Abstract The aim of this study was to evaluate the expression of the EZH2 protein and describe the clinical and microscopic characteristics of adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA). The study included 16 ACC cases and 12 PA. All ACC and PA cases were positive for EZH2 and the ACC samples showed significantly higher EZH2 expression. The clinical and microscopic covariates were described in relation to EZH2 staining in ACC samples. The highest mean values of EZH2 were observed in cases with local metastasis, recurrence, perineural invasion, and predominantly cribriform growth pattern without solid areas. EZH2 is a potential marker of malignancy. EZH (ACC . (PA) 1 metastasis recurrence invasion areas malignancy (PA

Abstract This study validated the content of an instrument designed to assess the knowledge, involvement (attitudes) and management (practice) of dentists relative to sickle-cell disease (KAPD-SCD). The instrument consisted of five domains composed of a total of thirteen items: I. Dentist’s self-assessment relative to sickle-cell disease; II. Dentist’s knowledge of the repercussions of sickle-cell disease on the stomatognathic system; III. Dentist’s knowledge of the complications of sickle-cell disease in the stomatognathic system; IV. Dentist’s knowledge concerning the dental management of sickle-cell disease patients; and V. Dentist’s involvement in an approach to sickle-cell disease. Twelve experts assigned scores to each item of the instrument. The criteria were clarity, understanding and appropriateness, leaving open fields for comments. Descriptive and content analyses of the data were made. Each expert analyzed 39 assessment units. The percentages considered for agreement were high (>80%), medium (70%-80%), or low (<70%), and each item was maintained or revised according to the percentage observed. There was high consensus in 74% of the assessment units (the corresponding items were maintained), medium consensus in 24% of them (the corresponding items were revised), and disagreement in 2% of them, namely as regards the “appropriateness” of item 5 (“Are there oral complications in sickle-cell disease?”), which was revised. The final version of the instrument had 16 items for different applications such as in the clinical care program, teaching program, or research program, with different cut-off scores for each application. In conclusion, the level of agreement among experts showed evidence of the content validity of the instrument. attitudes (attitudes practice (practice sicklecell sickle cell KAPDSCD. KAPDSCD KAPD SCD . (KAPD-SCD) I Dentists Dentist s selfassessment self II system III IV patients V clarity appropriateness comments made 3 >80%, 80 >80% , (>80%) 70%80%, 7080 70% 80% 70 (70%-80%) <70%, <70% (<70%) observed 74 maintained, maintained) 24 revised, revised) 2 “appropriateness Are disease, disease?”) 1 program cutoff cut off application conclusion (KAPD-SCD 8 >80 (>80% 70%80% 708 7 (70%-80% <70 (<70% disease?” >8 (>80 70%80 (70%-80 <7 (<70 disease? > (>8 70%8 (70%-8 < (<7 (> (70%- (< ( (70% (70 (7

The study assessed the Global Quality Score (GQS) and informational engagement of users with YouTube videos on the Brazilian public health system (SUS). The YouTube video search tool was used with the Portuguese keywords ‘unified health system’ and ‘SUS’. The first 100 videos returned in the search were studied, using the GQS to measure their educational value, usefulness, and information quality. Users’ engagement with the videos was calculated based on their number of likes/reactions and comments. Other data collected were authorship, year of publication, topic approached, target audience, video length, and use of references. Two trained and calibrated researchers collected the data. Multiple analysis was performed with Logistic Regression, using a 95% confidence interval and significance of p<0.05. There were no poor or generally poor GQS scores (scores 1 and 2) and most videos (58%) achieved moderate or good scores (scores 3 and 4). Videos published after the onset of COVID-19 had a 70% lower chance of engagement than those published in pre-pandemic years (OR: 0.30; 95%CI: 0.12–0.74). Videos that targeted healthcare professionals were 72% less likely to achieve higher GQS scores, than those with an unidentified target audience (OR: 0.28; 95%CI: 0.10–0.75). The informational engagement of the videos showed fewer comments than likes/reactions. Most YouTube videos about the SUS had moderate or good global quality, which was associated with their period of publication and choice of target audience. (GQS SUS. . (SUS) unified ‘SUS. ‘SUS ‘SUS’ 10 studied value usefulness quality Users likesreactions likes reactions authorship approached length references Regression 95 p005 p 0 05 p<0.05 2 58% 58 (58% 4. 4 4) COVID19 COVID 19 COVID-1 70 prepandemic pre pandemic OR (OR 0.30 030 30 95%CI 95CI CI 0.12–0.74. 012074 0.12–0.74 12 74 0.12–0.74) 72 0.28 028 28 0.10–0.75. 010075 0.10–0.75 75 0.10–0.75) (SUS 9 p00 p<0.0 5 (58 COVID1 COVID- 7 0.3 03 01207 0.12–0.7 0.2 02 01007 0.10–0.7 p0 p<0. (5 0. 0120 0.12–0. 0100 0.10–0. p<0 ( 012 0.12–0 010 0.10–0 p< 01 0.12– 0.10– 0.12 0.10 0.1

Abstract The aim of the present study was to compare the oral conditions of children with congenital Zika syndrome (CZS)-associated microcephaly, non-CZS-associated microcephaly, and normotypical children, as well as to characterize their sociodemographic aspects and medical history. A paired cross-sectional study was carried out on 14 children with CZS-associated microcephaly and 24 age-matched controls, in Belo Horizonte, in southeastern Brazil. Children’s oral conditions were assessed: dental caries experience (dmft/DMFT indices); developmental defects of enamel (DDE) index; dental anomalies; mucosal changes; lip sealing, and malocclusion (overjet, overbite, and/or posterior crossbite alterations). The quality of oral hygiene was analyzed by the simplified oral hygiene index. The children’s mothers also answered a questionnaire about sociodemographic and medical history data. The variables were analyzed descriptively. Female participants were more prevalent (60.5%), and the mean age of the participants was 4.9 years (±1.4) (range: 2–8 years) and 92.1% of their exhibited some oral condition. All participants with CZS-associated microcephaly showed absence of lip sealing and had malocclusion (100.0%). When compared to the other groups, children with CZS had a higher percentage of dental anomalies (35.7%), mucosal changes (71.4%), and unsatisfactory oral hygiene (64.3%). In a sample composed mainly of female participants aged less than 5 years, the prevalence of oral conditions and unsatisfactory oral hygiene was higher in the group with CZS-associated microcephaly, followed by the group with non-CZS-associated microcephaly. Normotypical children had the highest percentage of dental caries experience. CZSassociated associated nonCZSassociated non crosssectional cross sectional 1 2 agematched matched controls Horizonte Brazil Childrens Children s assessed dmft/DMFT dmftDMFT dmft DMFT indices indices) DDE (DDE index overjet, overjet (overjet overbite andor or alterations. alterations . alterations) childrens data descriptively 60.5%, 605 60.5% , 60 (60.5%) 49 4 9 4. ±1.4 (±1.4 range (range 28 8 2– 921 92 92.1 condition 100.0%. 1000 100.0% 100 0 (100.0%) groups 35.7%, 357 35.7% 35 7 (35.7%) 71.4%, 714 71.4% 71 (71.4%) 64.3%. 643 64.3% 64 3 (64.3%) 60.5 6 (60.5% ±1. (±1. 92. 100.0 10 (100.0% 35.7 (35.7% 71.4 (71.4% 64.3 (64.3% 60. (60.5 ±1 (±1 100. (100.0 35. (35.7 71. (71.4 64. (64.3 (60. ± (± (100. (35. (71. (64. (60 ( (100 (35 (71 (64 (6 (10 (3 (7 (1

Abstract The current study aims to assess the effectiveness of e-learning in compliance with the new biosafety recommendations in dentistry in the context of COVID-19 applied to the clinical staff of a dental school in Brazil. A quasi-experimental epidemiological study was carried out by means of a structured, pre-tested online questionnaire, applied before and after an educational intervention, using an e-learning format. After data collection, statistical tests were performed. A total of 549 members of the clinical staff participated in the study in the two collection phases, with a return rate of 26.9%. After the e-learning stage, a reduction was found in the reported use of disposable gloves, protective goggles, and surgical masks. The course had no impact on the staff’s knowledge concerning the proper sequence for donning PPE and showed 100% effectiveness regarding proper PPE doffing sequence. Knowledge about avoiding procedures that generate aerosols in the clinical setting was improved. Despite the low rate of return, it can be concluded that online intervention alone was ineffective in significantly improving learning about the new clinical biosafety guidelines. Therefore, the use of hybrid teaching and repetitive training is highly recommended. elearning e COVID19 COVID 19 COVID-1 Brazil quasiexperimental quasi experimental structured pretested pre tested questionnaire format performed 54 phases 269 26 9 26.9% stage gloves goggles masks staffs s 100 improved guidelines Therefore recommended COVID1 1 COVID- 5 2 26.9 10 26.

Abstract The aim of this study was to investigate the prevalence of unsatisfactory dental restorations on posterior primary teeth and associated factors in school children aged six to ten years. A cross-sectional study was conducted with children randomly selected from public schools in a small Brazilian town. Questionnaires were sent to the guardians addressing socioeconomic and behavioral aspects of the child. Oral examinations were performed at the schools to determine the quality of dental restorations, visible biofilm, and presence of moderate/extensive untreated caries (scores 3-6 ICDAS). This examination was performed by two previously trained and calibrated examiners. Associations were tested using multilevel logistic regression. Among the 400 children evaluated, 98 had restorations (217 teeth). The prevalence of unsatisfactory restorations was 34.6%. Restorations in amalgam were less likely to fail compared to those in glass ionomer cement (OR = 0.11; 95%CI: 0.02–0.49; p = 0.005). Children with moderate/extensive untreated caries were more likely to have unsatisfactory restorations (OR = 6.79; 95%CI: 2.20–20.93; p = 0.001). Children with a visible plaque index ≥ 20% were also more likely to have unsatisfactory restorations (OR = 2.28 95%CI: 1.05–4.92; p = 0.036). The prevalence of unsatisfactory restorations was high. The occurrence of this outcome was associated with restorative material, presence of caries, and visible plaque.

Abstract The objective of this study was to identify dental caries-protective factors among 5-year-old children using the salutogenic theory. A cross-sectional study was conducted in a small-sized municipality in the Southeast region of Brazil, with a representative sample of 247 children registered in preschool and their respective mothers. The data were collected through questionnaires administered to the mothers about the socioeconomic, behavioral, and biological aspects of the mother and children. Additionally, the collections included validated instruments concerning psychosocial aspects, such as a sense of coherence, resilience, family cohesion and religiosity, and intraoral examinations of the children through the decayed-missing-filled primary teeth (dmft) index. All examinations were performed by a trained and calibrated examiner. The non-adjusted and adjusted odds ratios (OR) and their respective confidence intervals (CI) were estimated using multiple logistic regression with a hierarchical model. Among the examined children, 41.7% were caries-free. In the final model, the chances of the absence of dental caries experience (dmft = 0) were greater in children with mothers who had higher education levels (> 8 years of study) (OR = 2.55 [95%CIi:1.42–4.59]) and those who lived in an environment of high family cohesion (OR = 3.66 [95%CI: 1.19–11.29]). The results indicated that mothers’ level of education and family relationships are protective factors against dental caries in 5-year-old children, which overlapped with behavioral and biological factors.

Abstract Objective: To assess the incidence of caries in a two-year period among low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW) children considering socioeconomic indicators, dietary factors and oral hygiene. Material and Methods: A convenience sample was formed of 42 low birth weight children aged two to five years at baseline. Two examiners diagnosed caries using the World Health Organization criteria. Birth weight, socioeconomic indicators and diet were collected from medical records and questionnaires. Binomial models were used to estimate unadjusted and adjusted rate ratios (RR) and respective 95% confidence intervals for the factors evaluated. Results: Thirty-six children were re-examined after two years. The incidence of dental caries was 36.7%. The dmft index was 0.44 (±1.25) at baseline and increased to 1.36 (±3.85) at follow-up. VLBW children (1,000 to 1,500 g) (RR=0.23; 95%CI: 0.08-0.72) and LBW children (1,500 to 2,500 g) (RR=0.06; 0.01-0.55) had fewer carious lesions compared to ELBW children (<1,000 g). Carious lesions were more frequent among children with a lower income (RR=6.05; 1.05-34.84) and less frequent among those who did not consume sweetened juice, tea or yogurt (RR: 0.21; 0.07-0.62). Conclusion: An inverse dose-response relation was found between birth weight and the incidence of caries. A lower income and the consumption of sweetened beverages were risk factors for the development of caries.

Abstract The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37–0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07–2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11–1.40), periodontal health (OR = 1.80; 95%CI = 1.04–3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96–12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.

ABSTRACT Objective: To assess the oral health knowledge, attitude, behaviour, and its association with sociodemographic and habitual factors among South Indian Population. Material and Methods: A total of 288 adults living in a residential community situated in Chennai were selected by systematic random sampling method participated in this cross-sectional study. Data collection was carried out using a validated questionnaire. Results: About 97.9% of the participants in our study had good knowledge, 33.3% had a positive attitude and 48.2% had adequate oral health behaviour. Sociodemographic and habitual factors like diet (p=0.006), education (p=0.009), and employment (p=0.003) were significantly associated with knowledge. On the other hand, diet (p=0.012) was the only factor significantly associated with attitude. Ownership of house (p= 0.030) was significantly associated with behaviour and no factor was associated with all three KAB profiles. Absence of correlation were identified between Knowledge-Attitude (r=0.11, p=0.23), Knowledge-Behaviour (r= -0.037, p= 0.68) and Attitude-Behaviour (r =0.01, p=0.94). Conclusion: It has been found a massive number of participants possessed a high knowledge level towards oral health. On the other hand, less than half of the participants had a positive attitude and adequate behaviour towards oral health. No positive linear correlation was seen among knowledge, attitude, and behaviour towards oral health.

Resumo Esse estudo avaliou os fatores individuais e contextuais associados às necessidades de tratamento odontológico especializado na população de 35 a 44 anos no estado de Minas Gerais. Foram utilizados dados secundários referentes à saúde bucal de adultos, obtidos no levantamento epidemiológico da Pesquisa das Condições de Saúde Bucal da população mineira e de dados municipais, obtidos de bancos de dados públicos. Foi realizada análise multinível para avaliar a associação de variáveis independentes individuais e contextuais com ausência ou presença de necessidades de tratamento odontológico na atenção secundária da rede de saúde bucal. Os indivíduos com maior renda (OR 0,53; IC95% 0,31-0,93) e com maior acesso aos cuidados em saúde bucal, que caracterizam a cobertura de primeira consulta da atenção primária (OR 0,94; IC95% 0,90-0,99) apresentaram menor necessidade de tratamento odontológico na atenção secundária. A renda e o acesso aos cuidados em saúde bucal estão relacionados às necessidades de tratamento odontológico especializado em Minas Gerais.

Abstract This study evaluated the individual and contextual factors associated with the specialised dental treatment needs of a population of adults aged 35 to 44 years old in the state of Minas Gerais. The individual variables were obtained from the database of the SB Minas Gerais project - a survey of oral health status of the population of Minas Gerais, Brazil. The variables at the municipal level were derived from any available public databases related to oral health services. A multilevel analysis was performed to evaluate the association of independent individuals and contextual variables with or without dental treatment needs in the secondary care of the oral health network. Individuals with a higher income (OR 0.53; CI95% 0.31-0.93) and with greater access to oral health care (OR 0.94; CI95% 0.90-0.99) had less secondary care treatment needs. Income and access to oral health care are related to the needs of specialised dental treatment in Minas Gerais.

Resumo Esse estudo avaliou os fatores individuais e contextuais associados às necessidades de tratamento odontológico especializado na população de 35 a 44 anos no estado de Minas Gerais. Foram utilizados dados secundários referentes à saúde bucal de adultos, obtidos no levantamento epidemiológico da Pesquisa das Condições de Saúde Bucal da população mineira e de dados municipais, obtidos de bancos de dados públicos. Foi realizada análise multinível para avaliar a associação de variáveis independentes individuais e contextuais com ausência ou presença de necessidades de tratamento odontológico na atenção secundária da rede de saúde bucal. Os indivíduos com maior renda (OR 0,53; IC95% 0,31-0,93) e com maior acesso aos cuidados em saúde bucal, que caracterizam a cobertura de primeira consulta da atenção primária (OR 0,94; IC95% 0,90-0,99) apresentaram menor necessidade de tratamento odontológico na atenção secundária. A renda e o acesso aos cuidados em saúde bucal estão relacionados às necessidades de tratamento odontológico especializado em Minas Gerais.

Abstract This study evaluated the individual and contextual factors associated with the specialised dental treatment needs of a population of adults aged 35 to 44 years old in the state of Minas Gerais. The individual variables were obtained from the database of the SB Minas Gerais project - a survey of oral health status of the population of Minas Gerais, Brazil. The variables at the municipal level were derived from any available public databases related to oral health services. A multilevel analysis was performed to evaluate the association of independent individuals and contextual variables with or without dental treatment needs in the secondary care of the oral health network. Individuals with a higher income (OR 0.53; CI95% 0.31-0.93) and with greater access to oral health care (OR 0.94; CI95% 0.90-0.99) had less secondary care treatment needs. Income and access to oral health care are related to the needs of specialised dental treatment in Minas Gerais.

ABSTRACT OBJECTIVE To perform a cross-cultural adaptation of the Clear Communication Index instrument from the Centers for Disease Control and Prevention (CDC-CCI) from English to Brazilian Portuguese. METHODS This study comprised initial discussion about the conceptual equivalence of the instrument by a committee formed by experts on health education. We performed translations, synthesis of translations, back-translations, revision by the committee, and linguistic revision. Semantic equivalence was obtained by analyzing the referential and general meaning of each item by the committee, resulting in a pre-final version of the instrument. Subsequently, thirty professionals with health sciences degrees performed a pre-test. These professionals used the pre-final version of the instrument to assess a health education material. A questionnaire was applied to evaluate the acceptability of the instrument, the understanding of each of the 20 items, as well as the individual and professional variables. We analyzed the scores attributed to the health education material, the variables related to healthcare professionals, the proportions of the acceptability of the instrument, and the comprehension of each item. RESULTS After we obtained the conceptual equivalence of the instrument, the committee of experts, the instrument’s main author, and the linguist produced the pre-final version using two translations, a synthesis of the translations, and two back-translations. A general equivalence was maintained in 15 of the 20 items (75%), four of the items were slightly altered (20%), and one item was very altered (5%). Nineteen items presented referential equivalence or near equivalence (95%). We then carried out with the pre-test, in which the professionals used the pre-final version. Two items in the domains of “risks” and “main message” were unclear and needed to be revised. CONCLUSION The process of cross-cultural adaptation of the Clear Communication Index provided an adapted version to the Brazilian Portuguese language.

ABSTRACT OBJECTIVE To perform a cross-cultural adaptation of the Clear Communication Index instrument from the Centers for Disease Control and Prevention (CDC-CCI) from English to Brazilian Portuguese. METHODS This study comprised initial discussion about the conceptual equivalence of the instrument by a committee formed by experts on health education. We performed translations, synthesis of translations, back-translations, revision by the committee, and linguistic revision. Semantic equivalence was obtained by analyzing the referential and general meaning of each item by the committee, resulting in a pre-final version of the instrument. Subsequently, thirty professionals with health sciences degrees performed a pre-test. These professionals used the pre-final version of the instrument to assess a health education material. A questionnaire was applied to evaluate the acceptability of the instrument, the understanding of each of the 20 items, as well as the individual and professional variables. We analyzed the scores attributed to the health education material, the variables related to healthcare professionals, the proportions of the acceptability of the instrument, and the comprehension of each item. RESULTS After we obtained the conceptual equivalence of the instrument, the committee of experts, the instrument’s main author, and the linguist produced the pre-final version using two translations, a synthesis of the translations, and two back-translations. A general equivalence was maintained in 15 of the 20 items (75%), four of the items were slightly altered (20%), and one item was very altered (5%). Nineteen items presented referential equivalence or near equivalence (95%). We then carried out with the pre-test, in which the professionals used the pre-final version. Two items in the domains of “risks” and “main message” were unclear and needed to be revised. CONCLUSION The process of cross-cultural adaptation of the Clear Communication Index provided an adapted version to the Brazilian Portuguese language.

ABSTRACT OBJECTIVE Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents. METHODS Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87–0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study. RESULTS The following variables remained associated with better OHL: high mother’s schooling level (RR = 1.07; 95%CI: 1.03–1.12), high income (RR = 1.04; 95%CI: 1.01–1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01–1.10), married parents (RR = 1.04; 95%CI: 1.01–1.09), “enmeshed” family cohesion (RR = 1.21; 95%CI: 1.12–1.30), “structured” (RR = 1.06; 95%CI: 1.01–1.12) or “rigid” (RR = 1.11; 95%CI: 1.04–1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01–1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03–1.13). CONCLUSION Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.