Edgard Michel-Crosato

Relationship between oral health and its impact on quality of life among adolescents

The aim of this study was to assess oral health status and its relationship with quality of life. A household population, cross-sectional study was carried out; participants were between 15 and 17 years of age (n = 247) and were examined by two calibrated dentists. Socio-economic status was classified according to ANEP-ABIPEME criteria. Clinical examinations to observe DMFT, CPI and Dean indices were performed as per WHO criteria. The Significant Caries Index (SiC) was used to evaluate polarization of the occurrence of caries among participants of the tercile with higher DMF-T. The OHIP instrument was used to measure quality of life. The Spearman and Mann-Whitney tests were used for assessing correlations (5% significance level). Examinations were carried out in 117 (47.37%) females and in 130 (52.63%) males. Of the examined participants, 45.75% were classified as belonging to socio-economic class C. Caries occurrence was observed in 218 subjects (88.26%); the mean DMFT was 5.40. The SiC index was 9.97. Almost half (47.77%) of the participants examined did not present sextants affected by periodontal disease. Of the participants examined, 80.16% presented absence of fluorosis. The mean OHIP was 3.95. The following correlations were observed: a positive and statistically significant correlation between the highest score in the OHIP and decayed teeth; a positive correlation with threshold significance between OHIP and DMFT; an inverse correlation between intact teeth and OHIP; and a positive and non statistically significant correlation between SiC and OHIP (correlation coefficient = 0.13, p = 0.245). Association between the mean OHIP and the terciles was not significant (p = 0.146); there were also no associations between periodontal condition and OHIP nor were there associations between the presence of fluorosis and mean OHIP.

Tendências de mortalidade por câncer de boca e orofaringe no Município de São Paulo, Brasil, 1980/2002

The current study assessed trends in oral cancer mortality in the city of Sao Paulo, Brazil, from 1980 to 2002. The official mortality information system supplied data on deaths whose underlying cause was classified as oral cancer, stratified by sex, age, and anatomic site. Death rates were estimated and adjusted by the direct method, using population data supplied by national censuses from 1980, 1991, and 2000 and a population count performed in 1996. There was an upward trend in overall cancer mortality, at a yearly rate of 0.72%. Accounting for more than one third of these deaths, tongue cancer was the main mortality category. Labial, gengival, and retromolar cancer showed a downward trend, while oropharyngeal cancer and cancer in unspecified parts of the mouth and oropharynx showed increasing mortality. Monitoring the magnitude and trends in cancer mortality can assist the planning of health initiatives aimed at reducing the disease burden from oral cancer in Brazil.

Cost-effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation

Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost‐effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM. Clinical information was gathered on 167 patients undergoing HSCT and divided according to the presence (n = 91) or absence (n = 76) of laser therapy and oral care. Cost analysis included daily hospital fees, parenteral nutrition (PN) and prescription of opioids. It was observed that the group without laser therapy (group II) showed a higher frequency of severe degrees of OM (relative risk = 16.8, 95% confidence interval −5.8 to 48.9, p < 0.001), with a significant association between this severity and the use of PN (p = 0.001), prescription of opioids (p < 0.001), pain in the oral cavity (p = 0.003) and fever > 37.8°C (p = 0.005). Hospitalization costs in this group were up to 30% higher. The introduction of oral care by a multidisciplinary staff including laser therapy helps reduce morbidity resulting from OM and, consequently, helps minimize hospitalization costs associated with HSCT, even considering therapy costs. Copyright

Estimating ages by third molars: Stages of development in Brazilian young adults

The purpose of this study was to estimate age through the analysis of third molar stages of development in Brazilian young adults. A cross-sectional study was conducted by analyzing 659 panoramic X-rays. Two techniques were used to establish the stages: Modified Scoring (MST) and Demirjian (DT). Regression formulas were calculated. Statistical analyses were conducted by t, Kappa tests, and simple and multiple linear regressions (5% level of significance). Out of the participants, 40.7% were female and 59.3% were male, with ages from 15-22 years. The Kappa test showed good results for intra-observer (0.84 for MST and 0.95 for DT) and inter-observer examination (0.81 for MST and 0.92 for DT). Differences were found in the stages of tooth formation between male and female, but differences were not observed between the left and right sides. We found that both DT and MST underestimated the ages in about 6 months, depending on the used classification and number of teeth. These methods are appropriate for assessing the ages of young Brazilians, although the DT showed better reproducibility.

Facial soft tissue thickness in the Brazilian population: New reference data and anatomical landmarks

Facial soft tissue thickness measurement can be useful among several medico-legal techniques that aim to establish the identity of skeletal remains. This study examined the soft tissue thickness that covered the faces of autopsied cadavers sent to the Medico-Legal Institute of Guarulhos from September 2010 to September 2011. Forty-nine anatomical facial landmarks were measured in cadavers less than 24h after death; these data were analysed using two-tailed t-tests. This project was approved by an ethics committee. One hundred cadavers were studied (74 males and 26 females). A majority of these individuals had died between 41 and 60 years old. Of the 49 anatomical landmarks, only five differed between the sexes (i.e., p-value less than 0.05): upper lip margin (p=0.006), superior labial sulcus (p=0.006), stomion (p=0.001), right lateral orbit (p=0.008), and left cheilion (p=0.009). The inclusion of additional anatomical landmarks allowed us to establish more precise facial thickness parameters that have the potential to be applied to cadaver facial approximations in Brazil; furthermore, some anatomic landmarks presented a higher discriminant power with regard to sex.

Dor Dental e Condição Sócio-Econômica: um Estudo Censitário em Escolares

Resumen pt: Objetivo: Verificar a relacao entre experiencia de dor dental e condicoes socioeconomicas em escolares. Metodo: Tratou-se de estudo censitario transvers...

Percepção dos agentes comunitários de saúde sobre a violência doméstica contra a mulher

The objective of this paper was the investigation of the community health agents perception about violence against woman. This is a qualitative study of descriptive and exploratory kind. It was developed through semi-structured interviews for the collection of data. Twenty-six community health agents who work at the 25 health centers in a medium size town in Southern Brazil were interviewed in 2005. To analyse the data it was used the collective subject speech method. The analysis of the results showed that there is domestic violence against women, either physical, sexual, psychological or economic, caused by partners. It is necessary to give theoretical and practical subsidies for the professionals to help them and to detect violence situations, find ways to get closer to the families and to deal with violence as well as with the cases of alcohol and drugs. Violence against women needs consistent public politicies, so that it can be effectively considered a question of public health from an extended concept of health.

Relationship Between Oral Health-Related Quality of Life and the Position of the Lower Third Molar: Postoperative Follow-Up

PURPOSE The aim of this study was to verify possible associations between oral health-related quality of life (QoL) and the position of the lower third molar among patients undergoing lower third molar surgery during the first postoperative week. MATERIALS AND METHODS We performed an interventional prospective study of 86 patients for whom the preoperative treatment plan included the removal of 2 third molar teeth from the same side in a 1-time procedure. The patients were divided into 2 groups depending on the position of the lower third molar. QoL was evaluated before and after the surgical procedure (during the first 7 days) with the Oral Health Impact Profile (OHIP) 14 questionnaire. Data were treated according to Stata 10.0 (StataCorp, College Station, TX). Variables were evaluated by use of split-plot analysis of variance for the repeated-measures analysis to identify the association between QoL and the position of the lower third molar. RESULTS Patients can have deterioration in their QoL immediately after surgery, especially during the first and second postoperative days, and subsequently show rapid improvement. The variation in the total OHIP score during the days after surgery was significant, whereas a decrease in QoL was observed immediately after the procedure (P = .001), which returned to initial value (preoperative) levels after the sixth postoperative day. The OHIP domains with higher scores (ie, those that had an impact) were physical pain, psychological discomfort, and physical disability (domains 2, 3, and 4, respectively). CONCLUSIONS Teeth considered to be associated with technical difficulties for extraction based on their position had a higher score on the OHIP-14 questionnaire and worse health-related QoL score. QoL outcomes may be as important as clinical signs in decisions regarding third molar extractions.

Uso da Classificação Internacional de Doenças na análise do absenteísmo odontológico

OBJETIVO: Comparar o uso das codificacoes da classificacao de doencas e agravos em solicitacoes de afastamento do trabalho por motivo odontologico. METODOS: Foram analisadas 240 solicitacoes emitidas em um servico publico federal entre janeiro de 2008 e dezembro de 2009. O uso da Classificacao Estatistica Internacional de Doencas e Problemas Relacionados a Saude - Decima Revisao (CID-10) foi comparado ao sistema de Classificacao Internacional de Doencas em Odontologia e Estomatologia (CID-OE). Foi determinada a especificidade da codificacao nas solicitacoes de afastamento, bem como da codificacao atribuida por peritos oficiais em inspecoes indiretas, pericias e juntas odontologicas. RESULTADOS: Do total de atestados, 22,9% nao apresentaram a CID, 7,1% apresentaram a CID-9, 3,3% a CID-OE e 66,7% a CID-10. A maioria das codificacoes foi concordante (55,1%), com maior especificidade nas codificacoes atribuidas apos avaliacao dos cirurgioes-dentistas peritos oficiais. CONCLUSOES: E necessario aperfeicoar a utilizacao da CID-10 entre os profissionais de Odontologia e pericia odontologica no trabalho. Sugere-se a incorporacao do uso da CID-OE e da Classificacao Internacional de Funcionamento, Incapacidade e Saude para a analise dos afastamentos do trabalho, fornecendo dados relevantes para o monitoramento do absenteismo por motivo odontologico.OBJECTIVE To compare the use of disease and injury classification codes in workplace absences requests due to dental causes. METHODS The study analyzed 240 requests in a federal public agency between January 2008 and December 2009. The use of the International Classification of Diseases - 10th Revision (ICD-10) was compared to the Application of the International Classification of Diseases to Dentistry and Stomatology (ICD-DA). The degree of specificity was determined for the codifications on workplace justifications, as well as for codifications assigned by official dental experts in indirect inspections and expert examinations. RESULTS Of the total number of dental certificates, 22.9% did not present the ICD, 7.1% used ICD-9, 3.3% used ICD-DA and 66.7% used ICD-10. The majority of codifications were concordant (55.1%), and greater specificity was found in codifications assigned after evaluation by official dental experts. CONCLUSIONS The results indicate the need to improve use of ICD-10 among dentists and official dental experts .For analysis of work absenteeism, it is suggested the use of ICD-DA and the International Classification of Functioning, Disability and Health, which provide relevant data for monitoring absenteeism due to dental reasons.

Dental age estimation in a Brazilian adult population using Cameriere’s method

The objectives of this study were to develop a specific formula to estimate age in a Brazilian adult population and to compare the original formula from Cameriere to this Brazilian formula. The sample comprised 1,772 periapical radiographs from 443 subjects (219 men, 224 women) that were organized into 12 groups according to sex (men or women) and age (20-29, 30-39, 40-49, 50-59, 60-69, and 70 years and older). The films were analyzed using the criteria described by Cameriere et al. (2004) and Adobe Photoshop®. We obtained a mean error of 8.56 (SD = 5.80) years for tooth 13, 7.99 (SD = 5.78) years for tooth 23, 8.38 (SD = 6.26) years for tooth 33, and 8.20 (SD = 6.54) years for tooth 43. When teeth were combined in the analysis, we observed lower mean errors. The Brazilian formula developed from this sample group was more accurate than Camerieres formula. However, other factors must be considered to improve age estimates in adults.