Gabriela dos Santos Pinto

Longevity of posterior restorations in primary teeth: Results from a paediatric dental clinic

OBJECTIVES The aim of this retrospective study was to evaluate the longevity of restorations in the posterior primary teeth of children attending to a public paediatric dental clinic and to test the factors associated with failures. METHODS Patient records of 329 children (162 boys and 166 girls) were used for collecting and analyzing data. A total of 565 restorations in primary teeth were included in the study. All children enrolled in the study were classified as high caries risk. The longevity of restorations from their placement until failure (up to 4 years of follow-up) was assessed using the Kaplan-Meier survival curves with log-rank test. Multivariate Cox regression analysis with shared frailty (p<0.05) was used to assess the factors associated with failures. RESULTS Up to 4 years of follow-up, the annual failure rates were 9.5% for composite fillings, 12.2% for light-cured glass ionomer restorations, and 12.9% for conventional glass ionomer restorations with statistical difference between the materials (p=0.014). Glass ionomer restorations had a higher risk of failure over time compared with composites (HR 1.86, 95% CI 1.17-2.97). In crude analysis, Class II restorations showed lower survival rate than Class I restorations (p=0.031) but lost significance after adjustments. CONCLUSIONS Our findings suggested that the material influenced the survival rate of primary posterior restorations, with composite presenting the best performance. CLINICAL SIGNIFICANCE Differences were observed between restorative materials with different properties in primary teeth up to 4 years of follow-up. This study provides valuable information regarding the primary teeth posterior restoration longevity in a paediatric population with restorations performed under daily life clinical environment.

Developmental defects of enamel and dental caries in the primary dentition: A systematic review and meta-analysis

OBJECTIVES This systematic review and meta-analysis evaluated the association between developmental defects of enamel and dental caries in the primary dentition. SOURCES Electronic searches were performed in PubMed, Web of Knowledge, Scopus and Scielo for the identification of relevant studies. STUDY SELECTION Observational studies that examined the association between developmental defects of enamel and dental caries in the deciduous dentition were included. Additionally, meta-analysis, funnel plots and sensitivity analysis were employed to synthesize the available evidence. Multivariable meta-regression analysis was performed to explore heterogeneity among studies. DATA A total of 318 articles were identified in the electronic searches. Of those, 16 studies were included in the meta-analysis. Pooled estimates revealed that children with developmental defects of enamel had higher odds of having dental caries (OR 3.32; 95%CI 2.41-4.57), with high heterogeneity between studies (I2 80%). Methodological characteristic of the studies, such as where it was conducted, the examined teeth and the quality of the study explained about 30% of the variability. Concerning type of defect, children with hypoplasia and diffuse opacities had higher odds of having dental caries (OR 4.28; 95%CI 2.24-8.15; OR1.42; 95%CI 1.15-1.76, respectively). CONCLUSIONS This systematic review and meta-analysis demonstrates a clear association between developmental defects of enamel and dental caries in the primary dentition.

Validation of the digital photographic assessment to diagnose traumatic dental injuries

INTRODUCTION Alternatives for monitoring dental trauma in epidemiological surveys may be useful, as data collection of epidemiological investigation can be jeopardized due to several conditions. AIM To investigate the validity of standard digital photographs to determine the occurrence of anterior dental trauma compared to the clinical examination in an epidemiological survey. METHODS Participants were children aged 8-12 years old attending both private and public schools; children were clinically evaluated for the assessment of dental trauma, and standard photographs were taken from maxillary and mandibular permanent incisors of each child. Validity was determined by calculating the percentages and respective 95% confidence interval of sensitivity, specificity, positive predictive value, and negative predictive value. Cohens kappa statistic was also used. RESULTS A total of 412 children were included, totaling 3296 teeth assessed for dental trauma presence. The prevalence of dental trauma was 11.2% (95% CI 8.29-14.61) and 10.2% (95% CI 7.45-13.53), respectively, for the clinical examination and the photographic method. Agreement between the gold standard and the photographic diagnosis was good: 0.64 for the prevalence of dental trauma and 0.66 for diagnosis of dental trauma on a tooth basis. The diagnosis through the photographic method had higher specificity (96.7%) than sensitivity (65.2%). High positive likelihood ratio and low negative likelihood ratio were also observed. CONCLUSION The photographic assessment method of dental trauma was valid and reliable as compared to the oral clinical examination.

Maternal Depression Increases Childhood Dental Caries: A Cohort Study in Brazil

Aim: To investigate the relationship between maternal depression and childhood caries in a cohort of adolescent mothers. Methods: This cross-sectional study nested in a cohort evaluated a sample of 538 mother/child dyads. When the children were 24-36 months of age, data regarding oral health from children and mothers were collected by clinical dental examination. A mothers major depressive disorder was assessed by using the Mini International Neuropsychiatric Interview (MINI [Plus]), at the current moment. Independent variables were obtained by using questionnaires. The outcome on dental caries experience was dichotomized by using 2 cut points: dmfs ≥1 and dmfs ≥3. Poisson regression analysis, using a hierarchical approach, was applied to assess the association between major depressive disorder in mothers with and those without caries experience and the outcome. Results: The prevalence of dental caries in children was 15.1% (n = 82). The mean dmfs index was 1.12 (SD = 3.72). The prevalence of major depressive disorder was 32.6% (n = 168). An interaction between caries status and depressive disorder was found, and after adjusted analysis, children from mothers with major depressive disorder with negative caries experience presented a higher caries prevalence (prevalence ratio 4.00, 95% confidence interval 1.29-12.41). Conclusion: Our findings suggest that maternal psychiatric disorders could have a negative impact on childrens oral health.

Maternal care influence on children's caries prevalence in southern Brazil.

This study aimed to investigate the influence of specific maternal-factors on caries prevalence in offspring. This cross sectional study was conducted in Pelotas, Brazil nested in a cohort of adolescent mothers with children aged 24-42 months. A questionnaire was administered to collect information in relationship to socio-economic, demographic, and behavioral maternal variables. The outcome (childrens dental caries prevalence - dmfs > 0) was collected from clinical examinations. Bivariate and multivariate analyses were conducted. A total of 538 mother/child dyads were evaluated and 15.1% of the children exhibited caries. Adjusted multivariate analysis showed children from mothers living without partners (p < 0.027) had more caries than those living with partners. Maternal perception of a childs oral health was associated to occurrence of caries, particularly when mothers classified their child as poor and these children had a higher level of caries. In addition, mothers accurately evaluated their childs teeth when associated with caries occurrence. Maternal oral health care practices were associated with childrens caries prevalence. Our results demonstrated mothers accurately evaluated the oral health of their offspring.

Scholarships for Scientific Initiation Encourage Post-Graduation Degree

This study aimed to evaluate the factors associated with the decision to attend an academic post-graduation program by dental students. A cross-sectional study was conducted in 2012, last-year undergraduate students from Dental Schools of Southern Brazil. A closed questionnaire was applied including questions grouped in three different blocks: pre-graduate, undergraduate period and future perspectives. The outcome was the decision to pursuit an academic post-graduation degree. Associations were tested using chi-squared test and chi-squared test for linear trends when appropriate. Multivariate Poisson regression was also performed. The sample was composed by 671 students (response rate of 69.9%, n=467). In relation to future perspectives, 68% of the interviewed students intended to attend a post-graduation program, but only 17.5% would choose a program with academic and research post-graduation program (Master and PhD programs). In the final model, students from public universities (PR 2.08, 95%CI 1.41-3.08) and students that received scientific initiation scholarship (PR 1.93 95%CI 1.14-3.27) presented a twice greater prevalence to seek academic post-graduate programs. Students with higher family incomes showed a lower prevalence to seek these programs (PR 0.50, 95%IC 0.28-0.90). Scholarships seem to encourage undergraduate students to pursue stricto sensu post-graduation.

Maternal periodontal disease and adverse perinatal outcomes: is there an association? A hospital-based case-control study

Abstract Objectives: The association between maternal periodontal disease and adverse perinatal outcomes although extensively studied remains unclear. The aim of this study was to evaluate, by a case-control study, conducted in three hospitals the association between preterm birth and/or low birth weight (PTB/LBW) and clinical parameters of maternal periodontal disease. Material and methods: Postpartum women who gave birth to a newborn PTB/LBW (case group), and postpartum women who had babies at full term with normal weight (control group) were included, in 1:2 ratio. Data were collected through medical records, interview, and periodontal clinical parameters. Bivariate analysis was performed to assess the PTB/LBW proportion relative to independent variables and multiple logistic regression analysis to assess the association between adverse perinatal outcomes and independent variables. Results: The sample consisted of 148 cases and 296 controls. By the 148 postpartum women with PTB/LBW in case group, 126 (87.5%) had preterm birth, and 75 (50.7%) had PTB and LBW. The periodontal status and generalized periodontitis presence were not associated with any adverse pregnancy outcomes. Having made four or more prenatal visits was a protective factor for all outcomes. The history of previous PTB/LBW was a risk factor for new cases of PTB and PTB and/or LBW. The presence of systemic disease was associated with preterm and low birth weight (PTLBW). Preeclampsia and cesarean delivery were associated with all outcomes. Conclusions: The clinical parameters of maternal periodontitis were not considered as a risk factor for the studied adverse perinatal outcomes. Clinical relevance: The present study demonstrated no association between maternal periodontitis and PTB/LBW.

Are Maternal Factors Predictors for Early Childhood Caries? Results from a Cohort in Southern Brazil

This study aimed to determine the influence of maternal factors on the early development of dental caries in Brazilian preschoolers. This cross-sectional study was nested in a cohort of adolescent mothers. The current wave was performed when the children were aged 24 to 42 months. The questionnaire-based survey targeted adolescent mothers and included demographic and socioeconomic variables as well as the maternal education level. In addition, clinical examinations were performed on the mothers and their children. Mothers were assessed for decayed, missing and filled teeth in the permanent dentition (DMFT index) and gingival assessment; their children were assessed for decayed, missing and filled teeth in the deciduous dentition (dmft index). Poisson regression with robust variance was used to estimate the prevalence ratio, risk ratio and 95% confidence intervals. This data was also used to identify the maternal risk factors associated with the outcomes (prevalence and severity of childhood caries). A total 538 mother-child dyads were evaluated; the prevalence of early childhood caries was 15.1% and maternal caries was 74.4%. After the adjustment, the children that exhibited a greater incidence of dental caries were from mothers of low socioeconomic status, or from those presenting decayed teeth and higher rates of gingival bleeding. The results of this study suggest that the oral health of mothers is a potentially important risk factor for the development of early childhood dental caries. Public health planners should consider this information when planning interventions in order to prevent the occurrence of early dental caries.