Abstract The aim of this multicenter study was to explore the early-life sugar consumption and dietary practices in Latin America as well as to investigate the association between breastfeeding duration and the age at which foods and beverages with added sugars are introduced. A cross-sectional study was conducted with 805 1- to 3-year-old children from 10 Latin American countries, as a complementary study to the Research Observatory for Dental Caries of the Latin American Region (OICAL). A Food Frequency Questionnaire previously tested in different countries was applied to children’s mothers and data on breastfeeding and age at introduction of sugary foods and beverages was collected. Statistical analysis included the Kruskal-Wallis test and Poisson regression with robust variance, with the calculation of crude and adjusted mean ratios (MR) and 95% of confidence intervals (CI). The average age at introduction of sugary foods and beverages was 10.1 months (95%CI 9.7–10.4) and 9.6 (95%CI 9.2–9.9) months, respectively, with a significant variation between countries (p < 0.001). The average daily frequency of sugary foods-beverages was 3.3 times per day (95%CI 3.1–3.5) and varied significantly between countries (p = 0.004). Breastfeeding duration of over six months was associated with an increase in the age of introduction of sweet drinks (16%; MR 1.16; 95%CI 1.05–1.28) and foods (21%; MR 1.21; 95%CI 1.10–1.33). In conclusion, most children from vulnerable settings in Latin America start consuming sugary products in the first year of life and a high frequency of consumption was reported through early childhood. Additionally, breastfeeding contributes to a delay in the introduction of sugary products. earlylife introduced crosssectional cross sectional 80 1 3yearold yearold 3 old OICAL. OICAL . (OICAL) childrens s collected KruskalWallis Kruskal Wallis variance (MR 95 CI. CI (CI) 101 10. 95CI 9.7–10.4 97104 9 7 4 96 6 9. 9.2–9.9 9299 2 respectively p 0.001. 0001 0.001 0 001 0.001) foodsbeverages 33 3. 3.1–3.5 3135 5 0.004. 0004 0.004 004 0.004) 16% 16 (16% 1.16 116 1.05–1.28 105128 05 28 21% 21 (21% 1.21 121 1.10–1.33. 110133 1.10–1.33 1.10–1.33) conclusion childhood Additionally 8 (OICAL (CI 9.7–10. 9710 9.2–9. 929 000 0.00 00 3.1–3. 313 (16 1.1 11 1.05–1.2 10512 (21 1.2 12 11013 1.10–1.3 9.7–10 971 9.2–9 92 0.0 3.1–3 31 (1 1. 1.05–1. 1051 (2 1101 1.10–1. 9.7–1 97 9.2– 0. 3.1– ( 1.05–1 105 110 1.10–1 9.7– 9.2 3.1 1.05– 1.10– 9.7 1.05 1.10 1.0

Resumo Avaliar o impacto das condições bucais na qualidade de vida relacionada à saúde bucal (QVRSB) em crianças de dez países da América Latina (AL). Foi realizado um estudo transversal com 930 pares de crianças/pais de 1 a 3 anos de 10 países da AL, como estudo complementar do Research Observatory for Dental Caries of the Latin American Region. A escala ECOHIS, previamente testada e validada em dez países, foi aplicada a pais/cuidadores de crianças para mensurar a QVRSB. A análise estatística incluiu análise descritiva de dados e análise de variância unidirecional (ANOVA-One-Way) para comparar grupos etários com QVRSB. Procedimentos de bootstrapping (1000 reamostragens; 95%IC Bca) foram realizados. A pontuação média da seção 'Impacto na Criança' na AL foi 4,0 (±8,3), na seção ‘Impacto na Família’ foi 2,0 (±4,0) e no escore total do ECOHIS foi 6,0 (±12,0). Na seção 'Impacto na Criança', Argentina 10,0(+2,4) e Venezuela 17,8(±17,5) demonstraram pontuações médias superiores aos dados totais da AL. Na seção ‘Impacto na Família’, os países com pontuações médias mais altas foram Argentina 4,9(±2,0), Equador 2,1(±3,1) e Venezuela 7,9(±7,8). No escore total do ECOHIS, Argentina 15,1 (±4,1) e Venezuela 25,7(±25,2) apresentaram escores médios superiores aos valores de AL. Houve associação entre a idade das crianças e o relato dos pais de impacto na QVRSB (p<0,001). As crianças de três anos tiveram média maior quando comparadas às de um e dois anos, tanto nas seções 'Impacto na Criança' e ‘Impacto na Família’ (p<0,001), quanto no escore total ECOHIS (p<0,001). Em conclusão, houveram diferenças na QVRSB entre os países da América Latina, impactando de forma mais significativa as crianças mais velhas.

Abstract To assess the impact of oral conditions on oral health-related quality of life (OHRQoL) in infants in ten Latin America countries (LAC). A cross-sectional study was conducted with 930 pairs of 1-to-3-year-old children/parents from 10 LAC, as a complementary study of the Research Observatory for Dental Caries of the Latin American Region. The scale ECOHIS, previously tested and valid in ten countries, was applied to parents/caregivers of children to measure OHRQoL. Statistical analysis included descriptive data analysis and one-way analysis of variance (ANOVA-One-Way) were performed to compare age groups with OHRQoL. Bootstrapping procedures (1000 re-samplings; 95%CI Bca) were performed. The mean scores of the ‘Child Impact’ section in the LAC was 4.0(±8.3), in the ‘Family Impact’ section was 2.0(±4.0), and in overall ECOHIS score was 6.0(±12.0). In the ‘Child Impact’ section, Argentina 10.0(+2.4) and Venezuela 17.8(±17.5) demonstrated mean scores higher than the LAC total data. In the ‘Family Impact’ section, the countries with higher mean scores were Argentina 4.9(±2.0), Ecuador 2.1(±3.1) and Venezuela 7.9(±7.8). In the overall ECOHIS score, Argentina 15.1 (±4.1) and Venezuela 25.7(±25.2) has higher mean scores than the values of LAC. There is an association between children's age and parents' report of impact on the OHRQoL (p<0.001). Three-year-olds had a higher mean when compared to one- and two-year-olds, both in the Impact on the Child and Impact on the Family (p<0.001) sections, as well as in the overall ECOHIS (p<0.001). In conclusion, there are differences in OHRQoL among Latin American countries, impacting older children more significantly.

In maxillary orthopedics and related areas, it is essential to determine patient growth peak in order to provide timely diagnosis and treatments. This requires the use of biological indicators that enable children and adolescents to be assigned to maturation stages. The aim of this study was to determine the correlation between cervical vertebrae maturation stages and chronological age in children and adolescents. In this study were evaluated 93 lateral cranium radiographs of 6- to 17-year-old patients who visited the Postgraduate Maxillary Orthopedics Clinic at the School of Dentistry at Universidad del Zulia. Two examiners made independent assessments of cervical vertebrae maturation stage using the method described by Baccetti et al. For each stage, descriptive statistics for chronological age were evaluated, classified according to sex. In addition, parametric and non-parametric tests were performed in which p <0.05 was considered significant. Mean age of the children and adolescents studied was 9.6 years, with standard deviation 2.5 years. The correlation coefficient (r= 0.771) certified a high positive correlation between bone maturation and chronological age. This correlation coefficient was highly positive for girls (r=0.858) and moderately positive for boys (r=0.688). The model obtained explains 59.4 % of the variation between bone maturation and chronological age, evidencing an average age increase of three years when maturation stage increases by approximately 1 year. The results suggest that although the degree of covariance between chronological age and maturation stages was highly positive in this study, chronological age does not allow bone maturation to be determined precisely, since it may be influenced by genetic and/or environmental factors.

En ortopedia maxilar y áreas afines resulta esencial determinar el pico de crecimiento de los pacientes para establecer diagnósticos y tratamientos oportunos para lo cual es necesario utilizar indicadores biológicos, que permiten ubicar a los niños y adolescentes en estadios de maduración. El objetivo de este estudio fue determinar la correlación de los estadios de maduración de las vértebras cervicales según la edad cronológica en niños y adolescentes. Se evaluaron 93 imágenes de radiografías lateral de cráneo, de pacientes entre 6 y 17 años de edad que asistieron a la clínica del Posgrado de Ortopedia Maxilar de la Facultad de Odontología de La Universidad del Zulia, dos examinadores estimaron de forma independiente el estadio de maduración de las vértebras cervicales, utilizando el método descrito por Baccetti et al. y para cada estadio se evaluaron los estadísticos descriptivos de la edad cronológica categorizando según sexo, además se realizaron pruebas paramétricas y no paramétricas donde un p <0,05 fue considerado como significativo. La edad media de los niños y adolescentes estudiados resultó de 9,6 años y una desviación típica de 2,5 años. El coeficiente de correlación (r=0,771) certificó una correlación positiva alta entre maduración ósea y edad cronológica, igual producto se obtuvo en el caso de las niños y adolescentes del sexo femenino (r=0,858), mientras los del sexo masculino obtuvieron una correlación positiva moderada (r= 0,688). El modelo obtenido explica el 59,4 % de la variación entre maduración ósea y edad cronológica, lo cual evidencia el aumento de la edad promedio en tres años, cuando el estadio de maduración aumenta 1 año aproximadamente. Los resultados registrados sugieren que, aunque el grado de covarianza entre edad cronológica y estadios de maduración en esta investigación fue positiva alta, la edad cronológica no permite determinar con exactitud la maduración ósea, pudiendo estar influenciada por factores genéticos y/o ambientales.

Se describe la experiencia en casos probables de chikungunya en la emergencia de adultos de un hospital de Maracaibo, Venezuela. Se reporta la morbilidad y mortalidad entre Septiembre a Diciembre 2014, así como el análisis y diagnóstico clínico de los casos agudos en una zona endémica para dengue.

This work reports experience in probable cases of chikungunya fever at adult emergency in a Maracaibo Hospital, Venezuela. It is describes morbidity and mortality between September to December 2014, as well as analysis and clinic diagnosis in acute and complicated cases in a endemic dengue fever zone.

Health is currently recognized as lying in the individual process rooted in genes, personal habits, the social model and the understanding of the ideological standpoint from which it is viewed. The aim of this study was to validate the Early Childhood Oral Health Impact Scale (ECOHIS) for use in Latin American communities, in order to demonstrate its efficacy for determining the impact of dental condition on children under 5 years of age and their families. The ECOHIS explores two domains: impact on children (9 questions) and on families (4 questions). Validation in Spanish was done in four stages. Stage I included translation and back-translation of the questionnaire (English-Spanish-English). Stage II was a pilot test on families in Venezuela to test stability (test-retest) and make semantic adjustments. Stage III included validation of the questionnaire applied to a Venezuelan sample (n=50) and two Argentine samples (A and B, made up of families with and without social risk, respectively; n=95), and consisted of statistical analysis to check the questionnaire's internal consistency and discriminant capacity. In the final stage, parents were given feedback on the results and significance of each domain in the questionnaire. From the results of this study it may be concluded that the Spanish version of the ECOHIS was reliable and valid for administering to populations with homogeneous social risk, and that parents without social risk factors (AC/B) have significantly greater perception of the impact of oral health on the family's quality of life. The trends recorded suggest that (a) larger samples should be used, including variables for diagnosing social vulnerability or general risk, (b) the association with dental condition should be established by applying indicators to discriminate distinct cut-off points in the dental caries process and (c) it should be ascertained whether there are changes in perception of the impact on quality of life before and after dental treatments, including impact on general health condition.

En la actualidad se reconoce que la salud esta en el proceso individual enraizado en los genes, los habitos personalisimos, el modelo social y la comprension de la ideologia de la cual depende en realidad el angulo desde el cual se la examina. El objetivo de este estudio fue validar el Early Childhood Oral Health Impact Scale (ECOHIS) para su aplicacion en comunidades latinoamericanas, a fin de demostrar su eficacia para determinar el impacto que el estado dentario produce sobre los ninos menores de 5 anos y su familia. El ECOHIS explora dos dominios: el impacto sobre el nino (9 preguntas) y sobre la familia (4 preguntas). Para la validacion en el idioma espanol se desarrollaron cuatro etapas. La etapa I: incluyo la traduccion reversa del cuestionario (inglés-espanol.ingles). La etapa II consistio en la prueba piloto realizada en familias venezolanas para comprobar la estabilidad (test-retest) y realizar el ajuste semantico. La etapa III incluyo la validacion del cuestionario aplicado en una muestra venezolana (n=50) y en dos muestras argentinas (AC/A y AC/B, constituidas por familias con y sin riesgo social, respectivamente; n=95), realizándose el analisis estadistico para comprobar la consistencia interna y la capacidad de discriminacion del cuestionario. En la ultima etapa se realizo la devolucion de la informacion a los padres acerca de los resultados y del significado de cada uno de los dominios del cuestionario. Los resultados obtenidos en el presente estudio permiten concluir que la version en espanol del ECOHIS resulto confiable y valida para su aplicacion en poblaciones con riesgo social homogeneo y que los padres sin factores de riesgo social (AC/B) muestran una percepcion significativamente mayor del impacto que el estado bucodental determina sobre la calidad de vida de la familia. Las tendencias registradas permiten recomendar la conveniencia de (a) ampliar el tamano de las muestras aplicadas en este estudio, incorporando variables que instalen el diagnostico de factores de vulnerabilidad social o de riesgo generales (b) establecer la asociacion existente con el estado dentario empleando indicadores que permitan discriminar puntos de corte diferenciados en el proceso de caries dental y (c) estudiar la existencia de cambios en la percepcion del impacto sobre la calidad de vida antes y despues de los tratamientos odontologicos incluyendo el impacto sobre el estado de salud general.

La Histiocitosis de células de Langerhans conocida anteriormente como Histiocitosis X, es un término aplicado a un grupo de desórdenes poco comunes del sistema fagocítico mononuclear, caracterizado por una acumulación clonal y proliferación anormal de células de Langerhans derivadas de la medula ósea. El propósito de esta investigación es reportar las alteraciones maxilo-faciales en un paciente con diagnostico de Histiocitosis de Células de Langerhans. Se presenta el caso de un varón de tres años de edad con diagnostico de Histiocitosis de Células de Langerhans con afección ósea multifocal y otros sitios especiales, con antecedentes de otitis media supurativa recurrente, diabetes insípida, dermatitis seborreica y lesiones hipercrómicas en miembros inferiores. La exploración extraoral evidenció lesiones eritematosas y descamativas en piel de cara y cuero cabelludo; intraoralmente se observó movilidad en dientes posteriores de ambos maxilares acompañada de recesión gingival, caries dental y erupción prematura del 26. Radiograficamente presentó lesiones osteolíticas en alas mayores de esfenoides, techo orbitario izquierdo, pared orbitaria externa derecha, arco cigomático, peñasco del temporal y zonas posteriores de ambos maxilares, además de agenesia de los gérmenes dentarios del 35 y 45. Adicionalmente al tratamiento sistémico de quimioterapia se realizó control de la infección dentobacteriana y tratamiento quirúrgico de las zonas maxilares afectadas. Se concluye que los maxilares al igual que los huesos del cráneo deben ser evaluados en pacientes con diagnóstico de Histiocitocis de Células de Langerhans, ya que estos sitios pueden ser los únicos huesos afectados como sucedió en el caso estudiado.

Langerhans Cell Histiocytosis, known earlier as Histiocytosis X is a term applied to a group of rare disorders of the reticuloendothelial system, characterized by an abnormal proliferation of Langerhans cells derived from bone marrow. The purpose of this research is to report the maxillofacial alterations of a patient with diagnostic of Langerhans Cell Histiocytosis. A three-year old male patient with diagnostic of Langerhans Cell Histiocytosis with multifocal bone involvement and special sites of disease is presented. He had a previous history of exophtalmus, recurrent suppurative otitis media, diabetes insipidus, seborrheic dermatitis and hyperchromic lesions in lower members. The extraoral exam showed erythematosus and desquamative lesions in face skin and the scalp, intraorally back teeth mobility of both maxilars was found together with gingival recession, dental caries and premature eruption of 26. Radiographically, he presented osteolitic lesions in the sphenoid major wings, left orbital roof, right external orbital wall, zygomatic arch, temporal bone and back areas of both maxilars, besides dental germ agenesia of 35 and 45. In addition to the systemic chemiotherapy treatment, a control of the dentobacterial infection and surgical treatment of the affected maxillary areas was made. The conclusion is that maxilars as well as the skull bones must be evaluated in patients with a diagnostic of Langerhans cell Histiocytocis, because this could be the only bone involvement to be found as it happened in this case.

La Histiocitosis de células de Langerhans conocida anteriormente como Histiocitosis X, es un término aplicado a un grupo de desórdenes poco comunes del sistema fagocítico mononuclear,  caracterizado por una acumulación clonal y proliferación anormal de células de Langerhans derivadas de la medula ósea. El propósito de esta investigación es reportar las alteraciones maxilo-faciales en un paciente con diagnostico de Histiocitosis de Células de Langerhans. Se presenta el caso de un varón de tres años de edad con diagnostico de Histiocitosis de Células de Langerhans con afección ósea multifocal y otros sitios especiales, con antecedentes de otitis media supurativa recurrente, diabetes insípida, dermatitis seborreica y lesiones hipercrómicas en miembros inferiores. La exploración extraoral evidenció lesiones eritematosas y descamativas en piel de cara y cuero cabelludo; intraoralmente se observó movilidad en dientes posteriores de ambos maxilares acompañada de recesión gingival, caries dental y erupción prematura del 26. Radiograficamente presentó lesiones osteolíticas en alas mayores de esfenoides, techo orbitario izquierdo, pared orbitaria externa derecha, arco cigomático, peñasco del temporal y zonas posteriores de ambos maxilares, además de agenesia de los gérmenes dentarios del 35 y 45. Adicionalmente al tratamiento sistémico de quimioterapia se realizó control de la infección dentobacteriana y tratamiento quirúrgico de las zonas maxilares afectadas. Se concluye que los maxilares al igual que los huesos del cráneo deben ser evaluados en pacientes con diagnóstico de Histiocitocis de Células de Langerhans, ya que estos sitios pueden ser los únicos huesos afectados como sucedió en el caso estudiado.

Langerhans Cell Histiocytosis, known earlier as Histiocytosis X is a term applied to a group of rare disorders of the reticuloendothelial system, characterized  by an abnormal proliferation of Langerhans cells derived from bone marrow. The purpose of this research is to report the maxillofacial alterations of a patient with diagnostic of Langerhans Cell Histiocytosis. A three-year old male patient with diagnostic of Langerhans Cell Histiocytosis with multifocal bone involvement and special sites of disease is presented. He had a previous history of exophtalmus, recurrent suppurative otitis media, diabetes insipidus, seborrheic dermatitis and hyperchromic lesions in lower members. The extraoral exam showed erythematosus and desquamative lesions in face skin and the scalp, intraorally back teeth mobility of both maxilars was found together with gingival recession, dental caries and premature eruption of 26. Radiographically, he presented osteolitic lesions in the sphenoid major wings, left orbital roof, right external orbital wall, zygomatic arch, temporal bone and back areas of both maxilars, besides dental germ agenesia of 35 and 45. In addition to the systemic chemiotherapy treatment, a control of the dentobacterial infection and surgical treatment of the affected maxillary areas was made. The conclusion is that maxilars as well as the skull bones must be evaluated in patients with a diagnostic of Langerhans cell Histiocytocis, because this could be the only bone involvement to be found as it happened in this case.

Oral candidiasis represents a serious problem for children with cancer. The mortality rate of this infection has increased due to fungal septicemia, associated with a primary buccal infection. Objective: Identify the Candida spp. in buccal lesions of patients with cancer, establish the predominant species and correlate them to age and sex of the patient, clinical presentation, type of neoplasic disease and cytostatic therapy received. Study design: 62 patients, between 0-16 years, were investigated in a cross sectional study. Sample inclusion criteria: Patients with malignant neoplasic disease that were receiving cytostatic treatment and had suspicious lesions of oral candidiasis. Patients with antifungal therapy, active caries, calculus or intraoral appliances were excluded. A clinical evaluation was carried out. The lesion sample was taken and studied by direct exam and culture in CHROMagar-Candida and Sabouraud-Dextrose Agar with chloramphenicol. The identification of the isolated yeast was done by the filamentation test, carbohydrate fermentation and assimilation. Results: Most of the cases (69.35%) were positive to oral candidiasis, C. albicans was the most frequent species found, followed by C. parapsilosis (14.89%), C. tropicalis (12.77%), C. krusei (4.26%), C. glabrata (2.13%) and C. lusitaniae (2.13 %). In some cases more than one specie were isolated (9.30%). The most frequent location of the lesion was in the tongue (72.70%). The pseudomembranous candidiasis was the most frequent clinical presentation found (78.71%). There were not significant statistically differences with regard to sex and age of the patient, type of neoplasic disease and cytostatic agent received. Conclusion: The results suggest that oral candidiasis is a frequent complication in the pediatric oncological population, being C. albicans the main etiological agent, however, there is an important participation of other Candida species.

OBJETIVO: Determinar las modificaciones en las UFC de estreptococos mutans, lactobacilos y de la capacidad amortiguadora de la saliva como indicadores de riesgo a la caries dental en niños y adolescentes que reciben quimioterapia. MATERIALES Y MÉTODOS. La muestra estuvo conformada por 10 pacientes, entre 5 y 15 años de edad, con diagnóstico de Leucemias, Linfomas o Neuroblastoma, la cual fue seleccionada aleatoriamente de la población objeto de estudio. Para registrar la presencia de la enfermedad caries dental, se realizó una evaluación clínica siguiendo los criterios de la OMS/OPS. La evaluación microbiológica y de la capacidad amortiguadora de la saliva, se realizó antes y después del tratamiento quimioterapéutico, utilizando para ello la Prueba CRT Bacteria y CRT Buffer VIVADENT ®. RESULTADOS: Se evidenció un incremento significativo (p< 0.05) de las UFC de estreptococos mutans. En los niveles de lactobacilos y capacidad amortiguadora, no se observaron modificaciones significativas después de la quimioterapia. CONCLUSIONES: Los resultados de este estudio sugieren la influencia de los agentes citóstaticos en el aumento ocurrido en las UFC de estreptococos mutans.

OBJETIVE: To determine the modifications of streptococci mutans, lactobacillus and salivary buffer capacity as risk indicators of dental caries in children and adolescents undergoing chemotherapy. MATERIALS AND METHODS: The sample comprised 10 patients between 5 and 15 years of age, diagnosed with Leukemia, Lymphomas or Neuroblastomas. In order to register the presence or absence of dental caries, a clinical evaluation was included, in accordance with WHO/PHO criteria. Microbiological evaluation and saliva buffering capacity were carried out before and after the chemotherapeutic treatment, using the VIVADENT ® CRT Bacteria and CRT Buffer. RESULTS: These showed a significant increase (p< 0.05) in Mutans Streptococci CFU. No significant modifications in Lactobacilli and buffering capacity were observed. CONCLUSION: The modifications in Mutans Streptococci CFU suggest the influence of cytostatic agents.

El objetivo de esta investigación fue evaluar un servicio odontológico público utilizando los niveles de riesgo a caries dental como indicadores para su medición. Se examinaron 79 pacientes en edades de 3 a 14 años al ingreso y egreso de su atención en el “Ambulatorio Carlos Márquez” del Municipio Barinas, Estado Barinas -Venezuela. Se utilizaron 6 parámetros de los establecidos por Tomás Seif para determinar niveles de riesgo a padecer caries dental. El riesgo a caries dental de los pacientes, se ubicó en moderado (54%) al ingresar al servicio y en bajo (79%) a su egreso. Los componentes existencia de caries clínicas o radiográficas, y presencia de restauraciones en boca, mostraron cambios significativos, al ingreso y egreso de los pacientes (P<0,05) ubicándose el primero de moderado riesgo (57%) a fuera de riesgo (97.5%) y de bajo riesgo (53.2%) a fuera de riesgo (67.1%) el segundo. No se observaron variaciones significativas al ingreso y egreso de los pacientes en “utilización de agentes fluorados, “ingesta de carbohidratos”, “higiene bucal,” y “motivación del paciente”. Se concluye que en el servicio estudiado, existe marcado predominio de la actividad curativa sobre la preventiva, haciéndose prioritario evaluar continua y permanentemente la atención que se dispensa, utilizando indicadores que a un bajo costo y en forma sencilla pero efectiva, permitan monitorear el riesgo de la población a padecer caries dental, aportando información útil que conlleve al diseño y ejecución de programas odontológicos que contribuyan cualitativamente en la resolución de los problemas bucales de esta vulnerable población.

The propose of this research was to evaluate a public odontological service using the risk levels to dental caries as measure indicators. 79 patients ranging from 3 to 14 year old where studied in the ambulatory “Carlos Marquez” in Barinas municipally Barinas state, Venezuela. The risk levels to dental caries were determined using six criteria from Tomas Seif. The risk levels to dental caries in patients were determined as moderate risk (54%) upon entering, and as low risk (79%) upon leaving the service. The components existence of dental clinic and radiography caries and presence of restaurations in the mouth showed significant changes from upon entering to upon leaving of this patients (p<0,05) being the first one from moderate risk (57%), to without risk (97,5%) and from the second one from low risk (53.2%) to without risk (67.1%). No significant variations were observed upon the entering or leaving of patients in the preventive criteria of (fluoride agents) carbohydrates consumption, bucal hygiene and motivations of the patients. In conclusion, in the service studied there is predominium of the curative activity in comparison preventive active, re- afirming that is necessary first evaluated permanently the attention in the service, by using indicators of low cost, simple but effective that can permitted evaluate the risk level to dental caries giving useful information that permitted to design and developed oral health strategic programs than contributed in the resolution of oral problems in this population.

Introduction: Systemic sicknesses can originate and proliferate alterations in the periodontium. The presence of Anti-neutrophil Cytoplasmic Antibodies (ANCA) in patients suffering destructive periodontal disease and systemic illness has been widely proven. Objective: To determine the existent relation between gingivitis and ANCA in children and adolescents suffering from leukemia. These patients were examined at the Autonomous Services of the University Hospital in Maracaibo, Venezuela, and at the Hospital of Pediatrics Foundation in Zulia State, Venezuela. Materials and Methods: 40 patients ranging from 6 to 16 years of age were included in a controlled study. 20 patients suffering from acute leukemia constituted an experimental group, and 20 more patients without apparent systemic sickness who formed a control group. All 40 patients underwent clinical evaluation, and periodontal tissue radiographic evaluation and assessment of ANCA through an enzyme-linked immunoasorbent assay (ELISA); this was done using an IMMCO Diagnostic" commercial kit. Results: No Significant differences in the gingivitis average index, plaque and bone loss between the experimental and the control group were evidenced. A significant correlation between gingivitis and ANCA was not evidenced either. Nevertheless, 7 out of 20 patients of the experimental group turned out to be ANCA positive. In contrast, no positive cases were reported in the control group. (p<0.05 Fisher Test). Conclusion: The results of this study suggest that the presence of ANCA is probably related to on going immune alterations in patients suffering from leukemia but not related to gingivitis.

Introducción: Las enfermedades sistémicas pueden originar y exacerbar alteraciones en el periodonto. Se ha demostrado la presencia de Anticuerpos Anticitoplasmáticos de neutrófilos (ANCA) en pacientes con enfermedad periodontal destructiva y con enfermedades sistémicas. Objetivo: Determinar la relación entre gingivitis y los ANCA en niños y adolescentes con leucemia que asistieron al Servicio Autónomo Hospital Universitario de Maracaibo y a la Fundación del Hospital de Especialidades Pediátricas Zulia - Venezuela. Material y Método: En un estudio controlado fueron incluidos un total de 40 sujetos entre 6 y 16 años de edad. Un grupo experimental de 20 pacientes con leucemia aguda y un grupo control de 20 sujetos sin enfermedad sistémica aparente, a los cuales se les realizó una evaluación clínica y radiográfica de los tejidos periodontales y la determinación de ANCA a través del ensayo inmunoenzimatico indirecto (ELISA); utilizando kit comercial IMMCO Diagnostic® . Resultados: No se evidenciaron diferencias significativas en el índice promedio de gingivitis, placa y pérdida ósea entre el grupo experimental y control. No se observó correlación significativa entre gingivitis y ANCA. Sin embargo, en el grupo experimental 7 de 20 pacientes resultaron ANCA positivo. En contraste, el grupo control no reportó casos positivos (p<0.05 Test de Fisher). Conclusión: Los resultados de este estudio sugieren que la presencia de ANCA probablemente está relacionada con alteraciones inmunes presentes en pacientes con Leucemia y no con la gingivitis.

Resumen Se determinaron las condiciones de salud bucal en preescolares y su relación con las actitudes y nivel educativo de los padres. La salud bucal se estableció en 132 niños, evaluando la caries inicial y manifiesta. Se midió también el índice de placa y el índice gingival, y se determinaron las actitudes hacia la higiene bucal y el nivel educativo de los padres. La caries manifiesta se reportó en el 41,9% de los preescolares cuyos padres tenían actitudes favorables (P <0,05). En individuos con progenitores cuya educación se ubicó en niveles bajos la caries inicial (33,3%) y manifiesta (54,2%) mostraron los valores más altos (P <0,05). Los grados mas severos encontrados en el índice de placa y el índice gingival se observaron en individuos cuyos padres tenían actitud desfavorable hacia la higiene bucal (33,3 y 66,6% respectivamente). Se concluye que en los preescolares estudiados existe relación estadísticamente significativa entre la caries dental, el índice gingival y el índice de placa con las actitudes y nivel educativo de sus padres, reafirmándose la necesidad de desarrollar programas preventivos con la participación de los padres de niños en edad preescolar, para la adquisición de hábitos de salud bucal

Oral health conditions and their relation to parental attitudes and educational level were determined in pre-school children. Oral health was evaluated in 132 children through the evaluation of initial and manifest cavities. The plaque index and gingival index were also measured, and attitudes toward oral hygiene and educational level of parents were determined. Manifest caries were reported in 41.9% of pre-school children whose parents had favorable attitudes (P <0.05). In individuals with parents of low educational level, initial (33.3%) and manifest (52.4) caries showed the highest values (P <0.05). The more severe degrees in plaque and gingival indices were observed in individuals whose parents had unfavorable attitudes toward oral hygiene (33.3 and 66.6%, respectively). It is concluded that in the studied children there is a statistically significant relation between dental caries, gingival index and plaque index, and the parental attitudes and educational level. This reaffirms the need for preventive programs with the participation of parents of children in pre-school age, for the acquisition of oral health habits

Determinaram-se as condições de saúde bucal em pré escolares e sua relação com as atitudes e nível educativo dos pais. A saúde bucal estabeleceu-se em 132 crianças, avaliando a cárie inicial e manifesta. Mediu-se também o índice de placa e o índice gengival, e determinaram-se as atitudes para a higiene bucal e o nível educativo dos pais. A cárie manifesta reportou-se em 41,9% dos pré escolares cujos pais tinham atitudes favoráveis (P <0,05). Em indivíduos com progenitores cuja educação se localizou em níveis baixos a cárie inicial (33,3%) e manifesta (54,2%) mostraram os valores mais altos (P <0,05). Os grados mais severos encontrados no índice de placa e o índice gengival se observaram em indivíduos cujos pais tinham atitude desfavorável para a higiene bucal (33,3 e 66,6% respectivamente). Conclui-se que nos pré escolares estudados existe relação estatisticamente significativa entre a cárie dental, o índice gengival e o índice de placa com as atitudes e nível educativo de seus pais, reafirmando-se a necessidade de desenvolver programas de prevenção com a participação dos pais de crianças em idade pré escolar, para a aquisição de hábitos de saúde bucal

Las complicaciones infecciosas causan significativa morbilidad y mortalidad en pacientes neutropénicos con cáncer. La gingivitis constituye una de estas complicaciones en oncología pediátrica. El propósito de este estudio fue determinar clínicamente la respuesta inflamatoria gingival y acumulación de placa dental en los periodos neutropénicos y no neutropénicos de niños y adolescentes con neoplasias linfohematopoyeticas (NLH), bajo tratamiento con agentes citostáticos, y contrastarla con la salud oral de individuos sin enfermedad sistémica asociada. Un total de 73 pacientes entre 4 y 16 años fueron incluidos en un estudio clínico controlado y divididos en dos grupos: G1 constó de 33 pacientes con leucemias agudas, linfoma no Hodgkin y enfermedad de Hodgkin, bajo terapia con agentes citostáticos, y G2 incluyó 40 sujetos sistémicamente sanos. Se utilizó el índice de gingivitis (IG) de Loe y Silness y el índice de placa (IP) de Silness y Loe; el G1 fue evaluado en dos momentos, con neutrófilos en sangre periférica >1500/mm3 (NT1) y con neutrófilos <1500/mm3 (NT2). No se observaron diferencias significativas en el IG de los dos grupos. No obstante, para el intervalo de 4 a 9 años, el IP aumentó significativamente en G1 entre NT1 y NT2 (p<0,05) y al comparar G2 con G1 NT2 (p<0,001). No se encontraron evidencias estadísticamente significativas de diferencias en el IG de los pacientes con NHL y los sujetos sanos, ni en los pacientes con NHL entre las fases neutropénica y no neutropénica. El aumento en la acumulación de placa en los niños de 4 a 9 años con NLH evidenciada durante la neutropenia no determinó el aumento de la inflamación gingival.

Significant morbidity and mortality may result in infectious complications in neutropenic patients with neoplastic disease. Gingivitis is frequently seen as an oral complication in Oncological Pediatrics. The purpose of this study was to clinically determine the inflammatory gingival reaction and accumulation of dental plaque of children and adolescents with lymphohematopoietic neoplasia (LHN) undergoing treatment with cytostatic agents, during non-neutropenic and neutropenic periods, and compare them with the oral health of systemically healthy individuals. A total of 73 children and adolescents, 4 to 16 years old, were included in a controlled clinical study and divided in two groups. G1 included 33 patients under treatment with cytostatic agents and diagnosed with acute leukemia, Hodgkin disease and non-Hodgkin lymphoma. G2 consisted of 40 patients without associated systemic disease. Evaluation of gingival status and plaque levels of study participants were performed by using the Plaque Index (PI) of Silness and Loe and the Gingivitis Index (GI) of Loe and Silness. G1 was evaluated at two instances, with neutrophils in peripheral blood at >1500/mm3 (NT1) and with neutrophils <1500/mm3 (NT2). No statistically significant differences were found in IG. However, for the 4 to 9 years range, PI increased significantly (p<0.05) between G1 NT1 and G1 NT2, and when comparing G1 NT2 with G2 (p<0.001). The prevalence of clinical gingivitis in patients with LHN is similar to that observed in systemically healthy children and adolescents. The plaque increase evidenced during neutropenia in 4 to 9 years old children with LHN did not determine the increase in gingival inflammation.

As complicações infecciosas causam significativa morbidade e mortalidade em pacientes neutropénicos com câncer. A gengivite constitui uma de estas complicações em oncologia pediátrica. O propósito deste estudo foi determinar clinicamente a resposta inflamatória gengival e acumulação de placa dental nos períodos neutropénicos e não neutropénicos de crianças e adolescentes com neoplasias linfohematopoyeticas (NLH), sob tratamento com agentes citostáticos, e contrasta-la com a saúde oral de indivíduos sem enfermidade sistêmica associada. Um total de 73 pacientes entre 4 e 16 anos foram incluídos num estudo clínico controlado e divididos em dois grupos: G1 constou de 33 pacientes com leucemia aguda, linfoma não Hodgkin e enfermidade de Hodgkin, sob terapia com agentes citostáticos, e G2 incluiu 40 sujeitos sistemicamente sadios. Utilizou-se o índice de gengivite (IG) de Loe e Silness e o índice de placa (IP) de Silness y Loe; o G1 foi avaliado em dois momentos, com neutrófilos em sangue periférico >1500/mm3 (NT1) e com neutrófilos <1500/mm3 (NT2). Não se observaram diferenças significativas no IG dos dois grupos. Não obstante, para o intervalo de 4 a 9 anos, o IP aumentou significativamente em G1 entre NT1 e NT2 (p<0,05) e ao comparar G2 com G1, NT2 (p<0,001). Não se encontraram evidências estatisticamente significativas de diferenças no IG dos pacientes com NHL e os sujeitos sadios, nem nos pacientes com NHL entre as fases neutropénica e não neutropénica. O aumento na acumulação de placa nas crianças de 4 a 9 anos com NLH evidenciada durante a neutropenia não determinou o aumento da inflamação gengival.