Associations and discrepancies between global self-ratings of oral health and general health: a Bayesian approach.

OBJECTIVE: To estimate the discrepancies between global ratings of oral health and general health and investigate the factors associated with self-rated oral health (SROH) and self-rated general health (SRGH). METHODS: Data were collected from 502 participants aged 18 to 81 years. A structured questionnaire was used to obtain data regarding sociodemographic characteristics and self-reported conditions. Global self-ratings of oral health and general health were the main outcomes. Discrepancies between self-ratings of oral health and general health were stratified by independent variables. Bayesian ordinal logistic regression models were fitted to estimate the posterior distributions of parameters and 95% credible intervals (95% CrI). RESULTS: The proportion of participants who rated their oral health worse than general health was 28.6% (95% CrI: 24.7-32.3). Negative discrepancies between SROH and SRGH were associated with being men, reporting gingivitis, and lower income. Sex (95% CrI: 1.12-2.25) impacted only on SRGH. Income (SROH - 95% CrI: 1.52-6.40; SRGH - 95% CrI: 1.08-4.56), tertiary education (SROH - 95% CrI: 1.13-2.53; SRGH - 95% CrI: 1.01-2.32), self-reported missing teeth (SROH - 95% CrI: 1.57-3.46; SRGH - 95% CrI: 2.21-4.92), self-reported gingivitis (SROH - 95% CrI: 1.10-2.40; SRGH - 95% CrI: 1.71-3.82), and self-reported chronic health problem (SROH - 95% CrI: 1.38-3.08; SRGH - 95% CrI: 1.61-3.59) impacted on both outcomes. CONCLUSIONS: Substantial discrepancies between self-rated oral health and self-rated general health were found and were associated with being male, reporting gingivitis, and having lower income.

Impact of gingivitis on oral health-related quality of life in 12-year-old schoolchildren of Quito, Ecuador.

PURPOSE: Evaluate the impact of gingivitis on oral health-related quality of life (OHRQoL) amongst 12-year-old schoolchildren from Quito, Ecuador. METHODS: We evaluated 998 school children using the Community Periodontal Index for gingival bleeding and calculus. OHRQoL was assessed with the Child Perceptions Questionnaire 11-14 (CPQ11-14) questionnaire. RESULTS: Of the 998 schoolchildren, 93% had gingival bleeding and 73% had dental calculus. Schoolchildren with more than one sextant with gingival bleeding had 1.18 times higher mean CPQ11-14 (RR 1.18, 95% CI 1.11-1.27) than those with none or just one affected sextant. Male schoolchildren presented a 15% lower mean Child Perceptions Questionnaire (CPQ) (RT 0.85; 95% CI 0.76-0.96). Children whose parents had incomplete secondary education had a 15% lower mean CPQ (RT 0.85; 95% CI 0.77-0.94). Bleeding in more than one sextant was significantly associated with worse quality of life in the emotional well-being (RT 1.40, 95% CI 1.03-1.90) and social well-being domains (RT 1.76, 95% CI 1.32-2.34). CONCLUSION: Gingival bleeding negatively impacted the OHRQoL of 12-year-old Ecuadorian schoolchildren living in Quito.

Application of an ancestrality estimate method through morphoscopic analysis of Brazilian skulls.

The objective of the investigation was to test a technique originating in the United States to verify the accuracy of the ancestry estimate in a sample of Brazilian skulls. The sample consisted of 120 skulls of Brazilian adults from the collection of the Institute of Education and Research in Forensic Sciences (IEPCF), Guarulhos-SP, Brazil, with ancestry determined by routine examination. In the skull, the following structures were analyzed: anterior nasal spine (ANS), inferior nasal aperture (INA), interorbital breadth (IOB) nasal aperture width (NAW), nasal bone structure (NBS), and post bregmatic depression (PBD). The Hefner and Ousley technique was applied to classify ancestry. Data were registered and correctness percentage was obtained. To improve ancestry prediction, Machine Learning techniques were used. Regarding the error of the studied method and the correctness of the complete sample, the study presented a percentage above 50%, with values such as 56.33% for whites and 53.07% for non-whites. The most frequent ANS parameter was marked (37.5%), INA straight (31.7%), IOB wide (38.3%), NAW medium (32.5%) NBS triangular (29.2%), and PBD present (78.3%). The application of the method in the sample of the study showed a limitation to estimate ancestry, suggesting a need for adaptation for its applicability in the Brazilian population.

Proposal of a formula mouth opening reduction assessment, for forensic purposes.

OBJECTIVES: To propose a formula for determining reduced mouth opening due to oral and maxillofacial trauma, based on the normal standard of the Brazilian population. MATERIALS AND METHODS: First, the maximum mouth opening was established, in millimeters, using a digital pachymeter, in patients between 22 and 60 years of age. The opening was measured from the upper to the lower incisor, at maximum amplitude, without pain and overbite. Second, the facial profile type and height were determined. A formula was developed to calculate the percentage of reduced mouth opening based on the normal average. RESULTS: The average mouth opening was found to be 51.71 mm in men and 47.94 mm in women, thus establishing a statistically significant difference in mouth opening between sexes. However, there was no statistically significant difference between age and profile type with mouth opening. The following formulas were developed to calculate the reduced mouth opening, based on the averages found, by using RA= [100-(A.1.93)].0.3 for males and RA= [100-(A.2,08)] .0.3 for female patients. CONCLUSION: Considering that mouth opening tends to be larger in men than in women, valid formulas can be used to determine the correct percentage of reduced mouth opening.

A Psychometric Network Analysis of OHIP-14 across Australian and Brazilian Populations.

OBJECTIVES: The aim of this study was to assess the structural validity of the Oral Health Impact Profile-14 (OHIP-14) instrument in Indigenous and non-Indigenous populations from Australia and Brazil using a network analysis approach. METHODS: Cross-sectional data collected using OHIP-14 were obtained for Indigenous and non-Indigenous populations from Australia and Brazil. Networks were estimated using the Gaussian graphical model. Items of the OHIP-14 instrument are represented as nodes and the partial correlations between items as edges. Dimensionality was assessed using exploratory graph analysis. Structural consistency and item stability were computed using a bootstrap sampling method. Standardized node strength across each dimension was also calculated. RESULTS: Four dimensions were identified across all samples, although the item arrangement of most dimensions presented variation. Similarities with the theoretical domains of the instrument were found. Items from the conceptually derived OHIP-14 domains formed separated clusters or blended with other items in a single dimension. Most dimensions across all samples showed an acceptable structural consistency. Item stability revealed some discrepancies among items of dimensions of both Indigenous networks. CONCLUSION: The psychometric network perspective adopted in this study provides validation of the OHIP-14 structure in Indigenous and non-Indigenous populations. The structural consistency and item stability analyses showed that both Indigenous networks present a higher number of cross-domain items and less defined boundaries between dimensions. These findings indicate that OHIP-14 does not measure attributes in the same extent among different cultures. KNOWLEDGE TRANSFER STATEMENT: This study demonstrates a new analytical framework from which to conceptualize and interpret the construct oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Network graphs facilitate knowledge translation of findings to professionals with no expertise in psychometric methods. OHIP-14 is a valuable tool to oral health research and clinical practice. Differences in conceptions of health may influence the extent that the instrument measures oral health impacts. Consequently, dimension scores do not always provide appropriate measures and should be avoided in research reports and assessments of treatment outcomes.

Influence of school environment on occurrence of traumatic dental injuries in 12 years old children.

BACKGROUND/AIM: Since children spend most of their time in school, some environmental characteristics of the schools may influence the occurrence of traumatic dental injuries (TDI). Therefore, the aim of this cross-sectional study was to assess the prevalence of TDI in 12 years old children in Quito, Ecuador, and its association with some school environmental aspects. MATERIAL AND METHODS: Six calibrated examiners evaluated 998 children from 31 public schools of Quito, to evaluate the occurrence of TDI in anterior teeth. School coordinators answered questionnaires on school physical conditions, promotion of health practices and the occurrence of negative episodes in school. The occlusion and socioeconomic status of the participants were also evaluated. Prevalence of TDI, unadjusted and adjusted by the design effect was calculated. Association between individual and contextual explanatory variables and presence of TDI were evaluated using multilevel Poisson regression analysis (P < .05). RESULTS: TDI prevalence adjusted by design effect was 20.7%. Children studying in schools with patio floor of grass and with access ramps had significantly lower prevalence of TDI than children studying in schools with patio floor of cement and with only stairs, respectively. The prevalence of TDI was also lower in children from schools that offered healthy meals or that had a proper place for oral hygiene. CONCLUSIONS: Schools with adequate physical structures and that promote health practices to their students have a lower prevalence of TDI.

Tooth crown mesiodistal measurements for the determination of sexual dimorphism across a range of populations: A systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to determine whether the tooth crown sexual dimorphism pattern reported in previous small studies can be generalized for a broader range of populations. LITERATURE REVIEW: A systematic literature review was performed by two independent examiners. The following databases were searched from October 2015 to July 2016: PubMed, Scopus, Lilacs, ScienceDirect, Medline, and Cochrane Reviews. No language restrictions were applied to the search. SELECTION CRITERIA: The inclusion criteria comprised original studies investigating mesiodistal permanent teeth that reported the sample population and standard deviation. All right-sided teeth, except the third molars, were measured and separated by sex in the included studies. Thirty-one studies were included in the quantitative data synthesis and meta-analysis. Studies of non-human teeth, skeletal remains, or an overly specific study population were excluded. MAIN RESULTS: Thirty-one trials, involving 6481 participants, provided data for the meta-analysis of teeth. Sexual dimorphism in mesiodistal crowns was found in all teeth across a range of populations, principally in lower canines (5.73%) and maxillary canines (4.72%), followed by the lower second molars (3.54%) and upper second molars(3.20%), and finally in the lower first molars(3.14%) and upper first molars(2.64%). CONCLUSIONS: A small degree of sexual dimorphism exists in all human teeth. Second molars and canines show the greatest sexual dimorphism. Additionally, smaller racial differences are present in mesiodistal crowns among groups living in different geographic areas; however, it is not possible to establish a single value applicable for all populations.

Cohesion, order and information flow in the collective motion of mixed-species shoals.

Despite the frequency with which mixed-species groups are observed in nature, studies of collective behaviour typically focus on single-species groups. Here, we quantify and compare the patterns of interactions between three fish species, threespine sticklebacks (Gasterosteus aculeatus), ninespine sticklebacks (Pungitius pungitius) and roach (Rutilus rutilus) in both single- and mixed-species shoals in the laboratory. Pilot data confirmed that the three species form both single- and mixed-species shoals in the wild. In our laboratory study, we found that single-species groups were more polarized than mixed-species groups, while single-species groups of threespine sticklebacks and roach were more cohesive than mixed shoals of these species. Furthermore, while there was no difference between the inter-individual distances between threespine and ninespine sticklebacks within mixed-species groups, there was some evidence of segregation by species in mixed groups of threespine sticklebacks and roach. There were differences between treatments in mean pairwise transfer entropy, and in particular we identify species-differences in information use within the mixed-species groups, and, similarly, differences in responses to conspecifics and heterospecifics in mixed-species groups. We speculate that differences in the patterns of interactions between species in mixed-species groups may determine patterns of fission and fusion in such groups.

Radiographic evaluation of dental and cervical vertebral development for age estimation in a young Brazilian population

Age estimation is guided by the evaluation of events that happen during the processes of bone and dental development. The purpose of this study was to validate the method of age estimation proposed by Lajolo et al. (2013) through oro-cervical radiographic indices in Brazilians. The study aimed to verify the effectiveness of age estimation equations through dental and cervical vertebrae examinations, in addition to including dental and cervical vertebrae data in new age estimation equations. The sample consisted of panoramic radiographs and teleradiographs from 510 subjects (8-24.9 years). Age estimation methods were applied by assessing the development of seven mandibular teeth, cervical vertebrae and third molars. Techniques used previously have been combinations of radiographic indices: Oro-Cervical Radiographic Simplified Score (OCRSS) and Oro-Cervical Radiographic Simplified Score without Wisdom Teeth (OCRSSWWT). In the second phase of the study, dental maturation, vertebral measurements, and real age were estimated by regression equations. OCRSS and OCRSSWWT had success rates of 67.4% (R2=0.64) and 70.8% (R2=0.62), respectively. When age estimation equations for tooth evaluations were applied, the average error was 1.3 years, and for cervical vertebrae measurements, the error was 1.9 years. When dental variables and the measurements of cervical vertebrae were included, the average error of equations was 1.0 year. Radiographic indices were easy to perform, and after adequate training, are reliable and can be used in forensic practice. The use of the new equations presented in this study is recommended because including cervical vertebrae and dental data provides greater accuracy for age estimation.

Influence of bethanechol on salivary parameters in irradiated patients.

BACKGROUND: Some studies have shown evidence that the prophylactic use of bethanechol chloride (BC) may be useful in preventing the incidence and/or severity of xerostomia (XT). However, the indication of BC in irradiated patients with XT needs to be better characterized. The study aimed to evaluate the influence of BC on XT, salivary flow rate, and salivary composition in patients previously submitted to head and neck radiotherapy. MATERIAL AND METHODS: Forty five irradiated patients complaining of XT used 50 mg/day of BC for 3 months, and the salivary parameters were evaluated in 4 Phases (Before BC therapy, after one month of BC, 2 months of BC, and 3 months of BC). Biochemical analysis included buffering capacity; pH; total protein concentration (TP); amylase concentration (AM); catalase (CAT) and peroxidase (PX) activities. In addition, unstimulated and stimulated salivary flow rates were determined and XT was classified. RESULTS: According to the XT grading system used, patients showed improvement in XT between Phase 1, and Phases 2, 3 and 4. In addition, some changes were observed in TP concentration (decreased); AM concentration (increased); and PX and CAT activities (decreased and increased, respectively) after Phase 2, for stimulated saliva collection (p<0.05). CONCLUSIONS: Our results suggested that when BC was used to treat salivary gland dysfunction induced by head and neck radiotherapy, improvement in XT symptoms, and some changes in saliva composition were shown.

Quality of life related to oral mucositis of patients undergoing haematopoietic stem cell transplantation and receiving specialised oral care with low-level laser therapy: a prospective observational study.

Oral mucositis is a painful condition that occurs in 80% of patients who undergo haematopoietic stem cell transplantation (HSCT). Our objective was to determine the impact of mucositis on quality of life (QoL) of patients subjected to HSCT treated with low-level laser therapy (LLLT). Patients were evaluated: (1) on the first day of treatment; (2) 5 days after autologous or 8 days after allogeneic transplantation; (3) once bone marrow had integrated; and (4) 30 days after discharge. Clinical evaluation was performed using the World Health Organization criteria; oral health QoL was measured using the Oral Health Impact Profile (OHIP-14); and mucositis symptoms with the Patient-Reported Oral Mucositis Symptom (PROMS) scale. The higher the score, the lower the patient's QoL. The OHIP-14 responses showed that at D + 5/D + 8, all domains had the highest scores, while at times 1 and 4, the scores were lower. In the PROMS scale, all domains scored worst at time 2, and the differences between the scores at the four times were statistically significant. The study has shown that QoL improves over time in patients undergoing LLLT therapy for mucositis prevention.

Accuracy and reliability of pulp/tooth area ratio in upper canines by peri-apical X-rays.

Due to the real need for careful staff training in age assessment, in order to improve capacity, consistency and competence, new research on the reliability and repeatability of methods frequently used in age assessment are required. The aim of this study was twofold: first, to test the accuracy of this method for age estimation; second, to obtain data on the reliability of this technique. A sample of 81 peri-apical radiographs of upper canines (44 men and 37 women), aged between 19 and 74years, was used; the teeth were taken from the osteological collection of Sassari (Sardinia, Italy). Three blinded observers used the technique in order to perform the age estimation. The mean real age of the 81 observations was 37.21 (CI95% 34.37 40.05), and estimated ages ranged from 36.65 to 38.99 (CI95%-Ex1 35.42; 41.28; CI95%-Ex2 33.89; 39.41; CI95%-Ex3 35.92; 42.06). The module differences found by the three observers were 3.43, 4.24 and 4.45, respectively for Ex1×Ex2, Ex1×Ex3 and Ex2×Ex3. The module differences observed among real and observed ages were 2.55 (CI95% 1.90; 3.20), 2.22 (CI95% 1.65; 2.78) and 4.39 (CI95% 3.80; 5.75), respectively for Ex1, Ex2 and Ex3. No differences were observed among measurements. This technique can be reproduced and repeated after proper training, since it was found high reliability and accuracy.

Thermographic characterization of masticatory muscle regions in volunteers with and without myogenous temporomandibular disorder: preliminary results.

OBJECTIVES: This study aims to conduct a non-invasive measurement of the cutaneous temperature of selected masticatory muscle regions of volunteers with and without myogenous temporomandibular disorder (TMD), using infrared thermography. METHODS: 23 females (10 myogenous TMD volunteers and 13 controls) were recruited and studied. The temperature at the surface of the facial area over the anterior temporalis and masseter muscles was assessed by medical thermography, using regional lateral views and clinical examination. RESULTS: The temperature levels measured at the masseter and anterior temporalis muscle regions in myogenous TMD volunteers (32.85 ± 0.85 and 34.37 ± 0.64 ºC, respectively) were significantly lower (p < 0.05) than those measured in controls (33.49 ± 0.92 and 34.78 ± 0.44 ºC, respectively). Medical infrared imaging indicated a mean difference of 1.4 ºC between the masseter and anterior temporalis regions. Analysis of the comparison between the absolute and normalized mean temperatures was performed using the pairwise comparison of receiver operating characteristic curves, and no statistically significant difference was observed (p > 0.05). The sensitivity and specificity of the thermographic assessment for the masseter region was of 70% and 73%, respectively and for the anterior temporalis region was of 80% and 62%, respectively. CONCLUSIONS: This method of evaluating masticatory muscle regions of this preliminary study seems to indicate that it can be used as an aid in complimentary diagnosing of TMDs.