Knowledge and perception regarding molar incisor hypomineralisation among dental students and dental hygienist students in Spain: a cross-sectional study.

BACKGROUND: Molar incisor hypomineralisation (MIH) has a high prevalence in the Spanish pediatric population and is a precursor of carious lesions in teeth in which it is present. Although this pathology is included in the curricula of the Degree in Dentistry and the Training Cycle in Oral Hygiene in our country, the contents currently taught seem to be insufficient in relation to the level of knowledge that we have today about this condition. METHODS: A digital questionnaire of 18 questions was sent to a sample of 448 students attending the 4th and 5th year of the Degree in Dentistry and 2nd year of the Training Cycle in Oral Hygiene from different universities and vocational training centers in the Valencian Community. Descriptive and multivariate statistical analysis of the data was subsequently performed. RESULTS: Of the 290 questionnaires that were obtained, 53.8% were from students attending the 2nd year of a training course in oral hygiene and 46.2% were from students pursuing a degree in dentistry. Most of the respondents had heard about MIH (75.2%), mainly through master classes. However, most students had difficulties distinguishing MIH lesions from other lesions (58.3%). The degree of knowledge about MIH was greater among dental students in all the aspects evaluated: prevalence, diagnosis, prevention, and treatment. Of all the students, 83.8% were interested in increasing their training on MIH, especially in the areas of diagnosis and treatment. CONCLUSION: The results of the present study justify the need to expand the content on MIH, both theoretical and practical, in the educational curricula of the Degree in Dentistry and Integrated Vocational Training Centers in Spain.

Salivary metabolomic profile associated with cariogenic risk in children.

OBJECTIVES: To identify the metabolomic differences in the saliva of healthy children versus children with active carious lesions and to estimate the predictive capacity of a model based on the salivary metabolomic profile. METHODS: A study of cases (n = 31) and controls (n = 37) was designed for children aged between 6 and 12 (mean age of the cases: 8.9; controls: 8.7). The said children attended public health centers in Valencia, Spain. Intraoral examinations were performed by a single examiner using ICDAS II diagnostic criteria. Unstimulated total saliva samples were analyzed by nuclear magnetic resonance (NMR) spectroscopy. RESULTS: The dft index for cases was 2.84 while it was 0.19 for the control group, the DMFT index was 1.13 and 0.11, respectively. The predictive model generated by the multivariate PLS-DA analysis projects a separation between the cases and the controls on the score chart with a predictive capacity and generating an area under the curve of 0.71. The metabolites: 3-methyl-2-oxovalerate, 3-hydroxybutyrate, lactate, acetone, citrate, ornithine, ethanolamine, taurine, proline, glycine, mannose, glucose, 1-6-Anhydro-ß-d-glucose and citraconate, are those that show greater significance in the model. In the controls, glycine (Cohen's d = 0.430) and glucose (Cohen's d = 0.560) present higher means compared to the cases. On the contrary, taurine (Cohen's d= -0.474) and mannose (Cohen's d= -0.456) show higher means in cases compared to controls. CONCLUSIONS: Our findings show a difference in the salivary metabolomic profiles, specifically in the groups of saccharides and amino acids, suggesting an association of these with the level of caries risk. CLINICAL SIGNIFICANCE: The results reported in the present study reinforce the use of salivary metabolomics as a research method for the search for salivary biomarkers that allow the evaluation of caries risk in patients. Furthermore, it brings us closer to a personalized medicine that will help in dental caries prevention strategies.

Relationship between Periodontal Condition of the Pregnant Woman with Preterm Birth and Low Birth Weight.

The aim of this study was to determine the association between the mother's periodontal condition and perinatal complications, such as preterm birth (PTB) and/or low birth weight (LBW), in a cohort of women in Valencia, Spain. Other related factors, such as tobacco, were also analysed. A prospective cohort study was carried out in a sample of 102 women with a single foetus and ages ranging between 18 and 42 years. Sociodemographic and obstetric variables, caries status, percentage of bleeding, clinical attachment loss (CAL), and probing pocket depth (PPD) data have been collected and analysed. The mean age was 32.4 years, and the BMI was normal. The average weight of new-borns (NB) was 3034 g. A total of 9.8% of the women smoked during their pregnancy. Bleeding percentage was 16.43% (SD 14.81%) and PPDs > 3 mm 8.8 (SD 11.08). The mean of CAL > 0 mm was 1.14 (SD 2.83). The frequency of PTB and LBW was 26%. No statistically significant differences were found between probing depth > 3 mm or CAL > 1 mm, with PTB and/or LBW. Periodontal disease in the mother was not statistically significantly related to either PTB or LBW. Tobacco use during pregnancy showed a statistical significance linked to LBW, but not with PTB.

Diagnostic Validity in Occlusal Caries Detection of ICDAS II, DIAGNOdent, Radiography and a Combination of the Three Methods: An In Vitro Study.

In this study, we compare the efficacy and diagnostic concordance of the ICDAS, the radiographic criterion and the instrument known as the DIAGNOdent fluorescence laser pen on occlusal caries lesions using a histological section as the gold standard. Of 100 teeth that did not present cavitated occlusal lesions or occlusal fillings, 80 were chosen through a randomization program and examined by two previously trained and calibrated researchers. Subsequently, the teeth were sectioned with a diamond disk and observed under an optical microscope. The results were studied for caries with a limit established in enamel and caries with extension to dentin. The intra-examiner (0.821-0.933) and inter-examiner (0.817-0.924) reproducibility obtained for both ICDAS and DIAGNOdent for the diagnosis of borderline enamel caries was high. Similarly, intra-examiner (0.686-1.000) and inter-examiner (0.809-0.944) reproducibility for diagnosis of caries with dentin extension was also high for both methods. The sensitivity obtained was 0.76 (ICDAS), 0.87 (DIAGNOdent) and 0.58 (Rx), whereas the specificity obtained was 0.66 (ICDAS), 0.4 (DIAGNOdent) and 0.77 (Rx) for lesions limited to enamel. For lesions with extension to dentin, the sensitivity obtained was 0.73 (ICDAS), 0.82 (DIAGNOdent) and 0.09 (Rx), and the specificity obtained was 0.79 (ICDAS), 0.52 (DIAGNOdent) and 0.97 (Rx). Sensitivity increases in both cases by combining diagnostic methods. In conclusion, ICDAS and DIAGNOdent are better diagnostic methods than Rx for the detection of occlusal caries, and the combination of these methods helps to obtain a better diagnosis.

A proposed community caries index of treatment need derived from the international caries detection and assessment system.

OBJECTIVE: To examine the accuracy of a short version of the International Caries Detection and Assessment System (ICDAS) in predicting caries treatment need for children. METHODS: The study is a validation study using data from three previously published cross-sectional studies. Participants were children with different dentitions from Kuwait, Brazil, and Spain. Children were clinically examined using ICDAS criteria. Children were classified into preventive, non-operative, and operative categories. Sensitivity and specificity, predictive values, likelihood ratios, and the area under the receiver operating characteristic (ROC) curve were used to measure the discriminative and diagnostic accuracy of the proposed short version of ICDAS compared to the full ICDAS. RESULTS: Clinical dental examination data from a total of 3076 children aged 1-15 years were used. The proposed short ICDAS and the full ICDAS showed a very good agreement on caries treatment need determination with Kappa scores of more than 0.833 in all dentitions. The short ICDAS showed excellent operating characteristics in all dentitions. The area under the ROC was more than 90% in primary dentition, 89% in permanent dentition, and 86% in mixed dentition in different populations. Lowest area under ROC and sensitivity values were observed when discriminating between non-operative and operative treatment categories. CONCLUSIONS: The proposed short version of the ICDAS showed good diagnostic accuracy in classifying children according to their caries treatment need. By reducing the number of surfaces examined and the time needed for clinical assessment, the short version of the ICDAS is a convenient alternative to the full ICDAS to be used in community settings.

Spanish Curriculum in Cariology for undergraduate dental students: Proceedings and consensus.

INTRODUCTION: Cariology is today a broad-based discipline and in the Spanish university teaching field, all this knowledge is not unified in a curriculum. Therefore, the aim was to develop a consensus text based on the European Core Curriculum, updated, and adapted to the characteristics of the Spanish university environment. MATERIALS AND METHODS: A Spanish Cariology Curriculum Group (SCCG) was set up with members of the Spanish Society of Epidemiology and Oral Public Health (SESPO), Spanish Society of Conservative and Aesthetic Dentistry (SEOC) and Spanish Society of Paediatric Dentistry (SEOP) and university experts to adapt the European Core Curriculum in Cariology for undergraduate dental students (ECCC) for Spain. The work was carried out online during 2018 and 2019, and also face-to-face meetings took place to obtain a draft curriculum open for discussion that was presented to all the Spanish universities. The final modifications to the document were specified in a Consensus Conference of Spanish universities offering a Degree in Dentistry that took place in Madrid on 19 November 2019. RESULTS: Thirty-eight university experts, under SCCG supervision, participated in the elaboration of the new framework document. A total of 16 universities, from 23 invited, reached a consensus as to the contents of the Spanish Curriculum in Cariology for undergraduate dental students. This new Curriculum emphasises learning outcomes, uses a consensus-based terminology pertaining to caries and other hard-tissue conditions, and introduces a new domain of competence in Domain III of ECCC. CONCLUSION: This new Cariology Curriculum is the result of a very broad-based consensus of university experts in Spain and lays the foundation for the implementation of an integrated teaching of Cariology in Spain in adherence to Alliance for a Caries Free Future (ACFF) objectives.

Effectiveness of removable appliances with temperature sensors in orthodontic patients: a systematic review and meta-analysis.

BACKGROUND/OBJECTIVE: Patient compliance during orthodontic treatment is one of the factors that most affects success in the final result. The use of removable appliances is frequent at an early age and the monitoring of its use is essential to assess the collaboration of the patient. The aim of this study was to establish the effectiveness of microsensors included in removable appliances during orthodontic treatment or in the retention phase to enable a reliable and individualized follow-up of the patient. SEARCH METHODS: The article search was carried out in various electronic databases and journals without any language restrictions. SELECTION CRITERIA: Studies using microsensors into removable appliances were selected with the key selection criterion of a minimum follow-up of 4 weeks. DATA COLLECTION AND ANALYSIS: The quality of the studies included was evaluated using the Cochrane scale for the randomized controlled trials and the Newcastle Ottawa Scale for control-case, cohort, and transversal studies. The mean of the differences with a 95% confidence interval was expressed for the continuous data. RESULTS: Twenty-nine full-text articles were analysed and included in the qualitative synthesis. In general, the mean daily wear time of removable appliances measured objectively was less than the time that the professional had predetermined. CONCLUSIONS: The use of microsensors as an objective measurement method enhances communication and boosts confidence in the orthodontist-patient relationship. More random clinical studies with temperature sensors are needed to establish to what extent they influence the orthodontic outcome. REGISTRATION: PROSPERO (CRD42019120525).

Need for Orthodontic Treatment in Pupils Aged between 12 and 15 in the Valencian Region (Spain).

The World Health Organization recommends carrying out periodic epidemiological studies in order to provide a basis for the evaluation of the state of health of the population at any given time; in doing so, action strategies can be established for the treatment of different pathologies. The objective of this study is to evaluate the need for orthodontic treatment in adolescents at school aged between 12 and 15 in the Spanish autonomous region known as Comunidad Valenciana (hereafter: Valencian Region). A cross-sectional study was carried out on a sample of 539 12-year-old schoolchildren and 460 15-year-olds, respectively, selected by cluster sampling and representative of the school-aged population of the Valencian Region, using the IOTN-DHC, IOTN-AC, and DAI indices. The need for specific orthodontic treatment according to the IOTN-DHC was 12.6% at 12 years and 7% at 15. For the IOTN-AC and DAI indices, the treatment needs were 4.3% and 0.9% at 12 years and 30.1% and 20.9% at the age of 15. These results were similar to those obtained in the previous study carried out on the same target population. There was no significant association between the need for treatment and gender or social class. We conclude that the need for orthodontic treatment presents values similar to those obtained in 2010.

Effect of per Capita Income on the Relationship between Periodontal Disease during Pregnancy and the Risk of Preterm Birth and Low Birth Weight Newborn. Systematic Review and Meta-Analysis.

This work analyzed the available evidence in the scientific literature about the risk of preterm birth and/or giving birth to low birth weight newborns in pregnant women with periodontal disease. A systematic search was carried out in three databases for observational cohort studies that related periodontal disease in pregnant women with the risk of preterm delivery and/or low birth weight, and that gave their results in relative risk (RR) values. Eleven articles were found, meeting the inclusion criteria. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67 (1.17-2.38), 95% confidence interval (CI)), and low birth weight (RR = 2.53 (1.61-3.98) 95% CI). When a meta-regression was carried out to relate these results to the income level of each country, statistically significant results were also obtained; on the one hand, for preterm birth, a RR = 1.8 (1.43-2.27) 95% CI was obtained and, on the other hand, for low birth weight, RR = 2.9 (1.98-4.26) 95% CI. A statistically significant association of periodontitis, and the two childbirth complications studied was found, when studying the association between these results and the country's per capita income level. However, more studies and clinical trials are needed in this regard to confirm the conclusions obtained.

Caries Prevalence Evolution and Risk Factors among Schoolchildren and Adolescents from Valencia (Spain): Trends 1998-2018.

The aim of this study was to determine the caries status and risk factors in the schoolchildren of Spain's Valencia region in 2018 and to compare them to the 20-year evolution of caries indicators in the region. A cross-sectional survey was conducted with 1722 children and adolescents aged between 6 and 15 using cluster sampling. Caries status, using International Caries Detection and Assessment System II (ICDAS II) criteria, and sociodemographic variables were recorded. To ensure the comparison with previous studies using WHO caries criteria, the cut-off point was established at ICDAS II code 4. Caries prevalence was found to be 37.4% and the decayed and filled teeth index (dft) was 1.23 at 6 years for deciduous dentition (DD). In permanent dentition (PD) at 12 years, caries prevalence was 30.1% with a 0.66 decayed, missing and filled teeth index (DMFT), and at 15 years, prevalence was 44.6% and DMFT was 1.21. Socioeconomic status poses a major risk factor for caries prevalence in deciduous dentition; it is 1.8 times higher in the lowest socioeconomic group. Deciduous dentition status has worsened in the most recent eight-year period, whereas in permanent dentition the 12- and 15-year values are similar to those of the 2010 survey. Evolution analysis suggests that community dental care programs be enhanced, involving preventive activities staring at the first year and targeting disadvantaged groups.

Factors related to the psychological impact of malocclusion in adolescents.

To study the association between orthodontic treatment need and the psychosocial impact of dental aesthetics in a sample of adolescents, as well as other associated factors. A transversal study was conducted on 1,158 adolescents (12-16 years old) examined at the schools selected for the 2018 epidemiological study on oral health in the Comunidad Valenciana (Spain). The need for orthodontic treatment was determined by DAI and IOTN. The psychosocial impact was established by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Other variables considered were sex, social class, DMFT index and Body-Mass Index, and having previously worn or presently wearing an orthodontic device. A lineal regression statistical technique was applied to study the significant associations with the scoring obtained in PIDAQ. The PIDAQ scores revealed a significant and positive lineal relationship with regard to need for orthodontic treatment: DAI (ẞ = 0.20) and IOTN-DHC (ẞ = 4.87), in women (ẞ = 2.66) and a negative one for having previously worn an orthodontic device (ẞ = - 5.74). The rest of the variables had no statistical significance (p > 0.05). The psychosocial impact of dental aesthetics in adolescents is associated with the presence of malocclusion and the female sex, while the condition of having previously worn an orthodontic device reduces the psychosocial impact.

Risk factors for orthodontic mini-implants in skeletal anchorage biological stability: a systematic literature review and meta-analysis.

The reason of the biological stability loss of mini-implants is still a matter of discussion between dentistry professionals. The main objective of this systematic literature review and meta-analysis was to analyze the risk factors that prejudice this loss. A search was made in the electronic databases Pubmed, Scopus, Embase and Cochrane, in addition a manual search was made too in Grey Literature (Opengrey). No limits were set on the year of publication or language. The inclusion criteria were: studies in humans treated with fixed appliances with mini-implants, where the risk factors for secondary stability were evaluated for a minimum of 8 weeks. After eliminating duplicate studies and assessing which ones achieve the inclusion criteria, a total of 26 studies were selected for the qualitative synthesis, 18 of them were included in the quantitative synthesis. Common risk variables were compared in all of them. Analyzing the forest and funnel plots, statistically significant differences were obtained only for location, the upper maxilla having lower risk than the mandible with an odds ratio of 0.56 and confidence interval of 0.39 to 0.80. Prospective studies under controlled conditions should be required in order to obtain a correct assessment of the variables analyzed.

Antibacterial Properties of Nanoparticles in Dental Restorative Materials. A Systematic Review and Meta-Analysis.

Background and Objectives: Nanotechnology has become a significant area of research focused mainly on increasing the antibacterial and mechanical properties of dental materials. The aim of the present systematic review and meta-analysis was to examine and quantitatively analyze the current evidence for the addition of different nanoparticles into dental restorative materials, to determine whether their incorporation increases the antibacterial/antimicrobial properties of the materials. Materials and Methods: A literature search was performed in the Pubmed, Scopus, and Embase databases, up to December 2018, following PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines for systematic reviews and meta-analyses. Results: A total of 624 papers were identified in the initial search. After screening the texts and applying inclusion criteria, only 11 of these were selected for quantitative analysis. The incorporation of nanoparticles led to a significant increase (p-value <0.01) in the antibacterial capacity of all the dental materials synthesized in comparison with control materials. Conclusions: The incorporation of nanoparticles into dental restorative materials was a favorable option; the antibacterial activity of nanoparticle-modified dental materials was significantly higher compared with the original unmodified materials, TiO2 nanoparticles providing the greatest benefits. However, the high heterogeneity among the articles reviewed points to the need for further research and the application of standardized research protocols.

Diagnostic Validity of Digital Imaging Fiber-Optic Transillumination (DIFOTI) and Near-Infrared Light Transillumination (NILT) for Caries in Dentine.

The objective of the study is to analyse the available evidence for the validity of the transillumination method in the diagnosis of interproximal caries. Bibliographic searches were carried out in three data bases (PubMed, Embase, Scopus) with the key words "Transillumination AND caries". A total of 11 studies were selected for the qualitative analysis and meta-analysis. In the qualitative analysis, both in vivo and in vitro studies were included. The gold standards were tomography, digital radiography, and clinical visual diagnosis. The meta-analysis determined the sensitivity, specificity, and area below the ROC curve relative to the transillumination method in the diagnosis of caries in dentine. Meta-analysis results obtained for transillumination gave a sensitivity value of 0.69 (confidence interval: 0.54-0.81), a specificity value of 0.89 (confidence interval: 0.61-0.98), while giving an AUC value of 0.79 (confidence interval: 0.67-0.87). Transillumination is a method offering moderate validity in the diagnosis of carious lesions in dentine, there is no strong evidence that may enable us to affirm that transillumination may fully substitute X-rays in the complementary diagnosis of carious lesions.

Oral health knowledge in relation to educational level in an adult population in Spain.

BACKGROUND: To analyze the relationship between oral health knowledge and educational level among an adult population in Spain, and between oral health knowledge and subjects' oral hygiene practices, dietary habits, toxic habits, and oral quality of life. MATERIAL AND METHODS: This transversal study used the Comprehensive Measure of Oral Health Knowledge (CMOHK) questionnaire to evaluate subjects' knowledge and understanding of oral health, and the World Health Organization oral health questionnaire for adults to evaluate dietary, oral hygiene, toxic habits, and oral quality of life. Participants (n=400) gave their informed consent and data release permission before taking part in the study, which was approved by the University of Valencia Ethics Committee (certificate No.: H145160675341). Statistical analysis was performed using SPSS v22.0 software, applying Student's t-test, ANOVA, and chi2 test, with significance set at p<0.05. RESULTS: Oral health knowledge results were: low 41.5% and high 58.5%. An association was found between educational level and oral health knowledge (Chi2: p=0.000). Oral hygiene habits presenting an association with higher levels of oral health knowledge were dental floss use, a higher number of teeth present, and lower prevalence of partial prostheses. A significant association was found between oral quality of life and oral health knowledge. CONCLUSIONS: Oral health knowledge is associated with the individual subject's educational level. But oral health knowledge is not necessarily reflected in the practice of healthy habits. Key words:Oral health literacy, oral health habits, oral health knowledge, CMOHK.

Effect of 2% Chlorhexidine Following Acid Etching on Microtensile Bond Strength of Resin Restorations: A Meta-Analysis.

Background and Objectives: The aim of this systematic review was to examine the effect of 2% chlorhexidine following acid etching on the microtensile bond strength of resin restorations for different follow-up times. Materials and Methods: A thorough search of PubMed, Scopus, and Embase databases were conducted. In vitro experimental studies or in vivo studies published up to December 2018 with an experimental group treated with a 2% chlorhexidine solution following acid etching and a control group were included, wherein the final restoration used a resin composite in both the groups. Results: Twenty-one articles were identified for qualitative analysis and 18 for meta-analysis. The difference in the means of microtensile bond strength between the two groups was calculated for the different follow-up times. The differences were significant for 6 months (4.30 MPa; 95% CI 2.72-5.89), 12 months (8.41 MPa; 95% CI 4.93-11.88), and 2-5 years including aged and thermocycling samples (9.08 MPa; 95% CI 5.36-12.81). There were no significant differences for the type of adhesive used. A meta-regression model showed a significant effect of time on the microtensile bond strength. Conclusions: The application of a 2% chlorhexidine solution after acid etching increased the microtensile bond strength significantly for follow-up times of 6 months or more. The adhesive type had no influence.

Use of DIAGNOdent and VistaProof in diagnostic of Pre-Cavitated Caries Lesions-A Systematic Review and Meta-Analysis.

OBJECTIVE: To analyse the published evidence of the validity of DIAGNDOdent and VistaProof in diagnosing carious depths in pre-cavitated lesions. Material and methods: A systematic review was carried out after identifying a total of 184 articles, including 27 concerning the qualitative review and a subsequent meta-analysis. The quality of the studies was evaluated by using the QUADAS-2 tool. Results: For DIAGNOdent, the sensitivity value was 0.77, the specificity value was 0.75 and AUC was 0.81 for the global meta-analyses. In relation to subgroups, the values estimated 0.85, 0.76 and 0.86, respectively, for the in vivo group and 0.71, 0.75 and 0.83 for the in vitro group. For VistaProof, sensitivity was 0.81, specificity 0.75 and AUC had a value of 0.80 in the global meta-analysis. For the subgroups, these were considered at 0.75, 0.81 and 0.89, respectively, for the in vivo group and 0.91, 0.74 and 0.76 for the in vitro group. Neither case presented publication bias when analysing the funnel plot, the classic fail-safe number and Egger's intercept. Conclusion: Both VistaProof and DIAGNOdent are valid as they offer a moderate to high diagnostic effectiveness for dentine depth in pre-cavitated lesions.

Effect of rapid maxillary expansion on sleep apnea-hypopnea syndrome in growing patients. A meta-analysis.

BACKGROUND: Changes produced in the upper airway after rapid maxillary expansion makes this procedure a therapeutic option for treating sleep apnea-hypopnea syndrome (SAHS) in children. The objective of this systematic review and meta-analysis was to analyze the evidence available for the effects of rapid maxillary expansion (RME) on SAHS, analyzing changes produced in oximetric variables: apnea-hypopnea index (AHI); oxygen saturation (SO2); sleep efficiency (SE), total sleep time (TST), percentage of rapid eye movement (REM) phase; and arousal index (AI). MATERIAL AND METHODS: An electronic search was conducted in the PubMed, Scopus, Embase, and Cochrane databases, and in grey literature (Opengrey). No limit was placed on publication date or language. Inclusion criteria were: patients in growth with sleep apnea who underwent rapid maxillary expansion with oximetric values registered before and after treatment. Articles with patient sample sizes <10 were excluded. Ten articles were included for qualitative synthesis and nine for meta-analysis (eliminating one observational study). RESULTS: AHI values underwent a mean reduction of 5.79 events/hour (CI -95% 9.06 to 2.5); an increase in mean oxygen saturation of 2.54 % (CI-95% -0.28 to 4.80, 6.7 %); a reduction in AI of 2.17 events/hour (CI-95% -5.25 to -0.582); an increase in REM phase of 1.20 % (CI-95% 1.02 to 1.38); and an increase in SE of 0.961% (CI-95% -1.574 to 3.495). CONCLUSIONS: RME would appear efficient for treating slight or moderate SAHS, as indicated by improvement in oximetric parameters; it may be effective as coadjuvant therapy to adenotonsillectomy in severe cases of children with maxillary compression. Key words:Rapid maxillary expansion, obstructive sleep apnea.

Does breastfeeding have a long-term positive effect on dental occlusion?

BACKGROUND: Breastfeeding produces beneficial effects on a baby's early growth and development, and general well-being. Some studies have associated breastfeeding with better occlusal development. The aim of this study was to assess the long-term effect of breastfeeding on occlusal development in children. MATERIAL AND METHODS: A retrospective cohort study was conducted to evaluate the occlusions of 320 children belonging to the Spanish INMA Project cohort, monitored from gestation onwards. The association between the duration of breastfeeding and different occlusal traits in mixed dentition (overjet, overbite, openbite, midline displacement, incisor crowding, incisor spacing, diastema, maximum maxillary and mandibular irregularity, anterior and posterior crossbite) at the age of 9 was assessed, as well as the orthodontic treatment need as determined by the "Index of Orthodontic Treatment Need" and the "Dental Aesthetic Index". RESULTS: A statistically significant association between the duration of breastfeeding and posterior crossbite was found. The Odds Ratio for posterior crossbite was 2.52 (IC 95% 1.34-4.74) for children breastfed up to 16 weeks, 0.56 (IC 95% 0.29-1.08) for children breastfed 16 to 45 weeks, and for more than 45 weeks of breastfeeding it was 0.50 (IC 95% 0.19-1.32). No association was found between breastfeeding and the other examined occlusal traits, nor with the orthodontic treatment need. CONCLUSIONS: Breastfeeding for less than 4 months increases the risk of posterior crossbite. However, breastfeeding duration is not linked to other malocclusion traits nor is it linked to the orthodontic treatment need of nine-year-old children. Key words:Breastfeeding, occlusion, malocclusion, dental development.

Oral health-related quality of life of adolescents after orthodontic treatment. A systematic review.

BACKGROUND: Given the prevalence of malocclusions and the impact they have on oral health, patients' quality of life assessments provide useful information, not only in terms of patients' needs and expectations before treatment, but about whether or not orthodontic treatments meet them satisfactorily. The present systematic review was carried out to evaluate changes in the quality of life of adolescent patients after orthodontic treatment. MATERIAL AND METHODS: An electronic search was conducted in the Pubmed, Embase, Cochrane and Scopus databases. The review followed PRISMA guidelines for systematic reviews and meta-analyses. RESULTS: Of the 817 studies identified in the initial search, only 10 met the inclusion criteria. In relation to the instrument used to assess oral health-related quality of life (OHRQoL), half the studies used the oral health impact profile-14 (OHIP-14) and the other half the child perceptions questionnaire (CPQ 11-14). All the studies, with the exception of Benson et al., reported a significant improvement in OHRQoL at the end of treatment. CONCLUSIONS: There is a positive association between OHRQoL and orthodontic treatment in adolescent patients. Key words:Quality of life, life quality, oral health related quality of life, QoL, OHRQoL, orthodontic treatment, adolescents, teenagers.