Relation of Dental Anomalies with Occlusal Alterations in the Pediatric Patients

Objective: To identify the dental anomalies that can modify the occlusal characteristics and their distribution in these occlusal alterations in the skeletal patterns of children. Material and Methods: We analyzed charts, panoramic and periapical radiographs of children aged 5 to 12 years from 2009 to 2012. The facial pattern was evaluated through subjective face analysis and cephalometric data, as well as the occlusion of patients with and without (control) dental anomalies. The relationship between the presence of dental anomalies and malocclusion was analyzed by the Chi-square test with significance level of 5%. Results: 73 children (27.8%) presented dental anomalies, being 49.3% in girls and 50.7% in boys in a total of 88 teeth involved. Anomalies observed in decreasing order were: enamel hypoplasias, eruptive ectopias, agenesis, supernumerary teeth, corono-radicular dilaceration, microdontia, transposition and imperfect amelogenesis. Of these, 22.2% presented associated dental anomalies, whose ectopic eruption with enamel hypoplasia were the most frequently encountered. When comparing the control group with children with dental abnormalities it was observed a significant relationship between the presence of dental anomalies and malocclusion (p<0.05). The most frequent alteration among patients with dental anomalies was deep overbite (24.6%), followed by crowding (23.3%), posterior crossbite (14.2%), anterior open bite (12.9%) and anterior crossbite (0.3%). Conclusion: Dental dysgenesis interferes with the development of occlusion and the resulting occlusal problems are distributed differently, taking into account the skeletal facial pattern in patients with and without dental anomalies.

Efeitos nos níveis clínicos e de s. mutans de um protocolo de controle de biofilme dental em adolescentes portadores de aparelho ortodôntico fixo / Effect on the clinical levels of s. mutans of a dental biofilm control protocol in adolescents with fixed orthodontic appliances

A utilização de acessórios durante o tratamento ortodôntico fixo aumenta o risco à ocorrência de manchas brancas, cárie e gengivite devido aos sítios retentores de biofilme dental. O objetivo deste estudo foi observar o efeito de um protocolo de controle de biofilme dental nos níveis de gengivite e risco à cárie em adolescentes portadores de aparelho ortodôntico fixo. Foram selecionados 21 pacientes de ambos os gêneros, entre 12 e 18 anos, que usavam aparelho fixo. Os critérios de exclusão foram: doenças sistêmicas, uso de antibiótico, gravidez e fumo. Os pacientes receberam instrução de higiene oral individualmente, reforçada mensalmente, e tiveram a saliva coletada no início e no final do estudo para avaliar o número de streptococcus mutans (SM) em unidades formadoras de colônias (UFC) e o risco à cárie. Nos tempos 1, 30, 60 e 90 dias, foram analisados os níveis clínicos de placa bacteriana corada (IPC) e gengivite (IG). Os pacientes receberam profilaxia com jato de bicarbonato de sódio a cada exame. Para comparação da contagem de SM nos dois tempos analisados, foi utilizado o teste t de Student; para os tempos do IPC e IG, utilizou-se a análise de variância (Anova), com post-hoc Tukey, ambos com significância de 5%. Ocorreu redução entre as avaliações iniciais e finais do IPC (72,72% ± 11,93% para 54,18% ± 16,87%), do IG (1,10 ± 0,47 para 0,44 ± 0,27) e da contagem de SM (1,16 ± 1,345 UFC para 0,536 ± 0,56 UFC), todos com p < 0,05. A implementação do protocolo melhorou as condições de gengivite e risco à cárie na população durante o período de estudo.

The use of appliances during fixed orthodontic treatment increases the risk of occurrence of white spot, caries and gingivitis due to presence of dental biofilm at the retentive sites. The objective of this study was to observe the effect of a dental biofilm control protocol on the levels of gingivitis and caries risk in adolescents with fixed orthodontic appliances. Twenty-one patients of both genders, between 12 and 18 years, participated in the study. The exclusion criteria were: systemic diseases, use of antibiotics, pregnancy and smokers. Patients received individual monthly oral hygiene instructions, and had their saliva collected at the beginning and the end of the study to assess the number of streptococcus mutans (SM) in colony forming units (CFU) and caries risk. At 1, 30, 60 and 90 days, clinical levels of bacterial plaque (CPI) and gingivitis (GI) were analyzed. Patients received prophylaxis with sodium bicarbonate jets at each exam. Student t test was used to compare SM counts at the two analyzed moments, while analysis of variance (Anova) was used for CPI and GI times, followed by Tukeyposthoc test, at a significance of 5%. Reductions in CPI levels (72.72% ± 11.93% to 54.18% ± 16.87%), GI levels (1.10 ± 0.47 to 0.44 ± 0.27) and SM counts (1.16 ± 1.345 UFC para 0.536 ± 0.56 UFC) were observed between the initial and the final assessments, all with p < 0.05. The implementation of the biofilm control protocol improved gingivitis conditions and caries risk in the population studied during the experimental period.