Luisa Jardim Correa de Oliveira

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.

Iniquidades em saude bucal: escolares beneficiarios do Bolsa Familia sao mais vulneraveis?

OBJECTIVE : To evaluate the association between being a recipient of the Bolsa Familia program and oral health conditions in Brazilian schoolchildren. METHODS : A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Familia program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS : Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Familia. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Familia . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS : Schoolchildren benefiting from the Bolsa Familia program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.OBJECTIVE To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren. METHODS A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.

[Inequalities in oral health: are schoolchildren receiving the Bolsa Família more vulnerable?].

OBJECTIVE : To evaluate the association between being a recipient of the Bolsa Familia program and oral health conditions in Brazilian schoolchildren. METHODS : A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Familia program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS : Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Familia. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Familia . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS : Schoolchildren benefiting from the Bolsa Familia program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.OBJECTIVE To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren. METHODS A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.

Factors associated with prevalence of oral lesions and oral self-examination in young adults from a birth cohort in Southern Brazil

The objective of this study was to assess the prevalence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regarding exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of individuals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.O objetivo foi determinar a prevalencia e caracteristicas de lesoes bucais, autoexame bucal e suas associacoes com determinantes ao longo da vida em uma populacao de adultos jovens. Uma amostra representativa (n = 720) dos nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1982, foi investigada, e a presenca de lesoes bucais e a realizacao do autoexame, verificadas aos 24 anos. As variaveis independentes foram obtidas de outros seguimentos dessa coorte. A prevalencia de lesoes bucais foi de 23,3% (IC95%: 20,3-26,6), e 31% dos individuos (IC95%: 27,6-34,4) relataram nunca ter realizado o autoexame da boca. A analise multivariavel mostrou que o baixo nivel socioeconomico ao nascimento, nao ter recebido instrucao de higiene oral ate os 15 anos de idade e fumar aos 22 anos foram associados a presenca de lesoes. A realizacao do autoexame bucal esteve associada a maior escolaridade materna ao nascimento e a ter recebido orientacao de higiene bucal pelo dentista aos 15 anos. Fatores socioeconomicos e comportamentais estao associados tanto a presenca de lesoes bucais quanto a realizacao do autoexame bucal.

Accuracy of partial protocol to assess prevalence and factors associated with dental caries in schoolchildren between 8-12 years of age

The aim of this study was to test accuracy and reliability of a partial protocol (PP) of oral examination involving the permanent first molars. This cross-sectional study was carried out in two stages. First, a cross-sectional study was performed in a representative sample of 1,211 children using DMFT-index in a full-mouth protocol (FM). A PP was simulated from FM data using only data from the permanent first molars. A second part was performed with 202 children examined by a gold standard examiner (FM) and three dentists using the PP to assess its reliability. Accuracy of PP was assessed by sensitivity/specificity/predictive positive and negative values. Inter-examiner reliability in comparison with gold standard examiner was assessed using weighted kappa. The prevalence of dental caries observed using DMFT index was 32.4% and was 30.2% for PP . The PP presented high sensitivity (93.1%; 95%CI: 91.5-94.5), showing similar magnitude of associations measures for all associated factors investigated. When compared with the gold standard FM examination, all examiners obtained high parameters of sensitivity and specificity (around 90%). Predictive negative values were higher than predictive positive values for the examiners. This study showed that this partial protocol involving the permanent first molars is accurate and reliable as a screening tool to assess dental caries prevalence and associated factors in schoolchildren.

Validity of the Brazilian version of the Venham's behavior rating scale

BACKGROUND Venhams Behavior Rating Scale (VBRS) is a measure of uncooperative behavior developed to assess childrens responses to dental stress. AIM To evaluate the validity of the Brazilian version of the VBRS. DESIGN Children aged 7-13 years were invited to participate in this study. Child behavior was concurrently assessed with both the VBRS and the Frankl Scale. A receiver operating characteristic curve (ROC) was plotted to determine the cut-off points of the Brazilian version of the VBRS. Criterion validity was determined using Spearmans correlation coefficient. Discriminant validity was tested before and after scale dichotomization. RESULTS A total of 265 children participated in this study. According to the ROC curve, the ≥1 cut-off point was best for this population (SENS 97.4%; SPEC 94.7%). The Brazilian version of the VBRS was significantly correlated with the Frankl Scale (r -0.69; <0.001, r -0.72; <0.001). Child behavior assessed was related to complexity of treatment, type of procedure, use of local anesthesia, and dental fear. CONCLUSIONS The results provide strong evidence for the validity of Brazilian version of the VBRS in behavior assessment of children aged 7-13 years during dental care.

Crown-Root Fractures in Primary Teeth: A Case Series Study of 28 Cases

Crown-root fractures in primary teeth are rare, with a wide variation of patterns that make diagnosis and treatment difficult. The aim of this study was to present a case series of crown-root fractures in primary teeth of children who attended a reference center. The study followed 28 cases of crown-root fractures in 26 children, representing 4% of the total number of attendees over 11 years of reference service at the Universidade Federal de Pelotas, Pelotas, Brazil. In most cases, the maxillary central incisors (85.7%) were involved. In the crown, 57.1% of the cases had a simple line of fracture, and 42.9% had multiple lines. Simple lines predominated in the root (89.3%). In cases with simple fracture lines in the crown, 37.6% underwent a total extraction, 31.2% required a partial extraction and 31.2% underwent pulpectomy. In most teeth with multiple lines of fractures in the crown, total extraction was performed (91.7%) All cases were followed-up until the eruption of the permanent successor tooth, and all patients had favorable outcomes.

Inequidades en salud bucal: escolares beneficiarios de la Beca Familia son más vulnerables?

OBJECTIVE : To evaluate the association between being a recipient of the Bolsa Familia program and oral health conditions in Brazilian schoolchildren. METHODS : A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Familia program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS : Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Familia. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Familia . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS : Schoolchildren benefiting from the Bolsa Familia program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.OBJECTIVE To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren. METHODS A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.

Fatores associados à prevalência de lesões bucais e à realização do autoexame bucal em adultos jovens de uma coorte de nascidos vivos do Sul do Brasil

The objective of this study was to assess the prevalence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regarding exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of individuals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.O objetivo foi determinar a prevalencia e caracteristicas de lesoes bucais, autoexame bucal e suas associacoes com determinantes ao longo da vida em uma populacao de adultos jovens. Uma amostra representativa (n = 720) dos nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1982, foi investigada, e a presenca de lesoes bucais e a realizacao do autoexame, verificadas aos 24 anos. As variaveis independentes foram obtidas de outros seguimentos dessa coorte. A prevalencia de lesoes bucais foi de 23,3% (IC95%: 20,3-26,6), e 31% dos individuos (IC95%: 27,6-34,4) relataram nunca ter realizado o autoexame da boca. A analise multivariavel mostrou que o baixo nivel socioeconomico ao nascimento, nao ter recebido instrucao de higiene oral ate os 15 anos de idade e fumar aos 22 anos foram associados a presenca de lesoes. A realizacao do autoexame bucal esteve associada a maior escolaridade materna ao nascimento e a ter recebido orientacao de higiene bucal pelo dentista aos 15 anos. Fatores socioeconomicos e comportamentais estao associados tanto a presenca de lesoes bucais quanto a realizacao do autoexame bucal.

Factores asociados a la prevalencia de lesiones bucales y a la realización del autoexamen bucal en adultos jóvenes de una cohorte de nacidos vivos del sur de Brasil

The objective of this study was to assess the prevalence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regarding exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of individuals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.O objetivo foi determinar a prevalencia e caracteristicas de lesoes bucais, autoexame bucal e suas associacoes com determinantes ao longo da vida em uma populacao de adultos jovens. Uma amostra representativa (n = 720) dos nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1982, foi investigada, e a presenca de lesoes bucais e a realizacao do autoexame, verificadas aos 24 anos. As variaveis independentes foram obtidas de outros seguimentos dessa coorte. A prevalencia de lesoes bucais foi de 23,3% (IC95%: 20,3-26,6), e 31% dos individuos (IC95%: 27,6-34,4) relataram nunca ter realizado o autoexame da boca. A analise multivariavel mostrou que o baixo nivel socioeconomico ao nascimento, nao ter recebido instrucao de higiene oral ate os 15 anos de idade e fumar aos 22 anos foram associados a presenca de lesoes. A realizacao do autoexame bucal esteve associada a maior escolaridade materna ao nascimento e a ter recebido orientacao de higiene bucal pelo dentista aos 15 anos. Fatores socioeconomicos e comportamentais estao associados tanto a presenca de lesoes bucais quanto a realizacao do autoexame bucal.