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ABSTRACT Objective: To compare the agreement of images in white light (WL), fluorescence (FL), and digital radiographs (DR), on the diagnosis and treatment decisions for occlusal caries lesions against a micro-CT gold standard. Material and Methods: Ten extracted third molars, with enamel and/or dentin caries (ICDAS 2-4), were included. Occlusal surface images were acquired with an intraoral camera (SoproLife®) in WL and FL modes. DR was obtained using an intraoral X-ray and a semi-direct digital system. A total of 780 images were needed, organized in a template, to be later examined by twenty-six dentists invited to compose the study. The Generalized Estimation Equations model was used to compare the proportions of the correct answers between the three methods and the gold standard. When significant, Bonferroni post-hoc test was used to identify differences (α=5%). Results: Most of the examiners were specialists (76.9%) with 14.5 years of experience. All diagnostic methods were similar and showed low agreement (DR 12.7%, WL 16.5%, and FL 16.5%) compared with gold standard caries diagnostic scores. Regarding treatment decisions, mean agreement for all diagnostic methods was higher (43.2%; p<0.001), and among all methods, WL (48.1%) and FL (51.2%) modes performed better than DR (30.4%, p<0.001). Conclusion: SoproLife® images could help clinicians to propose rational, minimally invasive treatments for occlusal caries lesions.

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ABSTRACT Objective: To analyze the relationship between malocclusion and bullying and its impact on the well-being and quality of life of students from low social development areas. Material and Methods: This cross-sectional study included 243 schoolchildren between 10 and 17 years. Malocclusion was analyzed using Dental Aesthetic Index. Bullying and self-perception of the impact of one's oral condition on quality of life and interpersonal relationships were assessed by questions from National Survey of Schoolchildren's Health and Child Perceptions Questionnaire 11-14 (CPQ11-14). Data were analyzed using the Spearman correlation coefficient and Mann-Whitney tests, considering groups: 10-11, 12-14 and 15-17 years. Results: No correlation was observed between malocclusion and bullying. However, in the 12-14 group, poor correlations were found between malocclusion and the CPQ11-14 (0.226) and between malocclusion and being shy/embarrassed due to oral aspects (0.298). Positive correlations were observed between bullying and the impact on the quality of life in the 10-11 (0.420) and 12-14 (0.425) groups. In the older group, a positive correlation (0.724) was observed between the concern about what others think of their oral health and the impact on their quality of life. Conclusion: There was no evidence of a relationship between malocclusion and bullying. However, the oral conditions negatively affected the interpersonal relationships and the student's quality of life.

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Introduction: Alagille syndrome (AGS) is an autosomal dominant disease with variable expressiveness that can affect the liver, heart, kidneys, blood vessels, eyes, face and skeleton. Objective: To describe a case of a pediatric patient with Alagille syndrome. Case report: The family history was negative for even the mildest manifestations of AGS. Clinically, the patient had a triangular face, hypertelorism, short philtrum and flat midface. Intraoral examination revealed the absence of the permanent upper lateral incisors, enamel hypoplasia and agreenish color in some teeth, gingival hyperplasia, retention of two primary lower incisors, presence of a supernumerary tooth, and a pediculated nodule of soft tissue on the lingual aspect of the left permanent mandibular first molar. Results: The dental treatment required the extraction of the retained primary teeth and the supernumerary tooth, excisional biopsy and histopathological examination of the lesion were performed and also application of topical fluoride. Also dietary and oral hygiene instructions were given. Conclusion: Currently, the patient makes frequent follow-up visits to monitor the dental development.

Introdução: A síndrome de Alagille (AGS) é uma doença autossômica dominante com expressividade variável que podem afetar o fígado, coração, rins, vasos sanguíneos, olhos, rosto e esqueleto. Objetivo: Descrever um caso de um paciente pediátrico com síndrome de Alagille. Relato do caso: A história familiar era negativa até mesmo para as manifestações mais leves de AGS. Clinicamente, o paciente apresentava face triangular, hipertelorismo, filtro curto e face média plana. O exame intraoral revelou ausência dos incisivos laterais superiores permanentes, hipoplasia de esmalte e aspecto esverdeado em alguns dentes, hiperplasia gengival, retenção de dois incisivos inferiores decíduos, presença de um dente supranumerário, e um nódulo de tecido mole pediculado na face lingual do primeiro molar inferior permanente esquerdo. Resultados: O tratamento odontológico exigiu a extração dos dentes decíduos retidos e do dente supranumerário, biópsia excisional e exame histopatológico da lesão além da aplicação de fluoreto tópico. Também foi realizada instrução dietética e de higiene oral. Conclusão: Atualmente, o paciente faz visitas de acompanhamento frequentes para monitorar o desenvolvimento dentário.

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Objective: Evaluate the impact of oral health status on the quality of life and personal satisfaction among adolescents from urban and rural areas, in Nova Friburgo, Brazil. Methods: Adolescents between 11 and 14 years, enrolled in the schools participating in the Health in School Program (HSP) of rural and urban of this city (n = 509), received the consent form for the participation in this study, along with the economic questionnaire to be handed to the responsible. Adolescent´s oral health status was evaluated clinically, through the Decayed, Missing and Filled Teeth (DMFT); pulpal involvement, ulceration, fistula and abscess criteria (PUFA); and Dental Treatment Needs Index (DTNI). The quality of life was measured through the Child Perception Questionnaire (CPQ11-14), while personal satisfaction´s evaluation, through the Subjective Happiness Scale (SHS), both as interview. Statistical tests were performed (Chi-Square; Fisher's exact; Mann-Whitney) with level of significance of 5%. Results: The final sample comprised 161 adolescents. The impact of oral health status on the quality of life of adolescents from both areas was not significantly different, although the aggravation of the oral condition showed a tendency to worse the quality of life. Similarly, there was no relation of the oral status with personal satisfaction, without differences between the groups. It was observed that rural adolescents presented better quality of life (p<0.010), while the urban ones had higher degree of personal satisfaction (p<0.001). Conclusion: Oral health status had a negative impact on the quality of life, but had no relation to personal satisfaction, regardless of the demographic area.

Objetivo: Avaliar o impacto do estado de saúde bucal na qualidade de vida e na satisfação pessoal de adolescentes das áreas urbana e rural de Nova Friburgo, Brasil. Métodos: Adolescentes entre 11 e 14 anos, matriculados nas escolas participantes do Programa Saúde na Escola (PSE) da zona rural e urbana desta cidade (n = 509), receberam o Termo de Consentimento Livre e Esclarecido para a participação neste estudo,juntamente ao questionário econômico a ser entregue para o responsável. O estado de saúde bucal do adolescente foi avaliado clinicamente, por meio dos índices Cariados, Perdidos e Obturados (CPOD); critérios de envolvimento pulpar, ulceração, fístula e abscesso (PUFA); e Índice de Necessidades de Tratamento Odontológico (INTO). A qualidade de vida foi mensurada por meio do Child Perception Questionnaire (CPQ11- 14), enquanto a avaliação da satisfação pessoal, por meio da Subjective Happiness Scale (SHS), ambos na forma de entrevista. Foram realizados testes estatísticos (Qui-Quadrado; Exato de Fisher; Mann-Whitney) com nível de significância de 5%. Resultados: A amostra final foi de 161 adolescentes. O impacto do estado de saúde bucal na qualidade de vida dos adolescentes de ambas as áreas não foi significativamente diferente, embora o agravamento da condição bucal tenha apresentado tendência a piorar a qualidade de vida. Da mesma forma, não houve relação da condição oral com a satisfação pessoal, sem diferenças entre os grupos. Observou-se que os adolescentes rurais apresentaram melhor qualidade de vida (p<0,010), enquanto os urbanos apresentaram maior grau de satisfação pessoal (p<0,001). Conclusão: O estado de saúde bucal teve impacto negativo na qualidade de vida, mas não teve relação com a satisfação pessoal, independente da área demográfica.

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BACKGROUND: Several factors can influence the oral health. AIM: To explore the clinical factors, individual characteristics, and environmental factors (religious-spiritual coping-RSC, sense of coherence [SOC], and socio-economic status) related to oral status and impact on oral health-related quality of life (OHRQoL) of children/adolescents (C/A). DESIGN: This study evaluated C/A up to 15 years old and their caregivers. Number of decayed (NDT) and missing teeth (NMT); history of dental trauma; caregiver's RSC and SOC, socio-economic factors, and OHRQoL were evaluated. Theoretical model exploring the direct and indirect effects was tested using a structural equation analysis. RESULTS: For younger group (0-6 years), having more NDT or more NMT had a greater impact on the OHRQoL (ß = 0.382, ß = 0.203, respectively). In the oldest group (7-15 years), a higher SOC had an inverse relationship with the impact on the family OHRQoL (ß=-0.201). The higher the age of the C/A, the lower the NDT (ß=-0.235), and the higher the family income the lower, the need for social benefit (ß = 0.275). Indirect relationships were observed between schooling with social benefit and OHRQoL in younger group. The family income indirectly influenced the OHRQoL in oldest group. CONCLUSIONS: Quality of life is affected directly and indirectly by environmental characteristics, oral status, and the age of patients.

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Objective: The aim of this article was to describe a case of Robinow syndrome in a pediatric patient. Case Report: Clinically, the patient had frontal bossing, flat facial profile with macrocephaly, midfacial hypoplasia, hypertelorism, wide palpebral fissures, triangular mouth, short upturned nose, short philtrum, ankyloglossia, prolonged retention of primary teeth and abnormal aligment of teeth. The radiographic exams indicated the presence of three impacted permanent supernumerary teeth, agenesis of eight permanent teeth and dental root shortening of all permanent teeth. The treatment proposed was the extraction of all retained primary teeth and the supernumerary teeth, dietary and oral hygiene instructions and orthodontic treatment. Also, important aspects to avoid complications associated with Robinow syndrome were discussed. Conclusion: This case describes uncommon oral findings and some important aspects to avoid complications associated with the Robinow syndrome. Early professional advice, treatment, and periodical follow-ups can improve the quality of life of these patients.

Objetivo: O objetivo deste artigo foi descrever um caso de síndrome de Robinow em um paciente pediátrico. Relato de Caso: Clinicamente, o paciente apresentava bossas frontais, perfil facial plano com macrocefalia, hipoplasia da face média, hipertelorismo, fissuras palpebrais amplas, boca triangular, nariz curto, filtro curto, anquiloglossia, retenção prolongada de dentes decíduos e dentes desalinhados. Os exames radiográficos indicaram a presença de três elementos supranumerários permanentes impactados, agenesia de oito dentes permanentes e encurtamento radicular de todos os dentes permanentes. O tratamento proposto foi a extração de todos os dentes decíduos retidos e os elementos supranumerários, instruções de higiene bucal e dietética e tratamento ortodôntico. Além disso, aspectos importantes para evitar complicações associadas à síndrome de Robinow são discutidos. Conclusão: Este caso descreve achados orais incomuns e alguns aspectos importantes para evitar complicações associadas à síndrome de Robinow. Aconselhamento profissional precoce, tratamento e acompanhamento periódico podem melhorar a qualidade de vida desses pacientes.

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Objective: The aim of this study was to evaluate the oral health status and to analyze the self- erception of the impact of oral health statuson the interpersonal relationship of students from a local school in Rio de Janeiro, Brazil. Methods: A non-probabilistic sample was used, consisting of 260 children and adolescents aged 8 to 15 years. Oral health status was evaluated by clinical examination according to the World Health Organization criteria. The perception of the students of their oral health status was assessed by interview using a questionnaire developed from PeNSE (Brazilian National School Health survey) and CPQ 11-14 (Child Perception Questionnaire). Chi- quare and Fisher's exact test were used, with level of significance of 5% (p< 0.05). Results: A DMFT index equal to 0 was observed in 51.5% of the participants. The questionnaire revealed that most students were happy about their own smile (88.1%). However, 35.8% had already avoided smiling and 18.5% had refrained from some daily activities because of the appearance of their teeth. Conclusion: Although half of the students were free of dental caries and most were satisfied with their smile, a sizable number felt upset and embarrassed about their teeth, which may interfere in the relationship with their peers.

Objetivo: O objetivo desse trabalho foi avaliar a condição de saúde bucal e analisar a autopercepção do impacto da saúde bucal no relacionamento interpessoal de escolares de uma instituição da rede pública municipal do Rio de Janeiro, Brasil. Método: A amostra foi do tipo não probabilística, sendo composta por 260 crianças e adolescentes, de 8 a 15 anos. A condição bucal foi verificada através de exame clínico de acordo com os critérios da Organização Mundial da Saúde. A percepção dos escolares em relação a própria condição bucal foi avaliada através de entrevista, cujo instrumento foi desenvolvido a partir da Pesquisa Nacional de Saúde do Escolar, 2012 e do Child Perception Questionnaire ( CPQ). 11-14 Os testes qui-quadrado e Exato de Fisher foram utilizados com nível designificância de 5% (p<0,05). Resultados: 51,5% da amostra apresentou CPOD zero. A análise do questionário mostrou que a maioria está feliz com o próprio sorriso (88,1%). Porém, 35,8% relatou já ter evitado sorrir e 18,5% já deixou de realizar alguma atividade por causa dos dentes. Conclusão: Embora a metade dos escolares se apresente livre de cárie e a maioria goste dopróprio sorriso, uma parcela considerável demonstra sentimentos como chateação e vergonha, podendo interferir no relacionamento com seus pares.

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The aim of this study was to check the in vitro accuracy of ICDAS criteria on digital images compared to visual examination for the diagnosis of occlusal caries against a micro-CT gold standard. ICDAS was scored in 40 extracted permanent molars by means of visual inspection and stereomicroscopic images. Visual examinations were performed in duplicate and at a one-week interval by three different calibrated examiners. The analysis of digital images by ICDAS criteria was also performed in duplicate, 1 month after visual examinations. The detection methods were compared by means of sensitivity, specificity, area under the curve, predictive positive and negative values, and accuracy for two different thresholds (1- sound vs. carious teeth; 2- tooth requiring operative vs. non-operative treatment). Sensitivity and accuracy values for threshold 1 in the visual ICDAS and image-based ICDAS methods were high for sensitivity (0.93 and 0.97) and for accuracy (0.83 and 0.85), but low for specificity (0.55 for both methods). Specificity values for threshold 2 were 0.77 and 0.82, while sensitivity was 0.33 and 0.28 for each method. Spearman's rank correlation coefficient was 0.53 and 0.43 (p<0.05) for visual and image-based ICDAS compared to the gold standard scores. Both visual and image-based ICDAS scores were similar to each other in terms of diagnostic accuracy when compared to the micro-CT gold standard. Low specificity for the presence of caries and sensitivity for the detection of caries requiring operative treatment were found.

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Abstract The aim of this study was to check the in vitro accuracy of ICDAS criteria on digital images compared to visual examination for the diagnosis of occlusal caries against a micro-CT gold standard. ICDAS was scored in 40 extracted permanent molars by means of visual inspection and stereomicroscopic images. Visual examinations were performed in duplicate and at a one-week interval by three different calibrated examiners. The analysis of digital images by ICDAS criteria was also performed in duplicate, 1 month after visual examinations. The detection methods were compared by means of sensitivity, specificity, area under the curve, predictive positive and negative values, and accuracy for two different thresholds (1- sound vs. carious teeth; 2- tooth requiring operative vs. non-operative treatment). Sensitivity and accuracy values for threshold 1 in the visual ICDAS and image-based ICDAS methods were high for sensitivity (0.93 and 0.97) and for accuracy (0.83 and 0.85), but low for specificity (0.55 for both methods). Specificity values for threshold 2 were 0.77 and 0.82, while sensitivity was 0.33 and 0.28 for each method. Spearman's rank correlation coefficient was 0.53 and 0.43 (p<0.05) for visual and image-based ICDAS compared to the gold standard scores. Both visual and image-based ICDAS scores were similar to each other in terms of diagnostic accuracy when compared to the micro-CT gold standard. Low specificity for the presence of caries and sensitivity for the detection of caries requiring operative treatment were found.

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OBJECTIVE: Titanium tetrafluoride (TiF4) is a topical agent used in the control of dental caries; however, it is highly acidic. To minimize this effect, cyclodextrins (CDs) are used. This study evaluated the in vitro potential of TiF4 and ß-CD on remineralization. METHODS: Forty bovine enamel blocks were selected by microhardness and randomly assigned to four groups (n = 10 per group): control (distilled and deionized water), 1% ß-CD solution, 1% TiF4 solution, and TiF4: ß-CD solution. The blocks were subjected to a pH cycling regimen for 8 days. After that, samples were evaluated by cross-sectional microhardness (CSMH), scanning electron microscopy (SEM), and energy dispersive spectrometry (EDS). Data were assessed for normality and analyzed using ANOVA and Tukey's tests (α = 0.05). RESULTS: Regarding CSMH, TiF4: ß-CD was statistically superior to the control (P = 0.033), ß-CD (P = 0.022), and TiF4 (P = 0.006). SEM photomicrography revealed the titanium dioxide coating on slabs treated with TiF4 and TiF4: ß-CD. EDS assessment demonstrated the presence of titanium on the surface of slabs treated with TiF4 and TiF4: ß-CD. CONCLUSION: The solution containing the inclusion nanocomplex formed of TiF4 and ß-CD was able to reharden the enamel subsurface.