Abstract Aim: To evaluate the experience, knowledge and attitudes of dentists and oral health technicians (OHTs) who work in Basic Health Units in the city of Curitiba, PR, Brazil, regarding cases of abuse against children and adolescents. Methods: In this observational study, three hundred eighty-three questionnaires (validated for Brazilian Portuguese) were sent to dentists and OHTs who work in public health units. The response rate was 38.12% (n = 146) for dentists and 40% (n = 77) for OHTs. Results: The mean age of the dentists was 40±8.29 years, and 53.43% treated more than 10 children per week. The OHTs' mean age was 45.39±9.71 years, and 62.35% attended to more than 10 children per week. Although the dentists perceived 185 suspected cases of maltreatment, only 35.67% were reported to authorities. In the OHT group, 22.08% were reported to authorities. Sixty-eight dentists (47%) and 11 OHTs (14.28%) reported having treated at least one case of orofacial trauma in the previous 6 months, totalizing 166 orofacial traumas. About the mechanism for reporting suspected cases, 83% of the respondents knew how to report. Over 50% of the responses concerning why the professionals did not report cases of physical violence against children included fear of retaliation and difficulties in diagnosis. Conclusions: Suspected cases of maltreatment against children and adolescents are underreported. More information is required to recognize suspected maltreatment cases and notify authorities.

O objetivo do estudo foi avaliar o efeito de tratamentos da base de bráquetes cerâmicos monocristalinos na resistência de união ao esmalte após recolagem. Setenta e cinco pré-molares foram selecionados e aleatoriamente distribuídos em 5 grupos (n=15) de acordo com o tratamento da base do bráquete: I - sem tratamento, primeira colagem (controle), II - jateamento com óxido de alumínio, III - jateamento seguido da aplicação de silano, IV - jateamento com partículas de dióxido de sílica (silicatização) seguido de silano, V - silicatização realizada em laboratório (Sistema Rocatec). Os bráquetes foram colados no esmalte com Transbond XT sem condicionamento ácido. Em seguida, os bráquetes foram removidos e suas bases foram submetidas aos diferentes tratamentos. Os bráquetes foram recolados, armazenados por 24 h e submetidos ao ensaio mecânico de cisalhamento com velocidade de 0,5 mm/min. Após, o índice de remanescente adesivo (IRA) foi avaliado em cada espécime. Os dados foram submetidos à análise de variância e teste de Tukey (α=0,05). Pode-se observar que houve diferença significativa apenas entre o sistema Rocatec e os demais grupos, o qual apresentou os menores valores de resistência. Os maiores valores de resistência foram observados para o grupo I (controle), sem diferença significativa dos grupos II, III e IV. A maioria dos grupos apresentou maior porcentagem de falhas na interface esmalte/resina (escore 1). Pode-se concluir que os tratamentos da base do bráquete cerâmico foram efetivos, apresentando valores similares ao grupo controle, exceto para o grupo em que foi usado Rocatec.

The aim of this study was to evaluate the shear bond strength of rebonded ceramic brackets after subjecting the bracket base to different treatments. Seventy-five premolars were selected and randomly distributed into five groups (n=15), according to the type of the bracket surface treatment: I, no treatment, first bonding (control); II, sandblasting with aluminum oxide; III, sandblasting + silane; IV, silica coating + silane; and V, silicatization performed in a laboratory (Rocatec system). The brackets were fixed on an enamel surface with Transbond XT resin without acid etching. The brackets were then removed and their bases were subjected to different treatments. Thereafter, the brackets were fixed again to the enamel surface and the specimens were subjected to shear bond strength (SBS) test. The adhesive remnant index (ARI) was then evaluated for each specimen. Data were subjected to ANOVA and Tukey's tests (α=0.05). A statistically significant difference was observed only between Rocatec and the other groups; the Rocatec group showed the lowest SBS values. The highest SBS values were observed for group 1, without any significant difference from the values for groups II, III and IV. Most groups had a higher percentage of failures at the enamel-resin interface (score 1). It was concluded that the surface treatments of rebonded ceramic brackets were effective, with SBS values similar to that of the control group, except Rocatec group.

A violência contra crianças e adolescentes é um grave problema mundial e de saúde pública, que ameaça o bem estar físico e mental, deixando sequelas irreparáveis. A notificação desta violência permite sua prevenção e proteção das crianças e adolescentes. Assim, o objetivo desse estudo foi avaliar a prevalência de lesões na região de cabeça e pescoço contra crianças e adolescentes, bem como caracterizar o tipo das lesões, o agressor e unidades notificadoras. Essa pesquisa retrospectiva foi realizada no Centro de Epidemiologia da Prefeitura Municipal de Curitiba. Um total de 10.483 notificações dos anos de 2010 (5.112) e 2011 (5.371) foi analisado, para compor a amostra das lesões físicas ocorridas no ambiente intrafamiliar, na faixa etária de 0 a 17 anos de idade. Em 2010, a frequência de abuso físico intrafamiliar foi de 322 casos. Destas, 57,1% eram do sexo masculino e 42,9% do sexo feminino, e 58% (187) delas tiveram lesões em cabeça e pescoço. No ano de 2011 foram 342 notificações, sendo que 49% eram do sexo masculino e 51% do sexo feminino e as lesões em cabeça e pescoço corresponderam a 65% (222) dos casos notificados. Houve aumento na prevalência de 6% das lesões físicas e 19% das lesões na região de cabeça e pescoço, do ano de 2010 para 2011. Conclui-se que é alta a prevalência de lesões na região de cabeça e pescoço, áreas facilmente observadas pelo profissional de saúde e da educação. A criação de órgãos notificadores em hospitais e unidades de saúde é fundamental para a vigilância epidemiológica e para definição de políticas adequadas.

Violence against children and adolescents is a public health issue worldwide that threatens physical and mental wellbeing and causes irreparable harm. Reports on this violence are an essential way to prevent it and to protect the children and adolescents. Thus, the objective of the present study was to evaluate the prevalence of physical injuries that occur in domestic environments and reported to the Child and Adolescent Protection Network. This retrospective study was conducted at the Epidemiology Center of the Municipality of Curitiba. A total of 10,483 reports for the years 2010 (5,112) and 2011 (5,371) were analyzed and from them were selected reports of physical injuries that occurred in the family environment. The children and adolescents were 0-17 years old, comprising 322 cases of physical abuse within the family in 2010. Out of these, 57.1% were male and 42.9% were female, and 58% (187) presented head and neck injuries. There were 342 reports in 2011, 49% were male and 51% were female; head and neck injuries corresponded to 65% (222) of the reported cases. The prevalence of injuries increased by 6% and head and neck injury increased by 19% between 2010 and 2011. It may be concluded that physical abuse is associated with a high prevalence of head and neck injury, which is easily observed by the health and education professionals. Notification organs should be created in Brazilian hospitals and health centers, which is essential to conduct epidemiological surveillance and appropriate policies.

AIM: To evaluate changes in blood pressure and heart rate in patients undergoing dental implant procedures, considering the dental setting as the main variable.METHODS: Fifty-five patients who underwent dental implant surgery were evaluated. Thirty-seven were treated at a university clinic and 18 were treated at a private office. Blood pressure and heart rate were measured at the following time-points: at the appointment prior to surgery (T0), immediately before the surgical procedure (T1), during anesthesia (T2), during implant installation (T3), immediately after the surgical procedure (T4) and at the first follow-up appointment after surgery (T5). The data were analyzed by two-way analysis of variance and Student's t-test.RESULTS: The university clinic patients had an increase in heart rate at T5 (t53=2.62, p<0.05) compared with private office patients. Systolic blood pressure in university clinic patients was higher at T2 (t53=2.86, p<0.01), T3 (t53=2.64, p<0.05), and T4 (t53=3.15, p<0.01). Diastolic blood pressure at T2 (t53=3.15, p<0.01) and T3 (t53=3.86, p<0.01) were also higher in university clinic patients.CONCLUSIONS: These results suggest that the dental setting is a relevant factor when planning dental implant surgery.

This study sought to validate the Portuguese translation of a questionnaire on maltreatment of children and adolescents, developed by Russell et al. and to test its psychometric properties for use in Brazil. The original questionnaire was translated into Portuguese using a standardized forward-backward linguistic translation method. Both face and content validity were tested in a small pilot study (n = 8). In the main study, a convenience sample of 80 graduate dentistry students with different specialties, from Curitiba, PR, Brazil, were invited to complete the final Brazilian version of the questionnaire. Discriminant validity was assessed by comparing the results obtained from the questionnaire for different specialties (pediatric dentistry, for example). The respondents completed the questionnaire again after 4 weeks to evaluate test-retest reliability. The comparison of test versus retest questionnaire answers showed good agreement (kappa > 0.53, intraclass correlation > 0.84) for most questions. In regard to discriminant validity, a statistically significant difference was observed only in the experience and interest domains, in which pediatric dentists showed more experience with and interest in child abuse compared with dentists of other specialties (Mann-Whitney test, p < 0.05). The Brazilian version of the questionnaire was valid and reliable for assessing knowledge regarding child abuse by Portuguese-speaking dentists.

OBJETIVO: Relatar o caso de um paciente com tetralogia de Fallot e sua condição bucal. DESCRIÇÃO DO CASO: Paciente do gênero masculino atendido no Curso de Especialização em Odontopediatria da Escola de Aperfeiçoamento Profissional da Associação Brasileira de Odontologia da seção Paraná dos cinco aos sete anos de idade. O exame clínico intrabucal inicial revelou quadro de cárie severa da infância. Durante o acompanhamento, verificou-se a erupção dos primeiros molares permanentes com a presença de defeitos de desenvolvimento de esmalte e perda de estrutura dental. À anamnese, a mãe relatou que o paciente foi portador de tetralogia de Fallot e que a cirurgia corretora foi realizada com um ano e 11 meses de idade. COMENTÁRIOS: A formação do esmalte dental dos primeiros molares permanentes ocorre a partir do primeiro mês de vida e é finalizada entre dois e quatro anos de idade. Neste caso, tal etapa coincidiu com o período anterior à cirurgia para correção da tetralogia de Fallot, fato que pode ter interferido negativamente no processo de mineralização dos primeiros molares permanentes. Os defeitos de desenvolvimento do esmalte podem levar a perda de estrutura dental, favorecendo o aparecimento da cárie dentária. Dessa forma, o odontopediatra deve realizar um diagnóstico precoce dessas alterações e intervir preventivamente para evitar a perda de tais dentes. Uma anamnese bem detalhada e a maior interação entre pediatras e odontopediatras podem proporcionar melhor acompanhamento de crianças com fatores de risco para apresentar defeitos de desenvolvimento do esmalte dentário.

OBJECTIVE: To report a case of a child with tetralogy of Fallot and his oral conditions. CASE DESCRIPTION: A male patient was assisted at the Pediatric Dentristry Specialization Course of the Brazilian Dentistry Association in the State of Paraná, Brazil, from five to seven years old. At the first intrabucal examination, the child presented a severe caries disease. During their treatment, enamel developmental defects were detected in the first permanent molar tooth, with loss of enamel structure. His mother reported that the patient had a surgical correction of tetralogy of Fallot cardiac malformation when he was 23 months old. COMMENTS: The enamel development of the first molar starts in the first month of life and ends around two to four years old. In this patient, the period of mineralization of the first molar was coincident with the period prior to the surgical correction of the cardiac problem. Probably, the development of dental enamel was impaired by the systemic repercussion of this congenital anomaly. Enamel developmental defects can present loss of dental structure, increasing the risk of caries. Therefore, the pediatric dentists should diagnose dental enamel developmental defects early, in order to prevent serious damages to the teeth. A detailed anamnesis and a good interaction between pediatricians and pediatric dentists will provide a better follow-up of children at risk of having dental enamel developmental defects.

OBJETIVO: Avaliar a presença de sinais e sintomas de disfunção temporomandibular (DTM) em crianças com cefaléias em um ambulatório de neuropediatria. MÉTODO: Foram examinados 50 pacientes com idade entre 4 e 18 anos, 31 com cefaléias (24 com enxaqueca, 4 com cefaléia tensional e 3 com cefaléia inespecífica) e 19 do grupo controle. Os dados compreenderam um questionário estruturado respondido pelos pais e uma avaliação subjetiva sobre o estado emocional das crianças. Foi aplicado um questionário específico para DTM e realizado um exame clínico dental. Foram considerados como sinais de DTM: limitação da abertura bucal, desvio da trajetória ao abrir a boca e ruído articular. Quanto aos sintomas, foram considerados: dor à palpação dos músculos masseter e temporal e na articulação temporomandibular. RESULTADOS: Foi encontrado um aumento significante de sinais e sintomas de DTM em pacientes com cefaléias quando comparados com o grupo controle. Houve, também, uma diferença significante de sinais e sintomas de DTM de acordo com a idade (aumento com a idade) e estado emocional (tenso>calmo). CONCLUSÃO: Há maior freqüência de sinais e sintomas de DTM no grupo de pacientes pediátricos com cefaléias, sendo importante avaliar essa patologia nessa população.

PURPOSE: The purpose of this study was to evaluate the presence of signs and symptoms of temporomandibular disorders (TMD) in children with headaches in a neuropediatric ambulatory. METHOD: Fifty patients between 4 and 18 years of age were examined: 31 had headaches (24 migraine, 4 tension type and 3 unspecific headache) and 19 formed the control group. The data collection was comprised of a structured questionnaire answered by the children's parents, and a subjective evaluation about the children’s emotional state. A specific questionnaire for TMD was applied, followed by a clinical dental examination of the children. As signs of TMD, mouth opening limitation, mandibular trajectory deviation in opening mouth, and joint noise were considered. As symptoms, pain on palpation of masseter and temporal muscles and on the poromandibular joint. RESULTS: A significant increase in signs and symptoms of TMD was found in patients with headaches when compared to the control group. There was also a significant difference in signs and symptoms of TMD according to age (increased with age) and emotional state (tense> calm). CONCLUSION: There is a higher frequency of TMD in pediatric patients with headaches; thus, it is important to look for TMD signs and symptoms in this population.

Os objetivos deste trabalho foram: realizar uma classificação do estágio de desenvolvimento de molares de ratas; determinar a atividade específica da lactato desidrogenase (LDH) e o perfil eletroforético das isoenzimas da LDH de acordo com o estágio de desenvolvimento dos molares. Também foi estudado a atividade específica da LDH e perfil eletroforético das isoenzimas de polpas de incisivos. O estágio de desenvolvimento do primeiro molar de ratas na idade de 15 dias e o segundo molar na idade de 18 dias foi determinado como o início da formação radicular. Aos 15 dias de idade, o perfil eletroforético das isoenzimas mostrou uma prevalência da LDH-1 seguida pela LDH-2. Entretanto o segundo molar superior apresentou uma prevalência da LDH-4 seguida de LDH-1, mas no segundo molar inferior o predomínio foi de LDH-1 seguido de LDH-2 e LDH-4. A partir dos 18 dias de idade a prevalência foi sempre da LDH-1. O perfil eletroforético das isoenzimas da LDH em polpas de incisivos nas idades estudadas (25-60 dias de idade) mostrou uma prevalência de LDH-1 > LDH-2 > LDH-3 > LDH-4 > LDH-5. Portanto, os resultados do presente estudo indicam que existem variações na prevalência das formas de isoenzimas da LDH de acordo com o estágio de desenvolvimento da raiz.

The objective of this study was to present a classification of the root development stage of female rat molar teeth and to evaluate the variation in the lactate dehydrogenase (LDH) activity and electrophoretic isoenzyme profile according to the stage of root development of the molar teeth. We also studied the LDH activity and isoenzymes of the pulp of incisor teeth. The stage of development of the rat first molar at the age of 15 days and that of the second molar at the age of 18 days was classified as the beginning of root formation. At the age of 15 days, the electrophoretic profile of the isoenzymes for the first molar showed a prevalence of LDH-1 followed by LDH-2. However, for the maxillary second molar there was a prevalence of LDH-4 followed by LDH-1, while for the mandibular second molar LDH-1 predominated followed by LDH-2 and LDH-4. From 18 days of age, the prevalence was always of LDH-1. The electrophoretic profile of LDH isoenzymes from the pulp of the incisor teeth at the ages studied (25 and 60 days) showed the following order of prevalence: LDH-1 > LDH-2 > LDH-3 > LDH-4 > LDH-5. These results suggest that there are variations in the prevalence of the various forms of LDH isoenzymes in the dental pulp of rats according to the developmental stage of the root.