A high salt intake in early life affects stress-coping response in males but not in female rats

Eating diets high in salt has been associated with alterations in the immune system and the potential development of neuropsychiatric disorders. This area of research shows promise, but there is currently a limited amount of research on this topic. The present study investigated whether a high salt diet (HSD) affects anhedonia and stress-coping response behaviors in young male and female Wistar rats. In this study, male and female Wistar rats were fed an HSD (8 % NaCl w/w) from weaning to post-natal day (PND) 64. From PND 60 to 64, the rats underwent a spontaneous locomotor activity test (SLA), sucrose splash test (SST), sucrose preference test (SPT), and forced swim test (FST), followed by euthanasia at PND 65. Male and female rats consuming the HSD exhibited an increase in water intake compared to the corresponding control diet (CD) groups. Male rats had lower body weight despite having similar food intakes compared to the CD group. Male rats displayed an active stress-coping behavior in the FST, characterized by increased mobility. Additionally, HSD-fed males exhibited a greater preference for sucrose solution in the SPT. However, no effect of diet and sex were detected in the SST and the SLA, and hypothalamic levels of leptin and ghrelin receptors. On the other hand, female rats were less susceptible to the experimental conditions applied in this protocol than males.

Family income modifies the association between frequent sugar intake and dental caries

AIM

The aim of this cross-sectional study was to investigate whether family income modifies associations between dental caries and sex, age, mother's education, type of preschool, sugar intake, and toothbrushing.

BACKGROUND

Dental caries is a multifactorial dyanamic disease primarily mediated by biofilm and sugar.

DESIGN

A randomly selected sample of 308 Brazilian preschool children aged 1-3 years underwent a clinical oral examination for the assessment of moderate/extensive dental caries using codes 3-6 of the International Caries Detection and Assessment System. Mothers were asked to fill out a form addressing the child's demographic and socioeconomic characteristics as well as the frequency of sugar intake. Statistical analysis involved descriptive statistics, the chi-squared test, and Poisson regression models.

RESULTS

The prevalence of moderate/extensive dental caries was 42.5%. The adjusted model revealed that within low-income families (<2 times the monthly minimum wage), the prevalence of dental caries was higher among children with a high frequency of sugar intake (≥ twice per day) than in those with a low frequency of sugar intake (< twice a day) (RR = 1.79; CI: 1.38-2.33). In families with higher income (≥2 times the monthly wage), no significant association between sugar intake and dental caries was, however, found.

CONCLUSIONS

In conclusion, monthly family income can modify the association between the high frequency of sugar intake and dental caries.

Is there a better interceptive treatment for unerupted palatally displaced canines? A network meta-analysis

This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.

How to use the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) in orthodontic research

Introduction:

Clinical trial protocols are essential documents that serve as a basis for research planning. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement aimed to increase the transparency and integrity of clinical trial protocols.

Objectives:

This paper described the main aspects of the SPIRIT, highlighting the importance of using this guideline in Orthodontics.

Results:

The SPIRIT is composed of 33 items and the diagram, which were presented and explained.

Conclusion:

The use of the SPIRIT checklist must become essential to increase the transparency and integrity of more reliable and less biased clinical trials in orthodontic research, improving the quality of future publications in this field.

Association between arch perimeter management and the occurrence of mandibular second molar eruption disturbances

OBJECTIVES

To investigate the association between the management of mandibular arch perimeter during development of the dentition and its effects on second permanent molar (M2) eruption.

MATERIALS AND METHODS

Seven electronic databases were searched without restrictions up to June 2020. Assessment was performed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for non-randomized clinical trials (non-RCT). Odds ratio (OR) with 95% confidence intervals was calculated from random-effects meta-analyses. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess the certainty of the evidence.

RESULTS

Five non-RCTs, with serious to moderate risk of bias, were included. A low certainty of evidence indicated that individuals undergoing mandibular arch perimeter management by controlling the position of the first molar had a high prevalence of M2 eruption difficulties. The odds of eruption disorders was 7.5 times higher (OR: 7.57, [3.72, 15.41], P < .001) in treated individuals. Subgroup analysis revealed that appliances that increased the arch perimeter lead to a greater chance of eruption disorders compared to appliances that only maintained the perimeter. The predictive factors for the M2 eruption difficulty were its previous mesioangulation in relation to the first molar (>24°) and the treatment time (>2 years).

CONCLUSIONS

Mandibular arch perimeter management during development of the dentition leads to an increase in the occurrence of M2 eruption difficulties. The identification of possible risk factors as well as the choice of the appropriate appliance type and the monitoring of these individuals seems to be essential to avoid undesirable effects with this therapy.

Malocclusion Impact Scale for Early Childhood (MIS-EC): development and validation

This study aimed to develop and validate the Malocclusion Impact Scale for Early Childhood (MIS-EC), a malocclusion-specific measure of oral health-related quality of life (OHRQoL) of children aged 3-5 years and their parents/caregivers. A pool of items was analysed to identify those relevant to the assessment of the impact of malocclusion on OHRQoL. Dental professionals and mothers of children with and without malocclusion rated the importance of these items. The final version of the MIS-EC was evaluated in a cross-sectional study comprising 381 parents of children aged 3-5 years to assess construct validity, internal consistency and test-retest reliability. Twenty-two items were identified from item pooling. After item reduction, eight items were chosen to constitute the MIS-EC, in addition to two general questions. The MIS-EC demonstrated good internal consistency (Cronbach's alpha = 0.79 for the Child Impact section and 0.53 for the Family Impact section), and excellent test-retest reliability (ICC = 0.94), floor effect was 55.7% and ceiling effect 0%. MIS-EC scores indicating worse OHRQoL were significantly associated with the presence of malocclusion (p < 0.05). The MIS-EC is reliable and valid for assessing the impact of malocclusion on the OHRQoL of preschool children and their parents/caregivers.

Nanohybrid composed of graphene oxide functionalized with sodium hyaluronate accelerates bone healing in the tibia of rats

This study synthesized and characterized a nanohybrid composed of graphene oxide (GO) functionalized with sodium hyaluronate (HY) (GO-HY), evaluated its effect in vitro and determined its osteogenic potential in vivo. The synthesized nanohybrid was analyzed by Scanning electron microscopy (SEM), Raman spectrometry, Thermogravimetry, Fourier-transform infrared (FTIR) spectroscopy and X-ray diffraction. MC3T3-E1 cell viability was assessed by MTT assay in 48 and 72 h. Bone defects were created in tibia of 40 Wistar rats and filled with blood clot (control), 1% HY, GO (50, 100 and 200 μg/mL) and the nanohybrid (50, 100 and 200 μg/mL). After 7 and 14 days, histomorphometric analysis was carried out to assess osteogenic potential of the nanohybrid. Immunohistochemical analysis evaluated the expression of vascular endothelial growth factor (VEGF) in bone defects. Thermogravimetric analysis, Raman and FTIR spectrometry confirmed the functionalization of GO with HY by covalent bonds. Five μg/mL concentrations of the nanohybrid did not alter the viability of the MC3T3-E1 cells. Histomorphometric analysis demonstrated that the nanohybrid at 100 μg/mL significantly accelerated the bone repair in tibia of rats when compared to controls (p < 0.01). Immunohistochemical analysis showed a significantly less intense VEGF expression in tibia treated with the nanohybrid when compared to controls (p < 0.05). The nanohybrid composed of GO functionalized with HY was able to induce the acceleration of the tissue regeneration process in bone defects created in the tibia of rats. This novel nanohybrid is a promising material for the field of bone tissue engineering.

Do adjunctive interventions in patients undergoing rapid maxillary expansion increase the treatment effectiveness?

OBJECTIVES

To evaluate the clinical effectiveness of adjunctive interventions in individuals undergoing rapid maxillary expansion (RME).

MATERIALS AND METHODS

MEDLINE, Web of Science, Cochrane, Scopus, LILACS, and Google Scholar were searched without restrictions up to June 2020. Trials involving participants undergoing orthopedic or surgical RME, along with adjunctive interventions, were included. Risk-of-bias assessments were performed using the Cochrane tool for randomized trials-2. The certainty level of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool.

RESULTS

Six randomized clinical trials, with low to high risk of bias, were included. Low certainty of the evidence suggested that low-level laser facilitated opening of the midpalatal suture during the active phase of RME. Likewise, moderate certainty demonstrated that low-level laser accelerated the healing process of the suture during the retention phase. The clinical impact of this outcome, that is, stability and retention time, was not evaluated. Very low evidence indicated that osteoperforations along the midpalatal suture increased maxillary transverse skeletal gains in young adults undergoing RME. Low evidence suggested that platelet-rich plasma therapy did not minimize the vertical and thickness bone loss after RME in the short term.

CONCLUSIONS

Based on currently available information, the use of low-level laser associated with maxillary expansion seems to provide a more efficient suture opening and bone healing. Limited evidence suggests that osteoperforations improve the skeletal effects of RME in non-growing individuals. There are no adjunctive interventions capable of reducing the periodontal side effects of RME.

Spatial density of adolescents aged 14 years old, victims of dental: A longitudinal study

BACKGROUND/AIM

Knowledge about the spatial density of the domiciles of dental trauma victims can assist in the identification of the most vulnerable areas and contribute to the planning of prevention, promotion, control, and treatment actions, focusing on the most affected areas. The aim of this study was to analyze the spatial density of domiciles of 14-year-old adolescent victims of dental trauma, in the city of Diamantina, Brazil, after a two-year follow-up period.

MATERIAL AND METHODS

This longitudinal study was carried out with 584 adolescents between 2013 and 2015. Dental trauma, overjet, and lip protection were assessed by two trained and calibrated examiners (K > 0.70). Information about binge drinking was collected among the adolescents through the Alcohol Use Disorders Identification Test and sociodemographic indicators were obtained through a questionnaire answered by the caregivers of the adolescents. Spatial analyses were performed to evaluate the spatial density of adolescents with dental trauma and the independent variables of interest according to the domicile using Ripley's K function and the Kernel Map.

RESULTS

Ripley's K function revealed spatial aggregation of the domiciles of adolescent victims of dental trauma in relation to males, binge drinking and overjet, with a confidence interval of 95%. The higher density of domiciles with adolescents with two or more traumatized teeth was found in the north-east region of the city. Boys were the most affected, their homes were located in the north, north-west, and south-east regions at baseline and follow-up. The largest density of domiciles of adolescents with overjet greater than 5 mm and inadequate lip protection was in the north-east region. Similar spatial distribution was identified for binge drinking for both years.

CONCLUSION

The majority of adolescents with dental trauma lived in the north-east and south-east regions, characterized by high population density and greater social vulnerability.

Influence of heritability on occlusal traits: a systematic review of studies in twins

BACKGROUND

The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits.

MATERIALS AND METHODS

MEDLINE, SCOPUS, Web of Science, LILACS, and Google Scholar were searched without restrictions up to March 2020. Studies with twin method were considered and the risk of bias assessment was performed using quality of genetic association studies checklist (Q-Genie). The coefficient of heritability (h²), model-fitting approaches, and coefficient correlation were used to estimate the genetic/environmental influence on occlusal traits. The GRADE tool was used to assess the quality of the evidence.

RESULTS

Ten studies met the eligibility criteria. Three studies presented good quality, five moderate quality, and two poor quality. Most studies have found that the intra-arch traits, mainly the maxillary arch morphology, such as width (h² 16-100%), length (h² 42-100%), and shape (h² 42-90%), and the crowding, mainly for mandibular arch (h² 35-81%), are under potential heritability influence. The traits concerning the inter-arch relationship, as overjet, overbite, posterior crossbite, and sagittal molar relation, seem not to be genetically determined. The certainty of the evidence was graded as low for all outcomes.

CONCLUSIONS

Although weak, the available evidence show that the heritability factors are determinant for the intra-arch traits, namely, arch morphology and crowding. Possibly due they are functionally related, the occlusal traits concerning the maxillary and mandibular relationship seem to have environmental factors as determinants. In this scenario, early preventive approaches can offer a more effective and efficient orthodontic treatment.

Oral disorders associated with the experience of verbal bullying among Brazilian school-aged children: A case-control study

BACKGROUND

Dental features have been considered a potential target of verbal bullying (VB) among school-aged children. The authors conducted a study to investigate the association between the presence of oral disorders and the occurrence of VB among 8- through 10-year-old school-aged children.

METHODS

The study included 445 school-aged children 8 through 10 years old. VB was verified by a specific validated question from the Child Perceptions Questionnaire 8-10 index. Oral disorders such as untreated caries, fluorosis, clinical consequences of untreated caries, and malocclusion were evaluated. The Pearson χ² test and bivariate and multivariate conditional logistic regression analyses were used for statistical analysis.

RESULTS

A total of 390 school-aged children completed the study. The results of the multivariate logistic regression model showed that a severe malocclusion (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.03 to 5.10), a greater maxillary misalignment (OR, 2.23; 95% CI, 1.05 to 4.73), and the presence of a tooth with pulp exposure (OR, 2.93; 95% CI, 1.58 to 5.45) were significantly associated with the occurrence of VB.

CONCLUSION

Children aged 8 through 10 years with a severe malocclusion, larger maxillary misalignment, or the presence of pulp exposure had increased odds of experiencing VB compared with children without those oral health conditions.

PRACTICAL IMPLICATIONS

Once oral disorders involved in VB are identified, appropriate approaches should be used to address this issue. With this course of action, oral health care professionals may use the treatment and preventive care to eliminate potential factors for peer aggression.

The ability of orthodontists and maxillofacial surgeons in predicting spontaneous eruption of mandibular third molar using panoramic serial radiographs

OBJECTIVE

To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis.

METHODS

22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2).

RESULTS

The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001).

CONCLUSIONS

Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.

Incremental or maximal mandibular advancement in the treatment of class II malocclusion through functional appliances: A systematic review with meta-analysis

To systematically review the effects of functional appliances (FA) using incremental vs maximal mandibular advancement regarding cephalometric measurements in class II malocclusion individuals and to assess patient-centred-outcomes. Six electronic databases were searched without restrictions up to April 2020. We included randomized and non-randomized controlled trials using identical FA. Trials involving participants who used adjunct appliances, inter-maxillary elastics, who received surgical treatment or that recruited individuals with cleft lip/palate or craniofacial deformity/syndrome were excluded. Risks of bias assessments were performed using the Cochrane risk of bias tool-2 and ROBINS-I tools. Mean differences (MD) with their 95% confidence intervals were calculated from random-effects meta-analyses. The GRADE tool was used to assess the certainty of the evidence. Six studies were included. Low to very low certainty of evidence indicated that incremental mandibular advancement resulted in greater gains in mandibular length (MD = 0.89 [0.38, 1.34], P = .0005), anterior mandibular displacement (MD = 0.73 [0.40, 1.06], P < .0001) and SNB angle (MD = 0.44 [0.02, 0.85], P = .04). No significant differences were found for maxillary, dento-alveolar and upper airway outcomes between construction bite protocols (P > .05). Study design and appliance-related factors influenced the results of the subgroup analyses. Existing evidence is inadequate to assess patient-related response and long-term outcome could not be assessed. Currently, there are a heterogeneous number of studies with low quality and methodological issues can lead to biases that strongly limit an evidence-based conclusion. Weak evidence suggests gains in mandibular skeletal parameters in the short term using FA with incremental mandibular advancement. Randomized trials evaluating key topics such as patient-centred outcomes need to be conducted to guide clinical management. PROSPERO (CRD42019147436).

Abuso físico de crianças e adolescentes: os profissionais de saúde percebem e denunciam?

Resumo O abuso físico de crianças é definido como qualquer ferida não acidental ou omissão dos seus responsáveis que cause risco à sua integridade. Este estudo objetivou avaliar se profissionais de saúde percebem e denunciam o abuso físico em crianças/adolescentes. Um total de 62 profissionais de saúde (odontólogos, médicos e enfermeiros) de Diamantina/MG, que realizam atendimento a crianças e adolescentes, responderam a um questionário. As variáveis coletadas foram relacionadas à identificação de abuso; denúncia às autoridades e dificuldades para a realização da denúncia. Realizou-se análise de frequência, teste do qui-quadrado e análise de conteúdo. Todos os profissionais relataram ter identificado e denunciado a ocorrência de abuso físico em crianças/adolescentes. Associação significativa foi observada entre a especialidade do profissional e o reconhecimento de abuso, bem como a realização de denúncia às autoridades. As principais dificuldades apresentadas para denunciar os casos às autoridades foram: falta de conhecimento na identificação do abuso e em como realizar a denúncia. A maioria dos participantes gostaria de receber treinamento para identificação e denúncia de abuso. Os profissionais de saúde percebem o abuso infantil, sendo os médicos aqueles que mais denunciam os casos.

Perceived impact of dental pain on the quality of life of children aged 1-3 years and their families

PURPOSE

To evaluate the perceived impact of dental pain on oral health-related quality of life (OHRQoL) among children aged 1-3 years and their families.

METHODS

A cross-sectional study was conducted with 306 randomly selected preschool and day care children in the city of Diamantina, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, the Brazilian version of the Early Childhood Oral Health Impact Scale, their child's general/oral health and the Brazilian version of the Dental Discomfort Questionnaire. The children underwent an oral examination. Descriptive statistics, Spearman's correlations, the Kruskal-Wallis test, Mann-Whitney test and Poisson regression were used to determine associations between the variables (prevalence ratio [PR], α = 5%).

RESULTS

The prevalence of dental caries and dental pain was 43.1% and 40.2%, respectively. Dental pain (PR: 1.96, 95% CI 1.52-2.54; p < 0.001), monthly household income (PR: 1.38, 95% CI 1.04-1.83; p = 0.026) and dental caries (PR: 1.06, 95% CI 1.03-1.10; p < 0.001) were significantly associated with the perceived impact on OHRQoL.

CONCLUSIONS

Dental pain, household income and dental caries were associated with a negative impact on the OHRQoL of children aged 1-3 years and their families.

Association between occlusal characteristics and the occurrence of dental trauma in preschool children: a case-control study

BACKGROUND/AIMS

Occlusal features may increase the risk of dental trauma. The aim of the present study was to evaluate the association between occlusal characteristics and the occurrence of dental trauma in preschool children.

MATERIALS AND METHODS

A population-based case-control study was conducted with a representative sample of 200 children 3-5 years of age enrolled at private and public preschools in the city of Diamantina, Brazil. The case and control groups were matched for gender, age and type of preschool (public or private) at a ratio of 1:1 (100 cases and 100 controls). Independent variables of interest to the study (occlusal characteristics) and potential confounders (sociodemographic characteristics, sucking habits and lip coverage) were investigated. Intra-examiner and inter-examiner kappa values were higher than 0.80 for all oral conditions evaluated. The SPSS 22.0 program was used to analyse the data. Descriptive and univariate analyses as well as simple and multiple logistic regression analyses were performed.

RESULTS

The occlusal feature most strongly associated with trauma was anterior open bite (OR = 3.80; 95% CI: 1.42-10.16). Maxillary anterior crowding (OR = 2.14, 95% CI: 1.00-4.63) and overjet (OR = 1.12, 95% CI: 0.58-2.17) were associated with the occurrence of trauma independently of the confounding variables (sociodemographic characteristics, sucking habits and lip coverage), but these variables lost their significance when adjusted for other types of malocclusion. Anterior open bite remained strongly associated with dental trauma, regardless of confounding variables and other types of malocclusion.

CONCLUSION

Anterior open bite was the main variable associated with dental trauma in the preschool children analysed independently of the confounding variables and the presence of other malocclusions.

Impact of two early treatment protocols for anterior dental crossbite on children's quality of life

Objective:

To assess the impact of two early treatment protocols for anterior dental crossbite on children’s quality of life.

Methods:

Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ_8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children’s quality of life. Children answered the questionnaire before treatment (T₁) and twelve months after orthodontic treatment onset (T₂). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed.

Results:

Children’s mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ_8-10 were significantly higher in T₁ as compared to T₂ (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T₂ between groups, after controlling for quality of life measures at T₁.

Conclusions:

The difference regarding the impact on quality of life between groups is not related to the protocol used.

n-3 Ingestion may modulate the severity of periodontal disease? Systematic review

The aim of this study was to determine the effects of n-3 ingestion on periodontal disease. Besides, we also investigated the relationship between plasma concentrations of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and/or aracdonic acid (AA), and periodontal disease. An electronic search was performed in several databases with the following keywords: "n-3," DHA, EPA and polynsaturated fatty acids (PUFA) in combination with the term "periodontal disease" (PD). Only studies conducted with humans, involving clinical parameters of PD assessment and use of n-3 were selected, without restriction to the date of publication. The search has returned 1368 articles, 11 of which were selected. The results were separated according to the type of n-3 ingestion: supplementation or n-3 content in normal diet. In the studies where n-3 has been supplemented, there was no significant difference in the clinical severity of PD compared to the control subjects. However, in patients where levels of n-3 were evaluated in a usual diet, a lower disease severity was reported. We have detected a preventive effect related to plasma levels of EPA and DHA against PD progression. Thus, n-3 ingestion may beneficially interfere in PD progression, depending on the duration and dosage of consumption.

Association between malocclusion and dental caries in adolescents: a systematic review and meta-analysis

AIM

To evaluate the scientific evidence regarding the association between malocclusion and dental caries in adolescents.

METHODS

Searches were conducted of six electronic databases, complemented by manual searching of the reference lists of the selected articles and grey literature. Two independent reviewers performed the selection of the articles, data extraction and the evaluation of the risks of bias through an assessment of methodological quality. Meta-analysis was performed considering the mean decayed, missing and filled teeth (DMFT) index for caries and the Dental Aesthetic Index (DAI) for malocclusion. Heterogeneity was tested using the I² statistic and a random effect model was employed. Summary effect measures were calculated as differences in means.

RESULTS

The initial search retrieved 2644 studies, only 15 of which were selected for full-text analysis. Four cross-sectional studies were included in the qualitative systematic review. Only one of these studies found no association between malocclusion and dental caries. The meta-analysis of three studies demonstrated that a lower DAI value was significantly associated with a lower mean DMFT index, except for the comparison of DAI 26-30 vs. 31-35.

CONCLUSIONS

Based on the studies analysed, the scientific evidence indicates an association between malocclusion and dental caries.

Effects of attention deficit hyperactivity disorder signs and socio-economic status on sleep bruxism and tooth wear among schoolchildren: structural equation modelling approach

BACKGROUND

The prevalence of both bruxism and attention deficit hyperactivity (ADHD) has increased in recent years.

AIM

This study evaluated the direct and indirect effects of signs of ADHD, reported by parents/caregivers and teachers, with sleep bruxism. In addition, this study explores the effects of socio-economic status (SES) on sleep bruxism.

DESIGN

This cross-sectional study was performed in Diamantina, Brazil, with 851 randomly selected schoolchildren aged 6-12 years. The schoolchildren were underwent an oral examination for the evaluation of bruxism. Moreover, parents/caregivers fill out a form for the assessment of sleep bruxism and sociodemographic factors. Parents/caregivers and teachers responded to the Swanson, Nolan and Pelham scale - version IV (SNAP-IV) for the assessment of ADHD signs. The structural equation modelling approach was used, and standardized coefficients to direct, indirect and total effects were calculated.

RESULTS

ADHD signs had a significant moderate (SC = -0.19, P < 0.01) effect on sleep bruxism. SES had a significant indirect effect on bruxism via sucking habits. Moreover, SES had a significant direct (SC = -0.16, P = 0.01) and total effect on tooth wear (SC = -0.17, P < 0.01).

CONCLUSION

This study concluded that signs of ADHD and SES have a complex direct and indirect effects on sleep bruxism among schoolchildren.

Association between oronasopharyngeal abnormalities and malocclusion in Northeastern Brazilian preschoolers

Objective:

Evidence is contradictory regarding the association between oronasopharyngeal abnormalities and malocclusion. The aim of the present study was to assess the association between oronasopharyngeal abnormalities and malocclusion (anterior open bite and posterior crossbite) in preschoolers.

Methods:

A cross-sectional study was conducted with a representative sample of 732 preschoolers aged 3-5 years old selected randomly from private and public preschools. Anterior open bite (AOB) and posterior crossbite (PC) were evaluated through a clinical exam. Parents/caregivers answered a questionnaire addressing sociodemographic indicators and oronasopharyngeal issues. Statistical analysis involved descriptive analysis and Poisson regression (p < 0.05).

Results:

The prevalences of AOB and PC were 21.0% and 11.6%, respectively. Being three years old (PR = 1.244; 95% CI = 1.110-1.394; p < 0.001), being four years old (PR = 1.144; 95% CI = 1.110 - 1.394; p = 0.015), absence of allergy (PR = 1.158; 95% CI = 1.057 - 1.269; p = 0.002), not having undergone nose surgery (PR = 1.152; 95% CI = 1.041 - 1.275; p = 0.006) and having a sore throat more than five times in the same year (PR = 1.118; 95% CI = 1.011 - 1.237; p = 0.030) were significantly associated with AOB. The absence of asthma (PR = 1.082; 95% CI = 1.012 - 1.156; p = 0.020), not having undergone throat surgery (PR = 1.112; 95% CI = 1.068 - 1.158; p < 0.001) and not having undergone nose surgery (PR = 1.114; 95% CI = 1.069 - 1.160; p < 0.001) remained associated with PC.

Conclusion:

Significant associations were found between oronasopharyngeal-reported abnormalities and the presence of AOB and PC in preschoolers.

Maternal Stress and Behavioral and Clinical Factors Associated with Dental Trauma in Schoolchildren

PURPOSE

The purpose of this study was to evaluate associations between traumatic dental injury (TDI) and maternal stress and demographic, behavioral, and clinical characteristics of schoolchildren.

METHODS

A cross-sectional investigation was conducted involving 396 eight- to 11- year-old schoolchildren in the city of Diamantina, Minas Gerais, Brazil. Maternal stress and demographic and behavioral (breastfeeding and non-nutritive sucking habits) factors were evaluated using a questionnaire. Overjet and TDI were recorded by a dentist who underwent training and a calibration exercise. Hierarchically-adjusted Poisson regression models were employed to determine factors associated with TDI.

RESULTS

In the final regression model, the prevalence of TDI was 75 percent higher among schoolchildren who were breastfed for less than six months (prevalence ratio [PR]=1.75; 95% confidence interval [CI]=1.16 to 2.66), 72 percent higher among those who engaged in finger-/thumb-sucking after three years of age (PR=1.72; 95% CI=1.16 to 2.56) and 91 percent among those with overjet greater than three mm (PR=1.91; 95% CI=1.29 to 2.84).

CONCLUSIONS

Breastfeeding duration, finger-/thumb-sucking and increased overjet were associated with TDI. These factors were aggravated by maternal stress, but it lost its significance in the multivariate analysis.

Severity of Dental Caries and Quality of Life for Toddlers and Their Families

PURPOSE

The purpose of this cross-sectional study was to evaluate the impact of untreated caries in different stages on the oral healthrelated quality of life (OHRQoL) of one- to three-year-olds and their families.

METHODS

The mothers of 308 children answered the Brazilian version of the Early Childhood Oral Health Impact Scale to determine their perceptions of the OHRQoL of their children. The mothers also answered a questionnaire addressing demographic and socioeconomic characteristics of their families. The children were submitted to a clinical examination for the diagnosis of dental caries using International Caries Detection and Assessment System criteria. Data analysis involved descriptive statistics, Kruskal-Wallis and Mann-Whitney tests, and hierarchically adjusted Poisson regression models.

RESULTS

The prevalence of untreated caries was 64.3 percent. Among the children with caries, 53.5 percent exhibited the severe stage of the condition. Negative impact on OHRQoL was significantly associated with severe stage of caries (prevalence ratio [PR] equals 2.80, 95 percent confidence interval [CI] equals 1.90 to 4.12, P<0.001), and a younger age for the mother (PR equals 1.69, 95 percent CI equals 1.27 to 2.25, P<0.001).

CONCLUSION

Untreated caries in advanced stages was associated with a poorer quality of life among one- to three-year-olds and their families.

Probiotic consumption decreases the number of osteoclasts during orthodontic movement in mice

AIMS

The aim of the present study was to investigate the effect of probiotic (Bacillus Subtilis) supplementation on bone remodelling induced by mechanical loading.

METHODS

C57BL/6 mice were divided in two groups: (1) Probiotic and (2) Vehicle (water). The probiotic (1.5×10⁸CFU/mL) was administered orally for 14 days, starting two days before the induction of orthodontic tooth movement (OTM). OTM was determined by histomorphometric analysis by comparing the right to the left side of the maxilla. The number of osteoclasts was determined by counting TRAP-positive cells. Osteoblasts were counted on Masson's trichrome-stained slides.

RESULTS

OTM was similar between groups (with and without probiotic supplementation) (p=0.46). The number of TRAP-positive cells increased (p<0.01) on the experimental side (where the spring coil was installed) in comparison to the control side in both groups. However, the number of osteoclasts decreased (p˂0.01) in the probiotic group, in comparison to the vehicle group. There was an increase in the number of osteoblasts (p˂0.05) in both the Vehicle and Probiotic groups on the side under OTM, independent of probiotic supplementation.

CONCLUSION

Oral Supplementation with a probiotic influenced the number of osteoclasts adjacent to the tooth root during orthodontic movement in mice.

Nickel-free vs conventional braces for patients allergic to nickel: Gingival and blood parameters during and after treatment

INTRODUCTION

Allergic and inflammatory reactions have commonly been associated with the release of metal ions during orthodontic treatment. Our objective was to evaluate prospectively gingival and blood status in patients allergic to nickel.

METHODS

Allergy to nickel was diagnosed using a patch test. Two groups were established: conventional braces (n = 21) and nickel-free braces (n = 21). The gingival index was used to determine gingival status before treatment, periodically for 12 months (evaluations every 3 months), and 1 month after the removal of the braces. Blood status was evaluated with a complete blood count, including the quantification of nickel and immunoglobin E before treatment, during treatment, and 1 month after removal of the braces. The data were analyzed using Mann-Whitney, Student t, Wilcoxon, repeated measures analysis of variance, Friedman, and chi-square tests. Either the Pearson or the Spearman correlation coefficients were calculated, when appropriate.

RESULTS

The number of basophils increased significantly among the evaluations in both groups (conventional, P = 0.002; nickel-free, P = 0.001), whereas the number of eosinophils and the immunoglobin E levels decreased significantly in the conventional group (P = 0.004). Plasma nickel levels were increased before and during treatment, and decreased 1 month after removing the braces in both groups, but the differences were significant only in the nickel-free group (P = 0.002). No correlations were found between the concentrations of nickel and immunoglobin E, basophils, or eosinophils, or between the gingival index and either bands or segmented neutrophils (P ≥ 0.05).

CONCLUSIONS

Patients treated with nickel-free braces had better gingival health and smaller blood changes than did those treated with conventional braces. All abnormalities tended to be eliminated after the removal of the braces.

Signs of attention deficit/hyperactivity disorder as a risk factor for traumatic dental injury among schoolchildren: a case-control study

BACKGROUND

The determination of risk factors for traumatic dental injury (TDI) is important to the implementation of preventive measures.

AIM

The aim of this study was to evaluate the association between signs of attention deficit/hyperactivity disorder (ADHD) and TDI.

MATERIAL AND METHODS

A case-control (1 : 1) study involved a population-based sample of 230 schoolchildren aged seven to 12 years. The case and control groups were composed of children with (n = 115) and without (n = 115) TDI, respectively. The groups were matched for age and sex. The outcome variable (TDI) was detected using the O'Brien criteria. The main independent variable (signs of ADHD) was evaluated using the Swanson, Nolan and Pelham scale (version IV) administered to parents and teachers. Socio-demographic characteristics and accentuated overjet were analyzed as confounding factors. Statistical analysis involved the McNemar's test as well as the bivariate and multivariate conditional logistic regression.

RESULTS

The multivariate regression demonstrated that schoolchildren with the signs of hyperactivity (parental reports) had a 2.33-fold greater chance of exhibiting TDI (95% CI: 1.10-4.94) than those without this condition, as well as those with accentuated overjet (OR = 3.13, 95% CI: 1.70-5.77).

CONCLUSION

Schoolchildren whose parents reported signs suggestive of hyperactivity had a greater chance of exhibiting TDI than those without such signs.

A commentary on randomized clinical trials: How to produce them with a good level of evidence

Randomized clinical trial (RCT) is the gold standard study for the evaluation of health interventions and is considered the second level of evidence for clinical decision making. However, the quality of the evidence produced by these studies is dependent on the methodological rigor employed at every stage of their execution. The purpose of randomization is to create groups that are comparable independent of any known or unknown potential confounding factor. A critical evaluation of the literature reveals that, for many years, RCTs have been developed based on inaccurate methodological criteria, and empirical evidence began to accumulate. Thus, guidelines were developed to assist authors, reviewers, and editors in the task of developing and assessing the methodological consistency of this type of study. The objective of this article is to review key aspects to design a good-quality RCT, supporting the scientific community in the production of reliable evidence and favoring clinical decision making to allow the patient to receive the best health care.

Dental caries, but not malocclusion or developmental defects, negatively impacts preschoolers' quality of life

BACKGROUND

Oral diseases can negatively influence the quality of life causing harm in the development of routine activities, child development and their well-being.

AIM

To investigate the impact of dental caries, malocclusion and developmental defects of enamel (DDE) on the oral health-related quality of life of preschool children and their parents.

DESIGN

A cross-sectional study was carried out with 646 children aged 2-6 years in Diamantina, Brazil. Calibrated dental examiners performed the oral examinations. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire on socio-economic indicators. Statistical analyses involved the chi-square test and Poisson regression.

RESULTS

Malocclusion and DDE did not cause a negative impact on the children's quality of life. Children with dental caries (PR: 1.92; 95%CI: 1.56-2.35) and those aged 5 (PR: 1.51; 95%CI: 1.13-2.02) and 6 years (PR: 1.51; 95%CI: 1.02-2.23) were more likely to have a negative quality of life impact on the total B-ECOHIS.

CONCLUSIONS

Dental caries was associated with a negative impact on the quality of life of children. Malocclusion and DDE did not cause a negative impact on the children's quality of life. Older children had higher frequency of negative impact on OHRQoL.

Rapid maxillary expansion in a pediatric patient with exocrine pancreatic insufficiency

Exocrine pancreatic insufficiency is a condition capable of promoting changes in craniofacial growth and development. This case report describes treatment of a 9-year-old patient with chronic pancreatic insufficiency, highlighting the diagnostic aspects involved and clinical implications of this condition with respect to dental treatment. The treatment plan involved oral hygiene recommendations and correction of bilateral posterior crossbite and anterior open bite. Just 2 weeks after orthodontic treatment, the corrected dentition relapsed completely, confirming the difficulty of promoting ossification in the median palatine suture. Orthodontists should be careful to develop an individualized treatment plan for each patient with this abnormality, because these determinations could mean the difference between success and failure of the treatment approach.

Prospective evaluation of the psychosocial impact of the first 6 months of orthodontic treatment with fixed appliance among young adults

OBJECTIVE

To evaluate the psychosocial impact of the first 6 months of orthodontic treatment with a fixed appliance among young adults and compare the results with those of a control group of patients awaiting treatment for malocclusion.

MATERIALS AND METHODS

A study was conducted with a sample of 120 patients on a waiting list for orthodontic treatment at a university. The participants were allocated to an experimental group submitted to treatment and a control group awaiting treatment. The groups were matched for sex and age. All participants were instructed to answer the Brazilian version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) at baseline and after 6 months. Statistical analysis involved the Wilcoxon test for the total PIDAQ score and the score of each subscale. All patients participated until the end of the study.

RESULTS

Significant differences between baseline and the 6-month evaluation were found for the total PIDAQ score as well as the dental self-confidence and social impact subscales in both groups. No differences between baseline and the 6-month evaluation were found regarding the psychological impact or esthetic concern subscales in the control group. The patients in the experimental group reported greater esthetic impact 6 months after beginning treatment (P < .001). The first 6 months of orthodontic treatment seem to improve psychosocial impact.

CONCLUSION

The first 6 months of orthodontic treatment seem to improve the psychosocial impact of malocclusion. The patients analyzed in the present study reported a greater esthetic impact and less psychological impact after 6 months of using an orthodontic appliance.

Retrospective evaluation of tooth injuries and associated factors at a hospital emergency ward

Background

The aim of study was to determine the occurrence of tooth injuries and associated factors among patients treated at a hospital emergency ward.

Methods

A cross-sectional study was conducted involving the analysis of 790 patient charts. The independent variables were gender, place of residence and type of accident. The dependent variable was tooth injury (fractures, concussion, luxation and avulsion). Statistical analysis involved the chi-square test, Poisson analysis and logistic regression. Explanatory variables with a p-value < 0.20 in the bivariate analysis were incorporated into the multivariate model.

Results

A total of 681 (86.2 %) patients had tooth injury, among whom 159 (20.1 %) had tooth fractures. Tooth concussion was associated with residence in urban areas (PR = 1.635; 95 % CI: 1.199-2.230), the male gender (PR = 1.673; 95 % CI: 1.225-2.285), violence (PR = 1.940; 95 % CI: 1.263-2.982) and sports (PR = 1.863; 95 % CI: 1.287-2.696). The prevalence rate of tooth fracture was higher among individuals having suffered a motorcycle (PR = 1.597; 95 % CI: 1.295-1.968) or bicycle accident (PR = 1.484; 95 % CI: 1.245-1.769). Victims of bicycle accidents had a 42.6-fold greater chance of suffering luxation (95 % CI: 20.917-86.808) and a threefold greater chance of suffering avulsion (95 % CI: 1.620-5.848). Victims of motorcycle accidents had a 2.96-fold greater chance of suffering avulsion (95 % CI: 1.471-5.937).

Conclusions

In the study, concussion was the most frequent type of tooth injury. Motorcycle and bicycle accidents were associated with tooth fractures, luxation and avulsion, whereas sports and violence were associated with dental concussion. The findings on tooth injuries can contribute to public health policies regarding the prevention and health promotion measures.

Effectiveness of orofacial myofunctional therapy in orthodontic patients: a systematic review

Objective

The aim of the present systematic review was to determine the existence of scientific evidence demonstrating the effectiveness of orofacial myofunctional therapy (OMT) as an adjuvant to orthodontic treatment in individuals with orofacial disorders. A further aim was to assess the methodological quality of the studies included in the review.

Methods

An electronic search was performed in eight databases (Medline, BBO, LILACS, Web of Science, EMBASE, BIREME, Cochrane Library and SciELO) for papers published between January 1965 and March 2011, with no language restrictions. Selection of articles and data extraction were performed by two independent researchers. The quality of the selected articles was also assessed.

Results

Search strategy resulted in the retrieval of 355 publications, only four of which fulfilled the eligibility criteria and qualified for final analysis. All papers selected had a high risk of bias.

Conclusions

The findings of the present systematic review demonstrate the scarcity of consistent studies and scientific evidence supporting the use of OMT in combination with orthodontic treatment to achieve better results in the correction of dentofacial disorders in individuals with orofacial abnormalities.

Gene Expression of Monocarboxylate Transporters and Oocyte-secreted Factors in Bovine Cumulus-oocyte Complexes Selected by Brilliant Cresyl Blue

Oocyte selection based on the brilliant cresyl blue (BCB) staining test has been successfully used to differentiate between competent and incompetent bovine oocytes. Here, the expression of genes involved in transport of monocarboxylates (Mct1-4) and oogenesis specific genes (Bmp15, Gdf9 and Has2) in BCB+ and BCB- selected immature and mature bovine cumulus-oocyte complexes (COC) was evaluated. In order to find specific molecular markers to characterize successful oocyte maturation, our study was also aimed at identifying the expression of Mcts and oogenesis specific genes in denuded oocytes and cumulus cells. Immature COCs morphological appropriate were (i) stained with 26 mm BCB for 90 min before IVM, (ii) exposed to same incubation conditions as stained COCs, but without BCB (holding group) or (iii) transferred into a maturation medium immediately after morphological selection (control group). mRNA expression was investigated by RT-PCR in COCs before and after IVM. No relationship was observed in the relative expression of Has2, Gdf9, Bmp15 or Mct1, 2 and 4 transcripts between BCB+ and BCB- COCs. Transcripts analysis showed that Gdf9 and Bmp15 in BCB+, BCB- and holding groups were up-regulated (p < 0.05) before IVM, while Has2 was up-regulated (p < 0.01) after IVM in the control group. Other genes remained stable during maturation (Mct1, 2 and 4). Our results showed, for the first time, Mct1, 2 and 4 expression in bovine COCs. Mct1 and Mct4 transcripts were present in denuded oocytes and cumulus cell, while Mct2 was detected only in cumulus cells. These differences between the three isoforms in localization suggest unique roles for each in monocarboxylate transport during maturation.

Discomfort associated with fixed orthodontic appliances: determinant factors and influence on quality of life

Objective

To investigate the determinant factors of discomfort attributed to the use of fixed orthodontic appliance and the effect on the quality of life of adolescents.

Material and Methods

Two hundred and seventy-two individuals aged between 9 and 18 years old, enrolled in public and private schools and undergoing orthodontic treatment with fixed appliance participated in this cross-sectional study. The participants were randomly selected from a sample comprising 62,496 individuals of the same age group. Data was collected by means of questionnaires and an interview. Discomfort intensity and bio-psychosocial variables were assessed using the Oral Impact on Daily Performance questionnaire. Self-esteem was determined using the Global Negative Self-Evaluation questionnaire. Statistical analysis involved the chi-square test and both simple and multiple Poisson regression analyses.

Results

Although most individuals did not present discomfort, there was a prevalence of 15.9% of impact on individuals' daily life exclusively due to the use of fixed orthodontic appliance . Age [PR: 3.2 (95% CI: 1.2-8.5)], speech impairment [PR: 2.2 (95% CI: 1.1-4.6)], poor oral hygiene [PR: 2.4 (95% CI: 1.2-4.8)] and tooth mobility [PR: 3.9 (95% CI: 1.8-8.1)] remained independently associated with a greater prevalence of discomfort (P ≤ 0.05).

Conclusions

Discomfort associated with the use of fixed orthodontic appliances exerted a negative influence on the quality of life of the adolescents comprising the present study. The determinants of this association were age, poor oral hygiene, speech impairment and tooth mobility.

Dissatisfaction with dentofacial appearance and the normative need for orthodontic treatment: determinant factors

Objective

This study aims at assessing the normative need for orthodontic treatment and the factors that determine the subjective impact of malocclusion on 12-year-old Brazilian school children.

Methods

A total of 451 subjects (215 males and 236 females) were randomly selected from private and public schools of Juiz de Fora, Brazil. The collected data included sociodemographic information and occlusal conditions. The esthetic subjective impact of malocclusion was assessed by means of the Orthodontic Aesthetic Subjective Impact Score - OASIS, whereas the malocclusion and the need for orthodontic treatment were assessed by means of the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC).

Results

Prevalence of normative need for orthodontic treatment was 65.6% (n = 155), and prevalence of orthodontic esthetic subjective impact was 14.9%. The following variables showed significant association with esthetic subjective impact of malocclusion: female (p = 0.042; OR = 0.5; CI = 0.2-0.9), public school student (p = 0.002; OR = 6.8; CI = 1.9-23.8), maxillary overjet ≥ 4 mm (p = 0.037; OR = 1.7; CI = 1-3) and gingival smile ≥ 4 mm (p = 0.008; OR = 3.4; CI = 1.3-8.8).

Conclusion

The normative need for orthodontic treatment overestimated the perceived need. Occlusal and sociocultural factors influenced the dissatisfaction of schoolchildren with their dentofacial appearance.

Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years

OBJECTIVE

This study aims to evaluate the impact of untreated dental caries and its clinical consequences on the quality of life of Brazilian schoolchildren aged 8-10 years.

METHODS

A randomly selected sample of 587 children underwent a clinical oral examination for the assessment of untreated dental caries and clinical consequences. The WHO criteria (decayed component of the decayed, missing, and filled teeth--D-DMFT in permanent teeth or d-dfmt in primary teeth) and the PUFA index, which records the presence of severely decayed permanent (upper case) and primary (lower case) teeth with visible pulpal involvement (P/p), as well as ulceration caused by dislocated tooth fragments (U/u), fistula (F/f), and abscesses (A/a), were used for the oral examination. Oral health-related quality of life (OHRQoL) was evaluated using the Child's Perception Questionnaire (CPQ8-10). Poisson regression was employed to test unadjusted and adjusted associations between untreated dental caries/clinical consequences and OHRQoL.

RESULTS

The prevalence of untreated dental caries was 64.6% (D/d component of DMFT/dmft > 0) and 17.9% of children exhibited clinical consequences of caries (PUFA/pufa index >0). In the adjusted models, untreated caries was significantly associated with the total CPQ8-10 score and all subscale scores. The clinical consequences of dental caries (PUFA/pufa index >0) were significantly associated with the total CPQ8-10 as well as the oral symptoms and functional limitations' subscales.

CONCLUSION

Untreated dental caries and its clinical consequences exerted a negative impact on the OHRQoL of the schoolchildren analyzed.

Oral physiology and quality of life in cancer patients

INTRODUCTION

Cancer treatment can affect the health of the teeth and support structures, which are essential to the chewing process, which may change the nutritional status of the patient.

OBJECTIVE

The aim of this study was to evaluate the impact of oral physiology changes on quality of life (QoL) of patients submitted to cancer treatment.

DESIGN

Initially 84 cancer patients were screened and only those presenting at least 15 natural teeth were selected for oral physiology and quality of life tests. The final sample comprised 30 patients. Twenty subjects were selected as controls paired by age and gender. Dental caries status, salivary flow, masticatory performance (MP), location of tumor, duration of chemo and radiotherapy and World Health Organization Quality of Life (WHOQOL- bref) questionnaire were assessed. Linear regression models were used to test the relationship between the WHOQOL-bref domains (physical, psychological, social relationship, environmental and overall QoL) and independent variables under study.

RESULTS AND DISCUSSION

Number of teeth, MP and salivary flow were lower in cancer patients, as well as for the scores obtained in Social Relationship, Environment and Overall QoL domains (p<0.050). Breast cancer caused a negative impact on Psychological (p<0.001) and Overall QoL scores (p=0.017). A similar negative effect was found for the duration of radiotherapy on Psychological (p=0.012) and Environmental (p=0.039) domains. On the other hand, the maintenance of teeth had a positive impact on Psychological (p=0.012) and Environmental (p=0.024) scores.

CONCLUSION

Oral physiology changes may impact the QoL of oncological patients. The maintenance of teeth was of positive importance, especially for the psychological aspects.

Correlation and comparative analysis of discriminative validity of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Early Childhood Oral Health Impact Scale (ECOHIS) for dental caries

Background

The perceptions of parents and children regarding oral health are useful to oral public health and clinical practice in pediatric dentistry. The primary aim of the present study was to evaluate the correlation between the total and item scores of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) (parental version and child’s self-reports) and the Early Childhood Oral Health Impact Scale (ECOHIS). Subsequently, the discriminative validity of these assessment tools regarding dental caries was compared.

Methods

One hundred twenty-one children randomly selected in the city of Diamantina (Brazil) were submitted to oral examinations. Parents answered the ECOHIS and SOHO-5p (parental version) and children answered the SOHO-5c (child’s self-reports). Statistical analysis involved the Mann–Whitney test as well as the calculation of Spearman’s correlation coefficients.

Results

A significant correlation was found between the SOHO-5p and ECOHIS (r = 0.85), whereas no significant correlations were found between the SOHO-5c and SOHO-5p (r = 0.00) or between the SOHO-5c and ECOHIS (r = −0.41). Significant differences in the impact on quality of life were found between children with severe decay and no severe decay (caries free, with initial or established caries) both the ECOHIS and SOHO-5p (p ≤0.05), whereas no difference was found in SOHO-5c (p > 0.05).

Conclusions

The ECOHIS and SOHO-5p were correlated with each other. The accounts of the children differed from their parents’ reports and were not capable of discriminating dental caries in advanced stages of progression.

Impact of oral mucosal conditions on oral health-related quality of life in preschool children: a hierarchical approach

OBJECTIVE

To determine the impact of oral mucosal conditions on OHRQoL in preschool children.

METHODS

A cross-sectional study was carried out with a selected representative sample of 724 children aged 2-5 years and their parents/caregivers. Data were collected through interviews with parents/caregivers, who also answered the B-ECOHIS. A clinical oral examination was performed to determine oral mucosal conditions, dental caries, dental trauma, and malocclusion. Data analysis involved descriptive statistics, the Kolmogorov-Smirnov normality test, the Mann-Whitney U-test and hierarchically adjusted Poisson regression models (P < 0.05, 95% CI).

RESULTS

The prevalence of oral mucosal conditions was 50.7%, the most prevalent of which were melanotic macules (17.8%), oral ulcers (11.0%), Fordyce's spots (9.4%), geographic tongue (5.2%), fissured tongue (1.9%), median rhomboid glossitis (1.8%), and fistula (1.4%). In the final multivariate model, child with 5 years of age (RR = 1.60; 95% CI: 1.08-2.38; P = 0.020), with presence of fistula (RR = 1.94; 95% CI: 1.27-2.95; P = 0.002), and with dental caries (RR = 2.58; 95% CI: 2.00-3.35; P < 0.001) had a negative impact on children's OHRQoL.

CONCLUSION

Child with 5 years of age, presence of fistula, and dental caries were associated with a negative impact on the quality of life of preschool children.