RESUMO
PURPOSE: The current data suggest that the presence of lower third molars predisposes the patient to a greater risk of mandibular angle fracture. Thus, the present review sought to determine whether an association exists between the presence of a lower third molar and the occurrence of a mandibular angle fracture in adults and to assess the influence of third molar position according to the Pell and Gregory classification. MATERIALS AND METHODS: The present study was a systematic review and meta-analysis of analytical observational studies. The present review included all reports of the relationship between mandibular angle fractures and lower third molars. No restriction regarding year, language, or publication status was used. The review protocol was registered at the PROSPERO database (registration no. CRD42016047057). Electronic searches unrestricted for publication period and language were performed in the PubMed, Scopus, SciELO, and Latin American and Caribbean Health Sciences databases. Google Scholar and OpenGrey databases were used to search the "gray literature," avoiding selection and publication biases. The entire search was performed by 2 eligibility reviewers. Association and proportion meta-analyses were planned for the studies with sufficient data. The primary predictor variable was the relationship between the presence of a lower third molar and the development of mandibular angle fractures. The secondary outcome variables were the vertical and horizontal positions of the lower third molar, according to the Pell and Gregory classification and their relationship to the susceptibility to developing a mandibular angle fracture. RESULTS: The search strategies resulted in 411 studies, from which 16 were selected for qualitative and quantitative review. The association meta-analysis included all the selected studies and showed that patients with lower third molars are 3.16 times more likely to develop mandibular angle fractures. The proportion meta-analysis included 5 studies and showed that the overall rate of mandibular angle fractures was 51.58% and that positions III and C are more likely to result in fracture, with a rate of 59.84 and 63.67%, respectively. CONCLUSIONS: The results of the present study have shown that the presence of impacted third molars increases by 3.16 times the risk of mandibular angle fractures in adults, with the greatest risk present when third molars are classified as IIIC according to Pell and Gregory. The available evidence is not sufficiently robust to determine whether third molar presence or the level of impaction is the main causative factor for the occurrence of mandibular angle fractures.
Assuntos
Fraturas Mandibulares , Dente Serotino/fisiopatologia , Humanos , Fatores de Risco , Dente Impactado/fisiopatologiaRESUMO
Introdução: estudos mostram que condições socioeconômicas podem interferir no nível de conhecimento dos pais sobre higiene bucal dos filhos, influenciando diretamente no índice de cárie. Objetivo: Avaliar o nível sócioeconômico e o conhecimento de uma amostra de 127 pais/responsáveis e correlacioná-lo com o índice de cárie diagnosticado em seus filhos com idades variando entre 3 e 5 anos. Método: foi aplicado um questionário composto por questões fechadas, abordando condições socioeconômicas e conhecimento dos pais/responsáveis sobre saúde e higienização bucal na primeira infância. Um único examinador calibrado realizou o levantamento epidemiológico nos filhos dos pais participantes. Os dados foram analisados por estatística descritiva e pelo teste de correlação linear de Pearson a um nível de significância de 5%. Resultados e Discussão: 60% dos pais possuíam renda de 3 a 5 salários mínimos, 70% com ensino médio completo e 73% das crianças com ceo-d=0. Ao avaliar a correlação entre o conhecimento dos pais/responsáveis e demais variáveis, observou-se diferença estatisticamente significante com o nível econômico/renda (p=0,006) e também com o grau de escolaridade dos pais (p=0,001). Houve diferença estatisticamente significante entre a correlação de índice de ceo-d e o conhecimento sobre saúde bucal (p=0,02). Não foi constatada correlação estatisticamente significante entre o índice ceo-d e a renda familiar (p=0,95), nem com o grau de escolaridade dos pais (p=0,06). Conclusão: concluiu-se que houve correlação negativa entre o índice de ceo-d das crianças e o conhecimento dos pais/responsáveis sobre saúde bucal, e correlação positiva entre o conhecimento dos pais/responsáveis e o nível sócioeconômico.(AU)
Introduction: studies show that socioeconomic conditions may interfere with parents' knowledge about oral hygiene of children, and then influencing caries index. Objective: to evaluate the socioeconomic level and knowledge of a sample of 127 parents/guardians and correlate it with caries index diagnosed in their children, ranging 3 to 5 years. Method: a questionnaire composed of closed questions was applied, addressing socioeconomic conditions and knowledge of parents/guardians about health and oral hygiene in early childhood. A single calibrated examiner performed the epidemiological survey on children of the participating parents. Data were analyzed by descriptive statistics and Pearson's linear correlation test at a significance level of 5%. Results and Discussion: 60% of the parents had income of 3 to 5 minimum wages, 70% with complete secondary education and 73% of the children with ceo-d = 0. When assessing the correlation between parents/guardians' knowledge and other variables, a statistically significant difference was observed with economic/income level (p = 0.006) and also with the parents' educational level (p = 0.001). There was a statistically significant difference between the correlation of ceo-d index and knowledge about oral health (p = 0.02). No statistically significant correlation was found between the ceo-d index and the family income (p = 0.95), nor with the parents' educational level (p = 0.06).Conclusion: it was concluded that there was a negative correlation between the children's ceo-d index and the knowledge of the parents/guardians about oral health, and a positive correlation between the knowledge of the parents/guardians and the socio-economic level.(AU)
Assuntos
Humanos , Criança , Odontopediatria , Saúde Bucal , Odontologia PreventivaRESUMO
Introdução: na literatura existem poucos levantamentos sobre alterações bucais pediátricas, uma vez que estes apresentam prevalências em faixas etárias mais abrangentes, incluindo jovens ou adultos. Objetivo: apresentar a prevalência das alterações bucais em tecidos moles que mais acometem crianças entre 6 e 12 anos de idade. Método: estudo prospectivo de identificação de lesões bucais da população infantil atendida na Clínica de Odontopediatria, da Faculdade de Odontologia da Universidade do Sagrado Coração, no período de outubro de 2012 a julho de 2013. Neste período, foram atendidas 129 crianças, sendo que 13 (10%) apresentaram alguma manifestação bucal em tecidos envolvendo tecidos moles. Os dados foram registrados por um único examinador em planilha própria, constando identificação do paciente, estado geral, tamanho, aspecto e localização da alteração, sintomas, tempo de instalação, tempo de recuperação, provável diagnóstico e tratamentos odontológicos realizados. Resultados e Discussão: as alterações bucais registradas foram: fístula/abscesso no rebordo alveolar (46,1%); estomatite herpética primária (15,4%); úlcera aftosa (15,4%); herpes simples recorrente (7,7%); língua fissurada (7,7%) e alveólise (7,7%). A localização mais frequente das alterações bucais registradas foi a mucosa alveolar superior (38,5%), seguida da mucosa alveolar inferior (23,1%), lábio superior direito (15,4%), maxila anterior (7,7%), rebordo gengival alveolar superior (7,7%) e dorso da língua (7,7%). A prevalência encontrada neste estudo prospectivo corrobora com outros levantamentos realizados na população infantil. Conclusão: é importante que os profissionais da área da saúde, especialmente o cirurgião-dentista, tenham o conhecimento da prevalência das principais lesões bucais em crianças para que estejam mais preparados para diagnosticá-las e tratá-las.
Introduction: in the literature there are few surveys of pediatric oral lesions, since these have prevalence in wider age groups, including young people or adults. Objective: present the prevalence of oral manifestations in soft tissues that most affect children between 6 and 12 years old. Methods: prospective study of oral lesions identification of children attendances at the Clinic of Pediatric Dentistry, Faculty of Dentistry, University of the Sacred Heart, from October 2012 to July 2013. During this period, 129 children were treated, and 13 (10%) had some oral manifestation in tissues surrounding soft tissues. Data were recorded by a single examiner at a specific note, consisting of patient identification, general condition, size, appearance and location of the oral manifestation, symptoms, installation time, recovery time, possible diagnosis and conducted dental treatments. Results and Discussion: Oral diseases recorded were: fistula/abscess alveolar (46.1%); primary herpetic stomatitis (15.4%), aphthous ulcer (15.4%), recurrent herpes simplex (7.7%), fissured tongue (7.7%) and alveolisys (7.7%). The most frequent location of oral abnormalities recorded was the superior alveolar mucosa (38.5%), followed by the inferior alveolar mucosa (23.1%), right upper lip (15.4%), anterior maxilla (7.7%), gingival superior alveolar (7.7%) and dorsum of the tongue (7.7%). The prevalence found in this prospective study corroborates other surveys in children. Conclusion: It is important that health professionals, especially the dentist, have knowledge of the prevalence of oral lesions in children in order to be better prepared to diagnose and treat them.