RCAAP Repository

PONTES, Antônio Luciano. Marcadores semântico-sintáticos em dicionários pedagógicos. Revista de Letras, Fortaleza, v. 1/2, n. 28, p. 5-10, 2006.

Surgical removal of the third molars in clinical regime making use of local anesthetics plays a great role in the everyday practice of odontology. These drugs are safe when used in the proper way, but they can lead to undesirable outcomes when used in the wrong quantities or concentrations. Based on the knowledge of such principle and on surgical clinical practice, where levels of anesthetic concentration in the blood can reach near-toxic levels, a study measuring the systemic concentration of local anesthetic was made by collecting and analyzing, in equipment of High-performance liquid chromatography (HPLC), blood samples of patients who were submitted to local anesthesia with mepivacaine 2% and adrenaline 1:100000 for the removal of the third molars. The study was relevant because mepivacaine is frequently used in ambulatory surgeries of third molars, making it important to investigate the behavior of plasmatic levels and their possible toxic manifestations. The sample consisted of twenty-six patients of both sexes, subdivided in two groups according to the number of third molars removed: one group had two removed in a single session, the other group had four. Monitoring was done using pulse oxymetre, regular measuring of blood pressure, heart rate, and electrocardiogram in radioscopic, according to the minimum recommendations of the American Association of Oral and Maxillofacial Surgeons (D´ERAMO et al, 2003). In the interval of 120 minutes there were collected 10 samples of 4 mL after the injection of local anesthetic, and the quantitative analysis of the plasmatic concentrations of mepivacaine was done in HPLC. The plasmatic levels of mepivacaína in both groups were growing and significant amongst themselves in all the respective intervals of collections of the sanguine samples. After the results were obtained, the values at each corresponding moment for both groups were compared, showing that the averages of the systolic and diastolic pressure of all of the intervals were not significant when compared with the values obtained in the preoperative consultation. According to the results this study it was possible to conclude that the surgery of third molars under local anesthesia, with mepivacaine 2% and adrenaline 1:100000, when respecting the safety margins recommended by the manufacturer, is a safe procedure and that there are no clinical systemic differences to the healthy patient when doses between 108mg (5,4mL) and 216mg (10,8mL) are used.

The primers are primary anticorrosive dyes, with anticorrosive property due to the presence of appropriate pigment. The most common used anticorrosive pigments are zarcão, zinc chromate, iron oxide and zinc powder. Paints based on epoxy resin are very used as primers, because their impermeability and, when associated with anticorrosive pigments, the increase in the resistance against corrosion. Films of paint-primers formulated with DGEBA epoxy resin (Diglycidyl Ether of Bisphenol A), crosslinked with polyaminoamida (Versamid 125) , and with two anticorrosive pigments, zinc chromate (toxic) and calcium silicate (not toxic), were studied by thermogravimetric analysis (TG), infrared spectroscopy (FTIR) and scanning electronic microscopy (SEM). Kinetic parameters, such as activation energy, were calculated by TG, using Ozawa-Wall-Flynn and Kissinger methods. Change in the mechanism of epoxy paint degradation was observed in the presence of the two pigments. Primer with calcium silicate was more thermally stable than that with zinc chromate, based on IPDT values. The immersion of primers films in hydrochloric acid in the concentrations range from 10-5 to 6,0 M led to a decrease in the thermal stability. The most affected primer was that with zinc chromate, in which porous was detected by SEM after the immersion in acid solution. The primer with calcium silicate has the advantage of being more thermally stable and more resistant to acid attack, in addition to its more important ecological property, the non toxicity.

The success of endodontic treatment depends on many factors, and the reduction or elimination of bacterial infection is the most important one. Therefore, the use of substances that act against these microorganisms and their products becomes an important stage in treatment. The aim of this in vivo split-mouth study was to compare the efficacy of a 1% chlorhexidine gel, calcium hydroxide/camphorated paramonochlorophenol (Callen PMCC®) as intracanal medications, and a Control group (1-visit endodontic treatment) against mutans streptococci (EGM) and anaerobic bacteria found in primary molars with necrotic pulps. A total of 21 children (37 teeth) participated in this study. Initial (pre-treatment) and final (14 days post-treatment) intra-canal samples were collected for microbiological analysis and were incubated in Mitis Salivarius Bacitracin plates under microaerophilic conditions for EGM counting; as well as in Brucella-agar plates, anaerobically, to allow growth of anaerobic bacteria. The success rate of the pulpectomies after a 12 months follow-up were also evaluated based on clinical and radiographic parameters. Chlorhexidine gel significantly reduced EGM levels (p=0,010, Wilcoxon test), whereas Callen PMCC® significantly reduced anaerobic bacteria levels (p=0,002). Significant difference was observed when comparing EGM reduction levels between the Chlorhexidine and Control groups (p=0,032, Mann-Whitney test). The success rate was 81,71% in the Callen PMCC® group, 78.57% in the Chlorhexidine group and 77.77% in the control group. We concluded that 1% chlorhexidine gel, as well as calcium hydroxide/camphorated paramonochlorophenol, has limited efficacy in the reduction of bacteria from deciduous infected root canals. The present results suggest that a possible association between these two medications in future studies may eliminate more efficiently these bacteria.

The purpose of this study was to evaluate the knowledge of dentists, and health professional who work in emergency rooms (physicians, nurses and emergency medical technicians) regarding primary treatment for dental avulsion in Fortaleza, Ceará. The survey was based on a questionnaire. Data were collected in dental offices, public units, institutions which offer pos graduate courses, dental meetings and units of public medical emergency. The storage of the tooth in a liquid medium was recommended in 72,41%, but milk was indicated in 45,2% of these cases. In the presence of tooth vitality of the periodontal ligament, 34,67% answered correct, when vitality was not present 45,24% would not reimplante teeth. 18,7% of the health professionals from emergency rooms demontrated knowledge about tooth avulsion, while 38,7% had seen a patients who suffered tooth avulsion. Of these only 4% would reimplant the avulsed tooth and 91% would refer the patient to a dentist. They recommended storage of the tooth in a gauze or cotton in 57,7%. This study concluded that dentists and professionals from emergency rooms do not have adequate knowledge for treatment of these dental traumas. This fact generates on unfavorable prognosis of teeth that suffer avulsion. Thus educational campaigns are need to inform better these professional to give the best prognosis for traumatically avulsed tooth

The intraoral repair of ceramic restorations consisted of a clinically effective method for solving fracture of porcelain, and its success depends on quality and durability of the bond between the ceramic and the resin. The purpose of this study was to evaluate the bond strength between lithium disilicate-based ceramic and composite resin when subjected to airborne-particule abrasion with 50 μm aluminum oxide or hydrofluoric acid treatment using two silanization protocols: drying at room temperature or by heating. Twenty blocks (7×7×5mm) of lithium disilicate-based hot-pressed ceramic were fabricated and randomly divided into four groups (n = 5): G1- etched with 9.5% hydrofluoric acid for 20 seconds silanated surface were dried with room-temperature air; G2- treatment performed the same way as G1 employing the drying of the silane surface was 45± 5˚C warm air; G3- airborne-particle abrasion with 50-μm aluminum oxide for 5 seconds and silanated surface was dried 45± 5˚C warm air; G4-treatment performed in the same way that G3 employing drying of silane at room temperature. After an adhesive (Single Bond 2) was applied and before adding 5 mm layers of a composite resin (Filtek Z250), obtaining a block of 10 mm in height. Each blocks ceramic / resin were stored in 37˚C distilled-water for 24 h and cut into ceramic-composite beams with 1mm2 of cross-sectional area for immediately tested by microtensile bond strenght test at a speed of 1 mm / min. Data were analyzed by ANOVA and Student-Newman Keuls (p <0.05). The mean (standard deviation) in MPa were: G1 - 32.14 (7.98), G2 - 35 (7.77) and G3 - 18.36 (6.17). Group 4 can not be assessed because there was a detachment of the resin during the procedure for obtaining specimens. G1 and G2 presented greater tensile strenght than G3 (p<0.05). There was no statistically significant difference between the mean values for groups G1 and G2 (p> 0.05). It was concluded that silane drying by a stream of warm air had an important role in the surface treatment of ceramic with air abrasion.

SILVA, Moisés Batista da. Uma palavra só não basta: um estudo teórico sobre as unidades fraseológicas. Revista de Letras, Fortaleza, v.1/2, n.28, p. 11-20, 2006.

For Bachelard, the imagination has an “unlimited power” that fulfills singular paper in the recriation of the real. This article seeks to verify the presence of an imagination of Bachelard in Iracema, by José de Alencar. For this, we came up with some considerations about the imagination of Bachelard. We investigated the presence of this imagination as much about the criation of Iracema (it is clear that Iracema is the result, not only of researches done by Alencar, but it is also result of his privileged imagination), as about the fictional universe – we pointed four elements that base the presence of the imagination in Iracema: “special habilities”, the figure of the “Pajé”, the “Tupã´s thunder” and the “Tupã´s wine”. Finally, we worked with the question of the metaphor in Iracema – as an element that also identifies with the philosofy of Bachelard.

LUZ, Eduardo Chaves Ribeiro da. Tristes trópicos,50 anos. Revista de Letras, Fortaleza, v. 1/2, n. 27, p. 40-44, 2005.

Introduction: Worldwide, oral cancer is the sixth more common cancer, the squamous cell carcinoma is the most prevalent histological type, representing 90-95% of all oral cavity malignant tumors. It occurs mainly in mild age males, and presents risk factors such as, tobacco, alcohol, U.V. radiation and human papiloma virus (HPV). It’s still common the diagnosis of Oral Squamous Cells Carcinoma (OSCC) in advanced stages, difficulting treatment and reducing survival rates. In order to increase survival rates and give a better quality of life and death, chemoradiation has been used in unresectable OSCC. Methods: Medical records of patients with unresectable oral cancer, from January 2004 to December 2008, attended in two states’ reference center were assessed. Collected variables were gender, age, anatomical site of lesion, histological grade, treatment performed and survival. Results: In analyzed period, fifty two medical records were assessed. Male were the most affected, with a 1,8:1 male:female ratio. There was a peak of incidence in fifth to seventh decades of life, and there wasn’t found patients under the fourth decade of life. Only one patient wasn’t associated with risk factors, tobacco or tobacco and alcohol were the associated risk factors found. There was a high prevalence of stage 4 OSCC (50 patients), and chemoradiation was the most used treatment. Conclusion: As shown in literature, the epidemiological data found in this study presents a higher prevalence of oral cancer among mild age males, with tobacco being the main risk factor. The fact that most patients are economically active shows the importance of early diagnosis, as advanced stages diagnosis reduces survival rates and difficults the reinsertion of these people in society. Chemoradiation is an evolution in treatment of such tumors, achieving a better quality of life and death and a loco regional control of disease. Key words: Oral Neoplasms; Esquamous Cell Carcinoma; Mouth; Epidemiology.

The purpose of this study was to determine the frequency and epidemiological profile of dental trauma among 6-12-year-old schoolchildren regularly attending the municipal public schools of Fortaleza, CE, Brazil, in 2007. Five hundred schoolchildren proportionally divided among the six regional executive educational bureaus were examined and data referring to age, gender, traumatized tooth/teeth, type of trauma, tooth loss due to trauma, presence of fistula, discoloration, restoration related to the traumatized tooth/teeth and predisposing factors were recorded on clinical forms. The data were grouped and each category was analyzed statistically by the chi-square test. The results revealed that among the 500 examined children, 130 (25.7%) had suffered dental trauma to either primary teeth (14 children - 2.9%) or permanent teeth (116 children - 22.8%). The age of 10 years had the most frequency of dental trauma (20.9%). The female gender was more prevalent (61.4%). The maxillary left central incisor (8.4%) and the maxillary right central incisor (6.8%) were the most frequently traumatized teeth. Fracture was the most prevalent type of dental trauma, corresponding to 23.7% of the cases. Tooth loss due to traumatic injury occurred in only 0.4% of the cases. Discoloration was absent in 97% of the patients. Enamel fracture was the most prevalent of all types of fractures (17.7%) followed by enamel/dentin fracture (4.4%). The data showed that 99.8% of the schoolchildren who presented fractured teeth did not receive adequate dental treatment. Composite traumas and fistulae occurred in only 0.4% and 0.1% of the patients, respectively. Regarding the predisposing factors, alterations in the overjet was observed in 33.7% of the children and inadequate lip coverage was present in 17.3%. The findings of the present study allowed concluding that, in general, family, educational authorities and caregivers should have sufficient knowledge to provide a safe environment and adequate care at the moment of a dental trauma in such a way that its sequelae can be prevented or minimized.

Tooth structure immediately adjacent to restorations is susceptible to secondary caries, which may be caused by imperfect adaptation of restorative materials and subsequent microorganism colonization. Therefore, in order to identify methods of preventing secondary caries and increasing clinical dental restoration durability, different restorative dental materials have been introduced and applied in dental clinics. Thus, this in situ study assessed the effects of different restorative materials on the microbiological composition of dental biofilm and evaluated their ability of protecting the adjacent enamel against acid attacks from bacterial activity. A double-blind, split-mouth design was performed in one phase of 14 days, during which, 20 volunteers wore intra-oral palatal devices with five human enamel slabs, which were extra-orally restored according to the manufacturer’s specifications, using one of the following materials: Filtek Z 250/Single Bond composite resin; Permite amalgam; Fuji II encapsulated resin-modified glass ionomer; Vitremer resin-modified glass ionomer and Ketac Molar conventional glass ionomer.. During the experimental period, all subjects used fluoride-containing dentifrice 3x/day and a 20% sucrose solution was dripped onto the slabs 8x/day in predetermined times. The biofilm formed on the slabs was analyzed to determine total and mutans streptococci as well as lactobacilli counts. Demineralization (delta S) was determined on enamel by cross-sectional microhardness at 20 and 70 -µm from the restoration margin. In order to verify the differences among the treatments, Kruskal-Wallis and ANOVA followed by Minimum Squares test were applied for cariogenic microbiota and delta S, respectivly. No statistically significant differences were found in the cariogenic microbiota grown on the slabs. At 20-µm distance, only Fuji II statistically differed from the other groups presenting the lowest demineralization. At 70-µm, Fuji II significantly inhibited demineralization when compared to Permite, Filtek-Z-250 and Ketac Molar. Concluding, in the background of fluoride dentifrice and under the cariogenic exposure condition of this study, only the encapsulated resin-modified glass ionomer material provided additional protection against secondary caries.

The therapeutic use of Varfarin, the most common oral anticoagulant it is indicated in many cases, including the atrial fibrillation, cardiac valvular prostheses and venous trombolic disease. Many discussions still exist related to the suspension or not before tooth extraction. People who are for it’s suspension agree that it may increase the risk of hemorrhage, however the ones who prefer to maintain it’s use refer the high risk of tromboembolism. Due to the controversy related to the cronic use of oral anticoagulant before tooth extraction and what to use to control bleeding after extraction, we decided to perform a one center randomized clinical trial study to compare the effectiveness of the hemostasis using soaked gauze with tranexamic acid at 4,8% and plain gauze and the use of collagen sponge (Hemospon®), using it inside the tooth socket after extraction. The sample was made of 84 surgical procedures performed in 38 patients who were under anticoagulant treatment and who needed at least one tooth extraction. The trial was divided in three groups regarding the method used to reach hemostasis after tooth extraction. In group I we used compression with soaked gauze with tranexamic acid at 4,8%; in group II we used collagen sponge (Hemospon®) inside the socket while in group III we compressed the socket with dry gauze for 8 minutes. There were two cases of post surgical bleeding, being one from group I and one from group II. The data collected was evaluated thru SPSS 1.5 (Statistic Package of Social Science) program. All the statistical analysis performed were considered significantly when p was less than 5%. We used the Qui square X2 Test, Fisher Exact Test e Analysis of Variance (ANOVA) to verify the variables of the data. There was no statistically significant difference between the groups, related to bleeding (p>0,05). The compression with dry gauze and suture, compression with soaked gauze with trenaxamic acid at 4.8% and suture and the use of collagen sponge (Hemospon®) in the tooth socket hold with suture showed similar efficacy to the control of post extraction bleeding in patients who are under anticoagulant treatment.

Contemporary adhesives systems present satisfactory bonding to enamel and dentin. However, replacement of the restorations due to secondary caries formation is still a major problem and of great concern in Dentistry. Thus, this study assessed in situ the effects of adhesive systems containing or not fluoride and/or the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) on the microbiological composition of dental biofilm and on enamel demineralization. During two phases of 14 days each, ten volunteers wore palatal appliances containing four human enamel slabs, which were extra-orally restored using a resin composite (Z250 3M-ESPE) and one of the following adhesive systems: Adper™ Single Bond 2 (total etch, G1); All-Bond SE™ (self-etch, G2); One-Up Bond F Plus (self-etch containing fluoride G3) and Clearfil Protect Bond (self-etch containing fluoride and MDPB, G4). The volunteers were randomly allocated to treatments, and those who received G1 and G2 in the first phase received G3 and G4 in the second one, and vice versa. The volunteers were asked to drop a 20% sucrose solution onto the slabs eight times per day and to use fluoridated dentifrice 3 times per day. The biofilm formed on the slabs was analyzed with regard to total and mutans streptococci as well as lactobacilli counts. Demineralization was determined on enamel around the restorations by cross-sectional microhardness. The data were analyzed by analysis of variance, ANOVA. No differences were found for microbiological composition or enamel demineralization among the studied adhesive systems. It can be concluded that that fluoride or MDPB addition to adhesives systems presented no effect in controlling caries around resin restorations in this in situ model.

Post-operative inflammatory-infectious changes after the removal of third molars are often associated with bacterial contamination of the surgical site in the trans-operative period. Thus, this study aims to conduct a prospective, double-blind, placebo-controlled randomized clinical trial with split-mouth metodology, to evaluate the effect of preoperative prophylactic administration of amoxicillin in the control of infectious-inflammatory events associated with surgery for the removal of third molars. After application of inclusion and exclusion criteria for patients seeking odontological attention in the discipline of Bucco-Dental Surgery and Clinic Stomatology in the Course of Dentistry in the Universidade Federal do Ceará during the period from January to November of 2008, a sample of 34 patients was obtained. Each patient was his own control, since the standardization of dental inclusion allowed the comparison between the sides of the mouth of a patient, and received two separate surgical procedures randomly chosen. The experimental side was the surgical procedure that used an initial prophylactic dose of 1 gram of amoxicillin one hour before the procedure to remove an upper and lower third molar from one side. The control side was the other in witch the patient received placebo capsules in the same way of the experimental side. The surgical procedure was standardized and performed by the same surgical team. The parameters evaluated were pain, swelling, maximum mouth opening, hyperthermia and oral findings in revaluations after 3, 7 and 14 days of the surgery. To the analysis of continuous variables was used the parametric T-student test for independent samples and the chi-square test for the analysis of categorical variables. In comparisons, bilateral tests were used where the level of significance adopted in this study was α = 0.05. The p-value was considered statistically significant when equal or less than 0.05. As regards the occurrence of general infectious-inflammatory events between the studied groups, there were no statistically significant differences in the revaluations. There was a significant reduction of painful symptoms assessed on the seventh postoperative day in the experimental group compared with the control, significant pattern was also observed on the third postoperative day on a greater magnitude of mouth opening in the experimental group compared to control. Under the conditions of this study it was concluded that the use of preoperative prophylactic antibiotic therapy was not effective in reducing the occurrence of inflammatory-infectious events (edema, hyperthermia and oral findings) in the postoperative periods evaluated, except for the painful symptoms and maximal mouth opening respectively on the seventh and third postoperative day, and that the systematic use of antibiotic medication can expose the patient to an unwanted risk of bacterial resistance adverse effects, related to the medication, without giving a clear explanation for benefits related to its use.

The aim of the present study was to find a relation between salivary peptides, caries experience and mutans streptococci (MS) levels in saliva of caries free (CF) and caries susceptible (CS) children in early childhood. One hundred and six 10 – 71 month-old children participated in the study. Fifty-eight children were CF and 48 who had experienced dental caries formed the CS group. Two samples of whole saliva were collected from all participants. Unstimulated whole saliva was collected, subsequently centrifuged. Supernatants were lyophilized, divided into two pools (CF and CS) and individual samples, and stored at -20oC for posterior analysis using LC-MS (Liquid Chromatography Mass Spectrometry) to study the peptide profile. Identification of salivary peptides was based on theoretical molecular masses available from online databases. Stimulated whole saliva was collected and used for MS detection in MSB agar medium. MS concentration in saliva was reported in cfu/mL. Dental examination was performed and dmfs/dmft scores were calculated. Data was analysed by using logistic regression. The chromatograms from CF and CS pools of saliva had different peak patterns. The identification of molecular masses suggested the presence of 9 peptides. Three of them were significantly related with caries experience. The presence of HNP-3 (α-defensin 3) (p = 0.019) and HBD-3 (β-defensin 3) (p = 0.034) reduced the chances of experiencing early childhood caries (ECC). The presence of PRP IB-4 significantly increased caries experience (p = 0.035). In addition, age (p = 0.020) and MS counts (p = 0.036) increased caries experience, however gender was not associated with dental caries (p = 0.877). Our results suggest that presence of specific peptides in saliva of CF or CS children in early childhood predisposes to a higher or lower risk of caries experience.

Two decades following the first cases of the Acquired Immunodeficiency Syndrome (Aids) registered in Brazil, health care for individuals living with HIV/Aids is still a significant challenge. Within this context, the need to implement an integrated health policy for this group has been frequently discussed. This is particularly relevant for oral health services, where the Family Health Program (PSF-Programa Saúde da Família) offers a potential tool to address this issue. This study has the objective of examining the political and organizational oral health strategies for people with HIV/Aids in the municipality of Fortaleza, Ceará state, and verifying the extent of oral care services in the municipal basic health structure. The methodology consisted of a qualitative and documentary study based on a systematic review of the literature and technical guidelines issued by the Ministry of Health and the secretariats of the State of Ceará and Municipality of Fortaleza. Additionally, the researchers used a quantitative approach using secondary data from the National Notifiable Diseases Health Information System (SINAN - Sistema de Informação de Agravos de Notificação). Finally, a snapshot of current conditions was taken by means of a questionnaire applied to 186 dental surgeons (DS) working in the PSF in Fortaleza. Analysis was undertaken using descriptive statistics, in particular tables and thematic maps to display the spatial distribution of the disease in Fortaleza, in addition to the literature review. Relatively little official documentation was found (policies and technical guidelines) relative to the oral health services for people living with HIV/Aids, especially at the federal level which only has articles and manuals available, mostly dealing with biosecurity and opportunistic oral lesions. The majority of official documentation was found at the municipal level. The study showed that until 2007, there were 3,311 people living with HIV/Aids in Fortaleza and that these individuals reside throughout the municipality. It was also determined that over half (58.06%) of the DS working in the PSF are aware of the presence of people with HIV/Aids in their working area, yet only 29.57% affirmed that they had treated members of this group in their health unit. The oral health care offered to this group was not equally distributed in the municipality; rather it was concentrated in a few locations, particularly the Executive Secretariat of Region II. It has been concluded that, despite international recognition given to the Brazilian National STD/Aids Program, it is necessary to move forward the debate on oral health services offered to this population group and that the treatment given to people with HIV/Aids has not been consolidated as a key component of oral health services offered by the PSF. This goes against a municipal policy already in existence directed towards this goal, thereby indicating the need for the reorganization and reorientation of the oral health care available to people with HIV/Aids.

The importance of the action of fluoride in the control of dental caries has been proved internationally over the period of many years, such that the fluoridation of public water supply has been accepted as a key control method. It is not enough, however, to simply apply fluoride to water; it is also necessary to assure that the population receives the appropriate quantity of the element. For this to happen, a surveillance system must be in place with the objective of monitoring the fluoridation of public water sources (heterocontrol). Within this context, the objective of this study is to evaluate the heterocontrol of fluoride levels in the water supply of Fortaleza, Ceará, through a descriptive, observational, longitudinal study. Towards this end, qualitative and quantitative analyses were employed. In the qualitative approach, we sought to understand the ways in which Fortaleza controls its water quality with respect to fluoride levels, describing the methodology used by the Environmental Health Surveillance System of Fortaleza for heterocontrol. For data collection, a semi-structured interview with a script was used and applied to the technicians responsible for heterocontrol. The interviews were conducted by the researcher, using a recorder to tape the answers given by the interviewees. In relation to the quantitative approach, the study sought to determine the fluoride levels in the Fortaleza public water supply according to the Municipal Environmental Surveillance Sector, and subsequently to compare these results to those of the Ceará Water Works (CAGECE), verifying the existence of under or over dosage. The period of January to November 2006 was defined to evaluate the data of the two institutions, using Student’s t-test to compare the averages of fluoride levels taken by Fortaleza Environmental Surveillance and CAGECE and to compare the averages with the standard values of 0.6 ppm of fluoride (minimum value) and 0.8 ppm (maximum value). Following the qualitative analysis, it was verified that there exists a structured system in the municipality of Fortaleza to collect, impound, store and analyze water samples in order to determine fluoride levels as well as the geographic distribution of the water collection sites and the training of those responsible for sample impounding. However, it was observed that fewer samples are analyzed per month than is ideal. As for the quantitative analysis, Fortaleza Environmental Surveillance found elevated fluoride levels over the period under study with an average of 0.8532 ppm and 53.6% of analyses above the accepted limits, thereby increasing the risk of dental fluorosis. Differences in the analyses of Fortaleza Environmental Surveillance and CAGECE were also encountered over this period, suggesting the need for more analysis to determine the true fluoride concentration in the city’s water supply. We conclude that the capital city of Ceará does have a methodology for heterocontrol, based on its scientific and technical documents. However, there are inherent flaws in the recent implementation of fluoride surveillance in the public water supply. We also conclude that there is no consensus between the data of the two institutions researched, thus making it necessary to undertake new analyses to identify the correct fluoride levels in the Fortaleza water supply and definitively establish the levels to be supplied to the general public.

Dental wear is the non-carious loss of dental hard tissue, characterized by a multifactorial etiology with the main factor the interaction between erosion caused by acids from diet or endogenous and abrasives forces intra-oral. This dissertation consisting of two articles, which aim, respectively: (1) to critically review the available literature about the techniques of analysis of micromorphological changes in structure dental subject to erosion and/or abrasion, (2) to evaluate the effect of NaF and MFP in dentifrices available in market in the prevention of demineralization of tooth structure by erosive or erosive and abrasive process. In study 1, the scientific literature to the issue was searched using base of data nationals and internationals and manual tracing of references cited in scientific papers. In study 2, a in situ study, randomized, double-blind, crossover, slipt-mouth was conducted in three phases of 5 days each, with the participation of 15 volunteers who used palatal devices, containing 4 blocks of human tooth enamel treated with different dentifrices: control (11,2 ppm F, silica), MFP (1450 ppm F, silica) and NaF (1450 ppm F, silica). The slabs were subjected to erosion by immersion in a cola drink (Coca-Cola®) for 60 s, 4 times a day, at predetermined times. Then, the volunteers brushed their teeth, for 25 seconds and, with the device in the mouth, swished the dentifrice/saliva slurry for 60 seconds, after on side of appliance (2 blocks) was brushed with a small portion of the dentifrice by 40 brushing strokes. The enamel changes were evaluated for microhardness test and scanning electron microscopy. Data scores were submitted to ANOVA (p < 0,05). The critical review presented in study 1 showed which the literature presents different methods for analysis of dental wear, ranging from techniques well-established to techniques of recent use, therefore their expertise is needed for the development of future studies. The results of study 2 demonstrated that there was no differences in remineralization effect of fluoride dentifrices in the condition of erosion and erosion plus abrasion in relation of control group (p > 0,05). However, the harness data concerning to condition (erosion or erosion + abrasion) showed different statistically (p < 0.0001). The results of these studies indicate the knowledge about techniques of analysis of dental wear is essential for its determination. Moreover, it is imperative the realization of more studies to evaluate the fluoride effect in form of NaF or MFP, present in dentifrices available in the market using complementary techniques that allow the measurement of wear.

Aggregatibacter actinomycetemcomitans is a pathogen strongly associated with the etiology of aggressive periodontitis. The purpose of this study was to evaluate by polymerase chain reaction (PCR) the presence of highly and minimally leukotoxic clones of A. actinomycetemcomitans in patients with aggressive periodontitis (AgP) and their family members (FM). Thirty five patients with AgP (33,9 ± 7,1 years), 33 FM (22,8 ± 11,4 years) and 41 patients with chronic periodontitis (CP) (44,1 ± 9,4 years) were clinical analyzed through plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL). Subgingival biofilm samples were collected from the interproximal periodontal sites (> PD and > CAL) of each patient and their microbiological analysis were taken by PCR, concerning A. actinomycetemcomitans was observed and its leukotoxic clones. The PD and CAL average of this sites were: AgP – 9,8 mm e 10,7 mm, FM – 5,3 mm e 4,6 mm e CP – 8,2 mm e 9,4 mm. Statistically significant difference was observed among the groups. The presence of A. actinomycetemcomitans was observed in 23 (51,1%) patients with aggressive periodontitis and in others ones, 16 (30,1%) with chronic periodontitis. Among them 37 (94,8%) showed minimally leukotoxic clones and 2 (5,1%) highly leukotoxic clone, one was AgP group, the other was FM group, also with aggressive disease. Concerning to periodontal status of the FM group, 30,3% had aggressive periodontitis, 36,3% chronic periodontitis and 33,3% were periodontally normal or had gingivitis. Among them 12,2% were A. actinomycetemcomitans positive. The higher values of PD and CAL were observed in aggressive periodontitis patients that were A. actinomycetemcomitans positive when compared with A. actinomycetemcomitans negative patients (p<0.05). The presence of A. actinomycetemcomitans was correlated with aggressive periodontitis clinical status (Odds ratio=3,1; CI: 1,4-7,0; p=0,009). The majority of the patients with aggressive periodontitis exhibited a generalized form of disease and were positives to minimally leukotoxic A. actinomycetemcomitans clones. The family members had any type of chronic or aggressive periodontal disease.