Occlusal Disorders in Patients with Sickle Cell Disease: Critical Literature Review.

OBJECTIVE: To identify the association of occlusal disorders in patients with sickle cell disease (SCD). STUDY DESIGN: A literature review was conducted, and articles published between 2010 and 2019 were searched on Bireme and PubMed websites and in MEDLINE and LILACS databases, in English, Portuguese, and Spanish, using the keywords "malocclusion," "sickle cell disease," and "cephalometry," combined by Boolean operators AND and OR. One of the criteria for the selection of articles was the presence of adolescents in the sample. This methodology followed the PRISMA recommendations. Seventy-nine articles were found, seven of which were included in the review as they met the inclusion criteria and the study goals. RESULTS: The prevalence of malocclusion in SCD patients ranged from 62.9% to 100%, which was considered very severe in 30.1% to 80.6%. The most common occlusal changes were Angle's class II malocclusion, increased maxillary overjet, and anterior open bite. In addition, class II skeletal pattern was the most prevalent due to mandibular retrusion. CONCLUSION: Malocclusion prevalence in SCD patients is high and considered to be a risk factor, with a significant rate of very severe malocclusion when compared to healthy patients.

Relação entre maloclusões e queixas de problemas mastigatórios e gastrointestinais em crianças / Relationship between malocclusions and complaints of masticatory and gastrointestinal problems in children

Objetivo: Avaliar a relação entre as maloclusões e queixas de problemas mastigatórios e gastrointestinais em crianças. Métodos: Realizou-se um estudo transversal com uma amostra intencional de 232 crianças de ambos os sexos, com idades entre 6 e 12 anos, provenientes de uma amostra de 634 crianças de 3 a 12 anos examinadas durante um levantamento de saúde bucal na cidade do Recife/PE. Participaram do estudo apenas as crianças livres de cárie. Foram excluídas as crianças com síndromes associadas a deformidades craniofaciais, as crianças submetidas a tratamento ortodôntico ou ortopédico facial prévio, crianças com presença de desgastes acentuados nas faces oclusais dos elementos dentários e crianças com alterações dentárias de forma, número ou tamanho. Os dados foram coletados através de dois instrumentos: entrevistas com os responsáveis e exames clínicos. As maloclusões foram avaliadas a partir da classificação de Angle e da observação da ocorrência de mordida aberta anterior, mordida cruzada anterior e mordida cruzada posterior. Foi utilizada ficha clínica padrão da Organização Mundial de Saúde. A análise estatística foi realizada utilizando-se os testes Quiquadrado de Pearson e Exato de Fisher. Resultados: Os sintomas de distúrbios gastrointestinais ocorreram em 19,8% das crianças, sendo a prisão de ventre a queixa mais citada (9,9%). Os sintomas gastrointestinais não foram associados à presença das maloclusões. A mordida cruzada anterior foi associada à dificuldade para mastigar (p < 0,05) e à necessidade de ingerir líquidos durante as refeições (p=0,017). Conclusão: As crianças com mordida cruzada anterior apresentaram maiores dificuldades mastigatórias em relação ao grupo sem esta maloclusão.(AU)

Objective: To evaluate the relationship between malocclusion and complaints of masticatory and gastrointestinal problems in children. Methods: A cross-sectional study was carried out with an intentional sample of 232 children of both sexes, 6 to 12 years of age, from a sample of 634 children, 3 to 12 years of age, who were examined during an oral health survey in the city of Recife, PE, Brazil. Only caries-free children participated in this study. Children with disabilities were excluded, as were children who had undergone orthodontic or facial orthopedic treatment, children with clearly accentuated wear on the occlusal surfaces of their teeth, and children with dental alterations in shape, size, or number. Data were collected through two instruments: interviews with the responsible guardians and clinical examinations. Malocclusions were evaluated by means of Angle classification and observation of the occurrence of anterior open bite, anterior crossbite, and posterior crossbite. The World Health Organization (WHO) standard clinical record was used. The statistical analyses were performed using the Pearson's chisquare test and the Fisher Exact test. Results: The symptoms of gastrointestinal disorders occurred in 19.8% of the children, constipation being the most cited complaint (9.9%). Gastrointestinal symptoms were not associated with the presence of malocclusions. Anterior crossbite was associated with difficulty in chewing (p<0.05) and the need to ingest liquids during meals (p=0.017). Conclusion: Children with anterior crossbite showed greater mastigatory difficulties when compared to the group without this malocclusion.(AU)

The concepts of minimally invasive dentistry and its impact on clinical practice: a survey with a group of Brazilian professionals.

This cross-sectional study aimed to assess the knowledge and attitudes of 123 Brazilian dentists in relation to the concepts and practice of minimally invasive dentistry (MID). Data were collected through a questionnaire developed and validated by experts. Statistical analysis was performed using an spss program and Pearson's chi-square test. Most participants had up to 10 years experience after graduation (69.9%), were specialised (60.2%) and worked in public and private service (43.1%). Regarding current concepts of dental caries, 87.0% were unaware and 65.9% answered that the treatment involves only the restorative phase. In relation to caries lesion arrest, 39.8% replied that it depended on the total removal of carious tissue. Most of them were aware of MID procedures (82.1%) but 49.6% did not follow them in daily practice. From these participants, 48.4% did not believe in the technique or did not know how to perform it. Decisions on partial or total removal of carious dentine, behaviour in relation to the procedures (permanent or temporary) and the practice of MID were not influenced by how long since the professionals had graduated or become specialised. It can be concluded that scientific evidence reaches most of the professionals, but does not benefit all patients, as many practitioners still follow the principles of total removal of carious tissue. Teaching should include making professionals fully aware of the carious process and encourage them to fully adopt the techniques and attitudes of MID.

Proposta de um protocolo para o atendimento odontológico do paciente idoso na atenção básica / Proposal of a protocol for the elderly patient dental attendance in basic health attention

Com o considerável aumento da população idosa, cresce a demanda por profissionais capacitados a lidar com essa faixa etária. Devido as suas modificações morfo-funcionais, essa população necessita de uma abordagem e de cuidados diferenciais. A saúde bucal merece atenção especial, pois este grupo populacional é detentor de altos níveis de edentulismo, doenças periodontais, ósseas e musculares, além do uso de próteses inadequadas. Um dos motivos se deve à incípiência de programas de saúde bucal voltados para os idosos. O objetivo deste estudo é desenvolver um protocolo de atendimento odontológico para o paciente idoso no programa de saúde da família, propondo uma reorientação da prática dos procedimentos odontológicos, evidenciando a importância do atendimento multidisciplinar, para a prevenção, controle e tratamento das suas afecções. As fontes foram obtidas nas bases de dados do BIREME, LILACS, BBO e SCIELO, sendo todos os artigos publicados em periódicos nacionais no período de 2000 a 2008, além do Caderno de Atenção Básica (nº 17) de 2006 do Ministério da Saúde.

With the considerable increasein the eldery population, growing demand for trained professionals to deal with this age group. Because their morphofunctional changes, this population needs a differencial approach and care. The oral health deserves special attention, because this population group is holding high levels of edentulism, periodontal disease, bone and muscle, in addition to the inappropriate use of prostheses. One reason is due to the scarcity of programs for oral health facing the elderly. The purpose of this study is to develop a protocol for dental care for the elderly patients in the program of family health, an reorientation of the proposed practice of dental procedures, emphasizing the importance of multidisciplinary care for the prevention, control and treatment of their diseases. The sources were obtained in the databases from BIREME, LILACS, BBO and SCIELO, and all articles published in national journals in the period 200 to 2008 in addition to Notebook basic care (No. 17) 2006 Ministry of Health.