Efeito de diferentes variáveis na percepção do desconforto cirúrgico durante a remoção de terceiros molares de mulheres

Orientadora: Profa. Dra. Rafaela ScariotCoorientador: Prof. Dr. Delson João da CostaTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Odontologia. Defesa : Curitiba, 30/10/2023Inclui referênciasResumo: Procedimentos para remoção de terceiros molares são rotineiros na prática odontológica e requerem conhecimento técnico e científico. Com o intuito de aprimorar o cuidado centrado no paciente, faz-se necessária a investigação das variáveis relacionadas ao desconforto cirúrgico. Esse estudo transversal observacional foi dividido em dois artigos, o primeiro artigo investigou o efeito das variáveis individuais, relacionadas a saúde da mulher, cirúrgicas, anatômicas e ansiedade sob a percepção do desconforto e o segundo verificou a influência de polimorfismos nos genes COMT, SLC6A4, TRPV1, HTR2A, ESR1 e ESR2 na percepção de desconforto durante a remoção de terceiros molares. Foram incluídas 200 mulheres, entre 18 e 45 anos, atendidas no serviço de Cirurgia e Traumatologia Bucomaxilofaciais da Universidade Federal do Paraná, durante o período de 24 meses. O desconforto cirúrgico foi avaliado através do questionário de autopercepção de cirurgia bucal (QCirDental). Variáveis individuais (idade, raça, índice de massa corporal [IMC]), variáveis relacionadas a saúde da mulher (fase do ciclo menstrual, níveis hormonais, uso de métodos contraceptivos, número de filhos, presença de dor crônica e orofacial), variáveis cirúrgicas (experiência do cirurgião, duração do procedimento cirúrgico, número de dentes removidos, necessidade de osteotomia e/ou odontosecção), variáveis anatômicas (curvatura radicular, divergência radicular, proporção coroa/raiz e classificação radiográfica de Winter), variáveis relacionadas a ansiedade (IDATE traço e estado, experiência e trauma em cirurgias odontológicas anteriores, medicamentos para ansiedade ou depressão) foram avaliadas. Amostras de sangue foram obtidas a fim de verificar o nível dos hormônios progesterona, estradiol e FSH. O DNA genômico do participante foi coletado através de raspagem da mucosa jugal. Os polimorfismos avaliados foram genotipados pela técnica de reação da cadeia em polimerase (PCR). Os dados foram submetidos a análise estatística através do software SPSS 25, com nível de significância de 5%. Como resultados, foi verificado que a mediana do desconforto cirúrgico de 1,50. IMC mais altos (p=0,042), fase folicular do ciclo menstrual (p=0,033), não ser mãe (p=0,047), menor número de filhos (p=0,047), maior duração do procedimento cirúrgico (p=0,012), traço de ansiedade alto (p<=0,01), experiência traumática em cirúrgica anterior (p=0,021), uso de medicação para ansiedade e depressão (p=0,016), foram associados a maior percepção de desconforto durante a remoção de terceiros molares. Além disso, genótipo TT para o polimorfismo rs174675 em COMT no modelo aditivo e dominante (p=0,014) e (p<=0,01) respectivamente, genótipo GG para o polimorfismo rs6113 em HTR2A no modelo dominante (p=0,038) foram variáveis associadas a maior percepção do desconforto durante a remoção de terceiros molares. Os resultados encontrados nesse estudo sugerem que diferentes fatores estão envolvidos na percepção do desconforto, tais como: IMC, ciclo menstrual, maternidade, número de filhos, duração do procedimento cirúrgico, traço de ansiedade, experiência traumática prévia, uso de medicamentos para ansiedade e depressão, polimorfismo rs174675 na COMT para mulheres com genótipo TT e o polimorfismo rs6313 em HTR2A para o genótipo GG. Isto reforça os princípios preconizados pelo modelo biopsicossocial. Enfatizando a necessidade de tratamento individualizado, priorizando o bem-estar dos pacientes submetidos à remoção de terceiros molares.Abstract: The removal of third molars is routine in dental practice and requires technical and scientific knowledge. In order to improve patient-centered care, it is necessary to investigate variables related to surgical discomfort. This cross-sectional observational study was divided into two articles. The first article investigated the effect of individual variables related to women's health, surgical aspects, anatomy, and anxiety on the perception of discomfort. The second article examined the influence of polymorphisms in the genes COMT, SLC6A4, TRPV1, HTR2A, ESR1, and ESR2 on discomfort perception during the removal of third molars. A total of 200 women aged 18 to 45, treated at the Oral and Maxillofacial Surgery and Traumatology Service of the Federal University of Paraná over a 24-month period, were included in the study. Surgical discomfort was assessed using the Oral Surgery Self-Perception Questionnaire (QCirDental). Various variables were evaluated, including individual factors (age, race, body mass index [BMI]), women's health-related variables (menstrual cycle phase, hormonal levels, contraceptive use, number of children, presence of chronic orofacial pain), surgical variables (surgeon experience, surgical procedure duration, number of teeth removed, need for osteotomy and/or odontosection), anatomical variables (root curvature, root divergence, crown/root ratio, and Winter's radiographic classification), and anxiety-related variables (state and trait anxiety, previous dental surgery experience, anxiety or depression medication). Blood samples were obtained to measure progesterone, estradiol, and FSH hormone levels. Genomic DNA was collected through buccal mucosa scraping, and polymorphisms were genotyped using the polymerase chain reaction (PCR) technique. The data were analyzed statistically using SPSS 25 software with a significance level of 5%. The results showed that the median surgical discomfort was 1.50. Higher BMI (p=0.042), follicular phase of the menstrual cycle (p=0.033), not being a mother (p=0.047), fewer children (p=0.047), longer surgical procedure duration (p=0.012), high anxiety trait (p<=0.01), traumatic experience in previous surgery (p=0.021), and use of anxiety and depression medication (p=0.016) were associated with a higher perception of discomfort during the removal of third molars. Additionally, the t T genotype for the rs174675 polymorphism in COMT in both additive and dominant models (p=0.014) and (p<=0.01) respectively, and the GG genotype for the rs6113 polymorphism in HTR2A in the dominant model (p=0.038) were variables associated with a higher perception of discomfort during the removal of third molars. The findings suggest that various factors contribute to discomfort perception, including BMI, menstrual cycle, motherhood, number of children, surgical procedure duration, anxiety trait, previous traumatic experience, and specific gene polymorphisms. This reinforces the principles of the biopsychosocial model and emphasizes the need for individualized treatment, prioritizing the well-being of patients undergoing the removal of third molars

Desconforto cirúrgico na remoção de terceiros molares : fatores individuais, clínicos e genéticos associados

Orientador: Prof. Dr. Nelson Luis Barbosa RebellatoCoorientador: Prof. Dr. Daniel BonottoDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Odontologia. Defesa : Curitiba, 16/07/2019Inclui referênciasResumo: Introdução: A remoção cirúrgica de terceiros molares é um dos procedimentos de cirurgia bucal mais comumente realizados. Até o momento, poucos estudos se dedicaram a avaliar o desfecho centrado no paciente, acerca da percepção sobre desconforto percebido durante a remoção de terceiros molares no momento transcirúrgico ou pós-operatório imediato. Mensurar o desconforto percebido pelos indivíduos é uma tarefa difícil, visto que se trata de uma característica multifatorial, de origem complexa, podendo ser influenciada por variáveis cirúrgicas, características clinicas e polimorfismos genéticos. Objetivo: Este estudo transversal observacional foi conduzido com o objetivo de quantificar o desconforto cirúrgico percebido pelo indivíduo submetido a remoção de terceiros molares, avaliar polimorfismos no gene FKBP Prolyl Isomerase 5 - FKBP5, Portador de Soluto Família 6 Membro 4 - SCL6A4 e Catecol -O-Metiltransferase COMT, além de avaliar qualidade de vida relacionada a saúde bucal e características clínicas e cirúrgicas. Materiais e Métodos: Foram incluídos 209 participantes, entre 18 e 64 anos, atendidos no serviço de Cirurgia e Traumatologia Buco-maxilo-faciais da Universidade Federal do Paraná, durante o período de 11 meses. O desconforto cirúrgico foi avaliado através do questionário validado de auto percepção de cirurgia bucal (QCirDental), aplicado num único momento, logo após o termino da cirurgia para remoção de terceiros molares. Variáveis individuais (sexo, idade, peso, altura) e referentes ao procedimento cirúrgico (experiência do cirurgião, tempo de duração do procedimento cirúrgico, número de dentes removidos, classificação radiográfica dos dentes removidos) também foram avaliados. A qualidade de vida relacionada a saúde bucal foi avaliada através do instrumento validado Oral Health Impact Profile - 14 (OHIP-14). O DNA genômico do participante foi coletado através de raspagem da mucosa jugal. Dois polimorfismos do gene FKBP5 (rs3800373 e rs1360780), além de dois polimorfismos do gene SCL6A4 (rs1042173 e rs81334) e um polimorfismo do gene COMT (rs174675) foram genotipados pela técnica de reação da cadeia em polimerase. Os dados foram submetidos a análise estatística, através do software SPSS 2.1.0. Foi adotado nível de significância de 5%, a variável percepção de desconforto apresentou distribuição não normal a partir do teste Kolgomorov-Smirnov, por isso os dados foram representados por mediana, mínimo e máximo. As variáveis independentes foram dicotomizadas pelas suas respectivas medianas, sendo utilizado teste U de MannWhitney e Kruskal Wallis. A distribuição dos genótipos foi avaliada nos modelos aditivo, dominante e recessivo. O equilíbrio de Hardy-Weinberg foi avaliado pelo teste do qui-quadrado. Para a correlação entre qualidade de vida e intensidade de desconforto cirúrgico percebido pelo indivíduo foi utilizado teste de correlação de Spearman. Resultados: A mediana do desconforto cirúrgico encontrada nesse estudo foi de 1,40. Foi observado que as mulheres apresentaram maior intensidade de desconforto associado a remoção cirúrgica de terceiros molares quando comparadas aos homens (p = 0,001), assim como pessoas com maior peso corporal (p = 0,004). Não foi observada associação entre variáveis inerentes ao procedimento cirúrgico com o desconforto. No modelo recessivo, o marcador rs3800373 foi associado a uma maior intensidade de percepção de desconforto cirúrgico (p = 0,026), não foi encontrada associação entre os genes SLC6A4 e COMT com maior intensidade de percepção do desconforto cirúrgico. Não foi verificada correlação entre qualidade de vida e intensidade de desconforto cirúrgico percebida pelo paciente. Conclusão: Mulheres, indivíduos com maior peso corporal e com genótipo AA para o marcador rs3800373 reportaram maior intensidade de percepção de desconforto associado a cirurgia para remoção cirúrgica dos terceiros molares. Palavras-Chave: 1 .Cirurgia bucal. 2.Terceiro Molar. 3.Dor. 4.Qualidade de Vida. 5.Polimorfismos Genéticos.Abstract: Introduction: Surgical removal of third molars is one of the most commonly performed oral surgery procedures. To date, few studies have focused on patientcentered outcome regarding perceived perceived discomfort during removal of third molars at the immediate postoperative or postoperative period. Measuring the discomfort perceived by individuals is a difficult task, since it is a multifactorial characteristic of complex origin and may be influenced by surgical variables, clinical characteristics and genetic polymorphisms. Objective: This observational crosssectional study was conducted to quantify the surgical discomfort perceived by the individual undergoing third molar removal, to evaluate FKBP Prolyl Isomerase 5 - FKBP5, Family Solute Carrier 6 Member 4 - SCL6A4 and Catechol -O gene polymorphisms - COMT methyltransferase, in addition to assessing oral health-related quality of life and clinical and surgical characteristics. MATERIALS AND METHODS: Twenty-nine participants, aged between 18 and 64 years old, attended at the Buccomaxillofacial Surgery and Traumatology service of the Federal University of Paraná during 11 months. Surgical discomfort was assessed using the validated oral surgery self-perception questionnaire (QCirDental), which was applied in a single moment, immediately after the surgery to remove third molars. Individual variables (gender, age, weight, height) and related to the surgical procedure (surgeon's experience, duration of the surgical procedure, number of teeth removed, radiographic classification of teeth removed) were also evaluated. Oral health-related quality of life was assessed using the validated Oral Health Impact Profile - 14 (OHIP-14). The participant's genomic DNA was collected by scraping the jugal mucosa. Two FKBP5 gene polymorphisms (rs3800373 and rs1360780), two SCL6A4 gene polymorphisms (rs1042173 and rs81334) and one COMT gene polymorphism (rs174675) were genotyped by the polymerase chain reaction technique. Data were subjected to statistical analysis using the SPSS 2.1.0 software. A significance level of 5% was adopted; the variable perception of discomfort presented a non-normal distribution from the Kolgomorov-Smirnov test, so the data were represented by median, minimum and maximum. Independent variables were dichotomized by their respective medians, using the Mann-Whitney and Kruskal Wallis U test. Genotype distribution was evaluated in additive, dominant and recessive models. Hardy-Weinberg equilibrium was evaluated by the chi-square test. For the correlation between quality of life and intensity of surgical discomfort perceived by the individual was used Spearman's correlation test. Results: The median of surgical discomfort found in this study was 1.40. It was observed that women had higher intensity of discomfort associated with surgical removal of third molars when compared to men (p = 0.001), as well as people with higher body weight (p = 0.004). There was no association between variables inherent to the surgical procedure and discomfort. In the recessive model, the marker rs3800373 was associated with a higher intensity of perception of surgical discomfort (p = 0.026). No association was found between the SLC6A4 and COMT genes with higher intensity of perception of surgical discomfort. There was no correlation between quality of life and intensity of surgical discomfort perceived by the patient. Conclusion: Women, individuals with higher body weight and AA genotype for the rs3800373 marker reported higher intensity of perceived discomfort associated with surgery for surgical removal of third molars. Keywords: 1.Oral, Surgery. 2Molar, Third. 3.Pain. 4.Quality of Life. 5.Polymorhism Genetic

Association Between Periodontal Health Knowledge and Oral Hygiene in Brazilian Adolescents

Objective: To evaluate the influence of oral health knowledge in adolescents’ oral hygiene pattern. Material and Methods: Cross-sectional study involving 291 participants aged between 14 and 19 years old enrolled in a public school in Curitiba, Brazil. A self-administered questionnaire containing five affirmations about periodontal diseases and their forms of prevention was arranged on a three-point Likert scale. Correct answers were given a weight=1 and incorrect ones, weight=0. The knowledge score (KS) was determined by the sum. Socioeconomic and demographic data were obtained by a questionnaire sent to those responsible. The oral hygiene pattern was evaluated through the simplified oral hygiene index (OHI-S) by a calibrated researcher (K=0.89). Mann-Whitney U test and univariate and multivariate Poisson regression with robust variance were used for data analysis (α=0.05). Results: There was an inversely proportional association between KS and OHI-S (p=0.018). The multiple model showed that adolescents with a lower KS (PR = 0.93, CI95%: 0.88-0.99), male gender (PR = 1.17, CI95%: 1.01-1.37) and whose caregivers presented a lower level of education (PR=1.30, CI95%: 1.03-1.64) showed a higher index of dental plaque. Conclusion: The level of oral health knowledge, the gender and the caregivers’ level of education influences the adolescents’ oral hygiene pattern

Evaluation of the bond strength at the resin-dentin interface using self-etching adhesive systems containing different functional monomers / Avaliação da resistência de união na interface resina-dentina usando sistemas adesivos autocondicionantes contendo diferentes monômeros funcionais

Background: Self-etching adhesive systems have attracted considerable interest in dentistry, as these materials simplify the restorative protocol and allow a less sensitive adhesive technique. The objective of the present study was to analyze in vitro the performance of self-etching adhesive systems containing different functional monomers. Materials and Methods:  The adhesives evaluated were: Clearfil SE Bond (CSE) adhesive containing 10-MDP, Optibond All-in-One (OPT) containing GPDM, Palfique Bond (PB) containing 3D-SR monomer. Immediate microtensite bond strength (mTBS) and after thermocycling were realized. Interaction between the functional monomers and dentin was characterized using thin-film X-ray diffraction (TF-XRD) and scanning electron microscopy (SEM). In the experiments were used 60 molars. Thirty molars were divided into 3 experimental conditions (n=10) according to the adhesive system; the teeth were restored and sectioned on “toothpick” specimens for mTBS. Additionally, five teeth were prepared in the form of discs and the adhesives applied without light curing on the surface for XRD analysis. For morphological evaluation in SEM, 25 teeth were treated with the respective adhesives. The mTBS data were submitted to ANOVA two factors and Tukey's test (5%).  Results: The adhesive vs. time interaction was statistically significant (p&lt;0.001), with the CSE adhesive obtaining the highest means and being the worst performance of BP. The analysis of XRD found that the monomers interact chemically with hydroxyapatite, but with different intensities. SEM images indicate that the applied adhesives infiltrate the dentin forming resin tags in greater or lesser amounts. Conclusions: The different functional monomers have a direct impact on the effectiveness of the adhesive bond, with the 10-MDP monomer, the CSE adhesive, highlighted by the higher TBS values. The self-etching adhesive systems allow a simplification in the restorative protocol, besides a less sensitive adhesive technique and less clinical time for the procedure. Therefore, knowing its mechanical and chemical properties is important to ensure longer-lasting restorations. 

Diagnosis, oral rehabilitation and multidisciplinary approach of a patient with a severely worn dentition and reduced occlusal vertical dimension/ Diagnóstico, reabilitação oral e abordagem multidisciplinar de um paciente com uma dentição gravemente desgastada e dimensão vertical oclusal reduzida

Bruxism is a parafunction that presents as an involuntary and unconscious disorder of mandibular movement, characterized by flatness and grinding of the teeth. It is a hyperactivity of the masticatory muscles that is mainly associated with stress and emotion, and occurs in wakefulness and / or during sleep, without defined etiology and treatment, although there are etiological hypotheses with a strong implication in the central nervous system. The most common approach is to multidiscipline, in order to minimize etiological factors and restore lost function and esthetics. This case report describes the diagnosis, the associated treatments and the clinical follow-up of a patient with posterior teeth severely worn due to bruxism. Therefore, were made restoration of vertical dimension of occlusion with ceramic “table top” overlays in the posterior teeth and laminate veneers in the anterior teeth. Subsequently, cognitive/behavioral therapies and interocclusal devices were used

Knowledge of Dentists and Dental Undergraduates Related to COVID-19

Objective:&nbsp;To assess the knowledge of Brazilian dentists and final-year dental undergraduates concerning COVID-19.&nbsp;Material and Methods:&nbsp;We conducted a self-administered online questionnaire about the symptoms, incubation period, and transmission routes of COVID-19. In total, there were three questions addressing these topics and 15 correct answers, so each participant could score from 0 to 15 points. Besides that, data such as sex, age, education level, years of work experience and place of work were collected. All data were submitted to statistical analysis with a 5% significance level.&nbsp;Results:&nbsp;476 participants were recruited. Regarding the respondents' perception of the most common symptoms of COVID-19, 99.4% responded fever, 95.2% cough, and 99.2% dyspnea. About the incubation period, 56.3% answered from 1 to 14 days. About the transmission routes, 98.3% recognized transmission through droplets, 80.3% through direct contact with infected persons, and 70.4% through indirect routes. The median knowledge score was 10 (4 – 14). Regarding the socio-demographic variables, participants aged 30 years or more had a higher score than those aged up to 29 years old (p=0.004). For education level, specialist dentists presented a higher score than undergraduates (p=0.006), general dentists (p=0.048) and Ph.D. (p=0.016). Participants with 15 years or more of work experience had a higher score than undergraduates (p=0.003). Concerning the workplace, participants working in the public sector had a higher score than those working in the private sector or universities (p=0.015).&nbsp;Conclusion:&nbsp;Participants recognized the main symptoms, incubation period, and transmission routes of the COVID-19 virus; however, the knowledge level of specialist dentists, older dentists, more experienced dentists, and dentists working in the public sector was higher than the other participants

Knowledge of Dentists and Dental Undergraduates Related to COVID-19

Objective: To assess the knowledge of Brazilian dentists and final-year dental undergraduates concerning COVID-19. Material and Methods: We conducted a self-administered online questionnaire about the symptoms, incubation period, and transmission routes of COVID-19. In total, there were three questions addressing these topics and 15 correct answers, so each participant could score from 0 to 15 points. Besides that, data such as sex, age, education level, years of work experience and place of work were collected. All data were submitted to statistical analysis with a 5% significance level. Results: 476 participants were recruited. Regarding the respondents' perception of the most common symptoms of COVID-19, 99.4% responded fever, 95.2% cough, and 99.2% dyspnea. About the incubation period, 56.3% answered from 1 to 14 days. About the transmission routes, 98.3% recognized transmission through droplets, 80.3% through direct contact with infected persons, and 70.4% through indirect routes. The median knowledge score was 10 (4 – 14). Regarding the socio-demographic variables, participants aged 30 years or more had a higher score than those aged up to 29 years old (p=0.004). For education level, specialist dentists presented a higher score than undergraduates (p=0.006), general dentists (p=0.048) and Ph.D. (p=0.016). Participants with 15 years or more of work experience had a higher score than undergraduates (p=0.003). Concerning the workplace, participants working in the public sector had a higher score than those working in the private sector or universities (p=0.015). Conclusion: Participants recognized the main symptoms, incubation period, and transmission routes of the COVID-19 virus; however, the knowledge level of specialist dentists, older dentists, more experienced dentists, and dentists working in the public sector was higher than the other participants

Desconforto cirúrgico na remoção de terceiros molares : fatores individuais, clínicos e genéticos associados

Orientador: Prof. Dr. Nelson Luis Barbosa RebellatoCoorientador: Prof. Dr. Daniel BonottoDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Odontologia. Defesa : Curitiba, 16/07/2019Inclui referênciasResumo: Introdução: A remoção cirúrgica de terceiros molares é um dos procedimentos de cirurgia bucal mais comumente realizados. Até o momento, poucos estudos se dedicaram a avaliar o desfecho centrado no paciente, acerca da percepção sobre desconforto percebido durante a remoção de terceiros molares no momento transcirúrgico ou pós-operatório imediato. Mensurar o desconforto percebido pelos indivíduos é uma tarefa difícil, visto que se trata de uma característica multifatorial, de origem complexa, podendo ser influenciada por variáveis cirúrgicas, características clinicas e polimorfismos genéticos. Objetivo: Este estudo transversal observacional foi conduzido com o objetivo de quantificar o desconforto cirúrgico percebido pelo indivíduo submetido a remoção de terceiros molares, avaliar polimorfismos no gene FKBP Prolyl Isomerase 5 - FKBP5, Portador de Soluto Família 6 Membro 4 - SCL6A4 e Catecol -O-Metiltransferase COMT, além de avaliar qualidade de vida relacionada a saúde bucal e características clínicas e cirúrgicas. Materiais e Métodos: Foram incluídos 209 participantes, entre 18 e 64 anos, atendidos no serviço de Cirurgia e Traumatologia Buco-maxilo-faciais da Universidade Federal do Paraná, durante o período de 11 meses. O desconforto cirúrgico foi avaliado através do questionário validado de auto percepção de cirurgia bucal (QCirDental), aplicado num único momento, logo após o termino da cirurgia para remoção de terceiros molares. Variáveis individuais (sexo, idade, peso, altura) e referentes ao procedimento cirúrgico (experiência do cirurgião, tempo de duração do procedimento cirúrgico, número de dentes removidos, classificação radiográfica dos dentes removidos) também foram avaliados. A qualidade de vida relacionada a saúde bucal foi avaliada através do instrumento validado Oral Health Impact Profile - 14 (OHIP-14). O DNA genômico do participante foi coletado através de raspagem da mucosa jugal. Dois polimorfismos do gene FKBP5 (rs3800373 e rs1360780), além de dois polimorfismos do gene SCL6A4 (rs1042173 e rs81334) e um polimorfismo do gene COMT (rs174675) foram genotipados pela técnica de reação da cadeia em polimerase. Os dados foram submetidos a análise estatística, através do software SPSS 2.1.0. Foi adotado nível de significância de 5%, a variável percepção de desconforto apresentou distribuição não normal a partir do teste Kolgomorov-Smirnov, por isso os dados foram representados por mediana, mínimo e máximo. As variáveis independentes foram dicotomizadas pelas suas respectivas medianas, sendo utilizado teste U de MannWhitney e Kruskal Wallis. A distribuição dos genótipos foi avaliada nos modelos aditivo, dominante e recessivo. O equilíbrio de Hardy-Weinberg foi avaliado pelo teste do qui-quadrado. Para a correlação entre qualidade de vida e intensidade de desconforto cirúrgico percebido pelo indivíduo foi utilizado teste de correlação de Spearman. Resultados: A mediana do desconforto cirúrgico encontrada nesse estudo foi de 1,40. Foi observado que as mulheres apresentaram maior intensidade de desconforto associado a remoção cirúrgica de terceiros molares quando comparadas aos homens (p = 0,001), assim como pessoas com maior peso corporal (p = 0,004). Não foi observada associação entre variáveis inerentes ao procedimento cirúrgico com o desconforto. No modelo recessivo, o marcador rs3800373 foi associado a uma maior intensidade de percepção de desconforto cirúrgico (p = 0,026), não foi encontrada associação entre os genes SLC6A4 e COMT com maior intensidade de percepção do desconforto cirúrgico. Não foi verificada correlação entre qualidade de vida e intensidade de desconforto cirúrgico percebida pelo paciente. Conclusão: Mulheres, indivíduos com maior peso corporal e com genótipo AA para o marcador rs3800373 reportaram maior intensidade de percepção de desconforto associado a cirurgia para remoção cirúrgica dos terceiros molares. Palavras-Chave: 1 .Cirurgia bucal. 2.Terceiro Molar. 3.Dor. 4.Qualidade de Vida. 5.Polimorfismos Genéticos.Abstract: Introduction: Surgical removal of third molars is one of the most commonly performed oral surgery procedures. To date, few studies have focused on patientcentered outcome regarding perceived perceived discomfort during removal of third molars at the immediate postoperative or postoperative period. Measuring the discomfort perceived by individuals is a difficult task, since it is a multifactorial characteristic of complex origin and may be influenced by surgical variables, clinical characteristics and genetic polymorphisms. Objective: This observational crosssectional study was conducted to quantify the surgical discomfort perceived by the individual undergoing third molar removal, to evaluate FKBP Prolyl Isomerase 5 - FKBP5, Family Solute Carrier 6 Member 4 - SCL6A4 and Catechol -O gene polymorphisms - COMT methyltransferase, in addition to assessing oral health-related quality of life and clinical and surgical characteristics. MATERIALS AND METHODS: Twenty-nine participants, aged between 18 and 64 years old, attended at the Buccomaxillofacial Surgery and Traumatology service of the Federal University of Paraná during 11 months. Surgical discomfort was assessed using the validated oral surgery self-perception questionnaire (QCirDental), which was applied in a single moment, immediately after the surgery to remove third molars. Individual variables (gender, age, weight, height) and related to the surgical procedure (surgeon's experience, duration of the surgical procedure, number of teeth removed, radiographic classification of teeth removed) were also evaluated. Oral health-related quality of life was assessed using the validated Oral Health Impact Profile - 14 (OHIP-14). The participant's genomic DNA was collected by scraping the jugal mucosa. Two FKBP5 gene polymorphisms (rs3800373 and rs1360780), two SCL6A4 gene polymorphisms (rs1042173 and rs81334) and one COMT gene polymorphism (rs174675) were genotyped by the polymerase chain reaction technique. Data were subjected to statistical analysis using the SPSS 2.1.0 software. A significance level of 5% was adopted; the variable perception of discomfort presented a non-normal distribution from the Kolgomorov-Smirnov test, so the data were represented by median, minimum and maximum. Independent variables were dichotomized by their respective medians, using the Mann-Whitney and Kruskal Wallis U test. Genotype distribution was evaluated in additive, dominant and recessive models. Hardy-Weinberg equilibrium was evaluated by the chi-square test. For the correlation between quality of life and intensity of surgical discomfort perceived by the individual was used Spearman's correlation test. Results: The median of surgical discomfort found in this study was 1.40. It was observed that women had higher intensity of discomfort associated with surgical removal of third molars when compared to men (p = 0.001), as well as people with higher body weight (p = 0.004). There was no association between variables inherent to the surgical procedure and discomfort. In the recessive model, the marker rs3800373 was associated with a higher intensity of perception of surgical discomfort (p = 0.026). No association was found between the SLC6A4 and COMT genes with higher intensity of perception of surgical discomfort. There was no correlation between quality of life and intensity of surgical discomfort perceived by the patient. Conclusion: Women, individuals with higher body weight and AA genotype for the rs3800373 marker reported higher intensity of perceived discomfort associated with surgery for surgical removal of third molars. Keywords: 1.Oral, Surgery. 2Molar, Third. 3.Pain. 4.Quality of Life. 5.Polymorhism Genetic

Promoção de Saúde Bucal para Adultos com Deficiência Intelectual: Um Relato de Experiência

O propósito deste trabalho é relatar uma experiência de extensão realizada em uma escola para adultos com deficiência intelectual, na cidade de Curitiba/PR. Entre 2014 e 2017 graduandos do curso de Odontologia da Universidade Federal do Paraná (UFPR), integrantes do grupo PET Odontologia, conduziram um projeto que realizou atividades de promoção e prevenção em saúde bucal, além de contar com ações de identificação e priorização para referência intramuros das necessidades de tratamento odontológico. Esse relato de experiência demonstra que as atividades de extensão atuam como um meio facilitador de acesso à saúde, além de contribuir para uma formação mais abrangente do futuro profissional.