Impact of Malocclusion on Oral Health-Related Quality of Life of 8-12 Years Old Schoolchildren in Southern Brazil

Abstract The aim of this study was to estimate the impact of malocclusion on the oral health-related quality of life (OHRQoL) of schoolchildren aged 8-12 years old in Southern Brazil. A two-stage cluster procedure was used to select 1,199 children in 20 public and private schools in Pelotas/Brazil. Cross-sectional data was collected, consisting of a socioeconomic questionnaire to parents, children’s interview and clinical oral examination. The clinical variables were obtained from clinical examination, and the Child Perceptions Questionnaire (CPQ) was assessed during children’s interview. To measure malocclusion and orthodontic treatment need the Dental Aesthetic Index was used. For data analysis multiple Poisson regression models estimating the rate ratios (RR) and their respective confidence intervals (95%CI) were used. Among 1,206 participants, 789 were aged 8-10 years and 417 between 11-12 years. The orthodontic treatment need was higher among the younger children (44.6%) than in the older ones (35.0%) (p value ≤0.05). There was a significant association in the CPQ social and emotional domains with malocclusion in the older schoolchildren. In the adjusted analysis (for socioeconomics and clinical variables) the effect of very severe malocclusion on OHRQoL was confirmed in both 8-10 and 11-12 age groups (RR(95%CI) of 1.24(1.02;1.51) and 1.28(1.01;1.62), respectively). The findings demonstrated that children with very severe malocclusion experienced greater negative impact on OHRQoL compared to those with mild or no malocclusion. The results suggest that malocclusion impacts the quality of life. The higher impact occurs in the social and emotional well-being domains.

Resumo O ojetivo desse estudo foi ostimar o impacto da maloclusão na qualidade de vida relacionada à saúde bucal (QVRSB) de escolares de 8 a 12 anos de idade em Pelotas/ RS. Seleção amostral foi realizada através da técnica de conglomerado em duplo estágio, selecionando 1.199 crianças de 20 escolas públicas e privadas em Pelotas/Brasil. A coleta de dados foi realizada com uma abordagem transversal e consistiu em um questionário socioeconômico aos pais, entrevista com as crianças e exame clínico de saúde bucal. As variáveis clínicas foram obtidas através do exame clínico, e o Child Perceptions Questionnaire (CPQ) foi respondido através da entrevista com a criança. Para mensurar maloclusão e necessidade de tratamento ortodôntico, o Índice de Estética Dental foi usado. Para análise dos dados foram utilizados modelos de regressão de Poisson multivariados, a fim de estimar as razões de taxa e seus intervalos de confiança (95%). De 1.206 participantes, 789 tinham entre 8 e 10 anos de idade e 417 entre 11 e 12 anos. A necessidade de tratamento ortodôntico foi maior entre crianças mais jovens (44.6%) do que em mais velhas (35.0%) (p ≤0.05). Uma associação estatisticamente significante foi observada entre os domínios social e emocional do CPQ e a maloclusão em crianças mais velhas. Na análise ajustada (para variáveis socioeconômicas e clínicas), o efeito de maloclusão muito severa na QVRSB foi confirmado nos grupos etários de 8 a 10 e 11 a 12 (RR (IC95%) de 1,24(1,02;1,51) e 1,28(1,01;1,62), respectivamente . Os achados demostraram que crianças com maloclusão muito severa experienciaram maior impacto negativo na QVRSB comparadas com aquelas sem maloclusão ou com maloclusão leve. Os resultados sugerem que a maloclusão impacta na qualidade de vida. Um maior impacto acontece nos domínios de bem estar social e emocional.

Anterior composite restorations in clinical practice: findings from a survey with general dental practitioners

Objectives: The aim of this study was to assess technical preferences of general dental practitioners when restoring anterior composite restorations. How the level of clinical experience or post-graduate training infuenced their options was also tested. Material and Methods: A cross-sectional study was performed using a questionnaire with general dental practitioners (GDPs) (n=276) in Southern Brazil. Information regarding post graduation training (specialization, master's or PhD degree) and linical experience (years since completing graduation) were gathered. The options regarding anterior composite restorations (type of composite, adhesive system, light curing unit, polishing procedures and rubber dam use) were collected. Data were submitted to descriptive analysis and associations were tested. Results: Response rate was 68% (187). GDPs selected microhybrid composite (52%) and 2-step total etch adhesive system (77%). LED was the preferred method of activation for 72.8%. Immediate polishing was preferred by 75%, using a combination of techniques. Most of the respondents (74.3%) did not use rubber dam. More experienced clinicians used more halogen lights (p<0.022), performed more light monitoring (p<0.001) and were resistant to use rubber dam (p<0.012). Dentists with post-graduation training used 3-etch-and-rinse system more frequently (p<0.04), usually monitored light intensity (p<0.014) and placed rubber dam more frequently (p<0.044). Conclusions: Hybrid composite, simplifed adhesives, LED units and immediate polishing were preferred by Southern Brazilian dentists for anterior composite restorations. Few dentists used rubber dam to perform composite restorations in anterior teeth. Clinical experience and post-graduation training infuenced the dentists' choices. .