Condições de saúde bucal em pessoas acometidas por Covid-19 / Oral health conditions in people affected by Covid-19

Objetivo: Descrever alterações bucais relatadas por pessoas acometidas pela COVID-19 e identificar a relação dessas manifestações com a forma de apresentação da doença (leve ou grave). Métodos: Estudo transversal, descritivo e analítico. O instrumento versou sobre dados sociodemográficos, hábitos deletérios, forma de acometimento da COVID-19 e alterações bucais em adultos residentes no estado do Ceará. A coleta dos dados foi realizada por questionário on-line com utilização dos Formulários Google® disponibilizado de forma pública. Os dados foram analisados utilizando o software SPSS® versão 24.0 IBM®, sendo calculadas frequências absoluta e relativa das variáveis do estudo e razão de prevalência. A associação entre variáveis foi verificada pelo teste Qui-quadrado, com nível de significância de 5%. Resultados: Do total de 1958 respondentes, 586 relataram acometimento pela COVID-19. Dos afetados pela doença, 566 (96,6%) são da faixa etária entre 18 e 59 anos, 436 (74,4%) mulheres, 304 (51,9%) pós-graduados e 358 (51,1%) casados; 391 (66,7%) habitam com três a cinco pessoas e têm rendimento superior a cinco salários-mínimos [290 (49,5%)]. Predominou a forma leve da COVID-19 [312 (53,2%)], embora tenha havido grande percentual da forma grave [274 (46,8%)]. Do total, 123 que tiveram alterações bucais, como dificuldade para mastigar e engolir os alimentos (62;50,4%), queimação na boca (30;24,4%) e ferida na boca (14;11,4%). Os acometidos pela forma grave da COVID-19 mostraram probabilidade 1,55 vezes maior de apresentar alteração bucal quando comparado ao caso leve da doença (p=0,006). Conclusão: Pessoas acometidas com a forma grave da COVID-19 estão mais propensas a apresentar alterações bucais.

Objective: To describe oral changes reported by people affected by COVID-19 and to identify the relationship of these manifestations with the form of presentation of the disease (mild or severe). Methods: Cross-sectional, descriptive and analytical study. The instrument was about social-demographic data, deleterious habits, form of involvement of COVID-19 and oral changes in adults living in the state of Ceará. Data collection was performed by online questionnaire using Google® Forms publicly available. Data were analyzed using SPSS® software version 24.0 IBM®, being calculated absolute and relative frequencies of the study variables and prevalence ratios. The association between variables was verified by the Chi-square test, with a significance level of 5%. Results: Of the total 1958 respondents, 586 reported affected by COVID-19. Of those affected by the disease, 566 (96.6%) were between 18 and 59 years of age, 436 (74.4%) were female, 304 (51.9%) had a graduate degree, and 358 (51.1%) were married; 391 (66.7%) lived with three to five people and had an income greater than five minimum wages [290 (49.5%)]. The mild form of COVID-19 [312 (53.2%)] predominated, although there was a large percentage of the severe form [274 (46.8%)]. Of the total, 123 (xx%) who had oral changes, such as difficulty chewing and swallowing food (62;50.4%), burning in the mouth (30;24.4%), and mouth sore (14;11.4%). Those affected by the severe form of COVID-19 were 1.55 times more likely to have mouth changes when compared to the mild case of the disease (p=0.006). Conclusion: People affected with the severe form of COVID-19 were more likely to present oral alterations.

Angle Class II, Division 2 Malocclusion and Association with Late Eruption

Objective: To verify the dental age of individuals with Angle Class II, division 2 malocclusion. Material and Methods: The sample consisted of 200 panoramic radiographs of schoolchildren from the city of Fortaleza in the state of Ceará, in the northeast of Brazil. These radiographs were divided into two groups (N=100): a Control group comprising radiographs of patients with normal occlusion and a CIID2 group comprising radiographs of patients with an Angle Class II, division 2 malocclusion. The Demirjian method was used to identify dental age. All the radiographs were evaluated by a sole duly trained and calibrated technician. The Kappa coefficient for inter-annotator agreement was 0.98 based on the criteria of eruption stage of each tooth. Statistical analysis was performed using the Chi-squared test, Student's t-test and the Mann-Whitney test, with a level of significance of 5%. Results: There was a significant statistical difference between the dental ages of the groups tested. The CIID2 group had a lower dental age than the control group, signifying late eruption in patients with an Angle Class II, division 2 malocclusion. Conclusion: Patients with an Angle Class II, division 2 malocclusion had a lower dental age than patients with normal occlusion, suggesting that orthodontic treatment should be delayed. The first molars, second pre-molars and canines suffered late eruption.

Prevalência e fatores de risco de acidentes com materiais pérfuro-cortantes em alunos de graduação em odontologia / Prevalence of accidents with sharps materials and its risk factors in graduate dental students

O objetivo do presente estudo foi estabelecer a prevalência de acidentes com materiais pérfuro-cortantes e seus fatores de risco em estudantes de Odontologia em instituições particulares reconhecidas pelo MEC no Estado do Ceará. A coleta de dados destes acidentes foi realizada por meio da análise de notificações no período de agosto de 2010 a agosto de 2014. A amostra foi composta por 124 notificações e a análise estatística realizada de forma descritiva, por meio da frequência percentual, sendo utilizado para a obtenção dos resultados o programa Microsoft Word® e uma entrevista com os gestores das respectivas instituições realizadas por áudio, ambas gravadas. O número total de notificações de acidentes foi maior no gênero feminino nas duas instituições; o semestre que apresentou mais notificações na instituição A foi o 8º (17,5%), já na instituição B foi o 7° (50%); a Clínica Odontológica (67,7%) e Clínica Integrada (80,9%) foram as disciplinas com maior índice de acidentes; a agulha (90,9%) foi o instrumental mais envolvido nos acidentes. Quanto ao encaminhamento nas instituições foi observado que o número de alunos que procuraram atendimento pós-acidente foi semelhante nas duas instituições, porém abaixo do ideal. Desta forma, observa-se que há necessidade de uma maior vigilância no aspecto educacional dos graduandos em Odontologia para se evitar futuros acidentes

The aim of this study was to determine the prevalence of accidents with sharps and its risk factors in dental students in private institutions recognized by the MEC in the state of Ceará. Data collection of such accidents in students were made from reports of analysis from August 2010 to August 2014. The percentage frequency of the 124 notifications was performed by Microsoft Word® program. Recorded interviews with the managers of these respective institutions were performed too. The number of accident reports were higher in females in both institutions; the semester 8º had more notifications in the Institution A (17.5%); in the institution B was the semester 7º (50%); the Dental Clinic (67.7 %) and Integrated Clinic (80.9 %) were the disciplines with higher rates of accidents; the needle (90.9%) was most frequently involved in accidents. The number of students who sought post-accident care was similar in the two institutions, but less than optimal. Thus, it was observed that there is need for greater vigilance in the educational aspect of the students graduate dental studentsto prevent future accidents.

Demirjian's system for estimating the dental age of northeastern Brazilian children.

Since Demirjian's system of estimating dental maturity was first described, many researchers from different countries have tested its accuracy among diverse populations. Some of these studies have pointed out a need to determine population-specific standards. In Brazil, the Northeast region is the one that most suffers the negative impact of exodus, specially related to the increase of abandoned children in the cities. The aim of this study was to test the accuracy of Demirjian's system for assessing the dental maturity of northeastern Brazilian children, so as to present a scale for maturity score conversion into dental age developed specifically for this population. This could be used for forensic, anthropological and legal matters, and also as a model for other countries attempting to formulate their own conversion scales. Panoramic radiographs of 1,491 children (821 females and 670 males), aged 7 to 13 years, from Ceará state, northeast Brazil, were assessed by a single observer to determine dental age (DA) according to Demirjian's system. The mean percentage of intra-observer agreement was 86.6%, with a mean Cohen's Kappa coefficient of 0.67 (substantial agreement). The DA was compared by paired t-test to subjects' chronological age (CA). The differences between CA and DA in all age groups were statistically significant (p<0.0001), demonstrating a great advancement in DA among Brazilians. Scatter plots were drawn for both genders, and the data were fitted to a growth curve, y=100/(1+e(-a(x)-(b))). Graphs corresponding to the 50(th) percentile curves were produced. A table with new values for the conversion of maturity score into dental age for northeastern Brazilian children is presented. The great advancement in DA, as obtained by Demirjian's system in this population, justified the determination of specific scores for dental maturity assessment.

Prevalence of malocclusions in 10- to 12-year-old schoolchildren in Ceará, Brazil.

PURPOSE: The aim of the present study was to determine the prevalence of malocclusions and dental characteristics of schoolchildren aged between 10 and 12 years in the city of Fortaleza, Ceará in northeastern Brazil. MATERIALS AND METHODS: Two hundred and sixty-four children (107 boys and 157 girls) were examined using the Angle classification system. The occlusal characteristics studied were the measurements for overbite, overjet, crowding and midline diastema. The children who were selected had not had prior orthodontic treatment and were born in Ceará, as were their parents and grandparents. RESULTS: Of the schoolchildren who were studied, 25.8% had normal occlusion, 47.7% had Class I malocclusion, 22.3% had Class II malocclusion and 4.2% had Class III malocclusion. There was no statistically significant difference between age and gender; 30.3% of the individuals had a normal overbite and 36.7% and 19.7% had increased and reduced overbites, respectively. A normal overjet was found in 33.7% of the subjects and increased and reduced overjet was found in 50% and 3.4%, respectively. Dental crowding was observed in 62.5% and the presence of midline diastema was observed in 14.8% of the schoolchildren. CONCLUSIONS: The most prevalent occlusal status was Class I malocclusion, with no distinction between age and gender. Increased overbite and overjet were predominant. There was a high occurrence of dental crowding among the subjects in contrast to the few cases of midline diastema.

Unilateral correction of space loss in the mixed dentition.

Distalization of maxillary molars is indicated for correction of Class II dental malocclusion and for space gain in cases of space deficiency. The ideal treatment with an intraoral fixed appliance for molar distalization should fulfill the following requirements: patient compliance; acceptable esthetics; comfort; minimum anterior anchor loss (as evidenced by inclination of incisors); bodily movement of the molars to avoid undesirable effects and unstable outcomes; and minimum time required during sessions for placement and activations. The purpose of this paper was to present an alternative treatment for space recovery in the area of the maxillary right second premolar when there has been significant mesial movement of the permanent maxillary right first molar. We used a modified appliance that allows unilateral molar distalization in cases of unilateral tooth/arch size discrepancy using the opposite side as anchor, thus reducing the mesialization of the anterior teeth.