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ABSTRACT: Orthodontic treatment in the orthognathic surgical patient commonly involves banding or bonding of erupted molars. Appliance displacement during surgery is a potentially serious complication. However, limited data exist about the prevalence of banding or bonding and the frequency of appliance failure in this patient population. The purpose of this study was to determine the prevalence of banding and bonding and appliance failure in a large cohort of patients undergoing orthognathic surgery at a single institution.
All patients who underwent orthognathic surgery from 2004 to 2006 at Kaiser Permanente Oakland Medical Center were identified, and preoperative and postoperative radiographs were retrospectively reviewed. Study variables included age at time of surgery, gender, date and type of surgery, Angle classification of occlusion, type of orthodontic appliance (band or bond) on erupted molar teeth, and failure as detected from postoperative imaging.
In the 1,003 patients there was a greater overall prevalence of molar bands (74.3%) than bonds (19.2%) with the vast majority (84.4%) of first molars and fewer (64.2%) second molars having banded appliances. The prevalence of bonded first and second molars was lowest in 2004 and highest in 2006. Appliance failure occurred in 19 patients (1.9%), most often involving maxillary second molars, and all were bonds. Of the 19 failed bonds, 2 were displaced into the mandibular osteotomy site and 1 was displaced into the posterior pharynx.
The prevalence of bonded molars in surgical patients increased from 2004 to 2006. Appliance malfunction occurred most often in bonded maxillary second molars. Although rare, failure and displacement of bonded appliances may have significant consequences.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 03/2011; 69(3):911-6. · 1.58 Impact Factor
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ABSTRACT: The aim of this community-based trial was to compare the effectiveness of the quad-helix appliance and removable plates for treating posterior crossbite.
Ninety-nine patients were randomly divided into 3 groups: quad-helix, expansion plate, and untreated. All subjects were in the mixed dentition, had posterior crosssbite, no sucking habits, no previous orthodontic treatment, and no Class III malocclusion. The following aspects were evaluated: posterior crossbite correction, maxillary and mandibular intermolar and intercanine expansions, length of treatment, cost-benefit analysis, success rate, and number of complications.
The length of treatment and the costs were higher in the expansion plate group than in the quad-helix group. The success rates were similar for the quad-helix and the expansion plate groups, and the number of complications was higher in the quad-helix group. No self-correction was observed in the untreated group, and relapses occurred in both experimental groups.
The average treatment time was significantly shorter and 11% less expensive than in the quad-helix group, making it the more cost-effective choice for treatment.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 01/2011; 139(1):e45-52. · 1.33 Impact Factor
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ABSTRACT: The aim of the present study was to investigate the prevalence of non-nutritive sucking habits and anterior open bite as well as their main causes (associated factors) in Brazilian children aged 30-59 months. A cross-sectional study was carried out during the National Immunization Day for polio in the city of Recife in the northeastern region of Brazil. The sample was made up of 1,308 children. Data were collected from interviews with mothers or guardians as well as from clinical examinations carried out by previously trained dental students. The chi-square test was used for statistical analysis at 5% significance level. The prevalence of non-nutritive sucking habits was 40%, and the habits were associated with gender (p=0.001), age (p=0.003) and feeding type (p<0.001). Anterior open bite was detected in 30.4% of children, and it was significantly associated with feeding type (p<0.001) and non-nutritive sucking habits (p<0.001). The variables found to be associated factors in the present study for the occurrence of non-nutritive sucking habits and anterior open bite emphasize the need to establish strategies that include orientation regarding health promotion based on the “common determining factors” approach. Public health policies should be adopted to encourage a longer duration of breastfeeding, thereby contributing towards reducing the prevalence of non-nutritive sucking habits and anterior open bite.
Brazilian dental journal 01/2011; 22(2):140-5.
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Aronita Rosenblatt
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ABSTRACT: The Cochrane Oral Health Group's Trials Register, Cochrane CENTRAL, Medline and Embase were consulted, along with the websites www.clinicaltrials.gov and www.controlled-trials.com and reference lists of identified articles. There were no language restrictions.
Only randomised controlled trials that included a minimum followup period of 12 months for interventions dealing with avulsed and replanted permanent teeth were considered.
Two review authors independently extracted data and assessed trial quality and the risk of bias in studies to be included.
Three studies (involving, in total, 162 patients and 231 teeth) were included. Study one (high risk of bias) investigated the effect of extra-oral endodontics. This showed no significant difference in radiographic resorption compared with intra-oral endodontics provided at week 1 for teeth avulsed for longer than 60 min dry time. Study two (moderate risk of bias) investigated a 10-min soaking in thymosin alpha 1 prior to replantation and then its further use as a daily gingival injection for the first 7 days. They reported a strong benefit at 48 months (14% with periodontal healing in the control group versus 77% for the experimental group). Study three (high risk of bias) investigated a 20-min soaking with gentamycin sulphate for both groups prior to replantation and then the use of hyperbaric oxygen daily in the experimental group for 80 min for the first 10 days. They reported a strong benefit at 12 months (43% periodontal healing versus 88% for the experimental group). There was no formal reporting of adverse events.
The available evidence suggests that extra-oral endodontic treatment is not detrimental for teeth replanted after more than 60 min dry time. Studies with moderate/ high risk of bias indicate that soaking in thymosin alpha 1 and gentamycin sulphate followed by hyperbaric oxygen may be advantageous but these strategies have not previously been reported as interventions for avulsed teeth and await further validation. More evidence with low risk of bias is required and, with the low incidence of avulsed teeth, collaborative multicentre trials are indicated.
Evidence-based dentistry 01/2010; 11(2):42-3.
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ABSTRACT: The aim of this study was to assess the influence of sucking habits and facial pattern measurements on the development of anterior open bite (AOB).
A case-control study was carried out on 60 children aged 7 and 8 years attending municipal public schools in the city of Recife, Brazil. Data collection included interviews with guardians, oral examinations, and facial growth pattern analysis using cephalometric radiographs. The following cephalometric measurements were assessed: SN.Gn, SN.GoGn, FMA, and Facial Axis. Statistical analyses were performed using the Student's t-test and Pearson's chi-square test at a 5% level of significance.
The percentage of children with sucking habits in the case group was much higher than in the control group (53.3%vs 16.7%) (P = 0.003). Children with sucking habits were six times more likely to develop AOB. Regarding the measurements assessed, no statistically significant differences were observed between groups.
This study found no evidence that variations in cephalometric angles (SN.Gn, FMA, SN.GoGn, and facial axis) are risk factors for AOB. Only sucking habits demonstrated a positive correlation with an increased AOB.
International Journal of Paediatric Dentistry 10/2009; 20(1):59-64. · 1.01 Impact Factor
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ABSTRACT: One of the key aspects of improving the dental care we offer to our patients is in basing our practice on the best available evidence.
The main purpose of this paper is to present some basic ways of searching reliable papers on Internet and to introduce some techniques to facilitate the development of strategic search skill to improve the quality of dental care, using dental trauma as an example.
After formulation of a clinical question on a dental trauma issue, a comparison was made between: data collected in PubMed using a given term; data collected in PubMed using the Medical Subject Headings vocabulary (Mesh) and data collected using the principles of evidence-based research, all by an independent researcher. A number of papers searched about a clinical question on dental trauma and a brief commentary about each Internet research database is presented. The authors reported that the best sites available to perform the sample search were those produced by academic centers, professional organizations and government-sponsored. To get evidence-based clinical papers we did internet search on PubMed, Cochrane, Center of Evidence-Based Dentistry and Knowledge Finder using the clinical question "Emergency Treatment for Avulsed Tooth".
All searched databases were efficient for scientific journals, but when we used the PI strategy, the search seemed to be more relevant and specific. The Cochrane, Center of Evidence-Based Dentistry and Knowledge Finder presented more reliable papers to answer our clinical question about dental trauma treatment.
It is imperative that dentists understand the advantages of searching the Internet and learning to use it effectively to guide practice and assist their patients in their pursuit for better oral health.
Dental Traumatology 05/2009; 25(2):190-3. · 1.20 Impact Factor
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ABSTRACT: The aim of this study was to assess the prevalence of dental trauma as compared to the prevalence of dental caries in children aged 3-59 months. A cross-sectional study was carried out during the National Immunization Day for Polio in Recife, northeast Brazil. The sample comprised 3489 children under the age of 5. The clinical examination was performed by 123 previously trained dental students. The inter-examiner agreement for crown fracture was 90.32% and for tooth discoloration it was 83.87%. The prevalence of dental caries was assessed using the dmf-t index. The statistical methods included descriptive analysis and the chi-square test with a margin of error of 5%. A total of 56 142 teeth were examined and the prevalence of dental trauma was 14.9%. Dental fracture was the most prevalent injury observed in 516 teeth (0.9%), followed by discoloration in 191 (0.9%), intrusion in 12 (0.02%) and extrusion in five (0.008%). The most affected teeth were the upper central incisors. The prevalence of dental trauma increased significantly with age and family income (P < 0.0001). Dental trauma was most prevalent from 2 to 5 years of age. The prevalence of dental caries was 14.3%. This prevalence increased significantly with age (P < 0.0001) and with the reduction in family income (P < 0.0001). The results showed that the prevalence of dental caries and dental trauma was similar, and that both caused the same amount of damage to dental health for the target population.
Dental Traumatology 04/2009; 25(2):219-23. · 1.20 Impact Factor
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ABSTRACT: This cross-sectional study aimed to assess the prevalence of posterior crossbites and non-nutritive sucking habits in 2750 Brazilian children aged from 18 to 59 months. The data were collected by 123 previously trained dental students and recorded on a response card according to the model developed by the Forsyth Institute, Boston, Maryland, USA, for optical reading. Information concerning sucking habits and family income was obtained during an interview with a parent or guardian. A clinical examination was also undertaken. Statistical analysis included chi-square and Fisher's exact tests. A posterior crossbite was observed as early as 18 months of age. The prevalence of a posterior crossbite was 10.4 per cent and was associated with age (P = 0.00) and with sucking habits (P = 0.01). The prevalence of sucking habits was 43.5 per cent. A posterior crossbite was not associated with socio-economic status (P = 0.38). While sucking habits were common among the age group studied (43.5 per cent), only a small percentage exhibited a posterior crossbite. These results suggest that further investigations into other aetiological factors, in particular genetics and respiratory problems, are necessary to provide more evidence that could clarify this issue.
The European Journal of Orthodontics 04/2009; 31(4):357-61. · 0.89 Impact Factor
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ABSTRACT: The aim of this longitudinal study was to assess the relationship between non-nutritive sucking habits and the presence of anterior open bites (AOBs) and posterior crossbites and their association with facial morphology among 4- to 6-year-old children attending state schools in the city of Recife, Brazil. The sample comprised 287 children, both males and females. The proportion of boys to girls was approximately 50 per cent. The average age was 4 years 5 months at the beginning and 6 years 6 months at the end of the study. Data were collected from interviews with mothers or carers, and the clinical examination was carried out by two calibrated examiners. Statistical analysis was undertaken using bivariate analysis, Pearson's chi-square, McNemar, and Stuart-Maxwell tests. The results revealed a significant reduction in AOB (P < 0.001) and a slight increase in the prevalence of posterior crossbites. Both occlusal traits were associated with a previous history of sucking habits. The most prevalent morphological facial type, assessed using the morphological facial index, was high (> or =88 mm) and a statistically significant (P = 0.02) association was found between facial morphology and an AOB. Children with an average or high facial morphology measurement exhibited a greater prevalence of AOB when compared with those with lower measurements. Self-correction of AOB was associated with cessation of sucking habits but facial morphology remained unaltered.
The European Journal of Orthodontics 09/2008; 30(6):580-5. · 0.89 Impact Factor
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Aronita Rosenblatt
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ABSTRACT: This was a general dental practice (GDP)-based, split-mouth, randomised controlled trial (RCT).
The Hall technique, where a preformed metal crown (PMC) is cemented with no local anaesthesia, caries removal or tooth preparation, was compared with restoration with the material the GDP would normally choose.
The outcomes were recorded as success; minor failure (restoration failure or reversible pulpitis, which could be managed by repair or replacement); or major failure (signs or symptoms of irreversible pulpal damage, such as dental abscess, or tooth broken down and unfeasible to repair or replace the restoration).
A total of 128 conventional restorations were placed on 132 control teeth, and 128 PMC on 132 intervention teeth. Eighty-nine per cent of Hall PMC were rated by dentists as causing no apparent discomfort through to merely mild discomfort: for the control restorations this was 78% (not a significant difference). The Hall PMC outperformed the control restorations in terms of the number of major and minor failures (see Table 1). Preference for the Hall technique was recorded at 77% for the children, 83% for carers and 81% for dentists who expressed a preference, which this was significant (Chi square, P<0.0001).
The Hall technique was preferred to conventional restorations by the majority of children, carers and dental practitioners. After 2 years, Hall PMC showed more favourable outcomes for pulpal health and restoration longevity than conventional restorations. The Hall technique appears to offer an effective treatment option for carious primary molar teeth.
Evidence-based dentistry 01/2008; 9(2):44-5.
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ABSTRACT: This study focused on factors related to nutritional risk in children over one year of age from low-income families in João Pessoa, Paraíba State, Northeast Brazil, and the frequency of related enamel defects. The study included 117 children, 56 at nutritional risk and 61 with normal growth. Nutritional evaluation, clinical dental examination, and interviews with mothers were conducted at the homes. Gestational and birth records were examined in the maternity hospital. Data were analyzed using the chi-square, Fisher's exact tests, and logistic regression. Enamel defects were associated with nutritional risk after the first year of life. Nutritional risk was associated with per capita family income, birth weight, and intrauterine growth index. These are relevant factors for individual nutritional planning and formation of dental enamel.
Cadernos de Saúde Pública 01/2008; 23(12):2928-37. · 0.89 Impact Factor
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ABSTRACT: To measure the association between dental caries and obesity in adolescents aged 12 to 15 years attending state and private schools.
Cross-sectional study. RESEARCH SETTING: State and private schools in the state of Paraiba, Brazil. Participants: 1665 obese and 1665 normal-weight adolescents.
These were chosen by means of an anthropometric study using height/age and weight/height indices, adopting as baseline the National Center for Health Statistics indices. The diagnostic criteria for caries were those of the World Health Organization (1997).
The average DMFT for obese adolescents from state schools was 4.27 and for those of normal weight it was 4.25 (p = 0.7802). In private schools, the corresponding figures were 1.90 and 1.91, respectively (p = 0.1151). In state schools, the caries prevalence amongst the obese group was 50.9% and amongst those of normal weight, 52.4% (p = 0.5393). In private schools, it was 9.0% amongst the obese group and 9.6% amongst those of normal weight (p 0.6790).
There was no statistically significant association between dental caries and obesity. Caries levels were higher amongst adolescents attending state schools.
Community dental health 01/2007; 23(4):251-3. · 0.75 Impact Factor
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ABSTRACT: This study assessed the relationship between nonnutritive sucking habits, facial morphology, and malocclusion in 3 planes of space (transverse, vertical, and anteroposterior) in 330 Brazilian children (4 years of age) attending state schools in the city of Recife, Brazil. The data were collected by interviews with the children's mothers or minders and by clinical examinations carried out by a calibrated examiner (kappa = 1). The chi-square test, Fisher's exact test, and multivariate analysis were used for statistical analysis. The prevalence of malocclusion in the sample was 49.7%, according to occlusal classification, and 28.5% of the children had 2 or 3 factors contributing to their malocclusion. Posterior crossbite was detected in 12.1%, anterior open bite in 36.4%, and increased overjet in 29.7%. A significant association was found between malocclusion and sucking habits (P <.001). Most of the children had a high facial skeletal pattern, although no association was found between facial morphology and malocclusion. The results draw attention to the magnitude of the problem in childhood and emphasize the need for longitudinal studies to support clinical practice guidelines for the target population.
American Journal of Orthodontics and Dentofacial Orthopedics 07/2004; 126(1):53-7. · 1.38 Impact Factor
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ABSTRACT: Dental caries continues to be a highly prevalent disease among Brazilian preschoolers, especially those with low socioeconomic status. The purpose of this randomized, controlled trial was to evaluate in vivo 245 simplified restorations in deciduous molars using glass ionomer cements (Vidrion R and Ketac-Molar). Dental restorations were evaluated at 6- and 12-month follow-ups. The teeth restored with Vidrion R (SS White) on a single tooth surface were successful in 87% of the cases evaluated at 6 months and in 63% at 12 months. The teeth restored with Ketac-Molar on one surface achieved a success rate of 95% at 6 months and 82% at 12 months. No recurrent caries or pulpal infection was evident. Logistic regression analysis demonstrated that teeth with cavities restricted to the occlusal surface on sclerotic dentin showed the best adhesion to the restorative material. The restorations with Ketac-Molar had a better clinical performance than those with Vidrion R.
Journal of dentistry for children (Chicago, Ill.) 73(2):91-7.
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ABSTRACT: This study aimed to assess the prevalence of temporomandibular disorders (TMD) and associated variables among adolescents from 16 to 18 years of age in their senior year of high school in the city of Recife, Pernambuco, Brazil, in 2005.
The studied variables were gender, self-esteem and nervous behavior, type of occlusion, and use of orthodontic appliances. In this cross-sectional study, the nonpatient population comprised 410 adolescents attending private and state schools. The data collection was conducted using 2 questionnaires, the first of which was used to evaluate the prevalence of TMD and the second to assess self-esteem. A clinical examination was conducted for the occlusion aspect of the evaluation.
The prevalence of TMD was 16.3% in the study group and there was no statistical difference between occlusions judged as normal or as malocclusions (P = .1148). There was a statistically significant association between students who had previously undergone orthodontic treatment and TMD (P = .0033, odds ratio: 3.08). The students classified in the low self-esteem group showed a significant increase in TMD (P= .0140). The group that classified themselves as nervous also showed an increase (P = .0034), with a higher prevalence also found in females (P = .0021).
This study suggests that low self-esteem and gender may be more frequently related than dental factors to TMD in adolescents.
The International journal of prosthodontics 20(6):599-604; discussion 605. · 1.38 Impact Factor
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ABSTRACT: The purpose of the present study was to evaluate the prevalence of early childhood caries among preschool children aged between 12 and 36 months from poor communities in the city of Recife, Brazil. This prevalence was evaluated along with the type and duration of feeding, supplementary diet in terms of cariogenicity and quantity of sugar intake. Of the 468 children studied, 28.46% presented caries and the association between the variable of a cariogenic diet and caries was strongly significant (x2 = 13.36 and p < 0.001). From the results of the present study it is possible to draw the following conclusions: the prevalence of early childhood caries in poor children aged 12-36 months in the city of Recife is in accordance with that found in other Brazilian cities, but is very high compared to that of the world population. Early childhood caries was not found to be related to the type of feeding; however, the number of sugary snacks between meals and a cariogenic diet were strongly related to early childhood caries. The prevalence of early childhood caries increases with age; and the first signs of the carious lesions were only detected after the eruption of the first molars, starting at 18 months.
ASDC journal of dentistry for children. 69(3):319-24, 236.
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ABSTRACT: The purpose of this longitudinal study was to assess the relationship between nonnutritive sucking habits and anterior open bite in 305 4- to 5-year-old children attending state schools in the city of Recife, Brazil.
The data were collected by interviewing the children's mothers or guardians and through clinical examinations carried out by 1 calibrated examiner (K = 1). Bivariate analyses (Pearson chi-square, McNemar, and Stuart-Maxwell tests) were used for the statistical analysis.
The prevalence of sucking habits was low, and the sample showed reductions after 1 year of follow-up. The prevalence of anterior open bite decreased from 33% to 29% after 1 year. A significant association was found between anterior open bite and sucking habits. Open bite self-correction was associated with the abandoning of deleterious habits.
The low prevalence of nonnutritive sucking habits and its reduction during the period studied seem to reflect a natural tendency in preschool children. Even presenting a slight reduction, the high prevalence of anterior open bite draws attention to the importance of longitudinal studies to support scientific evidences for early clinical intervention.
Pediatric dentistry 27(5):369-73. · 1.02 Impact Factor
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ABSTRACT: The purpose of the present study was to evaluate the prevalence of early childhood caries (ECC), in a cohort of children of low socioeconomic status at 48 months of age in João Pessoa, Paraíba, Brazil, in relation to feeding practices, oral health behaviors, fluoride exposure, and enamel defects. 224 children were clinically examined in the Knee-Knee position at the children's home under natural light. Teeth were dried and cleaned with gauze, and caries (WHO index) and defect (DDE Index) were determined. Questionnaires on children's oral hygiene and dietary history were completed by parents or guardians. The SAS statistical program was used with the Mantel-Haenszel tests. The results showed a prevalence of 10.7% and 33.0% for ECC and SECC, respectively. Of all the children examined, 79.9% had at least one tooth with enamel defects, which was the only statistically significant factor (p < 0.001) for ECC. The association between enamel defects and ECC indicates that alterations in the enamel surface may cause progression of dental caries.
Cadernos de Saúde Pública 21(6):1695-700. · 0.89 Impact Factor
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ABSTRACT: The purpose of this study was to ascertain the prevalence of cavities among adolescents in public and private schools in João Pessoa, Paraíba State, Brazil, comparing the DMFT in terms of gender and age, as well as education levels and quality among mothers in these two types of schools. The sample consisted of 3,330 adolescents between twelve and fifteen years old: 1,665 attending public schools and 1,665 attending private schools. The DMFT was evaluated by the WHO criteria (1997), using the Kappa (0.92) intra-examiner agreement for cavity diagnoses and the Mann-Whitney and Kruskal-Wallis statistical analyses. The prevalence of cavities in public schools was 51.6%, compared to 9.3% in private schools. The DMFT for girls was 4.79 and 3.46 for boys in public schools (p<0.0001) and 2.11 and 1.65 (p=0.0007) in private schools. At the age of 12 years, the DMFT was 3.37 in public schools and 1.35 in private schools, while for the age of 15 it was 5.65 and 2.88 for each type of school. Among children whose mothers graduated from high school, the average DMFT was 4.21 in public schools and 1.81 in private schools. The prevalence of cavities was higher among girls in public schools, increasing with age and decreasing with higher education levels among mothers.
Ciencia & saude coletiva 12(5):1229-36.
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Aronita Rosenblatt
SERBIULA (sistema Librum 2.0).
