It was possible to use the methodology proposed in this study in epidemiological surveys when examining the mixed dentition, although new strategies to improve training in IL diagnosis and calibration are necessary.
This study evaluated the effect of sealants on enamel demineralization, focusing on physical protection of the sealed enamel and fluoride protection of the adjacent unsealed enamel. Occlusal fissures with areas measuring 12 mm2 were delimited in 48 extracted molars, randomly divided into 4 groups (n =12): 1) no sealing; 2) sealing with a resin-modified glass-ionomer (Vitremer, 3M ESPE); 3) sealing with a fluoride-releasing composite sealant (Clinpro Sealant, 3M ESPE); and 4) sealing with a non-fluoridated composite sealant (Concise, 3M ESPE). A 4-mm2 window was outlined on the buccal enamel for analysis of fluoride uptake. Following treatment, groups 2, 3 and 4 were subjected to 5-days of pH-cycling, while group 1 was kept in a moist environment at 37 degrees C. Fluoride uptake was assessed by dental biopsy, and the amount of fluoride released to the cycling solutions was determined by ion analysis. Enamel demineralization around the sealants was evaluated by cross-sectional micro-hardness analysis. Group 2 showed higher levels of fluoride release (P < 0.01) and uptake by enamel (P < 0.05), and lower levels of demineralization (P < 0.05) than groups 3 and 4. Group 3 exhibited reduced demineralization on unsealed enamel and provided fluoride uptake in a distant enamel area, while group 4 did not.
Objectivesa) to evaluate the interexaminer reliability in caries detection considering different diagnostic thresholds and b) to indicate, by using Kappa statistics, the best way of measuring interexaminer agreement during the calibration process in dental caries surveys.MethodsEleven dentists participated in the initial training, which was divided into theoretical discussions and practical activities, and calibration exercises, performed at baseline, 3 and 6 months after the initial training. For the examinations of 6-7-year-old schoolchildren, the World Health Organization (WHO) recommendations were followed and different diagnostic thresholds were used: WHO (decayed/missing/filled teeth – DMFT index) and WHO + IL (initial lesion) diagnostic thresholds. The interexaminer reliability was calculated by Kappa statistics, according to WHO and WHO+IL thresholds considering: a) the entire dentition; b) upper/lower jaws; c) sextants; d) each tooth individually.ResultsInterexaminer reliability was high for both diagnostic thresholds; nevertheless, it decreased in all calibration sections when considering teeth individually.ConclusionThe interexaminer reliability was possible during the period of 6 months, under both caries diagnosis thresholds. However, great disagreement was observed for posterior teeth, especially using the WHO+IL criteria. Analysis considering dental elements individually was the best way of detecting interexaminer disagreement during the calibration sections.
RESUMOA partir do fim da Segunda Guerra Mundial passaram a ser elaboradas regulamentações internacionais para o desenvolvimento de Pesquisas envolvendo seres humanos. Para a realização destas pesquisas é essencial que principios éticos tais como autonomia e vulnerabilidade do sujeito da pesquisa sejam respeitados. Considerando a importancia do conhecimento dos pesquisadores sobre os aspectos éticos envolvidos na pesquisa com seres humanos, o presente estudo tem como objetivo discutir estes aspectos dentro de um contexto histórico. Nos dias atuais, pesquisas incluindo grupos vulneráveis e pessoas com autonomia reduzida são comumente realizadas e, apesar da existência de normas internacionais e nacionais, além de códigos e diretrizes publicadas a este respeito, muitas destas são realizadas desrespeitando a ética e os princípios morais, ferindo a dignidade humana.
Pala vras-cha veBioética; Autonomia Pessoal; Vulnerabilidade.O Cirurgiã-Dentista, Mestre em Cariologia FOP/UNICAMP.
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