ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers. Objective (MIH healthrelated health related (OHRQoL 10yearold yearold 10 year old parentscaregivers parents caregivers parents/caregivers Methods crosssectional cross sectional 40 810 8-1 out index malocclusion confounders p<0.05 p005 p 0 05 (p<0.05 Results 134 13 4 13.4% Parentscaregivers Parents wellbeing well being PR=1.92 PR192 PR 1 92 (PR=1.92 95%CI=1.163.19. 95CI116319 CI 95%CI=1.16 3.19 . 95 16 3 19 95%CI=1.16-3.19) PR=1.51 PR151 51 (PR=1.51 95%CI=1.032.23. 95CI103223 95%CI=1.03 2.23 03 2 23 95%CI=1.03-2.23) PR=4.19 PR419 (PR=4.19 95%CI=1.0616.49 95CI1061649 95%CI=1.06 16.49 06 49 95%CI=1.06-16.49 PR=3.21 PR321 21 (PR=3.21 95%CI=1.069.71. 95CI106971 9.71 9 71 95%CI=1.06-9.71) Conclusion Additionally selfperception self 81 8- p<0.0 p00 (p<0.0 13.4 PR=1.9 PR19 (PR=1.9 163 95%CI=1.163.19 95CI11631 95CI116 95%CI=1.1 319 3.1 95%CI=1.16-3.19 PR=1.5 PR15 5 (PR=1.5 032 95%CI=1.032.23 95CI10322 95CI103 95%CI=1.0 223 2.2 95%CI=1.03-2.23 PR=4.1 PR41 (PR=4.1 0616 95%CI=1.0616.4 95CI106164 95CI106 1649 16.4 95%CI=1.06-16.4 PR=3.2 PR32 (PR=3.2 069 95%CI=1.069.71 95CI10697 971 9.7 7 95%CI=1.06-9.71 p<0. p0 (p<0. 13. PR=1. PR1 (PR=1. 95%CI=1.163.1 95CI1163 95CI11 95%CI=1. 31 3. 95%CI=1.16-3.1 95%CI=1.032.2 95CI1032 95CI10 22 2. 95%CI=1.03-2.2 PR=4. PR4 (PR=4. 061 95%CI=1.0616. 95CI10616 164 16. 95%CI=1.06-16. PR=3. PR3 (PR=3. 95%CI=1.069.7 95CI1069 97 9. 95%CI=1.06-9.7 p<0 (p<0 PR=1 (PR=1 95%CI=1.163. 95CI1 95%CI=1 95%CI=1.16-3. 95%CI=1.032. 95%CI=1.03-2. PR=4 (PR=4 95%CI=1.0616 95CI1061 95%CI=1.06-16 PR=3 (PR=3 95%CI=1.069. 95%CI=1.06-9. p< (p< PR= (PR= 95%CI=1.163 95CI 95%CI= 95%CI=1.16-3 95%CI=1.032 95%CI=1.03-2 95%CI=1.061 95%CI=1.06-1 95%CI=1.069 95%CI=1.06-9 (p (PR 95%CI 95%CI=1.16- 95%CI=1.03- 95%CI=1.06-

ABSTRACT Objective: To estimate the prevalence of dental fear and evaluate its association with dental caries and with Molar Incisor Hypomineralization (MIH) in schoolchildren aged 11-14 years. Material and Methods: A cross-sectional study was conducted with 375 adolescents in Campina Grande, Brazil. Socioeconomic and oral health information was collected, while dental fear was measured using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS). The diagnosis of dental caries and MIH was performed by three trained examiners (κ ≥ 0.61) using the International Caries Detection & Assessment System – ICDAS II and a previously validated index, respectively. Data were descriptively analyzed using the Chi-Square, Fisher's Exact, and Poisson regression tests with robust variance (p<0.05). Results: The prevalence of dental fear was 18.4%, and the mean CFSS-DS total score was 28.96 ± 8.92. After adjusting for covariates family structure, schooling of parents/guardians, type of dental health service and dental pain in the last six months, the prevalence of dental fear was associated with dental pain in the last six months (PR=2.03; 95%CI=1.31-3.16; p=0.002). Conclusion: Although no association was found between dental fear, dental caries and MIH in adolescents, those who experienced dental pain in the last six months had a higher prevalence of dental fear. Objective (MIH 1114 11 14 11-1 years Methods crosssectional cross sectional 37 Grande Brazil collected Childrens Children s ScheduleDental Schedule Dental CFSSDS. CFSSDS CFSS DS . (CFSS-DS) κ 0.61 061 0 61 index respectively ChiSquare, ChiSquare Chi Square, Square Chi-Square Fishers Fisher Exact p<0.05. p005 p p<0.05 05 (p<0.05) Results 184 18 4 18.4% 2896 28 96 28.9 892 8 92 8.92 structure parentsguardians parents guardians parents/guardians PR=2.03 PR203 PR 2 03 (PR=2.03 95%CI=1.313.16 95CI131316 CI 95%CI=1.31 3.16 95 1 31 3 16 95%CI=1.31-3.16 p=0.002. p0002 p=0.002 002 p=0.002) Conclusion 111 11- (CFSS-DS 0.6 06 6 p00 p<0.0 (p<0.05 18.4 289 9 28. 89 8.9 PR=2.0 PR20 (PR=2.0 313 95%CI=1.313.1 95CI13131 95CI131 95%CI=1.3 316 3.1 95%CI=1.31-3.1 p000 p=0.00 00 0. p0 p<0. (p<0.0 18. 8. PR=2. PR2 (PR=2. 95%CI=1.313. 95CI1313 95CI13 95%CI=1. 3. 95%CI=1.31-3. p=0.0 p<0 (p<0. PR=2 (PR=2 95%CI=1.313 95CI1 95%CI=1 95%CI=1.31-3 p=0. p< (p<0 PR= (PR= 95CI 95%CI= 95%CI=1.31- p=0 (p< (PR 95%CI p= (p

Resumo Objetivo: Avaliar a relação entre os itens do questionário Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) e o sexo e a idade de crianças com níveis de medo odontológico moderado e elevado. Métodos: Estudo transversal, realizado em um município da região Nordeste do Brasil, com 185 crianças entre 8 e 10 anos, de ambos os sexos, que tiveram escore mínimo de 32 no questionário CFSS-DS, pontuação que configurava como com medo odontológico. Foi realizada a análise estatística descritiva, testes de Kolmogorov-Smirnov, U de Mann-Whitney e de Kruskal-Wallis. O nível de significância adotado foi de 5%. Resultados: A maioria das crianças era do sexo feminino (59,5%) e tinha 9 anos (37,3%). A média do escore total do CFSS-DS foi de 40,44 ± 6,81 (com mínimo de 32 e máximo de 75). De acordo com o CFSS-DS, 53,5% das crianças apresentaram elevado medo odontológico. Os itens: “Anestesia”, “Uma pessoa que você não conhece encostar em você”, “Motorzinho do dentista”, “Alguém colocar instrumentos na sua boca”, “Engasgar” e “Ter que ir para o hospital” apresentaram os maiores valores de mediana. Houve diferença significativa entre as crianças para o item “Uma pessoa que você não conhece encostar em você” (p=0,001). Conclusão: O item “Uma pessoa que você não conhece encostar em você” do questionário CFSS-DS apresentou diferença estatisticamente significante com a idade, não existindo diferenças nos demais itens em relação ao sexo.

Abstract Objective: To assess the relationship between the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire’s items and sex and age in children with moderate and high dental fear levels. Methods: Cross-sectional study carried out in a municipality in the Northeastern region of Brazil with 185 children aged 8-10 years of both sexes, who had a minimum score of 32 on the CFSS-DS questionnaire, corresponding to dental fear. Descriptive statistical analysis and the Kolmogorov-Smirnov, Mann-Whitney U, and Kruskal-Wallis tests were performed. The significance level adopted was 5%. Results: Most children were female (59.5%) and 9 years old (37.3%). The average of the total CFSS-DS score was 40.44 ± 6.81 (with a minimum of 32 and a maximum of 75). According to the CFSS-DS, 53.5% of children had high dental fear. Items “Injections,” “Having a stranger touch you,” “The dentist drilling,” “Having somebody put instruments in your mouth,” “Choking,” and “Having to go to the hospital” had the highest median values. A significant difference was observed between ages for the item “Having a stranger touch you” (p=0.001). Conclusion: The item “Having a stranger touch you” in the CFSS-DS questionnaire showed a statistically significant difference with age, while no differences were found regarding sex.

Abstract This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person’s Chi-square, Fisher’s exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians’ education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

RESUMO A síndrome respiratória aguda grave do novo coronavírus, SARS CoV-2, que se tornou uma pandemia, foi relatada pela primeira vez em Wuhan, Hubei, China em dezembro 2019. Pode acarretar sintomas leves, porém em alguns casos pode provocar graves complicações levando o indivíduo ao óbito. A doença se espalha através de gotículas de aerossol e tem um período de incubação do coronavírus estimado entre 2 e 14 dias (período este no qual o paciente tem alto potencial de infectar outras pessoas). Os endodontistas apresentam alto risco de exposição ao COVID-19 quando comparado a outros profissionais de saúde, pois a maior parte do trabalho envolve a geração de aerossóis e os atendimentos a pacientes em situações emergentes, como pulpite irreversível sintomática, periodontite apical sintomática, abscesso apical agudo e lesões dentárias traumáticas são imperativos. Dessa forma, essa revisão crítica aborda considerações sobre o atendimento endodôntico, nesta época de pandemia, cujas emergências imprimem necessidade real de tratamento, bem como os cuidados que devem ser adotados visando minimizar riscos tanto para o profissional quanto para os pacientes que buscam a resolução dos seus quadros clínicos de dor.

ABSTRACT The severe acute respiratory syndrome of the new coronavirus, SARS CoV-2, which became a pandemic, was first reported in Wuhan, Hubei, China, in December 2019. It can cause mild symptoms, but in some cases, it can cause serious complications, leading to death. The disease spreads through aerosol droplets and has an estimated incubation period between 2 and 14 days (a period in which the patient has high potential to infect other people). Endodontists have a high risk of exposure to COVID-19 when compared to other health professionals, since most of the work involves the generation of aerosols and care for patients in emergency situations, such as symptomatic irreversible pulpitis, symptomatic apical periodontitis, acute apical abscess and traumatic dental injuries, is imperative. Thus, this critical review addresses considerations about endodontic care in times of pandemic, whose emergencies imply a real need for treatment, as well as the care that must be adopted to minimize risks for both professionals and patients who seek the resolution of their clinical pain conditions.

Resumo O objetivo deste estudo foi investigar a prevalência de medo odontológico e avaliar sua associação com a cárie dentária e a Hipomineralização molar-incisivo (HMI), em escolares de 8 a 10 anos, em um município da região Nordeste do Brasil. Foram coletados dados de 466 estudantes matriculados em escolas públicas urbanas, em um estudo transversal. Os pais/responsáveis responderam a um questionário abordando características sociodemográficas, o medo odontológico foi mensurado por meio do Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), e os exames clínicos foram realizados por três examinadores calibrados para o diagnóstico de cárie dentária, utilizando o índice International Caries Detection & Assessment System (ICDAS II) e, por um índice previamente validado, para HMI. Foi realizada a análise descritiva dos dados e as associações entre medo odontológico, cárie dentária e HMI foram avaliadas pela regressão robusta de Poisson para amostras complexas (p<0,05). A prevalência de medo odontológico foi de 21,6%, e o escore médio total do CFSS-DS foi de 29,97 (IC 95%=29,05-30,89). No modelo multivariado ajustado, a prevalência de medo odontológico esteve associada à renda familiar (RP=1,78; IC 95%=1,02-3,08; p= 0,041). A renda familiar mensal foi associada ao medo odontológico em crianças, enquanto a cárie dentária e a HMI não foram associadas ao medo odontológico.

Abstract The aim of this study was to investigate the prevalence of dental fear and to evaluate its association with dental caries and molar incisor hypomineralization (MIH) in schoolchildren aged 8-10 years from a municipality in Northeastern Brazil. Data from 466 students enrolled in urban public schools in a cross-sectional study were collected. Parents/guardians answered a questionnaire addressing sociodemographic characteristics, dental fear was measured by means of the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and clinical examinations were performed by three calibrated examiners for diagnosis of dental caries, using the International Caries Detection & Assessment System - ICDAS II and a previously validated index for MIH. Descriptive data analysis was performed, and associations between dental fear, dental caries and MIH were analyzed using robust Poisson regression for complex samples (p<0,05). The prevalence of dental fear was 21.6%, and the mean total CFSS-DS score was 29.97 (CI 95%=29.05-30.89). In the multivariate adjusted model, the prevalence of dental fear was associated to family income (PR=1.78; CI 95%=1.02-3.08; p= 0.041). Monthly family income was associated with dental fear in children, whereas dental caries and MIH were not associated with dental fear.

The severe acute respiratory syndrome of the new coronavirus, SARS CoV-2, which became a pandemic, was first reported in Wuhan, Hubei, China in December 2019. It can cause mild symptoms, but in some cases it can cause serious complications, leading to death. The disease spreads through aerosol droplets and has estimated incubation period between 2 and 14 days (a period in which the patient has high potential to infect other people). Endodontists have high risk of exposure to COVID-19 when compared to other health professionals, since most of the work involves the generation of aerosols and care for patients in emergency situations, such as symptomatic irreversible pulpitis, symptomatic apical periodontitis, acute apical abscess and traumatic dental injuries, is imperative. Thus, this critical review addresses considerations about endodontic care in times of pandemic, whose emergencies imply real need for treatment, as well as the care that must be adopted in order to minimize risks for both professionals and patients who seek the resolution of their clinical pain conditions.

Abstract Objective: To analyze the use of continued-use medications by Brazilian children with microcephaly caused by Congenital Zika Virus Infection. Material and Methods: Cross-sectional study with 76 children of both genders. Information on age, use of continued-use medications, number and type of drugs used was collected. Data were analyzed using descriptive statistics. Results: Continued-use medications were used by 89.4% of the children, anticonvulsants / antiepileptics (88.1%), and those indicated for behavioral disorders (27.1%) were the most frequent. Sodium saccharin, sucrose, and sorbitol are the most common sugars in the composition of these drugs. Conclusion: The use of medicines is high, predominantly anticonvulsants and antiepileptics, which contain sugars in their composition. These drugs can lead to irreversible dental problems, such as tooth decay if proper oral hygiene is not present. Therefore, parents/guardians should be advised about adopting healthy oral hygiene habits after the administration of these drugs.

RESUMO Objetivo: Analisar comportamentos de risco para bulimia em adolescentes do sexo feminino de escolas públicas e particulares. Métodos: Estudo transversal com amostra aleatória de 850 estudantes do sexo feminino, com idades entre 15 e 18 anos, realizado em cidade do Nordeste do Brasil, utilizando o Bulimic Investigatory Test of Edinburgh (BITE) para avaliar comportamentos de risco para transtornos alimentares. Os dados foram analisados utilizando o teste do qui-quadrado de Pearson, o teste exato de Fisher e a regressão de Poisson, com o software Statistical Package for the Social Sciences (SPSS), adotando o nível de significância de p<0,05. Resultados: Da amostra estudada, 42,0% apresentou padrões de risco e práticas de dieta e controle de peso e 1,4% já apresentava sinais de bulimia instalados. O medo de ganhar peso foi relatado por 62,8% das adolescentes. As práticas de risco foram menos frequentes em estudantes de escolas públicas (Odds Ratio - OR - 0,82; intervalo de confiança de 95% - IC95% - 0,69-0,97). Entre as práticas restritivas, jejum por um dia inteiro foi o mais aplicado pelas participantes (29,9%). Entre os indivíduos com situação de risco, quase metade acreditava ter hábitos alimentares normais (razão de prevalência - RP - 0,42; IC95% 0,36-0,49). Estudantes que consideram seus hábitos alimentares normais, que têm medo de ganhar peso, que procuram conforto emocional em alimentos e seguem dietas rigorosas tiveram maior risco para bulimia (p<0,05). Conclusões: O número de estudantes com práticas de comportamento de risco para bulimia é alto, e o número daquelas que desconhecem essa situação também é muito alto. As situações de risco emergem como problemas de saúde coletiva, e indivíduos de escolas particulares são mais propensos a apresentar transtornos alimentares.

ABSTRACT Objective: To analyze the risk behavior for bulimia among female adolescents from public and private high schools. Methods: A cross-sectional study with a random sample of 850 female students aged 15-18 years was carried out in a city in northeastern Brazil, using the Bulimic Investigatory Test of Edinburgh (BITE) to assess the risk behavior for bulimia. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software and the Pearson’s chi-square , Fisher’s exact and robust Poisson regression tests, adopting the significance level of 5%. Results: Less than half of the sample (42.0%) showed standards of dietary risk and weight control practices; in 1.4% of the sample, bulimia signs were already installed. Fear of gaining weight was reported by 62.8% of the subjects. Risk practices were lower among students from public schools; (Odds Ratio - OR - 0.82; confidence interval of 95% - 95%CI - 0.69-0.97). Among restrictive practices, fasting for a whole day was the most applied (29.9% of the students). Among individuals who were at risk situation, almost half believed to have normal eating habits (prevalence ratio - PR - 0.42; 95%CI 0.36-0.49). Individuals who consider their eating habits normal, who are afraid of gaining weight, those who seek emotional comfort in food and follow strict diets had higher risk for bulimia (p<0.05). Conclusions: The number of female adolescent students with risk behavior practices for bulimia is high, and the frequency of those unaware of this situation is also very high. Risk situations emerge as a collective health problem, and individuals from private schools were more likely to be in this situation.

Abstract Objective: To evaluate in situ the effect of toothpastes containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate associated to fluoride (CPP-ACPF) on initial erosion prevention. Material and Methods: Bovine enamel blocks (n = 192) were randomly assigned into 4 phases according to the baseline surface hardness: GI: CPP-ACP Paste (MI Paste™), GII: CPP-ACPF Paste (MI Paste Plus™), GIII: Fluoridated paste and GIV: Placebo Paste. In each of the 4 crossover phases, twelve volunteers wore intraoral palatal appliances containing 4 enamel blocks for 2 hours, then the tested treatments were applied intraorally (3 min) and the appliance was maintained in the mouth for another 3 hours. After, the appliances were removed and immersed in hydrochloric acid (0.01 M, pH 2.3) for 30 seconds to promote erosive demineralization. The final surface hardness was evaluated and percentage of surface hardness loss was calculated. The data were analyzed by ANOVA and Tukey’s test (α = 5%). Results: The application of CPP-ACP paste, independent of fluoride content, resulted in significant lower enamel hardness loss (GI: 9.26% ±3.48 and GII: 9.14% ±1.73) compared to NaF (GIII: 15.5% ± 3.94) and placebo (GIV: 16.7% ± 4.07) pastes, which did not show difference between them. Conclusion: The CPP-ACP pastes were able to reduce initial erosive demineralization in relation to fluoride and placebo pastes. Nevertheless the formulation of CPP-ACP with fluoride did not provide an additional benefit.

RESUMO Objetivo Avaliar os hábitos de higiene oral, assim como a prevalência de cárie e erosão dentária em adolescentes em Campina Grande, Paraíba. Métodos Estudo transversal, com amostragem probabilística por conglomerado, envolvendo 201 escolares de 15 anos. Os hábitos de higiene oral foram obtidos por meio de questionário, e os dados socioeconômicos por entrevista. Adotou-se o índice CPO-D (Cariados, Perdidos e Obturados) para determinação da prevalência de cárie e o proposto por O’Sullivan, para avaliação da erosão dentária. Os dados foram analisados por meio do Statistical Package for the Social Sciences (SPSS) versão 18. Adotou-se um nível de significância de 5%. Resultados Todos os adolescentes relataram o uso de escova dental e dentifrício, 50,7% reportaram o uso do fio dental, sendo verificada associação entre o sexo e uso de enxaguatório bucal (p<0,05). Em relação à cárie, o CPO-D médio foi de 3,67 e 51,7% possuíam CPO-D inferior ou igual a 3. No tocante à erosão dentária 18,4% da amostra apresentava lesão erosiva, predominando lesões em esmalte (92%). Conclusão O uso do fio dental foi baixo e os adolescentes revelaram possuir índice insatisfatório. O CPO-D foi moderado e abaixo do relatado para a faixa etária brasileira. A prevalência de erosão dentária foi elevada, com lesões predominantes em esmalte.

ABSTRACT Objective To assess oral hygiene habits, and prevalence of dental caries and erosion in adolescents of Campina Grande, Paraíba, Brazil. Methods Cross-sectional study with random cluster sampling involving 201 15-year-old schoolchildren. Oral health habits were obtained through questionnaire, and socioeconomic data, by means of interviews. The DMFT index was adopted to determine the prevalence of caries and that proposed by O’Sullivan, to assess dental erosion. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 18. A 5% significance level was adopted. Results All subjects reported using toothbrush and toothpaste, 50.7% reported dental flossing, and association was found between sex and use of mouthwash (p <0.05). Regarding dental caries, the mean DMFT was 3.67 and 51.7% had DMFT lower than or equal to 3. For dental erosion, 18.4% of the sample had erosive lesions, predominantly enamel lesions (92%). Conclusion The use of dental floss was low and adolescents revealed unsatisfactory index. The DMF-T value was moderate and lower than that reported for the Brazilian age group. The prevalence of dental erosion was high, with predominance of enamel lesions.