Confiabilidade e validade do questionário children's fear survey schedule-dental subscale para avaliação do medo e ansiedade ao tratamento odontológico em crianças / Reliability and validity of the Brazilian version of the children's fear survey schedule-dental subscale

Identificação precoce da ansiedade em função do tratamento odontológico é uma ferramenta que pode auxiliar o profissional no atendimento e contribuir para pesquisas, especialmente com crianças. Este estudo teve como objetivo testar a confiabilidade e validade da versão brasileira do Childrens Fear Survey Schedule- Dental Subscale (CFSS-DS). A amostra foi composta por 136 crianças, que são atendidas sob livre-demanda na clínica de Odontopediatria da Faculdade de Odontologia de Bauru, Bauru - SP, Brasil. Todas recrutadas aleatoriamente. A versão em português brasileiro do CFSS-DS foi respondida por crianças previamente ao atendimento odontológico. A escala foi testada quanto à consistência interna e confiabilidade teste-reteste. Para testar a validade do critério, o comportamento das crianças foi avaliado utilizando a escala de Frankl durante o atendimento odontológico, e os resultados foram comparados com os escores de CFSS-DS das crianças. A análise fatorial também foi utilizada. Os resultados evidenciaram que a versão brasileira do CFSS-DS mostrou alta confiabilidade, quanto à confiabilidade testereteste (ICC = 0,76, p <0,001) e consistência interna ( de Cronbach = 0,90). Demonstrou boa validade de critério, as crianças com comportamento negativo apresentaram pontuação no CFSS-DS significativamente maiores (t = 16,64, p <0,001). A análise fatorial identificou os seguintes fatores: "medo de procedimentos habituais e anestesia", "medo de estranhos" e "medo de aspectos médicos gerais". Após análise dos resultados pode-se inferir que a versão brasileira do CFSS-DS é uma medida confiável e válida para aferir ansiedade em função do tratamento odontológico em crianças brasileiras de língua portuguesa. Dentistas e pesquisadores de Odontopediatria podem usar esta versão validada do CFSS-DS para identificar o medo do tratamento odontológico em crianças brasileiras.(AU)

Early recognition of anxiety caused by dental treatment is a tool that could help the dentist during the treatment as well as contribute to research, especially when dealing with children. The purpose of this study was to test the reliability and validity of the Brazilian version of the Childrens Fear Survey Schedule-Dental Subscale (CFSSDS). The sample was composed by 136 random children that attended the Pediatric Dentistry Clinic in the Bauru School of Dentistry, Bauru SP, Brazil. The children answered the CFSS-DS Brazilian-Portuguese version previously to dental treatment. The Scale was tested according to its internal consistency, and test-retest reliability. Frankl Scale was used to evaluate the childrens behavior during dental treatment in order to test the criteria validity. Results were compared to CFSS-DS score. Factorial analysis was used as well. According to the results, CFSS-DS Brazilian version presented high reliability, both in test-retest reliability (ICC = 0,76, p <0,001) and internal consistency ( de Cronbach = 0,90). Good criteria validity was also demonstrated, children with negative behavior presented significantly higher CFSSDS score (t = 16,64, p <0,001). Factorial analysis identified the following factors: fear of habitual procedures and anesthesia, fear of strangers and fear of general medical aspects. After results analysis, we can conclude that the CFSS-DS Brazilian- Portuguese version is a valid and reliable tool that can be used to measure anxiety caused by dental treatment in Brazilian children. Pediatric Dentists and researchers can use this validated CFSS-DS version to identify dental treatment fear in Brazilian Children.(AU)

Photodynamic inactivation of Candida albicans mediated by a low density of light energy.

Shorter times and lower energies of application of light sources are desirable to use photodynamic antimicrobial chemotherapy (PACT) to the clinical control of candidiasis, especially among babies and children. Light energies ranging from 39.5 to 100 J/cm(2) were previously applied to kill Candida albicans by PACT. The present study evaluated the efficacy of a combination of 0.05 mg/mL toluidine blue O (TBO) and a short time of application (60 s) and a low density of light energy (18 J/cm(2)) of a red light-emitting diode (LED) in killing C. albicans planktonic cells. Standard suspensions of C. albicans were randomly assigned for four treatment groups: control (L-P-), LED alone (L+P-), TBO alone (L-P+), and PACT (L+P+). After treatments, serial dilutions of suspensions were prepared and streaked on Sabouraud dextrose agar to determine colony-forming units of C. albicans per milliliter (CFU/mL). The results were analyzed by ANOVA and Tukey's post-hoc test (P < 0.05). PACT significantly reduced CFUs of C. albicans in comparison to other three treatments. Our results demonstrated a fungicidal effect of PACT mediated by a shorter time of application of LED on C. albicans planktonic cells. Further in vivo studies are needed to elucidate the efficacy of PACT to treat human fungal infections.

Rare case of bilateral gemination in deciduous teeth / Un caso infrecuente de geminación bilateral en dientes temporales

Gemination in bilateral mandibular primary teeth is a rare anomaly. This kind of anomaly features two crowns totally or partially separated, but only one root and one root canal. At intraoral clinical examination of children we found different anatomy of mandibular primary canines with two partially separated crowns. The radiographic exams showed geminated teeth. After 3-years of follow-up, the cone beam computed tomography showed the absence of the mandibular permanent lateral incisors and the aspect of normality of the permanent canines germs. Although the gemination in primary teeth itself is considered as a harmless anomaly, its presence could indicate the occurrence of some dental anomaly in the permanent dentition. To the best of our knowledge, this is the only case of bilateral mandibular geminated deciduous teeth after 3 years of follow-up. Therefore, we highlight the importance of the early diagnosis and follow-up of this anomaly until the eruption of the permanent dentition.

La geminación dientes temporales mandibulares bilateralmente es una anomalía poco frecuente. Este tipo de anomalía presenta dos coronas total o parcialmente separadas, pero solo una raíz y un canal radicular. Al examen clínico intraoral de los niños encontramos la variación anatómica de los caninos temporales mandibulares con dos coronas parcialmente separadas. Los exámenes radiográficos mostraron los dientes geminados. Después de 3 años de seguimiento, la tomografía computarizada Cone-Beam mostró la agenesia de los incisivos laterales permanentes mandibulares y el aspecto de normalidad de los gérmenes de los caninos permanentes. Aunque la geminación en dientes primarios se considera como una anomalía no patológica, su presencia puede indicar la presencia de alguna anomalía dental en la dentición permanente. Según nuestro nuestro conocimiento, este es el único caso de dientes temporales geminados mandibulares bilateralmente tras 3 años de seguimiento. Se destaca la importancia del diagnóstico precoz y el seguimiento de esta anomalía hasta la erupción de la dentición permanente.

Identificação do biomarcador NS1 na saliva como diagnóstico da dengue / NS1 biomarker identification on saliva for dengue diagnosis

Muitas ferramentas de diagnóstico da dengue tornaram-se disponíveis, porém requerem coleta de sangue como amostra para análise. Um método não invasivo de confirmar a infecção por dengue seria de importância considerável para os estudos clínicos e epidemiológicos. Testes de saliva podem encorajar os pacientes a serem mais receptivos para o diagnóstico da dengue. Possíveis problemas com o uso de sangue incluem a exigência de consentimento e a cooperação do paciente. Em muitos casos, flebotomia em indivíduos com fobia de agulhas, portadores de deficiências e discrasias sanguíneas e, especialmente em bebês e crianças, ou ainda devido a razões sociais, religiosas, à necessidade de um enfermeiro treinado e à necessidade de se separar o soro do plasma antes do teste. Objetivo deste trabalho foi identificar RNA viral em amostras de saliva de pacientes infectados com dengue durante o período febril; avaliar o teste rápido para identificar NS1 em amostra de saliva; identificar a presença de NS1 em amostras de saliva por meio do teste ELISA. Foram coletas amostras de saliva de pacientes durante o período febril com e sem dengue. Todos diagnósticos foram confirmados por exame de sangue para IgM/IgG. Foi feito o teste da Reação em Cadeia da Polimerase em Tempo Real em 10 amostras de pacientes com dengue. Em 44 amostras foram testados as tiras de diagnóstico rápido da dengue e ao teste ELISA NS1, para a detecção da proteína NS1. Esse estudo ressaltou a importância da busca pelo diagnóstico laboratorial rápido, prático e financeiramente acessível de doenças febris agudas com sintomas inespecíficos, principalmente em áreas de ocorrência de dengue. Nesse estudo foi encontrada alta especificidade (94%) e média sensibilidade (73%) nos resultados da identificação da proteína NS1 nas amostras de saliva em estágios precoces da infecção por dengue. Esse método, se aprimorado para saliva, poderá ter resultados ainda melhores, por isso mais estudos são necessários.

This study brings a literature review about the current dengue status worldwide and in Brazil followed by a systematic review that highlights the dengue diagnosis through saliva. A prospective study was also made, which evaluated the dengue virus infection diagnosis accuracy through the NS1 antigen detection in saliva samples using ELISA assays. The NS1-ELISA results in saliva were compared to the IgM-ELISA and IgG-ELISA serology. A total of 44 saliva samples were obtained from November 2012 to February 2013. The results showed that de NS1-ELISA presented a sensibility of 0.73, specificity of 0.94, Positive Predictive Value of 0.95, Negative Predictive Value of 0.70, Positive Likelihood Ratio of 13.15, Negative Likelihood Ratio of 0.28. Having these findings in mind, it is possible to suggest that the NS1 detection in saliva may be an important diagnostic tool in special cases, such as people that fear needles, with blood dyscrasias, babies, children, as well as to quickly monitor epidemics and their dissemination.

Dental manifestations in bariatric patients: review of literature.

The rate of bariatric surgery has significantly risen in the past decade as an increasing prevalence of extreme obesity can be observed. Although bariatric surgery is an effective therapeutic modality for extreme obesity, it is associated with risk factors affecting also oral health. Based on an overview of the current literature, this paper presents a summary of dental manifestations in bariatric patients. Bariatric surgeries are associated with an increased risk for gastro-esophageal reflux which in turn might account for the higher amount of carious and erosive lesions observed in bariatric patients. As a result, also dentin hypersensitivity might be observed more frequently. The current data indicate that recommended postsurgical meal patterns and gastric reflux might increase the risk for dental lesions, particularly in the presence of other risk factors, such as consumption of sweet-tasting foods and acidic beverages. Further research is needed to evaluate the correlation of bariatric surgery and the development of dental diseases.

Dental manifestations in bariatric patients: review of literature

The rate of bariatric surgery has significantly risen in the past decade as an increasing prevalence of extreme obesity can be observed. Although bariatric surgery is an effective therapeutic modality for extreme obesity, it is associated with risk factors affecting also oral health. Based on an overview of the current literature, this paper presents a summary of dental manifestations in bariatric patients. Bariatric surgeries are associated with an increased risk for gastro-esophageal reflux which in turn might account for the higher amount of carious and erosive lesions observed in bariatric patients. As a result, also dentin hypersensitivity might be observed more frequently. The current data indicate that recommended postsurgical meal patterns and gastric reflux might increase the risk for dental lesions, particularly in the presence of other risk factors, such as consumption of sweet-tasting foods and acidic beverages. Further research is needed to evaluate the correlation of bariatric surgery and the development of dental diseases.