Efficacy of articaine anesthesia with needle-free/Comfort-in method and conventional needle injection in dental patients with irreversible pulpitis: a randomized clinical trial.

OBJECTIVE: To assess the anesthetic efficacy of articaine with the needle-free/Comfort-in™ method compared to the conventional needle method. To assess pain during anesthesia application, onset of anesthesia and patient`s self-reported quality of life-related to oral health after the dental emergency appointment. MATERIALS AND METHODS: This parallel, randomized clinical trial was conducted by a single operator/dentist in the state of Maranhao, northeast of Brazil. Included participants were adult dental patients with one molar (maxillary) or premolar (maxillary or mandibular) tooth diagnosed with symptomatic irreversible pulpitis. The primary outcome was the anesthetic efficacy, measured using a combination of electrical and cold pulp tests (cold + EPT) and the Numerical Rating Scale (NRS). Secondary outcomes were pain during anesthesia application, onset of anesthesia, and patient`s quality-of-life (measured with the OHIP-14). RESULTS: 62 patients were randomized in the anesthesia needle-free group and Comfort-in group (34.26 ± 10.786 × 33.29 ± 8.399 years old, respectively). The group of patients in the Comfort-in group had 71.0% success. Patients from the Comfort-in group reported statistically lower pain during the anesthesia application than patients from the conventional group (2.13 ± 2.172 × 6.03 ± 3.146 NRS scores, respectively) as well as immediately after the anesthetic procedure. Patients self-reported negative impact in quality of life was similar between groups before (p > 0.05) and after (p > 0.05) the dental emergency. CONCLUSIONS: Comfort-in™ had similar efficacy to the conventional needle method. CLINICAL RELEVANCE: This trial showed that it is possible to anesthetize patients with tooth pulpits without using needles to provide comfort mainly to anxious patients.

Photobiomodulation therapy for hypersensitivity associated with molar-incisor hypomineralization: a case report.

Molar-incisor hypomineralization (MIH) is a qualitative defect of the dental enamel on permanent first molars and may be associated with permanent incisors. There is currently no defined therapeutic protocol for managing the hypersensitivity associated with this condition. The present case report describes the treatment of a patient with MIH and the impact on the patient's quality of life as assessed using the Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11-14). The maxillary central incisors, maxillary and mandibular first molars, and mandibular right canine of an 11-year-old girl were compromised by MIH. The long version of the CPQ11-14 was self-administered before treatment. Initially, the patient reported hypersensitivity of her maxillary right central incisor, maxillary and mandibular left first molars, and mandibular right canine when consuming cold food and beverages. This was confirmed by applying a jet of air to the teeth and asking the patient to report the level of sensitivity using the Wong-Baker FACES Pain Rating Scale. The patient reported that hypersensitivity was present every day or almost every day. Desensitizing treatment included 4 applications of photobiomodulation therapy (infrared diode laser) and 4 applications of fluoride varnish. After desensitization, the maxillary central incisors received direct composite resin restorations, while the maxillary left first molar, which had an amalgam restoration and recurrent caries, received a resin-modified glass ionomer cement restoration. At the conclusion of the treatment, the patient completed the CPQ11-14 again and reported less difficulty with consuming hot and cold foods and beverages, indicating that treatment had reduced hypersensitivity and its negative impact on her quality of life.

Comparison of gingival display in smile attractiveness among restorative dentists, orthodontists, prosthodontists, periodontists, and laypeople.

STATEMENT OF PROBLEM: Multidisciplinary treatment needs a common goal, and dentists should understand the esthetic perception of laypeople and the other specialists involved. Such information is sparse. PURPOSE: The purpose of this cross-sectional study was to compare the influence of gingival display on perceived smile esthetics among restorative dentists, orthodontists, prosthodontists, periodontists, and laypeople. MATERIAL AND METHODS: Photographs of the smiles of 2 volunteers (1 female and 1 male) were manipulated on a computer to produce gingival exposure of 1, 3, and 5 mm and central incisor coverage of 3 and 5 mm. The images were evaluated by using a 100-mm visual analog scale by 155 raters divided into 5 groups (restorative dentists, orthodontists, prosthodontists, periodontists, and laypeople). RESULTS: The dental specialists, mainly orthodontists and periodontists, were more sensitive about alterations in gingival display than the laypeople. For the female smile, higher mean scores were attributed to 1 mm of gingival exposure by all groups of raters. For the male smile, 3 mm of central incisor coverage received higher mean scores, except for the laypeople, who considered gingival display of 1 mm to be more attractive. For both smiles, 5 mm of gingival display was judged to be the least attractive. CONCLUSIONS: Considering the differences in opinion between dental specialists and laypeople and the acceptable variations in gingival display, the preferences of patients should be considered in the diagnosis and treatment decision-making process.

Efficacy of low-level laser therapy associated with fluoride therapy for the desensitisation of molar-incisor hypomineralisation: Randomised clinical trial.

BACKGROUND: Molar-incisor hypomineralisation (MIH) is a qualitative enamel defect. AIM: To investigate the low-level laser therapy (LLLT) associated with fluoride varnish for the desensitisation of teeth with MIH. DESIGN: A randomised clinical trial was conducted with 66 children, randomly allocated to the treatments: laser (L); fluoride varnish (FV); and laser + fluoride varnish (L + FV). The participants in the L group underwent two sessions of LLLT (48-hour interval). The FV group received four applications of varnish at one-week intervals. The L + FV underwent two sessions of LLLT and four applications of varnish. Prior to each session and one month after the onset of treatment, tooth sensitivity and its magnitude were evaluated. Intra- and inter-group comparisons were performed (α = 5%). RESULTS: A significant reduction in the mean sensitivity score was found over time in all groups. After the final treatment, a significant difference was found between the L and L + FV groups (P = .011), with a lower score in the L + FV group (0.09), whereas no difference was found between the FV and L + FV groups (P = .095). CONCLUSIONS: Fluoride varnish and the combination of treatments (L + FV) had greater desensitising action on teeth with MIH. Laser therapy demonstrated an immediate desensitising effect, whereas fluoride varnish had a late-onset effect.

Knowledge of parents/caregivers about the sleep bruxism of their children from all five Brazilian regions: A multicenter study.

BACKGROUND: Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists. AIM: To investigate parents' knowledge about SB among their children. DESIGN: A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P < 0.05). RESULTS: Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P > 0.05). CONCLUSION: There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge.

Guide for health professionals addressing oral care for individuals in oncological treatment based on scientific evidence.

OBJECTIVE: Oncological treatment can cause changes in the oral cavity compromising oral functions. The aim of the study was, based on a systematic review, to draft a guide directed at the team of health professionals involved in the oral care of oncological patients. METHODS: A systematic search of the literature was performed for articles published between 2000 and April 2017. Searches were made of electronic databases and hand search. The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and RCTs published in English, involving pediatric and adult oncological patients and focused on the prevention and treatment of oral complications as well as studies addressing the maintenance of oral health. Among the 1237 studies identified, 129 were pre-selected and 54 were selected to form the basis for the clinical guide. RESULTS: The studies analyzed stress the need for oral assessments as well as preventive and curative actions prior to oncological treatment. To minimize the severity of oral problems, the studies emphasize daily oral care, the treatment of xerostomia with saliva substitute and hydration, and low-level laser therapy, nystatin, acyclovir, respectively, for the prevention and treatment of oral mucositis, oral candidiasis, and infection by herpes simplex virus. Thus, the guide produced addresses oral assessments and professional and home care before, during, and after oncological treatment. CONCLUSION: The guide drafted has the function of assisting health professionals involved in the oral care of patients with cancer, enabling the prevention or treatment of oral complications stemming from oncological treatment.

Impact of untreated dental caries on the quality of life of Brazilian children: population-based study.

BACKGROUND: The assessment of oral health should consider clinical and biopsychosocial aspects. AIM: To evaluate the impact of untreated dental caries on the quality of life of children. DESIGN: A cross-sectional study was conducted with 647 Brazilian children. The Child Perceptions Questionnaire (CPQ8-10 ) and the 'oral health' global indicator were administered to the children and used as the outcomes. Parents answered a general questionnaire, and oral clinical examinations were performed. Data analysis involved descriptive statistics, chi-squared test, Mann-Whitney test, and Poisson's regression analysis (α = 5%). The psychometric properties of the CPQ8-10 were tested for younger age group (6/7 years). RESULTS: Untreated caries was a predictor of impact on quality of life for the following items: 'pain in teeth/mouth' (PR = 1.69; 95% CI: 1.41-2.04), 'difficulty biting/chewing hard foods' (PR = 1.28; 95% CI: 1.05-1.56), 'difficulty eating what you wanted to eat' (PR = 1.61; 95% CI: 1.29-2.02), 'trouble sleeping' (PR = 1.64; 95% CI: 1.27-2.13), 'missed school' (PR = 1.62; 95% CI: 1.24-2.12), 'trouble doing homework' (PR = 1.61; 95% CI: 1.12-2.31), and 'difficulty paying attention in class' (PR = 1.41; 95% CI: 1.01-1.96). CONCLUSION: Children with untreated dental caries feel greater negative impacts on quality of life than children without untreated caries.

Retrospective evaluation of tooth injuries and associated factors at a hospital emergency ward.

BACKGROUND: The aim of study was to determine the occurrence of tooth injuries and associated factors among patients treated at a hospital emergency ward. METHODS: A cross-sectional study was conducted involving the analysis of 790 patient charts. The independent variables were gender, place of residence and type of accident. The dependent variable was tooth injury (fractures, concussion, luxation and avulsion). Statistical analysis involved the chi-square test, Poisson analysis and logistic regression. Explanatory variables with a p-value < 0.20 in the bivariate analysis were incorporated into the multivariate model. RESULTS: A total of 681 (86.2 %) patients had tooth injury, among whom 159 (20.1 %) had tooth fractures. Tooth concussion was associated with residence in urban areas (PR = 1.635; 95 % CI: 1.199-2.230), the male gender (PR = 1.673; 95 % CI: 1.225-2.285), violence (PR = 1.940; 95 % CI: 1.263-2.982) and sports (PR = 1.863; 95 % CI: 1.287-2.696). The prevalence rate of tooth fracture was higher among individuals having suffered a motorcycle (PR = 1.597; 95 % CI: 1.295-1.968) or bicycle accident (PR = 1.484; 95 % CI: 1.245-1.769). Victims of bicycle accidents had a 42.6-fold greater chance of suffering luxation (95 % CI: 20.917-86.808) and a threefold greater chance of suffering avulsion (95 % CI: 1.620-5.848). Victims of motorcycle accidents had a 2.96-fold greater chance of suffering avulsion (95 % CI: 1.471-5.937). CONCLUSIONS: In the study, concussion was the most frequent type of tooth injury. Motorcycle and bicycle accidents were associated with tooth fractures, luxation and avulsion, whereas sports and violence were associated with dental concussion. The findings on tooth injuries can contribute to public health policies regarding the prevention and health promotion measures.

Pattern of oral-maxillofacial trauma stemming from interpersonal physical violence and determinant factors.

BACKGROUND/AIM: Facial trauma is among the most common types of injury. The aim of the present study was to assess the prevalence and pattern of oral-maxillofacial trauma stemming from interpersonal physical violence (IPV) and determine whether IPV is factor associated with oral-maxillofacial trauma. MATERIALS AND METHODS: A retrospective analysis was conducted of 790 complete patient charts for data on the type of IPV for the gender, area of residence (urban or rural), age and type of trauma. Statistical analysis involved the chi-squared test (P < 0.05), univariate/multivariate Poisson, and logistic regression (P < 0.20). Type of oral-maxillofacial trauma was the dependent variable. Socio-demographic status and type of IPV were the independent variables. RESULTS: One hundred forty (17.7%) individuals had oral-maxillofacial injuries stemming from IPV [80 (10.1%) due to urban violence (UV) and 42 (5.3%) due to domestic violence (DV)]. DV was more prevalent among females (69%), and UV was more prevalent among males (67.5%). The most common types of trauma were facial contusion and laceration, dental concussion, and mandibular fracture. Age and UV were explanatory factors for mandibular fracture. Females from rural areas and who suffered DV were more likely to exhibit facial contusion and dental concussion. CONCLUSIONS: Interpersonal physical violence was identified as a factor associated with oral-maxillofacial trauma, specifically mandibular fracture, facial contusion, and dental concussion.

Filling Material Bond Strength to Dentin Is Positively Influenced by the Agitation of Endodontic Final Irrigating Solutions.

Introduction: The final step of irrigation has been considered to of increase the bonding strength of filling material to dentin. This study investigated the impact of three final-step irrigation methods on the endodontic sealer bond strength to dentin by using a micro push-out test. Materials and Methods: Palatal roots of human maxillary molars were cleaned and shaped and randomly divided in six groups (n=15) according to the final-step irrigation method and the type of root canal sealer used. The solutions used for the final-step irrigation were 17% ethylenediaminetetraacetic acid and 2.5% sodium hypochlorite, which underwent three methods: 1) syringe-needle irrigation/conventional, 2) passive ultrasonic irrigation, and 3) XP-endo Finisher agitation. The root canal sealers used were: EndoSequence BC Sealer, and AH-Plus sealer. Roots were obturated with the single cone technique and then, cross-sectioned in 2-mm-thick slices (3 slices from each root). Push-out test was performed on the sliced specimens (cervical, middle, and apical thirds) with a universal testing machine. Bond strength values were recorded in megapascal (MPa). Subsequently, each specimen was longitudinally split to verify the type of failure. Data analysis was performed using Johnson transformation, three-way analysis of variance, Tukey's post-hoc tests, and the partial Eta squared test. Results: There were significant differences in bond strength between the sealers [AH: 4.46±2.24 and BC: 3.47±2.19 MPa (P<0.001)]; between final-step irrigation methods [passive ultrasonic irrigation: 4.52±2.25, XP-endo Finisher: 3.93±3.93 and syringe-needle irrigation/conventional: 3.37±2.51 MPa (P<0.001)], and between the root canal thirds represented by the sliced specimens [cervical: 5.45±2.39, middle: 4.14±1.99 and apical: 2.30±1.30 MPa (P<0.001)]. The interaction between the variables had no significance (P>0.05). Conclusion: Agitation of the final irrigating solution may improve the bonding of the sealer to canal walls. AH-Plus sealer had the highest bond strength. The bond strength reduced significantly towards the apical third.

Domestic Violence against Women Detected and Managed in Dental Practice: a Systematic Review.

This study aimed to investigate the knowledge of dental care professionals to identify and manage clinical situations that indicate violence against women. PRISMA guidelines were followed and a systematic review protocol was registered in PROSPERO. The systematic search was designed based on the PICo strategy. Six databases were used as primary research sources (PubMed, Scopus, LILACS, SciELO, Web of Science, and Embase). Three databases (OpenGrey, OpenThesis, and OATD) were used to detect the "grey literature". Observational studies (cross-sectional, cohort, or case-control) were included, and there were no restrictions of year or language of publication. Two authors selected and extracted the data from the eligible studies. The risk of bias was assessed with the JBI Critical Appraisal Checklist. The search resulted in 10,115 studies. Eleven met the eligibility criteria and were included in the qualitative synthesis. The studies were published from 1994 to 2018. All studies presented low risk of bias. Among the dental care professionals, only 1-7.1% of the dentists included injury search and examination of their patients for signs of violence. Less than 47% of the professionals had knowledge to identify violence injuries. When it comes to knowledge to identify signs of domestic violence, positive answers were below 24%. Considering all the variables assessed in this study, dental care professionals presented deficiencies regarding the knowledge and management of situations of domestic violence against women. Educational strategies are necessary to prepare dental care professional to identify and report suspicious cases.

Oral Health-Related Quality of Life among Adolescents in the First 6 Months of Fixed Orthodontic Therapy.

Clarification on disabilities that may arise during orthodontic treatment allows patients to have more realistic expectations. This prospective study assessed the impact of fixed orthodontic therapy on adolescents' quality of life over 6 months. A total of 78 adolescents aged 11-17 years were included. Quality of life was measured using the Child Perceptions Questionnaire (CPQ11-14, short form) at five moments: before treatment (T0), one week (T1), one month (T2), three months (T3), and six months (T4) after treatment initiation. Multiple and pairwise comparisons were conducted for CPQ11-14 scores (Friedman and Wilcoxon test; effect size). Changes in the quality of life were assessed as mean differences (T0-T1 and T0-T4) in total and domain scores (Kruskal-Wallis and Mann-Whitney test) (α = 5%). Significant differences were observed between T0 and T4 in the oral symptoms' domain (p < 0.001), and between T0 and T1, T2, T3, and T4 for emotional well-being (p < 0.001 for all). Significant differences in impact were also found between T0 and T2, T3, and T4 with regard to social well-being (p = 0.004, =0.049, and <0.001, respectively). Orthodontic therapy positively impacted the emotional and social aspects of adolescents' quality of life. Negative effects were primarily related to pain, mouth sores, and difficulty biting or chewing. Understanding the symptoms and feelings of orthodontic patients aids professionals in decision-making.

Histopathological diagnosis in pediatric stomatology: A 43-year retrospective study of 1,480 cases from a Brazilian institution.

OBJECTIVES: the aim of this study was to analyze the prevalence of histopathological diagnoses in oral biopsied tissues obtained from a Brazilian pediatric population. METHODS: an analytical, cross-sectional retrospective study was performed with biopsy files of patients ≤14 years of age from a Brazilian oral pathology laboratory over a 43-year period. Data included sex, age, location, and diagnoses. The prevalence was calculated by means of relative frequency. Associations between sex, age groups and diagnoses were verified with Pearson's chi-square test. RESULTS: from 19,456 oral biopsies, 1480 (7.6%) were obtained from patients aged ≤14 years. Most children were 10-14 years of age (60.1%) and females (55.1%), with an overall M:F of 1:1.2. Children aged 0-9 years and males had a higher frequency of lesions of the oral mucosa, whilst the 10-14 year age group showed a higher frequency of cysts, odontogenic tumors, and salivary gland lesions. The latter was also significantly higher in females. Samples consisted mostly of soft tissue lesions (53%) obtained from the lower lip (30.7%). Intraosseous lesions showed a slight predilection for the mandible (21.2%). Salivary gland lesions (28.8%) was the most common diagnostic category, followed by reactive lesions (18.8%), and cysts (16.1%). Mucocele (33.5%), dentigerous cyst (6.7%), and fibrous hyperplasia (5.9%) were the top three histopathological diagnoses. Malignant lesions affected only 0.9% of this population. CONCLUSION: our results were similar to other retrospective studies. Due to the low frequency of oral biopsies in children, data on the prevalence of oral pathology in this population might aid in the clinical and histopathologic diagnoses.

Cases of Maxillofacial Trauma Treated at Hospitals in a Large City in Northeastern Brazil: Cross-Sectional Study.

Maxillofacial trauma is associated with facial deformation, loss of function, emotional and social impacts, and high financial costs. This study investigated cases of maxillofacial trauma in a large Brazilian city through a cross-sectional study conducted at two public and two private hospitals. Primary data of 400 patients were collected through a questionnaire, clinical examination, and tomography. Statistical analysis at the 5% significance level was performed. Motorcycle accident was the major cause of trauma (41%); the most frequent trauma and treatment were mandibular fracture (24.3%) and surgery (71%), respectively. The female sex was more affected only regarding domestic accidents (p = 0.041) and falls (p < 0.001). Motorcycle accidents were more prevalent among 20 to 29 year-olds (p < 0.001), followed by physical aggression (p < 0.001) and sports accidents (p = 0.004). Falls were more frequent among 40 to 59 year-olds (p < 0.001). Mandibular fracture affected males and 20 to 29 year-olds more and was mainly associated with motorcycle accidents (48.2%) and physical aggression (22.7%) (p = 0.008). Nose fracture was more frequent in falls (29.6%), physical aggression (22.5%), and sports accidents (21.1%) (p < 0.001). Compound fracture was associated with motorcycle accidents (84.2%; p = 0.028). Maxillofacial trauma (mandibular, nasal, and zygomatic fractures) was associated with motorcycle accidents, physical aggression, and falls. Surgical treatment, hospital care, and public services were the most frequent.

Postoperative Pain Following Root Canal Instrumentation Using ProTaper Next or Reciproc in Asymptomatic Molars: A Randomized Controlled Single-Blind Clinical Trial.

Aim: The development of postoperative pain following root canal instrumentation may impair patient's comfort and undermine their trust in the dentist. This study assessed the effect of root canal instrumentation techniques (rotary (PTN; ProTaper Next®) and reciprocating (R; Reciproc®)) on the postoperative pain intensity (primary outcome) and tenderness on biting (secondary outcome) of patients' asymptomatic molars. Methodology: This study protocol was registered with ReBec-WHO (U1111-1182-2800). From a pool of 112 patients evaluated for eligibility (healthy adults (≤18 years old)), with a single asymptomatic molar (maxillary or mandibular) indicated for root canal treatment, diagnosed with asymptomatic irreversible pulpitis (including chronic hyperplastic pulpitis), 75 were randomly allocated in similar proportions to receive the intervention (two-appointment root canal therapy) in either the PTN or R group. The allocated procedures were performed using standardized protocols. Participants (blinded to the instrumentation technique) rated their pain intensity at 6, 12 and 24 h and from day 2 to day 7 following the root canal instrumentation appointment using a VAS and an NRS; the ibuprofen tablets taken and the presence of tenderness on biting were recorded. The instrumentation time was registered. Univariate and multivariate statistics measured the effect of independent variables on the outcomes. Results: From the 75 patients allocated, 8 patients (4 from each group) were lost; in total, 33 patients were analyzed in the PTN group and 34 in the R group. The frequencies of postoperative pain (p > 0.05) and tenderness on biting (p > 0.05) were similar between groups. The medication intake (mean of 1.31 tablets) and the time of instrumentation (approximately 11 min) were similar between groups. Conclusion: ProTaper Next and Reciproc® caused a slight risk of tenderness on biting and contributed to similar self-reported postoperative pain (low intensity) up to 7 days following root canal shaping.

Translation, cross-cultural adaptation, and validation of the heart disease fact questionnaire among the Brazilian population.

OBJECTIVE: This study aimed to translate, cross-culturally adapt, and validate the Heart Disease Fact Questionnaire into Brazilian Portuguese. METHODS: The Brazilian version of the Heart Disease Fact Questionnaire was developed through the processes of translation, back-translation, review committee, and pre-test. Test-retest reliability was measured using the intraclass correlation coefficient and the kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total Heart Disease Fact Questionnaire score was correlated with the Diabetes Knowledge Scale and the Diabetes Attitudes Questionnaire. Ceiling and floor effects were also evaluated in this study. RESULTS: For construct validity and floor and ceiling effect measurements, a total of 100 participants were selected. Reliability was measured using a sub-sample of 30 participants from the total sample. We identified adequate values of reliability (kappa between 0.22 and 1.00 and ICC=0.75) and internal consistency (Cronbach's alpha=0.79). We observed adequate correlations of the Heart Disease Fact Questionnaire score with Diabetes Knowledge Scale (r=0.348) and Diabetes Attitudes Questionnaire (r=0.136). No ceiling or floor effects found. CONCLUSION: Brazilian Portuguese version of the Heart Disease Fact Questionnaire has adequate psychometric properties according to the best scientific recommendations.

Impact of wearing fixed orthodontic appliances on oral health-related quality of life among Brazilian children.

OBJECTIVE: To assess the impact of wearing a fixed orthodontic appliance on oral health-related quality of life (OHRQoL) among Brazilian children. DESIGN: Cross-sectional study. SETTING: The Department of Paediatric Dentistry and Orthodontics at Federal University of Minas Gerais, Belo Horizonte, Brazil. PARTICIPANTS: Sample of 579 children aged 11-14 years. The children were divided into two groups: wearing (n = 160)and not wearing (n = 419)a fixed orthodontic appliance. METHODS: A clinical examination was performed by a single examiner to determine whether or not a fixed orthodontic appliance was worn,the presence of a malocclusion using the Dental Aesthetic Index (DAI)and cavitated carious lesions. The impact of wearing a fixed orthodontic appliance on OHRQoL was measured using the short form of the Brazilian version of the Child Perceptions Questionnaire (CPQ(11-14)). Data analysis involved descriptive statistics, Mann-Whitney test and univariate/multiple logistic regression. RESULTS: The total CPQ(11-14) score revealed a more frequent impact among children who wore a fixed orthodontic appliance than those who did not (P = 0·002).Similar findings were observed for the FL (P = 0·005),EWB (P = 0·006) and SWB (P = 0·003) subscales.There was no statistically significant difference between the two groups regarding the score on the OS subscale (P = 0·124).While females were 1·76 times more likely to have a worse OHRQoL than males, the use of a fixed orthodontic appliance was also significantly associated with a greater chance (OR = 1·60; CI = 1·11-2·33)of impacting OHRQoL when both variables were inserted together in the regression model. CONCLUSION: Children wearing a fixed orthodontic appliance had significantly worse OHRQoL compared with a control group with no malocclusion and not wearing a fixed appliance.

Assessment of the aesthetic impact and quality of life of home dental bleaching in adult patients.

BACKGROUND: This study aimed to evaluate the impact of home bleaching with 10% carbamide peroxide on the quality of life and aesthetic perception of patients. MATERIAL AND METHODS: A total of 107 patients between 18 and 38 years of age with good oral and general health and at least one anterior tooth in color A2 or darker were selected. Patients who previously underwent any type of bleaching procedures were excluded. All patients received a home bleaching treatment with 10% carbamide peroxide. Before beginning the bleaching treatment, the selected patients responded a form with the Oral Health Impact Profile short form (OHIP-14) and Oral Aesthetic Subjective Impact Scale (OASIS) questionnaire. One month after the bleaching treatment, the patients answered the same questionnaires again. The mean ΔE after bleaching was obtained for the canines and lateral and central incisors. The OHIP-14 and OASIS data were measured for the total sample before and after bleaching using the Wilcoxon signed-rank test with a 5% significance level. RESULTS: The effectiveness of whitening by significant color variation was observed in all groups of teeth with less variation in ΔE for central incisors. Comparing before and after bleaching, there was no significant difference in impact for any of the seven domains and total OHIP-14 scores, although a decrease was observed in the discomfort and psychological disability domains. As for the self-perception of dental aesthetics, measured by the OASIS, there was also no significant difference for all the items evaluated; however, it was possible to observe an increase in "concern with dental appearance" after bleaching. CONCLUSIONS: Home bleaching with 10% carbamide peroxide did not have a significant impact on patients' quality of life and aesthetic perception, although there was a decrease in the domain of psychological discomfort and an increase in concerns about dental appearance. Key words:Tooth Bleaching, quality of life, self-perception, dental aesthetics.

Dentin Microhardness and Sealer Bond Strength to Root Dentin are Affected by Using Bioactive Glasses as Intracanal Medication.

This study investigated the human dentin microhardness (MH) and the MTA Fillapex® (Fillapex) and AH Plus®(AH) bond strength (BS) to dentin after using calcium hydroxide (Ca(OH)2) and bioactive glasses (45S5 and an experimental niobium phosphate bioactive glass (NbG)) as intracanal medications. For the MH test dentin slices were filled with medications and were submitted to Knoop MH (KHN) test (at day-0 (baseline data/without medication) and at day-15 (after using medication)). For the BS test, after medications had remained for 15 days in the roots, dentin slices were obtained and filled with the sealers. Seven days later, sealer BS to dentin was measured by push-out test (MPa). Data were statistically analyzed. Failure mode was visually assessed. The use of NbG, 45S5 for 15 days, increased the dentin MH and reduced the BS between AH sealer and dentin, but did not interfere with the Fillapex BS.