Aspectos clínicos, radiográficos e histológicos da superfície oclusal de molares decíduos com e sem lesão de cárie: estudo in vitro

Fundação de Amparo a Pesquisa do Estado de São Paulo

Avaliacão da satisfação do usuário e da qualidade dos tratamentos endodônticos em Centros de Especialidades Odontológicas da Grande Natal-RN

Objective: To evaluate the degree of users satisfaction and technical quality of endodontic treatment in specialized dental clinics (CEO) of Grande Natal / RN between 2006 and 2008. Methodology: evaluated 282 endodontically treated teeth in CEOs through clinical and radiographic examinations. A questionnaire about the clinical condition of the tooth, evaluation of care and satisfaction with treatment was applied. Data on pre-and trans-operative were noted by the patient's clinical record. Endodontically treated teeth were examined by a specialist in endodontics, which compared with previous radiographs and current ones. The collected datas were presented descriptively by absolute numbers, percentages, averages. To determine the association between the independent and dependent variables was carried out through the bivariate association test Chi-square and Fisher exact test. Results: 79.8% presented with radiographic normal and 84.4% without pain symptoms. 8.2% of the teeth were fractured and 3.2% extracted. The persistence of the periapical lesion was associated with initial periapical status (p <0.05). 91.5% of patients are satisfied with the outcome of treatment. Such satisfaction is associated with absence of pain and an adequate esthetic tooth position (p <0.05). Conclusion: endodontic treatment in specialized dental clinics have an adequate technical quality, resulting in the success of endodontic therapy performed in these centers and that users are satisfied with the treatment

Atuação profissional e vivência do cirurgião-dentista na estratégia do programa de saúde da família

The purpose of this research was to analyze the working profile of dentists from the Family Health Program (PSF Programa de Saúde da Família, Brasil) of some Municipal Districts of Rio Grande do Norte (Brazil) in order to understand the way they handle the experience acquired with the work developed in that Program. This discussion evolves a reflection about the perspectives of consolidation of the FHP as well as the possible advancements of the Brazilian Unified Health System (SUS - Sistema Único de Saúde). The target population was composed of dentists from the FHP of Rio Grande do Norte. Thus we performed twenty-one interviews orientated by a semi-structured guidebook with open questions and identification data. We opted for recording the speech of all the professionals in order to ensure the accuracy of the information gathered. The main results found were: predominance in the female gender; the majority of dentists has no post graduation courses; in those few cases of dentists with some post-graduation a lack of correlation with Public or Collective Health was observed; the dentists interviewed present a profile directed to clinical activities; the dentists used to develop basic restorative and periodontic treatment, simple surgeries and educative and preventive activities, even though the last two ones are carried out in an extremely traditional way (lectures and topical application of fluoride). In addition, as biggest difficulties to manage the work dentists pointed out the lack of permanent and consumer material, inadequate infrastructure, no transport to take them to distant places, no integration with the Health Family Team, technical difficulty such to perform educative and preventive activities as to provide adequate service to a repressed lawsuit. The results indicate the existence of a necessity to lead them to reflect and redirect their practices. In order to reach this aim it must be considered as initial measure the investment and encouragement toward to permanent education as well as a close follow-up and evaluation of the actions developed by them

Medo de dentista em cena: uma análise de produções cinematográficas

The fear related to dental procedures can be acquired through disturbing experiences and/or negative cultural influences related in experiences of previous generations. Such influences may be present in diverse forms of cultural expression: in the cinema, plastic arts, music, literature, and diverse vehicles of printed and visual media. This research aimed investigates the images of fear related to the dental service and dentist in motion pictures. The study has qualitative approach, which used the documentary analysis of movies. The data collection was accomplished through research in the Internet by means of the Google tool (http://www.google.com.br), using the describing words filme and dentista . A total of 44 films were found. Of these, after selective criterion for films with scenes showing interaction between dentist and patient in the execution of clinical procedure, only 24 films were enclosed. Then, these were registered in data base created for this research. After second selective criterion of inclusion (scenes with suggestion of dental anxiety), 15 films remained. As regards cinematographic gender, the films with scenes showing "dental anxiety" varied between comedy (8), horror (3), drama (2), thriller (1) and childish (1). Of these films, scenes with images of situations that suggest fear of the dentist and his job were selected and described. The images were categorized by the identification of negative characteristics that incite "dental anxiety". Then, the classification of the categories was proceeded detaching the most recurrent characteristics in the scenes: situation of fear in the waiting-room; pain; instrument coarse/rudimentary; coarseness of the dentist; torture; and low qualification technique. The waiting-room was observed as a place of great tension, due to the noises coming from the dental attendance. The pain related to the Dentistry was the predominant subject in the majority of films (14), associated to others negative characteristics. The rudimentary aspects of procedures and instruments, and the coarse attitudes of the professional could be observed too. The dentist was characterized as confused, sadist, violent, insensitive, incompetent person and disturbed. Such results suggest that, despite the technological advances of the profession, the image of the dentist and his job is still transmitted in a negative way aspect and reinforces the dental anxiety

Validação de um método auxiliar de diagnóstico como preditivo da presença de cárie de dentina em dentes decíduos

Esse estudo se propôs a avaliar um método auxiliar de diagnóstico (DIAGNOdent®) na predição de cárie de dentina em dentes decíduos, através de validação histológica e de microdureza. Verificando possíveis diferenças entre os valores obtidos através do método auxiliar, além de determinar um ponto de corte para parada de remoção de tecido cariado. A amostra do estudo foi de 15 crianças que apresentaram 21 cavidades de cárie, tratadas e analisadas desde antes da realização da restauração até quando da exodontia do elemento dentário. Os espécimes foram analisados através do DIAGNOdent® antes da abertura das cavidades, após a remoção do tecido cariado e depois da reabertura das cavidades que se deu após a exodontia dos elementos dentários. Posteriormente, receberam preparo metalográfico para realização de testes de microdureza e microscopia óptica que serviram como forma de validação para as mensurações obtidas pela fluorescência a laser. Houve diferença significativa entre os valores DIAGNOdent® encontrados antes da abertura da cavidade e os demais (p < 0,0001). Havendo correlação significativa (r = 0,432 ; p = 0,019) apenas para as aferições obtidas antes da abertura das cavidades e quando do término da remoção do tecido cariado. Para a microdureza, as médias axiais foram significativamente maiores que as pulpares, existindo correlação entre a microdureza pulpar e os valores do DIAGNOdent® após a reabertura (r = - 0,472 ; p = 0,002). Valores de 15,38% para a sensibilidade, 100% para a especificidade, 100% para o valor preditivo positivo e 71,79% para o valor preditivo negativo, foram obtidos quando se utilizou um ponto de corte de 30 para fluorescência a laser, tendo como padrão-ouro a microdureza pulpar. Partindo da média dos valores de fluorescência a laser obtidos após a remoção do tecido cariado e acrescentando-se um desvio-padrão a esta, o método indicou o valor de 19 como ponto de corte para cessar a remoção de dentina. Concluiu-se que, nas condições analisadas, o método auxiliar de diagnóstico (DIAGNOdent®) é um método acurado na predição de cárie de dentina em dentes decíduos. Além disso, o método comprovou que o padrão usual de remoção de dentina garante a remoção do tecido cariado

A documentação odontológica sob a ótica dos cirurgiões-dentistas de Natal-RN

The dental documentation or handbook is a collection of documents produced by the professional with diagnostic and therapeutical purpose where the inherent information to the buccal and general health of patients are registered. The register and proper filling of these documents, taking care of the ethical and legal requirements, provide to the dentist the possibility to contribute with justice in cases of human identification and makes of these documents an essential element of evidence in the ethical processes, administrative, civil and criminal against the dentists. Ahead of this fact, understanding such requirements and the importance of the dentist to register himself adequately, this research verified the knowledge of Natal (RN) City s dentists with relation to the elaboration of the dental handbook, investigating the concepts and the importance attributed to the handbook, identifying the documents more used and filed by these professionals, besides inquiring the legal value of filed documents and the filling time of these ones. The sample was constituted by 124 dentists, who had answered a questionnaire, after having been randomly selected ITom a list of professionals subscribed in the Dentistry Local Council/RN Section. The analysis of the results showed that majority of the participant citÍzens (52,3%) confers to the dental documentation the clinical importance, followed by the legal and forensic-dentistry importance; 59,3% of the searched professionals do not distinguish satisfactorily or they do not observe differences between the dental handbook and the clinical filing card, the X-rays, the dental certificates, the prescriptions, the directions and the receipts; between the documents of common use to clínical and specialist ones, the contract of rendering of services and term of ITee and cleared up consent are the documents less used by the professionals. It was still verified, that only 13,1% of the sample register the signature of the patients in the clinical filing card, making it more credibility to be presented in judgement. In the same way, copies of dental certificates and prescriptions evaluated and signed by the patients are filed respectively by only 13,5% and 9,4% ofthe searched professionals and 50% ofthe sample, keep these documents filed for an indeterminate period of time, that is, these professionals have the guard of the handbook and they do not intend to disdain it, although 85,5% of the sample does not recognize the real proprietor of the handbook. It is concluded that a great part of the dentists is unaware about the importance of the dental documentation, and neglect its elaboration, leaving themselves exposed to several kinds of penalties foreseen in the legislation

A Perda Auditiva Induzida pelo Ruído (PAIR) na formação odontológica: conhecimentos e níveis de exposição

The rationalization of work in the Dentistry has been taking the professional to work for ways and systems based in the ergonomics, turning their work efficient and less tiring. Since their academic formation, the dentists surgeons are concerned with the high productivity in clinic and with the final result of the work, neglecting the way as it is executed, which reduce their work capacity and exhibits them to occupational diseases that could be minimized and/or forewarned. This research had as the main objective to investigate the knowledge of the Dentistry academics of Rio Grande do Norte Federal University concerning the Noise-induced Hearing Loss (NIHL), relating them at the noise levels that they are exposed, as well as to the preventive measures taken during the clinical activities. Was observed that 95% of the individuals know that the dentist surgeon is a professional in risk for NIHL. Among the causes of NIHL, the one that obtained the largest frequency citation was the high-speed handpieces, reminded by 92,4% of the academics. Among the students which enumerated protective measures for NIHL, 92% mentioned the use of the ear plugs, although 97% of the researched have told do not use any kind of preventive measure related to the noise. Was also observed that 96% of the academics notice the noise during the clinical attendance, what inconvenience 28,1% of them. Related the noise levels, the high-speed handpieces of the academics presented a medium value of 80,5 dB varying from 72,3 to 88,3 dB. The average of the ambient noise observed at the Integrated Clinic was about 74,8 dB. In spite of the noise levels in this research were observed below the established limits of tolerance by the legislation, they can provoke damages to the Dentistry professionals' health, or that suggests the need of an intervention and use of immediate preventive measures able to generate a healthy atmosphere of work and less risky

Relação entre a doença periodontal e doença cardiovascular: há uma preocupação por parte dos que fazem clínica médica e odontológica na cidade de Natal?

The relationship between periodontal and cardiovascular diseases is a reality in the current days. The knowledge about the role of periodontal disease as a risk factor to cardiovascular disease from dentistry and physicians is very important to try to eliminate this risk factor. The aim of this work was to investigate, using a questionary, if physicians and dentistry are aware about this relationship and if they think that it is important. These forms were distributed in 4 groups: cardiologists (n=90), physicians from other specialist (POS) (n=110), periodontists (n=35) and dentistry from other specialist (DOE) (n=85). We had a loss off 32,4% of the total sample due to a lack of response of some professionals. Our results showed that all cardiologists, all dentists and 68,2% of POE said that they had gotten information about the relationship between periodontal and cardiovascular disease, and just 6 POS don t believe that this relationship can occur. When questioned if, even when a periodontal disease is diagnosed, there is a habit to treat or orient the patient for treatment, 29,5% of cardiologists answered no, 25,5% of POE also answered that they did not orient and only 1 DOE answered that he did not treat nor orient. All periodontists said that treat their patients when periodontal disease was identify. The physicians seem not to find important the relationship that exist between periodontal and cardiovascular diseases and the dentistry have shown a good knowledge about this subject. Maybe, if physicians and dentistry work together, the incidence of cardiovascular disease decreases

Eficácia do cimento de ionômero de vidro como selante oclusal sobre a paralisação de lesões cariosas em dentina

Dental caries consists in a multifactorial and dynamic process. The knowledge of the ionic interactions among dental tissues and dental biofilm make possible its understanding as a process that can be stopped. Recently, the use of sealants have lost its function as preventive agent and passed to be argued as a possible therapeutical agent. This happens by hindering the substratum flow to the lesion inner and, therefore, controls the advance of the process. This study aimed to evaluate glass ionomer cement as a not invasive technique of treatment in occlusal caries without clinical cavitation, but with dentinal involvement. The research was accomplished using a controlled clinical trial with two groups (experimental and control) in 38 subjects (8-18 years) with 51 molars. The teeth of the experimental group were sealed with glass ionomer cement (Vidrion-R, S.S.White, Juiz de Fora, Brazil) and the molars control did not suffer intervention. The experimental group was followed by a year and the control by 8 months due the progression of the carious injury. Both groups were reevaluated to each 4 months with the use of clinical, radiographic and laser fluorescence (DIAGNOdent®) examination. The analysis of the clinical evaluation did not observe a significant difference between experimental and control groups. However, analysis with radiographic and laser fluorescence (DIAGNOdent®) examination observed a significant difference (p> 0,05) between groups, demonstrating a wors condition to the group without intervention. The results suggest that glass ionomer cement as sealant can be efficient to paralyze dentinal caries without clinical cavitation

Avaliação dos níveis de proteína C-reativa ultra-sensível em pacientes com periodontite crônica severa generalizada e sem periodontite

INTRODUCTION: The high sensitivity C-reactive protein (hsCRP) constitutes an inflammatory mediator used as predictor of cardiovascular risk that comes being researched as indicative relation factor between cardiovascular and periodontal diseases. PROPOSITION: To compare serumals levels of C-reactive protein between patients with and without generalized severe chronic periodontitis. METHODOLOGY: A seccional study was realized using a sample with 62 patients, being 31 participants carriers of periodontal diseases (Group I) and 31 without periodontal diseases (Group II), grouped to the pairs by age and sex. As inclusion criterio were selected patients with diagnosis of generalized severe chronic periodontitis, being preculeds, individuals which presented systemic disease, recent infection history, historical of CVA or stroke, smokers, pregnants and lactants. The research consisted of two stages, a clinc and other biochemist. The clinical stage is constituted of periodontal examination and the biochemist stage, of the peripheral blood collection for determination hsCRP levels and a hemogram to inquire any panel which could suggest infectious and/or inflammatory process. RESULTS: Periodontal disease group presented a average of 0,36mg/dL, while the group without disease presented 0,17 mg/dL, do not existing significant difference statistically between the averages (p = 0,061). The cardiovascular risk for the group I was classified high for 27,6% of participants and low for 72,4% of them. In the group II, 6,45% presented high risk e 93,5% low risk, being this significant relation statistically gotten for Fisher s Test (p = 0,042) presenting OR = 5,33; IC = 95% (1,02 27,4). The independets variables reseacred do not presented significant association statistically with the levels of hsCRP. CONCLUSION: The study indicated that despite of carriers patients of periodontal diseases do not present differents serumals levels of hsCRP from the other group, the periodontal disease was considered as risk factor for hsCRP plasmatic levels elevation

Avaliação da qualidade da atenção primária à saúde da criança no Rio Grande do Norte: visão das usuárias

The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS

Avaliação da eficiência da técnica de obturação pela compressão hidrùlica vertical após instrumentação automatizada

The purpose of this study was to evaluate through radiographic and microscopic analysis the efficiency of the filling techniques by vertical hidraulic compression after the root canal mechanical instrumentation in vitro as well to evaluate the marginal apical leakage through macroscopic and microscopic analysis. Thirty human mandibular molars were used , they were divided on three groups, these were subdivided on six subgroups with five specimens each, come down to 106 root canals filled. Initially, the teeth were instrumented with Profile system series 29 and filled with two ways: single accessory cone or single cone associated with gutta-percha secundary cone, with Fill Canal sealer or Sealer 26. Completed the filling, the teeth were coated with araldit and finger -nail polish except for the apical 2 mm and dried for 3 hours, thep radiographs were taken of the teeth in orto and disto-radiai directions. Next, the coronal seal was carried out with composite resin photopolymerized and with their process of making impermeable. Teeth of positive controls were used without araldit and finger-nail polish whereas the negative controls were used with total coat of araldit and finger-nail polish. The specimens were placed in 2% Methylene Blue dye for 24 hours and thermocycled for 7 days. Afterwards, sections were made of each tooth at mesial and distal roat, after this the teeth were radiographed at buccolíngual direction for a macroscopic analysis and at buccolingual and mesiodistal directions for assessment of the marginal apical leakage. Cross sections were made 3 mm to 3mm since the tooth apice. The sections obtained for each group were observed with a stereomicroscope to evaluate the quality of the root canal filling and the marginal apical leakage. The results showed that: In the four techniques the marginal dye leakage was present in the apical third; in all groups the quality of the root canal filling in the radiography was better at mesial root canal and the single cone technique showed inefficient when only a single distal root canal was present. In the radiographic evaluation the best quality of the root canal filling was observed in the 1A group (single accessory cone + FiIl Canal), as in the mesial root as in the distal root wich Shcwed twe root canals: when the distaI root had only one canal. the best result was showed by 28 group (single accessory cone associated with secundary cone + Fill Canal) In the macroscopic analysis of longitudinal !eaKage (outside surface). less leakage was showed as In the mesial root as in the distal root in the negative control group (3) followed 2A group (single accessory cone + Sealer 26). When the microscopic analysis of tranversal leakage of both roots (inside surface) was carried out. the groups that showed less dye leakage were the negative control (38) followed the 28 group (single acessory cone associated with secundary cone + Sealer 26). The homogeneity o filling was best noted in the 1 A group (.single accessoty cone + Fill Canal). The groups that showed less dye penetration in the tranversal leakage (total area) were negative control (3B) and 2B

Análises clínicas, radiográfica e microscópica de molares permanentes sem ou com lesão de cárie na superfície oclusal

O presente trabalho, objetivou avaliar comparativamente o diagnóstico clínico, radiógráfico e histológico de molares permanentes humanos sem ou com lesão de cárie na superfície oclusa!. Vinte e quatro dentes que estavam armazenados em formalina a 10% foram selecionados e em seguida submetidos a um exame clínico, através da inspeção visual, onde foram separados em 3 grupos: grupo 1 (G1), formado por dentes hígidos; grupo 2(G2), por dentes com pigmento na superfície oclusal e grupo 3(G3), aqueles com lesão de cárie na oclusal. Este exame foi realizado com auxílio de luz artificial proveniente de um refletor odontológico, sem qualquer manipulação da superfície. Para cada dente foram realizados duas tomadas radiográficas com e sem tela milimetrada, no sentido vestibulo lingual por um dos avaliadores, simulando uma radiografia interproximal, onde o feixe incidiu perpendicular ao longo eixo do dente. Em seguida os dentes foram preparados histomorfologicamente para coloração com hematoxilina e eosina e análise microscópica. Pela avaliação dos resultados a partir da amostra de 100%, foi possível concluir: 1) Os dentes clinicamente considerados hígidos (G1) apresentaram radiograficamente 74,99% de ausência de imagem radiolúcida e em 25% presença desta imagem na Junção Amelo¬dentinária e microscopicamente ausência de cárie em 100%; 2) os dentes que clinicamente apresentaram fissura pigmentada' (G2) notou-se em 33,33%, ausência da imagem radiolúcida e em 66,66% presente esta imagem na junção amelodentinária, 100% de ausência de cárie através da análise microscópica; 3) clinicamente, os dentes que apresentaram lesão de cárie (G3), radiograficamente foram comprovados 100% de imagem radiolúcida sugestiva de cárie e microscopicamente dos 100% destas, foram considerados cáries rasa (16,66%), média (61,10%) e profunda (22,22%) respectivamente

Avaliação imuno-histoquímica da BMP-2, BMP-4 e seus receptores (BMPRIA e BMPRII) em ameloblastomas e tumor odontogênico adenomatóide

BMPs are components superfamily ligands transformation growth fator-β (TGF-β) secreted into the extracellular environment, with mechanisms of intercellular communication through specific ligands and receptors in various target cells, being recognized for its influence in osteogenic induction, also play an important role in tissue homeostasis, cell proliferation, differentiation control , in addition to being present in the development of various malignancies. The aim of this study was to compare the immunohistochemical expression of BMP-2, BMP-4 and its receptors BMPRIA and BMPRII in cases of ameloblastoma and adenomatoid odontogenic tumor. The sample consisted of 20 cases of solid ameloblastoma (SA), 10 cases of ameloblastoma unicystic (UA) and 16 cases of adenomatoid odontogenic tumor (AOT). The expression of BMPs and their receptors was evaluated in the parenchyma and stroma of lesions, establishing the percentage of immunopositive cells (0 - negative; 1-1 % to 10 % of cells positive; 2 - 11% to 25% of positive cells; 3 - 26% to 50% of cells positive; 4 - 51% to 75 % of positive cells; 5 - more than 75% positive cells). Analysis of the expression of BMP-2 revealed no statistically significant differences in parenchymal (p = 0.925) and stromal component (p = 0.345) between the groups, as well as BMP-4 (p = 0.873 / p = 0.131). In the epithelial component, SA and AOT had a higher frequency of score 5. In turn, all cases of UA were classified as score 5. The analysis of the stromal component showed no statistically significant difference between groups with respect to median scores BMPRIA positivity (p = 0.768) and BMPRII (p = 0.779). In the epithelial component of SA and UA, no statistically significant correlations between imunoexpression proteins analyzed were observed. In turn, the group of AOT, statistically significant positive correlations between the scores of expression of all studied proteins were found. In the stromal component, statistically significant positive correlations were found only in the SA group in BMP -4 and BMPRII (r = 0.476; p = .034), in the UA in BMP-4 and BMPRIA (r = 0.709; p = 0.022). The results of this study suggest that the BMPs and their receptors are involved in the development process odontogenic tumors. BMP-4, in turn, besides being present in odontogenic tumors have the capacity to form mineralized material.

Imunoexpressão de galectinas em queilites actínias e sua relação com características clínicas e gradação histológica

Conselho Nacional de Desenvolvimento Científico e Tecnológico