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Pesquisa Brasileira em Odontopediatria e Clínica Integrada, Volume: 22, Publicado: 2022
  • Evaluation of Knowledge Levels of Dentistry Students on the COVID-19 and its Effects on Depression Original Article

    Kızılcı, Esra; Demiroğlu, Cansu; Duman, Burcu; Gümüş, Hüsniye

    Resumo em Inglês:

    ABSTRACT Objective To determine the level of knowledge of dentistry students regarding the COVID-19 outbreak and to evaluate whether the risk factors of the outbreak cause depression. Material and Methods This study was conducted with 516 dentistry students (3rd, 4th and 5th grades) who started clinical practice in their education. The first part of the questionnaires applied to the students includes questions about demographic information, while the second part contains questions to determine their knowledge levels on the COVID-19 pandemic and protection against it. In the third section, Beck Depression Inventory (BDI) was used to examine depression symptoms. The data were analyzed by frequency analyses and Chi-squared tests via the IBM SPSS 22.0 software. Results Of the 516 students, 150 (29%) participants were in the 3rd, 212 (41%) were in the 4th and 154 (30%) were in the 5th grade. 355 (69%) students stated that their knowledge level about COVID-19 was high. 30.9% were conscious of the importance of using masks. 29.6% were aware of the importance of using gloves, 30.3% of not shaking hands. According to BDI scores, 37.1% of the participants seemed to experience moderate to severe and very severe depression. Conclusion It was observed that the students didn’t have a sufficient level of knowledge about the factors affecting the spread of the pandemic. New stress factors such as COVID-19 may increase the incidence of depression.
  • The Effect of Coloring Beverages on Color Stability of Hybrid Ceramics with Different Surface Treatments Original Article

    Jalali, Hamid; Mostafavi, Azam Sadat; Balaghi, Fatemeh

    Resumo em Inglês:

    ABSTRACT Objective To assess the effects of coloring beverages on the color stability of two types of hybrid ceramics with different surface treatments. Material and Methods 180 specimens of two hybrid ceramics (Vita Enamic and Mazic Duro) and a feldspathic ceramic (Vita Mark II) were prepared (n=60 in each group). Half of the discs in each group were glazed while the other was polished. The specimens were then divided into three subgroups and immersed in distilled water, carrot juice, and coffee. The overall color difference (∆E) was calculated based on CIE L*a*b* color space. Data were analyzed using three-way and one-way ANOVA; Tukey’s honest significant difference was also done for pairwise comparisons (α=0.05). Results Vita Mark II specimens revealed less overall color changes compared to other groups. The ∆E of the glazed Vita Enamic specimens was greater than polished specimens following immersion in distilled water (p=0.03) and coffee (p=0.001), but it was not significant for carrot juice. The same results were obtained for polished Mazic Duro specimens. Relatively similar amounts of ∆E were recorded in polished and glazed subgroups of Vita Mark II. Conclusion The ∆E of hybrid ceramics was higher than Vita Mark II. Polishing could be recommended for surface treatment of hybrid ceramics instead of glazing, saving time and facilitating the process.
  • The Xylitol Applicability and its Effects in Health Area Worldwide: A Bibliometric Analysis Based on Randomized Controlled Trials Original Article

    Martins, Mariana Leonel; Leite, Karla Lorene de França; Magno, Marcela Baraúna; Masterson, Daniele; Vicente-Gomila, José Miguel; Cavalcanti, Yuri Wanderley; Maia, Lucianne Cople; Fonseca-Gonçalves, Andréa

    Resumo em Inglês:

    ABSTRACT Objective To describe and evaluate the xylitol products’ applicability and its effects in the health area worldwide utilizing a bibliometric analysis from randomized controlled trials (RCT) with humans. Material and Methods Electronic searches were carried out in Medline/PubMed, Scopus, Cochrane Library, Web of Science, and VHL databases. The main data extracted were: year, area of applicability, type of treatment, country, journal, xylitol posology and concentration, presentation form, outcomes, and effects. Results From 1476 studies, 257 were included. These studies were published between 1973-2021. The majority was carried out in dentistry (73.9%) and under preventive treatment (67.4%). These studies were developed in the USA (15.4%) and published in Caries Research (6.6%). The posology and concentration ranged between 0.004-67 g/day and 0.002-100%, respectively. The xylitol is usually used in the chewing gum form (44.0%), and for antimicrobial activity evaluation (38.5%). A positive effect was observed in 204 studies (79.3%) and was associated with xylitol concentration ≥ 15(p=0.007). Side effects were reported in 8.2and were associated with posology ≥ 5 g/day (p=0.03). Conclusion Most studies with xylitol were conducted to prevent diseases in the dentistry field. The chewing gum form and antimicrobial activity evaluation were more frequent. Most xylitol products have a positive effect, and few studies report side effects.
  • Self-Reported Periodontal Disease and its Association with Dental Anxiety in Lagos, Nigeria Original Article

    Sorunke, Modupeore Ekua; Onigbinde, Olubunmi O.; Oyapero, Afolabi; Coker, Olurotimi A.

    Resumo em Inglês:

    ABSTRACT Objective To determine the relationship between dental anxiety and self-reported periodontal status. Material and Methods The study was conducted among 263 patients at the Family Medicine Clinic of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria. Self-assessed gingival and periodontal disease was measured using the validated periodontal disease self-report surveillance questionnaire. The Modified Dental Anxiety Scale (MDAS) was used for evaluating dental anxiety. Student’s t-test was used to test for association between categorical variables. P-value < 0.05 was considered to be statistically significant. Results Seventy-seven (29.3%) participants had high dental anxiety, while 49 (18.6%) had very high dental anxiety. The prevalence of periodontal disease was higher among those with very high dental anxiety (77.6%), while female respondents had a significantly higher proportion of self-reported periodontitis (34.1%). There was a significantly higher prevalence of very high dental anxiety among respondents who had never visited the dentist (23.2%). Similarly, females (19.4%), middle-class respondents (30.8%), and those with a primary level of school education (23.5%) had a higher prevalence of high dental anxiety, even though the association was not significant. Conclusion The prevalence of self-reported periodontal disease among the respondents with very high dental anxiety was higher than in those with high dental anxiety and those without dental anxiety, but the difference was not significant.
  • Effect of Chelating Agents on Push-Out Bond Strength of NeoMTA Plus to Root Canal Dentin Original Article

    Anju, Pattath Kunjan; Purayil, Tina P.; Ginjupalli, Kishore; Ballal, Nidambur V.

    Resumo em Inglês:

    ABSTRACT Objective To evaluate and compare the effect of 17% Ethylenediaminetetraacetic Acid (EDTA), 9% Etidronic acid (HEDP), and 7% Maleic acid (MA) on the push-out bond strength of NeoMTA Plus sealer to the coronal, middle, and apical thirds of root canal dentin. Material and Methods Forty single-rooted human maxillary central incisors were selected and decoronated to 12 mm long root fragments. Working length was established and root canals were then enlarged up to rotary Protaper F3. After each instrumentation, the root canal was irrigated with 2.5% NaOCl. For the final irrigation regimen, the specimens were divided into 4 groups (n=10) and treated with EDTA, HEDP, MA or Saline. Root canals were coated with NeoMTA Plus sealer, and obturation was done with single cone obturation technique. Subsequently, three horizontal sections were taken from the coronal, middle and apical thirds of each specimen, and POBS was measured using a universal testing machine. The type of bond failures was assessed under a stereomicroscope. Statistical analysis was done with One-way ANOVA with Tukey’s Post hoc analysis. Results MA and EDTA showed the highest POBS. There was no significant difference in bond strength between MA and EDTA (p>0.05). HEDP and Saline showed lower POBS. Among all the four groups, the coronal third showed the highest values, followed by middle and apical thirds. Conclusion The type of chelating agent used during the root canal treatment significantly affects the bond strength of NeoMTA Plus to the root canal dentin.
  • Evaluation of the Frequency of Occupational Hazards Among a Group of Iranian General Dentists and its Prevention Criteria Original Article

    Afshar, Mehrnaz Karimi; Faryabi, Reza; Afshar, Marzieh Karimi; Torabi, Molook

    Resumo em Inglês:

    ABSTRACT Objective To evaluate the frequency of occupational hazards and the criteria for their prevention among Iranian dentists. Material and Methods This cross-sectional study was conducted on 187 general dentists in Kerman. The data collection tool was a questionnaire including personal information (gender, age, marital status, condition and place and years of employment, and the average of weekly working hours) and a valid and reliable questionnaire of occupational hazards, including 24 questions about occupational hazards (6 domain) and nine questions about criteria for the prevention of the risks of dentistry. The t-test, chi-square, and linear regression were used. Results 92 (49.2%) were men. The mean and standard deviation of the score of occupational hazards was 27.04±16.21 out of 96, and the criteria of prevention were 22.00±7.28 out of 36. Regression analysis showed significant correlations between single statuses, years of occupational and type of employment, weekly work hours and occupational hazards, participation in occupational injury identification courses, and hepatitis vaccination. In addition, there were significant correlations between gender, age, weekly work hours, and preventive measures. Moreover, 3.2% of dentists were in a high-risk group and 26.2% were weak in preventive measures. Conclusion A total of 32.6% of dentists are at moderate risk of occupational hazards, and 10.7% meet the prevention criteria properly. It is recommended to hold training classes to identify occupational hazards and the criteria for their prevention among dentists.
  • Visual Inspection and Toothbrush Care: A Mother-Baby Paired Cross-Sectional Study Original Article

    Ribeiro, Yuri Jivago Silva; Peixoto, Iza Teixeira Alves; Segato, Raquel Assed Bezerra; Nelson Filho, Paulo; Queiroz, Alexandra Mussolino de; Paula-Silva, Francisco Wanderley Garcia

    Resumo em Inglês:

    ABSTRACT Objective To evaluate the physical conditions and presence of residues of toothbrushes used by mothers and their babies and mothers' knowledge about toothbrush care. Material and Methods This was a cross-sectional study comprising a convenience sample represented by 60 mother-baby pairs. The mothers answered a questionnaire to evaluate their knowledge of toothbrush care. A calibrated dentist performed a visual inspection of the toothbrushes. Statistical analysis was performed using the chi-square and Fisher’s exact tests, with a significance level of 5%. Results It was found that 82% of the mothers had never received instructions regarding the care of toothbrushes after use (p=0.024). Most of them believed that their toothbrushes (70%) and their children’s toothbrushes (88%) were in good condition to use (p=0.043). However, most mother’s toothbrushes presented an unacceptable deformity of the bristles (65%) and the presence of residues (60%). In addition, babies’ toothbrushes also presented unacceptable deformities of the bristles (52%) and residues (55%). There was an association between the lack of instructions received by the mother and the presence of deformity and residues on the mother’s toothbrush bristles (p=0.037 and p=0.003, respectively). Conclusion Most mothers had never received instructions regarding toothbrush care, which is reflected in the condition of their and their baby’s toothbrushes, which presented unacceptable physical conditions concerning deformation and presence of residues.
  • Cytotoxicity of Reparative Endodontic Cements on Human Periodontal Ligament Stem Cells Original Article

    Pedrosa, Marlus da Silva; Alves, Tomaz; Rahhal, Juliana Garuba; Nogueira, Fernando Neves; Sipert, Carla Renata

    Resumo em Inglês:

    ABSTRACT Objective To compare the cytotoxicity of commercial reparative endodontic cements on human periodontal ligament stem cells (hPDLSCs). Material and Methods The culture of hPDLSCs was established. Cell density was set at 2 × 104 cells/well in 96-well plates. Extracts of Biodentine, Bio-C Repair, Cimmo HD, MTA Repair HP and White MTA were prepared. Then, the extracts were diluted (pure, 1:4 and 1:16) and inserted into cell-seeded wells for 24, 48, and 72 h to assess cell viability through MTT assay. hPDLSCs incubated with culture medium alone served as a negative control group. Data were analyzed by Two-Way ANOVA and Tukey’s test (α=0.05). Results At 24 h, pure extract of MTA Repair HP and Biodentine 1:16 presented higher cell viability compared to control. Lower cell viability was found for pure extract of Cimmo HD, MTA Repair HP 1:4 and 1:16, and White MTA 1:16. At 48 h, pure extract of Bio-C Repair and MTA Repair HP presented higher cell viability compared to control. At 72 h, only the pure extract of MTA Repair HP led to higher cell proliferation compared to control. Conclusion Biodentine, Bio-C Repair and MTA Repair HP were able to induce hPDLSCs proliferation. Cimmo HD and White MTA were found to be mostly cytotoxic in hPDLSCs.
  • Staff Knowledge and Attitudes Towards COVID-19 New Biosafety Practices at a Brazilian Dental School Original Article

    Marques-Medeiros, Ana Carolina; Martins, Renata Castro; Silva, Maria Elisa Souza e; Vilaça, Ênio Lacerda; Souza, Leandro Napier de; Martins, Maria Auxiliadora Parreiras; Gomez, Ricardo Santiago; Guimarães de Abreu, Mauro Henrique Nogueira

    Resumo em Inglês:

    ABSTRACT Objective To evaluate knowledge and attitudes towards biosafety recommendations during the COVID-19 pandemic at a Brazilian dental school. Material and Methods A cross-sectional study was performed in 2020 with the clinical staff of a Brazilian dental school. The whole clinical staff was sent pre-tested self-administered online questionnaires about knowledge and attitudes towards the recommendations for biosafety in dental settings in the context of the COVID-19 pandemic. Descriptive statistical analyses were carried out for proportion calculation. Results Disposable head covering caps, isolation gowns, and gloves were the most frequently reported personal protective equipment (PPE). The rates ranged from 52.9% to 88.5% for N95 respirators, from 68.6% to 92.6% for face shields, from 47.4% to 67.5% for conventional eye protection shields, and 45.1% to 77.4% for eye protection with solid side shields. Chlorhexidine gluconate was the most frequent mouthwash indicated before clinical dental care. The percentage of agreement to provide clinical care to patients with suspected COVID-19 varied from 23.5% to 50.0%. The percentage of respondents who agreed that bioaerosol-generating procedures should be avoided was higher than 74.5%. Less than 50% knew the correct sequence for doffing of PPE. Conclusion This study revealed important gaps in knowledge and attitudes towards prevention and control measures against infection in dental environments in the context of COVID-19, indicating the need for improvements.
  • In Vitro Microscopic Evaluation of Metal- And Zirconium-Oxide-Based Crowns’ Marginal Fit Original Article

    Heboyan, Artak; Marya, Anand; Syed, Azeem Ul Yaqin; Khurshid, Zohaib; Zafar, Muhammad Sohail; Rokaya, Dinesh; Anastasyan, Marine

    Resumo em Inglês:

    ABSTRACT Objective To evaluate the marginal adaptation of computer-aided designing and computer-aided machining (CAD/CAM) fabricated cobalt-chromium and zirconium-oxide-based ceramic crowns compared to those produced by a conventional method. Material and Methods The study consists of three groups; 45 crowns fabricated from cobalt-chromium (CAD-CoCr) and 45 crowns manufactured from zirconium CAD/CAM technology (CAD-Z), and 45 control (C) which consists of conventional metal-ceramic crowns. The marginal discrepancies in vertical dimensions were assessed utilizing a microscope in four surfaces (mesial, distal, vestibular, and oral) for each crown. On completion of the microscopic evaluation, multivariate analysis of variance (MANOVA) was used to study the difference in the four surfaces, considered altogether. Two-way ANOVA revealed the effect of three systems used for gap measurements of each landmark. The differences observed were considered significant at p<0.05. Results There were no differences in the four surfaces revealed by АNOVА in the three groups when considered altogether. Two-way ANOVA of each surface discovered no differences among all groups as well. Conclusion The CAD/CAM crowns revealed a comparable and satisfactory marginal adaptation compared to conventional metal-ceramic crowns.
  • Brazilian Adults Believe that Complete Dentures would be the Solution to the Oral Impacts Caused by Reduced Dentition Original Article

    Campos, Fernanda Lamounier; Kawachi, Ichiro; Rhodes, Gabriela Aparecida Caldeira; Sampaio, Aline Araujo; Chalub, Loliza Luiz Figueiredo Houri; Ferreira, Raquel Conceição

    Resumo em Inglês:

    Abstract Objective: To evaluate the direct and oral impact-mediated association between reduced dentitions and the self-perceived need for complete dentures (CD) in dentate adults. Material and Methods: Data from the Brazilian Oral Health Survey (2010) were analyzed. The outcome was self-perceived need for CD. Functional dentition (FDClassV) was defined by the presence of the following criteria: level I - ≥1 tooth in each arch, level II - 10 teeth in each arch, level III - 12 anterior teeth, level IV - ≥ 3 posterior occluding pairs (POPs) of premolars and level V - ≥1 bilateral POPs of molars. Oral impacts were assessed with Oral Impacts on Daily Performances scale. Results: FDClassV was associated with a less self-perceived need for CD both directly and mediated by oral impacts. Dentitions without level V were associated with the outcome mediated by oral impacts. Between individuals with 10 teeth in each arch, self-perceived need for CD was similar for those who had or not anterior teeth and POPs. Individuals with <10 teeth in each arch and level III did not have a higher frequency of self-perceived need for CD compared to those with level II. Conclusion: Oral impacts mediated the association between reduced dentitions and self-perceived need for CD. Individuals with tooth loss may report need for CD, even when they have dental configurations compatible with functionality.
  • Tooth Loss, Sociodemographic Conditions and Oral Health-Related Quality of Life in the Elderly Original Article

    Aguiar, Adriana Drummond de; Oliveira, Elizabeth Regina Araújo de; Miotto, Maria Helena Monteiro de Barros

    Resumo em Inglês:

    Abstract Objective: To verify the association between impacts produced by tooth loss and sociodemographic variables in the oral health-related quality of life (OHRQoL) in the elderly. Material and Methods: This is an analytical cross-sectional study carried out in the municipality of Vitória/ES, Brazil, which sample was composed of 402 older adults. The Oral Health Impact Profile (OHIP-14) was used to measure the individuals' OHRQoL. For data analysis, descriptive and bivariate analyses were performed using the Fisher's exact test and the Mantel-Haenzsel test to assess the effects of combined dimensions. The significance level adopted was 5%. To assess the strength of association between independent variables and dimensions, Odds-Ratio (OR) with 95% confidence interval (CI) was calculated. Results: The prevalence of negative impact on OHRQoL in the elderly was 32.6%. The greatest impact perception was found in individuals with up to 10 years of schooling (p=0.021 and OR=1.602), with need for removable partial dentures (p=0.000 and OR=2.873) and those who did not accept the loss of dental elements (p=0.000 and OR=3.064). Conclusion: Older female adults with socioeconomic class C/D-E, with up to 10 years of schooling, who lost 11 or more teeth, who declared the need for removable partial dentures, suffered greater impacts caused by tooth loss on OHRQoL.
  • Evaluation of Antimicrobial Photodynamic Therapy as an Adjuvant in Periodontal Treatment in Individual with Down Syndrome Original Article

    Silva, Maria das Graças Barbosa da; Fernandes Neto, José de Alencar; Catão, Maria Helena Chaves de Vasconcelos

    Resumo em Inglês:

    Abstract Objective: To evaluate the effectiveness of Antimicrobial Photodynamic Therapy (aPDT), associated with scaling and root planing in the non-surgical periodontal treatment of individuals with Down Syndrome. Material and Methods: A controlled, randomized, split-mouth study was conducted. A total of 8 participants diagnosed with Down Syndrome aged 17-38 years of both sexes with clinical periodontitis were included in the study. Participants were treated at least three times: at the baseline, Plaque Index (PI), Bleeding on Probing (BOP), and Probing Pocket Depth (PPD) were obtained. After one week, conventional scaling and root planing were performed, and two quadrants were randomly selected for aPDT application. The reassessment was obtained one month after the aPDT application. The significance level was set at 5%. Analyses were performed considering a 95% confidence interval. Results: In the intergroup evaluation, no statistically significant differences were observed (p>0.05). In the intragroup evaluation, no statistically significant variations were observed in relation to the PI (p>0.05) and PPD (p>0.05); however, a statistically significant reduction in the BOP was observed between the test group (p=0.013) and control group (p=0.015). Conclusion: The use of aPDT as adjuvant therapy did not promote additional benefits in decreasing PI and PPD after 1 month of treatment. However, a significant reduction in the BOP was observed in the intragroup evaluation.
  • Patients’ Management Patterns for Restorative Treatment Procedures: A 4-Year Overview at the Restorative Clinic of a Tertiary Hospital in Nigeria Original Article

    Awotile, Adenike Ololade; Oyapero, Afolabi; Adenuga-Taiwo, Olugbenga A.; Enone, Lillian Lami; Menakaya, Ifeoma Nkiruka; Loto, Adolphus Odogun

    Resumo em Inglês:

    Abstract Objective: To determine the patients’ management pattern for restorative treatment procedures at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital (LASUTH). Material and Methods: A descriptive and retrospective study design was employed to determine patients’ management patterns for the restorative treatment procedures at the Restorative Dentistry Clinic at LASUTH. Treatment records of patients who attended the Restorative Clinic at the Lagos State University Hospital, Ikeja, Lagos, Nigeria, from 2011 to 2014 were reviewed; the effective treatments during the period under review were recorded as treatment procedures and were recorded as operative, endodontic, fixed prosthodontics, and removable procedures. Results: A total of 14,437 (75%) operative; 1,353 (7.0%) endodontic; and 559 (2.9%) fixed prosthodontics and 2,852 (14.9%) removable prosthodontic procedures were carried out during the period under review. This study showed that operative procedures were the most performed restorative procedures, whereas removable prosthodontics and endodontic procedures ranked second and third, respectively, to operative procedures. Fixed prosthodontics procedures were the least performed restorative procedures. Conclusion: This study showed that more efforts were being expended by dentists on operative services compared to endodontic, removable, and fixed prosthodontics services combined. Comprehensive studies, embracing all disciplines of dentistry, should be carried out to determine the level of demand and clinical relevance of procedures in clinical dental practice and hence to set specific and general objectives of dental education for the populace. Access to dental health Insurance services should also be increased in the country.
  • Assessment of Children's Oral Health-Related Knowledge and Self-Efficacy in Expectant Mothers of Najran, Saudi Arabia Original Article

    Khan, Siraj Dain Ali Ahmed; Al-Garni, Musleh; Khurim, Mishary Nasser Al; Alkhathami, Eidan Safir; Sayhab, Bader Hussain Al; Salaah, Farhaan Mahdi Al; Qshanin, Khalaf Nasser Al

    Resumo em Inglês:

    Abstract Objective: To assess the knowledge of pregnant women regarding their child’s oral health. Material and Methods: A questionnaire was developed and the 1st section comprised sociodemographic variables. The second section contained questions about the eruption of teeth, fluoride importance, cariogenic food, and dental visits. The questionnaire was shared electronically via a link to the receptionist of the gynaecologist at different health centres of Najran to be filled by expectant mothers. The convenient sampling method was used to collect the responses. Data were presented using descriptive statistics. Results: A total of 572 pregnant women participated in this survey. Three hundred and fifteen (55.1%) knew that 1st primary tooth erupts at the age of 6 months. The majority of the respondents (n=332) agreed that toothbrushes and toothpaste could be used to clean a child's teeth; only 5.4%, 10%, and 24.5% preferred miswak, mouthwash, and toothbrush, respectively. Participants were well familiar with cariogenic food and occasionally allowed their children to take it. They have enough knowledge about fluoride toothpaste, but they were not familiar with the benefits of fluoride varnish. Almost 50% of the respondents agreed that the child should visit the dentist within six months, and 27.4% said they should visit the dentist whenever there is a problem. Conclusion: Almost 50% of participants showed a positive attitude towards most questions. However, there is a need to improve their behaviour and knowledge about many aspects of dental care.
  • Does the Use of Surface Electromyography Could Improve Quality of Life among Patients Rehabilitated by Mandibular Overdentures on Different Attachments? Original Article

    Fera, Maria; Goncharuk-Khomyn, Myroslav; Fera, Oleksandr; Bokoch, Anatoliy; Keniuk, Andrii; Kryvanych, Andriy

    Resumo em Inglês:

    Abstract Objective: To analyze and compare changes of quality of life parameter among dental patients rehabilitated by the implant-supported overdentures with different attachment systems. Material and Methods: Forty-eight patients were recruited as a study cohort. The implant placement procedure was based on the results obtained by CBCT scanning and individualized surgical templates manufactured for correct implant placement. Each individual received two k3Pro Implants (Sure Type with 4.0 or 4.5 mm in diameter) at the intraforaminal area due to standard protocol of implantation provided by the manufacturer under local anesthesia. All patients were distributed between two groups based on the fact of using either Locator- or ball-attachments. Rank correlation was measured using Spearman correlation coefficient, while linear correlation was evaluated by Pearson correlation coefficient. Results: No statistically meaningful differences were noted regarding patients’ distribution among groups considering age (p>0.05) and gender (p>0.05). Provided patient-level analysis demonstrated that increase of conventional full denture service time was positively correlated with escalation of OHIP-EDENT scores. The most prominent inter-correspondences were noted specifically between longevity of denture service and elevation of scores within “Functional limitation” (r=0.61; p<0.05), “Physical pain” (r=0.51; p<0.05) and “Physical disability” (r=0.57; p<0.05) subdomains. No statistically argumented regressions were noted between increase tendency of OHIP-EDENT scores and gender (p>0.05) or age (p>0.05) parameters. Conclusion: Significant improvements of quality of life measured with OHIP-EDENT were noted for both types of attachments compared to the pre-treatment situation independently of additionally provided surface electromyography-based alignment.
  • Comparison of Oncostatin M in Patients with Chronic Periodontitis with and without Diabetes Original Article

    Kolluri, Amulya; Gopalkrishna, Pratibha; Josyula, Venkat Rao; Gatta, Aditya Kiran; Chakravarthy, Kalyana Pentapati

    Resumo em Inglês:

    Abstract Objective: To compare the Oncostatin M (OSM) concentrations in tissues of patients with chronic periodontitis with and without diabetes. Material and Methods: Sixty-four subjects visiting the dental outpatient department were categorized as “healthy” (Group 1), “periodontitis” (Group 2), and “diabetes with periodontitis” (Group 3) groups. The clinical oral examination included assessment of plaque, gingivitis, probing depth, clinical attachment level. Blood glucose was assessed for group 3 patients. OSM concentration in the tissues was assessed using ELISA in all groups. Results: The mean OSM was 0.02 ± 0.04 pg/mg in the healthy group, 0.12 ± 0.09 pg/mg in the chronic periodontitis group and 0.13 ± 0.10 pg/mg in the diabetes-periodontitis group. A significantly higher mean OSM was seen in Group 2 and Group 3 than Group 1. The amount of OSM positively correlated with probing depth and clinical attachment level. Conclusion: Periodontal disease causes a rise in Oncostatin M, independent of the diabetic status. Expression of OSM in the gingival tissues can serve as an inflammatory marker.
  • Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study Original Article

    Rodrigues, Gabriella Fernandes; Monteiro, Amanda Souza Nunes; Vollú, Ana Lúcia; Pires, Paula Maciel; Silva, Aline Saddock de Sá; Lopes, Ricardo Tadeu; Oliveira, Branca Heloisa; Neves, Aline de Almeida; Barja-Fidalgo, Fernanda; Fonseca-Gonçalves, Andréa

    Resumo em Inglês:

    Abstract Objective: To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dentin caries lesions when applied under different concentrations and times. Material and Methods: Forty-two bovine blocks were selected and fixed in 24-well plates. Each well received a mixed bacterial inoculum added to the culture medium with 5% sucrose. The plates were incubated in microaerophilia (7 days) for caries formation, confirmed by micro-CT (M1). SDF was applied over the carious lesions for different times and concentrations (n=6): SDF 30% - immediate removal, 1 minute and 3 minutes; SDF 38%, - immediate removal, 1 minute and 3 minutes. The group without treatment was the control. Then, the samples were again scanned by micro-CT (M2) and submitted to a second cariogenic challenge for 21 days. Then, a final scan was performed (M3). Results: Mean pH at the culture medium and lesion depth were compared using Kruskal-Wallis and Wilcoxon tests. 38% SDF showed the lowest metabolic activity of the biofilm. All 38% groups and 30% 1 and 3 minutes did not show an increase in mean lesion depth comparing M3 with M1. However, only 30% 3 minutes and 38% 1 and 3 minutes showed a significant reduction of lesion depth. Conclusion: The minimum application time of 30% SDF to arrest dentin caries lesion was 1 minute, while 38% SDF arrested with application and immediate removal.
  • Pediatric Oral Health Self-reported by Caregivers of NormalHearing and Hearing-Impaired Children Original Article

    Miranda, Mayane Sarah Soares; Mourão, Aline Mansueto; Lamenha-Lins, Renata Matos; Nogueira, Raquel Fabiane; Carcavalli, Larissa; Lisboa, Sara Oliveira; Ferreira, Fernanda Morais; Serra-Negra, Junia Maria

    Resumo em Inglês:

    Abstract Objective: To verify and compare the sociodemographic data and caregivers’ self-perception of children’s oral health condition, hygiene habits and seek for dental services among family units of deaf and normalhearing children. Material and Methods: A comparative cross-sectional study was conducted with 64 parents/caregivers of 16 deaf and 48 normal-hearing children of 3-14 years old, belonging to reference centers in Belo Horizonte, southeastern Brazil. Deaf and hearing children were matched according to their sex and age. Sociodemographic characteristics of the family units and self-report of oral health conditions and care were assessed using a structured questionnaire, including information regarding seeking pediatric dental services. Descriptive analysis and chi-square test were performed (p<0.05). Results: Most individuals in the sample were mothers (84.4%). Low family income (p=0.024) and higher education level of guardians (p=0.018) were associated with families of hearing children. The report of clinical treatment or toothache as the main reason for the children’s last dental appointment was associated with families of deaf children (p=0.047). Conclusion: Based on caregivers’ reports, hearing-impaired children demonstrated greater vulnerability to present dental pain or clinical treatment as the main reasons for their last access to dental appointments.
  • Daily Toothbrushing Frequency and the Association with Parental Report of Dental Pain and Discomfort in Preschool Children Original Article

    Menoncin, Bruna Letícia Vessoni; Felipak, Patrícia Kochany; Fraiz, Fabian Calixto; Souza, Juliana Feltrin de; Menezes, José Vitor Nogara Borges

    Resumo em Inglês:

    Abstract Objective: To evaluate the impact of daily toothbrushing frequency on parental reports of dental pain and discomfort in preschoolers. Material and Methods: An observational cross-sectional study was conducted involving 376 children between four and five years of age at public preschools in the city of Campo Magro, Brazil. Parents/guardians answered a socioeconomic questionnaire that contained a single question on the child's daily toothbrushing frequency and the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B). Statistical analysis involved bivariate and multivariate Poisson regression analyses (α=0.05). Results: After the adjustments in the multivariate analysis, the prevalence of dental pain and discomfort was lower among children whose last visit to the dentist was for prevention (PR = 4.42; 95% CI: 1.75– 11.14; p=0.002) and those with a higher daily toothbrushing frequency (PR = 2.13; 95% CI: 1.12–4.05; p=0.021). Conclusion: A lower toothbrushing frequency is associated with parental reports of dental pain and discomfort in preschoolers. Educational and preventive measures that stimulate an increase in daily toothbrushing frequency can contribute to a better oral health status in preschoolers, consequently, less prevalence of dental pain and discomfort.
  • Smile Arc Esthetics in Middle-Aged Man from the Layperson’s Perspective Via Eye-Tracking Original Article

    Tanaka, Orlando Motohiro; Ribeiro, Vitor Gouveia; Gasparello, Gil Guilherme; Reyes, Ariel Adriano; Taffarel, Itamar Antonio; Vitral, Robert Willer Farinazzo

    Resumo em Inglês:

    Abstract Objective: To evaluate the perceptions of smile esthetics associated with variations in the vertical plane of the maxillary incisors in the smile arc using eye-tracking software. Material and Methods: An image of a 59-year-old Caucasian male model was adapted and edited to make three changes in the vertical plane, simulating a convex, straight, and reverse smile arc. Four areas of interest were inserted at the right and left eyes, nose, and mouth. Forty laypeople raters between 18 and 45 years of age participated of the study. Eye-tribe hardware and Ogama software were used to perform eye-tracking. Attractiveness and age-perception questions were also incorporated into the study. ANOVA test and Pearson’s correlation coefficient, at p < 0.05. Results: The most observed AOI in images with convex, straight, and reverse smiles, as assessed using heatmaps and point maps, was the mouth, followed by the right eye. A significant difference for the eye (p=0.02) was found when comparing convex and reverse smiles, whereas a significant difference for the mouth was observed between the straight and reverse smiles (p=0.03). Conclusion: Convex and straight smile arcs were associated with equal levels of attractiveness; the reverse smile was less attractive. No significant difference was noticed regarding age perception and the smile arcs. However, the reverse smile recorded a more complete fixation time.
  • Effectiveness of Chewing Gum Containing CPP-ACP for Remineralisation of Demineralised Enamel around Orthodontic Brackets: An in Situ Study Original Article

    Pithon, Matheus Melo; Santos, Amir Felipe Souza dos; Santos, Adrielle Mangabeira dos; Fidalgo, Tatiana Kelly da Silva; França, Adilis Kalina Alexandria de; Coqueiro, Raildo Silva; Andrade, Ana Carolina Dias Viana de; Oliveira, Dauro Douglas; Maia, Lucianne Cople

    Resumo em Inglês:

    Abstract Objective: To evaluate the effectiveness of chewing gums containing CPP-ACP in remineralisation of demineralised enamel around orthodontic brackets. Material and Methods: Enamel blocks from 120 bovine incisors were used. The blocks were flattened and polished, followed by the development of incipient subsurface caries. The blocks have been subjected to a baseline microhardness analysis. Orthodontic brackets were bonded to the exposed area of the blocks, reserving an area for hardness analysis. An in situ crossover (three-way crossover phases of 21 days with an interval of one week between them), controlled, randomised and blind experimental model was used, with the participation of 12 volunteers divided into groups: G1 – negative control group, without chewing gum; G2 – conventional sugar-free chewing gum, without CPP-ACP (placebo); and G3 – sugar-free chewing gum with CPP-ACP. The following parameters were analysed: superficial linear (Ra), volumetric roughness (Sa), and superficial structural loss, which was indicated by Gap measurement (difference between the healthy and treated area). Statistical tests used were the Friedman, Wilcoxon and Shapiro-Wilk, Kruskal Wallis' nonparametric tests and ANOVA. Results: There was a significant reduction in enamel microhardness after demineralisation in all the groups (p<0.05). This deleterious effect was attenuated in the three groups after the final evaluation, although there were no statistical differences (p<0.05); however, the final values did not return to the baseline values (p<0.05). Conclusion: Chewing gum containing CPP-ACP did not promote in situ remineralisation of demineralised enamel around orthodontic brackets.
  • Psychological Factors in Temporomandibular Disorders Patients during COVID-19 Pandemic: A Cross-Sectional Study Original Article

    Rocha, Thaís de Oliveira; Oliveira, Wagner de; Paula, Ângela Renata de; Oliveira, Daniela Lobo; Rode, Sigmar de Mello

    Resumo em Inglês:

    Abstract Objective: To assess the influence of the COVID-19 pandemic on levels of anxiety, stress, and orofacial pain in individuals with and without TMD. Material and Methods: In this cross-sectional study, the participants were divided into two groups (n=10, each) experimental group (EG) TMD patients and control group (CG), without TMD. The presence of TMD was confirmed using the RDC/TMD. The Beck Anxiety Scale (BAI), Perceived Stress Scale (PSS), and Oral Analog Scale were used for assessment. The Beck Anxiety Scale is composed of 21 multiple-choice questions describing symptoms of anxiety, while the PSS is a measure that evaluates life situations as stressful. An Oral Analogue Scale was applied to each individual to quantify orofacial pain, with 0 (zero) without pain and 10 (ten) being the worst pain ever felt. The comparison between groups was performed using the Mann-Whitney test. Logistic regression was used to verify TMD dependence in relation to BAI and PSS-10. Quantitative variables were correlated with each other by Pearson's correlation coefficient. The level of significance considered for all tests was 5%. Results: The association was statistically significant (p≤0.05) for BAI and PSS with a TMD. Conclusion: Although the COVID 19 pandemic has had a psychological impact on the general population, patients with TMD have higher levels of anxiety and stress than the control group.
  • Oral Health Literacy – Adult Questionnaire: Psychometric Properties and its Influence on Oral Health Status of School Teachers in Bhubaneswar, India Original Article

    Nagarajappa, Ramesh; Mahapatra, Ipsita; Satyarup, Dharmashree; Mohanty, Sharmistha

    Resumo em Inglês:

    Abstract Objective: To translate Oral Health Literacy – Adult Questionnaire from English to Odia language and test its psychometric properties and assess its influence on oral health status of school teachers. Material and Methods: A cross-sectional survey was performed among 400; 116 (29%) males and 284 (71%) female school teachers of Bhubaneswar. OHL-AQ questionnaire subsequent to being translated to Odia language utilizing World Health Organization recommended translation back translation protocol was then tested for the establishment of its psychometric properties with assistance from the selected expert panel of academicians. The oral health status of participants was assessed using the WHO oral health assessment form-2013. Chi-square, t-tests, one-way ANOVA, and linear regression were used for statistical analysis. Results: Internal consistency of OHL-AQ-O was acceptable with an alpha value of 0.70. Test-retest reliability showed almost perfect agreement (ICC=0.90, CI=0.85-0.93) indicating highly reliable translated scale (p=0.001). Overall mean oral health literacy scores were 13.02±1.86, with about 80% belonging to the high oral health literacy level group. Caries prevalence was 78%, with a mean DMFT of 3.04±2.55. Shallow pockets were absent majorly in teachers belonging to the high oral health literacy group (p=0.01). The multiple linear regression model depicted that only the teaching experience variable added significantly to the prediction (p=0.008). Conclusion: OHL-AQ-O questionnaire was found valid and reliable to measure OHL. Further application of the instrument in other communities and populations will support establishing the external validity of the OHL-AQ-O.
  • Pain Perception Before Endodontic Treatment: from Primary Care to Specialized Care Original Article

    Lima, Rafael Franco; Magalhães, Maria Beatriz Pires; Oliveira, Douglas Vaz; Freitas, Daniel Augusto Sabadini; Ferreira, Efigênia Ferreira; Martins, Renata Castro

    Resumo em Inglês:

    Abstract Objective: To analyze patients’ pain perception requiring endodontic treatment referred to a Dental Specialties Center. Material and Methods: Data was collected through a self-administered questionnaire for patients about their experience of pain and another for endodontists about the treatment performed. The results were analyzed descriptively using Pearson’s Chi-square test and Fisher’s Exact test, with Bonferroni correction (p≤0.05). Results: The median age of the patients was 39 years, and 71.1% were female. The median waiting time for treatment was five months. Pain was reported by 75.2% of patients, occurred more than one month earlier (63.6%), with moderate/severe intensity (66.9%), and most patients sought emergency treatment more than once (79.1%). In addition, pain was associated with sex (female; p=0.008); moderate/severe intensity (p<0.001); the number of times that patient had to go to the dentist because of the tooth treatment (twice or more; p=0.002); and type of tooth treated (posterior tooth; p=0.002). Conclusion: Severe pain episodes resulted in a repeated search for emergency services, which may overload the primary care service, especially if the waiting time for endodontic treatment is long.
  • Antibacterial and Antiadhesion Effects of Psidium guajava Fractions on a Multispecies Biofilm Associated with Periodontitis Original Article

    Gómez, Pablo Alejandro Millones; Mendizábal, Margarita Fe Requena; Poma, Roger Damaso Calla; Cifuentes, Tania Valentina Rosales; Quispe, Federico Martin Malpartida; Torres, Dora Jesús Maurtua; Amaranto, Reyma Evelyn Bacilio; Medina, Carlos Alberto Minchón; Contreras, Lusin Antonio Ponce

    Resumo em Inglês:

    Abstract Objective: To assess the antibacterial activity of Psidium guajava fractions and their effects on adhesion of a multispecies biofilm consisting of Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis in vitro. Material and Methods: Guava leaves were obtained from the mountains of northern Peru, where they grow wild and free of pesticides. The antimicrobial activity of 25 mg/mL petroleum ether, 25 mg/mL dichloromethane and 25 mg/mL methanol fractions of P. guajava was evaluated by measuring inhibition halos, as well as the effect on the adhesion of multispecies biofilms at 4, 7 and 10 days of growth by measuring the optical density. In addition, antimicrobial susceptibility was compared using the Kruskal-Wallis test and its multiple comparison tests, and differences in mean biofilm adhesion between each fraction were assessed by repeated measures analysis and the Tukey multiple comparison test. Results: The rank-based Kruskal-Wallis test highlighted differences in the effects of the fractions on the zone of inhibition for each oral bacterium, including S. gordonii (p=0.000), F. nucleatum (p=0.000), and P. gingivalis (p=0.000), the Tukey test showed that the group treated with 0.12% chlorhexidine exhibited the least amount of adhesion, followed by the group treated with the 1.56 mg/mL methanol fraction. Conclusion: The methanol fraction of P. guajava had an antibacterial effect on S. gordonii and P. gingivalis, and the 1.56 mg/mL methanol fraction decreased biofilm adhesion.
  • Qualitative Assessment of Surgical Repair of Three Types of Unilateral Cleft Lip Original Article

    Adetayo, Adekunle M.; Taiwo, Abdurazzak Olanrewaju; Adetayo, Modupe Olusola; Akinola, Moses A.; Adeyemo, Wasiu Lanre

    Resumo em Inglês:

    Abstract Objective: To assess the effect of the three types of unilateral cleft lip (UCL) [cleft lip only, cleft lip and alveolus, and cleft lip alveolus and palate] on the outcome of the repair. Material and Methods: This study was a case series of effect of types of UCL on the outcome of the repair. Fifteen subjects each were in three UCL phenotypes groups. Evaluation of the scar, lip, and nose was done qualitatively by both parents/guardians and professionals using a modified form of the criteria described by Christofides et al. (2006). Results: In the assessment of the surgical scar, the parents found a difference between the three types of cleft in terms of texture, shape, and width of the scar and presence of columella deviation. The professional assessors, however, only found the three types of cleft to be different in the presence of alar flattening. Conclusion: Differences truly exist in the outcome of surgical repair of the three types of unilateral cleft lip, especially in the aesthetics of the nose and in the width and shape of the residual lip scar. Thus, it is important to consider this in the assessment of UCL repair because putting the subtypes together might have a negative impact on the assessment.
  • Level of Satisfaction and Quality of Life of Caregivers of People with Disabilities in Secondary Dental Care Original Article

    Couto, Graziane Ribeiro; Fonseca, Emílio Prado; Amaral, Regiane Cristina do

    Resumo em Inglês:

    Abstract Objective: To assess the level of satisfaction and quality of life (QOL) of caregivers of Patients with Special Needs seen at the Dental Specialties Center in Aracaju, Brazil. Material and Methods: The Program for Primary Care Access and Quality Improvement (PMAQ – DSC) and the World Health Organization's Quality of Life - Brief (WHOQOL-BREF) questionnaires were applied to PSN and caregivers. Results: The PMAQ questionnaire was applied to 31 patients or caregivers; 97% had no paid work and 61% used public transportation to reach the Dental Specialties Center. The WHOQOL-BREF questionnaire was applied to 20 caregivers; 60% considered their life to be good; however, 60% had practically no leisure time. Correlation tests (Pearson’s coefficient) showed a statistically significant correlation between the physical and psychological domain (p=0.02; r=0.64), the psychological and social domain (p=0.033; r=0.48), and the psychological and environment domain (p<0.001; r=0.80). Conclusion: The caregivers and patients with special needs felt satisfied with the specialized oral health service offered by the municipality. Concerning the quality of life of caregivers, the majority stated they had a good quality of life, despite not having the opportunity to participate in leisure-oriented activities and often having negative feelings.
  • Comparison of the High Cycle Fatigue Behavior of the Orthodontic NiTi Wires: An in Vitro Study Original Article

    Farzanegan, Fahimeh; Shafaee, Hooman; Norouzi, Hamid; Bagheri, Hossein; Rangrazi, Abdolrasoul

    Resumo em Inglês:

    Abstract Objective: To compare the high-cycle fatigue behavior of four commercially available NiTi orthodontic wires. Material and Methods: Twelve NiTi orthodontic wires, round, 0.016-in, three per brand, were selected and divided into four groups: G1 - Heat-activated NiTi, G2 - Superelastic NiTi, G3 - Therma-Ti, and G4 - CopperNiTi. The atomic absorption spectrometry method was used to determine the chemical composition of investigated NiTi wires. We also performed a fatigue test at three-point bending using a universal testing machine for 1000 cycles in a 35 °C water bath. For the first and thousandth cycle, the average plateau load and the plateau length were determined in the unloading area of the force versus displacement diagram. In addition, we calculated the difference between the average plateau load of the first and thousandth cycle (∆F), as well as the difference between the plateau length of both cases (∆L). Results: According to our results, there were no significant differences between the average plateau load of the first and thousandth cycles of each group (p>0.05) and in the plateau length of the first and thousandth cycles of the groups (p>0.05). Conclusion: There were no significant differences between the groups changing the superelasticity property after high-cycle fatigue.
  • Oral Health Care of Children and Adolescents with Different Impairments of Cerebral Palsy: Barriers and Challenges Original Article

    Silva-Selva, Elizabeth Louisy Marques Soares da; Lins Filho, Paulo Cardoso; Macêdo, Thuanny Silva de; Freitas, Jaciel Leandro de Melo; Aguiar, Camilla Siqueira de; Vasconcelos, Márcia Maria Vendiciano Barbosa; Lima, Marília de Carvalho; Caldas Júnior, Arnaldo de França

    Resumo em Inglês:

    Abstract Objective: To evaluate the barriers to access and oral health care faced by children and adolescents with Cerebral Palsy (CP) according to their motor impairment through the perception of caregivers. Material and Methods: A case series study was carried out at three health institutions in Pernambuco, Brazil. The study sample consisted of 94 caregivers of 5-to-18-year-old patients with CP, according to GMFCS (The Gross Motor Function Classification System). Data were collected using a semi-structured form to evaluate the barriers to access and analyzed statistically by the chi-square and Fisher exact tests, adopting a 5% level of significance. In addition, binary logistic regression was performed to determine the weight of the variables in explaining the outcome variable. Results: There were major difficulties involving transportation (p=0.04) and structural accessibility to dental services (p<0.01) among children and adolescents with severe CP. In addition, the more severe the CP, the greater the difficulty of accessibility (OR=4.09,) and the lower the income (OR=8.80), the greater the motor impairment. Conclusion: Despite the availability of access to dental services, low-income families have more severe CP patients, contributing to the daily difficulties already faced by them in oral health care.
  • The Clinical Pattern and Prevalence of Streptococcus mutans and Streptococcus sobrinus among Adult and Children Patients with Dental Caries Original Article

    Zubaidah, Nanik; Dianawati, Nur; Ridwan, Rini Devijanti; Shirakawa, Toshiro; Kuntaman, Kuntaman; Setiawatie, Ernie Maduratna; Tanzil, Muhammad Iqbal; Kunarti, Sri

    Resumo em Inglês:

    Abstract Objective: To explore the clinical pattern, host factors, and presentation of Streptococcus mutans related to caries incidence among children and adults visiting Universitas Airlangga dental clinic. Material and Methods: This was an observational study with a cross-sectional approach with 50 patients in each group of carious children (6-12 years) and adults (18-35 years). Dental decay samples were taken by sterile excavator, put in a BHI’s transport medium, and directly incubated overnight at 37 ºC. The next day, they were sub-cultured microbiologically in Tryptone Yeast Cystine Sucrose Bacitracin (TYCSB) selective medium. Bacterial species and serogroups were examined by PCR. All patient’s data were collected from medical records and direct observation. Results: Caries were mostly media type in both children and adults. Oral hygiene (OHIS) in children was higher than in adults but not significantly different according to their DMFT. The highest scores for decay, missed and filled teeth were 16, 8 and 7, with an average of 6.82, 1.22 and 0.63, considered quite high. Conclusion: The prevalence of S. mutans was higher in children’s caries than in adults, but among the adult patients the co-incidence of S. mutans and S. sobrinus was associated with higher DMFT. The mutans serotypes e, f, and d were more prevalent among children than adults.
  • Fluoride Concentration in Public Water Supply in a City in the Amazon Region Original Article

    Bandeira, Rejane Helena Laranja; Rebelo, Maria Augusta Bessa; Freitas, Yan Nogueira Leite de; Quadros, Larissa Neves; Gomes, Andressa Coelho; Gomes, Andreia Coelho; Leite, Sarah Debora Camardella; Vieira, Janete Maria Rebelo

    Resumo em Inglês:

    Abstract Objective: To analyze the fluoride concentration in the public water supply in Manaus, Brazil. Material and Methods: Water samples were collected in 50 mL polyethylene bottles, identified, and labeled. The collection was performed from September 2016 to August 2018. For the selection of collection points, all neighborhoods of the city of Manaus, divided into four health districts (North, South, East, and West), were mapped. From each district, 30 samples were collected, totaling 120 monthly samples. Water samples were analyzed using an ion analyzer, ORION 720-A, and a specific electrode, ORION 96-09. The ion analyzer and electrode were calibrated in standard solutions. The levels were classified in intervals based on technical consensus to guide the health surveillance agencies. Results: Of the 2,874 water samples, 50.3% were within the recommended range, and 49.7% were inadequate, with 31.6% considered above the parameters and 18.1% below. Among the districts, the North had the highest percentages of unsatisfactory samples, resulting in limited action to prevent tooth decay. During the 24 months of analysis, there were large oscillations in the values in all four districts of Manaus. Conclusion: Results reinforce the importance of heterocontrol for the city to guarantee the effectiveness of this public health measure.
  • In Vivo Detection of External Apical Root Resorption Induced by Apical Periodontitis Using Periapical Radiography and Cone-Beam Computed Tomography Original Article

    Huamán, Stephanie Diaz; Arnez, Maya Fernanda Manfrin; Oliveira, Fernanda Maria Machado Pereira Cabral de; Rossi, Andiara De; Silva, Léa Assed Bezerra; Paula-Silva, Francisco Wanderley Garcia

    Resumo em Inglês:

    Abstract Objective: To compare the accuracy of periapical radiography (PR) and cone-beam computed tomography (CBCT) for the detection of external apical root resorption (EARR) due to root canal contamination. Material and Methods: Dog’s teeth with experimentally induced root resorption due to root canal contamination underwent or not root canal treatment (n=62). True positives (TP), false positives (FP), true negatives (TN), and false negatives (FN) in PR and CBCT diagnoses were determined using histopathologic findings as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (TP + TN) in the diagnosis of EARR were calculated. Data were compared using chi-squared test (α=0.05). Results: EARR was detected in 35% of roots by PR, in 47% by CBCT, and in 50% of the roots by microscopy (p=0.03 PR versus microscopy; p=0.67 CBCT versus microscopy). Overall, CBCT produced more accurate diagnoses than PR (p=0.008). PR and CBCT allowed the identification of large resorption in 100% of the cases and showed the same accuracy. However, for small resorptions, PR showed an accuracy of 0.83, whereas CBCT showed an accuracy of 0.96 (p=0.003). Conclusion: Cone-beam computed tomography showed higher accuracy in detecting external apical root resorption of endodontic origin.
  • Systemic Manifestations, Tooth Eruption and Enamel Defects in Children with Congenital Zika Virus Syndrome: 36-Month Follow-up Case Series Original Article

    Cavalcanti, Alidianne Fábia Cabral; Arruda, Taynná Dantas de; Aguiar, Yeska Paola Costa; Melo, Adriana Suely de Oliveira; Leal, Jeime Iara Bezerra de Freitas; Sakly, Emna Hidoussi; Goncharuk-Khomyn, Myroslav; Cavalcanti, Sérgio D’Avila L. B.; Cavalcanti, Alessandro Leite

    Resumo em Inglês:

    Abstract Objective: To describe systemic manifestations, the characteristics related to tooth eruption, and the occurrence of enamel defects in children with Congenital Zika Virus Syndrome (CZS). Material and Methods: Prospective case series based on nine children with confirmed CZS diagnosis assisted at a reference center in a municipality in the Northeast Region of Brazil. Through a structured interview directed to mothers, information related to prenatal, delivery, and postpartum periods was collected. Tooth eruption was monitored through clinical examinations for 36 months. The modified developmental defect of enamel index (DDE) was used to identify opacities and hypoplasia. Data were presented using descriptive statistics. Results: A high proportion (77.8%) had microcephaly, and 55.5% had low birth weight. Musculoskeletal disorders, swallowing difficulty, and self-injury practices were present in all children. Among the systemic findings, visual impairment (77.8%) and seizures (77.8%) were widely reported. Concerning disorders related to the stomatognathic system, bruxism (66.7%) and difficulty in sucking (33.3%) were present. For most children (77.8%), the deciduous right lower central incisor was the first tooth to erupt (minimum 8 months and maximum 17 months). Enamel defects were diagnosed in only two children (22.2%). Conclusion: A wide range of systemic manifestations was observed in children with CZS, including visual impairment and musculoskeletal disorders. Delayed eruption of the first deciduous tooth was also observed. Enamel defects were present in a small proportion of children.
  • Empathy in Professors and Students of a School of Dentistry in the Caribbean Original Article

    Díaz-Narváez, Víctor Patricio; Silva-Vetri, María Guadalupe; Calzadilla-Núñez, Aracelis; García, Ana Leonides Lopez; Lopez, Ana de la Portilla; Reyes-Reyes, Alejandro

    Resumo em Inglês:

    Abstract Objective: To estimate and compare the levels of empathy between undergraduate dentistry students and professors at a university in the Dominican Republic. Material and Methods: Cross-sectional and descriptive study. The studied population consisted of two groups. The first: students of the Dentistry Career (N=520; n=335: 64.42% of total students) were distributed in two areas, basic-preclinical and clinical, while the second group corresponded of teachers who work in both areas (N=92; n=56; 60.87% of all teachers). The total sample was n = 391. The Jefferson Scale of Physician Empathy (S-Version) was used. Reliability was estimated using Cronbach's α and intraclass correlation coefficient, descriptive statistics, two-way analysis of variance, Tukey's test, effect size, and power of the test. Significance level: α≤0.05 and β≤0.20. Results: The empathy and dimension values were, in general, higher in the professors of the clinical area in relation to the other areas studied, with the exception of the compassionate care dimension. Conclusion: The finding that clinical teachers have a greater value of empathy is potentially an advantage for training students, especially in the clinical area.
  • Translation and Cultural Adaptation of the Modified Child Dental Anxiety Scale – Faces (MCDASf) into Brazilian Portuguese Original Article

    Barbosa, Taís de Souza; Azevedo, Marina Sousa; Vidal, Giovanna Lucas; D’Almeida, Paulo Veríssimo Barbosa; Bruzamolin, Carolina Dea; Costa, Luciane Rezende; Costa, Vanessa Polina Pereira da; Goettems, Marília Leão

    Resumo em Inglês:

    Abstract Objective: To translate and culturally adapt the Modified Child Dental Anxiety Scale - Faces (MCDASf) into Brazilian Portuguese. Material and Methods: The MCDASf consists of eight questions about anxiety toward dental procedures that are answered on a five-point Likert scale ranging from “not worried” (1 point) to “very worried” (5 points). The answers correspond to a scale of face drawings ranging from extremely negative to extremely positive. The process consisted of initial translation, back-translation, expert committee review, and pretesting. Results: The first revised version was applied to 32 children aged 5 to 12 years, 16 from the city of Governador Valadares, Brazil (southeastern region) and 16 from the city of Pelotas, Brazil (southern region). In the first pretest, Item 5 was misunderstood by 6.25% of children in the southern region; Item 6 by 6.25% in both regions; Items 7 and 8 by 87.5% and 100% of those from the southeastern region, respectively, and by 12.5% and 25% of those from the southern region, respectively. Items 7 and 8 were modified by the expert committee, and the second revised version was applied to 32 children, 16 from each region. The only misunderstood items were 4 and 5, both by a 7-year-old boy in Governador Valadares. Conclusion: The Brazilian Portuguese version of the MCDASf was well understood by the sample of children.
  • A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla Original Article

    Sharifi, Roohollah; Bahrami, Hosna; Safaei, Mohsen; Mozaffari, Hamid Reza; Hatami, Masoud; Imani, Mohammad Moslem; Moradpoor, Hedaiat; Golshah, Amin

    Resumo em Inglês:

    Abstract Objective: To evaluate the level of pain experienced during infiltration anesthesia of the anterior maxilla following low-level laser therapy (LLLT) with 810-980 nm wavelengths. Material and Methods: In the current triple-blind clinical trial, 84 patients received a total of 168 infiltration anesthesia injections (1.8 mL of 2% lidocaine plus 1:100,000 epinephrine) in the anterior maxilla. Each patient received two injections into the buccal mucosa of the right and left central incisors with a two-week interval. One injection was performed after LLLT, while the other injection was administered conventionally without laser. The pain level was measured immediately after injection using a visual analog scale (VAS). Results: There was a significant difference in the pain level experienced with and without LLLT, such that the mean pain score following LLLT was significantly lower than that without LLLT (p<0.05). No significant difference was found in the pain level between laser and no laser groups in males, but the difference in this regard was significant in females (p<0.05) and female patients experienced a significantly lower level of pain following LLLT. Conclusion: The low-level laser therapy can be successfully used to decrease the level of pain experienced during infiltration anesthesia of the anterior maxilla.
  • Association between Volatile Sulfur Compounds Prevotella intermedia and Matrix Metalloproteinase-8 Expression Original Article

    Maitimu, Fergy Christin; Soeroso, Yuniarti; Sunarto, Hari; Bachtiar, Boy Muchlis

    Resumo em Inglês:

    Abstract Objective: To determine the correlation between levels of methyl mercaptan (CH3SH) hydrogen sulfide (H2S), the proportion of Prevotella intermedia (Pi), and matrix metalloproteinase-8 (MMP-8) gene expression levels in periodontitis patients accompanied by halitosis. Material and Methods: Samples were obtained from gingival crevicular fluid (GCF) in the deepest pocket and by swabbing in the tongue coating area in patients with periodontitis presenting with halitosis (n = 23) and healthy subjects as controls (n = 7). The values of CH3SH and H2S were obtained using Oral Chroma. The proportion of Pi and MMP-8 expression levels were evaluated using PCR-RT. All the result was statistically analyzed using SPSS software. Results: The levels of CH3SH and H2S in participants with PD ≥ 6 mm showed a robust negative correlation with the proportion of P. intermedia in GCF and tongue coating. No statistically significant association was detected between CH3SH and H2S levels and MMP-8 expression levels (p>0.05). Conclusion: There is no association between CH3SH and H2S levels, the proportion of P. intermedia, and MMP-8 expression in patients with periodontitis accompanied by halitosis.
  • Caries Experience and Knowledge About Oral Health Importance Among Children with Congenital Heart Diseases in Kosovo Original Article

    Rexhepi, Aida; Latifi-Xhemajli, Blerta; Kutllovci, Teuta; Bajrami, Shqiprim; Ahmeti, Dafina

    Resumo em Inglês:

    Abstract Objective: To determine the dental health of children with Congenital Heart Diseases (CHD) and to evaluate the parents’ knowledge of the importance of oral health and the risk of Bacterial Endocarditis. Material and Methods: This research included 140 children divided into the study group (80 children with CHD) and the control group (60 healthy children). The children were from different parts of Kosova, aged between 3-15. The parents were asked to complete a questionnaire containing demographic data (age and gender), general and special medical history (CHD types), knowledge about oral health importance and risk of bacterial endocarditis, and data about the daily oral hygiene child. The caries experience was reported using the DMFT/dmft index. Results: The average value of the dmft index was 6.7 for the study group and 5.62 for the control group, while the average value of DMFT index for the study group was 4.1, and for the control group was 3.47 (p>0.05). About 68.7% of parents of children with CHD were informed about their risk during dental interventions. However, knowledge was insufficient about the importance of oral health and dental prophylactic measures once only 32.7% of them were aware of those measures. Conclusion: No difference was observed between healthy and CHD children in caries experience and frequency of daily tooth brushing. Our findings provide evidence of a lack of knowledge about the importance of oral health and dental prophylactic measures among parents with CHD children.
  • Evaluation of Knowledge on Emergency Management of Avulsed Teeth Among Turkish Medical and Dental Students Original Article

    Duruk, Gulsum; Daşkıran, Ismail Cuneyt

    Resumo em Inglês:

    Abstract Objective: To evaluate the knowledge of medical and dental students regarding the emergency management of avulsed teeth. Material and Methods: This cross-sectional survey study was performed on 1841 students. Medical (n=746) and dental (n=845) students from different universities were included in this study. A questionnaire about the emergency management of avulsed teeth was conducted on the students. Also, 250 medical students from 3rd grade were included in the study and trained. The questionnaire was applied twice, before and after the training on the subject. Results: The mean correct answer scores were similar among the medical students in different grades (p>0.05). There were no statistically significant differences between the trained medical students and clinical dental students' correct answer scores, but there was a significant difference between the pre-clinical (1st-2nd-3rd years) and clinical (4th-5th years) dental students (p<0.01). Conclusion: Medical and preclinical dental students had lack of knowledge about the emergency management of avulsed teeth, while clinical dental and trained medical students were very knowledgeable. This result indicates the importance of education.
  • Efficacy of Resin Infiltration and Fluoride Casein Phosphopeptide Amorphous Calcium Phosphate Varnish on Non-cavitated Active White Spot Lesions in Children: A Randomized Clinical Trial Original Article

    Dhamija, Mohit; Tyagi, Rish; Kalra, Namita; Khatri, Amit

    Resumo em Inglês:

    Abstract Objective: To compare the efficacy of resin infiltration and fluoride casein phosphopeptide amorphous calcium phosphate varnish on non-cavitated active white spot lesions in 5-8 years old children. Material and Methods: 60 non-cavitated active white spot lesions in 60 patients with ICDAS II score 2 from both genders in the age range of 5 to 8 years were taken. Thirty lesions were treated by resin infiltration (Group 1) and 30 by Fluoride CPP-ACP varnish (Group 2). Resin infiltration was performed on the same day, while Fluoride CPP-ACP varnish was applied once a week for 4 weeks. The follow-up was done at 3, 6 months, and 12 months. Results: At 3, 6, and 12 months change in mean ICDAS II Score in group 1 was 1.5±0.5,1.13±0.73 and 0.9±0.88, respectively, while in group 2, it was observed to be 0.30±0.59, 0.4±0.89 and 0.06±0.82, respectively (p<0.001). Conclusion: Resin infiltration was more successful than Fluoride CCP-ACP varnish in active non-cavitated white spot lesions.
  • Association Between Caries Experience and School Performance in an Island Community: Full-Time versus Part-Time Public Schools Original Article

    Mattos, Monica Gentil; Santos, Paula Perrota; Souza, Ivete Pomarico Ribeiro de; Luiz, Ronir Raggio; Maia, Lucianne Cople; Neves, Aline de Almeida

    Resumo em Inglês:

    Abstract Objective: To investigate the association between caries experience and school performance among children and adolescents living in an island community without fluoridated water supply and to compare data according to the type of attended school (full-time or part-time). Material and Methods: A cross-sectional oral health survey in a convenience sample of students (n=147) attending four public schools was performed. Students were examined by one calibrated dentist in the school environment to the obtain prevalence of dental caries (DMFT/dmft) and its consequences using the PUFA/pufa index. Self-reported oral health behavior was also accessed. Data from each student’s school performance and absenteeism were extracted from official sources and the school performance was classified into “good” and “fair”. The final sample consisted of 120 students. Descriptive statistics, Mann-Whitney, Kruskal-Wallis, chi-square tests and binary logistic regression were performed to evaluate collected data. Results: Students´ age ranged between 5 to 19 years (10±4.3). DMFT/dmft mean were 1.3 (±2.3) and 3.05 (±3.4), respectively. Conclusion: Participants from the full-time school presented better oral health status than their peers in the part-time schools (p<0.05). A significant association was found between the prevalence of caries-free participants and good school performance when the factor age range was controlled (OR=2.87). Moreover, attendance to full-time schools appeared to be a protective factor for good oral health conditions.
  • Evaluation of Lung Volume and Effect of Vital Staining as Motivation to Quit Tobacco among Nicotine Dependents of Kanpur, India Original Article

    Kumar, Amit; Nagarajappa, Ramesh; Ramesh, Gayathri; Chandra, Vishal; Ahuja, Ravish; Azad, Anurag

    Resumo em Inglês:

    Abstract Objective: To quantify and compare respiratory functions and further screen the oral mucosa of tobacco and non-tobacco users. Material and Methods: First control group, non-tobacco users (n=55); Second group, smokers’ group (n=168) who currently smoked cigarettes; Third group smokeless/chewing type, tobacco group (n=81); Fourth group, both smokeless and smoking type tobacco users (n=46). Fagerstrom Test for Nicotine Dependences (FTND) and Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) instruments were used to assess nicotine dependence. Subsequently, spirometry and Toluidine Blue (TB) vital staining were performed. Chi-squared and one-way analysis of variance (ANOVA) were used for statistical analysis. Results: Fagerstrom test resulted in 48.8% of subjects with low dependency, followed by an increase in nicotine dependency from low to moderate (29.2%), moderate (15.6%), and highly dependent (6.4%) groups. All respiratory function tests and oral screening confirmed significant changes amongst tobacco and non-tobacco users. The forced vital capacity of non-smoker group was significantly different from other tobacco users’ group (p<0.05). Conclusion: Early effects of tobacco use can lead to complications with the respiratory system and oral cavity. Such data can be used to delineate the harm of tobacco and should be used to urge individuals to evade the utilization of tobacco.
  • Effect of Light-Curing Unit Type and Bulk-Fill Composite Resins with Different Photoinitiators on Marginal Gaps of Class II Restorations Original Article

    Alavi, Fereshteh Naser; Darabi, Farideh; Salari, Ashkan; Dehghan, Arefeh

    Resumo em Inglês:

    Abstract Objective: To evaluate the effect of two types of light-curing units (second and third generations) and two types of bulk-fill composite resins with different photoinitiators - Tetric N-Ceram Bulk Fill (TNCB) and Xtra Fil (XTF) on gap formation at the gingival margins of Cl II restorations. Material and Methods: Fifty-six standard Cl II cavities were prepared on the mesial and distal surfaces of premolar teeth, with the gingival margin of the cavities 1 mm apical to the CEJ. The samples were randomly assigned to two groups based on the composite resin type and two subgroups based on the light-curing unit type and restored. After 5000 rounds of thermocycling, gingival margin gap in each sample was measured in µm under an electron microscope at ×2000 magnification. Data were analyzed by two-way ANOVA and Tukey tests (α=0.05). Results: Marginal gaps of TNCB composite resin were significantly smaller than those of XTF composite resin (p<0.001). There were no significant differences between the two light-curing units in each group (p=0.887 with XTF and p=0.999 with TNCB). Conclusion: The gaps at gingival margins of Cl II cavities with TNCB bulk-fill composite were smaller than XTF composite resin. Both composite resins can be cured with both the second- and third-generation LEDs.
  • Cyclic Fatigue Resistance and Surface Roughness of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals – An Atomic Force Microscopy Study Original Article

    Bhat, Raksha; Kini, Arjun; Shetty, Preethesh; Kansara, Payalben; Penugonda, Bapanaiah

    Resumo em Inglês:

    Abstract Objective: To examine the cyclic fatigue resistance and surface topography of TruNatomy and ProTaper Gold nickel-titanium rotary files and evaluate the presence of alterations to surface topography following instrumentation in simulated curved canals. Material and Methods: Twenty-four nickel-titanium instruments, twelve each of TN and PTG file systems, were evaluated for cyclic fatigue resistance. The rotary files were rotated in a simulated root canal with standardized diameter, angle of curvature, and radius of curvature in a custom-made cyclic fatigue testing device until the instrument fracture occurred. The time to fracture for each instrument was recorded with a stopwatch; in seconds in each group. Fractured instruments were subjected to atomic force microscopy analysis measuring the average roughness and the root mean square values to investigate surface features of endodontic files. Mean values and standard deviation were calculated. Data were analyzed using the Mann-Whitney U test. Results: Time to fracture was marginally higher in PTG instruments than in the TN file systems. PTG files exhibited higher surface roughness when compared with TN files (p<0.05). Conclusion: TN file system had a higher cyclic fatigue resistance than PTG. Cyclic fatigue causing file breakage did affect the surface topography of the files. PTG files showed a higher surface porosity value than the TN files.
  • Judicial Vulnerability on the Exercise of Orthodontics: Construction and Validation of a Questionnaire Original Article

    Guedes, Cleverson Raymundo Sbarzi; Leite, Isabel Cristina Gonçalves; Pinheiro, Felipe de Almeida; Campos, Marcio José da Silva; Mota Júnior, Sergio Luiz; Phiton, Matheus Melo; Vitral, Robert Willer Farinazzo

    Resumo em Inglês:

    Abstract Objective: To develop and validate a questionnaire to measure the vulnerability of orthodontists, measuring the risks of being involved in civil liability lawsuits. Material and Methods: In-depth interviews were performed with three groups: G1- law professionals, G2 – orthodontists, and G3 – orthodontic patients. From the analysis of the content of Bardin, domains for the construction of the first version of the 53-question questionnaire were identified. The questionnaire was submitted to experts for validation, inclusion and exclusion of questions, but maintaining the 53-question format. It was submitted to the test-retest phases and verification of internal consistency. Results: 247 professionals answered the final version of the questionnaire. The intraclass correlation coefficient was 88.8%. Cronbach's alpha was 0.946, with high internal consistency. The Kaiser-Meyer-Olkin and Bartlett’s tests confirmed internal consistency showing the values of 0.909 and significance of <0.001, respectively. From the total score and factorial analysis, the sample was divided into three groups of judicial vulnerability. Conclusion: The results of this study demonstrated that the questionnaire is a valid tool to measure the risks of involvement in civil liability lawsuits by orthodontists. It presented a multidimensional character and might be applied as well as face to face or online, without prejudice to quality.
  • Factors Associated with Oral Health Literacy among Patients with Type 2 Diabetes Mellitus Attending Hospital Universiti Sains Malaysia Original Article

    Saddki, Norkhafizah; Hashim, Muhamad Izaat bin Mohd; Mohamad, Noraini

    Resumo em Inglês:

    Abstract Objective: To determine the oral health literacy (OHL) level and its associated factors among patients with type 2 diabetes mellitus attending Hospital Universiti Sains Malaysia (USM). Material and Methods: This cross-sectional study involved 135 diabetic patients with a mean age of 62.6 years old (SD=9.05) who attended the Diabetes Outpatient Clinic at Hospital USM, a teaching hospital in the north-eastern corner of Peninsular Malaysia. The Malay version of the Oral Health Literacy Instrument (OHLI-M) was used to assess the level of OHL among respondents. An additional self-administered questionnaire was used to obtain other variables of interest. Systematic random sampling was applied in this study. The data were analyzed using an independent t-test and ANOVA to determine factors associated with oral health literacy among respondents. Results: Most respondents have at least one oral health problem (62.2%). The most common problem was cavitated tooth (42.2%). Other problems include toothache (17.8%), mobile tooth (17.8%), and swollen gums (16.3%). OHL level for most respondents (40.7%) was inadequate. The mean total OHLI-M score was 67.9 (SD=17.74). The OHL score was significantly lower in respondents with the following characteristics: female, no formal education or had primary education, unemployed, lower income group, never visited a dentist, and had swollen gums. Conclusion: The OHL of most patients with type 2 diabetes mellitus attending the Diabetes Outpatient Clinic, Hospital USM still need to be improved. Oral health problems were common in patients with type 2 diabetes mellitus in this study. This study also highlighted the link between OHL and socio-demographic factors. Improving the OHL of patients may increase their capability to obtain and understand oral health messages needed to take appropriate actions that will eventually prevent oral diseases associated with diabetes mellitus.
  • Temporomandibular Disorders are Associated with Sociodemographic Factors, Health-Related and Oral Conditions in Adolescents: A Cross-Sectional Study Original Article

    Baldiotti, Ana Luiza Peres; Amaral-Freitas, Gabrielle; Scariot, Rafaela; Dias, Maria Luísa Leandro de Souza; Martins, Renata de Castro; Paiva, Saul Martins; Ferreira, Fernanda Morais

    Resumo em Inglês:

    Abstract Objective: To assess the association between temporomandibular disorder (TMD) with sociodemographic factors, health-related factors, and oral conditions in adolescents. Material and Methods: This cross-sectional study was developed with 89 adolescents between 13 to 18 years. TMD diagnosis was obtained by the Research Diagnostic Criteria for Temporomandibular Disease (RDC/TMD) Axis I. Diagnoses of chronic pain, depression, presence of non-specific physical symptoms, including pain and anxiety, were obtained by the RDC/TMD Axis II. The feeling of happiness was measured by the Subjective Happiness Scale. Socio-economic and demographic characteristics were collected through self-administered questionnaires. Patients were examined for dental caries, dental trauma, malocclusion, and tooth wear. Parents answered a sociodemographic, economic, and general health questionnaire. Data were submitted to descriptive statistics, and a logistic regression model was used to assess the association between TMD and the socio-economic, demographic, health-related, and clinical variables. Results: TMD prevalence was 42%. TMD was associated to skin color (p=0.040), use of medications in the past year (p = 0.020) and previous dental trauma (p=0.030). Also, it tended to be associated with the presence of probable awake bruxism (p=0.053). Conclusion: Sociodemographic factors, health-related factors, and oral conditions play a role in TMD, with nonwhite adolescents, those who had used medications in the past year and/or had previous dental trauma having a greater chance of present this disorder.
  • What Factors are Associated with Health-Related Quality of Life in Mixed Dentition Children? Original Article

    Fantini, Luís Carlos; Carneiro, Diego Patrik Alves; Venezian, Giovana Cherubini; Menezes, Carolina Carmo de; Vedovello, Silvia Amélia Scudeler; Vedovello Filho, Mario

    Resumo em Inglês:

    Abstract Objective: To associate the OHRQoL and HRQoL in mixed dentition children with the influence on age range, socioeconomic and clinical variables. Material and Methods: A cross-sectional study was carried out with 1,240 children between 6 and 12 years of age. HRQoL was assessed by the Quality of Life Assessment Scale, considered an outcome variable. OHRQoL was determined using specific questionnaires related to the age group: Oral Health Impact Scale in Early Childhood, Child Perceptions Questionnaire for 8 to 10 years, and 11 to 12 years. Dental caries and malocclusion were diagnosed. The socioeconomic class was evaluated. A multiple negative binomial regression analysis was used to test the relationship between HRQoL, OHRQoL scores and socioeconomic and clinical variables. Correlation analyses were performed between the total HRQoL and OHRQoL, with a significance level of 5%. Results: The HRQoL is inversely related to the impact of OHRQoL (p<0.05), modulated by the age group. There was a significant weak negative correlation between the HRQoL scores and the impact of OHRQoL (p<0.05). Conclusion: The OHRQoL impacts the HRQoL, modulated by the age group and with minor influence from socioeconomic and clinical variables.
  • Orthodontic Treatment Need among Nepalese High School Students Original Article

    Yadav, Rajiv; Mittal, Mitushi; Yadav, Anil K; Yadav, Neelam; Giri, Jamal; Venugopal, Adith

    Resumo em Inglês:

    Abstract Objective: To assess the need for orthodontic treatment among Nepalese high school students. Material and Methods: This is a quantitative, cross-sectional descriptive study. The sample comprises 938 children (537 males and 401 females) with an age group above 14 years. The subjects were selected voluntarily from seven different schools of Kathmandu valley using a multistage sampling technique. The Index of Orthodontic Treatment Need comprises two components: Dental Health Component (DHC) and Aesthetic Component (AC). Two trained and calibrated examiners performed the oral examination. Results: On analysis of the DHC component, it was found that 21% had no need, 18.1% had mild/little need, 24.3% had moderate/borderline need, 35.8% had severe need, and 0.7% had extreme treatment need. Similarly on analysis of AC component, it was found that 33% were AC-1, 30.8% were AC-2, 7.2% were AC-3, 8.2% were AC-4, 2.1% were AC-5, 3.6% were AC-6, 1.8% were AC-7, 7.4% were AC-8, 1.8% were AC-9, and 3.9% were AC-10. Conclusion: The Index of Orthodontic Treatment Need can be used as a tool for planning dental health resources and prioritizing the treatment need of different populations.
  • Apical Periodontitis Healing Following Treatment is Impacted by Root Canal Sealer Composition: An in Vivo and in Vitro Investigation Original Article

    Silva, Léa Assed Bezerra da; Bonifácio, Kléber Cortês; Liévana, Fernanda Souza; Martins, Giovana Gonçalves; Flores, Daniel Silva-Herzog; Leonardo, Mário Roberto; Silva, Raquel Assed Bezerra da; Paula-Silva, Francisco Wanderley Garcia

    Resumo em Inglês:

    Abstract Objective: To evaluate the periapical healing following root canal treatment in teeth with apical periodontitis (in vivo) and the cytotoxic potential of root canal sealers in vitro. Material and Methods: Apical periodontitis was induced in 60 dogs' teeth and root canals were filled with Sealapex (40 roots), EndoREZ (40 roots), intracanal dressing (20 roots), or left untreated (20 roots). After 30 and 90 days, histopathological analyses were made. In vitro, J774.1 macrophages were stimulated with root canal sealers extracts, cytotoxicity was assessed using lactate dehydrogenase assay, and qRT-PCR was used to analyze TNF-α gene expression. Results: In vivo, smaller apical periodontitis and lower inflammatory cell infiltrate were found in teeth treated with Sealapex compared to EndoREZ. In vitro, EndoREZ was cytotoxic and induced TNF-α gene expression by macrophages differently from Sealapex. Conclusion: Sealapex allowed improved tissue repair following root canal treatment in teeth with apical periodontitis compared to EndoREZ. Synthesis of TNF-α induced by LPS was enhanced by EndoREZ, whereas Sealapex prevented pro-inflammatory gene expression.
  • Determination of Shear Bond Strength of Nanocomposite to Porcelain and Metal Alloy Original Article

    Sarfraz, Zenab; Arooj, Zartashia; Fahim, Ayesha; Manzoor, Sadia; Javed, Mariyah; Saeed, Asfia; Khan, Abdul Samad; Khan, Sohail Abbas; Alam, Mohammad Khursheed

    Resumo em Inglês:

    Abstract Objective: To compare porcelain and metal repair done with both nanocomposite and conventional composite. Material and Methods: A total of 30 cylinders were fabricated from Porcelain (I), Porcelain fused to metal (II), and metal (III) substrate each. Control group (A) was bonded with conventional micro-hybrid composite and experimental group (B) was bonded with nanocomposite in a 2 mm thickness. All specimens were thermocycled and stored in distilled water at 37 °C for 7 days. A universal testing machine was used to measure the Shear bond strength (SBS). The difference between bond strengths of the groups was compared using an independent t-test. Results: In all three groups, the SBS was higher in the experimental group as compared to the control group. The use of nanocomposite of metal alloy presented maximum shear bond strength, followed by samples of porcelain fused to metal and finally porcelain, showing the lowest values of SBS. Conclusion: Porcelain and alloys bonded with nanocomposite exhibit enhanced adhesiveness as well as aesthetic and mechanical properties. This subsequently would translate into providing higher clinical serviceability and durability and hence a cost-effective and accessible repair option for human welfare.
  • Risk Factors for the Incidence of Dental Caries in Low, Very Low, and Extremely Low Birth Weight Children: A Cohort Study Original Article

    Teixeira, Natália Moreira; Carvalho, Fabíola Galbiatti de; Abreu, Mauro Henrique Nogueira Guimarães de; Souza-Oliveira, Ana Clara; Feuser, Elisa; Bendo, Cristiane Baccin; Martins, Carolina Castro

    Resumo em Inglês:

    Abstract Objective: To assess the incidence of caries in a two-year period among low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW) children considering socioeconomic indicators, dietary factors and oral hygiene. Material and Methods: A convenience sample was formed of 42 low birth weight children aged two to five years at baseline. Two examiners diagnosed caries using the World Health Organization criteria. Birth weight, socioeconomic indicators and diet were collected from medical records and questionnaires. Binomial models were used to estimate unadjusted and adjusted rate ratios (RR) and respective 95% confidence intervals for the factors evaluated. Results: Thirty-six children were re-examined after two years. The incidence of dental caries was 36.7%. The dmft index was 0.44 (±1.25) at baseline and increased to 1.36 (±3.85) at follow-up. VLBW children (1,000 to 1,500 g) (RR=0.23; 95%CI: 0.08-0.72) and LBW children (1,500 to 2,500 g) (RR=0.06; 0.01-0.55) had fewer carious lesions compared to ELBW children (<1,000 g). Carious lesions were more frequent among children with a lower income (RR=6.05; 1.05-34.84) and less frequent among those who did not consume sweetened juice, tea or yogurt (RR: 0.21; 0.07-0.62). Conclusion: An inverse dose-response relation was found between birth weight and the incidence of caries. A lower income and the consumption of sweetened beverages were risk factors for the development of caries.
  • Cytotoxicity Comparison of a Calcium Silicate-Based Resin Cement versus Conventional Self-Adhesive Resin Cement and a Resin-Modified Glass Ionomer: Cell Viability Analysis Original Article

    Kashi, Faezeh; Abbasi, Mahdi; Ahmadi, Elham; Omrani, Ladan Ranjbar; Rafeiee, Niyousha; Kharazifard, Mohammad Javad

    Resumo em Inglês:

    Abstract Objective: To compare the cytotoxicity level of a new calcium silicate-based resin cement (TheraCem) with two commonly used cements, including a conventional self-adhesive resin cement (Panavia SA) and a resinmodified glass ionomer cement (FujiCem2), on the human gingival fibroblast cells after 24 and 48 hours. Material and Methods: Twelve discs of each cement type were fabricated. The extract of cement disks was made by incubating them in the cell medium. Human gingival fibroblast cells were cultured and exposed to cement extracts for 24 h and 48 h. MTT assay was performed on extracts and optical density and cell viability rates were calculated by the spectrophotometer device at 570 nm. Data were analyzed using ANOVA and Tukey HSD tests. Results: The cell viability rates after 24 hours and 48 hours were as follows: TheraCem: 89.24% and 85.46%, Panavia SA: 49.51% and 46.57% and FujiCem2: 50.63% and 47.36%. TheraCem represented the highest cell viability rate. However, no significant difference was noted between Panavia SA and FujiCem2. Time had no significant effect on cell viability. Conclusion: TheraCem exhibited the best results among three tested cements and was considered non-toxic. Panavia SA and FujiCem2 were not significantly different regarding the cell viability rate. Time had no significant effect on the cytotoxicity level of cements.
  • Effect of Xylitol Varnishes on the Inhibition of Demineralization in Vitro Original Article

    Naves, Paula Andery; Moura, Alexandre Lima de; Rodrigues, Marcela Charantola; Diniz, Michele Baffi; Arana-Chavez, Victor Ellias; Jordão, Maísa Camillo; Cardoso, Cristiane de Almeida Baldini

    Resumo em Inglês:

    Abstract Objective: To evaluate the efficacy of xylitol varnishes in the inhibition of enamel demineralization in vitro. Material and Methods: Bovine enamel blocks (n=120) were randomly allocated to four groups (n = 30), and the surface hardness (SH) was measured at baseline. The blocks were treated with the following varnishes: 20% xylitol, 20% xylitol plus F (5% NaF), Duraphat™ (5% NaF, positive control), and placebo (no-F/xylitol, negative control). The varnishes were applied and removed after 6 h of immersion in artificial saliva. The blocks were subjected to pH cycles (demineralization and remineralization for 2 and 22h/day, respectively, for 8 days). Surface and cross-sectional hardnesses were measured to calculate the percentage of SH loss (%SHL) and the integrated loss of the subsurface hardness (ΔKHN). Data were statistically analyzed using Kruskal-Wallis and Tukey’s tests (p<0.05). Results: %SHL was significantly decreased by 20% xylitol plus F, Duraphat™, and 20% xylitol varnishes compared to placebo. The use of 20% xylitol plus F varnish led to a significantly lower percentage of SH loss compared to the use of 20% xylitol varnish without F. However, the experimental and commercial varnishes led to significantly lower subsurface demineralization compared to placebo and did not differ from each other. Conclusion: Xylitol varnishes, especially when combined with F, effectively prevent enamel demineralization.
  • Self-Declared Oral Health Conditions and Oral Health-Related Quality of Life of the Brazilian Homeless Population: A Cross-Sectional Study Original Article

    Paiva, Karime de Castro; Lima, Lavínea Silva de; Leite, Isabel Cristina Gonçalves

    Resumo em Inglês:

    Abstract Objective: To associate the impact of oral health-related quality of life with socio-demographic determinants, self-perception, oral health conditions and access to dental treatment among homeless adults. Material and Methods: A cross-sectional study was carried out in a medium-sized Brazilian city in Minas Gerais. Socio-demographic data on the use of dental services and access to hygiene supplies for oral health were collected. Clinical aspects were collected by clinical observation using the Community Oral Health Indicator and oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Medians and interquartile distance were compared using the Mann-Whitney and Kruskal-Wallis tests. Multiple linear regression included significant variables (p<0.05) of the bivariate analysis according to each OHIP-14 domain. Results: Women had the lowest scores for the physical and social disability domains. Oral health conditions were associated with physical and psychological limitations and disability. The presence of more teeth was associated with a negative impact on the functional and physical domains, and inflamed gums, lack of need for dental prosthesis, and use of private services were associated with a greater psychological disability. Conclusion: Oral health-related quality of life of the homeless population is affected, especially in the physical and psychological aspects. Equitable and inclusive health actions aimed at this population should include oral health.
  • Gingival Recession Treatment with the Use of Xenogeneic Matrix: Optimization of Patient-Centered Outcomes by the Digital Soft Tissue Design Original Article

    Krasnokutskyy, Oleksandr; Goncharuk-Khomyn, Myroslav; Rusyn, Vitaliy; Tukalo, Igor; Myhal, Ostap; Pal, Yulianna

    Resumo em Inglês:

    Abstract Objective: To evaluate the impact of the originally-developed approach aimed at pre-treatment graphical modelling of soft-tissue changes (digital soft tissue design) for the optimization of patient-centered outcomes after Class I and Class II single gingival recessions treatment with the use of a xenogeneic dermal matrix. Material and Methods: Patients enrolled in the study group received single gingival recession treatment via CAF+XDM method supported by pre-treatment graphical modelling of potential soft-tissue changes (digital soft tissue design), while patients enrolled in the control group received single gingival recession treatment via CAF+CTG method with no pre-treatment graphical modeling of gingival level changes. Patient-centered outcomes were measured by visual analogue scale, OHIP-14, and Mahajan's scales. Results: Realization of pre-treatment graphical modelling of soft-tissue changes supported the achievement of better patient-centered outcomes, such as root coverage (p<0.05), surgical phase (p<0.05), post-surgical phase (p<0.05), cost-effectiveness (p<0.05) and diagnostics and patient-orientation (p<0.05) based on patient's personal perception grades. Conclusion: Patient-centered results were found to be more successful within the group using the xenogeneic type of graft accompanied with the implementation of pre-treatment graphical modeling of soft tissue changes, which helped to balance patients' pre-operative expectations and post-operative satisfaction with the received results, reduce post-operative morbidity and improve oral health-related quality of life.
  • A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents Original Article

    Muniz Júnior, Arnoldo Brasil; Carneiro, Diego Patrik Alves; Menezes, Carolina Carmo de; Degan, Viviane Veroni; Vedovello, Silvia Amélia Scudeler; Vedovello Filho, Mario

    Resumo em Inglês:

    Abstract Objective: To evaluate the psychosocial impact of malocclusion and self-esteem in adolescents in the Amazon region. Material and Methods: A cross-sectional study was carried out with 212 adolescents with 12-year-old enrolled in all public schools in the Boca do Acre (Amazonas, Brazil). Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion. The self-perception of the need for orthodontic treatment was evaluated by the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and Global Negative Self-evaluation (GSE), the adolescent's self-esteem. The malocclusion was clinically evaluated by the Dental Aesthetic Index (DAI). The variables with p<0.20 in the individual analyses were tested in multiple logistic regression models, and those with p<0.10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI). Results: Adolescents with low self-esteem were 2.20 (95% CI: 1.23-3.93) times more likely to have a more significant impact on dental aesthetics (p<0.05). When verified by domains, the adolescents with low self-esteem had 2.33 (95% CI: 1.31-4.17) and 1.93 (95% CI: 1.09-3.42) times more likely to impact the psychological and social domains of the PIDAQ, respectively. Conclusion: Self-esteem influenced adolescents' perception of dental aesthetics in the domains related to psychological and social impact.
  • Dental Whitening: Self-Referred Needs versus Professional Indication Original Article

    Cavalcanti, Jéssica de Oliveira Sotero; Oliveira Neto, Inaldo Nogueira de; Dias, Marlon Ferreira; Lins-Filho, Paulo Cardoso; Guimarães, Renata Pedrosa

    Resumo em Inglês:

    Abstract Objective: To analyze the self-reported need of patients compared to professional indications for tooth whitening. Material and Methods: Initially, 58 undergraduate students responded to a form that highlighted the question: "Do you think you need to have your teeth whitened?" Among those who answered positively to the previous question, ten individuals were photographed with their smiles. In addition, they were asked to point out, on the Vita 3D-Master scale, which color they believed their teeth had, a value that was compared to the actual color obtained by a spectrophotometer. Finally, the photographs were presented to dentists, who were asked about the indication or not of the whitening treatment. Results: Most interviewees (63.8%) self-reported the need for whitening, as well as there was a greater incidence of a positive indication among professionals (53.9%). Pearson's Chi-square test revealed a relationship between patient gender and the training course on the desire to have teeth whitened. Among the professionals, the specialty, as well as time since graduation, interfered in the indication for whitening. Conclusion: Professionals and patients share the aesthetic ideal directly related to light teeth; most patients self-perceive the color of their teeth darker than it actually is; the opinion about the color of the teeth has an extremely subjective character and varies greatly from one professional to another.
  • Age-Related Pattern of Dental Trauma in a Nigerian Tertiary Health Institution Original Article

    Enabulele, Joan Emien; Chukwumah, Nneka Maureen

    Resumo em Inglês:

    Abstract Objective: To evaluate the pattern of traumatic dental injuries among children, adolescents, and adults. Material and Methods: This was a cross-sectional analytic study of children and adults who presented with dental trauma. Data utilized for this study were sociodemographic characteristics, history of the traumatic incident, presenting complaints, traumatized teeth and classification of the traumatized tissues using Ellis and Davey’s classification. Results: A total of 163 participants with 307 traumatized teeth were included in the study. The participants' age ranged from 2 years to 75 years, with a mean age of 25.36 ±15.4 years. Children <10 years were the least represented (14.7%), adolescents 10-19 years accounted for 23.9%., young adults 20 to 40 years were the most represented (44.8%) and older adults >40 years (16.6%). A higher proportion of the study participants were female 83 (50.9%) and the most prevalent complaint was broken teeth (57.1%) The most prevalent aetiology of the trauma documented was fall (36.2%). The most prevalent injury type was extended crown fracture with noticeable dentinal involvement without pulp exposure. There was a statistically significant association between injury type, aetiology and age group. Conclusion: Traumatic dental injuries affect children, adolescents and adults alike. The central incisors were the most vulnerable teeth across all age groups. Age was significantly associated with the etiology of dental trauma and injury type.
  • Evaluation of Microleakage at the Junction Between Combined Amalgam/Composite Resin Restorations Using Different Bonding Systems in Class II Cavities Original Article

    Zajkani, Elham; Omidi, Fatemeh; Taromi, Zahra

    Resumo em Inglês:

    Abstract Objective: To evaluate the microleakage at the junction between amalgam-composite resin restorations using different bonding systems. Material and Methods: In this in-vitro study, standard class II cavities were prepared on 40 human maxillary premolars. The axial and gingival floor depths of the cavities were 2 mm and 1 mm below (cementoenamel junction), respectively. The samples were divided into 4 groups (n = 10). In all groups, a layer of 1-mm thick amalgam was used as a coating for the initial part of the gingival floor. In group 1, no bonding system was used for amalgam restoration. In group 2, G-Premio Bond was applied. G-Premio bond + alloy primer and single bond + alloy primer were used in group 3 and group 4, respectively. The rest of the cavities in all groups were then repaired using FiltekZ250 composite. The samples were thermocycled at 500 rpm and immersed in 1% methylene blue solution for 24 hours to allow dye penetration. Once cut, the samples were placed under a stereomicroscope (40X) to determine the microleakage rate. Data analysis was carried out using post-hoc and Chi-square tests (p<0.05). Results: The highest and lowest microleakage rate was related to groups 1 and 3, respectively. There was a significant difference between groups (1,2) and (1,3), and (1,4), and groups (2,3) (p<0.05). Conclusion: The use of alloy primer and bonding could reduce the microleakage between the two restorations.
  • Erosive Effect of Analgesics on Primary Tooth Enamel - An in Vitro Study Original Article

    Rocha, Cristiane Tomaz; Nogueira, Ana Sarah Bôto; Almeida, Jordana de Andrade; Rodrigues, Lidiany Karla Azevedo; Neves, Beatriz Gonçalves

    Resumo em Inglês:

    Abstract Objective: To evaluate in vitro erosive effect of analgesics on primary tooth enamel. Material and Methods: The pH and the titratable acidity measurements of the medicines were performed in triplicate using a digital pH meter. Enamel slabs of primary teeth flat and polished were selected by initial surface microhardness analysis. Medications were selected and specimens were assigned into five groups (n=12): Dalsy; Magnopyrol; Paracetamol; Tylenol; and distilled water (negative control). Specimens were immersed in 5 ml of each group solution for 30 min, 4x/day for three days and stored in artificial saliva at 37 °C between immersions and at night. Final microhardness was determined. The data were submitted to Oneway ANOVA and Tukey's test. Scanning electron microscopy (SEM) analysis was performed in three specimens of each group. Results: Medicines showed acidic pH and mean values of titratable acidity ranged from 1.46 to 11.66 ml of 0.1N NaOH. The mineral loss of Magnopyrol was statistically significant in relation to the control group (p<0.01). Magnopyrol showed higher values when compared to Tylenol (p<0.05). SEM images displayed microstructure alterations in the Paracetamol group. Conclusion: Despite the low pH values, only Magnopyrol showed greater enamel softening. Paracetamol demonstrated morphological changes in primary tooth enamel.
  • Impact of Laughter Therapy on Anxiety and Pain in Pediatric Dentistry: A Double-Blinded Randomized, Controlled Clinical Trial Original Article

    Jahanimoghadam, Fatemeh; Shojaeepoor, Raziyeh; Aftabi, Reyhaneh; Shahravan, Arash; Horri, Azadeh; Jookar, Sima

    Resumo em Inglês:

    Abstract Objective: To evaluate the effect of laughter therapy on reducing anxiety and pain during dental procedures in children 5–7 years of age. Material and Methods: 48 children aged 5–7 years were included in this cross-over double-blinded clinical trial after the parents completed the Screen for Child Anxiety Related Disorder questionnaire (SCARED). After allocation into two groups: laughter intervention (A) and neutral intervention (B), the anxiety as well as pain were determined by Modified Child Dental Anxiety Scale Faces questionnaire (MCDASF) and the Wong-Baker Faces Scale, respectively. Also, the child’s behavior during the treatment was recorded using the Sound, Eye, Motor scale (SEM). Data were analyzed by SPSS 21 using Paired t-test, Independent t-test, Chi-square, Mann-Whitney and Wilcoxon’s test. Results: The mean score of anxiety in the laughter intervention group (17.42±2.74) was significantly less than (22.06±2.16) in the neutral intervention group (p=0.000) and lower in boys in both groups (p=0.000, p=0.047). The mean pain severity reported by the children in the neutral intervention group (5.33±1.81) was higher than in the laughter intervention group (2.38±1.87; p=0.00) and higher in girls in both groups (p=0.02; p=0.03). Conclusion: The laughter intervention before dental procedures had a significant effect on reducing anxiety and pain during dental treatment.
  • Effect of Different Preparations of Fluoride Gel on Salivary pH of Albino Rats Original Article

    Shakeel, Sadia; Ilyas, Muhammad Sharjeel; Fahim, Ayesha; Ahsan, Amna; Majid, Hina; Ashraf, Mariam; Akhter, Naseem; Alam, Mohammad Khursheed

    Resumo em Inglês:

    Abstract Objective: To evaluate the effect of different preparations of fluoride gels on the salivary pH of albino rats. Material and Methods: This experimental study consisted of 40 Albino rats randomly divided into four equal groups. Group A was the control group and received no intervention. Experimental group B received a topical application of 0.2% sodium fluoride gel. Experimental group C received topical application of stannous fluoride gel 0.4%. Experimental group D received topical application of APF gel (1.23% acidulated phosphate fluoride gel). The different preparations of the gels were applied once daily for 4 minutes on the occlusal surface of the right maxillary molars for 14 days. Salivary pH values were recorded immediately after the application of gels with the help of pH paper on day 1 and day 14. Results: There was a significant difference in the pH level of groups B, C and D after 14 days of fluoride application (p < 0.05). The non-parametric Kruskal Wallis test was applied for the comparison between the groups. Conclusion: This study concluded that all the fluoride gels after administration caused the acidic pH of saliva with the most acidic effect produced by APF gel.
  • Knowledge of Dentists and Dental Undergraduates Related to COVID-19 Original Article

    Reis, Giselle Emilãine da Silva; Petinati, Maria Fernanda Pivetta; Santos, Katheleen Miranda dos; Gerberb, Jennifer Tsi; Deliberador, Tatiana Miranda; Souza, Juliana Feltrin de; Rebellato, Nelson Luis Barbosa; Scariot, Rafaela

    Resumo em Inglês:

    Abstract Objective: To assess the knowledge of Brazilian dentists and final-year dental undergraduates concerning COVID-19. Material and Methods: We conducted a self-administered online questionnaire about the symptoms, incubation period, and transmission routes of COVID-19. In total, there were three questions addressing these topics and 15 correct answers, so each participant could score from 0 to 15 points. Besides that, data such as sex, age, education level, years of work experience and place of work were collected. All data were submitted to statistical analysis with a 5% significance level. Results: 476 participants were recruited. Regarding the respondents' perception of the most common symptoms of COVID-19, 99.4% responded fever, 95.2% cough, and 99.2% dyspnea. About the incubation period, 56.3% answered from 1 to 14 days. About the transmission routes, 98.3% recognized transmission through droplets, 80.3% through direct contact with infected persons, and 70.4% through indirect routes. The median knowledge score was 10 (4 – 14). Regarding the socio-demographic variables, participants aged 30 years or more had a higher score than those aged up to 29 years old (p=0.004). For education level, specialist dentists presented a higher score than undergraduates (p=0.006), general dentists (p=0.048) and Ph.D. (p=0.016). Participants with 15 years or more of work experience had a higher score than undergraduates (p=0.003). Concerning the workplace, participants working in the public sector had a higher score than those working in the private sector or universities (p=0.015). Conclusion: Participants recognized the main symptoms, incubation period, and transmission routes of the COVID-19 virus; however, the knowledge level of specialist dentists, older dentists, more experienced dentists, and dentists working in the public sector was higher than the other participants.
  • Obliteration of Dentinal Tubules by Desensitizing Agents Based on Silver Fluoride/Potassium Iodide or Pre-Reacted Glass Particles: An in Vitro Study Original Article

    Castro, Fernanda Novais Arantes Maciel de; Arantes, Diandra Costa; Rodrigues, Wagner Nunes; Moreira, Allyson Nogueira; Magalhães, Cláudia Silami

    Resumo em Inglês:

    Abstract Objective: To evaluate the efficacy of desensitizing agents for the obliteration of dentinal tubules subjected or not to a simulated oral environment. Material and Methods: Dentinal discs (n=8) treated with Riva-Star (RS) or PRG-Barrier-Coat (PRG) were submitted (cycled) or not submitted (control) to erosive-abrasive-thermal cycles and evaluated using scanning electron microscopy/energy dispersive spectroscopic analysis. The variables analyzed were tubule obliteration and dentin surface chemical composition. Data were analyzed by non-parametric tests (p<0.05). Results: The cycled and control groups did not differ significantly for the responses in each material. The PRG control and cycled groups had fewer visible tubules and a higher proportion of totally obliterated tubules than the RS groups. The percentages of silver coverage were higher in the RS-control than in the RS-cycled. There was a significant inverse correlation between the presence of silver and non-obliterated tubules (R=-0.791; p<0.001). The percentages of carbon, aluminum, strontium, and potassium were significantly higher in the PRG-control and PRG-cycled compared to the RS control. The percentages of calcium, phosphorus, and silver were significantly higher in the RS compared to the PRG groups. PRG-control showed a higher percentage of boron than RS-control. Conclusion: PRG promoted greater tubule obliteration than SR. Simulated stress did not affect the obliterating effect of each agent. Greater silver coverage corresponded to a lower proportion of non-obliterated tubules in RS. Carbon, aluminum, strontium, boron, and potassium predominated in the dentin surface treated with PRG, while calcium, phosphorus, and silver prevailed in RS groups.
  • Knowledge, Attitude and Practices Regarding Consumption of Carbonated Soft Drinks Among the Dental Students: A Cross-Sectional Study Original Article

    Metta, Kiran Kumar; Afif, Mawadah Ahmed Bin; AlThagfi, Nouf Mohammed Awwad; Ezzaddin, Rawan Osama Mohammed; Alam, Bayader Emad Mansour; Bandela, Vinod

    Resumo em Inglês:

    Abstract Objective: To assess and evaluate the knowledge, attitude, and practices regarding the consumption of carbonated drinks among dental students. Carbonated drinks are pervaded by carbon dioxide and have more adverse effects since they are acidic in nature. Nowadays, these are consumed more widely globally, causing many systemic diseases; diabetes and obesity are common. Material and Methods: This study includes 204 individuals belonging to the age group of 18-26 years. A self-structured objective type cross-sectional questionnaire survey was conducted to assess the knowledge, attitude, and practice of dental students regarding carbonated drinks. The participants were instructed to mark the most appropriate correct answer from the given list of close-ended type questions. Results: Of 204 dental students, the study population includes 125 female and 79 male students. 98.5% of the students knew about carbonated drinks, while 1.5% were unaware. Conclusion: Most participants preferred to have carbonated drinks even with their awareness about the ill effects of these drinks. Possible implications by the government authorities may probably increase awareness among the population.
  • Shame from Smiling and Speaking Due to Oral Health Problems in Brazilian Adolescents: A Nationwide Population-Based Study Original Article

    Firmino, Ramon Targino; Granville-Garcia, Ana Flávia; Paiva, Saul Martins; Campos, Priscila Hernandez de; Oliveira, Alba Valeska; Diniz, Michele Baffi

    Resumo em Inglês:

    Abstract Objective: To investigate the association between oral health problems and being ashamed of smiling or speaking among Brazilian adolescents. Material and Methods: This was a population-based cross-sectional study carried out with secondary data from 7,328 12-year-old Brazilian adolescents from the latest Brazilian national oral health survey (SB Brasil 2010). The question “In the previous 6 months, have you been ashamed of smiling or speaking due to your teeth?” was the outcome variable. Calibrated examiners performed clinical examinations on adolescents for the diagnosis of dental caries (DMF-T), dental trauma, dental fluorosis and occlusal alterations. Data were analyzed descriptively and by Poisson unadjusted and adjusted Poisson regression analysis (p<0.05). The final model was controlled by family income. Results: The prevalence of being ashamed of smiling or speaking was 13.6%. The following variables were associated with the outcome: female sex (PR= 1.33; 95% CI: 1.17-1.53), cavitated dental caries on upper incisors (PR= 1.81; 95% CI: 1.51-2.15), dental trauma (PR= 1.36; 95% CI:1.16-1.60), increased maxillary overjet (PR= 1.36; 95% CI:1.18-1.57), dental crowding (PR= 1.60; 95% CI:1.40-1.83), midline diastema (PR= 1.30; 95% CI:1.11-1.44), tooth loss (PR= 1.45; 95% CI:1.16-1.80), mild/questionable dental fluorosis (PR= 1.23; 95% CI:1.06-1.44) and moderate/severe dental fluorosis (PR= 1.67; 95% CI:1.15-2.44). Conclusion: Oral health problems that impact dental aesthetics were predisposing factors for being ashamed of smiling or speaking in Brazilian adolescents.
  • Comparative Study of the Shear Bond Strengths and Bracket Failure Rates of Two Orthodontic Adhesive Systems Original Article

    Okeke, Azubuike Chukwubumnobi; Utomi, Ifeoma; Folaranmi, Nkiruka

    Resumo em Inglês:

    Abstract Objective: To evaluate and compare the shear bond strengths (SBS) and bracket failure rates (BFR) of orthodontic brackets bonded with Light Cure adhesive against those bonded with Self Cure adhesive. Material and Methods: The study had in vitro and in vivo parts. In the in vitro part to determine SBS of Light Bond(LB)(R) and Rely.a.Bond(RB)(R) adhesives used in bonding brackets to 88 extracted teeth, each adhesive type was used to bond 44 brackets. The clinical study was conducted to determine the BFR of the LB(R) and RB(R) adhesives by bonding 256 teeth using each adhesive type. A standardized bonding procedure was followed in both the in vitro and in vivo parts of the study. Data were analyzed using frequency, percentage, mean, independent t-test, chi-square, and Pearson Correlation statistics. A p-value of ≤ 0.05 was considered significant. SPSS version 21.0 was used to analyze the data generated. Results: There was a significantly higher mean SBS 10.6MPa for LB(R) adhesive than the 7.0MPa of the RB(R) adhesive. In the in vivo study, (LB)(R) had a greater but not significant BFR of 9.0% than RB(R) (8.0%). No significant relationship existed between the SBS of either adhesive type (as determined in vitro) and their BFR in vivo. Conclusion: Higher SBS of LB(R) did not translate to less BFR in the clinic, nor did a lower SBS of RB(R) translate to more BFR in the clinic.
  • Assessing Moral Skills in General and Post-Graduate Dental Students in the Southeast of Iran: A Cross-Sectional Study Original Article

    Sajadi, Fatemeh Sadat; Torabi-Parizi, Molouk; Aftabi, Reyhaneh; Khosravi, Saeed

    Resumo em Inglês:

    Abstract Objective: To assess the level of moral skills in dental students and residents. Material and Methods: This cross-sectional and descriptive-analytical study was conducted on dental students and residents of Kerman University of Medical Sciences, selected by census sampling. Data collection tools included a demographic information checklist (age, gender, marital status, educational level (before basic sciences, after basic sciences, residency), and moral skills inventory questionnaire. The data were analyzed using a T-test and multiple regression analysis at a confidence level of 95%. Results: The total score of the moral skills questionnaire was about 44 out of 80, and there was no difference between males and females in moral skills (p=0.79). However, there was a significant difference in moral sensitivity between married and single students (p=0.036). Residents gained significantly higher moral integrity scores than students (p=0.046). Conclusion: The study highlights that the level of professional moral skills in Kerman dental students and residents was acceptable. Single students got higher scores in the moral sensitivity domain, although residents got the highest scores in the moral integrity domain. There was no significant correlation between gender and the level of moral skills.
  • Research Trends on Preventive and Therapeutic Use of TIF4 for Dental Caries and Erosion Original Article

    Chevitarese, Ana Beatriz; Leite, Karla Lorene de França; Marañón-Vásquez, Guido Artemio; Masterson, Danielle; Vicente-Gomila, José M.; Gonçalves, Andréa Fonseca; Pitton, Matheus; Maia, Lucianne Cople

    Resumo em Inglês:

    Abstract Objective: To evaluate TIF4 preventive and therapeutic use in caries and erosive lesions. Material and Methods: Searches were performed in six databases. Studies evaluating TiF4 use in vitro, in situ, and in vivo in caries and erosive lesions were included and imported into VantagePoint™ (VP). Data about publication year, authors, country, journal, study design, outcomes, TIF4 vehicles, application and intervention time, cariogenic challenge, erosive cycles, effects (positive/ negative /null) and approach (preventive/therapeutic) were analyzed through VP and Excel. Results: 93 published studies were included and an increase in publications was observed between 2010 and 2021. Forty-three authors published three or more articles, of which 67.4% were developed in Brazil and published in Caries Research (22.6%). 69.9% were in vitro studies with erosion assays (59.1%) and with preventive approaches (67.4%). The principal vehicle was a solution (69.9%) with a 1-min single application (58.0%) and with an intervention time of 5-7 days (22.6%). The principal cariogenic challenge in vitro was pH cycling (11.8%); in situ was sucrose + biofilm (6.2%); and in vivo, biofilm (6.2%). The most used erosive cycle was 4× per day in in vitro studies (20.4%) and 1× in vivo (2.1%). A positive effect was observed in prevention (41.9%) and treatment (24.7%) studies. Conclusion: TIF4 has shown a positive effect in prevention and therapeutic treatments for dental caries and erosion.
  • Cone Beam Computed Tomography Evaluation of Root Morphology of the Premolars in Saudi Arabian Subpopulation Original Article

    Iqbal, Azhar; Khattak, Osama; Issrani, Rakhi; Alonazi, Meshal Aber; Ali, Algarni Hmoud

    Resumo em Inglês:

    Abstract Objective: To evaluate root canal configuration and morphology of premolar teeth among Saudi subpopulations using cone beam computed tomography (CBCT). Material and Methods: In this retrospective cross-sectional study, CBCT images of 314 patients comprising 346 maxillary and 412 mandibular first premolar (FPM) teeth, 298 maxillary and 387 mandibular second premolar (SPM) teeth were analyzed to evaluate the number of roots, root canal morphology, and configuration based on the Vertucci's classification. The average intra-class correlation coefficient value was 0.931. Results: In the maxillary first premolar, 52.6% were two separate rooted and single rooted teeth, with one canal in 81.2% of the maxillary second premolar. Among the mandibular FPM, 96.6% of the teeth had one root and canal, and 97.9% of mandibular SPM had one root and canal. Type 1 canal configuration was seen as most common in all premolars. The number of roots in mandibular premolars did not reveal the difference among gender. Conclusion: Wide variations in root canal morphology and canal configuration system exists among maxillary and mandibular premolar teeth.
  • Factors Associated with Oral Health-Related Quality of Life in Preschoolers of Concepción, Chile: A Cross-Sectional Study Original Article

    Cartes-Velásquez, Ricardo; Nauduam-Elgueta, Yanara; Sandoval-Bustos, Gabriela; Campos, Valeria; León-Manco, Roberto Antonio; Luengo, Luis

    Resumo em Inglês:

    Abstract Objective: To identify the factors associated with Oral Health-Related Quality of Life (OHRQoL) in preschool children of Concepción, Chile. Material and Methods: A cross-sectional study was conducted in a sample of enrolled preschoolers who attend public schools in Concepción, Chile. To measure OHRQoL, the chilean version of the Early Childhood Oral Health Impact Scale (ECOHIS) was used; sociodemographic variables of the children and their parents were also recorded, as well as variables regarding the last visit to the dentist. To determine differences in the ECOHIS score for categorical variables, ANOVA and t-test were used, while Pearson's r was used to correlate ECOHIS with quantitative variables (p<0.05). Results: A total of 175 children were surveyed, with a distribution of 89 boys and 86 girls aged 56-to-79 months. The total score of the ECOHIS had a mean of 4.48 ±5.96, with a score between 0-38. Statistically significant associations were with parent's educational attainment (r=−0.159), dmft (r=0.380), OHI-S debris (r=0.174) and reason for the last visit to the dentist, the highest average in the ECOHIS scores was registered in the urgency reason. Conclusion: Oral health status, dental service utilization and educational level are associated with the OHRQoL of preschoolers of Concepción.
  • Differences in Early Childhood Caries Status on Parental Stress Levels and Socioeconomic Status in Makassar City, Indonesia, During the COVID-19 Pandemic Original Article

    Anwar, Ayub Irmadani; Panna, Selviawaty Sarifuddin; Akbar, Fuad Husain

    Resumo em Inglês:

    Abstract Objective: To analyze the differences in early childhood caries status on parental stress levels and socioeconomic status in Makassar City, Indonesia, during the COVID-19 pandemic. Material and Methods: This type of analytical observational study with a cross-sectional design was conducted in North Rantepao, Toraja City, South Sulawesi Province, Indonesia. The research subjects of this study were parents who met the criteria, were willing to participate in the study, and had children aged 6-17 years. The questionnaire instrument with the criteria for assessing children's dental and oral health was assessed based on parents' perceptions. Each item is rated on a scale from 1 (never) to 5 (always). Then the total score was divided into three categories, namely low (score 3-6), moderate (score 7-10), and high (score 11-15). Comparative test analysis using Chi-Square test. Results: Parents with high-stress levels had more children with poor oral health. There is a significant difference according to the level of stress and socioeconomic status of the parents. Conclusion: There is a significant difference between caries status in early childhood based on socioeconomic status and parental stress level.
  • Are We Hearing Right? The Negative Impact of New SARS-CoV-2 Preventive Measures and Prolonged Use of Treatment Modalities during Orthodontic Treatment Short Communication

    Marya, Anand; Venugopal, Adith; Ghoussoub, Mona Sayegh

    Resumo em Inglês:

    Abstract Since the dental treatment involves the use of various instruments and machines, there is ample presence of both distracting as well as destructive noise, and these are defined based on various parameters. With an increase in safety measures incorporated into dental practices, such as extra-oral suction devices and respirators, there has also been a corresponding rise in noise levels usually present in a clinic. Previous clinical experiments and trials have shown that the noise in a dental office can permanently bring about hearing damage. In addition to this, working with added safety measures during the pandemic, such as the use of personal protective equipment, respirators, and face shields can decrease operator efficiency and the ability to communicate normally. Dentistry has already been demonstrated to be one of the most hazardous occupations because of the high risk of infections. An Orthodontist must protect their eyes and mouth from potentially hazardous situations and the ears to prevent hearing damage.
  • Impact of COVID-19 on Oral Healthcare for Oncopediatric Patients: The Setting in a Reference Hospital in Northeast Brazil Short Communication

    Damascena, Lecidamia Cristina Leite; Bezerra, Paula Maria Maracajá; Santos, Fabio Gomes dos; Lucena, Nyellisonn Nando Nóbrega de; Vieira, Thiago Isidro; Viana Filho, José Maria Chagas; Bonan, Paulo Rogério Ferreti; Ribeiro, Isabella Lima Arrais; Serpa, Eliane Batista de Medeiros; Sousa, Simone Alves de; Valença, Ana Maria Gondim

    Resumo em Inglês:

    Abstract Objective: To describe the impact of the COVID-19 pandemic on dental care provided to pediatric cancer patients assisted in a referral hospital. Material and Methods: This is an observational, retrospective study based on secondary data extracted from worksheets of dental procedures for patients aged between 0 and 19 years assisted in the pediatric oncology sector of a hospital in João Pessoa, PB, Brazil. Dental procedures performed by the interdisciplinary team of researchers from August 2018 to February 2020 (19 months prior to the pandemic) and from April 2020 to October 2021 (19 months during the pandemic) were totaled and compared. A descriptive analysis of the data was performed. Results: There was a reduction of 80.2% in dental interventions implemented in the sector during the pandemic, with the number of procedures decreasing from 6,210 (the period before the pandemic) to 1,229 (during the pandemic). Most procedures in both periods were performed for patients assisted in beds, for whom there was a reduction of care provided for 81.2% from 5,275 to 994 procedures. Dental procedures in the outpatient clinic decreased by 74.9%, from 935 to 235. Conclusion: The COVID-19 pandemic negatively impacted dental care provided to pediatric oncology patients by restricting dental procedures to emergency demands, compromising performance prevention and health promotion actions.
  • Do Bulk-Fill Resin Composites Present More Susceptibility to Marginal Degradation in Different Clinical Scenarios? A Systematic Review and Meta-Analysis Systematic Review

    Santos, Monara Henrique dos; Santos, Lucas Rodrigues dos; Alves, Layla Narrely Santos; Moura, Helene Soares; Carvalho, Morgana Maria Souza Gadêlha de; Lins, Rodrigo Barros Esteves

    Resumo em Inglês:

    Abstract Objective: To compare the marginal degradation (susceptibility to marginal adaptation and marginal discoloration) of composite restorations placed in class II and V cavities using conventional and bulk-fill resin composites. Material and Methods: This study was approved by PROSPERO database (#42020201596). PubMed, Scopus, Embase, Web of Science, Lilacs, Cochrane, Open Grey, Clinical Trials, and Rebec databases were searched by three independent investigators using MeSH terms, supplementary concepts, synonyms, and free keywords, based on the PICOS strategy (P, population: restoration in permanent teeth; I, intervention: bulk-fill resin composite; C, comparison: conventional resin composite; O, outcome: marginal discoloration and adaptation; and S, study design: randomized and non-randomized clinical trials). The risk of bias was evaluated according to the Cochrane Collaboration’s tool, the meta-analyses by RevMan software, the certainty of evidence by the Grading of Recommendations Assessment, Development, and Evaluation, and the leave-one-out sensitivity test. The prevalence of successful events and the total number of restorations were used to calculate the risk difference at a confidence interval of 95%, according to a fixed-effect model. The heterogeneity was evaluated using the I2 index. Results: 16 from 10,780 studies were selected and included for qualitative and quantitative analysis. Two studies were considered as high risk of bias, one showing some concerns, and 13 as low risk of bias. Four meta-analyses evaluated the marginal adaptation and marginal discoloration in class II and V cavities, with a nonsignificant heterogeneity (I2 = 0%, p>0.05). The certainty of evidence was considered high, except for two subgroups of each outcome. Conclusion: There is evidence that composite restorations using conventional and bulk-fill resin composites present similar clinical performance related to marginal degradation.
  • Can Hemophilia Impact on the Oral Health Conditions of Children and Adolescents? A Systematic Review and Metanalysis Systematic Review

    Silva, Leandro Tavares da; Souza, Juliana Feltrin de; Wambier, Letícia Maíra; Menezes, José Vítor Nogara Borges; Torres-Pereira, Cassius de Carvalho; Fraiz, Fabian Calixto

    Resumo em Inglês:

    Abstract Objective: To analyze if the oral health conditions in children and adolescents are associated with hemophilia (PROSPERO-42020168192). Material and Methods: The search strategy was performed in PubMed, Scopus, Lilacs/BBO, Web of Science, Cochrane, and Grey literature databases. Two independent researchers assessed the risk of bias in these studies by the Newcastle-Ottawa Scale. For the meta-analysis, the clinical conditions data were extracted as numerical variables according to their indexes, such as dental caries experience (dmft/DMFT), gingival condition (Modified Gingival Index - IGM), and oral hygiene (Plaque Index - PI). The quality of the evidence of the meta-analysis was evaluated by the GRADE tool (GRADEproGDT). Results: From a total of 431 studies, 27 were included, and 10 were included in the meta-analysis. The studies presented a moderate risk of bias, ranging from 2 to 7 points. The dental caries experience in primary (-0.62; CI95%: -1.68–0.43) and permanent dentitions (-0.05; CI95%: -0.69–0.59), gingival condition (-0.12; CI95%: -0.27–0.03), and oral hygiene (0.36; CI95%: -0.06–0.77) did not differ between the groups. Conclusion: Based on studies with very weak evidence, there were no differences in the oral health conditions of children and adolescents with and without hemophilia.
  • Brazilian Dentistry is Among the Best in the World. Is it True? Letter To The Editor

    Vieira, Alexandre R.; Castro, Ricardo Dias de
  • Human Oral Microbiome and Systemic Diseases: What Stage are We at? Letter To The Editor

    Gómez, Pablo Alejandro Millones
  • Computer Vision Syndrome: Will the Pandemic Lead to Eye Problems for Dentists? Critical Review

    Marya, Anand; Venugopal, Adith; Karobari, Mohmed Isaqali; Heboyan, Artak

    Resumo em Inglês:

    ABSTRACT Over the past year and a half dental education has been conducted primarily online due to the SARS-CoV-2 pandemic. During the pandemic, we have spent many hours a day on our computers, mobile phones, and tablets to gather information and participate in online seminars and classrooms. Health consequences resulting from the overuse of these devices include carpal tunnel syndrome as well as computer vision syndrome (CVS). Computer vision syndrome, also known as digital eye strain, has several associated features such as eye burning, strained vision, dry eye, blurred vision, and associated neck and shoulder pain. Several predisposing factors have been linked with CVS, but often this problem gets ignored. The management of this syndrome is aimed at educating dentists on computer use, position, and the surrounding environment. Considering all this, we must ensure that we spend some time away from these devices every day to avoid any significant vision problems. The objective of preparing this manuscript was to provide a brief overview of the increased prevalence of computer vision syndrome and its associated features.
  • The Use of Bio-Inks and the Era of Bioengineering and Tooth Regeneration Critical Review

    Tauqir, Saman; Ali, Saqib; Marya, Anand

    Resumo em Inglês:

    Abstract Objective: To review existing literature and provide an update on the current use of Bio-Inks and potential future use. Material and Methods: A MeSH keyword search was conducted to find out relevant articles for this short review. Results: Bio inks used in 3D printing grafting require various properties essential for the selection. Combining multiple methods and improved properties is essential for developing successful bio-inks for 3D grafting of functional tissues and tooth pulp regeneration from stem cells. To date, researchers have made many efforts to grow teeth based on stem cells and inculcate regeneration of teeth along with surrounding tissues like alveolar bones and periodontal ligaments. Conclusion: 3D printing with Bio-Inks requires strict adherence to safety protocols for successful outcomes, making it difficult to employ this routinely.
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