Genomic DNA was extracted from remaining saliva and genetic polymorphisms in ESR1 (rs12154178, rs1884051, rs9340799 and rs2234693), in ESR2 (rs4986938 and rs1256049) and in miRNA17 (rs4284505) were genotyped using TaqMan chemistry and a real-time PCR equipment. Statistical differences in genotype and allele distributions between 'low' and 'high' calcium and phosphorus levels were determined using chi-square or Fisher´s exact tests. The analysis was also adjusted by sex (alpha of 5%). ESR1 rs9340799 had the less common genotype associated with higher calcium levels (p=0.03). The less common allele of ESR1 rs1884051 was associated with lower phosphorus levels (p=0.005) and there was an excess of heterozygotes for miRNA17 rs4284505 among individuals with lower calcium levels (p=0.002), both adjusted by sex. This study provides evidence that genetic polymorphisms in ESR1 and miRNA17 are involved in determining salivary calcium and phosphorus levels.

Resumo A homeostasia entre cálcio e fósforo salivares é importante para a manutenção da saúde bucal. O objetivo deste estudo foi avaliar se polimorfismos genéticos no receptor de estrógeno alfa (ESR1), receptor de estrógeno beta (ESR2) e no microRNA17 (microRNA17) estão associados com os níveis salivares de cálcio e fósforo. Saliva de 276 crianças com 12 anos de idade foi coletada com estímulo mastigatório e os níveis de cálcio e fósforo foram determinados por Espectrofotometria de Massa. O DNA genômico foi extraído da saliva remanescente e os polimorfismos genéticos em ESR1 (rs12154178, rs1884051, rs9340799 e rs2234693), em ESR2 (rs4986938 e rs1256049) e no miRNA17 (rs4284505) foram genotipados pela reação em cadeia da polimerase em tempo real utilizando sondas TaqMan. As diferenças estatísticas nas distribuições alélicas e genotípicas entre "baixo" e "alto" níveis de cálcio e fósforo foram determinadas usando os testes qui-quadrado e teste exato de Fisher. As análises foram ajustadas por sexo (alfa de 5%). O polimorfismo rs9340799 em ESR1 foi o genótipo menos comum associado com altos níveis de cálcio (p=0,03). O alelo menos comum em ESR1 rs1884051 foi associado com baixos níveis de fósforo (p=0,005) e houve um excesso de heterozigotos para miRNA17 rs4284505 entre os indivíduos com baixos níveis de cálcio salivar (p=0,002), ambos ajustados pelo sexo. Este estudo fornece evidências de que polimorfismos genéticos em ESR1 e miRNA17 estão envolvidos na determinação dos níveis de cálcio e fósforo salivares.

Polymorphisms in Nonamelogenin Enamel Matrix Genes Are Associated with Dental Fluorosis.

The aim of this study was to evaluate whether genetic polymorphisms in AMELX, AMBN, ENAM, TFIP11, and TUFT1 genes are associated with dental fluorosis (DF). A total of 1,017 children from 2 Brazilian cohorts were evaluated. These populations lived in cities with fluoridation of public water supplies. DF was assessed in erupted permanent teeth using the modified Dean index. The polymorphisms rs946252, rs12640848, rs4694075, rs5997096, and rs4970957 were analyzed by real-time PCR from genomic DNA. Associations between DF, genotype, and allele distribution were evaluated using the χ2 test, with an alpha of 5%. The polymorphisms rs4694075, rs5997096, and rs4970957 in AMBN, TFIP11, and TUFT1 were associated with DF (p < 0.05). In conclusion, enamel matrix genes are associated with DF.

Genes Involved in the Enamel Development Are Associated with Calcium and Phosphorus Level in Saliva.

Saliva components play a crucial role in the integrity of the dental enamel and in caries susceptibility. The saliva characteristics are controlled by many factors, including genetic factors. Therefore, this study aimed to evaluate the association between the genetic variations in genes expressed in enamel development with calcium and phosphorus levels in saliva. We collected 276 unrelated 12-year-old children from private and public schools. Saliva was collected for DNA extraction from oral cells and for measurement of calcium and phosphorus. Inductively coupled plasma-mass spectrometry determined calcium and phosphorus levels in whole saliva. Fifteen genetic variations in 9 genes were analyzed. The genotype was determined by real-time polymerase chain reactions. Data were analyzed using Plink with an alpha of 5%. Genetic variations in AMELX, AMNB and ESRRB were associated with the calcium level in saliva (p < 0.05). A borderline association was observed in ENAM allele distribution shown with phosphate level in saliva (p = 0.049). In conclusion, our results are the first to report that genetic variations contribute to calcium and phosphorus levels in saliva.

A utilização dos indicadores de saúde bucal e de desenvolvimento humano no monitoramento da atenção básica nos municípios da região metropolitana de Curitiba-PR / Use of oral health indicators and Human Development Indicators in monitoring of Primary Care in the municipalities of the Metropolitan Region of the city of Curitiba- state of Paraná

Objetivou-se com o presente trabalho monitorar as ações em saúde bucal dos municípios do Núcleo Urbano Central (NUC) da Região Metropolitana de Curitiba – Paraná, por meio do uso de sistemas de informação, verificando a existência de correlação entre Indicadores da Atenção Primária emSaúde Bucal e os de desenvolvimento humano. Trata-se de um estudo descritivo correlacional, comavaliação de dados secundários. Os indicadores de desenvolvimento humano utilizados foram o Índice de Desenvolvimento Humano Municipal referente ao ano de 2010 e o Índice Ipardes de Desempenho Municipal referente ao ano de 2011, obtidos na base de dados disponibilizada pelos Programa das Nações Unidas para o Desenvolvimento e Instituto Paranaense de Desenvolvimento Econômico eSocial. Ao passo que os indicadores em saúde bucal foram acessados e analisados pela produção ambulatorial do Sistema de Informação em Saúde do Sistema Único de Saúde e consistem naconsolidação do ano de 2012 em relação a: a) Primeira Consulta Odontológica Programática; b) AçãoColetiva de Escovação Dental Supervisionada; c) Procedimentos Odontológicos Individuais Básicos;e d) Exodontias de decíduos e permanentes. Na análise estatística quantitativa foi utilizado o teste de correlação de Pearson, com nível de significância de 95%. A análise dos dados explicitou que quanto maior o desenvolvimento humano, maior é o número de primeiras consultas odontológicas programáticas (r=0,5963). Encontrou-se ainda correlação entre o número de primeiras consultas e o de exodontias (r=0,6439). Percebeu-se os sistemas de informação como importantes ferramentas noplanejamento local das ações de saúde bucal dos municípios.

The aim of this study is to monitor the actions in oral health care of the cities which comprise the Central Urban Core of the Metropolitan Region of the city of Curitiba – state of Paraná, using information systems and assessing the correlation between Primary Oral Health Care and Human DevelopmentIndicators. This is a descriptive correlational study with evaluation of secondary data. The humandevelopment indicators used for this study were the Municipal Human Development Index of the year2010 and the Index of the Institute for Economic and Social Development of the State of Paraná (Ipardes) of Municipal Performance of the year 2011, collected in the database provided by the UnitedNations Development Program and Ipardes. The oral health indicators were accessed and analyzed by the outpatient department production of the Health Information System of the Brazilian Unified Health System and are related to the year of 2012. Four indicators were used: a) first programmatic dentalvisit; b) collective actions of supervised tooth brushing; c) individual basic dental procedures; and d) extractions of deciduous and permanent teeth. In quantitative statistical analysis, we used Pearson’s correlation test, with a significance level of 95%. Data comparison showed that the higher human development, the higher the first programmatic dental visit index (r=0.5963). Correlation was also foundbetween the number of first programmatic dental visits and the extractions index (r=0.6439). Thus,information systems are important tools in local planning of oral health actions in the municipalities.

Analysis of polymorphisms in the lactotransferrin gene promoter and dental caries.

Regarding host aspects, there has been strong evidence for a genetic component in the etiology of caries. The salivary protein lactotransferrin (LTF) exhibits antibacterial activity, but there is no study investigating the association of polymorphisms in the promoter region of LTF gene with caries. The objective of this study was firstly to search the promoter region of the human LTF gene for variations and, if existent, to investigate the association of the identified polymorphisms with dental caries in 12-year-old students. From 687 unrelated, 12-year-old, both sex students, 50 individuals were selected and divided into two groups of extreme phenotypes according to caries experience: 25 students without (DMFT = 0) and 25 with caries experience (DMFT ≥ 4). The selection of individuals with extreme phenotypes augments the chances to find gene variations which could be associated with such phenotypes. LTF gene-putative promoter region (+39 to -1143) of the selected 50 individuals was analyzed by high-resolution melting technique. Fifteen students, 8 without (DMFT = 0) and 7 with caries experience (mean DMFT = 6.28), presented deviations of the pattern curve suggestive of gene variations and were sequenced. However, no polymorphisms were identified in the putative promoter region of the LTF gene.

Contribuição do PET-Saúde para a área de odontologia da UFPR na consolidação das Diretrizes Curriculares Nacionais e do SUS, nos municípios de Curitiba e Colombo-PR / Contribution of the PET-Health program to UFPR's Dentistry area in consolidating the national curriculum guidelines and the Unified Health System (SUS) in the cities of Curitiba and Colombo, PR

O PET-Saúde veio consolidar as parcerias entre a UFPR e as Secretarias Municipais de Saúde de Colombo e de Curitiba. Essa integração conta ainda com a participação dos Programas de Residências da UFPR: Multiprofissional em Saúde da Família e Medicina de Família e Comunidade no município de Colombo. As atividades têm por objetivo a formação de um profissional com visão integral do processo saúde-doença e com prática humanizada da assistência à saúde individual e coletiva. Os acadêmicos e bolsistas/voluntários do PET-Saúde, sob orientação e acompanhamento de preceptores, tutores, e residentes, participam de diversas atividades nas USF, incluindo: participação nas reuniões de equipe, nos programas e oficinas, territorialização, visitas domiciliares, atenção integral às famílias por meio de ações educativas, preventivas e clínico-restauradoras, realização de atividades educativas e preventivas em equipamentos sociais, como escolas, creches, abrigos e centros de convivência. Além disso, está sendo conduzida uma pesquisa em duas fases para avaliar as condições de saúde bucal de escolares e seus familiares que residem nas áreas de abrangências das USF que participam do PET-Saúde. Com relação aos resultados parciais da pesquisa, verificou-se que, dos 593 escolares avaliados em Curitiba, 44,0% apresentaram alta severidade à cárie dentária. E no município de Colombo, dos 798 escolares avaliados, 36,6% apresentaram alta severidade à doença. Por meio do PET-Saúde, as atividades desenvolvidas possibilitam uma integração entre o ensino e o serviço, buscando sempre a disseminação do conhecimento e a formação de profissionais generalistas com capacidade de atender as demandas sociais (AU).

The PET-Health program consolidates the partnership between UFPR and the Department of Health in the cities of Colombo and Curitiba. This integration also includes the participation of UFPR Residency Programs: Multidisciplinary in Family Health and Family and Community Medicine programs in the city of Columbo. The activities are aimed at training a professional with a comprehensive approach to the health-disease process and with the ability to practice humane healthcare at the individual and collective levels. Students and monitors, under the guidance and supervision of tutors, mentors, and residents participate in various activities in the USF, including: participation in group meetings, programs and workshops, assignment of regions and home visits, and comprehensive family care through educational, preventive and clinical-restorative actions, besides educational and preventive activities in social facilities such as schools, daycare centers, shelters and community centers. In addition, a study is being conducted in two phases to evaluate the oral health status of the schoolchildren and their families who reside in areas covered by the USF taking part in the PET-Health program. With respect to the partial results of the survey, it was found that 44.0% of 593 schoolchildren in Curitiba had highly severe dental caries, and in the city of Columbus, 36.6% of 798 schoolchildren showed a highly severe degree of the disease. PET-Health activities enable integration between teaching and service, always striving to disseminate knowledge and to train general practitioners able to meet social demands (AU).

Analysis of the association between lactotransferrin (LTF) gene polymorphism and dental caries.

OBJECTIVE: The present study evaluated the association between lactotransferrin (LTF) gene polymorphism (exon 2, A/G, Lys/Arg) and dental caries. MATERIAL AND METHODS: A convenience sample of 110 individuals, 12 years old, was divided into: group 1, 48 individuals without caries experience (DMFT=0), and group 2, 62 subjects with caries experience (DMFT>or=1). DNA was obtained from a mouthwash with 3% glucose solution, followed by a scrapping of the oral mucosa. After DNA purification, polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP) was performed to access the study polymorphism. The LTF A/G (Lys/Arg) polymorphism had been previously reported as located in exon 1. RESULTS: Allele 1 of the study polymorphism was associated with low DMFT index and showed a protective effect against caries experience (OR=0.16, IC=0.03-0.76, p=0.01). CONCLUSIONS: Lactotransferrin A/G (exon 2, Lys/Arg) polymorphism was associated with susceptibility to dental caries in 12-year-old students.

Analysis of the association between lactotransferrin (LTF) gene polymorphism and dental caries

OBJECTIVE: The present study evaluated the association between lactotransferrin (LTF) gene polymorphism (exon 2, A/G, Lys/Arg) and dental caries. MATERIAL AND METHODS: A convenience sample of 110 individuals, 12 years old, was divided into: group 1, 48 individuals without caries experience (DMFT=0), and group 2, 62 subjects with caries experience (DMFT>1). DNA was obtained from a mouthwash with 3 percent glucose solution, followed by a scrapping of the oral mucosa. After DNA purification, polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP) was performed to access the study polymorphism. The LTF A/G (Lys/Arg) polymorphism had been previously reported as located in exon 1. RESULTS: Allele 1 of the study polymorphism was associated with low DMFT index and showed a protective effect against caries experience (OR=0.16, IC=0.03-0.76, p=0.01). CONCLUSIONS: Lactotransferrin A/G (exon 2, Lys/Arg) polymorphism was associated with susceptibility to dental caries in 12-year-old students.

The short-term in situ model to evaluate the anticariogenic potential of ionomeric materials.

OBJECTIVES: Aiming to contribute to the study of mechanisms involved in the anticariogenic properties of dental materials, this study assessed the suitability of a short-term in situ model to evaluate the anticariogenic potential of ionomeric materials. METHODS: The study used a 3-phase crossover, double blind design, and in each phase eight volunteers wore palatal appliances containing four enamel blocks restored with one of the following materials: composite resin (CR-Z250) (negative control), a conventional glass ionomer cement (GIC-Ketac-Fil) or a resin-modified GIC (RM-GIC-Vitremer). The restored blocks were covered with a "test plaque" of S. mutans, placed in palatal appliances and a cariogenic challenge was made during 1 min with 20% sucrose solution. After 45 min, test plaque was collected for fluoride (F) analysis. Enamel surface microhardness was previously determined at one side of the restoration and the percentage of surface microhardness change (%SMC) in relation to baseline (other side) was calculated. F concentration in enamel was also evaluated. RESULTS: Split-plot ANOVA showed a statistically lower %SMC on enamel around the ionomeric materials than around the CR (p<0.05). This result was supported by a statistically higher F concentration in test plaque (P<0.001) and in enamel (P<0.001) restored with the ionomeric materials when compared to the CR. CONCLUSIONS: The results suggest that the short-term in situ model tested is useful for studying the anticariogenic potential of dental materials that release fluoride.

Fluoride-releasing capacity and cariostatic effect provided by sealants.

This study evaluated the effect of sealants on enamel demineralization, focusing on physical protection of the sealed enamel and fluoride protection of the adjacent unsealed enamel. Occlusal fissures with areas measuring 12 mm2 were delimited in 48 extracted molars, randomly divided into 4 groups (n =12): 1) no sealing; 2) sealing with a resin-modified glass-ionomer (Vitremer, 3M ESPE); 3) sealing with a fluoride-releasing composite sealant (Clinpro Sealant, 3M ESPE); and 4) sealing with a non-fluoridated composite sealant (Concise, 3M ESPE). A 4-mm2 window was outlined on the buccal enamel for analysis of fluoride uptake. Following treatment, groups 2, 3 and 4 were subjected to 5-days of pH-cycling, while group 1 was kept in a moist environment at 37 degrees C. Fluoride uptake was assessed by dental biopsy, and the amount of fluoride released to the cycling solutions was determined by ion analysis. Enamel demineralization around the sealants was evaluated by cross-sectional micro-hardness analysis. Group 2 showed higher levels of fluoride release (P < 0.01) and uptake by enamel (P < 0.05), and lower levels of demineralization (P < 0.05) than groups 3 and 4. Group 3 exhibited reduced demineralization on unsealed enamel and provided fluoride uptake in a distant enamel area, while group 4 did not.

[Oral health of schoolchildren residing in areas with or without water fluoridation in Sorocaba, São Paulo State, Brazil]. / A saúde bucal de escolares residentes em locais com ou sem fluoretação nas águas de abastecimento público na região de Sorocaba, São Paulo, Brasil.

This study describes dental caries data and fluorosis in seven municipalities in the Sorocaba region, S o Paulo State, Brazil, comparing those with fluoridated as opposed to non-fluoridated water. Criteria were those proposed by the World Health Organization (WHO, 1997), adapted by the School of Public Health, University of S o Paulo. The sample was selected at random, without replacement, and was calculated by age, accepting a design error of 2 and a sampling loss of 20% (n = 96 per age). There were six trained examiners, with accepted agreement percentage above 89% for all variables. In the Sorocaba region, the dmft index in 5 year-old children was 3.1, and 37.6% were caries-free (DMFT = 0). At age 12, 32.3% were caries-free (DMFT = 0), and the DMFT index in the region was 2.6, thus characterizing the area as having a low prevalence of caries. In areas with fluoridated water, the proportion of caries-free children at 12 years was higher than in those without fluoridated water (p = 0.019), and the DMFT was lower (p = 0.001). Prevalence of fluorosis at age 12 was 12.7% in the Sorocaba area and did not pose a public health problem according to the community fluorosis index (CFI).

A saúde bucal de escolares residentes em locais com ou sem fluoretação nas águas de abastecimento público na região de Sorocaba, São Paulo, Brasil / Oral health of schoolchildren residing in areas with or without water fluoridation in Sorocaba, Säo Paulo State, Brazil

Este estudo apresenta dados de cárie dentária e fluorose em sete municípios representativos da região de Sorocaba, São Paulo, Brasil, que possuem ou näo flúor nas águas de abastecimento público. A metodologia utilizada foi proposta pela Organizaçäo Mundial da Saúde (WHO, 1997), adaptada pela Faculdade de Saúde Pública da Universidade de Säo Paulo. A amostra foi probabilística, admitindo um erro de desenho de 2 e perda amostral de 20,0 por cento (n = 96 por idade). Foram calibrados seis examinadores, com porcentagem de concordância acima de 89 por cento para as variáveis pesquisadas. Obteve-se o resultado de 37,6 por cento de crianças livres de cárie aos 5 anos (ceod = 0) e o índice ceod foi de 3,1. Aos 12 anos, 32,3 por cento dos escolares tinham CPOD = 0 e o índice CPOD foi de 2,6, sendo a regiäo considerada de baixa prevalência de cárie. Nos municípios com água fluoretada a proporçäo de crianças livres de cárie aos 12 anos foi maior (p = 0,019), e o índice ceod foi menor (p = 0,001). A prevalência de fluorose nas crianças examinadas foi de 12,7 por cento, estando dentro de limites aceitáveis segundo o índice de fluorose dentária da comunidade