Long-Term Follow-up of an Esthetically Demanding Case Using Slow Orthodontic Extrusion: A Case Report.

An internal root resorption lesion in the maxillary right central incisor was treated with orthodontic extrusion to improve the surrounding soft and hard tissue. Simultaneously with extraction, socket preservation was performed. After 4 months of healing, guided bone regeneration was performed and an implant was placed. At the second surgical phase, a flap was coronally advanced, and a connective tissue graft was placed. The emergence profile was modeled with a provisional crown before the final crown. The result was successful and well maintained over the 10-year follow-up period. The hard and soft tissue levels were stable, and no signs of inflammation were observed.

Bond Strength of Metallic or Ceramic Orthodontic Brackets to Enamel, Acrylic, or Porcelain Surfaces.

Bonding strategies within different brackets and dental materials are still a challenge concerning adhesion and dental surface damage. This study compared the shear and tensile bond strength of orthodontic ceramic and metallic brackets to enamel, acrylic, and ceramic surfaces after thermal cycling. Dental surfaces were divided into three groups: enamel, ceramic, and acrylic. Each group received stainless-steel and ceramic brackets. After thermal cycling, specimens were randomly divided into two subgroups considering tensile (TBS) or shear bond strength (SBS) test. After the mechanical testing, scanning electron and optical microscopy were performed, and the adhesive remnant index (ARI) was determined. The two-way ANOVA full factorial design was used to compare TBS, SBS, and ARI on the surface and bracket type (α = 0.05). There were significant differences in TBS, SBS, and ARI values per surface (p < 0.001 and p = 0.009) and type of bracket (p = 0.025 and p = 0.001). The highest mean SBS values were recorded for a ceramic bracket bonded to an acrylic surface (8.4 ± 2.3 MPa). For TBS, a ceramic bracket bonded to acrylic showed the worst performance (5.2 ± 1.8 MPa) and the highest values were found on a metallic bracket bonded to enamel. The adhesion of metallic or ceramic brackets is enough for clinical practice although the damage of the enamel surface after debonding is irreversible and harmful for the aesthetic outcome of the teeth.

Brazilian community health agents and qualitative primary healthcare information.

AIM: The aim of this study was to explore female community health agents' views about the value of recording qualitative information on contextual health issues they observe during home visits, data that are not officially required to be documented for the Brazilian System of Primary Healthcare Information. BACKGROUND: The study was conducted in community primary healthcare centres located in the cities of Araçatuba and Coroados (state of São Paulo) and Rio de Janeiro (state of Rio de Janeiro), Brazil. METHODS: The design was a qualitative, exploratory study. The purposeful sampling criteria were being female, with a minimum of three years of continuous service in the same location. Data collection with 62 participants was conducted via 11 focus groups (in 2007 and 2008). Audio files were transcribed and submitted to the method of thematic analysis. Four themes guided the analysis: working with qualitative information and undocumented observation; reflecting on qualitative information; integrating/analysing quantitative and qualitative information; and information-sharing with agents and family health teams. In 2010, 25 community health agents verified the final interpretation of the findings. FINDINGS: Participants valued the recording of qualitative, contextual information to expand understanding of primary healthcare issues and as an indicator of clients' improved health behaviour and health literacy. While participants initiated the recording of additional health information, they generally did not inform the family health team about these findings. They perceived that team members devalued this type of information by considering it a reflection of the clientele's social conditions or problems beyond the scope of medical concerns. Documentation of qualitative evidence can account for the effectiveness of health education in two ways: by improving preventative care, and by amplifying the voices of underprivileged clients who live in poverty to ensure the most appropriate and best quality primary healthcare for them.

Caminhos para a institucionalização do protagonismo juvenil na SMS-Rio: dos adolescentros ao RAP da Saúde / Pathways to institutionalization of Youth protagonism in the Municipal Secretariat of Health of Rio de Janeiro: from Adolescenters of Health RAP

Este trabalho visa descrever duas iniciativas de protagonismo juvenil implementadas pela Secretaria Municipal de Saúde do Rio de Janeiro (SMS-RJ), que estão interligadas e se complementam. A primeira é o Adolescentro Paulo Freire, um espaço de formação, acolhimento, aconselhamento, matriciamento e promoção da saúde vinculado à Clínica da Família Dr. Rinaldo De Lamare, com foco em adolescentes e jovens. A segunda, a Rede de Adolescentes e Jovens Promotores da Saúde, RAP da Saúde, projeto desenvolvido por meio de convênio com a ONG Centro de Promoção da Saúde (CEDAPS). O RAP da Saúde tem como objetivo ampliar as ações de promoção da saúde na cidade do Rio de Janeiro por meio do protagonismo juvenil e da intersetorialidade. Foram implantadas equipes de jovens promotores em oito unidades de saúde e espaços comunitários com realização de atividades de qualificação dos jovens e profissionais, articulação intersetorial, produção de materiais, disseminação da metodologia, participação em espaços de implementação de políticas públicas, entre outras. Percebe-se o fortalecimento da autoestima dos jovens promotores da saúde; o desenvolvimento de suas habilidades e competências; a qualificação das atividades educativas nas unidades de saúde; a disseminação da metodologia de educação entre pares; ampliação de ações intersetoriais em parceria; a criação de novas técnicas e vídeos para trabalhar temas de saúde e cidadania e, sobretudo, visibilidade positiva para os adolescentes e jovens das comunidades populares. O protagonismo juvenil é uma estratégia potente para promover saúde e desenvolvimento para os próprios jovens e suas comunidades(AU)

This paper aims to describe two juvenile initiatives, implemented by the Municipal Secretariat of Health of Rio de Janeiro, which are complementary and interconnected. The first is the Adolescenter Paulo Freire, a space for training, counselling and health promotion, connected to the Family Health Clinic Dr. Rinaldo De Lamare focused on adolescents and youngsters. The second, the Network of Adolescent and Youth Health Promoters, (RAP of Health), a project implemented through a cooperation with the NGO Center of Health Promotion (CEDAPS), which target is to increase health promotion activities in Rio de Janeiro through juvenile protagonism and intersectorality. Teams of Young Health Promoters were inserted in eight Health Units or community spaces achieving training activities to youngsters and professionals, intersectoral articulation, production of materials, dissemination of the methodology, participation in spaces of implementation of public policies, among others. The strengthening of the self-esteem of the young health promoters is noticed as well as the development of their abilities and competence, the quality of the educational activities in Health Units, the dissemination of educational methodology among peers, the increase of intersectoral partnership actions, the creation of new techniques and videos to work on health topics and citizenship and, most of all, the positive visibility of teens and youngsters from low income communities. Youth protagonism is a powerful strategy to promote health and development for themselves and their communities(AU)

Motivação para a amamentação: Estudo de fatores predisponentes / Motivation for breastfeeding: Study of predisposing factors

Apesar de o leite materno ser uniformemente aceite como o alimento mais completo e efetivo para assegurar a saúde do bebé, além dos claros benefícios para a mãe (OMS, 1991, 1992, 2002, 2004; Meyers, 2009), verifica-se que a taxa de amamentação do nosso país está ainda longe da pretendida (DGS, 2004a, 2004b; Orfao, Santos e Magalhães, 2013). Vários estudos (Mozingo et al., 2000; Gill, 2001; Galvão, 2003; Marinho e Galvão, 2003; Leal, 2004, 2005; Cardoso, 2006; Maia, 2007; Pinto, 2008; Bértolo e Levy, 2008) têm tentado determinar os fatores relacionados com este insucesso, ainda que poucos se centrem diretamente na influência da motivação (Nelas, Ferreira e Duarte, 2008, 2011; Takushi et al., 2008; Stockdale et al., 2008). O objetivo geral deste estudo é então conhecer alguns fatores associados à "Motivação para a amamentação" das puérperas do Hospital dos Lusíadas (HPP- HL), às 48h pósparto. Realizou-se nesse sentido um estudo quantitativo, descritivo-correlacional, com a aplicação de um questionário sociodemográfico, obstétrico, clínico e contextual, que incluiu uma adaptação traduzida da escala "Breastfeeding Motivacional Instructional Measurement Scale (BMIMS)" (Stockdale et al., 2008). Participaram 106 puérperas selecionadas por amostragem não probabilística acidental (Fortin, 2009), entre 2 de janeiro e 30 de setembro de 2012. Os resultados indicam valores moderadamente elevados de motivação para a amamentação, com perceção da importância da mesma, mas também da sua complexidade e da necessidade de apoio próximo e contínuo por parte dos profissionais de saúde. Verificou-se que a motivação para a amamentação é influenciada pelo número de consultas e formação/informação sobre amamentação recebida durante a gravidez. Verificou-se ainda relação entre o aleitamento materno exclusivo às 48h e a expectativa de sucesso. O contacto pele-a-pele e a amamentação na 1.ª hora pós parto apresentam uma tendência para se correlacionarem com a motivação para a amamentação, em especial com a perceção de suporte das enfermeiras. Estes resultados contribuem para uma melhor compreensão dos fatores associados à motivação para a amamentação, fornecendo resultados para programas de intervenção, contribuindo assim para a melhoria dos índices nacionais de prevalência desta prática, bem como para o início da validação de um instrumento internacionalmente reconhecido, que apresentou boas propriedades psicométricas.

Function, aesthetics and biomimetics in the interdisciplinary treatment: concerning a clinical case

The evolution of dentistry and dental specialties allowed for a clear improvement in the quality of treatment results for the patient's complete oral rehabilitation, considering both functional and aesthetic aspects. An adult patient's aesthetic and functional rehabilitation present an even more difficult challenge for the dental professional, particularly in those situations where the treatment involves an intimate collaboration between different specialties, demanding a critical planning. We will present a clinical case which involved an interdisciplinary approach, where the operative sequence and the multidisciplinary approach exerted in this case illustrates the importance of specialised knowledge and professional communication