Arnaldo de França Caldas Júnior

Influência da classe social nas razões clínicas das perdas dentárias

Com o objetivo de determinar a influencia da classe social nas razoes clinicas das perdas dentarias na cidade de Maceio, Alagoas, foi realizado um estudo transversal que envolveu 466 individuos adultos, com idade entre 18 a 76 anos. Foram coletados dados socioeconomicos e demograficos atraves de um formulario. O exame clinico determinou a razao pela qual o dente seria extraido e houve registro do CPO-D de todos os pacientes. Os pacientes foram incluidos em classes sociais com base nos dados coletados dos formularios. 54,1% dos individuos que participaram da pesquisa eram do sexo feminino, a idade teve media de 33,73 ± 13,68 anos, observou-se que 369 (79,2%) nao tinham completado o segundo grau e 385 (82,6) apresentaram renda familiar de ate quatro salarios minimos, com media de 3,4 ± 5,4. A principal razao das perdas dos dentes permanentes foi a carie dentaria. Os pacientes apresentaram em media 16,59 ± 6,96 dentes cariados, perdidos ou obturados, a maioria dos pacientes 219 (47,0%) apresentaram CPO-D entre onze a vinte dentes. Observou-se associacao estatisticamente significante entre a razao da perda e o grupo social a que pertencia o paciente (P<0,001). Concluiu-se que a classe social influenciou significativamente na razao clinica da perda dentaria.

Prevalence of overweight and obesity in elderly people from Vitória-ES, Brazil

The scope of this study was to estimate the prevalence of overweight and obesity and its association with socio-economic status in a sample of non-institutionalized elderly people from Vitória-ES, Brazil. This was a cross-sectional survey with a sample of 882 elderly people aged 60 and over. Obesity and overweight were assessed using the body mass index (BMI) and waist circumference (WC). All subjects answered a personal and socio-demographic questionnaire in relation to age, gender, marital status, physical activity, number of children, chronic diseases and smoking. Associations between categorical variables were tested using chi-square analysis with a 5% significance level. The prevalence of overweight and obesity was high (41.8% and 23.4%, respectively) and 50.7% of the elderly had a substantially increased waist circumference. About 4.3% of the individuals had diabetes, 50.4% had hypertension and 14.9% were found to have both diseases. It was observed that both the BMI and WC were significant associated (p<0.05) with sex, marital status, the presence of diseases and with cigarette smoking.

The relationship between nutrient intake, dental status and family cohesion among older Brazilians

The aim of this study was to investigate the relationship between inadequate nutrient intake, oral health and family cohesion. This was a cross-sectional study with a sample of 887 non-institutionalized elderly people from Vitória, Espírito Santo State, Brazil. Oral examination was performed by trained and calibrated examiners and three measurements were considered: number of posterior occluding pairs of natural teeth (POP), number of teeth and overall dental status. Nutrient intake was assessed by a 24-hour diet recall interview. The elderly persons perception of family cohesion was assessed using the family adaptability and cohesion scale. People with no POP were more likely than those with 5 or more POP to have inadequate intake of vitamin C (OR = 2.79; 95%CI: 1.16-6.71), calcium (OR = 3.74; 95%CI: 1.69-8.25), riboflavin (OR = 2.49; 95%CI: 1.10-5.64) and zinc (OR = 3.43; 95%CI: 1.07-10.94). There was no association between elderly peoples perceptions of family cohesion and inadequate intakes. It was concluded that oral health is related to inadequate intake of important nutrients among non-institutionalized elderly people.

Prevalência de más oclusões e alterações funcionais entre escolares assistidos pelo Programa Saúde da Família em Juazeiro do Norte, Ceará, Brasil

OBJETIVOS: determinar a prevalencia de mas oclusoes e alteracoes funcionais entre escolares assistidos pelo Programa Saude da Familia em Juazeiro do Norte. METODOLOGIA: realizou-se um estudo transversal na area assistida pela Unidade de Saude da Familia (USF) no 20 de Juazeiro do Norte. A partir de uma populacao de 704 criancas de ambos os generos com idades entre 6 e 12 anos, calculou-se a amostra utilizando-se um intervalo de confianca de 95%. Avaliou-se, clinicamente, os padroes oclusal e funcional do sistema estomatognatico de 84 criancas, as quais foram convocadas aleatoriamente por agentes comunitarias de saude. Os padroes foram classificados em: normal (oclusao e funcoes normais) ou alterado (presenca de ma oclusao e/ou alteracao funcional). A oclusao dividia-se nas relacoes: vertical, transversal e ântero-posterior. As funcoes analisadas foram: respiracao e degluticao. Para a analise estatistica, utilizaram-se os testes Qui-quadrado e de Fisher. RESULTADOS: 77,3% e 72,6% da amostra apresentaram mas oclusoes e padrao funcional alterado, respectivamente; 59,52% apresentaram ambas as alteracoes; 45,2% apresentaram alteracoes oclusais verticais; 60,7% alteracoes transversais e 20,2% alteracoes ântero-posteriores; 60,7% alteracoes respiratorias e 47,6% degluticao alterada. Houve associacao estatisticamente significativa entre a relacao vertical e as duas funcoes avaliadas (p<0,001) e entre a relacao transversal e a funcao respiratoria (p<0,05). CONCLUSOES: as prevalencias de mas oclusoes e de alteracoes funcionais foram elevadas, 77,3% e 72,6%, respectivamente. Houve uma forte associacao entre a relacao oclusal vertical e as funcoes avaliadas (respiracao e degluticao).

Association between symptoms of depression and oral health conditions: ORAL HEALTH AND SYMPTOMS OF DEPRESSION

AIMS To investigate the symptoms of depression and oral health status in Brazilian public healthcare system users. MATERIALS AND METHODS Analysis of a cross-sectional study conducted with a sample of 776 individuals aged 15 years or older, in the urban areas of Recife (Brazil), obtained by multistage sampling. Committee on Ethics in Research with Human Beings (CAAE) 0538.0.172.172-11. Depression symptoms were verified by means of Axis II of the Research Diagnostic Criteria in Temporomandibular Disorder. For the socioeconomic level, the economic classification criteria of the Brazilian Association of Research Companies and clinical exam record charts were used to establish variables related to oral health conditions. RESULTS The variables discomfort on occlusion (OR = 1.882 CI = 1.384-2.560), gingival bleeding (OR = 1.384 CI = 1.002-1.912), and self-perception of oral health (OR = 1.549 CI = 1.054-2.277), remained in the regression model. CONCLUSION Discomfort on occlusion, self-perception of oral health, gingival bleeding, sex, and skin color were shown to be associated with the presence of depressive symptoms.

PHOTODYNAMIC THERAPY FOR TREATMENT OF ORAL MUCOSITIS: PILOT STUDY WITH PEDIATRIC PATIENTS UNDERGOING CHEMOTHERAPY

BACKGROUND Oral mucositis has become a major dose-limiting toxicity of antineoplastic treatment. AIM The aim of this study was to evaluate the effect of photodynamic therapy (PDT) and low level laser therapy (LLLT) on the treatment of chemotherapy-induced mucositis in pediatric patients. METHODS An open, controlled, and blind, randomized clinical trial was conducted with 29 patients, from 10 months to 18 years old, who were divided into two groups. Group A was submitted to photodynamic therapy (0.01% Methylene Blue and red laser, λ660 nm) with 3J energy per point; and Group B submitted to low level laser therapy (λ660 nm) with 1J energy per point. The results were evaluated by using the WHO and ChIMES mucositis scales. The Chi-square, Exact Fisher, Students-t and Mann-Whitney tests, and the mixed linear regression model were used for comparison between the groups, with the maximum error admitted of 5%. RESULTS There was no difference between the groups as regards the number of sessions necessary for clinical cure of the oral lesions (p = 0.954) or reduction in pain reported by the patients (p = 0.258; p = 0.486). Within each group, however, there was significant reduction in pain (p = 0.032; p = 0.003). The number needed to treat (NNT) was 4.75. CONCLUSIONS PDT or LLLT could be used for treatment of oral mucositis in children/young patients. Each were well tolerated and presented satisfactory results in reducing pain associated with the lesion.

Characterization of women victims of violent death in a metropolitan area of Northeast Brazil

Objective: To analyze the frequency, body topographic local and the instruments used in women with violent death in the city of Recife and the metropolitan area and in the years from 2000 to 2009. Methods: Data collection was performed at the Institute of Forensic Medicine Persivo Antonio Cunha-PE from March to October 2010. Through a study, of chronological approach, necropsy reports in women residing in the Metropolitan Region of Recife-PE in the years 2000 to 2009 were selected. We analyzed the frequency of deaths, the type of instruments used and the topographic location of the lesion. Statistical analysis used the chi-square test or Fishers exact test, at the significance level of 5%. Results: The frequency distribution showed that the homicide was the 1st reason and represented 36.2% of the total mortality. The accident was the second most common cause with 30.2% followed by the suicides with 5.7%. Regarding the body topographic location, polytrauma presented 29.1% of the occurrences followed by the craniofacial complex with 26.3%. Within the complex craniofacial, the head was the most affected with 27.4%. The face corresponded to 4.2% of the cases. The type of instrument of more incidence was the blunt with 36%, followed by blunt-stabbing with 27%. Conclusion: The homicides demonstrate the magnitude of external causes as cause of premature death among women. The head and neck region is closely linked to the cases of violence against women.

Cumulative Trauma Disorders among Dentists

Abstract Objectives: The aim of this study was to investigate the cumulative trauma disorders [CTD] among public health dentists according to sex, age, working time, specialty, workload, and physical activity, identifying the frequency, intensity, and limitations caused by CTD in their professional practice. Methods: A cross-sectional study was carried out with 150 dentists in public health units. Subjects were classified according to socioeconomic and demographic levels, the presence or absence of CTD, and type of working process. The Portuguese version of the Nordic Musculoskeletal Questionnaire was used to evaluate these variables. The statistical analysis was performed using the SPSS software. The chi-square and Fishers exact tests were used to evaluate the association between variables, with a confidence interval set at 95% and a significance level at 5%. Results: Most subjects interviewed were female [79.3%] with an average of 20 years of professional experience [46.0%]. Despite 92% of respondents showing symptoms of musculoskeletal disorders, only 20% were diagnosed with CTD. Conclusions: The presence of CTD in the studied sample was high. The large number of dentists with the symptoms compared to the low number of dentists properly diagnosed is suggestive of underreporting and explains why governmental statistics do not have this data.

Temporomandibular disorder: otologic implications and its relationship to sleep bruxism

INTRODUCTION Temporomandibular disorder is an umbrella term for various clinical problems affecting the muscles of mastication, temporomandibular joint and associated structures. This disorder has a multifactor etiology, with oral parafunctional habits considered an important co-factor. Among such habits, sleep bruxism is considered a causal agent involved in the initiation and/or perpetuation of temporomandibular disorder. That condition can result in pain otologic symptoms. OBJECTIVE The aim of the present study was to investigate the relationship between temporomandibular disorder and both otologic symptoms and bruxism. METHODS A total of 776 individuals aged 15 years or older from urban areas in the city of Recife (Brazil) registered at Family Health Units were examined. The diagnosis of temporomandibular disorder was determined using Axis I of the Research Diagnostic Criteria for temporomandibular disorders, addressing questions concerning myofascial pain and joint problems (disk displacement, arthralgia, osteoarthritis and osteoarthrosis). Four examiners had previously undergone training and calibration exercises for the administration of the instrument. Intra-examiner and inter-examiner agreement was determined using the Kappa statistic. Individuals with a diagnosis of at least one of these conditions were classified as having temporomandibular disorder. The diagnosis of otologic symptoms and bruxism was defined using the same instrument and a clinical exam. RESULTS Among the individuals with temporomandibular disorder, 58.2% had at least one otologic symptom and 52% exhibited bruxism. Statistically significant associations were found between the disorder and both otologic symptoms and bruxism (p<0.01 for both conditions; OR=2.12 and 2.3 respectively). Otologic symptoms and bruxism maintained statistical significance in the binary logistic regression analysis, which demonstrated a 1.7 fold and twofold greater chance of such individuals have temporomandibular disorder, respectively. CONCLUSION The logistic regression analysis demonstrated strong associations between the disorder and both otologic symptoms and bruxism when analyzed simultaneously, independently of patient age and gender.

Qualidade e Tendências Metodológicas dos Ensaios Comunitários de Educação em Saúde Bucal

Objetivo: Analisar a qualidade dos periodicos e a tendencia metodologica dos ensaios comunitarios de educacao em saude bucal para a reducao e, ou controle da carie dentaria. Metodo: Estrategia de busca – Buscou-se estudos controlados do tipo ensaios comunitarios, clinicos randomizados e, ou quasi randomizados atraves do MEDLINE, LILACS, ADOLEC, BBO, PubMed, Pico, COCHRANE, BDTD, Scielo, Knowledge Finder, Busca Manual e Literatura Cinza. A data de publicacao se restringiu ao periodo de 1997 a 2010, sendo incluidos artigos em ingles, portugues e espanhol. Criterio de selecao Ensaios controlados cujas intervencoes fossem de educacao em saude. Extracao de dados e analise – Utilizando fichas de coleta padrao, dois revisores, de modo independente avaliaram os criterios de qualidade nos artigos selecionados atraves de uma escala especifica para essa area do conhecimento. Resultados: dos 317 estudos localizados inicialmente, 27 foram incluidos. O fator de impacto das revistas onde 81,4% dos trabalhos foi publicado esteve entre 2.462 e 0.961. O erro tipo Beta foi considerado em 9 (36,0%) artigos, a randomizacao foi considerada adequada em 16 (59,0%) publicacoes. Em virtude da natureza dessa intervencao o cegamento triplo foi dificil de ser obtido, a soma de uni, duplo e triplo totalizou 13 (48,0%) adocoes. Conclusao: Os melhores ensaios comunitarios de educacao em saude bucal estiveram presentes em revistas com alto fator de impacto para Odontologia, o que reforca o poder dos mesmos. Os estudos apresentaram uma relativa variedade metodologica, demonstrando a necessidade de mais rigor no delineamento dos mesmos a fim de nao sejam abertos espacos para vieses que possam comprometer seus resultados.