Maria Lúcia Marçal Mazza Sundefeld

Cárie precoce: influência de variáveis sócio-comportamentais e do locus de controle da saúde em um grupo de crianças de Araraquara, São Paulo, Brasil

The aim of this study was to evaluate the relationship between early childhood caries and socio-behavioral variables and the health locus of control in a group of children 24 to 35 months of age in Araraquara, Sao Paulo, Brazil. All children of both sexes enrolled in 7 municipal daycare centers were evaluated (n = 110). Exams were performed by an examiner previously trained to apply WHO criteria for determination of dental status. A questionnaire was completed by the mothers, with information on socioeconomic background, behaviors, and attitudes related to the childs oral health and the multidimensional health locus of control. Prevalence of early childhood caries (cavitated or non-cavitated lesions) was 28.2%; there was a significant association between paternal educational level and severe early childhood dental caries (p = 0.01); there were no statistically significant differences between the means for each health locus of control sub-scale and early childhood caries. The results suggest that fathers should be viewed not merely as providers but as an important influence on the childs development as a whole.

Clinical and histopathological analysis of oral squamous cell carcinoma in young people: A descriptive study in Brazilians

We retrospectively analysed the clinical and histological characteristics of oral squamous cell carcinoma (SCC) in a sample of Brazilian patients 45 years of age or less. Files from a single oral histopathological service were studied during the period 1990 to 2005 and the clinical data collected. The histological sections of the invasive part of each tumour were analysed and classified using the criteria of Bryne et al. A total of 46 patients were selected, 36 (78%) of whom were white; 38 (83%) were male; and the most common site was the floor of the mouth (n=14, 30%) followed by the tongue (n=13, 28%). Most selected patients used tobacco and alcohol, and 43 were diagnosed as having clinical stages III and IV disease. Nine of the tumours (20%) were well differentiated, 23 were moderately differentiated, and the rest (n=14) were poorly differentiated. The characteristics of this group suggest that oral SCC in young patients does not behave differently from the oral SCC found in the overall population.

Delayed replantation of rat teeth after use of reconstituted powdered milk as a storage medium.

Minimal extraoral dry storage period and moist storage for the avulsed tooth are identified as key steps for the treatment protocol of tooth replantation. Among the possible moist storage media, bovine milk has stood out because of its capacity of preserving the integrity of the periodontal ligament (PDL) fibers. This condition has attracted the attention to investigate the use of powdered milk, which is one of the presentation forms of bovine milk, as a feasible storage medium in cases of delayed tooth replantation. The aim of this study was to evaluate the healing process after delayed replantation of rat teeth stored in reconstituted powdered milk and long shelf-life (ultra high temperature) whole milk. Forty maxillary right rat incisors were assigned to four groups (n = 10): group I--the teeth were extracted and immediately replanted into theirs sockets; group II--the teeth were stored for 60 min in 200 ml of freshly reconstituted powdered milk; group III--the teeth were stored for 60 min in 200 ml of long shelf-life whole milk; group IV--the teeth were kept dry for the same time. All procedures were performed at room temperature. Next, the root canals of teeth in groups II, III, and IV were instrumented, filled with a calcium hydroxide-based paste, and replanted into their sockets. All animals received systemic antibiotic therapy and were killed by anesthetic overdose 60 days after replantation. The pieces containing the replanted teeth were removed, fixed, decalcified, and paraffin-embedded. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histomorphological analysis. There was statistically significant difference (P < 0.05) between groups I and IV regarding the presence of replacement resorption and PDL remnants on root surface. The powdered milk and long shelf-life whole milk presented similar results to each other and may be indicated as storage media for avulsed teeth.

Relação entre classe socioeconômica e fatores demográficos na ocorrência da disfunção temporomandibular

Diferentes fatores como estresse e oclusao podem diminuir a capacidade adaptativa do aparelho estomatognatico e levar a ocorrencia da disfuncao temporomandibular (DTM). Objetivou-se neste estudo verificar a relacao da classe economica, escolaridade, sexo e idade na ocorrencia da disfuncao temporomandibular. A populacao deste estudo constituiu-se em uma amostra estatisticamente significativa de individuos de ambos os sexos pertencentes a diferentes classes economicas da zona urbana do municipio de Piacatu, Sao Paulo, Brasil. Utilizou-se o Criterio de Classificacao Economica Brasil (CCEB) para a estratificacao economica da populacao. Retirou-se uma amostra de cada estrato, na qual se aplicou o Questionario de Fonseca para verificar o grau de DTM. Os dados coletados foram analisados estatisticamente por meio do teste qui-quadrado, com nivel de significância de 5%. No total, participaram da pesquisa 354 chefes de familia. Nao houve relacao estatisticamente significativa entre classe economica, escolaridade e faixa etaria com a disfuncao temporomandibular (DTM). Existiu relacao entre sexo e DTM (p<0,02). As variaveis classe economica, escolaridade e faixa etaria nao influenciam na ocorrencia da DTM; entretanto, existe significância quanto ao sexo do individuo.

Increased plasma and salivary cortisol levels in patients with oral cancer and their association with clinical stage

Objectives Dysregulation of the hypothalamus–pituitary–adrenal axis has been observed in patients with cancer. This cross-sectional study investigated whether patients with oral and oropharyngeal squamous cell carcinoma (SCC) show changes in cortisol levels in saliva and plasma compared with three control groups, and evaluated its correlation with clinicopathological data. Methods Salivary and plasma cortisol levels of 34 patients with oral SCC were compared with hormonal levels of 17 oropharyngeal SCC patients, 17 oral leukoplakia patients, 27 smokers and/or drinkers and 25 healthy volunteers. Multivariate analysis was used to evaluate the impact of clinical variables on the cortisol levels. Results The plasma (p<0.05) and salivary (p<0.01) cortisol levels were significantly higher in patients with oral SCC compared with all groups. Patients with oropharyngeal SCC had higher levels of salivary cortisol compared with smokers and/or drinkers (p<0.05) and patients with leukoplakia (p<0.01). Patients with advanced-stage oral SCC showed significantly higher levels of cortisol than those in an initial clinical stage. Men with oral SCC had higher salivary cortisol levels than women (p<0.05). Age, smoking, alcohol consumption, presence of teeth and awareness of cancer diagnosis had no significant effect on cortisol levels. Conclusions These results indicate a dysregulation of cortisol secretion in patients with oral cancer and suggest that this hormone can be a biomarker associated with the diseases clinical status.

Evaluation of sixth grade primary schoolchildren's knowledge about avulsion and dental reimplantation.

Dental trauma, particularly tooth avulsion, is a frequent cause of tooth loss in children, adolescents, and young adults. The avulsed tooth should be immediately reimplanted in its alveolus. This procedure can be performed by anyone at the accident site and not only by dental surgeons. Therefore, the purpose of this study is to evaluate the knowledge of sixth graders of the city of Araçatuba, SP, about dental avulsion and tooth reimplantation through a structured and standardized survey. Our sample consisted of 778 students. The data collected was processed using the program EPIINFO 2000. Most students were around 12 years of age and 94.5% related to practice some kind of sports. Results demonstrated that the possibility of tooth reimplantation after dental avulsion is not acknowledged among these students and dental traumatism was associated to caries, toothache, and use of orthodontic appliances. Only 18.9% of the students associated dental traumatism to an impact trauma; 3.6% would store the tooth in milk, and 3.1% believed the tooth could be reimplanted by anyone present at the accident site. In summary, the results show an overall the lack of knowledge about dental traumatism and highlight the need of special programs designed to educate school-aged students about emergency procedures to handle cases of dental traumatisms.

Effect of Disinfection and Accelerated Aging on Color Stability of Colorless and Pigmented Facial Silicone

PURPOSE The aim of this study was to evaluate the color stability of a facial silicone with different pigmentations submitted to disinfection and accelerated aging. MATERIALS AND METHODS Sixty replicas were fabricated with the silicone Silastic MDX 4-4210 and divided into three groups: no pigmentation, pigmentation with makeup powder, and pigmentation with ceramic powder. Half the replicas of each group were submitted to disinfection with Efferdent and the other with neutral soap for 60 days (n = 10). After this period, all replicas were inserted in a chamber for accelerated aging of nonmetallic specimens. The color measurements were carried out initially, after disinfection, and after accelerated aging (252, 504, 1008 hours). Color stability was evaluated through spectrophotometry. The values were submitted to ANOVA and the means to Tukeys test (p < 0.01). RESULTS The specimens disinfected with neutral soap exhibited higher ΔE values regardless of the type of pigmentation. The colorless replicas and the specimens pigmented with ceramic exhibited a statistically significant difference between the methods of disinfection in all periods. The specimens pigmented with makeup powder did not demonstrate a statistically significant difference. CONCLUSIONS The ceramic pigment presented greater color stability regardless of disinfection and period. On the other hand, the makeup pigment exhibited the highest values of chromatic alteration.

Longitudinal photographic observation of the occurrence of bubbles in pit and fissure sealants

The purpose of this study was to employ photographic evaluation to observe the presence or absence of bubbles in pit and fissure sealants Concise and Prisma Shield, at 7 days, 18 months, 36 months and 11 years after accomplishment of treatment. Methods: A hematoxylin-based staining solution was applied to the occlusal surface at the study periods, which allowed assessment of the sealing material on the surface. All occlusal surfaces were photographed and the photographs corresponding to each period were subjected to photographic evaluation. Results: There was statistically significant difference only at 18 months, with a significantly higher number of specimens with bubbles for the Prisma Shield sealant compared to the Concise, whereas the groups were similar at all other study periods. On the other hand, separate analysis of subsequent periods of the sealants did not reveal any significant difference. Conclusions: According to the results of the present longitudinal investigation, it may be concluded that the sealing materials showed that bubbles came into and went out with time. However, this fact did not interfere with its clinical purpose, provided the remaining material covers the expected region of pits and fissures.

Dental bleaching with a 10% hydrogen peroxide product: A six-month clinical observation

CONTEXT The possibility of bleaching vital teeth with peroxide-based products considerably revolutionized esthetic dentistry. AIM The aim of this clinical study was to evaluate tooth color change and dental sensitivity after exposure to preloaded film containing a 10% hydrogen peroxide whitening system (Opalescence Trθswhite Supreme). MATERIALS AND METHODS A total of 13 volunteers, aged 18 to 25 years, participated in this study. The patients used the whitening system once a day for 60 minutes during the 8-day study. For maxillary incisors and canines, the color change was visually evaluated with the Vita color scale before, immediately, and six months after the treatment. Tooth sensitivity was evaluated during the daily gel applications. All whitening applications were done in office and under the supervision of a dental professional. STATISTICAL ANALYSIS USED The results were analyzed using the Friedman Test (nonparametric repeated measures ANOVA) at a level of 5%, and Dunns Multiple Comparison Test at the level of 5%. RESULTS It was verified that the original mean color values observed at the baseline analysis differed significantly from those observed immediately after bleaching, as well as from those seen in the analysis at six months ( P = 0.001). There was no significant difference between the mean color values observed in the immediate time and in the analysis at six months ( P = 0.474). No tooth sensitivity was observed in any patients. CONCLUSION It was concluded that the bleaching technique using the 10% hydrogen peroxide system was effective in a short period of time without tooth sensitivity during applications.

Healing process of incisor teeth of diabetic rats replanted after storage in milk

Several local factors that influence the healing process of replanted teeth have been investigated. However, it remains unclear how systemic alterations, such as diabetes mellitus, affect the prognosis of these cases. The purpose of this study was to evaluate the healing process of incisors of non-controlled diabetic rats replanted after storage in bovine long shelf-life (UHT) whole milk. Thirty-two rats were randomly assigned to receive an endovenous injection of either citrate buffer solution (group I - control; n = 16) or streptozotocin dissolved in citrate buffer solution to induce diabetes (group II; n = 16). After confirmation of the diabetic status by analysis of the glycemic levels, the maxillary right incisor of each animal was extracted and immersed in milk for 60 min. The root canals of teeth were then instrumented, and were filled with a calcium hydroxide-based dressing and replanted into their sockets. All animals received systemic antibiotic and were killed by anesthetic overdose 10 and 60 days after replantation. The specimens containing the replanted teeth were removed, fixed, decalcified, and embedded in paraffin. Semi-serial 6-microm-thick sections were obtained and stained with hematoxylin and eosin for histologic and histometric analyses. The results showed that the connective tissue adjacent to the root surface was less organized in the diabetic animals than in the control animals in both periods; the root dentin was less severely affected by root resorption in the diabetic rats; there were no significant differences between the control and diabetic groups regarding the occurrence of replacement resorption and inflammatory resorption.