Posterior restorations: a birth cohort study

Direct restorations are still the first choice to restore posterior teeth due to their predictable and good clinical performance. Although most of clinicians and researchers believed that restorative materials were the main factors associated with failure of restorations, the literature have been pointed out that factors related to dentists and patients are also of great importance for longevity of restorations. When they are located on the proximal surface, restorations are more susceptible to overhangs and defects, being these characteristics a possible reason for periodontal tissue damage. However, it is still little scarce research on the association between proximal restorations and periodontal health. This study aimed to evaluate posterior restorations placed in adults from a birth cohort, investigating the association between determinants experienced during the life course and the quality of tooth fillings. In addition, the effect of subgengival and supragengival proximal restoration on periodontal health was assessed. A representative sample (n = 539) of all 5,914 births occurring in Pelotas in 1982 were prospectively investigated, being posterior restorations and periodontal health assessed at 31 yr-old. Exploratory variables included demographic and socio-economic, oral health and service utilization patterns during the life course. Tooth related variables (type of tooth, material, size of cavity) were also analyzed. Caries risk and socioeconomic status were assessed by group-based trajectories analyses. Multilevel Regression models were used to determine factors associated with restoration outcomes. Failures in posterior restorations showed a significant association with socioeconomic (lower tercile income at age 30) and clinical (high risk for dental caries) individual-related factors and tooth-related factors (size of cavity). These results suggest that, although tooth-related variables have an important role in the investigated restorations outcomes, patient-related factors, such as socioeconomic and oral health variables, are also associated with these conditions and should take in account when evaluating posterior restorations. The hypothesis that proximal direct restorations have a negative effect on periodontal health was partially confirmed. While not indicative of disease, an increase of mean periodontal attachment loss and probing depth was observed in sites with presence of supragingival and subgingival restorations when compared to sites with healthy surface. Therefore, it is expected that this increase can also be observed in the occurrence of periodontal disease in the future.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESAs restaurações diretas ainda são a primeira opção para substituir a estrutura dental em dentes posteriores. Por muito tempo acreditou-se que as propriedades dos materiais restauradores eram as principais responsáveis na longevidade das restaurações diretas. Ao longo do tempo a literatura tem reportado que além do material, fatores relacionados aos pacientes e aos operadores também são potenciais fatores de risco para a falha de restaurações. Quando localizadas em superfície proximal, as restaurações estão mais suscetíveis a sobrecontornos e defeitos, podendo essas características causar um dano ao tecido periodontal. Entretanto ainda é escassa a investigação do papel das restaurações na saúde periodontal adjacente. Este trabalho tem por objetivo avaliar as restaurações em dentes posteriores realizadas em adultos de uma coorte de nascimentos, investigando a associação entre determinantes experimentados ao longo da vida dos indivíduos e a qualidade das restaurações. Ainda, investigar o efeito das restaurações proximais supragengivais e supragengivais na saúde dos tecidos periodontais. Uma amostra representativa (n = 539) de todos os 5914 nascimentos ocorridos em Pelotas, RS, em 1982 foi investigada prospectivamente, e as restaurações posteriores foram avaliadas em 2013, aos 31 anos de idade. As variáveis de exposição incluíram características demográficas, socioeconômicas, de saúde bucal e de utilização de serviços ao longo da vida. Variáveis relativas ao dente (tipo, material restaurador, tamanho da cavidade) também foram analisadas. O risco de cárie e o status socioeconômico foram investigados por análises de trajetória em grupos. Modelos de análise de Regressão Multinível foram utilizados para determinar os fatores associados com os desfechos avaliados. Falhas em restaurações posteriores foram associadas significantemente com a menor renda aos 30 anos, com alto risco de cárie, com a presença de doença periodontal e com o maior tamanho da cavidade. Os resultados sugerem que, embora as variáveis relativas ao dente desempenhem um papel importante nos desfechos avaliados, fatores relacionados aos pacientes, como características socioeconômicas e de saúde bucal também estão associadas a estas condições, devendo ser levadas em consideração na avaliação de restaurações em dentes posteriores. A hipótese de que restaurações diretas proximais tem um efeito negativo na saúde periodontal foi parcialmente confirmada. Embora não seja indicativo de doença, foi observado um aumento médio da perda de inserção periodontal e da profundidade de sondagem em sítios com presença de restaurações supragengivais e subgengivais quando comparados a sítios com superfície hígida. Portanto é esperado no futuro que esse aumento reflita na maior ocorrência de doença periodontal nesses sítios

O status socioeconômico ao longo da vida associado á insatisfação com a aparência dentária

Nossos resultados demonstraram uma alta prevalência de insatisfação com a aparência dentária em adultos jovens nesta coorte de nascimento brasileira. As trajetórias de pobreza foram associadas à insatisfação com a aparência dentária, mesmo após o controle de variáveis de saúde bucal. Condições clínicas (presença de má oclusão, cáries não tratadas e dor dental) também estavam relacionadas com a insatisfação com a aparência dentária. Indivíduos insatisfeitos com a aparência geral estavam mais insatisfeitos com a aparência dentária

Factors Related to Early Marginal Bone Loss in Dental Implants—A Multicentre Observational Clinical Study

This study evaluated the effect of clinical and patient-related factors on marginal bone loss. The sample was composed of individuals who were treated at two dental schools in southern Brazil. The variables evaluated were divided into individual (age, sex, diabetes, hypertension and antihypertensive use), and implant levels (arch, position, brand, protection, torque, time). After implant installation and following the second stage, periapical radiographs were obtained to measure the distance between the peri-implant bone crest and implant platform. Measurements were performed using ImageJ software. Data were analyzed using linear and Poisson multilevel regression. Fifty-eight patients with 113 implants were evaluated. The mean marginal bone loss was 0.45 ± 0.48 mm. Considering the linear multivariate model, age, diabetes, torque and time between surgery and reopening were found to be significant (p < 0.05). In the dichotomous model (bone loss <0.2 mm and ≥0.2 mm), only high torques resulted in higher marginal bone loss (p = 0.033). Marginal bone loss occurred before the second surgical stage and was greater in implants with high torque. Torque below 20 N, reopening performed after six months, diabetic status and young age all resulted in higher marginal bone loss, but these values are probably not clinically significant. These variables must be better explored in future studies

Survey on the occurrence of dental trauma and preventive strategies among Brazilian professional soccer players

OBJECTIVES: The aims of this study were to verify the occurrence of dental injuries in professional Brazilian soccer players, the level of knowledge of the teams' medical departments about mouthguards, and the conducts adopted in cases of dental trauma during the match. MATERIAL AND METHODS: Closed questionnaires were sent to the physicians in charge of the medical departments of the 40 teams enrolled in the first and second divisions of the Brazilian professional soccer league in 2007. The data obtained were subjected to descriptive analysis to determine absolute and relative frequencies of answers for each one of the questions. RESULTS: Physicians from 38 (95%) of the 40 teams in the first and second divisions answered the questionnaires and 71.1% reported the occurrence of some type of dental injury during soccer practice, dental fractures (74.1%) and avulsions (59.3%) being the most prevalent ones. Regarding emergency conducts, approximately 50% answered that a successful replantation could be obtained in periods from 6 to 24 h after injury, and 27.8% were not able to answer this question. Regarding mouthguard use, 48.6% of the physicians did not know about mouthguards, and only 21.6% usually recommended their use by the soccer players. Among the physicians who do not recommend the use of mouthguards, 50% justified that it was not necessary. Almost 50% of the medical departments do not have a dentist as part of the health professional staff. CONCLUSIONS: It was possible to conclude that dental injuries are common during professional soccer practice and that there is a lack of information in the medical departments related to the emergency conducts and prevention of dental trauma