Evaluation of the Family Impact Scale for use in Brazil

OBJECTIVES: The objectives of this study were to assess the validity and reliability of the Family Impact Scale (FIS) applied in Brazilian parents after translations and cultural adaptations to Brazilian Portuguese language and to evaluate the nature and extent to which the family functioning is compromised by the child oral conditions. MATERIAL AND METHODS: Parents were recruited from general populations for pre-testing (n=20), validity (n=210) and test-retest reliability (n=20) studies. The children were examined for dental caries, gingivitis, fluorosis and malocclusion. RESULTS: The FIS discriminated among the categories of malocclusion and showed good construct validity. The Cronbach's alpha and intraclass correlation coefficients were 0.87 and 0.90, respectively. Almost 20% of the informants reported some family impact `sometimes' or `often/everyday' from the child's oral condition. Impact on FIS domains of this frequency ranged from 13.8% for financial difficulties to 24.4% for parental or family activities. CONCLUSIONS: The Brazilian Portuguese version of FIS is valid and reliable. The results suggest that child oral conditions have a negative impact on the family. Further research is required, as these findings were based on cross-sectional study and convenience samples

Secreção salivar e mastigação: efeitos estimulantes de alimento artificial e natural

The aim of the present study was to determine the relationship between the flow rate of saliva and characteristics of the food. Therefore, we determined the rate of saliva secretion in 16 healthy subjects in rest and while chewing natural and artificial foods (toast with and without margarine, three sizes of breakfast cake, and Parafilm). We also determined the chewing rate, number of chewing cycles until swallowing, and time until swallowing. The physical characteristics of the foods were quantified from force-deformation experiments. The results showed that the average at which mechanical failure occurred (yield force) was 1.86 &plusmn; 0.24 N for the breakfast cake and 16.3 &plusmn; 1.3 N for the melba toast. The flow rates obtained without stimulation and with Parafilm were significantly lower (P < 0.001) than the flow rates obtained from chewing food. No differences in flow rate occurred between the natural foods. The flow rates of the saliva as obtained without stimulation, with Parafilm stimulation, and with chewing on the various foods were significantly correlated (P < 0.05). There were no significant differences in chewing rate among the foods. The number of chewing cycles and the time until swallowing significantly depended on the type or volume of the food.O objetivo deste estudo foi determinar a relação entre o fluxo salivar e características de diferentes alimentos. Avaliou-se a taxa de secreção salivar em 16 indivíduos saudáveis, sem estimulação, na estimulação com Parafilm e na mastigação de alimentos naturais (torrada com e sem margarina e 3 volumes de bolo industrial). Determinou-se também a velocidade, o tempo de mastigação, o número de ciclos mastigatórios até o limiar da deglutição. As características físicas dos alimentos foram quantificadas através da experimentação força-deformação. Os resultados mostraram que a média em que a falha mecânica ocorreu foi 1,86 &plusmn; 0,24 N para o bolo industrial e 16,3 &plusmn; 1,3 N para a torrada. Os fluxos salivares obtidos sem estimulação e com a estimulação pelo Parafilm foram significativamente menores (P < 0,001) que os fluxos salivares obtidos na mastigação dos alimentos naturais. Não houve diferença significativa no fluxo salivar entre os alimentos naturais. Os fluxos salivares obtidos sem estimulação, com estimulação pelo Parafilm e na mastigação dos vários alimentos foram significantemente correlacionados (P < 0,05). Não houve diferença significativa na velocidade da mastigação entre os alimentos. O número de ciclos mastigatórios e o tempo de mastigação até o limiar da deglutição dependeram do tipo e do volume do alimento

Validity and reliability of the Child Perceptions Questionnaires applied in Brazilian children

<p>Abstract</p> <p>Background</p> <p>The Child Perceptions Questionnaires (CPQ_8–10and CPQ_11–14) are indicators of child oral health-related quality of life. The aim of this study was to assess the validity and reliability of the self-applied CPQ_8–10and CPQ_11–14in Brazilian children, after translations and cultural adaptations in the Brazilian Portuguese language.</p> <p>Methods</p> <p>Schoolchildren were recruited from general populations for pre-testing (n = 80), validity (n = 210), and test-retest reliability (n = 50) studies. They were also examined for dental caries, gingivitis, fluorosis, and malocclusion.</p> <p>Results</p> <p>Children with greater dental caries experience in primary dentition had higher impacts on CPQ domains. Girls had higher scores for CPQ_8–10domains than boys. Mean CPQ_11–14scores were highest for 11-year-old children and lowest for 14-year-old children. Construct validity was supported by significant associations between the CPQ_8–10and CPQ_11–14scores and the global rating of oral health (r = 0.38, r = 0.43) and overall well-being (r = 0.39, r = 0.60), respectively. The Cronbach's alpha was 0.95 for both questionnaires. The test-retest reliabilities of the overall CPQ_8–10and CPQ_11–14scores were both excellent (ICC = 0.96, ICC = 0.92).</p> <p>Conclusion</p> <p>The Brazilian Portuguese version of CPQ_8–10and CPQ_11–14was valuable and reliable for use in the Brazilian child population, although discriminant validity was sporadic due to the fact that impacts are mediated by others factors, such personal, social, and environmental variables.</p

Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study

Chronic pain has been often associated with myofascial pain syndrome (MPS), which is determined by myofascial trigger points (MTrP). New features have been tested for MTrP diagnosis. The aim of this study was to evaluate two-dimensional ultrasonography (2D US) and ultrasound elastography (UE) images and elastograms of upper trapezius MTrP during electroacupuncture (EA) and acupuncture (AC) treatment. 24 women participated, aged between 20 and 40 years (M ± SD = 27.33 ± 5.05) with a body mass index ranging from 18.03 to 27.59 kg/m2 (22.59 ± 3.11), a regular menstrual cycle, at least one active MTrP at both right (RTPz) and left trapezius (LTPz) and local or referred pain for up to six months. Subjects were randomized into EA and AC treatment groups and the control sham AC (SHAM) group. Intensity of pain was assessed by visual analogue scale; MTrP mean area and strain ratio (SR) by 2D US and UE. A significant decrease of intensity in general, RTPz, and LTPz pain was observed in the EA group (p = 0.027; p < 0.001; p = 0.005, respectively) and in general pain in the AC group (p < 0.001). Decreased MTrP area in RTPz and LTPz were observed in AC (p < 0.001) and EA groups (RTPz, p = 0.003; LTPz, p = 0.005). Post-treatment SR in RTPz and LTPz was lower than pre-treatment in both treatment groups. 2D US and UE effectively characterized MTrP and surrounding tissue, pointing to the possibility of objective confirmation of subjective EA and AC treatment effects.372152167COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSem informação2011/12659-

Anxiety/depression And Orofacial Myofacial Disorders As Factors Associated With Tmd In Children.

The purpose of this study was to evaluate factors associated with temporomandibular disorder (TMD) in children. TMD clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD; axis I), and subjective symptoms were evaluated using a structured questionnaire. Eighty-two children were selected, 40 with TMD (19 boys and 21 girls, mean age 9.84 ± 1.53 and 9.71 ± 1.30 years, respectively) and 42 without TMD (21 boys and 21 girls, mean age 10.27 ± 1.63 and 9.9 ± 1.37 years, respectively). Intra- and extra-oral examinations were carried out to determine the myofunctional characteristics of the masticatory system. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Data were analyzed using descriptive statistics and bivariate analysis followed by multiple logistic regression (α = 0.05). In bivariate analysis, the variables of open lips, anxiety, and depression had a p value < 0.15 and were entered into the multivariate logistic regression model. The most significant predictor factors were the presence of open lips (odds ratio = 5.42, p = 0.034) and anxiety (odds ratio = 18.59, p < 0.001). Thus, anxiety levels and open lips were associated with TMD in children. Owing to the cross-sectional design of the present study, the associations observed may have a bidirectional relationship.27156-6

Movimentos mandibulares em crianças portadoras ou não de sinais e sintomas de disfunção temporomandibular

This research aimed to evaluate mandibular movements in children with and without signs and symptoms of temporomandibular dysfunction. The sample taken consisted of 99 children aged 3 to 5 years distributed in two groups: I - Absence of signs and/or symptoms of TMD (25 girls/40 boys); II - Presence of signs and symptoms of TMD (16 girls/18 boys). The symptoms were evaluated through an anamnesis questionnaire answered by the child's parents/caretakers. The clinical signs were evaluated through intra- and extraoral examination. Maximum mouth opening and left/right lateral movements were measured using a digital caliper. The maximum protrusive movement was measured using a millimeter ruler. The means and standard deviations for maximum mouth opening in Group I and Group II were 40.82mm±4.18 and 40.46mm±6.66, respectively. The values found for the left lateral movement were 6.96mm±1.66 for Group I and 6.74mm±1.55 for Group II, while for the right lateral movement they were 6.46mm±1.53 and 6.74mm±1.77. The maximum protrusion movements were 5.67mm±1.76 and 6.12mm±1.92, in Groups I and II, respectively. The mandibular movement ranges neither differed statistically between groups nor between genders. FAPESP Process 96/0714-6.O objetivo desta pesquisa foi avaliar a amplitude dos movimentos mandibulares em crianças portadoras ou não de sinais e sintomas de disfunção temporomandibular. A amostra consistiu de 99 crianças entre 3 e 5 anos distribuídas em 2 grupos: I - Ausência de sinais e sintomas de DTM (25 meninas/40 meninos) II - Presença de sinais e sintomas de DTM (16 meninas/18 meninos). Os sintomas foram avaliados através de um questionário respondido pelos pais ou responsáveis das crianças. Os sinais clínicos foram avaliados através de exame intra e extra-oral por dois examinadores calibrados. Os movimentos de abertura máxima e lateralidade direita e esquerda foram mensurados com o auxílio de um paquímetro digital. Para o movimento de protrusão foi utilizada régua milimetrada. A média e o desvio padrão para abertura bucal máxima para o grupo I foi de 40,82mm±4,18 e para o grupo II 40,46mm±6,66. Os valores encontrados para a lateralidade esquerda foram 6,96mm±1,66 para o grupo I e 6,74mm±1,55 para o grupo II e, para a direita, foram 6,46mm±1,53 e de 6,74mm±1,77, respectivamente. Durante a protrusão foram encontrados valores de 5,67mm±1,76 para o grupo I e 6,12mm±1,92 para grupo II. Pode-se concluir que na amostra avaliada a amplitude dos movimentos mandibulares não diferiu estatisticamente entre os grupos, bem como entre os gêneros. FAPESP Processo 96/0714-6

Mastication and swallowing: influence of fluid addition to foods

INTRODUCTION: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. OBJECTIVES: The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume). Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p;0.05). Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake), but did not influence the chewing of fatty (cheese) and wet products (carrot). This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation

Mastication and swallowing: influence of fluid addition to foods

INTRODUCTION: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. OBJECTIVES: The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume). Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p;0.05). Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake), but did not influence the chewing of fatty (cheese) and wet products (carrot). This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation

Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder

Background: Oral health-related quality of life (OHRQoL) in children and adolescents with signs and symptoms of temporomandibular disorder (TMD) has not yet been measured. This study aimed to evaluate the validity and reliability of OHRQoL measure for use in children and preadolescents with signs and symptoms of TMD.Methods: Five hundred and forty-seven students aged 8-14 years were recruited from public schools in Piracicaba, Brazil. Self-perceptions of QoL were measured using the Brazilian Portuguese versions of Child Perceptions Questionnaires (CPQ)(8-10) (n = 247) and CPQ(11-14) (n = 300). A single examiner, trained and calibrated for diagnosis according to the Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD), examined the participants. A self-report questionnaire assessed subjective symptoms of TMD. Intraexaminer reliability was assessed for the RDC/TMD clinical examinations using Cohen's Kappa (kappa) and intraclass correlation coefficient (ICC). Criterion validity was calculated using the Spearman's correlation, construct validity using the Spearman's correlation and the Mann-Whitney test, and the magnitude of the difference between groups using effect size (ES). Reliability was determined using Cronbach's alpha, alpha if the item was deleted and corrected item-total correlation.Results: Intraexaminer reliability values ranged from regular (kappa = 0.30) to excellent (kappa = 0.96) for the categorical variables and from moderate (ICC = 0.49) to substantial (ICC = 0.74) for the continuous variables. Criterion validity was supported by significant associations between both CPQ scores and pain-related questions for the TMD groups. Mean CPQ(8-10) scores were slightly higher for TMD children than control children (ES = 0.43). Preadolescents with TMD had moderately higher scores than the control ones (ES = 0.62; p < 0.0001). Significant correlation between the CPQ scores and global oral health, as well as overall well-being ratings (p < 0.001) occurred, supporting the construct validity. the Cronbach's alphas were 0.93 for CPQ(8-10) and 0.94 for CPQ(11-14). for the overall CPQ(8-10) and CPQ(11-14) scales, the corrected item-total correlation coefficients ranged from 0.39-0.76 and from 0.28-0.73, respectively. the alpha coefficients did not increase when any of the items were deleted in either CPQ samples.Conclusions: the questionnaires are valid and reliable for use in children and preadolescents with signs and symptoms of temporomandibular disorder.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Estadual Campinas, Piracicaba Dent Sch, Dept Pediat Dent, Piracicaba, SP, BrazilUniversidade Federal de São Paulo, Dept Biol Sci, Diadema, SP, BrazilUniversidade Federal de São Paulo, Dept Biol Sci, Diadema, SP, BrazilFAPESP: 2008/00325-9Web of Scienc

Aesthetic And Functional Rehabilitation Of The Primary Dentition Affected By Amelogenesis Imperfecta.

The objective of this case report was to describe the oral rehabilitation of a five-year-old boy patient diagnosed with amelogenesis imperfecta (AI) in the primary dentition. AI is a group of hereditary disorders that affects the enamel structure. The patient was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of AI. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms. The main objectives of the selected treatment were to enhance the esthetics, restore masticatory function, and eliminate the teeth sensitivity. The child was monitored in the pediatric dentistry clinic at four-month intervals until the mixed dentition stage. Treatment not only restored function and esthetic, but also showed a positive psychological impact and thereby improved perceived quality of life. The preventive, psychological, and curative measures of a young child with AI were successful. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, and resin-filled celluloid forms to reestablish the oral functions and improve the child's psychosocial development.201579089