Auriculoterapia para reducir el dolor crónico de la columna vertebral de los trabajadores de la salud: ensayo clínico / Auriculotherapy for reducing chronic spinal pain in health workers: a clinical trial / Auriculoterapia para redução da dor crônica na coluna vertebral em trabalhadores da saúde: ensaio clínico

Objetivo: evaluar la efectividad de la auriculoterapia para reducir el dolor musculoesquelético crónico de la columna vertebral de los trabajadores de la salud. Método: ensayo clínico aleatorizado, triple ciego, realizado con trabajadores de la salud diagnosticados con dolor crónico en la columna vertebral. Se aplicaron ocho sesiones de auriculoterapia con semillas, dos por semana. Los resultados fueron medidos con la Escala Numérica del Dolor, el Inventario Breve del Dolor, el Cuestionario de Discapacidad de Roland-Morris y los instrumentos SF-36, en la 1.ª, 4.ª, 8.ª sesión y follow-up a los 15 días. Análisis descriptivo e inferencial. Resultados: participaron 34 trabajadores del grupo intervención y 33 del grupo control, ambos mostraron una reducción en la intensidad del dolor (p>0,05). En el follow-up se registró una mayor reducción en el grupo intervención (3,32 ± 0,42) que en el grupo control (5,00 ± 0,43) (p=0,007). En cuanto a la calidad de vida, mejoró la vitalidad (p=0,012) y la limitación por aspectos emocionales (p=0,025). La relación entre auriculoterapia, discapacidad física e interferencia del dolor no difirió entre los grupos (p>0,05). El uso de medicamentos en el follow-up se mantuvo en el grupo control (77,8%) con respecto al grupo intervención (22,2%) (p=0,013). Conclusión: la auriculoterapia tuvo el mismo efecto en ambos grupos sobre la intensidad del dolor y duró más en el follow-up. Hubo una mejora en la calidad de vida y una reducción en el consumo de medicamentos. REBEC: RBR-3jvmdn.

Objective: to evaluate the effectiveness of auriculotherapy in reducing chronic musculoskeletal pain in the spine of health workers. Method: a randomized, triple-blind clinical trial conducted with health workers diagnosed with chronic spinal pain. Eight sessions of auriculotherapy with seeds were applied, two per week. The outcomes were measured with the Numerical Pain Scale, Brief Pain Inventory, Rolland-Morris Disability Questionnaire and SF-36 instruments, in the 1st, 4th and 8th session, and in the 15-day follow-up period. Descriptive and inferential analyses were performed. Results: 34 workers took part in the Intervention Group and 33 in the Control Group, and both presented reduced pain intensity (p>0.05). In the follow-up period, there was a greater reduction in the Intervention Group (3.32 ± 0.42), when compared to the Control Group (5.00 ± 0.43) (p=0.007). In quality of life, there was improved vitality (p=0.012) and limitation due to emotional aspects (p=0.025). The relationship between auriculotherapy, physical disability and pain interference did not differ between the groups (p>0.05). Medication use in the follow-up period remained unchanged in the Control Group (77.8%) when compared to the Intervention Group (22.2%) (p=0.013). Conclusion: auriculotherapy exerted the same effect between the groups on pain intensity, lasting longer in the follow-up period. There was an improvement in quality of life and a reduction in medication use. REBEC: RBR-3jvmdn.

Objetivo: avaliar a eficácia da auriculoterapia na redução da dor musculoesquelética crônica na coluna vertebral de trabalhadores da área da saúde. Método: ensaio clínico randomizado, triplo cego, realizado com trabalhadores da saúde com diagnóstico de dor crônica na coluna vertebral. Aplicaram-se oito sessões de auriculoterapia com sementes, duas por semana. Desfechos mensurados com os instrumentos Escala Numérica da Dor, Inventário Breve de Dor, Questionário de Incapacidade de Rolland-Morris e SF-36, na 1ª, 4ª, 8ª sessão, e follow-up de 15 dias. Análise descritiva e inferencial. Resultados: participaram 34 trabalhadores no grupo intervenção e 33 no controle, ambos apresentaram redução da intensidade da dor (p>0,05). No follow-up, maior redução no grupo intervenção (3,32 ± 0,42), comparado ao controle (5,00 ± 0,43) (p=0,007). Na qualidade de vida, melhorou a vitalidade (p=0,012) e limitação por aspectos emocionais (p=0,025). Relação entre auriculoterapia, incapacidade física e interferência da dor não diferiu entre os grupos (p>0,05). O uso de medicamentos, no follow-up, manteve-se no grupo controle (77,8%) se comparado à intervenção (22,2%) (p=0,013). Conclusão: a auriculoterapia apresentou igual efeito entre os grupos na intensidade da dor, com maior durabilidade deste no follow-up. Houve melhora da qualidade de vida e redução do consumo de medicamentos. REBEC: RBR-3jvmdn.

Anthropometric measurements and their association with endothelial function and arterial stiffness of eutrophic individuals and with overweight

ABSTRACT Objective: The objective of the study was to assess the association of anthropometric measurements with endothelial function and arterial stiffness of eutrophic individuals and with overweight. Subjects and methods: A cross-sectional study was carried out with individuals with body mass index (BMI) between 18.5 kg/m² and < 30 kg/m², low to intermediate global cardiovascular risk scores, and aged ≥ 18 and < 60 years. We assessed the sociodemographic data, anthropometric variables (body weight, height, circumferences of the waist [WC], neck [NC], hip [HC], sagittal abdominal diameter [SAD], [BMI], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR]), biochemical parameters (lipid profile and nitric oxide), endothelial function (flow-mediated dilation [FMD], by ultrasound), and arterial stiffness (pulse wave velocity [PWV] and the amplification index [AIx@75] by oscillometry). Thirty-six individuals were included, 18 eutrophic and 18 with overweight, with a mean age of 37.5 ± 10.2 years, mostly at low cardiovascular risk (86.1%), female (80.6%), single (52.8%), employed with formal contracts (44.4%), and with over twelve years of education (88.9%). Results: The PWV presented positive and moderate correlation with the WC (r = 0.584; P = 0.001), WHR (r = 0.513; P = 0.001), and WHtR (r = 0.590; P = 0.001), and positive and low correlation with the NC (r = 0.372; P = 0.013) and SAD (r = 0.356; P = 0.033). Moreover, no anthropometric parameter presented a correlation with the AIx@75 or the FMD percentage in the total sample. Conclusion: Our findings show that in eutrophic individuals and with overweight the WC, WHR, WHtR, SAD, and NC were positively correlated with the PWV but not to the endothelial function in the overall sample. These are hypothesis-generating findings and they should be replicated in other studies.

Periodontal regeneration: is it still a goal in clinical periodontology?

Abstract In the last decades, Periodontal Regeneration has been one of the most discussed topics in Periodontics, attracting the attention of researchers and clinicians. This can be justified by the evident and continuous progress observed in the field, characterized by a better understanding of the biological mechanisms involved, significant improvement of operative and technical principles, and the emergence of a wide range of biomaterials available for this purpose. Together, these aspects put the theme much in evidence in the search for functional and esthetic therapeutic solutions for periodontal tissue destruction. Despite the evident evolution, periodontal regeneration may be challenging and require the clinician to carefully evaluate each case before making a therapeutic decision. With a critical reassessment of the clinical and preclinical literature, the present study aimed to discuss the topic to answer whether Periodontal Regeneration is still a goal in clinical periodontology. The main aspects involved in the probability of success or failure of regenerative approaches were considered. A greater focus was given to intrabony and furcation defects, clinical conditions with greater therapeutic predictability. Aspects such as more appropriate materials/approaches, long-term benefits and their justification for a higher initial cost were discussed for each condition. In general, deep intrabony defects associated with residual pockets and buccal/lingual class II furcation lesions have predictable and clinically relevant results. Careful selection of the case (based on patient and defect characteristics) and excellent maintenance are essential conditions to ensure initial and long-term success.

Oral health status of schoolchildren living in rural and urban areas in southern Brazil

Abstract This study assessed the effect of area of residence (rural vs. urban) on dental caries experience among southern Brazilian schoolchildren. This cross-sectional survey was conducted in Rosário do Sul, southern Brazil, and included 373 9-14-year-old schoolchildren attending public municipal schools (122 living in the rural area, and 251, in the urban area). Data collection included a questionnaire and a clinical examination. Clinical examination of the permanent dentition involved visible plaque index, gingival bleeding index and dental caries experience (non-cavitated and cavitated, inactive and active lesions). Samples of water were collected to check the fluoride concentration. Caries prevalence and extent using different criteria were compared between rural and urban schoolchildren using the chi-square test and the Mann-Whitney test, respectively. The association between explanatory variables and the extent of caries activity (number of active caries lesions) was assessed using Poisson regression. When caries was recorded at the cavity level (WHO criterion), no difference was observed between rural and urban populations (p ≥ 0.05). Conversely, higher caries prevalence and extent were found among urban schoolchildren when active non-cavitated lesions were also computed (p < 0.05). In the adjusted Poisson regression model, urban schoolchildren were 57% more likely to present more active lesions than rural students (RR = 1.57; 95%CI = 1.29-1.92). Rural communities did not have sufficient fluoride in the water supply, whereas ideal concentrations were detected in the urban areas. In conclusion, this cross-sectional study found that urban schoolchildren showed greater caries experience than rural students, and that this increment was related to active non-cavitated lesions.

Sampling strategy of an epidemiological survey using a satellite image program

ABSTRACT OBJECTIVE To describe the sampling strategy of an epidemiological survey with the aid of satellite images, including details of the multistage probability sampling process. METHODS A probability sample of individuals living in the rural area of Rosário do Sul, state of Rio Grande do Sul, Brazil, aged 15 years old or more, was evaluated. Participants answered questionnaires (medical history, sociodemographic characteristics, habits, alcohol use, quality of life, stress, rumination, and self-perceived periodontal diseases), and were subjected to clinical oral examinations as well as anthropometric measurements (blood pressure, height, weight, abdominal and waist circumferences). Oral evaluation comprehended a complete periodontal exam at six sites per tooth, including the following assessments: furcation involvement; dental abrasion; tooth decay, including the indexing of missing and filled surfaces; O'Brien index; gingival abrasion; oral cavity and lip lesions; complete periapical radiographic exam, and use of prostheses. Besides this oral clinical approach, subgingival plaque, crevicular gingival fluid, saliva, and blood samples were collected. Examiners were trained and calibrated during previous evaluations. A pilot study allowed the logistic of the performed exams to be adjusted as needed. RESULTS Among 1,087 eligible individuals, 688 were examined (63.3%). Age, sex, and skin color data were compared to data from the last demographic census (2010) of the Brazilian Institute of Geography and Statistics, which served to validate the sampling strategy. CONCLUSIONS The careful methods used in this study, in which satellite images were used in the delimitation of epidemiological areas, ensure the quality of the estimates obtained and allow for these estimates to be used in oral health surveillance and health policies improvements.

Oral health related quality of life among pregnant women: a randomized controlled trial

Abstract: The aim of the present study was to compare negative impacts of oral conditions in Oral Heath Related Quality of Life (OHRQoL) assessed by the Oral Health Impact Profile-14 (OHIP-14) scores in pregnant women receiving or not comprehensive periodontal treatment. This randomized controlled clinical trial included pregnant women aged between 18 and 35 years old. Participants were randomized in a test group with 96 and a control group with 114 women. Patients in the test group received comprehensive periodontal treatment, supra and subgingival scaling and root-planning and periodontal maintenance appointments. The OHIP-14 was applied before and after treatment. The primary outcome was changes in OHIP-14 scores after follow-up period. The impact of having received or not comprehensive periodontal treatment on the change of the OHIP-14 scores was also investigated. Both groups showed significant reduction in OHIP-14 scores and effect size for the test group was 0.60 and 0.36 for the control group. Multinomial logistic regression analysis showed that participants of the control group had 5.9-fold odds (CI 95% 1.88-18.52) of worsening in OHIP-14 scores and their perception of oral conditions in relation to test group. Comprehensive periodontal treatment during pregnancy can reduce the negative impacts in OHRQoL.

Condição periodontal e câncer: uma revisão de literatura / Periodontal condition and cancer: a literature review

Introdução: Estudos sugerem a relação entre doença periodontal e condições sistêmicas, dentre elas o câncer. A plausibilidade biológica desta possível associação é o aumento de marcadores inflamatórios na corrente sanguínea devido a uma infecção crônica. Objetivo: Revisar a literatura sobre a associação entre a condição periodontal e câncer em sítios específicos, bem como analisar a influência de fatores de risco e confundimento nessa inter-relação. Materiais e Métodos: A busca da literatura foi realizada na base de dados PubMed, utilizando as palavras-chave: "periodontal diseases"; "tooth loss"; "inflammation"; "risk factors" e "cancer". A busca foi limitada a artigos a partir do ano 2000, com delineamento caso-controle e coorte incluindo seres humanos. Resultados: Alguns estudos demonstraram associações estatisticamente significantes entre avaliações das medidas periodontais e/ ou a perda dentária, principalmente para o câncer oral e do trato gastrointestinal superior, além do câncer de mama, hematológico, de pâncreas e de pulmão, em diferentes populações. Essas associações persistem em alguns estudos mesmo após o ajuste para fatores de risco como o fumo, a condição socioeconômica e o consumo de álcool. Conclusões: Esta revisão de literatura sugere que o quadro inflamatório associado às doenças periodontais tem um possível papel no processo de carcinogênese, independente de outros fatores de risco associados. Porém, nenhum estudo apresentou resultados conclusivos sobre influência do quadro inflamatório periodontal na carcinogênese.(AU)

Introduction: Studies suggest the relationship between periodontal disease and systemic conditions, among them cancer. The biological plausibility of this possible association is the increase in inflammatory markers in the bloodstream due to a chronic infection. Aim: To review the literature about the association between periodontal status and cancer at specific sites and to analyze the influence of risk factors and confounding in this interrelationship. Methodology: The literature search was conducted in PubMed database using the keywords: "periodontal diseases"; "tooth loss"; "inflammation"; "risk factors" and "cancer". The search was limited to articles from 2000, with case-control and cohort including humans. Results: Some studies have shown statistically significant association between periodontal evaluation of measures and/ or tooth loss, especially for oral and upper gastrointestinal tract cancer, and breast cancer, hematologic, pancreas and lung, in different populations. These associations persist in some studies even after adjusting for risk factors such as smoking, socioeconomic status and alcohol consumption. Conclusion: This literature review suggests that the inflammatory process associated with periodontal disease have a possible role in the carcinogenesis process, independent of other risk factors. However, no study showed conclusive results about the influence of periodontal inflammatory process in carcinogenesis. (AU)

Dental flossing as a diagnostic method for proximal gingivitis: a validation study

ABSTRACT This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI). One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss) were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF) and the gingival tissue (GF). The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing). The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey's post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI), bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001) and 50.7% (p < 0.001) of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI), TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004) and 58.3% (p < 0.001) of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion

Abstract Two previous clinical studies evaluated the effect of end-rounded versus tapered bristles of soft manual brushes on the removal of plaque and gingival abrasion. However, the combined effect of an abrasive dentifrice on these outcomes has yet to be understood. The purpose of the present study was to compare the incidence of gingival abrasion and the degree of plaque removal obtained after the use of toothbrushes with tapered or end-rounded bristles in the presence or absence of an abrasive dentifrice. The study involved a randomized, single-blind, crossover model (n = 39) with a split-mouth design. Subjects were instructed to refrain from performing oral hygiene procedures for 72 hours. Quadrants were randomized and subjects brushed with both types of toothbrushes using a dentifrice (relative dentin abrasion = ± 160). Plaque and gingival abrasion were assessed before and after brushing. After 7 days, the experiment was repeated without the dentifrice. The average reduction in plaque scores and the average increase in the number of abrasion sites were assessed by repeated-measures ANOVA and Bonferroni's post-hoc tests. End-rounded bristles removed significantly more plaque than tapered bristles, regardless of the use of a dentifrice. The dentifrice did not improve plaque removal. In the marginal area (cervical free gingiva), no difference in the incidence of gingival abrasion was detected between toothbrush types when used with a dentifrice (p ≥ 0.05). However, the dentifrice increased the incidence of abrasion (p < 0.001), irrespective of the toothbrush type tested. End-rounded bristles therefore removed plaque more effectively without causing a higher incidence of gingival abrasion when compared with tapered bristles. An abrasive dentifrice can increase the incidence of abrasion, and should be used with caution by individuals who are at risk of developing gingival recession.

Correlations between supra- and subgingival clinical parameters in smokers and individuals who have never smoked / Correlações entre parâmetros clínicos supra e subgengivais em fumantes e em indivíduos que nunca fumaram

Introduction: Smoking is a risk factor for prevalence, severity and progression of periodontal disease and appears to suppress marginal periodontium inflammatory response. Purpose: To correlate Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) in smokers and never-smokers, as well as GBI and bleeding on probing (BOP ) in these groups. Material and method: We used baseline data of one quasi-experimental study in which 11 smokers and 14 subjects who never smoked were submitted to clinical periodontal examinations between September 2010 and October 2011. Result: The correlation between VPI and GBI was positive for both groups, it was strong and statistically significant in subjects who had never smoked and moderate in smokers. Regarding GBI and BOP correlations were moderate for smokers and weaker for individuals who had never smoked. Conclusion: Smokers have lower strength correlation between VPI and GBI compared to individuals who had never smoked resulting in a less pronounced marginal gingival bleeding. .

Introdução: O hábito de fumar é um fator de risco importante na prevalência, progressão e gravidade das doenças periodontais e parece suprimir a resposta inflamatória marginal no periodonto. Objetivo: Correlacionar Índice de Placa visível (IPV) e Índice de Sangramento Gengival (ISG) em fumantes e indivíduos que nunca fumaram, bem como correlacionar ISG e o sangramento à sondagem (SS) nesses dois grupos. Material e método: Foram utilizados dados de baseline de um estudo quasi-experimental, no qual 11 pacientes fumantes e 14 indivíduos que nunca fumaram foram submetidos a exames clínicos periodontais no período de setembro de 2010 e outubro de 2011. Resultado: A correlação entre IPV e ISG foi positiva para ambos os grupos, sendo forte e estatisticamente significante nos indivíduos que nunca fumaram e moderada nos fumantes. Com relação ao ISG e SS houve moderada correlação para os fumantes e fraca para os indivíduos que nunca fumaram. Conclusão: Fumantes apresentam uma correlação entre IPV e ISG de menor força em relação aos indivíduos que nunca fumaram resultando em um sangramento gengival marginal menos pronunciado. .

Avaliação da área residual de ligamento periodontal em dentes extraídos – estudo piloto / Evaluation of residual area of periodontal attachment in extracted teeth – Pilot Study

A doença periodontal está entre as principais doenças que podem afetar a cavidade bucal e é uma das causas mais expressivas de perda dentária no mundo. Sabe-se que, na maioria das pessoas, com medidas preventivas e terapêuticas adequadas há a possibilidade de manutenção dos dentes na cavidade bucal em conforto e função por toda a vida. O objetivo do presente estudo foi avaliar o nível de ligamento periodontal remanescente em dentes extraídos, recolhidos no gabinete odontológico da Secretaria Municipal de Rosário do Sul-RS. Consiste em um estudo piloto, realizado por meio de coleta de dentes extraídos no período de um mês. Fichas contendo gênero, idade e motivo da extração foram preenchidas pelo dentista e recolhidas juntamente com os dentes. Trinta e oito dentes foram corados e avaliados microscopicamente para a verificação de quanto apresentavam de inserção periodontal. A média da área de ligamento periodontal residual foi de 53,83%. A maior parte dos dentes apresentou coroa íntegra ou pequena destruição coronária e doença periodontal foram a principal razão encontrada para as exodontias. Pode ser concluído que uma quantidade significativa de ligamento periodontal residual foi observada. Porém, por ter sido este um estudo piloto, outros estudos são necessários para que os resultados sirvam de base para o planejamento de tratamento periodontal no atendimento público de saúde.

Periodontal disease is among the major diseases that can affect the oral cavity and it is one of the most significant causes of tooth loss in the world. It is known that with appropriate preventive and therapeutic measures is possible to maintain the teeth in the oral cavity in comfort and function throughout life for most people. The aim of this study was to evaluate the level of remaining periodontal ligament in extracted teeth, collected in the dental office of Secretaria Municipal de Saúde de Rosário do Sul – RS. It consists of a pilot study, conducted through the collection of extracted teeth in a month. Records containing gender, age and reason for extraction were filled by the dentist and collected together with the teeth. Thirtyeight teeth were stained and evaluated microscopically for verification of how much periodontal attachment they had. The mean residual area of the periodontal ligament was 53,83%. Most of the teeth was fully crown or small coronal destruction and periodontal disease is the main reason found for extractions. It can be concluded that a significant amount of residual periodontal ligament was observed. However, because it was a pilot study, further studies are needed to make results as a basis for planning periodontal treatment in public health care.

Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

Gingival overgrowth (GO) is a frequent finding in patients treated with cyclosporine (CsA). This study investigated the prevalence and severity of GO in patients who received kidney transplant and CsA therapy, as well as associations with pharmacological and clinical factors. This cross-sectional study included 63 kidney transplant recipients who were treated with CsA in a university hospital. Demographic, pharmacological, and periodontal data were collected. The primary variable was GO. Independent sample t- and chi-square tests were used to compare means in groups with versusl without GO. The response rate was 86.3%. Overall, 40% of patients had some degree of GO. Eleven individuals presented GO scores > 10%, and 5 individuals reached 30%. The mean GO percentage was low (6.79 ± 15.83). Patients that were concurrently under nifedipine treatment showed a non-significant trend toward a greater prevalence of GO. Mean CsA dosage and serum levels were 3.20 ± 0.94 mg/kg/d and 156.12 ± 162.75 ng/mL, respectively. There were no statistically significant differences between patients with versusl without GO nor between the groups receiving nifedipine, no drug, or verapamil. The GO prevalence and severity rates were lower than those reported in previous studies and seemed to be independent of drug interactions.

Gingival inflammation and platelet count in patients with leukemia: preliminary results

Leukemia has been associated with oral manifestations. However, the available literature on this topic consists of mostly reports of cases, without data about the periodontal parameters that may be under the influence of hematologic factors. The aim of this cross-sectional study was to assess the correlation between the Gingival Index and Bleeding on Probing with the platelet count in patients with leukemia. Patients with diagnosis of any kind of leukemia, at any stage of treatment, having a minimum age of 14 years, treated at the Department of Hematology-Oncology of the University Hospital of Santa Maria, Brazil, between December 2009 and March 2010, were assessed. Excluded patients were: edentulous, with orthodontic appliances, with psychomotor disturbances, requiring antibiotic prophylaxis for the examinations, or those using medications associated with gingival swelling. Two trained and calibrated examiners evaluated the Plaque Index, Gingival Index (GI), Probing depth, Bleeding on Probing (BOP), and Clinical Attachment Loss. Hematologic data were collected from a blood test performed on the same day as the periodontal examination. Thirty-seven patients (26 males), aged between 15 and 80 years (mean age 41.7 ± 18.31) were evaluated. Correlation between platelet count and BOP (p > 0.05), or between platelet count and GI (p > 0.05), were both weak (Pearson's correlation coefficient r = 0.171 and r = -0.003, respectively) and not statistically significant. It can be concluded from the preliminary results that the low platelet count was not correlated with the higher prevalence of gingival and periodontal bleeding in patients with leukemia.

Alterações no fluido gengival em sítios sem sinais clínicos de inflamação - ensaio com duas escovas dentais / Alterations in gingival fluid in sites without clinical signs of inflammation - trial with two toothbrushes

O presente estudo objetivou avaliar alterações no volume de fluido crevicular gengival (FCG) em sítios com ausência de sangramento gengival; 20 estudantes do primeiro ano de Odontologia foram incluídos. O delineamento experimental foi ensaio clínico cruzado. Volume de FCG foi medido em três sítios por paciente e as alterações no volume de FCG nos sítios com índice de sangramento gengival (ISG) igual a zero foram avaliadas. Estudantes foram alocados, após randomização, em dois grupos em cada período experimental para a utilização de escova iônica ou escova convencional. Dois períodos de 28 dias separados por um wash-out de 14 dias foram utilizados. Um examinador treinado realizou o ISG e o volume de FCG foi medido com tiras de papel absorvente e quantificado através do Periotron, no começo e no final de cada período experimental. Médias das alterações percentuais no volume de FCG foram comparadas entre os grupos pelo teste t pareado,  = 5%. Uma redução no percentual de volume de FCG foi observada nos dois grupos (-17,56 ± 20,12 e -22,22 ± 21,02) para a escova convencional e iônica respectivamente. Diferenças estatisticamente significantes não foram observadas entre os grupos. Pode-se concluir que em indivíduos com ISG igual a zero, uma redução no volume de FCG foi observada independentemente da escova utilizada ou do uso de recursos de controle de placa interproximal.

Doenças periodontais na gravidez: curso clínico e resposta ao tratamento / Periodontal diseases in pregnancy: clinical course and response to the treatment

A associação entre o período gestacional e o periodonto vem sendo relatada tendo diferentes plausibilidades biológicas. 0 periodonto é reconhecido como tecido alvo para a ação dos hormônios que tem seus níveis elevados ao longo da gestação. Uma alta prevalência de alterações periodontais tem sido relatada nesse período. Estudos recentes tem questionado a influência do período gestacional em produzir alterações significativas no periodonto. Atualmente, uma possível associação entre a presença de doenças periodontais na gestação e desfechos obstétricos tais como, o nascimento de bebês prematuros e/ou com baixo peso tem sido relatada na literatura. Para o planejamento de políticas de saúde que visem o bem estar das gestantes, bem como almejem a realização de procedimentos preventivos e terapêuticos é necessário o conhecimento de como esse período influência os diferentes órgãos, assim como diferentes condições sistêmicas e comportamentais podem interferir no curso fisiológico da gestação. Avaliar as alterações periodontais associadas a períodos com diferentes concentrações hormonais, tais como durante a gestação e no período pós-parto, assim como comparar a eficácia da terapia periodontal realizada durante a gestação com os resultados obtidos quando a mesma é executada após o parto foram os objetivos dessa tese. Gestantes com até 20 semanas de gestação realizando pré-natal no Hospital Materno Infantil Presidente Vargas, foram convidadas a participar do estudo e randomizadas em dois grupos (teste e controle). Exames clínicos avaliando a presença de placa (IPI), inflamação gengival (IG), presença de fatores retentivos de placa (FRP), profundidade de sondagem (PS), nível clínico de inserção (NIC), sangramento à sondagem (SS) e volume de fluido crevicular gengival (FCG) foram realizados no início do estudo e repetidos entre a 26-28ª semanas de gestação, 30 dias após o parto e 30 dias após a realização do tratamento...

The association between gestational period and the periodontium has been related with different biological plausibilities. The periodontium is recognized as a target tissue for the action of the hormones whose levels increase during pregnancy. A high prevalence of periodontal alterations has been reported in that period. Recent studies recent have been questioning the influence of the gestational period in producing significant alterations in the periodontium. Currently, a possible association among the presence of periodontal diseases during pregnancy and negative obstetric outcomes such as preterm labor and/or low birth weight infants has been reported. For the planning of health policies that seek the well being of pregnant women, as well for achieving preventive and therapeutic measures it is necessary to know how this period influences different organs, as well as how different systemic and behavioral conditions may interfere in the physiologic course of pregnancy. To evaluate periodontal alterations associated periods with different hormonal concentrations such as during pregnancy and postpartum, as well comparing the efficacy of periodontal therapy performed during pregnancy with the results obtained when the same therapy is performed after delivery were the objectives this thesis. Pregnant women with up to 20 gestational weeks accomplishing prenatal care in the Hospital Materno Infantil Presidente Vargas were invited to participate in the study and randomized in two groups (test and control). Clinical examinations comprised the presence of plaque (PII), gingival inflammation (GI), presence of plaque retentive factors (FRP), probing depth (PD), clinical attchment level (CAL), bleeding on probing (BOP) and gingival crevicular fluid (CGF) volume and was performed at baseline and repeated between 26-28th gestational weeks, 30 days after delivery and 30 days after the completion of periodontal treatment for women randomized for...

Assessment of the frequency of routine removal of dental plaque prior to caries diagnosis by dentists in three cities in southern Brazil

The aim of this study was to assess the frequency of routine use of dental prophylaxis prior to visual inspection, in order to diagnose caries, by dentists with different lapses of time after graduating time. One hundred and fifty one Brazilian dentists were interviewed in 3 Brazilian cities to determine if they usually remove dental plaque prior to visual inspection for caries diagnosis. The dentists were stratified according to year of graduation. The association between the lapse of time after graduating and the practice of routinely removing dental plaque before clinical examination was tested using the chi-square test with a significance level of 5 percent. Only 28.5 percent of the dentists reported that they usually remove dental plaque prior to clinical examination. The dentists who graduated in the last 15 years presented the lowest percentages of plaque removal prior to clinical examination (15.1 percent), whereas the more experienced dentists reported that they perform prophylaxis more frequently. Of the professionals who graduated from 1960-1975, 23.9 percent reported that they performed dental plaque removal prior to diagnosis, whereas the figure for those graduating from 1976-1990 was 46.2 percent. Most of the dentists interviewed reported that they did not remove dental plaque prior to performing visual diagnosis of caries.

Criteria adopted by dentists to indicate the extraction of periodontally involved teeth

When dealing with patients with periodontal disease of variable severities, dentists must often choose between treating and restoring the involved tooth or indicating its extraction. Different criteria have been adopted in this decision-making process. The purpose of this study was to evaluate the criteria adopted by dentists to indicate the extraction of teeth with periodontitis. Dentists were interviewed at their private practices in three cities of the state of Rio Grande do Sul, Brazil. The evaluated criteria included severity of attachment loss, tooth mobility, furcation involvement, prosthetic planning, periodontal-endodontic lesion, possible systemic involvement due to the presence of periodontitis, referral to a periodontist for evaluation, radiographic bone loss greater than 50 percent, presence of extensive caries, socio-economic and cultural status of the patient, among others. The most often adopted criteria to indicate the extraction of periodontally affected teeth were the presence of mobility (37.5 percent), severity of attachment loss (24.3 percent) and radiographic bone loss greater than 50 percent (21.2 percent). The results of the present study demonstrated the difficulties faced by dentists to indicate the extraction of teeth with severe attachment loss, in addition to the establishment of an adequate prognosis. Aspects associated with the past disease were still the most often reported to indicate the extraction of teeth for periodontal reasons.

Recursos diagnósticos de doenças periodontais utilizados por cirurgiões dentistas de três cidades do Rio Grande do Sul / Diagnosis tools ot periodontal disease used by dentists trom 3 cities in RioGrande do Sul

O objetivo do presente estudo foi através de uma entrevista realizada com cirurgiões-dentistas (CDs), com diferentes tempos de graduação, avaliar os instrumentos utilizados na consulta inicial, bem como avaliar os critérios diagnósticos utilizados na avaliação do periodonto. Os CDs foram entrevistados em seus consultórios privados em três cidades do Rio Grande do Sul.As alternativas na avaliação do periodonto foram: cor e textura do tecido gengival, presença de placa bacteriana, presença de sangramento após sondagem, exame do nível de inserção, presença de mobilidade, presença de contatos dentários prematuros, presença de áreas com envolvimento de furca, determinação de vitalidade pulpar; presença de sulcos com profundidade entre 2-3 mm, presença de supuração,dentre outros. 42, I% dos CDs relataram o uso de sonda milimetrada na consulta inicial.Quando os CDs foram entrevistados com relação aos parâmetros utilizados na avaliação do periodonto, a resposta com o maior percentual foi a avaliação da cor e textura do tecido gengiva I(67, 1%), seguidos da presença de sangramento a sondagem (63,2%) e presença de placa bacteriana (53,9%). Conclusões: Uma parcela significativa de CDs relata não utilizar sonda periodontal na consulta inicial e pode não estar examinando e diagnosticando doenças periodontais. Existe a necessidade de programas de educação continuada que possibilitem ao clínico, acesso aos novos conhecimentos teóricos que possibilitem uma conduta clínica de acordo com o conhecimento vigente.

Use of radiographs for periodontal diagnosis in private practice

The aim of the present study was to determine the percentage of dentists who use radiographic examination on the initial appointment, and establish the relation between the use of periodontal probe and graduation year. Dentists were interviewed in their private offices in three cities in Rio Grande do Sul. They were asked about the routine use of radiographic examination and, if applicable, what technique was applied and what clinical instrument was used at the first appointment. Opened and closed questions were included in the interview and for some of them more than one answer was possible. A significant number of dentists (62.9%) reported some kind of radiographic examination at the initial appointment. Among the radiographic techniques, the periapical was the most cited (74.3%), followed by the panoramic (36.2%) and bite-wing (32.9 %) techniques. There was an association between the use of periodontal probe and the use of radiographic examination at the initial appointment. Dentists who used periodontal probe used radiographic examination more frequently (p=0.010). More recently graduated dentists (1991-2005) used radiographic examination more than the others (p=0.022). In conclusion, a large number of dentists reported the use of radiographic examination at the initial appointment. There was an association between the use of this examination technique and the use of the periodontal probe; recently graduated dentists used radiographic examinations more frequently than the others.

O objetivo do presente estudo foi determinar o percentual de cirurgiões dentistas (CDs) que utilizam o exame radiográfico para diagnóstico na consulta inicial, assim como realizar associações entre o uso de sonda periodontal, tempo de conclusão da graduação e uso de radiografias. Os CDs foram entrevistados em seus consultórios particulares em três cidades do Rio Grande do Sul. Foram questionados a respeito da utilização rotineira do exame radiográfico, e quando utilizado qual a técnica realizada e quais instrumentos clínicos utilizava na consulta inicial. Foram utilizadas perguntas abertas e fechadas nas entrevistas, sendo que para algumas delas mais de uma resposta era possível. Um alto percentual dos CDs entrevistados (62.9%) faz uso rotineiro de algum tipo de radiografia na consulta inicial. Entre as técnicas radiográficas, a periapical foi a mais relatada (74,3%), seguidas pela panorâmica (36,2%) e interproximal (32,9%). Existe uma associação entre o uso de sonda periodontal e o uso de exame radiográfico na consulta inicial. CDs que utilizam a sonda periodontal também utilizam mais rotineiramente o exame radiográfico (p=0.010). Percebe-se também que CDs formados recentemente (1991-2005) utilizam mais o exame radiográfico quando comparados aos demais (p=0,022). Conclusões: Um elevado percentual de CDs utiliza exame radiográfico na consulta inicial. Existe uma associação entre a utilização deste exame e a utilização de sonda periodontal e CDs formados mais recentemente utilizam o exame radiográfico mais freqüentemente.