Are Premature Birth and Low Birth Weight Associated with Delay on the Eruption of Deciduous Teeth? A Systematic Review and Meta-analysis

ABSTRACT Objective: To investigate whether children with premature birth (PB) and/or with low birth weight (LBW) have different tooth eruption patterns than those born at term or with normal weight. Material and Methods: Searches were performed in the PubMed, Cochrane Library, Sc1opus, Web of Science, LILACS, and BBO databases as well as the grey literature. Three independent reviewers were involved in study selection, data extraction, and bias assessment. The risk of bias was assessed using the Modified Newcastle-Ottawa Scale. Meta-analysis was conducted to compute the mean difference (MD) in mean chronological or adjusted age at the eruption of the first deciduous tooth between preterm children and those born at full term. The GRADE approach was used. Results: Among a total of 316 articles identified, 21 were eligible for inclusion and three were included in the meta-analysis. PB was associated with the delay in the first tooth deciduous eruption when chronological age was considered (MD: 1.36; 95%CI: 1.02-1.69) but not when considering adjusted age (MD: -0.30; 95%CI: -0.67-0.07). The evidence was graded as having very low quality. Conclusion: Based on a low certainty of evidence the PB is associated with the delayed eruption of the first deciduous tooth when considering chronological age but not when adjusted age is considered.

Oral manifestations and dental approach in pediatric patient with lamellar congenital ichthyosis: 36-month follow-up

Introduction: Lamellar ichthyosis is an autosomal recessive congenital disease that causes dryness of the skin in the perioral region, which leads to pain during dental hygiene. Thus, the diet of patients with this disease tends to be pasty, which can lead to oral problems. Hyposalivation is suspected to be an oral manifestation of lamellar ichthyosis and may exert an influence on the incidence of carious lesions. Objective: Describe the treatment of a female patient diagnosed with lamellar ichthyosis who sought dental care initially when two years of age with complaints of dental pain, feeding difficulties and low weight. Case report: Atraumatic restorative treatment, extractions and topical application of fluoride varnish were performed in the patient, aesthetic of posterior installation of space, which also functioned as a rehabilitator. Conclusion: This study reinforces the need for the follow-up of the patient with LI by the dental surgeon since the birth of the first tooth, as dryness of the perioral skin and hyposalivation are conditions reported in individuals with lamellar ichthyosis. These conditions can affect oral hygiene and the frequency of carious lesions.

Introdução: A ictiose lamelar é uma doença congênita autossômica recessiva que causa ressecamento da pele na região peribucal, o que leva à dor durante a higiene dental, por isso a alimentação dos pacientes com essa doença tende a ser pastosa, podendo levar a problemas bucais. Suspeita-se que a hipossalivação possa ser uma manifestação oral da ictiose lamelar, podendo influenciar na incidência de lesões cariosas. Objetivo: Descrever o tratamento de uma paciente do sexo feminino, inicialmente com 2 anos de idade, diagnosticada com ictiose lamelar (IL), que procurou atendimento odontológico com queixa de dor dentária, dificuldade na alimentação e baixo peso. Relato do caso: Tratamento restaurador atraumático, exodontias e aplicação tópica de verniz fluoretado foram realizados na paciente, além de posterior instalação de mantenedor de espaço, o qual também funcionou como reabilitador estético. Conclusão: Este estudo reforça a necessidade do acompanhamento do paciente com IL pelo cirurgião dentista desde o nascimento do primeiro dente, pois secura da pele perioral e hipossalivação são condições relatadas em indivíduos com ictiose lamelar. Essas condições podem afetar a higiene bucal e a frequência de lesões cariosas.

Performance of ICDAS e-learning program in teaching graduate students on the detection of occlusal caries / Desempenho do programa de aprendizagem eletrônico ICDAS no ensino de alunos de pós-graduação na detecção de cáries oclusais

ABSTRACT Objective: The aim was evaluate the validity and reproducibility of the International Caries Detection and Assessment System (ICDAS) in detecting occlusal caries among graduate students after training using the e-learning program. Methods: A sample of forty-two primary teeth with different ranges of occlusal caries was selected. All teeth were mounted on a wax support and standardized photographs (EOS Rebel XTI, Canon, NY, USA) of the occlusal surfaces were taken. An experienced researcher randomly selected one specific site on the occlusal surface of each tooth to be examined later. Fifteen graduate students with no previous experience in the ICDAS scores completed the ICDAS e-learning program in Portuguese. After the training, visual examination of the occlusal surfaces was taken twice, independently, with a two-week interval. After visual examination, the teeth were longitudinally sectioned 1mm away from the previously selected occlusal site. The teeth were fixed on a wax support and photographed. Histological analysis was performed from these photographs by an experienced researcher to evaluate the depth of demineralization. Results: The Intraclass Correlation Coefficient (ICC) inter-examiner values among all participants varied from 0.54 to 0.96 and intra-examiner ICC reproducibility of the examiners ranges from 0.61 to 0.85, showing good to excellent reproducibility. For detection of enamel and dentine lesions (D1), ICDAS obtained sensitivity 0.835 and specificity 0.756. For dentine lesions (D3), the method revealed an increase in sensitivity but specificity was similar to D1. Conclusion: ICDAS e-learning training program was efficient for the training of caries lesions detection among graduate students.

RESUMO Objetivo: O objetivo foi avaliar a validade e a reprodutibilidade do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS) na detecção de cárie oclusal entre estudantes de pós-graduação após o treinamento usando o programa de e-learning. Métodos: Foi selecionada uma amostra de 42 dentes decíduos com diferentes faixas de cárie oclusal. Todos os dentes foram montados em um suporte de cera e foram tiradas fotografias padronizadas (EOS Rebel XTI, Canon, NY, EUA) das superfícies oclusais. Um pesquisador experiente selecionou aleatoriamente um local específico na superfície oclusal de cada dente para ser examinado posteriormente. Quinze estudantes de pós-graduação sem experiência anterior com o ICDAS concluíram o programa de e-learning em português. Após o treinamento, o exame visual das superfícies oclusais foi realizado duas vezes, independentemente, com intervalo de duas semanas. Após o exame visual, os dentes foram seccionados longitudinalmente a 1mm do local oclusal previamente selecionado. Os dentes foram fixados em um suporte de cera e fotografados. A análise histológica foi realizada a partir dessas fotografias por um pesquisador experiente para avaliar a profundidade da desmineralização. Resultados: Os valores interexaminadores do Coeficiente de Correlação Intraclasse (ICC) entre todos os participantes variaram de 0,54 a 0,96 e a reprodutibilidade intra-examinador do ICC dos examinadores variou de 0,61 a 0,85, mostrando reprodutibilidade boa a excelente. Para detecção de lesões de esmalte e dentina (D1), o ICDAS obteve sensibilidade 0,835 e especificidade 0,756. Para lesões de dentina (D3), o método revelou um aumento na sensibilidade, mas a especificidade foi semelhante ao D1. Conclusão: O programa de treinamento em e-learning do ICDAS foi eficiente no treinamento de detecção de lesões de cárie em estudantes de pós-graduação.

Association Between Periodontal Health Knowledge and Oral Hygiene in Brazilian Adolescents

Abstract Objective: To evaluate the influence of oral health knowledge in adolescents' oral hygiene pattern. Material and Methods: Cross-sectional study involving 291 participants aged between 14 and 19 years old enrolled in a public school in Curitiba, Brazil. A self-administered questionnaire containing five affirmations about periodontal diseases and their forms of prevention was arranged on a three-point Likert scale. Correct answers were given a weight=1 and incorrect ones, weight=0. The knowledge score (KS) was determined by the sum. Socioeconomic and demographic data were obtained by a questionnaire sent to those responsible. The oral hygiene pattern was evaluated through the simplified oral hygiene index (OHI-S) by a calibrated researcher (K=0.89). Mann-Whitney U test and univariate and multivariate Poisson regression with robust variance were used for data analysis (α=0.05). Results: There was an inversely proportional association between KS and OHI-S (p=0.018). The multiple model showed that adolescents with a lower KS (PR = 0.93, CI95%: 0.88-0.99), male gender (PR = 1.17, CI95%: 1.01-1.37) and whose caregivers presented a lower level of education (PR=1.30, CI95%: 1.03-1.64) showed a higher index of dental plaque. Conclusion: The level of oral health knowledge, the gender and the caregivers' level of education influences the adolescents' oral hygiene pattern.