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Dental caries is a multifactorial, bacterial, chronic infection that affects millions of people in the world and has become a public health problem. Also referred to as tooth decay, this disease is one of the most common disorders throughout the world, second only to the common cold. Dental caries is the most common chronic childhood disease in the United States and is 5 to 7 times more common than asthma. According to the World Oral Health Report in 2003, dental caries affect 60-80% of school children and a vast majority of adults. Dental caries is a chronic bacterial infection of the hard tissue of the tooth that is characterized by alternating phases of demineralization and remineralization. Dental decay can lead to significant pain and dysfunction that can interfere with basic functions such as eating, sleeping, and speaking. If left untreated, dental caries can result in cavities forming and eventually tooth loss. Although the prevalence and severity of dental caries has decreased over the years, this disease can be better controlled with proper fluoride exposure. Fluoride therapy has become the cornerstone strategy in the prevention of dental caries development and progression. With fluoride being available in various forms, fluoride exposure and/or treatment has greatly increased and has led to decreased incidences of dental caries. Fluoride has the ability to control the initiation and progression of carious lesions, mainly through the promotion of remineralization and the reduction in tooth enamel demineralization. Whether administered systemically or topically, the use of fluoride has proven to be effective in reducing the prevalence of dental caries. The aim of this review is to compare the topical methods of fluoride therapy with systemic applications. The goal is to evaluate the various forms of fluoride treatments based on cost effectiveness, safety, concentration and dosage of fluoride, ease of application, and accessibility to the community. This review will also identify the populations that are most susceptible to dental caries. The purpose of this review is to examine the benefits and risks of the various options of fluoride treatments in order to determine which would be the most the effective, safe, and efficient means of preventing dental caries in high risk populations. Based on the literature review, it was determined that the populations with the greatest risk for dental caries comprised of young children who were from lower socioeconomic backgrounds and elderly adults over the age of 65. After comparing the various forms of fluoride therapies, it was found that systemic fluoride treatments, mainly water fluoridation, would be the most effective in preventing dental caries in high caries risk populations.

In the United State today, many people do not have access to adequate dental treatment, while tooth decay is the single most common chronic childhood disease-five times more common than asthma and seven times more common than hay fever. At the same time, studies show that 80% of dental illness takes place in 25% of the population, which is comprised mostly of lower socioeconomic groups. A study undertaken by the National Health and Nutrition Examination Survey in 2000, concludes that poor children suffer five times as much tooth decay as their more affluent peers. Furthermore, in poor children with tooth decay, almost 80% remain untreated. Poor dental health there-fore is a major health concern for under privileged families.The goal of this project is to enhance and facilitate the delivery of better dental treatment by designing a new prototype for a portable dental office that will be more flexible and more usable in a variety of situations and locations. For the purpose of this study, this prototype will be considered or tested within the context of three different types of spaces: the single closed room; a large open public space; and within mobile and nonpermanent structures such as tents. Several aspects of working conditions specific to the dental office will be taken into account when developing this design including transportability, degree of flexibility, storability, hygiene, and the creation of a relaxing atmosphere all of which greatly impact both the dentists and patients experience and are essential to the creation of a successful portable dental office.

A obesidade e a cárie dentária são problemas de saúde pública, que atingem a população infantil. O objetivo deste estudo foi identificar a prevalência de cárie dentária e relacioná-la com a concentração da enzima anidrase carbônica VI, do íon cálcio, fluxo salivar e quantidade de biofilme dentário em crianças com sobrepeso/obesidade. Foram avaliadas 112 crianças de 4 a 6 anos de idade, de ambos os gêneros. A análise antropométrica foi realizada (percentil do IMC) e através dessa análise as crianças foram divididas em dois grupos: G1 sobrepesos/obesos (n=41) e G2 normais (n=71). Os exames bucais realizados para a cárie dentária foram os índices ceo-s e ICDAS II, quantidade de biofilme dentário pelo Índice de Placa de Turesky e volume de fluxo salivar estimulado. A concentração do íon Cálcio na saliva foi analisada pelo kit colorimétrico e da enzima Anidrase Carbônica VI pelo kit ELISA. Na sequência, as crianças de cada grupo foram divididas em 3 subgrupos: LC (livres de cárie), LI (com lesões iniciais) e C (com cárie). Os testes Wilcoxon, Mann-Whitney, teste t e correlação de Spearman foram aplicados (p<0,05). Não houve diferença significativa no ceo-s entre os grupos. Houve maior concentração média de cálcio salivar no G1 (G1=2847,96mM; G2=1230,90mM;p=0,001) e maior concentração da Anidrase Carbônica VI no G2 (G1=3455,18 pg/mL; G2=442428,9pg/mL;p=0,000). No G1 houve correlação negativa entre o ceo-s e íon Cálcio (r=-0,444;p=0,010). Já no G2, houve correlação negativa entre placa e a Anidrase Carbônica VI (r=-0,551;p=0,014). Pode-se concluir que o íon cálcio é fator protetor para cárie dentária em crianças. Já a anidrase carbônica VI parece não ser biomarcador para a cárie dentária. / Obesity and dental caries are public health problems that affect the child population. The aim of this study was to identify the prevalence of dental caries and relate it to the concentration of the enzyme carbonic anhydrase VI, calcium ion, salivary flow, and dental plaque in overweight/obesity children. The study was conducted on 112 children aged 4-6, of both genders. Anthropometric analysis was performed (BMI percentile) and by this analysis the children were divided into two groups: G1 - overweight/obese (n=41) and G2 - normal (n=71). The oral examinations performed for dental caries were the dmfs and ICDAS II indexes, measurement of the amount of dental plaque by the Turesky Board Index and volume of stimulated salivary flow. The concentration of calcium ion in saliva was measured by a colorimetric kit and the enzyme carbonic anhydrase VI by an ELISA kit. Then, children from each group were divided into three subgroups: CF (caries-free), IL (initial lesions) and D (decayed teeth). The Wilcoxon test, Mann-Whitney, t test and Spearman correlation (p<0.05) were applied. There was no significant difference in the dmfs between groups. There was higher concentration of salivary calcium in G1 (G1=2847.96mM; G2=1230.90mM; p=0.001), and higher concentration of carbonic anhydrase VI in G2 (G1 = 3455.18 pg/ml; G2 = 442428.9pg/ml; p = 0.000). In G1, there was negative correlation between dmfs and salivary calcium (r = -0.444; p = 0.010). In G2, there was negative correlation between dental plaque and carbonic anhydrase VI (r=-0.551; p=0.014). It can be concluded that the calcium ion is a protective factor for dental caries in children. The carbonic anhydrase VI does not seem to be a biomaker of dental caries.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-05-15T17:07:42Z No. of bitstreams: 1 AnnaVieira.pdf: 2823027 bytes, checksum: fce49db1d19b8bbf99ab34a0e9eaef9a (MD5) / Made available in DSpace on 2017-05-15T17:07:42Z (GMT). No. of bitstreams: 1 AnnaVieira.pdf: 2823027 bytes, checksum: fce49db1d19b8bbf99ab34a0e9eaef9a (MD5) Previous issue date: 2016-11-30 / Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (FAPEMA) / Untreated oral disease may compromise the health of the pregnant woman and her baby. Thus, studies aimed at understanding all the factors that influence the prevalence of tooth decay in pregnant women, as well as the reflection of the disease in pregnancy, are essential for planning strategies of health promotion and prevention in oral health. This Thesis studied aspects related to dental caries in women in the immediate postpartum period, based on data from the Multicenter Geravida Project, giving rise to two original articles. The first item is listed in Chapter I of this work and it is entitled: "Hyperglycemia and factors associated with dental caries during pregnancy." The objective of this work was to study, retrospectively, in women in the immediate postpartum period, the factors associated with dental caries in pregnancy, and verify if mothers with hyperglycemia have more tooth decay than those with normal blood glucose. The sample included 297 women. Caries was recorded as present when a lesion of fossa, fissure or smooth surface had an obvious cavity, undermined enamel, or a detectable softening of the floor or walls. The restored teeth that had one or more areas with carious lesions were considered decayed. It was recorded also the restored teeth without decay and lost by decay. The oral biofilm was assessed by visible plaque index, and blood glucose by HbA1c through test. Socioeconomic characteristics of harmful habits and oral health were obtained through structured questionnaires. Women also records the information was collected.The results showed that more than half of mothers (66%) had caries and that is not associated with hyperglycemia in pregnancy (p = 0.386). The model of hierarchical logistic regression showed that the variables maternal education ≤ 8 years of schooling (adjusted OR = 2.40 [CI 1.19 to 4.82]), have previous children (adjusted OR = 1.81 [CI 1, 08-3.03), flossing (adjusted OR = 048 [CI 0.27 to 0.86]) and visible plaque index ≥ 30% (adjusted OR = 1.83 [CI 1.05 to 3, 20]) are associated with the presence of caries in pregnancy. The second work is listed in Chapter II and is entitled, "Maternal dental caries: there is an association with prematurity?" and it aimed to investigate the relationship between dental caries and prematurity. The sample consisted of 279 women in the postpartum, and 91 had premature births and 188 births at term, respecting the proportionality of 1 case 2 controls. Data were collected through questionnaires, information from medical records and intra-oral clinical examination, which covered the dental caries record according to the WHO criteria and visible plaque indexThe results of this study showed that tooth decay is not associated with prematurity (OR = 1.08, p = 0.90). The presence of caries was identified in 62.3% of women with a positive outcome and 62.5% of women with a negative outcome. In addition, this study examined other factors associated with preterm birth, finding that prematurity is associated with maternal education (OR = 2.56, p = 0.010), low birth weight (OR = 12.18 p ˂ 0.001) and hypertension (OR = 2.32, p = 0.019). The results of this Thesis call attention to the high prevalence of tooth decay in pregnant women and the need to understand the factors that influence the mechanisms responsible for this phenomenon. / Doenças bucais não tratadas podem comprometer a saúde da gestante e do seu bebê. Neste sentido, estudos voltados para a compreensão de todos os fatores que influenciam a prevalência da cárie dentária em gestantes, bem como os reflexos da doença na gestação são imprescindíveis para o planejamento de estratégias de promoção e prevenção em saúde bucal. Esta Tese estudou aspectos relacionados à cárie dentária em mulheres no pós-parto imediato, a partir dos dados provenientes do Projeto Multicêntrico Geravida, dando origem a dois artigos originais. O primeiro artigo consta no Capítulo I deste trabalho e tem por título: “Hiperglicemia e fatores associados à carie dentária na gestação”. O objetivo deste trabalho foi estudar, retrospectivamente, em mulheres no pós-parto imediato, os fatores associados à cárie dentária na gestação, e verificar se as puérperas com hiperglicemia apresentam mais cáries dentárias que as com glicemia normal. A amostra totalizou 297 mulheres. A cárie foi registrada como presente quando uma lesão de fóssula, fissura ou de superfície lisa tinha uma cavidade evidente, esmalte socavado, ou um amolecimento detectável do assoalho ou das paredes. Os dentes restaurados que tinham uma ou mais áreas com lesão de cárie foram considerados cariados. Registrou-se também os dentes restaurados e sem cárie e os perdidos por cárie. O biofilme oral foi avaliado por meio do índice de placa visível e a glicose no sangue, através do teste Hb A1c. Características socioeconômicas, de hábitos nocivos e de saúde bucal foram obtidas através de questionários estruturados. Também foram coletadas informações dos prontuários das mulheres. A análise dos resultados mostrou que mais da metade das puérperas (66%) apresentaram lesões de cárie e que esta não está associada à hiperglicemia na gravidez (p = 0,386). O modelo de regressão logística hierarquizado mostrou que as variáveis escolaridade materna ≤ 8 anos de estudo (OR ajustado = 2,40 [IC 1,19 – 4,82]), ter filhos anteriores (OR ajustado = 1,81 [IC 1,08 – 3,03]), uso do fio dental (OR ajustado = 048 [IC 0,27 – 0,86]) e índice de placa visível ≥ 30% (OR ajustado = 1,83 [IC 1,05 – 3,20]) estão associados à presença de cárie na gestação. O segundo trabalho consta no Capítulo II e tem por título: “Cárie dentária materna: existe associação com a prematuridade?” cujo objetivo foi averiguar a relação entre cárie dentária e prematuridade. A amostra foi composta por 279 puérperas, sendo que 91 tiveram partos prematuros e 188 partos a termo, respeitando a proporcionalidade de 1 caso para 2 controles. Os dados foram coletados por meio de questionários, informações dos prontuários e exame clínico intra-bucal, que abrangeu o registro de cárie dentária de acordo com os critérios da OMS e índice de placa visível. Os resultados deste estudo mostraram que a cárie dentária não está associada à prematuridade (OR = 1,08, p = 0,90). A presença de cárie foi identificada em 62,3% das mulheres com desfecho positivo e em 62,5% das mulheres com desfecho negativo. Além da cárie da dentária, este trabalho analisou outros fatores associados com o nascimento prematuro, encontrando associação da prematuridade com a escolaridade materna (OR = 2,56, p = 0,010), o baixo peso ao nascer (OR = 12,18 p ˂ 0,001), e a hipertensão arterial (OR = 2,32, p = 0,019). Os resultados deste trabalho de Tese chamam a atenção para a elevada prevalência de cárie dentária em grávidas e para a necessidade de compreensão dos fatores que influenciam os mecanismos responsáveis por este fenômeno.

Regular development of our teeth is the result of reciprocal induction processes with continual development stages. The non-interrupted development of the organism is the basic precondition of healthy dental tissues. It is, therefore, necessary to be aware of the fact that everybody takes on full responsibility for their own health. If we want to have clean and healthy teeth without tooth ache, oulitis and other problems we must take proper dental care. Tooth decay is the most widespread disease affecting the humankind from of old and proper dental care is, therefore, very important. Deteriorating dental tissues result in tooth decay and have various speed and intensity. Tooth decay affects tooth enamel, get to dental pulp and consequently may cause neuritis the result of which is prolonged pain. In the worst case, abscess may appear. The consequences may become the source of protracted disorders of permanent teeth development. Stomatologists can introduce to us the basics of proper dental care. The first visit at the dentist is recommended before a problem appears. If some problems occur it is necessary to visit the dentist sooner, then the regular preventive exams follow. At least twice a year, we should undergo preventive checkups. Regular monitoring of dental health is important especially for the early identification of undesirable changes in our teeth and gums. Relationship between the dentist and child is also very important. Factors that are important for the prevention of teeth damage are motivation, suitable diet, physical condition, physical education, regular mouth hygiene performed with the use of chemical and mechanical applications. Using of fluoride, changes in life style, suitable eating habits and hygiene habits are also important. If a person develops bad eating habits at a young age the risk tooth decay is becoming more probable. Unhealthy nutrition causes metabolism disorders that result in the increased occurrence of tooth decay and mucosa disease in oral cavity. The nutrition composition is important also for the mineralization and development of hard adenoblasts. Not balanced nutrition leads to the poor development of man and, therefore, to the easier occurrence of the tooth decay. Most serious problems are caused by sugars as bacteria use it as a source, and acids as the subsequent products diminish tooth enamel, dentine or dental pulp. Alcohol, drugs and smoking are counted among other risk factors with negative influence on dentition. Eating disorders are the opposite of healthy and correct eating habits. They are often encountered in diseases connected mainly with lack of appetite. The excessive intake of food occurs especially in obese children. Strengthening of dental tissues resistance, supporting the mineralization process and protection against the bacteria creation is supported by fluorine. For the healthy development of tissues the intake of calcium, phosphor, proteins, minerals and vitamins is important. A very important part of the rational nutrition represent milk and cheese. Pregnant women and nursing mothers especially should follow an appropriate diet. Apart from others consequences, the nutrition structure influences the composition and amount of saliva. Chewing of gum that increases the production of saliva serves also to the teeth cleaning and balances the mouth pH. Chewing can even be better than tooth brushing with toothpaste. Teeth are the symbol of energy and vital force. Poor teeth show lack of immunity and represent the sign of lowering vitality.

Objetivo: o objetivo deste estudo foi avaliar as condições de saúde bucal e a ocorrência de anomalias dentárias em crianças tratadas para leucemia linfoblástica aguda (LLA) no Serviço de Oncologia Pediátrica (SOP) do Hospital de Clínicas de Porto Alegre (HCPA), comparadas com um grupo crianças saudáveis. Amostra: foram selecionadas 56 crianças com diagnóstico de LLA e analisadas as presenças de anomalias dentárias e os índices CPO-D (cariado, perdido, obturado-dente), IPV (índice de placa visível), ISG (índice de sangramento gengival) e fluxo salivar. As crianças tratadas apresentaram uma média de idade, na época do diagnóstico da LLA, de 5,3 ± 2,6, e 11,8 ± 4,2 na avaliação, sendo 32 masculinos e 24 femininos. Os pacientes tratados para LLA foram divididos em três grupos: crianças tratadas somente com quimioterapia, com quimio e radioterapia, e com quimio, radio e transplante de medula óssea. Resultados: os resultados revelaram 80,4% de anomalias dentárias nas crianças tratadas, ou seja, 45 destas apresentaram pelo menos uma alteração, e o grupo de pacientes tratados com quimio, radio e submetidos ao transplante de medula óssea foi o que revelou a maior média de anormalidades dentárias por indivíduo (15,37 ± 15,03), não ocorrendo diferença estatística entre os gêneros. As crianças tratadas para LLA obtiveram CPO-D de 1,9 ± 4,0, ISG de 26,5%, IPV de 72,0%, e índice de fluxo salivar médio de 0,19 mL/min criança. Já o grupo de crianças sadias apresentou CPO-D de 1,52 ± 3,5, ISG de 11,1%, IPV de 53,8% e índice de fluxo salivar médio de 0,27 mL/min. Conclusão: o tratamento para a cura da LLA provoca um aumento significativo no número de anomalias dentárias, sendo mais freqüente nos pacientes menores de cinco anos de idade, principalmente nos pacientes submetidos a quimio e radioterapia associadas ao transplante de medula óssea, o que requer, por parte do cirurgião-dentista, intervenções clínicas diferenciadas e cuidadosas nestes pacientes, tendo-se em vista também os índices aumentados de ISG e IPV. As alterações sofridas pelas glândulas salivares durante o tratamento não são permanentes sob o aspecto do fluxo salivar, que retorna à normalidade. A orientação e o acompanhamento adequados destes pacientes por parte da equipe de saúde bucal podem mantê-los com o índice de CPO-D dentro dos padrões preconizados pela Organização Mundial de Saúde. / Objective: the objective of this research was to evaluate oral health conditions and the occurrence of dental anomalies in children treated for acute lymphoblastic leukemia (ALL) in the Pediatric Oncology Service at Hospital de Clínicas de Porto Alegre (HCPA), in comparison to a healthy children group. Sample: 56 children diagnosed with ALL were selected and the occurrence of dental anomalies and the rates DMF-T (decayed, missing, filled-tooth), RVDP (rate of visible dental plaque), RGB (rate of gingival bleeding) and salivary flow were analyzed. The treated children at the time of the diagnostic for ALL were in the average age of 5,3 ± 2,6, and 11,8 ± 4,2 at the evaluation, with 32 male and 24 female. The patients treated for ALL were divided in three groups: children only treated with chemotherapy, with chemotherapy and radiotherapy, and with chemotherapy, radiotherapy and bone marrow transplant. Results: the results showed 80,4% of dental anomalies in treated children, it means that 45 children had at least one disorder, and the group of patients treated with chemotherapy, radiotherapy and who underwent a bone marrow transplant showed the highest average of dental anomalies per person (15,37 ± 15,03), with no statistic difference concerning gender. The children treated for ALL had DMF-T of 1,9 ± 4,0, RGB of 26,5%, RVDP of 72,0%, and average salivary flow of 0,19 mL/min child. But the healthy children group showed DMF-T of 1,52 ± 3,5, RGB of 11,1%, RVDP of 53,8% and average salivary flow of 0,27 mL/min. Conclusion: the treatment to cure ALL causes a significant increasing in the cases of dental anomalies, mainly in patients under chemotherapy and radiotherapy associated to bone marrow transplant, what requires from the oral surgeon, careful and specific clinical interventions, also considering the increased rates of RGB and RVDP. The disorders in the salivary glands during the treatment are not permanent in what concerns the salivary flow, that becomes normal again. The adequate orientation and care of these patients by the oral health team can keep their DMF-T rates in the patterns ruled by the World Health Organization.

Objetivo: o objetivo deste estudo foi avaliar as condições de saúde bucal e a ocorrência de anomalias dentárias em crianças tratadas para leucemia linfoblástica aguda (LLA) no Serviço de Oncologia Pediátrica (SOP) do Hospital de Clínicas de Porto Alegre (HCPA), comparadas com um grupo crianças saudáveis. Amostra: foram selecionadas 56 crianças com diagnóstico de LLA e analisadas as presenças de anomalias dentárias e os índices CPO-D (cariado, perdido, obturado-dente), IPV (índice de placa visível), ISG (índice de sangramento gengival) e fluxo salivar. As crianças tratadas apresentaram uma média de idade, na época do diagnóstico da LLA, de 5,3 ± 2,6, e 11,8 ± 4,2 na avaliação, sendo 32 masculinos e 24 femininos. Os pacientes tratados para LLA foram divididos em três grupos: crianças tratadas somente com quimioterapia, com quimio e radioterapia, e com quimio, radio e transplante de medula óssea. Resultados: os resultados revelaram 80,4% de anomalias dentárias nas crianças tratadas, ou seja, 45 destas apresentaram pelo menos uma alteração, e o grupo de pacientes tratados com quimio, radio e submetidos ao transplante de medula óssea foi o que revelou a maior média de anormalidades dentárias por indivíduo (15,37 ± 15,03), não ocorrendo diferença estatística entre os gêneros. As crianças tratadas para LLA obtiveram CPO-D de 1,9 ± 4,0, ISG de 26,5%, IPV de 72,0%, e índice de fluxo salivar médio de 0,19 mL/min criança. Já o grupo de crianças sadias apresentou CPO-D de 1,52 ± 3,5, ISG de 11,1%, IPV de 53,8% e índice de fluxo salivar médio de 0,27 mL/min. Conclusão: o tratamento para a cura da LLA provoca um aumento significativo no número de anomalias dentárias, sendo mais freqüente nos pacientes menores de cinco anos de idade, principalmente nos pacientes submetidos a quimio e radioterapia associadas ao transplante de medula óssea, o que requer, por parte do cirurgião-dentista, intervenções clínicas diferenciadas e cuidadosas nestes pacientes, tendo-se em vista também os índices aumentados de ISG e IPV. As alterações sofridas pelas glândulas salivares durante o tratamento não são permanentes sob o aspecto do fluxo salivar, que retorna à normalidade. A orientação e o acompanhamento adequados destes pacientes por parte da equipe de saúde bucal podem mantê-los com o índice de CPO-D dentro dos padrões preconizados pela Organização Mundial de Saúde. / Objective: the objective of this research was to evaluate oral health conditions and the occurrence of dental anomalies in children treated for acute lymphoblastic leukemia (ALL) in the Pediatric Oncology Service at Hospital de Clínicas de Porto Alegre (HCPA), in comparison to a healthy children group. Sample: 56 children diagnosed with ALL were selected and the occurrence of dental anomalies and the rates DMF-T (decayed, missing, filled-tooth), RVDP (rate of visible dental plaque), RGB (rate of gingival bleeding) and salivary flow were analyzed. The treated children at the time of the diagnostic for ALL were in the average age of 5,3 ± 2,6, and 11,8 ± 4,2 at the evaluation, with 32 male and 24 female. The patients treated for ALL were divided in three groups: children only treated with chemotherapy, with chemotherapy and radiotherapy, and with chemotherapy, radiotherapy and bone marrow transplant. Results: the results showed 80,4% of dental anomalies in treated children, it means that 45 children had at least one disorder, and the group of patients treated with chemotherapy, radiotherapy and who underwent a bone marrow transplant showed the highest average of dental anomalies per person (15,37 ± 15,03), with no statistic difference concerning gender. The children treated for ALL had DMF-T of 1,9 ± 4,0, RGB of 26,5%, RVDP of 72,0%, and average salivary flow of 0,19 mL/min child. But the healthy children group showed DMF-T of 1,52 ± 3,5, RGB of 11,1%, RVDP of 53,8% and average salivary flow of 0,27 mL/min. Conclusion: the treatment to cure ALL causes a significant increasing in the cases of dental anomalies, mainly in patients under chemotherapy and radiotherapy associated to bone marrow transplant, what requires from the oral surgeon, careful and specific clinical interventions, also considering the increased rates of RGB and RVDP. The disorders in the salivary glands during the treatment are not permanent in what concerns the salivary flow, that becomes normal again. The adequate orientation and care of these patients by the oral health team can keep their DMF-T rates in the patterns ruled by the World Health Organization.

A obesidade e a cárie dentária são problemas de saúde pública, que atingem a população infantil. O objetivo deste estudo foi identificar a prevalência de cárie dentária e relacioná-la com a concentração da enzima anidrase carbônica VI, do íon cálcio, fluxo salivar e quantidade de biofilme dentário em crianças com sobrepeso/obesidade. Foram avaliadas 112 crianças de 4 a 6 anos de idade, de ambos os gêneros. A análise antropométrica foi realizada (percentil do IMC) e através dessa análise as crianças foram divididas em dois grupos: G1 sobrepesos/obesos (n=41) e G2 normais (n=71). Os exames bucais realizados para a cárie dentária foram os índices ceo-s e ICDAS II, quantidade de biofilme dentário pelo Índice de Placa de Turesky e volume de fluxo salivar estimulado. A concentração do íon Cálcio na saliva foi analisada pelo kit colorimétrico e da enzima Anidrase Carbônica VI pelo kit ELISA. Na sequência, as crianças de cada grupo foram divididas em 3 subgrupos: LC (livres de cárie), LI (com lesões iniciais) e C (com cárie). Os testes Wilcoxon, Mann-Whitney, teste t e correlação de Spearman foram aplicados (p<0,05). Não houve diferença significativa no ceo-s entre os grupos. Houve maior concentração média de cálcio salivar no G1 (G1=2847,96mM; G2=1230,90mM;p=0,001) e maior concentração da Anidrase Carbônica VI no G2 (G1=3455,18 pg/mL; G2=442428,9pg/mL;p=0,000). No G1 houve correlação negativa entre o ceo-s e íon Cálcio (r=-0,444;p=0,010). Já no G2, houve correlação negativa entre placa e a Anidrase Carbônica VI (r=-0,551;p=0,014). Pode-se concluir que o íon cálcio é fator protetor para cárie dentária em crianças. Já a anidrase carbônica VI parece não ser biomarcador para a cárie dentária. / Obesity and dental caries are public health problems that affect the child population. The aim of this study was to identify the prevalence of dental caries and relate it to the concentration of the enzyme carbonic anhydrase VI, calcium ion, salivary flow, and dental plaque in overweight/obesity children. The study was conducted on 112 children aged 4-6, of both genders. Anthropometric analysis was performed (BMI percentile) and by this analysis the children were divided into two groups: G1 - overweight/obese (n=41) and G2 - normal (n=71). The oral examinations performed for dental caries were the dmfs and ICDAS II indexes, measurement of the amount of dental plaque by the Turesky Board Index and volume of stimulated salivary flow. The concentration of calcium ion in saliva was measured by a colorimetric kit and the enzyme carbonic anhydrase VI by an ELISA kit. Then, children from each group were divided into three subgroups: CF (caries-free), IL (initial lesions) and D (decayed teeth). The Wilcoxon test, Mann-Whitney, t test and Spearman correlation (p<0.05) were applied. There was no significant difference in the dmfs between groups. There was higher concentration of salivary calcium in G1 (G1=2847.96mM; G2=1230.90mM; p=0.001), and higher concentration of carbonic anhydrase VI in G2 (G1 = 3455.18 pg/ml; G2 = 442428.9pg/ml; p = 0.000). In G1, there was negative correlation between dmfs and salivary calcium (r = -0.444; p = 0.010). In G2, there was negative correlation between dental plaque and carbonic anhydrase VI (r=-0.551; p=0.014). It can be concluded that the calcium ion is a protective factor for dental caries in children. The carbonic anhydrase VI does not seem to be a biomaker of dental caries.

Objetivo: o objetivo deste estudo foi avaliar as condições de saúde bucal e a ocorrência de anomalias dentárias em crianças tratadas para leucemia linfoblástica aguda (LLA) no Serviço de Oncologia Pediátrica (SOP) do Hospital de Clínicas de Porto Alegre (HCPA), comparadas com um grupo crianças saudáveis. Amostra: foram selecionadas 56 crianças com diagnóstico de LLA e analisadas as presenças de anomalias dentárias e os índices CPO-D (cariado, perdido, obturado-dente), IPV (índice de placa visível), ISG (índice de sangramento gengival) e fluxo salivar. As crianças tratadas apresentaram uma média de idade, na época do diagnóstico da LLA, de 5,3 ± 2,6, e 11,8 ± 4,2 na avaliação, sendo 32 masculinos e 24 femininos. Os pacientes tratados para LLA foram divididos em três grupos: crianças tratadas somente com quimioterapia, com quimio e radioterapia, e com quimio, radio e transplante de medula óssea. Resultados: os resultados revelaram 80,4% de anomalias dentárias nas crianças tratadas, ou seja, 45 destas apresentaram pelo menos uma alteração, e o grupo de pacientes tratados com quimio, radio e submetidos ao transplante de medula óssea foi o que revelou a maior média de anormalidades dentárias por indivíduo (15,37 ± 15,03), não ocorrendo diferença estatística entre os gêneros. As crianças tratadas para LLA obtiveram CPO-D de 1,9 ± 4,0, ISG de 26,5%, IPV de 72,0%, e índice de fluxo salivar médio de 0,19 mL/min criança. Já o grupo de crianças sadias apresentou CPO-D de 1,52 ± 3,5, ISG de 11,1%, IPV de 53,8% e índice de fluxo salivar médio de 0,27 mL/min. Conclusão: o tratamento para a cura da LLA provoca um aumento significativo no número de anomalias dentárias, sendo mais freqüente nos pacientes menores de cinco anos de idade, principalmente nos pacientes submetidos a quimio e radioterapia associadas ao transplante de medula óssea, o que requer, por parte do cirurgião-dentista, intervenções clínicas diferenciadas e cuidadosas nestes pacientes, tendo-se em vista também os índices aumentados de ISG e IPV. As alterações sofridas pelas glândulas salivares durante o tratamento não são permanentes sob o aspecto do fluxo salivar, que retorna à normalidade. A orientação e o acompanhamento adequados destes pacientes por parte da equipe de saúde bucal podem mantê-los com o índice de CPO-D dentro dos padrões preconizados pela Organização Mundial de Saúde. / Objective: the objective of this research was to evaluate oral health conditions and the occurrence of dental anomalies in children treated for acute lymphoblastic leukemia (ALL) in the Pediatric Oncology Service at Hospital de Clínicas de Porto Alegre (HCPA), in comparison to a healthy children group. Sample: 56 children diagnosed with ALL were selected and the occurrence of dental anomalies and the rates DMF-T (decayed, missing, filled-tooth), RVDP (rate of visible dental plaque), RGB (rate of gingival bleeding) and salivary flow were analyzed. The treated children at the time of the diagnostic for ALL were in the average age of 5,3 ± 2,6, and 11,8 ± 4,2 at the evaluation, with 32 male and 24 female. The patients treated for ALL were divided in three groups: children only treated with chemotherapy, with chemotherapy and radiotherapy, and with chemotherapy, radiotherapy and bone marrow transplant. Results: the results showed 80,4% of dental anomalies in treated children, it means that 45 children had at least one disorder, and the group of patients treated with chemotherapy, radiotherapy and who underwent a bone marrow transplant showed the highest average of dental anomalies per person (15,37 ± 15,03), with no statistic difference concerning gender. The children treated for ALL had DMF-T of 1,9 ± 4,0, RGB of 26,5%, RVDP of 72,0%, and average salivary flow of 0,19 mL/min child. But the healthy children group showed DMF-T of 1,52 ± 3,5, RGB of 11,1%, RVDP of 53,8% and average salivary flow of 0,27 mL/min. Conclusion: the treatment to cure ALL causes a significant increasing in the cases of dental anomalies, mainly in patients under chemotherapy and radiotherapy associated to bone marrow transplant, what requires from the oral surgeon, careful and specific clinical interventions, also considering the increased rates of RGB and RVDP. The disorders in the salivary glands during the treatment are not permanent in what concerns the salivary flow, that becomes normal again. The adequate orientation and care of these patients by the oral health team can keep their DMF-T rates in the patterns ruled by the World Health Organization.