RESUMO
Purpose: To evaluate the oral health status of children who require in-home medical care, their oral hygiene and eating habits, and the association between oral health status and medical conditions.
Methods: Legal guardians of children who need in-home medical care were interviewed regarding their socioeconomic level and their children's medical and dental history, as well as their oral hygiene habits. An oral exam assessed the children's plaque level, caries experience, and periodontal disease. Descriptive and bivariate analyses were performed.
Results: Fifty-six children participated. Almost 61 percent had never received dental care and 58.9 percent had fair or poor oral hygiene. The most observed oral problems were gingival hyperplasia (46.4 percent), calculus (46.4 percent), and gingivitis (30.3 percent). The use of anticonvulsants and type of food were factors that correlated to calculus, gingivitis, or hyperplasia (P <0.05).
Conclusion: A significant number of children who require in-home medical care presented with deficient oral hygiene and periodontal problems, which were correlated with the use of anticonvulsants and gastrostomy feeding.
Assuntos
Cárie Dentária , Placa Dentária , Gengivite , Criança , Índice de Placa Dentária , Humanos , Saúde Bucal , Higiene BucalRESUMO
The aim of this study was to investigate the segregation patterns of molar incisor hypomineralization (MIH) in families, given the evidence that its etiology is influenced by genetics. Clinically, MIH may be detected in parents and/or siblings of MIH-affected children. Our study included children with at least one first permanent molar affected by MIH (proband) and their first-degree relatives (parents and siblings). The participants were examined clinically to detect MIH, according to the European Academy of Paediatric Dentistry criteria (2003). A total of 101 nuclear families (391 individuals) were studied. Proband diagnosis was followed by MIH classification of the subject, his parents and siblings, as affected, unaffected, or unknown. Segregation analysis was performed using the multivariate logistic regression model of the Statistical Analysis for Genetic Epidemiology package, and segregation models (general transmission, environmental, major gene, dominant, codominant and recessive models). The Akaike information criterion (AIC) was used to evaluate the most parsimonious model. In all, 130 affected individuals, 165 unaffected individuals, and 96 unknown individuals were studied. Severe MIH was found in 50.7% of the cases. A segregation analysis performed for MIH revealed the following different models: environmental and dominance (p = 0.05), major gene (p = 0.04), codominant (p = 0.15) and recessive models (p = 0.03). According to the AIC values, the codominant model was the most parsimonious (AIC = 308.36). Our results suggest that the codominant model could be the most likely for inheriting MIH. This result strengthens the evidence that genetic factors, such as multifactorial complex defect, influence MIH.
Assuntos
Hipoplasia do Esmalte Dentário , Incisivo , Criança , Hipoplasia do Esmalte Dentário/epidemiologia , Hipoplasia do Esmalte Dentário/genética , Humanos , Padrões de Herança , Dente Molar , PrevalênciaRESUMO
Abstract The aim of this study was to investigate the segregation patterns of molar incisor hypomineralization (MIH) in families, given the evidence that its etiology is influenced by genetics. Clinically, MIH may be detected in parents and/or siblings of MIH-affected children. Our study included children with at least one first permanent molar affected by MIH (proband) and their first-degree relatives (parents and siblings). The participants were examined clinically to detect MIH, according to the European Academy of Paediatric Dentistry criteria (2003). A total of 101 nuclear families (391 individuals) were studied. Proband diagnosis was followed by MIH classification of the subject, his parents and siblings, as affected, unaffected, or unknown. Segregation analysis was performed using the multivariate logistic regression model of the Statistical Analysis for Genetic Epidemiology package, and segregation models (general transmission, environmental, major gene, dominant, codominant and recessive models). The Akaike information criterion (AIC) was used to evaluate the most parsimonious model. In all, 130 affected individuals, 165 unaffected individuals, and 96 unknown individuals were studied. Severe MIH was found in 50.7% of the cases. A segregation analysis performed for MIH revealed the following different models: environmental and dominance (p = 0.05), major gene (p = 0.04), codominant (p = 0.15) and recessive models (p = 0.03). According to the AIC values, the codominant model was the most parsimonious (AIC = 308.36). Our results suggest that the codominant model could be the most likely for inheriting MIH. This result strengthens the evidence that genetic factors, such as multifactorial complex defect, influence MIH.
Assuntos
Humanos , Criança , Hipoplasia do Esmalte Dentário/genética , Hipoplasia do Esmalte Dentário/epidemiologia , Incisivo , Prevalência , Padrões de Herança , Dente MolarRESUMO
Ameloblasts are sensitive cells whose metabolism and function may be affected by inflammatory stimuli. The aim of this study was to evaluate the possible association between polymorphisms in immune response-related genes and molar-incisor hypomineralization (MIH), and their interaction with polymorphisms in amelogenesis-related genes. DNA samples were obtained from 101 nuclear families that had at least 1 MIH-affected child. Eleven single-nucleotide polymorphisms (SNPs) were investigated in immune response genes using TaqMan® technology allele-specific probes. A transmission disequilibrium test was performed to verify overtransmission of alleles in all MIH families, as well as in families only with mild or severe MIH-affected children. Gene-gene interactions between the immune-related and amelogenesis-related polymorphisms were analyzed by determining whether alleles of those genes were transmitted from heterozygous parents more often in association than individually with MIH-affected children. In severe cases of MIH, significant results were observed for rs10733708 (TGFBR1, OR = 3.5, 95% CI = 1.1-10.6). Statistical evidence for gene-gene interactions between rs6654939 (AMELX) and the SNPs rs2070874 (IL4), rs2275913 (IL17A), rs1800872 (IL10), rs1800587 (IL1A), and rs3771300 (STAT1) was observed. The rs2070874 SNP (IL4) was also significantly overtransmitted from heterozygous parents with the rs7526319 (TUFT1) and the rs2355767 (BMP2) SNPs, suggesting a synergistic effect of the transmission of these alleles with susceptibility to MIH. This family-based study demonstrated an association between variation in TGFBR1 and MIH. Moreover, the polymorphisms in immune response and amelogenesis genes may have an additive effect on the risk of developing MIH.
Assuntos
Amelogênese , Hipoplasia do Esmalte Dentário , Criança , Humanos , Incisivo , Dente Molar , Polimorfismo de Nucleotídeo Único , PrevalênciaRESUMO
The objective of this study was to evaluate the clinical survival of sealants applied in first permanent molars (FPMs) affected by molar-incisor hypomineralization (MIH), at 18 months of follow-up. Forty-one first permanent molars were selected from 21 children, 6-8 years of age. MIH was classified by one calibrated examiner (kappa = 0.80) according to EAPD criteria. The inclusion criteria were fully erupted FPMs with MIH or sound FPMs (without MIH) for which sealant treatment was indicated. The FPMs were assigned to two groups: CG (control group) and HG (MIH group). Both groups were treated with sealant (FluroShield). Clinical follow-up was performed from baseline to 18 months to assess anatomical form, marginal adaptation, retention and presence of caries, according to criteria set by the United States Public Health Service-Modified, and was conducted by a blinded examiner (kappa = 0.80). The actuarial method was used to evaluate the survival of the sealants. The survival rates for the groups were compared using Fisher's exact test (α = 5%). The cumulative survival rates were 81% at 1 month, 68.8% at 6 months, 68.8% at 12 months, and 62.6% at 18 months for CG, and 88% at 1 month, 84% at 6 months, 76% at 12 months, and 72% at 18 months for HG. No significant difference was found between the groups. The sealants in molars affected by MIH presented a survival rate similar to the sealants in the control, suggesting that sealants may be an adequate approach for preventing carious lesions in MIH-affected molars.
Assuntos
Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Cariostáticos/uso terapêutico , Hipoplasia do Esmalte Dentário/terapia , Falha de Restauração Dentária , Restauração Dentária Permanente/métodos , Fluoretos Tópicos/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Poliuretanos/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Criança , Cárie Dentária/prevenção & controle , Esmalte Dentário/efeitos dos fármacos , Dentição Permanente , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Reprodutibilidade dos Testes , Medição de Risco , Análise de Sobrevida , Fatores de Tempo , Resultado do TratamentoRESUMO
Abstract The objective of this study was to evaluate the clinical survival of sealants applied in first permanent molars (FPMs) affected by molar-incisor hypomineralization (MIH), at 18 months of follow-up. Forty-one first permanent molars were selected from 21 children, 6–8 years of age. MIH was classified by one calibrated examiner (kappa = 0.80) according to EAPD criteria. The inclusion criteria were fully erupted FPMs with MIH or sound FPMs (without MIH) for which sealant treatment was indicated. The FPMs were assigned to two groups: CG (control group) and HG (MIH group). Both groups were treated with sealant (FluroShield). Clinical follow-up was performed from baseline to 18 months to assess anatomical form, marginal adaptation, retention and presence of caries, according to criteria set by the United States Public Health Service-Modified, and was conducted by a blinded examiner (kappa = 0.80). The actuarial method was used to evaluate the survival of the sealants. The survival rates for the groups were compared using Fisher’s exact test (α = 5%). The cumulative survival rates were 81% at 1 month, 68.8% at 6 months, 68.8% at 12 months, and 62.6% at 18 months for CG, and 88% at 1 month, 84% at 6 months, 76% at 12 months, and 72% at 18 months for HG. No significant difference was found between the groups. The sealants in molars affected by MIH presented a survival rate similar to the sealants in the control, suggesting that sealants may be an adequate approach for preventing carious lesions in MIH-affected molars.
Assuntos
Humanos , Masculino , Feminino , Criança , Selantes de Fossas e Fissuras/uso terapêutico , Poliuretanos/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Cariostáticos/uso terapêutico , Fluoretos Tópicos/uso terapêutico , Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Falha de Restauração Dentária , Hipoplasia do Esmalte Dentário/terapia , Restauração Dentária Permanente/métodos , Fatores de Tempo , Análise de Sobrevida , Estudos Prospectivos , Reprodutibilidade dos Testes , Seguimentos , Resultado do Tratamento , Medição de Risco , Dentição Permanente , Cárie Dentária/prevenção & controle , Esmalte Dentário/efeitos dos fármacosRESUMO
Surgical procedure for removal of impacted teeth is a challenge for clinicians as it involves accuracy in the diagnosis and localization of the dental elements. The cone-beam computed tomography (CBCT), compared to the conventional radiography, has a greater potential to provide complementary information because of its three-dimensional (3D) images, reducing the possibility of failures in surgical procedures. Two 10-year-old boys presented with aesthetic issues associated with the juxtaposition of ectopic teeth with the permanent ones. Both two-dimensional and 3D preoperative radiographic diagnostic sets were produced. The occlusal and panoramic radiographs were not enough for proper localization of impacted incisors. Thus, the CBCT was used as a surgical guide. After 2 years of longitudinal following, no lesion was recorded, and the orthodontic treatment has proven successful. In all cases, CBCT contributed to both diagnosis and correct localization of supernumerary teeth, aiding the professional in the treatment planning, and consequently in the clinical success. The surgeries were completely safe, avoiding damage in noble structures, and providing a better recovering of the patients.
RESUMO
The purpose of this study was to evaluate the 12-month clinical performance of glass ionomer restorations in teeth with MIH. First permanent molars affected by MIH (48) were restored with glass ionomer cement (GIC) and evaluated at baseline, at 6 and at 12 months, by assessing tooth enamel breakdown, GIC breakdown and caries lesion associations. The data were analyzed using the chi-square test and actuarial survival analysis. The likelihood of a restored tooth remaining unchanged at the end of 12 months was 78%. No statistically significant difference was observed in the association between increased MIH severity and caries at baseline (p > 0.05) for a 6-month period, or between increased MIH severity and previous unsatisfactory treatment at baseline (p > 0.05) for both a 6- and 12-month period. A statistically significant difference was observed in the association between increased MIH severity and extension of the restoration, involving 2 or more surfaces (p < 0.05) at both periods, and between increased MIH severity and caries at baseline (p < 0.05) at a 12-month period. Because the likelihood of maintaining the tooth structures with GIC restorations is high, invasive treatment should be postponed until the child is sufficiently mature to cooperate with the treatment, mainly of teeth affected on just one face.