Violence against children and adolescents: the importance of knowledge of the spectrum of bruise colors in its diagnosis

Introduction: One of the violence types more observed against children is the physical abuse, which produces many types of traumatic injuries. Contusions are common trauma signs and may indicate aggression when frequently present in locations where accidental injuries are rare. Contusions in skin undergo color changes with the passage of time, and such change in color is called “spectrum of bruise colors of Legrand du Saulle”. Thus, it is possible to estimate the age of the lesion based on the evaluation of color. Injuries caused by child abuse often reach regions of head, face and neck, because they are exposed and easily accessible. Therefore, the dentist is responsible with regard to the diagnosis and the actions to be undertaken against the cases of child abuse. Objective: To present and discuss the significance of the spectrum of bruise colors as a considerable visible trace in suspicion of violence against children and adolescents, during dentists’ clinical routine. Literature review: The study of the “spectrum of bruise colors of Legrand du Saulle” refers to the estimation of the age of the injury, in respect to the color change. The application of this study is of great value for identify if a lesion occurred from a single incident or from multiple incidents, especially in cases where it occurs in the same region of the body, indicative of repetitive trauma. Conclusion: The spectrum of bruise colors is very important for health professionals, such as dentists, for the identification or suspicion of cases of abuse against children and adolescents. As great part of the lesions originated of abuse involve the areas of head and neck, it is unacceptable that these professionals are unaware of the basic signs to help in early diagnosis, which is the case of the colors of the lesions. However, concerning the chronology of the spectrum of bruise colors, it is not possible to establish rigorous times.

Dental development of children and adolescents with cleft lip and palate

Aim: To evaluate the dental development of Brazilian children and adolescents with cleft lip and palate. Methods: The sample consisted of 107 panoramic radiographs of children and adolescents with cleft lip and/or palate (cleft group) and 107 panoramic radiographs of children and adolescents without cleft lip and/or palate (control group), with chronological ages ranging from 6 to 15 years, matched in gender and chronological age within 60 days. Radiographs were digitized and masked and dental age was assessed using the method described by Demirjian et al. (1973). Three trained examiners conducted the assessments. Each examiner evaluated the radiographs three times. Data were statistically analyzed using non-parametric tests and univariate linear regression (p<0.05). Results: The dental age was overestimated in relation to the chronological age in both groups (p<0.0001). Compared to the control group, there was a delay in the dental age in the cleft group of 0.17 years (2.1 months). However, no statistically significant difference in the dental age between the cleft and the control group was found even when considering the different cleft types (p=0.152). Conclusions: There was no statistically significant difference in the dental age between the cleft and the control groups. The evaluation of dental development in individuals with cleft lip and palate should be approached in the same way as in individuals without clefts, with a focus on the individualization of diagnosis and treatment planning.

Parafunctional activities in brazilian children and adolescent

The etiology of TMD in children and adolescents is considered multifactorial and has been related to parafunctional habits.The objective of this research was to determine the prevalence of parafunctional habits in elementary school students of “Colégio Ipê de Assis” (Assis, SP - Brazil). In the present research was administered questionnaire (15 questions) proposed by the Center for Diagnosis and Treatment of TMD, School of Dentistry of Araçatuba, UNESP. The sample was composed of 80 elementary school students of the “Colégio Ipê de Assis” (Assis, SP - Brazil). The project was approved by the Ethics Committee in Research of the School of Dentistry of Araçatuba/ UNESP. All parents and responsible of the students received instruction about the research and preservation of identity and provide clarification if in doubt. Beyond that, they were requested to sign the informed consent in order to facilitate the participation of students. Females comprised 47,5% and males 52,5%, with age ranging from 10 to 14. The students were classified into two groups as follows: Group I-female, Group II- male. In addition, brazilian students from Groups I and II were classified according to type of oral habits presented. All students presented a parafunctional habit. Among the parafunctional habits chewing gum was the most common in both groups (72.2%, Group I and 78.5%, Group II) followed by resting chin on hand for both genders (69,5% for Group I and 67% for Group II). Tongue biting (5%) was less founded in Group II and stomach sleeping in Group I. The results obtained show the necessity of carring out preventive programs. Beside, resources of Health should increase preventive treatments.