Enfermedades gingivales en niños y adolescentes: primera parte / Gingival diseases in children and adolescents: first part

Las características de los tejidos gingivales y periodontales son diferentes en niños y adolescentes. La clasificación actual de enfermedades gingivales incluye a las gingivitis producidas por el biofilm y a las no producidas por el biofilm de placa. Las gingivitis son reversibles. Las condiciones de riesgo individuales, de origen externo o de origen sistémico, influyen en el agravamiento. La prevención de la gingivitis está enfocada en el control de los factores de riesgo.

Impacto das equipes de saúde bucal da Estratégia da Saúde da Família na saúde bucal de adolescentes do sul do Brasil / Impact of oral health teams of the Family Health Strategy on the oral health of adolescents in the south of Brazil

Resumo A Estratégia da Saúde da Família (ESF) tem demostrado resultados efetivos em indicadores de saúde. Neste estudo transversal foi avaliado o impacto das equipes de saúde bucal (ESB) da ESF na saúde bucal de 2581 adolescentes escolares, com idade de 12 e 15-19 anos de 36 municípios, 19 com e 17 sem ESB/ESF. Quatro dentistas realizaram exames bucais. Situação socioeconômica, uso e acesso aos serviços de saúde foram coletados em questionário estruturado. Presença das ESB na ESF foi a principal variável independente. Os desfechos foram CPOD e seus componentes, dor de dente, sangramento gengival e cálculo dentário. Os dados foram analisados pelas médias das regressões binomiais negativas e Poisson. O efeito da ESB/ESF e de variáveis individuais foi ajustado em modelo multinível. No modelo bruto não houve associação das ESB na ESF com nenhum dos desfechos analisados. Após o ajuste, jovens de áreas não cobertas pela ESB/ESF tiveram quase a metade da perda de dentes dos adolescentes das áreas cobertas (RM = 0,64 IC95%; 0,43-0,94).

Abstract The Family Health Strategy (FHS) has produced effective results in health indicators. In this cross-sectional study, the impact of the oral health teams (OHT) of the Family Health Strategy was evaluated on the oral health of 2581 adolescent schoolchildren aged 12 and 15-19 years in 36 municipalities (19 with and 17 without OHT/FHS). Four dentists performed oral examinations. Socioeconomic status, the use of and access to health services were assessed via a structured questionnaire. The presence of the OHT in the FHS were the main independent variables. Outcomes were Decayed, Missing, Filled Teeth (DMFT) and its components, toothache, gingival bleeding, and dental calculus. The data were analyzed by means of negative binomial and Poisson regression. Multilevel analysis was conducted to adjust the outcomes to OHT/FHS and individual variables. In the unadjusted model there was no association between the OHT in the FHS and the outcomes analyzed. After adjustment, young people in areas not covered by the OHT/FHS had almost half of the tooth loss of adolescents from the areas covered (RM = 0.64 CI 95%, 0.43 to 0.94).

Conditions for oral health in patients with autism / Condiciones de salud oral en pacientes con autismo

Autism is characterized as a behavioral disorder. The autistic patient has some difficulties with common life routines, such as oral hygiene and also improper diet. As a consequence the refusal of physical contact, the implementation of brushing and flossing by caregivers is difficult. The present study aimed to conduct an epidemiological study of autistic patients in treatment at the Rehabilitation Center and Neurological Organization in North of Brazil, adopting the CPO-D and ceo-d. The clinical examination has been performed with the patient sitting in chairs, at the Rehabilitation Centre itself, under artificial fluorescent light intended for room lighting. From 26 patients included in the study, 76.9 % of subjects were male with a mean age of 13 years. Fifty percent had caries, and 11.5% had lesions on the gums. The mean ceo-d of children 2­8 years was 0.67. In patients 10­15 years and 20­40 years, the mean CPO-D was 0.70, and 3.00, respectively. From the study, the most significant data, seen was that half of autistic patients had carious lesions. It is vital to improve oral health conditions in these patients and by using preventive dentistry, analyze their susceptibility to oral diseases.

El autismo se caracteriza como un trastorno conductual. El paciente autista tiene algunas dificultades en las rutinas ordinarias de la vida, tales como la higiene oral. Como consecuencia, la negativa al contacto físico, la implementación del cepillado y uso de hilo dental es difícil para los cuidadores. Este estudio tuvo como objetivo llevar a cabo un estudio epidemiológico de los pacientes autistas en el Centro de Rehabilitación y la organización neurológica en el norte de Brasil, adoptando el CPOD y ceod. El examen clínico se realizó con el paciente sentado en una silla en el propio Centro de Rehabilitación, bajo una luz fluorescente artificial para la iluminación de la habitación. Veintiseis pacientes fueron incluidos en el estudio, el 76,9 % de los sujetos eran varones con una edad media de 13 años con un 50 % de caries, y en un 11,5 % se observaron lesiones gingivales. La media ceod de los niños de 2 a 8 años fue de 0,67. En los pacientes de 10­15 años y 20­40 años, el promedio CPOD fue de 0,70 y 3,00, respectivamente. A partir del estudio se pudo determinar que la mitad de los pacientes autistas tienen caries. Es importante la educación de estos pacientes para mejorar la salud oral y la aplicación de la odontología preventiva.

Oral granuloma gravidarum: a retrospective study of 41 cases in Southern Brazil

Granuloma gravidarum (GG) is an inflammatory lesion, which develops in the oral mucosa of pregnant women in response to chronic low-grade irritants, under the influence of hormonal factors. Objective To characterize GG clinically by means of a retrospective study of the cases of the Oral Medicine Division, São Lucas Hospital, Brazil. Material and Methods Cases of GG diagnosed between 1980 and 2012 were analyzed. Data were obtained referring to the age of the patients, lesion location, clinical features, as well as the presence of local irritants. The gestation period in which the lesion developed was also investigated. Results Forty-one cases of GG were found. The lesions developed predominantly in the third trimester of pregnancy (51.22%) and the mean age of the patients was 28 years. Most GG was found in the gingiva (73.17%), was reddish color and had a mean diameter of 1.5 cm. Local irritants were involved in 75.6% of the cases. Conclusions The hormonal conditions of pregnancy can have an impact on the oral cavity, predisposing the patient to inflammatory lesions such as GG. .

Problemas sociales relacionados con el estado de salud periodontal de la población infantil urbano-marginal venezolana / Social problems related with the periodontal health status of the infantile urban marginal population of Venezuela

En los países subdesarrollados, donde las intervenciones comunitarias de tipo promocional o protector no han sido firmemente establecidas y en los que no existe seguimiento y control de los programas de educación y prevención para la salud, la mayoría de los individuos presentan gingivitis crónica desde edades tempranas, alcanzando esta su máxima expresión antes de los 20 años y manteniéndose igual durante toda la vida. A veces avanza a periodontitis, si no es tratada adecuadamente, lo cual tiene un impacto considerable tanto sobre la salud pública general como sobre los recursos económicos dedicados a mantenerla. En Venezuela, a pesar de que se cuenta con odontólogos especializados muy competentes, hospitales y clínicas con estructura e infraestructura adecuadas, la población más pobre carece de los servicios de salud bucal que necesitan, ya que existe un encarecimiento desmedido de los servicios médicos y estomatológicos privados. Se escribe este artículo con el objetivo de abordar los problemas sociales que más influyen en el estado de salud periodontal de la población infantil urbano marginal venezolana. La deficiente organización social, la exclusión de las clases con menos ingresos, las escasas medidas preventivo educativas sobre salud bucodental aplicadas por los servicios locales de salud, la pobre valoración de la población acerca de su salud general y bucal, la falta de motivación y por consiguiente de programas educativo-preventivos, fueron los problemas sociales más relacionados con el deterioro de la salud periodontal de esta población.

In the underdeveloped countries where the promotional or protecting communitarian intervention have not being firmly established, and where there is not follow-up and control of the health education and prevention programs, most of the individuals have Chronic Gingivitis since early ages, it reaches its maximal expression before arriving to 20 years old, and keeps the same during the whole life; sometimes it develops to periodontitis, if it is not adequately treated, having a considerable impact both on the general public health and on the economic resources used to keep it. Although there are in Venezuela very competent specialized odontologists, hospitals and clinics with the adequate structures and infrastructures, the poorest population does not have access to the oral health services they need, because there is a an excessive price raise of the private stomatologic and medical services. We write this article with the objective of dealing with the social problems striking on the periodontal health of the Venezuelan infantile urban marginal population. The deficient social organization, the exclusion of the classes with fewer incomes, the scarce preventive educative measures on oral dental health applied by the local health services, the poor evaluation the population makes on their general and oral health, the lack of motivation and therefore of educative-preventive programs, were the social problems related with the worsening of this population’s periodontal health.

A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan

OBJECTIVE: The aim of this retrospective analysis was to determine the age, gender, frequency and distribution of trauma-associated hard tissue and soft tissue lesions of the oral and maxillofacial region in a population from southern Taiwan. PATIENTS AND METHODS: Approximately 10 percent of the 27,995 biopsy records of patients with history of trauma resulting in lesions who were treated at our institution between 1991 and 2006 were examined for this study. RESULTS: In the included records, there were 2,762 soft tissue and 26 hard tissue lesions. Mucocele was the most frequent trauma-associated soft tissue lesion (955 cases). The youngest patients were those who presented with mucocele (mean age = 27.3 years), while the oldest patients were those with peripheral giant cell granuloma (58 years). The lower lip was the most frequent site of occurrence of mucocele (676, 64.5 percent) and was also the predominant site of occurrence of all soft tissue lesions (815, 29.5 percent), followed by the buccal mucosa (654, 23.4 percent) and the tongue (392, 14.2 percent). Trauma-associated hard tissue lesions included only osteoradionecrosis (24 cases) and traumatic bone cysts (2 cases). CONCLUSION: As little data of this nature have been reported from populations of Asian developing countries, the findings of this retrospective analysis is valuable for epidemiological documentation of type of traumatic oral lesions as well as for informing the professionals and the layman about the importance of this category of oral lesions.

Dor nos dentes e gengivas e fatores associados em adolescentes brasileiros: análise do inquérito nacional de saúde bucal SB-Brasil 2002-2003 / Dental and gingival pain and associated factors among Brazilian adolescents: an analysis of the Brazilian Oral Health Survey 2002-2003

Estimou-se a prevalência de dor nos dentes e gengivas e fatores associados em adolescentes brasileiros de 15 a 19 anos de idade. Foram utilizadas informações de 16.126 adolescentes participantes do levantamento epidemiológico nacional de saúde bucal - SB Brasil 2002-2003. O desfecho foi o relato de dor nos dentes e gengivas nos últimos seis meses. As variáveis exploratórias foram: renda per capita, escolaridade, condição de estudo, sexo, cor da pele, idade, localização geográfica da residência, tipo de serviço odontológico utilizado pela última vez, tempo decorrido da última consulta odontológica, índice CPO-D e seus componentes, cálculo dentário e o índice de estética dental. Foram realizadas análises brutas e múltiplas utilizando a regressão de Poisson. A prevalência da dor de dentes e gengivas foi de 35,6 por cento (IC95 por cento: 34,8-36,4). A prevalência de dor foi maior nas meninas, naqueles pertencentes a famílias com baixa renda per capita, nos não estudantes e estudantes de escola pública e naqueles com baixa escolaridade para a idade. Indivíduos que apresentaram altos níveis de cárie e cálculo dentário também apresentaram maiores prevalências do desfecho. A dor nos dentes e gengivas em adolescentes pode ser considerada um problema relevante em saúde pública sugerindo a necessidade de ações preventivas e de promoção da saúde.

The aim of this study was to estimate the prevalence of dental and gingival pain and associated factors among Brazilian adolescents (15-19 years of age). Data from 16,126 adolescents who participated in the Brazilian Oral Health Survey SB-Brazil 2002-2003 were used. The outcome measured was dental and gingival pain in the last six months. Independent variables were per capita income, schooling, school enrollment, gender, skin color, age, area of residence, time since last dental appointment, type of dental service, DMFT index and its components, dental calculus, and Dental Aesthetic Index. Simple and multiple Poisson regression analyses were performed. Prevalence of dental and gingival pain was 35.6 percent (95 percentCI: 34.8-36.4). Increased prevalence of pain was associated with: female gender, low income, non-students, students enrolled in public schools, and grade-for-age lag. In addition, adolescents with high levels of dental caries and dental calculus also reported higher prevalence of dental pain. Dental and gingival pain can be considered a relevant public health problem, suggesting the need for preventive measures.

Estado bucal en niños preescolares hijos de argentinos y migrantes / Oral status in preschool children descending from Argentines and migrants

La migración boliviana, peruana y paraguaya a la Argentina es parte de los procesos sociales de la región. El objetivo de este trabajo fue analizar el estado dentario y gingival de niños preescolares según nacionalidad de los padres. Material y métodos: fueron incluidos 342 niños que asisten a dos jardines de infantes dependientes del Go bierno de la Ciudad de Buenos Aires. Sobre los mismos se realizó: a) historia médica para cumplimentar los criterios de inclusión/exclusión. b) índice de placa (IP), índice gingival (IG), examen dentario, registro documental y obtención de ceod, ceos y sus componentes. Los niños se agruparon según nacionalidad de los padres. Se calculó la media artimética y el error estándar de los indicadores clínicos, análisis de varianza y prueba de Duncan y Kruskal Wallis. Resultados. En los 3 grupos el componente c fue de 4,69 +- 0,37; 5,14 +- 0,35 y 7,27 +- 0,41 respectivamente. Los hijos de inmigrantes bolivianos (grupo 3) registraron el componente c, cs, ceod, ceos e IG más elevado, con diferencias significativas con los grupos 1 y 2 (P<0,001). Los grupos 1 y 2 mostraron diferencias significativas en el IP (P<0,001), mientras que el grupo 3 no registró diferencias al considerar este indicador. Los niños libres de caries fueron en el grupo 1: 26,3 por ciento; grupo 2: 15 por ciento y grupo 3: 5,5 por ciento. Conclusión: la muestra revela un elevado nivel de caries en la dentición primaria, aunque los índices más elevados se registraron en los hijos de ambos padres migrantes bolivianos.

Enfermedad gingival: Resultados obstétricos / Gingival disease: Obstetric results

OBJETIVO: determinar los resultados obstétricos en las gestantes con enfermedad gingival, vincular la enfermedad gingival con los posibles resultados obstétricos en cuanto a: tiempo que terminó la gestación, peso del producto, Apgar y eventos sépticos obstétricos (sepsis ovular, rotura prematura de membrana y sepsis puerperal).También conocer el grado de conocimiento por las pacientes de las medidas de higiene bucal. MÉTODOS: Se realizó un estudio observacional analítico de cohorte a todas las gestantes pertenecientes al policlínico docente "Luis Li Trejent" del municipio Güines que se encontraban en el tercer trimestre de embarazo, en el mes de agosto del año 2006. Nos auxiliamos para la selección de esta muestra del registro de embarazadas existente en el centro. Se aplicó una planilla recopiladora de datos con el objetivo de investigar la presencia o no de enfermedad gingival y ver sus resultados obstétricos. RESULTADOS: La forma leve y moderada de la enfermedad gingival fue la más encontrada. Esta enfermedad es inversamente proporcional a la escolaridad. Se observó mayor aparición del parto pretérmino y el bajo peso al nacer en las gestantes enfermas, una relación directa entre la presencia de enfermedad gingival y los eventos sépticos estudiados durante la gestación, parto y puerperio, así como los estados de nutrición desfavorable. CONCLUSIONES: Al hacer un análisis de cómo influyó la enfermedad gingival en los resultados obstétricos pudimos concluir que en las gestantes investigadas fue considerable la aparición de la malnutrición, asma bronquial y el deficiente conocimiento de la higiene bucal por lo que no se logra el alta estomatológica en la mayoría de las gestantes, todo lo cual favorece la aparición de la enfermedad gingival(AU)

OBJECTIVE: to determine the obstetric results in pregnant women with gingival disease; to link the gingival disease with the possible obstetric results as regards time of gestation, weight of the infant, apgar score and obstetric septic events (ovular sepsis, early membrane rupture and puerperal sepsis); and to define the knowledge degree of the patients about the oral hygiene measures. METHODS: An observational analytical cohort study of all the pregnant women belonging to "Luis Li Trejent" teaching polyclinic of Güines municipality that were in the third trimester of pregnancy in August 2006 was conducted. The registry of pregnant women of the centre was used to select this sample. A form was given to them to collect data in order to investigate the presence or not of gingival disease and to know its obstetric results. RESULTS: The mild and moderate forms of gingival disease were the most found. This disease is inversely proportional to educational level. A greater appearance of preterm delivery and low birth weight were observed in the sick pregnant women, as well as a direct relation between the presence of gingival disease and the septic events studied during gestation, delivery and puerperium, and the unfavourable nutritional states. CONCLUSIONS: On analyzing how the gingival disease influenced on the obstetric results, it was concluded that there was a considerable appearance of malnutrition and bronchial asthma and a deficient knowledge of oral hygiene in the studied pregnant women, which made difficult the stomatological discharge in most of these patients, and favored the emergence of gingival disease(AU)

[Prevalence of peripheral soft connective tissue lesions in patients referred to pathology department of Shahid Beheshti dental school, 1981-2006]

Peripheral soft connective tissue lesions are common in oral mucosa and despite their benign nature can make problems for patients. According to our knowledge, a comprehensive study for these lesions was not performed in Iran General practitioners are commonly encountered affected with these lesions. They have not enough information about their clinical prevalence, may make mistake in diagnosis and treatment plan. The aim of this study was to evaluate peripheral soft connective tissue lesions prevalence in patients referred to Pathology department of Shahid Beheshti Dental School during 1981-2006. In this descriptive retrospective study [existing data], cases were patients that referred to Pathology Dept. [1981-2006] with complete files recorded in the Dept. Questionnaires included age, sex, location of lesion and lesion type which were retrieved from patient's files. The incomplete files were excluded. Finally the collected data were analyzed descriptively by SPSS Ver 11.0 software. A total number of 900 cases had peripheral soft connective tissue lesions during 1981-2006 from 4529 files in the department. 29.7% [268 cases] were irritation fibroma, 21.9% [197 cases] were peripheral giant cell granuloma, 19.5% [176 cases] were pyogenic granuloma, 19.3% [174 cases] were epulis fissuratum, 8% [72 cases] were peripheral ossifying fibroma, 0.5% [5 cases] were giant cell fibroma, 0.4% [4 cases] were oral focal mucinosis and 0.4% were inflammatory papillary hyperplasia. The most prevalent age was 50-59 years [18.1%] and 20-29 years [16.3%]. The lesions were more prevalent in women [61.9%] and were 38.1% in men. The most prevalent site was gingival [54.3%] and the least prevalent site was floor of the mouth [0.1%]. 19.9% peripheral soft connective tissue lesions were reported, the most frequent lesion was irritation fibroma that was similar to other reports

Prevalência e severidade da doença periodontal e acúmulo de biofilme dentário em crianças da clínica de odontopediatria da UFPB / Prevalence and serverity of the periodontal disease and accumulation dental biofilm in children from the Paediatric Dentistry Clinic at UFPB

Este trabalho objetivou verificar a prevalência e a severidade da doença periodontal em pacientes da Clínica de Odontopediatria da Universidade Federal da Paraíba, relacionando os níveis de doença com o gênero e o acúmulo de biofilme. Compôs a amostra 64 crianças na faixa etária de 09 a 11 anos que estavam em atendimento na referida Clínica. Foram coletados, por uma única examinadora, índices de biofilme dentário (IHOS e O'leary) e doença gengival (ISG), e registradas a presença de recessão gengival e de bolsa periodontal. Os dados foram analisados com o auxílio do programa SPSS e tratados estatisticamente pelos testes do Qui-quadrado e Exato de Fisher (p<0,05). Os resultados mostraram as prevalências: gengivite 100 por cento; recessão gengival 21,8 por cento; bolsa periodontal 4,6 por cento. Níveis de higiene oral insatisfatórios foram encontrados em 89,1 por cento e 54,7 por cento das crianças pelos índices de O'leary e IHOS, respectivamente. A presença de gengivite, recessão gengival e bolsa periodontal mostraram-se respectivamente em 62,2 por cento, 16,2 por cento e 5,4 por cento no gênero feminino e 59,3 por cento 29,6 por cento e 3,7 por cento no gênero masculino, não observando diferença estatisticamente significante de acometimento das alterações entre os gêneros. O acúmulo de biofilme mostrou níveis insatisfatórios pelos índices de O'leary e IHOS, respectivamente, em 88 por cento e 54,1 por cento para o gênero feminino e 89 por cento e 55,6 por cento para o masculino, não observando diferença estatística entre os gêneros. Da mesma forma, não foi possível observar relação entre o acúmulo de biofilme dentário e a presença de gengivite severa. A partir dos resultados concluí-se que: as condições de higiene oral foram insatisfatórias; a presença e severidade da gengivite se mostraram elevadas, bem como as prevalências de recessão gengival e de bolsa periodontal; não houve predileção das alterações segundo o gênero e não pode ser observada associação estatisticamente significativa entre o acúmulo de biofilme e os padrões de gengivite

Análisis del estado de la salud bucal de una población adolescente / Analysis of the oral health in an adolescent population

La prevalencia de caries, pérdida de piezas dentarias y enfermedad gingival en los adolescentes es elevada.El nivel socioeconómico, los hábitos de higiene y alimentación constituyen factores de riesgo. Las medidas de prevención y educación para la salud en controles clínicos, odontológicos e institucionales (escuelas, clubes etc) podrían evitar la aparición de estas patologías. Objetivos : Evaluar el estado de salud bucal de adolescente que concurren al Hospital "Ricardo Gutierrez", los factores de riesgo que la afecta y establecer estrategias de prevención en función de los resultados obtenidos. Población, material y métodos : Estudio analítico de un grupo de adolescentes (n=253) de 12 a 13 años que concurren a los consultorios de Adolescencia en forma espontánea o programada. Criterios de inclusión : adolescentes sanos, sin medicación o patología crónica que afecte la salud bucal. Los médicos pediatras recolectaron los datos mediante : observaciones clínicas del estado bucal (pérdida de piezas dentarias, obturación, caries visibles, patología gingival) y encuesta al adolescente y acompañante (nivel socioeconómico, hábitos de higiene bucal, ingesta de hidratos de carbono, educación para el cuidado de la salud). Los datos se procesaron en el programa estadístico EPI-info versión 6.04 y para el análisis multivariado se utilizó el programa SPSS 7.5. Resultados : Se observaron caries visibles en el 47,2 por ciento de los pacientes, gingivitis en el 60,6 por ciento, piezas obturadas en el 50 por ciento, y pérdida de piezas en el 15,4 por ciento. Se evaluaron el OR y la asociación de las variables encuestadas con el hecho en estudio (estado de la salud bucal). Se trabajó con un intervalo de confianza del 95 por ciento. Se observó asociación entre el hábito de cepillado con técnica inadecuada o ausente y la presencia de caries(OR:5,34) y gingivitis (OR:3,39). El 76,2 por ciento nunca había recibido información previa por parte del pediatra acerca del cuidado de la salud bucal. Conclusiones : Según las observaciones en esta población, el hábito de cepillado con técnica inadecuada constituiría un factor de riesgo para la aparición de caries y enfermedad gingival. La consulta del adolescente constituye una oportunidad para la educación en acciones preventivas para el cuidado de la salud bucal

Efecto del control metabólico en pacientes diabéticos tipo 1 y su asociación con enfermedad periodontal / Effect of metabolic control in type I diabetes patients and its association with periodontal disease

OBJECTIVE: To compare the frequency of periodontal disease in type 1 diabetes mellitus patients with and without metabolic control, having a control group of healthy patients. MATERIAL AND METHODS: A prolective cross sectional study with simple random sampling was carried out; patients were divided in three groups: A). Forty healthy subjects, B). Twenty diabetic patients with metabolic control, and C). Twenty diabetic patients without metabolic control. The diabetic subjects were evaluated with glycosylated hemoglobin (GHb) to determine the glucose control; clinical periodontal evaluations were performed for all teeth in each subject and following indexes were included: Plaque, gingival, mobility, probing depth, attachment level, bleeding on probing, and marginal bone loss. RESULTS: The imbalance of glucose of subjects with diabetes mellitus type 1 was associated with more frequency of periodontal disease (p < 0.05). CONCLUSION: The population of type 1 diabetes mellitus with imbalance of glucose showed association with periodontal disease.

Efecto de un programa de promoción de salud oral en la reducción del riesgo de caries en escolares del municipio de Angelópolis, Antioquia / Effect of a oral health promotion program on the reduction of caries risk in schoolchildren from the community of Angelopolis, Antioquia

Este estudio pretende evaluar la eficiencia y eficacia en la reducción del riesgo de caries de un programa principalmente de promoción de la salud oral multidimensional aplicado a un grupo de niños (n=119) matriculados desde el primero al quinto año de educación primaria. El grupo control lo constituyeron 98 niños con las mismas características matriculados en esta escuela, los cuales no recibieron ninguno de los elementos del programa. Los resultados se evaluaron con los índices COP-s, ceo-s, número de lesiones balncas y un nuevo índice que incluye información proporcionada por el niño acerca de la motivación para ir al odontólogo, el número de dientes permanentes sanos y de deciduos enfermos y el estado gingival de los individuos. Los datos fueron sometidos a un análisis multivariado con regresión logística en SPSS 8.0 para windows y prueba de chi-cuadrado. Los resultados muestran las superficies con manchas blancas y la desmotivación para ir al odontólogo como principales factores de riesgo para adquirir caries en dientes permanentes antes de la aplicación del programa. Luego de éste, la motivación para ir al odontólogo aparece como un factor atenuante ante el riesgo de caries, mientras que las superficies con mancha blanca se mantienen como factor de riesgo

Registro periodontal simplificado em gestantes / Periodontal screening and recording in pregnant women

Avalia através do PSR (Registro Periodontal Simplificado) a prevalência, severidade e necessidades básicas de tratamento da doença periodontal em gestantes que freqüentaram a Clínica de Prevençäo da Faculdade de Odontologia de Araraquara - UNESP. Foram examinadas 41 gestantes com idades que variaram de 16 a 37 anos. O PSR foi aplicado com auxílio de uma sonda especialmente recomendada para este exame (sonda Trinity - tipo 621 OMS), indicando os códigos 0 a 4 cujos critérios identificam de saúde gengival, sangramento, cálculo, bolsa periodontal rasa e profunda. Estes foram atribuídos a cada sextante, podendo ou näo estarem associados a um asterisco (*) diante da presença de recessäo gengival, invasäo de furca, mobilidade ou alteraçöes muco-gengivais. Demonstraram que 100 por cento das gestantes apresentaram alguma alteraçäo gengival, sendo os códigos 2 (56,1 por cento) e o * (19,5 por cento) os mais prevalentes. Os grupos etários de 15-19 e 20-24 anos apresentaram o código 2 como maior escore e ausência de sextante excluído (X). A partir do grupo de 25-29 anos, além da maior prevalência ainda ser do código 2 (54,5 por cento), ocorreram os códigos 3 e 4 (bolsa periodontal). Os códigos * e sextante excluído (X) tenderam a aumentar com a idade no grupo de 30-37 anos. De modo geral, os códigos 1 e 2 prevaleceram em relaçäo ao percentual de sextantes afetados, correspondendo a 41,6 por cento e 39,8 por cento, respectivamente e afetando 2,49 e 2,39 sextantes, em média, por gestante. Em relaçäo às necessidades de tratamento, 90,2 por cento das gestantes necessitaram tratamentos adicionais aos preventivos, ou seja, 61,0 por cento das gestantes necessitaram de raspagem e alisamento radicular e/ou eliminar margens de restauraçöes defeituosas e 29,2 por cento de tratamento complexo. O atendimento às necessidades de tratamento na gravidez deve receber especial atençäo com o intuito de se promover saúde bucal e motivaçäo, e conseqüentemente, contribuir para minimizar a provável transmissibilidade de microrganismos bucais patogênicos para a criança, obtendo assim uma prevençäo primária das principais doenças bucais

Occurrence of midline diastema and frenum attachments amongst school children in Nairobi, Kenya.

The aim of this study was to determine the prevalence of midline diastema, tongue tie and frenum attachments amongst school children in Nairobi. A total of 1802 children aged between 4 and 16 years were selected randomly using multistage sampling technique. To avoid oversampling in either sex, a proportionate sampling procedure was used. Thereafter, a thorough intra-oral examination was carried out using a mouth mirror under artificial or natural light with the children lying on a supine position. Presence or absence of midline interdental spaces unusually bigger than other interdental spaces were noted and recorded on a prepared dateacollection form. Accurate location of the origin of the frenum was done using Placek et al Morphological-functional classification of the labial frenum attachments. Data was analyzed manually by tally method. Results showed that 35% had upper and lower midline diastema. 55% were females and 45% were males. Their mean age was 7.6 years. 0.2% had a high lingual frenum. The commonest location of frenum attachment amongst children with lower midline diastema was the mucogingival junction (86%) whereas amongst those with upper midline diastema it was attached gingiva (50%). None of the children had frenum attachment on the interdental papilla. It was concluded that the maxilla had a higher prevalence of midline diastema than the mandible and that papillary penetrating frenum attachments amongst these patients were higher in the maxilla than the mandible.

Patología odontoestomatológica en un establecimiento correccional juvenil / Odontostomatological pathology in imprisoned teenagers

Se expone la situación bucal de un grupo de menores internados, su ambiente familiar, antecedentes personales, sociales y delictivos. Se anuncian consideraciones a partir de los hallazgos expuestos; se delinea el papel positivo de la internación, y sus limitaciones ante la escasez de cambios familiares y la rigidez del medio social. Se explica el papel de distintos aspectos de tiempo, en los hechos descriptos. Finalmente, se exponen conclusiones y formulan proposiciones a partir de observaciones efectuadas