ABSTRACT
ABSTRACT Despite the emphasis and effort devoted to preventive dentistry, massive coronal destruction caused by dental caries or trauma is still seen in pediatric dentistry practice today. The technical difficulties related to dental treatment are compounded by problems related to the behavior of young patients in these circumstances, which brings the need for a broader understanding of behavior management techniques and certain skills in dealing with patients by dental practitioners, aimed at ensuring the well-being of both patient and dentist during treatment. This case report presents and discusses the scientific rationale for the treatment options adopted, considering the techniques and materials already established for aesthetic rehabilitation of adult patients (such as resins, glass-fiber posts, and glass ionomers), and now employed and adapted for pediatric dental care, that would best suit the clinical situation described. At the end of treatment, the patient achieved full rehabilitation and a restored smile, through the use of modern techniques and materials, while the dental practitioner gained a better understanding of the optimal treatment possibilities and strategies for similar cases.
RESUMO Apesar da ênfase e esforço dedicados à Odontologia preventiva, as grandes destruições coronárias causadas por cárie ou traumatismos dentários ainda são hoje problemas que ocorrem na prática clínica da odontopediatria. Além das dificuldades técnicas relacionadas a tais tratamentos, soma-se a isso, os problemas inerentes ao controle da conduta de um paciente muito jovem, o que traz a necessidade de um maior conhecimento de técnicas de manejo comportamental e uma habilidade no trato odontológico por parte do profissional, visando o bem-estar de ambos nestas circunstâncias. O relato de caso a seguir tem como objetivo apresentar e discutir o embasamento científico da opção de tratamento adotada, considerando os materiais, pinos de fibra de vidro, ionômeros de vidro, resinas, e as técnicas disponíveis atualmente, ou seja, procedimentos já consagrados na reabilitação estética em adultos, agora aplicados e adaptados à odontologia de bebês, e que melhor solucionariam a situação clínica descrita, visando sua aplicabilidade em clínica. Ao final obtemos um paciente reabilitado, gozando de um tratamento com técnicas e materiais bastante modernos, com seu sorriso restabelecido, e um profissional informado das possibilidades e técnicas mais adequadas para o tratamento de pacientes em situações semelhantes.
ABSTRACT
AIM: To verify the incidence of dental caries in a multicentric prevention program applied in pediatric dentistry clinics from different regions of Brazil for 10 years, and compare with results obtained by previous studies. MATERIAL AND METHODS: 697 children of both genders, ranging from 30 months to 15 years, were included in a primary preventive strategy program for mechanical control of dental plaque through professional prophylaxis (sodium bicarbonate jet on a monthly schedule). Diagnosis of carious lesions was assessed by monthly clinical examinations and annual radiographs. This procedure aimed to provide a biological equilibrium without producing undesirable side effects. RESULTS: The average age of children at beginning of the program was 81.71 months. Before entering the program the children presented an average of 2.66 lesions/surface, while during the program the average was 0.20 lesions/surface; the incidence rate of caries per year before starting the program was on average 0.62 lesions/surface while during the program it was 0.05 lesions/surface; the time of permanence in the program was on average 44.15 months and the absence rate was 0.14 per year. CONCLUSION: The results confirm the effectiveness of the program, even when applied by different professionals and in different groups of children, turning it into an indispensible method for the control of dental caries.