Users’ dissatisfaction with dental care: a population-based household study

OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users’ dissatisfaction with such are.METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users’ dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals.RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms.CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units.

Dental caries experience in Indians of the Upper Xingu, Brazil

The present study describes the experience of dental caries in Indians communities of the Xingu, in order to supply parameters for further analysis of trends of the disease in Indians. We performed oral health examination in 288 Indians from four communities (Yawalapiti, Aweti, Mehinaku and Kamaiura) living in the southern part of the Xingu National Park, using international criteria defined by the World Health Organization. The outcome measures were the DMFT and dmft scores, and the care index. Indians of the Upper Xingu presented high levels of caries, in all age groups. The average DMFT for 11 to 13-year-old children - 5.93 - was lower than the index measured in 1993 for 12-year-old schoolchildren in nearby cities - 8.23 -, whose United Nations' human development index ranked medium. However, Indians presented a much lower care index, per age group, than these cities, and a high ratio of missing teeth for persons above 20 years old. These observations indicate low incorporation of dental care services. The irregularity of the services programmed for these communities, and the changing dietary and cultural patterns, mainly derived from their contact with the non-indigenous population of Brazil, reinforce the pressing need for health promotion initiatives aimed at these groups.

In vitro SCREENING ANTIBACTERIAL ACTIVITY OF Bidens pilosa LINNÉ AND Annona crassiflora MART. AGAINST OXACILLIN RESISTANT Staphylococcus aureus (ORSA) FROM THE AERIAL ENVIRONMENT AT THE DENTAL CLINIC

Currently multiresistant Staphylococcus aureus is one common cause of infections with high rates of morbidity and mortality worldwide, which directs scientific endeavors in search for novel antimicrobials. In this study, nine extracts from Bidens pilosa (root, stem, flower and leaves) and Annona crassiflora (rind fruit, stem, leaves, seed and pulp) were obtained with ethanol: water (7:3, v/v) and their in vitro antibacterial activity evaluated through both the agar diffusion and broth microdilution methods against 60 Oxacillin Resistant S. aureus (ORSA) strains and against S. aureus ATCC6538. The extracts from B. pilosa and A. crassiflora inhibited the growth of the ORSA isolates in both methods. Leaves of B. pilosa presented mean of the inhibition zone diameters significantly higher than chlorexidine 0.12% against ORSA, and the extracts were more active against S. aureus ATCC (p < 0.05). Parallel, toxicity testing by using MTT method and phytochemical screening were assessed, and three extracts (B. pilosa, root and leaf, and A. crassiflora, seed) did not evidence toxicity. On the other hand, the cytotoxic concentrations (CC50 and CC90) for other extracts ranged from 2.06 to 10.77 mg/mL. The presence of variable alkaloids, flavonoids, tannins and saponins was observed, even though there was a total absence of anthraquinones. Thus, the extracts from the leaves of B. pilosa revealed good anti-ORSA activity and did not exhibit toxicity.

FACTORS RELATED TO ORAL CANDIDIASIS IN ELDERLY USERS AND NON-USERS OF REMOVABLE DENTAL PROSTHESES

This study examined the association between oral candidiasis in elderly users and nonusers of prosthesis and its predisposing factors. To this end, we performed a cross-sectional study where saliva samples from 48 patients were collected they used prosthesis and 43 patients (control group) who did not use. Among the 91 patients, Candida spp were isolated in 40 (83.3%) who used prosthesis and in 23 (53.5%) in the control group. A statistically significant association was determined between the two groups, the isolation of yeasts and dental prosthesis (p < 0.05, OR = 4.3). The most common etiological agent was Candida albicans (37 isolates), with 23 (62.2%) in the denture group and 14 (37.8%) (control group). Among patients who presented clinical manifestations of oral candidiasis (n = 24), 83.3% (n = 20) belonged to the group that wore dentures, while only 16.7% (n = 4) belonged to the control group. Elderly patients with diabetes had 4.4 times higher estimated risk of developing oral candidiasis when compared with individuals without this condition. There was no statistically significant association between being user prostheses and have diabetes with the onset of candidiasis. No statistically significant association was determined between xerostomia, use of prosthesis and oral candidiasis. The use of prosthetics and poor oral hygiene in elderly patients predisposes to the development of oral candidiasis.

Atividade antimicrobiana, antiaderente e antifúngica in vitro de plantas medicinais brasileiras sobre microrganismos do biofilme dental e cepas do gênero Candida

Avaliou-se in vitro a atividade antimicrobiana, antifúngica e antiaderente da aroeira-do-sertão, malva e goiabeira sobre microrganismos do biofilme dental e candidose oral. Os extratos mostraram-se eficazes, inibindo o crescimento das bactérias do biofilme dental e fungos da candidose oral, sugerindo a utilização dessas plantas como meio alternativo na terapêutica odontológica.

Dental and facial characteristics of patients with juvenile idiopathic arthritis

OBJECTIVE: It has been shown that the temporomandibular joint is frequently affected by juvenile idiopathic arthritis, and this degenerative disease, which may occur during facial growth, results in severe mandibular dysfunction. However, there are no studies that correlate oral health (tooth decay and gingival diseases) and temporomandibular joint dysfunction in patients with juvenile idiopathic arthritis. The aim of this study is to evaluate the oral and facial characteristics of the patients with juvenile idiopathic arthritis treated in a large teaching hospital. METHOD: Thirty-six patients with juvenile idiopathic arthritis (26 female and 10 male) underwent a systematic clinical evaluation of their dental, oral, and facial structures (DMFT index, plaque and gingival bleeding index, dental relationship, facial profile, and Helkimo's index). The control group was composed of 13 healthy children. RESULTS: The mean age of the patients with juvenile idiopathic arthritis was 10.8 years; convex facial profile was present in 12 juvenile idiopathic arthritis patients, and class II molar relation was present in 12 (P = .032). The indexes of plaque and gingival bleeding were significant in juvenile idiopathic arthritis patients with a higher number of superior limbs joints involved (P = .055). Anterior open bite (5) and temporomandibular joint noise (8) were present in the juvenile idiopathic arthritis group. Of the group in this sample, 94% (P = .017) had temporomandibular joint dysfunction, 80% had decreased mandibular opening (P = 0.0002), and mandibular mobility was severely impaired in 33% (P = .015). CONCLUSION: This study confirms that patients with juvenile idiopathic arthritis a) have a high incidence of mandibular dysfunction that can be attributed to the direct effect of the disease in the temporomandibular joint and b) have a higher incidence of gingival disease that can be considered a secondary effect of juvenile idiopathic arthritis on oral health.

Color change using HSB color system of dental resin composites immersed in different common Amazon region beverages

The purpose of this study is to evaluate in vitro the color stability of composite resins when exposed to beverages with high coloring contents from the Amazon region. 240 samples from four different composite brands (Natural Look, Z350, 4Seasons and Opallis) of hue A3 were fabricated using an acrylic matrix. The samples were stored in distilled water at 37ºC for 24 hours. The initial color (T0) was registered using a Canon EOS Rebel XTi 10 mp camera, and then the samples were divided into four groups (n=15): G1 (coffee), G2 (açaí juice), G3 (energetic guaraná) and G4 (control - distilled water). The samples were exposed to solutions of DES (6hs) and RE (18hs) and placed in a double boiler under constant agitation, at 37ºC for 30 days. The samples were immersed in the coloring solutions for 15 minutes daily. After 7, 15 and 30 days, new photographic registers were made (T1, T2 and T3). The images were analyzed using Corel PHOTO-PAINT 12 software to identify the colors through the HSB system. The Kruskal-Wallis and t tests (p<0.05) demonstrated significant differences in color (hue, saturation and brightness). The results revealed that none of the tested composites showed color stability when exposed to coloring solutions, and that the Amazon region beverages (açaí juice and energetic guaraná) showed to be less coloring than coffee.

Nova técnica cirúrgica de preparo da veia safena para revascularização do miocárdio sem manipulação direta - no-touch

FUNDAMENTO: Otimização da veia safena na revascularização miocárdica. OBJETIVO: Apresentar a técnica no-touch de preparo da veia safena. Essa técnica consiste na retirada da veia safena do seu leito, com um pedículo de tecido adiposo, protegendo-a contra espasmos, sendo desnecessário distendê-la. MÉTODOS: Estudo prospectivo e randomizado, incluindo 156 pacientes submetidos a cirurgia de revascularização miocárdica. Comparação da técnica no-touch com duas outras técnicas: convencional e intermediária. Procedeu-se à avaliação da morfologia endotelial, utilizando a microscopia. A perviabilidade das pontes foi determinada com exame angiográfico num período médio de 18 meses após a operação. A enzima óxido nítrico sintetase endotelial (eNOS) foi identificada por meio do estudo imunohistoquímico. RESULTADOS: A avaliação morfológica mostrou integridade endotelial de 97% nas veias do grupo no-touch; enquanto quase metade da superfície endotelial das veias tratadas pelas outras técnicas exibiu ausência de células endoteliais. A angiografia revelou perviabilidade de 95,4% para as pontes do grupo no-touch, 88,9 e 86,2% para as pontes do grupo convencional e intermediária, respectivamente. O estudo imunohistoquímico revelou a presença da eNOS nas três camadas que compõem a parede da veia no grupo no-touch e redução dessa enzima no grupo convencional. CONCLUSÃO: A integridade endotelial e a atividade da eNOS foram melhor preservadas com o uso da técnica no-touch. A proteção mecânica fornecida pelo tecido gorduroso circundante à veia e a atividade vasodilatadora e bloqueadora da agregação plaquetária causada pelo óxido nítrico podem ser responsáveis pela proteção da veia contra o espasmo, como também por sua alta perviabilidade imediata.

Sobre o preparo dos parasitas da malária em distensões espessas, especialmente em amostras supersecas

I) the A. presents a method developed for the preparation of thick blood films, specially old desiccated smears. The observations are based on the experience of more than 53000 blood samples collected in the laboratory of the “Serviço de Malaria do Nordeste” as well as in the research department of the “Serviço de Malaria da Baixada Fluminenese”. II) As in introductory matter, he emphasizes the value of the obstacles presented by overdrying of the thick blood films occurring systematically in great malaria control organizations in which the laboratory receives materials from more or less remote localities, particularly in the Brazilian northeast, in regions invaded by Anopheles gambiae. III) An analysis of the causes of failure of the methods of Chorine and Knowles recorded in the literature for such purposes is given, as well as its adaptability for the simultaneous preparation of large numbers of samples. IV) The method is based the protective action of a previous fixation by a dilute solution of formalin, which, without preventing further dehemoglobinization, prevents morphological alterations in the parasites by the action of Knowles solution which is retained in this metod without modification. V) For washing out the acids of the dehemoglobinizating solution as well as for diluting the Giemsa stain, the A. proposes a very simple technique, extremely convenient for such purpose, which consists in adding acetic acid to the distilled water in the proportion of 1 drop for each 10cc of water, and then increasing the hydrogeni-on concentration to pH 7.2 with a 2% sol. of sodium carbonate. As indicator a 0.02% solution purple-bromcresol prepared in accordante to Medalia, is used. In this reaction there is the formation of the acetic acid ↔ sodium acetate, buffer system very suitable for giving a convenient pH and for preventing the precipitation of the dye, which can be used for two or three batches of 700 or 800 slides each, without changing the staining solution. VI) – The method can be summarized as follow: For a small number of samples, Coplin’s or any other staining jar can be used. Large number of slides must be placed in groups of 10 or 15 units each, the slides being separated by a piece of cardboard, according to Barber & Komp. A) Fix in dilute formalin (2%), during 5 minutes. b) Without washing, put in Knowles solution (see the formula in the text), no more than 20 minutes. c)Two successive washings in distilled water, buffered as explained above (which can be used several times). d) Dry and stain with Giemsa solution, prepared by using 1 drop of the stain for each c. c. of buffered distilled water. Time: 1 hour. E) Was in distilled water and dry.

Preparo de antígenos (Leprolinas Souza-Araujo) de culturas de bacilos ácido-álcool resistentes isolados de leprosos: seu emprêgo intradérmico, comparativamente com o da Lepromina, e subcutâneo ou intravenoso como tentativa terapêutica

The A. prepared five antigens from his leprosy cultures which by analogy with ROST's product he called Leprolins. The methods of its preparation and use are given. After a few tests to prove its innocuity for man the A. in cooperation with Dr. JOSÉ MARIANO, injected all five antigens intracutaneously in 120 patients. Now the products are being tested in 17 Leper Colonies of Brazil, in Argentina by Dr. SALOMON SCHUJMAN and in two leprosaria of Colombia. As antigen for skin tests the first results obtained are more or less identical with the results with Lepromin. Its use in serology for leprosy diagnosis will be made by Dr. T. PINTO of Rio, and Prof. LUIZ PRADO BARRIENTOS, of La Paz, Bolivia. As curative means the Leprolins are being injected into resistent lesions of leprosy and also by intraven injections, whose results Dr. José Mariano will publish soon. The Leprolins Souza-Araujo are put at disposal of all leprologists interested in its use.

Preparo de filmes-suporte para microscópio eletrônico

Working with low voltage microscope (R.C.A., EMC-2, of 30KV.) the authors verified that parlodion and Formvar films are quickly destroyed by intense heating under the electron beam. They have tried to employ oxide films, as Al2O3 and SiO, more resistant to heat. Al2O3 films are prepared by anodic oxidation of thin aluminium sheets, under 8 to 10 volts in a 3% ammonium citrate solution and subsequent aluminium dissolution in a O.25% HgCl2 solution. These films are very suitable when prepared with highly pure aluminium of extremely homogeneous surface. Best results were obtained with SiO films, evaporated in high vacuum over Parlodion films mounted on metallic grids. Employing 1 or 1.5 mg of SiOm highly homogeneous and resistant films are obtained, having little inferior transparence than the Parlodion ones. Pure SiO films (1.5 mg) are obtained by elimination of the Parlodion under slow heating until 250°C; they are greatly transparent but little resistant to water, thus beeing indicated in dry preparations. For particles which deposite in a chain-like form around thin fibers, the authors employ the mounting on Parlodion fibers, obtained by heating Parlodion films on microscope grids about 190°C.

Helicobacter pylori detection in gastric biopsies, saliva and dental plaque of Brazilian dyspeptic patients

Helicobacter pylori is an important human pathogen that causes chronic gastritis and is associated with the development of peptic ulcer disease and gastric malignancies. The oral cavity has been implicated as a potential H. pylori reservoir and may therefore be involved in the reinfection of the stomach, which can sometimes occur following treatment of an H. pylori infection. The objectives of this paper were (i) to determine the presence of H. pylori in the oral cavity and (ii) to examine the relationship between oral H. pylori and subsequent gastritis. Gastric biopsies, saliva samples and dental plaques were obtained from 78 dyspeptic adults. DNA was extracted and evaluated for the presence of H. pylori using polymerase chain reaction and Southern blotting methods. Persons with gastritis were frequently positive for H. pylori in their stomachs (p < 0.0001) and there was a statistically significant correlation between the presence of H. pylori in gastric biopsies and the oral cavity (p < 0.0001). Our results suggest a relationship between gastric infection and the presence of this bacterium in the oral cavity. Despite this, H. pylori were present in the oral cavity with variable distribution between saliva and dental plaques, suggesting the existence of a reservoir for the species and a potential association with gastric reinfection.