Are sleep disorders associated with traumatic dental injuries in school children? A cross-sectional study.

BACKGROUND: To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and disorders. METHODS: A cross-sectional study was carried out with a representative sample of schoolchildren aged 8 to 10 years (n = 1402) from Florianopolis, Brazil. Clinical examinations for TDIs were performed according to the classification proposed by Andreasen. Parents/caregivers completed a questionnaire addressing sociodemographic characteristics and sleep behaviours/disorders (sleep duration, insomnia, sleep rhythmic movement, snoring, and signs of sleep apnoea). Descriptive analysis and Poisson regression were performed. RESULTS: The prevalence of TDIs was 10.9%. Insomnia was observed in 3.0% of the children, snoring in 42.8%, sleep rhythmic movement in 27.9%, and signs of obstructive sleep apnoea in 33.6% of the schoolchildren. Most children (75.2%) slept less than eight hours a day. The prevalence of TDIs was higher among schoolchildren with an increased overjet (PR: 1.65; 95% CI: 1.15-2.35; P < 0.01), after adjusting for monthly family income, caregiver's schooling, and sleep behaviours. The prevalence of TDIs was not associated with sleep behaviours/disorders. CONCLUSIONS: Parent-reported sleep disorders such as insomnia, sleep rhythmic movement, snoring and signs of sleep apnoea were not associated with the prevalence of TDIs in schoolchildren. © 2024 Australian Dental Association.

Pathways between verbal bullying and oral conditions among school children.

PURPOSE: To investigate the direct and indirect pathways between verbal bullying and adverse oral conditions among school-aged children. METHODS: A cross-sectional survey was conducted with 8- to 10-year-old children, enrolled in public schools in Southern Brazil. Verbal bullying was collected by self-reports. Independent variables included sociodemographic characteristics (sex, age, household income, and caregivers' educational level) and oral conditions (anterior open bite, anterior teeth crowding, upper anterior diastema, large overjet, untreated dental caries, and PUFA index). The pathways between verbal bullying and the independent variables were analysed through structural equation modelling. RESULTS: 1369 children were included. The prevalence of verbal bullying was 26.2% (95% confidence interval [CI] 23.9-28.6%). Verbal bullying was directly influenced by large overjet (standard coefficient [SC] 0.13, P < 0.01), untreated dental caries (SC 0.63, P = 0.01) and PUFA index (SC 0.75, P = 0.02). Sex (SC - 0.005, P = .04) and age (SC - 0.006, P < 0.01) indirectly influenced verbal bullying via untreated dental caries. CONCLUSIONS: Verbal bullying was directly influenced by large overjet, untreated dental caries and PUFA index. Sex and age indirectly impacted verbal bullying through untreated dental caries.

Premature loss of primary molars: impact on the oral health-related quality of life of schoolchildren.

PURPOSE: Evaluate the impact of the premature loss of primary molars due to caries on oral health-related quality of life (OHRQoL) in schoolchildren. METHODS: A cross-sectional study was conducted with children eight to ten years of age at public schools in the city of Florianópolis selected through cluster sampling. The collection of the clinical data occurred in the school setting by four trained and calibrated examiners (Kappa > 0.7) DMFT/dmft index, PUFA/pufa index, accentuated overjet, and anterior open bite. Sex and age of the child and guardian's schooling (classified as ≤ 8 or > 8 years) were collected through a questionnaire answered by the guardians. OHRQoL was assessed using the Child Perceptions Questionnaire 8-10. The data were submitted to bivariate, multivariate, and hierarchical Poisson analyses. RESULTS: A total of 1456 children participated in the study. The prevalence of premature tooth loss due to caries was 5.8% (n = 85). The prevalence of negative impact on OHRQoL was 47.4% (n = 691). Negative impact on OHRQoL was significantly associated with the premature loss of primary molars (p < 0.001) as well as the sex (girls), guardian's schooling (> 8 years) and the presence of untreated caries (p < 0.001). CONCLUSION: The premature loss of primary molars due to caries was associated a negative impact on the OHRQoL of children eight to ten years of age. Negative impact is also associated with untreated caries, sex, and the level of schooling of guardians.

Shaping ability of hand, rotary and reciprocating files in primary teeth: a micro-CT study in vitro.

PURPOSE: Compare canal transportation and dentin removal using micro computed tomography (micro-CT) and measure instrumentation time in the root canal preparation of primary molars using K-files, ProDesign Logic and Reciproc files. METHODS: A representative sample of 81 root canals of primary molars was randomised into three groups: K-files (#15-40), ProDesign Logic (#25) and Reciproc (R25). A single-trained operator prepared all root canals. A standardised micro-CT evaluation was performed before and after instrumentation using the CTan® program. Instrumentation time was also recorded. Statistical analysis involved one-way ANOVA, Tukey's post hoc test, Kruskal-Wallis test and Dunn's test, considering a 5% level of significance. RESULTS: Reciproc led to more canal transportation than K-files and ProDesign Logic (p < 0.001) in middle third, whereas K-files led to the most canal transportation in the apical third (p = 0.017). ProDesign Logic and Reciproc removed less dentin on the opposite side of the root curvature in the apical third compared to K-files (p = 0.008). Instrumentation time was better with ProDesign Logic and Reciproc than K-files (p < 0.001). CONCLUSION: ProDesign Logic demonstrated good results with regard to canal transportation and required less instrumentation time in primary molars. Reciproc and K-files led to the most canal transportation in the middle and apical third, respectively.

Accidental ingestion of a dental irrigation needle: a case report.

BACKGROUND: Providing patient's safety during dental treatment procedures is mandatory. One of the preventable issues in dental treatments is foreign body ingestion or aspiration. Despite the rarely occurrence, these accidents could not be ignored due to high potential adverse consequences. CASE REPORT: This case represents a rare incidence of an accidental ingestion of a curved irrigation needle by a 5-year-old boy in root canal treatment. Patient monitoring with chest and abdomen radiographs was done till, on the third day, the needle expelled uneventfully without surgical intervention. CONCLUSION: Since most of dental treatments require small and sharp instruments, following the preventive and standard protocols is strictly recommended. In the case of accident, oral health care professionals should be aware of how to manage life-threatening situations.

In vitro comparison between apex locators, direct and radiographic techniques for determining the root canal length in primary teeth.

AIM: To compare the accuracy of three electronic apex locators in the measurement of the root length of primary teeth with the radiographic and direct visual techniques. METHODS: The sample of the in vitro study was 102 root canals of primary molars. For the direct visual technique, the root canal file was introduced into the canal until its tip passed the apical foramen, then it was moved back to the limit of the foramen or root resorption and the measurement was made with a millimetre ruler. For the radiographic measurement, a calibrated and blinded researcher (κ > 0.87) measured the root canals using the same rule. Measurements with apex locators were performed by inserting the file into the canal until the word "Apex" or audible warning to indicate the foramen or resorption. For data analysis, one-way ANOVA for repeated measurements and the Sidak post hoc tests were performed. RESULTS: The direct measurement (µ = 8.57) did not present statistical difference when compared to the Root ZX II measurement (µ = 8.45), as opposed to the radiographic measurements (µ = 8.12), the Endus (µ = 8.24) and iPex II (µ = 8.29). CONCLUSION: The use of apex locators was superior to the radiographic method and the Root ZX II was the most effective.

Prevalence of enamel defects and association with dental caries in preschool children.

AIM: This was to evaluate the prevalence of the developmental defects of enamel (DDE) in primary teeth and its association with dental caries. METHODS: A cross-sectional study with a randomised representative sample was carried out with 1101 children aged 2-5 years enrolled in public preschools (50% prevalence of DDE in primary teeth, a standard error of 3%, and a confidence level of 95%). Three calibrated dentists (K > 0.62) performed clinical examination. Data collected were: sex, age, DDE (Modified DDE Index) and dental caries (WHO). Descriptive analysis, Chi-square test and multinomial logistic regression were applied for data analysis. RESULTS: Among children, 565 (51.3%) were boys; mean age was 3.7 (±0.9 years). The prevalence of enamel defect was 39.1%; the prevalence of diffuse opacities, demarcated opacities and enamel hypoplasia was 25.3, 19.1 and 6.1%, respectively. The prevalence of dental caries was 31.0%, with mean def-t 1.14 (±2.44). Primary teeth with enamel hypoplasia had three times the odds of having dental caries than those with absence of enamel defects (OR = 3.10; 95% CI: 1.91, 5.01). CONCLUSION: The presence of enamel defects was moderate and associated with dental caries.

Bacterial intensity and localization in primary molars with caries disease.

AIM: The aim was to assess the characteristics and outcomes of infections affecting the structures of carious primary molars. MATERIALS AND METHODS: Forty primary molars were used and classified according to the following clinical situation: With profound caries lesion, with bone loss at the furcation region, with perforation of the pulp chamber floor, and residual roots. The teeth were demineralized, cut, and stained with both haematoxylin-eosin and Brown and Brenn staining techniques. Assessment was performed using optical microscopy. RESULTS: Statistical analysis of the data by means of the Chi-square test suggests that there was a significant relationship (P<0.001) between the intensity and localization of infection and the level of destruction of dental structures. A significant difference was also observed in the intensity and localization of infection between the groups regarding crown, furca, and root (P<0.001). CONCLUSION: More intense and profound the infection, more severe is the dental destruction. The groups of residual roots showed the most severe bacterial infection compared to other groups.

Electronic determination of root canal working length in primary molar teeth: an in vivo and ex vivo study.

AIM: To evaluate in vivo and ex vivo the accuracy of an electronic apex locator in primary molar teeth with or without root resorption. METHODOLOGY: Fifteen primary molar teeth with 30 root canals were divided into two groups: roots without resorption (n = 13) and roots with resorption (n = 17). Root canals were measured with the Root ZX apex locator in vivo, and then after tooth extraction, each canal was measured electronically ex vivo. The actual root canal length was measured visually, with the placement of a K-file into the most cervical edge of either apical foramen or resorption. The Student's t-test was applied for statistical analysis at a 5% significance level. RESULTS: The electronic apex locator was precise in 69% and 65% of the cases with and without root resorption, respectively (tolerance = ± 0.5 mm), in vivo and 69% and 77%ex vivo. When the tolerance was ± 1 mm, however, these figures increased to 92% and 94% for root canals with and without resorption, respectively, in vivo and ex vivo. No significant difference was observed between the resorbed and non-resorbed root canals measured using the Root ZX. CONCLUSION: The Root ZX apex locator was accurate in determining in vivo and ex vivo the working length ± 1 mm in primary molar teeth in over 90% of roots regardless of the presence of root resorption.

Erosive effects of acidic center-filled chewing gum on primary and permanent enamel.

BACKGROUND: The higher incidence of dental erosion in children and teenagers possibly reflects a high intake of acidic food and beverages as well as a more frequent diagnosis on this condition. AIM: The aim of this study was to evaluate the erosive potential of acidic filling of chewing gum in primary and permanent enamel. METHODS AND MATERIALS: Eighty enamel blocks (40 primary and 40 permanent teeth) were used and randomly distributed into eight groups. Groups were divided according to types of dental substrates (permanent or primary), frequency of exposure to the acidic substance (2X or 4X/day), and concentration (pure or diluted). Exposure time to the acidic content of the chewing gum was five minutes under agitation, during five days. RESULTS: All groups showed a significant decrease in surface microhardness (P P = 0.002), D3 (pure, 4X/day) and D4 (diluted, 4X/day) (P = 0.009) regarding the concentration, then the diluted acid content was associated with a greater decrease in microhardness. CONCLUSION: It is concluded that the acidic filling of a chewing gum reduced the microhardness of primary and permanent enamel.

Ovulation of aged follicles does not affect embryo quality or fertility after a 14-day progestagen estrus synchronization protocol in ewes.

The aim was to examine the effect of ovulation of aged follicles on embryo quality and fertility in ewes. In Experiment 1, ewes (n = 39) received a prostaglandin analogue on Day 6 of the cycle and then received either a progestagen sponge from Day 6 to 20 after estrus (Single sponge) or a progestagen sponge on Day 6 that was replaced on Day 11 and 16 and removed on Day 20 (Multiple sponges). In a subgroup of ewes, the growth of ovarian follicles was characterised using ultrasonography. Fertile rams were introduced 48 hours after sponge withdrawal; we slaughtered the ewes on Day 5 of pregnancy and recovered the embryos. The mean age of the ovulatory follicles was greater in ewes that received a single sponge compared with multiple sponges (8.7+/-0.8 days, range 4 to 14, versus 4.5+/-0.7 days, range 3 to 6; P<0.05). However, the groups did not differ (P>0.05) in ovulation rate (2.4+/-0.3 corporal lutea per ewe) or the proportion of good quality embryos recovered (71 to 82%; developed to the early morula stage or further). In Experiment 2, ewes (570 in total) received treatments similar to those in Experiment 1 but were kept until lambing. Ewes that received a single sponge came into heat earlier (P<0.05) than those that received multiple sponges, but > or = 97% of ewes in all groups (P>0.05) were bred by 48 to 72 hours after ram introduction. There was no difference (P>0.05) between groups for the proportion of ewes that lambed to first service (80 to 86%) or the number of lambs per ewe (1.94+/-0.08 lambs). We conclude that when luteolysis occurs at the beginning of progestagen synchronisation, ewes will ovulate aged follicles, but that compared to shorter duration follicles, these follicles produce oocytes that are equally competent to be fertilised and develop into good quality embryos and full-term lambs.

Effect of diet quantity and urea supplementation on oocyte and embryo quality in sheep.

The objective was to investigate the effects of dietary energy and urea supplementation on oocyte and embryo quality in sheep using in vivo and in vitro experimental models. Sixty-three ewes were fed grass meal at 0.5 or 2.0 times maintenance energy requirements (MER). The diet was supplemented with feed grade urea (U) for half of the ewes on each energy treatment. Ewes were stimulated with 1000 IU eCG and either slaughtered on the day of pessary withdrawal, for in vitro embryo production, or mated and slaughtered on Day 5 for embryo recovery. Urea decreased cleavage rate (48.3 vs 39.7%) and consequently blastocyst rate (41.6 vs 36.8%) but the differences were not significant. Oocytes from animals on 2.0 MER had a lower cleavage rate (54.9 vs 36.0%) and blastocyst yield (49.3 vs 31.4%) than those on 0.5 MER. However, there was an interaction between urea and energy for cleavage (P = 0.04) and blastocyst yield (P = 0.03) indicating a variable response to urea in the presence of high energy. This was manifested by a decrease in cleavage rate in the presence of urea and high energy (22%, 8 of 36), and a reduction in blastocyst development (19%, 7 of 36). When blastocyst development rate was expressed as a proportion of cleaved oocytes there was no difference between groups; in addition, there was no difference between groups in terms of blastocyst hatching rate (overall mean 66.1%) or blastocyst cell number on Day 8 (overall mean +/- SEM, 138.4 +/- 9.0, n=61). The effect of urea on cleavage rate in vivo was more severe. Urea supplementation reduced (P<0.001) the cleavage rate (93 vs 62%). Despite this, the yield of blastocysts was unaffected. Oocytes from ewes on 0.5 MER exhibited a lower (P<0.05) cleavage rate than those on 2.0 MER (66 vs 87%). This effect was also apparent at the blastocyst stage (40.0 vs 50.9%), although the difference was no longer significant. There were no differences in hatching rate (overall mean 70.7%) or blastocyst cell numbers (overall mean +/- SEM, 166.3 +/- 15.6, n=40). Collectively, these results suggest that both high dietary energy and urea content influence subsequent embryo development in vitro, and the deleterious effects of urea are likely influenced by concomitant energy intake.

Risk for HIV infection among bisexual men seeking HIV-prevention services and risks posed to their female partners.

The present study interviewed gay (n = 473) and bisexual men (n = 146) as part of an HIV prevention program and investigated social cognitive factors associated with HIV risk. Results indicated that HIV risk in homosexual men was associated with sexual openness and connections to gay communities, factors not associated with risk for bisexual men. Compared with men at lower risk, those who practiced high-risk sex scored lower on measures of perceived safer sex norms, safer sex self-efficacy, and social skills. Bisexual men with primary female partners often had not disclosed their bisexuality to female partners (75%), and 64% had not modified their behavior to protect female partners. Bisexual men who engage in high-risk behaviors therefore pose a risk to female partners who may be unaware of their involvement with men.

The mobility experience and neighborhood attachment.

In this study, I consider variables associated with an individual's most recent move into his or her current residence as predictors of neighborhood attachment. Using the 1978-1979 Seattle Community Attachment Survey, I find that elements of the mobility experience such as an individual's past history of migration, the motivations for moving, the amount of time involved in the move, and the distance traveled during the move have an effect on short- and long-term neighborhood attachment patterns independent of residential stability and investment predictors. The findings imply that psychosocial factors such as familiarity with the environment, increased premove exposure to the new environment, and perceived control during instances of transition have some impact on individuals' postmove attitudes and behaviors, and suggest that researchers should look beyond traditional "types of people" explanations of urban neighborhood attachment.

The neurological basis of attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is a serious disability with long-term consequences. At present the disorder is considered organic in pathology, particularly in regard to central nervous system functioning. This paper reviews research on ADHD. The role of neurochemical stimulation is discussed, and the signs of neurological deficits are explored. Nearly 600,000 young people in the United States receive medication daily for ADHD, and these drugs mimic brain neurotransmitters. The chemical action of these drugs and the cognitive, affective, and behavioral effects are discussed. Side effects and dosage levels are also examined. Basic behavior modification with ADHD children and how these techniques can be combined with effective drug treatment are elaborated.