Periodontal status among 12-year-old schoolchildren: a population-based cross-sectional study in Quito, Ecuador

Abstract This study aimed to estimate the prevalence and extent of bleeding on probing and calculus in 12-year-old schoolchildren of Quito, Ecuador, and evaluate the associated factors. We conducted an epidemiological survey with a representative sample of 1,100 12-year-old schoolchildren from public schools in the urban area of Quito, Ecuador. We assessed the periodontal health using the Community Periodontal Index (CPI). The prevalence and extent of the periodontal condition was based on the presence of at least one site with bleeding on probing (BOP), and the presence of dental calculus was also evaluated. We used univariate and multiple multilevel Poisson regression analyses to verify the association between the independent variables and the number of sextants with BOP and calculus. The prevalence of BOP and calculus was 92% and 69.9%, respectively. The adjusted mean of the affected sextants was 4.3 and 2.2 for BOP and calculus, respectively. The mother's schooling and malocclusion were associated with the number of sextants with bleeding. The mother's schooling and dental caries experience were associated with calculus. Gingival bleeding and the presence of dental calculus are highly prevalent in 12-year-old schoolchildren from Quito. Gingival bleeding is associated with maternal education and malocclusion, and dental calculus is associated with maternal education and dental caries.

Phytotherapy: knowledge, experience and prescription in oral healthcare. A cross-sectional survey of dental practitioners / Conhecimento, experiência e prescrição de fitoterapia em saúde bucal: Um levantamento transversal com dentistas clínicos

ABSTRACT Herbal medicine is widely used as an integrative complementary treatment for common chronic diseases, yet potential risks include adverse effects and coprescription Aim This exploratory survey assessed Brazilian dentists' knowledge, attitudes, and practices regarding phytotherapy Material and Method This study used a consecutive sample of registered dentists who were active in clinical practice and attending advanced training for complex oral rehabilitation at a leading dental school in Latin America. Participants responded to a semi-structured 38-item instrument designed to collect data on sociodemographic, professional and health variables, and on their knowledge, use, prescription and opinions of phytotherapy. Quantitative data were analyzed with descriptive and inferential statistics. Qualitative data were described and analyzed with a thematic approach Results A total 53 dentists responded the survey (88.3% response rate). Six dentists reported formal education in phytotherapy and 33 had informal knowledge. Twenty-one dentists (39.6%) reported using herbal medicine, and 17 (32.1%) prescribed phytotherapy to their patients, mostly traditional medicinal plants. A logistic regression model showed that post-graduate degree and personal use of phytotherapy were associated with phytotherapy prescription. Opinions on how to improve the rational use of phytotherapy included the need for research evidence, specific academic education, and knowledge dissemination to clinicians. As a clinical recommendation, it was proposed that questions on herbal medicine should be asked during the dental patient's anamnesis Conclusions Dentists with post-graduate degrees and personal use of phytotherapy prescribe herbal medicines for their patients in real-world clinics, regardless of formal education on the subject. Qualitative findings indicate the need to implement scientific initiatives.

RESUMO A fitoterapia é amplamente utilizada como um tratamento integrativo e complementar para doenças crônicas comuns, mas os riscos potenciais incluem efeitos adversos e co-prescrição Objetivo Esta pesquisa exploratória avaliou o conhecimento, as atitudes e as práticas de cirurgiões-dentistas brasileiros sobre fitoterapia Materiais e Método Uma amostra consecutiva foi composta por dentistas com registro profissional, que eram ativos em prática clínica e frequentavam treinamento avançado para reabilitação oral complexa em uma das principais escolas de odontologia da América Latina. Os participantes responderam a um instrumento semiestruturado de 38 itens para coletar dados sobre variáveis sociodemográficas, profissionais e de saúde, bem como conhecimento, uso, prescrição e opiniões sobre fitoterapia. Os dados quantitativos foram analisados com estatística descritiva e inferencial. Os dados qualitativos foram descritos e analisados com abordagem temática Resultados Um total de 53 dentistas respondeu à pesquisa (taxa de resposta de 88,3%). Seis cirurgiões-dentistas relataram formação em fitoterapia e 33 possuíam conhecimento informal. Vinte e um dentistas (39,6%) relataram o uso de fitoterápicos e 17 (32,1%) prescreveram fitoterapia para seus pacientes, principalmente plantas medicinais tradicionais. Um modelo de regressão logística mostrou que pós-graduação e uso pessoal de fitoterapia estiveram associados à prescrição de fitoterapia. As opiniões para melhorar o uso racional da fitoterapia incluíram a necessidade de evidências de pesquisa, formação acadêmica específica e disseminação do conhecimento para os clínicos. Como recomendação clínica, foram propostas questões sobre fitoterapia para a anamnese odontológica do paciente Conclusões Cirurgiões-dentistas com pós-graduação e uso pessoal de fitoterapia prescrevem mais medicamentos fitoterápicos para seus pacientes em clínicas do mundo real, independentemente da educação formal sobre o assunto. Os resultados qualitativos indicam a necessidade de iniciativas de implementação científica.

Does the school environment exert influence on quality of life related to traumatic dental injury in children?

Abstract The aim of this cross-sectional study was to assess whether favorable factors related to school characteristics have a positive effect on the impact of traumatic dental injury (TDI) on oral health-related quality of life (OHRQoL). An epidemiological survey of oral health was conducted with 12-year-old schoolchildren from Quito, Ecuador. Children were examined for TDI, dental caries, and malocclusion. Individual socioeconomic data were also collected. Information on the physical environment, health practices, and occurrence of negative episodes at school was collected from the school coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was used to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth-brushing environment for their students exhibited a lower impact on OHRQoL, even after adjustment for the occurrence of TDI and other variables. A favorable school environment may exert a positive effect on OHRQoL, independent of the occurrence of TDI.

Household food insecurity, dental caries and oral-health-related quality of life in Brazilian Indigenous adults / Insegurança alimentar domiciliar, cárie dentária e qualidade de vida relacionada à saúde bucal em Indígenas adultos brasileiros

Abstract Food insecurity is a complex phenomenon that affects the health and wellbeing of vulnerable families. The aim of this study was to investigate the relationship between household food insecurity, dental caries, oral health-related quality of life, and social determinants of health among Indigenous adults. A cross-sectional study was conducted among Kaingang adults aged 35-44 years old from the Guarita Indigenous Land, Brazil. Food insecurity was assessed through the EBIA scale. Dental caries was assessed using the DMFT index. Participants answered the OHIP-14 questionnaire and a structured interview. Descriptive and multivariate analyzes using Poisson regression models were performed. The final sample included 107 adults from 97 households. Approximately 95% lived in food insecure families. Severe food insecurity was present in 58% of the households. The phenomenon was associated to the Bolsa Família benefit, household size, and greater perception of oral health impacts on quality of life. The high number of families affected by food insecurity reveals the social vulnerability of the Kaingang people. Food insecurity in Kaingangs adults is associated to oral health perception and social determinants of health.

Resumo Insegurança alimentar é um fenômeno complexo que afeta a saúde e o bem-estar de famílias vulneráveis. Este estudo objetivou investigar a relação entre insegurança alimentar domiciliar, cárie dentária, qualidade de vida relacionada à saúde bucal, e determinantes sociais de saúde entre indígenas adultos. Foi conduzido um estudo transversal com adultos Kaingang entre 35-44 anos da Terra Indígena Guarita, Brasil. Insegurança alimentar foi avaliada pela escala EBIA. Cárie dentária foi avaliada pelo índice CPOD. Participantes responderam o questionário OHIP-14 e uma entrevista estruturada. Foram realizadas análises descritivas e multivariadas usando modelos de regressão de Poisson. A amostra incluiu 107 adultos Kaingang de 97 domicílios. Aproximadamente 95% dos participantes viviam em famílias com insegurança alimentar. Insegurança alimentar grave esteve presente em 58% dos domicílios. O fenômeno foi associado ao Bolsa Família, densidade familiar e percepção dos impactos da saúde bucal na qualidade de vida. O alto número de famílias afetadas pela insegurança alimentar revela a vulnerabilidade social do povo Kaingang. Insegurança alimentar em adultos Kaingang está associada à percepção da saúde bucal e determinantes sociais da saúde.

Análise das sentenças de processos judiciais envolvendo a odontologia julgados em primeira instância no tribunal de justiça de São Paulo no ano de 2019 / Analysis of dental lawsuit verdicts judged at first instance at the São Paulo Court of Justice in 2019

Após o surgimento do Código de Defesa do Consumidor, a Odontologia passou por modificações jurídicas, fornecendo condições aos pacientes para cobrarem do profissional o cumprimento de suas obrigações. O objetivo do estudo foi analisar as decisões em primeira instância de processos julgados na área de Odontologia no ano de 2019 no Tribunal de Justiça de São Paulo (TJ-SP) em relação ao tempo de processo, especialidade do procedimento, tipo de pessoa requerida, tipo de justiça, classe do processo, realização de perícia, posicionamento do magistrado em relação ao laudo, tipo de obrigação estabelecida no processo, responsabilidade civil, pedido de reconvenção, e decisão judicial. Foi utilizado o acesso ao banco de sentenças do TJ-SP com os seguintes descritores no campo de busca: "dentista" e "responsabilidade profissional". Foram encontradas 234 sentenças. O tempo máximo entre o início do processo e o julgamento foi de 17 anos e o tempo mínimo, de 1 ano. A Implantodontia foi a especialidade mais processada (42,3%), e o dano moral foi a classe processual mais solicitada (29,9%). Em 75,6% das sentenças, a realização da perícia foi solicitada e, destes, em 70,9% dos casos o magistrado se embasou nas informações fornecidas no laudo para determinar sua sentença. A obrigação de resultado foi a mais associada à Odontologia pelos Magistrados, com estabelecimento da responsabilidade civil em 140 sentenças. Dessa forma, ressalta-se a importância do laudo pericial, visto que este atua de modo a esclarecer o magistrado, e consequentemente, se torna um fator essencial para guiar a decisão judicial.

Análise dos custos da adoção das novas medidas de biossegurança nos institutos oficiais de perícias médico e odontolegais brasileiros durante a pandemia do COVID-19 / Analysis of the costs of implementing the new biosafety measures in the Brazilian official Institutes of Medical and Dental Expertise during the COVID-19 pandemic

Introdução: A COVID-19 é uma doença de etiologia viral associada à infecção causada pelo novo coronavírus. Devido ao seu padrão de transmissão, foram estabelecidas novas medidas de biossegurança. O uso dos equipamentos de proteção individual (EPI) é fundamental para controle da disseminação da doença, inclusive durante a realização de exames periciais nos Institutos Oficiais de Perícias (IOP). Objetivo: Analisar os custos das medidas de biossegurança adotadas a partir da pandemia do COVID-19 nos IOP do Brasil. Material e Método: O estudo consiste em uma avaliação econômica parcial do tipo microcusteio. A coleta foi realizada para estimar os custos diretos incorridos da adoção de novas normas de biossegurança, considerando uma equipe de necropsia de um IOP. Adotou-se a perspectiva do gestor do IOP e seguiram-se as práticas recomendadas pela REBRATS. A estimativa dos custos foi calculada por turno. Foi considerado um cenário mais otimista (-20% dos custos) e mais pessimista (+20% dos custos). Resultados: O valor total por turno variou de R$106,93 a R$160,39 segundo análise de sensibilidade. Será necessário investir, em média, R$100.000,00 anuais para cada IOP. Considerando a despesa do funcionário, na ausência de fornecimento de EPI pela gestão, o valor médio por turno foi de R$57,62. Conclusão: Os custos para adoção das novas medidas de biossegurança nos IOP durante a pandemia do COVID-19 são onerosos. Anualmente, o investimento representa um montante significativo, porém indispensável para garantir a segurança da equipe e o adequado fornecimento do serviço.

Brazilian Oral health teams in primary care and oral cancer: Results of a national evaluation

Abstract Oral cancer is one of the most prevalent cancers in Brazil. An understanding of how public policies are implemented to address this problem can contribute to the construction of solutions. The "Programa de Melhoria do Acesso e da Qualidade" (PMAQ-AB and PMAQ-CEO) at the level of primary and secondary care are evaluations that also collect data on prevention and monitoring strategies for oral cancer. This study aimed to analyze the results of the incorporation of oral health teams to evaluate the strategies adopted by Brazil regarding the impact on the diagnosis of oral cancer. Of the 17,202 family health teams evaluated, 72.10% had oral health teams (OHT). Considering the strategies for prevention, screening, campaign, and follow-up of suspected cases, 72.27% of the campaign teams and 59.09% of the teams who accompanied suspected cases had OHT. In secondary care, more than 65% of the teams in the Southeast and South regions registered cases of oral cancer, and the referral network was more represented. The inclusion of OHT had a positive impact on campaign actions, follow-up, referral to specialists, and registration of suspected cases throughout Brazil.

Age estimation in Brazilian adults by Kvaals and Camerieres methods

Abstract The aim of this study was to verify the precision and applicability of two methods of age estimation, Kvaal's and Cameriere's methods, among Brazilian adults. A sample composed of periapical radiographs of canine teeth belonging to 320 Brazilian adults was analyzed, divided into groups according to sex (male and female) and age group (20-29 years, 30-39 years, 40-49 years and 50-59 years). Kvaal's method presented better results when compared to the results of Cameriere's method in the general evaluation of each canine tooth, except for the upper left canine (tooth 23), which presented a mean error (ME) with no statistically significant difference between the methods (Kvaal: ME = 7.43, p = 0.4991, Cameriere: ME = 7.55, p = 0.6982). In the evaluation by age groups, Kvaal's method presented a lower variation between the real age and estimated age when applied to the age groups of 20-29 years and 30-39 years compared to the results provided by Cameriere's method. With respect to the groups aged 40 to 49 years and 50 to 59 years, Cameriere's method presented better performance than the results provided by Kvaal's method. The methods of estimating age proposed by Kvaal and Cameriere are simple and nondestructive and have demonstrated reproducibility and reliability. The Kvaal method was more accurate for the age groups of 20-29 and 30-39 years, and for those over 40 years, the Cameriere method was the most accurate.

Necropsia odontolegal: técnicas e vias de acesso com finalidade de identificação humana / Dental autopsy: techniques and access ways with human identification purpose

Introdução: A Odontologia Legal ocupa importante espaço dentre as Ciências Forenses, oferecendo seus conhecimentos específicos da Odontologia em prol da resolução de casos de natureza cível, criminal, administrativa e trabalhista. O avanço da Odontologia Legal está diretamente ligado à busca pela identificação humana, o que tornou possível a crescente presença do perito odontolegista nos Institutos Médico Legais (IMLs), oficializada pela Lei 5081/66. O objetivo deste trabalho foi apresentar, por meio de uma revisão de literatura, as principais técnicas de necropsia bucal com finalidade de permitir o exame de identificação humana, bem como as diferentes vias de acesso, desenvolvidas ou utilizadas pelos odontolegistas. As técnicas preconizam incisões em diversas regiões de cabeça e pescoço, com a remoção ou não dos maxilares e são selecionadas para serem utilizadas de acordo com o estado de degradação dos corpos e a necessidade de preservação das estruturas e tecidos faciais, já que em diversos casos, os cadáveres deverão ser devolvidos aos seus familiares para serem velados posteriormente. Conclui-se que o uso das técnicas de necropsia bucal é necessário para a análise detalhada dos arcos dentais, de onde são retiradas as informações post-mortem para, em seguida, serem confrontadas à documentação ante-mortem do cadáver. Essas técnicas devem ser escolhidas de acordo com a praticidade e agilidade do exame, mas sob os critérios do estado inicial do corpo e a necessidade estética final do procedimento

Forensic Dentistry plays an important role within the Forensic Sciences, offering its expertise in Dentistry for the resolution of cases for civil, criminal, administrative and labor. The advancement of Forensic Dentistry is directly linked to the search for human identification, which is made possible the growing presence of the forensic odontologist in the Medical Legal Institutes (IMLs), a right granted by the Brazilian Federal Law n. 5081/66. The objective was to present, through a literature review, the main techniques of oral autopsy, and the various access ways, developed and used by dental examiners in order to facilitate and expedite the identification of bodies. Such techniques recommends incisions in various regions of the head and neck, with or without removal of the jaws, and are selected according to the state of preservation of the bodies, and the need for preservation of facial tissues and structures since, in many cases, the bodies must be returned to their families later to be veiled. It is concluded that the use of oral necropsy techniques is necessary for a detailed analysis of the dental arches, where postmortem data can be acquired and then confronted to the documented antemortem data of the corpse. The techniques are chosen by a practical and less time consuming criteria, but under the initial state of preservation and necessity of final aesthetic variables

Can dental anesthesia lead to death? Crime investigation report / Anestesia odontológica pode levar à morte? Relato de investigação criminal

Emergency situations that may lead to the death of an individual, even when there is no cause directly related to the treatment, occur with certain frequency in dental offices. The purpose of this study was to report a case that involved an inquiry and police investigation related to the death of a female patient after the injection of two ampoules of 2% lidocaine anesthetic for dental treatment. The patient died despite assistance given by the professional and by SAMU (Urgent Mobile Medical Service). The legal authorities inquired into the possibility that the amount of anesthetic may have caused the patient's death. However, it was proven that the amount of anesthesia was adequate, and the recommendation of the Public Prosecutor's Office was for closure of the case because of lack of evidence justifying occurrence of the crime

Situações de emergência que podem levar à morte de um indivíduo, mesmo quando não há causa diretamente relacionada ao tratamento, ocorrem com certa frequência nos consultórios odontológicos. O objetivo deste estudo foi relatar um caso que envolveu uma investigação e um inquérito policial relacionada à morte de uma paciente do sexo feminino após a injeção de duas ampolas do anestésico lidocaína a 2% para a realização de tratamento odontológico. A paciente faleceu apesar da assistência prestada pelo profissional e pelo SAMU (Serviço de Atendimento Móvel de Urgência). As autoridades investigaram a possibilidade de que a quantidade de anestésico poderia ter causado a morte do paciente. No entanto, foi comprovado que a quantidade de anestesia era adequada e a recomendação do Ministério Público foi de encerramento do caso devido à falta de evidências que justificassem a ocorrência do crime

Epidemiological profile of caries and need for dental extraction in a Kaingang adult Indigenous population / Perfil epidemiológico de cárie e necessidade de extração dentária em uma população Indígena Kaingang adulta

ABSTRACT: Introduction: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far. Objective: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous. Methods: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs. Results: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth. Conclusion: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.

RESUMO: Introdução: O perfil epidemiológico de cárie dentária dos povos indígenas é complexo e heterogêneo. A saúde bucal do povo Kaingang, terceira maior população indígena do Brasil, ainda não foi investigada. Objetivo: O objetivo deste estudo foi avaliar a prevalência e severidade de cárie, além dos fatores associados à necessidade de extração dentária entre adultos Indígenas Kaingang. Métodos: Foi realizado um inquérito de saúde bucal entre adultos Kaingang com idade entre 35 e 44 anos residentes na Terra Indígena Guarita, Rio Grande do Sul. Exames clínicos foram realizados a fim de analisar as condições da coroas dentárias e as necessidades de tratamento, seguindo os critérios e diretrizes da Organização Mundial da Saúde e da Pesquisa Nacional de Saúde Bucal SB Brasil 2010. Resultados: O total de 107 Indígenas Kaingang foi examinado. O índice de dentes cariados, perdidos e obturados (CPOD) médio observado foi de 14,45 (± 5,80). Dois terços do escore do indíce foram compostos do componente "perdidos". A dentição inferior anterior apresentou as maiores taxas de dentes hígidos, enquanto os primeiros molares inferiores apresentaram as menores. Necessidade de extração dentária foi observada em 34,58%, sendo associada com a localização da aldeia, tempo da última consulta odontológica e maior número de dentes cariados. Conclusão: As altas frequências de cárie não tratada e dentes perdidos observados nessa população indicam a falta de assistência adequada. É necessário discutir modelos de atenção à saúde para combater iniquidades sociais e de saúde.

Functional dentition and prosthodontic status in an Indigenous population from the South of Brazil

Aim: to analyze the prevalence of different definitions of functional dentition, prosthodontic status and associated factors, in an indigenous population from Brazil. Methods: a cross-sectional oral health survey was conducted with Indigenous adults aged 35-44 years. A single examiner collected clinical data through oral examinations and sociodemographic data using a structured questionnaire. Dentitions were classified according to four classification systems of functional dentition: FDWHO (> 20 teeth), FDGROUP2 (> 10 teeth in each arch), FDGROUP3 (all anterior teeth), and FDGROUP4 (> 10 teeth in each arch, all anterior teeth, and sufficient posterior region). Use and need of prosthodontics was also evaluated. Uni and multivariate analysis were conducted at the level of significance of 5%. Results: Indigenous adults presented considerably low frequencies of prosthodontic use and functional dentition, independently of the definition analyzed. Substantial differences of prevalence rates were observed among the four definitions of functional dentition, ranging from 48.62% to 11.93%. Age and municipality were associated with use of dental prosthesis and prosthodontic need, respectively. Significant discrepancies in functional dentition rates were observed regarding sex and time of the last dental appointment. Conclusions: Indigenous adults are severely affected by tooth loss and, consequently, by low frequencies of functional dentition. The scenario is worsened by the elevated need of the population for prosthodontics. The phenomenon was associated with age, sex, access to specialized dental care and time of the last dental visit

Photoanthropometry of the face in the young white brazilian population

Abstract The aim of the present study is to describe the simplified facial pattern of young Brazilian men and women using the facial index (FI), upper face index (UFI), and nasal index (NI) in indirect anthropometric measurements applied to frontal photographic images. The images were obtained from 660 adult white men and 689 adult white women aged 30 years ± 6 months, and classified according to regions of birth, as follows: south (S), southeast (SE), midwest (MW), northeast (NE), and north (N). The nasion, zygion, gnathion, stomion, subnasale, and alare landmarks were labeled on the images using the SAFF 2D® software. Based on the coordinates, the linear distances between the landmarks of interest were calculated and presented as indices. The analysis of variance and Student's t-test were used for assessing the regions of birth and gender, respectively. The collected data allowed obtaining the facial profile of the young adult Brazilian population. There were differences in the facial profiles between men and women and also between some regions, especially between the N and the other Brazilian regions (p<0.05). The UFI did not show a statistically significant difference (p>0.05) between genders for any of the regions. The discriminant analysis for gender assessment demonstrated higher accuracy when the three indices were analyzed together. In the decision tree for gender assessment, the NI showed better results than the other indices.

Resumo O objetivo do estudo é verificar o padrão facial simplificado a partir dos índices facial (IF), da face superior (IFS) e nasal (IN) de homens e mulheres jovens brasileiros a partir da antropometria indireta aplicada em imagens fotográficas em norma frontal. Foram utilizadas imagens de adultos brancos de 30 anos (± 6 meses), sendo 689 do gênero feminino e 660 do masculino, divididos pela região de nascimento, sendo Sul, Sudeste, Centro-oeste, Nordeste e Norte. Os pontos: násio, zígio, gnátio, estômio, subnasal e alar foram marcados nas imagens por meio do software SAFF 2D®. A partir das coordenadas geradas em pixels, foram calculadas as distâncias lineares entre os pontos de interesse, que foram transformadas em índices. Os índices foram analisados estatisticamente de acordo com a região do nascimento pela análise de variância e o gênero pelo teste t de Student. Com os dados foi possível traçar o perfil simplificado da face da população brasileira de adultos jovens por meio da fotoantropometria. Foram observadas diferenças no perfil facial entre os gêneros e também entre algumas regiões, com maior frequência entre a região N e as demais partes do país (p<0,05). Quando separados por regiões do país, o IFS não mostrou diferença estatisticamente significante (p>0,05) entre os gêneros para nenhuma região. A análise discriminante para estimativa de gênero mostra que melhores taxas de acerto são alcançadas quando considerados os três índices em conjunto. Para a árvore de decisão de estimativa de gênero, o IN desempenhou os melhores resultados, quando comparado aos demais índices analisados.

Sexing the cranium from the foramen magnum using discriminant analysis in a brazilian sample

Abstract In the identification process, the foramen magnum has shown controversial results in sex estimation. The present study aimed to analyze the morphometric variables of the foramen magnum in Brazilian adult cranium for sex estimation. The sample was composed of 100 craniums (53 males and 47 females) from the documented collection of the Institute of Teaching and Research in Forensic Sciences. The protocol measurement was constituted of two linear measurements: maximum length of the foramen magnum and maximum breadth of the foramen magnum and two formulas to calculate the area, method one (M1) and method two (M2). Descriptive statistics showed statistically significant differences between sex (p<0.05) for all variables. The univariate discriminant functions showed an accuracy between 56.0-62.0%, and the multivariate analysis showed a percentage of accuracy between 60.0-65.0%, the greatest accuracy was found combining the two linear measurements with M1(71.7%), even after cross-validation (66%). Receiver Operating Characteristic (ROC) curve analysis showed that M2 is the best parameter for estimating sex (AUC=0.693). A reference table for Brazilians using the foramen magnum parameters was developed based on the results of the ROC curve analysis. In conclusion, the foramen magnum should be used with caution to estimate sex in forensic cases of fragmentary craniums, due to the limited accuracy.

Resumo No processo de identificação humana, a análise do forame magno apresenta resultados controversos para estimativa do sexo. O presente estudo teve como objetivo analisar as variáveis morfométricas do forame magno em crânios adultos brasileiros para estimação sexual. A amostra foi composta por 100 crânios (53 sexos masculino e 47 sexo feminino) pertencentes a coleção osteológica documentada do Instituto de Ensino e Pesquisa em Ciências Forenses. A medida do protocolo foi constituída por duas medidas lineares: comprimento máximo do forame magno e largura máxima do forame magno e duas fórmulas para calcular a área, método um (M1) e método dois (M2). As estatísticas descritivas evidenciaram diferenças estatisticamente significativas (p<0,05) para todas as variáveis. As funções discriminantes univariadas apresentaram uma porcentagem de acerto entre 56,0-62,0% e a análise multivariada mostrou uma porcentagem de acerto entre 60,0-65,0%. A análise da curva ROC apontou que M2 é o melhor parâmetro para estimar o sexo (AUC=0,693). Uma tabela de referência para brasileiros que utilizam os parâmetros do forame magnum foi desenvolvida com base nos resultados da análise da curva ROC. Em conclusão, o foram e magnum deve ser usado com precaução para estimar o sexo em casos forenses de cranio fragmentado, devido à precisão limitada.

Craniometric variation among Brazilian and Scottish populations: a physical anthropology approach

Aim: The present investigation intended to compare the craniometric variations of two samples of different nationalities (Brazilian and Scottish). Materials and methods: The Brazilian sample consisted of 100 modern complete skulls, including 53 female skulls and 47 male skulls, and the Scottish sample consisted of 100 historical skulls (61 males, 39 females) and 36 mandibles (24 males, 12 females). The cranial measurement protocol was composed of 40 measurements, 11 bilateral and 29 unilateral, and the measurement protocol of the mandible was composed of 15 measurements, with six that were bilateral and nine that were unique. The comparative analysis of the metric variability between the two samples was performed using the means and medians analysis, the t-test, the Wilcoxon test, and the coefficient of variance, with a significance level of 5%. Results: The results showed that, among the 72 analysed variables, 44 measurements (61.11%) presented statistical differences between the samples. The Scottish skull tends to have a cranial length (GOL diff=5.53), breadth (XCB diff=3.78) and height (NPH diff=5.33) greater than the Brazilian skulls, and the Scottish mandibles tend to show a higher mandibular ramus height (MRH diff=9.25), a higher mandibular body height (HMB diff=6.37) and a larger bigonial breadth (BGB diff=5.29) than the Brazilians. The discriminant analysis of the 51 cranial measurements and 21 mandibular measurements showed a variation of the percentage of accuracy between 46.3-83.8%. Conclusion: The metric analysis demonstrated that there is variability between the two samples studied (61,11%), but a concrete cause cannot be determined considering the multifactorial aspects of the variations of form and size

Measurement of oral health quality of life among patients who underwent haematopoietic stem-cell transplantation

Abstract Oral mucositis is a painful condition that occurs in patients who have undergone haematopoietic stem-cell transplantation (HSCT) and has a huge impact on their quality of life. The objective of this study was to examine the extent to which interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) are associated with oral health quality of life among patients who underwent HSCT. A. C. Camargo Cancer Center patients were evaluated over 20 months at 4 different time-points: a) at patient admission (M1); b) on the day of infusion of HSC (M2); c) 12 and 20 days after the first day of the conditioning regimen for autologous and allogeneic transplantation, respectively (M3); and d) 30 days after the first day of the conditioning regimen (M4). Mucositis clinical evaluations were performed using World Health Organization (WHO) criteria. Oral health quality of life was measured using the Oral Health Impact Profile short form (OHIP-14), Oral Mucositis Quality of Life (OMQoL) and Patient-Reported Oral Mucositis Symptom (PROMS) scales. Correlations between clinical data and quality of life scores were examined. STATA 11.0 was used to perform the statistical analyses (5% level of significance). Eighty-two patients participated in the study; 62.2% were male, 28.05% had multiple myeloma, and the mean age was 48.49 years (SD 13.76). Higher scores (worse quality of life) were observed as mucositis scores increased, but the results were not significant. The OMQoL had a high correlation with OHIP-14 (0.8377), but the correlation between the PROMS scale and the OHIP-14 was lower (0.6643). Higher concentrations of IL-6 and TNF-α were associated with worse quality of life, according to all indices (p < 0.05). Oral mucositis was associated with quality of life scores (p < 0.01).

Dental Management Survey Brazil (DMS-BR): creation and validation of a management instrument

Abstract Questionnaires for the assessment of knowledge and self-perception can be useful to diagnose what a dentist knows about management and administration. The aim of the present study was to create and validate the Dental Management Survey Brazil (DMS-BR) scale, based on meetings with experts in the field. After having elaborated the first version, 10 audits were performed in dental offices in order to produce the final version, which included nine dimensions: location, patient, finance, marketing, competition, quality, staff, career, and productivity. The accuracy of the instrument was measured by intrarater and interrater reliability. In the validation phase, 247 Brazilian dentists answered a web-based questionnaire. The data were processed using Stata 13.0 and the significance level was set at 95%. The instrument had intrarater and interrater reliability (ICC-0.93 and 0.94). The overall average of respondents for the DMS-BR scale was 3.77 (SD = 0.45). Skewness and kurtosis were below absolute values 3 and 7, respectively. Internal validity measured by Cronbach’s alpha was 0.925 and the correlation of each dimension with the final result of the DMS-BR ranged between 0.606 and 0.810. Correlation with the job satisfaction scale was 0.661. The SEM data ranged between 0.80 and 0.56. The questionnaire presented satisfactory indicators of dentists’ self-perception about management and administration activities.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

Abstract The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children’s Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children’s dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers’ associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children’s ages, family income, parents’ schooling, mothers’ participation in their children’s school activities, dental caries, and presence of workers’ associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Accuracy of mandibular measurements of sexual dimorphism using stabilizer equipment

Abstract The objective of this investigation was to compare the accuracy of mandibular measurements using a stabilizer (MS) with gold standard computed tomography (GS) images. Sixty mandibles were studied. Werth TomoScope HV Compact® was used to obtain CT images (GS), and the MS was also used. Analysis of the CT scans was performed using the VG Studio Max software® (Volume Graphics GmbH, Heidelberg, Germany), and MS was used after the proper positioning of the mandible. Descriptive and paired t test measures were used, and a ROC curve was calculated, as well as sensibility and specificity. MedCalc and STATA 13.0® were used (95% level of significance). Bicondylar breadth, bicoronoid breadth and minimum ramus breadth reached the highest concordance correlation coefficients at 0.99 (0.99-1.00), 0.99 (0.99–1.00) and 1.00 (0.99–1.00), respectively. Comparing observers with GS, the lowest accuracy was noted for the maximum mandibular length [0.59 (0.45–0.69), 0.64 (0.51–0.74)], the breadth of the right (0.14 (0.04–0.23), 0.14 (0.004–0.24)) and left mandibular body [0.14 (0.03–0.24), 0.16 (0.05-0.26)], and the right [0.58 (0.45–0.69), 0.63 (0.51–0.73) and left (0.59 (0.45–0.70), 0.59 (0.46–0.69)] mandibular angle. Various measurements exhibited good sensibility for males using MS: maximum mandibular length (78.12), bicondylar breadth (78.12), left mandibular notch breadth (84.37), and the left height of the mandibular body at the mental foramen (75.00). High specificity in discriminating females was observed for the left maximal ramus height (85.19), mandibular length (85.71), bicoronoid breadth (96.43), right height of the mandibular body at the mental foramen (82.19), bimental breadth (78.57), breadth right (92.86) and left (96.43) mandibular body, minimum ramus breadth (89.29), and left mandibular angle (85.71). MS was able to discriminate sexual dimorphism.

Fragile X syndrome: panoramic radiographic evaluation of dental anomalies, dental mineralization stage, and mandibular angle

ABSTRACT Fragile X syndrome (FXS) is a disorder linked to the chromosome X long arm (Xq27.3), which is identified by a constriction named fragile site. It determines various changes, such as behavioral or emotional problems, learning difficulties, and intellectual disabilities. Craniofacial abnormalities such as elongated and narrow face, prominent forehead, broad nose, large and prominent ear pavilions, strabismus, and myopia are frequent characteristics. Regarding the oral aspects, deep and high-arched palate, mandibular prognathism, and malocclusion are also observed. Objective: The purpose of this study was to evaluate the dental radiographic characteristics as described in 40 records of patients with panoramic radiography. Material and Methods: The patients were in the range of 6–17 years old, and were divided into two groups (20 subjects who were compatible with the normality standard and 20 individuals diagnosed with the FXS), which were matched for gender and age. Analysis of the panoramic radiographic examination involved the evaluation of dental mineralization stage, mandibular angle size, and presence of dental anomalies in both deciduous and permanent dentitions. Results: The results of radiographic evaluation demonstrated that the chronology of tooth eruption of all third and second lower molars is anticipated in individuals with FXS (p<0.05). In this group, supernumerary deciduous teeth (2.83%), giroversion of permanent teeth (2.31%), and partial anodontia (1.82%) were the most frequent dental anomalies. In addition, an increase was observed in the mandibular angle size in the FXS group (p<0.05). Conclusion: We conclude that knowledge of dental radiographic changes is of great importance for dental surgeons to plan the treatment of these individuals.