Evaluation of caries risk in pre-school children using the CAMBRA protocol and CAST index / Avaliação do risco de cárie em crianças em idade pré-escolar utilizando o protocolo CAMBRA e o índice CAST

Objective: To evaluate the risk of caries and oral health condition in children, using the CAMBRA protocol of the American Academy of Pediatric Dentistry (AAPD) and the Species and Treatment Index for Caries Assessment (CAST) in preschoolers. Method: Method: It is characterized as a cross-sectional retrospective observational analytical study, with clinical examination procedures, questionnaires and oral hygiene analysis in children from 2 to 5 years old. 507 preschoolers aged 2 to 5 years were evaluated in public daycare centers in the city of São Gonçalo - Brazil. Results: The CAMBRA protocol has a moderate risk of 55.4%, while 44.6% has a high risk of caries, from 2 to 5 years. When considering the range of 2 to 3 years apart, 67.1% of children are at high risk. The CAST index showed 10.6% of lesions caused by caries, correlated between caries and the CAST index. Conclusion: It is necessary to implement preventive strategies to reduce caries in this studied group

Influence of the volume of restorative material on the concentration of stresses in the restorative interface

To evaluate the microtensile strength in the adhesive interface depending on the volume of the composite resin used to restore class I cavities. Forty-eight human third molars received a standardized class I cavity preparation and they were separated i

Comparison between dmf/DMF and ICDAS in Brazilian schoolchildren: a cross-sectional study / Comparação entre ceo/CPO e ICDAS em escolares brasileiros: um estudo transversal

The objective was to compare the use of the International Caries Detection and Assessment System (ICDAS-II) and the dmft/DMFT (WHO) indexes in epidemiological surveys in schools. Two calibrated examiners analyzed 402 public school children aged 5-12 years, in the city of Mesquita, Rio de Janeiro, Brazil, using ICDAS-II and WHO criteria. The schools are located in areas covered by the Family Health Strategy. The DMF-DMF-S, dmf-t, dmf-s, the prevalence of decayed teeth, and examination time were calculated using both systems. The research subjects participated in health education and prevention activities and oral hygiene training. Data were statistically analyzed and the mean dmf-t / DMF-T was 2.35 (sd ± 2.15) and 3.18 (sd ± 2.31), respectively, using the WHO criteria. When considering the score of the three-ICDASII the average was 2.64 (sd ± 1.89) and 3.45 (sd ± 2.48). With the score-2 ICDASII, 4386 surfaces with lesions were identified, 2795 (63.7%) were not considered when we used the dmf-t / DMF-T. The average examination time was almost twice as long to ICDAS-II (3.2 ± 1.9 min) and WHO (1.8 ± 0.9 min). Conclusion: The ICDAS-II, and provide information on non-cavitated lesions of caries, shows significant experience of dental caries in schoolchildren from the city, and can generate data comparable with previous research that used the WHO criteria

Use of the web in promoting education in oral health among schoolchildren / Uso da web na promoção de educação em saúde bucal em escolares

This study aimed to evaluate the acceptance and acquisition of knowledge through web learning related to self-care for the maintenance of oral health. The study population was children from the 4th and 5th school year, from 9 to 16 years old. It was evaluated Visible Plaque Index and Gingival Bleeding Index. Participants’ knowledge was tested at baseline and then evaluated after each web distance education moment. This education process had four web distance moments. The evaluation of knowledge was done through a questionnaire containing 10 closed questions. The time interval was 30 days between the 1st and 2nd meetings and 60 days between the subsequent meeting. Concerning the questionnaires, the different moments were compared by chi-square (X2). Only question number six presented a statistical significance at 5%, however, between the first and the second moment 100% of the questions had a significant increase of correct answers (p> 5%). It is concluded that oral health education by web, was able to improve oral hygiene and knowledge related to oral health.

Physical evaluation of the luting systems for veneer ceramic after aging / Avaliação física dos sistemas de cimentação para faceta cerâmica após envelhecimento

The aim of this in vitro study was evaluated the amount of color change and degree of conversion of the luting systems for ceramic veneer cementation. Forty-eight human incisors were randomly divided into six groups (n=8) according to the bonding procedure: RelyX Veneer/Single Bond 2; RelyX ARC/Single Bond 2; Filtek Z350 XT Flowable /Single Bond 2; Variolink Veneer/Tetric N-Bond; Variolink II/Tetric N-Bond; Tetric N-Flow/Tetric N-Bond. Ceramic veneers (IPS Empress Esthetic) were cemented using the different bonding procedures. Color differences of the ceramic surface after cementation and 300 h(150kJ/m2) of UV aging test, were examined with a colorimeter. Fourier transform infrared spectroscopy (FT-IR) was used to evaluate the degree of conversion for each luting system. Data were analyzed with one-way ANOVA and Tukey's test (α=0.05). All the luting systems demonstrated significant changes in color stability. The ΔE of the systems ranged from 6,11 to 9,33. Tetric N-Flow and RelyX Veneer showed the highest degree of conversion, while lowest values were found for RelyX ARC. All luting systems demonstrated clinically unacceptable (ΔE≥ 3.3) color changes. Despite to the dual cure of the RelyX ARC luting cement, it showed the lowest degree of conversion values, while Tetric N-Flow and RelyX Veneer presented the highest and similar degree of conversion

Avaliação dos fatores determinantes à perda dentária em usuários de um posto de saúde em Teresina, Piauí / Evaluation of the determinants of tooth loss in users of a health center in Teresina, Piauí

Introdução: A perda dentária é considerada um problema de saúde pública que gera impactos negativos na qualidade de vida do indivíduo. Objetivo: Avaliar os fatores determinantes da perda dentária em usuários de um posto de saúde em Teresina - Piauí. Método: Foram entrevistados 384 usuários, de ambos os gêneros, com faixa etária de 15 a 60 anos de idade, através de um questionário. A amostra foi constituída por pessoas que haviam perdido pelo menos um elemento dentário. Resultados: Segundo o grau de escolaridade, predominaram os usuários com nível fundamental incompleto (47,92%), a faixa salarial mais prevalente foi entre 1 e 3 salários mínimos (68,23%) e aqueles que ganham menos de 1 salário mínimo (21,61%). Perguntou-se sobre a função dos dentes, a maioria (88,81%) respondeu triturar, mastigar, comer e morder alimentos. Em relação à forma de higienização bucal, 99,48% responderam que utilizavam escova e dentifrício, 45,31% responderam que utilizavam o fio dental, 69,53 % relataram uso de soluções para enxágue bucal e 60,16% responderam que utilizam o palito. Conclusão: Predomínio de usuários com nível fundamental incompleto e renda familiar de 1 a 3 salários mínimos. Percebe-se a necessidade de incentivo para propostas de promoção e autocuidado em saúde bucal

Avaliação da condição de saúde oral de pacientes com transtornos psiquiátricos / Patients of oral health condition evaluation with phychiatric disorders

Introdução: A perda dentária é um dos problemas de saúde bucal mais prevalentes população mundial, que acomete principalmente adultos e idosos. Objetivo: Determinar o estado de saúde oral e investigar a associação da condição de saúde bucal com variáveis sóciodemográficas de indivíduos com transtornos psiquiátricos. Método: Os pacientes eram assistidos em Centros de Atenção Psicossocial (GE) e assinaram um termo de Consentimento Livre e Esclarecido. A amostra do estudo foi de 78 pacientes psiquiátricos de idades entre 20 e 50 anos. Experiência com cárie, condições de higiene oral e periodontal foram avaliadas pelos índices CPOD, IPV (Índice de placa visível), ISG (sangramento gengival), respectivamente. Aplicou-se os testes qui-quadrado de Pearson, teste de Mann-Whitney e regressão logística na análise estatística. Como grupo controle (GC), foram recrutados pacientes que procuravam tratamento odontológico numa Unidade Básica de Saúde de Teresina-PI, os quais foram pareados segundo gênero e renda. Resultados: GC apresentou menos dentes hígidos (p=0,002). A diferença entre os grupos com relação ao CPOD foi significativa (p=0,004), especialmente no componente perdidos (p=0,004). A condição periodontal não foi significativa entre os grupos. Conclusão: Os pacientes psiquiátricos avaliados tem uma condição de saúde oral mais comprometida (número maior de dentes perdidos)

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie