RESUMO
Dentin reactions to caries, crucial for pathogenesis and for the determination of the severity of caries lesions, are believed to be reasonably detected by stereomicroscopy (SM) and polarized light microscopy in quinoline (PLMQ), but accuracies are not available. Here, stereomicroscopy of wet (SW) and dry (SD) ground sections of natural occlusal caries lesions resulted in moderate (0.7, for normal dentin) and low accuracies (< 0.6, for carious and sclerotic dentin) as validated by contrast-corrected microradiography. Accuracies of PLMQ were moderate for both normal (0.71) and carious dentin (0.71). The hypothesis that detection of dentin reactions by SM and PLMQ would be influenced by the contrast quality of micrographic images was rejected. Dentin reactions were scored by SW, SD, PLMQ, and three types of microradiographic images with varying contrast qualities and each technique was compared against the one that resulted in the highest number of scores for each dentin reaction. Large differences resulted, mainly related to the detection of sclerotic dentin by both SW and SD, and normal and carious dentin by PLMQ. It is concluded that contrast-corrected microradiography should be preferred as the gold standard and SM and PLMQ should be avoided, but the relationship of PLMQ with dentin mineralization deserves further investigation.
RESUMO
Aim: To assess inter-examiner reproducibility in the detection of 20 occlusal caries in permanentteeth using three diagnostic codes and criteria: WHO (1997), Nyvad and ICDAS-II. Methods:Three graduate students (G) and two undergraduate dental students (UG) without previousexperience in the use of Nyvad and ICDAS-II were trained by a reference examiner. Examinervalidity was assessed by consensus agreement between the investigators. Two cutoff pointswere used for ICDAS-II and Nyvad to represent reproducibility values: the A- lesion, B- cavitylesion. Results: According to the examiners consensus, the kappa values ranged from 0.71 to0.85 for G group and from 0.85 to 0.95 for UG group (ICDAS-II). For the Nyvad index valuesvaried from of 0.77 to 1.00 (G) and from 0.65 to 0.74 (UG), for the WHO index, values obtainedranged from 0.66 to 1.00 (UG) and 1.00 (G). Using a cutoff A, interexaminers reproducibility(ICDAS-II) ranged from 0.73 to 0.87 (G) and 1.00 (UG). According to Nyvad criteria, the kappavalue ranged from 0.78 to 1.00 (G) and from 0.70 and 0.90 (UG) when compared to theconsensus. The kappa values using the cutoff point B ranged from 0.66 to 1.00 (G), 0.76-0.89(UG) in ICDAS-II and the in Nyvad criteria varied from 0.87 to 1.00 (G) and from 0.65 to 0.88(UG). Conclusions: Reproducibility values ranged from good to perfect. The reproducibilityrevealed precise answers in the occlusal caries lesions diagnosis according to the criteria used.The best use of reliability tools for examiner training was important regardless of the examinersbeing undergraduate or graduate students.
Assuntos
Diagnóstico Bucal , Reprodutibilidade dos TestesRESUMO
Objetivo: O objetivo deste estudo foi investigar o conhecimento de pais de estudantes de uma escola da rede pública da Paraíba sobre a cárie dentária e as dificuldades encontradas por eles para adotarem hábitos de higiene bucal. Materiais e Métodos: O estudo foi desenvolvido no município de Guarabira, PB, Brasil. A população estudada constituiu-se de 46 pais/responsáveis de estudantes de 5 a 12 anos de idade da Escola Municipal de Ensino Fundamental Paulo Brandão, situada na área de abrangência da Unidade de Saúde da Família Santa Terezinha. As informações foram coletadas através de questionário estruturado, abordando conhecimentos dos pais e hábitos de higiene de seus filhos. Os dados foram analisados a partir da distribuição de frequências e por meio de estatística descritiva. Para os procedimentos descritivos, foram apresentadas medidas de tendência central (média e mediana) e de dispersão (desvio padrão). Resultados: Os resultados mostraram que 80,5% dos participantes eram do sexo feminino e 19,5% do sexo masculino. Foi predominante entre os participantes uma renda familiar de 1 salário mínimo (50%) ou até mesmo nenhuma renda (30,4%). Com relação ao nível escolar, houve predominância do ensino fundamental incompleto (54,3%). A maioria dos participantes (95,6%) considerou que a cárie pode ser prevenida; 71,8% respondeu 3 vezes para a frequência de escovação diária das crianças. Quanto à frequência da troca da escova dos filhos, 39,1% trocam de escova a cada 3 meses e 15,2% dos pais/responsáveis realizam esta troca após 6 meses de uso, seja por dificuldades financeiras (41,3%), por esquecimento (50%) ou falta de informação sobre o assunto (8,7%). Conclusão: A baixa condição sócio-econômica e de informação dificultam a adoção de hábitos saudáveis da população estudada.(AU)
Aim: The aim of the present study was to investigate the knowledge of parents of students from a public school in Paraiba concerning dental caries and the difficulties encountered by them to adopt healthy oral habits. Materials and Methods: This study was carried out in Guarabira, Paraiba, Brazil. The population studied consisted of 46 parents/guardians of students from 5 to12 years of age from the Paulo Brandão Public School, located in within the jurisdiction of the Santa Terezinha Family Health Unit. A structured questionnaire was applied with objective and subjective questions addressing parents'/guardians' knowledge and hygiene habits of their children. Data were analyzed based on frequency distribution and descriptive statistics. For descriptive procedures, measures of central tendency (mean and median) and dispersion (standard deviation) were presented. Results: Among the participants, 80.5% were female and 19.5% male. Regarding salaries, those who received a minimum wage (50%), or even no income (30.4%), was predominant. Regarding the educational level of the parents/guardians, an incomplete high school education (54.3%) was predominant. Most participants (95.6%) considered that caries were preventable, and, concerning the frequency of daily brushing, 71.8% answered three times/day. As regards the frequency of change in toothbrush, 39.1% answered that they change their toothbrush every 3 months, while 15.2% of the parents only change it every 6 months, because of financial difficulties (41.3%), because they forget (50%), or due to a lack of information on the subject (8.7%). Conclusion: This study suggested that low socioeconomic conditions and a lack of information hinder the adoption of healthy habits within the studied population.(AU)