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Development and validation of a questionnaire about fluoride knowledge
(2025) Cardinali, Ana Beatriz Alonso Civitarese; Leite, Karla Lorene de França; Silva, Kenderson Santos; Jural, Lucas Alves; Rocha, Deborah Rackel Caldas da; Perazzo, Matheus França; Cury, Jaime Aparecido; Faria, Lucianne Cople Maia de
To develop and validate a questionnaire about fluoride knowledge (FKQ). Methods: Questions to evaluate knowledge about fluoride sources and daily fluoridated water and dentifrices consumption were developed and validated. Sociodemographic data were also collected from the participants, and data were collected for testing their psychometric properties and instrument validation. The model adjustment was tested in 456 dentists, students, and health personnel via confirmatory factor analysis (CFA) with unidimensional categorical indicators. Cronbach’s alpha coefficient was used to estimate the instrument’s reliability. External validation measurements were represented by questions related to sociodemographic data, fluoride source knowledge and daily practices, and the consumption of fluoride water and dentifrices. Results: The model showed adequate fit via confirmatory factor analysis (CFA); the fit indices were comparative fit index (CFI) = 0.941, Tucker‒Lewis index (TLI) = 0.927, and root mean square error of approximation (RMSEA) = 0.075, with factorial loadings varying between 0.25 and 0.91. The Cronbach's alpha coefficient for the 13 items was 0.68, demonstrating substantial and adequate reliability in the total instrument. Conclusion: The FKQ can estimate the knowledge of dentists, dental students, and health personnel about fluoride use.
Translation, adaptation, and preliminary psychometric evaluation of the PoSSe scale into brazilian portuguese
(2025) Maferano, Eduardo Frederico Eduardo; Cetira Filho, Edson Luiz; Perazzo, Matheus de França; Firmino, Ramon Targino; Granville-Garcia, Ana Flávia; Carvalho, Abrahão Cavalcante Gomes de Souza; Silva, Paulo Goberlanio de Barros; Ogden, Graham Richard; Costa, Fábio Wildson Gurgel
This study aimed to cross-culturally adapt the PoSSe scale to Brazilian Portuguese and conduct a preliminary evaluation of its content validity, internal consistency, reliability, and reproducibility. A methodological and observational study was conducted following a five-stage protocol for scale adaptation. The sample consisted of 48 patients who underwent lower third molar surgery, with a mean age of 24.06 years (SD = 6.73), predominantly female (60.4%), recruited from the School of Dentistry at the Federal University of Ceará. The patients completed the translated version of the PoSSe scale and were interviewed to assess item comprehension. Data analysis included descriptive statistics, internal consistency (Cronbach’s alpha), item-total correlation, and exploratory factor analysis. The translation and back-translation processes were consistent, with minor discrepancies resolved. Interviews confirmed the clarity of the items, requiring no further adjustments. The scale demonstrated adequate internal consistency (Cronbach’s alpha: D2 = 0.856, D3 = 0.883, and D7 = 0.910) across different assessment periods. Factor analysis reduced the number of factors to four domains. The PoSSe scale domain scores showed a positive correlation with the overall scale, except for the “sensation” domain on the second day (p = 0.792). In conclusion, the PoSSe scale was successfully translated and adapted to Brazilian Portuguese, demonstrating preliminary evidence of content validity, internal consistency, and reliability. However, further studies with more diverse samples are needed to assess its psychometric properties fully
Structural analysis of socioeconomic factors and school jet lag in traumatic dental injury among children
(2025) Bernardino, Veruska Medeiros Martins; Lima, Larissa Chaves Morais de; Neves, Érick Tássio Barbosa; Perazzo, Matheus de França; Paiva, Saul Martins de; Granville-Garcia, Ana Flávia
The objective of this study was to analyze the directions by which school jet lag is associated with traumatic dental injury in children, evaluating direct and indirect effects of socioeconomic factors and sleep. A representative, population-based, cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians answered a sociodemographic questionnaire, the Sleep Disturbance Scale for Children and the Circadian Energy Scale. Four examiners underwent training and calibration exercises for the diagnosis of traumatic dental injury (K > 0.80) using the criteria proposed by Andreasen (2007). Descriptive analysis was followed by structural equation modeling to determine direct and indirect associations between the variables incorporated into the theoretical model. School jet lag [standardized coefficient (SC): -0.238, 95%CI: -0.390–0.087], income (SC: -0.151, 95%CI: 0.0010–0.292), and number of residents in the home (SC: -0.109, 95%CI: -0.212–0.007) were directly associated with traumatic dental injury, whereas sleep disturbances and schooling of the parents/guardians exerted an indirect effect. Sociodemographic factors and school jet lag were associated with traumatic dental injury in children eight to ten years of age.
Risk and protective factors in early childhood development: a scoping review
(2025) Martins, Isabela Melo; Perazzo, Matheus França; Faria, Patricia Corrêa de; Santos, Ingrid Garcia; Mateus, Ana Cláudia; Silva, Amanda Meira Fernandez; Tavares, Naraiana de Oliveira; Costa, Luciane Ribeiro de Rezende Sucasas da
Objectives: mapping evidences on risk and protective factors associated with early childhood development in Brazilian children. Methods: a scoping review was conducted. The databases used were: PubMed, Embase, BVS, Cochrane, APA PsycNet, ProQuest Library, and gray literature, searched on 04/23/2024, covering publications from 2015 to 2024. Searched descriptors: “Child preschool” OR Infant OR pediatric OR pediatric) AND (“child development” OR “mental health” OR “child guidance”) AND (“Protective Factors” OR “Risk Factors”). Extracted information included the main author, year of publication, study design, study location, participants (number and age), and identified risk and protective factors. Out of a total of 6,812 documents, 24 were included. Results: a total of 43 risk factors and 15 protective factors in early childhood development were identified. The most frequently cited risk factors were socioeconomic vulnerability (n=10), low parental schooling (n=3), males (n=5) and teenage pregnancy (n=2). In contrast, the most cited protective factors included a supportive environment (n=3), higher family income (n=2), and higher maternal schooling (n=2). Conclusion: early childhood development in Brazilian children is positively influenced by factors such as a supportive family environment, higher income and maternal schooling. On the other hand, low parental schooling, teenage pregnancy and males, negatively impact in this development.
Semantic equivalence of an instrument to assess mothers/caregivers beliefs about early childhood caries
(2025) Souza, Kethlen Sara Correa de; Miranda, Juliana Freire-Maia; Clementino, Luna Chagas; Perazzo, Matheus de França; Garcia, Brenda Heaton Raul; Paiva, Saul Martins; Martins Júnior, Paulo Antônio
The knowledge and beliefs can affect the behavior of parents about preventive oral care of their children. Aim: This study aimed to perform the semantic equivalence of an instrument that assesses beliefs, knowledge, behaviors and barriers to oral care of mothers/caregivers about early childhood caries in their children aged 0 to 5 years between the original English version and the Brazilian Portuguese language version. Methods: Conceptual and item equivalence were initially performed. Following, semantic equivalence was evaluated according to the following steps: (1) translations of the instrument into Brazilian Portuguese, performed by two independent translators (both native in Brazilian Portuguese and fluent in English); (2) unification of the two translations by an expert committee; (3) two back-translations performed by two independent translators (both native in English and fluent in Brazilian Portuguese); (4) unification of the two back-translations by an expert committee; (5) unified back-translated version sent to the authors of the original instrument for evaluation; (6) committee review; (7) pre-test in a group of 20 Brazilian mothers/caregivers of children aged 0 to 5 years; (8) review and final version of the instrument in Brazilian Portuguese. Results: All items adequately reflected the Brazilian culture. Small divergences were found during translations and back-translations, and the expert committee chose the versions that would best fit into Brazilian culture. Pre-test also brought important insights to the process. All changes made were presented and approved by the original authors. Conclusion: The semantic equivalence allowed the development of a Brazilian Portuguese version of the instrument semantically equivalent to the original version.
Structural validity and measurement invariance of the scale of oral health outcomes for 5‐year‐old children
(2025) Perazzo, Matheus de França; Granville-Garcia, Ana Flávia; Delmônico, Bianka Fernandes; Sherriff, Andrea; Paiva, Saul Martins de; Celeste, Roger Keller; Tsakos, Georgios
Background: Important psychometric approaches (structural validity, measurement invariance) remain underdeveloped inmeasuring oral health-related quality of life, particularly for preschool children across diverse contexts.Aim: This study aimed to evaluate the structural validity of the child's self-reported version of the Scale of Oral Health Outcomesfor 5-year-old children (SOHO-5) and test the measurement invariance from cultural and clinical/non-clinical comparisonperspectives.Design: Three datasets were analysed: two from Brazil and one from the United Kingdom (UK). One Brazilian dataset wasderived from clinical data collection (nbr- cl. = 193), while the others were from non-clinical epidemiological school-based studies(nbr-ncl. = 768, nuk-ncl. = 296). Dimensionality was tested through parallel analysis and confirmed by unidimensional indexes.Measurement invariance across datasets was tested via multi-group Confirmatory Factor Analysis (CFA).Results: Unidimensionality was empirically confirmed for all three datasets. The multi-group CFA tests reached partial scalarinvariance threshold between the Brazilian and UK non-clinical datasets. However, there was no scalar equivalence when com-paring non-clinical with clinical datasets, neither within Brazil nor between countries.Conclusion: The child's self-reported version of the SOHO-5 is a unidimensional oral health-related quality-of-life measure thatis psychometrically comparable across different cultures (partial scalar invariance), but not between clinical and non- clinical groups.
Refining scale measurement: reassessing oral impacts on daily performances properties with item response theory
(2025) Celeste, Roger Keller; Perazzo, Matheus de França; Tsakos, Georgios; Reichenheim, Michael Eduardo
Objectives: Many oral health-related quality of life instruments have been developed but few have undergone a comprehensivepsychometric assessment. One commonly used measure is the Oral Impact on Daily Performance (OIDP). This study revised theconfigural and metric properties as well as the performance of items based on Item Response Theory (IRT) of a dichotomous-item version of OIDP in Brazil.Methods: The nine-item dichotomous version of the OIDP was analysed using data from a nationally representative samplefrom the Oral Health Survey (SBBrasil 2010). It consisted of 30 064 individuals aged 12 to 75 and was split into two partitionscomprising n 1 = 20 040 and n 2 = 10 024, respectively. Confirmatory factor analyses (CFA) were conducted on the larger partitionand cross-validated on the smaller to assess configural and metric properties. The item performance was evaluated using a2-parameter item response theory (IRT) model. Sampling weights were used in all analyses.Results: The unidimensional model presented two violations of conditional independence, one between items i5 (practisingsports) and i4 (going out) and another between items i6 (trouble in speaking) and i7 (shame of speaking or smiling). A CFA of themost parsimonious model (removing i5, i6 and i7) yielded a RMSEA = 0.02, WRMR = 1.42, CFI = 0.99 and TLI = 0.99. The IRTanalyses showed that three pairs of items had very similar levels of difficulty and discrimination suggesting redundancy.Conclusions: A shorter dichotomous version of the OIDP scale has acceptable configural and metric properties. Being moreconcise and thus efficient, it may be better suited for large-scale population surveys than the version currently in use.
Structural equation modeling of the association between oral health literacy and dental caries in children
(2025) Lima, Larissa Chaves Morais de; Neves, Érick Tássio Barbosa; Perazzo, Matheus de França; Bernardino, Veruska Medeiros Martins; Silva, Samara Ellen da; Paiva, Saul Martins de; Ferreira, Fernanda de Morais; Granville-Garcia, Ana Flávia
The aim of this study was to explore the association between oral health literacy (OHL) and dental caries in children, evaluating the direct and indirect effects of brushing frequency, obesity, and socioeconomic factors. A cross-sectional study was conducted with 739 schoolchildren aged eight to ten years and their parents/caregivers who answered a questionnaire addressing sociodemographic characteristics and oral hygiene habits as well as the OHL – Adult Questionnaire. Cavitated dental caries in the schoolchildren was evaluated using International Caries Detection and Assessment System criteria. Descriptive analysis was performed, followed by structural equation modeling into the theoretical model (95% CI). Goodness-of-fit indices were considered satisfactory (root mean square error of approximation < 0.06; comparative fit index > 0.90–0.95; standardized root mean square residual < 0.10 and Tucker-Lewis Index > 0.90–0.95). Mother’s age (standardized coefficient [SC]: -0.08; p < 0.01), caregiver’s schooling (SC: -0.22; p < 0.01), obesity (SC: 0.13; p < 0.01), and brushing frequency (SC: -0.09; p < 0.01) had a direct effect on dental caries, whereas OHL had an indirect influence on the outcome. Mother’s age, caregiver’s schooling, brushing frequency, and obesity directly affected the occurrence of cavitated carious lesions in children in the mixed dentition phase, whereas OHL had an indirect effect on this clinical outcome.
Association of dental caries, family cohesion, and orofacial dysfunction in children aged 8 to 10 with possible sleep bruxism: pathway analysis
(2025) Leal, Tiago Ribeiro; Perazzo, Matheus de França; Neves, Érick Tássio Barbosa; Ortiz, Fernanda Ruffo; Gomes, Monalisa Cesarino; Granville-Garcia, Ana Flávia
Objective The aim of the present study was to explore the association of dental caries, family cohesion, and orofacial dysfunction in children 8–10 years of age with sleep bruxism. A school-based analytical cross-sectional study was conducted involving 739 school children in a medium-sized city in Brazil. Materials and methods The parents/guardians answered a socioeconomic questionnaire and the Family Adaptability and Cohesion Assessment Scale (FACES III). The children reported whether they had experienced bullying in the previous 30 days. The diagnosis of possible sleep bruxism (PSB) was based on the reports of parents/guardians. Four trained examiners (Kappa > 0.80) diagnosed cavitated carious lesions using the International Caries Detection and Assessment System and administered the Nordic Orofacial Test-Screening to investigate orofacial dysfunction. Data analysis involved structural equation modelling. The direct and indirect associations between the variables of the theoretical model were determined through the calculation of standardised coefficients and goodness-of-fit indices. Result The cavitated lesions (path coefficient [PC]: −0.23; p < 0.01) and family cohesion (PC: 0.13; p < 0.01) exerted a direct influence on the prevalence of PSB. Family income exerted an indirect influence on PSB, exerting a direct influence on cavitated lesions (PC: 0.24; p < 0.01) and family cohesion (PC: 0.217; p < 0.01). Bullying and orofacial dysfunction were not significantly associated with PSB. Conclusion In conclusion, cavitated carious lesions and low family cohesion exerted a direct influence on the occurrence of PSB. Family income had an indirect effect, whilst bullying and orofacial dysfunction had no influence on the outcome.
Impact of psychosocial factors on oral health-related quality of life in Brazilian preschool children: structural equation modeling
(2025) Araújo, Ítallo Lins Paes de; Gomes, Monalisa Cesarino; Neves, Érick Tássio Barbosa; Firmino, Ramon Targino; Paiva, Saul Martins de; Perazzo, Matheus de França; Granville-Garcia, Ana Flávia
Objective To investigate the pathways through which psychosocial factors, dental caries and dental visits impact the oral health-related quality of life (OHRQoL) of preschool children and their parents/guardians using structural equation modeling. Methods A cross-sectional study was conducted with 769 pairs of 5-year-old preschool children and their parents/guardians. The parents/guardians answered questionnaires addressing sociodemographic characteristics and oral hygiene factors, as well as the Sense of Coherence Scale (SoC) and Multidimensional Health Locus of Control Scale (MHLC). The children and parents/guardians also answered the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5). Dental caries lesions in children were classified using the International Caries Detection and Assessment System (ICDAS) by two calibrated examiners (Kappa > 0.80). Descriptive analysis and confirmatory factor analysis of the measurement models were performed, followed by structural equation modeling. Results Goodness-of-fit indices were considered adequate (root mean square error approximation = 0.03; comparative fit index = 0.96; standardized root mean square residual = 0.06; Tucker–Lewis index = 0.95). Weak sense of coherence (β: − 0.09; p < 0.03), external locus of control (β: − 0.14; p < 0.01), and cavitated teeth (β: 0.25; p < 0.01) exerted a direct impact on the OHRQoL of the children, and visit to the dentist (β: 0.16; p < 0.01) had an indirect effect. Conclusion Psychosocial factors and dental condition directly impact the OHRQoL of preschool children and their parents/guardians, while dental visits have an indirect effect. This highlights the need for integrated approaches that consider both clinical and psychological aspects to improve the OHRQoL of preschool children.
Unraveling applications of gold nanoparticles in dentistry: a scoping review
(2025) Lima, Maria Heloísa da Conceição Tavares de; Avelino, Maria Eduarda Lemos; Cavalcanti, Marcela Rosa Nogueira; Perazzo, Matheus França; Moraes, Sandra Lucia Dantas de; Lopes, Daniela Siqueira
Objectives This review aims is to map the available evidence regarding the applications of gold nanoparticles (AuNps) in dentistry. Materials and Methods This scoping review protocol followed the guidelines of the Joanna Briggs Institute and the PRISMA-ScR. Two authors independently performed all steps in the study selection and data extraction phases. Data and sources Through a search across Medline, Embase, Web of Science, Scopus, and a manual search, this review identified studies that analyzed the use of gold nanoparticles in dentistry. Eligibility Criteria Original research full-text articles (experimental and observational studies), in all languages, on the application of gold nanoparticles in chemical and biological aspects of Dentistry. Study selection From 1268 records identified, 34 studies fulfilled the eligibility criteria. China and India had the largest number of publications in AuNPs (11.76 %, both). 88.23 % of studies were conducted in vitro, and operative dentistry was the most prevalent specialty (47.05 %). Concerning the outcomes, studies focused on evaluating the antimicrobial properties of AuNPs, (38.23 %), material development and characterization (35.29 %), clinical or technological applications (20,58 %), and physical and mechanical properties (14.7 %). Conclusion Gold nanoparticles have vast potential for various applications in dentistry and biomedicine, with particular emphasis on their antibacterial and antibiofilm properties, which are the most studied. However, despite the large number of preclinical studies conducted, there is still a lack of established standards for the use of these nanoparticles, highlighting the need to develop protocols to guide new in vivo and in vitro studies before advancing to clinical trials.
Clinical evaluation of the accuracy of two face scanners with different scanning technologies
(2025) Srinivasan, Murali; Leles, Cláudio Rodrigues; Berisha, Florentin; Bronzino, Innocenzo; Moreira, Yasmin Milhomens; Sung-Jin, Kim; Koungjin, Park; Jae-Hyun, Lee
Objectives: This study compared the clinical accuracy of two different stationary face scanners, employing progressive capture and multi-view simultaneous capture scanning technologies. Methods: Forty dentate volunteers participated in the study. Soft tissue landmarks were marked with a pen on the participants’ faces to measure the distances between them. Clinical measurements were manually obtained using a digital vernier caliper by two independent examiners. The participants were then scanned using one of two stationary face scanners: Obiscanner (Fifthingenium), which employs progressive capture technology requiring the subject’s head to rotate during image acquisition, or RAYFace (RAY), which utilizes multiple cameras to simultaneously capture a complete 3D image. The scans were imported into mesh-processing software, and digital measurements were taken by the same examiners. Data analysis included pairwise comparison tests and the calculation of the intra-class correlation coefficient (ICC; α = 0.05). Results: Digital measurements were significantly longer than clinical measurements across all measured distances (p < 0.001). Comparisons between the scanners revealed that vertical measurements using RAYface exhibited greater percentage differences compared to those using Obiscanner (p < 0.05), while horizontal measurements were more variable with Obiscanner than those obtained using RAYface (p < 0.05). Intra-examiner differences were significant for both methods (p < 0.001), although inter-examiner differences were only significant for clinical measurements (p < 0.001), not for digital measurements (p > 0.05). Inter-examiner reliability for digital measurements was high (ICC≥0.99). Conclusions: Significant differences were observed in the accuracy of the two stationary face scanners using progressive capture and multi-view simultaneous capture scanning technologies, with each device demonstrating specific strengths and limitations. Clinical Significance: Although face scanners offer relatively high accuracy and consistency, particularly across different acquisition technologies, careful consideration of their performance characteristics is essential for optimizing accuracy in facial measurements
The effect of single-implant mandibular overdenture on the pattern of denture uses and patient-reported outcomes: a 2-year prospective study
(2025) Veríssimo, Aretha Heitor; Ribeiro, Anne Kaline Claudino; Silva, Daniel Mariano Sousa; Dantas, Euler Maciel; Leles, Cláudio Rodrigues; Carreiro, Adriana da Fonte Porto
Objectives To assess the effect of single-implant mandibular overdenture (SIMO) on the patterns of denture use after the transition to overdenture treatment and the changes in patient-reported outcomes (PROMs) throughout a 2-year follow-up. Materials and methods Complete denture was provided to edentulous patients and the pattern of denture use was assessed after an adaptive period of 3 months after denture delivery and post-insertion care. Then, patients were invited to SIMO treatment. For those who accepted implant treatment, a single morse taper implant was inserted in the mandibular midline and loaded after four months using an O’ring-ball attachment. The pattern of denture use, patient satisfaction, and oral healthrelated quality of life impacts (OHRQoL) were assessed at the pre-and up to 2-year post-treatment follow-up. Data analyses included regression analysis for longitudinal data using Generalized Estimating Equations (GEE). Results Conventional dentures were provided to 58 patients, and 25 underwent SIMO treatment. At baseline assessment, 13 patients (52%) presented poor adaptation and discontinuous use of the mandibular denture. At the 3-month follow-up after the delivery of SIMO, there was a significant reduction in the impacts on OHRQoL and a notable improvement in patient satisfaction, which remained unaltered throughout the 2-year assessments. Treatment benefits were more pronounced for patients poorly adapted to the mandibular denture (p<0.05). All patients showed continuous use of the mandibular denture after conversion to a SIMO. Conclusions SIMO significantly improves PROMs and positively changes the pattern of denture use in patients who are poorly adapted to the conventional mandibular denture. Immediate changes were sustained after two years of SIMO use. Clinical relevance The delayed loaded SIMO markedly improved patient satisfaction with the mandibular denture and reduced OHRQoL impacts. It also shifted patients with discontinuous use into continuous users after the transition to overdenture treatment. SIMO can be a minimally invasive and less costly alternative for patients struggling with uncomfortable conventional mandibular dentures.
Translation, content validity and internal structure of the Brazilian version of the Adolescent Resilience Questionnaire (B-ARQ)
(2025) Gomes, Genara Brum; Gatti-Reis, Luisa; Perazzo, Matheus França; Araújo, Marisa Alves; Mattos, Flávio de Freitas; Gartland, Deirdre; Paiva, Saul Martins de; Pordeus, Isabela Almeida
Resilience refers to one's ability to face life's challenges and achieve positive outcomes, and has drawn increasing interest from researchers and policymakers. The Adolescent Resilience Questionnaire (ARQ) is a measure that assesses resilience in adolescents according to a multidimensional perspective, encompassing its several different domains. This cross-sectional study aimed to translate and evaluate the measurement properties of the Brazilian version of the ARQ (B-ARQ) for use with Brazilian adolescents. Two native speakers in Brazilian Portuguese language who were also fluent in English language translated the ARQ from English into Portuguese. A committee of experts in validation studies compared the translated versions. A summarized version was produced and back-translated by a translator native of the English language and fluent in Portuguese. The B-ARQ was pre-tested in a sample of 21 adolescents. An expert committee considered the suggestions and defined the final version of the instrument, which was tested in a sample of 210 adolescent students from public and private schools in the city of Dom Pedrito, Brazil. All students filled out the 88-item instrument as well as a socio-demographic questionnaire. Statistical analysis included descriptive statistics of all variables (frequency distribution, floor, ceiling effects), internal consistency, and confirmatory factor analysis of the version with 88 items and the shortened version with 49 items. The short version with 49 items was validated in a cross-sectional study in an adolescent population of high school students using exploratory factor analysis in the Unites States. The 88-item ARQ had poor structural validity with unsatisfactory model fit indices. Therefore, the investigation focused on the short 49-item version of the ARQ (B-ARQ-SV). The final model presented satisfactory RMSEA = 0.042 (p = 0.994, 90% CI: 0.037-0.047) and SRMR of 0.076, despite the low CFI (0.878). The internal consistency was estimated with McDonald's Omega for each factor: Confidence (ω = 0.480), Negative Cognition (ω = 0.588), Empathy/tolerance (ω = 0.295), Emotional insight (ω = 0.425), Social Skill (ω = 0.235), Family Domain Connectedness (ω = 0.785), Family Domain Availability (ω = 0.847), Peers Domain Connectedness (ω = 0.719), Peers Domain Availability (ω = 0.402), School Domain Supportive environment (ω = 0.677), School Domain Connectedness (ω = 0.013), Community Domain Connectedness (ω = 0.791). One scale showed a ceiling effect (frequency higher than 15.0%), but we identified no critical floor effect. The B-ARQ-SV is a valid (in terms of content and structural validity) and reliable (in terms of internal consistency) measurement instrument to assess resilience in Brazilian adolescents.
Validation of the Piers-Harris Children Self- Concept Scale - PHCSCSV1-6 in Brazilian Portuguese for adolescents
(2025) Medeiros, Rafaella Araújo Amancio de Lima; Firmino, Ramon Targino; Sousa, Myrelle Leal Campos; Perazzo, Matheus França; Costa, Edja Maria Melo de Brito; Paiva, Saul Martins; Granville-Garcia, Ana Flávia
The study validated the Piers-Harris Children Self-Concept Scale (PHCSCSV1-6) for Brazilian adolescents, an instrument for measuring self-concept. The culturally adapted Brazilian Portuguese version (BR-PHCSCS) was administered to 325 adolescents aged 12-18 years at public and private schools in two cities in Northeast Brazil. Psychometric properties analyzed included internal consistency (Cronbach’s alpha and McDonald’s omega), reproducibility (Intraclass Correlation Coefficient [ICC]), convergent validity (Depression, Anxiety and Stress Scale [DASS-21]), discriminant validity (sociodemographic variables), predictive validity (dental caries and occlusal aspects) and factorial validity (Exploratory Factor Analysis [EFA]). The scale exhibited satisfactory Cronbach’s alpha = 0.79; McDonald’s omega = 0.78; ICC = 0.97. The scale showed a multidimensional structure with six factors, explaining 45.3% of the variance. Convergent validity was confirmed with BR-PHCSCS and DASS-21 scores (rs = -0.575, p < 0.001). Discriminant validity revealed associations with type of school (p = 0.033), number of children (p = 0.027), guardian’s education level (p = 0.008), and monthly income (p = 0.018). The self-concept of BR-PHCSCS was not associated with occlusal problems or caries experience. BR-PHCSCS demonstrated satisfactory psychometric properties for Brazilian adolescents aged 12-18 years and can be reliably used for other situations that exert an influence on the construct.
Colorimetric and visual assessment of two-color chewing gum mixing ability test: correlation and reference parameters in dentate subjects
(2025) Srinivasan, Murali; Takeshita, Lisa; Jain, Prachi; Moreira, Yasmin Milhomens; Schimmel, Martin Heinz Salvador; Leles, Cláudio Rodrigues
Objective: This study assessed the chewing performance of dentate subjects, using mixing ability tests with twocolored chewing gums, and aimed to correlate the visual and optoelectronic measurement methods to provide a correspondence scale for predicting the standard deviation of hue (SD-Hue) values based on visual parameters and the number of chewing strokes. Design: Two chewing gums were used (Hue-Check Gum® and Vivident Fruitswing®), and tests were performed with 1, 5, 10, 15, 20, 25, and 30 chewing cycles. The analysis included optoelectronic analysis to measure the level of color mixture (ViewGum software) expressed as the SD-Hue, ranging from 0 to 1, where lower values correspond to a higher level of mixture, and subjective analysis (SA) on a 5-point ordinal scale. Data analysis included bivariate correlation, definition of double-sided 90 % reference ranges, and GEE regression. Results: There were significant correlations between SD-Hue and the number of chewing cycles and SA scores (p < 0.001), and SA score was strongly correlated with the number of chewing cycles (p < 0.001). A downward logarithmic curve for SD-Hue and SA can be observed according to the number of chewing cycles. The mixture level progressively increased by approximately 50 % for each five chewing cycles. Conclusion: It was possible to correlate visual and optoelectronic methods and to establish a scale prediction of SD-Hue values based on SA and the number of chewing cycles. The color mixing measured by optoelectronic and visual methods was proportional to the number of chewing cycles. For every five cycles, the level of color mixture was reduced by 50 %, expressed in a downward logarithmic curve, independently from the chewing gum type.
Risk factors for oral mucositis in pediatric oncology patients undergoing chemotherapy: a prospective cohort
(2025) Santos, Fabio Gomes dos; Bezerra, Paula Maria Maracajá; Leles, Cláudio Rodrigues; Ribeiro, Isabella Lima Arrais ; Sousa, Simone Alves de; Valença, Ana Maria Gondim
Objective: To verify the risk factors for incidence and severity of oral mucositis (OM) in children and adolescents during anticancer treatment. Methods: A prospective cohort was carried out with 105 patients under 19 years, followed for ten consecutive weeks and submitted to chemotherapy (CT) with or without another treatment modality. Sociodemographic variables were collected using a specific form, with CT regimens obtained from medical records and the oral cavity evaluated by Oral Modified Assessment Guide (OAG). Bivariate comparison tests were used to summarize data and test within- and between-group differences. The longitudinal changes in the participants’ condition were modeled by mixed-model regression, using generalized estimating equations. Results: The incidence of mild/moderate and severe OM (SOM) ranged from 43.8% to 64.8% and 16.2% to 31.4%, respectively. The sex, age, type of tumor, treatment modality did not statistically influence the severity of OM. The longer the time since the chemotherapy session, the lower the risk of presenting OM and SOM. However, the chances of OM or SOM not occurring at longer intervals between chemotherapy sessions were very low. In most patients who developed OM, the mild/moderate condition persisted for ten weeks and the severe form for three weeks. Conclusion: Children and adolescents with cancer showed oscillations in the severity of OM during antineoplastic treatment and only the time since the last chemotherapy was statistically significant for severity of OM and OAG score.
Effects of L-glutamine and hyaluronic acid associated with photobiomodulation on oral mucositis: a randomized clinical trial
(2025) Santos, Rodrigo Wilmes dos; Martins, Allisson Filipe Lopes; Sousa Neto, Sebastião Silvério de; Morais, Marilia Oliveira; Moreira, Victor Hugo Lopes de Oliveira; Arantes, Diego Antonio Costa; Leite, Angélica Ferreira Oton; Freitas, Nilceana Maya Aires; Mendonça, Elismauro Francisco de; Leles, Cláudio Rodrigues
Objective To investigate whether the application of L-glutamine (L-G) and hyaluronic acid (HA) associated with photobiomodulation (PBM) and the Preventive Oral Care Protocol (POCP) would present similar efficacy as the exclusive use of PBM, associated with POCP, in the prevention and control of severe oral mucositis (OM). Study design Patients with head and neck cancer undergoing radiochemotherapy (RCT) were randomized into two groups: group A, patients that received PBM+POCP (n=24), and group B, patients that received PBM+POCP+L-G+HA (n=24). OM was assessed using the National Cancer Institute (NCI) and World Health Organization (WHO) scales. The impact of oral health on patients’ quality of life and perception of OM symptoms was evaluated. Assessments were made at the 1st, 7th, 14th, 21st, and 30th radiotherapy (RT) sessions. Results When the severity of OM was assessed according to the WHO scale in the 30th RT, group B showed lower rates of severe OM than group A. There were no differences when using the NCI scale. The impact of oral health on quality of life and the symptoms reported by patients were lower in group B at all times evaluated. Conclusion The combination of PBM+POCP+L-G+HA resulted in a significantly lower severity of OM than PBM+POCP alone, according to the WHO scale at the 30th RT. Trial registration Brazilian Clinical Trials Registry—REBEC no. RBR-6ybmgcv. Registration March 27, 2022.
The effect of implant distribution on functional and patient-reported outcomes of mandibular overdentures retained by four mini implants
(2025) Sá, Jaqueline Ferreira de; Nascimento, Lays Noleto; Sousa, Júlia Fonseca de Moraes; Curado, Thalita Fernandes Fleury; Srinivasan, Murali; McKenna, Gerald; Schimmel, Martin Heinz Salvador; Leles, Cláudio Rodrigues
Purpose: This study investigated the effects of implant distribution on functional and patient-reported outcomes of patients treated with a mandibular overdenture retained by four mini implants. Materials and methods: Seventy-four participants received four titanium-zirconium mini implants in the anterior mandible, and the relative position of the implants was assessed in post-treatment computed tomography scans with three reference points in the incisal region and first molars of the overdenture. DICOM files were analysed using Blooming Artefact Reduction filters to allow the visualisation of the mini implants in their three-dimensional position without overlapping bone structures. The implant distribution parameters were the polygon area formed by the four mini implants (implant area), anterior and posterior cantilever extensions, and antero-posterior spread. Outcomes included anterior and posterior maximum voluntary bite force (MBF), masticatory performance (MP), oral health-related quality of life impacts (OHIP-Edent) and satisfaction with the overdenture. Paired t-test, Pearson's correlation test and multiple regression were used for data analysis. Results: The implant distribution area was the most relevant variable for all functional parameters. The larger the distribution, the better the MP (p = 0.003), and the anterior (p = 0.011) and posterior MBF (p < 0.001). Concerning patient-reported outcomes, no effect of implant distribution was observed (p > 0.05), suggesting that the potential benefit of better distribution may not affect patients' perception of the treatment. Conclusion: Findings corroborate the influence of implant distribution of the four mini implants on functional parameters and, although the best implant distribution may depend highly on anatomical factors, these parameters should be considered an important prognostic factor for treatment success.
The impact of nutritional status on oral health outcomes and management in older adults: a systematic review and meta-analysis
(2025) Srisanoi, Kittipit; Maniewicz, Ines Wnuk Sabrina; McKenna, Gerald; Müller, Frauke; Leles, Cláudio Rodrigues; Papi, Piero; Woodside, Jayne; Srinivasan, Murali
Objective: This systematic review and meta-analysis evaluated the relationship between nutritional status and the oral health ofolder adults (aged 75 years or older). The PECO focus question was, ‘What is the occurrence, association and impact of nutritionalstate on the oral health outcomes and its management in older adults?’Methods: A comprehensive literature search was performed across MEDLINE (PubMed), Embase and the Cochrane Library.Publications up to April 2025 were considered, yielding 3324 records for initial screening. Quality assessment of the includedstudies predominantly revealed a low to moderate risk of bias.Results: Eighty-three studies were included for data analysis. Meta-analyses demonstrated that older adults at risk of malnu-trition had fewer teeth (SMD = −0.29; 95% CI: −0.46, −0.11; p = 0.002). Those with < 20 teeth and who were not rehabilitatedwith dentures were more likely to be malnourished (OR = 4.00; 95% CI: 1.21, 13.18; p = 0.02). Malnutrition was associated withself-reported chewing problems (OR = 2.38; 95% CI: 1.74, 3.26; p < 0.0001), swallowing problems (OR = 3.18; 95% CI: 2.20, 4.61;p < 0.0001) or dry mouth (OR = 2.35; 95% CI: 1.91, 2.88; p < 0.0001). Conversely, those with oral pain showed lower odds of mal-nutrition risk (OR = 0.68; 95% CI: 0.52, 0.89; p = 0.005).Conclusions: Fewer teeth, existing chewing or swallowing problems, dry mouth and the absence of removable dentures whereneeded, were associated with malnutrition in care-dependent older adults. The current lack of longitudinal studies and proof ofcausality for malnutrition affecting oral health outcomes underscores the need for further research to better clarify the complexrelationship between oral health and nutrition in older populations.

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