Resumo Este estudo teve como objetivo avaliar o efeito na qualidade de vida relacionada à saúde bucal (QVRSB) de dois protocolos de tratamento para fluorose dentária, em indivíduos incluídos em um ensaio clínico randomizado. Setenta voluntários, os quais viviam em uma área de fluorose endêmica no Brasil, e que possuíam pelo menos quatro dentes ântero-superiores com índice de Thylstrup e Fejerskov de 1 a 7, foram randomizados em dois grupos de tratamento (n= 35): GI- microabrasão de esmalte; ou GII- microabrasão associada com clareamento caseiro. A microabrasão foi realizada com ácido fosfórico 37% e pedra pomes e, o clareamento caseiro com peróxido de carbamida 10% e uso de moldeira. Os voluntários responderam um questionário antes e 1 mês após o tratamento, visando avaliar mudanças na QVRSB através do instrumento Oral Impact on Daily Performance (OIDP). Diferenças nos escores de impacto geral entre e nos mesmos grupos de tratamento foram analisadas através dos testes Wilcoxon (mesmo grupo) e Mann-Whitney (entre grupos), respectivamente. Alterações no escores dos domínios foram analisadas usando o teste Wilcoxon (a<0.05). Um mês após o tratamento, os indivíduos relataram melhora na QVRSB. Ambos os grupos apresentaram menores escores do OIDP (p<0,001), sem diferença entre eles. Os escores dos domínios comer, limpar os dentes, sorrir e estado emocioal diminuíram após o tratamento para toda a amostra. Concluiu-se que o tratamento com microabrasão melhorou a QVRSB de indivíduos vivendo em uma área de fluorose endêmica independentemente da associação com o clareamento caseiro.

Abstract This study aimed to evaluate the effect on oral health-related quality of life (OHRQoL) of two treatment protocols for dental fluorosis in individuals enrolled in a randomized clinical trial. Seventy volunteers, who lived in a fluorosis endemic area in Brazil, and had at least four maxillary anterior teeth showing fluorosis with a Thylstrup and Fejerskov index from 1 to 7, were randomized into two treatment groups (n= 35): GI- enamel microabrasion; or GII- microabrasion associated with at-home bleaching. Microabrasion was performed using 37% phosphoric acid and pumice, and at-home tooth bleaching with 10% carbamide peroxide in a tray. Volunteers completed a questionnaire at baseline and 1-month post treatment to assess changes in OHRQoL, using the Oral Impact on Daily Performance (OIDP). Differences in overall impact scores between and within treatment groups were analyzed with Wilcoxon (within) and Mann-Whitney (between) tests. Changes in performance scores were analyzed using Wilcoxon tests (a< 0.05). One month after treatment, subjects reported improvement in OHRQoL. Both groups showed lower OIDP scores (p< 0.001), but there was no difference between them. Eating, cleaning teeth, smiling and emotional state performance scores were lower after treatment for the whole sample. In conclusion, the treatment with microabrasion improved the OHRQoL in this sample of individuals living in a fluorosis endemic area regardless of the addition of at-home bleaching.

Abstract This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child’s age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p < 0.001), whereas radiographic sequelae did not (0.236). The predicted risk of color change was 29.0% (95%CI 19–41) for teeth with enamel fracture, and 26.0% (95%CI 14–40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35–82) and those with subluxation (15.8% 95%CI 10–22). Risk of premature loss was 27.3% (95%CI 13–45) for teeth with extrusive luxation, and 10.2% (95%CI 5–17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.