Conhecimentos e práticas em saúde bucal com crianças hospitalizadas com câncerKnowledge and practices of oral health on hospitalized children with cancer

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Objectives:Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX.Material and Methods:For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05).Results:Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment.Conclusions:The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

Resumo Esse estudo tem por objetivo avaliar o impacto da atual Política Nacional de Saúde Bucal, conhecida como Programa Brasil Sorridente (PBS), sobre a provisão de serviços odontológicos no Estado do Rio de Janeiro. Para tanto, foi investigada a evolução na disponibilidade de serviços focalizados pela PBS, entre o ano de implantação e 2010. Os itens analisados foram: Atenção Básica – Estratégia Saúde da Família: evolução no número de equipes de saúde bucal, e procedimentos (ações básicas, primeira consulta programática, preventivos coletivos, preventivos individuais, cirúrgicos) por habitante;Atenção Especializada: identificação dos municípios que possuem Centros de Especialidades Odontológicas – CEO, verificação da evolução dos procedimentos endodônticos e periodontais; e Fluoretação da águas: presença ou não de água fluoretada. De acordo com os resultados observou-se evolução nos indicadores analisados, os quais foram distintos segundo o porte demográfico dos municípios. Conclui-se que a PNSB favoreceu a organização dos serviços de saúde bucal nos municípios fluminenses, embora ainda existam desafios a serem superados.

Aim: To identify the prevalence of dental caries in inland Brazilian adolescents, and to analyze the influence of socio-demographic and clinical variables, and access to dental service on caries experience. Methods: This study had a non-probabilistic sample comprising 504 adolescents aged 12 years, attending public schools in the city of Nova Friburgo, mountain region of Rio de Janeiro, Brazil. The World Health Organization (WHO, 1997) criterion was used by previously calibrated examiners to report dental caries. Variables were obtained by means of a semistructured questionnaire applied to the adolescents' parents. Results: The D 3 MFT mean was 1.90 and the Significant Caries (SIC) Index was 4.54, mainly represented by the carious component. Multiple logistic regression analysis revealed that parents with over 8 years of schooling (OR=0.579), absence of pain (OR=0.396) and not visiting the dentist (OR=0.270) might suggest protective factors against the disease; the possible risk factors were male gender (OR=1.982) and pain, extraction and others were reasons for consultation (OR=2.435). Conclusions: Although the prevalence of caries was slightly below the national mean, polarization of the disease was clearly observed. Education and no access to the dentist led to protection against the disease. These results may contribute to planning of oral health actions directed towards this target population for the control of caries.

Hypodontia is characterized by partial or total congenital missing of one or more teeth, on one or both dentitions. Heredity is the main etiological factor and the principal clinical features are reduction on number, size and form of teeth, and late eruption. Removable partial prosthesis, fixed prosthesis, overdentures and adhesive prosthesis are alternative treatments, and the indication is type dependent. The aim of this study was to describe the clinical case of an eleven-year-old child with eight missing permanent teeth of idiopathic etiology.The patient had facial and skeletal symmetry, normal development and was not related to any syndrome. Clinical characteristics: permanent teeth with good periodontal conditions (16, 12, 11, 21, 22, 26, 36, 31, 42, 46), primary teeth (53, 63, 64, 73, 83); overbite and microdontia on teeth 12 and 22. The treatment plan was done initially by documenting of the case for teeth analysis (study casting models, periapicals and panoramic x-rays, and photographs), and followed by the exodontics of teeth 73 and 83.A removable appliance in autocured acrylic resin, using teeth in acrylic for maintenance of functional space and occlusion was planned and carried out.An anterior track for vertical dimension gain was used because of his accentuated overbite. The patient will be monitored until the end of the craniofacial growth, when it will be again evaluated and forwarded for the final oral rehabilitation. Hypodontia diagnosis and management should be performed as early as possible not to interfere with the craniofacial development of the child.

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The aim of this study was to evaluate the effect of saliva contamination (SCT) and re-etching time (RET) on the shear bond strength (SBS) of the Fluroshield sealant. Forty-five extracted third molars were sectioned and flattened until reach an enamel surface area. Then, all samples were etched for 30 sec with 35% phosphoric acid and then they were distributed into 9 groups (n=10) according to SCT and RET (seconds), respectively: G1- control (no SCT and no RET); G2- 30s and 0s; G3- 60s and 0s; G4-30s and 2s; G5- 30s and 5s; G6- 30s and 15s; G7-60s and 2s; G8- 60s and 5s; G9- 60s and 15s. The sealant was applied according to the manufacturer's instructions. The samples were stored in distilled water at 37ºC for 72h and subjected to the SBS test. The results indicated that there was no statistically significant difference between the groups (p>0.05). However, it could be noticed that: 1- the longer the SCT, the lower the SBS values; 2 - the longer the RET, the higher the SBS values. It could be concluded that there was a tendency to the shortest SCT (30s) associated to the longest RET (5 and 15s) to reach similar SBS values for the control group.