Prevalence of oral manifestations of hypophosphatemic rickets in patients treated in a peruvian pediatric hospital / Prevalencia de manifestaciones bucales del raquitismo hipofosfatémico de pacientes atendidos en un hospital pediátrico peruano

Objective: To describe the prevalence of oral manifestations of hypophosphatemic rickets in patients treated in a Peruvian referral pediatric hospital during the years 2012-2016. Material and methods: An observational, descriptive, retrospective, cross-sectional study was carried out. The sample consisted of patients diagnosed with hypophosphatemic rickets who attended the outpatient clinic of the Stomatology Service and the Genetics Service of the National Institute of Child Health (INSN), Lima, Peru, between the years 2012-2016. The research project was assessed and approved by the Research Ethics Committee of the Health Service. Medical records stored in a database of the health institution with the Code CIE E83.3, which corresponds to the diagnosis of Hypophosphatemic Rickets, were requested for the study. Results: Fifteen children received health care, of which only 10 were treated at the Stomatology Service. The distribution of the data was obtained from these 10 patients according to the proposed objective. A higher frequency of gingival lesions was found at the soft tissue level (41.18%); at the bone tissue level, only one case of dentigerous cyst was observed; and at the dental level, 90% of the patients had dental caries. Conclusion: The most frequent oral manifestations of hypophosphatemic rickets in pediatric patients treated at the National Institute of Child Health (2012-2016) were gingivitis and dental caries.

Objetivo:Describir la prevalencia de las manifestaciones bucales del raquitismo hipofosfatémico de pacientes atendidos en un hospital pediátrico de referencia peruano durante los años 2012-2016. Material y Métodos:Se realizó un estudio tipo observacional, descriptivo, retrospectivo, transversal. Para la selección de la muestra se consideró a los pacientes que acudieron a la consulta externa del Servicio de Odontoestomatología y el Servicio de Genética del Instituto Nacional de Salud del Niño, Lima, Perú; en el periodo comprendido entre los años 2012-2016 y que presentaron como diagnóstico Raquitismo Hipofosfatémico. El proyecto de investigación fue evaluado por un Comité de Ética en Investigación del servicio de salud. Se solicitaron las historias clínicas consignadas en una base de datos de la institución de salud con el Código CIE E83.3, que corresponde a este diagnóstico. Resultados: Fueron atendidos 15 niños, de los cuales solo 10 fueron tratados en el Servicio Odontoestomatología; siendo de estos 10 pacientes la distribución de los datos obtenidos según el objetivo propuesto. Se encontró mayor frecuencia de lesiones a nivel de tejido blando de gingivitis con 41.18%, a nivel de tejido óseo solo se presentó un caso de quiste dentígero; y a nivel de tejido dental el 90% de los pacientes presentó caries dental. Conclusión: Las manifestaciones bucales más frecuentes del raquitismo hipofosfatémico de pacientes pediátricos atendidos en el Instituto Nacional de Salud del Niño (2012-2016), fueron la gingivitis y caries dental.

A falta de dentição funcional está associada ao comprometimento das funções bucais entre adultos brasileiros / The absence of functional dentition is associated with the lack of commitment to oral functions among Brazilian adults

Resumo Objetivou-se identificar se a falta de dentição funcional (DF) está associada com o comprometimento das funções bucais/atividades diárias entre adultos brasileiros. Para isto, foram utilizados dados da Pesquisa Nacional de Saúde Bucal - SB Brasil 2010. A DF foi avaliada pelo critério proposto pela Organização Mundial de Saúde (pelo menos 20 dentes na boca). O instrumento Impactos Odontológicos nos Desempenhos Diários (IODD) foi utilizado para avaliar as atividades diárias/funções bucais. Análises descritivas, bivariadas (Qui-quadrado) e múltiplas (Regressão Logística) foram realizadas, sendo estimado o odds ratio e o intervalo de confiança 95% (OR/IC95%). Foram incluídos e avaliados 9564 adultos. Foram considerados sem DF 2200 adultos (20,5%). Tiveram impacto em pelo menos uma das atividades diárias/funções bucais avaliadas, 55,0% dos adultos. A falta de DF entre adultos foi associada (p ≤ 0,05) com o impacto na fala (1,88/1,33-2,64) e vergonha ao sorrir ou falar (1,35/1,00-1,83). Uma prevalência considerável de falta de DF foi identificada, esta ausência foi associada às atividades diárias/funções bucais (fala e vergonha ao sorrir e falar). A reabilitação dentária de pacientes sem DF deve considerar a devolução destas funções bucais perdidas (fala e vergonha ao sorrir ou falar).

Abstract The scope of this study was to identify if the absence of functional dentition (FD) is associated with a lack of commitment to oral functions/daily activities among Brazilian adults. For this purpose, data from the National Survey of Oral Health (referred to as SB Brasil 2010) was used. FD was evaluated by the criterion proposed by the WHO (at least 20 teeth in the mouth). The Oral Impacts on Daily Performance (OIDP) questionnaire was used to evaluate daily activities/oral functions. Descriptive, bivariate (chi-squared) and multiple (logistic regression) analysis was conducted, and the odds ratio estimated with a 95% confidence interval (OR/CI95%). The research evaluated 9,564 adults, of which 2,200 adults (20.5%) were considered to have poor FD, and at least one of the daily activities/oral functions evaluated had an impact among 55% of adults. The lack of FD between adults was associated (p ≤ 0.05) with the impact on speech (1.88/1.33-2.64) and being ashamed to smile or talk (1.35/1.00-1.83). A considerable prevalence of lack of FD was identified, this absence being associated with the lack of commitment to the daily activities/oral functions. Dental rehabilitation of patients with a lack of FD should consider the restoration of these lost oral functions (speech and being ashamed to smile or talk).

Características clínicas orales en pacientes con distrofia muscular de Duchenne: estudio descriptivo / Oral characteristics of patients with Duchenne muscular dystrophy (DMD): descriptive study

Introducción: En su evolución, la DMD afecta el sistema estomatognático, situación no explorada en nuestro país. Objetivo: Describir características clínicas orales y asociación con edad, en pacientes con distrofia muscular de Duchenne (DMD). Pacientes y Método: Estudio descriptivo, transversal en 81 pacientes con DMD del Instituto Teletón Santiago, reclutados desde agosto a noviembre 2017, con consentimiento informado. Se efectuó examen clínico diagnóstico para determinar la presencia de caries clínicas (índice ceod/COPD), índice de higiene (Índice Green y Vermillion Simplificado), presencia de maloclusiones y asociaciones de variables orales con edad. Resultados: 65,4% de los pacientes no presentaban caries ni restauraciones, registrándose un promedio COPD = 1,7 ± 1,2 y ceod= 2,1 ± 1,6. El índice de higiene oral promedio fue de 1,9 ± 0,8 considerado como regular. 67,9% de los pacientes presentaba alguna maloclusión, existiendo una relación esta- dísticamente significativa entre presencia de mordida cruzada y grupo etario (p < 0,05). Conclusiones: La menor presencia de caries clínica en pacientes con DMD a lo referido en bibliografía para pacientes sanos, podría atribuirse a los controles periódicos odontológicos otorgados por Instituto Teletón San- tiago. El aumento de las maloclusiones con el avance de la edad, podría ser un indicador del progreso de la enfermedad, ya que los cambios en la función muscular masticatoria son dependientes del tiempo y producen aumento del ancho transversal mandibular originando las maloclusiones más prevalentes como la mordida cruzada y abierta. Palabras clave: Distrofia muscular Duchenne, caries, higiene oral, malo- clusiones.

Oral characteristics of patients with Duchenne muscular dystrophy (DMD). Descriptive study Introduction: In its evolution, Duchenne muscular dystrophy (DMD) affects the stomatognathic system, a condition that has not been studied in our country. Objective: To describe the oral clinical characteristics and age-related association in patients with DMD. Patiens and Method: Cross-sectional des- criptive study including 81 patients with DMD of Instituto Teletón Santiago, recruited from August to November 2017, with informed consent. A diagnostic clinical examination was performed to establish the presence of clinical cavities (DEFT, DMFT index), oral hygiene index (Green and Vermillion, simplified), presence of malocclusions, and age-related associations. Results: 65.4% of patients did not have caries or restorations, showing an average of DMFT = 1.7 ± 1.2, and DEFT= 2.1 ± 1.6. Average oral hygiene index was 1.9 ± 0.8.which is considered regular. 67.9% of the patients had some type of malocclusion, with a statistically significant relation between the presence of cross bite and age group (p < 0.05). Conclusions: Lower presence of clinical caries in DMD patients as referred to in bibliography for healthy patients, could be due to periodic dental controls provided by Instituto Teletón Santiago. Increased ca- ses of malocclusions with age may be an indicator of progress of the disease, because changes in the function of mastication muscles are time-dependent, and increase transverse jaw width, causing more prevalent malocclusions such as cross bite and open bite. Key words: Duchenne muscular dystrophy, caries, oral hygiene, malocclu- sions.

Prevalence and factors associated with enamel defects among preschool children from a southeastern city in Brazil / Prevalência e fatores associados aos defeitos de desenvolvimento de esmalte em crianças pré-escolares de uma cidade do sudeste do Brasil

Abstract This study sought to determine the prevalence of developmental defects of enamel (DDE) among preschool children and investigate associations with sociodemographic and socioeconomic factors and weight status. A cross-sectional study was conducted with 118 children aged 3 to 5 years. Data were collected via clinical examinations and a self-administered questionnaire completed by the parents. The diagnosis of DDE was performed using the modified DDE Index. Information on socioeconomic indicators (mother's schooling, monthly income per capita), child's sex and age, and age of mother at the birth of the child were obtained by questionnaire. The children's weight status was determined based on weight-for-age at the time of the exam. Statistical analysis involved the chi-squared test and Poisson regression with robust variance. The prevalence of DDE was 50.0%. DDE were more frequent in males (p = 0.025) and children whose families were classified as being at poverty line (p = 0.040). In the Poisson model controlled for child's sex and mother's schooling, children whose families were classified as being at the poverty line had a greater prevalence rate of DDE. In conclusion, the prevalence of DDE was high in the present sample and associated with lower household income. Weight status was not associated with DDE.

Resumo Objetivou-se avaliar a prevalência de defeitos de desenvolvimento de esmalte (DDE) em pré-escolares e investigar a associação com fatores sociodemográficos e socioeconômicos e peso da criança. Foi realizado um estudo transversal com 118 crianças de três a cinco anos de idade. Os dados foram coletados por meio de exame clínico e questionário autoaplicável respondido pelos pais. Para o diagnóstico de DDE utilizou-se o Developmental Defects of Enamel Index. Informações sobre indicadores socioeconômicos (escolaridade da mãe e renda familiar per capita), gênero e idade da criança e idade da mãe ao nascimento da criança foram obtidas do questionário. O status de peso foi determinado baseando-se no peso e idade da criança no momento do exame. A análise estatística incluiu teste do qui-quadrado e regressão de Poisson. A prevalência de DDE foi 50.0%, sendo mais frequente em crianças do sexo masculino (p = 0.025) e provenientes de famílias incluídas na linha de pobreza (p = 0.040). No modelo de regressão de Poisson ajustado para gênero e escolaridade da mãe, observou-se que as crianças provenientes de famílias incluídas na linha de pobreza apresentaram maior prevalência de DDE. Conclui-se que a prevalência de DDE foi alta e associada com renda familiar per capita. O peso da criança não foi associado com DDE.

Prevalence of oral lesions and chronic non-communicable diseases in a sample of chilean institutionalized versus non-institutionalized elderly

Chile is experiencing a process of demographic aging with an increase in the number of elderly people, a percentage of which resides in long-term establishments for the elderly (LEE). however, there is little information on the reality of the elderly in these long-term care facilities, so this study was conducted to compare the epidemiological profile of the prevalent oral pathologies as well as chronic non-communicable diseases (NCDs), of institutionalized versus non-institutionalized elderly subjects. seventy-six institutionalized and forty-three non-institutionalized subjects were examined intraorally, and their clinical health record, gender and age were obtained, according to inclusion/exclusion criteria. the results indicate that female gender is the most common, with an average age of 78.5 year, with those 80 years old and above comprising the predominant group. the most prevalent oral lesions within the institutionalized group were denture stomatitis and irritative hyperplasia, while in the non-institutionalized these two lesions were found less frequently. as for the presence of xerostomia, there was no difference between the groups. the most common condition in both groups was total maxillary and mandibular edentulous, with the latter variable present more frequently in the institutionalized group (p<0.05). the predominant NCD for both groups were arterial hypertension, arthritis-osteoarthritis and diabetes mellitus (p>0.05), and depression was the most prevalent NCD in the non-institutionalized group (p<0.05). this study provides valuable information on the epidemiology of elderly´s oral lesions and NCDs to inform the decision-making process of public health policies.

Enamel defects and tooth eruption disturbances in children with sickle cell anemia

Abstract Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson's chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson's chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Oral health evaluation in special needs individuals / Avaliação da saúde bucal em pessoas com necessidades especiais

ABSTRACT Objective To identify the prevalence of the main oral problems present in special needs children and to relate the underlying conditions with the clinical and demographic variables. Methods The study was based on the physical examination of 47 students from the Associação de Pais e Amigos dos Excepcionais diagnosed as Down syndrome, cerebral palsy and intellectual deficit. For data collection, we used a self-administered questionnaire that included indices of dental caries and oral hygiene, Angle classification, malposition of dental groups and oral hygiene habits. Results The predominant age group was 12-25 years (46.8%) and most patients were male (55.3%). Regarding daily brushing, 63.8% reported brushing their teeth three times a day, and 85.1% did it by themselves. A total of 48.9% were rated as Angle class I, and 25.5% had no type of malocclusion. A high dental carries index (decayed, missing, filled >10) was observed in 44.7%, and 53.2% had inadequate oral hygiene (zero to 1.16). There was a statistically significant difference between cerebral palsy and the act of the participants brushing their teeth by themselves. Conclusion There was a high decayed-missing-filled teeth index and malocclusion class I, as well as inadequate oral hygiene. The type of underlying condition of the participants influenced the act of brushing teeth by themselves.

RESUMO Objetivo Conhecer a prevalência dos principais problemas bucais em crianças com necessidades especiais, e relacionar as doenças de base com variáveis clínicas e demográficas. Métodos O estudo foi realizado a partir de exame clínico em 47 alunos da Associação de Pais e Amigos dos Excepcionais com diagnóstico médico de síndrome de Down, paralisia cerebral e deficit intelectual. Para a coleta de dados, foi utilizado um questionário autoaplicativo com índices de cárie dentária e higiene oral, classificação de Angle, malposição de grupos dentários e hábitos de higiene oral. Resultados A faixa etária predominante foi de 12 a 25 anos (46,8%) e a maioria era do sexo masculino (55,3%). Em relação à escovação dentária, 63,8% relataram escovar os dentes três vezes ao dia, sendo que 85,1% realizavam-na sozinhos. Constatou-se que 48,9% dos examinados apresentavam uma classificação de Angle tipo I e 25,5% não apresentavam qualquer tipo de maloclusão. Os avaliados (44,7%) apresentaram alto índice de cárie dentária (cariados, perdidos e obturados >10) e 53,2% apresentaram higiene oral inadequada (zero a 1,16). Houve diferença estatisticamente significativa entre a paralisia cerebral e o ato de escovar os dentes sozinho. Conclusão Constataram-se altos índices de cárie e de maloclusão classe I, além de inadequada higiene oral. Houve influência do tipo de patologia de base na realização do ato de escovar os dentes sozinhos.

Impacto de la hipomineralización incisivo molar en la experiencia de caries en escolares de 6-12 años en Santiago, Chile / Molar incisor hypomineralisation and its impact on caries experienced by 6-12 year-old schoolchildren from Santiago, Chile

Objetivo: El objetivo de este estudio fue determinar las consecuencias clínicas expresadas en índices COPD y ceod y su relación con la presencia de hipomineralización incisivo molar (HIM) en una población de escolares de 6 a 12 años de la provincia de Santiago. Método: Este estudio de corte transversal fue realizado en 851 escolares de 6 a 12 años de la provincia de Santiago, quienes fueron evaluados por 2 dentistas calibrados. Con consentimiento de los tutores legales, los escolares fueron examinados, y se utilizaron los criterios diagnósticos para HIM de la Academia Europea de Odontopediatría (EAPD). La historia de caries fue determinada con COPD/ceod de acuerdo a los criterios de la OMS. Los datos fueron recolectados en una ficha especialmente diseñada para esto. Los datos fueron analizados con test «t¼ para muestras individuales (considerando p < 0,05). Resultados: Los escolares afectados por HIM tuvieron una media de COPD de 0,91 (±1,21) y una media de ceod de 1,98 (±2,48), el cual fue mayor que el COPD y ceod de escolares sin HIM (0,41 [±0,95] y 1,34 [±2,15] respectivamente). La diferencia entre ambos grupos fue estadísticamente significativa para COPD (p < 0,000) y ceod (p = 0,002). Conclusiones: Escolares de la provincia de Santiago de 6 a 12 años afectados con HIM presentaron mayor COPD/ceod que escolares sin HIM.

Objective. The aim of this study was to determine the clinical consequences, expressed in DMFT and dmft, and their relationship with Molar Incisor Hypomineralisation (MIH) in a population of schoolchildren of 6 to 12 years old in the Santiago Province. Method: A cross-sectional study was conducted on 851 schoolchildren between 6-12 years old from the Santiago Province were examined by two calibrated examiners. With informed consent from their parents, the schoolchildren were examined, and the European Academy of Paediatric Dentistry (EAPD) diagnostic criteria was used for MIH detection. Caries history was assessed with the DMFT/dmft score according to WHO criteria. Data was collected with a form specially designed for this study. Data was analysed using Student's t-test for individual samples and a post-hoc Bonferroni (P < .05). Results: The mean DMFT score in the MIH-affected schoolchildren was 0.91 (±1.21), with a mean dmft score of 1.98 (±2.48), which were greater than the scores in the non-MIH affected schoolchildren (mean DMFT score 0.41 [±0.95] and mean dmft 1.34 [±2.15]). The differences between DMFT and dmft scores in the two groups were statistically significant (P < .000 and P = .002, respectively). Conclusions: Schoolchildren of Santiago Province of 6-12 year old diagnosed with MIH had higher DMFT/dmft scores compared to schoolchildren not affected with MIH.

Impacto das equipes de saúde bucal da Estratégia da Saúde da Família na saúde bucal de adolescentes do sul do Brasil / Impact of oral health teams of the Family Health Strategy on the oral health of adolescents in the south of Brazil

Resumo A Estratégia da Saúde da Família (ESF) tem demostrado resultados efetivos em indicadores de saúde. Neste estudo transversal foi avaliado o impacto das equipes de saúde bucal (ESB) da ESF na saúde bucal de 2581 adolescentes escolares, com idade de 12 e 15-19 anos de 36 municípios, 19 com e 17 sem ESB/ESF. Quatro dentistas realizaram exames bucais. Situação socioeconômica, uso e acesso aos serviços de saúde foram coletados em questionário estruturado. Presença das ESB na ESF foi a principal variável independente. Os desfechos foram CPOD e seus componentes, dor de dente, sangramento gengival e cálculo dentário. Os dados foram analisados pelas médias das regressões binomiais negativas e Poisson. O efeito da ESB/ESF e de variáveis individuais foi ajustado em modelo multinível. No modelo bruto não houve associação das ESB na ESF com nenhum dos desfechos analisados. Após o ajuste, jovens de áreas não cobertas pela ESB/ESF tiveram quase a metade da perda de dentes dos adolescentes das áreas cobertas (RM = 0,64 IC95%; 0,43-0,94).

Abstract The Family Health Strategy (FHS) has produced effective results in health indicators. In this cross-sectional study, the impact of the oral health teams (OHT) of the Family Health Strategy was evaluated on the oral health of 2581 adolescent schoolchildren aged 12 and 15-19 years in 36 municipalities (19 with and 17 without OHT/FHS). Four dentists performed oral examinations. Socioeconomic status, the use of and access to health services were assessed via a structured questionnaire. The presence of the OHT in the FHS were the main independent variables. Outcomes were Decayed, Missing, Filled Teeth (DMFT) and its components, toothache, gingival bleeding, and dental calculus. The data were analyzed by means of negative binomial and Poisson regression. Multilevel analysis was conducted to adjust the outcomes to OHT/FHS and individual variables. In the unadjusted model there was no association between the OHT in the FHS and the outcomes analyzed. After adjustment, young people in areas not covered by the OHT/FHS had almost half of the tooth loss of adolescents from the areas covered (RM = 0.64 CI 95%, 0.43 to 0.94).

Estado de salud oral en discapacitados residentes en la Fundación Pequeño Cottolengo don Orione, Paraguay / Oral health status of disabled residents at the Fundación Pequeño Cottolengo don Orione, Paraguay

Viven con discapacidad aproximadamente 600 millones de individuos, cifra que va en aumento; de éstos el 80 % reside en países de bajos ingresos. En el Paraguay, se estima que aproximadamente el 15 % de la población presenta algún tipo de discapacidad. El objetivo fue describir el estado de salud oral de las personas con discapacidad que residen en la Fundación Pequeño Cottolengo Don Orione de Mariano Roque Alonso, Paraguay 2012. Se realizó un estudio observacional descriptivo de corte transversal en 37 niños, jóvenes y adultos en edades comprendidas entre 12 y 68 años. Fueron analizadas las lesiones de caried a través del índice CPO-D, lesiones no cariosas, lesiones de tejidos blandos y la presencia de factores de riesgo como nivel y frecuencia de higiene, placa microbiana, saliva y dieta. El índice CPO-D fue 16,24; se detectó presencia de lesiones no cariosas en 48,65 % y fluorosis en 2,70 %. Se encontraron fracturas a nivel de esmalte en 43,24 % y la higiene oral fue deficiente medido por medio del índice de Loë y Silness. El 24,32 % tenía saliva viscosa; el Índice de placa bacteriana fue de 2,04. Mientras que, en ninguno de los casos los momentos de azúcar superaron tres. El 100 % de la población se cepilla una vez al día por la mañana antes del desayuno. En la población de estudio existen valores elevados en cuanto a caries y dientes perdidos, por tanto, se deben aumentar los programas de concientización en los cuidadores para promover la preservación de los dientes y la salud oral.

Approximately 600 million people worldwide live with disabilities, a figure that is increasing; 80 % of these individuals live in low-income countries. In Paraguay, it is estimated that approximately 15 % of the population has some type of disability. The objective of this study was to describe the state of oral health of people with disabilities who reside in the Fundación Pequeño Cottolengo Don Orione de Mariano Roque Alonso, Paraguay 2012. A descriptive cross-sectional study was performed on 37 children, youth and adults aged between 12 and 68 years. We analyzed carious lesions thorough DMF-T index, lesions involving soft tissue and the presence of risk factors such as hygiene, microbial plaque, saliva and diet. The DMFT index was 16.24; presence of non-carious lesions was detected in 48.65 % and 2.70 % fluorosis. Level enamel fractures were found in 43.24 % and oral hygiene was poor by Loë and Silness index. Of the population studied, 24.32 % had viscous saliva and plaque index was 2.04. While they did not exceed sugar times three in any cases; 100 % of the population brushed once a day in the morning before breakfast. In the study population there are high values of missing and decayed teeth, therefore, awareness programs to promote the preservation of the teeth and oral health should be emphasized.

A presença de fluorose dentária estaria associada ao traumatismo dentário entre escolares? / Is there an association between the presence of dental fluorosis and dental trauma amongst school children?

Resumo Objetivou-se avaliar se diferentes graus de fluorose dentária estão associados à presença de traumatismo dentário entre escolares. Trata-se de um estudo transversal conduzido entre escolares de 12 anos. Os exames foram realizados por 24 cirurgiões-dentistas treinados e calibrados. A coleta de dados ocorreu em 36 escolas públicas sorteadas entre as 89 do município. Adotou-se como critério de diagnóstico para fluorose dentária o Índice de Dean e para o traumatismo dentário considerou-se sinais clínicos de fraturas coronárias e avulsão dentária. Foram conduzidas análises descritivas, bivariadas e múltiplas. Entre os 2755 escolares incluídos, 1089 (39,6%) foram diagnosticados com fluorose dentária e 106 (3,8%) possuíam um dente ou mais com traumatismo. Identificou-se maior prevalência da fluorose dentária, independente do grau de severidade, entre indivíduos com um dente ou mais com traumatismo dentário. Essa associação foi mais forte com os graus mais severos de fluorose. Além disso, constatou-se que a presença de fluorose foi maior entre aqueles com autopercepção da presença de manchas nos dentes e que recebiam assistência odontológica na escola. Portanto, a fluorose dentária foi associada à presença de traumatismo dentário, independente de sua severidade.

Abstract Our objective was to evaluate whether there is an association with the different levels of dental fluorosis and the presence of dental trauma amongst school children. A transversal study was conducted amongst school children from the age of 12. Dental examinations were conducted by 24 well trained and fully qualified dental surgeons. Data was collected from 36 randomly selected public schools amongst 89 schools in a municipality. The criteria used to diagnose dental fluorosis was based on the Dean’s fluorosis Index and for diagnosing dental trauma we looked for clinical signs of crown fractures and dental avulsions. Multiple descriptive analysis, which was bivariate, was carried out. Amongst the 2,755 school children that took part in the study 1,089 (39.6%) were diagnosed with dental fluorosis and 106 (3.8%) had one tooth or more with dental trauma. We noted a high prevalence of dental fluorosis, independent of the level of severity, amongst individuals with one tooth or more who had dental trauma. This association was even more evident where there were severely high levels of fluorosis. We also noted that the presence of fluorosis was greater amongst those that actively paid more attention to discoloration on their teeth and who received treatment from a dental professional at their schools. Nevertheless dental fluorosis was associated with the presence of dental trauma, independent of its severity.

Oral disorders in patients with chronic renal failure: narrative review / Alteraciones bucodentales en pacientes con insuficiencia renal crónica: revisión narrativa

Abstract: chronic renal failure (CRF) is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, which makes them more likely to develop pathological conditions in the oral cavity, potentially increasing morbidity, mortality and affecting the quality of life of patients. Among the lesions we can find dysgeusia, periodontitis, candidiasis, gingival bleeding, petechiae, and joint alterations. Gingivitis and xerostomia associated to long-term use medications can cause oral lesions. Children with CRF show two oral conditions of interest: high incidence of dental anomalies and low caries activity. In patients receiving a kidney transplant, previous dental treatment is critical because the immune status of the patient will be affected not only by the toxemia, but by the immunosuppressive drugs used to prevent transplant rejection. Therefore, the dentist plays an important role in training parents and/or guardians, doctors and paramedics on the treatment of oral lesions in these patients.

Resumen: la insuficiencia renal crónica (IRC) es una de las nefropatías más conocidas, caracterizada por la disminución del estado de la función renal global. Se encuentra asociada a patologías como la hipertensión arterial, diabetes mellitus, las uropatías, glomerulonefritis crónica y enfermedades autoinmunes. Los pacientes con IRC presentan alteraciones del aparato masticatorio, que son propias de la enfermedad, y otras como consecuencia de su tratamiento. La salud bucal en los pacientes de diálisis y trasplantados tiende a ser pobre, siendo más propensos a desarrollar condiciones patológicas en la cavidad oral y con un potencial impacto sobre la morbilidad, mortalidad y calidad de vida del paciente. Entre las lesiones podemos encontrar disgeusia, periodontitis, candidiasis, sangramiento gingival, petequias, alteraciones a nivel articular, entre otras. La gingivitis y xerostomía asociadas a medicamentos de uso obligatorio pueden generar lesiones orales. Los niños con IRC exhiben dos condiciones orales de interés: alta incidencia de anomalías dentarias y baja actividad cariosa. En el paciente que recibirá un trasplante renal, el tratamiento dental previo es primordial, pues el estado inmune del paciente no sólo se verá afectado por la toxemia, sino por los fármacos inmunodepresores que se usan para evitar el rechazo de órganos implantados. Por lo anterior, el odontólogo juega un papel importante en la instrucción a padres y/o representantes, médicos y paramédicos para el control y tratamiento de lesiones en boca de estos pacientes.

Estudio retrospectivo de una población de pacientes sometidos a exodoncias en la Cátedra de Cirugía y Traumatología Bucomaxilofacial I de la Facultad de Odontología de la Universidad de Buenos Aires, en el período entre enero 2012 - mayo 2014 / A retrospective study on a patient population undergoing tooth extraction at the Department of Oral and Maxillofacial Surgery I, School of Dentistry, University of Buenos Aires, over a January 2012 - May 2014 period

La extracción dentaria es una de las prácticas odontológicas realizadas con mayor frecuencia, pero a corto plazo los pacientes necesitan rehabilitaciones orales para optimizar el funcionamiento del sistema estomatognático. Dado que conocer las características de la población que demanda exodoncias puede contribuir a elaborar estrategias para limitar la pérdida de piezas dentarias, nos propusimos 1) registrar las características de la población que demanda exodoncias; 2) identificar las piezas dentarias extraídas; 3) registrar las causas de exodoncia; 4) identificar patologías bucales durante la consulta para una exodoncia. Para llevarlo a cabo se seleccionaron aleatoriamente 2000 historias clínicas de pacientes que concurrieron a la Cátedra de Cirugía y Traumatología Buco Maxilofacial I de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA) y se realizaron exodoncias con anestesia local entre enero de 2012 y mayo de 2014...

Dental extraction is one of the most frequent practices in dentistry, causing necessary oral rehabilitation to ensure normal stomatognathic system function. The purpose of this study was to get to know the characteristics of the population in need of dental extraction so as to develop strategies tending to limit teeth loss. We set to 1) record the characteristics of the population on demand for dental extraction; 2) Identify teeth extracted; 3) Record cause of dental extraction; 4) Identify oral pathologies during examination for dental extraction. We selected 2000 Records of patients who attended “Cátedra de Cirugía y Traumatología Bucomaxilofacial I de la Facultad de Odontología de la Universidad de Buenos Aires, FOUBA” for dental extraction with local anesthetics in the period between January 2002 and May 2014...

Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador – CEREST (Worker’s Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

Impacto de la salud bucal en la calidad de vida de escolares de 11 a 14 años, Licantén, 2013 / Oral health impact on the quality of life of 11 to 14 year-old schoolchildren, Licantén, 2013

INTRODUCCIÓN La salud bucal forma parte de la salud general, siendo reconocida como un componente esencial para la calidad de vida. Se ha desarrollado hace algunos años el concepto de «calidad de vida relacionada con la salud bucal¼, para esto se han creado diferentes índices enfocados en adultos y niños. Para estos últimos se desarrolló el Child- Oral index in Daily Performances (Child-OIDP), el cual consta de 8 dimensiones que evalúan el impacto de la salud bucal en la realización de sus actividades diarias. OBJETIVO Evaluar la calidad de vida relacionada con la salud bucal a través del índice Child-OIDP en escolares de 11 a 14 años de la comuna de Licantén en el 2013. METODOLOGÍA Se utilizó la encuesta Child-OIDP en la totalidad de 203 escolares de 11 a 14 años del sector urbano de la comuna. Se realizó un análisis exploratorio de los datos determinando medidas de distribución por frecuencia y porcentaje, y promedios con su desviación estándar. Las diferencias en los valores del Child-OIDP se determinaron con test no paramétricos: chi cuadrado, Kruskal-Wallis y Mann-Whitney-Wilcoxon, todas con un nivel de significación de p < 0,05. RESULTADOS Los problemas bucales que afectaron a los niños con mayor frecuencia fueron: color de los dientes (42,36%) y posición de los dientes (41,87%). El Child-OIDP promedio para la muestra fue de 6,92% ± 10,32%. Las actividades más afectadas en los niños debido a problemas bucales fueron: comer (39,9%), sonreír (34,5%) y cepillarse (32,2%). CONCLUSIÓN Los problemas dentales son frecuentes en niños de Licantén y pueden interferir significativamente en la ejecución de tareas diarias.

INTRODUCTION Oral health is part of the general health status, being recognized as an essential component of quality of life. Some years ago the concept of "Oral health-related quality of life" was introduced and several indices have been created focusing on its assessment in adults and children. For the latter the Child- Oral index in Daily Performances (Child-OIDP) was developed, which consists of 8 dimensions that assess the impact of oral health in performing daily activities. OBJECTIVE To evaluate the oral health-related quality of life using the Child-OIDP index in schoolchildren from 11-14 years old in Licantén, 2013. METHODOLOGY The Child-OIDP questionnaire was used on a sample of 203 schoolchildren aged 11 to 14 years from the urban sector of the community. An exploratory analysis of the data for determining frequency and percentage distribution, and means with standard deviation was performed. Differences in Child-OIDP values were determined using non-parametric tests: chi-square, Kruskal Wallis, and Mann-Whitney-Wilcoxon, all with a significance level of p < 0.05. RESULTS The most frequent oral problems affecting children were: color of teeth (42.36%) and tooth position (41.87%). The Child-OIDP mean for the sample was 10.32% ± 6.92%. The activities that most affected children were eating (39.9%), smile (34.5%), and cleaning teeth (2.2%). CONCLUSION Dental problems are common in children from Licantén and can interfere in daily activities.

Nutritional Status of Children Residing In Social Welfare Hostel in Bangalore City.

Background: Health Care needs of children residing in Social Welfare Hostels is of utmost importance as they are in need of optimum health and nutrition care. Methodology: Study Setting: Social Welfare Hostel. Study Design: Cross sectional study. Study Duration: June to September 2013. Study subjects: Children( 7-14yrs of age) residing in the Social Welfare Hostel. Sample Size: A total of 200 children were residing in the hostel and hence the complete enumeration of them were considered for the study (purposive Sampling). Study variables: Socio-Demographic profile, measurement of height, weight, estimation of Hemoglobin percentage by Sahli’s method and clinical examination. Every child was examined physically from head to toe to assess their nutritional deficiencies. Enquiry was made about the health problems and occurrence of any ailment during previous two weeks. Data Collection: Using Semi- structured questionnaire, interview method. Data analysis: SPSS V 20. Results: Out of 200 subjects, 47(35.07%) of the study population were underweight, 71 (35.50%) had stunting and 38 (19%) had wasting. Prevalence of anemia was 47.5%. The common conditions observed were Flurosis (45.5%), skin problems (42.5%), dental caries (31.5%) and Cheilosis (24.5%). Conclu-sion: The nutritional status of children in social welfare hostels are not satisfactory. Periodic Health check up for the children residing in Social Welfare Hostels must be emphasized.

Aspectos sociodemograficos e clinicos da qualidade de vida relacionada a saude bucal em adolescentes / Aspectos sociodemogragicos y clinicos de la calidad de vida relacionada con la salud bucal en adolescentes / Sociodemographic and clinical aspects of quality of life related to oral health in adolescents

OBJETIVO: Estimar a prevalência e identificar fatores sociodemográficos e parâmetros bucais associados ao impacto negativo da condição bucal na qualidade de vida de adolescentes. MÉTODOS: Foram analisados dados de 5.445 adolescentes entre 15 e 19 anos que participaram do inquérito nacional de saúde bucal (SBBrasil 2010), considerando a complexidade do desenho amostral. O desfecho foi a qualidade de vida relacionada à saúde bucal, avaliada por meio do questionário Oral Impacts on Daily Performance e analisada de forma discreta. As variáveis de exposição foram sexo, cor da pele, escolaridade, renda familiar, idade, cárie não tratada, perda dentária, dor de dente, oclusopatias, sangramento gengival, cálculo dentário e bolsa periodontal. Foram conduzidas análises de regressão de Poisson e apresentadas as razões de médias (RM), com respectivos intervalos de 95% de confiança (IC95%). RESULTADOS: Dos pesquisados, 39,4% relataram pelo menos um impacto negativo na qualidade de vida. Após o ajuste, a média do impacto negativo foi de 1,52 (IC95%1,16;2,00) vez maior no sexo feminino e 1,42 (IC95% 1,01;1,99), 2,66 (IC95% 1,40;5,07) e 3,32 (IC95% 1,68;6,56) vezes maior nos pardos, amarelos e indígenas, respectivamente, em relação aos brancos. Quanto menor a escolaridade, maior a média de impacto negativo (RM 2,11, IC95% 1,30;3,41), assim como em indivíduos com renda familiar até R$ 500,00 (RM 1,84, IC95% 1,06;3,17) comparados aos de maior renda. Encontrou-se maior impacto na qualidade de vida entre adolescentes com quatro ou mais lesões de cáries não tratadas (RM 1,53, IC95% 1,12;2,10), uma ou mais perdas dentárias (RM 1,44, IC95%1,16;1,80), com dor de dente (RM 3,62, IC95% 2,93;4,46) e com oclusopatia grave (RM 1,52, IC95% 1,04;2,23) e muito grave (RM 1,32, IC95% 1,01;1,72). ...

OBJETIVO: Estimar la prevalencia e identificar factores sociodemográgicos y parámetros bucales asociados con el impacto negativo de la condición bucal en la calidad de vida de adolescentes. MÉTODOS: Se analizaron datos de 5.445 adolescentes entre 15 y 19 años que participaron de la pesquisa nacional de salud bucal (SBBrasil 2010), considerando la complejidad del diseño de muestreo. El resultado fue la calidad de vida relacionada con la salud bucal, evaluada por medio de cuestionario Oral Impacts on Daily Performance y analizada de forma discreta. Las variables de exposición fueron sexo, color de la piel, escolaridad, renta familiar, edad, caries no tratada, pérdida dentaria, dolor de diente, maloclusiones, sangramiento de encías, cálculo dentario y bolsa periodontal. Se efectuaron análisis de regresión de Poisson y se presentaron los cocientes de promedios (RM), con sus respectivos intervalos de 95% de confianza (IC95%), RESULTADOS: Entre los investigados, 39,4% relataron por lo menos un impacto negativo en la calidad de vida. Posterior al ajuste, el promedio del impacto negativo fue de 1,52 (IC95% 1,16;2,00) veces mayor en el sexo femenino y 1,42 (IC95% 1,01;1,99), 2,66 (IC95%1,40;5,07) y 3,32 (IC95%1,68;6,56) veces mayor en los pardos, amarillos e indígenas, respectivamente, con relación a los blancos. En la medida que disminuye la escolaridad, mayor el promedio del impacto negativo (RM 2,11, IC95%1,30;3,41), así como en individuos con renta familiar hasta R$ 500,00 (RM 1,84, IC95%1,06;3,17) en comparación con los de mayor renta. Se encontró mayor impacto en la calidad de vida entre adolescentes con cuatro o más lesiones de caries no tratadas (RM1,53, IC95%1,12;2,10), una o más pérdidas dentarias (RM1,44, IC95%1,16;1,80), con dolor de diente (RM3,62, IC95%2,93;4,46), y con maloclusión grave (RM1,52, IC95%1,04;2,23) y muy grave ...

OBJECTIVE: To estimate the prevalence and to identify sociodemographic and oral health factors associated with the negative impact of oral health conditions on the quality of life in adolescents. METHODS: Data from 5,445 adolescents aged 15-19, who took part in the Brazilian Oral Health Survey (SBBrasil 2010) were analyzed, using a multistage sampling design. The outcome was quality of life related to oral health, which was assessed using the Oral Impacts on Daily Performance questionnaire and analyzed as a discrete variable. The independent variables were sex, skin color, schooling, household income, age, untreated dental caries, malocclusion.,gingival bleeding, dental calculus, and periodontal pocket. Poisson regression analysis was carried out and mean ratios (MR) with their respective 95% confidence intervals (95%CI) were presented. RESULTS: Of the total, 39.4% reported at least one negative impact on their quality of life. After adjustment, the mean negative impact was 1.52 (95%CI 1.16;2.00) times higher in females and 1.42 (95%CI 1.01;1.99), 2.66 (95%CI 1.40;5.07) and 3.32 (95%CI 1.68;6.56) higher in those with brown, yellow, and indigenous skin color, respectively, when compared to those with white skin. The lower the level of schooling, the greater the negative impact (MR 2.11, 95%CI 1.30;3.41), likewise for individuals with household income below R$ 500.00 (MR 1.84, 95%CI 1.06;3.17) compared with those with higher incomes. The greatest impact on quality of life was found among adolescents with four or more teeth with untreated dental caries (MR 1.53, 95%CI 1.12;2.10), one or more missing teeth (MR 1.44. 95%CI 1.16;1.80). those with dental pain (RM 3.62, 95%CI 2.93;4.46) and with severe (MR 1.52, 95%CI 1.04;2.23) and very severe malocclusion (MR 1.32, 95%CI 1.01;1.72). CONCLUSIONS: Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken ...

Padrao epidemiologico das oclusopatias muito graves em adolescentes brasileiros / Patron epidemiologico de las maloclusiones muy graves en adolescentes brasilenos / Epidemiological pattern of severe malocclusions in Brazilian adolescents

OBJETIVO: Descrever o padrão de distribuição das oclusopatias em adolescentes brasileiros e identificar fatores associados a esse agravo bucal. MÉTODOS: Foram analisados dados de 7.328 e 5.445 adolescentes de 12 e 15-19 anos, respectivamente, participantes da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010). O desfecho foi oclusopatia muito grave segundo o índice de estética dental. As variáveis de exposição foram sexo, cor da pele, renda familiar mensal, número de bens, aglomeração no domicílio, cárie não tratada, perda dentária, uso, frequência e motivo da consulta odontológica. Foram conduzidas análises de regressão logística considerando a complexidade do desenho amostral, com base em modelo hierarquizado. RESULTADOS: Prevalência de oclusopatia muito grave foi observada em 6,5% e 9,1% nos jovens de 12 e 15-19 anos, respectivamente. Após análise ajustada, a chance do desfecho foi 1,59 (IC95% 1,08;2,34) vez maior nos pardos e pretos em relação aos brancos e 2,66 (IC95% 1,26;5,63) vezes maior dentre aqueles com perda de pelo menos um primeiro molar aos 12 anos. Jovens de 15-19 anos cuja renda familiar mensal foi de até R$ 1.500,00 (OR 2,69 [IC95% 1,62;4,47]) e aqueles que consultaram o dentista para tratamento (OR 2,59 [IC95% 2,55;4,34]) apresentaram maior chance de oclusopatia muito grave quando comparados aos de maior renda e que procuraram o dentista para prevenção. CONCLUSÕES: A distribuição das oclusopatias em adolescentes brasileiros segue o padrão de iniquidade social de outros agravos à saúde. Essas informações são úteis para a formulação de critérios relacionados tanto com a distribuição e provisão de recursos quanto com as prioridades de tratamento ortodôntico fundamentados no princípio ...

OBJETIVO: Describir el patrón de distribución de las maloclusiones en adolescentes brasileños e identificar factores asociados a este agravio bucal. MÉTODOS: Se analizaron datos de 7.328 y 5.445 adolescentes de 12 y 15-19 años, respectivamente, participantes de la Investigación Nacional de Salud Bucal (SBBrasil 2010). El resultado fue maloclusión muy grave según el índice de estética dental. Las variables de exposición fueron sexo, color de la piel, renta familiar mensual, número de bienes, aglomeración en domicilio, caries no tratada, pérdida dentaria, uso, frecuencia y motivo de la consulta odontológica. Se realizaron análisis de regresión logística considerando la complejidad del diseño de muestreo, con base en el modelo jerarquizado. RESULTADOS: Prevalencia de maloclusión muy grave fue observada en 6,5% y 9,1% en los jóvenes de 12 y 15-19 años, respectivamente. Posterior al análisis ajustado, el chance del resultado fue 1,59 (IC95%1,08;2,34) veces mayor en los pardos y negros con respecto a los blancos y 2,66 (IC95%1,26;5,63) veces mayor entre los que presentaron pérdida de al menos un molar a los 12 años. Jóvenes de 15-19 años cuya renta familiar mensual fue de hasta R$ 1.500,00 (OR2,69[IC95%1,62;4,47]) y los que consultaron el dentista para tratamiento (OR2,59[IC95%2,55;4,34]) presentaron mayor chance de maloclusión muy grave al ser comparados con los de mayor renta y que buscaban al dentista para prevención. CONCLUSIONES: La distribución de las maloclusiones en adolescentes brasileños sigue el patrón de inequidad social de otros agravios a la salud. Estas informaciones son útiles para la formulación de criterios relacionados tanto con la distribución y provisión de recursos, como con las prioridades de tratamiento ortodóntico fundamentados ...

OBJECTIVE: To describe the distribution of malocclusion and its associated factors in Brazilian adolescents. METHODS: Data from 7,328 subjects aged 12 years and 5,445 adolescents aged 15-19 years were analyzed. The adolescents took part in the Brazilian Oral Health Survey (SBBrasil 2010). The outcome was severe malocclusion according to the dental aesthetic index. The independent variables were sex, skin color, monthly household income, possessions, number of individuals in the household, untreated dental caries, missing teeth and dental appointments or lack thereof, frequency, and reason. Logistical regression analysis was carried out, considering the complex sampling cluster design, based on a hierarchical model. RESULTS: The prevalence of severe malocclusion was 6.5% and 9.1% in the 12-year-olds and the 15-19-year-olds, respectively. After adjustment, those with lighter- skinned black or black skin were 1.59 (95%CI 1.08;2.34) times more likely to present the outcome compared with those with white skin. The loss of one or more first molars increased 2.66 (95%CI 1.26;5.63) the chance to present severe malocclusion by the age of 12. Adolescents aged 15-19 whose household income was below R$ 1,500.00 (OR 2.69 [95%CI 1.62; 4.47]) and those who had seen a dentist for treatment (OR 2.59 [95%CI 2.55;4.34]) had the greatest chance of having severe malocclusion compared with those with higher incomes and those who visited the dentist for prevention. .

Perinatal factors associated with developmental defects of enamel in primary teeth: a case-control study

The present study was designed to evaluate associations between developmental defects of enamel (DDE) in the primary dentition and aspects related to mothers and preschoolers in the city of Diamantina, Brazil. A case-control study was carried out involving children aged three to five years. The case group was composed of 104 children with at least one dental surface affected by DDE. The control group comprised 105 children without DDE, matched for gender and age. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel Index. Information was collected through interviews investigating socio-demographic aspects, gestation, birth weight, prematurity and breastfeeding. Simple and multiple regression analyses were performed, providing unadjusted and adjusted prevalence ratios (Poisson regression). DDE were more prevalent among children who had not been breastfed (PR = 1.57; 95% CI: 1.1-2.2) and those whose mothers were under 24 years of age at the birth of the child (PR = 1.41; 95% CI: 1.1-1.9). The prevalence of DDE in the primary dentition was higher among children who had not been breastfed and those whose mothers were under 24 years of age at the birth of the child.

Condições orais de crianças e adolescentes em hemodiálise: estudo clínico e laboratorial / Oral conditions of children and adolescents with Chronic Kidney Disease: clinical and laboratory study

Avanços na nefrologia pediátrica têm resultado em um acentuado aumento no número de crianças e adolescentes que sobrevivem à Insuficiência Renal Crônica. Embora muitas complicações da doença possam ser prevenidas ou tratadas efetivamente, as terapias atuais têm introduzido novos problemas, inclusive em relação à saúde oral. Os objetivos deste estudo foram realizar uma revisão sistemática da literatura para buscar evidências relacionadas à menor prevalência de cárie dentária em crianças e adolescentes com Insuficiência Renal Crônica, e avaliar as condições orais de crianças e adolescentes com Insuficiência Renal Crônica, em hemodiálise, em relação à experiência de cárie, às condições periodontais e à microbiota fúngica. Para este estudo transversal foram incluídos 52 pacientes renais de três centros de Nefrologia Pediátrica, pareados por idade, sexo, cor e classe social com 52 indivíduos saudáveis atendidos no Centro de Vigilância e Monitoramento de Traumatismo Dento Alveolar da FO/UFRJ. Os pacientes foram examinados para a análise do número de dentes cariados, perdidos e obturados, percentual de placa visível e sangramento gengival, acúmulo de cálculo dental, medidas de profundidade de bolsa, nível clínico de inserção, recessão gengival e percentual de sangramento à sondagem. Foram realizadas coletas de saliva estimulada para a avaliação do fluxo, pH e capacidade tampão e para a determinação das concentrações salivares de cálcio, fósforo e ureia por método colorimétrico. Para a análise da microbiota fúngica, as coletas foram realizadas com swab estéril friccionado no dorso da língua. A identificação das espécies isoladas em meio cromogênico (CHROMagar® Candida, França) foi determinada pelo sistema de assimilação de substrato API Candida 20C® (Biomerieux, Mary L’Etoile, França). A média de idade dos participantes foi de 13 anos, sendo 53,80% do sexo masculino, em ambos os grupos. Os pacientes em hemodiálise apresentaram menor prevalência de cárie dentária (p=0,004; teste de McNemar), maior acúmulo de placa e maior deposição de cálculo dental (p=0,001; teste de Wilcoxon), e ainda, relataram usar fio dental com menos frequência do que os controles (p=0,013; teste de McNemar). Em relação às análises salivares, foram observados valores significativamente maiores no pH, na capacidade tampão e na concentração de ureia salivar dos pacientes renais em hemodiálise, quando comparados aos controles (p=0,001; teste de Wilcoxon). A frequência de colonização fúngica nos pacientes em hemodiálise (34,6%) e nos controles (46,20%) foi semelhante (p=0,362; teste de McNemar). As espécies predominantes foram a Candida parapsilosis e a Candida albicans, nos pacientes em hemodiálise e nos controles, respectivamente. A duração da terapia de hemodiálise mostrou-se associada ao aumento na freqüência de colonização por Candida spp. (p=0,04; teste Qui-quadrado) e ao maior número de unidades formadoras de colônias (p=0,03; teste Mann-Whitney). Crianças e adolescentes com Insuficiência Renal Crônica, submetidas ao tratamento de hemodiálise, apresentaram maior acúmulo de placa e cálculo dental e ineficiência na realização da higiene bucal, sendo necessário motivá-los em relação ao autocontrole.

Advances in pediatric nephrology have resulted in a marked increase in the number of children and adolescents who survive Chronic Kidney Disease. Although many complications of the disease can be prevented or treated effectively, current therapies have introduced new problems, including in relation to oral health. The aims of this study were to perform a systematic review of the literature to find evidence related to a lower prevalence of dental caries in children and adolescents with Chronic Kidney Disease, and to evaluate the oral conditions of children and adolescents with Chronic Kidney Disease, on hemodialysis, in relation to dental caries experience, periodontal conditions and fungal microbiota. For this cross-sectional study were included 52 kidney patients from three centers of Pediatric Nephrology, matched for age, sex, ethnicity and social class with 52 healthy subjects from Centre for Surveillance and Monitoring Trauma Dental Alveolar FO / UFRJ. Patients were examined for the analysis of the number of decayed, missing and filled teeth, percentage of visible plaque and gingival bleeding, dental calculus accumulation, measurements of pocket depth, clinical attachment level, gingival recession and percentage of bleeding on probing. Estimulated saliva samples were collected to assess salivary flow rate, pH and buffer capacity and to determine the salivary concentrations of calcium, phosphate and urea by colorimetric method. For analysis of fungal microbiota, samples were collected with sterile swab on the dorsum of the tongue. The identification of isolated species on chromogenic medium (CHROMagar Candida®, France) was determined by substrate assimilation system API Candida® 20C (Biomerieux, Mary L'Etoile, France). The average age of participants was 13 years old. There are 53.80% males in both groups. Patients on hemodialysis had lower prevalence of dental caries (p=0.004; McNemar’s test), greater accumulation of plaque and greater calculus deposition (p=0.001; Wilcoxon test). Renal patients also reported flossing less often than in the controls (p=0.013; McNemar’s test). Regarding salivary analyzes, renal patients showed significantly higher values of pH, buffer capacity and salivary urea concentration, when compared to matched controls (p=0.001; Wilcoxon test). The frequency of fungal colonization in the hemodialysis patients (34.6%) and in the controls (46.20%) was similar (p=0.362; McNemar’s test). The predominant species were Candida parapsilosis and Candida albicans, in the hemodialysis patients and controls, respectively. The duration of hemodialysis therapy was...