The purpose of this study was to assess the current knowledge and recommendations of obstetricians and dentists as to the dental care to pregnant patients in the cities of Londrina/PR and Bauru/SP, Brazil. Questionnaires were distributed to professionals of both cities, arguing on the following issues: oral health during pregnancy; contact between prenatal care and dental care providers; prenatal fluoride supplementation; selection of therapeutic agents for local anesthesia, pain control and treatment of infection; and dental procedures that can be performed during each trimester. Data were analyzed by frequency of responses and statistical analyses were carried out using X² (type of workplace/service) and t test (time since graduation), significant if p<0.05. Seventy-nine obstetricians and 37 dentists responded the questionnaires. Most physicians referred the patient to dental care only when a source of dental problem was mentioned, limiting the adoption of a preventive approach. Forty-three percent of dentists and 34% of obstetricians did not know the potential contribution of periodontal infection as a risk factor for preterm low birth-weight babies. There was divergence from scientific literature as to the recommendation of local anesthetics (dentists and obstetricians), prenatal fluoride supplementation (obstetricians) and dental radiographs (dentists). The findings of this survey with dentists and obstetricians showed that dental management during pregnancy still presents some deviations from scientific literature recommendations, indicating the need to update these health care professionals in order to establish guidelines for prenatal dental care.

O objetivo primeiro do Tratamento Restaurador Atraumático (TRA) é reduzir a indicação de extrações dentárias através de uma técnica operatória de baixo custo. Considerando as dificuldades do Serviço de Saúde Pública do Brasil de suprir a demanda de serviço requerida pela população adulta de baixa renda, que usualmente recebe atendimento emergencial, o objetivo deste estudo é avaliar a performance clínica de um cimento de ionômero de vidro de alta viscosidade empregado através da técnica atraumática modificada em cavidades de uma e de múltiplas superfícies, comparativamente à abordagem restauradora convencional. Serão analisados a performance clínica dos materiais; o custo (material e recursos humanos); a satisfação do paciente com o tratamento recebido; e o impacto preventivo do tratamento.

The primary objective of the Atraumatic RestorativeTreatment (ART) is to reduce the indication of tooth extraction by means of a low-cost technique. Considering the difficulties of Brazilian public services to meet the demand of care of the low-income population, with lack of care to the adult population, which usually receives only emergency care, the aim of this study is to assess the performance of high-viscosity glass ionomer cements accomplished by the modified atraumatic restorative treatment in one- and multiple-surface cavities, compared to the conventional restorative approach. It will be analyzed the clinical performance of the materials; cost (material and human resources); patient satisfaction with the treatment received; and preventive effect of treatment.

Este estudo avaliou a rugosidade superficial (Ra, µm) de 2 resinas compostas microparticuladas (Durafill; Perfection), 1 híbrida (Filtek Z250) e 2 compactáveis (Surefil; Fill Magic), antes (baseline) e após a realização de 8 técnicas de acabamento e polimento. A rugosidade foi avaliada com rugosímetro. Dez espécimes de cada resina foram submetidos aos seguintes procedimentos: A - brocas cabide; B - pontas diamantadas fina/extrafina; C - sistema Sof-Lex; D - sistema Super-Snap; E - pontas de borracha + pastas de polimento; F - pontas diamantadas + pontas de borracha + pastas de polimento; G - pontas diamantadas + Sof-Lex; H - pontas diamantadas + Super-Snap. Os dados foram submetidos à análise de variância a dois critérios e teste de Tukey. Foi observada diferença estatisticamente significante (p<0.05) tanto entre as resinas compostas quanto entre as técnicas de acabamento/polimento. Para todas as resinas, a maior rugosidade foi produzida com o emprego das pontas diamantadas (Ra: 0.69-1.44 µm). O menor valor de rugosidade foi obtido com o sistema Sof-Lex (Ra: 0.11- 0.25 µm). A Durafill apresentou melhor lisura que a Perfection e a Z250, que apresentaram melhor lisura que as resinas compactáveis. A seqüência completa de discos Sof-Lex produziu a melhor lisura para todas as resinas. Em áreas sem acesso aos discos, as pontas de borracha e pastas de polimento produziram lisura de superfície satisfatória para as resinas híbridas enquanto as brocas carbide produziram polimento adequado para as resinas compactáveis.

This study examined the average surface roughness (Ra, µm) of 2 microfilled (Durafill and Perfection), 1 hybrid (Filtek Z250) and 2 packable composite resins (Surefil and Fill Magic), before (baseline) and after eight different finishing and polishing treatments. The surface roughness was assessed using a profilometer. Ten specimens of each composite resin were randomly subjected to one of the following finishing/polishing techniques: A - carbide burs; B - fine/extrafine diamond burs; C - Sof-Lex aluminum oxide discs; D - Super-Snap aluminum oxide discs; E - rubber polishing points + fine/extrafine polishing pastes; F - diamond burs + rubber polishing points + fine/extrafine polishing pastes; G - diamond burs + Sof-Lex system; H - diamond burs + Super-Snap system. Data were analyzed using two-way ANOVA and Tukey's HSD test. Significant differences (p<0.05) were detected among both the resins and the finishing/polishing techniques. For all resins, the use of diamond burs resulted in the greatest surface roughness (Ra: 0.69 to 1.44 µm). The lowest Ra means were obtained for the specimens treated with Sof-Lex discs (Ra: 0.11 to 0.25 µm). The Ra values of Durafill were lower than those of Perfection and Filtek Z250, and these in turn had lower Ra than the packable composite resins. Overall, the smoothest surfaces were obtained with the use the complete sequence of Sof-Lex discs. In areas that could not be reached by the aluminum oxide discs, the carbide burs and the association between rubber points and polishing pastes produced satisfactory surface smoothness for the packable and hybrid composite resins, respectively.

O objetivo deste estudo longitudinal foi avaliar a efetividade de um programa de saúde bucal, iniciado durante a gestação, sobre a experiência de cárie de primigestas e seus filhos. Oitenta e uma gestantes, pertencentes a classes sociais pouco favorecidas, foram selecionadas com base no diagnóstico clínico de lesões de cárie ativas e foram divididas aleatoriamente em grupo controle ou experimental. A condição dentária inicial foi estabelecida através do índice CPOS e do diagnóstico das lesões de mancha branca. As medidas preventivas foram aplicadas durante a gestação e 6 e 12 meses após o parto. Ambos os grupos receberam abordagem educativa. O grupo experimental recebeu adicionalmente tratamento com anti-microbianos e adequação bucal utilizando cimento de ionômero de vidro. A prevalência de crianças cárie-ativas com a idade de dois anos foi de 33,3% no grupo controle e 14,7% no grupo experimental. Foi observada diferença significativa na prevalência de cárie entre crianças com e sem placa dentária visível. O número médio de superfícies com lesões de cárie (incluindo as desmineralizações) foi maior para as crianças do grupo controle quando comparadas às do grupo experimental (6,3 x 3,2), porém sem atingir significância estatística. O incremento de cárie na dentição da mãe apresentou correlação significativa com a incidência de cárie na dentição das crianças. Estes dados suportam a evidência de associação entre a incidência de cárie na primeira infância e a presença de placa, assim como a influência significativa de fatores maternos.

The aim of this prospective study was to determine the effectiveness of caries preventive measures started during pregnancy on the caries experience of first-time mothers and their infants. Eighty-one pregnant women with low social background were selected on the basis of the presence of active carious lesions and were randomly divided into control (38) and experimental (43) groups. The initial dental status (DMFS and white spot lesions) was established through clinical examination. The prophylactic measures were repeated during pregnancy and 6 and 12 months after delivery. Both groups received primary care intervention. They were instructed in relation to the etiologic factors of dental caries and received oral hygiene kits. Oral hygiene instructions were reinforced through interactive brushing. The experimental group also received antimicrobial treatment (topical application of NaF and iodine solution immediately after prophylaxis and 3 and 5 days later) and restorative care using glass ionomer cement. By the time the children were 2 years of age, 33.3% of the infants in the control group and 14.7% in the experimental group had caries activity. A significant difference in caries prevalence was observed between children with and without visible dental plaque. The mean number of tooth surfaces with carious lesions (including areas of demineralization) was higher among the children in the control group compared to the experimental group (6.3 x 3.2), however, with no statistical significance. Maternal caries increase was a significant factor influencing the caries experience of the children. These data support the evidence of an association between caries prevalence in young children and clinical (dental plaque) and maternal factors.

O presente estudo avaliou a correlação entre a presença de manchas extrínsecas pretas no esmalte dental e experiência de cárie de escolares brasileiros. A população alvo consistiu de 263 crianças com idades entre 6 e 12 anos. Os exames clínicos foram realizados por quatro dentistas calibrados de acordo com o critério da Organização Mundial de Saúde para diagnóstico de cárie. O teste c² foi usado para comparar a prevalência de cárie entre crianças com e sem manchas pretas no esmalte. O teste de correlação de Spearman foi usado para analisar a relação entre a presença de mancha preta e a severidade da doença cárie. A presença de manchas pretas foi diagnosticada em 14,8 por cento das crianças. O número de crianças livre de cárie na dentição permanente não foi estatisticamente diferente entre os grupos. O CPO-D médio foi 1,46 ± 1,39 para crianças com manchas pretas e 2,42 ± 2,09 para crianças sem mancha. Observou-se correlação negativa entre a presença (r = -0,16; p<0,05) e severidade (r = -0,15; p<0,01) da mancha preta e o CPO-D.

This study evaluated the correlation between the presence of black extrinsic tooth stains and caries in Brazilian schoolchildren. The target population consisted of 263 children aged 6-12 years. Clinical examinations were performed by four dentists calibrated for the World Health Organization criteria for caries diagnosis. The c² test was used to compare the prevalence of caries between groups of children with and without black tooth stains. Spearman's correlation test was used to analyze the relationship between the presence of black stains and caries severity. Black stains were observed in 14.8% of the children. The number of children with caries-free permanent dentition was not statistically different between groups. The mean DMF-T was 1.46 ± 1.39 for children with black stains and 2.42 ± 2.09 for children without black stains. A negative correlation was observed between the presence (r = -0.16; p<0.05) and severity (r = -0.15; p<0.01) of black stains and DMF-T.

O propósito deste estudo foi comparar o padrão de microinfiltração em restaurações classe V usando diferentes combinações de cimento ionomérico/resina composta. Cinqüenta cavidades foram preparadas nas superfícies vestibular e lingual de caninos e de pré-molares recém-extraídos. A margem gengival dos preparos estendeu-se até a dentina/cemento, e a margem oclusal localizou-se em esmalte. As cavidades foram restauradas como se segue: cimentos ionoméricos restauradores modificados por componentes resinosos (Fuji II LC e Vitremer); sistema adesivo/resina composta (Scotchbond Multi-Uso/Silux Plus); técnica sanduíche empregando-se o sistema adesivo/resina composta descrito, com um cimento ionomérico forrador (Vitrebond e GC Lining LC). Os espécimes foram armazenados em água destilada, polidos, submetidos à ciclagem térmica e imersos em fucsina. A extensão de penetração do corante foi classificada segundo o critério de escores, e os dados foram analisados estatisticamente, não sendo observadas diferenças significativas tanto entre materiais como entre margens.

The purpose of this study was to compare the microleakage of class V restorations using different combinations of glass ionomer/composite resin. Fifty cavities were prepared on the buccal and lingual aspects of recently extracted premolars and canines. The gingival margins of the preparations were extended into the cementum, and the occlusal margins were kept at the enamel level. The teeth were then divided into five groups and restored as follows: resin-modified glass ionomer cement restorative materials (Fuji II LC and Vitremer); composite resin/adhesive system (Scotchbond Multipurpose/Silux Plus); sandwich technique using the same composite resin/adhesive system and a resin-modified glass ionomer cement liner material (Vitrebond and GC Lining LC). The teeth were stored in distilled water, finished and thermocycled prior to immersion in a 2% basic fuchsin solution. The depth of dye penetration was scored and the results analyzed using Kruskal-Wallis and Wilcoxon Tests. The results revealed no significant differences between any of the groups for both cervical and occlusal margins.