Protocolo de pesquisa: avaliação do Tratamento Restaurador Atraumático em pacientes adultos

O objetivo primeiro do Tratamento Restaurador Atraumático (TRA) é reduzir a indicação de extrações dentárias através de uma técnica operatória de baixo custo. Considerando as dificuldades do Serviço de Saúde Pública do Brasil de suprir a demanda de serviço requerida pela população adulta de baixa renda, que usualmente recebe atendimento emergencial, o objetivo deste estudo é avaliar a performance clínica de um cimento de ionômero de vidro de alta viscosidade empregado através da técnica atraumática modificada em cavidades de uma e de múltiplas superfícies, comparativamente à abordagem restauradora convencional. Serão analisados a performance clínica dos materiais; o custo (material e recursos humanos); a satisfação do paciente com o tratamento recebido; e o impacto preventivo do tratamento.The primary objective of the Atraumatic RestorativeTreatment (ART) is to reduce the indication of tooth extraction by means of a low-cost technique. Considering the difficulties of Brazilian public services to meet the demand of care of the low-income population, with lack of care to the adult population, which usually receives only emergency care, the aim of this study is to assess the performance of high-viscosity glass ionomer cements accomplished by the modified atraumatic restorative treatment in one- and multiple-surface cavities, compared to the conventional restorative approach. It will be analyzed the clinical performance of the materials; cost (material and human resources); patient satisfaction with the treatment received; and preventive effect of treatment

Prenatal dental care: evaluation of professional knowledge of obstetricians and dentists in the cities of Londrina/PR and Bauru/SP, Brazil, 2004

The purpose of this study was to assess the current knowledge and recommendations of obstetricians and dentists as to the dental care to pregnant patients in the cities of Londrina/PR and Bauru/SP, Brazil. Questionnaires were distributed to professionals of both cities, arguing on the following issues: oral health during pregnancy; contact between prenatal care and dental care providers; prenatal fluoride supplementation; selection of therapeutic agents for local anesthesia, pain control and treatment of infection; and dental procedures that can be performed during each trimester. Data were analyzed by frequency of responses and statistical analyses were carried out using X² (type of workplace/service) and t test (time since graduation), significant if

Effect of caries-preventive measures directed to expectant mothers on caries experience in their children

O objetivo deste estudo longitudinal foi avaliar a efetividade de um programa de saúde bucal, iniciado durante a gestação, sobre a experiência de cárie de primigestas e seus filhos. Oitenta e uma gestantes, pertencentes a classes sociais pouco favorecidas, foram selecionadas com base no diagnóstico clínico de lesões de cárie ativas em superfícies dentárias livres e proximais (SC inicial 13,98). A condição dentária inicial foi estabelecida através do índice CPOS e do diagnóstico das lesões de mancha branca. A condição periodontal foi avaliada a partir do índice ICNTP. O fluxo salivar e a capacidade tampão da saliva também foram analisados. Sessenta e quatro pares mãe-filho finalizaram o estudo, estando 34 no grupo experimental e 30 no grupo controle. Setenta e cinco por cento das mães tinham entre 14 e 20 anos no início do estudo e foram classificadas como adolescentes. Ambos os grupos receberam uma abordagem educativa (informação sobre a etiologia, transmissão e prevenção da doença cárie, instruções de higiene oral e aconselhamento sobre dieta). O grupo experimental recebeu adicionalmente tratamento com antimicrobianos (profilaxia profissional e aplicações tópicas de flúor gel e solução a base de iodo) e adequação bucal utilizando cimento de ionômero de vidro. A prevalência de crianças cárie-ativas com a idade de dois anos foi de 33,3% no grupo controle e 14,7% no grupo experimental. Foi observada diferença significativa na prevalência de cárie entre crianças com e sem placa dentária visível (p = 0,032). O número médio de superfícies com lesões de cárie (incluindo as desmineralizações) foi maior para as crianças do grupo controle quando comparadas às do grupo teste (6,3 x 3,2), porém sem atingir significância estatística. Cinco crianças no grupo controle exibiram seis ou mais superfícies dentárias cariadas. Esta situação não foi observada em criança alguma do grupo experimental. O incremento de cárie na dentição da mãe foi computado ao longo do estudo e apresentou correlação significativa com a incidência de cárie na dentição das crianças (p = 0,0009). Estes dados suportam a evidência de associação entre a incidência de cárie na primeira infância e a presença de placa, assim como a influência significativa de fatores maternos.The aim of this long-term study was to determine the effecti veness of a cariespreventive program starting during pregnancy on the caries experience of first time mothers and their infants. Eighty-one pregnant women from low social background were selected on the basis of presence of active carious lesions (initial DS 13.98). Initial dental status (DMFS and white spot lesions) and periodontal score (CPITN) were established by clinical examination. Salivary flow rate and buffer capacity were also analyzed. Sixty-four mother-child couples ended the study; thirty-four were in the test group and thirty in the control group. Seventy five per cent of the mothers aged among 14 and 20 years at baseline, and were classified as adolescents. The prophylactic measures, aiming a reduction in caries-risk, were repeated at intervals of 6 months: during pregnancy and 6 and 12 months after delivery. Both groups received educational approach (information about caries etiologic factors, its transmission and prevention, oral hygiene instructions and dietary counseling). Test group also received antimicrobial treatment (professional tooth cleaning and fluoride and iodine topical applications), and restorative care using a glass-ionomer cement. At the children age of 2 years, 33.3 per cent of the infants in the control group were caries-active, compared with 14.7 per cent in the test group. A significant difference in caries prevalence was observed between children with and without visible dental plaque (p = 0.032). The mean ds (including initial caries) was higher in children of control group than in test group (6.3 x 3.2), although not statistically significant. Five children in control group exhibited six or more decayed surfaces compared with no children in this situation on test group. Mothers caries increment among baseline and last recall was assessed and was a significant factor in the caries experience of the children (p = 0.0009). These data support the evidence of an association between caries prevalence in young children and clinical (dental plaque) and maternal factors

Effect of caries-preventive measures directed to expectant mothers on caries experience in their children

O objetivo deste estudo longitudinal foi avaliar a efetividade de um programa de saúde bucal, iniciado durante a gestação, sobre a experiência de cárie de primigestas e seus filhos. Oitenta e uma gestantes, pertencentes a classes sociais pouco favorecidas, foram selecionadas com base no diagnóstico clínico de lesões de cárie ativas em superfícies dentárias livres e proximais (SC inicial 13,98). A condição dentária inicial foi estabelecida através do índice CPOS e do diagnóstico das lesões de mancha branca. A condição periodontal foi avaliada a partir do índice ICNTP. O fluxo salivar e a capacidade tampão da saliva também foram analisados. Sessenta e quatro pares mãe-filho finalizaram o estudo, estando 34 no grupo experimental e 30 no grupo controle. Setenta e cinco por cento das mães tinham entre 14 e 20 anos no início do estudo e foram classificadas como adolescentes. Ambos os grupos receberam uma abordagem educativa (informação sobre a etiologia, transmissão e prevenção da doença cárie, instruções de higiene oral e aconselhamento sobre dieta). O grupo experimental recebeu adicionalmente tratamento com antimicrobianos (profilaxia profissional e aplicações tópicas de flúor gel e solução a base de iodo) e adequação bucal utilizando cimento de ionômero de vidro. A prevalência de crianças cárie-ativas com a idade de dois anos foi de 33,3% no grupo controle e 14,7% no grupo experimental. Foi observada diferença significativa na prevalência de cárie entre crianças com e sem placa dentária visível (p = 0,032). O número médio de superfícies com lesões de cárie (incluindo as desmineralizações) foi maior para as crianças do grupo controle quando comparadas às do grupo teste (6,3 x 3,2), porém sem atingir significância estatística. Cinco crianças no grupo controle exibiram seis ou mais superfícies dentárias cariadas. Esta situação não foi observada em criança alguma do grupo experimental. O incremento de cárie na dentição da mãe foi computado ao longo do estudo e apresentou correlação significativa com a incidência de cárie na dentição das crianças (p = 0,0009). Estes dados suportam a evidência de associação entre a incidência de cárie na primeira infância e a presença de placa, assim como a influência significativa de fatores maternos.The aim of this long-term study was to determine the effecti veness of a cariespreventive program starting during pregnancy on the caries experience of first time mothers and their infants. Eighty-one pregnant women from low social background were selected on the basis of presence of active carious lesions (initial DS 13.98). Initial dental status (DMFS and white spot lesions) and periodontal score (CPITN) were established by clinical examination. Salivary flow rate and buffer capacity were also analyzed. Sixty-four mother-child couples ended the study; thirty-four were in the test group and thirty in the control group. Seventy five per cent of the mothers aged among 14 and 20 years at baseline, and were classified as adolescents. The prophylactic measures, aiming a reduction in caries-risk, were repeated at intervals of 6 months: during pregnancy and 6 and 12 months after delivery. Both groups received educational approach (information about caries etiologic factors, its transmission and prevention, oral hygiene instructions and dietary counseling). Test group also received antimicrobial treatment (professional tooth cleaning and fluoride and iodine topical applications), and restorative care using a glass-ionomer cement. At the children age of 2 years, 33.3 per cent of the infants in the control group were caries-active, compared with 14.7 per cent in the test group. A significant difference in caries prevalence was observed between children with and without visible dental plaque (p = 0.032). The mean ds (including initial caries) was higher in children of control group than in test group (6.3 x 3.2), although not statistically significant. Five children in control group exhibited six or more decayed surfaces compared with no children in this situation on test group. Mothers caries increment among baseline and last recall was assessed and was a significant factor in the caries experience of the children (p = 0.0009). These data support the evidence of an association between caries prevalence in young children and clinical (dental plaque) and maternal factors

Research proposal: evaluation of ART in adult patients Protocolo de pesquisa: avaliação do Tratamento Restaurador Atraumático em pacientes adultos

The primary objective of the Atraumatic RestorativeTreatment (ART) is to reduce the indication of tooth extraction by means of a low-cost technique. Considering the difficulties of Brazilian public services to meet the demand of care of the low-income population, with lack of care to the adult population, which usually receives only emergency care, the aim of this study is to assess the performance of high-viscosity glass ionomer cements accomplished by the modified atraumatic restorative treatment in one- and multiple-surface cavities, compared to the conventional restorative approach. It will be analyzed the clinical performance of the materials; cost (material and human resources); patient satisfaction with the treatment received; and preventive effect of treatment.O objetivo primeiro do Tratamento Restaurador Atraumático (TRA) é reduzir a indicação de extrações dentárias através de uma técnica operatória de baixo custo. Considerando as dificuldades do Serviço de Saúde Pública do Brasil de suprir a demanda de serviço requerida pela população adulta de baixa renda, que usualmente recebe atendimento emergencial, o objetivo deste estudo é avaliar a performance clínica de um cimento de ionômero de vidro de alta viscosidade empregado através da técnica atraumática modificada em cavidades de uma e de múltiplas superfícies, comparativamente à abordagem restauradora convencional. Serão analisados a performance clínica dos materiais; o custo (material e recursos humanos); a satisfação do paciente com o tratamento recebido; e o impacto preventivo do tratamento

Prenatal dental care: evaluation of professional knowledge of obstetricians and dentists in the cities of Londrina/PR and Bauru/SP, Brazil, 2004

The purpose of this study was to assess the current knowledge and recommendations of obstetricians and dentists as to the dental care to pregnant patients in the cities of Londrina/PR and Bauru/SP, Brazil. Questionnaires were distributed to professionals of both cities, arguing on the following issues: oral health during pregnancy; contact between prenatal care and dental care providers; prenatal fluoride supplementation; selection of therapeutic agents for local anesthesia, pain control and treatment of infection; and dental procedures that can be performed during each trimester. Data were analyzed by frequency of responses and statistical analyses were carried out using X² (type of workplace/service) and t test (time since graduation), significant if p<0.05. Seventy-nine obstetricians and 37 dentists responded the questionnaires. Most physicians referred the patient to dental care only when a source of dental problem was mentioned, limiting the adoption of a preventive approach. Forty-three percent of dentists and 34% of obstetricians did not know the potential contribution of periodontal infection as a risk factor for preterm low birth-weight babies. There was divergence from scientific literature as to the recommendation of local anesthetics (dentists and obstetricians), prenatal fluoride supplementation (obstetricians) and dental radiographs (dentists). The findings of this survey with dentists and obstetricians showed that dental management during pregnancy still presents some deviations from scientific literature recommendations, indicating the need to update these health care professionals in order to establish guidelines for prenatal dental care