Tradução e adaptação brasileira do Questionnaire D'Alimentation / Brazilian translation and adaptation of theQuestionnaire D'Alimentation

RESUMO: Objetivo: traduzir o instrumento em língua francesa "Questionnaire D'Alimentation" para o português brasileiro e realizar a adaptação transcultural em adolescentes brasileiros. Métodos: a tradução foi realizada com base em protocolo que consistiu na tradução para o português brasileiro (por um professor formado em Letras e uma Cirurgiã Dentista fluentes em francês), tradução reversa para o francês (realizada por dois professores de francês), revisão por Comitê de especialistas (duas tradutoras, uma nativa e uma juramentada, e duas professoras universitárias, sendo uma Cirurgiã Dentista e uma Fonoaudióloga) e equivalência cultural (pré-teste). A versão utilizada no pré- teste consistiu de 26 questões com cinco respostas possíveis (5-Likert), distribuídas em cinco domínios (Alimentação- mastigação, Hábitos, Carnes, Frutas e Legumes). O pré-teste e teste-reteste foram realizados com uma amostra de 20 adolescentes (10 meninos/10 meninas) de escolas públicas de Piracicaba (Brasil). Nesta fase, a alternativa "não entendi" foi incluída a cada questão, a fim de identificar aquelas não compreendidas. A confiabilidade teste-reteste foi avaliada para cada domínio utilizando os coeficientes de correlação intra-classe (CCI). Resultados: no pré-teste, foi observada uma excelente compreensão do instrumento; no teste-reteste, os CCIs variaram entre 0,45-0,81 (moderada a excelente concordância). Conclusão: a versão em Português do Questionnaire D'Alimentationmostrou ser de fácil compreensão por parte dos adolescentes brasileiros e útil na avaliação da função mastigatória e dos distúrbios de alimentação e deglutição que podem alterar a ingestão de alimentos.

ABSTRACT: Purpose: to translate the French language instrument "Questionnaire D'Alimentation" to Brazilian Portuguese and culturally adapt it for adolescents. Methods: the translation was based on a protocol that consisted of translation to Brazilian Portuguese (by a professor with a Literary Arts degree and a Doctor of Dental Surgery, both fluent in French and Brazilian Portuguese); back-translation into French; revision by a Committee of specialists (two translators, one native and one sworn translator, and two university professors, one being a Doctor of Dental Surgery and a Speech Therapist) and cultural equivalence (pre-test). The version used in the pre-test consisted of 26 questions with five possible responses (5-Likert), distributed in five domains (Food-Mastication, Habits, Meats, Fruits and Vegetables). The pre-test and test-retest was performed with a sample of 20 adolescents (10 boys/10 girls) from public schools of Piracicaba (Brazil). At this stage, the alternative "I did not understand" was added to each question in order to identify those that were not understood. Test-retest reliability was assessed for each domain using intra-class correlation coefficients (ICCs). Results: in the pre-test, an excellent comprehension of the instrument was observed; in test-retest, ICCs ranged from 0.45 to 0.81 (moderate to excellent agreement). Conclusion: the Portuguese version of the Questionnaire D'Alimentationhas shown to be easy to understand by Brazilian adolescents and useful in the evaluation of the masticatory function and feeding or swallowing disorders that may affect food intake.

Family risk as adjunct for organizing the demand for oral health service in the Family Health Strategy / Risco familiar como elemento para organização da demanda em saúde bucal na Estratégia Saúde da Família

Introduction: One of the main problems of the public health services, in which the family oral health team is included, is access by users to dental treatment in primary care, with particular reference to caries disease. Objective: The aim of this study was to evaluate the relationship between family risk, for prioritization of home visits and oral health conditions, with a view to providing evidence about the first indicator for organizing the demand for oral health in the Family Health Strategy (FHS). Method: The application of family health is based on Form A of the primary care information database SIAB ("Sistema de Informação de Atenção Básica"), used for registering families with the FHS. Eleven dentists examined the oral health conditions of 1165 persons (608 from 12 to 19 years; and 557 from 35 to 44 years of age), classifying them into six codes from A to F. Multinomial logistic regression was used (α=0.05) to analyze the association between family risk variables and oral health situation. Result: There was significant association between family risk and presence of caries disease with treatment needs (OR: 2.08, p<0.0001). Conclusion: Persons who have family risk would have twice as much chance of presenting caries disease in comparison with those without risk, corroborating the relevance of this element in organizing the demand for oral health. .

Introdução: Um dos principais problemas dos serviços públicos de saúde, em que a equipe de saúde bucal da família está inserida, é o acesso dos usuários ao tratamento odontológico na atenção primária, principalmente no que se refere à doença cárie. Objetivo: O objetivo deste estudo foi avaliar a relação entre risco familiar - para priorização de visitas domiciliares - e condições de saúde bucal, visando a prover evidência sobre o primeiro indicador para organização da demanda em saúde bucal, na Estratégia Saúde da Família (ESF). Método: A verificação do risco familiar baseou-se na ficha A do SIAB, utilizada para o cadastramento das famílias na ESF. Onze cirurgiões dentistas examinaram as condições de saúde bucal de 1165 pessoas (608 de 12 a 19 anos e 557 de 35 a 44 anos de idade), classificando-as em seis códigos de A a F. Empregou-se a regressão logística multinomial (α=0,05) para análise da associação entre as variáveis de risco familiar e a situação de saúde bucal. Resultado: Houve associação significativa entre risco familiar e presença da doença cárie com necessidade de tratamento (OR: 2,08; p<0,0001). Conclusão: As pessoas que possuem risco familiar teriam duas vezes mais chance de apresentar a doença cárie em comparação às sem risco, corroborando a relevância deste elemento na organização da demanda em saúde bucal. .

Evaluation of proximal enamel thickness and crown measurements in maxillary first premolars

Estimating enamel thickness and planning the resultant optimal morphology of premolars aresubstantial steps before interproximal stripping. Aim: To analyze proximal enamel thickness andcrown measurements in maxillary premolars. Methods: The mesiodistal, buccolingual andcervico-occlusal measurements of 40 human maxillary first premolars (20 right, 20 left) wereregistered with a digital caliper. The teeth were embedded in acrylic resin and sectioned mesiodistallyat the level of the contact areas to obtain 1 mm-thick central sections. Enamel thickness on theproximal surfaces was measured using a perfilometer. Measurements were compared by theStudent’s t-test (α = 0.05). Results: The mean enamel thickness on the mesial surface was 1.22mm for the right (± 0.17) and left (± 0.18) sides. On the distal surface, the corresponding valueswere 1.28 mm (± 0.19) on the right side and 1.39 mm (± 0.17) on the left side. Mean values, inmillimeters, for the mesiodistal, buccolingual and cervico-occlusal measurements on both sidesranged from 7.03 (± 0.43) to 7.07 (± 0.48), 9.59 (± 0.48) to 9.65 (± 0.58) and 8.65 (± 0.66) to8.85 (± 0.65), respectively. There were no significant differences between right and left teeth.However, enamel thickness was significantly greater (p<0.05) on the distal surface. Conclusions:In maxillary first premolars, considering the greater thickness of distal enamel, interproximalstripping during orthodontic treatment may be more pronounced on this surface. The greatestmean value was observed for the buccolingual crown measurement, followed by the cervicoocclusaland mesiodistal dimensions.

Orthodontic retainers: analysis of prescriptions sent to laboratories

OBJECTIVE: To investigate the most commonly fabricated orthodontic retainers. METHODS: Information on the type and amount of maxillary and mandibular retainers produced in a three-month period was collected from six laboratories in the cities of São Paulo, Mauá and Guarulhos - Brazil. The retainers were grouped according to the total production. For the maxillary arch, the groups were: 1S - Begg retainer, 2S - Hawley retainer, 3S - transpalatal arch retainer, 4S - buccal resin-arch retainer and 5S - vacuum-formed retainer, Planas appliance, bonded lingual retainer and V-loop bonded lingual retainer. The groups relative to the mandibular arch were: 1I - 3-3 bonded lingual retainer (canine to canine), 2I - Hawley retainer and V-loop bonded lingual retainer, 3I - Begg retainer, 4I - buccal resin-arch retainer, vacuum-formed retainer and Planas appliance. The data were presented in box plots. Groups were compared using the Student's-t test with Bonferroni correction. RESULTS: The average of maxillary appliances fabricated ranged from 189.5 (1S) to 3.95 (5S). There were significant differences between groups 1S versus 5S and 2S versus 5S (p < 0.0001). Mean values for the mandibular retainers ranged from 55.3 (1I) to 4.2 (4I). Significant difference was observed between groups 2I and 4I (p < 0.0001). CONCLUSIONS: For the maxillary arch, the most requested retainers were Begg and Hawley retainers. Regarding the mandibular arch, bonded lingual retainers and Hawley retainer were the most frequent ones.

Associação entre flexão da base do crânio e prognatismo maxilar em dois grupos raciais / Association between cranial base flexure and maxilllary prognathism in two racial groups

A associação entre flexão da base do crânio e prognatismomaxilar foi avaliada em dois grupos raciais brasileiros. A amostraconsistiu de 240 crânios macerados de leucodermas (n = 120) emelanodermas (n = 120) de ambos os gêneros. A flexão da base docrânio e o prognatismo maxilar foram investigados por meio da estimativados valores médios dos ângulos NHBa e NABa, respectivamente.Aplicou-se o teste t Student (a = 0,05) nas comparações dos valoresmédios do ângulo NHBa, entre grupos raciais e gêneros. A associaçãoentre os ângulos NHBa e NABa foi avaliada pela análise de correlaçãolinear. Os valores médios do ângulo NHBa apresentaram-se maiores emmelanodermas (femininos = 183° e masculinos = 181,7°), comparadosaos leucodermas (femininos = 180,7° e masculinos = 178,4°), p <0,01. A maioria das correlações entre os ângulos NHBa e NABa não foisignificativa. Houve diferenças raciais e dimorfismo sexual no que serefere à flexão da base do crânio. As correlações entre as grandezasangulares que medem a flexão da base do crânio e o prognatismo maxilarnão foram significativas, à exceção dos melanodermas femininos.Sugere-se uma tendência para a elevação do prognatismo maxilar àmedida que aumenta a inflexão da base do crânio no referido grupo.

The association between cranial base flexure and maxillaryprognathism was assessed in two Brazilian racial groups. Thesample comprised 240 dry skulls of white (n = 120) and black (n = 120)Brazilians, of both genders. Cranial base flexure and maxillary prognathismwere investigated by estimating the mean values of the NHBa andNABa angles, respectively. TheNHBa angle mean values were comparedbetween racial groups and genders using the student t-test (a = 0.05).The association between NHBa and NABa angles was assessed by thelinear correlation analysis. NHBa angle mean values were higher in blackindividuais (females = 183° and males = 181.7"), compared with whiteindividuais (females = 180.;0 and males = 178.4°), p < 0.01. Most ofthe correlations between NHBa and NABa angles were not significant.Concerning the cranial base flexure, there were racial differences andsexual dimorphism. The correlations between the angular variables usedto estimate cranial base flexure and maxillary prognathism were notsignificant, except for black females. It may be suggested that a trendto increased maxillary prognathism is related to the enlargement of thecranial base flexure angle in the above-mentioned group.

Association between nonnutritive sucking habits and anterior open bite in the deciduous dentition of Japanese-Brazilians

OBJECTIVE: Assess the association between nonnutritive sucking habits and anterior open bite in the deciduous dentition of Japanese-Brazilian children. METHODS: 410 children of Japanese origin were assessed, 206 boys and 204 girls, between 2 and 6 years of age, in schools in São Paulo State, Brazil. Questionnaires concerning their nonnutritive sucking habits were sent to their legal guardians. Chi-square tests (p<0.05) were applied to assess the association between nonnutritive sucking habits and anterior open bite, and the logistic regression test to obtain the relative risk. RESULTS: The prevalence of sucking habits found in the sample was of 44.6% and for the anterior open bite, 4.4%. There was a statistically significant association between anterior open bite and sucking habits (O.R.=10.77), persistence of sucking habits from 2 to 4 years old (O.R.=22.06), and the persistence of sucking habits from 4 to 6 years old (O.R.=17.31). As for the interruption period of the habit, the group that had interrupted the habit for a period equal or inferior to six months showed an increased prevalence of open bite compared to the group without this habit or in which the habit was interrupted for more than six months. CONCLUSION: Japanese-Brazilian children that had sucking habits have greater chance of acquiring anterior open bite in the deciduous dentition.

Avaliação comparativa do espaçamento anterior em nipo-brasileiros e leucodermas, na dentição decídua / Comparative assessment of anterior spacing in Japanese-Brazilian and white children in the primary dentition

OBJETIVO: avaliar comparativamente a prevalência das características de espaçamento anterior em nipo-brasileiros e leucodermas, na dentição decídua. MÉTODOS: duas amostras de crianças com 2 a 6 anos de idade foram selecionadas: 405 nipo-brasileiros de 36 escolas do estado de São Paulo e 510 leucodermas de 11 instituições públicas da cidade de São Paulo. As variantes oclusais foram classificadas em quatro categorias, nas arcadas superior e inferior: espaçamento generalizado; somente espaços primatas; ausência de espaços; e apinhamento. Foi aplicada regressão logística para análise do efeito dos fatores idade, sexo e grupo étnico sobre a prevalência das características oclusais (α = 0,05). RESULTADOS: em nipo-brasileiros, o espaçamento generalizado foi a característica mais prevalente nas arcadas superior (46,2 por cento) e inferior (53,3 por cento). A frequência dos espaços primatas foi maior na arcada superior (28,2 por cento versus 15,3 por cento). Para a ausência de espaços (21,7-26,4 por cento) e o apinhamento (4,0-4,9 por cento), a variação entre as arcadas foi relativamente pequena. Em leucodermas, a ausência de espaços e a presença exclusiva dos primatas evidenciaram distribuição similar à observada nos nipo-brasileiros. O espaçamento generalizado foi diagnosticado em aproximadamente 50 por cento das arcadas. A prevalência de apinhamento foi maior na arcada inferior (12,8 por cento versus 3,9 por cento). O único modelo de regressão logística que apresentou algum fator significativo foi o ajustado para a prevalência de apinhamento. Apenas o fator racial foi significativo (p < 0,001). CONCLUSÃO: sugere-se que as características de espaçamento anterior, na dentição decídua, não estariam condicionadas à idade ou ao sexo. Contudo, leucodermas teriam chances 2,8 vezes maiores de apresentar apinhamento na arcada inferior, em comparação aos nipo-brasileiros.

OBJECTIVE: To carry out a comparative evaluation of the prevalence of anterior spacing characteristics in Japanese-Brazilian and white children in primary dentition. METHODS: Two selected samples of children aged 2-6 years were: 405 Japanese-Brazilians from 36 schools in the State of São Paulo and 510 white children from 11 public institutions in São Paulo city. The spacing features in the maxillary and mandibular arches were assigned to four categories: generalized spacing; only primate spaces; no spacing; and crowding. Logistic regression was used to analyze the effect of age, gender and ethnic group on the prevalence of the occlusal characteristics (α=0.05). RESULTS: In Japanese-Brazilians, generalized spacing was the most prevalent trait in the maxillary (46.2 percent) and mandibular (53.3 percent) arches. The frequency of primate spaces was higher in the maxillary arch (28.2 percent versus 15.3 percent). Concerning no spacing (21.7-26.4 percent) and crowding (4.0-4.9 percent), the variation between arches was relatively small. In white children, no spacing and exclusive presence of primate spaces showed distributions similar to that observed in Japanese-Brazilians. Generalized spacing was diagnosed in approximately 50 percent of the arches. Crowding prevalence was higher in the mandibular arch (12.8 percent versus 3.9 percent). The regression model adjusted for crowding prevalence was the only significant one. Only racial factor was significant (p<0.001). CONCLUSION: It may be suggested that anterior spacing features in primary dentition would not be influenced by age or gender. Nevertheless, white children would have 2.8 times more chances of presenting crowding in the mandibular arch, in comparison with Japanese-Brazilians.

Análise da forma do arco dentário e da distância intercaninos em más-oclusões de classe I / Assessment of arch form and intercanine width in class I malocclusions

Há um interesse clínico justificável pela avaliação do formato de arco mais favorávelà estabilidade pós-correção ortodôntica. Assim, o objetivo deste estudo foi compararas formas dos arcos dentários e as distâncias intercaninos maxilar e mandibular antes eapós o tratamento, em más-oclusões de Classe I. A amostra incluiu 28 pares de modelosde estudo pré e pós-tratamento de pacientes dos 11 anos e sete meses aos 24 anos eum mês de idade no início do tratamento e dos 13 anos e 11 meses aos 25 anos e setemeses ao final (22 do gênero feminino, seis do masculino). Um examinador calibrado avaliouas formas dos arcos com gabaritos Ortho Form e mensurou as distâncias intercaninospor meio de paquímetro digital (precisão de 0,01 mm). A análise das coincidências entreformatos dos arcos foi realizada pela estatística Kappa. As distâncias intercaninos foramcomparadas pelo teste t Student (a = 5%). O formato ovoide foi o mais frequente pré e póstratamento,apesar dos coeficientes Kappa terem indicado 30% e 14,5% de coincidência paraos arcos maxilar e mandibular, respectivamente. As distâncias intercaninos maxilares pré(34,66 mm ± 2,7 mm) e pós-tratamento (34,76 mm ± 2,0 mm) não diferiram estatisticamente.Também não houve diferenças significativas entre as distâncias intercaninos mandibularespré (26,98 mm ± 2,0 rnrn) e pós-tratamento (26,40 mm ± 1,7 rnrn). Nos casos tratados demás-oclusões de Classe I, o formato ovoide foi o mais prevalente em ambos os arcos e asdistâncias intercaninos não foram significativamente alteradas.

There is a justifiable clinical interest in the assessment of the most favorablearch form related to post-treatment stability in Orthodontics. Thus, the aim of this study wasto compare pre- and post-treatment maxillary and mandibular arch forms and intercaninewidths, in Class I malocclusions. The sample consisted of 28 pre- and post-treatment pairsof study casts taken from patients aged 11 years and 7 months to 24 years and 1 month atthe beginning of treatment and from 13 years and 11 months to 25 years and 7 months atthe end (22 females, 6 males). One calibrated examiner assessed arch forms using the OrthoForm templates and measured intercanine widths by means of a digital caliper (accurate to0.01 mm). Analysis of coincidence between arch forms was carried out using Kappa statistics.Intercanine widths were compared using the student's t-test (a = 5%). Ovoid was themost frequent pre- and post-treatment arch form, although kappa coefficients have indicated30% e 14.5% of coincidence for the maxillary and mandibular arches, respectively. Pre-(34.66 mm ± 2.7 mm) and post-treatment (34.76 mm ± 2. Omm) maxillary intercanine widthswere not statistically different. Similarly, no significant differences were found between pré(26.98 mm ± 2.0 mm) and post-treatment (26.40 mm ± 1.7 mm) mandibular intercaninewidths. After treatment of these Class I malocclusions, the ovoid shape was the most prevalentone in both dental arches and the intercanine widths were not significantly modified.

Crown dimensions and proximal enamel thickness of mandibular second bicuspids

To achieve proper recontouring of anterior and posterior teeth, to obtain optimal morphology during enamel stripping, it is important to be aware of dental anatomy. This study aimed at evaluating crown dimensions and proximal enamel thickness in a sample of 40 extracted sound, human, mandibular, second bicuspids (20 right and 20 left). Mesiodistal, cervico-occlusal and buccolingual crown dimensions were measured using a digital caliper, accurate to 0.01 mm. Teeth were embedded in acrylic resin and cut along their long axes through the proximal surfaces to obtain 0.7 mm-thick central sections. Enamel thickness on the cut sections was measured using a perfilometer. Comparative analyses were carried out using the Student's-t test (α= 5 percent). The mean mesiodistal crown widths for right and left teeth were 7.79 mm (± 0.47) and 7.70 mm (± 0.51), respectively. Mean cervico-occlusal heights ranged from 8.31 mm (± 0.75) on the right to 8.38 mm (± 0.85) on the left teeth. The mean values for the buccolingual dimension were 8.67 mm (± 0.70) on the right and 8.65 mm (± 0.54) on the left teeth. The mean enamel thickness on the mesial surfaces ranged from 1.35 mm (± 0.22) to 1.40 mm (± 0.17), on the left and right sides, respectively. On the distal surfaces, the corresponding values were 1.44 mm (± 0.21) and 1.46 mm (± 0.12). No significant differences were found between measurements for right and left teeth. However, enamel thickness was significantly greater on the distal surfaces, compared with the mesial surfaces.

Relação entre o tempo de amamentação e o desenvolvimento de hábitos de sucção não nutritivos / Relantionship between breastfeeding duration and the development of non-nutritive sucking habits

O objetivo deste estudo epidemiológico transversal foi analisar a influência do tempo deamamentação, excluindo totalmente o uso de mamadeiras, no desenvolvimento de hábitos bucaisde sucção não nutritivos (chupeta ou dedos), na fase da dentadura decídua. Foram avaliadas 551crianças brasileiras, sendo 256 do sexo masculino e 295 do sexo feminino, com três a seis anos,matriculadas em uma escola pública da zona leste da cidade de São Paulo. A amostra foi dividida emcinco grupos, de acordo com o histórico do tempo de amamentação: grupo 1- nunca amamentadas;grupo 11- amamentação interrompida antes dos três meses; grupo 11I- amamentação entre o iníciodo terceiro mês e o final do quinto mês; grupo IV - amamentação interrompida entre o iníciodo sexto mês e o final do oitavo mês; grupo V - amamentação estendendo-se do nono mês emdiante. Os resultados foram analisados estatisticamente mediante o teste qui-quadrado (x2). Aprevalência do uso da chupeta permaneceu alta e constante nos grupos I, 11, 111 e IV, exibindoredução significante apenas no grupo V. Verificou-se ausência de relação significante entre operíodo de amamentação e a prevalência dos hábitos de sucção digital, assim como a ausênciade diferença entre os gêneros quanto à prevalência dos hábitos pesquisados. Concluiu-se quea amamentação estendida além dos nove meses de idade pode contribuir para a redução naprevalência do hábito de sucção de chupeta.

The purpose of this cross-sectional study was to analyze the influence of breastfeedingduration in the development of nonnutritive sucking habits (pacitier and/or digitsucsing), in the de deciduous dentition. The sample comprised 551 Brazilian children, 256 malesand 295 females, aged three to six years, enrolled in a publish school located in the eastzone of São Paulo city. The children were assigned in tive groups: group I - never breastfed;group II- breastfed for a period shorter than three months; group III, breastfed for three to tivemonths; group IV - breastfed for six to nine months; and group V, breastfed for nine monthsar longer. The results were submitted to chi-square (x2) statistical testo The prevalence of thepaGitier sucking habit, was high and relatively constant in groups I, II, III and II, and revealed asubstantial reduction only in group V There was absence of statistically signiticant differencesin the frequenGies of paGitier use end/or digit sucking habits between genders, regardless ofbreastfeeding duration. It was concluded that children who were breastfeed for nine months arlonger had a lower prevalence of paGitier sucking habit.

Association between infant feeding duration and the terminal relationships of the primary second molars

This study was developed to assess the effect of prolonged bottle feeding and breastfeeding on the anteroposterior relationship of the dental arches in 3-6-year-old children attending preschools in the eastern zone of São Paulo city. Methods: The association between infant feeding duration (artificial and natural) and occlusal characteristics were evaluated in 485 childrenat the stage of complete primary dentition, who attended municipal preschools in the eastern zone of São Paulo city. The information related to types and duration of child breastfeeding was investigated by means of questionnaires filled out by parents/guardians. The occlusal characteristics corresponding to the terminal relationships of the primary second molars were classified as vertical plane (VP), mesial step (MS) and distal step (DS). Logistic regression analysis (p < 0.05) was applied. Results: Considering the right and left sides, DS was diagnosed in 9.7% of the cases, MS in 14.2% and VP in 76.1%, without significant differences between sides and genders. The association between the presence of DS and the age of bottle-feeding and breastfeeding cessation was significantly high (p < 0.001). The older the child when bottle-feeding ceased (3-4 years old) and the shorter the breastfeeding duration (<3 months), the greater the chances of the child presenting DS. Conclusions: Breastfeeding duration is one of the factors that could influence the development of DS because the longer the breastfeeding duration, the higher the percentage of children who were not bottle fed, ranging from 5.8% (among children who interrupted breastfeeding before the age of 3 months) to 63.8% (after 12 months of age).

Breastfeeding and non-nutritive sucking patterns related to the prevalence of anterior open bite in primary dentition

OBJECTIVE: Nutritional, immunological and psychological benefts of exclusive breastfeeding for the frst 6 months of life are unequivocally recognized. However, mothers should also be aware of the importance of breastfeeding for promoting adequate oral development. This study evaluated the association between breastfeeding and non-nutritive sucking patterns and the prevalence of anterior open bite in primary dentition. MATERIAL AND METHODS: Infant feeding and non-nutritive sucking were investigated in a 3-6 year-old sample of 1,377 children, from São Paulo city, Brazil. Children were grouped according to breastfeeding duration: G1 - non-breastfed, G2 - shorter than 6 months, G3 - interruption between 6 and 12 months, and G4 - longer than 12 months. Three calibrated dentists performed clinical examinations and classifed overbite into 3 categories: normal, anterior open bite and deep bite. Chi-square tests (p<0.05) with odds ratio (OR) calculation were used for intergroup comparisons. The impact of breastfeeding and non-nutritive sucking on the prevalence of anterior open bite was analyzed using binary logistic regression. RESULTS: The prevalence estimates of anterior open bite were: 31.9 percent (G1), 26.1 percent (G2), 22.1 percent (G3), and 6.2 percent (G4). G1 would have signifcantly more chances of having anterior open bite compared with G4; in the total sample (OR=7.1) and in the subgroup without history of non-nutritive sucking (OR=9.3). Prolonging breastfeeding for 12 months was associated with a 3.7 times lower chance of having anterior open bite. In each year of persistence with non-nutritive sucking habits, the chance of developing this malocclusion increased in 2.38 times. CONCLUSIONS: Breastfeeding and non-nutritive sucking durations demonstrated opposite effects on the prediction of anterior open bite. Non-breastfed children presented signifcantly greater chances of having anterior open bite compared with those who were breastfed for periods longer than 12 months, demonstrating the benefcial infuence of breastfeeding on dental occlusion.

O formato dos arcos dentários em tomografia computadorizada por feixe cônico / The dental arch form in cone beam computed tomography

O formato dos arcos dentários tem implicações para a funcionalidade oclusal, estética do sorriso e da face, assim como para a estabilidade em longo prazo das correções ortodônticas. Desse modo, o objetivo neste estudo foi avaliar comparativamente o formato dos arcos maxilar e mandibular em imagens por tomografia computadorizada por feixe cônico (TCFC) e modelos de gesso. A amostra consistiu de imagens por TCFC e modelos de gesso pré-tratamento de 30 pacientes ortodônticos, de ambos os gêneros, com média de idadede 5,3 ± 25,4 anos. Um examinador treinado avaliou o formato dos arcos visualmente em imagens axiais por TCFC, adquiridas com o aparelho i-CAT (lrnaging Sciences, Hatfield, PA,EUA) e modelos de gesso, com o auxílio do gabarito Ortho Form (3M Unitek, Monrovia, CA, EUA).A análise estatística foi realizada por meio do teste de coincidência de McNemar-Bowker(a = 0,05). Para os arcos maxilar e mandibular, os formatos cônico de menor dimensão (40%-43,3%) e ovoide (26,7%) foram os mais frequentes. Não houve diferenças significantesentre os métodos na classificação do formato dos arcos maxilares e mandibulares. Conclui-se que as imagens por TCFC apresentam desempenho satisfatório para avaliação do formatodos arcos dentários durante diagnóstico e planejamento ortodôntico.

The dental arch form has been implicated in the occlusal function, smile andfacial esthetics, as well as in long-term stability of corrective orthodontic treatment. Thus, the aim of this study was to assess maxillary and mandibular arch form in cone beam computedtomography (CBCT) in comparison with the categorization by means of plaster models. The sample consisted of pre-treatment CBCT images and plaster models of 30 orthodontic patients, of both genders and mean age of 25.4 ± 5.3 years. A trained examiner assessed arch form by visual inspection on axial CBCT images, acquired with the i-CAT tomograph (Imaging Sciences, Hatlield, PA, USA), and plaster models using the Ortho Form template (3M Unitek,Monrovia, CA, USA). Statistical analysis was carried out using the McNemar-Bowker test of symmetry (a = 0.05). For maxillary and mandibular arches, parabolic with short dimension(40%-43.3%) and elliptical (26.7%) forms were the most frequent ones. No significant differences were found between the classification methods for maxillary and mandibular arches. It may be concluded that CBCT images demonstrated satisfactory performance for the assessment of dental arch form during orthodontic diagnosis and treatment planning.

Avaliação cefalométrica comparativa do índice de proporção entre as alturas faciais anterior e posterior, em pacientes não tratados ortodonticamente / Comparative cephalometric evaluation of the proportion index between anterior and posterior facial heights, in patients without orthodontic treatment

O índice da altura facial (IAF)exprime a rotação mandibular durante o tratamentoortodôntico e/ou crescimento craniofacial, de modo que seu controle ou modificação seja importante para o sucesso do tratamento ortodôntico. O objetivo neste trabalho foi estimaro IAF,segundo Horn, em pacientes portadores de má-oclusão, sem histórico de tratamento ortodôntico. Foram avaliadas telerradiografias em norma lateral de 50 pacientes, sendo 23do gênero masculino (na faixa etária dos oito anos e cinco meses aos 18 anos e quatro meses) e 27 do gênero feminino (na faixa etária dos oito anos e seis meses aos 22 anos e três meses). Um examinador calibrado realizou os traçados e as medições das alturas faciais anterior e posterior, para o cálculo do IAF.Foram determinadas as distribuições dos índices por gênero. Para a análise de diferenças dos índices médios quanto ao gênero foi aplicadoo teste t Student (a = 0,05). No grupo de pacientes do gênero masculino, a média do IAF foi de 0,6787 (dp = 0,0664); para pacientes do gênero feminino, a média foi de 0,6281 (dp = 0,0608). Os valores de referência para o IAF variaram de 0,65 a 0,75, indicando umcrescimento craniofacial harmonioso. Valores de IAF menores que 0,65 denotam um padrão facial hiperdivergente, com perfil convexo. Conclui-se que, para pacientes do gênero feminino, houve predomínio do padrão de crescimento hiperdivergente, com perfil facial convexo. Contudo, para o gênero masculino, o padrão de crescimento equilibrado, com perfil facial reto, foi observado com maior frequência.

The Facial Height Index (FHI)provides information on the mandibular rotationduring the orthodontic treatment stui/or craniofacial growth, hence, its control or modification is important for the orthodontic treatment be succeeded. The aim of this study was to estimate the FHI in patients with malocclusions, according to Horn, but without orthodontictreatment history. Lateral cephalometric radiographs of 50 patients, 23 males (aged between 8 years and 5 months to 18 years and 4 months) and 27 females (aged between 8 years and 6 months to 22 years and 3 months), were assessed. A calibrated examiner carried outthe tracings and the measurements of the anterior and posterior facial heights, in order to calculate the FHJ. The distributians ot the indexes were determined between genders. Thedifferences between the average indexes, according to gender, were analyzed using the student's t-test (a = 0.05). In male patients, the average FHI was 0.6787 (sd = 0.0664); for female patients, the average FHI was 0.6281 (sd = 0.0608). The reference FHI valuesvary trom 0.65 to 0.75, indicating a balanced;harmanious craniofacial growth. FHI values smaller than 0.65 are related to a facial hyperdivergent pattern, with convex profile. It maybe concluded that, for female patients, it was observed a hyperdivergent growth pattern, with convex facial profile. However, for the male ones, the growth pattern was balanced, with straight facial profile.

Mesiodistal width and proximal enamel thickness of maxillary first bicuspids

This study aimed at evaluating measurements relative to the mesiodistal crown width and enamel thickness of maxillary first bicuspids. The sample consisted of 40 extracted sound bicuspids (20 right and 20 left), selected from white patients (mean age: 23.7 ± 4.2 years), who were treated orthodontically with tooth extraction at a private clinic in São Paulo, SP, Brazil. All teeth were embedded in acrylic resin and cut along their long axis through the proximal surfaces, parallel to the buccal side, to obtain 0.6-mm central sections. The mesiodistal crown width and proximal enamel thickness were measured using a stereoscopic microscope connected to a computer. Measurements for right and left teeth, as well as the mesial and distal enamel thicknesses in the total sample, were compared by the Wilcoxon test (α = 0.05). The mesiodistal crown width mean values found were 7.51 mm (± 0.54) on the right side and 7.53 mm (± 0.35) on the left side. The mean enamel thickness on the distal surfaces for both sides was 1.29 mm (right: s.d. = 0.12 and left: s.d. = 0.18). The mean values for the mesial surfaces were 1.08 mm (± 0.14) and 1.19 mm (± 0.25), on the right and the left sides, respectively. No significant differences were found between the crown measurements and enamel thicknesses on the left and right sides. However, enamel thickness was significantly greater on the distal surfaces. Reliable measurements of enamel thickness are useful to guide stripping, which may be an attractive alternative to tooth extraction because it allows the transverse arch dimension to be maintained.

Effect of breast- and bottle-feeding duration on the age of pacifier use persistence

This study evaluated the effect of breast- and bottle-feeding duration on the age of pacifier use persistence. Questionnaires (n = 723) with information on nutritive and nonnutritive sucking habits of children aged 3-6 years were assessed. The sample was divided according to breastfeeding duration: G1 - non-breastfed, G2 - up to 3 months, G3 - discontinued between 4 and 6 months, G4 - discontinued between 7 and 12 months, and G5 - longer than 12 months. The children were also assigned to 4 groups by age of pacifier use persistence, as well as by age of bottle-feeding persistence: no habits, up to 2 years, 3-4 years and 5-6 years. Associations between nutritive sucking habits and pacifier use were analyzed using logistic regression. The larger breastfeeding groups were G2 (37.9 percent) and G4 (19.4 percent). Many children discontinued pacifier use and bottle-feeding at 3-4 years of age (24.9 percent and 40.1 percent, respectively). Chances of non-breastfed children (G1) with prolonged pacifier-sucking habits, in the three age ranges, were progressively higher in comparison with group G4 (OR: 4.0-7.5, p < 0.01). When comparing bottle-fed with non bottle-fed children, the age range at which bottle-feeding had been discontinued was significantly associated with that of pacifier use cessation: up to 2 years (OR = 6.2), 3-4 years (OR = 7.6) and 5-6 years (OR = 27.0), p < 0.01. It may be suggested that breastfeeding duration has an inversely proportional effect on the age of pacifier use persistence. Bottle-fed children who use pacifiers tend to discontinue these habits at the same period.

Estimativa radiográfica da espessura do esmalte proximal em primeiros pré-molares superiores / Radiographic estimate of approximal enamel thickness in maxillary first premolars

A estimativa radiográfica da espessura do esmalte é relevante para aplicação das técnicas de desgaste proximal no tratamento ortodôntico, visando evitar danos aos tecidos adjacentes. Esta pesquisa teve por objetivo validar estimativas da espessura doesmalte proximal, executadas por meio de radiografias convencionais, com base nos dados das análises de secções dentárias. Foram avaliadas imagens radiográficas das faces proximais de 40 dentes primeiros pré-molares superiores humanos hígidos extraídos. Dois examinadores em consenso realizaram as mensurações radiográficas com auxílio de paquímetro digital,sobre negatoscópio, em sala com baixa intensidade de luz. Para validação, secções longitudinais centrais dos dentes (1 mm) foram analisadas ao perfilômetro, instrumento de precisão milesima!. As análises comparativas foram viabilizadas pelo teste de Mann-Whitney (a = 5%). As médias de espessura do esmalte, nas imagens radiográficas das faces mesial e distal,foram equivalentes a ] ,28 mm (± 0,15) e ] ,27 mm (± 0,12), respectivamente. Por outro lado, ao perfilômetro, os valores foram: 1,22 mm (± 0,17) para a face mesial e ] ,32 mm (± 0,19) para a dista!. Não houve diferenças significantes entre dentesdos lados direito e esquerdo, para os dois métodos. Ao perfilômetro, a espessura média do esmalte foi maior na face distal(p < 0,0 I). Houve diferença significativa entre métodos para a espessura do esmalte na face distal; mais elevada ao perfilômetro(p < 0,05). A espessura do esmalte foi subestimada por mensurações radiográficas nas faces distais de primeiros pré-molares superiores. Contudo, sugere-se que a subestimativa radiográfica observada neste estudo não apresenta significância clínica.

Radiographic estimation of approximal enamel thickness is important for application of stripping techniques, during orthodontic treatment, to avoid damaging the adjacent tissues. The aim of this study was to validate the estimates of approximal enamelthickness, carried out using conventional radiographs, based on data from histological analysis of teeth sections. Radiographic images ofthe approximal surfaces of 40 extracted human maxillary first premolars were assessed. Measurements were performedby two examiners in consensus using digital caliper and viewing box, under subdued lighting in sec/uded room. For validation, longitudinal sections (1 mm), at the tooth center; were analyzed using a perfilometer; a higb precision measuring device. Data werecompared by Mann-Whitney test (a = 5%). Mean enamel thicknesses, in radiographic images ofthe mesial and distal surfaces, were equivalent to 1.28 mm (± 0.15) and 1.27 mm (± 0.12), respectively. However, by perfilometer; the values were: 1.22 mm (±0.17)for the mesial surface and 1.32 mm (± 0.19) for the distal one. No significant difJerences werefound between right and lefl teeth, by the studied methods. By perfilometer; the distal mean enamel thickness was greater compared with that for the mesial surface (p < 0.01). Considering the distal surface, there was significant difference between methods; mean enamel thickness washigher by perfilo meter (p < 0.05). Enamel thickness was underestimated by radiographic measurements in the distal surfaces of maxillaryfirst premolars. Nevertheless, it may be suggested that the radiographic underestimation observed in this study does nothave c1inicalsignificance.

Comparative study of dental arch width in plaster models, photocopies and digitized images

The aim of this study was to comparatively assess dental arch width, in the canine and molar regions, by means of direct measurements from plaster models, photocopies and digitized images of the models. The sample consisted of 130 pairs of plaster models, photocopies and digitized images of the models of white patients (n = 65), both genders, with Class I and Class II Division 1 malocclusions, treated by standard Edgewise mechanics and extraction of the four first premolars. Maxillary and mandibular intercanine and intermolar widths were measured by a calibrated examiner, prior to and after orthodontic treatment, using the three modes of reproduction of the dental arches. Dispersion of the data relative to pre- and posttreatment intra-arch linear measurements (mm) was represented as box plots. The three measuring methods were compared by one-way ANOVA for repeated measurements (á = 0.05). Initial / final mean values varied as follows: 33.94 to 34.29 mm / 34.49 to 34.66 mm (maxillary intercanine width); 26.23 to 26.26 mm / 26.77 to 26.84 mm (mandibular intercanine width); 49.55 to 49.66 mm / 47.28 to 47.45 mm (maxillary intermolar width) and 43.28 to 43.41 mm / 40.29 to 40.46 mm (mandibular intermolar width). There were no statistically significant differences between mean dental arch widths estimated by the three studied methods, prior to and after orthodontic treatment. It may be concluded that photocopies and digitized images of the plaster models provided reliable reproductions of the dental arches for obtaining transversal intra-arch measurements.

Correlação entre a presença do ceceio anterior e os tipos de trespasse vertical interincisivos na dentadura decídua / Correlation between anterior lisping and the vertical interincisal trespass in primary dentition

Introdução: Mediante um levantamento epidemiológico em 333 crianças brasileiras, 157 do gênero masculino e 176 do gênero feminino, na faixa etária dos 3 aos 6 anos de idade, matriculadas em uma escola de educação infantil na cidade de São Paulo, foram avaliadas as prevalências e as inter-relações dos diferentestipos de trespasse vertical interincisivos com o ceceio anterior. Métodos: Todas as crianças envolvidas foramsubmetidas ao exame clínico da oclusão no plano vertical anterior e à avaliação fonoaudiológica. Além da análise estatística descritiva, abrangendo o cálculo e a tabulação das prevalências dos quatro tipos de trespasse vertical interincisivos (normal, aumentado, nulo e negativo), bem como a da alteração fonoarticulatória estudada, efetuou-se a análise de significância estatística, mediante teste do Qui quadrado, com nível de significância de 0,05 (95% de confiança) para a verificação das possíveis relações entre esses dois fatores. Resultados: Os dados quantitativos mostraram as seguintes prevalências: 1 - tipos de trespasse verticalinterincisivos: 48,30% para o normal, 22,50% para o aumentado, 9,30% para o nulo e 19,80% para o negativo; e 2 - presença de ceceio anterior nos tipos de trespasse vertical interincisivos: 42% para o normal, 12,50% para o aumentado, 12,50% para o nulo e 32,90% para o negativo. Conclusão: Os resultados da análise estatística mostraram que houve significância para os portadores de ceceio anterior em relação ao trespasse vertical interincisivos negativo e significância estatística para os não portadores de ceceio anterior em relação ao trespasse vertical interincisivos aumentado

Relação entre hábitos de sucção não nutritivos e mordidas cruzadas posteriores na dentadura decídua / Relanshionshipbetween non-nutritive sucking habits and posterior crossbite in the deciduous dentition

Este estudo avaliou a relação entre os hábitos de sucção não nutritivos e a prevalência de mordidas cruzadas posteriores na dentadura decídua. Com este objetivo, foram realizados exames clínicos em 1.377 crianças brasileiras (690 do gênero masculino e 687 do feminino) com três a seis anos de idade, matriculadas em escolas infantis da cidade de São Paulo. Com base em questionários respondidos pelas mães, investigou-se até que idade as crianças persistiram com os hábitos de chupeta e/ou dedo, classificando-as em quatro grupos: G 1 (sem hábitos), G2 (até os dois anos), G3 (até os três a quatro anos) e G4 (até os cinco a seis anos). Aplicou-se o teste do qui-quadrado (p < 0,05) para avaliar a associação entre a idade de persistência destes hábitos e a presença de mordida cruzada posterior, assim como o cálculo do odds ratio (or) para determinar a razão de chances para o desenvolvimento da má-oclusão pesquisada. Os resultados demonstraram que as crianças que persistiram com os hábitos de chupeta e/ou dedo entre cinco e seis anos revelaram oito vezes mais chances para o desenvolvimento de mordidas cruzadas posteriores, em relação as crianças que nunca possuíram tais hábitos, enquanto que as crianças com hábitos de sucção não nutritivos até os dois anos de idade revelaram um risco quatro vezes maior. Portanto, concluiu-se que a idade de persistência dos hábitos de sucção não nutritivos exerce significativa influência no risco de desenvolvimento de mordidas cruzadas posteriores.

The aim of this study was to evaluate the relationship between non-nutritive sucking habits and the prevalence of posterior crossbite in the primary dentition of Brazilian children. The sample comprised 1377 Brazilian children, 690 males and 687 females, aged three to six years, enrolled in public preschools of São Paulo city. Questionnaires concerning the age of persistency of non-nutritive sucking habits were answered by their mothers and the children were G3 (between three and four years) and G4 (between five and six years). Chi-square test (p< 0.05) was used to analyze theassociation between non-nutritive sucking habits and the prevalence of posterior crossbite. Furthermore, odds ratio (or) was also calculated in order to investigate relative risks for the development of this malocclusion according to the age of persistency of the sucking habits. The results showed a significant association between non-nutritive sucking habits and the prevalence of posterior crossbite. Children that exhibited non-nutritive sucking habits between five and six years reveled an eight times higher risk for the development of posterior crossbite, when compared to children that never had non-nutritive sucking habits, whereas children that persisted with non-nutritive sucking habits for less than two years of age revealed a four times higher risk for the development of posterior crossbite.