Aesthetic and functional rehabilitation of anterior teeth after trauma: a case report

Traumatic dental injuries are common clinical problems during childhood, and may have complex etiologies causing physical and physiological impairment. The aim of this study was to report the management of a severe traumatic dental injury in an 8-year-old female patient, victim of a motorcycle accident, who was taken to a pediatric dentistry clinic three months after the accident. After clinical and radiografic examination, we observed the avulsion of the permanent maxillary central incisors and of the permanent left lateral incisor, with considerable lingual interposition, interfering in speech and swallowing. The patient showed low risk of caries and good behavior during the appointments. However, she demonstrated to be embarrassed to smile. Besides the preventive treatment concerning caries, the treatment plan included immediate care and subsequent monitoring of the psychosocial reestablishment. For this purpose, an acrylic partial denture was made in order to replace the missing anterior teeth, maintaining the characteristics of the mixed dentition and preserving the aesthetics and the function. Follow-up appointments were performed one, three and six months after the first visit, aiming to monitor the adaptation of the prosthesis, as well as the growth and development of the child’s dentition. Thus, the aesthetic and functional rehabilitation was achieved regarding the patient’s satisfaction, enabling immediate social reinsertion.Lesões dentárias traumáticas são problemas clínicos comuns durante a infância e podem ter etiologias complexas, causando deficiências físicas e fisiológicas. O objetivo deste estudo foi relatar um caso de lesão dentária traumática grave em uma paciente de 8 anos de idade, vítima de um acidente de moto, que foi levada para uma clínica de odontopediatria três meses depois do acidente. Exames clínicos e radiológicos diagnosticaram a avulsão dos incisivos centrais superiores permanentes, do incisivo lateral esquerdo permanente e do canino esquerdo decíduo, com considerável interposição da língua, interferindo na fala e deglutição. A paciente apresentou baixo risco de cárie e bom comportamento durante as consultas. No entanto, ela demonstrou estar envergonhada para sorrir. Além do tratamento preventivo para a cárie, o plano de tratamento incluiu atendimento imediato e acompanhamento posterior do restabelecimento psicossocial da paciente. Para este efeito, uma prótese parcial acrílica foi feita para substituir os dentes anteriores que faltavam, mantendo as características da dentição mista e preservando sua estética e função. Consultas de acompanhamento foram realizadas em um, três e seis meses após a primeira visita, com o objetivo de monitorar a adaptação da prótese, bem como o crescimento e desenvolvimento da dentição da criança. Assim, a reabilitação estética e funcional foi alcançada considerando a satisfação da paciente, permitindo sua reinserção social imediata

Impact of gastroplasty on salivary characteristics, dental health status and oral sensory aspects: A controlled clinical study

Background: Saliva is a non-invasive source of biomarkers useful in the study of different pathophysiological conditions. The qualitative and quantitative study of saliva, as well as the assessment of oral health, can be particularly useful for a better understanding of obesity due to its importance in the food oral perception and ingestion. Objectives: To evaluate the effect of treatment of morbid obesity (dietary counselling versus gastroplasty) on salivary characteristics, oral sensory perception and dental health in a controlled study. Methods: Seventy-three adults (60 females; 19–59 years) with morbid obesity were divided in: Control group (CG; n = 34) followed-up during a 6-months dietary programme, and Gastroplasty group (GG; n = 39) evaluated immediately before, 3 and 6 months after gastroplasty. Dietary habits, Oral Health Impact Profile and xerostomia complaints were investigated by interview. The clinical examination included anthropometric and caries experience evaluation. Salivary flow rate, buffering capacity, total protein and alpha-amylase levels, and sensitivity for the four basic tastes were assessed. Two-way mixed model and sign test were applied. Results: Physical and clinical aspects did not differ between groups in the beginning of the study, and GG showed a rapid weight loss after surgery (p <.001). An improvement in most of the dietary aspects was observed, especially in the GG. A worsening in the dental health status was observed over time in both groups, with an increase in the number of filled and decayed teeth. CG showed a better oral health-related quality of life, while xerostomia complains increased in GG after gastroplasty. Salivary flow rate remained stable in both groups, but a decrease in buffering capacity, total protein and alpha-amylase activity was observed in GG after 6-months; taste sensitivity increased from baseline to 6-months in GG

Influence of the dental prosthetic status on self-perceptions of health and treatment needs : a cross-sectional study of middle-aged adults with chronic disease

Background: Subjective aspects of dental prosthesis need in middle-aged adults are poorly explored, especially when the population presents chronic diseases. Objectives: To investigate if the use and necessity of dental prosthesis influence the self-perceptions of health and dental treatment need in middle-aged adults with chronic diseases. Material and Methods: A cross-sectional study was performed in 210 middle-aged adults. Socio-demographic aspects, dental services use, oral and general perceptions of health, dental treatment need and OIDP were assessed using a standardized questionnaire. One trained dentist evaluated the use and necessity of dental prosthesis. Data were analyzed using Chi-square and multivariate logistic regression ( p <0.05). Results: The use of dental prosthesis showed a proportion of 2.2:1 for upper to lower arch. Dental prosthesis need was largely prevalent (90 and 95% in upper and lower arch, respectively). The self-perceptions of dental treatment need and oral health were associated with the use and necessity of dental prosthesis ( p <0.05), which could not be observed in relation to the general self-perception. The adjusted model demonstrated that the subjective necessity of dental treatment was 16.04 (1.92-133.7) fold higher in individuals with necessity of rehabilitation in the lower arch. Besides, a positive self-perception of oral health (satisfied) was 2.59 (1.38-4.85) more expressive in individuals that used a dental prosthesis in upper arch. Conclusions: The self-perception of oral health was influenced by the use of maxillary dental prosthesis in individuals with chronic disease. Moreover, individuals were more likely able to perceive treatment need when the lower jaw was affected by tooth loss

Low-level laser therapy and anesthetic infiltration for orofacial pain in patients with fibromyalgia : a randomized clinical trial

To compare the analgesic effect of anesthetic infiltration of lidocaine 2% and low-level laser therapy (LLLT) by GaAlAs into tender points of patients with orofacial pain and fibromyalgia (FM). A randomized clinical trial was performed with adults (N=66) that were allocated into two groups (1:1): Group A received LLLT irradiation by Diode Laser GaAlAs (780nm) with expositions twice a week during six weeks and Group B was treated with anesthetic infiltration of lidocaine 2% without vasoconstrictor once a week for four weeks. The pain assessment included the Visual Analogic Scale (VAS) and tenderness to palpation. No dropout and adverse effect was observed during the study. The pain decreased significantly in each group after the treatment (p=0.0001, ?=1.0), even though no statistical difference was found between both treatments (p=0.46, ?= 0.82). The presence of tender points decreased after both treatments, with responsively in some types of masticatory muscles (p<0.05) except posterior temporalis muscle. The patients? perception showed that both treatments were effective and a few patients reported that the treatment did not improve welfare. The LLLT by GaAlAs and anesthetic infiltration of lidocaine 2% were equally effective to control orofacial pain in FM individuals

Understanding the relationship between orofacial structures and feeding habits of preschoolers: A multivariate analysis

The understanding of the relationship between orofacial structures and feeding habits in preschoolers is helpful for health professionals and those dedicated to food science. The hypothesis tested was whether this relationship is already present even at a very young age. This cross-sectional study included 91 healthy caries-free children (50 girls/41 boys; 3.4–6.2 years; mean 4.1 years) and a comprehensive evaluation of the stomatognathic system was performed: dietary intake, facial and occlusal morphology, gustatory sensitivity, bite and lip forces, and orofacial myofunctional aspects (mastication, swallowing and breathing functions). Principal component analysis summarized the variables related to the form and function of the orofacial aspects; further, K-means analysis identified two clusters of participants with similar aspects. Cluster 1 (“Low orofacial myofunctional functioning”; n = 51) was characterized by children who showed the worst performance of mastication, swallowing and breathing functions and whose parents reported the consumption of sweets, cookies, chocolate, but not fresh fruits the day before, in addition to the higher bottle-feeding and pacifier use duration. This cluster also showed higher sweet taste threshold. Cluster 2 (“High orofacial myofunctional functioning”; n = 40) showed lower bottle-feeding and pacifier use duration, higher gustatory sensitivity, greater maxillo-mandibular dimensions, and better orofacial function performance. The variables sex and BMI did not associate to clusters profile. The frequencies of open bite and current sucking habit (pacifier) also differed between clusters. The results showed that an association between form and function of the structures that comprise the stomatognathic system and dietary intake is already present in children with primary dentition

Assessment of the differences in masticatory behavior between male and female adolescents

Orientador: Paula Midori Castelo FerruaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O comportamento mastigatório pode diferir entre os sexos, o que em última análise influenciaria o diagnóstico e o plano de tratamento de distúrbios oro-miofuncionais; sendo assim, o presente estudo teve como objetivos descrever e comparar os diferentes aspectos que determinam o desempenho mastigatório entre adolescentes do sexo feminino e masculino. Noventa e um adolescentes saudáveis (47 meninas, 44 meninos), livres de cárie, com idades entre 14-17 anos foram incluídos. A performance da mastigação e máxima força de mordida foram avaliadas por meio de goma de mascar e gnatodinamômetro digital, respectivamente. O comportamento mastigatório foi avaliado pelo aspecto subjetivo da qualidade da função mastigatória (questionário) e pela Avaliação Miofuncional Orofacial com Escores (OMES), determinando-se o tempo total de mastigação, frequência de ciclos mastigatórios e aspectos oro-miofuncionais; o fluxo salivar também foi investigado. O exame físico envolveu medidas da morfometria facial, peso corporal, estatura, massa muscular esquelética e avaliações oclusais e dentárias. Os dados foram submetidos à estatística descritiva, teste de normalidade, t-test/Mann-Whitney, teste de correlação de Pearson/Spearman e regressão linear múltipla (?=0,05). Observou-se que os meninos apresentaram maiores dimensões faciais, maior força de mordida, frequência de ciclos mastigatórios e melhor performance mastigatória do que as meninas. Eles também apresentaram menor tempo de mastigação e número de ciclos mastigatórios e pontuaram menos nos aspectos oro-miofuncionais (ou seja, apresentaram mais alterações nas funções oro-miofuncionais). A força de mordida mostrou fraca correlação com a massa muscular esquelética em meninos (r=0,3035; p=0,0451). A performance mastigatória mostrou ser dependente da força de mordida em meninos (Adj R2=19,2%; Poder=84,1%); entre as meninas, a performance mastigatória mostrou ser dependente da frequência de ciclos mastigatórios e do comportamento mastigatório (aspecto subjetivo) (AdjR2=34,1%; Poder=96,1%). Meninos provavelmente compensam o menor tempo de mastigação, menor número de ciclos mastigatórios e as alterações oro-miofuncionais com uma maior força de mordida e maior frequência mastigatória. Os resultados deste estudo suportam a existência de diferenças entre os sexos feminino e masculino para vários aspectos relacionados à função e ao comportamento mastigatório, daí a importância de se considerar as diferenças sexuais na avaliação da função mastigatória e no acompanhamento de terapias oro-miofuncionais em adolescentesAbstract: Chewing behavior may differ between genders, which ultimately influence the diagnosis and treatment plan of orofacial myofunctional disorders; thus, the present study aimed to describe and compare the different masticatory aspects which influence the masticatory performance between male and female adolescents. Ninety-one (47 girls, 44 boys) healthy subjects, caries-free, aged 14-17 years were included. The masticatory performance and maximum bite force were evaluated using a chewing gum and a digital gnathodynamometer, respectively. The masticatory behavior was assessed by the subjective aspect of the quality of masticatory function (questionnaire) and the Orofacial Myofunctional Evaluation with Scores (OMES), determining the total chewing time, frequency of chewing cycles and oro-myofunctional aspects; salivary flow was also investigated. The physical examination involved assessments of facial morphometry, body weight, height, skeletal muscle mass and dental/occlusal evaluations. Data were submitted to descriptive statistics, normality test, t-test/Mann-Whitney, Pearson/Spearman correlation test and multiple linear regression (p<0.05). Boys showed larger amount of skeletal muscle mass, larger facial dimensions, higher bite force and frequency of chewing cycles and better masticatory performance than girls. They also showed shorter chewing time and number of chewing cycles and scored less in the oro-myofunctional aspects (that is, more changes in oro-facial myofunctional status). Bite force showed a weak correlation with skeletal muscle mass only in boys. The masticatory performance has shown to be dependent on the bite force in boys (Adj R2=19.2%; Power=84.1%); among girls, masticatory performance showed to be dependent on the frequency of chewing cycles and masticatory behavior (subjective aspect) (Adj R2=34.1%; Power=96.1%). Boys probably compensate for the shorter chewing time, fewer number of chewing cycles and oro-facial myofunctional alterations using a more powerful bite force and higher chewing frequency. The findings of the present study support the existence of gender differences in many masticatory function aspects and behavior, hence the importance of considering sex differences when evaluating masticatory function and myofunctional therapy outcomes among young subjectsMestradoOdontopediatriaMestra em Odontologia2242/2014CAPE

Assessment Of The Differences In Masticatory Behavior Between Male And Female Adolescents

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Chewing behavior may show sex differences; thus, the present study aimed to compare the masticatory aspects and the prediction of masticatory performance between male and female adolescents. Ninety-one healthy subjects (47 girls, 44 boys), caries-free and aged 14-17 years, were included. Masticatory performance and maximal bite force were evaluated using a color-changeable chewing gum and digital gnathodynamometer, respectively. Masticatory behavior was assessed by the subjective aspect of the quality of the masticatory function (validated questionnaire) and the Orofacial Myofunctional Evaluation with Scores expanded (OMES-e) was used to determine chewing time, frequency of chewing cycles and other aspects. Salivary flow rate was also assessed. The physical examination involved measurements of facial morphometry, body weight, height, skeletal muscle mass, and dental/occlusal evaluations. It was observed that boys showed larger facial dimensions, higher bite force and chewing frequency and better masticatory performance than girls. They also showed shorter chewing time, fewer chewing cycles and lower score for OMES-e (that is, more changes in orofacial myofunctional aspects). Bite force showed a weak correlation with skeletal muscle mass only in boys (r = 0.3035; p = 0.0451). The masticatory performance was dependent on the bite force in boys (Adj R-2 = 19.2%; Power = 84.1%); among girls, Masticatory performance was dependent on the frequency of chewing cycles and masticatory behavior (subjective aspect) (Adj R-2 = 34.1%; Power = 96.1%). The findings support the existence of sex differences in many masticatory aspects of function and behavior, hence the importance of considering sex differences when evaluating masticatory function and myofunctional therapy outcomes among young subjects. (C) 2016 Elsevier Inc All rights reserved.163115122State of Sao Paulo Research Foundation (FAPESP, SP, Brazil) [2014/24804-4]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Assessment of the differences in masticatory behavior between male and female adolescents

Chewing behavior may show sex differences; thus, the present study aimed to compare the masticatory aspects and the prediction of masticatory performance between male and female adolescents. Ninety-one healthy subjects (47 girls, 44 boys), caries-free and aged 14-17 years, were included. Masticatory performance and maximal bite force were evaluated using a color-changeable chewing gum and digital gnathodynamometer, respectively. Masticatory behavior was assessed by the subjective aspect of the quality of the masticatory function (validated questionnaire) and the Orofacial Myofunctional Evaluation with Scores expanded (OMES-e) was used to determine chewing time, frequency of chewing cycles and other aspects. Salivary flow rate was also assessed. The physical examination involved measurements of facial morphometry, body weight, height, skeletal muscle mass, and dental/occlusal evaluations. It was observed that boys showed larger facial dimensions, higher bite force and chewing frequency and better masticatory performance than girls. They also showed shorter chewing time, fewer chewing cycles and lower score for OMES-e (that is, more changes in orofacial myofunctional aspects). Bite force showed a weak correlation with skeletal muscle mass only in boys (r = 0.3035; p = 0.0451). The masticatory performance was dependent on the bite force in boys (Adj R-2 = 19.2%; Power = 84.1%); among girls, Masticatory performance was dependent on the frequency of chewing cycles and masticatory behavior (subjective aspect) (Adj R-2 = 34.1%; Power = 96.1%). The findings support the existence of sex differences in many masticatory aspects of function and behavior, hence the importance of considering sex differences when evaluating masticatory function and myofunctional therapy outcomes among young subjects163115122FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2014/24804-

Assessment of the differences in masticatory behavior between male and female adolescents

Chewing behavior may show sex differencesthus, the present study aimed to compare the masticatory aspects and the prediction of masticatory performance between male and female adolescents. Ninety-one healthy subjects (47 girls, 44 boys), caries-free and aged 14-17 years, were included. Masticatory performance and maximal bite force were evaluated using a color-changeable chewing gum and digital gnathodynamometer, respectively. Masticatory behavior was assessed by the subjective aspect of the quality of the masticatory function (validated questionnaire) and the Orofacial Myofunctional Evaluation with Scores expanded (OMES-e) was used to determine chewing time, frequency of chewing cycles and other aspects. Salivary flow rate was also assessed. The physical examination involved measurements of facial morphometry, body weight, height, skeletal muscle mass, and dental/occlusal evaluations. It was observed that boys showed larger facial dimensions, higher bite force and chewing frequency and better masticatory performance than girls. They also showed shorter chewing time, fewer chewing cycles and lower score for OMES-e (that is, more changes in orofacial myofunctional aspects). Bite force showed a weak correlation with skeletal muscle mass only in boys (r = 0.3035p = 0.0451). The masticatory performance was dependent on the bite force in boys (Adj R-2 = 19.2%Power = 84.1%)among girls, Masticatory performance was dependent on the frequency of chewing cycles and masticatory behavior (subjective aspect) (Adj R-2 = 34.1%Power = 96.1%). The findings support the existence of sex differences in many masticatory aspects of function and behavior, hence the importance of considering sex differences when evaluating masticatory function and myofunctional therapy outcomes among young subjects. (C) 2016 Elsevier Inc All rights reserved.State of Sao Paulo Research Foundation (FAPESP, SP, Brazil) [2014/24804-4]Univ Campinas UNICAMP, Piracicaba Dent Sch, Dept Pediat Dent, Ave Limeira 901, BR-13414903 Piracicaba, SP, BrazilUniv Campinas UNICAMP, Piracicaba Dent Sch, Dept Morphol, Ave Limeira 901, BR-13414903 Piracicaba, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Biol Sci, Campus Diadema,R Sao Nicolau 210, BR-09913030 Diadema, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Biol Sci, Campus Diadema,R Sao Nicolau 210, BR-09913030 Diadema, SP, BrazilFAPESP:2014/24804-4Web of Scienc