Ana Cristina Oliveira

Psychometric properties of the Brazilian version of the Child Perceptions Questionnaire (CPQ11–14) – short forms

BackgroundThe need to evaluate the impact of oral health has led to the development of instruments for measuring oral health-related quality of life (OHQoL). One such instrument is the Child Perceptions Questionnaire (CPQ11–14), developed specifically for 11-to-14-year-old children. As this questionnaire was considered long (37 items), shorter forms were developed with 8 (Impact Short Form: 8 – ISF:8) and 16 items (Impact Short Form: 16 – ISF:16) to facilitate use in the clinical setting and population-based health surveys. The aim of the present study was to translate and cross-culturally adapt these CPQ11–14 short forms for Brazilian Portuguese and evaluate the measurement properties of these versions for use on Brazilian children.MethodsFollowing translation and cross-cultural adaptation, the ISF:8 and ISF:16 were tested on 136 children from 11 to 14 years of age in the city of Belo Horizonte, Brazil. The instrument was administered by a trained researcher who also performed clinical examinations. The measurement properties (i.e. criterion validity, construct validity, internal consistency reliability, test-retest reliability) were determined. Discriminant validity was tested between groups, which were divided into children with no cavities and no malocclusion; children with cavities and without malocclusion; and children with malocclusion and without cavities.ResultsThe mean total score was 6.8 [standard deviation (SD) 4.2] for the ISF:8 and 11.9 (SD 7.6) for the ISF:16 (p < 0.001). Statistically significant associations were found between oral abnormalities and the subscales of the ISF:8 and ISF:16 (p < 0.05). Both test-retest stability and internal consistency, as measured by the intra-class correlation coefficient (ICC) (ISF:8 = 0.98 and ISF:16 = 0.97) and Cronbachs alpha (ISF:8 = 0.70 and ISF:16 = 0.84) proved to be adequate. Construct validity was confirmed from the correlation between the short form scores and oral health and overall well-being ratings. The score on the short forms of the CPQ11–14 was able to discriminate between different oral conditions. Criterion validity was satisfactory (p < 0.05).ConclusionThe Brazilian versions of CPQ11–14 ISF:8 and ISF:16 have satisfactory psychometric properties, similar to those of the original instrument.

Implications of edentulism on quality of life among elderly.

This study aimed was to test the association between quality of life and edentulism among elderly individuals in a city in southeastern Brazil. This cross-sectional study was carried out with 163 individuals aged 60 years or older, functionally independent and non-institutionalized. Data were collected with a questionnaire and oral examination. The edentulism was the dependent variable. The independent variables were sex, age, household income and quality of life (WHOQOL-Old) and their scores. To assess the association between the dependent variable and independent variables was used bivariate analysis (p < 0.10). Poisson regression model was performed, adjusting for age and sex. The average age of participants was 69 years (± 6.1), 68.7% were female and 52.8% were diagnosed as completely edentulous (90% CI: 0.33–1.24). When the independent variables were associated to the prevalence of edentulism, statistically significant associations were found for age (p = 0.03) and social participation dimension of the WHOQOL-Old (p = 0.08). In the Poisson regression, social participation remained statistically associated to edentulism {RP = 2.12 [90% CI (1.10–4.00)]}. The social participation proved to have a significant association to edentulism, thereby attesting to the negative effect of this condition on social aspects.

What is new in genetics and osteogenesis imperfecta classification

OBJECTIVE Literature review of new genes related to osteogenesis imperfecta (OI) and update of its classification. SOURCES Literature review in the PubMed and OMIM databases, followed by selection of relevant references. SUMMARY OF THE FINDINGS In 1979, Sillence et al. developed a classification of OI subtypes based on clinical features and disease severity: OI type I, mild, common, with blue sclera; OI type II, perinatal lethal form; OI type III, severe and progressively deforming, with normal sclera; and OI type IV, moderate severity with normal sclera. Approximately 90% of individuals with OI are heterozygous for mutations in the COL1A1 and COL1A2 genes, with dominant pattern of inheritance or sporadic mutations. After 2006, mutations were identified in the CRTAP, FKBP10, LEPRE1, PLOD2, PPIB, SERPINF1, SERPINH1, SP7, WNT1, BMP1, and TMEM38B genes, associated with recessive OI and mutation in the IFITM5 gene associated with dominant OI. Mutations in PLS3 were recently identified in families with osteoporosis and fractures, with X-linked inheritance pattern. In addition to the genetic complexity of the molecular basis of OI, extensive phenotypic variability resulting from individual loci has also been documented. CONCLUSIONS Considering the discovery of new genes and limited genotype-phenotype correlation, the use of next-generation sequencing tools has become useful in molecular studies of OI cases. The recommendation of the Nosology Group of the International Society of Skeletal Dysplasias is to maintain the classification of Sillence as the prototypical form, universally accepted to classify the degree of severity in OI, while maintaining it free from direct molecular reference.

Prevalence and associated factors of traumatic dental injuries in Brazilian schoolchildren.

OBJECTIVES This study investigated the prevalence of traumatic dental injury (TDI) and associated factors in the permanent incisors of Brazilian schoolchildren. METHODS A cross-sectional survey was carried out with 1,612 male and female children aged 11 to 14 attending public and private elementary schools in Belo Horizonte, Brazil. A multistage sampling technique was adopted to select the children. Oral examinations were performed by calibrated examiners for the diagnosis of TDI (criteria proposed by Andreasen) and dental caries [Decayed, Missing and Filled Teeth Index (DMFT)]. The Social Vulnerability Index was used for socioeconomic classification. Data analysis involved descriptive statistics and the Poisson regression model. RESULTS The prevalence of TDI was 17.1%. Falls (43.6%) were the most common cause of TDI, mainly at home (41.8%). Boys were more affected than girls. There was no statistically significant association between TDI and socioeconomic status. The adjusted results revealed that TDI was significantly associated with DMFT [1.11, 95% confidence interval (CI): 1.06 to 1.16] and overjet (1.15, 95% CI: 1.00 to 1.31). CONCLUSIONS TDI was associated with dental caries and overjet and was not influenced by socioeconomic status.

Validity and reliability of the Brazilian version of the psychosocial impact of dental aesthetics questionnaire

Oral health-related quality of life (OHRQoL) is an important aspect of health outcomes and its assessment should be made using validated instruments. The psychosocial impact of dental aesthetics questionnaire (PIDAQ) is an OHRQoL instrument that assesses the psychosocial impact of dental aesthetics was developed and validated for use on young adults. The aim of the present study was to assess the reliability, validity, and applicability of the PIDAQ for young adults in Brazil. After translation and cross-cultural adaptation, the questionnaire was completed by 245 individuals (124 males and 121 females) aged 18-30 years from the city of Belo Horizonte, Brazil. In order to test discriminant validity, the subjects were examined for the presence or absence of malocclusion based on the dental aesthetic index criteria. Dental examinations were carried out by a previously calibrated examiner [weighted kappa = 0.64-1.00, intraclass correlation coefficient (ICC) = 0.78-1.00]. Internal consistency measured by Cronbachs alpha of the subscales was between 0.75 and 0.91 and test-retest reliability was assessed using the ICC, which ranged from 0.89 to 0.99 for dental self-confidence and social impact, thereby revealing satisfactory reliability. Discriminant validity revealed that subjects without malocclusion had different PIDAQ scores when compared with those with malocclusion. The results suggest that the Brazilian version of the PIDAQ has satisfactory psychometric properties and is thus applicable to young adults in Brazil. Further research is needed to assess these properties in population studies.

Prevalence and association of dental injuries with socioeconomic conditions and alcohol/drug use in adolescents between 15 and 19 years of age

BACKGROUND The aim of the present study was to investigate the prevalence of dental trauma, etiological factors, predisposing factors, and associations with socioeconomic status and the risk of alcohol and illicit drug use among adolescents in the city of Belo Horizonte, Brazil. METHODS A cross-sectional study was carried out that included clinical examinations and self-administered questionnaires. The sample population was composed of 891 adolescents from public and private schools. The Social Vulnerability Index (SVI) was used for socioeconomic classification. Information on alcohol and illicit drug use was obtained using two questionnaires: the Alcohol Use Disorders Identification Test (AUDIT) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). RESULTS The prevalence of traumatic dental injury (TDI) was 24.7%. Falls (17.7%) was the most frequently cited etiological factor in dental injury. Among the participants with TDI, 32.8% were students in the private school system (P = 0.006). A total of 56.8% of individuals with accentuated overjet had some type of TDI (P = 0.000). There was a high prevalence of adolescents who consumed alcoholic beverages (50.3%) and used illicit substances (15.2%). However, no statistically significant associations were found between these variables and the presence of TDI. The results of the analysis demonstrate that individuals in a private school system [prevalence ratio (PR) = 1.11; 95% confidence interval (CI): 1.03-1.20] and those with accentuated overjet (>3 mm) (PR = 1.17; 95% CI: 1.10-1.25) had a 1.11- and 1.17-fold greater chance of belonging to the group of individuals diagnosed with some type of TDI. CONCLUSIONS The prevalence of dental trauma in the study population was high. The same was true regarding alcohol and illicit drug use among the adolescents examined, although no statistically significant associations were found between these variables and a history of TDI. Private school system and accentuated overjet were significantly associated with dental trauma.

Feeding and nonnutritive sucking habits and prevalence of open bite and crossbite in children/adolescents with Down syndrome

OBJECTIVE To analyze the influence of breastfeeding, bottle feeding, and nonnutritive sucking habits on the prevalence of open bite and anterior/posterior crossbite in children with Down syndrome (DS). MATERIALS AND METHODS A cross-sectional study was carried out in 112 pairs of mothers/children with DS between 3 and 18 years of age at a maternal/childrens hospital in Rio de Janeiro, Brazil. The children with DS were clinically examined for the presence of open bite as well as anterior and posterior crossbite. Information on breastfeeding, bottle feeding, and nonnutritive sucking habits was collected using a structured questionnaire. The control variables were age and mouth posture of children/adolescents and mothers schooling. Statistical analysis of the data was performed using the chi-square test and multiple logistic regression. RESULTS The prevalence of anterior open bite was 21%, anterior crossbite was 33%, and posterior crossbite was 31%. The use of bottle feeding for more than 24 months (prevalence ratio [PR] = 1.6) was associated with the occurrence of open bite. Having breastfed for less than 6 months (PR = 1.4) and pacifier sucking for more than 24 months (PR = 3.1) were associated with the prevalence of anterior crossbite. Finger sucking (PR = 2.9) and the use of bottle feeding for more than 24 months (PR = 2.6) were associated with posterior crossbite. CONCLUSION The prevalence of open bite and crossbite in children with DS was associated with the use of bottle feeding and pacifier sucking for more than 24 months, breastfeeding for less than 6 months, and finger sucking.

Prevalence and determinant factors of malocclusion in children with special needs

Careful attention to malocclusion in children with special needs leads to a considerable improvement in the quality of life. The present study analysed the prevalence of malocclusion in children with Down syndrome (DS) and cerebral palsy (CP) as well as associations with individual, socio-economic, and behavioural factors. A cross-sectional study was carried out that included 181 mothers and their children with DS and CP (aged 3-12 years) at two institutions for individuals with special needs in Rio de Janeiro, Brazil. Data were collected using a questionnaire administered to the mothers and a dental examination of the children. Clinical examination recorded the following: anterior/posterior crossbite and anterior openbite (AOB). The control variables were the mothers level of education as well as the gender and age of the child. Statistical analysis of the data was performed using the chi-square test and multiple logistic regression. An anterior crossbite was present in 20.4 percent, a posterior crossbite in 21.5 percent, and an AOB in 29.8 percent. The presence of DS, bottle feeding, and non-nutritive sucking habits for 24 months or more was determinant factors for an anterior crossbite and the presence of DS, bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months was determinant factors for a posterior crossbite. The presence of CP and non-nutritive sucking habits for 24 months or more was determinant factors for an AOB. Thus, the prevalence of malocclusion in children with special needs was associated with the type of disability, use of bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months.

Predisposing Factors for Traumatic Dental Injury in Primary Teeth and Seeking of Post-trauma Care

The aim of the present study was to investigate predisposing factors for traumatic dental injury (TDI) in the primary dentition and seeking of dental care after the occurrence of TDI. A randomized population-based cross-sectional study was carried out with 814 children aged 3 to 5 years enrolled at public and private preschools in the city of Campina Grande, PB, Brazil. Parents were asked to fill out a questionnaire on demographic data and the childs history of TDI. TDI was evaluated by clinical examinations performed by three previously calibrated dentists (Kappa: 0.85 to 0.90). Bivariate and multivariate Poisson regression models were constructed for TDI and the parent-reported search for dental care (α=0.05). The prevalence of TDI was 34.6%. The most common type of TDI was enamel fracture (55.0%). The central incisors were the most frequently affected teeth (87.5%). Predictors for TDI in the primary dentition were household income >U

Impact of Early Surgery and Immunosuppression on Crohnʼs Disease Disabling Outcomes

312.50 (PR: 1.355; 95% CI: 1.050-1.724) and overjet >2 mm (PR: 1.539; 95% CI: 1.219-1.942). The predictor for seeking dental care following TDI was parents age >30 years (PR: 1.753; 95% CI: 1.039-2.960). Household income and overjet were associated with TDI. Among children having suffered TDI, parents age is a crucial determinant for seeking dental care.