Longitudinal study for dental caries calibration of dentists unexperienced in epidemiological surveys

Abstract This study aimed to make a longitudinal analysis of interexaminer calibration reproducibility in diagnosing dental caries in posterior teeth, by examiners without previous experience in epidemiological studies. A group of 11 inexperienced examiners underwent theoretical-practical training and calibration assessments, assisted by a standard examiner. An examiner who did not participate directly in the research selected 5-year-old children with and without caries. The D3 diagnostic threshold was used to evaluate dental caries, based on the World Health Organization (WHO) criteria. The initial calibration (baseline) was performed after the theoretical-practical training session, and consisted of examining 20 children; the second calibration occurred three months later, and involved evaluating another 18 children. The interexaminer agreement was obtained by kappa statistics, and by overall percentage agreement. The paired t-test was applied to compare the values for kappa means and overall percentage agreement between the time points studied. At baseline, the values for kappa (> 0.81) and overall percentage agreement (> 95.63%) were considered high. At the 3-month calibration assessment, all the examiners showed some decrease in both kappa (p < 0.0001) and overall percentage agreement (p = 0.0102). The calibration process currently proposed by the WHO is effective. However, reproducibility was not maintained over time for inexperienced examiners evaluating the posterior teeth of 5-year-old children, under epidemiological conditions.

Use of dentifrices and mouthwashes during orthodontic treatment in the clinical management of orthodontists / Utilização de dentifrícios e colutórios durante o tratamento ortodôntico na conduta clínica dos ortodontistas

ABSTRACT Objective: To evaluate the knowledge of orthodontic professionals regarding the prescription of dentifrices and antiseptics during orthodontic treatment. Methods: An observational and descriptive exploratory study of national scope was conducted with 440 Brazilian orthodontists, based on previous sample calculations, to evaluate the clinical practice of orthodontists in prescribing dentifrices and antiseptics. Self-managed electronic questionnaires were sent to orthodontic professionals. The data were analyzed by means of absolute and relative frequency distribution tables. Results: It was verified that the most indicated mouthwash (39.8%) was Colgate Periogard® and 421 of the participants (95.7%) know its active ingredient (chlorhexidine digluconate). Besides Colgate Periogard® antiseptic, the participants were also questioned about which active ingredient present on the following antiseptics, whose assertive answers were in the following order of %, Cepacol® (Sanofi-Aventis®) with 60.7%, Colgate Plax® (Colgate®) with 54.5% and Listerine® (Jhonson&Jhonson®) with 51.6%. As for the chlorhexidine therapeutic regime, 63.9% have stated assertively its use, being this one of 2 times a day during 7 to 10 days. The most indicated tooth was Colgate Total 12®, and 60.18% of these individuals correctly indicated its active compound. Conclusion: According to the methodology employed, it could be concluded that orthodontic professionals know and prescribe methods of chemical control to patients during orthodontic treatment and most identify the active chemical compounds present in antiseptic and tooth formulas.

RESUMO Objetivo: Avaliar o conhecimento dos profissionais da ortodontia quanto à prescrição de dentifrícios e antissépticos durante o tratamento ortodôntico. Métodos: Foi realizado um estudo observacional e descritivo exploratório de abrangência nacional com 440 ortodontistas brasileiros, baseado em cálculo amostral prévio, para avaliação da prática clínica dos ortodontistas na prescrição de dentifrícios e antissépticos. Questionários eletrônicos auto administrados foram enviados aos profissionais da Ortodontia. Os dados foram analisados por meio de tabelas de distribuição de frequência absolutas e relativas. Resultados: Verificou-se que o antisséptico bucal mais indicado (39,8%) foi o Colgate Periogard® (Colgate®) e 421 dos participantes (95,7%) conhecem o seu ingrediente ativo (digluconato de clorexidina). Além do antisséptico Colgate Periogard®, os participantes também foram questionados sobre qual o ingrediente ativo presente nos seguintes antissépticos, cujas respostas assertivas estavam na seguinte ordem %, Cepacol® (Sanofi-Aventis®) com 60,7%, Colgate Plax® (Colgate®) com 54,5% e Listerine® (Jhonson&Jhonson®) com 51,6%. Quanto ao regime terapêutico da clorexidina 63,9% indicaram assertivamente sua utilização sendo a mesma de 2 vezes ao dia durante 7 a 10 dias. O dentifrício mais indicado foi o Colgate Total 12®, sendo que 60,18% desses indivíduos indicaram corretamente seu composto ativo. Conclusão: De acordo com a metodologia empregada, pôde-se concluir que os profissionais da ortodontia conhecem e prescrevem métodos de controle químico aos pacientes durante o tratamento ortodôntico e a maioria identifica os compostos químicos ativos presentes nas fórmulas de antissépticos e dentifrícios.

A double-blinded randomized clinical trial of pain perception during orthodontic treatment / Ensaio clínico randomizado duplo cego de percepção da dor durante tratamento ortodôntico

Introduction: Orthodontic movement can cause painful symptoms, especially in the early stages of treatment. Objective: This study aimed to compare the performance of chewing gum and ibuprofen in pain control during the initial period of orthodontic treatment. Material and method: A randomized blind clinical trial, with an allocation ratio of 1:1, was developed with patients aged ≥18 years old. The sample size was established considering a significance level of 5% and test power of 80%, resulting in a minimum of 30 volunteers per group (n=90). Participants were paired regarding sex, age, the severity of malocclusion, defined by the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and crowding, determined by Little's irregularity index. The sample was randomly allocated to three groups: Group I (control) placebo; Group II chewing gum; and Group III Ibuprofen. Pain perception was evaluated by the Visual Analog Scale (VAS) in the first 24, 36, and 48 hours after activation of the orthodontic appliance. The data were analyzed by generalized linear models for repeated measures in time. Result: No statistically significant difference (p>0.05) was observed among the groups for the methods of pain therapy evaluated in 24, 36, and 48 hours post-activation. Conclusion: There was no difference among the method used for pain control during the orthodontic treatment.

Introdução: A movimentação ortodôntica pode causar sintomatologia dolorosa, principalmente nas fases iniciais do tratamento. Objetivo: Este estudo teve como objetivo comparar o desempenho da goma de mascar e do ibuprofeno no controle da dor durante o período inicial do tratamento ortodôntico. Material e método: Foi desenvolvido um ensaio clínico randomizado cego, com razão de alocação de 1:1, com pacientes com idade ≥ 18 anos. O tamanho da amostra foi estabelecido considerando um nível de significância de 5% e poder do teste de 80%, resultando em um mínimo de 30 voluntários por grupo (n=90). Os participantes foram pareados quanto ao sexo, idade, gravidade da má oclusão, definida pelo Componente de Saúde Bucal (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN), e apinhamento, determinado pelo índice de irregularidade de Little. A amostra foi distribuída aleatoriamente em três grupos: Grupo I (controle) placebo; Goma de mascar Grupo II; e Grupo III Ibuprofeno. A percepção da dor foi avaliada pela Escala Visual Analógica (EVA) nas primeiras 24, 36 e 48 horas após a ativação do aparelho ortodôntico. Os dados foram analisados por modelos lineares generalizados para medidas repetidas no tempo. Resultado Não foi observada diferença estatisticamente significativa (p>0.05) entre os grupos para os métodos de terapia da dor avaliados em 24, 36 e 48 horas pós-ativação. Conclusão: Não houve diferença entre o método utilizado para controle da dor durante o tratamento ortodôntico.

What Factors are Associated with Health-Related Quality of Life in Mixed Dentition Children?

Abstract Objective: To associate the OHRQoL and HRQoL in mixed dentition children with the influence on age range, socioeconomic and clinical variables. Material and Methods: A cross-sectional study was carried out with 1,240 children between 6 and 12 years of age. HRQoL was assessed by the Quality of Life Assessment Scale, considered an outcome variable. OHRQoL was determined using specific questionnaires related to the age group: Oral Health Impact Scale in Early Childhood, Child Perceptions Questionnaire for 8 to 10 years, and 11 to 12 years. Dental caries and malocclusion were diagnosed. The socioeconomic class was evaluated. A multiple negative binomial regression analysis was used to test the relationship between HRQoL, OHRQoL scores and socioeconomic and clinical variables. Correlation analyses were performed between the total HRQoL and OHRQoL, with a significance level of 5%. Results: The HRQoL is inversely related to the impact of OHRQoL (p<0.05), modulated by the age group. There was a significant weak negative correlation between the HRQoL scores and the impact of OHRQoL (p<0.05). Conclusion: The OHRQoL impacts the HRQoL, modulated by the age group and with minor influence from socioeconomic and clinical variables (AU).

A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents

Abstract Objective: To evaluate the psychosocial impact of malocclusion and self-esteem in adolescents in the Amazon region. Material and Methods: A cross-sectional study was carried out with 212 adolescents with 12-year-old enrolled in all public schools in the Boca do Acre (Amazonas, Brazil). Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion. The self-perception of the need for orthodontic treatment was evaluated by the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and Global Negative Self-evaluation (GSE), the adolescent's self-esteem. The malocclusion was clinically evaluated by the Dental Aesthetic Index (DAI). The variables with p<0.20 in the individual analyses were tested in multiple logistic regression models, and those with p<0.10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). Results: Adolescents with low self-esteem were 2.20 (95% CI: 1.23-3.93) times more likely to have a more significant impact on dental aesthetics (p<0.05). When verified by domains, the adolescents with low self-esteem had 2.33 (95% CI: 1.31-4.17) and 1.93 (95% CI: 1.09-3.42) times more likely to impact the psychological and social domains of the PIDAQ, respectively. Conclusion: Self-esteem influenced adolescents' perception of dental aesthetics in the domains related to psychological and social impact (AU).

Knowledge and clinical practices of orthodontists regarding the treatment of patients with aids. A nationwide study

Aim: To evaluate orthodontists' knowledge and clinical practices regarding the treatment of patients with HIV/AIDS. Methods: Cross-sectional study performed with 655 Brazilian orthodontists based on a previously calculated sample size. Self-administered questionnaires were sent to orthodontists to collect information on knowledge and clinical conduct regarding the care of patients with HIV/AIDS. The study evaluated the awareness of possible risk factors for contamination, oral manifestations of HIV, need for more information on the care of HIV-positive patients, whether orthodontic treatment is indicated in HIV-positive patients, and whether they had knowingly performed orthodontic treatment in HIV-positive patients. Simple regression models were adjusted, and crude Odds Ratios estimated the associations with 95% confidence intervals. The variables with P < 0.20 in the crude analysis were tested in multiple logistic regression models, and those with P ≤ 0.05 were maintained in the final model. Magnitudes were estimated by adjusted Odds Ratios values, with 95% confidence intervals. Results: Orthodontists who were aware of the oral manifestations of HIV/AIDS, those having work experience of more than 20 years, and those who believed that orthodontic treatment could be indicated for these patients were 3.30 (1.79-6.10), 2.74 (1.36-5.52) and 1.92 (1.13-3.24) times more likely to perform orthodontic treatment in HIV-positive patients, respectively. Most orthodontists (92.9%) reported they needed to obtain more information about orthodontic care in patients with HIV/AIDS. Conclusion: Although orthodontists reported feeling able and qualified to provide dental care to patients with HIV/AIDS, gaps in their knowledge need to be addressed with further training

Impact of malocclusion severity on the quality of life of non-white adolescents / Impacto da severidade da má oclusão na qualidade de vida de adolescentes não brancos

Abstract The aim of this study was to evaluate the impact of malocclusion severity on the oral health-related quality of life (OHRQoL) of non-white adolescents. A cross-sectional study was conducted with 585 non-white Brazilian adolescents (12-15 years). The Dental Aesthetic Index (DAI) was used for the clinical assessment of malocclusion and Oral Health Impact Profile (OHIP-14) on OHRQoL. Deep bite and transverse occlusal relationships were assessed in association with the DAI. The adolescents with DAI 3 and 4 were distributed into 4 groups: G1 - individuals without transverse occlusal relationships or deep bite; G2 - individuals with only posterior crossbite; G3 - individuals with only deep bite; and G4 - individuals with Brodie bite. The backward stepwise procedure was used to select variables on each level, eliminating variables with a p≤0.20. From the logistic regression analyses, the adjusted odds ratios were estimated with the respective 95% confidence intervals. The adolescents with severe malocclusion divided into the G2, G3 and G4 showed p-value of 0.0501, 0.1475, and 0.5407, respectively, but did not remain in the final model. Malocclusion severity had no impact on the OHRQoL of non-white adolescents.

Resumo O objetivo deste estudo foi avaliar o impacto da severidade da má oclusão na qualidade de vida relacionada à saúde bucal (OHRQoL) de adolescentes não brancos. Estudo transversal foi realizado com 585 adolescentes brasileiros não brancos (12-15 anos). O Índice de Estética Dental (DAI) foi utilizado para a avaliação clínica da má oclusão e o Oral Health Impact Profile (OHIP-14) na OHRQoL. A sobremordida profunda e as relações oclusais transversais foram avaliadas em associação com o DAI. Os adolescentes com DAI 3 e 4 foram divididos em 4 grupos: G1 - indivíduos com relação transversal normal ou com ausência de sobremordida; G2 - indivíduos com mordida cruzada posterior; G3 - indivíduos com sobremordida profunda; e, G4 - indivíduos com mordida em Brodie. O modelo final estimou as variáveis selecionadas após o ajuste para aquelas que permaneceram no modelo multivariado em níveis iguais e superiores. A partir das análises de regressão logística, os odds ratios foram ajustados e estimados com os respectivos intervalos de confiança de 95%. Os adolescentes com má oclusão severa divididos em G2, G3 e G4 mostraram um p-valor de 0.0501, 0.1475, e 0.5407, respectivamente, mas não permaneceram no modelo final. A severidade da má oclusão não teve impacto na OHRQoL de adolescentes não brancos.

Force degradation of elastomeric chains after storage time and mechanical brushing

Abstract The purpose of this in vitro study was to evaluate the force decrease of different elastomeric chains after different times: initial, 10 minutes, 1 day, 28 days and after mechanical brushing. Twenty orthodontic elastomeric chains segments were utilized for each commercial brand. Initially, the elastomeric chain of 15mm long were immediate stretched up to 20 mm in an Instron and the force was measured in gf. After all specimens were placed stretched on rectangular acrylic jigs with distance of 20 mm, immersed in deionized water at 37oC for 10 minutes and the force (gf) was measured again. Five test measurements of remaining force were made at the following time intervals: initial, 10 minutes, 1 day, 28 days and mechanical brushing. After 28 days, the acrylic plates with the specimens were adapted in the mechanical brushing machines (MSCT 3) and the elastomeric chains were submitted to mechanical brushing and the force (gf) measure again. The force (gf) was submitted to mixed-model ANOVA and Sidak post-hoc test (α=0.05). A statistically significant reduction in the force was found for all orthodontic elastomeric chain types after 1 day, 28 days and mechanical brushing (p<0.05). Morelli and 3M Unitek elastomeric chains showed significantly higher force than Abzil and GAC (p<0.05) after 1 day, 28 days and mechanical brushing. In conclusion, the force delivered by all elastomeric chains decayed rapidly over time. Morelli and 3M Unitek elastomeric chains consistently had a significantly greater force after mechanic brushing, while GAC the lowest.

Resumo O objetivo deste estudo in vitro foi avaliar a redução da força de diferentes cadeias elastoméricas após diferentes tempos: inicial, 10 minutos, 1 dia, 28 dias e após escovação mecânica. Vinte segmentos de cadeias elastoméricas ortodônticas foram utilizadas para cada marca comercial. Inicialmente, a cadeia elastomérica de 15 mm de comprimento foi esticada imediatamente até 20 mm na Instron e a força foi medida em (gf). Após, todas as amostras foram adaptadas esticadas em placas retangulares de acrílico na distância de 20 mm, imersas em água deionizada a 37o C por 10 minutos e a força (gf) foi medida novamente. Cinco medidas de força foram feitas nos seguintes intervalos de tempo: inicial, 10 minutos, 1 dia, 28 dias e após a escovação mecânica. Após 28 dias, as placas de acrílico com as amostras foram adaptadas na máquina de escovação (MSCT 3) e as cadeias elastoméricas foram submetidas a escovação mecânica e a medida de força (gf) novamente. Os dados da força (gf) foram submetidos a ANOVA modelo misto e teste post-hoc de Sidak (α = 0,05). Uma redução estatisticamente significativa na força foi encontrada para todos os tipos de cadeia elastomérica ortodôntica após 1 dia, 28 dias e escovação mecânica (p<0,05). As cadeias elastoméricas Morelli e 3M Unitek apresentaram força significativamente superior em relação a Abzil e GAC (p<0,05) após 1 dia, 28 dias e escovação mecânica. Em conclusão, a força distribuída por todas as cadeias elastoméricas decaiu rapidamente com o tempo. As cadeias elastoméricas Morelli e 3M Unitek consistentemente tiveram uma força significativamente maior após a escovação mecânica, enquanto GAC a mais baixa.

Does dental trauma in early childhood have the potential to affect the quality of life of children and families? / Os traumatismos dentários na primeira infância têm potencial para afetar a qualidade de vida das crianças e das famílias?

ABSTRACT Objective: To evaluate the influence of dental trauma on oral health-related quality of life (OHRQoL) of children and their families. Methods: A total of 571 children aged five years were randomly selected at public schools. Trauma was clinically evaluated in accordance with the Andreasen classification. Caries experience in the anterior region and increased overjet were determined according to the World Health Organization criteria. The Early Childhood Oral Health Impact Scale (ECOHIS) was answered by the parents and used to evaluate OHRQoL. In addition, this questionnaire has aspects related to socioeconomic status. Simple logistic regression was performed, and the raw Odds Ratios with the respective 95% confidence intervals (95%CI) were estimated. The variables with p<0.20 were tested in multiple logistic regression models, and those with p≤0.05 remained in the model and the adjusted odds ratio with respective 95%CI was estimated. Results: Income showed a magnitude of association of 1.56 and 2.70 with the OHRQoL of children and families, respectively. The avulsion variable showed 9.65- and 8.25-times greater chance of influencing the OHRQoL of children and families, respectively. The experience of caries showed 3.80- and 2.42-times greater chance of influencing the OHRQoL of children and families, respectively. Conclusions: Dental trauma did not influence OHRQoL of children and their families negatively. However, avulsion and caries experience in low-income families was associated with a negative perception of OHRQoL.

RESUMO Objetivo: Avaliar a influência do traumatismo dentário na qualidade de vida relacionada à saúde bucal (QVRSB) de crianças e suas famílias. Métodos: 571 crianças de 5 anos de idade foram aleatoriamente selecionadas de escolas públicas. O trauma foi avaliado clinicamente de acordo com a classificação de Andreasen. A experiência de cárie na região anterior e a presença de overjet foram determinadas com base nos critérios da Organização Mundial da Saúde. A versão brasileira do questionário ECOHIS (Escala de Impacto na Saúde Oral na Primeira Infância) avaliou a QVRSB e foi respondida pelos pais; além disso, foram avaliados aspectos socioeconômicos. Realizou-se uma regressão logística simples, bem como as razões de chances brutas com os respectivos intervalos de confiança de 95%. As variáveis ​​com p <0,20 foram testadas nos modelos de regressão logística múltipla, e aquelas com p≤0,05 permaneceram no modelo. Resultados: A renda mostrou uma magnitude de associação de 1,56 e 2,70 com a QVRSB das crianças e famílias, respectivamente. A variável avulsão apresentou chance 9,65 e 8,25 vezes maior de influenciar a QVRSB de crianças e famílias, respectivamente. A experiência de cárie mostrou chance 3,80 e 2,42 vezes maior de influenciar a QVRSB de crianças e famílias, respectivamente. Conclusões: O trauma dental não influenciou negativamente a QVRSB das crianças e suas famílias. Entretanto, especificamente a avulsão, e a experiência de cárie nos dentes anteriores em famílias de baixa renda estiveram associadas a uma percepção negativa da QVRSB.

Avaliação da qualidade de vida relacionada a saúde bucal de crianças e suas famílias e fatores associados / Evaluation of quality of life related to the health of children and their families and associated factors

Introdução O desenvolvimento do complexo craniofacial resulta da interação de fatores genéticos e ambientais. Dentre as ocorrências que podem afetar esse desenvolvimento, estão as odontológicas. A cárie dentária e a má oclusão são de etiologia multifatorial e atingem grande parte da população, podendo impactar a qualidade de vida. Objetivo O objetivo deste estudo foi avaliar o impacto de fatores clínicos, funcionais e sociais na qualidade de vida relacionada a saúde bucal de crianças e suas famílias. Material e método A amostra consistiu de 753 crianças matriculadas nas escolas públicas da cidade de Araraquara-SP. Foram realizados exames bucais para avaliar a ocorrência cárie dentária (ceo-d e CPO-D) e a má oclusão (Foster, Hamilton) e aplicado um questionário socioeconômico aos pais, além do questionário para avaliação da qualidade de vida relacionada a saúde bucal (ECOHIS). Os dados foram avaliados por meio de análise bivariada e, em seguida, pelo modelo de regressão logística múltipla, considerando o nível de significância de 5%. Resultado A condição social, além das variáveis clínicas de cárie dentaria e trauma dental, apresentou associação com o impacto negativo na qualidade de vida relacionada a saúde bucal nas três sessões do questionário: criança, pais e geral, respectivamente. Conclusão A experiência da cárie dentária, o nível socioeconômico e o trauma dental foram variáveis preditoras para o impacto negativo na qualidade de vida relacionada a saúde bucal de crianças e suas famílias. Os hábitos estão mais relacionados ao índice ceo-d e ao nível socioeconômico do que com a má oclusão.

Introduction The development of the craniofacial complex results from the interaction of genetic and environmental factors. Dental caries and malocclusion have a multifactorial etiology and affect a large part of the population, which may impact the quality of life. Objective The aim of this study was to evaluate the impact of clinical, functional and social factors on oral health-related quality of life of children and their families. Material and method The sample consisted of 753 children enrolled in public schools in the city of Araraquara-SP. Oral examinations were performed to assess dental caries (dmft and DMFT) and malocclusion (Foster, Hamilton) and a socioeconomic questionnaire was administered to the parents, in addition to the quality assessment questionnaire. health-related life expectancy (ECOHIS). Data were evaluated by bivariate analysis and then by multiple logistic regression model, considering the significance level of 5%. Result Social condition, besides the clinical variables dental caries and dental trauma were associated with the negative impact on oral health-related quality of life in the three questionnaire sessions, child, parent and general respectively. Conclusion The experience of dental caries, socioeconomic status and dental trauma were predictive variables for the negative impact on oral health-related quality of life of children and their families. Habits seem to be more related to the dmft index and socioeconomic level than to malocclusion.

On-line Searches for Terms Related to Hand Hygiene During the COVID-19 Pandemic Worldwide

ABSTRACT Objective: To analyze the difference in the on-line searches for terms related to hand hygiene during the COVID-19 pandemic in developed and middle-income countries. Material and Methods: The cross-sectional study analyzed the digital data through the Google Trends website to obtain the variation of the relative search volume (RSV) through the terms "alcohol gel" and "handwashing." According to socio-economic development, the countries were divided into two groups: countries from different continents and hemispheres, with more than 15 million inhabitants, with more than 50% of the population with access to the Internet network and over 1,000 confirmed cases of infected with COVID-19. The paired t-test was applied to compare the means. The significance value adopted was p<0.010. Results: The searches related to the term "hand washing" were more significant when compared to the term "alcohol gel," and the term "alcohol gel" presented a higher average volume of research in developed countries (p<0.010). The developed countries had a higher average relative volume of research than middle-income countries (p<0.010). Developed countries sought more for the term "alcohol gel," and the term "hand washing" showed no difference in the volume of research about the country's socio-economic aspect. Conclusion: Developed countries have a higher volume of search for hand hygiene terms. The middle-income countries must create proposals for raising awareness outside the on-line environment so that this information reaches the entire population during the pandemic.

Affective relationships as predictors of TMD symptoms in young adults / Relações afetivas como preditoras de sintomas de DTM em adultos jovens

Abstract Introduction Orofacial pain is a critical TMD symptom that can influence physical and social capacity. Objective To evaluate the association of temporomandibular disorders (TMD) symptoms with affective relationships and demographic variables in young adults. Material and method A cross-sectional study involving 395 young adults was developed. Diagnostic Criteria for TMD, anxiety, and depression were collected from questionnaires. The Dental Health Component of the Index of Orthodontic Treatment Need measures the orthodontic treatment need. Questionnaires also contained questions related to the previous orthodontic treatment. Logistic regression models were adjusted, estimating crude odds ratio with the 95% confidence intervals. The variables with p<0.20 in the analyses were assessed in a multiple logistic regression model, remaining with p≤0.10. Result There was no significant association of TMD symptoms with sex, age, medication use for pain, previous orthodontic treatment, orthodontic treatment need, anxiety, and depression (p>0.05). Individuals without an affective relationship are 1.78 (95%CI: 0.99-3.17) times more likely to report TMD symptoms. Conclusion Affective relationships showed an association with TMD symptoms in young adults.

Resumo Introdução A dor orofacial é um sintoma crítico da DTM que pode influenciar a capacidade física e social. Objetivo Avaliar a associação dos sintomas das desordens têmporomandibulares (DTM) com as relações afetivas e variáveis demográficas em adultos jovens. Material e método Estudo transversal envolvendo 395 adultos jovens foi realizado. Os critérios diagnósticos para DTM, ansiedade e depressão foram coletados a partir de questionários. O Componente de Saúde Bucal do Índice de Necessidade de Tratamento Ortodôntico mensurou a necessidade de tratamento ortodôntico. Os questionários também continham questões relacionadas ao tratamento ortodôntico anterior. Modelos de regressão logística foram ajustados, estimando odds ratio bruto com os intervalos de confiança de 95%. As variáveis com p<0.20 nas análises foram avaliadas em modelo de regressão logística múltipla, permanecendo as variáveis com p≤0.10. Resultado Não houve associação significativa dos sintomas de DTM com sexo, idade, uso de medicamentos para dor, tratamento ortodôntico prévio, necessidade de tratamento ortodôntico, ansiedade e depressão (p>0.05). Indivíduos sem relacionamento afetivo têm 1.78 (IC95%:0.99-3.17) vezes mais chance de relatar sintomas de DTM. Conclusão Os relacionamentos afetivos mostraram associação com os sintomas de DTM em adultos jovens.

Behavioral and clinical aspects associated with probable sleep bruxism in early childhood / Aspectos comportamentais e clínicos associados ao provável bruxismo do sono na primeira infância

Introduction: Although many studies are being carried out with sleep bruxism, the literature points to a lack of studies with methodological quality in children. Objective: To evaluate the behavioral and clinical aspects associated with probable sleep bruxism in early childhood. Material and method: A cross-sectional observational study carried out with 371 children between 4 and 6 years of age. Parents answered a questionnaire with aspects related to their children's sleep behavior. Among the clinical characteristics, the presence of lip sealing, clicking, teeth marks on the jugal mucosa, and the side of the tongue was evaluated. Tooth wear was assessed using the BEWE index criteria. Simple logistic regression models were adjusted for each independent variable, estimating the gross odds ratios with the respective 95% confidence intervals. Variables with P <0.20 in the individual analyzes were adjusted in a multiple logistic regression model, with those with P ≤ 0.05 remaining in the model. Result: 42.4% of parents reported that their children gritted their teeth while sleeping. Children who showed wear on their teeth were 1.53 times more likely to grind their teeth. There was no significant association with the other variables analyzed (P > 0.05). Conclusion: Behavioral aspects were not associated with probable sleep bruxism. Among the clinical characteristics evaluated, tooth wear showed an association, which may indicate the probable bruxism of sleep in early childhood.

Introdução: Embora muitos estudos estejam sendo realizados com o bruxismo do sono, a literatura aponta uma carência de estudos com qualidade metodológica em crianças. Objetivo: Avaliar os aspectos comportamentais e clínicos associados ao provável bruxismo do sono na primeira infância. Material e método: Estudo observacional transversal realizado com 371 crianças entre 4 e 6 anos de idade. Os pais responderam a um questionário com aspectos relacionados ao comportamento do sono de seus filhos. Entre as características clínicas, foram avaliados a presença de selamento labial, estalidos, marcas dos dentes na mucosa julgal e na lateral da língua. O desgaste dentário foi avaliado por meio dos critérios do índice de BEWE. Foram ajustados modelos de regressão logística simples, para cada variável independente, estimando-se os odds ratios brutos com os respectivos intervalos de 95% de confiança. As variáveis com P< 0.20 nas análises individuais foram ajustadas em um modelo de regressão logística múltipla, permanecendo no modelo aquelas com P ≤ 0.05. Resultado: 42.4% dos pais relataram que seus filhos rangiam os dentes enquanto dormiam. Crianças que apresentaram desgastes nos dentes, tinham 1.53 vezes mais chances de ranger os dentes. Não houve associação significativa com as demais variáveis ​​analisadas (P> 0.05). Conclusão: Aspectos comportamentais não apresentaram associação com o provável bruxismo do sono. Entre as características clínicas avaliadas, o desgaste dentário apresentou associação, podendo ser um indicador para o provável bruxismo do sono na primeira infância.

Influence of social capital on self-perception related to orthodontic treatment need

Aim: To evaluate the influence of social capital on self-perception related to orthodontic treatment need. Methods: A cross-sectional study was conducted with a sample of 578 11-16 years-old adolescents from a city in southern Brazil. Social capital was evaluated using the Social Capital Questionnaire for Adolescent Students (SCQ-AS). Index of Orthodontic Treatment Need (IOTN) assessed malocclusion and self-perception related to orthodontic treatment need. Sociodemographic aspects of adolescents were also evaluated. Individual analyses were performed, relating the study variables to the outcome, estimating the odds ratio with the respective confidence intervals of 95%. The variables with p<0.20 in the individual analyses were tested in the multiple logistic regression models, and those with p<0.10 remained in the model. Results: Social capital did not influence the self-perception related to orthodontic treatment need. Adolescents with high orthodontic needs were 5.35 (CI 95%: 2.68 to 10.65) times more likely to perceived orthodontic treatment need (p <0.05). Crowding and dental absence were associated with self-perception related to orthodontic treatment need (p <0.05). Conclusions: Social capital did not influence the self-perception related to orthodontic treatment need

Malocclusion and dental appearance in underprivileged Brazilian adolescents

Abstract Satisfaction with dental aesthetics is a subjective indicator used in epidemiological studies and is related to health behaviours. Little is known about the factors that influence this indicator, particularly among adolescents who live in a situation of social vulnerability. The aim of this study was to investigate the relationship between malocclusion and dental appearance in underprivileged Brazilian adolescents. This analytical cross-sectional study was conducted in Piracicaba, Brazil, and evaluated 884 adolescents from 13 to 19 years of age. The dependent variable was satisfaction with dental appearance, and the independent variables were classified as individual (components of the Dental Aesthetic Index - DAI, sex and age) and contextual (social exclusion index). For statistical analysis, multilevel regression models were estimated. The individual variables were considered Level 1, and the contextual variable was considered Level 2, with a level of significance of 5%. The mean age of the adolescents was 15.3 years. Female adolescents more frequently affirmed that they were satisfied with their dental appearance than did male individuals. There was an increase in dissatisfaction with oral health with the increase in anterior maxillary overjet, midline diastema, larger anterior irregularity in the maxilla, larger anterior irregularity in the mandible, anterior open bite and antero-posterior molar relation. Satisfaction with dental appearance was associated with individual factors such as sex and DAI components.

Association between normative and perceived esthetic results after treatment of mandibular retrognathism / Associação entre os resultados estéticos normativos e percebidos pós-tratamento do retrognatismo mandibular

Abstract Introduction This cross-sectional study aimed to associate the normative cephalometric results of mandibular retrognathism treatment with patient perception on the esthetic improvement of facial profile. Objective this cross-sectional study aimed to associate the normative cephalometric results of mandibular retrognathism treatment with patient perception on the esthetic improvement of facial profile. Material and method The normative cephalometric results were obtained from lateral cephalometric radiographs of a sample of 24 Class II malocclusion patients in the pubertal growth spurt. Such patients were treated with a mandibular advancement device and evaluated by comparing pre- and post-treatment variables. The same radiographs were used to produce standardized black silhouettes that were randomly arranged. Patients were instructed to choose their preferred profile and indicate the changes perceived using a 7-point Likert scale. The data were compared with cephalometric results using a mixed-model methodology for time-repeated measures, Student's t-test, and t-test for heterogeneous variances, at 5% significance level. Result A rate of 75% of patients preferred post-treatment silhouettes and changes were perceived regardless of the choice of either pre- or post-treatment profile. There was no significant difference between the cephalometric variables of the tracings that produced the silhouettes considered better or worse after the evaluation. Conclusion There was no association between the cephalometric results after treatment and the perception of esthetic improvement by patients treated for mandibular retrognathia.

Resumo Introdução Este estudo transversal buscou associar resultados cefalométricos normativos do tratamento do retrognatismo mandibular com melhora estética do perfil facial na percepção do paciente. Objetivo este estudo transversal buscou associar resultados cefalométricos normativos do tratamento do retrognatismo mandibular com melhora estética do perfil facial na percepção do paciente. Material e método Os resultados cefalométricos normativos obtidos em radiografias cefalométricas laterais de uma amostra de 24 pacientes com maloclusão de Classe II em fase de crescimento tratados com aparelho de avanço mandibular, foram avaliados comparando-se as grandezas pré e pós-tratamento. As mesmas radiografias foram utilizadas para gerar silhuetas negras padronizadas que foram dispostas aleatoriamente. Os pacientes foram instruídos a escolher seu perfil preferido e indicar quanta mudança foi percebida por meio de uma escala de Likert de 7 pontos. Os dados foram comparados com resultados cefalométricos aplicando-se metodologia de modelos mistos para medidas repetidas no tempo, teste t de student e teste t para variâncias heterogêneas, com nível de significância de 5%. Resultado 75% dos pacientes escolheram silhuetas pós-tratamento e a mudança foi percebida independentemente da escolha por pré ou pós-tratamento. Não houve diferença significativa entre as variáveis ​​cefalométricas dos traçados que deram origem às silhuetas consideradas melhores e piores após a avaliação. Conclusão Não houve associação entre os resultados cefalométricos pós-tratamento e a percepção da melhora estética por pacientes ortodônticos.

Dentoskeletal and aesthetic effects of mandibular protraction appliance (MPA) using Ricketts analysis / Efeitos dentoesqueléticos e tegumentares do aparelho de protração mandibular (APM) usando a análise cefalométrica de Ricketts

Objective: This study was designed to evaluate the skeletal, dental and soft tissue effects of mandibular deficiency treatment with the mandibular protraction appliance (MPA) using 12 factors of the Ricketts analysis. Material and method: This cross-sectional retrospective study sample consisted of a group (n = 27), with Class II malocclusion, convex facial profile, increased horizontal trespass and mandibular deficiency, with initial mean age of 12.27 and final of 15.18 years, treated with fixed appliance combined with the MPA, in an average time of 2.9 years. Initial and final radiographs were investigated using Ricketts analysis. The dependent t-test was used to compare the initial and final phases of the MPA group, with a significance level of 5%. Result: Statistically significant differences were observed for dental changes such as retrusion (p=0.000) and palatal inclination of the maxillary incisors (p=0.000); protrusion (p=0.000) and buccal inclination of the mandibular incisors (p=0.000); increased interincisal angle (p=0.002) and improved molar ratio (p=0.003). There was also a restriction of the anterior displacement of the maxilla (p=0.000) and a decrease in the mandibular plane angle (p=0.024). The variable inferior labial protrusion with significance (p=0.000), reiterated the improvement in the profile. Conclusion: The effects of MPA on correction of malocclusion Class II, verified by Ricketts analysis occurred predominantly by dentoalveolar changes, decrease in the Mandibular Plane Angle, and restriction of anterior displacement of the maxilla, which contributed to the improvement in the patient's profile.

Objetivo: Este estudo analisou as alterações dentárias, esqueléticas e tegumentares promovidas pelo Aparelho de Protração Mandibular (APM) por meio da análise de Ricketts. Material e método: A amostra contou com 27 pacientes (14 meninas e 13 meninos) com má oclusão de Classe II, perfil facial convexo, trespasse horizontal aumentado e deficiência mandibular, com idade média inicial de 12,27 e final de 15,18 anos, tratados com aparelho fixo combinado com o APM. A comparação das telerradiografias iniciais (T1) e finais (T2) foi realizada pelo teste t dependente, com nível de significância de 5%. Resultado: Observou-se diferença estatisticamente significante para a retrusão (p=0.000) e lingualização dos incisivos superiores (p=0.000), protrusão (p=0.000) e vestibularização dos incisivos inferiores (p=0.000), aumento do ângulo interincisivos (p=0.002), melhora da relação molar (p=0.003), restrição do deslocamento anterior da maxila (p=0.000), diminuição do ângulo do plano mandibular (p=0.024) e melhora do perfil facial (p=0.000). Conclusão: O APM promoveu alterações dentoalveolares, observadas principalmente pela diminuição do ângulo do plano mandibular e restrição do deslocamento para anterior da maxila que contribuíram para a melhora do perfil do paciente.

Fatores associados às faltas em tratamentos ortodônticos em centro de especialidades odontológicas / Factors associated with absences from orthodontic treatment at a dental specialty center

Resumo O objetivo deste estudo foi identificar os fatores associados ao não comparecimento dos usuários ao tratamento ortodôntico, em três centros de especialidades odontológicas regionais (CEO-R) localizados no estado do Ceará. Metodologia: Os dados foram extraídos de prontuários de pacientes que concluíram o tratamento ortodôntico. Foi calculada a taxa de ausências, com o objetivo de estabelecer um coeficiente de faltas entre os municípios. A fim de descrever o padrão geográfico da ocorrência, foram construídos mapas temáticos baseados nas distribuições. Para as associações entre a variável desfecho (falta ao tratamento) e as independentes (sexo, idade, quebra de aparelho, mudança de profissional, renda e local de residência do usuário), utilizou-se a análise de regressão logística múltipla com p ≤ 0,05. Resultados: Foram examinados 237 prontuários em 20 municípios, com 8.283 consultas ortodônticas realizadas e 2.665 (32,17%) faltas. Apresentou diferença estatisticamente significativa a variável mudança de profissional. Conclusão: O maior número de faltas foi associado à mudança de profissional.

Abstract The aim of this study was to identify the factors associated with the users failing to keep orthodontic treatment appointments (absences), in three regional dental specialty centers (CEO-R) located in the State of Ceará. Methodology: This was a cross-sectional epidemiological study with secondary data source of 3 CEO-R, from which 237 medical records of complete orthodontic treatments were examined, with 8.283 appointments and 2.665 (32.17%) missing appointments. Data collection was standardized by an electronic questionnaire.. Factors associated with users missing appointments were calculated by means of absence rates and thematic maps were constructed based on distributions of the geographical pattern of occurrence. To evaluate the association between the outcome variable (absence from treatment) and the independent variables (sex, age, breakage of appliance, change of professional, income and place of user's residence) multiple logistic regression analysis was used with p ≤ 0.05. Results: There were high absence rates for both city headquarters and non-headquarter CEO-Rs. The variable change of professional showed statistical significance, in relation to the number of absences. Conclusion: The highest number of absences was associated with change of professional.

Bayesian model and spatial analysis of oral and oropharynx cancer mortality in Minas Gerais, Brazil / Modelo Bayesiano e análise espacial da mortalidade por câncer de boca e orofaringe em Minas Gerais, Brasil

Abstract The objective of this study was to determine of oral and oropharynx cancer mortality rate and the results were analyzed by applying the Spatial Analysis of Empirical Bayesian Model. To this end, we used the information contained in the International Classification of Diseases (ICD-10), Chapter II, Category C00 to C14 and Brazilian Mortality Information System (SIM) of Minas Gerais State. Descriptive statistics were observed and the gross rate of mortality was calculated for each municipality. Then Empirical Bayesian estimators were applied. The results showed that, in 2012, in the state of Minas Gerais, were registered 769 deaths of patients with cancer of oral and oropharynx, with 607 (78.96%) men and 162 (21.04%) women. There was a wide variation in spatial distribution of crude mortality rate and were identified agglomeration in the South, Central and North more accurately by Bayesian Estimator Global and Local Model. Through Bayesian models was possible to map the spatial clustering of deaths from oral cancer more accurately, and with the application of the method of spatial epidemiology, it was possible to obtain more accurate results and provide subsidies to reduce the number of deaths from this type of cancer.

Resumo O objetivo deste estudo foi determinar a taxa de mortalidade por câncer de boca e aplicar o Modelo Bayesiano Empírico e a Análise Espacial para suavizar a taxa bruta de mortalidade por câncer de boca e orofaringe. Foi usado o Capítulo II da Classificação Internacional de Doenças (CID-10) para Categorias C00 a C14. Os dados foram extraídos do Sistema de Informações sobre Mortalidade do Brasil (SIM) do Estado de Minas Gerais. As estatísticas descritivas e as taxas brutas de mortalidade foram calculadas para cada município. Posteriormente, foram aplicados os estimadores Bayesianos Empíricos. Em 2012, em Minas Gerais, foram registradas 769 mortes para o câncer de boca e orofaringe, dos quais 607 (78,96%) eram homens e 162 (21,04%) mulheres. Houve uma grande variação na distribuição espacial da taxa de mortalidade bruta. Foi possível identificar aglomeração nas regiões Sul, Central e Norte com maior precisão pelo Estimador Bayesiano Modelo Global e Local. Através dos Modelos Bayesian foi possível mapear aglomeração espacial de mortes por câncer de boca e orofaringe com maior precisão. Assim, pela epidemiologia espacial foi possível obter resultados mais precisos e fornecer subsídios para ações para reduzir a mortalidade por este tipo de câncer.

Influence of different treatments of the ceramic surface and thermal cycling on the bond strength of brackets to ceramic / Influência de diferentes tratamentos de superfície da cerâmica e ciclagem térmica na resistência de união de bráquetes à cerâmica

Objective: To evaluate in vitro the effect of different treatments of the ceramic surface and thermal cycling on the shear bond strength (SBS) of metallic brackets bonded to feldspathic ceramic. Material and method: Ceramic cylinders were divided into four groups (n=4) according to the treatment of ceramic surface: G1-Clearfil Ceramic Primer silane and Transbond XT (CCPT); G2-etched with 10% hydrofluoric acid (HFA) for 60 s, CCP and Transbond XT (ACCPT); G3-etched with 10% HFA for 60 s, Ambar Adhesive and Transbond XT (AAAT); and, G4 - etched with 10% HFA for 60 s, RelyX Ceramic Primer silane -RCP, adhesive primer Transbond and Transbond XT (ACPPT). Brackets were bonded to the cylinders with Transbond XT and light-activated for 40 s with LED Radii Plus. All specimens were stored in deionized water at 37 °C for 24 h, and two cylinders from each group were subject to 7,000 thermal cycles in a thermal cycler (5 °C/55 °C). After storage and thermal cycling, the SBS test was performed at a crosshead speed of 1 mm/min. Data were subjected to two-way ANOVA and Tukey's post hoc test (α=0.05). Result: The SBS of ACCPT was significantly higher than the other groups (p<0.05). The specimens submitted to thermal cycling showed significantly lower SBS than those without thermal cycling (p<0.05), regardless the ceramic surface treatment. The ARI showed predominance of score 0 for all groups. Conclusion: Acid etching, CCP silane and Transbond XT method obtained the best results for bracket bonding. Thermal cycling reduced SBS for all groups. Score 0 was predominant for ARI in all groups.

Objetivo: Avaliar in vitro o efeito de diferentes tratamentos de superfície da cerâmica e ciclagem térmica na resistência da união ao cisalhamento (RUC) de bráquetes metálicos colados na cerâmica felspática. Material e método: Cilindros cerâmicos foram separados em 4 grupos (n=4) de acordo com os tratamentos da superfície da cerâmica: G1-Clearfil Ceramic Primer silano e Transbond XT (CCPT); G-condicionamento com ácido hidrofluorídrico a 10% (AHF) por 60s, CCP e Transbond XT (ACCPT); G3-condicionamento com AHF a 10% por 60s, Adesivo Ambar e Transbond XT (AAAT); e, G4 condicionamento com AHF a 10% por 60s, RelyX Ceramic Primer silano, primer adesivo Transbond e Transbond XT (ACPAT). Os bráquetes foram fixados nos cilindros com Transbond XT e fotoativado por 40s com LED Radii Plus. Todas as amostras foram armazenadas em água deionizada a 37 °C por 24 h e dois cilindros de cada grupo foram submetidos a 7.000 ciclos térmicos na máquina para ciclagem térmica (5 °C/55 °C). Após armazenagem e ciclagem térmica, a RUC foi realizada à velocidade de 1 mm/min. Na Análise de Variância de 2 fatores e ao teste de Tukey's post hoc test (α=0,05) a RUC do G2 foi significante maior do que dos demais grupos (p<0,05). Resultado: As amostras submetidas à ciclagem térmica apresentaram valores de RUC significantemente menores do que as amostras sem ciclagem térmica (p<0,05), independente do tratamento de superfície da cerâmica. Conclusão: Nas condições desse estudo o melhor resultado para colagem foi obtido com o condicionamento, silano CCP e Transbond XT. A ciclagem térmica reduziu a RUC em todos os grupos.