Inspection of the actions of veterinarians qualified to act in the National Programme for Control and Eradication of Animal Brucellosis and Tuberculosis / Fiscalização das ações de médicos veterinários habilitados para atuar no Programa Nacional de Controle e Erradicação da Brucelose e Tuberculose Animal

The inspection of qualified professionals is an important action of the National Programme for Control and Eradication of Animal Brucellosis and Tuberculosis (PNCEBT). The data for this study were obtained by compiling reports of 63 inspections in loco of qualified private veterinarians between 2008 and 2011 in the state of Espírito Santo, Brazil. Through the findings of this study, it was observed that all inspected professionals are regularly registered in the CRMV-ES, nevertheless it was found pending issues regarding the registration to conduct vaccinations against brucellosis. It was observed that most professionals keep the infrastructure and equipment for conducting tuberculosis and brucellosis tests. The majority adopts the official models of certification, however there is a significant delay in sending reports of actions, and many professionals reported a lack of demand for certification of properties.(AU)

A fiscalização de profissionais habilitados é uma importante ação do Programa Nacional de Controle e Erradicação da Brucelose e Tuberculose Animal (PNCEBT). Com este trabalho, buscou-se reunir informações das fiscalizações relativas à habilitação de médicos veterinários privados no estado do Espírito Santo. Os dados deste estudo foram obtidos mediante a compilação dos relatórios de 63 fiscalizações in loco entre 2008 e 2011. Por meio dos achados deste estudo, observou-se que todos os profissionais fiscalizados estão regularmente inscritos no CRMV-ES, todavia foram verificadas pendências quanto ao cadastro para realizar vacinações contra brucelose. Observou-se que a maior parte dos profissionais mantém a infraestrutura e os equipamentos para a realização de exames de brucelose e tuberculose. A maioria adota os modelos oficiais de atestados, contudo há um expressivo atraso no envio dos relatórios de ações, e muitos profissionais relataram falta de demandas para certificação de propriedades.(AU)

Analysis of poultry transit, notification systems and legislation in the state of Sergipe, 2008-2012 / Análise do trânsito de aves, dos sistemas de notificação e da legislação no estado de Sergipe entre 2008 e 2012

The purpose of this study was to assess the transit of poultry, as well as the inspection on the outbreak of diseases, by addressing the issues concerning the system of the National Program on Poultry Sanity and its legal resolutions. The data on the animal transportation and the occurrence of the diseases were collected from the official services. A legislation-based assessment was also carried out for the period from 2008 to 2012 in the state of Sergipe, Brazil. Results showed an intense transit of poultry in just about all towns of the state in the period under study, especially in chicken farms where less number of poultry is bred: from 5,000 to 15,000. Besides, 64% of poultry transportation was found to be intermunicipal. The state of Sergipe has received poultry particularly from the states of Pernambuco (49.87%), Bahia (20.85%), Minas Gerais (5.94%), Paraíba (5.16%), and Goiás (5.05%). The number of transit indicates an increase in transit over the years. In addition, three of six municipalities which saw these diseases (Estância, São Cristóvão and Itaporanga d'Ajuda) are responsible for a great part of the poultry transit. Results also showed that the majority of activities of the State Program on Poultry Sanity would be carried out in the municipalities where a larger poultry marketing flow takes place, thereby seeking to record a greater number of notifications on the diseases and, then, carry out the surveillance activities. Therefore, regarding the poultry transit, it is recommended to do a mapping of the risk regions for poultry diseases, as well as studies about the epidemiological characterization of the municipalities of the state of Sergipe.(AU)

O objetivo deste estudo foi avaliar o trânsito de aves, sua fiscalização e o surgimento de enfermidades, abordando questões referentes ao sistema do Programa Nacional de Sanidade Avícola e suas determinações legais. Dessa forma, compilaram-se dados do serviço oficial sobre o trânsito dos animais e a ocorrência de doenças, realizando-se também uma avaliação da legislação vigente entre 2008 e 2012, no estado do Sergipe. Observou-se no período averiguado um intenso trânsito de aves em quase toda a totalidade dos municípios, principalmente entre granjas que alojam pequenas quantidades de aves (5.000 a 15.000), e 64% do total do transporte de aves ocorreu entre municípios do Estado. Os estados fornecedores de aves para Sergipe foram sobretudo Pernambuco (49,87%), Bahia (20,85%), Minas Gerais (5,94%), Paraíba (5,16%) e Goiás (5,05%). O número de guias de trânsito emitidas aponta um crescimento do trânsito ao longo dos anos. Verificaram-se que três municípios (Estância, São Cristóvão e Itaporanga d'Ajuda), dos seis acometidos por enfermidades, são aqueles responsáveis por grande parte do trânsito realizado. O estudo mostrou que para os municípios sergipanos, nos quais acontece maior fluxo de comercialização avícola, seriam indicadas mais das ações do Programa Estadual de Sanidade Avícola, com a finalidade de registrar maior número de notificações de enfermidades e, consequentemente, exercer ações de vigilância. Assim, quanto ao trânsito animal, recomendam-se a adoção de um mapeamento das regiões de risco sanitário para as enfermidades de aves e a realização de estudos sobre a caracterização epidemiológica dos municípios de Sergipe.(AU)

Relação entre fatores socioeconômicos, clínicos e saúde bucal em escolares da zona rural: um estudo longitudinal / Relationship among socioeconomic and clinical factors with oral health, in schoolchildren from rural areas: a longitudinal study

Objetivos: Este estudo longitudinal avaliou: a) o impacto de ações bimestrais de atenção básica em saúde bucal no incremento da cárie e mancha branca em uma população rural; b) associações entre variáveis sociais, econômicas e cárie e mancha branca. Materiais e método: exames (baseline, após 6 e 12 meses) e ações educativas e preventivas bimestral (baseline, 2, 4, 6, 8, 10, 12 meses) foram realizados em 161 crianças. A análise univariada (Qui-Quadrado) utilizou CPOD, ceod e mancha branca como variáveis de desfecho (p<0,05). Resultados: a mancha branca estava presente em 42,82%, 33,33% e 28,03% das crianças no baseline, após 6 e 12 meses, respectivamente. No baseline, houve associação significativa entre grau de escolaridade da mãe (p=0,0040) e número de pessoas na família (p=0,0068), para os desfechos CPOD e ceod, respectivamente. Após seis meses, houve associação entre CPOD e grau de escolaridade da mãe (p=0,0059), ceod e número de pessoas na família (p=0,0173) e grau de escolaridade do pai (p=0,0412), além de associação entre mancha branca e água ingerida (p=0,0350). Após doze meses, apenas o grau de escolaridade da mãe (p=0,0049) foi estatisticamente associado ao CPOD. Conclusão: apesar da alta experiência de cárie, houve diminuição substancial das manchas brancas após implementaçãodo programa preventivo.

Oral physiology and quality of life in cancer patients / Fisiología oral y calidad de vida en pacientes con cáncer

Introduction: Cancer treatment can affect the health of the teeth and support structures, which are essential to the chewing process, which may change the nutritional status of the patient. Objective: The aim of this study was to evaluate the impact of oral physiology changes on quality of life (QoL) of patients submitted to cancer treatment. Design: Initially 84 cancer patients were screened and only those presenting at least 15 natural teeth were selected for oral physiology and quality of life tests. The final sample comprised 30 patients. Twenty subjects were selected as controls paired by age and gender. Dental caries status, salivary flow, masticatory performance (MP), location of tumor, duration of chemo and radiotherapy and World Health Organization Quality of Life (WHOQOL-bref) questionnaire were assessed. Linear regression models were used to test the relationship between the WHOQOL-bref domains (physical, psychological, social relationship, environmental and overall QoL) and independent variables under study. Results and Discussion: Number of teeth, MP and salivary flow were lower in cancer patients, as well as for the scores obtained in Social Relationship, Environment and Overall QoL domains (p< 0.050). Breast cancer caused a negative impact on Psychological (p< 0.001) and Overall QoL scores (p=0.017). A similar negative effect was found for the duration of radiotherapy on Psychological (p=0.012) and Environmental (p=0.039) domains. On the other hand, the maintenance of teeth had a positive impact on Psychological (p=0.012) and Environmental (p=0.024) scores. Conclusion: Oral physiology changes may impact the QoL of oncological patients. The maintenance of teeth was of positive importance, especially for the psychological aspects (AU)

Introducción: El tratamiento del cáncer puede afectar la salud de los dientes y estructuras de apoyo, que son esenciales para el proceso de masticación, que pueden cambiar el estado nutricional del paciente. Objetivo: El objetivo de este estudio fue evaluar el impacto de los cambios fisiológicos orales sobre la calidad de vida (QoL) de los pacientes sometidos a tratamiento contra el cáncer. Métodos: Inicialmente 84 pacientes con cáncer fueron examinados y sólo los que presentan al menos 15 dientes naturales fueron seleccionados para la fisiología oral y la calidad de las pruebas de la vida. La muestra final quedó conformado por 30 pacientes. Veinte sujetos fueron seleccionados como controles emparejados por edad y sexo. Dental estado de la caries, el flujo salival, rendimiento masticatorio (MP), la ubicación del tumor, la duración de la quimioterapia y la radioterapia y lo cuestionario de La Organización Mundial de la Salud Calidad de Vida (WHOQOL-BREF) cuestionario fueron evaluados. Se utilizaron modelos de regresión lineal para probar la relación entre los dominios del WHOQOL-BREF (psicológicos relación física,, social, ambiental y de calidad de vida en general) y variables independientes bajo estudio. Resultados y Discusión: Número de dientes, MP y el flujo salival fueron menores en los pacientes de cáncer, así como para las puntuaciones obtenidas en la relación social, medio ambiente y dominios de calidad de vida general (p <0,050). El cáncer de mama causó un impacto negativo en la psicológica (p <0,001) y las puntuaciones de calidad de vida global (p = 0,017). Un efecto negativo similar se encontró para la duración de la radioterapia sobre psicológica (p = 0,012) y ambientales (p = 0,039) dominios. Por otra parte, el mantenimiento de dientes tuvo un impacto positivo en la psicológica (p = 0,012) y del Medio Ambiente (p = 0,024) resultados. Conclusión: los cambios orales fisiología pueden afectar la calidad de vida de los pacientes oncológicos. El mantenimiento de dientes fue de importancia positiva, sobre todo por los aspectos psicológicos (AU)

Associação do risco familiar com saúde bucal, qualidade de vida e variáveis socioeconômicas / Association of familial risk with oral health, quality of life and socioeconomic variables / Asociación del riesgo familiar con salud oral, calidad de vida y variables socioeconómicas

Objetivo: avaliar a relação do risco familiar com saúde bucal, qualidade de vida e variáveis socioeconômicas. Métodos: estudo observacional transversal com 311 indivíduos com idade entre 18 e 71 anos, residentes na área de abrangência de quatro unidades de saúde da família (USF), localizadas em dois municípios do estado de São Paulo. Os voluntários foram avaliados de acordo com: (1) situação clínica (CPO-D e necessidade de tratamento), (2) autopercepção de saúde bucal (OHIP-14), (3) qualidade de vida (WHOQOL-BREF), e (4) condição socioeconômica. Para avaliar o risco familiar, utilizou-se a Escala de Coelho. Os dados foram analisados por meio de modelo multinível formado por componentes fixos (representados pelas variáveis estudadas) e componentes aleatórios (representados pelos bairros e pelas variâncias nos diferentes níveis). Resultados: a média de idade dos participantes foi de 36,7 anos (dp=13), com CPO-D médio de 12,9 (dp=7,0). A média da Escala de Risco de Coelho entre os voluntários foi de 2,67 com erro padrão de 0,32. Apresentaram maior escore de risco total os indivíduos de maior idade (p=0,0486), que moravam em casas com mais residentes (p<0,001), com menos anos de escolaridade (p=0,0137), que não possuíam automóvel (p=0,0048) e com maior escore de OHIP-14 (p=0,0130). Conclusão: a escala de risco familiar associou-se positivamente às variáveis socioeconômicas, e os indivíduos com maior risco familiar apresentaram pior autopercepção da saúde bucal, mas não percebiam uma pior qualidade de vida em geral.

Objective: to assess the relation of familial risk with oral health, quality of life and socioeconomic variables. Methods: cross-sectional observational study encompassing 311 individuals (18 to 71 years old) living in the catchment area of four Family Health Units located in two municipalities of São Paulo state. The participants were evaluated according to: (1) clinical situation (CPO-D and treatment necessity); (2) self-perception oral health (OHIP-14), (3) quality of life (WHOQOL-BREF); and (4) socioeconomic status. The Coelho Scale was used for assessing familial risk. Data were analyzed using a multilevel model formed by fixed components (represented by the studied variables) and random components (represented by the neighborhoods and the variances in the different levels). Results: the participants' average age was 36.7 years old (SD=13), and the average CPO-D was 12.9 (SD=7.0). The average of the Coelho´s Risk Scale among the volunteers was 2.67, with a standard error of 0.32. The participants with higher total risk score were older individuals (p=0.0486) who lived in houses with more residents (p<0.001), who wereless educated (p=0.0137), who did not own a vehicle (p=0.0048), and who had a higher OHIP-14 score (p=0.0130). Conclusion: the familial risk scale was positively associated with the socioeconomic variables, and the individuals with higher familial risk score had worse self-perception of their oral health. However, they did not perceive themselves as having worse general quality of life.

Objetivo: evaluar la relación del riesgo familiar con salud bucal, calidad de vida y las variables socioeconómicas. Métodos: estudio observacional transversal que abarca 311 individuos (18 a 71 años de edad) habitantes en la zona de captación de cuatro Unidades de Salud Familiar ubicadas em dos municipios del estado de São Paulo. Los participantes fueron evaluados de acordo con: (1) situación clínica (necesidad de tratamiento y CPOD); (2) auto percepción de salud bucal (OHIP-14): (3) calidad de vida (WHOQOL-BREF); y (4) nivel socioeconómico. Para medición del riesgo familiar, se utilizo la Escala de Coelho. Los datos fueron analizados mediante el modelo multinivel que consiste de componentes fijos (representados por las variables) y componentes aleatorios (representados por los barrios y las variaciones en los diferentes niveles). Resultados: la edad media de los participantes fue 36,7 años (de = 13), y la media de lo CPO-D fue 12,9 (de = 7,0). La media de riesgo de la Escala de Coelho fue 2,67 con un error estándar de 0,32. Tuvieran puntuaciones de riesgo más altas los individuos de mayor edad (p = 0,0486), que vivían en hogares con más residentes (p <0,001), con menos años de educación (p = 0,0137), que no tenían coche (p = 0,0048) y que tuvieran mayor score de OHIP-14 (p = 0,0130). Conclusión: la escala de riesgo familiar se asoció positivamente con las variables socioeconómicas y los individuos con mayor riesgo familiar tuvieran una percepción peor de su salud bucal, sin embargo, no se percibirán como que teniendo peor calidad de vida en general.

Geographic information system and multilevel analysis: gingival status among 12-year-old schoolchildren in São Paulo, Brazil.

OBJECTIVE: To evaluate gingival and calculus status among schoolchildren 12 years of age using a geographic information system and multilevel analysis. METHODS: A total of 1 002 schoolchildren were selected from 18 municipal districts by means of cluster sampling, from among 25 public and private schools in Piracicaba, São Paulo, Brazil, in 2005. Examinations were carried out by a single calibrated examiner utilizing the criteria of the World Health Organization, as well as the Community Periodontal Index. Social, economic, and behavioral variables were recorded with the use of a questionnaire and were used in the individual analysis (first level). The variables "percentage of heads of families without income" and "percentage of illiterate heads of families" were used in the contextual analysis (second level). RESULTS: A geographic information system was constructed for mapping the distribution of gingival bleeding. The variables were visually distinguished in the maps and demonstrated a tendency toward better gingival health in the central areas of the city, which are recognized as more privileged. On the contextual level, only the "percentage of illiterate heads of families" was significantly associated to gingival bleeding. CONCLUSIONS: The study confirms better oral health status among schoolchildren from privileged families, but does not confirm the data regarding "income." The individuals from areas in which the heads of family did not have income were not associated to a higher prevalence of gingival problems. This suggests that these individuals are reasonably protected from the impact of social privation due to the actions of public health care services in the municipality.

Geographic information system and multilevel analysis: gingival status among 12-year-old schoolchildren in São Paulo, Brazil / Sistema de información geográfica y análisis de niveles múltiples: estado gingival en escolares de 12 años de edad en São Paulo, Brasil

OBJECTIVE: To evaluate gingival and calculus status among schoolchildren 12 years of age using a geographic information system and multilevel analysis. METHODS: A total of 1 002 schoolchildren were selected from 18 municipal districts by means of cluster sampling, from among 25 public and private schools in Piracicaba, São Paulo, Brazil, in 2005. Examinations were carried out by a single calibrated examiner utilizing the criteria of the World Health Organization, as well as the Community Periodontal Index. Social, economic, and behavioral variables were recorded with the use of a questionnaire and were used in the individual analysis (first level). The variables "percentage of heads of families without income" and "percentage of illiterate heads of families" were used in the contextual analysis (second level). RESULTS: A geographic information system was constructed for mapping the distribution of gingival bleeding. The variables were visually distinguished in the maps and demonstrated a tendency toward better gingival health in the central areas of the city, which are recognized as more privileged. On the contextual level, only the "percentage of illiterate heads of families" was significantly associated to gingival bleeding. CONCLUSIONS: The study confirms better oral health status among schoolchildren from privileged families, but does not confirm the data regarding "income." The individuals from areas in which the heads of family did not have income were not associated to a higher prevalence of gingival problems. This suggests that these individuals are reasonably protected from the impact of social privation due to the actions of public health care services in the municipality.

OBJETIVO: Evaluar el estado gingival y la presencia de sarro en escolares de 12 años de edad mediante el empleo de un sistema de información geográfica y análisis de niveles múltiples. MÉTODOS: En el año 2005, se seleccionó a un total de 1 002 escolares de 18 distritos municipales mediante muestreo por grupos, con la participación de 25 escuelas públicas y privadas de Piracicaba, en el estado de São Paulo, Brasil. Un único examinador calibrado, que utilizó los criterios de la Organización Mundial de la Salud, así como el Índice Periodontal Comunitario, llevó a cabo los exámenes. Mediante un cuestionario, se registraron las variables sociales, económicas y conductuales, y estas se emplearon en el análisis individual (primer nivel). En el análisis contextual (segundo nivel), se utilizaron las variables "porcentaje de cabezas de familia sin ingresos" y "porcentaje de cabezas de familia analfabetas". RESULTADOS: Se construyó un sistema de información geográfica para elaborar mapas de la distribución de la hemorragia gingival. Los mapas, donde se pueden distinguir visualmente las variables, demostraron una tendencia hacia una mejor salud gingival en las zonas del centro de la ciudad, consideradas como privilegiadas. En el nivel contextual, únicamente el "porcentaje de cabezas de familia analfabetas" se asoció significativamente con el sangrado gingival. CONCLUSIONES: El presente estudio confirma una mejor salud bucodental en los escolares pertenecientes a familias privilegiadas, pero no confirma los datos en cuanto a "ingresos". Las personas residentes en zonas donde las cabezas de familia no tenían ingresos no presentaron una mayor prevalencia de problemas gingivales. Esto indica que estas personas, como consecuencia de las actividades de los servicios de atención de salud pública del municipio, están razonablemente protegidas de la repercusión de la privación social.

Estudo retrospectivo da raiva no Estado da Paraíba, Brasil, 2004 a 2011 / Retrospective survey of rabies in Paraíba State, Brazil, from 2004 to 2011

O objetivo deste trabalho foi realizar um estudo retrospectivo da raiva em herbívoros no estado da Paraíba, Brasil, avaliando aspectos epidemiológicos da doença no período de 2004 a 2011. Foram utilizados os registros da notificação dos casos de raiva contidos no Sistema Continental de Vigilância Epidemiológica (SIVCONT). Durante o período avaliado, foram submetidas para diagnóstico amostras de 17.454 animais de todo o Brasil, das quais 43 (0,25%) foram procedentes do estado da Paraíba, e todas elas foram positivas para raiva. A frequência de focos de raiva por município variou de 2,3% a 11,6%. A distribuição dos casos variou conforme a espécie afetada, havendo predominância nos bovinos (93%), seguidos de equinos (4,7%) e um morcego (2,3%) (p < 0,001). Foi observada predominância de casos positivos nos quais a notificação foi efetuada por proprietários (53,5%), seguido de terceiros (39,5%) e vigilância (7%) (p = 0,001). Com relação aos meses de ocorrência dos focos em todos os anos do período avaliado, as frequências variaram de 4,7% no mês de agosto a 14% no mês de abril. Houve predominância de focos no ano de 2010 (41,9%), com diferença significativa entre os anos (p < 0,001). Em conclusão, sugere-se a adoção de medidas estratégicas de controle da raiva e vigilância contínua das doenças nervosas no estado da Paraíba.

The aim of this work was to perform a retrospective study of rabies in herbivores in the state of Paraíba, Brazil, in order to evaluate epidemiological aspects of the disease from 2004 to 2011. Data on notification of rabies cases included in the Continental Epidemiological Surveillance System (SIVCONT) were used. During the study period samples from 17,454 animals from Brazil were sent to rabies diagnosis, from which 43 (0.25%) samples from the state of Paraiba, and all of them were positive for rabies. The frequency of rabies outbreaks by county ranged from 2.3% to 11.6%. The distribution of cases ranged according to species affected, with predominance in cattle (93%), followed by horses (4.7%) and one bat (2.3%) (p < 0.001). It was observed a predominance of positive cases when the notification was made by owners (53.5%), followed by others (39.5%) and surveillance (7%) (p = 0.001). Related to occurrence of outbreaks by month in all years of the study period, the frequencies ranged from 4.7% in August to 14% in April. It was found predominance of outbreaks in 2010 (41.9%), with significant differences among years (p < 0.001). In conclusion, it is suggested the adoption of strategic measures for the control of rabies and continuous surveillance of nervous diseases in herbivores in the state of Paraíba.

A cohort study of caries incidence and baseline socioeconomic, clinical and demographic variables: a Kaplan-Meier survival analysis.

PURPOSE: To determine the incidence of dental caries and evaluate the influence of socioeconomic, clinical and demographic variables on the time for disease to appear in the permanent teeth after 3 years of follow-up. MATERIALS AND METHODS: The random sample of this cohort study consisted of 427 5-year-old preschool children attending 22 public preschools in Piracicaba, SP, Brazil. Dental caries was measured using the dmf/DMF indices. The Kaplan- Meier survival analysis method was used to study the isolated effect of socioeconomic, clinical and demographic variables on caries incidence after 3 years. A Cox proportional hazards regression model was built to test the influence of the variables collected at baseline on time to develop DMFT increment. RESULTS: Survival analysis showed that children without past caries experience in primary teeth at baseline remained caries free in permanent teeth for a longer period than children with past caries experience at baseline. The variables monthly family income, parents' educational level, number of people living in the household, home ownership and car ownership were not significant. CONCLUSION: Children who presented past caries experience in primary teeth at baseline are at greater risk of developing DMFT increment than children who have no past caries experience at baseline.

[Sample size and costs estimate in epidemiological survey of dental caries]. / Tamanho de amostra e estimativa de custo em levantamento epidemiológico de cárie dentária.

This study aimed to analyze how the prevalence and the distribution of dental caries influence the sample size in epidemiological surveys, and how much are the costs. Secondary data of oral health surveys in 12-year-old schoolchildren from Bauru in 1976, 1984, 1990, 1994, and 2001, and from Piracicaba in 2001 and 2005 were studied. Sample sizes were estimated taking into account the mean DMFT and standard deviation of each survey, establishing sampling errors of 1%, 2%, 5%, and 10%. Costs were estimated considering permanent material, consumption material and human resources. The sample size in both towns needed to be increased, ranging from 119 in 1976 to 1,118 in 2001 in Bauru, and from 954 in 2001 to 1,252 in 2005 in Piracicaba, when a sampling error of 10% was considered. The cost of dental caries surveys was verified considering different sampling errors. This cost depends on how acceptable is the margin of difference between the true mean and the one found in the survey. In conclusion, the reduction in the prevalence of dental caries has determined the need for increase in sample size and in costs for conducting the surveys.

Tamanho de amostra e estimativa de custo em levantamento epidemiológico de cárie dentária / Sample size and costs estimate in epidemiological survey of dental caries

O objetivo do presente estudo foi analisar como a prevalência e a distribuição da cárie dentária influenciam o tamanho da amostra em levantamentos epidemiológicos, e os custos para sua realização. Foram utilizados dados de levantamentos realizados em escolares de 12 anos em Bauru nos anos de 1976, 1984, 1990, 1994 e 2001, e em Piracicaba nos anos de 2001 e 2005. Os tamanhos amostrais foram dimensionados considerando-se a média e o desvio padrão obtidos, fixando-se erro amostral em 1 por cento, 2 por cento, 5 por cento e 10 por cento. Os custos foram estimados considerando material permanente, de consumo e recursos humanos. Verificou-se aumento no tamanho das amostras em ambos os municípios, variando de 119 em 1976 para 1.118 em 2001 em Bauru, e de 954 em 2001 para 1.252 em 2005 em Piracicaba, considerando-se um erro amostral de 10 por cento. Considerando-se diferentes erros amostrais, verificou-se o custo para o levantamento, sendo que o mesmo depende do quanto o pesquisador se permite errar em relação ao verdadeiro valor da média da população. Conclui-se que a diminuição da prevalência da cárie dentária determinou o aumento no tamanho das amostras e a elevação dos custos para realização dos levantamentos.

This study aimed to analyze how the prevalence and the distribution of dental caries influence the sample size in epidemiological surveys, and how much are the costs. Secondary data of oral health surveys in 12-year-old schoolchildren from Bauru in 1976, 1984, 1990, 1994, and 2001, and from Piracicaba in 2001 and 2005 were studied. Sample sizes were estimated taking into account the mean DMFT and standard deviation of each survey, establishing sampling errors of 1 percent, 2 percent, 5 percent, and 10 percent. Costs were estimated considering permanent material, consumption material and human resources. The sample size in both towns needed to be increased, ranging from 119 in 1976 to 1,118 in 2001 in Bauru, and from 954 in 2001 to 1,252 in 2005 in Piracicaba, when a sampling error of 10 percent was considered. The cost of dental caries surveys was verified considering different sampling errors. This cost depends on how acceptable is the margin of difference between the true mean and the one found in the survey. In conclusion, the reduction in the prevalence of dental caries has determined the need for increase in sample size and in costs for conducting the surveys.

Estudo longitudinal dos sinais e sintomas de disfunção temporomandibular frente a tratamento conservador com placa estabilizadora em clínica de graduação / Longitudinal study of signs and symptoms of temporomandibular dysfunction aftre conservative tretment with stabilizing splints by undergraduate students

Objetivo: Avaliar longitudinal a eficácia da terapia oclusal em pacientes com Disfunção Temporomandibular (DTM) atendidos em clínica de graduação de curso de Odontologia. Materiais e Métodos: Os indivíduos foram examinados clinicamente utilizando-se o índice internacional Research DiagnosticCriteria for Temporomandibular Disorders (RDC/TMD) na época de seu atendimento (T0) e reavaliados 6meses após o início do tratamento com placas estabilizadoras (T1). Dezesseis pacientes participaram das duasavaliações. Oitenta e oito por cento dos pacientes examinados eram do sexo feminino. Foram avaliados os seguintes parâmetros: 1) Dor: através de Escala VAS (dor no momento da avaliação, dor média nos últimos 6 meses e pior dor nos últimos 6 meses), 2) Amplitude dos movimentos mandibulares (abertura bucal, protrusão e lateralidade); 3) Sons articulares (clique, crepitação) e 4) Sensibilidade à palpação dos músculos mastigatórios e da articulação temporomandibular. Os dados foram comparados entre os dois momentos utilizando-se o teste “t” pareado ou Wilcoxon. Correlação de Pearson foi realizada entre as variáveis dor e amplitude dos movimentos mandibulares. O índice de significância foi ajustado em p<0,05. Resultados: Houve melhora significativa entre as duas sessões para as variáveis relacionadas à dor e amplitude dos movimentos mandibulares (p<0,05), exceto protrusão (p=0,438). Houve correlação negativa significativa somente entre a dor média e aamplitude da abertura bucal antes do tratamento (p<0,05). Após o tratamento, essa correlação não persistiu (p>0,05). Conclusões: As placas oclusais lisas planas mostraram melhora significativa para a dor e amplitude dos movimentos mandibulares, mostrando ser um tratamento eficiente a ser realizado em clínicas de graduação para pacientes com dor miofascial e deslocamento de disco.

Reproducibility of adjunct techniques for diagnosis of dental caries in an epidemiological situation.

PURPOSE: To evaluate the reproducibility of visual exams under natural light (VE1), visual exams under artificial light (VE2), radiographic bitewing exams (BW), fibre optic transillumination exams (FOTI) and DIAGNOdent exams (DD) in epidemiological settings. MATERIALS AND METHODS: Three examiners and one benchmark examiner examined thirteen 12-year-old schoolchildren under epidemiological conditions for the D3 (carious lesions in dentin) and D1+D3 (carious lesions in enamel or dentin) diagnostic criteria. RESULTS: The reproducibility (intra/interexaminer agreement) under both diagnostic criteria was 'almost perfect' for the exams VE1 (D3: κintra = 0.91/κinter = 0.85; D1+D3: κintra = 0.89/κinter = 0.84), VE2 (D3: κintra = 0.91/κinter = 0.85; D1+D3: κintra = 0.88/κinter = 0.83), BW (D3: κintra = 0.95/κinter = 0.92; D1+D3: κintra = 0.99/κinter = 0.90) and FOTI (D3: κintra = 0.97/κinter = 0.93; D1+D3: κintra = 0.87/κinter = 0.83) exams and 'fair' for the DD exam (D3: κintra = 0.36/κinter = 0.35; D1+D3: κintra = 0.30/κinter = 0.32). CONCLUSION: It was concluded that the VE1, VE2, BW, and FOTI exams presented good reproducibility under epidemiological conditions, and can be used accurately in epidemiological surveys.

Diagnosis of secondary caries in esthetic restorations: influence of the incidence vertical angle of the X-ray beam.

The aim of this study was to evaluate the accuracy on the diagnosis of secondary caries-like lesions simulated on esthetic restorations of different materials, changing the incidence vertical angle (IVA) of the x-ray beam. Twenty human teeth received MOD inlay preparations. In the experimental group (n=10), a round cavity was made in the floor of the proximal box to simulate the caries-like lesion. All teeth were restored with 3 composite resins (Charisma, Filtek-Z250 and TPH-Spectrum) at 3 moments. Two radiographic images were acquired with 0º and 10º IVA. Ten observers evaluated the images using a 5-point confidence scale. Intra- and interobserver reliability was analyzed with the Interclass Correlation Coefficient and the diagnostic accuracy was evaluated using the area under the ROC curve (A(z)), Friedman test and Wilcoxon test (α=0.05). Higher accuracy values were obtained with 10º IVA (A(z)=0.66, Filtek-Z250>A(z)=0.56, TPH-Spectrum) compared to 0º (A(z)=0.55, Charisma>A(z)=0.37, TPH-Spectrum), though without statistically significant difference (p>0.05). The detection of secondary caries-like lesions simulated on esthetic restorations of different materials suffered no negative influence by changing the IVA of the x-ray beam.

Validity of caries-detection methods under epidemiological setting.

PURPOSE: To evaluate the validity of the visual exam and adjunct diagnostic technologies for posterior permanent teeth under epidemiological conditions. METHODS: A probabilistic sample of 165 12-year-old schoolchildren from Piracicaba, São Paulo, Brazil, was examined by visual exam (VI1), visual exam + artificial lighting (VI2), bitewing (BW), fiber optic transillumination (FOTI), DIAGNOdent and the associations among them. The D1+D3 and D3 diagnostics criteria, under epidemiological conditions, were adopted. The sensitivity, specificity and accuracy were calculated to determine the validity of the exams. RESULTS: The most accurate diagnostic method was VI2+BW exam for all dental surfaces under both diagnostic criteria. It was concluded that the BW was the best adjunct diagnostic technology on epidemiological dental caries surveys, increasing the validity of the dental exams.

Diagnosis of secondary caries in esthetic restorations: influence of the incidence vertical angle of the X-ray beam

The aim of this study was to evaluate the accuracy on the diagnosis of secondary caries-like lesions simulated on esthetic restorations of different materials, changing the incidence vertical angle (IVA) of the x-ray beam. Twenty human teeth received MOD inlay preparations. In the experimental group (n=10), a round cavity was made in the floor of the proximal box to simulate the caries-like lesion. All teeth were restored with 3 composite resins (Charisma, Filtek-Z250 and TPH-Spectrum) at 3 moments. Two radiographic images were acquired with 0º and 10º IVA. Ten observers evaluated the images using a 5-point confidence scale. Intra- and interobserver reliability was analyzed with the Interclass Correlation Coefficient and the diagnostic accuracy was evaluated using the area under the ROC curve (Az), Friedman test and Wilcoxon test (α=0.05). Higher accuracy values were obtained with 10º IVA (Az=0.66, Filtek-Z250>Az=0.56, TPH-Spectrum) compared to 0º (Az=0.55, Charisma>Az=0.37, TPH-Spectrum), though without statistically significant difference (p>0.05). The detection of secondary caries-like lesions simulated on esthetic restorations of different materials suffered no negative influence by changing the IVA of the x-ray beam.

O objetivo deste estudo foi avaliar a precisão no diagnóstico de lesões iguais-à-cárie secundárias simuladas em restaurações estéticas de materiais diferentes, mudando o ângulo vertical de incidência (AVI) do feixe de raios-x. Vinte dentes humanos foram submetidos a preparo cavitário inlay MOD. No grupo experimental (n=10), no soalho da caixa de proximal, foi confeccionada uma cavidade esférica para simular lesões iguais-a-cárie. Todos os dentes foram restaurados com 3 resinas compostas (Charisma, Filtek-Z250, TPH-Spectrum), em três tempos diferentes. Duas imagens radiográficas foram adquiridas com 0 e 10 graus de AVI o feixe de raios-x. Dez observadores avaliaram as imagens usando uma escala de confiança de 5-pontos. A reprodutibilidade intra- e inter- observador foi analisada com o coeficiente de correlação interclasse e a precisão do diagnóstico foi avaliada usando a área sob a curva ROC (Az), o teste de Friedman e de Wilcoxon (α=0,05). Os mais altos valores de precisão (p>0,05) foram observados com o AVI em 10º (Filtek-Z250 Az=0,66>TPH-Spectrum Az=0,56) comparado com 0º (Charisma Az=0,55>TPH-Spectrum Az=0,37), porém, sem diferenças estatisticamente significantes (p>0,05). A detecção de lesões iguais-à-cárie secundárias simulada em restaurações estéticas de diferentes materiais não foi influenciada pela mudança de AVI do feixe de raios-x.

Extensão universitária e trabalho voluntário na formação do acadêmico em odontologia / University extension and volunteer work in the education of undergraduate dental students

Este estudo destacou a importância da vivência do acadêmico em odontologia em atividades extramuros e experiências de trabalho voluntário para a aquisição de conhecimentos e habilidades importantesna futura prática profissional. Foi realizada uma revisão bibliográfica nas bases de dados Medline, Scielo eLilacs, selecionando os artigos relacionados às atividades de extensão e voluntariado desempenhadas pelosalunos de odontologia. A extensão universitária e o serviço voluntário ainda encontram dificuldades, dentrodos cursos de Odontologia, para se estabelecerem como práticas importantes para a formação do aluno.Entretanto, o mercado de trabalho atual exige um profissional com conhecimentos tanto da técnica quantodas características socioculturais da comunidade no desenvolvimento de sua prática odontológica, uma vezque o ser humano necessita ser compreendido nos seus aspectos biopsicosociais para ser tratado de formaintegral. Desta forma, os cursos de Odontologia deveriam prestigiar de forma igualitária na formação doaluno, tanto as habilidades reabilitadoras como as de promoção de saúde, adquiridas, em grande parte, ematividades extra-murais, de maneira a resgatar a formação integral do profissional da saúde. Além disso,o acadêmico deve estar atento às oportunidades oferecidas nestes aspectos durante a graduação, já que aodontologia está se tornando mais competitiva, e o cirurgião-dentista que resume sua vida profissional apenasao seu consultório, perde a chance de fazer-se conhecer e atuar em outros espaços sociais.

Assessment of caries experience in 12-year-old adolescents in Piracicaba, Sao Paulo, Brazil.

PURPOSE: The aim of the present study was to analyse the association between socioeconomic and behavioural factors and the presence of active non-cavitated caries lesions in 12-year-old adolescents in Piracicaba, São Paulo, Brazil. MATERIALS AND METHODS: A cross-sectional study was carried out in 1001, 12-year-old adolescents who were selected by the cluster sampling method. A modified version of the World Health Organization criteria for identifying lesions including white lesions (WL) in enamel was used. Information on behavioural and socioeconomic factors was obtained using a semi-structured questionnaire. The outcome variables were DMFS, DMFS+WL and WL. The data obtained were analysed using the chi-square test and a logistic regression model. RESULTS: The mean DMFS was 1.87 (SD = 3.05) and DMFS+WL was 2.27 (SD = 3.66). The logistic regression model showed that income was statistically significantly associated with DMFS, DMFS+WL and WL, whereas educational level of the father, number of residents in the house and number of dental visits were associated with DMFS and DMFS+WL. The onset of toothbrushing was associated with WL. CONCLUSIONS: The present study showed that economic factors are associated with all stages of caries development. In addition to these factors, family size, number of dental visits, educational level of the father and onset of toothbrushing could be considered markers of dental health risk.

Avaliação de variáveis socioeconômicas na prevalência de cárie e fluorose em municípios com e sem fluoretação das águas de abastecimento / Assessment of socioeconomic variables in the caries and fluorosis prevalence in cities with and without water supply fluoridation

O objetivo deste estudo foi pesquisar a possível associação de variáveis socioeconômicas com as prevalências de cárie e de fluorose em dois municípios de Estado de São Paulo: Holambra, sem fluoretação das águas de abastecimento, e Piracicaba, que possui fluoretação das águas. Em Piracicaba - SP, foram selecionadas, aleatoriamente, 24 escolas (n = 1002) e, em Holambra - SP, realizado censo em seis escolas (n = 119), totalizando 1.121 escolares com idade de 12 anos de escolas públicas e privadas. Os exames foram realizados por um examinador calibrado (Kappa > 0,91 para cárie e Kappa = 0,89 para fluorose). Foram calculados os índices CPOD (média de dentes cariados perdidos e obturados por indivíduo) e índice de Dean para a prevalência de fluorose. Foram realizadas análises univariada e de regressão logística multivariada. As variáveis escolaridade do pai, tipo de água ingerida e atividade de cárie foram indicadores de risco para cárie, enquanto gênero e renda, indicadores de risco para fluorose. Concluiu-se que Piracicaba - SP, que possuía água fluoretada, teve as médias de prevalência de cárie menores e Holambra - SP, que não possuía fluoretação das águas de abastecimento, apresentou prevalência mais baixa de fluorose. A renda foi considerada um indicador de risco para fluorose e houve associação entre variáveis sociais e experiência de cárie.

The aim of this study was to investigate possible association of socioeconomic variables and dental caries and fluorosis in two districts of the State of São Paulo: Piracicaba (public water supply fluoridation since 1971) and in Holambra (non-fluoridated water supply), Sao Paulo, Brazil. Twenty-four schools (n = 1,002) were randomly selected in Piracicaba and a census was conducted in 6 schools (n = 119) in Holambra, totaling 1,121 12-year-old schoolchildren enrolled in both public and private schools. The dental exams were made by one previously calibrated examiner (Kappa > 0.91 for tooth decay and Kappa = 0.89 for fluorosis). DMFT and Dean index for fluorosis prevalence. Univariate and multiple logistic regression analyses were conducted. In conclusion, Piracicaba (fluoridation in water supply) had lower prevalence of caries, while Holambra, having no fluoridated water, revealed lower prevalence of fluorosis; income was considered a risk indicator for fluorosis and social variables were associated with caries experience.