RESUMO
Objetivo. Evaluar indicadores de salud oral en niños y adolescentes con parálisis cerebral en Lima-Perú. Métodos. Estudio observacional, descriptivo y transversal de una muestra de 171 pacientes de dos centros de referencia nacional especializados, periodo 2012- 2013, que cumplieron los criterios de inclusión. Para los índices de higiene oral (IHO) de Greene & Vermillion, índice de dientes cariados, perdidos y obturados (CPOD) y análisis de maloclusión dentaria (MD) se evaluaron 126 niños (6,0-11,9 años) y 45 adolescentes (12,0-19,0 años). Resultados. El IHO fue de 2,55 (malo) en el 91,8%, IHO regular en el 8,2% y ninguno mostró IHO bueno, observándose el mismo comportamiento en ambos grupos etarios. La prevalencia de caries fue 100% y CPOD de 4,55 ±1,56; los niños registraron CPOD de 4,52 ±1,537 y los adolescentes CPOD de 4,64 ±1,626. El 74,3% mostró MD, los niños evidenciaron MD en el 69,8% y los adolescentes mostraron 86,7%. En los niños, se observó relación molar (RM) Clase I derecha en el 42,1% e izquierda en el 44,4%; los adolescentes evidenciaron RM Clase III derecha en el 42,2% e izquierda en el 37,8%. Para los niños, el overbite (OB) no fue registrable en el 33,3% y normal en el 29,4%; en adolescentes, se registró OB normal en el 40%. Se observó con mayor frecuencia línea media dentaria desviada hacia el lado izquierdo. Conclusiones. En la mayoría de niños y adolescentes con parálisis cerebral de centros especializados se encontró alto índice de caries CPOD, mala higiene oral y presencia de maloclusiones.
Objective. To evaluate oral health indicators in children and adolescents with cerebral palsy in Lima-Peru. Methods. An observational, descriptive and cross-sectional study of a sample of 171 patients from two specialized national referral centers for the 2012- 2013 period who met the inclusion criteria. For the Greene & Vermillion oral hygiene index (OHI), decayed, missing and filled teeth (DMFT) and the dental malocclusion (DM) analysis, 126 children (6.0-11.9 years-old) and 45 adolescents (12.0-19.0 years- old) were evaluated. Results. The OHI was 2.55 (poor hygiene) in the 91.8%, regular OHI in the 8.2% and no one showed a good IHO, observing the same behavior in both age groups. The prevalence of caries was 100% and the DMFT was 4.55 ± 1.56; the children registered a DMFT of 4.52 ± 1.537 and the adolescents 4.64 ± 1.626. The DM was present in 74.3%; the children showed a 69,8% of DM and the adolescents showed 86.7%. In children, a right class I molar relationship (MR) was observed in 42.1% and a left MR in 44.4%; the adolescents showed right Class III in 42.2% and left in 37.8%. In children, the overbite (OB) was not registered in the 33.3% of the cases and it was normal in the 29.4%; the adolescents registered a normal OB in 40%. It was more frequently observed a deviation of the dental midline to the left. Conclusions. In most children and adolescents with cerebral palsy from specialized centers, a high index of DMFT caries, poor oral hygiene and the presence of malocclusions were found.
RESUMO
OBJECTIVE: The aim of this pilot study was to address the reliability, internal validity and viability of oral health methods used in the South American Youth/Child cARdiovascular and Environmental study. METHODS: South American Youth/Child cARdiovascular and Environmental study was a multicentre feasibility observational study and conducted in seven South American cities. The training sessions were performed in two steps before data collection: the first verified the inter-rater reproducibility between the examiners of the six centres in relation to the gold standard, and the second one verified the inter-rater reproducibility between the examiners at each centre in relation to the main rater. The diagnostic methods used were International Caries Detection and Assessment System II and Pulpal Involvement, Ulceration, Fistula and Abscess for dental caries and Periodontal Screening and Recording and Index Plaque for periodontal disease. Anthropometric variables were measured and used to calculate the body mass index and were classified according to the cut-off points defined by the International Obesity Task Force. Cohen's kappa coefficient and proportions of agreement were calculated to report inter-rater and intra-rater reliability in the calibration process and pilot study. RESULTS: The inter-rater weight kappa ranged from 0.78 to 0.88 and proportion of agreement from 96.07% to 98.10% for the International Caries Detection and Assessment System II and for the Periodontal Screening and Recording, 0.68 to 0.95 and 94.40% to 98.33%, respectively, in the calibration process. At the pilot study, a total of 490 children (40.8% overweight and 12.9% obese) and 364 adolescents (23.4% overweight and 4.3% obese) were examined. The prevalence of dental caries was 66% in children and 78% in adolescents, and gingival bleeding was 49% and 58.20%, respectively. CONCLUSION: The results demonstrated good reliability and internal validity after the examiners were trained, as well as the feasibility of using the methods chosen for this multicentre study.