Tooth Loss, Sociodemographic Conditions and Oral Health-Related Quality of Life in the Elderly

Abstract Objective: To verify the association between impacts produced by tooth loss and sociodemographic variables in the oral health-related quality of life (OHRQoL) in the elderly. Material and Methods: This is an analytical cross-sectional study carried out in the municipality of Vitória/ES, Brazil, which sample was composed of 402 older adults. The Oral Health Impact Profile (OHIP-14) was used to measure the individuals' OHRQoL. For data analysis, descriptive and bivariate analyses were performed using the Fisher's exact test and the Mantel-Haenzsel test to assess the effects of combined dimensions. The significance level adopted was 5%. To assess the strength of association between independent variables and dimensions, Odds-Ratio (OR) with 95% confidence interval (CI) was calculated. Results: The prevalence of negative impact on OHRQoL in the elderly was 32.6%. The greatest impact perception was found in individuals with up to 10 years of schooling (p=0.021 and OR=1.602), with need for removable partial dentures (p=0.000 and OR=2.873) and those who did not accept the loss of dental elements (p=0.000 and OR=3.064). Conclusion: Older female adults with socioeconomic class C/D-E, with up to 10 years of schooling, who lost 11 or more teeth, who declared the need for removable partial dentures, suffered greater impacts caused by tooth loss on OHRQoL.

Prevalência de perdas dentárias precoces em crianças de população ribeirinha da região amazônica / Prevalence of early tooth loss in children from riverside populations of the amazon region

Objetivo: Avaliar a prevalência de perdas precoces dentárias em crianças de populações ribeirinhas da Amazônia. Método: Estudo transversal, sendo a amostra composta por 112 crianças de 3 a 9 anos de idade residentes nas comunidades ribeirinhas São Pedro e Aurá localizadas no estado do Pará. Os dados foram obtidos através do exame clínico e anotados em fichas padronizadas para o estudo e, posteriormente, submetidos à análise descritiva. Para o estudo da distribuição de freqüências da perda dentária precoce em relação à comunidade, gênero e dentição, foi utilizado o Teste Qui-quadrado, com nível de significância de 5% (p menor que 0,05). Resultados: A prevalência de perda dentária precoce foi de 18%, sendo que a perda ocorreu em 19,23% das crianças do Aurá e em 14,71% das crianças de São Pedro. Foi observado que a perda foi maior no masculino (26%) do que no feminino (11,29%), sendo que esta diferença foi estatisticamente significativa (p= 0,04). Em relação aos dentes, houve 27 casos de perdas, sendo o 75 (segundo molar decíduo inferior esquerdo) e o 85 (segundo molar decíduo inferior direito), com maior prevalência, ambos com 18,52%. Houve uma maior prevalência de perda nas idades de 7 (27,27%) e 8 (29,41%) anos, sendo a cárie dentária a causa predominante da perda. Como conseqüência, os resultados mostram que a mais observada foi a perda de espaço (43,18%), enquanto que a menos observada foi a presença de mordida cruzada(4,55%). Conclusão: Apesar da prevalência da perda não ser sido tão alta, esta poderá ser diminuída através de políticas públicas junto às comunidades ribeirinhas, principalmente de caráter educativo e preventivo, evitando desta maneira os agravos e conseqüências indesejáveis que a perda precoce pode trazer ao indivíduo.

Objective: To evaluate the prevalence of early tooth loss in children of riverside communities living in the Amazon region of Brazil. Methods: This study was an epidemiological survey conducted on 112 children aged 3 to 9 years living in two communities, São Pedro and Aurá, in the State of Pará, Brazil. The data were collected by clinical examination and recorded on custom-made forms designed for this research and later submitted to descriptive analysis. In order to study the frequency of early teeth loss in relation to community, gender and dentition, the Chi- Square test was used at a 5% significance level (p less than 0.05). Results: The prevalence of early tooth loss was 18%, occurring in 19.23% of the children in Aurá and 14.71% of the children in São Pedro. It was observed that the loss was greater among males (26%) than females (11.29%), and this difference was statistically significant (p=0.04). In relation to the teeth, there were 27 loss cases, with the highest prevalence of tooth loss for the teeth 75 (primary mandibular left second molar) and 85 (primary mandibular right molar) both with 18.52%. There was a higher prevalence of loss at the ages of 7 (27.27%) and 8 (29.41%), the dental caries being the prevailing cause of loss. As a result of the early tooth loss, the most frequently observed result was the loss of space (43.18%), whereas the least observed was the presence of crossbite (4.55%). Conclusion: Although the prevalence of tooth loss was excessively high, it may be reduced through public policies directed to riverside communities, mainly with educational and preventive actions to avoid problems and consequences that the early tooth loss may cause to the person.

Consecuencias de las pérdidas de los primeros molares permanentes en niños que acudieron al servicio de cirugía odontopediátrica de la Facultad de Odontología de la Universidad Nacional de Asunción en el año 2010 / Consequences of loss of first permanent molars in children who attended the dentist surgery department of the Faculty of Dentistry, National University of Asuncion in 2010

El primer molar permanente es una pieza fundamental en la cavidad bucal, realiza funciones primordiales: levante de mordida, estabiliza la oclusión y determina el patrón de masticación, siendo fundamental para el desarrollo de una oclusión fisiológica y una adecuada función masticatoria. Tiene una morfología oclusal compleja con cúspides, fosas y surcos que lo hacen más susceptible al ataque carioso, con la consecuente destrucción y pérdida del mismo, llevando así a numerosas patologías. Con el objetivo de conocer tales patologías se realizó un estudio observacional, descriptivo de corte transversal con muestreo no probabilístico de casos consecutivos. La muestra estuvo constituida por 32 pacientes de 8 a 15 años de edad que acudieron al servicio de odontopediatría de la Facultad de Odontología, Universidad Nacional de Asunción, en el año 2010. Las variables fueron: rotaciones, extrusiones, inclinaciones y migraciones dentarias. También se consideró: edad, sexo y hemiarcadas. Los resultados destacan que el grupo etario más afectado fue el comprendido entre 12 a 13 años, con predominio del sexo femenino. La mayoría había perdido por lo menos dos molares. Se encontró mayor pérdida en el maxilar inferior, hemiarcada derecha. Las derivaciones más frecuentes fueron rotaciones, inclinaciones, migraciones y extrusiones dentarias. El resultado de este trabajo sirvió de base para las charlas ofrecidas a los padres que acompañaron a los niños a la consulta donde se dio énfasis al papel que desempeñan los primeros molares permanentes y las consecuencias de su pérdida haciendo hincapié en los trastornos que genera en la estabilización de la oclusión.

El sistema masticatorio y las alteraciones funcionales consecuentes a la pérdida dentaria / The masticatory system and functional alterations consequent to tooth loss

A pesar de las mejoras ocurridas en las condiciones de salud general de la población, aún es frecuente, con el proceso de envejecimiento, la de pérdida de piezas dentarias, acarreando disturbios en el sistema masticatorio y reflejándose en todo el organismo del anciano. De esta forma, este trabajo realizó una revisión de literatura al respecto de este sistema, sus funciones, peculiaridades y alteraciones especialmente relacionadas a la pérdida dentaria, enfatizando la importancia de las rehabilitaciones protésicas para restaurar la función y los cuidados necesarios en el planeamiento, instalación y manutención de las prótesis en los pacientes de la tercera edad. Fue posible concluir que, debido a la complejidad del sistema masticatorio y de todas las estructuras relacionadas, la reunión del mayor número posible de informaciones durante la anamnesis, examen clínico, radiográfico y de modelos de estudio montados en el articulador son de mucha importancia para el éxito de cualquier tratamiento que envuelve pacientes ancianos. Estos tratamientos, deben someterse a un planeamiento multidisciplinar donde cada especialidad siga una secuencia lógica e integrada de ejecución, para que sean alcanzados los resultados anhelados

Despite of the improvements happened in the general conditions of population health, it's frequent the occurrence of teeth loss with the aging. This phenomenon cause masticatory system disturbance and can be observed in all the elderly organism. By this way, this study realized a literature review about this system, its functions, peculiarities and alterations related to the loss of tooth, emphasizing the importance of prosthetic rehabilitations to restore the functions and the necessary care on treatment planning, installation and prosthesis maintenance in elderly people. In virtue of masticatory system complexity and its related structures, it can be concluded that the reunion of a great data number during the anamnesis, clinical and radiographic examination, and the mounting of diagnostic casts in semi-adjustable articulator are very important for a successful treatment involving elderly people. These treatments may involve a multidisciplinary planning where each involved specialty follow a logic and integrated sequence of execution to reach the desired results

Loss of space and changes in the dental arch after premature loss of the lower primary molar: a longitudinal study.

The purpose of the study was to evaluate the space changes, dental arch width, arch length and arch perimeter, after the unilateral extraction of lower first primary molar in the mixed dentition period. A longitudinal study was conducted among forty children in the age group of 6-9 years, who reported for extraction of lower first primary molar in the department of Pedodontics, Govt. Dental College, Trivandrum. Study models were made from alginate impression taken before extraction and after extraction at the periodical intervals of two months, four months, six months and eight months. The mesiodistal width of lower first primary molar of the non-extracted side was taken as the control. The results of the study showed statistically significant space loss in the extraction side ( P value < 0.01) and no significant space loss in the control side (P value > 0.05). The rate of loss was greatest in the first four months. The arch width, arch length and arch perimeter had no significant change from initial to eight months follow up. The present study challenges the use of a space maintenance under the circumstances of premature loss of mandibular primary molar for preventing space loss.

Papillon-Lefevre syndrome: a report of two cases.

Papillon-Lefevre Syndrome (PLS) is an inherited autosomal recessive disorder presenting with Palmar plantar Keratoderma and Juvenile Periodontitis leading to early loss of both the dentitions. Two cases of PLS in a family with a history of consanguineous descent are presented.

Inclinaçäo dos pilares em próteses adesivos inferiores / Pillars inclination in mandibular resin-bonded prosthesis

O presente estudo visa discutir a indicaçäo de próteses adesivas indiretas (PAI) como tratamento restaurador para as perdas de primeiro molar inferior, especialmente nas situaçöes de ampla inclinaçäo dos pilares. Foi realizada avaliaçäo radiográfica panorâmica de pacientes com perda do referido elemento dentário há mais de 10 anos e de pacientes de grupo controle, com oclusäo fisiologicamente ideal, além de radiovisiografias (sistema Digoral) de terceiro grupo, visando verificar qual inclinaçäo máxima pode ser compensada, através de desgaste, nos preparos para as PAI, visando manter o preparo em esmalte e ampliando sua longividade