Is There Variation in the Morphology of the Frontal Sinus in Individuals with Different Craniofacial Patterns? A Systematic Review with Meta-Analysis.

To evaluate differences in the morphology of the frontal sinus in adolescents and adults with different craniofacial patterns, searches up to April 2024 were conducted in six databases and other information sources to identify observational studies. Study selection, data extraction, and quality assessment using the NOS scale were performed independently by two reviewers. Random effects meta-analyses were conducted to estimate the difference in frontal sinus measurements between different craniofacial skeletal patterns (α = 0.05). The certainty of the evidence was evaluated according to GRADE. Fourteen studies were included in the review. All studies had methodological limitations that affected their quality. The syntheses showed that skeletal Class II subjects presented a significantly smaller width of the frontal sinus than skeletal Class I subjects (MD = 0.56; 95% CI: 0.38, 0.74; p < 0.0001; I2 = 3%). Skeletal Class III subjects showed a frontal sinus width (MD = -0.91; 95% CI: -1.35, -0.47; p < 0.0001; I2 = 36%) and area (MD = -28.13; 95% CI: -49.03, -7.23; p = 0.0084; I2 = 66%) significantly larger than those of the skeletal Class I subjects. The available evidence suggests a positive relationship between mandibular and frontal sinus size. There is limited evidence to make reliable estimates of the association of other craniofacial patterns and frontal sinus characteristics. These reported results are not conclusive and should be evaluated carefully due to the very low certainty of the evidence. The current evidence is scarce and consists of studies with methodological limitations; the results of the studies are often inconsistent, and the pooled estimates are imprecise. New high-quality research is still necessary.

Maternal Knowledge of Oral Health During Pregnancy and Childbirth.

OBJECTIVE: This cohort study was to investigate maternal knowledge of the oral health of woman and children during pregnancy and after childbirth, and the associated factors. METHODS: Groups of women participating in a public prenatal dental care programme in Brazil were assessed, in two different stages. In the first stage, pregnant women were assessed for their own oral health. In the second stage, after childbirth, women were assessed for the oral health of their child. The examiner assigned a maternal knowledge score to the questionnaires, considering the ideal alternatives within the context of oral health promotion as correct answers. Statistical analysis included the Kruskal-Wallis and multiple linear regression tests, considering a level of significance of P < 0.05. RESULTS: Ninety-eight women were included in the study, with a mean age 26.27 years (SD 6.51). In the regression analysis, the maternal knowledge score was associated with the presence of myths about oral health (P < 0.01), the children first dental appointment in the first year of life (P = 0.07), the presence of a non-nutritious sucking habit (P < 0.01), considering dental treatment to be important during pregnancy (P < 0.01), and having been instructed on oral health during pregnancy (P < 0.01) and after the children birth (P = 0.02). CONCLUSION: This study suggests that the women showed a regular score of knowledge about their oral health and that of their children, as they still believed in some myths about oral health and the risks of dental treatment during pregnancy. Women who received guidance on oral health in pregnancy and after birth showed higher knowledge of their oral health and that of their children, demonstrating the importance of carrying out health promotion actions during pregnancy and the first years of the child's life.

Evaluation of parasite contamination on toothbrushes in children in Southeastern Brazil / Evaluación de la contaminación parasitaria en cepillos de dientes en niños del sudeste de Brasil

ABSTRACT Introduction : The toothbrush is an important object for the hygiene of the oral cavity and an effective mechanism to remove the oral waste. Objective : To evaluate the perception of care, storage and parasitic contamination of toothbrushes in children with special health care needs (CSHCN) and children without special health care needs (CWSHCN) in Southern of Minas Gerais State. Material and Methods : This is an observational cross-sectional non-randomized study. The population consisted in 54 children, with age between 7 and 14 years. The questionnaire was distributed to patients to evaluate the perception of care and storage of children's toothbrushes. Investigation of toothbrushes contamination was performed by parasitological examination and real-time polymerase chain reactions. Results : Regarding the procedures performed after brushing, 50.0% of children with special health care needs (CSHCN) and 56.3% of children without special health care needs (CWSHCN) report washing their brush bristles with water (p <0.001). Both groups did not use an antiseptic solution on toothbrushes. 73.3% of (CSHCN) and 58.7% of (CWSHCN) answered that they use some protection (brush holder and bathroom cabinet) to avoid exposure of brushes to the environment (p <0.001). Conclusion : The children investigated by the study presented good conditions of care and storage of their toothbrushes. No contamination by pathogenic parasites was found during the study period.

RESUMEN Introducción : El cepillo de dientes es un objeto importante para la higiene de la cavidad bucal y un mecanismo eficaz para eliminar los residuos bucales. Objetivo : Evaluar la percepción del cuidado, almacenamiento y contaminación parasitaria de los cepillos dentales en niños con necesidades especiales de salud (CSHCN) y niños sin necesidades especiales de salud (CWSHCN) en el sur del estado de Minas Gerais. Material y Métodos : Se trata de un estudio observacional transversal no aleatorio. La población consistió en 54 niños, con edad entre 7 y 14 años. El cuestionario fue distribuido a los pacientes para evaluar la percepción del cuidado y almacenamiento de los cepillos dentales de los niños. La investigación de la contaminación de los cepillos dentales se realizó mediante un examen parasitológico y reacciones en cadena de la polimerasa en tiempo real. Resultados : En cuanto a los procedimientos realizados tras el cepillado, el 50,0% de los niños con necesidades especiales de atención sanitaria (NCNEAS) y el 56,3% de los niños sin necesidades especiales de atención sanitaria (NSNEAS) refieren lavar las cerdas del cepillo con agua (p <0,001). Ambos grupos no utilizaron una solución antiséptica en los cepillos de dientes. El 73,3% de los (NCNEAS) y el 58,7% de los (NSNEAS) contestaron que utilizan alguna protección (portacepillos y mueble de baño) para evitar la exposición de los cepillos al medio ambiente (p <0,001). Conclusiones : Los niños investigados por el estudio presentaron buenas condiciones de cuidado y almacenamiento de sus cepillos dentales. No se encontró contaminación por parásitos patógenos durante el período de estudio.

Use of P-CPQ to measure the impact of oral health on the quality of life of children with special health care needs / Uso de la P-CPQ para medir el impacto de la salud oral en la calidad de vida de los niños con necesidades especiales de atención médica / Uso do P-CPQ para mensuração do impacto da saúde bucal na qualidade de vida de crianças com necessidades especiais de saúde

Abstract Introduction and objective: the WHO defined the concept of quality of life as the self-perception that the individual has about his position in the social, cultural and ideological context, being these factors the main responsible for denoting the worst parameters regarding oral health care during the dental clinical examination performed by the dentist. To evaluate the impact of oral health on the quality of life of children with special health care needs aged 7 to 14 years old and the influence of different types of specialties on the quality of life, in the view of parents/caregivers in the Brazil southeast region. Materials and methods: the sample was composed of 62 children enrolled in municipal public schools and the Association of Parents and Friends of the Exceptional. The validated Parental- Caregivers Perception Questionnaire (P-CPQ) was used as an instrument for data collection, applied in the home environment and answered by the main responsible. The relation between demographic factors, type of special need and P-CPQ was evaluated with alpha of 0.05. Results: the worst parameters in Family Impact Scale were observed when the mother and father was responsible for data transmission (p= 0.004). Oral health was associated with the worst parameters of oral symptoms on quality of life in the view of parents (p = 0.012). There was no statistically significant difference regarding the impact of the child's type of specialty on quality of life. Conclusion: the variables caregiver and oral health status child are related to the worst indicators regarding the impact of oral health on quality of life.

Resumen Introducción y objetivo: la OMS definió el concepto de calidad de vida como la autopercepción que tiene el individuo sobre su posición en el contexto social, cultural e ideológico, siendo estos factores los principales responsables de denotar los peores parámetros en cuanto al cuidado de la salud bucal durante el examen clínico dental realizado por el dentista. Evaluar el impacto de la salud bucal en la calidad de vida de los niños con necesidades especiales de atención de la salud de 7 a 14 años de edad y la influencia de los diferentes tipos de especialidades en la calidad de vida, en opinión de los padres/cuidadores de la región sudoriental del Brasil. Materiales y métodos: la muestra se compuso de 62 niños matriculados en escuelas públicas municipales y en la Asociación de Padres y Amigos de los Excepcionales. Se utilizó el cuestionario validado Parental- Caregivers Perception Questionnaire (P-CPQ) como instrumento para la reunión de datos, aplicado en el entorno doméstico y contestado por el principal responsable. La relación entre los factores demográficos, el tipo de necesidad especial y el P-CPQ se evaluó con un alfa de 0,05. Resultados: los peores parámetros en la Escala de Impacto Familiar se observaron cuando la madre y el padre fueron los responsables de la transmisión de datos (p= 0,004). La salud oral se asoció con los peores parámetros de los síntomas orales sobre la calidad de vida a juicio de los padres (p = 0,012). No hubo diferencias estadísticamente significativas en cuanto al impacto del tipo de especialidad del niño en la calidad de vida. Conclusión: las variables "cuidador" y "estado de salud bucal del niño" se relacionan con los peores indicadores relativos al impacto de la salud bucal en la calidad de vida.

Resumo Introdução e objetivo: a OMS definiu o conceito de qualidade de vida como a autopercepção que o indivíduo tem sobre sua posição no contexto social, cultural e ideológico, sendo esses fatores os principais responsáveis por denotar os piores parâmetros quanto aos cuidados com a saúde bucal durante o exame clínico odontológico realizada pelo dentista. Avaliar o impacto da saúde bucal na qualidade de vida de crianças com necessidades especiais de cuidados de saúde de 7 a 14 anos de idade e a influência de diferentes tipos de especialidades na qualidade de vida, na visão dos pais/cuidadores na região sudeste do Brasil. Materiais e métodos: a amostra foi composta por 62 crianças matriculadas nas escolas públicas municipais e na Associação de Pais e Amigos dos Excepcionais. Foi utilizado o Parental- Caregivers Perception Questionnaire (P-CPQ) como um instrumento de mensuração, aplicado no ambiente familiar e respondido pelo responsável principal. A relação entre fatores demográficos, tipo de necessidade especial e o P-CPQ foi avaliada com alfa de 0,05. Resultados: os piores parâmetros em relação à qualidade de vida foram observados quando a mãe foi a responsável pela transmissão dos dados (p= 0,004). A variável estado de saúde bucal (p= 0,012) apresentou resultados relevantes quando relacionadas com os piores parâmetros na percepção do impacto da saúde bucal na qualidade de vida na percepção dos cuidadores sobre suas crianças. Não houve diferença estatisticamente significante com relação ao impacto do tipo de especialidade da criança na qualidade de vida. Conclusão: as variáveis cuidador e estado de saúde oral da criança estão relacionadas com os piores indicadores relativos ao impacto da saúde oral sobre a qualidade de vida.

Genetic polymorphisms in interleukin-6 and interleukin-1-beta were associated with dental caries and gingivitis.

OBJECTIVE: Evaluate the association between single nucleotide polymorphisms (SNPs) in Interleukin-6 (IL-6) gene (rs1800795) and in Interleukin-1-beta (IL-1ß) gene (rs1143627 and rs1143629) with dental caries and gingivitis in Brazilian children. MATERIAL AND METHODS: Three hundred and fifty-three children aged 8-11 years were included. Visible biofilm and gingival bleeding were evaluated by Community Periodontal Index. The International System for Detection and Assessment of Carious Lesions (ICDAS) was used to investigate dental caries. Real-time PCR evaluated SNPs in the DNA. Chi-square test, haplotype analysis and logistic regression were applied (alpha of 5%). RESULTS: The GG genotype in rs1800795 (IL-6) decreases the risk of gingivitis in a co-dominant model (p = .05; OR = 0.64). The GG genotype in rs1143627 (IL-1ß) reduces the risk of dental caries (Co-dominant model: ICDAS0 versus ICDAS1-6: p = .05; OR = 0.55. ICDAS0-2 versus ICDAS3-6: p = .02; OR = 0.49. Recessive model: ICDAS0 versus ICDAS1-6: p = .005; OR = 0.48. ICDAS0-2 versus ICDAS3-6: p = .004; OR = 0.45. Logistic regression: ICDAS0-2 versus ICDAS3-6: p = .05; OR = 0.24; CI 95%= 0.05-1.00). The GG genotype in rs1143629 was more frequent in ICDAS0 (p = .05; OR: 0.60). In the haplotype analysis, IL-1ß was associated with gingivitis. CONCLUSION: The rs1800795 in IL-6 gene was associated with gingivitis. The rs1143627 and rs1143629 in IL-1ß were associated with dental caries and gingivitis.

A High-Fat Diet Exacerbates the Course of Experimental Trypanosoma cruzi Infection That Can Be Mitigated by Treatment with Simvastatin.

The protozoan Trypanosoma cruzi is responsible for triggering a damage immune response in the host cardiovascular system. This parasite has a high affinity for host lipoproteins and uses the low-density lipoprotein (LDL) receptor for its invasion. Assuming that the presence of LDL cholesterol in tissues could facilitate T. cruzi proliferation, dietary composition may affect the parasite-host relationship. Therefore, the aim of this study was to evaluate myocarditis in T. cruzi-infected C57BL/6 mice-acute phase-fed a high-fat diet and treated with simvastatin, a lipid-lowering medication. Animals (n = 10) were infected with 5 × 103 cells of the VL-10 strain of T. cruzi and treated or untreated daily with 20 mg/kg simvastatin, starting 24 h after infection and fed with a normolipidic or high-fat diet. Also, uninfected mice, treated or not with simvastatin and fed with normolipidic or high-fat diet, were evaluated as control groups. Analyses to measure the production of chemokine (C-C motif) ligand 2 (CCL2), interferon- (IFN-) γ, interleukin- (IL-) 10, and tumor necrosis factor (TNF); total hepatic lipid dosage; cholesterol; and fractions, as well as histopathological analysis, were performed on day 30 using cardiac and fat tissues. Our results showed that the high-fat diet increased (i) parasite replication, (ii) fat accumulation in the liver, (iii) total cholesterol and LDL levels, and (iv) the host inflammatory state through the production of the cytokine TNF. However, simvastatin only reduced the production of CCL2 but not that of other inflammatory mediators or biochemical parameters. Together, our data suggest that the high-fat diet may have worsened the biochemical parameters of the uninfected and T. cruzi-infected animals, as well as favored the survival of circulating parasites.

Audiovisual distraction methods for anxiety in children during dental treatment: A systematic review and meta-analysis.

BACKGROUND: Dental treatment can cause symptoms such as fear and anxiety. Audiovisual distraction (AD) is a simple and low-cost technique that does not interfere with the dental treatment. AIM: The aim of this study was to perform a systematic review and meta-analysis to evaluate the effectiveness of AD methods for children who experience anxiety during dental treatment. MATERIALS AND METHODS: Two reviewers performed a database search of the studies published between January 1950 and November 2015. The inclusion criteria were papers published in the English language, child samples aged 4-10 years, and use of AD. All potentially relevant studies were identified by the title and the abstract. After the full-text analysis of the potentially relevant studies, the selected studies were included in the systematic review. A meta-analysis calculation was performed for the overall data and the subgroup data. RESULTS: Thirty-seven nonduplicated studies were found. However, after reviewing the articles, only five were included. A high variability was observed among the papers. Tools and questionnaires used to measure the anxiety during dental treatment presented the most common variability. Meta-analysis demonstrated a lower anxiety level in AD method groups when Modified Child Dental Anxiety Scale was used (P = 0.02) with a mean difference (confidence interval) of -8.72 (-16.7, -1.38). CONCLUSION: The AD method is effective for controlling dental anxiety in children.

Posttraumatic displacement management: lateral luxation and alveolar bone fracture in young permanent teeth with 5 years of follow-up.

Dental trauma is an important public health problem due to high prevalence and associated limitations. The external impact accounting for trauma may result in different injury types to teeth and supporting structures. This paper describes a clinical case of tooth trauma in an 8-year-old patient exhibiting the displacement of three permanent teeth with open root apexes. Although the traumatic impact resulted in two injury types to teeth and supporting tissues (lateral luxation and alveolar bone fracture), the therapeutic approach was the same in both situations. The bone and teeth were repositioned by digital pressure, stabilized by semirigid splint, and followed up at every week. After six weeks, the splint was removed. At that moment, the clinical and radiographic findings indicated normal soft/hard tissues and absence of pulp/periodontal pathologies. At the fifth year of follow-up, the treatment success of the case was confirmed, although it has been observed that all lower incisors exhibited pulp obliteration as a consequence of the dental trauma.

Effect of acidic challenge preceded by food consumption on enamel erosion.

OBJECTIVES: This in vitro study aimed to evaluate the effect of food consumption followed by acidic challenge on enamel erosion. METHODS: Seventy-five enamel blocks obtained from bovine teeth were divided randomly into five groups (n=15 per group): GI - erosion with previous immersion in milk; GII - erosion with previous immersion in cheese extract; GIII - erosion with previous immersion in liver extract; GIV - erosion with previous immersion in broccoli extract; and GV - erosive effect of cola drink (control). Over 24 h, the slabs were submitted to 3 pH-cycles, each consisting of immersion in the studied food (GI to GIV) for 5 min followed by immersion in a cola drink for 5 min, and subsequently, the slabs were stored in artificial saliva (110 min). At the end of the pH-cycles, the slabs were stored in artificial saliva for 18 h. Enamel alterations were assessed by profilometry (µm). Data were tested using ANOVA and Scott-Knott's tests (P<.05). RESULTS: Mean erosion depths for enamel (µm) were 0.46 in GI, 0.55 in GII, 0.64 in GIII, 0.54 in GIV, and 1.18 in GVI. Enamel loss by acidic challenge alone (GV) was significantly higher than when the acidic challenges were preceded by food extract immersion. CONCLUSIONS: The data suggest that all studied foods could minimize the erosive effect on enamel.