Needlestick and Sharp Instruments Injuries among Brazilian Dentistry Students

BACKGROUND

The occurrence of occupational accidents is common among students and dentists. The present study is aimed to evaluate the prevalence and characteristics of needlestick and sharp instrument injuries among dentistry students.

MATERIALS AND METHODS

A documentary research was carried out with data being obtained from the analysis of 137 medical records of injuries caused by needlestick and sharp instruments occurring in the period from 2012 to 2016 and were analyzed regarding the characteristics of the victim (gender and age) and the accident (year, time, environment, and time interval between exposure and search for care). Data were organized in the Statistical Package for Social Sciences software version 18 and were presented through descriptive statistics.

RESULTS

The occurrence of accidents was high (43.1%), with the predominance of female victims (66.1%) and aged up to 23 years (55.9%). The majority of events occurred in the afternoon (54.4%), in the clinical setting (70.7%), and in 75% of the cases, the search for care occurred within 2 h after exposure.

CONCLUSION

Accidents with needlestick and sharp instruments have high frequency and involve mainly female students. They are more common in the afternoon and in the clinical setting and the time interval was between exposure and the search for care complied with recommendations of the Brazilian legislation.

Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users

The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user’s perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws.

Reduction and Fixation of Unstable Fractures of the Zygomatic Arch: Report of a Series of Cases

Background:

This study evaluated a series of cases of fracture in the zygomatic arch with displacement of the fractured segment.

Materials and Methods:

This prospective cohort study was conducted between May 2008 and February 2009. The study sample which consist of 10 patients of both genders with fractures in the zygomatic arch. The collection instrument included a specific sheet with data concerning the patient's age, cause, side of the fracture, type of treatment performed, recurrence and presence of lesions in the facial nerve. The radiographic indices of Waters and Hirtz were used. The data were presented by means of descriptive statistics (absolute and percentage distributions).

Results:

Most of the patients were male (90.0%), the most frequent etiology was a motorcycle accident (70.0%) and the left side was more affected (60.0%). There was no recurrence in any of the patients examined; however, 1 patient had a lesion in the facial nerve. The treatment performed for all patients was reduction and fixation with titanium miniplates.

Conclusion:

Fractures in the zygomatic arch are more frequent in young male individuals and the most common cause is a motorcycle accident, with the use of miniplates constituting an effective treatment without recurrence.

Antifungal activity and mode of action of thymol and its synergism with nystatin against Candida species involved with infections in the oral cavity: an in vitro study

BACKGROUND

Limitations of antifungal agents used in the treatment of oral candidiasis, as the development of resistant strains, are known by the scientific community. In this context, the aim of this study was to evaluate the antifungal activity of thymol against Candida albicans, Candida tropicalis and Candida krusei strains and to determine its mode of action and synergistic effect when combined with the synthetic antifungal nystatin.

METHODS

The minimum inhibitory concentration (MIC) was determined using a microdilution technique, and the minimum fungicidal concentration (MFC) was determined via subculture sowing. The mode of action of thymol was established by verifying fungal growth in the presence of sorbitol or ergosterol. The fractional inhibitory concentration index (FIC) was determined using the checkerboard method.

RESULTS

Thymol presented an antifungal effect, with MICs of 39 μg/mL for C. albicans and C. krusei and 78 μg/mL for C. tropicalis. The results of the antifungal test remained unchanged in the presence of sorbitol; however, the MIC value of thymol against C. albicans increased eight times (from 39.0 to 312.5 μg/mL) in presence of exogenous ergosterol. The combination of thymol and nystatin reduced the MIC values of both products by 87.4%, generating an FIC index of 0.25.

CONCLUSIONS

Thymol was found to have a fungicidal effect on Candida species and a synergistic effect when combined with nystatin.

Fluoride release/uptake from different orthodontic adhesives: a 30-month longitudinal study

The aim of this study was to test the null hypothesis that there is no difference in fluoride release between resin-modified glass ionomer cements (RMGICs) and composites in the long term. The materials were divided into 5 groups: a nonfluoride-releasing composite - Group TXT (Transbond XT), a fluoride-releasing composite - Group QC (Quick-Cure), and three RMGICs - Groups FOLC, FOB and MC (Fuji Ortho LC, Fuji Ortho Band, and Multi-Cure). Fluoride release was measured at time intervals of 1 h, 1, 7, 14, 21 and 29 days, followed by further evaluations performed at 6, 12, 18, 24 and 30 months using selective ion electrodes connected to an ionic analyzer. Fluoride releasing and re-releasing experiments were analyzed using the Kruskal-Wallis test and Mann-Whitney test with the Bonferroni correction. The amount of fluoride released by FOB was larger in comparison with the other adhesives (p=0.01). In the long-term, FOLC and MC had a similar performance (p>0.05). The composites presented a low fluoride release, but fluoride ion uptake and re-release capacity of QC was statistically significant (p<0.05) during the experiment. In conclusion, the null hypothesis was rejected, the RMGIC Fuji Ortho Band and the composite Quick-Cure presented greater fluoride release and re-release capacity when recharged.

Use of alcohol vinegar in the inhibition of Candida spp. and its effect on the physical properties of acrylic resins

Background

Given the high prevalence of oral candidiasis and the restricted number of antifungal agents available to control infection, this study investigated the in vitro antifungal activity of alcohol vinegar on Candida spp. and its effect on the physical properties of acrylic resins.

Methods

Tests to determine the Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC) of vinegar alcohol (0.04 g/ml of acetic acid) and nystatin (control) were performed. The antifungal activity of alcohol vinegar was assessed through microbial growth kinetic assays and inhibition of Candida albicans adhesion to acrylic resin at different intervals of time. Surface roughness and color of the acrylic resin were analyzed using a roughness meter and color analyzer device.

Results

Alcohol vinegar showed MIC_75% and MFC_62.5% of 2.5 mg/ml, with fungicidal effect from 120 min, differing from nystatin (p < 0.0001), which showed fungistatic effect. Alcohol vinegar caused greater inhibition of C. albicans adhesion to the acrylic resin (p ≤ 0.001) compared to nystatin and did not change the roughness and color parameters of the material.

Conclusion

Alcohol vinegar showed antifungal properties against Candida strains and caused no physical changes to the acrylic resin.

Loss on drying, calcium concentration and pH of fluoride dentifrices

Introduction:

Fluoride dentifrices containing calcium carbonate have advantages such as control of dental plaque and progression of dental caries, also contributing to oral hygiene, represent most dentifrices marketed in Brazil.

Aim:

To evaluate the physicochemical properties of seven fluoride dentifrices containing calcium carbonate in relation to hydrogen potential (pH), loss on drying and calcium concentration.

Materials and Methods:

Data collection was performed using the potentiometric method for pH ranges, gravimetric analysis for loss on drying and atomic absorption spectrometry for the concentration of calcium ions. All tests were performed in triplicate and the analysis was performed entirely at random according to one-way analysis of variance at 5% significance level.

Results:

The pH values were alkaline and ranged from 8.67 (Oral-B 123^®) to 10.03 (Colgate Máxima Proteção Anticáries^®). The results of loss on drying ranged from 33.81% (Oral-B 123^®) to 61.13% (Close Up^®), with significant differences between brands tested. In relation to the calcium content, the highest and lowest concentrations were found in dentifrices Even^® (155.55 g/kg) and Colgate Ultra Branco^® (129 g/kg), respectively, with significant difference (P < 0.05).

Conclusion:

Fluoride dentifrices analyzed showed alkaline pH and high levels of loss on drying and calcium concentration. However, these physicochemical characteristics differed according to the different brands tested.

Safety and Tolerability of Essential Oil from Cinnamomum zeylanicum Blume Leaves with Action on Oral Candidosis and Its Effect on the Physical Properties of the Acrylic Resin

The anti-Candida activity of essential oil from Cinnamomum zeylanicum Blume, as well as its effect on the roughness and hardness of the acrylic resin used in dental prostheses, was assessed. The safety and tolerability of the test product were assessed through a phase I clinical trial involving users of removable dentures. Minimum inhibitory concentration (MIC) and minimum fungicidal concentrations (MFC) were determined against twelve Candida strains. Acrylic resin specimens were exposed to artificial saliva (GI), C. zeylanicum (GII), and nystatin (GIII) for 15 days. Data were submitted to ANOVA and Tukey posttest (α = 5%). For the phase I clinical trial, 15 healthy patients used solution of C. zeylanicum at MIC (15 days, 3 times a day) and were submitted to clinical and mycological examinations. C. zeylanicum showed anti-Candida activity, with MIC = 625.0 µg/mL being equivalent to MFC. Nystatin caused greater increase in roughness and decreased the hardness of the material (P < 0.0001), with no significant differences between GI and GII. As regards the clinical trial, no adverse clinical signs were observed after intervention. The substance tested had a satisfactory level of safety and tolerability, supporting new advances involving the clinical use of essential oil from C. zeylanicum.

Dental caries experience and use of dental services among Brazilian prisoners

This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, and oral health impacts were investigated. The mean DMFT index value was 19.72. Of the components, the decayed component showed the highest mean value (11.06 ± 5.37). Statistically significant association was found between DMFTs with values from 22 to 32 and oral health satisfaction (p = 0.002), difficulty speaking (p = 0.024), shame of talking (p = 0.004) and smiling (p < 0.001). Regarding the use of dental services, 80% had their last dental appointment less than one year ago, with most visits occurring in prison (80%), with restorative treatment (32%), followed by dental pain (26.4%), being the main reasons for such appointments. Most prisoners used dental services provided by the prison. Although restorative treatment has been the main reason for the use of dental services, “decayed” and “missing” components contributed to the high mean DMFT index.

Effect of Endodontic Irrigating Solutions on the Micro Push-out Bond Strength of a Fibre Glass Dowel

PURPOSE

To evaluate the effect of different endodontic irrigating solutions on the micro push-out bond strength of a fiber glass dowel.

MATERIAL AND METHODS

Seventy 16-mm long root segments of bovine incisors were prepared and randomly assigned to 7 groups (n=10) according to the type of irrigating solution used prior to the cementation of the intra-radicular fiber glass dowels: G1: 5.25% NaOCl + 17% EDTA; G2: 5.25% NaOCl; G3: 17% EDTA; G4: 2% chlorhexidine gel; G5: 70% alcohol; G6: 11.5% polyacrylic acid; and G7: saline (control). After treatment of intracanal dentin, the glass fibre dowels were cemented with self-adhesive resin cement (RelyX Unicem). Six slices with the thickness of 1.00 ± 0.05 mm were obtained from each tooth at the coronal, middle and apical root thirds (2 slices per third) using a low-speed saw. Micro push-out tests were performed at a crosshead speed of 0.5mm/min and the data (MPa) were analyzed statistically by ANOVA and Tukey's and Dunnett's tests.

RESULTS

There were statistically significant differences (p<0.0001) among the irrigating solutions, but no significant difference (p=0.0591) was found among the root thirds. G5 presented the highest bond strength mean of all groups (p<0.0001). The use of 70% alcohol increased the adhesion values by 53% compared to the group control.

CONCLUSION

The use of 70% alcohol increased the bond strength of the fiber glass dowel to the dentin walls. However, the push-out bond strength between the dowel and the root dentin was not affected by the root third (coronal, middle and apical).

Evaluation of total soluble solids content (TSSC) and endogenous pH in antimicrobials of pediatric use

BACKGROUND

The use of liquid pharmaceutical preparations is a daily occurrence for some children. Evidences show a significant relation between the intake of oral sucrose based medicines and an increase incidence in dental caries.

AIM

This in vitro experimental study evaluated the Total Soluble Solids Content (TSSC) by means of Brix scale refractometry and the endogenous pH of antimicrobials of pediatric use presented as oral suspensions.

MATERIALS AND METHODS

Nine medications (6 chemotherapics and 3 antibiotics) were evaluated by random experiment with 3 repetitions for each sample. The analysis of TSSC readings were performed by Brix refractometry using the Abbé refractometer, and the pH values were determined by potentiometry.

RESULTS

The mean TSS contents ranged from 11.73 (Keflaxina) to 63.83 (Azitromed). The minimum and maximum mean pH values were 4.12 (Keflaxina) and 10.97 (Zitroneo), respectively.

CONCLUSIONS

The chemotherapic antimicrobials evaluated in this study presented the highest TSSC means, while the antibiotics showed pHs below the values considered as critical, which may contribute to the development of caries lesions in case of inadequate administration of these medications to children.

Myofibroblasts and their relationship with oral squamous cell carcinoma

Myofibroblasts are hybrid-phenotype differentiated cells in between fibroblasts and smooth muscle cells. Due to their contractile features and ability to synthesize extracellular matrix components, cytokines, proteases, and proangiogenic factors, myofibroblasts have been implicated in the pathogenesis of fibrocontractive diseases and in the progression of many tumors, including oral squamous cell carcinoma (SCC).

Objective

To perform a literature review on the origin of myofibroblasts, their main morpho-physiological and immunohistochemical aspects, and to discuss the correlations with oral SCC.

Method

A search was made on the PUBMED database to select the main papers in the literature in English related to the subject, published between January 1991 and December 2011.

Conclusion

Myofibroblasts are an important component of the stroma of oral SCCs, although they are not present in all tumors. Abundant presence of myofibroblasts may be associated with local disease recurrence and decreased patient survival. However, given the relatively limited number of studies on the subject, further research is needed to clarify the molecular mechanisms by which myofibroblasts influence the biological behavior of oral SCC.

A Randomized Clinical Trial of Schinus terebinthifolius Mouthwash to Treat Biofilm-Induced Gingivitis

Objectives. This study aimed to investigate the efficacy of a Schinus terebinthifolius (ST) mouthwash in reducing gingival inflammation levels (GI) and biofilm accumulation (BA) in children with gingivitis. Methods. This was a randomized, controlled, triple blind, and phase II clinical trial, with children aged 9-13 years (n = 27) presenting with biofilm-induced gingivitis. The sample was randomized into experimental (0.3125% ST, n = 14) and control (0.12% chlorhexidine/CHX, n = 13) groups. Products were masked as regards color, flavor and aroma. Intervention protocol consisted in supervised rinsing of 10 mL/day for 01 minute for 10 days. Gingival bleeding and simplified oral hygiene indexes were used to assess the efficacy variables, measured at baseline and after intervention by calibrated examiners. Data were statistically treated with paired t-test, unpaired t-test, and Wilcoxon and Mann-Whitney tests ( α = .05). Results. It was found that both ST and CHX were able to significantly reduce GI levels after 10 days (P < 0.001) and there was no significant difference between them (P > 0.05). CHX was the only product able to significantly reduce BA after 10 days when compared to baseline (P < 0.05). Conclusion. ST mouthwash showed significant anti-inflammatory activity (equivalent to CHX), but it was not able to reduce biofilm accumulation.

Prevalence of Dental Trauma in Children Aged 1–3 Years in Joao Pessoa (Brazil)

AIM

This was to determine the prevalence and distribution of traumatic injuries to primary anterior teeth in children from 1 to 3 years-old.

METHODS

A cross-sectional survey was carried out through clinical examination of the primary dentitions of preschool children enrolled in public nursery schools in Joao Pessoa (Brazil). A total of 293 boys and girls participated in the study. The children were clinically examined for signs of trauma according to Andreasen's classification.

RESULTS

Traumatic injuries were identified in 10.2% of children. The largest percentage of injuries was demonstrated by 2-3 years-old, with no significant difference between boys and girls. The most common type of injury was enamel fracture and enamel-dentine fracture. The maxillary central incisor was the most vulnerable to injury, without differences between the right and left side.

STATISTICS

The data were entered in the SPSS program, and the chi square test was used with a 5% significance level.

CONCLUSION

The primary dentition was most affected by fracture of enamel, especially the maxillary central incisor teeth, in patients between 2 and 3 years of age. There is a need of providing adequate preventive and treatment care for preschool children.

Negative self-perception of smile associated with malocclusions among Brazilian adolescents

This study estimated the prevalence of negative self-perception of smile because of occlusion abnormalities and investigated their association according to standard clinical criteria. The sample consisted of 1290 randomly selected Brazilian adolescent boys and girls aged 12-16 years. The outcome of interest was dissatisfaction with smile, and data were collected using a standardized questionnaire. Occlusion characteristics were assessed using the dental aesthetic index (DAI). The other study variables were gender, age, and use of dental services. A chi-square test and Poisson multiple regression were used for statistical analysis. Of the 1290 students interviewed and examined, 539 (41.8 per cent) were dissatisfied with their smile; of these, 373 (69.2 per cent) assigned their dissatisfaction to the presence of an occlusal abnormality, and 166 (30.8 per cent) reported reasons other than occlusal abnormalities for their negative self-perception of their smile. In multivariate analysis, the following variables were associated with the outcome of interest: maxillary anterior irregularity [prevalence ratio (PR) = 1.40; 95 per cent confidence interval (CI) = 1.29-1.80], incisal spacing (PR = 1.37; 95 per cent CI = 1.19-1.57), vertical open bite (PR = 1.34; 95 per cent CI = 1.15-1.55), mandibular anterior irregularity (PR = 1.29; 95 per cent CI = 1.14-1.46), permanent anterior teeth missing (PR = 1.21; 95 per cent CI = 1.05-1.39), and incisal diastema (PR = 1.14; 95 per cent CI = 1.01-1.31). The negative self-perception of smile was statistically associated with severity of occlusal disorders according to the DAI scores, which suggests that self-perception should be used together with standard clinical criteria when decisions about orthodontic treatments are made in public health care systems.

VIOLÊNCIA SEXUAL CONTRA MULHERES PORTADORAS DE NECESSIDADES ESPECIAIS: PERFIL DA VÍTIMA E DO AGRESSOR

Estudo transversal e descritivo caracterizou 19 vítimas de violência sexual portadores de necessidades especiais e agressores entre 396 casos registrados no período de 2004 e 2009 em Campina Grande - Paraíba. Os dados foram coletados por pesquisadores treinados, registrados em instrumento estruturado elaborado para o estudo e testado previamente; organizados e analisados com auxílio do software Statistical Package for the Social Sciences 17.0 e estatística descritiva. Verificou-se que 4,8% dos casos registrados envolveram mulheres portadoras de necessidades especiais. As vítimas, na maioria com deficiência intelectual, eram solteiras, com idade entre 12 e 19 anos e baixa escolaridade. O agressor era em sua maioria único e conhecido da vítima; constatou-se o emprego de constrangimento em 21,1% dos casos, sendo a força física e a grave ameaça as mais frequentes. As equipes de saúde podem contribuir para a prevenção e detecção da violência sexual, com atenção a portadores de necessidades especiais.

Smoking among undergraduate students in the area of health

The aim of this study was to evaluate the relationship between smoking and socio-demographic and behavioral factors among undergraduate students in the area of health at the State University of Paraíba, Brazil. An analytical cross-sectional study was conducted with a representative sample from each of the following courses: Dentistry, Nursing, Psychology, Pharmacy, Physical Therapy and Physical Education. A total of 492 students were interviewed using a structured questionnaire. The chi-square and Fisher's Exact tests were used for statistical analysis at a 5% level of significance. Smoking prevalence was 5.7% and stress was the main reason for starting the habit (36.8%). In the multivariate analysis by logistic regression, the variables of gender, religious persuasion, semester attended in the course, and alcohol consumption were significantly associated with smoking (p<0.05). Although other studies reported a strong relationship between university students and smoking, the prevalence of smokers was low. Most of the variables studied revealed a correlation with smoking. Since smoking and alcohol consumption are the two major human addictions, this study suggests a bidirectional relationship between these variables.

Bilateral maxillary and mandibular fourth molars: a case report and literature review

Supernumerary teeth are those present in addition to the normal set of teeth. These teeth are found in both the primary and the permanent dentitions, and are most frequently seen in the maxillary anterior and molar regions. Supernumerary molars are divided into two types, depending on their location: distomolars and paramolars. Distomolars usually occur in the form of a fourth molar distal to the third molar, while paramolars are rudimentary supernumerary teeth that might develop buccally or lingually to the molar series. The management of a supernumerary tooth should be part of a comprehensive treatment plan. This paper reports a rare case of a male patient with bilateral maxillary and mandibular fourth molars, and reviews the literature on supernumerary teeth.

[Nutritional intervention program associated with physical activity: discourse of obese elderly women]

Obesity is a complex nutritional problem with social and psychological dimensions, which affects individuals of all ages. In addition to presenting risk factors for some diseases, obesity may interfere with the quality of life of the elderly. This qualitative study of an exploratory nature investigated the discourse of obese elderly women regarding their participation in a nutritional intervention program associated with physical activity. Eighteen obese elderly women attending Centers of Reference and Citizenship in the city of João Pessoa, state of Paraiba, Brazil were enlisted in the study. Interviews using a series of questions that addressed the core issue pertaining to the scope of the study was the technique used for data collection. The data obtained were analyzed by the collective subject discourse (CSD) technique. The following central ideas emerged from CSD: changes in lifestyle, in eating habits, in health and in self-esteem. The core ideas reflected the value attributed to the aforesaid program for promotion of health of the group of elderly women who participated in the study. It is hoped that this research might elicit further investigation in the area of health of the elderly.

Avaliação in vitro do potencial erosivo de bebidas isotônicas

Isotônico é uma bebida destinada a reidratar, bem como repor eletrólitos, carboidratos e outros nutrientes. O objetivo deste estudo in vitro foi avaliar o pH endógeno, a acidez total titulável (ATT) e o teor de sólidos solúveis totais (SST) de nove bebidas isotônicas à temperatura ambiente (±23ºC) e após resfriamento (±9ºC). A avaliação do pH foi feita por potenciometria e a capacidade tampão foi realizada por meio da diluição de cada uma das substâncias. Incrementos de 0,1NKOH foram adicionados até que se atingisse a neutralidade. As leituras dos SST foram feitas por refratometria usando o refratômetro de Abbé. As médias do pH variaram de 2,03 (Gatorade Tangerina®) a 2,93 (Marathon Limão®) e todos as bebidas mostraram pH abaixo do valor crítico de 5,5. As médias da ATT variaram de 0,10 para o Marathon Limão® a 0,32 para o Gatorade Tangerina®. O Gatorade Tangerina® apresentou o menor valor de SST (6,33%) e o Marathon Guaraná e Açaí® mostrou o maior valor de SST (12,50%). Foram observadas diferenças estatisticamente significantes entre as temperaturas para o pH (G3, G4, G5, G6 e G8), para os SST (G2, G3, G6 e G9) e para a ATT (G2, G3 e G5). Ao se comparar os grupos 1 e 3 (Marathon Guaraná Açaí® x Gatorate Guaraná Açaí®) observou-se diferença estatisticamente significante entre em relação ao pH para a temperatura ambiente, em relação aos SST para as temperaturas ambiente e a ±9ºC e para a ATT na temperatura ambiente. As bebidas analisadas apresentaram baixo pH endógeno, podendo as mesmas serem consideradas potencialmente erosivas aos tecidos dentais se consumidas de modo inadequado e com elevada frequência. Com relação à temperatura, recomenda-se a ingestão dessas bebidas resfriadas.

Injuries to the head and face in 0-4-year-old child victims of fatal external causes in Campina Grande, PB, Brazil

We evaluated the presence of injuries to the head and face in Brazilian 0-4-year-old child victims of fatal external causes by analyzing forensic medical reports derived from all autopsies performed in 0-4-year-old children at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2007. The study sample consisted of 81 reports (1.8%) referring to children who were confirmed to have died from external causes. Most victims were males (56.8%) and 1 year of age (27.2%). Drowning (34.6%) and motor vehicle accidents (22.2%) were the most common causes of death. Injuries to the head and to the face were found in 33.3% and 34.6% of the victims, respectively. There was a strong association between the occurrence of motor vehicle accidents and the presence of injuries to the head (p < 0.01; odds ratio [OR]=21.25 [5.29-85.31]) and to the face (p < 0.01; OR = 19.23 [4.83-76.56]). There was also an association between the existence of injuries to the head and presence of maxillofacial injuries (p < 0.01; OR = 5.09 [1.87-13.84]). Drowning and motor vehicle accidents were the main causes of death in children aged 0 to 4 years. Parents should adopt measures to make the home environment safer and prevent fatal accidents by limiting their children's access to pools and cisterns. Reduction in child mortality from motor vehicle accidents involves parental vigilance in the road traffic environment and home education on driveway safety.

Endogenous pH, Titratable Acidity and Total Soluble Solid Content of Mouthwashes Available in the Brazilian Market

OBJECTIVES

To evaluate in vitro the endogenous pH, titratable acidity and total soluble solid content (TSSC) of mouthwashes available in the Brazilian market.

METHODS

The study sample was composed of 10 commercial brands of mouthwashes based on different active ingredients: Cepacol(R), Clinerize(R), Equate(R), Listerine Cool Citrus(R), Oral-B(R), Periogard(R), Peroxyl(R), Plax Overnight(R), Prevident 220(R) and Sanifill(R). The experiments were performed in triplicate. The endogenous pH was evaluated by potentiometry, titratable acidity was evaluated by the addition of 0.1N KOH increments to the mouthwashes, and TSSC readings were performed by Brix refractometry using the Abbé refractometer.

RESULTS

pH values ranged from 3.56 (Peroxyl(R)) to 7.43 (Cepacol(R)) and three mouthwashes presented pHs below 5.5. The titratable acidity values ranged from 0.007 (Periograd(R)) to 0.530 (Prevident(R)). Oral B(R) and Clinerize(R) presented the lowest (4.7%) and the highest (23.70%) TSSC, respectively.

CONCLUSIONS

Some of the mouthwashes evaluated in this study presented low endogenous pH, even below the critical value for enamel dissolution (pH<5.5), high titratable acidity and high TSSC, and may be potentially erosive to the dental tissues if not properly used.

A influência do padrão de aleitamento no desenvolvimento de hábitos de sucção não nutritivos na primeira infância

O estudo analisou a relação entre o padrão de aleitamento e o desenvolvimento de hábitos de sucção não-nutritivos em crianças de 12 a 36 meses de idade, de creches públicas na cidade de João Pessoa (PB). A amostra constou de 292 crianças, de ambos os gêneros e a coleta de dados abrangeu entrevistas com as mães/responsáveis. As informações dos formulários consistiam na descrição da frequência e duração dos hábitos de sucção não-nutritivos, bem como dos métodos de aleitamento. Os dados foram analisados através do programa SPSS, realizando-se distribuições de frequências e os testes estatísticos do qui-quadrado e Exato de Fisher. Observou-se que, com relação à presença de hábitos de sucção não-nutritivos, 69,2% das crianças tinham algum tipo de hábito, sendo 61,6% a sucção de chupeta e 8,2% a sucção digital. De toda a amostra, 10,2% realizaram aleitamento natural exclusivo, 4,9%, o aleitamento artificial exclusivo e 84,9%, o aleitamento misto. Considerando os tipos de aleitamento, 83,8% das crianças realizaram aleitamento natural exclusivo durante os seis primeiros meses de vida. O padrão de aleitamento apresentou associação significativa com a presença de hábitos de sucção não-nutritivos. Quanto maior a duração do aleitamento natural exclusivo, menor a prevalência de hábitos de sucção não-nutritivos e o padrão de aleitamento.

Prevalence and characteristics of injuries to the head and orofacial region in physically abused children and adolescents--a retrospective study in a city of the Northeast of Brazil

The aim of this study was to evaluate the prevalence and characteristics of injuries to the head and orofacial region in physically abused children and adolescents from a city of the Northeast of Brazil, based on the review of forensic medical reports. This retrospective study was undertaken by the analysis of expert medical reports derived from medical forensic exams performed at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2006. From a universe of 11 624 reports issued in this time span, the study sample consisted of 1070 reports referring to children and adolescents aged 0-17 years that were confirmedly victims of physical abuse. Male children (52.8%) in the 13- to 17-year-old range (72.4%) were the most frequent victims, with an association between gender and age group (P = 0.039). Most children (58.2%) presented a single type of injury, with a statistically significant association between number of injuries and gender (P = 0.040), but no significant association between number of injuries and age (P = 0.163). The percentage of victims injured in the head and face corresponded to 56.3%, with a statistically significant association between the presence of injury in the head and face and gender (P = 0.046). As much as 12.4% of the children and adolescents presented intraoral injuries, with no significant difference between genders (P = 0.543). However, a statistically significant association was observed between the number of existing injuries and the presence of oral injuries (P = 0.005). The maxilla was predominantly affected (55.6%), most injuries (94.8%) being soft-tissue lacerations located mainly in the upper lip (46.4%). The findings of this survey revealed a high prevalence of injuries to the head and orofacial region of physically abused children and adolescents.

Traumatic dental injuries and associated factors among Brazilian preschool children aged 1-5 years

The aim of this study was to evaluate the prevalence of dental trauma in children aged 1 to 5 years old and its associated factors (gender, age group, malocclusion and labial-closing), interviewing parents and guardians for additional information on the trauma occurrence. A transversal study of 820 preschool children from the City of Caruaru, Pernambuco, Brazil was conducted. Data were collected by means of a clinical examination and a structured interview. The statistical analysis included a distribution of frequencies, a bi- and a multi-variate analysis at a significance level of 5%. Trauma prevalence was 20.1%, tooth 61 was the most often affected, and enamel fractures followed by the fractures of the enamel and the dentine were the most frequent alterations. Trauma prevalence was highest in 3- to 5-year-old males with malocclusion (open bite and protrusion) (p < 0.05). According to most parents and/or guardians, the most usual etiology was falling and the place most often cited was home. All the variables studied, except for lip coverage, were associated with dental trauma. The outcome of the present study showed high prevalence of dental trauma in a pediatric population under the age of 5 years. Falls and accidental collisions were the etiological factors most often cited. The front upper incisors were the teeth most often affected, and enamel fracture was the trauma most often observed.

Prevalência de más oclusões em crianças com 12 a 36 meses de idade em João Pessoa, Paraíba

OBJETIVO: verificar a prevalência de más oclusões em crianças de 12 a 36 meses de idade, de creches públicas no município de João Pessoa / PB. MÉTODOS: a amostra constou de 292 crianças, sendo 161 meninos (55,1%) e 131 meninas (44,9%), selecionados aleatoriamente. As crianças foram examinadas nas dependências das instituições selecionadas, sob luz natural, e os dados foram registrados em um formulário pré-estruturado, sendo os exames feitos por um examinador calibrado (Kappa = 0,85), avaliando a presença de sobremordida, de sobressaliência, de mordida aberta anterior e de mordida cruzada posterior. Os dados foram analisados por meio do programa estatístico SPSS. RESULTADOS E CONCLUSÕES: a prevalência de má oclusão na amostra foi de 40,7%, com a mordida aberta anterior presente em 35,6% das crianças, a mordida cruzada posterior em 5,1%, e sobressaliência moderada e sobremordida moderada em 35,5% e 24,7%, respectivamente. Com o desenvolvimento da oclusão, a prevalência de mordida aberta anterior aumentou, demonstrando a magnitude desse problema na primeira infância.