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

Qualidade de vida, eficiência mastigatória e presença de disfunção temporomandibular em usuários de prótese parcial removível com arco dental curto inferior

Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. In addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of different lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory efficiency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OHIP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quality of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinical analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability. The statistical tests used were chi-squared and analysis of variance as well as Tukey s post test, when applicable, all with a 95% confidence level. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn t, but this result wasn t statistically significant. The mean of the results of masticatory efficiency, WHOQOL and OHIP didn t show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that studied patients with low posterior support using lower PRP didn t have better masticatory efficiency, general quality of life, less impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn t use the prosthesis

Percepção dos idosos sobre saúde bucal

The assessment of oral health status in elderly patients is essential for the development of specific health policies. The prevalence of oral diseases is high in this population. The self-perception of oral health conditions influences the demand for oral care and quality of life for seniors. The aim of this study was to assess self-perception of oral health status in 100 elderly of both sexes, aged 60 years or older and functionally independent the Basic Health Unit of Felipe Camarão II, Natal, Brazil. For comparison of self-perception data was collected in Bom Pastor, Natal / RN. In this research data were collected a questionnaire grouped into two parts. The first part with the socio-demographic data, subjective and objective condition of oral health and access to the service, the second part GOHAI Index. This index consists of 12 items that make it possible to obtain information involving aspects of chewing, speech, phonation, and self-assessed oral health. The results were subjected to statistical tests of Mann-Whitney and Kruskal-Wallis test (α = 0.05), to identify possible predictors of self-evaluation. As a result, 69% were female, ages ranged from 60 to 86 years, with a median of 65 years. In relation to marital status 48% were married. For the years of study, the sample had an average of 3 years. For the last visit to the dentist, only 27% of seniors had visited the Dentist for less than a year. Regarding the questions about the presence of gingival and dental problems were answered by 46% and 21% respectively. The data on the perception of your teeth and gums, 44%. The index showed GOHAI value for self-perception of 30 points to Felipe Camarão and 28 points for the Bom Pastor, both considered a low perception. We identified predictors of self-rated number of people in the room, participate in any associational activity, there is problems with your teeth and your gums. Concluded a negative self-perception of oral health condition by Gone in both areas, influenced by socioeconomic and cultural issues, although they realize the importance given to oral health, but by the misfortunes of other prominent favored little valuing of oral health

Impacto sócio-dentário das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes

Nas últimas décadas, com a significativa redução da cárie dentária em crianças e adolescentes, uma maior atenção tem sido dada a outros problemas bucais como as oclusopatias. Em termos epidemiológicos no Brasil, esta tem ocupado o terceiro lugar dentre os problemas de saúde oral na população e, portanto, a inclusão destas como um problema de saúde pública se deve não apenas à sua alta prevalência, mas também ao impacto social, que interfere diretamente na qualidade de vida das pessoas. Diante do exposto é que este estudo objetiva buscar o impacto da presença e severidade das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes escolares de um município. Sendo assim, foram examinados 356 escolares na faixa etária de 15 -19 anos e determinadas a prevalência, severidade e necessidade de tratamento de oclusopatias através dos índices DAI, IOTN e ICON. O impacto sócio dentário das oclusopatias na qualidade de vida dos adolescentes foi analisado através do índice CS-OIDP. A fim de se verificar possíveis influências de variáveis estudadas na determinaçao do impacto na qualidade de vida das oclusopatias, estas serão coletadas através do estatus sócio-econômico, gênero, idade e tipo escola. Nos resultados parciais, relacionado a 50% da amostra, se observou uma maior prevalência do escolares de escola pública(68,1%), idade entre 15-16 anos(74,7%), gênero feminino(52,7%) e maior prevalência do SES baixo(77,5%). A análise estatística usando o teste qui-quadrado mostrou uma associação significativa do impacto da oclusopatia na qualidade de vida apenas quando avaliada com o índice ICON e o A-IOTN do examinado, comprovando uma associação da necessidade de tratamento com a presença do impacto na qualidade de vida. Com isso, busca-se comprovar e enfatizar a necessidade de se estabelecer políticas públicas que trabalhem na prevenção e interceptação dessas oclusopatias na população, melhorando, portanto, a qualidade de vida e saúde oral dos adolescentes.

Impacto sócio-dentário das ocusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes

Nas últimas décadas, com a significativa redução da cárie dentária em crianças e adolescentes, uma maior atenção tem sido dada a outros problemas bucais como as oclusopatias. Em termos epidemiológicos no Brasil, esta tem ocupado o terceiro lugar dentre os problemas de saúde oral na população e, portanto, a inclusão destas como um problema de saúde pública se deve não apenas à sua alta prevalência, mas também ao impacto social, que interfere diretamente na qualidade de vida das pessoas. Diante do exposto é que este estudo objetiva buscar o impacto da presença e severidade das oclusopatias e suas respectivas necessidades de tratamento na qualidade de vida de adolescentes escolares de um município. Sendo assim, foram examinados 356 escolares na faixa etária de 15 -19 anos e determinadas a prevalência, severidade e necessidade de tratamento de oclusopatias através dos índices DAI, IOTN e ICON. O impacto sócio dentário das oclusopatias na qualidade de vida dos adolescentes foi analisado através do índice CS-OIDP. A fim de se verificar possíveis influências de variáveis estudadas na determinaçao do impacto na qualidade de vida das oclusopatias, estas serão coletadas através do estatus sócio-econômico, gênero, idade e tipo escola. Nos resultados parciais, relacionado a 50% da amostra, se observou uma maior prevalência do escolares de escola pública(68,1%), idade entre 15-16 anos(74,7%), gênero feminino(52,7%) e maior prevalência do SES baixo(77,5%). A análise estatística usando o teste qui-quadrado mostrou uma associação significativa do impacto da oclusopatia na qualidade de vida apenas quando avaliada com o índice ICON e o A-IOTN do examinado, comprovando uma associação da necessidade de tratamento com a presença do impacto na qualidade de vida. Com isso, busca-se comprovar e enfatizar a necessidade de se estabelecer políticas públicas que trabalhem na prevenção e interceptação dessas oclusopatias na população, melhorando, portanto, a qualidade de vida e saúde oral dos adolescentes.

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

Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

Efeito in vitro da terapia fotodinâmica sobre bactérias orais em suspensão e na formação de biofilme : ensaio com azul de metileno e toluidina ativados por luz halógena

Photodynamic therapy (PDT) has been proposed as an alternative method for the treatment of biofilm-dependent oral diseases like dental caries. This therapy consists of simultaneous action of a visible light (L) and a photosensitizer (FS) in the presence of oxygen, which leads to production of different reactive oxygen species that can interact with the bacterial cell components, and promote cell death. This study aims to evaluate the antimicrobial action of PDT on oral bacteria in suspension, as well as the formation of mono and multi-species biofilms, in vitro, from a standard strain of Streptococcus mutans (ATCC 25175) and saliva samples, respectively. The dye methylene blue (MB) and toluidine blue (TB) were used at a concentration of 100 mg/ L and activated by halogen light (600 to 750 nm) from a modified hand held photopolymerizer (Ultralux ®, Dabi Atlante, Ribeirão Preto , São Paulo, Brazil.). Planktonic cultures were prepared and submitted to different experimental conditions: 1. PDT using TB 2. PDT using MB, 3. L+ FS- , 4. TB + L - ; 5. MB+ L-; 6. L- FS- (negative control) and 7. administration of 0.12% chlorhexidine digluconate (positive control) (Periogard ®, Colgate-Palmolive Company, New York, USA). The immediate and mediated action of PDT on bacterial suspensions, as well as its effect on biofilm formation were observed from the number of colony-forming units per milliliter (CFU/mL) and measures optical density (OD). The data were statistically analyzed using the Kruskal-Wallis and Mann-Whitney test for the significance level of 5%. According to the results, the PDT showed no antibacterial action on suspensions of S. mutans, regardless of the dye used. PDT with MB activated by halogen light was able to reduce 86.6% CFU/mL multi-species planktonic cultures, however, this reduction was not significant (p > 0.05). PDT showed antibacterial effect, mediate on multi-species planktonic cultures with TB (p < 0.001) and MB (p < 0.001), activated by halogen light. PDT was able to prevent the formation of multispecies biofilm, through the activation of TB by halogen light (p = 0.01). We conclude that activation of the dye toluidine blue and methylene blue, by halogen light (PDT) showed antimicrobial activity, compared to multi-species planktonic cultures prepared from saliva samples

Os significados do tabagismo construídos na dinâmica social

The present study has the purpose of catching the significances of smoking in the social dinamics based on the Theory of Social Representations. It was developed among adults with ages from 20 to 59 years, low social and economic conditions, at Natal RN, Brazil. The Free-words Association Test was applied as the instrument of data collection and a semi-structured interview with the smokers and non-smokers, besides a structured interview with smokers, non-smokers and ex-smokers. All data was analyzed by the descriptive statistics using the Analysis of Content Technique of the thematic kind and by the softwares ALCESTE and EVOC 2000. Elaborations about smoking were marked by social, cultural and historical dimension, however they showed sensibility to changes and revealed positive and negative aspects of the habit. The analysis of the semi-structured interviews showed the following categories and under-categories respectively: Initiation of the habit (Friends and Family and Appreciation and Beauty); Psychosocial Implications of smoking (Personal relationship, Work and Financial); Behavior when facing smoking (Positive, Negative and Neutral); Smoking Effects (Smokers´ health and the other people health); Description about oral diseases ( Bad breath, Oral cancer and Dental problems); Smoking treatment (Physician and psychological, Supernatural and Difficulties). ALCESTE analysis presented 4 classes: Ambivalence between pleasure and get ill, Smoking as a trouble and danger to society, Social discrimination of smokers and Mouth as a place of reaffirmation of the discrimination. Those helped us to understand the psychosocial repercussion of the habit. On the social representation structure we identified as a probable central nucleus of the smoker group the categories Pleasure and Bad to the health and as peripheral elements Alcoholic Drink, Financial damage and Nervousness. For the non-smoker group the category Bad to the health comes first and Stop Smoking comes as a peripheral element. Finally, we hope that the knowledge of these representations can contribute to plan and/or to rethink over the professional practices and public policies related to smoking. Besides that, for an amplified comprehension of the study object the discussions over the identified representations should be deepen and amplified to other population and social groups

Comprovação da real comunicação entre o endodonto e o periodonto através do canal cavo inter-radicular e sua prevalência em molares inferiores humanos

The neurovascular system of the pulp and of the periodontium is interconnected and among the possible intercommunications between these two tissues, there is the cavo inter-radicular canal. It is a small canal that goes through any inter-radicular dentine and arises in the furca region of the multi-radicular teeth. Its predominance has been studied in the literature, by several methodologies, with divergent results. The objective of this work was to establish, in vitro, the predominance of the cavo inter-radicular canal, in human lower molars, through the diaphanization technique and dye leakage. For this research, 140 teeth (100 first and second 40 lower molars) were selected, extracted due to different reasons, belonging to a teeth bank of the Endodontics discipline of the Dentistry College at Federal University of Rio Grande do Norte. The teeth were preserved in formol until the moment of use and immersed in physiological solution. Had the endodontic access fulfilled and the whole external surface, except for the furcation, sealed with two layers of nail enamel. The cleaning of the pulpar chamber floor was carried out with sodium hypochlorite solution 5%, being this solution renewed every 5 minutes, during 1 hour. The teeth were immersed in Indian dye and, after drying of the dye, they had their crowns split up in the amelo-cemental junction. Then, they were examined in a stereomicroscope, where marks of the coloring were observed in the furcation and on the pulpar floor. After this recording, the sample was diaphanized and with the transparent teeth, it was possible to observe in the stereomicroscope, the true inter-radicular canals. As a result of this experiment, the presence of these canals was observed in 13 % of the first and 7, 5 % of the second evaluated molars. The study showed that both the presence of the cavo inter-radicular canal is real and the diaphanization and dye leakage is an efficient method for this type of research

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

Atividades preventivas realizadas pelos cirurgiões-dentistas do PSF de Natal-RN

Family Health Program (FHP) presents itself as a restructured model on basic cares besides having prevention practices and promotion in health as essential parts. According to that, the purpose of this study is to perceive which prevention practices in oral health are accomplished by the dentists from the FHP of Natal-RN as well as the way they have been developed, the knowledge basis to execute the procedure and the use of evaluation instruments by the dentists and by the Oral Health Co-Ordinator. A list of dentists participating on the FHP of Natal in March, 2006 (n= 91) was obtained so it was possible to formulate a structured interview. After excluding those with less than six months attending to the program, and considering the loss, eighty dentists got to be interviewed. It had questions about individual and group preventive procedures, sources of basement to develop the activities and to verify the impact and evaluation instruments. Besides that, an interview was made with the Oral Health Co-Ordinator about the evaluating process and the existence of a protocol as well as about document analysis in the Ambulatory Informations System Unique Health System (AIS-UHS), Information of Basic Care System and Pact of Recorder. The main individual activities consist on Oral Hygiene Orientation (87,5%) and Fluoridization (95%). Group activities remain at scholar groups acts(91,25%) being fluoridization done by 91,25% and educative activities by 86,25% mainly through speeches (61,25%).Orientations about oral cancer were detached on the aged group (39,96%)and hypertensive and diabetic group (19,51%), as well as integration with the health team was respectively 21,93% and 39,02%. Speeches and talk rounds are the main activities for aged, hypertensive and diabetics, and are also expressive to pregnant women. For pregnant women and babies group predominate hygiene and diet orientation. About the evaluation instruments 73,75% of the dentists do not consider their existence, despite 73,75% consider that actions have impact specially due to a increase of hygiene and decrease of caries index on the children. The main sources of basement are clinical experience (42,5%) and preparative courses (33,75%), only 7,5% mentioned population need and local reality. The Oral Health Co-Ordinator related the Attention Pact Recorder and records from the AIS - UHS as evaluation source but also detached the lack of epidemiologic surveying. She mentioned the increase of supervised brushing as a positive result and detached the hardness of the professional to act inside the family and as a team. The AIS-UHS records showed that fluoridization is more used individually and the supervised brushing is predominant as a group action, besides that educative activities at the Health Establishment predominate due to actions at the community. Facing the results, it was verified the act in different groups, special attention given to scholars, as well as focus the activities on caries giving less emphasis to other oral problems. Despite that, there was no epidemiologic instruments or data of the local reality to guide the actions and to be part of the planning and evaluation process

A educação em saúde pública na práqtica cotidiana: atuação dos cirurgiões-dentistas do PSF de Natal-RN

Considering education a support to health promotion, care integration and citizenship formation,the purpose of this research was to analyze the perception of the oral surgeons from the Family Health Program of Natal-RN over education in health as well as their performance as educators based on their activities on the program. A qualitative study was accomplished by a semi-structured interview and a Free Association of Words Test with 80 oral surgeons from the Family Health Program of Natal-RN. The instruments were analyzed through the meaning analysis and the Central Nucleus of Vergès Theory. The results showed a lack of planning in health actions so there is no standardization on the educative practices done by the oral surgeons which mostly are focused on scholars. There was an agreement among the group according to the oral surgeons´ perception about education in health that education is related to its function of recall prevention ideas to the population. Most part of the context units analyzed by the professionals´ speech show the knowledge of education in health as an inadequate behavior change instrument of the individuals. An interesting point was a quotation cited by some professionals that included actual themes such as citizenship, motivation and life quality, put inside the speech of education in health. To the oral surgeons the biggest difficulties on the development of the educative actions are due to the lack of incentive by the Municipal Health Bureau and to the detachment and lack of valorization of the themes by the population. The oral surgeons consider themselves co-responsible for the formation of a population which is able to request its health. They also mention the knowledge about the need of the community participation on the planning of the Family Health Program actions. Finally, it is notable the need for more encouragement so the oral surgeons can be more capable and have more interest in applying education in health on the perspective of a new model in health, because once capable and stimulated they can awake the population to education importance as a great transformation instrument for people searching for a fair, equalitarian and citizeness society

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