Randomized Clinical Study of the Use of MTA and Biodentine™ for Pulpotomy in Primary Teeth

ABSTRACT Objective: To verify, through clinical and radiographic evaluations, the in vivo response of the dentin-pulpal complex of human primary teeth after pulpotomy with MTA and Biodentine™ in a follow-up period of 3, 6, and 12 months. Material and Methods: Thirty teeth were divided into MTA pulpotomy (n = 15) and Biodentine™ pulpotomy (n = 15) from children between 5 and 9 years of age, a randomized clinical trial with simple random sampling. The materials were inserted into the cavity after opening and removing the coronary pulp tissue. The cavity base consisted of glass ionomer cement and light-cured composite resin restoration. Clinical and radiographic analyses were performed after 3, 6, and 12 months. Statistical analysis by Fisher's exact test for dichotomous data at a 5% significance level was utilized. Results: Both materials caused color change after 12 months. However, MTA showed a higher percentage than Biodentine™ (p<0.0001). Pain was detected only with Biodentine™ at six months and mobility at 12 months (p=0.0013). Radiographically, after 12 months, periapical lesions, interradicular lesions, and internal resorption were evidenced in 13% of the cases for Biodentine™-treated teeth (p<0.0013). MTA induced pulp calcification in 13% of cases, unlike Biodentine™ (p<0.0013). Conclusion: BiodentineTM and MTA are suitable for clinical use in pulpotomy treatment, yet both materials lead to tooth discoloration.

Single Nucleotides Polymorphisms in COX2 Gene and their Association with Signs and Symptoms of Teething - A Pilot Study

ABSTRACT Objective: To investigate the association between single nucleotide polymorphisms in the COX2 gene (rs689466 and rs5275) and local and systemic signs and symptoms of teething. Material and Methods: Forty-four pairs of mothers-babies/toddlers were included. Erupted primary teeth were evaluated during clinical examination. Local and systemic signs and symptoms of teething were obtained from mothers' reporting via anamnesis. Samples of buccal cells were retrieved for DNA genotyping using real-time PCR. The T-test, Chi-square test, logistic regression, and haplotype analyses were applied. Results: Almost all mothers (95.5%) reported at least one local or systemic sign and symptom of teething. The most common was increased salivation (79.5%), diarrhea (72.3 %), and fever (70.5 %). The mean number of signs and symptoms per child was higher in boys than girls (mean = 5.1; SD= 1.5; p=0.008). Sleep disturbance (p=0.03) and loss of appetite (p=0.05) were more reported in boys. The rs689466 and rs5275 were not associated with signs and symptoms of teething (p>0.05). Conclusion: The single nucleotide polymorphisms in the COX2 gene (rs689466 and rs5275) were not associated with local and systemic signs and symptoms of teething.

Establishing Cephalometric Norms in Primary Dentition Using Comprehensive Craniofacial Growth Analysis - A Digital Cephalometric Study

ABSTRACT Objective: To establish cephalometric norms in primary dentition among males and females using novel customized Comprehensive Cephalometric Growth (CCG) Analysis. Material and Methods: The study was conducted on 67 subjects with a mean age of 5.5 yrs. Digital lateral cephalometric radiographs were obtained using Planmeca Pro One. The digital images were then transferred to Nemoceph software. Craniofacial Growth (CCG) Analysis was configured in the software with five sub-groups. This sub-grouping was done such that related components were grouped together and comprehensively; it would provide an assessment of every component of the craniofacial region that could be affected either by treatment maneuver or growth process. The same was used for the cephalometric analysis and to determine the cephalometric norms in the primary dentition. Results: Certain linear measurements were higher among males when compared to females. However, most measurements remained similar among males and females during this age group. The CCG analysis provided a comprehensive knowledge of the craniofacial parameters during the growth process. Conclusion: The cephalometric norms during primary dentition thus established using Comprehensive Craniofacial Growth analysis would provide the data for early diagnosis and treatment planning in interceptive orthodontic treatment procedures.

Influence of Depression and Use of Alcohol and / or Tobacco by Parents in the Oral Health of Children with Disabilities

ABSTRACT Objective: To investigate the influence of parental depression and substance use in the oral health care of children with disabilities. Material and Methods: A cross-sectional study was conducted involving 151 children with disabilities and their parents/caregivers. To detect the presence of depression and alcohol or tobacco use, the parents/caregivers answered three questionnaires: two versions of the Patient Health Questionnaire (PHQ), AUDIT (Alcohol Use Disorders Identification Test), and the Fagerstrom Test for Nicotine Dependence (FTND). Then, the children with disabilities underwent oral examination to evaluate biofilm control, gingival condition and the dental carie index (decayed, missing, and filled teeth - dmft ̸ DMFT). Results: There was a statistically significant association between tobacco use and dental caries in deciduous teeth (p=0.046). The children of smokers had six times greater need for dental treatment than that of non-smokers (OR= 6.36; CI= 1.3-30.5). There was no statistically significant association between the oral health of the children with disabilities and parental alcohol consumption and depression (p>0.05). Children with medical condition had a higher need for dental treatment than children with intellectual disability (p=0.003). Conclusion: Parental smoking habits increase dental caries in the deciduous teeth of children with disabilities, but parental depression and alcohol use do not influence the oral health of children with disabilities. Children with medical condition have more treatment needs than children with intellectual disability.

Clinical and Radiographic Sequelae in Primary Teeth due to Dental Trauma

Objective: To evaluate the presence of clinical and radiographic sequelae in primary teeth affected by dental trauma and its association with age at the time of trauma in children attended at a Public Higher Education Institution. Material and Methods: This is a longitudinal clinical study, in which 229 patients with history of dental trauma in primary teeth were examined, totaling 390 traumatized teeth. Relative frequency analysis was used, and for associations, the Chi-square test was used to verify the relationship of age at the time of trauma with variables such as type of trauma. Results: The most prevalent age group was over 24 months, and fall from own height as the main etiological factor; 71.0% of traumas had involvement of 2 teeth, 9.5% had history of anterior trauma and 66.6% of traumas involved supporting tissues. Regarding the type of injury to dental tissue, the most prevalent was enamel fracture (58.3%) and to periodontium, lateral dislocation (30.8%). Children older than two years had less trauma related to dental tissue (p<0.01), higher number of injuries to the periodontium (p=0.03); and most of them did not present extra-oral changes associated with trauma (p=0.01). During the 12- month period, 325 teeth were examined, and the most frequent clinical sequelae observed was crown discoloration. In the radiographic evaluation, inflammatory root resorption was the most prevalent. Conclusion: Children older than two years presented more injuries to the periodontium. After 12 months, the main clinical sequelae observed was enamel discoloration and the main radiographic sequelae was inflammatory root resorption.

Estética em dentes decíduos traumatizados: clareamento e restauração / Aesthetics in traumatized primary teeth: bleaching and restoration

O trauma dental decorrente de quedas, acidentes e atividades esportivas tem alta prevalência e pode impactar na qualidade de vida das crianças e suas famílias devido às alterações estéticas adversas. Este trabalho relata o caso clínico de paciente do sexo feminino, 3 anos de idade que procurou atendimento odontológico devido à fratura da coroa e descoloração do dente 51 após trauma. Clinicamente foi observada a presença de fístula e abcesso na região do dente. O dente foi submetido a tratamento endodôntico, seguido de clareamento interno/ externo com peróxido de hidrogênio a 35%. Após a finalização do clareamento, realizou-se a restauração da fratura permitindo o restabelecimento da estética e função. Um acompanhamento de 5 anos foi realizado até a erupção completa da coroa do dente 11. Neste período, não se observou alterações clínicas nem radiográficas do dente traumatizado, e o dente sucessor irrompeu sem nenhum comprometimento. Concluiu-se que o clareamento interno/ externo de dente decíduo seguido da restauração foi satisfatório para o restabelecimento da estética e função dentária da criança sem nenhuma alteração para o germe sucessor.

Dental trauma caused by falls, accidents and sports activities has high prevalence and may influence the quality of life of children and their family due to adverse cosmetic changes. This case report presents a three years old gril who refered to dental care due to crown fracture and discoloration of primary central incisor after trauma. Clinically, it was observed the presence of fistula and abscess in the tooth region. Endodontic treatment was done followed by internal/external bleaching with 35% hydrogen peroxide. The tooth was then restored providing aesthetics and function for the patient. There was a five years follow-up until full eruption of permanentÆs central incisorÆs crown. In this period, there were no clinical or radiographic changes on the traumatized tooth, and the successor tooth erupted without any impairment. It was concluded that the result of internal/external primary tooth bleaching followed by restoration, was satisfactory restoring aesthetics and function with no alteration to the successor tooth.

Tratamientos pulpares en dientes primarios / Pulp therapies in primary teeth

El mantenimiento de las piezas dentarias para desempeñar sus funciones en la alimentación, en la expresión oral, en el mantenimiento de espacios en las arcadas dentarias, en el estímulo para el crecimiento y desarrollo de los maxilares, entre otras acciones, ha sido considerado esencial para el logro de un desarrollo armónico. Por otro lado, y a pesar de los avances en la materia, la caries dental es la causa más frecuente de las patologías pulpares en los dientes primarios y constituye el principal motivo de su deterioro y/o su pérdida. Las características histo-patológicas de la pulpa dental, la brevedad de su ciclo vital, el tamaño relativo de las cámaras pulpares, favorecen el rápido compromiso pulpar y propician que el proceso infeccioso progrese rápidamente a la necrosis. Ello ha determinado y determina el desarrollo de numerosas técnicas y tratamientos, diferentes ofertas terapéuticas de las cuales ninguna ha alcanzado el consenso universal. Como establecen las Guías de Odontología Pediátrica sobre tratamientos pulpares en dientes primarios, la literatura dental en esta área ofrece escasa y pobre evidencia para sustentar las diferentes técnicas y constantemente señalan la necesidad de nuevos y rigurosos estudios que la avalen.

Chemomechanical versus drilling methods for caries removal: an in vitro study

The purpose of this study was to compare the performance of chemomechanical caries removal (CMCR) with that of conventional drilling for efficacy of caries removal, time spent, morphological changes and microhardness of surface dentin, and microleakage of subsequent restorations. Forty-six carious deciduous molars were randomly divided into two groups: one each for caries removal by (1) CMCR and by (2) drilling. The completeness of caries removal was evaluated by visual and tactile criteria and a caries detector device. Twenty teeth in each group were restored with glass ionomer (GI) and subjected to thermocycling before undergoing microleakage and microhardness tests. In each group, three restored teeth were used for polarized light microscopic analysis, and three unrestored teeth for scanning electron microscopy (SEM). There was no significant difference in the completeness of caries removal between groups. However, time spent for caries removal by CMCR was significantly longer than that required for drilling. Restorations in the CMCR group had significantly more microleakage than those in the drilling group. Dentin hardness of the cavity floor after CMCR was also significantly lower. Microscopic analyses showed roughened and irregular dentin surfaces in the CMCR group, unlike the smooth surfaces observed in the drilling group. In conclusion, CMCR was as efficacious as drilling in term of completeness of caries removal, but required longer excavation times and resulted in lower microhardness of residual dentin as well as more microleakage after restorations with GI. Further laboratory and clinical evaluations on the efficiency and performance of CMCR for the durability of subsequent restorations are required.

Análise da prevalência de defeitos de esmalte na dentição decídua adquiridos no período gestacional / Analysis of prevalence on the loss of enamel of deciduous dentition occurring during pregnancy

O período gestacional é importante para a formação dos dentes decíduos do bebê. Os Defeitos de Desenvolvimento do Esmalte Dentário são anormalidades que podem ocorrer na estrutura do esmalte por acometimentos durante sua formação. O objetivo é analisar a prevalência de defeitos de esmalte na dentição decídua adquiridos no período gestacional. Realizou-se um estudo observacional, longitudinal, descritivo e retrospectivo, de abordagem quantitativa, em um município sul catarinense, no período de março de 2012 a dezembro de 2013. Participaram 68 bebês, de 1 a 3 anos de idade, e suas mães, que frequentaram um programa educativo. A coleta de dados realizou-se um questionário autoaplicável, anônimo, destinado às mães, como também o exame clínico da cavidade bucal dos bebês. Os resultados evidenciaram que o estado civil predominante foi de amasiadas (55,9%), a profissão foi do lar (36,8%) e a renda familiar de 3 salários mínimos (79,4%). A maioria (52,9%) tinha segundo grau incompleto. Verificou-se que 14,7% dos bebês possuíam Defeitos de Desenvolvimento do Esmalte Dentário na arcada superior, e 5,9% na arcada inferior. Constatou-se 11,8% casos de opacidade na arcada superior, 5,9% na inferior, e 2,9% de hipoplasia na superior, todos em incisivos. Relação a problemas de saúde na gestação observou-se que 74,6% apresentaram. O uso de medicações no período gestacional e problemas de saúde neste período revelou significância estatística (p=0,010). Concluiu-se que houve alterações na formação dos dentes decíduos e o aparecimento de opacidades e hipoplasias, relacionadas às complicações sistêmicas, e ao uso de medicações no período gestacional, porém sugerem-se mais estudos...

The pregnancy period is an important part of the formation of deciduous baby teeth. The defects of dental enamel Development are abnormalities that may occur in the enamel structure progressively during their formation. The objective was analyze the prevalence of enamel defects in the primary dentition which occurs during pregnancy. We conducted an observational, longitudinal, descriptive and retrospective quantitative survey, in a town south of Santa Catarina Brazil, from March 2012 to December 2013. 68 babies between 1 to 3 years old and their mothers who attended an educational program. The data was collected by means of an anonymous standardized questionnaire which was addressed the mothers well as through clinical examinations of the oral cavity the participating babies. The predominant results showed that the marital status of the mothers was common law partner (55.9%), the profession was housewife (36.8%) and the average family income was three minimum wages (79.4%). Most of the respondents (52.9%) had not completed high school. It was found that 14.7% the studied babies had the defects of dental enamel development in the upper arch, while 5.9% in the lower arch. 11.8% the analyzed babies had cases of opacity in the upper arch, 5.9% at the bottom, and 2.9% hypoplasia at the top, all in incisors. The study concludes that there were changes in the formation primary teeth and the appearance of opacities and hypoplasia, and that these were related to systemic complications well as the use of medications during pregnancy...

Changes in Oral Health-related Behavior of Infants following a Preventive Program of Continuing Education Directed to their Parents

To evaluate changes in oral health-related behavior of infants following preventive program of continuing education directed to their parents.Material and Methods:We analyzed 53 dental files of infants aged up to 36 months, who participated in the Prevention and Education Program of the Infants Clinic, School of Dentistry of Bauru (USP), and attended at least 2 visits with a maximum of 4 missing appointments. Initially an educational lecture was conducted, pointing issues related to diet and oral hygiene. At the following visit, the professional filled in a form with questions about diet and hygiene performed at home. The following information was extracted from dental files: reason of the first visit, age, number of teeth, number of visits, missing appointments, and dietary and oral hygiene risk factors. The data were tabulated and analyzed using descriptive statistics comparing the information obtained from the first visit to that of the last one.Results:The reason for the first visit was dental caries prevention (88.68%) followed by dental trauma (7.55%), and needed of curative treatment (3.77%). The mean age of the sample was 14.85 months, the tooth number mean was 12.64 at first visit, the mean number of visits was 7 and the mean missing appointments was 0.83. The percentage of infants with inadequate diet and hygiene habits was 88.68% and 62.26%, and only 12.762% and 57.57% of these have changed their habits, respectively.Conclusion:After the preventive program of continuing education, the dietary habits showed were more difficult to change in relation to hygiene ones...

Prevalence of Teething Symptoms in Primary Teeth and Associated Factors: Cross-Sectional Study in Children aged 12-23 months in Pelotas, Brazil

To identify the main teething symptoms reported by mothers and associated factors. Material and Methods:Cross-sectional study conducted with mothers of children aged 12-23 months visiting 12 public health care centers during National Children Vaccination day in Pelotas, Rio Grande do Sul, Brazil, in 2011. Mothers were interviewed and information on teething symptoms and socioeconomic (family structure, income, maternal schooling and child skin color) and demographic variables (maternal age and child sex) was collected. Chi-square, Fisher exact test and Poisson regression analyses were performed (P<0.05). Results:A total of 188 mother-child pairs were interviewed. Teething symptoms were reported by 91.93% mothers. Symptoms most frequently reported were excessive salivation (67.7%), irritability (65.2%), fever (44.1%), feeding difficulty (34.2%) and sleep disturbance (31.7%). Teething symptoms were not associated with socioeconomic and demographic variables investigated (p>0.05). Conclusion:Most mothers linked children symptoms with primary teeth eruption. Excessive salivation and irritability were the symptoms most reported by mothers. Socioeconomic and demographic variables were not statistically associated with maternal report of teething symptoms in their children. Dentists should provide adequate orientation to mothers and follow up their children. Dentists should refer to medical care services if symptoms persist, once these symptoms can be attributed to other causes...

Effectiveness of electronic apex locator during the root canal length in primary teeth: an in vitro study

To evaluate the use of electronic apex locator to measure the root canal length in primary teeth, comparing this measure with the measurements obtained by conventional radiography and by the direct measurement of the root canal lenght.Material and Methods:The sample consisted of nine multi-rooted primary teeth, totaling 32 root canals. Endodontic access was performed with a spherical diamond tip, then the pulp was extirpated and the canal irrigated with 0.9% saline. An endodontic file was used to measure the root canal length by electronic apex locator, using the Novapex ® according to the manufacturer's instructions, and by direct method. An endodontic ruler was used to determine fileÆs length. Conventional radiographic was also performed. Statistical analysis was performed by analysis of variance (ANOVA). The level of significance was 95%.Results:The average of the root canal length was 9.98 ± 2.16 to the direct method; 11.52 ± 1.87 to conventional radiography; and 10.91 ± 1.92 to the electronic apex locator. The results of this study showed a high correlation between the values given by the different methods, regardless of the presence or absence of physiological root resorption. There were not statistically significant differences amongst the methods studied (p> 0.05).Conclusion:Electronic apex locator was an accurate method measure the root canal length in primary teeth, and its use is indicated in endodontic treatment of these teeth...

Chronology of deciduous teeth eruption: agreement between classic authors

Assessing agreement between the eruption age of deciduous teeth eruption (DTE) in a children sample the City of Vitoria,Brazil, and the eruption age reported by classical authors.Material and Methods:The data derive from a cohort study with 86 newborns until their 36th month of age. Average DTE age of each child was calculated and testing was performed to comparing DTE age described by classic authors. Then, kappa test, McNemar and prevalence adjusted kappa were applied. Results:Average DTE ranged between 8 and 29 months of age in the lower arch, and 11 to 30 months in the upper arch. There was higher agreement proportion for DTE age of 71/81 (kappa= 0.82; IC95%= 0.72-0.93) and 52/62 (kappa= 0.88; IC95%= 0.78-0.99) between Minot (1873) and Shour and Massler (1941). Followed by deciduous teeth eruption age between the latter author and Logan and Kronfeld (1939) for 51/61 and 55/65 and between Lunt and Law (1974) for 53/63 and 73/83. High McNemar values were found for DTE age of 51/61 (McNemar= 54.0; p= 0.000), 72/82 and 75/85 between Logan and Kronfeld (1939) and Lunt and Law (1974) and for 51/61 between the latter author and Shour and Massler (1941). Conclusion:The sequence of DTE found here was similar to that reported in several studies, as well as average eruption age of deciduous upper and lower central incisors. However, average age was always later for the other teeth. Levels of agreement were higher for deciduous incisor and canine eruption than for deciduous molars...

Conservative treatment of deep dentin lesions in primary molars: case-series

To carry out a descriptive analysis of a case-series in which the indirect pulp capping (IPC) has been performed for treating primary molars with extensive caries lesions in dentin, in the Private of Specialization in Pediatric Dentistry. Material and Methods:Asingle calibrated examiner evaluated the medical records of 155 patients aged 2 to 13 years attended at the Foundation for Scientific and Technological Development of Dentistry (FUNDECTO) partnership the University of São Paulo (USP) in 2011-2013 in search of extensive caries lesions treated during this period. Were found only 20 deep caries lesions and with satisfactory clinical and radiographic documentation. Then, the materials and techniquesused were collected, as well as instant success described after treatment and observation for no progression of the disease (pain, abscess or fistula). Results:The 20 lesions evaluated reached at least 2/3 of the dentin thickness and were active. In 70% of cases, the restorations were carried out with high viscosity or encapsulated glass ionomer cement, and in 30% of case with light-cured resin. In only one case was used calcium hydroxide cement as liner material before inserting resin. In the teeth treated, only three cases were considered failures. Conclusion:Regardless of the restorative material used and the technique employed, good immediate success rates of the conservative treatment in deep dentin lesions were found, which consequently reduces the risk of exposure and pulp intervention...

Mantenedor fixo estético-funcional como tratamento para perda precoce de dentes decíduos anteriores / Aesthetic-functional fixed appliance as treatment of premature of primary anterior teeth

A perda precoce de dentes decíduos pode acarretar dano à oclusão e outras sequelas estético-funcionais indesejáveis. Nesses casos, tão importante quanto a reabilitação do paciente, é a escolha adequada do tipo de aparelho mantenedor de espaço. Este trabalho é um relato de caso clínico no qual uma criança de três anos de idade apresentou perda precoce dos incisivos superiores decíduos onde foi instalado um aparelho mantenedor estético-funcional fixo. Em um período inicial de quatro meses de acompanhamento a mãe relatou boa aceitação quanto à adaptação e higienização do aparelho. Consultas de proservação do caso serão feitas mensalmente até o início da erupção dos incisivos permanentes.

The premature loss of primary teeth can cause damage to occlusion and other undesirable aesthetic-functional sequelaes. ln such cases, as important as the rehabilitation of the patient, is the accurate choice of space maintenance appliance. This work is a case report in which a child of three years old showed premature loss of deciduous incisors and a aesthetic-functional fixed appliance was installed. ln an initial follow-up of 4 months, the mother reported good acceptance on the adjustment and cleaning of the device. The clinical visits of proservation of the case will be scheduled monthly until the eruption of the permanent incisors.

Frequency and variability of dental morphology in deciduous and permanent dentition of a Nasa indigenous group in the municipality of Morales, Cauca, Colombia / Frecuencia y variabilidad de la morfología dental en dentición temporal y permanente de un grupo de indígenas Nasa del municipio de Morales (Cauca, Colombia)

Abstract Objectives: To determine the frequency, variability, sexual dimorphism and bilateral symmetry of fourteen dental crown traits in the deciduous and permanent dentition of 60 dental models (35 women and 25 men) obtained from a native, indigenous group of Nasa school children of the Musse Ukue group in the municipality of Morales, Department of Cauca, Colombia. Methods: This is a quantitative, descriptive, cross-sectional study that characterizes dental morphology by means of the systems for temporary dentition from Dahlberg (winging), and ASUDAS (crowding, reduction of hypocone, metaconule and cusp 6), Hanihara (central and lateral incisors in shovel-shape and cusp 7), Sciulli (double bit, layered fold protostylid, cusp pattern and cusp number) and Grine (Carabelli trait); and in permanent dentition from ASUDAS (Winging, crowding, central and lateral incisors in shovel-shape and double shovel-shape, Carabelli trait, hypocone reduction, metaconule, cusp pattern, cusp number, layered fold protostylid, cusp 6 and cusp 7). Results: The most frequent dental crown features were the shovel-shaped form, grooved and fossa forms of the Carabelli trait, metaconule, cusp pattern Y6, layered fold, protostylid (point P) and cusp 6. Sexual dimorphism was not observed and there was bilateral symmetry in the expression of these features. Conclusions: The sample studied presented a great affinity with ethnic groups belonging to the Mongoloid Dental Complex due to the frequency (expression) and variability (gradation) of the tooth crown traits, upper incisors, the Carabelli trait, the protostylid, cusp 6 and cusp 7. The influence of the Caucasoide Dental Complex associated with ethno-historical processes cannot be ruled out.

Resumen Objetivos: Determinar la frecuencia, la variabilidad, el dimorfismo sexual y la simetría bilateral de 14 Rasgos Morfológicos Dentales Coronales (RMDC) en dentición temporal y permanente de 60 modelos (35 mujeres y 25 hombres) obtenidos de un grupo de indígenas escolares Nasa del cabildo Musse Ukue del municipio de Morales, departamento del Cauca. Métodos: Estudio descriptivo transversal cuantitativo que caracteriza la morfología dental mediante los sistemas en dentición temporal Dahlberg (winging), Asudas (crowding, reducción de hipocono, metacónulo y cúspide 6), Hanihara (incisivos centrales y laterales en pala y cúspide 7), Sciulli (doble pala, protostílido, pliegue acodado, patrón cuspídeo y número de cúspides) y Grine (cúspide de Carabelli); y en dentición permanente Asudas (Winging, crowding, incisivos centrales y laterales en pala, doble pala, cúspide de Carabelli, reducción del hipocono, metacónulo, patrón cuspídeo, número de cúspides, pliegue acodado, protostílido, cúspide 6 y cúspide 7). Resultados: Los RMDC más frecuentes fueron la forma de pala, formas surco y fosa de la cúspide de Carabelli, metacónulo, patrón cuspídeo Y6, pliegue acodado, protostílido (punto P) y cúspide 6. No se observó dimorfismo sexual y hubo simetría bilateral en la expresión de los rasgos. Conclusiones: La muestra estudiada presenta una alta afinidad con grupos étnicos pertenecientes al Complejo Dental Mongoloide debido a la frecuencia (expresión) y variabilidad (gradación) de los RMDC, incisivos en pala, la cúspide Carabelli, el Protostílido, la cúspide 6 y la cúspide 7; sin embargo, no se puede descartar influencia del Complejo Dental Caucasoide asociado con procesos etno-históricos.

Materiales restauradores en odontopediatría. Revisión / Restorative materials in pediatric dentistry. review

El presente artículo es una revisión sobre la importancia de los diversos materiales dentales que de usan en odontopediatría, se realizó un exhaustiva revisión de artículos en las principales revistas de odontopediatría y en las bases de datos Pub Med, EBCO, HINARY, Imbiomed, Latindex, los cuales fueron distribuídos entre los autores para ser analizados y distribuídos por los mismos en múltiples reuniones como parte del Grupo de estudio de materiales dentales de la Sociedad peruana de Odontopediatr¡a.

This article is a review on the importance of the various dental materials that are used in pediatric dentistry, we performed an exhaustive review of articles in leading journals of pediatric dentristy and in the databases Pub Med, EBSCO, HINARI, IMBIOMED, Latindex, which were distributed among the authors to be analyzed and discussed by them and in multiple meetings as part of the study group of dental materials of the Peruvian Society of Pediatric Dentistry.

Cistos radiculares em incisivos decíduos traumatizados: série de casos / Radicular cysts in traumatized primary teeth: case series

Este estudo buscou verificar a ocorrência de casos de cisto radicular em incisivos superiores decíduos traumatizados e descrever suas características relacionadas à criança, ao dente, ao trauma e ao cisto. Para tanto, realizou-se um levantamento das informações clínicas e radiográficas, de 2498 prontuários de pacientes atendidos na Clínica do Centro de Pesquisa e Atendimento de Traumatismo de Dentes Decíduos da Disciplina de Odontopediatria da FOUSP, no período de 1998 a setembro de 2013. Foi utilizado o método exploratório descritivo de uma série de casos. Foram avaliados 30 prontuários com casos de cistos, totalizando 32 incisivos superiores decíduos traumatizados com cisto. A ocorrência de cisto em pacientes com incisivos superiores decíduos traumatizados foi de 1,2%. Os resultados mostraram que a maioria dos cistos acometeram o gênero feminino (59,4%), os incisivos centrais superiores decíduos (93,8%), em crianças maiores de 5 anos (81,2%), mas que sofreram traumatismos com menos de 4 anos de idade (81,2%). A maioria dos casos não apresentou alteração clínica que levasse a suspeita de lesão cística, pois não foi encontrado em 90,7% retração gengival, 65,6% alteração de cor da mucosa vestibular, 65,6% fistula, 75% abscesso, 56,2% abaulamento gengival, 78,1% depressão da mucosa vestibular e 56,3% flutuação cistíca. A alteração clínica mais frequente foi a alteração de cor da coroa (56,3%). A média da idade do paciente no momento do trauma foi de 2,7 anos e do diagnóstico do cisto de 5,9 anos, sendo que a média de tempo do trauma até o diagnóstico do cisto foi de 2,8 anos. Em 46,9% dos dentes ocorreu trauma dental. A maioria dos traumas foram de baixa severidade (59,3%)

Em 46,8% dos casos, o dente decíduo envolvido na lesão apresentava maior formação radicular que seu homólogo e em 62,5% o germe sucessor do dente decíduo com a lesão cística encontrava-se em estágio de Nolla anterior que o homólogo. A maioria das lesões císticas (81,2%) não envolveu dentes adjacentes, mas promoveram deslocamento de germes em 56,2%. Na dentição permanente foram encontrados repercussões em 31,3,% dos casos e retenção prolongada do permanente em 15,6%. Diante dos achados deste estudo observou-se que o cisto radicular em incisivos decíduos traumatizados é raro, assume um perfil menos agressivo, de crescimento controlado e necessitando de um tempo longo para se desenvolver. Além do mais, parece causar sequelas menos danosas às dentições, influenciar no processo de rizólise e rizogênese e estar relacionado a traumas de baixa severidade. O diagnóstico deve ser realizado pelos achados radiográficos, sendo que a reabsorção radicular externa sem formação óssea, assimetria no tamanho do folículo do germe dentário sucessor ao dente envolvido com a lesão cística e o folículo homólogo, bem como a diferença de altura e/ou posição entre os germes dentários homólogos deveriam ser considerados como sinais radiográficos no diagnóstico de cistos radiculares.

The present study aimed to verify the occurrence of radicular cyst in traumatized primary upper incisors and describe their characteristics in relation to the children, teeth, trauma and cysts. The survey of 2, 498 patients that presented and were treated at the Research and Clinical Center of Dental Trauma in Primary Teeth of the School of Dentistry of the University of Sao Paulo from 1998 to September 2013 was carried out, in order to collect clinical and radiographic information. A descriptive and exploratory approach was taken in the study. A total of thirty clinical records involving radicular cysts included thirty two traumatized primary upper incisors were studied in detail. The overall occurrence of cysts in patients with traumatized primary incisors was 1.2% with females affected more (59.4%) often than males 93.8% involved the upper central incisors. 81.2% of the children were older than 5 year of age but suffered traumatic injuries before 4 years old. In most cases, gingival recession (90.7%); color change of the vestibular mucosa (65.6%); fistula (65.6%); abscess (75%); gingival bulging (56.2%); depression of the vestibular mucosa (78.1%) and cystic fluctuation (56.3%) were not present showing no clinical alterations that might suggest cystic lesion. The most frequent clinical alteration was the color change of the crown (56.3%). The mean patient age at the time of traumatic injury was 2.7 years and the diagnosis of cyst at 5.9 years, and the mean time from trauma to diagnosis of cysts was 2.8 years. The hard tissue trauma occurred in 46.9% of teeth. Most injuries (59.3%) were of low severity.

The radicular formation in the primary tooth involved in the lesion in 46.8% of cases was larger than its homologous and 62.5 % of cases the successor tooth germ of primary tooth with the cystic lesion was at a Nolla stage earlier than the homologous. The majority (81.2%) of cystic lesions did not involve adjacent teeth but promoted displacement of tooth germs in 56.2%. Repercussions in the permanent dentition were found in 31.3% of cases and prolonged retention of permanent in 15.6%. Given the findings, this study observed that the radicular cyst in traumatized primary incisors is rare. It assumes a less aggressive profile, controlled growth and requiring a long time to develop. Moreover, it seems to cause less harmful sequelae in dentitions, influence the process of root resorption and root formation and is associated with low severity trauma. The diagnosis must be made by radiographic findings. An external root resorption without bone formation, asymmetry in size between dental follicle (dental follicle of successor germ to the primary tooth involved with the cystic lesion and th homologous tooth follicle) and the difference in height and/or position between homologous teeth germs should also be considered amongst the radiographic signs in the diagnosis of radicular cysts.

The influence of interdental spacing on the detection of proximal caries lesions in primary teeth

The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344) of 76 children (4-12 years old) were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen). Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm). The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

Estimación de la estatura a partir de las dimensiones de la dentición temporal / Estimation of stature from dimensions of the deciduous dentition

La estimación de la estatura a partir de segmentos óseos o dentarios es un procedimiento complejo y con validez discutible, especialmente cuando se trata de restos humanos de subadultos. El objetivo de este estudio fue evaluar el método de Carrea para la determinación de la estatura a partir de las dimensiones de piezas temporales maxilares y en un segundo paso proponer un método matemático adecuado para la estimación de la estatura. Se determinó el arco y radio-cuerda maxilar en 42 pacientes de entre 36 y 84 meses y se aplicó el método de Carrea, comparando la estatura estimada con la real. Posteriormente se realizó una regresión lineal multivariada con la estatura como variable dependiente y el arco y radio-cuerda maxilar como variable independiente. El método de Carrea resultó negativo en todo los casos. Se determinó una ecuación de regresión que permitió la estimación correcta de la estatura en 57,5 por ciento de los casos con +/-5cm y en un 97 por ciento con +/-10cm, lo que supone una utilidad práctica para la estimación de la estatura que debe ser complementada con otros métodos.

The estimation of stature from bone or tooth segments is a complex procedure with questionable validity, especially when dealing with human remains of subadults. The aim of this study was to evaluate the Carrea method for determining stature from the dimensions of deciduous maxillary teeth and in a second step to propose a suitable mathematical method for estimating stature. We determined the arch and radio-cord maxillary in 42 patients between 36 and 84 months and applied the Carrea method, comparing estimated with actual stature. Subsequently a multivariate linear regression with stature as dependent variable and the the arch and radio-cord maxillary as independent variable. Carrea method was negative in all cases. We determined a regression equation that allowed the correct estimation of stature in 57.5 percent of cases with +/- 5 cm and in 97 percent with +/-10cm, which is a handy utility for estimating the stature that is complemented with other methods.