Oral health-related quality of life in children and adolescents with cerebral palsy: paired cross-sectional study.

OBJECTIVES: To evaluate the impact of oral health conditions on the Oral Health-Related Quality of Life (OHRQoL) in children and adolescents with Cerebral Palsy (CP) and compare with children and adolescents without CP. METHODS: This was a paired cross-sectional study, consisting of 121 children and adolescents with CP and 121 without CP, aged 6 to 14 years. Caregivers filled a socioeconomic-demographic and the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Physical examination of the oral cavity assessed the dental caries experience, need for treatment, consequences of untreated dental caries, presence of dental trauma, bruxism and malocclusion. A descriptive analysis and Kruskal-Wallis and Mann-Whitney tests (p < 0.05) were performed. Variables with p values ≤ 0.20 in the bivariate analysis were included in the adjusted model analysis. Variables with a p value < 0.05 remained in the final Poisson Regression model. RESULTS: Caries experience had a negative impact on the quality of life of both groups, with and without CP. Presence of gastroesophageal reflux and difficulty to opening the mouth also had a negative impact on the OHRQoL of the group with CP. CONCLUSION: Children and adolescents with CP suffered a greater negative impact on OHRQoL than individuals without CP. Difficulty in opening the mouth and the presence of GER had a negative effect on the quality of life of individuals with CP, while dental caries had a negative impact on the OHRQoL of children and adolescents of both groups.

Gut capacity of broiler breeder hens.

1. Broiler breeders are subjected to qualitative or quantitative feed restrictions to prevent obesity, which causes major health and welfare problems. Diluting their feed by adding inert or low nutrient, bulky materials can reduce obesity, but the capacity of the gut needs to be determined to apply this strategy successfully. Two trials were conducted to measure the bulk capacity of Ross 308 broiler breeders prior to and after the onset of lay. The trial was completely randomised, with nine individually-caged breeders, with each cage as a replicate, totalling 189 birds per trial2. Birds were given ad libitum access to one of 21 maize-soyabean based feeds, an undiluted control or progressive dilution (10, 20, 30 and 40%) with either cellulose fibre, rice husk, sand, vermiculite or sawdust. Feeds were analysed for density, crude-, acid detergent- and neutral detergent-fibre, water-holding capacity (WHC), cation-exchange capacity and oil-holding capacity.2. In general, feed intake (scaled to body weight0.67) increased and then declined as the proportion of each diluent increased. Intake increased linearly when rice hulls and sand were used as diluents.3. Water holding capacity was the most appropriate measure to define the gut capacity of broiler breeders.4. The trial data was used to estimate the maximum-scaled feed intake (SFImax) in broiler breeders, which was 240-56.1WHC + 4.34WHC2 g/kg0.67/d.

Physiologic and behavioural signs during a dental appointment in children and teenagers with Cerebral Palsy: a comparative cross-sectional study.

AIM: To evaluate the heart rate (HR) and behaviour of children and teenagers with Cerebral Palsy (CP) when having a dental appointment. METHODS: A comparative cross-sectional study was carried out with 60 participants with CP, between 2 and 14 years old (study group-SG), and 60 normotypical individuals (CG). The sample was paired according to age, gender and socioeconomic status. Behaviour was evaluated during dental prophylaxis using the Frankl Scale, and HR was measured at five moments: before the appointment, when sitting in the dental chair, during the clinical examination, during prophylaxis and immediately after prophylaxis. Mann-Whitney, Friedman and Chi-square tests were applied at a significance level of 5%. RESULTS: SG presented significantly higher HR (p < 0.001) and more participants with uncooperative behaviour (p < 0.001) than CG in all observational periods. Furthermore, SG participants with uncooperative behaviour presented higher HR values than those in SG who were cooperative in all observational periods (p ≤ 0.002). CONCLUSIONS: Individuals with CP have a higher HR before and during the clinical session, and are frequently more uncooperative with the procedure than normotypical individuals.

Exploring the association of predisposing factors of Cerebral Palsy and developmental defects of enamel: a case-control study.

AIM: To evaluate the occurrence of developmental defects of enamel (DDE) in children and adolescents with Cerebral Palsy (CP) and to analyze the effect of common factors in the etiology of CP on the occurrence of DDE. METHODS: A case-control study was carried out using the modified DDE index to classify enamel defects. The study group (SG) consisted of 45 participants with CP aged between three and 14 years. The control group (CG) consisted of 88 normotypical schoolchildren, paired by gender and age group. Caregivers answered a questionnaire on their socioeconomic status and medical history. The Chi-square tests, bivariate and multivariate analysis were performed (level significance < 0.05). RESULTS: The occurrence of DDE in SG and CG was 60% and 64.8%, respectively (p value = 0.726). The most frequent defect observed in SG was diffuse opacity (44.4%), followed by demarcated opacity (26.7%) and enamel hypoplasia (2.2%). No difference was observed in the defect's distribution among both groups (p value = 0.083). For SG, the bivariate analysis revealed a statically significant association between the presence of DDE and age group 7-14 years old and maternal schooling below 11 years. After adjusting for confounding variables, age, family income and maternal schooling were not associated with DDE. CONCLUSION: In conclusion, the occurrence of DDE was high and similar in both groups. The pre, peri or post-natal factors associated with CP were not significant for the presence of DDE.

Risk Factors Associated with Probable Sleep Bruxism of Children and Teenagers with Cerebral Palsy.

AIM: To assess the association between probable sleep bruxism (PSB) and other occlusal characteristics in children and teenagers with Cerebral Palsy (CP). STUDY DESIGN: A cross-sectional study was carried out with 148 participants (74 with CP and 74 without special needs) aged between 2 and 14 years old. Participants underwent an oral clinical examination to evaluate the occlusal characteristics. Parents/caregivers filled out a questionnaire with information related to the typical sounds of PSB, sociodemographic factors and the presence of harmful oral habits in the study participants. Data analysis was carried out, using Chi-square or Fisher's exact test and Odds Ratio (p<0.05). RESULTS: PSB and malocclusion (68.9% and 95.9%, respectively) were more prevalent in participants with CP than in participants without CP. The association between PSB and the presence of a wear facet was statistically significant (p < 0.001) in participants with CP. In this group, 64.8% of participants with PSB presented tooth wear. CONCLUSION: Presence of dental wear facets was significantly associated with PSB in individuals with cerebral palsy.