Andréa Clemente Palmier

Indicadores socioeconômicos e serviços odontológicos em uma região brasileira desfavorecida

OBJETIVO: Avaliar a associacao entre proporcao de exodontias, indicadores socioeconomicos e oferta de servicos odontologicos em uma regiao desfavorecida do Brasil. METODOS: Um estudo ecologico foi realizado em 52 municipios do Estado de Minas Gerais, Brasil. Os indicadores socioeconomicos utilizados foram os criterios de alocacao de recursos financeiros destinados a saude, os indices de desenvolvimento humano municipal, de Theil e de Gini e as condicoes de saneamento. Em relacao a oferta de servicos de saude bucal, foram considerados o numero de habitantes, o numero de cirurgioes-dentistas residentes no municipio, o numero de dentistas que trabalhavam no servico publico e o numero de equipes de saude bucal. A utilizacao de servicos foi avaliada pelos indicadores de saude bucal preconizados pelo Pacto da Atencao Basica e pelo numero de procedimentos realizados na atencao primaria. As 17 variaveis avaliadas foram agrupadas em componentes. Analisou-se a relacao entre esses componentes fatoriais e a variavel dependente, proporcao de exodontias. RESULTADOS: As variaveis foram agrupadas em seis componentes (condicoes socioeconomicas, desigualdades sociais, indicadores do Pacto da Atencao Basica, numero de procedimentos realizados, razao dentistas:populacao, cobertura da Estrategia Saude da Familia) que explicaram, no conjunto, 73,5% da variância total. As desigualdades na distribuicao de renda (P = 0,031) e a cobertura da Estrategia Saude da Familia (P = 0,015) tiveram significativamente maior peso para explicar a diferenca na proporcao de exodontias realizadas nos municipios estudados. CONCLUSOES: Os fatores socioeconomicos e de organizacao dos servicos de saude bucal explicam grande parte da mutilacao dentaria nessa regiao.

Relação entre condição gengival e fatores sociodemográficos de adolescentes residentes em uma região brasileira

The scope of this study is to correlate the gingival condition and sociodemographic status of adolescents living in an economically disadvantaged Brazilian region. The survey was conducted with a random sample of 450 adolescents in 13 cities selected in the Jequitinhonha Valley (State of Minas Gerais). The gingival condition was evaluated using a calibrated examiner (Kappa ≥ 0.85). The oral exam was based on the Community Periodontal Index (CPI). The frequencies of individuals were calculated and sextants subsequently assessed using Multiple Correspondence Analysis (ANACOR) to reveal the relationship between CPI and sociodemographic characteristics. The results showed that: 16 (3.6%) were healthy; 235 (52.2%) had gingival bleeding; 36 (8%) had dental calculus and 163 (36.2%) had both bleeding and calculus. ANACOR identified two groups with similarities in relation to periodontal disease. Group one featured 19-year-olds with healthy CPI who work and have higher family income. Group two included 15- and 16-year-olds of both sexes with CPI and gingival bleeding in elementary school with lower family income, who declared themselves to be of mixed or Afro-descendant race. The presence of gingivitis was related to the socioeconomic and demographic characteristics of adolescents in the region.The scope of this study is to correlate the gingival condition and sociodemographic status of adolescents living in an economically disadvantaged Brazilian region. The survey was conducted with a random sample of 450 adolescents in 13 cities selected in the Jequitinhonha Valley (State of Minas Gerais). The gingival condition was evaluated using a calibrated examiner (Kappa ≥ 0.85). The oral exam was based on the Community Periodontal Index (CPI). The frequencies of individuals were calculated and sextants subsequently assessed using Multiple Correspondence Analysis (ANACOR) to reveal the relationship between CPI and sociodemographic characteristics. The results showed that: 16 (3.6%) were healthy; 235 (52.2%) had gingival bleeding; 36 (8%) had dental calculus and 163 (36.2%) had both bleeding and calculus. ANACOR identified two groups with similarities in relation to periodontal disease. Group one featured 19-year-olds with healthy CPI who work and have higher family income. Group two included 15- and 16-year-olds of both sexes with CPI and gingival bleeding in elementary school with lower family income, who declared themselves to be of mixed or Afro-descendant race. The presence of gingivitis was related to the socioeconomic and demographic characteristics of adolescents in the region.

Two-stage technique in third molar autotransplantation: case report

Tooth autotransplantation is an option for treating patients presenting early tooth loss. The teeth most commonly removed are the first molars, and their absence could lead to several oral health problems in patients. This transplant technique consists of the transposition and repositioning of a tooth from one area to another, in the same patient. Dental implants have high success rates, but tooth autotransplantation is less complex and less expensive, because the patient’s own tooth is used. In the context of dental rehabilitation, tooth transplantation is focused on re-establishing masticatory function and esthetics. Success rates are variable, but in the majority of cases they exceed 80%. This article aims to report the case of a patient who underwent autotransplantation of the maxillary left third molar into the maxillary right first molar position. The surgical procedure was performed on two stages. After a 3-year clinical and radiographic follow-up period, a satisfactory result was achieved with the transplanted tooth presenting a healthy pulp and periodontal tissues, reestablishing the patient’s function and esthetics. Indexing terms: Oral surgery. Organ transplantion. Third molar. Tooth.

Hospital Dental Treatment for Special Health Care Needs Patients in Minas Gerais state, Brazil: A Cluster Analysis

Objective: To describe and group some demographic and healthcare characteristics of hospital dental care for the special health care needs population. Material and Methods: Cross-sectional census survey with a total of 1,063 visits with special health care need patients under general anesthesia or sedation at the Brazilian Health System Minas Gerais, Brazil, over 12 months. Clinical diagnosis was divided into “mental and behavioral disorders and diseases of the nervous system” and “others”. Age group, gender, clinical diagnosis and care by a general dentist were submitted to descriptive and multivariate cluster analysis. The analysis was performed using the software SPSS version 19.0. Results: Cluster 1 (N=173) had no ICD codes for nervous system (NS) diseases and mental and behavioral disorders. Clusters 2 (N=564) and 3 (N=326) are quite similar except for gender distribution. Cluster 1 was 3.5 times more frequent among non-host cities than HER host cities. Dental treatment was mostly performed on males diagnosed with mental and behavioral disorders and diseases of the NS who were over the age of 25 years and were seen by general dentists. The clusters were distributed unevenly between EHR host and non-host cities. Conclusion: Non-host performed more frequently treatment for patients with no mental and behavioral disorders and diseases of the NS than EHR host cities.

Utilização dos serviços de atendimento odontológico hospitalar sob sedação e/ou anestesia geral por pessoas com necessidades especiais no SUS-MG, Brasil

This study identified the demographic characteristics of individuals and dental treatment care under sedation/general anesthesia in a hospital environment in the Unified Health System in the State of Minas Gerais (SUS-MG). All Hospitalization Authorizations (AIHs) for Dental Treatment for Patients with Special Needs procedures were evaluated between July 2011 and June 2012. Demographic and health care variables for treatment were also assessed. Hospitalization rates per 10,000 inhabitants, and health care coverage provided in the state of Minas Gerais and in each of the Broader Health Regions were calculated. Descriptive analysis of data was carried out by calculating the central trend and variability frequency and measurements. All 1,063 AIHs paid during the study period were evaluated, which is equivalent to a rate of 0.54 hospitalizations per 10,000 individuals. The majority of the patients were adult, male, diagnosed with mental or behavioral disorders and resident in 27.7% of the municipalities in Minas Gerais. The procedures were performed in 39 municipalities and the care coverage was equal to 1.58%. The study reveals a classic demographic and clinical profile of patient attendance. Difficulties in establishing a network of dental care were identified.This study identified the demographic characteristics of individuals and dental treatment care under sedation/general anesthesia in a hospital environment in the Unified Health System in the State of Minas Gerais (SUS-MG). All Hospitalization Authorizations (AIHs) for Dental Treatment for Patients with Special Needs procedures were evaluated between July 2011 and June 2012. Demographic and health care variables for treatment were also assessed. Hospitalization rates per 10,000 inhabitants, and health care coverage provided in the state of Minas Gerais and in each of the Broader Health Regions were calculated. Descriptive analysis of data was carried out by calculating the central trend and variability frequency and measurements. All 1,063 AIHs paid during the study period were evaluated, which is equivalent to a rate of 0.54 hospitalizations per 10,000 individuals. The majority of the patients were adult, male, diagnosed with mental or behavioral disorders and resident in 27.7% of the municipalities in Minas Gerais. The procedures were performed in 39 municipalities and the care coverage was equal to 1.58%. The study reveals a classic demographic and clinical profile of patient attendance. Difficulties in establishing a network of dental care were identified.