Women's oral health-related quality of life as a risk factor for TMD symptoms. A case-control study.

OBJECTIVE: To investigate the association between temporomandibular disorder (TMD) symptoms and women's oral health-related quality of life (OHRQoL).Methods: An observational case-control study was performed with 765 adult women aged 21.5 years on average. Oral Health Impact Profile (OHIP-14) assessed OHRQoL and determined the selection of cases and controls matched by age and marital status at a ratio of 1:4 (153 cases: 612 controls). American Academy of Orofacial Pain's self-explanatory questionnaire assessed the TMD symptoms. The TMD symptoms' impact on OHRQoL was analyzed, estimating the odds ratio with a 95% confidence interval. RESULTS: Of the women, 86.9% in the case group, and 69.6% in the control group presented some TMD symptoms (p< 0.05). Women with an impacted OHRQoL are 2.95 (95% CI:1.79-4.86) times more likely to report some TMD symptoms (p< 0.05). DISCUSSION: Women with a negative impact on OHRQoL are more likely to report TMD symptoms.

Relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion.

OBJECTIVE: This study aimed to evaluate the relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion. METHODS: A cross-sectional study developed with 543 adolescents from 11 to 13 years of age and severe malocclusion was selected. Dental aesthetic index (DAI) diagnosed the malocclusion and selected the groups with greater severity (DAI 3 and 4). Aesthetic concern was assessed using the oral aesthetic subjective impact scale (OASIS) and considered an outcome variable. The global negative self-evaluation (GSE) evaluated self-esteem. The variables were analysed using Poisson multiple regression and the model adjustment determined by the Akaike information criterion (AICC). The effect of each variable on OASIS was expressed as a prevalence ratio (PR) with 95% confidence intervals. The analyses were performed using the R program with a significance level of 5%. RESULTS: A significant association was observed between aesthetic concern scores and self-esteem (p<.05). Individuals with low self-esteem had OASIS scores 14% higher (PR: 1.14; 95% CI: 1.08-1.21). There was no significant association between OASIS and gender and age (p>.05). CONCLUSIONS: Self-esteem modulates how the individual perceives malocclusion. Adolescents with severe and very malocclusion and low self-esteem have greater aesthetic concerns.

A resistência ao cisalhamento aumenta com o elástico com amortecedor de impacto associado ao bráquete ortodôntico? / Does shear bond strength improve with the elastic with impact buffer associated with the orthodontic bracket?

Resumo Objetivou-se avaliar in vitro a resistência ao cisalhamento (RUC) do bráquete ortodôntico associado ao elástico Guard como absorvedor de impactos e o índice de remanescente adesivo (IRA). Sessenta pré-molares humanos foram selecionados e distribuídos aleatoriamente em três grupos (n = 20): G1) sem elástico; G2) com elástico convencional (3M Unitek) e G3) com elástico Guard (3M Unitek). Os bráquetes Kirium Roth 0.22 (3M ESPE) foram fixados no terço médio da face vestibular do dente com resina Transbond XT (3M Unitek) e fotoativados por 3 segundos em cada face do bráquete com o dispositivo Valo (Ultradent). Após armazenamento por 24 horas, as amostras foram submetidas a uma velocidade de 1 mm/minuto. Os bráquetes foram retirados e o IRA avaliado em estereomicroscópio (Olympus) em aumento de 8x. Os dados do RUC foram submetidos à análise de variância e teste de Tukey (α = 0,05), e os dados ARI foram submetidos ao teste exato de Fisher. G3 mostrou valores RUC (20,1 ± 4,5) significativamente mais elevados do que o Grupo G1 sem elástico (15,3 ± 3,7) (P < 0,05). Não foi observada diferença estatística entre G2 (16,9 ± 6,0) e os demais grupos (P > 0,05). Não houve diferença significativa entre os grupos na avaliação do IRA (P = 0,3303). Em conclusão, a resistência ao cisalhamento do bráquete foi maior quando associado ao elástico Guard, sendo estatisticamente significante em relação aos bráquetes sem elástico. Menos da metade da resina permaneceu no dente em todos os grupos estudados para o IRA.(AU)

Abstract This in vitro study aimed to evaluate the shear bond strength (RUC) of the orthodontic bracket associated with the Guard elastic as an impact absorber and the remaining adhesive index (ARI). Sixty human premolars were selected and randomly distributed in three groups (n = 20): G1) without elastic; G2) with conventional elastic (3M Unitek); and G3) with Guard elastic (3M Unitek). Kirium Roth slot brackets 0.22 inch (3M ESPE) was fixed to the middle third of the buccal face of the tooth with Transbond XT resin (3M Unitek) and photoactivated for 3 seconds on each bracket face with the Valo (Ultradent) device. After storage for 24 hours, the samples were subjected to a speed of 1 mm/minute. The brackets were taken off, and the ARI was evaluated in a tereomicroscope (Olympus) in 8x magnification. The RUC data were subjected to analysis of variance and Tukey's test (α = 0.05), and ARI data were subjected to Fisher's exact test. G3 showed RUC values (20.1 ± 4.5) significantly higher than the group without elastic G1 (15.3 ± 3.7) (P < 0.05). No statistical difference was observed between G2 (16.9 ± 6.0) and the other groups (P > 0.05). There was no significant difference between groups in the assessment of ARI (P = 0.3303). In conclusion, completing the RUC of the Guard and the conventional elastic band was superior concerning the other groups. Less than half of the resin remained in the tooth in all groups studied for the ARI. (AU)

Impact of Dental Aesthetic Index characteristics on the severity levels of malocclusion in a non-White population.

INTRODUCTION: This study evaluated the impact of the esthetic and occlusal characteristics of the Dental Aesthetic Index (DAI) on the need for orthodontic treatment in a non-White population. METHODS: A cross-sectional study was conducted with 1296 non-White adolescents aged 12 years. DAI was the outcome variable (DAI 1 and 2 and DAI 3 and 4). The independent variables were categorized on the basis of the occlusal esthetic characteristics evaluated by DAI (tooth absence, crowding, spacing, midline diastema, maxillary misalignment, mandibular misalignment, maxillary anterior overjet, mandibular overjet, anterior open bite, and anteroposterior molar relationship). Simple logistic regression models were adjusted for the outcome, and the raw odds ratios were estimated. Variables with a P value of <0.20 for individual analyses were tested in a multiple logistic regression model, with P ≤0.05 remaining. RESULTS: A total of 1296 adolescents (764 girls and 532 boys) were evaluated; 1067 (82.3%) had DAI 1 or 2 (minor to a moderate need for orthodontic treatment), and 229 (17.7%) had DAI 3 or 4 (defined need for orthodontic treatment). The results showed that adolescents with diastema, maxillary irregularity, mandibular irregularity, mandibular overjet, anterior open bite, and the altered molar relationship had 5.34, 2.36, 2.63, 3.56, 8.73, and 5.16 times more likelihood to have DAI 3 or 4 (P ≤0.05), respectively. CONCLUSIONS: Diastema, maxillary and mandibular misalignment, mandibular overjet, anterior open bite, and anteroposterior molar relationship were the characteristics that influenced the determination of the need for orthodontic treatment in a non-White population using the DAI index.

Correlation between malocclusion and history of bullying in vulnerable adolescents.

OBJECTIVES: To assess the correlation between malocclusion and a history of bullying. MATERIALS AND METHODS: A cross-sectional study of 494 adolescents aged 12 to 15 years was conducted. The National School Health Survey questionnaire (PeNSE 1 and 2) was used to determine history of bullying by identifying the victim and the abuser. Variables were evaluated based on the individual (age), environment (income, father's and mother's education, housing, government assistance, and parents' occupation), social and emotional well-being (CPQ11-14 domains), self-perceived need for orthodontic treatment, and clinical conditions (crowding, diastema, maxillary and mandibular overjet, and anterior open bite). Data were analyzed by Spearman correlation and by multivariate analysis, which allowed graphical representation of the eight variables studied in only two dimensions. RESULTS: There was no correlation between bullying and variables related to the individual and the environment. Maxillary overjet and self-perception related to the need for orthodontic treatment were important to explain the data variability. CONCLUSIONS: Malocclusion did not correlate with bullying history. However, increased maxillary overjet influences adolescent self-perception, suggesting a potential condition for bullying events.

Comparison of the friction forces delivered by different elastomeric patterns and metal ligature on conventional metal brackets with a NiTi arch wire versus a self-ligating system: An in vitro study.

OBJECTIVES: The aim of this study was to measure the frictional resistance of different types of ligatures used on conventional and self-ligating brackets. MATERIALS AND METHODS: Monoblock (conventional) and Portia (self-ligating) brackets were used and the archwire used was nickel-titanium. On conventional brackets the ligatures tested were the Elastomeric type and steel 0.30 tie-wire. The groups were divided according to the ligature types (n=8): (1) conventional elastomeric ligature; (2) relaxed conventional elastomeric ligature; (3) elastomeric ligature in shape-8; (4) double vertical elastomeric ligatures; (5) double-crossed elastomeric ligatures; (6) crossed ligature; (7) steel wire ligature; and (8) self-ligating ligature (self-ligating bracket). A segment of five brackets, each ligature types, was mounted. The archwire, between the bracket and the ligature, was connected on Instron® Universal test machine to simulate the frictional resistance. The maximum frictional resistance was obtained, and the mean values were submitted to the analysis of variance (ANOVA) and the Tukey's post-hoc test (α=0.05). RESULTS: The elastomeric ligature in shape-8 showed the highest value compared with other groups (P<0.05). Although the crossed elastomeric ligature presented the lowest mean value and it was not statistically different regarding relaxed conventional elastomeric ligature, steel wire ligature and self-ligating (P≥0.05). CONCLUSIONS: The frictional resistance was influenced by ligature types. Elastomeric Ligature in shape-8 showed the highest frictional force. Crossed Elastomeric Ligature had the lowest frictional force value.

Influência da cor e dos ciclos de estiramento na degradação da força dos elásticos intermaxilares / Influence of the color and the stretching cycles in the force degradation of intermaxillary elastics

Resumo Este estudo in vitro teve como objetivo avaliar a força liberada por elásticos ortodônticos coloridos e naturais e a degradação da força ao longo de 24 horas. No total foram utilizados 40 elásticos com força leve, divididos em quatro Grupos (n = 10) de acordo com o diâmetro (1/4 pol. e 3/16 pol.) e cor (elásticos com borracha natural e elásticos coloridos). Para causar fadiga nos elásticos, foi utilizada uma máquina de ensaio simulando movimentos mandibulares. As leituras da força elástica foram feitas na máquina de Teste Universal Instron 4411 nos intervalos de tempo de 1, 4, 15 e 24 horas. Os dados de redução da força foram analisados pelo teste de Tukey (a= 5%). Os resultados demonstraram redução da força ao longo do tempo em todos os grupos, com o elástico colorido de 1/4 de polegada de diâmetro apresentando força significativamente maior do que o de borracha natural em todos os intervalos de tempo. Já os elásticos de 3/16 polegadas de diâmetro, apesar de apresentarem degradação de força, não apresentaram diferença significativa para os tipos de cor. Elásticos coloridos e de cor natural, de ambos os diâmetros, apresentaram degradação da força ao longo de 24 horas, porém os elásticos coloridos de 1/4 de polegada de diâmetro apresentaram valores de força superiores aos da cor natural (AU)

Abstract This in vitro study aimed to evaluate the force released by orthodontic colored and natural elastics and the degradation of force over the course of 24 hours. In total 40 elastics with light force were used, divided into four Groups (n=10) according to their diameter (1/4 inch and 3/16 inch) and color (elastics with natural rubber color and colored elastics). To cause fatigue on the elastics, a test machine simulating mandibular movements was used. The elastic force readouts were taken on the Instron 4411 Universal Test Machine in the intervals of 1, 4, 15 and 24 hours. The reduction in force data was analyzed by the Tukey test (a= 5%). The results demonstrated a reduction in force over the course of time in all the groups, with the colored elastic 1/4 inch in diameter showing significantly higher force than those of natural rubber color in all the time intervals. While the 3/16 inch diameter elastics, although showing degradation of force, did not show significant difference for types of color. Colored and natural elastics, of both diameters, showed degradation of force over 24 hours, however, the colored 1/4 inch diameter elastics showed higher force values than those of the natural color (AU)

Avaliação do tratamento de superfície de resina composta na resistência de união de bráquetes metálicos / Evaluation of composite resin surface treatment in the union resistance of metallic brackets

O objetivo deste estudo experimental in vitro foi avaliar a Resistência de União ao Cisalhamento (RUC) da colagem de bráquetes em diferentes tratamentos de superfície de resina composta, associados a dois agentes de união. Foram confeccionados 90 corpos de prova com resina composta Filtek Z350 (3M/ESPE). Os corpos de prova foram aleatoriamente divididos em nove grupos (n=10): (1) grupo controle; (2) silano e primer; (3) adesivo universal (5) ácido fosfórico, silano e primer (4) ácido fosfórico, adesivo universal; (6) ácido fluorídrico, silano e primer; (7) ácido fluorídrico e adesivo universal; (8) broca, silano e primer e (9) broca e adesivo universal. Em seguida, foi aplicado na superfície de colagem do bráquete metálico (Standart Edgewise para incisivo central superior ­ Morelli, Sorocaba/SP) a resina ortodôntica Transbond XT/3M. O bráquete foi colado na resina composta Filtek Z350 (3M/ESPE). Após 24 horas foram submetidos ao teste de cisalhamento na máquina Instron, com velocidade de 0,5mm/min. Os dados foram submetidos à ANOVA e teste de Tukey. Em seguida foi avaliado o Índice de Remanescente Adesivo (IRA). Não houve diferença significativa entre os agentes de união quanto à resistência de união (p>0,05). Os oito grupos que receberam agentes de união apresentaram resistência significativamente maior do que o grupo controle (p<0,05). O grupo preparado com ácido fluorídrico apresentou menor resistência que os preparados com ácido fosfórico (com silano + primer transbond) e broca diamantada (com silano + primer transbond e com adesivo universal), p<0,05. Concluiu-se que o tratamento de superfície influencia na resistência de união. (AU)

Abstract The aim of this in vitro experimental study was to evaluate the shear bond strength of bracket bonding in different composite resin surface treatments associated with two bonding agents. Ninety specimens were made with Filtek Z350 composite resin (3M/ESPE). The specimens were randomly divided into nine groups (n=10): (1) control group; (2) silane and primer; (3) universal adhesive (5) phosphoric acid, silane and primer (4) phosphoric acid, universal adhesive; (6) hydrofluoric acid, silane and primer; (7) hydrofluoric acid and universal adhesive; (8) drill, silane and primer and (9) universal drill and adhesive. Transbond XT/3M orthodontic resin was then applied to the bonding surface of the metal bracket (Standart Edgewise for upper central incisor ­ Morelli, Sorocaba/SP). The bracket was bonded to the Filtek Z350 composite resin (3M/ ESPE). After 24 hours they were submitted to the shear bond test on the Instron machine at a speed of 0.5mm/min. Data were submitted to ANOVA and Tukey test. Then the Adhesive Remnant Index (ARI) was evaluated. There was no significant difference between bonding agents regarding bond strength (p> 0.05). The eight groups that received bonding agents showed significantly higher resistance than the control group (p <0.05). The group prepared with hydrofluoric acid presented lower resistance than those prepared with phosphoric acid (with silane + transbond primer) and diamond drill (with silane + transbond primer and universal adhesive), p <0.05. It was concluded that the surface treatment influences the bond strength.(AU)

What Factors are Associated with Health-Related Quality of Life in Mixed Dentition Children?

Abstract Objective: To associate the OHRQoL and HRQoL in mixed dentition children with the influence on age range, socioeconomic and clinical variables. Material and Methods: A cross-sectional study was carried out with 1,240 children between 6 and 12 years of age. HRQoL was assessed by the Quality of Life Assessment Scale, considered an outcome variable. OHRQoL was determined using specific questionnaires related to the age group: Oral Health Impact Scale in Early Childhood, Child Perceptions Questionnaire for 8 to 10 years, and 11 to 12 years. Dental caries and malocclusion were diagnosed. The socioeconomic class was evaluated. A multiple negative binomial regression analysis was used to test the relationship between HRQoL, OHRQoL scores and socioeconomic and clinical variables. Correlation analyses were performed between the total HRQoL and OHRQoL, with a significance level of 5%. Results: The HRQoL is inversely related to the impact of OHRQoL (p<0.05), modulated by the age group. There was a significant weak negative correlation between the HRQoL scores and the impact of OHRQoL (p<0.05). Conclusion: The OHRQoL impacts the HRQoL, modulated by the age group and with minor influence from socioeconomic and clinical variables (AU).

A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents

Abstract Objective: To evaluate the psychosocial impact of malocclusion and self-esteem in adolescents in the Amazon region. Material and Methods: A cross-sectional study was carried out with 212 adolescents with 12-year-old enrolled in all public schools in the Boca do Acre (Amazonas, Brazil). Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion. The self-perception of the need for orthodontic treatment was evaluated by the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and Global Negative Self-evaluation (GSE), the adolescent's self-esteem. The malocclusion was clinically evaluated by the Dental Aesthetic Index (DAI). The variables with p<0.20 in the individual analyses were tested in multiple logistic regression models, and those with p<0.10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). Results: Adolescents with low self-esteem were 2.20 (95% CI: 1.23-3.93) times more likely to have a more significant impact on dental aesthetics (p<0.05). When verified by domains, the adolescents with low self-esteem had 2.33 (95% CI: 1.31-4.17) and 1.93 (95% CI: 1.09-3.42) times more likely to impact the psychological and social domains of the PIDAQ, respectively. Conclusion: Self-esteem influenced adolescents' perception of dental aesthetics in the domains related to psychological and social impact (AU).

Knowledge and clinical practices of orthodontists regarding the treatment of patients with aids. A nationwide study

Aim: To evaluate orthodontists' knowledge and clinical practices regarding the treatment of patients with HIV/AIDS. Methods: Cross-sectional study performed with 655 Brazilian orthodontists based on a previously calculated sample size. Self-administered questionnaires were sent to orthodontists to collect information on knowledge and clinical conduct regarding the care of patients with HIV/AIDS. The study evaluated the awareness of possible risk factors for contamination, oral manifestations of HIV, need for more information on the care of HIV-positive patients, whether orthodontic treatment is indicated in HIV-positive patients, and whether they had knowingly performed orthodontic treatment in HIV-positive patients. Simple regression models were adjusted, and crude Odds Ratios estimated the associations with 95% confidence intervals. The variables with P < 0.20 in the crude analysis were tested in multiple logistic regression models, and those with P ≤ 0.05 were maintained in the final model. Magnitudes were estimated by adjusted Odds Ratios values, with 95% confidence intervals. Results: Orthodontists who were aware of the oral manifestations of HIV/AIDS, those having work experience of more than 20 years, and those who believed that orthodontic treatment could be indicated for these patients were 3.30 (1.79-6.10), 2.74 (1.36-5.52) and 1.92 (1.13-3.24) times more likely to perform orthodontic treatment in HIV-positive patients, respectively. Most orthodontists (92.9%) reported they needed to obtain more information about orthodontic care in patients with HIV/AIDS. Conclusion: Although orthodontists reported feeling able and qualified to provide dental care to patients with HIV/AIDS, gaps in their knowledge need to be addressed with further training

Impact of malocclusion severity on the quality of life of non-white adolescents.

The aim of this study was to evaluate the impact of malocclusion severity on the oral health-related quality of life (OHRQoL) of non-white adolescents. A cross-sectional study was conducted with 585 non-white Brazilian adolescents (12-15 years). The Dental Aesthetic Index (DAI) was used for the clinical assessment of malocclusion and Oral Health Impact Profile (OHIP-14) on OHRQoL. Deep bite and transverse occlusal relationships were assessed in association with the DAI. The adolescents with DAI 3 and 4 were distributed into 4 groups: G1 - individuals without transverse occlusal relationships or deep bite; G2 - individuals with only posterior crossbite; G3 - individuals with only deep bite; and G4 - individuals with Brodie bite. The backward stepwise procedure was used to select variables on each level, eliminating variables with a p≤0.20. From the logistic regression analyses, the adjusted odds ratios were estimated with the respective 95% confidence intervals. The adolescents with severe malocclusion divided into the G2, G3 and G4 showed p-value of 0.0501, 0.1475, and 0.5407, respectively, but did not remain in the final model. Malocclusion severity had no impact on the OHRQoL of non-white adolescents.

Impact of malocclusion severity on the quality of life of non-white adolescents / Impacto da severidade da má oclusão na qualidade de vida de adolescentes não brancos

Abstract The aim of this study was to evaluate the impact of malocclusion severity on the oral health-related quality of life (OHRQoL) of non-white adolescents. A cross-sectional study was conducted with 585 non-white Brazilian adolescents (12-15 years). The Dental Aesthetic Index (DAI) was used for the clinical assessment of malocclusion and Oral Health Impact Profile (OHIP-14) on OHRQoL. Deep bite and transverse occlusal relationships were assessed in association with the DAI. The adolescents with DAI 3 and 4 were distributed into 4 groups: G1 - individuals without transverse occlusal relationships or deep bite; G2 - individuals with only posterior crossbite; G3 - individuals with only deep bite; and G4 - individuals with Brodie bite. The backward stepwise procedure was used to select variables on each level, eliminating variables with a p≤0.20. From the logistic regression analyses, the adjusted odds ratios were estimated with the respective 95% confidence intervals. The adolescents with severe malocclusion divided into the G2, G3 and G4 showed p-value of 0.0501, 0.1475, and 0.5407, respectively, but did not remain in the final model. Malocclusion severity had no impact on the OHRQoL of non-white adolescents.

Resumo O objetivo deste estudo foi avaliar o impacto da severidade da má oclusão na qualidade de vida relacionada à saúde bucal (OHRQoL) de adolescentes não brancos. Estudo transversal foi realizado com 585 adolescentes brasileiros não brancos (12-15 anos). O Índice de Estética Dental (DAI) foi utilizado para a avaliação clínica da má oclusão e o Oral Health Impact Profile (OHIP-14) na OHRQoL. A sobremordida profunda e as relações oclusais transversais foram avaliadas em associação com o DAI. Os adolescentes com DAI 3 e 4 foram divididos em 4 grupos: G1 - indivíduos com relação transversal normal ou com ausência de sobremordida; G2 - indivíduos com mordida cruzada posterior; G3 - indivíduos com sobremordida profunda; e, G4 - indivíduos com mordida em Brodie. O modelo final estimou as variáveis selecionadas após o ajuste para aquelas que permaneceram no modelo multivariado em níveis iguais e superiores. A partir das análises de regressão logística, os odds ratios foram ajustados e estimados com os respectivos intervalos de confiança de 95%. Os adolescentes com má oclusão severa divididos em G2, G3 e G4 mostraram um p-valor de 0.0501, 0.1475, e 0.5407, respectivamente, mas não permaneceram no modelo final. A severidade da má oclusão não teve impacto na OHRQoL de adolescentes não brancos.

The influence of elastomeric ligatures pigmentation on smile aesthetics during orthodontic treatment.

AIM: To assess the influence of elastomeric ligatures, subjected to a previous in vitro pigmentation process using different substances, on smile aesthetics during orthodontic treatment, from the perception of students and professionals. METHODS: Eight elastomeric ligatures of five commercial brands (3M/Unitek, American Orthodontics, Morelli, Ortho Technology, and Orthometric) (n=8) were immersed in coffee, Coca-Cola, and red wine for one minute per day, for 28 days; and another group of ligatures was immersed in artificial saliva. All samples were photographed and subsequently analyzed using the Adobe Photoshop software, by the RGB method. Afterwards, the pigmented ligatures were inserted in a patient wearing orthodontic brackets, and zoomed photographs of the smile were taken and presented to 40 evaluators, who filled in a satisfaction scale sheet to express their opinion on the smile aesthetics of each photograph. The color data were subjected to analysis of variance (ANOVA) and Tukey tests. RESULTS: The substance with the highest pigmentation potential was coffee (p< 0.05) followed by red wine (p< 0.05). Comparison among the brands used in this study showed that American Orthodontics and Orthometric had the lowest degree of pigmentation when immersed in coffee and red wine (p< 0.05), respectively. However, the brand that showed the highest level of satisfaction among the evaluators was Ortho Technology. CONCLUSIONS: The presence of pigmented elastomeric ligatures affected smile aesthetics, when compared with the control group.

Is the adolescent's esthetic concern associated with anterior occlusal conditions or the malocclusion severity level?

OBJECTIVES: To assess the esthetic impact of anterior occlusal conditions and malocclusion severity levels. MATERIALS AND METHODS: A population-based cross-sectional study of 700 adolescents aged 15 to 19 years was conducted. The Oral Aesthetic Subjective Impact Scale (OASIS) was used to evaluate the subjective esthetic impact of malocclusion. The Dental Aesthetic Index (DAI) criteria were used to diagnose the anterior occlusal characteristics in isolation and the severity levels of malocclusion. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). RESULTS: Of the adolescents, 42% showed negative self-perception of malocclusion. In addition, 15.4% of adolescents had severe malocclusion (DAI 3) and 18.9% very severe malocclusion (DAI 4). Crowding and spacing were shown to be 2.90 (CI: 2.06-4.09) and 2.53 (CI: 1.65-3.86) times, respectively, more likely to cause a negative esthetic impact in adolescents (P < .05). In addition, adolescents with orthodontic treatment need (DAI 2, 3, and 4) were more likely to report a negative esthetic impact (P < .05). CONCLUSIONS: Anterior crowding and spacing are the conditions that most influence the esthetic concern of adolescents. Adolescents with very severe malocclusion and higher orthodontic treatment need are more likely to report a negative esthetic impact.

Anxiety and oral habits as factors associated with malocclusion.

Objective: The aim of this study was to associate the presence of oral habits with anxiety and malocclusion.Methods: Cross-sectional observational study with 199 schoolchildren 6-14 years old. Malocclusion was evaluated by using the Index of Orthodontic Treatment Need (IOTN). Oral Habits Questionnaire and Hospital Anxiety and Depression Scale (HADS) were used to assess oral habits and anxiety. The schoolchildren were divided into two groups: mixed and permanent dentition. The associations between the outcome variable (oral habits) and the independent variables (anxiety and malocclusion) were evaluated using the Exact Fischer test and the Chi square test.Results: Of the individuals with malocclusion in permanent dentition, 77.4% reported some deleterious oral habit, and 55% of those with no malocclusion at this stage had deleterious habits.Discussion: Oral habits may be associated with the presence of malocclusion in different stages of occlusal development (mixed and permanent dentition) and may be influenced by anxiety.

The influence of elastomeric ligatures pigmentation on smile aesthetics during orthodontic treatment

ABSTRACT Aim: To assess the influence of elastomeric ligatures, subjected to a previous in vitro pigmentation process using different substances, on smile aesthetics during orthodontic treatment, from the perception of students and professionals. Methods: Eight elastomeric ligatures of five commercial brands (3M/Unitek, American Orthodontics, Morelli, Ortho Technology, and Orthometric) (n=8) were immersed in coffee, Coca-Cola, and red wine for one minute per day, for 28 days; and another group of ligatures was immersed in artificial saliva. All samples were photographed and subsequently analyzed using the Adobe Photoshop software, by the RGB method. Afterwards, the pigmented ligatures were inserted in a patient wearing orthodontic brackets, and zoomed photographs of the smile were taken and presented to 40 evaluators, who filled in a satisfaction scale sheet to express their opinion on the smile aesthetics of each photograph. The color data were subjected to analysis of variance (ANOVA) and Tukey tests. Results: The substance with the highest pigmentation potential was coffee (p< 0.05) followed by red wine (p< 0.05). Comparison among the brands used in this study showed that American Orthodontics and Orthometric had the lowest degree of pigmentation when immersed in coffee and red wine (p< 0.05), respectively. However, the brand that showed the highest level of satisfaction among the evaluators was Ortho Technology. Conclusions: The presence of pigmented elastomeric ligatures affected smile aesthetics, when compared with the control group.

RESUMO Objetivo: Avaliar a influência das ligaduras elásticas submetidas a um processo prévio de pigmentação in vitro, com diferentes substâncias, na estética do sorriso durante o tratamento ortodôntico, segundo a percepção de alunos e profissionais. Métodos: Oito ligaduras elásticas de cinco marcas comerciais (3M Unitek, American Orthodontics, Morelli, Ortho Technology e Orthometric) (n = 8) foram imersas em café, Coca-Cola e vinho tinto por um minuto por dia, por 28 dias, e outro grupo de ligaduras foi imerso em saliva artificial. Todas as amostras foram fotografadas e posteriormente analisadas no software Adobe Photoshop, pelo método RGB. Em seguida, as ligaduras pigmentadas foram inseridas em um paciente com braquetes ortodônticos, e fotografias ampliadas do sorriso foram tiradas e apresentadas a 40 avaliadores, que preencheram uma escala de satisfação para representar sua opinião sobre a estética do sorriso de cada fotografia. Os dados de cor foram submetidos à análise de variância (ANOVA) e testes de Tukey. Resultados: A substância com maior potencial de pigmentação foi o café (p< 0,05), seguido do vinho tinto (p< 0,05). A comparação entre as marcas utilizadas nesse estudo mostrou que a American Orthodontics e a Orthometric apresentaram o menor grau de pigmentação quando imersas em café e vinho tinto (p< 0,05), respectivamente. Porém, a marca que apresentou maior nível de satisfação entre os avaliadores foi a Ortho Technology. Conclusões: A presença de ligaduras elásticas pigmentadas afetou a estética do sorriso, quando comparada à do grupo controle.

Impact of anterior occlusal conditions in the mixed dentition on oral health-related quality-of-life item levels.

OBJECTIVES: To evaluate the impact of anterior occlusal conditions in the mixed dentition on item-level analysis of oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: A population-based cross-sectional study of 787 children aged 8 to 10 years was conducted. The Child Perceptions Questionnaire (CPQ8-10) was used to evaluate OHRQoL, and the analysis of item levels was performed on CPQ8-10 domains. Anterior occlusal characteristics were diagnosed according to the Dental Aesthetic Index criteria. Individual analyses were performed relating the outcome as independent variables. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). RESULTS: No associations were found with regard to anterior occlusal characteristics (P < .001) after the variables of the previous determinants were adjusted for multivariate analysis. However, the following variables were significantly associated with negative impact on OHRQoL item levels: sex, in oral symptoms (OR = 1.42; CI, 1.07-1.89) and emotional well-being (OR = 1.34; CI, 1.00-1.79); race, in oral symptoms (OR = 1.48; CI, 1.10-1.98), emotional well-being (OR = 1.54; CI, 1.14-2.06), and social well-being (OR = 1.34; CI, 1.00-1.80); and family income in functional limitation (OR = 1.46; CI, 1.06-2.02), emotional well-being (OR = 1.71; CI, 1.21-2.42), and social well-being (OR = 1.59; CI, 1.14-2.21). CONCLUSIONS: Anterior occlusal conditions did not affect the levels of OHRQoL items.

How is orthodontic treatment need associated with perceived esthetic impact of malocclusion in adolescents?

INTRODUCTION: The purpose of this research was to evaluate the esthetic impact of orthodontic treatment need in adolescents. METHODS: This cross-sectional study was performed with 1172 adolescents aged 12 (n = 638) years and 15 (n = 534) years from Salvador, Bahia, Brazil. The esthetic impact was the following outcome variables: Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale. The normative orthodontic treatment need was assessed by the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) and by the Dental Aesthetic Index (DAI). Logistic regression models were adjusted, estimating crude odds ratio with the respective 95% confidence intervals. The variables with P ≤0.20 in the individual analyses were tested in multiple logistic regression models, remaining the variables with P ≤0.05. RESULTS: The results showed a statistically significant association for the esthetic impact (Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale) when assessing the normative orthodontic treatment need by the DAI (P <0.05). However, there was no significant association between subjective esthetic impact and normative needs when using the IOTN-DHC (P >0.05). CONCLUSIONS: DAI was more associated with the adolescents' esthetic concern than IOTN-DHC and should be the Index of Orthodontic Treatment Need to be selected to complement the patient's self-perception.