Comparison Between Radiographs, White and Fluorescent Images in the Diagnosis and Treatment Decisions for Occlusal Caries: An Ex Vivo Study

ABSTRACT Objective: To compare the agreement of images in white light (WL), fluorescence (FL), and digital radiographs (DR), on the diagnosis and treatment decisions for occlusal caries lesions against a micro-CT gold standard. Material and Methods: Ten extracted third molars, with enamel and/or dentin caries (ICDAS 2-4), were included. Occlusal surface images were acquired with an intraoral camera (SoproLife®) in WL and FL modes. DR was obtained using an intraoral X-ray and a semi-direct digital system. A total of 780 images were needed, organized in a template, to be later examined by twenty-six dentists invited to compose the study. The Generalized Estimation Equations model was used to compare the proportions of the correct answers between the three methods and the gold standard. When significant, Bonferroni post-hoc test was used to identify differences (α=5%). Results: Most of the examiners were specialists (76.9%) with 14.5 years of experience. All diagnostic methods were similar and showed low agreement (DR 12.7%, WL 16.5%, and FL 16.5%) compared with gold standard caries diagnostic scores. Regarding treatment decisions, mean agreement for all diagnostic methods was higher (43.2%; p<0.001), and among all methods, WL (48.1%) and FL (51.2%) modes performed better than DR (30.4%, p<0.001). Conclusion: SoproLife® images could help clinicians to propose rational, minimally invasive treatments for occlusal caries lesions.

Relationship between Malocclusion, Bullying, and Quality of Life in Students from Low Social Development Area: A Cross-Sectional Study

ABSTRACT Objective: To analyze the relationship between malocclusion and bullying and its impact on the well-being and quality of life of students from low social development areas. Material and Methods: This cross-sectional study included 243 schoolchildren between 10 and 17 years. Malocclusion was analyzed using Dental Aesthetic Index. Bullying and self-perception of the impact of one's oral condition on quality of life and interpersonal relationships were assessed by questions from National Survey of Schoolchildren's Health and Child Perceptions Questionnaire 11-14 (CPQ11-14). Data were analyzed using the Spearman correlation coefficient and Mann-Whitney tests, considering groups: 10-11, 12-14 and 15-17 years. Results: No correlation was observed between malocclusion and bullying. However, in the 12-14 group, poor correlations were found between malocclusion and the CPQ11-14 (0.226) and between malocclusion and being shy/embarrassed due to oral aspects (0.298). Positive correlations were observed between bullying and the impact on the quality of life in the 10-11 (0.420) and 12-14 (0.425) groups. In the older group, a positive correlation (0.724) was observed between the concern about what others think of their oral health and the impact on their quality of life. Conclusion: There was no evidence of a relationship between malocclusion and bullying. However, the oral conditions negatively affected the interpersonal relationships and the student's quality of life.

Retenção do conhecimento sobre saúde bucal em uma amostra de escolares de Nova Friburgo / Knowledge retention about oral health in a sample of school children from Nova Friburgo

As medidas de orientação para a prevenção da cárie apoiam-se na educação em saúde bucal do paciente. Este trabalho avaliou a retenção do conhecimento sobre saúde bucal em escolares, antes e depois da realização de oficinas educativas. Após a aprovação no comitê de ética em pesquisa (CEP Nº2.987.965) este estudo foi realizado com crianças do ensino fundamental de uma escola pública em Nova Friburgo-RJ. Um questionário sobre práticas de higiene bucal e dieta, e conhecimento sobre as doenças bucais foi desenvolvido e aplicado antes da realização de oficinas educativas em saúde bucal e 15, 30, 60 e 90 dias após. A amostra foi de 136 escolares, 54,4% meninos e 45,6% meninas, com média de idade de 8,7 anos. Antes das oficinas as crianças relataram limpar seus dentes todos os dias (91,2%), pelo menos três vezes ao dia (60,3%), utilizando escova, pasta e fio dental (52,9%); 59,6% das crianças relataram saber o que causava a cárie antes das oficinas; 15 e 30 dias após as oficinas, os percentuais foram de 94,9% e 98,5%, respectivamente (p<0,05), diminuindo para 58,8% após 60 dias. Para a gengivite, apenas 11,8% das crianças relataram saber a causa da doença antes das oficinas; 15 e 30 dias após os percentuais foram de 81,6% e 94,9%, respectivamente, diminuindo para 13,2% após 60 dias. Com base nos resultados observou-se uma diminuição na retenção do conhecimento após 30 dias da realização das atividades educativas, sugerindo que esta população deva receber um programa de educação em saúde bucal de forma continuada.

Guidance measures for the prevention of caries are supported by education in the patient's oral health. This study evaluated the retention of knowledge about oral health in schoolchildren before and after educational workshops. After approval by the Research Ethics Committee (CEP No. 2,987,965) the study was carried out with elementary school children from a public school in Nova Friburgo. A questionnaire on hygiene and dietary practices and knowledge about oral diseases was applied before educational workshops on oral health and 15, 30, 60 and 90 days after. The sample consisted of 136 students, 54.4% boys and 45.6% girls, with an average age of 8.7 years. Before the workshops children reported cleaning their teeth every day (91.2%), at least three times a day (60.3%), using a brush, toothpaste and dental floss (52.9%); 59.6% of children reported knowing what caused decay before participating in the workshops; 15 and 30 days after the workshops the percentages were 94.9% and 98.5%, respectively (p <0.05), decreasing to 58.8% 60 days after. For gingivitis, only 11.8% of children reported knowing the cause of the disease before the workshops; 15 and 30 days after the percentages were 81.6% and 94.9%, respectively, decreasing to 13.2% after 60 days. Based on the results, there was a decrease in knowledge retention after 30 days of educational activities, suggesting that this population should receive an oral health education program on an ongoing basis.

Impact of oral health on the quality of life and personal satisfaction of adolescents from urban and rural areas from a city in brazil: a cross-sectional study

Objective: Evaluate the impact of oral health status on the quality of life and personal satisfaction among adolescents from urban and rural areas, in Nova Friburgo, Brazil. Methods: Adolescents between 11 and 14 years, enrolled in the schools participating in the Health in School Program (HSP) of rural and urban of this city (n = 509), received the consent form for the participation in this study, along with the economic questionnaire to be handed to the responsible. Adolescent´s oral health status was evaluated clinically, through the Decayed, Missing and Filled Teeth (DMFT); pulpal involvement, ulceration, fistula and abscess criteria (PUFA); and Dental Treatment Needs Index (DTNI). The quality of life was measured through the Child Perception Questionnaire (CPQ11-14), while personal satisfaction´s evaluation, through the Subjective Happiness Scale (SHS), both as interview. Statistical tests were performed (Chi-Square; Fisher's exact; Mann-Whitney) with level of significance of 5%. Results: The final sample comprised 161 adolescents. The impact of oral health status on the quality of life of adolescents from both areas was not significantly different, although the aggravation of the oral condition showed a tendency to worse the quality of life. Similarly, there was no relation of the oral status with personal satisfaction, without differences between the groups. It was observed that rural adolescents presented better quality of life (p<0.010), while the urban ones had higher degree of personal satisfaction (p<0.001). Conclusion: Oral health status had a negative impact on the quality of life, but had no relation to personal satisfaction, regardless of the demographic area.

Objetivo: Avaliar o impacto do estado de saúde bucal na qualidade de vida e na satisfação pessoal de adolescentes das áreas urbana e rural de Nova Friburgo, Brasil. Métodos: Adolescentes entre 11 e 14 anos, matriculados nas escolas participantes do Programa Saúde na Escola (PSE) da zona rural e urbana desta cidade (n = 509), receberam o Termo de Consentimento Livre e Esclarecido para a participação neste estudo,juntamente ao questionário econômico a ser entregue para o responsável. O estado de saúde bucal do adolescente foi avaliado clinicamente, por meio dos índices Cariados, Perdidos e Obturados (CPOD); critérios de envolvimento pulpar, ulceração, fístula e abscesso (PUFA); e Índice de Necessidades de Tratamento Odontológico (INTO). A qualidade de vida foi mensurada por meio do Child Perception Questionnaire (CPQ11- 14), enquanto a avaliação da satisfação pessoal, por meio da Subjective Happiness Scale (SHS), ambos na forma de entrevista. Foram realizados testes estatísticos (Qui-Quadrado; Exato de Fisher; Mann-Whitney) com nível de significância de 5%. Resultados: A amostra final foi de 161 adolescentes. O impacto do estado de saúde bucal na qualidade de vida dos adolescentes de ambas as áreas não foi significativamente diferente, embora o agravamento da condição bucal tenha apresentado tendência a piorar a qualidade de vida. Da mesma forma, não houve relação da condição oral com a satisfação pessoal, sem diferenças entre os grupos. Observou-se que os adolescentes rurais apresentaram melhor qualidade de vida (p<0,010), enquanto os urbanos apresentaram maior grau de satisfação pessoal (p<0,001). Conclusão: O estado de saúde bucal teve impacto negativo na qualidade de vida, mas não teve relação com a satisfação pessoal, independente da área demográfica.

Oral findings in a family with Tuberous sclerosis complex.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder with a multisystemic character that may present alterations in multiple organ systems, including oral manifestations. This case report describes a family (mother and two sons) with TSC that underwent a multidisciplinary approach, emphasizing their oral manifestations and highlights the adequate approach taken. The children presented many and distinct features of TSC in different systems; however the family revealed similar oral manifestations. The oral findings were dental enamel pits on permanent teeth and spread gingival fibromas on both jaws. The dental planning was the same for all three patients and included guidelines on oral hygiene and dietary habits, fluoride therapy and a preventive approach through six-month reevaluations. In multisystemic disorders, early multidisciplinary action is vital to provide comprehensive care and reduce or even prevent complications from the condition, thus ensuring the patient's quality of life.

Diagnóstico de cárie sob o enfoque da odontologia baseada em evidências / Caries diagnosis under the focus of the evidence-based dentistry

Todo cirurgião-dentista, principalmente o odontopediatria, necessita ter conhecimento suficiente quanto aos métodos de diagnóstico disponíveis para a detecção de cárie dentária, além de entender a efetividade desses métodos para dar apropriado peso ao resultado nos momentos de decisão clínica. O objetivo deste trabalho é verificar o que diz a literatura sobre os procedimentos utilizados no diagnóstico da cárie dentária, em odontopediatria, por meio da metodologia proposta pela Odontologia baseada em evidências (OBE). Este estudo foi dividido em duas etapas. Na primeira, foi realizada uma busca na base de dados MEDLINE de textos relacionados ao assunto, em língua inglesa, e revisão de alguns livros de epidemiologia. Em seguida, todos os resumos dos trabalhos apresentados pela base de dados, a partir das palavras-chave indicadas pelo Medical Subject Headings (MeSH), foram lidos e classificados quanto à relevância e pertinência ao tema. O periódico que mais publicou artigos relevantes foi o Caries Research, e os países que mais pesquisaram com a metodologia da OBE foram o Reino Unido e os Estados Unidos. Nenhuma metanálise pertinente ao tema foi realizada até o presente momento

Any dental clinician, specially the pediatric dentist, needs to have know-how about the available diagnostic procedures for dental caries detectionand understand the effectiveness of these procedures in order to give appropriate weight to the result in clinical decision taking. The purpose of the present paper is to verify the status of the literature about the procedures available in dental caries diagnosis, in pediatric dentistry,using the evidence-based dentistry methodology. This study was carried out in two phases. The first one consisted in a search for texts related to the theme, in English language and indexed in the MEDLINE database,as well as a review of some Epidemiology books. After that, all abstractsof the papers obtained through the key words provided by the Medical Subject Headings (MeSH), were read and classified according to their relevance and pertinence. The journal and the countries that most published relevant and pertinent papers were Caries Research and the United Kingdom (UK) and United States of America (USA), respectively. No pertinent meta-analysis has been made until the present moment

Caries diagnosis under the focus of thee vidence-based dentistry

Any dental clinician, specially the pediatric dentist, needs to have knowhow about the available diagnostic procedures for dental caries detection and understand the effectiveness of these procedures in order to give appropriate weight to the result in clinical decision taking. The purpose of the present paper is to verify the status of the literature about the procedures available in dental caries diagnosis, in pediatric dentistry,using the evidence-based dentistry methodology. This study was carried out in two phases. The first one consisted in a search for texts related to the theme, in English language and indexed in the MEDLINE database,as well as a review of some Epidemiology books. After that, all abstracts of the papers obtained through the key words provided by the Medical Subject Headings (MeSH), were read and classified according to their relevance and pertinence. The journal and the countries that most published relevant and pertinent papers were Caries Research and theUnited Kingdom (UK) and United States of America (USA), respectively.No pertinent meta-analysis has been made until the present moment.

Todo cirurgião-dentista, principalmente o odontopediatra, necessita ter conhecimento suficiente quanto aos métodos de diagnóstico disponíveis para a detecção de cárie dentária, além de entender a efetividade desses métodos para dar apropriado peso ao resulta donos momentos de decisão clínica. O objetivo deste trabalho é verificar o que diz a literatura sobre os procedimentos utilizados no diagnóstico da cárie dentária, em odontopediatria, por meio da metodologia proposta pela Odontologia baseada em evidências (OBE). Este estudofoi dividido em duas etapas. Na primeira, foi realizada uma busca nabase de dados MEDLINE de textos relacionados ao assunto, em língua inglesa, e revisão de alguns livros de epidemiologia. Em seguida, todos os resumos dos trabalhos apresentados pela base de dados, a partir das palavras-chave indicadas pelo Medical Subject Headings (MeSH),foram lidos e classificados quanto à relevância e pertinência ao tema.O periódico que mais publicou artigos relevantes foi o Caries Research,e os países que mais pesquisaram com a metodologia da OBE foram o Reino Unido e os Estados Unidos. Nenhuma metanálise pertinente ao tema foi realizada até o presente momento.

Remoção químico-mecânica da cárie: evidências atuais / Chemo-mechanical caries removal: current evidences

Ao longo dos anos, a Odontologia Restauradora vem aprimorando as técnicas de remoção do tecido cariado, visando facilitar a rotina clínica. Um desses avanços foi a introdução da remoção químico-mecânico da cárie. O presente trabalho tem como objetivo apresentar dois produtos atualmente disponíveis para a remoção químico-mecânica da cárie, bem como comparar suas técnicas. Os produtos disponíveis são o Carisolv e o Papacárie®, que não requerem o uso de anestesia local e instrumentos rotatórios. Eles diferem na origem e composição. As evidências científicas atuais conferem ao Carisolv maior visibilidade internacional em razão das pesquisas já publicadas, ao passo que o Papacárie® necessita de um maior número de pesquisas para comprovar sua efetividade prática clínica