Mechanical control of biofilm in children with cerebral palsy: a randomized clinical trial.

BACKGROUND: Dental biofilm removal is difficult and can be ineffective in individuals with cerebral palsy. OBJECTIVE: Determine the effectiveness of brushing with an electric toothbrush on and off in comparison with manual brushing for the removal of biofilm in children aged four to 16 years with cerebral palsy. METHODS: A crossover, randomized, simple-blind, clinical trial was conducted. The examiner was blinded to the brushing method (G1: manual; G2: electric toothbrush on; and G3: electric toothbrush off). The order was determined randomly. The participants (n = 40) were examined before and after brushing performed by caregivers using the Turesky-Quigley-Hein biofilm index. Statistical analysis involved the paired t-test, Wilcoxon, Kruskal-Wallis, and anova tests. RESULTS: Biofilm was significantly reduced with the three brushing methods (P < 0.001) (mean reductions: 47.6% in G1; 47.4% in G2; 44.5% in G3). Significant differences were found between G1 and G3 (P < 0.001) and between G2 and G3 (P = 0.007). No significant difference was found between G1 and G2 (P = 0.06). CONCLUSION: All methods reduced biofilm. Effectiveness was similar between manual brushing and with the electric toothbrush on, whereas both these methods achieved better results in comparison with the electric toothbrush switched off.

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.

Association between dental trauma and alcohol use among adolescents.

AIM: To investigate the association between dental trauma and alcohol use among adolescents between 14 and 19 years of age. MATERIALS AND METHODS: A cross-sectional study was carried out involving a clinical exam performed by a calibrated researcher (intra-examiner Kappa = 0.93) and a self-administered questionnaire. The sample was representative of schoolchildren from the city of Diamantina (Brazil) and was made up of 738 adolescents. The type of school (public or private) was used as a socioeconomic indicator. Information on alcohol use (high risk and hazardous use) was acquired through the administration of the Alcohol Use Disorders Identification Test, which has been validated for use in Brazil. RESULTS: The prevalence of dental trauma was 26.6%, and the prevalence of dangerous alcohol use was 44.3%. Dental trauma was significantly associated with a high risk of problems related to alcohol intake (P = 0.031), hazardous alcohol use (P = 0.009) and binge drinking (P = 0.036). The results of the Poisson logistic regression revealed that hazardous alcohol use [PR = 1.30 (95% CI: 1.01-1.66) P = 0.042] remained associated with dental trauma independently from age, gender, overjet, and type of school. CONCLUSIONS: The high prevalence of dental trauma found among adolescents in the city of Diamantina (Brazil) was greater among those at high risk for problems related to alcohol intake and was significantly associated with hazardous alcohol use.

Non-accidental collision followed by dental trauma: associated factors.

The aim of the present cross-sectional survey was to assess factors associated with non-accidental collision followed by dental trauma among adolescents in the city of Diamantina, Brazil. A total of 387 students from 12 to 15 years of age (mean = 14 SD = 0.9) were randomly selected. The study was carried out in two stages. Firstly, data were collected through dental examinations of permanent incisors. Secondly, a thorough interview was held with 85 adolescents who exhibited dental trauma in the dental examinations. The interview consisted of a detailed description of the incident and physical environment in which it occurred. Descriptive analysis and the chi-square test (P < 0.05) were performed. The prevalence of dental injury was 22% (n = 85). Dental trauma was more prevalent in boys (P = 0.001) and individuals with overjet >3 mm (P = 0.007) and inadequate lip coverage (P = 0.013). Analysis of the event revealed that 22.3% of the cases of dental trauma occurred because of non-accidental collision. Non-accidental collision followed by injury occurred mainly at school (P < 0.001) and in an environment with a concrete, tiled or ceramic floor (P = 0.001). No statistically significant associations were found between non-accidental collision and gender, age or mother's schooling. It was concluded that the non-accidental collisions happened especially at school and in indoor environments with a concrete, tiled or ceramic floor.

Fanconi's anemia in dentistry: a case report and brief literature review / Anemia de Fanconi em odontologia: relato de caso e breve revisão da literatura

PURPOSE: To present a critical analysis of the dental literature about the oral, skeletal and developmental manifestations associated with Fanconi's anemia (FA) and to describe a clinical case. CASE DESCRIPTION: Patient: male, Caucasian, 18 years-old. At the physical exam, the patient's appearance was roughly that of a 12-year-old child. The oral exam revealed carious lesions, gingivitis, bilateral crossbite and anterior open bite. Several teeth were absent and several primary teeth were present. CONCLUSION: The review of the literature reveals a heterogeneous pattern for the oral manifestations of FA, as observed in the case described in the present report. The most common oral manifestations of the disease are gingivitis, periodontitis, dental agenesis and squamous cell carcinoma.

PROPOSTA: O objetivo deste estudo foi realizar uma análise crítica da literatura considerando as manifestações bucais, esqueléticas e de desenvolvimento associadas à anemia de Fanconi (AF) e apresentar um caso clínico. DESCRIÇÃO DO CASO: Trata-se de um paciente branco, sexo masculino, de 18 anos de idade, com aparência de uma criança de aproximadamente 12 anos de idade. Ao exame bucal observaram-se lesões de cárie, gengivite, mordida cruzada bilateral e mordida aberta anterior. Vários dentes permanentes estavam ausentes e muitos dentes decíduos ainda estavam presentes. CONCLUSÃO: A revisão crítica da literatura revelou um padrão heterogêneo com relação às manifestações bucais da AF, como observado no caso clínico descrito. As manifestações bucais mais comuns da doença são gengivite, periodontite, agenesia dental e carcinoma de células escamosas.