Orientador: Maria Jacira Silva Simões / Banca: Silvio Rocha Corrêa da Silva / Banca: Rubens Garcia Ricco / Resumo: A cárie dental pode ser um dos sinais clínicos que caracterizam a presença de hábitos alimentares inadequados, principalmente na freqüência de ingestão de açúcar. Os objetivos desta pesquisa foram verificar a situação nutricional de escolares de 10 a 15 anos, segundo o IMC (Índice de Massa Corporal), identificando os casos de obesidade, sobrepeso, desnutridos e eutróficos, analisando o risco de cárie dentária de cada grupo e a freqüência de ingestão de açúcar através de questionário de freqüência alimentar específico. Os resultados mostraram que dos 353 alunos participantes, 56 apresentaram-se obesos e 57 com sobrepeso, o que significa que 113 estavam acima do peso, representando 32% do total, considerado um percentual preocupante. Com relação ao risco de cárie dentária, os resultados mostraram que os grupos acima do peso (obeso e sobrepeso) e o grupo desnutridos, tiveram um percentual maior para o risco moderado, enquanto que o grupo classificado em eutróficos teve como maior percentual um elevado risco à cárie dentária. O questionário de freqüência alimentar, respondido por 50 alunos escolhidos aleatoriamente dos quatro grupos, mostrou que 86% ingerem refrigerantes no almoço, 60% ingerem refrigerante no jantar, 68% ingerem leite com achocolatado no café da manhã, 64% tem o hábito de ingerir algum tipo de alimento açucarado, no período da tarde, 32% alimentam-se duas vezes ao dia e 36%, ingerem produtos que contêm açúcar, duas vezes ao dia. Concluiu-se que a classificação C (uma ou mais cavidades em situação de cárie crônica, mas sem placa, sem gengivite e/ou mancha branca ativa), foi a que mais predominou, em todos os grupos, no exame do risco de cárie...(Resumo completo, clicar acesso eletrônico abaixo). / Abstract: The dental carie can be one of the characteristic clinical indications of unsuitable nutritious habits, specially regarding the human body sugar introduction frequency. This research purpose is the investigation of 10 – 15 years old students nutritional level , according Body Mass Coeficient (BMC), identifying the obesity cases, overweight , low weight and normal weight . The analysis of the relationship between each group dental carie probability and human body sugar introduction frequency was carried out through a specific nutritious questionary. The results show that from an amount of 353 students, 56 are obese and 57 show overweight. It means 113 students were over the normal weight (32% of the total number of students). It’s a high level .Regarding the dental carie risc, the results show the overweight group and the lowweight group showed a bigger percentage level for the moderate dental carie risc while the groups inside the normal weight range shows a bigger percentage for a high dental carie risc. The nutritious frequency questionary, fullfilled for fifty students randomly chosen from the four groups shows that 86% drink refreshment during the lunch , 60% in the dinner, 68% drink chocolate in the breakfast, 64% eat some kind of sugar meal in the afternoon, 32% have meal 2 times a day and 36% eat or drink sugar foods 2 times a day. The conclusion is: The C classification ( one or more dental cavities in chronical carie situation, but without bacterial plate , no gum sick and/or active white band) was predominant in all groups. According to BMC, females shows bigger percentage of overwheigt people and obese people and a big number of low weight children ...(Complete abstract, click electronic address below). / Mestre

Observar há relação entre o CPO-D e a dependência ao açúcar extrínseco não láctico (AENL) na faixa etária de 15 a 19 anos em escolares da rede pública estadual do ensino médio do município de Porto Alegre. Metodologia: Este estudo é observacional do tipo analítico transversal, realizado no município de Porto Alegre; cuja amostra incluiu 400 escolares de ambos os sexos de nove escolas sorteadas da rede pública estadual com faixa etária entre 15 e 19 anos. Para a coleta dos dados foram utilizados ficha de levantamento epidemiológico para o CPO-D, baseada na do Projeto Saúde Bucal Brasil (2004) e aplicação do questionário de abuso e dependência de AENL (ROSA, 2005). Resultados: O CPO-D médio da amostra foi de 0,90; sendo no sexo feminino (0,98) ligeiramente maior que no masculino (0,79). A relação entre CPOD dos dependentes (0,94) e dos não dependentes (0,88) não se mostrou estatisticamente significativa (p=0,794).No que tange a variável dependência 34% responderam positivamente ao questionário; sendo que o sexo feminino (42,5) apresentou maior dependência que o masculino (22,7%), tendo assim uma diferença estatística significativa (p<0,001). Conclusões: A relação entre dependência de AENL e o CPO-D não foi significativa, contudo existem fatores de proteção, como flúor, acesso a serviço odontológico, fator econômico e outros que podem ter interferido no resultado. / To observe the relation between the DMF-T index and the dependency to non lactic extrinsic sugars (NLES) in teenagers from 15-19 years of age belonging to state public schools in the city of Porto Alegre. Methodology: This study is observational analytical cross, held in the city of Porto Alegre, whose sample included 400 male and female students from nine schools drawn from the public network with state age group between 15 and 19 years. For data collection were used sheet of epidemiological survey for the DMF-T, based on the Project's Oral Health Brazil (2004) and implementation of the questionnaire of abuse and dependence on NLES (ROSA, 2005).Results: The mean DMF-T was 0.90; being the sex feminine (0.98) slightly higher than the masculine (0.79). The relation between the DMF-T of the dependents (0.94) and from the non-dependents (0.88) was not statistically significant (p=0,794). In relation to the variable dependency, 34% answered positively the questionnaire; the feminine group (42, 5%) presented a higher dependancy than the male group (22, 7%), and this difference was statistically significant (p<0,001). Conclusions: The relation between dependancy of NLES and DMF-T was not statistically significant; nevertheless there are factors of caries protection, as fluoride, access to dental service, economical factors and others that can interfere in this result.

A detecção de lesões cariosas nos estágios iniciais possibilita a escolha de tratamentos baseados na preservação da estrutura dental. Dessa forma, a utilização de exames capazes de diagnosticar precocemente essas lesões, como a Tomografia por Coerência Óptica (OCT Optical Coherence Tomography) é adequada. Assim, o objetivo do trabalho foi avaliar a capacidade da OCT em quantificar os estágios de desmineralização do esmalte durante o desenvolvimento de lesões simuladas de cárie, tendo como padrão de referência o teste de microdureza seccional. Foram utilizados 53 dentes terceiros molares hígidos, os quais tiveram as coroas seccionadas para obtenção de 210 amostras. Para avaliar as possíveis alterações sofridas por cada amostra, essas foram examinadas através da técnica de OCT no início do experimento e novamente examinadas após o término do período de ciclagem estabelecido para cada grupo, utilizando os coeficientes de atenuação óptica total e o cálculo de área em gráficos de intensidade de sinal de OCT, como parâmetros de análise. Posteriormente, as amostras foram submetidas a testes de microdureza seccional. A diferença entre os coeficientes de atenuação óptica obtidos antes e depois da ciclagem de pH apresentou elevado grau de correlação com os resultados de microdureza seccional. Por meio da análise das áreas provenientes de gráficos de intensidade de sinal de OCT e microdureza Knoop, ambos em função da profundidade, foi observada relação de linearidade entre os resultados e elevada correlação entre as técnicas avaliadas (&rho; = 0,99). De acordo com os resultados, a técnica de OCT foi capaz de detectar diferentes graus de desmineralização do esmalte dental humano em lesões simuladas de cárie. / The detection of carious lesions in early stages enables treatment choose based on dental structure preservation. This way, the utilization of exams capable of early diagnosis of these lesions, like OCT (Optical Coherence Tomography), is appropriate. Therefore, the objective of this work was to assess the capability of OCT in quantifying the enamel demineralization stages during the development of simulated caries lesions, having as reference standard the sectional microhardness test. There were used 53 sound third molars, which had their crowns sectioned to obtain 210 samples. To assess possible changes in each sample, these were examined by the OCT technique in the beginning of the experiment and again in the end of the cycling period established to each group, using the total optical attenuation coefficient and the area calculations using OCT signal intensity as analysis parameters. After that, the samples were submitted to sectional microhardness test. The difference between optical attenuation coefficients taken before and after the pH cycling, showed a high level of correlation with the microhardness results. Through areas analysis of OCT signal intensity and Knoop microhardness against depth, it was observed linearity relation between results and high correlation among assessed techniques (&rho;=0,99). According to the results, the OCT technique was capable of detecting different degrees of demineralization of the human enamel in carious simulated lesions.

Este trabalho teve como objetivo comparar parâmetros nutricionais com presença de cárie e condição clínica periodontal entre grupos de adolescentes com e sem obesidade atendidos nas Clínicas de Nutrição e Odontologia da Faculdade São Lucas, Porto Velho- RO. O estudo foi transversal, do tipo caso- controle. Foram incluídos indivíduos entre dez e 19 anos de idade, de ambos os gêneros, previamente avaliados quanto ao estado nutricional (Índice de massa corporal IMC de peso para estatura, soma das dobras cutâneas triciptal e subescapular e inquérito de freqüência alimentar), foram alocados nos seguintes grupos: eutróficos (entre percentil 15 e 85 para IMC) e obeso (acima do percentil 85 para IMC e dobras cutâneas), sendo 18 indivíduos em cada grupo. Foram determinados o CPO-D, os índices de controle de placa e de sangramento gengival bem como valores de profundidade de sondagem e nível clínico de inserção em toda a boca. Os resultados apresentaram que a obesidade não foi fator diferencial com relação ao índice CPO-D, e que quanto maior o índice CPO-D, menor foi a ingestão de vegetais e maior o consumo de doces. A obesidade também não foi diferencial na ocorrência de periodontite e não houve relação entre a ocorrência de periodontite e os valores dos ICP e ISG. Já o padrão de ingestão alimentar entre os adolescentes positivos e negativos para periodontite demonstra que os grupos têm ingestão semelhante de proteínas e carboidratos complexos, porém em relação à ingestão de vegetais e doces (carboidratos simples), ocorre variação importante. O grupo positivo para periodontite faz ingestão bem menor de vegetais e maior de doces do que o grupo negativo para a periodontia. Conclui-se que não houve relação entre obesidade e doença periodontal, assim com não houve relação do ICP e ISG com a periodontite, que a doença periodontal foi mais presente em jovens com idade a partir de 15 anos; houve uma relação dignificante entre a baixa ingestão de vegetais e alta ingestão de doces (carboidratos simples) tanto com a o quadro clínico de periodontite, como para um alto índice CPO-D e que A orientação nutricional para uma alimentação saudável, medidas de higiene oral adequadas podem prevenir o aparecimento ou o agravamento das doenças bucais. / This search had as an objective to compare nutritionals parameters with caries presence and periodental clinicals condition among teens groups and without obesity taken care in the Nutritions Clinics and Dentistry at São Lucass college in Porto Velho-Ro. The study was transversal, which means that each case has been controlled. They had been put individuals between ten to 19 years old in both kind, previously evaluated how much to the nutritional state (IMC of weight for each stature, the add of the cutaneous triciptal and to subscapular and alimentary frequencys inquiry), they had been placed in the following groups: eutróficos (between percentile 15 to 85 for IMC) and obese (above of percentile 85 for IMC and cutaneous folds), being 18 individuals in each group. The CPO-D, the indices of teeths matters and gingival bleed as well as values of depth of sounding and clinical level of insertion in all the mouth. The results had presented that the obesity was not the main differential related to index CPO-D, and that the bigger the CPO-D, less was the ingestion of vegetable ingestion and the biggest absorption of candy. The obesity also was not the main differential in the periodontitis occurrence and it did not have relation to the occurrence of periodontitis and the values of ICP and ISG. But the standard of alimentary ingestion between the positive and negative adolescents for periodontite demonstrates that the groups have similar protein ingestion and complex carbohydrate, however in relation to the ingestion of vegetables and candies (simple carbohydrate), it occurs important variation. The positive group for periodontitis ingest less vegetable and much candies than the other group, the negative one.Which can be concluded that it did not have relation between obesity and periodontal illness, also did not have relation of ICP and ISG with the periodontitis, and the periodontal illness was more present in teens from15 years old; it had a significant related to a low vegetable ingestion and a high candy ingestion (simple carbohydrate) in such a clinical chart of periodontitis, as for one high index CPO-D and that the nutritional orientation for a healthful feeding, and verbal hygiene can prevent the appearance or the aggravation of the buccal illnesses.

La canneberge (Vaccinium macrocarpon) et ses produits dérivés renferment de fortes teneurs en composés phénoliques qui sont reconnus pour leurs bienfaits sur la santé buccodentaire. Cependant, la richesse en acides organiques du jus de canneberge lui confère une faible palatabilité et peut provoquer des effets secondaires indésirables. Le procédé d'électrodialyse avec membrane bipolaire (EDMB) permet le retrait sélectif des acides organiques du jus, et la production d'un jus pouvant être consommé sans dilution préalable. Ainsi, le projet de recherche visait à évaluer l'effet de la désacidification du jus de canneberge par EDMB sur les facteurs étiologiques des deux principales infections buccodentaires, soit la carie dentaire et la parodontite. À cet égard, les propriétés antibactériennes des jus brut et désacidifiés ont été évaluées vis-à-vis des colonisateurs primaires des tissus dentaires (Streptococcus gordonii, Streptococcus oralis, Streptococcus salivarius), des streptocoques cariogènes (Streptococcus mutans, Streptococcus sobrinus) et des bactéries parodontopathogènes clés (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis). De même, l'impact de la désacidification du jus de canneberge sur les défenses de l'hôte (la barrière épithéliale gingivale et la réponse immunitaire) a été évalué dans des modèles in vitro. Les résultats de ces travaux ont montré que le retrait des acides organiques du jus de canneberge diminue ses propriétés bactéricides contre certaines espèces bactériennes à l'étude. Cependant, consommer un jus désacidifié plutôt qu'un jus brut dilué pourrait diminuer l'adhésion des bactéries aux tissus buccodentaires. D'autre part, la désacidification du jus a préservé l'intégrité de la barrière épithéliale gingivale comparativement au produit brut. Néanmoins, bien que les jus de canneberge non dilués aient démontré des propriétés anti-inflammatoires, ces dernières sont réduites suite à la désacidification du produit. Les résultats indiquent que la désacidification modérée du jus de canneberge par EDMB représente une stratégie prometteuse pour la production d'un jus favorisant le maintien d'une bonne santé buccodentaire. / The high content in phenolic compounds found in cranberry (Vaccinium macrocarpon) is associated with well-known beneficial effects on oral health. However, cranberry juice (CJ) is rich in organic acids, which are responsible for the low palatability of the product and can cause gastrointestinal discomfort. Electrodialysis with bipolar membrane (EDBM) is an ecoefficient process that can be used for the deacidification of CJ, thus removing the requirement to dilute the product prior to consumption. This study aimed to evaluate how the deacidification of CJ by EDBM impacts its effects against the etiological factors of dental caries and periodontitis. The antibacterial activities of the raw and deacidifed CJ samples were assessed on commensal streptococci (Streptococcus gordonii, Streptococcus oralis, Streptococcus salivarius), cariogenic streptococci (Streptococcus mutans, Streptococcus sobrinus), and key periodontopathogenic bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis). Moreover, the impact of CJ deacidification on the host oral defenses (oral epithelial barrier function and host inflammatory response) was investigated in in vitro models. It appears from the results that removing organic acids from the product reduced the bactericidal activities of CJ against some bacterial species included in the study, though it should be noted that deacidified CJ had generally higher anti-adherence properties compared to its raw diluted counterpart. On the other hand, deacidification of CJ helped preserve the integrity of the oral epithelial barrier compared to the raw beverage. However, even though all undiluted CJ samples exerted anti-inflammatory properties, exposition to deacidified CJ appears to lower this property in an oral epithelial cell model. Overall, this work brought evidence that a moderate deacidification of CJ by EDBM could allow the production of cranberry juice that provides benefits with respect to the maintenance of oral health.

La canneberge (Vaccinium macrocarpon) et ses produits dérivés renferment de fortes teneurs en composés phénoliques qui sont reconnus pour leurs bienfaits sur la santé buccodentaire. Cependant, la richesse en acides organiques du jus de canneberge lui confère une faible palatabilité et peut provoquer des effets secondaires indésirables. Le procédé d'électrodialyse avec membrane bipolaire (EDMB) permet le retrait sélectif des acides organiques du jus, et la production d'un jus pouvant être consommé sans dilution préalable. Ainsi, le projet de recherche visait à évaluer l'effet de la désacidification du jus de canneberge par EDMB sur les facteurs étiologiques des deux principales infections buccodentaires, soit la carie dentaire et la parodontite. À cet égard, les propriétés antibactériennes des jus brut et désacidifiés ont été évaluées vis-à-vis des colonisateurs primaires des tissus dentaires (Streptococcus gordonii, Streptococcus oralis, Streptococcus salivarius), des streptocoques cariogènes (Streptococcus mutans, Streptococcus sobrinus) et des bactéries parodontopathogènes clés (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis). De même, l'impact de la désacidification du jus de canneberge sur les défenses de l'hôte (la barrière épithéliale gingivale et la réponse immunitaire) a été évalué dans des modèles in vitro. Les résultats de ces travaux ont montré que le retrait des acides organiques du jus de canneberge diminue ses propriétés bactéricides contre certaines espèces bactériennes à l'étude. Cependant, consommer un jus désacidifié plutôt qu'un jus brut dilué pourrait diminuer l'adhésion des bactéries aux tissus buccodentaires. D'autre part, la désacidification du jus a préservé l'intégrité de la barrière épithéliale gingivale comparativement au produit brut. Néanmoins, bien que les jus de canneberge non dilués aient démontré des propriétés anti-inflammatoires, ces dernières sont réduites suite à la désacidification du produit. Les résultats indiquent que la désacidification modérée du jus de canneberge par EDMB représente une stratégie prometteuse pour la production d'un jus favorisant le maintien d'une bonne santé buccodentaire. / The high content in phenolic compounds found in cranberry (Vaccinium macrocarpon) is associated with well-known beneficial effects on oral health. However, cranberry juice (CJ) is rich in organic acids, which are responsible for the low palatability of the product and can cause gastrointestinal discomfort. Electrodialysis with bipolar membrane (EDBM) is an ecoefficient process that can be used for the deacidification of CJ, thus removing the requirement to dilute the product prior to consumption. This study aimed to evaluate how the deacidification of CJ by EDBM impacts its effects against the etiological factors of dental caries and periodontitis. The antibacterial activities of the raw and deacidifed CJ samples were assessed on commensal streptococci (Streptococcus gordonii, Streptococcus oralis, Streptococcus salivarius), cariogenic streptococci (Streptococcus mutans, Streptococcus sobrinus), and key periodontopathogenic bacteria (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis). Moreover, the impact of CJ deacidification on the host oral defenses (oral epithelial barrier function and host inflammatory response) was investigated in in vitro models. It appears from the results that removing organic acids from the product reduced the bactericidal activities of CJ against some bacterial species included in the study, though it should be noted that deacidified CJ had generally higher anti-adherence properties compared to its raw diluted counterpart. On the other hand, deacidification of CJ helped preserve the integrity of the oral epithelial barrier compared to the raw beverage. However, even though all undiluted CJ samples exerted anti-inflammatory properties, exposition to deacidified CJ appears to lower this property in an oral epithelial cell model. Overall, this work brought evidence that a moderate deacidification of CJ by EDBM could allow the production of cranberry juice that provides benefits with respect to the maintenance of oral health.

Les manifestations orales de la maladie de Crohn sont bien établies chez les adultes. Toutefois, aucune étude ne s’est concentrée sur les manifestations orales pathologiques chez la population infantile. En ce qui concerne la santé dentaire, très peu d’études ont évalué la prévalence de carie chez les patients atteints de la maladie de Crohn. Les objectifs de cette étude sont de décrire les manifestations orales des enfants et des adolescents atteints de la maladie de Crohn et tout lien possible avec le stade de la maladie (active ou rémission) ainsi que de déterminer s’il existe un lien entre la prévalence de carie et le score de potentiel cariogène de la diète des patients. Hypothèses • Les manifestations buccodentaires décrites chez les adultes sont présentes chez les enfants et adolescents du groupe de Ste-Justine. • Il existe différentes manifestations propres à la population infantile. • L’indice carieux des enfants atteints de la maladie de Crohn est supérieur à celui des enfants en bonne santé. • L’indice de potentiel cariogène est élevé chez les patients atteints de la maladie de Crohn • Le stade de la maladie influence la prévalence des manifestations. Méthodologie Un certificat d’éthique à la recherche fut obtenu de l’hôpital Ste-Justine. Sur 40 patients recrutés, 21 sujets (9 filles, 12 garçons) âgés de 5,1 à 17,3 ans ont participé à l’étude de type transversale. Un questionnaire médical, un examen buccal complet, l’analyse des journaux alimentaires ainsi qu’une revue des dossiers médicaux a permis d’établir la prévalence des lésions pathologiques, la prévalence de carie (indice CAO) et le score de potentiel cariogène (SPC) selon la méthode du Dre Monique Julien. Résultats Les analyses statistiques démontrent: • Aucune différence significative entre le CAO des patients atteints de la maladie et celui du groupe contrôle. • Aucune manifestation orale autre que celles présentées dans la littérature. • 57% des patients ont rapporté avoir eu des ulcères buccaux au cours de la maladie. • Les patients en phase active ne sont pas différents de ceux en rémission en ce qui concerne les manifestations orales, le CAO et le SPC. • Les enfants qui prennent du méthotrexate ont un CAO plus élevé. • Les patients qui ont plus de caries n’ont pas nécessairement une diète plus cariogène. Conclusion Selon les résultats de notre étude, nous n’avons pas observé de manifestations orales propre à la population infantile. De plus, les enfants atteints de la maladie ne semblent pas être un groupe à risque de carie dentaire. Davantage d’études sont nécessaires sur les manifestations orales de la maladie de Crohn chez la population pédiatrique. / Oral manifestations of Crohn’s disease are well documented in adults. However, no studies have investigated the oral manifestations of this condition in children and adolescents. Regarding oral health, only a few studies have evaluated the prevalence of dental caries in these patients. The objectives of this study are to describe the oral manifestations of Crohn’s disease in children and establish a link between the state of the disease (active and in remission) with the prevalence of dental caries and the cariogenicity of the diet of these children. Hypotheses • The oral manifestations described in adults are present in children and adolescents of the Ste-Justine group. • There are different oral manifestations in children. • Children with Crohn’s disease have more dental caries than children in good health. • The cariogenicity index of the diet is high in patients with Crohn’s disease • The state of the disease has an effect on the prevalence of the oral manifestations. Methodology An ethic’s certification was obtained from Ste-Justine Hospital. Of 40 recruited patients, 21 patients (9 girls, 12 boys) ranging in age from 5.1 to 17.3 years of age participated in our transversal study. A medical history, a complete oral exam, a diet analysis and a review of the medical chart gave us the opportunity to record the presence of oral manifestations, the prevalence of dental caries (DMFT) and the cariogenicity score (SPC). The DMFT of Crohn’s disease patients was compared with the DMFT of Quebec children establish in the Dr. Brodeur epidemiological study conducted in 1996. The patients were also divided into two groups according to the state of the disease (active or remission) to evaluate if it affected the prevalence of oral lesions, the DMFT and the SPC. Results The statistics show : • No significant difference between the DMFT of Crohn’s disease patients and the control group. • No oral manifestations other than those published in the adult literature. • 57% of patients reported to have ulcers at some time during the disease • The patient in the active phase is not different then those in remission ones regarding oral manifestations, DMFT and SPC. • Children taking methotrexate have a higher DMFT • Patients with a higher DMFT do not necesserarily have a higher SPC Conclusion The results of our study do not demonstrate any new oral manifestations in Crohn’s disease in children that have not already been described in adults. In addition, children with Crohn’s disease do not seem to be at high risk for dental caries. Further studies are necessary on the oral manifestations of Crohn’s disease in the pediatric population.

A obesidade e a síndrome metabólica têm aumentado em proporções preocupantes em nível mundial. Além das consequências sistêmicas, a obesidade e suas comorbidades também têm sido relacionadas com a condição bucal. O objetivo deste estudo foi identificar a progressão de lesões cariosas, presença de biofilme dentário, fluxo salivar e presença de saburra lingual em indivíduos eutróficos, sendo avaliados em dois momentos e portadores de síndrome metabólica antes e após a cirurgia bariátrica. A amostra foi constituída por 150 indivíduos, divididos em dois grupos: grupo controle (GC: 75) e grupo obeso (GO: 75), ambos avaliados em T0 e T1, sendo GC 6 meses após a primeira avaliação e GO 6 meses após a cirurgia bariátrica. A avaliação antropométrica dos indivíduos foi realizada por meio do IMC e circunferência da cintura. Os índices ICDAS II e CPOD foram utilizados para avaliar a progressão da cárie dentária. O método de fluorescência verde (QLF- Quantitative Light-induced Fluorescence) avaliou a perda mineral nas superfícies lisas dos dentes e presença de biofilme dentário. O fluxo salivar estimulado foi avaliado em mL/min. O Índice de Saburra Lingual foi utilizado para a avaliação da presença de saburra na língua. Para análise estatística, utilizou-se os testes Qui Quadrado, Exato de Fisher, Mann-Whitney, Kruskal-Wallis e Regressão Logística Múltipla, adotando nível de significância de 5%. Os resultados mostraram que houve diferença significativas entre os grupos, GC apresentou maior número de dentes hígidos (p=0,038) e dentes sem alteração no esmalte (p=0,005) quando comparado ao GO. Ao comparar GC e GO no T1, verificou-se que houve diferença significativa em relação ao CPOD (p<0,0001), dentes restaurados (p<0,0001) e área da lesão (Ws) (p=0,045), sendo as piores condições encontradas encontradas em GO. Observou-se que houve diferença significativa entre a perda mineral e quantidade de biofilme dentário por fluorescência entre os grupos, mas não entre T0 e T1. Diante dos resultados, podese concluir que indivíduos portadores de síndrome metabólica, comparado com os eutróficos, apresentam maior número de lesões cariosas antes e após a cirurgia bariátrica. No presente estudo a cirurgia bariátrica não interferiu na progressão das lesões cariosas, todavia, destaca-se a necessidade de abordagem multiprofissional e contínua, atuando na prevenção de doenças e atenção odontológica. / Obesity and the metabolic syndrome have increased in alarming proportions at world level. Apart from systemic consequences, obesity and its comorbidities have also been related to the oral condition. The aim of this study was to identify the caries lesion progression, presence of dental biofilm, the salivary flow and tongue coating in eutrophic individuals, being evaluated in two moments and individuals with metabolic syndrome before and after undergoing bariatric surgery. The sample consisted of 150 individuals divided into two groups: Control Group (CG: 75) and Obese Group (OG): 75, both evaluated in T0 and T1; CG being evaluated six months after T0, and EG, 6 months after bariatric surgery. Anthropometric assessment of individuals was made by means of BMI and waist circumference measurement. The ICDAS II and DMFT indices were used for evaluating the progression of dental caries. The Quantitative Light-induced Fluorescence (QLF) method, for evaluating mineral loss on the smooth tooth surfaces and the presence for dental biofilm. The stimulated salivary flow was evaluated in mL/min. The Winkel tongue coating index (WTCI) was used to evaluate the presence of tongue coating. For statistical analysis, the Chi- Square, Fishers Exact, Kruskal-Wallis and Multiple Logistic Regression tests were used, adopting a significance level of 5%. The results showed statistical difference between the groups: CG presented a higher; number of healthy teeth (p=0.038) and teeth without changes in enamel (p=0.005) when compared to OG. When comparing CG and EG after the second evaluation (T1), statistically significant difference was verified in relation to DMFT (p<0.0001), restored teeth (p<0.0001) and lesion area (Ws) (p=0.045), being the worst conditions found in OG. It was observed that there was a significant difference between mineral loss and the quantity dental biofilm by fluorescence between groups, but not between T0 and T1. In view of the results, the authors concluded that patients with metabolic syndrome, compared to eutrophic, have a higher number of caries lesions before and after bariatric surgery. In the present study, bariatric surgery did not influence in caries lesion progression, however, highlights the necessity to a continuous multi professional approach to acting in the prevention of diseases and dental care.

Esta pesquisa in vitro, avaliou comparativamente a acurácia do diagnóstico do método radiográfico digital com o método radiográfico convencional, na detecção de lesões de cárie oclusal em molares decíduos. O material foi composto por 55 dentes posteriores decíduos, que apresentavam pigmentações e pelo menos um sítio suspeito de lesão de cárie oclusal, sem restaurações e superfícies sem selantes. As radiografias digitais foram executadas com o sistema Dixi3 (Planmeca, Helsink, Finland) e as radiografias convencionais com o filme Insight (Kodak Eastman Co., EUA), ambas de modo padronizado, em idênticas condições geométricas. As imagens foram avaliadas individualmente por três radiologistas, em ideais condições de interpretação radiográfica e sem acesso aos recursos de manipulação de imagens do sistema digital. Os achados foram classificados de acordo com o seguinte critério: 0 - ausência de radiolucidez no esmalte, 1- radiolucidez confinada ao esmalte, 2- radiolucidez no esmalte até o limite dentina-esmalte, 3- radiolucidez no esmalte e na metade mais externa da dentina, 4- radiolucidez no esmalte alcançando a metade mais interna da dentina. O padrão ouro foi obtido pelo estudo histológico. Os dados foram analisados através do teste de Freidman (P <= 0,05). Os resultados obtidos com os filmes radiográficos convencionais foram similares aos resultados obtidos com as radiografias digitais diretas e o padrão ouro, porém os resultados obtidos com o sistema radiográfico digital foram significativamente menores que o histológico. Nas condições deste estudo, concluímos que o método de radiografia digital subestimou a extensão das lesões de cárie oclusal em molares decíduos. / This in vitro research, evaluated the accuracy of the direct digital radiographic method compared to the conventional radiographic method in the analysis of the extension of occlusal carious lesions in primary molars. The material was composed by 55 primary molars presenting pigmentation and, at least, one suspect site of occlusal carious lesion, these teeth had neither restoration nor surfaces with sealant. Digital radiographs were obtained with the Dixi3 system (Planmeca, Helsink, Finland) and the conventional radiographs with the Insight film (Kodak Eastman Co., USA), both in standard form and identical geometrical conditions. The images were evaluated individually by three radiologists, in ideal conditions for radiographic interpretation and with no access to the resources of imaging manipulation from the digital system. The results were rated according to the following criteria: 0 - absence of radiolucence in the enamel: 1 - radiolucence confined to the enamel, 2 - radiolucence in the enamel to the limit dentine-enamel, 3 - radiolucence in the enamel and in the half outer part of the dentine, 4 - radiolucence in the enamel reaching to the half inner part of the dentine. The gold standard was obtained by histological study. Data were compared by the Friedman`s test (P <= 0.05). The results obtained with the conventional radiographic films were similar to those obtained with both direct digital radiographs and gold standard; however, the results obtained with the digital radiographic system were significantly lower than those observed in the histological analysis. In the conditions of this study, it was concluded that the direct digital radiographic method significantly underestimate the extension of the occlusal caries lesions in primary molars.

Made available in DSpace on 2017-07-24T19:22:28Z (GMT). No. of bitstreams: 1 Flavia Tanaka.pdf: 954441 bytes, checksum: 2a9a2dd535c25850feca5625419095e5 (MD5) Previous issue date: 2004-07-06 / In order to contribute to the epidemiological surveillance process and indeed to diagnose the real condition of oral health of public school children in the city of Maringá, Parana State, Brazil, it was conducted this research. The prevalence of dental caries was evaluate using systematic random sample which was constituted by 610 subjects, both genders, living in the urban cluster.The methodology was based on the SB Brazil Project – Conditions of Buccal Health of the Brazilian Population. It was used diagnosis criteria of the World Health Organization (WHO), which included permanent and deciduous teeth. The Kappa Test indicated concordance in two levels (good and very good) inter and intra examiners. The mean dmf-t and DMF-T indexes were 1,8 and 1,5, respectively. The decay mean present in decayed deciduous teeth higher (1,0) than in filled tooth (0,7), while referring to permanent teeth, the filled teeth presented higher (1,1) than the decayed teeth (0,4). The lost component “M” was not significant in both ages and revealed a positive tendency of the odontological services in maintaining permanent and deciduous teeth. At 6 years, 47,7% of children (30,8% dmf-t index of 1 to 3, 17,3% of 4 to 7 and 4,3% higher numbers) and at 12 years, 50% of children (33,2% with DMF-T index of 1 to 3, 21,6% of 4 to 7 and 2,1 higher numbers) were caries free. When the polarization phenomenon was confirmed, 21,6% and 23,7% of school children concentrated major rates of disease. At 12 years, the children presented a statistically significant difference (p<0.05) among genders, where boys presented superior DMF-T index. The comparison of the dental decay distribution between municipal and state schools did not identified statistically significant differences in the dmf-t index, but on the contrary, this differences were observed to DMF-T index .The comparison of the results in this study with epidemiological researches made in the same city in previous years (1991 and 1994), showed an effective reduction in the decay prevalence to 12 years children, although at 6 years old this same prevalence was not observed. It was concluded the oral health of school children of this evaluated sample is in accordance to the objectives proposed by the World Health Organization to the year of 2000, presenting low prevalence of decay and the continuity of the educational and prevention programs is essential to reach the projected goals to the year of 2010. / Visando contribuir com o processo de vigilância epidemiológica e conhecer as reais condições de saúde bucal de escolares de ensino público do município de Maringá, Paraná, Brasil, conduziu-se esta pesquisa. A prevalência de cárie foi avaliada em uma amostra sistemática constituída de 610 crianças de 6 e 12 anos de idade, de ambos os sexos, residentes na zona urbana. A metodologia empregada baseou-se no Projeto SB Brasil – Condições de Saúde Bucal da População Brasileira, incluindo-se a avaliação clínica de dentes decíduos e permanentes de acordo com os critérios de diagnóstico preconizados pela Organização Mundial da Saúde (OMS). O teste Kappa indicou boa e ótima concordância inter e intra examinadores. O ceo-d e o CPO-D médio foram iguais a, respectivamente, 1,8 e 1,5. Nos dentes decíduos, observou-se que a média de dentes decíduos cariados (1,0) predominou sobre a de obturados (0,7), ao passo que nos dentes permanentes, a média do componente obturado (1,1) predominou sobre a do cariado (0,4). A participação pouco expressiva do componente perdido “P”, nas duas idades revelou uma tendência positiva dos serviços odontológicos quanto à preservação de ambas dentições. Encontravam-se livres de cárie, aos 6 anos de idade, 47,7% das crianças (30,8% com ceo-d de 1 a 3, 17,3% de 4 a 7 e 4,3% com valores maiores) e aos 12 anos, 50,0% (33,2% com CPO-D de 1 a 3, 21,6% de 4 a 7 e 2,1% com valores maiores). Confirmando o fenômeno da polarização, 21,6% e 23,7% dos escolares concentraram as maiores taxas da doença. Aos 12 anos, houve diferença estatisticamente significante (p<0,05) na ocorrência de cárie entre os sexos, sendo esta superior para os meninos. Comparando-se a distribuição da cárie dentária entre escolas municipais e estaduais não foram identificadas diferenças estatisticamente significantes ao se analisar o índice ceo-d, porém estas foram observadas focando-se o índice CPO-D. A comparação dos resultados deste estudo com os obtidos em levantamentos epidemiológicos realizados no mesmo município, em anos anteriores (1991 e 1994), mostrou uma efetiva redução na prevalência de cárie para a idade de 12 anos, contudo, aos 6 anos esta mesma tendência não pôde ser observada. Conclui-se que a saúde bucal dos escolares pertencentes à amostra analisada está de acordo com as metas preconizadas pela OMS para o ano 2000, havendo o registro de baixa prevalência da doença cárie e que a continuidade de programas educativos e preventivos são fundamentais para se alcançar os novos objetivos propostos para o ano 2010.