Knowledge of Dentists about Hypomineralization Enamel Defects: A Cross-Sectional Study

ABSTRACT Objective: To evaluate a group of Brazilian dentists on their knowledge of Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molars (HSPM) related to clinical aspects, consequences, and diagnostic criteria. Material and Methods: In this cross-sectional, the participants were invited by e-mail and Whatsapp® to answer a questionnaire about their knowledge of hypomineralization enamel defects (MIH/HSPM) on the Google Forms® platform. The questionnaire comprised eight questions about personal data and multiple-choice questions about their knowledge concerning clinical aspects, diagnostic criteria of MIH/HSPM and differential diagnosis through clinical images. Chi-square test was applied with the significance level set at 5%. Results: Most participants (n = 492; 91.1%) reported having knowledge about MIH/HSPM. The general dentists gave more incorrect answers (n = 40; 65.6 %;) about dental tissues affected by MIH/HSPM. Overall, 83.3% of the dentists gave the correct answer to which dentitions are associated with this condition. In addition, most dentists presented knowledge about the consequences related to possible fractures (n= 487; 90.2%) and about an increased risk of caries (n= 479; 88.9%) in the affected teeth. Regarding the differential diagnosis performed through clinical images, most participants gave incorrect answers (p≤0.001). Conclusion: The participants presented knowledge about the dentition associated with this condition and possible consequences related to the teeth affected by MIH/HSPM; however, they showed difficulties concerning clinical diagnostic criteria.

Aesthetic perceptions and social judgments about different enamel opacities.

This study aimed to evaluate adolescents' aesthetic perceptions and their social judgments regarding different enamel opacities. Sample size was calculated and resulted in the inclusion of 100 adolescents (aged 10 to 15 years) from a public school in Jequié, Bahia, Brazil. Images of enamel opacities were manipulated to create aesthetic enamel defects, such as enamel color changes (unilateral and bilateral white opacity, unilateral and bilateral yellowish opacity, and unilateral and bilateral yellowish opacity with loss of structure). The images of the opacities were based on Fédération Dentaire Internationale's Developmental Defects of Enamel (DDE) Index. Aesthetic perception and social judgments were evaluated using a validated questionnaire with 12 questions (six positive and six negative points) on social aspects, considering the six manipulated images and the control. The photographic analyses were projected one-by-one by computer to adolescents individually in a classroom. Participants had one minute to observe each image and answer the questionnaire. The data were analyzed by descriptions, and the Friedman Wilcoxon test (p < 0.05). The results indicate that all opacities negatively impacted social judgment (p < 0.001). The enamel aesthetic defects most affecting an individual's perception were bilateral yellow opacity with or without loss of structure (p < 0.001). Regarding social judgment, all participants showed a negative perception of all the tested opacity types (p < 0.001). In conclusion, even opacities presenting only a color change caused aesthetic dissatisfaction to the individuals and changes in their social judgment toward others. Color changes in dental enamel have several aesthetic consequences.

Defining the Prevalence of Molar Incisor Hypomineralization in Brazil

Abstract Objective: To define the prevalence of Molar Incisor Hypomineralization (MIH) in Brazil since the reports ranged from 2.5% to 40.2%. Material and Methods: We studied 407 children from 7 to 14 years of age. MIH was measured using the European Academy of Paediatric Dentistry criteria of 2003. Clinical data were collected by a calibrated dentist (Kappa=0.88) and included affected teeth and degree of MIH severity (mild/severe). Mild MIH cases were considered when the tooth presented demarcated opacity ≥ 1.0mm, without any loss of structure. While severe cases were defined by teeth in which loss of structure was present, or past or current lesion that required treatment, or presence of atypical restorations. In addition, published data (nine studies) reporting MIH in Brazilians were identified, and the heterogeneity of these studies was tested (I2 index/ p≤0.01). Results: In the original sample studied, the majority of patients were males (55.3%; n = 225), with an average age of 10.1 years (± 2.1 years). The prevalence of MIH in this group was 14.5% (59 affected in 407), and most of the affected teeth had a mild degree of alteration (77.4% or 202 in 261 teeth). Conclusion: A meta-analysis including nine published reports, and our original data showed that MIH prevalence in Brazil is 13.48 (95% CI, 8.66% -18.31%).

Aesthetic perceptions and social judgments about different enamel opacities

Abstract This study aimed to evaluate adolescents' aesthetic perceptions and their social judgments regarding different enamel opacities. Sample size was calculated and resulted in the inclusion of 100 adolescents (aged 10 to 15 years) from a public school in Jequié, Bahia, Brazil. Images of enamel opacities were manipulated to create aesthetic enamel defects, such as enamel color changes (unilateral and bilateral white opacity, unilateral and bilateral yellowish opacity, and unilateral and bilateral yellowish opacity with loss of structure). The images of the opacities were based on Fédération Dentaire Internationale's Developmental Defects of Enamel (DDE) Index. Aesthetic perception and social judgments were evaluated using a validated questionnaire with 12 questions (six positive and six negative points) on social aspects, considering the six manipulated images and the control. The photographic analyses were projected one-by-one by computer to adolescents individually in a classroom. Participants had one minute to observe each image and answer the questionnaire. The data were analyzed by descriptions, and the Friedman Wilcoxon test (p < 0.05). The results indicate that all opacities negatively impacted social judgment (p < 0.001). The enamel aesthetic defects most affecting an individual's perception were bilateral yellow opacity with or without loss of structure (p < 0.001). Regarding social judgment, all participants showed a negative perception of all the tested opacity types (p < 0.001). In conclusion, even opacities presenting only a color change caused aesthetic dissatisfaction to the individuals and changes in their social judgment toward others. Color changes in dental enamel have several aesthetic consequences.

Evaluation of genetic polymorphisms in MMP2, MMP9 and MMP20 in Brazilian children with dental fluorosis.

Recent studies suggested that genetics contribute to differences in dental fluorosis (DF) susceptibility among individuals having the same environmental exposure. This study evaluated if MMP2, MMP9 and MMP20 are expressed during enamel development and assessed the association between polymorphisms in these genes with DF. Mice susceptible and resistant to DF were used to evaluate if MMPs were candidate genes for DF. The animals received fluoride and their enamels were used for immunohistochemistry. Additionally, 481 subjects from a city with fluoridation of public water supplies were recruited. Genotyping was performed using real time PCR. Allele/genotype frequencies were compared between groups. MMP2, MMP9 and MMP20 immunostaining was detected in both animal groups. DF was observed in 22.4% of the subjects. A borderline association was observed in MMP2 (rs243865), MMP9 (rs17576) and in MMP20 (rs1784418) (p = 0.06, p = 0.08 and p = 0.06 respectively). Briefly, MMPs were expressed during enamel maturation and genetic polymorphisms were not associated with DF.

Polymorphisms in genes involved in enamel development are associated with dental fluorosis.

OBJECTIVE: To evaluate the association between polymorphisms in DLX1, DLX2, MMP13, TIMP1 and TIMP2 genes with dental fluorosis (DF) phenotype. DESIGN: Four hundred and eighty one subjects (108 with DF and 373 DF free) from 6 to 18 years of age were recruited. This population lived in Rio de Janeiro, a city with fluoridation of public water supplies. DF was assessed using the Deans index modified. Only erupted permanent teeth were assessed. Genetic polymorphisms in DLX1, DLX2, MMP13, TIMP1 and TIMP2 were analyzed by real-time PCR from genomic DNA. Association between DF, genotype, and allele distribution were evaluated using chi-square and logistic regression analyses with an alpha level of 5%. RESULTS: DF was more prevalent in Afro-descendants than in Caucasians (p=0.08; OR=1.83; CI 95%=1.18-2.82). Logistic regression analysis adjusted by the ethnicity demonstrated a statistical difference for TIMP1 genotype (p=0.033; OR=2.93, 95%CI, 1.09-7.90). When only the severer cases of DF were analyzed, polymorphisms in DLX1 and DLX2 were associated with DF (p<0.05). CONCLUSION: Our results provided evidence that polymorphisms in TIMP1, DLX1 and DLX2 genes may be associated with DF phenotypes.

The functional EGF+61 polymorphism and nonsyndromic oral clefts susceptibility in a Brazilian population.

Nonsyndromic oral clefts are considered a problem of public health in Brazil, presenting a multifactorial etiology that involves genetic and environmental components, such as maternal alcohol consumption. Several candidate genes have been investigated to identify some association with nonsyndromic clefts risk. The epidermal growth factor (EGF) gene is implicated in the normal craniofacial development and its functional +61 A>G polymorphism has been related to cancer susceptibility. It has been suggested that cancer and oral clefts may share the same molecular pathways.Objective Our goal was to evaluate the association between the EGF+61 A>G polymorphism and nonsyndromic oral clefts susceptibility.Material and Methods The case-control study included 218 cleft cases and 253 controls from Brazil. The control group was comprised of individuals without congenital malformations, dental anomalies and family history of clefts. The cleft phenotypes and subphenotypes were determined based on clinical examination. Genomic DNA was extracted from oral mucosa cells obtained by mouthwash. The EGF+61 A>G polymorphism genotype was determined by polymerase chain reaction-restriction fragment length polymorphism.Results We noticed the association between maternal alcohol consumption during pregnancy and cleft occurrence. The A allele and AA genotype were over-represented in cleft cases compared with control group when we considered the bilateral cleft lip with or without cleft palate (CL±P) cases, cleft cases with tooth agenesis and cleft cases presenting family history of cleft, but the differences were not statistically significant. Contradictorily, the G allele was higher in cleft palate only (CP) cases than in control group, showing a borderline p value. Comparing the different cleft phenotypes, we observed statistical differences between CP and CL±P cases. Our data suggest the EGF+61 A>G polymorphism was not related with nonsyndromic oral clefts susceptibility in a Brazilian population, but supported the different genetic background between CL±P and CP. Moreover, we confirmed the potential effect of maternal alcohol intake on cleft risk in our population.

The functional EGF+61 polymorphism and nonsyndromic oral clefts susceptibility in a Brazilian population

AbstractNonsyndromic oral clefts are considered a problem of public health in Brazil, presenting a multifactorial etiology that involves genetic and environmental components, such as maternal alcohol consumption. Several candidate genes have been investigated to identify some association with nonsyndromic clefts risk. The epidermal growth factor (EGF) gene is implicated in the normal craniofacial development and its functional +61 A>G polymorphism has been related to cancer susceptibility. It has been suggested that cancer and oral clefts may share the same molecular pathways.Objective Our goal was to evaluate the association between the EGF+61 A>G polymorphism and nonsyndromic oral clefts susceptibility.Material and Methods The case-control study included 218 cleft cases and 253 controls from Brazil. The control group was comprised of individuals without congenital malformations, dental anomalies and family history of clefts. The cleft phenotypes and subphenotypes were determined based on clinical examination. Genomic DNA was extracted from oral mucosa cells obtained by mouthwash. The EGF+61 A>G polymorphism genotype was determined by polymerase chain reaction-restriction fragment length polymorphism.Results We noticed the association between maternal alcohol consumption during pregnancy and cleft occurrence. The A allele and AA genotype were over-represented in cleft cases compared with control group when we considered the bilateral cleft lip with or without cleft palate (CL±P) cases, cleft cases with tooth agenesis and cleft cases presenting family history of cleft, but the differences were not statistically significant. Contradictorily, the G allele was higher in cleft palate only (CP) cases than in control group, showing a borderline p value. Comparing the different cleft phenotypes, we observed statistical differences between CP and CL±P cases. Our data suggest the EGF+61 A>G polymorphism was not related with nonsyndromic oral clefts susceptibility in a Brazilian population, but supported the different genetic background between CL±P and CP. Moreover, we confirmed the potential effect of maternal alcohol intake on cleft risk in our population.

Aesthetic solution to fluorosis in a child / Solução estética para a fluorose em criança

Dental fluorosis is a defect of enamel formation caused by chronic ingestion of fluoride from different sources during tooth development, which results in interference in proper mineralization. Clinically the tooth enamel may present as white striae along the lines of enamel, opaque white spot and in more severe cases as brown spots. Diagnosis is based on clinical characteristics associated with a history of exposure to fluoride. The aim of this report is to present a treatment in a child with severe aesthetic compromising in anterior maxillary permanent teeth caused by fluorosis. The treatment was based on a combination of three techniques in order to be minimally invasive, enhance aesthetics and preserving the dental structure

Fluorose dental é um defeito na formação do esmalte causado pela ingestão crônica de flúor de diferentes origens durante o desenvolvimento dentário, o que resulta em uma interferência na mineralização adequada. Clinicamente, o esmalte dentário pode assumir uma tonalidade esbranquiçada ou exibir pequenas manchas ou linhas brancas e, nos casos mais severos, manchas amarronzadas. O diagnóstico é baseado em características clínicas associadas com a história de exposição ao flúor. O foco deste estudo é mostrar o tratamento em uma criança com grande comprometimento estético em dentes permanentes anteriores superiores acometidos por fluorose. O tratamento baseou-se numa combinação de três técnicas, a fim de ser minimamente invasiva, melhorar a estética e preservar a estrutura dentária

Discordant tooth agenesis and peg-shaped in a pair of monozygotic twins: Clinical and molecular study.

The present report aimed to study an uncommon case of a pair of twins that presented a discordant dental phenotype. Family investigation, clinical, radiographic examination and molecular analysis were performed in both girls. Molecular analysis confirmed the monozygosity by deoxyribonucleic acid chip technology. One twin presented tooth agenesis in left upper lateral incisor and peg-shaped on the contra lateral side while the other twin had no dental alterations. The dental casts study employed digital caliper to compare morphological dimensions and showed alteration only in peg-shaped tooth. In conclusion, this study provide support that one or more mutated gene could cause discordances in dental phenotype in these monozygotic twins.

Granuloma periapical extenso en la región de molar primario: asociación con agenesia del premolar sucesor / Extensive periapical granuloma in the primary molar region: association with agenesis of the succesor premolar

El objetivo de este trabajo fue explorar la posible asociación entre un granuloma periapical extenso en la región de molares primarios y la agenesia del premolar sucedáneo. Una niña blanca de 10 años con una tumefacción indolora en la región mandibular derecha quien al examen radiográfico reveló presencia de una lesión radiolúcida, única, bien definida y amplia, con un diámetro de aproximadamente 15 mm, en íntima asociación con la región periapical del segundo molar inferior primario derecho con destrucción de la corona clínica por caries, también se observa la ausencia del segundo premolar inferior sucesor derecho. Se procedió a la eliminación total de la lesión intraósea y el diente asociado, el tejido extirpado fue diagnosticado histopatológicamente como un Granuloma Periapical. Después de 3 meses de seguimiento la paciente mostró una buena cicatrización postquirúrgica del defecto óseo por la eliminación de la lesión inflamatoria. Este caso clínico concluye que la etiopatogenia de la agenesia dentaria no es del todo conocida y sugiere que otros factores no genéticos, como grandes lesiones periapicales, podrían influir a nivel local en las primeras etapas de la odontogénesis y llevar a cabo la formación del segundo premolar inferior, aunque se necesitan más estudios sobre el tema

The aim of this study was to explore the possible association between a large periapical granuloma in the primary molar region and agenesia of the successor premolar. A 10 years old white girl with a painless swelling in the right mandibular region in the radiographic examination revealed the presence of a radiolucent lesion, single, well defined and comprehensive, with a diameter of about 15 mm, in close association with the apical region of the second right primary molar widely decayed, also noting the absence of the second premolar successor. Proceeded to the total elimination of the intraosseous lesion and the associated tooth, the removed tissue was histopathologically diagnosed as a periapical granuloma. Three-month follow-up after treatment the patient showed good postoperative bone defect healing by eliminating the inflammatory lesion. This clinical report concludes that the etiopathogenesis of dental agenesis is not entirely known and suggests that other non-genetic factors, such as large periapical lesions, could influence locally in the early stages of odontogenesis and compromise the formation of the lower second premolar, although more research is needed on the subject

Caries experience in individuals with cleft lip and palate.

PURPOSE: The purpose of this study was to assess if children with clefts have an increased caries experience. METHODS: Caries data was collected via clinical examination of 115 4- to 21-year-olds with clefts and 230 controls. Cleft type was confirmed through their medical records and fluoride exposure history; oral hygiene habits and dietary history were obtained though a questionnaire. RESULTS: The adherence to the preventive oral health habits (tooth-brushing, use of fluoride, and dietary factors) were not different among groups excluding the use of dental floss. The mean DMFT was 1.20 (±1.8 SD) for the cleft group and 0.90 (±1.8) for the control group. There was no significant difference in the DMFT scores between children with clefts and the control group (P=.16). The mean dmft was 1.68 (±2.1) for the cleft group and 2.61 (±2.9) for the control group. The prevalence of dental caries in primary teeth was significantly lower in the cleft-affected children vs the control group (P=.02). The percentage of caries-free individuals was similar in cleft and control groups (P=.90), and was also similar in different cleft types (P=.67). CONCLUSION: Caries experience in children born with clefts is not higher in comparison to control children.

Management of an unerupted dilacerated maxillary central incisor after trauma to the primary predecessor.

The most common cause of permanent maxillary incisor dilaceration is usually trauma to the primary predecessor, such as avulsions, intrusions, or gross displacement of primary incisors. The purpose of this case report was to describe the surgical exposure and orthodontic traction of an unerupted dilacerated permanent maxillary central incisor performed on a young girl. During the surgical exposure, a hole was placed in the tooth crown, and elastic chains, inserted though the hole, were used for traction. The alignment and leveling of the impacted incisor were performed with sequential stainless steel wires. Good periapical and periodontal health, combined with adequate occlusion and a positive esthetic outcome, demonstrated the satisfactory results of this case.

Genetic variation in MMP20 contributes to higher caries experience.

UNLABELLED: Matrix metalloproteinases play an important role during the initial process of enamel development and therefore may play a role in caries. OBJECTIVES: To evaluate the association between MMP20 and caries experience in Brazilian children. METHODS: Eligible unrelated children with or without caries were evaluated using a cohort design. Demographic data and oral health habits were obtained though a questionnaire. Caries data was collected by clinical examination. Genotyping of the selected polymorphism was carried out by real-time PCR from genomic DNA. Allele and genotype frequencies were compared between groups with distinct caries experience and oral health habits. RESULTS: Of 388 subjects, 161 were caries free children. There were no differences between caries levels and genotype distribution in the total cohort. When ethnic background was considered, differences in genotype distribution were observed in caries free children vs. children with caries in Caucasians (p=0.03). Differences could also be seen when poor oral hygiene was used to stratify the analysis (p=0.02). Regression analysis, adjusted for genotype and ethnicity, confirmed that ingestion of sweets between meals increases the risk of presenting carious lesions (p=0.00001; OR=2.33; 95%CI 1.53-3.54). CONCLUSION: Variation in MMP20 may be associated with caries experience mainly in Caucasian subjects with poor oral health habits.

TGFB3 and BMP4 polymorphism are associated with isolated tooth agenesis.

OBJECTIVE: To evaluate the association of the polymorphisms in the TGFB3 gene (rs2268626) and the BMP4 gene (rs17563) with isolated human tooth agenesis. MATERIALS AND METHODS: One hundred and seventy-five unrelated individuals (125 control individuals without tooth agenesis and 50 cases with tooth agenesis) were evaluated using a case-control design. The participants of the study were recruited through the Dental School of the Federal University of Rio de Janeiro, Brazil. Genotyping of the selected polymorphisms for TGFB3 (48 individuals with tooth agenesis and 125 control cases) and BMP4 (46 individuals with tooth agenesis and 88 control cases) were carried out by real-time PCR using the Taqman assay method from a genomic DNA isolated from buccal epithelial cells of all individuals. RESULTS: Significant statistical differences were found for genotype frequencies between tooth agenesis and TGFB3 control samples (p = 0.026). In addition, significant differences were also observed for allele and genotype frequencies between unilateral tooth agenesis and TGFB3 control samples (p = 0.014 and 0.004 for allele and genotype frequencies, respectively). For BMP4, genotype distribution had a statistically significant difference between groups (p = 0.047). The GG genotype of BMP4 was more frequent in individuals with three or more missing teeth than in the control group (p < 0.0001). CONCLUSIONS: These results indicate that polymorphisms in the TGFB3 gene and in BMP4 genes contribute to tooth agenesis. Nonetheless, the extents to which this polymorphism may actually contribute to the tooth agenesis status should be clarified.

Prevalence of dental anomalies in nonsyndromic individuals with cleft lip and palate: a systematic review and meta-analysis.

OBJECTIVE: To assess whether individuals born with nonsyndromic oral clefts display a higher frequency of dental anomalies. DESIGN: A search of MEDLINE, BIREME, OVID ALL EMB Reviews, and The Cochrane Library was conducted. The methodologic quality of the papers selected was assessed and scored. Papers reporting observational controlled studies of nonsyndromic forms of oral cleft matched for dental anomalies in primary and/or permanent teeth were included without language restrictions. Eligible studies were scored as "A"-low risk of bias, "B"-moderate risk of bias, or "C"-high risk of bias and poor quality. Fixed and random effects models were used to aggregate individual odds ratios (OR) and to derive pooled estimates and 95% confidence intervals. RESULTS: Six studies fulfilled our selection criteria and were included in the meta-analysis. Three distinct subgroup analyses were carried out in terms of dental anomalies. In the tooth agenesis meta-analysis, a random effects model was used because of heterogeneity and showed a significant association between tooth agenesis and oral clefts (OR  =  12.31; 95% confidence interval [CI]  =  3.75 to 40.36). In the remaining analyses, the fixed effects model revealed a positive association between supernumerary (OR  =  4.99; 95% CI, 2.58 to 9.64) and crown morphologic abnormalities (OR  =  5.69; 95% CI, 3.96 to 8.19) with oral clefts. Most included studies were of low to moderate quality. CONCLUSION: Although general limitations in study design were observed, the evidence suggests that a higher number of dental anomalies in the permanent dentition are noted in individuals born with oral clefts.

Abordagem multidisciplinar no tratamento de um paciente pediátrico com traumatismo dentário / Multidisciplinary approach to treat a pediatric patient with dental trauma

Objetivou-se relatar uma abordagem multidisciplinar na reabilitação funcional e estética após traumatismo dentário em um pacientepediátrico. Um paciente do sexo masculino, 9 anos de idade, apresentou-se com fratura coronária complexa do elemento 21 e impactação do elemento 11 devido a presença de odontoma. No elemento 11, após a remoção do odontoma foi observado a sua erupção espontânea restabelecendo sua estética e função. No elemento 21, o paciente recebeu um tratamento multidisciplinar, no qual realizou-se: aumento de coroa clínica, tracionamento ortodôntico, tratamento endodôntico, cimentação de retentor intrarradicular e restauração estética. As abordagens multidisciplinares são componentes importantes para o sucesso da reabilitação funcional e estética de complexas fraturas coronárias.

The objective was to report a multidisciplinary approach in the functional and esthetic rehabilitation after dental trauma in apediatric patient. A male patient, 9 years old, presented with a complex crown fracture of the element 21 and 11 impaction of the element due to the presence of odontoma. In element 11, after the removal of odontoma was found at his spontaneous eruption restoring its function and aesthetics. In element 21, the patient received a multidisciplinary treatment, following: an increase in clinical crown, orthodontic traction, endodontic treatment, cement retainer intraradicular and aesthetic restoration. Multidisciplinary approaches are important components for successful rehabilitation of complex functional and aesthetic crown fractures.

A adesão a medidas preventivas em saúde bucal em crianças e adolescentes portadores de fissura labiopalatina / Adherence to preventive oral health measures in children and adolescents with cleft lip and palate

O objetivo deste estudo foi o de avaliar a adesão a medidas preventivas em saúde bucal de crianças e adolescentes portadores de fissuras labiopalatinas. A amostra foi composta por crianças e adolescentes com idade entre 5 e 18 anos, portadores de fissura labiopalatina isolada, em tratamento em um hospital de referência para reabilitação de malformações craniofaciais no Rio de Janeiro, entre os meses de agosto e novembro de 2009. O responsável/paciente respondeu a um questionário composto por dados sócio-demográficos e hábitos de higiene bucal e dieta. Através do exame clínico e dos prontuários médico/odontológico, foi possível identificar o tipo de fissura oral: fissura de lábio isolada (FL); fissura de lábio associada ao palato (FLP) e fissura de palato isolada (FP). Cento e oito questionários foram respondidos, e a amostra final foi composta por 100 questionários correspondentes a 53 crianças e 47 adolescentes com a maior prevalência do gênero masculino (55,0%) e indivíduos caucasianos (46%). O tipo de fissura oral mais frequente foi a FLP (63%,0), seguida da fl(19,0%) e da FP (18,0%). A maioria dos participantes do estudo relatou que realizava a escovação dos dentes três vezes ao dia, não fazia uso do fio dental e do enxaguatório bucal. A ingestão de doces entre as refeições foi mais relatada pelas crianças (66,0%), sem diferença estatística entre crianças e adolescentes (p=0,08). Observou-se que 15 (27,3%) meninos e 19 (42,2%) meninas relataram usar fio dental, sem diferença entre os gêneros (p=0,11). De acordo com os resultados observados, a adesão de medidas preventivas em saúde bucal na população foi considerada parcial. Embora a maioria dos participantes realizasse a escovação dentária três vezes ao dia, o uso do fio dental foi negligenciado, e a ingestão de doces entre as refeições foi relatada por um grande número de participantes do estudo.

The aim of this study was to assess the adherence to preventive oral health measures of children and adolescents with cleft lip and palate. The sample was composed of children and adolescents aged varied 5 to 18 years, with isolated cleft lip and palate in treatment at a referral hospital for rehabilitation of craniofacial malformations in Rio de Janeiro, between August and November 2009. The guardian/patient answered a questionnaire comprising socio-demographic data and oral hygiene habits and diet. Through clinical records and medical/dental care, it was possible to identify the type of oral clefts: cleft lip (CL), cleft lip with cleft palate (CLP) and cleft palate alone (CP). One hundred and eight questionnaires were completed and the final sample consisted of 100 questionnaires corresponding to 53 children and 47 adolescents with a higher prevalence of males (55%) and caucasians (46%). The most common type of oral cleft was CLP (63.0%), followed by CL (19.0%) and CP (18.0%). Almost all participants reported that they brushed their teeth three times a day; on the other hand, they did not use dental floss and mouthwash. The intake of sweets between meals was reported more frequently by children (66.0%), no statistical diff erence between children and adolescents (p=0.08) was observed. It was observed that 15 (27.3%) boys and 19 (42.2%) girls reported using dental floss, there was no diff erence between genders (p=0.11). According to the results, adherence to preventive measures in oral health in this population was considered partial. Although most participants to perform the tooth brushing three time a day, flossing has been neglected and eating sweets between meals was reported by a large number of study participants.

Supernumerary teeth vary depending on gender.

The presence of supernumerary teeth (ST) is a dental developmental anomaly of patterning and morphogenesis. Its variability of morphology, location and developmental timing can shed light on its etiology. In this work we report ST patterns. Orthopantomograms of 1,166 pediatric subjects were examined and the morphology, location and timing of the formation of ST were determined. The frequency of supernumerary teeth in the studied population was 2.3% (n = 27). Twenty-five subjects presented one ST. Maxilla midline was the most commonly affected region (nine cases). We noted high incidence of conical morphology in the midline region. Only teeth with tuberculate morphology presented delayed formation. ST in the midline region occurred more often in males whereas ST in the incisor region were more common in females. In conclusion, ST patterns vary depending on gender.

Supernumerary teeth vary depending on gender

The presence of supernumerary teeth (ST) is a dental developmental anomaly of patterning and morphogenesis. Its variability of morphology, location and developmental timing can shed light on its etiology. In this work we report ST patterns. Orthopantomograms of 1,166 pediatric subjects were examined and the morphology, location and timing of the formation of ST were determined. The frequency of supernumerary teeth in the studied population was 2.3 percent (n = 27). Twenty-five subjects presented one ST. Maxilla midline was the most commonly affected region (nine cases). We noted high incidence of conical morphology in the midline region. Only teeth with tuberculate morphology presented delayed formation. ST in the midline region occurred more often in males whereas ST in the incisor region were more common in females. In conclusion, ST patterns vary depending on gender.