Publication Trends Studies Involving Disabled Persons with Dental Care Needs: A 20-Year Bibliometric Analysis

ABSTRACT Objective: To evaluate scientific production on disabled persons with dental care needs over a 20-year period. Material and Methods: The search was conducted in the PubMed database using the MeSH terms "Disabled Persons" AND "Dentistry". Three researchers selected articles based on readings of the title, abstract and full text. The articles were categorized according to periodical, country, study design, subject and classification of comorbidities and associated disorders. Three hundred ninety-seven articles published in 140 periodicals were included. Results: The periodicals Special Care in Dentistry (54), Dental Clinics of North America (14) and British Dental Journal (14) accounted for 21% of the publications. The studies were conducted in 50 countries, with the United States accounting for 33%. More than half (52%) of the studies had a cross-sectional design. The main subject addressed was oral diagnosis and most of the comorbidities were generalized disabilities. Conclusion: Although a large number of the periodicals have contributed to knowledge building on disabled persons with dental care needs, the number of articles is small compared to other fields of dentistry. Moreover, important gaps in knowledge persist and projects with better methodological designs are needed to offer a more substantial contribution to clinical practice.

Compound odontoma causing impaction of primary tooth in a 4-year-old child: case report / Impacção de dente decíduo por presença de odontoma composto em criança de 4 anos: relato de caso

Objetivo: relatar um caso raro de impacção de um incisivo decíduo inferior pela presença de odontoma composto, bem como descrever a sua abordagem clínica. Relato de caso: paciente do sexo masculino, com 4 anos de idade, apresentava ausência do incisivo lateral decíduo inferior esquerdo. O exame radiográfico mostrou impacção do incisivo não erupcionado próximo a estruturas radiopacas sugestivas de odontoma composto. O paciente foi acompanhado por dois anos, momento em que se realizou abordagem cirúrgica do caso. Após a cirurgia, a hipótese de diagnóstico de odontoma composto foi confirmada e com o acompanhamento ocorreu a erupção dos incisivos centrais permanentes inferiores. O paciente foi encaminhado para tratamento ortodôntico. Considerações finais: esse relato de caso aborda um caso raro de odontoma composto associado à não erupção de dente decíduo, uma vez que odontomas costumam ser detectados preferencialmente na segunda década de vida do paciente, sendo associados à impacção de dentes permanentes. Além disso, apresenta um protocolo de abordagem clínica para esses casos quando diagnosticados em idade precoce no paciente infantil.(AU)

Objective: to report a rare case of impaction of a primary mandibular incisor due to the presence of a compound odontoma and describe its clinical management. Case report: a 4-year-old boy presented with a "missing" primary left mandibular lateral incisor. Radiographs showed impaction of the unerupted incisor by adjacent radiopaque structures consistent with a compound odontoma. The patient was recalled periodically for 2 years, at which time surgical excision was performed. The diagnosis of compound odontoma was confirmed histologically, and the permanent mandibular central incisors erupted uneventfully; the patient was referred for orthodontic treatment. Final considerations: this case report describes an unusual case of compound odontoma associated with an unerupted deciduous tooth; odontomas are rare in this age range, occurring predominantly in the second decade of life and in association with impaction of permanent teeth. We also propose a protocol for clinical management of such early-onset cases.(AU)

New Post-COVID-19 Biosafety Protocols in Pediatric Dentistry

Abstract The most recent Severe Acute Respiratory Syndrome - COVID-19 - caused by coronavirus infection (SARS-CoV-2) has high-virulence transmission and direct human contagiousness by proximity. Thus, the considerable occupational risk in pediatric dentistry is evident, given the nature and form of procedures performed in an outpatient setting. Thus, the aim of this paper was to identify and contextualize technical and scientific information available to date aimed at preventing and minimizing risks for patients, caregivers and professionals. The results indicate that protective measures are being developed considering procedures according to risks and benefits, and five points stand out: 1. Regulation of resumption of elective procedures, screening and scheduling patients; 2. Restructuring clinical environment and infection control; 3. Improvement of personal protective equipment and biosafety recommendations; 4. Maximization of the use of non-invasive techniques, use of high-powered dental suction, and absolute isolation of the operative field; and 5. Minimization of the use of air-water syringe, dental spittoon and high-speed handpiece. The measures to be taken require reflection for the restart of a "new clinical practice", especially aiming at behavioral and structural changes regarding operational biosafety.

Eruption hematoma in deciduous and permanent dentition: Case reports / Hematoma de erupção em dentição decídua e permanente: relato de casos clínicos

Cisto de erupção é um cisto de tecido mole decorrente de uma dilatação do espaço folicular em torno da coroa do dente em erupção, causado pelo acúmulo de líquido ou de sangue. Quando a cavidade cística que circunda a coroa do dente contém sangue, a lesão é denominada hematoma de erupção. O objetivo deste trabalho foi relatar dois casos clínicos de hematomas de erupção, assintomáticos, um relacionado à dentição decídua e o outro à dentição permanente. O tratamento dos casos foi baseado no acompanhamento, sem necessidade de intervenção cirúrgica e foi observada a correta erupção dos dentes.

Eruption cyst is a soft tissue cyst, resulting from dilation of the follicular space around the crown of the erupting tooth, caused by the accumulation of fluid or blood. When the cystic cavity surrounding the crown of the tooth contains blood, the lesion is called an eruption hematoma. The objective of this study was to report two clinical cases of asymptomatic eruptive hematomas, one related to deciduous dentition and the other to permanent dentition. The treatment of the cases was based on follow-up, without the necessity of surgical intervention and the correct eruption of the teeth was observed.

Traumatismos alveolodentários e fatores associados em crianças assistidas em um curso de Odontologia no sul do Brasil / Traumatic dental injuries and associated factors in children assisted in a school of Dentistry in Southern Brazil

Aim: To estimate the prevalence of traumatic dental injuries (TDI) and investigate demographic and socioeconomic factors associated among children attending at School of Dentistry, Southern Brazil. Methods: A cross-sectional study was carried out with 374 children attending the Pediatric Clinic, from School of Dentistry at the Universidade Luterana do Brasil, Canoas, Southern Brazil. Information from parents/caregivers on socioeconomic factors were obtained with an structured questionnaire. Children were clinically examined and TDI was recorded following Andreasen criteria. Poisson regression with robust variance was employed to determine factors associated with TDI. Results: A total of 15.0% of children exhibited TDI (95% CI 11.5-19.0%). The most common dental injuries involved hard tissues (enamel fracture, enamel and dentine fracture). Adjusted analysis revealed that the probability of TDI was almost 90% higher in older children (10 to 12 years) compared to children who were 7 to 9 years old; (PR 1.89; 95% CI 1.05­3.43), two fold higher in children from older mothers (≥ 35 years) (PR 2.01; 95% CI 1.23­3.30), and 66% higher in children from mothers with lower education (≤8 years) (PR 1.66; 95% CI 1.02­2.70). Conclusion: Our findings showed a high prevalence of TDI. Moreover, sociodemographic factors, specially, maternal schooling and aging were associated with the outcome. Epidemiological studies of specific groups allowed in the organization of health services and elaboration of preventive and curative strategies.

Objetivo: estimar a prevalência de traumatismos alveolodentários (TAD) e investigar fatores sociodemográficos associados em crianças assistidas em um Curso de Odontologia no Sul do Brasil. Métodos: Um estudo transversal foi realizado com 374 crianças atendidas na Clínica Infantil do Curso de Odontologia da Universidade Luterana do Brasil, Canoas, Brasil. Informações sobre fatores sociodemográficos foram obtidas com pais ou cuidadores por meio de um questionário estruturado. As crianças foram clinicamente examinadas e TAD foram registrados, conforme critério de Andreasen. Regressão de Poisson com variância robusta foi empregada para determinar os fatores associados com o desfecho. Resultados: A prevalência de TAD foi de 15,0% (IC 95% 11,0-19,0%). As lesões mais comuns foram lesões aos tecidos duros (fratura de esmalte e de esmalte e dentina), especialmente na dentição permanente. A análise ajustada mostrou que a probabilidade de TAD foi quase 90% maior em crianças de maior idade (10 a 12 anos) em relação a crianças de 7 a 9 anos (RP 1,89; IC 95% 1,05­3,43), duas vezes maior em filhos de mães com maior idade (≥ 35 anos) (RP 2,01; IC 95% 1,23­3,30) e 66% maior em crianças de mães com menor escolaridade (≤8 anos) (RP 1,66; IC 95% 1,02­2,70). Conclusão: Observou-se uma alta prevalência de TAD. Além disso, fatores sociodemográficos, especialmente escolaridade e idade materna, estiveram associados ao desfecho. Estudos epidemiológicos de grupos específicos permitem a organização de serviços de saúde e a elaboração de estratégias preventivas e curativas.

Amelogenesis imperfecta in a child with cerebral palsy / Amelogenese imperfecta em uma criança com paralisia cerebral

Amelogenesis Imperfecta (AI) is an inherited alteration that affects the enamel of primary and permanent teeth, with no systemic manifestations. Cerebral Palsy (CP) is a congenital condition that affects the central nervous system before the age of two, influencing the performance of activities usually conducted by children with normal development. The objective of this study was to describe the dental treatment performed in a 10-year-old child with both amelogenesis imperfecta and cerebral palsy. The family of the child sought the office of the extension project "Gaining Health: Dental Care for Patients with Disabilities" of the Lutheran University of Brazil, located in the city of Canoas, in search of aesthetic rehabilitation. Upon physical and radiographic examination, the AI diagnosis was confirmed. The use of physical restraint with the consent of the parents was necessary to perform dental care. The treatment began with orientations on oral hygiene and eating habits, in addition to supragingival scaling. Next, it was decided to cover the posterior teeth with glass ionomer and to reconstruct the anterior teeth with resin-based composite, using acetate crowns. In the follow-up of the case, an improvement in oral health and aesthetics of the patient was observed. Moreover, this report demonstrates that the complex dental care of disabled patients can be performed in an outpatient environment.

A Amelogênese Imperfeita (AI) é uma alteração hereditária que afeta o esmalte dentário dos dentes decíduos e permanentes, com ausência de manifestações sistêmicas. A Paralisia Cerebral (PC) é uma alteração congênita que afeta o sistema nervoso central antes dos dois anos de idade, dificultando o desempenho de atividades frequentemente realizadas por crianças com desenvolvimento normal. O objetivo deste estudo foi descrever o tratamento odontológico realizado em criança com 10 anos de idade com Amelogênese Imperfeita e Paralisia Cerebral. A família procurou a clínica do Projeto de Extensão "Conquistando Saúde: Atendimento odontológico à pacientes com deficiência" da Universidade Luterana do Brasil Canoas/RS em busca de reabilitação estética. Ao exame físico e radiográfico confirmou-se o diagnóstico de AI. A utilização de estabilização física com a concordância dos pais foi necessária para a realização do tratamento odontológico. O tratamento iniciou com orientações de higiene bucal, dieta e raspagens supra gengivais. Na sequência, optou-se pelo recobrimento com ionômero de vidro dos dentes posteriores e reconstrução dos anteriores com resina composta utilizando-se coroas de acetato. No acompanhamento do caso observou-se melhora na saúde bucal e estética da paciente. Além disso, este relato demonstra que o atendimento odontológico complexo em pacientes com deficiência pode ser realizado em ambiente ambulatorial.

Percepção de estudantes de graduação em Odontologia frente ao atendimento de pessoas com deficiência / Perception of Dental undergraduate students related to the attendance of special needs people or people with disabilities

O objetivo deste estudo foi identificar e analisar a percepção de estudantes frente ao atendimento de pessoas com deficiência no projeto de extensão "Conquistando saúde: atendimento odontológico de pessoas com deficiência" da Universidade Luterana do Brasil (ULBRA), em Canoas/RS. O delineamento do estudo foi qualitativo e envolveu 13 estudantes. Os dados foram obtidos por meio de entrevista semiestruturada realizada no ambulatório do curso de Odontologia por um pesquisador treinado e os dados foram analisados por análise de conteúdo. As questões versavam a respeito do conhecimento em relação a pessoas com deficiência, a motivação para participar do projeto e os sentimentos norteadores dos atendimentos. A maioria dos entrevistados modificou opiniões existentes sobre o que acreditavam ser uma pessoa com deficiência e seus sentimentos prévios aos atendimentos, acrescentando novos conceitos e sentimentos que fomentaram sua construção profissional. A oportunidade de vivenciar o atendimento odontológico de pessoas com deficiências ainda na graduação em Odontologia contribui para a formação de um profissional mais capacitado tanto técnica quanto emocionalmente. Com isto, há ampliação do atendimento, minimizando a dificuldade enfrentada por estes pacientes na busca pelo atendimento odontológico (AU).

This study aimed to identify and to analyze students' perceptions regarding the assistance of people with disabilities in the extension project "Conquering health: dental assistance of people with disabilities", of Universidade Luterana do Brasil (ULBRA) in Canoas/RS. It is a qualitative study developed with 13 students. Data were collected by a trained researcher using semistructured interviews in the Dental College Clinic and were analyzed with content analysis. The questions approached participants' knowledge regarding people with disabilities, their motivations to take part of the project, and feelings guiding their assistance. Most participants changed their opinions about what they believed to be a person with disabilities as well as their previous feelings towards assistance, adding new concepts and feelings that encourage professional performance. The opportunity to deeply experience dental assistance of people with disabilities while attending undergrad dentistry school contributes to the development of better professionals, both technically and emotionally. Therefore, there is an amplification of dental assistance, minimizing difficulties faced by patients with disabilities when looking for dental assistance (AU).

An unusual presentation of oral mucocele in a young pediatric patient / Uma apresentação incomum de mucocele oral em paciente pediátrico jovem

Mucocele is a common condition of the minor salivary glands that is generally found on the lower lip. Although etiology is uncertain, mucocele are usually caused by local trauma. Cases involving infants are rarely reported in the literature. The objective of this study is to report an unusual case of mucocele in the fi rst year of life that was treated with surgical removal and postoperative follow-up. This report illustrates the main features of clinical interest and discuss classifi cation, differential diagnosis and the treatment approaches described in the literature.

Mucocele é uma alteração comum de glândulas salivares menores que acomete principalmente o lábio inferior. Embora a etiologia seja incerta, normalmente é causada por um trauma local. Casos envolvendo bebês são raramente relatados na literatura. O objetivo deste estudo é descrever um caso não usual de mucocele no primeiro ano de vida. O tratamento foi a remoção cirúrgica da mucocele e acompanhamento pós-operatório. Com o presente relato pretende-se ilustrar os principais aspectos de interesse clínico, discutindo a classifi cação e o diagnóstico diferencial, além das modalidades terapêuticas descritas na literatura

Eruption cyst associated with tooth rotation on deciduous dentition: A case report / Cisto de erupção associado com giroversão dentária na dentição decídua: relato de caso

The eruption cyst is a benign soft tissue anomaly that may occur during eruption of deciduous or permanent teeth. It is usually asymptomatic and its treatment involves clinical follow-up of dental eruption. However, it may become infected or cause discomfort and pain. In such cases, surgical treatment is recommended. The present report aimed to describe a clinical case of eruption cyst located on the deciduous mandibular incisors' area of a four-month-old female infant since her birth. After surgical treatment a change was observed in the position (rotation) of the tooth associated with the cystic lesion. Rotation of the mandibular incisor persisted during the deciduous dentition development.

O cisto de erupção é uma anomalia benigna de tecidos moles que pode ocorrer durante a erupção dos dentes permanentes ou decíduos. Ele é geralmente assintomático e seu tratamento envolve acompanhamento clínico da erupção dental. No entanto, ele pode se tornar infectado ou causar desconforto e dor. Em tais casos, é recomendado tratamento cirúrgico. O presente relato teve como objetivo descrever um caso clínico de cisto de erupção localizado na área dos incisivos inferiores decíduos presente em um bebê de quatro meses de idade desde seu nascimento. Após o tratamento cirúrgico foi observada uma mudança na posição (rotação) do dente associado com a lesão cística. A rotação do incisivo inferior persistiu durante o desenvolvimento da dentição decídua.

Clarifying the effect of behavioral and clinical factors on traumatic dental injuries in childhood: a hierarchical approach.

AIM: To explore associations between traumatic dental injuries (TDI) in Brazilian preschool children and clinical, behavioral, and socio-demographic factors using a hierarchical approach. MATERIAL AND METHODS: A cross-sectional study was conducted involving 1316 children aged 0-5 years at public preschools in the city of Canoas (southern Brazil). Demographic (sex and age), socioeconomic (mother's schooling, income and family structure) and behavioral (use of pacifier, breastfeeding duration and bottle use at 12 months) factors were collected through a questionnaire. TDI (Andreasen criteria) and malocclusion (overjet and anterior open bite) were recorded by trained and calibrated examiners. Poisson regression was employed to determine factors associated with TDI using a hierarchical approach. RESULTS: The prevalence of TDI was 13.3%. In the final model, the probability of TDI was 50% higher in children who used a pacifier (PR: 1.50; 95% CI: 1.08-2.10), 77% higher in children with overjet between 3 and 5 mm (PR: 1.77; 95% CI: 1.22-2.57) and nearly threefold higher in children with overjet > 5 mm (PR: 2.73; 95% CI: 1.77-4.20) compared with children with overjet ≤ 2 mm. Additional analysis demonstrated that overjet represented the pathway by which pacifier use was associated with TDI. CONCLUSION: Pacifier use is strongly associated with the occurrence of TDI in the primary dentition, and accentuated overjet represents a pathway to this association. These findings suggest the need for prevention strategies that address early counseling on pacifier use to reduce the occurrence of TDI.

Gains in children's dental health differ by socioeconomic position: evidence of widening inequalities in southern Brazil.

UNLABELLED: Oral health inequalities are the measures by which equity in oral health is tracked. Despite widespread improvement in children's dental health globally, substantial socio-economic disparities persist and may be worsening. OBJECTIVES: Quantify 10-year changes in child caries occurrence by socio-economic position in a Southern Brazilian city and compare oral health inequalities over time. METHODS: Representative surveys of dental caries in children (age <6 years) in Canoas, Brazil, were conducted in 2000 and 2010 following standardized methods. For each survey year, we calculated disparities by socio-economic position (maternal education and family income) in age- and sex-standardized caries occurrence (prevalence: dmft > 0; severity: mean dmft) using absolute measures (difference and Slope Index of Inequality) and relative measures (ratio and Relative Index of Inequality). RESULTS: Comparing 2010 to 2000, caries occurrence was lower in all socio-economic strata. However, reductions were more pronounced among socio-economically advantaged groups, yielding no improvement in children's oral health disparities. Some disparity indicators were consistent with increasing inequality. CONCLUSIONS: Overall, dental caries levels among children in Canoas improved, but inequalities in disease distribution endured. Concerted public health efforts targeting socio-economically disadvantaged groups are needed to achieve greater equity in children's oral health.

Exploring the impact of oral diseases and disorders on quality of life of preschool children.

OBJECTIVE: To assess the impact of oral health outcomes on Oral Health-Related Quality of Life (OHRQoL) in a school-based sample of Brazilian preschool children and their families. METHODS: A cross-sectional study was conducted in 1036 children aged 2-5 years attending all the public nurseries in Canoas, Brazil. Caregivers were asked to complete questionnaire on socioeconomic status and the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the children's OHRQoL. Clinical assessment included dental caries, traumatic dental injuries (TDI) and malocclusion. Multivariable Poisson regression models with robust variance were fitted to assess covariates for the prevalence of impacts on OHRQoL following a theoretical hierarchical framework. RESULTS: 17.4% of the caregivers reported that their child had an impact on at least one ECOHIS item. Negative impacts were more prevalent on items related to pain, difficult drinking and eating some foods. The multivariable Poisson regression analysis showed that dental caries, TDI and malocclusion were associated with the outcome. The prevalence of having any impact on OHRQoL was almost three times higher for children with dental caries (PR 2.74 95% CI 2.02-3.72) compared to those who were caries free; and approximately 1.5 times higher for those who presented TDI (PR 1.70 95% CI 1.27-2.27) and malocclusion (PR 1.42 95% CI 1.04-1.94). CONCLUSIONS: The findings showed that caregivers of young children with oral disease and disorders perceived that both the children and other family members had poorer quality of life. Oral health policies should be included into general health programs based on common risk approach.

Avaliação bibliométrica da produção científica da revista Stomatos / Bibliometric evaluation of the scientific production of the Stomatos Dental Journal

This cross-sectional study aimed to evaluate the abstracts of all articles published in the Stomatos Dental Journal between 1995 and 2009 and to obtain data on the methodological design of each article, the dental specialties focused on, and the authors’ institution of origin. A total of 206 abstracts were reviewed by two independent examiners. The results showed that the most frequent study designs were literature reviews (24.3%), cross-sectional studies (24.3%), laboratory in vitro studies (22.3%), and case reports (18.4%). The dental specialties with the highest number of articles were operative dentistry (16%), endodontics (15.5%), pediatric dentistry (10.7%), and oral and maxillofacial surgery and traumatology (10.2%). Most articles had Universidade Luterana do Brasil (ULBRA/Canoas) as the institution of origin (75.2%). Our findings revealed a pressing need to increase the number of studies with higher levels of evidence in all dental specialties and also to encourage the publication of articles from other institutions in order to qualify the journal.

Este estudo transversal teve como objetivo avaliar o perfil dos artigos publicados na revista Stomatos no período de 1995 a 2009 quanto ao tipo de delineamento metodológico, especialidade odontológica e instituição de ensino superior de procedência dos autores. Um total de 206 resumos foram revisados por dois examinadores independentes. Os resultados mostraram que os delineamentos mais utilizados foram a revisão de literatura (24,3%), o estudo transversal (24,3%), o estudo laboratorial in vitro (22,3%) e o relato de caso (18,4%). As especialidades odontológicas com maior número de publicações foram a dentística (16%), endodontia (15,5%), odontopediatria (10,7%) e cirurgia e traumatologia bucomaxilofacial (10,2%). A maioria dos artigos tinha o Curso de Odontologia da Universidade Luterana do Brasil (ULBRA/Canoas) como instituição de ensino oficial (75,2%). Os resultados revelaram uma necessidade premente de aumentar a publicação de estudos com maior nível de evidência, em todas as especialidades, e também de reduzir a endogenia, através da participação de autores de outras instituições, para permitir a qualificação da revista.

Dente decíduo duplo: relato de um caso atípico / Double deciduos tooth: report of an unusual case

Dentes duplos são anomalias da formação dentária decorrentes da união de dois germes dentários ou da tentativa de divisão destes. A fusão é caracterizada pela união de dois dentes adjacentes, enquanto que na geminação ocorre a tentativa de divisão de um único dente. Essa anomalia pode ocorrer tanto na dentição decídua quanto na permanente. No entanto, verifica-se maior prevalência nos dentes decíduos e geralmente são unilaterais, envolvendo um ou dois dentes adjacen-tes na região de incisivos e caninos inferiores. Objetivo: O objetivo do presente estudo é descrever o tratamento de um caso atípico de dente duplo na região posterior da dentição decídua. Relato do caso: Este artigo relata um caso raro de dente duplo numa paciente de dois anos e dez meses de idade, decorrente da fusão de um canino com o primeiro molar decíduo superior. O dente duplo apresentava necrose pulpar em apenas um dos dentes envolvidos na fusão e foi tratado endodonticamente com o uso de uma pasta iodoformada. O sucesso clínico e radiográfico do caso foi constatado mediante o acompanhamento clínico da paciente. Considerações finais: O cirurgião-dentista deve estar atento ao corre-to diagnóstico e pronto atendimento das anomalias da odontogênese, estando apto para realizar a abordagem mais adequada a cada condição clínica observada.

Association between occlusal anomalies and dental caries in 3- to 5 year-old Brazilian children.

OBJECTIVE: To investigate the association between certain occlusal anomalies and the occurrence and severity of dental caries in Brazilian preschool children. DESIGN: Cross-sectional study. SETTING: Twenty-eight public nursery schools in Canoas, southern Brazil. SUBJECTS AND METHODS: The study population comprised 890 three- to five-year-old children. Five trained and calibrated observers examined children for determination of decayed, missing and filled tooth (dmft) index (World Health Organization criteria including white spots) and orthodontic variables. OUTCOME MEASURES: Caries severity (dmft) and caries occurrence (dmft ≥ 1). STATISTICAL ANALYSIS: Multivariable analysis was performed using Poisson regression with robust variance in order to determine the occlusal anomalies which represent risk factors for the occurrence of the binary outcome. RESULTS: Caries severity was significantly higher among children without spacing in the maxillary anterior teeth (P = 0·001) and mandibular anterior teeth (P = 0·003) and among children without accentuated overjet (P = 0·023). The multivariable analysis demonstrated that children without spacing in maxillary anterior teeth had an increased risk of dental caries (prevalence ratio = 1·43; 95% CI, 1·05-1·93). Open bite, accentuated overjet and posterior cross-bite were not associated with this outcome in the final model. CONCLUSIONS: Absence of spacing in the maxillary labial segment represents a risk factor for dental caries in preschool children.

Atenção odontológica em pacientes com deficiências: a experiência do curso de Odontologia da ULBRA (Canoas/RS) / Dental attention in patients with disabilities: the experience in the School of Dentistry of the Lutheran University (Canoas/RS)

O objetivo deste estudo foi avaliar o perfil dos pacientes com deficiência atendidos no projeto de extensão "Conquistando Saúde: atendimento a pacientes com necessidades especiais" do Curso de Odontologia da Universidade Luterana do Brasil - Campus Canoas / RS, no período de 2001 a 2006. A coleta dos dados foi feita a partir dos prontuários dos pacientes atendidos no referido período. Observou-se um equilíbrio entre os pacientes do sexo masculino e feminino, uma maior procura ao serviço por pacientes jovens, procedentes de Canoas e com distúrbios neurológicos. Aproximadamente 80% dos pacientes apresentavam experiência de cárie. A partir dos resultados obtidos sugere-se o estabelecimento de políticas públicas de promoção de saúde e reorientação de serviços odontológicos que facilitem o acesso e a utilização por indivíduos com deficiências.

The objective of this study was to evaluate the profile of patients with disabilities served by the extension project "Conquering Health: serving patients with special needs" in the School of Dentistry Lutheran University of Brazil - Canoas Campus/RS, from 2001 to 2006. The data was collected from patients's charts. A similar number of male and female patients, a higher prevalence of young patients, coming from Canoas and with neurological disorders was observed. Approximately 80% of the patients with disabilities presented caries. The results obtained suggest the establishment of public policies on health promotion and reorientation of dental services that facilitate access and use by individuals with disabilities.

Exploring factors associated with traumatic dental injuries in preschool children: a Poisson regression analysis.

OBJECTIVE: This cross-sectional study aimed to investigate the factors associated with dental trauma in preschool children using Poisson regression analysis with robust variance. SUBJECTS AND METHODS: The study population comprised 888 children aged 3- to 5-year-old attending public nurseries in Canoas, southern Brazil. Questionnaires assessing information related to the independent variables (age, gender, race, mother's educational level and family income) were completed by the parents. Clinical examinations were carried out by five trained examiners in order to assess traumatic dental injuries (TDI) according to Andreasen's classification. One of the five examiners was calibrated to assess orthodontic characteristics (open bite and overjet). Multivariable Poisson regression analysis with robust variance was used to determine the factors associated with dental trauma as well as the strengths of association. Traditional logistic regression was also performed in order to compare the estimates obtained by both methods of statistical analysis. RESULTS: 36.4% (323/888) of the children suffered dental trauma and there was no difference in prevalence rates from 3 to 5 years of age. Poisson regression analysis showed that the probability of the outcome was almost 30% higher for children whose mothers had more than 8 years of education (Prevalence Ratio = 1.28; 95% CI = 1.03-1.60) and 63% higher for children with an overjet greater than 2 mm (Prevalence Ratio = 1.63; 95% CI = 1.31-2.03). Odds ratios clearly overestimated the size of the effect when compared with prevalence ratios. CONCLUSIONS: These findings indicate the need for preventive orientation regarding TDI, in order to educate parents and caregivers about supervising infants, particularly those with increased overjet and whose mothers have a higher level of education. Poisson regression with robust variance represents a better alternative than logistic regression to estimate the risk of dental trauma in preschool children.

Proteja o sorriso do seu bebê: avaliação de dez anos de extensão universitária / Protect your baby smile: evaluation of ten years of academic extension

A importância da extensão universitária na formação discente tem sido tema de vários estudos e atualmente está inserida nas diretrizes que regem os cursos de graduação na área da Odontologia. Atividades de promoção de saúde bucal que visem à atenção precoce voltada às crianças em idade pré-escolar são de grande valor em função do comprometimento dessa parcela da população brasileira por doenças bucais como cárie e gengivite. A inserção do aluno de graduação de Odontologia na execução de atividades para com estas crianças por meio do projeto de extensão "'Proteja o Sorriso do Seu Bebê" já tem sido realizado há cerca de dez anos. Frente a isso, esta pesquisa teve por objetivo quantificar os resultados alcançados por meio deste projeto, bem como avaliar de uma forma qualitativa o retorno que o mesmo tem trazido à comunidade e aos alunos participantes dessa atividade extensionista, através da análise de questionários aplicados aos acadêmicos e professoras das escolas. Com base nos resultados pode-se concluir que o projeto tem contribuido na formação acadêmica e oferecido um benefício à população alvo do mesmo no que diz respeito à educação em saúde bucal.

The importance of university extension in training student has been the subject of several studies and it is currently included in the guidelines that conduct the graduate programs in thefi eld of Dentistry. Activities of promoting oral health aimed at the early attention focused on children of pre-school age are of great value in commitment terms of this portion of the Brazilian population for oral diseases such as caries and gingivitis. The insertion of the graduate student inthe implementation of activities to these children through the extension project of “Protect your baby’s Smile” has been performed about ten years. In front of it, this study aimed to quantify theresults achieved through this project, as well as a qualitative assessment of the return that it has brought to the community and for students joining this extension activity, through the analysisof questionnaires applied to the academic and the school teachers. Based on the results it can beconcluded that the project has contributed in the academic formation and helped to benefi t the aimpopulation regarding the education in oral health.

Clinical performance of ART restorations in primary teeth: a survival analysis.

OBJECTIVE: To assess the survival of Atraumatic Restorative Treatment (ART) restorations in primary teeth performed in a dental clinical setting. STUDY DESIGN: One hundred and five single-surface ART restorations placed in 56 preschool children (mean age 31 months) were included. Final-year dental students performed the restorations using standard ART procedures with hand instruments. A resin-modified glass ionomer cement (Vitremer 3M/ESPE) was used as a restorative material. Performances of the restorations were assessed directly by the ART evaluation criteria. Follow-up period ranged from 6 to 48 months. Survival estimates for restoration longevity were evaluated using the Kaplan-Meier method. Log-rank test (P < or = .05) was used to compare the success rates according to demographic and clinical characteristics of the restorations at baseline (age, sex, arch and segment). RESULTS: Mean and median estimate times of survival were 37 (95% CI: 32-42) months and 38 (95% CI: 29-47) months respectively. Success rates for ART restorations were 89%, 85% and 72% in 6 to 11, 12 to 24 and 25 to 48 months of evaluation respectively. Differences in success rates among demographic and clinical characteristics were not statistically significant. CONCLUSION: High survivals rates of the ART restorations found in this study seem to indicate the reliability of this approach as an appropriate treatment option for primary teeth in a clinical setting.

Traumatismo na dentição decídua e fatores associados em pré- escolares do município de Canela/RS / Traumatic injuries in the primary dentition associated factors among preschoolers children in the city of Canela, RS, Brazil

Objetivo: Verificar a prevalência de injúrias traumáticas na dentição decídua e fatores associados em pré-escolares do município de Canela/RS. Método: Foram examinadas 1095 crianças, de ambos os sexos, na faixa etária entre zero e cinco anos. A coleta de dados foi realizada durante a Campanha Nacional de Multivacinação e envolveu a aplicação de um questionário para a coleta das variáveis demográficas, experiência odontológica anterior, relato dos responsáveis e exame físico para detecção de sinais clínicos de trauma. Para avaliar possíveis associações foi utilizado teste qui-quadrado, razão de prevalência e análise de regressão logística. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Luterana do Brasil/RS (ULBRA). Resultados: A prevalência de traumatismo observada foi de 23,6%, sem diferença significativa entre os sexos. A faixa etária mais afetada foi entre dois e três anos e o dente mais atingido foi o incisivo central superior (83,8%). As lesões aos tecidos duros representaram 71,7% da amostra, enquanto que as lesões aos tecidos de sustentação representaram 11,2%. Foi observada associação estatisticamente significativa (p=0,001) entre a presença de sinal clínico de trauma e o relato do responsável, assim como a maior probabilidade das crianças com sinal de trauma terem consultado um cirurgião-dentista. Conclusão: A alta prevalência de injúrias traumáticas observadas nos pré escolares de Canela, assim como sua localização e distribuição, contribuem para o estabelecimento de um perfil epidemiológico da população brasileira. Destaca-se também a associação verificada entre a presença de sinal clínico de trauma e o relato do responsável, assim como a indicação de que episódios de trauma, muitas vezes, justificam a primeira consulta ao cirurgião dentista.

Objective: To assess the prevalence of traumatic injuries in the primary dentition and associated factors among preschoolers in the city of Canela, RS, Brazil. Methods: One-thousand-and ninety-five children of both genders aged 0 to 5 years were examined in this study. Data collection occurred at the same time of the National Multi-Vaccination Campaign and involved the application of a questionnaire to obtain demographic data, previous dental experience, parent's and/or caregiver's report and physical examination for detection of clinical signs of trauma. The chi-square test, prevalence rate and logistic regression analysis were used to assess possible associations. This research protocol was approved by the Research Ethics Committee of the Lutheran University of Brazil (ULBRA). Results: The prevalence of trauma was 23.6%, with no significant difference between the genders. The 2-3-year-old age group was the most affected and the maxillary central incisors were the most commonly affected teeth (83.8%). Lesions to the hard tissues represented 71.7% of the traumatic injuries, while the lesions on the supporting tissues corresponded to 11.2%. Statistically significant association (p=0.001) was observed between the clinical signs of trauma and the parent's and/or caregiver's report, as well as a greater probability that children with signs of trauma had received dental treatment. Conclusion: The high prevalence of traumatic injuries observed among preschool children in Canela, RS, Brazil, as well as their location and distribution contribute to establish an epidemiological profile of the Brazilian population. It is also outstanding the association between the clinical signs of trauma and the parental report, as well as the indication that trauma episodes often justify the first dental visit.