Marcelo de Castro Meneghim

In Vitro evaluation of microleakage of different materials used as pit-and-fissure sealants

The aim of this study was to evaluate in vitro the marginal microleakage of different materials used as pit-and-fissure sealants (Delton, Filtek Flow, Dyract Flow and Vitremer). Fifty-six extracted sound human third molars were randomly assigned to 4 groups (n=14). After sealant placement, the teeth were thermocycled (500 cycles; 5 degrees C, 37 degrees C and 55 degrees C), isolated, immersed in 2% buffered methylene blue dye for 4 h, included in acrylic resin and sectioned longitudinally in a buccolingual direction. The sections were analyzed for leakage using an stereomicroscope. A 4-criteria ranked scale was used to score dye penetration. All materials exhibited dye penetration to some extension and no statistically significant difference was observed among the groups (p>0.05). In conclusion, the findings of this study showed that a flowable composite resin, a flowable compomer and resin-modified glass ionomer placed on occlusal pits and fissures had similar marginal sealing as the unfilled self-cured resin-based sealant.

Educação em saúde: uma reflexão histórica de suas práticas

This text aims to contextualize the transformations occurred in the practice of health education since the political scenario in the end of 19th century, when the first extended initiatives of the Brazilian State in the health field were organized, until the creation of the Brazilian Unified Health System.

Avaliaçäo da prevalência de cárie dentária em escolares do Município de Piracicaba-SP, Brasil, após 25 anos de fluoretaçäo das águas de abastecimento público

A fluoretacao das aguas de abastecimento publico e considerada o metodo de prevencao de caries mais efetivo em termos de abrangencia coletiva. Alem disso, trata-se de uma medida simples, economica, segura e eficaz. Gracas a essa medida, associada ao uso de dentifricios fluoretados e aos programas preventivos implantados nos municipios, o pais experimenta uma reducao da prevalencia de carie. Este trabalho tem por objetivo avaliar a evolucao das prevalencias de carie dentaria nos anos de 1971 (inicio da fluoretacao das aguas de abastecimento publico), 1977, 1980, 1992 e 1996, na cidade de Piracicaba, SP, Brasil. Comparando-se as prevalencias de carie em escolares de 7 a 12 anos, de ambos os sexos, nos anos de 1971 a 1996, verificou-se uma reducao do indice CPOD de 79%. Foi observado que, no levantamento epidemiologico de 1996, o indice CPOD foi igual a 2,0 para os 12 anos de idade, superando as metas da OMS para o ano 2000. Verificou-se uma reducao de carie estatisticamente significante (no nivel de 5%), ao se compararem as prevalencias em escolares de Piracicaba nos ultimos 25 anos de fluoretacao das aguas de abastecimento. Busca-se discutir os resultados desses levantamentos com os de outras localidades, bem como fazer uma analise em relacao as recomendacoes da OMS para o ano 2000 e 2010.The fluoridation of public water supply is considered the most effective method of dental caries prevention for a community. Furthermore, it is a simple, economic, secure and efficient procedure. By using this method, associated with fluoridated toothpastes and preventive programs implanted in some cities, the country experiments a decrease in dental caries prevalence. The purpose of this paper is to evaluate the evolution of the dental caries prevalence in 1971 (when the fluoridation of public water supply began), 1977, 1980, 1992 and 1996 in Piracicaba, SP, Brazil. Comparing the dental caries prevalence in male and female students from 7 to 12 years old, from 1971 to 1996, a 79% decrease in DMF index was observed. The 1996 epidemiologic survey showed that DMF index was 2.0 for the age of 12, surpassing the goal that the WHO had set for the year 2000. There was a statistically significant decrease in dental caries prevalence (at the level of 5%) when compared with dental caries prevalence in students from Piracicaba in these 25 years of fluoridation of public water supply. An attempt is made to compare the results of these epidemiologic surveys with those from other localities, as well as to analyze what the WHO aims for 2000 and 2010.

Evaluation of the effectiveness of a voice training program for teachers.

OBJECTIVES To investigate the effects of a voice education program to teachers on vocal function exercise and voice hygiene and compare a pre- and post-vocal exercise for the teachers voice quality. METHODS A random sample of 102 subjects was divided into two groups: experimental group (29 women and seven men) with vocal hygiene and training exercises and control group (52 women and 14 men) with vocal hygiene. Two sessions were held about voice hygiene for the control group and five sessions for the experimental group, one being with reference to the vocal hygiene habit and four vocal exercise sessions. Acoustic analysis of the vowel [i] was made pre- and post-vocal exercise and for the situations of initial and final evaluation of the educational program. Student t test (paired) and Proc MIXED (repeated measures) were used for analyses with level of significance (α = 0.05). RESULTS The training exercises, posture and relaxation cervical, decreased the mean of fundamental frequency (f(0)) for men (P = 0.04), and for the phonation, intensity, and frequency exercises, there was a significant increase for f(0) in woman (P = 0.02) and glottal to noise excitation ratio (P = 0.04). There was no statistically significant difference intergroup evaluations after 3 months. The control group presented increased mean voice intensity in the final evaluation (P = 0.01). CONCLUSIONS Voice training exercises showed a positive and immediate impact on the teachers quality of voice, but it was not sustained longitudinally, suggesting that actions for this purpose should be continued at schools.

Association of breastfeeding, pacifier use, breathing pattern and malocclusions in preschoolers

OBJECTIVE To evaluate the association of breastfeeding duration, pacifier use and nasal air flow with occlusal disorders among children. METHODS This cross-sectional observational study included 138 children aged 4 and 5 years selected in all the daycare centers of the city of Campo Limpo Paulista, Brazil. Questionnaires were applied to mothers to identify total duration of exclusive breastfeeding and non-nutritive sucking. The independent variables were: Sucking (pacifier, bottle, finger), breastfeeding duration and nasal air flow. The dependent variables were: Open bite, crossbite, overjet, overbite, diastema and maxillary deficiency. Frequency distribution calculations were performed, a chi-square test, the Fisher exact test and, after that, stepwise logistic regression were used for statistical analysis, and the level of significance was set at 5%. RESULTS The use of a pacifier was the most deleterious factor and increased chances of having open bite in 33.3 times, marked overjet in 2.77 times and posterior crossbite in 5.26 times. CONCLUSION There was a significant association between non-nutritive sucking, particularly the use of a pacifier, and occlusal disorders. These findings are important to plan the treatment of preschoolers.

Epidemiological assessment of predictors of caries increment in 7-10- year-olds: a 2-year cohort study

Objective The aim of this 2-year cohort study (2003 to 2005) was to investigate how caries experience, at initial lesions (early or non-cavited lesions) and cavited stages, predicts caries increment in permanent teeth in 7-10- year-olds. Material and Methods The random sample of 765 children attending public schools in the city of Piracicaba, SP, Brazil, was divided into two groups: 423 children aged 7-8 years and 342 children aged 9-10 years. All subjects were examined by a calibrated examiner, using dental mirror and ball-ended probes, after tooth brushing and air-drying in an outdoor setting, based on the World Health Organization criteria. Active caries with intact surfaces were also recorded as initial lesion (IL). Univariate analysis was used for statistical analysis (Odds Ratios and Chisquare). Results The association between the DMFT (decayed, missing and filled teeth) increment and the presence of IL was significant only for 9-10-year-old children. The children with DMFT>0 at baseline were more prone to have DMFT increment, with the highest risk for caries increment occurring in children aged 7-8 years. Conclusion The predictors of caries increment were the presence (at baseline) of caries experience in permanent teeth for both age groups (7-8; 9-10-year-olds) and the presence of the IL (at baseline) for 9-10-year-olds.

The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters

BACKGROUND The detection of carious lesions in the initial stages of development is very important in order to prevent the occurrence of cavitation. AIMS AND OBJECTIVES The aim of the present study was to compare three methods-visual examination, FOTI, and bitewing radiographic examination-for the detection of noncavitated and cavitated approximal carious lesions. MATERIALS AND METHODS Seventy students (mean age 14 years) with low caries prevalence were examined by three examiners. The tooth surfaces judged as having caries by at least one examiner or one diagnostic method were scheduled for tooth separation. RESULTS The results showed that the incorporation of FOTI and radiographic examination represented an additional diagnostic yield of 50% and about 110%, respectively, compared to clinical examination alone. CONCLUSION We conclude that FOTI or radiographic examination, or both, used as adjuncts to clinical examination, could improve the detection of noncavitated and cavitated approximal carious lesions. Although FOTI should not replace bitewing radiographic examination, it does seem to have additional value for the detection of carious lesions on approximal surfaces of the posterior teeth in school children with low caries prevalence.

Longitudinal evaluation of the impact of dental caries treatment on oral health-related quality of life among schoolchildren

This study aimed to evaluate the impact of dental caries treatment on oral health-related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ8-10 ) instrument. Brazilian schoolchildren, 8-10 yr of age, were randomly selected and assigned to two groups--dental caries treatment (DCT) and caries-free (CF)--according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥ 0]. The CPQ8-10 instrument was administered at baseline and at 4 wk of follow-up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ8-10 scores were observed between the baseline and follow-up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8-10 scores. Responsiveness of the CPQ8-10 instrument (magnitude of change in CPQ8-10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ8-10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.

Dental status of Portuguese HIV+ patients and related variables: a multivariate analysis.

OBJECTIVE The aim of this cross-sectional study was to evaluate the dental status of 101 Portuguese HIV+ subjects aged 22-71 years (mean = 39) and its association with clinical, socioeconomic, and behavioral variables. MATERIALS AND METHODS A calibrated dentist performed clinical examination and collected data on dental caries, periodontal status, dental plaque levels, prosthetic conditions, and need. The volunteers completed questionnaires on socioeconomic and behavioral variables as well as the Oral Health Impact Profile (OHIP-14) questionnaire. Univariate and multiple logistic regression (MLR) analyses were performed. RESULTS The mean number of decayed, missing or filled teeth index (DMFT index) was 16.44, standard deviation (s.d.) = 8.42. MLR demonstrated that salaried employee and those with OHIP-14 <or=4.22, or any/no dental plaque were less prone to have DMFT > median (=17). As regards prosthetic status, 28.8% of the examined individuals used dental prosthesis. MLR demonstrated that HIV+ with DMFT >17 or those who knew they were HIV-positive for longer than 5 years were more prone to need dental prostheses. The mean OHIP-14 index was 5.83 (s.d. = 7.79). CONCLUSIONS The dental health status of HIV-infected Portuguese patients was unsatisfactory and related to clinical, socioeconomic, and behavioral variables.

Amamentação, hábitos bucais deletérios e oclusopatias em crianças de cinco anos de idade em São Pedro, SP

Objective: To estimate the frequency of malocclusion and their associations with the type and period of breastfeeding, deleterious oral habits, and information received by mothers during the pre-natal period, in 5-year-old children attending municipal daycare centers. Methods: The sample consisted of 162 children resident in the municipality of Sao Pedro, SP, Brazil. In an interview with each of the mothers, information was collected about the time and form of breastfeeding, presence of deleterious habits, and information the mother received during the pre-natal period. The epidemiological exam was performed at the daycare center facilities by a single, previously calibrated examiner, under direct lighting. The following variables were evaluated: presence and severity of malocclusion [slight overcrowding and spacing (OS)], open occlusal relationship (open bite) (OPB), vertical overlap (over bite) (OVB), uni- or bilateral crossbite (CB), positive overjet (OV) and the primary second molar terminal plane relationship (TPR)]. Data analysis consisted of univariate analysis (chi-square test) and multiple logistic regressions. Results: The prevalence of malocclusions was 95.7% (OS = 22.8%; OPB = 24.7%; OVB = 20.4%; CB = 14.8%; and OV = 13.0%). In TPR the straight terminal plane was predominant (85.0%). Among the deleterious oral habits, the use of a pacifier was the only risk indicator (OR = 5.25; p = 0.001) for open occlusal relationship (open bite) in children that used it for over three years, detected in the logistic regressions. Conclusion: The prevalence of malocclusions and deleterious oral habits in the studied sample was high. Children that used a pacifier for over three years showed greater probability of presenting with open occlusal relationship (open bite).