Impact of primary dentition malocclusion on the oral health-related quality of life in preschoolers.

BACKGROUND: Malocclusion is a condition frequently seen in primary dentition due to the interaction of environmental, genetic and behavioural factors. The occurrence of some types of malocclusions can have an impact on oral health-related quality of life in children. Hence, the present study aimed to verify the impact of primary dentition malocclusion on oral health-related quality of life in preschool children. METHODS: A population-based cross-sectional study was conducted in Florianopolis, Brazil, with a representative sample of 1050 preschoolers aged between 2 and 5 years, randomly selected. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale and also to a questionnaire on socio-economic indicators. Data obtained from the questionnaire were obtained by item response theory based on model of gradual response. The malocclusion assessed was: anterior open bite, increased overjet and posterior crossbite. Poisson regression model was employed for multivariate analysis (P < 0.05). RESULTS: Malocclusion was observed in 36.7% of the children. Of these, 11.4% were anterior open bite, 67.2% were increased overjet, and 21.4% were posterior crossbite. Malocclusion's impact on oral health-related quality of life was 28.6%. In children aged 4-5 years, the prevalence of malocclusion's impact on quality of life was 49.5% higher than in children aged 2-3 years. Statistical analysis showed that preschool children with malocclusion showed no significant impact on quality of life. CONCLUSIONS: The findings of the present study indicate that the occurrence of primary dentition malocclusion has no impact on the quality of life of children aged 2-5 years.

Malocclusion traits and sucking habits in preschool children: a cross-sectional study

Objective: The aim was to evaluate the prevalence of malocclusion traits altogether and separate in anterior open bite, accentuated overjet and posterior cross-bite, and the possible association between them and sucking habits and breastfeeding. Methods : A preschool-based cross-sectional study was conducted with 472 children aged 24-60 months and their parents (response rate 86.6%). Three trained dentists (Kappa > 0.70) examine children for anterior open bite, accentuated overjet and posterior cross-bite and parents answered a questionnaire indicating the presence of breastfeeding, bottle usage, pacifier usage, finger sucking and the length of usage of all these habits. Results : The prevalence of malocclusion traits was 38.8%, Accentuated overjet was the most prevalent (30.3%) followed by posterior cross-bite (8.9%) and anterior open bite (7.4%). The unadjusted Poisson regression showed that children who were not breastfed had 63.0% more prevalent malocclusion traits when compared with those who were breastfed (RP 1.63, 95%CI 1.06-2.50). Length of pacifier usage in months was the only habit remained in the adjusted model associated with anterior open bite (RP 1.10, 95%CI 1.05-1.14, p < 0.000) and accentuated overjet (RP 1.03, 95%CI 1.01- .05, p = 0.004). For posterior cross-bite none habit showed association in the adjusted model. All models were adjusted for age and sex. Conclusion : Accentuated overjet is the most prevalent malocclusion trait. Length of pacifier usage is associated with the presence of malocclusion traits, anterior open bite and accentuated overjet. None of the investigated habits is associated with posterior cross-bite.

Objetivo: O objetivo foi estimar a prevalência de maloclusões avaliadas em conjunto e separadamente em mordida aberta anterior, sobressaliência acentuada e mordida cruzada posterior, e a possível associação entre elas e os hábitos de sucção e amamentação. Métodos : Estudo transversal foi realizado com 472 pré- escolares de 24 a 60 meses e seus pais (taxa de resposta de 86,6%). Três dentistas treinados (Kappa > 0,70) examinaram as crianças para mordida aberta anterior, sobressaliência acentuada e mordida cruzada posterior e os pais responderam a um questionário indicando a presença de amamentação, uso de mamadeira, uso de chupeta, sucção de dedo e tempo de hábito. Resultados : A prevalência de maloclusões foi de 38,8%. A sobressaliência acentuada foi o mais prevalente (30,3%), seguido da mordida cruzada posterior (8,9%) e da mordida aberta anterior (7,4%). A regressão de Poisson não ajustada mostrou que as crianças que não foram amamentadas apresentaram 63,0% maior prevalência de maloclusão quando comparadas com aquelas que foram amamentadas (RP 1,63, IC95% 1,06-2,50). A duração do uso de chupeta em meses foi o único hábito que permaneceu no modelo ajustado associado à mordida aberta anterior (RP 1,10, IC 95% 1,05-1,14, p < 0,000) e sobressaliência acentuada (RP 1,03, IC 95% 1,01- 1,05, p = 0,004). Para mordida cruzada posterior nenhum hábito mostrou associação no modelo ajustado. Todos os modelos foram ajustados por idade e sexo. Conclusão : A sobressaliência acentuada é a maloclusão mais prevalente. O tempo do uso de chupeta está associado à presença de maloclusão, mordida aberta anterior e sobressaliência acentuada. Nenhum dos hábitos investigados está associado à mordida cruzada posterior.

Structure of the Bacterial Community in Different Stages of Early Childhood Caries.

PURPOSE: To characterise in vivo the structure of bacterial communities in decayed and sound primary teeth. MATERIALS AND METHODS: Samples of biofilms were collected from three groups of patients with complete and exclusively primary dentition (n = 45): G1: sound teeth (n = 15); G2: enamel lesion (n = 15); G3: dentin lesion (n = 15). DNA was extracted (CTAB 2%) from the biofilm, the partial 16S rRNA gene was amplified with Bacteria Universal Primers (BA338fGC - UN518r) and subjected to DGGE (denaturing gradient gel electrophoresis). Multidimensional scaling and ANOSIM (analysis of similarity) were employed to determine the structure of the bacterial communities. The amplicon richness was determined by averaging amplicons, with the differences between treatments determined with ANOVA, while means were compared using Tukey's test (p < 0.05). RESULTS: Compared to sound teeth, a greater variety of bacterial communities was found in decayed teeth. Despite the differences between the bacterial communities of sound teeth and decayed teeth, the Venn diagram showed that the samples had 38 amplicons in common. Greater amplicon richness was observed in samples of decayed teeth (enamel: 20.5 ± 2.7; dentin: 20.1 ± 2.8) compared with the sound samples (12.0 ± 4.3) (p <0.05), indicating enhanced growth for specific groups of bacteria on decayed teeth. CONCLUSION: Although there is less bacterial diversity on sound than ECC-decayed teeth, the bacterial communities are very similar.

Mouth Breathing and Prevalence of Sleep Bruxism among Preschoolers aged 2 to 5 years

Objective: To determine the prevalence of bruxism, associating it with mouth breathing in preschool children in Florianopolis, Brazil. Material and Methods: Clinical examination and questions to parents/guardians of 429 children aged 2-5 were conducted. The clinical examination was performed by three calibrated examiners to register the presence of tooth wear on incisors and molars. The questions were related to sleep bruxism (teeth grinding) and mouth breathing. For determinate diagnosis, were "possible" bruxism by the American Academy of Sleep Medicine and "probable" bruxism, whereas the Item Response Theory was employed for mouth breathing. To determine the associations, a Chi-square test and Fisher exact test with a standard error of 5% and 95% interval confidence were applied. Results: The clinical examination revealed bruxism in 8.2%, whereas the parental report revealed bruxism in 17.2%. When clinical examination was associated with the parent's report, bruxism was present in 2.1%. Among the non-clinical variables, the most prevalent changes included: child presenting a regular stuffy nose (19.6%), followed by child is always open-mouthed (16.1%). A significant statistical association between bruxism and age was obtained (p<0.05), the age group with prevalence of 4 and 5 years old with 68.9%. There was no mouth breathing association with the presence of bruxism (p>0.05). Conclusion: Bruxism was prevalent for children aged 4-5 and bruxism had no association with mouth breathing.

Implant-supported Oral Rehabilitation in Child with Ectodermal Dysplasia - 4-year Follow-up.

Ectodermal dysplasia (ED) is an anomaly determined by genetic factors that alter ectodermal structures such as skin, hair, nails, glands, and teeth. Children affected by this condition require extensive, comprehensive, and multidisciplinary treatment. An 8-year-old female patient visited the Dentistry Clinic of the Federal University of Santa Catarina with the chief complaint of multiple missing teeth. The mother reported that the patient had ED. Clinical and radiographic examination revealed the congenital absence of several primary and permanent teeth and tooth germs. Subsequent oral rehabilitation comprised the application of a maxillary denture and mandibular implant-supported fixed prosthesis. The child was also supplied with a wig for further enhancement of esthetics aimed at improving her emotional wellbeing. Psychological follow-up and speech therapy were also provided. After 4 years of follow-up, implant-supported oral rehabilitation has proved to be a satisfactory treatment option, allowing restoration of masticatory, phonetic, and esthetic function, as well as an improvement in the patient's self-esteem and social wellbeing.

Antimicrobial activity of ozone and NaF-chlorhexidine on early childhood caries.

An early childhood carie (ECC) is an extremely destructive form of tooth decay. The aim of this study was to investigate the action of ozone (O3), and the association of sodium fluoride (NaF) with chlorhexidine (CHX) on bacteria related to ECC. Overnight culture of the bacteria was performed. On exponential phase the suspension was adjusted (101-108 CFU/mL). A drop (10µL) of each concentration of bacteria was applied on sheep blood agar plates and treated with O3 (2, 20, 200, and 2,000 ppm); after 18 hours, recovery analysis of CFU verified the reduction of bacterial activity. For NaF-CHX, sterile 96-well plates were prepared and divided into groups: G1 (150 µL TSB); G2 (20 µL of bacteria + 25 µL CHX + 25 µL NaF); and G3 (150 µL TSB + 20 µL of bacteria + 50 µL water). The plates were verified by analysis of the optical density (0, 12, 14, 16, and 18 hours). The data from O3 test were submitted to ANOVA and Tukey's test (p < 0.05). For the data from NaF-CHX, the ANOVA 2-way and Bonferroni's test (p < 0.05) were used. The number of CFU/mL showed death > 3log10 (99.9%) for all bacteria (ozone ≥ 20ppm), while the combination of NaF-CHX was more effective (p < 0.001) compared to each substance tested alone and the control group. The antimicrobial agents tested were able to inhibit all bacteria tested; O3 seemed to be a good alternative for controlling progression of carious lesions, while the association of NaF-CHX showed to be a good antimicrobial with easy and inexpensive application.

Antimicrobial activity of ozone and NaF-chlorhexidine on early childhood caries

Abstract An early childhood carie (ECC) is an extremely destructive form of tooth decay. The aim of this study was to investigate the action of ozone (O3), and the association of sodium fluoride (NaF) with chlorhexidine (CHX) on bacteria related to ECC. Overnight culture of the bacteria was performed. On exponential phase the suspension was adjusted (101-108 CFU/mL). A drop (10μL) of each concentration of bacteria was applied on sheep blood agar plates and treated with O3 (2, 20, 200, and 2,000 ppm); after 18 hours, recovery analysis of CFU verified the reduction of bacterial activity. For NaF-CHX, sterile 96-well plates were prepared and divided into groups: G1 (150 µL TSB); G2 (20 µL of bacteria + 25 µL CHX + 25 µL NaF); and G3 (150 µL TSB + 20 µL of bacteria + 50 µL water). The plates were verified by analysis of the optical density (0, 12, 14, 16, and 18 hours). The data from O3 test were submitted to ANOVA and Tukey’s test (p < 0.05). For the data from NaF-CHX, the ANOVA 2-way and Bonferroni’s test (p < 0.05) were used. The number of CFU/mL showed death > 3log10 (99.9%) for all bacteria (ozone ≥ 20ppm), while the combination of NaF-CHX was more effective (p < 0.001) compared to each substance tested alone and the control group. The antimicrobial agents tested were able to inhibit all bacteria tested; O3 seemed to be a good alternative for controlling progression of carious lesions, while the association of NaF-CHX showed to be a good antimicrobial with easy and inexpensive application.

Application of 17% EDTA Enhances Diffusion of (45)Ca-labeled OH(-) and Ca(2+) in Primary Tooth Root Canal.

Proper cleaning of the root canal is key to the success of endodontic treatment as it allows more effective diffusion of medication throughout the dentinal tubules. The aim of this in vitro study was to investigate the efficacy of 17% ethylenediaminetetraacetic acid (EDTA) in enhancing diffusion of hydroxyl (OH(-)) and calcium ions (Ca(2+)) throughout the root canal in primary teeth. The canals of 25 primary tooth roots were cleaned with endodontic files and 1% sodium hypochlorite. Three groups (G) were then established: GI, in which final irrigation was performed with 1% sodium hypochlorite; GII, in which 17% EDTA was used; and GIII, in which no irrigation was performed. The roots canals in GI and GII were filled with a calcium hydroxide-based paste labeled with the radioisotope calcium-45. Diffusion of OH(-) was detected with pH strips and Ca(2+) analyzed by measuring radioactivity in counts per min. Group II differed statistically from the other groups in diffusion of OH(-) at 24 hr (p<0.05), but no significant difference among groups was found at the day 7 evaluation; GII also differed statistically from the other groups in diffusion of Ca(2+) at 24 hr (p<0.05). These results suggest that application of 17% EDTA in primary tooth enhances diffusion of OH(-) and Ca(2+).

Pyogenic granuloma on the tongue: a pediatric case report.

Pyogenic granuloma (PG) is a rare, benign, vascular, hyperplasic, soft tissue lesion caused by diverse factors, including traumatic injuries. This article presents a case involving the surgical removal of PG on the tongue of a 4-year-old boy who had difficulty with speech and eating because of the tongue lesion. The parents reported that the child had the habit of nibbling on and sucking his tongue. The lesion was excised and histopathological analysis confirmed the diagnosis of PG; however, because the child continued to nibble and suck on his tongue, the lesion recurred. A second surgery was performed with the same histopathological diagnosis. At a one-year follow-up, the child had ceased his tongue habits, and no recurrence was seen.

Effect of endodontic irrigation with 1% sodium hypochlorite and 17% EDTA on primary teeth: a scanning electron microscope analysis.

This study evaluated the efficacy of 2 final irrigation solutions for removal of the smear layer (SL) from root canals of primary teeth, using scanning electron microscope (SEM) analysis. Thirty primary molars were selected and a single operator instrumented the canals. The initial irrigation was done with a 1% sodium hypochlorite (NaOCl) solution. After the preparation, the roots were randomly divided into 3 groups for final irrigation: Group 1, 1% NaOCl (n = 10); Group 2, 17% EDTA + 1% NaOCl (n = 10); and Group 3, 17% EDTA + saline solution (n = 10). The roots were prepared for SEM analysis (magnification 1000X). The photomicrographs were independently analyzed by 2 investigators with SEM experience, attributing scores to each root third in terms of SL removal. Kruskal-Wallis and Mann-Whitney tests revealed that there was no statistical difference between the groups (P = 0.489). However, a statistical difference was found (P < 0.05) in a comparison of root thirds, with the apical third having the worst results. Comparing the thirds within the same group, all canals showed statistical differences between the cervical and apical thirds (P < 0.05). The authors determined that no substance or association of substances were able to completely remove SL.

Assessment of diffusion of hydroxyl and calcium ions of root canal filling materials in primary teeth.

PURPOSE: The purpose of this study was to evaluate the diffusion of hydroxyl (OH-) and calcium (Ca+2) of 2 intracanal calcium hydroxide-based medications through the root dentin and cementum of primary teeth. METHODS: Forty roots were selected and a single operator instrumented the canals. The irrigation was performed with a 1% sodium hypochlorite solution, and a final irrigation used 17% ethylenediaminetetraacetic acid solution. The teeth were divided into 3 groups: (1) group 1 (N=15)- thickened calcium hydroxide paste blended with propylene glycol paste; (2) group 2 (N=15)-Calen; and (3) group 3 (N=10)-no medication. Diffusion of the OH-ions was determined using a digital pH meter, and diffusion of Ca+2 ions was determined through atomic absorption spectrometry at baseline, 24 hours, 7 days, 15 days, and 30 days later. RESULTS: Two-way analysis of variance and Tukey's test revealed that Group 1 achieved significantly higher pH values (P<.01), followed by Groups 2 and 3. There was a statistically significant difference between groups (P<.01) in the amount of Ca+2 ions released; group 1 had the highest diffusion values, followed by group 2, both with peak diffusion at 7 days. CONCLUSIONS: Thickened calcium hydroxide paste blended with propylene glycol paste achieved the greatest diffusion of hydroxyl and calcium through the dentin and cementum of primary teeth.