Association of Oral Health-Related Quality of Life with the Longevity of ART-Restorations in Children

ABSTRACT Objective: To evaluate the association of oral health-related quality of life (OHRQoL) with the longevity of ART-restorations in children after 18 months. Material and Methods: A longitudinal clinical study with 62 six- to seven-year-old children, both genders, 31 of whom underwent four weeks of oral health education strategy (OHES) followed by ART (GOHES+ART) and the others only ART (GART). The Brazilian short-version of the Child Perceptions Questionnaire (16-CPQ8-10) was used to evaluate the OHRQoL and the perception of change in oral health was assessed by a single question. Data was analyzed using Mann-Whitney, Wilcoxon and Friedman's tests. Results: After 18 months, GOHES+ART reported a greater impairment on OHRQoL, mainly in oral symptoms domain (p<0.05). In this period, greater impairment of oral symptoms was reported in children with failed restorations and with treatment considered to have a minor failure (p<0.05). In inter-group analysis, the GOHES+ART, with 2 to 4 restorations, Class I, of small size, located in the upper arch and with a smaller failure, reported more oral symptoms than the GART. Conclusion: In the long-term, children submitted to OHES followed by ART reported more oral symptoms. Factors such as number, class, size and location of the restorations need to be considered for the implementation of an efficient and effective oral health program, as well as for greater longevity of ART-restorations.

Assessment of anxiety and stress markers in children submitted to educational strategies and ART-restoration: A randomized clinical trial.

OBJECTIVE: Although atraumatic restorative treatment (ART) is considered to be a good option for anxious patients, there is a lack of information whether ART associated to oral health educational strategy (OHES) would positively influence the level of anxiety and stress in children. This study aimed to evaluate the impact of OHES on anxiety and stress markers of schoolchildren submitted to ART. DESIGN: A sample of 78 six- to eight-year-old schoolchildren, with carious lesions in dentin, were randomly divided into groups: OHES + ART-group (n = 39) and ART-group (n = 39). OHES consisted of an educational interactive strategy performed once a week for four weeks. ART was performed using a standardized procedure with hand instruments and glass-ionomer cement. Anxiety and stress markers were assessed subjectively by the modified Venham Picture Test (m-VPT), modified Venham Anxiety Scale (m-VAS), while objective measures consisted of heart rate (HR) and salivary cortisol and alpha-amylase levels evaluated before, during and after treatment. RESULTS: The two groups did not differ in the perceived anxiety and in anxious behavior, and the variation along the treatment was not significant in both groups (p > 0.05). Both groups also showed higher HR "Before ART-restoration" than the other time-points as an anticipatory anxiety. ART group showed higher HR than OHES + ART group during the "Explanation of procedure" (p = 0.041) and "Deep excavation" (p = 0.018), and only ART group showed higher amylase levels "Before ART" compared to "After ART" (p = 0.004). CONCLUSIONS: It was concluded that OHES associated with ART showed a positive effect in modulating heart rate and alpha-amylase levels, that is, those markers of stress objectively measured during ART-restoration.

Niveles de proteína c-reactiva en gestantes con y sin periodontitis crónica del Instituto Nacional Materno Perinatal / C-reactive protein levels in pregnant women with and without chronic periodontitis in Maternal Perinatal National Institute

Objetivo. Evaluar los niveles de Proteína C-Reactiva (PC-R) en gestantes con y sin periodontitis crónica teniendo en cuenta la covariable infección genito urinaria. La PC-R ha estado implicada como posible mediador inflamatorio sistémico en la asociación de periodontitis y efectos adversos en el embarazo. Material y método. Fueron medidos los niveles de PC-R con la técnica de inmuno turbidimetría a un total de 48 gestantes, 33 con periodontitis crónica y 15 sin periodontitis crónica según los criterios de la Asociación Americana de Periodoncia. Resultados. Se encontraron diferencias significativas (p=0,04), en los niveles de PC-R entre las gestantes con periodontitis (5,13 ± 4,47 mg/L) y sin periodontitis crónica (3,05 ± 2,41mg/L) siendo mayores los niveles de PC-R en las gestantes con periodontitis crónica. Conclusión. La periodontitis crónica juega un rol importante en la elevación de los niveles de proteína C-reactiva, lo que podría mediar la relación entre periodontitis y efectos adversos en el embarazo.

Objective. To asses plasma CRP levels in pregnant women with and without chronic periodontitis taking into account the covariate genito urinary infection C-reactive protein (CRP) has been implicated as a possible systemic inflammatory mediator of the association of periodontitis and adverse pregnancy outcomes. Material and method. The levels of PC-R were measured with immuno turbidimetric technique to a total of 48 pregnant women, 33 with chronic periodontitis and 15 without chronic periodontitis according to the criteria of the American Academy of Periodontology. Results. Significative differences were found (p=0,04), in the CRP level in pregnant women with periodontitis (5.13±4.47 mg/L and without chronic periodontitis (3.05±2.41 mg/L. We found statistical significant differences between the groups. Conclusion. Chronic periodontitis plays an important role in increasing levels of C-reactive protein and this may mediate the relationship between periodontitis and adverse pregnancy outcomes.