Follow-up interval for dental appointments: a randomized clinical trial with children with low caries risk

Abstract The objective of this study was to evaluate the effect of different follow-up consultation intervals on caries incidence in children with low caries risk. The study was composed of 224 children aged between 3 and 5 years and with low risk of caries. The children were randomly allocated into two groups, according to two different follow-up consultation intervals: Group 1 (G1) - 12-month follow-up interval; Group 2 (G2) - 18-month follow-up interval. All oral clinical examinations were performed by a single examiner who was previously calibrated and blinded in relation to the study groups. An external dentist provided the advice on oral hygiene and diet and evaluated the children's socioeconomic conditions. The Chi-square and Mann-Whitney tests were used to evaluate the differences between groups. Poisson regression analyses were performed to assess the association of caries incidence with the other variables. At the end of the study there was a significant difference between the groups regarding initial active lesions (p = 0.012), and children in G2 were at a higher risk of developing initial active lesions than those in G1 (p = 0.047). Children who had a higher number of teeth with initial active lesions in the follow-up consultations were at a higher risk of developing cavitated dentin caries (p = 0.001). Both follow-up intervals are justifiable. Although significant results have been observed for initial active caries lesions within the 18-month follow-up interval, it should be noted that these lesions can be treated using just preventive measures. Besides, different return interval had no effect in cavitated dentin lesions.

Monitoring of caries disease by risk assessments and activity

ABSTRACT Dental caries is a non-communicable disease and is considered a public health problem. For diagnosis and correct treatment, the study of risk assessment and caries activity is necessary. The caries risk assessment is a way to formalize the balance and imbalance of predictably disease to diagnose dental caries. Therefore, the caries risk assessment is performed through different evaluation systems. Another parameter of great importance to be studied is the activity of caries, because through it is done the correct treatment decision for the patient. The objective of this article is to inform the reader about: the concepts and caries risk factors; the different caries risk assessment systems described in the literature; and which systems are validated. In addition, this literature review provides for identification and evaluation of risk factors and activity of caries lesions in order to enable greater objectivity in the diagnosis and facilitate the decisions of a successful treatment.

RESUMO A cárie dentária é uma doença não infecciosa e é considerada um problema de saúde pública. Para seu diagnóstico e correto tratamento é necessário a avaliação do risco e da atividade da doença cárie. A avaliação do risco de cárie é uma maneira de formalizar o equilíbrio e desequilíbrio da doença de modo previsível para realizar o diagnóstico da doença presente. Para tanto, a avaliação do risco de cárie é realizada através de diferentes sistemas. Outro parâmetro de grande importância a ser estudado é a atividade da doença cárie, pois através dela é realizada a correta decisão de tratamento para o paciente. Assim, o objetivo do presente artigo foi informar ao leitor: os conceitos e fatores de risco de cárie; os diferentes sistemas de avaliação de risco de cárie descritos na literatura; e quais sistemas são validados. Contudo, esta revisão de literatura proporciona a identificação e avaliação dos fatores de risco e atividade das lesões de cárie afim de possibilitar uma maior objetividade no diagnóstico e facilitar as decisões de um tratamento bem-sucedido.

Epidemiological study of traumatic dental injuries in 5- to 6-year-old Brazilian children

Monitoring traumatic dental injury (TDI) in primary teeth through epidemiological cross-sectional surveys provides descriptive information relevant to the development of public policies focused on the prevention of such injuries for the target population. The aim of this study was to assess the prevalence of TDI in 5- to 6-year-old Brazilian children and its association with biological and socioeconomic factors. A total of 684 children aged 5 to 6 years old, from 11 public schools in the city of Barueri (Brazil) were evaluated. Clinical examinations were carried out in the schools, by two trained and calibrated examiners. Gauze and a mouth mirror were used for the examinations. The reported TDIs were classified according to the Andreasen (2007) criteria for primary teeth. The results showed that 52.3% of the children had TDI. Enamel fracture (63.4%) was the most frequently observed sign of TDI, and the most affected teeth were the primary maxillary central incisors (26.9% maxillary right central incisor and 24% maxillary left central incisor). There was no association between the presence of TDI and biological or socioeconomic factors. In conclusion, the prevalence of TDI was high and had no statistically significant association with biological and socioeconomic factors.

Comparação da dinâmica da resposta celular utilizando dois diferentes biomateriais: Nanopartículas de Hidroxiapatita e Agregado Trióxido Mineral (MTA) / Comparison of dynamic cellular response using to different biomaterials: Nanobeads of Hidroxyapatite and Mineral Trioxide Aggregate (MTA)

As células da polpa dental têm o potencial de responder a estímulos externos e reparar o tecido dentário lesionado. Nos dentes, as lesões cariosas profundas e as lesões traumáticas são frequentes e resultam em alterações pulpares. Com o desenvolvimento da ciência e a busca de formas inovadoras de tratamento utilizando biomateriais de tamanho cada vez menor, verificar a biocompatibilidade desses materiais antes da aplicação clínica se mostra necessário e promissor. Assim, a finalidade deste estudo foi avaliar a biocompatibilidade de uma nova nanopartícula de hidroxiapatita utilizando células pulpares humanas em cultura. As Nanopartículas de Hidroxiapatita (HAp) utilizadas em nosso estudo são um material novo e ainda não disponível para a prática clínica. Como parâmetro comparativo, foi utilizado o material já consagrado na Odontologia para tratamentos endodônticos, o Agregado Trióxido Mineral (MTA). Para tanto, foram realizados testes de biocompatibilidade (MTS (3-(4,5-dimetiltiazol-2-y)5-(3-carboximetoxifenil)-2-(4-sulfofenil-2H-tetrazolio)). Foi preparada uma solução de material na concentração de 0,1g/ml diluído em meio de cultura, proporção preconizada pela norma ISO 10.993-12 (ISO, 1996). Esta solução foi diluída em 3 diferentes concentrações (1/10, 1/100 e 1/1000). Também foram realizados testes de migração celular e testes de capacidade de diferenciação, na concentração de 1/100

Como resultados pudemos verificar que as células da polpa foram viáveis quando expostas a diferentes concentrações de HAp, proliferaram mais quando tratadas com HAp na concentração de 1/100, migraram em direção aos materiais estudados e diferenciaram-se em tecido mineralizado quando em contato direto com ambos materiais estudados. Concluímos que o novo material testado é biocompatível e capaz de induzir mineralização em células de polpa dental sugerindo que as HAp podem ter aplicações clínicas futuras em tecidos mineralizados como osso e dente

The dental pulp cells have the potential to respond to external stimuli and repair the dental tissue injury. On teeth, deep carious lesions and traumatic injuries are common and result in pulp changes. With the development of science and the search for innovative treatment forms using reduced size biomaterials, to verify the biocompatibility of these materials before clinical application has become necessary and promising. Thus, the purpose of this study was to evaluate the biocompatibility of a new hydroxyapatite nanoparticle using human pulp cells in culture. The nanoparticles of hydroxyapatite (HAp) used in our study are new material and not yet available for clinical practice. As a comparator, we used the material already used in dentistry to root canal treatment, the Mineral Trioxide Aggregate (MTA). To do so, biocompatibility (MTS (3-(4,5-dimetiltiazol-2-y)5-(3-carboximetoxifenil)-2-(4-sulfofenil-2H-tetrazolio)). A solution of the material in a concentration of 0.1 g / ml diluted in culture medium recommended by ISO 10993-12 (ISO 1996) standard was prepared. This solution was diluted in three different concentrations (1/10, 1/100 and 1/1000). Were also performed cell migration and differentiation capacity assays at a concentration of 1/100

As results, we found that the pulp cells were viable when exposed to different concentrations of HAp, they proliferated more when treated with 1/100 HAp concentration, migrated toward the studied materials and differed into mineralized tissue when there was direct contact with both materials studied. We conclude that the new material tested is biocompatible and able to induce mineralization of dental pulp cells suggesting that the HAp may have future clinical applications in mineralized tissues such as bone and tooth

Frenectomia lingual em bebê utilizando eletrocautério e tetracaína: relato de caso / Electrocautery and tetracaine in baby lingual frenectomy: case report

O artigo relata o caso clínico de frenectomia lingual em bebê, utilizando eletrocautério e anestesia tópica oftálmica (cloridrato de tetracaína). O uso de eletrocautério proporciona diminuição do tempo de trabalho, maior conforto e segurança do procedimento cirúrgico para o bebê e para o profissional. Já a utilização de anestesia tópica oftálmica, é recomendada para procedimentos de controle da dor, tendo melhor absorção em mucosa umedecida, maior profundidade e maior tempo de ação. Esta técnica segue os princípios da odontologia minimamente invasiva.

The article reports a case of lingual baby frenectomy, using electrocautery and topical ophthalmic anesthetic (tetracaine hydrochloride). The use of electrocautery provides reduction of working time, increased comfort and safety of surgery for the baby and the professional. And the use of topical ophthalmic anesthetic is recommended for pain control procedures, and better absorption in the mucosa, deeper and longe r action. This technique follows the principies of minimally invasive dentistry.