Fusion of permanent teeth as post-traumatic sequelae of trauma in primary dentition: A case report with fifteen years of follow-up.

Traumatic dental injuries in primary dentition present risk of sequelae in the permanent dentition. In this case report, we describe the management and long term follow-up of sequelae affecting permanent central incisor due to prior intrusive luxation and subluxation of the corresponding primary tooth. A 5-year-boy was referred for treatment, with history of fall by the age of 21 months, which caused subluxation of the primary maxillary right and left central incisors, and intrusion of the maxillary right lateral incisor. Radiographic and clinical monitoring was regularly performed. Hypoplasia and crown dilaceration of the permanent maxillary right central incisor was detected, as well as an enamel bridge between the central and lateral right incisors was diagnosed by cone bean tomography. Gingevectomy followed by the breaking of the enamel junction between the crowns of lateral and central incisors and indirect facet in composite resin were used to treat the sequelae. A precise diagnosis, involving a multidisciplinary team, contributed to the success of treatment. Key words:Case reports, follow-up studies, pediatric dentistry, tooth, deciduos, complications.

Nonpharmacologic Intervention on the Prevention of Pain and Anxiety During Pediatric Dental Care: A Systematic Review.

BACKGROUND: Nonpharmacologic interventions may be used to reduce fear and anxiety during dental treatment. OBJECTIVES: To systematically review trials on the effect of nonpharmacologic interventions in behavior, anxiety, and pain perception in children undergoing dental treatment. DATA SOURCES: Medline, Scopus, Web of Science and CINAHL, Google Scholar, and studies' reference lists. PARTICIPANTS AND INTERVENTIONS: Studies performed with children and adolescents that evaluated the effect of interventions on children's behavior, anxiety, and pain perception during dental treatment were included. STUDY APPRAISAL METHODS: Independent quality assessment of the studies was carried out following the classification categories present on the Cochrane Handbook for Development of Systematic Reviews of Intervention. RESULTS: Twenty-two articles, reporting 21 studies, were selected. Most studies tested distraction techniques. Eight studies presented bias and results were not considered. The remaining 13 studies had control groups with inactive controls, and 4 also included a variation of the intervention. Of the 4 studies assessing behavior, 3 found difference between intervention and control. Anxiety was evaluated by 10 studies: 4 found differences between intervention and control and 2 found differences between interventions. Five studies investigated pain perception: 3 found difference comparing active versus inactive interventions. In 1 of the 3, variations in the intervention decreased pain perception. CONCLUSIONS: More research is needed to know whether the techniques are effective for improving behavior and reducing children's pain and distress during dental treatment. However, the majority of the techniques improved child's behavior, anxiety, and pain perception.

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

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.

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.

Epidemiology of malocclusions in primary dentition and associated factors

This study aimed to evaluate malocclusion occurrence in children with complete primary dentition, describing the most frequent one and verifying potential associations with demographic, socioeconomic, and behavioral variables. Subjects and method: 502 children with complete primary dentition from primary schools in the city of Pelotas, RS, Brazil, were examined. Data was collected based on questionnaires distributed to the mothers, as well as on physical examinations of the oral cavity. The children with malocclusion presented at least one of the following changes: anterior open bite, deep overbite, posterior crossbite, and overjet. Chi-square tests for heterogeneity and linear trend were used to verify associations with demographic, socioeconomic, and behavioral variables. Results: the occurrence of malocclusions in the population studied was 67.5%. From them, 33.6% presented anterior open bite, 22.3% presented deep overbite, 9.8% presented posterior crossbite, and overjet was present in 1.8%. The most frequent malocclusion was anterior open bite, which was directly associated with the use of pacifier (p<0.001), duration of use (p<0.001), and frequency use (p<0.001). There was also an inverse association with children's age (p=0.007) and maternal level of education (p=0.016). An association was found between the number of children and anterior open bite (p=0.039). Conclusion: the population studied presented high prevalence of malocclusions, and anterior open bite was the most frequent one, which was associated with the use of pacifier, as well as the duration and frequency of use.

Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study.

This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p < 0.001), whereas radiographic sequelae did not (0.236). The predicted risk of color change was 29.0% (95%CI 19-41) for teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

Primary incisor intruded through the nasal cavity: a case report.

Intrusive luxation may cause complications for the primary tooth and generate adverse sequelae in the permanent successor. Although intrusion is prevalent in the primary dentition, full intrusion is a rare event that requires specialized treatment and a multidisciplinary approach. This article describes the case of a 1-year-old girl who presented with traumatic displacement of the maxillary left central incisor into the nasal cavity. The parents sought treatment 1 month after the child sustained the injury, and the impacted tooth was removed through her left nostril under general anesthesia. Four-year clinical and radiographic follow-up revealed no adverse sequelae.

Crown-Root Fractures in Primary Teeth: A Case Series Study of 28 Cases.

Crown-root fractures in primary teeth are rare, with a wide variation of patterns that make diagnosis and treatment difficult. The aim of this study was to present a case series of crown-root fractures in primary teeth of children who attended a reference center. The study followed 28 cases of crown-root fractures in 26 children, representing 4% of the total number of attendees over 11 years of reference service at the Universidade Federal de Pelotas, Pelotas, Brazil. In most cases, the maxillary central incisors (85.7%) were involved. In the crown, 57.1% of the cases had a simple line of fracture, and 42.9% had multiple lines. Simple lines predominated in the root (89.3%). In cases with simple fracture lines in the crown, 37.6% underwent a total extraction, 31.2% required a partial extraction and 31.2% underwent pulpectomy. In most teeth with multiple lines of fractures in the crown, total extraction was performed (91.7%) All cases were followed-up until the eruption of the permanent successor tooth, and all patients had favorable outcomes.

Validation of the digital photographic assessment to diagnose traumatic dental injuries.

INTRODUCTION: Alternatives for monitoring dental trauma in epidemiological surveys may be useful, as data collection of epidemiological investigation can be jeopardized due to several conditions. AIM: To investigate the validity of standard digital photographs to determine the occurrence of anterior dental trauma compared to the clinical examination in an epidemiological survey. METHODS: Participants were children aged 8-12 years old attending both private and public schools; children were clinically evaluated for the assessment of dental trauma, and standard photographs were taken from maxillary and mandibular permanent incisors of each child. Validity was determined by calculating the percentages and respective 95% confidence interval of sensitivity, specificity, positive predictive value, and negative predictive value. Cohen's kappa statistic was also used. RESULTS: A total of 412 children were included, totaling 3296 teeth assessed for dental trauma presence. The prevalence of dental trauma was 11.2% (95% CI 8.29-14.61) and 10.2% (95% CI 7.45-13.53), respectively, for the clinical examination and the photographic method. Agreement between the gold standard and the photographic diagnosis was good: 0.64 for the prevalence of dental trauma and 0.66 for diagnosis of dental trauma on a tooth basis. The diagnosis through the photographic method had higher specificity (96.7%) than sensitivity (65.2%). High positive likelihood ratio and low negative likelihood ratio were also observed. CONCLUSION: The photographic assessment method of dental trauma was valid and reliable as compared to the oral clinical examination.

Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study

Abstract This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p < 0.001), whereas radiographic sequelae did not (0.236). The predicted risk of color change was 29.0% (95%CI 19-41) for teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

Atitudes e conhecimento dos pais quanto ao uso de dentifrícios fluoretados em crianças de um a 65 meses de idade / Attitudes and knowledge of parents regarding the use of fluoride dentifrices in children aged one to sixty-five months

Objetivo: analisar o conhecimento dos pais sobre o flúor, os dentifrícios, seu uso e o motivo da escolha. Sujeitos e método: estudo transversal com dados coletados em entrevistas com pais de crianças de um a 65 meses de idade, sobre questões socioeconômicas, conhecimento sobre flúor, motivo pela escolha do dentifrício, quantidade utilizada e hábitos de higiene bucal da criança. Os dados foram analisados por meio de estatística descritiva. Resultados: foram entrevistados 202 pais. A média de idade das crianças participantes do estudo foi de 35,6 meses (±15,06). Os pais citaram os seguintes critérios para a compra do dentifrício: ausência de flúor (20,3%), preço (6,9%), sabor (11,4%), marca (10,9%), e 20,8% dos pais responderam não haver critério. Com relação ao início da administração do dentifrício fluoretado para as crianças, 43,1% dos paisrelataram que ocorreu até um ano, 21,8% mais de um ano, e 35,1% não lembravam. Sobre a quantidade utilizada de dentifrício, 32,2% dos pais apontaram usar a técnica longitudinal, 41,1% a transversal, 26,2% a dogrão de arroz, e 5% não responderam. Com relação à higiene bucal ser realizada sozinha ou com ajuda, em 12,2% ela é realizada somente pela criança, em 47,7% dos casos é a criança com a ajuda de um adulto, e em40,1% é feita somente pelo adulto. Conclusão: Os pais têm conhecimentos sobre o flúor e sua finalidade, porém não utilizam a dose recomendada para a idade e não há uma conscientização quanto à motivação para a escolha do dentifrício. Assim, há necessidade de investir em educação a respeito dos dentifrícios para a escolha consciente e o uso adequado.

Oral health-related quality of life of preschool children assisted at a University Dental Clinic / Oral health-related quality of life of preschool children assisted at a University Dental Clinic

Objective: This study assessed parental perception on children?s oral health-related quality of life (OHRQoL), and children?s views on their own teeth. Subjects and method: The sample included in this cross-sectional study consisted of 106 parents and their children, aged 0-6 years, who were assisted at a School of Dentistry. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess OHRQoL. Socioeconomic information and reasons for seeking dental care were asked and obtained from parents, while clinical information were collected from files. Children expressed the views on their teeth through an instrument with drawings. Data was analyzed by the Fisher?s exact test and Poisson regression. Results: The mean ECOHIS score was 8.31. Higher impacts on OHRQoL were observed in older children (RR=1.75; 95% CI=1.21-2.54), children referred to the clinic due to either dental trauma (RR=2.44; 95% CI=1.28-4.66) or caries (RR=2.64; 95% CI=1.39-5.05), children who have hadcaries (RR=2.15; 95% CI=1.50-3.08), and children whose parents perceived their own oral health as poor (RR=1.45; 95% CI=1.02-2.05). Twenty-three (31%) children expressed dissatisfaction with their oral health. Conclusions: The impact of oral diseases was high for this population. Children whose parents considered their own oral healthas regular/poor presented higher impact on quality of life. Moreover, older children, taken to the dentist due to caries or dental trauma, and with previous dental caries experience, presented negative impact on OHRQoL.

Oral mucosal lesions' impact on oral health-related quality of life in preschool children.

OBJECTIVES: The aim of this study was to assess the prevalence of oral mucosal lesions and their impact on oral health-related quality of life (OHRQoL) in children aged 5 years. METHODS: A sample of 1118 children from Pelotas' birth cohort, born in 2004 (response rate of 85.8%), were selected to participate in the study. Data were collected using a questionnaire applied to mothers and from the oral examinations of the children. OML were identified by type, site, and size. Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess caregivers' perception on children's OHRQoL. Descriptive, bivariate, and multivariate Poisson regression analyses were carried out, considering the impact on OHRQoL (total ECOHIS score) as the outcome. RESULTS: The prevalence of the OML was 30.1% (95% CI 27.5-32.9). Ulcers were the more prevalent type of lesion (29.4%), and the most affected site was the gums (31.0%). In bivariate analysis, there was a positive association between the presence of OML and OHRQoL impact measured by the following: mean overall score of ECOHIS (P < 0.001); extent (P < 0.001); prevalence (P = 0.030); and intensity (P = 0.010). After adjustments for sociodemographic and oral health variables, children with OML presented higher impact on OHRQoL [rate ratio (RR) 1.38 95% CI 1.11; 1.72] comparing with their counterparts. Analyzing specific domains, children with OML also presented higher impact on children symptoms (RR 1.46 95% CI 1.20; 1.66) and family functional (RR 3.14 95% CI 1.59; 6.22) domains. CONCLUSION: Almost one-third of children presented with oral mucosal lesions, and these lesions impaired children's oral health-related quality of life.

Educação Em Saúde Bucal Direcionada Aos Deficientes Visuais / Oral Health Education Targeting People With Visual Impairments

O objetivo deste estudo foi revisar na literatura estudos que abordem formas de realização de promoção de saúde e prevenção de doenças bucais para pacientes com deficiência visual. Foi realizada revisão sistemática da literatura nas bases de dados PubMed Central, Biblioteca Virtual de Saúde (BVS) e Scopus, sem limite de data de publicação. Foram incluídos ensaios clínicos nas línguas inglesa, portuguesa e espanhola, com algum tipo de intervenção de promoção de saúde bucal voltada para deficientes visuais totais ou parciais. Os artigos foram selecionados e os dados extraídos pelos autores. A busca resultou em 688 artigos dos sites PubMed,BVS e Scopus. Foram eliminados 303 artigos repetidos e, dentre os demais, selecionados nove que abordavam o tema desta revisão. As datas de publicação dos estudos variaram de 1991 a 2013. O total de deficientes visuais participantes destes estudos foi de 431 com idades entre seis e 49 anos. Todas as intervenções educativas foram efetivas e realizadas por odontólogos. A orientação verbal foi o recurso educativo mais utilizado Os resultados encontrados nos estudos deixam clara a necessidade e importância da implantação de estratégias de educação em saúde bucal para essa população. Programas de orientação de higiene bucal envolvendo recursos adaptados e comunicação verbal são efetivos no estabelecimento de uma rotina de higiene adequada, agregando conhecimento aos pacientes e seus familiares e resultando em melhora nos índices de saúde bucal.

The aim of this study was to review the literature about oral health promotion and oral disease prevention for patients with visual impairment. A systematic literature review was conducted using PubMed Central, BVS (Virtual Health Library) and Scopus without restriction for publication date. Clinical trials in English, Portuguese and Spanish that presented any oral health promotion intervention targeting people with visual impairments were included. The articles were selected and data extracted by author. The search resulted in 688 articles from the PubMed, BVS and Scopus websites. Three hundred and three repeated items were eliminated and, among the others, 9 that addressed the topic of this review were selected. The publication dates of the studies ranged from 1991 to 2013. The total number of visually impaired participants of these studies was 431, aged 6 to 49 years. All educational interventions were effective and performed by dentists. The verbal guidance was the most used educational resource. The results demonstrated the need and importance of implementing strategies for oral health education for this population. Oral hygiene orientation programs involving tailored resources and verbal communication are effective in establishing a routine for proper hygiene, providing knowledge to patients and their families, with improvement in oral health indices.

Perceived dental pain: determinants and impact on brazilian schoolchildren.

AIMS: To assess reports of dental pain in a school-based sample of children in South Brazil and test its association with socioeconomic, demographic, psychosocial, and clinical variables. Also, the consequences of dental pain on oral health perception and its impact on daily life were investigated. METHODS: A two-stage cluster procedure was used to select 1,199 children in 20 public and private schools in Pelotas, Brazil. Children were interviewed to obtain selfreports of dental pain. They were also asked about perception of their oral health and dental fear. Mothers answered a questionnaire on socioeconomic characteristics. A clinical oral examination was conducted to assess dental caries, malocclusion, and dental trauma. Multivariate Poisson regression analysis was used to investigate factors associated with dental pain in the previous 6 months and its effect on oral health perception. RESULTS: The prevalence of dental pain was 35.7% (95% confidence interval [CI] 33.0-38.5) in the previous 6 months. A higher prevalence of dental pain was observed for children from lower-income families (prevalence ratio [PR] 1.39; 95% CI 1.10-1.76), for girls (PR 1.24; 95% CI 1.06-1.46), for those living in overcrowded houses (PR 1.23; 95% CI 1.01-1.49), for those who reported dental fear (PR 1.19; 95% CI 1.00-1.42), and for those with caries experience (PR 1.57; 95% CI 1.34- 1.84), after adjustments. Dental pain presence influenced oral health perception (PR 2.56; 95% CI 1.55-3.29) and impacted the children's daily life (PR 1.89; 95% CI 1.64-2.17). CONCLUSION: A high percentage of schoolchildren suffered from dental pain, which was influenced by demographic, socioeconomic, psychosocial, and clinical characteristics, causing a negative impact on oral health perception.

Nonuse of dental service by schoolchildren in Southern Brazil: impact of socioeconomics, behavioral and clinical factors.

OBJECTIVES: To assess clinical, behavioral and socioeconomic factors associated with nonuse of dental services by schoolchildren. METHODS: A cross-sectional school-based study with 1211 children aged 8-12 years was carried out in Pelotas, Brazil. The outcome (never having had a dental appointment) and independent variables were collected through interview with parents and children, including sex, age, parent's schooling, family income, self-perception about oral health, and dental fear. Dental caries was assessed by clinical examination performed at schools. RESULTS: 291 (24.3 %; 95 % CI 22.0-26.9) of the children had never visited a dentist. Multivariate Poisson regression analysis showed that the outcome was associated with children from mothers with little education (≤0.001), from public schools (≤0.001), from crowded households (≤0.001), who had no caries (≤0.001), who had dental fear (≤0.001), and who started oral hygiene later (0.04). CONCLUSIONS: Despite the extensive increase in oral health coverage, especially in the public system in the last years in Brazil, there is still an unassisted portion of the population of schoolchildren. It was observed that socioeconomic, behavioral, and clinical factors influenced the nonuse of dental services.

Oral health-related quality of life of schoolchildren: impact of clinical and psychosocial variables.

BACKGROUND: Besides the clinical aspects, the patient's perspective of oral health-related quality of life (OHRQoL) may be influenced by a series of individual characteristics. AIM: The aim was to investigate the impact of clinical and psychosocial variables on the OHRQoL of Brazilian schoolchildren. DESIGN: A school-based cross-sectional study was conducted with children of 8-10 year old attending public (15) and private (5) schools (n = 749). Questionnaires were applied to parents to obtain socioeconomic characteristics, and children were interviewed. Assessment of OHRQoL was performed using the Child Perceptions Questionnaire 8-10 (CPQ). Oral health examinations included periodontal condition, dental caries, dental trauma, and malocclusion assessment. Unadjusted analyses were undertaken using t-tests and one-way analysis of variance. Multiple linear regression was used to assess the effects of independent variables on CPQ scores. RESULTS: Factors associated with higher CPQ scores in the linear regression analysis after adjustments were family income, presence of decayed teeth, self-reported dental trauma, dental fear, and dental pain. CONCLUSION: Oral health-related quality of life was influenced by psychosocial and clinical variables.

Long-term clinical and radiographic follow up of subluxated and intruded maxillary primary anterior teeth.

AIMS: This study aimed to determine the kinds of sequelae resulting from intrusive luxation and subluxative injuries in primary anterior teeth as well as the timing of such sequelae. MATERIALS AND METHODS: In this longitudinal retrospective study, data were collected from dental records and radiographs of patients with traumatic dental injury (TDI) treated at the Centre for the Study and Treatment of Dental Trauma in Primary Dentition (Pelotas, RS, Brazil). Fifty-two children, with seventy intruded teeth, and 76 children, with 99 subluxated teeth, met the inclusion criteria. Sequelae, such as crown discoloration, fistula, pulp canal obliteration (PCO), inflammatory root resorption (IRR), and internal root resorption, were investigated. The data on the sequelae were distributed into eight follow-up periods: 0-30 days, 31-90 days, 91-180 days, 181-365 days, 1-2 years, 2-3 years, 3-4 years, and >4 years. RESULTS: The sample comprised 99 subluxation cases and 70 intruded teeth. Crown discoloration was the most prevalent sequelae. Among the subluxated teeth, <50% of IRR, fistula, crown discoloration, and PCO occurred within 180 days after TDI; however, the sequelae were also diagnosed after longer periods. Majority of sequelae of intrusion were diagnosed within the 181-365 days and 1-2 years periods but were also observed after more than 4 years of follow up. CONCLUSIONS: For both intrusion and subluxation, trauma sequelae were diagnosed even after the 3-4 years of follow-up.

Longevity of posterior restorations in primary teeth: results from a paediatric dental clinic.

OBJECTIVES: The aim of this retrospective study was to evaluate the longevity of restorations in the posterior primary teeth of children attending to a public paediatric dental clinic and to test the factors associated with failures. METHODS: Patient records of 329 children (162 boys and 166 girls) were used for collecting and analyzing data. A total of 565 restorations in primary teeth were included in the study. All children enrolled in the study were classified as high caries risk. The longevity of restorations from their placement until failure (up to 4 years of follow-up) was assessed using the Kaplan-Meier survival curves with log-rank test. Multivariate Cox regression analysis with shared frailty (p<0.05) was used to assess the factors associated with failures. RESULTS: Up to 4 years of follow-up, the annual failure rates were 9.5% for composite fillings, 12.2% for light-cured glass ionomer restorations, and 12.9% for conventional glass ionomer restorations with statistical difference between the materials (p=0.014). Glass ionomer restorations had a higher risk of failure over time compared with composites (HR 1.86, 95% CI 1.17-2.97). In crude analysis, Class II restorations showed lower survival rate than Class I restorations (p=0.031) but lost significance after adjustments. CONCLUSIONS: Our findings suggested that the material influenced the survival rate of primary posterior restorations, with composite presenting the best performance. CLINICAL SIGNIFICANCE: Differences were observed between restorative materials with different properties in primary teeth up to 4 years of follow-up. This study provides valuable information regarding the primary teeth posterior restoration longevity in a paediatric population with restorations performed under daily life clinical environment.