Má-oclusão, necessidade de tratamento ortodôntico e qualidade de vida em escolares de 8 a 12 anos: um estudo transversal na cidade de Pelotas/RS/Brasil

• Autor(a) principal: Simões, Roberto Cuchiara
• Data de Publicação: 2012
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFPel - Guaiaca
• Texto Completo: http://guaiaca.ufpel.edu.br/handle/123456789/2267
• topic: Epidemiologia; Má-oclusão; Qualidade de vida.; Epidemiology; Malocclusion; Quality of life.; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA::ODONTOPEDIATRIA

Malocclusions are highly prevalent in children and adolescents may cause impacts in their daily life as well as be expensive due to the treatments, therefore being considered as a public health problem. Thus, the purposes of this study are: to carry out a literature review addressing the main orthodontic treatment need indexes to be used in epidemiological studies in the mixed dentition stage and, perform a survey, in 8-12-years-old schoolchildren in Pelotas/RS, to check the prevalence of malocclusion and the orthodontic treatment need relating them to demographics and socioeconomics factors, as well as estimate the impact of malocclusion in oral health related to quality of life (OHRQoL). For this cross-sectional study, a minimum stratified random sample of 922 children was estimated for 20 schools (municipal, state and private). The data collection was composed of: questionnaire sent to the parents obtain socioeconomics variables; interview with the children to collect, among other information, demographic data and to apply the Child Perceptions Questionnaire (CPQ); oral clinical examination of the children for malocclusion, orthodontic treatment need (Dental Aesthetic Index - DAI), for dental caries (CPOD index) and for dental traumas (O Brien s index). For data analysis, association between malocclusion, orthodontic treatment need and independent variables was tested using univariate and bivariate analysis. To investigate the independent association of the expositions in the presence of malocclusion and the impact in the quality of life of the children, multiple logistic regression models were used, estimating the odds ratio and their respective confidence intervals (95%). The literature review showed that, despite the lack of an ideal index to be used in mixed dentition stage, the DAI advantages seem to overcome its limitations enabling it to be used for such purpose. In the epidemiological survey developed with 1,206 children, the prevalence of malocclusion was 83,7%. Spacing in the anterior width (50,4%) and crowding (35,9%) were the most prevalent malocclusions. The orthodontic treatment need was higher in the younger children (8 to 10 years old) (44,60%) and lower in the older ones (11 and 12 years old) (35.01%).A decrease was observed, as aging occurred, of the proportion of children with anterior segment spacing, median diastema and anterior open bite. Concerning sex, a higher prevalence of anterior segment spacing and median diastema in the boys was observed, whereas the prevalence of anterior open bite was higher among the girls. An association with the social and emotional well-being CPQ domains and the DAI scores in 11-12-year-old children was noticed. In the crude analysis for CPQ8-10 and CPQ11-14, the presence of very severe malocclusion influenced the OHRQoL of the schoolchildren. When adjusted for clinical and social economical variables, the very severe malocclusion effect was confirmed. The results show high prevalence of malocclusion and orthodontic treatment need and, that very severe malocclusion was associated with greater negative impact on OHRQoL (especially in the domains of emotional and social well-being) mostly in the 11-12-year-old children if compared to the 8-10-year-old children.