Dental caries experience in children attending an infant oral health program

Aim: To investigate: a) caries experience in 5 year-old children and its relationship to the caries risk evaluation made before 1 year of age; b) compliance of parents to an infant oral health program as well as the abandonment reasons. Methods: Group A (GA) - 242 children (60-71 months old) who stayed in the program and had been enrolled since their first year of life underwent a clinical examination according to the WHO's criteria; their parents/caregivers were interviewed to ascertain their compliance to the program. Group B (GB) - parents of 60 children, who had dropped out of the program, were interviewed to check the reasons of withdrawing. The caries risk classification was based on the file at the first appointment. Chi-square test was used (α=0.05) for statistical analyses. Results: Most of the children were free of caries (71.1%). Caries risk evaluation showed low sensibility (34.3%, 95% CI = 22.4-46.1) and high specificity (74.4%, 95% CI = 67.6-81.2) to caries experience. Sixty-two mothers (25.6%) reported difficulty to follow the guidelines. The main reason for dropping out was changing to similar health services (40.0%). Conclusions: Caries risk in the first year of life was not efficient to predict dental caries experience at 5 years of age. Educational practice should be improved to increase the compliance of the parents to the program.

Relationship between psychological factors and symptoms of TMD in university undergraduate students.

Temporomandibular disorders is a collective term used to describe a number of related disorders involving the temporomandibular joints, masticatory muscles and occlusion with common symptoms such as pain, restricted movement, muscle tenderness and intermittent joint sounds. The multifactorial TMD etiology is related to emotional tension, occlusal interferences, tooth loss, postural deviation, masticatory muscular dysfunction, internal and external changes in TMJ structure and the various associations of these factors. The aim of this study was to evaluate the prevalence of the relationship between signs of psychological distress and temporomandibular disorder in university students. A total 150 volunteers participated in this study. They attended different courses in the field of human science at one public university and four private universities. TMD was assessed by the Research Diagnostic Criteria (RDC) questionnaire. Anxiety was measured by means of a self-evaluative questionnaire, Spielberger's Trait-State anxiety inventory, to evaluate students'state and trait anxiety. The results of the two questionnaires were compared to determine the relationship between anxiety levels and severity degrees of chronic TMD pain by means of the chi-square test. The significance level was set at 5%. The statistical analysis showed that the TMD degree has a positive association with state-anxiety (p = 0.008; p < 0.05) and negative with trait-anxiety (p = 0.619; p < 0.05). Moreover a high TMD rate was observed among the students (40%). This study concluded that there is a positive association between TMD and anxiety.

Head and neck carcinogenesis: Impact of MTHFD1 G1958A polymorphism

Objective: To investigate the MTHFD1 G1958A polymorphism involved in the folate metabolism as a risk for head and neck cancer, and to find the association of the polymorphism with the risk factors and clinical and histopathological characteristics. Methods: Retrospective study investigating MTHFD1 G1958A polymorphism in 694 subjects (240 patients in the Case Group and 454 in the Control Group) by Restriction Fragment Length Polymorphism (RFLP) Analysis. Multiple logistic regression and chi-square tests were used in the statistical analysis. Results: Multivariable analysis showed that smoking and age over 42 years were disease predictors (p < 0.05). MTHFD1 1958GA or AA genotypes were associated with smoking (p = 0.04) and alcoholism (p = 0.03) and were more ofen found in more advanced stage tumors (p = 0.04) and in patients with a shorter survival (p = 0.03). Conclusion: Te presence of MTHFD1 G1948A polymorphism associated with smoking and alcoholism raises the head and neck cancer risk.

Relationship between anxiety and chronic orofacial pain of temporomandibular disorder in a group of university students

Purpose: This study evaluated the relationship between anxiety levels and severity degrees of chronic orofacial pain of temporomandibular disorder in brazilian university students. Methods: 150 volunteers (117 men and 33 women), with age ranging from 17 to 30 years, were subjects to this study. Spielberger's trait-state anxiety inventory was used to evaluate trait and state anxiety of the students, while examination for chronic orofacial pain was performed in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Association between anxiety levels and severity degrees of chronic orofacial pain was tested using the Chi-square test. The significance level was set at p<.05. Results: The results showed that 32.7% (n = 49) of the subjects exhibited TMD, and the intensity of chronic orofacial pain was classified as degree 1 in 85.7% (n = 42) and as degree 2 in 14.3% (n = 7) of them. Based on the results of the Spielberger's trait-state anxiety inventory, the majority of the students had moderate anxiety (48.6% and 48.1%, respectively). The correlation between trait-anxiety levels and chronic orofacial pain degrees was significant and positive (p<.05). However, no significant correlation was found to state-anxiety levels and chronic orofacial pain degrees (p>.05). Conclusion: It was concluded that chronic orofacial pain of TMD could be present in university students and anxiety may be related. © 2010 Japan Prosthodontic Society. Published by Elsevier Ireland. All rights reserved.

Prevalence of chewing side preference in the deciduous, mixed and permanent dentitions

Aim: This study evaluated the prevalence of the chewing side preference (CSP) in the deciduous, mixed and permanent dentitions. Materials and methods: Three-hundred subjects were divided in three groups (n = 100): Group 1 - children with deciduous dentition; group 2-children with mixed dentition; group 3 - subjects with permanent dentition. The CSP was determined using a direct method (visual observation) developed by McDonnell et al. (2004). Descriptive statistic was used to observe the prevalence of CSP. The Pearson's Chi-square was used to investigate signicant associations between gender, presence of CSP and preferred side (right/left). Results and conclusion: Eighty-seven percent of group 1 had a CSP. Eighty-two percent of group 2 had a CSP. Seventy-six percent of group 3 had a CSP. There was no statistically significant association between presence of CSP and gender in all groups. There was no statistically significant association between preferred side (right/left) and gender in all groups. Clinical significance: There is a higher prevalence of subjects in deciduous, mixed and permanent dentition that presented chewing side preference. The early diagnosis of the presence of chewing side preference can prevent the unilateral chewing pattern with prophylactic therapy applied to the first teeth (deciduous).

Associação entre doenças crônicas em adultos e redução dos níveis de atividade física

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Contaminação microbiana das soluções de processamento radiográfico: Risco de infecção cruzada

Objective: To evaluate the microbial contamination in samples of radiographic developing and fixing solutions, radiographic processing water, dental unit waterlines and dental office's external water supply. Methods: Samples of 50 private dental offices and 20 dental offices of the School of Dentistry de Araçatuba-UNESP were collected. The samples were subjected to neutralization of the residual inhibitory agents followed by pre-enrichment in peptone water and EVA broth and were inoculated in selective and non-selective culture media. The DNA of the samples was extracted and the presence of superinfectant microorganisms was evaluated by PCR. The differences in the prevalence of the microorganisms in the samples of the solutions were analyzed by repeated-measures analysis of variance for category data, while the Chi-Square and Mann-Whitney tests were used to evaluate the existence of associations between the total number of heterotrophic microorganisms and infection control protocols. The significance level was set at 5%. Results: Samples of radiographic fixing solution presented a remarkably less frequent contamination than radiographic developing solution and radiographic processing water. The latter exhibited microorganisms typically originated from the oral microbiota and human skin as well as microorganisms frequently found in dental unit waterlines. There was less contamination of radiographic processing water in the dental offices where the x-ray film packets were disinfected before processing or were covered by a plastic film. Additionally, all samples of dental office's external water supply were drinkable. Conclusion: Covering the x-ray film packets with a plastic film protection barrier was proven the best manner to reduce the contamination of the evaluated solutions.

Evaluation of a radiographic method to detect tibial dyschondroplasia lesions in broilers

This study aimed at developing radiographic techniques for the early detection of dyschondroplastic lesions in the tibia of broilers. The experiment was carried out at the facilities of UNIFOR/MG and Formiga and UNIFENAS/ Alfenas with 420 one-day-old male Cobb broilers. At 20 days of age, all birds were radiographed and identified with an alpha-numeric metal ring in the right leg. At 40 days of age, 42 broilers previously selected as a function of bone mineral density and lesion thickness scores were again radiographed and scored, and then sacrificed. Their right tibia was removed for gross and histological examination of the growth plate. The results showed that radiographic techniques are correlated with gross and histological examination and that there was no significant differences among techniques (P>0.05). it was concluded that the use of radiographic examination to identify tibial dyschondroplasia in broilers precludes the use of bone mineral density to diagnose this condition. The non-parametric statistical Chi-square test at 5% significance level was used to analyze the results.

In vitro susceptibility of oral Candida albicans strains to different pH levels and calcium hydroxide saturated aqueous solution

Candida albicans is present in the oral cavity and in the whole digestive tract of humans and other animals, being frequently related to endodontic treatment failure. The present study determined the incidence of C. albicans in the oral cavity and the susceptibility of isolates to different pH values and saturated calcium hydroxide aqueous solution at pH 12.5. Sixty-five patients attending the Endodontic Clinic at the Sagrado Coração University participated in the study. The collected samples were cultivated in selective media for C. albicans and the isolates were tested in terms of resistance to both alkaline pH and saturated aqueous solution of calcium hydroxide. In relation to time variables, yeast viability was assessed by the Sabouraud's agar culture and fluorescein diacetate and ethidium bromide fluorescent staining method. Results from the different pHs and experimental times, including those from different techniques measuring fungal viability, were compared using the chi-square and Fisher's exact tests (α=0.05). The yeasts became completely inviable after 48 h of contact with the calcium hydroxide solution. On the other hand, when exposed to the alkaline culture broth, the yeasts were found to be viable at pHs 9.5 and 10.5 for up to 7 days. In conclusion, C. albicans can only be completely inhibited by direct contact with saturated calcium hydroxide aqueous solution after 48 h of exposure.

Prospective study of postoperative sensory disturbances after surgical treatment of mandibular fractures

Introduction: This present study's purpose is to evaluate the degree of paresthesia and recovery of inferior alveolar nerve in patients with mandible fractures who underwent surgical treatment. Material and methods: Nineteen patients were evaluated (27 hemimandibles) at six different times: preoperative (T1), postoperative 1 week (T2), postoperative 1 month (T3), postoperative 3 months (T4), postoperative 6 months (T5), and postoperative 1 year (T6). Subjective and objective methods were used for this evaluation. Results: The results were analyzed using likelihood ratio chi-square test for the hypothesis of no association between indicators of sensitivity and responses to the questionnaire, and the Cochran-Mantel-Haenszel test for equality hypothesis. All objective tests showed a statistically significant worsening in sensitivity at T2 (p < 0. 0001) and a significant improvement after T4 (α < 0. 05). The subjective tests showed an association with the objectives tests, and improvement in sensitivity after T4 (p < 0. 0001) was noted. Discussion: The first postoperative week is the period in which there are major changes with respect to sensitivity, and after 3 months postoperatively, the recovery reaches its apex with little difference observed after this period. In this research 100 % of the patients analyzed recovered all sensibility until T6. © 2012 Springer-Verlag.

Treatments for invasive carcinoma of the cervix: What are their impacts on the pelvic floor functions?

Aims: Describe the impact of surgery, radiotherapy and chemoradiation in the pelvic floor functions in cervical cancer patients. Materials and Methods: A prospective study with women submitted to radical hysterectomy (RH) (n = 20),exclusive radiotherapy (RT) (n= 20)or chemoradiation (CT/RT)(n = 20)for invasive cervical cancer. Urinary, intestinal and sexual function, as well as vaginal length and pelvic floor musclecontraction were evaluated. Comparisons between groups were performed by Kruskal-Wallis and Chi-square tests (p < 0.05). Results: The groups were similar in stress urinary incontinence incidence (p = 0.56), urinary urgency (p = 0.44),urge incontinence (p = 0.54),nocturia(p = 0.53), incomplete bowel emptying (p = 0.76),bowel urgency(p = 0.12)and soilage(p = 0.43). The CT/ RT group presented a higher urinary frequency(p < 0.001)and diarrhea(p = 0.025). Patients in the RH group were more sexually active(p = 0.01) and experienced less dyspareunia (p = 0.021). Vaginal length was shorter in RT group (5.5 ± 1.9 cm) and CT/ RT(.3 ± 1.5 cm) than in the RH group (7.4 ± 1.1 cm) (p < 0.001). Pelvic floor muscle contraction was similar (p = 0.302). Conclusions: RT and CT/RT treatment for cervical carcinoma are more associated to sexual and intestinal dysfunctions.

Dental students' familiarity with the medical management of dental patients at Brazilian dental schools

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Spirituality: Do teachers and students hold the same opinion?

Background:  Few studies have investigated potential differences between the opinions of educators and undergraduates regarding spirituality in patient care. Understanding these differences, could lead to better strategies for educational proposes. Purpose:  To compare the opinions of medical teachers (MTs) and medical students (MSs) regarding spirituality training in a Brazilian medical school. Methods:  A cross-sectional study was conducted. MTs and MSs filled out a questionnaire containing the Duke Religion Index, and questions regarding spirituality in clinical practice and at medical school. A comparison between early-curriculum MSs, late curriculum MSs and MTs was carried out. Chi-square (categorical) and Mann-Whitney (continuous/ordinal) tests were used. Results:  A total of 475 MSs and 44 MTs were evaluated. Results showed that MSs did not address spirituality as frequently as MTs (p<0.001), and that most participants did not feel prepared to address this issue, and believe that Brazilian medical schools are not giving all the required information in this field. Nevertheless, they believe MSs should be prepared to discuss these issues. Late-curriculum MSs believed that spirituality plays a more positive role in patient health (p=0.027), and were more prone to address this issue than early-curriculum MSs (p=0.023). Conclusion:  These findings revealed some of the challenges faced by spirituality medical training in Brazil, and differences between MTs and MSs regarding this issue. Further studies are needed to replicate these findings in other countries. © Blackwell Publishing Ltd 2013.

Time in the stair-climbing test as a predictor of thoracotomy postoperative complications

Objectives: The stair-climbing test as measured in meters or number of steps has been proposed to predict the risk of postoperative complications. The study objective was to determine whether the stair-climbing time can predict the risk of postoperative complications. Methods: Patients aged more than 18 years with a recommendation of thoracotomy for lung resection were included in the study. Spirometry was performed according to the criteria by the American Thoracic Society. The stair-climbing test was performed on shaded stairs with a total of 12.16 m in height, and the stair-climbing time in seconds elapsed during the climb of the total height was measured. The accuracy test was applied to obtain stair-climbing time predictive values, and the receiver operating characteristic curve was calculated. Variables were tested for association with postoperative cardiopulmonary complications using the Student t test for independent populations, the Mann-Whitney test, and the chi-square or Fisher exact test. Logistic regression analysis was performed. Results: Ninety-eight patients were evaluated. Of these, 27 showed postoperative complications. Differences were found between the groups for age and attributes obtained from the stair-climbing test. The cutoff point for stair-climbing time obtained from the receiver operating characteristic curve was 37.5 seconds. No differences were found between the groups for forced expiratory volume in 1 second. In the logistic regression, stair-climbing time was the only variable associated with postoperative complications, suggesting that the risk of postoperative complications increases with increased stair-climbing time. Conclusions: The only variable showing association with complications, according to multivariate analysis, was stair-climbing time. © 2013 by The American Association for Thoracic Surgery.

Associação entre composição corporal, equilíbrio e mobilidade de idosos com 80 anos ou mais

Study design: cross-sectional study. Objective: The objective of this study was to analyze the association between body composition, mobility and balance of elderly aged 80 years or older. Methods: The sample consisted of 123 elderly aged 80 and 95 years (83.2 ± 2.7 years) with 78 women (83.2 ± 2.9 years) and 45 men (83.2 ± 2, 4 years) residing in the city of Presidente Prudente - SP. Assessment of body composition was made by absorpiometria dual energy X-ray (DXA). The mobility and balance were assessed by means of tests of speed walking, and static balance lower limb strength. For statistical analysis we carried out the chi-square test, the software used was SPSS (13.0) and the significance level was set at 5%. Results: In males, those with higher performance in the functional tests showed higher percentages of muscle mass (MM) (35.6%) compared to lower performance (15.6%), p = 0.026. In the female group, the elderly with higher performance on tests showed higher bone mineral density (BMD) values (30.8%) compared with those with lower performance (20.5%) p = 0.041. Conclusion: MM for elderly males and BMD for females were the components of body composition that is associated with functional capacity.