OBJECTIVES: This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS: A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg’s organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer’s instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS: A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION: In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.

RESUMOO objetivo do estudo foi determinar a prevalência de sinais e sintomas de disfunção temporomandibular (DTM), segundo o nível de ansiedade de adolescentes da cidade de São Roque-SP. Foi utilizado o Índice de Fonseca para determinar a presença e o grau de severidade da DTM. Para avaliar o nível de ansiedade, foi utilizado o Inventário de Ansiedade Traço-Estado. Os participantes foram 3538 adolescentes entre 10 e 19 anos. Os resultados revelaram que 73,3% dos adolescentes apresentavam DTM e 72,7%, apresentavam ansiedade. Foram observadas associações estatisticamente significativas entre a presença de DTM e a presença de ansiedade, mas apenas com o sexo feminino, e correlação positiva, embora baixa, entre o grau de DTM e o nível de ansiedade. Conclui-se que adolescentes do sexo feminino apresentam maior chance de desenvolver DTM que os do sexo masculino, e quanto maior o nível de ansiedade do adolescente, maior a chance de desenvolver DTM.

ABSTRACTThe aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorder (TMD), according to the level of anxiety in adolescents in the city of São Roque-SP. The Fonseca Index was used to determine the presence and severity of TMD. To assess the level of anxiety the State-Trait Anxiety Inventory it was used. The participants were 3,538 adolescents with ages varying between 10 and 19 years. The results revealed that 73.3% of the adolescents had TMD, and that a "slight" degree of TMD was the most prevalent category. Anxiety was present in 72.7% of the adolescents. The analysis showed the existence of a significant association among female students between the presence of TMD and anxiety. A significant positive correlation was observed between the degree of TMD and the level of anxiety. The results indicate that female adolescents have a higher chance of developing TMD than male adolescents, and that the chance of developing TMD augments with the level of anxiety.

OBJETIVO: avaliar se há relação entre bruxismo e presença de ruídos articulares em crianças. MÉTODOS: participaram do estudo 48 crianças entre 6 e 9 anos atendidas na Clínica Infantil da Faculdade de Odontologia da Universidade Nove de Julho. Foram selecionadas 21 crianças com bruxismo e 27 crianças no grupo controle. Um único examinador previamente treinado e "cego" em relação aos grupos realizou exame de palpação manual e auscultação bilateral das Articulações Temporomandibulares com a utilização de estetoscópio, extra-auricular lateral e dorsal para a análise dos ruídos articulares, diferenciando-os em crepitação e estalidos. Foi realizado o número mínimo de 3 repetições nas mensurações dos ruídos para cada criança. Foram realizadas as análises descritivas de todas as variáveis e o teste qui-quadrado foi utilizado para avaliar a associação entre as variáveis, adotando-se um nível de significância de 5%. RESULTADOS: em relação à presença de ruído 37,5% (n=18) apresentaram algum tipo de ruído articular, sendo que 72,2% (n=13) apresentaram estalido e 27,8% (n=5) apresentaram crepitação. Das 18 crianças que apresentaram algum tipo de ruído, 66,7% (n=12) também eram bruxistas. Foi observada associação estatisticamente significante entre a presença de ruído e bruxismo. Ao analisar a associação entre ruído e as variáveis gênero e idade, o grupo estudado não houve associação entre ruído e gênero, porém em relação à idade, houve uma maior porcentagem de crianças sem a presença de ruído articular aos 6 anos de idade, sendo estatisticamente significante. CONCLUSÃO: os dados do presente estudo mostraram associação entre bruxismo e ruídos articulares em crianças.

PURPOSE: the aim of the present study was to determine whether bruxism is associated with joint sounds in children. METHODS: children aged six to nine years were recruited from the pediatric clinic of the School of Dentistry of University Nove de Julho (Brazil). Twenty-one children with bruxism and 27 children without this condition (control group) were selected. The evaluation was performed by a previously trained examiner who was blinded to the allocation of the groups and involved manual palpation as well as lateral and dorsal extra-auricular auscultation of the temporomandibular joints with the aid of a stethoscope for the determination of joint sounds, differentiating a click/pop from crepitus. At least three readings were performed on each child. Descriptive statistics were conducted and the chi-square test was used to test associations among the variables, with the level of significance set to 5% (p < 0.05). RESULTS: a total of 37.5% (n = 18) of the sample exhibited some type of joint sound. Among these children, 72.2% (n = 13) exhibited a click/pop and 27.8% (n = 5) exhibited crepitus. Among the 18 children with joint sounds, 66.7% (n = 12) also had bruxism. A statistically significant association was found between joint sounds and bruxism. No association was found between joints sounds and sex. However, a significant association was found with regard to age, as a greater percentage of children at six years of age had no joint sounds. CONCLUSION: the present findings demonstrate an association between bruxism and joint sounds in children.

Objectives: Compare the effectiveness of PapacarieTM gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings. Material and Methods: A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with PapacarieTM and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations. Results: No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment. Conclusion: PapacarieTM is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia.

Objetivo verificar se existe relação entre a presença de disfunção temporomandibular (DTM) relacionada à variabilidade da dimensão vertical de oclusão em crianças e adolescentes na faixa etária de 7 a 12 anos. Métodos foram avaliadas 96 crianças e adolescentes do Instituto Rogacionista em São Paulo. A pesquisa diagnóstica da disfunção temporomandibular foi por meio do Índice de Helkimo e exame clínico posterior. Para a mensuração dos dados referentes à dimensão vertical foram empregadas as distâncias comissura labial - canto externo do olho e base do nariz – mento. A comparação dos valores médios das medidas antropométricas entre os gêneros e os grupos com e sem disfunção temporomandibular foi realizada empregando-se a análise de variância (ANOVA) complementada pelo teste least significance diference. Resultados a dimensão vertical de oclusão demonstrou medidas distintas nas crianças e adolescentes em todas as faixas etárias avaliadas, foram observadas alterações significantes dessa medida nas idades de 10 e 12 anos de ambos os gêneros. Conclusão pode -se concluir que na amostra estudada houve relação direta entre a presença  de DTM e  Dimensão vertical de oclusão (DVO), correlação positiva entre as medidas  comissura labial – canto do olho externo e Násio – Mento no sexo feminino e alterações significantes na dimensão vertical de oclusão nas idades de 10 e 12 anos para ambos os sexos.

Purpose to establish the relationship between the presence of temporomandibular disorders and variability of vertical dimension of occlusion aged between 7 and 12 years. Methods it was analyzed 96 children and adolescents of Rogacionista Institute in Sao Paulo, Brazil. The diagnostic investigation of temporomandibular disorders was through Helkimo index and subsequent clinical examination. To measure the data on the vertical dimension were employed distances labial - corner of his eye and nose base - ment. To compare the mean values of anthropometric measurements between genders and the groups with and without TMD, we used analysis of variance (ANOVA) complemented by least significance diference test. Results the vertical dimension of occlusion showed distinct measures in children and adolescents in all age groups studied, significant changes were observed for this measure at ages 10 and 12 years of both genders. Conclusion we can conclude that in this sample there was a direct relationship between TMD and DVO, positive correlation between the measures lip commissure – corner of eye and nasium - mentum in females and significant changes in the vertical dimension of occlusion at the ages of 10 and 12 years for both sexes.

OBJECTIVES: The aim of the present study was to analyze the efficacy of Papacarie¯ gel compared with the traditional method (low-speed bur) in reducing the counts of total bacteria, Lactobacillus, total Streptococcus and Streptococcus mutans group. METHODS: A randomized, controlled clinical trial with a split-mouth design was performed. The sample comprised 40 deciduous teeth in 20 children (10 males and 10 females) aged four to seven years. The teeth were randomly allocated to two groups: G1, or chemomechanical caries removal with Papacarie Duo¯, and G2, or the removal of carious dentin tissue with a low-speed bur. Infected dentin was collected prior to the procedure, and the remaining dentin was collected immediately following the removal of the carious tissue. Initial and final counts of bacterial colonies were performed to determine whether there was a reduction in the number of colony-forming units (CFUs) of each microorganism studied. ClinicalTrials.gov: NCT01811420. RESULTS: Reductions were found in the numbers of total bacteria, total Streptococcus and Streptococcus mutans group following either of the caries removal methods (p<0.05). A reduction was also noted in the number of Lactobacillus CFUs; however, this difference did not achieve statistical significance (p>0.05). CONCLUSION: Papacarie¯ is an excellent option for the minimally invasive removal of carious tissue, achieving significant reductions in total bacteria, total Streptococcus and S. mutans with the same effectiveness as the traditional caries removal method.

AIM: To assess the influence of dental etching on the shear strength of different glass ionomer cements. METHODS: The crown of 60 bovine incisors was prepared to obtain a flat, smooth surface, were attached to a PVC tube and randomly divided into six groups: Group 1 - Riva Self Cure without etching; Group II - Riva Self Cure with pre-etching; Group III - Maxxion R without etching; Group IV - Maxxion R with pre-etching; Group V - KetacTM Molar Easymix without etching; and Group VI - KetacTM Molar Easymix with pre-etching. Etching was performed with 10% polyacrylic acid for 30 s. A standardizing device was used for preparation of the test specimens (SBS Test Method). Following preparation, the specimens were stored in distilled water at 37° C for 24 h. The shear test was performed on a Kratos universal testing machine at a crosshead speed of 0.5 mm/min. The specimens were then viewed under a stereomicroscope at a magnification of x90 for analysis of fractures. RESULTS: The results revealed that pre-etching increased the shear strength of Riva glass ionomer cement (SDI) alone, whereas no statistically significant differences were found with regard to the other materials tested. CONCLUSIONS: Pre-etching with 10% polyacrylic acid for 30 s increased the shear strength of Riva glass ionomer cement.

AIM: To evaluate the clinical status of permanent first molars and associations with dental caries, gingival bleeding, dental fluorosis and malocclusion. METHODS: An observational study was carried out in a rural community denominated Morro do Saboó in the city of São Roque, state of São Paulo, Brazil. A total of 194 children aged seven to ten years were examined for dental caries using the index proposed by the World Health Organization. Other conditions were determined using the Gingival Alterations Index, Dean's Index and Dental Aesthetic Index. The chi-squared test was used for the statistical analysis of the data. RESULTS: A total of 85.5% of the sample exhibited gingival bleeding and 69.9% exhibited malocclusion. A total of 53.6% had a clinical aspect of normality with regard to dental fluorosis. There was a predominance of sound teeth in the upper arch and teeth with carious lesions in the lower arch. No significant differences were found between sexes regarding gingival bleeding, dental fluorosis or malocclusion. Significant associations were found between tooth status and oral alterations (gingival bleeding, malocclusion and fluorosis) in teeth 16, 26 and 46 and between tooth status and gingival bleeding in tooth 36 (p<0.001). CONCLUSIONS: Caries activity in the permanent first molars was mainly associated with dental fluorosis and malocclusion. Strategies aimed at health promotion should be adopted on a large scale to minimize the prevalence of oral diseases.

OBJECTIVE: To determine whether there is a correlation between halitosis and mouth breathing in children. STUDY DESIGN: Fifty-five children between 3 and 14 years of age were divided into two groups (nasal and mouth breathing) for the assessment of halitosis. A descriptive analysis was conducted on the degree of halitosis in each group. The chi-square test was used for comparison between groups, with a 5% level of significance. RESULTS: There was a significantly greater number of boys with the mouth-breathing pattern than girls. A total of 23.6% of the participants had no mouth odor, 12.7% had mild odor, 12.7% had moderate odor and 50.9% had strong odor. There was a statistically significant association between halitosis and mouth breathing. CONCLUSIONS: The occurrence of halitosis was high among the children evaluated, and there was a statistically significant association between halitosis and mouth breathing.

OBJETIVO: avaliar e comparar a postura de cabeça e pescoço e a relação com a classe oclusal, entre crianças respiradoras orais e respiradoras nasais. MÉTODOS: realizou-se um estudo observacional, de corte transversal em que participaram 110 crianças divididas em Grupo I: respiradoras nasais e Grupo II: respiradoras orais. Para avaliação da respiração utilizou-se o teste do vapor no espelho e água na boca, e exame clínico intra-oral para classificação oclusal de Angle. A análise da postura foi realizada por meio de fotogrametria e o software Alcimage® para mensuração do ângulo pré-definido pelos pontos Processo Espinhoso da sétima vértebra cervical, Manúbrio do Esterno e Ápice do Mento. Os dados obtidos foram tabulados e submetidos à análise estatística, utilizando o programa SPSS 12.0, num intervalo de confiança de 95%. RESULTADOS: foi possível observar valores significativamente maiores do ângulo cervical para o Grupo II (96,59º±8,79) quando comparado ao Grupo I (86,60º±8,53) (p<0,001). As crianças respiradoras orais apresentaram oclusão classe II de Angle (p<0,05). Os participantes classe II apresentaram maior ângulo cervical, diferindo estatisticamente dos pacientes classe I (p<0,05). CONCLUSÃO: existe relação entre respiração oral, alteração na postura da cabeça e pescoço e oclusão classe II de Angle nas crianças estudadas, sendo a anteriorização da cabeça a alteração mais evidente em crianças respiradoras orais.

PURPOSE: to evaluate and compare head and neck posture, and the relationship between occlusal class, among mouth and nasal breathing children. METHODS: an observational, cross-sectional study was carried out, in which 110 children took part. These were divided into Group I: nasal breathers, and Group II: mouth breathers. For evaluating the respiration, we used mirror clouding and filling the mouth with water tests, with intrabuccal clinical exam for the Angle occlusal classification. Posture analysis was carried out by means of photogrammetry, and the software Alcimagem® was used to measure the predefined angle by the protuberances of the Spinous Process of the 7th Cervical Vertebra, Manubrium of the sternum and Mentum Vertex. The obtained data were tabulated and submitted to a statistical analysis, using the program SPSS 12.0 with a 95% confidence interval. RESULTS: a larger cervical angle was observed for Group II (96.59º±8.79) than for Group I (86.60º±8.53), showing statistically significant differences (p<0.001). The majority (68.5%) of the mouth breathing individuals presented class II occlusion Angle, and this relationship was significant (p<0.05). The class II individuals showed a larger cervical angle, differing statistically from the class I patients (p<0.05). CONCLUSION: it may be concluded that there is a connection between mouth breathing, alteration in head and neck posture and class II occlusal Angle in the studied children. In mouth breathing subjects, forward inclination of the head is predominant.