Traumatic dental injuries (TDIs) are the fifth most prevalent condition worldwide. Proper diagnosis and emergency management are essential for ensuring a favourable outcome and prognosis. Although other international guidelines provide recommendations for the emergency management of TDI, specific clinical situations are not always addressed. To provide the dental health team and patients with recommendations based on the best scientific evidence available for the outpatient emergency management of people suffering from TDI. The Chilean Ministry of Health formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, supported the guideline-development process, including evidence synthesis. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks. The panel agreed on 15 recommendations for outpatient management of TDIs, such as fractures, luxations and avulsions in primary and permanent dentition. Conditional recommendations for permanent teeth included performing partial pulpotomy with calcium hydroxide or bioceramic in complicated crown fractures, stabilizing with a rigid splint in cervical root fracture, performing digital repositioning and splinting in lateral and extrusive luxation for more than 48 h, performing dental reimplantation in avulsed teeth with extended extra-oral time > 1 h, not treating the root surface and prescribe antibiotics in avulsed teeth. Conditional recommendations for primary teeth included performing just the extraction of the mobile fragment in complicated crown-root fractures and not splint in teeth with subluxation, lateral or extrusive luxation. Conditional recommendations for the use of mouthwash with 0.12% chlorhexidine twice a day for a period of 7–14 days in people with TDIs and against prescribing antibiotics in people with crown fracture, intra-alveolar root fracture or tooth luxation associated with trauma.
The aim of this study was to determine differences in maturation stages of the mandibular third molars (MTM) of Chilean individuals by age, sex, and side. The maturation stage of 930 lower third molar teeth were analysed, in patients aged between 9 and 24 years (432 males and 498 females), by panoramic radiography. The stage of maturity of the MTM was classified from A to H, following the method established by Demirjian. Multinomial logistic regression was performed for maturation stage by age. The lowest age of complete maturity of the MTM was 16 years in both sexes (Stage H). The correlation between maturation stage and sex was significant, positive, and high for both sexes, in both tooth 48 and tooth 38, showing that increasing age and maturation stage are correlated. In both males and females, maturation Stage H of the MTM was associated with the age of 18 years. The fit of the model was significant, showing that it has a greater predictive power than the null model. Nagelkerke’s pseudo R2 explained 73.5% of the variations of the model. In the contemporary Chilean population, if the maturity of the MTM is at a stage prior to complete calcification of the crown (Stage D), it is very unlikely that the individual is aged 18 years or over. It is highly probable that a Chilean individual with complete root formation of the MTM is legally of age, regardless of side or sex.
To identify HRQoL instruments available for oral cavity cancer (OCC) or oropharyngeal cancer (OC) patients and to summarize the evidence on conceptual model measurement, psychometric and administration properties. We searched MEDLINE, CENTRAL, EMBASE, and LILACS until April 2023. We included studies evaluating the concept model measurement, psychometric and administration properties of instruments measuring HRQoL in OCC or OC patients. Two researchers assessed each instrument independently, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. We calculated the overall and seven attribute-specific scores (range 0–100) using the conceptual and measurement model, reliability, validity, responsiveness, interpretability, burden, and alternative forms. We included seven instruments across 42 articles. The overall EMPRO score of these instruments varied between 84.1 and 29.3, with five questionnaires exceeding the threshold score of 50.0. The domains of conceptual and measurement model and interpretability performed best, while responsiveness exhibited the lowest performance. The findings support the use of EORTC QLQ-H N43, EORTC QLQ-C30, and EORTC QLQ-OH15 as suitable HRQoL instruments for both cross-sectional or longitudinal studies to measure physical, symptomatic, psychological, or social impacts in patients with OCC or OC. FACT-H N and UW-QoL were deemed appropriate for evaluating HRQoL in cross-sectional studies in these patients.
Objective: The proposed study aims to compare the effectiveness of conventional endodontic treatment (ET) with that of ET associated with antimicrobial photodynamic therapy (aPDT) in patients with apical lesion. Methods: Controlled, double-blind, randomized clinical trial (RCT); superiority study with three parallel arms. Randomization will be conducted in exchange blocks of six, with allocation 1:1:1. The control group will receive conventional ET, while experimental group 1 (EG1) will receive conventional ET + aPDT with laser at 660 nm, fluence of 600 J/cm2; EG2 will receive conventional ET + aPDT with laser at 660 nm, fluence of 1200 J/cm2. The primary outcome will be canal disinfection before treatment, measured by analysis of colony formation (CFU/mL) and the success rate measured after 6 months on the clinical and radiographic evaluations. The mean and standard deviation will be calculated for continuous outcomes, and the CFU/mL mean between groups will be evaluated by ANOVA test. The Chi-squared test will be calculated for binary outcomes. A logistic regression analysis will be performed to assess differences in the success rate between groups, adjusted for the covariates. The Stata 18 software will be used, with a significance threshold of 5%. Conclusions: Few RCTs have evaluated the effectiveness of aPDT in root canal disinfection in patients with permanent dentition presenting apical lesion. New RCTs with larger numbers of participants are needed to support using aPDT as an adjuvant to conventional ET in root canal disinfection for routine use in clinical practice. The trial was registered prospectively in ClinicalTrials.gov (NCT05916859).
The updating of anatomical terms is essential to facilitate teaching and learning as well as international communication through publications and presentations at scientific events. In the posterior wall of the axilla, the teres major, teres minor and triceps brachii muscles form three spaces through which neurovascular structures of clinical significance run. The current study seeks to define and propose terms for these spaces which have been omitted by Terminologia Anatomica. The definition of the Latin term 'Spatium' was investigated using A Latin Dicionary, while the term 'Espacio' was analyzed using Diccionario panhisp & aacute;nico de t & eacute;rminos m & eacute;dicos (Real Academia Nacional de Medicina de Espa & ntilde;a, 2023), as well as the lexemes of the words 'scapula' and 'humerus', for which the Diccionario M & eacute;dico-Biol & oacute;gico, Hist & oacute;rico y Etimol & oacute;gico de la Universidad de Salamanca was consulted. The presence of the term 'Spatium' in the Terminologia Anatomica was also investigated. Finally, 10 anatomy textbooks in Spanish were reviewed to identify the terms used for these spaces. In reviewing the latest edition of Terminologia Anatomica, it was found that the term 'Spatium' appears 25 times in different chapters and it was evident that no terms for scapulohumeral spaces appear in the chapters on upper limb structures. Moreover, in 100 % of the anatomy textbooks reviewed, at least one term is used to describe the scapulohumeral spaces. We believe that the proposed terms: 'Spatium humerotricipitale', 'Spatium scapulotricipitale' and 'Spatium teretricipitale' more accurately describe both the location and their association with the bone/muscle structures that form them. We therefore suggest that these terms be revised for inclusion in future editions of Terminologia Anatomica.
INTRODUCTION:Laser photobiomodulation (laser PBM) is an effective means of accelerating burn wound contraction, however it is still unclear whether laser PBM produces greater benefit when applied directly to excised and unexcised burn wounds . The aim of this systematic review of preclinical studies was to determine the effectiveness of laser PBM in the wound contraction rate in excised and unexcised burn wounds.MATERIALS AND METHODS:A systematic search was conducted in the EMBASE, MEDLINE and LILACS databases. Preclinical studies were included that analysed the effectiveness of laser PBM in burn wound contraction, and assessed wound closure. The SYRCLE risk of bias tool was used. Random effects models were used to estimate the pooled effect.RESULTS:Thirteen studies were included in the qualitative analysis and six in the quantitative analysis. Two weeks after the lesion, laser PBM favoured the wound contraction percentage, increasing the closure rate in excised burn wounds (SMD= 1.34, CI 95% 0.41 to 2.27, 0.41-2.27, I2=0%, =0%, low certainty of evidence. In unexcised burns, it was uncertain whether laser PBM increased or diminished the wound contraction rate (SMD=1.22(SMD=1.22 CI 95% -0.05 to 2.49, I2=68%; =68%; very low certainty of evidence).CONCLUSIONS:In the animal model, laser PBM is effective in increasing the wound contraction rate in excised burns. However, due to the low certainty of the evidence, uncertainty remains about the true magnitude of the effect of laser on wound contraction in animals; our results should therefore be interpreted with caution.
Correct detailed description of the anatomy of the digastric muscle (DM) in different populations should be carried out to improve the teaching of anatomy, avoid misinterpretations and help to avoid intercurrences during surgical procedures in the region. The aim of this study was to carry out a study of the DM in adult Brazilian individuals. The sample consisted of 50 DM from adult individuals (22 right side and 28 left side) fixed in 10 % formaldehyde. The morphology of the DM was observed, identifying possible anatomical variations; these were characterized and classified according to the number of the muscle bellies, direction of the fibre, and points of origin and insertion. The morphometric measurements were performed using a digital calliper. Student's t-test for dependent samples was used to measure differences between sides; one-way ANOVA was used to analyse the different classifications, and the chi-squared test to analyse qualitative variables, with significance threshold of 5 %. The anterior belly of the DM was classified as Type I in 28 samples (56 %), Type II in 20 (40 %) and Type III in 2 (4 %). The mean length was 37.8 mm, width 12.1 mm and thickness 5.39 mm, with no statistically significant differences found for these variables. The intermediate tendon of the DM was classified as Type I in 31 samples (62 %), Type II in 10 (20 %) and Type III in 9 (18 %); its mean total length was 45.1 mm. The posterior belly of the DM was Type I in 50 samples (100 %), with mean length 70.8 mm and width 8.15 mm. Anatomical variations of the DM, particularly its anterior belly, in Brazilian adults are very frequent. They must therefore be carefully identified to help avoid intercurrences during surgical procedures in the region, and to help correct evaluation of swollen lymph nodes in the submental triangle.
Sex identification of a deceased human individual by means of the mandible is very important for forensic dentistry. The aim of the present study was to determine the sex of Chilean individuals by mandible analysis in panoramic radiographies. Linear and angular parameters of the mandible were analyzed from panoramic radiographies (PR). The study included PR of adult Chilean individuals, of both sexes, with optimum solution and contrast, and which allowed the angles and rami of the mandible to be viewed. Sex was determined by univariate and bivariate discriminant function analysis. The sample consisted of 594 PR of individuals aged between 18 and 84 years. The best sex predictor using univariate discriminant function analysis was the mandibular ramus height (MRH) (74.1 %), followed by the distance from the mental foramen - mandibular base (DMF-MB) (69.1 %) and the bicondylar breadth (BC) (66.7 %). The parameters that presented the lowest sex prediction were the angle of the mandible (AM) with 55.0 % and the distance between mental foramina (DMF) with 53.7 %. The best sex prediction was obtained by the step model of discriminant function analysis (80.2 %), including only three parameters: MRH, BC and DMF-MB. The parameters height of the mandibular ramus, bicondylar breadth and distance from the mental foramen - base of the mandible are good predictors of sex in Chilean individuals when used in conjunction; they are therefore indicated for sex determination in the contemporary Chilean population.
The anastomosis between the posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA) courses along half of the lateral wall of the maxillary sinus. Risk of injury to the anastomosis between PSAA and IOA during surgical procedures has been reported. The aim of the present study was to carry out a systematic review and meta-analysis to determine the frequency, location, and diameter of the anastomosis between PSAA and IOA in imaging studies (cone-beam computed tomography, spiral cone-beam computed tomography, and computed tomography). A search was carried out in the PubMed, EMBASE, and LILACS. Original works were included reporting imaging studies to analyze the frequency, location, and diameter of the anastomosis in humans. The risks of bias were analyzed using the AQUA tool. Generalized linear mixed models were used to estimate the frequency and the 95
Sex estimation is the first step in human identification. The mandibular ramus and the condyle have been widely used as indicators for sexual diagnosis because they are regions that undergo important morphological changes which increase sexual dimorphism. The object of the present study was to carry out a systematic review to determine the metric parameters of the mandibular ramus that present the greatest sexual dimorphism, and to sex estimation from the angle of mandible (MA). We included documents in English, Spanish and Portuguese which analysed sex estimation or sex diagnosis by metric analysis of the mandibular ramus in humans. The search was conducted in PubMed/MEDLINE, EMBASE, LILACS, up to December 2020. The risks of bias were analysed using the AQUA tool. The search identified 538 studies. After exclusion of duplicates and irrelevant articles, 39 studies were included for qualitative analysis. Of these, 18 studies were carried out on dry mandibles and 21 by imaging techniques, totalling 7270 participants of 14 different nationalities. We found 14 sex-estimation parameters in the mandibular ramus, plus the MA. Sex estimation by the MA is variable; it is a good predictor only for some populations. The height of the mandibular ramus, the angle of mandible, the bicondylar angle and the height of the coronoid process were the estimation parameters cited in the greatest number of studies. The mandibular ramus presents great sexual dimorphism and can be used as a sex predictor in different populations. Although some parameters of the mandibular ramus can present accuracy of almost 80 % when analysed in isolation, more accurate sex estimation is achieved when the parameters are analysed in conjunction.
The posterior superior alveolar artery (PSAA) and the infra-orbital artery (IOA) present intraosseous and extraosseous rami which form an anastomosis in the lateral wall of the maxillary sinus. This anastomosis is always present, however it has not yet been included in anatomical terminology (AT), and different terms are used in scientific communication to refer to it. The aim of this study was to carry out a review of the different terms used to name this vascular structure. A literature review was carried out on the terms used to name the anastomosis between the PSAA and IOA in imaging studies and human cadavers that assessed the presence/frequency of this anatomical structure. The search was carried out in the Medline, EMBASE and LILACS databases, in Portuguese, Spanish and English, with no date restrictions. Qualitative analysis was applied to the studies selected, analysing the terminology used to refer to the anasto-mosis between the PSAA and IOA. Of the 2108 original articles found, 60 were selected as potentially relevant and 54 studies were finally included for qualitative analysis. Sixteen terms were found to refer to the anastomosis between the PSAA and IOA, the most frequent being Posterior Superior Alveolar Artery (PSAA), followed by Alveolar Antral Artery (AAA). Many terms are used in the medical literature to designate the anastomosis between the PSAA and IOA, the most frequent being PSAA and AAA. There is a need to unify the terms used to designate this vascular structure, and to incorporate the selected term into anatomical terminology, in order to avoid confusion in scientific communication.
Laser photobiomodulation (laser PBM) is known to be able to accelerate burn wound healing in the animal model; however little evidence exists on the action of laser PBM on the expression of important proteins in wound healing in the animal model, such as VEGF and TGF-beta 1. The aim of this study was to carry out a systematic review in order to analyse the effect of laser PBM on VEGF and TGF-beta expression during burn wound repair in the animal model. A systematic review was carried out of the EMBASE, PubMed/MEDLINE and LILACS databases. The studies included were preclinical studies that analysed the action of laser PBM on the expression of VEGF and TGF-beta (1, 2, 3) during burn wound repair in the animal model. The SYRCLE risk of bias tool was used. Random effect models were used to estimate the combined effect. Increased VEGF expression was observed with the use of laser PBM at 4.93 J/cm(2) per point in the first two weeks after induction of the burn wound, with greater size of effect in the second week (SDM = 5.72; 95% CI: 3.14 to 8.31, I-2 = 0 %; very low certainty of evidence). We also observed that the effect of laser PBM on TGF-beta 1 expression was greater than in the control in the first week (SDM =-0.45; 95% CI:-1.91 to 1.02, I-2 = 51 %; very low certainty of evidence), but diminished in the third week after induction of the lesion (SDM =-2.50; 95% CI: 3.98 to-1.01, I-2 = 0 %; very low certainty of evidence). Laser PBM has an effect on TGF-beta 1 and VEGF expression, promoting burn wound repair in the animal model.
The lateral pterygoid muscle (LPM) is intimately related with the temporomandibular joint (TMJ), playing an important role in its physiology. This makes it of interest to researchers who investigate temporomandibular disorders. The literature indicates that anatomical variations exist in the insertion of the superior fascicle of the LPM. Imaging and cadaver studies have revealed that the LPM may present an accessory fascicle. The study object was to carry out macroscopic analysis of the LPM, examining the origin and insertion of its superior and inferior fascicles. The study used 38 half-heads of adult individuals fixed in formaldehyde 10 %. To carry out macroscopic analysis of the LPM, an initial incision was made along the lower margin of the zygomatic arch; the origin of the masseter muscle was then dissected, separating its insertion on the lateral face of the mandibular ramus and retracting the muscle to posteroinferior. Two incisions were made on the zygomatic arch and the insertion of the temporal muscle on the coronoid process was identified with dissection pincers; it was dissected to gain access to the infratemporal fossa and the two fascicles of the LPM. The superior fascicle (SF) originated on the infratemporal face of the greater wing of the sphenoid, and on the superior third of the lateral face of the lateral lamina of the pterygoid process of the sphenoid in 26 samples. In 12 samples, it originated on the greater wing of the sphenoid and the infratemporal crest of the sphenoid. Type I insertion was found in 20 samples, Type II in 6 samples and Type III in 12 samples. In all the samples analysed, the inferior fascicle (IF) originated on the inferior two thirds of the lateral face of the lateral lamina of the pterygoid process and on the lateral face of the pyramidal process of the palatine, with insertion on the pterygoid fovea. The accessory fascicle (AF) of the LPM was present in 6 samples. The AF originated on the greater wing of the sphenoid in 2 cases and inferior to the superior fascicle in 4 cases; its insertion was on the capsular disc complex in all cases. The results obtained in our study contribute anatomical data on the LPM in Brazilian adult individuals, with evaluation of its insertion points.
The canalis sinuosus (CS) is a double-curved bone canal in the anterior region of the maxilla. The CS contains a vasculo-nervous bundle consisting of the anterior superior alveolar nerve and its corresponding arteries and veins. The CS and its accessory canals (AC) have been little described in the literature and are often omitted in imaging evaluations before procedures in the region. The object of the present study was to evaluate the frequency of the CS and its AC in Chilean individuals, and to carry out a morphometric analysis of these anatomical structures by cone-beam computed tomography (CBCT) by sex, side and age range. CBCT examinations of 28 patients were studied, evaluating the presence, diameter and terminal portion of the CS. We also evaluated the presence and number of AC, and their terminal portion. The diameter of the AC was classified as greater or smaller than 1.0 mm. Non-parametric tests were used for quantitative variables and chi-squared for qualitative variables. The SPSS v.27.0 software was used, with a significance threshold of 5 %. The CS was present in all the samples analysed, generally presenting a diameter greater than 1.0 mm. Alterations were found, and the diameter could be greater depending on the segment evaluated, however it was not affected by sex, side or age range. The terminal portion of the CS is usually located adjacent to the region of the nasal cavity. The frequency of AC was very high, and the most common location was in the region of the upper central incisor; in 61.3 % of cases their diameter ?1.0 mm. The high frequency of CS and AC shows the importance of carrying out a detailed imaging study before invasive procedures in the anterior region of the maxilla.
The lateral pterygoid muscle (LPM) is one of the muscles involved in jaw movements, and is therefore of great importance in the physiology of the temporomandibular joint. This muscle has classically been considered to have two heads, superior and inferior, however previous studies have indicated the presence of a third head (TH). The object of this research was therefore to evaluate, through a study in cadavers, the presence of the third head of the LPM and its relation with the joint disc of the TMJ in adult individuals. The study used 30 half-skulls of adult individuals, 11 right side and 19 left side. The number of heads on each LPM was analysed, with the length and thickness of each. The Chi-squared, Mann-Whitney U, Kruskall-Wallis and Spearman's correlation coefficient tests were applied, with a significance threshold of 5 %. The TH of the LPM was present in 20 % of the samples. Statistically significant differences were found in the thickness of the superior head (SH) vs. the inferior head (IH) (p<0.001) and between TH vs. SH and TH vs. IH (p=0.010). No correlation was found between the thickness of the heads or in their lengths. The LPM most frequently presents two heads, superior and inferior. The TH is an anatomical variation that may be present in 20 % of cases. The IH usually presents the greatest thickness. The use of cadavers is a good method for analysing the presence of the TH and the morphometry of the various heads of the LPM.
Background and objective: To determine the effectiveness of photobiomodulation therapy (PBMT) in the burn wound healing compared with the control or with the use of antibiotics, in animal models. Materials and methods: A systematic search was conducted in EMBASE, MEDLINE, and LILACS databases. Preclinical studies were included that analyzed the effectiveness of PBMT in the burn wound healing, which assessed wound contraction, angiogenesis, proliferation of fibroblasts, and collagen deposition. SYRCLE risk of bias tool was used. Random effects models were used to estimate the pooled effect. Results: Thirty-eight studies were included. PBMT favored wound contraction (mean difference = -11.47, 95% confidence interval -19.87 to -3.08, I2 = 0%; moderate certainty of evidence). PBMT also favored angiogenesis at doses between 11 and 20 J/cm2, and increased the collagenization rate. Conclusions: In animal models, PBMT favored wound contraction, angiogenesis, and collagen deposition in second- and third-degree burn wounds.
Background: Osteoarthritis (OA) is a chronic, progressive, degenerative pathology. Inducing OA in an animal model is useful for studying the pathology and testing the effectiveness of new treatments. The object of the present study was to determine the macroscopic and microscopic changes occurring in rabbit temporomandibular joints (TMJ) at 15, 30 and 45 days after induction of OA by monoiodoacetate (MIA) and papain. Materials and methods: Twenty two male rabbits were used in the experiment, divided into three groups: a control group (n = 4) and two experimental groups, MIA (n = 9) and papain (n = 9). The progress of the disease was analysed at 15, 30 and 45 days after induction of OA. Morphological and histological analyses were carried out of the joint disc and the mandibular condyle. Results: The most evident changes were expressed in the condyle and disc of joints with OA induced by MIA. The condyles presented deformation, fissures and loss of joint surface, the chondrocytes lost their morphology and organisation. In more advanced stages there was loss of the mid zone of the joint disc. Conclusions: The effects of papain were associated with condyle deformation, disorientation of the chondrocytes in the middle layer, and proliferation in deep zones; there was also an increase in the extracellular matrix. Both inductors generated changes in the TMJ and its joint surfaces; MIA was more effective and coincided more closely with the classic signs of the evolution of OA.
The skull is a reliable structure for determining the sex of an adult individual; it is generally resistant in adverse conditions, allowing it to be used for the analysis of sexual dimorphism. In the present study we analysed 10 non-metric characteristics of skulls of Brazilian adult individuals in order to: Determine the strength of association between sex and the morphological characteristics of the skull, the morphological characteristic(s) with greatest diagnostic influence for sex, and analyse whether the morphological characteristics of the skull predict sex. The study included 179 macerated skulls of Brazilian adults, (69 female, 110 male). The sex of all the skulls included was identified. The investigators were calibrated prior to analysis and all the evaluations were carried out under blinding. Pearson's Chi-squared test was used. The sensitivity and specificity were analysed and a ROC curve was constructed. Binary logistic regression was carried out. The SPSS v.22 software was used, with a significance threshold of 5 %. All the characteristics analysed presented statistically significant differences (p<0.05). The frontal profile, the superciliary arch and the glabella presented the greatest sensitivity, best balance between sensitivity and specificity and greatest area under curve. The regression model with the frontal profile, superciliary arch and mastoid process was significant [X2(2) = 115,728 p=0.000, R-2 Negelkerke=0.657], and presented correct sex classification in 90 % of cases (Males: 87.4 %; Females: 83.1 %). In unknown individuals for whom the skull is present, non-metric analysis of the frontal profile, superciliary arch, mastoid process and glabella can be used as instruments for sex identification.
Background: The present study investigated the influence of body dissatisfaction (BD) on the self-esteem of Brazilian adolescents. Methods: A cross-sectional study was carried out with 1011 students at public and private schools in the city of Fortaleza, Brazil. The body shape questionnaire and the Rosenberg self-esteem scale were applied. Chi-square test, Student’s t-test, Pearson’s correlation, the odds ratio and binary logistic regression were used. Results: The rate of low self-esteem was 33.8% in the adolescents; 27.8% of the adolescents presented some degree of BD, with severe BD in 5.8%. A significant low negative correlation was found between self-esteem and BD in all the adolescents. In the Odds Ratio analysis, it was observed that the odds of having low self-esteem increased in adolescents with BD as compared to adolescents without BD, being 3.85 times higher in females (CI 95%, 2.12–6.99), 2.83 times higher in males (CI 95%, 1.22–6.58), 5.79 times higher in adolescents attending public schools (CI 95% 2.06–16.26), and 2.96 times higher in adolescents attending private schools (CI 95%, 1.79–4.88). Conclusions: Low self-esteem affected one-third of the adolescents, both male and female. BD and education in public schools are predictor variables of low self-esteem in adolescents.