Oral manifestations and dental approach in pediatric patient with lamellar congenital ichthyosis: 36-month follow-up

Introduction: Lamellar ichthyosis is an autosomal recessive congenital disease that causes dryness of the skin in the perioral region, which leads to pain during dental hygiene. Thus, the diet of patients with this disease tends to be pasty, which can lead to oral problems. Hyposalivation is suspected to be an oral manifestation of lamellar ichthyosis and may exert an influence on the incidence of carious lesions. Objective: Describe the treatment of a female patient diagnosed with lamellar ichthyosis who sought dental care initially when two years of age with complaints of dental pain, feeding difficulties and low weight. Case report: Atraumatic restorative treatment, extractions and topical application of fluoride varnish were performed in the patient, aesthetic of posterior installation of space, which also functioned as a rehabilitator. Conclusion: This study reinforces the need for the follow-up of the patient with LI by the dental surgeon since the birth of the first tooth, as dryness of the perioral skin and hyposalivation are conditions reported in individuals with lamellar ichthyosis. These conditions can affect oral hygiene and the frequency of carious lesions.

Introdução: A ictiose lamelar é uma doença congênita autossômica recessiva que causa ressecamento da pele na região peribucal, o que leva à dor durante a higiene dental, por isso a alimentação dos pacientes com essa doença tende a ser pastosa, podendo levar a problemas bucais. Suspeita-se que a hipossalivação possa ser uma manifestação oral da ictiose lamelar, podendo influenciar na incidência de lesões cariosas. Objetivo: Descrever o tratamento de uma paciente do sexo feminino, inicialmente com 2 anos de idade, diagnosticada com ictiose lamelar (IL), que procurou atendimento odontológico com queixa de dor dentária, dificuldade na alimentação e baixo peso. Relato do caso: Tratamento restaurador atraumático, exodontias e aplicação tópica de verniz fluoretado foram realizados na paciente, além de posterior instalação de mantenedor de espaço, o qual também funcionou como reabilitador estético. Conclusão: Este estudo reforça a necessidade do acompanhamento do paciente com IL pelo cirurgião dentista desde o nascimento do primeiro dente, pois secura da pele perioral e hipossalivação são condições relatadas em indivíduos com ictiose lamelar. Essas condições podem afetar a higiene bucal e a frequência de lesões cariosas.

Are technology-based health education methods able to reduce oral health inequalities between the sexes in adolescents? A cluster randomized trial.

PURPOSE: Determine if different technology-based health education interventions can reduce oral health inequalities between the sexes in a sample of adolescents. METHODS: A cluster randomized clinical trial was conducted in three phases with an initial sample of 291 male and female adolescents 14-19 years of age. Phase I (n = 288) comprised a clinical examination performed by a calibrated examiner using the simplified oral hygiene index (OHI-S) and gingival bleeding index (GBI). Phase II involved two educational interventions: video (VD; n = 147) or oral counselling (OR; n = 141) with standardized content. In phase III, an App was made available to half of the clusters (OR + App; n = 66/OR without App; n = 71/VD + App; n = 63/VD without App; n = 63), and the clinical examination was performed a second time. Data were evaluated using descriptive analysis and nonparametric tests. RESULTS: In phase I, boys had a lower standard of oral hygiene compared with girls, with higher mean OHI-S (p = 0.039) and GBI (p = 0.015). After VD and OR interventions, no significant difference between sexes was found regarding the mean OHI-S. However, males had a higher mean GBI compared with females in the OR group (p = 0.006). When the App was added to OR and VD groups, males in the 'OR without App' group had a higher mean GBI compared with females (p = 0.007). CONCLUSION: This clinical trial demonstrated that educational interventions involving information technologies were effective at reducing oral health inequalities between the sexes among adolescents. However, oral counselling alone was not efficient in reducing GBI in male adolescents.

Genetic polymorphisms are associated with alterations in anxiety levels and vital signs in patients undergoing third molar extractions.

OBJECTIVE: The objective of this study was to evaluate the association between SLC6A4 (rs1042173 and rs3813034), DRD2 (rs6275 and rs6276), ANKK1 (rs1800497), and COMT (rs174675) genetic polymorphisms and alterations in anxiety levels and vital signs in individuals undergoing third molar extractions. STUDY DESIGN: One hundred sixty-eight individuals were evaluated at the pre-, trans-, and postoperative periods by checking systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and body temperature. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI). Buccal mucosa cells were collected for genetic evaluation using real-time polymerase chain reaction. Statistical analysis was performed at a significance level of 5%. RESULTS: The level of anxiety was associated with rs1800497 for STAI-Trait (P = .031) and rs174675 for STAI-State (P = .007). Considering the vital signs, there was a significant difference between the values of respiratory rate and rs1042173 (P = .029), rs3813034 (P = .024), and rs6275 (P = .025). The diastolic blood pressure values differed significantly for rs1042173 (P = .042), and the body temperature values differed significantly for rs174675 (P = .016). CONCLUSIONS: Polymorphisms in SLC6A4, DRD2, ANKK1, and COMT genes could be associated with alterations in anxiety levels and vital signs in individuals undergoing third molar extractions.

Knowledge of Dentists and Dental Undergraduates Related to COVID-19

Abstract Objective: To assess the knowledge of Brazilian dentists and final-year dental undergraduates concerning COVID-19. Material and Methods: We conducted a self-administered online questionnaire about the symptoms, incubation period, and transmission routes of COVID-19. In total, there were three questions addressing these topics and 15 correct answers, so each participant could score from 0 to 15 points. Besides that, data such as sex, age, education level, years of work experience and place of work were collected. All data were submitted to statistical analysis with a 5% significance level. Results: 476 participants were recruited. Regarding the respondents' perception of the most common symptoms of COVID-19, 99.4% responded fever, 95.2% cough, and 99.2% dyspnea. About the incubation period, 56.3% answered from 1 to 14 days. About the transmission routes, 98.3% recognized transmission through droplets, 80.3% through direct contact with infected persons, and 70.4% through indirect routes. The median knowledge score was 10 (4 - 14). Regarding the socio-demographic variables, participants aged 30 years or more had a higher score than those aged up to 29 years old (p=0.004). For education level, specialist dentists presented a higher score than undergraduates (p=0.006), general dentists (p=0.048) and Ph.D. (p=0.016). Participants with 15 years or more of work experience had a higher score than undergraduates (p=0.003). Concerning the workplace, participants working in the public sector had a higher score than those working in the private sector or universities (p=0.015). Conclusion: Participants recognized the main symptoms, incubation period, and transmission routes of the COVID-19 virus; however, the knowledge level of specialist dentists, older dentists, more experienced dentists, and dentists working in the public sector was higher than the other participants (AU).

Unexpected formation of root-like structures subsequent to the avulsion of immature permanent teeth: Case report.

This report describes the unexpected formation of root-like structures following the avulsion of immature permanent teeth without replantation. A 6-year-old female patient had avulsed the four permanent mandibular incisors and the two deciduous mandibular canines. The patient was seen in an emergency healthcare unit but did not receive specialized treatment for tooth replantation. As follow-up treatment, she received a removable prosthesis. After 4 years of follow-up, an image obtained by panoramic radiography showed formations similar to four root structures in the alveolus of the previously avulsed permanent teeth. This finding was confirmed by periapical radiography and computed tomography. This case report demonstrates that in teeth with incomplete root development, even after avulsion without replantation, cells from the pulp stump may have the capacity to form mineralized structures that appear radiographically comparable to root dentin.

Effect of different factors on patient perception of surgical discomfort in third molar surgery

Abstract: The aim of this study was to evaluate patient perception of surgical discomfort in third molar surgery and the association with clinical variables and polymorphisms associated with the FKBP5, SLC6A4, and COMT genes. This cross-sectional observational study was carried out on 196 participants aged between 18 and 64 years at the Federal University of Paraná in 11 months. The intensity of surgical discomfort was assessed using the QCirDental questionnaire. Data on surgical and individual procedures were also cataloged. The oral health related quality of life was assessed by the Oral Health Impact Profile questionnaire (OHIP-14). The DNA sample was obtained from cells of the oral mucosa. Five markers of the FKBP5, SLC6A4, and COMT genes were genotyped. The data were submitted to statistical analysis with a significance level of 5%. Women reported greater intensity of discomfort associated with third molar surgery compared to men (p = 0.001). In the recessive model, the AA genotype of the rs3800373 marker was associated with greater surgical discomfort (p = 0.026). Therefore, women and individuals of the AA genotype for the rs3800373 marker in the FKBP5 gene reported greater surgical discomfort associated with third molar surgery.

Effect of different factors on patient perception of surgical discomfort in third molar surgery.

The aim of this study was to evaluate patient perception of surgical discomfort in third molar surgery and the association with clinical variables and polymorphisms associated with the FKBP5, SLC6A4, and COMT genes. This cross-sectional observational study was carried out on 196 participants aged between 18 and 64 years at the Federal University of Paraná in 11 months. The intensity of surgical discomfort was assessed using the QCirDental questionnaire. Data on surgical and individual procedures were also cataloged. The oral health related quality of life was assessed by the Oral Health Impact Profile questionnaire (OHIP-14). The DNA sample was obtained from cells of the oral mucosa. Five markers of the FKBP5, SLC6A4, and COMT genes were genotyped. The data were submitted to statistical analysis with a significance level of 5%. Women reported greater intensity of discomfort associated with third molar surgery compared to men (p = 0.001). In the recessive model, the AA genotype of the rs3800373 marker was associated with greater surgical discomfort (p = 0.026). Therefore, women and individuals of the AA genotype for the rs3800373 marker in the FKBP5 gene reported greater surgical discomfort associated with third molar surgery.

Prevalence of orofacial pain in wind instrument players / Prevalência de dor orofacial em músicos de instrumento de sopro

ABSTRACT BACKGROUND AND OBJECTIVES: This cross-sectional observational study was conducted due to the uncertainties that still exist about the role of playing wind instruments in musculoskeletal complaints. Therefore, the objective was to assess the prevalence of temporomandibular dysfunction and associated factors in wind instrument players. METHODS: Wind instrument players from the School of Music of Fine Arts of Paraná were evaluated for nine-months. Axes I and II of the Research Diagnostic Criteria for Temporomandibular Disorders was used to obtain the variables of interest. The statistical analyses were performed using the SPSS 2.0 software, using the Fishers Exact test, with a significance level of 5%. RESULTS: Thirty-five musicians were examined, 85.7% were male, and 14.3% were female. The temporomandibular dysfunction prevalence was 51.4% being more commonly found in the group II (disc displacements) 34.2%. This result was statistically meaningful when associated with females (p=0,052). Group I disorders (muscle disorders) were diagnosed in 5 patients (14.2%) and group III disorders (joint disorders) were diagnosed in 3 patients (8.5%). Gender also influenced the presence of chronic pain, being more frequent in females (p=0.019). CONCLUSION: In this research, we found a high prevalence of individuals affected by temporomandibular dysfunction. Therefore, studies with expanded samples are necessary, as well as educational and preventive measures. Temporomandibular dysfunction specialists should devote more attention to this group of people.

RESUMO JUSTIFICATIVA E OBJETIVOS: Estudo observacional transversal foi conduzido devido às incertezas que ainda existem sobre o papel de tocar instrumentos musicais de sopro nas queixas musculoesqueléticas. Portanto, o objetivo foi avaliar a prevalência de disfunção temporomandibular e fatores associados em músicos de instrumento de sopro. MÉTODOS: Foram avaliados músicos de instrumento de sopro da Escola de Música Belas Artes do Paraná, durante o período de nove meses. Para obtenção das variáveis de interesse, os eixos I e II do instrumento Research Diagnostic Criteria for Temporomandibular Disorders foi utilizado. As análises estatísticas foram realizadas com o software SPSS 2.0, utilizando-se o teste Exato de Fisher, com nível de significância 5%. RESULTADOS: Foram avaliados 35 músicos, 85,7% do sexo masculino e 14,3% do sexo feminino. A prevalência de disfunção temporomandibular foi de 51,4%, sendo mais comumente encontrado no grupo II (deslocamentos do disco) 34,2%. Esse resultado apresentou-se estatisticamente significante quando associado ao sexo feminino (p=0,052). Distúrbios do grupo I (distúrbios musculares) foram diagnosticados em 5 pacientes (14,2%) e distúrbios do grupo III (distúrbios articulares) foram diagnosticados em 3 pacientes (8,5%). O sexo também influenciou na presença de dor crônica, sendo mais frequente no sexo feminino (p=0,019). CONCLUSÃO: Nesta pesquisa encontrou-se grande prevalência de indivíduos acometidos por disfunção temporomandibular. Portanto, é necessário o desenvolvimento de estudos com amostras ampliadas, bem como propagar medidas educativas e preventivas, sendo esse um público para o qual o especialista em dor e disfunção temporomandibular deve dedicar maiores cuidados.

Association Between Periodontal Health Knowledge and Oral Hygiene in Brazilian Adolescents

Abstract Objective: To evaluate the influence of oral health knowledge in adolescents' oral hygiene pattern. Material and Methods: Cross-sectional study involving 291 participants aged between 14 and 19 years old enrolled in a public school in Curitiba, Brazil. A self-administered questionnaire containing five affirmations about periodontal diseases and their forms of prevention was arranged on a three-point Likert scale. Correct answers were given a weight=1 and incorrect ones, weight=0. The knowledge score (KS) was determined by the sum. Socioeconomic and demographic data were obtained by a questionnaire sent to those responsible. The oral hygiene pattern was evaluated through the simplified oral hygiene index (OHI-S) by a calibrated researcher (K=0.89). Mann-Whitney U test and univariate and multivariate Poisson regression with robust variance were used for data analysis (α=0.05). Results: There was an inversely proportional association between KS and OHI-S (p=0.018). The multiple model showed that adolescents with a lower KS (PR = 0.93, CI95%: 0.88-0.99), male gender (PR = 1.17, CI95%: 1.01-1.37) and whose caregivers presented a lower level of education (PR=1.30, CI95%: 1.03-1.64) showed a higher index of dental plaque. Conclusion: The level of oral health knowledge, the gender and the caregivers' level of education influences the adolescents' oral hygiene pattern.