Abstract The aim of this paper was to present a summary of the process of developing and preparing the final documents of the national consensus for teaching undergraduate Brazilian dental students the dental caries curriculum in the Portuguese language. The final document was developed in three steps: a) The ABENO and LAOHA cariology group invited experts from all five regions of Brazil to participate in the discussion. The theoretical support for crafting the first draft of the consensus was based on two publications: National Curriculum Guidelines of the Dentistry graduation in Brazil, Ministry of Education (2021) and the competences described in the European Core Curriculum for Cariology (ORCA-ADEE, 2011); b) The group of experts was divided into 5 working groups: G1-Domain, Main and Specific Competences, G2-Essential knowledge, G3-Life course perspective, G4-Social determinants and dental caries, G5- Glossary. The document was finalized by thoroughly reviewing the process using Delphi methodology; c) The 5-chapter document (one from each working group) was submitted to three open public consultations in 2022 (May-June, August, and October) using Google-forms. The suggestions (content/wording) were discussed within the group as: totally accepted, partially accepted, and rejected. A total of 192 suggestions were registered from 31 dental schools in all regions of Brazil. The number of suggestions received per Group were: 84, 28, 26, 24, 30 suggestions for G1, G2, G3, G4 and G5, respectively. The majority of suggestions were totally accepted by the group of experts (n = 172, 89.6%), 15 were partially accepted (7.8%), and 5 were rejected. Conclusion The final document could be considered to be the first national consensus for teaching the dental caries curriculum in Brazil.

RESUMO Racional: Em função do alto grau de falência que se observa no tratamento clínico da obesidade mórbida, observa-se um aumento da procura pela cirurgia bariátrica como alternativa para o controle da obesidade e comorbidades. Objetivo: Avaliar a evolução do diabete melito tipo 2, da hipertensão arterial sistêmica e da dislipidemia em pacientes submetidos à gastroplastia redutora em Y-de-Roux no período de pós-operatório tardio. Métodos: Análise retrospectiva de 59 pacientes inseridos em programa de cirurgia bariátrica. Foram coletados dados antropométricos (altura e peso corporal) e laboratoriais (LDLc, HDLc, VLDLc, triglicerídeo -TG - e glicose) nos períodos pré e pós-operatório por meio de prontuários médicos. Resultados: Entre os pacientes, 86% eram mulheres com idade de 43±11 anos e 52% tinham cursado o ensino médio. O tempo médio de pós-operatório foi de 7±3 anos. Houve redução no peso e no índice de massa corporal no pós-operatório, respectivamente (133±06 kg vs 91±04 kg p<0,05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0,05). Observou-se concentrações inferiores no pós-operatório, comparado com o pré-operatório, da glicose (101,00±26,99 vs 89,11±15,19, p=0,014), colesterol total (179,00±37,95 vs 167,48±28,50, p=0,016), LDLc (104,30±33,12 vs 91,46±24,58, p=0,016), VLDLc (25,40±11,12 vs 15,68±7,40, p<0,01), e TG (143,35±86,35 vs 82,45±37,39, p<0,01) e maiores de HDLc (43,53±8,23 vs 57,90±15,60, p<0,01 ). No pós-operatório 40% dos pacientes hipertensos ainda estavam em tratamento para hipertensão arterial sistêmica. Houve remissão do diabete melito tipo 2 e da dislipidemia em 81% e 94% dos casos, respectivamente. Conclusão: A gastroplastia redutora em Y-de-Roux mostrou ser procedimento eficaz em longo prazo, com resultados persistentes na perda de peso, remissão do DM2 e da dislipidemia.

ABSTRACT Background: Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. Aim: To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Methods: Retrospective analysis of 59 patients included in the bariatric surgery program. Anthropometric (height and body weight) and laboratory (LDLc, HDLc, VLDLc, triglyceride -TG - and glucose) data were collected on pre- and postoperative stages, through medical records. Results: Among the patients, 86% were female aged 43±11, of whom 52% had attended high school. The average postoperative time was 7±3 years. During the postoperative period, there were decreases of weight and body mass index, respectively (133±06 kg vs 91±04 kg p<0.05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0.05). In comparison to the preoperative stage, lower concentrations of glucose (101.00±26.99 vs 89,11±15.19, p=0.014), total cholesterol rates (179.00±37,95 vs 167.48±28,50, p=0.016), LDLc (104.30±33.12 vs 91.46±24.58, p=0.016), VLDLc (25.40±11,12 vs 15.68±7.40, p<0.01), and TG (143.35±86.35 vs 82.45±37.39, p<0.01) and higher concentrations of HDLc (43.53±8.23 vs 57.90±15.60, p<0.01) were identified in the postoperative stage. 40% of hypertensive patients were still undergoing high blood pressure treatment during the postoperative stage. There was remission of type 2 diabetes mellitus and dyslipidemia on 81% and 94% of the cases, respectively. Conclusion: Roux-en-Y gastric bypass has proven itself to be an effective long term procedure, promoting weight loss, remission of DM2 and dyslipidemia.

RACIONAL: A obesidade é doença crônica com elevado crescimento na população. A cirurgia bariátrica é considerada o tratamento mais efetivo para redução de peso; por outro lado, deficiências nutricionais são observadas após esse procedimento. OBJETIVO: Avaliar a evolução da perda ponderal e a presença de anemias carenciais em pacientes submetidos ao bypass gástrico em Y-de-Roux em uso de suplementação de vitaminas e minerais. MÉTODOS: Análise retrospectiva de 137 pacientes de ambos os sexos, com idade entre 18-60 anos, em uso de suplementação de polivitaminas e minerais incluindo informações pessoais, dados antropométricos e laboratoriais nos períodos pré-operatório, 12, 24, 36 e 48 meses de pós-operatório. RESULTADOS: No pós-operatório, em ambos os sexos, ocorreu perda de peso em relação ao pré-operatório, ganho de peso aos 48 meses e manutenção do índice de massa corporal. Houve diminuição do percentual de perda de excesso de peso aos 48 meses pós-operatórios comparado com os tempos 12, 24 e 36 meses em homens e diminuição aos 48 meses pós-operatórios em relação aos 24 meses no sexo feminino. Houve diminuição da ferritina sérica em ambos os sexos e aumento do ferro sérico aos 48 meses pós-operatório no sexo masculino. Houve diminuição da vitamina B12 e aumento do ácido fólico séricos aos 48 meses do pós-operatório no sexo feminino. CONCLUSÕES: O tratamento cirúrgico mostrou-se eficaz para redução de peso, redução do índice de massa corporal e alcance do sucesso no pós-operatório tardio juntamente com a suplementação de polivitamínico e minerais na prevenção de deficiências nutricionais importantes e anemias.

BACKGROUND: Obesity is a chronic disease with high growth in population and bariatric surgery is currently considered the most effective treatment for weight reduction; on the other hand, nutritional deficiencies are observed after this procedure. AIM: To analyze weight loss progression and nutritional anemia in patients submitted to Roux-en-Y gastric bypass on use of vitamin and mineral supplementation. METHODS: Retrospective analysis of 137 patients of both sexes, aged between 18-60 years, using supplemental multivitamins and minerals, were included; personal information, anthropometric and laboratory data in the preoperative, 12, 24, 36 and 48 months postoperatively were collected. RESULTS: Postoperatively, in both sexes, occurred weight loss compared to the pre-operative weight gain at 48 months and maintenance of body mass index. There was a decrease in the percentage of excess weight loss at 48 months postoperatively compared to the time of 12, 24 and 36 months in men and decreased at 48 postoperative months compared to the time of 24 months in females. There was a decreased in serum ferritin in both sexes and increased serum iron at 48 months postoperatively in males. There was a decreased in vitamin B12 and folic acid increased serum at 48 postoperative months in females. CONCLUSIONS: Surgical treatment was effective for reducing weight, body mass index reduction and achievement of success in the late postoperative period along with multivitamin and mineral supplementation on prevention of serious nutritional deficiencies and anemia.

RACIONAL: Com o avanço da obesidade nos últimos anos, a procura pela cirurgia bariátrica tem aumentado de forma alarmante. O aconselhamento nutricional no período pré-operatório é de grande importância, pois contribui para maior taxa de sucesso no pós-operatório. OBJETIVO: Avaliar o perfil nutricional dos pacientes inseridos em um programa multidisciplinar para o tratamento da obesidade grave e em pré-operatório de cirurgia bariátrica, caracterizando o consumo de nutrientes saudáveis. MÉTODOS: Foi realizada análise retrospectiva de 30 pacientes sendo coletadas informações pessoais, antropométricas e dietéticas por meio de recordatórios de 24 horas. A análise da ingestão energética foi realizada no programa Dietpro 5.1 Profissional(r). O tratamento estatístico do consumo calórico foi realizado pelo teste ANOVA com post hoc por Bonferroni e para os dados antropométricos foi utilizado o teste t pareado. RESULTADOS: Do total dos pacientes 73% eram mulheres e 27% homens, com idade de 48,4+12,9 e 49,8+8,1, respectivamente. Foi observado menor peso na 5ª consulta quando comparado com a 1ª. Houve diminuição no consumo calórico nas 2ª, 3ª, 4ª e 5ª consultas quando comparadas com a 1ª. Observou-se que na 5ª consulta mais de 50% dos pacientes realizavam seis refeições ao dia. Houve aumento no consumo de frutas ao longo das consultas chegando a 72,2% dos pacientes que consumiam de uma a duas porções de frutas ao dia. A ingestão de verduras e legumes era elevada em todas as consultas no período pré-operatório e o consumo de produtos integrais, apesar de baixo, aumentou ao longo do período pré-operatório, alcançando 30% da população ao final do estudo. CONCLUSÃO: Houve diminuição do peso corporal, tendência na redução do IMC e circunferência do abdome e melhora quantitativa e qualitativa do consumo alimentar da população estudada.

BACKGROUND: Along with the augmentation in obesity rates in recent years, the demand for bariatric surgery has startlingly increased. Nutritional counseling in the preoperative period is very important because it contributes to higher success rate in the post-operative period. AIM: To assess the nutritional status of patients in a multidisciplinary program for the treatment of severe obesity and pre-operatively for bariatric surgery, characterizing the consumption of healthy nutrients. METHODS: A retrospective analysis of 30 patients was conducted. Personal information, anthropometric data and dietary assessment by 24-hour food record were collected. The analysis of energy intake was performed in Dietpro 5.1 Professional(r) program. The statistical treatment of the caloric intake was performed by an ANOVA test with Bonferroni´s post hoc and for anthropometric data the paired t test was used. RESULTS: From the total, 73% of the patients were women and 27% male, mean age was 48.4+12.9 and 49.8+8.1, respectively. A lower weight in the 5th appointment was observed when compared with the 1st one. There was a reduction in caloric intake in the 2nd, 3rd, 4th and 5th appointments when compared with the 1st. It was observed that in the 5th appointment more than 50% of the patients underwent six meals a day. There was an increase in the consumption of fruit along the appointments and 72.2% of patients consumed 1-2 servings of fruit a day. Vegetables intake was high in all appointments in the pre-operative period and, although low, the whole grain products consumption has increased during the pre-operative period achieving 30% of the study population. CONCLUSION: There was a decrease in body weight, a trend in the decrease of the body mass index and waist circumference and quantitative and qualitative improvement of food consumption.