Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Brazilian Schoolchildren Aged 8 to 10 Years

ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers.

Prevalence of Dental Fear and its Association with Painful Oral Conditions in Adolescents

ABSTRACT Objective: To estimate the prevalence of dental fear and evaluate its association with dental caries and with Molar Incisor Hypomineralization (MIH) in schoolchildren aged 11-14 years. Material and Methods: A cross-sectional study was conducted with 375 adolescents in Campina Grande, Brazil. Socioeconomic and oral health information was collected, while dental fear was measured using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The diagnosis of dental caries and MIH was performed by three trained examiners (κ ≥ 0.61) using the International Caries Detection & Assessment System - ICDAS II and a previously validated index, respectively. Data were descriptively analyzed using the Chi-Square, Fisher's Exact, and Poisson regression tests with robust variance (p<0.05). Results: The prevalence of dental fear was 18.4%, and the mean CFSS-DS total score was 28.96 ± 8.92. After adjusting for covariates family structure, schooling of parents/guardians, type of dental health service and dental pain in the last six months, the prevalence of dental fear was associated with dental pain in the last six months (PR=2.03; 95%CI=1.31-3.16; p=0.002). Conclusion: Although no association was found between dental fear, dental caries and MIH in adolescents, those who experienced dental pain in the last six months had a higher prevalence of dental fear.

Difficulties of dental practice among left-handed Tunisian students: a cross-sectional survey

Abstract In dentistry, most equipment is designed for right-handed (RH) individuals. Thus, left-handed (LH) individuals are often forced to adapt to demanding RH working conditions, and therefore, experience difficulties in their practice. The objective of this study was to determine the prevalence of left handedness among dental students at the Dental Clinic of Monastir, Tunisia, and to investigate the difficulties for LH individuals during clinical practice. A cross-sectional study was conducted among dental students during the academic year from September 2019 to March 2020. An adaptation of the Grad-Corllet Diagram and a specific questionnaire on clinical practices were administered to 221 participants. Data were analyzed using SPSS 24.0 statistical software for descriptive statistics and the chi-square test was performed (with a 5% significance level). The study revealed that 18.1% of dental students were LH. Among which, 82.5% of LH students had difficulties using instruments designed for RH dentists, 47.5% of LH students preferred the 3 o'clock working position, and 77.5% of LH students preferred to work in a sitting position. Most LH students (70%) reported that endodontic treatment was the most difficult procedure to perform. All students, whether RH or LH, presented a higher percentage of pain in the lumbar and neck/cervical regions; however, LH students presented higher values (77.5%) with statistically significant differences being reported for lower back pain (p = 0.026) and neck pain (p = 0.012). This study highlights the difficulties that LH dental students face in performing dental work. Dental Schools should provide LH students with appropriate equipment and a proper learning environment.

Profile of Hospitalizations of Children and Adolescents Victims of Transport Accidents: A Retrospective Study

Abstract Objective: To present the profile of hospitalizations due to transport accidents in individuals aged 0-19 years in a reference hospital for urgent and emergency traumatology care. Material and Methods: This retrospective study is grounded on analyzing medical records of children and adolescents hospitalized due to transport accidents in 2016 and 2017. The bivariate analyses included Chi-square and Fischer's exact tests and binary logistic regression, with a 5% significance level. Results: Four hundred and seventy-five (43.7%) of the 1,088 medical records investigated corresponded to transport accidents, and accidents involving motorcycles were the most frequent (68.3%), affecting adolescents (81.3%), while children were more involved in accidents as pedestrians (57.1%). Advancing age increases the likelihood of the outcome, with a significant association in the multivariate analysis (p<0.001). The mandible was most frequently affected in maxillofacial fractures. Conclusion: Transport accidents predominantly affect male adolescents, involving motorcycles, and the lower limbs are the most affected. The mandible was the most affected bone in maxillofacial fractures.

Systemic Manifestations, Tooth Eruption and Enamel Defects in Children with Congenital Zika Virus Syndrome: 36-Month Follow-up Case Series

Abstract Objective: To describe systemic manifestations, the characteristics related to tooth eruption, and the occurrence of enamel defects in children with Congenital Zika Virus Syndrome (CZS). Material and Methods: Prospective case series based on nine children with confirmed CZS diagnosis assisted at a reference center in a municipality in the Northeast Region of Brazil. Through a structured interview directed to mothers, information related to prenatal, delivery, and postpartum periods was collected. Tooth eruption was monitored through clinical examinations for 36 months. The modified developmental defect of enamel index (DDE) was used to identify opacities and hypoplasia. Data were presented using descriptive statistics. Results: A high proportion (77.8%) had microcephaly, and 55.5% had low birth weight. Musculoskeletal disorders, swallowing difficulty, and self-injury practices were present in all children. Among the systemic findings, visual impairment (77.8%) and seizures (77.8%) were widely reported. Concerning disorders related to the stomatognathic system, bruxism (66.7%) and difficulty in sucking (33.3%) were present. For most children (77.8%), the deciduous right lower central incisor was the first tooth to erupt (minimum 8 months and maximum 17 months). Enamel defects were diagnosed in only two children (22.2%). Conclusion: A wide range of systemic manifestations was observed in children with CZS, including visual impairment and musculoskeletal disorders. Delayed eruption of the first deciduous tooth was also observed. Enamel defects were present in a small proportion of children.

Knowledge, attitudes, and perceptions regarding child abuse and neglect among dentists in Turkey

Abstract Limited research attention has been paid to Turkish dentists' perceptions of child abuse and neglect (CA/N). This study aimed to examine Turkish dentists' knowledge about, attitudes toward, and perceptions of CA/N. A total of 229 Turkish dentists responded to the self-administered, valid and reliable questionnaire. It consisted of 34 questions that could be classified into the following conceptual categories: a) sociodemographic data, b) knowledge about legal procedures and the orofacial characteristics and findings that are indicative of CA/N, and c) self-efficacy and attitudes toward CA/N. Multivariate analysis of variance was conducted and partial eta squared coefficients were used statistically. Knowledge about legal obligations was associated with occupational experience, highest CA/N education, frequency of child dental treatment. Prior experience with case of suspected CA/N demonstrated the greatest effects. Knowledge about the orofacial characteristics and findings that are indicative of CA/N was associated with prior experience with at least one case of suspected CA/N. The most frequently provided reasons for failure to report cases of suspected CA/N were fear that the child would be harmed. Turkish dentists demonstrated moderate levels of knowledge about their legal obligations and the orofacial characteristics and findings that are indicative of CA/N. Dentists should receive detailed education on CA/N in their undergraduate and postgraduate education. In addition, it is necessary to increase awareness and knowledge about CA/N by providing in-service trainings at the institutions where they work.

Estão os estudantes de odontologia com medo do Coronavírus? Um estudo piloto utilizando a escala de medo da COVID-19 / Are dental students afraid of the Coronavirus? A pilot study using the fear of COVID-19 Scale

Introdução: a pandemia da COVID-19 acarretou mudanças em todos os segmentos da sociedade, inclusive com impacto na educação odontológica. Objetivo: avaliar o medo frente à COVID-19 em estudantes de Odontologia. Metodologia: estudo transversal composto por 40 estudantes de Odontologia de uma universidade privada. Foram coletados dados referentes a questões sociodemográficas e aplicada a Escala de Medo da COVID-19 (EMC-19). Os dados foram tabulados utilizando-se o software IBM SPSS e analisados descritivamente (frequências absoluta e percentual, medidas de tendência central e de variabilidade). Resultados: a maioria dos estudantes era do sexo feminino (60,0%), tinha entre 16 e 20 anos (50,0%) e 45,0% possuía renda familiar mensal de mais de um e menos de três salários mínimos. A média do escore total na EMC-19 foi de 18,45 (DP = 6,08), com escore mínimo de 7 e máximo de 30. A maior parte dos estudantes apresentou "pouco medo" da COVID-19 (55,0%). Os itens "Eu tenho muito medo da COVID-19", "Eu tenho medo de morrer por causa da COVID-19", e "Eu fico nervoso ou ansioso quando vejo notícias nos jornais e nas redes sociais sobre a COVID-19" obtiveram os maiores valores médios. Conclusão: a maioria dos estudantes apresentou pouco medo da COVID-19, apesar dos itens "Eu tenho muito medo da COVID-19", "Eu tenho medo de morrer por causa da COVID-19" e "Eu fico nervoso ou ansioso quando vejo notícias nos jornais e nas redes sociais sobre a COVID-19" terem obtido os maiores valores médios.

Introduction: the COVID-19 pandemic brought changes in all segments of society, including with impact on dental education. Objective: to evaluate the fear of COVID-19 in dental students. Methodology: cross-sectional study composed of 40 dental students from a private university. Data were collected regarding sociodemographic issues and the Fear of COVID-19 Scale (FCV-19S) was applied. The data were tabulated using the IBM SPSS software and analyzed descriptively (absolute and percentage frequencies, measures of central tendency and variability). Results: most students were female (60.0%), between 16 and 20 years old (50.0%) and 45.0% had a monthly family income of more than one and less than three minimum wages. The average of the total score on the FCV-19S was 18.45 (SD = 6.08), with a minimum score of 7 and a maximum of 30. Most students showed "little fear" of COVID-19 (55.0 %). The items "I am very afraid of COVID-19", "I am afraid of dying because of COVID-19", and "I get nervous or anxious when I see news in the newspapers and on social media about COVID-19" obtained the highest average values. Conclusion: most students showed little fear of COVID-19, despite the items "I am very afraid of COVID-19", "I am afraid of dying because of COVID-19" and "I get nervous or anxious when I see news in newspapers and social media about COVID-19" having obtained the highest average values.

Presence of molar-incisor hypomineralization is associated with dental caries in Brazilian schoolchildren

Abstract This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

Considerations on endodontic care in times of SARS CoV-2 pandemic / Considerações sobre o atendimento endodôntico em tempos de pandemia SARS CoV-2

ABSTRACT The severe acute respiratory syndrome of the new coronavirus, SARS CoV-2, which became a pandemic, was first reported in Wuhan, Hubei, China, in December 2019. It can cause mild symptoms, but in some cases, it can cause serious complications, leading to death. The disease spreads through aerosol droplets and has an estimated incubation period between 2 and 14 days (a period in which the patient has high potential to infect other people). Endodontists have a high risk of exposure to COVID-19 when compared to other health professionals, since most of the work involves the generation of aerosols and care for patients in emergency situations, such as symptomatic irreversible pulpitis, symptomatic apical periodontitis, acute apical abscess and traumatic dental injuries, is imperative. Thus, this critical review addresses considerations about endodontic care in times of pandemic, whose emergencies imply a real need for treatment, as well as the care that must be adopted to minimize risks for both professionals and patients who seek the resolution of their clinical pain conditions.

RESUMO A síndrome respiratória aguda grave do novo coronavírus, SARS CoV-2, que se tornou uma pandemia, foi relatada pela primeira vez em Wuhan, Hubei, China em dezembro 2019. Pode acarretar sintomas leves, porém em alguns casos pode provocar graves complicações levando o indivíduo ao óbito. A doença se espalha através de gotículas de aerossol e tem um período de incubação do coronavírus estimado entre 2 e 14 dias (período este no qual o paciente tem alto potencial de infectar outras pessoas). Os endodontistas apresentam alto risco de exposição ao COVID-19 quando comparado a outros profissionais de saúde, pois a maior parte do trabalho envolve a geração de aerossóis e os atendimentos a pacientes em situações emergentes, como pulpite irreversível sintomática, periodontite apical sintomática, abscesso apical agudo e lesões dentárias traumáticas são imperativos. Dessa forma, essa revisão crítica aborda considerações sobre o atendimento endodôntico, nesta época de pandemia, cujas emergências imprimem necessidade real de tratamento, bem como os cuidados que devem ser adotados visando minimizar riscos tanto para o profissional quanto para os pacientes que buscam a resolução dos seus quadros clínicos de dor.

Contexto socioespacial de vítimas de homicídio doloso em uma capital do nordeste brasileiro / The socio-spatial context of intentional homicide victims in a capital of Brazilian Northeast

Resumo Introdução O homicídio, para além de um problema de saúde pública, é também revelador de um complexo contexto de desigualdade social, que impera nas capitais e grandes cidades do Brasil. Objetivo Analisar o contexto socioespacial de vítimas de homicídio doloso em uma capital do nordeste brasileiro. Método Estudo ecológico, de base documental, com abordagem quantitativa, realizado em João Pessoa, no estado da Paraíba, no Brasil, em 2015. Consideraram-se 369 vítimas de homicídio doloso. Os dados foram analisados à luz da estatística descritiva e da geografia espacial. Resultados As vítimas de homicídio doloso eram predominantemente homens, adultos jovens, não brancos, solteiros e com menos de sete anos de estudo. Ademais, verificou-se sobreposição, em grande medida, das áreas em que residiam aqueles indivíduos com as áreas de piores condições socioeconômicas. Conclusão O homicídio repercute substancialmente no quadro epidemiológico, porquanto, para além de sua característica letal, as questões que o circunscrevem, em que figura, de forma importante, são questões sociais complexas, amplas e de difícil modificação no curto prazo.

Abstract Background The homicide, besides being a public health problem, also reveals a complex context of social inequality that prevails in capitals and larges cities of Brazil. Objective The objective of this study was to analyze the socio-spatial context of intentional homicide victims in a capital of Brazilian Northeast. Method An ecological and documentary based study with a quantitative approach was carried out in João Pessoa, state of Paraíba, Brazil, in 2015, which considered 369 victims of homicide. Data analysis was carried out in light of descriptive statistics and spatial analysis. Results Victims of malice murder were predominantly male, young adults, non-white, singles, and less than seven years of studies. In addition, there was overlap, to a large extent of the areas where the victims of malice murder resided, with the map of the areas with the worst socioeconomic conditions. Conclusion Homicide has a substantial repercussion on the epidemiological context, in addition to its lethal characteristic. The issues surrounding them, in which important complex social issues appear, are broad and difficult to change in the short term.

Uso dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos / Use of the health services according to social determinants, health behaviors and quality of life among diabetics

Resumo Este estudo investigou a utilização dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos. A amostra foi composta por 416 diabéticos cadastrados na Estratégia Saúde da Família de um município do Nordeste do Brasil. A análise dos dados incluiu estatísticas descritivas, bivariadas e multivariada por meio da modelagem de Árvore de Decisão usando o algoritmo Chi-squared Automatic Interaction Detector (CHAID). Evidenciou-se expressiva utilização dos serviços públicos de saúde (80,7%). A utilização do serviço público de saúde com regularidade envolveu indivíduos com escolaridade baixa ou média (p < 0,001), empregados ou aposentados e/ou pensionistas (p = 0,019), com alto impacto do diabetes na qualidade de vida (p = 0,032), e que realizavam a quantidade recomendada de exames de glicemia em jejum ao ano (p < 0,001). A utilização dos serviços de saúde pôde ser explicada por diferenças relacionadas aos determinantes sociais, aos comportamentos em saúde e ao impacto do diabetes na qualidade de vida dos usuários.

Abstract The aim of this study was to investigate the use of health services according to social determinants, health behaviors and quality of life among diabetics (n = 416) attended by the Family Health Strategy in a northeastern city in Brazil. Data analysis included descriptive, bivariate and multivariate statistics. Decision Tree modeling was applied using the Chi-squared Automatic Interaction Detector (CHAID) algorithm. Results showed that public health services were used by 80.7% of the sample. The regular use of public health services involved individuals with low or medium schooling (p < 0.001), employed or retired and/or pensioners (p = 0.019), with a high impact of diabetes on quality of life (p = 0.032), and who performed the number of fasting blood glucose tests per year recommended by the Ministry of Health (p < 0.001). The use of health services could be explained by differences related to social determinants, health behaviors and the impact of diabetes on quality of life.

Maxillofacial Injuries in Brazilian Children and Adolescents Victims of Physical Violence: A Single Forensic Center Analysis

Abstract Objective: To identify the prevalence of maxillofacial injuries resulting from interpersonal violence in Brazilian children and adolescents. Material and Methods: This is a retrospective study conducted at a Center of Forensic Medicine and Forensic Dentistry with a sample of 335 medical reports of victims aged up to 19 years. Variables involved sex and age group, perpetrator, occurrence of the event, characterization of injuries, presence of maxillofacial injuries, type of tissue involvement, and injuries in the oral cavity. Data were analyzed using descriptive, and the Chi-square was used for categorical data. Results: Most victims were female (60.3%) and aged 15-19 years (57.6%). Aggressions occurred at home (50.6%), in the evening (39.5%) and involved perpetrators known to the victim (91.5%). Most victims had multiple injuries (75.8%), involving up to three regions of the body (93.4%). Injuries with blunt objects were the most frequent (86.2%). The prevalence of maxillofacial injuries was 36.7%, with low involvement of the oral cavity (8.4%). A significant association between the presence of injuries on the face and variables "perpetrator" (p=0.015) and "number of injuries" (p=0.006) was observed. Conclusion: Female adolescents were the main victims of physical violence, with repercussions in different regions of the body. The prevalence of maxillofacial injuries was high, although with little involvement of oral cavity structures.

Access to Oral Health Actions According to Social and Individual Determinants

Abstract Objective: To investigate the socioeconomic, demographic and health needs that influence the access to oral health actions. Material and Methods: The sample consisted of 609 individuals who lived in areas covered by the Family Health Strategy in a city of the Northeast of Brazil. All individuals living in areas covered by the FHS with age equal to or higher than six years were included. Data analysis included descriptive, bivariate and multivariate statistics using decision-tree based Chi-squared automatic interaction detection (CHAID). Results: Most participants were female, aged 25-34 years, ranging in age from 6 to 87 years. It was evidenced that, among the studied variables, the most relevant for understanding the access to oral health actions were: age (p<0.001), educational level (p-value in Node 1 = 0.009; p-value in Node 7 = 0.005) and self-perception of oral health (p=0.001). Conclusion: The results suggest that access to oral health actions is influenced by several social and individual factors, and it is marked by inequalities that favor individuals with higher educational level, better self-perception of oral health and lower age groups.

Use of Medicines by Infants with Microcephaly Caused by Congenital Zika Virus Infection and Implications to Oral Health

Abstract Objective: To analyze the use of continued-use medications by Brazilian children with microcephaly caused by Congenital Zika Virus Infection. Material and Methods: Cross-sectional study with 76 children of both genders. Information on age, use of continued-use medications, number and type of drugs used was collected. Data were analyzed using descriptive statistics. Results: Continued-use medications were used by 89.4% of the children, anticonvulsants / antiepileptics (88.1%), and those indicated for behavioral disorders (27.1%) were the most frequent. Sodium saccharin, sucrose, and sorbitol are the most common sugars in the composition of these drugs. Conclusion: The use of medicines is high, predominantly anticonvulsants and antiepileptics, which contain sugars in their composition. These drugs can lead to irreversible dental problems, such as tooth decay if proper oral hygiene is not present. Therefore, parents/guardians should be advised about adopting healthy oral hygiene habits after the administration of these drugs.

Caracterização de homicídios e aspectos associados ao uso de drogas ilícitas em uma capital no nordeste brasileiro / Characterization of homicide and associated factors with use of drugs in a state capital city in northeast brazil

INTRODUÇÃO: O homicídio é um problema de Saúde Pública no Brasil não raro relacionado com drogas ilícitas. OBJETIVO: Caracterizar os homicídios e os aspectos associados ao uso de drogas ilícitas. MÉTODOS: Estudo transversal, com abordagem quantitativa, realizado em João Pessoa, no estado da Paraíba, no Brasil, em 2014. Consideraram-se 424 vítimas de homicídios cujos dados foram coletados através de um instrumento próprio, analisados com auxílio de software estatístico, com Teste de Qui-Quadrado e Regressão Robusta de Poisson, considerando um nível confiança de 95% e significância estatística quando p<0,05. RESULTADOS: Predominância de vítimas de homicídios homens (93,2%), não brancos (97,2%), com até 30 anos, considerando as faixas etárias de menor de 20 anos (22,6%), de 20 a 24 (26,7%) e 25 a 29 (18,8%), com menos de sete anos de estudo (67,5%), com histórico de envolvimento com drogas ilícitas (72,5%) e de encarceramento (59,7%). Observaram-se associações entre envolvimento com drogas ilícitas e as variáveis: sexo (p=0,037), idade (p=0,002) e histórico de encarceramento (p<0,001). A prevalência ajustada de envolvimento com drogas ilícitas foi 67% maior entre aqueles com histórico de encarceramento (RP: 1,67; IC95%: 1,44-1,94) e 28% menor entre indivíduos com 30 anos ou mais (RP: 0,72; IC: 0,58-0,88). CONCLUSÃO: O homicídio está inserido em um quadro de complexas questões sociais, dentre as quais se insere o envolvimento com drogas ilícitas, e é mais prevalente entre indivíduos com histórico de encarceramento e menos prevalente entre os de mais de 30 anos.

INTRODUCTION: Homicide is a public health problem in Brazil that is often related to illicit drugs. OBJECTIVE: To characterize homicides and aspects associated with the use of illicit drugs. METHODS: A cross-sectional study with a quantitative approach carried out in Joao Pessoa, in the state of Paraiba, Brazil, in 2014. 424 homicide victims whose data were collected through a specific instrument were considered, analyzed descriptively and analytically with the aid of statistical software, with Chi Squared Test and Robust Poisson Regression, considering a confidence level of 95% and statistical significance when p<0.05. RESULTS: Prevalence of homicide victims (93.2%), non-whites (97.2%), with up to 30 years, considering the age groups below 20 years (22.6%), 20-24 (26.7%) and 25 to 29 (18.8%), with less than seven years of study (67.5%), with a history of involvement with illicit drugs (72.5%) and incarceration (59.7%). There was an association between involvement with illicit drugs with sex (p=0.037), age (p=0.002) and history of incarceration (p<0.001). There was a 67% higher prevalence of involvement with illicit drugs among those with a history of incarceration (PR: 1.67, 95% CI: 1.44-1.94) and 28% lower among individuals aged 30 years or older (PR: 0.72, CI: 0.58-0.88). CONCLUSION: Homicide is part of a complex set of social issues, including involvement with illicit drugs, which is more prevalent among young adults and individuals with a history of incarceration.

Avaliação micro e macroscópica de escovas dentais / Micro and macroscopic evaluation of toothbrushes

Introdução: as escovas dentais possuem como principal função a limpeza dos tecidos bucais. Objetivo: analisar as características micro e macroscópicas de escovas dentais de uso infantil e adulto. Metodologia: foram selecionadas 11 escovas dentais (cinco de uso infantil e seis de uso adulto). Dois pesquisadores treinados analisaram aspectos microcoscópicos e macroscópicos, de acordo com os parâmetros da Portaria n° 97/SVS (ANVISA). Os dados foram tabulados e analisados utilizando-se o Microsoft Excel, sendo apresentados por meio de estatística descritiva. Resultados: foram encontradas cerdas arredondadas em 40% das escovas de uso infantil e em 66,7% de uso adulto, com farpas em 60% das escovas de uso infantil e em 50% de uso adulto, com a parte ativa ovalada em 60% das escovas de uso infantil e em 50% de uso adulto e com as cerdas macias em 80% das escovas de uso infantil e em 50% de uso adulto. O comprimento e a largura da parte ativa das de uso infantil variaram de 19,14 a 25,03 mm e de 8,82 a 13,98 mm respectivamente, enquanto, nas de uso adulto, o comprimento variou de 25,77 a 37,02 mm e a largura de 12,57 a 15,40 mm. As escovas de uso infantil possuíam comprimento total entre 137,91 e 163,82 mm e as de uso adulto entre 180,08 mm e 195,42 mm. Conclusão: a maioria das escovas dentais analisadas não estão adequadas aos parâmetros estabelecidos na legislação brasileira, sendo essencial que o cirurgião-dentista oriente individualmente o paciente acerca de qual escova é a mais indicada.

Introduction: toothbrushes have the main function of cleaning the oral tissues. Objective: to analyze the micro and macroscopic characteristics of children's and adult's toothbrushes. Methodology: eleven toothbrushes were selected (five for children and six for adults). Two trained researchers analyzed microscopic aspects and macroscopic aspects of the brushes, according to the parameters of Ordinance Number 97/SVS (ANVISA). Data were tabulated and analyzed by using Microsoft Excel and were presented by using descriptive statistics. Results: rounded bristles were found in 40% of the children's brushes and 66.7% of the adult, with barbs in 60% of the children's brushes and 50% of the adult, with the active part oval in 60% of the children's brushes and 50% adult brushes and soft bristles on 80% of the children's brushes and 50% of the adult. The length and width of the active part of the children's brushes ranged from 19.14 to 25.03 mm and from 8.82 to 13.98 mm respectively, while the adult brushes ranged from 25.77 to 37.02 mm in length and from 12.57 to 15.40 mm in width. The children's brushes had a total length between 137.91 and 163.82 mm and the adult brushes were between 180.08 mm and 195.42 mm. Conclusion: most of the toothbrushes analyzed are not adequate by the parameters established by the Brazilian legislation, so it is essential that the dentist individually guide the patient as to which toothbrush is the most suitable.

Analysis of prevalence and diagnostic criteria of molar-incisor hipomineralization / Análisis de prevalencia y criterios diagnósticos de hipomineralización molar-incisiva

To identify the prevalence and diagnostic criteria of Molar-Incisor Hipomineralization (MIH) in the scientific literature. Materials and Methods: This is a bibliographical research conducted through the analysis of indexed articles until October 2017 in the PubMed, Web of Science and Scopus databases. The Medical Subject Headings (MESH) used were "Dental Enamel Hypoplasia" and "Molar Incisor Hypomineralization". The analysis of articles was carried out by two reviewers, who collected information independently. The following information was collected: author, year of publication, place of work (continent and country), sample calculation, sample number, age of participants, type of study, prevalence of molar-incisor hypomineralization and criteria used for diagnosis. Data were tabulated using Microsoft Excel for Windows and presented using descriptive statistics. Results: A total of 484 articles were found and 57 were included in the study. Most of the studies were conducted in Europe (35%), and 31.6% of the studies mentioned using a probability sampling. The number of study participants ranged from 99 for a study in Brazil to 3,591 in Kenya. The most frequent age was 8 years, while the predominant type of study was cross-sectional (91.2%). The prevalence varied from 0.4% to 37.3% and most studies (73.6%) employed the European Academy of Pediatric Dentistry criteria for the diagnosis of MIH. Conclusion: There is great variability in prevalence in different countries, probably due to the use of different diagnostic criteria being used, and due to different age groups and geographical variation.

Objetivo: Identificar la prevalencia y los criterios diagnósticos de la hipomineralización de incisivos molares (HIM) en la literatura científica. Materiales y métodos: Investigación bibliográfica realizada a través del análisis de artículos indexados hasta octubre de 2017 en las bases de datos PubMed, Web of Science y Scopus. Los Medical Subject Headings (MESH) utilizados fueron "Dental Enamel Hypoplasia" y "Molar Incisor Hypomineralization". El análisis de los artículos fue llevado a cabo por dos revisores, quienes recolectaron información de manera independiente. Se recopiló la siguiente información: autor, año de publicación, lugar de trabajo (continente y país), cálculo y número de muestra, edad de los participantes, tipo de estudio, prevalencia de hipomineralización molar-incisiva y criterios utilizados para el diagnóstico. Los datos se tabularon con Microsoft Excel para Windows y se presentaron con estadísticas descriptivas. Resultados: Se encontraron un total de 484 artículos y 57 se incluyeron en el estudio. La mayoría de los estudios se llevaron a cabo en Europa (35%), y el 31,6% de los estudios mencionados utilizaron una muestra probabilística. El número de participantes en el estudio varió de 99 en un estudio en Brasil a 3.591 en un estudio desde Kenia. La edad más frecuente fue de 8 años, mientras que el tipo de estudio predominante fue transversal (91,2%). La prevalencia varió de 0,4% a 37,3% y la mayoría de los estudios (73,6%) emplearon los criterios de la Academia Europea de Odontología Pediátrica para el diagnóstico de HIM. Conclusión: Existe una gran variabilidad en la prevalencia de HIM en diferentes Países, probablemente debido al uso de diferentes criterios de diagnóstico, al utilizar diferentes grupos de etarios y a la variación geográfica.

Risk behavior for bulimia among adolescents / Comportamento de risco para bulimia em adolescentes

ABSTRACT Objective: To analyze the risk behavior for bulimia among female adolescents from public and private high schools. Methods: A cross-sectional study with a random sample of 850 female students aged 15-18 years was carried out in a city in northeastern Brazil, using the Bulimic Investigatory Test of Edinburgh (BITE) to assess the risk behavior for bulimia. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software and the Pearson's chi-square , Fisher's exact and robust Poisson regression tests, adopting the significance level of 5%. Results: Less than half of the sample (42.0%) showed standards of dietary risk and weight control practices; in 1.4% of the sample, bulimia signs were already installed. Fear of gaining weight was reported by 62.8% of the subjects. Risk practices were lower among students from public schools; (Odds Ratio - OR - 0.82; confidence interval of 95% - 95%CI - 0.69-0.97). Among restrictive practices, fasting for a whole day was the most applied (29.9% of the students). Among individuals who were at risk situation, almost half believed to have normal eating habits (prevalence ratio - PR - 0.42; 95%CI 0.36-0.49). Individuals who consider their eating habits normal, who are afraid of gaining weight, those who seek emotional comfort in food and follow strict diets had higher risk for bulimia (p<0.05). Conclusions: The number of female adolescent students with risk behavior practices for bulimia is high, and the frequency of those unaware of this situation is also very high. Risk situations emerge as a collective health problem, and individuals from private schools were more likely to be in this situation.

RESUMO Objetivo: Analisar comportamentos de risco para bulimia em adolescentes do sexo feminino de escolas públicas e particulares. Métodos: Estudo transversal com amostra aleatória de 850 estudantes do sexo feminino, com idades entre 15 e 18 anos, realizado em cidade do Nordeste do Brasil, utilizando o Bulimic Investigatory Test of Edinburgh (BITE) para avaliar comportamentos de risco para transtornos alimentares. Os dados foram analisados utilizando o teste do qui-quadrado de Pearson, o teste exato de Fisher e a regressão de Poisson, com o software Statistical Package for the Social Sciences (SPSS), adotando o nível de significância de p<0,05. Resultados: Da amostra estudada, 42,0% apresentou padrões de risco e práticas de dieta e controle de peso e 1,4% já apresentava sinais de bulimia instalados. O medo de ganhar peso foi relatado por 62,8% das adolescentes. As práticas de risco foram menos frequentes em estudantes de escolas públicas (Odds Ratio - OR - 0,82; intervalo de confiança de 95% - IC95% - 0,69-0,97). Entre as práticas restritivas, jejum por um dia inteiro foi o mais aplicado pelas participantes (29,9%). Entre os indivíduos com situação de risco, quase metade acreditava ter hábitos alimentares normais (razão de prevalência - RP - 0,42; IC95% 0,36-0,49). Estudantes que consideram seus hábitos alimentares normais, que têm medo de ganhar peso, que procuram conforto emocional em alimentos e seguem dietas rigorosas tiveram maior risco para bulimia (p<0,05). Conclusões: O número de estudantes com práticas de comportamento de risco para bulimia é alto, e o número daquelas que desconhecem essa situação também é muito alto. As situações de risco emergem como problemas de saúde coletiva, e indivíduos de escolas particulares são mais propensos a apresentar transtornos alimentares.