The impact of the COVID-19 pandemic in Brazil: a study in tertiary dental care.

The pandemic caused by coronavirus has resonated throughout different levels of health care in Brazil and, in this context, the present research aimed to evaluate this impact on tertiary dental care provided by the Unified Health System (SUS). Therefore, an ecological study was conducted with data obtained from the Hospital Information System processed by the Portal of the Department of Informatics of SUS. The sample consisted of patients of all sexes and age groups, whose Hospital Admission Authorizations (AIHs) were approved for dental tertiary care procedures from January 2015 to December 2020. Descriptive analyses and the ANOVA test with a significance level set at p < 0.05 were used. When the annual mean numbers of AIHs approved were evaluated, findings showed that on an average, the Southeast region authorized a higher number of procedures (p-value < 0.001), however, in the pandemic year (2020), a reduction of approximately 24.5% of these hospitalizations occurred throughout Brazil, with the Midwest being the region most affected (32.12%). A percentage increase occurred in the Surgical Treatment of Oral sinus/Oral nasal Fistula (16.1%), in addition to a significant decrease in performing procedures for Resection of Mouth Lesion (33.4%). In the pandemic year, there was a reduction of 14% in expenditures related to hospital services and 23.26% related to professional services. It was concluded that the data presented demonstrated a significant reduction in AIHs for tertiary dental care in the pandemic year.

The impact of the COVID-19 pandemic in Brazil: a study in tertiary dental care

Abstract The pandemic caused by coronavirus has resonated throughout different levels of health care in Brazil and, in this context, the present research aimed to evaluate this impact on tertiary dental care provided by the Unified Health System (SUS). Therefore, an ecological study was conducted with data obtained from the Hospital Information System processed by the Portal of the Department of Informatics of SUS. The sample consisted of patients of all sexes and age groups, whose Hospital Admission Authorizations (AIHs) were approved for dental tertiary care procedures from January 2015 to December 2020. Descriptive analyses and the ANOVA test with a significance level set at p < 0.05 were used. When the annual mean numbers of AIHs approved were evaluated, findings showed that on an average, the Southeast region authorized a higher number of procedures (p-value < 0.001), however, in the pandemic year (2020), a reduction of approximately 24.5% of these hospitalizations occurred throughout Brazil, with the Midwest being the region most affected (32.12%). A percentage increase occurred in the Surgical Treatment of Oral sinus/Oral nasal Fistula (16.1%), in addition to a significant decrease in performing procedures for Resection of Mouth Lesion (33.4%). In the pandemic year, there was a reduction of 14% in expenditures related to hospital services and 23.26% related to professional services. It was concluded that the data presented demonstrated a significant reduction in AIHs for tertiary dental care in the pandemic year.

Síndrome da fissura orbital superior associada a traumatismos craniomaxilofaciais / Superior orbital fissure syndrome associated with craniomaxillofacial traumatism

Introdução: A Síndrome da Fissura Orbital Superior (SFOS) é uma condição de ocorrência rara, inicialmente descrita por Hirchfield em 1858. Caracterizada pela presença de oftalmoplegia, ptose da pálpebra superior e midríase, podendo ocorrer parestesia da pálpebra superior e da região frontal, associada à lesão dos pares de nervos cranianos: oculomotor, troclear, abducente (III, IV e VI) e, por vezes, o nervo trigêmeo (V). A identificação da SFOS é importante, visto que sua incidência é rara no trauma, e sua identificação pode ajudar a direcionar o tratamento de forma mais adequada. Relato de caso: O presente trabalho descreve dois casos da SFOS associados a traumas craniofaciais, cita as possíveis etiologias relacionadas a essa síndrome e descreve a situação de trauma agudo. Considerações Finais: A avaliação das condições sistêmicas do paciente e de exames complementares, como tomografias computadorizadas, auxilia o diagnóstico diferencial entre patologias que acometem a região orbital e a base de crânio, fraturas e traumas craniofaciais. A identificação da SFOS no trauma agudo orienta a abordagem imediata ou precoce quando indicada, como nos casos de hematomas retrobulbares ou em grandes deslocamentos ósseos maxilofaciais com necessidade de redução cirúrgica. Nos casos com indicação de abordagem tardia, as fraturas craniofaciais são tratadas de forma conservadora, e o paciente é encaminhado para atendimento especializado... (AU)

Introduction: The superior orbital fissure syndrome (SOFS) is a rare condition and initially described by Hirchfield in 1858. Characterized by the presence of ophthalmoplegia, upper eyelid ptosis and mydriasis, and there may be paresthesia of the upper eyelid and forehead associated by the injury of the cranial nerves like: oculomotor, trochlear, abducens (III, IV and VI) and sometimes the trigeminal nerve (V). The identification of SOFS is important, since its incidence is rare in trauma, and its identification may help to target the treatment more adequately. Case report: The present study describes two cases of SFOS associated with craniofacial trauma, cites the possible etiologies related to this syndrome and describes the situation of acute trauma. Final considerations: The evaluation of the patient's systemic conditions and complementary exams, such as computed tomography, help the differential diagnosis between pathologies that affect the orbital region and the skull base, and fractures and traumatic head injuries. The identification of SFOS in acute trauma guides the immediate or early approach when indicated, as in cases of retrobulbar hematomas or large maxillofacial bone dislocations requiring surgical reduction. In cases with indication for late approach, craniofacial fractures are treated conservatively and the patient is referred for specialized care... (AU)

Radiation-induced Oral Mucositis in Brazilian Patients: Prevalence and Associated Factors.

Aim: To determine the prevalence of radiation-induced oral mucositis (OM) and associated factors. PATIENTS AND METHODS: A cross-sectional retrospective study was performed at a reference dental care center. The medical records of patients submitted to radiotherapy for the treatment of head and neck cancer were used to collect clinical and demographic variables. The data were submitted to descriptive analysis and multivariate Poisson regression with robust variance [p<0.05; 95% confidence intervaI (CI)]. RESULTS: Four hundred and thirteen patients were analyzed. The mean age was 55±14 years. The prevalence of OM in the overall sample was 41.9% and was higher among males (78.2%). The following variables were significantly associated with the outcome: radiation dose [prevalence ratio (PR)= 1.04; 95% CI=1.02-1.06]; concomitant chemotherapy (PR=1.48, 95% CI=1.05-2.08); oral candidiasis (PR=1.97, 95% CI=1.44-2.68); and osteoradionecrosis (PR=1.51, 95% CI=1.10-2.06). CONCLUSION: Radiation-induced OM was associated with radiation dose, concomitant chemotherapy, oral candidiasis and osteoradionecrosis. The rate of OM underscores the importance of adequate oral care prior to treatment for head and neck cancer.

Osteoradionecrosis prevalence and associated factors: A ten years retrospective study

BACKGROUND: Osteoradionecrosis (ORN) is one of the most serious complications of head and neck radiotherapy and is considered a public health problem worldwide. This study aims to determine the prevalence and associated factors of ORN in patients undergoing radiotherapy for head and neck malignancy. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted, in which all medical records of patients undergoing head and neck radiation in the period between 2006 to 2015 (10 years) were examined. Clinical and demographic data were extracted. Multivariate Poisson regression analysis with robust variance was employed to access the relationship between ORN and independent variables (p < 0.05; 95% CI). RESULTS: The sample comprised 413 medical records of patients undergoing radiotherapy. The prevalence of ORN was 9.7 %. Most participants were males (78.2%). The mean age of subjects was 55 years (± 14 years). The mandible was the main site of occurrence of ORN (85.0%). The following variables were associated with ORN: presence of oral mucositis (PR = 3.03; 95% CI: 1.30-7.03), history of smoking (PR = 0.23; 95% CI: 0.07-0.74), number of teeth removed before radiotherapy (PR = 1.06; 95% CI: 1.01-1.11) and visit to the dentist before radiation (PR = 0.08; 95% CI: 1.02-1.11). CONCLUSIONS: The prevalence of ORN was low and was associated with the presence of oral mucositis and the number of removed teeth before radiation. Visiting the dentist before radiotherapy and stopping smoking were protective factors for ORN

Comparative study of oral and salivary parameters in patients with and without loss of bone mass.

Osteoporosis is an insidious and increasingly prevalent disease that can cause fractures and affect patients' quality of life. The current study comparatively evaluates patients with and without loss of bone mass in terms of salivary calcium, viscosity, and pH. A controlled cross-sectional study was conducted in two groups of 32 postmenopausal women subjected to a bone densitometry scan and later referred for dental management at the Federal University of Minas Gerais, Brazil. The patients were assigned to two groups: Group 1 - patients with low bone mineral density (BMD) and Group 2 - patients without bone mineral changes. The following salivary parameters were evaluated: calcium concentration, flow rate, viscosity, pH, and average total protein. An oral examination was performed for assessment of DMFT variables and tongue coating. Data were analyzed using descriptive and inferential statistics, adopting a p-value < 0.05. The patients' mean age was 60 years (± 7.35). Salivary flow, pH, and viscosity were similar among the groups. Average total protein was 14.8 mg/mL and 19.0 mg/mL in Groups 1 and 2, respectively. Tongue coating and salivary calcium levels were significantly higher in Group 1 (p < 0.001). Salivary calcium is an important screening tool and may eventually be used for the diagnosis of bone mineral changes.

Comparative study of oral and salivary parameters in patients with and without loss of bone mass

Abstract Osteoporosis is an insidious and increasingly prevalent disease that can cause fractures and affect patients' quality of life. The current study comparatively evaluates patients with and without loss of bone mass in terms of salivary calcium, viscosity, and pH. A controlled cross-sectional study was conducted in two groups of 32 postmenopausal women subjected to a bone densitometry scan and later referred for dental management at the Federal University of Minas Gerais, Brazil. The patients were assigned to two groups: Group 1 - patients with low bone mineral density (BMD) and Group 2 - patients without bone mineral changes. The following salivary parameters were evaluated: calcium concentration, flow rate, viscosity, pH, and average total protein. An oral examination was performed for assessment of DMFT variables and tongue coating. Data were analyzed using descriptive and inferential statistics, adopting a p-value < 0.05. The patients' mean age was 60 years (± 7.35). Salivary flow, pH, and viscosity were similar among the groups. Average total protein was 14.8 mg/mL and 19.0 mg/mL in Groups 1 and 2, respectively. Tongue coating and salivary calcium levels were significantly higher in Group 1 (p < 0.001). Salivary calcium is an important screening tool and may eventually be used for the diagnosis of bone mineral changes.

Taking advantage of an unerupted third molar: a case report.

INTRODUCTION:: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. OBJECTIVE:: To report a clinical case that took advantage of an unerupted third molar. CASE HISTORY:: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. RESULTS:: After 12 months, the third molar reached the proper position. CONCLUSION:: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

Taking advantage of an unerupted third molar: a case report

ABSTRACT Introduction: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. Objective: To report a clinical case that took advantage of an unerupted third molar. Case history: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. Results: After 12 months, the third molar reached the proper position. Conclusion: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

RESUMO Introdução: o objetivo do tratamento odontológico cirúrgico é deslocar os dentes para a posição correta na arcada dentária. Objetivo: relatar um caso clínico de aproveitamento de terceiro molar não irrompido. Histórico do caso: paciente do sexo masculino, com 18 anos de idade, foi encaminhado, pelo dentista responsável pelo caso, para avaliação dos terceiros molares. Ao exame clínico, os terceiros molares inferiores não eram visíveis. Com a tomografia computadorizada (TC), foi possível identificar a presença de um dente supranumerário na região do lado esquerdo do ramo da mandíbula, além de impacção do terceiro molar, causadora de reabsorção radicular no segundo molar, tornando impossível a permanência desse dente na cavidade bucal. Logo, optou-se pela remoção tanto do segundo molar quanto do dente supranumerário, além da instalação de um aparelho no terceiro molar, durante o procedimento cirúrgico, para posterior tracionamento. Resultados: após 12 meses, o terceiro molar alcançou a posição adequada. Conclusão: nos casos em que o segundo molar inferior permanente apresenta reabsorção radicular atípica, um terceiro molar impactado pode substituir o dente reabsorvido, de maneira eficaz, através de uma abordagem ortocirúrgica apropriada.

Oral paracoccidioidomycosis: Retrospective analysis of 55 Brazilian patients.

Paracoccidioidomycosis (PCM) is a rare fungal infection in the world, but endemic and acquired exclusively in Latin America, with the highest prevalence in South America and Brazil, particularly. Changes in oral cavity are common and constitute the first clinical manifestation in many patients. The aim of this study was to describe the prevalence of oral PCM and analyse the profile of the disease and patients. Retrospective research, consisting of information present in the medical records in the period 1998-2015, whose histopathological diagnosis was oral PCM. Fifty-five oral PCM cases were confirmed. Of these patients, 90.9% were males and 9.1% were females. The average age was 49.66 years and the most reported occupation was rural workers. The painful symptomatology was present in 61.82% of patients. Erythematous lesions were predominant in 73% of them. In single lesions (22 cases), the most common locations were jugal mucosa and tongue. In multiple involvement (30 cases), the most affected regions were lips, jugal mucosa and alveolar ridge. Epidemiology of PCM, was similar to several other studies, especially in Brazil. This is the most important fungal infection in Latin America and the recognition of oral lesions is extremely important, as is often the first and in many cases the only manifestation of the disease.

Oral candidiasis: A retrospective study of 276 Brazilian patients.

BACKGROUND: Although oral candidiasis (OC) is a very common fungal infection of oral cavity, clinical features of affected patients and their demographic profile are not well documented. OBJECTIVE: The objective of the study was to assess the demographic profile of patients diagnosed with OC and its clinical features in an import Brazilian center of oral and maxillofacial pathology. MATERIALS AND METHODS: A retrospective study consisted of 276 patients diagnosed with OC by cytopathology Periodic Acid-Schiff (PAS) staining, during the period of 20 years. The variables related to patients were gender, age and skin color. Regarding infection, the data collected were location, color, symptoms, early manifestation, or recurrent and associated factors. RESULTS: Male and female were equally affected, and the median age was 43 years. The majority of lesions were of primitive origin, asymptomatic and affecting only one site of oral cavity. The most affected site was the palate followed by tongue. More than a half of the patients (56.2%) had red lesions. The main associated factors related were the use of removable prostheses, bone marrow transplantation and AIDS. CONCLUSIONS: OC affects predominantly adults and elderly, without difference between sex and skin color. Although clinical findings are crucial, cytopathology tests are important complementary examinations to reach a definitive diagnosis. PAS staining seems to be more used in cases of erythematous candidiasis since white lesions are easier to diagnose clinically.

Estudo comparativo das condições bucais e salivares em pacientes com e sem perda de massa óssea / Dosagem de cálcio e viscosidade salivar em pacientes com perda de massa óssea / Comparative study of salivary and oral condition in patients with and without loss of bone mass

Introdução: A osteoporose é uma doença silenciosa e de crescente prevalência, que é capaz de causar fraturas e influenciar na qualidade de vida dos pacientes. Objetivo: Avaliar comparativamente a saliva de pacientes com e sem perda de massa á óssea quanto a dosagem de cálcio, viscosidade e pH. Material e Métodos: Foi realizado um estudo transversal controlado, com dois grupos com 32 indivíduos do sexo feminino no período de pós-menopausa, portadoras de exame de densitometria óssea e encaminhadas pelo SUS, para tratamento odontológico na UFMG. Grupo 1: pacientes com diminuição de massa óssea. Grupo 2: pacientes sem alterações de massa óssea. Foram avaliados: concentração de cálcio, fluxo, viscosidade e dosagem de pH salivar. Também foi realizado um exame bucal, buscando variáveis como CPO-D e saburra lingual. Os dados obtidos foram analisados por estatística descritiva e inferencial, adotando-se um valor de p < 0,05. Resultados: A média de idade das pacientes foi de 60 anos (± 7.35), nos dois grupos e os valores de fluxo salivar, pH e viscosidade foram semelhantes entre os grupos analisados. A média de proteínas totais foi de 14,8 mg/mL e 19,0 mg/mL nos grupos com alteração de massa óssea e sem alteração, respectivamente. A presença de saburra lingual e os valores de cálcio salivar foram significativamente maiores no grupo de pacientes com alteração de massa óssea (< 0.001). Conclusão: O cálcio salivar se mostrou uma importante ferramenta de rastreio e pode, futuramente, ser utilizado para se realizar o diagnóstico de alterações de massa óssea.(AU)

Introduction: Osteoporosis is a silent and increasingly prevalent disease that can cause fractures and influence patients' quality of life. Objective: To evaluate comparatively the saliva of patients with and without loss of bone mass in the dosage of calcium, viscosity and pH .Methods: a controlled cross-sectional study was conducted with two groups of 32 women in the postmenopausal period, applying a bone densitometry exam, who were later referred for dental management at the Federal University of Minas Gerais (UFMG). Patients were separated into two groups: group 1 - patients with low BMD and group 2 - patients without bone mass changes. The parameters evaluated in saliva were: salivary calcium concentration, flow, viscosity, pH, and average total protein. An oral examination was also performed, searching for DMFT variables and tongue coating. Data were analyzed using descriptive and inferential statistics, adopting a p-value < 0.05. Results: The patients' mean age was 60 years (± 7:35). The salivary flow, pH, and viscosity were similar among the groups. The average total protein was 14.8 mg/mL and 19.0 mg/ml in groups with low BMD and no observed changes, respectively. The presence of tongue coating and salivary calcium values were significantly higher in patients with low BMD (p < 0.001). Conclusion: Salivary calcium provided important screening tools and may eventually be used to make the diagnosis of bone mass changes, as it presented statistically significant results in the group with low bone mass.(AU)

Estudo comparativo das condições bucais e salivares em pacientes com e sem perda de massa óssea / Comparative study of salivary and oral condition in patients with and without loss of bone mass

A osteoporose é uma doença silenciosa e de crescente prevalência, que é capaz de causar fraturas e influenciar na qualidade de vida dos pacientes. Objetivo: Avaliar comparativamente a saliva de pacientes com e sem perda de massa á óssea quanto a dosagem de cálcio, viscosidade e pH. Material e Métodos: Foi realizado um estudo transversal controlado, com dois grupos com 32 indivíduos do sexo feminino no período de pós-menopausa, portadoras de exame de densitometria óssea e encaminhadas pelo SUS, para tratamento odontológico na UFMG. Grupo 1: pacientes com diminuição de massa óssea. Grupo 2: pacientes sem alterações de massa óssea. Foram avaliados: concentração de cálcio, fluxo, viscosidade e dosagem de pH salivar. Também foi realizado um exame bucal, buscando variáveis como CPO-D e saburra lingual. Os dados obtidos foram analisados por estatística descritiva e inferencial, adotando-se um valor de p < 0,05. Resultados: A média de idade das pacientes foi de 60 anos (± 7.35), nos dois grupos e os valores de fluxo salivar, pH e viscosidade foram semelhantes entre os grupos analisados. A média de proteínas totais foi de 14,8 mg/mL e 19,0 mg/mL nos grupos com alteração de massa óssea e sem alteração, respectivamente. A presença de saburra lingual e os valores de cálcio salivar foram significativamente maiores no grupo de pacientes com alteração de massa óssea (< 0.001). Conclusão: O cálcio salivar se mostrou uma importante ferramenta de rastreio e pode, futuramente, ser utilizado para se realizar o diagnóstico de alterações de massa óssea

Neoplasias malignas em região de cabeça e pescoço: perfil epidemiológico dos pacientes submetidos à radioterapia/quimioterapia e atendidos na Faculdade de Odontologia da UFMG / Malignancies in head and neck: epidemiological profile of patients undergoing radiotherapy / chemotherapy and treated at School Dentistry of UFMG

No Brasil, a mortalidade por doenças crônico-degenerativas vem mostrando uma ascensão progressiva, destacando-se as neoplasias malignas como a segunda causa de morte. O câncer bucal possui uma predominância em países em desenvolvimento, em especial na classe social com níveis socioeconômicos mais baixos. Diante disso, o objetivo do trabalho foi verificar o perfil epidemiológico dos pacientes submetidos à radioterapia/quimioterapia e atendidos na Faculdade de Odontologia da UFMG. Para tanto realizou-se um estudo quanti-qualitativo, documental, analítico, do tipo transversal. Foram analisados todos os registros dos pacientes atendidos no projeto "Atendimento de suporte odontológico ao paciente portador de neoplasia maligna e irradiado em região de cabeça e pescoço", no intervalo de 2005 a 2104. Após a coleta, os dados foram digitados em um banco criado no programa R versão 3.0.3 e analisados por estatística descritiva. Dos 458 registros analisados entre 2005 e 2014 351(76,6%) corresponderam a indivíduos do sexo masculino e 107(23,4%), ao sexo feminino, sendo a idade média encontrada de 55,57 (±12,2) anos. Verificou-se que o carcinoma de células escamosas foi o mais prevalente com 334(73,2%) dos casos. Em relação à localização do tumor, a cavidade oral apareceu com 193(43,0) dos casos, já os tumores localizados em faringe e laringe, apareceram com 156(34,7%). Em relação ao tratamento, a radioterapia foi realizada em 409(89,7%) dos pacientes, já a quimioterapia foi realizada em 237(52,7%) dos casos. Ao analisar as complicações pósradioterapia, foram registrados 144(32,6%) casos de mucosite, 76(17,2%) de candidose e apenas 40(10,6%) de osteorradionecrose. Diante do exposto, podemos concluir que houve uma maior prevalência de pacientes do sexo masculino, com a sexta década de vida, como a mais acometida, sendo expressivo o número de casos em que o tratamento preconizado foi a radio e quimioterapia. O tipo de Câncer mais frequente foi o de células escamosas, localizados principalmente na cavidade oral e a complicação pós-radioterápica mais encontrada foi a mucosite

In Brazil, mortality from chronic diseases has shown a progressive rise, especially malignant neoplasms as the second cause of death. The oral cancer has a predominance in developing countries, especially in the social class with lower socioeconomic levels. Thus, the objective of this study was to determine the epidemiological profile of patients undergoing radiotherapy / chemotherapy and treated at UFMG School of Dentistry. Therefore there was a quantitative and qualitative study, documentary, analytical, cross-sectional. We analyzed all records of patients seen in the project "Support dental support to patients with malignancy and irradiated in the head and neck" in the range of 2005 to 2104. After collection, the data were entered into a database created the program R version 3.0.3 and analyzed using descriptive statistics. Of the 458 records analyzed between 2005 and 2014 351 (76.6%) corresponded to male and 107 Males (23.4%) females, with an average age of 55.57 found (± 12.2) years . It was found that the squamous cell carcinoma is the most prevalent 334 (73.2%) cases. Regarding the location of the tumor, oral cavity appeared with 193 (43.0) of the cases, since the tumors located in the pharynx and larynx, appeared in 156 (34.7%). Regarding treatment, radiotherapy was performed in 409 (89.7%) patients, since chemotherapy was performed in 237 (52.7%) cases. By analyzing the post-radiation complications were recorded 144 (32.6%) cases of mucositis, 76 (17.2%) of candidiasis and only 40 (10.6%) of osteoradionecrosis. Given the above, we can conclude that there was a higher prevalence of male patients, with the sixth decade of life, as the most affected, with a significant number of cases where the patient was treated with the radiation and chemotherapy. The most frequent type of cancer was squamous cell, located mainly in the oral cavity and post-radiotherapy most frequent complication was mucositis

Evolução da cobertura em saúde bucal na estratégia saúde da família em municípios paraibanos / Evolution of the family health Strategy oral health coverage in municipalities in Paraíba

A institucionalização da Avaliação em Saúde vem crescendo nas últimas décadas no Brasil, contribuindo para a racionalidade das intervenções setoriais da gestão em saúde. Este estudo avaliou a evolução da cobertura em saúde bucal na Estratégia Saúde da Família em municípios paraibanos, classificando-os em três categorias: satisfatório, intermediário e insatisfatório, a partir de indicadores disponibilizados nos sistemas de informações, nos anos de 2004 a 2010. Para tanto, adotou-se uma abordagem indutiva com procedimento estatístico-comparativo e técnicasa de documentação indireta, utilizando os indicadores: cobertura populacional potencial, para Equipes de Saúde da Família (ESF) e Equipes de Saúde Bucal (ESB). O universo constituiu-se dos 223 municípios do estado da Paraíba. Os dados foram analisados por meio do teste do Qui-Quadrado (p<0,05). Constatou-se um aumento significante (p<0,01) da cobertura referente às ESF e ESB. A cobertura populacional potencial para ESF em 2004 foi satisfatória 77,13% (n=172) dos municípios e em 99,10% (n=221) no ano de 2010. Em relação à ESB, também satisfatórianos anos de 2004 e 2010, respectivamente, em 68,16% (n=152) e 96,41% (n=215) das localidades. Conclui-se quede 2004 a 2010, houve aumento no número de municípios paraibanos com cobertura populacional potencial satisfatória das ESF e das ESB.

The institutionalization of health assessment has been growing in recent decades in Brazil, contributing to the rationality of sectorial interventions in health administration. This study evaluated the evolution of oral health coverage in the Family Health Program in municipalities in Paraíba, classifying them into three categories: satisfactory, intermediate, and unsatisfactory, using indicators provided in information systems, between 2004 and 2010. To this end, we adopted an inductive approach with a comparative-statistical procedure and an indirect documentation technique, using the indicators: population coverage potential, for Family Health Teams (FHT) and Oral Health Teams (OHT). The universe consisted of the 223 municipalities in the state of Paraiba. Data were analyzed using the chi-square test (p <0.05). A significant increase (p <0.01) of coverage for the FHT and OHT was observed. The potential population coverage for the FHT was a satisfactory 77.13% (n=172) of the municipalities in 2004, and 99.10% (n=221) in 2010. In relation to the OHT, the coverage was also satisfactory in 2004 and 2010, respectively, in 68.16% (n=152) and 96.41% (n=215) of the localities. It is concluded that, from 2004 to 2010, there was an increase in the number of Paraiba's municipalities with satisfactory population coverage potential of the FHT and OHT.

Avaliação da atividade antibacteriana das tinturas de Hamamelis virginiana L. e Stryphnodendron rotundifolium Mart. frente a bactérias bucais / Evaluation of the antibacterial activity of Hamamelis virginiana L. andStryphnodendron rotundifolium Mart. tinctures against oral bacteria

Objetivo: Avaliar, in vitro, a atividade antibacteriana dastinturas de Hamamélis (Hamamelis virginiana L.) eBarbatimão (Stryphnodendron rotundifolium Mart.) sob as bactérias Streptococcus mutans (ATCC 25175),Streptococcus oralis (ATCC 10557) e Streptococcussalivarius (ATCC 9758). Materiais e Metodos: Utilizou-se aclorexidina 0,12% como controle positivo. Água destilada e álcool 70% foram escolhidos como controles negativos.Efetivou-se a diluição das tinturas desde 1:1 (forma pura)até 1:64 (D6) em álcool 70%, o qual está presente na fórmula das tinturas fitoterápicas. O meio de cultura bacteriana utilizado foi o Brain Heart Infusion (BHI), havendo as emeadura em placas de petri com auxílio de swabs.Realizou-se o teste de suscetibilidade e, em seguida, foram incubadas a 37°C, em microaerofilia, por 48 horas. O estudo foi realizado em duplicata e os halos foram mensurados como auxílio de um paquímetro manual. Resultados: O controle positivo apresentou halos de inibição de 16, 15, e 16 mmpara S. mutans, S. oralis e S. salivarius, respectivamente.Nenhuma das tinturas avaliadas, em quaisquer formas,diluídas ou puras, obteve halos de inibição para estas bactérias bucais. A água destilada e o álcool também não promoveram atividade. Conclusão: As tinturas da Hamamélise Barbatimão não apresentam atividade antibacteriana sobreS. mutans, S. oralis e S. salivarius.

Objective: To evaluate the in vitro the antibacterial activity ofthe Hamamelis (Hamamelis virginiana L.) and Barbatimão(Stryphnodendron rotundifolium Mart.) tinctures againstStreptococcus mutans (ATCC 25175), Streptococcus oralis(ATCC 10557) and Streptococcus salivarius (ATCC 9758).Material and Methods: Chlorhexidine (0.12%) was used aspositive control. Distilled water and 70% alcohol were chosenas negative controls. The dilution of the tinctures was carriedout from 1:1 (pure form) to 1:64 (D6) in 70% alcohol, which isfound in the tinctures formula. The culture medium Brain Heart Infusion (BHI) was used, and microorganisms were inoculatedon petri plates using swabs. Plates were incubated at 37 ºC,in microaerophilia, for 48 hours. Tests were performed induplicate and halos were measured using a manual caliper.Results: The positive control showed inhibition halos of 16,15, and 16 mm on S. mutans, S. oralis and S. salivarius,respectively. None of the tinctures evaluated, in any form(diluted or pure), were found to show inhibition halos onthese oral bacteria. Distilled water and 70% alcohol did not exhibit activity. Conclusion: The tinctures of Hamamelis and Barbatimão did not demonstrated antibacterial activity on S.mutans, S. oralis and S. salivarius.

Perfil das Internações de Crianças eAdolescentes com Fraturas do Crânio e Ossos da Face na Região Nordeste do Brasil / Profile of Hospitalization of Children and Adolescents with Fractures of the Skull and Facial Bones in Northeastern Brazil

Analisar o perfil das internações de crianças eadolescentes com fraturas do crânio e ossos da face naregião Nordeste, Brasil, no período de 2008 a 2010. Materiale Métodos: Utilizou-se uma abordagem indutiva comprocedimento comparativo-descritivo e técnica dedocumentação indireta. Os dados foram obtidos medianteconsulta aos sítios do DATASUS para os anos de 2008 a2010, nas faixas etárias de 0 a 19 anos, considerando asinformações disponíveis para cada estado da regiãonordeste, sendo analisados descritivamente por meio defrequências absolutas e percentuais. Resultados: No anode 2008, obteve-se um valor total de 1.418 notificações, commaior prevalência do gênero masculino (77,36%) e faixaetária mais acometida a de 15 a 19 anos, sendo a Bahia oestado com número mais expressivo de internações (n=274;17,42%). No ano de 2010, foram registradas 1.352internações, evidenciando-se maior envolvimento do gêneromasculino (79,66%) e da faixa etária de 15 a 19 anos,constatando-se que o Ceará apresentou valores maiselevados de internação (n=301; 22,26%). Conclusão: Houveuma maior ocorrência de fraturas em indivíduos do sexomasculino e a faixa etária mais acometida foi a de 15 a 19anos. Os estados da Bahia e do Ceará apresentaram o maiornúmero de internações, já os estados de Sergipe e doMaranhão foram os menos acometidos no período estudado...

To analyze the profile of hospitalization of childrenand adolescents with fractures of the skull and facial bonesin the Northeastern Brazil from 2008 to 2010. Material andMethods: We used an inductive approach with descriptivestatisticalprocedure and technique of indirect documentation.Data were obtained by consulting the DATASUS websitesfor the years 2008 to 2010, in the age group 0-19 years.Results: In 2008, we obtained a total of 1,418 notifications,with higher prevalence in males (77.36%); the most affectedage group was 15-19 years, and the state of Bahia had themost significant number of hospitalizations (n = 274; 17.42%).In 2010, there were 1,352 admissions, with greaterinvolvement of males (79.66%) aged 15 to 19 years, and thestate of Ceará showed significantly higher hospitalizationrates (n = 301, 22.26%). Conclusion: There was a higherincidence of fractures in males and the most affected agegroup was 15-19 years. The states of Bahia and Ceará hadthe largest number of admissions and the states of Maranhãoand Sergipe were the least affected in the studied period...

Influência de diferentes ácidos fosfóricos na adesão ao esmalte / Influence of different phosphoric acids in enamel adhesion

The aim of this study was to evaluate in vitro the shear bond strength of a composite resin after acid etching with phosphoric acid 37% with and without chlorhexidine. Thirty bovine incisors were divided into two groups (n = 15), according to the type of acid etching applied in enamel – G1 (phosphoric acid 37%) and G2 (phosphoric acid 37% with chlorhexidine 2%). The conditioning of the surface followed the manufacturers’ recommendations; after this step, there was the application of adhesive and the insertion of composite resin in a rubber matrix with a center hole of 4 mm. The specimens were submitted to analysis of shear strength in a Shimadzu AGS-X Universal Testing Machine with crosshead speed of 1 mm/min and the values measured in MPa. After the test, the Adhesive Remnant Index (ARI) was assessed. Data were analyzed by descriptive and inferential statistics, adopting a significance level of 5%. The mean shear strength reported for the two groups were, respectively, 12.02 MPa and 11.86 MPa (unpaired t-test; p-value > 0.05). As for the ARI, the most frequent scores for G1 and G2 were 3 and 5, with no statistically significant difference between groups (Mann-Whitney test; p-value > 0.05). Under the experimental conditions of the study, we conclude that the addition of chlorhexidine to phosphoric acid 37% did not affect the bond strength to the enamel surface nor the type of failure found.

O objetivo deste estudo foi avaliar in vitro a resistência ao cisalhamento de uma resina composta após condicionamento com ácido fosfórico 37% com e sem clorexidina. Trinta incisivos bovinos foram divididos em dois grupos (n = 15) de acordo com o tipo de ataque ácido aplicado ao esmalte – G1 (ácido fosfórico a 37%) e G2 (ácido fosfórico 37% com clorexidina a 2%). O condicionamento da superfície obedeceu às recomendações dos fabricantes e, em seguida a esta etapa, realizou-se a aplicação do adesivo e procedeu-se a inserção da resina composta em matriz de borracha com orifício central de 4 mm. Os corpos de prova foram submetidos ao teste de resistência ao cisalhamento em máquina de ensaios mecânicos Shimadzu com velocidade de carga de 1mm/min e os valores registrados em MPa. Após o ensaio, foi observado o Índice de Remanescente Adesivo (IRA). Os dados foram analisados por estatística descritiva e inferencial, adotando-se nível de signifi cância de 5%. A média da resistência ao cisalhamento registrada para os dois grupos foi, respectivamente, 12,02 MPa e 11,86 MPa (teste t não pareado; p-valor> 0,05). Quanto ao IRA, os escores mais frequentes para G1 e G2 foram 3 e 5, não sendo observada diferença estatisticamente significante (Teste Mann-Whitney; p-valor>0,05). Nas condições experimentais do estudo, conclui-se que a adição de clorexidina ao ácido fosfórico 37% não interferiu na resistência de união à superfície do esmalte nem no tipo de fratura encontrado.