Natal teeth in premature neonates, products of twin gestation. A case report

Se presenta el caso de 02 recién nacidas gemelares, pre-términos tardíos, producto de gestación monocoriónica - biamniótica con presencia de dientes natales, los cuáles requirieron evaluación odontológica para definir la mejor conducta a seguir y con ello evitar riesgos o desenlaces fatales como la aspiración hacia bronquios. La evaluación evidenció escasa movilidad de piezas dentarias en ambos casos, por lo que se recomendó mantener los dientes; del mismo modo, se dio consejería a los padres sobre la higiene y cuidado de la salud bucal de sus hijas con control ambulatorio a los 3 meses.

We present the case of 2 twin newborns, late preterm, who were a product of monochorionic - diamniotic gestation and presented with natal teeth, which required a dental evaluation to define the best management strategy and thereby avoid risks or fatal outcomes such as bronchial aspiration. The evaluation showed little mobility of teeth in both cases, so it was recommended to keep the teeth. The parents were counseled on proper oral health care and hygiene for their daughters and scheduled for an outpatient follow-up at 3 months.

Shaping ability of a pediatric motor-driven instrumentation system in primary molar root canal prototypes

Abstract Evaluate the shaping ability and preparation time using a pediatric motor-driven rotary instrumentation compared to other systems in resin prototypes of primary molars. Methods: Thirty specimens were scanned in micro-CT and divided into three groups according to the instrumentation type: pediatric motor-driven Sequence baby File (SBF); conventional motor-driven (Sequence Rotary File - SRF); manual K file. Instrumentation time was timed. After preparation, the specimens were scanned again. The pre- and post-instrumentation images were superimposed to measure the amount of root canal deviation and the resin remnant thickness. ANOVA followed by the Tukey test analyzed the comparisons between groups (p<0.05). Results: No statistically significant differences occurred in root canal deviation among groups (p>0.05). There were statistically significant differences in the comparison among root thirds (p<0.001) but without significant differences in the interaction group vs. root third (p>0.05). Both motor-driven instrumentations showed statistically greater weariness than manual instrumentation (p<0.001), without significant significant differences between SBF and SRF. Motor-driven instrumentation had a shorter working time than manual instrumentation (p<0.001). Conclusion: Pediatric motor-driven instrumentation demonstrated good outcomes in relation to root canal deviation and amount of remnant structure, with shorter instrumentation time. SBF can be a suitable alternative for endodontic instrumentation in primary molars.

Resumo Objetivo: Avaliar os resultados da instrumentação endodôntica e o tempo de preparo de lima odontopediátrica ativada por motor (Sequence Baby File- SBF) em canais de molares decíduos prototipados. Métodos: Trinta espécimes foram escaneados em micro-CT e divididos em três grupos de acordo com o tipo de instrumentação: mecanizada odontopediátrica (SBF); mecanizada convencional; lima K manual. O tempo de instrumentação foi cronometrado. Após o preparo, os espécimes foram escaneados novamente. As imagens pré e pós-instrumentação foram sobrepostas e a quantidade de desvio do canal radicular e a espessura de resina remanescente foram mensurados. Para as análises de comparações entre os grupos foram realizados teste ANOVA seguido do teste de Tukey (p<0,05). Resultados: Não ocorreram diferenças estatisticamente significativas entre os grupos no desvio do canal radicular (p>0,05). Houve diferenças estatisticamente significativas na comparação entre terços radiculares (p<0,001), mas sem diferenças significativas na interação grupo vs. terço radicular (p>0,05). A instrumentação mecanizada apresentou desgaste estatisticamente maior do que a instrumentação manual (p<0,001), sem diferenças estatísticas entre a SBF e a lima mecanizada convencional. A instrumentação mecanizada teve menor tempo de trabalho quando comparado a instrumentação manual (p<0,001). Conclusão: A instrumentação mecanizada odontopediátrica demonstrou bons resultados em relação ao desvio do canal radicular e quantidade de estrutura remanescente, com menor tempo de instrumentação. A SBF pode ser uma alternativa adequada para a instrumentação endodôntica em molares decíduos.

Frecuencia de tratamientos pulpares en una población pediátrica peruana: un estudio retrospectivo en un centro dental especializado de 2015 a 2019 / Frequency of Pulp Treatments in a Peruvian Pediatric Population: a Retrospective Study in a Specialized Dental Center from 2015 to 2019

Resumen Los tratamientos pulpares constituyen uno de los tipos de procedimientos más realizados en pacientes pediátricos, cuyo objetivo primordial es devolver la función masticatoria, estética y fonética. El objetivo del presente estudio fue determinar la frecuencia de los tratamientos pulpares realizados en pacientes de 3 a 11 años de edad atendidos en el Servicio de Odontopediatría del Centro Dental Docente Cayetano Heredia desde enero de 2015 hasta diciembre de 2019. Se realizó la búsqueda de las historias clínicas de pacientes atendidos en el Servicio de Odontopediatría que hayan contado con los criterios de inclusión y exclusión. Se recogieron datos sobre edad, sexo, tipo de dentición y pieza dentaria, para la elaboración de una base de datos, y posteriormente tablas de contenido. De una muestra de 514 historias clínicas virtuales, con 1166 tratamientos pulpares realizados, el tratamiento pulpar indirecto fue el más realizado para ambos sexos, 41.17% (n=247) para el sexo femenino y 34.98% (n=198) para el sexo masculino. Según rango de edad, 3 a 5 años de edad son los pacientes que más tratamiento pulpar indirecto se realizaron con 39.06% (n=359). La mayoría de pacientes que presentaban dentición decidua se les realizaron el tratamiento de tratamiento pulpar indirecto con 39.32% (n=326). Siendo la pieza dental mayormente tratada con tratamiento pulpar indirecto la 84 con 41.18 % (n=70). El tratamiento pulpar que más se realizó dentro de nuestro estudio fue el tratamiento pulpar indirecto seguido de la pulpectomía y pulpotomía. El sexo femenino, grupo etario de 3 a 5 años y dentición decidua fueron los que más recibieron tratamientos pulpares. Los dientes con mayor frecuencia de tratamientos pulpares fueron la segunda molar inferior izquierda y la primera molar inferior derecha, y las que de menor frecuencia fueron las caninos inferiores derecho e izquierdo.

Abstract Pulp treatments are one of the types of procedures most performed in pediatric patients, whose primary objective is to restore the masticatory, aesthetic and phonetic function. The objective of this study was to determine the frequency of pulp treatments performed in patients from 3 to 11 years of age treated at the Pediatric Dentistry Service of the Centro Dental Docente Cayetano Heredia from January 2015 to December 2019. The search for the medical records of patients treated at the Pediatric Dentistry Service who have met the inclusion and exclusion criteria. Data were collected on age, sex, type of dentition and tooth, for the elaboration of a database, and later tables of contents. Of a sample of 514 virtual medical records, with 1166 pulp treatments performed, indirect pulp treatment was the most performed for both sexes, 41.17% (n=247) for females and 34.98% (n=198) for males. According to age range, 3 to 5 years of age are the patients who received more indirect pulp treatment with 39.06% (n=359). The majority of patients with deciduous dentition underwent indirect pulp treatment with 39.32% (n=326). Being the tooth most treated with indirect pulp treatment 84 with 41.18% (n=70). The pulp treatment that was most performed in our study was indirect pulp treatment followed by pulpectomy and pulpotomy. The female sex, age group 3 to 5 years and deciduous dentition were the ones that received the most pulp treatments. The teeth with the highest frequency of pulp treatments were the second lower left molar and the first lower right molar, and those with the least frequency were the lower right and left canines.

Factores asociados con la caries de infancia temprana severa en niños peruanos / Factors associated to severe early childhood caries in Peruvian children

Introducción: La caries de infancia temprana severa es un problema de salud pública que afecta a los niños que la padecen y a sus familias. Objetivo: Determinar la asociación de variables sociodemográficas, de higiene y alimentación con la caries de infancia temprana severa en niños peruanos. Métodos: Se realizó un estudio observacional, analítico, de casos y controles, de octubre a diciembre del 2019. La muestra estuvo compuesta por 264 niños de 2-5 años de edad y sus acompañantes (100 del grupo sin caries y 164 del grupo con caries de infancia temprana severa) que asistieron al Departamento de Odontopediatría del Instituto Nacional de Salud del Niño en Lima, Perú. Se realizó una entrevista estructurada directa, con preguntas cerradas sobre variables sociodemográficas, de higiene, de alimentación y una evaluación clínica, utilizando el índice cpo-s. Se utilizaron las pruebas estadísticas de chi cuadrado, Kruskal-Wallis y el modelo de regresión logística binaria. Resultados: De las variables sociodemográficas, experiencia dental negativa y seguro de salud, tuvieron un valor p < 0,05. Igual resultado tuvo el uso de una pasta dental fluorada, alimentación por biberón, tiempo de alimentación por biberón y edad de inicio del cepillado dental. En el modelo de regresión logística binaria solo las variables uso de pasta dental fluorada (OR = 0,578; 95 por ciento IC: 0,495-0,674) y edad de inicio del cepillado dental (OR = 0,924; 95 por ciento IC: 0,850-0,938) tuvieron un p < 0,05. Conclusiones: Las variables edad de inicio del cepillado dental y uso de una pasta dental fluorada están asociadas con la aparición de caries de infancia temprana severa en niños peruanos. Las variables sociodemográficas y de alimentación no están asociadas(AU)

Introduction: Severe early childhood caries is a public health problem affecting sufferers and their families. Objective: Determine the association of sociodemographic, hygiene and food intake variables to severe early childhood caries in Peruvian children. Methods: An observational analytical case-control study was conducted from October to December 2019. The study sample was 264 children aged 2-5 years (100 from the group without caries and 164 from the group with severe early childhood caries) and their companions, who attended the Children's Dental Care Department at the National Children's Health Institute in Lima, Peru. Direct structured interviews were held based on closed-ended questions about sociodemographic, hygiene and food intake variables, and a clinical evaluation was performed using the cpo-s index. Use was made of the chi-square statistical test, the Kruskal-Wallis test and the binary logistic regression model. Results: Among the sociodemographic variables considered, a negative dental care experience and health insurance obtained a value of p < 0.05. The same result was obtained by use of fluoride toothpaste, bottle feeding, bottle feeding time and age at tooth brushing start. In the binary logistic regression model only the variables use of fluoride toothpaste (OR = 0.578; 95 por ciento CI: 0.495-0.674) and age at tooth brushing start (OR = 0.924; 95 por ciento CI: 0.850-0.938) obtained a value of p < 0.05. Conclusions: The variables age at tooth brushing start and use of fluoride toothpaste are associated to the appearance of severe early childhood caries in Peruvian children. Sociodemographic and food intake variables are not associated(AU)

Talon's cusp in a primary maxillary central incisor A report of a rare odontogenic anomaly

Talon's cusp, a type of dens evaginatus (DE) in a primary tooth, is a rare odontogenic anomaly which is reported sparingly in the literature. We report this case describing the presence of a talon's cusp on the right primary maxillary central incisor in a 2-year-old boy precipitating discomfort, owing to occlusal interference. The treatment plan involved pulpectomy and reduction of the lingula DE extension under general anesthesia.

Lesion sterilization and tissue repair of primary molar to the eruption of its permanent successor: a case report / Esterilização da lesão e reparação de tecidos de molar decíduo: relato de caso clínico até a erupção do permanente sucessor

The aim of this study is to report a clinical case of lesion sterilization and tissue repair in primary molar, with follow-up until the eruption of the permanent successor. A 6-year-old male patient came to the Pediatric Dentistry Clinic at Faculdade Sao Leopoldo Mandic in Campinas-SP, with his mother, complaining of "caries in several teeth". On clinical examination, it was found that tooth 85 had a severe carious lesion with pulp involvement and fistula. Radiographically, radiolucency was observed in the furcation region. It was then decided to perform lesion sterilization and tissue repair of the tooth with CTZ paste. After 6 months of the procedure, the tooth was clinically and radiographically normal and after 3 years it was observed that tooth 85 was in complete root resorption. After extraction, the permanent successor erupted naturally without clinical or radiographic alterations. It can be concluded that the present clinical case demonstrated success in the use of CTZ paste in the lesion sterilization and tissue repair of primary molars, until the complete eruption of the permanent successor. (AU)

O objetivo desse estudo é relatar o caso clínico de esterilização da lesão e reparação de tecidos em molar decíduo com pasta CTZ, com acompanhamento até a erupção do pré-molar sucessor. Paciente do sexo masculino, 6 anos de idade, apresentou-se à Clínica de Odontopediatria da Faculdade São Leopoldo Mandic em Campinas-SP, acompanhado de sua mãe, queixando-se de "cárie em vários dentes". Ao exame clínico, verificou-se que o dente 85 apresentava lesão de cárie severa com envolvimento pulpar e fístula. Radiograficamente, observou-se radiolucidez na região de furca. Optou-se, então, por realizar a esterilização da lesão e reparação de tecidos do dente com pasta CTZ. Após 6 meses da realização do procedimento, o dente apresentava-se clinica e radiograficamente normal e após 3 anos observou-se que o elemento 85 estava em rizólise completa. Feita a extração, o permanente sucessor erupcionou naturalmente sem alterações clínicas ou radiográficas. Pode-se concluir que o presente caso clínico demonstrou sucesso do emprego da pasta CTZ na esterilização da lesão e reparação de tecidos de molar decíduo, até completa erupção do permanente sucessor. (AU)

Microfiltración marginal de resinas de relleno masivo y nanohíbrida en molares deciduos / Marginal microleakage of bulk fill and nanohybrid resins in deciduous teeth

Introducción: En la atención odontológica a niños es crucial seleccionar materiales restaurativos con buen rendimiento clínico y corto tiempo de aplicación, especialmente en pacientes con capacidad de atención limitada. Las resinas compuestas, con el mejoramiento de sus propiedades físicas y mecánicas, constituyen hoy uno de los materiales de mayor elección por el odontopediatra. Las resinas de relleno masivo son una alternativa atractiva para las restauraciones en el sector posterior. Objetivo: Comparar el grado de microfiltración marginal de resinas de relleno masivo y nanohíbrida en molares deciduos. Métodos: Estudio experimental, in vitro, en cuarenta molares deciduos; exodonciados por motivos terapéuticos, divididos en dos grupos. Grupo I: resina nanohíbrida con técnica incremental (Tetric® N Ceram - Ivoclar Vivadent) y Grupo II: resina de relleno masivo con técnica monoincremental (Tetric® N Ceram bulk fill - Ivoclar Vivadent). Se realizó un proceso de termociclado manual de 500 ciclos, entre 5 ºC ± 2 ºC y 55 ºC ± 2 ºC. Las muestras fueron sumergidas en azul de metileno al 0,5 por ciento durante 24 horas a 37 ºC. Se analizaron con el microscopio estereoscópico de luz a 40X. Resultados: Todas las muestras presentaron microfiltración. Con el uso de resina nanohíbrida, el 25 presentó microfiltración leve; el 30 por ciento, moderada; y el 45 por ciento, severa. En el grupo de la resina de relleno masivo, el 30 por ciento presentó microfiltración leve; el 35 por ciento, moderada; y el 35 por ciento, severa. No se encontró diferencia significativa entre ambos grupos (p = 0,55). Conclusiones: Ambas resinas, de relleno masivo y nanohíbrida, presentaron similar microfiltración marginal in vitro, en molares deciduos; por lo que la técnica de relleno masivo, por su fácil y rápida aplicación en un solo tiempo, es una buena alternativa en la rehabilitación dental odontopediátrica(AU)

Introduction: In children's dental care it is crucial to select restorative materials of proven clinical quality and a short application period, particularly with patients of limited attention capacity. Due to their improved physical and mechanical properties, composite resins are currently one of the materials of choice for children's dental care. Bulk fill resins are an attractive alternative for posterior restorations. Objective: Compare the degree of marginal microleakage of bulk fill and nanohybrid resins in deciduous teeth. Methods: An experimental in vitro study was conducted of 40 deciduous teeth extracted for therapeutic reasons, which were divided into two groups. Group I: nanohybrid resin by incremental technique (Tetric® N Ceram - Ivoclar Vivadent) and Group II: bulk fill resin by monoincremental technique (Tetric® N Ceram bulk fill - Ivoclar Vivadent). A manual 500-cycle thermocycling procedure was performed at 5ºC ± 2ºC to 55ºC ± 2ºC. The samples were soaked in 0.5 percent methylene blue at 37ºC for 24 hours and analyzed under a light stereo microscope at 40X. Results: Microleakage was present in all the samples. In the nanohybrid resin group, microleakage was mild in 25 percent, moderate in 30 percent and severe in 45 percent. In the bulk fill resin group, microleakage was mild in 30 percent, moderate in 35 percent and severe in 35 percent. No significant difference was found between the groups (p = 0.55). Conclusions: Both resins, bulk fill and nanohybrid, presented similar in vitro marginal microleakage in deciduous molars. The bulk fill technique is therefore a good alternative for children's dental rehabilitation, due to its easy and fast application in a single session(AU)

Rehabilitación de incisivos deciduos con pernos en fibra de vidrio y resina compuesta: reporte de caso / Rehabilitation of deciduous incisors using glass fiber core post and composite resin: case report / Reabilitação de incisivos decíduos com pinos em fibra de vidro e resina composta: relato de caso

Resumen La caries de la infancia temprana hace referencia a la presencia de una o más superficies cariadas, perdidas o restauradas en dientes deciduos en niños menores de 6 años de edad, siendo clasificada como severa cuando afecta a niños menores de 3 años. En dientes deciduos con gran destrucción coronal por caries dental, pero con integridad radicular, la rehabilitación puede ser compleja debido a la calidad y cantidad de estructura remanente. El objetivo de este caso, fue reportar la rehabilitación de cuatro incisivos deciduos severamente afectados por caries dental de la infancia temprana utilizando pernos en fibra de vidrio y restauraciones directas en resina compuesta. Paciente masculino de tres años de edad que presenta lesiones de caries dental activas y cavitadas y necrosis pul- par en los cuatro incisivos deciduos superiores. En la fase higiénica se realizaron actividades de educación, motivación en higiene y adecuación del medio bucal; en la fase restauradora se realizaron los tratamientos endodónticos, cementación de pernos en fibra de vidrio y restauraciones en resina compuesta con matrices anatómicas de celuloide y en la fase de mantenimiento se realizaron controles clínicos, radiográficos y actividades específicas de prevención. La rehabilitación con pernos de fibra de vidrio y resina compuesta logró reestablecer la forma, función y estética de los dientes del paciente.

Abstract The early childhood caries refers to the presence of one or more decayed, lost or restored surfaces in deciduous teeth in children under 6 years, being classified as severe when it affects children under 3 years of age. In deciduous teeth with several coronal destruction due to dental caries but with root integrity, rehabilitation can be complex due to the quality and/or quantity of the remaining structure. The aim of this case was to report the rehabilitation of four deciduous incisors severely affected by early childhood caries using fiberglass posts and direct restorations with composite resin. A three-year-old male patient with active and cavitated dental caries lesions and pulpal necrosis in the four upper deciduous incisors. In the hygienic phase, activities in education and motivation in oral hygiene were carried out; in the corrective phase, endodontic treatments were performed, cementation of glass fiber posts and were made restorations with composite resin using anatomical celluloid matrices; in the maintenance phase, the patient received support and reinforcement of the recommendations in the diet and the oral hygiene. The rehabilitation using fiber posts and composite resin reestablished the shape, function and esthetics of the teeth of the patient.

Resumo A cárie da primeira infância referee a presença de uma ou mais superfícies cariadas, perdidas ou restauradas em dentes decíduos de crianças menores de 6 anos de idade, sendo classificada como severa quando afeta menores de 3 anos. Em dentes decíduos com extensa destruição coronária pela cárie dentária mas que apresentam integridade radicular, a reabilitação pode ser considerada complexa devido a qualidade e quantidade da estrutura remanescente. O objetivo deste caso foi reportar a reabilitação de quatro incisivos decíduos superiores severamente afetados pela cárie da primeira infância, utilizando pinos de fibra de viro e restaurações diretas em resina composta. Paciente do sexo masculino de 3 anos de idade apresentava lesões de cárie dentária ativas, cavitadas e com necrose pulpar nos quatro incisivos decíduos permanentes. Na fase de adequação do meio bucal, foi realizada a instrução e orientação de higiene oral; na fase restauradora foram realizados os tratamentos endodônticos, cimentação de pinos de fibra de vidro e restaurações em resina composta com matrizes anatômicas de celulose. Na fase de manutenção, foram realizados os controles clínicos, radiográficos e atividades específicas de prevenção. A reabilitação com pinos de fibra de vidro e resina composta foram capazes de reestabelecer a forma, função e estética dos dentes do paciente.

Teething Beliefs and Traditional Practices towards Infant Teething Symptoms among Caretakers in Abha City, Saudi Arabia

Objectives: To investigate symptoms that are associated with teething as reported by caretakers and the related measures undertaken to relieve it. To study the relationship between caretaker, child-related factors and the reported teething symptoms. To correlate reported teething symptoms with clinical findings during the teething period. Materials and methods: The current study was a cross-sectional survey conducted among Saudi caretakers of children aged 6-36 months of age, following the survey, each child was clinically examined as well. The following survey was carried out at Mahala Maternal and child health Hospital, Abha city. A convenience sampling method was adopted for collecting the data. A total of 300 caretakers along with their children were approached who agreed to be part of the study. All the caretakers were asked to fill a structured-questionnaire, the questionnaire was asked to be completed using a face-to-face interview along with children’s guardians and it was further followed by the clinical examination of the child. Conclusion: The present study showed that most caretakers reported their children to suffer from both local oral disturbances (gum rubbing 41% followed by redness and swelling 20%) and systemic manifestations (increased biting, drooling, fever, diarrhoea, and loss of appetite) during their teething period.

Radicular cyst associated with primary molar: Surgical intervention and space management

Radicular cysts associated with primary teeth are rare. This case report describes radicular cyst associated with carious primary mandibular second molar in a 5-year-old patient and discusses its surgical intervention, space management, and follow-up for 3½ years.

Factores de riesgo maternos y neonatales asociados al retardo de la dentición temporal / Maternal and neonatal risk factors associated with the temporary teething delay

Se realizó un estudio analítico, observacional, de casos y controles, en niños de los círculos infantiles Pétalos de Rosa y La Espiguita, pertenecientes al área de salud del Policlínico Docente Armando García Aspurú de Santiago de Cuba, durante el período de febrero de 2015 a marzo de 2016, con vistas a determinar los factores maternos y neonatales asociados al retraso en la aparición de dientes temporales. La población quedó conformada por 150 niños de 2do a 4to años de vida, de los cuales se tomaron 2 controles (N=100) por cada caso (N=50). En la serie se obtuvo asociación estadísticamente significativa de las variables estado nutricional de la madre, ganancia de peso de la madre, enfermedades maternas, lactancia materna y peso del niño al nacer, con la alteración del brote dentario temporal en los niños. Se recomendó realizar intervenciones educativas en los círculos infantiles y las comunidades para apoyar el trabajo del médico de la familia

An analytic, observational, of cases and controls study, in children from Pétalos de Rosa and La Espiguita day care centers, belonging to the health area of Armando García Aspurú Teaching Polyclinic was carried out in Santiago de Cuba, during February, 2015 to March, 2016, aimed at determining the maternal and neonatal factors associated with the delay in the emergence of the temporary teeth. The population was conformed by 150 children from 2nd to 4th years of life, from whom 2 controls were taken (N=100) for each case (N=50). In the series a statistically significant association of the variables mother's nutritional state, mother's weight gain, maternal diseases, breast feeding and child birth weight was obtained, with the disorder of the temporary teething eruption in the children. It was suggested to carry out educational interventions in the day care centers and communities to support the family doctor's work

Optimal Xeno-free Culture Condition for Clinical Grade Stem Cells from Human Exfoliated Deciduous Teeth

BACKGROUND AND OBJECTIVES: Stem cells from human exfoliated deciduous teeth (SHED) are a promising clinical resource for various tissue defects, including lumbar spondylosis, neural compression, and cleft palate. Use of media containing animal-derived serum carries potential risk of infectious diseases and unwanted immunogenicity. To increase the potential utility of SHED for clinical application, SHED was adapted to xeno-free conditions. METHODS: Define xeno-free culture media were compared with the conventional serum containing media in the culture of SHED. Cultured SHED in different media were further characterized through proliferative capacities, cellular phenotype, and differentiation potential. RESULTS: Selected xeno-free media were capable of supporting the growth of SHED. MSCGM-CD Bulletkit medium greatly increased the number and proliferate capacity of colony-forming unit-fibroblast than SHED cultured in other media. In addition, the characteristic surface markers expression and multipotent differentiation potential of SHED in the MSCGM-CD Bulletkit medium were comparable to those observed with serum-containing medium. CONCLUSIONS: The xeno-free medium described herein has the potential to be further used for the safe expansion and to determine efficient way to produce clinical grade dental stem cells for therapeutic applications.

Rare Case of Multiple Compound Odontomas with Dens Invaginatus Associated with Impacted Primary and Unerupted Permanent Maxillary Central Incisor – A Case Report.

Aims: An Odontoma is usually found in the surrounding area of the unerupted permanent tooth bud and rarely adjacent to the primary central incisor. Histopathological examination of the Odontoma revealed presence of surface invagination similar to Dens invaginatus. Presentation of Case: A seven year-old healthy girl presented with an unerupted maxillary left primary central incisor along with swelling of labial gingiva in that region. No history of traumatic injury was recorded. Radiological examination revealed impacted primary maxillary left central incisor and three irregular masses of calcified tooth like tissues. Discussion: Odontomas are commonly occuring hamartomas associated with permanent dentition. Odontomas are rarely associated with Primary dentition. Multiple Odontomas leading to impaction of primary incisors is still rarer. This report presents a case of an impacted primary central incisor and unerupted permanent central incisor due to multiple odontomas, one of which was histologically diagnosed as multiple compound odontoma with Dens invaginatus. The Odontomas and impacted primary central were surgically removed to facilitate the eruption of permanent incisor. Conclusion: This report presents a unique and rare case of multiple Odontomas leading to impaction of primary tooth and unerupted permanent incisor. This report also proves Odontomas with deep surface invagination similar to Dens Invaginatus can be present.

Wear of primary teeth caused by opposed all-ceramic or stainless steel crowns

PURPOSE: This study was conducted to evaluate the effects of full-coverage all-ceramic zirconia, lithium disilicate glass-ceramic, leucite glass-ceramic, or stainless steel crowns on antagonistic primary tooth wear. MATERIALS AND METHODS: There were four study groups: the stainless steel (Steel) group, the leucite glass-ceramic (Leucite) group, the lithium disilicate glass-ceramic (Lithium) group, and the monolithic zirconia (Zirconia) group. Ten flat crown specimens were prepared per group; opposing teeth were prepared using primary canines. A wear test was conducted over 100,000 chewing cycles using a dual-axis chewing simulator and a 50 N masticating force, and wear losses of antagonistic teeth and restorative materials were calculated using a three-dimensional profiling system and an electronic scale, respectively. Statistical significance was determined using One-way ANOVA and Tukey's test (P.05). CONCLUSION: Leucite glass-ceramic and lithium disilicate glass-ceramic cause more primary tooth wear than stainless steel or zirconia.

The effects of calcium sodium phosphosilicate on the enamel remineralization of primary teeth / 实用口腔医学杂志

Objective:To study the effect of calcium sodium phosphosilicate(CSP)on the enamel remineralization of primary teeth. Methods:30 extracted human healthy primary molars were collected.Each tooth was cut bucco-lingually and mesial-distally into 4 sections.The sections were assigned randomly into 4 groups(n =30).Demineralization and remineralization cyclic model was estab-lished by etching with 35% phosphate acid for 2 min and then treated by unexposure of the sample to nothing(control,group A),so-dium monofluorophosphat(MFP,group B),CSP(group C)and MFP +CSP(group D).The cyclic was repeated twice daily for 30 d. The enamel surface morphology was observed by SEM and the surface microhardness(SMH)was measured.Results:On the tenth day,squamous morphology was observed on the enamel surface of group A and that of group D appeared less demineralization.The SMH value of group D was significant higher than that of group A(P <0.05).On the thirtieth day,obvious demineralization was ob-served in group A.Group B,C and D appeared surface remineralization.The SMH value of group B,C and D was significant higher than that of group A(P <0.05).Highest SMH value was achieved in group D.Conclusion:CSP combined with fluoride is more ef-fective in the enamel remineralization of primary teeth than the single application of them.

Prótesis fija con sistema tubo-barra en odontopediatría: reporte de un caso clínico de 12 meses de seguimiento / Fixed prosthesis with tube-bar system in pediatric dentistry: a case report over 12 months of follow-up

Introducción: La pérdida prematura de incisivos primarios puede producir alteraciones estéticas, funcionales y psicológicas. La rehabilitación protésica permite reemplazar los dientes faltantes y evitar las secuelas que ello puede acarrear. Objetivo Describir la técnica y evolución clínica de una prótesis fija anterior tipo Denari durante 12 meses de seguimiento. Descripción del caso Paciente de sexo femenino de 3 años de edad que acude en busca de atención profesional posterior a la avulsión de los incisivos centrales superiores. Con la finalidad de devolver la estética del sector anterosuperior, recuperar la función oral e interferir con el hábito de interposición lingual se decidió realizar una terapia basada en prótesis parcial fija tipo Denari. Durante el año de seguimiento la prótesis fue muy bien tolerada por la paciente y sin alteración de los tejidos blandos adyacentes, destacando un aumento en el espacio interincisal, lo que demuestra el crecimiento transversal. Conclusión La prótesis dental en niños es una tarea exigente, marcada por la necesidad de adaptación a los cambios continuos que conllevan los procesos de crecimiento y maduración de complejo maxilofacial. En este contexto es que la prótesis tipo Denari con sistema tubo-barra es una excelente y estética alternativa en pacientes de corta edad en donde la prótesis va a permanecer en la boca por un largo período de tiempo, sin interferir en el crecimiento, desarrollo y función del sistema estomatognático.

Introduction: Premature loss of primary incisors may result in aesthetic, functional and psychologic problems. Prosthetic restoration allows replacing missing teeth, avoiding the unwanted consequences that their absence may carry. Objective The aim of this clinical case is to describe the technique and clinical evolution of a Denari fixed anterior prosthesis over 12 months of follow-up. Case description 3 year-old female patient sought professional attention after the avulsion of the upper central incisors. In order to restore the natural appearance of the anterior superior area, recover oral function and intervene in the habit of tongue interposition, the treatment decided upon was a partially fixed Denari prosthesis. During the follow-up year the prosthesis was very well tolerated by the patient and without altering any adjacent soft tissues. We highlight an increase in the interincisal space, which demonstrates transversal growth. Conclusion A dental prosthesis in a child is a demanding task marked by the need to adapt to the continuous changes brought about by maxillofacial growth and maturation. It is in this context that the Denari prosthesis with its tube-bar system is an excellent and esthetic alternative in young patients where the prosthesis is going to remain in place for a prolonged period without interfering in the growth, development and function of the stomatognatic system.

Two endodontics techniques analysis in primary molars with fistula / Análise de duas técnicas endodônticas em molares decíduos fistulados

The purpose of this research was to follow the radiolucent area (pixels) in the furcation area and the behavior of the endodontically treated deciduous molars with different simplified echniques.

A proposta da pesquisa foi acompanhar a area radiolúcida (pixels) na região de furca e a resposta clínica de molares decíduos tratados endodonticamente com diferentes tecnicas simplificadas.

Does the Presence of Sucrose in Pediatric Antibiotics Influence the Enamel Mineral Loss and the Streptococcus mutans Counts in Dental Biofilm?

The role of antibiotics containing sucrose on the formation of dental caries is still controversial. This study aimed to investigate the effect of two antibiotics (amoxicillin and potassium clavulanate suspension), with and without sucrose, on human dental hardness and Streptococcus mutans counts in dental biofilm. Primary tooth fragments (n=72) were coated with nail varnish leaving a window of 2.25 mm diameter. Specimens were fixed in 24-well polystyrene plates, containing BHI medium. S. mutans (clinical strains) represented the inoculum to form biofilm on the fragments for 24 h. Twelve fragments were separated for the initial count of microorganisms (baseline). The other fragments were divided into 4 groups (n=12) of treatment: G1 (Clavulin(r)), G2 (Betamox(r)), G3 (chlorhexidine 0.12%), G4 (sucrose 10%). All specimens had their self-control area (covered area). The cross-sectional microhardness (CSMH) was evaluated for each specimen. All the treated groups had a loss of hardness compared to their self-controls (p<0.05). Both drugs inhibited the S. mutans growth and promoted no CSMH difference among them. Both antibiotics eliminated all formed biofilm and did not cause mineral loss from the enamel, regardless the presence of sucrose in its formulation.

O papel dos antibióticos contendo sacarose na formação de cárie dentária é ainda controverso. Este estudo teve como objetivo investigar o efeito de dois antibióticos (amoxicilina / clavulanato de potássio suspensão oral), com e sem sacarose, na dureza do esmalte dental humano e na contagem de Streptococcus mutans no biofilme dental. Fragmentos de dentes decíduos (n = 72) foram revestidos com verniz deixando uma janela de exposição de 2,25mm de diâmetro. Os espécimes foram fixados em placas de poliestireno de 24 poços, contendo meio de cultura BHI. S. mutans (estirpes clínicas) representaram o inoculo para formar biofilmes sobre os fragmentos por 24 h. Doze fragmentos foram separados para a contagem inicial de microrganismos (baseline). Os restantes dos fragmentos foram divididos em 4 grupos (n = 12) de tratamento: G1 (Clavulin(r)), G2 (Betamox(r)), G3 (clorexidina 0,12%), G4 (sacarose a 10%). Todas as amostras tiveram sua área de controle (área coberta). A microdureza transversal (CSMH) foi avaliada para cada espécime. Todos os grupos tratados tiveram uma perda de dureza quando comparados com os seus respectivos controles (p <0,05). Ambos os fármacos inibiram o crescimento de S. mutans e não promoveram diferença da CSMH entre eles. Ambos os antibióticos eliminaram todo o biofilme formado, não promovendo assim, perda mineral do esmalte, independente da presença de sacarose na sua formulação.

Exploratory study of the prevalence of traumatic injuries in preschool children in the city of Macapá, Brazil

Objective:To verify the prevalence of dental trauma and the most common types of trauma in primary dentition of preschool children in the city of Macapá, Brazil. Material and Methods:A convenience sample of 177 preschool children aged 1-4 years of both genders was examined. Data collection occurred in public schools in different regions examiner. For comparison of data, statistical Chi-square test was applied, arranged in order of frequency (p<0.05). Results:The prevalenceof traumatic injuries was 46.3%,there was no statistically significant difference between genders (p = 0.09). The least affected age group was 1 year old (p=<0.001). The most common type of injury was enamel fracture (88.3%) and the most affected teeth were upper central deciduous incisors (70.1%) and upper lateral deciduous incisors (17.6%). Conclusion:Due to the high prevalence of dental trauma in this population, preventive and educational measures are needed to reduce the number of cases both in the private network and in promotions of public and community health

Effect of Two Microshear Test Devices on Bond Strength and Fracture Pattern in Primary Teeth

This in vitro study evaluated the influence of two devices for application of shear load in microshear tests on bond strength and fracture pattern of primary enamel and dentin. Eighty primary molars were selected and flat enamel (40 teeth sectioned mesio-distally) and dentin (40 teeth sectioned transversally) surfaces were obtained. Both surfaces were polished to standardize the smear layer. Two-step etch-and-rinse adhesive systems (Adper Single Bond and XP Bond) were used. Polyethylene tubes was placed over the bonded surfaces and filled with composite resin. The microshear testing was performed after storage in water (24 h/37 °C) using two devices for application of microshear loads: a notched rod (Bisco Shear Bond Tester) or a knife edge (Kratos Industrial Equipment). Failure modes were evaluated using a stereomicroscope. Bond strength data were subjected to ANOVA and chi-square test to compare the failure mode distributions (α=0.05). No significant differences were observed between the groups for dentin and enamel bond strength or fracture patterns (p>0.05). The predominant failure mode was adhesive/mixed. In conclusion, the devices for application of shear loads did not influence the bond strength values, regardless of adhesive system and substrate.

Este estudo in vitro avaliou a influência de dois dispositivos para aplicação de força de cisalhamento em testes de resistência de união ao microcisalhamento e no padrão de fratura em dentina e esmalte de dentes decíduos. Oitenta molares decíduos foram selecionados e superficies planas em esmalte (40 dentes seccionados no sentido mésio-distal) e dentina (40 dentes seccionados transversalmente) foram obtidas. Ambas as superficies foram abrasionadas para padronização da lama dentinária. Dois sistemas adesivos de condicionamento ácido prévio (Adper Single Bond e XP Bond) foram utilizados. Tubos de polietileno foram colocados sobre as superficies, nas quais já haviam sido aplicados os sistemas adesivos, e preenchidos com resina composta. O teste de resistência de união ao microcisalhamento foi realizado após armazenamento dos espécimes em água (24 h/37 °C) utilizando dois dispositivos para a aplicação das forças de cisalhamento: cisalha côncava (Bisco Shear Bond Tester) e cisalha plana (Kratos Industrial Equipment). O padrão de fratura foi avaliado usando estereomicroscópio. Os dados de resistência de união foram submetidos à ANOVA e o teste quiquadrado foi utilizado para comparar a distribuição dos padrões de fratura (α=0,05). Não foram observadas diferenças estatisticamente significantes entre os grupos, tanto para a resistência de união a dentina e esmalte quanto para o padrão de fratura (p>0,05). O modo de falha predominante foi adesiva/mista. Em conclusão, os dispositivos para aplicação de força de cisalhamento não influenciam os valores de resistência de união, independente do sistema adesivo e substrato.