Necesidad y tipo de tratamiento en cirugía bucomaxilofacial durante la pandemia por COVID-19 en un servicio de urgencias odontológicas del AMBA / Need and type of treatment in maxillofacial surgery during the COVID-19 pandemic in a dental emergency department in the AMBA

Objetivo: Analizar y describir los requerimientos de atención quirúrgica bucomaxilofacial de urgencia en el Servicio de Urgencias Odontológicas y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires durante el aislamiento social preventivo y obligatorio por la pandemia de COVID-19. Materiales y métodos: Se realizó un estudio observacional descriptivo de análisis retrospectivo durante el período de aislamiento social preventivo y obligatorio inicial de 93 días, comprendido entre el 20 de marzo y el 20 de junio de 2020. Se evaluó la totalidad de historias clínicas de los pacientes que acudieron al Servicio de Urgencias Odontológicas y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires y se caracterizó a aquellos que requerían distintos tipos de tratamiento quirúrgico bucal y maxilofacial. Resultados: Durante el período estudiado, se atendieron 4564 pacientes, de los cuales 1337 (29,3%) requirieron tratamientos quirúrgicos como terapéutica para la resolución de la urgencia. De estos, el 93,2% fueron exodoncias de piezas erupcionadas o retenidas; el 1,7%, biopsias quirúrgicas; el 2,4%, tratamientos agudos de infecciones que involucran espacios anatómicos vecinos; el 0,8%, resolución de traumatismos en los maxilares, y el 1,9%, tratamientos de complicaciones posquirúrgicas. Conclusión: Los resultados ponen de relieve la necesidad de disponer de servicios de guardia odontológica en el ámbito del AMBA que cuenten con recursos humanos calificados y entrenados para resolver urgencias de tipo quirúrgico

Aim: The objective of this study was to analyze and describe the requirements for the emergency care of oral and maxillofacial surgical treatment in the emergency dental department of the School of Dentistry of the University of Buenos Aires during the Preventive and Mandatory Social Isolation. Materials and methods: We conducted a retrospective analysis of a descriptive observational study during the initial period of 93 days of Preventive and Compulsory Social Isolation, from March 20, 2020 to June 20, 2020. All the medical records of the patients who attended the emergency dental department of the School of Dentistry of the University of Buenos Aires were evaluated and those who required different types of oral and maxillofacial surgical treatment were characterized. Results: A total of 4564 patients were attended during the period studied, of which 1337 (29.3%) required surgical treatment as a therapy for the resolution of their emergencies. Of these, 93.2% were exodontia of erupted or retained teeth, 1.7% surgical biopsies, 2.4% acute treatment of infections involving neighboring anatomical spaces, 0.8% resolution of maxillary alveolar trauma and 1.9% treatment of post-surgical complications. Conclusion: The results highlight the need to have dental emergency services in the AMBA area that have qualified and trained human resources to solve the surgical type emergencies that may arise (AU)

Extrações dentárias autorrelatadas e fatores associados em comunidades quilombolas do Semiárido baiano, em 2016 / Extracciones dentales auto-relatadas y factores asociados en comunidades quilombolas del Semi-árido bahiano, Brasil, en 2016 / Self-reported tooth extractions and associated factors in quilombola communities in the semi-arid region of Bahia state, Brazil, 2016

Objetivo: estimar a prevalência de extrações dentárias autorrelatadas e analisar os fatores associados em comunidades quilombolas de Feira de Santana, Bahia, Brasil. Métodos: estudo transversal, com 864 quilombolas; a associação entre autorrelato de extrações dentárias (sem experiência de extração; ≤5 dentes extraídos; >5 dentes extraídos) e possíveis fatores associados foi estimada por meio da regressão logística multinomial, considerando-se 95% de intervalo de confiança (IC95%). Resultados: extrações dentárias foram autorrelatadas por 82,0% dos quilombolas, sendo 49,8% com ≤5 e 32,2% com >5 dentes extraídos; ser do sexo masculino (OR ajustada = 1,7 - IC95% 1,1;2,7), encontrar-se empregado sem carteira assinada (OR ajustada = 2,7 - IC95% 1,3;5,7), ter idade ≥60 anos (OR ajustada = 5,2 - IC95% 1,9;14,1) e ter tido cárie dentária (OR ajustada = 4,1 - IC95% 2,5;6,7) associaram-se a maiores chances de ter extraído dentes. Conclusão: extrações dentárias estão associadas a condições de vulnerabilidade social vivenciadas pelos quilombolas do Semiárido baiano.

Objetivo: estimar la prevalencia de extracciones dentales auto-relatadas y analizar los factores asociados en las comunidades quilombolas de Feira de Santana, Bahia, Brasil. Métodos: estudio transversal, con 864 quilombolas; la asociación entre auto-relato de extracciones dentales (sin experiencia de extracción, ≤5 dientes extraídos y >5 dientes extraídos) y los posibles factores asociados fue estimada a través de la regresión logística multinomial considerando el 95% de intervalo de confianza (IC95%). Resultados: extracciones dentales fueron auto-relatadas por el 82,0%, siendo 49,8% con ≤5 y 32,2% con >5 dientes extraídos; sexo masculino (Odds Ratio ajustado = 1,7 - IC95%1,1;2,7), trabajadores sin estar en planilla (OR ajustado = 2,7 - IC95%1,3;5,7), con edad ≥60 (OR ajustado = 5,2 - IC95%1,9;14,1) y que mencionaron haber tenido caries dentales (OR ajustado = 4,1 - IC95%2,5;6,7), se asociaron a más probabilidades de haber extraído los dientes. Conclusión: extracciones dentales parecen estar asociadas a condiciones de vulnerabilidades sociales vividas por los quilombolas del Semiárido bahiano.

Objective: to estimate the prevalence of self-reported tooth extractions and analyze associated factors in quilombola communities in Feira de Santana, Bahia, Brazil. Methods: this was a cross-sectional study, with 864 quilombolas; association between self-reported tooth extractions (no experience of extraction; ≤5 extracted teeth; >5 extracted teeth), and possible associated factors was estimated using multinomial logistic regression, with a 95% confidence interval (95%CI). Results: tooth extractions were self-reported by 82.0% of quilombolas, 49.8% of whom had ≤5 teeth extracted and 32.2% of whom had >5 teeth extracted; greater likelihood of tooth extraction was associated with being male (adjusted OR = 1.7 - 95%CI1.1;2.7), working as an unregistered worker (adjusted OR = 2.7 - 95%CI1.3;5.7), being ≥60 years old (adjusted OR = 5.2 - 95%CI1.9;14.1) and reporting having dental caries (adjusted OR = 4.1 - 95%CI2.5;6.7). Conclusion: tooth extractions are associated with social vulnerability conditions experienced by the quilombolas of the semi-arid region of Bahia state.

Presença de Centros de Especialidades Odontológicas e sua relação com a realização de exodontias na rede de atenção de saúde bucal no Brasil / Presence of Specialized Dentistry Centers and the relationship with dental extractions in the oral healthcare network in Brazil / Presencia de Centros de Especialidades Odontológicas y su relación con la realización de exodoncias en la red de atención de salud bucal en Brasil

Resumo: Objetivou-se avaliar a associação entre presença de Centros de Especialidades Odontológicas (CEO) e a proporção de exodontias em relação ao total de procedimentos odontológicos em serviços públicos do Brasil. Trata-se de um estudo ecológico, em que foram avaliados dados sociodemográficos, dos serviços de saúde bucal e produção ambulatorial de 5.333 municípios nos biênios de 2000/2001 e 2015/2016. A principal variável de exposição foi a presença de CEO, e o desfecho a média nacional da proporção de exodontias em relação ao número de procedimentos odontológicos preventivos e curativos. Foram realizadas análises de interação e regressão múltipla usando modelo binomial com função de ligação logito. A média nacional da proporção de exodontias em relação aos procedimentos odontológicos preventivos e curativos foi 27,07% e 15,11% em 2000/2001 e 2015/2016, respectivamente. Na análise de interação entre a presença de CEO e a cobertura superior a 80% de equipes de saúde bucal (ESB), houve menores proporções de exodontias em relação aos procedimentos odontológicos preventivos e curativos (OR = 0,71; IC95%: 0,71-0,72). Na análise de regressão múltipla, municípios com Índice de Desenvolvimento Humano entre 0,6-0,7 (OR = 0,77; IC95%: 0,77-0,77), Produto Interno Bruto per capita maior que 20 mil Reais (OR = 0,45; IC95%: 0,45-045) e maior população residente em zona urbana (OR = 0,72; IC95%: 0,72-0,72) apresentaram menor proporção de exodontias em relação aos procedimentos odontológicos preventivos e curativos em 2015/2016. Conclui-se que ocorreram menores proporções de exodontias em relação aos procedimentos odontológicos preventivos e curativos em municípios com ao menos um CEO e com mais de 80% de cobertura de ESB, o que aponta que municípios com Rede de Atenção à Saúde Bucal consolidada têm melhor desempenho na oferta de cuidados odontológicos.

Abstract: This study aimed to assess the association between the presence of Specialized Dentistry Centers and dental extractions as a proportion of all dental procedures in public services in Brazil. This was an ecological study that assessed sociodemographic data, oral health services, and outpatient production in 5,333 municipalities in 2000-2001 and 2015-2016. The principal exposure variable was the presence of Specialized Dentistry Centers, and the outcome was the mean national proportion of dental extractions in relation to all preventive and curative dental procedures. Interaction and multiple regression analyses were performed using a binomial model with log link function. The mean national proportions of dental extractions in relation to preventive and curative dental procedures were 27.07% and 15.11% in 2000-2001 and 2015-2016, respectively. In the analysis of interaction between the presence of Specialized Dentistry Centers and coverage greater than 80% by the oral health teams, there were lower proportions of dental extractions in relation to preventive and curative dental procedures (OR = 0.71; 95%CI: 0.71-0.72). In the multiple regression analysis, municipalities with Human Development Index of 0.6-0.7 (OR = 0.77; 95%CI: 0.77-0.77), annual per capita GDP greater than BRL 20,000 (OR = 0.45; 95%CI: 0.45-045), and proportionally higher urban populations (OR = 0.72; 95%CI: 0.72-0.72) showed fewer dental extractions as a proportion of all preventive and curative dental procedures in 2015-2016. In conclusion, there were lower proportions of tooth extractions in municipalities with at least one Specialized Dentistry Center and with a coverage of greater than 80% by the oral health teams, highlighting that municipalities with a consolidated Oral Health Care Network present better performance in the supply of dental care.

Resumen: Este trabajo tuvo el objetivo de evaluar la asociación entre la presencia de Centros de Especialidades Odontológicas (CEO) y su proporción de exodoncias, en relación con el total de procedimientos odontológicos en los servicios públicos de Brasil. Se trata de un estudio ecológico, en que se evaluaron datos sociodemográficos, servicios de salud bucal y atención ambulatoria en 5.333 municipios, durante los bienios de 2000/2001 y 2015/2016. La principal variable de exposición fue la presencia de CEO y el resultado la media nacional de la proporción de exodoncias, respecto al número de procedimientos odontológicos preventivos y curativos. Se realizó tanto un análisis de interacción, como de regresión múltiple, usando un modelo binomial con función de vinculación logit. La media nacional de la proporción de exodoncias, en relación con los procedimientos odontológicos preventivos y curativos, fue 27,07% y 15,11% en 2000/2001 y 2015/2016, respectivamente. En el análisis de interacción entre la presencia de CEO y la cobertura superior a un 80% de equipos de salud bucal (ESB) hubo menores proporciones de exodoncias, en relación con los procedimientos odontológicos preventivos y curativos (OR = 0,71; IC95%: 0,71-0,72). En el análisis de regresión múltiple, los municipios con un Índice de Desarrollo Humano entre 0,6-0,7 (OR = 0,77; IC95%: 0,77-0,77), PIB per cápita mayor que BRL 20.000 (OR = 0,45; IC95%: 0,45-045) y mayor población residente en zona urbana (OR = 0,72; IC95%: 0,72-0,72) presentaron una menor proporción de exodoncias, respecto a los procedimientos odontológicos preventivos y curativos en 2015/2016. Se concluye que hubo menores proporciones de exodoncias, en lo que respecta a los procedimientos odontológicos preventivos y curativos en municipios con al menos un CEO, y con más de un 80% de cobertura de ESB, lo que apunta a que los municipios con una Red de Atención a la Salud Bucal consolidada tienen un mejor desempeño en la oferta de cuidados odontológicos.

Tendencia de actividades odontológicas realizadas en atención primaria del Servicio de Salud Valparaíso - San Antonio, chile: 2008 a 2018 / The evolution of dental services carried out in primary health care centers of the valparaíso - san antonio health service in chile: 2008-2018

INTRODUCCIÓN: La actual Política de Salud Bucal chilena indica que la atención odontológica está orientada a la promoción y prevención, reforzando la atención odontológica en Atención Primaria de Salud (APS). Se desconoce cómo esta política se ha materializado en el tiempo, pues, a la fecha, no existen estudios que analicen la tendencia de este tipo de actividades. El objetivo de este estudio fue analizar la tendencia de las actividades odontológicas, realizadas en adultos y adultos mayores, en APS del Servicio de Salud Valparaíso - San Antonio (SSVSA). MATERIAL Y MÉTODOS: Se realizó un estudio ecológico de tipo mixto entre los años 2008-2018, en 8 de las 9 comunas del SSVSA. Se analizó la tendencia del porcentaje de actividades promocionales-preventivas (APP) y de exodoncias utilizando las bases de datos "Resúmenes Estadísticos Mensuales-A09" (REM-A09). RESULTADOS: El 24,53% y 11,36% de las actividades realizadas correspondieron a APP y a exodoncias, respectivamente. El grupo de 20-64 años presentó un mayor porcentaje de APP y un menor porcentaje de exodoncias que el grupo de 65 y más años, en cada una de las comunas. Hubo una tendencia al aumento del porcentaje de APP y a la disminución del porcentaje de exodoncia en la mayoría de las comunas estudiadas. DISCUSIÓN: La tendencia de las actividades odontológicas realizadas en APS ha evolucionado a lo largo de los años, con diferencias entre comunas del SSVSA. Para poder determinar cuáles son los motivos que explican los resultados encontrados, se sugiere realizar otros estudios enfocados a la gestión odontológica local de APS. (AU)

BACKGROUND: The current Chilean Oral Health Policy indicates that dental care is aimed at promotion and prevention, thus reinforcing the presence of dental programs in Primary Health Care (PHC) Centers. It is unknown how this policy has materialized over time, since no studies to date have analyzed the trend of dental services carried out in PHC. The objective of this study was to analyze the evolution of dental services carried out in adults in PHC of the Valpa-raíso - San Antonio Health Service (VSAHS). MATERIALS AND METHODS: A mixed ecological study was carried out between 2008 and 2018, in 8 of the 9 municipalities of the VSAHS. The per-centage trends of promotional-preventive services (PPS) and extractions were analyzed, using the databases "Resúmenes Estadísticos Mensuales-A09" (REM-A09). RESULTS: The percentage of dental services dedicated to PPS and extractions were 24.53% and 11.36%, respectively. The group of adults between 20 and 64 years of age presented a higher percentage of PPS and a lower percentage of extractions than the 65 and over group in each municipality. There was also a trend of the percentage of PPS services increasing over time, while the percentage of extractions decreased in most of the municipalities studied. DISCUSSION: The type of den-tal services carried out in PHC has evolved over time, and differences were found between municipalities of the VSAHS. To explain these results, future studies should focus on the local management of dental services in PHC. (AU)

Dental consultation requests to oral and maxillofacial surgery in a hospital in Brazil

Introduction: This study analyzed dental consultation requests to the division of oral and maxillofacial surgery in a Brazilian tertiary hospital. Methods: A cross-sectional study with data collected retrospectively from inpatients' electronic medical records containing dental consultation requests made between January 2013 and December 2017. Results: 327 consultation requests were analyzed. Mean (SD) patient age was 38.71 (24.4) years; 164 (50.2%) were male and 267 (81.7%) were Caucasian. Regarding systemic conditions, 34 (10.4%) were classified as ASA I, 86 (26.3%) as ASA II, 182 (55.7%) as ASA III, and 25 (7.6%) as ASA IV. Dental consultations were mostly requested by the internal medicine team (n = 42, 12.8%). The most common reason for consultation was septic teeth (n = 131, 40.1%). Complementary tests were required in 188 (57.5%) cases. Surgical intervention was required in 82 (25.0%), with tooth extraction as the most prevalent procedure (20.2%). The most demanding service was inpatient care, with 276 (84.4%) requests. Cases were resolved in 249 (76.1%). Conclusions: The division of oral and maxillofacial surgery in our hospital deals with a great amount of consultations, contributing with surgical procedures to the adequacy of patients' oral health with a high effectiveness rate. Our data illustrate the contribution of dentists in a hospital setting, assisting the medical team in providing comprehensive care for inpatients. (AU)

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.

Condição de saúde bucal e motivos para extração dentária entre uma população de adultos (20-64 anos) / Oral health condition and reasons for tooth extraction among an adult population (20-64 years old)

Resumo O presente estudo caracterizou a condição de saúde bucal e os principais motivos autorrelatados da extração dentária em uma população de adultos. Estudo transversal que examinou 248 adultos de 20-64 anos, representativos da população de Piracicaba (SP). O exame bucal domiciliar utilizou os índices CPOD, CPI, uso e necessidade de prótese dentária segundo critérios da OMS e presença de biofilme visível. Foram coletados dados demográficos, socioeconômicos e motivos da extração dentária por meio de questionário. A análise descritiva foi estratificada pela idade em 20-44 e 45-64 anos. O CPOD médio foi 20,37, P = 3,34 nos adultos jovens e P = 13,41 nos mais velhos. Bolsa periodontal (CPI ≥ 3) foi encontrada em 20,5% dos adultos jovens e 53,0% dos mais velhos. Enquanto 38,8% usavam prótese superior, 46,7% necessitavam de prótese inferior. A dor foi o motivo autorrelatado mais prevalente para realização da extração dentária, sendo esta escolha principalmente pela falta de outra opção de tratamento e no serviço privado. Conclui-se que os adultos jovens (20-44 anos) apresentaram menos dentes perdidos e doença periodontal, uso e necessidade de prótese. Dor e falta de opção de outros tratamentos foram os principais motivos autorrelatados para realização das extrações dentárias.

Abstract The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.

Estudio retrospectivo de una población de pacientes sometidos a exodoncias en la Cátedra de Cirugía y Traumatología Bucomaxilofacial I de la Facultad de Odontología de la Universidad de Buenos Aires, en el período entre enero 2012 - mayo 2014 / A retrospective study on a patient population undergoing tooth extraction at the Department of Oral and Maxillofacial Surgery I, School of Dentistry, University of Buenos Aires, over a January 2012 - May 2014 period

La extracción dentaria es una de las prácticas odontológicas realizadas con mayor frecuencia, pero a corto plazo los pacientes necesitan rehabilitaciones orales para optimizar el funcionamiento del sistema estomatognático. Dado que conocer las características de la población que demanda exodoncias puede contribuir a elaborar estrategias para limitar la pérdida de piezas dentarias, nos propusimos 1) registrar las características de la población que demanda exodoncias; 2) identificar las piezas dentarias extraídas; 3) registrar las causas de exodoncia; 4) identificar patologías bucales durante la consulta para una exodoncia. Para llevarlo a cabo se seleccionaron aleatoriamente 2000 historias clínicas de pacientes que concurrieron a la Cátedra de Cirugía y Traumatología Buco Maxilofacial I de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA) y se realizaron exodoncias con anestesia local entre enero de 2012 y mayo de 2014...

Dental extraction is one of the most frequent practices in dentistry, causing necessary oral rehabilitation to ensure normal stomatognathic system function. The purpose of this study was to get to know the characteristics of the population in need of dental extraction so as to develop strategies tending to limit teeth loss. We set to 1) record the characteristics of the population on demand for dental extraction; 2) Identify teeth extracted; 3) Record cause of dental extraction; 4) Identify oral pathologies during examination for dental extraction. We selected 2000 Records of patients who attended “Cátedra de Cirugía y Traumatología Bucomaxilofacial I de la Facultad de Odontología de la Universidad de Buenos Aires, FOUBA” for dental extraction with local anesthetics in the period between January 2002 and May 2014...

Prevalence of mesiodens in orthodontic patients with deciduous and mixed dentition and its association with other dental anomalies

OBJECTIVE: To determine the prevalence of mesiodens in deciduous and mixed dentitions and its association with other dental anomalies. MATERIAL AND METHODS: Panoramic radiographs of 1,995 orthodontic patients were analyzed retrospectively, obtaining a final sample of 30 patients with mesiodens. The following aspects were analyzed: gender ; number of mesiodens; proportion between erupted and non-erupted mesiodens; initial position of the supernumerary tooth; related complications; treatment plan accomplished; and associated dental anomalies. The frequency of dental anomalies in the sample was compared to reference values for the general population using the chi-square test (c²), with a significance level set at 5%. RESULTS: The prevalence of mesiodens was 1.5% more common among males (1.5:1). Most of the mesiodens were non-erupted (75%) and in a vertical position, facing the oral cavity. Extraction of the mesiodens was the most common treatment. The main complications associated with mesiodens were: delayed eruption of permanent incisors (34.28%) and midline diastema (28.57%). From all the dental anomalies analyzed, only the prevalence of maxillary lateral incisor agenesis was higher in comparison to the general population. CONCLUSION: There was a low prevalence of mesiodens (1.5%) in deciduous and mixed dentition and the condition was not associated with other dental anomalies, except for the maxillary lateral incisor agenesis.

OBJETIVO: determinar a prevalência de mesiodens nos estágios de dentição decídua e mista, e verificar sua associação com outras anomalias dentárias. MÉTODOS: radiografias panorâmicas de 1.995 pacientes ortodônticos foram analisadas retrospectivamente, obtendo-se uma amostra de 30 pacientes com o mesiodens. Os seguintes aspectos foram analisados: distribuição entre os sexos, número de mesiodens; se irrompido ou não irrompido; posição; complicações; tratamento instituído, e anomalias dentárias associadas. A frequência de anomalias dentárias na amostra estudada foi comparada a valores de referência para a população em geral por meio do teste qui-quadrado (c²), com um nível de significância de 5% (p < 0,05). RESULTADOS: a prevalência de mesiodens foi de 1,5%, sendo mais comum no sexo masculino (1,5:1). A maior parte dos mesiodens estavam não irrompidos (75%) e numa posição vertical, voltada para a cavidade bucal. O tratamento mais empregado foi a exodontia. As principais complicações associadas ao mesiodens foram o atraso na erupção dos incisivos permanentes (34,28%) e diastema mediano (28,57%). Pacientes com mesiodens não apresentaram prevalência aumentada de microdontia, agenesia de dentes permanentes ou outros supranumerários. De todas as anomalias analisadas, apenas a prevalência de agenesia de incisivo lateral superior mostrou-se aumentada em comparação à população em geral. CONCLUSÃO: o mesiodens foi encontrado em uma prevalência baixa (1,5%) nas dentições decídua e mista, e não apresentou associação com outras anomalias dentárias, com exceção da agenesia de incisivo lateral superior.

Reasons and pattern of tooth mortality as perceived by dental professionals in Udaipur City, Rajasthan, India / Percepção das razões e do padrão de mortalidade de dentes por profissionais de odontologia da cidade de Udaipur, Rajasthan, Índia

The aim of the present study was to assess the reasons for tooth mortality as perceived by the dentists for the patients attending the dental clinics and hospitals in Udaipur city. Material and methods: A closed-ended questionnaire survey was conducted among 211 dental practitioners of Udaipur city. The reasons for extraction of permanent and deciduous teeth among patients who had attended during the study period were categorized and the dentists were requested to record the age and sex of the patient, the tooth extracted, and the reason for the extraction. Results: A total of 785 permanent teeth were extracted. There was a significant difference observed between the number of extractions in males (53.1%) and females (46.9%) (P<0.029). Extractions were most common in the 55-64 years of age group (32.7%). Dental caries (206, 26.2%) and periodontitis (188, 23.9%) were the most frequent reasons for tooth extraction. Conclusion: The results of the present study revealed caries as the dominant reason given by dentists for tooth extraction in all the age groups of the subjects studied...

O objetivo do presente estudo foi avaliar a percepção das razões de mortalidade dentária pelos dentistas em relação aos pacientes que frequentam as clínicas odontológicas e hospitais na cidade de Udaipur. Materiais e métodos: Uma pesquisa com questionário fechado foi realizada com 211 dentistas da cidade de Udaipur. As razões para a extração de dentes permanentes e decíduos entre os pacientes que receberam atendimento no período do estudo foram categorizadas e os dentistas foram solicitados a registrar a idade e o sexo do paciente, o dente extraído e a razão para a extração. Resultados: Um total de 785 dentes permanentes foi extraído. Houve diferença significativa observada entre o número de extrações no sexo masculino (53,1%) e feminino (46,9%) (P < 0,029). Extrações foram mais comuns no grupo de idade de 55 a 64 anos (32,7%). Cárie dentária (206, 26,2%) e periodontite (188, 23,9%) foram os motivos mais frequentes para extração de dentes. Conclusão: Os resultados do presente estudo revelaram a cárie como a razão dominante dada por dentistas para extração de dentes em todas as faixas etárias dos sujeitos estudados...

Complications of exodontia: A retrospective study.

Purpose: The purpose of this study was to analyze the incidence of various complications following routine exodontia performed using fixed protocols. Materials and Methods: A total of 22,330 extractions carried out in 14,975 patients, aged between 14 and 82 years, who reported to the Department of Oral and Maxillofacial Surgery at Padmashree Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, were evaluated for various complications. Results: The most common complications encountered were tooth fracture, trismus, fracture of cortical plates and dry socket. Wound dehiscence, postoperative pain and hemorrhage were encountered less frequently. Luxation of adjacent teeth, fracture of maxillary tuberosity, and displacement of tooth into adjacent tissue spaces were rare complications. Conclusion: The practice of exodontia inevitably results in complications from time to time. It is imperative for the clinician to recognize impending complications and manage them accordingly.

Prevalence of dental caries and treatment needs amongst the school children of three educational zones of urban Delhi, India.

Context : Dental caries is the most common oral disease that affects significant number of Indian population. The prevalence of caries in India is reported 31.5% to 89%. Aims : T0 his study was aimed to estimate the prevalence of dental caries and treatment needs in school going children of Delhi. Materials and Methods : A0 school based cross-sectional study was conducted in various educational zones of Delhi. A total of 520 school children in age range of 9-12 years were examined using WHO (1997) criteria. Statistical Analysis Used : C0 hi-square test. Results : T0 he prevalence of dental caries was found to be 52.3% with mean deft and DMFT of 0.5038 ± 1.0859 and 0.8250 ± 1.3437, respectively. Besides various treatment needs 49.7% required restorative treatment. Conclusion : T0 he prevalence of dental caries in Delhi school children is high with D+d components comprising of more than 95%. This indicates lack of awareness and affordability to the dental facilities available. Therefore, there is a need to develop preventive and promotional oral health strategies to combat this infectious disease.

Epidemiología y tratamiento de la pericoronaritis aguda en el Hospital Barros Luco Trudeau, Santiago, Chile / Epidemiology and treatment of acute pericoronitis at Barros Luco Trudeau Hospital, Santiago, Chile

La pericoronaritis se caracteriza por la inflamación de los tejidos blandos, que rodean la corona de un diente total o parcialmente erupcionado, acompañado por dolor. El objetivo de este trabajo es describir la epidemiología y el tratamiento de la pericoronaritis aguda, en pacientes que acuden al servicio de urgencia del Hospital Barros Luco Trudeau. Se realizó un estudio descriptivo retrospectivo. Se analizaron 9531 fichas clínicas correspondientes a pacientes atendidos en la urgencia dental del Hospital Barros Luco Trudeau, tomando como muestra 456 atenciones con el diagnóstico de pericoronaritis aguda. Se consideraron como variables la edad, el género, la pieza dentaria involucrada y el tratamiento realizado. El análisis de los resultados arrojó una edad promedio de 24 años, con una proporción aproximada de 1:2 de hombres frente a mujeres. Las piezas dentarias más afectadas fueron los terceros molares mandibulares. Respecto al tratamiento, aproximadamente el 70 por ciento de los casos se medicó con antibioterapia y analgésicos no esteroidales (AINES),mientras que sólo en un 40 por ciento se realizó el debridamiento mecánico de la zona. Independientemente del manejo inicial, la mayor parte de las piezas involucradas fueron extraídas de forma inmediata o derivadas para su remoción. Los resultados obtenidos concuerdan con la literatura disponible, en relación a las variables edad, género y piezas dentarias involucradas. Con respecto al tratamiento, la evidencia reporta que lo óptimo es la realización conjunta de una terapia mecánico-local y sistémica, medidas que fueron poco frecuente en el servicio estudiado.

Pericoronitis is characterized by inflammation of the soft tissues surrounding the crown of a tooth wholly or partially erupted, accompanied by pain. To describe the epidemiology and treatment of acute pericoronitis in patients attending the emergency department of the Hospital Barros Luco Trudeau. A descriptive retrospective study was carried out. We analized 9531 files of patients treated in the Emergency Department Dental Hospital Barros Luco Trudeau and we obtained a sample of 456 files with the diagnosis of acute pericoronitis. The variables considered were age, gender, tooth and the treatment involved. The analysis of the results showed an average age of 24 years, with an approximate ratio of 1:2 of men versus women. The most affected teeth were mandibular third molars. Regarding treatment, approximately 70 percent of cases medicated with antibiotics and analgesics nonsteroidal antiinflammatory drugs (NSAIDs), where as only 40 percent had mechanical debridement of the area. Regardless of initial treatment, most of the parts involved were immediately extracted or derived for removal. Our results are consistent with the available literature regarding the variables age, gender and teeth involved. With regard to treatment, the literature reported that the best evidence is the joint realization of a local mechanical therapy and systemic measures that were rare in the service studied.

Barriers to the adoption of the ART approach as perceived by dental practitioners in governmental dental clinics, in Tanzania

OBJECTIVES: This study aimed to determine the magnitude of the barriers to the practice of Atraumatic Restorative Treatment (ART) as perceived by dental practitioners working in pilot dental clinics, and determine the influence of these barriers on the practice of ART. MATERIAL AND METHODS: A validated and tested questionnaire on barriers that may hinder the practice of ART was administered to 20 practitioners working in 13 pilot clinics. Factor analysis was performed to generate barrier factors. These were patient load, management support, cost sharing, ART skills and operator opinion. The pilot clinics kept records of teeth extracted; teeth restored by conventional approach and teeth restored by ART approach. These treatment records were used to compute the percentage of ART restorations to total teeth treated, percentage of ART restorations to total teeth restored and percentage of total restorations to total teeth treated. The mean barrier scores were generated and compared to independent variables, using the t-test. The influence of barriers to ART-related dependent variables was determined using Pearson correlation coefficients. RESULTS: Mean barrier values were low, indicating low influence on ART practice. Female practitioners had higher scores on patient load than male practitioners (p = 0.003). Assistant Dental Officers had higher scores on cost sharing than Dental Therapists (p = 0.024). Practitioners working in urban clinics had higher mean scores on patient load than those who worked in rural clinics (p = 0.0008). All barrier factors were negatively correlated with ART practice indices but all had insignificant association with ART practice indices. CONCLUSION: The barriers studied were of low magnitude, with no significant impact on practice of ART in dental clinics in the pilot area.

Dental needs in brazilian patients subjected to head and neck radiotherapy

In spite of its recognized benefits in the treatment of malignant tumors, radiation therapy have several side effects in the head and neck region. The evaluation of oral conditions by a dentist is important to prevent or minimize these problems. The aim of this retrospective review was to analyze the dental needs in 357 patients who received radiotherapy in the head and neck region and were treated at Orocentro/FOP/UNICAMP, between January 1990 and December 2004. Review of patient files showed that dental examination before radiotherapy was not performed in 148 patients (41.5 percent) and was done in 209 patients (58.5 percent). From the total of examined patients, 94 (45 percent) did not require dental procedures at the moment of examination, while 115 (55 percent) presented some sort of dental need. Following the patients after the radiotherapy, it was observed that the group of patients that was evaluated before radiation presented less need of restorations, root canal filling and dental extractions than those who were not evaluated. The results of this study confirm that the evaluation of oral conditions prior to radiotherapy is essential to minimize the dental needs, emphasizing the importance of the dentist in the multidisciplinary team that treats cancer patients.

Apesar dos benefícios da radioterapia no tratamento de tumores malignos, vários são os seus efeitos colaterais na região de cabeça e pescoço. Sendo assim, a avaliação das condições bucais pelo cirurgião dentista é fundamental para prevenir e/ou minimizar estes danos. Este estudo retrospectivo teve como objetivo verificar as condições dentárias e as necessidades de tratamento odontológico dos 357 pacientes que receberam radioterapia na região de cabeça e pescoço, atendidos pelo Orocentro/ FOP/UNICAMP, no período de janeiro de 1990 a dezembro de 2004. Em 148 (41,5 por cento) do total dos pacientes a avaliação odontológica não foi realizada previamente à radioterapia. A avaliação odontológica pré-radioterápica foi realizada em 209 pacientes (58,5 por cento) dos quais 94 (45 por cento) não tinham necessidades de tratamento odontológico no momento da avaliação, enquanto 115 (55 por cento) apresentavam algum tipo de necessidade odontológica. O grupo de pacientes avaliados antes da radioterapia apresentou menores necessidades de restaurações, endodontias e exodontias que os pacientes não avaliados. Conclui-se que a avaliação das condições bucais previamente à radioterapia é essencial para diminuir as necessidades de tratamento odontológico enfatizando a importância da participação do cirurgião-dentista na equipe multidisciplinar que trata pacientes com câncer.

Dental caries experience and treatment needs of green marble mine laborers in Udaipur district, Rajasthan, India.

BACKGROUND AND OBJECTIVES: The study was undertaken at Kesariyaji, located in Udaipur district of Rajasthan. There are about 3 million workers who marble mine at Rajasthan. Living conditions of these workers are substandard and most of them are immigrant workers living in tiny shacks. Majority of them belong to lower socioeconomic status with poor educational background. The present study was carried out to estimate dental caries prevalence and treatment needs of laborers working in the green marble mines of Udaipur district. BASIC RESEARCH DESIGN: The data was collected using the methods and standards recommended by the WHO. Dentition status and treatment needs along with decayed, missing, and filled teeth (DMFT) index, and decayed, missing, and filled surfaces score were recorded. Standard error of mean was calculated for all the mean values of treatment needs. There were three examiners, who were trained before the survey for inter-examiner variability, and the reliability was tested by means of weighted kappa statistics, which was 90%. PARTICIPANTS: The study population comprised 513 men in four age groups of 18-25, 26-34, 35-44, and 45-54 years, respectively. RESULTS: The mean DMFT for all age groups was 3.13 with highest mean of 4.0 for the age group of 45-54 years. Mean decayed teeth were 2.60, 3.33, 1.46, and 1.5 for the age groups 15-24, 25-34, 35-44, and 45-54 years, respectively. Filled component was nil for all age groups. Most of the subjects required one surface filling with a very less proportion needing pulp care. CONCLUSIONS: The missing component constituted the major part of DMFT index in the 45-54 years age group and the absence of filled component in the whole study population implies that the treatment needs of the study population are unmet. Thus, intervention in the form of oral health promotion and curative services are the need of the hour.

Dental caries prevalence and treatment needs of Down syndrome children in Chennai, India.

PURPOSE: To assess the prevalence of caries and the treatment needs of Down syndrome children in the Indian city of Chennai. MATERIALS AND METHODS: Among the 130 Down syndrome children examined, only the children aged < or =15 years were included in the study ( n = 102). There were 57 male and 45 female children in the total study sample. A specially prepared case record was used to record the findings for each child. The dentition status and the treatment needs required were recorded. Comparisons of the findings were done based on age and gender distribution. RESULTS: Twenty-nine per cent of the total sample of Down syndrome children was found to be caries-free. Extraction (in 38 children) and one-surface filling (in 26 children) were the most needed specific treatments for primary and permanent teeth, respectively. Oral prophylaxis (99%) was the most required treatment in the overall treatment category. CONCLUSIONS: Contrary to the findings of earlier studies, the percentage of caries-free Down syndrome children was found to be lower in our study. However, their basic needs like oral prophylaxis, restorations and extractions remain the same and can be easily fulfilled by an efficient, community-based dental team.

Causas de extracciones en el servicio de emergencia dental, Hospital Rancagua, año 2006 / Causes of exodontias in the emergency dental service, Rancagua Hospital, year 2006

El objetivo del presente trabajo es dar a conocer las causas de las extracciones dentales en el Servicio de Emergencia Dental, Hospital Rancagua. Durante 1 año se registraron todas las extracciones dentales realizadas en este servicio. Se registraron datos por cada extracción realizada. Se anotó la edad y sexo del paciente, y la causa de la exodoncia. Las causas que se consideraron fueron: periodoncia, caries, traumas, y otras. Se realizaron 1.731 extracciones; el 52.1 por ciento se efectuaron en hombres y el 47.9 por ciento en mujeres. Se extrajeron debido a caries el 82.9 por ciento, por causas periodontales el 13.3 por ciento, por trauma el 1.3 por ciento, por otras causas el 2.5 por ciento. No hubo diferencias estadísticamente signifi cativas en la distribución por sexos de las exodoncias. La edad media de las exodoncias por periodoncia fue mayor que por caries. El motivo predominante para buscar ayuda en el servicio de emergencia fue dolor dental. En conclusión, la caries dental fue la razón principal de las extracciones en los pacientes atendidos en el Servicio de Emergencia Dental. Por lo tanto, para reducir el porcentaje de extracciones en esta población, los esfuerzos deben focalizarse en la prevención y tratamiento de las caries.

The aim of this paper is to show the causes of the dental extractions in the emergency dental service, Rancagua hospital. For one year all the dental extractions carried out in this service were registered. Data was registered for each extraction carried out. A note was made of the age and sex of the patient, and the cause of the exodontia. The causes considered were: periodontia, caries, traumas, and others. 1.731 extractions were carried out; 52.1 percent were on men and 47.9 percent on women. 82.9 percent of extractions were due to caries, 13.3 percent for periodontal reasons, 1.3 percent because of trauma, and 2.5 percent for other causes. There were not statistically significant differences in the distribution by sexes of the exodontias. The average age of the exodontias due to periodontia, was greater than that for caries. Dental pain was the predominant motive for seeking attention at emergency service. In conclusion, dental caries was the main reason for extraction in patients attending the dental emergency service. Therefore, in order to reduce the rate of dental extractions in this population, effort should focus on prevention and treatments of caries.

Demanda de atención y estado dentario en servicios y consultorios odontológicos de Rosario / Care demand and dental status in dental services and offices of Rosario city

La población de mayores recursos de Rosario puede acceder a la atención privada, los sectores medios y carenciados se atienden con obras sociales y servicios públicos. Esto últimos carecen de programas para el cuidado bucal de los adultos, realizando prioritariamente extracciones. El objetivo de este estudio fue conocer el grado de adhesión a cuidados para la conservación de las piezas dentarias en tres subpoblaciones. Los concurrentes de 15-45 años fueron invitados a participar respondiendo una anamnesis estandarizada sobre edad, sexo, tipo de servicio, índice CPO, tiempo transcurrido entre consultas y pieza extraida el día de entrevista. En los servicios públicos hubo mayoría de piezas perdidas y en el privado de obturaciones. El tiempo transcurrido entre visitas fue menor en el privado (p=0,04) y la causa más frecuente fue por obturación, mientras que en los públicos lo fue por extracción (p=0,01). Las piezas más extraidas fueron premolares y molares en todos los servicios.

Evaluación clínica de la terapia con dexametasona e ibuprofeno en la cirugía de los terceros molares retenidos / A clinical evaluation of dexamethasone and ibuprofen therapy in impacted third molar surgery

La eliminación quirúrgica de los terceros molares ocasiona considerable dolor, edema y disfunción. Los factores que contribuyen a estas secuelas son complejos, pero muchos de ellos son relativos al proceso inflamatorio. Los corticoesteroides han sido sugeridos para la reducción del edema posterior a procedimientos quirúrgicos, incluyendo la remoción de los terceros molares. Sin embargo, su uso es tema controversial debido a su potencial tóxico. Otros autores recomiendan la terapia combinada de esta droga con AINEs, como el Ibuprofeno. Objetivos:el objetivo de este estudio doble ciego fue evaluar y comparar un glucocorticoide como lo es la dexametasona en combinación con ibuprofeno y placebo para el control de la inflamación debida a la cirugía de los terceros molares. Así como también dilucidar su verdadero potencial tóxico. Métodos: se seleccionaron al azar 30 pacientes (9 de sexo masculino y 21 de sexo femenino) de 15 a 35 años, divididos en dos grupos: el primero recibió 8 mg de Dexametasona (Decalona®) y el segundo placebo, una hora antes de la cirugía por vía intramuscular. Ambos grupos recibieron 400 mg de Ibuprofeno (Brugesic®) por vía oral cada 6 horas durante dos días y 500 mg de amoxicilina (Trimoxal®) cada 8 horas por 7 días. El efecto antiinflamatorio del tratamiento fue evaluado por tres métodos: subjetivo, medición de referencias anatómicas y por un método computarizado de fotografías digitales. Mientras que el dolor fue evaluado mediante la Escala Visual Análoga. Resultados: los resultados obtenidos demostraron la superioridad de la terapia con dexametasona e ibuprofeno para el control del edema postoperatorio sobre la terapia con ibuprofeno exclusivamente. No se encontraron diferencias estadísticamente significativas en cuanto al dolor. También se demostró la ausencia de complicaciones postoperatorias y reacciones adversas al administrar dexametasona con la posología indicada

The surgical removal of impacted third molar teeth can result in considerable pain, swelling and dysfunction. The factors contributed to postoperative pain, edema and trismus are complex, but many of the contributors factors are related to the inflammatory process. Pharmacologic strategies for minimizing the clinical manifestation of surgical trauma are often directed toward blocking the acute inflammation. Corticosteroids have been suggested for the reduction of inflammatory sequel of surgical procedures, including the removal of third molar teeth. Others authors recommend the combination of this drug with some NSAIDs like Ibuprofen.Objetives: the purpose of this double-blind study was to evaluate and to compare a prototype glucocorticoid, dexamethasone in combination with Ibuprofen and placebo for suppression of swelling due to the surgical removal of the third molar and determinate their real toxicity. METHODS: thirty patients, including 9 males and 21 females aged between 15 and 35 years old, randomly divided in two groups: one of the group received 8 mg dexamethasone (Decalona®) and the other group received placebo, one our prior to each procedure, either dexamethasone or placebo was administered intramuscularly. Both groups received 400 mg ibuprofen (Brugesic®) each 6 hours for two days and 500 mg amoxiciline (Trimoxal®) each 8 ours for 7 days. The effect of treatment was evaluated using three methods: subjectively, anatomical references measurements, and digital photos by computerized method.. Pain was evaluated by Analog Visual Scale. Results: This investigation revealed a higher efficacy of the therapy with dexamehtasone e ibuprofen than ibuprofen alone to edema postoperative control. Our results demonstrated no statically significant differences with regard to pain. We also no observed postoperative infection neither adverse effect with this therapy in the evaluated patients.