The Top 100 Most-Cited Articles on Permanent Teeth Avulsion: A Bibliometric Analysis

INTRODUCTION

Knowledge of bibliometric indices on the avulsion of permanent teeth can help researchers to identify gaps in the literature. The aim of this study was to analyze the bibliometric characteristics of the 100 most-cited articles on the avulsion of permanent teeth.

MATERIALS AND METHODS

Two researchers conducted an unfiltered search in the Core Collection section of the Web of Science (WoS-CC) database. The following data were extracted: position in the citation list, total number and density of citations, title, authors, institution, country, year of publication, journal, keywords, study design, tooth storage medium, and other topics of interest. Bibliometric networks were generated and analyzed using the VOSviewer software. Descriptive analysis and a Poisson regression analysis were performed (P < .05).

RESULTS

The number of citations per article varied between 31 and 407. The average was 70.05, and 13 articles received more than 100 citations. J.O. Andreasen (n = 13) and M. Trope (n = 15) were the authors who contributed most often to publications. The United States was the country with the highest number of articles (n = 31). Authors associated with the University of Copenhagen, Denmark (n = 9) and University of North Carolina, USA (n = 10) showed higher productivity. In vitro/animal model studies were the most frequent study designs (n = 50), and the most-discussed topic of interest was prognosis (n = 47). There was strong clustering among 13 research groups.

CONCLUSION

Observational studies, published by authors from Europe and about prognosis or treatment presented more citation ratio in WoS-CC. Clinical studies on permanent tooth avulsion are needed to increase the quality of scientific evidence and provide insights for health professionals and public policy makers.

Is there an association between dental caries and genetics? Systematic review and meta-analysis of studies with twins

OBJECTIVE

This review aimed to assess the agreement of dental caries experience between monozygotic (MZ) and dizygotic (DZ) twins.

DATA RESOURCES

This systematic review was performed by reviewers in the databases Embase, MEDLINE-PubMed, Scopus, Web of Science and manual searches and gray literature Google Scholar® and Opengray. Observational studies that evaluated dental caries in twins were included. The risk of bias was analyzed using the Joanna Briggs checklist. Meta-analyses were performed to assess the pooled Odds Ratio to estimate the agreement values of dental caries experience and DMF index between pairs of twins (p < 0.05). To assess the certainty of evidence, the GRADE scale was used.

STUDY SELECTION

2533 studies were identified, of which 19 were included in the qualitative analysis, six in the quantitative synthesis, with two meta-analyses being carried out. Association between genetics and the development of the disease was observed in most studies. In the risk of bias analysis, 47.4% had moderate risk. Higher agreement of dental caries experience was observed in MZ twins than DZ in both dentitions (OR: 5.94; 95% CI: 2.00-17.57). However, there was no difference between the MZ and DZ twin groups in the analysis comparing DMF index agreement (OR: 2.86; 95%CI: 0.25-32.79). The certainty of evidence was considered low and very low for all studies included in meta-analyses.

CONCLUSION

With very low certainty of the evidence, the genetic factor seems to influence the agreement of the caries experience.

CLINICAL RELEVANCE

Understanding the genetic influence on the disease has the potential to contribute to the development of studies that may use biotechnologies for prevention and treatment as well as guide future research involving gene therapies aiming to prevent the occurrence of dental caries.

Association between genetic factors and molar-incisor hypomineralisation or hypomineralised second primary molar: A systematic review

OBJECTIVE

To determine the association between genetic factors and molar-incisor hypomineralisation (MIH) and/or hypomineralised second primary molars by means of a systematic review.

DESIGN

A search was performed in Medline-PubMed, Scopus, Embase and Web of Science databases; manual search and search in gray literature were also performed. Selection of articles was performed independently by two researchers. A third examiner was involved in cases of disagreement. Data extraction was performed using an Excel® spreadsheet and independent analysis was performed for each outcome.

RESULTS

Sixteen studies were included. There was an association between MIH and genetic variants related to amelogenesis, immune response, xenobiotic detoxification and other genes. Moreover, interactions between amelogenesis and immune response genes, and SNPs in the aquaporin gene and vitamin D receptors were associated with MIH. Greater agreement of MIH was found in pairs of monozygotic twins than dizygotic twins. The heritability of MIH was 20 %. Hypomineralised second primary molars was associated with SNPs in the hypoxia-related HIF-1 gene and methylation in genes related to amelogenesis.

CONCLUSION

With very low or low certainty of evidence, an association was observed between MIH and SNPs in genes associated with amelogenesis, immune response, xenobiotic detox and ion transport. Interactions between genes related to amelogenesis and immune response as well as aquaporin genes were associated to MIH. With very low certainty of evidence, hypomineralised second primary molars was associated to a hypoxia-related gene and to methylation in genes related to amelogenesis. Moreover, higher agreement of MIH in pairs of monozygotic twins than dizygotic twins was observed.

Early childhood caries management using fluoride varnish and neutral fluoride gel: a randomized clinical trial

The aim of this study was to evaluate the clinical efficacy of varnish and neutral fluoride gel in the management of early childhood caries (ECC). A randomized clinical trial was conducted to compare two strategies for ECC management: topical application of neutral fluoride gel (NFG group) and varnish (FV group) every four months for a period of one year. The sample consisted of children between the ages of three and four years, enrolled in public daycare centers. The incidence of ECC between the groups was compared by assessing values (new dmfs) at two levels: d2 when enamel/dentin were affected and d3 when dentin affected. Pearson's Chi-square, Fisher's Exact, Kolmogorov-Smirnov and Mann-Whitney tests were used to compare the incidence and increment of caries between the NFG and FV groups (p<0.05). A total of 240 children were included in this study and 213 children (88.7%) were followed up for 12 months. The incidence of ECC was 24.1% in the GF and 21.0% in the FV groups (p=0.586). The increment of caries in d2mfs was 1.36 (95% CI = 0.83 - 1.89) in the NFG and 1.33 (95% CI = 0.75 - 1.89) in FV (p=0.756) groups. Increment of caries in d3mfs was 1.60 (95% CI = 0.95 - 2.25) in NFG and 1.40 (95% CI = 0.75 - 2.04) in FV (p=0.468). Neutral fluoride gel and fluoride varnish exhibited similar efficacy in the management of ECC after 12 months of follow-up.

Impact of hypomineralised second primary molar on preschoolers' oral health-related quality of life-A hierarchical approach

BACKGROUND

Hypomineralised second primary molar (HSPM) is a developmental enamel defect associated with dental caries.

AIM

To evaluate the impact of HSPM on oral health-related quality of life (OHRQoL) in preschoolers through hierarchical analysis.

DESIGN

This population-based cross-sectional study assessed 834 5-year-old preschoolers, in Teresina, Piauí, Brazil, using sociodemographic questionnaires and Early Childhood Oral Health Impact Scale (ECOHIS). Dental examination was performed by two calibrated examiners (κ ≥ 0.80) for the diagnosis of HSPM (EAPD), dental caries (dmft and pufa indices), and malocclusion (Foster and Hamilton criteria). Analysis of the determinants of OHRQoL was stratified at three levels (P < .05).

RESULTS

Severe HSPM was associated with OHRQoL in bivariate analysis (P < .05). In adjusted final multivariate analysis (model 1), the presence of dental caries with or without clinical consequences was associated with worse OHRQoL (P < .05). In model 2, after the removal of dental caries, preschoolers with severe HSPM had greater probability of having a negative impact on OHRQoL in the child impact section (RR = 2.14; 95% CI = 1.26-3.65), family impact section (RR = 1.99; 95% CI = 1.16-3.42), and total score (RR = 2.09; 95% CI = 1.25-3.49) of the ECOHIS.

CONCLUSION

Severe HSPM had a negative impact on the OHRQoL of preschoolers and their families, but the presence of dental caries neutralised this impact.

Impact of Pulp Necrosis on Oral Health-Related Quality of Life of Children with Early Childhood Caries

Purpose: To assess the impact of pulp necrosis on the oral health-related quality of life (OHRQoL) of children with early childhood caries and their caregivers.<br/>Methods: A cross-sectional study was performed with a consecutive sample of children who were divided into three groups: (1) caries-free children; (2) with untreated carious lesions and without pulp necrosis; and (3) with untreated carious lesions and at least one tooth with pulp necrosis. Data were collected using a sociodemographic questionnaire, the Early Childhood Oral Health Impact Scale (ECOHIS) and a dental clinical examination using the International Caries Detection and Assessment System index. Descriptive statistics, Kruskal-Wallis tests, Mann-Whitney tests and Poisson regression were performed (P <0.05).<br/>Results: A total of 532 children and their legal guardians participated in the study. Children with pulp necrosis had a greater negative impact on the OHRQoL versus those with untreated carious lesions without pulp necrosis (ratio of unadjusted and adjusted rates [RR] = 1.59; 95 percent confidence interval [95% CI] = 1.36 to 1.86; P <0.001), as measured by the total ECOHIS score. in Group 3, four- and five-year-old children had a greater negative impact on the OHRQoL than two- and three-year-old peers (RR = 1.36; 95% CI = 1.08 to 1.72; P <0,001).<br/>Conclusion: The presence of pulp necrosis increased the negative impact on OHRQoL of children with untreated carious lesions and their guardians.

Effect of fluoridated water on dental caries and fluorosis in schoolchildren who use fluoridated dentifrice

This cross-sectional study evaluated the prevalence and severity of dental caries and fluorosis in children and adolescents using fluoridated toothpaste, from areas with and without fluoridated water. Parents of 5-year-old children and 12-year-old adolescents from neighbourhoods that are supplied with and without fluoridated water answered questionnaires for determining socio-economic and demographic characteristics and habits related to oral health. The individuals were examined, and dental caries and fluorosis were measured by dmft/DMFT and TF indexes, respectively. Descriptive, bivariate and logistic regression analyses were performed (p < 0.05). Of 692 participants, 47.7% were 5-year-olds and 52.3% were 12-year-olds. The mean dmft/DMFT in the 5-year-olds/ 12-year-olds from Exposed and Not Exposed fluoridated water groups was 1.53 (± 2.47) and 3.54 (± 4.10) / 1.53 (± 1.81) and 3.54 (± 3.82), respectively. Children (OR = 2.86, 95% CI = 1.71-4.75) and adolescents (OR = 1.95, 95% CI = 1.24-3.05), who did not consume fluoridated water, had greater caries experience. Among adolescents, there was an association between fluoridated water and the prevalence of very mild/mild fluorosis (OR = 5.45, 95% CI: 3.23-9.19) and moderate fluorosis (OR = 11.11, 95% CI = 4.43-27.87). Children and adolescents, who consumed fluoridated water, presented lower prevalence and severity of dental caries compared to those who used only fluoridated toothpaste as the source of fluoride. There is an association between water fluoridation and very mild/mild and moderate fluorosis in adolescents.

Association of Oral Health Teams implantation with collective actions and extractions in Paraná State, Brazil

This article aims to monitor the indicators of outpatient production of Dentistry and to evaluate the association of collective action and extraction indicators with the number of Oral Health Teams (OHT) between 2006 and 2015 in Paraná. In this longitudinal ecological study, consolidated secondary data were analyzed (collective actions of supervised brushing-SB, topical application of fluoride-TAF, fluoride mouthwash-FM, oral examination for epidemiological purposes-OE and extractions of permanent teeth-EX) from the Ambulatory Information System (SIA-SUS) and OHT numbers from the National Registry System of Health Establishments. Descriptive analyzes and Pearson's correlation were performed, with significance level of p<0.05. It was verified the increase of the OHT implantation over time and a strong positive correlation with collective procedures of SB (r=0.78; p=0.007) and FM (r=0.76; p=0.011) and moderate negative correlation with EX (r=-0.53). It was concluded that the evaluated indicators showed that the implementation of Oral Health Teams may have contributed to changes to the healthcare model, with an increase in preventive collective procedures and reduction of tooth loss in Paraná.

Does outpatient dental treatment have impact on the quality of life of children with early childhood caries?

AIM

To assess the impact of outpatient dental treatment on oral health-related quality of life (OHRQoL) of children and their families.

MATERIALS AND METHODS

This prospective observational study was conducted with children with untreated dental caries, recruited from a public university/the pediatric dentistry clinic of a public university in the northeastern Brazil. Sociodemographic data were collected, a clinical examination was carried out before and after dental treatment, and the Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was applied to those responsible for the children, before and after dental treatment. Descriptive and bivariate statistics were used, and the Wilcoxon and Student's t tests were applied (p < 0.05).

RESULTS

The study included 64 children, of both sexes, aged between 3 and 5 years old. The majority had a dmft index higher than or equal to 6 (60.9%), with a mean value of 7.11 (± 4.11). Sociodemographic conditions such as sex, age, and socioeconomic status had no impact on their OHRQoL (p > 0.05). The mean total ECOHIS questionnaire scores and those of its domains decreased after completion of the treatments (p < 0.05), except for scores in the self-image and distress domains of the parents (p > 0.05). This study reinforces the relevance of adopting oral health policies aimed at the prevention and treatment of ECC.

CONCLUSION

Outpatient dental treatment had a positive impact on the OHRQoL of children and their families.

CLINICAL RELEVANCE

The possibility of evaluating the services provided by the pediatric dentistry clinic.

Fluoridated water impact on tooth decay and fluorosis in 17-20-year-olds exposed to fluoride toothpaste

OBJECTIVE

To determine the impact of water fluoridation on the prevalence and severity of dental caries and fluorosis in individuals aged 17-20 years exposed to fluoride toothpaste.

METHODS

The study population consisted of 660 students from public schools, residents of areas supplied with fluoridated water (exposed group) or not (not exposed group). Students from both groups had access to fluoride toothpaste throughout life. A questionnaire about socioeconomic demographic aspects, conditions related to access and exposure to fluoridated water, and habits related to oral health was applied. Dental caries was measured by the DMFT index and dental fluorosis by the TF index. The chi-square test, t test, and subsequently logistic regression were applied for data analysis.

RESULTS

Caries experience (DMFT≠0) was significantly higher in students from areas not exposed to fluoridated water, after adjustments to clinical conditions, demographic socioeconomic profile, and hygiene habits. The DMFT mean (±SD) was significantly higher in students from areas not exposed to fluoridated water than exposed (3.83 [±3.28] and 2.48 [±2.71] respectively). The prevalence of very mild/mild and moderate fluorosis was 41.1% and 21% for students either exposed to fluoridated water or not, respectively.

CONCLUSION

Exposure to fluoridated water was associated with a lower prevalence and severity of tooth decay, in spite of the use of fluoridated toothpaste. The prevalence of dental fluorosis at all levels was higher in fluoridated areas, however, in both groups, there were few cases with esthetic implications.

Hypomineralized Teeth Have a Higher Frequency of Dental Hypersensitivity

Purpose: The purposes of this study were to: (1) compare dental hypersensitivity (DH) between hypomineralized permanent first molars and unaffected controls molars in patients with molar-incisor hypomineralization (MIH); and (2) assess the influence of opacity, color, and subject age on DH. Methods: This cross-sectional study identified 40 children/adolescents, who were attending a children's dental clinic and had one to three first permanent molars hypomineralized (demarcated opacities). The severity and color of the hypomineralized lesions were also evaluated. The assessment of DH was made using evaporative stimulus using a jet of compressed air applied by a dental syringe for one second, perpendicular to the occlusal surface employing the visual analogue scale (VAS) and the Schiff cold air sensitivity scale (SCASS). To verify the association between the presence or absence of DH and MIH, Pearson's chi-square and Fisher's exact test (P<0.05) were performed. Results: The frequency of DH was 28.0 percent in hypomineralized teeth and 9.4 percent in normal controls (by VAS; P=0.002). A higher frequency of opacities was observed (P<0.001). Older individuals had DH more frequently (P<0.05). Conclusions: Hypomineralized molars presented a higher frequency of dental hypersensitivity than control teeth, and dental hypersensitivity was associated with darker opacities of the lesion and older-aged subjects.

Breathing problems, being an only child and having parents with possible sleep bruxism are associated with probable sleep bruxism in preschoolers: a population-based study

PURPOSE

To determine the prevalence of probable sleep bruxism (SB) in preschoolers and associated factors.

METHODS

A cross-sectional, population-based study was carried out with 862 dyads of parents/preschoolers aged 5 from Teresina, Brazil. Data collection was performed through a questionnaire answered by parents/guardians about socioeconomic, demographic, and health condition data. Each child was examined for diagnosis of probable SB based on the presence of dental wear associated or not with the report of teeth grinding by parents/guardians. The analysis of independent variables was stratified into four levels of determinants: demographic characteristics of the child (distal), characteristics of the family, environmental factors (intermediate), and health conditions (proximal). Descriptive analysis and bivariate and multivariate Poisson's regression were performed using a hierarchical approach (p < 0.05).

RESULTS

The prevalence of probable SB was 36%. In the final adjusted multivariate hierarchical model, a preschooler who was the only child (PR = 1.25; 95%CI = 1.02-1.51), with breathing problems (PR = 1.43; 95%CI = 1.19-1.73), and having parents/guardians with possible sleep bruxism (PR = 1.65; 95%CI = 1.32-2.07) had a higher prevalence of probable SB.

CONCLUSION

The prevalence of probable SB in preschoolers was high and associated with the condition of being an only child, the presence of breathing problems, and having parents/guardians with possible sleep bruxism.

Consumption of Acidic Beverages is a Predisposing Factor for Erosive Tooth Wear in Preschool Children: A Population-based Study

Purpose: In a cross-sectional population-based study of 888 5-year-old preschoolers from Teresina, Brazil, to determine the prevalence and factors associated with erosive tooth wear (ETW).
Materials and Methods: In a questionnaire, parents provided information on sociodemographic factors, their children's eating/drinking habits, and oral health. Dental examination was performed at the schools by two calibrated examiners for the diagnosis of ETW, following the criteria of the modified O'Brien Index.
Results: The prevalence of ETW was 3.3%. The maxillary incisors were the most highly affected teeth, followed by the mandibular and maxillary molars. The majority of the lesions reached only the enamel (72.1%) and up to 1/3 of the dental surface (63.1%). The occlusal surface was the most affected (47.8%). Preschoolers who had an acidic food-consumption profile had a 2.74 times (95% CI = 1.03-7.30) higher chance of having ETW than children without this profile.
Conclusion: The prevalence of erosive tooth wear on the deciduous teeth was low and associated with the consumption of acidic beverages.

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Molar-incisor hypomineralization in quilombola children and adolescents: A study of prevalence and associated factors

OBJECTIVES

This cross-sectional observational study determined the prevalence and factors associated with molar-incisive hypomineralization (MIH) in quilombola children and adolescents in north-eastern Brazil.

METHODS

The sample consisted of 251 children and adolescents (8 to 14 years old) living in the rural quilombola community Lagoas in São Raimundo Nonato, Piauí (census population). Sociodemographic and health-related data were collected from pre-, peri- and post-natal health records and a clinical examination for MIH diagnosis was performed by four previously trained and calibrated examiners. Descriptive data analysis and Poisson regression were performed. The magnitude of the association was determined by adjusted prevalence ratio (PR) and confidence intervals (95% CI).

RESULTS

The prevalence of MIH was 46.6%. The presence of MIH was associated with gestational diabetes (PR = 2.49, 95% CI 2.08-2.99; p <0.001) and acute foetal distress (PR = 1.39; 95% CI 1.04-1.86; p = 0.025).

CONCLUSION

It was concluded that the prevalence of MIH in the quilombola community was high and associated with gestational diabetes and acute foetal distress.

Prevalence of Enamel Defects in Premolars Whose Predecessors Were Treated with Extractions or Antibiotic Paste

PURPOSE

To determine the prevalence of developmental defects of the enamel (DDE) in premolars whose infected predecessors were submitted to pulp therapy with antibiotic paste or extractions due to pulp necrosis.

MATERIALS AND METHODS

A cross-sectional study with a consecutive sample consisting of children and adolescents who presented with fully erupted premolars, was evaluated. Data were collected by dental examinations, in which the modified DDE index was applied. Dental records were evaluated and three groups of premolars were determined according to the clinical history of predecessors: GCTZ: with pulp necrosis and treated with CTZ (chloramphenicol, tetracycline, zinc oxide and eugenol) paste; GE: with pulp necrosis and treated by extraction; GH: healthy and physiologically exfoliated. Descriptive analysis and a logistic regression (p <0.05) were performed.

RESULTS

The study included 1017 premolars, DDE was present in 22.5%. Premolars belonging to the GE group presented higher odds of DDE (odds ratio (OR) = 3.52, 95% CI:2.29-5.40) than those of GCTZ group (OR = 2.43, 95% CI:1.51-3.91) and GH group (p <0.01). Enamel defects were more frequent in maxillary premolars (OR = 3.22, 95% CI:1.65-6.27, OR = 3.39, 95% CI:1.67-6.90, OR = 2.90, 95% CI:1.48-5.66 and OR = 3.10, 95% CI:1.54-6.23).

CONCLUSIONS

The prevalence of enamel defects was higher in premolars whose predecessors were removed because of necrosis, followed by those treated with CTZ paste and those that were healthy by the time exfoliation occurred.

Pre-term birth and asthma is associated with hypomineralized second primary molars in pre-schoolers: A population-based study

BACKGROUND

Hypomineralized second primary molar (HSPM) is a developmental enamel defect that represents a caries-risk factor. There are few studies about HSPM epidemiology in representative populations.

AIM

To determine the prevalence and factors associated with HSPM in pre-schoolers.

DESIGN

This is a cross-sectional population-based study of 5-year-old pre-schoolers from Teresina, Brazil. The sample was randomly selected and stratified by geographic region of the city, type of school (public and private), and sex of the pre-schoolers (n = 811). Sociodemographic status and pre-, peri-, and post-natal conditions were collected by structured questionnaires. Two calibrated examiners diagnosed HSPM using the criteria of the European Academy of Paediatric Dentistry for molar-incisor hypomineralization. Severity, colour, location, and extent of lesions were also evaluated. Descriptive analysis of the data and a Poisson regression analysis were performed (P < .05).

RESULTS

The prevalence of HSPM was 14.9. Demarcated opacities (75.6%) and white/cream colour were the most prevalent (71.4%). Pre-term pre-schoolers had 66% (PR = 1.66, 95% CI = 1.07-2.58), and those who reported asthma in the first year of life had 69% (PR = 1.69, 95% CI = 1.01-2.85) higher prevalence of HSPM.

CONCLUSIONS

Pre-term birth and reported asthma in the first year of life were associated with HSPM. The prevalence of HSPM in pre-schoolers aged 5 years old in Teresina was high.

Does low-cost GIC have the same survival rate as high-viscosity GIC in atraumatic restorative treatments? A RCT

Atraumatic Restorative Treatment (ART) is one of the strategies used to control dental caries; it involves hand instruments for removal of carious tissue, and restorations using high-viscosity Glass Ionomer Cement (GIC). The present controlled clinical trial aimed to evaluate the performance of low-cost GIC indicated for ART in primary teeth, compared with high-viscosity GIC, after one year of follow-up. Two-to six-year-old children with dentin caries lesions on one or two surfaces of anterior and posterior teeth were selected. The children were randomly assigned to 2 groups according to the restorative material used: G1 (control) - Ketac Molar®; G2 (experimental) - Vitro Molar®. Treatments were performed in a school setting, following the guidelines of the ART. A total of 728 restorations were performed in 243 children. Descriptive analysis and Poisson regression were applied, with a significance level of p < 0.05. After 12 months, 559 (76.8%) restorations were re-evaluated. The success rate was evaluated by the prevalence ratio (PR), associated with restorations performed in primary second molars (PR = 1.21; 95%CI = 1.03-1.42), and with small (PR = 1.35; 95%CI = 1.14-1.60) or medium cavities (PR = 1.29; 95%CI = 1.08-1.55), using Ketac Molar® material (PR= 1.07; 95%CI = 1.01-1.15), considering p < 0.05. Small or medium restorations in primary second molars performed with high-viscosity GIC (Ketac Molar®) were more successful than restorations performed with low-cost GIC indicated for ART.

Impacto da cárie dentária na qualidade de vida de pré-escolares mensurado pelo questionário PedsQL

Resumo O objetivo do estudo foi avaliar o impacto da cárie dentária na qualidade de vida de pré-escolares. A população foi constituída por pré-escolares com idade de 5 anos, matriculados em instituições públicas e privadas de Teresina, PI, Brasil. Instrumento de qualidade de vida validado para população brasileira (Pediatric Quality of Life Inventory - PedsQL™) foi aplicado para as crianças e responsáveis, além de questionário socioeconômico-demográfico para os responsáveis. No exame dentário o índice ceod foi utilizado para avaliar a experiência de cárie. Das 566 crianças examinadas, 50,2% apresentaram experiência de cárie. Foi observada associação entre experiência de cárie e pior qualidade de vida no domínio de saúde bucal na percepção das crianças (RR= 0,981; IC95% = 0,97-0,99) e dos pais (RR= 0,955; IC95% = 0,94-0,97). De acordo com a percepção das crianças, cárie em dentes posteriores foi associada a pior qualidade de vida no domínio capacidade física (RR= 0,985; IC95% = 0,97-0,99). Concluiu-se que experiência de cárie impactou negativamente na QVRSB (qualidade de vida relacionada à saúde bucal) no domínio saúde bucal da criança de acordo com a percepção das crianças e dos pais. Cárie localizada em molares impactou negativamente na QVRSB no domínio capacidade física segundo a percepção das crianças.

Impact of Developmental enamel defects on quality of life in 5-year-old children

BACKGROUND

Developmental enamel defects (DDE) represent one of the prevalent oral problems in childhood; however, few studies have evaluated its impact on quality of life in the children's own perception.

AIM

To evaluate the DDE impact on quality of life of 5-year-old children.

METHODS

This cross-sectional observational study assessed 566 children aged 5 years old, in Teresina, Piauí, Brazil, according to their self-perceptions. Children answered the Pediatric Quality of Life Inventory^™ Version 4.0 and Oral Health Scale. The dmft index, modified DDE index and Foster and Hamilton criteria were used to diagnose dental caries, DDE and malocclusion, respectively. A single examiner performed the clinical examination. Descriptive analyses and Poisson regression with robust variance were performed.

RESULTS

The prevalence of DDE was 33.7%. For children's self-reports, the presence of DDE had a negative association with oral health-related quality of life (OHRQoL; PR 1.09, 95% CI 1.02-1.15). Enamel hypoplasia had a negative impact on the physical function (PR 1.05; 95% CI 1.01-1.10) and oral health (PR 1.06, 95% CI 1.01-1.11) domains. Diffuse opacity had a negative impact on the social aspect (PR 1.09, 95% CI 1.02-1.18).

CONCLUSIONS

Enamel defects had a negative impact on OHRQoL according to the self-reports of the children.

Quilombola children and adolescents show high prevalence of developmental defects of enamel

Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children's parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

Association Between Duration of Breastfeeding and Malocclusion in Primary Dentition in Brazil

Purpose: To evaluate the relationship between type and duration of breastfeeding and the development of malocclusion in primary dentition.<br/> Methods: A cross-sectional observational study was conducted with children of both sexes, aged 30 to 48 months, who attended to a dental program for maternal and child care. The mothers completed a questionnaire about the form (exclusive breast-feeding or not) and duration of breastfeeding, their children's non-nutritive sucking habits, and their sociodemographic information. The clinical examination was done by a calibrated examiner in the knee-to-knee position and under indirect light to evaluate the primary occlusion. Pearson's chi-square test or Fisher's exact test and Poisson regression were performed for statistical analysis.<br/> Results: Over 45 percent of 252 children who were evaluated had malocclusion, such as anterior open bite (13.6 percent), posterior crossbite (3.6 percent), anterior crossbite (2.8 percent), midline shift (21.5 percent), overbite (19.8 percent), and overjet (32.9 percent). Children who were exclusively breastfed for less than six months had a 50 percent higher prevalence of anterior open bite (P =0.009) compared to those who had exclusive breastfeeding for more than six months.<br/> Conclusion: Exclusive breastfeeding for less than six months was associated with anterior open bite. The other malocclusion types were not associated with the time and type of feeding the children received in the early phase of the primary dentition. (J Dent Child 2019;86(1):17-23)<br/> Received August 29, 2018; Last Revision November 20, 2018; Accepted January 3, 2019.

Factors associated with molar-incisor hypomineralisation in schoolchildren aged 8-10 years: a case-control study

BACKGROUND

The aetiology of molar-incisor hypomineralisation (MIH) is multifactorial and may involve genetic and environmental factors.

AIM

To verify the factors associated with MIH in schoolchildren from 8 to 10 years of age.

DESIGN

This is a case-control study with a sample consisting of children aged 8 to 10 years, paired by gender and school type, in a ratio of 1:3. The case group included 186 children with MIH and the control included 558 children without MIH. Data were collected through a semi-structured questionnaire and clinical examination. Chi-square, linear-by-linear, Mann-Whitney, and logistic regression tests were conducted. A value of P < 0.05 was considered significant.

RESULTS

The prevalence of mild MIH was 19.5%, moderate MIH 2.2% and severe MIH 3.2%. An association was observed between MIH with treatment need and a higher mean DMF-T and decayed and missing teeth (P < 0.05). According to the aetiological factors studied, mothers who presented a fever during pregnancy had a 2.54 times greater chance of having children with severe MIH than mothers who did not present a fever (P = 0.045).

CONCLUSION

The presence of fever during pregnancy and the need for treatment were associated with MIH.

Cellular profile of primary molars with pulp necrosis after treatment with antibiotic paste

The interradicular region of primary molars is permeated by many foramina, channels and accessories that connect the pulp cavity with the periapical tissues anatomically. Thus, pulp decomposition products or drugs used in endodontic treatment can trigger inflammatory reactions. The aim of this study was to evaluate the blood cell profile of the alveolar region after extraction of primary molars treated with CTZ paste. Forty-eight primary molars were selected with clinical and radiographic signs of extraction. The sample was divided into three groups with 16 teeth each: Group 1-healthy teeth; Group 2-untreated decayed teeth; and Group 3-teeth treated with CTZ paste. Immediately after the extraction, blood from the interface of the tooth socket was collected and smears were performed for further evaluation. The slides were stained by the Fast Panoptic® method and analysed by two previously trained examiners who counted the leucocytes in sets of 100 cells/slide, differentiating them into neutrophils, lymphocytes, monocytes, eosinophils and basophils. The data were analysed statistically by the MANOVA test. The blood samples from Group 2 differed significantly from Group 1 samples for all classes of leucocytes, except basophils, with higher average for lymphocytes (62.56), monocytes (7.81) and eosinophils (2.31). For Group 3, there was a relative difference (P < 0.05) to Group 2, of monocytes and eosinophils values. The blood cellularity interface in the tooth socket of primary teeth treated with CTZ paste is similar to those of healthy, exfoliated teeth and physiologically different from untreated decayed teeth.

Satisfaction level of parents of children in a dental program of maternal child attention / Nível de satisfação dos pais/responsáveis de crianças atendidas em programa odontológico de atenção materno-infantil / Nivel de satisfacción de los padres

OBJETIVO: Avaliar o nível de satisfação dos pais e/ou responsáveis de crianças atendidas em programa odontológico de atenção materno-infantil e implantar um sistema permanente de avaliação simplificada das ações desenvolvidas. METODOLOGIA: estudo transversal quantitativo, desenvolvido no Instituto de Perinatologia Social do Piauí onde funciona o Programa Preventivo para Gestantes e Bebês (PPGB). Os dados foram coletados através de um questionário estruturado auto administrado e uma escala visual simplificada que continha questões relativas à percepção dos mesmos logo após o atendimento. Foram aplicados 569 questionários no período de março a outubro de 2014.  Foi realizada a análise descritiva das variáveis categóricas. RESULTADOS: Os itens acolhimento, ambiente, atendimento, importância do atendimento e localização do programa tiveram aprovação “ótimo” e “bom” entre 91% e 97,7% no questionário, enquanto na escala visual os valores ficaram entre 76,6% e 98,8% de satisfação. A localização obteve o menor índice de satisfação tanto no questionário como na escala visual. CONCLUSÃO: O Programa Preventivo para Gestantes e Bebês foi bem avaliado por pais e/ou responsáveis pelas crianças atendidas e a implantação de um sistema permanente de avaliação simplificada das ações desenvolvidas é viável e de fácil aplicação. DESCRITORES: Avaliação. Satisfação do paciente. Prevenção.

Crown-root fracture with pulp exposure: a case report with 16-year follow-up

A 12-year-old boy presented for dental care 35 days after he fell from his bicycle. Clinical and radiographic examinations revealed a longitudinal crown-root fracture with pulp exposure in the maxillary left central incisor. The radiograph also suggested necrosis of the maxillary right central incisor. Urgent treatment of the left central incisor involved gingivectomy followed by autogenous bonding of the tooth fragment with self-curing composite resin. Immediately after bonding, coronal access was prepared, chemical and mechanical preparation was completed, and a calcium hydroxide intracanal dressing was placed. One week after the initial appointment, endodontic treatment was initiated in the right central incisor. The root canal of the maxillary left central incisor was maintained with calcium hydroxide paste (replaced at 45-day intervals) for 1 year and then definitively obturated. At the 16-year follow-up, satisfactory periodontal, esthetic, and clinical conditions were observed, and a radiograph revealed no resorption or periapical changes.

Natal and neonatal teeth: a review of 23 cases

Natal teeth erupt in utero, whereas neonatal teeth present during the first month of life. The lower central incisors are the most frequently affected teeth. The etiology is unknown, and the choice of treatment depends on several factors. The purpose of this paper is to review 23 cases of children with natal or neonatal teeth who attended a dental care program in a university maternal and infant oral health clinic. There was no gender predilection. Most were natal teeth (83 percent) and presented a mild degree of mobility (64 percent). Only two patients had breast-feeding difficulties (nine percent). Tooth maintenance was the most common treatment of choice (64 percent), and only two patients presented Riga-Fede disease (nine percent).

Autogenous bonding of lower incisors: case report and 17-year follow-up

Among injuries that affect permanent teeth, the most prevalent is an uncomplicated crown fracture. Currently, autogenous bonding of the fragments is still the procedure of choice to restore fractured anterior teeth if the fragments are recovered by the patient and taken to a dental office within a reasonable time in an appropriate storage medium. There is no study or case report in the literature regarding autogenous bonding of lower incisors. This study presents a case with a 17-year follow-up for a 9-year-old patient who underwent uncomplicated crown fractures of the permanent mandibular central incisors and was treated by autogenous bonding of the tooth fragments. After 17 years, clinical and radiographic dental elements present vitality, and the restorations remain without major cosmetic changes. This case shows that autogenous bonding can be considered as a treatment option in the management of fractured lower incisors.

Impacto de um projeto de extensão universitária na formação profissional de egressos de uma universidade pública

INTRODUÇÃO: Dentre as competências necessárias à formação profissional em Odontologia no Brasil, está aquela destinada à atuação nos serviços de saúde. Nesse processo de formação, a participação em programas de extensão universitária amplia as possibilidades de aprendizado por permitir a vivência entre os ambientes acadêmico e comunitário. OBJETIVO: Determinar o impacto que as informações e ações desenvolvidas em um programa de extensão universitária exerceram na formação profissional de egressos de uma universidade pública. MATERIAL E MÉTODO: Foi realizado um estudo observacional transversal descritivo. A população do estudo foi composta por 268 cirurgiões-dentistas, que participaram do projeto de extensão universitária do curso de Odontologia da Universidade Federal do Piauí - Programa Preventivo para Gestantes e Bebês, no período de 1997 a 2011. Foi utilizado questionário enviado por e-mail como instrumento de coleta de dados, incluindo perguntas relativas à importância que o programa exerceu na qualificação profissional dos ex-estagiários. RESULTADO: O percentual de resposta foi de 52,6%, ou seja, 141 cirurgiões-dentistas responderam ao questionário. Os resultados apontaram que 98,6% dos sujeitos classificaram o Programa Preventivo para Gestantes e Bebês como ótimo; 91,5% declararam aplicar os conhecimentos adquiridos no projeto em sua rotina profissional; 28,4% implantaram programas semelhantes; 85,8% atendem gestantes em suas rotinas de trabalho e, destes, 19,8% relataram dificuldade nos atendimentos; 69,5% atendem bebês em suas rotinas de trabalho e, destes, 63,3% se sentem capacitados para executar procedimentos clínicos. CONCLUSÃO: As informações e ações desenvolvidas no Programa Preventivo para Gestantes e Bebês apresentaram impacto positivo na qualificação profissional de egressos, contribuindo para que os mesmos atuem com segurança nos atendimentos de gestantes e bebês.