Did the Use of Minimum Interventions for Caries Management Change during the COVID-19 Pandemic? A Cross-Sectional Study.

The aim of this study was to evaluate changes in the frequency of use of minimum intervention (MI) techniques for caries management during the COVID-19 pandemic. A questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of noninvasive, microinvasive, minimally invasive, and mixed interventions, nonaerosol or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test, and the effect size (ES) was calculated. An α = 0.05 was adopted. A total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the noninvasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p < 0.01; ES = 0.11). The frequency of sealants to repair defective restorations was the only microinvasive technique that increased during the pandemic (p < 0.01; ES = 0.03). Among the minimally invasive techniques, the use of atraumatic restorative treatment increased significantly (p < 0.01; ES = 0.06), while the use of air abrasion decreased (p = 0.02; ES = 0.04) during COVID-19 pandemic. Moreover, nonrestorative cavity control (mixed intervention) increased during pandemic period (p < 0.001; ES = 0.11). Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.

Cone-beam computed tomography study of mandibular morphology and tooth compensation in asymmetrical patients.

INTRODUCTION: This study evaluated mandibular morphology and transverse dental compensation between symmetrical and asymmetrical subjects, allocated according to sagittal skeletal patterns. In addition, the hypothesis that mandibular morphology and dental compensations differed between symmetrical/asymmetrical groups and also among the different types of sagittal skeletal patterns was tested. METHODS: Cone-beam computed tomography images of 96 patients were included in this study and were divided into 2 groups according to the degree of menton deviation: a symmetrical group with deviation up to 2.0 mm (n = 48; mean age, 15 ± 6 years), and an asymmetrical group with deviation from 3.5 mm (n = 48; mean age, 16 ± 8 years). The 2 groups were divided in accordance with the ANB angle: Class I, II, and III. Skeletal and dental measurements were performed. Intergroup and intragroup analyses were carried out, using a 2-way analysis of variance to assess the interaction of factors: symmetry and sagittal skeletal pattern; and the Student t test for differences between deviated (Dv) and nondeviated (NDv) sides. RESULTS: Symmetrical/asymmetrical groups and Class I, II, and III groups were similar in relation to demographic aspects (P = 0.412 and P = 0.357 for sex and age, respectively). Asymmetrical patients had higher values for body length and mandibular ramus and condyle height on the NDv side (P = 0.011, P = 0.024, and P = 0.001, respectively). When comparing the different skeletal patterns, patients with a Class III relationship demonstrated higher values for mandibular ramus height. Intergroup analysis showed no differences in dental parameters. In the comparison between the sides, the asymmetrical group showed a significant difference in canine inclination (P = 0.008), mandibular ramus height (P = 0.004), condyle height (P = 0.010) and gonion to midsagittal plane distance (P = 0.018). CONCLUSIONS: Asymmetrical subjects showed higher values for canine inclination and mandibular body, ramus and condylar height on the NDv side. The hypothesis was partially confirmed that mandibular morphology and dental compensations are different between symmetrical/asymmetrical groups and among different sagittal skeletal patterns.

Effect of treatment of transverse maxillary deficiency using rapid palatal expansion on oral health-related quality of life in children: A randomized controlled trial.

INTRODUCTION: This trial aimed to longitudinally evaluate the effect of the treatment of transverse maxillary deficiency using rapid palatal expansion (RPE) on self-perceived oral health-related quality of life (OHRQOL) in children. METHODS: Eighty participants aged 8-10 years with transverse maxillary deficiency and bilateral posterior crossbite were randomly assigned to 2 groups (n = 40 each): a group treated with RPE using hyrax-type appliances and a nontreated control group. OHRQOL was assessed by using the Child Perceptions Questionnaire for 8-10-year-olds at 4 times: before RPE, during RPE (T1), at the end of RPE (T2), and 1 month after the appliance removal (T3). Generalized mixed models were used for data analysis (α = 0.05). RESULTS: Both groups exhibited similar demographic characteristics and OHRQOL scores at baseline. All participants completed the study. RPE had a time-dependent effect on OHRQOL. At T1 and T2, this therapy is expected to increase the overall OHRQOL scores by 1.17 times (ie, ∼17% increase; T1 95% confidence interval [CI], 1.08-1.26; T2 95% CI, 1.09-1.27; P = 0.001). In contrast, the overall OHRQOL scores at T3 are expected to be 0.28 times the baseline scores (ie, ∼72% reduction; T3 95% CI, 0.26-0.31; P = 0.001). All individual domains of the OHRQOL evidenced a positive impact of treatment at T3 (P = 0.001). Only the oral symptoms and social well-being domains showed a significantly negative impact of the treatment at T1 and T2. CONCLUSIONS: Correction of the transverse maxillary deficiency by RPE in children aged 8-10 years improves OHRQOL. There is a temporary worsening of OHRQOL during the treatment of this condition using RPE. REGISTRATION: This trial was not registered. PROTOCOL: The protocol was not published before trial commencement. FUNDING: This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil, Financing Code 001.

Perception Regarding Pediatric Dentist's Appearance and Factors Influencing the Child's Responses.

OBJECTIVE: To develop, validate, and apply an instrument for assessing the children's perception regarding pediatric dentist's appearance, based upon the influence of age, gender, previous dental experience, and anxiety. STUDY DESIGN: Images and a nine-item questionnaire were developed. The acceptability, convergent-construct validity, and reliability based on reproducibility and internal consistency were evaluated. The validated instrument was applied in a cross-sectional study, with children (n=120) aged 7-12 years asked to evaluate images of pediatric dentists wearing different dental attire (A:all-white (control); B:printed coat and cap, colorful face mask; C:printed coat, cap and face mask; and D:white coat and cap, printed face mask). Children's age, gender, and previous dental experiences were collected with the guardians. The Children's Fear Survey Schedule-Dental Subscale assessed children's anxiety. Descriptive and inferential statistics were carried out (p<0.05). RESULTS: The instrument showed excellent acceptability, construct validity with moderate and strong correlations (>0.40), satisfactory reproducibility (ICC >0.70), and internal consistency (Cronbach's alpha coefficient >0.70). Considering only the attire, the children's perceptions were more positive with the use of attire C and D (p<0.05). Intergroup analysis of all the variables did not identify a statistically significant difference (p>0.05). In the intragroup analysis, compared to attire A: younger children have higher perception scores to attire D; girls, children with previous experience and without anxiety favored attire C and D; and children without previous experience showed no difference in comparison to A but did between B and C (p<0.05). CONCLUSION: The C and D attires promoted a more positive perception of the appearance of a pediatric dentist when compared to A; however, age, gender, previous dental experience, and anxiety did not influence the perception scores.

Does dental trauma influence the social judgment and motivation to seek dental treatment by children and adolescents? Development, validation, and application of an instrument for the evaluation of traumatic dental injuries and their consequences.

BACKGROUND: One's smile clearly plays a significant role in the perception and judgment that others have of one's appearance and personality. AIM: We sought to develop and validate a questionnaire related to the social judgment of children and adolescents and to evaluate, through its application, the perceptions and judgment of children and adolescents regarding their view of different traumatic dental injuries and their consequences (TDIs-Cs) as well as the motivation to seek dental treatment. DESIGN: The aspects of acceptability, discriminative properties, internal consistency, test-retest reliability, and construct validity were evaluated in the developed questionnaire. A cross-sectional study was conducted involving 100 boys and girls aged 10-15 years. Images of an adolescent male and female were either manipulated or not (control) to create different types of TDI-C (eg, enamel fracture, enamel and dentin fracture, crown colour change, and tooth loss/avulsion). These images were analysed by the participants, using a previously validated questionnaire with a six-positive-point and six-negative-point scale, in relation to their social physical and psychosocial characteristics. The data were analysed with the Friedman, Wilcoxon, and Mann-Whitney tests (P < 0.05). RESULTS: The developed questionnaire presented high acceptability, strong discriminative properties, satisfactory internal consistency, and satisfactory test-retest reliability, but weak construct validity. The presence of TDI-C had a negative effect on all characteristics evaluated (P < 0.001). Tooth loss had the highest level of rejection. Additionally, the presence of TDI-C had a greater negative impact on the aspects of 'starting fights', 'being given a nickname', and 'being ashamed to smile' in males than in females (P < 0.05). Children and adolescents with TDI-C were judged as needing to seek dental treatment (P < 0.001). CONCLUSION: The questionnaire developed showed properties of validity and reliability in its administration in a child and adolescent population. TDIs-Cs have a negative influence on the social judgment of children and adolescents.

Common 3-dimensional coordinate system for assessment of directional changes.

INTRODUCTION: The aims of this study were to evaluate how head orientation interferes with the amounts of directional change in 3-dimensional (3D) space and to propose a method to obtain a common coordinate system using 3D surface models. METHODS: Three-dimensional volumetric label maps were built for pretreatment (T1) and posttreatment (T2) from cone-beam computed tomography images of 30 growing subjects. Seven landmarks were labeled in all T1 and T2 volumetric label maps. Registrations of T1 and T2 images relative to the cranial base were performed, and 3D surface models were generated. All T1 surface models were moved by orienting the Frankfort horizontal, midsagittal, and transporionic planes to match the axial, sagittal, and coronal planes, respectively, at a common coordinate system in the Slicer software (open-source, version 4.3.1; http://www.slicer.org). The matrix generated for each T1 model was applied to each corresponding registered T2 surface model, obtaining a common head orientation. The 3D differences between the T1 and registered T2 models, and the amounts of directional change in each plane of the 3D space, were quantified for before and after head orientation. Two assessments were performed: (1) at 1 time point (mandibular width and length), and (2) for longitudinal changes (maxillary and mandibular differences). The differences between measurements before and after head orientation were quantified. Statistical analysis was performed by evaluating the means and standard deviations with paired t tests (mandibular width and length) and Wilcoxon tests (longitudinal changes). For 16 subjects, 2 observers working independently performed the head orientations twice with a 1-week interval between them. Intraclass correlation coefficients and the Bland-Altman method tested intraobserver and interobserver agreements of the x, y, and z coordinates for 7 landmarks. RESULTS: The 3D differences were not affected by the head orientation. The amounts of directional change in each plane of 3D space at 1 time point were strongly influenced by head orientation. The longitudinal changes in each plane of 3D space showed differences smaller than 0.5 mm. Excellent intraobserver and interobserver repeatability and reproducibility (>99%) were observed. CONCLUSIONS: The amount of directional change in each plane of 3D space is strongly influenced by head orientation. The proposed method of head orientation to obtain a common 3D coordinate system is reproducible.

Force decay of latex and non-latex intermaxillary elastics: a clinical study.

OBJECTIVE: To evaluate force decay between intermaxillary orthodontic elastics with and without latex in the oral medium at different time intervals. MATERIALS AND METHODS: Intermaxillary orthodontic elastics with and without latex [1/8″ (3.2mm), 1/4″ (6.35mm), and 5/16″ (7.94mm) in diameter] were evaluated 'clinically'. For this purpose, 26 patients served as hosts for the elastics during the evaluation period. Initially, 52 thermoplasticized plates 1mm thick were made according to the patients' mould. Then, the orthodontic accessories were bonded to the plates, which kept the elastics distended throughout the experimental period. The force released by the elastics at this distance was evaluated at 0, 12, and 24 hours. Statistical analyses were performed using the Friedman, Wilcoxon, and Mann-Whitney tests (significance set at 5 per cent). RESULTS: Elastics with and without latex presented with permanent deformation and increasing internal diameter throughout the entire period. Elastics with latex, 1/8″ (3.2mm) in diameter, sustained higher levels of force than those without latex. Elastics measuring 1/4″ (6.35mm) and 5/16″ (7.94mm) in diameter without latex sustained higher levels of force at 0 and 12 hours compared to those with latex. At the end of the experiment (24 hours), no significant difference was observed between the elastics (P > 0.05). LIMITATIONS: This study only evaluated three time intervals: 0, 12, and 24 hours. If the behaviour was evaluated at different time intervals, different behaviours of these materials might be revealed. CONCLUSION: Elastics with latex 1/8″ in diameter sustained a higher level of final force than the corresponding type without latex. The 1/4 and 5/16 elastics with and without latex were not different at the end of the evaluation period.

Effect of bromelain and papain gel on enamel deproteinisation before orthodontic bracket bonding.

AIM: To test the hypothesis that enamel surface deproteinisation with different concentrations of bromelain in association with 10% papain increases the shear bond strength (SBS) of brackets bonded with orthodontic composite and resin modified glass ionomer cement (RMGIC). MATERIALS AND METHODS: Orthodontic brackets were attached according to the following protocols to 195 bovine incisors, which were acquired and divided into 13 groups: 1) Transbond XT (TXT) according to the manufacturer's recommendations; 2) Deproteinisation with 3% bromelain (BD) plus 10% papain and TXT; 3) 6% BD plus 10% Papain and TXT; 4) RMGIC, without enamel deproteinisation and without acid etching; 5) RMGIC, with 3% BD plus 10% papain and without acid etching; 6) RMGIC, with 6% BD plus 10% papain and without acid etching; 7) attachment using RMGIC following etching with polyacrylic acid; 8) 3% BD plus 10% papain, attachment using RMGIC and etching with polyacrylic acid; 9) 6% BD plus 10% papain, and attachment using RMGIC following etching with polyacrylic acid; 10) etching with 37% phosphoric acid and attachment using RMGIC; 11) 3% BD plus 10% papain, etching with 37% phosphoric acid and attachment using RMGIC; 12) 6% BD plus 10% papain, etching with 37% phosphoric acid and attachment using RMGIC; 13) deproteinisation with 2.5% sodium hypochlorite (NaOCl), etching with polyacrylic acid and RMGIC. After bonding, the brackets were removed by a universal mechanical testing machine, which recorded shear bond strength at failure. The material remaining on the tooth was assessed using the adhesive remnant index (ARI). RESULTS: Deproteinisation with 3% and 6% bromelain gel plus papain significantly increased the shear bond strength (p < 0.05), when acid etching was performed with phosphoric acid, followed by primer application and attachment using Transbond XT (Group 3) and when attached with RMGIC without etching. Deproteinisation with 6% bromelain gel plus papain significantly increased (p < 0.05) the ARI score only when attachment was performed using RMGIC, without etching (Group 6). CONCLUSIONS: Deproteinisation with bromelain associated with papain in a gel increased the shear bond strength and is recommended before orthodontic bracket attachment.

Do dental esthetics have any influence on finding a job?

INTRODUCTION: Our objective was to determine whether dental esthetics have any influence on finding a new job. METHODS: Ten patients with orthodontic treatment needs for various types of malocclusions were selected. Smiling facial photographs of all patients were obtained and digitally altered (orthodontic correction of teeth). After the images were obtained, 2 different questionnaires were prepared (survey groups A and B) with the photographs without alteration (showing malocclusion) and altered (with orthodontic correction). Subjects appeared in one questionnaire (survey group) with an ideal smile and also in the other (survey group) with a nonideal smile. The images were evaluated by 100 persons responsible for hiring staff for commercial companies. In each survey group, 4 questions were asked regarding the individuals' likelihood of being hired, honesty, intelligence, and efficiency at work. Analysis of variance for repeated measures was used to determine the differences in the evaluations of patients with ideal and nonideal dental esthetics for the 4 characteristics evaluated. The level of significance adopted was 5%. RESULTS: The photographs of persons with ideal dental esthetics were, on average, evaluated as superior with respect to intelligence and likelihood of being hired than were the photographs of the same subjects with nonideal dental esthetics. For the characteristics of honesty and efficiency, no significant differences were observed in the evaluations between those with ideal and nonideal smiles (P <0.05). CONCLUSIONS: Persons with ideal smiles are considered more intelligent and have a greater chance of finding a job when compared with persons with nonideal smiles.

Perception of laypersons and dental professionals and students as regards the aesthetic impact of gingival plastic surgery.

OBJECTIVE: To evaluate the degree of perception of laypersons, professionals, and dental students, regarding the aesthetic appearance of the smile in cases of gingival plastic surgery of the maxilla for correction of a gingival smile, by examining alterations in photographs. MATERIALS/METHODS: Alterations were made to an extraoral front-view-photograph of a gingival smile in normal occlusion, by gingival recontouring of the maxilla, simulating a gingival plastic surgery procedure to diminish gingival exposure. For this purpose, specific image-manipulation program (Adobe-Photoshop-Software-CS3) was used. Images were printed on photographic-paper, attached to questionnaire, distributed among laypersons, professionals, and dental students to evaluate degree of aesthetics (n = 150). To evaluate degree of aesthetics, an attractiveness scale was used, with 0 representing hardly attractive, 5 for attractive, and 10 for very attractive. Differences between examiners were examined by Mann-Whitney test. All the statistics were performed with a confidence level of 95 per cent. RESULTS: Both dental professionals and students and laypersons were capable of identifying alterations resulting from gingival plastic surgery. In all evaluated groups, they demonstrated that large gingival extension does not always affect aesthetic appearance of the smile, and maxillary incisors not being much visualized is characterized as hardly attractive, with statistically lower scores being attributed (P < 0.05). CONCLUSIONS: According to aesthetic parameters, the presence of the gingiva is important in the composition of the smile, however, only when exposed to small extent.

Esthetic perception of black spaces between maxillary central incisors by different age groups.

INTRODUCTION: The aim of this research was to evaluate esthetic perceptions of the smile, especially regarding black spaces between the maxillary central incisors, by laypersons in 3 age groups. METHODS: Photographs were digitally manipulated to simulate black spaces in the region of the maxillary central incisor crenations. The images were printed on photographic paper and attached to a questionnaire that was given to 150 laypersons in 3 age groups: 15 to 19, 35 to 44, and 65 to74 years. They were asked to use a visual analog scale method to rate the smiles from a score of 0, corresponding to "not very attractive," to 10, "very attractive." Differences between the examiners were verified by the Mann-Whitney test. All statistics were performed with a degree of confidence of 95%. RESULTS: The results showed that older persons had more difficulty perceiving black spaces. In the younger groups, the subjects were better able to perceive the black spaces, and the larger the black space, the less attractive they rated the photograph (P < 0.01). CONCLUSIONS: Younger people are more likely than older people to perceive black spaces in maxillary incisor crenations. The larger the black spaces, the less attractive they rate the smile.

The effect of socioeconomic aspects and dental history on pediatric patients' dental anxiety.

This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A cross-sectional study design with a sample of 120 children aged 7-12 years old was used. Data relating to anxiety levels prior to dental care, socioeconomic aspects (family income, education level, child's school type), and child's dental history (previous dental appointments, previous treatment, caries experience) were collected. Additionally, participants completed the Brazilian version of the Children's Fear Survey Schedule- Dental Subscale (B-CFSS-DS) to assess dental anxiety. Descriptive analyses, chi-squared (X 2 ) tests, and Mann-Whitney U tests were performed, with a significance level of 5%. A total of 51 boys (42.5%) and 69 girls (57.5%) were included. There was no significant difference in dental anxiety between them. However, younger children had higher mean B-CFSS-DS scores (p = 0.036, Mann-Whitney). A higher prevalence of dental anxiety was found in participants from low-income families (p = 0.012, X 2 ) and in patients who did not receive endodontic treatment (p=0.034, X 2 ). Higher mean B-CFSS-DS scores were also observed in participants who did not receive endodontic treatment (p=0.001, Mann-Whitney) compared with those that did receive endodontic treatment. No relationship was found between education level, patient school type, first dental appointment, caries experience, and dental anxiety data. Younger children presented a profile of greater dental anxiety. Socioeconomic factors and dental data exerted some effect on dental anxiety, where children from low-income families and those not subjected to endodontic treatment displayed higher rates of dental anxiety.

Development, validation and application of a Brazilian knowledge scale about sports doping in dentistry.

To evaluate the knowledge of Brazilian dentists of sports doping through the development, validation and application of the Brazilian Knowledge Scale about Sports Doping in Dentistry (B-KSSDD). A scale with 12 items was developed to assess a dentist's ability to determine whether the use of a medication characterised sports doping according to the World Anti-Doping Agency. A preliminary study to validate the B-KSSDD was carried out with 135 dentists, allowing the evaluation of ceiling and floor effects, convergent and discriminant validity, test-retest reliability and internal consistency of the instrument. A sample size calculation using the results of the preliminary study and the B-KSSDD was completed online using SurveyMonkey® by 270 participants from all regions of the country. The B-KSSDD showed evidence of convergent and discriminant validity, good temporal stability (ICC = 0.75) and internal consistency (alpha = 0.89). In the main study, the participants obtained an average score of 4.19/12 points on the B-KSSDD, suggesting that these professionals have insufficient knowledge about sports doping. The age of participants showed a negative association with knowledge about doping, while frequency of treating athletes and frequency of performing surgeries showed positive associations with knowledge about doping. The dentists had insufficient knowledge of the subject. Age of participants and frequency with which they attend to athletes are associated with knowledge about sports doping. Professional updating and education policies on doping are necessary for dentists, as athlete patients are at risk for severe sporting and financial penalties.

Factors associated with depression, anxiety and stress among dentists during the COVID-19 pandemic.

The objective of this work was to evaluate the relationship between factors associated with the COVID-19 pandemic and depression, anxiety, and stress (DAS) in dentists. Factors associated with the COVID-19 pandemic were evaluated using a questionnaire and scores of the Depression, Anxiety, and Stress Scales-21 were measured. The differences between the DAS scores based on the factors associated with the COVID-19 pandemic were tested through the successive application of multivariate analysis of variance (MANOVA, α = 0.05). After a sample size calculation, 998 participants with a mean age of 39.39 (± 11.69) years were included. The effect size indicated that changes in sleep quality (η2 = 0.161), eating habits (η2 = 0.057), and physical health (η2 = 0.051) were the ones that most negatively affected DAS scores. The highest DAS scores were observed in professionals who lived with someone at high-risk for COVID-19 (p < 0.001) and in those who did not engage in leisure activities during the pandemic (p < 0.001). Dentists who worked on the frontline against COVID-19 had higher scores of anxiety and stress (p = 0.029). The highest scores for anxiety, depression, and/or stress were seen in dentists living with someone at high-risk for COVID-19, who acts on the frontline, who does not practice in leisure activities during the pandemic, who completely changed eating habits, quality of sleep and physical health during the pandemic. In general, DAS levels of dentists were associated with factors related to the COVID-19 pandemic.

Does dental trauma and its consequences influence the professional hiring process? Development, validation and application of an assessment tool.

OBJECTIVES: To develop and validate a questionnaire concerning the aspects evaluated during the hiring process by human resources professionals (HRPs); to apply the validated questionnaire; and to evaluate the perceptions and judgment of HRPs regarding different traumatic dental injuries (TDIs) and their consequences (TDI-Cs). MATERIALS AND METHODS: The acceptability, discriminative properties, internal consistency and test-retest reliability of the developed questionnaire were evaluated, using the same methodology as the main study and adopting a pilot sample. For both the validation process and the application phase, images of one male and one female were manipulated, or not (control), to create different types of TDI (enamel fracture, enamel and dentin fracture, avulsion) and TDI-Cs (crown discoloration, tooth loss due to avulsion). In the application phase, the images were analyzed by 100 HRPs using the validated questionnaire, and the results were analyzed using the Friedman, Wilcoxon and Mann-Whitney tests (P < 0.05). RESULTS: The developed questionnaire produced excellent acceptability, strong discriminative properties, satisfactory internal consistency and excellent to good test-retest reliability. The presence of TDIs and TDI-Cs had a negative effect on the evaluated aspects used during the hiring process (P < 0.001). Tooth loss provoked the worse level of judgment in all evaluated characteristics and in professional hiring. CONCLUSIONS: The developed questionnaire produced valid and reliable responses concerning the aspects evaluated during the hiring process by Brazilian HRPs. TDIs and TDI-Cs had a negative influence on the aspects evaluated during the HRP professional hiring process. CLINICAL SIGNIFICANCE: TDIs and TDI-Cs had a negative influence on the aspects evaluated during the HRP professional hiring process.

Aesthetic perceptions and social judgments about different enamel opacities.

This study aimed to evaluate adolescents' aesthetic perceptions and their social judgments regarding different enamel opacities. Sample size was calculated and resulted in the inclusion of 100 adolescents (aged 10 to 15 years) from a public school in Jequié, Bahia, Brazil. Images of enamel opacities were manipulated to create aesthetic enamel defects, such as enamel color changes (unilateral and bilateral white opacity, unilateral and bilateral yellowish opacity, and unilateral and bilateral yellowish opacity with loss of structure). The images of the opacities were based on Fédération Dentaire Internationale's Developmental Defects of Enamel (DDE) Index. Aesthetic perception and social judgments were evaluated using a validated questionnaire with 12 questions (six positive and six negative points) on social aspects, considering the six manipulated images and the control. The photographic analyses were projected one-by-one by computer to adolescents individually in a classroom. Participants had one minute to observe each image and answer the questionnaire. The data were analyzed by descriptions, and the Friedman Wilcoxon test (p < 0.05). The results indicate that all opacities negatively impacted social judgment (p < 0.001). The enamel aesthetic defects most affecting an individual's perception were bilateral yellow opacity with or without loss of structure (p < 0.001). Regarding social judgment, all participants showed a negative perception of all the tested opacity types (p < 0.001). In conclusion, even opacities presenting only a color change caused aesthetic dissatisfaction to the individuals and changes in their social judgment toward others. Color changes in dental enamel have several aesthetic consequences.

Alterações dimensionais em marcas de mordidas humanas simuladas em alimentos: estudo in vitro / Dimensional changes in simulated human bite marks on food: in vitro study

Objetivo: avaliar alterações dimensionais em marcas de mordidas simuladas em um tipo de queijo e de goiabada com o decorrer do tempo. Materiais e Métodos: mordidas foram simuladas em 20 amostras-padrão formato retangular nas medidas 30 x 60 mm e espessura de 20 mm de queijo tipo muçarela (n=10) e goiabada (n=10) com a utilização de um manequim odontológico montado em oclusão normal e acoplado à máquina universal de ensaios mecânicos. Amostras foram mantidas em superfície de vidro em ambiente com temperatura e umidade controladas seguida da aferição das distâncias intercaninas das marcas a cada hora com auxílio de paquímetro digital, durante 120 horas de experimentação. A temperatura e umidade mantiveram-se constantes durante todo período. As medidas obtidas foram estatisticamente analisadas por meio dos testes de Friedman, de Wilcoxon, coeficiente de correlação de Spearman e a partir da análise de regressão linear simples. O nível de significância adotado foi de 5%. Resultados: os alimentos testados mantiveram o padrão das medidas lineares nas primeiras quatro horas (p>0,05). Após esse período, ocorreu uma deformação progressiva, levando ao aumento significativo das medidas (p<0,05). Conclusão: a marca de mordida em queijo tipo muçarela e goiabada apresentou-se dimensionalmente estável nas primeiras quatro horas, pós mordida. Após esse período, as marcas já não apresentaram características favoráveis para serem utilizadas como registro para fins de comparação.

Objective: to evaluate dimensional changes in simulated bite marks in a type of cheese and guava paste over time. Materials and Methods: Bites were simulated on 20 standard rectangular samples. in the measures 30 x 60 mm and thickness of 20 mm of mozzarella cheese (n=10) and guava paste (n=10) using a dental manikin mounted on normal occlusion and coupled to the universal mechanical testing machine. The samples were kept on a glass surface in an environment with controlled temperature and humidity , followed by the measurement of intercanine distances of the marks, every hour, with the aid of a caliper digital, during 120 hours of experimentation. The temperature and humidity remained constant throughout the period. The measurements obtained were statistically analyzed using the Friedman, Wilcoxon, Spearman's correlation coefficient and from the linear regression analysis simple (IBM SPSS. 21.0, 2012, Armonk, NY: IBM Corp.). The level of significance adopted was 5%. Results: the foods tested maintained the pattern of linear measurements in the first four hours (p>0.05). After this period, a progressive deformation occurred, leading to the significant increase in measurements (p<0.05). Conclusion: the bite mark in mozzarella cheese and guava paste it was dimensionally stable in the first four hours, post-bite. After this period, brands no longer have favorable characteristics to be used as a record for comparison purposes.

Perception of attractiveness of missing maxillary lateral incisors replaced by canines.

OBJECTIVE: The aim of this study was to evaluate the degree of perception of attractiveness of the smile among dentists, dental students, and lay persons in cases of agenesis of the maxillary lateral incisors replaced by canines for space closure. METHODS: A smiling front view extraoral photograph of a 20-year-old woman was digitally altered simulating agenesis and its treatment, by means of: repositioning, reshaping or bleaching the canine, and gingival contour. A questionnaire was distributed to individuals of the three groups (n= 150), with a view to evaluating their degree of esthetic perception. An attractiveness scale was also used, with '0' representing unattractive and '10', very attractive. RESULTS: In the comparative evaluation among all the photographs, the original image obtained the highest level of acceptance. Photograph 'i' (agenesis of both lateral incisors treated with reposition and reshaping of the canines) was ranked as the least attractive by the dentists, whereas the student and lay persons ranked photograph 'f' (agenesis of both lateral incisors treated with reposition of the canines, gingival contour, bleaching and reshaping) as the worst. CONCLUSION: The methods of treatment most accepted among the dentists and students were those that involved changes in the gingival contour, whereas among lay persons, they were those that involved only reshaping.

YouTube™ como uma fonte de informações sobre odontologia do sono / YouTube™ as a source of information about dental sleep medicine

Objetivo: Avaliar a qualidade e a confiabilidade do conteúdo de vídeos sobre Odontologia do Sono no YouTube™. Métodos: Foi realizada uma busca no YouTube™, utilizando o termo "Odontologia do Sono", na qual selecionou-se os 100 primeiros vídeos para análise realizada por dois pesquisadores. Foram incluídos vídeos sobre o tema, na língua portuguesa brasileira, com no máximo 24 minutos. Foram extraídos: título, data, duração, visualização, curtida, fonte, público-alvo, objetivo e assunto. A qualidade foi avaliada através da Escala de Qualidade Global (EQG), e a confiabilidade, através da adaptação de um índice previamente publicado, ambos pontuando até 5 pontos, onde mais pontos significavam maior qualidade e confiabilidade. Foram realizados os testes de Mann-Whitney U, Kruskal-Wallis e a correlação de Spearman (p < 0,05). Resultados: 58 vídeos foram incluídos, cuja mediana da duração foi 2,4 ± 7,6 minutos. A maioria dos vídeos era produzida por cirurgiões-dentistas (CD) (75,9%; n = 44), sobre apneia (96,6%; n = 56), com o objetivo educacional/informativo (65,5%; n = 38) e direcionado para leigos (58,6%; n = 34). A maioria apresentou mediana baixa de 2,0 ± 1,0 na EQG (41,4%; n = 24), e na escala de confiabilidade, a mediana de 3,0 ± 1,0 (60,3%; n = 35). Houve correlação moderada da EQG (p = 0,62; p < 0,01) e da confiabilidade (ρ = 0,41; p < 0,01) com a duração do vídeo, e também entre EQG e confiabilidade (ρ = 0,66; p < 0,01). Vídeos educacionais/informativos, produzidos por CD, e direcionados a leigos, apresentaram uma maior EQG e confiabilidade (p < 0,01). Vídeos que incluíam bruxismo tinham maior EQG (p = 0,01). Programas de televisão e vídeos que não eram comerciais apresentaram maior confiabilidade (p < 0,05). Conclusão:A maioria dos vídeos possuía qualidade baixa e confiabilidade moderada. Vídeos educacionais/informativos, feitos por CD, direcionados a leigos, que incluíam bruxismo, programas de televisão e que não eram comerciais, apresentaram maior qualidade e confiabilidade.

Aim: To assess the quality and reliability of video content on Dental Sleep Medicine on YouTube™. Methods: A search was performed on YouTube™ using the term "Dental Sleep Medicine". The first 100 videos were selected for analysis by two researchers. Videos on the subject were included, in Brazilian Portuguese with a maximum of 24 minutes. The following data were extracted: title, date, duration, views, likes, source, target audience, objective and subject. Quality was assessed using the Global Quality Scale (GQS), and reliability using a previously published index adapted, both ranging from 1 to 5 points, where more points meant greater quality and reliability. Spearman correlation, Mann-Whitney U, and Kruskal-Wallis test (p < 0.05) were performed. Results: 58 videos were included, with a median duration of 2.4 ± 7.6 minutes. Most of the videos were produced by dentists (75.9%; n = 44), about apnea (96.6%; n = 56), with an educational/informational objective (65.5%; n =38), and aimed at laypeople (58.6%; n = 34). Most had a low median of 2.0 ± 1.0 on the GQS (41.4%; n = 24), and on the reliability scale, the median was 3.0 ± 1.0 (60.3%; n = 35). There was a moderate correlation between both GQS (ρ = 0.62; p < 0.01) and reliability (ρ = 0.41; p < 0.01) with video duration, and also between GQS and reliability (ρ = 0 .66; p < 0.01). Educational/informational videos, produced by dentists, and aimed at laypeople showed higher GQS and reliability (p < 0.01). Videos that included bruxism had higher GQS (p = 0.01). Television programs and non-commercial videos were more reliable (p < 0.05). Conclusion: Most videos had low quality and moderate reliability. Educational/informational videos, made by dentists, aimed at laypeople, that included bruxism, television programs, and that were not commercials, presented higher quality and reliability.

The effect of socioeconomic aspects and dental history on pediatric patients' dental anxiety

Abstract This study aimed to characterize the profile of dental anxiety in pediatric patients, identifying the effect exerted by socioeconomic factors using dental data. A cross-sectional study design with a sample of 120 children aged 7-12 years old was used. Data relating to anxiety levels prior to dental care, socioeconomic aspects (family income, education level, child's school type), and child's dental history (previous dental appointments, previous treatment, caries experience) were collected. Additionally, participants completed the Brazilian version of the Children's Fear Survey Schedule- Dental Subscale (B-CFSS-DS) to assess dental anxiety. Descriptive analyses, chi-squared (X 2 ) tests, and Mann-Whitney U tests were performed, with a significance level of 5%. A total of 51 boys (42.5%) and 69 girls (57.5%) were included. There was no significant difference in dental anxiety between them. However, younger children had higher mean B-CFSS-DS scores (p = 0.036, Mann-Whitney). A higher prevalence of dental anxiety was found in participants from low-income families (p = 0.012, X 2 ) and in patients who did not receive endodontic treatment (p=0.034, X 2 ). Higher mean B-CFSS-DS scores were also observed in participants who did not receive endodontic treatment (p=0.001, Mann-Whitney) compared with those that did receive endodontic treatment. No relationship was found between education level, patient school type, first dental appointment, caries experience, and dental anxiety data. Younger children presented a profile of greater dental anxiety. Socioeconomic factors and dental data exerted some effect on dental anxiety, where children from low-income families and those not subjected to endodontic treatment displayed higher rates of dental anxiety.