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.

Avaliação do conhecimento e do manejo clínico bucal de endocrinologistas frente a pacientes que estejam em rastreamento ou em tratamento para diabetes mellitus / Evaluation of endocrinologists' knowledge and oral clinical management of patients being examined or treated for diabetes mellitus / Evaluación de los conocimientos de los endocrinólogos y de la gestión clínica oral de los pacientes examinados o tratados por diabetes mellitus

Introdução: Diabetes Mellitus é uma doença crônica resultante de defeitos na secreção do hormônio insulina e/ou de sua ação prejudicada no organismo. Indivíduos diabéticos podem apresentar complicações bucais significativas como, por exemplo, a doença periodontal. Objetivo: Avaliar o conhecimento dos endocrinologistas cadastrados/ativos no Conselho Regional de Medicina da Paraíba quanto ao manejo clínico bucal de pacientes em rastreamento e tratamento para diabetes. Materiais e Métodos: Estudo transversal, no qual 47 endocrinologistas participaram por meio de formulário estruturado, baseado nas diretrizes conjuntas da Sociedade Brasileira de Periodontologia e da Sociedade Brasileira de Endocrinologia e Metabologia (2022). Todas as análises foram conduzidas com auxílio do software IBM SPSS Statistics versão 20.0 e as variáveis do estudo foram analisadas por meio do teste Qui-quadrado de Pearson (p<0,05). As variáveis consideradas relevantes para o desfecho foram avaliadas usando o algoritmo CHAID (Chi-squared Automatic Interaction Detector). Resultados: A maioria dos participantes tinha até 40 anos (55,3%), era do sexo feminino (91,5%) e tinha, no máximo, 10 anos de tempo de experiência (55,3%). A partir da análise multivariada, por meio da Árvore de Decisão (CHAID), verificou-se a associação entre possuir manejo clínico bucal adequado endocrinologistas com faixa etária >40 anos e com conhecimento sobre os sinais clínicos da doença periodontal. Conclusões: Apesar do conhecimento teórico dos endocrinologistas ser relativamente satisfatório, ainda existe uma lacuna entre conhecimento teórico e prática clínica na conduta da maioria desses profissionais, que ainda se distancia do que é preconizado pelas evidências científicas e diretrizes atuais.

Introduction: Diabetes Mellitus is a chronic disease resulting from defects in insulin hormone secretion and/or its impaired action in the body. Diabetic individuals may present significant oral complications such as periodontal disease. Objective: To evaluate the knowledge of endocrinologists registered/active in the Regional Council of Medicine of Paraíba regarding the clinical oral management of patients in screening and treatment for diabetes. Materials and Methods: Cross-sectional study, in which 47 endocrinologists participated by means of a structured form, based on the joint guidelines of the Brazilian Society of Periodontology and the Brazilian Society of Endocrinology and Metabology (2022). All analyses were conducted using IBM SPSS Statistics version 20.0 software and the study variables were analyzed using Pearson's chi-square test (p<0.05). Variables considered relevant to the outcome were evaluated using the CHAID (Chi-squared Automatic Interaction Detector) algorithm. Results: Most participants were up to 40 years old (55.3%), female (91.5%), and had a maximum of 10 years of experience time (55.3%). From multivariate analysis, using the Decision Tree (CHAID), an association was found between having adequate clinical oral management endocrinologists aged >40 years and having knowledge about the clinical signs of periodontal disease. Conclusions: Although the theoretical knowledge of endocrinologists is relatively satisfactory, there is still a gap between theoretical knowledge and clinical practice in the conduct of most of these professionals, which is still far from what is recommended by scientific evidence and current guidelines.

Introducción: La Diabetes Mellitus es una enfermedad crónica que resulta de defectos en la secreción de la hormona insulina y/o de su acción alterada en el organismo. Los individuos diabéticos pueden presentar importantes complicaciones orales como la enfermedad periodontal. Objetivo: Evaluar el conocimiento de los endocrinólogos registrados/activos en el Consejo Regional de Medicina de Paraíba sobre el manejo clínico oral de pacientes en screening y tratamiento de diabetes. Materiales y Métodos: Estudio transversal, en el cual participaron 47 endocrinólogos por medio de formulario estructurado, basado en las directrices conjuntas de la Sociedad Brasileña de Periodoncia y de la Sociedad Brasileña de Endocrinología y Metabología (2022). Todos los análisis se realizaron con el software IBM SPSS Statistics versión 20.0 y las variables del estudio se analizaron mediante la prueba de chi cuadrado de Pearson (p<0,05). Las variables consideradas relevantes para el resultado se evaluaron mediante el algoritmo CHAID (Chi-squared Automatic Interaction Detector). Resultados: La mayoría de los participantes tenían hasta 40 años (55,3%), eran mujeres (91,5%) y tenían un máximo de 10 años de tiempo de experiencia (55,3%). A partir da análise multivariada, por meio da Árvore de Decisão (CHAID), verificou-se a associação entre possuir manejo clínico bucal adequado endocrinólogos com faixa etária >40 anos e com conhecimento sobre os sinais clínicos da doença periodontal. Conclusões: Embora os conhecimentos teóricos dos endocrinólogos sejam relativamente satisfactórios, ainda existe uma brecha entre os conhecimentos teóricos e a prática clínica na conduta da maioria destes profissionais, ainda distante do que é recomendado pela evidência científica e pelas orientações vigentes.

Avaliação do conhecimento de cirurgiões-dentistas diante do atendimento a cardiopatas graves na atenção primária / Assessment of the knowledge of dentists in the face of care for severe cardiac patients in primary care

O objetivo desse estudo foi avaliar o conhecimento dos cirurgiões-dentistas que trabalham na atenção primária à saúde em um município do nordeste Brasileiro, frente ao atendimento de pacientes portadores de doenças cardiovasculares. Para tanto, de uma população de 36 dentistas, uma amostragem por conveniência de 25 profissionais (69,4%) foi analisada, sob a forma de um questionário autoaplicável. A maioria dos profissionais é formada há mais de 10 anos, sendo que todos se utilizam de artifícios para controle de ansiedade, principalmente a franca conversa (96%). Quanto à prevenção da endocardite infecciosa, foi demonstrada dúvida quanto aos procedimentos onde profilaxia antibiótica é necessária em cardiopatas graves. Outras questões que os profissionais demonstraram despreparo teórico foram quanto ao diagnóstico de hipertensão arterial sistêmica, a qual apenas 64% dos odontólogos assinalaram corretamente; tempo de estabilidade de angina de peito (36,9%) e quantidade de anestésicos com vasopressor à base de epinefrina seguro ao paciente em particular (54,2%). De acordo com a análise das respostas e sua comparação junto ao levante bibliográfico, tem-se claramente em vista a necessidade dos profissionais se atualizarem, sob alguma forma de educação permanente(AU)

The correct evaluation of patients with cardiovascular disease is based on a careful anamnesis and on the previous knowledge of the main coronary diseases and its sequels. This study aims to evaluate the knowledge of dentists working in primary health care in the city of Campina Grande about patients with cardiovascular disease. For this purpose, from a population of 36 dentists, a convenient sample of 25 professionals (69.4%) was analyzed in the form of a self-administered questionnaire. Most professionals is formed more than 10 years, all of which make use of anxiety handling, especially an honest conversation (96%). As for the prevention of infective endocarditis has been demonstrated doubt as to the procedures where antibiotic prophylaxis is needed in severe heart disease. Other issues that professionals demonstrated theoretical unpreparedness were the diagnosis of hypertension, which only 64% of dentists pointed out correctly; time of stable angina pectoris (36.9%) and the safe amount of anesthetic with vasoconstrictor epinephrine to the cardiac patient (54.2%). Conclusion: According to the analysis of the responses and its comparison with the literature, highlighting the need to implement a continuing education(AU)

[Use of the health services according to social determinants, health behaviors and quality of life among diabetics]. / Uso dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos.

The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.

Este estudo investigou a utilização dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos. A amostra foi composta por 416 diabéticos cadastrados na Estratégia Saúde da Família de um município do Nordeste do Brasil. A análise dos dados incluiu estatísticas descritivas, bivariadas e multivariada por meio da modelagem de Árvore de Decisão usando o algoritmo Chi-squared Automatic Interaction Detector (CHAID). Evidenciou-se expressiva utilização dos serviços públicos de saúde (80,7%). A utilização do serviço público de saúde com regularidade envolveu indivíduos com escolaridade baixa ou média (p < 0,001), empregados ou aposentados e/ou pensionistas (p = 0,019), com alto impacto do diabetes na qualidade de vida (p = 0,032), e que realizavam a quantidade recomendada de exames de glicemia em jejum ao ano (p < 0,001). A utilização dos serviços de saúde pôde ser explicada por diferenças relacionadas aos determinantes sociais, aos comportamentos em saúde e ao impacto do diabetes na qualidade de vida dos usuários.

Uso dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos / Use of the health services according to social determinants, health behaviors and quality of life among diabetics

Resumo Este estudo investigou a utilização dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos. A amostra foi composta por 416 diabéticos cadastrados na Estratégia Saúde da Família de um município do Nordeste do Brasil. A análise dos dados incluiu estatísticas descritivas, bivariadas e multivariada por meio da modelagem de Árvore de Decisão usando o algoritmo Chi-squared Automatic Interaction Detector (CHAID). Evidenciou-se expressiva utilização dos serviços públicos de saúde (80,7%). A utilização do serviço público de saúde com regularidade envolveu indivíduos com escolaridade baixa ou média (p < 0,001), empregados ou aposentados e/ou pensionistas (p = 0,019), com alto impacto do diabetes na qualidade de vida (p = 0,032), e que realizavam a quantidade recomendada de exames de glicemia em jejum ao ano (p < 0,001). A utilização dos serviços de saúde pôde ser explicada por diferenças relacionadas aos determinantes sociais, aos comportamentos em saúde e ao impacto do diabetes na qualidade de vida dos usuários.

Abstract The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.

Access to Oral Health Actions According to Social and Individual Determinants

Abstract Objective: To investigate the socioeconomic, demographic and health needs that influence the access to oral health actions. Material and Methods: The sample consisted of 609 individuals who lived in areas covered by the Family Health Strategy in a city of the Northeast of Brazil. All individuals living in areas covered by the FHS with age equal to or higher than six years were included. Data analysis included descriptive, bivariate and multivariate statistics using decision-tree based Chi-squared automatic interaction detection (CHAID). Results: Most participants were female, aged 25-34 years, ranging in age from 6 to 87 years. It was evidenced that, among the studied variables, the most relevant for understanding the access to oral health actions were: age (p<0.001), educational level (p-value in Node 1 = 0.009; p-value in Node 7 = 0.005) and self-perception of oral health (p=0.001). Conclusion: The results suggest that access to oral health actions is influenced by several social and individual factors, and it is marked by inequalities that favor individuals with higher educational level, better self-perception of oral health and lower age groups.

Conhecimento dos cirurgiões-dentistas em atendimento de pacientes com coagulopatias hereditárias / Knowledge of dentists in the care of patients with hereditary coagulopathies

Objetivo: verificar o conhecimento dos cirurgiões-dentistas que trabalham nas Unidades Básicas de Saúde (UBS) com Equipes de Saúde Bucal (ESB) modalidade I, no município de Campina Grande, sobre o atendimento odontológico de pacientes com coagulopatias hereditárias. Sujeitos e método: por meio de questionário autoaplicável, foi feita uma entrevista com os cirurgiões-dentistas do município em questão para analisar os seus conhecimentos. Participaram da pesquisa 24 profissionais que se encaixaram nos critérios de inclusão e responderam de forma adequada o questionário com questões objetivas, sendo que os participantes foram orientados a assinalar somente uma alternativa para cada questionamento. Resultados: a maioria dos profissionais é formada há mais de 10 anos. A média de acertos das respostas foi de 50%. Em relação aos achados clínicos que determinam a possível presença de distúrbio hemorrágico, 44% afirmaram que são: púr-pura, sangramento gengival espontâneo e hemartrose. Os pacientes considerados de risco elevado para o tratamento odontológico foram: pacientes sem distúrbios hemorrágicos revelados, mas com exames complementares alterados; pacientes em tratamento com AAS; e pacientes em tratamento com anticoagulante por via oral. A maioria (68%) não considera a utilização de sugadores de saliva como risco para sangramento bucal. Os procedimentos odontológicos que os profissionais não se sentem seguros a executar, nesse tipo de paciente, foram: exodontias (88%); tratamento periodontal cirúrgico (76%); raspagem e alisamento coronoradicular (RACR) (28%); anestesia do nervo alveolar inferior ou outros (24%); tratamento endodôntico (20%); e anestesia infiltrativa (8%). Conclusão: os dados obtidos na pesquisa mostraram que o conhecimento dos cirurgiões-dentistas das UBS do município de Campina Grande não é satisfatório, havendo dúvidas sobre a maioria dos tratamentos odontológicos direcionados aos pacientes com coagulopatias hereditárias. (AU)

Objective: this study aimed to determine the knowledge of dentists working in UBS with ESB mode I in the city of Campina Grande on Patients with hereditary Coagulopathies. Through self-administered questionnaire, own and without exclusion criteria, an interview was conducted with dental surgeons of the municipality concerned to analyze their knowledge of the relevant topic. By itself and without exclusion criterion an interview was made with the dentists concerning to analyze their knowledge about hereditary coagulopathies. Subjects and method: the participants were 24 dentists which fit the inclusion criteria and responded adequately to the questionnaire which contained objective questions, and the respondents were asked to point out only one alternative of each questioning. Results: most of them were graduated over 10 years. The mean score was 50% of the questionnaire. In relation to clinical findings that determine the possible presence of bleeding disorder, 44% said they are: purple spontaneous gingival bleeding and hemarthrosis; patients considered at high risk for dental treatment were patients without bleeding disorders disclosed but with altered exams; patients being treated with ASA; and patients treated with anticoagulant orally. Most dentists (68%) do not consider the use of saliva-sucking as a risk for oral bleeding. Dental procedures that professionals do not feel safe running in those patients were: extractions (88%); surgical periodontal treatment (76%); RACR (28%); anesthesia of nerve alveolar inferior or other (24%); endodontic treatment (20%); and infiltrative anesthesia (8%). Conclusion: the data obtained from the survey showed that knowledge of dentists from Campina Grande municipality is not satisfactory and there is doubt on most dental treatments targeted to patients with inherited bleeding disorders. (AU)

Quality of life related to oral health of patients undergoing hemodialysis and associated factors.

PURPOSE: To evaluate quality of life related to oral health (QoLROH) of Brazilians undergoing hemodialysis and to identify associated factors. MATERIAL AND METHODS: A cross-sectional study was conducted with 226 patients undergoing hemodialysis at two reference medical centers. Participants answered a sociodemographic questionnaire and the Brazilian version of the Oral Health Impact Profile (OHIP-14). Descriptive and multivariate statistics using Decision Tree Analysis by the Chi-square Automatic Interaction Detector (CHAID) algorithm, as well as Ordinal Logistic Regression analyses were performed. RESULTS: The Decision Tree revealed that the impact on QoLROH could be explained by age (p = 0.002), tooth pain in the last 6 months (p = 0.026), and region of residence (p = 0.025). CONCLUSIONS: The results suggest that being older, living in rural areas, and reporting tooth pain in the last 6 months may influence the QoLROH of patients undergoing hemodialysis.

Access to Oral Health Services in Areas Covered by the Family Health Strategy, Paraíba, Brazil

Objective: To evaluate access to oral health services and associated factors in areas covered by the Family Health Strategy. Material and Methods: This is a populationbased study with a systematic random sample of 759 individuals aged ≥ 06 years of a municipality in northeastern Brazil. Data on socio-economic and demographic conditions, tooth pain severity in the last six months and issues related to access to oral health services were collected. Data were analyzed using Pearson's chi-square test and Poisson regression analysis, considering 5% significance level. All tests were performed using the Statistical Package for Social Sciences software (SPSS) version 18.0. Results: 61.7% of individuals had access to dental services, 53.5% of them in the public sector. Through Poisson multivariate regression, individuals more likely to have full access were students (PR: 3.085, 95% CI 1.75-5.43), adolescents (PR: 2.297, 95% CI 1.30-4.04), adults at reproductive phase (PR: 2.127, 95% CI 1.24-3.62) and those with toothache in the last six months (PR: 1.314, 95% CI 1.08-1.59). Illiterates and individuals with up to complete elementary school were associated with lower likelihood of having full access to oral health services. Conclusion: More than half of the sample had access to oral health services, being higher in the public sector than in the private sector. Having full access to oral health services was associated in the multivariate model with age, education and toothache in the last six months.

Steps for biomodel acquisition through addtive manufacturing for health / Passos para a obtenção de biomodelos em manufatura aditiva para a saúde

ABSTRACT The use of rapid prototyping in medical and dental fields consists of three-dimensional models using Computer Aided Design systems and Computer Aided Manufacturing systems. Such systems focus specifically on enhanced 3D visualization tools that provide a precise preoperative planning opportunity through three-dimensional printing, to the professional. The objective of this study was to describe the main steps in the biomodel manufacturing using an Objet 3D printer (CONNEX 350), whose raw material is a light-curing resin. The steps are adopted by researchers from three-dimensional technologies laboratory (LT3D), of the Center for Strategic Technologies in Health (NUTES), from the State University of Paraíba (UEPB), Brazil. It begins with the acquisition of tomographic images that are processed through specific software and exported to the digital Stereo lithography (STL) format. The additive manufacturing technique is Stereo lithography, which consists in the construction of biomodel by photopolymerization of a liquid epoxy resin using ultraviolet radiation. The biomodel that comes from this process was brought to a pressurizing machine to remove the resin support, washing it with water jets. After this step, this biomodel was sent to the health professional in charge. The use of biomodels constitutes a major breakthrough in the area of Dentistry, allowing more precise diagnosis by professionals, simulation and surgical planning, previous adaptation of biomaterials and orthoses, as well as interaction between the surgeon and the patient, thus obtaining more satisfactory aesthetic results and decreased surgical time.

RESUMO A utilização da prototipagem rápida na área médico-odontológica consiste na obtenção de modelos tridimensionais através de sistemas Computer Aided Design (CAD) e Computer Aided Manufacturing (CAM). Tais sistemas incidem especificamente sobre ferramentas de visualização aprimoradas 3D, que fornecem ao profissional a oportunidade de planejamento pré-operatório preciso através da impressão tridimensional. O objetivo deste trabalho é descrever as principais etapas na fabricação de biomodelos utilizando uma impressora 3D Objet (CONNEX 350), cuja matéria prima é uma resina fotopolimerizável. As etapas descritas são adotadas pelos pesquisadores do Laboratório de Tecnologias Tridimensionais (LT3D) do Núcleo de Tecnologias Estratégicas em Saúde, da Universidade Estadual da Paraíba, e iniciam-se com a aquisição das imagens tomográficas que são processadas por meio do softwares específicos e exportadas para o formato Stereolitography (STL). A técnica de manufatura aditiva utilizada é a estereolitografia, que consiste na construção do biomodelo por fotopolimerização de uma resina epoxy líquida usando radiação ultravioleta. O biomodelo resultante deste processo é levado à máquina pressurizadora para remoção da resina de suporte através de lavagem por jatos de água. Após esta etapa o mesmo é enviado ao profissional de saúde responsável. O uso de biomodelos constitui um grande avanço para a área da Odontologia, permitindo a realização de diagnósticos mais precisos por parte do profissional; simulação e planejamento cirúrgico; adaptação prévia de biomateriais e órteses; bem como a comunicação entre o cirurgião e o paciente, obtendo assim, resultados estéticos mais satisfatórios e diminuição do tempo cirúrgico.

Avaliação do grau de higiene bucal e condição periodontal de escolares

Objetivo: avaliar a prevalência e a severidade da gengivite em escolares com higiene bucal deficiente, na faixa etária de 9 a 12 anos, e sua relação com possíveis fatores de risco locais. Sujeitos e método: foi realizado um estudo descritivo de corte transversal para avaliar as condições gengivais em escolares de duas escolas da rede pública de ensino, sendo a amostra composta por 36 escolares. Os índices aplicados foram: Índice de Higiene Oral Simplificado (IHO-S), Índice de Sangramento à Sondagem e Índice de Placa. O nível socioeconômico foi determinado pela classe socioeconômica a que pertencia a família. Os dados foram registrados no software SPSS para Windows®, versão 20.0, e analisados por meio de estatística descritiva e inferencial. Na análise bivariada, utilizou-se teste t de Student e a Análise de Variância (ANOVA). Resultados: foi observada uma prevalência de 100% de gengivite em todos os escolares, sendo a forma leve (97,2%) a mais frequente, havendo uma correlação positiva entre o IHO-S e o número de superfícies sangrantes. Conclusão: os escolares apresentaram elevada prevalência de gengivite na forma leve, relacionada à higiene bucal deficiente, o que evidencia a necessidade de realização de atividades preventivas que motivem a prática diária de higiene bucal efetiva.

Additive Manufacturing for Surgical Planning of Mandibular Fracture.

Currently, imaging techniques such as Computed Tomography with three-dimensional reconstruction (3D) and Magnetic Resonances are being routinely used in pre-surgical planning in all fields of medicine. Nowadays, virtual three-dimensional images, commonly displayed on two-dimensional surfaces, such as the computer screen, can be used to produce rapidly prototyped models, with excellent dimensional accuracy and fine reproduction of anatomical structures, providing professionals with the ability to use the biomodel in planning and simulating medical and dental procedures (oral and maxillofacial surgery, making individualized facial implants and prostheses, measurements and previous adaptations of prefabricated fixation plates), thus contributing to considerable reductions in surgical time and consequently the duration of anesthesia, minimizing infection risks and reducing hospital costs. In this report, we describe a case of surgical planning and treatment of bilateral atrophic mandibular fracture, in which, for surgical planning, authors used Rapid Prototyping as an adjunct tool, considering the advantages already outlined.

Intracanal pain remission in child with amelogenesis imperfecta. Case report / Remissão de dor intracanal em criança com amelogênese imperfeita. Relato de caso

ABSTRACTBACKGROUND AND OBJECTIVES:Amelogenesis imperfecta is characterized by enamel structural defects, which may severely affect dental structure in both dentitions. When accompanied by severe decay, it may impair the pulp complex requiring endodontic treatment and in case of incomplete root formation treatment becomes more complex due to pulp volume and anatomic conditions. This study aimed at reporting a clinical case of patient with amelogenesis imperfecta and with multiple incomplete root formation as a consequence.CASE REPORT:Female patient, 12 years old, leucodermic, with painful symptoms, who has looked for dental assistance. At intraoral clinical evaluation teeth presented with shape and size changes, yellowish color, covered by a thin enamel layer with roughened surface and absent in some areas, with anterior vestibular sulcus fistula and without edema. At radiographic evaluation, both dentitions were affected by the abnormality with delayed chronology of permanent teeth eruption. At the end of all evaluations, patient was diagnosed with amelogenesis imperfecta, and periodontal treatment was started, followed by endodontic treatment.CONCLUSION:Amelogenesis treatment is complex, especially when in more advanced stages of dental structure destruction. However, it is possible to reestablish patient’s functionality and esthetics with good planning and multidisciplinary approach.

RESUMOJUSTIFICATIVA E OBJETIVOS:A amelogênese imperfeita é caracterizada por defeitos estruturais do esmalte, os quais podem acometer gravemente a estrutura dentária, em ambas as dentições. Quando acometida por lesões cariosas graves, pode comprometer o complexo pulpar, necessitando de tratamento endodôntico, e em se tratando de dentes com rizogênese incompleta, o tratamento torna-se mais complexo, em virtude do volume pulpar e das condições anatômicas. O objetivo deste estudo foi relatar um caso clínico de paciente com amelogênese imperfeita e que teve como consequência múltiplos casos de rizogênese incompleta.RELATO DO CASO:Paciente do gênero feminino, 12 anos, leucoderma, com sintomas dolorosos procurou atendimento odontológico. Ao exame clinico intraoral, apresentava dentes com alteração de forma e tamanho, coloração amarelada, recobertos por uma fina camada de esmalte com superfície rugosa e em algumas áreas ausente, com fístula na região do sulco vestibular anterior e sem edema. Ao exame radiográfico ambas as dentições mostraram-se acometidas por anomalia, com retardo na cronologia de erupção dos dentes permanentes. Ao final de todos os exames, recebeu o diagnóstico de amelogênese imperfeita, dando inicio ao tratamento, que começou pelo tratamento periodontal, seguido pelo endodôntico.CONCLUSÃO:O tratamento da amelogênese é complexo, principalmente quando em estágios mais avançados de destruição da estrutura dentária. Contudo é possível restabelecer a funcionalidade e a estética do paciente quando se faz um bom planejamento do caso, com interação multidisciplinar.

Evaluation of the knowledge of pregnant women about the relationship between oral diseases and pregnancy complications / Avaliação do conhecimento das gestantes quanto à relação entre alterações bucais e intercorrências gestacionais

Introduction: Chronic persistent low-level infection in pregnant women, such as periodontal disease (PD) may impair maternal-fetal unit, since the infectious process induces the release of chemical mediators involved in the process of prematurity. Objective: To assess the knowledge of mothers as regards the relationship between oral diseases and pregnancy complications. Method: A cross-sectional epidemiological study was conducted with 104 pregnant women indexed in the Primary Care Information System (SIAB), in the Family Health Strategies (FHS), using a structured questionnaire. Data were recorded in SPSS and analyzed using descriptive and inferential statistics, considering a significance level of 5%. Result: Most patients (64.4%) were domestic workers, (48.1%) aged 24 to 34 years, (55.8%) showed complete the 2nd grade and incomplete high school education, and (49%) were primiparous. Among the participants, 76% were unaware of the relationship between oral disease, prematurity and giving birth to low birth weight babies. Statistically significant association was found between: educational level and knowledge about prenatal dental care (p = 0.012); since it was shown that 90.4% ignored the existence of this activity and 65.4% had never received information about the care of baby's oral hygiene (p = 0.003). Conclusion: Most women were unaware of the relationship of PD with prematurity, and showed lack of information about the care of mother and baby oral hygiene, highlighting the need for greater integration between the dental surgeon and other primary care professionals to promote oral health care of pregnant women and reduce the ratio of PD with pregnancy complications. .

Introdução: Uma infecção crônica persistente de baixa intensidade na gestante, como a doença periodontal (DP), pode comprometer a unidade materno-fetal, já que o processo infeccioso induz a liberação de mediadores químicos envolvidos no processo de prematuridade. Objetivo: Avaliar o conhecimento das gestantes quanto à relação entre alterações bucais e intercorrências gestacionais. Método: Foi realizado um estudo epidemiológico de corte transversal, com 104 gestantes cadastradas no Sistema de Informação da Atenção Básica (SIAB), em Estratégias de Saúde da Família (ESF), empregando-se um questionário estruturado. Os dados foram registrados no SPSS e analisados por meio de estatística descritiva e inferencial, considerando-se um nível de significância de 5%. Resultado: A maioria das gestantes (64,4%) era doméstica, (48,1%) com idade entre 24 a 34 anos, (55,8%) apresentava o 2º grau completo e incompleto e (49%) era primípara. Dentre as participantes, 76% desconheciam a relação entre doença bucal, prematuridade e nascimento de bebês de baixo peso. Verificou-se associação estatisticamente significativa entre: escolaridade e o conhecimento sobre o pré-natal odontológico (p = 0,012), ao evidenciar que 90,4% ignoraram a existência desta atividade e 65,4% nunca haviam recebido informações sobre os cuidados de higiene bucal do bebê (p=0,003). Conclusão: A maioria das gestantes desconhecia a relação da DP com a prematuridade e apresentou carência de informações sobre os cuidados de higiene bucal materna e do bebê, evidenciando a necessidade de uma maior integração entre o Cirurgião-Dentista e os demais profissionais da atenção básica na propagação dos cuidados com a saúde bucal das gestantes para reduzir a relação da DP com as intercorrências gestacionais. .

Condição de Saúde de Mulheres Privadas de Liberdade: Uma Revisão Integrativa / Health Condition of Imprisoned Women: An Integrative Review

Verificar como a temática referente à condição desaúde da mulher em situação de privação de liberdade vemsendo abordada nos últimos 5 anos. Material e métodos: foirealizada uma revisão integrativa sobre a condição de saúdede mulheres privadas de liberdade nos últimos 5 anos, combase em protocolo básico com três etapas realizadas pordois pesquisadores e um avaliador. A busca se deu nasbases de dados Scielo, PubMed e LILACS. O aprofundamentoanalítico dos artigos se deu a partir da localização de todosos estudos na íntegra. Resultados: foram encontrados 2artigos na LILACS, 0 na Scielo e 38 estudos na PubMed,sendo na última etapa analisados 8 artigos na íntegra queresponderam que trataram das condições de saúde dasmulheres em situação de regime fechado. Todos os estudosestavam indexados na base de dados Medline. Estesdemonstraram que a temática relativa à saúde da mulherencarcerada vem sendo abordada na forma de tentarcompreender o perfil deste público crescente na sociedade,no qual a situação de saúde e agravos trazem aspectossemelhantes nos estudos. Conclusão: a abordagem da saúdeda mulher em situação de cárcere apresenta resultadossemelhantes nos estudos, identificando um cenário demulheres que são mais acometidas por agravos á saúde doque a população feminina geral, além de terem poucascondições de acesso aos cuidados de saúde, muitas vezesprestados indevidamente. Os agravos da saúde mental sãoevidentes. As condições biopsicossociais préencarceramentosão relevantes na situação de saúde geraldas detentas...

To verify how health condition of imprisonedwomen has been approached over the past five years.Material and Methods: This was an integrative review onthe health status of women deprived of freedom over thelast five years. This study was based on a basic protocolwith three steps performed by two researchers and oneexaminer. Bibliographical searches of full articles werecarried out in the databases SciELO, PubMed and LILACS.Results: A total of two articles were found in LILACS, 0 inScielo, and 38 in PubMed. In the final step, eight articlesaddressing the health conditions of women in closed prisonswere fully analyzed. All articles were indexed in the Medlinedatabase. The studies have addressed the health conditionsof imprisoned women and characterized their profile. Bothhealth condition and health issues were approached by theauthors. Conclusion: Similar results were found in the studiesconcerning the health condition of imprisoned women. Weobserved that women deprived of freedom are more affectedby health issues than the general female population and haveless access to care, which is frequently provided in animproper way. Mental health diseases are evident, andbiopsychosocial conditions prior to imprisonment influencethe overall health condition of prisoners...

A randomized, controlled clinical trial on the clinical and microbiological efficacy of punica granatum linn mouthwash

To evaluate the clinical efficacy of a mouthwash containing Punica granatumL as compared to 0.12% chlorhexidine digluconate on the control of dental biofilm and gingival inflammation.Material and Methods:A randomized, controlled, double-blind clinical trial was carried out comprising a sample of 35 students aged nine to twelve years having Simplified Oral Hygiene Index value equal to or higher than 1.6, with at least 20 teeth. The sample was divided into two groups: group A, administration of 0.12% chlorhexidine mouthwash twice a day for 14 days; and group B, administration of Punica granatum mouthwash (6.25%) following the same protocol described above. The Plaque Index (PI) and Bleeding on Probing Index (BPI) were used to evaluate biofilm control and gingival inflammation on days 0, 7 and 14. Counting of oral streptococci from saliva samples was also performed on days 0 and 14. The data were analyzed using Student‟s t test and Analysis of Variance (ANOVA).Results:The findings showed that P. granatum mouthwash reduced the mean values of PI and BPI, but with no significant difference. However, there was a significant reduction in the counting of oral streptococci. In the control group, all variables were found to be significantly reduced.Conclusion:Punica granatum mouthwash was not effective for the control of dental biofilm and gingival inflammation, but it was effective in reducing the counting of oral streptococci...

[Factors associated with tooth loss among adults in rural areas in the state of Pernambuco, Brazil]. / Fatores associados às perdas dentárias entre adultos em áreas rurais do estado de Pernambuco, Brasil.

The scope of this study was to estimate the prevalence of tooth loss and associated factors among Brazilian adults aged 20 to 59 years in rural areas in the state Pernambuco, Brazil. A cross-sectional study was conducted on a random sample of 568 participants. The number of lost teeth (d" 12 and > 12) was the outcome investigated. The independent variables were as follows: sociodemographic characteristics, subjective oral health conditions, impact of oral health on quality of life using the short version of the Oral Health Impact Profile (OHIP-14), and the use of dental services. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. The prevalence of subjects with at least one tooth lost was 91.4%. Tooth loss was strongly associated with age group, self-perceived oral health and oral health impact on quality of life. The high prevalence of tooth loss among Brazilian adults in rural areas shows a need for a reorientation of public dental services aimed at this population group.

[Self-rated oral health and associated factors among adults in rural settlements, Pernambuco State, Brazil]. / Autoavaliação da saúde bucal e fatores associados entre adultos em áreas de assentamento rural, Estado de Pernambuco, Brasil.

The aim of this study was to estimate prevalence of negative self-rated oral health and associated factors among adults in rural settlements. The probabilistic sample consisted of 557 adults 20 to 59 years of age in rural settlements in Pernambuco State, Brazil. The dependent variable was self-rated oral health, with the following independent variables: demographic characteristics, predisposition and availability of resources, oral health-related behavior, objective oral health conditions, and subjective oral health conditions. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. Prevalence of negative self-rated oral health was 70.5%. Negative self-rated oral health was associated with younger age, lower schooling, female gender, and black or brown skin color. Predictors of negative self-rated oral health included skin color, self-defined need for dental care, and the impact of oral health problems on quality of life.

Autoavaliação da saúde bucal e fatores associados entre adultos em áreas de assentamento rural, Estado de Pernambuco, Brasil / Self-rated oral health and associated factors among adults in rural settlements, Pernambuco State, Brazil / Autoevaluación de la salud bucal y factores asociados entre adultos en áreas de asentamiento rural, estado de Pernambuco, Brasil

O objetivo deste estudo foi estimar a prevalência de autoavaliação negativa de saúde bucal e fatores associados entre adultos em áreas de assentamento rural. A amostra probabilística consistiu de 557 adultos entre 20 a 59 anos em áreas de assentamento rural no Estado de Pernambuco, Brasil. A variável dependente foi autoavaliação da condição de saúde bucal e as independentes foram: características demográficas, de predisposição/disponibilidade de recursos, comportamentos relacionados à saúde bucal, condições objetivas e subjetivas relacionadas à saúde bucal. Foram estimadas as razões de prevalência bruta e ajustada por meio de regressão de Poisson. A prevalência de autopercepção negativa da saúde bucal foi de 70,5%. A autoavaliação negativa da saúde bucal foi mais prevalente em indivíduos mais jovens, de baixa escolaridade, entre as mulheres, e entre os de cor preta e parda. Os preditores da autoavaliação negativa da saúde bucal foram a cor da pele, a necessidade autorreferida de tratamento odontológico e o impacto das condições de saúde bucal na qualidade de vida.

The aim of this study was to estimate prevalence of negative self-rated oral health and associated factors among adults in rural settlements. The probabilistic sample consisted of 557 adults 20 to 59 years of age in rural settlements in Pernambuco State, Brazil. The dependent variable was self-rated oral health, with the following independent variables: demographic characteristics, predisposition and availability of resources, oral health-related behavior, objective oral health conditions, and subjective oral health conditions. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. Prevalence of negative self-rated oral health was 70.5%. Negative self-rated oral health was associated with younger age, lower schooling, female gender, and black or brown skin color. Predictors of negative self-rated oral health included skin color, self-defined need for dental care, and the impact of oral health problems on quality of life.

El objetivo de este estudio fue estimar la prevalencia de autoevaluación negativa de salud bucal y factores asociados entre adultos en áreas de asentamiento rural. La muestra probabilística consistió en 557 adultos entre 20 a 59 años en áreas de asentamiento rural en el estado de Pernambuco, Brasil. La variable dependiente fue la autoevaluación de la condición de salud bucal y las independientes fueron: características demográficas, de predisposición/disponibilidad de recursos, comportamientos relacionados con la salud bucal, condiciones objetivas y subjetivas relacionadas con la salud bucal. Fueron estimadas las razones de prevalencia bruta y ajustada por medio de la regresión de Poisson. La prevalencia de autopercepción negativa de la salud bucal fue de un 70,5%. La autoevaluación negativa de la salud bucal fue más prevalente en individuos más jóvenes, de baja escolaridad, entre las mujeres, y entre los afrobrasileños y mestizos/mulatos. Los predictores de la autoevaluación negativa de la salud bucal fueron el color de la piel, la necesidad autorreferida de tratamiento odontológico y el impacto de las condiciones de salud bucal en la calidad de vida.