Eyes wide open to avoid misleading diagnosis and treatment planning.

INTRODUCTION: The treatment of impacted and transposed teeth is a challenge for clinical practice. A precise assessment of the relative position of the transposed tooth could lessen the risks of adverse effects, such as root resorption and periodontal problems. DESCRIPTION OF THE CASE: An 18-year-old patient went to the Orthodontic Department of the Federal University of Juiz de Fora, Brazil for a re-evaluation of the orthodontic treatment to which she had been receiving since the age of 12. Attempted traction of an impacted maxillary canine resulted in root resorption, marked mobility and alteration in the position of adjacent teeth as well as loss of alveolar bone in the anterior region of the maxilla. This tooth was not only partially transposed, but it also had ankylosis, external and internal tooth resorption, which indicated the need for tooth extraction. A change was made to the treatment plan, with the extraction of the canine, bone graft and mesial movement of the posterior teeth. RESULTS: All the spaces were closed at the end of treatment, with normal overbite and overjet. At the follow-up, the teeth position, the shape of dental arches, disocclusion guides and dental occlusion were preserved. The bone graft in the maxilla showed height and mineral density stability. CONCLUSION: The presence of the maxillary permanent canines in the dental arch is important for both aesthetics and a functional occlusion. However, despite the importance of their maintenance in the arch, it is well advised that each case be analysed individually.

Equivalência semântica da versão brasileira do instrumento Patient Satisfaction Questionnaire / Semantic equivalence of the brazilian version of the Patient Satisfaction Questionnaire instrument

A avaliação da satisfação do paciente com os serviços de saúde tem raízes históricas nos movimentos sociais, associadas a interesses de marketing, economia, psicologia, sociologia e da organização dos serviços de saúde. Ao longo dos anos, pesquisas sobre a satisfação do paciente tornaram-se cada vez mais difundidas. Há interesse na avaliação da qualidade dos cuidados de saúde, eficácia, adesão do paciente ao tratamento e, recentemente, como desfecho em ensaios clínicos. Na Ortodontia, critérios objetivos têm sido amplamente utilizados, e esforços para aprimorar a avaliação da perspectiva do paciente são necessários. A adolescência é marcada por diferentes emoções e mudanças pessoais, com os adolescentes enfrentando desafios de saúde e comportamentais que requerem atenção de profissionais e gestores. A má oclusão se destaca como uma condição de saúde bucal relevante para os adolescentes. O Patient Satisfaction Questionnaire (PSQ) é um instrumento condição- específico de autorrelato que mensura a satisfação de pacientes adolescentes com o tratamento ortodôntico. Inicialmente, um instrumento de 38 itens foi desenvolvido nos Estados Unidos, que posteriormente foi adaptado na Holanda, quando foram acrescentados mais 20 itens. Como o instrumento foi desenvolvido em outra língua e cultura, antes de sua utilização no Brasil, é necessário um processo de adaptação transcultural para se obter um instrumento válido e confiável para essa cultura específica. Segundo uma perspectiva universalista, seis etapas devem ser testadas no processo de verificação da equivalência: semântica, conceitual, operacional, item, medida e funcional. A equivalência semântica é uma das etapas desse processo e avalia a transferência de significado entre as línguas, buscando obter um efeito semelhante em populações de diferentes origens. O presente estudo teve como objetivo traduzir o PSQ para a língua portuguesa do Brasil e adaptá-lo para uso no Brasil, avaliando a equivalência conceitual, semântica, de itens e operacional entre a versão original do instrumento e a versão brasileira (B-PSQ). O PSQ possui 58 itens, distribuídos em 6 dimensões: relação médico-paciente, aspectos situacionais da clínica, melhora dentofacial, melhora psicossocial, função dentária e uma categoria residual. Foram utilizados os seguintes métodos: 1) duas traduções independentes para o português brasileiro foram realizadas por dois tradutores, ambos nativos em português brasileiro e fluentes em inglês; 2) redação da primeira versão síntese em português por um comitê de experts; 3) duas retro-traduções independentes para o inglês por dois tradutores, ambos nativos em inglês e fluentes em português; 4) revisão pelo comitê de experts; 5) redação de uma versão síntese das retro-traduções pelo comitê; 6) redação da segunda versão síntese em português pelo comitê de experts; 7) pré-teste do instrumento, realizado em duas etapas, incluindo um estudo transversal e uma etapa qualitativa posterior, por meio de entrevistas individuais semiestruturadas com 10 adolescentes; 8) revisão e versão final do B-PSQ. As equivalências semântica, conceitual, operacional e de itens entre a versão original e o B-PSQ foram alcançadas por meio de métodos cuidadosos e rigorosos, com tradução efetiva e avaliação de experts, incorporando a visão da população-alvo.

The evaluation of patient satisfaction with healthcare services has historical roots in social movements, associated with interests in marketing, economics, psychology, sociology, and health services organization. Over the years, patient satisfaction research has become increasingly widespread. There is interest in the evaluation of healthcare quality, efficacy, patient adherence to treatment, and, recently, as an outcome measure in clinical trials. In Orthodontics, objective criteria have been used extensively, and efforts to improve the evaluation of the patient's perspective are warranted. Adolescence is marked by different emotions and personal changes, with adolescents facing health and behavioral challenges that require attention from professionals and managers. Malocclusion stands out as one oral health condition relevant to adolescents. The Patient Satisfaction Questionnaire (PSQ) is a condition- specific self-reported instrument that assesses the satisfaction of adolescent patients with orthodontic treatment. At first, a 38-item instrument initially developed in the United States was subsequently adapted in the Netherlands when 20 items were added. As the instrument was developed in another language and culture, before its use in Brazil, a previous process of cross-cultural adaptation is necessary to obtain a valid and reliable instrument for this specific culture. According to a universalist approach, six steps must be tested in the evaluation of equivalence: semantic, conceptual, operational, item, measurement, and functional. Semantic equivalence is one of the steps in this process and evaluates the transfer of meaning between languages, seeking to achieve a similar effect in populations from different origins. The present study aimed to translate the PSQ into Brazilian Portuguese and cross-culturally adapt it for use in Brazil, assessing the semantic, conceptual, operational, and item equivalence between the original version of the instrument and the Brazilian version (B-PSQ). The PSQ has 58 items, distributed in 6 dimensions: doctor-patient relationship, situational aspects of the clinic, dentofacial improvement, psychosocial improvement, dental function, and a residual category. The following methods was used: 1) two independent translations into Brazilian Portuguese were carried out by two translators, both native in Brazilian Portuguese and fluent in English; 2) draft of the first summarized version in Portuguese by a committee of experts; 3) two independent back-translations into English by two translators, both native in English and fluent in Portuguese; 4) review by the expert committee; 5) draft of a summarized version of the back-translations by the committee; 6) draft of the second summarized version in Portuguese by the committee of experts; 7) pre-test of the instrument, carried out in two stages, including a cross-sectional study and a subsequent qualitative stage, using individual semi-structured interviews with 10 adolescents; 8) review and final version of the B-PSQ. Semantic, conceptual, operational, and item equivalence between the original version and the B-PSQ were achieved through careful and rigorous methods, with effective translation and expert evaluation, incorporating the views of the target population.

Classification of the midpalatal suture maturation in individuals older than 15 years: a cone beam computed tomographic study.

PURPOSE: The aim of this study was to classify the maturation of the midpalatal suture (MPS) in a sample of individuals aged 15 years and older. METHODS: Tomographic images in axial sections of the MPS of 289 female individuals and 198 male individuals aged between 15 and 40 years were analyzed and classified in stages of maturation (A, B, C, D, and E), stage A represents the earliest maturation stage of the suture and in stage E the fusion of the MPS has occurred in the maxilla. The Kruskal-Wallis and Student-Newman-Kells tests were used to compare the chronological ages among different maturation stages. Spearman's correlation coefficient was used to assess the correlation between patient's age and the maturation stages of the MPS. RESULTS: Stage A was not observed in the sample. Stages B and C represent, respectively, 1.03% and 34.09% of the sample, stage D was found in 16.63% of the sample while stage E was the most prevalent stage found (48.25%). For females, it was revealed no statistically significant difference in the mean ages among stages C, D and E (p = 0.4753). For males, a statistically significant difference was observed, with the mean age of individuals in stages D and E of the MPS maturation higher than in other stages (p = 0.0001). There was a significant, but weak, correlation between patient's age and the maturation stages of the suture (rs = 0.11/p = 0.01). CONCLUSION: No individuals in stage A of suture maturation were found and stage B was identified in only 1% of the sample. The majority of the patients (64.88%) presented at least partial fusion of the MPS (stages D and E).