Lara Jansiski Motta

Association between halitosis and mouth breathing in children

OBJECTIVE: To determine whether there is a correlation between halitosis and mouth breathing in children. STUDY DESIGN: Fifty-five children between 3 and 14 years of age were divided into two groups (nasal and mouth breathing) for the assessment of halitosis. A descriptive analysis was conducted on the degree of halitosis in each group. The chi-square test was used for comparison between groups, with a 5% level of significance. RESULTS: There was a significantly greater number of boys with the mouth-breathing pattern than girls. A total of 23.6% of the participants had no mouth odor, 12.7% had mild odor, 12.7% had moderate odor and 50.9% had strong odor. There was a statistically significant association between halitosis and mouth breathing. CONCLUSIONS: The occurrence of halitosis was high among the children evaluated, and there was a statistically significant association between halitosis and mouth breathing.

Craniocervical posture and bruxism in children.

AIM  The aim of this study was to investigate, using photogrammetry, the relationship between head posture and bruxism in children with complete deciduous dentition. MATERIAL AND METHODS  Forty-two children aged between 3 and 6 years, with complete deciduous dentition, participated in the study. Twenty-one children diagnosed with bruxism according to the diagnostic criteria of the American Academy of Sleep Medicine were selected for the bruxism group, and 21 children without bruxism were selected for the control group. Markers were placed on three anatomical landmarks (spinous process of the seventh cervical vertebra, manubrium of the sternum and mental protuberance) and photographic measurements were made to evaluate head posture. Angles between markers were determined using the ALCimagem® software for quantitative image analysis. The Students t-test was used at a significance level of 0.05 for the comparison of head posture (mean cervical angle) between the bruxism and control groups. RESULT  There was a significant difference (p < 0.005) in the mean cervical angle between the control (89.58° ± 8.03°) and bruxism (98.99° ± 8.15°) groups. CONCLUSION  In the present study, children with bruxism showed greater alterations in head posture than controls.

Relação da postura cervical e oclusão dentária em crianças respiradoras orais

PURPOSE: to evaluate and compare head and neck posture, and the relationship between occlusal class, among mouth and nasal breathing children. METHODS: an observational, cross-sectional study was carried out, in which 110 children took part. These were divided into Group I: nasal breathers, and Group II: mouth breathers. For evaluating the respiration, we used mirror clouding and filling the mouth with water tests, with intrabuccal clinical exam for the Angle occlusal classification. Posture analysis was carried out by means of photogrammetry, and the software Alcimagem® was used to measure the predefined angle by the protuberances of the Spinous Process of the 7th Cervical Vertebra, Manubrium of the sternum and Mentum Vertex. The obtained data were tabulated and submitted to a statistical analysis, using the program SPSS 12.0 with a 95% confidence interval. RESULTS: a larger cervical angle was observed for Group II (96.59o±8.79) than for Group I (86.60o±8.53), showing statistically significant differences (p<0.001). The majority (68.5%) of the mouth breathing individuals presented class II occlusion Angle, and this relationship was significant (p<0.05). The class II individuals showed a larger cervical angle, differing statistically from the class I patients (p<0.05). CONCLUSION: it may be concluded that there is a connection between mouth breathing, alteration in head and neck posture and class II occlusal Angle in the studied children. In mouth breathing subjects, forward inclination of the head is predominant.

Aesthetic restoration of deciduous anterior teeth after removal of carious tissue with Papacárie.

The development of conservative techniques for the removal of carious tissue and the improvement of dental restoration materials allow better preservation of the dental structure. Chemomechanical caries removal is a conservative and atraumatic alternative. Papacárie is a papain-based material developed to act only on the carious dentin, allowing its easy removal with a blunt curette. This study aims to present a clinical case of aesthetic restoration of both upper deciduous central incisors after the removal of carious tissue with Papacárie.

Accuracy study of the main screening tools for temporomandibular disorder in children and adolescents

The aims of the present study were to assess the degree of sensitivity and specificity of the screening questionnaire recommended by the American Academy of Orofacial Pain (AAOP) and the patient-history index proposed by Helkimo (modified by Fonseca) and correlate the findings with a clinical exam. All participants answered the questionnaires and were submitted to a clinical exam by a dentist who had undergone calibration training. Both the AAOP questionnaire and Helkimo index achieved low degrees of sensitivity for the detection of temporomandibular disorder (TMD), but exhibited a high degree of specificity. With regard to concordance, the AAOP questionnaire and Helkimo index both achieved low levels of agreement with the clinical exam. The different instruments available in the literature for the assessment of TMD and examined herein exhibit low sensitivity and high specificity when administered to children and adolescents stemming from difficulties in comprehension due to the age group studied and the language used in the self-explanatory questions.

Assessment of chemomechanical removal of carious lesions using Papacarie Duo™: randomized longitudinal clinical trial.

BACKGROUND Chemomechanical removal of carious lesions consists of the dissolution of carious tissue by the application of a natural or synthetic agent, followed by atraumatic mechanical removal. AIM The aim of the present study was to assess the effectiveness of Papacarie Duo ® gel in the chemomechanical removal of carious lesions in primary teeth in comparison to the traditional method (low-speed bur). SETTINGS AND DESIGN A randomized clinical trial was conducted with 20 children between 5 and 8 years of age. MATERIALS AND METHODS Two teeth were treated in each child (split-mouth design), with the randomization of two methods: Group 1 - chemomechanical caries removal with Papacarie Duo™; and Group 2 - removal of carious dentin tissue using a low-speed bur. Both methods involved restoration with glass ionomer cement and follow up. The following aspects were evaluated: time required for the procedure; pain (face evaluation scale); retention of the restorative material in the cavity; and the presence of secondary caries after 30 days. STATISTICAL ANALYSIS USED Chi-squared test, Students t-test, and Wilcoxon test. RESULTS No statistically significant differences between methods were found regarding time required for the procedure (P = 0.13), the occurrence of pain (P = 0.585), or restoration status at the 30-day clinical evaluation (P = 0.713). CONCLUSION The findings of the present study demonstrate that the two methods achieve similar results. The advantages of minimally invasive treatment, such as chemomechanical caries removal with Papacarie Duo™, are its ease of use, patient comfort, and the fact that it causes less damage to dental tissue.

Influence of temporomandibular disorder on temporal and masseter muscles and occlusal contacts in adolescents: an electromyographic study

BackgroundThe aim of the present study was to analyse the influence of temporomandibular disorder (TMD) on electromyographic activity in the masseter and temporal muscles of adolescents and investigate a possible association with the number of occlusal contacts.MethodsThe Helkimo Index was administered for the diagnosis of TMD and classification of the adolescents into three groups: without TMD; with mild TMD; and with moderate/severe TMD. Carbon paper was used for the determination of occlusal contact points. A standardised electromyographic evaluation was performed on the masticatory muscles at rest, during habitual chewing and during maximum voluntary clenching. The readings were normalised to maximum voluntary clenching. Statistical analysis involved the chi-squared test and Fisher’s exact test. The Kruskal-Wallis test and one-way analysis of variance with Dunn’s post hoc test were used to compare differences between groups. Pearson’s correlation coefficients (r) were calculated for the determination of correlations between the number of occlusal contacts and RMS values.ResultsElectromyography revealed significant differences in the right and left masseter and temporal muscles at rest and during chewing among the three groups. These differences were not observed during maximum voluntary clenching. No statistically significant differences were found between the groups with and without TMD regarding the number of occlusal contacts.ConclusionElectromyographic activity in the masseter and temporal muscles was greater among adolescents with moderate to severe TMD.

Evaluation of effect of low-level laser therapy on adolescents with temporomandibular disorder: study protocol for a randomized controlled trial

BackgroundA number of problems involving the temporomandibular joint (TMJ) and associated structures can lead to temporomandibular disorder (TMD). The aim of the proposed study is to assess the effect of low-level laser therapy on occlusal contacts, mandibular movements, electromyography activity in the muscles of mastication and pain in adolescents with TMD.Methods/DesignA randomized, controlled, double-blind, clinical trial will be carried out involving 85 male and female adolescents between 15 and 18 years of age. The research diagnostic criteria for TMD will be used to assess all individuals who agree to participate. All participants will be submitted to a clinical examination and electromyographic analysis of the masseter muscles and anterior bundle of the temporal muscles bilaterally, to determine TMD. Based on the clinical findings, the participants will be classified as having or not having TMD. Those with TMD will be divided into four groups, three of which will receive low-level laser therapy and one of which will receive a placebo treatment. The treatments will involve the TMJ region alone, the masseter and temporal muscles alone, or both these regions together. The data will be submitted to descriptive statistical analysis. The chi-square test and Fisher’s exact test will be used to determine associations among the categorical variables. The Student’s t test and analysis of variance will be used for the comparison of mean electromyographic signals. Pearson’s correlation coefficients will be calculated for the analysis of correlations among the continuous variables.Trial registrationThe protocol for this study has been submitted to Clinical Trials – registration number (NCT01846000).

Tooth whitening with hydrogen peroxide in adolescents: study protocol for a randomized controlled trial

BackgroundTechnological innovations in dental materials have been fueled by the desire of patients to improve the esthetics of their teeth. This emphasis on esthetics has led dentists to seek resources that respect the standards established by society, but without compromising the integrity of the teeth.Methods/designThe aim of the proposed controlled clinical trial will be to assess colorimetric changes and increased dental sensitivity in adolescent patients submitted to tooth whitening with 6% and 7.5% hydrogen peroxide using home kits with whitening strips. Adolescents aged 12 to 20 years will be allocated to different groups based on treatment (n = 16 per group): (1) placebo; (2) 6.0% hydrogen peroxide (White Class with Calcium, FGM); (3) 7.5% hydrogen peroxide (White Class with Calcium, FGM); and (4) 7.5% hydrogen peroxide (Oral B 3D White, Oral-B). After the whitening procedures, the participants will be evaluated using a visual analog scale for tooth sensitivity and digital spectrophotometry to measure changes in color. Descriptive analysis of the data will be performed. Either the chi-squared test or Fisher’s exact test will be used for the determination of associations among the categorical variables. Student’s t-test and analysis of variance will be used to compare mean colorimetric data. Pearson’s correlation coefficients will be calculated to determine the strength of correlations among the continuous variables.DiscussionThis randomized trial will provide an opportunity to evaluate products such as whitening strips in comparison to other self-administered methods, especially in adolescents.Trial registrationThe protocol for this study was submitted to Clinical Trials in November 2013 with registration number NCT01998386.

Evaluation of Cranio-cervical Posture in Children with Bruxism Before and After Bite Plate Therapy: A Pilot Project.

[Purpose] The aim of the present study was to evaluate the effect of a biteplate on the cranio-cervical posture of children with bruxism. [Subjects and Methods] Twelve male and female children aged six to 10 years with a diagnosis of bruxism participated in this study. The children used a biteplate during sleep for 30 days and were submitted to three postural evaluations: initial, immediately following placement of the biteplate, and at the end of treatment. Posture analysis was performed with the aid of the Alcimagem® 2.1 program. Data analysis (IBM SPSS Statistics 2.0) involved descriptive statistics and the Student’s t-test. [Results] A statistically significant difference was found between the initial cranio-cervical angle and the angle immediately following placement of the biteplate. However, no statistically significant difference was found between the initial angle and the angle after one month of biteplate usage. [Conclusion] No significant change in the cranio-cervical posture of the children was found one month of biteplate usage. However, a reduction occurred in the cranio-cervical angle when the biteplate was in position.