Sociodemographic factors affect the quality of life and burden of caregivers in special care in dentistry

AIMS

To analyze the epidemiological profile and quality of life (QoL) of patients with special needs and overload their caregivers.

METHODS AND RESULTS

Health-related QoL was assessed in a quantitative, observational, cross-sectional study of prospective characteristics using the WHOQOL-BREF and ZARIT-22 questionnaires. This study included 122 patients were included; they were divided into patients without caregiver assistance (n = 63) who answered WHOQOL-BREF, 49 caregivers (n = 49) who responded to ZARIT-22, and 10 patients were secondarily caregivers of their parents and answered the ZARIT-22 + WHOQOL-BREF questionnaires. The WHOQOL-BREF general score was 71.94 ± 10.58, and patients born in urban areas and married had positive correlations (p < .05) with the QoL scores in the physical and social domains. ZARIT-22 scores showed an average of 58.63 ± 14.07. Data cross-checking revealed that patients of white races (p = .030) and who lived in urban regions (p = .003) generated less overload to caregivers.

CONCLUSION

In the WHOQOL-BREF analysis, family income was a factor with direct impact, and all caregivers referred to moderate-to-high overload, with an increase in prevalence as far away from the service the patient resides.

Effectiveness of orthodontic toothbrush versus conventional toothbrush on plaque and gingival index reduction: A systematic review and meta-analysis

OBJECTIVE

In orthodontic patients submitted to oral hygiene instruction, what is the efficacy of orthodontic toothbrush (O-TB) versus conventional toothbrush (C-TB) on plaque and gingival index reduction in randomized and non-randomized controlled clinical trials?

METHODS

Electronic database search was performed on PubMed, ClinicalTrials.gov, Cochrane Library and Google Scholar. Database research, study selection, data extraction and ROBINS-I and Risk of Bias Tool 2.0 analysis were conducted by two independently examiners in duplicate. Two different meta-analyses were performed for plaque index and gingival index, followed by the analysis of overall quality of the evidence using GRADE.

RESULTS

A total of 158 studies were identified for screening; six articles were included in qualitative synthesis, and of those, three were subjected to a quantitative synthesis (meta-analysis). Three non-randomized studies presented an overall 'low', 'moderate' and 'high' risk of bias for each one of the articles, and the three randomized clinical trials presented 'low risk' for two articles and 'some concerns' quality for the other one. The overall strength of evidence was ranked 'very low' quality for plaque index and gingival index subgroups.

CONCLUSIONS

Gingival bleeding is not modified by orthodontic design toothbrush, but there is circumstantial scientific evidence for recommending the use of an O-TB instead a C-TB based on the analysis of plaque index control. Although major plaque removal of the O-TB was validated by meta-analysis, this improvement is not completely clarified which calls for further clinical studies to assess the effects of using an O-TB compared with a C-TB.

Defining dysmorphic facial features in congenital Zika syndrome

Congenital Zika syndrome (CZS) constitutes a recently identified malformation caused by Zika virus infection during pregnancy. Limited data is available to date on the facial dysmorphic features of these patients. This study evaluated the facial dysmorphisms of children with CZS, compared with clinically healthy children, using clinical examination and standardized photographic images. Sixty-three children with CZS (9.70 ± 3.2 months-age), and 31 Controls (8.67 ± 6.2 months-age) joined the study. Seven out of 15 indices differed between groups: midfacial height (MFH)/horizontal facial reference (HFR) (p = .0003), interalar distance/HFR (p = .0027), nasal root depth/MFH (p = .0030), posterior nasal length/MFH (p = .0002), vertical position of the ear/MFH (p <.0001), ear length/MFH (p = .0005), chin height/total facial height (CH/TFH) (p <.0001). A CH/TFH of 0.229 showed 93.9% sensitivity and 80.6% specificity in diagnosing CZS. Children with CZS had broad, short faces, decreased intercanthal distance, short posterior nasal length, prominent nasal root, broad nasal wings, and high-set and long ears. Increased chin height index provided the most accurate diagnostic potential.

Combined Orthodontic-Orthognathic Approach for Dentofacial Deformities as a Risk Factor for Gingival Recession: A Systematic Review

PURPOSE

The objective of this systematic review was to evaluate the risk of development of gingival recession (GR) as a result of the combined orthodontic-orthognathic approach.

MATERIALS AND METHODS

The PubMed, Google Scholar, ClinicalTrials.gov, and Cochrane Library databases were searched. Included articles mentioned gingival parameters in their materials and methods sections; specifically, they evaluated GR, which was measured before and after the surgical procedure. Study parameters such as methodology, evaluation period, sample characteristics, and follow-up were extracted by 2 authors independently.

RESULTS

In total, 133 relevant articles were identified from the databases; after screening and full-text analysis, 9 studies were included in this systematic review. Meta-analysis could not be conducted because of considerable heterogeneity in methods. The incidence of GR in the range of 0.5 to 3.0 mm as a significant clinical finding after orthognathic surgery showed statistically significant differences in all included articles. Among patients with GR, the mean age was 23.0 to 29.5 years and the mandibular incisors were the most common site. However, no case of recession greater than 3.0 mm was associated with surgery.

CONCLUSIONS

On the basis of the findings of this review, GR of approximately 0.5 to 3.0 mm is a common finding after the combined orthodontic-orthognathic approach. Although periodontal damage up to 3 mm can be observed as an isolated finding in mainly the incisors, true recession is not associated with orthognathic surgery in general.

Dental alterations on panoramic radiographs of patients with osteogenesis imperfecta in relation to clinical diagnosis, severity, and bisphosphonate regimen aspects: a STROBE-compliant case-control study

OBJECTIVE

This study aimed to assess the prevalence of dental findings on panoramic radiographs (PRs) of patients with osteogenesis imperfecta (OI) and correlate these results with epidemiologic and medical data.

STUDY DESIGN

A case-control study was conducted with 24 patients with OI and 48 sex- and age-matched controls. Demographic, clinical, and bisphosphonate regimen-related data were recorded. The outcome variables were the presence or absence of dental alterations in PRs. Mann-Whitney U test, Pearson's χ² test, and multinomial logistic regression analysis (95% confidence interval) were used (significance level of 5%).

RESULTS

OI type 4 demonstrated a high prevalence (62.5%), followed by type 1 (37.5%). With regard to prevalence associated with severity, the moderate form was the most prevalent (P = .028). The mean time of intravenous pamidronate regimen was 6.6 ± 4.4 years. Dentinogenesis imperfecta was observed in 75% of patients with OI, and this group showed a high prevalence of dental abnormalities in comparison with controls (P < .05). Bisphosphonate therapy was associated with ectopic teeth (P = .007) and tooth impaction (P = .033). Pulp obliteration was significant with bisphosphonate treatment over a period of 7 years (P = .026).

CONCLUSIONS

This study found a significant prevalence of dental alterations in patients with OI, and certain alterations were associated with bisphosphonate therapy, indicating its influence on the dentin-related physiopathology.

Remineralização de Esmalte Através da Incorporação de Nanopartículas em Materiais Resinosos: Revisão de Literatura

O objetivo deste trabalho é uma revisão da literatura sobre a remineralização de esmalte através da incorporação de nanopartículas (NP) em materiais resinosos (MR). Para isso, foi feita uma busca na base de dados Pubmed, utilizando os descritores “nanoparticles”, “tooth remineralization” e “resin cements”. Foram encontrados 133 artigos, nos anos de 2007 a 2017, sendo utilizados 25, a partir dos critérios de inclusão (artigos no idioma inglês e estudos com nanopartículas inclusas em MR) e de exclusão (artigos de revisão de literatura e sistemática). Os estudos analisados indicam que adesivo dental com NP de fosfato de cálcio amorfo (FCA) pode remineralizar e inibir cárie a longo prazo. Adição de cargas silanizadas em resinas compostas experimentais com FCA mostra melhoria na deposição mineral. Ionômero de vidro modificado por resina com NP mostrou apenas efeito protetor em relação ao desafio cariogênico. Adesivo com NP cristalinas de titânio promove propriedades remineralizante e bactericida fotocatalítica. Tratamento com nanohidroxiapatita de estrôncio indica um padrão de deposição de cristais melhorado em comparação com qualquer outra modalidade. Os resultados apresentados são promissores para futuras tecnologias dentais, mas precisam ser testados clinicamente.Palavras-chave: Nanoparticles. Tooth Remineralization. Resin Cements.

Avaliação in vitro de Resinas Ortodônticas Auto-Adesivas Experimentais Associadas a Bráquetes Cerâmicos

Objetiva-se avaliar in vitro resistência ao cisalhamento (RC) antes e após termociclagem, módulo de flexão (MF) e grau de conversão (GC) de resinas ortodônticas auto-adesivas experimentais associadas a bráquetes cerâmicos. 48 bráquetes cerâmicos policristalinos (n 12) foram colados em esmalte bovino. Monômeros funcionais ácidos MDP (10-metacriloiloxi-decilo-dihidrogeno- fosfato) e GDMA-P (glicerol-dimetacrilato-fosfato) foram adicionados a resinas ortodônticas auto-adesivas experimentais de três passos sendo comparadas a grupos Controle Positivo e Controle Negativo. RC foi avaliada antes (n 6) e após (n 6) 2.000 ciclos térmicos. No teste de flexão de três pontos (n 3) foram confeccionadas barras de resina controle, com MDP e com GDMA-P. GC (n3) foi avaliado por micro-espectroscopia Raman. Os resultados foram analisados por ANOVA e teste de Tukey pós-hoc (p <0,05). Para RC, o Controle Positivo (8,47 ± 0,88MPa) e o MDP (7,07 ± 2,69MPa) obtiveram maiores resultados antes da termociclagem, sem diferença estatística entre eles. A RC reduziu estatisticamente para todos os grupos após a termociclagem (p <0,05) e não foi observada diferença entre os grupos. MF não mostrou diferença significativa entre as resinas (p 0,451). A resina controle obteve 84,5 ± 4,3% de GC, significativamente superior (p <0,05) ao GDMA-P e MDP (58,8 ± 4,0% e 23,0 ± 5,2%, respectivamente). A resina ortodôntica experimental incorporada com MDP obtém desempenho de ligação semelhante ao da resina convencional de três passos. No entanto, a presença de monômero ácido funcional reduz a GC.Palavras-chave: Orthodontics Dental. Materials. In vitro Techniques.