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

Avaliação clínica longitudinal do periodonto de dentes pilares e não pilares de próteses parciais removíveis

The literature has shown a relation between periodontics and the removable partial denture (RPD), with progressive destruction observed in the support structures. The aim of this study was to clinically assess periodontal condition in users of removal partial denture (RPD), and compare right abutments teeth, indirect abutments and controls before installation and after 1 year, in addition to comparing tooth-supported and tooth mucosa-supported abutments. A total of 50 patients, 32 women and 18 men, mean age of 45 years, took part in the study. The patients were examined by a single examiner at prosthesis installation and after 3, 6, 9 and 12 months. The following were verified at each examination: Probe Depth (PD), Plaque Index (PI), Gingival Index (GI), the amount of Keratinized Mucosa (KM), Gingival Recession (GR) and Dental Mobility (DM); in addition patients received oral hygiene orientation, accompanied by prophylaxis, periodontal scaling and root planing (PSRP), when necessary. Analysis of Variance (ANOVA) with Tukey-Kramer post test was used to assess the dependent variables (PD, PI, KM, GR) of the three groups over time while Friedman s test was used for GI. To assess the outcomes of prosthesis type in the right abutment group, a confidence interval-based analysis was performed. The results showed that the control group was the least compromised in all the variables studied. With respect to development of the groups over time, it was verified that the measures for GR, PD, GI and KM increased from initial examination to 1 year of use in all the groups, but only PI showed a significant increase. There was a non-discriminatory low prevalence of dental mobility. The tooth mucosa-supported prosthesis had significantly higher values for GR, GI and PI and significantly lower ones for KM when compared to tooth-supported. Over time, both types of prostheses showed no significant differences from initial to final examination for the variables GR, PD, KM and GI, with PI significant only for tooth-supported. The results showed that the teeth most involved in RPD design had greater potential of periodontal damage, probably because of greater dental biofilm accumulation. Abutments elements adjacent to the free extremities had less favorable periodontal condition than those adjacent to interpolated spaces, but the use of RPD did not worsen the initial condition

Transporte longitudinal de sedimento na zona costeira de Natal/RN

The longshore sediment transport (LST) is determinant for the occurrence of morphological changes in coastal environments. Understanding their movement mechanisms and transport is an essential source of information for the project design and coastal management plans. This study aims to characterize, initially, the active hydrodynamic circulation in the study area, comprised of four beach sectors from the south coast of Natal, assessing the average annual LST obtained through three proven equations (CERC, Kamphuis and Bayram et al.), defining the best formulation for the study area in question, and analyze the seasonal variability and the decadal transport evolution. The coastal area selected for this work constitutes one of the main tourist corridors in the city, but has suffered serious damage resulting from associated effects of hydrodynamic forcings and their disorderly occupation. As a tool was used the Coastal Modelling System of Brazil (SMC-Brazil), which presents integrated a series of numerical models and a database, properly calibrated and validated for use in developing projects along the Brazilian coastline. The LST rates were obtained for 15 beach profiles distributed throughout the study area. Their extensions take into account the depth of closure calculated by Harllermeier equation, and regarding the physical properties of the sediment, typical values of sandy beaches were adopted, except for the average diameter, which was calculated through an optimization algorithm based on equilibrium profile formulation proposed by Dean. Overall, the results showed an intensification of hydrodynamic forcings under extreme sea wave conditions, especially along the headlands exist in the region. Among the analyzed equations, Bayram et al. was the most suitable for this type of application, with a predominant transport in the south-north direction and the highest rates within the order of 700.000 m3 /year to 2.000.000 m3 /year. The seasonal analysis also indicated a longitudinal transport predominance in the south to north, with the highest rates associated with the fall and winter seasons. In these periods are observed erosive beach states, which indicate a direct relationship between the sediment dynamics and the occurrence of more energetic sea states. Regarding the decadal evolution of transportation, it was found a decrease in transport rate from the 50’s to the 70’s, followed by an increase until the 2000’s, coinciding with the beginning of urbanization process in some stretches of the studied coastline.

Estudo Clínico Longitudinal Comparativo da Condição Periodontal de Pilares Diretos de Próteses Parciais Removíveis Dento- Suportada e Dento-Muco-Suportada

Objective: To perform a long-term clinical evaluation of the periodontium of removable parti al denture (RPD) wearers, comparing the direct pillar teeth of tooth-supported and toothtissue supported RPDs. Method: Fifty patients with mean age of 45 years were enrolled in the study. The individuals were examined by a single examiner at the moment of denture installation and after 3, 6, 9 and 12 months. In each exam, the following parameters were verified: gingival recession (GR), probing depth (PD), plaque index (PI), gingival index (GI) e amount kerati nized mucosa (KM). All patients received oral hygiene instructions and prophylaxis and, when necessary, scaling and root planing. An analysis from the confidence interval was done to evaluate the endpoints regarding the type of denture in the direct pillar group. Results: The tooth-tissue supported dentures showed significantly higher GR, GI and PI values, and significantly lower KM values. Over time, neither of the types of denture presented statistically significant difference from the initial to the final examination for the parameters GR, PD, KM and GI, while the PI was significant only for the tooth-supported dentures. Conclusion: Pillar teeth adjacent to free ends presented a less favorable periodontal conditi on than the pillar teeth adjacent to intercalated spaces. However, the use of RPD did not aggravate the initial condition, after a follow-up period of 12 months. The findings of the study indicate that, within 1 year, there were no significant differences between the direct pillars of the toothsupported and tooth-ti ssue supported dentures, and suggest the need of professional follow up for a longer period.

Estudo Clínico Longitudinal Comparativo da Condição Periodontal de Pilares Diretos de Próteses Parciais Removíveis Dento- Suportada e Dento-Muco-Suportada

Objective: To perform a long-term clinical evaluation of the periodontium of removable parti al denture (RPD) wearers, comparing the direct pillar teeth of tooth-supported and toothtissue supported RPDs. Method: Fifty patients with mean age of 45 years were enrolled in the study. The individuals were examined by a single examiner at the moment of denture installation and after 3, 6, 9 and 12 months. In each exam, the following parameters were verified: gingival recession (GR), probing depth (PD), plaque index (PI), gingival index (GI) e amount kerati nized mucosa (KM). All patients received oral hygiene instructions and prophylaxis and, when necessary, scaling and root planing. An analysis from the confidence interval was done to evaluate the endpoints regarding the type of denture in the direct pillar group. Results: The tooth-tissue supported dentures showed significantly higher GR, GI and PI values, and significantly lower KM values. Over time, neither of the types of denture presented statistically significant difference from the initial to the final examination for the parameters GR, PD, KM and GI, while the PI was significant only for the tooth-supported dentures. Conclusion: Pillar teeth adjacent to free ends presented a less favorable periodontal conditi on than the pillar teeth adjacent to intercalated spaces. However, the use of RPD did not aggravate the initial condition, after a follow-up period of 12 months. The findings of the study indicate that, within 1 year, there were no significant differences between the direct pillars of the toothsupported and tooth-ti ssue supported dentures, and suggest the need of professional follow up for a longer period.