RESUMO Objetivo: Mensurar a prevalência de burnout e de biomarcadores salivares em policiais militares do quadro de saúde de São Paulo que atuaram frente à pandemia do Covid-19. Métodos: Realizado estudo observacional com corte transversal em amostra de 104 participantes estratificado por idade, cor da pele, gênero, patente militar, função desempenhada, tempo de serviço, uso de medicamentos, tabagismo, etilismo e renda econômica. A apuração dos dados sociodemográficos coletados utilizou o inventário de burnout de Maslach- adaptado e exame da saliva, através da espectroscopia de infravermelho por transformada de Fourier. Os testes estatísticos de qui-quadrado, de PLS-DA e de hipótese foram fixados em IC=95%. Resultados: Quando em análise conjunta, os indicadores sociodemográficos apresentaram associação estatística com burnout, pelo p-valor de 62,72. Do total da amostra 80,77% apresentaram burnout e 19,23% apresentaram risco de desenvolvimento. Os testes salivares indicaram a presença de biomarcadores (amida, fragmentos genéticos e polissacarídeos) que reforçam os parâmetros validados de diagnóstico precoce para burnout. Conclusões: Do total da amostra estudada, 80,77% apresentaram burnout e 19,23% risco de desenvolvimento da doença. Mulheres brancas, entre 30 a 40 anos, auxiliares de saúde, com mediana entre 03 e 06 salários mínimos e com menos de 10 anos de serviço apresentaram as prevalências mais altas do burnout quando comparados aos seus pares durante o enfrentamento do Covid-19. Houve associação dos indicadores sociodemográficos em sua totalidade em relação aos níveis mensurados de estresse. Biomarcadores salivares apresentaram associação com estresse na fase inicial. Objetivo Covid19. Covid19 Covid 19. 19 Covid-19 Métodos idade pele gênero militar desempenhada medicamentos tabagismo econômica Maslach saliva Fourier quiquadrado, quiquadrado qui quadrado, quadrado qui-quadrado PLSDA PLS DA IC95 IC 95 IC=95% Resultados conjunta pvalor p valor 6272 62 72 62,72 8077 80 77 80,77 1923 23 19,23 amida, amida (amida polissacarídeos Conclusões estudada doença brancas 3 4 0 1 inicial Covid1 Covid-1 IC9 9 IC=95 627 6 7 62,7 807 8 80,7 192 2 19,2 Covid- IC=9 62, 80, 19, IC=

ABSTRACT Objective: Study the prevalence of burnout and the salivary biomarkers in military police officers in the São Paulo health-care team who worked during the Covid-19 pandemic in Brazil. Method: An observational cross-sectional study was conducted in a sample of 104 participants distinguished by age, skin color, gender, military rank, function performed, length of service, use of medications, smoking, alcohol consumption, and income. The analysis of the social demographic data collected used an adapted Maslach Burnout Inventory and saliva examination through Fourier transform infrared spectroscopy. The statistical tests of chi-square, PLS-DA, and hypothesis were fixed at the 95% confidence. Results: The social demographic indicators presented statistical association with burnout, with chi-square 62.72 (p<0.05). The prevalence of burnout (80.77%) and risk of development (19.23%) were observed. The presence of biomarkers in saliva (amide, genetic fragments and polysaccharides) in those experiencing burnout aligned with current literature. Conclusion: Of the total sample, 80.77% had burnout and 19.23% risk of developing the disease. Young white women, in the role of health assistants, with median income between 3 and 6 times the minimum wage and with less than 10 years of service`s length had the highest prevalence of burnout in relation to their peers. There was an association of social demographic indicators with measured stress levels. Salivary biomarkers were also associated with stress in the initial phase of burnout. There is a pressing need for further studies, aiming to support greater knowledge for this population researched. Objective healthcare care Covid19 Covid 19 Covid-1 Brazil Method crosssectional cross sectional age color gender rank performed service medications smoking consumption spectroscopy chisquare, chisquare chi square, square PLSDA, PLSDA PLS DA, DA PLS-DA 95 confidence Results 6272 62 72 62.7 p<0.05. p005 p p<0.05 . 0 05 (p<0.05) 8077 80 77 (80.77% 1923 23 (19.23% observed amide, amide (amide polysaccharides literature Conclusion 80.77 19.23 disease women assistants 1 services s peers levels studies researched Covid1 Covid- 9 627 7 62. p00 p<0.0 (p<0.05 807 8 (80.77 192 2 (19.23 80.7 19.2 p0 p<0. (p<0.0 (80.7 (19.2 80. 19. p<0 (p<0. (80. (19. p< (p<0 (80 (19 (p< (8 (1 (p (

RESUMO O manejo terapêutico, bem como o próprio vírus do HIV tem sido associados à quadros de alterações em nível ósseo, podendo ter uma relação também com os processos alveolares maxilo-mandibulares e potencial desenvolvimento de quadros de doenças periodontais, em especial a periodontite. Objetivo: O objetivo do trabalho foi avaliar a condição da saúde periodontal de indivíduos adultos jovens vivendo com HIV/AIDS, por meio da aferição do Nível de Inserção Clínica Periodontal e levantar dados gerais sobre as condições de saúde frente ao HIV e sobre a qualidade de vida desse público. Os dados foram coletados em um Centro de Referência em IST/AIDS de São Paulo – SP, Brasil. Métodos: O método empregado teve como guia norteadora indicadores previamente validados. No total, foram avaliados 31 indivíduos com idades entre 20 e 24 anos, ambos os gêneros e em uso da terapia antirretroviral. Para as análises foi utilizado o software Excel Microsoft®. Resultados: Foi observado uma prevalência de periodontite no público avaliado de 45,17%. Frente a qualidade de vida o público foi classificado como “Regular” e não foi observado quadros de Periodontite Necrozante, que está fortemente associado a infecção pelo HIV. Conclusão: O público avaliado apresentou alta prevalência de periodontite, o que reforça a importância da Odontologia no acompanhamento das Pessoas Vivendo com HIV/Aids, no sentido de prevenir o agravamento dos quadros de doenças periodontais. terapêutico ósseo maxilomandibulares maxilo mandibulares periodontais Objetivo HIVAIDS AIDS HIV/AIDS ISTAIDS IST SP Brasil Métodos validados total 3 2 anos antirretroviral Microsoft Microsoft® Resultados 4517 45 17 45,17% Regular “Regular Necrozante Conclusão HIVAids Aids HIV/Aids 451 4 1 45,17 45,1 45,

ABSTRACT The therapeutic management, as well as the HIV virus itself, has been associated with alterations at the bone level, which may also have a relationship with the maxillomandibular alveolar processes and potential development of periodontal diseases, especially periodontitis. Objective: The objective of this study was to evaluate the periodontal health condition of young adults living with HIV/AIDS, through the measurement of the Periodontal Clinical Insertion Level (CAL) and to raise general data on the health conditions facing HIV and on the quality of life of this audience. Methods: Data were collected at a Reference Center for STI/AIDS in São Paulo - SP, Brazil. The method used was guided by previously validated indicators. In total, 31 individuals aged between 20 and 24 years, both genders and using TAAP were evaluated. For the analyses, the Excel Microsoft® software was used. Results: There was a prevalence of periodontitis in the assessed public of 45.17%. In view of the quality of life, the public was classified as “Regular” and no cases of Necrozing Periodontitis were observed, which is strongly associated with HIV infection. Conclusions: The evaluated public showed a high prevalence of periodontitis, which reinforces the importance of Dentistry in monitoring People Living with HIV/AIDS, in order to prevent the worsening of periodontal diseases. management itself level diseases Objective HIVAIDS AIDS HIV/AIDS CAL (CAL audience Methods STIAIDS STI SP Brazil indicators total 3 2 years analyses Microsoft Results 4517 45 17 45.17% Regular “Regular observed infection Conclusions 451 4 1 45.17 45.1 45.

ABSTRACT Introduction: Syphilis is classified as a sexually transmitted infectious-contagious disease with the causative agent Treponema pallidum (Tp). It presents distinct stages of evolution: The primary phase is characterized by the appearance of the hard chancre, the secondary phase by the spread of Tp through the bloodstream and systemic involvement, and the tertiary phase by organ infection and nervous system impairment. In congenital syphilis, the Tp is transmitted vertically from mother to child. Objective: Report a case in which the dental team participated in the diagnosis of syphilis. Case presentation: A male 26-year-old patient with leukoderma, HIV-positive and under regular antiretroviral treatment, with no other chronic systemic changes and no previous history of Tp infection, was referred for evaluation by the oral health team. The patient reported having had bisexual relations in recent months with a condom and orogenital contact without a condom. He had not noticed any type of "wound" on the body. Intraoral examination found multiple reddish macules scattered on the lingual dorsum, with a slight detachment and little pain. The quick test was a reagent for syphilis. The patient was referred for evaluation at the medical clinic. Treatment started by two applications of benzyl penicillin with a 7 days' separation between them. Complementary blood tests were also indicated, with special attention to VDRL, which eventually confirmed the Tp infection. Conclusions: Participation of the oral health team in the diagnosis of syphilis constitutes a complementary force for the improvement of health care processes.

RESUMEN Introducción: La sífilis se clasifica como una enfermedad contagiosa infecciosa de transmisión sexual, con el agente causal Treponema pallidum (Tp). Presenta distintos estadios de evolución: la fase primaria caracterizada por la aparición del chancre duro; la fase secundaria, la diseminación de la Tp a través del torrente sanguíneo y la afectación sistémica; y la fase terciaria, en que hay infección de órganos y deterioro del sistema nervioso, además de sífilis congénita, forma esta en la que Tp es transmitida verticalmente por la mujer embarazada. Objetivo: Informar sobre un caso en el que la participación del equipo dental colaboró en el proceso de diagnóstico de la sífilis. Presentación del caso: Paciente con 26 años de edad, leucodermia, VIH positivo y en tratamiento antirretroviral regular, sin otros cambios crónicos a nivel sistémico y sin antecedentes de infección por Tp. Se remitió para evaluación con el equipo de salud oral. Informó haber tenido relaciones bisexuales en los últimos meses con un condón y contacto orogenital sin condón. No notó ningún tipo de "herida" en el cuerpo. En el examen intrabucal, se encontraron múltiples máculas rojizas dispersas en el dorso lingual, con un ligero desprendimiento y con poco dolor. La prueba rápida fue un reactivo para sífilis. El paciente fue remitido para su evaluación a clínica médica. Comenzó el tratamiento con dos aplicaciones de penicilina bencilo, con un intervalo de 7 días y se solicitó análisis de sangre complementarios, con especial atención al VDRL, que posteriormente confirmó la infección por Tp. Conclusiones: La participación del equipo de salud bucal frente al diagnóstico de la sífilis, se constituye como una fuerza complementaria para la mejora de los procesos en salud.

Tuberculosis (TB) is a contagious infectious disease caused by Mycobacterium tuberculosis (Koch's bacillus). Co-infection with human immunodeficiency virus (HIV) and TB has reached a significant importance as a public health problem and this association has been recognized as the most significant event that changed "the balance between man and Koch's bacillus" in the last century, and has a large contribution to the risk for disease spreading. Tuberculosis has two main standard categories of clinical manifestations: primary and secondary. Primary TB is responsible for the initial infection with lungs being the involved organ. Oral lesions are observed as a secondary TB clinical manifestation with most frequent sites being hard and soft palate, tongue, lips, gums, tonsils, and salivary glands. A case of classical TB lesions in the oral cavity is reported, and the importance of a correct diagnosis through careful history taking is emphasized. Treatment selection needs to be done assertively, with great determination and building a link between patient and treatment protocol, in order to promote patient's adherence.

La tuberculosis (TB) es una enfermedad infecciosa contagiosa causada por Mycobacterium tuberculosis (bacilo de Koch). La coinfección del Virus de Inmunodeficiencia Humana (VIH) con TB son problemas de salud pública graves, además que esta asociación ha sido identificado como el evento más significativo que cambió "el equilibrio entre el hombre y el bacilo de Koch" en el último siglo y es crucial en el riesgo de propagación de la enfermedad. La tuberculosis se manifiesta en dos estándares: primaria y secundaria; el primario es responsable de la infección inicial y el órgano de elección es el pulmón. Las lesiones orales se observan a nivel secundario y los sitios más frecuentes son el paladar duro y blando, lengua, labios, encías, amígdalas y las glándulas salivales. Esta revisión presenta un caso con lesiones clásicas de tuberculosis en la cavidad bucal haciendo hincapié en la importancia de un correcto diagnóstico a través de la anamnesis. El tratamiento se debe hacer con la seguridad, la determinación y la formación de enlaces que facilitan la adherencia del paciente al tratamiento.

Behçet's disease (BD) is a multi-systemic vascular disorder characterized by oral and genital ulcers, cutaneous, ocular, arthritic, vascular, central nervous system and gastrointestinal involvement. It usually affects young adults and the etiopathogenesis is unknown. A 21-year-old girl, Caucasian, with diagnostic BD, presented with rheumatoid arthritis, genital lesions and multiple recurrent ulcers inside the mouth, with an erythematous halo, covered by yellowish exudates exacerbated during menstrual periods, and in situations of stress and anxiety. The application of low power laser in ulcers was considered in order to decrease the inflammatory symptoms and pain, beyond getting the healing process accelerated. The proposed therapy was able to promote pain relief, increase local microcirculation and repair ulcerated lesions, eliminating the need for administration of systemic or topical medications, leading to improved quality of life.

La enfermedad de Behçet (EB) es un trastorno vascular multisistémico caracterizado por úlceras orales y genitales, cutáneas, oculares, artritis, vascular, sistema nervioso central y afectación gastrointestinal. Afecta a los adultos jóvenes y la etiopatogenia es desconocida. Una paciente de 21 años de edad, caucásica, diagnosticada de EB, artritis reumatoide, lesiones genitales y múltiples úlceras recurrentes dentro de la boca, con un halo eritematoso, cubiertas por exudado amarillento exacerbadas durante los períodos menstruales y en situaciones de estrés y ansiedad. Se considera el tratamiento con láser de baja potencia en las úlceras con el fin de disminuir los síntomas inflamatorios y de dolor, más allá de lograr la aceleración del proceso de regeneración. El tratamiento propuesto fue capaz de proporcionar el alivio del dolor, aumentar la microcirculación local y reparar las lesiones ulceradas, eliminando la necesidad de administrar medicamentos sistémicos o tópicos, que conduce a mejorar la calidad de vida.

Behçet's disease (BD) is a multi-systemic vascular disorder characterized by oral and genital ulcers, as well as cutaneous, ocular, arthritic, vascular, central nervous system and gastrointestinal involvement. It usually affects young adults, and its pathological origin is unknown. The case of a 47-year-old woman with recurrent ulcers in the oral cavity is presented. She linked the pain with sitting and during the sexual act, with vaginal and oral cavity pain, due to the lesions present at those sites, as well as swelling and pain in the knees, making walk painful. The patient was kept under observation and underwent multidisciplinary treatment with prescription of topical and systemic drugs to improve quality of life. Dentists should be aware of BD and the need of multidisciplinary treatment to increase the patient's quality of life.

La Enfermedad de Behçet (EB) es un trastorno vascular multi-sistémico caracterizado por úlceras orales y genitales, cutáneas, oculares, artritis, y afectación vascular, sistema nervioso central y gastrointestinal. Por lo general afecta a los adultos jóvenes y la etiopatogenia es desconocida. Se presenta un caso de mujer de 47 años de edad que presenta úlceras recorrentes en la cavidad oral. Ella ha relacionado com el dolor al sentarse, durante el acto sexual, dolor vaginal y oral, cavidad, debido a las lesiones presentes en los lugares mencionados, hinchazón y dolor em las rodillas causando dificultad para caminar. El paciente se mantuvo em observación y se sometió a través de untratamientomultidisciplinariocon la prescripción de produtos farmacéuticos tópicos y sistémicos para mejorar la calidad de vida. El conocimiento del clínico sobre EB ayuda en el tratamento multidisciplinario de promoción de la calidad de vida para el paciente.

Osteopetrosis is characterized by a considerable increase in bone density resulting in defective remodeling, caused by failure in the normal function of osteoclasts, and varies in severity. It is usually subdivided into three types: benign autosomal dominant osteopetrosis; intermediate autosomal recessive osteopetrosis; and malignant autosomal recessive infantile osteopetrosis, considered the most serious type. The authors describe a case of chronic osteomyelitis in the maxilla of a 6-year-old patient with Malignant Infantile Osteopetrosis. The treatment plan included pre-maxilla sequestrectomy and extraction of erupted upper teeth. No surgical procedure was shown to be the best to prevent the progression of oral infection. Taking into account the patient's general condition, if the patient develops severe symptomatic and refractory osteomyelitis surgery should be considered. The patient and his family are aware of the risks and benefits of surgery and its possible complications.

La osteopetrosis se caracteriza por un aumento considerable de la densidad ósea que resulta en un remodelado defectuoso, causado por mal funcionamiento de los osteoclastos, de severidad variable. Usualmente se divide en 3 tipos: osteopetrosis dominante autosómica benigna, osteopetrosis recesiva autosómica intermedia y osteopetrosis infantil recesiva autosómica maligna, considerado el tipo de mayor gravedad. Los autores describen un caso de osteomielitis crónica en el maxilar superior de paciente de 6 años de edad con osteopetrosis infantil maligna. El plan de tratamiento incluyó secuestrectomía y exondoncia de los dientes superiores erupcionados. Ningún procedimento quirúrgico se ha comprobado que sea superior a otros en la prevención del avance de infecciones bucales. Tomando en cuenta las condiciones generales del paciente al desarrollar osteomielitis refractaria y sintomática severa, la cirugía debe ser considerada. El paciente y sus familiares deben ser conscientes de los riesgos y beneficios de la cirugía, así como de sus posibles complicaciones.

The advent of highly active antiretroviral therapy (HAART) has caused a reduction in mortality, thus contributing to an increase in the number of women with HIVࢧAIDS who reach the climacteric period, experience decline in ovarian function, and develop complications of viral infection and HAART, which can accelerate bone loss. The aim of this study was to detect possible alterations in the jaws of HIV-infected women by panoramic radiography. The study comprised a total of 120 women above 40 years of age who were divided into the following two groups: women who are HIV positive (Group I) and women with no known HIV infection (Group II). Measurement of the following three radiomorphometric indexes was performed by panoramic radiography: Mental Index (MI), Panoramic Mandibular Index (PMI) and Antegonial Depth (AD). A total of 70% of women in the control group and 50% of women in the HIV group were in the postmenopausal period, and the average values of both MI (p = 0.0054) and AD (p < 0.0001) for this period were lower in the HIV group than in the control group. For patients who were in the premenopausal period, the average AD was lower in the HIV group than in the control group (p = 0.0003). Despite the difference in the average age between groups, greater bone resorption in the mandible was found in the group of HIV-positive women.

We studied xerostomy and its correlation with periodontal and dental cavity diseases in HIV patients, through measurement of salivary flow and through variables such as saliva buffer capacity, salivary pH, periodontal index, MDF index, dental carie risk and risk of periodontal disease. One hundred patients were analyzed. They were distributed into two groups: Group I (test) - 50 patients evidently HIV+, from whom information was collected and analyzed regarding age, gender, skin color, habits, general and oral diseases, levels of T-CD4 lymphocytes, viral load and highly active antiretroviral therapy (HAART); and Group II - (control) 50 HIV- patients, from whom information was collected and analyzed regarding age, gender, skin color, habits, general and oral diseases. In both groups, measurement of salivary flow, pH and buffer capacity was made. Group I presented high MDF, bacteria plaque and bleeding, with a greater susceptibility to the risks of oral cavities and periodontal disease. The salivary flow and the buffering capacity of the saliva were low, indicating a high level of xerostomy. Two important modifying factors influence these pathologies in an incisive way: one is immunossuppression and the other is HAART therapy. The control exhibited results that are closer to normality; it had better oral-health conditions.