A 12-month Follow-Up Study of Pulp Oxygen Saturation in Deciduous Molars After Selective and Nonselective Carious-Tissue Removal: A Randomized Pilot Trial

ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.

Effectiveness of non-operative approaches in active enamel carious lesions: a retrospective longitudinal study

Abstract The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00-2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98-0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.

Is there a better interceptive treatment for unerupted palatally displaced canines? A network meta-analysis

Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12-9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31-10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09-1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11-1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00-1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.

Aspectos anatômicos e funcionais da língua após frenectomia em gemelares: relato de casos clínicos / Anatomic and functional aspects of the tongue after frenectomy in twin: clinical cases report

Objetivo: Relatar dois casos clínicos de alteração de frênulo lingual em gemelares, com 10 anos de idade, ambas do sexo feminino, avaliadas nos aspectos anatômicos e funcionais da língua antes e 15 dias após a frenectomia. Relato de casos: Inicialmente, o odontopediatra realizou a anamnese com a mãe. Em seguida, as participantes foram submetidas à avaliação clínica odontológica e, posteriormente, foi realizada a avaliação fonoaudiológica do frênulo lingual. A avaliação fonoaudiológica foi realizada por meio do Protocolo de Avaliação do Frênulo da Língua, que foi aplicado antes e 15 dias após a frenectomia. As duas participantes apresentaram melhor desempenho em provas anatômicas após o procedimento cirúrgico. Entretanto, algumas alterações, principalmente ao elevar a língua, continuaram sendo observadas em uma das pacientes 15 dias após a frenectomia. Ademais, as duas participantes passaram a executar a maioria dos movimentos de língua com maior precisão. No que se refere à fala, somente a participante que apresentava um maior número de alterações fonéticas anteriores, permaneceu com algumas alterações na fala decorridos 15 dias da cirurgia. Discussão: Algumas dificuldades envolvendo mobilidade da língua e alterações na fala podem persistir após a realização da cirurgia, indicando a necessidade de intervenção fonoaudiológica específica. Conclusão: Ambos os casos apresentaram melhora no desempenho tanto nas provas anatômicas quanto funcionais após a frenectomia.

Aim: to report two clinical cases of alteration of the lingual frenulum in twins, aged 10 years, both female, evaluated in the anatomical and functional aspects of the tongue before and 15 days after the frenectomy. Case reports: Initially, the paediatric dentistry performed the anamnesis with the mother. Then, the participants were submitted to a dental clinical evaluation and, sub-sequently, the speech language pathologist evaluation of the lingual frenulum was performed. The speech language pathologist assessment was performed using the Tongue Frenulum Evaluation Protocol, which was applied before and 15 days after the frenectomy. Both participants performed better in anatomical tests after the surgical procedure. However, some changes, especially when elevating the tongue, continued to be observed in one of the patients 15 days after the frenectomy. In addition, the two participants started to perform most of the tongue movements with greater precision. About speech, only the participant who had a greater number of previous phonetic changes, remained with some speech disorders after 15 days of surgery. Discussion: Some di-fficulties involving mobility of the tongue and changes in speech may persist after surgery, indicating the need for specific speech therapy intervention. Conclusion:Both cases showed improvement in performance both in anatomical and functional tests after frenectomy

Reduction in erosive tooth wear using stannous fluoride-containing dentifrices: a meta-analysis

Abstract Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW.

Impact of Early Childhood Caries and Maternal Behaviors on Oral Health-Related Quality of Life of Children

Abstract Objective: To evaluate the impact of early childhood caries, maternal behaviors and associated factors on the oral health-related quality of life (OHRQoL) of preschool children. Material and Methods: This cross-sectional study was conducted with 163 preschool children aged 3-4 old from Porto Alegre, Southern Brazil. Mothers completed the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) and answered questions about sociodemographic and maternal behaviors characteristics. The severity of dental caries was assessed by ICDAS criteria for evaluated early childhood caries (ECC). A Poisson regression model was used to investigate the association of ECC and associated factors on OHRQoL. Results: A total of 91.4% of preschooler children was ECC (ICDAS ≥ 1). Mean ECOHIS function domain and parental anxiety domain scores were significantly higher in children with dental caries (p<0.05). The adjusted Poisson regression model showed that household income, maternal education, mother's job status and breastfeeding time was significantly associated with ECOHIS scores. Regarding oral conditions, child caries experience was associated with worsening child and family quality of life (RR 2.21; 95% IC: 1.43-3.41). Conclusion: Our findings suggest that ECC, socioeconomic and maternal behaviors characteristics influence children's OHRQoL.

The Role of Mother's Knowledge, Attitudes, Practices in Dental Caries on Vulnerably Preschool Children

Abstract Objective: To analyze the association between Early Childhood Caries (ECC) and mother´s knowledge, attitudes, and practices (KAP). Material and Methods: This cross-sectional study included a random sample of 163 preschool children aged 3-4 old in southern Brazil. The severity of dental caries and ECC was assessed by ICDAS criteria, while mothers completed the semi-structured questionnaire (KAP-ECC). Maternal behavior characteristics and answered questions about socioeconomic and demographic variables. Logistic regression was performed to evaluate the association of exploratory variables with ECC. For this approach, we calculated the odds ratio (OR) and 95% confidence intervals (95% IC). Results: Dental examinations revealed that 91.4% of children presented ECC (ICDAS = 3, 4, 5 or 6). Among those children, 31.9% presented cavities (ICDAS ≥ 3). Family income was significantly associated with the presence of ECC (OR 2.17; 95% CI: 1.41-3.36). Regarding KAP-ECC, mothers have knowledge related to ECC etiology, reported dental hygiene attitudes and practices that can prevent ECC but reported less healthy attitudes and practices regarding child's diet, specifically with respect to bottle and breastfeeding habits (OR 0.52; 95% CI: 0.33-0.81). Conclusion: ECC was more frequent in children from low-income families and whose mothers reported the belief that milk with chocolate does not contribute to caries and that disagreed that it is normal that a 2-year-old baby wakes up during the night to suckle. That is, good knowledge toward health habits may impact on lower occurrence of ECC; however, this condition also depends on the socioeconomic level.

A Longitudinal Study of Early Childhood Caries and Associated Factors in Brazilian Children

Abstract Early childhood caries (ECC) affects children all over the world and has high prevalence and severity in preschool children. Different social, biological and behavioral factors compose a network of causal factors for ECC. The aim was to evaluate the association between socioeconomic variables and caries at baseline, and the presence of Streptococcus mutans and Lactobacillus spp. microorganisms with the progression of caries lesions after two years of follow-up in a group of children. At baseline, 163 children (3-4 years old) living in the areas of 12 primary care services of the Hospital Group Conceição (GHC, Porto Alegre, RS, Brazil) were evaluated. After two years, 119 children were re-evaluated. Clinical examinations were conducted by calibrated examiners using the ICDAS criteria. A sociodemographic questionnaire was applied to the children’s parents and saliva samples were collected from the children for microbiological analysis. Descriptive statistics and multivariate Poisson regression analysis were performed in the statistical analysis. The factors associated with the caries progression were marital status of mothers (p=0.040), higher S. mutans counts (p=0.031) and the presence of cavitated lesions at baseline (p<0.001). The caries lesions progression in preschool children enrolled in primary health care was directly associated with marital status, presence of cavitated lesions at baseline and higher S. mutans counts at two-year follow-up.

Resumo A cárie precoce na infância (CPI) acomete crianças em todo o mundo e apresenta alta prevalência e severidade em pré-escolares. Diferentes fatores sociais, biológicos e comportamentais constituem uma rede de fatores causais da CPI. O objetivo deste estudo foi avaliar a associação entre as variáveis socioeconômicas e presença de cárie na linha de base e a presença de Streptococcus mutans e Lactobacillus spp. com a progressão de lesões de cárie após dois anos de acompanhamento em um grupo de crianças. Na avaliação inicial, foram avaliadas 163 crianças (3-4 anos de idade) pertencentes a 12 unidades básicas de saúde do Grupo Hospitalar Conceição (GHC, Porto Alegre, RS, Brasil). Após dois anos, foram reavaliadas 119 crianças. Os exames clínicos foram realizados por examinadores calibrados usando os critérios ICDAS. Um questionário sociodemográfico foi aplicado aos pais das crianças e amostras de saliva foram coletadas de crianças para análise microbiológica. Foram realizadas estatísticas descritivas e regressão multivariada de Poisson na análise estatística. Os fatores associados com a progressão de cárie foram o estado marital das mães (p=0,040) e a presença de lesões cavitadas no início do estudo e uma maior contagem de S. mutans (p=0,031) após dois anos de acompanhamento. A progressão de cárie em pré-escolares pertencentes às unidades de atenção primária em saúde foi diretamente associada com o estado marital das mães, presença de lesões cavitadas na linha de base e maior contagem de S. mutans após dois anos de acompanhamento.

Impacto da cárie dentária, maloclusão e hábitos orais na qualidade de vida relacionada à saúde oral em crianças pré-escolares / Impact of dental caries, malocclusion and oral habits on the oral health-related quality of life of preschool children

RESUMO Introdução As doenças e desordens bucais, bem como hábitos orais, podem causar impacto na qualidade de vida das crianças. Objetivo Associar a cárie dentária, maloclusão e hábitos orais com a qualidade de vida de crianças pré-escolares. Métodos Estudo transversal com 93 crianças de 3 a 5 anos de idade, acometidas, ou não, por lesões de cárie não tratadas. Os responsáveis responderam ao questionário sobre hábitos orais e ao Questionário sobre a Qualidade de Vida Relacionada à Saúde Bucal de Crianças na Idade Pré-escolar (B-ECOHIS). Um odontopediatra avaliou a gravidade das lesões de cárie e a presença de alterações oclusais. O nível de significância utilizado foi de 5%. Resultados O B-ECOHIS evidenciou impacto na qualidade de vida, conforme o aumento da idade, nos domínios dos sintomas, aspectos psicológicos, autoimagem e interação social e de função familiar. A cárie dentária apresentou impacto sobre a qualidade de vida das crianças e de seus familiares, especialmente em relação aos domínios dos sintomas e limitações. Hábitos de respiração oronasal e chupeta também evidenciaram efeitos negativos na qualidade de vida das crianças e de seus familiares. Não foi observada associação entre maloclusão e qualidade de vida relacionada à saúde oral. Conclusão A cárie dentária, os hábitos de sução de chupeta e de respiração oronasal demonstraram impacto negativo na qualidade de vida relacionada à saúde oral das crianças.

ABSTRACT Introduction Oral diseases and disorders as well as oral habits can impact the quality of life of children. Purpose To associate the dental caries, malocclusion and oral habits with the quality of life of preschool children. Methods Cross-sectional study with 93 children from three to five years of age who have or have not been affected by untreated carious lesions. Parents answered the questionnaire on oral habits and quality of life instrument related to oral health denominated Early Childhood Oral Health Impact Scale (B-ECOHIS). A pediatric dentist assessed the severity of the carious lesions and the presence of occlusal disorders. The level of significance used was 5%. Results The B-ECOHIS demonstrated impact on quality of life with increasing age in the fields of symptoms, psychological aspects, self-image and social interaction and family function. Dental caries were shown to have an impact on the quality of life of children and their families, especially in relation the domains of symptoms and limitations. Oronasal breathing and pacifier habits negatively impacted the quality of life of children and their families. There was no association between malocclusion and quality of life related to oral health. Conclusion The dental caries, the pacifier suction habits and oronasal breathing demonstrated negative impact on quality of life related to oral health of children.

Differential Impacts of Caries Classification in Children and Adults: A Comparison of ICDAS and DMF-T

Abstract The aim of this study was to describe and compare findings regarding the prevalence and severity of dental caries when using ICDAS and DMFT/dmft in an epidemiological study with children and their mothers. This cross-sectional study evaluated 150 preschoolers and their mothers. Data were collected with ICDAS and then transformed into DMFT/dmft. ICDAS scores related to caries were analyzed according to three different cut-off-points: CP1 (0-healthy/1-6-caries), CP2 (0-1-healthy/2-6-caries) and CP3 (0-2-healthy/3-6-caries), representing the D/d of DMFT/dmft. ICDAS codes regarding restorations, except sealants, were considered the F/f and the code 97 as the M/m of DMFT/dmft index. Prevalence of caries and its severity with ICDAS were 92%, 84% and 31.3% in children and 97.3%, 96.6% and 80% in adults according to CP1/CP2/CP3, respectively. Admitting CP3 as the standard for data transformation of ICDAS in DMFT/dmft, it was observed that DMFT/dmft index would underestimate 60% of non-cavitated lesions in children and 16.6% in adults. The DMFT/dmft underestimated the presence of disease to disregard non-cavitated lesions for the pediatric population evaluated. The choice of which is the best index for epidemiological surveys will depend on the purpose of the research and the target population: if it is to estimate the needs of the population to determine clinical care in children and adults, the DMFT/dmft may be sufficient. However, if the objective is to have a more comprehensive diagnosis of caries at the population level in order to develop preventive strategies, to halt and reverse the disease, the detection of non-cavitated-lesions becomes important, mainly in young children.

Resumo O objetivo deste estudo foi descrever e comparar os achados sobre a prevalência e severidade da cárie dentária ao utilizar ICDAS e CPOD/ceod em um estudo epidemiológico com crianças e suas mães. Este estudo transversal avaliou 150 pré-escolares e suas mães. Os dados foram coletados utilizando-se o ICDAS e depois transformados em CPOD/ceod. Os códigos do ICDAS relacionados à cárie foram analisados de acordo com três diferentes pontos de corte: CP1 (0-hígido/1-6-cárie), CP2 (0-1 hígido/2-6-cárie) e CP3 (0-2 hígido/3-6-cárie), representando o D/d do índice CPOD/ceod. Os códigos do ICDAS referentes às restaurações, exceto selantes, foram considerados o O/o e o código 97 do ICDAS como o P/e do índice CPOD/ceod. A prevalência de cárie e sua severidade com o ICDAS foram de 92%, 84% e 31,3% em crianças e 97,3%, 96,6% e 80% em adultos de acordo com o CP1 / CP2 / CP3, respectivamente. Admitindo o ponto de corte CP3 como o padrão para a transformação de achados do ICDAS em CPOD/ceod, foi observado que o índice CPOD/ceod subestimaria 60% das lesões não cavitadas em crianças e 16,6% em adultos. O CPOD/ceod subestima a presença da doença ao desconsiderar as lesões não cavitadas na população pediátrica avaliada. A escolha de qual é o melhor índice para levantamentos epidemiológicos vai depender do propósito da pesquisa e da população-alvo: se o objetivo for estimar as necessidades da população para determinar cuidados clínicos em crianças e adultos, o CPOD/ceod pode ser suficiente. No entanto, se o objetivo for ter um diagnóstico mais abrangente da doença ao nível da população, a fim de desenvolver estratégias preventivas, para paralisar e reverter a doença, a detecção de lesões não cavitadas torna-se importante, principalmente em crianças pequenas.

Freio lingual: abordagem clínica interdisciplinar da Fonoaudiologia e Odontopediatria / Lingual frenulum: interdisciplinary clinical approach of Speech Terapy and Pediatric Dentistry

Introdução: O freio lingual é uma estrutura anatômica cujo papel é muito importante para a sucção, fala e alimentação. Um freio curto e aderido pode impedir o movimento da língua e com isso causar impactos anatômicos e funcionais para o paciente. Objetivos: O objetivo deste relato de caso é demonstrar, com olhar clínico interdisciplinar, as ações conjuntas entre a Odontopediatria e a Fonoaudiologia frente à alteração de freio lingual em uma criança com alteração na fala. Foi realizado diagnóstico em conjunto e traçado o plano de tratamento que constou de frenectomia e acompanhamento fonoaudiológico no intuito de monitorar as evoluções e proporcionar tratamento global. Conclusão: O procedimento cirúrgico, realizado pela Odontopediatria trouxe ganhos anatômicos e de mobilidade de língua, entretanto os aspectos alterados da fala permaneceram imediatamente após a intervenção, enfatizando a necessidade do tratamento e do acompanhamento fonoaudiológico.

Introduction: The lingual frenulum is an important anatomic structure involved in the act of suction, speech and feeding. A short and adhered frenulum limits the tongue movement and therefore, can cause anatomic and functional impacts in the patient. Aim: The aim of this case report is to show, with an interdisciplinary approach, strategies implemented by the Speech Therapy and Pediatric Dentistry for alterations in a lingual frenulun of a child with speech problems. This alteration was diagnosed and the treatment plan defined by both professionals and the frenectomy was conducted. Speech therapist followed up the patient in order to provide global treatment. Conclusion: Surgical procedure, conducted by the pediatric dentist improved tongue mobility, however speech alterations still were present after the intervention, emphasizing the need of a speech monitoring and therapy.

Dental avulsion: are the dentist prepared to the correct management?

To evaluate the knowledge of dentists from the health units (HU) of Porto Alegre -Brazil, regarding the management of avulsion of permanent teeth.Material and Methods:All dentists (n = 117) from HU were invited to answer a self-applied questionnaire regarding the treatment and preservation of avulsed permanent teeth in different clinical scenarios, based on the guidelines of the International Association of Dental Trauma (IADT). The professional data were also collected. The correlation between the performance of each professional and professional data was performed, (StudentÆs t test, PearsonÆs and SpearmanÆs correlations), assuming 5% significance.Results:The response rate was 56.41%. The mean performance rate of the dentists regarding the clinical questions was 69.3%, but 37.4% had poor performance (less than 70% correct). The greatest number of hits was where the patient comes with the already replanted teeth (89.2%); 87.3% agreed in situations where the injured child reaches two hours of trauma with the tooth in a liquid medium, however in cases that period of trauma was more than two hours and tooth was dehydrated, the professionals performance was reduced (64.9%). There was a lack of knowledge about the use of intracanal medication (error rate of 56.9%); 41% are mistaken about the period to start endodontics procedures; 32.8% did the wrong about contention of avulsed teeth and clinical and radiographs follow-up. Dentists with postgraduate performed better than those without (p = 0.011)...

Hipomineralização de molar-incisivo [HMI): relato de caso e acompanhamento de tratamento restaurador / Molar incisor hypomineratization (MIH): case report and restorative tratment follow-up

Introdução: Hipomineralização molar incisivo (HMI) é a displasia do esmalte dos dentes que afeta um ou mais primeiros molares permanentes frequentemente associados aos incisivos permanentes. Pacientes com essa alteração apresentam vários problemas clínicos, que podem incluir um desgaste dentário acentuado, perda do esmalte, aumento da suscetibilidade à cárie e sensibilidade dentária. O tratamento da hipomineralização molar-incisivo dependerá da gravidade do dente afetado, abrangendo desde medidas preventivas até procedimentos restauradores complexos. Objetivos: Relatar um caso de um paciente infantil, 7 anos, gênero feminino, diagnosticada com HMI. Além, disso, descrever a abordagem terapêutica, tratamento restaurador e acompanhamento de 28 meses. Conclusão: Pacientes com hipomineralização molar-incisivo necessitam de acompanhamento longitudinal para prevenir perda de estrutura dentária e manutenção do tratamento restaurador.

Introduction: Molar incisor hypomineralization (MIH) is defined as the enamel dysplasia that affects one or more first permanent molars and frequently permanent incisors. These patients have several oral health problems that may include increased tooth wear, loss of enamel, higher susceptibility to dental caries and tooth sensitivity. The treatment of molar incisor hypomine-ralization depends on the severity of the affected teeth, including preventive measures as well as extensive restorative procedures. Objectives: To present a case report of a patient, female, diagnosed at 7 years old with MIH and to describe restorative procedures with a 28-months follow-up period. Conclusion: MIH Patients require longitudinal follow-up to prevent loss of tooth structure and maintenance of restorative treatment.

Aesthetic and functional rehabilitation of a supernumerary peg-shaped tooth in the primary dentition / Reabilitação funcional e estética em dente supranumerário conóide na dentição decídua

Supernumerary teeth are common changes in the human dentition that can compromise a congruous dental and facial growth and development. Early diagnosis and proper treatment of these developmental changes are essential for establishing occlusal, functional, and aesthetic congruence. Thus, this article reports the functional and aesthetic rehabilitation of a supernumerary peg-shaped tooth located in the anterior maxillary region of a preschooler. The tooth was restored directly using nanocomposite resin system, a putty index of the incisal position, and modified cotton roll isolation. This minimally invasive procedure not only allows future adjustment but also perfect control of the rehabilitation and simultaneous reestablishment of the child's self-esteem and tooth aesthetics and function. However, treatment should not be limited to the restorative technique. Maintenance of oral health and arch integrity are essential for the correct transition between the primary and permanent dentitions, preventing the treatment from affecting the permanent dentition.

As anomalias dentárias de número são alterações comuns da dentição humana que podem interferir na harmonia do crescimento e desenvolvimento dento-facial. O diagnóstico precoce e o tratamento adequado destas alterações de desenvolvimento são essenciais para que uma harmonia oclusal, funcional e estética, possa ser estabelecida. Assim, este artigo relata a reabilitação funcional e estética um dente supranumerário conóide, localizado na região ântero-superior da maxila, de uma criança em idade pré-escolar. A reanatomização do elemento dental foi realizada através de restauração direta em resina composta nanoparticulada, uso do guia palatina de silicone de adição e isolamento relativo modificado. Este procedimento minimamente invasivo além de ser passível de ajustes posteriores, permite o perfeito controle da reabilitação realizada e possibilita o restabelecimento simultâneo estético-funcional e da auto-estima da criança. Entretanto, o tratamento não deve se limitar exclusivamente à técnica restauradora. Sendo fundamental a manutenção da saúde bucal e da integridade da forma do arco para que seja possível à transição correta da dentição decídua para a permanente, permitindo que o impacto do tratamento realizado contemple a ausência de alterações na dentição permanente.

Cri-du-Chat syndrome: conservative dental treatment in an 8-year old child / Síndrome de Cri-du-Chat: tratamento odontológico conservador em uma criança de 8 anos de idade

O objetivo deste artigo é relatar o caso de uma paciente de 8 anos de idade com a síndrome do miado do gato (CdCS) que foi encaminhada à clínica de odontopediatria para tratamento odontológico de urgência. As principais queixas eram uma lesão traumática nos incisivos centrais superiores permanentes e dificuldade em realizar a higiene oral. A paciente foi extremamente cooperativa durante a avaliação clínica, demonstrando capacidade de colaborar com opções de tratamentos conservadores sob anestesia local. O exame clínico mostrou overjet acentuado, lesões de cárie e uma higiene oral muito pobre. Avaliações clínicas e radiográficas foram necessárias para diagnosticar e determinar estratégias de tratamento das lesões traumáticas, lesões de cárie e gengivite, as quais foram realizadas ao longo de cinco consultas odontológicas. Os desfechos do tratamento são descritos. Este caso ilustra a variedade de achados clínicos que os odontopediatras podem encontrar na cavidade oral e face de pacientes com CdCS e os problemas que essas alterações podem causar. No atendimento desses pacientes, os dentistas devem tentar fornecer o melhor tratamento possível, priorizando o uso de técnicas conservadoras.

The aim of this article was to report the case of an 8-year old patient with Cri-du-Chat syndrome (CdCS) referred to the pediatric dental clinic for urgent dental treatment. The chief complaints were a traumatic injury to both permanent maxillary central incisors and difficulty performing oral hygiene. The patient was extremely cooperative during clinical evaluation, demonstrating ability to withstand conservative treatment options. Dental examination revealed accentuated overjet, carious lesions, and very poor oral hygiene. Clinical and radiographic evaluations were necessary to diagnose and determine treatment strategies for the traumatic injuries, carious lesions, and gingivitis, which were implemented over a total of five dental visits. Outcomes of the treatment strategies adopted are described. This case report illustrates the variety of clinical findings that pediatric dentists may encounter in the oral cavity and face of patients with CdCS and the problems that these alterations may cause. When faced with a CdCS patient, dentists should try to provide the best treatment possible and prioritize the use of conservative techniques.

Entrevista com prof. Dr. Fernando Borba de Araújo / Interview with Fernando Borba de Araújo

Comente sobre sua escolha de fazer Odontologia. - A escolha de uma profissão da área da saúde sofreu grande influência pelo fato de meu pai ser médico, pois eu o admirava muito. Também, pelo convívio com seus colegas de profissão e sua atenção com os pacientes, numa Medicina, na época, com proposta bem diferente da de hoje! Como todo jovem visionário, queria trabalhar com algo em que pudesse ajudar os outros e formatasse minha participação num mundo por mim sonhado! Assim, prestei o vestibular para Medicina na UFRGS, em 1975. Fiquei bem colocado na lista de espera, mas acabei entrando na segunda opção, para Odontologia. A intenção era cursar algumas disciplinas de equivalência, e tentar novo vestibular no ano seguinte! Joguei-me nessa luta, imprimi um novo ritmo na minha vida, mas não foi necessário muito tempo para se fazer presente a paixão pela Odontologia. Nunca mais a abandonei! Logo depois de graduado, fui influenciado e optei por ser docente. Continuando a estudar eu estaria encontrando um argumento para o contínuo crescimento profissional. Atualmente, tenho presente um sentimento de absoluto envolvimento com o ensino, a pesquisa e com o atendimento de pacientes na clínica da faculdade e na particular, com 30 anos completados em 2012! Devo à Odontologia as minhas maiores amizades, a construção da minha família (pelo fato da minha esposa ser colega) e também por ter me permitido conhecer o meu país, e muitos outros, de forma nunca imaginada!

Tratamento minimamente invasivo em caso de hipoplasia de esmalte: relato de caso / Minimally invasive treatment of enamel hypoplasia: Case report

O aparecimento de crianças com defeitos na formação do esmalte é uma rotina em consultórios osontopediátricos. Portanto, suas causas, giagnóstico e tratamento são de grande importância na prática clínica. Estudos dessas patologias são vistos em várias áreas da Odontologia, citando inúmeras causas e tratamentos propostos. Nesse estudo, abordou-se um relato de caso de tratamento estético, minimamente invasivo de hipoplasia de esmalte. Ela se apresentou com colaboração amarelo-castanha, em um dente anterossuperior permanente. A criança possuía 9 anos de idade, com histórico de trauma no dente decíduo subjacente (dente 61), envolvendo luxação intrusiva do dente aos 3 anos de idade, sendo essa a provável causa do defeito do esmalte no seu sucessor permanente (dente 21). Para tanto, um tratamento restaurador sem desgaste de esmalte foi feito com uso de corantes e resinas compsotas, utilziando a técncia incremental, mascarando completamente a lesão hipoplásica subjacente, sem necessidade de microabrsão ou desgaste para obtenção de tratamento restaurador estético satisfatório

Children with enamel defects are very common in Pediatric Dentistry. Therefore, its causes, diagnoses and treatments are very important in the day by day clinic. A lot of studies about these pathologies are seen in different areas of dentistry, related to find different causes and proposing treatments. At this study we aim to show a case report about a minimally invasive treatment in a case of enamel hypoplasia in an anterior permanent teeth in a children with 9 years old, with a esthetic complain. These hypoplasia has a yellow, almost brown color, presented in the vestibular face of the tooth 21, with an earlier history of intrusive luxation of tooth 61 at 3 years old, having no immediate treatment for the trauma. Being these trauma the possible cause of the enamel defect. As a treatment for this case, a restorative treatment was chosen without enamel removal,using composite resins, masquerading all de lesion, without need of microabrasion for esthetic treatment, achieving satisfactory esthetic

ART acceptability in children: a randomized clinical trial / Aceitabilidade da ART em crianças: um ensaio clínico randomizado

Aim: to compare the acceptability of the ART and the conventional restoration approaches in children. Methods: The sample of the current randomized clinical trial was 30 children 4 to 7 years old who had at least one class II active cavity in a primary molar that was accessible to hand instruments. The treatment groups were: Control Group- treatment with local anesthesia, rubber dam, rotary instruments and composite resin. Test Group- treatment according to ART approach using only hand instruments, no anesthesia and glass ionomer. In both groups, only the demineralized carious tissue and unsupported enamel were removed. The acceptability of the two groups was assessed by measuring the emotional feelings represented by Face Image Scale (FIS) before and after the procedure. Results: There was no significant difference between the two groups regarding changes in FIS scores. Fifty percent of the children from the Test Group got more satisfied after the procedure, while 64% of the participants from Control Group did not change their feelings.Conclusion: The ART approach had not demonstrated to have a best acceptability then the conventional approach. However the short time taken to complete the procedure seems to be worthy aspects when dealing with very young children or patients with behaviors problems.

Objetivo: comparar a aceitabilidade da ART e de restaurações convencionais em crianças. Material e métodos: A amostra do presente ensaio clínico randomizado foi composta por 30 crianças de 4 a 7 aanos de idade que tinham pelo menos uma cavidade ativa classe II em um primeiro molar que era acessível a instrumentos manuais. Os grupos de tratamento foram: grupo controle– tratamento com anestesia local, isolamento absoluto, instrumentos rotatórios e resina composta; grupo teste– tratamento de acordo com ART utilizando instrumentos manuais somente, sem anestesia e ionômerode vidro. Em ambos os grupos, somente tecido cariado desmineralizado e esmalte sem suporte foram removidos. Aaceitabilidade dos dois grupos foi acessada por mensuração das sensações emocionais usando a Escala de Imagem Facial (EIF) antes e depois do procedimento. Resultados : Não houve diferenças significativas entre os grupos na mudanças dos escores da EIF. 50% das crianças do grupo teste ficaram mais satisfeitas, enquanto 64%das crianças do controle não mudaram seus sentimentos. Conclusão: ART não demonstrou ter melhor aceitabilidade do que o tratamento convencional. Entretanto, o menor tempo utilizado paracompletar o procedimento parece ser um aspecto válido em crianças muitojovens ou pacientes com problemas de comportamento.

Anquilose dentária na dentição decídua e mista: revisão da literatura / Dental ankylosis in deciduous teeth: a literature review

O objetivo deste trabalho foi revisar a literatura sobre a o diagnóstico, conduta e seqüelas clínicas frente aos casos de pacientes que apresentam dentes anquilosados na dentição decídua e mista. A etiologia, tratamento e as consequências da presença dentes decíduos anquilosados ainda é escassa. Portanto, uma extensa busca na literatura sobre o assunto poderá colaborar para um melhor diagnóstico e conduta clínica pelo cirurgião dentista.

The objective of this study was to perform a literature review in the diagnosis, conduct and clinical sequels in patients with dental ankylosis in deciduous and mixed dentition. The etiology, treatment and consequences of the presence of dental ankylosis is still scarce. Therefore, a extensive search in the literature reports on the issue, could collaborate for a better diagnosis and clinical practice of the surgeon dentist.

Professional flossing as a diagnostic method for gingivitis in the primary dentition

The aim of this study was to evaluate flossing as a diagnostic method for interproximal gingival bleeding in children. For this crossover study, 23 pre-schoolchildren presenting neither restorations nor approximal carious cavities and with at least 15 percent of gingival bleeding sites were selected. Examinations were performed at three different moments (3-4 days interval). Examinations comprised repeated measurements of two gingival indices with a 10-minute interval in the following sequences: the Ainamo & Bay Gingival Bleeding Index (GBI) followed by the Carter & Barnes flossing index (CBI); CBI followed by GBI; and GBI followed by GBI. Data analysis was performed only for the interproximal sites, considering the GBI as the gold-standard. Agreement between indices, sensitivity (SE), specificity (SP), positive (PPV) and negative predictive values (NPV) were estimated. Percentage agreements in sequences GBI-CBI, CBI-GBI and GBI-GBI were 70.3 percent, 76.4 percent and 84.5 percent, respectively. Validation of flossing in the first sequence (GBI-CBI) resulted in values of 0.61 (95 percentCI 0.53 - 0.68), 0.72 (95 percentCI 0.69 - 0.76), 0.33 (95 percentCI 0.28 - 0.39) and 0.89 (95 percentCI 0.86 - 0.92) respectively for SE, SP, PPV and NPV. It can be concluded that professional flossing is a useful tool in the diagnosis of interproximal gingival inflammatory status in children, especially in conditions of gingival health.