Desgaste erosivo en preescolares de 5 años de Montevideo­Uruguay: primer estudio poblacional / Erosive tooth wear in 5 -year- old preschool children of Montevideo­Uruguay: first population study / Desgaste erosivo em preescolares de 5 anos de MontevideoUruguai: primer estudo populacional

Objetivo: determinar prevalencia, extensión, severidad y distribución del desgaste erosivo (DE) en preescolares de Montevideo. Metodología: estudio transversal de base poblacional, muestra representativa de centros educativos públicos y privados. Fueron indagados aspectos sociodemográficos, biológicos y de comportamiento con un cuestionario auto-reportado por padres/responsables. Los exámenes fueron realizados por dos operadores Kappa ≥ 0,7. DE fue registrado con el índice O´Brien modificado, reportándose porcentaje y promedio; intervalo de confianza (IC) 95%. Se realizaron análisis de asociación con sexo y nivel socioeconómico. Resultados: se examinaron 614 preescolares. Prevalencia: 57,6% (IC95%: 52,7-62,5). Extensión: 4,8 (IC95%: 4,3-5,3). DE severo: 8,2% (IC95%: 5,5-10,9) Las superficies más afectadas fueron palatino de incisivos superiores. Los preescolares de nivel socioeconómico alto presentaron mayor DE que los de nivel bajo; 73,1% (IC95%:61,9-84,2) y 48,4% (IC95%:39,2-57,7) respectivamente (p≤0,01). Conclusiones: la prevalencia y extensión del DE fue alta. Estos datos pueden contribuir en la modificación de medidas que apunten a controlar la prevalencia de DE.

Aims: assess the prevalence, extent,severity, and distribution of erosive tooth wear (ETW) in preschoolers of Montevideo. Methods: cross-sectional populationbased study of representative sample of public and private educational centers. Sociodemographic, biological, and behavioral aspects were investigated with a self-reported questionnaire to parents /guardians. The examinations were performed by two examiners (Kappa ≥ 0.7). The ETW was registered with modified O´Brien index, reported in percentage and average, confidence interval (CI) 95%. Analysis of association with sex and socioeconomic level were carried out.Results: 614 preschoolers were examined. Prevalence: 57.6% [95%CI=52.7-62.5]. Severe ETW: 8.2% [95%CI 5.5-10.9]. ETW extension: 4.8 [95%CI=4.3-5.3]. The most affected surfaces were palatal upper incisors. Preschoolers of high socioeconomic level presented higher ETW than those of low level; 73.1% (95% CI: 61.9-84.2) and 48.4% (95% CI: 39.2-57.7) respectively (p≤0.01). Conclusion: ETW prevalence and extent was high. These data can contribute to the modification of measures that aim to control ETW prevalence.

Objetivo: determinar prevalência, extensão, severidade e distribuição do desgaste erosivo (DE) em pré-escolares de Montevidéu. Metodologia: estudo transversal de base populacional, amostra representativa de centros educacionais públicos e privados. Aspetos sociodemográficos, biológicos e comportamentais foram investigados por meio de questionário autorreferência pelos pais/responsáveis. Os exames foram realizados por dois operadores Kappa ≥ 0,7. DE foi registado com o Índice O´Brien modificado, relatando porcentagem e média; intervalo de confiança (IC) 95%. Foi realizada análise de associação com sexo e nível socioeconômico. Resultados: 614 pré-escolares foram examinados. Prevalência: 57,6% (IC95%: 52,7-62,5). Extensão: 4,8 (IC 95%: 4,3-5,3). DE grave: 8,2% (IC 95%: 5,5-10,9). As superfícies mais afetadas foram palatinas dos incisivos superiores. Pré-escolares de alto nível socioeconômico apresentaram maior DE que os de baixo nível; 73,1% (IC 95%: 61,9-84,2) e 48,4% (IC 95%: 39,2-57,7) respetivamente (p≤0,01). Conclusões: a prevalência e extensão da DE foi alta. Esses dados podem contribuir em la modificação de medidas que visam controlar a prevalência de DE.

Demarcated opacity in primary teeth increases the prevalence of molar incisor hypomineralization

Abstract This cross-sectional study aimed to assess the prevalence of molar incisor hypomineralization (MIH) and its relationship with the number of primary teeth with developmental defects of enamel (DDE). A representative population-based sample of 731 schoolchildren was randomly selected from the public school system in Curitiba, Brazil. Schoolchildren aged 8 years with fully erupted permanent first molars and incisors were eligible for the study. MIH and DDE were classified by four calibrated examiners (kappa > 0.75) according to EAPD criteria and to the FDI-modified DDE index. Clinical data were collected in a school environment. Socioeconomic information was collected through a self-administered semistructured questionnaire applied to the children's caregivers. Statistical analyses were carried out using Poisson multiple regression with robust variance (α = 0.05). MIH prevalence was 12.1% (95%CI: 10-15), and opacities were the most prevalent defect. Socioeconomic factors were not associated with MIH. Children with demarcated opacity in primary teeth presented a higher prevalence of MIH than those without DDE in primary teeth. In the multiple analysis, the increase of one primary tooth affected by demarcated opacity increased the prevalence of MIH by 33% (PR = 1.33, 95%CI: 1.15-1.53, p < 0.001). Asian children had a higher prevalence of MIH (PR = 2.91, 95%CI: 1.08-8.09 p = 0.035) than did Caucasian children.Conclusion: Based on these findings, the prevalence of MIH in Curitiba was 12.1%. Demarcated opacity in primary teeth could be considered a predictor of MIH.

Association Between Presence of Enamel Defects, Dental Caries and Socioeconomic Conditions on Brazilian Children

Objective: To verify the relationship between developmental enamel defects (DED) in permanent incisors and socioeconomic conditions and dental caries in children within the life course context. Material and Methods: A total of 350 children aged 9-11 years from 13 public schools in the city of Bauru, Brazil were examined. Clinical exams were performed to observe the presence of caries and developmental enamel defects using the DMFT and DED indexes, respectively. In addition, information about family income and parental schooling was collected. Statistical analysis used the Spearman Correlation Coefficient and the Chi-square test to verify the association between DED, socioeconomic conditions and dental caries. The significance level adopted was 5%. Results: Association between presence of dental caries and DED (p=0.04), delimited opacity (p=0.02) and opacity (p=0.01) was observed. Inverse correlation for the decayed component with maternal schooling and family income was also verified. Regarding the types of development enamel defect (DED), correlation between delimited opacity, opacity and DED with the DMFT index was observed. Conclusion: The results of this study indicated association between enamel defects and caries, as well as correlation between income and parental schooling and dental caries.

Oral health-related quality of life in Colombian children with molar-incisor hypomineralization / Calidad de vida relacionada con la salud oral en niños Colombianos con Hipomineralización Inciso- Molar

The aim of this study was to assess the impact of MolarIncisor Hypomineralization (MIH) on Oral HealthRelated Quality of Life (OHRQoL) in schoolchildren from a public educational institution in Bucaramanga, Colombia. Eightyeight 7to 10yearolds took part in the study; of whom half had MIH. The translated and adapted version of the Child Perceptions Questionnaire (CPQ 810) was applied by means of an inter view. The dependent variable was OHRQoL and explanatory variables were presence and severity of MIH, sex, age, socioeconomic status and social security. Frequencies and proportions were calculated for qualitative variables, and measures of central tendency, dispersion and position were calculated for quantitative variables. Chisquare, Fisher's Exact Test, MannWhitney U Test and KruskalWallis tests were used, as appropriate. A pvalue <0.05 was considered statistically significant. Parents or caregivers of participating children signed informed consent, and children signed an assent. A statistically significant difference was found for age groups (p<0.001), socioeconomic status (p=0.015) and social security (p=0.045) according to the presence of MIH. Likewise, statistically significant differences were found for each of the four domains of the questionnaire and for the overall CPQ 810 score (p<0.0001) according to the presence of MIH. The presence of the MolarIncisor Hypomineralization may have negative impact on the Oral HealthRelated Quality of Life of the participating children (AU)

El objetivo de este trabajo fue evaluar el impacto de la Hipomineralización Inciso Molar sobre la Calidad de Vida Relacionada con la Salud Oral (CVRSO) en escolares vinculados con una institución educativa pública de Bucaramanga, Colombia. Ochenta y ocho menores de 7 a 10 años hicieron parte del estudio, la mitad presentaba HIM; a todos se les aplicó la versión traducida y adaptada del Child Perceptions Questionnaire (CPQ 810) mediante entrevista. La variable de salida fue la CVRSO y las variables explicatorias, la presencia y severidad de HIM, el género, la edad, el estrato socioeconómico y la seguridad social. Se calcularon frecuencias y proporciones para las variables cualitativas, y medidas de tendencia central, dispersión y posición para las cuantitativas. Se utilizaron las pruebas Chi2, Test Exacto de Fisher, U. de Mann Whitney y KruskalWallis según fuera apropiado. Un valor de p<0,05 fue considerado estadísticamente significativo. Los padres o cuidadores de los menores participantes firmaron un consentimiento informado y los niños y niñas, un asentimiento. Se encontró una diferencia estadísticamente significativa en los grupos de edad (p<0,001), el estrato socioeconómico (p=0,015), y la seguridad social (p=0,045) según la presencia de HIM. Así mismo, se obtuvo una diferencia estadísticamente significativa en cada uno de los cuatro dominios del cuestionario y en el puntaje global del CPQ 810 (p<0,0001) de acuerdo con la presencia de HIM. Según las percepciones de los participantes al responder al CPQ 810, se podría sugerir la presencia de la Hipomineralización Inciso Molar influye de forma negativa sobre la Calidad de Vida Relacionada con la Salud Oral en los niños participantes (AU)

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren

Abstract This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

Etiología de las opacidades severas del esmalte: una evaluación basada en un estudio prospectivo médico y social en 17000 niños / Aetiology of severe demarcated enamel opacities: an evaluation based on prospective medical and social data from 17000 children

Durante los años 70s, los odontólogos describieron una prevalencia creciente de un nuevo tipo de alteración en el esmalte. Este era muy específico, con áreas de demarcado esmalte hipomineralizado y se encontraba en su mayoría en los primeros molares permanentes y en los incisivos. Diferentes estudios trataron de relelar la etiología de estas alteraciones, pero hasta ahora no se han encontrado factores claramente relacionados. El propósito del presente trabajo fue evaluar los factores etiológicos de las opacidades demarcadamente severas (OSD) en los primeros molares permanentes en una gran cohorte de niños incluidos en el proyecto "Todos los niños del sudeste de Suecia" (ABIS). Se llevó a cabo un estudio prospectivo de los niños de 5 condados suecos nacidos entre el 1º de octubre de 1997 y el 1 de octubre de 1999, un total de 17000 niños que fueron seguidos desde su nacimiento y fueron registrados un gran número de factores sobre nutrición, enfermedades, medicación, infecciones, situación social, etc. Con la ayuda de 89 clínicas del Servicio Dental Público, en la misma área, se realizaron exámenes preliminares de los niños nacidos entre octubre 1º de 1997 y octubre 1º de 1999. Se analizaron 595 niños con opacidades severamente marcadas (OSD) en los primeros molares. Estos niños, y un grupo control de 1200 niños seleccionados al azar fueron luego invitados para ser examinados por odontopediatras. En estos exámenes se identificaron 224 casos severos, como así también 253 niños sin ninguna alteración en el esmalte. Fueron analizados estos dos grupos. No hubo ninguna correlación entre OSD y las variables del banco de datos del ABIS. Los análisis muestran que no existe asociación entre OSD y datos pre, peri y neonatales. Sin embargo, hemos encontrado una asociación positiva entre OSD y el alimento a pecho por más de 6 meses.

Análise dos fatores de risco ou de proteção para fluorose dentária em crianças de 6 a 8 anos em Fortaleza, Brasil / Analysis of protection or risk factors for dental fluorosis in 6 to 8 year-old children in Fortaleza, Brazil

OBJETIVO: Investigar os fatores de risco ou de proteção para a fluorose dentária na dentição permanente de crianças de 6 a 8 anos em um bairro no Município de Fortaleza, Brasil. MÉTODOS: Este estudo de caso-controle incluiu 67 crianças com fluorose nos incisivos superiores e inferiores permanentes erupcionados, conforme o índice de Dean, e 57 controles. A presença de fluorose foi determinada como variável dependente. Os dados acerca das variáveis independentes foram obtidos através de entrevistas com os pais das crianças. O teste exato de Fisher foi utilizado para verificar a existência de associação entre fluorose e as variáveis independentes. Foi calculada a razão de chances (odds ratio, OR) para verificar a associação e a probabilidade de fluorose no grupo-caso, ambos com significância de 95 por cento. RESULTADOS: Houve associação significativa da fluorose com tipo de moradia (própria, alugada ou ocupada), mas não com fonte de água para consumo ou uso de dentifrícios fluoretados e suplementos de flúor. Na análise univariada, o risco de fluorose foi maior em crianças que iniciaram o consumo de leite em pó reconstituído com água antes dos 2 anos de idade (OR = 4,53; IC95 por cento: 1,07 a 26,74) e nas que não mamaram (OR = 6,66; IC95 por cento: 1,61 a 38,62). Na análise multivariada, somente a amamentação apresentou associação com a fluorose (4,54; IC95 por cento: 1,21 a 16,66). CONCLUSÕES: A amamentação se configurou como fator de proteção contra a fluorose. É preciso estabelecer critérios de classificação mais específicos para permitir a investigação de relações entre fluorose e classe socioeconômica.

OBJECTIVE: To investigate protection or risk factors for dental fluorosis in permanent teeth of 6 to 8 year-old children in a neighborhood of Fortaleza, Brazil. METHODS: This case-control study included 57 controls and 67 children with fluorosis affecting superior and inferior incisors teeth as determined by the Dean classification criteria. Presence of fluorosis was considered as the dependent variable. Data concerning independent variables were obtained through interviews with the parents. Fisher's exact test was used to determine associations between fluorosis and the independent variables. Odds ratios (OR) were calculated to investigate associations and likelihood of fluorosis in the case group, with 95 percent significance level. RESULTS: Fluorosis was significantly associated with type of housing (owned, rented or squatted), but not with the source of drinking water or use of fluoridated toothpaste and fluoride supplements. Univariate analysis showed that the risk of fluorosis was higher in children who began drinking powdered milk mixed with water before 2 years of age (OR = 4.53; IC95 percent: 1.07-26.74) and in those who did not breastfeed (OR = 6.66; IC95 percent: 1.61-38.62). In the multivariate analysis, only breastfeeding was associated with fluorosis (4.54; IC95 percent: 1.21-16.66). CONCLUSIONS: Breastfeeding was a protection factor against fluorosis. More specific categorization criteria must be established to investigate relationships between fluorosis and socioeconomic class.

Estudo da mineralização dentária em crianças da região metropolitana de Recife / Study of the dental mineralization in children of the Recife metropolitan region

Com o propósito de estudar a mineralização dentária de crianças da região metropolitana de Recife, foram utilizadas 1.352 radiografias panorâmicas de indivíduos do sexo masculino e 1.346 do sexo feminino, distribuídas entre faixas etárias variando de 4 a 15 anos. Em cada radiografia, foram avaliados os estágios de mineralização dos incisivos, caninos, pré-molares e molares tanto da maxila como da mandíbula. Para esta avaliação, utilizou-se um diagrama de oito estágios de mineralização preconizado por Nicodemo e Demirjian et al. Foram obtidas, para cada faixa etária, as médias e os desvios padrões dos estágios de mineralização de cada um dos dentes estudados para ambos os sexos. Para verificar a existência de diferença estatisticamente significativa no desenvolvimento dentário entre os sexos feminino e masculino, foi aplicado o teste t de Student. Verificou-se que, de maneira geral, a mineralização dentária ocorreu primeiro no sexo feminino, indicando precocidade do desenvolvimento dentário nas meninas. Os resultados possibilitaram correlacionar a idade cronológica com as diversas fases de formação dentária, o que permitiu traçar um panorama do desenvolvimento da dentição permanente para a população da região de Recife.

Immediate implants placed into infected sockets: a case report with 3-year follow-up

The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persisting after failed endodontic treatment and endodontic surgery, and discusses the relationship between the procedure and periapical lesions. Surgical removal of hopeless teeth 11, 12 and 21 was performed conservatively in such a way to preserve the anatomy and gingival esthetics. A second surgical access was gained at the apical level, allowing the debridement of the surgical chamber for elimination of the periapical lesion, visual orientation for setting of the implants and filling of the surgical chamber with xenogenous bovine bone graft. After this procedure, the bone chamber was covered with an absorbent membrane and the healing screws were positioned on the implants. Later, a provisional partial removable denture was installed and the implants were inserted after 6 months. After 3 years of rehabilitation, the implants present satisfactory functional and esthetic conditions, suggesting that immediate implant placement combined with guided bone regeneration may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history in the anterior maxilla.

A integridade estética/funcional do tecido periodontal pode ser comprometida pela perda do elemento dental. Os implantes imediatos tornaram-se uma opção viável na manutenção da arquitetura periodontal, desde que haja a compatibilidade com o alvéolo e a possibilidade da contaminação local ser totalmente eliminada. O objetivo deste estudo foi descrever o procedimento de instalação de implantes imediatos na região anterior de maxila usados na reposição de dentes com lesões crônicas periapicais, discutindo a relação entre o procedimento e lesões periapicais. A remoção dos dentes condenados (11, 12 e 21) foi feita de forma conservadora a fim de preservar a estética e arquitetura periodontal. Um segundo acesso cirúrgico foi obtido a nível apical, permitindo: o debridamento da loja cirúrgica, orientação visual dos implantes e o preenchimento com enxerto ósseo bovino. A loja óssea foi coberta por uma membrana absorvível e uma prótese parcial removível provisória foi instalada e após 6 meses os implantes foram reabilitados. Após 3 anos de reabilitação, os implantes se apresentam em condições satisfatórias de estética/função, sugerindo que a instalação de implantes imediatos combinados com a regeneração tecidual guiada em lesões periapicais crônicas podem ser indicados para repor dentes perdidos devido a lesões periapicais crônicas com história de insucesso endodôntico na maxila anterior.

Pérdida dental y patrones de caries en preescolares de una comunidad suburbana de Campeche / Tooth loss and caries patterns in schoolchildren from a suburban community of Campeche

Objetivos: la caries dental es una enfermedad crónica, infecciosa, multifactorial y transmisible. Es muy prevalente y es la causa principal de pérdida dental durante la infancia. El objetivo del presente estudio fue determinar la prevalencia de pérdida de dientes y los patrones de caries en niños preescolares de una comunidad suburbana de Campeche, México. Material y métodos: se realizó un estudio transversal en 109 preescolares de 5-6 años de edad. Los criterios para diagnosticar caries dental fueron el índice ceod (OMS) y el "criterio de magnitud de la lesión cariosa" (CMLC). Se consideró como pérdida dental a la ausencia total del diente o al grado 4 del CMLC (pérdida mayor a 2/3 parte de la corona clínica). Los patrones de ataque de caries registrados fueron: 1) patrón anterior, 2) patrón posterior y 3) patrón anterior-posterior. Todos los sujetos fueron evaluados clínicamente por dos cirujanos dentistas capacitados y estandarizados (kappa <0.85). El análisis consistió en el cálculo de medidas de frecuencia, de tendencia central y de dispersión, según la escala de medición de las variables. El análisis bivariado se realizó con la prueba de chi2. Resultados: trece (11.9 por ciento) de los 109 sujetos tuvieron 34 (1.7 por ciento) de dientes perdidos de un total de 2041 piezas temporales examinadas. Los dientes perdidos con mayor frecuencia fueron los 2dos molares inferiores. De los sujetos con caries (n=82) 47.6 por ciento presentaron el patrón anterior-posterior, 46.3 por ciento tuvieron patrón posterior y 6.1 por ciento exhibieron patrón anterior. No existieron diferencias sustanciales en relación a la edad y sexo. Conclusiones: la pérdida dental en esta población fue alta. El patrón de mayor prevalencia fue el anterior-posterior

Epidemiology of traumatic injuries to the permanant incisors of 9-12-years-old school children in Damascus, Syria

This cross-sectional survey was carried out to assess epidemiological data concerning dental injuries to the permanent incisors of Syrian children. It included 1087 children aged 9 to 12 years, of both sexes, randomly selected from public and private primary schools in Damascus. The response rate was 100%. The prevalence of traumatic injuries to the permanent incisors rose from 5.2% at the age of 9 years to 11.7% at the age of 12 years [P = 0.007]. The difference in prevalence between boys and girls was not statistically significant [P > 0.05]. The majority [59.8%] of children who had experienced injuries to the permanent incisors reported that they were not taken to the dentist for evaluation or treatment of the damage. Among those children who had experienced traumatic injuries to the teeth 93.1 % presented with untreated damage. Because some injuries were minor, such as small enamel fractures, the proportion of children who needed treatment was 63.2%. There was a tendency for children with an incisal overjet greater than 5 mm to have experienced dental injuries [P = 0.06]. Children with inadequate lip covcmgc were more likely to have experienced dental injuries than those with adequate lip coverage [P = 0.000]. The most common reported cause of iniuries to the permanent incisors was violence [42.5%], followed by traffic accidents [24.1%] collisions with people or inanimate objects [16.0%] and falls [9.1%]. In conclusion, traumatic dental injury may pose a serious dental public health problem

Contribuiçäo ao estudo da morfologia facial, de portadores de fissura transforame incisivo unilateral, através da cefalometria radiográfica, em norma frontal / Contribution to facial morphology study of the unilateral cleft lip and palate patients, by cephalometric radiographs, in frontal norm

Nesta pesquisa utilizamos a cefalometria radiográfica, em norma frontal, para estudar algumas dimensöes lineares da face, em uma amostra de 100 brasileiros, leucodermas, de ambos os sexos, com idade média de 20 anos, distribuídos em 2 grupos: grupo controle e de portadores de fissura transforame incisivo unilateral. De cada paciente foi obtida uma telerradiografia, em norma frontal e, em cada uma delas, foram mensuradas algumas grandezas cefalométricas, através de computador. Os valores obtidos foram tratados estatisticamente, através da análise quantitativa e qualitativa