Temporomandibular Disorders are Associated with Sociodemographic Factors, Health-Related and Oral Conditions in Adolescents: A Cross-Sectional Study

Abstract Objective: To assess the association between temporomandibular disorder (TMD) with sociodemographic factors, health-related factors, and oral conditions in adolescents. Material and Methods: This cross-sectional study was developed with 89 adolescents between 13 to 18 years. TMD diagnosis was obtained by the Research Diagnostic Criteria for Temporomandibular Disease (RDC/TMD) Axis I. Diagnoses of chronic pain, depression, presence of non-specific physical symptoms, including pain and anxiety, were obtained by the RDC/TMD Axis II. The feeling of happiness was measured by the Subjective Happiness Scale. Socio-economic and demographic characteristics were collected through self-administered questionnaires. Patients were examined for dental caries, dental trauma, malocclusion, and tooth wear. Parents answered a sociodemographic, economic, and general health questionnaire. Data were submitted to descriptive statistics, and a logistic regression model was used to assess the association between TMD and the socio-economic, demographic, health-related, and clinical variables. Results: TMD prevalence was 42%. TMD was associated to skin color (p=0.040), use of medications in the past year (p = 0.020) and previous dental trauma (p=0.030). Also, it tended to be associated with the presence of probable awake bruxism (p=0.053). Conclusion: Sociodemographic factors, health-related factors, and oral conditions play a role in TMD, with nonwhite adolescents, those who had used medications in the past year and/or had previous dental trauma having a greater chance of present this disorder (AU).

Contextual and individual factors associated with dental pain in adolescents from Southeastern Brazil

Abstract The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37-0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07-2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11-1.40), periodontal health (OR = 1.80; 95%CI = 1.04-3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96-12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.

Factors associated with toothache among Brazilian adults: a multilevel analysis

Abstract The aim of this study was to evaluate the factors associated with toothache in the adult population of Minas Gerais, Brazil. Individual data from a population sample (age 35 to 44 years) were collected from a secondary database of the SB Minas survey. Sampling was carried out by clusters and with multiple drawing stages. The eligibility criteria were to reside in areas chosen for the research, be within the age group, and accept to participate in the research. The individual variables assessed by a questionnaire and dental exams were sex, income, race/skin color, root caries, periodontal condition, need for dental treatment, and last dental appointment. The contextual variables, assessed by municipal indexes, were Human Development Index (HDI), illiteracy, unemployment, half minimum wage, quarter minimum wage, oral health team coverage, access to individual health care, and supervised tooth brushing average. The dependent variable was toothache in the past six months. A descriptive analysis was made using the Statistical Package for the Social Sciences and Hierarchical Linear and Nonlinear Modeling Software was used to perform the multilevel analyses for individual and contextual levels. An association was found between toothache and low income (OR = 2.00; 95%CI = 1.32-3.13), dental caries (OR = 1.86; 95%CI = 1.22-2.86), periodontal condition, and living on a quarter of the minimum wage or less (OR = 1.03; 95%CI = 1.00-1.08). Clinical and social factors were associated with toothache, reinforcing the need to improve public polices in oral health focused on the adult population.

Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) / Evaluation of secondary care in endodontics at a Dental Specialties Center (DSC)

Resumo Objetivou-se avaliar a atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) de Belo Horizonte (MG). A coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas; (2) sobre o tratamento restaurador, com dados dos prontuários. O programa SPSS 19.0 foi utilizado para analisar os resultados por meio de frequência e percentis. Foram finalizados 452 tratamentos endodônticos em pacientes adultos. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos foi realizada em pré-molares superiores (23,7%), seguida de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o CEO em 81,2% dos casos e finalizado em 24,1% casos (n = 109). A contrarreferência após o tratamento restaurador ocorreu em 58,7% dos casos finalizados. É necessário um planejamento conjunto do tratamento odontológico entre a atenção básica e secundária e, dentro desta última, entre as especialidades, além de um adequado processo de referência e contrarreferência, visando garantir a integralidade do cuidado e a eficiência e eficácia do serviço.

Abstract This study aimed to evaluate secondary endodontic care at a Dental Specialties Center (DSC) in Belo Horizonte, MG. Data collection used two forms: (1) on endodontic treatment, completed by the endodontists (2) on the restorative treatment, with data from the medical records. The SPSS 22.0 program was used to analyze the results using frequency and percentiles. In total, 452 endodontic procedures were completed in adult patients. The patients had a median of 39 years of age, most were female (69.7%) and had a primary care referral order (96.2%). Most endodontic treatments were performed in upper premolars (23.7%) followed by lower molars (22.3%), using a mixed technique (74.1%) and in a single session (64.2%). The referral for restorative treatment was for the DSC in 81.2% of cases and finished in 24.1% (n = 109). The counter-referral following restorative treatment occurred in 58.7% of the completed cases. It is necessary to jointly plan the dental treatment between primary and secondary care and, within the latter, among the specialties, in addition to an adequate referral and counter-referral process aimed at ensuring comprehensive care and efficient and effective service.

The need for endodontic treatment and systemic characteristics of hematopoietic stem cell transplantation patients

Abstract The aim of this study is to investigate the relationship between the epidemiological and clinical profiles of patients before and after hematopoietic stem cell transplantation (HSCT) and the need for endodontic treatment. The subjects included 188 individuals enrolled in the dental care program for transplanted patients of the School of Dentistry, Federal University of Minas Gerais (Faculdade de Odontologia da Universidade Federal de Minas Gerais, FO-UFMG) from March 2011 through March 2016. The patients were subjected to an HSCT conditioning dental regimen based on a thorough clinical and radiographic evaluation. Intraoral periapical and bite-wing X-rays were obtained, and after evaluation, specific dental treatment was planned and performed. The following demographic and clinical data were collected from the patients' medical records: age, gender, transplantation stage, primary disease, transplant type, medication used, complete blood count at the time of visit, and need for endodontic treatment. The Kolmogorov-Smirnov and the chi-square tests were used. Leukemia (31.3%) and multiple myeloma (17.9%) were the most prevalent primary diseases. Most patients were subjected to allogeneic-related transplantation (83.6%). Most patients exhibited platelet counts and hemoglobin concentrations below the reference values in the pre-transplantation stage, while the neutrophil and platelet counts and the hemoglobin levels were within the reference ranges in the post-transplantation stage. The proportions of individuals requiring endodontic treatment were similar between the pre- and post-transplantation groups: 24.3% and 24.7%, respectively. The systemic conditions of the patients referred for dental treatment were compromised.

Análise do conhecimento dos pais/responsáveis pelas crianças atendidas na clínica infantil da Unimontes sobre traumatismos dentários / Knowledge of dental trauma of parents / caregivers of children treated at Unimontes pediatric clinic

Objetivo: Verificar se os pais / responsáveis pelas crianças, com histórico ou nÆo de trauma dentário, atendidas na Clínica Infantil da Unimontes, tinham conhecimento sobre traumas dentoalveolares e acesso a informaçães pertinentes aos procedimentos em atendimentos emergenciais que envolvem estes tipos de lesães. Método: Participaram 73 responsáveis pelas crianças. A coleta foi realizada por meio de um questionário, abordando a história de trauma das crianças e o conhecimento e atitudes dos responsáveis em atendimentos emergenciais que envolvem traumas dentários. Os dados foram analisados utilizando os Testes Qui-quadrado (χ2) e Mann Whitney, com nível de confiança de 95%. Resultados: Segundo o relato dos pais/responsáveis, 25,0% das crianças apresentaram história de trauma dental, em 83,3% destes casos, o trauma foi em decorrência de queda, e 72,2% ocorreram na própria casa da criança. Os dentes decíduos anteriores foram os mais envolvidos (94,4%), a fratura de esmalte dentário a mais prevalente (38,9%), seguida de escurecimento dental (33,3%). Independentemente das crianças terem ou nÆo uma experiência prévia com trauma dentário, a minoria (8,3%) e nenhum (0,0%) dos pais/responsáveis tinham conhecimentos adequados de como agir em situaçães de fratura dentária e avulsÆo dentária, respectivamente. NÆo houve associaçÆo significativa entre o conhecimento dos responsáveis e conduta frente à fratura e avulsÆo dentária, quando se considerou o nível socioeconômico e escolaridade dos pais / responsáveis (p>0,05%). A maioria dos pesquisados declarou que nÆo tinha recebido orientaçães sobre condutas tomadas em casos de traumatismo dentário (83,3%) e gostaria de receber mais informaçães sobre o assunto (91,7%). ConclusÆo: Observou-se a carência de informaçães e conhecimento dos pais/responsáveis quanto ao atendimento de urgência em casos de traumas dentários independente das suas crianças terem ou nÆo uma experiência prévia com trauma dentário...

Objective: To verify whether the parents/caregivers of children with and without dental trauma history treated at the UNIMONTES Pediatric Clinic had knowledge of dentoalveolar traumas and access to information pertinent to the emergency procedures care involving these types of lesions. Method: Seventy-three parents/caregivers took part in the study. Data collection was performed by using a questionnaire arguing on the children?s history of trauma, and also the knowledge and attitudes of the parents/caregivers about the emergency procedures involving dental trauma. Data were analyzed using the chi-square and Mann-Whitney tests, with a 95% confidence level. Results: According to the parents/caregivers, 25.0% of the children had history of trauma and 83.3% of these cases were due to falls and 72.2% occurred at home. The primary anterior teeth were the most affected (94.4%), enamel fracture was the most prevalent type of fracture (38.9%), followed by tooth darkening (33.3%). Regardless of the children having or not history of dental trauma, the parents/caregivers had little or no adequate knowledge on how to act in situations involving dental fracture (8.3%) and dental avulsion (0.0%). There was no significant association between the parents/caregivers? knowledge and their attitude when dealing with dental fracture and avulsion, when the parents/caretakers? socioeconomic level and instruction was considered (p>0.05). Most participants affirmed that they had not been instructed on how to behave in case of the dental trauma (83.3%) and would like to have more information on this subject (91.7%). Conclusion: Parents / caregivers did not have information and knowledge of emergency care on dental trauma cases, regardless whether their children had history of dental trauma or not...

Perception of orthodontists regarding the management of root resorption – clinical and legal aspects

Aim: To evaluate the management adopted by orthodontists regarding root resorption caused byorthodontic treatment, relating it to their time of experience and the applicable legal norms.Methods: the study population consisted of 56 orthodontists from the city of Belo Horizonte(Minas Gerais State), and the tool to collect the data was a questionnaire with open and closedquestions. Data were subjected to descriptive analysis. The association between the variableswas analyzed by the chi-square test with significance level of 5%. Results: 57.6% of professionalstemporarily interrupt the treatment; in the prevention and/or control, most professionals (80.4%)perform initial and periodical radiographs (every six months). Among the professionals with lessthan 5 years of experience as a specialist, 88.9% usually make periodic radiographic control;100% affirmed to file the documents. No significant difference was found between dentists withdifferent times of experience regarding the practice of archiving the documents (p = 0.271).Among those with 5-15 years of experience, 77.4% perform periodic radiographic control and45.2% had already detected root resorption. Among those with more than 15 years of experience,71.4% usually perform the periodic radiographic control, and 85.7% had already faced somecase of root resorption in the clinical practice. Conclusions: Although most orthodontists adopt acorrect management facing the occurrence, prevention and control of root resorption associatedwith orthodontic treatment, the majority are unaware about existing legislation in our country.

Geometric and dimensional characteristics of simulated curved canals prepared with proTaper instruments

OBJECTIVE: This study identified which regions of ProTaper instruments work during curved root canal instrumentation. MATERIAL AND METHODS: Twelve ProTaper instruments of each type, S1, S2, F1, and F2, were assessed morphometrically by measuring tip angle, tip length, tip diameter, length of each pitch along the cutting blades, and instrument diameter at each millimeter from the tip. Curved canals in resin blocks were explored with manual stainless steel files and prepared with ProTaper instruments until the apical end following four distinct sequences of instrumentation: S1; S1 and S2; S1, S2, and F1; S1, S2, F1, and F2. Image analysis was employed for measuring canal diameters. The diameters of the canals and diameters of the instruments were compared. Data were analyzed by one-way ANOVA and Tukey's test. RESULTS: No statistically significant difference was found between the canals and instrument diameters (p>0.05). The largest diameters in the end-point of the instrumented canals were obtained with F1 and F2 instruments and in the initial and middle thirds with S1 and S2 instruments. CONCLUSIONS: All instruments worked at the tip and along their cutting blades, being susceptible to fail by torsion, fatigue, or the combination of these two mechanisms.

Características físicas, estruturais e mecânicas de instrumentos endodônticos de NiTi ProTaper / Physical, structural and mechanical characteristics of ProTaper nickel-titanium endodontic instruments

Neste trabalho foi realizado um estudo das características estruturais, físicas e mecânicas de instrumentos endodônticos de NiTi ProTaper. As características geométricas e dimensionais dos instrumentos foram analisadas utilizando microscópio óptico. Canais curvos em blocos de acrílico formatados por estes instrumentos foram analisados utilizando um programa de análise de imagens com o intuito de verificar a geometria. As características topográficas foram avaliadas por microscopia eletrônica de varredura (MEV), a composição química foi analisada semi-quantitativamente por espectrometria de energia de raio-X (EDS), a estrutura cristalina da liga identificada por difração de raio-X (DRX), enquanto que as temperaturas de transformação foram determinadas por calorimetria exploratória diferencial (DSC). O comportamento mecânico foi avaliado através de ensaios de torção e flexão, de acordo com a especificação ISO 3630-1. A resistência à fadiga foi avaliada em um dispositivo de bancada utilizando um canal artificial com raio de curvatura de 5 mm e ângulo de 45°. Foi também avaliada a influência da deformação cíclica em torção nas propriedades torcionais e na resistência à fadiga flexural. Os instrumentos apresentaram boa padronização geométrica, características superficiais aceitáveis, adequada razão estequiométrica, predominância de fase B e temperaturas de transformação favoráveis à ocorrência de superelasticidade. Os diâmetros obtidos nos canais de acrílico foram fortemente relacionados com as dimensões do último instrumento empregado na formatação. Todos os instrumentos exerceram trabalho na ponta e ao longo das hastes cortantes...

A percepçäo de mäes pertencentes a diferentes níveis sócio-econômicos sobre a saúde bucal dos seus filhos bebês / The perception of mothers from diferent socioeconomic levels about their babies oral health

Para a realizaçäo de um trabalho bem sucedido de promoçäo de saúde bucal é fundamental conhecer as necessidades e limitaçöes da comunidade assistida. Além disso, quanto mais precocemente forem empregadas medidas educativas e preventivas, melhores resultados poderäo ser obtidos. Sendo assim, o objetivo deste estudo foi avaliar o nível de conhecimento das mäes de crianças de zero a três anos sobre a saúde bucal de seus filhos bebês. A técnica da entrevista dirigida com classificaçäo dos resultados foi aplicada em 68 mäes, sendo 34 correspondentes ao nível sócio-econômico alto(A), cujos filhos frequentavam escolas particulares, e 34 pertencentes ao nível sócio-econômico baixo(B), cujos filhos frequentavam creches públicas, em Belo Horizonte, MG. Observou-se que 67,7 por cento das mäes de nível sócio-econômico A conheciam adequadamente os cuidados para com a saúde bucal dos seus filhos, contra apenas 17,6 por cento do nível B. Na categoria A, 82,3 por cento das mäes já tinham recebido orientaçöes sobre a saúde bucal das crianças e na B apenas 14,7 por cento das mäes. O maior responsável por estas informaçöes foi o Cirurgiäo Dentista (70,6 por cento/A, 11,8 por cento/B). Das mäes de nível A, 94,1 por cento tinham conhecimento sobre a dieta mais adequada ao bebê, contra 35,3 por cento das de nível B. A frequência e momento adequados em relaçäo a higiene bucal das crianças foram maior em A (70,6 por cento), em comparaçäo com B (23,5 por cento). A totalidade das mäes A (100 por cento) sabiam a finalidade do uso de fluoretos, contra 58,8 por cento das mäes B. Tendo em vista os resultados, nota-se que as mäes de nível sócio-econômico A detiveram uma manancial de informaçöes sobre a saúde bucal de seus filhos, o que näo ocorreu com mäes de nível sócio-econômico B, indicando que o fator sócio-econômico interfere marcadamente no acesso à informaçäo

Desvio apical de canais radiculares com limas de níquel-titânio acionadas a motor e manuais de aço inoxidável / Lateral deviations in root canals using rotatory nickel-titanium instruments and hand stainless steel files

O propósito deste estudo foi investigar a manutençäo do trajeto original do canal, quando formatado com instrumentos de NiTi ProFile .04 Série 29 acionados a motor e limas tipo K de aço inoxidável. O tempo gasto também foi avaliado. Foram selecionadas as raízes mesiais de 32 molares inferiores humanos, com curvatura variando entre 26§ e 40§. Trinta e dois canais (16MV e 16ML) foram formatados com instrumentos de NiTi acionados a motor, a os 32 restantes (16MV e 16ML) com limas manuais de aço inoxidável. A manutençäo do trajeto original do canal foi determinada pela sobreposiçäo das radiograias de odontometria e pós-formataçäo (instrumento no CT) para examinar o desvio. A incidência de desvio, durante a instrumentaçäo, näo foi diferente estatisticamente entre os dois grupos. Entretanto, em relaçäo ao tempo, os instrumentos de NiTi acionados a motor foram significativamente mais rápidos que os de aço inoxidável. Ocorreram duas fraturas e uma deformaçäo de limas ProFile .04 Série 29