Validation of the brazilian version of the oral health impact profile - Aesthetic questionnaire.

The aim of the study was to develop the Brazilian version of the Oral Health Impact Profile - Aesthetic Questionnaire (OHIP-Aes-Braz) and test its psychometric properties. The questionnaire test versions were developed by a panel of experts and a pre-test was conducted in a focus group. Data used for testing its psychometric properties were obtained from a randomized controlled clinical trial on tooth bleaching. Seventy-nine Brazilian adults were included. The questionnaires were applied before tooth bleaching treatment (baseline), one week (T1), and one month after the intervention (T2). Reliability was assessed in terms of internal consistency and stability, while validity was ascertained by criterion and construct validity. The sensitivity to change was assessed comparing the total scores at baseline and T2, using the Wilcoxon test (α = 0.05). Both stability and internal consistency (intra-class correlation coefficient=0.95, Cronbach's α = 0.92) proved to be adequate. Construct validity was confirmed as the correlation between OHIP-Aes-Braz scores with tooth color satisfaction and self-perceived oral health were in the expected direction. A positive correlation between OHIP-Aes-Braz and OHIP-14 (rs=0.63) and OIDP (rs=0.77) was observed. The instrument was responsive once differences in total scores before and after treatment were statistically significant (p<0.001). The OHIP-Aes-Braz presented good psychometric properties and showed sensitivity to change regarding aesthetics evaluation in Brazilian adults treated with tooth bleaching. A valid and reliable instrument allows a suitable assessment of oral health-related quality of life in Brazilian patients submitted to aesthetics dental interventions.

Validation of the brazilian version of the oral health impact profile - Aesthetic questionnaire

Abstract The aim of the study was to develop the Brazilian version of the Oral Health Impact Profile - Aesthetic Questionnaire (OHIP-Aes-Braz) and test its psychometric properties. The questionnaire test versions were developed by a panel of experts and a pre-test was conducted in a focus group. Data used for testing its psychometric properties were obtained from a randomized controlled clinical trial on tooth bleaching. Seventy-nine Brazilian adults were included. The questionnaires were applied before tooth bleaching treatment (baseline), one week (T1), and one month after the intervention (T2). Reliability was assessed in terms of internal consistency and stability, while validity was ascertained by criterion and construct validity. The sensitivity to change was assessed comparing the total scores at baseline and T2, using the Wilcoxon test (α = 0.05). Both stability and internal consistency (intra-class correlation coefficient=0.95, Cronbach's α = 0.92) proved to be adequate. Construct validity was confirmed as the correlation between OHIP-Aes-Braz scores with tooth color satisfaction and self-perceived oral health were in the expected direction. A positive correlation between OHIP-Aes-Braz and OHIP-14 (rs=0.63) and OIDP (rs=0.77) was observed. The instrument was responsive once differences in total scores before and after treatment were statistically significant (p<0.001). The OHIP-Aes-Braz presented good psychometric properties and showed sensitivity to change regarding aesthetics evaluation in Brazilian adults treated with tooth bleaching. A valid and reliable instrument allows a suitable assessment of oral health-related quality of life in Brazilian patients submitted to aesthetics dental interventions.

Resumo O objetivo do estudo foi desenvolver a versão brasileira do Oral Health Impact Profile - Aesthetic Questionnaire (OHIP-Aes-Braz) e testar suas propriedades psicométricas. As versões de teste do questionário foram desenvolvidas por um painel de especialistas e um pré-teste foi realizado em um grupo focal. Os dados usados para testar suas propriedades psicométricas foram obtidos a partir de um ensaio clínico randomizado controlado de clareamento dental. Setenta e nove brasileiros adultos foram incluídos. Os questionários foram aplicados antes do tratamento clareador (baseline), uma semana (T1) e um mês após a intervenção (T2). A confiabilidade foi avaliada em termos de consistência interna e estabilidade, enquanto a validade foi avaliada pela validade de critério e de construto. A sensibilidade à mudança foi avaliada pela comparação entre os escores totais no baseline e T2, usando o teste de Wilcoxon ((=0,05). Tanto a estabilidade quanto a consistência interna (coeficiente de correlação intraclasse=0,95, alfa de Cronbach=0,92) mostraram-se adequadas. A validade de construto foi confirmada uma vez que a correlação dos escores do OHIP-Aes-Braz com a satisfação com a cor dos dentes e a autopercepção da saúde bucal foram na direção esperada. Uma correlação positiva entre OHIP-Aes-Braz e OHIP-14 (r s =0,63) e OIDP (r s =0,77) foi observada. O instrumento foi responsivo uma vez que as diferenças nos escores totais antes e depois do tratamento foram estatisticamente significantes (p<0,001). O OHIP-Aes-Braz apresentou boas propriedades psicométricas e mostrou sensibilidade a mudanças na avaliação estética em adultos brasileiros submetidos ao clareamento dental. Um instrumento válido e confiável permite uma avaliação adequada da qualidade de vida relacionada à saúde bucal em pacientes brasileiros submetidos a intervenções odontológicas estéticas.

Oral manifestations of congenital Zika virus infection in children with microcephaly: 18-month follow-up case series.

AIMS: To describe oral manifestations in children born with microcephaly attributed to congenital Zika virus syndrome (CZS). METHODS: Data was collected in semiannual intervals from 2017 to 2019, by oral exams of the children and interview with caregivers at a Public Dental Center in Rio de Janeiro, Brazil. A single calibrated examiner performed clinical examinations. RESULTS: Of 38 eligible children, 34 were followed-up from 12 to 30 months of age, 20 boys and 14 girls. The mean age of emergence of their first primary tooth was 12.4 months (SD = 2.9). By 30 months of age only 14.7% (n = 5) had complete primary dentition. Alteration in the sequence of tooth emergence was observed in 41.1% (n = 14). Radiographic examination demonstrated dental agenesis (14.7% n = 5). Dental developmental alterations (38.2%, n = 13), enamel defects (14.7%, n = 5), eruption cysts/hematoma (23.5%, n = 8), gingival bleeding (55.8%, n = 19), narrow palate, and bruxism (64.7%, n = 22) were also observed. No child had dental caries. CONCLUSION: Children with microcephaly attributed to CZS presented oral manifestations early in life.

Clinical accuracy data presented as natural frequencies improve dentists' caries diagnostic inference: Evidence from a randomized controlled trial.

BACKGROUND: The authors assessed whether dentists' diagnostic inferences differ when test accuracy information is communicated using natural frequencies versus conditional probabilities. METHODS: A parallel, randomized controlled trial with dentists was carried out in Rio de Janeiro, Brazil. The dentists received a question on the probability of a patient having interproximal caries, given a positive bite-wing radiograph. This question was asked using information that was formulated into either natural frequencies or conditional probabilities. RESULTS: Only 14 (13.9%) of the dentists gave the correct answer; 13 in the natural frequencies group, and 1 in the conditional probabilities group (P < .001). There were 7 nearly correct answers in the natural frequencies group and none in the conditional probabilities group (P = .005). CONCLUSIONS: Representing diagnostic test accuracy in natural frequencies substantially helped dentists make diagnostic inferences. Nearly twice as many dentists overestimated the presence of interproximal caries when given information in conditional probabilities. PRACTICAL IMPLICATIONS: Our study findings show information shared using natural frequencies may be more accurately interpreted by dentists than that based on conditional probabilities. Patients will probably receive different standards of care depending on the format in which dentists receive diagnostic test accuracy information.

Evidence-based pediatric dental practice within the clinician's reach: the case of the esthetic effect of topical silver diamine fluoride for caries control in primary dentition / Prática odontopediátrica baseada em evidência científica ao alcance do clínico: o caso do efeito estético do uso tópico de diaminofluoreto de prata para o controle da cárie na dentição decídua

ABSTRACT Objective: The aim of this paper was to demonstrate how a general dental practitioner tried to answer, based on scientific evidence, to the question: "Does the darkening of caries lesions caused by silver diamine fluoride treatment contribute to reducing parents' acceptance of such treatment?". Methods: The dentist adopted the following approach: formulation of a specific question; bibliographic search using controlled vocabulary and free terms; selection of full-text articles for reading; reading and critical appraisal of selected articles; summary of the available evidence; translation of the evidence into clinical practice. The dentist identified 45 studies and selected 20 to be read in full, but only three could be used; two controlled trials from China and one from Brazil. Results: Results showed that the esthetic effect was neither a major issue nor a decisive factor for the indication of the proposed treatment. However, although there is robust scientific evidence on the effectiveness of silver diamine fluoride in arresting and preventing caries lesions, there is scarce information about its esthetic effect. Thus, the lack of studies assessing the impact of the darkening of caries lesions and the esthetic effect of the treatment on the quality of life of children and their parents must be emphasized. Conclusion: The dentist concluded that there is insufficient evidence about the esthetic effect of silver diamine fluoride applications on primary teeth and opted to inform it to his/her patients' caregivers and to share with them the decision whether to use it or not in each specific case.

RESUMO Objetivo: Mostrar como um cirurgião-dentista clínico geral procurou responder, com base em evidência científica, à pergunta: "O escurecimento das lesões de cárie em dentes decíduos tratados com diaminofluoreto de prata contribui para a redução da aceitação desse tipo de tratamento pelos pais?". Métodos: O dentista seguiu o seguinte roteiro: formulação de uma pergunta específica; realização da busca bibliográfica utilizando descritores e termos livres; seleção dos artigos científicos completos para leitura; leitura e avaliação crítica dos artigos selecionados; resumo da evidência disponível e aplicação da evidência à sua prática clínica. O dentista localizou 45 trabalhos e selecionou 20 para leitura na íntegra, mas apenas três puderam ser utilizados, sendo dois ensaios controlados realizados na China e um no Brasil. Resultados: Os resultados mostraram que a estética não foi uma questão importante nem um fator decisivo para a indicação do tratamento proposto. No entanto, embora haja evidência científica robusta sobre a efetividade do diaminofluoreto de prata em paralisar e prevenir lesões de cárie, há pouca informação sobre seu efeito estético. Assim, a falta de estudos que avaliam o impacto do escurecimento das lesões de cárie e o efeito estético do tratamento sobre a qualidade de vida das crianças e seus familiares deve ser ressaltada. Conclusão: O dentista concluiu que não existe evidência suficiente sobre o efeito estético das aplicações de diaminofluoreto de prata em dentes decíduos e optou por informar os responsáveis por seus pacientes a respeito e compartilhar com eles a decisão sobre a indicação do mesmo para cada caso específico.

Translation and cross-cultural adaptation of an instrument designed for the assessment of quality of life in orthognatic patients

INTRODUCTION: The Orthognathic Quality of Life Questionnaire (OQLQ) was developed in 2000 and validated in 2002, aiming at assessing the impact and the benefits of orthosurgical treatment on patients' quality of life. OBJECTIVE: Cross-culturally translate into Brazilian Portuguese and back-translate into English a quality of life instrument, assuring maintenance of its properties. METHODS: At first, equivalence of concepts and items was discussed by a group of specialists who scrutinized all questionnaire items. Additionally, four patients in need of orthosurgical treatment were interviewed by means of the focus group methodology. Relevance of the questionnaire items was assured prior to its translation which was carried out by two translators who worked independently. Both translations were tested in 20 patients and then consolidated. The consolidated questionnaire version was back-translated into English by two translators who worked independently, and the consolidated back-translation was assessed by the authors of the original questionnaire as well as by the researchers. RESULTS: The OQLQ was translated into Brazilian Portuguese. This translation was tested in a pilot study comprising 12 patients, aged between 16 and 34 years old. CONCLUSION: The OQLQ Brazilian Portuguese translation proves to be an appropriate instrument to access the impact of dentofacial deformities on the quality of life of patients in the Brazilian public health system and who are in need of orthosurgical treatment.

INTRODUÇÃO: o Questionário de Qualidade de Vida para Pacientes Orto-cirúrgicos (Orthognathic Quality of Life Questionnaire - OQLQ) foi desenvolvido em 2000 e validado em 2002, com o objetivo de analisar os impactos e benefícios do tratamento ortodôntico-cirúrgico na qualidade de vida dos pacientes. OBJETIVO: realizar a tradução e adaptação transcultural desse instrumento para o português, assegurando a manutenção de suas propriedades. MÉTODOS: primeiramente, realizou-se a equivalência conceitual e de itens, onde um grupo de especialistas debateu cada item do questionário, e quatro pacientes com necessidade de tratamento ortodôntico-cirúrgico foram entrevistados, utilizando o método de grupo focal. Após verificar a pertinência e relevância dos itens, o questionário foi traduzido por dois tradutores, de forma independente. As duas versões foram testadas em 20 pacientes e, depois, unificadas. Essa versão unificada foi retraduzida para o inglês por dois tradutores independentes, e a unificação das retraduções foi avaliada pelos autores do questionários original e pela equipe de pesquisa. RESULTADOS: a partir dessas avaliações, foi produzida a versão brasileira do OQLQ, a qual foi testada em um estudo piloto que envolveu 12 pacientes, com idade entre 16 e 34 anos. CONCLUSÃO: a versão brasileira do questionário OQLQ pode ser considerada um instrumento apropriado para acessar o impacto da deformidade dentofacial na qualidade de vida de pacientes da rede pública de saúde com necessidade de tratamento ortodôntico-cirúrgico.

The Oral Health Impact Profile-14: a unidimensional scale?

The aim of this study was to investigate the dimensional structure of the Oral Health Impact Profile-14: (OHIP-14). Data was obtained from studies carried out in Rio de Janeiro (N = 504) and Carlos Barbosa (N = 872), in the State of Rio Grande do Sul, Brazil. Exploratory factor analysis (EFA) was performed to identify the latent dimensions of the OHIP-14. Confirmatory factor analysis (CFA) was carried out of both samples to compare the one-dimensional structure found by the EFA and the proposed three-dimensional structure. This factorial structure was assessed using goodness-of-fit indices. In the Rio de Janeiro study, the eigenvalue was 9.2 and this one factor explained 65.6% of total variance, while in the Carlos Barbosa study the eigenvalue was 7.9 and this one factor explained 56.6% of variance. CFA indicated an adequate fit of the one-factor model for the Rio de Janeiro study (RMSEA = 0.04; CFI = 0.98; TLI = 0.98) and for the Carlos Barbosa study (RMSEA = 0.05; CFI = 0.97; TLI = 0.97). Our findings suggest that the OHIP-14 measures one single construct.

The Oral Health Impact Profile-14:: a unidimensional scale? / Oral Health Impact Profile-14:: uma escala unidimensional? / Oral Health Impact Profile-14:: ¿una escala unidimensional?

The aim of this study was to investigate the dimensional structure of the Oral Health Impact Profile-14: (OHIP-14). Data was obtained from studies carried out in Rio de Janeiro (N = 504) and Carlos Barbosa (N = 872), in the State of Rio Grande do Sul, Brazil. Exploratory factor analysis (EFA) was performed to identify the latent dimensions of the OHIP-14. Confirmatory factor analysis (CFA) was carried out of both samples to compare the one-dimensional structure found by the EFA and the proposed three-dimensional structure. This factorial structure was assessed using goodness-of-fit indices. In the Rio de Janeiro study, the eigenvalue was 9.2 and this one factor explained 65.6% of total variance, while in the Carlos Barbosa study the eigenvalue was 7.9 and this one factor explained 56.6% of variance. CFA indicated an adequate fit of the one-factor model for the Rio de Janeiro study (RMSEA = 0.04; CFI = 0.98; TLI = 0.98) and for the Carlos Barbosa study (RMSEA = 0.05; CFI = 0.97; TLI = 0.97). Our findings suggest that the OHIP-14 measures one single construct.

O objetivo foi investigar a estrutura dimensional do Oral Health Impact Profile-14: (OHIP-14). Os indivíduos nas amostras foram provenientes de dois estudos realizados no Brasil, um no Rio de Janeiro, Brasil (N = 504) e o outro em Carlos Barbosa, Rio Grande do Sul, Brasil (N = 872). Análise fatorial confirmatória (AFC) foi conduzida para identificar as dimensões latentes do OHIP-14 e comparar um modelo de estrutura unidimensional com um modelo de três dimensões. A estrutura dimensional foi avaliada através de índices de qualidade de ajuste. A estrutura com um fator apresentou, no estudo do Rio de Janeiro, um autovalor de 9,2 e esta estrutura explicou 65,6% da variância total, enquanto que no estudo de Carlos Barbosa o autovalor foi de 7,9 e esta estrutura unidimensional explicou 56,6% da variância total. AFC realizada indicou um ajuste adequado para o modelo de 1 fator para o estudo do Rio de Janeiro (RMSEA = 0,04; CFI = 0,98; TLI = 0,98) e para o estudo de Carlos Barbosa (RMSEA = 0,05; CFI = 0,97; TLI = 0,97). O modelo de um fator foi mais parcimonioso. Nossos resultados sugerem que o OHIP-14 seja um instrumento unidimensional.

El objetivo fue investigar la estructura dimensional del Oral Health Impact Profile-14: (OHIP-14). Los individuos en las muestras provinieron de dos estudios realizados en Brasil, uno en Río de Janeiro (N = 504) y el otro en Carlos Barbosa, Río Grande do Sul (N = 872). Un análisis factorial confirmatorio (AFC) se llevó a cabo para identificar las dimensiones latentes del OHIP-14 y comparar un modelo de estructura unidimensional con un modelo de tres dimensiones. La estructura dimensional fue evaluada a través de índices de calidad de ajuste. La estructura con un factor presentó, en el estudio de Río de Janeiro, un autovalor de 9,2 y esta estructura explicó un 65,6% de la variancia total, mientras que en el estudio de Carlos Barbosa el autovalor fue de 7,9 y esta estructura unidimensional explicó un 56,6% de la variancia total. El AFC realizado indicó un ajuste adecuado para el modelo de 1 factor en el estudio de Río de Janeiro (RMSEA = 0,04; CFI = 0,98; TLI = 0,98) y en el estudio de Carlos Barbosa (RMSEA = 0,05; CFI = 0,97; TLI = 0,97). El modelo de un factor fue más parsimonioso. Nuestros resultados sugieren que el OHIP-14 sea un instrumento unidimensional.

How does orthodontic treatment affect young adults' oral health-related quality of life?

INTRODUCTION: Studies in the dental literature do not yet provide conclusive evidence for the functional and psychosocial benefits of orthodontic treatment. In this cross-sectional study, we aimed to assess the oral health-related quality of life of young Brazilian adults, aged 18 to 30 years, who had completed orthodontic treatment compared with untreated subjects waiting for treatment. METHODS: The subjects were recruited at a state-funded university clinic. The sample comprised 100 patients in the retention phase of orthodontic treatment for more than 6 months (treated group) and 100 persons who were seeking orthodontic treatment and were still on a waiting list (nontreated group). Data were collected by using the oral health impact profile, the index of orthodontic treatment need (malocclusion severity and esthetic impairment), the Brazilian economic classification criteria (socioeconomic status), and the index of decayed, missing, and filled teeth (oral health status). Statistical analyses were performed by using chi-square and Fisher exact tests and negative binomial regression. RESULTS: The mean oral health impact profile scores were 3.1 (SD ± 2.99) and 15.1 (SD ± 8.02) in the treated and nontreated groups, respectively. The most frequent impacts in the treated and nontreated groups were "painful aching" and "been self-conscious," respectively. Comparisons between the groups were controlled for malocclusion severity, clinician-assessed esthetic impairment, age, sex, socioeconomic status, and oral health status. Nontreated young adults had mean oral health impact profile scores 5.3 times higher than did the treated subjects. CONCLUSIONS: Young Brazilian adults who received orthodontic treatment had significantly better oral health-related quality of life scores in the retention phase, after treatment completion, than did nontreated subjects.

Efeitos do tratamento ortodôntico em indicadores clínicos e na qualidade de vida associada à saúde bucal de adolescentes de 12 a 15 anos de idade / Effects of orthodontic tretament in clinical indicators and quality of life associated with oral health in adolescents 12 a 15 years old

A literatura científica ainda não é consistente em relação aos benefíciospsicossociais proporcionados pelo tratamento ortodôntico. O objetivo deste estudo foi descrever as alterações na qualidade de vida relacionada à saúde bucal (OHRQol) e nos indicadores clínicos de adolescentes brasileiros de 12 a 15 anos, tratados ortodonticamenteem uma instituição pública de ensino (lPE). A amostra foi constituída de 92 jovens que se encontravam recebendo tratamento ortodôntico entre os anos de 2006 a 2008. A OHRQoL foi mensurada com o Oral Health Impact Profile - Short Form (OHIP-14) e as necessidades normativa e estética de tratamento ortodôntico foram avaliadas com o índice de necessidade de tratamento ortodôntico (lOTN). As avaliações foram repetidas em três momentos: noexame inicial (T1); um ano depois do início do tratamento ortodôntico (T2); dois anos depois do início do tratamento (T3). Observou-se significativa redução dos escores de OHRQoL ao longo do tratamento: as médias dos escores passaram de 10,4 para 9,2 e para 1,6 daprimeira, para a segunda e a terceira avaliações (p < 0,001) e os domínios desconforto psicológico e incapacidade psicológica foram os mais afetados. Nos dois anos de avaliação não se observou alteração na média do CPO-Ddos pacientes e houve melhora significativa na gravidade da má-oclusão (p < 0,001) e na estética dos pacientes avaliados (p < 0,001). O tratamento ortodôntico produziu modificação na qualidade de vida relacionada com a saúde bucal dos adolescentes estudados, especialmente em relação aos aspectos psicológicos, e também melhorou sua estética e a gravidade da má-oclusão.

Literature is not yet conclusive about orthodontic treatment's psychosocial benefits. The aim of this study was to assess oral health-related quality of life (OHQoL) in brazilian adolescents who was under orthodontic treatment during two years of prospective evaluation in a Public University. The sample consisted of 92 subjects, 12 to 15 years of age,who received treatment between 2006 and 2008. OHQoL was assessed with the Brazilian version of the short form of the Oral Health Impact Profile (OHIP-14), malocclusion severity and aesthetic impairment with the Index of Orthodontic Treatment Need (lOTN). Ali subjects completed three distinct intervals of interviews: iitst interview before treatment (T]), one yearafter the placement of the fixed appliance (T2) and two years after the placement of the fixed appliance. There was significant reduction in scores OHRQoL during the treatment: the meanscores reduced from 10.4 to 9.2 and 1.6 of the first to the second and third assessments (p < 0.00]) and the domains "Psychological Disconfort" and "Psychological Disability" werethe most significantly aftected. After two years of evaluation, there was no change in patients mean DMFT and there was a significant improvement in severity of malocclusion (p < 0.001) and patients aesthetics (p < 0.00]) It was concluded that orthodontic treatment changed theoral health related quality of life in brazilian adolescents, especially in psychological aspects, and also improved its aesthetics and severity of malocclusion.

Fluoride varnishes and decrease in caries incidence in preschool children: a systematic review.

The objective of this systematic review was to evaluate whether there is conclusive evidence that the professional application of fluoride varnish decreases the incidence of dental caries in preschool children. We searched the BBO, LILACS, MEDLINE and Cochrane electronic databases to identify controlled clinical trials that evaluated the development of cavitated caries lesions in children up to six years of age. Two researchers performed a critical appraisal of the studies selected for inclusion. Five-hundred and thirteen articles were found, but only eight met our inclusion criteria. Most of these eight studies were of poor methodological quality. They were also heterogeneous in relation to participants' previous caries experience, type of intervention performed on the control group, children's exposure to other sources of fluoride, and varnish application interval. The absolute differences between caries incidences in the control and test groups ranged from 0.30 to 1.64 and the preventive fractions varied from 5% to 63%. Fluoride varnish may be effective to decrease the incidence of dental caries in preschoolers, but more randomized clinical trials with better methodological quality are necessary to provide conclusive evidence in this respect.

Preferencias dos cirurgioes-dentistas do municipio do Rio de Janeiro com relacao ao tratamento de dentes deciduos com necrose pulpar / Preferences of dentists from the city of Rio de Janeiro regarding the treatment of primary teeth with pulp necrosis

Objetivo: Conhecer as condutas adotadas por cirurgioes-dentistas que atuam em unidades de atendimento basico de saude do municipio do Rio de Janeiro, com relacao ao tratamento de dentes deciduos com necrose pulpar e identificar os fatores capazes de influenciar a escolha dessas condutas. Metodo: Foram entrevistados 51 cirurgioes-dentistas de 10 unidades de saude localizadas em 4 areas programaticas, atraves de um questionario previamente testado. Os entrevistados forneceram informacoes sobre sua idade, sexo, faculdade frequentada, pos-graduacao, tempo de formado e de atuacao no servico publico. Alem disso, os cirurgioes-dentistas foram questionados sobre as suas condutas em diferentes situacoes clinicas que sugeriam a necrose pulpar em um dente deciduo de uma crianca de 4 anos de idade. Resultados: A maioria dos cirurgioes-dentistas optou por manter os dentes deciduos com necrose pulpar, especialmente nos casos de trauma e de criancas com bom comportamento. Geralmente, esses profissionais realizavam terapias pulpares minimamente invasivas com tratamentos restritos a camara pulpar ou com uma instrumentacao limitada a entrada dos canais radiculares. Nenhum dos cirurgioes-dentistas entrevistados optou pelo tratamento endodontico convencional. Nao foi observada associacao significante entre qualquer conduta clinica e fatores relacionados aos profissionais (p>0,01). Conclusao: Verificou-se uma grande diversidade na escolha do tratamento para dentes deciduos com necrose pulpar, demonstrando a necessidade de se adotar na rede publica de saude um protocolo para esses casos com base em evidencia cientifica e na disponibilidade dos recursos.

Objective: To know the approaches adopted by dentists that work at public health centers (PHC) in the city of Rio de Janeiro, RJ, Brazil, with respect to the treatment of primary teeth with pulp necrosis, and to identify factors capable of influencing the choices of these approaches. Method: Fifty dentists from 51 from 10 PHC located in 4 programmatic areas were interviewed using a previously calibrated questionnaire. The interviewees provided information about their age, gender, dental school they graduated from, post-graduate degree, time since graduation and, public service activity. In addition, the dentists were argued about their conduct in different clinical situations that suggested the presence of pulp necrosis in a primary tooth in a year-old child. Results: Most dentists opted for maintaining the primary teeth with necrotic pulp, especially in cases of trauma and children with good behavior. These professionals usually performed minimally invasive pulpal therapies with treatments restricted to the pulp chamber or with instrumentation limited to the root canal entrance. None of the interviewed dentists opted for conventional endodontic treatment. There was no significant association (p>0.01) between any clinical approach and factors related to the professionals. Conclusion: There was great diversity in treatments proposed for primary teeth with pulp necrosis, demonstrating the need for the public health service adopting a protocol for these cases based on scientific evidence and availability of resources.

Survey of Brazilian governmental health agencies shows conflicting recommendations concerning oral hygiene practices for children / Pesquisa com Secretarias de Saude no Brasil revela recomendacoes divergentes relacionadas a praticas de higiene bucal em criancas

The aims of this study were to detect whether recommendations concerning oral hygiene practices for children among Brazilian health agencies are consistent and to verify whether possible inconsistencies in these recommendations might be associated with an apparent gap in the scientific evidence. Fifty-four Brazilian health agencies were contacted by mail or electronic mail and were asked to send any material containing recommendations on oral hygiene practices aimed at children. A search was subsequently carried out on the Cochrane Oral Health Review Group and PubMed-Clinical Queries websites in order to assess the scientific evidence available on this subject. Forty (74 percent) agencies answered and 21 materials containing oral hygiene recommendations were obtained. Eleven pertinent systematic reviews were identified. This preliminary study detected some conflicting and not evidence-based oral hygiene messages, which emphasizes the need to carry out and disseminate systematic reviews on these controversial issues in order to bridge the gap between knowledge and practice.

Os objetivos deste estudo foram verificar se as recomendacoes fornecidas por orgaos governamentais brasileiros sobre higiene bucal em criancas sao consistentes e se possiveis inconsistencias nessas recomendacoes estao associadas a uma aparente falta de evidencia cientifica. Cinquenta e quatro orgaos governamentais brasileiros foram contatados por endereco eletronico ou postal. Foi solicitado que enviassem materiais contendo recomendacoes sobre praticas de higiene bucal para criancas. Em seguida, realizou-se uma busca nos sites Cochrane Oral Health Review Group e PubMed-Clinical Queries para avaliar a evidencia cientifica disponivel sobre o assunto. Quarenta (74 por cento) orgaos governamentais responderam e 21 materiais contendo recomendacoes sobre higiene bucal foram obtidos. Foram identificadas 11 revisoes sistematicas pertinentes. Este estudo preliminar detectou algumas recomendacoes divergentes e nao baseadas em evidencia cientifica, ressaltando a necessidade de se realizar revisoes sistematicas da literatura sobre esses topicos para aproximar a pesquisa cientifica da pratica clinica.

O uso de vernizes fluoretados e a redução da incidência de cárie dentária em pré-escolares: uma revisão sistemática / Fluoride varnishes and decrease in caries incidence in preschool children: a systematic review

O objetivo desta revisão sistemática foi verificar se existe evidência conclusiva de que o verniz fluoretado reduz a incidência de cárie dentária em pré-escolares. Foram feitas buscas nas bases eletrônicas BBO, LILACS, MEDLINE e Cochrane para identificar ensaios clínicos controlados que avaliassem o desenvolvimento de lesões cavitadas de cárie em crianças com até seis anos de idade. Dois pesquisadores analisaram criticamente os trabalhos selecionados para inclusão. Foram encontrados 513 artigos e oito foram incluídos. Esses estudos apresentaram problemas quanto ao desenho e, além disso, eram heterogêneos quanto à experiência prévia de cárie dos participantes, ao tipo de intervenção administrada ao grupo controle, à exposição das crianças a outras fontes de fluoretos, e ao intervalo entre as aplicações de verniz. As diferenças absolutas entre as incidências de cárie nos grupos controle e teste e as frações prevenidas variaram de 0,30 a 1,64 e de 5 a 63 por cento, respectivamente. O verniz fluoretado parece ser efetivo para reduzir a incidência de cárie dentária em pré-escolares, mas outros ensaios clínicos de melhor qualidade metodológica são necessários para se obter evidência conclusiva a esse respeito.

The objective of this systematic review was to evaluate whether there is conclusive evidence that the professional application of fluoride varnish decreases the incidence of dental caries in preschool children. We searched the BBO, LILACS, MEDLINE and Cochrane electronic databases to identify controlled clinical trials that evaluated the development of cavitated caries lesions in children up to six years of age. Two researchers performed a critical appraisal of the studies selected for inclusion. Five-hundred and thirteen articles were found, but only eight met our inclusion criteria. Most of these eight studies were of poor methodological quality. They were also heterogeneous in relation to participants' previous caries experience, type of intervention performed on the control group, children's exposure to other sources of fluoride, and varnish application interval. The absolute differences between caries incidences in the control and test groups ranged from 0.30 to 1.64 and the preventive fractions varied from 5 percent to 63 percent. Fluoride varnish may be effective to decrease the incidence of dental caries in preschoolers, but more randomized clinical trials with better methodological quality are necessary to provide conclusive evidence in this respect.

A influência dos hábitos de sucção de chupeta e uso de mamadeira na dentição decídua / Influence of pacifier and baby bottle in primary dentition

Verifica-se a deficiência de informações sobre o momento do início das alterações faciais e dentárias presentes na criança portadora de hábitos de sucção. Portanto, objetivou-se descrever as características oclusais da dentição decídua em pré-escolares de diferentes faixas etárias e avaliar a frequência e gravidade da mordida aberta anterior; a inclinação dos incisivos decíduos em relação as suas bases ósseas; o ângulo interincisal; o trespasse horizontal; a prevalência de mordida cruzada posterior; e a relação entre os caninos e o tipo de plano terminal. A amostra foi composta por 34 pacientes distribuídos em: grupo M (nove pacientes): com o hábito de mamadeira; grupo MC (13 pacientes): com o hábito de mamadeira e chupeta; grupo C (12 pacientes): controle (sem hábitos). A coleta de dados foi realizada através de entrevistas face a face, exame clinico, modelos de estudo, fotografias intra e extrabucais e radiografias cefalométricas laterais. Observou-se uma maior frequência de mordida aberta anterior nos grupos "mamadeira" e "mamadeira e chupeta". Verificou-se uma diferença estatisticamente significativa entre os grupos quando se avaliou a presença de mordida aberta e a prática de hábitos (p=O,02). A chance de apresentar mordida aberta anterior era 9,2 vezes maior entre as crianças que praticavam algum hábito de sucção (p=O,05). As medidas lineares dos incisivos superiores e inferiores em relação às suas bases ósseas mostraram um aumento estatisticamente significativo em relação à prática de hábitos de sucção. Concluiu-se que o hábito de sucção apresenta efeitos deletérios nas características de normalidade da dentição decídua em idade pré-escolar.

This study aims to describe preschool oclusal characteristics of the deciduous dentition in different phases and evaluating alterations ofthe normal occlusion, while associates the pacifier sucking habits and the use of baby's bottle. The study purposed association related to the existence of each type of habit with: frequency and gravity of the open bite; inclination of the deciduous incisors in the bone baseline; interincisal angle; overjet; prevalence of posterior crossbite; relation between canines and molars. The population was defined as children who presented complete deciduous dentition, of both gender, wuh ages between 2 and 5 years. Sample was composed of 34 patients distributed in: Group M (9) - baby's bottle habit, without use of pacifier; GroupMe (13) - habits of baby 's bottle and pacifier; Group C (12) - control (without sucking of pacifier or baby's bottle). The data 's collection was carried through interviews, clinical examination, study models, photographs and cephalometric x-rays. The results showed a high frequency of anterior open bite in patients of habits groups. Patients between 21 and 36 months presented a higher prevalence of anterior open bite when compared witn others (p=O.02). Through the logistic regression it was verified that the possibility to present open bite was 9.2 times higher between children who practiced some sucking habits (p=O.05). Moreover,linear measures of upper and lower incisors in the baseline bone had shown significant increase in patients wuh sucking habits. This study concluded that sucking habits practice have deleterious effects in primary dentition of preschool children.

Más-oclusões e seu impacto na qualidade de vida de adolescentes que buscam tratamento ortodôntico / Oral health-related quality of life and orthodontic treatment seeking

Os objetivos desse estudo foram avaliar a gravidade da má-oclusão e a qualidade de vida relacionada a saúde bucal de adolescentes brasileiros de 12 a 15 anos de idade que buscaram tratamento. A amostra foi constituída de 325 jovens, sendo 20 1 que procuraram tratamento em uma clínica de ensino de Ortodontia (grupo ortodôntico) e 124 que nunca procuraram tratamento ortodôntico (grupo de comparação). A qualidade de vida foi mensurada utilizando o Oral Health Impact Profile, em sua versão reduzida (OHIP-14), traduzido e validado para o português, e a necessidade normativa e estética de tratamento ortodôntico foi avaliada com o índice de Necessidade de Tratamento Ortodôntico (IOTN). As regressões logísticas múltiplas e simples mostraram que os adolescentes que buscaram tratamento apresentaram pior qualidade de vida do que os do grupo de comparação (p<0,001). Os indivíduos dogrupo ortodôntico também apresentaram más-oclusões mais graves (p=0,003) e estética mais comprometida, quando graduada pelo avaliador (ortodontista) (p=0,008) e também quando auto-avaliada pelos adolescentes (p<0,0001). Não foram observadas diferenças significativas no impacto na qualidade de vida entre os gêneros (p=0,22). Entretanto, quando apenas o grupo ortodônticofoi analisado, o gênero feminino demonstrou impactos significativamente mais negativos (p=0,005). Quando os fatores de confusão (experiência de cárie, nível socioeconômico, gravidade da má-oclusão e impacto estético) foram controlados, os adolescentes que buscaram tratamento tiveram 3,1 vezes mais chances de ter escores altos (impacto negativo) no OHIP-14 do que os que nunca buscaram tratamento. A gravidade da má-oclusão teve influência inferior a procura por tratamento, por outro lado, os adolescentes com auto-avaliação estética ruim tiveram 11,7 vezes mais chances de ter impacto negativo no OHIP-14. Sendo assim, foi possível concluir que os indivíduos que procuraram tratamento ortodôntico apresentaram más-oclusões...

The aim of this study was to assess malocclusion severity and oral health-related quality of life (OHQOL) in 12-15 year old Brazilian adolescents who sought orthodontic treatment in the Department of 0rthodontics of a Brazilian University. The sample consisted of 325 subjects, 12 to I5 years of age; 201 of these had sought orthodontic treatment (orthodontic group),and 124 were selected from a public school and had never undergone or sought orthodontic treatment (comparison group). Oral health-related quality of life (OHQOL) was assessed with the Brazilian version of the short form of the Oral Health Impact Profile (OHIP-14) and malocclusion severity with the Index for Orthodontic Treatment Need (IOTN). Simple and multiplelogistic regression analysis revealed that individuals who sought orthodontic treatment reported worse OHQOL than did adolescents in the comparison group (p

[Semantic equivalence of the Brazilian version of the Early Childhood Oral Health Impact Scale]. / Equivalência semântica da versão em português do instrumento Early Childhood Oral Health Impact Scale.

The North American instrument Early Childhood Oral Health Impact Scale (ECOHIS) was created to assess the oral health-related quality of life of preschool children and their families. Its use in Brazil requires prior cultural adaptation, and semantic equivalence is one step in this process. The objective of this study was to evaluate the semantic equivalence between the ECOHIS and its Brazilian version. The methodology included six steps: translation of the ECOHIS into Portuguese, done by two translators; a pre-test, in which the two translations were tested in a group of 20 parents/guardians of children 2-5 years of age; unification of the two versions; two back-translations done independently by two translators; review of the translations and back-translations; and production of a final version of the questionnaire. The two translated versions were very similar, and after completion of all steps a final version of the ECOHIS was obtained. The use of translations and back-translations carefully evaluated by experts and incorporating suggestions from the target population allowed the development of a Brazilian version of the ECOHIS that is semantically equivalent to the original instrument.

Equivalência semântica da versão em português do instrumento Early Childhood Oral Health Impact Scale / Semantic equivalence of the Brazilian version of the Early Childhood Oral Health Impact Scale

O instrumento norte-americano Early Childhood Oral Health Impact Scale (ECOHIS) foi criado para avaliar a qualidade de vida relacionada à saúde bucal de crianças pré-escolares e seus familiares. Para que possa ser utilizado no Brasil é necessário fazer sua adaptação transcultural, sendo a equivalência semântica uma das etapas deste processo. O objetivo deste estudo foi avaliar a equivalência semântica entre o ECOHIS e a sua versão em português. A metodologia incluiu seis etapas: a tradução do ECOHIS, que envolveu duas tradutoras; um pré-teste, em que as duas traduções foram submetidas a vinte responsáveis por crianças de 2 a 5 anos de idade; a unificação das duas versões; duas retraduções feitas independentemente por dois tradutores; a revisão das traduções e retraduções e; a produção de um questionário final. As duas versões traduzidas mostraram-se bastante semelhantes e após a realização de todas as etapas obteve-se uma versão final do ECOHIS. O uso de traduções e retraduções que foram avaliadas por especialistas e incorporaram sugestões da população-alvo, permitiu obter uma versão brasileira do ECOHIS que possui equivalência semântica com o instrumento original.

The North American instrument Early Childhood Oral Health Impact Scale (ECOHIS) was created to assess the oral health-related quality of life of preschool children and their families. Its use in Brazil requires prior cultural adaptation, and semantic equivalence is one step in this process. The objective of this study was to evaluate the semantic equivalence between the ECOHIS and its Brazilian version. The methodology included six steps: translation of the ECOHIS into Portuguese, done by two translators; a pre-test, in which the two translations were tested in a group of 20 parents/guardians of children 2-5 years of age; unification of the two versions; two back-translations done independently by two translators; review of the translations and back-translations; and production of a final version of the questionnaire. The two translated versions were very similar, and after completion of all steps a final version of the ECOHIS was obtained. The use of translations and back-translations carefully evaluated by experts and incorporating suggestions from the target population allowed the development of a Brazilian version of the ECOHIS that is semantically equivalent to the original instrument.

Amelogenesis imperfecta: report of a successful transitional treatment in the mixed dentition.

The term amelogenesis imperfecta is applied to a clinically heterogeneous group of hereditary disorders that interfere with the normal development of dental enamel. These disorders cause a deficiency in the enamel's quantity and/or the quality that may result in poor dental esthetics. The purpose of this paper was to describe a case of hypoplastic amelogenesis imperfecta in an 8-year-old girl whose dissatisfaction with the appearance of her teeth led to impaired social functioning. Since the patient was in the mixed dentition stage, a temporary treatment aiming to improve dental esthetics, preserve oral function, and allow for the recovery of the patient's self-confidence was performed by a multidisciplinary team.

Mensuração do impacto dos problemas bucais sobre a qualidade de vida de crianças: aspectos conceituais e metodológicos / Measuring the impact of oral health problems on children's quality of life: conceptual and methodological issues

As crianças estão sujeitas a problemas de saúde bucal que podem causar impacto na sua vida diária e na vida de suas famílias. A necessidade de instrumentos para acessar o impacto da saúde bucal na qualidade de vida das crianças tem sido ressaltada, e questionários foram desenvolvidos ou adaptados para este grupo específico. O objetivo deste trabalho é descrever os instrumentos de mensuração do impacto da saúde bucal na qualidade de vida de crianças e as dificuldades para esta mensuração. Entre esses instrumentos destacamos o Child Oral Health Quality of Life Questionnaire, para crianças de 6-7, 8-10 e 11-14 anos; o Child-Oral Impacts on Daily Performances, para a idade de 11-12 anos e o Early Childhood Oral Health Impact Scale para a faixa etária de 2-5 anos. Apesar dos progressos nessa área, mais estudos são necessários para a elaboração de medidas que abordem a criança dentro do processo dinâmico de saúde e doença no seu contexto psicológico, familiar e social, e a utilização, tanto na prática clínica quanto na pesquisa, dos instrumentos existentes deve ser estimulada.

Children are subject to oral health problems that can impact their own quality of life and that of their families. The need for measurements to assess the impact of oral health on children's quality of life has been emphasized, and questionnaires have been developed or adapted to this specific group. The aim of this study was to describe such instruments (identified in the literature) and discuss their inherent difficulties. Among such instruments, we highlight the Child Oral Health Quality of Life Questionnaire, for children aged 6-7, 8-10, and 11-14, the Child-Oral Impacts on Daily Performances, for children aged 11-12, and the Early Childhood Oral Health Impact Scale for children aged 2-5. Although progress was observed in this area, more research is needed to develop measurements that apply to children in their dynamic health/disease process, encompassing their psychosocial, family, and social context. The use of such instruments should be encouraged in clinical practice and research.