Marcelo Carlos Bortoluzzi

Impact of traumatic dental injuries on the quality of life of schoolchildren.

BACKGROUND  Knowledge of the impact of traumatic dental injuries (TDI) on childrens quality of life is sparse. AIM  To determine the association between TDI and oral health-related quality of life (OHRQoL) among schoolchildren aged 11-14 years. MATERIAL AND METHODS  A cross-sectional study was carried out involving a representative sample of 409 schoolchildren from 13 municipalities in the Midwest Region of the Brazilian Southern State of Santa Catarina. Clinical examination included the presence and type of TDI and the treatment provided (or needed) according to criteria used in the UK Childrens Dental Health Survey. Dental caries in anterior teeth and malocclusion status were also collected according to WHO criteria. OHRQoL was assessed using the short form of the Child Perceptions Questionnaire (CPQ11-14), and the outcome was the prevalence of one or more adverse impacts on quality of life occurring often/very often. RESULTS  The prevalence of TDI was 16.6% (95% CI 13.0-20.2). The prevalence of one or more adverse impacts occurring often/very often was 46.6% (95% CI 41.7-51.5). Logistic regression modeling for the outcome indicated an independent and significant association between the prevalence of one or more adverse impacts occurring often/very often and the presence of TDI even after adjustment for gender, presence of dental caries in anterior teeth and malocclusion. A prevalence ratio of 1.79 (95% CI 1.16-2.76) of one or more adverse impacts occurring often/very often in schoolchildren with TDI was found, compared to those without TDI. CONCLUSIONS  Traumatic dental injuries appear to affect schoolchildrens OHRQoL.

Does smoking increase the incidence of postoperative complications in simple exodontia

OBJECTIVE To investigate whether smoking has adverse effects in simple exodontia. METHODS A single-centre, prospective study of postoperative inflammatory complications in simple exodontia was performed. All procedures were conducted under similar and sterile conditions. Postoperative complications (PCs) in exodontia were classified as alveolar osteitis (AO) or alveolar infection (AI) and their incidences then added. RESULTS A logistic regression model for PCs revealed tooth sectioning [odds ratio (OR) = 4.3, 95% confidence interval (CI) 1.0-18.8; P = 0.050], smoking (OR = 4.5, 95% CI 1.0-18.9; P = 0.03) and amount of smoking (> 20 cigarettes/day: OR = 12.3, 95% CI 1.0-149.8; P = 0.04) to be associated with the occurrence of PCs. CONCLUSIONS Tooth sectioning, smoking and degree of smoking are all associated with the development of PCs such as AO and AI after simple exodontia. Dentists must be alert to these factors when performing simple exodontia in smokers in view of the increased risk for PCs.

Impact of Dentofacial Deformity on Quality of Life: Age and Gender Differences Evaluated Through OQLQ, OHIP and SF36

ABSTRACT Objectives The aim of this study was to verify the impact of dentofacial deformity on quality of life and explore gender and age differences. Material and Methods The impact of dentofacial deformity (DD) on quality of life was evaluated through questionnaires; Short Form Health Survey (SF36), Oral Health Impact Profile Questionnaire (OHIP), Orthognathic Quality of Life Questionnaire (OQLQ) and a single question answered by a Visual Analogue Scale. Results Significant differences between male and female patients were observed in domains of OQLQ (oral function, P = 0.006; awareness of facial deformity, P = 0.018; and facial aesthetics, P < 0.001) and OHIP (physical pain, P = 0.006; psychological discomfort, P = 0.007; psychological disability, P = 0.006; and handicap, P = 0.01). Conclusions The impact of dentofacial deformity was more pronounced in female Brazilian population. Age of patients with dentofacial deformity produced impacts over quality of life in different ways and according to the applied questionnaire and the interaction between age and gender may also produce different impacts in patients with dentofacial deformity. The domains of Orthognathic Quality of Life Questionnaire, Oral Health Impact Profile Questionnaire and Short Form Health Survey showed unaccepted distances in the pattern of answer rising doubts of their ability to assess quality of life as a generic and broad concept. There is a necessity to create a single quality of life instrument capable to measure impacts with sensitivity and specificity and from a generic concept to condition-specific health problem.

Frequency of micronucleus in oral epithelial cells after exposure to mate-tea in healthy humans.

Objectives: The aim of this study was to evaluate the possibility of technique simplification for cytology slides in order to evaluate the frequency of micronuclei (FMic) and conduct a experiment looking to know the FMic of oral epithelial cells of healthy volunteers exposed to mate tea (Ilex paraguarariensis). Material and Methods: This is a laboratorial and nonrandomized trial (quasi-experiment), where the nonusers subjects were exposed to mate-tea, consumed in the traditional way, two drinks, two times a day for a single week. Two cytology of exfoliated epithelial cells were obtained before and after the mate tea exposition. Results: The sample was composed by 10 volunteers. The age ranged from 18 to 33 years (Mean 23; SD5.5). The use of mate tea did not showed significant variation in the FMic (Wilcoxon Signed Ranks Test p= .24). Conclusions: The proposed technique simplification showed to be reliable, without losses when compared to the conventional technique and with the advantage of eliminate toxic substances, becoming simple and practical tool for research in dentistry. The acute exposure to mate tea did not induce an increase of FMic in exfoliated buccal cells of healthy nondrinkers and nonsmokers subjects and may not have genotoxic effect. More human studies are needed before a conclusion can be made on the oral carcinogenic risk of mate tea to humans. Key words:Micronucleus, Oral Cancer, Cytology, Mate tea, Ilex paraguariensis.

Mandibular Fracture in A Patient Treated with A Protocol Prosthesis after 3 Years of Function due to Biomechanical Complications - Clinical Case Report

The article presentsa case of mandible fracturecaused by the lossof an implantina protocolprosthesis increasingcantilever, causingbone lossaround the implant. The fracturewas treatedbyrigid fixation, fourimplantsanda new prosthesis. The authors discuss the possible causes and prevention of this complication.

Predicting Pain After Tooth Extraction: Pain Prediction Index

AIMS To identify relevant variables that may predict pain after routine extraction of erupted teeth, to construct a Pain Prediction Index (PPI) based on these variables, and to verify how these variables are related by using valid structural equation modeling (ie, path analysis). METHODS This study was designed as an observational prospective study for postoperative memory of pain after dental extraction of erupted teeth. Data from a total of 781 surgical procedures related to dental extractions were included. Pain was self-reported by the patients and was evaluated by a verbal category scale (VCS) on the seventh postoperative day. The database was searched for predictive variables that were significantly (P < .05) associated with postoperative pain. RESULTS Pain was scored by patients as none in 65.4% of cases (511); light in 22.9% (179); moderate in 11% (86); and severe in 0.6% (5). Seven predictive variables were strongly related to postoperative pain: gender (female); age (younger than 33); number of extracted teeth (three); surgical technique (surgical flap, ostectomy, or teeth sectioning); number of local anesthetic cartridges (more than three); time in surgery (greater than 25 minutes); and any surgical complications. These variables were used to compose the PPI. The retained PPI classified 66.3% of the patients correctly for both pain and no pain; however, when more than three points were scored on the PPI, it correctly predicted pain in 55.6% of cases. CONCLUSION The present study identified seven predictive variables that were strongly related to postextraction pain and documented that the PPI could correctly predict pain in the majority of patients.

Nasolabial Cyst Associated with Odontogenic Infection

The nasolabial cyst or Klestadt cyst is a relatively uncommon nonodontogenic cyst that develops in the nasal alar region; it has uncertain pathogenesis. This lesion has slow growth and variable dimensions and is characterized clinically by a floating tumefaction in the nasolabial fold area around the bridge of the nose, causing an elevation of the upper lip and relative facial asymmetry. Diagnosis is primarily made clinically; if necessary, this is complemented by imaging. This paper reports the case of a 39-year-old male patient who complained of pain in the right upper premolar region and poor aesthetics due to a firm tumor in the right wing of the nose. Initially, this was thought to be due to an odontogenic abscess; however, the differential diagnosis was that a nasolabial cyst was communicating with the apex of teeth 14 and 15. Surgical treatment was carried out, followed by histopathological examination and concomitant endodontic treatment of the teeth involved.

Tooth Loss, Chewing Ability and Quality of Life

Objectives: The aim of this study was to observe the tooth loss over age in a sample of Brazilian patients and analyze their ability to chew, relating it to how much the lost of oral function impact over quality of life (QoL). Materials and methods: This is a single center, observational study and the data were collected through clinical examination followed of questionnaires to obtain socio demographic information, the ability to chew (through the index of chewing ability - ICA) and QoL (through Oral Health Impact Profile, OHIP-14). Results: The sample was composed of 171 random volunteers with mean age of 47 (SD 15.2). Low number of natural teeth was associated with increase in age (Spearman’s rho correlation coefficient -.7, P<.001, 2-tailed) and chew disability (ICA: chew’s ability versus disability) (Mann-Whitney U-Test, P<.001). Chew disability showed a negative impact over the QoL (overall OHIP; Mann-Whitney U Test P<.001) and in 5 of 7 OHIP domains (Functional Limitation, Physical Pain, Psychological Discomfort, Physical Disability, Psychological Disability). Age over than 40 years, was also associated with chewing disability (Pearson Chi-Square P<.001) and poorer quality of life (Mann-Whitney U test P=.01). Conclusion: This study observed that the chewing disability produce a significant and negative impact over oral health related quality of life and both, poor quality of life and chewing disability are related with the decrease of the number of natural teeth.