Uso de cenário com pessoas com deficiência e seus familiares no ensino odontológico / Use of scenarios with people with disabilities and their families in dental education

O objetivo deste estudo foi usarum cenário envolvendo pessoas com deficiência, seus familiares e estudantes de Odontologia para avaliar a percepção dos estudantes a respeito das necessidades destas pessoas.Trata-se de um estudo qualitativo transversal no qual participaram 60 estudantesde Odontologia matriculados na disciplina de Clínica Integrada Para Pacientes com Necessidades Especiais. Formaram-se grupos focais quereceberam um questionário semiestruturado com questões que exploraram aspectos sobre o atendimento de pessoas com deficiência e da rotina destas pessoas. Na sequência utilizou-se um cenário no qual estudantes interagiram com pessoas com deficiência e seus familiares. Na última etapa os grupos formularam hipóteses a respeito do atendimento destes pacientes. Os dados coletados nos três momentos foram agrupados em categorias e temas e analisados no software Atlas Ti. Os principais resultados obtidos foram agrupados em categorias de acordo com a percepção dos estudantes antes e depois da criação do cenário. Os dados obtidos após a análise qualitativa revelam que antes da criação do cenário os estudantes se colocaram no centro da discussão argumentando que atender pessoas com deficiência seria uma oportunidade para desenvolver suas habilidades, sem se preocupar com a pessoa com deficiência em si. Após a criação do cenário parece ter havido uma mudança importante na percepção dos estudantes acerca dessas pessoas e de suas famíliase as palavras respeito e empatiaapareceram frequentemente nos textos produzidos pelos estudantes. Aproximar os estudantes da realidade vivida pela pessoa com deficiência e de sua família parece ser uma alternativa para educar o estudante de Odontologia (AU).

The aim of this study was to use a scenario involving people with disabilities, their families,and dental students to assess students'perceptions of the needs of peoplewithdisabilities. This is a qualitative cross-sectional study that included60 dentalstudents enrolled in the discipline of Integrated Clinical Careof Patients with Special Needs.Focus groups were formed and each group received a semi-structured questionnaire with questions aboutaspects of the care provided to people with disabilities andabouttheir routine.Ascenario wasthenused in which students interacted with people with disabilities and their families. In the last phase of the study, the groups formulated hypotheses about the care of these patients. The data collected inthree time periods were grouped into categories and themes and analyzed using the Atlas Ti software. The results obtained were categorizedaccording to the students' perception before and after the creation of the scenario. After the qualitative analysis, the data revealedthat,before the creation of the scenario, the students placed themselves at the center of the discussion,arguing that attending to people with disabilities would be an opportunity to develop their skills without worrying about peoplewith disabilities themselves. After the creation of the scenario,there seems to have been an important change in the students' perception of these people andoftheir families and the words 'respect'and 'empathy'appeared frequently in the texts produced by the students. Bringing students closer to the reality experienced by people with disabilities and their families seems to be an alternative to educate dentalstudents (AU).

Analysis of Salivary Flow, pH, Buffer Capacity, and Creatinine in Individuals Undergoing Hemodialysis

Objective: To quantify salivary creatinine levels patients with end-stage renal disease (ESRD) before, during, and after hemodialysis sessions. Material and Methods: Sixty-eight individuals, aged between 4 and 25 years, were selected, and among these, 34 were diagnosed with ESRD and were undergoing hemodialysis (Group 1) and 34 were clinically healthy patients (Group 2). Saliva samples were collected before, during, and after hemodialysis sessions for Group 1 and compared with those of Group 2. Stimulated saliva flow rate (SSFR), buffer capacity (BC), pH, and salivary creatinine levels were determined. Shapiro-Wilk test, followed by the Friedman, Mann-Whitney and ANOVA tests were used to analyze the variables. Results: Mean SSFR values of Group 1 at the three stages of hemodialysis sessions did not differ from those of Group 2. Furthermore, BC and pH values were within their normal limits, and no difference was detected between the two groups. Mean salivary creatinine levels at baseline and during hemodialysis were significantly higher in Group 1 that in Group 2, but these values were not different between Groups at the end of hemodialysis. Conclusion: Salivary creatinine levels reduce significantly after hemodialysis sessions suggesting that saliva may be used to monitor the efficiency of hemodialysis or even indicate the moment at which it should start.

Oral rehabilitation in a patient with bipolar affective disorder: clinical case report

Objective: This study, through a literature review, aimed to present the key aspects found in Bipolar Affective Disorder (BAD), as well as present a case report of a patient who received dental care in the Discipline of Dentistry for Patients with Special Needs of PUCPR. Case report:Female patient, 30 years of age, leukoderma, diagnosed by medical and psychological exams as suffering from BAD and slight mental retardation. The most evident characteristics inherent to the primary illness included swings in mood and affection as well as bipolar or manic depressions. The special school where she studied and worked referred her to receive dental care in the Discipline of Dentistry for Patients with Special Needs of PUCPR. Her main complaint was the lack of upper front teeth and the esthetic. The treatment plan included adequacy of oral environment through basic periodontal therapy and production of removable partial dentures. Conclusion: People with BAD requires extra care with regard to behavioral management.

Free gingival graft to increase gingival dimensions in Down syndrome patients: clinical case report

Introduction:Down Syndrome (DS) patients have increased susceptibility to the development of periodontal diseases by the occurrence of several factors, such as inadequate hygiene, mouth breathing, dental morphology, leukocyte reduction and increased inflammatory mediators. Objective:This study aimed to review the literature on the main aspects of DS and present a clinical case of a DS patient treated with basic periodontal therapy and free gingival graft surgery. Case report: DS patient, leucoderma, aged 26 years showed gingival recession and little amount of keratinized tissue in the area of teeth #31 and #41. After surgery, there was an increase in the keratinized tissue band. Conclusion: The free gingival graft surgery performed in DS patients was effective, as the increase of keratinized tissue band occurred.

Clinical evaluation of dental treatment needs in chronic renal insufficiency patients.

OBJECTIVE: To evaluate the need for dental treatment in chronic renal insufficiency (CRI) patients undergoing hemodialysis. DESIGN: Transversal study and case control. SETTING: CRI patients were examined at the Pequeno Príncipe Hospital in Curitiba, Brazil. The control group was examined at Nossa Senhora da Conceição Health Clinic in Campo Magro, Brazil. SUBJECTS (MATERIALS) AND METHODS: Thirty-four CRI patients were undergoing hemodialysis. The control group consisted of 34 normoreactive individuals paired by gender and age. INTERVENTIONS: The clinical examination was performed under an artificial light, using an oral mirror, an exploratory probe, a periodontal probe, and a tongue depressor. MAIN OUTCOME MEASURES: This study adopted the methodology proposed by the World Health Organization (WHO). RESULTS: The CRI patient group needs periodontal and orthodontic treatment. The control group needs restorative treatments, prostheses, as well as surgical and endodontic treatment. CONCLUSION: The profile of dental treatment needs proved to be distinct among the studied groups.

Prader-Willi Syndrome: clinical case report

Introduction: Prader-Willi syndrome (PWS) is a neurobehavioral genetic disease whose cause is failure on chromosome 15. It is considered the primary genetic cause of obesity, since it is characterized by hyperphagia. Although the scientific literature will produce articles on Prader-Willi syndrome, few reported oral conditions of these patients. Objective: This study aimed to describe the oral health status of a patient diagnosed with PWS. Case report: A boy aged 10 years-old, leucoderma, attended the Discipline of Dentistry for Special Care Patients, Pontifical Catholic University of Paraná (PUCPR), with all the inherent PWS characteristics such as hyperphagia and obesity. Clinical, radiographic and laboratory tests were performed to verify the oral health conditions which showed the presence of biofilm accumulation, gingivitis and a high DMFT index. It was necessary to adequate oral environment through extractions, restorations, and prophylactic therapy. Conclusion: Considering the information obtained, it was concluded that the motivation to maintain oral health should be constant for this patient and involve family, since hyperphagia, which is a determinant for obesity, decisively contributes to the evolution of oral diseases.

Analysis of salivary pH, flow rate, buffering capacity, concentrations of calcium, urea and total proteins in 2-8 years-old children with Down's syndrome

Introduction: Down syndrome (DS) is a genetic disorder caused by trisomy of chromosome 21. It is the most common chromosomal abnormality found in humans. Despite the motor difficulties and biofilm accumulation, individuals with DS have low caries prevalence. In this context it is assumed that saliva plays an important role in maintaining oral health. Objective: To evaluate the following salivary components: pH, buffering capacity and salivary flow volume in children with DS aging 2-8 years-old in the city of Curitiba (PR). Material and methods: Saliva samples were collected from 20 children with DS. The following parameters were evaluated: buffering capacity, flow rate, pH, and concentrations of calcium, urea and total proteins. Results: There was a normal distribution among the variables and the values observed were not statistically significant (p > 0.05). Conclusion: The results of this study revealed that there were no statistically significant differences in salivary flow, pH, buffering capacity, urea, calcium and total proteins in the subjects studied.

Análise sialométrica em indivíduos portadores da síndrome de Down / Sialometric assessment of individuals with Down

A síndrome de Down (SD) é a alteração cromossômica mais comum no ser humano e caracteriza-se pelo aparecimento de um cromossomo extra, localizado no par 21. Objetivo: Nesta pesquisa estudou-se a velocidade de fluxo, o pH e a capacidade de tamponamento salivar em pacientes portadores da síndrome de Down. Materiais e Métodos: Foram selecionados 60 indivíduos não aparentados, pareados em idade e sexo, residentes em Curitiba, Paraná, sendo 30 indivíduos diagnosticados com SD (grupo experimental) e 30 indivíduos normorreativos (grupo controle). Para as avaliações bioquímicas salivares coletaram-se as amostras pelo método Spitting preconizado por Navazesh (1992) e posteriormente realizaram-se as análises. O fluxo salivar foi calculado através da fórmula de Banderas-Tarabay (1997). O pH salivar foi mensurado com o auxílio de um medidor digital e a capacidade tampão com o kit Caritest® – SL. Resultados: O valor médio do fluxo salivar foi estatisticamente menor para os indivíduos portadores da SD e os valores médios de pH e capacidade tampão salivar não diferiram entre os grupos. Conclusão: Indivíduos com SD apresentaram alterações uantitativas e não qualitativas do fluido salivar...

Down syndrome (DS) is the most common chromosomal abnormality in humans and is characterizedby the appearance of an extra chromosome, located at par 21. Objective: In this research we studiedthe flow rate, pH and buffering capacity of saliva in patients with Down syndrome. Materials and methods:60 unrelated individuals were selected matched by age and sex, living in Curitiba, Paraná, with 30 patientsdiagnosed with DS (experimental group) and 30 normoreactive individuals (control group). For biochemicalassessment, salivary samples were collected by Spitting method, recommended by Navazesh (1992) and thenthe analyses were carried out. Salivary flow was calculated using the formula of Banderas-Tarabay (1997).Salivary pH was measured with the aid of a digital meter and buffering capacity with the Caritest® – SL kit.Results: The mean salivary flow was statistically lower for patients with SD and the average values of pH andsalivary buffer capacity did not differ between groups. Conclusion: Individuals with SD showed no quantitativeand qualitative changes in salivary fluid...

Sialometric analysis in young patients with chronic renal insufficiency.

The present study aimed to evaluate whether or not quantitative changes occur in the salivary flow of patients with chronic renal insufficiency (CRI) who have been submitted to Hemodialysis. Twenty-nine chronic renal patients, between 4 and 25 years of age, submitted to Hemodialysis at Hospital Pequeno Príncipe in Curitiba, Paraná, Brazil participated in this study. The results form this study were compared with those of a group consisting of 29 healthy patients, paired by sex and age, whose parents sought out dental treatment at local health clinic in Campo Magro, Paraná. For Sialometric evaluations, samples were collected at the beginning, during and at the end of Hemodialysis, as well as after the analyses had been performed. Salivary flow was calculated by the Banderas-Tarabay formula (1997). The results revealed that the mean salivary flow values presented no difference between the groups. It could therefore be concluded that CRI did not determine quantitative alterations in salivary fluid.

Abordagem terapêutica em molares decíduos anquilosados: relato de caso clínico / Terapeutícal approach of ankylosed decíduous molars: case report

A anquilose dento alveolar, comum em molares decíduos, é definida como uma intercorrência no processo da erupção dentária, caracterizada pela fusão anatõmica entre o cemento e/ou dentina com o osso alveolar. Pode apresentar diferentes graus de infraoclusão, ocorre em qualquer etapa do período eruptivo e a sua etiologia é desconhecida. O diagnóstico precoce é de extrema importância para evitar a instalação de má-oclusão. O objetivo deste trabalho é apresentar uma revisão de literatura sobre a anquilose, bem como o relato de um caso clínico com os respectivos tratamentos.

The dentoalveolar ankylosis, common in deciduous molars, is an anomaly of dental eruption, due to abnormal fusion between cemento and/or dentine with the alveolar bone. It is characterized by presents different degrees of infraocclusion that can occurs in distinct stages of eruptive period which etiology is ignored. In order to prevent malloclusions, the correct diagnosis of dentoalveolar ankylosis seems to be very important. This paper aims to presents a dentoalveolar ankylosis literature review and a clinical case report, with the respective treatment.

Abordagem odontopediátrica integrada em crianças com paralisia cerebral / Odontopediatrics approach integrated in children with cerebral palsy

Este estudo tem a finalidade de descrever métodos de atendimento que minimizem as dificuldades encontradas durante a realização do tratamento odontológico em pacientes com paralisia cerebral. A classificação, a etiologia e os problemas sistêmicos associados são relatados para que o profissional possa conhecer o tipo de paralisia cerebral com a qual está trabalhando e alcançar sucesso no tratamento odontológico, tanto curativo como preventivo.

Síndrome de Apert: relato de caso clínico / Apert Syndrome: clinical case report

Tomando como base um caso clínico da Síndrome de Apert, esta pesquisa tem como objetivo apresentar a importância da assistência ao paciente com esta deficiência, enfatizando o tratamento odontológico. Essa síndrome é uma acrocefalossindactilia tipo I e tem como principais características a craniosinostose, hipoplasia do terço médio da face e sindactilia das mãos e dos pés. No exame intrabucal foi observado presença de dentes hígidos, mordida aberta anterior, apinhamento dental, relação molar Classe III de Angle, palato ogival, fenda palatina e úvula bífida. Sua ocorrência é estimada em 1 a cada 160.000 nascidos vivos e é considerada uma das mais importantes síndromes craniofaciais, sendo, portanto, uma patologia importante para a Odontologia

Estudo da eficácia de três diferentes métodos de controle de placa bacteriana em indivíduos portadores de deficiência visual / Study of the effectiveness of three methods differents of bacterial plate control in individuals bearers of visual deficiency

No Brasil existem mais de 16 milhões de portadores de deficiência visual permanente e 160 mil cegos totais (IBGE-Censo 2000). Após o exame clínico dos pacientes internos do Instituto Paranaense de Cegos (IPC) pôde-se constatar uma grande deficiência na higiene bucal desses pacientes, apresentando alto índice de placa, doença periodontal e cárie. Prevenindo a formação da placa bacteriana é possível controlar e evitar tais doenças bucais. Baseado nessas informações este trabalho teve o objetivo de experimentar e avaliar a eficiência de 3 métodos diferentes de controle de placa bacteriana em indivíduos portadores de deficiência visual, comparando a escovação habitual (grupo A), escovação orientada (grupo B) e associação da escovação habitual com bochechos diários de enxaguatório bucal a base de triclosan (grupo C). Foi realizada a mensuração do IHO-S (Índice de Higiene Oral Simplificado)¹ antes e após duas semanas da utilização de cada um dos métodos. Os resultados demonstram uma redução da placa bacteriana estatisticamente significativa de 30% no grupo A, 37% no grupo B e 45% no grupo C. Através dos resultados obtidos conclui-se que apenas a motivação para higiene bucal gerou uma diminuição de placa em todos os indivíduos estudados e o meio que demonstrou uma redução mais efetiva foi a a escovação habitual com bochechos de enxaguatório bucal a base de triclosan, embora esta redução não é estatisticamente significativa entre os grupos, pode ser considerada clinicamente relevante.

Síndrome da Blefarofimose: relato de caso / Blepharofimosis syndrome: case report

Este trabalho apresenta um caso clínico da Síndrome da Blefarofimose, em uma criança de cinco anos de idade com retardo mental moderado. Trata-se de uma síndrome na qual ocorre diminuição da fenda palpebral, tanto no sentido horizontal quanto no sentido vertical, devido a uma parada do desenvolvimento embrionário em torno do terceiro mês de vida intra-uterina. É caracterizada por uma tríade semiológica composta pela associação de ptose palpebral, epicanto inverso e telecanto, formando uma verdadeira síndrome clínica. O trabalho clínico realizado consistiu em manejo do comportamento, educação preventiva para a mãe, tratamento restaurador e ortodôntico através da expansão rápida da maxila visando, principalmente, a melhora da função respiratória