Atenção secundária em Odontologia e a articulação no processo de referência na Rede de Atenção em Saúde Bucal / Secondary care in Dentistry and the articulation of the referral process in the Oral Health Care Network

Os residentes do Programa de Residência Multiprofissional em Saúde da Família (PRMSF) da Universidade Federal do Paraná (UFPR) atuam em um município da região Sul, sendo a Odontologia uma das áreas que compõem o programa. Esses possuem campo prático diversificado, estando inseridos tanto na Atenção Primária à Saúde (APS), primeiro nível de atenção e coordenadora do cuidado, quanto na atenção secundária, atuando no serviço de cirurgia oral menor, inserido no Centro de Especialidades de Piraquara (CESP) no Paraná, uma vez que não há possibilidade de estruturação de um Centro de Especialidades Odontológicas (CEO). Dessa forma, é possível acompanhar o processo de referência e contra referência dos pacientes no serviço. Essa realidade também é observada em outras regiões do Brasil, consequência da falta de condições logísticas, estruturais e de recursos humanos, o que demanda aprimoramento do planejamento, orientação e consolidação de políticas públicas em saúde bucal. O objetivo desse estudo é relatar a experiência dos residentes cirurgiões-dentistas do PRMSF da UFPR em um Centro de Especialidades de um município da região metropolitana de Curitiba, capital do estado do Paraná, que mesmo não se qualificando nos parâmetros propostos pelo Ministério da Saúde brasileiro para implementação do CEO, apresentou a iniciativa de incorporar especialidades odontológicas mais urgentes para a população. Portanto, é importante o enfrentamento de problemas específicos, como ausência de levantamento epidemiológico municipal, tempo de espera, distância geográfica entre os serviços e comunicação entre profissionais da atenção básica e especializada (AU).

Residents of the Multiprofessional Residency Program in Family Health (MRPFH) at the Federal University of Paraná (UFPR) work in a city in the South region, where Dentistry is one of the areas included in the program. These have a diversified practical field, inserted both in Primary Health Care (PHC), first level of care and care coordinator;and in secondary care, working in the minor oral surgery serviceat the Piraquara Specialty Center (CESP) in Paraná, since there is no possibility of structuring a Center of Dental Specialties (CEO). Thus, it is possible to monitor the referral and counter-referral process of patients in the service. This reality is also observed in other Brazilian regions, as a result of the lack of logisticalandstructural conditions and human resources, which demands improvement in planning, guidance and consolidation of public policies in oral health. This study aimed to report the experience of dental professionals, residents of MRPFHat UFPR in a Specialty Center in a city in the metropolitan region of Curitiba, capital of the state of Paraná, which, despite not qualifying in the parameters proposed by the Brazilian Ministry of Healthfor the implementation of CEO, presented the initiative to incorporate the most urgent dental specialties for the population. Therefore, it is important to consider specific problems, such as the absence of a municipal epidemiological survey, waiting time, geographical distance between services and communication between primary and specialized care professionals (AU).

Perfil do usuário e tempo de espera para tratamento endodôntico público em um município brasileiro / User profile and waiting time for public endodontic treatment in a Brazilian municipality / Perfil del usuario y tiempo de espera para tratamiento endodóncico público en un municipio brasileño

RESUMO Objetivo Avaliar o perfil do usuário e o tempo de espera para tratamento endodôntico no Centro de Especialidade Odontológicas (CEO) Positivo, localizado na cidade de Curitiba, PR. Brasil. Métodos Este estudo transversal utilizou dados primários de 77 pacientes que aguardavam na fila de espera para a especialidade de Endodontia, de março a de julho de 2017. Os dados coletados foram: tempo de espera, gênero, idade, dentes referenciados e quantidade de encaminhamentos por Unidade de Saúde do serviço público. Resultados O tempo médio de espera foi de aproximadamente 11 meses. Do total, 56% eram do gênero feminino, com média de idade de 35,5 anos. Os dentes mais referenciados foram os póstero-inferiores. Conclusão O tempo na fila de espera é considerado longo, o que requer maior diálogo com a atenção básica para a formulação de estratégias voltadas à redução dos agravos bucais e à maior capacitação profissional para diagnóstico e condução dos casos.

ABSTRACT Objective To evaluate the user's profile and waiting time for endodontic treatment at the Center of Dental Specialties (CDS) Positivo, located in the city of Curitiba, PR. Brazil. Methods This is a cross-sectional study using primary data from 77 patients queue specialty of Endodontics, from March to July 2017. Data collected were: waiting time, sex, age, referenced teeth and number of referrals per Public Service Health Unit. Results The mean waiting time was approximately 11 months. Of the total, 56% were female, with a mean age of 35.5 years. The most referenced teeth were the lower posterior. Conclusion Waiting time in queue is considered long, which requires a greater dialogue with the primary attention for the formulation of strategies aimed at the reduction of the oral diseases and the greater professional capacity for the diagnosis and the conduction of the cases.

RESUMEN Objetivo Evaluar el perfil de usuario y el tiempo de espera para tratamiento endodóncico en el Centro de Especialidad Odontológica (CEO) Positivo, localizado en la ciudad de Curitiba, PR. Brasil. Métodos Este estudio transversal utilizó datos primarios de 77 pacientes en lista de espera para la especialidad de Endodoncia, de marzo a julio de 2017. Los datos recolectados fueron: tiempo de espera, género, edad, dientes referenciados y cantidad de encaminamientos por Unidad de Salud del Servicio Público. Resultados El tiempo promedio de espera fue de aproximadamente 11 meses. Del total, 56% eran del género femenino, con promedio de edad de 35,5 años. Los dientes más referenciados fueron los postero-inferiores. Conclusión El tiempo en la lista de espera es considerado largo, lo que requiere mayor diálogo con la atención básica para la formulación de estrategias dirigidas de reducción de las enfermedades bucales y la mayor capacitación profesional para diagnóstico y conducción de los casos.

Are healthcare workers immunized after receiving hepatitis B vaccination according to recommended guidelines? A systematic review and meta-analysis.

OBJECTIVES: Nowadays, it is believed that more than 240 million people worldwide are infected with the hepatitis B virus (HBV), associated with irreversible health-related consequences, represented by hepatic failure, cirrhosis, and hepatocellular carcinoma, and already are ranked as 15th cause of human death around the world. METHODS: A systematic review and a meta-analysis were performed to evaluate the effectiveness of vaccination and immunization on health professionals against HBV. The review was registered at the PROSPERO database (CRD42017075643). A search for cross-sectional studies was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and in the gray literature. The Effective Public Health Practice Project Modified Scale was used to evaluate the internal quality of the studies included. RESULTS: A total of 1865 articles were identified after the removal of duplicates. Of these, 790 studies remained after screening the titles and abstracts. Finally, ten studies remained after full-text reading for qualitative analysis, all of which were used in the meta-analysis. A significant difference was found in the vaccine protocol for health professionals immunized against hepatitis B, compared to those not immunized. The risk ratio was 7.37 (95% confidence interval = 3.92-13.83; P < 0.00001). CONCLUSION: This study showed that the vaccine protocol is effective in immunizing health professionals against hepatitis B.

Is catechol-O-methyltransferase gene associated with temporomandibular disorders? A systematic review and meta-analysis.

BACKGROUND: Temporomandibular disorder (TMD) is a condition, in which multiple factors act synergistically to determine the outcome of the disorder. AIM: A systematic review and meta-analysis was conducted to evaluate the association between genetic polymorphisms in catechol-O-methyltransferase (COMT) and TMD. DESIGN: Observational studies that investigated this association were included. The risk of bias and study quality were evaluated according to the Newcastle-Ottawa tool. The meta-analysis was performed for each polymorphism associated with TMD signs and symptoms. RESULTS: A total of 1903 articles were identified. Ten remained in the qualitative analysis: six were classified as low risk of bias and four with moderate risk of bias, and three were included in the meta-analysis. The polymorphism rs6269, in the genotypic model (0.65; CI = 0.44-0.97; P = .04) and in the allelic model (0.73; CI = 0.54-0.98; P = .04), was associated with myofascial pain. The rs9332377 was associated with myofascial pain in the genotypic model (2.69; CI = 1.51-4.76; P = .0007) and in the allelic model (1.46; CI = 1.01-2.13; P = .05) and with painful TMD in the genotypic model (2.08; CI = 1.27-3.40; P = .004) and in the allelic model (1.34 CI = 0.98-1.82; P = .06). CONCLUSION: The polymorphisms in COMT were significantly associated with TMD.

Impacto do uso de próteses totais na qualidade de vida de idosos institucionalizados / Impacto del uso de prótesis total en la calidad de vida de los ancianos institucionalizados / Impact of the use of complete dentures on the quality of life of institutionalized elderly people

RESUMO Introdução: O uso de próteses totais tem impacto na qualidade de vida relacionada à saúde bucal e os idosos são uma parcela da população a ser pesquisada sob essa perspectiva. Objetivo: Avaliar a autopercepção do impacto do uso de próteses totais na qualidade de vida relacionada à saúde bucal de idosos institucionalizados. Métodos: Participaram 20 idosos do Lar dos Idosos Recanto do Tarumã, Curitiba, Paraná, Brasil. Foram avaliados aspectos demográficos, econômicos, de hábitos e clínicos, juntamente com aplicação do questionário Geriatric Oral Health Assessment Index. Os dados foram submetidos à análise descritiva e bivariada (Teste do Qui-Quadrado), com significância de 5 porcento. Resultados: A média de idade foi de 75,2 anos (DP= 8,8) e o tempo médio de uso de prótese foi de 27,9 anos (DP= 18,5). Renda inferior a um salário mínimo foi indicada por 80,0 porcento, e visitas ao cirurgião-dentista pela última vez há mais de um ano, por 70,0 porcento. Os piores relatos foram referentes à mastigação, representados por problemas para mastigar alimentos e desconforto ao comer, com 25 porcento de respostas positivas em cada questão; a soma das frequências das respostas "às vezes" e "sempre" quanto à insatisfação ou à infelicidade com a aparência da boca foi reportada 60 porcento dos pesquisados. A retenção insatisfatória da prótese inferior se deu em 50,0 porcento casos, enquanto os problemas com oclusão estiveram presentes também em metade da amostra. Os defeitos estiveram presentes em 70,0 porcento das próteses superiores e 45,0 porcento das inferiores. Não foi encontrada associação significativa (p> 0,05) entre as variáveis independentes e o desfecho. Conclusões: Os idosos avaliados, independentemente das condições das próteses totais, relataram qualidade de vida relacionada à saúde bucal satisfatória(AU)

RESUMEN Introducción: El uso de prótesis totales tiene un impacto en la calidad de vida relacionada con la salud bucal, y los ancianos son parte de la población que se investigará desde esta perspectiva. Objetivo: Evaluar la autopercepción del impacto del uso de prótesis totales en la calidad de vida relacionada con la salud bucal de ancianos institucionalizados. Métodos: Participaron 20 ancianos de "Lar dos Idosos Recanto do Tarumã", Curitiba, Paraná, Brasil. Los aspectos demográficos, económicos, de hábitos y clínicos se evaluaron junto con la aplicación del cuestionario Geriatric Oral Health Assessment Index. Los datos fueron sometidos a análisis descriptivo y bivariado (prueba de chi cuadrado), con significación del 5 por ciento. Resultados: La edad media fue de 75,2 años (DE= 8,8) y el tiempo medio de uso de la prótesis fue de 27,9 años (DE= 18,5). Los ingresos menores a un salario mínimo se indicaron en el 80,0 por ciento, y las visitas al cirujano dental la última vez, hace más de un año, en el 70, 0 por ciento. Los peores informes estaban relacionados con la masticación, representados por problemas para masticar los alimentos y la incomodidad al comer, con el 25 por ciento de respuestas positivas en cada pregunta. La suma de las frecuencias de las respuestas "a veces" y "siempre" sobre la insatisfacción o la infelicidad con la apariencia de la boca se informó en el 60 por ciento de los encuestados. La retención insatisfactoria de la prótesis inferior se produjo en el 50 por ciento de los casos, mientras que la oclusión también presentó problemas en la mitad de la muestra. Los defectos estuvieron presentes en el 70,0 por ciento de las prótesis superiores y en el 45,0 por ciento de las inferiores. No se encontró asociación significativa (p> 0,05) entre las variables independientes y el desenlace. Conclusiones: Los ancianos evaluados, independientemente de las condiciones de las prótesis totales, informaron una calidad de vida relacionada con la salud bucal satisfactoria(AU)

ABSTRACT Introduction: The use of complete dentures has an impact on oral health-related quality of life. Elderly people are the population sector to be researched into from this perspective. Objective: Evaluate the self-perception of the impact of the use of complete dentures on the oral health-related quality of life of institutionalized elderly people. Methods: The study sample was 20 elderly people from Lar dos Idosos Recanto do Tarumã, Curitiba, Paraná, Brazil. Evaluation of demographic and economic details, habits and clinical aspects was based on the information collected with the Geriatric Oral Health Assessment Index questionnaire. The data were subjected to descriptive and bivariate analysis (Chi-squared test), with a significance of 5 percent. Results: Mean age was 75.2 (SD = 8.8) years and mean time of denture use was 27.9 (SD = 18.5) years. Income was below minimum wage in 80.0 percent of the participants, whereas the last visit to the dentist had occurred more than a year ago in 70.0 percent. The worst reports had to do with chewing, represented by problems to chew food and discomfort when eating, with 25 percent positive answers to each question. The sum of the frequencies of the answers "sometimes" and "always" about dissatisfaction with or unhappiness about the appearance of the mouth was reported by 60 percent of the respondents. Unsatisfactory retention of the lower denture occurred in 50.0 percent of the cases, whereas occlusion problems were present in half of the sample. Defects were present in 70.0 percent of the upper dentures and 45.0 percent of the lower dentures. No significant association (p> 0.05) was found between independent variables and outcome. Conclusions: The elderly people evaluated, regardless of the conditions of their complete dentures, reported satisfactory oral health-related quality of life(AU)

Anxiety and Sleep Quality in Dental Students at a Private Brazilian University.

The aim of this cross-sectional study was to evaluate the impact of anxiety and quality of sleep on quality of life (QOL) in undergraduate dental students. A total of 141 students were enrolled. All were required to answer the following questionnaires: the State-Trait Anxiety Inventory (STAI) subscale state (S) (STAI-S); the Sleep Assessment Questionnaire (SAQ); and the simplified World Health Organization Quality of Life survey (WHO QOL-bref). The statistical analysis included univariate and bivariate analyses and Poisson regressions. The mean age of the participants was 22.9 (SD=5.2) years; 81.6% were women, and 37.6% studied during the morning shift. The mean STAI-S score was 50.3 (SD=9.4). Sleep problems, classified as "always" or "frequently", were reported by 11.3% and 18.4% of the sample, respectively. Quality of life had a mean score of 13.2 (SD=2.0). The STAI-S and SAQ scores showed a significant association with all WHOQOL-bref dimensions (p<0.05). Analyses performed using multivariate regression and the highest STAI-S score (RR=1.46, 95%CI=1.03-2.06) and SAQ (RR=1.39, 95%CI=1.02-1.90) demonstrated significant sleep problems, even when other variables were controlled to prevent confounding biases. In conclusion, the dental students evaluated showed high levels of anxiety and sleep disorders impacting on QOL.

Perfil dos pacientes atendidos na clínica de odontopediatria de uma universidade privada de Curitiba, PR, Brasil / Profile of patients attended in the clinic of pediatric dentistry of a private university of Curitiba, PR, Brazil

Introdução: Propôs-se traçar o perfil dos pacientes atendidos na Clínica de Odontopediatria da Universidade Positivo, Curitiba, PR, Brasil. Métodos: Com desenho analítico, observacional e transversal, foram selecionados todos os prontuários (n=1527) dos pacientes atendidos no período de janeiro de 2009 a dezembro de 2017. As informações coletadas foram: ano de atendimento, gênero, cor da pele, motivo da consulta, idade da primeira consulta, hábitos deletérios, escovação e uso do fio dental. Os dados foram tabulados e apresentados em tabelas de frequências por meio do SPSS, versão 21. Resultados: A média da idade foi igual a 8 } 2,7 anos, com maior frequência de meninas (51,3%) e crianças de cor branca (83,7%). Como motivo da consulta houve predomínio da categoria "rotina" (43,5%) e "tratamento ortodôntico" (20,6%). A maioria das crianças (69,4%) realizou a primeira consulta na clinica com idade superior a quatro anos. Constatou-se que 52,9% das crianças não apresentaram hábitos deletérios. Em relação a escovação dentaria, 99,0% da amostra relataram faze-la, entretanto, o uso do fio dental não foi uma pratica adotada por boa parte dos pesquisados (64,6%). Conclusões: O perfil aqui determinado poderá servir de subsídios para o desenvolvimento de estratégias de promoção e de recuperação da saúde ofertadas pelo serviço em questão.

Introduction: It was proposed to delineate the profile of patients attended in the Pediatric Dentistry Clinic of Universidade Positivo, Curitiba, PR, Brazil. Methods: With analytical, observational and cross-sectional design, all records (n=1,527) of patients attended in the period from January 2009 to December 2017, were selected. The data collected were: year of attendance, gender, skin color, reason for consultation, age at first examination, deleterious habits, brushing, and flossing. Data were tabulated and shown in frequency tables using the SPSS, version 21. Results: The mean of the age was 8 } 2,7 years old, with higher frequency of girls (51.3%) and white children (83.7%). The prevailing reason for the consultation was "routine" (43.5%) and "orthodontic treatment" (20.6%). Most of the children (69.4%) performed the first consultation above four years of. It was found that 52.9% of children did not present showed deleterious habits. Regarding tooth brushing, more than 99.0% of the sample reported doing so, however, the use of dental floss was not a practice adopted by a good part of the total sample of researched (64.6%). Conclusions: The profile determined here may serve as a basis for the development of health promotion and recovery strategies offered by the service in question.

Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder.

AIM: The aim of the study was to evaluate the oral health conditions of children and adolescents with attention deficit hyperactivity disorder (ADHD). MATERIALS AND METHODS: Two groups were selected: a test group comprising 51 individuals with ADHD and a control group with 50 individuals without ADHD, with ages ranging from 7 to 14 years. Through an intraoral clinical examination, the numbers of decayed, missing, and filled teeth (DMFT index), the visible plaque index (VPI), the gingival bleeding index (GBI), bruxism, and dental traumatism were verified. A questionnaire confirmed oral hygiene supervision. RESULTS: In the test group, the average DMFT index was 3.41 while it was 2.52 in the control group (p = 0.405). The VPI in the test and control groups was 36.84% and 24.54%, respectively (p = 0.004). The GBI was 8.37% for the test group and 4.94% for the control group (p = 0.012). The DMFT index when supervised the oral hygiene by those responsible in comparison with the nonsupervision was 1.89 and 4.31, respectively, in the test group, and 1.71 and 2.94, respectively, in the control group. CONCLUSION: These data suggest that children and adolescents with ADHD present with worse oral health conditions and need greater attention from dental professionals and those responsible for their diet and oral hygiene. CLINICAL SIGNIFICANCE: Attention deficit hyperactivity disorder needs a special attention. This research brings this important issue focus on oral health. HOW TO CITE THIS ARTICLE: Begnini GJ, Brancher JA, Guimarães ATB, et al. Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder. Int J Clin Pediatr Dent 2019;12(6):543-547.

Associação entre doença periodontal, parto prematuro e baixo peso ao nascer / Asociación entre la enfermedad periodontal, el nacimiento prematuro y bajo peso al nacer / Association between periodontal disease, preterm birth and low birth weight

Objetivo: avaliar a associação entre doença periodontal, parto prematuro e recém-nascidos de baixo peso, em um grupo de mulheres no município de Curitiba, PR, Brasil. Métodos: no presente caso-controle foram avaliadas 51 mães, com idade entre 16 e 40 anos, divididas em dois grupos: as que tiveram parto prematuro, sendo os recém-nascidos de baixo peso; e as que não tiveram parto prematuro também com recém-nascidos de baixo peso. Foram coletados dados das mães e dos recém-nascidos por meio de questionários e análise de registros médicos. O exame periodontal foi realizado em seis sítios de cada dente presente, com exceção dos terceiros molares. Resultados: foi encontrado que 82,4 porcento das mulheres tiveram partos normais, 25,5 porcento das mães tiveram seus bebês prematuramente, 19,6 porcento dos bebês nasceram com peso inferior a 2 500 g e 5,9 porcento das mulheres tinham doença periodontal. Conclusão: nesta amostra não foi identificada associação entre doença periodontal, parto prematuro e recém-nascidos de baixo peso(AU)

Objetivo: evaluar la asociación entre la enfermedad periodontal, los nacimientos prematuros y recién nacidos con bajo peso en un grupo de mujeres en la ciudad de Curitiba, PR, Brasil. Métodos: en estudio de casos y controles se evaluaron 51 madres, de edades comprendidas entre los 16 y 40 años, divididas en dos grupos: las que habían tenido un parto prematuro y con bajo peso y las que no habían tenido un parto prematuro pero sí bebés con bajo peso. Se recogieron datos de las madres y los recién nacidos a través de cuestionarios y análisis de los registros médicos. El examen periodontal se llevó a cabo en seis sitios de cada diente presente, excepto los terceros molares. Resultados: se encontró que 82,4 por ciento de las mujeres tuvieron un parto normal, el 25,5 pr ciento de las madres tenían a sus bebés antes de tiempo, el 19,6 por ciento de los bebés que nacieron con un peso inferior a 2 500 g, y 5,9 por ciento de las mujeres tenían enfermedad periodontal. Conclusiones: en esta muestra no se identificó ninguna asociación entre la enfermedad periodontal y los partos prematuros y el bajo peso al nacer(AU)

Objective: evaluate the association between periodontal disease, preterm births and low birth weight neonates in a group of women from the city of Curitiba, PR, Brazil. Methods: in this case-control study, an evaluation was conducted of 51 mothers aged 16-40 years divided into two groups: those with a preterm delivery and low birth weight babies, and those without a preterm delivery but with low birth weight babies. Data about the mothers and the neonates were collected via questionnaires and medical record analysis. Periodontal examination was performed at six sites of each tooth present, except for the third molars. Results: it was found that 82.4 percent of the women had had a normal delivery and 25.5 percent a preterm delivery. 19.6 percent of the babies weighed less than 2 500 g at birth, and 5.9 percent of the women had periodontal disease. Conclusions: no association was found in the sample between periodontal disease and preterm delivery and low birth weight(AU)

Associação entre doença periodontal, parto prematuro e baixo peso ao nascer / Asociación entre la enfermedad periodontal, el nacimiento prematuro y bajo peso al nacer / Association between periodontal disease, preterm birth and low birth weight

Objetivo: avaliar a associação entre doença periodontal, parto prematuro e recém-nascidos de baixo peso, em um grupo de mulheres no município de Curitiba, PR, Brasil. Métodos: no presente caso-controle foram avaliadas 51 mães, com idade entre 16 e 40 anos, divididas em dois grupos: as que tiveram parto prematuro, sendo os recém-nascidos de baixo peso; e as que não tiveram parto prematuro também com recém-nascidos de baixo peso. Foram coletados dados das mães e dos recém-nascidos por meio de questionários e análise de registros médicos. O exame periodontal foi realizado em seis sítios de cada dente presente, com exceção dos terceiros molares. Resultados: foi encontrado que 82,4 porcento das mulheres tiveram partos normais, 25,5 porcento das mães tiveram seus bebês prematuramente, 19,6 porcento dos bebês nasceram com peso inferior a 2 500 g e 5,9 porcento das mulheres tinham doença periodontal. Conclusão: nesta amostra não foi identificada associação entre doença periodontal, parto prematuro e recém-nascidos de baixo peso(AU)

Objetivo: evaluar la asociación entre la enfermedad periodontal, los nacimientos prematuros y recién nacidos con bajo peso en un grupo de mujeres en la ciudad de Curitiba, PR, Brasil. Métodos: en estudio de casos y controles se evaluaron 51 madres, de edades comprendidas entre los 16 y 40 años, divididas en dos grupos: las que habían tenido un parto prematuro y con bajo peso y las que no habían tenido un parto prematuro pero sí bebés con bajo peso. Se recogieron datos de las madres y los recién nacidos a través de cuestionarios y análisis de los registros médicos. El examen periodontal se llevó a cabo en seis sitios de cada diente presente, excepto los terceros molares. Resultados: se encontró que 82,4 por ciento de las mujeres tuvieron un parto normal, el 25,5 pr ciento de las madres tenían a sus bebés antes de tiempo, el 19,6 por ciento de los bebés que nacieron con un peso inferior a 2 500 g, y 5,9 por ciento de las mujeres tenían enfermedad periodontal. Conclusiones: en esta muestra no se identificó ninguna asociación entre la enfermedad periodontal y los partos prematuros y el bajo peso al nacer(AU)

Objective: evaluate the association between periodontal disease, preterm births and low birth weight neonates in a group of women from the city of Curitiba, PR, Brazil. Methods: in this case-control study, an evaluation was conducted of 51 mothers aged 16-40 years divided into two groups: those with a preterm delivery and low birth weight babies, and those without a preterm delivery but with low birth weight babies. Data about the mothers and the neonates were collected via questionnaires and medical record analysis. Periodontal examination was performed at six sites of each tooth present, except for the third molars. Results: it was found that 82.4 percent of the women had had a normal delivery and 25.5 percent a preterm delivery. 19.6 percent of the babies weighed less than 2 500 g at birth, and 5.9 percent of the women had periodontal disease. Conclusions: no association was found in the sample between periodontal disease and preterm delivery and low birth weight(AU)

Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents.

BACKGROUND: The prevalence of signs and symptoms of temporomandibular disorders (TMD) increases during adolescence and adulthood. Few studies have examined TMD prevalence in Brazilian adolescents. AIM: To investigate the prevalence of TMD in Brazilian adolescents. METHODS: A representative population-based sample of 934 adolescents (10-14-years-old) was examined. TMD screening was performed using a questionnaire by the American Academy of Orofacial Pain. TMD diagnoses used research diagnostic criteria for temporomandibular disorders (RDC/TMD-Axis-I). Examinations were performed by a single calibrated examiner (kappa > 0.80). RESULTS: The prevalence of TMD symptoms was 34.9%; the most frequently reported symptoms were headache and neck ache (20.9%), followed by joint sounds (18.5%). Myofascial pain was the most prevalent type (10.3%), followed by disc displacement with reduction (8.0%) and arthralgia (3.5%). There was a significant association between sex and TMD symptoms; prevalence was significantly higher in girls (RP = 1.37; 95% CI = 1.14-1.65; p = 0.001). Myofascial pain of TMD and displacement with reduction were more prevalent in girls (RP = 1.76; p = 0.007 and RP = 2.06; p = 0.004, respectively). CONCLUSION: TMD symptoms were present in 34.9% of adolescents, with myofascial pain being the most prevalent type (10.3%). TMD was significantly more common in girls. Routine pediatric dental care should include a TMD screening.

Avaliação do índice de biofilme dentário em pacientes sob tratamento ortodôntico corretivo / Biofilm evaluation index in patients under orthodontic treatment

A presença do aparelho ortodôntico fixo dificulta a higienização bucal, tornando comum o aparecimento de problemas periodontais e cárie dentária. O presente estudo avaliou o acúmulo de biofilme dentário em 23 pacientes portadores de aparelhos ortodônticos corretivo utilizando o IHO-S (Índice de Higiene Oral Simplificado) submetidos a dois diferentes tipos de ligaduras do arco (elástica e metálica). Uma hemiarcada recebeu ligadura elástica e a contralateral ligadura metálica, divididas de forma aleatória. O IHO-S foi avaliado em dois períodos, sendo o Tempo 1 (T1) 30 dias após a ativação do arco e o Tempo 2 (T2) 30 dias após o T1. Todos os indivíduos foram orientados quanto à higiene bucal em T1 para posterior análise do IHOS em T2. As ligaduras não apresentaram diferença estatisticamente significativa quando comparadas tanto em T1 quanto em T2 em relação ao acúmulo de biofilme dentário. Já os índices IHOS quando comparados em T1 e T2 apresentaram redução de 67% após a instrução de higiene bucal. A forma de ativação do arco ortodôntico não sugere aumento significativo de biofilme dentário, mas o incentivo e a atenção do profissional na orientação da saúde bucal têm grande importância na prevenção da cárie dentária e gengivite durante o tratamento ortodôntico. (AU)

The presence of fixed orthodontic appliances impedes the maintence of oral hygiene and result in biofilm accumulation. The aim of this study was evaluate the Oral Hygiene Index in twenty-three subjects scheduled for fixed orthodontic treatment. Two commonly used auxiliaries (elastomeric rings and ligature wires) for trying archwires were tested. Brackets in one side were ligated with elastomeric rings, and brackets in a contralateral side were ligated with steel ligatures in a randomizate trial. The OHI were divided in two blocks, Time 1 (T1) that corresponds thirty days after archwire ligation and Time 2 (T2) that corresponds thirty days after T1. All of subjects received a oral health instruction in T1 and another evaluation of OHI in T2. The two archwire ligation techniques showed no significant differences in OHI for T1 or T2. The OHI presents 67% of reduction in T1 and T2 after oral health instruction. The archwire ligation does not represents a significant factor of a pathogenic dental plaque and a oral hygiene instruction can be important to prevent periodontal disease and enamel demineralization. (AU)

Implementação e avaliação de um curso blended learning de Bioquímica para estudantes de Odontologia / Implementation and assessment of a blended learning course in Biochemistry for Dental students

O objetivo deste estudo foi avaliar o desempenho de estudantes do curso de Odontologia na disciplina de Bioquímica por meio do uso da metodologia Blended Learning. Para isso formaram-se dois grupos: um composto por estudantes que cursaram a disciplina de Bioquímica no formato tradicional no ano de 2015, denominado grupo em classe (EC); e outro com aqueles que cursaram a mesma disciplina no formato Blended Learning no ano de 2016, denominado grupo BL. Os objetivos de aprendizagem, o conteúdo apresentado e as avaliações foram os mesmos para ambos. O desempenho dos estudantes foi mensurado por meio de avaliações bimestrais presenciais e individuais com níveis de dificuldade semelhantes entre os grupos. Os resultados obtidos foram analisados utilizando o teste ANOVA a dois fatores, com nível de significância de 0,05. No ano de 2015 participaram da pesquisa 198 estudantes, 54,4% do gênero feminino e 45,5% do gênero masculino. No ano de 2016, 148 estudantes participaram da pesquisa, também com predomínio de estudantes do gênero feminino (52,7%). Os estudantes do grupo BL obtiveram melhores resultados no 1º, 2º e 3º bimestres (p<0,05). A média anual dos estudantes do grupo BL também foi melhor do que a média do grupo EC. Este estudo sugere que a metodologia Blended Learning propicie maior ganho de conhecimento aos estudantes quando comparada à metodologia de ensino centrada em aulas presenciais (AU).

The aim of the present study was to assess the performance of dental students in a blended learning course in biochemistry. Two groups were assessed: one made up of students who took the conventional course (CC) in biochemistry in 2015, and one that attended the blended learning (BL) course in biochemistry in 2016. The learning goals, the syllabus, and the assessments were the same for both groups. Students' performance was checked by individual bimonthly classroom-based tests with similar levels of difficulty between the groups. The results were analyzed by two-way ANOVA and the level of significance was set at 0.05. A total of 198 students (54.4% female and 45.5% male) participated in the study in 2015, whereas 148 students (52.7% female) participated in the study in 2016. Students from the BL group had a better performance in the 1st, 2nd, and 3rd bimesters (p<0.05). The annual average of students in the BL group was also better than that of the CC group. This study therefore suggests that the blended learning method provides students with larger knowledge gain than does the classroombased method (AU).

Oral health status in victims of child abuse: a case-control study.

BACKGROUND: Few studies have evaluated the oral health status of children with a history of maltreatment. AIM: This case-control study evaluated oral health in children who were victims of abuse and in child protective services in Curitiba, Brazil. DESIGN: One hundred twenty-two children who were victims of abuse and 240 children with no history of abuse (mean ages, 8.56 and 8.24 years, respectively) were included in the study. Dental caries were assessed according to the Decayed, Missing, or Filled Teeth index (dmft index and DMFT index) by two calibrated examiners. The presence of anterior open bite and posterior crossbite was recorded. Data were analyzed using bivariate and adjusted odds ratios using a multivariate logistic regression model analyses. RESULTS: In the case group, we found a higher DMFT index (P < 0.001) and a significantly higher prevalence of missing primary teeth (P = 0.04), untreated decayed permanent teeth (P < 0.001), filled permanent teeth (P < 0.001), and anterior open bite (P = 0.04). Children who were victims of abuse presented an odds ratio of 6.48 (95% CI: 3.52-11.95) for caries in permanent teeth and an odds ratio of 2.28 (95% CI: 1.04-4.99) for open bite. CONCLUSION: Victims of child abuse had a worse oral health status, demonstrating the need to establish special policies for oral healthcare for this population.

Desafios na formação do Cirurgião-Dentista para o SUS / Challenges in the formation of Dentist to the SUS

A mudança na estrutura curricular realizada pelas escolas de Odontologia, com a inserção de estágios e clínicas integradas, fez com que o desafio da formação profissional para o Sistema Único de Saúde (SUS) fosse possível. Entretanto, ainda existem cursos e docentes que valorizam a Odontologia tecnicista, distanciando os futuros profissionais do atendimento generalista, que é uma das necessidades do SUS. Estas mudanças curriculares possibilitaram um processo de aprendizagem privilegiado, com a promoção e disseminação de saúde por meio de atividades coletivas, acolhimento ampliado em clínica e participação da sociedade em um trabalho de equipe. Neste contexto, a modificação curricular nos cursos de graduação em Odontologia é de extrema necessidade, porém sabe-se que essa mudança deve ser feita de maneira gradativa e constante, garantindo que as mudanças implementadas sejam eficazes e preparem os acadêmicos à sua vida profissional (AU).

The curricular changes carried out by Dental Schools, with the inclusion of internships and integrated clinical work, made the challenge of training for the Unified Health System (SUS) possible. However, there are still courses and teachers that value the technical Dentistry, distancing the future professionals of the general practice, which is one of the SUS needs. These curricular changes allowed a privileged learning process, with the promotion and dissemination of health through collective activities in clinical care and expanded participation of society in a team effort. In this context, curricular modification in undergraduate courses in dentistry is extremely need, but it is known that should be made gradually and steadily, ensuring that the changes implemented are effective and prepare the students for their professional life (AU).

Oral health status of patients with special needs from a rehabilitation association in Curitiba (PR, Brazil)

Introduction:Patients with special needs commonly show significant systemic and oral diseases. Objective:We carried out a survey on the oral health status from individuals with special needs of Associação Paranaense de Reabilitação (APR), in Curitiba, PR, Brazil. Material and methods: Clinical oral examination was performed and a specific questionnaire was applied to 87 individuals, aged from 5 to 14 years-old. Results: The mean age average was 9 yearsold, and 57.5% were males. The mean DMFT was 1.4, and 54% of the sample showed DMFT = zero. The oral health status from the studied sample was similar to that found in the same age group of the general population. Conclusion: We indicate that strategies for controlling oral health diseases tailored for this group must be stimulated, once the vulnerability is present.

Epidemiological study to determine factors associated with dental caries in schoolers

Introduction:Dental caries is a large problem affecting all population. In Brazil, caries prevalence has decreased over the last years, but it is still a public health issue requiring frequent evaluation and care by dentists. Objective: To evaluate the oral health conditions of schoolers aged 5-12 years relating them with socioeconomic and demographic determinants. Material and methods: The children were examined by a previously calibrated examiner to obtain DMF and dmf scores. The parents answered a questionnaire regarding to the socioeconomic condition. Prior to the examinations, the parents signed a free and clarified consent form and only their children were evaluated. The results were analyzed descriptively and by Chi-square test, at significance level of p<0.05. Results: : The sample (n=111) showed a mean age of 7+1.7 years (mean + standard deviation), composed of 58 boys and 58 girls. 66.6% of the sample exhibited dmf values = 0, while 102 schoolers had DMF values = 0. With regard to the parents' education level, 78.37% of the mothers had more than 9 years of education and 43.34% of the fathers had 9 to 11 years of study. Concerning to family income, 36.93% of the families presented mean income of 1-3 minimum wages (R$ 788.00 to R$ 2,364.00). No statistically significant differences (p≤0.05) were seen between caries rates vs. parents' education and caries rates vs. family income. Conclusion: 5-12 year schoolers showed low dmf and DMF values, suggesting that parents' education and income might have influenced on the results. Further studies are necessary to understand/assess the predisposing factors to dental caries development.

Child abuse: perception and knowledge by Public Health Dentistry teams in Brazil

Abstract Aim: To evaluate the experience, knowledge and attitudes of dentists and oral health technicians (OHTs) who work in Basic Health Units in the city of Curitiba, PR, Brazil, regarding cases of abuse against children and adolescents. Methods: In this observational study, three hundred eighty-three questionnaires (validated for Brazilian Portuguese) were sent to dentists and OHTs who work in public health units. The response rate was 38.12% (n = 146) for dentists and 40% (n = 77) for OHTs. Results: The mean age of the dentists was 40±8.29 years, and 53.43% treated more than 10 children per week. The OHTs' mean age was 45.39±9.71 years, and 62.35% attended to more than 10 children per week. Although the dentists perceived 185 suspected cases of maltreatment, only 35.67% were reported to authorities. In the OHT group, 22.08% were reported to authorities. Sixty-eight dentists (47%) and 11 OHTs (14.28%) reported having treated at least one case of orofacial trauma in the previous 6 months, totalizing 166 orofacial traumas. About the mechanism for reporting suspected cases, 83% of the respondents knew how to report. Over 50% of the responses concerning why the professionals did not report cases of physical violence against children included fear of retaliation and difficulties in diagnosis. Conclusions: Suspected cases of maltreatment against children and adolescents are underreported. More information is required to recognize suspected maltreatment cases and notify authorities.

Evaluating of oral and salivary conditions of two specific groups of workers

Introduction and Objective: Tooth decay is one of the most common chronic oral diseases found in industrial countries and is a multifactorial disease which has sugar as a key dietary factor. The amount of saliva concentration and presence of cariogenic bacteria will favor the development of caries. Because of this, the aim of this study was to collect and analyze data on oral alterations referred to tooth decay, oral pH changes, and changes of the oral microbiota in two distinct groups of workers. Material and methods: 30 individuals belonging to two different groups of workers: group A (GA) - workers who maintain daily contact with the confectionery; group B (GB) - workers who do not have such contact. Saliva collection was done by analysis of the salivary pH in both groups, as well as cultivation of Lactobacillus spp and S. mutans. We also evaluate the dental status of individuals belonging to the two groups through the DMFT index. Results: After the examinations of 30 workers (17 from the GA [9 men and 8 women] and 13 in the GB [7 men and 6 women]), the mean DMFT of the individuals in the group A and group B, was 7.41 (SD 5.14) 7.08 (SD 5.56), respectively, without statistically significant differences (p < 0.05). The count of S. mutans and Lactobacillus spp, was not statistically significant. Conclusion: There was no statistically significant relationship between presence of dental caries and the fact that workers are in contact with sugar because they work on candy food industry, but new studies are needed for more precise research.