Análise da interface adesiva entre cimentos resinosos e diferentes terços da dentina intrarradicular

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo das condições de saúde bucal e avaliação da microbiota periodontopatogênica de uma população indígena brasileira

Pós-graduação em Odontologia - FOA

Perfil clínico-epidemiológico de saúde bucal em pacientes de hanseníase

O objetivo deste estudo foi avaliar o perfil clínico-epidemiológico de saúde bucal em pacientes portadores de hanseníase em PQT através da avaliação clínica da mucosa bucal, dos indicadores epidemiológicos IPV (Índice de Placa Visível), ISG (ìndice de Sangramento Gengival), ICPOD (Índice de Dentes Cariados, Perdidos e Obturados) e mensuração do fluxo salivar pelo ISS (Índice de Secreção Salivar), além da capacidade tampão pelo pH salivar. A amostra foi de 80 pacientes na faixa etária de 8 a 73 anos submetidos ao exame clínico bucal e coleta estimulada de saliva, divididos em Grupo de Estudo (GE), constituído de 40 pacientes portadores de hanseníase em PQT, atendidos no CRTDS Dr. Marcello Candia Marituba-Pa; e Grupo Controle (GC), de pacientes não portadores de hanseníase. Os resultados apontaram, 62,5% de alterações inespecíficas da mucosa bucal, dentre as mais frequentes pigmentação racial na gengiva, linha alba mordiscada na mucosa jugal, inflamação gengival, varicosidade no ventre lingual e trauma por uso de prótese no GE, não havendo diferença estatística significante (p=0,14) com o GC. A média do IPV no GE foi de 50,4% das superfícies dentárias com acúmulo de placa bacteriana, não havendo também diferença estatisticamente significante (p=0,40) com o GC. O IPV foi maior nos indivíduos sem acesso ao serviço odontológico e à medida que aumentou o grau de incapacidade dos pacientes menor foi o acesso ao serviço. A média do ISG foi de 29,7% das superfícies dentárias com sangramento gengival, não havendo diferença estatística significante (p=0,35) com o GC. O ICPOD médio foi de 11,6 variando de 4,0 a 24, o que aumentou com o avanço da idade. O maior acúmulo de placa, o sangramento gengival e o consumo de alimentos carigênicos fora do horário da refeição também contribuiram para o aumento do ICPOD. Outro fator relacionado ao aumento de ICPOD foi o não acesso ao serviço odontológico por 70% dos pacientes hansenianos, havendo diferença estatisticamente significante (p=0,0005) com o GC e a falta de orientação de higiene bucal em 60%, havendo diferença estatisticamente significante (p=0,01) com o GC. O ISS médio foi de 0,9ml/min e não apresentou associação com as doses do PQT e nem com o uso de prednisona. Dos pacientes do GE, 25% apresentaram hipossalivação, mas não houve aumento de ICPOD e nenhum dos grupos revelou alteração de pH salivar, variando de 5,85 a 7,34, com capacidade tampão dentro do padrão de normalidade. Concui-se que perfil clínico-epidemiológico dos pacientes portadores de hanseníase assemelha-se a do grupo controle, não tendo sido diagnosticado nenhuma alteração da mucosa bucal específica para hanseníase, o que não anula, entretanto a póssibilidade da cavidade bucal ser fonte de infecção para hanseníase necessitando de confirmação histopatológica e/ou PCR para detecção de M. leprae viável. Além disso, os dados mostraram que a maioria dos pacientes hansenianos avaliados não tem acesso ao serviço odontológico, nem orientação de higiene bucal, resultante da falta de políticas públicas de saúde bucal para hansenianos.

Saúde e qualidade de vida de adolescentes de um assentamento rural no Pontal do Paranapanema-SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Oral health status of people living with HIV/AIDS attending a specialized service in Brazil

Verify factors that influence the oral health status of people living with HIV/AIDS (PLWHA) in Brazil. The study was cross-sectional and includes 177 HIV-positive individuals, who answered questionnaire on the sociodemographic conditions, HIV aspects, habits, and satisfaction with the service. The oral health data were collected by means of the decayed, missing, and filled teeth (DMFT) index, use and need of dentures, and the Community Periodontal Index. Average number of the DMFT was 17.64. Most HIV-positive patients presented good periodontal status, 35.0% used dentures, 41.5% needed denture in the maxilla, and 62.0% in the mandible. In the multivariate analysis, older age and dissatisfaction with health care were associated with nonuse of dentures. The abandonment of the use of antiretroviral therapy increased the risk of PLWHA presenting more than three decayed teeth. Poor oral health of the PLWHA was mainly influenced by sociodemographic factors and use and satisfaction with service.

Análise da interface adesiva entre pinos de fibra de vidro e dentina intrarradicular submetida à irrigação com diferentes agentes condicionantes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Saúde bucal e qualidade de vida em indivíduos com paralisia cerebral e Síndrome de Down: percepção dos cuidadores

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Decline in dental caries among 12-year-old children in Brazil, 1980-2005

Objectives This study was conducted to determine changes in values on the decayed, missing and filled teeth (DMFT) index in 12-year-old children in Brazil between 1980 and 2005, and to correlate DMFT values with human development index (HDI) values, time, population size of municipality and fluoridation of the water supply. Methods The present study represents a retrospective ecological study using secondary data from epidemiological surveys published in indexed journals, as well as data obtained from epidemiological official surveys carried out in Brazil in 1986, 1996 and 2003, and in the State of Sao Paulo in 1998 and 2002. Units of study were represented by Brazilian municipalities holding average DMFT index values for 12-year-old children. Multiple regression analysis was used to examine the correlations among DMFT and HDI values, and time, population size and fluoridation of the water supply. Results The final database included 550 records of DMFT values in 428 different towns. Regression analysis showed statistically significant correlations between DMFT index values and time (P < 0.001), fluoridation of the water supply (P < 0.001) and size of municipality (P < 0.001). Estimated mean DMFT index values were 8.36 in 1980, 6.08 in 1985, 4.45 in 1990, 3.29 in 1995, 2.46 in 2000 and 1.86 in 2005. Conclusions Data showed a significant decrease in dental caries across the entire country, with an average reduction of 25% occurring every 5 years. General trends indicated that a reduction in DMFT index values occurred over time, that a further reduction in DMFT index values occurred when a municipality fluoridated its water supply, and mean DMFT index values were lower in larger than in smaller municipalities.

Dental caries related to quality of life in two Brazilian adolescent groups: a cross-sectional randomised study

Objectives: To analyse dental caries-related quality of life (QoL) in adolescent (1519-year-old) subjects in a suburban area (SA) and a downtown area (DA) of Bauru, Sao Paulo, Brazil, in 2009. Methods: This was a cross-sectional, randomised study. The sample consisted of 185 and 147 adolescents from the SA and DA, respectively. The caries index used was that for decayed, missing and filled teeth (DMFT) (World Health Organization criteria). The 14-item Oral Health Impact Profile (OHIP-14) was used to assess QoL. The non-parametric MannWhitney test, Spearmans correlation coefficient and chi-squared test were used in the statistical analysis. Results: The DMFT index, Significant Caries (SiC) Index and percentage of caries-free students were similar (P > 0.05) between these populations, but findings on the Care Index differed (P < 0.05). There was a correlation between the DMFT index and OHIP-14 score in SA subjects (mean DMFT index = 3.01) in the dimensions of physical pain (r = 0.25; P < 0.01) and psychological disability (r = 0.17; P = 0.02). The DMFT index in DA subjects (mean DMFT index = 2.95) showed a correlation with functional limitation (r = 0.19; P = 0.02). The correlation in SA subjects between the caries component (mean = 1.22) of the DMFT index and OHIP-14 was significant only for the physical pain dimension (r = 0.16; P = 0.03). In DA subjects, correlations between the caries component (mean = 0.37) and all dimensions of OHIP-14 were statistically significant (P < 0.05). Conclusions: Despite the similarities in means in the DMFT index, the SiC Index and the caries-free percentage of subjects in both localities, access to dental treatment proved to be less effective for SA adolescents. Physical pain and psychological disability were the most frequent negative manifestations of impact on QoL. The SA adolescents were more negatively affected by dental caries in terms of QoL.

Oral manifestations in patients with hypogammaglobulinemia

Objective. The overall objective of this study was to assess the oral manifestations and their association with immunologic status and health history, of individuals with hypogammaglobulinemia. Study Design. A case-controlled study of 100 subjects with hypogammaglobulinemia and 93 control individuals was performed. All participants were examined for dental caries, periodontal disease, mucosal lesions/infections, and general oral health problems. Decayed, missing, filled teeth and community periodontal index were recorded. Complete blood count, serum immunoglobulins, and lymphocyte immunophenotyping were measured on the same day of the oral health assessment. Results. Individuals with hypogammaglobulinemia showed higher prevalence of enamel hypoplasia and complaints of dry mouth, and lower prevalence of dental caries and periodontal disease. Conclusions. The systemic conditions associated with hypogammaglobulinemia were not associated with enhanced susceptibility to caries, gingivitis, or periodontitis; however, individuals with hypogammaglobulinemia were more likely to report more episodes of recurrent aphthous ulcers compared with control individuals. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:e19-e24)

Oral health as a predictive factor for oral mucositis

OBJECTIVES: Oral mucositis is a complication frequently associated with hematopoietic stem cell transplantation, decreasing a patient’s quality of life and increasing the occurrence of opportunistic infections. The purpose of this study was to determine the incidence and severity of oral mucositis and to assess the correlation of this disease with the oral health of an individual at the time of hematopoietic stem cell transplantation. METHODS: Before transplantation, patients’ oral health and inflammatory conditions were determined using the gingival index and the plaque index, which are based on gingival bleeding and the presence of dental plaque, respectively. Additionally, the dental health status was determined using the decayed, missing, and filled teeth index. The monitoring of oral mucositis was based on the World Health Organization grading system and was performed for five periods: from Day 0 to D+5, from D+6 to D+10, from D+11 to D+15, from D+16 to D+20, and from D+21 to D+30. RESULTS: A total of 97 patients (56% male and 44% female) who underwent hematopoietic stem cell transplantation at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo between January 2008 and July 2009 were prospectively examined. The incidence of ulcerative mucositis was highest from days +6 to +10 and from days +11 to +15 in the patients who underwent autologous and allogeneic hematopoietic stem cell transplantation, respectively. CONCLUSION: The data, including the dental plaque and periodontal status data, showed that these oral health factors were predictive of the incidence and severity of oral mucositis in a cohort of patients with similar conditioning regimens before hematopoietic stem cell transplantation

Dental caries-related quality of life and socioeconomic status of preschool children, Bauru, SP

AIM: To evaluate oral health-related quality of life of preschool children of Bauru, State of São Paulo, Brazil, and associate it with socioeconomic profile of households. METHODS: The sample consisted of 229 preschool children between 3 and 5 years and the dmft (decayed, missing due to caries, filled teeth) index was adopted for assessment children's dental caries in accordance with the standards recommended by the World Health Organization. Questionnaires were used for evaluation oral health-related quality of life (Early Childhood Oral Health Impact Scale) and socioeconomic profile of parents or guardians of the preschool children. Statistical analysis was performed descriptively by relative and absolute frequencies and by Spearman's correlation and Kruskal-Wallis test (p <0.05). RESULTS: A dmft of 1.65 (± 2.87) and a Sic Index 4.88 (± 3.20) were found, indicating the polarization of dental caries in the studied group. It was verified low influence of oral health on quality of life of the children examined. With respect to socioeconomic classification, 66.38% of families were in the lower middle class. Linear and statistically significant correlation was found between dmft and oral health-related quality of life for the overall score and domains of the questionnaire (p<0.001). CONCLUSIONS: It was found low influence of oral health on quality of life of the preschool children and the assessment of socioeconomic conditions of the children's families may guide practices aiming to reducing inequalities in the distribution of dental caries in the population.

Migration background is associated with caries in Viennese school children, even if parents have received a higher education.

BACKGROUND A low level of education and the migration background of parents are associated with the development of caries in children. The aim of this study was to evaluate whether a higher educational level of parents can overcome risks for the development of caries in immigrants in Vienna, Austria. METHODS The educational level of the parents, the school type, and the caries status of 736 randomly selected twelve-year-old children with and without migration background was determined in this cross sectional study. In children attending school in Vienna the decayed, missing, and filled teeth (DMFT) index was determined. For statistical analysis, a mixed negative-binomial-model was used. RESULTS The caries status of the children with migration background was significantly worse compared to that of the native Viennese population. A significant interaction was found between migration background and the educational level of the parents (p = 0.045). No interaction was found between the school type and either the migration background (p = 0.220) or the education level of the parents (p = 0.08). In parents with a higher scholarly education level, migration background (p < 0.01) and school type (p = 0.018) showed an association with DMFT values. In parents with a low education level, however, migration background and school type had no significant association with DMFT values. CONCLUSION These data indicate that children with a migration background are at higher risk to acquire caries than other Viennese children, even when the parents have received a higher education.

Evolutionary conservation and murine embryonic expression of the gene encoding the SERTA domain-containing protein CDCA4 (HEPP)

Cdca4 (Hepp) was originally identified as a gene expressed specifically in hematopoietic progenitor cells as opposed to hematopoietic stem cells. More recently, it has been shown to stimulate p53 activity and also lead to p53-independent growth inhibition when overexpressed. We independently isolated the murine Cdca4 gene in a genomic expression-based screen for genes involved in mammalian craniofacial development, and show that Cdca4 is expressed in a spatio-temporally restricted pattern during mouse embryogenesis. In addition to expression in the facial primordia including the pharyngeal arches, Cdca4 is expressed in the developing limb buds, brain, spinal cord, dorsal root ganglia, teeth, eye and hair follicles. Along with a small number of proteins from a range of species, the predicted CDCA4 protein contains a novel SERTA motif in addition to cyclin A-binding and PHD bromodomain-binding regions of homology. While the function of the SERTA domain is unknown, proteins containing this domain have previously been linked to cell cycle progression and chromatin remodelling. Using in silico database mining we have extended the number of evolutionarily conserved orthologues of known SERTA domain proteins and identified an uncharacterised member of the SERTA domain family, SERTAD4, with orthologues to date in human, mouse, rat, dog, cow, Tetraodon and chicken. Immunolocalisation of transiently and stably transfected epitope-tagged CDCA4 protein in mammalian cells suggests that it resides predominantly in the nucleus throughout all stages of the cell cycle. (c) 2006 Elsevier B.V. All rights reserved.

Escovagem de dentes em ambiente escolar e redução do índice de placa bacteriana: avaliação da efetividade de um projeto de saúde oral

Dada a elevada prevalência de cárie em Portugal em idades jovens, a equipa de saúde escolar do concelho de Oliveira do Bairro (distrito de Aveiro), desenvolveu, durante o ano letivo 2012/13, um projeto de educação para a saúde, denominado Senhor Dente, dirigido a crianças em idade pré‐escolar (3‐6 anos) que consistiu na implementação da escovagem na escola. Com este estudo pretendeu‐se determinar o grau de redução da placa bacteriana nas crianças abrangidas pelo referido projeto, de forma a avaliar a sua efetividade na redução das cáries dentárias. Efetuou‐se um estudo quasi experimental, no qual foi avaliado o índice de placa bacteriana individual antes e após a implementação do projeto (ninicial = 256; nfinal = 190). Antes da intervenção, estimou‐se uma prevalência de cárie dentária de 32,8% (IC 95%: 27,0‐38,6). Após a implementação da escovagem dentária na escola, observou‐se uma redução do índice de placa bacteriana de 2,45 (IC 95%: 2,38‐2,51), havendo uma associação estatisticamente significativa entre a variação no índice de placa bacteriana e o valor inicial do índice de dentes cariados, perdidos e obturados por cárie e, também, com o intervalo de tempo decorrido entre os 2 momentos de avaliação. Os resultados demonstraram a efetividade dos programas de saúde escolar que promovam a escovagem dentária diária na escola e sugerem a necessidade de avaliar qual deve ser a duração destes projetos, como forma de otimizar os recursos necessários para o seu desenvolvimento.