Head and neck squamous cell carcinoma in young patients: a 26-year clinicopathologic retrospective study in a Brazilian specialized center

BACKGROUND: To describe the clinicopathologic profile of young patients with head and neck squamous cell carcinoma (HNSCC) and compare to middle-aged and elderly adults. MATERIAL AND METHODS: Patients' individual records were reviewed for clinicopathologic data. Eighty-nine patients with age 18-45 years old met the inclusion criteria of the study. Two additional groups of middle-aged (n = 89) and old (n = 89) adults were set to comparative analysis. RESULTS: Young patients represented 11.9% of all patients diagnosed with HNSCC. Women were more affected by HNSCC in the young and elder groups (p= 0.04), and young patients were more prone to be non-smokers (p= 0.01) and have lymph node metastasis at the time of diagnosis (p = 0.04). In the young group, patients diagnosed with the disease in advanced stages were more prone to have a positive familial history of cancer (p= 0.04), a positive status of alcohol consumption (p= 0.03), and to be heavy drinkers (p= 0.01). Survival was not different for the young group in comparison to the other groups. CONCLUSIONS: HNSCC in young patients had a different profile when compared to older patients, especially regarding sex and exposure to the classic risk factors for this disease. The survival of the young group is similar to the older groups and advanced clinical stage is predictor of worse survival

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An instrument calibrated by Item Response Theory to assess knowledge about head and neck cancer

Introduction: Head and neck tumors are in the 9º place among the most frequent cancers in the world, being the incidence of 700,000 new cases per year. To suspect and to diagnose early the cancer implies to know well the subject. The questionnaire is a good instrument for measuring knowledge. Objective: To provide an item bank, calibrated by the Item Response Theory (IRT), to evaluate the "knowledge about head and neck cancer", in any respondent, in order to benefit the studies on this construct, in the area of health education. Methods: To evaluate the "knowledge about head and neck cancer", we started with a scale already calibrated by the IRT, with 24 items for schoolchildren (n = 2,006). A further 29 items of equal difficulty were created (n = 994 schoolchildren). Then, 60 new items, of equal construct and greater difficulty (n = 883 dentistry professionals) were incorporated into this scale. Results: The analysis of 2,847 responses resulted in a bank with 113 items on head and neck cancer calibrated by IRT and arranged on a skill scale. Conclusion: From this collection of items, different questionnaires can be set up according to the skill level of the respondent. The results of the evaluations, in single or distinct moments, can be compared since the items are on the same scale of ability.

Stress hormones concentrations in the normal microenvironment predict risk for chemically induced cancer in rats.

Evidence show that stress hormones can influence cancer progression, but its role in carcinogenesis is poorly understood. In this study, we used a new method based on oral carcinogenesis model in rats to test the hypothesis that physiological levels of stress hormones in the normal tissue microenvironment would have significant predictive value for chemically induced cancer occurrence. Male Wistar rats were submitted to a tongue biopsy for measuring not-stress induced levels of norepinephrine, corticosterone, adrenocorticotropic hormone (ACTH) and brain-derived neurotrophic factor (BDNF) in the tissue before carcinogenic induction. Rats were treated with the 4-nitroquinoline-1-oxide (4NQO) chemical carcinogen for twenty weeks and then euthanized for microscopic evaluation of the tongue lesions. Increased pre-carcinogen norepinephrine concentrations and reduced basal corticosterone levels in the normal tissue microenvironment were predictive for oral squamous cell carcinoma (OSCC) occurrence. Likewise, increased pre-carcinogen norepinephrine levels in the normal microenvironment were associated a lower expression of pCDKN2a-p16 in OSCCs. Post-carcinogen levels of corticosterone and BDNF in oral leukoplakia tissues (precursor lesion of OSCC) and post-carcinogen corticosterone concentrations in OSCCs were higher than basal levels in the normal mucosa. Increased norepinephrine concentrations in OSCCs were associated to a greater tumor volume and thickness. Furthermore, higher levels of norepinephrine, ACTH and BDNF in OSCCs were associated to a lesser intensity of the lymphoplasmocytic infiltrate. This study shows that pre-carcinogen stress hormones levels in the normal microenvironment may be predictive for chemically induced cancer in rats. Moreover, chemical carcinogenesis can promote stressor-like effects with hormonal changes in the tissue microenvironment, which may be associated to tumor progression.

Two-Year Clinical Evaluation of a Nanofilled Etch-and-Rinse and a Self-Etch Adhesive System Containing MDPB and Fluoride in Non-carious Cervical Lesions.

OBJECTIVES: The aim of this clinical study was to evaluate the performance of restorations for non-carious cervical lesions performed with a two-step etch-and-rinse or with a two-step self-etch adhesive. MATERIALS AND METHODS: The teeth to be restored (15 patients, N = 90 restorations) were randomly assigned into 3 groups (n = 30), according to the adhesive system: group 1 (G1): Peak LC Bond; group 2 (G2): Clearfil Protect Bond; and group 3 (G3): prior selective acid etching of the enamel margins before bonding with Clearfil Protect Bond. The NCCLs were restored with Amelogen Plus composite resin. Two calibrated examiners evaluated the restorations using modified US Public Health Service criteria. The data of retention, marginal integrity, and marginal discoloration were analyzed using the Kruskal-Wallis and Wilcoxon tests. RESULTS: There were no significant differences in clinical performance among the groups for the variables: retention, marginal integrity, and marginal discoloration after 1 year and 2 years. The alpha rates after 2 years were: 93.3% for G1 and 96.7% for G2 and G3 for retention; 93.3%, 100%, and 90% for G1, G2, and G3 for marginal discoloration; 86.7%, 96.7%, and 90% for G1, G2, and G3 for marginal integrity, respectively. CONCLUSIONS: The adhesives presented similar clinical performance at the end of 2 years. Also, the prior etching with phosphoric acid did not significantly improve the clinical performance of self-etch adhesive.

Three-Year Clinical Evaluation of Class I Restorations in Posterior Teeth. Effects of Two Adhesive Systems.

This longitudinal study evaluated the clinical performance of 97 direct class I resin composite restorations after 3 years. The restorations were performed using 2 types of adhesive systems: (1) Adper™ Single Bond Plus (SB) (3M ESPE, 3mespe.com), which is a two-step etch-and-rinse system, and (2) Adper Scotchbond™ SE (SE) (3M ESPE), which is a two-step self-etching system. Two calibrated examiners evaluated the restorations using modified US Public Health Service criteria. The materials were applied following the manufacturer's instructions, and 15 patients received at least one of the two adhesive systems. The restorations were evaluated 7 days after placement (baseline) and again after 3 years. Statistical analysis was performed using a proportion t-test at a significance level of 5% (P < .05). At baseline, all restorations received an Alpha score for the variable marginal discoloration and marginal integrity. After 3 years, marginal discoloration received an Alpha score for 53.19% of the restorations performed with SB and 52.08% with SE. Marginal integrity was rated as Alpha for 65.96% and 68.75% of the restorations with SB and SE systems, respectively. The remaining restorations received Bravo scores for all variables. Eight restored teeth presented postoperative sensitivity at baseline (5 SB; 3 SE), but no sensitivity was found after 3 years. No secondary caries was verified. No statistically significant differences were observed between the teeth restored with the SB and SE systems for marginal discoloration (P = .7880) and marginal integrity (P = .8132) after 3 years. Direct class I resin composite restorations performed with a two-step etch-and-rinse and a two-step self-etching adhesive system demonstrated satisfactory clinical performance after 3 years.

Lip Cancer: A Clinicopathological Study and Treatment Outcomes in a 25-Year Experience.

PURPOSE: There are few clinical studies focusing on treatment outcomes of lip cancer. This study investigated the clinicopathologic variables of a large sample of patients with lip squamous cell carcinoma (LSCC) treated in a reference head and neck cancer center for the past 25 years and analyzed the influence of these variables on treatment outcomes. MATERIALS AND METHODS: This retrospective cohort study reviewed the clinical records of patients with LSCC. Epidemiologic data were age, gender, ethnicity, type of occupation, tobacco smoking, alcohol consumption, comorbid conditions, and family cancer history. Clinicopathologic features included the lip location of the tumor, TNM classification, clinical staging, histopathologic grade, surgical margin analysis, and treatment modality. Local recurrence, second primary tumor, and survival were the outcome variables. Statistical analysis was performed by χ(2) test, Fisher exact test, and binary logistic regression analysis. Survival analysis was assessed through the Kaplan-Meier curve. Level of statistical significance was set at a P value less than .05 for all tests. RESULTS: In total, 144 patients with LSCC were studied. There were 117 men (81.25%) and 27 women (18.75%) with a mean age of 60.21 years. One hundred thirty-four patients (93.05%) were considered of white ethnicity, and in 57 cases (39.58%), the patients reported an occupation that was related to long-term solar exposure. Most cancers had initial clinical staging of 1 or 2 (84.02%). Microscopically, lesions were predominantly well (43.05%) and moderately (40.96%) differentiated tumors. Clinical staging was related to a specific higher survival rate (P = .0049). One hundred twelve cases (77.78%) underwent surgical treatment and only 6 patients (4.80%) had local recurrence, which was directly associated with compromised surgical margins (P = .0320). CONCLUSION: A high success rate in LSCC treatment was observed in this study. Compromised surgical margin was associated with tumor recurrence and is a critical event in lip cancer treatment.

Adherence to standard precautions from the standpoint of the Health Belief Model: the practice of recapping needles.

The aim of this study was to apply the Health Belief Model to explain the adherence to the recommendation not to recap needles by dentists and dental assistants of the public health system in a municipality in the State of São Paulo. A questionnaire validated and adapted for the oral health area was used, which included variables related to the frequency of recapping and health beliefs using Likert-type scales. The relationship between beliefs and adherence to the recommendation not to recap needles was obtained by regression analysis. Of all the professionals in this study (n=79), the majority (83.5%) reported recapping needles at least once in the last month. Through regression analysis, it was observed that the relationship between the beliefs described by the model and the attitude whether or not to follow the recommendation not to recap needles was explained by a lower perception of psychological barriers and a greater perception of stimuli not to recap needles. The conclusion reached is that the acceptance of recommendations to prevent working accidents with biological material was explained by some dimensions of the Health Belief Model, enabling discussion about reformulation of training offered to professionals of the public health system.

Adherence to standard precautions from the standpoint of the Health Belief Model: the practice of recapping needles / Adesão às precauções padrão sob o prisma do Modelo de Crenças em Saúde: a prática de reencapar agulhas

The aim of this study was to applythe Health Belief Model to explain the adherence to the recommendation not to recap needles by dentists and dental assistants of the public health system in a municipality in the State of São Paulo. A questionnaire validated and adapted for the oral health area was used, which included variables related to the frequency of recapping and health beliefs using Likert-type scales. The relationship between beliefs and adherence to the recommendation not to recap needles was obtained by regression analysis. Of all the professionals in this study (n=79), the majority (83.5%) reported recapping needles at least once in the last month. Through regression analysis, it was observed that the relationship between the beliefs described by the model and the attitude whether or not to follow the recommendation not to recap needles was explained by a lower perception of psychological barriers and a greater perception of stimuli not to recap needles. The conclusion reached is that the acceptance of recommendations to prevent working accidents with biological material was explained by some dimensions of the Health Belief Model, enabling discussion about reformulation of training offered to professionals of the public health system.

Objetivou-se neste estudo aplicar o Modelo de Crenças em Saúde a fim de explicar a adesão à recomendação de não reencapar agulhas por cirurgiões-dentistas e auxiliares de saúde bucal da rede pública de um município paulista. Utilizou-se um questionário validado e adaptado para a área de saúde bucal, que contemplava variáveis relativas à frequência do reencape e crenças em saúde, por meio de escalas tipo Likert. A relação entre as crenças e a adesão à recomendação de não reencapar agulhas foi obtida por meio da análise de regressão. Da amostra de profissionais obtida por adesão ao estudo (n = 79), a maioria (83,5%) relatou ter reencapado agulhas pelo menos alguma vez no último mês. Por meio da análise de regressão, foi observado que a relação entre as crenças descritas pelo modelo e a atitude de aderir ou não à recomendação de não reencapar agulhas foi explicada por uma menor percepção de barreiras psicológicas e por uma maior percepção de estímulos para não reencapar agulhas. Conclui-se que a aceitação das recomendações para prevenir acidentes do trabalho com material biológico foi explicado por algumas dimensões do Modelo de Crenças em Saúde, possibilitando a discussão sobre a reformulação de capacitações oferecidas para profissionais do sistema público de saúde.

Clinical trial evaluating color change and tooth sensitivity throughout and following in-office bleaching.

The aim of this study was to assess the color alteration and sensitivity of teeth throughout and following in-office bleaching. Twenty-two volunteers participated in this clinical trial of bleaching treatment (35% hydrogen peroxide bleaching gel and placebo) applied on maxillary incisors and canines. According to a split-mouth design, the volunteers' maxillary hemi-arches received either the bleaching or placebo agent, applied four times, at 1-week intervals. Color alteration and tooth sensitivity were assessed throughout and following bleaching. Statistical calculations were performed using gamma distribution and repeated-measures ANOVA. There was a statistically significant difference between teeth submitted to a bleaching agent and placebo (P < .001). At the end of the first, second, third, and fourth sessions, the bleached teeth presented color scores statistically lower than those observed immediately before bleaching. There was no difference in the color scale scores of the bleached teeth between bleaching sessions. The sensitivity data test showed a significant difference among treatments (P < .0001). Color alteration and dental sensitivity were altered by the bleaching agent.

Dentifrício à base de ALOE VERA e Própolis na redução de placa dental: estudo comparativo

A fitoterapia é uma prática usada desde a antiguidade e, no âmbito odontológico, observa-se grande número de dentifrícios com extratos de plantas e produtos naturais incorporados em suas formulações, como Aloe vera e própolis, devido as suas propriedades anti-inflamatórias e antimicrobianas. Proposição: comparar a eficácia de um dentifrício com Aloe vera e própolis em sua formulação no controle da placa dental supragengival em relação a outro de uso difundido e sem esses componentes. Material a Métodos: foram analisados os índices de placa (IHOS – índice de higiene oral simplificado) em 30 pacientes divididos em três grupos, sendo o grupo I (apenas água e escova dental para higienização bucal), o grupo II (Colgate Ação Total) e o grupo III (Forever Bright Tooth Gel) nos dias zero e após 15 dias, tendo-se submetidos os dados a análise estatística comparativa, Teste de Fiedman (p < 0,0001) e Teste de Comparação Múltipla de Dunn’s (p < 0,05). Resultados: encontrou-se significância quando comparados os grupos I e II (p < 0,05) e os grupos I e III (p < 0,01), sendo que não houve diferença estatisticamente significante quando comparados os grupos II e III (p > 0,05). Conclusão: não houve desvantagem do dentifrício com Aloe vera e própolis em sua formulação em relação a outro dentifrício de uso difundido no controle de placa dental supragengival e o uso de dentifrícios pela população em geral é importante para suprir deficiências nas técnicas de higiene bucal através da ação de substâncias com ação efetiva no controle da placa dental e no intuito de evitar a desmotivação dos pacientes.

Adolescents' knowledge regarding oral health using validated instrument by Item Response Theory / Conhecimento de adolescentes sobre saúde bucal utilizando instrumento validado pela Teoria de Resposta ao Item

Objective: The aim of this study was to evaluate the level of 6th grade of elementary schoolchildren's knowledge at an elementary school in the municipality of Araçatuba, São Paulo, Brazil, using a validated instrument for Item Response Theory. Methods: A questionnaire was developed based on a literature search of articles in computerized databases such as Pubmed, Bireme and SciELO. We selected questions that had a greater range of adjustments and by applying the Technical Focus Group, these questions were reformulated using language appropriate for the study population. Subsequently the questionnaire was subjected to application of Item Response Theory that was standardized with 19 items. For data processing for correction of the questionnaire, we used the software for analysis and EPI2000 of TRI, BILOG software. A total of 979 questionnaires were applied to adolescents aged 12-14 years who attended the 22 state schools in the city. Results: The percentage of questionnaires completed was 84.4%. All questionnaire items were discriminatory, yet most needed below average skill of knowledge to be answered correctly. Sixteen percent of correct items received over 75%. Only items 2, 3 and 15 obtained indices close to 50%. Sixteen items had hit percentage above 75%. Only items 2, 3 and 15 had percentages close to 50%. Conclusion: From the results of this study, we could conclude that the students have a good level of oral health knowledge, however further research is required to spread the use of Item Response Theory in analysis of assessment tools, especially in dentistry.

Objetivo: Avaliar o nível de conhecimento dos escolares da 6ª série do ensino fundamental do município de Araçatuba, São Paulo, por meio de um instrumento validado pela Teoria de Resposta ao Item. Métodos: Foi elaborado um questionário baseado em uma pesquisa bibliográfica de artigos em bancos de dados informatizados como Pubmed, Bireme e SciELO. Foram selecionadas as perguntas que possuíam uma maior variação de acertos e por meio da aplicação da Técnica do Grupo Focal, foram reformuladas com uma linguagem adequada à população de estudo. Posteriormente o questionário foi submetido a aplicação da Teoria de Resposta ao Item em que foi padronizado com 19 itens. Para o processamento dos dados para correção do questionário, utilizou-se o software EPI2000 e para as análises da Teoria de Resposta ao Item, o software BILOG. Foram aplicados 979 questionários em adolescentes com idade entre 12 a 14 anos que frequentavam as 22 escolas da rede estadual de ensino do município. Resultados: A porcentagem de questionários respondidos foi de 84,4%. Todos os itens do questionário foram discriminatórios, no entanto a maioria necessitava de habilidade abaixo da média do conhecimento para serem respondidos corretamente. Dezesseis itens obtiveram porcentagem de acerto acima de 75%. Somente os itens 2, 3 e 15 obtiveram índices próximos de 50%.Conclusão: Frente aos resultados deste trabalho, pôde-se concluir que os escolares possuem um bom nível de conhecimento sobre saúde bucal. No entanto, pesquisas adicionais são necessárias para disseminar o uso da Teoria de Resposta ao Item em análises de instrumentos de avaliação, especialmente na Odontologia.

Temporomandibular joint vibration before and after exercises and occlusal splints.

Temporomandibular joint (TMJ) sounds are frequent in patients. The aim of this study was to analyze patients with clicking at the end of opening and at the beginning of closing their mouths treated by muscular exercises through chewing and by occlusal splints. Fifteen patients with clinically verified clicking and TMJ and 15 patients without sounds were selected by the Research Diagnostic Criteria for Temporomandibular Disorders. They were submitted to electrovibratography at consultation and 60 and 120 days of treatment by occlusal splints and exercises. Patients demonstrated significant reduction of TMJ sounds after treatment, but vibration intensity was not similar with that of the control group after 120 days.

Dentists' level of knowledge of the treatment plans for periodontal ligament injuries after dentoalveolar trauma.

This study investigated the level of knowledge held by dentists about the possible treatment plan procedures for periodontal ligament injuries after dentoalveolar trauma. A 5-item self-applied questionnaire was prepared with questions referring to the professional profile of the interviewees and to the treatment plan they would propose for periodontal ligament injuries secondary to dentoalveolar trauma. The questionnaires were filled out by 693 dentists attending the 23rd Annual Meeting of the Brazilian Society for Dental Research, and the data obtained were subjected to descriptive analysis. Either the chi-square test or Fisher's exact test was applied to assess associations among variables, at a 5% level of significance. The results revealed that dentists experienced difficulty in establishing a treatment plan for subluxation, and for extrusive, lateral and intrusive luxations. In general, holding a dental specialty degree had no influence on the knowledge about treatment plan procedures for the most severe injuries. It could be concluded that the dentists participating in this study, whether specialists or not, did not have sufficient knowledge to treat most of the periodontal ligament injuries resulting from dentoalveolar trauma adequately.

Dentists' level of knowledge of the treatment plans for periodontal ligament injuries after dentoalveolar trauma

This study investigated the level of knowledge held by dentists about the possible treatment plan procedures for periodontal ligament injuries after dentoalveolar trauma. A 5-item self-applied questionnaire was prepared with questions referring to the professional profile of the interviewees and to the treatment plan they would propose for periodontal ligament injuries secondary to dentoalveolar trauma. The questionnaires were filled out by 693 dentists attending the 23rd Annual Meeting of the Brazilian Society for Dental Research, and the data obtained were subjected to descriptive analysis. Either the chi-square test or Fisher's exact test was applied to assess associations among variables, at a 5 percent level of significance. The results revealed that dentists experienced difficulty in establishing a treatment plan for subluxation, and for extrusive, lateral and intrusive luxations. In general, holding a dental specialty degree had no influence on the knowledge about treatment plan procedures for the most severe injuries. It could be concluded that the dentists participating in this study, whether specialists or not, did not have sufficient knowledge to treat most of the periodontal ligament injuries resulting from dentoalveolar trauma adequately.

Effect of disinfection and accelerated aging on color stability of colorless and pigmented facial silicone.

PURPOSE: The aim of this study was to evaluate the color stability of a facial silicone with different pigmentations submitted to disinfection and accelerated aging. MATERIALS AND METHODS: Sixty replicas were fabricated with the silicone Silastic MDX 4-4210 and divided into three groups: no pigmentation, pigmentation with makeup powder, and pigmentation with ceramic powder. Half the replicas of each group were submitted to disinfection with Efferdent and the other with neutral soap for 60 days (n = 10). After this period, all replicas were inserted in a chamber for accelerated aging of nonmetallic specimens. The color measurements were carried out initially, after disinfection, and after accelerated aging (252, 504, 1008 hours). Color stability was evaluated through spectrophotometry. The values were submitted to ANOVA and the means to Tukey's test (p < 0.01). RESULTS: The specimens disinfected with neutral soap exhibited higher ΔE values regardless of the type of pigmentation. The colorless replicas and the specimens pigmented with ceramic exhibited a statistically significant difference between the methods of disinfection in all periods. The specimens pigmented with makeup powder did not demonstrate a statistically significant difference. CONCLUSIONS: The ceramic pigment presented greater color stability regardless of disinfection and period. On the other hand, the makeup pigment exhibited the highest values of chromatic alteration.

Silent period of masticatory cycles in dentate subjects and complete denture wearers.

PURPOSE: The purpose of this study was to assess, through electromyographic activity (EMG), the silent period (SP) of masseter and anterior temporal muscles in dentate subjects (DS) and complete denture wearers (CDW). MATERIALS AND METHODS: The evaluations were performed at the initial and final period of the mastication for the DS group. For the CDW group, the evaluations were performed at the initial period of mastication, with old complete dentures worn for more than 10 years (OCDW) and at the final period of the mastication with new complete dentures (NCDW), 5 months after rehabilitation. Twenty-four asymptomatic subjects (12 DS, 12 CDW) answered a questionnaire based on the Research Diagnostic Criteria for temporomandibular disorders. The CDW group answered the questionnaire before and after new denture insertion and after 5 months of rehabilitation. The SP of the muscles was recorded through EMG at the initial and final periods of mastication using artificial food (Optocal). The operator monitored 35 chewing cycles performed to grind the artificial food and selected eight open-close-clench-chewing cycles for the record. RESULTS: The SP of the muscles analyzed with new complete dentures showed no statistical difference in comparison to the old dentures. There was a statistically significant difference in the SP between the CDW and DS groups for initial and final chewing. CONCLUSION: Lowered muscular capacity and ability reduced the SP of muscles after rehabilitation with NCDWs.

Técnica do grupo focal como método de avaliação do conhecimento de adolescentes sobre saúde bucal / The focus group technique as a method of evaluating teenager knowledge of oral health

O presente estudo tem como objetivo analisar, por meio da técnica do GrupoFocal, o entendimento de adolescentes em relação à saúde bucal. A pesquisa foi realizada em três escolas públicas da cidade de Araçatuba, Estado de São Paulo, com dez alunos em cada uma delas. Para a realização dos grupos focais foram abordadas as seguintes palavras, presentes em perguntas de questionários sobre saúde bucal, as quais apresentaram altos índices de erros: saúde bucal; placa bacteriana; dente permanente; flúor; gengiva sangra?; fio dental; transmissão da cárie. Durante as discussões dos grupos focais, observou-se que muitos adolescentes ficavam surpresos com a situação a qual foram submetidos e com o tema que estavam discutindo. A palavra 'saúde bucal' foi associada à condição de limpeza da cavidade bucal, não identificando a saúde bucal como parte da saúde geral. O termo'transmissão da cárie' não teve um entendimento suficiente. A expressão 'dente permanente'foi bem compreendida, sendo associada a um tipo de dente que não seria mais substituído. A palavra 'flúor' teve maior associação à função de limpeza do que à proteção dos dentes. Conclui-se que a utilização da técnica do Grupo Focal é de grande importância na interpretação do conhecimento dos adolescentes sobre saúde bucal e na adequação da terminologia de questionários sobre o mesmo tema.

This study aims to the understanding of adolescents regarding oral health, using the Focus Group technique. The study was conducted at three public schools in the city of Araçatuba, São Paulo State, Brazil, with ten students in each. In orderto conduct the focus groups, the following words, which featured high error levels, were addressed in survey questions on oral health: oral health; plaque, permanent teeth; fluoride;gum bleeds?; dental floss; transmission of cavities. During the discussions in the focus groups, it was observed that many teenagers were surprised at the situation to which they were submitted and at the topic they were discussing. The word 'oral health' was associated with the condition of cleanliness of the oral cavity, not identifying oral health as part of general health. The term 'transmission of cavities' did not have a sufficient understanding.The term 'permanent tooth' was well understood and was associated with a type of tooth that would not be replaced. The word 'fluoride' had more association with the task of cleaning than protection of the teeth. It is concluded that the use of the focus group technique is of great importance in the interpretation of the knowledge of adolescents on oral health and the appropriateness of the terminology of questionnaires on the same subject.

Longitudinal behavioral analysis during dental care of children aged 0 to 3 years.

'When' and 'how' the dentist intervenes have repercussions on children's physical and emotional patterns. The objective of the present study was to conduct a longitudinal behavioral analysis during dental care of babies aged 0 to 3 years. A total of 216 patients seen at the Baby Clinic of the School of Dentistry at Araçatuba, São Paulo State University (UNESP), were selected. The selection criterion was attendance at ten dental care sessions at bimonthly intervals for routine procedures such as clinical examination and oral hygiene. There was a predominance of cooperative behavior compared to uncooperative behavior when each visit was analyzed separately. The behavior of the patients must have been directly influenced by their psychomotor development. Constant attendance and exposure of the baby to non-stressful dental stimuli are factors that favor a cooperative behavior.

Estatística de levantamentos epidemiológicos sobre cárie dentária, publicados no Brasil e no exterior, de 1960 a 2001 / Statistics from epidemiological surveys about dental decay, published in Brazil and in the exterior, from 1960 to 2001

Os levantamentos epidemiológicos são importantes para implantação, execução e avaliação de projetos e ações de saúde numa comunidade. Na realização de levantamentos epidemiológicos o planejamento, objetivos, amostra, treinamento e calibração da equipe, execução e divulgação dos resultados é de suma importância. Neste sentido, para que os resultados sejam consistentes e confiáveis, a preocupação com a amostra e com a análise estatística no momento da tabulação dos dados é fundamental para que esses possam ser inferidos para toda a população. Este trabalho tem como objetivo investigar o tipo de metodologia estatística utilizada em trabalhos publicados sobre levantamentos epidemiológicos de cárie dentária no período de 1960 a 2001. Por meio de um levantamento bibliográfico realizado nas bases de dados BBO, MEDLINE e SCIELO. Os artigos encontrados foram analisados com relação à metodologia estatística aplicada em todo o estudo, da amostragem até a tabulação dos dados. Observou-se que a maioria das pesquisas (72,6%), limitou-se a apresentar o número de elementos que constituiu a amostra, sem esclarecer o planejamento para obtenção.

The epidemiological surveys are important to the deployment, implementation and evaluation of projects and health actions in a community. The planning, goals, samples, team training/calibration, carrying out and publication of results are extremely important in the epidemiological surveys. Thus, the care with the sample and statistical analysis is fundamental for the results to be consistent and trustworthy in order to be able to be inferred for all the population. The aims of this study is to investigate the statistical methodology used in papers on dental caries epidemiological surveys published from 1960 to 2001. A bibliographical survey was carried out in BBO, MEDLINE and SCIELO databases. The papers found were analyzed with regards to the statistical methodology applied in the whole study, from the sampling to the tabling of data. Most studies (72.6%) only presented the number of elements that composed the sample, without explaining the planning involved in obtaining it.

Healing process of incisor teeth of diabetic rats replanted after storage in milk.

Several local factors that influence the healing process of replanted teeth have been investigated. However, it remains unclear how systemic alterations, such as diabetes mellitus, affect the prognosis of these cases. The purpose of this study was to evaluate the healing process of incisors of non-controlled diabetic rats replanted after storage in bovine long shelf-life (UHT) whole milk. Thirty-two rats were randomly assigned to receive an endovenous injection of either citrate buffer solution (group I - control; n = 16) or streptozotocin dissolved in citrate buffer solution to induce diabetes (group II; n = 16). After confirmation of the diabetic status by analysis of the glycemic levels, the maxillary right incisor of each animal was extracted and immersed in milk for 60 min. The root canals of teeth were then instrumented, and were filled with a calcium hydroxide-based dressing and replanted into their sockets. All animals received systemic antibiotic and were killed by anesthetic overdose 10 and 60 days after replantation. The specimens containing the replanted teeth were removed, fixed, decalcified, and embedded in paraffin. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histologic and histometric analyses. The results showed that the connective tissue adjacent to the root surface was less organized in the diabetic animals than in the control animals in both periods; the root dentin was less severely affected by root resorption in the diabetic rats; there were no significant differences between the control and diabetic groups regarding the occurrence of replacement resorption and inflammatory resorption.