Análise das condições bucais e microbiológicas salivar de pacientes infantis em programação para o transplante hepático e avaliação da qualidade de vida da saúde geral de seus doadores / Analysis of the oral conditions and salivary microbiology of pediatric patients in programming for liver transplantation and evaluation of the quality of life of their donors' general health

O transplante hepático (Tx) pediátrico é o tratamento definitivo e indicado para doenças hepáticas terminais. Nele, estão envolvidos dois cenários: o da criança receptora e do doador, que abrangem questões como a saúde geral e bucal, imunossupressão e qualidade de vida. A imunossupressão pode acarretar infecções oportunistas como os poliomavírus BK e JC que causam complicações clínicas no pós-transplante. Assim, esta pesquisa trata-se de um estudo longitudinal que se propôs avaliar três vertentes: i) as condições odontológicas das crianças no processo do transplante hepático; ii) avaliar a excreção oral e viremia dos poliomavírus BK e JC nas crianças antes e após o Tx; iii) avaliar o impacto da qualidade de vida (QV) dos doadores. Para analisar as vertentes relacionadas ao receptor, foram incluídas 84 crianças em programação para o transplante hepático no Hospital Municipal Infantil Menino Jesus em São Paulo, mas apenas 51 fizeram parte da amostra final. Foram utilizadas as categorias avaliativas do Bedside Oral Exam BOE para avaliar as condições bucais pré- e pós-transplante imediato. Juntamente com o exame clínico bucal, foram realizadas seis coletas, uma pré-transplante e cinco semanalmente no pós-transplante, de saliva e sangue para avaliar a presença dos poliomavírus. Em contrapartida, para avaliar a QV dos doadores, participaram desse estudo 25 adultos. Para essa avaliação foi utilizado o questionário SF-36 versão 2, que é autoaplicável e aborda oito domínios sobre a saúde física e emocional, sendo aplicado no pré-Tx (um dia anterior a cirurgia) e no pós-Tx (um mês após a cirurgia). As análises estatísticas utilizadas para cada objetivo foram: i) análise descritiva das condições bucais nos dois momentos e comparadas através do teste de Wilcoxon; ii) análise da variável dicotômica e o teste de McNemar para identificar a presença do BK e JC; iii) teste de Shapiro-Wilk, seguido pela comparação dos dados paramétricos pelo teste t pareado e dados não paramétricos pelo teste de Wilcoxon considerando significância estatística de p<0,05 para a avaliação da QV do doador. As análises foram realizadas através do software JAMOVI. Assim, os resultados encontrados para cada objetivo foram: i) no pré-transplante a característica mais frequente foi à alteração de cor nas mucosas (78.6% n=84) e no pós-transplante alteração nos lábios (27.4% n=51), na função deglutição (13.8% n=51) e na cor dos dentes (27.4% n=51); apesar disso as crianças apresentavam BOE escore 8, 9 ou 10 tanto no pré-transplante (92.8% n=84) como no pós-transplante (90.4% n=51); ii) em relação à excreção oral e viremia dos poliomavírus, apenas observamos a presença do BK na saliva em uma amostra (2%) na segunda e uma amostra (2%) na quinta semana pós-Tx; e no plasma em uma amostra (2%) na terceira e em uma amostra (2%) na quinta semana pós-Tx. O JC não foi detectado em nenhuma das amostras analisadas; iii) em relação à QV do doador, foi possível verificar uma diferença estatisticamente significativa nos domínios relacionados à capacidade funcional (média no pré-Tx= 85.4 e média no pós-Tx= 47.6; p<0.001), limitação por aspectos físicos (média no pré-Tx= 82.5 e média no pós-Tx= 52.5; p<0.001), dor (média no pré-Tx= 83.9 e média no pós-Tx= 60.5; p=0.002) e limitação por aspectos emocionais (média no pré-Tx= 82.5 e média no pós-Tx= 52.5; p<0.001). Conclui-se que as crianças possuíam uma boa condição bucal no pré e pós-transplante apesar de terem sido encontradas alterações na mucosa no pré-transplante e alterações em lábios e dentes no pós-transplante. A presença do poliomavírus BK é um evento raro em pacientes pediátricos no processo de transplante hepático. No que diz respeito ao impacto da QV nos doadores, houve uma piora no pós-transplante considerando os aspectos físicos e emocionais.

Oral findings in children on liver transplantation programming: a scoping review.

OBJECTIVE: To identify oral characteristics found in children with liver disease in programming for liver transplantation. DATA SOURCE: The methodology was written according to PRISMA-ScR. We adopted the methodological framework and recommendations for this type of review by Arksey and O'Malley and the Joanna Briggs Institute. The protocol was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). A systematic search (Medline/PubMed, Scopus, Web of Science, and ProQuest) was conducted to identify studies that met the inclusion criteria: systematic reviews; prospective clinical trials (parallel or crossover group designs); observational studies (cohort, case-control, and cross-sectional studies); clinical case series; and case reports evaluating children with liver disease in preparation for transplantation. The last search was conducted in July 2021, and no restrictions were imposed as to language or year of publication. Studies presenting mixed data with post-transplant evaluation, and studies evaluating not only liver transplantation but also other solid organs were excluded. Screening, inclusion, and data extraction were performed by two reviewers independently. A narrative synthesis was conducted to describe the findings of the study. DATA SYNTHESIS: The bibliographic search identified 830 references. A total of 21 articles were read in their entirety after the inclusion criteria assessment. Finally, after evaluating the exclusion criteria, only 3 studies were considered for the qualitative analysis. CONCLUSIONS: Children with liver disease in preparation for transplantation may present enamel defects, tooth pigmentation, caries, gingivitis, and opportunistic infections such as candidiasis.

Teledentistry and COVID-19 molecular surveillance strategy for a safe clinical environment in Paediatric Dentistry / Teleodontología y estrategia de vigilancia molecular para COVID-19 proporcionando un entorno clínico seguro en Odontología Pediátrica / Teleodontologia e estratégia de vigilância molecular para a COVID-19 proporcionando um ambiente clínico seguro na Odontopediatria

The aim of this manuscript is to describe a hybrid care model to paediatricpatients on a virtual basis for dental treatment before conducting an in-person surveillance by using combined nasal/oral swabbing (NOS).This longitudinal study used a convenience sample of paediatric patients and members of the dental team from an undergraduate paediatric dentistry clinic at the University of São Paulo School of Dentistry during the COVID-19 pandemic. Firstly, parents werecontacted and teledentistry was used for screening children who need dental treatment. Appointments were scheduled once a week for two months, in which a pre-COVID-19 screening was performed. Dental team and children's parents completed a questionnaire addressing COVID-19-related symptoms. Members of the dental team and children were tested for COVID-19 before entering the dental clinic, by NOS and RT-PCR screening.Ninety-three individuals were enrolled and all of them completed the electronic questionnaire on symptoms and had NOS collected weekly, totalising 241 pairs of swabs. No participant reported COVID-19 symptomsbefore entering the clinic for treatment. Only one child tested positive in the third week of sampling. The hybrid care model associated with molecular testing for asymptomatics provided a safe clinical environment regarding the transmission of SARS-CoV-2 (AU).

El propósito de este manuscrito es describir un modelo híbrido de atención odontológica, a través de una plataforma virtual que precede a la realización de vigilancia molecular presencial mediante hisopado nasal/oral combinado, en pacientes pediátricos. Eneste estudio longitudinal se utilizó una muestra de conveniencia de pacientes pediátricos y miembros del equipo odontológico en la clínica de pregrado de la Facultad de Odontología de la Universidade de São Paulo durante la pandemia de COVID-19. En primerlugar, se contactó con los padres y se utilizó la consulta virtual para seleccionar a los niños que requerían tratamiento odontológico. Se programaron citas una vez a la semana durante dos meses, en las que se realizó el cribado previo a COVID-19. El equipo dental y los padres de los niños rellenaron un cuestionario en el que se abordaban los síntomas relacionados con la COVID-19. A continuación, los miembros del equipo dental y los niños fueron sometidos a pruebas de detección de COVID-19 antes de entrar en la clínica para atendimiento mediante cribado con hisopo nasal/oral y RT-PCR. Se inscribieron 93 personas, todas las cuales cumplimentaron el cuestionario electrónico sobre síntomas y se les recogieron muestras semanalmente, con un total de 241 pares dehisopos. Ningún participante declaró síntomas de COVID-19 antes de entrar en la clínica para recibir tratamiento. Sólo un niño dio positivo en la tercera semana de toma de muestras. El modelo de tratamiento híbrido unido a las pruebas moleculares para asintomáticos proporcionó un entorno clínico seguro con respecto a la transmisión del SARS-CoV-2 (AU).

O objetivo deste manuscrito é descrever um modelo de atendimento odontológico híbrido, por meio de uma plataforma virtual anterior a realização de uma vigilância molecular presencial usando esfregaço combinado nasal/oral, em pacientes pediátricos. Este estudo longitudinal utilizou uma amostra de conveniência de pacientes pediátricos e membros da equipe odontológica na clínica de graduação da Faculdade de Odontologia da Universidade de São Paulo durante a pandemia COVID-19. Primeiro, os pais foram contactados e a consulta virtual foi utilizada para o rastreio de crianças que necessitavam de tratamento odontológico. Foram agendadas consultas uma vez por semana durante dois meses, nas quais foi realizado um rastreio pré-COVID-19. A equipe odontológica e os pais das crianças preencheram um questionário que abordava os sintomas relacionados com a COVID-19. Em sequência, os membros da equipe odontológica e as crianças foram testados para o COVID-19 antes de entrarem na clínica para atendimento, através do rastreio com esfregaço nasal/oral e RT-PCR. Noventa e três indivíduos foram inscritos e todos eles preencheram o questionário eletrônico sobre os sintomas e tiveram amostras coletadas semanalmente, totalizando 241 pares de cotonetes. Nenhum participante comunicou sintomas de COVID-19 antes de entrar na clínica para tratamento. Apenas uma criança testou positivo na terceira semana de amostragem. O modelo de tratamento híbrido associado a testes moleculares para assintomática proporcionou um ambiente clínico seguro no que diz respeito à transmissão da SARS-CoV-2 (AU).

Publication Trends Studies Involving Disabled Persons with Dental Care Needs: A 20-Year Bibliometric Analysis

ABSTRACT Objective: To evaluate scientific production on disabled persons with dental care needs over a 20-year period. Material and Methods: The search was conducted in the PubMed database using the MeSH terms "Disabled Persons" AND "Dentistry". Three researchers selected articles based on readings of the title, abstract and full text. The articles were categorized according to periodical, country, study design, subject and classification of comorbidities and associated disorders. Three hundred ninety-seven articles published in 140 periodicals were included. Results: The periodicals Special Care in Dentistry (54), Dental Clinics of North America (14) and British Dental Journal (14) accounted for 21% of the publications. The studies were conducted in 50 countries, with the United States accounting for 33%. More than half (52%) of the studies had a cross-sectional design. The main subject addressed was oral diagnosis and most of the comorbidities were generalized disabilities. Conclusion: Although a large number of the periodicals have contributed to knowledge building on disabled persons with dental care needs, the number of articles is small compared to other fields of dentistry. Moreover, important gaps in knowledge persist and projects with better methodological designs are needed to offer a more substantial contribution to clinical practice.

Oral findings in children on liver transplantation programming: a scoping review / Achados odontológicos em crianças em programação para o transplante hepático: revisão de escopo

Abstract Objective: To identify oral characteristics found in children with liver disease in programming for liver transplantation. Data source: The methodology was written according to PRISMA-ScR. We adopted the methodological framework and recommendations for this type of review by Arksey and O'Malley and the Joanna Briggs Institute. The protocol was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). A systematic search (Medline/PubMed, Scopus, Web of Science, and ProQuest) was conducted to identify studies that met the inclusion criteria: systematic reviews; prospective clinical trials (parallel or crossover group designs); observational studies (cohort, case-control, and cross-sectional studies); clinical case series; and case reports evaluating children with liver disease in preparation for transplantation. The last search was conducted in July 2021, and no restrictions were imposed as to language or year of publication. Studies presenting mixed data with post-transplant evaluation, and studies evaluating not only liver transplantation but also other solid organs were excluded. Screening, inclusion, and data extraction were performed by two reviewers independently. A narrative synthesis was conducted to describe the findings of the study. Data synthesis: The bibliographic search identified 830 references. A total of 21 articles were read in their entirety after the inclusion criteria assessment. Finally, after evaluating the exclusion criteria, only 3 studies were considered for the qualitative analysis. Conclusions: Children with liver disease in preparation for transplantation may present enamel defects, tooth pigmentation, caries, gingivitis, and opportunistic infections such as candidiasis.

RESUMO Objetivo: Identificar características bucais em crianças hepatopatas em programação para o transplante hepático. Fontes de dados: A metodologia foi descrita de acordo com o PRISMA-ScR. Adotamos a estrutura metodológica e recomendações para este tipo de revisão por Arksey e O'Malley e o Instituto Joanna Briggs. O protocolo foi registrado no Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). Uma pesquisa sistemática (Medline/PubMed, Scopus, Web of Science e ProQuest) foi conduzida para identificar estudos que preenchessem os critérios de inclusão: revisões sistemáticas; ensaios clínicos prospectivos (desenhos de grupos paralelos ou cruzados); estudos observacionais (coorte, caso-controle e estudos transversais); séries de casos clínicos; e relatos de casos que avaliam crianças com doenças hepáticas em preparação para o transplante. A última busca foi conduzida em julho de 2021, e não foram impostas restrições quanto ao idioma ou ano de publicação. Foram excluídos estudos que apresentavam dados mistos com avaliação pós-transplante e estudos que avaliavam não só o transplante de fígado, mas também de outros órgãos sólidos. O rastreio, inclusão e extração de dados foram realizados por dois revisores independentemente. Foi conduzida uma síntese narrativa para identificar os resultados do estudo. Síntese dos dados: A pesquisa bibliográfica identificou 830 referências. Foram lidos 21 artigos na íntegra após avaliação dos critérios de inclusão. Finalmente, após a avaliação dos critérios de exclusão, apenas três estudos foram considerados para análise. Conclusões Crianças com doença hepática em preparação para o transplante podem apresentar defeitos de esmalte, pigmentação dentária, cárie, gengivite além de infecções oportunistas como a candidíase.

Saliva: an important alternative for screening and monitoring of COVID-19 in children.

The increasing number of cases of COVID-19 worldwide poses challenges to healthcare systems not only in effectively identifying individuals positive for SARS-CoV-2, but also in isolating cases to minimise contagion in early diagnosing more severe cases that will need hospitalization. Less-invasive collection methods are indispensable in a pandemic scenario as large-scale tests are necessary to understand the actual evolution of contagion in different populations, thus enabling decision-making based on scientific evidence. Saliva has been shown to be an alternative for diagnosing viral infections as this biological fluid can be easily and quickly collected without using specific devices and causing less discomfort during collection, which is an important factor for use in children. Despite the smaller percentage of severe cases of COVID-19 among children, they seem to play an important role in the contagion as they have the same potential of transmission as that of adults. Knowing the evolution of COVID-19 pandemic in children is extremely important, mainly regarding the changing in rules of social distancing, such as re-opening schools and recreational activities spaces. In addition, countless cases of a severe multi-systemic inflammatory syndrome that shares clinical and laboratory features with Kawasaki's disease have been recently related to SARS-CoV-2 infections in children, adolescents and young adults. In view of this scenario, the aim of this study was to present saliva as an alternative for seeking diagnostic and prognostic markers of COVID-19 in children, including adequate sample collection techniques for different age groups.

Talon cusp in the temporary dentition of a patient with Kabuki syndrome: Case report with a two-year follow-up.

The presence of dental abnormalities in the same individual may be related to syndromic cases and occur through associated systemic changes. Kabuki syndrome presents well-defined systemic changes, but its clinical characteristics related to the oral cavity have not been fully explained. This study aimed to report the dental changes in a child diagnosed with Kabuki syndrome. A male brown patient aged 2 years and 7 months, accompanied by his mother to the dental visit, they main complaint was the presented of an additional tooth behind upper right central incisor. Anamnesis, intra- and extraoral examinations, and dental X-rays were performed, revealing a talon cusp. Considering the dental clinical findings, the patient was referred to a medical geneticist who additionally requested cardiological and genetic examinations, which established the Kabuki syndrome. The caregivers were advised that the talon cusp would not cause any injury to the natural exfoliation of the tooth and that oral hygiene should be performed carefully. Abnormalities in the oral cavity and developmental delay may be associated with a potential undiagnosed syndrome. The medical evaluation becomes decisive for investigation, diagnosis, and final conduct of the case.

Effect of two erosive protocols using acidic beverages on the shear bond strength of orthodontic brackets to bovine enamel

Abstract Objective: To assess the short-term effect of two in vitro erosive challenge protocols on the bond strength of metal orthodontic brackets on bovine enamel. Methods: Sixty bovine incisors were selected and randomly divided into six groups: AS7 (artificial saliva - 7 days, Control Group); CC7 (Coca-Cola™ - 7 days); LJ7 (lime juice - 7 days); AS30 (artificial saliva - 30 days, Control Group); CC30 (Coca-Cola™ - 30 days); LJ30 (lime juice - 30 days). Microhardness testing was performed prior to the erosive challenge to verify the standardization of samples. Immersion was performed 4x/day for five minutes, for either 7 or 30 days. After immersions were concluded, the brackets were bonded and shear bond strength was assessed after 48 hours. The Adhesive Remnant Index (ARI) was also assessed. Data were analyzed by two-way ANOVA, followed by Tukey's post-hoc and Student's t test for paired samples, and the Kruskal-Wallis non-parametric test (α = 5%). Results: The mean and standard deviation of microhardness testing of total samples were 281.89 ± 44.51 KHN. There was no statistically significant difference in shear bond strength for the time factor (7 or 30 days; F5.54= 0.105; p = 0.901). However, there was a statistically significant difference for the solution factor (F5.54= 6.671; p = 0.003). These differences occurred among solutions of Saliva x Coca-Cola™ (p = 0.003) and Coca-Cola™ x Lime Juice (p= 0.029). The assessment of the Adhesive Remnant Index showed no significant difference between groups. Conclusions: The immersion time used in the erosion protocols did not affect the bond strength of brackets to teeth. Coca-Cola™ induced significantly higher shear bond strength values than lime juice and artificial saliva. However, the short term effects of 7/30 days in this in vitro study may not be extrapolated for in vivo ones. Clinical studies should be conducted, substantiating the laboratory results.

Resumo Objetivo: avaliar o efeito de curto prazo de dois protocolos de desafio erosivo, in vitro, na resistência adesiva de braquetes ortodônticos metálicos em esmalte bovino. Métodos: Sessenta incisivos bovinos foram selecionados e divididos aleatoriamente em seis grupos: SA7 (saliva artificial - 7 dias, Grupo Controle); CC7 (Coca-Cola® - 7 dias); SL7 (suco de limão - 7 dias); SA30 (saliva artificial - 30 dias, Grupo Controle); CC30 (Coca-Cola® - 30 dias); SL30 (suco de limão - 30 dias). Foi realizado o teste de microdureza antes do desafio erosivo, para verificar a padronização das amostras. A imersão foi realizada quatro vezes ao dia, por cinco minutos, durante 7 ou 30 dias. Finalizadas as imersões, os braquetes foram colados e, após 48 horas, foi avaliada a resistência ao cisalhamento. O Índice de Adesivo Remanescente (IAR) também foi avaliado. Para análise dos dados, foram utilizados os testes ANOVA dois fatores, seguido do post-hoc de Tukey e teste t de Student para amostras pareadas, e o teste não-paramétrico de Kruskal-Wallis (α?#8197;= 5%). Resultados: a média e o desvio-padrão do teste de microdureza das amostras totais foi igual a 281,89 ± 44,51 KHN. Não houve diferença estatisticamente significativa na resistência ao cisalhamento para o fator tempo (7 ou 30 dias; F5,54= 0,105; p= 0,901). Contudo, houve diferença estatisticamente significativa para o fator solução (F5,54=6,671; p= 0,003). Essas diferenças ocorreram entre as soluções de Saliva x Coca-Cola® (p= 0,003) e Coca-Cola® x suco de limão (p= 0,029). Ao avaliar o Índice de Adesivo Remanescente, não foi possível verificar diferença significativa entre os grupos. Conclusões: o tempo de imersão utilizado nos protocolos de erosão não afetou a resistência de união dos braquetes aos dentes. A Coca-Cola® induziu valores de resistência ao cisalhamento significativamente mais altos do que o suco de limão e a saliva artificial. No entanto, os efeitos em curto prazo de 7 e 30 dias, nesse estudo in vitro, não podem ser extrapolados para os estudos in vivo. Estudos clínicos devem ser conduzidos, fundamentando os resultados laboratoriais.

Effect of two erosive protocols using acidic beverages on the shear bond strength of orthodontic brackets to bovine enamel.

OBJECTIVE: To assess the short-term effect of two in vitro erosive challenge protocols on the bond strength of metal orthodontic brackets on bovine enamel. METHODS: Sixty bovine incisors were selected and randomly divided into six groups: AS7 (artificial saliva - 7 days, Control Group); CC7 (Coca-Cola™ - 7 days); LJ7 (lime juice - 7 days); AS30 (artificial saliva - 30 days, Control Group); CC30 (Coca-Cola™ - 30 days); LJ30 (lime juice - 30 days). Microhardness testing was performed prior to the erosive challenge to verify the standardization of samples. Immersion was performed 4x/day for five minutes, for either 7 or 30 days. After immersions were concluded, the brackets were bonded and shear bond strength was assessed after 48 hours. The Adhesive Remnant Index (ARI) was also assessed. Data were analyzed by two-way ANOVA, followed by Tukey's post-hoc and Student's t test for paired samples, and the Kruskal-Wallis non-parametric test (α = 5%). RESULTS: The mean and standard deviation of microhardness testing of total samples were 281.89 ± 44.51 KHN. There was no statistically significant difference in shear bond strength for the time factor (7 or 30 days; F5.54= 0.105; p  = 0.901). However, there was a statistically significant difference for the solution factor (F5.54= 6.671; p  = 0.003). These differences occurred among solutions of Saliva x Coca-Cola™ (p  = 0.003) and Coca-Cola™ x Lime Juice (p = 0.029). The assessment of the Adhesive Remnant Index showed no significant difference between groups. CONCLUSIONS: The immersion time used in the erosion protocols did not affect the bond strength of brackets to teeth. Coca-Cola™ induced significantly higher shear bond strength values than lime juice and artificial saliva. However, the short term effects of 7/30 days in this in vitro study may not be extrapolated for in vivo ones. Clinical studies should be conducted, substantiating the laboratory results.

Influence of maternal anxiety on child anxiety during dental care: cross-sectional study.

CONTEXT AND OBJECTIVES:: Anxiety is usually classified as a disorder of neurotic nature and is often related to contexts of stress, which may include worries, motor tension and autonomic hyperactivity. The aim of this study was to assess the influence of mothers' anxiety on their children's anxiety during dental care. DESIGN AND SETTING:: Analytical cross-sectional study conducted at in a private dentistry school in the south of Brazil. METHODS:: Convenience sampling was used. All mothers of children undergoing treatment were invited to participate in this study. Data to investigate anxiety related to dental treatment among the children were collected through applying the Venham Picture Test (VPT) scale. For the mothers, the Corah scale was applied. A self-administered sociodemographic questionnaire with questions about demographic, behavioral, oral health and dental service variables was also used. RESULTS:: 40 mother-child pairs were included in the study. The results showed that 40% of the children were anxious and 60% of the mothers were slightly anxious. Local anesthesia was the procedure that caused most anxiety among the mothers, making them somewhat uncomfortable and anxious (60%). Family income higher than R$ 1,577.00 had an influence on maternal anxiety (75.6%). Maternal anxiety had an influence on child anxiety (81.3%). CONCLUSION:: Most of the children showed the presence of anxiety, which ranged from fear of dental care to panic, inferring that maternal anxiety has an influence on children's anxiety. Dental procedures did not interfere with the mothers' anxiety, but caused positive feelings, whereas they affected the children more.

Influence of maternal anxiety on child anxiety during dental care: cross-sectional study / Influência da ansiedade materna na ansiedade infantil frente ao atendimento odontológico: estudo transversal

ABSTRACT CONTEXT AND OBJECTIVES: Anxiety is usually classified as a disorder of neurotic nature and is often related to contexts of stress, which may include worries, motor tension and autonomic hyperactivity. The aim of this study was to assess the influence of mothers’ anxiety on their children’s anxiety during dental care. DESIGN AND SETTING: Analytical cross-sectional study conducted at in a private dentistry school in the south of Brazil. METHODS: Convenience sampling was used. All mothers of children undergoing treatment were invited to participate in this study. Data to investigate anxiety related to dental treatment among the children were collected through applying the Venham Picture Test (VPT) scale. For the mothers, the Corah scale was applied. A self-administered sociodemographic questionnaire with questions about demographic, behavioral, oral health and dental service variables was also used. RESULTS: 40 mother-child pairs were included in the study. The results showed that 40% of the children were anxious and 60% of the mothers were slightly anxious. Local anesthesia was the procedure that caused most anxiety among the mothers, making them somewhat uncomfortable and anxious (60%). Family income higher than R$ 1,577.00 had an influence on maternal anxiety (75.6%). Maternal anxiety had an influence on child anxiety (81.3%). CONCLUSION: Most of the children showed the presence of anxiety, which ranged from fear of dental care to panic, inferring that maternal anxiety has an influence on children’s anxiety. Dental procedures did not interfere with the mothers’ anxiety, but caused positive feelings, whereas they affected the children more.

RESUMO CONTEXTO E OBJETIVO: A ansiedade é geralmente classificada como um transtorno de caráter neurótico, frequentemente relacionado a contextos de estresse variando entre preocupações, tensão motora e hiperatividade autonômica. O objetivo desta pesquisa foi avaliar a influência da ansiedade materna na ansiedade de seu filho durante o atendimento odontológico. TIPO DE ESTUDO E LOCAL: Estudo analítico transversal realizado em uma faculdade particular do sul do Brasil. MÉTODOS: Amostragem por conveniência foi utilizada. Todas as mães das crianças em tratamento foram convidadas a participar da pesquisa. A coleta dos dados para verificar a ansiedade relacionada com o tratamento odontológico nas crianças foi realizada a partir da aplicação da escala “Venham Picture Test” (VPT). Para as mães, foi utilizada a escala de Corah. Também se utilizou um questionário sociodemográfico autoaplicativo sobre variáveis demográficas, comportamentais, de saúde bucal e de serviço odontológico. RESULTADOS: Foram incluídos 40 pares de mães e crianças. Os resultados mostraram que 40% das crianças estavam ansiosas e 60% das mães estavam levemente ansiosas. A anestesia local foi o procedimento que causou mais ansiedade entre as mães, deixando-as um pouco desconfortáveis e ansiosas (60%). Renda familiar maior de R$ 1.577,00 influenciou a ansiedade materna (75.6%). A ansiedade materna influenciou a ansiedade das crianças (81.3%). CONCLUSÃO: A maioria das crianças apresentou ansiedade, o que variou do medo ao pânico ao atendimento odontológico, inferindo que a ansiedade materna tem influência na ansiedade dos seus filhos. Os procedimentos odontológicos não interferem na ansiedade das mães, atingindo mais as crianças, porém provocam sentimentos positivos.

Influence of orthodontic treatment on root resorption: a systematic review

Objective: To perform a systematic review relating the existence of root resorption during orthodontic treatment. Methods: The research was performed in two electronic databases (PubMed and OpenGrey). The OpenGrey database was used exclusively for searching the "grey literature", avoiding selection and publication bias. Eligibility criteria included full texts available online, but with no language restriction. Aiming to work with more current articles on the subject, a filter for thelast ten years was applied. Articles that had no direct relation with the main outcome of this study were excluded, as well as clinical case reports and opinions, literature review articles, editorials, and letters to the editor. All eligible studies were assessed for risk of bias and individual quality, and all research steps were performed independently by two eligibility reviewers. Results: Initially, 77 articles were selected, but after the application of exclusion criteria, only 71 were included. Six articles were eligible for qualitative assessment. Overall, incisors are the teeth most affected by root resorption and there is a higher rate of root resorption in retraction mechanics. Conclusion: There is a relationship between root resorption and orthodontic treatment.

Agreement between orthodontists in the diagnosis of sagittal facial patterns / Concordância de ortodontistas no diagnóstico dos padrões sagitais da face

The cephalometric analysis has assisted orthodontics in describing face features in terms of numbers/angles, but these results are not always consistent with ideal individual patterns. Some orthodontists have made use of subjective analysis as an auxiliary method in the diagnosis; however, the consistency of the reproducibility of these methods has been questioned. Hence, this study aimed to verify whether the diagnosis of sagittal facial patterns can be accomplished with a reliable reproduction. This is an analytical observational study including an initial sample of 120 teleradiographs and 120 photographs in lateral norm of patients from the Graduate Program in Dentistry, Faculty of Health of the Methodist University of São Paulo. First, a previously calibrated examiner separated the photographs into three Sagittal Facial Patterns (Pattern I, II and III). Thus, it was obtained three groups comprising 45 photographs for the Pattern I; 45 photographs for the Pattern II and 30 photographs for the Pattern III. After this initial selection, the cephalometric analysis of 120 teleradiographs was performed using measurements of ANB and SN-GoGn angles. From this second analysis, it was selected only the photographs in which the result of subjective analysis matched the cephalometric analysis, totalizing a final sample size of 52 photographs. These 52 photographs were separated and set on an album to be reassessed by 19 orthodontists, in order to observe or not an agreement between the facial patterns among professionals. The kappa test analyzed the level of agreement of 19 professionals in relation to the cephalometric reference. The degree of agreement between professional judgment and cephalometry was found to be 73.08%, and the result of the kappa test was 0.59 (moderate agreement). Taken together, the accuracy in the diagnosis of facial pattern by means of subjective facial analysis demonstrates that the subjective method is reliable for clinical use.

A análise cefalométrica auxiliou a ortodontia a descrever numericamente as características da face, mas nem sempre estes resultados condizem com os padrões individuais ideais. Alguns ortodontistas utilizam análises subjetivas como método auxiliar no diagnóstico, porém a reprodução do método é discutida. Sendo assim, o trabalho objetiva verificar se o diagnóstico do Padrão sagital da face é possível de ser realizado com reprodução confiável. Trata-se de um estudo observacional analítico com uma amostra inicial de 120 telerradiografias e 120 fotografias em norma lateral de pacientes pertencentes ao Programa de Pós-Graduação em Odontologia da Faculdade da Saúde da Universidade Metodista de São Paulo. Primeiramente, um avaliador, previamente treinado, separou as fotografias nos Três Padrões sagitais da face (Padrão I, II e III). Dessa forma obtiveram-se três grupos compostos por 45 fotografias no Padrão I; 45 fotografias no Padrão II e 30 fotografias no Padrão III. Após essa seleção inicial foi realizado a análise cefalométrica das 120 telerradiografias desses pacientes utilizando as medidas dos ângulos ANB e SN.GoGn. A partir dessa segunda análise foram selecionadas apenas as fotografias em que o resultado da análise subjetiva coincidiu com a análise cefalométrica resultando em um novo número amostral final de 52 fotografias. Estas 52 fotografias foram separadas e montadas em um álbum para serem reavaliadas por 19 ortodontistas com o intuito de observar ou não a concordância dos Padrões Faciais entre os profissionais. Para a análise de dados utilizou-se o Teste Kappa com o intuito de analisar o nível de concordância dos 19 profissionais com a referência cefalométrica. Dessa forma, o grau de concordância entre a avaliação profissional e a cefalometria encontrado foi de 73,08% sendo o resultado do Teste Kappa de 0,59 - considerado moderado. Conclui-se que existe exatidão no diagnóstico do padrão facial por meio da analise subjetiva da face, o que demonstra que este método subjetivo é confiável para a utilização na prática clínica.