Abstract Sex estimation is an important procedure in forensic anthropology for human identification. The development of new technologies, such as three-dimensional computed tomography (CT), has provided excellent alternatives for this purpose. This study examined and compared a morphological method for sex estimation using two different approaches – direct measurement of physical structures and tomographic analysis using 3D images. A total of 111 skulls from the Museum of Human Anatomy at the University of São Paulo (MAH-USP) were used, (60 males and 51 females). All specimens were scanned by Philips Brilliance 64 CT scanner equipment and their corresponding images were reconstructed in three-dimensional (3D) models. The morphological characteristics of the skulls were analyzed by an observer who was blinded to the sex of the specimens. Five cranial structures were analyzed: external occipital crest, mastoid process, supraorbital margin, glabella, and mental eminence. The structures were scored 1 to 5 according to Buikstra and Ubelaker and validated by Walker. The success rates of the sex estimates obtained through direct measurement of the dry skulls ranged from 67.4% to 70.4% as compared to 60.2% to 68.1% for CT reconstruction. When analyzed separately, the maximum accuracy of the method was 68.33% in males and 88.24% in females in the physical analysis of structures. The glabella and mastoid process were the most effective structures to estimate sex through both techniques, respectively. Our results show that 3D CT images can be accurately used in the morphological analysis for sex estimation, representing a viable alternative in forensic anthropology. identification technologies threedimensional three dimensional CT, , (CT) purpose D 11 MAHUSP MAH USP (MAH-USP 60 (6 females. . females) 6 (3D models crest margin eminence Walker 674 67 4 67.4 704 70 70.4 602 2 60.2 681 68 68.1 reconstruction separately 6833 33 68.33 8824 88 24 88.24 techniques respectively (CT ( 67. 7 70. 60. 68. 683 3 68.3 882 8 88.2 88.

Resumo Insegurança alimentar é um fenômeno complexo que afeta a saúde e o bem-estar de famílias vulneráveis. Este estudo objetivou investigar a relação entre insegurança alimentar domiciliar, cárie dentária, qualidade de vida relacionada à saúde bucal, e determinantes sociais de saúde entre indígenas adultos. Foi conduzido um estudo transversal com adultos Kaingang entre 35-44 anos da Terra Indígena Guarita, Brasil. Insegurança alimentar foi avaliada pela escala EBIA. Cárie dentária foi avaliada pelo índice CPOD. Participantes responderam o questionário OHIP-14 e uma entrevista estruturada. Foram realizadas análises descritivas e multivariadas usando modelos de regressão de Poisson. A amostra incluiu 107 adultos Kaingang de 97 domicílios. Aproximadamente 95% dos participantes viviam em famílias com insegurança alimentar. Insegurança alimentar grave esteve presente em 58% dos domicílios. O fenômeno foi associado ao Bolsa Família, densidade familiar e percepção dos impactos da saúde bucal na qualidade de vida. O alto número de famílias afetadas pela insegurança alimentar revela a vulnerabilidade social do povo Kaingang. Insegurança alimentar em adultos Kaingang está associada à percepção da saúde bucal e determinantes sociais da saúde.

Abstract Food insecurity is a complex phenomenon that affects the health and wellbeing of vulnerable families. The aim of this study was to investigate the relationship between household food insecurity, dental caries, oral health-related quality of life, and social determinants of health among Indigenous adults. A cross-sectional study was conducted among Kaingang adults aged 35-44 years old from the Guarita Indigenous Land, Brazil. Food insecurity was assessed through the EBIA scale. Dental caries was assessed using the DMFT index. Participants answered the OHIP-14 questionnaire and a structured interview. Descriptive and multivariate analyzes using Poisson regression models were performed. The final sample included 107 adults from 97 households. Approximately 95% lived in food insecure families. Severe food insecurity was present in 58% of the households. The phenomenon was associated to the Bolsa Família benefit, household size, and greater perception of oral health impacts on quality of life. The high number of families affected by food insecurity reveals the social vulnerability of the Kaingang people. Food insecurity in Kaingangs adults is associated to oral health perception and social determinants of health.

Abstract Oral cancer is one of the most prevalent cancers in Brazil. An understanding of how public policies are implemented to address this problem can contribute to the construction of solutions. The “Programa de Melhoria do Acesso e da Qualidade” (PMAQ-AB and PMAQ-CEO) at the level of primary and secondary care are evaluations that also collect data on prevention and monitoring strategies for oral cancer. This study aimed to analyze the results of the incorporation of oral health teams to evaluate the strategies adopted by Brazil regarding the impact on the diagnosis of oral cancer. Of the 17,202 family health teams evaluated, 72.10% had oral health teams (OHT). Considering the strategies for prevention, screening, campaign, and follow-up of suspected cases, 72.27% of the campaign teams and 59.09% of the teams who accompanied suspected cases had OHT. In secondary care, more than 65% of the teams in the Southeast and South regions registered cases of oral cancer, and the referral network was more represented. The inclusion of OHT had a positive impact on campaign actions, follow-up, referral to specialists, and registration of suspected cases throughout Brazil.

Resumo Insegurança alimentar é um fenômeno complexo que afeta a saúde e o bem-estar de famílias vulneráveis. Este estudo objetivou investigar a relação entre insegurança alimentar domiciliar, cárie dentária, qualidade de vida relacionada à saúde bucal, e determinantes sociais de saúde entre indígenas adultos. Foi conduzido um estudo transversal com adultos Kaingang entre 35-44 anos da Terra Indígena Guarita, Brasil. Insegurança alimentar foi avaliada pela escala EBIA. Cárie dentária foi avaliada pelo índice CPOD. Participantes responderam o questionário OHIP-14 e uma entrevista estruturada. Foram realizadas análises descritivas e multivariadas usando modelos de regressão de Poisson. A amostra incluiu 107 adultos Kaingang de 97 domicílios. Aproximadamente 95% dos participantes viviam em famílias com insegurança alimentar. Insegurança alimentar grave esteve presente em 58% dos domicílios. O fenômeno foi associado ao Bolsa Família, densidade familiar e percepção dos impactos da saúde bucal na qualidade de vida. O alto número de famílias afetadas pela insegurança alimentar revela a vulnerabilidade social do povo Kaingang. Insegurança alimentar em adultos Kaingang está associada à percepção da saúde bucal e determinantes sociais da saúde.

Abstract Food insecurity is a complex phenomenon that affects the health and wellbeing of vulnerable families. The aim of this study was to investigate the relationship between household food insecurity, dental caries, oral health-related quality of life, and social determinants of health among Indigenous adults. A cross-sectional study was conducted among Kaingang adults aged 35-44 years old from the Guarita Indigenous Land, Brazil. Food insecurity was assessed through the EBIA scale. Dental caries was assessed using the DMFT index. Participants answered the OHIP-14 questionnaire and a structured interview. Descriptive and multivariate analyzes using Poisson regression models were performed. The final sample included 107 adults from 97 households. Approximately 95% lived in food insecure families. Severe food insecurity was present in 58% of the households. The phenomenon was associated to the Bolsa Família benefit, household size, and greater perception of oral health impacts on quality of life. The high number of families affected by food insecurity reveals the social vulnerability of the Kaingang people. Food insecurity in Kaingangs adults is associated to oral health perception and social determinants of health.

Abstract The aim of this study was to verify the precision and applicability of two methods of age estimation, Kvaal’s and Cameriere’s methods, among Brazilian adults. A sample composed of periapical radiographs of canine teeth belonging to 320 Brazilian adults was analyzed, divided into groups according to sex (male and female) and age group (20–29 years, 30–39 years, 40–49 years and 50-59 years). Kvaal’s method presented better results when compared to the results of Cameriere’s method in the general evaluation of each canine tooth, except for the upper left canine (tooth 23), which presented a mean error (ME) with no statistically significant difference between the methods (Kvaal: ME = 7.43, p = 0.4991, Cameriere: ME = 7.55, p = 0.6982). In the evaluation by age groups, Kvaal’s method presented a lower variation between the real age and estimated age when applied to the age groups of 20-29 years and 30-39 years compared to the results provided by Cameriere’s method. With respect to the groups aged 40 to 49 years and 50 to 59 years, Cameriere’s method presented better performance than the results provided by Kvaal’s method. The methods of estimating age proposed by Kvaal and Cameriere are simple and nondestructive and have demonstrated reproducibility and reliability. The Kvaal method was more accurate for the age groups of 20-29 and 30-39 years, and for those over 40 years, the Cameriere method was the most accurate.

RESUMO: Introdução: Má higiene bucal, uso regular de enxaguante bucal e ausência de visitas ao dentista podem corresponder a potenciais fatores de risco para o desenvolvimento de câncer de cabeça e pescoço. Objetivo: Determinar se a higiene bucal está associada à ocorrência de câncer em cavidade oral e cabeça e pescoço em uma amostra brasileira. Método: O estudo caso controle analisou variáveis de higiene bucal, como frequência de escovação, perda dentária, necessidade e uso de prótese e visita regular ao dentista em pacientes de cinco hospitais do estado de São Paulo, pareados por sexo e idade, provenientes do projeto multicêntrico Genoma do Câncer de Cabeça e Pescoço (GENCAPO). Resultados: As neoplasias mais frequentes nos 899 pacientes incluídos foram: bordo de língua (11,41%) e base de língua (10,92%). A análise estatística múltipla encontrou os seguintes valores de odds ratio: escovar uma vez 0,33 (IC95% 0,25 - 0,44); escovar duas vezes 0,42 (IC95% 0,35 - 0,52); uso de fio dental sempre 0,19 (IC95% 0,13 - 0,27); uso de fio dental às vezes 0,19 (IC95% 0,15 - 0,24); sangramento 2,40 (IC95% 1,40 - 4,09); prótese 1,99 (IC95% 1,54 - 2,56), visita ao dentista 0,29 (IC95% 0,22 - 0,37); boa higiene 0,21 (IC95% 0,17 - 0,27); higiene regular 0,20 (IC95% 0,15 - 0,25); e número de dentes ausentes (6 ou mais) 3,30 (IC95% 2,67 - 4,08). Conclusões: Esses dados mostraram que, na população estudada, indicadores de boa higiene, como escovar os dentes e uso do fio dental, foram fatores de proteção para o câncer de boca e cabeça e pescoço, enquanto sangramento e muitos dentes ausentes foram fatores de risco.

ABSTRACT: Introduction: Poor oral hygiene, regular use of mouthwash and absence of visits to the dentist could correspond to potential risk factors for the development of head and neck cancer. Objective: The objective of this study was to determine whether oral hygiene is associated with the occurrence of oral cavity and head and neck cancer in a Brazilian sample. Method: The variables of oral hygiene condition, such as toothbrushing frequency, dental loss, need and use of prosthesis, and regular visit to the dentist in a case-control study were analyzed in patients from five hospitals in the state of São Paulo, Brazil, paired by gender and age, from the multicenter project Genoma do Câncer de Cabeça e Pescoço (GENCAPO). Results: The most frequent malignancies in the 899 patients included were those of the tongue border (11.41%) and tongue base (10.92%). The multivariable statistical analysis found odds ratio values: Brushing once 0.33 (95%CI 0.25 - 0.44); Brushing twice 0.42 (95%CI 0.35 - 0.52); Flossing always 0.19 (95%CI 0.13 - 0.27); Flossing sometimes 0.19 (95%CI 0.15 - 0.24); Bleeding 2.40 (95%CI 1.40 - 4.09); Prosthesis 1.99 (95%CI 1.54 - 2.56); Visiting the dentist 0.29 (95%CI 0.22 - 0.37); Good hygiene 0.21 (95%CI 0.17 - 0.27); Regular hygiene 0.20 (95%CI 0.15 - 0.25); number of missing teeth (6 or more) 3.30 (95%CI 2.67 - 4.08). Conclusion: These data showed that, in the population studied, indicators of good hygiene such as brushing teeth and flossing were protective factors for mouth and head and neck cancer, while bleeding and many missing teeth were risk factors.

RESUMO: Introdução: Má higiene bucal, uso regular de enxaguante bucal e ausência de visitas ao dentista podem corresponder a potenciais fatores de risco para o desenvolvimento de câncer de cabeça e pescoço. Objetivo: Determinar se a higiene bucal está associada à ocorrência de câncer em cavidade oral e cabeça e pescoço em uma amostra brasileira. Método: O estudo caso controle analisou variáveis de higiene bucal, como frequência de escovação, perda dentária, necessidade e uso de prótese e visita regular ao dentista em pacientes de cinco hospitais do estado de São Paulo, pareados por sexo e idade, provenientes do projeto multicêntrico Genoma do Câncer de Cabeça e Pescoço (GENCAPO). Resultados: As neoplasias mais frequentes nos 899 pacientes incluídos foram: bordo de língua (11,41%) e base de língua (10,92%). A análise estatística múltipla encontrou os seguintes valores de odds ratio: escovar uma vez 0,33 (IC95% 0,25 - 0,44); escovar duas vezes 0,42 (IC95% 0,35 - 0,52); uso de fio dental sempre 0,19 (IC95% 0,13 - 0,27); uso de fio dental às vezes 0,19 (IC95% 0,15 - 0,24); sangramento 2,40 (IC95% 1,40 - 4,09); prótese 1,99 (IC95% 1,54 - 2,56), visita ao dentista 0,29 (IC95% 0,22 - 0,37); boa higiene 0,21 (IC95% 0,17 - 0,27); higiene regular 0,20 (IC95% 0,15 - 0,25); e número de dentes ausentes (6 ou mais) 3,30 (IC95% 2,67 - 4,08). Conclusões: Esses dados mostraram que, na população estudada, indicadores de boa higiene, como escovar os dentes e uso do fio dental, foram fatores de proteção para o câncer de boca e cabeça e pescoço, enquanto sangramento e muitos dentes ausentes foram fatores de risco.

ABSTRACT: Introduction: Poor oral hygiene, regular use of mouthwash and absence of visits to the dentist could correspond to potential risk factors for the development of head and neck cancer. Objective: The objective of this study was to determine whether oral hygiene is associated with the occurrence of oral cavity and head and neck cancer in a Brazilian sample. Method: The variables of oral hygiene condition, such as toothbrushing frequency, dental loss, need and use of prosthesis, and regular visit to the dentist in a case-control study were analyzed in patients from five hospitals in the state of São Paulo, Brazil, paired by gender and age, from the multicenter project Genoma do Câncer de Cabeça e Pescoço (GENCAPO). Results: The most frequent malignancies in the 899 patients included were those of the tongue border (11.41%) and tongue base (10.92%). The multivariable statistical analysis found odds ratio values: Brushing once 0.33 (95%CI 0.25 - 0.44); Brushing twice 0.42 (95%CI 0.35 - 0.52); Flossing always 0.19 (95%CI 0.13 - 0.27); Flossing sometimes 0.19 (95%CI 0.15 - 0.24); Bleeding 2.40 (95%CI 1.40 - 4.09); Prosthesis 1.99 (95%CI 1.54 - 2.56); Visiting the dentist 0.29 (95%CI 0.22 - 0.37); Good hygiene 0.21 (95%CI 0.17 - 0.27); Regular hygiene 0.20 (95%CI 0.15 - 0.25); number of missing teeth (6 or more) 3.30 (95%CI 2.67 - 4.08). Conclusion: These data showed that, in the population studied, indicators of good hygiene such as brushing teeth and flossing were protective factors for mouth and head and neck cancer, while bleeding and many missing teeth were risk factors.

RESUMO: Introdução: O perfil epidemiológico de cárie dentária dos povos indígenas é complexo e heterogêneo. A saúde bucal do povo Kaingang, terceira maior população indígena do Brasil, ainda não foi investigada. Objetivo: O objetivo deste estudo foi avaliar a prevalência e severidade de cárie, além dos fatores associados à necessidade de extração dentária entre adultos Indígenas Kaingang. Métodos: Foi realizado um inquérito de saúde bucal entre adultos Kaingang com idade entre 35 e 44 anos residentes na Terra Indígena Guarita, Rio Grande do Sul. Exames clínicos foram realizados a fim de analisar as condições da coroas dentárias e as necessidades de tratamento, seguindo os critérios e diretrizes da Organização Mundial da Saúde e da Pesquisa Nacional de Saúde Bucal SB Brasil 2010. Resultados: O total de 107 Indígenas Kaingang foi examinado. O índice de dentes cariados, perdidos e obturados (CPOD) médio observado foi de 14,45 (± 5,80). Dois terços do escore do indíce foram compostos do componente “perdidos”. A dentição inferior anterior apresentou as maiores taxas de dentes hígidos, enquanto os primeiros molares inferiores apresentaram as menores. Necessidade de extração dentária foi observada em 34,58%, sendo associada com a localização da aldeia, tempo da última consulta odontológica e maior número de dentes cariados. Conclusão: As altas frequências de cárie não tratada e dentes perdidos observados nessa população indicam a falta de assistência adequada. É necessário discutir modelos de atenção à saúde para combater iniquidades sociais e de saúde.

ABSTRACT: Introduction: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far. Objective: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous. Methods: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs. Results: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth. Conclusion: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.

RESUMO: Introdução: O perfil epidemiológico de cárie dentária dos povos indígenas é complexo e heterogêneo. A saúde bucal do povo Kaingang, terceira maior população indígena do Brasil, ainda não foi investigada. Objetivo: O objetivo deste estudo foi avaliar a prevalência e severidade de cárie, além dos fatores associados à necessidade de extração dentária entre adultos Indígenas Kaingang. Métodos: Foi realizado um inquérito de saúde bucal entre adultos Kaingang com idade entre 35 e 44 anos residentes na Terra Indígena Guarita, Rio Grande do Sul. Exames clínicos foram realizados a fim de analisar as condições da coroas dentárias e as necessidades de tratamento, seguindo os critérios e diretrizes da Organização Mundial da Saúde e da Pesquisa Nacional de Saúde Bucal SB Brasil 2010. Resultados: O total de 107 Indígenas Kaingang foi examinado. O índice de dentes cariados, perdidos e obturados (CPOD) médio observado foi de 14,45 (± 5,80). Dois terços do escore do indíce foram compostos do componente “perdidos”. A dentição inferior anterior apresentou as maiores taxas de dentes hígidos, enquanto os primeiros molares inferiores apresentaram as menores. Necessidade de extração dentária foi observada em 34,58%, sendo associada com a localização da aldeia, tempo da última consulta odontológica e maior número de dentes cariados. Conclusão: As altas frequências de cárie não tratada e dentes perdidos observados nessa população indicam a falta de assistência adequada. É necessário discutir modelos de atenção à saúde para combater iniquidades sociais e de saúde.

ABSTRACT: Introduction: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far. Objective: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous. Methods: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs. Results: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth. Conclusion: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.

Resumo No processo de identificação humana, a análise do forame magno apresenta resultados controversos para estimativa do sexo. O presente estudo teve como objetivo analisar as variáveis morfométricas do forame magno em crânios adultos brasileiros para estimação sexual. A amostra foi composta por 100 crânios (53 sexos masculino e 47 sexo feminino) pertencentes a coleção osteológica documentada do Instituto de Ensino e Pesquisa em Ciências Forenses. A medida do protocolo foi constituída por duas medidas lineares: comprimento máximo do forame magno e largura máxima do forame magno e duas fórmulas para calcular a área, método um (M1) e método dois (M2). As estatísticas descritivas evidenciaram diferenças estatisticamente significativas (p<0,05) para todas as variáveis. As funções discriminantes univariadas apresentaram uma porcentagem de acerto entre 56,0-62,0% e a análise multivariada mostrou uma porcentagem de acerto entre 60,0-65,0%. A análise da curva ROC apontou que M2 é o melhor parâmetro para estimar o sexo (AUC=0,693). Uma tabela de referência para brasileiros que utilizam os parâmetros do forame magnum foi desenvolvida com base nos resultados da análise da curva ROC. Em conclusão, o foram e magnum deve ser usado com precaução para estimar o sexo em casos forenses de cranio fragmentado, devido à precisão limitada.

Abstract In the identification process, the foramen magnum has shown controversial results in sex estimation. The present study aimed to analyze the morphometric variables of the foramen magnum in Brazilian adult cranium for sex estimation. The sample was composed of 100 craniums (53 males and 47 females) from the documented collection of the Institute of Teaching and Research in Forensic Sciences. The protocol measurement was constituted of two linear measurements: maximum length of the foramen magnum and maximum breadth of the foramen magnum and two formulas to calculate the area, method one (M1) and method two (M2). Descriptive statistics showed statistically significant differences between sex (p<0.05) for all variables. The univariate discriminant functions showed an accuracy between 56.0-62.0%, and the multivariate analysis showed a percentage of accuracy between 60.0-65.0%, the greatest accuracy was found combining the two linear measurements with M1(71.7%), even after cross-validation (66%). Receiver Operating Characteristic (ROC) curve analysis showed that M2 is the best parameter for estimating sex (AUC=0.693). A reference table for Brazilians using the foramen magnum parameters was developed based on the results of the ROC curve analysis. In conclusion, the foramen magnum should be used with caution to estimate sex in forensic cases of fragmentary craniums, due to the limited accuracy.

Abstract Oral mucositis is a painful condition that occurs in patients who have undergone haematopoietic stem-cell transplantation (HSCT) and has a huge impact on their quality of life. The objective of this study was to examine the extent to which interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) are associated with oral health quality of life among patients who underwent HSCT. A. C. Camargo Cancer Center patients were evaluated over 20 months at 4 different time-points: a) at patient admission (M1); b) on the day of infusion of HSC (M2); c) 12 and 20 days after the first day of the conditioning regimen for autologous and allogeneic transplantation, respectively (M3); and d) 30 days after the first day of the conditioning regimen (M4). Mucositis clinical evaluations were performed using World Health Organization (WHO) criteria. Oral health quality of life was measured using the Oral Health Impact Profile short form (OHIP-14), Oral Mucositis Quality of Life (OMQoL) and Patient-Reported Oral Mucositis Symptom (PROMS) scales. Correlations between clinical data and quality of life scores were examined. STATA 11.0 was used to perform the statistical analyses (5% level of significance). Eighty-two patients participated in the study; 62.2% were male, 28.05% had multiple myeloma, and the mean age was 48.49 years (SD 13.76). Higher scores (worse quality of life) were observed as mucositis scores increased, but the results were not significant. The OMQoL had a high correlation with OHIP-14 (0.8377), but the correlation between the PROMS scale and the OHIP-14 was lower (0.6643). Higher concentrations of IL-6 and TNF-α were associated with worse quality of life, according to all indices (p < 0.05). Oral mucositis was associated with quality of life scores (p < 0.01).

Abstract The objective of this investigation was to compare the accuracy of mandibular measurements using a stabilizer (MS) with gold standard computed tomography (GS) images. Sixty mandibles were studied. Werth TomoScope HV Compact® was used to obtain CT images (GS), and the MS was also used. Analysis of the CT scans was performed using the VG Studio Max software® (Volume Graphics GmbH, Heidelberg, Germany), and MS was used after the proper positioning of the mandible. Descriptive and paired t test measures were used, and a ROC curve was calculated, as well as sensibility and specificity. MedCalc and STATA 13.0® were used (95% level of significance). Bicondylar breadth, bicoronoid breadth and minimum ramus breadth reached the highest concordance correlation coefficients at 0.99 (0.99-1.00), 0.99 (0.99–1.00) and 1.00 (0.99–1.00), respectively. Comparing observers with GS, the lowest accuracy was noted for the maximum mandibular length [0.59 (0.45–0.69), 0.64 (0.51–0.74)], the breadth of the right (0.14 (0.04–0.23), 0.14 (0.004–0.24)) and left mandibular body [0.14 (0.03–0.24), 0.16 (0.05-0.26)], and the right [0.58 (0.45–0.69), 0.63 (0.51–0.73) and left (0.59 (0.45–0.70), 0.59 (0.46–0.69)] mandibular angle. Various measurements exhibited good sensibility for males using MS: maximum mandibular length (78.12), bicondylar breadth (78.12), left mandibular notch breadth (84.37), and the left height of the mandibular body at the mental foramen (75.00). High specificity in discriminating females was observed for the left maximal ramus height (85.19), mandibular length (85.71), bicoronoid breadth (96.43), right height of the mandibular body at the mental foramen (82.19), bimental breadth (78.57), breadth right (92.86) and left (96.43) mandibular body, minimum ramus breadth (89.29), and left mandibular angle (85.71). MS was able to discriminate sexual dimorphism.

Abstract Questionnaires for the assessment of knowledge and self-perception can be useful to diagnose what a dentist knows about management and administration. The aim of the present study was to create and validate the Dental Management Survey Brazil (DMS-BR) scale, based on meetings with experts in the field. After having elaborated the first version, 10 audits were performed in dental offices in order to produce the final version, which included nine dimensions: location, patient, finance, marketing, competition, quality, staff, career, and productivity. The accuracy of the instrument was measured by intrarater and interrater reliability. In the validation phase, 247 Brazilian dentists answered a web-based questionnaire. The data were processed using Stata 13.0 and the significance level was set at 95%. The instrument had intrarater and interrater reliability (ICC-0.93 and 0.94). The overall average of respondents for the DMS-BR scale was 3.77 (SD = 0.45). Skewness and kurtosis were below absolute values 3 and 7, respectively. Internal validity measured by Cronbach’s alpha was 0.925 and the correlation of each dimension with the final result of the DMS-BR ranged between 0.606 and 0.810. Correlation with the job satisfaction scale was 0.661. The SEM data ranged between 0.80 and 0.56. The questionnaire presented satisfactory indicators of dentists’ self-perception about management and administration activities.

The objectives of this study were to develop a specific formula to estimate age in a Brazilian adult population and to compare the original formula from Cameriere to this Brazilian formula. The sample comprised 1,772 periapical radiographs from 443 subjects (219 men, 224 women) that were organized into 12 groups according to sex (men or women) and age (20-29, 30-39, 40-49, 50-59, 60-69, and 70 years and older). The films were analyzed using the criteria described by Cameriere et al. (2004) and Adobe Photoshop®. We obtained a mean error of 8.56 (SD = 5.80) years for tooth 13, 7.99 (SD = 5.78) years for tooth 23, 8.38 (SD = 6.26) years for tooth 33, and 8.20 (SD = 6.54) years for tooth 43. When teeth were combined in the analysis, we observed lower mean errors. The Brazilian formula developed from this sample group was more accurate than Cameriere’s formula. However, other factors must be considered to improve age estimates in adults.

OBJETIVO:Analisar tendências recentes da mortalidade por câncer de boca, focalizando diferenças quanto a sexo e raça.MÉTODOS:Foram utilizados dados oficiais de população e mortalidade na cidade de São Paulo entre 2003 e 2009 para estimar coeficientes de mortalidade por câncer de boca (C00-C10, Classificação Internacional de Doenças, 10a Revisão), com ajuste por idade e estratificação por sexo (feminino e masculino) e cor (negros e brancos). Para cálculo de tendências foi utilizado o procedimento de Prais-Winsten de autorregressão para análise de séries temporais.RESULTADOS:No período de estudo, 8.505 indivíduos residentes na cidade morreram de câncer de boca. Os coeficientes apresentaram tendência crescente para mulheres (taxa de crescimento anual = 4,4%, IC95% 1,4;7,5) e estacionária para homens, representando inversão das tendências anteriores entre os sexos, na cidade. Identificou-se tendência crescente para negros, com elevada taxa de aumento anual (9,1%, IC95% 5,5;12,9), e tendência estacionária para brancos. A mortalidade por câncer de boca em negros quase dobrou durante o período e ultrapassou a mortalidade em brancos para quase todas as categorias.CONCLUSÕES:A mortalidade entre mulheres aumentou mais do que entre homens e duplicou entre negros. A vigilância de tendências da mortalidade por câncer de boca entre os estratos de sexo e cor pode contribuir para programas de saúde que reduzam a carga de doença e atenuem diferenças em saúde que são injustas, evitáveis e desnecessárias.

OBJECTIVE:To analyse recent trends in oral cancer mortality, focusing specifically on differences concerning gender and race.METHODS:Official information on deaths and population in the city of Sao Paulo, 2003 to 2009, were used to estimate mortality rates from oral cancer (C00 to C10, International Classification of Diseases, 10th Revision), adjusted for age and stratified by gender (females and males) and race (blacks and whites). The Prais-Winsten auto-regression procedure was used to analyse the time series.RESULTS:During the study period, 8,505 individuals living in the city of Sao Paulo died of oral cancer. Rates increased for females (rate of yearly increase = 4.4%, 95%CI 1.4;7.5), and levelled off for men, which represents an inversion of previous trends among genders in the city. Increases were identified for blacks, with a high rate of yearly increase of 9.1% (95%CI 5.5;12.9), and levelled off for whites. Oral cancer mortality in blacks almost doubled during the study period, and surpassed mortality in whites for almost all categories.CONCLUSIONS:Mortality presented a higher increase among women than in men, and it doubled among backs. The surveillance of trends of oral cancer mortality across gender and racial groups may contribute to implementing socially appropriate health policies, which concurrently reduce the burden of disease and the attenuation of unfair, avoidable and unnecessary inequalities in health.

OBJETIVO:Analizar tendencias recientes de mortalidad por cáncer de boca, enfocando diferencias con respecto a sexo y razaMÉTODOS:Se utilizaron datos oficiales de población y mortalidad en la ciudad de Sao Paulo (Brasil) entre 2003 y 2009 para estimar coeficientes de mortalidad por cáncer de boca (C00-C10, Clasificación Internacional de Enfermedades, 10ª Revisión), con ajuste por edad y estratificación por sexo (femenino y masculino) y raza (negros y blancos). Para calcular las tendencias se utilizó procedimiento de Prais-Winsten de auto-regresión para análisis de series temporales.RESULTADOS:En el período de estudio, 8505 individuos residentes en la ciudad murieron por cáncer de boca. Los coeficientes presentaron tendencia creciente en mujeres (tasa de crecimiento anual = 4,4%, IC95%: 1,4;7,5) y estacionaria en hombres, representando inversión de las tendencias anteriores entre sexos, en la ciudad. Se identificó tendencia creciente en negros, con elevada tasa de crecimiento anual (9,1%, IC95%:5,5;12,9), y tendencias estacionaras en blancos. La mortalidad por cáncer de boca en negros casi se duplicó durante el período y sobrepasó la mortalidad en blancos para casi todas las categorías.CONCLUSIONES:la mortalidad entre mujeres aumentó más que en hombres y se duplicó en negros. La vigilancia de tendencias de mortalidad por cáncer de boca entre los estratos de sexo y raza puede contribuir en programas de salud que reduzcan la carga de enfermedad, y atenúen las diferencias que son injustas, evitables e innecesarias.