ABSTRACT
OBJECTIVES: To identify and qualify the evidence of published studies evaluating whether rapid maxillary expansion (RME) treatment modifies the head and cervical posture in growing patients. MATERIALS AND METHODS: Electronic database searches were conducted until January 2021 using PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and LILACS. Grey literature was explored using ClinicalTrials, OpenGrey and Google Scholar. Trials involving participants who underwent RME were included. Risk of Bias (RoB) assessment was conducted using the Cochrane tool for randomized trials and the Methodological Index for Non-randomized Studies (MINORS) for non-randomized trials. The certainty level of evidence was evaluated through the Grading of Recommendations, Assessment, Development and Evaluation tool (GRADE). RESULTS: Six clinical trials were included. The RoB scores had unclear and high risks of bias. Low certainty of evidence suggested that the effects following RME include a decrease in craniocervical angulation, as well as a very low certainty of evidence for a decrease in head elevation, an increase in cervical lordosis, and an increase in the inclination of the cervical spine. CONCLUSIONS: There is low and very low evidence that RME alters the head and cervical posture in growing patients. Further investigation regarding long-term effects, possible changes due to somatic growth, and clinical relevance is needed.
Subject(s)
Palatal Expansion Technique , Posture , HumansABSTRACT
OBJECTIVE: The aim of the study was to explore the presence of inequalities in the use of dental services among <12-year-old children residing in Peru, according to their wealth quintile and natural region of residence. METHODS: This was a cross-sectional secondary data analysis of the 2017 Demographic and Family Health Survey of Peru (n = 39 881 children). Generalized Poisson regression models, adjusted for gender, age, maternal ethnicity, place of residence and health coverage, were used to study the association between wealth quintile and use of dental services followed by stratified models by the natural region (Metropolitan Lima, coast, Andes mountains and jungle) and predicted probability graphs to study the effect of the natural region on inequalities in the use of dental services. RESULTS: Inequalities in the use of dental services among children were observed according to the wealth quintile and natural region. A social gradient was present in the Andes mountains, coast and jungle regions. The greatest inequalities were observed in the coast (richest vs poorest quintile PR = 1.81 95% CI = 1.56-2.11) and jungle regions (richest vs poorest quintile PR = 1.81 95% CI = 1.53-2.14). The jungle presented the lowest proportion of children using dental services, while Metropolitan Lima had the highest proportion. No significant differences were observed between wealth quintiles among children from Metropolitan Lima. CONCLUSIONS: Differences in socioeconomic inequalities in the use of dental services among natural regions were observed. The distribution of dental centres and personnel, and the geographical and demographic characteristics of each region, may play an important role in the presence of the inequalities observed.
Subject(s)
Dental Care , Health Status Disparities , Child , Cross-Sectional Studies , Health Surveys , Humans , Peru/epidemiology , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Abstract Introduction: the aim of this study was to determine the association between access to oral hygiene information and toothbrushing in children under 12 years in Peru in 2017. Methods: cross-sectional study of secondary data using the database of the 2017 Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES). The association between access to oral hygiene information and toothbrushing was estimated using multivariate regression analysis. The sample consisted of 24,076 records of children. The dependent variable was information about toothbrushing practices (daily toothbrushing, toothbrushing frequency and toothpaste use) and the independent variable was access to oral hygiene information. Covariables included sex, age, area of residence, and natural region. Results: the prevalence of access to oral hygiene information was 62.39%. A significant association was found between 2 of the 3 reported toothbrushing practices and access to oral hygiene information, with children under 12 years being more likely to brush teeth daily (PR = 1.03; 95% CI 1.02-1.05) and with a toothbrushing frequency 2 to more times a day (PR = 1.06; 95% CI 1.04 - 1.08) compared to children who did not receive hygiene and oral care information. The use of toothpaste was not associated with access to oral hygiene information. Conclusion: there was an association between daily toothbrushing, toothbrushing frequency and access to oral hygiene information in children in Peru in 2017.
Resumen Introducción: el objetivo del presente estudio consistió en determinar la asociación entre el acceso a la información sobre higiene oral y el cepillado dental en niños menores de 12 años en el Perú, en el año 2017. Métodos: estudio transversal de datos secundarios utilizando la base de datos de la Encuesta Demográfica y de Salud Familiar (ENDES) del año 2017. Se estimó la asociación entre el acceso a la información de hygiene oral y el cepillado mediante un análisis multivariado de regresión. La muestra fue conformada por 24.076 registros de niños. La variable dependiente fue la información acerca de las prácticas de cepillado dental (cepillado diario, frecuencia del cepillado y uso de la pasta dental) y la variable independiente fue el acceso a la información de higiene oral. Las covariables incluyeron sexo, edad, área de residencia y región natural. Resultados: la prevalencia del acceso a la información de higiene oral fue 62.39%. Se encontró asociación significativa entre 2 de las 3 prácticas de cepillado reportadas y el acceso a la información de higiene oral; los niños menores de 12 años tuvieron más probabilidades de cepillarse diariamente (PR=1.03; 95% IC 1.02-1.05), con una frecuencia de cepillado de 2 o más veces al día (PR = 1.06; 95% IC 1.04-1.08), en comparación con niños que no recibieron información de higiene y cuidado oral. El uso de pasta dental no estuvo asociado al acceso a la información de higiene oral. Conclusión: existe asociación entre el cepillado diario, la frecuencia del cepillado y el acceso a la información sobre higiene oral en niños del Perú en 2017.
