Impact of hypomineralised second primary molar on preschoolers' oral health-related quality of life-A hierarchical approach.

BACKGROUND: Hypomineralised second primary molar (HSPM) is a developmental enamel defect associated with dental caries. AIM: To evaluate the impact of HSPM on oral health-related quality of life (OHRQoL) in preschoolers through hierarchical analysis. DESIGN: This population-based cross-sectional study assessed 834 5-year-old preschoolers, in Teresina, Piauí, Brazil, using sociodemographic questionnaires and Early Childhood Oral Health Impact Scale (ECOHIS). Dental examination was performed by two calibrated examiners (κ ≥ 0.80) for the diagnosis of HSPM (EAPD), dental caries (dmft and pufa indices), and malocclusion (Foster and Hamilton criteria). Analysis of the determinants of OHRQoL was stratified at three levels (P < .05). RESULTS: Severe HSPM was associated with OHRQoL in bivariate analysis (P < .05). In adjusted final multivariate analysis (model 1), the presence of dental caries with or without clinical consequences was associated with worse OHRQoL (P < .05). In model 2, after the removal of dental caries, preschoolers with severe HSPM had greater probability of having a negative impact on OHRQoL in the child impact section (RR = 2.14; 95% CI = 1.26-3.65), family impact section (RR = 1.99; 95% CI = 1.16-3.42), and total score (RR = 2.09; 95% CI = 1.25-3.49) of the ECOHIS. CONCLUSION: Severe HSPM had a negative impact on the OHRQoL of preschoolers and their families, but the presence of dental caries neutralised this impact.

Impact of Developmental enamel defects on quality of life in 5-year-old children.

BACKGROUND: Developmental enamel defects (DDE) represent one of the prevalent oral problems in childhood; however, few studies have evaluated its impact on quality of life in the children's own perception. AIM: To evaluate the DDE impact on quality of life of 5-year-old children. METHODS: This cross-sectional observational study assessed 566 children aged 5 years old, in Teresina, Piauí, Brazil, according to their self-perceptions. Children answered the Pediatric Quality of Life Inventory™ Version 4.0 and Oral Health Scale. The dmft index, modified DDE index and Foster and Hamilton criteria were used to diagnose dental caries, DDE and malocclusion, respectively. A single examiner performed the clinical examination. Descriptive analyses and Poisson regression with robust variance were performed. RESULTS: The prevalence of DDE was 33.7%. For children's self-reports, the presence of DDE had a negative association with oral health-related quality of life (OHRQoL; PR 1.09, 95% CI 1.02-1.15). Enamel hypoplasia had a negative impact on the physical function (PR 1.05; 95% CI 1.01-1.10) and oral health (PR 1.06, 95% CI 1.01-1.11) domains. Diffuse opacity had a negative impact on the social aspect (PR 1.09, 95% CI 1.02-1.18). CONCLUSIONS: Enamel defects had a negative impact on OHRQoL according to the self-reports of the children.

Cellular profile of primary molars with pulp necrosis after treatment with antibiotic paste.

The interradicular region of primary molars is permeated by many foramina, channels and accessories that connect the pulp cavity with the periapical tissues anatomically. Thus, pulp decomposition products or drugs used in endodontic treatment can trigger inflammatory reactions. The aim of this study was to evaluate the blood cell profile of the alveolar region after extraction of primary molars treated with CTZ paste. Forty-eight primary molars were selected with clinical and radiographic signs of extraction. The sample was divided into three groups with 16 teeth each: Group 1-healthy teeth; Group 2-untreated decayed teeth; and Group 3-teeth treated with CTZ paste. Immediately after the extraction, blood from the interface of the tooth socket was collected and smears were performed for further evaluation. The slides were stained by the Fast Panoptic® method and analysed by two previously trained examiners who counted the leucocytes in sets of 100 cells/slide, differentiating them into neutrophils, lymphocytes, monocytes, eosinophils and basophils. The data were analysed statistically by the MANOVA test. The blood samples from Group 2 differed significantly from Group 1 samples for all classes of leucocytes, except basophils, with higher average for lymphocytes (62.56), monocytes (7.81) and eosinophils (2.31). For Group 3, there was a relative difference (P < 0.05) to Group 2, of monocytes and eosinophils values. The blood cellularity interface in the tooth socket of primary teeth treated with CTZ paste is similar to those of healthy, exfoliated teeth and physiologically different from untreated decayed teeth.

Early childhood caries management using fluoride varnish and neutral fluoride gel: a randomized clinical trial.

The aim of this study was to evaluate the clinical efficacy of varnish and neutral fluoride gel in the management of early childhood caries (ECC). A randomized clinical trial was conducted to compare two strategies for ECC management: topical application of neutral fluoride gel (NFG group) and varnish (FV group) every four months for a period of one year. The sample consisted of children between the ages of three and four years, enrolled in public daycare centers. The incidence of ECC between the groups was compared by assessing values (new dmfs) at two levels: d2 when enamel/dentin were affected and d3 when dentin affected. Pearson's Chi-square, Fisher's Exact, Kolmogorov-Smirnov and Mann-Whitney tests were used to compare the incidence and increment of caries between the NFG and FV groups (p<0.05). A total of 240 children were included in this study and 213 children (88.7%) were followed up for 12 months. The incidence of ECC was 24.1% in the GF and 21.0% in the FV groups (p=0.586). The increment of caries in d2mfs was 1.36 (95% CI = 0.83 - 1.89) in the NFG and 1.33 (95% CI = 0.75 - 1.89) in FV (p=0.756) groups. Increment of caries in d3mfs was 1.60 (95% CI = 0.95 - 2.25) in NFG and 1.40 (95% CI = 0.75 - 2.04) in FV (p=0.468). Neutral fluoride gel and fluoride varnish exhibited similar efficacy in the management of ECC after 12 months of follow-up.

Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice.

This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

Quilombola children and adolescents show high prevalence of developmental defects of enamel. / Crianças e adolescentes quilombolas apresentam alta prevalência de defeitos de desenvolvimento do esmalte.

Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children's parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

Dentes com defeitos de desenvolvimento do esmalte (DDE) apresentam porosidades e/ou irregularidades que os tornam suscetíveis a acúmulo de biofilme e predisposição à cárie e doenças periodontais. O objetivo deste artigo é determinar a prevalência de DDE e fatores associados em crianças e adolescentes residentes em comunidade quilombola. A população foi censitária e composta por indivíduos na faixa etária de 3 a 14 anos. Os responsáveis responderam a questionário contendo dados socioeconômicos demográficos e histórico de agravos durante a gravidez e infância. Foi aplicado o Índice DDE modificado. Foram realizadas análise descritiva e regressão de Poisson com variância robusta (p<0,05). Foram examinados 406 indivíduos. A prevalência de DDE foi de 80,5%, sendo que em dentes decíduos foi de 42,2% e permanentes 61,1%. Houve associação entre DDE e maior idade da criança (RP=1,09; IC95%=1,01-1,17), uso de antibiótico na gravidez (RP=1,14; IC95%=1,07-1,22) e relato de desnutrição durante a primeira infância (RP=1,12; IC95%=1,03-1,22). A prevalência de DDE em crianças e adolecentes da comunidade quilombola foi alta. E os fatores associados foram maior idade da criança, uso de antibióticos na gravidez e desnutrição durante a primeira infância.

Consumption of Acidic Beverages is a Predisposing Factor for Erosive Tooth Wear in Preschool Children: A Population-based Study.

Purpose: In a cross-sectional population-based study of 888 5-year-old preschoolers from Teresina, Brazil, to determine the prevalence and factors associated with erosive tooth wear (ETW).
Materials and Methods: In a questionnaire, parents provided information on sociodemographic factors, their children's eating/drinking habits, and oral health. Dental examination was performed at the schools by two calibrated examiners for the diagnosis of ETW, following the criteria of the modified O'Brien Index.
Results: The prevalence of ETW was 3.3%. The maxillary incisors were the most highly affected teeth, followed by the mandibular and maxillary molars. The majority of the lesions reached only the enamel (72.1%) and up to 1/3 of the dental surface (63.1%). The occlusal surface was the most affected (47.8%). Preschoolers who had an acidic food-consumption profile had a 2.74 times (95% CI = 1.03-7.30) higher chance of having ETW than children without this profile.
Conclusion: The prevalence of erosive tooth wear on the deciduous teeth was low and associated with the consumption of acidic beverages.

Prevalence of Enamel Defects in Premolars Whose Predecessors Were Treated with Extractions or Antibiotic Paste.

PURPOSE: To determine the prevalence of developmental defects of the enamel (DDE) in premolars whose infected predecessors were submitted to pulp therapy with antibiotic paste or extractions due to pulp necrosis. MATERIALS AND METHODS: A cross-sectional study with a consecutive sample consisting of children and adolescents who presented with fully erupted premolars, was evaluated. Data were collected by dental examinations, in which the modified DDE index was applied. Dental records were evaluated and three groups of premolars were determined according to the clinical history of predecessors: GCTZ: with pulp necrosis and treated with CTZ (chloramphenicol, tetracycline, zinc oxide and eugenol) paste; GE: with pulp necrosis and treated by extraction; GH: healthy and physiologically exfoliated. Descriptive analysis and a logistic regression (p <0.05) were performed. RESULTS: The study included 1017 premolars, DDE was present in 22.5%. Premolars belonging to the GE group presented higher odds of DDE (odds ratio (OR) = 3.52, 95% CI:2.29-5.40) than those of GCTZ group (OR = 2.43, 95% CI:1.51-3.91) and GH group (p <0.01). Enamel defects were more frequent in maxillary premolars (OR = 3.22, 95% CI:1.65-6.27, OR = 3.39, 95% CI:1.67-6.90, OR = 2.90, 95% CI:1.48-5.66 and OR = 3.10, 95% CI:1.54-6.23). CONCLUSIONS: The prevalence of enamel defects was higher in premolars whose predecessors were removed because of necrosis, followed by those treated with CTZ paste and those that were healthy by the time exfoliation occurred.

Does low-cost GIC have the same survival rate as high-viscosity GIC in atraumatic restorative treatments? A RCT.

Atraumatic Restorative Treatment (ART) is one of the strategies used to control dental caries; it involves hand instruments for removal of carious tissue, and restorations using high-viscosity Glass Ionomer Cement (GIC). The present controlled clinical trial aimed to evaluate the performance of low-cost GIC indicated for ART in primary teeth, compared with high-viscosity GIC, after one year of follow-up. Two-to six-year-old children with dentin caries lesions on one or two surfaces of anterior and posterior teeth were selected. The children were randomly assigned to 2 groups according to the restorative material used: G1 (control) - Ketac Molar®; G2 (experimental) - Vitro Molar®. Treatments were performed in a school setting, following the guidelines of the ART. A total of 728 restorations were performed in 243 children. Descriptive analysis and Poisson regression were applied, with a significance level of p < 0.05. After 12 months, 559 (76.8%) restorations were re-evaluated. The success rate was evaluated by the prevalence ratio (PR), associated with restorations performed in primary second molars (PR = 1.21; 95%CI = 1.03-1.42), and with small (PR = 1.35; 95%CI = 1.14-1.60) or medium cavities (PR = 1.29; 95%CI = 1.08-1.55), using Ketac Molar® material (PR= 1.07; 95%CI = 1.01-1.15), considering p < 0.05. Small or medium restorations in primary second molars performed with high-viscosity GIC (Ketac Molar®) were more successful than restorations performed with low-cost GIC indicated for ART.

Impact of dental caries on the quality of life of preschoolers measured by PedsQL questionnaire. / Impacto da cárie dentária na qualidade de vida de pré-escolares mensurado pelo questionário PedsQL.

The objective of this study was to evaluate the impact of dental caries on the quality of life of preschool children. The population was made up of preschoolers aged 5 years, enrolled in public and private institutions of Teresina, PI, Brazil. The Pediatric Quality of Life Inventory (PedsQL™) was applied to children and caregivers, as well as a socioeconomic-demographic questionnaire for those responsible. In the dental examination the ceod index was used to evaluate the caries experience. Of the 566 children examined, 50.2% presented with caries experience. It was observed an association between caries experience and poorer quality of life in the oral health domain in the children's perception (RR = 0.981, 95% CI = 0.97-0.99) and parents (RR = 0.955, 95% CI = 0, 94-0.97). According to the children's perception, caries in the posterior teeth was associated with poorer quality of life in the physical capacity domain (RR = 0.985, 95% CI = 0.97-0.99). It was concluded that caries experience had a negative impact on the OHRQoL (oral health-related quality of life) in children's oral health according to the perception of children and parents. Caries located in molars had a negative impact on HRQoL in the physical ability domain according to the children's perception.

O objetivo do estudo foi avaliar o impacto da cárie dentária na qualidade de vida de pré-escolares. A população foi constituída por pré-escolares com idade de 5 anos, matriculados em instituições públicas e privadas de Teresina, PI, Brasil. Instrumento de qualidade de vida validado para população brasileira (Pediatric Quality of Life Inventory - PedsQL™) foi aplicado para as crianças e responsáveis, além de questionário socioeconômico-demográfico para os responsáveis. No exame dentário o índice ceod foi utilizado para avaliar a experiência de cárie. Das 566 crianças examinadas, 50,2% apresentaram experiência de cárie. Foi observada associação entre experiência de cárie e pior qualidade de vida no domínio de saúde bucal na percepção das crianças (RR= 0,981; IC95% = 0,97-0,99) e dos pais (RR= 0,955; IC95% = 0,94-0,97). De acordo com a percepção das crianças, cárie em dentes posteriores foi associada a pior qualidade de vida no domínio capacidade física (RR= 0,985; IC95% = 0,97-0,99). Concluiu-se que experiência de cárie impactou negativamente na QVRSB (qualidade de vida relacionada à saúde bucal) no domínio saúde bucal da criança de acordo com a percepção das crianças e dos pais. Cárie localizada em molares impactou negativamente na QVRSB no domínio capacidade física segundo a percepção das crianças.

Prevalence and associated factors to sleep bruxism in adolescents from Teresina, Piauí. / Prevalência e fatores associados ao bruxismo do sono em adolescentes de Teresina, Piauí.

INTRODUCTION: Sleep bruxism (SB) is defined as a repetitive jaw muscle activity whose epidemiology in adolescents has been little studied. This cross-sectional study aimed to determine the prevalence of sleep bruxism and associated factors in adolescents. METHODOLOGY: The sample consisted of 594 students aged 11 to 14 years old from Teresina, Piauí, Brazil. Self-administered questionnaire was answered by parents/caregivers and dental clinical examination was performed. Pearson's chi-squared test was used to assess the association between SB and independent variables. Poisson regression analysis with robust variance was applied, with results expressed in prevalence ratio (PR). RESULTS: The prevalence of SB in adolescents was 22.2%. Multivariate analysis showed a higher prevalence of SB in male gender adolescents (PR = 1.41; 95%CI 1.04 - 1.89), presenting snoring (PR = 1.39; 95%CI 1.02 - 1.89) and difficulty falling asleep (PR = 1.92; 95%CI 1.38 - 2.66). CONCLUSION: SB is a frequent condition in adolescents, and the factors associated with its prevalence were: male sex, snoring and difficulty falling asleep.

Is the fluoride intake by diet and toothpaste in children living in tropical semi-arid city safe?

Data about total fluoride intake in children living in a tropical semi-arid climate city is scarce, thus we conducted this study. Fifty-eight children aged two to five years, living in a Brazilian tropical city with optimally fluoridated water were selected. Dietary samples were collected using the duplicate diet method on two non-consecutive days in the children's home toothpaste was determined by subtracting the amount of fluoride recovered after brushing from the amount placed on the toothbrush. The mean total dose (SD) of fluoride intake was 0.043(0.016) mg F·kg-1·d-1, with the major (60.6%) contribution from water. The factors associated with the ingestion of fluoride from toothpaste were fluoride concentration of the toothpaste (p = 0.03) and the use of kids toothpaste (p = 0.02). The findings suggest that children have a low fluoride intake, measured by at-home meals and use of fluoride toothpaste; drinking water is the main source of fluoride ingestion.

Distraction osteogenesis in Goldenhar Syndrome: case report and 8-year follow-up.

Goldenhar syndrome is a well-known condition featuring the following triad of anomalies: ocular abnormalities, microtia and vertebral anomalies. This syndrome involves structures arising from the first and second branchial arches. Craniofacial anomalies, including mandibular, zygomatic and/or maxillary hypoplasias are found in 50% of patients with Goldenhar syndrome. Patients with this syndrome may present unilateral or bilateral underdevelopment of the mandible. Several treatments for the correction of the dento-facial deformity have been described, among them distraction osteogenesis is one that shows promising results. Distraction osteogenesis is the process of bone formation that occurs during slow separation of the segments of bone after an osteotomy and it has been used to alleviate facial asymmetry. Mandibular distraction osteogenesis has been applied for many years, but long-term reports present controversial results. The purpose of the case report is to describe the immediate and long-term effects of distraction osteogenesis used to treat mandible asymmetry in a 5-year-old boy with Goldenhar syndrome.

Early childhood caries management using fluoride varnish and neutral fluoride gel: a randomized clinical trial

Abstract The aim of this study was to evaluate the clinical efficacy of varnish and neutral fluoride gel in the management of early childhood caries (ECC). A randomized clinical trial was conducted to compare two strategies for ECC management: topical application of neutral fluoride gel (NFG group) and varnish (FV group) every four months for a period of one year. The sample consisted of children between the ages of three and four years, enrolled in public daycare centers. The incidence of ECC between the groups was compared by assessing values (new dmfs) at two levels: d2 when enamel/dentin were affected and d3 when dentin affected. Pearson's Chi-square, Fisher's Exact, Kolmogorov-Smirnov and Mann-Whitney tests were used to compare the incidence and increment of caries between the NFG and FV groups (p<0.05). A total of 240 children were included in this study and 213 children (88.7%) were followed up for 12 months. The incidence of ECC was 24.1% in the GF and 21.0% in the FV groups (p=0.586). The increment of caries in d2mfs was 1.36 (95% CI = 0.83 - 1.89) in the NFG and 1.33 (95% CI = 0.75 - 1.89) in FV (p=0.756) groups. Increment of caries in d3mfs was 1.60 (95% CI = 0.95 - 2.25) in NFG and 1.40 (95% CI = 0.75 - 2.04) in FV (p=0.468). Neutral fluoride gel and fluoride varnish exhibited similar efficacy in the management of ECC after 12 months of follow-up.

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

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.

Prevalência e fatores associados a defeitos de desenvolvimento do esmalte em crianças de 5 anos de idade matriculadas em creches na cidade de Teresina, Brasil / Prevalence and factors associated with developmental defects of enamel in five-year-old children enrolled in preschools in the city of Teresina, Brazil

Resumo Introdução Crianças com defeitos de desenvolvimento de esmalte (DDE) são mais suscetíveis à hipersensibilidade dentinária, maloclusões e dificuldades relativas à adesão de materiais restauradores. O conhecimento sobre a prevalência de DDE e seus fatores associados permite aos profissionais obter maior compreensão desse problema de saúde bucal, minimizando, dessa forma, as sequelas e melhorando a saúde bucal e a qualidade de vida dos indivíduos afetados. Objetivo Determinar a prevalência de DDE e seus fatores associados na dentição decídua. Método Trata-se de estudo transversal com amostra probabilística de 566 pré-escolares de 5 anos de idade, matriculados em creches públicas e privadas de Teresina, Piauí, Brasil. Foi aplicado questionário socioeconômico e de história médica da criança aos responsáveis. Os exames clínicos foram conduzidos por um único examinador (kappa = 0,93 para DDE e 0,86 para cárie) que utilizou os índices DDE modificado e ceo-d. Foi realizada a análise descritiva dos dados, além dos testes qui-quadrado e exato de Fisher e a regressão de Poisson, considerando como significativo p ≤ 0,05. Resultados A prevalência de DDE foi de 33,7%. A média de dentes com DDE por criança foi de 3,12 ± 2,23. O tipo mais prevalente de DDE foi opacidade demarcada (9,5%). Os segundos molares superiores foram os dentes mais afetados (11,9%). Houve associação entre DDE e estudar em creche pública (p = 0,026) e cárie (p = 0,012). Crianças com experiência de cárie apresentaram maior prevalência de DDE (RP: 1,29; IC95%: 1,01-1,64). Conclusão A prevalência de DDE na dentição decídua foi de 33,7% e se mostrou associada à experiência de cárie.

Abstract Background Children with Developmental Defects of Enamel (DDE) are more susceptible to dentin hypersensitivity, malocclusions, and difficulties related to the adhesion of restorative materials. Knowledge about the prevalence and factors associated with DDE allows professionals to gain a greater understanding of this oral health problem, minimizing sequelae, improving oral health and quality of life of affected individuals. Objective To determine the prevalence and factors associated with DDE in primary dentition. Method This is a cross-sectional study assessing a random sample of 566 preschool five-year-old children, enrolled in public and private preschools in Teresina, Piauí, Brazil. It was applied the socioeconomic and medical history of the child questionnaire for the parents or guardians. Clinical examinations were conducted by a single examiner (kappa = 0.93 for DDE and 0.86 for caries) that used the modified DDE index and dmft. Descriptive analysis, chi-square and Fisher's exact tests, and Poisson regression were performed, considering significant p ≤ 0.05. Results the prevalence of DDE was 33.7%. The mean DDE teeth per child was 3.12 ± 2.23. The most prevalent type of DDE was demarcated opacity (9.5%). The second molars were the most affected teeth (11.9%). There was an association between DDE and study at public preschool (p = 0.026) and dental caries (p = 0.012). Children with experience of caries were more likely to DDE (PR: 1.29; 95% CI: 1.01 to 1.64). Conclusion prevalence of DDE in the primary dentition was 33.7% and was associated with caries experience.

Crianças e adolescentes quilombolas apresentam alta prevalência de defeitos de desenvolvimento do esmalte / Quilombola children and adolescents show high prevalence of developmental defects of enamel

Resumo Dentes com defeitos de desenvolvimento do esmalte (DDE) apresentam porosidades e/ou irregularidades que os tornam suscetíveis a acúmulo de biofilme e predisposição à cárie e doenças periodontais. O objetivo deste artigo é determinar a prevalência de DDE e fatores associados em crianças e adolescentes residentes em comunidade quilombola. A população foi censitária e composta por indivíduos na faixa etária de 3 a 14 anos. Os responsáveis responderam a questionário contendo dados socioeconômicos demográficos e histórico de agravos durante a gravidez e infância. Foi aplicado o Índice DDE modificado. Foram realizadas análise descritiva e regressão de Poisson com variância robusta (p<0,05). Foram examinados 406 indivíduos. A prevalência de DDE foi de 80,5%, sendo que em dentes decíduos foi de 42,2% e permanentes 61,1%. Houve associação entre DDE e maior idade da criança (RP=1,09; IC95%=1,01-1,17), uso de antibiótico na gravidez (RP=1,14; IC95%=1,07-1,22) e relato de desnutrição durante a primeira infância (RP=1,12; IC95%=1,03-1,22). A prevalência de DDE em crianças e adolecentes da comunidade quilombola foi alta. E os fatores associados foram maior idade da criança, uso de antibióticos na gravidez e desnutrição durante a primeira infância.

Abstract Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children's parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

Topography of Primary Molar Pulp Chamber Floor: A Scanning Electron Microscopy and Micro-Computed Tomography Analysis

ABSTRACT Objective: To determine in vitro the frequency, shape, type, diameter, and patency of accessory canals in the primary molars pulp chamber floor. Material and Methods: Sixteen healthy primary molars were evaluated by micro-computed tomography and scanning electron microscopy. Descriptive analyses of the frequency, shape (round, oval, or irregular), type (blind, true, or hidden), patency and diameter of the accessory canals were performed. Results: Half of the teeth presented accessory canals, 62.5% of which were located in the upper molars and 37.5% in the lower molars. The most frequent shape was irregular. In three-dimensional analysis, blind accessory canals (12.5%) and with patency (18.7%) of the teeth were observed. The average accessory canal diameter was 51.97 µm (± 26.03 µm). Conclusion: Upper molars showed a higher frequency of accessory canals with larger diameters. The irregular shape was the most frequent. 18.7% of accessory channels showed patency.

Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice

Abstract This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

Resumo Este estudo transversal avaliou a prevalência e severidade de cárie dentária e fluorose em crianças de 5 anos e adolescentes de 12 anos usuários de dentifrício fluoretado, em áreas com e sem água fluoretada. Os responsáveis pelas crianças e adolescentes responderam questionários para determinação de características socioeconômicas e demográficas e hábitos relacionados à saúde. Os indivíduos foram examinados e a cárie e a fluorose foram mensuradas pelos índices ceo-d / CPOD e TF, respectivamente. Foram realizadas análises descritivas, bivariadas e de regressão logística (p <0,05). Dos 692 participantes, 47,7% tinham 5 anos e 52,3% tinham 12 anos. A média de ceod / CPOD em crianças de 5/12 anos dos grupos de exposto e não exposto à água fluoretada foi 1,53 (± 2,47) e 3,54 (± 4,10) / 1,53 (± 1,81) e 3,54 (± 3,82), respectivamente. Crianças (OR = 2,86, IC 95% = 1,71-4,75) e adolescentes (OR = 1,95, IC 95% = 1,24-3,05) que não consumiram água fluoretada tiveram maior experiência de cárie. Entre os adolescentes, houve associação entre a água fluoretada e a prevalência de fluorose muito leve / leve (OR = 5,45, IC 95%: 3,23-9,19) e fluorose moderada (OR = 11,11, IC 95% = 4,43-27,87). Crianças e adolescentes que consumiram água fluoretada apresentaram menor prevalência e severidade de cárie dentária em comparação com aqueles que usaram apenas dentifrício fluoretado como fonte de flúor. Houve uma associação entre a fluoretação da água e fluorose muito leve / leve e moderada em adolescentes.