Impact of orthodontic brackets on intraoral and extraoral scans.

INTRODUCTION: The purpose of this study was to evaluate whether the presence of orthodontic brackets influences the accuracy of digital models generated by intraoral and extraoral scanning from the same patients. METHODS: Eighteen orthodontic patients in permanent dentition underwent full-arch intraoral scanning with a CEREC Omnicam scanner (Dentsply Sirona, York, Pa). Alginate impressions from each patient's arch were taken, and plaster models were made and scanned. Intermolar, intercanine, and mesiodistal width of the incisors were measured on 2 digital and 1 plaster models. Analysis of variance or Friedman's test was used, with differences between pairs verified by the Bonferroni test or Wilcoxon test, respectively. Both digital models were superimposed using surface-based registration. RESULTS: Lin's lowest coefficient of agreement was 0.960 (95% confidence interval, 0.900-0.984), which was clinically adequate. No statistically significant differences between the 3 types of model measurements were observed, except for the mandibular left lateral incisor in which scanned intraoral digital models presented Δmedium of 0.05 mm, which was higher than the plaster model. The superimposition of the extraoral and intraoral digital models revealed a minimum difference between models with a mean of means of 0.12 ± 0.03 mm. CONCLUSIONS: Brackets bonded to teeth affected intraoral scanning; however, the intraoral digital models are clinically comparable and present fewer distortions than plaster models. Moreover, measurements on intraoral and extraoral digital models are excellent in terms of trueness and precision and can be used clinically and in plaster models.

Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial.

BACKGROUND: The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine. OBJECTIVE: To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants. SUBJECTS AND METHODS: A total of 44 people, aged 17-49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)-a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg's Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study. RESULTS: All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001). LIMITATIONS: Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error. CONCLUSIONS: The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects. CLINICAL TRIAL REGISTRATION: This study was not registered. PROTOCOL: The protocol was not published before trial commencement.

Oral health-related quality of life of children before, during, and after anterior open bite correction: A single-blinded randomized controlled trial.

INTRODUCTION: One of the goals of malocclusion treatment is to improve the oral health-related quality of life (OHRQoL) of patients. The aim of this trial was to assess the OHRQoL of children before, during, and after anterior open bite (AOB) correction, compared with nontreated children, in a 2-arm parallel single-blind randomized controlled trial. METHODS: Eighty children with AOB aged 8-10 years were randomly assigned to 2 groups (n = 40 each): a group treated with the use of fixed palatal crib (FPC; TG) and a control group (nontreated; CG). Randomization was performed with the use of BioEstat software. The outcome (OHRQoL) was assessed with the use of the validated Brazilian Portuguese version of the Child Perceptions Questionnaire (CPQ8-10) applied before (baseline, phase 1), 3 months after FPC placement (phase 2), and 1 month after FPC removal (phase 3) in the TG. In the CG, CPQ8-10 was applied at baseline (phase 1), 3 months (phase 2), and 12 months (phase 3). Data were analyzed by means of a blinded statistic with the use of Friedman, Wilcoxon, and Mann-Whitney tests (α = 0.05). RESULTS: All participants finished the RCT, and demographic characteristics were similar between groups. In phase 1, the TG had lower scores for the "social well-being" domain (P = 0.02). In phase 2, the CG had higher scores than the TG for the "emotional well-being" and "social well-being" domains, but the opposite was observed for "oral symptoms" and "functional limitations" (P < 0.001). In phase 3, the TG showed a lower impact on OHRQoL than the CG in all domains and in the overall score (P < 0.001). In the 3 phases, the CG showed progressive increase (mean scores 70.37, 74.70, and 84.22, respectively; P < 0.001) and the TG a decrease (mean scores 70.20, 70.80, and 6.05, respectively; P < 0.001) in overall scores. The increase of scores in the CG was considered to represent a serious harm. CONCLUSIONS: Correction of AOB had a positive impact and failure to correct it had a negative impact on the OHRQoL of children. REGISTRATION: This trial was not registered. PROTOCOL: The protocol was not published before trial commencement.

Time perspective and associated factors in Brazilians living with HIV.

BACKGROUND: a person's time perspective can be an important variable for the understanding of behaviours that interfere with the quality of life of people living with HIV. AIMS: to analyse the relationships between socio-demographic, clinical, and behavioural variables and the time perspective in Brazilians living with HIV. METHODS: a cross-sectional study was conducted with a convenience sample of 281 people living with HIV in Brazil. The time perspective was evaluated using the Zimbardo Temporal Perspective Inventory (ZTPI-25). RESULTS: the main findings indicate that people living with HIV are more oriented towards a future and positive past perspective, and that socio-demographic, clinical, and behavioural factors may influence the different temporal perspective constructs in people living with HIV. CONCLUSION: health professionals can use the results of the present study to support strategies that encourage individuals living with HIV to self-care and lead healthier lives.

Motor performance tests as screening instruments for frailty in the older adults.

OBJECTIVE: To verify the association between frailty and motor performance, and identify which test is the best predictor of frailty in the older adults. METHODS: Cross-sectional, population- and home-based study that analyzed data from 286 older adults. The association between physical performance tests and frailty was verified by binary logistic regression. The diagnostic power of the performance tests and the identification of the best cut-off points to frailty were evaluated using the ROC curve and the area under the ROC curve. RESULTS: The prevalence of frailty was 23.8%. Frailty was associated with worse performances in the 'chair stand' test (p=<0.01) and the 'pick up a pen' test (p=<0.01). Performance requiring more than 14 seconds in the 'chair stand' test proved to be a good criterion for discriminating frailty in the older adults, considering the sensitivity and specificity. CONCLUSION: The worst performances in the tests were associated with the frailty syndrome. All tests were able to predict frailty in the older adults. However, taking into account the high sensitivity of the use of the 'pick up a pen' test to confirm a diagnosis of frailty (84.6%), this is recommended for use in home environments.

Perception of Esthetic Impact of Smile Line in Complete Denture Wearers by Different Age Groups.

PURPOSE: To evaluate esthetic perceptions based on tooth exposure when smiling of patients wearing complete dentures by evaluators in different age groups. MATERIALS AND METHODS: Alterations were made to a front view photograph of a smiling patient wearing complete maxillary and mandibular dentures. Alterations in the smile line were simulated to increase or decrease tooth exposure (increments of 0.5 mm). For this purpose, image manipulation software was used. After manipulation, images were printed on photo paper, attached to a questionnaire, and distributed to individuals in three age groups (n = 150). To evaluate the esthetic perception for each image, a visual analog scale was used, with 0 representing least attractive, 5 representing attractive, and 10 representing very attractive. Differences between examiners were analyzed using the Mann-Whitney test. All statistical analyses were performed with a degree of confidence of 95%. RESULTS: Two evaluators did not observe any differences between images. The images given the best and worst scores were E and O (alterations of 2 and 7 mm), respectively, in the 15- to 19-year-old group, B and O (alterations of 0.5 and 7 mm), respectively, in the 35- to 44-year-old group, and A and M (no alteration and 6 mm alteration), respectively, in the 65- to 74-year-old group. When the images were presented together (images 1 and 2), the unaltered image was selected by individuals of different age groups as the best, and the image with a change of 7 mm was selected as the worst. CONCLUSION: In this study, complete dental prostheses with smile lines that coincided with the cervical margins of the anterior teeth were the most acceptable. Less exposure of the maxillary teeth when smiling corresponded with decreased attractiveness.

Relationship between BMI and physical performance among older adults.

Our objective was to examine the relationship between body mass index (BMI) and physical performance in community-dwelling older adults. This was a descriptive and association study, based on secondary data derived from a population-based epidemiological research involving 316 older adults. The BMI was thus classified: <22.0 kg/m(2), underweight; 22.0 ≤ BMI ≤ 27.0 kg/m(2), adequate; >27.0 kg/m(2), overweight. Physical performance was assessed based on "chair stand", "pick up a pen" and walking tests. Associations between BMI and performance at each test were tested by Cox regression for survival analysis with multiple modeling adjusted by gender and age, adopting a significance level of 5% (α = 0.05). Individuals with underweight (ßadjusted = 0.64; p = 0.004), performed poorly in the "chair stand" test when compared to individuals with adequate weight. The BMI was a predictor of good physical function, with underweight being more of a limiting factor than overweight.

Development, validation, and application of a Brazilian sleep myths and truths assessment scale (SLEEP-MTAS).

OBJECTIVE: This study aimed to develop, validate, and apply a scale assessing knowledge of sleep-related myths and truths and associate it with sociodemographic factors. METHODS: A scale with 15 questions was created, containing statements about the characteristics of sleep and related to sleep and dentistry. Each answer ranged from 0 to 4 points, generating a total score from 0 to 60, where higher scores represented greater knowledge. A preliminary study with 200 people assessed its convergent and discriminant construct validity, internal consistency, and temporal stability. The main study included 1965 respondents over 18 years. Additionally, sociodemographic data were collected and a classification of the level of knowledge was performed. Data were analyzed with Student's t-test and one-way ANOVA (p < 0.05). RESULTS: The questionnaire showed convergent (p < 0.001) and discriminant (p = 0.024) construct validity, internal consistency (alpha = 0.7), and temporal stability (ICC = 0.87). In the main study, 90.3% of the participants had moderate and high knowledge, with the score ranging from 24 to 58. Adults over 28 years old (p < 0.001), from the southern region of Brazil (p < 0.001), who lived in capital or metropolitan areas (p < 0.001), with higher education (p < 0.001), without religion (p < 0.001), and involved in dentistry (p < 0.001) had greater knowledge than their peers. CONCLUSIONS: The scale presented good psychometric properties. Most participants had moderate and high knowledge on sleep, with a difference in knowledge related to the age, region and area of residence, education, involvement with dentistry, and religion.

Impact of Orthognathic Correction of Class II Malocclusion on the Perception of Social Characteristics.

OBJECTIVE: To evaluate the influence on the perception of social characteristics after orthognathic treatment for the correction of Class II malocclusion. METHODS: A cross-sectional study was conducted with the participation of 240 observers who evaluated images of individuals before and after orthognathic surgery for the correction of malocclusion. Based on the images, two different questionnaires were applied containing 44 questions each for evaluating social competence, intellectual ability, psychological adjustment, and attractiveness. The mean scores for evaluations of the images were compared using the Mann-Whitney U test at 5% level of significance (α=0.05). RESULTS: Orthognathic treatment significantly (p<0.05) improved the evaluation of individuals in the requisites of the score attributed to the image (p=0.008), extroversion (p=0.026), happiness (p=0.006), self-confidence (p=0.046), and attractiveness (p=0.015). CONCLUSION: Orthognathic treatment for the correction of Class II malocclusions has a positive effect on the perception of social characteristics of individuals. The individuals subjected to orthognathic surgery were evaluated as being more attractive, intelligent, socially competent, and psychologically adjusted.

Cross-sectional relationships between sedentary behavior and frailty in older adults.

BACKGROUND: The aim of this study was to analyze the association between frailty and sedentary behavior and to examine the discriminative ability of sedentary behavior in screening frailty in older adults. METHODS: This was a cross-sectional study based on data from an epidemiologic population-based household survey involving 316 community-dwelling older adults (≥60 years) of both sexes (173 women and 143 men). The frailty was measured from an adapted version of the criteria proposed by Fried et al. in 2001, which is based on the presence of three or more of the following components: shrinking, weakness, poor endurance/exhaustion, slowness and low activity. Sedentary behavior was determined by the International Physical Activity Questionnaire (long version). RESULTS: The prevalence of frailty was 23.8%, and the average time in sedentary behavior was 6.1±3.2 h/day. Sedentary behavior was independently and positively associated with frailty (PR=1.10; 95% CI: 1.02-1.19; P=0.013). The ROC curve showed that the sedentary behavior could discriminate frail older adults (AUC=0.66; 95% CI: 0.61-0.72), and the best cutoff point was 7 h/day (sensitivity =54% and specificity =75%). CONCLUSIONS: Frailty is strongly associated with sedentary behavior. Sedentary behavior can be a potential marker in screening of frailty in community-dwelling older adults. Our findings suggest that reducing the time with sedentary behavior and increasing the time with physical activity may prevent frailty syndrome.

Impact of malocclusion on affective/romantic relationships among young adults.

OBJECTIVE: To evaluate the extent to which different types of malocclusion influence the development of affective/romantic relationships among young adults of both sexes. MATERIALS AND METHODS: A cross-sectional study was conducted with 360 men and women ranging in age from 18 years to 25 years. Criteria for exclusion from the sample were the following: participants could not be married, visually impaired, or students of a higher education course in the area of health. In this study, images of young adult men and women in the same age range as that of the evaluators were used. These images were manipulated to create different types of malocclusion: diastema, open bite, crowding, gingival (or gummy) smile, little exposure of teeth. Six groups of images containing six images each were formed and consisted of two experimental images (digitally manipulated) and four control images. These images were provided to the participants, who evaluated them by means of a questionnaire and a visual analog scale. The Kruskal-Wallis, Mann-Whitney, chi-square, and Fisher exact tests were used for data analysis. RESULTS: All malocclusions had a negative impact on acceptance by the evaluators for the purposes of affective/romantic relationships, with crowding being the type of malocclusion that led to the highest level of rejection (P < .01). CONCLUSION: Malocclusions have a negative influence on the development of affective/romantic relationships among young adults. Individuals with good occlusion are seen in a more positive light, from the perspective of affective life.

Handgrip explosive force is correlated with mobility in the elderly women.

The analysis of explosive force, through rate of force development (RFD) and contractile impulse (CI), from handgrip strength data seems to be useful and promising information to study the aging of musculoskeletal system and health status. We aimed to test the hypothesis that, in elderly women, the handgrip explosive force could be better associated to the functional mobility than maximum handgrip strength. Handgrip strength and the performance of Timed Up & Go Test (TUG) were measured from sixty-five community-dwelling healthy elderly women. The average slope of the moment-time curve (Δ moment/Δ time) over the time interval of 0-200 ms relative to the onset of contraction was calculated to provide the RFD and CI. The highest strength achieved during the isometric contraction was used as maximum handgrip strength. Pearson correlations were used to assess the strength of the relationship between the handgrip strength parameters (Maximum strength and explosive force from 0-200 ms) and TUG test performance from older women. The correlation analysis showed that the TUG test performance was inversely correlated to the handgrip strength parameters, with better relationship with explosive force parameters. The handgrip explosive force seems to be a promising predictor of functional mobility of elderly women, since it showed a better relationship with functional mobility than maximum handgrip strength.

Comparison of explosive force between young and elderly women: evidence of an earlier decline from explosive force.

The aging process causes many changes in muscle strength, and analysis of explosive force from handgrip strength seems to be useful and promising in studying the aging musculoskeletal system. Therefore, the purpose of this study was to investigate if explosive force parameters [rate of force development (RFD) and contractile impulse (CI) over the time interval of 0-200 ms from the onset of contraction] during handgrip efforts decline differently than maximum handgrip strength with increasing age. Twenty healthy young women (20-27 years) and 65 healthy elderly women, assigned into three age groups (50-64, 65-74, and 75-86 years), participated in this study. All participants performed two maximal grip attempts. Handgrip data were recorded as force-time curves, peak force, and explosive force parameters. Our results revealed that peak force decreased significantly (p < 0.05) for those who are 65 years old, while explosive force parameters decreased significantly (p < 0.05) for those aged 50 years. These data indicate that the decline in explosive grip force-generating capacity may begin earlier (i.e., for those aged 50 years old) than peak force during the aging process. Our findings suggest that the aging process reduces the explosive grip force-generating capacity before affecting peak force.

Photos vs silhouettes for evaluation of profile esthetics between white and black evaluators.

OBJECTIVE: To determine whether photos or silhouettes are adequate methods for evaluating the esthetic profiles of black subjects and whether black and white evaluators have different preferences for esthetic profiles. MATERIALS AND METHODS: One photographic record of the profile of a black female patient with accentuated dental bimaxillary dentoalveolar protrusion was randomly selected. The image of the patient's profile was altered to produce a series of seven photos and seven silhouettes (a total of 14 images) with different lip positions but uniform distances in relation to the esthetic plane created by Ricketts (line E). Fifty black and 50 white lay evaluators were invited to enumerate the photos and silhouettes, produced according to the lip position, in the order in which they considered most esthetically pleasing. RESULTS: The number of preferences found to be within the esthetic norm was slightly higher among the photographs than among the silhouettes; the esthetic profile with a deviation of -2 mm from line E was elected as the most attractive, and the esthetic pattern with a deviation of +6 mm from the normal line E was considered the least attractive. There were no statistically significant differences between the preferences related to the variables race, sex, and educational background. CONCLUSIONS: The esthetic attractiveness of the facial profiles of black subjects in photos and silhouettes was evaluated in a similar manner among black and white evaluators. Among both black and white evaluators, the greatest preference was for the slightly concave profile, which was within the limit considered standard.

Perception of the esthetic impact of gingival smile on laypersons, dental professionals, and dental students.

OBJECTIVE: The aim of this study was to evaluate perceptions regarding esthetic appearance of the smile in cases of orthognathic surgery for correction of maxillary gingival display. STUDY DESIGN: Alterations were made to an extraoral front-view photograph of a gingival smile in normal occlusion by repositioning the maxilla to simulate bone tissue removal and gingival exposure. Images were printed on photographic paper attached to questionnaires distributed among laypersons, professionals, and dental students to evaluate degree of esthetics (n = 150). To evaluate degree of esthetics, an attractiveness-scale was used, with 0 representing hardly attractive, 5 attractive, and 10 very attractive. RESULTS: All of the evaluated groups demonstrated that large gingival extension does not always affect esthetic appearance of the smile. Insufficiently visualized maxillary incisors were considered hardly attractive and received statistically lower scores (P < .05). CONCLUSIONS: According to esthetic parameters, gingiva play important roles in composition of the smile, but only when they are exposed to a small extent.

Cross sectional: perception of children from public and private schools regarding the esthetic impact of different types of face masks.

PURPOSE: The purpose was to evaluate the esthetic perception among children from public and private schools regarding the use of different types of face masks. METHODS: Six different types of orthopedic face masks made from images of the same patient were evaluated. Initially, the images were standardized with the help of Adobe Photoshop software. The variable considered was type of mask: (A) Delaire with facebow; (B) Petit; (C) Delaire; (D)Turley; (E) Hickham; and (F) Sky Hook. The images were printed on photographic paper and incorporated into a specific personalized questionnaire that was distributed to 7- to 10-year-olds attending public and private schools (n=120). The data obtained were compared via chi-square, Fisher's exact tests, Mann-Whitney and Spearman's tests. RESULTS: The proportion of participants who chose image A as the best was significantly higher (P<.05) compared to the other masks. Images B and F were chosen as the worst, without a significant difference between them (P>.05). The mean scores between groups were not significantly correlated between private vs public schoolchildren (r=0.32) and between boys and girls (r=0.41). CONCLUSIONS: Delaire face mask with facebow was chosen as the most attractive, and the Petit and Sky Hook face masks were voted the least attractive.

Perception of the esthetic impact of mandibular incisor extraction treatment on laypersons, dental professionals, and dental students.

OBJECTIVE: To evaluate the degree of perception of laypersons, dental professionals, and dental students regarding dental esthetics in cases with mandibular central incisor extraction. MATERIALS AND METHODS: Using a smile photograph of a person with normal occlusion and all teeth, modifications were made to reflect the extraction of a mandibular incisor of various compositions and sizes. For this purpose a program specifically for image manipulation (Adobe Photoshop CS3, Adobe Systems Inc) was used. After manipulation the images were printed on photographic paper, attached to a questionnaire and distributed to laypersons, dental professionals, and dental students (n  =  90) to evaluate the degree of perception and esthetic using a scale of attractiveness, where 0  =  hardly attractive, 5  =  attractive, and 10  =  very attractive. The differences between examiners were checked by the Mann-Whitney test. All the statistics were performed with a confidence level of 95%. RESULTS: The results demonstrated the skill of the dental professionals and dental students in perceiving the difference between cases of normal occlusion and cases where an incisor was lacking (P < .05). The photograph in which the lateral incisors were shown to be larger than the central incisor was the one that obtained the highest value among the cases of extraction in all groups of evaluators. CONCLUSIONS: It can be concluded that dental professionals and dental students are more skillful at identifying deviation from normality. In addition, central incisor extraction should always be discarded when there are other treatment options available.

Síntomas depresivos en ancianos brasileños: estudio de base poblacional / Depressive symptoms in Brazilians elderly: population-based study

Objective: to analyze the factors related to the depressive symptoms in elderly of a community with low socio-economic indicators. Methods: epidemiological cross-sectional population-based household study. The study included 316 elderly resident of a city in Brazil's northeast Region. Data were collected in January 2011. The depressive symptoms were evaluated by means of a Geriatric Depression Scale (15-item version). The independent variable included socio-demographic factors, health state, functional limitation and life style. Crude and adjusted Poisson regression models were used in the statistical analyses. Results: the prevalence of depressive symptoms was 20 percent. The adjusted regression model showed that the depressive symptoms were positively related to the female sex (PR = 2.00); marital status: single (PR = 2.73) and divorced (PR = 3.59); change for worse (PR = 2.53) or better (PR = 2.86) health state in comparison to the 12 previous months; worse health state in relation to other people of the same age (PR = 2.22); and functional limitation (PR = 1.72). There was an inverse association between the depressive symptoms and financial difficulty (PR = 0.46). Conclusions: the results suggest that socio-demographic factors, health self-assessment and functional capacity can be stronger depression determinants than morbidity and life style(AU)

Objetivo: analizar los factores asociados a los síntomas depresivos en ancianos de una comunidad con bajos indicadores socioeconómicos. Métodos: estudio epidemiológico transversal de base poblacional y domiciliar. El estudio incluye 316 ancianos residentes en una ciudad de la región nordeste de Brasil. Los datos fueron colectados en enero de 2011. Los síntomas depresivos fueron evaluados por la Escala de Depresión Geriátrica (versión 15 ítems). Las variables independientes incluyeron factores sociodemográficos, estado de salud, limitación funcional y estilo de vida. Fueron usados modelos simples y ajustados de regresión de Poisson en los análisis estadísticos. Resultados: la prevalencia de síntomas depresivos fue de 20 por ciento. El modelo de regresión ajustado mostró que la sintomatología depresiva fue positivamente asociada al sexo femenino (RP = 2,00), estados civiles soltero (RP = 2,73) y divorciado (RP = 3,59), mudanza para peor (RP = 2,53) o mejor (RP = 2,86) en el estado de salud comparado a 12 meses anteriores, peor estado de salud en relación a otras personas de la misma edad (RP = 2,22) y limitación funcional (RP = 1,72). Fue observada asociación inversa entre sintomatología depresiva y dificultades financieras (RP = 0,46). Conclusiones: los resultados sugieren que factores sociodemográficos, autoevaluación de la salud y capacidad funcional pueden ser determinantes más fuertes de depresión de que morbilidad y estilo de vida(AU)