Impact of oral onditions on Quality of Life in Peruvian Preschoolers in Rural and Urban Areas / Impacto de las alteraciones bucales en la calidad de vida de preescolares peruanos de zonas rurales y urbanas

Abstract The objective of this study is to determine the impact of oral conditions on the quality of life related to the oral health of preschool children in a rural and urban area of Cusco. The study was descriptive and cross-sectional, from a population of 179 preschoolers aged 3 to 5 years, from two public early childhood education institutions, and their respective parents or caregivers in the department of Cusco, Peru. We worked with the entire population that met the inclusion and exclusion criteria, seventy-four preschool children were selected for each area, deciding to have the same amount of children per group based on the smallest group. A clinical odonto-stomatological examination was carried out for oral conditions (dental caries, malocclusion, and dental trauma) according to the WHO's criteria and a survey that was used for sociodemographic characteristics. In addition, a validated Peruvian version of the ECOHIS questionnaire was used to obtain data on the impact on quality of life. All the variables of the total and individual scores of the ECOHIS domains were analyzed individually and the Kruskal-Wallis test was used to determine the association between variables. The oral conditions prevalence in preschool children in rural areas referring to dental caries was 100% (dmft index > 6), dental trauma 10.8%, and malocclusions 60.8%; for the urban area dental caries was 93.2% (dmft index > 6), dental trauma 9.5% and malocclusions 36.5%. Of the three oral conditions only the experience of dental caries was related to the OHRQOL of preschoolers in urban and rural areas.

Resumen El objetivo de este estudio es determinar el impacto de las alteraciones bucales en la calidad de vida relacionada con la salud bucal de niños preescolares de una zona rural y urbana de Cusco. El estudio fue descriptivo y transversal, de una población de 179 preescolares de 3 a 5 años de edad, de dos instituciones públicas de educación inicial, y sus respectivos padres o cuidadores en el departamento de Cusco, Perú. Se trabajó con toda la población que cumplió con los criterios de inclusión y exclusión, se seleccionaron setenta y cuatro niños preescolares por cada área, decidiendo tener la misma cantidad de niños por grupo en base al grupo más pequeño. Se realizó un examen clínico odonto-estomatológico para detectar alteraciones bucales (caries dental, maloclusión y trauma dental) según los criterios de la OMS y una encuesta que se utilizó para las características sociodemográficas. Además, se utilizó una versión peruana validada del cuestionario ECOHIS para obtener datos sobre el impacto en la calidad de vida. Todas las variables de los puntajes totales e individuales de los dominios ECOHIS fueron analizadas individualmente y se utilizó la prueba de Kruskal-Wallis para determinar la asociación entre variables. La prevalencia de alteraciones bucales en niños preescolares de zonas rurales referida a caries dental fue del 100% (índice dmft > 6), traumatismo dental 10,8% y maloclusiones 60,8%; para la zona urbana la caries dental fue del 93,2% (índice dmft > 6), el traumatismo dental 9,5% y las maloclusiones 36,5%. De las tres alteraciones bucales, sólo la experiencia de caries dental se relacionó con la OHRQOL de los preescolares de las zonas urbana y rural.

Prevalencia de Anomalías Dentomaxilares y Necesidad de Tratamiento Ortodóncico en Escolares del Pueblo Originario Rapa Nui / Prevalence of Dentomaxillary Anomalies and Need for Orthodontic Treatment in School Children of the Rapa Nui Native People

El objetivo de este estudio fue determinar la prevalencia de anomalías dentomaxilares y la necesidad de tratamiento ortodóncico en escolares pertenecientes al pueblo originario de Rapa Nui. Se realizó un estudio descriptivo, observacional, transversal y no probabilístico. Se evaluaron 85 alumnos entre primero básico y primero medio, entre los 6 y 16 años de edad, de dos colegios de Rapa Nui. Se realizó un examen clínico estandarizado, realizado por dos investigadores previamente calibrados, donde se completó una ficha clínica diseñada para el estudio. Para el análisis de las anomalías dentomaxilares se realizó un escaneo digital de la cavidad oral completa para su posterior análisis. De 85 estudiantes evaluados, 75 (88,2 %) se encontraban afectados por algún tipo de anomalía dentomaxilar en el plano sagital, vertical y/o transversal, independiente de su gravedad. Un 87,1 % de los estudiantes necesitan tratamiento ortodóncico según el Índice de Necesidad de Tratamiento Ortodóncico, de los cuales un 57,7, % se clasificó dentro de los rangos de moderado, grave y muy grave. Existe una alta prevalencia de anomalías dentomaxilares en los escolares pertenecientes al pueblo originario Rapa Nui, encontrándose por sobre las cifras nacionales como internacionales, lo cual da como resultado que la mayoría de los alumnos evaluados necesiten de algún tipo tratamiento ortodóncico, ya sea preventivo, interceptivo y/o correctivo.

The aim of this study was to determine the prevalence of dentomaxillary anomalies and the need for orthodontic treatment in schoolchildren belonging to the Rapa Nui native people. A descriptive, observational, cross- sectional and non-probabilistic study was carried out. Eighty- five students between first grade and first middle school, between 6 and 16 years of age, from two schools of Rapa Nui were evaluated. A standardized clinical examination was performed by two previously calibrated investigators, where a clinical record designed for the study was completed. For the analysis of dentomaxillary anomalies, a digital scan of the full mouth was performed for subsequent analysis. Of 85 students evaluated, 75 (88.2 %) were affected by some type of dentomaxillary anomaly in the sagittal, vertical and/or transversal plane, regardless of its severity. Some 87.1 % of the students needed orthodontic treatment according to the Orthodontic Treatment Need Index, of which 57.7 % were classified within the moderate, severe and very severe ranges. There is a high prevalence of dentomaxillary anomalies in schoolchildren belonging to the Rapa Nui native people, which is above the national and international figures, resulting in the majority of the students evaluated needing some type of orthodontic treatment, whether preventive, interceptive and/or corrective.

Prevalence of Dental Caries in 5-Year-Old Children in a Northeast Brazilian Capital

ABSTRACT Objective: To evaluate the prevalence of dental caries in children aged five years in a Northeast Brazilian Capital (Fortaleza, CE) and its association with sociodemographic conditions, presence of malocclusion, and gingival bleeding. Material and Methods: This is a quantitative, descriptive, observational, and cross-sectional study carried out in a representative sample of 3,582 children aged five years in the city of Fortaleza-CE. Data was collected in public and private schools distributed in the city's Regional Health Coordination (CORES). Each of the six CORES worked with five field teams, participating in inter-examiner training and calibration with a final KAPPA coefficient of 0.87. Data were collected using a clinical form adapted from the SB Brasil 2010 questionnaire on sociodemographic conditions. The indices of dmft, need for treatment, malocclusion, and gingival bleeding were used for oral health conditions. The data were submitted to Pearson's Chi-square or Fisher's Exact tests, and the variables that show values of p<0.05 were submitted to a multinomial logistic regression model (forward stepwise model). Results: 57.1% of children were caries-free, and the mean dmft-d was 1.65 (1.65±2.65). CORES I and VI were the ones that presented the most significant association with caries attacks in all primary molars. The highest percentage of caries in the 2nd upper molar (60.6%), 1st lower molar (59%), and 2nd lower molar (58.8%) were found in children with normal occlusion. There was a significant association between gingival bleeding and caries in all molars and the need for treatment. Conclusion: These results allow us to observe that the prevalence of dental caries in 5-year-old children in Fortaleza is low, although with a tendency to increase.

Family functioning and dental trauma, malocclusion and anthropometry in adolescents

Aim: The aim of the study was to investigate perceived family cohesion and adaptability and its association with trauma, malocclusion and anthropometry in school adolescents. Methods: Cross-sectional study with a representative sample of 921 adolescents from 13 to 19 years old of both sexes, enrolled in state public schools of a northeastern Brazilian municipality. A questionnaire with sociodemographic questions, the FACES III scale was applied and a clinical oral examination (dental trauma and malocclusion) and anthropometric (BMI by age) were performed. For statistical analysis, was evaluated by the Chi-square test. The variables that presented significance in the bivariate analysis of up to 25% were taken to the multivariate analysis (multinomial logistic regression), variables that presented significance in bivariate analysis of up to 25% were taken to multivariate analysis and all conclusions were drawn considering the significance level of 5%. Results: As a result, it was identified that displaced families were associated with low maternal education, agglutinated families associated with the absence of caries. Rigid families were associated with marked overjet and caries. The prevalence of dental trauma (37.5%) was considered high. Conclusion: It was concluded that family cohesion and adaptability were associated with oral health and socioeconomic factors

Maloclusiones funcionales y su relación con hábitos orales en niños con dentición mixta / Functional malocclusions and their association with oral habits in children with mixed dentition

Objetivo: Relacionar la prevalencia de maloclusiones funcionales con hábitos orales en niños con dentición mixta. Materiales y métodos: La muestra estuvo constituida por 61 pacientes que asistieron a la Facultad de Odontología de la UNNE entre los meses de abril y noviembre de 2018, seleccionados mediante un muestreo al Azar Sistemático. Se evaluó en ellos la presencia de maloclusiones funcionales como mordidas abiertas y cruzadas, líneas medias desviadas, apiñamiento dentario, resalte maxilar. Como hábitos orales se consideró la succión digital, interposición lingual y deglución atípica, interposición de labios y objetos, respiración bucal, onicofagia. Se realizó un análisis descriptivo empleando el software estadístico InfoStat Versión 2019 y para conocer la asociación entre las maloclusiones funcionales y los hábitos orales se emplearon pruebas de Chi cuadrado (nivel de signi- ficación de P ≤0,05). Resultados: Se observó la presencia de maloclusiones funcionales en un 64% de los niños, y se encontró que el api- ñamiento dentario fue el predominante con un 39%. La pre- valencia de hábitos orales fue de 66%, la interposición labial y de objetos fue la que se detectó con mayor frecuencia con un 39%. Se observó mayor presencia de mordida abierta en pacientes con hábitos parafuncionales como ser succión digi- tal e interposición lingual. La asociación entre maloclusiones funcionales y hábitos orales fue estadísticamente significativa (χ 2 = 6,17, P = 0.0130). Conclusión: Se identificó una alta prevalencia de malo- clusiones funcionales en niños con dentición mixta, asociadas a hábitos orales (AU)

Aim: To determine the association between prevalence of functional malocclusions and oral habits in children with mixed dentition. Materials and methods: The sample consisted of 61 patients who attended the UNNE School of Dentistry from April to November 2018, selected through systematic random sampling. Presence of functional malocclusions such as open bite, crossbite, deviated midlines, dental crowding, and maxil- lary protrusion were evaluated. The oral habits of finger suck- ing, lingual interposition and atypical swallowing, interposi- tion of lips and objects, mouth breathing, and onychophagia were considered. A descriptive analysis was performed using the Statistical Software InfoStat Version 2019. Chi-square tests were used to determine the association between function- al malocclusions and oral habits (significance level P ≤0.05). Results: Functional malocclusions were present in 64% of the children, with dental crowding being the most prevalent, in 39%. Prevalence of oral habits was found in 66%, with la- bial and object interposition having the highest frequency, in 39%. Open bite was more frequent in patients with parafunc- tional habits such as finger sucking and lingual interposition. The association between functional malocclusions and oral habits was statistically significant (χ2 = 6.17, P = 0.0130). Conclusion: High prevalence of functional malocclu- sions was identified in children with mixed dentition, associ- ated with oral habits (AU)

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.

Alterations of oral functions and dental malocclusions in adolescents: a cross-sectional population-based study / Alterações das funções orais e má oclusão em adolescentes: um estudo transversal de base populacional

Abstract This article aims to assess whether alterations of oral functions (AOF) are associated with malocclusion (MO)'s type and severity. Cross-sectional study of a representative sample of 332 adolescents aged 12 years in São Luís-MA, Northeastern Brazil. MO criteria included Angle's classification, Dental Aesthetic Index, and other morphological problems. The AOF were evaluated by breathing, phonation, chewing, and swallowing. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic and multinomial regression analyses (α=5%). Mouth breathing was associated with defined (OR=3.84; 95%CI=1.45-10.12), disabling (OR=4.34; 95%CI=1.99-9.49), and class III (OR=4.15; 95%CI=1.19-14.54) MO. Phonation problems were associated with defined (OR=2.01; 95%CI=1.02-4.39), disabling (OR=3.04; 95%CI=1.55-5.96), and Class II (OR=2.02; 95%CI=1.28-3.18) MO. Chewing disorders were associated with posterior crossbite (PCB) (OR=2.32; 95%CI=1.12-4.82). Swallowing disorders were associated with Class III MO (OR=5.66; 95%CI=1.35-23.71), PCB (OR=6.13; 95%CI=2.76-13.62), and posterior open bite (OR=4.53; 95%CI=1.72-8.92). Breathing and phonation alterations are associated with MO in anterior arch segments, while chewing and swallowing disorders, in the posterior segments.

Resumo O objetivo deste artigo é avaliar se alterações das funções orais (AFO) estão associadas ao tipo e gravidade da maloclusão (MO). Estudo transversal com amostra representativa de 332 adolescentes de 12 anos em São Luís-MA, Nordeste do Brasil. Critérios de MO incluíram Classificação de Angle, Índice de Estética Dental e outros problemas morfológicos. As AFO foram avaliadas por respiração, fonação, mastigação e deglutição. Odds ratios (OR) e intervalos de confiança de 95% (IC95%) foram calculados em análises de regressão logística e multinomial (α=5%). Respiração oral foi associada com MO definida (OR=3,84; IC95%=1,45-10,12), incapacitante (OR=4,34; IC95%=1,99-9,49) e classe III (OR=4,15; IC95%=1,19-14,54). Problemas de fonação foram associados às MO definidas (OR=2,01; IC95%=1,02-4,39), incapacitantes (OR=3,04; IC95%=1,55-5,96) e Classe II (OR=2,02; IC95%=1,28-3,18). Alterações na mastigação foram associadas à mordida cruzada posterior (MCP) (OR=2,32; IC95%=1,12-4,82). Deglutição atípica foi associada à MO Classe III (OR=5,66; IC95%=1,35-23,71), MCP (OR=6,13; IC95%=2,76-13,62) e mordida aberta posterior (OR=4,53; IC95%=1,72-8,92). Alterações de respiração e fonação estão associadas às MO nos segmentos anteriores do arco, enquanto as de mastigação e deglutição, nos segmentos posteriores.

Manifestaciones bucales de pacientes con mucopolisacaridosis / Oral manifestations in patients with mucopolysaccharidosis

Objetivo: Describir las características bucales prevalentes de pacientes argentinos con mucopolisacaridosis (MPS) atendidos en el Servicio de Odontología del Hospital Nacional "Prof. Alejandro Posadas". Materiales y métodos: Se consideraron las historias clínicas de 19 pacientes con diagnóstico de MPS. Se registraron la edad, el sexo, el lugar de residencia, el tipo de MPS y la presencia de retraso madurativo. La muestra estuvo constituida por 13 niños (6,7±3 años) y 6 adultos (26±9 años): 2 eran mujeres (1 con MPS tipo I; 1 con MPS tipo IV A) y 17 eran hombres (15 con MPS tipo 2; 1 con MPS tipo 1; 1 con MPS tipo III); 13 de los pacientes presentaban discapacidad intelectual. Se evaluaron: tipo de dentición, oclusión, macroglosia, hipoplasias del esmalte, tipo de respiración predominante, clase molar y tratamiento realizado. Resultados: Ambos casos con MPS I presentaban mordida abierta anterior y giroversión dental, y solo uno de estos, diastemas, microdoncia, hipoplasias del esmalte, macroglosia y respiración bucal. De los 15 pacientes con MPS II, 11 presentaban mordida abierta anterior (73%), 3 mordida cruzada posterior (20%), 5 giroversión dental (33%), 11 diastemas (73%), 3 retraso en la erupción (20%), 4 hiperplasia gingival (26%), 13 macroglosia (87%), 7 hipoplasias del esmalte (47%), 2 microdoncia (13%), 9 respiración bucal (60%). Se registraron 5 pacientes con clase molar I (33%), 3 con clase molar II (20%), 3 con clase molar III (20%) y en 3 casos no se pudo evaluar (20%). En el paciente con MPS tipo III se halló mordida abierta anterior, diastemas, retraso en la erupción, macroglosia, respiración bucal y clase molar II; y en el caso de MPS tipo IV A, mordida abierta anterior, diastemas, hiperplasia gingival, macroglosia y clase molar II. El 90% de los pacientes requirió tratamiento odontológico (AU)

Aim: To identify the most prevalent oral manifestations of 19 Argentine patients with mucopolysaccharidos (MPS) attending the Dentistry Service of the National Posadas Hospital. Materials and methods: The medical records of 19 patients diagnosed with MPS were considered. Age, sex, place of residence, type of MPS, and presence of maturational delay were recorded. The sample consisted of 13 children (6.7 ± 3 years) and 6 adults (26 ± 9 years): 2 were women (1 with MPS type I; 1 with MPS type IV A) and 17 were men (15 with MPS type 2; 1 with MPS type 1; 1 with MPS type III); 13 of the patients had intellectual disabilities. The following were evaluated: type of dentition, occlusion, macroglossia, enamel hypoplasia, predominant type of respiration, molar class and treatment performed Results: Both cases with MPS I presented anterior open bite and dental gyroversion, and only one of these, diastemas, microdontia, enamel hypoplasia, macroglossia and mouth respiration. Of the 15 patients with MPS II, 11 presented anterior open bite (73%), 3 posterior crossbite (20%), 5 dental gyroversion (33%), 11 diastemas (73%), 3 delayed eruption (20%), 4 gingival hyperplasia (26%), 13 macroglossia (87%), 7 enamel hypoplasia (47%), 2 microdontia (13%), 9 mouth breathing (60%). 5 patients with molar class I (33%), 3 with molar class II (20%), 3 with molar class III (20%) and in 3 cases it could not be evaluated (20%). In the patient with type III MPS, anterior open bite, diastemas, delayed eruption, macroglossia, mouth breathing and molar class II were found; and in the case of type IV A MPS, anterior open bite, diastemas, gingival hyperplasia, macroglossia and molar class II. 90% of the patients required dental treatment. Conclusion: The most observed oral manifestations were macroglossia (84.2%) and anterior open bite (73%) (AU)

The perception of caregivers of poor oral health of their children and its related clinical conditions / Percepção de cuidadores sobre a má saúde bucal das crianças e sua relação com condições clínicas

ABSTRACT Objective: To determine the association between the perception of caregivers regarding the oral health of their children and socio-demographic characteristics, report of dental pain, and clinical oral conditions. Methods: A cross-sectional study was conducted with 570 children aged two to five years old, enrolled at public preschools, and with their caregivers. Data regarding perceptions of oral health status in children, socio-demographic characteristics, and dental pain were collected from a questionnaire. Three examiners (Kappa>0.7) evaluated children's oral health status using the dmft index, pufa index, and the Andreasen classification for traumatic dental injury (TDI). The occurrence of open bite and overjet was also investigated. Descriptive analyses, and unadjusted and adjusted logistic regression were used, considering a 5% significance level. Results: A total of 24.7% of children had poor oral health status, which increased 4.92-fold (95% confidence interval [95%CI] 3.05-7.93) when children had dental caries, and 3.78-fold (95%CI 1.63-8.76) when there were consequences from dental caries. The perception of poor oral health was also associated to open bite (Odds Ratio [OR] 1.98; 95%CI 1.16-3.38) and TDI (OR 1.68; 95%CI 1.06-2.68). No associations were found between the perception of caregivers and socio-demographic variables or overjet. Conclusions: The perception of caregivers of poor oral health in their children was associated to dental caries, its consequences, TDI, and open bite.

RESUMO Objetivo: Determinar a associação entre a percepção dos cuidadores sobre a saúde bucal das crianças e características sociodemográficas, relato de dor dentária e condições clínicas bucais. Métodos: Foi realizado um estudo transversal com 570 crianças de dois a cinco anos matriculadas em pré-escolas públicas e seus cuidadores. Os dados referentes à percepção do estado de saúde bucal nas crianças, características sociodemográficas e dor dentária foram coletados por meio de um questionário. Três examinadores (Kappa>0,7) avaliaram o estado de saúde bucal das crianças usando o índice ceo-d, o índice PUFA e a classificação de Andreasen para traumatismo dentário (TD). A ocorrência de mordida aberta e overjet também foi investigada. Análise descritiva e regressão logística não ajustada e ajustada foram realizadas, considerando um nível de significância de 5%. Resultados: A percepção da má condição de saúde bucal nas crianças foi de 24,7%, a qual aumentou 4,92 vezes (IC95% ­3,05-7,93) quando as crianças apresentaram cárie dentária e 3,78 vezes (intervalo de confiança de 95% [IC95%] 1,63-8,76) quando houve consequências de cárie dentária. A percepção de saúde bucal ruim também foi associada a mordida aberta (Odds Ratio [OR] 1,98; IC95% 1,16-3,38) e TD (OR 1,68; IC95% 1,06-2,68). Não foram encontradas associações entre as percepções dos cuidadores e variáveis sociodemográficas ou overjet. Conclusões: As percepções dos cuidadores sobre a má condição de saúde bucal das crianças foram associadas à cárie dentária, suas consequências, TD e mordida aberta.

Association between malocclusion, tongue position and speech distortion in mixed-dentition schoolchildren: an epidemiological study

Abstract Background Malocclusions are highly prevalent in childhood and adolescence, being considered a public health problem worldwide, in addition to be considered an important predictor in the tongue position and speech disorders. Objective Evaluate the association of malocclusions with tongue position and speech distortion in mixed-dentition schoolchildren from the south of Brazil. Methodology This cross-sectional study was performed using a database of an epidemiological survey realized in the southern of Brazil, in 2015, for evaluating the dental and myofunctional condition of the mixed-dentition from 7-13 years' schoolchildren. The outcome variables were tongue position and speech distortion, evaluated by a trained and calibrated examiner. Characteristics regarding sociodemographic and oral health measures (Angle's classification of the malocclusion, overjet, overbite, posterior crossbite and respiratory mode) were also assessed. Poisson regression models with adjusted robust variance were used to evaluate the association among predictors variables in the outcomes. Results are presented as prevalence ratio (PR) and 95% confidence interval (95% CI). Results A total of 547 children were evaluated. Schoolchildren who presented anterior open bite (PR 2.36 95%CI 1.59-3.49) and having oral/oral-nasal breathing (RP 2.51 95%CI 1.70-3.71) are more likely to have altered position of the tongue. Both deep bite and being male represent protection factors for the abnormal tongue position. Regarding speech distortion, deep overbite presents a protective relationship to speech distortion (PR 0.41; 95%CI 0.24-0.71), whereas schoolchildren with posterior crossbite were more likely to present this problem (PR 1.77; 95%CI 1.09-2.88). Conclusion Anterior open bite and posterior crossbite were the malocclusions related to speech distortion and/or altered tongue position. Oral/oral-nasal breathing was also related to myofunctional changes. Deep bite malocclusion was a protective factor for both speech problems and altered tongue position when compared to a normal overbite.

Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study

ABSTRACT Objective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. Results: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. Conclusion: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

RESUMO Objetivo: Avaliar a influência da má oclusão na primeira infância na qualidade de vida relacionada à saúde bucal (QVRSB). Métodos: Este estudo de coorte de 7 anos envolveu 639 pré-escolares (1 a 5 anos) que foram avaliados inicialmente em um levantamento transversal conduzido em 2010. As crianças completaram a versão brasileira do Child Perception Questionnaire (CPQ8-10) para avaliar sua QVRSB no período do acompanhamento. Variáveis exploratórias foram coletadas na linha de base, incluindo a presença e severidade de má oclusão (sobressaliência e cobertura labial). Características socioeconômicas, hábitos de saúde bucal e padrões de assistência odontológica também foram investigados. Um modelo de regressão de Poisson multinível foi utilizado para medir a associação entre má oclusão e QVRSB. Com essa abordagem, calculou-se a razão de taxa de incidência (IRR, incidence rate ratio) e o intervalo de confiança de 95% (IC 95%). Resultados: No total, 449 crianças foram reavaliadas (taxa de acompanhamento de 70,3%). A prevalência de sobressaliência acentuada e cobertura labial inadequada foi de 13,5% e 11,9%, respectivamente. A média±DP de pontuação do CPQ8-10 foi 10,57±10,32. A presença de selamento labial inadequado foi associada com maiores médias na pontuação total do CPQ8-10 (IRR 1,51; IC 95% 1,29-1,77) e nos domínios de bem-estar social, bem-estar emocional e limitação funcional. Crianças com sobressaliência acentuada (>3 mm) também demonstraram médias nas pontuações do CPQ8-10 total maiores do que suas contrapartes normais. A presença dessa condição também influenciou os domínios de sintomas bucais (IRR 1,29; IC 95% 1,08-1,53) e bem-estar emocional (IRR 1,30; IC 95% 1,02-1,66). Conclusão: Os resultados do presente estudo sugerem que a má oclusão na primeira infância é um fator de risco para baixa QVRSB no futuro.

Ortodontia em saúde coletiva: epidemiologia das oclusopatias e da necessidade de tratamento ortodôntico em adolescentes / Orthodontics in public health: epidemiology of malocclusions and the need for orthodontic treatment in adolescents

A Epidemiologia tornou-se um ramo da ciência muito utilizado para a verificação das necessidades da população, o planejamento de ações e a organização dos serviços em saúde. Para isso, primeiramente, é fundamental realizar o diagnóstico situacional, a partir de dados específicos, em busca da compreensão e atuação sobre os problemas de saúde encontrados em coletividade. As oclusopatias têm sido uma das condições bucais mais prevalentes e, em consequência, houve o crescimento da demanda por tratamento ortodôntico. Nesta perspectiva, índices oclusais foram elaborados para medir a ocorrência das oclusopatias tendo em vista a priorização da necessidade de tratamento. O conhecimento da temática em escala global permitiu uma visão ampliada do problema e das estratégias desenvolvidas em saúde bucal. Neste contexto, a presente pesquisa teve os seguintes objetivos: 1) realizar uma revisão sistemática das evidências científicas existentes sobre a prevalência da necessidade de tratamento ortodôntico em adolescentes na faixa etária de 12 à 15 anos de idade; 2) investigar a prevalência das oclusopatias e a necessidade normativa de tratamento ortodôntico em adolescentes de 12 anos de idade. Na revisão sistemática foram incluídos trabalhos nacionais e internacionais publicados nas bases de dados Cochrane, Embase, Portal Regional da Biblioteca Virtual em Saúde (BVS), PubMed, Scientific Electronic Library Online (Scielo), Scopus e Web of Science (WOS). A busca inicial não se limitou a nenhum filtro disponível nas bases de dados e utilizou os seguintes descritores: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child e adolescent. Termos utilizados na literatura científica também foram empregados: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index e DAI index. Foram incluídas publicações que avaliaram a prevalência da necessidade de tratamento ortodôntico em adolescentes entre 12 à 15 anos de idade utilizando o Índice de Estética Dentária (DAI) e/ou Índice de Necessidade de Tratamento Ortodôntico (IOTN) em estudos epidemiológicos transversais, sem restrições de ano do periódico e idioma. Do total de artigos encontrados (n=2255), 525 estudos permaneceram após a remoção por duplicidade. Os títulos e resumos destas publicações foram avaliados e aplicando os critérios de exclusão, selecionou-se 38 artigos. Para elegibilidade, os critérios de inclusão foram empregados e 11 estudos foram eleitos. Os textos completos destas publicações foram obtidos para leitura e análise da qualidade metodológica. Com relação aos achados da necessidade de tratamento ortodôntico global, houve variabilidade nos resultados, mas observou-se que a prevalência foi considerada alta. Quanto às ações desenvolvidas, foram sugeridas a educação em saúde bucal para os adolescentes e pais com foco na prevenção e no tratamento interceptativo precoce das oclusopatias, bem como, inserção da ortodontia nos programas de saúde com a implantação de mais centros especializados. A segunda etapa desta pesquisa consistiu em um estudo observacional e transversal, realizado com 461 adolescentes de 12 anos de idade, matriculados em escolas públicas de um município de médio porte do Estado de São Paulo. A oclusão e a necessidade de tratamento ortodôntico foram avaliadas por meio da Classificação de Angle e do DAI. Os dados foram analisados utilizando estatística descritiva e as distribuições absolutas e percentuais das variáveis categóricas foram tabuladas. A verificação da associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle e o DAI foi realizada por meio do teste G, adotando-se um nível de significância de 5%. O processamento e a análise dos dados foram realizados com auxílio do Programa Epi-InfoTM versão 7.2. (Center for Disease Control and Prevention). O diagnóstico da oclusão, segundo a Classificação de Angle, mostrou que 8,89% apresentavam oclusão normal, 56,83% oclusopatia em Classe I, 24,08% em Classe II e 10,20% em Classe III. A prevalência da necessidade de tratamento ortodôntico, segundo o DAI, foi de 52,69% dos adolescentes considerando tratamento eletivo à obrigatório. Houve associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle com o DAI (p <0,0001). A prevalência das oclusopatias e da necessidade normativa de tratamento ortodôntico foi elevada, sendo 18,44% dos adolescentes com necessidade de tratamento obrigatório. Os índices foram eficazes para a identificação das oclusopatias, entretanto por avaliarem aspectos clínicos distintos, poderiam ser utilizados concomitantemente para aprimorar o diagnóstico das oclusopatias(AU)

Epidemiology has become a branch of science widely used to define the needs of the population, plan actions and organize health services. For this, first, it is essential to perform the situational diagnosis, based on specific data, in search of understanding and acting on the health problems found in the community. Malocclusion has been one of the most prevalent oral conditions and, as a result, there has been an increase in demand for orthodontic treatment. In this perspective, occlusal indexes were developed to measure the occurrence of malocclusions in order to prioritize the need for treatment. The knowledge of the theme on a global scale allowed an expanded view of the problem and the strategies developed in oral health. In this context, the present research had the following objectives: 1) to carry out a systematic review of the existing scientific evidence on the prevalence of the need for orthodontic treatment in adolescents aged 12 to 15 years old; 2) to investigate the prevalence of malocclusions and the normative need for orthodontic treatment in 12-year-old adolescents.The systematic review included national and international works published in the Cochrane, Embase, Regional Portal of the Virtual Health Library (VHL Regional Portal), PubMed, Scientific Electronic Library Online (Scielo), Scopus and Web of Science (WOS) databases. The initial search was not limited to any filter available in the databases and used the following descriptors: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child and adolescent. In addition, terms used in the scientific literature were also used: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index and DAI index. Were included publications that evaluated the prevalence of the need for orthodontic treatment in adolescents between 12 and 15 years of age using the Dental Aesthetic Index (DAI) and / or Orthodontic Treatment Needs Index (IOTN) in cross-sectional epidemiological studies, without restrictions on year of the journal and language. Of the total articles found (n = 2255), 525 studies remained after removal due to duplication. The titles and abstracts of these publications were evaluated and applying the exclusion criteria, 38 articles were selected. For eligibility, the inclusion criteria were used and 11 studies were elected. The complete texts of these publications were obtained for reading and analysis of methodological quality. As for the actions developed, oral health education recommendations were suggested for adolescents and parents with a focus on prevention and early interceptive treatment of malocclusions, as well as insertion of orthodontics in health programs with the implementation and development of specialized centers. The second stage of this research consisted of an observational, crosssectional, survey-type study conducted with 461 12-year-old adolescents enrolled in public schools in the medium-sized municipality of the State of São Paulo. Occlusion and the need for orthodontic treatment were assessed using the Angle Classification and the DAI. The data were analyzed using descriptive statistics and the absolute and percentage distributions of categorical variables were tabulated. The verification of the association between the results of clinical exams for the diagnosis of malocclusions using the Angle Classification and the DAI was performed using the G test, adopting a significance level of 5%. Data processing and analysis were performed using the Epi-InfoTM version 7.2 program. (Center for Disease Control and Prevention). The diagnosis of occlusion, according to the Angle Classification, showed that 8.89% had normal occlusion, 56.83% occlusion Class I, 24.08% Class II and 10.20% Class III. The prevalence of the need for orthodontic treatment, according to the DAI, was 52.69% of adolescents considering elective treatment to mandatory treatment. There was an association between the results of clinical examinations for the diagnosis of malocclusions using the Angle Classification with the DAI (p <0.0001). The prevalence of malocclusions and the normative need for orthodontic treatment was high, with approximately 18,44% of adolescents in need of mandatory treatment. The indices were effective for the identification of malocclusions, however, by evaluating different clinical aspects, they could be used concomitantly to improve the diagnosis of malocclusions(AU)

Nature and severity of dental malocclusion in children suffering from transfusion-dependent (-thalassemia major

ABSTRACT Objective: To evaluate the prevalence and severity of malocclusion in children suffering from β-thalassemia and to assess orthodontic treatment need using Grainger's Treatment Priority Index (TPI) and index of orthodontic treatment need (IOTN)-dental health component (DHC). Methods: A cross-sectional study was conducted on 200 transfusion-dependent children diagnosed with homozygous β-thalassemia and 200 healthy school children aged 11-17 years. The TPI and IOTN-DHC data was recorded for both groups. Total TPI score for each subject was calculated and graded according to malocclusion severity estimate (MSE). Independent sample t-test was used to compare mean TPI scores, overjet and overbite between thalassemic and healthy children. Chi-square test was used to compare the frequency of IOTN-DHC grades, Angle's classification, and MSE grades between thalassemic and healthy children. Results: The most prevalent malocclusion was Class I in normal children (67.5%) and Class II in thalassemic children (59%). The mean overjet and overbite were significantly (p<0.001) greater in thalassemic children than in healthy children. Severe tooth displacements were 3.5 times greater in thalassemic children, compared to controls. A greater proportion of thalassemic children were in IOTN grades 3 and 4, compared to the controls (p<0.001). MSE grades 4 and 5 were significantly (p<0.001) more prevalent in thalassemic children, compared to the controls. Conclusion: There is a high prevalence of Angle's Class II malocclusion in thalassemic children. Majority of these children are categorized in higher grades of IOTN-DHC and TPI-MSE, showing a great severity of malocclusion and high orthodontic treatment needs.

RESUMO Objetivo: Avaliar a prevalência e gravidade da má oclusão em crianças que sofrem de beta-talassemia e mensurar a necessidade de tratamento ortodôntico usando o Índice de Prioridade de Tratamento (IPT) de Grainger e o Índice de Necessidade de Tratamento Ortodôntico (Index of Orthodontic Treatment Need - IOTN) - Componente de Saúde Dental (Dental Health Component - DHC). Métodos: Um estudo transversal foi conduzido com 200 crianças com diagnóstico de beta-talassemia homozigótica dependentes de transfusão e 200 crianças saudáveis em idade escolar, entre 11 e 17 anos. Os dados do IPT e do IOTN-DHC foram documentados para ambos os grupos. A pontuação total do IPT para cada sujeito foi calculada e classificada de acordo com a Estimativa de Severidade da Má oclusão (ESM). O teste t para amostras independentes foi usado para comparar os escores médios de IPT, sobressaliência e sobremordida, entre as crianças saudáveis e as com talassemia. O teste qui-quadrado foi usado para comparar a frequência dos escores do IOTN-DHC, a classificação de Angle e os escores do ESM entre crianças com beta-talassemia e crianças saudáveis. Resultados: A má oclusão mais prevalente foi a Classe I em crianças normais (67,5%) e a Classe II em crianças com beta-talassemia (59%). Os valores médios de sobressaliência e a sobremordida foram significativamente (p< 0,001) maiores em crianças com beta-talassemia do que em crianças saudáveis. Os deslocamentos dentários graves foram 3,5 vezes maiores em crianças com beta-talassemia em comparação com os controles. Uma proporção maior de crianças com beta-talassemia estava nos escores 3 e 4 do IOTN em comparação com os controles (p <0,001). Os escores 4 e 5 de ESM foram significativamente (p< 0,001) mais prevalentes em crianças com beta-talassemia em comparação com os controles. Conclusão: Há uma alta prevalência de má oclusão de Classe II de Angle em crianças com beta-talassemia. A maioria dessas crianças é categorizada em escores superiores de IOTN-DHC e IPT-ESM, mostrando uma grande gravidade de má oclusão e alta necessidade de tratamento ortodôntico.

Prevalence of malocclusion and non-physiological oral habits in primary school children from Ercilla, Chile / Prevalencia de maloclusión y hábitos bucales no fisiológicos en niños de primaria de Ercilla, Chile

Introduction: Dentomaxillary Anomalies (DMA) affect the growth and morphology of the stomatognathic system of individuals, representing a public health problem. Few studies have described its prevalence among vulnerable populations in Chile. The aim of the study was to explore the prevalence of DMA and its association to non-physiological habits (NFH) and sociodemographic characteristics among primary school children living in Ercilla, Chile. Material and Methods: A convenience sample of 327 primary school students from six schools in Ercilla, were assessed through an intraoral and extraoral evaluation. Overjet, overbite, molar relationship, presence of DMAs, and NFHs were measured. Descriptive statistics, analysis of association between DMAs and studied factors, and logistic regression models were done and odds ratio with 95% confidence intervals presented. Results: A total of 61.5% of students presented at least one DMA. Chi-square test showed no significant association between DMA prevalence and NHFs, however, after adjusting for sociodemographic factors, children with NFH were 1.69 (95%CI 1.02-2.78) times more likely to have DMAs. Gender and area of residence were not significantly associated with DMAs. Conclusion: In children from Ercilla, DMAs were associated with NFHs, however, sociodemographic characteristics did not have a significant role in the presence of DMA, suggesting that sociodemographic factors might not strongly influence orthodontic needs among children from this geographical area.

Introducción: Las anomalías dentomaxilares (ADM) afectan el crecimiento y la morfología del sistema estomatognático de los individuos, lo que representa un problema de salud pública. Pocos estudios han descrito su prevalencia en poblaciones vulnerables en Chile. El objetivo del estudio fue explorar la prevalencia de ADM y su asociación con hábitos no fisiológicos (HNF) y características sociodemográficas en niños de escuela primaria que viven en Ercilla, Chile. Material y Métodos:Se evaluó una muestra de conveniencia de 327 estudiantes de educación básica de seis escuelas de Ercilla mediante una evaluación intraoral y extraoral. Se midieron el resalte, la sobremordida, la relación molar, la presencia de DMA y HNF. Se realizó estadística descriptiva, análisis de asociación entre ADMs y los factores estudiados, y modelos de regresión logística y se presentaron odds ratio con intervalos de confianza del 95%. Resultados: El 61,5% de los alumnos presentó al menos una ADM. La prueba de chi-cuadrado no mostróuna asociación significativa entre la prevalencia de ADM y HNF, sin embargo, después de ajustar de acuerdo a factores sociodemográficos, los niños con HNF tenían 1,69 (IC del 95%: 1,02 a 2,78) veces más probabilidades de tener ADMs. El género y el área de residencia no se asociaron significativamente con las ADMs. Conclusión: En los niños de Ercilla, las DMA se asociaron con NFH, sin embargo, las características sociodemográficas no tuvieron un papel significativo en la presencia de DMA, lo que sugiere que los factores sociodemográficos podrían no influir fuertemente en las necesidades de ortodoncia entre los niños de esta área geográfica.

Dental malocclusions in the anterior sextant, in a group of mexican patients between 3 and 14 years old / Frecuencia de maloclusiones dentarias en el sextante anterior, en un grupo de pacientes mexicanos entre 3 y 14 años

Aim: To evaluate the association between the frequency of malocclusions in the anterior sextant with dentition type, age, and sex. Material and methods: A descriptive, transversal and prospective study was carried out, in a convenience sample of 200 patients between 3 and 14 years old, of both sexes who attended the pediatric dentistry clinic of Dentistry Faculty from Autonomous University of Tlaxcala, Mexico. A dentist was standardized by a direct method (k=0.998, p=0.0001). Results: Crossbite and edge to edge bite were the most frequent (18% and 17% respectively), in no case the alterations in the previous sextant were related to sex, except altered overjet with age and dentition type (likelihood ratio=18,169, p=0.0001) (X2=18.820, p=0.0001). Conclusion: These observations highlight the importance of the diagnosis of possible alterations in the occlusion of the anterior sextant in both dentitions, in order to preventatively avoid major sequelae.

Objetivo: Evaluar la asociación entre la frecuencia de maloclusiones en el sextante anterior con el tipo de dentición, la edad y el sexo. Material y Métodos: Se llevó a cabo un estudio descriptivo, transversal, prolectivo en una muestra por conveniencia conformada por 200 pacientes entre 3 y 14 años, de ambos sexos atendidos en la clínica de odontopediatría de la Facultad de Odontología, de la Universidad Autónoma de Tlaxcala. Se estandarizó a una cirujana dentista a través del método directo (k=0,998, p=0,0001). Resultados: La mordida cruzada y borde a borde fueron las que se presentaron con mayor frecuencia (18% y 17% respectivamente), en ningún caso las alteraciones en el sextante anterior se relacionaron con el sexo, no así, el resalte alterado que se asoció con la edad y con el tipo de dentición (Razón de verosimilitudes=18.169, p=0.0001, X2=18.820, p=0.0001). Conclusión: El comportamiento observado permite reconocer la importancia del diagnóstico de las alteraciones en la oclusión del sextante anterior en ambas denticiones, con el propósito de actuar anticipadamente para evitar secuelas mayores.

Prevalence of malocclusions and dysfunctional oral habits in preschool children of municipal establishments in Viña del Mar / Prevalencia de maloclusiones y hábitos orales parafuncionales en preescolares de establecimientos municipales de Viña del Mar

Introduction: Malocclusions are a public health problem at national and global level, being third in the ranking of the most prevalent oral pathologies.Its origin is multifactorial, with dysfunctional oral habits being a risk factor. The objective of this study was to determine the prevalence of malocclusions and dysfunctional oral habits in students aged between 4 and 6 years in state-run public schools in Viña del Mar, Chile. Material and methods: A prevalence study was carried out in 184 students selected by random cluster sampling. Malocclusions were assessed by clinical examination, while dysfunctional oral habits were assessed by questionnaires and clinical examination. The data were analyzed using Fisher's exact test, Chi-square test and the PHI correlation coefficient. Results: The prevalence of malocclusions was 54.35% (95% CI [47.04% - 61.47%]), with dental crowding being the most frequent, while prevalence of dysfunctional oral habits was 95.11% (95% CI [90.82% - 97.45%]), led by lingual interposition. In none of the cases statistically significant differences of age, gender or class were noticed. The evidence provided by this study indicates that the presence of malocclusions is independent of the presence of dysfunctional oral habits, except between open bite and interposition of objects, whose magnitude of dependence was minor (0.2). Conclusion: There is a high prevalence of malocclusions and dysfunctional oral habits in preschool children, with dental crowding and lingual interposition being the most frequent, respectively. The presence of malocclusions is independent of the presence of dysfunctional oral habits.

Introducción: Las maloclusiones constituyen un problema de salud pública a nivel nacional y mundial, ocupando el tercer lugar en el ranking de patologías bucodentales más prevalentes. Su origen es multifactorial, siendo algunos de sus factores de riesgo los hábitos orales disfuncionales. El objetivo fue determinar la prevalencia de maloclusiones y hábitos orales disfuncionales en alumnos entre 4 y 6 años pertenecientes a establecimientos municipales de Viña del Mar. Material y Métodos: Se realizó un estudio de prevalencia en 184 alumnos seleccionados por muestreo aleatorio por conglomerados. Las maloclusiones fueron evaluadas mediante examen clínico, mientras que los hábitos orales disfuncionales a través de cuestionarios y examen clínico. Los datos fueron analizados utilizando el test Chi2, prueba exacta de Fisher y el coeficiente de correlación Phi. Resultados: La prevalencia de maloclusiones fue de 54.35% (IC 95% [47,04% - 61,47%]), siendo el apiñamiento la más frecuente, mientras que la de hábitos orales disfuncionales fue de 95.11% (IC 95% [90,82% - 97,45%]), liderada por la interposición lingual. Para ambos casos no se observaron diferencias estadísticamente significativas con edad, género y curso. La evidencia aportada por este estudio señala que la presencia de maloclusiones es independiente de la presencia de hábitos orales disfuncionales, excepto entre mordida abierta e interposición de objetos, cuya magnitud de dependencia fue leve (0.2). Conclusión: Existe una alta prevalencia de maloclusiones y hábitos orales disfuncionales en pre-escolares, siendo los más frecuentes el apiñamiento y la interposición lingual, respectivamente. La presencia de maloclusiones es independiente de la presencia de hábitos orales disfuncionales.

Prevalence of malocclusion and dental caries among Aymara children in Colchane, Chile / Prevalencia de maloclusión y caries dental en niños Aymaras de Colchane, Chile

Describe the prevalence of malocclusions, dental caries and the need for orthodontic treatment according to the Index of Orthodontic Treatment Need (IOTN) among Aymara schoolchildren, Indian group has lived in the highlands of the Andes Mountains. 76 Aymara schoolchildren between 5 and 15 years old in Colchane, Chile, where a cross-sectional study was conducted. DMFT/dmft index, Dental component (DHC) of IOTN and demographics were determined. Frequencies and mean (SD) were calculated. Bivariate analyses were conducted using Fisher's exact to test the association between sex and stage of dentition (p<0.05). Stata version 14 was used for all analyses. Among the 76 participants, 47.4 % (N=36) were male. Participants were on average 9.96 years old (SD=2.5). Over half presented dental caries (61.8 %, n=47) and 36.8 % (N=28) had missing teeth due to caries. The DMFT index was 2.1 (SD=1.9). The most frequent biotype was brachyfacial 88.2 % (N=67). Malocclusion was observed in 81.6 % (N=62) of participants. Class I, was the most frequent (67 %, N=51) malocclusion in the different stages of dentition. The most prevalent treatment need was grade 4 and 5 "need treatment" of the IOTN, observed in 71 % (N=54) of the sample with significant differences according to the stage of dentition (p<0.05). In this study, a high prevalence of malocclusion and a high percentage of dental caries was observed in Aymara children.

Describir la prevalencia de maloclusiones, caries dental y la necesidad de tratamiento de ortodoncia según el Índice de Necesidad de Tratamiento de Ortodoncia (IOTN), en escolares Aymaras, grupo indígena que vive en el altiplano de la Cordillera de los Andes. Estudio transversal de 76 escolares Aymaras de 5 a 15 años de Colchane, Chile. Se determinó el índice COPD/ceod, el componente dental (DHC) del IOTN y la demografía. Se calcularon las frecuencias y la media (DE). Se realizaron análisis bivariados utilizando el exacto de Fisher para probar la asociación entre el sexo y la etapa de la dentición (p<0,05). Se utilizó la versión 14 de Stata para todos los análisis. Entre los 76 participantes, 47,4 % (N = 36) eran hombres. Los participantes tenían un promedio de 9,96 años (DE = 2,5). Más de la mitad presentó caries dental (61,8 %, n = 47) y 36,8 % (N = 28) tenían dientes perdidos por caries. El índice DMFT fue 2,1 (DE = 1,9). El biotipo más frecuente fue el braquifacial 88,2 % (N = 67). Se observó maloclusión en el 81,6 % (N = 62) de los participantes. La Clase I fue la maloclusión más frecuente (67 %, N = 51) en las diferentes etapas de la dentición. La necesidad de tratamiento más prevalente fue la definida con los grados 4 y 5 de "necesidad de tratamiento" del IOTN, observada en el 71 % (N = 54) de la muestra con diferencias significativas según la etapa de la dentición (p <0,05). En este estudio, se observó una alta prevalencia de maloclusión y un alto porcentaje de caries dental en niños aymaras.

Association between maloclusion and self-perception of oral aesthetics in adolescents

Aim: To evaluate the aesthetic self-perception capacity of adolescents from public schools regarding the presence of oral alterations from malocclusions. Methods: Cross-sectional and quantitative study with 374 adolescents between 16 and 18 years old, belonging to public schools in the city of Parnaíba, Piauí. The adolescents were separated by gender (male and female) and examined for malocclusions. The problem identified for each participant was recorded for later comparison of the influence of its presence with aesthetic self-perception. Then, all adolescents, including those who demonstrated normal occlusion during the clinical evaluation, answered a questionnaire containing eight questions about their perception of their own smile and its impact on their interpersonal relationships. Self-perception was also analyzed by comparing the responses of those with normal occlusion with that of malocclusion individuals. Student's t-tests were used to verify if there was a difference between the groups. Results: The most prevalent malocclusions after clinical examination were midline deviations, crowding and diastemas, and the ones that most scored in the adolescents' perception were crowding, misalignment and diastemas. Conclusion: The adolescents were able to perceive the aesthetic alterations resulting from malocclusions, being determinants of dissatisfaction when smiling. They were not ashamed to smile, did not consider that the ideal smile would improve their self-esteem and that misaligned teeth would not interfere with flirting and interpersonal relationships

Prevalência de oclusopatias em jovens de 12 anos de idade: impactos físicos, sociais e emocionais / Prevalence of malocclusions in 12-year-olds: physical, social and emotional impacts

As oclusopatias representam um importante problema de saúde pública por apresentarem alta prevalência, possibilidade de prevenção, tratamento e promoverem prejuízos significantes na qualidade de vida dos indivíduos acometidos. Assim, torna-se fundamental a realização de estudos que investiguem a distribuição, a severidade e as consequências das oclusopatias em diferentes populações, visando contribuir para o desenvolvimento de estratégias e políticas públicas que minimizem a instalação e o agravamento das oclusopatias. Entretanto, nota-se que não há consenso sobre qual índice de oclusopatias melhor se adequa para a realização de estudos epidemiológicos, oferecendo critérios completos para classificar a presença, severidade e a necessidade de tratamento ortodôntico. Nesse contexto, a presente pesquisa teve como objetivos: realizar uma revisão de literatura sobre os índices de oclusopatias e analisar suas aplicações na saúde pública; e investigar a prevalência, severidade e necessidade de tratamento das oclusopatias e seus impactos na qualidade de vida relacionada à saúde bucal em adolescentes de 12 anos de idade. A revisão incluiu trabalhos nacionais e internacionais publicados nas bases de dados Pubmed, SciELO, Web of Science, Scopus, Bireme e Embase. A busca nas bases de dados considerou o período de 1899 a 2019 e utilizou os seguintes termos: saúde pública, métodos epidemiológicos, índices, levantamentos epidemiológicos, odontologia preventiva, maloclusão, oclusopatias e ortodontia. Foram incluídas publicações sobre o desenvolvimento e uso de índices de oclusopatias em estudos clínicos e epidemiológicos, sem restrições de metodologia e linguagem. Os títulos e resumos dos artigos encontrados foram avaliados e as versões completas das publicações elegíveis foram obtidas para leitura e análise. Cinquenta e dois índices e suas variações foram identificados e, desses, a maioria destinava-se a avaliações individuais, portanto sua utilização em saúde pública foi dificultada pelos requisitos de sua aplicação, como a necessidade de especialistas, análise de modelos de gesso, exames complementares como radiografias cefalométricas e fotografias, equipamentos específicos, necessidade de acompanhamento longitudinal dos casos, e avaliações exclusivamente objetivas ou subjetivas. Os índices apresentaram aspectos positivos ao analisarem parcialmente as condições físicas, funcionais, psicológicas e sociais, entretanto, ainda é um desafio encontrar um índice unânime para avaliação da necessidade de tratamento ortodôntico e os impactos das oclusopatias sobre a qualidade de vida dos indivíduos, com aplicabilidade em saúde pública. A segunda etapa desta pesquisa consistiu em um estudo observacional, transversal, analítico, do tipo inquérito, realizado com 453 adolescentes de 12 anos, matriculados em escolas públicas do município de Araçatuba-SP. A oclusão foi avaliada por meio do Índice de Estética Dental (DAI), enquanto o Child Perceptions Questionnaire11-14 (CPQ11-14) foi utilizado para avaliar a qualidade de vida relacionada à saúde bucal. Os escores do CPQ11-14 foram comparados de acordo com o sexo e presença de oclusopatia por meio do teste de Mann-Whitney. A análise segundo a severidade da oclusopatia foi realizada por meio do teste de Kruskal-Wallis. A correlação entre a severidade da oclusopatia e a qualidade de vida relacionada à saúde bucal foi avaliada com base nos resultados dos escores do DAI e do CPQ11-14 por meio do teste de correlação de Spearman. A prevalência de oclusopatia definida ou superior foi de 53,86%, enquanto a oclusopatia muito grave ou incapacitante foi observada em 18,76% dos adolescentes. Houve correlação positiva significativa (r = 0,7006; p <0,0001) entre os escores do DAI e do CPQ11-14. Adolescentes com oclusopatias apresentaram escores totais do CPQ11-14, assim como escores dos domínios bem-estar emocional e social, significativamente maiores (p <0,05) comparados àqueles sem oclusopatia. O escore total do CPQ11-14 foi significativamente maior (p = 0,0251) nos adolescentes do sexo feminino (16,91 + 10,52) em relação aos do sexo masculino (14,61 + 9,70). A presença de oclusopatias foi elevada, com predomínio de oclusopatias classificadas como definidas, e com necessidade de tratamento eletivo. Essa condição impactou negativamente a qualidade de vida relacionada à saúde bucal dos adolescentes, principalmente os aspectos emocionais e sociais. O impacto das oclusopatias em diferentes aspectos da qualidade de vida deve ser considerado na elaboração de estratégias de diagnóstico e tratamento(AU)

Malocclusion represents an important public health problem because it has a high prevalence, possibility of prevention, treatment and promotes significant losses in the life of affected individuals. Thus, it is essential to carry out studies that investigate the distribution, severity and consequences of malocclusions in different populations, aiming to contribute to the development of strategies and public policies that minimize the installation and aggravation of malocclusions. However, it is noted that there is no consensus on which rate of malocclusion is best suited to carry out epidemiological studies, offering complete criteria to classify the presence, severity, and the need for orthodontic treatment. In this context, the present research had as objectives: to carry out a literature review on the rates of malocclusion and to analyze its applications in public health; and to investigate the prevalence, severity and need for treatment of malocclusions and their impact on oral health-related quality of life in 12-year-old adolescents. The review included national and international works published in the databases Pubmed, SciELO, Web of Science, Scopus, Bireme and Embase. The search in the databases considered the period from 1899 to 2019 and used the following terms: public health, epidemiological methods, indexes, epidemiological surveys, preventive dentistry, malocclusion, and orthodontics. Publications on the development and use of malocclusion indexes were included in clinical and epidemiological studies, without restrictions on methodology and language. The titles and abstracts of the articles found were evaluated and the full versions of the eligible publications were obtained for reading and analysis. Fifty-two indices and their variations were identified and, of these, most were intended for individual evaluations, therefore their use in public health was hampered by the requirements of their application, such as the need for specialists, analysis of plaster models, complementary exams such as cephalometric radiographs and photographs, specific equipment, the need for longitudinal monitoring of cases, and exclusively objective or subjective evaluations. The indices showed positive aspects when partially analyzing physical, functional, psychological and social conditions, however, it is still a challenge to find a unanimous index to assess the need for orthodontic treatment and the impacts of malocclusions on the quality of life of individuals, with applicability in public health. The second stage of this research consisted of an observational, cross-sectional, analytical, survey-type study carried out with 453 12- year-old adolescents enrolled in public schools in the city of Araçatuba-SP. Occlusion was assessed using the Dental Aesthetics Index (DAI), while the Child Perceptions Questionnaire11-14 (CPQ11-14) was used to assess oral health-related quality of life. The scores of CPQ11-14 were compared according to gender and presence of malocclusion using the Mann-Whitney test. The analysis according to the severity of the malocclusion was performed using the Kruskal-Wallis test. The correlation between the severity of malocclusion and oral health-related quality of life was assessed based on the results of the DAI and CPQ11-14 scores using the Spearman correlation test. The prevalence of defined or higher malocclusion was 53.86%, while very severe or disabling malocclusion was observed in 18.76% of adolescents. There was a significant positive correlation (r = 0.7006; p <0.0001) between the DAI and CPQ11-14 scores. Adolescents with malocclusions had total CPQ11-14 scores, as well as scores in the emotional and social well-being domains, significantly higher (p <0.05) compared to those without malocclusion. The total score of CPQ11-14 was significantly higher (p = 0.0251) in female adolescents (16.91 + 10.52) compared to male adolescents (14.61 + 9.70). The presence of malocclusions was high, with a predominance of malocclusions classified as defined, and in need of elective treatment. This condition had a negative impact on the quality of life related to the adolescents' oral health, especially the emotional and social aspects. The impact of malocclusions on different aspects of quality of life must be considered when developing diagnostic and treatment strategies(AU)

Relationship between the occlusal and sociodemographic characteristics of patients of a latin american postgraduate program in orthodontics / Relación entre las características oclusales y sociodemográficas de los pacientes de un posgrado latinoamericano de ortodoncia

Objective: To describe and compare the occlusal characteristics, and to determine their relationship with the sociodemographic characteristics in subjects who began treatment in the Postgraduate Program in Orthodontics at the University of Antioquia (Medellín-Colombia) between 2012-2016. Materials and Methods: This descriptive study included 106 patients (14-60 years, 52 women and 54 men). A calibrated investigator (Bland Altman: <1, Kappa: ≥0.8) evaluated the discrepancy index (DI), the dental aesthetic index (DAI) and sociodemographic variables in standardized initial records. Correlations and associations between them were established. Results: The DAI mean was 35.62±12.76 and the DI mean was 20.37±13.78. The great majority of patients (92.4%) belonged to low and medium-low socioeconomic strata. Differences were observed regarding oral breathing (p=0.02) and atypical swallowing (p=0.01) indices. Discussion: Despite the severity and high complexity in the index scores, contrary to what was expected, no correlation was found between them. It seems that malocclusions do not have a particular sociodemographic characterization, with aesthetics being the main reason for consultation. Conclusions: The patients evaluated had a high degree of treatment complexity according to the DI and a high severity of malocclusion according to the DAI. No relationships were found between the indices and sociodemographic variables, except for habits of oral breathing and atypical swallowing.

Objetivo: describir y comparar las características oclusales, y determinar su relación con las características sociodemográficas en los sujetos que iniciaron tratamiento en el Posgrado de Ortodoncia de la Universidad de Antioquia (Medellín-Colombia) entre 2012-2016. Materiales y métodos: este estudio descriptivo incluyó 106 pacientes (14-60 años, 52 mujeres y 54 hombres). Un investigador calibrado (Bland Altman: <1, Kappa: ≥0.8) evaluó en las ayudas iniciales estandarizadas el índice de discrepancia (DI), el índice de estética dental (DAI) y las variables sociodemográficas en la historia clínica. Se establecieron las correlaciones y asociaciones entre ellas. Resultados: el promedio DAI fue 35,62±12,76 y el promedio DI fue 20,37±13,78. El 92,4% pertenecía a estratos socioeconómicos bajo y medio bajo. Se observaron diferencias en los índices en los pacientes con respiración oral (p=0,02) y deglución atípica (p=0,01). Discusión: a pesar de la severidad y alta complejidad reflejadas en los puntajes de los índices, contrario a lo esperado, no se encontró correlación entre estos. Parece ser que la maloclusiones no tienen una caracterización sociodemográfica, siendo la estética el motivo de consulta principal. Conclusiones: los pacientes evaluados tuvieron un alto grado de complejidad de tratamiento según el DI y una alta severidad de la maloclusión según el DAI. No se encontraron relaciones entre los índices y las variables sociodemográficas excepto para hábito de respiración oral y deglución atípica