Leandro Silva Marques

Validations of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS)

This study aimed to evaluate the psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). A total of 247 children aged 2 to 5 years and their parents/guardians participated in this study. A clinical oral examination was performed and the parents/guardians completed the ECOHIS questionnaire. Within a period of four-weeks, 20% of the participants repeated the ECOHIS questionnaire. Construct validity was determined using Spearmans rank correlation. Discriminant validity, internal consistency and test-retest reliability were also evaluated. The children were divided into 2 groups: group 1 (with dental caries) and group 2 (caries-free). Children with caries showed higher mean ECOHIS scores than the caries-free children. The child impact section (p < 0.01), family impact section (p < 0.01) and total ECOHIS scores (p < 0.01) were significantly correlated with tooth decay. Cronbachs alpha coefficients demonstrated satisfactory internal consistency. The Brazilian version of the ECOHIS is a valid instrument for assessing oral health-related quality of life in preschool children with Brazilian Portuguese-speaking primary caregivers.

Incidence of dental trauma among adolescents: a prospective cohort study

We estimated the incidence of traumatic dental injuries (TDI) in a 2-year follow-up of adolescents with and without previous dental trauma and verified the hypothesis that individuals with previous trauma are more prone to recurrent TDI events. The present study was developed in three phases. First, a dental trauma cross-sectional study was carried out with 2260 schoolchildren aged 11-13 years in Biguaçu, southern Brazil. In the second phase, a case-control study was developed to identify risk factors associated with dental trauma. The third step was a 2-year longitudinal observational study with the participants of the second phase of the study. The exposed group of individuals with previous dental traumatism (208) and a non-exposed group (208) of participants who had no previous signs of dental trauma were followed up for 2 years. Descriptive, univariate, simple and conditional multiple logistic regression analyses were performed. The greatest incidence of dental trauma was identified among adolescents with previous dental trauma (11.9%-11.44/1000 incisors) when compared with those without previous dental trauma (2.7%-2.45/1000 incisors) (P < 0.001). In the study period, adolescents with previous dental trauma showed a 4.85 times greater odds ratio for presenting further dental trauma when compared with adolescents without previous dental trauma (P = 0,005) after adjusting for incisal overjet, lip coverage and mothers schooling. A notable difference was observed regarding the incidence of TDI between the case and control groups. Individuals with previous dental trauma had greater chances of developing develop further dental trauma in a 2-year follow-up.

Severe root resorption in orthodontic patients treated with the edgewise method: Prevalence and predictive factors

INTRODUCTION Our aims in this study were to assess the prevalence of severe root resorption and identify possible associations in orthodontic patients treated with the edgewise method. METHODS The sample included 1049 patients who had periapical radiographs taken for all incisors before and after treatment. The radiographs were examined by 2 orthodontists using an x-ray viewer with standard light intensity. These variables were collected: root shape, overbite, initial resorption, and hypodontia. The patients were classified according to sex, Angle classification, ethnicity, age, duration of treatment, type of dentition (mixed or permanent), and treatment with or without extraction of 4 premolars. Resorption was considered severe when it affected more than a third of the length of the root. Statistical analysis included the chi-square test and both simple and multiple logistic regression (P < or =0.05). RESULTS Severe root resorption was observed in 14.5% of the sample. Patients treated with exodontia of the first premolars (odds ratio [95% CI] = 6.38 [4.2-9.7]), those who had triangle-shaped roots at the beginning of treatment (odds ratio [95% CI] = 4.67 [3.1-6.9]), and those with initial root resorption (odds ratio [95% CI] = 4.52 [2.7-7.6]) had a greater chance of developing severe root resorption during orthodontic treatment. CONCLUSIONS A high prevalence of severe root resorption was observed in Brazilian patients treated with the edgewise method. The main factors directly involved in severe resorption were extraction of first premolars, triangle-shaped roots, and root resorption before treatment.

Aesthetic impact of malocclusion in the daily living of Brazilian adolescents

Objective The aim of the present study was to determine the biopsychosocial impact of malocclusion on the daily living of Brazilian adolescents (14 to 18 years of age) through normative and subjective records and identify factors directly involved in the self-perception of malocclusions. Design Cross-sectional. Setting Public and private schools in the city of Belo Horizonte, Brazil. Subjects and methods The sample was made up of 403 adolescents, with no prior history of orthodontic treatment, who were selected randomly from a population of 182,291 students in the same age range. The oral impact of malocclusion was assessed using the Oral Impact on Daily Performance (OIDP), whereas clinical criteria were assessed using the Dental Aesthetic Index (DAI). Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and self-esteem was assessed using the Global Negative Self-Evaluation (GSE) scale. Other variables were assessed using questionnaires. The chi-square test, simple and multiple logistic regression analyses were used for the statistical analysis. Results Ninety five adolescents (24%) reported feeling embarrassed to smile (aesthetic impact). A logistic regression suggested that the following variables were directly involved in the self-perception of malocclusion: upper anterior crowding ⩾2 mm ( P =0.009), median diastema ⩾2 mm ( P =0.040), normative treatment need (highly desirable) ( P <0.001) and low economic level ( P <0.001). Conclusion Negative repercussions on daily living were found in Brazilian adolescents with malocclusions affecting anterior dental aesthetics.

Factors associated with the development of early childhood caries among Brazilian preschoolers.

The aim of this study was to assess the prevalence of early childhood caries (ECC) in children and investigate the influence of sociodemographic variables, quality of oral hygiene and child-related aspects. A cross-sectional study was carried out with 593 children aged three to five years. Data were collected through clinical examinations and interviews with parents. Interviews with parents of the children were conducted to acquire information on sociodemographic aspects, breastfeeding, bottle feeding and harmful oral habits. Statistical analysis involved the chi-square test and the Poisson regression. The prevalence of ECC was 53.6%. The occurrence of ECC was greater among children with unsatisfactory oral hygiene (PR: 2.95; 95% CI: 2.42-3.60) and those from a family with a lower monthly household income (PR: 1.62; 95% CI: 1.24-2.10). In conclusion, unsatisfactory oral hygiene and monthly income exerted an influence on the occurrence of ECC among preschoolers.

Severity of malocclusion in patients with cerebral palsy: Determinant factors

INTRODUCTION Our aims in this study were to compare the biopsychosocial aspects of patients with cerebral palsy and subjects in a control group, establish the severity of malocclusion, and identify determinant factors. METHODS The group with cerebral palsy included 60 patients diagnosed with the spastic form of the disease. The control group included 60 randomly selected healthy subjects with various malocclusions. Data were collected through questionnaires, medical charts, and clinical evaluations. The criteria of the dental aesthetic index were used for the diagnosis of malocclusion. Comparisons between groups and between the independent variables and dependent variable (severity of malocclusion) were performed by using the chi-square test (P ≤ 0.05) and multivariate logistic regression (forward stepwise procedure). RESULTS Significant differences between the groups were found for these variables: tooth loss, overjet, anterior open bite, facial type, breathing pattern, drooling, difficulty in swallowing, and lip incompetence. CONCLUSIONS The main risk factors associated with the severity of malocclusion were cerebral palsy, mouth breathing, lip incompetence, and long face.

Developmental defects of enamel in primary teeth: prevalence and associated factors.

BACKGROUND   Studies on the prevalence of enamel defects in the primary dentition as a whole are scarce, as most investigations examine specific population groups. OBJECTIVES   The aim of this study was to evaluate the prevalence of enamel defects in primary teeth and determine whether prematurity, birthweight, and socio-demographic variables are associated with such defects. DESIGN   A cross-sectional study was carried out with 381 children aged 3-5 years. Data were collected through clinical examinations and interviews with parents during the National Immunisation Day. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel (DDE) Index. Through interviews, information was collected on socio-demographic aspects, pregnancy, birthweight, prematurity, and breastfeeding. Statistical analysis was performed using the SPSS program for Windows and involved descriptive analysis, Fishers exact test, the chi-square test, and Poisson regression. RESULTS   The prevalence of developmental defects of enamel was 29.9%. Demarcated opacity was the most frequent type of defect. Children with a history of very low birthweight had a greater prevalence of enamels defects (PR, 2.7; 95% CI, 1.66-4.61). Prematurity and socio-demographic variables were not associated with enamel defects. CONCLUSION   Children with a history of very low birthweight had a greater frequency of enamel defects in primary teeth.

Relationships of beta-blockers and anxiolytics intake and salivary secretion, masticatory performance and taste perception

OBJECTIVE Assess the influence of salivary flow on physiological parameters of the stomatognathic system in patients who take beta-blockers or anxiolytic medications. DESIGN Sixty patients were divided into three groups based on the following criteria: Group 1, control (n=20; no use of medication); Group 2, use of antihypertensive beta-blockers (n=20); and Group 3, use of benzodiazepine anxiolytics (n=20). Salivary flow was assessed by determining stimulated and non-stimulated flow/minute. The quantification of the sense of taste was determined on a visual analogue scale (VAS) using solutions of 0.9% NaCl (salty), 50% sucrose (sweet), 20% unsweetened coffee (bitter) and 4.2% vinegar (sour). The DMFT index (number of decayed/missing/filled teeth) was determined by a calibrated examination, following the criteria of the World Health Organization (WHO). Masticatory performance was assessed with an Optosil comminution test and Rosim-Ramler equation. RESULTS The results did not reveal a significant correlation between salivary flow and masticatory performance (p>0.05). We observed significant decreased non-stimulated salivary flow for Group 2 (p=0.05) when compared to controls. However, taste perception was not influenced by salivary secretion amongst groups. Furthermore, we observed a significant negative correlation between non-stimulated salivary flow and DMFT in Group 1 (p=0.02; r=-0.52). CONCLUSIONS Patients under beta-blockers therapy presented reduced non-stimulated salivary flow when compared to controls, without influencing the sense of taste or masticatory performance. The use of anxiolytics did not affect salivary flow and taste perception in the studied sample.

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression.

The aim of this cross-sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3-5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health-related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio-economic characteristics of the family. Statistical analyses were performed using the chi-square test, Kruskal-Wallis test, Mann-Whitney U-test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Childs age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children.

Prevalence of Nickel Allergy and Longitudinal Evaluation of Periodontal Abnormalities in Orthodontic Allergic Patients

OBJECTIVE To determine the prevalence of nickel allergy in a sample of orthodontic patients and longitudinally compare the clinical periodontal status of these individuals with that of a group of nonallergic patients. MATERIALS AND METHODS The initial sample consisted of 96 patients selected randomly from a databank of patients who sought orthodontic care at a teaching institution. Following the selection and beginning of treatment, periodontal status was assessed over a 12-month period (one evaluation every 3 months-T(1), T(2,) T(3,) T(4)) using the Loe index. The evaluations were performed blindly by a single, calibrated examiner and were followed by prophylaxis and orientation regarding oral hygiene. The prevalence of nickel allergy was determined by the patch test 9 months after the beginning of treatment and occurred in 16 individuals (17.2%). Two groups were then established: the allergic group (AG, n = 16) and the age-paired nonallergic control group (NAG, n = 16). Data were analyzed using the Mann-Whitney U-test and Friedmans analysis of variance (ANOVA) tests (P < or = .05). RESULTS Significant differences were present between groups at the T(3) and T(4) evaluations for the LOE index (P = .045 and .009), with allergic individuals showing higher mean values than nonallergic individuals (hyperplasia, change in color, and bleeding). No significant differences were found in the intragroup evaluations between the four evaluations (P > .05). CONCLUSIONS The results suggest a cumulative effect from nickel throughout orthodontic treatment associated with clinically significant periodontal abnormalities in allergic individuals over time.