To test the hypothesis that treatment with orthodontic appliances disturbs masticatory and swallowing performances. Twenty-seven subjects with malocclusions requiring orthodontic treatment were included in this prospective study. The masticatory and swallowing performances were evaluated at five different times: before bracket placement (T0), immediately after archwire placement (T1), 48 h after archwire placement (T2), 30 days after archwire placement (T3) and 3 months after the initial appointment (T4). Masticatory performance was determined by the median particle sizes for the Optocal test food after 15 chewing strokes, and the swallowing thresholds were registered for both the test food and a natural food (peanuts). Pain during mastication was evaluated using a 100-mm visual analogue scale. Masticatory performance was significantly reduced at T2, at which time patients reported the highest pain values. The time spent to the first swallow was increased at T2 for the natural food but not for the test food. The values for pain, masticatory and swallowing performances at T3 and T4 were similar to those at T0. Orthodontic patient masticatory function is only reduced during the period of higher pain experience, which could also disrupt the deglutition of harder foods. However, neither mastication nor deglutition processes were disturbed by orthodontic appliances in long-term treatment.

This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.

Objectives This two-arm, parallel-group, tooth-randomised, controlled noninferiority clinical trial aimed to compare survival rates between the sealing and restoring of cavitated occlusal carious lesions in dentine [International Caries Detection and Assessment System (ICDAS) 5] of deciduous molars using resin-modified glass-ionomer cement (RMGIC) and to assess caries progression radiographically. Materials and methods A total of 68 molars with ICDAS 5 occlusal lesions were randomly allocated into two groups, a sealing group (n = 31), in which RMGIC was placed directly over the carious lesion, and a restoration group (n = 37), in which a restoration with the same material was placed after selective caries removal. During the baseline and follow-up visits, dental caries was registered and caries activity was assessed according to a visuotactile criterion. At baseline, patient caries status (dmf-t) and cavity depth and extent (mesiodistal and buccolingual) were measured before RMGIC placement. An independent and blinded examiner evaluated the treated teeth using the USPHS criteria after one and two years. Standardised interproximal radiographs were taken for caries progression assessments. Results During the follow-up period, no lesion progression was observed radiographically. After one year (n = 60; 27 sealed and 33 restored) and two years (n = 48; 23 sealed and 25 restored) of follow-up, the treatment success rates were 78.8% and 76.0% in the restoration group and 59.3% and 47.8% in the sealing group, respectively. Multivariate Cox regression showed that lesions smaller than 2 mm in the mesiodistal extent were less prone to fail after one year (p = 0.03). However, survival curves (log-rank test) were statistically significantly different only after two years (p < 0.001). Conclusions Sealing ICDAS 5 occlusal lesions of deciduous molars using RMGIC achieved lower survival rates than restorations. Both sealing and restoration effectively arrested caries progression for two years. Clinical relevance Sealing dentine carious lesions can be effective for treating lesions involving the inner and outer half of the dentine. Ultraconservative treatments can arrest carious lesions presenting obvious cavitation in primary molars. Trial Registration: ReBEC Register no. RBR-225n35.

Objetiva-se avaliar o perfil dos pacientes com transtorno do espectro autista (TEA) atendidos na Disciplina de Atendimento Odontológico do Paciente com Necessidades Especiais (PNE) da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (UFRGS). A partir dos prontuários odontológicos dos pacientes atendidos em nível ambulatorial entre os anos de 2001 e 2019 foram obtidas informações em relação a idade do paciente no primeiro atendimento, gênero, forma de acesso, condição sistêmica do paciente com TEA, medicamento de uso contínuo utilizado e tratamento recebido em sua última visita a clínica. Os dados foram tabulados em planilha Excel® e analisados com base no valor percentual. Verificou-se que 6,4% dos pacientes especiais atendidos na disciplina apresentavam TEA, sendo 75,3% do gênero masculino com uma média de idade de 19,56 anos. Destes pacientes, 78,3% faziam uso de medicação sendo as mais frequentes os antipsicóticos (60,8%), anticonvulsivantes (39,2%), antidepressivos (12,4%) e ansiolíticos (11,3%).  Os tratamentos mais realizados em sua última visita clínica foram prevenção (36%), periodontal (17,5%), dentística (14,4%) e cirurgia (13,4%). Destaca-se assim, a importância de o cirurgião-dentista estar atento às condições sistêmicas associadas dos pacientes com TEA, as quais estão ligadas ao uso de medicamentos e deve possuir o conhecimento farmacológico, para possibilitar um atendimento clínico com segurança, tendo em vista que há probabilidade de manifestações bucais e sistêmicas com o uso destes medicamentos, além de suas reações adversas.

Abstract This study assessed the effectiveness of models for developing subsurface caries lesions in vitro and verified mineral changes by transverse microradiography (TMR). Enamel blocks from permanent (n=5) and deciduous teeth (n=5) were submitted to lesion induction by immersion in demineralizing solutions during 96 h, followed by pH cycles of demineralization (de) and remineralization (re) for 10 days. Two de-/re solutions were tested. Demineralizing solution “A” was composed by 2.2 mM CaCl2, 2.2 mM KH2PO4, 0.05 M acetic acid, with pH 4.4 adjusted by 1 M KOH. Demineralizing solution “B” was composed by 2.2 mM CaCl2, 2.2 mM NaH2PO4, 0.05 M acetic acid and 0.25 ppmF, with pH 4.5 adjusted by 1M KOH. Solution “A” produced cavitated lesions in permanent teeth, whereas solution “B” led to subsurface lesions in deciduous teeth. Solution “B” was then tested in enamel blocks from permanent teeth (n=5) and subsurface lesions were obtained, so that solution “B” was employed for both substrates, and the blocks were treated with slurries of a fluoride dentifrice (1450 ppm F, as NaF, n=5) or a fluoride-free dentifrice (n=5). Solution “B” produced subsurface lesions in permanent and primary teeth of an average (±SD) depth of 88.4µm (±14.3) and 89.3µm (±15.8), respectively. TMR analysis demonstrated that lesions treated with fluoride-free dentifrice had significantly greater mineral loss. This study concluded that solution “B” developed subsurface lesions after pH cycling, and that mineral changes were successfully assessed by TMR.

Este estudo teve o objetivo de delinear o perfil sociodemográfico de crianças, adolescentes, mulheres e idosos que vivenciaram violência no município de Porto Alegre (RS) no período de janeiro de 2017 a dezembro de 2019. Foi realizada pesquisa quantitativa, de abordagem epidemiológica, com recorte dos registros de ocorrência em crianças, adolescentes, mulheres e idosos. Os dados foram coletados por meio de notificações via Sistema de Informação de Agravos de Notificação (Sinan), disponibilizados pela Equipe de Vigilância de Doenças Crônicas e Agravos Não Transmissíveis da Coordenadoria Geral de Vigilância em Saúde da Secretaria Municipal de Saúde de Porto Alegre. As variáveis analisadas foram: ano de notificação, idade, sexo, cor, se possui alguma deficiência, local da ocorrência, recorrência, tipo de violência, sexo do agressor e encaminhamentos. Foram notificados 8.394 casos. Entre os anos notificados, a maior prevalência ocorreu em 2019, com 42,68%. Foi identificado que 30,34% das notificações referiam-se a vítimas crianças, 22,81% aos adolescentes, 40,65% às mulheres e 6,18% a idosos. A maioria dos casos ocorreu com pessoas brancas (72,49%) e o tipo de violência mais prevalente na notificação foi a tentativa de suicídio, com 29,96%, ocorrida na residência (71,63%). Conclui-se que as notificações de violência contra crianças, adolescentes, mulheres e idosos no município de Porto Alegre aumentaram nos anos de 2017 a 2019.

No abstract

Segundo a Organização Mundial da Saúde (OMS) o acesso à saúde é desigualmente distribuído, sendo esse contexto agravado para pessoas com deficiência (PcD), entre os quais é alta a prevalência de doenças crônicas. O Transtorno do Espectro Autista é caracterizado por dificuldades persistentes na comunicação e interação social em diversos contextos, como déficits na reciprocidade social, em comportamentos não verbais de comunicação utilizados na interação entre indivíduos e em habilidades para desenvolver, manter e compreender relacionamentos. Tratamentos odontológicos e medidas de prevenção em saúde bucal para estes pacientes é um desafio na prática clínica do cirurgião-dentista. O objetivo deste relato de caso foi descrever o acompanhamento odontológico de um paciente com Transtorno do Espectro do Autismo e outras comorbidades por um período de 16 anos na clínica de atendimento odontológico ao paciente com necessidades especiais da Faculdade de Odontologia da UFRGS.  De 2005 a 2019, realizaram-se procedimentos odontológicos, incluindo medidas preventivas, restaurações, endodontia e exodontias, preservando sempre os cuidados pertinentes a sua condição sistêmica e seu comportamento de difícil gestão, proporcionando-lhe um benefício emocional positivo através de estímulos constantes, inclusão gradual do paciente no ambiente odontológico associado as atividades de reforço positivo, respeitando as suas limitações. Pode-se concluir que o atendimento odontológico humanizado e individualizado com técnica de gestão comportamental de reforço positivo com apoio familiar realizado no paciente com TEA foi fundamental para o seu sucesso, permitindo realizar o tratamento necessário e motivando o cuidado permanente com sua saúde bucal.