Agenesia e fatores associados em pacientes portadores de fissura labiopalatina: uma revisão de literatura / Agenesis and associated factors in patients with cleft lip and palate: a review of the literature

Objetivo: verificar as principais agenesias dentárias e os fatores associados em portadores de fissura labiopalatina por meio de uma revisão de literatura. Métodos: foi realizada uma revisão de literatura utilizando as bases de dados PubMed, SciELO e Google Acadêmico. Revisão de literatura: foram incluídos 34 artigos, sendo 2 casos clínicos, 15 estudos retrospectivos, 10 revisões de literatura, 4 estudos de caso-controle e 5 estudos transversais; além de 3 referências escolhidas através de outras buscas para complementar a revisão. A partir dos estudos incluídos no trabalho, foi possível verificar que a maior prevalência ocorre no sexo masculino. E a fissura que mais acomete a população é a transforame incisivo. Pôde-se analisar também que não há causa exata, porém, existem fatores predisponentes, como os ambientais e os hereditários. Considerações finais: esta revisão de literatura poderá auxiliar os profissionais de saúde para a realização de diagnóstico e planejamento precoces, a fim de encontrar o melhor e mais eficiente tratamento para cada caso. O tratamento precoce, por uma equipe multidisciplinar, certamente garantirá uma melhor qualidade de vida aos pacientes.(AU)

Objective: to verify the main dental agenesis and associated factors in cleft lip and palate through a literature review. Methods: a literature review was carried out using PubMed, SciELO and Google Scholar databases. Literature review: 34 studies were included, 2 clinical studies, 1 retrospective study, 10 literature reviews, 4 case-control studies and 5 cross-sectional studies. In addition to 3 references chosen through other searches complementary to the review. From the included studies, it was verified a higher frequency of cleft lift and palate for the male sex, and a higher frequency of more severe clefts, such as the incisive transformation, in comparison to the labiopalatine. It can also be analyzed that there is no exact cause; however, there are environmental and hereditary predisposing factors. Final considerations: this literature review may help health professionals to carry out early diagnosis and treatment planning, in order to find the best and most efficient treatment for each case. Early treatment by a multidisciplinary team will certainly guarantee a better quality of life for patients.(AU)

Validity of the Brazilian version of the Dental Subscale of Children's Fear Survey Schedule.

BACKGROUND: Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) is a tool widely used to assess dental fear in children. AIM: To translate and to verify the psychometric properties, including factor analyses of the Brazilian version of the CFSS-DS (B-CFSS-DS) in two settings. DESIGN: The CFFS-DS was translated into the Portuguese language. In the first cross-sectional study (dental setting), 128 children (age: 4-12 years) participated. Mothers were interviewed; children's dental fear was assessed through the CFSS-DS and the Venham picture test; and child behaviour was assessed using the Frankl Scale. The second was a longitudinal study, with 103 schoolchildren (age: 4-12 years). Two receiver operating characteristic curves were drawn to establish the cut-off points. RESULTS: The B-CFSS-DS version showed good internal consistency in dental and school settings (Cronbach's α = 0.88 and 0.77 respectively) and a good test-retest reliability (Weighted Kappa = 0.767), as well as good criterion and discriminant validities. Factor analyses showed four factors. CONCLUSION: The Brazilian version of the CFSS-DS is a valid tool for dental fear assessment in children aged 4-12 years. Further studies with representative samples should be performed to strengthen the findings of this study, especially in the school setting.

Maternal periodontal disease and adverse perinatal outcomes: is there an association? A hospital-based case-control study.

Objectives: The association between maternal periodontal disease and adverse perinatal outcomes although extensively studied remains unclear. The aim of this study was to evaluate, by a case-control study, conducted in three hospitals the association between preterm birth and/or low birth weight (PTB/LBW) and clinical parameters of maternal periodontal disease. Material and methods: Postpartum women who gave birth to a newborn PTB/LBW (case group), and postpartum women who had babies at full term with normal weight (control group) were included, in 1:2 ratio. Data were collected through medical records, interview, and periodontal clinical parameters. Bivariate analysis was performed to assess the PTB/LBW proportion relative to independent variables and multiple logistic regression analysis to assess the association between adverse perinatal outcomes and independent variables. Results: The sample consisted of 148 cases and 296 controls. By the 148 postpartum women with PTB/LBW in case group, 126 (87.5%) had preterm birth, and 75 (50.7%) had PTB and LBW. The periodontal status and generalized periodontitis presence were not associated with any adverse pregnancy outcomes. Having made four or more prenatal visits was a protective factor for all outcomes. The history of previous PTB/LBW was a risk factor for new cases of PTB and PTB and/or LBW. The presence of systemic disease was associated with preterm and low birth weight (PTLBW). Preeclampsia and cesarean delivery were associated with all outcomes. Conclusions: The clinical parameters of maternal periodontitis were not considered as a risk factor for the studied adverse perinatal outcomes. Clinical relevance: The present study demonstrated no association between maternal periodontitis and PTB/LBW.

Maternal and Child Clinic, Dental School, University of Passo Fundo (UPF): patient profile / Clínica Materno-Infantil da Faculdade de Odontologia - Universidade de Passo Fundo (UPF): perfil dos pacientes

ABSTRACT Objective: Characterizing the profile of patients seen at the Maternal and Child Clinic from the University of Passo Fundo Dental School. Methods: 694 records were evaluated in the years 2000 to 2011. Demographic (gender, age and place of residency), clinical and therapeutic variables (previous dental experience, caries, reason for dental appointment, procedures performed, number of appointments and completion of treatment) were collected for descriptive statistical analysis and associations. Results: There was a higher demand for treatment from male children (51.4%) aged 25 to 36 months (61.4%), being 86% of patients from Passo Fundo, Rio Grande do Sul. It was also found that 51% of patients had caries and the main reason for dental appointment was treating such lesion (43.2%). Among the most commonly performed procedures, the non-invasive treatments (49.4%) were the ones that occurred more frequently. Regarding the studied variables, there was an association between children aged 25 - 36 months, living in Passo Fundo, and caries treatment. Conclusion: The evaluated and associated data allowed the definition of the profile of patients seen at the Maternal and Child Clinic. The great majority of patients were male subjects aged 25 -36 months, from Passo Fundo, and who had not undergone previous dental treatment, being caries the major reason for appointment. This study traces the profile of patients and reinforces the need for early preventive treatment and proposals for this age group, aiming at decreasing the need for treatment and reducing diseases in children.

RESUMO Objetivo: Caracterizar o perfil do paciente atendido na clínica materno-infantil da FO-UPF. Métodos: Avaliaram-se 694 prontuários de 2000 a 2011. As variáveis demográficas (gênero, idade e procedência), clínicas e terapêuticas (experiência odontológica anterior, experiência de cárie, motivo da consulta, procedimentos realizados, número de consultas e conclusão do tratamento), foram coletadas para análise estatística descritiva, e associações. Resultados: Observou-se maior procura de atendimento de crianças do gênero masculino (51,4%), com idade entre 25 a 36 meses (61,4%) e que 86% dos pacientes residiam em Passo Fundo-RS. Verificou-se também que, 51% apresentavam cárie e que o principal motivo das consultas foi tratamento da cárie dental (43,2%). Dentre os procedimentos mais realizados, os tratamentos não invasivos (49,4%) foram os mais verificados. Em relação as variáveis estudadas foi encontrada associação entre as crianças que residiam em Passo Fundo, possuíam entre 25 a 36 meses e buscaram atendimento para tratar lesões cariosas. Conclusão: Os dados avaliados e associados, permitiram definir o perfil dos pacientes atendidos na clínica materno-infantil: pertencem ao gênero masculino na sua maioria, estão na faixa etária dos 25 a 36 meses, residem na cidade de Passo Fundo, não possuíam experiência odontológica anterior, apresentavam experiência de cárie ao chegar à clínica e a cárie dentária, representou o principal motivo para as consultas. Este estudo traça o perfil do paciente e fortalece a necessidade de programas e propostas para o atendimento ainda mais precoce e preventivo nesta faixa etária, para que se consiga diminuir as necessidades de tratamento e a doença nestas crianças.

Early-life events and developmental defects of enamel in the primary dentition.

OBJECTIVE: To investigate the occurrence of developmental defects of enamel (DDE) in the primary teeth of children aged 24-36 months and their association with early-life events. METHODS: This study was undertaken with children aged 24-36 months in Pelotas, Southern Brazil. Information on demographic and socioeconomic characteristics, events occurring during pregnancy and neonatal events was collected previously. In this study, information on the health-related behaviours of mothers and children was collected using questionnaires and information about children's oral health was achieved through clinical oral examination. The outcome, the prevalence of DDE (≥1), was determined using the DDE index (FDI). Bivariate and multivariate logistic regression analyses were performed. RESULTS: Five hundred and three mother/child dyads were evaluated, and 13.1% of the children had DDE. Multivariate analysis showed that children with Apgar scores less than 7 had around 2.5-fold higher odds of developing DDE than children with Apgar scores between 7 and 10 (OR = 2.78; 95% confidence interval [CI], 1.35-5.73). The analysis of different types of enamel defects shows that the presence of hypoplasia (OR 3.13; 95% CI, 1.35-7.27) and diffuse opacities (OR 3.95; 95% CI, 1.68-9.27) remained associated in adjusted analysis with Apgar scores. CONCLUSION: Early-life events may cause DDE. A lower Apgar score was associated with a higher prevalence of enamel defects.

Reabilitação estética após fratura mandibular unilateral e perda precoce de dentes anteriores: relato de caso

Discutir reabilitação de um caso clínico de avulsão precoce de dentes decíduos com fratura mandibular unilateral ocorrida após uma queda de três metros de altura. Relato de caso: paciente do gênero masculino, leucoderma, 2 anos e 5 meses de idade, apresentou-se na emergência do Hospital São Vicente de Paulo na cidade de Passo Fundo - RS com história de queda da laje da casa que estava em reforma. Ao exame físico intraoral, observou-se ausência dos elementos dentários 51 e 61, equimose em região mandibular unilateral e fratura mandibular. Como tratamento adotado utilizou-se um mantedor de espaço estético- -funcional após a redução da fratura mandibular. Considerações finais: a ausência dos padrões de sorriso das crianças influencia a saúde e qualidade oral de vida de duas maneiras, no aspecto psicológico que inclui autopercepção da criança do seu próprio sorriso e o aspecto social que inclui a utilização do sorriso para demonstração de sentimentos. No caso relatado, o paciente embora jovem valorizava a questão estética e solicitou a reabilitação, fator importante a ser considerado, pois a autoimagem e a autoestima estão em formação e se não bem trabalhadas podem trazer consequências psicológicas para a vida adulta

Are Maternal Factors Predictors for Early Childhood Caries? Results from a Cohort in Southern Brazil

Abstract This study aimed to determine the influence of maternal factors on the early development of dental caries in Brazilian preschoolers. This cross-sectional study was nested in a cohort of adolescent mothers. The current wave was performed when the children were aged 24 to 42 months. The questionnaire-based survey targeted adolescent mothers and included demographic and socioeconomic variables as well as the maternal education level. In addition, clinical examinations were performed on the mothers and their children. Mothers were assessed for decayed, missing and filled teeth in the permanent dentition (DMFT index) and gingival assessment; their children were assessed for decayed, missing and filled teeth in the deciduous dentition (dmft index). Poisson regression with robust variance was used to estimate the prevalence ratio, risk ratio and 95% confidence intervals. This data was also used to identify the maternal risk factors associated with the outcomes (prevalence and severity of childhood caries). A total 538 mother-child dyads were evaluated; the prevalence of early childhood caries was 15.1% and maternal caries was 74.4%. After the adjustment, the children that exhibited a greater incidence of dental caries were from mothers of low socioeconomic status, or from those presenting decayed teeth and higher rates of gingival bleeding. The results of this study suggest that the oral health of mothers is a potentially important risk factor for the development of early childhood dental caries. Public health planners should consider this information when planning interventions in order to prevent the occurrence of early dental caries.

Resumo Objetivo deste estudo foi determinar a influência de fatores maternos sobre o desenvolvimento de cárie em pré-escolares brasileiros. Este estudo transversal foi aninhado em uma coorte de mães adolescentes. Esta fase foi realizada quando as crianças estavam com idades entre 24 a 42 meses. O questionário aplicado às mães adolescentes incluiu variáveis demográficas, socioeconômicas e a escolaridade materna. Os exames clínicos foram realizados nas mães e em seus filhos. O exame clínico das mães avaliou dentes cariados, perdidos e restaurados na dentição permanente (CPOD) e condição gengival; o exame clínico dos filhos avaliou dentes cariados, perdidos e restaurados na dentição decídua (ceo-d). Regressão de Poisson com variância robusta foi utilizada para estimar a razão de prevalência, risco relativo e os intervalos de confiança de 95%. Os dados também foram utilizados para identificar os fatores de risco maternos associados com o desfecho (prevalência e severidade da cárie na infância). No total, foram avaliados 538 díades mãe-criança; a prevalência de cárie precoce na infância foi de 15,1% e a cárie materna ocorreu em 74,4%. Após ajuste, as crianças que apresentaram uma maior incidência de cárie dentária eram filhas de mães de baixo nível socioeconômico, que apresentam mais dentes cariados e mais sangramento gengival. Os resultados deste estudo sugerem que a saúde bucal das mães é um fator de risco potencialmente importante para o desenvolvimento da cárie da primeira infância. Gestores de saúde pública devem considerar esta informação ao planejar intervenções, a fim de prevenir a ocorrência de cárie da primeira infância.

Are Maternal Factors Predictors for Early Childhood Caries? Results from a Cohort in Southern Brazil.

This study aimed to determine the influence of maternal factors on the early development of dental caries in Brazilian preschoolers. This cross-sectional study was nested in a cohort of adolescent mothers. The current wave was performed when the children were aged 24 to 42 months. The questionnaire-based survey targeted adolescent mothers and included demographic and socioeconomic variables as well as the maternal education level. In addition, clinical examinations were performed on the mothers and their children. Mothers were assessed for decayed, missing and filled teeth in the permanent dentition (DMFT index) and gingival assessment; their children were assessed for decayed, missing and filled teeth in the deciduous dentition (dmft index). Poisson regression with robust variance was used to estimate the prevalence ratio, risk ratio and 95% confidence intervals. This data was also used to identify the maternal risk factors associated with the outcomes (prevalence and severity of childhood caries). A total 538 mother-child dyads were evaluated; the prevalence of early childhood caries was 15.1% and maternal caries was 74.4%. After the adjustment, the children that exhibited a greater incidence of dental caries were from mothers of low socioeconomic status, or from those presenting decayed teeth and higher rates of gingival bleeding. The results of this study suggest that the oral health of mothers is a potentially important risk factor for the development of early childhood dental caries. Public health planners should consider this information when planning interventions in order to prevent the occurrence of early dental caries.

Maternal care influence on children's caries prevalence in southern Brazil.

This study aimed to investigate the influence of specific maternal-factors on caries prevalence in offspring. This cross sectional study was conducted in Pelotas, Brazil nested in a cohort of adolescent mothers with children aged 24-42 months. A questionnaire was administered to collect information in relationship to socio-economic, demographic, and behavioral maternal variables. The outcome (children's dental caries prevalence - dmfs > 0) was collected from clinical examinations. Bivariate and multivariate analyses were conducted. A total of 538 mother/child dyads were evaluated and 15.1% of the children exhibited caries. Adjusted multivariate analysis showed children from mothers living without partners (p < 0.027) had more caries than those living with partners. Maternal perception of a child's oral health was associated to occurrence of caries, particularly when mothers classified their child as poor and these children had a higher level of caries. In addition, mothers accurately evaluated their child's teeth when associated with caries occurrence. Maternal oral health care practices were associated with children's caries prevalence. Our results demonstrated mothers accurately evaluated the oral health of their offspring.

Avaliação da utilização de dentifrício fluoretado em crianças

Introdução: o uso de dentifrício fluoretado é uma das principais formas de prevenção e controle da doença cárie em crianças. Objetivo: avaliar a utilização de dentifrícios fluoretados por crianças que procuraram atendimento odontológico em uma instituição de ensino superior. Sujeitos e método: este estudo transversal envolveu pais/responsáveis e crianças que procuraram atendimento nas Unidades de Clínica Infantil da Faculdade de Odontologia da Universidade Federal de Pelotas, no período de 14 a 29 de janeiro de 2014. Foi realizada uma entrevista com o responsável para a coleta de dados demográficos e socioeconômicos, hábitos de higiene e visitas odontológicas prévias. Foi mostrado um folheto ilustrativo sobre as quantidades de dentifrício e solicitou-se ao responsável que colocasse o dentifrício na escova. As escovas foram pesadas em balança de precisão. Os dados foram analisados no programa Stata 10.0. Resultados: participaram do estudo 87 crianças, com idades entre 3 e 12 anos, das quais 50 (56,8%) frequentavam regularmente a instituição. O dentifrício fluoretado na concentração adequada era usado por 82 crianças (96,5%) e foi introduzido antes de 1 ano de idade em 27 delas (31,8%). Sessenta e oito por cento das crianças era responsável pela própria escovação e 73,6% pela colocação de dentifrício na escova. Conclusões: os responsáveis desconheciam a idade correta para introdução do dentifrício e os riscos de fluorose. Os achados sugerem que mais esforços devem ser empregados na orientação do correto uso de dentifrícios fluoretados por crianças, principalmente em ambiente acadêmico.

Validation of the digital photographic assessment to diagnose traumatic dental injuries.

INTRODUCTION: Alternatives for monitoring dental trauma in epidemiological surveys may be useful, as data collection of epidemiological investigation can be jeopardized due to several conditions. AIM: To investigate the validity of standard digital photographs to determine the occurrence of anterior dental trauma compared to the clinical examination in an epidemiological survey. METHODS: Participants were children aged 8-12 years old attending both private and public schools; children were clinically evaluated for the assessment of dental trauma, and standard photographs were taken from maxillary and mandibular permanent incisors of each child. Validity was determined by calculating the percentages and respective 95% confidence interval of sensitivity, specificity, positive predictive value, and negative predictive value. Cohen's kappa statistic was also used. RESULTS: A total of 412 children were included, totaling 3296 teeth assessed for dental trauma presence. The prevalence of dental trauma was 11.2% (95% CI 8.29-14.61) and 10.2% (95% CI 7.45-13.53), respectively, for the clinical examination and the photographic method. Agreement between the gold standard and the photographic diagnosis was good: 0.64 for the prevalence of dental trauma and 0.66 for diagnosis of dental trauma on a tooth basis. The diagnosis through the photographic method had higher specificity (96.7%) than sensitivity (65.2%). High positive likelihood ratio and low negative likelihood ratio were also observed. CONCLUSION: The photographic assessment method of dental trauma was valid and reliable as compared to the oral clinical examination.

Maternal care influence on children's caries prevalence in southern Brazil

Abstract This study aimed to investigate the influence of specific maternal-factors on caries prevalence in offspring. This cross sectional study was conducted in Pelotas, Brazil nested in a cohort of adolescent mothers with children aged 24-42 months. A questionnaire was administered to collect information in relationship to socio-economic, demographic, and behavioral maternal variables. The outcome (children's dental caries prevalence - dmfs > 0) was collected from clinical examinations. Bivariate and multivariate analyses were conducted. A total of 538 mother/child dyads were evaluated and 15.1% of the children exhibited caries. Adjusted multivariate analysis showed children from mothers living without partners (p < 0.027) had more caries than those living with partners. Maternal perception of a child's oral health was associated to occurrence of caries, particularly when mothers classified their child as poor and these children had a higher level of caries. In addition, mothers accurately evaluated their child's teeth when associated with caries occurrence. Maternal oral health care practices were associated with children's caries prevalence. Our results demonstrated mothers accurately evaluated the oral health of their offspring.

Longevity of posterior restorations in primary teeth: results from a paediatric dental clinic.

OBJECTIVES: The aim of this retrospective study was to evaluate the longevity of restorations in the posterior primary teeth of children attending to a public paediatric dental clinic and to test the factors associated with failures. METHODS: Patient records of 329 children (162 boys and 166 girls) were used for collecting and analyzing data. A total of 565 restorations in primary teeth were included in the study. All children enrolled in the study were classified as high caries risk. The longevity of restorations from their placement until failure (up to 4 years of follow-up) was assessed using the Kaplan-Meier survival curves with log-rank test. Multivariate Cox regression analysis with shared frailty (p<0.05) was used to assess the factors associated with failures. RESULTS: Up to 4 years of follow-up, the annual failure rates were 9.5% for composite fillings, 12.2% for light-cured glass ionomer restorations, and 12.9% for conventional glass ionomer restorations with statistical difference between the materials (p=0.014). Glass ionomer restorations had a higher risk of failure over time compared with composites (HR 1.86, 95% CI 1.17-2.97). In crude analysis, Class II restorations showed lower survival rate than Class I restorations (p=0.031) but lost significance after adjustments. CONCLUSIONS: Our findings suggested that the material influenced the survival rate of primary posterior restorations, with composite presenting the best performance. CLINICAL SIGNIFICANCE: Differences were observed between restorative materials with different properties in primary teeth up to 4 years of follow-up. This study provides valuable information regarding the primary teeth posterior restoration longevity in a paediatric population with restorations performed under daily life clinical environment.