Dental Environment Stress: Findings among Lusophone Dental Students

Objective: To perform cross-cultural adaptation of the Dental Environment Stress (DES), to test its construct validity and reliability, and to identify the sources of stress among Brazilian dental students. Material and Methods: The DES was transculturally adapted to Portuguese using translation/back-translation, review by an expert bilingual committee and consensus building. The first version was tested in a sample of 42 dental students to check the understanding level of the alternatives. The final version was applied to all the students enrolled in a Brazilian Public Dental School. Construct validity was assessed through factor analysis, performed by principal components analysis and Varimax rotation and reliability by internal Cronbach's alpha coefficient (95% CI). Wilcoxon rank sum was conducted to test for gender and Kruskall-Wallis for year comparison. Multivariate analysis relied on ordinal logistic regression modeling. Results: Factor analysis revealed five factors that possessed eigenvalues greater than 1.5 and together explained 46.88% of the total variance. Internal consistency of each factor was adequate, with Cronbach's alpha ranging from 0.65 to 0.84. 'Examinations and grades' (82.80%) was the highest scored item. Females presented higher rates, as well as second's and fifth's years students. The entering students were generally concerned with factors related to "Academic Performance", whereas clinical year students with "Insecurity Concerning their Professional Future". Conclusion: The Portuguese version of the DES presented good results, thus it could be a valid instrument to assess the factors of perceived stress in Lusophone countries, subsidizing the development of strategies to minimize the stress and optimize school performance.

Evaluation of a preventive educational program for malocclusions: 7-year study

Abstract This study aimed at evaluating the Protocol for the Prevention of Malocclusions (PPM), established in the preventive educational program developed by the Public Infant Oral Health Program of the State University of Londrina (PIOHP-UEL). Guardians of three-year-olds or older, maintaining nutritive (bottle) and/or non-nutritive (pacifier and finger) sucking habits, attended meetings designed to alert and guide them to eliminating these habits from their children. PPM patient records (2006-2013) were assessed and the data were described and evaluated by the Chi-square test, with a 5% significance level. Results 506 of the 802 guardians/children referred to the PPM joined. As for the children, the most frequently assessed habits were: bottle (56.1%), bottle and pacifier (18.4%), finger (11.9%), bottle and finger (7.1%), pacifier (5.7%), pacifier and finger (0.6%), and bottle/pacifier/finger (0.2%). After parent participation in the meetings, 335 (66.2%) children abandoned their habits. There was a statistical difference between type of oral habit and time to abandonment (p = 0.0001). However, those with only one habit abandoned it more easily (72.6%) than those with two or more associated habits (48.1%) (p = 0.042). Presence or absence of breastfeeding and parents' level of education had no significant effect on habit abandonment. Conclusion PPM was an important tool for spreading knowledge to guardians, greatly contributing to the abandonment of deleterious oral habits. Bottle sucking warrants special attention - mentioned by 81.8% of parents - either alone or associated with other habits. Thus, educational actions to implement the children's approach to oral health are fundamental to making behavioral changes and promoting education of healthy habits, thereby keeping malocclusions from developing.

Luxation injuries in primary teeth: a retrospective study in children assisted at an emergency service

The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5 percent. Trauma incidence was higher in boys (57.0 percent) and in children less than two years of age (40.3 percent). Falling while walking or running was the most predominant etiologic factor (37.7 percent), and the most prevalent type of injury was subluxation (32.6 percent). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0 percent). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

Análise dos traumatismos e suas seqüelas na dentição decídua: uma revisão da literatura / Analysis of dental trauma and its sequelae in the primary dentition: a review of the literature

Introdução: Estudos mostram que traumatismos na dentiçãodecídua são eventos comuns, podendo resultar em seqüelas quepodem comprometer o dente decíduo afetado. Na literatura, afreqüência dos traumatismos na dentição decídua é variável,enquanto a faixa etária, o gênero, o fator etiológico e os dentesmais afetados apresentam prevalências semelhantes. Em relaçãoao tipo de trauma mais freqüente, diferenças podem ser encontradasem razão de critérios da amostragem como o tipo de estudo e olocal de realização da pesquisa. Várias são as seqüelas que podemcomprometer os dentes decíduos após traumatismos, destacandosea descoloração coronária, a necrose pulpar, a obliteração docanal pulpar e a reabsorção radicular. Estudos apontam o tipo detrauma e a idade da criança no momento do trauma como fatoresimportantes que determinam a ocorrência destas seqüelas.Objetivo: Este artigo propôs revisar estudos relevantes daliteratura referentes aos fatores epidemiológicos e as seqüelas emdentes decíduos traumatizados, proporcionando ao leitor uma visãogeral do traumatismo na dentição decídua.Conclusão: Em conclusão à análise dos artigos revisados, pôdeseobservar uma relação direta entre o grau de severidade dostraumatismos e a ocorrência de seqüelas nos dentes decíduosafetados, enfatizando-se a importância do acompanhamentoperiódico destes casos.

Dispositivo de Dunn e de Chenet no tratamento do torcicolo congênito / Dunn and Chenet's devices in the treatment of congenital torticollis

O torcicolo congênito é caracterizado por fibrose e encurtamento do músculo esternocleidomastóideo. O diagnóstico é clínico e pode ser feito pela posição anômala da cabeça e presença de massa fibrosa fusiforme, pequena, indolor e dura à palpação, localizada na região central ou inferior do músculo afetado. O tratamento é fisioterápico, sendo a intervenção cirúrgica restrita aos casos que não respondem a fisioterapia. Se não tratado, pode levar a alterações permanentes na coluna e na musculatura ocular, além de assimetria facial, relacionada a subdesenvolvimento da mandíbula, com conseqüênte maloclusão. O objetivo do presente trabalho é enfatizar o papel do Odontopediatra no diagnóstico precoce e no tratamento multiprofissional da patologia, demonstrando, através de um caso clínico, os dispositivos de Dunn e de Chenet, que estimulam o desenvolvimento mandibular e são uma alternativa eficiente, segura, simples e prática para auxiliar no tratamento, reduzindo ou eliminado as seqüelas da patologia.

Intradermal vaccination of adults with three low doses (2 µg) of recombinant hepatitis B vaccine. I: seroconversion rate and adverse effects

A total of 250 dentists (53.6 percent men and 46.4 percent women), with a mean age of 35.1 ± 9.8 years, were submitted to serological tests for the diagnosis of hepatitis B (HB) - HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe - using a radioimmunoassay. One or more of these markers were detected in 78 individuals (31.2 percent) who were excluded from the group to be vaccinated. Of the 172 HB-susceptible individuals, 135 (78.5 percent) responded to the call and were intradermally injected with three 2 µg doses of the Belgian HB recombinant vaccine, applied at an interval of one month between the 1st and 2nd dose and of five months between the 2nd and 3rd dose. A new determination of HB markers carried out 50 days after the 3rd dose showed that 110 (81.5 percent) individuals had become anti-HBs positive (65.5 percent good responders and 34.5 percent poor responders). Mean serum anti-HBs titer of these 110 dentists was 42.4 U S/N, similar in both sexes. The adverse effects analyzed in 106 dentists were: (a) local: pain (12.3 percent), burning sensation (14.1 percent), pruritus (25.5 percent), erythema (28.3 percent), local heat (18.9 percent), and a hypochromic spot (32.1 percent); (b) systemic (4.7 percent): discomfort in two patients, and fever, anorexia, and asthenia in one patient each. Intradermal administration of a fourth 2 µg vaccine dose to 39 dentists (poor or non-responders) increased the total number of anti-HBs-positive individuals from 110 (81.5 percent) to 114 (84.4 percent), with the number of good responders increasing from 72 (65.5 percent) to 85 (74.6 percent). We conclude that the Belgian recombinant vaccine applied in the scheme used here induces a high rate of seroconversion and causes only mild and transitory adverse effects.

Intradermal vaccination of adults with three low doses (2 µg) of recombinant hepatitis B vaccine. II: persistence of immunity and induction of immunologic memory

Of the 110 dentists who had presented seroconversion 50 days after the intradermal application of three 2 µg doses of the Belgian recombinant vaccine against hepatitis B (HB), administered eight years before at an interval of one month between the 1st and 2nd doses and of five months between the 2nd and 3rd doses, 51 were included for the assessment of the persistence of immunity. None of the dentists had hepatitis or had received HB vaccine during this period. All subjects were submitted to serological tests for the detection of the following markers of hepatitis B virus (HBV) infection: HBsAg, anti-HBc, HBeAg, anti-HBe, and anti-HBs, with no HBsAg, anti-HBc, HBeAg or anti-HBe being detected. A microparticle enzyme immunoassay (MEIA) revealed the presence of anti-HBs at protective titers (> 10 mIU/ml) in 42 dentists (82.4 percent), with the anti-HBs titer being higher than 100 mIU/ml in 36 of them (70.6 percent) (good responders), between 10 and 100 mIU/ml in 6 (11.8 percent) (poor responders), and lower than 10 mIU/ml in 9 (17.6 percent) (non-responders). According to clinical data and serological tests, none of the dentists had presented disease or latent HBV infection during the eight years following the first vaccination. A 2 µg booster dose was administered intradermally to eight dentists with anti-HBs titers lower than 10 mIU/ml (non-responders) and to six dentists with titers ranging from 10 to 100 mIU/ml (poor responders); the determination of anti-HBs one month later demonstrated the occurrence of seroconversion in the eight non-responders and an increase in anti-HBs titer in the six poor responders. In summary, the present results demonstrated the prolonged persistence of protection against HBV infection and the development of immunologic memory provided by vaccination against HB - with intra-dermal application of three 2 µg doses of the Belgian recombinant vaccine at 0, 1, and 6 months - carried out eight years before in 51 dentists.

Dispositivo confeccionado em silicone, para isolamento relativo da região antero-superior de bebês / Dispositive prepared with silicone for relative isolation of the antero-superior teeth

Visando a melhoria das condições de atendimento a indivíduos com menos de 24 meses foi desenvolvido um dispositivo para isolamento relativo da região antero-superior propiciando melhor atendimento nos tratamentos realizados. Este dispositivo é confeccionado em silicone e posssui uma utilização bastante diversificada