Impacto de las condiciones bucales en la calidad de vida de niños y adolescentes

La calidad de vida se ha definido como la percepción de un individuo con relación a su posición en la vida, en el contexto de la cultura y en el sistema de valores en el cual él vive y en relación a sus objetivos, expectativas, patrones y preocupaciones. El constructo calidad de vida posee dos elementos básicos: multidimensionalidad y subjetividad. El primero se refiere a las varias dimensiones o dominios de este constructo, incluyendo los aspectos físicos (síntomas), las funciones, el bienestar emocional y el bienestar social de un individuo. Lo segundo, a su vez, se refiere al hecho que calidad de vida solo puede ser interpretada a partir de la perspectiva del paciente, tomando en consideración percepciones, valores y necesidades. Tales elementos están en consonancia con el concepto de práctica basada en evidencias (PBE) que ha sido ampliamente utilizada en Odontología. La PBE, en Odontología, es un abordaje amplio de cuidados en salud bucal que exige la integración sensata de la experiencia clínica del cirujano dentista con la mejor evidencia científica disponible en la literatura, tomando en consideración la opinión del paciente que está siendo tratado y el de sus familiares

Temporary restorative treatment in children and adolescents with amelogenesis imperfecta: Scoping review.

Background: Amelogenesis imperfecta (AI) is a group of disorders that affect the enamel of the teeth, either in quality or quantity. This alteration causes sensitivity and is associated with factors that could affect the strength of the adhesive bond of the restorative material. Aim: To review the literature regarding the most used temporary restorative treatment in children and adolescents with AI. Methods: This scoping review aimed to include case reports, literature reviews and original studies that evaluated restorative materials for the teeth of children and adolescents with AI. Editorials, meeting abstracts and letters to the editor were excluded. The following electronic databases were used: Medline (Ovid), PubMed, Ebsco, Scopus (Elsevier) and Web of Science (Thomson Reuters). Manual searches in the reference lists of the included articles were also carried out. Finally, a search in Google Scholar restricted to the first 100 hits was performed. Duplicates were eliminated upon identification. The search covered a period between the years of 2011 and 2016. PRISMA guidelines were used for reporting the review. The evidence ranking was carried out by means of the Oxford criteria. Results: Six articles met the eligibility criteria and were included in this scoping review. Three articles were case reports, one was a review and two were original studies. For the treatment of AI, direct or indirect composite resins were the most commonly used material of choice in the retrieved studies because they demonstrate greater longevity, aesthetics and function compared to the other materials used. Conclusions: Among children and adolescents with AI, the temporary restorative treatment that demonstrated better long-term results in permanent teeth was the direct and indirect composite resins. However, high quality studies should be conducted to confirm the results presented herein

Malocclusion characteristics amongst individuals with autism spectrum disorder: a systematic review and meta‑analysis

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Quedas no ambiente hospitalar, qualidade e segurança do paciente:: metassíntese da literatura.

Objetivo: Analisar as publicações referentes à assistência de enfermagem e a sua interface com a ocorrência de quedas de pacientes em ambiente hospitalar. Método: Trata-se de uma metassíntese nas bases de dados Lilacs, Scielo, e Medline, publicados entre julho de 2004 a julho de 2014; nos idiomas português, inglês ou espanhol. Resultados: Foram selecionados treze artigos, que contemplaram os critérios de inclusão, cujas análises identificaram duas categorias: (1) “Fatores relacionados à ocorrência de quedas”; (2) “Iniciativas em enfermagem para a melhoria da segurança do paciente: em foco a prevenção das quedas”. Conclusão: Conclui-se que as quedas podem ocorrer em ambientes hospitalares. Entretanto, medidas e ajustes no cuidado prestado, no ambiente e na organização podem impactar positivamente na ocorrência destes eventos. Destarte, a enfermagem exercita um olhar mais amplo em relação a equipe e às famílias dos pacientes hospitalizados. Descritores: Acidentes por Quedas. Segurança do Paciente. Qualidade da Assistência à Saúde

Dental anomalies in individuals with osteogenesis imperfecta: a systematic review and meta-analysis of prevalence and comparative studies

Background: Osteogenesis imperfecta (OI) is a rare genetic disorder primarily caused by mutations in the genes involved in the production of type 1 collagen. OI is also known as brittle bone disease. Objective: This study aims to describe the prevalence of dental anomalies (except dentinogenesis imperfecta) in individuals with OI, and compare the prevalence of dental anomalies between individuals with and without OI and between individuals with different types of OI. Search methods: Searches in PubMed, Web of Science, Scopus, Ovid, and gray literature were performed in October 2022. Selection criteria: Observational studies (with or without a comparison group) that evaluated the prevalence of dental anomalies in individuals with OI. Data collection and analysis: Data items were extracted by two authors. Quality assessment employing the Joanna Briggs Institute checklists and meta-analyses was conducted. Results were provided in prevalence values and odds ratio (OR) / 95% confidence interval (CI). Strength of evidence was determined. Results: Eighteen studies were included. Most prevalent dental anomalies in individuals with OI included pulp obliteration (46.4%), dental impaction (33.5%), dental impaction of second molars (27%), and tooth agenesis (23.9%). Individuals with OI type III/IV had 20.16-fold greater chance of exhibiting tooth discoloration in comparison with individuals with OI type I (CI: 1.10–370.98). In comparison with the group without OI, the individuals with OI had 6.90-fold greater chance of exhibiting dental impaction (CI: 1.54–31.00). High methodological quality was found in 47% of the studies. Strength of evidence was low or very low. Conclusions: Pulp obliteration, dental impaction, and tooth agenesis were the most prevalent dental anomalies in the OI group. Individuals with OI were more likely to have dental impaction than individuals without OI. Individuals with OI type III/IV (severe-moderate) are more likely to have tooth discoloration than individuals with OI type I (mild)

Dental and maxillomandibular incidental findings in panoramic radiography among individuals with mucopolysaccharidosis: a cross-sectional study

Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases. Objectives: To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals. Methodology: A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher’s exact test and chi-square test (p<0.05). Results: For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals. Conclusion: The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals

Efficacy of treatment of class II furcation lesions using membrane associated with bone grafting in mandibular molars compared to membrane only: a systematic review and meta-analysis.

Objective: The objective of the present systematic review and meta-analysis was to compare treatment with membrane associated with bone grafting and treatment exclusively with membrane in the approach of Class II furcation defects in mandibular molars. Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were conducted in five databases (PubMed, Web of Science, Scopus, Ovid, and Lilacs), in Septem-ber 2021, without restriction regarding publication year or language. Studies comparing membranes associated with bone grafting and membranes exclusively in the treatment of Class II furcation lesions were included. Cross-sectional, case-control studies, and reviews were excluded. Study selection, data extraction, and risk of bias assessment (MINORS) were performed by two review authors. The certainty of the evidence (GRADE) was evaluated and meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided. Results: Four hundred eighty-six references were iden-tified and four studies were included. Greater reduction in probing depth [MD = 0.32 (CI = 0.09, 0.56)] and greater clinical attachment level gain [MD = 0.41 (CI = 0.24, 0.57)] were observed when membrane and bone grafting were used. The risk of bias of included studies was low. Conclusions: This present systematic review and meta-analysis demonstrated that treatment of Class II furcation defects in mandibular molars using membrane and bone grafing is significantly more efficacious than treatment with the exclusive use of membrane

Pathways that explain racial differences on edentulism among older adults : 2019 Brazil National Health Survey

This study aimed to evaluate the pathways that explain the association between race/skin color and edentulism in elderly Brazilians. This was a cross-sectional study using data from participants aged 60 years or older from the 2019 Brazilian National Health Survey, a nationally representative population-based sample. Data were obtained by a structured interview and participants were classified as edentulous if they reported having lost all natural teeth. Information on race, socioeconomic level, behavioral aspects, psychosocial aspects, and access to dental care was collected by interviewers using a questionnaire. The pathways between race/skin color and edentulism were analyzed using structural equation modeling. The final sample of the study included 22,357 participants. Most participants were white (51.5%; 95% confidence interval [CI]: 50.3–52.6), and 36.8% (95%CI: 35.7–37.9) were edentulous. Race/skin color was indirectly associated with edentulism via enabling factors. These findings suggest that socioeconomic inequalities are key in explaining racial inequalities in edentulism among Brazilian older adults

<i>In situ</i> observation of strain and phase transformation in plastically deformed 301 austenitic stainless steel

To inform the design of superior transformation-induced plasticity (TRIP) steels, it is important to understand what happens at the microstructural length scales. In this study, strain-induced martensitic transformation is studied by in situ digital image correlation (DIC) in a scanning electron microscope. Digital image correlation at submicron length scales enables mapping of transformation strains with high confidence. These are correlated with electron backscatter diffraction (EBSD) prior to and post deformation process to get a comprehensive understanding of the strain-induced transformation mechanism. The results are compared with mathematical models for enhanced prediction of strain-induced martensitic phase transformation

Pathways of socioeconomic inequalities in self-perceived oral health

Although there is a large body of evidence of the influence of social determinants on oral health, information on the mechanisms by which these determinants operate is poorly documented. Therefore, we aimed to investigate the pathways through which socioeconomic inequalities may influence self-perceived oral health (SPOH) in Brazilian adults. This cross-sectional study used data from the National Health Survey (NHS) of 2019, with a representative sample of adults aged 18 to 59 years (n = 65,803). The outcome was SPOH, assessed by a global self-item. Structural equation modeling was used to test direct and indirect pathways connecting a latent variable for socioeconomic position (SEP) to SPOH via psychosocial, behavioral, and biological factors. Higher SEP was directly associated with better SPOH [standardized coefficient (SC) = 0.069; p < 0.01)] fewer depressive symptoms (SC = -0.059; p < 0.01), fewer missing teeth (SC = 0.131; p < 0.01), and more healthy behaviors (SC = 0.643; p < 0.01). Fewer depressive symptoms (SC = -0.141; p < 0.01), more healthy behaviors (SC = 0.242; p < 0.01), and fewer missing teeth (SC = 0.058; p < 0.01) were directly associated with good SPOH. Among specific indirect effects of SEP on SPOH, the behavioral pathway was the one that best explained this association (SC = 0.155). Socioeconomic inequities in SPOH are mediate by psychosocial, behavioral, and biological factors. This has implications for positioning health strategies in the social context in which people live, to facilitate healthy choices and promote good oral health