Relationship between overweight/obesity in the first year of age and traumatic dental injuries in early childhood: Findings from a birth cohort study.

BACKGROUND/AIM: The impact of traumatic dental injuries (TDI) in the primary dentition on oral health-related quality of life indicates the need for the planning of prevention strategies. The aim of this study was to assess whether anthropometric characteristics in early life are associated with TDI by preschool age. MATERIALS AND METHODS: A birth cohort was recruited from the public healthcare system in the city of Porto Alegre, Brazil. Socio-demographic variables, type of birth, head circumference, weight, and length were collected at birth (WHO standards). Head circumference, body mass index for age, and height for age were collected at 12 months. TDI (Andreasen criteria) at three years of age (n = 458) were recorded by two examiners who had undergone training and calibration exercises. Multivariable analysis was carried out with Poisson regression with robust variance. RESULTS: A total of 31.0% of the children (142/458) exhibited TDI at three years of age. In the final model, the risk of TDI was 47% higher among children with a smaller head circumference upon birth and nearly 60% higher among those who were overweight/obese at 12 months of age (RR: 1.58; 95% CI: 1.15-2.17). The risk of TDI was also significantly higher among boys (RR 1.50; 95% CI: 1.13-2.00), but the outcome was not significantly associated with socioeconomic variables or other anthropometric variables. CONCLUSION: Overweight/obesity in early life is a risk factor for TDI in preschool children.

FTO polymorphism, cardiorespiratory fitness, and obesity in Brazilian youth.

OBJECTIVES: The aim of the present study was to evaluate the relationship between the rs9939609 fat mass and obesity-associated (FTO) polymorphism and cardiorespiratory fitness (CRF) with overweight/obesity outcomes in youth. METHODS: This study included 420 youths, comprising 211 boys and 209 girls aged 7-17. Overweight/obesity were evaluated by body mass index (BMI), waist circumference (WC), and the percentage of fat (PF) according to two skinfold thickness measurements. Genotyping of the rs9939609 polymorphism was conducted using real-time Polymerase Chain Reaction (PCR) utilizing TaqMan(®) probes, and CRF was evaluated through a 9-minute run/walk test, categorized as fit or unfit. Logistic regression was utilized to evaluate a possible association between the polymorphism and CRF, with three obesity indicators evaluated. RESULTS: Individuals with the genotype risk (AA) of FTO polymorphism rs9939609 showed higher prevalence of overweight/obesity, as evaluated by BMI (OR: 3.21; CI: 1.71-6.05), WC (OR: 2.59; CI: 1.35-4.97), and PF (OR: 2.59; CI: 1.36-4.92). Additionally, students with the AA genotype in the unfit model had a significant odds ratio for obesity (OR: 4.40; CI: 1.83-10.61 for BMI; OR: 3.54; CI: 1.58-7.96 for WC), whereas we did not observe associations between the AA genotype with BMI and WC using the fit model. Conversely, PF was associated with the AA genotype only in the fit model (OR: 3.24; CI: 1.26-8.34). CONCLUSIONS: This study demonstrated that the rs9939609 (FTO) polymorphism showed a relationship with obesity in the population studied and an interaction with CRF. Students with low levels of CRF and the AA genotype have a higher risk of being overweight/obese. This association was not found in students with higher levels of CRF. Am. J. Hum. Biol. 28:381-386, 2016. © 2015 Wiley Periodicals, Inc.

Risk factors for traumatic dental injuries in the primary dentition: concepts, interpretation, and evidence.

The purpose of this comprehensive review is to explore the main concepts related to quantification and interpretation of risk factors and investigate characteristics associated with traumatic dental injuries (TDI) in the primary dentition. Initially, the main concepts related to causality and risk factors were summarized, including how to measure, express, and compare risk as well as interpret statistical significance. Based on a structured search through PubMed, original research articles regarding TDI and associated factors in the primary dentition were then reviewed by two examiners. Studies with a sample size of at least 300 children aged between 0 and 6 years were summarized according to journal, country, study design, and type of statistical analysis. Variables associated with TDI in primary teeth were identified from studies with multivariable analysis. Measures of effect size and P values were presented. Thirty-two studies were retrieved: most were cross-sectional in design and only 17 (53.1%) performed multivariable analysis. Most investigations did not find an association between gender and socioeconomic variables with TDI. Increased overjet was the only factor consistently identified as an associated factor. Behavioral characteristics have been recently investigated and suggested as potential risk factors for TDI in the primary dentition. In conclusion, increased overjet is undoubtedly associated with TDI in the primary dentition. As behavioral factors may be targeted by preventive strategies, their role on TDI occurrence should be clarified in future cohort studies. Clinicians should understand the terms and measures described in studies on risk factors to properly apply knowledge and benefit patients.

Enamel fracture in the primary dentition has no impact on children's quality of life: implications for clinicians and researchers.

AIM: The aim of this study was to quantify the impact of traumatic dental injuries (TDI) on oral-health-related quality of life (OHRQoL) of preschool children, when enamel fractures were either included or excluded within the category of TDI. MATERIAL AND METHODS: An oral health survey was undertaken of preschool children, age 1-5 years attending public nurseries in Canoas, Brazil. Children were examined for TDI, dental caries, and malocclusion. Parents were interviewed on their perception of their child's OHRQoL (Early Childhood Oral Health Impact Scale-ECOHIS) and their sociodemographic background. Multivariable Poisson regression models with robust variance were fitted to assess the impacts of TDI (including and excluding enamel fractures) on OHRQoL. RESULTS: A full dataset was collected from 76% of the eligible population. The prevalence of TDI was 13.4% (171/1275). The prevalence of any impact (ECOHIS ≥ 1) was significantly higher in children with crown discoloration (29.7%), enamel/dentin fracture (29.2%), and avulsion (73.3%), compared to children with enamel fracture (16.2%) or without a TDI (15.8%) (P < 0.001). Enamel fractures were the most prevalent TDI (40%) but halved the proportion of children with a reported impact from their TDI. The mean increase in OHRQoL impact for those children with a TDI was 1.59 (95%CI 1.20-2.10) when enamel fracture was included, and 1.86 (95%CI 1.39-2.50) when it was excluded. CONCLUSION: Enamel fractures have no significant impact on young children's quality of life. Including enamel fractures within the diagnosis of TDI increases the prevalence of TDI while reducing the OHRQoL impact of TDI for the primary dentition.

Traumatic Dental Injuries in the primary dentition: a 15-year bibliometric analysis of Dental Traumatology.

AIM: To explore the profile of articles on traumatic dental injuries (TDI) in the primary dentition published in Dental Traumatology in the last 15 years using bibliometric analysis. METHODS: Three researchers read all titles and abstracts of articles published in Dental Traumatology between 2000 and 2014 (excluding editorials and letters) and selected all articles on TDI in the primary dentition. The articles were categorized according to year of publication, country in which the study was conducted, study design, and topics addressed. Divergences were resolved by consensus between the researchers. RESULTS: Among a total of 1257 articles published, 98 were initially excluded. Among the remaining 1159 articles, 152 (13.1%) focused on TDI in the primary dentition. The articles were conducted in 29 countries, with Brazil (38.8%) and Turkey (11.8%) accounting for the largest numbers. Cross-sectional studies (36.2%) and case report/case series (33.6%) were the most frequent study designs. Only two systematic reviews were published. The most commonly addressed topics were frequency/etiology/associated factors (36.8%), treatment (30.9%), and prognosis (19.7%). Among the articles addressing treatment, two-thirds were case reports or case series. The effects of TDI in primary teeth on their permanent successors were addressed in 20.4% of the articles (31/152). CONCLUSIONS: The number of articles on TDI in the primary dentition has increased, but remains low. The evaluation of study designs and topics addressed identified gaps that could contribute to the development of new studies on TDI in the primary dentition, especially cohort studies that evaluate risk factors, prognosis, and treatment.

Oral health care for people with disabilities in Brazil: Transition from the specialized dental services between 2014 and 2018.

OBJECTIVE: To identify changes in the dental service provision to people with disabilities (PD) in the Dental Specialties Centers (acronym CEO in Portuguese-Centro de Especialidades Odontológicas) between the first and second cycles of the Program for the Improvement of Access and Quality of CEO and analyse factors associated with any changes. METHODS: This nationwide ecological time series study adopted the CEO as the analysis unit. The 827 CEO who participated in the two program's cycles (2014 and 2018) were included. Data on the structure and the work process were considered to identify features of providing services to PD in both cycles. Latent transition analysis (LTA) was performed to identify latent status (LS) with similar features and model the transition between LS over time. Models with five variables and with two to five LS were tested, considered best conceptual interpretability and best model fit parameters: human resources structure (dentist working exclusively with PD) and work process that identified guarantee of PD treatment at the CEO, the CEO's interface with primary care, and the interface with tertiary care. Spatial analysis was performed to identify spatial patterns of LS in the Brazilian territory with choropleth maps. A multinomial logistic regression model was performed to identify factors associated with changes in the provision of CEO (improved, remained or worsened). FINDINGS: The best-fit model identified four LS: 'Better', 'Medium better', 'Medium worse' and 'Worse'. CEO remained in the LS 'Better' (94%), LS 'Medium' (5.3%) and LS 'Worse' (78.4%). It is noteworthy that the highest proportion of CEO, in both cycles, was in the LS 'Better', featured by the CEO, characterized by all the CEO guaranteeing treatment to users with PD, high proportions of professionals working exclusively with PD, and most CEO articulated with primary care and with tertiary care. However, there is a decrease in the number of postgraduate professionals specializing in this service profile (1.3%). The higher the population growth, the greater the likelihood of the CEO achieving 'improved' in the LS. Moreover, the higher the number of goals, the lower the likelihood of the CEO getting 'worse' in the LS. CONCLUSION: Advances in dental service provision were observed, with more significant transitions to the 'Better' class, with improvements mainly in the interface with primary and tertiary care. Disability will be an even more significant concern as the population ages. Initiatives that can remove barriers and empower PD are potent in the provision of oral health services.

Impact of traumatic dental injuries on oral health-related quality of life of preschool children: A systematic review and meta-analysis.

BACKGROUND: Observational studies have suggested that traumatic dental injuries (TDI) can lead to pain, loss of function and esthetic problems, with physical, emotional and social consequences for children and their families. However, population-based studies that investigate the impact of TDI on oral health-related quality of life (OHRQoL) among preschool children are scarce and offer conflicting results. The aim of the systematic review and meta-analysis was to evaluate the impact of TDI on OHRQoL among preschool children (PROSPERO-CRD42015032513). METHODS: An electronic search of six databases was performed in PubMed (MEDLINE), ISI Web of Science, Scopus, Science Direct, EMBASE and Google Scholar, with no language or publication date restrictions. The eligibility criteria were TDI as the exposure variable, OHRQoL as the outcome and a population of children up to six years of age. RevMan software was used for data analysis. Results are expressed as odds ratios with 95% confidence intervals for the total score of the Early Childhood Oral Health Impact Scale (ECOHIS) as well as the scores of the Child Impact Section (CIS) and Family Impact Section (FIS). The random effect model was chosen and heterogeneity was evaluated using the I2 test. RESULTS: 2,013 articles were initially retrieved; 1,993 articles were excluded based on title and abstracts; 10 articles excluded after full-text analysis. Ten studies comprising a population of 7,461 preschool children were included in the systematic review and nine studies were included in the meta-analysis. TDI caused a negative impact on OHRQoL based on the overall ECOHIS (OR: 1.24; 95% CI: 1.08-1.43) and CIS (OR: 1.23; 95% CI: 1.07-1.41), but not the FIS (OR: 1.09; 95% CI: 0.90-1.32). CONCLUSIONS: TDI negatively impacted on OHRQoL of preschool children. The present findings indicate the need for TDI prevention and treatment programs in early childhood.

Exploring the impact of malocclusion and dentofacial anomalies on the occurrence of traumatic dental injuries in adolescents.

OBJECTIVE: To investigate the association between malocclusion/dentofacial anomalies and traumatic dental injuries (TDI) in adolescents. MATERIALS AND METHODS: The sample of this cross-sectional study comprised 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório, southern Brazil. Parents answered a structured questionnaire addressing demographic and socioeconomic characteristics. An examiner who had undergone a training and calibration exercise recorded malocclusion/dentofacial anomalies (Dental Aesthetic Index, DAI), TDI (Andreasen), and dental caries (World Health Organisation). Statistical analyses (SPSS software) involved Poisson regression with robust variance. RESULTS: The prevalence of TDI was 11.6%, and the prevalence of defined, severe, and handicapping malocclusion was 24.0%, 21.6%, and 22.0%, respectively. The multivariate analysis demonstrated that the probability of TDI was approximately twofold higher among adolescents with severe malocclusion (prevalence ratio [PR] 2.22; 95% confidence interval [CI] 1.14-4.31) and handicapping malocclusion (PR 1.95; 95% CI 1.01-3.85) in comparison to those with normal occlusion or minor malocclusion. Defined malocclusion was not significantly associated with the outcome. Among the dentofacial anomalies evaluated, the probability of TDI was nearly twofold higher among adolescents with overjet greater than 3 mm (PR 1.96; 95% CI 1.14-3.37) and 2.2-fold higher among those with an abnormal molar relationship (PR 2.24; 95% CI 1.17-4.32), after controlling for confounding variables. CONCLUSIONS: Severe and handicapping malocclusion, accentuated overjet, and abnormal molar relationship were strongly associated with the occurrence of TDI. Future studies should investigate whether the treatment of these conditions can help reduce the occurrence of TDI in adolescents.

Percepção do acadêmico frente ao atendimento odontológico de pacientes com necessidades especiais / Students' perception ofdental care forpatients with special needs

Pessoas com necessidades especiais são definidas como indivíduos que apresentam alguma condição que implica em hábitos e modos de vida diferenciados. Atualmente esse público compõe parte significante da sociedade, tornando imprescindível a criação de programas que facilitem o atendimento e tornem os profissionais capacitados para a resolução das condições diagnosticadas nesses pacientes. Desta forma, o presente trabalho teve como objetivo avaliar a percepção dos acadêmicos de Odontologia frente ao atendimento dos pacientes com necessidades especiais dentro do Projeto de Extensão "Um Sorriso Especial". Este estudo apresentou um delineamento qualitativo, e foi realizado por meio de entrevistas semiestruturadas comos 18 discentes de Odontologia doCentro Universitário Luterano de Palmas, noinício e ao final da participação noprojeto. Todos os dados foram coletados durante 2017/2 e 2018/1, sendo transcritos e analisados para apresentação dos resultados.As questões abordavam a respeito do conhecimento em relação a pessoas com deficiência, a motivação para participar do projeto e os sentimentos norteadores dos atendimentos. Os resultados mostraram,em sua maioria,mudanças positivas nos discentes, pois modificaram suas opiniões acerca do conceito de uma pessoa com deficiência, seus sentimentos antecedentes aos atendimentos, acrescendo sentimentos de gratidão e realização,além da maior percepçãosobre a importância do projeto na formação acadêmica. Portanto, conclui-se que a experiência no atendimento às pessoas com necessidades especiais dentro da graduação contribui para a formação de um profissional mais completo nos aspectos técnicos e humanos (AU).

People with disabilities are those who have a condition that requiresa differentiated approach by social entities. At presentthis public makes up a significant part of society, therefore,it essential to create programs that facilitatecare and trainprofessionals capable of treatingconditions diagnosed in patients withoutinterference. Basedon thispremise, the aim of the present study wasto evaluate the perception of Dentistry studentswith regard to providing care forpatients with special needs within the extension project "A Smile". This study hada qualitative design andwasconductedby means of semi-structured interviews held with18 students who participated in the project atthe dentistry clinic of an education institution inthe North ofBrazil. All data were collected duringthe periods of2017/2 and 2018/1.Statements weretranscribed and analyzed to enablepresentation of the results. The questions coveredknowledge aboutpeople with disabilities, thestudents'motivation to participate in the project and the feelingsthat guidedthe attendanceprovided. The qualitative results showed mostly positive changes inthe students' perceptionsbecausethey altered their views on the concept of a disabled person, their feelings prior to attendance, adding feelings of gratitude and Realization beyond the change inthe importance of the project in the academic formation. Therefore, it wasconcluded that the experience ofattending topeople with special needs within the undergraduateperiodcontributedto the formation of more complete professionals fromboth technical and humanepoints of view (AU).

Factors associated with caries: a survey of students from southern Brazil. / Fatores associados à cárie: pesquisa de estudantes do sul do Brasil.

OBJECTIVE: To describe the factors associated with dental caries among students from Santa Cruz do Sul, Rio Grande do Sul, Brazil. METHODS: A cross-sectional study was conducted in a random sample of 623 students of both genders, aged 10-17 years old. Tooth decay was performed using the index of the World Health Organization (1997), DMFT (permanent dentition) that expresses the sum of decayed, missing and filled teeth per person. The maternal educational level was rated using criteria of the Brazilian Association of Market Research Companies. The remaining variables were obtained by a structured questionnaire. Poisson regression analysis was used to test the association between variables using robust models and a subsequently adjusted model. Data were expressed as prevalence ratio (PR). RESULTS: Multivariate analysis identified the following factors related to the experience of dental caries: residence in rural municipalities (PR: 1.15; 95%CI: 1.0-1.3), attending a city school (PR: 3.30; 95%CI: 1.1-9.4) or a state school (PR: 3.40; 95%CI: 1.1-9.6); and having an illiterate mother or a mother that only attended up to the 4th year of school (PR: 1.67; 95%CI: 1.1-2.4) or high school (PR: 1.54; 95%CI: 1.1-2.2). CONCLUSIONS: The presence of caries in students in southern Brazil was associated with residence in rural areas, mother with little education and attendance to a public school.

Differences in body posture, strength and flexibility in schoolchildren with overweight and obesity: A quasi-experimental study.

BACKGROUND: Body posture and its components have been widely discussed, given the high prevalence of musculoskeletal disorders in children and adolescents. Among children and adolescents with overweight and obesity issues, these changes can be pronounced. OBJECTIVES: This study sought to investigate whether a global exercise routine could result in positive changes in the angles and distances measured in postural assessments and in the number of abdominal and flexibility exercise repetitions performed by children and adolescents with overweight or obesity. METHODS: A quasi-experimental design including an experimental group (EG) and a control group (CG) was used. The primary outcome variables included ratings of body posture (using SAPO software) and measures of abdominal muscle strength (number of sit-ups) and flexibility. The EG received an interdisciplinary intervention the included 48 sessions of global postural exercises performed three times a week. RESULTS: Of the 46 schoolchildren evaluated (EG, n = 23 and CG, n = 23), significant changes were observed in the EG from pre-to post-test in the thoracic angle (p = 0.001) and abdominal muscle strength (p = 0.016) for boys and in the thoracic angle (p = 0.010), abdominal muscle strength (p = 0.003) and flexibility (p = 0.010) for girls. CONCLUSIONS: Overall, the exercise program led to changes in the angle and distance measurements obtained in postural evaluations and contributed to increases in the number of repetitions of abdominal and flexibility exercises, indicating improvements in the EG group's body posture and health indicators.

Estágio Supervisionado em Odontologia no Sistema Único de Saúde: revisão integrativa / Supervised internship in dentistry in the unique health system: an integrative review

Este estudo visa analisar a relevância dosEstágios Supervisionados em Odontologia no Sistema único de Saúde para o ensino, serviço e comunidade. Trata-se deuma revisão de literatura integrativacombusca nas bases de dadosBVS/LILACS, SciELO e Google Acadêmico. Os estudos para análise foram escolhidos após o estabelecimento de critérios de inclusão(artigos publicados nos últimos 5 anosque tratem das percepções dos envolvidos nessa vivência de integração,autores clássicos, teses, relatos de experiência, artigos em português, inglês e espanhol)e exclusão(artigos semDOIoutratando deestágiosem outras áreasesistemas de saúde). Assim, após a busca inicial, foram selecionados 113 estudosno total sendo 25, 8e 100,respectivamente,da BVS/LILACS, SciELO e Google Acadêmico. No entanto, após a leitura dos artigos na íntegra somente 17publicaçõesforam selecionadas. Dessa forma, das competênciasgerais apresentadas pelas Diretrizes Curriculares Nacionais em Odontologia, os estudos indicam que trabalho em equipe, atenção integral à saúde do usuário e comunicação adequada com usuários e membros da equipe são as características mais estimuladasna formação dos estudantes. Ademais, destaca-se a atenção primária como principal cenário de atuação do estagiário, compouco enfoque nos demais níveis de atenção. Analisou-se que perante as fragilidades desse processo, o estudante, sob orientação da preceptoria, deve adaptar-se àrealidade vivenciada para exercer a sua função com sucesso. Logo, o estágio insere o estudante na realidade profissional,além de trabalhar as suas insegurançase a capacidade de adaptação (AU).

This study aims to analyze the relevance of Supervised Internships in Dentistry at SUS for teaching, serviceand community. This is an integrative literature review, which was elaborated through a search in the databases: BVS/LILACS, SCIELO and GOOGLE ACADEMIC. The studies for analysis were chosen after the establishment of inclusion criteria: articles publishedin the last 5 years dealing with the perceptions of those involved in this integration experience, classical authors, theses, experience reports, articles in Portuguese, English and Spanish; and exclusion: articles without DOI and dealing with internshipsin other areas and health systems. Thus, after reading the titles, 113 studies were selected in total, 25, 8 and 100 respectively from the BVS/LILACS, SCIELO and Google academic. However, after reading the articles in full, only 17 publications were selected. Thus, from the general characteristics presented by the National Curriculum Guidelines in dentistry, studies indicate that teamwork, comprehensive care to the user's health and adequate communication with users and team members are the characteristicsmost encouraged by academics. Furthermore, primary care is highlighted as the main scenario in which the intern works, with little focus on other levels of care. It was analyzed that, in view of the weaknesses of this process, the student, under the guidance of the preceptorship, must adapt to the reality experienced in order to successfully perform his role. Therefore, the internship inserts the student into the professional reality, in addition to working on their insecurities and adaptability (AU).

Association between overweight and obesity in schoolchildren with rs9939609 polymorphism (FTO) and family history for obesity.

OBJECTIVE: To determine the association between overweight/obesity in schoolchildren with FTO rs9939609 polymorphism (fatmass and obesity associated) and family history of obesity. METHODS: Cross-sectional study comprising a sample of 406 children aged 7-17 years in a city in southern Brazil. Overweight/obesity in schoolchildren was assessed by body mass index (BMI), and family history of obesity was self-reported by parents. Polymorphism genotyping was performed by real time PCR (polymerase chain reaction). The association between the nutritional status of schoolchildren with the presence of family obesity, stratified by polymorphism genotypes (AA [at-risk for obesity], AT, and TT), was assessed by prevalence ratio values (PR) through Poisson regression. RESULTS: Among schoolchildren with the AA genotype, 57.4% had overweight/obesity; the percentage was lower for the AT and TT genotypes (33.1% and 28.9%, respectively). Overweight/obesity in schoolchildren was associated with a family history of obesity, especially among children with the AA genotype. The prevalence was higher among those with an obese mother (PR: 1.28; p<0.001), obese maternal or paternal grandmother (PR: 1.22; p=0.047), and obese paternal grandfather (PR: 1.32; p<0.001). CONCLUSIONS: There is an association between the AA genotype of rs9939609 polymorphism and BMI among schoolchildren. The association between overweight/obesity in schoolchildren with a family history of obesity was found mainly among students with the AA genotype.

Perfil de utilização de anestésicos locais por cirurgiões-dentistas em pacientes hipertensos de uma cidade brasileira / Profile of use of local anesthetics by dental surgeons in hypertensive patients in a Brazilian city / Perfil del uso de anestésicos locales por cirujanos dentistas en pacientes hipertensos en una ciudad brasileña

Justificativa e Objetivos: O sucesso da técnica anestésica é fundamental para qualquer procedimento e garantia de segurança ao paciente, sendo sustentado por protocolos e fundamentos de caráter imperativo a fim de conferir o melhor atendimento. Nesse sentido, o presente trabalho verificará a utilização dos anestésicos locais, com ênfase em pacientes hipertensos, nos consultórios particulares da cidade de Palmas/TO. Métodos: Trata-se de um estudo descritivo, do tipo transversal de abordagem quantitativa realizado por meio de um questionário fechado de construção livre aplicado para profissionais do serviço privado de Palmas/TO, após assinatura do Termo de Consentimento Livre e Esclarecido. Foi realizada análise descritiva de 113 questionários por intermédio do Statistical Package for the Social Sciences 22.0. Resultados: Dos entrevistados, 58,4% eram mulheres, a especialidade mais encontrada foi implantodontia (20,4%); 53,1% apontaram que a escolha do anestésico é feita de acordo com a condição do paciente; 47,8% dos profissionais possuem mais de 3 tipos de anestésicos disponíveis para o atendimento; 53,1% apontou ensino de anestesiologia na graduação satisfatório; 65,5% não frequenta cursos e palestras sobre esse tema; 41,6% dos dentistas aferiam a pressão somente em hipertensos, lidocaína foi o sal mais utilizado de forma geral e também de forma especifica ao considerar somente hipertensos. Conclusão: O anestésico local mais utilizado em hipertensos é a lidocaína 2% com adrenalina 1:100.000, porém a maioria dos profissionais só afere a pressão arterial em já diagnosticados com hipertensão, expondo resultados relativamente satisfatórios em virtude de condutas que ainda necessitam ser readequadas.(AU)

Background and Objectives: The success of the anesthetic technique is f undamental to any procedure and guarantees patient safety, being supported by imperative protocols and fundamentals to provide the best care. This study verifies the use of local anesthetics, focusing on hypertensive patients in private offices of the city of Palmas/Tocantins. Methods: This is a quantitative cross-sectional descriptive study supported by a closed questionnaire of free construction applied to professionals from the private health service of Palmas; all participants signed informed consent forms. In total, 113 questionnaires underwent descriptive analysis using the Statistical Package for the Social Sciences 22.0. Results: Of the interviewees, 58.4% were women, the most common specialty was prosthodontics (20.4%); 53.1% answered that the choice of anesthetic is made according to the patient's condition; 47.8% of professionals have more than 3 types of anesthetics available for care; 53.1% indicated teaching anesthesiology in undergraduate courses satisfactory; 65.5% did not attend courses and lectures on this topic; 41.6% of dentists measured pressure only in hypertensive patients, lidocaine was the most widely used salt and specifically when considering only hypertensive. Conclusion: The most commonly used local anesthetic in hypertensive patients is lidocaine 2% with adrenaline 1:100,000, but most professionals only check blood pressure in patients already diagnosed with hypertension, showing relatively satisfactory results due to conducts that still need to be adjusted.(AU)

Justificación y objetivos: El éxito de la técnica anestésica es fundamental para cualquier procedimiento y garantía de seguridad del paciente, lo cual es respaldado por protocolos y fundamentos imperativos para brindar la mejor atención. El presente trabajo tuvo como objetivo verificar el uso de anestésicos locales en pacientes hipertensos en oficinas privadas de la ciudad de Palmas (Tocantins, Brasil). Métodos: Este es un estudio descriptivo, transversal, cuantitativo, en el cual se aplicó un cuestionario cerrado de construcción libre a profesionales del servicio privado de Palmas, después de firmar el término de consentimiento libre y esclarecido. Se analizaron 113 cuestionarios por medio del Statistical Package for the Social Sciences 22.0. Resultados: De los entrevistados, el 58,4% eran mujeres, la especialidad más encontrada fue la implantología (20,4%), el 53,1% señaló que la elección del anestésico se realiza según la condición del paciente, el 47,8% de los profesionales tienen más de 3 tipos de anestésicos disponibles para la atención, el 53,1% indicó que la enseñanza de anestesiología en cursos de grado fue satisfactoria, el 65,5% no asistió a cursos y conferencias sobre este tema, el 41,6% de los dentistas verificaron la presión solo en pacientes hipertensos, lidocaína era la sal más utilizada en general y también de manera específica cuando se consideraban solo pacientes hipertensos. Conclusión: El anestésico local más utilizado en los pacientes hipertensos es la lidocaína 2% con adrenalina 1:100.000, pero la mayoría de los profesionales solo ajustan la presión arterial en los pacientes ya diagnosticados con hipertensión, lo cual apunta resultados relativamente satisfactorios debido a las conductas que aún deben ser ajustadas.(AU)

Perfil de utilização de anestésicos locais de uma cidade brasileira com ênfase em diabéticos / Profile of use of local anesthetics in a Brazilian city with emphasis on diabetics

Objetivo: avaliar o conhecimento de cirurgiões-dentistas que trabalham em consultórios particulares de Palmas, Tocantins, quanto à utilização de anestésicos locais em pacientes portadores de diabetes mellitus. Materiais e método: trata-se de um estudo descritivo qualitativo, aprovado pelo Comitê de Ética em Pesquisa da FAMERP de São José do Rio Preto, sob o protocolo 032/2007 e CAAE: 0065.0.000.140-07, respeitando-se a Resolução 466/12, do Conselho Nacional de Saúde. A coleta de dados foi realizada por meio da aplicação de um questionário, utilizando um formulário estruturado. Resultados: de 113 participantes, 47 (41,6%) eram do sexo masculino e 66 (58,4%) do sexo feminino, com idade média de 35 anos. O anestésico mais utilizado pelos cirurgiões-dentistas avaliados foi a lidocaína 2% + adrenalina 1:100.000 (53,1%), o qual também é o mais utilizado para pacientes diabéticos controlados (64,6%). Quanto à variedade de anestésicos, 47,8% dos avaliados relataram possuir somente 3 tipos de anestésicos no consultório e que 83,2% nunca presenciaram nenhum problema decorrente do uso de anestésico. Além disso, 65,5% relataram não participar de cursos para atualização de conhecimentos, sendo que 53,1% mostraram-se insatisfeitos com o ensino de anestesiologia que receberam na graduação. Conclusão: observou-se que os cirurgiões-dentistas do atendimento odontológico particular de Palmas precisam de uma reciclagem profissional, a fim de atualizarem conhecimentos adquiridos na graduação sobre indicação e utilização de anestésicos locais em tratamentos odontológicos de pacientes com necessidades especiais, com ênfase em pacientes portadores de diabetes mellitus.(AU)

Objective: to evaluate the knowledge of dentists who work in private offices in Palmas, Tocantins, regarding the use of local anesthetics in patients with diabetes mellitus. Materials and method: this research is a qualitative descriptive study, approved by the Research Ethics Committee of FAMERP from São José do Rio Preto, under protocol number 032/2007 and CAAE: 0065.0.000.140-07 in compliance with the Resolution 466/12 of the National Health Council. Data collection was performed through the application of a questionnaire, using a structured form. Results: 47 (41.6%) out of 113 participants were male and 66 (58.4%) female, with an average age of 35 years old. The anesthetic most used by the dentists evaluated was lidocaine 2% + adrenaline 1: 100,000 (53.1%) which is also the most used for controlled diabetic patients (64.6%). As for the variety of anesthetics, 47.8% of those evaluated reported having only 3 types of anesthetics in the office and that 83.2% never saw any problems resulting from the use of anesthetics. Furthermore, 65.5% reported not participating in courses to update knowledge and 53.1% were dissatisfied with the teaching of anesthesiology they received during graduation. Conclusion: it was observed that dentists who work in private dental offices in Palmas need a professional retraining in order to update knowledge acquired during graduation on the indication and use of local anesthetics in dental treatments for patients with special needs, with an emphasis on patients with diabetes mellitus.(AU)

Bibliometric Analysis of the Scientific Production of the Pesquisa Brasileira em Odontopediatria e Clinica Integrada: 2007-2017

Objective: To analyze the bibliometric profile of articles published in the Pesquisa Brasileira em Odontopediatria e Clinica Integrada (PBOCI). Material and Methods: In this documental study, two trained examiners independently assessed the abstracts of all articles published between 2007 and 2017. Articles were categorized according to the study design, dental specialty and institutional affiliation of the main author. The full article was read whenever the abstract did not allow its classification. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: In total, 670 articles were identified, with predominance of publications in the areas of Pediatric Dentistry (33.3%), Community Health (18.7%) and Restorative Dentistry (12.2%). The most used designs were cross-sectional (58.3%), especially in the areas of Pediatric Dentistry and Community Health; and laboratory studies (25.7%), mainly in the areas of Restorative Dentistry and Endodontics. The Brazilian universities that most published in the Journal were the Federal University of Paraíba (9.7%), followed by the State University of São Paulo (6.4%) and University of São Paulo (6%), characterizing predominance of the Southeastern and Northeastern regions. The publications of authors with international affiliation represented 9.1%. The distribution among nations reveals studies from countries such as India (34.5%), Nigeria (14.8%), Bosnia (11.5%) and Iran (8.2%). Conclusion: PBOCI has provided Brazilian and foreign researchers the opportunity to disseminate studies in all areas of Dentistry, but studies in the fields of Pediatric Dentistry and Community Health are predominant. The most frequent designs were cross-sectional and laboratorial, and in relation to foreign participation, there is predominance of research from countries such as India, Nigeria and Bosnia.

Relação entre obesidade e presença de cárie dentária em adolescentes no município Santa Cruz do Sul-RS, Brasil / Relation between obesity and the presence of dental caries in adolescents in Santa Cruz do Sul municipality, Brazil / Relación entre obesidad y presencia de carie dental en adolescentes del municipio de Santa Cruz do Sul-RS, Brasil

OBJETIVO: O objetivo deste estudo foi identificar fatores associados com indicadores de obesidade e a manifestação de cárie dentária em escolares de Santa Cruz do Sul-RS, Brasil.MÉTODOS: Este foi um estudo transversal que envolveu uma amostra da população randomizada (12-17 anos) de 623 escolares de ambos os sexos. Os critérios da Organização Mundial da Saúde (OMS) foram usados para classificar a cárie dentária. O Índice de massa corporal (IMC) e a circunferência da cintura (CC) foram medidos, e o percentual de gordura corporal (% GC) foi avaliado através do somatório de dobras cutâneas. Modelos de regressão de Poisson foram utilizados para associar as variáveis, e foram adotados intervalos de confiança de 95%.RESULTADOS: A prevalência elevada do IMC foi detectada nos participantes do sexo feminino (59,8%) Razão de Prevalência (RP) excesso de peso: 1,01, IC 95%: 0,8-1,1; e a obesidade RP: 0,91, IC 95%: 0,7-1,1), CC (obesidade RP: 0,99, IC 95%: 0,8-1,1) e %G (RP moderadamente alto/alto: 0,99, IC 95%: 0,7-1,3), entretanto, não foram associados com a prevalência de cárie dentária.CONCLUSÃO: Os resultados não demonstraram associação entre IMC, CC e %G e cárie dentária em escolares do sul do Brasil. Entretanto, ressaltamos que o baixo nível socioeconômico e habitação rural foram associados com a cárie dentária. Estas descobertas ressaltam a importância da implementação de políticas públicas de saúde e medidas preventivas para a promoção da saúde oral(AU)

OBJETIVO: O objetivo deste estudo foi identificar fatores associados com indicadores de obesidade e a manifestação de cárie dentária em escolares de Santa Cruz do Sul-RS, Brasil.MÉTODOS: Este foi um estudo transversal que envolveu uma amostra da população randomizada (12-17 anos) de 623 escolares de ambos os sexos. Os critérios da Organização Mundial da Saúde (OMS) foram usados para classificar a cárie dentária. O Índice de massa corporal (IMC) e a circunferência da cintura (CC) foram medidos, e o percentual de gordura corporal (% GC) foi avaliado através do somatório de dobras cutâneas. Modelos de regressão de Poisson foram utilizados para associar as variáveis, e foram adotados intervalos de confiança de 95%.RESULTADOS: A prevalência elevada do IMC foi detectada nos participantes do sexo feminino (59,8%) Razão de Prevalência (RP) excesso de peso: 1,01, IC 95%: 0,8-1,1; e a obesidade RP: 0,91, IC 95%: 0,7-1,1), CC (obesidade RP: 0,99, IC 95%: 0,8-1,1) e %G (RP moderadamente alto/alto: 0,99, IC 95%: 0,7-1,3), entretanto, não foram associados com a prevalência de cárie dentária.CONCLUSÃO: Os resultados não demonstraram associação entre IMC, CC e %G e cárie dentária em escolares do sul do Brasil. Entretanto, ressaltamos que o baixo nível socioeconômico e habitação rural foram associados com a cárie dentária. Estas descobertas ressaltam a importância da implementação de políticas públicas de saúde e medidas preventivas para a promoção da saúde oral(AU)

OBJETIVO: El objetivo de este estudio fue identificar factores asociados con indicadores de obesidad y manifestación de carie dental en escolares de Santa Cruz do Sul-Rs, Brasil.MÉTODOS: Este fue un estudio transversal que envolvió una muestra de la población randomizada (12-17 años) de 623 escolares de ambos sexos. Los criterios de la Organización Mundial de Salud (OMS) fueron usados para clasificar la carie dental. El Índice de masa corporal (IMC) y la circunferencia de la cintura (CC) fueron medidos, y el porcentaje de grasa corporal (% GC) fue evaluado a través de suma de doblas cutáneas. Modelos de regresión de Poisson fueron utilizados para asociar las variables y fueron adoptados intervalos de confianza del 95%.RESULTADOS: La alta prevalencia del IMC fue detectada en los participantes del sexo femenino (59,8%) Razón de Prevalencia (RP) exceso de peso: 1,01, IC 95%: 0,8-1,1; y obesidad RP: 0,91, IC 95%: 0,7-1,1), CC (obesidad RP: 0,99, IC 95%: 0,8-1,1) y %G (RP moderadamente alto/alto: 0,99, IC 95%: 0,7-1,3), entretanto, no fueron asociados con prevalencia de carie dental.CONCLUSIÓN: Los resultados no demostraron asociación entre IMC, CC y %G y carie dental en escolares del sur de Brasil. Mientras, resaltamos que el bajo nivel socioeconómico y habitación rural fueron asociados con carie dental. Estos descubrimientos resaltan la importancia de la implementación de políticas públicas de salud y medidas preventivas para la promoción de salud oral(AU)

Relationship between anthropometric measures and cardiovascular risk factors in children and adolescents.

BACKGROUND: Obesity has been identified as an important risk factor in the development of cardiovascular diseases; however, other factors, combined or not with obesity, can influence cardiovascular risk and should be considered in cardiovascular risk stratification in pediatrics. OBJECTIVE: To analyze the association between anthropometry measures and cardiovascular risk factors, to investigate the determinants to changes in blood pressure (BP), and to propose a prediction equation to waist circumference (WC) in children and adolescents. METHODS: We evaluated 1,950 children and adolescents, aged 7 to 18 years. Visceral fat was assessed by WC and waist-hip relationship, BP and body mass index (BMI). In a randomly selected subsample of these volunteers (n = 578), total cholesterol, glucose and triglycerides levels were evaluated. RESULTS: WC was positively correlated with BMI (r = 0.85; p < 0.001) and BP (SBP r = 0.45 and DBP = 0.37; p < 0.001). Glycaemia and triglycerides showed a weak correlation with WC (r = 0.110; p = 0.008 e r = 0.201; p < 0.001, respectively). Total cholesterol did not correlate with any of the variables. Age, BMI and WC were significant predictors on the regression models for BP (p < 0.001). We propose a WC prediction equation for children and adolescents: boys: y = 17.243 + 0.316 (height in cm); girls: y = 25.197 + 0.256 (height in cm). CONCLUSION: WC is associated with cardiovascular risk factors and presents itself as a risk factor predictor of hypertension in children and adolescents. The WC prediction equation proposed by us should be tested in future studies.

Oral hygiene, dietary habits and prevalence of dental caries in adolescents from rural and urban areas in Rio Grande do Sul, Brazil / Higiene bucal, hábitos alimentares e prevalência de cárie dentária em adolescentes da zona rural e urbana no Rio Grande do Sul, Brasil

ABSTRACT Objective: To determine the condition of oral hygiene, dietary habits and prevalence of dental caries in adolescents, listing these habits and comparing residents from rural and urban areas. Methods: Cross-sectional study involving of 623 adolescents of both sexes, aged 12 to 17 year old in Santa Cruz do Sul, Brazil. Data were collected through sociodemographic questionnaires and dental examination. We conducted a descriptive analysis of the exposure variables and outcome. A bivariate analysis was then performed using the Chi-square test. Results: The prevalence of caries was 63.6%, in which adolescents living in rural areas had a prevalence of 70.7% and 56.4% in the urban area. The level of mother's education ≤4 years and socioeconomic class B1/B2 and C1/C2 showed statistically significant differences between the areas of residence. Among the demographic variables, the rural area showed a higher prevalence of caries. Conclusion: The results showed a high prevalence of dental caries among the adolescents studied and indicate a correlation between prevalence and the low level of mother's education, socioeconomic status (low to medium) and residence in rural areas. It should be understood that, while the multifactorial nature and stratified caries actions are not taken into consideration, the actions implemented will continue to fail, frustrating the expectations set by government entities.

RESUMO Objetivo: Verificar a condição de higiene bucal, hábitos alimentares e prevalência de cárie dentária em adolescentes, relacionando tais hábitos e comparando residentes da zona rural e urbana. Métodos: Estudo transversal, composto por 623 adolescentes de ambos os sexos, com idade entre 12 e 17 anos do município de Santa Cruz do Sul, Rio Grande do Sul, Brasil. Os dados foram coletados através de questionários sociodemográficos e exame clínico odontológico. Realizou-se análise descritiva das variáveis de exposição e desfecho. A análise bivariada foi realizada através de teste de qui-quadrado. Resultados: A prevalência de cárie foi de 63,6%, na qual os adolescentes da zona rural apresentaram prevalência de 70,7% e os da zona urbana 56,4%. O grau de instrução materna ≤4 anos e a classe socioeconômica B1/B2 e C1/C2 apresentaram diferenças estatisticamente significativas entre as zonas de moradia. Entre as variáveis demográficas, a zona rural apresentou maior prevalência de cárie. Conclusão: Os resultados evidenciaram alta prevalência de cárie entre os adolescentes e indicam uma correlação da prevalência com a baixa escolaridade materna, classe socioeconômica (média a baixa) e a residência na zona rural. Deve-se compreender que, enquanto não for levado em consideração a multifatoriedade e a ação estratificada da doença cárie, as ações implementadas continuarão falhando e frustrando as expectativas estabelecidas pelas entidades governamentais.

Oral and maxillofacial injuries in preschool children: a study in a hospital in southern Brazil

Oral and maxillofacial (OMF) injuries in children may lead to developmental and functional disorders. In this cross-sectional study, we analyzed the pattern of OMF injuries in preschool children admitted to the emergency department of a hospital in southern Brazil. Subjects and method: We retrospectively reviewed the medical records of 1,533 patients admitted from January to December 2011 to identify children aged 0 to 5 years with a diagnosis of OMF trauma. Data were collected on demographic, seasonal and clinical variables. Results: The sample consisted of 288 preschool children (aged 0-5 years) with OMF injuries. Of these, 61.1% were male and 53.2% were <3 years of age. Most children (84.8%) received first medical care from an dentist. Isolated facial injuries were the most common type of injury (85.1%) in this age group. Soft tissue injuries were the most common injury outcome (77.9%), occurring mainly in the nose and lips. Random accidents were the most common cause of OMF trauma (87.7%), and injuries due to falls occurred in 85.9% of these cases. The most common dental trauma was tooth displacement (69.6%). Conclusion: In conclusion, our findings indicate a higher prevalence of OMF injuries in soft tissues, especially in boys in the first three years of life. Falls were the leading cause of injury. Information related to OMF injuries in children are essential for the control of accidents and development of public health policies.