Efeito limiar de renda na periodontite e interações com raça/etnia e educação

Objectives: The aims of this study were to explore the shape of the relationship of income and education with periodontal health, and to assess the interactions between them and race/ethnicity. Method: Individual level data from the Brazilian National Oral Health Survey in 2010 (Pesquisa Nacional de Saúde Bucal—SB Brasil 2010) were obtained for 9,779 subjects. Relations between per capita income and education with periodontal health were smoothed using Locally Weighted Scatter-plot Smoother (Lowess) technique. Multivariable logistic regression was used to assess independent effects of income, education, race/ethnicity adjusted for age, sex and time since last dental appointment. Results: Prevalence of adults with moderate to severe and severe periodontitis was 17.6 and 6.5%, respectively. The relationship between periodontal health and income was curvilinear, showing a threshold of no relationship for income levels higher than US$600/ month. In multivariable analysis, after controlling for covariates, only income was significantly associated with periodontal health. There was no significant interaction of income with race or education, neither between race and education. Conclusion: The relation between periodontal health and income was curvilinear and indicated the presence of a threshold, supporting income transfer programs. Beyond the threshold, only education presented a negative linear relationship with moderate to severe periodontitis.Objetivo: Os objetivos deste estudo foram explorar a relação entre renda e educação com doença periodontal e avaliar a interação entre eles e raça/etnia. Método: Dados individuais do inquérito epidemiológico de saúde bucal da Pesquisa Nacional de Saúde Bucal (SB Brasil 2010) foram obtidos para 9.779 indivíduos. A relação entre renda per capita e educação com saúde periodontal foi suavizada usando técnica de Locally Weighted Scatterplot Smoother (LOWESS). Utilizou-se regressão logística multivariável para avaliar os efeitos independentes de sexo, idade, renda, educação, raça/etnia, posse de bens, última visita ao dentista e número de pessoas por dormitório. Resultados: A prevalência de adultos com doença periodontal moderada e grave foi de 17,6 e 6,5$ 1.050/mensais, a partir do qual não havia relação entre as variáveis. Na análise multivariavel, após ajuste por covariadas, apenas renda estava associada significativamente com saúde periodontal. Não foram encontradas interações significantes entre renda e educação ou raça/etnia, nem entre educação com raça/etnia. Conclusões: A relação entre saúde periodontal e renda foi curvilínea com a presença de efeito de limar, dando suporte para programas de transferência de renda. Além do limiar, apenas educação mostrou associação linear negativa com periodontite moderada a severa

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability

Competence in Streptococcus pneumoniae and Close Commensal Relatives: Mechanisms and Implications

The mitis group of streptococci comprises species that are common colonizers of the naso-oral-pharyngeal tract of humans. Streptococcus pneumoniae and Streptococcus mitis are close relatives and share ~60–80% of orthologous genes, but still present striking differences in pathogenic potential toward the human host. S. mitis has long been recognized as a reservoir of antibiotic resistance genes for S. pneumoniae, as well as a source for capsule polysaccharide variation, leading to resistance and vaccine escape. Both species share the ability to become naturally competent, and in this context, competence-associated killing mechanisms such as fratricide are thought to play an important role in interspecies gene exchange. Here, we explore the general mechanism of natural genetic transformation in the two species and touch upon the fundamental clinical and evolutionary implications of sharing similar competence, fratricide mechanisms, and a large fraction of their genomic DNA

Hidden Gems in the Transcriptome Maps of Competent Streptococci

Natural transformation is regarded as an important mechanism in bacteria that allows for adaptation to different environmental stressors by ensuring genome plasticity. Since the discovery of this phenomenon in Streptococcus pneumoniae, remarkable progress has been made in the understanding of the molecular mechanisms and pathways coordinating this process. Recently, the advent of high-throughput sequencing allows the posing of questions that address the system at a larger scale but also allow for the creation of high-resolution maps of transcription. Thus, while much is already known about genetic competence in streptococci, recent studies continue to reveal intricate novel regulation pathways and components. In this perspective article, we highlight the use of transcriptional profiling and mapping as a valuable resource in the identification and characterization of “hidden gems” pertinent to the natural transformation system. Such strategies have recently been employed in a variety of different species. In S. mutans, for example, genome editing combined with the power of promoter mapping and RNA-Seq allowed for the identification of a link between the ComCDE and the ComRS systems, a ComR positive feedback loop mediated by SigX, and the XrpA peptide, encoded within sigX, which inhibits competence. In S. pneumoniae, a novel member of the competence regulon termed BriC was found to be directly under control of ComE and to promote biofilm formation and nasopharyngeal colonization but not competence. Together these new technologies enable us to discover new links and to revisit old pathways in the compelling study of natural genetic transformation

Postgraduate education and employment patterns of dental graduates: a twelve-year analysis (2007 to 2019)

Avaliar a trajetória de graduados em Odontologia é importante para garantir o alinhamento adequado dos currículos odontológicos às necessidades da sociedade. Este estudo observacional transversal descritivo teve como objetivo caracterizar o perfil sociodemográfico-familiar e a trajetória de educação na pós-graduação e de atuação profissional de cirurgiões-dentistas egressos de universidade pública do Sul do Brasil. Foram convidados a participar do estudo todos os egressos que concluíram a graduação em Odontologia nesta universidade, entre 2007 e 2019. A coleta de dados aconteceupelo autopreenchimento de instrumento semiestruturado online, pré-testado, organizado em três dimensões (perfil sociodemográfico-familiar, educação na pós-graduação e atuação profissional). Aanálise das questões objetivas foi realizada por estatísticas descritivas e as abertas pela análise temática de conteúdo. Participaram do estudo 245 cirurgiões-dentistas (percentual de resposta: 25,7%). A maioria eram mulheres (68,6%), com 26 a 32 anos (73,9%), solteiros (71,4%), sem filhos (92,7%), naturais (51,4%) e residentes (59,2%) na cidade onde cursaram Odontologia e trabalham (67,5). A renda pessoal mensal foi de 5 a 10 saláriosmínimos (36,7%). Atuam na Odontologia (97,1%) e estão satisfeitos com a profissão (79,6%). Realizaram ou estão realizando cursos de pós-graduação (94,3%), concluídos em até três anos após a graduação (58%), principalmente especialização (62,8%), nas áreas de Saúde Coletiva, Ortodontia e Implantodontia. Setor privado mostrou-seo maior empregador dos cirurgiões-dentistas (60,8%), entretanto, a atuação no serviço público cresceu entre os egressos de 2010-2019 (2,4% para 20,7%). Estudos de acompanhamento destes egressos são recomendados para avaliação do curso e das demandas/desafios contextuais que caracterizam a profissão de cirurgião-dentista no Brasil.The assessment of dental graduates’ trajectory over time is important to ensure a proper alignment of dental curricula with the needs of society. This cross-sectional, observational anddescriptivestudy aimed at characterizing the sociodemographic profile, the postgraduateeducation choices,and the employment pattern of dental graduates from a publicuniversity in the South region of Brazil. Dental graduates from 2007 to 2019 were invited to participate via e-mail. The survey was self-administered and hosted online. The content of the surveyencompassed three main spheres of interest-sociodemographic profile, postgraduateeducation choices, and employment pattern. Atotalof245 graduates participated in the study(response rate of 25.7%). The majority were women(68.6%), aged 26 to 32 years old (73.9%), single (71.4%), without children (92.7%), born (51.4%) and residing(59.2%) inPorto Alegre, the city in which the university is located and where they work (67.5%). Monthly income reported was 5 to 10 times the minimum wage (36.7%). Most participantswere activelyworkingin Dentistry (97.1%) and weresatisfied with the dental profession (79.6%). The majority attendedor is currently enrolled in postgraduatecourses (94.3%), completedwithin three years after graduation, mainlyspecialization courses (62.8%), in the areas of Public Health, Orthodontics and Implantology. Most reported to be working in the private sector (60.8%). However, there was an increase in employmentin the public sector among those who graduatedbetween2010and 2019compared to 2007-2008(from 2.4% to 20.7%). Fundamentally, the continuing assessment of dental graduates’ path and perceptions is essential to better adjust and shape dental curricula in the future

Publication rates of editorial board members in oral health journals

The aim of this study was to measure the publication rate of editorial board members in their board journals and to evaluate associated variables. We evaluated the ten highest-ranked journals according to the 5-year impact factor under ‘Dentistry, Oral Surgery & Medicine’ subject category for 2010, 2011, and 2012. All original research papers with at least one member of the editorial board as author were counted. Final analyses assessed associated variables such as size of the editorial board, number of papers published each year, and each journal’s impact factor. Overall, there was an increase in the average number of articles published from 2010 (115.2 ± 52.2) to 2012 (134.7 ± 47.4). The number and percentage of articles published with editorial board members as authors over the three years did not follow the same pattern, with a slight decrease from 2010 to 2011 and an increase in 2012. The number of articles with editorial board members as authors was significantly higher for journals with impact factors ≥4.0. Journals with a higher impact factor and larger editorial board were associated with higher chances of editorial board members publishing in their respective journals. Participation of editorial board members as authors in publishing varies significantly among journals

Attitudes and clinical practices of dentists towards implant treatment

Modalidades terapêuticas para dentes com comprometimento periodontal incluem abordagens conservadoras e cirúrgicas, confecção de próteses dentárias e a extração seguida da colocação de um implante dentário. O objetivo do presente estudo foi avaliar a tomada de decisão de cirurgiões-dentistas brasileiros acerca da indicação da terapia implantar bem como possíveis fatores modificadores. O estudo teve caráter transversal e foi conduzido entre cirurgiões-dentistas brasileiros no período de junho a novembro de 2012. O instrumento conteve 27 questões divididas em quatro diferentes seções abordando características sociodemográficas, questões sobre o exercício profissional, a tomada de decisão frente a casos clínicos e a concordância ou não com diferentes afirmações acerca das terapias endodôntica, periodontal e implantar. Um total de 155 dentistas responderam o questionário. A idade média dos participantes foi 35,5 anos. Cinquenta e um por cento da amostra foi composta por homens e 44,5% relataram ser professores. Cento e trinta e seis (87,7%) participantes afirmaram já ter realizado ou estar realizando algum curso de pós-graduação. Homens relataram realizar mais procedimentos de inserção de implantes e aumento de seio maxilar. Consequentemente, os mesmos indicavam tais tratamentos de forma mais frequente quando comparados a mulheres. Professores de forma geral e dentistas que não haviam realizado nenhum curso de pós-graduação indicaram o uso de terapias regenerativas com maior frequência. De forma contrária, periodontistas e dentistas que não estavam envolvidos com cargos de docência preferiram a indicação de terapia ressectiva para o mesmo caso. Protesistas apresentaram uma preferência por procedimentos mais invasivos. Frente às dificuldades encontradas por cirurgiões-dentistas bem como a falta de uniformidade presente em suas opções terapêuticas, faz-se necessária a criação de protocolos e diretrizes que venham a auxiliar o clínico na tomada de decisão em casos complexos.Periodontally involved teeth require attention and comprehensive treatment for reestablishment of good health conditions. Therapeutic modalities include conservative and surgical periodontal approaches, confection of dental prostheses and extraction followed by dental implant insertion. The aim of the present study was to evaluate Brazilian dentists’ decision making regarding periodontally involved teeth and implant therapy indications as well as possible modifying factors such as gender, enrollment in teaching positions and specialization areas. This cross-sectional questionnaire-based study was conducted among Brazilian dentists between June and November 2012. The questionnaire comprised 27 questions divided into four different sections: socio-demographic characteristics, questions about their clinical practice towards implant therapy, decision making in four clinical cases and agreement with different statements regarding endodontic, periodontal and implant therapies. A total of 155 dentists answered the questionnaire. The average age of the participants was 35.5 years. Fifty one percent were male and 44.5% were involved in teaching positions. One-hundred and thirty six (87.7%) respondents had already pursued a post-graduation programme or were currently involved in one. Men performed more implant placement and sinus grafting procedures than women; consequently they also indicated it more to their patients. Dental faculty and dentists who had not followed any further training programme more often preferred the use of regenerative therapies. As opposed, dentists not involved in teaching positions and periodontists were more prone to select resective therapies. Prosthodontists had a preference for more invasive treatments. Considering the difficulties faced by professionals when handling complex cases, there is an urgent need to establish international protocols and guidelines to help the clinician towards the more appropriate treatment option