Comparison of two early treatment protocols for anterior dental crossbite in the mixed dentition: A randomized trial.

OBJECTIVE: To evaluate and compare two treatment protocols to correct anterior dental crossbite in the mixed dentition. MATERIALS AND METHODS: Thirty children, 8-10 years of age, participated. Individuals were divided into two groups. Group 1 consisted of 15 children treated with an upper removable appliance with finger springs; group 2, 15 children treated by bonding resin-reinforced glass ionomer cement bite pads on the lower first molars. The 30 participants were evaluated before treatment (T1) and 12 months after treatment began (T2). The variables evaluated included overjet, perimeter of the maxillary arch, intercanine distances in the maxilla and mandible, SNA, SNB, ANB, and U1.NA. Data analysis included descriptive statistics, paired t-test and Student's t-test. Effect sizes and confidence intervals were also calculated. RESULTS: Group 1 showed a significant increase in overjet ( P < .001), intercanine distance in the maxilla ( P = .006), intercanine distance in the mandible ( P = .031), and U1.NA ( P = .002). Group 2 showed a significant increase in overjet ( P = .008), intercanine distance in the mandible ( P = .005), and U1.NA ( P < .001). For all the evaluated variables, no statistically significant differences were observed between the two groups. CONCLUSIONS: No significant differences were observed between the two protocols: use of a removable maxillary biteplate with finger springs and bonding of resin-reinforced glass ionomer cement bite pads on the lower first molars, for the correction of anterior crossbite in the mixed dentition.

Nickel allergy: blood and periodontal evaluation after orthodontic treatment.

The aim of this study was to assess periodontal status and blood parameters in orthodontic patients with nickel allergy one month after removal of brackets. Ninety-six randomly selected patients were initially evaluated. Allergy to nickel was diagnosed using a patch test. After determining the prevalence of subjects allergic to nickel, two groups were formed: 16 allergic (experimental) and 16 non-allergic (control) patients. Their periodontal status was determined regularly by a single, blinded, duly calibrated examiner using the Löe Index (GI) and their blood was tested (complete blood test, including nickel and IgE levels) after nine months of orthodontic treatment and again one month after removing the orthodontic appliances. Statistical analyses included paired and non-paired t-tests, Mann-Whitney, Wilcoxon, McNemar and linear trend chi-square tests (p≤0.05). Comparison of the values recorded during orthodontic treatment and one month after removing the appliances showed that in the allergic group there was significant increase in eosinophils (p=0.046), basophils (p=0.001) and monocytes (p=0.002), and decrease in number of bands (p=0.000), while in the control group, there was increase in lymphocytes (p=0.039) and decrease in segmented neutrophils (p=0.030) and IgE levels (p=0.001). In both groups, plasma nickel levels increased (p=0.010; p=0.039) and GI scores decreased. One month after removing the brackets, blood and periodontal parameters from patients with and without nickel allergy were similar.

O objetivo do presente estudo foi avaliar a condição periodontal e os parâmetros sanguíneos em pacientes alérgicos ao níquel, um mês após remoção dos aparelhos. Noventa e seis pacientes selecionados aleatoriamente foram inicialmente avaliadas. Alergia ao níquel foi diagnosticada usando um teste de contato. Após a determinação da prevalência de alergia ao níquel, formaram-se dois grupos: 16 pacientes alérgicos (experimental) e 16 não alérgicos (controle). Condição periodontal foi diagnosticada através do Índice de Löe (IG). Parâmetros sanguíneos foram determinados por meio de um exame de sangue completo, incluindo a quantificação de níquel e níveis de IgE. Avaliações do estado periodontal foram realizados por um único examinador de forma cega, devidamente calibrado e amostras de sangue foram tomadas depois de nove meses de tratamento e um mês após a remoção dos aparelhos ortodônticos. Análise estatística utilizada foi testes t pareado e não pareado, Mann-Whitney, Wilcoxon, McNemar e qui-quadrado de tendência linear (p≤0,05). Em comparação com os valores observados durante o tratamento, o número de eosinófilos (p=0,046), basófilos (p=0,001) e monócitos (p=0,002) aumentou significativamente depois da remoção dos aparelhos ortodônticos, ao passo que o número de bastões (p=0,000) diminuiu entre os períodos no grupo alérgico. O número de linfócitos (p=0,039) aumentou no grupo controle e o número de segmentados (p=0,030) diminuiu. A diminuição dos níveis de IgE (p=0,001) entre os períodos ocorreu no grupo de controle. Níveis de níquel no plasma aumentou após a remoção de aparelhos ortodônticos em ambos os grupos (p=0,010; p=0,039). O IG diminuiu em ambos os grupos. Parâmetros periodontais e sanguíneos de pacientes com alergia ao níquel foram semelhantes aos não alérgicos um mês após a remoção dos aparelhos.

Nickel allergy: blood and periodontal evaluation after orthodontic treatment / Alergia ao níquel: avaliação periodontal e sanguínea após o tratamento ortodôntico

The aim of this study was to assess periodontal status and bloodparameters in orthodontic patients with nickel allergy one monthafter removal of brackets. Ninety-six randomly selected patientswere initially evaluated. Allergy to nickel was diagnosed using apatch test. After determining the prevalence of subjects allergic tonickel, two groups were formed: 16 allergic (experimental) and 16non-allergic (control) patients. Their periodontal status wasdetermined regularly by a single, blinded, duly calibrated examinerusing the Lõe Index (GI) and their blood was tested (complete bloodtest, including nickel and IgE levels) after nine months oforthodontic treatment and again one month after removing theorthodontic appliances. Statistical analyses included paired andnon-paired t-tests, Mann-Whitney, Wilcoxon, McNemar and lineartrend chi-square tests (p≤0.05). Comparison of the values recordedduring orthodontic treatment and one month after removing theappliances showed that in the allergic group there was significantincrease in eosinophils (p=0.046), basophils (p=0.001) andmonocytes (p=0.002), and decrease in number of bands (p=0.000),while in the control group, there was increase in lymphocytes(p=0.039) and decrease in segmented neutrophils (p=0.030) andIgE levels (p=0.001). In both groups, plasma nickel levels increased(p=0.010; p=0.039) and GI scores decreased. One month afterremoving the brackets, blood and periodontal parameters frompatients with and without nickel allergy were similar.

O objetivo do presente estudo foi avaliar a condição periodontal eos parâmetros sanguíneos em pacientes alérgicos ao níquel, ummês após remoção dos aparelhos. Noventa e seis pacientesselecionados aleatoriamente foram inicialmente avaliadas. Alergiaao níquel foi diagnosticada usando um teste de contato. Após adeterminação da prevalência de alergia ao níquel, formaram-sedois grupos: 16 pacientes alérgicos (experimental) e 16 nãoalérgicos (controle). Condição periodontal foi diagnosticadaatravés do Índice de Lõe (IG). Parâmetros sanguíneos foramdeterminados por meio de um exame de sangue completo,incluindo a quantificação de níquel e níveis de IgE. Avaliações doestado periodontal foram realizados por um único examinador deforma cega, devidamente calibrado e amostras de sangue foramtomadas depois de nove meses de tratamento e um mês após aremoção dos aparelhos ortodônticos. Análise estatística utilizadafoi testes t pareado e não pareado, Mann-Whitney, Wilcoxon,McNemar e qui-quadrado de tendência linear (p≤0,05). Emcomparação com os valores observados durante o tratamento, onúmero de eosinófilos (p=0,046), basófilos (p=0,001) e monócitos(p=0,002) aumentou significativamente depois da remoção dosaparelhos ortodônticos, ao passo que o número de bastões(p=0,000) diminuiu entre os períodos no grupo alérgico. O númerode linfócitos (p=0,039) aumentou no grupo controle e o número desegmentados (p=0,030) diminuiu. A diminuição dos níveis de IgE(p=0,001) entre os períodos ocorreu no grupo de controle. Níveisde níquel no plasma aumentou após a remoção de aparelhosortodônticos em ambos os grupos (p=0,010; p=0,039). O IGdiminuiu em ambos os grupos. Parâmetros periodontais esanguíneos de pacientes com alergia ao níquel foram semelhantesaos não alérgicos um mês após a remoção dos aparelhos.

Prevalence of sleep bruxism and associated factors in preschool children.

PURPOSE: The purpose of this study was to evaluate the prevalence of sleep bruxism and associated factors in three- to five-year-olds. METHODS: A representative cross-sectional study was conducted with a sample of 749 preschool children during immunization campaigns. Data acquisition involved an oral clinical exam, anthropometric measures, and a questionnaire administered in interview form. All data were analyzed using the chi-square test and Poisson regression with robust variance with the aid of SPSS software. RESULTS: The prevalence of sleep bruxism among preschool children was approximately 14 percent. Statistically significant associations were found: between sleep bruxism and lower dental crowding (prevalence ratio=3.38; 95% confidence interval=1.9-5.7); for the habit of biting on objects (PR=2.49; 95% CI=1.4-4.4); for duration of breast-feeding for a period longer than 12 months (PR=1.98; 95% CI=1.2-3.2); and for bottle-feeding for more than 24 months (PR=1.93; 95% CI=1.2-3.1). CONCLUSIONS: Lower arch crowding, the habit of biting on objects, and prolonged breast-feeding and bottle-feeding were associated with sleep bruxism in the preschool children analyzed in the present study.

Impact of treated/untreated traumatic dental injuries on quality of life among Brazilian schoolchildren.

BACKGROUND/AIM: The joint evaluation of oral health-related quality of life and traumatic dental injury (TDI) is an important tool for setting priorities in public oral health programs. The purpose of the present study was to compare the impact of treated TDI, untreated TDI, and absence of TDI on the quality of life of schoolchildren aged 11-14 years. MATERIAL AND METHODS: A cross-sectional study was carried out with 668 schoolchildren from the city of Diamantina, Brazil. The clinical examination involved the determination of the presence and type of TDI based on the criteria proposed by O'Brien. Malocclusion was evaluated using the criteria of the Dental Aesthetic Index, and dental caries was diagnosed using the DMFT/dmft index. The impact of TDI on quality of life was assessed using the Child Oral Impact on Daily Performances (Child-OIDP). The outcome was the absence (Child-OIDP = 0) or presence (Child-OIDP ≥ 1) of impact on quality of life. RESULTS: The prevalence of TDI was 34.3%. Schoolchildren with untreated TDI experienced a greater impact on eating (P = 0.016) and smiling (P < 0.001) in comparison with those without TDI. No significant differences were found in the Child-OIDP score between schoolchildren with treated TDI and those without trauma. The unadjusted and adjusted results of the Poisson regression analysis of the Child-OIDP demonstrated that schoolchildren with untreated TDI were more likely to experience an impact on 'eating and enjoying food', 'smiling and showing teeth', and 'overall score'. CONCLUSIONS: Untreated TDI was associated with a negative impact on the quality of life of schoolchildren, whereas treated TDI and absence of TDI were not associated with impact on quality of life.

Impact of untreated dental caries on quality of life of preschool children: different stages and activity.

OBJECTIVE: The aim of the present population-based cross-sectional study was to evaluate the association between untreated dental caries, considering stages and activity, and the impact on OHRQoL among preschool children and their parents/caregivers. METHODS: A randomly selected sample of 451 Brazilian preschool children aged three to 5 years underwent a clinical oral examination for the assessment of dental caries using the ICDAS II criteria. Parents/caregivers were asked to answer two questionnaires: one on the OHRQoL of the children (ECOHIS) and another on the demographic and socioeconomic characteristics of the children and families. Statistical analysis involved descriptive statistics, the chi-square test, Mann-Whitney test and hierarchically adjusted Poisson regression models. RESULTS: The prevalence of early childhood caries was 51.2%. The majority of teeth with caries exhibited severe decay (60.6%). Untreated severe decay, such as active lesions within visible dentin (P < 0.001), extensive active and inactive cavity without pulp exposure or fistula (P < 0.001 and P = 0.001, respectively), extensive cavity with pulp exposure and absence of fistula (P = 0.003) and root remnant (P = 0.002), were associated with a negative impact on quality of life. CONCLUSION: Active and inactive untreated severe carious lesions were associated with a negative impact on the quality of life of preschoolers and their parents/caregivers.

Degree of dental anxiety in children with and without toothache: prospective assessment.

BACKGROUND: Few prospective studies on the anxiety of children in the dental office have been published. AIMS: To monitor dental anxiety levels in children with and without previous experience with toothache over a period of six consecutive visits. DESIGN: A longitudinal study was carried out involving 167 children treated at a public dental service. Levels of anxiety in the dental setting were assessed in children without toothache (G1) and those with toothache (G2) using the modified Venham picture test (VPT). Data acquisition was carried out over a 6-week period, with each child treated in the dental office once a week. Six assessments of anxiety were performed in the waiting room prior to dental treatment. RESULTS: A significant reduction in anxiety scores occurred between appointments in both groups. In the inter-group comparison, G2 had significantly higher anxiety scores than G1. Although statistically significant reductions in anxiety scores occurred through to the fifth appointment, a tendency toward stagnation in anxiety scores was observed beginning with the fourth appointment. CONCLUSIONS: Dental anxiety scores were reduced over the course of six appointments. Children with toothache had higher levels of dental anxiety than those that had never experienced toothache.

Developmental defects of enamel in primary teeth: prevalence and associated factors.

BACKGROUND: Studies on the prevalence of enamel defects in the primary dentition as a whole are scarce, as most investigations examine specific population groups. OBJECTIVES: The aim of this study was to evaluate the prevalence of enamel defects in primary teeth and determine whether prematurity, birthweight, and socio-demographic variables are associated with such defects. DESIGN: A cross-sectional study was carried out with 381 children aged 3-5 years. Data were collected through clinical examinations and interviews with parents during the National Immunisation Day. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel (DDE) Index. Through interviews, information was collected on socio-demographic aspects, pregnancy, birthweight, prematurity, and breastfeeding. Statistical analysis was performed using the SPSS program for Windows and involved descriptive analysis, Fisher's exact test, the chi-square test, and Poisson regression. RESULTS: The prevalence of developmental defects of enamel was 29.9%. Demarcated opacity was the most frequent type of defect. Children with a history of very low birthweight had a greater prevalence of enamels defects (PR, 2.7; 95% CI, 1.66-4.61). Prematurity and socio-demographic variables were not associated with enamel defects. CONCLUSION: Children with a history of very low birthweight had a greater frequency of enamel defects in primary teeth.

Influence of periodontal treatment on objective measurement of masticatory performance.

In a previous study, we evaluated the influence of periodontal treatment and physiological parameters on the subjective perception of mastication using the Oral Impact on Daily Performance Questionnaire (OIDP). In this study, we investigated the influence of periodontal treatment on the objective measures of masticatory performance in the same study sample. Patients with chronic periodontitis (n = 28) were examined on two occasions with a 45-day interval. Electrical activity of the masticatory muscles and maximum bite force were determined. In addition, masticatory performance was assessed using silicone impression blocks as test material. The median particle size of the chewed blocks was determined employing a sieving method. The number of teeth and the probing depth were also recorded. The probing depth was significantly reduced following treatment (P < 0.001). The median particle size of the chewed material was also reduced, which indicates a significant improvement in masticatory performance after treatment (P < 0.001). Bite force and muscle activity were significantly correlated both before and after treatment (P < 0.05). There was a negative correlation between masticatory performance and number of teeth (P < 0.05); moreover, individuals with a lower number of teeth exhibited poorer masticatory performance (P = 0.01). Periodontal treatment had a positive influence on masticatory performance 45 days after conservative treatment.

Level of agreement between self-administered and interviewer-administered CPQ8₋10 and CPQ1₋14.

OBJECTIVES: The aim of the present study was to assess the psychometric properties and level of agreement between the self-administered and interviewer-administered Child Perceptions Questionnaire (CPQ) for children between 8 and 10 years of age (CPQ(8-10) ) and between 11 and 14 (CPQ(11-14) ) years of age. METHODS: A randomized cross-over study was carried out, involving 180 children (Group 1 - 90 children between 8 and 10; Group 2 - 90 children between 11 and 14 years of age) in the state of Minas Gerais, Brazil. All children completed both administration modes of the CPQ; half of each group received interviewer-administered mode first [Subgroup A (CPQ(8-10) n = 45) and Subgroup C (CPQ(11-14) n = 45)], and the other half performed the self-administered mode first [Subgroup B (CPQ(8-10) n = 45) and Subgroup D (CPQ(11-14) n = 45)]. Test-retest reliability of each mode of administration was tested on 60 children (30 for CPQ(8-10) ; 30 for CPQ(11-14) ), who were not included in the other analyses. The level of agreement between scores on the self-administered and interviewer-administered versions of the CPQ(8-10) and CPQ(11-14) was established using the intraclass correlation coefficient (ICC). The order of presentation of both instruments was tested considering the four subgroups (A, B, C and D). The calculation of effect size proposed by Cohen (1992) was used to test the clinical significance of the findings. RESULTS: Both the self-administered and interviewer-administered versions of CPQ(8-10) and CPQ(11-14) demonstrated acceptable psychometric properties. Agreement between the administration modes for the CPQ(8-10) and CPQ(11-14) was 0.90 and 0.88 (ICC), respectively. With the exception of the functional limitation subscale, the scores of the subscales and overall score on the CPQ(8-10) were significantly higher in the group of children who responded to the interviewer-administered measure first. With the CPQ(11-14) , statistically significant differences were found only for the emotional well-being subscale. CONCLUSIONS: Both administration modes of the CPQ(8-10) and CPQ(11-14) demonstrated satisfactory psychometric properties and a high level of agreement. Although statistically significant differences were observed for oral symptoms, emotional well-being and social well-being, with the first administration of the interviewer-administered version, the effect of the order of administration had small to medium effects on the CPQ scores.

Cornelia De Lange syndrome: a case report of a Brazilian boy.

Cornelia de Lange syndrome is a rare multisystem disorder characterized by a distinctive facial appearance, delayed growth and psychomotor skills, behavioral problems, malformation of the upper limbs, and impairment on the quality of life of affected subjects. This article reports a case of a child with the syndrome, emphasizing the orofacial manifestations. Knowledge on the etiopathological aspects and characteristic features of this condition is essential so that professionals can provide health care and help improve the quality of life of affected individuals and their families.

Treatment of chronic periodontitis and its impact on mastication.

BACKGROUND: The aim of the present study is to assess the impact of conventional periodontal treatment of chronic periodontitis on the perception of mastication. METHODS: The patients (n = 28; age range: 23 to 56 years, mean age: 37.9 years) were evaluated on two occasions (before and after treatment) with a 45-day interval using the Oral Impact on Daily Performance questionnaire. An electromyography system was used for the determination of activity in muscles of mastication and bite force. Masticatory performance was assessed using a test material. The median particle size of the masticated material was determined using a sieve method and the Rosin-Rammler equation. The clinical criteria were the number of teeth and probing depth, both determined by a single calibrated observer masked to the treatment phase. The data were analyzed in the pretreatment and post-treatment periods using Wilcoxon test; Spearman correlation coefficient; and two multiple linear regression models (backward stepwise procedure). RESULTS: There was a significant negative correlation between the number of teeth (number of mastication units) and difficulty eating (P <0.05) before and after treatment. Probing depth had a positive relationship with the total Oral Impact on Daily Performance score before treatment (P <0.01). CONCLUSIONS: The subjective perception of the impact of oral health on mastication diminished after periodontal treatment. The number of teeth had considerable importance in the perception of impact on mastication in the sample studied.

Factors associated with the desire for orthodontic treatment among Brazilian adolescents and their parents.

BACKGROUND: In the period of adolescence physical appearance takes on significant importance in the construction of personal identity, including one's relationship with one's own body. A variety of social, cultural, psychological and personal factors influences the self-perception of dental appearance and the decision to undergo orthodontic treatment. Adolescents who seek orthodontic treatment are concerned with improving their appearance and social acceptance. The aim of the present study was to determine factors associated to the desire for orthodontic treatment among Brazilian adolescents and their parents. METHODS: The sample consisted of 403 subjects aged 14 to 18 years, selected randomly from a population of 182,291 schoolchildren in the same age group. The outcome variable "desire for orthodontic treatment" was assessed through a questionnaire. Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and the Dental Aesthetic Index (DAI) was used for clinical assessment. Statistical analysis involved the chi-square test as well as both simple and multiple logistic regression analyses. RESULTS: The majority (78%) of the Brazilian adolescents desired orthodontic treatment and 69% of the parents reported that their children were not in orthodontic treatment due to the high costs involved. There was significant association (p < or = 0.05) between the desire for orthodontic treatment and most types of malocclusion. However, there was no significant association between the desire for orthodontic treatment and the variables gender and age. CONCLUSIONS: The following were considered factors associated to the desire for treatment: upper anterior crowding > or = 2 mm and parents' perception of their child's need for treatment.

Aesthetic impact of malocclusion in the daily living of Brazilian adolescents.

OBJECTIVE: The aim of the present study was to determine the biopsychosocial impact of malocclusion on the daily living of Brazilian adolescents (14 to 18 years of age) through normative and subjective records and identify factors directly involved in the self-perception of malocclusions. DESIGN: Cross-sectional. SETTING: Public and private schools in the city of Belo Horizonte, Brazil. SUBJECTS AND METHODS: The sample was made up of 403 adolescents, with no prior history of orthodontic treatment, who were selected randomly from a population of 182,291 students in the same age range. The oral impact of malocclusion was assessed using the Oral Impact on Daily Performance (OIDP), whereas clinical criteria were assessed using the Dental Aesthetic Index (DAI). Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and self-esteem was assessed using the Global Negative Self-Evaluation (GSE) scale. Other variables were assessed using questionnaires. The chi-square test, simple and multiple logistic regression analyses were used for the statistical analysis. RESULTS: Ninety five adolescents (24%) reported feeling embarrassed to smile (aesthetic impact). A logistic regression suggested that the following variables were directly involved in the self-perception of malocclusion: upper anterior crowding > or = 2 mm (P=0.009), median diastema > or = 2 mm (P=0.040), normative treatment need (highly desirable) (P<0.001) and low economic level (P<0.001). CONCLUSION: Negative repercussions on daily living were found in Brazilian adolescents with malocclusions affecting anterior dental aesthetics.