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Aim: To compare oral health indicators of children/adolescents with Down syndrome (DS) with a group of children/adolescents without DS., Methods and Results: This cross-sectional study included 144 individuals with DS, ages 4 to 18 years, matched for age and sex with a group of 144 individuals without DS, and their parents/caregivers. Parents/caregivers completed a questionnaire regarding sociodemographic information and habits related to their children's oral health. Clinical examination of the children/adolescents evaluated dental caries experience (DMFT/dmft), bleeding on periodontal probing, presence of visible plaque, clinical consequences of untreated dental caries (PUFA/pufa), and malocclusion (DAI). The chi-square test, linear by linear test, and Mann-Whitney test were used to compare the variables between the groups (p < .05). Children/adolescents without DS brushed their teeth more times per day (p < .001) and had a higher frequency of daily sugar intake (p < .001). The children/adolescents in the DS group had a greater presence of gingival bleeding (p < .001) and had a greater number of cases of "severe malocclusion" and "very severe malocclusion" (p = .001). No difference was found in the prevalence of dental caries between the two groups., Conclusion: The children/adolescents in the DS group had a greater presence of gingival bleeding during the clinical examination and had a greater need for orthodontic treatment., (© 2023 Special Care Dentistry Association and Wiley Periodicals LLC.)

Introduction: Malocclusion is one of the most prevalent oral health problems and can affect self-esteem, social relations, and oral health-related quality of life. The present study aimed to evaluate associations between malocclusion and orofacial dysfunction, nonnutritive sucking habits, cavitated carious lesions, and anxiety in Brazilian children., Methods: An analytical cross-sectional study was conducted with a representative sample of 739 children aged 8-10 years. Parents or guardians provided sociodemographic data and information on the nonnutritive sucking habits of the children. The children answered the Revised Children's Manifest Anxiety Scale. Four trained examiners examined the children for the diagnosis of malocclusion (dental aesthetic index), dental caries (International Caries Detection and Assessment System), and orofacial dysfunction (Nordic Orofacial Test-Screening). The control variables were selected using a directed acyclic graph. Descriptive statistics were performed, followed by unadjusted and adjusted robust logistic regression analysis (P <0.05)., Results: The following variables remained associated with the occurrence of malocclusion in the final model: nonnutritive sucking habits (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.25-4.08), orofacial dysfunction (OR, 1.56; 95% CI, 1.13-2.17), and cavitated carious lesion (OR, 1.39; 95% CI, 1.03-1.89)., Conclusions: Nonnutritive sucking habits, orofacial dysfunction, and cavitated carious lesions were associated with the presence of malocclusion in children aged 8-10 years., (Copyright © 2022 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the impact of malocclusion and dental caries on oral health- related quality of life (OHRQoL) in adolescents and the differences between adoles- cents' self-reports and caregiver's proxy reports. Methods: A population-based cross-sectional study was conducted with 1,612 Brazil- ian adolescents and 1,168 caregivers. Adolescents completed the Child Perceptions Questionnaire and caregivers completed the Parental-Caregiver Perceptions Question- naire. Malocclusion (dental esthetic index) and dental caries (DMFT) were documented. Multiple Poisson regression was conducted. Results: A self-reported model demonstrated that adolescents with malocclusion had an impact on emotional (PR=1.14; 95 percent confidence interval [95% CI=1.03 to 1.26) and social domains (PR=1.35; 95% CI=1.20 to 1.50). Dental caries had an impact on the emotional domain (prevalence ratio [PR]=1.34; 95% CI=1.21 to 1.48). The caregiver model showed that malocclusion had an impact on oral symptoms (PR=1.12; 95% CI=1.03 to 1.21), functional limitations (PR=1.18; 95% CI= 1.05 to 1.33), and emotional (PR=1.23; 95% CI=1.10 to 1.54) and social domains (PR=1.22; 95% CI=1.02 to 1.45). Those with dental caries felt an impact on oral symptoms (PR=1.09; 95% CI=1.01 to 1.19), functional limitations (PR=1.18; 95% CI=1.05 to 1.33) and social domains (PR=1.24; 95% CI=1.04 to 1.45). Conclusions: Adolescents reported a negative impact on OHRQoL both in relation to dental caries and malocclusion. Caregivers observed the impact of oral conditions on more domains than the adolescents reported.

Purpose: Children should feel sad when they believe that a negative outcome is permanent. The sadness that an oral problem might bring tends to contribute to children's loneliness and increase the social stress levels. The aim of this study was to evaluate the impact of untreated dental caries, dental pain, malocclusion, and traumatic dental injury on prevalence of sadness related to oral health among Brazilian children., Methods: This cross-sectional study was carried out with 397 children aged 8-10 years randomly selected from public and private schools in Diamantina, Brazil. The Brazilian version of the CPQ 8-10 was applied. Sadness was collected through the question, "In the last month how often did you feel sad because of your teeth or mouth?" and dental pain through the question, "In the last month, how many times have you had pain in your teeth?" One calibrated examiner (Kappa value intra examiner: 0.77-0.91; Kappa value inter examiner: 0.80-1.00) performed the exam for dental caries (DMFT), malocclusion (DAI), and dental trauma (O'Brien). Parents answered questions addressing socioeconomic issues. Descriptive analyses, Chi-square test, and hierarchical Poisson regression models were performed (IC 95%; p < 0.05).", Results: The prevalence of sadness related to oral health was 30.5% (n = 121). Sadness related to oral health was associated with untreated dental caries (PR: 1.46; 95% CI 1.32-2.46; p = 0.001 ) and dental pain (PR: 2.91; 95% CI 2.00-4.22; p < 0.001). Other clinical variables analyzed (traumatic dental injury and malocclusion) were not significantly associated with sadness related to oral health., Conclusions: Children with untreated dental caries and dental pain presented a higher report of sadness related to oral health., (© 2021. European Academy of Paediatric Dentistry.)

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.

Introduction: Attention deficit-hyperactivity disorder is a behavioral disorder characterized by a lack of focus, impulsive behavior, and or excessive activity. This research aimed to evaluate the association between signs of attention deficit-hyperactivity disorder and malocclusion in schoolchildren., Methods: A cross-sectional study was conducted with a representative sample of 633 children aged 7-12 years. The children were clinically examined for malocclusion using the Dental Aesthetic Index. The predominant breathing pattern was also determined. Parents answered a questionnaire addressing socioeconomic characteristics and the presence of nonnutritive sucking habits. The Swanson, Nolan, and Pelham Scale-IV was filled out by both parents and teachers to compare behavioral patterns. The children were submitted to a neuropsychological evaluation using the Raven's Colored Progressive Matrix Test. Data analysis involved the chi-square test and Poisson regression analysis., Results: The prevalence of malocclusion was 42% higher among children with signs of hyperactivity reported by both parents and teachers (prevalence ratio [PR], 1.42; 95% confidence interval [CI], 1.11-1.81; P = 0.004). In the final Poisson regression model, the prevalence of malocclusion was lower among schoolchildren aged 11 and 12 years (PR, 0.62; 95% CI. 0.52-0.73; P <0.001) and higher among those who used a pacifier for at least 4 years (PR, 1.25; 95% CI, 1.02-1.54; P = 0.029) as well as those classified as mouth breathers (PR, 1.28; 95% CI, 1.09-1.51; P = 0.003)., Conclusions: The prevalence of malocclusion was higher among children with signs of hyperactivity independently of age, pacifier use, and mouth breathing., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: To compare removable and fixed orthodontic devices in the correction of non-skeletal anterior crossbite in children and adolescents in the mixed dentition., Materials and Methods: Electronic searches were conducted in the following databases: PubMed, Web of Science, Scopus, Medline Ovid, Lilacs, US Clinical Trials, and Proquest. A hand search of the reference lists of the included articles and a Google Scholar search were also conducted. References were evaluated by 2 review authors. Articles that met the eligibility criteria were included. Data extraction, methodological quality assessment (Cochrane tool), and strength of the evidence evaluation (GRADE) were also carried out., Results: Seven articles were included. The results showed that removable and fixed devices were equally efficacious for overjet correction. Removable and fixed devices can also present inconveniences regarding pain and discomfort levels, the accomplishment of everyday activities (leisure and school), and the performance of functions, such as chewing and speech. However, treatment time and costs were significantly lower in orthodontic therapy with fixed appliances. Sequence generation, allocation concealment, and complete outcome data were not a concern. Blinding of participants or personnel was not reported in any article, and blinding of the assessor was a concern in 2 articles. Selective reporting was a concern in 2 articles. The certainty of the evidence for overjet correction was very low., Conclusion: Removable and fixed orthodontic devices are efficacious for overjet correction in non-skeletal anterior crossbite. However, treatment time and costs are lower for cases treated with fixed devices., (Copyright © 2020 Elsevier Inc. All rights reserved.)

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.

Aims: To assess the impact of oral conditions among children/adolescents with Down syndrome (DS) on the Oral Health-related Quality of Life (OHRQoL) of their families in comparison with a group without DS., Methods and Results: Families of 144 children/adolescents with DS aged 4-18 years were compared with families of individuals without DS. Dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), gingival bleeding (GBI), visible plaque (VPI), and malocclusion were evaluated. Parents/caregivers answered the Family Impact Scale (FIS) and questionnaires on sociodemographic conditions and the health of children/adolescents. Data analysis included chi-square test and Poisson regression. There was no difference between groups regarding the impact of the children's/adolescents' oral condition on their families' OHRQoL for all domains and the total FIS score (P > 0.05). A negative impact on the OHRQoL of families of children/adolescents with DS was determined by dental caries (PR = 3.95, CI = 2.09-7.46), clinical consequences of untreated dental caries (PR = 1.83, CI = 1.18-2.84), defined malocclusion (PR = 2.75, CI = 1.23-6.13), and severe malocclusion (PR = 2.82, CI = 1.02-7.74)., Conclusion: There is no difference on the OHRQoL of families of children/adolescents with and without DS. Dental caries experience, clinical consequences of untreated dental caries, defined malocclusion, and severe malocclusion determined the negative impact on the OHRQoL of families of children/adolescents with DS., (© 2019 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Objective: To evaluate the impact of the first six months of orthodontic treatment with fixed appliances on the oral health-related quality of life (OHRQoL) of adolescents, comparing boys and girls, using a specific condition questionnaire., Design: Cross-sectional., Setting: School of Dentistry of the Federal University of Minas Gerais, Belo Horizonte, Brazil., Participants: Adolescents aged 10-17 years., Methods: Forty-six adolescents participated in this study. Adolescents' OHRQoL was evaluated using the Brazilian version of the questionnaire Impact of Fixed Appliances Measure. This questionnaire comprises 43 questions distributed across nine domains: aesthetics; functional limitation; dietary impact; oral hygiene impact; maintenance impact; physical impact; social impact; time constraints; and travel/cost/inconvenience implications. The answer options follow the Likert scale, in the range of 1-5. A higher score indicates a more negative impact on the OHRQoL. Adolescents' malocclusion was assessed using the Dental Aesthetic Index. Information on family income, adolescents' age and tooth extraction was also collected. A directed acyclic graph was used to identify potential confounders. Statistical analysis involved the chi-square test, the Student's t test and the analysis of covariance. The minimal clinically important difference was also calculated., Results: Of the 46 participants, 25 were girls and 21 were boys. The female adolescents presented a more negative impact from the orthodontic treatment on the quality of life when compared to the male adolescents ( P < 0.001), regardless of the influence of the confounding variables. The most negative repercussions were identified in the domains of oral hygiene ( P = 0.002), physical impact ( P < 0.001) and social impact ( P < 0.001)., Conclusion: The impact of the first six months of orthodontic treatment on OHRQoL is more negative in female individuals than in male individuals. The results of this study may be useful for the oral healthcare provider during the counselling of adolescents undergoing fixed appliance therapy.

Background: Previous studies have shown a high prevalence of malocclusion in people with Down syndrome (DS) compared to individuals without DS, but no systematic review to summarize the evidence on this topic has been performed thus far., Aim: To evaluate whether children/adolescents with DS are more affected by malocclusion than those without DS., Design: A search was performed in seven electronic databases. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The strength of the evidence from the selected studies was evaluated by the Grading of Recommendations Assessment, Development and Evaluation system., Results: Eleven publications were included in the systematic review and eight were meta-analysed. The meta-analysis showed that malocclusion was more prevalent in children/adolescents with DS for Angle Class III (risk difference [RD] = 0.40; confidence interval [CI] = 0.33, 0.46), posterior crossbite (risk ratio [RR] = 3.09; CI = 2.02, 4.73), anterior crossbite (RR = 2.18; CI = 1.41, 3.39), and anterior open bite (RD = 0.21; CI = 0.06, 0.36)., Conclusion: The occurrence of malocclusion was higher in children/adolescents with DS compared to individuals without the syndrome. The strength of the evidence of the studies analysed, however, was considered moderate and low., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Malocclusion is public health problem because of its high prevalence, treatment possibility, and impact on the individual's quality of life. This article aims to determining the prevalence of malocclusion in adolescents and to test its association with social vulnerability. A representative transversal study was performed with 1612 adolescents aged between 11 and 14 years old who came from public and private schools in Belo Horizonte, Brazil. The adolescents were examined by three calibrated examiners for diagnosis of malocclusion, using the Dental Aesthetic Index. The Social Vulnerability Index from Belo Horizonte was used to determine the degree of social vulnerability from adolescents. The data were analyzed using Poisson regression with robust variance (p<0,05). Most adolescents presented absence/minor malocclusion (68.7%). Dental crowding was diagnosed in 51.9% from the sample, diastema in 23.7%, anterior open bite in 7.6 %. Malocclusion was associated with social vulnerability (PR=1.25;95% CI=1.01-1.55). Dental crowding was the most prevalent type of malocclusion. The more socially vulnerable adolescents had worse indicators of malocclusion.

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 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.

Background/objectives: The aesthetic impact of malocclusion can have negative repercussions on quality of life, social interaction, interpersonal relationships, and psychological well-being. The aim of this study was to evaluate the impact of malocclusion on the quality of life of Brazilian adolescents., Methods: A representative cross-sectional study of 1612 adolescents from Belo Horizonte, Minas Gerais was conducted. The adolescents responded to the Brazilian version of the Child Perception Questionnaire (CPQ11-14-ISF:16) to assess the impact of the condition on quality of life. Cases of malocclusion were diagnosed using the Dental Aesthetic Index while clinical examination was performed by three calibrated examiners. Data regarding traumatic dental injuries, dental caries, gender, type of school, age and social vulnerability was collected. Data analysis was performed using bivariate and multivariate Poisson regression with robust variance (P < 0.05)., Results: The prevalence of malocclusion was 31.3%. The presence of definite malocclusion (PR = 1.28; CI = 1.13-1.45), severe malocclusion (PR = 1.24; CI = 1.04-1.47) and handicapping malocclusion (PR = 1.55; CI = 1.31-1.84) was associated with a greater negative impact on Emotional Well-Being. The presence of definite malocclusion (PR = 1.18; CI = 1.02-1.36), severe malocclusion (PR = 1.46; CI = 1.21-1.76) and handicapping malocclusion (PR = 1.61; CI = 1.35-1.94) was also associated with a greater negative impact on Social Well-Being., Conclusions: Adolescents with handicapping malocclusion, where the need for treatment was mandatory, suffered from a greater negative impact on quality of life, with emotional and social aspects most affected., (© The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com)

The aim of the present study was to evaluate the impact of clinical oral factors, socioeconomic factors and parental sense of coherence on affected self-confidence in preschool children due to oral problems. A cross-sectional study with probabilistic sampling was conducted at public and private preschools with 769 five-year-old children and their parents/caretakers. A questionnaire addressing socio-demographic characteristics as well as the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Sense of Coherence Scale (SOC-13) were administered. The dependent variable was self-confidence and was determined using the SOHO-5 tool. Dental caries (ICDAS II), malocclusion and traumatic dental injury (TDI) were recorded during the clinical exam. Clinical examinations were performed by examiners who had undergone training and calibration exercises (intra-examiner agreement: 0.82-1.00 and inter-examiner agreement: 0.80-1.00). Descriptive statistics and Poisson regression analysis were performed (a=5%). Among the children, 91.3% had dental caries, 57.7% had malocclusion, 52.8% had signs of traumatic dental injury and 26.9% had bruxism. The following variables exerted a greater negative impact on the self-confidence of the preschool children due to oral problems: attending public school (PR=2.26; 95% CI: 1.09-4.68), a history of toothache (PR=4.45; 95% CI: 2.00-9.91) and weak parental sense of coherence (PR=2.27; 95% CI: 1.03-5.01). Based on the present findings, clinical variables (dental pain), socio-demographic characteristics and parental sense of coherence can exert a negative impact on self-confidence in preschool children due to oral problems.

Objective:: The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents' oral health -related quality of life (OHRQoL)., Methods:: This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents' malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents' age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance., Results:: Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents' malocclusion was significantly associated with a higher negative impact on parents'/caregivers' perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables., Conclusions:: Parents/caregivers reported a negative impact of malocclusion on adolescents' OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL.

The aim of this study was to evaluate the impact of malocclusion on the oral health-related quality of life (OHRQoL) of 120 Brazilian adolescents with the Child Perceptions Questionnaire for 11 to 14 year olds (CPQ11-14). Malocclusion was evaluated by 2 calibrated dentists using the Dental Aesthetic Index. Adolescents' sex and age and the families' monthly income were recorded and considered as confounding variables. A total of 117 adolescents completed the CPQ11-14, for a response rate of 97.5%. The multivariate model demonstrated that adolescents diagnosed with malocclusion (n=77) were significantly more likely to report a negative impact on the overall CPQ11-14 score (prevalence ratio [PR] = 1.35; 95% confidence interval [CI] = 1.20-1.51; P < 0.05), as well as on the emotional (PR = 1.74; CI = 1.35-2.24; P < 0.01) and social well-being (PR = 1.62; CI = 1.24-2.12; P < 0.05) subscales, than were those adolescents with no malocclusion (n = 40).

Marfan syndrome is an autosomal-dominant genetic disorder that affects connective tissues. Diagnosis is based on genetic history as well as major and minor clinical criteria. This article presents a case of Marfan syndrome, emphasizing the clinical manifestations of the disease, and provides an overview of oral management. Knowledge of the etiopathologic and clinical aspects of this condition is essential to providing dental treatment aimed at improving the quality of life of affected individuals.

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.

Objective: Evidence is contradictory regarding the association between oronasopharyngeal abnormalities and malocclusion. The aim of the present study was to assess the association between oronasopharyngeal abnormalities and malocclusion (anterior open bite and posterior crossbite) in preschoolers., Methods: A cross-sectional study was conducted with a representative sample of 732 preschoolers aged 3-5 years old selected randomly from private and public preschools. Anterior open bite (AOB) and posterior crossbite (PC) were evaluated through a clinical exam. Parents/caregivers answered a questionnaire addressing sociodemographic indicators and oronasopharyngeal issues. Statistical analysis involved descriptive analysis and Poisson regression (p < 0.05)., Results: The prevalences of AOB and PC were 21.0% and 11.6%, respectively. Being three years old (PR = 1.244; 95% CI = 1.110-1.394; p < 0.001), being four years old (PR = 1.144; 95% CI = 1.110 - 1.394; p = 0.015), absence of allergy (PR = 1.158; 95% CI = 1.057 - 1.269; p = 0.002), not having undergone nose surgery (PR = 1.152; 95% CI = 1.041 - 1.275; p = 0.006) and having a sore throat more than five times in the same year (PR = 1.118; 95% CI = 1.011 - 1.237; p = 0.030) were significantly associated with AOB. The absence of asthma (PR = 1.082; 95% CI = 1.012 - 1.156; p = 0.020), not having undergone throat surgery (PR = 1.112; 95% CI = 1.068 - 1.158; p < 0.001) and not having undergone nose surgery (PR = 1.114; 95% CI = 1.069 - 1.160; p < 0.001) remained associated with PC., Conclusion: Significant associations were found between oronasopharyngeal-reported abnormalities and the presence of AOB and PC in preschoolers.

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., (© 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim of the present study was to search for scientific evidence concerning the association between breastfeeding and bottle feeding and risk of malocclusion in mixed and permanent dentitions. An electronic search was performed in eight databases up to February 2015. Additionally, a gray literature search and hand searches of the reference lists of the selected studies were also carried out. There were no restrictions on language or on year of publication. The methodology of the included articles was evaluated using the Newcastle Ottawa scale. Out of the 817 identified citations, six studies fulfilled the eligibility criteria and were included in the systematic review. One study showed that children with mixed and permanent dentitions breastfed for more than 6 months presented greater mean protrusion of mandibular incisors and inclination of maxillary incisors compared with those breastfed for less than 6 months or those who were bottle-fed (p < 0.05). One study revealed that breastfeeding and bruxism were associated with Class II [OR = 3.14 (1.28 - 7.66)] and Class III [OR = 2.78 (1.21 - 6.36)] malocclusion in children with permanent dentition, while another study showed that an increase in breastfeeding duration was associated with a lower risk of malocclusion in children with both mixed and permanent dentitions (p < 0.001). Three studies did not report any significant association. Risk of bias was high in most selected articles. These findings do not support an association between breastfeeding and bottle feeding and the occurrence of malocclusion in mixed and permanent dentitions.

Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting., Methods: Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1) and 12 months after placement of fixed appliances (T2). Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID)., Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p< 0.001), which contributed to improve patient's overall quality of life (p< 0.001). Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score., Conclusion: Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances.

Objective: To assess the agreement between adolescents and their parents/caregivers regarding the impact of malocclusion on adolescents' oral health-related quality of life (OHRQoL)., Materials and Methods: A consecutive sample of 141 adolescent and parent/caregiver pairs was selected. Adolescents answered the short version of the Child Perceptions Questionnaire (CPQ11-14), while parents answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). The CPQ11-14 and the P-CPQ have 14 items in common that are organized through four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). Agreement on the overall score and agreement on the subscales were determined using comparison and correlation analysis. The comparison analysis was carried out by comparing the mean directional and absolute differences, and the correlation analysis was performed using the intraclass correlation coefficient (ICC)., Results: A total of 135 pairs of adolescents and parents/caregivers agreed to answer the questionnaires, providing a response rate of 95.7%. The mean age of the adolescents was 11.50 years. The mean directional difference was significant for the OS (P < .001) and FL (P = .040) subscales as well as for the overall score (P = .007). Adolescents' reports were higher than parents/caregivers' reports. The mean absolute difference for the overall score was 7.26, representing 12.9% of the maximum possible overall score. The ICC was 0.16 for the overall score, indicating poor agreement., Conclusion: Poor agreement was observed between adolescents and their parents/caregivers in rating the impact of malocclusion on adolescents' OHRQoL.

Aim: To evaluate the effect of malocclusion among adolescents on their families' oral health-related quality of life (OHRQoL)., Methods: A consecutive sample of 125 parents/caregivers of Brazilian adolescents was chosen. Participants were asked to answer the Brazilian version of the Family Impact Scale (FIS). The main independent variable was adolescents' malocclusion, which was measured with the Dental Aesthetic Index. Gender, age, and family monthly income were the other independent variables. Data analysis involved descriptive statistics, Mann-Whitney test, and univariate and multiple logistic regression., Results: Among the 125 participants initially admitted to the present study, two were excluded so that 123 parents/caregivers participated providing a response rate of 98.4 %. The overall FIS score revealed a more frequent effect for families of adolescents who presented malocclusion (P = 0.005). Significant findings were also observed for parental emotions (P = 0.022), family conflict (P = 0.010), and financial burden (P = 0.010) subscales. When the independent variables family monthly income and malocclusion were inserted together in the regression model, families with a monthly income of <5 Brazilian minimum wages (approximately US$ 325.00 per month) were more likely to have a worse OHRQoL, and families whose adolescents presented malocclusion were 3.55 more likely to have a poorer quality of life than those families whose adolescents did not present malocclusion., Conclusions: Families of adolescents with malocclusion were more likely to report a worse OHRQoL.

The World Health Organization recommends exclusive breast feeding for at least six months. However, there is no scientific evidence of the benefits of breast feeding for oral health in children under primary dentition. This study aimed to search for scientific evidence regarding the following question: is bottle feeding associated with malocclusion in the primary dentition compared to children that are breastfed? An electronic search was performed in seven databases. The systematic review included 10 cohort studies. It was not possible to conduct meta-analysis; therefore a qualitative analysis was assessed. The majority of studies evaluated feeding habits by means of questionnaires and conducted a single examination. Three studies observed that bottle feeding was significantly associated with overjet and posterior crossbite. Studies reported several cut-off times for breastfeeding (varying from 1 month up to 3 years of age) and several types of malocclusion. Controlling for non-nutritive sucking habits was reported for only half of the studies and this may have led to biased results. The scientific evidence could not confirm a specific type of malocclusion associated with the feeding habits or an adequate time of breastfeeding to benefit the children against malocclusion. Further cohort studies are needed to confirm this evidence.

The aim of the present study was to assess the impact of malocclusion on oral health-related quality of life (OHRQoL) among preschool children and their families. This study involved 732 preschoolers. Parents/caregivers filled out the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire addressing sociodemographic data. Overbite, overjet, and crossbite were recorded during the clinical examination. Bivariate and multiple Poisson regression analyses were performed and prevalence ratio (PR) were calculated (α = 5%). The prevalence of negative impact from malocclusion on OHRQoL was 27.6% among the children and 22.3% among the families. Mother's schooling (PR = 1.37; 95% CI: 1.10-1.70), parent's/caregiver's assessment of child's oral health (PR = 2.07; 95% CI: 1.60-2.58), history of toothache (PR = 3.84; 95% CI: 2.34-6.30), and visits to the dentist (PR = 0.59; 95% CI: 0.37-0.94) remained significantly associated with OHRQoL in the final model for the children, whereas parent's/caregiver's assessment of child's oral health (PR = 2.32; 95% CI: 1.71-3.14) and history of toothache (PR = 2.28; 95% CI: 1.69-3.09) remained significantly associated with OHRQoL for the families. Malocclusion was not associated with a negative impact on OHRQoL. In contrast, parents'/caregivers' perceptions regarding the oral health of their children and a history of toothache were predictors of a negative impact on the OHRQoL., (© 2014 Eur J Oral Sci.)

The aim of the present study was to determine the prevalence of malocclusion and associations with socioeconomic indicators among preschoolers. A cross-sectional study was conducted with 732 children 3 to 5 years of age in the city of Campina Grande, Brazil. Three dentists underwent a calibration exercise (K = 0.85–0.90) and diagnosed malocclusion based on the criteria proposed by Foster & Hamilton and Grabowski et al. Parents/guardians answered a questionnaire addressing sociodemographic aspects. Data analysis involved descriptive statistics and bivariate Poisson regression (PR; α = 5%). The prevalence of malocclusion was 62.4%. The most frequent types were increased overjet (42.6%), anterior open bite (21%) and deep overbite (19.3%). An association was found between malocclusion and age: the prevalence of malocclusion was greater among younger children, with the highest prevalence among 3-year-olds (PR = 1.116; 95%CI = 1.049–1.187). The prevalence of malocclusion was high. Mother's schooling and household income were not associated with malocclusion. Socioeconomic factors were also not associated with the occurrence of malocclusion.

The aim of the study was to verify the prevalence of anterior open bite (AOB) and posterior cross-bite (PC) in the primary dentition and the association with sociodemographic factors, presence and duration of nutritive and non-nutritive habits. A cross-sectional study was carried out with 732 preschoolers in Campina Grande, PB, Brazil. Clinical exams were performed by three calibrated examiners (Kappa: 0.85-0.90). A questionnaire addressing sociodemographic data as well as nutritive and non-nutritive sucking habits was administered to parents/caregivers. Data analysis involved descriptive statistics and Poisson regression analysis (α=5%). The prevalence of AOB and PC was 21.0% and 11.6%, respectively. AOB was significantly associated with the three-year-old age group (PR: 1.37; 95%CI: 1.24-1.52), enrollment in public school (PR: 1.09; 95%CI: 1.01-1.17) and duration of pacifier sucking ≥ 36 months (PR: 1.41; 95%CI: 1.30-1.53). PC was associated with pacifier use (PR: 1.11; 95%CI: 1.05-1.17) and duration of breastfeeding <12 months (PR: 1.05; 95%CI: 1.00-1.10). Socioeconomic factors appear not to be related to AOB or PC in the primary dentition, except type of preschool. Breastfeeding should be encouraged for longer periods and the use of pacifier beyond 3 years of age represents a predisposing factor for both types of malocclusion, especially AOB.

The purpose of the present study was to evaluate the impact of malocclusion on Oral Health-Related Quality of Life (OHRQoL) of children and their families. A population-based cross-sectional study was carried out in Belo Horizonte, MG, Brazil. A representative sample of 1069 male and female preschoolers aged 60 to 71 months was randomly selected from public and private preschools and daycare centers. Data were collected using the B-ECOHIS. In addition, a questionnaire addressing socioeconomic and demographic data was self-administered by the parents/guardians. The criteria used to diagnose malocclusion were based on Foster and Hamilton (1969), Graboswki et al. (2007) and Oliveira et al. (2008). Descriptive, univariate and multiple Poison logistic regression analyses were carried out. The prevalence of malocclusion was observed in 46.2% of the children and deep overbite was the most prevalent type of malocclusion (19.7%), followed by posterior crossbite (13.1%), accentuated overjet (10.5%), anterior open bite (7.9%) and anterior crossbite (6.7%). The impact of malocclusion on OHRQoL was 32.7% among the children and 27.1% among the families. In Poisson multiple regression model adjusted for socioeconomic status, no significant association was found between malocclusion and OHRQoL of the children (PR=1.09, 95% CI: 0.96-1.24) and their families (PR=1.11, 95% CI: 0.94-1.31). It is concluded that children with malocclusion in this sample did not have a negative impact on their OHRQoL and of their families.

Objectives: The purpose of this study was to evaluate the impact of oral health conditions on oral health-related quality of life (OHRQoL) in population-based sample of Brazilian preschool children. A further aim was to identify the influence of socio-demographic profile and perceptions regarding general health and oral health status on OHRQoL., Methods: An epidemiological survey was carried out at public and private preschools in the city of Belo Horizonte, Brazil. The sample consisted of 1632 5-year-old male and female preschoolers randomly selected using a multi-stage sampling technique and their parents/caregivers. Oral examinations of the children were performed by a single, previously calibrated examiner for the assessment of dental caries experience, malocclusion, traumatic dental injury and developmental defects of enamel. Caregivers were asked to complete the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) and a form on socio-demographic data. Descriptive, bivariate and adjusted Poisson regression model analyses were carried out., Results: In the child section of the B-ECOHIS, OHRQoL was negatively impacted by decayed, missing and filled teeth [prevalence ratios (PR) = 2.18; 95% CI, 1.88-2.52], position of the child among siblings in the family (PR = 1.20; 95% CI, 1.04-1.39), type of preschool (PR = 1.36; 95% CI, 1.10-1.69), age of parents/caregivers (PR = 1.18; 95% CI, 1.04-1.34), monthly household income (PR = 1.48; 95% CI, 1.18-1.85) and perception of the child's general health status (PR = 1.26; 95% CI, 1.06-1.51). In the family section, the adjusted results demonstrated a negative impact on OHRQoL associated with dental caries experience (PR = 3.40; 95% CI, 2.83-4.08), age of parents/caregivers (PR = 1.16; 95% CI, 1.01-1.33) and monthly household income (PR = 1.41; 95% CI, 1.16-1.72)., Conclusions: Dental caries experience was the only normative criteria with a negative impact on OHRQoL. Families with low income and younger parents reported a greater impact on quality of life. According to parents' perceptions, a poor general health status rating was related to poorer quality of life among the children., (© 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: An instrument was developed in Canada to assess impairments related to oral functioning of individuals with four years of age or older with Down syndrome (DS). The present study attempted to carry out the cross-cultural adaptation and validation of the instrument for the Brazilian Portuguese language and to test its reliability and validity., Findings: After translation and cross-cultural adaptation, the instrument was tested on caregivers of people with DS. Clinical examination for malocclusion was carried out in people with DS by two calibrated examiners. Inter and Intra examiner agreement was assessed by Intraclass Correlation Coefficient (ICC) and ranged from 0.92 to 0.97 respectively. Total of 157 people with DS and their caregivers were able to compose the sample. They were selected from eight institutions for people with DS in five cities of southeastern Brazil. The mean age of people with DS was 20.7 [±13.1] and for caregivers was 53.1 [±13.7]. The mean instrument score was 18.6 [±9.0]. Internal reliability ranged from 0.49 to 0.80 and external reliability ranged from 0.78 to 0.88. Construct validity was verified by significant correlations identified between malocclusion and the total instrument; and caregivers' educational level and the instrument (p<0.05). Discriminant validity was proved as the instrument presented different mean comparing people with DS and non-DS (p<0.05)., Conclusions: Initial validity tests indicated that the instrument related to the oral health for people with DS may be a valid instrument to this segment of the population in Brazil.

Objective: To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument., Materials and Methods: A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05)., Results: Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income., Conclusions: Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Objective: To determine the incidence of malocclusion in a 5-year follow-up of school children and verify the hypothesis that individuals with previous malocclusion are more prone to maintain the same characteristics in the transition from primary to mixed dentition., Materials and Methods: School children, ages 8 to 11 years, participated. Inclusion criteria consisted of normal occlusion in primary dentition or subsequent malocclusions, anterior open bite and/or posterior crossbite and/or overjet measuring more than 3 mm, and that subjects had not submitted to orthodontic treatment and adenoidectomy. Data collection was based on evaluation of occlusion in school children in the actual stage of mixed dentition. Descriptive, Chi-square, and relative risk (RR) 95% confidence interval (CI) analyses were carried out., Results: The greatest incidence of malocclusion was found in children with malocclusion (94.1%) when compared with those without malocclusion (67.7%) (RR  =  1.4 [1.2-1.6]; P < .001). Anterior open bite (RR  =  3.1 [1.7-5.8]), posterior crossbite (RR  =  7.5 [4.9-11.5]), and overjet greater than 3 mm (RR  =  5.2 [3.4-8.0]) in the primary dentition are risk factors for malocclusion in early mixed dentition. Spontaneous correction of the anterior open bite was confirmed in 70.1% of cases. Posterior crossbite and overjet greater than 3 mm were persistent in 87.8% and 72.9% of children., Conclusions: Malocclusion incidence was high. Individuals with previous anterior open bite, greater overjet, and posterior crossbite had greater risk of having the same characteristics in the mixed dentition.

Careful attention to malocclusion in children with special needs leads to a considerable improvement in the quality of life. The present study analysed the prevalence of malocclusion in children with Down syndrome (DS) and cerebral palsy (CP) as well as associations with individual, socio-economic, and behavioural factors. A cross-sectional study was carried out that included 181 mothers and their children with DS and CP (aged 3-12 years) at two institutions for individuals with special needs in Rio de Janeiro, Brazil. Data were collected using a questionnaire administered to the mothers and a dental examination of the children. Clinical examination recorded the following: anterior/posterior crossbite and anterior openbite (AOB). The control variables were the mother's level of education as well as the gender and age of the child. Statistical analysis of the data was performed using the chi-square test and multiple logistic regression. An anterior crossbite was present in 20.4 percent, a posterior crossbite in 21.5 percent, and an AOB in 29.8 percent. The presence of DS, bottle feeding, and non-nutritive sucking habits for 24 months or more was determinant factors for an anterior crossbite and the presence of DS, bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months was determinant factors for a posterior crossbite. The presence of CP and non-nutritive sucking habits for 24 months or more was determinant factors for an AOB. Thus, the prevalence of malocclusion in children with special needs was associated with the type of disability, use of bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months.

Cornelia de Lange syndrome is a rare multisystem disorder characterized by a distinctive facial appearance, delayed growth and psychomotor skills, behavioral problems, malformation of the upper limbs, and impairment on the quality of life of affected subjects. This article reports a case of a child with the syndrome, emphasizing the orofacial manifestations. Knowledge on the etiopathological aspects and characteristic features of this condition is essential so that professionals can provide health care and help improve the quality of life of affected individuals and their families.

Oral health-related quality of life (OHRQoL) is an important aspect of health outcomes and its assessment should be made using validated instruments. The psychosocial impact of dental aesthetics questionnaire (PIDAQ) is an OHRQoL instrument that assesses the psychosocial impact of dental aesthetics was developed and validated for use on young adults. The aim of the present study was to assess the reliability, validity, and applicability of the PIDAQ for young adults in Brazil. After translation and cross-cultural adaptation, the questionnaire was completed by 245 individuals (124 males and 121 females) aged 18-30 years from the city of Belo Horizonte, Brazil. In order to test discriminant validity, the subjects were examined for the presence or absence of malocclusion based on the dental aesthetic index criteria. Dental examinations were carried out by a previously calibrated examiner [weighted kappa = 0.64-1.00, intraclass correlation coefficient (ICC) = 0.78-1.00]. Internal consistency measured by Cronbach's alpha of the subscales was between 0.75 and 0.91 and test-retest reliability was assessed using the ICC, which ranged from 0.89 to 0.99 for dental self-confidence and social impact, thereby revealing satisfactory reliability. Discriminant validity revealed that subjects without malocclusion had different PIDAQ scores when compared with those with malocclusion. The results suggest that the Brazilian version of the PIDAQ has satisfactory psychometric properties and is thus applicable to young adults in Brazil. Further research is needed to assess these properties in population studies.

Aim: The purpose of the present study was to assess the prevalence of malocclusion in the primary dentition in a randomised representative sample of Brazilian preschool children., Materials and Methods: A cross-sectional survey was carried out in Belo Horizonte, Brazil, involving 1069 male and female preschool children from 60 to 71 months of age, randomly selected from public and private preschools and daycare centers. A questionnaire addressing demographic data was sent to parents/guardians in order to characterise the sample. The oral examination of the children was performed by a single, previously calibrated dentist (kappa inter-examiner agreement value = 0.82). The criterion for the categorisation of malocclusion was at least one of the following conditions: posterior crossbite, overjet (> 2 mm), anterior crossbite, anterior open bite and deep overbite. Univariate analysis was performed using the SPSS software, Results: The prevalence of malocclusion was 46.2%. Deep overbite was the most prevalent alteration (19.7% of the sample). Posterior crossbite was diagnosed in 13.1% of the children; 10.5% had accentuated overjet; 7.9% had anterior open bite; and 6.7% had anterior crossbite., Conclusion: Malocclusion in primary dentition is becoming a significant problem. The prevalence in the present study was high, especially vertical and transversal malocclusions.

Objective: To determine risk indicators for signs and symptoms of temporomandibular disorders (TMD) in children with cerebral palsy (n = 60) and control subjects (n = 60)., Study Design: The subjects were assessed by means of questionnaire and clinical exam: 1) signs and symptoms of TMD; 2) malocclusions [Dental Aesthetic Index (DAI)]; 3) harmful habits; and 4) bio-psychosocial characteristics. Statistical analysis involved the chi-square, Fisher's exact tests (p < or = 0.05) and multivariate logistic regression (forward stepwise procedure). Variables that achieved a p-value < or = 0.20 were used as potential predictors of signs and symptoms of TMD and applied as co-variables in the multivariate analysis., Results: The prevalence of at least one sign and/or symptom of TMD in the present sample was 1.7% (n = 1) among the individuals in the control group and 13.3% (n = 8) among the individuals with cerebral palsy. The presence of cerebral palsy (Odds Ratio: 9.08; p = 0.041), male gender (OR: 6.21; p = 0.027), severity of the malocclusion (OR: 4.75; p = 0.031), mouth breathing (OR: 5.40; p = 0.022) and mixed dentition (OR: 4.73; p = 0.035) were identified as risk indicators for signs and symptoms of TMD., Conclusions: It was concluded that children with cerebral palsy had a significantly greater chance of developing signs and symptoms of TMD.

Aim: The aim of this study was to evaluate parents' perceptions of dental fluorosis and other oral health conditions depicted in photographs of anterior teeth., Materials and Methods: The sample comprised 120 parents (average age 39.3 years) whose children were undergoing dental treatment at the School of Dentistry of the Federal University of Minas Gerais. Seven photographs were selected: P1, open bite; P2, dental fluorosis TF 1 associated with open bite; P3, dental fluorosis TF 1; P4, midline deviation and crowding; P5, dental hypoplasia; P6, teeth without oral problems; P7, dental fluorosis TF 3. All photographs were randomly shown to all the parents, who classified the conditions observed based on a numeric scale: 0-19 (very unsatisfactory), 20-39 (unsatisfactory), 40-59 (neutral), 60-79 satisfactory and 80-100 (very satisfactory). The reasons for dissatisfaction and the possible treatment choice were examined., Results: P6 (normal teeth) was the most satisfactory photograph according to the parents (mean 61.2), and all photographs were statistically significantly different from one another (Mann-Whitney test, p ≤ 0.05), except the following pairs: P1 (mean 52.9) and P7 (mean 50.2) (p 0.537); P2 (mean 32.6) and P3 (mean 39.0) (p 0.073); and P5 (mean 18.9) and P4 (mean 18.4) (p 0.923). Alignment and crowding were considered the most prevalent problem in all cases (27.5 to 90.8% of parents) and orthodontic treatment was the most frequently cited option for treating all conditions (34.2 to 89.2% of parents)., Conclusion: In general, parents were dissatisfied with the oral conditions depicted in all photographs. Midline deviation associated to crowding (P4) and dental hypoplasia (P5) were considered the most unsatisfactory conditions. The most frequently cited oral problems by the parents were alignment and crowding. Orthodontic treatment was considered the best option by the majority of parents.

Introduction: Our aims in this study were to compare the biopsychosocial aspects of patients with cerebral palsy and subjects in a control group, establish the severity of malocclusion, and identify determinant factors., Methods: The group with cerebral palsy included 60 patients diagnosed with the spastic form of the disease. The control group included 60 randomly selected healthy subjects with various malocclusions. Data were collected through questionnaires, medical charts, and clinical evaluations. The criteria of the dental aesthetic index were used for the diagnosis of malocclusion. Comparisons between groups and between the independent variables and dependent variable (severity of malocclusion) were performed by using the chi-square test (P ≤ 0.05) and multivariate logistic regression (forward stepwise procedure)., Results: Significant differences between the groups were found for these variables: tooth loss, overjet, anterior open bite, facial type, breathing pattern, drooling, difficulty in swallowing, and lip incompetence., Conclusions: The main risk factors associated with the severity of malocclusion were cerebral palsy, mouth breathing, lip incompetence, and long face., (Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Aim: The aim of the present study was to assess the prevalence of traumatic dental injury (TDI) in primary teeth and determine predisposing factors., Materials and Methods: A cross-sectional study was carried out on 388 male and female Brazilian preschool children between 60 and 71 months of age. A questionnaire addressing demographic data and history of TDI was sent to parents/caregivers. Socioeconomic status was determined using the Social Vulnerability Index (SVI), family income, number of people in the household and parents/caregivers' schooling. The chi-square test was used for the statistical analysis., Results: The prevalence of TDI was 62.1%; 61.7% of the teeth were affected by enamel fracture. Statistically significant associations were found between TDI and increased overjet [OR = 2.24, 95% CI = 1.11- 4.55] and anterior crossbite [OR = 0.38, 95% CI=0.17-0.87]. No statistically significant associations were found between TDI and number of people in the household, family income, social vulnerability, parents/caregivers' schooling, lip competence, overbite, anterior open bite and dental caries (p>0.05)., Conclusion: The prevalence of TDI was high and enamel fracture was the most common sign of TDI. Children with an increased overjet suffer more TDIs. Socioeconomic factors had no influence over the prevalence of TDI.

Background: In the period of adolescence physical appearance takes on significant importance in the construction of personal identity, including one's relationship with one's own body. A variety of social, cultural, psychological and personal factors influences the self-perception of dental appearance and the decision to undergo orthodontic treatment. Adolescents who seek orthodontic treatment are concerned with improving their appearance and social acceptance. The aim of the present study was to determine factors associated to the desire for orthodontic treatment among Brazilian adolescents and their parents., Methods: The sample consisted of 403 subjects aged 14 to 18 years, selected randomly from a population of 182,291 schoolchildren in the same age group. The outcome variable "desire for orthodontic treatment" was assessed through a questionnaire. Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and the Dental Aesthetic Index (DAI) was used for clinical assessment. Statistical analysis involved the chi-square test as well as both simple and multiple logistic regression analyses., Results: The majority (78%) of the Brazilian adolescents desired orthodontic treatment and 69% of the parents reported that their children were not in orthodontic treatment due to the high costs involved. There was significant association (p < or = 0.05) between the desire for orthodontic treatment and most types of malocclusion. However, there was no significant association between the desire for orthodontic treatment and the variables gender and age., Conclusions: The following were considered factors associated to the desire for treatment: upper anterior crowding > or = 2 mm and parents' perception of their child's need for treatment.

Aim: Evaluate the psychometric properties of the Brazilian version of the Family Impact Scale (FIS)., Methods: Following translation and cross-cultural adaptation, the FIS was tested on 123 parents-caregivers of children between 11 and 14 years of age with dental caries and malocclusions. The parents were recruited from the Paediatric Dental and Orthodontic clinics where their children were receiving dental care. Psychometric properties were assessed through internal consistency, test-retest reliability, construct validity and discriminant validity., Results: The mean FIS score was 6.97 (SD 7.81) for the dental caries group and 7.25 (SD 7.70) for the malocclusion group. The FIS score was unable to discriminate different family impact caused by children's oral health conditions. Internal consistency was confirmed by a Cronbach's alpha coefficient of 0.79. Test-retest reliability revealed good reproducibility (ICC 0.83). Construct validity was good, demonstrating highly significant correlations between parent's perceptions regarding the overall wellbeing indicator for their children and the total FIS and subscales. Financial burden demonstrated no significant correlation with global indicators., Conclusions: Overall psychometric results for the Brazilian version of the FIS confirm it as a reliable, valid questionnaire for assessing the family impact caused by children's oral conditions.

Objective: The aim of the present study was to determine the biopsychosocial impact of malocclusion on the daily living of Brazilian adolescents (14 to 18 years of age) through normative and subjective records and identify factors directly involved in the self-perception of malocclusions., Design: Cross-sectional., Setting: Public and private schools in the city of Belo Horizonte, Brazil., Subjects and Methods: The sample was made up of 403 adolescents, with no prior history of orthodontic treatment, who were selected randomly from a population of 182,291 students in the same age range. The oral impact of malocclusion was assessed using the Oral Impact on Daily Performance (OIDP), whereas clinical criteria were assessed using the Dental Aesthetic Index (DAI). Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and self-esteem was assessed using the Global Negative Self-Evaluation (GSE) scale. Other variables were assessed using questionnaires. The chi-square test, simple and multiple logistic regression analyses were used for the statistical analysis., Results: Ninety five adolescents (24%) reported feeling embarrassed to smile (aesthetic impact). A logistic regression suggested that the following variables were directly involved in the self-perception of malocclusion: upper anterior crowding > or = 2 mm (P=0.009), median diastema > or = 2 mm (P=0.040), normative treatment need (highly desirable) (P<0.001) and low economic level (P<0.001)., Conclusion: Negative repercussions on daily living were found in Brazilian adolescents with malocclusions affecting anterior dental aesthetics.

Aim: The objectives of the present study were to assess predictive factors associated to self-perception regarding the need for orthodontic treatment among 170 impoverished schoolchildren., Materials and Methods: A cross- sectional study was conducted in public schools in the city of Belo Horizonte-MG (Brazil). Children's self-perception regarding the need for treatment was assessed using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a questionnaire addressing biopsychosocial factors. The chi-square test and multiple logistic regression were used in the data analysis., Results: The predictive factors for the self-perception of orthodontic treatment need on the part of the impoverished schoolchildren included ridicule from persons close to the children regarding the appearance of the teeth (OR 2.81; 95%CI 1.2 to 6.4), dissatisfaction with oral aesthetics due to the alignment of the teeth (OR 2.45; 95%CI 1.1 to 5.4) and missing teeth (OR 3.02; 95%CI 1.0 to 9.23)., Conclusion: The alignment of the teeth, missing teeth and ridicule from others regarding the appearance of the teeth are the factors that most strongly influence self- perception regarding the need for orthodontic treatment among impoverished schoolchildren.

The Parental-Caregiver Perceptions Questionnaire (P-CPQ) is an instrument that assesses a parent's or a caregiver's perceptions regarding the impact of children's oral health status on quality of life. The aim of this study was to evaluate the psychometric properties of the Brazilian version of the P-CPQ. Following translation and cross-cultural adaptation, the P-CPQ was tested on 123 parents and caregivers of children between 11 and 14 years of age with dental caries and malocclusions. The parents/caregivers were recruited at dental clinics of the Federal University of Minas Gerais, where their children were receiving dental care. Psychometric properties were assessed through internal consistency, test-retest reliability, construct validity and discriminant validity. The mean P-CPQ score was 13.01 (SD=12.14) for the dental caries group and 16.57 (SD=13.13) for the malocclusion group. Internal reliability was confirmed by a Cronbach's alpha coefficient of 0.84. Test-retest reliability revealed satisfactory reproducibility (ICC=0.83). Construct validity was satisfactory, demonstrating significant correlations between global indicators and the total scale. The P-CPQ score was able to discriminate between different parental/caregiver perceptions of oral conditions in their children (dental caries and malocclusion). The results for the Brazilian version of the P-CPQ confirm that this questionnaire is a reliable and valid instrument to assess parental perceptions on the impact that oral health status has on children's life quality.

Objective: To investigate the association of finger and pacifier-sucking habits, breathing pattern, and adenoid size with the development of malocclusion in primary dentition., Materials and Methods: A case-control study was carried out involving 300 preschool children, ages 3 to 6 years, randomly selected from 10 public and 10 private preschools from a large representative sample of 745 children. The study was developed to identify risk factors associated with the development of malocclusion. The case group (n = 150) was composed of individuals with at least one of the following malocclusions: anterior open bite, posterior crossbite, or overjet of more than 3 mm. The control group (n = 150) was made up of individuals without malocclusions. Other variables were assessed through questionnaires about oral habits, including the use of a dummy, finger sucking, duration of these habits; mouth-breathing analysis; and a lateral cephalometric radiograph to evaluate the airway obstruction related to the adenoids. Multiple logistic regression analyses were performed. Statistical significance was P < .05., Results: The risk factors for the occurrence of malocclusion in preschool children were duration of pacifier-sucking after 2 years of age (OR = 14.7) and mouth-breathing pattern (OR = 10.9). No significant associations were found between hypertrophied adenoids or finger-sucking habits and the occurrence of malocclusion., Conclusions: The malocclusion in the primary dentition in preschool children was directly related to the duration of pacifier-sucking after 2 years of age and the mouth-breathing pattern.

Introduction: Our aims in this study were to determine the prevalence of malocclusion stemming from vertical or transversal occlusal alterations in subjects with Down syndrome (DS) and the associations with individual, socioeconomic, and behavioral factors., Methods: A cross-sectional study was carried out with 112 pairs of mothers and their children with DS between 3 and 18 years of age attending a genetics clinic at a public hospital in Rio de Janeiro, Brazil. Data were collected with a questionnaire given to the mothers and a clinical examination of the child or adolescent. Univariate, bivariate, and multiple logistic regression (backward stepwise) analyses were conducted., Results: The results showed a prevalence of malocclusion in 74% of the sample. After the adjustment of the logistic regression model, these variables--age, nail or finger biting habit, mouth posture, and cold or sore-throat episodes in the previous 6 months--were associated with the prevalence of malocclusions in these subjects., Conclusions: The data demonstrate a high prevalence of malocclusions stemming from vertical or transversal occlusal alterations in children and adolescents with DS. Age, nail or finger biting, mouth posture, and upper airway infections were related to malocclusions in these patients.