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Statement of problem Evidence provided by implant-supported mandibular overdenture research on different loading protocols is important. However, methodological inconsistency, as well as inadequate reporting of results, hampers a consistent decision in terms of clinical applicability. Purpose The purpose of this systematic review and meta-analysis was to evaluate whether immediate or early loading protocols can achieve comparable clinical outcomes when compared with a conventional loading protocol in edentulous patients rehabilitated with mandibular overdentures. Material and methods In accordance with the Participant, Intervention, Comparison, Outcome strategy, prospective clinical studies without restrictions as to language or follow-up period were included. The Cochrane collaboration and ROBINS-I tools were used for quality assessment and risk-of-bias evaluation. The follow-up for the different outcomes ranged from 3 to 168 months, with the focus on implant success and survival rates, marginal bone loss, bleeding on probing, probing depth, plaque index, and the implant stability quotient. Statistical analyses in which standard mean differences were applied with a 95% confidence interval when continuous data were included were performed. For dichotomous data, risk difference was adopted. Results The search strategy resulted in 14 234 references. Twenty-three studies fulfilled the inclusion criteria. Meta-analysis showed statistically significant differences for plaque index at 12 months (standard mean difference=0.284 [0.022, 0.545], P=.033, I2=35%), probing depth at 36 months (standard mean difference=0.460 [0.098, 0.823], P=.013, I2=0%), and on pooled results for plaque index (standard mean difference=0.157 [0.031, 0.284], P=.015, I2=18%) in which the conventional loading protocol presented lower indices than those of immediate loading protocol or early loading protocol. Implant stability quotient presented a statistically significant difference only at 3 months (standard mean difference=0.602 [0.309, 0.895], P .05) were not found. Conclusions Immediate loading protocol or early loading protocolfor mandibular overdentures has been determined to be a well-established treatment and worthy of consideration in clinical practice.

Titanium-zirconium (Ti-Zr) alloy has been widely used as a biomaterial for implant devices, and it is commonly treated by sandblasting followed by acid etching (SLA) to improve biological responses. Although protein adsorption is the first biological response, the effect of this SLA treatment on the proteomic profile of proteins adsorbed from saliva and blood plasma has not been tested. In this study, the proteomic profile was evaluated by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Streptococcus sanguinis was used to test whether the protein layer affects bacterial adhesion. SLA treatment affected the proteomic profile, showing exclusive proteins adsorbed from saliva (14) and plasma (3). However, both groups exhibited close patterns of intensity for common proteins, molecular functions and biological processes mediated by proteins. Interestingly, Ti-ZrSLA showed higher bacterial adhesion (∼1.9 fold over) for the surface coated with plasma proteins. Therefore, SLA treatment of Ti-Zr alloy changed the proteomic profile, which may affect bacterial adhesion.

Oropharyngeal candidiasis (OPC) is the most prevalent oral infection in immunocompromised patients, primarily associated with Candida albicans. Increasing evidence points to a significant role of mucosal bacteria on the transition of C. albicans from commensal to pathogenic. In this work, we hypothesized that changes in the abundance or composition of the mucosal bacterial microbiota induced by dietary sucrose during the development of OPC can modulate C. albicans virulence. C. albicans burdens and mucosal lesions were evaluated in a mouse cortisone immunosuppression model amended with sucrose. We also analyzed the mucosal bacterial composition using 16S rRNA gene sequencing and culture methods. In immunocompetent mice, sucrose significantly increased total bacterial burdens and reduced alpha diversity, by increasing the relative abundance of mitis group streptococci. In immunocompromised mice, C. albicans infection was associated with a significantly reduced bacterial alpha diversity due to an increase in the relative abundance of enterococci. When exposed to dietary sucrose, these mice had reduced C. albicans burdens and reduced bacterial alpha diversity, associated with an increase in the relative abundance of Lactobacillus. SparCC correlation networks showed a significant negative correlation between Lactobacillus and Enterococcus in all Candida-infected mice. Depletion of lactobacilli with antibiotic treatment partially restored C. albicans burdens in mice receiving sucrose. In coculture in vitro experiments, mouse oral Lactobacillus johnsonii isolates inhibited growth of Enterococcus faecalis isolates and C. albicans. These results support the hypothesis that the sucrose-induced attenuation of C. albicans virulence was a result of changes in the mucosal bacterial microbiome characterized by a reduction in enterococci and an increase in lactobacilli. IMPORTANCE By comparing Candida albicans virulence and the mucosal bacterial composition in a mouse oral infection model, we were able to dissect the effects of the host environment (immunosuppression), infection with C. albicans, and local modulating factors (availability of sucrose as a carbon source) on the mucosal bacterial microbiome and its role on fungal virulence. We showed that changes in endogenous microbial communities in response to sucrose can lead to attenuation of fungal disease. We also showed that Lactobacillus johnsonii may curtail Candida virulence both by inhibiting its growth and by inhibiting the growth of potentially synergistic bacteria such as enterococci. Our results support the concept that Candida pathogenesis should be viewed in the contexts of both a susceptible host and a mucosal bacterial microbiota conducive to virulence.

Microbiologically induced corrosion plays a key role in implanted materials survival, especially those exposed to the oral environment. Despite considerable progress in this field, a consensus is still missing due to contradictory findings regarding the role of oral biofilms in the electrochemical behavior of titanium (Ti) implant surfaces. This scoping review comprehensively reviews and discusses the current evidence and new perspectives on microbial corrosion. The main focus is understanding oral biofilm formation and its synergistic effect under the corrosion/tribocorrosion phenomenon. We critically revisited the literature to refine key concepts and mechanisms involved in polymicrobial biofilm formation on implant devices, microbial corrosion phenomenon, and its consequence for surrounding tissues. To summarize what is currently known about this topic, we have conducted a scoping review. Data of eligible in vitro studies suggest that oral biofilm and bacterial metabolites products can affect negatively the electrochemical behavior of Ti material and promote implant surface deterioration. Relevant experimental strategies to practically approach the field of microbial corrosion mechanisms are outlined. Finally, new approaches to enhance biomaterial development should consider improved corrosion resistance to promote higher implant survival.

Objective: To verify differences between salivary flow in pediatric cancer patients before starting antineoplastic treatment and in healthy pediatric patients. Material and Methods: This is an observational, cross-sectional, paired study with sample of 120 children and adolescents (3-18 years). Thirty pediatric cancer patients were selected for convenience at “Napoleao Laureano” Hospital (G1). Another group was composed of 90 individuals attended at the School of Dentistry Clinics of the Federal University of Paraiba, matched by age (G2). Data collection was performed in two steps for both groups. Information regarding pediatric cancer patients was obtained by interview with parents / guardians and searching medical records, while in the other group by interview with parents / guardians. Saliva collection was performed using standard method in both groups: unstimulated salivary flow rate (USFR) being the mean volume expelled in 1 minute. Data were analyzed by the Shapiro-Wilk, Kolmogorov-Smirnov and Mann-Whitney tests ( α = 5%). Results: Mean USFR for G1 and G2 was 0.52 mL / min and 0.66 mL / min, respectively (p>0.05) and, in both groups, significant difference was observed (p

AIMS To evaluate the unstimulated salivary flow (USF) and salivary colonization of total Streptococcus spp. (TS) and mutans-group (MS) in pediatric patients with hematological tumors. Correlations of salivary and microbiological changes with chemotherapy and patient-related factors were also verified. METHODS AND RESULTS Eligible children (n = 31) were evaluated before (control) and after (2, 5, and 10-weeks) the chemotherapy protocol was applied. Saliva samples were collected by the traditional spitting method to determine the USF (ml/min). Salivary TS and MS were determined by colony-forming units (CFU ) counts in a selective medium. The caries experience was evaluated by DMFT/dmft indexes. Data were submitted to Student's t-test, one-way ANOVA, and correlation tests (α = 0.05). The USF rate at baseline was 0.89 (±0.73) ml/min with up to 20% reduction during the follow-up and did not differ statistically during chemotherapy (p > .05). Chemotherapy did not modify the salivary TS load (p > .05), but induced a dysbiotic shift with higher MS counts (∼ 5 fold-increase) at 10-weeks (p

The purpose of this study was to implement a model of permanent oral health care for oncopediatric patients and to observe its effects on severe oral mucositis and subsequent treatment interruptions. We performed a quasi-experimental study in the Pediatric Department of Napoleão Laureano Hospital, in the city of João Pessoa, Brazil. A integrated oral care was implemented by a dentistry team for prevention of comorbidities, such as infections, oral pain, oral function maintenance, oral mucositis, and interventions for lesions due to severe oral mucositis. The oral comorbidities were compared before and after the implementation. The duration of severe oral mucositis (SOM) before and after the interventions and the interruptions in treatment due to SOM were the main outcome measures. Permanent oral health care reduced the duration of SOM and reduced pediatric chemotherapy interruptions due to SOM by 81.8%.Conclusion: The permanent oral health care to offer to oncopediatric patients increased surveillance regarding oral comorbidities and reduced chemotherapy interruptions due to severe oral mucositis. This care plan could be adopted anywhere around the world. What is Known: • Several studies on oral care for pediatric oncology patients, especially regarding both prevention of and treatment for oral mucositis during antineoplastic therapy, have been published. What is New: • This study describes the benefits of permanent oral care with daily oral surveillance for pediatric patients, which reduced the duration of severe oral mucositis, increased surveillance and the efficiency in diagnostic for signs of oral mucositis, enabling early intervention, and decreased chemotherapy interruptions, contributing positively to the course of treatment.

Objectives To test the role of exopolysaccharide (EPS) polymers matrix to modulate the composition/virulence of biofilms growing on titanium (Ti) surfaces, the effect on antibiotic susceptibility, and whether a dual-targeting therapy approach for disrupted EPS matrix could improve the antimicrobial effect. Materials and methods A microcosm biofilm model using human saliva as inoculum was used, and the microbial composition was assessed by checkerboard DNA-DNA hybridization. EPS-enriched biofilms virulence was tested using fibroblast monolayer. Povidone-iodine (PI) was used as EPS-targeting agent followed by amoxicillin + metronidazole antibiotic to reduce bacterial biomass using an in situ model. Results An EPS-enriched environment, obtained by sucrose exposure, promoted bacterial accumulation and led to a dysbiosis on biofilms, favoring the growth of Streptococcus, Fusobacterium, and Campylobacter species and even strict anaerobic species related to peri-implant infections, such as Porphyromonas gingivalis and Tannerella forsythia (~3-fold increase). EPS-enriched biofilm transitioned from a commensal aerobic to a pathogenic anaerobic profile. EPS increased biofilm virulence promoting higher host cell damage and reduced antimicrobial susceptibility, but the use of a dual-targeting approach with PI pre-treatment disrupted EPS matrix scaffold, increasing antibiotic effect on in situ biofilms. Conclusion Altogether, our data provide new insights of how EPS matrix creates an environment that favors putative pathogens growth and shed light to a promising approach that uses matrix disruption as initial step to potentially improve implant-related infections treatment.

Objective To compare the effectiveness and acceptability of a newly developed pediatric sialometer as an alternative to the conventional spitting method. Methods A clinical study was carried out with healthy children (G1; n = 30) and oncological children (G2; n = 30). A newly developed pediatric sialometer was compared to the traditional spitting method to determine unstimulated salivary flow (mL/min), with a one-hour wash out period between sample collections. A semi-structured questionnaire was applied to G1 and G2 using the Facial Anxiety Scale to evaluate the device’s acceptability. The children’s behavior was also observed throughout saliva collection. The data were analyzed by Mann-Whitney U, Wilcoxon, Student’s t and Chi-Square tests (α = 5%). Results There was no significant difference between groups and methods (P > 0.05). However, the saliva collected with the pediatric sialometer was clearer and had less apparent contamination. The device characteristics were rated positively, with high acceptability even among children with more difficult conditioning (G2) (P > 0.05). Conclusion The newly developed pediatric sialometer presented herein can be an alternative option for saliva collection in pediatric dentistry, with good reproducibility and acceptability by children.

Made available in DSpace on 2020-12-12T02:36:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-03-04 Polymicrobial infections are one of the most common reasons for inflammation of surrounding tissues and failure of implanted biomaterials. Because microorganism adhesion is the first step for biofilm formation, physical-chemical modifications of biomaterials have been proposed to reduce the initial microbial attachment. Thus, the use of superhydrophobic coatings has emerged because of their anti-biofilm properties. However, these coatings on the titanium (Ti) surface have been developed mainly by dual-step surface modification techniques and have not been tested using polymicrobial biofilms. Therefore, we developed a one-step superhydrophobic coating on the Ti surface by using a low-pressure plasma technology to create a biocompatible coating that reduces polymicrobial biofilm adhesion and formation. The superhydrophobic coating on Ti was created by the glow discharge plasma using Ar, O2, and hexamethyldisiloxane gases, and after full physical, chemical, and biological characterizations, we evaluated its properties regarding oral biofilm inhibition. The newly developed coating presented an increased surface roughness and, consequently, superhydrophobicity (contact angle over 150°) and enhanced corrosion resistance (p < 0.05) of the Ti surface. Furthermore, proteomic analysis showed a unique pattern of protein adsorption on the superhydrophobic coating without drastically changing the biologic processes mediated by proteins. Additionally, superhydrophobic treatment did not present a cytotoxic effect on fibroblasts or reduction of proliferation; however, it significantly reduced (≈8-fold change) polymicrobial adhesion (bacterial and fungal) and biofilm formation in vitro. Interestingly, superhydrophobic coating shifted the microbiological profile of biofilms formed in situ in the oral cavity, reducing by up to ≈7 fold pathogens associated with the peri-implant disease. Thus, this new superhydrophobic coating developed by a one-step glow discharge plasma technique is a promising biocompatible strategy to drastically reduce microbial adhesion and biofilm formation on Ti-based biomedical implants. Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas (UNICAMP), 901 Limeira Avenue Department of Oral Health and Diagnostic Sciences University of Connecticut Health Center, 263 Farmington Avenue Dental Research Division Guarulhos University, 88 Eng. Prestes Maia Street Laboratory of Technological Plasmas Institute of Science and Technology São Paulo State University (UNESP), 511 Três de Março Avenue Laboratory of Technological Plasmas Institute of Science and Technology São Paulo State University (UNESP), 511 Três de Março Avenue

Oral rehabilitation devices are susceptible to bio-tribocorrosion phenomena in the oral environment due to the synergism of wear, chemical, biochemical, and microbiological processes. This review summarizes the clinical problems and advances obtained based on current scientific evidence as well as the influence of tribological fundamentals, testing methodologies, and protocols in tribocorrosion analyses. The main clinical question related to oral rehabilitation with dental implants is the treatment failure, which is influenced by material degradation. Titanium-based implants are exposed to wear and corrosion challenges in the oral environment since the implantation and along the lifetime service. The titanium (Ti) properties such as structural material, connection design, surface treatments, alloying elements are influencing factors for material behavior. In addition, wear-corrosion factors such as cyclic loads, micromovements, oral biofilm, decontamination methods are also associated with dental implants degradation. These environmental conditions to which dental implants are submitted leads to the release of Ti particles and ions with cytotoxic and harmful effects on peri-implant surrounding tissues. In this context, the current state of the art of bio-tribocorrosion over the last decade has been steadily increasing to understand material degradation. The basic test system used to translate the tribocorrosion phenomena in the oral environment to the bench consists of electrochemical and tribological synergic analysis. The mechanical (applied load, frequency, stroke distance, and number of cycles) and electrochemical (solution composition, concentration of anions, and pH) test conditions are determinants for materials tribocorrosion performance. To overcome the tribocorrosion phenomena some strategies have been used such as alloying elements for Ti-alloys manufacture, surface treatments, and biomolecules immobilization. Further studies need to have the tribocorrosion analyses as the basis for new smart materials development considering the importance of such aspects for the biomaterial clinical behavior. Finally, tribological tests are relevant strategies for understanding the mechanisms of degradation in the oral environment and for providing a way to improve the clinical outcomes of dental implants.

Made available in DSpace on 2020-12-12T02:13:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-11-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Centro Nacional de Pesquisa em Energia e Materiais Laboratório Nacional de Nanotecnologia Universidade Estadual de Campinas Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Fundo de Apoio ao Ensino, à Pesquisa e Extensão, Universidade Estadual de Campinas Hypothesis: Although bioactive glass (BG) particle coatings were previously developed by different methods, poor particle adhesion to surfaces and reduced biological effects because of glass crystallization have limited their biomedical applications. To overcome this problem, we have untangled, for the first time, plasma electrolytic oxidation (PEO) as a new pathway for the synthesis of bioactive glass-based coating (PEO-BG) on titanium (Ti) materials. Experiments: Electrolyte solution with bioactive elements (Na2SiO3-5H2O, C4H6O4Ca, NaNO3, and C3H7Na2O6P) was used as a precursor source to obtain a 45S5 bioglass-like composition on a Ti surface by PEO. Subsequently, the PEO-BG coating was investigated with respect to its surface, mechanical, tribological, electrochemical, microbiological, and biological properties, compared with those of machined and sandblasted/acid-etched control surfaces. Findings: PEO treatment produced a coating with complex surface topography, Ti crystalline phases, superhydrophilic status, chemical composition, and oxide layer similar to that of 45S5-BG (~45.0Si, 24.5 Ca, 24.5Na, 6.0P w/v%). PEO-BG enhanced Ti mechanical and tribological properties with higher corrosion resistance. Furthermore, PEO-BG had a positive influence in polymicrobial biofilms, by reducing pathogenic bacterial associated with biofilm-related infections. PEO-BG also showed higher adsorption of blood plasma proteins without cytotoxic effects on human cells, and thus may be considered a promising biocompatible approach for biomedical implants. Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas (UNICAMP), Av. Limeira, 901 Oral Health and Diagnostic Sciences Department Division of Periodontology University of Connecticut School of Dental Medicine, 263 Farmington Avenue Department of Dental Materials and Prosthodontics School of Dentistry at Araraquara São Paulo State University (UNESP), R. Humaitá, 1680 Institute of Physics Gleb Wataghin University of Campinas (UNICAMP) Cidade Universitária Zeferino Vaz, arão Geraldo Laboratory of Technological Plasmas Institute of Science and Technology São Paulo State University (UNESP), Av. Três de Março, 511 Department of Mechanical Engineering University of São Paulo (USP), Trabalhador São Carlense, 400 Department of Periodontology Dental Research Division Guarulhos University, Eng Prestes Maia, 88 Department of Dental Materials and Prosthodontics School of Dentistry at Araraquara São Paulo State University (UNESP), R. Humaitá, 1680 Laboratory of Technological Plasmas Institute of Science and Technology São Paulo State University (UNESP), Av. Três de Março, 511 FAPESP: 2018/04630-2 Fundo de Apoio ao Ensino, à Pesquisa e Extensão, Universidade Estadual de Campinas: 3164/18

Polymicrobial infection is the main cause of dental implant failure. Although numerous studies have reported the ability of titanium (Ti) surface modifications to inhibit microbial adhesion and biofilm accumulation, the majority of solutions for the utilization of Ti antibacterial surfaces have been testedin in vitro and animal models, with only a few developed surfaces progressing into clinical research. Motivated by this huge gap, we critically reviewed the scientific literature on the existing antibacterial Ti surfaces to help understand these surfaces' impact on the "puzzle" of undesirable dental implant-related infections. This manuscript comprises three main sections: (i) a narrative review on topics related to oral biofilm formation, bacterial-implant surface interactions, and on how implant-surface modifications can influence microbial accumulation; (ii) a critical evidence-based review to summarize pre-clinical and clinical studies in an attempt to "fit pieces into the puzzle" to unveil the best way to reduce microbial loads and control polymicrobial infection around dental implants showed by the current in vivo evidence; and (iii) discussion and recommendations for future research testing emerging antibacterial implant surfaces, connecting basic science and the requirements for future clinical translation. The findings of the present review suggest no consensus regarding the best available Ti surface to reduce bacterial colonization on dental implants. Smart release or on-demand activation surface coatings are a "new piece of the puzzle", which may be the most effective alternative for reducing microbial colonization on Ti surfaces, and future studies should focus on these technologies.

O estudo objetiva identificar as facilidades e dificuldades vivenciadas pelos alunos em atividade prática de estimativa de idade proposta pela disciplina de Odontologia Legal, verificando sua percepção quanto à funcionalidade e/ou importância da atividade na sua formação acadêmica. Trata-se de uma pesquisa de campo aplicada, quantitativa, exploratória, documental e analítica, do tipo transversal. Durante uma atividade prática da disciplina de Odontologia Legal da Universidade Federal da Paraíba, aplicou-se um questionário com perguntas abertas e fechadas acerca das facilidades e dificuldades vivenciadas na aplicação de um método de estimativa de idade e da percepção dos alunos quanto a funcionalidade e importância da atividade. A amostra (n=52) foi composta pelos alunos matriculados na disciplina de Odontologia Legal nos períodos letivos 2014/2 e 2015/1, que participaram da atividade prática. Os dados foram analisados descritivamente. A opção ”Excelente” foi maioria em três dos quatro critérios avaliados. Como pontos positivos, destacaram-se a aplicabilidade (19,0%), fixação do conteúdo (17,2%), relevância para formação profissional (12,1%) e praticabilidade (12,1%). Como pontos negativos e dificuldades encontradas foram ressaltadas a subjetividade do método em estudo (25,0%), a má qualidade das projeções radiográficas (18,2%), a restrição de aplicação do método a crianças e adolescentes (9,1%) e a necessidade de estudo prévio (9,1%). Em conclusão, a atividade prática de estimativa de idade contribuiu para a formação profissional dos alunos, sendo a aplicabilidade do método o ponto positivo mais frequentemente apontado, enquanto a subjetividade do mesmo se constituiu na maior dificuldade vivenciada pelos graduandos.

Objective: To evaluate the agreement and applicability of the Chronological Dental Mineralization Table of Nicodemo, Moraes and Medici Filho (1974) to estimate age held by undergraduate Dentistry students at the Federal University of Paraiba. Material and Methods: Field research applied with a sample of 50 students according to inclusion and exclusion criteria. Sequentially, 3 panoramic radiographs were exposed (actual age known only by teachers), and students were instructed to interpret them from the selection of 2-4 teeth under formation. Data were analyzed using SPSS software (Statistical Package for Social Sciences), version 20.0, adopting significance level of 5%. Results: Most students chose 3 teeth, with percentages of 56.0% (n = 28); 38.0% (n = 19) and 58.0% (n = 29) for radiographs 1, 2 and 3, respectively. Teeth selected with greater frequency were: 47 (20.1%, n = 33) and 45 (19.5%, n = 32) - radiography 1; 38 (22.7%, n = 32) and 18 (13.4%, n = 19) - radiography 2; and 47 (17.9%; n = 26) and 36 (13.7%; n = 20) - radiography 3. The agreement between estimated and actual ages was 60.0% for radiography 1, 12.0% for radiography 2 and 32.0% for radiography 3. Age was underestimated in 40.0% (n = 20) and 88.0% (n = 44) in radiographs 1 and 2, respectively. Overestimation of the actual age occurred only in radiography 3 (68.0%; n = 34). The linear regression analysis revealed that it is possible to estimate the actual age from the maximum age stipulated by training students with 88.1% success rate. Conclusion: The method is applicable; however, the correlation between estimated and actual ages varied considerably among radiographs, and maximum estimated values were closer to the actual age than minimum values.

Objective: To characterize the profile of hospitalizations and deaths related to craniofacial fractures in Brazilian children and adolescents. Material and Methods: This is an ecological cross-sectional study with inductive approach with comparative-descriptive procedure and indirect documentation technique. Data were obtained from the DATASUS / SIH-SUS website for the years 2010-2014, considering information for each state of the five Brazilian regions. Admission rates were calculated per 100,000 inhabitants, and data were analyzed by population rates, averages and absolute and relative frequencies. Results: The Northeastern region of Brazil showed the highest hospitalization rate (81.72), followed by the Northern (56.84), Southern (50.94), Midwestern (44.25) and Southeastern regions (30.28). In all regions, the years with the highest hospitalization rates were: 2010 for the Northern (13.17) and Southeastern regions (6.61), 2013 for the Northeastern (20.07) and Midwestern regions (10.17) and 2014 for the Southerner region (10.52). The highest hospitalization rates in all regions of the country in the last five years were observed for male children and adolescent. In relation to age group, higher rates were recorded from 15 to 19 years. Of the total of 27,244 hospitalizations (3.8%), 1028 patients died and 35.5% of them occurred in the Northeastern region. Considering the years under study, the average length of stay and average daily hospitalization cost were respectively 4.0 days and US$ 82.7. Conclusion: The Northeast region of Brazil had the highest hospitalization rate of children and adolescents by craniofacial fractures, and male adolescents and those aged 15-19 years were the most affected in different regions of the country. Costs of hospital admissions due to this type of injury are significant, with more deaths as a result of these injuries in Brazil in the last 5 years evaluated with the highest prevalence in the Northeastern region of Brazil.

Objective: It was evaluated the applicability of the Table of Permanent Teeth Mineralization among Brazilians for age estimation with forensic purposes. Method: The PRISMA guidelines (Preferred Report of Systematic Reviews and Meta-Analysis) were used for study design, and bibliographical searches were performed in the databases: Web of Science, Pubmed, Scopus, Cochrane, LILACS and SIGLE, according to PICO/PECO strategy. Results: A total of 10,280 records were retrieved from the databases, of which 20 articles were selected for full-text analysis after preliminary screening. Five articles plus one additional article selected by manual search were included in the final review, totaling six articles. The selected studies presented a cross-sectional design, five of which were developed in Brazil and two abroad. The assessment of methodological quality, performed with the use of QUADAS adapted by Lopes (2012), indicated that all six studies met more than 50% of the quality requirements and one of them met all the requirements. To compare the estimated and actual chronological age, four studies utilized correlation analysis while two employed descriptive statistics. The findings revealed discrepancy between the estimated age and the actual chronological age, which led the majority of authors to advocate a moderate use of the method as well as to indicate the use of correction factors for specific populations and its association with other age estimation methods. Conclusion: the existing evidence on the applicability of the Nicodemo, Moraes and Médici Filho’s method (1974) for age estimation with forensic purposes is moderate, given the scarcity of studies and methodological heterogeneity between them. Objetivo: Avaliou-se a aplicabilidade da Tabela Cronológica de Mineralização dos dentes permanentes em Brasileiros para estimativa da idade com fins forenses, por meio de uma revisão sistemática. Método: A pesquisa foi desenvolvida baseada no protocolo do Preferred Report of Systematic Reviews and Meta-Analysis (PRISMA). As buscas foram realizadas nas bases de dados: Web of Science, Pubmed, Scopus, Cochrane, Lilacs e Sigle, sendo a estratégia baseada no acrônimo PICO/PECO (MAIA; ANTONIO, 2012). Resultados: Foram recuperados 10.280 registros nas referidas bases, e após a triagem inicial 20 artigos seguiram para leitura na íntegra. Ao final, permaneceram 5 artigos e mais um foi adicionado por hand searching, perfazendo 6 artigos. Os estudos apresentaram delineamento seccional, sendo cinco realizados no Brasil e dois no exterior. A avaliação da qualidade metodológica, realizada com o auxilio do QUADAS adaptado por Lopes (2012), indicou que os 6 estudos apresentaram mais de 50% das respostas positivas, sendo que um atendeu a todos os requisitos. Para comparar as idades estimada com a cronológica, 4 dos artigos utilizaram análise de correlação e os demais, estatística descritiva. Os resultados demonstraram discrepâncias entre a idade estimada e a cronológica, fazendo com que a maioria dos autores indicasse o uso parcimonioso do método, procurando utilizar fatores de correção para populações específicas ou a sua associação a outros métodos de estimativa de idade. Conclusão: A evidência científica acerca da aplicabilidade do método de Nicodemo, Moraes e Médici Filho (1974) na estimativa de idade com fins forenses é moderada, sobretudo considerando a quantidade dos estudos existentes e a heterogeneidade metodológica entre eles.

O objetivo deste estudo foi analisar a cobertura de saúde bucal brasileira e o acesso da população ao serviço público odontológico entre os anos de 2008 e 2012. Trata-se de um estudo ecológico, comparativo-descritivo, por documentação indireta. As médias de Equipes de Saúde Bucal (ESB) do serviço público brasileiro variam de acordo com as regiões. No período avaliado, o Nordeste apresentou maior média de ESBs (64,0); seguido das regiões Sul (56,0); Centro-Oeste (53,0); Norte (44,0) e Sudeste (43,0). A região Nordeste concentra as maiores médias populacionais que nunca realizaram consulta odontológica, mas essa é a região que apresenta a maior oferta de serviço odontológico. As menores médias concentram-se no Sul, que após o Nordeste é a região com maior oferta de serviço público odontológico. Verificou-se diferença entre a proporção da população que nunca realizou consulta odontológica e a proporção da população com cobertura de plano de saúde (p=0,009). O acesso e a utilização dos serviços públicos de saúde bucal pela população brasileira, nas diferentes regiões geoeconômicas, bem como a quantidade de equipes de saúde bucal é desigual, havendo maior procura pela atenção em saúde bucal entre os usuários que possuem plano de saúde privado, que pertencem ao sexo feminino, e residem na área urbana.

O objetivo deste trabalho foi discutir casos de mucosite oral grave quimioinduzida, tratados com solução oral para bochecho associado a laseterapia de baixa potência em pacientes pediátricos oncológicos. As patologias apresentadas pelos pacientes que apresentaram a mucosite foram: Leucemia Linfoblástica Aguda (LLA), Osteossarcoma e Tumor de Wilms. As lesões se apresentaram nos seguintes sítios anatômicos: vermelhão do lábio, mucosa labial, e língua. O tempo médio para regressão das lesões foi de 6,8 ± 3,9 dias. O protocolo de tratamento consistiu na utilização da solução para mucosite oral utilizada no Hospital Napoleão Laureano, João Pessoa/PB. Concomitante ao uso da solução oral, iniciou-se a terapia fotodinâmica com laser de baixa potência (ECCO Fibras e Dispositivos; n/s–040401; modelo–BM0004A), calibrado para um comprimento de onda de 670 nm, potência de 40mW e densidade de energia de 4 J/cm2. Todos os pacientes tiveram remissão das lesões de mucosite oral em até 14 dias após o início da intervenção terapêutica. Concluiu-se que o protocolo utilizado, com o uso da laserterapia de baixa potência aliado à solução de mucosite oral mostrou-se eficaz no tratamento da mucosite oral em pacientes pediátricos em tratamento antineoplásico.

O estudo teve o objetivo de explicar a “inibição de sorrir” em pacientes oncológicos pediátricos a partir de variáveis relacionadas à má oclusão, cárie e doença periodontal. Esta é uma pesquisa transversal realizada em um hospital de referência no estado da Paraíba, sendo a amostragem feita por conveniência, composta por 52 pacientes com idades de 12 anos e15 a19 anos. Utilizaram-se como instrumentos de coleta duas fichas (exame clínico e entrevista) do levantamento Saúde Bucal Brasil2010. Apesquisa foi realizada entre anos de2011 a2014. Os dados foram analisados no software R (versão 3.1.1), recorrendo a técnicas estatísticas descritivas e inferenciais. Na análise descritiva, utilizaram-se valores absolutos e percentuais e medidas de tendência central e dispersão. Na análise inferencial, por intermédio da regressão logística binária, se identificou as variáveis significantes para explicar a inibição ao sorrir dos pacientes do estudo. Observou-se como fatores de risco para a inibição ao sorrir, ter desalinhamento maxilar (OR=6,59), relação molar alterada (OR=9,16), número de dentes cariados (OR=1,71), e presença de sangramento gengival (OR=15,88). A má oclusão, cárie dentária e gengivite são fatores associados à vergonha de sorrir nos pacientes pediátricos oncológicos.