Improvement on OHRQoL after endodontic treatment associated with aPDT in traumatized primary teeth: a 12-month follow-up case report.

Dental trauma is often associated with a negative impact on the oral health-related quality of life (OHRQoL). The management of traumatized teeth is a challenge in the daily pediatric dentistry clinic, due to the sequels generated over time. Pulp necrosis is a frequent sequel that requires a pulpectomy. Antimicrobial photodynamic therapy (aPDT) is an adjuvant technique, effective in eradicating microorganisms from the root canals. This case report aimed to describe OHRQoL after endodontic treatment associated with aPDT in traumatized primary teeth of a 4-year-old female patient attended at a Dental Trauma Care Program considering a period of 12-month follow-up. The Brazilian version of the Oral Health Early Childhood Impact Scale (B-ECOHIS) was used to evaluate the OHRQoL. The dental trauma and its sequels had a negative impact on the child's OHRQoL. The proposed treatments (endodontic and restorative procedures) improved the patient's OHRQoL. The association of aPDT with conventional endodontic treatment was effective in this case. It allowed the sinus tract regression and new bone formation. Besides that, this case report emphasizes the need and importance to follow-up dental trauma cases in the pediatric dentistry clinic.

Association between craniofacial morphological patterns and tooth agenesis-related genes.

BACKGROUND: The aim of the present study was to assess if genetic polymorphisms in tooth agenesis (TA)-related genes are associated with craniofacial morphological patterns. METHODS: This cross-sectional, multi-center, genetic study evaluated 594 orthodontic Brazilians patients. The presence or absence of TA was determined by analysis of panoramic radiography. The patients were classified according to their skeletal malocclusion and facial growth pattern by means of digital cephalometric analysis. Genomic DNA was extracted from squamous epithelial cells of buccal mucosa and genetic polymorphisms in MSX1 (rs1042484), PAX9 (rs8004560), TGF-α (rs2902345), FGF3 (rs1893047), FGF10 (rs900379), and FGF13 (rs12838463, rs5931572, and rs5974804) were genotyped by polymerase chain reaction using TaqMan chemistry and end-point analysis. RESULTS: Genotypes (p = 0.038) and allele (p = 0.037) distributions for the FGF3 rs1893047 were significantly different according to the skeletal malocclusion. Carrying at least one G allele increased in more than two times the chance of presenting skeletal class III malocclusion (OR = 2.21, CI 95% = 1.14-4.32; p = 0.017). There was no association between another skeletal craniofacial pattern and some polymorphism assessed in the present study. CONCLUSION: Our results suggest that the genetic polymorphism rs1893047 in FGF3 might contribute to variations in the craniofacial sagittal pattern.

Dificuldades, caminhos e potencialidades da descentralização do atendimento à tuberculose / Difficulties, ways and potential of tuberculosis care decentralization

Objetivo: compreender as dificuldades e os caminhos para a descentralização do atendimento à tuberculose por meio da opinião dos enfermeiros atuantes em um Centro de Referência. Método: trata-se de pesquisa qualitativa e transversal. Os dados foram coletados mediante um questionário semiestruturado, com aplicação da técnica Análise de Conteúdo. Resultados: as principais dificuldades apontadas foram a desestruturação da rede, falta de compromisso da gestão, desorganização do serviço e qualificação profissional insuficiente. Os caminhos sugeridos para atingir a descentralização foram a melhoria na estrutura das unidades, organização do serviço, educação permanente, motivação da equipe e mobilização da gestão. Entre os benefícios, foram citados os objetivos do Programa de Controle da Tuberculose. Considerações finais: é preciso cautela quando a Rede de Atenção à Saúde não está estruturada para descentralizar os serviços, especialmente porque é necessário garantir o suporte no tratamento das pessoas atendidas no município.

Objective: to understand the difficulties and ways to decentralize tuberculosis care through the opinion of nurses working in a Reference Center. Method: It is a qualitative and transversal research. Data were collected using a semi-structured questionnaire and Content Analysis technique was applied to the responses. Results: The main difficulties pointed out were the disruption of the care network, lack of commitment by managers, disorganization of services and insufficient professional qualification. The ways suggested to achieve decentralization were to improve the structure of the units, service organization, permanent education, team motivation and managerial mobilization. Among the benefits, they highlighted the achievement of the objectives of the Tuberculosis Control Program. Final considerations: Caution is needed when the Health Care Network is not structured to decentralize services, especially as it is necessary to guarantee support or the treatment of people attended in the municipality.

Is dental agenesis associated with craniofacial morphology pattern? A systematic review and meta-analysis.

BACKGROUND/OBJECTIVE: Craniofacial discrepancies have been associated with congenital dental anomalies. The aim of this study was to determine if there is any scientific evidence in the literature regarding the association between dental agenesis and craniofacial morphology. MATERIALS AND METHODS: A systematic review and meta-analysis following the PRISMA Statement were conducted and registered in PROSPERO database. A broad search was conducted on databases (PubMed, Virtual Health Library, Web of Science, and Scopus) and grey literature. Articles that were selected based on predetermined eligibility criteria were assessed for quality and risk of bias according to the guidelines described by Folkes and Fulton. Those articles with similarities were submitted to meta-analysis using the RevMan 5.3 program. The certainty of the evidence was tested using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation). RESULTS: An electronic search of 975 articles resulted in 12 articles. These and four articles identified through manual search were eligible to be assessed for methodological quality and the risk of bias. Eleven articles presented moderate to high methodological quality. The included articles observed a reduced mandibular plane, a smaller maxilla and more differences with the increase in the severity of dental agenesis. Seven articles were included in the meta-analyses. Dental agenesis presented smaller SNA angle (P < 0.0001/CI -1.74 [-2.55, -0.92]) with moderate certainty of the evidence; and smaller ANB angle (P = 0.01/CI -0.80 [-1.44, -0.17]), with low certainty of the evidence. CONCLUSIONS: This systematic review and meta-analysis demonstrated that dental agenesis may be associated with specific craniofacial morphology. Further studies are necessary due to the variation of the certainty of the evidence. CONFLICT OF INTEREST: none declared. REGISTRATION: PROSPERO (CRD42017055882).

Assessment of oral health-related quality of life in adolescents, young adults, and adults with dental agenesis: A comparative study.

AIM: To detect the impact on oral health-related quality of life (OHRQoL) in adolescents, young adults, and adults with dental agenesis (DA). METHODS: A comparative study (1:2) matched for age and sex was designed. Data of participants, aged 14-55 years (group with DA: G1; group without DA: G2), and who answered the Brazilian version of the Oral Health Impact Profile-14 questionnaire, were collected. One-way analysis of variance and Student's t-test were applied, considering p <.05 to be significant. RESULTS: The final sample consisted of 90 participants (G1 = 30; G2 = 60), with a mean age of 28.76 (±10.87) years. The mean scores in the G1 and G2 groups were 5.30 ± 5.35 and 2.45 ± 3.95, respectively. Comparing the means of both groups, in terms of the total score (p = .01), psychological discomfort (p = .04), psychological disability (p = .01), and social disability (p = .04) showed statistical differences. Evaluating G1, the age did not influence the negative impact on OHRQoL. The variables, years of study (≥9), DA severity, and location of DA in the anterior and posterior regions negatively influenced OHRQoL in different domains (p <.05). CONCLUSION: Despite low OHRQoL, DA generated negative impact on OHRQoL in adolescents/young adults, and adults.

Tooth agenesis-related GLI2 and GLI3 genes may contribute to craniofacial skeletal morphology in humans.

OBJECTIVE: The present cross-sectional, multi-centre, genetic study aimed to determine, whether single nucleotide polymorphisms (SNPs) in tooth agenesis (TA)-associated GLI2 and GLI3 genes contribute to the development of craniofacial skeletal morphology in humans. DESIGN: Orthodontic patients from an ethnically heterogeneous population were selected for the present study (n = 594). The presence or absence of TA was determined by analysis of panoramic radiography and dental records. The subjects were classified according to their skeletal malocclusion and facial growth pattern by means of digital cephalometric analysis. Genomic DNA was extracted from squamous epithelial cells of the buccal mucosa and SNPs in GLI2 (rs3738880, rs2278741) and GLI3 (rs929387, rs846266) were analysed by polymerase chain reaction using TaqMan chemistry and end-point analysis. RESULTS: Class II skeletal malocclusion presented a significantly lower frequency of TA (P < 0.05). Subjects without TA showed significantly higher ANB angles (P < 0.05). Genotype and/or allele distributions of the SNPs in GLI2 (rs3738880, rs2278741) and GLI3 (rs846266) were associated with the presence of TA (P < 0.05). The SNPs rs3738880, rs2278741 and rs929387 were also associated with some type of skeletal malocclusion (P < 0.05), but not with the facial growth pattern (P > 0.05). The G allele for TA-related GLI2 rs3738880 was strongly linked to the presence of Class III skeletal malocclusion (OR = 2.03; 95% CI = 1.37-3.03; P<3125 × 10-6). GLI2 rs2278741 C allele was overrepresented in individuals without TA, suggesting it as a protective factor for this dental phenotype (OR = 0.43; 95% CI = 0.24-0.78; P<625 × 10-5). CONCLUSION: The present study suggests that SNPs in TA-associated GLI2 and GLI3 genes may also play a role in the development of skeletal malocclusions. rs3738880 and rs2278741 in GLI2 seems to contribute to the genetic background for skeletal Class III and TA, respectively. TA could be an additional predictor of craniofacial morphology in some cases. Further research replicating the reported associations should be performed.

Determination of TNF-a Gene Polymorphisms on Skeletal Pattern in Class II Malocclusion.

Bone development and growth is a non-going, life-long process, varying greatly among individuals and much of this variation could be modulated by genetic factors. The purpose of this study was to evaluate the association between the polymorphisms in the TNF-a gene and skeletal class II malocclusion. Single nucleotide polymorphisms in TNF-a (rs1799724; rs1800629) gene were studied in 79 skeletal class II malocclusion and 102 skeletal class I malocclusion subjects from Straight Wire Group of Studies on Orthodontics and Functional Orthopedics for Maxillary from Rio de Janeiro, Brazil. The Genotyping of these selected polymorphisms was carried out by TaqMan real-time PCR using genomic DNA extracted from buccal cells. All allele and genotype frequencies were compared between the groups using the PLINK® software in a free, in a dominant and in a recessive model using a chi-square test (p≤0.05). There was no significant association of TNF-a (rs1799724; rs1800629) genotype and allele distribution with skeletal class II malocclusion. Regardless of the dominant or recessive genetic model, the preferential genotype associations for rs1799724 and rs1800629 was insignificant. In conclusion, no evidence of association is apparent between genetic polymorphisms involving TNF-a and skeletal class II malocclusion or the position of the maxilla and mandible in the postero-anterior direction.

Determination of tnf-a gene polymorphisms on skeletal pattern in class ii malocclusion

Abstract Bone development and growth is a non-going, life-long process, varying greatly among individuals and much of this variation could be modulated by genetic factors. The purpose of this study was to evaluate the association between the polymorphisms in the TNF-a gene and skeletal class II malocclusion. Single nucleotide polymorphisms in TNF-a (rs1799724; rs1800629) gene were studied in 79 skeletal class II malocclusion and 102 skeletal class I malocclusion subjects from Straight Wire Group of Studies on Orthodontics and Functional Orthopedics for Maxillary from Rio de Janeiro, Brazil. The Genotyping of these selected polymorphisms was carried out by TaqMan real-time PCR using genomic DNA extracted from buccal cells. All allele and genotype frequencies were compared between the groups using the PLINK® software in a free, in a dominant and in a recessive model using a chi-square test (p≤0.05). There was no significant association of TNF-a (rs1799724; rs1800629) genotype and allele distribution with skeletal class II malocclusion. Regardless of the dominant or recessive genetic model, the preferential genotype associations for rs1799724 and rs1800629 was insignificant. In conclusion, no evidence of association is apparent between genetic polymorphisms involving TNF-a and skeletal class II malocclusion or the position of the maxilla and mandible in the postero-anterior direction.

Resumo O desenvolvimento e crescimento ósseo é um processo contínuo, que dura toda a vida, variando muito entre os indivíduos e grande parte dessa variação pode ser modulada por fatores genéticos. O objetivo deste estudo foi avaliar a associação entre os polimorfismos no gene TNF-a e a má oclusão da classe II esquelética. Polimorfismos no gene TNF-a (rs1799724; rs1800629) foram estudados em 79 indivíduos com má oclusão esquelética de classe II e 102 indivíduos com má oclusão esquelética classe I do Grupo de Estudos em Ortodontia e Ortopedia Funcional dos Maxilares do Rio de Janeiro, Brasil. A genotipagem destes polimorfismos foi realizada por PCR em tempo real, através de DNA genômico extraído de células bucais. Todas as frequências alélicas e genotípicas foram comparadas entre os grupos utilizando o software PLINK® em um modelo livre, dominante e recessivo. Foi aplicado o teste do qui-quadrado (p≤0,05). Não houve associação significativa na distribuição genotipica e alélica do gene TNF-a (rs1799724; rs1800629) com a má oclusão de classe II esquelética. Independentemente do modelo genético dominante ou recessivo, as associações genotípicas preferenciais para rs1799724 e rs1800629 foram insignificantes. Pode-se concluir que, não existe evidência de associação entre polimorfismos genéticos envolvendo TNF-a e má oclusão esquelética de classe II ou a posição da maxila e mandíbula na direção póstero-anterior.

Genetic variants in ACTN3 and MYO1H are associated with sagittal and vertical craniofacial skeletal patterns.

OBJECTIVE: This study aimed to evaluate the association of genetic variants inACTN3 and MYO1H with craniofacial skeletal patterns in Brazilians. DESIGN: This cross-sectional study enrolled orthodontic and orthognathic patients selected from 4 regions of Brazil. Lateral cephalograms were used and digital cephalometric tracings and analyzes were performed for craniofacial phenotype determination. Participants were classified according to the skeletal malocclusion in Class I, II or III; and according to the facial type in Mesofacial, Dolichofacial or Brachyfacial. Genomic DNA was extracted from saliva samples containing exfoliated buccal epithelial cells and analyzed for genetic variants inACTN3 (rs678397 and rs1815739) and MYO1H (rs10850110) by real-time PCR. Chi-square or Fisher's exact tests were used for statistical analysis (α = 5%). RESULTS: A total of 646 patients were included in the present study. There was statistically significant association of the genotypes and/or alleles distributions with the skeletal malocclusion (sagittal skeletal pattern) and facial type (vertical pattern) for the variants assessed inACTN3 (P < 0.05). For the genetic variant evaluated in MYO1H, there was statistically significant difference between the genotypes frequencies for skeletal Class I and Class II (P < 0.05). The reported associations were different depending on the region evaluated. CONCLUSION: ACTN3 and MYO1H are associated with sagittal and vertical craniofacial skeletal patterns in Brazilian populations.

Prevalence and factors associated with body image dissatisfaction among university students: repeated surveys analysis / Prevalências e fatores associados à insatisfação com a imagem corporal em universitários: análise de inquéritos repetidos

Abstract Body image dissatisfaction may favor the onset of disorders such as anorexia and bulimia. The aim of this study was to compare the prevalence of body image dissatisfaction between two surveys and to assess sociodemographic factors and link with university associated with body image dissatisfaction due to overweight and thinness. Two cross-sectional studies were carried out with samples of 1,085 and 1,041 public higher education institution students in years 2012 and 2014, respectively. The body silhouette scales measured body image dissatisfaction due to overweight and thinness. Sociodemographic variables (sex, age and marital status) and link with the university (study shift, university time and study areas) were the independent variables. Comparisons between surveys were performed using the Chi-square test and the association between variables by Odds Ratio (OR). There was an increase in the prevalence of body image dissatisfaction in students of the Engineering area between surveys. In 2012, younger presented lower chances of dissatisfaction due to overweight and the males higher chances of dissatisfaction due to thinness (OR: 2.06; 95%CI: 1.50-2.84). In 2014, males, younger, without partner, enrolled in the 2nd year of university and of the Health Sciences area (OR: 0.49; CI95%: 0.25-0.97) presented lowers chances of presenting dissatisfaction due to overweight. The prevalence of body image dissatisfaction due to overweight between surveys is higher in men and was associated with lower chances of dissatisfaction due to overweight in both surveys and in younger students.

Resumo A insatisfação com a imagem corporal pode favorecer o surgimento de transtornos, como a anorexia e bulimia. Objetivou-se comparar as prevalências de insatisfação com a imagem corporal entre dois inquéritos e analisar os fatores sociodemográficos e de vínculo com a universidade associados à insatisfação por excesso e por magreza. Este estudo (inquéritos transversais) foi realizado com amostras de 1.085 e 1.041 universitários, nos anos de 2012 e 2014, respectivamente. A insatisfação com imagem corporal por excesso e por magreza foram as variáveis dependentes. As variáveis sociodemográficas (sexo, idade e situação conjugal) e de vínculo com a universidade (período de estudo, tempo de universidade e áreas de estudo) foram as variáveis independentes. As comparações entre os inquéritos foram realizadas pelo teste Qui-quadrado e a associação entre as variáveis pelo Odds Ratio (OR). A prevalência de insatisfação por excesso aumentou entre os inquéritos em universitários do sexo masculino. Em 2012, os universitários mais jovens apresentaram menores chances de insatisfação por excesso e os homens maiores chances de insatisfação por magreza (OR: 2,06; IC95%: 1,50-2,84). Em 2014, os homens, os mais jovens, aqueles sem parceiro, do 2º ano de exposição à universidade e da área das Ciências da Saúde (OR: 0,49; IC95%: 0,25-0,97) apresentaram menores chances de insatisfação por excesso. As prevalências de insatisfação por excesso, entre os inquéritos, foram maiores em homens, e associados com menores chances de insatisfação por excesso, em ambos os inquéritos, os universitários mais jovens.

Traumatic dental injury in permanent teeth: knowledge and management in a group of Brazilian school teachers.

BACKGROUND/AIM: School is a place with a high frequency of dental trauma, and several studies have shown that teachers' knowledge in how to act during acute dental emergencies is lacking. Therefore, this study aimed to assess the knowledge and actions of a group of Brazilian school teachers relative to dental trauma in permanent teeth. MATERIALS AND METHODS: A cross-sectional, observational study, from 27, schools randomized by lot was performed. All 205 teachers in the 27 schools answered a structured and self-administered questionnaire. The questionnaire contained questions about the participants' education level, work experience and first-aid training, as well as knowledge about and attitudes towards dental trauma in permanent teeth as well as their experience in dental emergency situations. RESULTS: Of the 205 teachers, 91.2% reported having no knowledge about dental trauma and 16.6% of teachers had seen cases of acute dental trauma. Among the 205 teachers, 23.9% had received first-aid training and 4.1% had been educated in dental trauma. Regarding actions of acute injuries to permanent teeth, the teachers showed a significant error rate. No association was found between the level of education and first-aid training or experience with dental trauma. In relation to the experience of the teacher, association was found when managing trauma to soft tissue. CONCLUSION: The knowledge and actions of Brazilian schoolteachers in relation to care of acute injuries in permanent teeth were inconsistent and based on unfounded concepts, beliefs and intuition, and lack of training. Continuing education of teachers in oral care due to a dental trauma should be a good plan of action.

Perfil Epidemiológico dos Traumatismos Dentários em Crianças e Adolescentes no Brasil / Epidemiological Profile of Dental Trauma in Children and Adolescents in Brazil

O traumatismo dentário - TD é considerado, pela Organização Mundial de Saúde ? OMS um problema de saúde pública que apresenta alta prevalência e gera impacto negativo na qualidade de vida relacionada à saúde bucal de crianças/adolescentes e familiares com sequelas biológicas, socioeconômicas, psicológicas e comportamentais. Assim, o presente estudo objetivou realizar uma revisão critica da literatura sobre os estudos que avaliam o perfil epidemiológico do TD em crianças e adolescentes, mapeando a distribuição desses estudos no Brasil. A busca na literatura foi feita utilizando os descritores: traumatismos dentários, criança, adolescente, e epidemiologia, nas Bases Medline, Lilacs, SciELO, BBO e no Google Acadêmico. Os mesmos termos em inglês foram utilizados no Pubmed. De 248 artigos encontrados inicialmente, foram removidas as duplicatas e aplicados os critérios de inclusão e exclusão, selecionando-se 53 artigos. Observou-se que há muitos estudos sobre a prevalência dos TD desenvolvidos no Brasil durante os últimos anos. No entanto, os estudos estão concentrados em algumas regiões específicas como Rio Grande do Sul, Santa Catarina, Minas Gerais e São Paulo. A prevalência de TD em dentição decídua foi de 9,4% e 62,1%, e permanente variou de 8,0% a 58,6%. Os fatores como gênero, sobressaliência acentuada e cobertura labial inadequada foram frequentemente associados ao TD em crianças e adolescentes. Baseado nos levantamentos epidemiológicos dos artigos selecionados neste trabalho, conclui-se que, devido à concentração das pesquisas em alguns centros, não há um perfil representativo da população brasileira e os dados compilados dos estudos devem ser comparados com cautela, devido à grande diferença metodológica existente nos estudos.

Traumatic dental injury (TDI) is considered by the World Health Organization as a public health problem with high prevalence, which generates negative impact on oral health related to quality of life of children / adolescents and their families, causing biological, socioeconomic, psychological and behavioral sequelae. The present study aimed to conduct a critical review of the literature on studies assessing the epidemiological profile of the TDI in children and adolescents, mapping the distribution of these studies in Brazil. The search was performed using the descriptors ?dental trauma, children, adolescents, epidemiology and Brazil?, in the Medline, Lilacs, SCiELO, BBO, Google Scholar, and Pubmed. Initially, 248 articles were found. After removing the duplicates and applying the inclusion and exclusion criteria, 53 articles were selected. It has been observed that there are many studies of prevalence of TDI developed in recent years in Brazil. However, these studies are concentrated in some specific areas such as Rio Grande do Sul, Santa Catarina, Minas Gerais, and São Paulo. The prevalence of TDI in the primary dentition was 9.4% and 62.1%, ranging from 8.0% to 58.6% in the permanent dentition. Factors such as gender, increased overjet and inadequate lip coverage were often associated with TDI in children and adolescents. Based on the epidemiological surveys of the articles selected in this study, we concluded that there is no representative profile of the Brazilian population due to the concentration of research in some centers, thus data should be compared with caution due to the large methodological difference between the studies.

Eu e meu filho hospitalizado: concepção das mães / I an my hospitalized child: mother´s conceptions

O estudo de natureza fenomelógica, que pelo seu modo de ser, não existe um caminho sistemático de aprendizagem de postura que compreende a verdade com um caráter de provisoriedade, mutabilidade e relatividade. O objetivo da pesquisa constitui-se de compreender as experiências da mãe com o filho hospitalizado explícitos e implícitos em seus relatos. O campo de investigação foi a unidade pediátrica de um hospital público do município de Fortaleza. A coleta das descrições ocorreu entre os meses de agosto e setembro de 2003. Participaram da investigação oito mães de crianças hospitalizadas, e o processo de escolha foram aleatórios, tendo vigorado o critério de saturação teórica, através da técnica de entrevista com roteiro. Para interpretação das informações utilizei a hermenêutica, possibilitando ter compreensão do sentido do fenômeno. As descrições revelam que as mães experimentam diversas emoções, por se perceberem lançadas no mundo desconhecido do hospital e necessitam do cuidado da equipe de saúde para se adaptar e enfrentar o sofrimento que esse evento gera.