Epidermolysis bullosa (EB) is a rare inherited group of genodermatoses characterized by mucocutaneous fragility and blister formation, either spontaneously or as a result of minimal mechanical trauma. The repetition of these episodes in the oral cavity leads to atrophy of the mucosa, causing microstomia, ankyloglossia, tongue denudation, and vestibule obliteration, characteristics that make dental treatment difficult. Patients with EB are at high risk for caries due to the presence of dental anomalies; they also tend to have a soft diet and difficulties with mechanical removal of the dental biofilm. This case report presents a patient diagnosed with EB and describes the difficulties faced by the clinician during dental treatment as well as the measures adopted to safely manage the patient's dental care.

Preventive HIV/AIDS actions focusing on overcoming the limitations of interventions of a behavioral nature and incorporating concerns with the socio-cultural determinants of these behaviors currently constitute both a necessity and a gap. This article deals with a study on prevention in the school environment based on a strategy of reducing vulnerability. It is a qualitative and quantitative case study that, within the context of this strategy, evaluates the sida prevention work carried out by students who function as multiplying agents in a public high school in the outskirts of the city of São Paulo. The following stands out in the results: the effectiveness of the proposal, broadly accepted and favorably absorbed by the school's students; the diversified profile of voluntary students acting as multiplying agents; and the tension between the cognitive-behavioral model and the socialconstructivist model in the educational processes concretely operated by the multiplying agents. The article concludes that there is a possibility and interest in the action of students acting as multiplying agents from the standpoint of the strategies of reduction of vulnerability. It also points out the need to develop mechanisms for the recruitment and training of agents capable of problematizing and overcoming the said tension.KEY WORDS: Sida; prevention; school; vulnerability; adolescence; evaluation.Ações preventivas de HIV/AIDS, orientadas à superação dos limites das intervenções de corte comportamentalista, incorporando preocupações com os determinantes sócio-culturais desses comportamentos, constituem hoje uma necessidade e, ao mesmo tempo, uma lacuna. O presente artigo trata de estudo de prevenção no ambiente escolar baseado em estratégia de redução de vulnerabilidade. Constitui um estudo de caso, de corte quanti-quali, que, no contexto desta estratégia, avalia o trabalho de prevenção de aids desenvolvido por alunos multiplicadores em uma escola estadual de ensino médio na periferia da cidade de São Paulo. Entre os resultados, destacam-se: a efetividade da proposta, com ampla aceitação e favorável aproveitamento pelos alunos da escola; o perfil diversificado do aluno multiplicador voluntário; e a tensão entre modelos cognitivo-comportamentalistas e social-construtivistas nos processos educativos concretamente operados pelos multiplicadores. Conclui-se pela possibilidade e interesse da ação de alunos multiplicadores na perspectiva das estratégias de redução de vulnerabilidade, apontando-se a necessidade de desenvolver mecanismos de captação e capacitação capazes de problematizar e superar a tensão apontada.

The objective of this study was to evaluate bacterial prevalence in 31 root canals of human deciduous teeth with necrotic pulp and periapical lesions using bacterial culture. After crown access, the material was collected using absorbent paper points for microbiological evaluation and determination of colony forming units (CFU). Anaerobic microorganisms were found in 96.7% of the samples, black-pigmented bacilli in 35.5%, aerobic microorganisms in 93.5%, streptococci in 96.7%, and S. mutans in 48.4%. We concluded that in human deciduous teeth root canals with necrotic pulp and periapical lesions the infection is polymicrobial, with a large number of microorganisms and a predominance of streptococci and anaerobic microorganisms.

Development of immunity to hepatitis B virus in cirrhotic patients waiting for liver transplantation is highly desirable. Though a double-dose regimen is available, little is know about its effectiveness. We examined the efficacy of double-dose hepatitis B virus vaccination in cirrhotic patients waiting for liver transplantation. We studied 43 patients who were waiting for liver transplantation. They were vaccinated with three doses of 40 µ µ µ µ µg hepatitis B vaccine at 0, 1 and 6 months; the normal dose is 20 µ µ µ µ µg. Efficacy was measured based on seroconversion of anti-HBs. Global response to the primary vaccination scheme was 67.5% (29 patients). Forty-one per cent of responders had anti-HBs titers above 1,000 IU/mL. No factors were associated with response, based on multivariate analysis. The vaccination scheme of 40 µ µ µ µ µg at 0, 1 and 6 months was superior to conventional vaccination doses (20 µ µ µ µ µg) for cirrhotic patients on a waiting list for liver transplantation.

he aim of this study was to evaluate the antibacterial action of root canal mechanical preparation using 2.5% sodium hypochlorite as the irrigating solution and a calcium hydroxide paste as the antibacterial intracanal dressing in human primary teeth root canals with pulp necrosis and apical periodontitis by means of microbial culture. A total of 26 root canals of human primary teeth with pulp necrosis and apical periodontitis were used. Samples were collected before, 72h after biomechanical treatment and 72h after removal of the intracanal dressing. Comparison by Wilcoxon test showed that root canal mechanical preparation effectively eliminated all microorganisms in 20% of the root canals, and the intracanal dressing in 62.5%; however, the cumulative action of biomechanical treatment and intracanal dressing eliminated the microorganisms of 70% of the root canals (p<0.001). Isolated root canal mechanical preparation presented poorer microbiological results that those obtained with root canal mechanical preparation and the use of an intracanal dressing indicating the necessity of topical application of an intracanal medication between sessions in primary teeth with pulp necrosis and apical periodontitis. Uniterms: Tooth, deciduos; Apical periodontitis; Root canal preparation; Calcium hydroxide. objetivo do presente estudo foi avaliar, por meio de cultura bacteriológica, a ação antibacteriana do preparo biomecânico utilizando como solução irrigadora o hipoclorito de sódio a 2,5% e da pasta Calen utilizada como curativo de demora em canais radiculares de dentes decíduos de humanos com necrose pulpar e lesão periapical. Foram selecionados 26 dentes decíduos de humanos portadores de necrose pulpar e lesão periapical. As colheitas microbiológicas foram efetuadas antes e 72 horas após o preparo biomecânico e 72 horas após a remoção do curativo de demora. A comparação por meio do teste de Wilcoxon mostrou que o preparo biomecânico foi eficaz na eliminação dos microrganismos dos canais radiculares em 20% dos casos e o curativo de demora em 62,5%, enquanto que a ação cumulativa do preparo biomecânico e do curativo de demora eliminou os microrganismos em 70,0% dos casos (p<0.001). Pôde-se concluir que o preparo biomecânico, isoladamente, apresentou resultados microbiológicos inferiores àqueles obtidos quando o mesmo foi associado ao curativo de demora, mostrando a necessidade de aplicação tópica de um curativo de demora entre sessões em dentes decíduos portadores de necrose pulpar e lesão periapical. Unitermos: Dente decíduo; Periodontite periapical; Preparo de canal radicular; Hidróxido de cálcio. 351J Appl Oral Sci. 2005;13(4):351-5