MÍNIMA INTERVENÇÃO TECIDUAL DO TRATAMENTO RESTAURADOR ATRAUMÁTICO EM PROGRAMAS DE PROMOÇÃO DE SAÚDE / MINIMUM TISSUE INTERVENTION OF ATRAUMATIC RESTORATIVE TREATMENT IN HEALTH PROMOTION PROGRAMS

Introdução: O Tratamento Restaurador Atraumático (TRA) é um método de mínima intervenção cirúrgico-restauradora dental implementado pela Organização Mundial de Saúde (OMS) que segue uma filosofia de tratamento associada à promoção de saúde. Objetivo: Este trabalho teve por objetivo realizar uma apreciação teórica, sobre a proposta de maior preservação tecidual do Tratamento Restaurador Atraumático (TRA) nos programas de promoção de saúde. Revisão de Literatura: Com o melhor entendimento do processo de desenvolvimento da lesão cárie, as restaurações atraumáticas têm sido aplicadas baseadas na filosofia de mínima intervenção tecidual e preservação da estrutura dental proporcionando ao agente de saúde um instrumento de apoio para atuação nas atividades educativas, com destaque para a interação das atividades preventivas e curativas no sucesso do procedimento. Conclusão: O Tratamento Restaurador Atraumático (TRA) é uma proposta terapêutica de controle das lesões de cárie, que visa a preservação tecidual e que pode ser explorada nos programas de promoção de saúde em Saúde Pública, desde que haja indicações para o seu uso.Palavras-chave: Saúde Bucal. Cárie Dentária. Tratamento.AbstractIntroduction: The Atraumatic Restorative Treatment is a method of minimal surgical-restorative intervention implemented by the World Health Organization, which follows a treatment philosophy associated with health promotion. Objective: This study aimed to perform a theoretical assessment on the proposal of greater tissue preservation of the Atraumatic Restorative Treatment in health promotion programs. Literature review: With a better understanding of the development of caries lesion, the atraumatic restorations have been applied based on the philosophy of minimal tissue intervention and preservation of tooth structure, providing for the health worker a support instrument for the performance of the educational activities, highlighting the importance of the relationship between preventive and operative activities for the success of the procedure. Conclusion: the Atraumatic Restorative Treatment is a therapeutic approach for the control of caries lesions which aims tissue preservation and can be exploited in programs of health promotion in public health since there are indications for its use.Keywords: Oral Health. Dental caries. Treatment

A 12-month Follow-Up Study of Pulp Oxygen Saturation in Deciduous Molars After Selective and Nonselective Carious-Tissue Removal: A Randomized Pilot Trial

Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR

A 12-month Follow-Up Study of Pulp Oxygen Saturation in Deciduous Molars After Selective and Nonselective Carious-Tissue Removal: A Randomized Pilot Trial

Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR

Clinical effect of photodynamic therapy on primary carious dentin after partial caries removal

Abstract This study was conducted to assess the clinical effect of photodynamic therapy (PDT) in the decontamination of the deep dentin of deciduous molars submitted to partial removal of carious tissue. After cavity preparation, dentin samples were taken from the pulp wall of nineteen deciduous molars before and after PDT application. Remaining dentin was treated with 0.01% methylene blue dye followed by irradiation with an InGaAlP diode laser (λ – 660 nm; 40 mW; 120 J/cm2; 120 s). Dentin samples were microbiologically assessed for the enumeration of total microorganisms, Lactobacillus spp. and mutans streptococci. There was no significant difference in the number of colony-forming units (CFU) for any of the microorganisms assessed (p > 0.05). Photodynamic therapy, using 0.01% methylene blue dye at a dosimetry of 120 J/cm2 would not be a viable clinical alternative to reduce bacterial contamination in deep dentin

Knowledge on oral cancer among dentistry students at Federal University of Maranhão

INTRODUCTION: Oral cancer is a multifactorial disease of high incidence worldwide and considered a public health problem, in which prevention and early diagnosis are the best ways to reverse this situation. PURPOSE: To evaluate the level of knowledge on oral cancer in a population of dentistry students. METHOD: A questionnaire on oral cancer was applied to 150 students from six classes, divided into three groups according to their semesters. The variables studied were statistically analyzed by applying the chi-square test with confidence interval of 95% and significance level of 5%. RESULT: Eighty-eight students (60.61%) considered their level of knowledge on oral cancer good and regular, while 37.93% rated their knowledge as insufficient. Squamous cell carcinoma was listed as the most common cancer by only 38.25% of students, with the highest percentage of correct answers being observed for groups 2 (55.56%) and 3 (67.39%). The level of knowledge on the risk factors increased over the semesters; however, 77.85% considered their level of confidence to perform diagnostic procedures low. CONCLUSION: The level of knowledge on oral cancer was considered good or regular among dentistry students, and although they showed good level of knowledge on the risk factors and to specific issues of the disease, there is a clear need to implement continued educational measures throughout the course to consolidate learning on this disease

Aspectos Gerais, Diagnóstico e Condutas Pelo Cirurgião Dentista Frente aos Maus Tratos Contra Crianças e Adolescentes

A violência contra crianças e adolescentes tornou-se um problema de saúde pública de amplitude mundial por consequência do aumento vertiginoso nos últimos anos dos casos de morbimortalidade e pela diminuição na qualidade de vida e desenvolvimento das vítimas. Os profissionais da área da saúde podem ser os primeiros a identificar condições de maus tratos, sendo necessário conhecimento acerca dos sinais e sintomas que as vítimas apresentam. A prevalência de lesões na face e cavidade bucal coloca o cirurgião dentista em posição privilegiada para o reconhecimento do abuso infantil. Porém, dentre os profissionais, o cirurgião dentista é o que menos notifica os casos às autoridades competentes, mesmo sendo dever deste. Com a finalidade de mudar essa realidade, esse trabalho teve como objetivo apresentar aos profissionais da odontologia as principais características do abuso infantil, bem como fazer um correto diagnóstico e conduzi-los corretamente às autoridades competentes. Para tal, foi realizado um levantamento bibliográfico nas bases de dados MEDLINE-Pubmed, Scielo e LILACS utilizando os descritores “Child abuse”, “Dentists”, “Mandatory Reporting” e o operador “AND”, nos idiomas inglês, português e espanhol, publicadas a partir de 2000 até o momento atual, bem como a utilização da legislação brasileira, manuais, sites, institutos e academias. Desse modo, todos os serviços de proteção à criança e adolescente dependem das pessoas e entidades que notificam os casos para atingirem seus objetivos. Como forma de contribuir, recomenda-se demonstrar a importância da percepção e da notificação principalmente aos profissionais de saúde