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)

Clinical complications during early treatment of anterior open bite

Abstract The object of this study was to compare the clinical complications of 4 different appliances used in the early treatment of anterior open bite (AOB), and to test the null hypothesis that there is no difference in the number of complications among the appliances. Records from 99 Class I malocclusion patients with AOB treated using bonded spurs, BS, n = 25; chin cup, CC, n = 25; fixed palatal crib, FPC, n = 25; and removable palatal crib, RPC, n = 24) were examined. The total number and frequency of clinical complications that occurred over 12 months were described and compared by using chi-square and Kruskal-Wallis tests (Dunn's post-test) (α = 5%, CI = 95%). The incidence of clinical complications was 66.7%, comprising: breakage, bond failure, maladjustment, allergy, soft-tissue lesion, loss of removable appliance and abandonment. Eighteen patients gave up treatment; this occurred more frequently in the groups with removable appliances. Regarding the total number of complications per patient, Group BS exhibited a significantly higher number than the other groups (p < 0.0001). A low frequency of complications (1 to 3) was found in the groups, except for Group BS, in which 8% of the patients presented moderate frequency (4 to 6). In terms of appliance types (fixed or removable), there was no difference in the incidence of complications (p > 0.094). The null hypothesis was rejected, since the BS group exhibited the highest total number and frequency of complications. There was no difference between fixed and removable appliances in terms of incidence of clinical complications, although more patients using removable appliances abandoned their treatment.

Prevalência de mordida aberta e fatores associados em pré-escolares de Salvador-BA em 2019 / Prevalence of open bite and associated factors in preschoolers from Salvador-BA in 2019

Resumo Introdução A mordida aberta anterior é um dos tipos de má-oclusão mais frequentes em pré-escolares, sendo considerada um dos problemas oclusais mais difíceis de tratar, principalmente por sua etiologia multifatorial e sua íntima relação com hábitos bucais deletérios. Objetivo Identificar a prevalência de mordida aberta anterior nos pré-escolares de Salvador-BA, bem como fatores potencialmente associados à mesma. Material e método Trata-se de um estudo de corte transversal em 1.577 crianças em idade pré-escolar (36 a 71 meses), que frequentavam creches públicas municipais de Salvador-BA. Resultado A média de idade das crianças foi aproximadamente 54 meses. A maioria pertencia ao sexo masculino (50,29%). A população de estudo foi predominantemente composta por negros e pardos (92,02%). A prevalência de má-oclusão foi de 40,46% e, destes, 14,02% possuíam mordida aberta. Com relação à escolaridade, a maior parte das mães (55,86%) e dos pais (50,08%) foi igual ou superior ao Ensino Fundamental II Completo. A sucção digital foi comum em 6,73% das crianças e 10,39% faziam sucção de chupeta. Foram identificados, como fatores de proteção à mordida aberta, a escolaridade do pai maior ou igual ao Ensino Fundamental II completo (RP= 0,62 IC= 0,41-0,95) e a onicofagia (RP= 0,34 IC= 0,21-0,56). Como fatores de risco, identificaram-se o uso de chupeta (RP= 17,98 IC= 10,91-29,62) e a sucção digital (RP= 11,04 IC= 6,0-20,32). Conclusão Medidas educativas direcionadas aos pais e responsáveis se fazem essenciais para a prevenção do desenvolvimento de hábitos deletérios nos pré-escolares. Outros estudos são necessários a fim de aprofundar o entendimento sobre os fatores de proteção identificados neste estudo.

Abstract Introduction The previous open bite is one of the most frequent types of malocclusions in preschoolers, being considered one of the most difficult occlusal problems to treat, mainly due to its multifactorial etiology and its intimate relationship with deleterious oral habits. Objective Identify the prevalence of anterior open bite in preschoolers in Salvador-BA as well as factors potentially associated with it. Material and method This is a cross-sectional study of 1577 preschool children (36 to 71 months) who attended municipal public daycare centers in Salvador-BA. Result The children's average age was approximately 54 months. Most were male (50.29%). The study population was predominantly composed of blacks and browns (92.02%). The prevalence of malocclusion was 40.46%, of which 14.02% of these children had an open bite. Regarding schooling, most mothers (55.86%) and fathers (50.08%) were equal to or higher than complete primary school. The digital sucking was common in 6.73% of the children and 10.39% used pacifiers. As protective factors for open bite were found the father's education level ≥ 1st complete degree (PR = 0.62 CI = 0.41-0.95) and nail-biting (PR = 0.34 CI = 0.21-0.56). As risk factors were found the use of pacifiers (PR = 17.98 CI = 10.91-29.62) and digital suction (PR = 11.04 CI = 6.0-20.32). Conclusion Educational measures aimed at parents and guardians are essential to prevent the development of harmful habits in preschoolers. Other studies are needed for in order to deepen the understanding of the identified protection factors in this study.

Maxilla Pseudoarthrosis Ten Years After Orthognathic Surgery: case report / Pseudoartrosis Maxilar Diez Años Después de la Cirugía Ortognática: relato de un Caso

ABSTRACT: Many orthodontic treatments alone cannot reestablish an ideal occlusion, requiring correction through orthognathic surgery. An adequate surgical planning, execution and case follow-up can provide surgical stability between the maxilla and the mandible. Soft tissue conservation and proper correction during a healing phase are important to achieving this goal. Patient C.L.B.S, 38 years old, female, presented with Angle Class I occlusion, facial profile class II, maxilla with mobility, chin surgically advanced and anterior open bite. She was submitted to orthognathic surgery 10 years ago. In the panoramic radiography the absence of bone formation in the maxilla was observed, causing an open bite. For the surgery conventional radiographs were used, as well as the dental cast in articulator for model surgery and preparation of surgical guide. With the surgery an improvement in the patient's aesthetics profile and an ideal occlusion, static and functional were expected. The treatment was orthodontic-surgical, with correction of the dento-facial deformity with counter-clockwise rotation of the maxilla, lowering repositioning in 3 mm of its posterior portion through Le Fort I osteotomy, advancement of the 4 mm mandible with bilateral sagittal osteotomy, and genioplasty for posterior repositioning with a Z-osteotomy, to improve mentual harmony. There was an improvement in the profile and aesthetics of the patient, which developed an Angle Class I profile, a decrease in the mentual projection, and an aesthetic and functional improvement. The orthognathic surgery allowed the advancement of the mandible, the repositioning of the maxilla and the mentual posterior repositioning, obtaining the correction of the Angle class II profile and the anterior open bite, resulting in an important improvement of facial profile and esthetics, presence of skeletal stability, restoration of function, self-esteem and quality of life.

RESUMEN: En muchos casos, el tratamiento ortodóntico por si solo no puede restablecer una oclusión ideal, siendo necesaria una cirúrgia ortognática. Una buena planificación quirúrgica, ejecución y seguimiento del caso, pueden proporcionar estabilidad entre los maxilares. La preservación de los tejidos blandos y una fijación adecuada son esenciales para ese objetivo. La paciente CLBS, 38 años, se presentó con oclusión Clase I de Angle, teniendo perfil clase II, maxilar con movilidad, mentón quirúrgicamente avanzado y mordida abierta anterior. La paciente fue sometida a cirugía ortognática 10 años antes. En radiografía panorámica, se nota la ausencia de formación ósea debido a una fijación maxilar realizada erróneamente, lo que causó la mordida abierta. Durante la planificación, fueron utilizadas radiografías convencionales, modelos de yeso en articulador para cirugía de modelo y confección de guía quirúrgica. Con el procedimento quirúrgico se esperaba obtener una mejora en el perfil de la paciente y una oclusión ideal, estática y funcional. El tratamiento fue ortodóntico-quirúrgico, con corrección de la deformidad dento-facial con giro antihorario de la mandíbula, con reposicionamiento inferior de 3 mm de su parte posterior, por medio de osteotomía Le Fort I, avance de la mandíbula de 4 mm con osteotomía sagital bilateral, y retroceso del mentón en su posición original con osteotomía en Z, mejorando la armonía del mentón. Hubo una mejora en perfil y en la estética de la paciente, como también una mejora en el perfil, estética y funcionalidade, con diminución del mentón. La cirúrgia ortognática permitió el movimiento de la mandíbula, reposicionamiento maxilar y además fue posible retroceder el mentón, obteniendo la corrección del perfil Clase II y de la mordida abierta anterior. El resultado representa una mejora del perfil y de la estética facial, además se nota una estabilidad esquelética, con restablecimiento de la función, autoestima y calidad de vida.

Global distribution of malocclusion traits: A systematic review

Abstract Objective: Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions. Methods: An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016. Results: Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids. Conclusion: Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.

Resumo Objetivo: considerando-se que os estudos disponíveis sobre a prevalência das más oclusões são de base local ou nacional, esse estudo teve como objetivo reunir dados para determinar a distribuição dos tipos de má oclusão em uma escala global, nas dentições permanente e mista. Métodos: foi realizada uma busca eletrônica através das ferramentas de pesquisa do PubMed, Embase e Google Acadêmico, para reunir estudos publicados até dezembro de 2016 sobre a prevalência das más oclusões, tanto na dentição permanente quanto na dentição mista. Resultados: dos 2.977 estudos encontrados, 53 foram analisados. Na dentição permanente, a distribuição mundial das más oclusões de Classe I, II e III foi, respectivamente, de 74,7% [31 - 97%], 19,56% [2 - 63%] e 5,93% [1 - 20%]. Na dentição mista, a distribuição dessas más oclusões foi de 73% [40 - 96%], 23% [2 - 58%] e 4% [0,7 - 13%]. Em relação às más oclusões verticais, observou-se prevalência de 21,98% de sobremordida profunda e 4,93% de mordida aberta. A mordida cruzada posterior afetou 9,39% da amostra. Os africanos mostraram a maior prevalência de Classe I e mordida aberta na dentição permanente (89% e 8%, respectivamente) e na dentição mista (93% e 10% respectivamente), enquanto os caucasianos apresentaram a maior prevalência de Classe II na dentição permanente (23%) e na dentição mista (26%). A má oclusão de Classe III na dentição mista foi mais prevalente entre xantodermas. Conclusão: mundialmente, nas dentições mista e permanente, as más oclusões de Classe I de Angle são mais prevalentes do que as de Classe II, especificamente entre os africanos; a menos prevalente foi a Classe III, ainda que mais prevalente entre os xantodermas na dentição mista. Na dimensão vertical, as mordidas abertas foram mais prevalentes entre xantodermas na dentição mista. A mordida cruzada posterior apresentou maior prevalência na dentição permanente na Europa.

Subjective facial analysis and its correlation with dental relationships

ABSTRACT INTRODUCTION: Subjective facial analysis is a diagnostic method that provides morphological analysis of the face. Thus, the aim of the present study was to compare the facial and dental diagnoses and investigate their relationship. METHODS: This sample consisted of 151 children (7 to 13 years old), without previous orthodontic treatment, analyzed by an orthodontist. Standardized extraoral and intraoral photographs were taken for the subjective facial classification according to Facial Pattern classification and occlusal analyses. It has been researched the occurrence of different Facial Patterns, the relationship between Facial Pattern classification in frontal and profile views, the relationship between Facial Patterns and Angle classification, and between anterior open bite and Long Face Pattern. RESULTS: Facial Pattern I was verified in 64.24% of the children, Pattern II in 21.29%, Pattern III in 6.62%, Long Face Pattern in 5.96% and Short Face Pattern in 1.99%. A substantial strength of agreement of approximately 84% between frontal and profile classification of Facial Pattern was observed (Kappa = 0.69). Agreement between the Angle classification and the Facial Pattern was seen in approximately 63% of the cases (Kappa = 0.27). Long Face Pattern did not present more open bite prevalence. CONCLUSION: Facial Patterns I and II were the most prevalent in children and the less prevalent was the Short Face Pattern. A significant concordance was observed between profile and frontal subjective facial analysis. There was slight concordance between the Facial Pattern and the sagittal dental relationships. The anterior open bite (AOB) was not significantly prevalent in any Facial Pattern.

RESUMO INTRODUÇÃO: a análise facial subjetiva é um método diagnóstico que privilegia a avaliação morfológica da face; assim, o principal objetivo do presente trabalho foi comparar os diagnósticos faciais e dentários e investigar a correlação entre eles. MÉTODOS: a amostra consistiu de 151 crianças (7 a 13 anos de idade), sem nenhum tratamento ortodôntico prévio, analisadas por um ortodontista. Foram realizadas fotografias padronizadas extrabucais e intrabucais, para a classificação subjetiva dos Padrões Faciais e das relações dentárias segundo a classificação de Angle. Investigou-se a ocorrência de diferentes tipos de Padrões Faciais, em vistas frontal e de perfil; a relação entre os Padrões Faciais e as relações dentárias de Classe e, também, entre a má oclusão de mordida aberta anterior e o Padrão Face Longa. RESULTADOS: o Padrão Facial I (PF I) esteve presente em 64,24% das crianças; o PF II, em 21,29%; o PF III, em 6,62%; o PF Face Longa, em 5,96% e o PF Face Curta, em 1,99%. Observou-se concordância substancial entre a avaliação do PF na vista frontal e na de perfil, igual a 84% (Kappa = 0,69). Houve concordância entre a avaliação da relação dentária de Classe e do PF em 63% da amostra (Kappa = 0,27). O PF Face Longa não demonstrou maior prevalência da má oclusão de mordida aberta. CONCLUSÃO: os Padrões Faciais I e II foram os mais prevalentes em crianças, enquanto o menos prevalente foi o Padrão Face Curta. Verificou-se concordância significativa entre as análises faciais frontal e de perfil. Existe uma ligeira concordância entre o Padrão Facial e a relação sagital dentária. A mordida aberta anterior não se apresentou mais prevalente em nenhum tipo de Padrão Facial.

Occlusal and cephalometric characteristics of anterior open-bite among Colombian 5-10 years old school children / Características oclusales y esqueléticas de mordida abierta anterior en escolares colombianos de 5 a 10 años

Abstract: objetive. The aim of this study was to determine oclussal and skeletal characteristics of anterior open bite (AOB) according to sex and socioeconomic status (SES) in school children in the municipality of Pasto, Colombia. Methodology. A cross-sectional study was carried out involving 384 children between 5 and 10 years of age. A clinical assessment was performed to evaluate AOB, and information regarding socio-demographic variables, such as sex and SES according to Colombian standards, was obtained. Standardized lateral cephalograms and cast models were taken from participating subjects. A statistical analysis was performed using frequencies, percentages, t-student, ANOVA, Mann-Whitney and Kruskal-Wallis tests. Results. Prevalence of AOB was 8.1 percent, showing a significant difference according to SES. The most common Angle’s classification was Class II with 70.6 percent in the right molars, and 58.8 percent in the left molars, according to occlusal characteristics. Statistically significant differences were observed in the ratio of posterior and anterior facial height (PFH:AFH) (p=0.050) according to sex. The distance between the upper first molar and palatal plane (U6-PP) (p=0.028), the Overbite (p=0.032) and Gonial° (p=0.033) values showed statistically significant differences according to SES in vertical skeletal measures. The 64.7 percent of AOB were of dental origin. Conclusion. Results suggest variations in some vertical skeletal measures according to sex and SES in children with AOB. Since a high percentage of AOB is caused by dental factors, preventive programs are required to control this condition.

Resumen: el objetivo de este estudio fue determinar las características oclusales y esqueléticas de mordida abierta anterior (MAA) según sexo y nivel socioeconómico en escolares de Pasto, Colombia. Metodología. Se diseñó un estudio transversal con la participación de 384 niños entre 5 y 10 años. Se realizó una valoración clínica para evaluar la MAA y se obtuvo información sobre variables socio-demográficas como edad, sexo y estrato socioeconómico (ESE) basado en los parámetros de Colombia. A los participantes se les tomó cefalometrías laterales estandarizadas y modelos de estudio de yeso. Se hizo un análisis estadístico usando frecuencias, porcentajes, t-student, ANOVA, Mann- Whitney y Kruskal-Wallis. Resultados. La prevalencia de MAA fue 8,1 por ciento y existió una diferencia significativa según ESE. La clasificación de Angle más común fue la Clase II para el molar derecho en 70,6 por ciento e izquierdo: en 58,8 por ciento de acuerdo a las características oclusales. Diferencias estadísticamente significativas fueron observadas en la razón entre la altura facial posterior y anterior (PFH: AFH) según sexo (p=0,05). Los valores de la distancia entre el primer molar superior y el plano palatino (U6-PP) (p=0,028), el Overbite (p=0,032) y Gonial° (p=0,033) tuvieron una diferencia estadísticamente significativa con respecto al ESE en las medidas esqueléticas verticales. El 64,7 por ciento de MAA fueron de origen dental. Conclusión. Los resultados sugieren variaciones en algunas medidas esqueléticas verticales según sexo y ESE. Debido a que existe un alto porcentaje de MAA dental, se requieren programas preventivos para controlar esta condición.

Craniofacial changes and symptoms of sleep-disordered breathing in healthy children

INTRODUCTION: The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees. OBJECTIVE: The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children. METHODS: A cross-sectional observational study was conducted. A sample comprising 687 healthy schoolchildren, aged 7-12 years old and attending public schools, was assessed by medical history, clinical medical and dental examination, and respiratory tests. The self-perceived quality of life of mouth breathing children was obtained by a validated questionnaire. RESULTS: Out of the total sample, 520 children were nose breathers (NB) while 167 (24.3%) were mouth breathers (MB); 32.5% had severe hypertrophy of the palatine tonsils, 18% had a Mallampati score of III or IV, 26.1% had excessive overjet and 17.7% had anterior open bite malocclusion. Among the MB, 53.9% had atresic palate, 35.9% had lip incompetence, 33.5% reported sleepiness during the day, 32.2% often sneezed, 32.2% had a stuffy nose, 19.6% snored, and 9.4% reported having the feeling to stop breathing while asleep. However, the self-perception of their quality of life was considered good. CONCLUSION: High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB. .

INTRODUÇÃO: a principal causa da respiração bucal e dos distúrbios respiratórios do sono (DRS) está associada ao estreitamento das vias aéreas superiores, em diferentes graus. OBJETIVO: avaliar a prevalência de alterações morfológicas e funcionais da face e os principais sintomas clínicos de DRS em crianças saudáveis. MÉTODOS: estudo transversal, observacional, com amostra de 687 escolares saudáveis, provenientes de escolas públicas, com idades entre 7 e 12 anos. Foram avaliados pela história clínica, exame clínico médico e odontológico e testes respiratórios. A autopercepção da qualidade de vida dos escolares com respiração bucal foi obtida por meio de um questionário validado. RESULTADOS: na amostra total, 520 crianças eram respiradoras nasais (RN) e 167 (24,3%) eram respiradoras bucais (RB); 32,5% tinham hipertrofia das amígdalas palatinas, 18% tinham índice Mallampati obstrutivo (III e IV); 26,1% tinham overjet exagerado e 17,7%, mordida aberta anterior. Entre os RB, 53,9% tinham palato atrésico; 35,9% com ausência de selamento labial; 33,5% relataram sonolência diurna; 32,2%, espirros frequentes; 32,2%, nariz entupido; 19,6% roncavam e 9,4% relataram ter a sensação de parar de respirar durante o sono. Entretanto, a autopercepção da qualidade de vida desses escolares foi considerada boa. CONCLUSÃO: foi encontrada alta prevalência de alterações faciais, de sinais e de sintomas clínicos de respiração bucal nos escolares saudáveis examinados, necessitando diagnóstico e tratamento para reduzir o risco de DRS. .

Association between anterior open bite and impact on quality of life of preschool children

The aim of this study was to evaluate the association between different types of malocclusion and the impact on quality of life among preschoolers and their families. A cross-sectional study was carried out involving 451 children 3-5 years of age. A clinical exam was performed to evaluate the malocclusions according to criteria proposed by Foster and Hamilton. This examination was conducted by a calibrated dentist. Parents/caregivers answered the Early Childhood Oral Health Impact Scale (ECOHIS) for the assessment of Oral Health-Related Quality of Life (OHRQoL) and the questionnaire on socioeconomic and demographic characteristics. Data analysis involved descriptive statistics, chi-square, Mann-Whitney and hierarchically adjusted Poisson regression. The prevalence of malocclusion was 28.4%. The most frequent conditions were posterior crossbite (20.4%), anterior open bite (9.5%) and increased overjet (8.4%). A significant association was found between anterior open bite and OHRQoL (p< 0.001). The adjusted analysis confirmed the association between anterior open bite and a negative impact on quality of life (PR = 2.55; 95%CI: 1.87 to 3.47; p< 0.001). Anterior open bite was associated with a negative impact on the quality of life of preschoolers.

Factors associated with the prevalence of anterior open bite among preschool children: A population-based study in Brazil

INTRODUCTION: The aim of this study was to identify factors associated with the prevalence of anterior open bite among five-year-old Brazilian children. METHODS: A cross-sectional study was undertaken using data from the National Survey of Oral Health (SB Brazil 2010). The outcome variable was anterior open bite classified as present or absent. The independent variables were classified by individual, sociodemographic and clinical factors. Data were analyzed through bivariate and multivariate analysis using SPSS statistical software (version 18.0) with a 95% level of significance. RESULTS: The prevalence of anterior open bite was 12.1%. Multivariate analysis showed that preschool children living in Southern Brazil had an increased chance of 1.8 more times of having anterior open bite (CI 95%: 1.16 - 3.02). Children identified with alterations in overjet had 14.6 times greater chances of having anterior open bite (CI 95%: 8.98 - 24.03). CONCLUSION: There was a significant association between anterior open bite and the region of Brazil where the children lived, the presence of altered overjet and the prevalence of posterior crossbite. .

INTRODUÇÃO: este estudo objetivou identificar os fatores associados à prevalência de mordida aberta anterior em crianças brasileiras com cinco anos de idade. MÉTODOS: foi realizado um estudo transversal analítico com dados do inquérito epidemiológico nacional de saúde bucal SB Brasil 2010. O desfecho estudado foi a mordida aberta, classificada em presente ou ausente. As variáveis independentes foram classificadas em individuais, sociodemográficas e clínicas. Os dados foram analisados por meio das análises bivariada e multivariada por meio do programa estatístico SPSS (versão 18.0), com nível de significância de 5%. RESULTADOS: a prevalência de mordida aberta anterior foi de 12,1% entre as crianças investigadas. Aqueles pré-escolares residentes na região Sul do Brasil apresentaram uma chance 1,8 vezes maior de serem diagnosticados com a mordida aberta anterior (IC 95%: 1,16 - 3,02). As crianças identificadas com alguma alteração de sobressaliência tiveram 14,6 vezes mais chance de pertencer ao grupo de crianças com mordida aberta (IC 95%: 8,98 - 24,03). CONCLUSÃO: verificou-se que mordida aberta anterior apresentou associação significativa com a região brasileira em que as crianças viviam, com a presença de alguma alteração de sobressaliência e com a prevalência de mordida cruzada posterior. .

Sucking habits and anterior open bite among Venezuelan and Brazilian children

AIM: To investigate the associations between nutritive and non-nutritive sucking habits and the prevalence of anterior open bite, in children from Aragua-Venezuela and São Paulo-Brazil. METHODS: Seven calibrated examiners (κ = 0.89-1.0) performed clinical assessments in Venezuelans (N = 809) and Brazilians (N = 1,377) aged 3-6 years. Sucking habits were investigated using questionnaires answered by the mothers. Data were analyzed using logistic regression models (α = 0.05). RESULTS: Among 380 children with anterior open bite, 309 were Brazilians. Approximately 65% of Brazilians with pacifier-sucking habit lasting beyond 3 years of age had this malocclusion. Brazilians who prolonged pacifier and digit-sucking habits beyond 3 years of age have, respectively, 68.5 and 14.5 times more chances of presenting anterior open bite than children without sucking habits (p < 0.001). In Venezuelans with open bite, 37.7% had digit-sucking habits beyond 3 years of age, resulting in a high odds ratio (9.3; p < 0.001) when compared to children without this habit. No significant effect was found for bottle feeding. However, non-breastfed Venezuelan children or those breastfed for periods shorter than 6 months have a two-fold higher chance of presenting anterior open bite than children who were breastfed for longer periods, p = 0.008. CONCLUSIONS: Infant feeding had some effect on Venezuelan children, since insufficient breastfeeding was related to a higher prevalence of anterior open bite. Pacifier-sucking was more prevalent in Brazilians, corresponding to pronounced chances (8-68 times greater) of diagnosing anterior open bite in pacifier users compared to non-users. Among Venezuelans, on the other hand, digit-sucking effect surpassed that of pacifier use and was associated with far higher chances (6-9 times) for this malocclusion...

Prevalence and Associated Factors for the Development of Anterior Open Bite and Posterior Crossbite in the Primary Dentition

The aim of the study was to verify the prevalence of anterior open bite (AOB) and posterior cross-bite (PC) in the primary dentition and the association with sociodemographic factors, presence and duration of nutritive and non-nutritive habits. A cross-sectional study was carried out with 732 preschoolers in Campina Grande, PB, Brazil. Clinical exams were performed by three calibrated examiners (Kappa: 0.85-0.90). A questionnaire addressing sociodemographic data as well as nutritive and non-nutritive sucking habits was administered to parents/caregivers. Data analysis involved descriptive statistics and Poisson regression analysis (α=5%). The prevalence of AOB and PC was 21.0% and 11.6%, respectively. AOB was significantly associated with the three-year-old age group (PR: 1.37; 95%CI: 1.24-1.52), enrollment in public school (PR: 1.09; 95%CI: 1.01-1.17) and duration of pacifier sucking ≥36 months (PR: 1.41; 95%CI: 1.30-1.53). PC was associated with pacifier use (PR: 1.11; 95%CI: 1.05-1.17) and duration of breastfeeding <12 months (PR: 1.05; 95%CI: 1.00-1.10). Socioeconomic factors appear not to be related to AOB or PC in the primary dentition, except type of preschool. Breastfeeding should be encouraged for longer periods and the use of pacifier beyond 3 years of age represents a predisposing factor for both types of malocclusion, especially AOB.

O objetivo do estudo foi verificar a prevalência de mordida aberta anterior (MAA) e mordida cruzada posterior (MCP) na dentição decídua e a associação com fatores sociodemográficos, presença e duração de hábitos nutritivos e não nutritivos. Um estudo transversal foi conduzido com 732 pré-escolares de Campina Grande, Brasil. Os exames clínicos foram realizados por três examinadores calibrados (Kappa: 0,85-0,90). Um questionário abordando dados socioeconômicos, bem como hábitos de sucção nutritiva e não-nutritiva foi aplicado aos pais/responsáveis. A analise dos dados envolveu estatística descritiva e analise de regressão de Poisson (α=5%). A prevalência de MAA e MCP foi 21,0% e 11,6%, respectivamente. A MAA foi associada ao grupo de três anos de idade (RP: 1,37; 95%IC: 1,24-1,52), pertencer à escola publica (RP: 1,09; 95%IC: 1,01-1,17) e duração do habito de sucção de chupeta ≥36 meses (RP: 1,41; 95%IC: 1,30-1,53). A MCP foi associada ao uso de chupeta (RP: 1,11; 95%IC: 1,05- 1,17) e tempo de amamentação <12 meses (RP: 1,05; 95%IC: 1,00-1,10). Os fatores socioeconômicos aparentam não estar relacionados à MAA ou MCP na dentição decídua, exceto pelo tipo de pré-escola. A amamentação natural deve ser incentivada por maiores períodos de tempo e o uso de chupeta além dos três anos de idade representa um fator de predisposição para ambas as má-oclusões, especialmente a MAA.

Prevalência e correlação entre padrão facial, mordida aberta anterior e mordida cruzada posterior / Prevalence and correlation among facial pattern, anterior open bite and posterior crossbite

Objetivo: o presente estudo objetivou analisar, por meio de uma amostra de escolares, a correlação entre o padrão facial, a mordida aberta anterior e a mordida cruzada posterior. Métodos: a amostra utilizada no estudo foi composta por 1.006 crianças brasileiras, entre 9 e 13 anos de idade. A média de idade foi de 10,85 ± 1,04 anos. As crianças selecionadas encontravam-se em fase de dentição mista tardia ou permanente jovem, tendo como critério para exclusão a presença de mordida topo a topo, dentes supranumerários, ou qualquer tratamento ortodôntico prévio. O material do estudo consistiu de fotografias extrabucais e de avaliação clínica da presença de mordida aberta anterior e mordida cruzada posterior. As prevalências foram determinadas em porcentagens; o dimorfismo sexual e a relação entre mordida aberta, mordida cruzada e os padrões faciais, foram avaliados pelo teste qui-quadrado. Resultados: a prevalência de mordida aberta anterior foi de 20,97%, a de mordida cruzada posterior foi de 25,05%. Os padrões faciais foram: 25,15% de dolicofaciais, 63,72% de mesofaciais e 11,13% de braquifaciais. Não houve dimorfismo entre os sexos para as prevalências dessas más oclusões. Conclusão: o padrão dolicofacial está relacionado a uma maior prevalência de mordida aberta anterior e de mordida cruzada posterior.

Má oclusão em pré-escolares: uma análise do SB Brasil 2010 / Malocclusion in preschool children: an analysis of SB Brasil 2010

Objetivo: identificar os fatores associados à prevalência de mordida aberta anterior em crianças brasileiras com cinco anos de idade. Métodos: foi realizado um estudo transversal analítico com dados do inquérito epidemiológico nacional de saúde bucal-SB Brasil 2010. O desfecho estudado foi a mordida aberta, classificada em presente e ausente. As variáveis independentes foram classificadas em individuais, sociodemográficas e clínicas. Os dados foram analisados por meio das análises bivariada e multivariada através do programa estatístico SPSS (versão 18.) com nível de significância de 95%. Resultados: a prevalência de mordida aberta anterior foi de 12,1% entre crianças investigadas...

Prevalence of malocclusion and orthodontic treatment needs among 16 and 17 year-old school-going children in Shimla city, Himachal Pradesh.

Background: Many studies have been conducted in India to know the prevalence of malocclusion and the orthodontic treatment needs using dental aesthetic index (DAI), but no study so far has been conducted in Shimla city, Himachal Pradesh. Objective: To know the prevalence of malocclusion and orthodontic treatment needs among 16- and 17 year-old school-going children in Shimla city, Himachal Pradesh. Materials and Methods: The study was carried out on 622 (365 boys and 257 girls) school children, aged 16 and 17 years, from February 2009 to May 2009. Type III examination was conducted and the assessment of malocclusion was done according to the DAI. Results: 20.28% of the male and 24.52% of the female students in the sample were affected with malocclusion. The mean DAI scores of the male and female children were 22.26 and 21.79, respectively. Distribution of the four DAI grades was as follows: DAI-I (no abnormality or minor malocclusion) 79.58%, DAI-II (definite malocclusion) 16.39%, DAI-III (severe malocclusion) 3.69%, DAI-IV (very severe/handicapping malocclusion) 0.34%. Conclusion: The present study shows that 20.42% of the children examined had malocclusion which required treatment.

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

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

Non-nutritive sucking habits, anterior open bite and associated factors in Brazilian children aged 30-59 months

The aim of the present study was to investigate the prevalence of non-nutritive sucking habits and anterior open bite as well as their main causes (associated factors) in Brazilian children aged 30-59 months. A cross-sectional study was carried out during the National Immunization Day for polio in the city of Recife in the northeastern region of Brazil. The sample was made up of 1,308 children. Data were collected from interviews with mothers or guardians as well as from clinical examinations carried out by previously trained dental students. The chi-square test was used for statistical analysis at 5 percent significance level. The prevalence of non-nutritive sucking habits was 40 percent, and the habits were associated with gender (p=0.001), age (p=0.003) and feeding type (p<0.001). Anterior open bite was detected in 30.4 percent of children, and it was significantly associated with feeding type (p<0.001) and non-nutritive sucking habits (p<0.001). The variables found to be associated factors in the present study for the occurrence of non-nutritive sucking habits and anterior open bite emphasize the need to establish strategies that include orientation regarding health promotion based on the "common determining factors" approach. Public health policies should be adopted to encourage a longer duration of breastfeeding, thereby contributing towards reducing the prevalence of non-nutritive sucking habits and anterior open bite.

O objetivo do presente estudo foi avaliar a prevalência de hábitos de sucção não nutritiva e mordida aberta anterior, assim como, determinar os seus fatores de risco (fatores associados) em crianças brasileiras de 30-59 meses. Um estudo transversal foi realizado durante o Dia Nacional de Vacinação contra a pólio na cidade do Recife, situada na região nordeste do Brasil. A amostra foi composta por 1308 crianças. Os dados foram coletados a partir de entrevistas com as mães ou responsáveis, bem como, de exames clínicos realizados por estudantes de odontologia, previamente treinados. O teste qui-quadrado foi utilizado para análise estatística com nível de significância de 5 por cento. A prevalência de hábitos de sucção não nutritiva foi de 40 por cento, e os hábitos estavam associados com sexo (p=0,001), idade (p=0,003) e tipo de alimentação (p<0,001). A mordida aberta anterior foi detectada em 30,4 por cento das crianças. A mordida aberta anterior foi significativamente associada com o tipo de alimentação (p<0,001) e hábitos de sucção não nutritiva (p<0,001). No presente estudo, as variáveis consideradas fatores associados para a ocorrência de hábitos de sucção não nutritiva e mordida aberta anterior enfatizam a necessidade de estabelecer estratégias que incluam a orientação sobre a promoção da saúde baseada na abordagem dos "fatores de risco comum". Deste modo, as políticas públicas de saúde devem ser adotadas para incentivar uma maior duração do aleitamento materno, contribuindo, assim, para reduzir a prevalência de hábitos de sucção não nutritiva e mordida aberta anterior.

Mordida aberta anterior e sua associação com os hábitos de sucção não-nutritiva em pré-escolares / Prevalence of anterior open bite and its association with non-nutritive sucking habits in preschoolers

OBJETIVO: Observar a prevalência de mordida aberta anterior entre os pré-escolares do município de Patos, Paraíba, verificando a sua associação com os hábitos de sucção não-nutritiva. MÉTODOS: Este estudo caracterizou-se como transversal e observacional, com enfoque quantitativo, o qual contou com uma amostra representativa de 140 pré-escolares entre 4 e 5 anos de idade, de ambos os gêneros e com dentição decídua completa, matriculados em creches municipais da cidade de Patos, Paraíba. O estudo foi realizado em duas etapas. Na primeira etapa os pais assinaram o Termo de Consentimento Livre e Esclarecido, aplicou-se um questionário para coletar informações sobre hábitos de sucção não-nutritiva e práticas de aleitamento da criança. Na segunda etapa fez-se o exame intra-bucal da criança, avaliando a ocorrência de mordida aberta anterior. Os dados obtidos foram trabalhados no Programa SPSS versão 13.0., sendo utilizadas técnicas de estatística descritiva e inferencial (teste qui-quadrado). RESULTADOS: A prevalência de mordida aberta anterior encontrada na população investigada foi de 27,9 por cento, estando a sua ocorrência associada ao tempo de amamentação natural (p<0,001), ao tempo de uso da mamadeira (p=0,025) e à sucção de chupeta (p<0,001), principalmente se esta continuou após os 3 anos de idade (p<0,001) e se foi constante (p<0,001). CONCLUSÃO: A prevalência de mordida aberta anterior foi baixa entre os pré-escolares do município de Patos, Paraíba, estando associada à sucção de chupeta quando esta ocorreu no período após os 3 anos de idade e de forma constante.

OBJECTIVE: Investigated the association between anterior open bite and non-nutritive sucking habits in preschoolers of Patos, Paraíba, Brazil. METHODS: This observational, quantitative, cross-sectional study included 140 preschoolers aged 4 to 5 years, of both genders, with complete set of primary teeth, attending public daycare facilities of the city of Patos, Paraíba. The study was done in two stages. In the first stage, the parents signed a free and informed consent form and answered a questionnaire on the non-nutritive sucking habits and feeding practices of the child. In the second stage, the oral cavity was examined to determine if the child had an anterior open bite. The data were processed by the software SPSS version 13.0 using descriptive and inferential (chi-square test) statistics. RESULTS: The prevalence of anterior open bite in the studied population was 27.9 percent. Its occurrence was associated with breastfeeding duration (p<0.001), prolonged bottle-feeding (p=0.025) and use of pacifiers (p<0.001), especially if pacifiers were used regularly (p<0.001) after the child's third year of life (p<0.001). CONCLUSION: The prevalence of anterior open bite was low in preschoolers of Patos, Paraíba. It was mostly associated with the regular use of a pacifier after the third year of life.

Prevalência de mordida aberta anterior e protrusão dentária em pré-escolares da cidade do Recife (PE, Brasil) / Prevalence of anterior open bite and overjet preschoolers in the city of Recife (PE, Brazil)

O objetivo deste trabalho foi verificar a prevalência de maloclusões (mordida aberta anterior, protrusão dentária) e sua associação com idade, gênero e tipo de escola em 2.651 pré-escolares da cidade do Recife, PE, Brasil. As crianças foram sentadas em cadeiras escolares na sala da própria creche/escola para a execução do exame clínico; os menores de dois anos foram atendidos no sistema perna-perna ou joelho-joelho, por meio de iluminação natural e artificial. A protrusão dentária foi considerada quando sobressaliência maior que 3 mm, mensurada por meio de sonda periodontal milimetrada. A mordida aberta anterior foi registrada quando não houve contato com os dentes anteriores e os posteriores se mantiveram em oclusão. Foi registrada em ficha clínica a combinação dos dois tipos de maloclusão, ou seja, de mordida aberta e de protrusão dentária. Os dados foram avaliados estatisticamente pelo teste Qui-quadrado e a medida para avaliar a associação entre os eventos foi o odds ratio. A prevalência de protrusão dentária foi 66,1 por cento e mordida aberta anterior, 19,8 por cento; houve associação entre as maloclusões, idade e tipo de escola, porém não houve associação estatisticamente significante entre maloclusão e gênero. Conclui-se que a prevalência de maloclusões em pré-escolares foi elevada e esteve associada à idade e tipo de escola.

The objective of this work was to verify the prevalence of malocclusions (anterior open bite, overjet) and its association with age, gender and type of school with a sample of 2,651 preschool children in the city of Recife, PE, Brazil. The children were seated in school chairs in the room of the day care/school for the clinical exam, children aging two years or less were assisted in the system knee-knee, through natural and artificial illumination. The dental protrusion was verified when the overjet was larger than 3 mm through periodontal probe in millimeters. The presence of anterior open bite was detected when there was no contact with the anterior teeth and the posterior ones stayed in occlusion. t was also registered in clinical record a combination of the two malocclusions types, in other words, open bite and of dental protrusion. The data were analyzed at Qui-square and the association among the events was the odds ratio. The prevalence of protrusion was 66.1 percent and previous open bite 19.8 percent. There was association among this malocclusions, age and type of school, however there was not significant statistical association between malocclusion and gender. It was concluded that the prevalence of malocclusion in preschoolers was high and it was associated to the age and school type.

Vertical interincisal trespass assessment in children with speech disorders

Through a transversal epidemiological study, conducted with 333 Brazilian children, males (157) and females (176), aged 3 to 6 years old, enrolled in a public preschool, this study aimed to evaluate the prevalence of the different types of vertical interincisal trespass (VIT) and the relationship between these occlusal aspects and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/. All children involved were submitted to a VIT examination and to a speech evaluation. Statistical significance was analyzed through the Qui-square test, at a significance level of 0.05 (95 percent confidence limit). The quantitative analysis of the data demonstrated the following prevalences: 1 - the different types of VIT: 48.3 percent for normal overbite (NO), 22.5 percent for deep overbite (DO), 9.3 percent for edge to edge (ETE) and 19.8 percent for open bite (OB); 2 - interdental lisping in relation to the different types of VIT: 42 percent for NO, 12.5 percent for DO, 12.5 percent for ETE, 32.9 percent for OB; and 3 - children with anterior tongue thrust in the articulation of lingua-alveolar phonemes in relation to the different types of VIT: 42.1 percent for NO, 14 percent for DO, 10.5 percent for ETE, 33.3 percent for OB. The results demonstrated that there was a significant relationship between open bite and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/; and that there was a significant relationship between deep overbite and the absence of anterior lisping and anterior tongue thrust in the articulation of the lingua-alveolar phonemes.