Reliability between the two-colour chewing gum and the gummy-jelly tests used for the assessment of masticatory performance.

OBJECTIVE: This study aimed to evaluate the reliability of two methods used to assess masticatory performance and attempt to correlate them to achieve interchangeability between the methods. METHODS: Twelve healthy dentate volunteers (men = 6, women = 6; mean age = 28.3 ± 4.1) with no known dental or medical pathologies were requested to participate in this study. Each participant completed three masticatory performance assessments, including two two-colour mixing-ability tests using chewing-gums (CG: gum#1 and gum#2) and the gummy-jelly (GJ) test. For each method, participants created five samples each (total = 15 measurements per participant, gum#1 = 5, gum#2 = 5, GJ = 5). For the gum#1 and gum#2 methods, the predetermined chewing cycles were fixed at 10, 15, 20, 25 and 30 cycles, and for the GJ method, the time duration was fixed at 10, 15, 20, 25 and 30 s. The parameter measures were submitted to Z-score transformation, and Bland-Altman plots were generated to graphically compare the differences between two techniques against their means. Additionally, mountain plot was used to assess the cumulative distribution of measurement error between the methods. RESULTS: A total of 180 measurements were recorded. There were significant correlations between the number of chewing cycles/chewing time and masticatory performance using the gum#1 (r = -.753; p < .001), gum#2 (r = -.838; p < .001) and GJ (r = .730). When all tests were considered together for each method, significant correlations were found (p < .001). A descriptive range of mean values aiming to produce reference value ranges for predictive purposes was achieved considering the interchangeably among the methods [CG = GJ (VoH-mg = dL): 10 cycle = 10 s: 0.329 = 110; 15 cycles = 15 s: 0.177 = 164; 20 cycles = 20 s: 0.130 = 205; 25 cycles = 25 s: 0.086 = 200; 30 cycles = 30 s: 0.077 = 267]. CONCLUSION: The strong correlations and high consistency between the two masticatory performance methods found in this study conclude that the two assessment methods are reliable and interchangeable. Further evaluations are warranted to arrive at a conversion formula for translation of the results between the two methods.

Immediately loaded single-implant mandibular overdentures compared to conventional complete dentures: A cost-effectiveness analysis.

BACKGROUND: In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients. OBJECTIVE: The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER). RESULTS: Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score. CONCLUSIONS: Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources. CLINICAL SIGNIFICANCE: The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost.

Gender differences among dentistry conference speakers in Brazil / Diferenças de gênero entre palestrantes de congressos odontológicos no Brasil

ABSTRACT This study aimed to evaluate possible gender differences among the invited speakers of Brazilian dentistry meetings. The selected meetings (n=15) were held in different states distributed among the five Brazilian regions. The conference programs were manually reviewed, and a database was constructed. Data analysis was performed using descriptive statistics, chi-square and Mann-Whitney tests. A total of 1,195 speakers was identified, 19.7% (n= 235) of which were women. The results of this study provide an overview of the trends of gender disparity in dentistry conferences in Brazil. These findings suggest disseminated gender-discriminatory practices in the promotion of women participation as speakers in such events. This requires more effective approaches to promote gender balance among conference organizing committees and encourage greater visibility and promotion of equity and diversity policies in dental professional societies to ensure more equitable conference programs.

RESUMO Este estudo objetivou avaliar possíveis disparidades de gênero entre palestrantes de congressos de odontologia. Os congressos selecionados (n=15) aconteceram em diferentes estados, distribuídos entre as cinco regiões do País. A programação dos congressos foi avaliada, e um banco de dados foi construído. Os dados foram analisados por estatística descritiva (testes qui-quadrado e Mann-Whitney). Foram identificados 1.195 palestrantes, dos quais 19,7% (n=235) eram mulheres. Os resultados deste estudo fornecem uma visão geral das tendências de disparidade de gênero em conferências odontológicas no Brasil. Sugerem disseminação de prática discriminatória na participação de mulheres como palestrantes nesses eventos. São necessárias abordagens mais eficazes para promover o equilíbrio de gênero entre os comitês organizadores dos congressos, encorajando e promovendo políticas de equidade e diversidade, ampliando a participação e o protagonismo das mulheres nesses eventos.

Consensus on the terminologies and methodologies for masticatory assessment.

A large number of methodological procedures and experimental conditions are reported to describe the masticatory process. However, similar terms are sometimes employed to describe different methodologies. Standardisation of terms is essential to allow comparisons among different studies. This article was aimed to provide a consensus concerning the terms, definitions and technical methods generally reported when evaluating masticatory function objectively and subjectively. The consensus is based on the results from discussions and consultations among world-leading researchers in the related research areas. Advantages, limitations and relevance of each method are also discussed. The present consensus provides a revised framework of standardised terms to improve the consistent use of masticatory terminology and facilitate further investigations on masticatory function analysis. In addition, this article also outlines various methods used to evaluate the masticatory process and their advantages and disadvantages in order to help researchers to design their experiments.

Cost-effectiveness randomized clinical trial on the effect of photobiomodulation therapy for prevention of radiotherapy-induced severe oral mucositis in a Brazilian cancer hospital setting.

OBJECTIVES: This study aimed to assess the cost-effectiveness of photobiomodulation therapy (PBMT) in association with a Preventive Oral Care Program (POCP) compared with POCP alone in the treatment of radiotherapy (RT)-induced oral mucositis (OM). METHODS: The cost-effectiveness was evaluated from the health provider perspective and conducted alongside a randomized, double-blind clinical trial. Participants were randomly assigned to either PBMT (n = 25) or control (n = 23) group. The PBMT group participants received PBMT associated with POCP. In the control group, patients were submitted to POCP alone. Costs were identified, quantified, and valued through observation and consultation of the hospital's financial sector database and estimated in Brazilian real and converted to international dollars using the purchasing power parity exchange rate. The incremental cost-effectiveness ratio (ICER) was estimated by considering the prevention of severe OM, interruption of RT, and oral health-related quality of life (OHRQoL) scores, measured by the OHIP-14 and patient-reported OM symptoms scale (PROMS). RESULTS: The incremental cost of PBMT was $857.35, and the cost per session was $25.69. The ICER was $ 2867.39 to avoid one case of severe OM and $ 2756.75 to prevent one interruption in RT due to OM. ICER to reduce 1 point in OHIP-14 and PROMS scores were $170.79 and $31.75, respectively. CONCLUSION: PBMT is more cost-effective than POCP alone in preventing severe OM, worsening of the OHRQoL, and RT interruptions. PBMT is a promising therapy, especially to avoid interruptions in oncological treatment. TRIAL REGISTRATION: ReBEC-RBR-5h4y4n.

Effect of photobiomodulation on the severity of oral mucositis and molecular changes in head and neck cancer patients undergoing radiotherapy: a study protocol for a cost-effectiveness randomized clinical trial.

BACKGROUND: Oral mucositis (OM) is the most frequent and debilitating acute side effect associated with head and neck cancer (HNC) treatment. When present, severe OM negatively impacts the quality of life of patients undergoing HNC treatment. Photobiomodulation is a well-consolidated and effective therapy for the treatment and prevention of severe OM, and is associated with a cost reduction of the cancer treatment. Although an increase in the quality of life and a reduction in the severity of OM are well described, there is no study on cost-effectiveness for this approach considering the quality of life as a primary outcome. In addition, little is known about the photobiomodulation effects on salivary inflammatory mediators. Thus, this study aimed to assess the cost-effectiveness of the photobiomodulation therapy for the prevention and control of severe OM and its influence on the salivary inflammatory mediators. METHODS/DESIGN: This randomized, double-blind clinical trial will include 50 HNC patients undergoing radiotherapy or chemoradiotherapy. The participants will be randomized into two groups: intervention group (photobiomodulation) and control group (preventive oral care protocol). OM (clinical assessment), saliva (assessment of collected samples) and quality of life (Oral Health Impact Profile-14 and Patient-Reported Oral Mucositis Symptoms questionnaires) will be assessed at the 1st, 7th, 14th, 21st and 30th radiotherapy sessions. Oxidative stress and inflammatory cytokine levels will be measured in the saliva samples of all participants. The costs are identified, measured and evaluated considering the radiotherapy time interval. The incremental cost-effectiveness ratio will be estimated. The study will be conducted according to the Brazilian public health system perspective. DISCUSSION: Photobiomodulation is an effective therapy that reduces the cost associated with OM treatment. However, little is known about its cost-effectiveness, mainly when quality of life is the effectiveness measure. Additionally, this therapy is not supported by the Brazilian public health system. Therefore, this study widens the knowledge about the safety of and strengthens evidence for the use of photobiomodulation therapy, providing information for public policy-makers and also for dental care professionals. This study is strongly encouraged due to its clinical relevance and the possibility of incorporating new technology into public health systems. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials-ReBEC, RBR-5h4y4n . Registered on 13 June 2017.

The economic burden of opioid prescription by dentists: A 12-month survey of consumer expenditure in Brazil.

OBJECTIVES: To describe consumer expenditure on opioids prescribed by dentists in Brazil during a 12-month period. METHODS: We surveyed individual dispensed prescriptions of opioids in private pharmacies from October 2012 to September 2013. A descriptive analysis of costs included a calculation of the overall and mean maximum price to consumers. Monetary costs were converted from local currency units (Brazilian Real - BRL) to international dollars using purchasing power parity (PPP) exchanging rates. RESULTS: 129,708 prescriptions were retrieved from the database. The overall expenditure on opioids was R$4,316,383.46 BRL or $2,721,315.82 (PPP). The mean cost of an individual prescription was R$33.27 BRL ($20.98 PPP), ranging from 14.19 to 3,255.60 BRL. Codeine was frequently prescribed (87.2 percent). CONCLUSIONS: The expenditure on opioids is a significant cost to Brazilian patients, especially given that the Brazilian Public Health System should dispense these drugs free of charge. Codeine was the most prescribed opioid.

Cost-effectiveness analysis of the single-implant mandibular overdenture versus conventional complete denture: study protocol for a randomized controlled trial.

BACKGROUND: Preliminary clinical studies on the single-implant mandibular overdenture (SIMO) have reported favorable results as an alternative to the conventional complete dentures for rehabilitation of the edentulous mandible. Clinical and patient-reported outcomes were assessed but no evidence is available with respect to the cost-effectiveness of this treatment, which is particularly important to test whether the incremental cost associated with the implant treatment is justified facing the benefits from the intervention. Thus, the aim of this study is to assess the cost-effectiveness of single-implant mandibular overdentures. METHODS/DESIGN: This randomized clinical trial will include edentulous individuals who meet eligibility criteria. Participants will be randomized into one of the treatment groups: a conventional complete denture group or a single-implant mandibular overdenture group. Direct costs related to therapies in both groups will be identified, measured and valuated for 1 year after treatment. Oral health-related quality of life and satisfaction with the dentures will be the primary outcome variables. Incremental cost-effectiveness ratios will be estimated and graphically presented on cost-effectiveness planes. A Markov decision tree will be constructed to set out the consequences of the competing alternatives. Sensitivity analysis on the most important assumptions will be performed in order to assess the robustness of the model. DISCUSSION: This is the first trial-based cost-effectiveness study on single-implant mandibular overdentures. Specific challenges in designing the protocol are considered. The expected results are of high clinical relevance and may contribute to the decision-making process when choosing between different alternatives for the rehabilitation of the edentulous mandible. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02710357 , registered on 11 March 2016.

Fatores associados ao edentulismo funcional em idososbrasileiros / Factors associated with functional edentulism in elderly Brazilians

Introdução: A retenção de uma dentição natural funcional e estéti‑ca com pelo menos 20 dentes é uma meta global de saúde bucal daOrganização Mundial de Saúde. Apesar da redução expressiva das perdasdentárias entre adolescentes e adultos, isso não vem ocorrendo entreidosos, indicando um acúmulo da necessidade de reabilitação protéticanessas populações.Objetivo: Identificar os fatores individuais e contextuais associados aoedentulismo funcional em idosos no Brasil.Métodos: Trata‑se de um estudo transversal tendo como amostra osidosos de 65 a 74 anos investigados no levantamento epidemiológicoPesquisa Nacional de Saúde Bucal de 2010 (SBBrasil 2010). O desfechoinvestigado foi o edentulismo funcional – presença de menos de 20dentes naturais. As variáveis independentes foram organizadas emmodelo multinível, considerando o ambiente externo, característicassocioeconômicas dos indivíduos, o comportamento relacionado à saúdebucal e suas características demográficas.Resultados: A prevalência de edentulismo funcional foi de 73,3%(IC95%= 69,7‑76,9). Ser do sexo feminino, possuir menores níveisde renda familiar e maior tempo transcorrido desde a última visita aodentista, e ter realizado a última consulta odontológica por motivosnão relacionados à revisão, prevenção ou check‑up, extração, dor outratamento foram fatores associados ao edentulismo funcional.Conclusão: Os fatores de risco associados ao edentulismo funcional emidosos reforçam o impacto das desigualdades sociais. Estratégias paramelhoria das condições de vida e promoção de comportamentos saudá‑veis têm o potencial de reduzir a prevalência de perda dentária.(AU)

Introduction: The retention of a functional and aesthetic dentition withat least 20 natural teeth is a global goal of World Health Organization.Despite the important reduction of tooth loss in teenagers and adults,this is not occurring in elderly, indicating an accumulation of the needfor prosthetic rehabilitation in these populations.Objective: To identify individual and contextual factors associated tofunctional edentulism in Brazilian elderly.Methods: This cross‑sectional study investigates a sample of 65 to 74years elderly from the National Oral Health Survey 2010 (SBBrasil 2010).The outcome variable was functional edentulism, i.e., presence of lessthan 20 natural teeth. Independent variables were organized into multi‑level model, considering the external environment, socioeconomic char‑acteristics of subjects, oral health‑related behavior and demographiccharacteristics.Results: The prevalence of functional edentulism was 73.3%(CI95%=69.7‑76.9). Being female, having lower levels of household in‑come and more time elapsed since the last visit to the dentist, and havingattended the last dental appointment for reasons unrelated to the revi‑sion, prevention or check‑up, extraction, pain or treatment were factorsassociated the functional edentulism.Conclusion: The risk factors related to functional edentulism in elderlyreinforce the impact of social inequalities. Strategies for improving liv‑ing conditions and promoting healthy behaviors have the potential toreduce the prevalence of tooth loss.(AU)

Exploring motivations to seek and undergo prosthodontic care: a cross-sectional study in a Brazilian adult sample.

This study explored the influence of individual and social factors regarding intentions and behaviors related to prosthodontic treatment, using the theory of planned behavior (TPB). A cross-sectional study was designed with a sample of 225 individuals with some degree of tooth loss. A questionnaire was used containing factors that would have potential influence on the intentions and behaviors of individuals, as well as clinical and sociodemographic data. Descriptive statistics, internal consistency analysis, chi-square test for trend, and logistic regression were used for data analysis. The TPB components - attitude toward the behavior (ATB), subjective norm (SN), and perceived behavioral control (PBC) - showed good internal consistency (alpha = 0.60-0.78). Intention and behavior were associated with TPB components and the overall scale. Similarly, positive intentions and behaviors were associated with age, upper tooth loss, anterior tooth loss, and higher social status. Multiple logistic regression showed that intention was associated with PBC (OR =1.57; P<0.016), while behavior was associated with tooth loss in both arches (OR =9.3; P<0.001), anterior tooth loss (OR =5.13; P<0.001), higher social status (OR =3.06; P<0.03), and PBC (OR =1.38; P=0.03). The presence of anterior tooth loss was the most relevant factor for prosthodontic treatment demand and utilization, while socioeconomic status and an individual's perceived ease or difficulty in undergoing treatment played a significant, but secondary, role in behavior toward prosthodontic care.

Cárie dentária, disponibilidade de açúcar e fatores associados nas capitais brasileiras em 2003: um estudo ecológico / Dental caries, sugar availability and associated factors in the Brazilian capital cities: an ecological study

Introdução: A associação entre a disponibilidade de açúcar e a cárie dentária, utilizando-se dados populacionais, ainda não foi testada na população brasileira. Objetivo: Investigar a associação entre a experiência de cárie em crianças e a disponibilidade domiciliar de açúcar no Brasil, em 2003. Buscou-se ainda testar a provável influência de indicadores socioeconômicos e do acesso à água fluoretada. Material e Método: Este estudo ecológico analisou dados das 27 capitais brasileiras sobre cárie em crianças de cinco e 12 anos, e abastecimento de água fluoretada, obtidos do levantamento nacional de saúde bucal de 2003. Os dados sobre disponibilidade domiciliar de açúcar foram obtidos da Pesquisa de Orçamento Familiar (POF) de 2003 e, sobre indicadores socioeconômicos, do Programa das Nações Unidas para o Desenvolvimento em 2000. Na análise estatística, foram utilizados testes de correlação e regressão linear simples e múltipla. Resultado: Não houve associação significativa entre a experiência de cárie em crianças de cinco anos e as variáveis independentes. Na idade de 12 anos, menor experiência de cárie foi correlacionada à maior aquisição de refrigerantes, ao maior tempo de fluoretação e ao IDH e à renda per capita mais elevados. O resultado da regressão linear múltipla, ajustado pelo tempo de fluoretação das águas, indicou que esta variável explica os níveis de cárie mais baixos. Após o ajuste pelos demais fatores, nenhuma variável foi associada à cárie. Conclusão: Não houve associação entre a experiência de cárie em crianças e a disponibilidade domiciliar de açúcar nas capitais brasileiras em 2003, quando indicadores socioeconômicos e presença de água fluoretada foram considerados na análise.

Introduction: The association between sugar availability and dental caries, using population data, was not tested in the Brazilian population yet. Objective: To investigate the association between dental caries experience in children and household sugar availability in Brazil in 2003. It was also aimed to test the possible influence of socioeconomic indicators and presence of fluoridated water supply. Material and Method: This ecological study analyzed data of the 27 Brazilian capital cities on caries experience of 5 and 12 years-old children and water fluoridation obtained from the National Survey of Oral Health in 2003; sugar availability from the Household Budget Survey in 2003; and socioeconomic indicators from the United Nations Development Programme in 2000. Correlation tests, simple and multiple linear regression were used in the statistical analysis. Result: There was no association between caries experience in the 5 years-old and the independent variables. At the age 12, lower caries experience was correlated with higher acquisition of soft drinks, public water fluoridation, Human Development Index and per capita income. Results of the multiple linear regression, adjusted by time of water fluoridation showed that this variable explained the lower levels of caries. After adjusting for the other factors, none of the variables were significantly associated to dental caries. Conclusion: There was no association between dental caries in children and sugar availability in the Brazilian capital cities in 2003 when socioeconomic indicators and presence of fluoridated water were considered in the analysis.

Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients.

BACKGROUND: Temporomandibular disorder (TMD) patients might present a number of concurrent clinical diagnoses that may be clustered according to their similarity. Profiling patients' clinical presentations can be useful for better understanding the behavior of TMD and for providing appropriate treatment planning. The aim of this study was to simultaneously classify symptomatic patients diagnosed with a variety of subtypes of TMD into homogenous groups based on their clinical presentation and occurrence of comorbidities. METHODS: Clinical records of 357 consecutive TMD patients seeking treatment in a private specialized clinic were included in the study sample. Patients presenting multiple subtypes of TMD diagnosed simultaneously were categorized according to the AAOP criteria. Descriptive statistics and two-step cluster analysis were used to characterize the clinical presentation of these patients based on the primary and secondary clinical diagnoses. RESULTS: The most common diagnoses were localized masticatory muscle pain (n = 125) and disc displacement without reduction (n = 104). Comorbidity was identified in 288 patients. The automatic selection of an optimal number of clusters included 100% of cases, generating an initial 6-cluster solution and a final 4-cluster solution. The interpretation of within-group ranking of the importance of variables in the clustering solutions resulted in the following characterization of clusters: chronic facial pain (n = 36), acute muscle pain (n = 125), acute articular pain (n = 75) and chronic articular impairment (n = 121). CONCLUSION: Subgroups of acute and chronic TMD patients seeking treatment can be identified using clustering methods to provide a better understanding of the clinical presentation of TMD when multiple diagnosis are present. Classifying patients into identifiable symptomatic profiles would help clinicians to estimate how common a disorder is within a population of TMD patients and understand the probability of certain pattern of clinical complaints.

Indicadores socioeconômicos e de saúde da Atenção Básica nos municípios da região metropolitana de Belo Horizonte / Socioeconomic and health indicators of primary health care in the metropolitan region of Belo Horizonte

Objetivo: investigar a associação entre os indicadores socioeconômicos e de saúde da Atenção Básica nos municípios da Região Metropolitana de Belo Horizonte, Minas Gerais. Materias e Métodos: estudo ecológico com utilização de dados secundários referentes à Região Metropolitana de Belo Horizonte. As variáveis dependentes foram os indicadores de saúde geral e de saúde bucal da Atenção Básica. As variáveis exploratórias foram taxa de alfabetização, Índice de Desenvolvimento Humano, Índice de Gini e Índice Mineiro de Responsabilidade Social. A análise de Cluster Hierárquico foi realizada para segmentação dos municípiosa partir dos indicadores socioeconômicos, por meio do método Between-linkage group e a medida Distância Euclidiana Quadrática. A comparação dos indicadores de saúde da Atenção Básica entre os clusters foi feita através do teste t-Student, com nível de significância estabelecido em 5%. Resultados: os municípios foramagrupados em dois clusters: 1) piores indicadores socioeconômicos (N=23) e 2) melhores (N=10). O cluster 1apresentou maiores cobertura da Estratégia de Saúde da Família e média anual de visitas domiciliares (76,6 ±32,5; 6,1 ± 24,6, respectivamente) do que o cluster 2 (70,4 ± 27,9; 0,8 ± 0,6, respectivamente) (p < 0,05). Emrelação aos indicadores de Saúde Bucal não houve diferenças estatisticamente significantes entre os clusters.Conclusão: sugere-se que há uma associação entre municípios da região metropolitana de Belo Horizontecom piores indicadores socioeconômicos e maior cobertura da Saúde da Família e média de visita domiciliar.

Social and health indicators as a measure of access to primary heathcare in Brazil.

The aim was to investigate the influence of social and health indicators on access to Primary Healthcare in the Belo Horizonte Metropolitan Area, Minas Gerais State, Brazil. Secondary data of 34 municipalities were analyzed; the dependent variables were three basic healthcare indicators: coverage of the Family Health Strategy; coverage of scheduled first dental appointment and mean annual number of appointments in medical specialties per inhabitant. All independent variables were analyzed using Principal Component Analysis, with VARIMAX rotation and Kaiser normalization. Student's t-test was used to compare the components originated by the factor analysis in relation to the primary care indicators with a significance of 5%. The development conditions had significantly greater weight in cities with low FHS coverage (p=0.022). The socioeconomic conditions were weighted significantly higher in municipalities with high dental appointment coverage (p=0.030) and with greater mean number of medical appointments (p=0.022). Socioeconomic and development conditions may be crucial to the identification of municipalities with the best and worst primary care indicators.

Social and health indicators as a measure of access to primary heathcare in Brazil / Indicadores sociais e de saúde como medida de acesso aos cuidados primários no Brasil

The aim was to investigate the influence of social and health indicators on access to Primary Healthcare in the Belo Horizonte Metropolitan Area, Minas Gerais State, Brazil. Secondary data of 34 municipalities were analyzed; the dependent variables were three basic healthcare indicators: coverage of the Family Health Strategy; coverage of scheduled first dental appointment and mean annual number of appointments in medical specialties per inhabitant. All independent variables were analyzed using Principal Component Analysis, with VARIMAX rotation and Kaiser normalization. Student's t-test was used to compare the components originated by the factor analysis in relation to the primary care indicators with a significance of 5 percent. The development conditions had significantly greater weight in cities with low FHS coverage (p=0.022). The socioeconomic conditions were weighted significantly higher in municipalities with high dental appointment coverage (p=0.030) and with greater mean number of medical appointments (p=0.022). Socioeconomic and development conditions may be crucial to the identification of municipalities with the best and worst primary care indicators.

O objetivo foi investigar a influência de indicadores sociais e de saúde no acesso à Atenção Primária na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil. Os dados secundários de 34 municípios foram analisados e as variáveis dependentes foram três indicadores básicos de saúde: cobertura da Estratégia Saúde da Família, cobertura de primeira consulta odontológica programada e número médio anual de consultas médicas por habitante. As variáveis independentes foram analisadas usando Análise de Componentes Principais, com rotação VARIMAX e normalização Kaiser. O teste T Student foi utilizado para comparar os componentes fornecidos pela análise fatorial em relação aos indicadores básicos de saúde com significância de 5 por cento. As condições de desenvolvimento foram significativamente maiores em cidades com baixa cobertura da ESF (p=0,022). As condições socioeconômicas foram significativamente mais relevantes em municípios com alta cobertura de primeira consulta odontológica (p=0,030) e com maior número médio de consultas médicas (p=0,022). Condições socioeconômicas e de desenvolvimento podem ser decisivas para a identificação dos municípios com melhores e piores indicadores de atenção primária.

Effect of anterior teeth display during smiling on the self-perceived impacts of malocclusion in adolescents.

OBJECTIVE: To investigate the impact of the anterior teeth display during smiling (ATDDS) on the self-perceived psychosocial impacts of malocclusion in adolescents. MATERIALS AND METHODS: This cross-sectional study included a convenience sample of 301 adolescents (mean age 16.1 years, SD 1.8 years; 58.1% female). Two instruments were used for data collection: (1) the Dental Aesthetic Index (DAI) and (2) the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). In addition, ATDDS was assessed in posing smiling, and adolescents' satisfaction with their dental appearance was investigated. Data analysis included descriptive statistics, Kruskal-Wallis test and Mann-Whitney U-test, Spearman correlation, and multiple linear regression analysis. RESULTS: Significant associations were observed between independent variables (ATDDS, DAI scores, and satisfaction with dental appearance) and total PIDAQ score (R(2)  =  0.37) and dental self-confidence (R(2)  =  0.37), psychological impact (R(2)  =  0.30), esthetic concern (R(2)  =  0.20), and social impact (R(2)  =  0.15). CONCLUSION: The excessive anterior teeth display during smiling may potentially influence the self-perceived psychosocial impacts of malocclusion in adolescents depending on the severity level of malocclusion and the self-reported satisfaction with dental appearance.

[Oral health in 12 year-old students from public and private schools in the city of Goiânia, Brazil]. / Condição de saúde bucal em escolares de 12 anos de escolas públicas e privadas de Goiânia, Brasil.

OBJECTIVE: To compare 12-year-old students from public and private schools in the city of Goiânia, Brazil, in terms of the prevalence of caries, periodontal conditions, dentofacial anomalies, and fluorosis. METHODS: In 2003, the 2002-2003 Oral Health Conditions in the Brazilian Population project (SB Brasil) was expanded to Goiânia as a cross-sectional study, as described in the present article. The sample included 1 947 students from urban schools: 1 790 (91.9%) attended public schools and 157 (8.1%) attended private schools. Data on the following oral conditions were collected through clinical examination: dental caries (decayed, missing, or filled teeth index, DMFT), periodontal condition (Community Periodontal Index, CPI), dentofacial anomaly (Dental Aesthetics Index, DAI), and dental fluorosis (Dean index). The groups were compared using the chi-square and Mann-Whitney U tests. RESULTS: There were differences between the public and private schools for all the variables. DMFT, CPI, and DAI indexes were higher in children from public schools (P < 0.05). Fluorosis was more prevalent in students from private schools (P < 0.05). CONCLUSIONS: The type of school was associated with the oral health condition of the children in this sample. Investments in actions and services to mitigate this inequality and its effects should be made as part of the policies to promote oral health.

Condição de saúde bucal em escolares de 12 anos de escolas públicas e privadas de Goiânia, Brasil / Oral health in 12 year-old students from public and private schools in the city of Goiânia, Brazil

OBJETIVO: Comparar os alunos de 12 anos das escolas públicas e privadas de Goiânia, Goiás, quanto à prevalência de cárie, condição periodontal, anomalia dentofacial e fluorose. MÉTODOS: Em 2003, o Projeto Condições de Saúde Bucal da População Brasileira 2002-2003 (SB Brasil) foi ampliado para Goiânia na forma de um estudo transversal, descrito neste trabalho. A amostra foi constituída por 1 947 escolares de 12 anos frequentando escolas da zona urbana do Município: 1 790 (91,9 por cento) eram de escolas públicas e 157 (8,1 por cento) de escolas privadas. Através de exame clínico, foram coletados dados sobre as seguintes condições bucais: cárie dentária (índice de dentes cariados, perdidos e obturado, CPOD), condição periodontal (índice periodontal comunitário, CPI), anormalidade dento-facial (índice de estética dental, DAI) e fluorose dentária (índice de Dean). Para comparação entre os grupos foram utilizados os testes do qui-quadrado e U de Mann Whitney. RESULTADOS: Houve diferença entre os tipos de escola para todas as variáveis investigadas. Os escolares de instituições públicas apresentaram índices mais elevados de cárie, condição periodontal e anomalia dentofacial do que aqueles de escolas privadas (P < 0,05). Os escolares de instituições privadas apresentaram maior prevalência de fluorose (P < 0,05). CONCLUSÕES: O tipo de escola foi associado à condição de saúde bucal dos escolares pesquisados. São recomendados investimentos em ações e serviços que busquem minimizar tais desigualdades e seus efeitos como parte das políticas de saúde bucal.

OBJECTIVE: To compare 12-year-old students from public and private schools in the city of Goiânia, Brazil, in terms of the prevalence of caries, periodontal conditions, dentofacial anomalies, and fluorosis. METHODS: In 2003, the 2002-2003 Oral Health Conditions in the Brazilian Population project (SB Brasil) was expanded to Goiânia as a cross-sectional study, as described in the present article. The sample included 1 947 students from urban schools: 1 790 (91.9 percent) attended public schools and 157 (8.1 percent) attended private schools. Data on the following oral conditions were collected through clinical examination: dental caries (decayed, missing, or filled teeth index, DMFT), periodontal condition (Community Periodontal Index, CPI), dentofacial anomaly (Dental Aesthetics Index, DAI), and dental fluorosis (Dean index). The groups were compared using the chi-square and Mann-Whitney U tests. RESULTS: There were differences between the public and private schools for all the variables. DMFT, CPI, and DAI indexes were higher in children from public schools (P < 0.05). Fluorosis was more prevalent in students from private schools (P < 0.05). CONCLUSIONS: The type of school was associated with the oral health condition of the children in this sample. Investments in actions and services to mitigate this inequality and its effects should be made as part of the policies to promote oral health.

The prevalence of clinical diagnostic groups in patients with temporomandibular disorders.

The aim of this study was to observe the prevalence of diagnostic groups of temporomandibular disorders (TMD) in patients who were referred or sought treatment for TMD and/or orofacial pain in a private clinic. The clinical records of 357 patients were evaluated and selected based on inclusion/exclusion criteria; the mean age was 32 years. A clinical examination was performed and the diagnosis was based on the American Academy of Orofacial Pain criteria. Results showed that 86.8% of patients were women and 93.3% of the patients presented more than one diagnosis. The most frequent chief complaint (n = 216, chi2 = 30.68, p = 0.001) and total diagnosis realized (n = 748, chi2 = 14.14, p = 0.001) were muscle related. We concluded that women seek treatment for dysfunction/disorders of orofacial structures more than men do; patients seeking specialized treatment have more than one diagnosis and muscle dysfunction is more prevalent than intra-articular disorders.