Representações sociais como instrumento de informação para a saúde bucal coletiva

In addition to understanding the distribution of the populations’ health-disease process, epidemiology has sought to study the causality associated with this process, which humanity developed over time, and to interpret the narrative of this field of knowledge. A solid review of the literature was done to emphasize the importance of using popular knowledge as a qualitative health-related investigation strategy and to demystify the use of social representations in the field of dentistry. By initiating the design of a new paradigm for understanding the oral health-disease process, which favors the idea that it is also the result of a sociocultural production, knowledge of the circumstances and context in which it is inserted becomes critical for health assessment actions. Although scientific dentistry has advanced the understanding of oral diseases, communication with popular knowledge leaves much to be desired, since most professionals find themselves trapped in a fragmented model of care. Reconstruction of the logic by which the representations of oral health were produced and socialized over time can be considered a relevant and productive purpose of the representations in the dental area.

Work conditions and occupational health of dentists in Brazilian public health system

Conselho Nacional de Desenvolvimento Ciêntífico e Tecnológico (CNPq)

Dental care for cerebral palsy patients using auxiliary resources to inhibit pathological tonic reflexes

Cerebral paralysis is a chronic illness that affects the central nervous system. In this article the author describes the techniques used at CAOE (Odontological Center for Assistance to patients with special needs) to restraint CP patients during dental treatment, because they present some pathological reflexes which interfere in their odontological assistance. Also it shows how to perform a special physical restraint and how to keep the mouth open by using simple tools including a homemade one. All the devices used during the dental treatment in cerebral palsy patients, such as the physical restraint with bands or sheet to wrap them up, cylindrical pad or cushion made of a soft material, or simple tools including a homemade one to keep the mouth open are usually and safely used in CAOE. All these simple devices are necessary, because there are no available funds for the acquisition of expensive material or equipment. Despite of a shortage of resources we can easily and efficiently assist these patients.

Reflexões sobre o conceito de atendimento humanizado em Odontologia

Humanization at dental care is highly important due to uneven relation between scientific / technical advances in dentistry and thequality of human contact. The dental treatment goes beyond the field of scientific knowledge. Therefore, the dental treatment requiresbalance among technical skill, scientific training, and humanist vision of health promotion. Contemporarily, humanization is understoodas tripod based on user's rights, dental practice and organization of a humanized model. Curriculum integration of ethical, humanistic,scientific and technical contents is an important and current challenge on teaching / learning process for professionals at Dentistry. Thispaper aims to, guided by the literature review, to present some considerations on human care in dentistry, with emphasis on theimportance of professional /patient relationship for promoting oral health. It is suggested that dentists reflect on the urgent need ontheoretical basis of humanization and patient-professional relationship for health care.Descriptors: Humanization of Assistance; Dental Staff

Restauração transcirúrgica como alternativa na resolução das perfurações endodônticas

The endodontic perforations are iatrogenic communications that result in a communication between the endodonto and periodontium. This occurrence represents about 10 % of cas- es of failure in endodontic treatment. The management may vary and is related to the drilling site endodontic. This paper aims to report a case of iatrogenic perforation and one of the possible alternatives for the treatment of endodontic perforations -level cervical tooth. During the opening coronary perforation occurred due to improper slope cervical penetration drill. Considering the drilling site, we opted for sealing com- posite resin after surgical access and absolute isolation. After sealing, the channel was filled with medication and instru- mented based on calcium hydroxide. Later the canal was obturated by lateral condensation technique with Sealapex. The radiographic follow-up showed regression of the lesion and the clinical silence confirmed the success of the treatment.

Avaliação da infiltração marginal de três cimentos endodônticos após preparo para retentor de acordo com o momento do preparo

Objetivo: o objetivo desse estudo in vitro foi avaliar a infiltração marginal coronária após o preparo para retentor em dentes obturados com três diferentes cimentos, de acordo com o período entre a obturação do canal radicular e o preparo para retentor. Métodos: Noventa dentes humanos recentemente extraídos foram limpos e instrumentados e, então, obturados com Sealapex, Endométhasone ou TopSeal. Brocas Gates-Glidden foram utilizadas para o preparo imediato de 10 dentes de cada cimento até manter 5mm de obturação remanescente. Sessenta raízes obturadas foram incubadas a 37°C em meio úmido por 30 e 60 dias para serem, depois, preparadas para os retentores como descrito anteriormente. A superfície externa de cada raiz foi coberta com Araldite. Os espécimes foram imersos em corante azul de metileno a 2% sob vácuo por 24h, para então poderem ser analisados. A infiltração foi mensurada pelo software Sigma Scan da parte superior da obturação à porção apical alcançada pelo corante. Resultado: o Sealapex e o TopSeal apresentaram menor infiltração após o preparo para retentor do que o Endométhasone. O preparo imediato para o retentor apresentou menor infiltração do que o preparo para o retentor após 30 e 60 dias da obturação do canal radicular.

Confocal laser scanning microscopy investigation of bond interfaces involved in fiber glass post cementation

Objective: This confocal microscopy study evaluated the cement/dentin and cement/post interfaces along theroot canalwallswhenfiberglasspostswerebonded to dentin using different types of cements. Material & Methods: Thirty endodontically treated premolars were divided into 3 groups according to the adhesive materials used in the bonding procedure: Prime & Bond 2.1/Self Cure + Enforce, RelyX Unicem and RelyX Luting. Rhodamine B dye was incorporated in the luting materials for the cementation of the fiber glass posts (Exacto, Angelus) to dentin. Three transversal slices (apical, middle and coronal) were examined under confocal laser scanning microscopy. Statistical analysis was performed using the Kappa, Kruskal-Wallis and Dunnet tests, in a significance level of 5%. Results: The Prime & Bond 2.1/Self Cure + Enforce presented a uniform formation of tags in the dentin but gaps in the cement/dentin interface. The RelyX Unicem and RelyX Luting presented an adhesive interface with a fewer amount of gaps, but showed shorter tag formation than the Enforce system. All cements presented the same pattern of bubbles inside the cements. The RelyX Luting presented a greater amount of cracks inside the cement in comparison with the other cements in the coronal third, while no difference was observed between RelyX Unicem and Enforce. The RelyX Luting showed the lowest quantity of cement penetration into the post. Conclusion: In general, the quality of bonding interfaces of fiber posts luted to root canals was affected by both location and type of cement.

Chronic osteomyelitis of the maxilla and mandible: microbiological and clinical aspects

Osteomyelitis of the mandible and maxilla are common in developing countries and their treatment may be long-standing and difficult. Thus, the aim of this study was to discuss the main biological aspects of the chronic osteomyelitis of the jaws of especial interest for dental team. These infections are associated with a complex microbiota composed mainly by anaerobic bacteria, sometimes associated with microorganisms originated from the skin and digestive tract. These data suggest that chronic osteomyelitis of the mandible and maxilla should be treated as anaerobic infections in most cases. In addition, local surgical treatments are relevant in the therapy outcome, associated to the use of antimicrobial agents, and the failure to accomplish them is a major cause of treatment failure.

Efeitos da radioterapia sobre as condições bucais de pacientes oncológicos

This study evaluated the oral conditions of 50 cancer patients undergoing head and neck radiotherapy (RT). Clinical examinations were performed before treatment, immediately after 30 days after RT and 6 months after conclusion of RT. Periodontal conditions were evaluated using the criteria of the Periodontal Screening and Recording (SRP) and the need for dental treatment were determined. The presence of xerostomia, mucositis and other side effects of RT were also evaluated. Soon after the beginning of RT, the irradiated patients of radiotherapy developed severe mucositis, dermatitis, dysgeusia, xerostomia and, to a lesser extent, candidosis. After completion of radiotherapy, 68% of patients had level III or IV mucositis. It was found that the development of mucositis hinders oral hygiene and these factors contribute to exacerbate inflammation of periodontal tissues. The data from this study evidenced that the main cause of desertion of RT and of severity of sequelae of RT depends on the oral conditions of patients before starting treatment and the absence of previous dental treatment prior RT.

Opportunistic microorganisms in patients with head and neck trauma

The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.

Qualidade de vida de pacientes submetidos à radioterapia para tratamento de lesões malignas de cabeça e pescoço

In order to evaluate the quality of life of patients with head and neck cancer, this study analyzed data of 24 patients with squamous cell carcinoma, which indicated therapy was radiotherapy or not be combined with chemotherapy and surgery. The study was conducted in the Unit of Radiotherapy of Megavoltage located in the São José de Rio Preto-SP, in the period August 2007 to January 2008. Then, it was used the questionnaire of quality of life from University of Washington which enabled the identification of different quality of life patterns associated with the different stages of radiotherapy, indicating to be viable the prospect of recognition of prognostic factors of reduction in multiple domains of quality of life. From the data collected and analyzed, it was identified that the areas with the worst score in the begin of radiotherapy were appearance, speech and anxiety; during the treatment were taste, saliva and anxiety; and in the end were taste, saliva and swallowing. Throughout the treatment, it was observed the deterioration of patients' mood. In this regard, emphasizes the importance of dental and psychological follow-up, within the framework of a multidisciplinary care for patients with head and neck cancer during radiotherapy treatment.

Clinical evaluation of multiple-surface ART restorations: three-year follow-up

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

Púrpura trombocitopênica idiopática: importância do cirurgião-dentista no diagnóstico

This paper presents a case report of a patient with idiopathic thrombocytopenic purpura (ITP) diagnosed in routine dental care. ITP is defined as a decrease in the number of circulating platelets and generally shows oral manifestations. In this light, we show that the general dental practitioner must be ready to detect ITP signs and symptoms, especially oral changes that are not of dental origin, so as to immediately prescribe the proper treatment. Without this treatment, this pathology may well be irreversible and fatal.