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Rosai–Dorfman disease is a rare benign histiocytic proliferative disease of unknown cause that, in exceptional cases, presents with lesions confined to the skin. Clinically variable types of lesions such as papules, nodules and plaques have been reported. We present a case of a 27-year-old woman with a 1-year history of erythematous papular and nodular lesions on the malar and right axillary regions, previously misdiagnosed as acne. She reported no fever, malaise or weight loss, while physical examination and laboratory workup were normal. Bacteriological and mycobacteriological cultures were negative. Histopathological findings showed dense infiltration of inflammatory cells involving the entire dermis, consisting of large macrophages with emperipolesis, S100 and CD68 positive, neutrophils, eosinophils, lymphocytes and plasma cells. The patient was treated with oral prednisolone without improvement. Dapsone was subsequently initiated with favourable clinical response. The present article aimed to emphasise the clinical and histological differential diagnosis and share the treatment experience.

Objectives To investigate the association between the management of mandibular arch perimeter during development of the dentition and its effects on second permanent molar (M2) eruption. Materials and Methods Seven electronic databases were searched without restrictions up to June 2020. Assessment was performed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for non-randomized clinical trials (non-RCT). Odds ratio (OR) with 95% confidence intervals was calculated from random-effects meta-analyses. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess the certainty of the evidence. Results Five non-RCTs, with serious to moderate risk of bias, were included. A low certainty of evidence indicated that individuals undergoing mandibular arch perimeter management by controlling the position of the first molar had a high prevalence of M2 eruption difficulties. The odds of eruption disorders was 7.5 times higher (OR: 7.57, [3.72, 15.41], P < .001) in treated individuals. Subgroup analysis revealed that appliances that increased the arch perimeter lead to a greater chance of eruption disorders compared to appliances that only maintained the perimeter. The predictive factors for the M2 eruption difficulty were its previous mesioangulation in relation to the first molar (>24°) and the treatment time (>2 years). Conclusions Mandibular arch perimeter management during development of the dentition leads to an increase in the occurrence of M2 eruption difficulties. The identification of possible risk factors as well as the choice of the appropriate appliance type and the monitoring of these individuals seems to be essential to avoid undesirable effects with this therapy.

Objective: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. Methods: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). Results: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). Conclusions: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS. RESUMO Objetivo: Avaliar a habilidade de ortodontistas e cirurgiões bucomaxilofaciais (CBMF) em propor um prognóstico para terceiros molares inferiores. Métodos: Foram analisados 22 pacientes tratados ortodonticamente sem extração, cujos terceiros molares inferiores irrompidos espontaneamente (n= 44) foram avaliados por meio de radiografias panorâmicas seriadas. A primeira radiografia foi obtida logo após o tratamento ortodôntico (RX1), entre 13 e 19 anos de idade. A segunda radiografia (RX2) foi avaliada dois anos depois, em média. As radiografias foram analisadas aleatoriamente por 54 especialistas, 27 ortodontistas e 27 CBMFs, para obter sua opinião sobre a abordagem a ser adotada na RX1. Em seguida, outra opinião foi coletada adicionando-se a segunda radiografia seriada (RX1+2). Resultados: A concordância das respostas foi moderada para os CBMFs (Kappa = 0,44; p< 0,0001) e significativa para os ortodontistas (Kappa = 0,39; p< 0,0001). Após analisar apenas a primeira radiografia (RX1) dos molares antes deles irromperem espontaneamente, os CBMFs indicaram extração em 44,5% dos casos; enquanto os ortodontistas, em 42%, sem diferença entre os grupos (p= 0,22). Na análise de RX1+2, os ortodontistas mantiveram o mesmo nível de indicação de extração (45,6%, p= 0,08), enquanto os cirurgiões passaram a indicar mais extrações (63,2%, p< 0,0001). Conclusões: Ortodontistas e CBMFs não foram capazes de predizer a erupção de terceiros molares por meio da análise de uma única radiografia panorâmica, indicando extrações em cerca da metade dos terceiros molares examinados. Uma análise de acompanhamento, incluindo mais uma radiografia, não melhorou a precisão do prognóstico entre os ortodontistas, e piorou entre os CBMFs.

To systematically review the effects of functional appliances (FA) using incremental vs maximal mandibular advancement regarding cephalometric measurements in class II malocclusion individuals and to assess patient-centred-outcomes. Six electronic databases were searched without restrictions up to April 2020. We included randomized and non-randomized controlled trials using identical FA. Trials involving participants who used adjunct appliances, inter-maxillary elastics, who received surgical treatment or that recruited individuals with cleft lip/palate or craniofacial deformity/syndrome were excluded. Risks of bias assessments were performed using the Cochrane risk of bias tool-2 and ROBINS-I tools. Mean differences (MD) with their 95% confidence intervals were calculated from random-effects meta-analyses. The GRADE tool was used to assess the certainty of the evidence. Six studies were included. Low to very low certainty of evidence indicated that incremental mandibular advancement resulted in greater gains in mandibular length (MD = 0.89 [0.38, 1.34], P = .0005), anterior mandibular displacement (MD = 0.73 [0.40, 1.06], P .0001) and SNB angle (MD = 0.44 [0.02, 0.85], P = .04). No significant differences were found for maxillary, dento-alveolar and upper airway outcomes between construction bite protocols (P .05). Study design and appliance-related factors influenced the results of the subgroup analyses. Existing evidence is inadequate to assess patient-related response and long-term outcome could not be assessed. Currently, there are a heterogeneous number of studies with low quality and methodological issues can lead to biases that strongly limit an evidence-based conclusion. Weak evidence suggests gains in mandibular skeletal parameters in the short term using FA with incremental mandibular advancement. Randomized trials evaluating key topics such as patient-centred outcomes need to be conducted to guide clinical management. PROSPERO (CRD42019147436).

Tobias, Joseph A., Sheard, Catherine, Pigot, Alex L., Devenish, Adam J. M., Yang, Jingyi, Sayol, Ferran, Neate‐Clegg, Montague H. C., Alioravainen, Nico, Weeks, Thomas L., Barber, Robert A., Walkden, Patrick A., MacGregor, Hannah E. A., Jones, Samuel E. I., Vincent, Claire, Phillips, Anna G., Marples, Nicola M., Montaño‐Centellas, Flavia A., Leandro‐Silva, Victor, Claramunt, Santiago, Darski, Bianca, Freeman, Benjamin G., Bregman, Tom P., Cooney, Christopher R., Hughes, Emma C., Capp, Elliot J. R., Varley, Zoë K., Friedman, Nicholas R., Korntheuer, Heiko, Corrales‐Vargas, Andrea, Trisos, Christopher H., Weeks, Brian C., Hanz, Dagmar M., Töpfer, Till, Bravo, Gustavo A., Remeš, Vladimír, Nowak, Larissa, Carneiro, Lincoln S., Moncada R., Amilkar J., Matysioková, Beata, Baldassarre, Daniel T., Martínez‐Salinas, Alejandra, Wolfe, Jared D., Chapman, Philip M., Daly, Benjamin G., Sorensen, Marjorie C., Neu, Alexander, Ford, Michael A., Mayhew, Rebekah J., Fabio Silveira, Luis, Kelly, David J., Annorbah, Nathaniel N. D., Pollock, Henry S., Grabowska‐Zhang, Ada M., McEntee, Jay P., Carlos T. Gonzalez, Juan, Meneses, Camila G., Muñoz, Marcia C., Powell, Luke L., Jamie, Gabriel A., Matthews, Thomas J., Johnson, Oscar, Brito, Guilherme R. R., Zyskowski, Kristof, Crates, Ross, Harvey, Michael G., Jurado Zevallos, Maura, Hosner, Peter A., Bradfer‐Lawrence, Tom, Maley, James M., Stiles, F. Gary, Lima, Hevana S., Provost, Kaiya L., Chibesa, Moses, Mashao, Mmatjie, Howard, Jeffrey T., Mlamba, Edson, Chua, Marcus A. H., Li, Bicheng, Gómez, M. Isabel, García, Natalia C., Päckert, Martin, Fuchs, Jérôme, Ali, Jarome R., Derryberry, Elizabeth P., Carlson, Monica L., Urriza, Rolly C., Brzeski, Kristin E., Prawiradilaga, Dewi M., Rayner, Matt J., Miller, Eliot T., Bowie, Rauri C. K., Lafontaine, René‐Marie, Scofield, R. Paul, Lou, Yingqiang, Somarathna, Lankani, Lepage, Denis, Illif, Marshall, Neuschulz, Eike Lena, Templin, Mathias, Dehling, D. Matthias, Cooper, Jacob C., Pauwels, Olivier S. G., Analuddin, Kangkuso, Fjeldså, Jon, Seddon, Nathalie, Sweet, Paul R., DeClerck, Fabrice A. J., Naka, Luciano N., Brawn, Jeffrey D., Aleixo, Alexandre, Böhning‐Gaese, Katrin, Rahbek, Carsten, Fritz, Susanne A., Thomas, Gavin H., Schleuning, Matthias (2022): AVONET: morphological, ecological and geographical data for all birds. Ecology Letters 25 (3): 581-597, DOI: 10.1111/ele.13898, URL: http://dx.doi.org/10.1111/ele.13898

Exacerbated inflammatory response and altered vascular function are hallmarks of dengue disease. Reactive oxygen species (ROS) production has been associated to endothelial barrier disturbance and microvascular alteration in distinct pathological conditions. Increased ROS has been reported in in vitro models of dengue virus (DENV) infection, but its impact for endothelial cell physiology had not been fully investigated. Our group had previously demonstrated that infection of human brain microvascular endothelial cells (HBMEC) with DENV results in the activation of RNA sensors and production of proinflammatory cytokines, which culminate in cell death and endothelial permeability. Here, we evaluated the role of mitochondrial function and NADPH oxidase (NOX) activation for ROS generation in HBMEC infected by DENV and investigated whether altered cellular physiology could be a consequence of virus-induced oxidative stress. DENV-infected HBMECs showed a decrease in the maximal respiratory capacity and altered membrane potential, indicating functional mitochondrial alteration, what might be related to mtROS production. Indeed, mtROS was detected at later time points after infection. Specific inhibition of mtROS diminished virus replication, cell death, and endothelial permeability, but did not affect cytokine production. On the other hand, inhibition of NOX-associated ROS production decreased virus replication and cell death, as well as the secretion of inflammatory cytokines, including IL-6, IL-8, and CCL5. These results demonstrated that DENV replication in endothelial cells induces ROS production by different pathways, which impacts biological functions that might be relevant for dengue pathogenesis. Those data also indicate oxidative stress events as relevant therapeutical targets to avoid vascular permeability, inflammation, and neuroinvasion during DENV infection.

To evaluate the perceived impact of dental pain on oral health-related quality of life (OHRQoL) among children aged 1–3 years and their families. A cross-sectional study was conducted with 306 randomly selected preschool and day care children in the city of Diamantina, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, the Brazilian version of the Early Childhood Oral Health Impact Scale, their child’s general/oral health and the Brazilian version of the Dental Discomfort Questionnaire. The children underwent an oral examination. Descriptive statistics, Spearman’s correlations, the Kruskal–Wallis test, Mann–Whitney test and Poisson regression were used to determine associations between the variables (prevalence ratio [PR], α = 5%). The prevalence of dental caries and dental pain was 43.1% and 40.2%, respectively. Dental pain (PR: 1.96, 95% CI 1.52–2.54; p

This study aimed to develop and validate the Malocclusion Impact Scale for Early Childhood (MIS-EC), a malocclusion-specific measure of oral health-related quality of life (OHRQoL) of children aged 3-5 years and their parents/caregivers. A pool of items was analysed to identify those relevant to the assessment of the impact of malocclusion on OHRQoL. Dental professionals and mothers of children with and without malocclusion rated the importance of these items. The final version of the MIS-EC was evaluated in a cross-sectional study comprising 381 parents of children aged 3–5 years to assess construct validity, internal consistency and test-retest reliability. Twenty-two items were identified from item pooling. After item reduction, eight items were chosen to constitute the MIS-EC, in addition to two general questions. The MIS-EC demonstrated good internal consistency (Cronbach’s alpha = 0.79 for the Child Impact section and 0.53 for the Family Impact section), and excellent test-retest reliability (ICC = 0.94), floor effect was 55.7% and ceiling effect 0%. MIS-EC scores indicating worse OHRQoL were significantly associated with the presence of malocclusion (p < 0.05). The MIS-EC is reliable and valid for assessing the impact of malocclusion on the OHRQoL of preschool children and their parents/caregivers.

N/a.

Background The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits. Materials and methods MEDLINE, SCOPUS, Web of Science, LILACS, and Google Scholar were searched without restrictions up to March 2020. Studies with twin method were considered and the risk of bias assessment was performed using quality of genetic association studies checklist (Q-Genie). The coefficient of heritability (h2), model-fitting approaches, and coefficient correlation were used to estimate the genetic/environmental influence on occlusal traits. The GRADE tool was used to assess the quality of the evidence. Results Ten studies met the eligibility criteria. Three studies presented good quality, five moderate quality, and two poor quality. Most studies have found that the intra-arch traits, mainly the maxillary arch morphology, such as width (h2 16–100%), length (h2 42–100%), and shape (h2 42–90%), and the crowding, mainly for mandibular arch (h2 35–81%), are under potential heritability influence. The traits concerning the inter-arch relationship, as overjet, overbite, posterior crossbite, and sagittal molar relation, seem not to be genetically determined. The certainty of the evidence was graded as low for all outcomes. Conclusions Although weak, the available evidence show that the heritability factors are determinant for the intra-arch traits, namely, arch morphology and crowding. Possibly due they are functionally related, the occlusal traits concerning the maxillary and mandibular relationship seem to have environmental factors as determinants. In this scenario, early preventive approaches can offer a more effective and efficient orthodontic treatment.

Papular epidermal nevus with "skyline" basal cell layer (PENS) is a keratinocytic nevus that can occur sporadically or has a familial transmission. There are 5 families reported with PENS, in which there are 2 family members affected with each case. We present the sixth familial case, with the peculiarity of being the first time in which there are 3 family members with PENS, while reviewing the other cases described until now. In addition, we present a new histopathological finding, an inflammatory lichenoid infiltrate on the upper dermis in PENS lesions. This finding could be the result of trauma to the biopsied lesion, or it may represent a new inflammatory histological variant.

Objectives To evaluate the clinical effectiveness of adjunctive interventions in individuals undergoing rapid maxillary expansion (RME). Materials and Methods MEDLINE, Web of Science, Cochrane, Scopus, LILACS, and Google Scholar were searched without restrictions up to June 2020. Trials involving participants undergoing orthopedic or surgical RME, along with adjunctive interventions, were included. Risk-of-bias assessments were performed using the Cochrane tool for randomized trials-2. The certainty level of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool. Results Six randomized clinical trials, with low to high risk of bias, were included. Low certainty of the evidence suggested that low-level laser facilitated opening of the midpalatal suture during the active phase of RME. Likewise, moderate certainty demonstrated that low-level laser accelerated the healing process of the suture during the retention phase. The clinical impact of this outcome, that is, stability and retention time, was not evaluated. Very low evidence indicated that osteoperforations along the midpalatal suture increased maxillary transverse skeletal gains in young adults undergoing RME. Low evidence suggested that platelet-rich plasma therapy did not minimize the vertical and thickness bone loss after RME in the short term. Conclusions Based on currently available information, the use of low-level laser associated with maxillary expansion seems to provide a more efficient suture opening and bone healing. Limited evidence suggests that osteoperforations improve the skeletal effects of RME in non-growing individuals. There are no adjunctive interventions capable of reducing the periodontal side effects of RME.

BACKGROUND/AIM Knowledge about the spatial density of the domiciles of dental trauma victims can assist in the identification of the most vulnerable areas and contribute to the planning of prevention, promotion, control, and treatment actions, focusing on the most affected areas. The aim of this study was to analyze the spatial density of domiciles of 14-year-old adolescent victims of dental trauma, in the city of Diamantina, Brazil, after a two-year follow-up period. MATERIAL AND METHODS This longitudinal study was carried out with 584 adolescents between 2013 and 2015. Dental trauma, overjet, and lip protection were assessed by two trained and calibrated examiners (K > 0.70). Information about binge drinking was collected among the adolescents through the Alcohol Use Disorders Identification Test and sociodemographic indicators were obtained through a questionnaire answered by the caregivers of the adolescents. Spatial analyses were performed to evaluate the spatial density of adolescents with dental trauma and the independent variables of interest according to the domicile using Ripley's K function and the Kernel Map. RESULTS Ripley's K function revealed spatial aggregation of the domiciles of adolescent victims of dental trauma in relation to males, binge drinking and overjet, with a confidence interval of 95%. The higher density of domiciles with adolescents with two or more traumatized teeth was found in the north-east region of the city. Boys were the most affected, their homes were located in the north, north-west, and south-east regions at baseline and follow-up. The largest density of domiciles of adolescents with overjet greater than 5 mm and inadequate lip protection was in the north-east region. Similar spatial distribution was identified for binge drinking for both years. CONCLUSION The majority of adolescents with dental trauma lived in the north-east and south-east regions, characterized by high population density and greater social vulnerability.

This study aimed to determine the incidence of mandibular third molar (M3) impaction after orthodontic treatment by edgewise appliances, and identify possible determinant factors of M3 impaction. A retrospective cohort study was conducted with 1154 patients. Complete orthodontic records were analyzed pretreatment and posttreatment, considering the following variables: type of Angle malocclusion, treatment with or without extraction of first premolars, overbite, stage of dentition, M3 prior angulation and duration of orthodontic treatment. Impaction was determined after radiographic evidence of total closure of the root apex. The chi-square test and Poisson regression (p < 0.05) were used for statistical analysis with a hierarchical approach. Rate ratios (RR) and 95% confidence intervals (CI) were calculated. Mandibular M3 impaction incidence was 17%. Overbite equal to or greater than 4 mm (RR = 1.23, 95%CI: 1.11–1.26, p < 0.001), prior mesial angulation of M3 (RR = 0.59, 95%CI: 0.52–0.68, p < 0.001), non-extraction of first premolars (RR=1.06, 95%CI: 1.01–1.12, P=0.019) and orthodontic treatment time equal to or less than three years (RR = 0.94. 95%CI: 0.90–0.99, p < 0.014) were significantly associated with impacted M3. There was no correlation between the type of Angle malocclusion and the risk of impaction. In conclusion, the incidence of mandibular M3 impaction was considered low. The main pretreatment factors directly involved in impaction were mesioangulation of M3 and overbite equal to or greater than 4 mm. Orthodontic treatment with extraction of first premolars and treatment time greater than 3 years reduce the risk of impaction.

Background/aims Occlusal features may increase the risk of dental trauma. The aim of the present study was to evaluate the association between occlusal characteristics and the occurrence of dental trauma in preschool children. Materials and methods A population-based case-control study was conducted with a representative sample of 200 children 3-5 years of age enrolled at private and public preschools in the city of Diamantina, Brazil. The case and control groups were matched for gender, age and type of preschool (public or private) at a ratio of 1:1 (100 cases and 100 controls). Independent variables of interest to the study (occlusal characteristics) and potential confounders (sociodemographic characteristics, sucking habits and lip coverage) were investigated. Intra-examiner and inter-examiner kappa values were higher than 0.80 for all oral conditions evaluated. The SPSS 22.0 program was used to analyse the data. Descriptive and univariate analyses as well as simple and multiple logistic regression analyses were performed. Results The occlusal feature most strongly associated with trauma was anterior open bite (OR = 3.80; 95% CI: 1.42-10.16). Maxillary anterior crowding (OR = 2.14, 95% CI: 1.00-4.63) and overjet (OR = 1.12, 95% CI: 0.58-2.17) were associated with the occurrence of trauma independently of the confounding variables (sociodemographic characteristics, sucking habits and lip coverage), but these variables lost their significance when adjusted for other types of malocclusion. Anterior open bite remained strongly associated with dental trauma, regardless of confounding variables and other types of malocclusion. Conclusion Anterior open bite was the main variable associated with dental trauma in the preschool children analysed independently of the confounding variables and the presence of other malocclusions.

The genus Gracilaria synthesizes sulfated polysaccharides (SPs). Many of these SPs, including those synthesized by the edible seaweed Gracilaria birdiae, have not yet been adequately investigated for their use as potential pharmaceutical compounds. Previous studies have demonstrated the immunomodulatory effects of sulfated galactans from G. birdiae. In this study, a galactan (GB) was extracted from G. birdiae and evaluated by cell proliferation and antioxidant tests. GB showed no radical hydroxyl (OH) and superoxide (O2&minus, ) scavenging ability. However, GB was able to donate electrons in two further different assays and presented iron- and copper-chelating activity. Urolithiasis affects approximately 10% of the world&rsquo, s population and is strongly associated with calcium oxalate (CaOx) crystals. No efficient compound is currently available for the treatment of this disease. GB appeared to interact with and stabilize calcium oxalate dihydrate crystals, leading to the modification of their morphology, size, and surface charge. These crystals then acquired the same characteristics as those found in healthy individuals. In addition, GB showed no cytotoxic effect against human kidney cells (HEK-293). Taken together, our current findings highlight the potential application of GB as an antiurolithic agent.

Sleep bruxism (SB) in children has been associated with several sleep characteristics, which may alter their sleep pattern. This change affects the internal biological clock and consequently the chronotype profile. The aim of this study was to evaluate the existence of an association between possible SB in children with specific chronotype profiles and sleep characteristics. The study included 207 parents/guardians of children aged between 3 and 12 years who were waiting for their children's dental treatment at the Pediatric Dentistry Clinic of the Federal University of Rio de Janeiro, Brazil. A questionnaire on the socio-demographic characteristics of parents and children as well as on the features of the children's sleep was applied. In addition, the CIRENS scale (Circadian Energy Scale) was completed by the parents to identify the children's chronotype. A chi-squared test was used to determine the association between possible SB, the chronotype, and sleep characteristics. A multiple logistic regression model was implemented to observe the influence of chronotype, age, and other independent variables on the possible SB. The logistic regression model demonstrated that nocturnal agitation (p = 0.009; OR = 3.42) and nightmares (p = 0.045; OR = 3.24) were associated with possible SB in children. Although no significant association (p = 0 .089) between the chronotype profile and possible SB was observed in the 3 to 5 years age group, a proportional difference was observed between the chronotype categories in this age group-12.5% of children with SB had a morning type, while 26.4% had an intermediate type and 47.8% an evening type compared to those without possible SB. Nocturnal agitation and nightmares were associated with possible SB. In addition, young children with an evening chronotype had a tendency toward possible SB.

Objective: To assess the impact of two early treatment protocols for anterior dental crossbite on children’s quality of life. Methods: Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children’s quality of life. Children answered the questionnaire before treatment (T1) and twelve months after orthodontic treatment onset (T2). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed. Results: Children’s mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ8-10 were significantly higher in T1 as compared to T2 (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T2 between groups, after controlling for quality of life measures at T1. Conclusions: The difference regarding the impact on quality of life between groups is not related to the protocol used. RESUMO Objetivo: avaliar o impacto de dois protocolos de tratamento precoce para a mordida cruzada anterior dentária na qualidade de vida de crianças. Métodos: trinta crianças de 8 a 10 anos de idade com mordida cruzada anterior dentária participaram desse estudo. Os indivíduos foram divididos em dois grupos: Grupo 1 - 15 crianças em tratamento com aparelho removível superior com molas digitais; Grupo 2 - 15 crianças em tratamento com batentes de cimento de ionômero de vidro resinoso nos primeiros molares permanentes inferiores. A qualidade de vida foi avaliada por meio da versão brasileira do Child Perceptions Questionnaire (CPQ8-10), o qual contém quatro subescalas: sintomas bucais (SB), limitações funcionais (LF), bem-estar emocional (BE) e bem-estar social (BS). Um escore mais alto indica um impacto mais negativo na qualidade de vida. As crianças responderam ao questionário antes do tratamento (T1) e 12 meses após o início do tratamento ortodôntico (T2). Estatística descritiva, o teste Wilcoxon e análise de covariância (ANCOVA) foram realizados. Resultados: a média de idade das crianças foi de 9,07 ± 0,79 anos no Grupo 1 e de 9,00 ± 0,84 no Grupo 2. Para o Grupo 1, os escores das subescalas LF e BE e o escore total do CPQ8-10 foram significativamente maiores em T1 do que em T2 (p= 0,004, p= 0,012 e p= 0,015, respectivamente). Para o Grupo 2, não houve diferença estatisticamente significativa. A ANCOVA não mostrou diferença significativa entre os grupos em relação à qualidade de vida em T2, após o controle para as medidas de qualidade de vida em T1. Conclusões: a diferença em relação ao impacto na qualidade de vida entre os grupos não foi relacionada ao protocolo de tratamento utilizado.

Objective: To evaluate and compare two treatment protocols to correct anterior dental crossbite in the mixed dentition. Materials and Methods: Thirty children, 8–10 years of age, participated. Individuals were divided into two groups. Group 1 consisted of 15 children treated with an upper removable appliance with finger springs; group 2, 15 children treated by bonding resin-reinforced glass ionomer cement bite pads on the lower first molars. The 30 participants were evaluated before treatment (T1) and 12 months after treatment began (T2). The variables evaluated included overjet, perimeter of the maxillary arch, intercanine distances in the maxilla and mandible, SNA, SNB, ANB, and U1.NA. Data analysis included descriptive statistics, paired t-test and Student's t-test. Effect sizes and confidence intervals were also calculated. Results: Group 1 showed a significant increase in overjet (P < .001), intercanine distance in the maxilla (P = .006), intercanine distance in the mandible (P = .031), and U1.NA (P = .002). Group 2 showed a significant increase in overjet (P = .008), intercanine distance in the mandible (P = .005), and U1.NA (P < .001). For all the evaluated variables, no statistically significant differences were observed between the two groups. Conclusions: No significant differences were observed between the two protocols: use of a removable maxillary biteplate with finger springs and bonding of resin-reinforced glass ionomer cement bite pads on the lower first molars, for the correction of anterior crossbite in the mixed dentition.

Objective To evaluate whether the carbohydrate-restricted diet leads to higher levels of food cravings in individuals with binge eating. Methods A total of 146 individuals with binge eating participated in the Low-Carb Diet Group (n=48) and Control Group (n=98). The Binge Eating Scale, Hay’s questionnaire, Food Cravings Questionnaire - Trait and State, Cognitive restraint subscale and its adapted version for the cognitive restraint toward carbohydrates, were used as measures. Parametric tests were used for comparison between groups (Student’s t test), and Pearson’s correlation test to verify correlations between variables of interest. Results No differences were found between groups with and without diet concerning the level of binge eating or food craving total score. The differences found were the higher levels of cognitive restraint (p=0.01), cognitive restraint for carbohydrates (p=0.01) and subscales of ‘guilt about food craving’ (p=0.04) in the Low-Carb Diet Group. Conclusion Individuals with binge eating and a history of low-carb diet have greater cognitive restraint toward carbohydrates and association with altered eating attitudes (guilt about food craving). RESUMO Objetivo Avaliar se a dieta com restrição de carboidratos acarreta níveis elevados de desejos intenso por comida em indivíduos com compulsão alimentar. Métodos Participaram 146 indivíduos com compulsão alimentar divididos nos Grupos Dieta Low Carb (n=48) e Grupo Controle (n=98). Foram utilizados como medidas: Escala de Compulsão Alimentar Periódica, Questionário de Hay, Questionário de Desejos Intensos por Comida – Traço e Estado, Subescala de restrição cognitiva e sua versão adaptada para a restrição cognitiva direcionada aos carboidratos. Foram utilizados testes paramétricos para comparação entre grupos (teste t de Student) e o teste de correlação de Pearson para verificar correlações entre variáveis de interesse. Resultados Não foram encontradas diferenças entre grupos com e sem prática de dieta em relação ao nível de compulsão alimentar ou ao escore total para desejos intensos por comida. As diferenças encontradas foram os maiores níveis de restrição cognitiva (p=0,01), restrição cognitiva para carboidratos (p=0,01) e subescalas de ‘culpa por causa dos desejos’ (p=0,04) no Grupo Dieta Low Carb. Conclusão Indivíduos com compulsão alimentar e histórico de dieta com restrição de carboidratos (low carb) possuem maior restrição cognitiva direcionada aos carboidratos e associação com atitudes alimentares alteradas (culpa pelos desejos).

Dental features have been considered a potential target of verbal bullying (VB) among school-aged children. The authors conducted a study to investigate the association between the presence of oral disorders and the occurrence of VB among 8- through 10-year-old school-aged children.The study included 445 school-aged children 8 through 10 years old. VB was verified by a specific validated question from the Child Perceptions Questionnaire 8-10 index. Oral disorders such as untreated caries, fluorosis, clinical consequences of untreated caries, and malocclusion were evaluated. The Pearson χA total of 390 school-aged children completed the study. The results of the multivariate logistic regression model showed that a severe malocclusion (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.03 to 5.10), a greater maxillary misalignment (OR, 2.23; 95% CI, 1.05 to 4.73), and the presence of a tooth with pulp exposure (OR, 2.93; 95% CI, 1.58 to 5.45) were significantly associated with the occurrence of VB.Children aged 8 through 10 years with a severe malocclusion, larger maxillary misalignment, or the presence of pulp exposure had increased odds of experiencing VB compared with children without those oral health conditions.Once oral disorders involved in VB are identified, appropriate approaches should be used to address this issue. With this course of action, oral health care professionals may use the treatment and preventive care to eliminate potential factors for peer aggression.

The morphology and composition of roots with different degrees of oxidation as a function of time were evaluated aiming to identify possible hazardous elements and nanoparticles. The roots were obtained from an abandoned coal mine located in the city of Criciúma, Santa Catarina, Brazil. From the roots, analyses were performed to identify nanoparticles (NPs) and ultrafine particles (UFPs), containing possible hazardous elements (PHEs) that cause potential environmental risks and impacts on human health. The identification of nanoscale materials requires greater robustness, so advanced integrated techniques have been used. The characterization of different types of roots was done by using focused ion beam (FIB), to evaluate nano-compound assemblies with high-resolution transmission electron microscopy/energy dispersive spectroscopy (HR-TEM/EDS). The results showed the presence of NPs containing Hg, Co, Cr, Ni, and V. The presence of these elements has increased consistently with the increase of C concentration in the roots, suggesting that the PHEs were gradually released from organic matter and inorganic minerals of coal. However, even with their decrease in roots, it was found that these elements still remained in the soil in significant quantities, even after 15 years of inactivation of the coal mine.

Some antioxidant compounds decrease the amount of intracellular reactive oxygen species (ROS) and consequently reduce the deleterious effects of ROS in osteoblasts. Thus, these compounds fight against osteoporosis. Brown seaweeds are a rich source of antioxidant fucose-containing sulfated polysaccharides (fucans and fucoidans). We obtained six fucoidans (FRFs)&mdash, F0.3, F0.5, F0.7, F1.0, F1.5, and F2.1&mdash, from Dictyota mertensii by proteolytic digestion followed by sequential acetone precipitation. Except for F0.3, all FRFs showed antioxidant activity in different in vitro tests. In pre- osteoblast-like cells (MC3T3-L1) exposed to H2O2-oxidative stress, caspase-3 and caspase-9 were activated, resulting in apoptosis of the cells. We also observed a decrease in superoxide dismutase (SOD) and alkaline phosphatase (ALP) activity. The antioxidant FRFs protected the cells from the oxidative damage caused by H2O2, decreasing intracellular ROS and caspase activation, and increasing SOD activity. The most effective protection against damage was provided by F0.7, F1.5, and F2.1. At 0.5 mg/mL, these FRFs also suppressed the H2O2-mediated inhibition of ALP activity. The data indicated that FRFs F0.7, F1.5, and F2.1 from D. mertensii were antioxidants that protected bone tissue from oxidative stress and could represent possible adjuvants for the treatment of bone fragility through counteracting oxidative phenomena.

Linking protein misfolding and innate immunity Multiple innate immune sensors undergo rapid assembly into large complexes known as signalosomes. This is an essential step during cellular responses to microbes and danger signals. How this process is regulated to avoid accumulation of potentially toxic protein aggregates remains poorly understood. Abdel-Nour et al. identified a pathway, dependent on heme-regulated inhibitor, eukaryotic initiation factor 2α, activating transcription factor 4, and heat shock protein B8, which controls the folding and scaffolding of innate immune sensors, allowing optimal proinflammatory signaling (see the Perspective by Pierre). The pathway appears to mirror the endoplasmic reticulum unfolded protein response (UPR), and so was named the cytosolic UPR (cUPR). The cUPR may represent a general mechanism to control protein misfolding in cells. Science , this issue p. eaaw4144 ; see also p. 28

Introduction The aim of this systematic review was to identify, evaluate, and provide a synthesis of the available literature on the effects of lip bumper (LB) therapy on the mandibular dental arch of children and adolescents. Methods MEDLINE, Scopus, Web of Science, Cochrane Library, and Lilacs were systematically searched without restrictions up to May 2019. Risk-of-bias assessment was performed using Cochrane's tool for randomized controlled trials (RCTs) and the Risk of Bias in Nonrandomized Studies of Interventions tool for non-RCTs. The Grading of Recommendations, Assessment, Development and Evaluation tool was used to assess the quality of the evidence. Results After examination of the full texts, 6 studies were included. One RCT presented unclear risk of bias, and 5 non-RCTs presented serious to moderate risk of bias. LB therapy resulted in a buccal inclination of the incisors, distalization of the permanent first molars, and distal inclination of the permanent first molars, which increased perimeter and arch length. An increase in the arch width with greater gain in the interpremolar and/or deciduous molar distance and less gain in intercanine and intermolar distances was also reported. LB therapy increased the risk of second molar impaction with inclination >30° and the risk of ectopic eruption when treatment time was >2 years. The level of the evidence was graded as very low for variable arch length and second molar eruption disturbances. All other outcomes were graded as having low level of evidence. Conclusions Owing to the low level of certainty identified, the conclusions should be considered cautiously. Increase in arch perimeter and width was attributed to the proclination of the incisors, buccalization of the deciduous molar and premolar areas, and distal inclination of the molars. However, there was an increased chance of impaction and ectopic eruption of permanent second molar after treatment with LB.

Early detection of viruses by the innate immune system is crucial for host defense. The NLRP3 inflammasome, through activation of caspase-1, promotes the maturation of IL-1β and IL-18, which are critical for antiviral immunity and inflammatory response. However, the mechanism by which viruses activate this inflammasome is still debated. Here, we report that the replication of cytopathogenic RNA viruses such as vesicular stomatitis virus (VSV) or encephalomyocarditis virus (EMCV) induced a lytic cell death leading to potassium efflux, the common trigger of NLRP3 inflammasome activation. This lytic cell death was not prevented by a chemical or genetic inhibition of apoptosis, pyroptosis, or necroptosis but required the viral replication. Hence, the viruses that stimulated type I IFNs production after their sensing did not activate NLRP3 inflammasome due to an inhibition of their replication. In contrast, NLRP3 inflammasome activation induced by RNA virus infection was stimulated in IFNAR-deficient or MAVS-deficient cells consequently to an increased viral replication and ensuing lytic cell death. Therefore, in a context of inefficient IFN response, viral replication-induced lytic cell death activates of the NLRP3 inflammasome to fight against infection.

Urolithiasis affects approximately 10% of the world population and is strongly associated with calcium oxalate (CaOx) crystals. Currently, there is no efficient compound that can be used to prevent this disease. However, seaweeds’ sulfated polysaccharides (SPs) can change the CaOx crystals surface’s charge and thus modify the crystallization dynamics, due to the interaction of the negative charges of these polymers with the crystal surface during their synthesis. We observed that the SPs of Caulerpa cupressoides modified the morphology, size and surface charge of CaOx crystals. Thus, these crystals became similar to those found in healthy persons. In the presence of SPs, dihydrate CaOx crystals showed rounded or dumbbell morphology. Infrared analysis, fluorescence microscopy, flow cytometry (FITC-conjugated SPs) and atomic composition analysis (EDS) allowed us to propose the mode of action between the Caulerpa’s SPs and the CaOx crystals. This study is the first step in understanding the interactions between SPs, which are promising molecules for the treatment of urolithiasis, and CaOx crystals, which are the main cause of kidney stones.

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The aim of this study was to evaluate the association between respiratory disorders and sleep bruxism, with an evaluation of demographic/socioeconomic factors and childhood stress as confounding variables. A cross-sectional study was performed in the city of Diamantina, Brazil, with 448 randomly selected schoolchildren aged 8 to 11 years. The schoolchildren underwent an oral examination for the evaluation of bruxism. Parents/caregivers answered a questionnaire for the assessment of sleep bruxism; socioeconomic-demographic factors; and respiratory disorders, such as rhinitis, sinusitis, and bronchitis. The schoolchildren filled out the Children’s Stress Scale. Poisson regression models were constructed separately for each respiratory disorder to determine prevalence ratios (PRs) and 95% confidence intervals (CIs). Sleep bruxism was more prevalent among children with rhinitis (PR = 1.45; 95%CI 1.08–1.93; p = 0.012) and sinusitis (PR = 1.58; 95%CI 1.06–2.36; p = 0.023). No significant association was found between sleep bruxism and bronchitis. A greater frequency of sleep bruxism was found among children whose mothers had a higher level of schooling and those who reported stress in the resistance/exhaustion phase. Rhinitis and sinusitis were associated with sleep bruxism. Moreover, sleep bruxism was more prevalent among children whose mothers had a higher level of schooling and those with higher degrees of stress.

Introduction Allergic and inflammatory reactions have commonly been associated with the release of metal ions during orthodontic treatment. Our objective was to evaluate prospectively gingival and blood status in patients allergic to nickel. Methods Allergy to nickel was diagnosed using a patch test. Two groups were established: conventional braces (n = 21) and nickel-free braces (n = 21). The gingival index was used to determine gingival status before treatment, periodically for 12 months (evaluations every 3 months), and 1 month after the removal of the braces. Blood status was evaluated with a complete blood count, including the quantification of nickel and immunoglobin E before treatment, during treatment, and 1 month after removal of the braces. The data were analyzed using Mann-Whitney, Student t, Wilcoxon, repeated measures analysis of variance, Friedman, and chi-square tests. Either the Pearson or the Spearman correlation coefficients were calculated, when appropriate. Results The number of basophils increased significantly among the evaluations in both groups (conventional, P = 0.002; nickel-free, P = 0.001), whereas the number of eosinophils and the immunoglobin E levels decreased significantly in the conventional group (P = 0.004). Plasma nickel levels were increased before and during treatment, and decreased 1 month after removing the braces in both groups, but the differences were significant only in the nickel-free group (P = 0.002). No correlations were found between the concentrations of nickel and immunoglobin E, basophils, or eosinophils, or between the gingival index and either bands or segmented neutrophils (P ≥ 0.05). Conclusions Patients treated with nickel-free braces had better gingival health and smaller blood changes than did those treated with conventional braces. All abnormalities tended to be eliminated after the removal of the braces.

Cancer cells demand high ATP provisions to support proliferation, and targeting of energy metabolism is a good strategy to increase their sensitivity to treatments. In Brazil, wine manufacture is expanding, increasing the amount of pomace that is produced. We determined the phenolic composition and antioxidant properties of a dark skin Grape Pomace Extract and its effects on metabolism and redox state in human hepatocarcinoma HepG2 cells. The material and the methods used represented the industrial process since pomace derived from white wine production and the extract concentrated by pilot plant scale reverse osmosis. Grape pomace extract was rich in polyphenols, mainly anthocyanins, and presented high antioxidant capacity. Short-term metabolic effects, irrespective of any cytotoxicity, involved increased mitochondrial respiration and antioxidant capacity and decreased glycolytic metabolism. Long-term incubation was cytotoxic and cells died by necrosis and GPE was not toxic to non-cancer human fibroblasts. To the best of our knowledge, this is the first report to characterize pomace extract from white wine production from Brazilian winemaking regarding its effects on energy metabolism, suggesting its potential use for pharmaceutical and nutraceutical purposes.

Immune reconstitution inflammatory syndrome (IRIS) represents paradoxical immune-mediated inflammation in response to an infecting pathogen, occurring after initiation of antiretroviral therapy (ART), concomitantly with immune system recovery. It has also been described in Kaposi's sarcoma (KS). We report a case of a 9-year-old Guinean girl, who developed Kaposi's sarcoma, following introduction of ART. KS associated with immune reconstitution inflammatory syndrome is rare, especially in children, but with the increased use of ART is becoming more prevalent.

Objective: To evaluate the psychosocial impact of the first 6 months of orthodontic treatment with a fixed appliance among young adults and compare the results with those of a control group of patients awaiting treatment for malocclusion. Materials and Methods: A study was conducted with a sample of 120 patients on a waiting list for orthodontic treatment at a university. The participants were allocated to an experimental group submitted to treatment and a control group awaiting treatment. The groups were matched for sex and age. All participants were instructed to answer the Brazilian version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) at baseline and after 6 months. Statistical analysis involved the Wilcoxon test for the total PIDAQ score and the score of each subscale. All patients participated until the end of the study. Results: Significant differences between baseline and the 6-month evaluation were found for the total PIDAQ score as well as the dental self-confidence and social impact subscales in both groups. No differences between baseline and the 6-month evaluation were found regarding the psychological impact or esthetic concern subscales in the control group. The patients in the experimental group reported greater esthetic impact 6 months after beginning treatment (P < .001). The first 6 months of orthodontic treatment seem to improve psychosocial impact. Conclusion: The first 6 months of orthodontic treatment seem to improve the psychosocial impact of malocclusion. The patients analyzed in the present study reported a greater esthetic impact and less psychological impact after 6 months of using an orthodontic appliance.

Background Oral diseases can negatively influence the quality of life causing harm in the development of routine activities, child development and their well-being. Aim To investigate the impact of dental caries, malocclusion and developmental defects of enamel (DDE) on the oral health-related quality of life of preschool children and their parents. Design A cross-sectional study was carried out with 646 children aged 2–6 years in Diamantina, Brazil. Calibrated dental examiners performed the oral examinations. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire on socio-economic indicators. Statistical analyses involved the chi-square test and Poisson regression. Results Malocclusion and DDE did not cause a negative impact on the children's quality of life. Children with dental caries (PR: 1.92; 95%CI: 1.56–2.35) and those aged 5 (PR: 1.51; 95%CI: 1.13–2.02) and 6 years (PR: 1.51; 95%CI: 1.02–2.23) were more likely to have a negative quality of life impact on the total B-ECOHIS. Conclusions Dental caries was associated with a negative impact on the quality of life of children. Malocclusion and DDE did not cause a negative impact on the children's quality of life. Older children had higher frequency of negative impact on OHRQoL.

Carcinoma of the uterine cervix is the second most common female tumor worldwide, surpassed only by breast cancer. Natural products from seaweeds evidencing apoptotic activity have attracted a great deal of attention as new leads for alternative and complementary preventive or therapeutic anticancer agents. Here, methanol extracts from 13 species of tropical seaweeds (Rhodophytas, Phaeophyta and Chlorophyta) collected from the Northeast of Brazil were assessed as apoptosis-inducing agents on human cervical adenocarcinoma (HeLa). All extracts showed different levels of cytotoxicity against HeLa cells, the most potent were obtained from the brown alga Dictyota cilliolata (MEDC) and Dictyota menstrualis (MEDM). In addition, MEDC and MEDM also inhibits SiHa (cervix carcinoma) cell proliferation. Studies with these two extracts using flow cytometry and fluorescence microscopy showed that HeLa cells exposed to MEDM and MEDC exhibit morphological and biochemical changes that characterize apoptosis as shown by loss of cell viability, chromatin condensation, phosphatidylserine externalization, and sub-G1 cell cycle phase accumulation, also MEDC induces cell cycle arrest in cell cycle phase S. Moreover, the activation of caspases 3 and 9 by these extracts suggests a mitochondria-dependent apoptosis route. However, other routes cannot be ruled out. Together, these results point out the methanol extracts of the brown algae D. mentrualis and D. cilliolata as potential sources of molecules with antitumor activity.

The aim of this study was to evaluate the association between different types of malocclusion and the impact on quality of life among preschoolers and their families. A cross-sectional study was carried out involving 451 children 3-5 years of age. A clinical exam was performed to evaluate the malocclusions according to criteria proposed by Foster and Hamilton. This examination was conducted by a calibrated dentist. Parents/caregivers answered the Early Childhood Oral Health Impact Scale (ECOHIS) for the assessment of Oral Health-Related Quality of Life (OHRQoL) and the questionnaire on socioeconomic and demographic characteristics. Data analysis involved descriptive statistics, chi-square, Mann-Whitney and hierarchically adjusted Poisson regression. The prevalence of malocclusion was 28.4%. The most frequent conditions were posterior crossbite (20.4%), anterior open bite (9.5%) and increased overjet (8.4%). A significant association was found between anterior open bite and OHRQoL (p < 0.001). The adjusted analysis confirmed the association between anterior open bite and a negative impact on quality of life (PR = 2.55; 95%CI: 1.87 to 3.47; p < 0.001). Anterior open bite was associated with a negative impact on the quality of life of preschoolers.

Background: Non-nutritive sucking habits can result in negative consequences on the development of orofacial structures and occlusion. Aim: Assess factors associated with non-nutritive sucking habits in children after 3 years old. Materials and Methods: A case-control study was carried out in two stages. In the first stage, a cross-sectional study was conducted with 638 children aged 3-6 years. In the second stage, a case-control study (1:2) was conducted. The case group included all children who presented some non-nutritive sucking habits in the first stage of the study (n = 110). The control group (n = 220) was made up of children who had never presented non-nutritive sucking habits, matched to the case group for gender and age. The data were collected during the national poliomyelitis vaccination campaign, through a questionnaire applied to parents/guardians with questions related to the presence of sucking habits, sociodemographic aspects, birth aspects, and early life of the child. Statistical analysis involved descriptive analysis, chi-square test, Mann-Whitney test, and conditional logistic regression. Results: Reduction in maternal education was a protective factor for the development of non-nutritive sucking habits (education ≤8 years OR = 0.38, CI 95%: 0.16, 0.89, P = 0.025). Prematurity (OR = 3.30, CI 95%: 1.13, 9.69, P = 0.030) and a longer period using a baby bottle (OR = 1.03, CI 95%: 1.01, 1.05, P = 0.006) remained associated with a greater possibility of the occurrence of sucking habits, regardless of monthly family income. Conclusion: Non-nutritive sucking habits were associated with maternal education, premature birth, and greater time of bottle feeding in children after 3 years old.

The aims of the present study were to compare aspects related to malocclusion between individuals with Down syndrome (DS) and a control group, establish malocclusion severity, and identify determinant factors. A total of 120 individuals (60 with DS and 60 with no physical or mental impairment), were included in the study. Data were collected through interviews, analyses of the medical charts, and oral examinations. The criteria of the Dental Aesthetic Index were used for the diagnosis of malocclusion. Chi-square test (p ≤ 0.05) and multivariate logistic regression were used for comparisons between the two groups and to determine the association between the dependent (malocclusion severity) and independent variables. Statistically significant differences were found between the two groups for the following variables: missing teeth, diastema, overjet, mandibular protrusion, anterior open bite, posterior crossbite, facial type, lip incompetence, and Angle classification. DS, a history of premature birth, and long face pattern were found to be associated with malocclusion severity. Individuals with DS exhibited more occlusal problems than those in the control group.

The purpose of this study was to evaluate associations between traumatic dental injury (TDI) and maternal stress and demographic, behavioral, and clinical characteristics of schoolchildren.A cross-sectional investigation was conducted involving 396 eight- to 11- year-old schoolchildren in the city of Diamantina, Minas Gerais, Brazil. Maternal stress and demographic and behavioral (breastfeeding and non-nutritive sucking habits) factors were evaluated using a questionnaire. Overjet and TDI were recorded by a dentist who underwent training and a calibration exercise. Hierarchically-adjusted Poisson regression models were employed to determine factors associated with TDI.In the final regression model, the prevalence of TDI was 75 percent higher among schoolchildren who were breastfed for less than six months (prevalence ratio [PR]=1.75; 95% confidence interval [CI]=1.16 to 2.66), 72 percent higher among those who engaged in finger-/thumb-sucking after three years of age (PR=1.72; 95% CI=1.16 to 2.56) and 91 percent among those with overjet greater than three mm (PR=1.91; 95% CI=1.29 to 2.84).Breastfeeding duration, finger-/thumb-sucking and increased overjet were associated with TDI. These factors were aggravated by maternal stress, but it lost its significance in the multivariate analysis.

The aim of this study was to evaluate the correlation between the Child Perceptions Questionnaire 8 to 10 (CPQ8-10) and child-Oral Impact on Daily Performances (child-OIDP) indexes according to their total and item scores, as well as assess the discriminative validity of these assessment tools regarding dental caries and malocclusion among schoolchildren. A sample of 300 children aged between 8 and 10 years answered the questionnaires in two distinct steps. First, half of the sample (G1 = 150) answered the CPQ8-10 and the other half (G2 = 150) answered the child-OIDP. A week after, G1 answered the child-OIDP and G2 answered the CPQ8-10. Dental Aesthetic Index and WHO criteria were used to categorize malocclusion and dental caries, respectively. Descriptive analysis, Spearman's correlation and Mann-Whitney test were performed in this study. The CPQ8-10 and child-OIDP demonstrated a statistically significant and moderate correlation between their total scores. Regarding the discriminative validity, CPQ8-10 demonstrated a significant association between the “emotional status” daily activity and dental caries, and between the “eating”, “sleeping”, and “studying” daily activities and malocclusion. Concerning the child-OIDP, a significant difference was found only between the “social contact” activity and presence of dental caries. Both instruments were not capable of distinguishing children with and without dental caries and/or malocclusion by their total scores. However, the instruments were able to discriminate between children with and without those oral disorders in different dimensions. Thus, the CPQ8-10 and the child-OIDP demonstrated a different capacity to assess the impact on OHRQoL among schoolchildren.

To evaluate the scientific evidence regarding the association between malocclusion and dental caries in adolescents. Searches were conducted of six electronic databases, complemented by manual searching of the reference lists of the selected articles and grey literature. Two independent reviewers performed the selection of the articles, data extraction and the evaluation of the risks of bias through an assessment of methodological quality. Meta-analysis was performed considering the mean decayed, missing and filled teeth (DMFT) index for caries and the Dental Aesthetic Index (DAI) for malocclusion. Heterogeneity was tested using the I2 statistic and a random effect model was employed. Summary effect measures were calculated as differences in means. The initial search retrieved 2644 studies, only 15 of which were selected for full-text analysis. Four cross-sectional studies were included in the qualitative systematic review. Only one of these studies found no association between malocclusion and dental caries. The meta-analysis of three studies demonstrated that a lower DAI value was significantly associated with a lower mean DMFT index, except for the comparison of DAI 26–30 vs. 31–35. Based on the studies analysed, the scientific evidence indicates an association between malocclusion and dental caries.

Physical abuse of children is defined as any non-accidental injury or omission of their caregivers that causes risk to the child's integrity. This study aimed to evaluate whether health professionals perceive and report physical abuse in children/adolescents. A total of 62 health professionals (dentists, physicians and nurses) from Diamantina/MG who attend to children and adolescents answered a questionnaire. The collected variables were related to the identification of abuse; denunciation to the authorities and difficulties in making the complaint. Frequency analysis, chi-square test and content analysis were performed. All professionals had identified and reported the occurrence of physical abuse in children/adolescents. Significant association was observed between the specialty of the professional and the recognition of abuse as well as denunciation to the authorities. The main difficulties presented to denounce the cases to the authorities were lack of knowledge in identifying the abuse and how to make the complaint. Most participants expressed that they would like to receive training in identifying and reporting abuse. Health professionals perceive child abuse, and physicians are the ones who most report the cases.O abuso físico de crianças é definido como qualquer ferida não acidental ou omissão dos seus responsáveis que cause risco à sua integridade. Este estudo objetivou avaliar se profissionais de saúde percebem e denunciam o abuso físico em crianças/adolescentes. Um total de 62 profissionais de saúde (odontólogos, médicos e enfermeiros) de Diamantina/MG, que realizam atendimento a crianças e adolescentes, responderam a um questionário. As variáveis coletadas foram relacionadas à identificação de abuso; denúncia às autoridades e dificuldades para a realização da denúncia. Realizou-se análise de frequência, teste do qui-quadrado e análise de conteúdo. Todos os profissionais relataram ter identificado e denunciado a ocorrência de abuso físico em crianças/adolescentes. Associação significativa foi observada entre a especialidade do profissional e o reconhecimento de abuso, bem como a realização de denúncia às autoridades. As principais dificuldades apresentadas para denunciar os casos às autoridades foram: falta de conhecimento na identificação do abuso e em como realizar a denúncia. A maioria dos participantes gostaria de receber treinamento para identificação e denúncia de abuso. Os profissionais de saúde percebem o abuso infantil, sendo os médicos aqueles que mais denunciam os casos.

The purpose of this cross-sectional study was to evaluate the impact of untreated caries in different stages on the oral healthrelated quality of life (OHRQoL) of one- to three-year-olds and their families.The mothers of 308 children answered the Brazilian version of the Early Childhood Oral Health Impact Scale to determine their perceptions of the OHRQoL of their children. The mothers also answered a questionnaire addressing demographic and socioeconomic characteristics of their families. The children were submitted to a clinical examination for the diagnosis of dental caries using International Caries Detection and Assessment System criteria. Data analysis involved descriptive statistics, Kruskal-Wallis and Mann-Whitney tests, and hierarchically adjusted Poisson regression models.The prevalence of untreated caries was 64.3 percent. Among the children with caries, 53.5 percent exhibited the severe stage of the condition. Negative impact on OHRQoL was significantly associated with severe stage of caries (prevalence ratio [PR] equals 2.80, 95 percent confidence interval [CI] equals 1.90 to 4.12, P0.001), and a younger age for the mother (PR equals 1.69, 95 percent CI equals 1.27 to 2.25, P0.001).Untreated caries in advanced stages was associated with a poorer quality of life among one- to three-year-olds and their families.