Therapies used for the management of myofascial temporomandibular disorders: bibliometric analysis / Terapias utilizadas para o manejo da disfunção temporomandibular de origem miofascial: análise bibliométrica

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder (TMD) is the term used to describe a set of painful and functional conditions that can affect the temporomandibular joint (TMJ), the masticatory muscles and/or their associated structures. For myofascial TMD, conservative therapies, including drugs, physical therapy, occlusal splint and pain self-management show the best benefits to the patient. The objective of this study was to carry out, through a bibliometric analysis, a review of the existing knowledge regarding the treatments used in myofascial TMD. CONTENTS: The search was conducted in the Web of Science (WOS) and SCOPUS databases in July and updated in December 2023, through the MeSh descriptors "Temporomandibular Joint Dysfunction Syndrome" and "Therapeutics". Moreover, bibliometric mapping was performed using the VOSviewer software. For the analysis, data on the terms of the title and abstract, type of document, number of citations, name of journals, most cited article and year of publication were included. Besides these, the country of the corresponding author, type of treatment, type of study and the results were included in the analysis. Of the 760 articles identified, 63 were selected to compose this review. Of these, most were original articles, clinical trials and were published in 2012. The most frequent treatments were: occlusal splint, laser, manual therapy, botulinum toxin and dry needling. Of the 15 countries analyzed, Brazil was the country with the highest number of publications. CONCLUSION: There was an increase in articles published on the topic, with Brazil being the country with the highest number of publications. Finally, the most used treatments were occlusal splint and laser.

RESUMO JUSTIFICATIVA E OBJETIVOS: Disfunção temporomandibular (DTM) é um termo utilizado para descrever um conjunto de condições dolorosas e funcionais que podem afetar a articulação temporomandibular (ATM), os músculos mastigatórios e/ou suas estruturas associadas. Para DTM miofascial, terapias conservadoras, incluindo fármacos (analgésicos e/ou anti-inflamatórios), fisioterapia, placa oclusal e autogestão da dor apresentam os melhores benefícios para o paciente. O objetivo deste estudo foi abordar, através de uma análise bibliométrica, o conhecimento existente sobre os tratamentos utilizados na DTM de origem miofascial. CONTEÚDO: A busca foi realizada na base de dados Web of Science (WOS) e SCOPUS, em julho e atualização em dezembro de 2023, por meio dos descritores do MeSh "Temporomandibular Joint Dysfunction Syndrome" e "Therapeutics". Além disso, um mapeamento bibliométrico foi realizado no software VOSviewer. Para análise, foram incluídos dados sobre os termos do título e do resumo, tipo de documento, número de citações, nome dos periódicos, artigo mais citado e ano de publicação e, além destes, o país do autor correspondente, tipo de tratamento, tipo de estudo e resultados. Dos 760 artigos identificados, 63 foram selecionados para compor esta revisão. Destes, a maioria era artigos originais, ensaios clínicos e foram publicados em 2012. Os tratamentos mais frequentes foram: placa oclusal, laser, terapia manual, toxina botulínica e agulhamento a seco. Dos 15 países analisados, o Brasil foi o país com maior número de publicações. CONCLUSÃO: Houve um aumento de artigos sobre a temática publicados, sendo o Brasil o país com mais publicações e os tratamentos mais utilizados foram placa oclusal e laser.

Non-Invasive Methods and the Use of Infiltrating Resins for the Control of Caries Progression in Deciduous Teeth: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To evaluate the influence of non-invasive treatment associated with the use of infiltrating resin for managing caries lesions in primary teeth. Material and Methods: A systematic review was performed by selecting articles from 6 online databases, using a search algorithm and eligibility criteria for data extraction and data synthesis for the papers included. Clinical trials involving primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the outer dentin) were included, presenting full text and answering the study's guiding question. This study used the RoB 2 tool for the risk of bias assessment and GRADE for certainty of evidence. Random effects meta-analyses were implemented, and lesion progression treatment effects were estimated through relative risk (RR) and associated 95% confidence intervals. Results: A total of 440 studies were found. After analyzing the inclusion criteria and removal of duplicates, eight studies were analyzed for quality evidence. Five of the eight studies included in this review contributed to the meta-analysis, all with some reflections regarding the risk of bias. Overall, the results of the meta-analysis showed that non-invasive treatment, when associated with the use of infiltrating resins, significantly reduced the risk of caries progression in relation to the treatment without this addition for follow-up periods ranging from 12 months to 2 years (RR 0.51 [0.40-0.65]). Conclusion: There is moderate certainty of evidence that the use of infiltrating resins associated with non-invasive treatments decreases the risk of caries progression in primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the dentin outer) when combined with non-invasive control methods alone.

An exploratory study of children with caries and its relationship to SARS-CoV-2

Abstract This exploratory study investigated whether children with dental decay were more likely to have COVID-19 than those without caries. The children underwent dental inspection and blood collection for detection of SARS-CoV-2 antibodies. Fifty-four children aged 6 to 9 years participated in the survey, which was conducted between March and June 2020 in the municipality of Ipojuca, Pernambuco, Brazil. The diagnosis of caries was performed using the dmft and DMFT indices. Parents reported signs and symptoms of sickness in their children during this period. The serology test aimed to verify the immune response of the children to coronavirus by detecting IgM/IgG antibodies. Statistical analyses were performed at P < 0.05. The majority of the children presented caries (68.5%). Of the nine children who tested positive for COVID-19 (16.7%), eight presented IgG antibodies to the virus, and only one had IgG and IgM antibodies to SARS-CoV2. Children who tested positive for SARS-CoV-2 had a higher percentage of caries lesions than those who tested negative for SARS-CoV-2 (77.8% vs 65.9%), but this difference was not statistically significant.

Quality of sleep and musculoskeletal pain in adolescents: observational study / Qualidade de sono e dores musculoesqueléticas em adolescentes: estudo observacional

ABSTRACT BACKGROUND AND OBJECTIVES: Musculoskeletal pain (MSP) is related to psychogenic factors and quality of sleep, showing that this triad is a biopsychosocial process. The aim of this study was to analyze an association between poor sleep quality and MSP in adolescents. METHODS: This study has an observational, cross-sectional character, in which 545 adolescents, aged between 11 and 15 years, were analyzed. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), the presence of MSP using the Nordic Musculoskeletal Questionnaire (NMQ), temporomandibular disorder using the Axis II of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and excessive daytime sleepiness using the Epworth Sleepiness Scale (ESS). Pearson Chi-square or Fishers Exact test were used to assess the association between two categorical variables. RESULTS: The prevalence of poor sleep quality, sleep disorders, MSP and excessive daytime sleepiness were, respectively, 66.8, 9.5, 87.5 and 30.5%. An association was observed between the quality of sleep and the number of hours of sleep per night [OR = 1.49; (1.01 to 2.21)], and between sleep disorders and MSP in the upper back [OR=1.9; (1.0 to 3.3)], and the wrists and hands [OR=2.8; (1.4 to 5.7)]. However, there was no association between sleep quality and MSP [OR=1.29; (0.76 to 2.17)]. CONCLUSION: An association was found between sleep disorders and MSP, as well as between the number of hours slept per night and quality of sleep.

RESUMO JUSTIFICATIVA E OBJETIVOS: As dores musculoesqueléticas (DME) possuem relação com fatores psicogênicos e qualidade de sono, evidenciando que essa tríade se refere a um processo biopsicossocial. O objetivo deste estudo foi analisar a associação entre má qualidade de sono e DME em adolescentes. MÉTODOS: Realizou-se estudo observacional, com delineamento transversal, no qual foram analisados 545 adolescentes, na faixa etária entre 11 e 15 anos. A qualidade do sono foi avaliada através do Índice de Qualidade do Sono de Pittsburgh (PSQI), a presença de DME pelo Questionário Nórdico de Sintomas Osteomusculares (QNSO), disfunções temporomandibulares pelo Eixo II dos Critérios Diagnósticos de Pesquisa em Disfunção Temporomandibular (RDC/TMD) e a sonolência diurna excessiva através da Escala de Sonolência de Epworth (ESE). Para avaliar associação entre duas variáveis categóricas, foi utilizado o teste Qui-quadrado de Pearson ou o teste Exato de Fisher. RESULTADOS: A prevalência da má qualidade do sono, distúrbios do sono, DME e sonolência diurna excessiva foram 66,8, 9,5, 87,5 e 30,5%, respectivamente. Observou-se associação entre qualidade do sono e quantidade de horas de sono por noite [OR=1,49; (1,01 a 2,21)], e entre distúrbios do sono e DME na parte superior das costas [OR=1,9; (1,0 a 3,3)] e nos punhos e mãos [OR=2,8; (1,4 a 5,7)]. No entanto, não foi verificada associação entre qualidade do sono e DME [OR=1,29; (0,76 a 2,17)]. CONCLUSÃO: Foi verificada associação entre distúrbios de sono e DME, bem como entre qualidade do sono e quantidade de horas dormidas por noite.

Are exercises with or without occlusal splints more effective in the reduction of pain in patients with temporomandibular disorders of myogenic origin? A systematic review

Abstract Temporomandibular disorders (TMD) is a term used to describe a set of clinical conditions that may compromise the temporomandibular joint (TMJ) and masticatory muscles and/or associated structures, considered the most frequent cause of orofacial pain of non-dental origin. In recent years, many forms of physical therapy have been used in the treatment of TMD to reduce pain and improve the range of mandibular movement present in this impairment. Among these resources are kinesiotherapy (exercise), electrothermal and manual therapy, acupuncture, training posture, mobilizations, and biofeedback. Objectives To determine if exercises with or without occlusal splints are effective in reducing pain in patients with temporomandibular disorders (TMD) of myogenic origin. Methodology This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD 42019134244). Controlled trials published in PubMed, Scopus, and Cochrane Library following PRISMA guidelines up to April 2022 were randomized and included. The population above 18 years, which evaluated the effectiveness of exercise with or without occlusal splints in reducing pain in patients with TMD of myogenic origin, diagnosed through the Research Diagnostic Criteria for Temporomandibular Disorders, was also included. There was no restriction on the period of publication. Cochrane risk of bias analysis was performed. Results Of the five included articles, all showed a reduction of pain, but without significant differences between the interventions performed. Additionally, studies that evaluated the quality of life and mandibular movements showed a reduction in pain, but no significant differences between therapies. Conclusion The analyzed studies showed no difference in the improvement of pain, quality of life, and mandibular movements between the groups that performed only exercises or the associated treatments.

Sense of coherence and quality of life in adolescents with heart disease / Senso de coerência e qualidade de vida em adolescentes com doenças cardíacas

Abstract Objective: The aim of this study was to assess the association between the Sense of Coherence (SoC) and Quality of Life (QoL) in adolescents with heart disease. Methods: A cross-sectional study was carried out with 164 adolescents with congenital or valvular heart disease, aged between 10 and 18 years, treated in a referral center in the city of Recife - Brazil. The information collected contains census data, type of heart disease, economic status identified according to the Brazilian Criteria for Economic Classification (ABEP), as well as an evaluation of the SoC and the QoL. Results: The SoC (50.09) and QoL (72.23) exhibited high average scores. The SoC was positively correlated with all dimensions of the QoL scale (p<0.001). The social and school dimensions, respectively, presented the highest and lowest scores. The linear regression analysis revealed that the SoC influenced the school and emotional dimensions. Conclusions: This study demonstrates that the SoC is a protective factor in the life of adolescents. This factor helps on the improvement of perception of QoL and on successfully dealing with daily adversities and chronic stress.

Resumo Objetivo: Avaliar a associação entre Senso de Coerência (SOC) e Qualidade de Vida (QV) em adolescentes cardiopatas. Métodos: Foi realizado um estudo transversal com 164 adolescentes portadores de cardiopatias congênitas ou valvares, com idade entre 10 e 18 anos, atendidos em um Centro de Referência na cidade de Recife - Brasil. As informações coletadas contêm dados censitários, tipo de cardiopatia, situação econômica identificada de acordo com os Critérios Brasileiros de Classificação Econômica (ABEP), além de uma avaliação do Senso de Coerência e da Qualidade de Vida. Resultados: Tanto o Sentido de Coerência (50,09) quanto a Qualidade de Vida (72,23) exibiram valores médios elevados. Senso de Coerência foi positivamente correlacionado com todas as dimensões da Qualidade de Vida (p<0,001). As dimensões social e escolar foram as pontuações mais altas e mais baixas, respectivamente. A análise de regressão linear revelou que o Sentido de Coerência influenciou as dimensões escolar e emocional. Conclusões: Este estudo demonstra que o Sentido de Coerência é um fator de proteção na vida dos adolescentes. Esse fator auxilia na melhora da percepção de Qualidade de Vida e no enfrentamento com sucesso das adversidades do dia a dia e do estresse crônico.

Oral manifestations in hospitalized children with COVID-19

Abstract As the pandemic progressed, the incidence of viruses among children also increased. This study investigates the presence of oral lesions in hospitalized children by analyzing data collected from medical records of infants seen at the pediatric Infectious disease unit at the General Hospital of the University of Pernambuco, Recife, Brazil, from March to August 2020. This study includes children aged 0 to 12 years diagnosed with severe symptoms of COVID-19. The data describe the frequencies and percentages of categorical variables, expressed as mean, median, and standard deviation. The chi-square test evaluated the association of oral manifestations according to the presence of comorbidities. Of 89 children, 20.2% had oral manifestations, and mucositis was the most prevalent lesion (12.4%). Of the 18 children with oral manifestations, 12 did not present comorbidities, but 7.9% had multisystem inflammatory syndrome and 5.6% had Kawasaki disease. Results show that children with oral lesions had longer hospital stays. These findings indicate the need for further studies to clarify the relationship between the oral manifestations of COVID-19 in pediatric patients for screening of the virus by dentists.

Use of digital screens by adolescents and association on sleep quality: a systematic review / Uso de telas digitais por adolescentes e associação com a qualidade do sono: uma revisão sistemática / Uso de pantallas digitales por adolescentes y asociación con la calidad del sueño: una revisión sistemática

This study aimed to analyze the influence of digital screen use on adolescents' quality of sleep. This systematic review was recorded on PROSPERO (CRD42020203403) and conducted according to PRISMA guidelines. Studies covering adolescents from 10 to 19 years were included without language or publication restrictions which answered the following guiding question: "Does the use of digital screen influence adolescents' quality sleep?". Article search included the following databases: (MEDLINE/PubMed), LILACS, SciELO, Scopus, EMBASE, Web of Science, IBECS, Cochrane Library, ClinicalTrials.gov, and Open Gray. The following descriptors were used: "Sleep Quality", "Screen Time", and "Adolescent". The Newcastle-Ottawa Scale (NOS) assessed the methodological quality of the cohort studies, and a modified NOS was used to assess the cross-sectional ones. In total, 2,268 articles were retrieved, of which 2,059 were selected for title and abstract reading, after duplicates were deleted. After this stage, 47 articles were selected for full reading, resulting in the 23 articles which compose this review. Excessive use of digital screens was associated with worse and shorter sleep, showing, as its main consequences, night awakenings, long sleep latency, and daytime sleepiness. The use of mobile phones before bedtime was associated with poor quality of sleep among adolescents. Our evaluation of the methodological quality of the chosen studies found seven to be poor and 16, moderate.

Este estudo buscou analisar a influência do uso de telas digitais na qualidade do sono de adolescentes. Esta revisão sistemática foi registrada no PROSPERO (CRD42020203403) e realizada de acordo com as diretrizes do PRISMA. Foram incluídos estudos que abrangem a faixa etária de 10 a 19 anos sem restrição de idioma ou data de publicação e que responderam à seguinte pergunta condutora: "O uso da tela digital influencia a qualidade do sono dos adolescentes?". A busca por artigos incluiu as seguintes bases de dados: (MEDLINE/PubMed), LILACS, SciELO, Scopus, EMBASE, Web of Science, IBECS, Cochrane Library, ClinicalTrials.gov e Open Gray. Os descritores utilizados foram "Qualidade do Sono", "Tempo de Tela" e "Adolescente". A Escala de Newcastle-Ottawa (NOS) foi utilizada para avaliar a qualidade metodológica dos estudos de coorte e a escala NOS modificada foi usada para avaliar os estudos transversais. Foram encontrados 2.268 artigos, dos quais 2.059 foram selecionados para leitura de títulos e resumos após a exclusão das duplicatas. Foram então selecionados 47 artigos para leitura na íntegra, dos quais 23 foram escolhidos para compor esta revisão. O uso excessivo de telas digitais foi associado à má qualidade e menor duração do sono, apresentando como principais consequências despertares noturnos, maior latência do sono e sonolência diurna. Ademais, o uso do celular antes de dormir foi associado à má qualidade do sono em adolescentes. A avaliação da qualidade metodológica classificou sete estudos como sendo de baixa qualidade e 16 de qualidade moderada. Concluímos que o uso de telas digitais influenciou a qualidade do sono dos adolescentes.

Este estudio buscó analizar la influencia del uso de pantallas digitales en la calidad del sueño de los adolescentes. Esta revisión sistemática se registró en PROSPERO (CRD42020203403) y se realizó de acuerdo con los lineamientos de PRISMA. Se incluyeron los estudios en que participaron el grupo etario entre los 10 y los 19 años, sin restricción de idioma o fecha de publicación, y que respondieran a la siguiente pregunta orientadora: "¿El uso de la pantalla digital influye en la calidad del sueño de los adolescentes?". La búsqueda de artículos se realizó en las siguientes bases de datos: (MEDLINE/PubMed), LILACS, SciELO, Scopus, EMBASE, Web of Science, IBECS, Cochrane Library, ClinicalTrials.gov y Open Gray. Los descriptores utilizados fueron "Calidad del sueño", "Tiempo de pantalla" y "Adolescente". Se utilizaron la Escala Newcastle-Ottawa (NOS) para evaluar la calidad metodológica de los estudios de cohortes y la NOS modificada para evaluar los estudios transversales. Del total de 2.268 artículos encontrados, se seleccionaron 2.059 para la lectura de títulos y resúmenes después de excluidos los duplicados. Luego se seleccionaron 47 artículos para lectura completa, de los cuales 23 fueron elegidos para componer esta revisión. El uso excesivo de las pantallas digitales estuvo asociado con la mala calidad y menor duración del sueño, teniendo como principal consecuencia los despertares nocturnos, el aumento de la latencia del sueño y la somnolencia diurna. Además, el uso del teléfono celular antes de acostarse se asoció con una mala calidad del sueño en los adolescentes. La evaluación de la calidad metodológica clasificó siete estudios como de baja calidad y 16 como de calidad moderada. Se concluyó que el uso de las pantallas digitales influye en la calidad del sueño de los adolescentes.

Viral symptoms in children and SARS-COV-2: information for pediatric dentists for the control of transmission

Abstract: The new coronavi rus, which has spread worldwide, has spiraled out of control in Brazil. The number of infected children has increased, and more Infants Special Care Units are needed to prevent deaths. This study aims to report the most common signs and symptoms in children infected by seasonal respiratory viruses and those infected by COVID-19. This knowledge is essential to educate pediatric dentists, who may contribute to identifying the difference in symptoms and notify the cases, thus preventing the spread of COVID-19. This study was carried out in a Family Health Center of Ipojuca, state of Pernambuco, Brazil, and included 54 children seen for dental emergency care. The parents provided information about the signs and symptoms of their children' s health conditions during the lockdown from March to July 2020. All children had a serological test to detect any exposure to the virus. Kolmogorov-Smirnov and Mann-Whitney tests were used to assess the distribution of the data and compare the quantitative variables between the groups. Among the study participants, 16.7% tested positive for COVID-19. The most prevalent symptoms were headache (38.9%), sneezing (35.2%), and fever (20.4%); six out of nine children with a positive test had symptoms after infection of an adult in the family. Children infected with COVID-19 showed similar clinical signs to those with negative results. Pediatric dentists should acquire knowledge to report on sick children and prevent the spread of the disease.

Odontogenic Infection and dental Pain negatively impact Schoolchildrens Quality of Life / Infecção odontogênica e odontalgia impactam negativamente a qualidade de vida de crianças escolares

ABSTRACT The aim of this study is to assess the prevalence of odontogenic infection in lowincome Brazilian schoolchildren and evaluate its association with the subjective variables of oral healthrelated quality of life and dental pain. In this crosssectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ810) and selfreports of dental pain were collected. Data were statistically analyzed using MannWhitney or KruskalWallis test with a posttest by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional wellbeing (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among lowincome Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's selfperception of quality of life.

RESUMO O objetivo deste estudo foi avaliar a prevalência de infecção odontogênica em crianças escolares brasileiras de baixa renda e analisar a sua associação com as variáveis subjetivas da autopercepção de qualidade de vida relacionada à saúde bucal e dor dentária. Neste estudo transversal, 230 crianças escolares com 8 a 10 anos de idade realizaram exame clínico bucal no qual os índices CPOD/ ceod e PUFA/pufa foram mensurados. Com isso, as crianças responderam individualmente ao Child Perceptions Questionnaire (CPQ810) e relatos de dor dentária foram coletados. Os dados foram estatisticamente analisados utilizandose o teste MannWhitney ou KruskalWallis, com posterior teste da correlação de Dunn e Pearson. Dentre as crianças examinadas, 42,6% apresentavam infecção odontogênica e 80% reportou experiência de dor dentária. A idade (p=0,034) e experiência de dor dentária (p<0,002) das crianças foram associadas à infecção odontogênica, bem como o seu bemestar emocional (p=0,008) e social (p=0,009) e impacto geral na qualidade de vida (p=0,019). Além disso, a intensidade (p<0,001), frequência (p<0,001) e duração (p<0,001) da odontalgia foram correlacionadas com o impacto geral na qualidade de vida da criança. A prevalência de infecção odontogênica permanece elevada em crianças escolares brasileiras. Infecção pediátrica e sua dor relacionada induzem não apenas diversas desordens biológicas, mas também afetam negativamente a autopercepção de qualidade de vida das crianças.

Evaluation of Sleep Quality and Daytime Sleepiness in Dentistry Students

Abstract Objective: To evaluate sleep quality and excessive daytime sleepiness in undergraduate dentistry students. Material and Methods: This research is characterized as an observational study of transversal type, having analysed undergraduate students in dentistry from a public university in the State of Pernambuco, Brazil. The sample consisted of 325 students enrolled between the 1st and 10th academic semester. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), while excessive daytime sleepiness was analysed through the Epworth Sleepiness Scale (ESS). The t-Student and Mann-Whitney tests were used for the numerical values, with the F-test (ANOVA) or the Kruskal-Wallis test being used to compare more than two categories. Results: It was observed that 71.1% of students presented a poor sleep quality, with more than half of the students exhibiting excessive daytime sleepiness (58.1%). A relationship between sleep quality and the academic semester was verified. However, gender and age were not associated with sleep quality or with excessive daytime sleepiness. Conclusion: A high prevalence of poor sleep quality and excessive daytime sleepiness was observed among undergraduate students in dentistry. The data suggest that the undergraduate degree in Dentistry can influence the students' quality of sleep, regardless of age or gender.

Toma de decisiones para el tratamiento de caries oclusales en el sistema de salud público brasileño / Decision-making for the treatment of occlusal caries in the Brazilian public health system

ABSTRACT Introduction: Caries diagnosis errors have become a public health problem. Objective: Verify the consistency in terms of decision-making between Brazilian dentists from the country's public health system and the International Caries Detection and Assessment System (ICDAS), and evaluate the influence of professional experience on the management of the decay. Methods: There are 80 dentists in the public health service of Recife city, Brazil. All dentists were invited to participate in this cross-sectional study. Forty dentists agreed to answer questions about their decision-making in relation to the treatment of occlusal caries in low, moderate and high-risk caries situations. The time of clinical experience, the use of methods for the assessment of caries risk and the lesion activity were also inquired about. The T-test was applied with a significance level of 5 por ciento to compare the correlation between the International Caries Detection and Assessment System scores regarding the mean age of participants. Results: The disagreement between the dentists and the criteria used by the International Caries Detection and Assessment System for decision-making were mainly related to the sound surfaces or lesions restricted to the tooth enamel. It was thus verified that lack of consistency for the low-risk condition reached a score of 3 (32 percent), while moderate (95 percent) and high-risk (85 percent) conditions lay at a classification code of 0. The time of professional experience was not considered to have interfered with decision-making on any scale, regardless of the risk condition of the patient (p> 0.05). Conclusions: A divergence in terms of decision-making between dentists of the public health system and the International Caries Detection and Assessment System could be observed, specifically regarding sound surfaces or surfaces with lesions restricted to the tooth enamel. Furthermore, professional experience was seen as not influencing the management of caries(AU)

RESUMEN Introducción: Los errores de diagnóstico de caries se han convertido en un problema de salud pública. Objetivo: Verificar la concordancia de la toma de decisiones entre los dentistas brasileños del sistema de salud pública del país y el Sistema Internacional de Detección y Evaluación de Caries (ICDAS), así como evaluar la influencia de la experiencia profesional en el manejo de la caries. Métodos: De los 80 dentistas que existen en servicio público de salud en la ciudad de Recife, Brasil, todos fueron invitados a participar en este estudio transversal. Cuarenta dentistas acordaron responder sobre su toma de decisión en relación con el tratamiento de la caries oclusal en situaciones de caries de bajo, moderado y alto riesgo. El tiempo de experiencia clínica, el uso de métodos para la evaluación del riesgo de caries y la actividad de la lesión también fueron cuestionados. La prueba T, para un nivel de significancia del 5 por ciento, fue aplicada para comparar la correlación entre los escores del Sistema Internacional de Detección y Evaluación de Caries en relación con el promedio de edad de los participantes. Resultados: El desacuerdo entre los dentistas y los criterios utilizados por el ICDAS para la toma de decisiones se concentró en los códigos de clasificación que representan superficies sanas o lesiones restringidas al esmalte de los dientes. Se verificó así que la falta de consistencia para la condición de bajo riesgo se concentró en la puntuación de 3 (32 por ciento), mientras que las condiciones moderada (95 por ciento) y de alto riesgo (85 por ciento) se concentraron en los códigos de clasificación de 0. El factor tiempo de experiencia profesional no interfirió en la prevalencia de concordancia de la toma de decisión para cualquier escore, independientemente de la condición de riesgo del paciente (p> 0,05). Conclusiones: Se pudo observar una divergencia en cuanto a la toma de decisiones entre los dentistas del sistema de salud pública y el Sistema Internacional de Detección y Evaluación de Caries, específicamente con respecto a superficies sanas o superficies con lesiones restringidas al esmalte de los dientes. Además, la experiencia profesional no influyó en el manejo de la caries(AU)

Lesiones bucales y maxilofaciales en niños y adolescentes / Oral and maxillofacial lesions in children and adolescents

Introduction: Despite the vast literature reporting the prevalence of oral and maxillofacial diseases in the last decades, few studies have focused on lesions biopsied in the pediatric population. Objective: To determine the prevalence of oral and maxillofacial lesions that were biopsied in children and adolescents aged 0-19 years. Methods: Observational and descriptive study. We carried out a retrospective review of 862 reports of pathological examinations performed in an oral pathology laboratory of the northeast of Brazil, during the period from March 2001 to December 2009. The categories were neoplasms, hyperplastic/reactionary lesions, salivary gland lesions, bone lesions, healthy tissues and teeth, oral mucosal lesions, cystic lesions, odontogenic tumors, periapical inflammation, dental alteration and conclusive diagnosis. Results: The epidemiological profile of patients was characterized by females (53.24 percent), Caucasian (45.12 percent), with a mean age of 13.06 years. Salivary gland lesions were the category with the largest number of cases (182), and mucocele was the most prevalent histopathological diagnosis (18.44 percent), with an average size of 1.97 cm. Most cases were asymptomatic (70.88 percent). Conclusions: This study showed a predominance of lesions diagnosed as benign, the most prevalent lesions were associated with the salivary gland. Females were the most affected(AU)

Introducción: A pesar de la gran cantidad de literatura que informa sobre la prevalencia de enfermedades bucales y maxilofaciales en las últimas décadas, pocos estudios se concentraron en las lesiones biopsiadas en la población pediátrica. Objetivo: Determinar la prevalencia de las lesiones bucales y maxilofaciales que fueron biopsiadas en los niños y adolescentes de 0 a 19 años. Métodos: Estudio observacional y descriptivo. Se realizó una revisión retrospectiva de 862 informes de los exámenes patológicos realizados en un laboratorio de Patología Oral del nordeste de Brasil, durante el período comprendido entre marzo de 2001 y diciembre de 2009. Las categorías fueron: neoplasias, hiperplásicas / lesiones reactivas, lesiones de las glándulas salivales, lesiones óseas, tejidos y dientes sanos, lesiones de la mucosa bucal, lesiones quísticas, tumores odontogénicos, inflamación periapical, alteración dental y diagnóstico concluyente. Resultados: El perfil epidemiológico de los pacientes se caracterizó por las mujeres (53,24 por ciento), de raza caucásica (45,12 por ciento) con una edad media de 13,06 años. Lesiones de las glándulas salivales fueron la categoría con el mayor número de casos (182), y el mucocele fue el diagnóstico histopatológico más frecuente (18,44 por ciento), con un tamaño medio de 1,97 cm. La mayoría de los casos fueron asintomáticos (70,88 por ciento). Conclusiones: Este estudio mostró un predominio de las lesiones diagnosticadas como benignas. Las lesiones más frecuentes se relacionaron con la glándula salival. Las mujeres fueron las más afectadas(AU)

Individual and average responses of sleep quality and daytime sleepiness after four weeks of strength training in adolescents

Abstract Aims: To analyze the average and individual responses of sleep quality and daytime sleepiness in adolescents after four weeks of strength training. Methods: 19 adolescents with sleep problems recruited in the Federal Institute of Pernambuco, were subject to anthropometric evaluations as well as those for body composition assessment, a 1 repetition maximum test, the sleep parameters (Pittsburgh Sleep Quality Index-PSQI and Epworth Sleepiness Scale-ESS) and were submitted to four weeks of strength-training, performed alternately by segment, two sessions per week, according to recommendations for this population. Results: A decrease in the average PSQI score was observed (10.3±3.3 vs 8.8±4.0; p=0.006), but not in ESS (p>0.05), after intervention. The individual analyses demonstrated that ~63% of adolescents experienced reductions ≥ 3 points in the PSQI and ~58% of them experienced reductions ≥ 3 points in the measure of daytime sleepiness. The prevalence of poor sleep quality and daytime sleepiness reduced from 84.2% to 68.4% and from 52.6% to 31.6%, respectively. The comparisons of high and low responders to exercise training show that adolescents who reduced ≥3 points in the score of a least one sleep parameter presented lower weight, fat mass, and fat percentage (p<0.05). Conclusion: A short-term strength-training program is able to improve global sleep quality, but not daytime sleepiness in adolescents. Furthermore, the changes after training are highly heterogeneous. Further studies are required to better understand the effects of strength training on sleep parameters of adolescents.

Mecanismo de ação da clorexidina sobre as enzimas metaloproteinases e sua repercussão clínica: um estudo de revisão

Analisar o mecanismo de ação da clorexidina sobre as enzimas matrizes metaloproteinases (MMPs) e sua repercussão clínica. Materiais e método: a estraté- gia de busca incluiu as bases de dados Medline, Lilacs e Pubmed. A seleção dos artigos foi feita com base nos seguintes critérios: ter sido escrito em inglês, espanhol ou português, no formato de artigo original, com resumos disponíveis, abordar aspectos que relacionem as MMPs aos sistemas adesivos e/ou a influência da clorexidina sobre estas enzimas, e ter sido publicado entre os anos de 2005 a 2015. Resultados: foram encontrados 34 artigos, porém, após a análise crítica dos resumos, apenas 18 estudos foram incluídos. Considerações finais: o uso da clorexidina como primer terapêutico após o condicionamento ácido previne a ativação da enzima metaloproteinase que degrada a rede de colágeno causando falhas em restaurações adesivas. Logo, o uso de tal substância deve ser estimulado para evitar falhas em restaurações adesivas, aumentando o tempo de vida útil dessas.

Maloclusões e disfunção da tuba auditiva em crianças: uma revisão integrativa / Malocclusions and auditory tube dysfunction in children: an integrative review

RESUMO Esta revisão integrativa da literatura objetivou analisar as evidências científicas disponíveis sobre a relação entre as maloclusões e a disfunção da tuba auditiva. Através dos descritores "malocclusion","eustachian tube", "otitis media", fez-se uma busca na Biblioteca Virtual em Saúde / Bireme, incluindo artigos publicados em inglês, português e espanhol, sem limite de data de publicação. Os artigos repetidos nas bases de dados, relatos de caso e os que não se apresentaram em formato de artigo científico, tais como resenhas, teses, editoriais, dissertações e cartas foram excluídos. Após análise foram selecionados 09 artigos que preenchiam os critérios de inclusão estabelecidos, sendo que a maioria foi conduzido no continente Europeu e apenas um estudo foi realizado no Brasil. Foi possível verificar uma escassez de artigos sobre a relação entre as maloclusões e a disfunção da tuba auditiva. Não houve um consenso entre os estudos disponíveis sobre a relação entre as desordens da orelha média e as maloclusões, no entanto os estudos de intervenção mostraram que a expansão rápida da maxila tem efeito positivo no funcionamento da tuba auditiva. Em meio a escassez de artigos, verifica-se a necessidade de mais estudos sobre essa temática para que a Odontologia e a Fonoaudiologia, juntamente com as demais áreas da saúde, possam contribuir na escolha de tratamentos que possibilitem uma melhora na qualidade de vida desta população.

ABSTRACT This integrative literature review aimed to analyze the scientific evidence available on the relationship between malocclusions and auditory tube dysfunction. A search was carried out on the Virtual Health Library / Bireme/Medicine(r), using the descriptors "malocclusion", "Eustachian tube", "otitis media", to identify articles published in English, Portuguese and Spanish, of any publication date. Articles excluded were those repeated in databases, case reports and reviews, theses, editorials, essays and letters that did not appear in scientific paper format. Following analysis, 9 articles were selected that met the established inclusion criteria, most conducted on the European continent, and one only in Brazil. A shortage of articles on the relationship between malocclusions and auditory tube dysfunction became apparent. There was no consensus among the available studies on the relationship between the middle ear disorders and malocclusions; however, intervention studies have shown that rapid maxillary expansion has a positive effect on the functioning of the auditory tube. The current lack of articles indicates the need for more studies on this topic for dentistry and speech therapy, alongside other areas of health, to be able to contribute to the choice of treatments that allow improvements in the lives of people with these conditions.

Necesidades de tratamiento ortodóncico en niños y su relación con el género, los ingresos familiares y los grupos étnicos / Orthodontic treatment needs in children and its relationship with gender, family income and ethnic groups

Introduction: malocclusions are considered public health problems, needing an uniform method of assessment that prioritizes the attendance of individuals with greater orthodontic treatment need, with this purpose, the Index of Orthodontic Treatment Need has been used in many countries. Objetive: to evaluate the orthodontic treatment need in school going children, attending in Recife, northeast Brazil and also establishes its relationship with gender, family income and ethnic groups. Methods: 433 children, aged 6-12 years formed the sample. The dental health component grades it was recorded to define the orthodontic treatment need. Results: the findings revealed that 59.5 % of children had at least one type of malocclusion; 40.5 % had no need for orthodontic treatment (grade 1 and 2); 5.5 % were borderlines, indicating moderate need (grade 3); 54 % had definite treatment (grade 4), but no children were classified in grade 5. No statistically significant differences were found between genders (p= 0.217), family income (p= 0.176) and ethnic groups (p= 0.281). Conclusion: the most of the children had moderate and great orthodontic needs treatment. There was no association between orthodontic treatment need and gender, family income or ethnic groups(AU)

Introducción: las maloclusiones se consideran un problema de salud pública, que requiere un método uniforme de evaluación que priorice la asistencia de las personas con mayores necesidades de tratamiento de ortodoncia, para este fin, el Índice de Necesidad de Tratamiento Ortodóncico se ha utilizado en muchos países. Objetivo: evaluar la necesidad de tratamiento ortodóncico en niños en edad escolar que viven en Recife, noreste de Brasil, y establecer su relación con el género, el ingreso familiar y los grupos étnicos. Métodos: 433 niños de 6 a 12 años conformaron la muestra. Los datos obtenidos en el componente de salud dental fueron recodificadas para definir la necesidad del tratamiento ortodóncico. Resultados: los resultados revelaron que 59,5 % de los niños tienen al menos un tipo de maloclusión; 40,5 % no tenía necesidad de tratamiento de ortodoncia (grado 1 y 2); 5,5 % tenía una condición de frontera, lo que indica la necesidad moderada (grado 3); 54 % tenían un tratamiento definitivo (grado 4), y no hubo niños clasificados en el grado 5. No se encontraron diferencias estadísticamente significativas entre sexos (p= 0,217), ingreso familiar (p= 0,176) y los grupos étnicos (p= 0,281). Faculty of Dentistry: La mayoría de los niños tenían necesidad de tratamiento ortodóncico moderada o grande. No hubo asociación entre la necesidad de tratamiento de ortodoncia y el sexo, ingresos o grupos étnicos(AU)

Sociodemographic Factors and Oral Health Conditions Related to the Impact on the Quality of Life of Adolescents

Objective: To identify the sociodemographic factors and the oral health conditions related to the impact on the quality of life of adolescents. Material and Methods: Cross-sectional study with 1,417 students of both sex aged 15-19 years in São Lourenço da Mata - PE, Brazil. The collected information comprised sociodemographic data (gender, age, race / color), oral health status (dental caries, periodontal disease and pain) and impact on oral health-related quality of life of adolescents through the OIDP test. Statistical analysis used the Pearson's chi-square test and multiple logistic regression, with 5% significance level. Results: High impact on oral health-related quality of life was evidenced in 66.1% of adolescents. The prevalence of dental caries, gingival bleeding and pain was respectively 51.29%, 49.60% and 73.6%. The multiple regression analysis found that the high impact on the quality of life was related to the oral health condition and sex of teenagers, showing that girls, who had higher prevalence of dental caries and pain, had greater impact related to oral health. Conclusion: Dental caries and pain of dental origin cause a high impact on the quality of life of adolescents, being higher among girls.

Relação entre maloclusões e queixas de problemas mastigatórios e gastrointestinais em crianças / Relationship between malocclusions and complaints of masticatory and gastrointestinal problems in children

Objetivo: Avaliar a relação entre as maloclusões e queixas de problemas mastigatórios e gastrointestinais em crianças. Métodos: Realizou-se um estudo transversal com uma amostra intencional de 232 crianças de ambos os sexos, com idades entre 6 e 12 anos, provenientes de uma amostra de 634 crianças de 3 a 12 anos examinadas durante um levantamento de saúde bucal na cidade do Recife/PE. Participaram do estudo apenas as crianças livres de cárie. Foram excluídas as crianças com síndromes associadas a deformidades craniofaciais, as crianças submetidas a tratamento ortodôntico ou ortopédico facial prévio, crianças com presença de desgastes acentuados nas faces oclusais dos elementos dentários e crianças com alterações dentárias de forma, número ou tamanho. Os dados foram coletados através de dois instrumentos: entrevistas com os responsáveis e exames clínicos. As maloclusões foram avaliadas a partir da classificação de Angle e da observação da ocorrência de mordida aberta anterior, mordida cruzada anterior e mordida cruzada posterior. Foi utilizada ficha clínica padrão da Organização Mundial de Saúde. A análise estatística foi realizada utilizando-se os testes Quiquadrado de Pearson e Exato de Fisher. Resultados: Os sintomas de distúrbios gastrointestinais ocorreram em 19,8% das crianças, sendo a prisão de ventre a queixa mais citada (9,9%). Os sintomas gastrointestinais não foram associados à presença das maloclusões. A mordida cruzada anterior foi associada à dificuldade para mastigar (p < 0,05) e à necessidade de ingerir líquidos durante as refeições (p=0,017). Conclusão: As crianças com mordida cruzada anterior apresentaram maiores dificuldades mastigatórias em relação ao grupo sem esta maloclusão.(AU)

Objective: To evaluate the relationship between malocclusion and complaints of masticatory and gastrointestinal problems in children. Methods: A cross-sectional study was carried out with an intentional sample of 232 children of both sexes, 6 to 12 years of age, from a sample of 634 children, 3 to 12 years of age, who were examined during an oral health survey in the city of Recife, PE, Brazil. Only caries-free children participated in this study. Children with disabilities were excluded, as were children who had undergone orthodontic or facial orthopedic treatment, children with clearly accentuated wear on the occlusal surfaces of their teeth, and children with dental alterations in shape, size, or number. Data were collected through two instruments: interviews with the responsible guardians and clinical examinations. Malocclusions were evaluated by means of Angle classification and observation of the occurrence of anterior open bite, anterior crossbite, and posterior crossbite. The World Health Organization (WHO) standard clinical record was used. The statistical analyses were performed using the Pearson's chisquare test and the Fisher Exact test. Results: The symptoms of gastrointestinal disorders occurred in 19.8% of the children, constipation being the most cited complaint (9.9%). Gastrointestinal symptoms were not associated with the presence of malocclusions. Anterior crossbite was associated with difficulty in chewing (p<0.05) and the need to ingest liquids during meals (p=0.017). Conclusion: Children with anterior crossbite showed greater mastigatory difficulties when compared to the group without this malocclusion.(AU)

Perfil do atendimento aos adolescentes nas Urgências Odontológicas das Unidades de Pronto Atendimento (UPA) no Estado de Pernambuco / Profile of adolescents' Care in Emergency Dental Units in the State of Pernambuco

As Unidades de Pronto Atendimento (UPAs) foram implementadas no Estado de Pernambuco em 2011, por isso fez-se necessário avaliar o perfl do atendimento aos adolescentes na urgência odontológica das Unidades de pronto Atendimento (UPA) do Estado de Pernambuco. Trata-se de um estudo de caracterização da demanda em que foram coletados dados dos prontuários de todas os adolescentes que procuraram o serviço de urgência odontológica, durante o intervalo de seis meses. Os dados foram tabulados em um banco de dados no programa SPSS 17.0 e foi realizada a análise descritiva através da obtenção das frequências percentuais das variáveis. Foram atendidos 1473 adolescentes, sendo 61% do sexo feminino na faixa etária de 15 a 19 anos de idade (63,7%). Em relação à classifcação de risco, 78,2% dos pacientes foram classifcados como verde, mas a queixa mais referida foi dor (91,4%). Dos procedimentos realizados 37,4% foi restauração, 17,4% exodontia e 17,1% abertura coronária. Os dados coletados demonstraram que apesar da maior prevalência de dor, como queixa principal, o tratamento restaurador foi o procedimento mais realizado, sugerindo que a urgência odontológica está sendo utilizada como porta de entrada para a obtenção de serviços que deveriam estar sendo realizados na atenção básica

The Emergency Care Units were implemented in the state of Pernambuco in 2011, so it was necessary to evaluate the profle of adolescents' dental care in the emergency care units of the State of Pernambuco. It is a demand characterization study in which data were collected from medical records of all adolescentes who sought emergency dental service during the six-month interval. The data were compiled in a database using SPSS 17.0 and the descriptive analysis was performed by obtaining the percentage frequencies of the variables. 1473 adolescents were assisted, 61% were females aged 15-19 years (63.7%). Regarding the risk classifcation, 78.2% of patients were classifed as green, but most reported complaint was pain (91.4%). About the procedures performes, 37.4% was restauration, 17.4% extraction and 17.1% crown opening. The data collected showed that despite the higher prevalence of pain as the main complaint, the restorative treatment was most performed procedure, suggesting that dental emergency is being used as a gateway to obtaining services that should be being carried out in primary care