Publication Trends Studies Involving Disabled Persons with Dental Care Needs: A 20-Year Bibliometric Analysis

Objective: To evaluate scientific production on disabled persons with dental care needs over a 20-year period. Material and Methods: The search was conducted in the PubMed database using the MeSH terms “Disabled Persons” AND “Dentistry”. Three researchers selected articles based on readings of the title, abstract and full text. The articles were categorized according to periodical, country, study design, subject and classification of comorbidities and associated disorders. Three hundred ninety-seven articles published in 140 periodicals were included. Results: The periodicals Special Care in Dentistry (54), Dental Clinics of North America (14) and British Dental Journal (14) accounted for 21% of the publications. The studies were conducted in 50 countries, with the United States accounting for 33%. More than half (52%) of the studies had a cross-sectional design. The main subject addressed was oral diagnosis and most of the comorbidities were generalized disabilities. Conclusion: Although a large number of the periodicals have contributed to knowledge building on disabled persons with dental care needs, the number of articles is small compared to other fields of dentistry. Moreover, important gaps in knowledge persist and projects with better methodological designs are needed to offer a more substantial contribution to clinical practice

Analysis of the oral conditions and salivary microbiology of pediatric patients in programming for liver transplantation and evaluation of the quality of life of their donors\' general health

O transplante hepático (Tx) pediátrico é o tratamento definitivo e indicado para doenças hepáticas terminais. Nele, estão envolvidos dois cenários: o da criança receptora e do doador, que abrangem questões como a saúde geral e bucal, imunossupressão e qualidade de vida. A imunossupressão pode acarretar infecções oportunistas como os poliomavírus BK e JC que causam complicações clínicas no pós-transplante. Assim, esta pesquisa trata-se de um estudo longitudinal que se propôs avaliar três vertentes: i) as condições odontológicas das crianças no processo do transplante hepático; ii) avaliar a excreção oral e viremia dos poliomavírus BK e JC nas crianças antes e após o Tx; iii) avaliar o impacto da qualidade de vida (QV) dos doadores. Para analisar as vertentes relacionadas ao receptor, foram incluídas 84 crianças em programação para o transplante hepático no Hospital Municipal Infantil Menino Jesus em São Paulo, mas apenas 51 fizeram parte da amostra final. Foram utilizadas as categorias avaliativas do Bedside Oral Exam BOE para avaliar as condições bucais pré- e pós-transplante imediato. Juntamente com o exame clínico bucal, foram realizadas seis coletas, uma pré-transplante e cinco semanalmente no pós-transplante, de saliva e sangue para avaliar a presença dos poliomavírus. Em contrapartida, para avaliar a QV dos doadores, participaram desse estudo 25 adultos. Para essa avaliação foi utilizado o questionário SF-36 versão 2, que é autoaplicável e aborda oito domínios sobre a saúde física e emocional, sendo aplicado no pré-Tx (um dia anterior a cirurgia) e no pós-Tx (um mês após a cirurgia). As análises estatísticas utilizadas para cada objetivo foram: i) análise descritiva das condições bucais nos dois momentos e comparadas através do teste de Wilcoxon; ii) análise da variável dicotômica e o teste de McNemar para identificar a presença do BK e JC; iii) teste de Shapiro-Wilk, seguido pela comparação dos dados paramétricos pelo teste t pareado e dados não paramétricos pelo teste de Wilcoxon considerando significância estatística de p<0,05 para a avaliação da QV do doador. As análises foram realizadas através do software JAMOVI. Assim, os resultados encontrados para cada objetivo foram: i) no pré-transplante a característica mais frequente foi à alteração de cor nas mucosas (78.6% n=84) e no pós-transplante alteração nos lábios (27.4% n=51), na função deglutição (13.8% n=51) e na cor dos dentes (27.4% n=51); apesar disso as crianças apresentavam BOE escore 8, 9 ou 10 tanto no pré-transplante (92.8% n=84) como no pós-transplante (90.4% n=51); ii) em relação à excreção oral e viremia dos poliomavírus, apenas observamos a presença do BK na saliva em uma amostra (2%) na segunda e uma amostra (2%) na quinta semana pós-Tx; e no plasma em uma amostra (2%) na terceira e em uma amostra (2%) na quinta semana pós-Tx. O JC não foi detectado em nenhuma das amostras analisadas; iii) em relação à QV do doador, foi possível verificar uma diferença estatisticamente significativa nos domínios relacionados à capacidade funcional (média no pré-Tx= 85.4 e média no pós-Tx= 47.6; p<0.001), limitação por aspectos físicos (média no pré-Tx= 82.5 e média no pós-Tx= 52.5; p<0.001), dor (média no pré-Tx= 83.9 e média no pós-Tx= 60.5; p=0.002) e limitação por aspectos emocionais (média no pré-Tx= 82.5 e média no pós-Tx= 52.5; p<0.001). Conclui-se que as crianças possuíam uma boa condição bucal no pré e pós-transplante apesar de terem sido encontradas alterações na mucosa no pré-transplante e alterações em lábios e dentes no pós-transplante. A presença do poliomavírus BK é um evento raro em pacientes pediátricos no processo de transplante hepático. No que diz respeito ao impacto da QV nos doadores, houve uma piora no pós-transplante considerando os aspectos físicos e emocionais.Pediatric liver transplantation (LT) is the definitive and indicated treatment for end-stage liver disease. Two scenarios are involved: the recipient child and the donor, which include issues such as general and oral health, immunosuppression and quality of life. Immunosuppression can lead to opportunistic infections such as the BK and JC polyomaviruses that cause post-transplant clinical complications. Thus, this research is a longitudinal study that proposed to evaluate three aspects: i) the oral conditions of children in the liver transplantation process; ii) to evaluate the oral excretion and viremia of BKPyV and JCPyV polyomavirus of children in this process; iii) to evaluate the impact of quality of life (QoL) of donors. To analyze the recipient-related strands, 84 children on schedule for liver transplantation at the Hospital Municipal Infantil Menino Jesus in São Paulo were included, but only 51 were part of the final sample. The evaluative categories of the Bedside Oral Exam -BOE were used to assess the children\'s pre- and post-transplantation oral conditions. Along with the clinical oral examination, six collections of saliva and blood were made, one pre-transplant and five weekly post-transplant, to assess the presence of polyomavirus. In contrast, to assess the QoL of the donors, 25 adults participated in this study. For this assessment, we used the SF-36 version 2 questionnaire, which is self-administered and covers eight domains of physical and emotional health, being applied pre-transplant (one day before surgery) and post-transplant (one month after surgery). The statistical analyses used for each objective were: i) descriptive analysis of the oral conditions at the two moments and compared using the Wilcoxon test; ii) analysis of the dichotomous variable and McNemar\'s test to identify the presence of BKPyV and JCPyV; iii) Shapiro-Wilk test, followed by comparison of parametric data by the paired t-test and non-parametric data by the Wilcoxon test considering statistical significance of p<0.05 for the evaluation of the donor\'s QoL. The analyses were performed using the JAMOVI software. Thus, the results found for each objective were: i) in before transplant the most frequent characteristic was the change in mucosal color (78.6% n=84) and in post-transplant the change was in the lips (27.4% n=51), in swallowing function (13.8% n=51) and in the color of the teeth (27.4% n=51); despite this, the children had BOE scores of 8, 9 or 10 both before transplant (92. 8% n=84) and post-transplant (90.4% n=51); ii) regarding oral excretion and viremia of polyomaviruses, we only observed the presence of BK in saliva in 1 (2%) in the second and 1 (2%) sample in the fifth week post-Tx; and in plasma in 1 (2%) in the third and 1 (2%) sample in the fifth week post-Tx. JC was not detected in any of the analyzed samples; iii) regarding donor QoL, it was possible to verify a statistically significant difference in the domains related to functional capacity (mean before LT= 85.4 and mean post-LT= 47.6; p<0. 001), limitation by physical aspects (mean before LT= 82.5 and mean post-LT= 52.5; p<0.001), pain (mean before LT= 83.9 and mean post-LT= 60.5; p=0.002) and limitation by emotional aspects (mean before LT= 82.5 and mean post-LT= 52.5; p<0.001). We conclude that the children had a good oral condition before and post transplantation although changes in mucosa were found before transplant and changes in lips and teeth post-transplant. The presence of BK polyomavirus is a rare event in pediatric patients in the process of liver transplantation. Regarding the impact of QoL in donors, there was a worsening in post-transplantation considering the physical and emotional aspects

Influence of maternal anxiety on child anxiety during dental care: cross-sectional study

ABSTRACT CONTEXT AND OBJECTIVES: Anxiety is usually classified as a disorder of neurotic nature and is often related to contexts of stress, which may include worries, motor tension and autonomic hyperactivity. The aim of this study was to assess the influence of mothers’ anxiety on their children’s anxiety during dental care. DESIGN AND SETTING: Analytical cross-sectional study conducted at in a private dentistry school in the south of Brazil. METHODS: Convenience sampling was used. All mothers of children undergoing treatment were invited to participate in this study. Data to investigate anxiety related to dental treatment among the children were collected through applying the Venham Picture Test (VPT) scale. For the mothers, the Corah scale was applied. A self-administered sociodemographic questionnaire with questions about demographic, behavioral, oral health and dental service variables was also used. RESULTS: 40 mother-child pairs were included in the study. The results showed that 40% of the children were anxious and 60% of the mothers were slightly anxious. Local anesthesia was the procedure that caused most anxiety among the mothers, making them somewhat uncomfortable and anxious (60%). Family income higher than R$ 1,577.00 had an influence on maternal anxiety (75.6%). Maternal anxiety had an influence on child anxiety (81.3%). CONCLUSION: Most of the children showed the presence of anxiety, which ranged from fear of dental care to panic, inferring that maternal anxiety has an influence on children’s anxiety. Dental procedures did not interfere with the mothers’ anxiety, but caused positive feelings, whereas they affected the children more

Effect of two erosive protocols using acidic beverages on the shear bond strength of orthodontic brackets to bovine enamel

Abstract Objective: To assess the short-term effect of two in vitro erosive challenge protocols on the bond strength of metal orthodontic brackets on bovine enamel. Methods: Sixty bovine incisors were selected and randomly divided into six groups: AS7 (artificial saliva - 7 days, Control Group); CC7 (Coca-Cola™ - 7 days); LJ7 (lime juice - 7 days); AS30 (artificial saliva - 30 days, Control Group); CC30 (Coca-Cola™ - 30 days); LJ30 (lime juice - 30 days). Microhardness testing was performed prior to the erosive challenge to verify the standardization of samples. Immersion was performed 4x/day for five minutes, for either 7 or 30 days. After immersions were concluded, the brackets were bonded and shear bond strength was assessed after 48 hours. The Adhesive Remnant Index (ARI) was also assessed. Data were analyzed by two-way ANOVA, followed by Tukey’s post-hoc and Student’s t test for paired samples, and the Kruskal-Wallis non-parametric test (α = 5%). Results: The mean and standard deviation of microhardness testing of total samples were 281.89 ± 44.51 KHN. There was no statistically significant difference in shear bond strength for the time factor (7 or 30 days; F5.54= 0.105; p = 0.901). However, there was a statistically significant difference for the solution factor (F5.54= 6.671; p = 0.003). These differences occurred among solutions of Saliva x Coca-Cola™ (p = 0.003) and Coca-Cola™ x Lime Juice (p= 0.029). The assessment of the Adhesive Remnant Index showed no significant difference between groups. Conclusions: The immersion time used in the erosion protocols did not affect the bond strength of brackets to teeth. Coca-Cola™ induced significantly higher shear bond strength values than lime juice and artificial saliva. However, the short term effects of 7/30 days in this in vitro study may not be extrapolated for in vivo ones. Clinical studies should be conducted, substantiating the laboratory results