A population-based study on the impact of orofacial dysfunction on oral health-related quality of life among Brazilian schoolchildren.

OBJECTIVE: The aim of the present study was to assess the impact of orofacial dysfunction on oral health-related quality of life (OHRQoL) among Brazilian schoolchildren. MATERIAL AND METHODS: A population-based study was conducted with 531 children aged eight to 10 years at schools in the city of Campo Magro, Brazil. The Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) was the outcome variable used to measure the impact on OHRQoL. The main independent variable was orofacial function, which was diagnosed using the Nordic Orofacial Test-Screening (NOT-S). Descriptive, bivariate and multiple Poisson regression analyses were performed using a multilevel approach, with the significance level set to 5%. RESULTS: The mean (±SD) total CPQ8-10 score was 13.95 ± 0.5. The multilevel Poisson regression model revealed that the mean CPQ8-10 score was higher among girls (RR: 1.38, 95% CI: 1.17-1.63; p < 0.001) than boys and that children from families with a higher income had lower CPQ8-10 scores (RR: 0.67, 95% CI: 0.51-0.88; p = 0.004) than those from families with a lower income. Children who sought dental care due to pain or factors other than prevention (RR: 1.41; 95% CI: 1.18-1.68), those with orofacial dysfunction (RR: 1.62; 95% CI: 1.30-2.02) and those with a history of traumatic dental injury (RR: 1.39; 95% CI: 1.15-1.69) also experienced a greater impact on OHRQoL. CONCLUSIONS: Schoolchildren with orofacial dysfunction experience a greater negative impact on OHRQoL.

Validity and reliability of the Brazilian version of the psychosocial impact of dental aesthetics questionnaire.

Oral health-related quality of life (OHRQoL) is an important aspect of health outcomes and its assessment should be made using validated instruments. The psychosocial impact of dental aesthetics questionnaire (PIDAQ) is an OHRQoL instrument that assesses the psychosocial impact of dental aesthetics was developed and validated for use on young adults. The aim of the present study was to assess the reliability, validity, and applicability of the PIDAQ for young adults in Brazil. After translation and cross-cultural adaptation, the questionnaire was completed by 245 individuals (124 males and 121 females) aged 18-30 years from the city of Belo Horizonte, Brazil. In order to test discriminant validity, the subjects were examined for the presence or absence of malocclusion based on the dental aesthetic index criteria. Dental examinations were carried out by a previously calibrated examiner [weighted kappa = 0.64-1.00, intraclass correlation coefficient (ICC) = 0.78-1.00]. Internal consistency measured by Cronbach's alpha of the subscales was between 0.75 and 0.91 and test-retest reliability was assessed using the ICC, which ranged from 0.89 to 0.99 for dental self-confidence and social impact, thereby revealing satisfactory reliability. Discriminant validity revealed that subjects without malocclusion had different PIDAQ scores when compared with those with malocclusion. The results suggest that the Brazilian version of the PIDAQ has satisfactory psychometric properties and is thus applicable to young adults in Brazil. Further research is needed to assess these properties in population studies.

Horizontal root fracture with displacement in the primary dentition.

Root fractures in the primary dentition are uncommon and little information is available concerning adequate treatment and prognosis. The most recently published guidelines recommend more invasive approaches but also discuss the need for further studies. This article examines how a horizontal root fracture in the primary dentition of a 3-year-old girl was treated by reducing the coronal fragment, followed by semi-rigid containment for 21 days. Radiographs taken one year after the initial trauma confirmed the success of this alternative approach.

Microleakage of an adhesive system used as a fissure sealant.

AIM: The aim of this study was to investigate the microleakage of pit and fissure sealants in primary teeth and to determine if multi-step methods should produce better results in terms of microleakage prevention. METHODS AND MATERIALS: A total of 40 intact primary molars were randomly assigned to one of four sealant groups: resin based sealant Ultraseal XT (US - Ultradent) (Group 1, n=10); adhesive system Scotchbond Multi Purpose Plus (SBMP - 3M/ESPE) used as a sealant (Group 2, n=10); primer (SBMP) and US (Group 3, n=10); and primer, bond (SBMP) and US (Group 4, n=10). After thermocycling (x700, 5-55 degrees C) all teeth surfaces were made impermeable with the exception of the occlusal surface. Samples were immersed in 50% silver nitrate for 8 hours, sectioned longitudinally with two cuts in the central fissure pit, and then immersed in photo development solution followed by 16 hours in fluorescent light. Pictures were obtained by light microscope (x40) and the degree of microleakage was evaluated by three blinded evaluators. The data were analyzed using the Kruskal Wallis test. RESULTS: Significant statistical differences (p<.05) were observed between Groups 1-3, Groups 2-3, Groups 2-4, and Groups 3-4. Group 3 showed higher microleakage scores. CONCLUSION: The adhesive system and the resin based sealant demonstrated similar microleakage properties, suggesting the possibility that adhesives can be used in a clinical setting. Additionally, the increase in the number of clinical steps required by common application of resin based sealant, including use of primer or primer and bond, did not lead to better results in preventing microleakage. CLINICAL SIGNIFICANCE: The adhesive system can be used as a sealant without increasing the microleakage. Thus, the use of the adhesive system before the application of the sealant is not necessary to reduce the microleakage, although further research is warranted to support this conclusion.

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old.

The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Dental caries remains as the main oral condition with the greatest impact on children's quality of life.

PURPOSE: The objective of this study was to assess the negative impact of dental caries on the OHRQoL of 8- to 10-year-old Brazilian children. METHODS: This population-based case-control study involved 546 children (8-10 years old), 182 cases with a high negative impact on OHRQoL and 364 controls with a low negative impact on OHRQoL. Children's OHRQOL was measured using the Child Perceptions Questionnaire (CPQ8-10). Cases and controls (1x2 ratio) were individually matched by school and gender. Dental caries experience, malocclusion, and traumatic dental injuries were used as independent variables. Dental examinations were carried out at school during daytime hours by two calibrated examiners (Kappa = 0.93-interexaminer and 0.95- intraexaminer). The data were analyzed by descriptive statistics, conditional bivariate and multiple logistic regression, with the significance level set at 5%. RESULTS: There was no significant difference in traumatic dental injuries and malocclusion between the case and control groups (p>0.05). Children with DMFT/dmft ≥3 had a 2.06-fold (95%CI = 1.28-3.31, p = 0.003) greater chance of experiencing a high negative impact on OHRQoL than those with DMFT/dmft = 0. CONCLUSION: Children with high dental caries experience are more likely to present a high negative impact on OHRQoL than those with no dental caries experience.

Dental caries and social factors: impact on quality of life in Brazilian children.

The objective of this study was to evaluate the impact of dental caries and social determinants in the Oral Health Related Quality of Life (OHRQoL) of children in Belo Horizonte, Brazil. This is a population-based cross-sectional study with a representative sample of 1,204 children aged 8 to 10 years randomly selected from 19 public and private schools. The children were clinically examined at school by two trained and calibrated examiners (Kappa = 0.78 - 1.00). The Decayed, Missing and Filled Teeth Index (DMF-T and dmf-t) was used for the diagnosis of dental caries. The social factors were determined by parents'/caregivers' schooling, household income, number of people in the household, type of school, and by the Social Vulnerability Index. The Brazilian version of the Child Perceptions Questionnaire for ages 8 to 10 years was used to assess the impact on quality of life. A total of 278 (23.1%) out of 1,204 children had at least one cavitated carious lesion and 47.0% presented a negative impact on OHRQoL. In the final multivariate Poisson's regression model, household income and presence of untreated dental caries were statistically associated with a negative impact on OHRQoL (p < 0.001).Children with dental caries and from low-income families had a higher negative impact on OHRQoL.

Validity and Reliability of the Brazilian Version of the Rapid Estimate of Adult Literacy in Dentistry--BREALD-30.

OBJECTIVE: The aim of the present study was to translate, perform the cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry to Brazilian-Portuguese language and test the reliability and validity of this version. METHODS: After translation and cross-cultural adaptation, interviews were conducted with 258 parents/caregivers of children in treatment at the pediatric dentistry clinics and health units in Curitiba, Brazil. To test the instrument's validity, the scores of Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) were compared based on occupation, monthly household income, educational attainment, general literacy, use of dental services and three dental outcomes. RESULTS: The BREALD-30 demonstrated good internal reliability. Cronbach's alpha ranged from 0.88 to 0.89 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility (intraclass correlation coefficient = 0.983 and Kappa coefficient ranging from moderate to nearly perfect). In the bivariate analysis, BREALD-30 scores were significantly correlated with the level of general literacy (rs = 0.593) and income (rs = 0.327) and significantly associated with occupation, educational attainment, use of dental services, self-rated oral health and the respondent's perception regarding his/her child's oral health. However, only the association between the BREALD-30 score and the respondent's perception regarding his/her child's oral health remained significant in the multivariate analysis. CONCLUSION: The BREALD-30 demonstrated satisfactory psychometric properties and is therefore applicable to adults in Brazil.

Oral Health-Related Quality of Life and Traumatic Dental Injuries in Young Permanent Incisors in Brazilian Schoolchildren: A Multilevel Approach.

BACKGROUND: Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children. OBJECTIVE: To describe the association of oral health-related quality of life (OHRQoL) and domains (oral symptons, functional limitation, emotional- and social-well-being) of children with individual and contextual variables. METHODS: A cross-sectional study was performed using a representative sample of 1,201 schoolchildren, 8-10 years-old, from public and private schools of Belo Horizonte, Brazil. The CPQ8-10 was used to assess OHRQoL, dichotomized in low and high impact. Sociodemographic information was collected through questionnaires to parents. Children were examined at schools, using the Andreasen criteria. Individual variables were gender, age, number of residents in home, parents/caregivers' level of education, family income, and TDI (dichotomized into without trauma/mild trauma and severe trauma). Dental caries and malocclusion were considered co-variables. Contextual variables were the Social Vulnerability Index and type of school. Ethical approval and consent forms were obtained. Data were analyzed using SPSS for Windows 19.0 and HLM 6.06, including frequency distribution, chi-squared test and multilevel approach (p < 0.05). RESULTS: The prevalence of a negative impact on OHRQoL in children with severe trauma was 55.9%. The TDI negatively impacted emotional and social domains of OHRQoL. A multilevel analysis revealed a significant difference in OHRQoL according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; ICC = 0.16). The negative impact on OHRQoL was higher in girls (p = 0.009), younger children (p = 0.023), with severe TDI (p = 0.014), those from public schools (p = 0.017) and whose parents had a lower education level (p = 0.001). CONCLUSION: Severe trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.

Malocclusion and oral health-related quality of life in Brazilian school children.

OBJECTIVE: To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument. MATERIALS AND METHODS: A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05). RESULTS: Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. CONCLUSIONS: Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Oral manifestations and treatment of a child with Sjögren's syndrome.

Sjögren's syndrome (SS) is a chronic inflammatory systemic autoimmune disease affecting the exocrine, salivary and lacrimal glands. The condition occurs more often in adults and is rare in childhood. SS should be considered in the differential diagnosis of recurrent parotitis and keratoconjunctivitis sicca. Oral manifestations include early tooth decay and xerostomia. Treatment consists of operative dentistry and saliva management. This paper reports a case of a 10-year-old Brazilian boy with SS, stressing the oral manifestations, treatment conduct, clinical importance and need for an early diagnosis in order to improve the patient's quality of life.

Dental caries and social factors: impact on quality of life in Brazilian children

The objective of this study was to evaluate the impact of dental caries and social determinants in the Oral Health Related Quality of Life (OHRQoL) of children in Belo Horizonte, Brazil. This is a population-based cross-sectional study with a representative sample of 1,204 children aged 8 to 10 years randomly selected from 19 public and private schools. The children were clinically examined at school by two trained and calibrated examiners (Kappa = 0.78 - 1.00). The Decayed, Missing and Filled Teeth Index (DMF-T and dmf-t) was used for the diagnosis of dental caries. The social factors were determined by parents’/caregivers’ schooling, household income, number of people in the household, type of school, and by the Social Vulnerability Index. The Brazilian version of the Child Perceptions Questionnaire for ages 8 to 10 years was used to assess the impact on quality of life. A total of 278 (23.1%) out of 1,204 children had at least one cavitated carious lesion and 47.0% presented a negative impact on OHRQoL. In the final multivariate Poisson’s regression model, household income and presence of untreated dental caries were statistically associated with a negative impact on OHRQoL (p < 0.001).Children with dental caries and from low-income families had a higher negative impact on OHRQoL.

Academic trajectories of dental researchers receiving CNPq's productivity grants.

The present study analyzed the profile of dental researchers receiving grants related to their productivity in research from the Brazilian National Research and Development Council (CNPq). Data collection was carried out in March 2008, using the Brazilian database for curriculum vitae (Lattes Format). There were 144 researchers registered in the database and linked to 25 institutions. These researchers published a total of 12,997 full-text articles, 6,927 of which were published in the last 5 years. Category 1 grant holders (n=77) were responsible for 53.5% of this production; Category 2 grant holders (n=65) were responsible for 45.1%; Senior grant holders (n=2) were responsible for 1.4%. Regarding institutional affiliation, 90.3% of the research grants holders develop activities at public institutions and 9.7% develop activities in private institutions. Furthermore, 84.0% of the researchers are linked to institutions located in the southeast region of Brazil and 75.0% of the researchers perform their activities in the state of São Paulo. This study performed a mapping of the distribution of CNPq researchers, revealing a concentration in the southeast region of the country, especially in the state of São Paulo. The findings of the present study also demonstrate the important contribution of grant holders to the scientific production in dentistry in Brazil.

Evaluation of the dental structure loss produced during maintenance and replacement of occlusal amalgam restorations.

The aim of this in vitro study was to evaluate four different approaches to the decision of changing or not defective amalgam restorations in first primary molar teeth concerning the loss of dental structure. Ditched amalgam restorations (n = 11) were submitted to four different treatments, as follows: Control group - polishing and finishing of the restorations were carried out; Amalgam group - the ditched amalgam restorations were replaced by new amalgam restorations; Composite resin group - the initial amalgam restorations were replaced by composite resin restorations; Flowable resin group - the ditching around the amalgam restorations was filled with flowable resin. Images of the sectioned teeth were made and the area of the cavities before and after the procedures was determined by image analysis software to assess structural loss. The data were submitted to ANOVA complemented by the Student Newman Keuls test (p < 0.05). The cavities in all the groups presented significantly greater areas after the procedures. However, the amalgam group showed more substantial dental loss. The other three groups presented no statistically significant difference in dental structure loss after the re-treatments. Thus, replacing ditched amalgam restorations by other similar restorations resulted in a significant dental structure loss while maintaining them or replacing them by resin restorations did not result in significant loss.

Academic trajectories of dental researchers receiving CNPq's productivity grants

The present study analyzed the profile of dental researchers receiving grants related to their productivity in research from the Brazilian National Research and Development Council (CNPq). Data collection was carried out in March 2008, using the Brazilian database for curriculum vitae (Lattes Format). There were 144 researchers registered in the database and linked to 25 institutions. These researchers published a total of 12,997 full-text articles, 6,927 of which were published in the last 5 years. Category 1 grant holders (n=77) were responsible for 53.5 percent of this production; Category 2 grant holders (n=65) were responsible for 45.1 percent; Senior grant holders (n=2) were responsible for 1.4 percent. Regarding institutional affiliation, 90.3 percent of the research grants holders develop activities at public institutions and 9.7 percent develop activities in private institutions. Furthermore, 84.0 percent of the researchers are linked to institutions located in the southeast region of Brazil and 75.0 percent of the researchers perform their activities in the state of São Paulo. This study performed a mapping of the distribution of CNPq researchers, revealing a concentration in the southeast region of the country, especially in the state of São Paulo. The findings of the present study also demonstrate the important contribution of grant holders to the scientific production in dentistry in Brazil.

Este estudo teve como objetivo verificar o perfil dos pesquisadores de Odontologia, bolsistas de produtividade em pesquisa, do Conselho Nacional de Desenvolvimento e Pesquisa (CNPq). A coleta dos dados foi realizada em março de 2008, a partir da base de dados do curriculum vitae (Plataforma Lattes). Observou-se que estavam registrados 144 pesquisadores vinculados a 25 instituições brasileiras de ensino e pesquisa. Esses pesquisadores publicaram um total de 12.997 artigos completos, sendo 6.927 produzidos nos últimos 5 anos. Os bolsistas da categoria 1 (n=77) foram responsáveis por 53,5 por cento dessa produção, os da categoria 2 (n=65) por 45,1 por cento e os bolsistas seniores (n=2) por 1,4 por cento. Em relação ao vínculo institucional, 90,3 por cento dos pesquisadores bolsistas desenvolvem suas atividades em instituições públicas e 9,7 por cento em instituições privadas. Observou-se ainda que 84,0 por cento dos pesquisadores estão vinculados a instituições localizadas na região sudeste do Brasil, sendo que do total dos pesquisadores, 75,0 por cento atuam no Estado de São Paulo. Este estudo demonstrou a importante contribuição dos bolsistas para a produção científica da área. Ademais, possibilitou o mapeamento da distribuição desses pesquisadores, evidenciando a concentração dos mesmos na região sudeste do país, especialmente no Estado de São Paulo.

Evaluation of the dental structure loss produced during maintenance and replacement of occlusal amalgam restorations

The aim of this in vitro study was to evaluate four different approaches to the decision of changing or not defective amalgam restorations in first primary molar teeth concerning the loss of dental structure. Ditched amalgam restorations (n = 11) were submitted to four different treatments, as follows: Control group - polishing and finishing of the restorations were carried out; Amalgam group - the ditched amalgam restorations were replaced by new amalgam restorations; Composite resin group - the initial amalgam restorations were replaced by composite resin restorations; Flowable resin group - the ditching around the amalgam restorations was filled with flowable resin. Images of the sectioned teeth were made and the area of the cavities before and after the procedures was determined by image analysis software to assess structural loss. The data were submitted to ANOVA complemented by the Student Newman Keuls test (p < 0.05). The cavities in all the groups presented significantly greater areas after the procedures. However, the amalgam group showed more substantial dental loss. The other three groups presented no statistically significant difference in dental structure loss after the re-treatments. Thus, replacing ditched amalgam restorations by other similar restorations resulted in a significant dental structure loss while maintaining them or replacing them by resin restorations did not result in significant loss.