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1.
Cien Saude Colet ; 24(8): 2909-2922, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389538

RESUMO

This systematic review and meta-analysis aimed to estimate and compare the prevalences of dental fluorosis in Brazilian cities supplied with non-fluoridated water and in locations that uses groundwater. In December of 2016, cross-sectional studies were searched in eight databases, including the "grey literature". The prevalences were estimated through a mixed random effects model considering the locations as subgroups. The heterogeneity among the studies was assessed with I2 statistics and the Cochran's Q test. A total of 1038 records were found, from which only 18 articles met the inclusion criteria and were subjected to analysis. The meta-analytic model estimated a prevalence of dental fluorosis of 8.92 % (95 % CI: 5.41 % to 14.36 %) in cities supplied with non-fluoridated water, and of 51.96 % (95 % CI: 31.03 % to 72.22 %) in cities supplied by artesian wells. The heterogeneity among the studies was high: I2 = 95 % (p < 0.01) in the first subgroup of cities and I2 = 98 % (p < 0.01) in the second subgroup. The prevalence was significantly higher (p < 0.001) in populations exposed to artesian well water, indicating that the presence of natural fluoride at high concentrations represents a risk factor for the occurrence of dental fluorosis.

2.
Ciênc. Saúde Colet ; 24(8): 2909-2922, ago. 2019. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-1011878

RESUMO

Resumo Trata-se de uma revisão sistemática e metanálise para estimar e comparar as prevalências de fluorose dental em localidades brasileiras abastecidas com água tratada sem suplementação de flúor e em localidades que utilizam de água de origem subterrânea. Em dezembro de 2016 foram buscados estudos transversais em 8 bases de dados incluindo a "literatura cinzenta". As prevalências foram estimadas utilizando modelo misto de efeitos aleatórios considerando as localidades como subgrupo. A heterogeneidade entre os estudos foi avaliada através da estatística I2 e do teste Q de Cochran. Foram encontrados 1.038 registros, dos quais apenas 18 artigos preencheram os critérios de inclusão, sendo submetidos para análise. O modelo metanalítico estimou em 8,92% (IC95%:5,41% até 14,36%) a prevalência de fluorose dental em municípios com água tratada sem suplementação de flúor e em 51,96% (IC95%: 31,03% até 72,22%) em municípios abastecidos por poços artesianos. A heterogeneidade entre os estudos foi alta, I2 = 95% (p < 0,01) no primeiro subgrupo de municípios e I2 = 98% (p < 0,01) no segundo subgrupo. A prevalência foi significativamente maior (p < 0,001) em populações expostas à água de poços artesianos, indicando que a presença de flúor natural em concentrações elevadas representa um fator de risco para a ocorrência de fluorose dental.


Abstract This systematic review and meta-analysis aimed to estimate and compare the prevalences of dental fluorosis in Brazilian cities supplied with non-fluoridated water and in locations that uses groundwater. In December of 2016, cross-sectional studies were searched in eight databases, including the "grey literature". The prevalences were estimated through a mixed random effects model considering the locations as subgroups. The heterogeneity among the studies was assessed with I2 statistics and the Cochran's Q test. A total of 1038 records were found, from which only 18 articles met the inclusion criteria and were subjected to analysis. The meta-analytic model estimated a prevalence of dental fluorosis of 8.92 % (95 % CI: 5.41 % to 14.36 %) in cities supplied with non-fluoridated water, and of 51.96 % (95 % CI: 31.03 % to 72.22 %) in cities supplied by artesian wells. The heterogeneity among the studies was high: I2 = 95 % (p < 0.01) in the first subgroup of cities and I2 = 98 % (p < 0.01) in the second subgroup. The prevalence was significantly higher (p < 0.001) in populations exposed to artesian well water, indicating that the presence of natural fluoride at high concentrations represents a risk factor for the occurrence of dental fluorosis.

4.
Angle Orthod ; 88(4): 483-493, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29664334

RESUMO

OBJECTIVE: To assess the scientific evidence regarding the influence of reminder therapy on plaque index, gingival index, and white spots in patients subjected to orthodontic treatment. MATERIALS AND METHODS: Randomized clinical trials were searched in the electronic databases LILACS, PubMed, SciELO, Scopus, Web of Science, Embase, LIVIVO, and Cochrane Library. The databases OpenThesis and OpenGrey were used to capture the "gray literature," preventing selection and publication biases. The risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials tool. The software Review Manager was used for the meta-analysis. The heterogeneity among studies was assessed through the I 2 statistic. A summary of the overall strength of evidence available was assessed using the Grades of Recommendations Assessment, Development, and Evaluation tool. RESULTS: A total of 332 records were found, from which only 7 articles met the inclusion criteria and were subjected to analysis. Reminder therapy showed improved scores for the plaque index (standardized mean difference = -1.22; 95% confidence interval = -2.03 to -0.42; P = .003) and the gingival index (standardized mean difference = 1.49; 95% confidence interval = -2.61 to 0.37; P = .009). Moreover, there was lower occurrence of white spots (relative risk = 0.53; 95% confidence interval = 0.38 to 0.74; P < .001) when reminder therapy was implemented. CONCLUSIONS: According to the existing high-quality evidence, reminder therapy is a valuable strategy and may contribute to the reduction of plaque and gingival indices as well as to the lower occurrence of white spots in patients subjected to orthodontic treatment.

5.
Arch Oral Biol ; 85: 166-171, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29100105

RESUMO

OBJECTIVE: This study compared three methods designed for age estimation. METHODS: A sample of 468 radiographs (234 panoramic and 234 carpal radiographs) collected from patients ranging from 5 to 14 years old (mean age: 11.27years old±2.27years) was used. Three age estimation methods: were applied: one founded on dental development, one founded on hand and wrist development, and a method combining both measurements. For each method, the mean error (ME), mean absolute error (MAE), root mean square error (RMSE), and mean percentage of absolute error (MPAE) were quantified. The methods: were compared based on their effectiveness for estimating age in relation to sex and age range. RESULTS: The data show that the method exclusively using the development of the hand and wrist had the highest error rates (ME: 1.28M, 1.85F; MAE: 1.64M, 1.96F; RMSE: 1.94M, 2.32F) for both males (M) and females (F). In males, the method combining dental and skeletal development obtained outcomes that were slightly better than the method founded on only dental development (MPAE: 6.99% and 7.47%, respectively). In females, the opposite result was observed (MPAE: 8.48% and 6.59%, respectively). The method founded exclusively on skeletal development significantly overestimated (p=0.001) the age (mean chronological and estimated ages: 11.27 and 12.88, respectively). CONCLUSION: The methods involving dental development provided more accurate age estimates of chronological age. The method exclusively based on hand and wrist development resulted in outcomes that were highly discrepant from the chronological age.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Determinação da Idade pelos Dentes/métodos , Adolescente , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Radiografia Panorâmica
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