Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study

Abstract Objective: To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dentin caries lesions when applied under different concentrations and times. Material and Methods: Forty-two bovine blocks were selected and fixed in 24-well plates. Each well received a mixed bacterial inoculum added to the culture medium with 5% sucrose. The plates were incubated in microaerophilia (7 days) for caries formation, confirmed by micro-CT (M1). SDF was applied over the carious lesions for different times and concentrations (n=6): SDF 30% - immediate removal, 1 minute and 3 minutes; SDF 38%, - immediate removal, 1 minute and 3 minutes. The group without treatment was the control. Then, the samples were again scanned by micro-CT (M2) and submitted to a second cariogenic challenge for 21 days. Then, a final scan was performed (M3). Results: Mean pH at the culture medium and lesion depth were compared using Kruskal-Wallis and Wilcoxon tests. 38% SDF showed the lowest metabolic activity of the biofilm. All 38% groups and 30% 1 and 3 minutes did not show an increase in mean lesion depth comparing M3 with M1. However, only 30% 3 minutes and 38% 1 and 3 minutes showed a significant reduction of lesion depth. Conclusion: The minimum application time of 30% SDF to arrest dentin caries lesion was 1 minute, while 38% SDF arrested with application and immediate removal.

Direct bonded space maintainer: an alternative in clinical practice after unilateral premature loss of posterior primary tooth

Introduction: The primary dentition is extremely important, because besides the importance during chewing, acts as a guide to eruption for permanent teeth, stimulates the bone growth and helps in digestion and phonation. In cases of premature loss, it is necessary that the professional make adequate planning to space maintenance, so that it is not lost until the eruption of the permanent successor, thus avoiding the establishment of malocclusions. Objective: To describe the clinical steps for preparation and placement of a direct bonded space maintainer, as well as the follow-up until the eruption of the successor tooth. Case report: Girl, eight years old, presented an adjacent fistula to theprimary mandibular right second molar. After clinical and radiographic evaluation, tooth extraction was indicated, due to the impossibility of performing the endodontic treatment. A direct bonded space maintainer was made and installed as an alternative to the band and loop, commonly used in these cases of unilateral loss. Conclusion: The direct bonded space maintainer was a good option for the case presented, as it was able to fulfill its function until the eruption of the successor tooth. It is a good alternative in clinical practice due to the time optimization and material savings it provides.

Introdução: A dentição decídua é de extrema importância, pois exerce função mastigatória, atua como guia de erupção para os dentes permanentes, estimula o crescimento ósseo e auxilia na digestão e fonação. Em casos de perda prematura de algum dente, é necessário que o profissional faça um planejamento adequado para manutenção do espaço, de forma que este não seja perdido até a erupção do sucessor permanente, evitando assim o estabelecimento de más-oclusões. Objetivo: Descrever as etapas clínicas para confecção e instalação do aparelho mantenedor de espaço adesivo, bem como o acompanhamento até a erupção do sucessor. Relato do caso: Menina, 8 anos, apresentou fístula adjacente ao segundo molar inferior direito decíduo. Após avaliação clínica e radiográfica, foi indicada a exodontia do dente, devido à impossibilidade de realizar o tratamento endodôntico. Confeccionou-se e instalou-se o aparelho mantenedor de espaço adesivo, como uma alternativa ao banda-alça, comumente utilizado nesses casos de perda unilateral. Conclusão: O mantenedor de espaço colado foi uma boa opção para o caso apresentado, pois foi capaz de cumprir sua função até a erupção do dente sucessor, constituindo-se uma boa alternativa na prática clínica, devido à otimização do tempo e economia de material que proporciona.

Knowledge of paediatric patients and their guardians about mouth guards

Introduction: Mouth guards are devices used to prevent injuries during sports activities. Objective: The aim of this study is to evaluate the knowledge of paediatric patients and their guardians about mouth guards. Methods: Paediatric patients from 9 to 15 years old and their guardians who sought care in the Paediatric Clinic of the Dentistry School were invited to participate. Their knowledge about mouth guards was collected through a two-part questionnaire with open and closed ended questions. The first part of the questionnaire contained sociodemographic questions and a main question about what a mouth guard is. The second part was solely about mouth guards and was applied immediately after an explanation about mouth guards at the end of the first part. All data collected were tabulated and analysed descriptively. Results: A total of 122 guardians were interviewed; 39.3% had children who practised some type of sports activity and 32% reported a trauma episode. Most (54.9%) did not know what a mouth guard was but, after explanation, 57.4% had seen someone using one. A total of 33 paediatric patients were interviewed, 60.6% of whom practised some sport; 27.3% of these had already suffered some type of dental trauma during the activity. None of the interviewees used a mouth guard during their sports activity, although 97% believed that using a mouth guard was important and 78.8% believed that the protector did not interfere with the activity. Conclusion: Guardians and paediatric patients have little knowledge about mouth guards.

Introdução: Os protetores bucais são usados para prevenir lesões durante atividades esportivas. Objetivo: O objetivo deste estudo é avaliar o conhecimento sobre os protetores bucais dos pacientes pediátricos e seus responsáveis. Métodos: Pacientes pediátricos de 9 a 15 anos, que procuraram atendimento na Clínica Pediátrica da Faculdade de Odontologia e seus responsáveis foram convidados a participar. Seu conhecimento sobre protetores bucais foi coletado através de um questionário em duas partes com perguntas abertas e fechadas. A primeira parte do questionário continha algumas questões sociodemográficas e uma questão principal sobre o que é um protetores bucais. A segunda parte era apenas sobre protetores bucais e foi aplicada imediatamente após uma explicação sobre os protetores bucais no final da primeira parte. Todos os dados coletados foram tabulados e analisados de forma descritiva. Resultado: Um total de 122 guardiões foram entrevistados, 39.3% tiveram crianças que praticavam algum tipo de atividade esportiva e 32% relataram um episódio de trauma. A maioria (54.9%) não sabia o que é um protetor bucal, mas após a explicação, 57.4% tinham visto alguém usando um. Um total de 33 pacientes pediátricos foram entrevistados, 60.6% praticaram algum esporte e 27.3% deles já sofreram algum tipo de trauma dental durante a atividade. Nenhum dos entrevistados usa um protetor bucal durante a atividade esportiva, embora 97% acreditem que usar um protetor bucal é importante e 78.8% acreditam que o protetor não interfere com a atividade. Conclusão: Em conclusão, os guardiões e pacientes pediátricos têm pouco conhecimento sobre os protetores bucais.