Eduardo Hebling

Effects of human aging on periodontal tissues

Loss of teeth is frequently associated with periodontal disease in older adults. The aim of this review was to present the effects of aging on the periodontal tissues. Aging alone does not lead to critical loss of periodontal attachment in healthy elderly persons. The effects of aging on periodontal tissues are based on molecular changes in the periodontal cells, which intensify bone loss in elderly patients with periodontitis. These effects may be associated with (1) alterations in differentiation and proliferation of osteoblasts and osteoclasts; (2) an increase in periodontal cell response to the oral microbiota and mechanical stress leading to the secretion of cytokines involved in osseous resorption; and (3) systemic endocrine alterations in the elderly people.

Periapical status and prevalence of endodontic treatment in institutionalized elderly.

The aim of this study was to determine the prevalence and frequency of apical periodontitis and root fillings in 450 institutionalized Brazilian elderly. The teeth with apical periodontitis were assessed using the Periapical Index (PAI) score. A total of 942 teeth were evaluated in 98 subjects (57 females and 41 males) with mean age of 74 years. The observed frequency of total edentulous subjects was high (76%) in this population. A total of 126 teeth showed root fillings, of these only 46 (36.5%) were scored as having adequate quality. Apical periodontitis was found in 114 teeth (12.1%) in 42 (42.9%) subjects. 80 (70.2%) inadequate root-filled teeth showed apical periodontitis. There was a significant correlation between the presence of periapical pathology and inadequate root-filled teeth. Inadequate root-filled teeth were associated with an increased prevalence of apical periodontitis in these subjects. This fact may result in increased endodontic retreatment needs for this population.

Considerações para elaboração de protocolo de assistência ortodôntica em saúde coletiva

This study offers help for drawing up a community health orthodontic assistance protocol, especially for the public health system. A preventive and interceptive orthodontic program is suggested through the inclusion of approaches in existing healthcare programs that may help prevent malocclusions, extending the services offered by Basic Healthcare Units to include fitting space retainer appliances and interceptive procedures. Possible occlusion problems are discussed and rated as high or low priority for treatment, stressing occlusal deviations that should not be treated precociously. Preventive and interceptive orthodontic treatment should primarily be offered to children with deciduous and mixed dentition. The management and inclusion of orthodontic procedures can be deployed through the management of physical, human and financial resources, establishing access criteria for these services. The use of an appropriate orthodontic assistance protocol and correct planning of orthodontic actions could pave the way for preventive and interceptive procedures at the Basic Healthcare Units, while more resources could be allocated to setting up Specialty Reference Centers offering more complex corrective orthodontic procedures.

Responsabilidade civil do ortodontista

O objetivo da terapia ortodontica e a correcao de problemas dentarios e esqueleticos, visando resultados esteticos e funcionais estaveis. Tais objetivos, naturalmente, aumentam a expectativa do paciente quanto aos resultados e geram duvidas nos ortodontistas em diversas situacoes clinicas. Este trabalho teve como objetivo esclarecer as principais duvidas dos ortodontistas quanto a sua responsabilidade pelos casos tratados, seus direitos e deveres na relacao profissional/paciente e na prevencao de acoes judiciais. A comunicacao com o paciente e/ou responsavel, com a descricao do plano, riscos, beneficios e custos do tratamento, bem como a elaboracao, anuencia e guarda da documentacao ortodontica, sao fundamentais na prevencao de litigios judiciais. A conduta profissional deve ser embasada nos principios da etica e da moral.

Sensibilidade ao Látex e Dosagem de Anticorpos Específicos em Profissionais da Área da Saúde

UNLABELLED The scope of this study was to verify the occurrence of sensitivity to latex and conduct dosage of anti-latex antibodies in health professionals of the Dental, Medical and Nursing Schools of the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil. This was a cross-sectional observational study. The intentional sample was composed of 295 professionals. Sensitivity was evaluated by means of a structured and validated questionnaire and the presence of IgE-latex by means of collection of 10 ml of blood submitted to analysis using the Immunocap-pharmacia® system. The IgE-latex values were categorized in different groups. RESULTS 22.4% (n=66) showed latex sensitivity, class V of the IgE latex (17.5-42 KUA\L); 77.6 % (n=229) showed no sensitivity, class 0 or 1 of the IgE-latex (<0.35KUA\L-8,6KUA\L). Fishers test showed a significant correlation statistic (p<0.05) in relation to the following variables: gender; atopy; eczema of the hands; allergy to medicination; chronic illness; use of anti-inflammatory; prior surgeries. CONCLUSION Positive values of IgE were observed in the professionals with sensitivity, suggesting the adoption of prophylactic measures for the prevention and or adaptation of the work environment, preserving the health of these workers.O objetivo deste estudo foi verificar a ocorrencia da reacao de sensibilidade ao latex e realizar dosagem de anticorpos antilatex em profissionais dos cursos de odontologia, medicina e enfermagem da Universidade Federal do Espirito Santo (UFES), Vitoria-ES, Brasil. Estudo observacional, transversal. A amostra intencional foi composta por 295 profissionais. A sensibilidade foi avaliada por meio de questionario estruturado e validado, e a presenca de IgE-latex por meio da coleta de 10ml de sangue submetido a analise com emprego do sistema Immunocap-Pharmacia®. Os valores IgE-latex foram distribuidos em diferentes classes. Resultados: 22,4,% (n=66) apresentaram sensibilidade ao latex, classe V IgE latex (17,6-42 KUA\L); 77,6 % (n=229) sem sensibilidade, classe 0 IgE-latex (<0,35KUA\L). O teste de Fisher mostrou correlacao estatistica significativa (p<0,05) em relacao as seguintes variaveis: genero; atopia; eczema nas maos; alergia a medicamento; doenca cronica; uso de anti-inflamatorio; cirurgias anteriores. Conclusao: Observou-se valores positivos de IgE-latex nos profissionais com sensibilidade ao latex, sugerindo a necessidade de adocao de medidas profilaticas para a prevencao e ou adequacao do ambiente de trabalho, preservando a saude destes trabalhadores.

Oral myiasis in older adult with severe Alzheimer’s disease: ORAL MYIASIS IN OLDER ADULT WITH SEVERE DEMENTIA

AIMS Myiasis is a disease caused by the invasion of tissues by larvae of flies. The aim of this study was to carry out a review of reported cases of oral and maxillofacial myiasis in older adults and to show a case report of oral myiasis in a 95-year-old frail man with severe Alzheimers disease from Brazil. METHODS AND RESULTS Between 1988 and 2017, 35 oral and maxillofacial myiasis cases were reported in older adults in English-language studies from PubMed and Lilacs databases. CONCLUSIONS Oral and maxillofacial myiasis in older adults showed low incidence and good prognosis of cure, when there were no systemic complications. Weakness, frailty, dementia, oral lesions, labial incompetence, poor oral hygiene, and bad breath were associated with this disease in reported cases. Preferential therapy choices were debridement alone or combined with Ivermectin. In this case report, debridement and Ivermectin prescription was an effective therapy for an older adult with severe Alzheimers disease.

Análise de custo de materiais utilizados em restaurações dentárias em resina composta

INTRODUCTION: Composite resins are materials commonly used in direct posterior dental restorations. The cost of the materials is part of the calculation of the value of dental fees. OBJECTIVE: The aim of this study was to determine and to assess the total value of the materials used in composite resin direct posterior dental restorations. MATERIAL AND METHOD: The calculation of costs was based on the method of variable costing system. The repetitions were obtained from classes I and II cavities in artificial premolars and molars teeth. A list of the materials was obtained by a panel of experts and based on the excellence standards established in the literature for dental team treatment. The values of the materials were obtained from an average of the values founded in the supplier market. The repetitions were obtained from Classes I and II cavities in pre-manufactured premolars and molars. The materials were quantified for each type of preparation. The resins used were weighed on a precision balance after their insertion in each type of preparation. The data were assessed by descriptive statistics and by Mann-Whitney and Kruskal-Wallis tests. RESULT: The cost found for restoration of Class I was R

Cost analysis of materials used in Class III, IV and V composite resin restorations

17.56 and for Class II was R

Evolução das políticas públicas de saúde bucal: de 1930 a 2010

17.73. There was no statistically significant difference in cost between the types of cavities and teeth, and the average of total materials was R

Oral health‐related quality of life: a critical appraisalof assessment tools used in elderly people

17.65. CONCLUSION: These values might be used in the calculation of the final value of the restorative procedure, aiding in the management of public or private dental care services.