Is sickle cell anemia a risk factor for severe dental malocclusion?

The aim of this study was to investigate possible associations between sickle cell anemia (SCA) and the severity of dental malocclusion (MO). This was a retrospective cohort study of 93 individuals with SCA (G1) and 186 individuals without the disease (G2). SCA patients were randomly selected by a simple draw from patients treated in the Centro de Hematologia e Hemoterapia do Maranhão (HEMOMAR) in northeastern Brazil. Patients aged between 16 and 60 were included after being tested for the hemoglobin S gene. G2 consisted of individuals living in the same residence as the patients. The Dental Aesthetic Index (DAI), as well as some morphological deviations not included in DAI, were used for the orthodontic evaluation of MO. Poisson regression with robust variance adjustment was employed to estimate relative risk (RR). In the multivariate analysis, SCA was associated with moderate (RR = 1.36) and very severe MO (RR = 8.0). SCA is correlated with anterior tooth loss (RR = 1.94), anterior spacing (RR = 1.66), overjet (RR = 1.87), anterior crossbite (RR = 1.94), and open bite (RR = 1.94). Thus, SCA is a risk factor for moderate and very severe MO.

Prevalence of long face pattern in Brazilian individuals of different ethnic backgrounds

Objective: The long face pattern is a facial deformity with increased anterior total facial height due to vertical excess of the lower facial third. Individuals with long face may present different degrees of severity in vertical excess, as well as malocclusions that are difficult to manage. The categorization of vertical excess is useful to determine the treatment prognosis. This survey assessed the distribution of ethnically different individuals with vertical excess according to three levels of severity and determined the prevalence of long face pattern. Material and Methods: The survey was comprised of 5,020 individuals of Brazilian ethnicity (2,480 females and 2,540 males) enrolled in middle schools in Bauru-SP, Brazil. The criterion for inclusion of individuals with vertically impaired facial relationships was based on lip incompetence, evaluated under natural light, in standing natural head position with the lips at rest. Once identified, the individuals were classified into three subtypes according to the severity: mild, moderate, and severe. Then the pooled sample was distributed according to ethnical background as White (Caucasoid), Black (African descent), Brown (mixed descent), Yellow (Asian descent) and Brazilian Indian (Brazilian native descent). The Chi-square (χ 2 ) test was used (p<0.05) to compare the frequency ratios of individuals with vertically impaired facial relationships in the total sample and among different ethnicities, according to the three levels of severity. Results: The severe subtype was rare, except in Black individuals (7.32%), who also presented the highest relative frequency (45.53%) of moderate subtype, followed by Brown individuals (43.40%). In the mild subtype, Yellow (68.08%) and White individuals (62.21%) showed similar and higher relative frequency values. Conclusions: Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively.

Occlusal characteristics and orthodontic treatment need in black adolescents in Salvador/BA (Brazil): an epidemiologic study using the Dental Aesthetics Index

OBJECTIVE: The objective of this article is to evaluate the need of orthodontic treatment, prevalence and severity of the malocclusions in individuals of black ethnicity in a representative sample of schoolchildren of the city of Salvador/Brazil, as well as to verify if the malocclusion was affected by socio-demographic conditions such as age and gender. METHODS: The reference population was constituted of schoolchildren with age between 12 and 15 years, enrolled in public and private schools. The malocclusion was evaluated in 486 students of black ethnicity, with ages varying from 12 to 15 years, selected in random sample in multiple stages. The adopted significance level was 1% and the power of the test was 90%. A questionnaire registering demographic characteristics was filled out by each individual. The Dental Aesthetics Index (DAI) was used by previously calibrated examiners (kappa 0.89), according to criteria of the World Health Organization. RESULTS: It was verified that most of the individuals (76%) had little or any need for orthodontic treatment. About 24% showed a condition of severe malocclusion, culminating in a vital need for orthodontic treatment. The main occlusal characteristics found in the group with high need of orthodontic treatment were dental crowding and accentuated overjet. The age was positively related to the improvement of the maxillary overjet and to the presence of crowding. CONCLUSION: The development of public politics that aim the insertion of orthodontic treatment among the procedures of health programs, with the implementation and development of specialized centers, is fundamental.

OBJETIVO: averiguar a necessidade de tratamento ortodôntico, prevalência e severidade das más oclusões em indivíduos negros numa amostra representativa de escolares da cidade de Salvador/BA (Brasil), além de determinar se as más oclusões eram afetadas por condições sociodemográficas como idade e sexo. MÉTODOS: o desenho epidemiológico foi transversal, e a população de referência se constituiu de escolares com idades entre 12 e 15 anos, matriculados em escolas de primeiro e segundo graus, públicas e privadas. Participou do estudo um total de 486 indivíduos sorteados em amostra probabilística em múltiplo estágio. O nível de significância adotado foi de 1% e o poder do teste foi de 90%. Aos participantes foram aplicados questionários registrando características demográficas e, depois, avaliados por examinadores previamente calibrados (Kappa 0,89), utilizando-se o Índice de Estética Dentária (IED) segundo critérios da Organização Mundial de Saúde. RESULTADOS: constatou-se que a maioria dos indivíduos (76%) observados nesse estudo possuía pouca ou nenhuma necessidade de tratamento ortodôntico. Cerca de 24% apresentaram uma condição de má oclusão severa, acarretando uma imprescindível necessidade de tratamento ortodôntico. As principais características oclusais encontradas no grupo com maior necessidade de tratamento ortodôntico foram apinhamento dentário e overjet maxilar acentuado. A idade foi positivamente relacionada com a melhora do quadro do overjet maxilar e com a presença de apinhamento dentário. CONCLUSÃO: torna-se fundamental o desenvolvimento de políticas públicas que objetivem a inserção do tratamento ortodôntico entre os procedimentos dos programas de saúde, com a implementação e desenvolvimento de centros especializados.

Maloclusiones y su impacto psicosocial en estudiantes de un liceo intercultural / Malocclusions and its psychosocial impact in intercultural highschool students

Las maloclusiones están consideradas como la tercera patología oral de mayor prevalencia e impacto en el mundo, a pesar de esto son pocos los estudios en Chile que abordan el tema y consideran sus consecuencias en la calidad de vida o su relación con grupos poblacionales específicos. El objetivo de este estudio es determinar la prevalencia y su impacto psicosocial en jóvenes que estudian en un liceo con población indígena. Se realizó un estudio descriptivo de corte transversal, en 129 alumnos, 73,6 por ciento pehuenche, del Liceo de Ralco; se utilizó el Índice Estético Dental para cuantificar la magnitud de las maloclusiones y un Cuestionario de Autoimagen para evaluar el aspecto psicosocial. Los resultados muestran una prevalencia del 67,4 por ciento y un 21,7 por ciento para el nivel discapacitante de maloclusiones, siendo significativamente mayor en población pehuenche y rural, valores por sobre el de estadísticas nacionales e internacionales. A más de la mitad de los jóvenes las maloclusiones le ocasionan problemas para relacionarse con sus pares. Todo lo anterior hace necesario implementar estrategias preventivas y curativas que den solución a este problema.

Malocclusions are regarded as the third oral disease with most prevalence and impact in the world, despite this there are few studies in Chile that address the issue and consider their impact on the quality of life and relationship to specific population groups. The aim of this study is to determine the prevalence and psychosocial impact on young people studying in a high school with indigenous people. We performed a descriptive cross-sectional study in 129 students, 73.6 percent pehuenche, of Ralco High-school; Dental Aesthetic Index was used to quantify the malocclusion magnitude and a Selfimage Questionnaire for assessing psychosocial aspect. The results show a prevalence of 67.4 percent and 21.7 percent for disabling malocclusions level, was significantly higher in pehuenche and rural population, this values are over national and international statistics. More than half of youngs have troubles to relating with their peers to cause of malocclusion. This requires the implementation of preventive and curative strategies providing a solution to this problem.

Jarabak 's cephalometric analysis of Brazilian black patients

The treatment of skeletal disharmonies presents better results when performed during the growth period. The physical changes that occur in every individual express growth, which is ruled by genetic, general and environmental factors. In order to identify such disharmonies and hence concentrate the clinical actions during treatment and influence facial growth, cephalometrics appears as a useful a diagnostic tool for identifying facial growth patterns or growth direction. Jarabak's cephalometric analysis is used to assess facial growth pattern of subjects with normal occlusion or malocclusions. The purpose of this study was to obtain mean values for cephalometric measurements from Jarabak's cephalometric analyses of black Brazilian subjects resident in the city of Piracicaba, São Paulo state, Brazil and vicinities, who presented Class I molar relationship with normal overjet and overbite, mild or no tooth crowding or spacing, and no history of orthodontic treatment. A sample of 37 stone plaster casts and 37 lateral teleradiographs from both male and female individuals aged 10 to 14 years was evaluated. Data were analyzed statistically by Student's t-test at 5 percent significance level. There was no significant differences between genders. The cephalometric measurements obtained in this study were similar to the Jarabak's standards, except for S-N mean value in females (66.50 mm ± 3.16), which was significantly lower than the standard.

A possibilidade de influenciar o crescimento das estruturas faciais continua sendo um grande desafio para os ortodontistas. As desarmonias esqueléticas apresentam melhores resultados se corrigidas no período de crescimento. As transformações ocorridas em um indivíduo representam a expressão do crescimento, que é regulado por fatores genéticos, gerais e ambientais. A fim de localizar as desarmonias, para concentrar as ações clínicas durante o tratamento e influenciar o crescimento facial, a cefalometria é um recurso diagnóstico útil na identificação do padrão facial ou na sua tendência de crescimento. A análise de Jarabak é utilizada para estudar o padrão de crescimento facial de indivíduos com oclusão normal ou com maloclusões. O objetivo do presente trabalho foi determinar os valores médios para as grandezas cefalométricas utilizadas na análise cefalométrica de Jarabak em indivíduos melanodermas, brasileiros, da região de Piracicaba, e com relação molar em Classe I com trespasse horizontal e vertical normal, com mínimo ou nenhum apinhamento ou diastemas e sem histórico de tratamento ortodôntico. Para tanto, foi utilizada uma amostra de 37 modelos de gesso pedra e 37 telerradiografias de cabeça, em norma lateral, de indivíduos de ambos os gêneros, compreendidos na faixa etária entre 10 a 14 anos. Os resultados foram submetidos ao teste "t" de Student, com nível de significância de 5 por cento. Não houve diferenças significantes entre os gêneros. As medidas encontradas na população estudada foram semelhantes ao padrão, diferindo somente o S-N para o gênero feminino, que foi de 66,50 mm (± 3,16), significantemente menor que a média padrão.

Etiología de la maloclusión desde un punto de vista antropológico / Etiology of malocclusion from an anthropological view point

Podemos decir que no puede desconocerse el hecho de que los caminos de la diversidad genética, ya sea producida por mutaciones al azar o mezclas étnicas o raciales, puedan tener una importante significación en la aparición de la maloclusión. Esta diversidad, sostenida por la explicación genética e implícita en el fundamento de la teoría evolutiva de Darwin, no explica la prevalencia de la malformación, ya que parece evidente que ella no constituye una ventaja en la lucha por la supervivencia. Parece entonces razonable sostener que la prevalencia y difusión de la MO se explica mejor en términos de aquellas características propias de la condición humana, que se ven plasmadas en un sentido totalizador, en los conceptos de cultura y civilización. Pero este punto de vista nos conduce más allá de las determinaciones biológicas, al terreno de los factores y pautas culturales en el dominio de lo simbólico. Es así que creemos que ambos aspectos -los factores genéticos y los culturales- se complementan, sin que sea posible comprender cómo la MO ha llegado a constituir una característica de nuestra especie, excluyendo a alguno de estos términos

Características de la oclusión de acuerdo con el tipo racial, en niños de 12 a 15 años / Characteristics of occlusion according to race type, in children aged 12-15 years

Se realiza un estudio en 2 118 niños de 12 a 15 años de edad y se determinan las características raciales y de la oclusión, según los métodos científicos establecidos por el Instituto de la Infancia y del doctor Angle, respectivamente, con el objetivo de conocer la relación entre ambos aspectos. Previa agrupación de datos, se realiza el análisis de los resultados y se obtienen diferencias significativas en el índice de oclusión normal entre el grupo negroide y los europoides y mezcla racial. La clase I de Angle predominó sobre la clase II división 1, clase III y clase II división 2, enumeradas estas en orden descendente, de acuerdo con los índices obtenidos. En cuanto a las razas, la clase I y clase II división I fueron mayoresen el grupo europoide, la clase II división 1 fueron mayores en el grupo europoide, la clase II división 2 en la mezcla racial y la clase III en el grupo negroide, con diferencias estadisticamente significativas. No se encontraron niños pertenecientes al grupo mongoloide