Prevalence of traumatic dental injuries in emergency dental services: A systematic review and meta-analysis.

OBJECTIVES: This study aimed to perform a systematic review and meta-analysis regarding the prevalence of traumatic dental injuries (TDI) in emergency dental services. METHODS: Seven electronic and two grey literature databases were searched, up to December 2021, for studies that reported the TDI prevalence among dental emergencies. The Joanna Briggs Institute critical appraisal checklist for prevalence studies, and The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used to assess the risk of bias and quality of evidence respectively. The R software was used to perform a proportion meta-analysis on a random-effects model to estimate the pooled prevalence and respective 95% CI. RESULTS: From a total of 1476 studies identified after excluding duplicates, 38 met the inclusion criteria, and another five were identified through hand searching, summing 43 included observational studies with a total sample of 209099 individuals searching for emergency dental care. The overall pooled prevalence of TDI was 15.4% (95% CI: 11%-21%, I² = 100%). Paediatric dental emergency services and age group from 0 to 21 years presented the highest prevalence, 29% (95% CI: 22%-38%, I² = 99.5%) and 24% (95% CI: 15%-35%, I² = 98%) respectively. CONCLUSIONS: The overall pooled prevalence of TDI in emergency dental services was 15.4%, and 24% in the age group under 21 years. Considering the impact of prompt and correct emergency care in the long-term prognosis of TDI, such knowledge is relevant to organize emergency healthcare and support public policies in this area.

Cross-cultural adaptation of a questionnaire assessing the child and parents' expectations of orthodontic treatment in Brazil.

INTRODUCTION: The Sayers and Newton questionnaire was developed in England to assess the child's and parent's expectations about orthodontic treatment. OBJECTIVE: The aim of this study was to carry out the cross-cultural adaptation of the questionnaire for the Brazilian Portuguese language, to test its reliability, and to compare patients' and their parents' expectations of orthodontic treatment. METHODS: After translation and cross-cultural adaptation, the questionnaire was applied to 98 patients (12-14 years), who had been referred for treatment, and their caregivers. The internal consistency of the instrument was assessed by Cronbach's Alpha Coefficient and the test-retest reliability, by Intraclass Correlation Coefficient (ICC). RESULTS: Internal reliability was confirmed by a Cronbach's alpha coefficient of 0.75. Test-retest reliability revealed satisfactory reproducibility (ICC = 0.85). The results showed some significant differences between the expectations of the patients and their caregivers (p < 0.05). There were no significant gender differences (p > 0.05). CONCLUSIONS: The process of cross-cultural adaptation of the Sayers and Newton questionnaire for the Brazilian Portuguese was concluded. This study demonstrated that this instrument is reliable and applicable to assess the child's and parent's expectations about orthodontic treatment in Brazil, and it has acceptable psychometric properties.

The Correlation of Crack Lines and Definitive Restorations with the Survival and Success Rates of Cracked Teeth: A Long-term Retrospective Clinical Study.

INTRODUCTION: Cracked teeth frequently require protective adhesive restorations. This long-term, longitudinal retrospective clinical study aimed to evaluate the factors influencing the success and survival rates of cracked teeth with crack lines (CLs) in different directions when restored early with onlays or full-coverage crowns. METHODS: The dental records of 71 patients with a total of 86 cracked teeth with different pulpal and periapical diagnoses and with follow-ups spanning over 1-11 years were included. Data regarding the demographics; clinical symptoms and signs; bruxism; occlusal interferences; eating habits; pulpal and periapical diagnoses; number, direction, location, and extent of CLs; probing depth; and coronary condition before and after the placement of definitive restorations were collected. Univariate associations between tooth survival and explanatory variables were assessed. The long-term survival rate was estimated using Kaplan-Meier analysis and the log-rank test. A multivariate analysis was performed using Cox regression analysis. RESULTS: The overall success rate was 93.0%, and the overall survival estimates of cracked teeth restored early were 98.6%, 94.9%, and 55.9% at the 1-, 5-, and 11-year follow-ups, respectively. The direction of the CLs did not influence the survival of the tooth. No significant association was observed between the type of tooth, probing depth, root canal treatment, and tooth loss (P > .05). The multivariate analysis showed that previously treated cracked teeth (P < .05), the provision of onlay restorations (P < .05), and the placement of posts (P < .05) had higher correlations with tooth loss. Additionally, the placement of full-coverage crowns resulted in lower tooth loss compared with the placement of onlays (P < .05). CONCLUSIONS: Previous endodontic treatment in teeth that subsequently develop CLs has a negative impact on the survival rate of the teeth. Moreover, early placement of full-coverage crowns should be implemented for cracked teeth regardless of the direction or the number of CLs because it is associated with a higher cracked tooth survival rate.

Cross-cultural adaptation of a questionnaire assessing the child and parents' expectations of orthodontic treatment in Brazil

ABSTRACT Introduction: The Sayers and Newton questionnaire was developed in England to assess the child's and parent's expectations about orthodontic treatment. Objective: The aim of this study was to carry out the cross-cultural adaptation of the questionnaire for the Brazilian Portuguese language, to test its reliability, and to compare patients' and their parents' expectations of orthodontic treatment. Methods: After translation and cross-cultural adaptation, the questionnaire was applied to 98 patients (12-14 years), who had been referred for treatment, and their caregivers. The internal consistency of the instrument was assessed by Cronbach's Alpha Coefficient and the test-retest reliability, by Intraclass Correlation Coefficient (ICC). Results: Internal reliability was confirmed by a Cronbach's alpha coefficient of 0.75. Test-retest reliability revealed satisfactory reproducibility (ICC = 0.85). The results showed some significant differences between the expectations of the patients and their caregivers (p < 0.05). There were no significant gender differences (p > 0.05). Conclusions: The process of cross-cultural adaptation of the Sayers and Newton questionnaire for the Brazilian Portuguese was concluded. This study demonstrated that this instrument is reliable and applicable to assess the child's and parent's expectations about orthodontic treatment in Brazil, and it has acceptable psychometric properties.

RESUMO Introdução: O questionário de Sayers e Newton foi desenvolvido na Inglaterra para avaliar as expectativas dos pacientes e de seus responsáveis quanto ao tratamento ortodôntico. Objetivo: O objetivo do presente estudo foi realizar a adaptação transcultural do questionário para a língua portuguesa do Brasil, testar sua confiabilidade e comparar as expectativas de pacientes e responsáveis em relação ao tratamento ortodôntico. Métodos: Após tradução e adaptação transcultural, o questionário foi aplicado a 98 pacientes (12-14 anos), encaminhados ao departamento de Ortodontia da PUC-MINAS para tratamento e de seus responsáveis. A consistência interna do instrumento foi avaliada pelo coeficiente alfa de Cronbach, e a confiabilidade teste-reteste, pelo coeficiente de correlação intraclasse (ICC). Resultados: A confiabilidade interna foi confirmada pelo coeficiente alfa de Cronbach de 0,75. A confiabilidade teste-reteste revelou reprodutibilidade satisfatória (ICC = 0,85). Os resultados mostraram algumas diferenças significativas entre as expectativas dos pacientes e de seus responsáveis (p < 0,05). Não houve diferenças significativas quanto ao sexo (p > 0,05). Conclusões: Foi concluído o processo de adaptação transcultural do questionário de Sayers e Newton para o português brasileiro. Esse estudo demonstrou que esse instrumento é confiável e aplicável para avaliar as expectativas dos pacientes e dos pais sobre o tratamento ortodôntico no Brasil e possui propriedades psicométricas aceitáveis.

Pulp healing in immature replanted permanent teeth: A competing risk analysis.

BACKGROUND/AIM: Tooth displacement during avulsion causes total rupture of the pulp's neurovascular supply. Revascularization and pulp healing may occur in immature teeth, which gives rise to the recommendation that root canal treatment may not be required. The aim of this study was to evaluate the prognostic factors for the pulp's response after replantation of young permanent teeth. METHODS: Records from 117 patients with 133 replanted permanent immature teeth were reviewed, and pulp outcomes were classified as healing (hard tissue deposition on the dentinal walls followed by narrowing of the pulp lumen or ingrowth of bone-like tissue inside the pulp canal) or non-healing (pulp necrosis with infection). The effect of clinical and demographic co-variates on the hazards of both outcomes was assessed performing a competing risk model. RESULTS: Pulp necrosis with infection was diagnosed in 78.2% of the teeth, and healing was observed in 12.8% of the teeth. A total of 12 teeth (9.0%) were censored due to prophylactic removal of the pulp or severe external root resorption caused by eruption of adjacent canines. The cs-Cox model demonstrated that the hazards of pulp healing increased in teeth with extra-alveolar periods <15 min (csHR: 7.83, 95% CI 1.76-34.80, p = .01), while the hazards of pulp necrosis with infection decreased (csHR: 0.31, 95% CI: 0.10-0.92, p = .04). Teeth replanted with Moorrees' stages 4 and 5 of root development had higher hazards of pulp necrosis with infection than teeth with stage 2 of root development (csHR: 2.23, 95% CI 1.11-4.50, p = .03; csHR: 2.89, 95% CI: 1.40-5.95; p = .01). CONCLUSIONS: Pulp healing rarely occurred after replantation of young permanent teeth being associated with short extra-alveolar periods <15 min. Early stages of root development decreased the hazards of pulp necrosis with infection.

Tratamento endodôntico de segundo molar inferior com presença de canal mesiomediano: relato de caso / Endodontic treatment of second mandibular molar with presence of middle mesial canal: case report

Introdução: A identificação de possíveis variações anatômicas é decisiva para o correto diagnóstico e planejamento da terapia endodôntica. Objetivo: Relatar o tratamento endodôntico de um dente #37, no qual foi identificado um terceiro canal na raiz mesial (canal mesio-mediano, CMM). Caso clínico: Dente #37 com diagnóstico de pulpite irreversível sintomática, foi encaminhado para realizar tratamento endodôntico. Durante o acesso coronário, e com auxílio de microscópio operatório (MO), foram identificadas trincas coronárias. Foi solicitada uma tomografia computadorizada de feixe cônico (TCFC), a partir da qual foi descartada a presença de trinca radicular. A TCFC possibilitou, também, identificar a presença de um terceiro canal na raiz mesial, localizado entre os canais mesiovestibular e mesiolingual. O tratamento endodôntico foi executado pelo sistema reciprocante WaveOne GOLD. A solução irrigadora de escolha para o preparo químico-mecânico foi o hipoclorito de sódio a 5,25%. Imediatamente antes da obturação, os canais foram irrigados com EDTA a 17%, para auxiliar na remoção da smear layer e, em seguida, foi realizada nova irrigação com hipoclorito de sódio a 5,25%. Os canais foram secos com pontas de papel absorvente e obturados pela técnica de onda contínua de condensação. Resultados: Os canais radiculares do dente #37 foram devidamente instrumentados e obturados. A paciente não apresentou qualquer sintomatologia pós-operatória, sendo encaminhada para a reabilitação protética final. Conclusão: A TCFC e o microscópio operatório foram decisivos para o correto planejamento do caso, tanto em relação à trinca observa- da quanto à detecção do canal mesiomediano (AU).

Introduction: Identification of possible anatomical variations is crucial for the correct diagnosis and planning of endodontic therapy. Objective: To report the endodontic treatment of tooth #37, in which a third canal was located in the mesial root (middle mesial canal - MMC). Methods: Tooth #37 was diagnosed with symptomatic irreversible pulpitis and referred for endodontic treatment. Coronary cracks were found during coronal access using a dental operating microscope (DOM). A cone-beam computed tomography (CBCT) was requested. CBCT revealed cracks involving the pulp chamber floor and a third root canal in the mesial root, between the mesiobuccal and the mesiolingual canals. Endodontic treatment was performed with the WaveOne GOLD reciprocating system. The chemical-mechanical preparation was performed with 5.25% sodium hypochlorite and 17% EDTA to remove the smear layer, followed by another irrigation with sodium hypochlorite. The canals were dried with absorbent paper points. The root canal obturation was performed with the continuous wave of condensation technique. Results: The root canals of tooth #37 were correctly instrumented and obturated. The patient did not present with any postoperative symptoms, and was referred for final prosthetic rehabilitation. Conclusion: CBCT and DOM were paramount for the correct planning of the case, as regards the presence of cracks and the detection of the middle mesial canal (AU).

Survival of Replanted Permanent Teeth after Traumatic Avulsion.

INTRODUCTION: Tooth replantation is the treatment of choice for avulsion, even though its long-term prognosis shows great variability and few studies have adopted survival analysis to evaluate the fate of such teeth. The present study aimed to evaluate both the survival rate of replanted permanent teeth after traumatic avulsion as well as its clinical and demographic determinants. METHODS: Records from 576 patients treated at the Dental Trauma Clinic at the Federal University of Minas Gerais, Brazil, were analyzed to collect clinical and radiographic data. Kaplan-Meier curves and a multivariate Cox regression model were used to estimate the probability of replanted teeth remaining functional in the mouth and to determine prognostic factors. RESULTS: The post-replantation survival rate was 50% after 5.5 years. Immature teeth presented an increase of 51.3% in the loss rate (P = .002). Each additional year in the patient's age at the time of trauma, up to the limit of 16 years, reduced the loss rate of replanted teeth by 15% (P < .001). The storage of the avulsed teeth in milk decreased the loss rate of replanted teeth by 56.4% (P = .015) when compared with those kept dry. CONCLUSIONS: The overall survival rate after replantation of permanent teeeth was 50% after 5.5 years. Advanced stages of root development, together with the increase in the patient's age at the moment of trauma, up to the limit of 16 years, were good prognostic factors for tooth survival. The storage of avulsed teeth in milk was also associated with enhanced tooth survival after replantation.

Prevalence of traumatic orofacial and dental injury in unidentified bodies-Data from a forensic medicine institute in Brazil.

BACKGROUND/AIM: Orofacial trauma and traumatic dental injuries (TDI) are serious public health problems due to their high prevalence, severe morbidity, high costs of treatment, and long-term sequelae. However, the extent of the problem may be underestimated since trauma analysis, from a forensic odontology perspective, is not widely represented in the scientific literature. The aim of this study was to investigate the occurrence of traumatic orofacial injuries (TOI) and TDI in unidentified bodies and their association with the cause of death. MATERIALS AND METHODS: A retrospective analysis was conducted of dental and autopsy reports of unidentified bodies admitted to the Institute of Forensic Medicine of Belo Horizonte (IFM-BH), Brazil, between 2015 and 2016. The final sample was made up of 536 bodies. Demographic data, the location where the body was found, cause of death, and the presence and type of orofacial trauma were collected. RESULTS: The mean of the estimated age of the bodies was 38 years and the median was 35 years. Most of the bodies were from males (87.5%) and were found downtown in the city of Belo Horizonte (60.4%). Violence was the most common cause of death (64%), generally by gunshot (48.7%). Bodies with an estimated age ≤35 years were eight times more likely to have died from violent causes. TOI was registered in 50.9% of the reports. TDI was observed in 10.8% of the bodies. Victims of violent death were seven times more likely to present TOI. Such association was not observed when the presence of TDI was considered. CONCLUSIONS: There is a positive association between TOI and violent death in unidentified bodies.

Antimicrobial Photodynamic Therapy associated with long term success in endodontic treatment with separated instruments: A case report.

This paper describes a case with a 5- year follow-up of Antimicrobial Photodynamic Therapy (aPDT) associated with long-term success in endodontic treatment in a tooth with separated instruments. The patient presented with a tooth exhibiting a periapical lesion, slight swelling, and severe pain. A radiograph revealed the presence of two separated files in the middle and apical thirds of the mesial root on a lower first molar. Attempts at bypassing were not successful. In the mesial root, instrumentation was limited to the coronal ends of the separated instruments. The apical patency could not be achieved due to the blockage of the separated files. aPDT was performed in two visits, at a 660-nm wavelength and 100 mW of power, for 90 s to a total energy of 9.0 Joules. Methylene blue solution was used as photosensitizer at concentration of 0005%. A 300-µm light diffusor was coupled to the diode laser and was inserted into the root canal 2 mm short of WL, where it was set to allow better diffusion of light. Each root canal was sealed with gutta-percha by warm vertical compaction and Pulp Canal Sealer™. After 5 years of follow-up, clear evidence of remineralization of the radiolucency and bone healing was observed. This case report suggests that the addition of aPDT to conventional endodontic treatment improved microbial disinfection leading to a successful long-term outcome.

Pulp canal obliteration after traumatic injuries in permanent teeth - scientific fact or fiction?

Pulp canal obliteration (PCO) is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. The underlying mechanisms of PCO are still unclear, and no experimental scientific evidence is available, except the results of a single histopathological study. The lack of sound knowledge concerning this process gives rise to controversies, including the most suitable denomination. More than a mere semantic question, the denomination is an important issue, because it reflects the nature of this process, and directly impacts the treatment plan decision. The hypothesis that accelerated dentin deposition is related to the loss of neural control over odontoblastic secretory activity is well accepted, but demands further supportive studies. PCO is seen radiographically as a rapid narrowing of pulp canal space, whereas common clinical features are yellow crown discoloration and a lower or non-response to sensibility tests. Late development of pulp necrosis and periapical disease are rare complications after PCO, rendering prophylactic endodontic intervention useless. Indeed, yellowish or gray crown discoloration may pose a challenge to clinicians, and may demand endodontic intervention to help restore aesthetics. This literature review was conducted to discuss currently available information concerning PCO after traumatic dental injuries (TDI), and was gathered according to three topics: I) physiopathology of PCO after TDI; II) frequency and predictors of pulpal healing induced by PCO; and III) clinical findings related to PCO. Review articles, original studies and case reports were included aiming to support clinical decisions during the follow-up of teeth with PCO, and highlight future research strategies.

Pulp canal obliteration after traumatic injuries in permanent teeth - scientific fact or fiction?

Abstract: Pulp canal obliteration (PCO) is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. The underlying mechanisms of PCO are still unclear, and no experimental scientific evidence is available, except the results of a single histopathological study. The lack of sound knowledge concerning this process gives rise to controversies, including the most suitable denomination. More than a mere semantic question, the denomination is an important issue, because it reflects the nature of this process, and directly impacts the treatment plan decision. The hypothesis that accelerated dentin deposition is related to the loss of neural control over odontoblastic secretory activity is well accepted, but demands further supportive studies. PCO is seen radiographically as a rapid narrowing of pulp canal space, whereas common clinical features are yellow crown discoloration and a lower or non-response to sensibility tests. Late development of pulp necrosis and periapical disease are rare complications after PCO, rendering prophylactic endodontic intervention useless. Indeed, yellowish or gray crown discoloration may pose a challenge to clinicians, and may demand endodontic intervention to help restore aesthetics. This literature review was conducted to discuss currently available information concerning PCO after traumatic dental injuries (TDI), and was gathered according to three topics: I) physiopathology of PCO after TDI; II) frequency and predictors of pulpal healing induced by PCO; and III) clinical findings related to PCO. Review articles, original studies and case reports were included aiming to support clinical decisions during the follow-up of teeth with PCO, and highlight future research strategies.

Prevalence and risk factors associated with traumatic dental injury among 12-year-old schoolchildren in Montes Claros, MG, Brazil.

The scope of this study was to determine the prevalence of trauma in the permanent dentition of 12-year-old schoolchildren and assess associations with demographic factors such as gender and socioeconomic status and overjet and lip coverage clinical factors. A cross-sectional analysis was conducted using a representative sample of 638 students. Data were gathered by means of clinical examinations and self-administered questionnaires. Descriptive analysis was performed, followed by the use of the chi-square test and Poisson logistic regression model for the determination of significant associations. The prevalence of traumatic dental injury was 34.9%. Falls constituted the main etiological factor (49.7%), and occurred in the home (48.2%). The results of the Poisson regression analysis revealed that accentuated overjet (> 5 mm) remained associated with traumatic dental injury irrespective of the other variables [PR = 1.50 (95% CI: 1.41 to 1.61); p = 0.003]. Moreover, a statistically significant association was found between accentuated overjet and dental trauma. No significant associations were found between TDI and socioeconomic status. These findings highlight the need for prevention strategies and orthodontic correction at the onset of the permanent dentition.

Prevalence and risk factors associated with traumatic dental injury among 12-year-old schoolchildren in Montes Claros, MG, Brazil / Prevalência e fatores de risco associados ao traumatismo dentário em escolares de 12 anos de idade em Montes Claros, Minas Gerais, Brazil

The scope of this study was to determine the prevalence of trauma in the permanent dentition of 12-year-old schoolchildren and assess associations with demographic factors such as gender and socioeconomic status and overjet and lip coverage clinical factors. A cross-sectional analysis was conducted using a representative sample of 638 students. Data were gathered by means of clinical examinations and self-administered questionnaires. Descriptive analysis was performed, followed by the use of the chi-square test and Poisson logistic regression model for the determination of significant associations. The prevalence of traumatic dental injury was 34.9%. Falls constituted the main etiological factor (49.7%), and occurred in the home (48.2%). The results of the Poisson regression analysis revealed that accentuated overjet (> 5 mm) remained associated with traumatic dental injury irrespective of the other variables [PR = 1.50 (95% CI: 1.41 to 1.61); p = 0.003]. Moreover, a statistically significant association was found between accentuated overjet and dental trauma. No significant associations were found between TDI and socioeconomic status. These findings highlight the need for prevention strategies and orthodontic correction at the onset of the permanent dentition.

Introdução: O objetivo do presente estudo foi determinar a prevalência de traumatismo dentário na dentição permanente em escolares de 12 anos de idade e sua associação com fatores demográficos (gênero e condição socioeconômica) e clínicos (sobressaliência acentuada e proteção labial). Metodologia: Um estudo transversal foi realizado em uma amostra representativa de 638 escolares. Dados foram coletados por exame clínico e questionário autoaplicável. Foram realizadas análises descritivas, seguidas do teste qui-quadrado e modelo de regressão de Poisson para determinar associações. Resultados: A prevalência de traumatismo dentário foi de 34,9%. Queda foi o principal fator etiológico (49,7%). Os resultados da regressão logística de Poisson revelaram que o aumento do overjet (> 5 mm) se manteve associado aos traumatismos dentários de forma independente das demais variáveis [PR = 1.50 (95% CI: 1.41 to 1.61); p = 0.003]. Conclusão: Associação estatisticamente significativa foi observada entre aumento do overjet e presença de traumatismo dentário. Não foi observada associação estatística entre os traumatismos dentários e a condição socioeconômica. Os resultados encontrados sugerem a necessidade de estratégias de prevenção e correção ortodôntica na dentição permanente. .

Prevalence, Etiology and Treatment Needs of Traumatic Dental Injuries in Schoolchildren aged 12 years at Brasília, Brazil

To investigate the prevalence of dental trauma, its causes, sites and age at the occurrence of injuries and treatment needs related to dental trauma in schoolchildren aged 12 years at Brasília, DF, Brazil.Material and Methods:A cross-sectional, population-based study was conducted on a sample of 1,389 schoolchildren of public and private schools. Two questionnaires were used: one targeted to parents/legal caretakers and the other responded by the schoolchildren. The criteria for classification of trauma used in the ChildrenÆs Dental Survey in the United Kingdom were adopted. The examinations were performed by two trained and calibrated examiners (inter and intra-examiner kappa: 0.85 to 1.00). The association between dental trauma and the study variables was evaluated by the chi-square test.Results:A total of 1,445 students were examined, with a response rate of 80.48%. Prevalence of 14.63% (public schools) and 23.40% (private schools) of dental trauma was found...(AU)

The most common cause of dental trauma was fall (7.87%), followed by collision with objects or persons(5.03%), inadequate use of the teeth (2.33%), sports accidents (2.11%) and car accidents (0.66%). It was observed that 256 students presented injury to at least one tooth, with predominance of enamel fracture (88.67%) followed by discoloration (5.47%), enamel and dentin fracture (3.90%) and tooth loss (1.95 %). The teeth most affected by trauma were the maxillary central incisors. The accidents occurred predominantly at home (44.25%) and at the school (26.99%). Only 28.51% had received treatment for the injuries.Conclusion:Dental trauma in the study population was significant, presenting diverse etiology and expressive treatment needs, indicating the importance of preventive programs to inform the population on the possible complications after trauma, as well as the need to follow-up traumatized teeth to avoid subsequent problems...

Socio-economic indicators and predisposing factors associated with traumatic dental injuries in schoolchildren at Brasília, Brazil: a cross-sectional, population-based study.

BACKGROUND: This study assessed the prevalence of traumatic dental injuries (TDI) and its association with sociodemographic and physical characteristics in the anterior permanent teeth of 12-year-old schoolchildren at the city of Brasília - DF, Brazil. METHODS: A cross-sectional, population-based study was conducted on a sample of 1,389 boys and girls aged 12 years, enrolled in public and private fundamental schools at the Administrative Region (RA) of Brasília, Brazil, from October 2011 to September 2012. The demographic details were achieved by a structured questionnaire. The study recorded the type of damage, the size of incisal overjet, and whether lip coverage was inadequate. Sociodemographic data included sex, income and educational level of the parents or caretakers. RESULTS: A total of 1118 schoolchildren were examined, yielding a response rate of 80.48%. The prevalence of TDI was 14.63% in public schools and 23.40% in private schools. The students did not differ according to sex, income and educational level of the parents or caretakers concerning the occurrence of traumas in permanent anterior teeth. Increased overjet and inadequate lip coverage were found to be important contributing factors for TDIs. CONCLUSION: In conclusion, this study showed an expressive prevalence of TDI in 12-year-old in schoolchildren at Brasília DF, Brazil. Sex and educational level of the parents were not associated with trauma. The increased overjet and inadequate lip coverage were significantly associated with dental trauma.

Aspectos sociodemograficos e clinicos da qualidade de vida relacionada a saude bucal em adolescentes / Aspectos sociodemogragicos y clinicos de la calidad de vida relacionada con la salud bucal en adolescentes / Sociodemographic and clinical aspects of quality of life related to oral health in adolescents

OBJETIVO: Estimar a prevalência e identificar fatores sociodemográficos e parâmetros bucais associados ao impacto negativo da condição bucal na qualidade de vida de adolescentes. MÉTODOS: Foram analisados dados de 5.445 adolescentes entre 15 e 19 anos que participaram do inquérito nacional de saúde bucal (SBBrasil 2010), considerando a complexidade do desenho amostral. O desfecho foi a qualidade de vida relacionada à saúde bucal, avaliada por meio do questionário Oral Impacts on Daily Performance e analisada de forma discreta. As variáveis de exposição foram sexo, cor da pele, escolaridade, renda familiar, idade, cárie não tratada, perda dentária, dor de dente, oclusopatias, sangramento gengival, cálculo dentário e bolsa periodontal. Foram conduzidas análises de regressão de Poisson e apresentadas as razões de médias (RM), com respectivos intervalos de 95% de confiança (IC95%). RESULTADOS: Dos pesquisados, 39,4% relataram pelo menos um impacto negativo na qualidade de vida. Após o ajuste, a média do impacto negativo foi de 1,52 (IC95%1,16;2,00) vez maior no sexo feminino e 1,42 (IC95% 1,01;1,99), 2,66 (IC95% 1,40;5,07) e 3,32 (IC95% 1,68;6,56) vezes maior nos pardos, amarelos e indígenas, respectivamente, em relação aos brancos. Quanto menor a escolaridade, maior a média de impacto negativo (RM 2,11, IC95% 1,30;3,41), assim como em indivíduos com renda familiar até R$ 500,00 (RM 1,84, IC95% 1,06;3,17) comparados aos de maior renda. Encontrou-se maior impacto na qualidade de vida entre adolescentes com quatro ou mais lesões de cáries não tratadas (RM 1,53, IC95% 1,12;2,10), uma ou mais perdas dentárias (RM 1,44, IC95%1,16;1,80), com dor de dente (RM 3,62, IC95% 2,93;4,46) e com oclusopatia grave (RM 1,52, IC95% 1,04;2,23) e muito grave (RM 1,32, IC95% 1,01;1,72). ...

OBJETIVO: Estimar la prevalencia e identificar factores sociodemográgicos y parámetros bucales asociados con el impacto negativo de la condición bucal en la calidad de vida de adolescentes. MÉTODOS: Se analizaron datos de 5.445 adolescentes entre 15 y 19 años que participaron de la pesquisa nacional de salud bucal (SBBrasil 2010), considerando la complejidad del diseño de muestreo. El resultado fue la calidad de vida relacionada con la salud bucal, evaluada por medio de cuestionario Oral Impacts on Daily Performance y analizada de forma discreta. Las variables de exposición fueron sexo, color de la piel, escolaridad, renta familiar, edad, caries no tratada, pérdida dentaria, dolor de diente, maloclusiones, sangramiento de encías, cálculo dentario y bolsa periodontal. Se efectuaron análisis de regresión de Poisson y se presentaron los cocientes de promedios (RM), con sus respectivos intervalos de 95% de confianza (IC95%), RESULTADOS: Entre los investigados, 39,4% relataron por lo menos un impacto negativo en la calidad de vida. Posterior al ajuste, el promedio del impacto negativo fue de 1,52 (IC95% 1,16;2,00) veces mayor en el sexo femenino y 1,42 (IC95% 1,01;1,99), 2,66 (IC95%1,40;5,07) y 3,32 (IC95%1,68;6,56) veces mayor en los pardos, amarillos e indígenas, respectivamente, con relación a los blancos. En la medida que disminuye la escolaridad, mayor el promedio del impacto negativo (RM 2,11, IC95%1,30;3,41), así como en individuos con renta familiar hasta R$ 500,00 (RM 1,84, IC95%1,06;3,17) en comparación con los de mayor renta. Se encontró mayor impacto en la calidad de vida entre adolescentes con cuatro o más lesiones de caries no tratadas (RM1,53, IC95%1,12;2,10), una o más pérdidas dentarias (RM1,44, IC95%1,16;1,80), con dolor de diente (RM3,62, IC95%2,93;4,46), y con maloclusión grave (RM1,52, IC95%1,04;2,23) y muy grave ...

OBJECTIVE: To estimate the prevalence and to identify sociodemographic and oral health factors associated with the negative impact of oral health conditions on the quality of life in adolescents. METHODS: Data from 5,445 adolescents aged 15-19, who took part in the Brazilian Oral Health Survey (SBBrasil 2010) were analyzed, using a multistage sampling design. The outcome was quality of life related to oral health, which was assessed using the Oral Impacts on Daily Performance questionnaire and analyzed as a discrete variable. The independent variables were sex, skin color, schooling, household income, age, untreated dental caries, malocclusion.,gingival bleeding, dental calculus, and periodontal pocket. Poisson regression analysis was carried out and mean ratios (MR) with their respective 95% confidence intervals (95%CI) were presented. RESULTS: Of the total, 39.4% reported at least one negative impact on their quality of life. After adjustment, the mean negative impact was 1.52 (95%CI 1.16;2.00) times higher in females and 1.42 (95%CI 1.01;1.99), 2.66 (95%CI 1.40;5.07) and 3.32 (95%CI 1.68;6.56) higher in those with brown, yellow, and indigenous skin color, respectively, when compared to those with white skin. The lower the level of schooling, the greater the negative impact (MR 2.11, 95%CI 1.30;3.41), likewise for individuals with household income below R$ 500.00 (MR 1.84, 95%CI 1.06;3.17) compared with those with higher incomes. The greatest impact on quality of life was found among adolescents with four or more teeth with untreated dental caries (MR 1.53, 95%CI 1.12;2.10), one or more missing teeth (MR 1.44. 95%CI 1.16;1.80). those with dental pain (RM 3.62, 95%CI 2.93;4.46) and with severe (MR 1.52, 95%CI 1.04;2.23) and very severe malocclusion (MR 1.32, 95%CI 1.01;1.72). CONCLUSIONS: Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken ...

[Sociodemographic and clinical aspects of quality of life related to oral health in adolescents]. / Aspectos sociodemográficos e clínicos da qualidade de vida relacionada à saúde bucal em adolescentes.

OBJECTIVE: To estimate the prevalence and to identify sociodemographic and oral health factors associated with the negative impact of oral health conditions on the quality of life in adolescents. METHODS: Data from 5,445 adolescents aged 15-19, who took part in the Brazilian Oral Health Survey (SBBrasil 2010) were analyzed, using a multistage sampling design. The outcome was quality of life related to oral health, which was assessed using the Oral Impacts on Daily Performance questionnaire and analyzed as a discrete variable. The independent variables were sex, skin color, schooling, household income, age, untreated dental caries, malocclusion.,gingival bleeding, dental calculus, and periodontal pocket. Poisson regression analysis was carried out and mean ratios (MR) with their respective 95% confidence intervals (95%CI) were presented. RESULTS: Of the total, 39.4% reported at least one negative impact on their quality of life. After adjustment, the mean negative impact was 1.52 (95%CI 1.16;2.00) times higher in females and 1.42 (95%CI 1.01;1.99), 2.66 (95%CI 1.40;5.07) and 3.32 (95%CI 1.68;6.56) higher in those with brown, yellow, and indigenous skin color, respectively, when compared to those with white skin. The lower the level of schooling, the greater the negative impact (MR 2.11, 95%CI 1.30;3.41), likewise for individuals with household income below R$ 500.00 (MR 1.84, 95%CI 1.06;3.17) compared with those with higher incomes. The greatest impact on quality of life was found among adolescents with four or more teeth with untreated dental caries (MR 1.53, 95%CI 1.12;2.10), one or more missing teeth (MR 1.44. 95%CI 1.16;1.80). those with dental pain (RM 3.62, 95%CI 2.93;4.46) and with severe (MR 1.52, 95%CI 1.04;2.23) and very severe malocclusion (MR 1.32, 95%CI 1.01;1.72). CONCLUSIONS: Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken into account when planning preventive, monitoring and treatment strategies for oral health problems in groups with the highest impact on their quality of life.

[Relevant methodological issues from the SBBrasil 2010 Project for national health surveys]. / Aspectos metodológicos do Projeto SBBrasil 2010 de interesse para inquéritos nacionais de saúde.

The SBBrasil 2010 Project (SBB10) was designed as a nationwide oral health epidemiological survey within a health surveillance strategy. This article discusses methodological aspects of the SBB10 Project that can potentially help expand and develop knowledge in the health field. This was a nationwide survey with stratified multi-stage cluster sampling. The sample domains were 27 State capitals and 150 rural municipalities (counties) from the country's five major geographic regions. The sampling units were census tracts and households for the State capitals and municipalities, census tracts, and households for the rural areas. Thirty census tracts were selected in the State capitals and 30 municipalities in the countryside. The precision considered the demographic domains grouped by density of the overall population and the internal variability of oral health indices. The study evaluated dental caries, periodontal disease, malocclusion, fluorosis, tooth loss, and dental trauma in five age groups (5, 12, 15-19, 35-44, and 65-74 years).

[Oral health epidemiology and surveillance models in Brazil]. / Perfis epidemiológicos de saúde bucal no Brasil e os modelos de vigilância.

National surveys are important tools for public health surveillance and thus key elements in monitoring health conditions and system performance. In the field of oral health, such surveys began with the oral health survey in 1986 and later in 1996 and with the SBBrasil Project in 2003. The 2010 edition of SBBrasil is the principal oral health surveillance strategy for the production of primary data. In order to contribute to this discussion, this article proposes: (a) to present and discuss the Brazilian experience with nationwide oral health surveys and (b) to discuss the use of data in health surveillance models. One can conclude that oral health surveys in Brazil have great possibilities as a tool for health services and academia. Such surveys have shown evident potential for verifying trends in the oral health profile, as well as for producing valid indicators for use in health services.

Predominio de la caries dental en niños de una pequeña ciudad brasileña / Dental caries prevalence in children from a brazilian small town

Objetivo: determinar el predominio de la caries dental en niños de 6 a 12 años de edad que viven en las zonas urbanas y rurales en una pequeña ciudad en Brasil, así como comprobar la relación entre aspectos demográficos y la experiencia de caries. Materia y Métodos: el estudio transversal se llevó a cabo con una población de 185 estudiantes que residen en la ciudad de Patis, estado de Minas Gerais, Brasil, siendo 72 de 6 años de edad y 113 de 12 años de edad. Después del cepillado supervisado, los niños fueron examinados. Resultados: se observó que el predominio de caries en dentición primaria en los niños de 6 años de edad fue 87,5% y el índice de ceod de 5,2 y 74,4%, y CPOD de 2,8 entre los estudiantes de 12 años. El predominio de caries dental fue elevada entre los niños de 6 a 12 años de edad, residentes en las zonas rurales con un predominio del componente cariado de los índices ceod y CPOD. Conclusiones: los resultados han demostrado que existe una necesidad de tratamiento acumulado y una baja cobertura de servicios dentales locales, lo que sugiere la importancia de centralizar los esfuerzos para adoptar mejores estrategias para cambiar la situación existente.

Objectives: the aim of this study was to evaluate the prevalence of dental caries in schoolchildren between 6 and 12 years old living in urban and rural areas of a small city of Brazil, to investigate the relationship between demographics and caries experience. Methods: we conducted cross-sectional study population of 185 children living in the city of Patis, Minas Gerais State. Seventy two children were 6 years- old and 113 were 12 12 year old. Children were examined after supervised toothbrushing. Results: it was observed that the prevalence of caries in primary teeth in 6 year old school children was 87.5% and the dmft index was5.2 and in the 12 year old group, a prevalence of 74.4%, and DMFT of 2.8. The prevalence of dental caries was higher in 6 than in 12 year old children, living in rural areas with a predominance of the decay component of the results showed the need for accumulated treatment and low coverage of the local dental service, suggesting the importance to centralize efforts to adopt more appropiate strategies to reverse the deficit situation.