Tratamento endodôntico em dente permanente traumatizado com rizogênese incompleta: relato de caso / Endodontic treatment in permanent traumatised tooth with incomplete rhizoganis: case report / Tratamiento endodóntico en diente permanente traumatizado con rizoganis incompleta: presentación de un caso

Os traumatismos dentários representam um problema de saúde pública devido à alta prevalência e impacto psicossocial, sendo muito frequentes em crianças podendo resultar em necrose pulpar e culminar na rizogênese incompleta de dentes permanentes. Nestes casos de traumatismos em dentes permanentes com rizogênese incompleta e necrose pulpar, o tratamento mais indicado pela literatura é a apicificação, sendo um tratamento complexo e longo. Considerando a importância deste tema, o objetivo deste trabalho é relatar o caso de um paciente com traumatismo dental e necrose pulpar, que acarretou a interrupção do desenvolvimento completo e adequado do ápice dentário, sendo necessária a intervenção por meio da técnica de apicificação e o acompanhamento a longo prazo. O caso trata-se de uma menina em que um traumatismo dentário acarretou fratura de um incisivo central superior com formação radicular incompleta, comprometendo tanto a estética quanto a vitalidade do dente. Foi realizado o tratamento endodôntico com apicificação e posteriormente ao plug apical de MTA. O dente foi restaurado definitivamente com resina composta e realizado acompanhamento do paciente. Nas consultas de acompanhamento houve ausência de sintomatologia dolorosa e satisfação da paciente com a aparência atual. Sendo assim, a apicificação apresenta-se como uma ótima alternativa para dentes com rizogênese incompleta e necrose pulpar, embora longo houve uma melhora estética e satisfação do paciente.

Dental trauma represents a public health problem due to its high prevalence and psychosocial impact, being very frequent in children and can result in pulp necrosis and culminate in incomplete root formation of permanent teeth. In these cases of trauma to permanent teeth with incomplete root formation and pulp necrosis, the most indicated treatment in the literature is apexification, which is a complex and long treatment. Considering the importance of this topic, the objective of this work is to report the case of a patient with dental trauma and pulp necrosis, which caused the interruption of the complete and adequate development of the dental apex, requiring intervention through the apexification technique and follow-up. long-term. The case is about a girl in which a dental trauma resulted in a fracture of a maxillary central incisor with incomplete root formation, compromising both the esthetics and the vitality of the tooth. Endodontic treatment was performed with apexification and then apical MTA plug. The tooth was definitively restored with composite resin and the patient was followed up. In the follow- up consultations, there was no painful symptomatology and the patient was satisfied with her current appearance. Thus, the apexification presents itself as a great alternative for teeth with incomplete root formation and pulp necrosis, although in the long run there was an aesthetic improvement and patient satisfaction.

Los traumatismos dentales representan un problema de salud pública debido a su alta prevalencia e impacto psicosocial, siendo muy frecuentes en niños y pudiendo dar lugar a necrosis pulpar y culminar en la formación incompleta de la raíz de los dientes permanentes. En estos casos de traumatismos en dientes permanentes con formación radicular incompleta y necrosis pulpar, el tratamiento más indicado en la literatura es la apexificación, que es un tratamiento complejo y largo. Considerando la importancia de este tema, el objetivo de este trabajo es relatar el caso de una paciente con traumatismo dentario y necrosis pulpar, que causó la interrupción del desarrollo completo y adecuado del ápice dentario, requiriendo intervención a través de la técnica de apexificación y seguimiento. a largo plazo. Se trata de una niña en la que un traumatismo dental provocó la fractura de un incisivo central maxilar con formación radicular incompleta, comprometiendo tanto la estética como la vitalidad del diente. Se realizó tratamiento endodóntico con apexificación y posterior taponamiento apical con MTA. El diente fue restaurado definitivamente con resina compuesta y el paciente fue sometido a seguimiento. En las consultas de seguimiento, no había sintomatología dolorosa y la paciente estaba satisfecha con su aspecto actual. Así, la apexificación se presenta como una gran alternativa para dientes con formación radicular incompleta y necrosis pulpar, aunque a la larga se produjo una mejoría estética y satisfacción de la paciente.

Acesso e utilização de serviços odontológicos por gestantes: revisão integrativa de literatura / Access and use of dental services by pregnant women: an integrative literature review

Resumo O objetivo deste artigo é identificar as produções científicas sobre o acesso e utilização de serviços odontológicos por gestantes. Foi realizada uma revisão integrativa de literatura com busca nas bases de dados BVS e MEDLINE/PubMed. Na base BVS os descritores foram: "acesso aos serviços de saúde", "saúde bucal" e "gestantes", e na PubMed: "Health services accessibility", "oral health" e "pregnant women", associados entre si pelo operador booleano AND. Foram encontrados cinco estudos que preencheram os critérios de inclusão e exclusão, sendo sistematizados em duas categorias empiricas e co-relacionadas: número expressivo de gestantes que não realizam o pré-natal odontológico e importância de medidas educativas que sinalizem a necessidade de receberem acompanhamento odontológico durante as consultas de pré-natal. Existe a necessidade de mais estudos, para embasar políticas de saúde pública que contemplem esta temática. As pesquisas existentes demonstram baixa adesão ao pré-natal odontológico e que os principais fatores observados como complicadores do acesso e utilização dos serviços odontológicos foram os relacionados aos aspectos socioeconômicos, culturais e educacionais.

Abstract The objective of this article is to identify the scientific productions on the access and use of dental services by pregnant women. A search was carried out on the BVS and MEDLINE/PubMed online databases to produce this integrative literature review. In the BVS database, the Portuguese descriptors were: "acesso aos serviços de saúde", "saúde bucal" and "gestantes", and in PubMed: "Health services accessibility", "oral health" and "pregnant women", all associated with each other by the Boolean operator "AND". We identified five studies that met the inclusion and exclusion criteria and were systematized into two empirical and co-related categories: the significant number of pregnant women who do not perform prenatal dental care and the importance of educational measures that signal the need to receive dental care during prenatal visits. Further studies on the subject are required to support public health policies that consider this theme. Existing research shows low adherence to prenatal dental care and that the main factors hindering the access to and use of dental services were related to socioeconomic, cultural and educational aspects.

Dental care utilization among children in Brazil: an exploratory study based on data from national household surveys / Utilização de serviços odontológicos entre crianças no Brasil: estudo exploratório a partir das pesquisas nacionais por amostra de domicílios

Abstract Wide availability of access to dental services can be considered a predictor of better oral health outcomes in a population. This article aims to compare data from the Brazilian National Household Sample Surveys (PNAD) on dental services utilization among children aged 4 to 12 years. This cross-sectional study was carried out using data from the 1998, 2003, and 2008 National Household Sample Surveys, involving a total of 61.438, 64.659 and 59.561 children, respectively. Ninety-nine percent confidence intervals were considered for the prevalence of each outcome of interest. In 1998, 60.8% (99%CI: 59.4;62.1) of children had been to a dentist; this prevalence was 65.5% (99%CI: 64.4;66.7) in 2003 and 73.8% (99%CI: 72.1;74.2) in 2008. In 1998, 41.2% (99%CI: 39.1;43.3) of children in the lowest household income quartile had been to a dentist; this value was 61.4% (99%CI: 59.5;63.2) in 2008. Among children from families whose head of household had 4 years of formal education or fewer, 49.5% and 63% had been to a dentist in 1998 and 2008, respectively. The lifetime prevalence of dentist attendance among Brazilian children increased between 1998 and 2008, especially among those from low-income families and those whose head of household had a low educational level.

Resumo A ampla disponibilidade de acesso aos serviços odontológicos pode ser considerada um fator preditor de melhores resultados na saúde bucal da população. O objetivo deste artigo é comparar os dados obtidos das Pesquisas Nacionais por Amostras de Domicílios (PNADs), em relação a utilização de serviços odontológicos, entre crianças de 4 a 12 anos. Estudo transversal, com dados obtidos a partir das PNADs realizadas em 1998, 2003 e 2008, envolvendo um total de 61.438, 64.659 e 59.561crianças, respectivamente. Considerou-se intervalos de confiança de 99% para os desfechos. No ano de 1998, 60,8% (IC99%: 59,4;62,1) das crianças haviam ido ao dentista, em 2003, 65,5% (IC99%: 64,4;66,7), e em 2008, 73,8% (IC99%: 72,1;74,2). Com relação à renda domiciliar, em 1998, 41,2% (IC99%: 39,1;43,3) das crianças inseridas nas famílias na menor faixa de renda foram ao cirurgião-dentista, em 2003 49,9% (IC99%: 48;51,9) o fizeram e, em 2008, 61,4% (IC99%: 59,5;63,2). Entre as que pertenciam a famílias onde o chefe possuía até 4 anos de estudo, 49,5% e 63%, em 1998 e 2008, foram às consultas odontológicas. A prevalência de crianças brasileiras que já haviam ido ao dentista aumentou entre 1998 e 2008, especialmente entre aquelas pertencentes a famílias com renda domiciliar menor e com chefes possuindo menor escolaridade.

Teaching and Learning Regarding the Dentist-Pediatric Patient Relationship: A Qualitative Study

Objective: To investigate the perceptions of dental students on the learning process regarding the dentist-pediatric patient relationship. Material and Methods: A qualitative study with an exploratory approach was conducted involving semistructured interviews with sixteen dental undergraduate students randomly selected from the thirty-two students in the last semester of the dentistry course. The transcribed interviews were submitted to content analysis. Results: The sample was composed of nine female (56.3%) and seven male (43.7%) students (median age: 23 years). The factors perceived as most influential with regard to learning the dentistpediatric patient relationship were observations of professors, other dentists or colleagues and the regular practice of dental procedures. While half of the participants considered lectures on the subject satisfactory, the other half reported a need for more instruction on how to deal with specific clinical situations. Most of the participants would like to have learned more about the dentist-pediatric patient relationship. Conclusion: The majority of students recognized that the teaching and learning process regarding the dentist-pediatric patient relationship is not easy. They reported having little counseling on the how to develop this relationship. The students suggested that the dentist-patient relationship should be addressed more during the course through the inclusion of lectures or classes on this issue as well as the demonstration of specific clinical situations.

Use of Dental Services Among Brazilian Children Aged Zero to Three Years: Analysis of National Household Surveys

Objective: To describe the use of dental services among children aged zero to three years in Brazil according to socio-demographic characteristics. Material and Methods: A cross-sectional study was carried out using data from the 1998, 2003 and 2008 Brazilian National Household Surveys involving a total of 25,769, 25,644 and 22,237 children, respectively. Prevalence rates and 99% confidence intervals (CI) were calculated. Results: : In 1998, 10.4% (99%CI: 9.7-11.1) of the children had been to the dentist. This figure was 13.4% (99%CI: 12.6-14.3) in 2003 and 16.2% (99%CI: 15.2-17.1) in 2008. In 2008, the prevalence rates of dental appointments in lifetime were respectively 10.2% (99%CI: 9.2-11.4) and 30.6% (99%CI: 27.7-33.6) for children in the lowest and highest income quartiles, 10.2% (99%CI: 8.9-11.7) and 22.4% (99%CI: 20.9- 23.9) for children from families whose head of household had up to four and nine or more years of schooling, 9.6% (99%CI: 2.2-11.1) and 27.5% (99%CI: 24.5-30.8) for those living in the northeast and central west regions of the country. Conclusion: Statistically significant increases in the prevalence rates of the use of dental services among Brazilian children aged zero to three years occurred between 1998 and 2008. The rates were lower among children belonging to socially and ethnically disadvantaged groups.

Anxiety in Children submitted to Dental Appointment

Objective: To determine anxiety in children undergoing dental treatment and to evaluate associated factors. Material and Methods: The sample consisted of 48 children during dental appointment in dental clinics of the Franciscano University Center, 48 caregivers, and 46 dentistry students. The modified Venham Picture Test was used to determine anxiety of children during dental appointment, before and after treatment. For determining anxiety related to dental care among caregivers, the modified Corah's dental anxiety scale was used. The Lipp`s stress symptoms inventory for adults was applied to determine the stress level of dentistry students. In addition, the individual characteristics of participants were recorded to determine their association with the presence of anxiety. Results: Anxiety was observed in 60.4% of children, and it was related to invasive dental procedures (p = 0.021), history of dental pain (p = 0.002), presence of bruxism (p = 0.028), anxious caregivers (p = 0.023), and stress of the dental student that conducted the appointment (p = 0.005). Conclusion: Overall, the majority of pediatric patients showed anxiety, which was directly related to misbehavior during dental care. Moreover, anxiety was related to individual characteristics of children and was influenced by the anxiety level of caregivers, as well as the emotional state of dentistry students during the dental appointment.

Levels of Anxiety and Salivary Alpha-Amylase in Children During Restorative Dental Treatment

Objective: To assess levels of anxiety and salivary alpha-amylase in children and its association with the use of informative or aversive behavioral management techniques during restorative dental procedures. Material and Methods: A cross-sectional study was performed with 69 children aged 4-12 years submitted to restorative dental treatment. The level of anxiety of patients was verified by means of the Modified Venham Picture Test and levels of salivary alpha-amylase were measured before and after the restorative procedure. The behavioral management techniques used during the dental procedure were registered. Associations between variables were analyzed using the chi-square test, considering statistically significant associations with p ≤ 0.05. Results: Salivary alpha-amylase showed high and moderate levels prior to dental procedure in 47 children (68.1%). Variables gender and behavioral management techniques were not associated with anxiety, as measured by VPT and salivary alphaamylase activity. However, younger children showed higher levels of alpha-amylase (p = 0.001). Conclusion: The sample revealed that the visit to the dentist has generated anxiety, manifested by behavioral and physiological changes, especially in children under 72 months; thus, no association between anxiety and the different management techniques was observed.

Access to dental services among 6-to-12-year-old children in Brazil: an exploratory study based on the national household sample survey, 2008

Objective:To analyze the access and use of dental services among 6-to-12-year-old childrenin Brazil. Material and Methods:A cross-sectional study was conducted based on micro-data from the National Household Sample Survey carried out by the Brazilian Institute of Geography and Statistics in 2008. A total of 48,854 children were included and confidence intervals of 99% (CI 99%) were considered for the prevalence rates of the outcomes. The statistical significance of differences was analyzed using these intervals, level of 1%.Results:A total of 79.3% (CI 99%: 79.3%-79.3%) of children had been to the dentist at least once in their lives. A total of 62.1% (99% CI: 62.1%-62.1%) of children from families earning up to one quarter the monthly per capita household income and 95.5% (99% CI: 95.4-95.5) of those from families earning two or more times the minimum wage were among the 25,161 children that had been to the dentist in the previous year. Regarding region of residence, 68.2% (CI 99%: 68.2%-68.2%) of children from the northeastern region of the country and 89.5% (CI 99%: 89.5%-89.6%) of those from the southern region had been to the dentist. Conclusion:A considerable number of Brazilian children had never been to the dentist by the year 2008. In addition, individuals living in the southern region and from families with greater monthly household income were among those who had already been to the dentist. These data provide evidence for guiding public policies and actions aimed at minimizing the lack of dental follow up among Brazilian children

Associação entre história de aleitamento e relatos de hábitos orais e alergia em crianças / Association between history of breastfeeding and reports of oral habits and allergy in children

Objetivo: Este trabalho teve como propósito verificar a associação entre o tipo e o tempo de amamentação fornecida ao bebê com a presença de hábitos de respiração bucal, bruxismo, mordida aberta anterior e presença de processos respiratórios alérgicos. Materiais e métodos: Foram analisados todos os prontuários clínicos de crianças entre 0 a 12 anos de idade atendidos nos ambulatórios odontológicos do Centro Universitário Franciscano (UNIFRA), no período de 2005 a 2010. De um total de 507 prontuários, foram incluídos no estudo prontuários de 390 crianças. Resultados: Os resultados demonstraram haver associação entre o tipo de amamentação com a presença de respiração bucal, bruxismo e mordida aberta anterior (p<0,05). No entanto, não foram encontradas associações entre o tipo de amamentação fornecida ao bebê e a presença de processos respiratórios alérgicos, bem como o período de amamentação e a presença de hábitos de respiração bucal, bruxismo, mordida aberta anterior e alergia. Alem disso, constatou-se que a maioria das crianças atendidas nos ambulatórios odontológicos da UNIFRA recebeu mais amamentação natural (85%) que artificial (14%). Conclusão: Concluiu-se, portanto, que o tipo de amamentação fornecida ao bebê pode colaborar para o correto desenvolvimento da face e assim evitar o surgimento de alterações no sistema estomatognático.

Aim: The purpose of this study was to assess the association between type and duration of breastfeeding with the presence of mouth breathing habits, bruxism, anterior open bite and presence of respiratory allergic conditions. Materials and Methods: It was analyzed all dental records of children aging between 0 and 12 years old who were attended by dental students Franciscan University Center (UNIFRA) since 2005 to 2010. Of a total of 507 dental records, 395 were included in the study. Results: The results showed an association between breastfeeding the presence of mouth breathing, bruxism and anterior open bite (p <0.05). However, there was no association between breast feeding and the presence of respiratory allergy as well as time of breastfeeding and the presence of mouth breathing, bruxism, and anterior open bite allergy. The majority of children UNIFRA received more natural breastfeeding (85%) than artificial (14%). Conclusion: The breastfeeding provided the baby can contribute to the proper development of the face and thus prevent the emergence of changes in the stomatognathic system.