Parental perceptions of oral health-related quality of life of Brazilian children and adolescents with autism spectrum disorder

Objective:This paper aimed to assess the oral health-related quality of life (OHRQoL) of children and adolescents with autism spectrum disorder (ASD) using the parental/caregiver perceptions questionnaire (PCPQ). Materials and methods: Children aged 2 to 14 years, enrolled in the ACOLHER/PNE project at the Fluminense Federal University, RJ, Brazil, were assessed. The main independent variable was dental caries experience, diagnosed according to the World Health Organization (WHO) criteria. The variable was categorized as caries-free when dmft/DMFT=0 and caries experience when dmft/DMFT ? 1. Caregiver schooling, age, sex, and socioeconomic factors (Brazilian minimum wage – BMW) were the other independent variables. Quality of life (QoL) was measured using PCPQ subscales and total score. Mann-Whitney U, Kruskal-Wallis, and multivariate Poisson regression correlation analysis were performed. Results: The median age of patients was 8 (SD= 3.76). The study group consisted of 57 (76.0%) males and 18 (24.0%) females. Fifty parents (66.7%) have more than eight years of education and 35 (46.7%) earn less than 2 BWM. The impact values were significantly higher in male individuals in the oral symptoms (OS) domain and in individuals without caries experience in the social well-being (SW) domain (p<0.05). Conclusions: these results seem to suggest that individuals with ADS without caries experience in permanent dentitions in the SW domain and males in the OS domain had a higher impact quality of life. 

Ectodermal Dysplasia in child: multidisciplinary management

Ectodermal Dysplasia (ED) represents a group of hereditary conditions in which anatomical structures derived from the ectoderm show defects in its development. It is observed aplasia or hypoplasia of the tissues, among them the changes of dental relevance, as the anomalies regarding the number and morphology of the teeth. Due to the particularity of the cases, the dental surgeon must adapt the operative techniques and the choice of dental materials to each individual, according to the perceived need and condition. The objective of the present study is to report the clinical case of a 10 - year old male patient with ectodermal dysplasia who was attended in the discipline of Patients with Special Needs of Dentistry of the Federal University of Fluminense and its multidisciplinary aspects.KeywordsChildren with disabilities; Dental care for disabled; Ectodermal dysplasia; Oral rehabilitation.

Síndrome da imunodeficiência adquirida na criança e no adolescente: conduta odontológica

A Síndrome da Imunodeficiência Adquirida (SIDA/AIDS) foi relatada inicialmente em 1981 nos Estados Unidos. Esta doença ataca o sistema imunológico do paciente deixando-o vulnerável às infecções oportunistas e neoplasias malignas. O cirurgião-dentista tem um papel muito importante no curso desta doença, visto que algumas lesões bucais aparecem na fase inicial, e o profissional pode fazer um diagnóstico precoce tornando o tratamento mais benéfico. É preciso fazer a avaliação do bem-estar do paciente, avaliações clínicas e laboratoriais, principalmente em crianças e adolescentes. Dentre as diversas doenças que acometem o paciente com a SIDA/AIDS, podem-se citar a fúngica, a bacteriana ou a viral sendo a candidíase oral, herpes simples e xerostomia as principais manifestações clínicas. Existem três vias diferentes de transmissão pelo vírus HIV: a Peri natal, a Transplacentária e a Pós-natal, e os exames mais utilizados para o diagnóstico da doença são o ELISA e o WESTERN BLOT. Sendo assim, o objetivo deste estudo é apresentar maiores conhecimento sobre o assunto, vias de transmissão, principais manifestações bucais em crianças e adolescentes com AIDS e a importância do cirurgião dentista.

Imperfect osteogenese: child case report

Osteogenesis Imperfecta leads to alterations in type 1 collagen fiber, apart from causing bone fracture, blue sclera and other related deformities. As few medical records are available in the field of dentistry regarding these alterations, having a better understanding of this medical disorder and its dental management has become a matter of extreme relevance if one is to provide adequate treatment for patients suffering from this medical condition. This paper reports the case of a 2-year old patient with Osteogenesis Imperfecta who received treatment as part of the Acolher Project – PNE run by the Federal Fluminense University in Rio de Janeiro, Brazil.

Accuracy of pen-type laser fluorescence device and radiographic methods in detecting approximal carious lesions in primary teeth - an in vivo study

BACKGROUND

The diagnosis of approximal lesions is limited due to the difficulty of direct examination of these areas.

AIM

To determine the accuracy of pen-type laser fluorescence (LFpen) device, compared to digital bitewing (BW) radiography, in diagnosing approximal carious lesions in posterior primary teeth at cavitation and non-cavitation thresholds.

DESIGN

A total of 46 children (aged 3-9 years) were assessed and 195 approximal surfaces of 184 primary molars were examined by digital BW and LFpen. Visual-tactile inspection based on the International Caries Detection and Assessment System (ICDAS-II) was used as the reference standard. All examinations were performed by the same examiner. Sensitivity, specificity, and accuracy were calculated. Spearman's correlation coefficients were calculated between LFpen and BW readings and the reference standard.

RESULTS

Sensitivity, specificity and AUC were 81.8, 86.7, and 0.84 for BW and 49.1, 87.9, and 0.69 for LFpen both at non-cavitation thresholds. At cavitation thresholds, BW showed higher specificity (96.0), sensitivity (93.0), and AUC (0.98) than did LFpen (72.0, 86.9, and 0.82, respectively), but a lower correlation was indicated by LFpen readings.

CONCLUSION

Bitewing had a better diagnostic accuracy and significantly outperformed LFpen in the detection of non-cavitated lesions. Similar results were obtained by the two methods at the cavitation threshold.

Effect of dentifrice containing fTCP, CPP-ACP and fluoride in the prevention of enamel demineralization

OBJECTIVE

To evaluate the effect of different fluoride- and calcium- and/or phosphate-containing products on their ability to prevent enamel demineralization under pH cycling conditions.

MATERIAL AND METHODS

Enamel bovine specimens were assigned to the following groups: G1-MPP (MI Paste Plus, 0.2% NaF, Recaldent™, GC Corporation Tokyo, Japan); G2-FD (Crest™ Cavity Protection, 0.243% NaF, Procter & Gamble, USA); G3-CLP (Clinpro™ 5000, 1.1% NaF, 3M ESPE, USA); and G4-CO (Control without fluoride, Silica-based dentifrice; Daudt Ltda, Brazil). The specimens were soaked in demineralizing solution for 6 h and remineralizing solution for 18 h alternatively for 10 days. The toothpaste was prepared with deionized water in a 1:3 ratio (w/v) for three minutes daily. The solutions were renewed every 48 h. After cycling, enamel changes were analysed by percentage change of SMH (%SMH) and energy-dispersive X-ray spectroscopy (EDS). The %SMH value observed for G3-CLP (2.9 ± 39.2) was higher than that found in G4-CO (-13.0 ± 20.7), G1-MPP (-8.9 ± 20.9) and G2-FD (-3.9 ± 27.1). The %SMH was similar for all treatment groups (one-way ANOVA and Tukey's HSD; p < .05). The pH, Ca²⁺ and P_total in the remineralization solutions were not different among all groups (Kruskal-Wallis; p < .05). At 24 h, the Ca²⁺ concentration in the demineralization solution was significantly lower in G1-MPP. Ca²⁺ concentration increased in all groups after 48 h, except for G3-CLP. The EDX quantitative analysis showed that the atomic % of elements is lower level at G4-CO.

CONCLUSIONS

The Clinpro™ 5000 demonstrated having the most protective effect against demineralization; however, the % SMH was similar for all groups.

Can the Enterococcus faecalis identified in the root canals of primary teeth be a cause of failure of endodontic treatment?

OBJECTIVE

This study investigated the presence of Enterococcus faecalis in primary teeth with primary root canal infections and related to the possible failure of pulpectomy outcome after 36 months.

MATERIAL AND METHODS

Root canal samples were obtained from 25 out of 244 patients using the sterile paper cone method. The identification of E. faecalis was done with culture and molecular tests using species-specific 16S rRNA gene-based polymerase chain reaction (PCR). After 36 months, the pulpectomy outcome was evaluated.

RESULTS

Enterococcus faecalis was found in five (20%) samples, and dental caries were the cause of primary infection in all of them. Pulpectomy outcome was evaluated only in teeth that completed the entire clinical protocol and were followed up to 36 months (n = 8). From these, 75% (n = 6) were successful and 25% (n = 2) failed. E. faecalis was present in 50% of both successful and failed cases.

CONCLUSIONS

Enterococcus faecalis was not related to the failure of endodontic treatment of primary teeth.