Pattern of oral and maxillofacial trauma and associated factors: An 8-year prospective study.

BACKGROUND/AIMS: Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT victims on the health system. The aim of this study was to conduct an 8-year prospective analysis of OMFT cases from an emergency service. MATERIALS AND METHODS: A hospital-based 8-year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Data regarding sociodemographic (gender, age, and skin color) and socio-economic profiles (educational level, family income, and occupation), OMFT profile (etiology, OMFT type, and treatment), associated factors [alcohol consumption and personal protective equipment (PPE) use], OMFT occurrence (injury day and hour), length of hospital stay, and cost were collected. Descriptive and inferential analyses of data were performed. RESULTS: Most OMFT cases involved men with low schooling and family income, resulting from traffic accidents. OMFT severity was associated with longer hospital stay, higher hospital costs and nonuse of PPE, midface fractures (mainly orbital-zygomatic fractures), closed reduction, and open reduction/internal fixation. Traffic accidents were the main cause of longer hospital stays for victims aged 41-60 years with better socio-economic status compared with cases that had higher hospital costs. In general, higher hospital costs were associated with victims of violence under 40 years of age, with low schooling and farmers. Alcohol consumption and non-use of PPE also contributed to increasing the length of hospital stay. CONCLUSION: Oral and maxillofacial trauma severity was associated with longer hospital stay and higher hospital costs. Associated factors such as alcohol consumption and non-use of PPE contributed to increase the length of hospital stay and OMFT severity.

Teething symptoms in children with congenital Zika syndrome: A 2-year follow-up.

BACKGROUND: The eruption of primary teeth represents a stage of many challenges for parents. AIM: To investigate the occurrence of signs and symptoms related to the eruption of the primary dentition in children with congenital Zika syndrome. DESIGN: Longitudinal study developed with 79 children followed up for a period of 24 months. Data on sex, gestational age, low birthweight, microcephaly, signs and symptoms related to the dental eruption phase, and use and type of medication were collected. Data were presented by descriptive and inferential statistics (chi-square test). RESULTS: The majority (94.9%) exhibited simultaneously two or more signs and symptoms related to dental eruption. Increased salivation (91.1%), irritability (86.1%), and gingival itching (83.5%) were the most commonly reported signs and symptoms. Bivariate analysis showed association between elevation of body temperature and sex (P < 0.05). Almost two-thirds of mothers (63.3%) reported using medication to relieve symptoms presented by the child; however, the use of topical medication prevailed (57.1%). CONCLUSION: All children with congenital Zika syndrome presented manifestations related to the eruption of primary teeth, with increased salivation, irritability, and gingival pruritus. The use of ointments and gels was the option of mothers in the treatment of the oral discomfort presented by infants.

Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion.

The aim of this study was to evaluate whether there is an association between risk behavior for eating disorders (EDs) and dental erosion and caries. A controlled cross-sectional study was conducted in Brazil, involving 850 randomly selected female adolescents. After evaluating risk behavior for eating disorders through the Bulimic Investigatory Test of Edinburgh, 12 adolescents were identified with severe risk behavior for EDs and matched to 48 adolescents without such risk. Dental examinations, anthropometric measurements, and eating habits and oral hygiene were performed. Adolescents with high severity eating disorder condition were not more likely to show dental caries (p = 0.329; OR = 2.2, 95% CI: 0.35-13.72) or dental erosion (p = 0.590; OR = 2.33; 95% CI: 0.56-9.70). Adolescents with high body mass index (BMI) were five times more likely to have high severity eating disorder condition (p = 0.031; OR = 5.1; 95% CI: 1.61-23.07). Therefore, high severity risk behavior for EDs was not significantly associated with dental caries and dental erosion. However, high BMI was a risk factor for developing eating disorders and should be an alert for individuals with this condition.

Antifungal activity and mode of action of thymol and its synergism with nystatin against Candida species involved with infections in the oral cavity: an in vitro study.

BACKGROUND: Limitations of antifungal agents used in the treatment of oral candidiasis, as the development of resistant strains, are known by the scientific community. In this context, the aim of this study was to evaluate the antifungal activity of thymol against Candida albicans, Candida tropicalis and Candida krusei strains and to determine its mode of action and synergistic effect when combined with the synthetic antifungal nystatin. METHODS: The minimum inhibitory concentration (MIC) was determined using a microdilution technique, and the minimum fungicidal concentration (MFC) was determined via subculture sowing. The mode of action of thymol was established by verifying fungal growth in the presence of sorbitol or ergosterol. The fractional inhibitory concentration index (FIC) was determined using the checkerboard method. RESULTS: Thymol presented an antifungal effect, with MICs of 39 µg/mL for C. albicans and C. krusei and 78 µg/mL for C. tropicalis. The results of the antifungal test remained unchanged in the presence of sorbitol; however, the MIC value of thymol against C. albicans increased eight times (from 39.0 to 312.5 µg/mL) in presence of exogenous ergosterol. The combination of thymol and nystatin reduced the MIC values of both products by 87.4%, generating an FIC index of 0.25. CONCLUSIONS: Thymol was found to have a fungicidal effect on Candida species and a synergistic effect when combined with nystatin.

Dental trauma in Brazilian children and adolescents with cerebral palsy.

BACKGROUND: Assessing the frequency and factors associated with dental trauma in pediatric populations with cerebral palsy is important for the planning and implementation of prevention and health promotion programs. The aim of this study was to determine the prevalence and factors associated with dental trauma in children and adolescents with cerebral palsy. MATERIAL AND METHODS: Cross-sectional study with a non-probabilistic sample of 80 patients aged 2-18 years was treated in a rehabilitation institution in northeastern Brazil. Caregivers completed a socioeconomic questionnaire, while oral exams were performed by a calibrated investigator (K = 0.75-1.00), with record of the Dental Trauma Index, DMFT and dmft, and Dental Aesthetics and malocclusion indices. Bivariate and multivariate Poisson regression analyses (α = 0.05) were performed with the Statistical Package for Social Sciences, version 17. RESULTS: The prevalence of dental trauma was 36.3%, enamel fracture was the most common trauma (89.1%), and the upper central incisors were the most affected dental elements (63.0%). Patients with dental trauma were male, aged 7-18 years, with family income more than one minimum wage, caregiver's education over 4 years, increased overjet, lip hypotonia, quadriplegia, epilepsy, oral breathing, and severe communication skills. The presence of dental trauma was not associated with socioeconomic characteristics (gender, age, family income, and caregiver's educational level), oral health perception, and systemic and oral conditions (dental caries, malocclusion, and lip hypotonia) were evaluated (P > 0.05). CONCLUSION: The prevalence of dental trauma was high, but not associated with clinical variables and evaluated socioeconomic indicators.

Use of alcohol vinegar in the inhibition of Candida spp. and its effect on the physical properties of acrylic resins.

BACKGROUND: Given the high prevalence of oral candidiasis and the restricted number of antifungal agents available to control infection, this study investigated the in vitro antifungal activity of alcohol vinegar on Candida spp. and its effect on the physical properties of acrylic resins. METHODS: Tests to determine the Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC) of vinegar alcohol (0.04 g/ml of acetic acid) and nystatin (control) were performed. The antifungal activity of alcohol vinegar was assessed through microbial growth kinetic assays and inhibition of Candida albicans adhesion to acrylic resin at different intervals of time. Surface roughness and color of the acrylic resin were analyzed using a roughness meter and color analyzer device. RESULTS: Alcohol vinegar showed MIC75% and MFC62.5% of 2.5 mg/ml, with fungicidal effect from 120 min, differing from nystatin (p < 0.0001), which showed fungistatic effect. Alcohol vinegar caused greater inhibition of C. albicans adhesion to the acrylic resin (p ≤ 0.001) compared to nystatin and did not change the roughness and color parameters of the material. CONCLUSION: Alcohol vinegar showed antifungal properties against Candida strains and caused no physical changes to the acrylic resin.

Head and maxillofacial injuries in child and adolescent victims of automotive accidents.

BACKGROUND: Victims of motor vehicle accidents may suffer multiple lesions, including maxillofacial injuries. The aim of this study was to evaluate the prevalence and factors associated with head, facial, and maxillofacial injuries in child and adolescent victims of automobile accidents. A cross-sectional study was carried out with analysis of forensic medical reports from the Legal Medical Institute of Campina Grande, Brazil, between January 2008 and December 2011. Descriptive and inferential statistical analysis was conducted using the chi-square test (α = 0.05). From 1613 medical reports analyzed, the sample is composed 232 (14.4%) reports referring to child and adolescent victims of automobile accidents aged 0-19 years of both sexes. Victims were mostly adolescents aged from 15 to 19 years (64.2%), males (73.7%), and motorcyclists (51.3%). More than half of the victims had single lesions (54.3%) located in the head (20.7%) and face (21.6%). Head injuries occurred more frequently in children aged 0-4 years (53.8%, PR = 5.065, 95% CI = 1.617-5.870) and pedestrians (30.4%, PR = 2.039, 95% CI = 1.024-4.061), while facial and maxillofacial injuries occurred in higher proportion among females (31.1%, PR = 0.489, 95% CI = 0.251-0.954). Our findings suggest that accidents involving motorcyclists are the most prevalent, affecting male adolescents aged from 15 to 19 years, resulting in a high frequency of injuries in the head and face regions.

Association between dental erosion and diet in Brazilian adolescents aged from 15 to 19: a population-based study.

Dental erosion is a pathological condition resulting from the irreversible dissolution of the mineralized portion of the teeth, being recognized in modern society as an important cause of loss of tooth structure. The aim of this study was to assess the prevalence and its association with diet in Brazilian adolescents of Campina Grande, PB, Brazil. A population-based study was conducted on a stratified sample of 675 adolescents aged from 15 to 19 of both sexes using the index proposed by O'Sullivan. Dental examinations were performed by two calibrated dentists (kappa = 0.82). The significance level adopted was 5%. The prevalence of dental erosion was 21%, and the upper central incisors and lateral incisors were the most affected elements, with 50.5% and 40.2%, respectively. The buccal surface showed greater impairment (51.4%) and 67.8% of teeth with dental erosion had more than half of the surface of affected area. Most damage was on the enamel (93.5%). There were no statistically significant differences between the occurrence of dental erosion and gender, age, socioeconomic status, self-reported ethnicity, and diet. There was high prevalence of dental erosion in its early stages among adolescents and there were no significant differences in the frequency of the consumption of foods and beverages and the presence of dental erosion.

Locked mouths: Tooth loss in a women's prison in northeastern Brazil.

BACKGROUND: Prisoners, in general, exhibit unsatisfactory oral conditions, especially with regard to the large number of missing teeth and with untreated caries. The aim of this study was to assess tooth loss, use of and need for prosthetic rehabilitation, and use of dental services among inmates. A cross-sectional study involving 65 inmates was developed at the Regional Women's Prison of Campina Grande, Brazil. Data regarding sociodemographic and sentencing profile, use of dental services, dental morbidity, and self-perceived oral health impacts were investigated. Chi-square, Pearson, and Kruskal-Wallis (P < 0.05) statistical tests were used. The mean tooth loss was 11.3 teeth. Significant association between tooth loss and oral health satisfaction (P = 0.049), self-perceived need for dental prosthesis (P < 0.001), uncomfortable teeth brushing (P = 0.005), difficult speaking (P = 0.002), and difficulty in performing routine tasks (P = 0.025) was observed. It was observed that 29.2% of inmates were using some type of prosthesis, all deemed unsuitable for use, and 78.5% of inmates needed prosthetic rehabilitation. The oral health condition of the population studied was found to be poor, and prisoners showed significant tooth loss and need for dentures, with the aggravation of having tooth extraction as the major reason for seeking dental care.

General Dentist's Knowledge and Attitude Towards Non-Surgical Endodontic Retreatment in Tunisia: A Cross-Sectional Study.

Introduction: Root canal retreatment is carried out in cases where previous endodontic therapies failed and involves the removal of root canal filling materials, followed by cleaning, shaping, and obturating of the canals. Aims: : The objective of this study was to collect information regarding attitudes, methods, and materials employed during the non-surgical endodontic retreatment (NSER) by general dentists working in Sousse Governorate, Tunisia. Materials and Methods: A descriptive cross-sectional survey was conducted among 147 general dentists working in the Sousse Governorate, Tunisia, from May to November 2021. Data were collected by sending a structured questionnaire to the dental practitioners through email. All the data were analyzed by using the SPSS 10 computer software. Results: A total of 96 dentists responded to this survey. The response rate was 63.5%, with a female predominance (53.2.3%). 81.2% of the respondents performed at least one non-surgical endodontic retreatment (NSER) weekly. Our study revealed that the mandibular first molar is the tooth that most often requires endodontic retreatment (83.5%). Half of the participants never used the rubber dam during this procedure. Moreover, the majority of respondents (61.9%) simultaneously used manual files and rotary nickel-titanium instruments for root canal desobturation. Most of the dentists (69.57%) systematically use solvents during root canal desobturation. Conclusion: Our survey highlights that the majority of general dentists have adequate knowledge about endodontic retreatment. Nevertheless, dentists are yet to start the application of these newer strategies towards the management of endodontic failures.

Negative self-perception of smile associated with malocclusions among Brazilian adolescents.

This study estimated the prevalence of negative self-perception of smile because of occlusion abnormalities and investigated their association according to standard clinical criteria. The sample consisted of 1290 randomly selected Brazilian adolescent boys and girls aged 12-16 years. The outcome of interest was dissatisfaction with smile, and data were collected using a standardized questionnaire. Occlusion characteristics were assessed using the dental aesthetic index (DAI). The other study variables were gender, age, and use of dental services. A chi-square test and Poisson multiple regression were used for statistical analysis. Of the 1290 students interviewed and examined, 539 (41.8 per cent) were dissatisfied with their smile; of these, 373 (69.2 per cent) assigned their dissatisfaction to the presence of an occlusal abnormality, and 166 (30.8 per cent) reported reasons other than occlusal abnormalities for their negative self-perception of their smile. In multivariate analysis, the following variables were associated with the outcome of interest: maxillary anterior irregularity [prevalence ratio (PR) = 1.40; 95 per cent confidence interval (CI) = 1.29-1.80], incisal spacing (PR = 1.37; 95 per cent CI = 1.19-1.57), vertical open bite (PR = 1.34; 95 per cent CI = 1.15-1.55), mandibular anterior irregularity (PR = 1.29; 95 per cent CI = 1.14-1.46), permanent anterior teeth missing (PR = 1.21; 95 per cent CI = 1.05-1.39), and incisal diastema (PR = 1.14; 95 per cent CI = 1.01-1.31). The negative self-perception of smile was statistically associated with severity of occlusal disorders according to the DAI scores, which suggests that self-perception should be used together with standard clinical criteria when decisions about orthodontic treatments are made in public health care systems.

Difficulties of dental practice among left-handed Tunisian students: a cross-sectional survey.

In dentistry, most equipment is designed for right-handed (RH) individuals. Thus, left-handed (LH) individuals are often forced to adapt to demanding RH working conditions, and therefore, experience difficulties in their practice. The objective of this study was to determine the prevalence of left handedness among dental students at the Dental Clinic of Monastir, Tunisia, and to investigate the difficulties for LH individuals during clinical practice. A cross-sectional study was conducted among dental students during the academic year from September 2019 to March 2020. An adaptation of the Grad-Corllet Diagram and a specific questionnaire on clinical practices were administered to 221 participants. Data were analyzed using SPSS 24.0 statistical software for descriptive statistics and the chi-square test was performed (with a 5% significance level). The study revealed that 18.1% of dental students were LH. Among which, 82.5% of LH students had difficulties using instruments designed for RH dentists, 47.5% of LH students preferred the 3 o'clock working position, and 77.5% of LH students preferred to work in a sitting position. Most LH students (70%) reported that endodontic treatment was the most difficult procedure to perform. All students, whether RH or LH, presented a higher percentage of pain in the lumbar and neck/cervical regions; however, LH students presented higher values (77.5%) with statistically significant differences being reported for lower back pain (p = 0.026) and neck pain (p = 0.012). This study highlights the difficulties that LH dental students face in performing dental work. Dental Schools should provide LH students with appropriate equipment and a proper learning environment.

Knowledge, attitudes, and perceptions regarding child abuse and neglect among dentists in Turkey.

Limited research attention has been paid to Turkish dentists' perceptions of child abuse and neglect (CA/N). This study aimed to examine Turkish dentists' knowledge about, attitudes toward, and perceptions of CA/N. A total of 229 Turkish dentists responded to the self-administered, valid and reliable questionnaire. It consisted of 34 questions that could be classified into the following conceptual categories: a) sociodemographic data, b) knowledge about legal procedures and the orofacial characteristics and findings that are indicative of CA/N, and c) self-efficacy and attitudes toward CA/N. Multivariate analysis of variance was conducted and partial eta squared coefficients were used statistically. Knowledge about legal obligations was associated with occupational experience, highest CA/N education, frequency of child dental treatment. Prior experience with case of suspected CA/N demonstrated the greatest effects. Knowledge about the orofacial characteristics and findings that are indicative of CA/N was associated with prior experience with at least one case of suspected CA/N. The most frequently provided reasons for failure to report cases of suspected CA/N were fear that the child would be harmed. Turkish dentists demonstrated moderate levels of knowledge about their legal obligations and the orofacial characteristics and findings that are indicative of CA/N. Dentists should receive detailed education on CA/N in their undergraduate and postgraduate education. In addition, it is necessary to increase awareness and knowledge about CA/N by providing in-service trainings at the institutions where they work.

Craniofacial trauma in Brazilian child victims of traffic accidents: A single-trauma center analysis.

BACKGROUND: Road traffic accidents are a significant public health problem and a major cause of economic loss globally. OBJECTIVES: The aim of the study was to describe the epidemiological profile of child victims of traffic accidents and the prevalence of craniofacial trauma in a municipality in the northeastern region of Brazil. MATERIAL AND METHODS: A documentary study was carried out through the analysis of the medical records of the traffic accident victims hospitalized in emergency wards in the municipality of Campina Grande, Paraíba, Brazil, from January to December 2016. A total of 1,884 medical records were evaluated, among which 85 (4.5%) referred to children aged 0-12 years. The information related to the sociodemographic profile of the victims, traffic accidents and clinical variables was collected. The data was analyzed using descriptive and inferential statistics, and a 5% level of significance was adopted. RESULTS: The victims were predominantly males (64.7%) and 9-12-year-old children (43.5%). Most accidents were recorded in the evening (48.2%) and on the weekend (32.9%). Among the victims, 37.6% were involved in motorcycle accidents. Craniofacial injuries were found in 44.7% of the children. Most victims were not admitted to the intensive care unit (ICU) (80.0%). Craniofacial trauma was significantly associated with motorcycle (p = 0.043) and automobile accidents (p = 0.013). CONCLUSIONS: Our findings suggest that motorcycles are the vehicles most frequently involved in traffic accidents, which predominantly affect males and children aged 9-12 years, and result in a high prevalence of craniofacial trauma.

Head and Face Injuries in Brazilian Homicide Victims - A Retrospective Study.

INTRODUCTION: Violence is a serious problem in view of its magnitude and impact on the health of the population in several countries. The aim of the study was to evaluate the occurrence of head and face injuries among homicide victims in a municipality in the Northeastern region of Brazil. MATERIALS AND METHODS: A cross-sectional study carried out at the Police Station for Crimes against Persons of the Civil Police, which evaluated 168 police inquiries of homicide victims notified from January 2015 to December 2018. Variables analyzed were related to the Victim's sociodemographic profile, homicide characteristics and body region involved. Descriptive data analysis and Pearson's Chi-square test (P < 0.05) were performed. RESULTS: There was greater involvement of men (92.9%) aged 20-29 years (36.3%), drug users (70.7%) and with a criminal record (65.9%). There was a predominance of simple homicides (92.3%), with greater occurrence on Sundays (16.7%), in the night shift (40.1%), revenge was the main reason for the crime (32%), and firearms as the main means used (89.2%). Regarding the number of body regions affected, victims were more frequently affected in 2 regions (36.5%). Head injuries were identified in 68.3% of victims, while face injuries represented 35.3%. There was an association between the presence of head injuries and number of injuries (P < 0.05). DISCUSSION: The prevalence of head and face injuries resulting from homicide was high and victims are predominantly young men, drug users and those with a criminal record. The association was found between the presence of head injuries and number of injuries.

Incisor Molar Hypomineralization and Quality of Life: A Population-Based Study with Brazilian Schoolchildren.

AIM: To assess the impact of incisor molar hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perception of students and their parents/caregivers. MATERIALS AND METHODS: This is a cross-sectional population-based study with 463 Brazilian students aged 11-14 years. OHRQoL was measured using the Child Perceptions Questionnaire (B-CPQ11-14ISF: 16) applied to students and the short version of the Parental-Caregiver Perceptions Questionnaire (B-P-CPQ) applied to parents/caregivers. The diagnosis of MIH followed the European Academy of Paediatric Dentistry criteria modified in 2019. Caries experience (ICDAS II), malocclusion (DAI), and socioeconomic and demographic factors were assessed as confounding factors for impact on OHRQoL. Cluster analysis was carried out to dichotomize the negative impact into greater and lesser impact. The chi-square test and Poisson regression were performed (p < 0.05) to verify associations between quality of life and MIH, adjusted for confounding variables. RESULTS: The prevalence of MIH was 10.8%. Multivariate regression demonstrated that caries experience was the only oral disease that impacted OHRQoL according to students' self-perception in the functional limitation domain (PR = 1.82; 95% CI = 1.20-2.77) and in the total questionnaire score (PR = 1.59; 95% CI = 1.00-2.51). However, according to the perception of parents/caregivers, in addition to caries experience, which affected OHRQoL in the oral symptoms (PR = 3.57; 95% CI = 1.71-7.414) and emotional well-being domains (PR = 1.71; 95% CI = 1.08-2.69), as well as in the total B-P-CPQ score (PR = 1.67; 95% CI = 1.01-2.76), malocclusion also affected OHRQoL in the social well-being domain (PR = 1.50; 95% CI = 1.07-2.10) and in the total questionnaire score (PR = 1.54; 95% CI = 1.11-2.15). CONCLUSION: According to students and their parents/caregivers' perception, incisor molar hypomineralization did not influence OHRQoL of the studied sample.

Presence of molar-incisor hypomineralization is associated with dental caries in Brazilian schoolchildren.

This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

Injuries to the head and face in 0-4-year-old child victims of fatal external causes in Campina Grande, PB, Brazil.

We evaluated the presence of injuries to the head and face in Brazilian 0-4-year-old child victims of fatal external causes by analyzing forensic medical reports derived from all autopsies performed in 0-4-year-old children at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2007. The study sample consisted of 81 reports (1.8%) referring to children who were confirmed to have died from external causes. Most victims were males (56.8%) and 1 year of age (27.2%). Drowning (34.6%) and motor vehicle accidents (22.2%) were the most common causes of death. Injuries to the head and to the face were found in 33.3% and 34.6% of the victims, respectively. There was a strong association between the occurrence of motor vehicle accidents and the presence of injuries to the head (p < 0.01; odds ratio [OR]=21.25 [5.29-85.31]) and to the face (p < 0.01; OR = 19.23 [4.83-76.56]). There was also an association between the existence of injuries to the head and presence of maxillofacial injuries (p < 0.01; OR = 5.09 [1.87-13.84]). Drowning and motor vehicle accidents were the main causes of death in children aged 0 to 4 years. Parents should adopt measures to make the home environment safer and prevent fatal accidents by limiting their children's access to pools and cisterns. Reduction in child mortality from motor vehicle accidents involves parental vigilance in the road traffic environment and home education on driveway safety.

Prevalence and characteristics of injuries to the head and orofacial region in physically abused children and adolescents--a retrospective study in a city of the Northeast of Brazil.

The aim of this study was to evaluate the prevalence and characteristics of injuries to the head and orofacial region in physically abused children and adolescents from a city of the Northeast of Brazil, based on the review of forensic medical reports. This retrospective study was undertaken by the analysis of expert medical reports derived from medical forensic exams performed at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2006. From a universe of 11 624 reports issued in this time span, the study sample consisted of 1070 reports referring to children and adolescents aged 0-17 years that were confirmedly victims of physical abuse. Male children (52.8%) in the 13- to 17-year-old range (72.4%) were the most frequent victims, with an association between gender and age group (P = 0.039). Most children (58.2%) presented a single type of injury, with a statistically significant association between number of injuries and gender (P = 0.040), but no significant association between number of injuries and age (P = 0.163). The percentage of victims injured in the head and face corresponded to 56.3%, with a statistically significant association between the presence of injury in the head and face and gender (P = 0.046). As much as 12.4% of the children and adolescents presented intraoral injuries, with no significant difference between genders (P = 0.543). However, a statistically significant association was observed between the number of existing injuries and the presence of oral injuries (P = 0.005). The maxilla was predominantly affected (55.6%), most injuries (94.8%) being soft-tissue lacerations located mainly in the upper lip (46.4%). The findings of this survey revealed a high prevalence of injuries to the head and orofacial region of physically abused children and adolescents.

Traumatic dental injuries and associated factors among Brazilian preschool children aged 1-5 years.

The aim of this study was to evaluate the prevalence of dental trauma in children aged 1 to 5 years old and its associated factors (gender, age group, malocclusion and labial-closing), interviewing parents and guardians for additional information on the trauma occurrence. A transversal study of 820 preschool children from the City of Caruaru, Pernambuco, Brazil was conducted. Data were collected by means of a clinical examination and a structured interview. The statistical analysis included a distribution of frequencies, a bi- and a multi-variate analysis at a significance level of 5%. Trauma prevalence was 20.1%, tooth 61 was the most often affected, and enamel fractures followed by the fractures of the enamel and the dentine were the most frequent alterations. Trauma prevalence was highest in 3- to 5-year-old males with malocclusion (open bite and protrusion) (p < 0.05). According to most parents and/or guardians, the most usual etiology was falling and the place most often cited was home. All the variables studied, except for lip coverage, were associated with dental trauma. The outcome of the present study showed high prevalence of dental trauma in a pediatric population under the age of 5 years. Falls and accidental collisions were the etiological factors most often cited. The front upper incisors were the teeth most often affected, and enamel fracture was the trauma most often observed.