RESUMO
OBJECTIVE: Latin American and Carribean (LAC) are currently experiencing a rapid aging of their population, coupled with a significant burden of oral diseases. Despites this, there is a scarcity of evidence regarding the manner in wich geriatric dentistry is being taught in dental schools across LAC. So, the objective of this study is to investigate the current status of geriatric dentistry education at undergraduate and postgraduate levels in selected LAC dental schools. METHODS: An electronic questionnaire was developed and emailed to all 539 dental schools in 19 LAC countries. The questionnaire recorded activity levels, contents and methodology of geriatric dentistry education as part of dental degree programmes. Reminders by email and telephone calls were used to encourage non-responders to complete the questionnaire. RESULTS: In total, 317 schools from 17 countries responded to the questionnaire (response rate: 58.8%). Geriatric dentistry was taught in 54.6% of the schools at the undergraduate level and in 6.9% at the postgraduate level. Thirty two percent of the schools had a programme director trained in geriatric dentistry. Geriatric dentistry was taught as an independent course in 14.5% of the schools. Dry mouth, periodontal disease, denture-related conditions and prosthodontic management, oral mucosal disease and age-related changes of the orofacial complex were the most frequently covered topics. Clinical teaching of geriatric dentistry was reported by 26.5% of the schools, with 38.0% providing clinical training in outreach facilities. CONCLUSIONS: Geriatric dentistry education remains incipient in LAC, with only one in every four dental school offering it as a standalone course. There is an urgent need to further develop geriatric dentistry education in the continent, including further research to develop a minimum geriatric dentistry curriculum.
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The aim of the SmoCar (Smoking in the Caribbean) study was to estimate the prevalence of smoking and the disparities in the smoking practices of three regions in the Caribbean: Jamaica, Dominican Republic, and Puerto Rico. The secondary objective was to assess the prevalence and severity of gingivitis in relation to the smoking practices. The study population comprised 1,847 (weighted N = 1,830) individuals (18 years and older) who were volunteer participants from the capitals of Jamaica, Dominican Republic, and Puerto Rico. A structured interview was used to assess the participants' smoking behaviors. The gingival index was used to determine the extent of gingival inflammation. Polytomous regression was used to estimate the adjusted odds ratios (aORs) for smoking status (current, past, or never), according to risk factors (sex, age-group, education, marital status, tooth-brushing frequency, and city of residence). Logistic regression models were used to assess the associations between different smoking status variables and mild to moderate/severe gingivitis. The majority of the participants were never-smokers, with current smokers being found most commonly in Kingston (33.22%), followed by San Juan (12.76%) and Santo Domingo (8.8%). Both current (aOR = 2.22, 95% confidence interval [1.45, 3.40]) and past (aOR = 1.87, 95% confidence interval [1.19, 2.93]) smoking (vs. never smoking) was strongly associated with severe gingivitis. Smoking was the most prevalent in Jamaicans and the least prevalent in Dominicans. The study population of current smokers was found to have a fourfold increased risk of severe gingivitis and a twofold increased risk of moderate gingivitis.
Assuntos
Gengivite/epidemiologia , Fumar/epidemiologia , Adulto , Fatores Etários , Região do Caribe/epidemiologia , Estudos Transversais , Placa Dentária/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Índice Periodontal , Prevalência , Características de Residência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Escovação Dentária , Adulto JovemRESUMO
OBJECTIVE: To estimate the prevalence, severity, and associated risk factors of gingival inflammation in a group of adults from Kingston, Jamaica; Santo Domingo, Dominican Republic; and San Juan, Puerto Rico. METHODS: In this representative cross-sectional study, participants completed medical and oral health questionnaires and received an oral clinical examination by trained and calibrated examiners. Clinical assessments included: gingival health (modified Löe-Silness index), visible plaque and presence of calculus. Findings were summarized as mean overall and interproximal gingival indices (GI; IGI), gingival bleeding index (GBI), gingival inflammation prevalence (GI>=0.5) and severity (mild, moderate, severe), mean and interproximal visible plaque indices (VPI; IVPI), and calculus index. Multivariate logistic regression was used to evaluate the associations between risk factors and gingival bleeding on probing (BOP) at >= 40% sites;. odds ratios were estimated. RESULTS: All 1,847 participants presented gingival inflammation; most (81.9%) had moderate inflammation. Mean GI, VPI, IVPI, and calculus indices were 1.49, 0.94, 0.96, and 0.66, respectively; most participants presented a VPI >= 30%. BOP >= 40% of sites was significantly associated with education (ORmiddle/technical vs. university education=1.61; p =0.001 and ORnone/basic vs. university= 2.86; p<0.001), calculus index (OR: 10.35), VPI >= 30% (OR: 7.85; p<0.001 for both), and being a resident of Kingston or Santo Domingo (vs. San Juan, OR: 4. 74 and OR: 7.09, respectively), after adjusting for age, gender, smoking, dental visit frequency, diabetes, and hypertension. CONCLUSION: Gingival inflammation was highly prevalent. Most participants presented moderate gingival inflammation. Educational attainment, dental calculus, and VPI >= 30% were strongly associated with gingival inflammation.
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Cálculos Dentários/epidemiologia , Placa Dentária/epidemiologia , Gengivite/epidemiologia , Saúde Bucal , Adolescente , Adulto , Estudos Transversais , Índice de Placa Dentária , República Dominicana/epidemiologia , Escolaridade , Feminino , Gengivite/patologia , Humanos , Jamaica/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Índice Periodontal , Prevalência , Porto Rico/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND: Gingivitis is a common oral health problem. Untreated gingivitis may progress to periodontitis, a common cause of tooth loss. The prevalence of gingivitis and calculus among Puerto Rican children is unknown. Understanding this prevalence can support early public health preventative strategies. This study aims to estimate the prevalence of gingivitis and calculus among 12-year-old Puerto Ricans by health region and to explore differences in distribution by school type (proxy for socio-economic status) and gender. METHODS: A probability-based sample of 113 schools was selected proportional to enrollment size and stratified by health region, school type, and gender. Two trained examiners evaluated the presence of gingivitis and both supragingival and subgingival dental calculus. Gingivitis was defined as the presence of gingival bleeding upon gentle probing (BOP) in at least one site, and the extent of the problem was classified according to the percentage of teeth whose gingiva presented BOP (limited: 25-49% of the teeth tested; extensive: >50% of teeth tested). Logistic and linear regression models, adjusted for health regions, were used to compare gingivitis and calculus prevalence and extent between genders and school types. RESULTS: Gingivitis was found in 80.41% of the 1586 children evaluated. Urban-public schoolchildren had a slightly higher prevalence (83.24%) compared to private (79.15%, p = 0.16); those in rural-public (77.59%) and private schools had similar prevalence (p = 0.15). Extensive gingivitis was present in 60.81% of all children. The mean percentage of sites presenting BOP (BOP%) was 17.79%. Rural and urban public schoolchildren presented significantly higher BOP% compared to children from private schools (p = 0.0005, p = 0.002, respectively). Dental calculus was detected in 61.59% of the sample, boys presenting significantly higher (p = 0.005) total and supragingival calculus. Rural-public schoolchildren had a significantly higher prevalence of subgingival calculus compared to private schoolchildren (p = 0.02). CONCLUSIONS: Gingivitis prevalence is higher among 12-year-old Puerto Ricans compared to data reported for U.S. adolescents. Public schoolchildren presented significantly higher BOP% sites compared to private schoolchildren. Boys presented a significantly higher total and supragingival calculus prevalence than girls. Oral health disparities related to gender and school type were identified by this study. Studies exploring the reasons for these disparities are recommended.
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Cálculos Dentários/epidemiologia , Gengivite/epidemiologia , Criança , Estudos Transversais , Humanos , Índice Periodontal , Prevalência , Porto Rico/epidemiologia , População Rural/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Fatores Sexuais , População Urbana/estatística & dados numéricosRESUMO
OBJECTIVE: Gingivitis, an inflammation of the gingival tissues, typically progresses to periodontitis. The objective of this study is to estimate the prevalence of gingivitis in 35- to 70-year-olds residing in San Juan, Puerto Rico, and assess the differences in gingivitis distribution between age and gender groups. METHODS: A cross-sectional epidemiological study was conducted with a sample of patients from a private practice and patients/employees of the Puerto Rico Medical Center. Participants completed a medical history questionnaire and received soft/hard tissue and gingival assessments based on a modified Löe-Silness index. Descriptive statistics were employed to estimate the overall gingivitis prevalence, severity (mild, moderate, severe), and mean gingival index (GI). Bleeding on probing (BOP) prevalence and the mean percentage of BOP sites were calculated by gender and age. Multinomial logistic regression was used to evaluate the associations between age, gender, and severity in 3 categories; multivariate logistic regression was used for having >=40% sites with BOP (vs. having <40% sites with BOP as reference). Odds ratios were also estimated. RESULTS: All 300 participants (52% women; 48% men) had gingivitis. The mean GI was 1.38. Moderate gingivitis was detected in 83% of the participants, mild in 7.3%, and severe in 9.3%. BOP was observed in 99% of the subjects (mean % BOP sites = 34%). After adjusting for age, men had significantly higher odds of moderate (OR = 4.66) and severe gingivitis (OR =10.06), compared to women, as well as 1.76 times higher odds of having 40% or more sites with BOP. CONCLUSION: Gingivitis was observed in all participants. Men had significantly higher GI, compared to women. The prevalence of gingivitis was higher in Puerto Rico than in the US.
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Gengivite/epidemiologia , Índice Periodontal , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Gengivite/patologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Projetos Piloto , Prevalência , Porto Rico/epidemiologia , Índice de Gravidade de Doença , Fatores SexuaisRESUMO
This study aimed to evaluate the scientific evidence regarding the effectiveness of silver diamine fluoride (SDF) in preventing and arresting caries in the primary dentition and permanent first molars. A systematic review (SR) was performed by 2 independent reviewers using 3 electronic databases (PubMed, ScienceDirect, and Scopus). The database search employed the following key words: "topical fluorides" AND "children" AND "clinical trials"; "topical fluorides" OR "silver diamine fluoride" AND "randomized controlled trial"; "silver diamine fluoride" AND "children" OR "primary dentition" AND "tooth decay"; "silver diamine fluoride" OR "sodium fluoride varnish" AND "early childhood caries"; and "silver diamine fluoride" AND "children". Inclusion criteria were articles published in English, from 2005 to January 2016, on clinical studies using SDF as a treatment intervention to evaluate caries arrest in children with primary dentition and/or permanent first molars. Database searches provided 821 eligible publications, of which 33 met the inclusion criteria. After the abstracts were prescreened, 25 articles were dismissed based on exclusion criteria. The remaining 8 full-text articles were assessed for eligibility. Of these, 7 publications were included in the SR. These included 1 study assessing the effectiveness of SDF at different concentrations; 3 studies comparing SDF with other interventions; 2 investigations comparing SDF at different application frequencies and with other interventions; and 1 study comparing semiannual SDF applications versus a control group. The literature indicates that SDF is a preventive treatment for dental caries in community settings. At concentrations of 30% and 38%, SDF shows potential as an alternative treatment for caries arrest in the primary dentition and permanent first molars. To establish guidelines, more studies are needed to fully assess the effectiveness of SDF and to determine the appropriate application frequency.
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Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Compostos de Amônio Quaternário/uso terapêutico , Criança , Fluoretos Tópicos , Humanos , Dente Molar , Compostos de Prata , Dente DecíduoRESUMO
OBJECTIVE: To identify the types, food sources, and pattern of carbohydrates that significantly contribute to dental caries in Puerto Rican children. METHODS: As part of an island-wide cross-sectional oral health study in 1,587 twelve-year-olds, diet intake was assessed in a representative subset (n = 801) with a 24-hour dietary recall. Carbohydrate intake was quantified using a computer-based diet analysis program. Caries was assessed using the National Institute of Dental and Craniofacial Research diagnostic criteria. Odds ratios were used to associate carbohydrate intake quartiles with caries, after controlling for important confounders. RESULTS: A total of 723 subjects had complete data. Most were females (54%) and attended public schools (77%). The caries prevalence was 33%. The highest quartile intake for the following sugars significantly increased the odds of caries compared to the lowest quartile: total carbohydrates (OR = 1.93, 95% CI = 1.08-3.46), total sugars (OR = 1.88, 95% CI = 1.01-351), sucrose (OR = 2.05, 95% CI = 1.13-3.70), fructose (OR = 1.95, 95% CI = 1.05-3.62), and inositol (OR = 2.52, 95% CI = 1.38-4.63). The main food sources of these sugars were juices, including natural juices with no added sugars, and sweetened beverages. The odds of caries also increased significantly in children whose 10% of total energy intake was from total sugars (OR = 3.76, 95% CI = 1.03-13.7). CONCLUSION: After adjusting for important caries risk factors, total carbohydrates, total sugars, ≥10% kilocaloric energy from total sugars, and sucrose, fructose, and inositol intake significantly increased caries risk. Our findings can help raise awareness about the potential caries risk from the main sources of these sugars, natural fruit juices and sweetened beverages, which are consumed in great quantities in many societies.
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Cariogênicos/efeitos adversos , Cárie Dentária/epidemiologia , Dieta Cariogênica/efeitos adversos , Bebidas/efeitos adversos , Criança , Estudos Transversais , Cárie Dentária/etiologia , Esmalte Dentário/patologia , Sacarose Alimentar/efeitos adversos , Ingestão de Energia , Feminino , Frutose/efeitos adversos , Humanos , Inositol/efeitos adversos , Masculino , Razão de Chances , Saúde Bucal/estatística & dados numéricos , Prevalência , Porto Rico/epidemiologia , Fatores de Risco , Edulcorantes/efeitos adversosRESUMO
BACKGROUND: Dental caries is the most prevalent chronic illness worldwide. In the US dental caries has been described as a "silent epidemic", affecting 58.2 % of 12-15 year-olds, particularly in minority and immigrant groups. Caries is associated with complex yet preventable biological and behavioral factors such as dental plaque and diet, as well as social determinants of health. In developed nations, a higher risk caries has been associated with populations of low socio-economic status (SES), especially in areas with greater income disparity. An island-wide study conducted in Puerto Rico in 1997 revealed a high prevalence of dental caries in 12-year-olds and a significant health disparity between children attending private and public schools. The purpose of the present study was twofold: 1) to estimate caries levels of 12-year-old school Puerto Ricans in 2011; and 2) compare results to data obtained in 1997 to explore any possible change in caries outcomes after a government health insurance (GHI) reform was implemented. METHODS: In this cross-sectional study, a probability sample of 133 out of 1,843 schools was selected proportional to enrollment size, and stratified by 1997 GHI regions, school type, and gender. Calibrated examiners conducted oral soft tissue and caries examinations. Dental caries prevalence was estimated. Mean Decayed Missing Filled Tooth/Surface (DMFT/S) indices and mean Significant Caries Index (SiC) were calculated and compared retrospectively to data obtained in 1997. RESULTS: The final sample included 1,587 school-enrolled children. About 53 % of participants were female and 77 % attended public schools. Between 1997 and 2011, reductions were observed in caries prevalence (81 to 69 %), mean DMFT scores (3.8 to 2.5), mean DMFS scores (6.5 to 3.9), and mean SiC index (7.3 to 5.6) in both private and public schools, with a more prominent decrease in private schools. Between 1997 and 2011, overall the filled component increased (50 to 67 %), while decayed and missing component decreased (42 to 30 %) and (8 to 3 %), respectively. CONCLUSIONS: Among 12-year-old schoolchildren in Puerto Rico between 1997 and 2011, caries prevalence, extent, and severity decreased as well as the DMFT missing component, while the filled component increased. Dental caries prevalence was high and the health disparity persists between children enrolled in public and private schools after more than a decade of the GHI implementation. The relationship between GHI implementation and other potentially relevant co-factors for caries warrants further research, as does the seemingly entrenched disparity across groups.
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Cárie Dentária/epidemiologia , Hispânico ou Latino , Saúde Bucal , Criança , Estudos Transversais , Índice CPO , Feminino , Humanos , Masculino , Prevalência , Porto Rico/epidemiologiaRESUMO
BACKGROUND: Periodontitis and vitamin D deficiency are both highly prevalent in Puerto Rico. The aim of this pilot study was to evaluate the association between vitamin D levels and periodontal disease in Puerto Rican adults. METHODS: A sex-, age-, and BMI-matched case-control, cross-sectional study was conducted on 24 cases of moderate/severe periodontitis and 24 periodontally healthy controls aged 35 to 64 years. Each participant completed a socio-demographic questionnaire, underwent a full-mouth periodontal examination and provided blood sample to measure serum 25-hydroxyvitamin D (25 (OH) D) levels to assess vitamin D status. RESULTS: A total of 19 matched case-control pairs (28 females, 10 males) completed the study. Mean serum 25 (OH) D levels were significantly lower in cases (18.5 ± 4.6 ng/ml) than in controls (24.2 ± 7.1 ng/ml; p = 0.006). Lower odds of periodontal disease were observed per unit of 25 (OH) D level (OR 0.885; 95 % CI 0.785, 0.997; p < 0.05). CONCLUSIONS: Lower serum vitamin D levels are significantly associated with periodontitis in Puerto Rican adults.
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Periodontite/complicações , Deficiência de Vitamina D/complicações , Adulto , Estudos Transversais , Feminino , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Porto Rico/epidemiologia , Vitamina DRESUMO
PURPOSE: To evaluate the clinical efficacy of two commercially available, fluoride-free, alcohol-free mouthwashes containing either 0.075% or 0.07% cetylpyridinium chloride (CPC) in controlling established dental plaque and gingivitis compared to a non-antibacterial control mouthwash. METHODS: A 6-week double-blind, randomized clinical trial was conducted in Trujillo Alto, Puerto Rico. Recruited subjects were randomly assigned to one of three treatment groups: (1) a fluoride-free, alcohol-free mouthwash containing 0.075% CPC (TG); (2) a fluoride-free, alcohol-free mouthwash containing 0.07% CPC (PC); and (3) a fluoride-free, alcohol-free mouthwash without antibacterial agent (NC). Subjects were instructed to rinse with the assigned mouthwash, after tooth brushing, twice daily (morning and evening). After 4 and 6 weeks of product use, subjects were examined for gingivitis (Whole Mouth Gingival, Gingival Interproximal, Gingival Severity Indexes) and plaque (Whole Mouth Plaque, Plaque Interproximal, and Plaque Severity Indexes) parameters. ANCOVA and post hoc Tukey's pair-wise comparisons (α = 0.05) were performed for treatment group comparisons. RESULTS: A total of 132 subjects were screened; 120 were enrolled; and 116 completed the study. After 6 weeks of product use, participants who rinsed with the CPC-containing mouthwashes exhibited statistically significant (P < 0.05) reductions in all the gingivitis and plaque parameters evaluated, whereas in those using the non-antibacterial mouthwash, significant reductions were only observed in whole mouth and interproximal plaque scores. No statistically significant (P > 0.05) differences were observed, with respect to the gingival and plaque parameters, between the two CPC-containing mouthwashes.
Assuntos
Cetilpiridínio/uso terapêutico , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Antissépticos Bucais , Adulto , Álcoois/análise , Método Duplo-Cego , Feminino , Fluoretos/análise , Humanos , Masculino , Porto RicoRESUMO
PURPOSE: To evaluate the clinical efficacy of a mouthwash containing 0.075% cetylpyridinium chloride (CPC) in a fluoride-free, alcohol-free base and a mouthwash containing essential oils in a fluoride-free, 21.6% alcohol base as compared to a fluoride-free, alcohol-free non-antibacterial mouthwash in controlling established dental plaque and gingivitis after 6 weeks of twice daily use. METHODS: A 6-week, parallel-group, randomized double blind clinical trial was conducted in Santo Domingo, Dominican Republic. Recruited subjects were randomly assigned to one of three treatment groups: (1) a mouthwash containing 0.075% CPC in a fluoride-free, alcohol-free base (CPC); (2) a commercially-available mouthwash containing essential oils in a fluoride-free, 21.6% alcohol base (EO); or (3) a fluoride-free, alcohol-free non-antibacterial mouthwash (NC). Subjects were instructed to rinse with the assigned mouthwash, after tooth brushing, twice daily (morning and evening). After 4 and 6 weeks of product use, subjects were examined for gingivitis (Whole Mouth Gingival, Gingival Interproximal, Gingival Severity Indexes) and plaque (Whole Mouth Plaque, Plaque Interproximal, and Plaque Severity Indexes) parameters. For treatment group comparisons, ANCOVA and post hoc Tukey's pair-wise comparisons (α = 0.05) were performed. RESULTS: 132 subjects were screened; 120 were enrolled; and 116 completed the study. After 6 weeks of product use, subjects using the CPC and EO mouthwashes exhibited statistically significant (P < 0.001) reductions of all gingival and plaque measurements compared to subjects using the NC mouthwash. Subjects using the CPC mouthwash did not exhibit a statistically significant (P > 0.05) reduction with respect to gingival severity and all plaque measures (Whole, Interproximal, and Severity) when compared to EO mouthwash. Subjects using the CPC mouthwash exhibited statistically significant (P < 0.05) reductions in Gingival Index scores of 5.1% (P = 0.005), and Gingival Interproximal Index scores of 5.5% (P = 0.016) relative to subjects using the EO mouthwash. These reductions were not considered clinically significant.
Assuntos
Cetilpiridínio/uso terapêutico , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Antissépticos Bucais , Óleos Voláteis/uso terapêutico , Método Duplo-Cego , HumanosRESUMO
OBJECTIVE: To estimate the prevalence of hypodontia in a group of 10- to 14-year-olds from a group of orthodontic clinics in Puerto Rico. METHODS: A cross-sectional study was conducted to estimate the prevalence of hypodontia in 10- to 14-year-olds from orthodontic clinics located in each of 9 regions (as determined by the government-run health insurance program, Reforma) in Puerto Rico. A total of 1,911 patients, ranging in age from 10 to 14 years, were evaluated using patient charts covering from May 2004 through June of that same year. A logistic regression model was done to evaluate the relation between the prevalence of hypodontia in the study group and clinic location, gender, and age; a 5% significance level was used. RESULTS: The overall weighted prevalence of hypodontia was 6.02%. Females showed a higher weighted prevalence of hypodontia than did males (7.02% vs. 4.72%, respectively: p = 0.06). The prevalence also varied by geographic region, ranging from 3.21% at the San Juan clinic to 10.68% at the Aibonito clinic (p = 0.01). The most prevalent missing teeth were the maxillary lateral incisors, followed by the lower second premolars (1.9%). CONCLUSION: The prevalence of hypodontia in Puerto Rico was 6.02%. Females presented a higher prevalence of hypodontia than did males. Each of the clinics in Fajardo, Bayamón, San Juan, and Guayama had a lower prevalence of hypodontia than the Aibonito clinic did. The tooth most frequently missing in the study group was the maxillary right lateral incisor.
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Anodontia/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Hospitais Especializados , Humanos , Masculino , Ortodontia , Prevalência , Porto Rico/epidemiologiaRESUMO
OBJECTIVE: To explore the association between hygiene knowledge and habits and gingivitis in Puerto Rican school children. METHODS: Questionnaires on oral health knowledge and hygiene habits were provided to almost half of the 12-year-olds who participated in an island-wide cross-sectional oral health study. The evaluations included gingival examinations in 2 quadrants. Odds ratios (ORs) (with 95% CIs) were computed using logistic regression models and oral health-related knowledge and hygiene habits to gingivitis. RESULTS: Of the 823 participants who completed the questionnaire 53.43% were female, and 81% had gingivitis. Most reported having received instructions on brushing (98%), flossing (89.5%), and using mouthwash (90%). The majority (75%) rated their gums as healthy, and 44.68% agreed that oral health affects general health. Nearly half (44%) reported brushing their teeth at least 2 times a day, and 80.25%, flossing daily. In multivariate analysis, not having been instructed on how to brush was related to greater odds of having gingivitis (OR: 7.32; 95% CI: 1.5-35.67). Flossing more than once a day was associated with half the odds of gingivitis (OR: 0.50; 95% CI: 0.29-0.88). CONCLUSION: The children had knowledge of oral hygiene methods but were mostly unaware that gingival health could affect systemic health. Fewer than half reported brushing 2 or more times a day. Not having been instructed on how to brush was associated with higher odds of gingivitis.
Assuntos
Gengivite , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Saúde Bucal , Higiene Bucal , Humanos , Estudos Transversais , Feminino , Criança , Masculino , Higiene Bucal/estatística & dados numéricos , Gengivite/epidemiologia , Saúde Bucal/estatística & dados numéricos , Inquéritos e Questionários , Hispânico ou Latino/estatística & dados numéricos , Porto Rico , Escovação Dentária/estatística & dados numéricos , Modelos LogísticosRESUMO
OBJECTIVE: Estimate the DGC dimensions and determine whether the DGC dimension varies by gingival biotype. METHODS: A cross-sectional study was performed in the Undergraduate and Prosthodontic Graduate Program clinics of the School of Dental Medicine, University of Puerto Rico from August 2011 to April 2012. A total of 53 participants who needed restorative crowns in their teeth were recruited. Prior to crown preparation, the gingiva was classified as having a thin, mixed or thick biotype, according to transparency, using a standardized 15 UNC Hu-Friedy periodontal probe. The DGC dimension was measured by transulcus probing. Descriptive statistics were calculated in mesial, medial, and distal sites by phenotypes. Differences between and within the sites' DGC dimension mean were determined using a Friedman test. The level of significance was 0.05. RESULTS: Mean DGC dimensions, in millimeters, for all sites measured were: 3.09 (95% CI: 2.91-3.27), 3.40 (95% CI: 3.18-3.62), 2.70 (95% CI: 2.51-2.89), and 3.17 (95% CI: 2.94-3.41) in mesial, medial, and distal sites, respectively. In thick, mixed, and thin biotypes the mesial sites showed greater DGC dimension means than the medial and distal (p<0.05) sites. Mean DGC dimension was greater for the thin compared to mixed and thick biotypes at mesial, medial and distal sites (p<0.001). Nevertheless, the thick biotype presented the smallest DGC mean dimensions compared to mixed and thin biotypes at the same sites. CONCLUSION: The DGC dimensions in all sites were similar to those reported in the literature. DGC dimensions are different for thin, mixed and thick gingival biotypes.
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Antropometria , Periodonto/anatomia & histologia , Adulto , Idoso , Classificação , Tecido Conjuntivo/anatomia & histologia , Estudos Transversais , Coroas , Inserção Epitelial/anatomia & histologia , Feminino , Gengiva/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Odontometria , Adulto JovemRESUMO
OBJECTIVE: Compare the efficacy of the micro-osteoperforation (MOP) and corticotomy techniques in terms of maxillary canine retraction. METHODS: Thirteen patients (5 females, 8 males; mean age, 18.07 ± 6.74 years) with healthy permanent dentition and requiring the extraction of maxillary first premolars were included in a split-mouth randomized clinical trial. Those subjects with previous orthodontic or endodontic treatment of the canines were excluded. At least 3 months post-extraction, MOPs and corticotomies were performed distal to the canines. Mini-screws with closed-coil springs (150 g) were used for the canine retraction. Dental casts were made at baseline (T0) and 3 months post-intervention (T1). Trained and calibrated examiners measured the distances from the canines to the second premolars on both sides. A signed-rank sum test was used to compare the amount of canine retraction achieved in 3 months (T0-T1) on the 2 sides. RESULTS: Retraction (mm) at the incisal level was similar in the corticotomy (3.34 ± 1.01) and MOP patients (2.74 ± 1.10) (P = 0.11); furthermore, there were no differences in the degree of medial retraction between the corticotomy (2.56 ± 0.67) and MOP (2.27 ± 0.82) (P = 0.31) procedures. No adverse events were observed. CONCLUSION: There were not any clinically or statistically significant differences in retraction between the interventions. At 3 months, a MOP is as effective as a corticotomy in accelerating the rate of tooth movement.
Assuntos
Dente Canino , Boca , Masculino , Feminino , Humanos , Criança , Adolescente , Adulto Jovem , Adulto , Dente Canino/cirurgia , Assistência Odontológica , Dente Pré-Molar/cirurgia , Técnicas de Movimentação Dentária/métodosRESUMO
OBJECTIVE: We aimed to estimate the overall distribution of odontogenic infection by socio-demographic and medical characteristics in patients admitted to the Adult University Hospital (AUH) in Puerto Rico (PR). METHODS: A cross-sectional study was undertaken with the medical charts of 129 patients (≥21 years) with odontogenic infection who had been admitted (2011-2015) to the AUH and treated by the Oral and Maxillofacial Surgery Post - graduate Program of the University of PR. The patients were selected from the hospital's billing database after having been identified using the International Classification of Diseases (9th and 10th revisions). The study variables included age, gender, municipality of residence, medical insurance, infection etiology, surgical and antibiotic treatments, length of stay (LOS), and the presence of diabetes. Descriptive and frequency statistics were calculated for all the variables; chi-squared, Kruskal-Wallis, Kendall tau, and Mann-Whitney tests were performed. A P < .05 was considered statistically significant. RESULTS: The mean age of the subjects was 40.36 (SD: 14.74) years, and they ranged in age from 21 to 81 years; the majority were enrolled in the public health insurance plan of PR. The leading cause of infection was dental caries. Diabetes was associated with longer LOSs; P < .01. CONCLUSION: In our study, the relative frequency of admitted patients with an odontogenic infection, most of them with low income, increased over time with dental caries being the principal cause of infection.
Assuntos
Cárie Dentária , Humanos , Adulto , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Porto Rico/epidemiologia , Hospitais Universitários , DemografiaRESUMO
OBJECTIVE: To estimate the prevalence of short root anomaly (SRA) in a group of Puerto Ricans at the Advanced Education Program in Orthodontics of the University of Puerto Rico. METHODS: A cross-sectional study was conducted with digital panoramic x-rays of 203 patients (112 females and 91 males; mean age: 17 years) in Puerto Rico. Utilizing the modified Lind's method, 406 maxillary right and left central incisors (1) were measured and evaluated for SRA. Root and crown length and R/C ratio were compared by sex and side. Linear regression was used to evaluate the associations between the R/C ratio and age, sex, and side (right/left). All the statistical analyses were evaluated using significance level of .05 (2). RESULTS: The prevalence of SRA was 0.49%. The average root and crown lengths for the maxillary right and left central incisors were 19.47 and 10.28 mm, respectively. Sex was associated with root and crown length, not with the R/C ratio. No differences were observed in the R/C ratio by the side. There were no significant associations between age, sex, and side and R/C ratio in the multivariate analysis. CONCLUSION: The prevalence of SRA in our population is lower than any reported in the literature. The R/C ratio in our Hispanic population was the highest compared with those of other ethnicities. Neither the sex nor the side of the incisor was associated with the R/C ratio. These findings are contrary to those of prior reports stating that males have higher R/C ratios than females.
Assuntos
Incisivo/diagnóstico por imagem , Anormalidades Dentárias/epidemiologia , Raiz Dentária/anormalidades , Adolescente , Estudos Transversais , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Incisivo/anormalidades , Masculino , Prevalência , Porto Rico/epidemiologia , Radiografia Dentária Digital/métodos , Radiografia Panorâmica/métodos , Ápice Dentário/anormalidades , Ápice Dentário/diagnóstico por imagem , Coroa do Dente/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Adulto JovemRESUMO
OBJECTIVE: To assess the microtensile bond strength (MTBS) and interfacial characteristics of universal adhesives applied on dentine air-abraded using different powders. The analysis includes the cytotoxicity of the powders and their effect on odontogenic gene expression. METHODS: Sound human dentine specimens were air-abraded using bioglass 45S5 (BAG), polycarboxylated zinc-doped bioglass (SEL), alumina (AL) and submitted to SEM analysis. Resin composite was bonded to air-abraded or smear layer-covered dentine (SML) using an experimental (EXP) or a commercial adhesive (ABU) in etch&rinse (ER) or self-etch (SE) modes. Specimens were stored in artificial saliva (AS) and subjected to MTBS testing after 24 h and 10 months. Interfacial nanoleakage assessment was accomplished using confocal microscopy. The cytotoxicity of the powders was assessed, also the total RNA was extracted and the expression of odontogenic genes was evaluated through RT-PCR. RESULTS: After prolonged AS storage, specimens in the control (SML) and AL groups showed a significant drop in MTBS (p > 0.05), with degradation evident within the bonding interface. Specimens in BAG or SEL air-abraded dentine groups showed no significant difference, with resin-dentine interfaces devoid of important degradation. The metabolic activity of pulp stem cells was not affected by the tested powders. SEL and BAG had no effect on the expression of odontoblast differentiation markers. However, AL particles interfered with the expression of the odontogenic markers. SIGNIFICANCE: The use of bioactive glass air-abrasion may prevent severe degradation at the resin-dentine interface. Unlike alumina, bioactive glasses do not interfere with the normal metabolic activity of pulp stem cells and their differentiation to odontoblasts.
Assuntos
Colagem Dentária , Adesivos Dentinários , Resinas Compostas , Cimentos Dentários , Dentina , Expressão Gênica , Humanos , Teste de Materiais , Cimentos de Resina , Propriedades de Superfície , Resistência à TraçãoRESUMO
OBJECTIVE: Compare maxillary anterior dentition measurements, using Chu's proportion gauge with a T-bar tip (PG-TT) and a Two-Tip Compass (T-TC), in a group of Puerto Ricans, to determine the reliability of the PG-TT. METHODS: This cross-sectional study was conducted at the University of Puerto Rico, School of Dental Medicine, Medical Sciences Campus. The participants (18-35 years old) were dental students or employees of the university. Previously, the examiner had been trained and calibrated in instrument usage. Calibration participants (n = 16) received an oral exam, prophylaxis, and a chlorhexidine mouthwash for home use. After 3 days, the upper-anterior teeth were measured using the 2 instruments. The agreement was determined using weighted kappa statistics (Kw), and 0.80 was the minimum acceptable level. The examiner achieved almost perfect agreement (inter-examiner KwT-TC = 0.95 [0.96-0.93]; KwPG-TT = 0.82 [0.81-0.87]) with a reference examiner. RESULTS: Fifty participants (25 women and 25 men) were evaluated. Length: The teeth of the men presented an unacceptable level of agreement, except for in the right central incisors. For the women, a strong level of agreement was observed only in the lateral incisors and left canines. When the teeth of both sexes were considered, a strong level of agreement was detected, except for in the right canines and left central incisors. Width: The level of agreement was unacceptable, except for in the right canines (distal). CONCLUSION: T-TC is a more reliable instrument to measure tooth dimensions as compared to the PG-TT.
Assuntos
Dente Canino/anatomia & histologia , Incisivo/anatomia & histologia , Adolescente , Adulto , Estudos Transversais , Dentição , Feminino , Hispânico ou Latino , Humanos , Masculino , Maxila , Odontometria/métodos , Porto Rico , Reprodutibilidade dos Testes , Fatores Sexuais , Adulto JovemRESUMO
OBJECTIVE: Dental caries is one of the most prevalent chronic diseases in children. Currently, no data are available on dental caries prevalence in the Dominican Republic. The purpose of this study was to estimate the prevalence of dental caries in schoolattending 12-year-olds in San Pedro de Macorís, Dominican Republic. METHODS: A cross-sectional epidemiological study using a probabilistic sample, stratified by type of school (public/private) and gender, was conducted. Two calibrated examiners conducted the evaluations of oral soft/hard tissues. Caries experience was summarized in terms of prevalence; the number of decayed, missing, and filled teeth (DMFT) and surfaces (DMFS); and the significant caries (SiC) index, in all the participants, and by gender and school type. Logistic and Poisson regression models were used to compare caries experience by sex and school type. RESULTS: Four hundred and two 12-year-olds enrolled in 14 public and 11 private schools were evaluated. The overall dental caries prevalence was 73%. The mean DMFS was 3.87, the mean DMFT was 2.64, and the SiC index was 5.07. Girls had significantly higher mean DMFS, DMFT, and SiC indices than did boys. Public school attendees had significantly higher DMFS, DMFT, and SiC indices than did those children attending private schools. The decayed (D) component accounted for 71% of the DMFT value. CONCLUSION: The WHO's goal of all 12-year-olds having a DMFT less than or equal to 3 was met by all the participants in our study. Girls and public-school attendees carry the burden of the disease. The high D component of the index suggests that there are unmet dental-caries needs. This information will assist in the design and implementation of future primary and secondary prevention programs.