Impact of Wearing Palatal Expanders on the Quality of Life of Children Aged 8 to 10 Years

Objective: To assess the impact of wearing palatal expanders on the oral health-related quality of life (OHRQoL) of children aged 8 to 10 years. Material and Methods: The sample consisted of 35 children aged 8 to 10 years treated at the orthodontics and pediatric dentistry outpatient clinics affiliated with the Dental School. Children were divided in two groups: 17 were submitted to palatal expansion treatment (Group 1), while 18 just received coronal polishing and topical fluoride application (Group 2). The Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) was used to assess children’s OHRQoL. The questionnaire was administered before the expander was placed, at the end of its activation, and before its removal. Intervals between the interviews were similar in the two groups. Descriptive statistics and ANOVA were used for data analyses. Results: The overall CPQ8-10 score was not significantly different between the groups. The results show statistically significant differences between the two groups only for the functional limitations domain after activation of the appliance (p=0.001). Conclusion: Palatal expanders may negatively affect children's functions only during the initial wearing period

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Perception of parents and caregivers regarding the impact of malocclusion on adolescents’ quality of life: a cross-sectional study

ABSTRACT Objective: The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents’ oral health -related quality of life (OHRQoL). Methods: This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents’ malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents’ age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance. Results: Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents’ malocclusion was significantly associated with a higher negative impact on parents’/caregivers’ perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables. Conclusions: Parents/caregivers reported a negative impact of malocclusion on adolescents’ OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL

Parent-assessed quality of life among adolescents undergoing orthodontic treatment: a 12-month follow-up

Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting.Methods:Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1) and 12 months after placement of fixed appliances (T2). Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID).Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p< 0.001), which contributed to improve patient's overall quality of life (p< 0.001). Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score.Conclusion:Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances

Cross-cultural adaptation and validation of the Impact of Fixed Appliances Measure questionnaire in Brazil

Abstract: The aim of this study was to translate and cross-culturally adapt the condition-specific instrument Impact of Fixed Appliances Measure (IFAM), assessing its validity and reliability for use among Brazilian children/adolescents. The IFAM was translated, back-translated, cross-culturally adapted, and pilot-tested. The Brazilian version of the IFAM (B-IFAM) was tested on 161 10-to-18-year-old children/adolescents. Internal consistency was assessed using Cronbach's alpha (α) and test-retest reliability by intraclass correlation coefficients (ICC). Construct validity was conducted using Pearson correlation among the overall and subscales of the B-IFAM. Discriminant validity was evaluated by comparisons of B-IFAM's means and SD with children's/adolescents' sex (Student t-test). Internal consistency was 0.89 for overall score and 0.55–0.86 for subscales. ICC for test-retest reliability was 0.81 for overall score and 0.55–0.78 for subscales. The overall score of the B-IFAM presented large correlation coefficients with most subscales (r = 0.52–0.74), supporting construct validity. Discriminant validity demonstrated statistically significant difference in the overall score, aesthetics, and physical impact subscales among female and male children's/adolescents' (p < 0.05). In the conclusion, the B-IFAM overall score and some subscales demonstrated adequate psychometric properties regarding reliability and validity. The study achieved a specific-condition instrument feasible for use on Brazilian children/adolescents who wear fixed orthodontic appliances

Digital smile design as a tool in the planning of porcelain laminate veneers restoration

ABSTRACT Digital smile design is an important tool for esthetic planning in dentistry as it facilitates ease of communication between professionals and patients. This clinical report has the objective of describing a clinical procedure involving digital smile design for the placement of porcelain laminate veneer restorations. The digital smile design included dental and facial analyzes. The smile curve was drawn and a dental ruler was used to delimitate the spaces between each tooth. An approximate simulation of the smile was generated using Adobe Photoshop software. For esthetic and functional evaluation of the digital plan was created a diagnostic waxing and mock-up. The laminate veneers were made with feldspathic porcelain. Digital smile design was essential for successful planning because it enabled better patient contact with the end result. This case demonstrates the importance of this tool in esthetic dentistry

Effect Of Chlorhexidine Varnish On Gingival Growth In Orthodontic Patients: A Randomized Prospective Split-mouth Study.

Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application.2066-7