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

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

High p16INK4a immunoexpression is not HPV dependent in oral leukoplakia.

OBJECTIVE: To evaluate the prevalence of HPV DNA detection in fresh tissue from oral leukoplakia by Linear Array assay, and its correlation with p16INK4a immunoexpression in the northwest region of the São Paulo state, Brazil. PATIENTS AND METHODS: Fifty patients diagnosed with oral leukoplakia were included in the study. Sociodemographic, clinicopathologic and lifestyle data, fresh tissue and formalin fixed paraffin embedded (FFPE) tissue samples were collected. The fresh tissue was stored at -80 °C and then submitted to further viral DNA detection by the Linear Array method. Immunohistochemical analysis for the p16INK4a expression was performed. RESULTS: Of the 50 patients included in the study, 62 % were men, and the age ranged from 25 to 82 years. Twenty-three (46 %) were elderly, 46 % were middle-aged adults, and only 12 % were young adults. Most patients were smokers (76 %), 14 % were former smokers, and 10 % were non-smokers. Most patients (56 %) were current drinkers, 22 % were ex-drinkers and 22 % were non-drinkers. Thirty-two percent of the lesions presented some degree of dysplasia. No lesions were positive to HPV by Linear Array detection. Thirty (60 %) OL had p16-low immunoexpression and 20 (40 %) had p16-high immunoexpression. CONCLUSION: HPV was not identified in the population studied. The high p16INK4a immunoexpression is not dependent on HPV in oral leukoplakia. Broader epidemiological studies are required to clarify the geographic variability in the prevalence of HPV in head and neck squamous cell carcinoma and oral potentially malignant lesions.

Maus tratos infantis: avaliação do currículo dos cursos em odontologia / Child abuse: curriculum evaluation of dental courses in Brazil

O objetivo desta pesquisa foi avaliar se o tema maus tratos infantis é abordado nos cursos de graduação em Odontologia no Brasil. Trata-se de um estudo exploratório transversal descritivo, desenvolvido com todos os cursos de Odontologia do país. Foram enviados questionários aos 201 coordenadores e 174 foram recebidos, porém somente 28 retornaram respondidos (taxa de resposta de 16,09%). Destes, 19 (67,8%) correspondem a instituições privadas, 06 (21,4%) públicas e 03 (10,7%) de gestão compartilhada. A temática é abordada em 21 cursos (75%), principalmente nas disciplinas de odontopediatria, odontologia legal e saúde coletiva. Quanto à carga horária destinada a este tema, 16 cursos (21,19%) afirmaram ser igual ou menor que 08 horas e 14 coordenadores (66,66%) declararam ser obrigatória a abordagem de tal tema dentro do conteúdo programático do curso. Devido à importância do tema maus tratos infantis e frente aos resultados deste estudo, é pertinente concluir que este assunto tem sido trabalhado de forma incipiente nos cursos de odontologia no Brasil (AU).

The aim of this study was to evaluate whether the theme child abuse is addressed in the undergraduate dentistry in Brazil. This is a cross-sectional exploratory study, in which all universities in the country with the course of dentistry were questioned. Questionnaires were forwarded to all 201 coordinators of education of dentistry in Brazil, which consist in all existing courses at the time of the research. 174 questionnaires were received by the coordinators; however, only 28 were answered (response rate of 16.09%). Of these, 19 (67.8%) were private institutions, 06 (21.4%) public and 03 (10.7%) were joint management. The theme is approached by 21 institutions (75%), mainly in the disciplines of Dentistry, Forensic Dentistry and Public Health. Regarding the amount of hours designated for this theme, 16 institutions (21.19%) mentioned to reserve 08 hours or less during the course, on the other hand, 14 institutions (66.66%) stated that they were required to approach this issue within the course. Due to the importance of the theme child abuse and compared to the results of this study, it seems reasonable to conclude that this matter has been worked very incipient in Dental Courses in Brazil (AU).

Evaluation of p16ink4a expression and presence of HPV-16 DNA by real time PCR in patients with oral leukoplakia / Avaliação da expressão da p16Ink4a e a presença do DNA do HPV-16 pela Real time PCR em pacientes com leucoplasia bucal

Objetivo: Avaliar a expressão do p16Ink4a por imunohistoquímica e a presença do HPV16 pela Real time PCR em tecido fresco, plasma e saliva de pacientes com leucoplasia bucal (LB) e hiperplasia fibrosa inflamatória (HFI). Material e métodos: Foram incluídos 67 pacientes com o diagnóstico de LB e 44 pacientes com diagnóstico de HFI no estudo. Foram coletados dados sociodemográficos, clinicopatológicos, amostras de tecido fresco, sangue e saliva, que foram armazenados em um freezer a -80o C para realização de análise molecular. Também foi utilizado o tecido parafinizado para realização da imunohistoquímica para a p16Ink4a. As amostras de materiais biológicos obtidos dos pacientes foram submetidas à detecção do DNA do HPV-16 pela Real time PCR. O tecido parafinizado dos mesmos pacientes foram utilizados para avaliar a expressão da p16Ink4a pela imunohistoquímica. Resultados: Dos 67 pacientes incluídos de LB no estudo, 55,2% eram do sexo masculino com uma média de idade de 57,1 anos. Os pacientes idosos (>45 anos) compuseram 86,6% da amostra. As localizações anatômicas mais acometidas por LB foram a mucosa jugal (35,8%) e língua (20,9%). Sobre o tabagismo, 71,8% dos pacientes eram fumantes, onde a maioria (47,8%) foi classificada como tabagista leve. Em relação ao consumo de álcool, 47,4% eram alcoolistas, sendo a sua maioria classificada como alcoolista leve (59,3%). O grupo HFI foi composto por 54,5% pacientes do sexo masculino com uma média de idade de 57,3 anos. 90,9% dos pacientes eram idosos (>45 anos). A ocorrência das lesões foram em mucosa jugal (31,8%) e rebordo alveolar (25%). A expressão para p16Ink4a na LB foi fraca (41,8%) e para o grupo HFI, majoritariamente a expressão foi forte (68,2%). Real time PCR não detectou HPV-16 em nenhumas das amostras analisadas. Conclusão: Os achados em nosso estudo mostraram que a detecção de HPV de alto risco em tecido fresco, plasma e saliva para LB e HFI não se correlacionaram com a superexpressão da p16Ink4a(AU)

Objective: To evaluate the expression of p16Ink4a by immunohistochemistry and the presence of HPV-16 by Real time PCR in fresh tissue, blood plasma, and saliva of patients with oral leukoplakia (OL) and inflammatory fibrous hyperplasia (IFH). Material and methods: Sixty-seven patients with the diagnosis of OL and 44 patients with the diagnosis of IFH were included in the study. Sociodemographic, clinicopathological, fresh tissue, blood, and saliva samples were collected and stored at - 80o C for molecular analysis. Paraffinized-embedded tissue was also used to perform the immunohistochemistry for p16Ink4a. Samples of biological material obtained from the patients were submitted to HPV-16 DNA detection by real time PCR, both with specific probes. Paraffinized-embedded tissue from the same patients were used to evaluate the expression of p16ink4a by immunohistochemistry. Results: Out of the 67 included OL patients, 55.2% were male with a mean age of 57.1 years. Elderly patients (> 45 years) comprised 86.6% of the sample. The prevalence of lesions was highest in the buccal mucosa (35.8%) followed by the mobile tongue (20.9%). 71.8% were smokers and the majority (47.8%) was classified as light smoker. Regarding alcohol consumption, 47.4% were alcoholics, most of whom were classified as light alcoholics (59.3%). The IFH group was composed of 54.5% of male patients with a mean age of 57.3 years. 90.9% of the sample were elderly patients (> 45 years). The highest occurrence of the lesions was in buccal mucosa (31.8%) and alveolar ridge (25%). The expression for p16Ink4a in LB was mostly weak (41.8%) and for the IFH group, the expression was mostly strong (68.2%). There was no positivity in any of the samples for HPV-16 by real time PCR. Conclusion: Our findings showed the HR-HPV detection in fresh tissue, plasma blood and saliva for OL and IFH does not correlate with p16Ink4a immunoexpression in paraffinized-embedded tissue(AU)