Comparison of student satisfaction in public versus private dental schools in Brazil.

This study compared perceptions of the teaching and learning process of twenty-four senior dental students from a public school and fifteen from a private school by means of a questionnaire with direct questions. Another five students in each group completed a qualitative survey with five open-ended questions. The questionnaires assessed perceptions of the interaction between didactic and clinical content, the role of professors during the course, and their future professional practice in Brazil. Quantitative data were summarized as means and standard deviations and statistically analyzed with the Student t test, P<0.05. Qualitative data were analyzed using a content analysis method. The results revealed that the students in the private school had more positive perceptions than those in the public school of how much the didactic classes contributed to professional practice, the level of motivation for the topics discussed, and how well coursework related to clinical practice. Both groups mentioned the importance of the clinical component of learning and perceived that professors showed little commitment to the professional preparation of dental students. Students' perceptions of their preparation to work in different Brazilian communities and with different segments of society varied widely. The qualitative analyses confirmed students' dissatisfaction with their learning. No difference was found between students in the public and private schools in their assessment of how well prepared they were to enter the working market. These findings indicate that measures should be taken to improve the quality of teaching and the satisfaction of dental school students in Brazil.

Implicações clínicas da dentição reduzida / Clinical implications of reduced dentition

Uma vez questionada a "Síndrome dos 28 Dentes" diferentes estudos foram conduzidos sobre dentição reduzida. Através de revisão de literatura os autores tentam justificar a manutenção de um arco dental reduzido avaliando as implicações clínicas desse, na saúde bucal dos pacientes.

Since "The 28' Teeth syndrome" was questioned, different studies about shortened dental arch were published. By means of a literature review, the authors try to justify the indication of a shortened dental arch evaluating the clinical implications of this planning strategy upon patients' oral health.

Obesity and periodontal disease in diabetic pregnant women.

This cross-sectional study investigated the impact of pregestational overweight and obesity on periodontal status of patients with gestational diabetes mellitus (GDM). Sixty pregnant women with gestational diabetes mellitus (GDM) were recruited for the study. According to the pregestational body mass index (BMI), patients were classified into 3 groups: normal, overweight or obese. The periodontal assessment parameters were the presence of gingival bleeding (GB) and bleeding on probing (BOP) per tooth. Clinical attachment loss (CAL) was assessed per tooth and classified according to following values: 1) absence of attachment loss; 2) between 1 and 2 mm, 3) between 3 and 5 mm; and 4) CAL > or = 6 mm. The means of individual percentage of teeth with GB and BOP and the means of the individual classified values of CAL were compared through ANOVA. Differences between the groups were established through post hoc Bonferroni test for multiple comparisons (p < 0.05). The analysis revealed significant differences between the normal group and the obese group considering GB (52.76% +/- 27.99% and 78.85% +/- 27.44%, respectively) and CAL (2.21 +/- 0.41 and 2.61 +/- 0.54, respectively). Although an increase was found in BOP as the BMI increased (ranging from 55.65% to 75.31%), no statistically significant differences were found among the groups. Patients with GDM and pregestational obesity had significantly more gingivitis and periodontal attachment loss that those with normal pregestational BMI. Periodontal treatment should be considered in the establishment of future recommendations for metabolic control for this special group of patients.

Hand and ultrasonic instrumentation in the treatment of chronic periodontitis after supragingival plaque control.

This study compared the clinical effects of hand or ultrasonic scaling and root planing on the treatment of chronic periodontitis. After supragingival plaque control, twenty patients were examined by a blinded and calibrated examiner for probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP). Experimental teeth were allocated to the following subgingival treatment groups according to PPD: 1) hand instrumentation; 2) hand instrumentation with irrigation; 3) ultrasonic instrumentation; 4) ultrasonic followed by hand instrumentation. Time used in the procedures was recorded. Follow-up examinations were performed at 30 and 90 days after treatment. Each patient's individual BOP, PPD and CAL means were analyzed with repeated-measures ANOVA. Differences in the instrumentation time were analyzed with 1-way ANOVA. Significance level was established at 5%. All treatments produced significant changes in the clinical parameters. BOP reduced, in proximal surfaces, from 67.21-79.17% at baseline to 45.75-51.54% at 90 days. Significant reductions were also found for PPD and CAL in all groups, both in proximal and free surfaces. Reductions in mean PPD at 90 days ranged from 0.92 to 1.14 mm for the free surfaces and from 1.01 to 1.35 mm for proximal surfaces, whereas reductions in CAL ranged from 0.43 to 0.82 mm and from 0.60 to 0.73 mm for free and proximal surfaces, respectively. Mean instrumentation time ranged from 4.77 to 5.30 minutes. No statistically significant differences were found among the four study groups. It can be concluded that the four methods of subgingival instrumentation were equally efficacious in the improvement of the studied clinical parameters.

Obesity and periodontal disease in diabetic pregnant women

O objetivo do presente estudo foi examinar o efeito da massa corporal prévia à gestacão (IMC - índice de massa corpórea) sobre o periodonto de pacientes com diabete mellitus gestacional (DMG). A amostra constituiu-se de 60 gestantes classificadas em 3 grupos segundo o IMC: normal, sobrepeso ou obeso. Os parâmetros de avaliacão periodontal foram sangramento gengival (SG), sangramento à sondagem (SS) e perda de insercão clínica periodontal (PI) categorizada de acordo com os seguintes valores: 1) correspondente à ausência de perda de insercão; 2) PI entre 1 e 2 mm, 3) PI entre 3 e 5 mm; e 4) PI > 6 mm. Médias das porcentagens dos dentes com SG e SS e as médias dos valores categorizados, por dente, da perda de insercão foram comparadas por meio do teste ANOVA e as diferencas entre os grupos foram estabelecidas por meio do teste post hoc de Bonferroni para comparacões múltiplas (p < 0,05). Diferencas estatisticamente significantes foram identificadas entre o grupo normal e obeso com relacão às médias percentuais da presenca de SG (52,76 n 27,99% e 78,85 n 27,44%, respectivamente) e às médias da categorizacão da PI (2,21 n 0,41 mm e 2,61 n 0,54 mm, respectivamente). Embora tenha se observado aumento no percentual médio de SS à medida do incremento do IMC, não foram observadas diferencas estatisticamente significantes entre os grupos, e a variacão foi de 55,65% a 75,31%. Pacientes com DMG e obesidade pré-gestacional apresentaram significativamente mais gengivite e perda de insercão periodontal que aquelas com IMC pré-gestacional normal. O tratamento periodontal deve ser considerado na determinacão de futuras recomendacões de controle metabólico para esse grupo especial de pacientes.

Hand and ultrasonic instrumentation in the treatment of chronic periodontitis after supragingival plaque control

Este estudo comparou, clinicamente, o efeito de raspagem e alisamento radicular por instrumentações manual e ultra-sônica no tratamento da periodontite crônica, após o controle de placa supragengival em 20 pacientes. Os parâmetros clínicos profundidade de sondagem (PS), nível de inserção clínica (NIC) e sangramento à sondagem (SS) foram avaliados por um examinador calibrado e cego. Os dentes experimentais foram alocados para uma das seguintes abordagens subgengivais, de acordo com a profundidade de sondagem: 1) manual, 2) manual associada à irrigação, 3) ultra-sônica, 4) ultra-sônica previamente à manual. O tempo usado nos procedimentos foi registrado. Avaliações foram feitas 30 e 90 dias após os tratamentos. Médias individuais de SS, PS e NIC foram analisadas pelo teste ANOVA de medidas repetidas (p < 0,05). Diferenças no tempo de instrumentação foram analisadas por meio do teste ANOVA para um critério de classificação (p < 0,05). Os resultados revelaram que os tratamentos produziram alterações significativas nos parâmetros clínicos sem diferenças estatisticamente significantes entre os quatro grupos. Observaram-se reduções no SS, que, nas faces proximais, variou de 67,21 a 79,17%, no início, para 45,75 a 51,54% no final. Também foram observadas reduções significativas na PS e no NIC em todos os grupos, tanto para faces livres quanto proximais: as médias da PS aos 90 dias reduziram entre 0,92 e 1,14 mm nas faces livres e entre 1,01 e 1,35 mm nas proximais, enquanto para NIC as reduções foram de 0,43 a 0,82 mm e 0,60 a 0,73 mm, para as faces livres e proximais respectivamente. A média do tempo operatório variou de 4,77 a 5,30 minutos. Pôde-se concluir que as quatro modalidades terapêuticas de instrumentação subgengival foram igualmente eficazes na melhora dos parâmetros clínicos estudados.

A participação de odontólogos em equipes multidisciplinares / The dentist involvement in multidisciplinary approach

Limitações na abordagem unidirecional de atenção à saúde têm sido mostradas por estudos que ressaltam a importância dos múltiplos fatores envolvidos no estabelecimento, manifestação e resposta a tratamentos de diferentes condições patológicas. A necessidade de sintetizar os conhecimentos de diferentes áreas para melhorar a efetividade de atenção à saúde, dentro de um modelo promocional, tem exigido a formação de equipes multidisciplinares. Entretanto, a pouca freqüência da participação de odontólogos nas equipes, principalmente dentro dos hospitais, tem sido objeto de questionamento. Assim, o objetivo desse trabalho é mostrar a importância da participação de odontólogos na composição de equipes multidisciplinares de atenção à saúde, assim como, refletir sobre a complexidade dessa atividade

Correlation between visual and radiographic examinations of non-cavitated occlusal caries lesions -- an in vivo study.

The aim of this study was to conduct an in vivo investigation of the correlation between the visual and radiographic scoring systems by Ekstrand et al.7 (1997) for the diagnosis of occlusal caries lesions. The study sample comprised 147 occlusal sites from 23 patients. Two trained and experienced examiners performed the clinical visual examinations. A third examiner, which was also trained, experienced and blind to the results of the visual clinical examination, performed the analysis of the bitewing radiographs. The correlation between visual and radiographic scores was assessed by Goodman & Kruskal's gamma correlation coefficient. Results showed a strong correlation between the scores for occlusal caries found in the visual and radiographic diagnosis systems used in this study.

Correlation between visual and radiographic examinations of non-cavitated occlusal caries lesions: an in vivo study

O presente estudo verificou in vivo a correlação existente entre os sistemas de escore visual e radiográfico de Ekstrand et al.7 (1997) para diagnóstico de lesões de cárie oclusal. A amostra do estudo foi constituída de 147 sítios oclusais obtidos a partir de 23 pacientes. Os exames clínicos visuais foram realizados por dois examinadores treinados e calibrados. A análise das radiografias interproximais foi realizada por um terceiro examinador também treinado e calibrado, que desconhecia os resultados do exame clínico visual. A correlação entre os escores visual e radiográfico foi avaliada por meio do coeficiente de correlação gamma de Goodman & Kruskal. Os resultados revelaram uma forte correlação existente entre os escores dos sistemas de diagnóstico visual e radiográfico de cárie oclusal adotados no presente estudo.

Methodological considerations on descriptive studies of induced periodontal diseases in rats.

The aim of this study was to show the technique and the methodological approach used in describing histological characteristics of induced periodontal disease in rats. To reach that inflammatory process, periodontal disease was induced by ligature, with or without sucrose-rich diet. Twenty-four female adult (60 days old) Wistar rats were divided in four groups: Group 1, or control (which received standard diet), Group 2 (which received ligature around the upper second molars and a standard diet), Group 3 (which received a sucrose-rich diet), and Group 4 (which received ligature around the upper second molars and a sucrose-rich diet). The animals were followed for a period of 30 days, after which they were sacrificed. The upper second molars were removed, processed, and the histological characteristics were analyzed by a descriptive dichotomous method. The results were analyzed by the Fisher's exact test (significance level of 95%) and by a residual test, which showed the relation between groups and histological characteristics. The animals which received ligature (Groups 2 and 4) showed histological characteristics related with periodontitis, whilst the animals without ligatures showed no periodontal destruction. This was shown by a distribution of these groups in extremes of a graphic representation. The use of a ligature, as done in this study, was able to promote a chronic inflammatory process in the periodontium of rats, regardless of the adopted diet. The correspondence factorial analysis was capable of showing these characteristics, being one more tool to be used in histological research.

Methodological considerations on descriptive studies of induced periodontal diseases in rats

O objetivo do presente estudo foi apresentar a técnica e um método de descriçäo das características histológicas da doença periodontal induzida em ratos. Fez-se induçäo de periodontite com uso de ligaduras, com ou sem dieta rica em sacarose. Vinte e quatro ratos Wistar adultos (60 dias) foram divididos em quatro grupos: grupo 1 ou controle (recebeu dieta padräo), grupo 2 (recebeu ligadura ao redor dos segundos molares superiores e dieta padräo), grupo 3 (recebeu dieta rica em sacarose) e grupo 4 (recebeu ligadura ao redor dos segundos molares superiores e dieta rica em sacarose). Os animais foram acompanhados por um período de 30 dias, ao final do qual foram sacrificados. Os segundos molares superiores foram removidos e processados; fez-se análise histológica por método descritivo, dicotômico. Os resultados foram analisados pelo teste exato de Fisher (nível de significância de 95 por cento) e pelo teste do resíduo, que mostrou a relaçäo entre os grupos e características histológicas. Os animais com ligadura (grupos 2 e 4) mostraram características histológicas de periodontite, enquanto animais sem ligaduras näo apresentaram sinais de destruiçäo periodontal. O uso de ligaduras, no presente estudo, foi capaz de promover processo inflamatório crônico nos ratos, independente do tipo de dieta. A análise fatorial de correspondência serviu como método para mostrar tais características, sendo mais uma ferramenta para uso em pesquisa básica