Fernanda Campos Sousa de Almeida

Popularização do autoexame da boca: um exemplo de educação não formal - Parte II

One of the largest challenges of the universities, especially the public ones, is to transpose the scientific knowledge produced into their walls for the general population. The non-formal education is an important tool, and yet very little used by researchers and professors to approximate the scientific knowledge. The oral cancer reaches more than 11.000 Brazilians a year. In spite of the high incidence, this pathology is still little known by the general population and part of the medical and dental class. Basing on the epidemic data in researches and scientific papers, the oral cancer was the elect theme for the action in education and communication of the first national campaign with no government character of prevention in oral cancer, being a great example of as that can be made. This paper intends to describe the methodology used in communication and the results obtained in this successful experience.

Collagenous fibroma (desmoplastic fibroblastoma) of alveolar bone: a case report

O fibroma colagenoso (fibroma desmoplasico) e um tumor de tecido mole raro de origem fibroblastica. Na mucosa oral apenas dois casos foram descritos pela literatura. Nos descrevemos o caso de uma mulher de 42 anos de idade, cuja queixa era uma lesao indolor, de crescimento lento sob sua protese total superior. Os achados histologicos da lesao incluiram fibroblastos escassos, estrelados ou fusiformes, dispersos em um estroma rico em colageno. As celulas lesionais foram positivas para vimentina, mas rara marcacao foi observada para actina musculo liso e fator XIIIa. A excisao cirurgica total foi realizada e a recidiva da lesao nao e esperada.

Estratégias e resultados da prevenção do câncer bucal em idosos de São Paulo, Brasil, 2001 a 2009

OBJETIVO: Descrever estrategias e resultados da campanha de diagnostico precoce e prevencao do câncer bucal para a populacao com 60 anos ou mais desenvolvida desde 2001 no Estado de Sao Paulo. METODOS: A partir de documentos publicados pelo Ministerio da Saude, Instituto Nacional de Câncer, Secretaria de Estado da Saude de Sao Paulo, Fundacao Oncocentro de Sao Paulo, Secretaria Municipal da Saude de Sao Paulo, Faculdade de Saude Publica da Universidade de Sao Paulo e Casa de Saude Santa Marcelina, procurou-se evidenciar a problematica do câncer bucal e apresentar as principais estrategias utilizadas para desenvolver a campanha. Ainda, avaliou-se o impacto da campanha na incidencia de casos novos de câncer bucal entre os examinados. RESULTADOS: Em 2001, foram examinados 90 886 idosos, contra 629 613 idosos em 2009. As estrategias identificadas foram: capacitacao dos profissionais, desenvolvimento de material impresso para orientar os municipios sobre como conduzir a campanha, codigos e criterios a serem utilizados, orientacoes para a consolidacao dos dados, estabelecimento de fluxos de referencia, capacitacao pratica junto com o especialista na propria unidade de saude a partir do reexame dos individuos que apresentavam alteracao em tecidos moles e ampliacao do numero de servicos dirigidos ao diagnostico bucal. Entre 2005 e 2009, houve reducao significativa na taxa de casos confirmados de câncer bucal em cada 100 000 examinados, de 20,89 para 11,12 (P = 0,00003). CONCLUSOES: A campanha trouxe beneficios a saude bucal da populacao idosa. Pode ser ampliada para outros grupos etarios e outras regioes do pais e servir de subsidio para o desenvolvimento de acoes de prevencao de câncer bucal em outros paises, desde que respeitadas as caracteristicas locais.

Photoelastic Stress Analysis Surrounding Implant-Supported Prosthesis and Alveolar Ridge on Mandibular Overdentures

The purpose of this research was to evaluate the maximum stress around osseointegrated implants and alveolar ridge, in a mandible with left partial resection through a photoelastic mandibular model. The first group consisted of two implants: traditional model (T), implants placed in the position of both canines; fulcrum model (F), implants placed in the position of left canine CL and right lateral incisor LiR. Both models linked through a bar and clips. The second group was consisted of three implants, with implants placed in the position of both canines (CR and CL) and the right lateral incisor (LiR), which composed four groups: (1) model with 3 “O” rings, (2) model 2 ERAs, bar with clips, (3) model 2 ERAs bar without clips; (4) model “O” ring bar and ERA. An axial and an oblique load of 6.8 kgf was applied on a overdenture at the 1st Pm, 2nd Pm, and 1st M. Results showed that the area around the left canine (CL) was practically free of stress; the left lateral incisor (LiL) developed only small tensions, and low stress in all the other cases; the right canine tooth suffered the largest concentrations of stress, mainly with the ERA retention mechanism.

Reorganization of secondary and tertiary health care levels: impact on the outcomes of oral cancer screening in the São Paulo State, Brazil

This study presents the strategies for prevention and early detection of oral cancer by means of screening in the elderly population of São Paulo, the richest and the most populous state of Brazil. This research was a retrospective longitudinal study based on the analysis of secondary data. The variables - number of participating cities, coverage of screening, and number of suspicious and confirmed cases of oral cancer - were divided into two periods: 2001-2004 and 2005-2008. Data were analyzed statistically by the chi-square test at 5% significance level. The implementation of a nationwide public oral health policy in 2004 and the reorganization of the secondary and tertiary health care were evaluated as mediator factors able to interfere in the achieved outcomes. From 2001 to 2008, 2,229,273 oral examinations were performed. There was an addition of 205 participating cities by the end of the studied period (p<0.0001). The coverage of oral cancer screening increased from 4.1% to 16% (p<0.0001). There was a decrease in the number of suspicious lesions (from 9% in 2005 to 5% in 2008) (p<0.0001) and in the rate of confirmed oral cancer cases per 100,000 examinations (from 20.89 in 2001 to 10.40 in 2008) (p<0.0001). After 8 years of screening, there was a decrease in the number of suspicious lesions and confirmed cases of oral cancer in the population. The reorganization of secondary and tertiary health care levels of oral care seems to have contributed to modify these numbers, having a positive impact on the outcomes of oral cancer screening in the São Paulo State.

New Uses for Rehabilitation Protocol for Oral Sinus Communications in ARONJ Patients

This report presents a new use for rehabilitation protocol for oral sinus communications in patients with antiresorptive agent-induced osteonecrosis of the jaw. The treatment plan consisted of constructing an atraumatic complete denture with rounded edges, made with nontoxic resin, to prevent any injury to the mucosa and recurrence of the disease. The patient was followed up for 4 years, without any complications, and was socially reintegrated by resuming the normal life he experienced before tooth loss.

A FORMAÇÃO HUMANÍSTICA, SOCIAL E ÉTICA DO GRADUANDO EM ODONTOLOGIA

Objective: This study debates the meaning of the curricular changes at Sao Paulo State University Dental School and the contribution of faculty for the comprehensive education of undergraduate students. Material and Methods: A qualitative study was made through ethnographic analysis and thematic content analysis. Data collection consisted in participantobservation, documentary data. Results: Analysis of the activities allow concluding that great advances have been perceived from this process of curricular changes like faculty pedagogical qualification, diversification of practice scenario, and reorganization of clinical education. But, one of the most important considerations from the process was to regain the interest in undergraduate education by academic community. Conclusion: In order to achieve a comprehensive dental education extending the same approach to patient care it is necessary to have the involvement of all institution. That will occur through the curricular changes and participation of all faculty members, who must become involved themselves in the process of humanistic, social and ethical education of the undergraduate students. DESCRIPTORS Education, dental. Ethics, dental. Teaching. Faculty.

Oral Cancer Screening in Elderly in Sao Paulo State, Brazil (2001 to 2009)

Objective: To describe and explore analytically the trends of oral cancer positive cases incidence during nine-year screenings campaign of Sao Paulo´s State (Brazil) and to show other countries and health services an option for tracking at-risk population. Material and Methods: Secondary official data were tabulated and analysed using the Excel and STATA statistical 10.0 software packages. After descriptive statistics, the trend curves were calculated by moving average for each variable (type moving average of two samples centred) to attenuate the random variability of the series, and trends classified: stable, ascending and descending. Results: The trend of municipalities numbers remained stable; the number of examined people, the screening coverage and the absolute number of patients referred to secondary health care showed an increasing trend; and the percentage of suspected cases showed a decreasing trend during the nine-year period. A decrease in the number of suspicious lesions and confirmed cases of oral cancer among the volunteers was observed, and the reorganization of secondary and tertiary levels of oral care helped to modify these numbers. Conclusion: We believe this experience was more important to help health services organization than for the oral cancer diagnosis itself, and it might be used to inspire other countries and oral health services.

The symbolic value of prostheses in maxillofacial rehabilitation

http://dx.doi.org/10.1016/j.oraloncology.2014.09.003 1368-8375/ 2014 Elsevier Ltd. All rights reserved. q DOI of original article: http://dx.doi.org/10.1016/j.oraloncology.2010.02.02 We read the article entitled ‘‘Quality of Life Perspectives in Patients with Oral Cancer,’’ published in Oral Oncology with great interest and would like to congratulate Rogers [1] on his important contribution to the field. The author reports on head and neck mutilation and its effects on patient quality of life, pointing out that restoring dentition is important for the sake of appearance, psychosocial well-being and self-esteem. The author also states that oral rehabilitation plays a decisive role in maintaining the quality of life of patients, and needs to be taken into consideration along with motivation and individual patient needs. Our group has been working in the maxillofacial prosthetic rehabilitation of cancer patients since 1998, and agrees with Dr. Rogers. Based on our clinical practice and on the research recently conducted by our group, we would like to extend the discussion a bit further by stressing the importance of listening carefully to patients and analyzing their discourses, as an integral aspect of treatment. Patient feedback, in its different forms, confirms that rehabilitation rather than merely restoring aesthetics, chewing and speech can restore the patient’s confidence in his/her cure, and the feeling that their rehabilitation is indeed feasible. Our group is conducting qualitative research to understand the deeper implications of maxillofacial prosthetics rehabilitation on a patient’s quality of life, by evaluating how patients who were submitted to oral resections refer to their rehabilitation process. What they communicated to us surprised us, since they revealed meanings that showed the magnitude of the importance that they gave to prosthetic rehabilitation. One of the patients who most impacted our team said:

Prevention and Early Detection of Oral Cancer: Screening in Risk Populations

Objetivo: Avaliar a viabilidade de programa de prevencao e diagnostico precoce do câncer de boca direcionado a grupos considerados de risco para esta enfermidade, como tabagistas e etilistas cronicos. Metodo: No periodo entre junho de 2000 e julho de 2002, o programa foi realizado em pacientes do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP) e grupos de apoio comunitarios, estruturado em palestras periodicas, exame bucal dos interessados e encaminhamento quando necessario para exames complementares e tratamento. Resultados: Foram examinadas 509 pessoas, das quais 215 pertenciam ao sexo masculino (42,2%), 59,7% eram brancos e com media de idade de 49,8 anos. Destas, 131 apresentaram lesao fundamental na boca, que foram encaminhadas a Faculdade de Odontologia da Universidade de Sao Paulo (FOUSP), para realizacao de exame complementar. Dos 48 (38,7%) pacientes que compareceram ao ambulatorio, 11 foram submetidos a biopsia. Os achados das biopsias foram de hiperqueratose em 3, hiperplasia papilomatosa em 2, hiperplasia fibrosa em 3, um caso de displasia leve, um adenocarcinoma e um carcinoma epidermoide. A citologia esfoliativa, 5 pacientes tiveram o diagnostico de classe I e 11 como classe II de Papanicolau. Conclusao: O elevado numero de lesoes fundamentais diagnosticadas demonstra ser de extrema importância o exame oral periodico de pacientes de risco, entretanto o metodo proposto, como deslocamento de equipes especificas para o rastreamento dos pacientes, mostrou-se bastante trabalhoso e oneroso para ser efetivamente incorporado em servicos de atencao a saude. Por outro lado, servicos de atencao permanente em conjunto a atuacao periodica de campanhas de esclarecimento a populacao, foram considerados os metodos de maior resultado para o diagnostico precoce do câncer de boca.