Periodontitis en niños sanos de 3 años: dos casos con seguimiento a 5 años / Periodontitis in healthy 3-year-old children: two cases with 5-year follow-up

Objetivo: La periodontitis en dentición primaria es ex- cepcional en niños sin enfermedades sistémicas. El objetivo de este informe es describir las características clínicas y ra- diográficas de dos casos de niños de 3 años sistémicamente sanos con periodontitis, y su tratamiento con seguimiento a 5 años. Casos clínicos: En ambos casos, a los 3 años de edad los niños fueron derivados al especialista en periodoncia por su odontopediatra debido a la pérdida muy temprana de inci- sivos inferiores. El examen clínico y radiográfico mostró pér- dida de inserción clínica, pérdida ósea y movilidad dental en otros incisivos superiores e inferiores. Se realizó la intercon- sulta médica y se descartó que los niños padecieran enferme- dades relacionadas con el diagnóstico de periodontitis como manifestación de una enfermedad sistémica. El tratamiento consistió en la instrucción de medidas de higiene bucal que debían ser ejecutadas por los padres, ins- trumentación subgingival, antisépticos locales, medicación antibiótica sistémica y mantenimiento periodontal. No se rea- lizaron extracciones como parte del tratamiento. En ambos casos uno de los incisivos presentes al momento de la con- sulta se perdió prematuramente, antes de los 4 años. El resto de los incisivos primarios cumplieron su ciclo normal. Luego de 5 años de seguimiento, a la edad de 8 años, ambos niños presentaban los incisivos y los primeros molares permanentes periodontalmente sanos y el resto de los dientes primarios sin signos de periodontitis (AU)

Aim: Periodontitis in primary dentition is exceptional in children without systemic diseases. The objective of this article is to describe the clinical and radiographic charac- teristics of two cases of systemically healthy 3-year-old chil- dren with periodontitis, and their treatment, with a 5-year follow-up. Clinical cases: In both cases, at 3 years of age, the chil- dren were referred to a periodontic specialist by their pediat- ric dentist, due to the very early loss of lower incisors. Clin- ical and radiographic examination showed loss of clinical attachment, bone loss and dental mobility in other upper and lower incisors. A medical consultation was carried out and diseases related to the diagnosis of periodontitis as a mani- festation of a systemic disease were ruled out. The treatment consisted of instruction on oral hygiene measures that had to be carried out by the parents, subgingival instrumentation, local antiseptics, systemic antibiotic medication, and perio- dontal maintenance. No extractions were performed as part of the treatment. In both cases, one of the incisors present at the time of consultation was lost prematurely, before the age of 4 years. The rest of the primary incisors completed their normal cycle. After 5 years of follow-up, at the age of 8 years, both children showed periodontally healthy incisors and first permanent molars, and the rest of the primary teeth without signs of periodontitis (AU)

Prevalencia de mancha blanca en dentición temporaria en el Hospital de Odontología Infantil Don Benito Quinquela Martín / Prevalence of white spot in temporary dentition at Don Benito Quinquela Martin Children's Dentistry Hospital

Introducción: La caries dental es una enfermedad infecciosa y multifactorial, que co- mienza por una desmineralización del esmalte producida por la acción de ácidos generados por bacterias presentes en el biofilm dental. Estas lesiones se inician como manchas blancas (MB) y es el único estadio de la caries dental capaz de ser revertido mediante la aplicación profesional de agentes remineralizantes, por lo que es fundamental la detección y tratamiento temprano de las mismas. Objetivo: Determinar la prevalencia de manchas blancas en la dentición temporaria de los niños atendidos en el Servicio de Clínica y Orientación del Hospital de Odontología Infantil (HOI) «Don Benito Quinquela Martín¼. Materiales y métodos: Se evaluó una muestra de 94 niños con dentición temporaria, en el Servicio de Clínica y Orientación del HOI, teniendo en cuenta los ingresos y reingresos, durante el período comprendido entre septiembre de 2019 y febrero de 2020. Resultados: La prevalencia de manchas blancas de un total de 94 niños evaluados fue del 55 %. De los pacientes que presentaron MB, el 59 % fue de sexo masculino y el 41 % de sexo femenino. La media de edad fue de 4.77 años. De los pacientes atendidos, 73 concurrieron por primera vez y 21 pacientes fueron reingresos. Conclusión: La prevalencia de manchas blancas en la muestra evaluada de niños atendidos en el Servicio de Clínica y Orientación del HOI fue del 55 %. Este resultado sugiere la necesidad de continuar y potenciar la promoción de la salud bucal, no solo como herramienta estratégica para brindar conocimientos acerca de los beneficios de una correcta higiene oral y una dieta saludable, sino también como factor de prevención en cuanto a la aparición de lesiones de caries y posteriores consecuencias adversas (AU)

Introduction: Dental caries is an infectious and multifactorial disease that begins with the demineralization of the enamel produced by the action of acids generated by bacteria in the dental biofilm. These lesions start as white spots (WS), and it's the only stage of dental caries capable of being reverted by the professional application of remineralizing agents. Hence, its early detection and treatment are essential. Objective: To determine the prevalence of white spots in the temporary dentition of children treated at the Clinical and Orientation Service of "Don Benito Quinquela Martin" Children's Dentistry Hospital (CDH). Materials and methods: A sample of 94 children with temporary dentition was evaluated on admission and readmission at CDH's Clinical and Orientation Service between September 2019 and February 2020. Results: The prevalence of WS in 94 children evaluated was 55%: 59% of patients who presented WS were males, and 41% were females. The mean age was 4.77 years. Seventy-three patients seen attended for the first time, and the other 21 were readmissions. Conclusion: The prevalence of WS in children who attended CDH's Clinical and Orientation Service was relevant. This result indicates that we must continue and enhance oral health promotion as a strategy to give knowledge about good oral hygiene benefits, a healthy diet, and to prevent the appearance of caries lesions and subsequent consequences (AU)

Clinical, radiographic and histological evaluation of primary teeth pulpotomy using mta and ferric sulfate

Abstract The aim of this study was to evaluate the clinical, radiographic and histological outcomes of the dentin-pulp complex from primary molars after pulpotomy with mineral trioxide aggregate (MTA) and 15.5% ferric sulfate (FS). Thirty-one primary molars were randomly allocated into MTA or FS groups. Clinical and radiographic evaluations were recorded at 3-, 6-, 12- and 18-month follow-up. Teeth at the regular exfoliation period were extracted and processed for histological analysis. Clinical and radiographic data were tested by statistical analysis (p≤0.01). Histological outcomes were analyzed descriptively. All of the treated teeth presented clinical success over the experimental periods. Both groups exhibited 100% of radiographic success at 3, 6 and 12 months. At the 18-month follow-up, one tooth from FS group presented inter-radicular radiolucency (p>0.01). Histologically, the treated teeth presented pulp vitality and absence of inflammatory infiltrate into the connective tissue. Only MTA group showed hard tissue barrier surrounded by odontoblasts over the pulp stumps. Both MTA and 15.5% FS are effective for pulpotomies of primary teeth. Although MTA is considered the first-choice material, FS may be a suitable alternative when treatment cost is an issue.

Resumo O objetivo deste estudo foi avaliar os resultados clínicos, radiográficos e histológicos do complexo dentino-pulpar de molares decíduos após pulpotomia com agregado trióxido mineral (MTA) e sulfato férrico (SF) 15,5%. Trinta e um molares decíduos foram alocados aleatoriamente nos grupos MTA ou SF. As avaliações clínicas e radiográficas foram realizadas aos 3, 6, 12 e 18 meses de acompanhamento. Os dentes no período regular de esfoliação foram extraídos e processados ​​para análise histológica. Os dados clínicos e radiográficos foram analisados estatisticamente (p≤0,01). O resultados histológicos foram analisados ​​descritivamente. Todos os dentes tratados apresentaram sucesso clínico ao longo dos períodos experimentais. Ambos os grupos exibiram 100% de sucesso radiográfico aos 3, 6 e 12 meses. Aos 18 meses de acompanhamento, um dente do grupo SF apresentou radiolucidez interradicular (p>0,01). Histologicamente, os dentes tratados apresentaram vitalidade pulpar e ausência de infiltrado inflamatório no tecido conjuntivo. Somente o grupo MTA mostrou barreira de tecido duro rodeada por odontoblastos sobre os cotos pulpares. MTA e SF 15,5% são eficazes para pulpotomias de dentes decíduos. Embora o MTA seja considerado o material de primeira escolha, o SF pode ser uma alternativa adequada quando o custo do tratamento é um problema.

Ankylosis of Permanent First Molar: Diagnosis by Cone Beam Computed Tomography / Anquilosis del Primer Molar Permanente: Diagnóstico por Tomografía Computarizada con Haz Cónico

ABSTRACT: Ankylosis is an anomaly of tooth eruption characterized by the fusion of cementum and alveolar bone, and may affect from small regions to the entire root surface. Clinical assessment combined with imaging exams can aid diagnosis. Radiographic testing enables assessing only proximal regions of possibly affected roots. Whereas cone beam computed tomography (CBCT) allows a three-dimensional assessment of axial, coronal, and sagittal planes of all dental extension, eliminating thus overlapping images and helping to confirm the correct diagnosis. The present study contains a case report of a male patient with ankylosis in tooth 16 diagnosed by CBCT, aiming at providing information for dentists about this anomaly, its characteristics and situations in which CBCT should be indicated.

RESUMEN: La anquilosis es una anomalía de la erupción del diente caracterizada por la fusión de cemento y hueso alveolar, y puede afectar desde pequeñas regiones hasta toda la superficie de la raíz. La evaluación clínica combinada con los exámenes de imagen puede ayudar a diagnosticar esta anomalía. Las pruebas radiográficas permiten evaluar sólo las regiones proximales de las raíces posiblemente afectadas. La tomografía computarizada de haz de cono (CBCT) permite una evaluación tridimensional de los planos axial, coronal y sagital de toda la extensión dental, eliminando así las imágenes superpuestas y ayudando a confirmar el diagnóstico correcto. En el presente estudio se presenta un reporte de caso de un paciente con anquilosis en el diente 16 diagnosticado por CBCT, con el objetivo de proporcionar información para los dentistas sobre esta anomalía, sus características y situaciones en las que debe indicarse la CBCT.

Tratamiento con pasta 3 Mix-MP en molares primarios no vitales: estudio preliminar / Treatment of nonvital primary molars with 2 Mix-MP paste: a preliminary study

Estimar la frecuencia de éxito clínico-radiográfico del tratamiento endodóntico no instrumentado con pasta 3Mix-MP en molares primarios con diagnóstico de necrosis pulpar. Materiales y métodos: estudio experimental, prospectivo y longitudinal, realizado en la Cátedra de Odontología Integral Niños de la FOUBA (agosto 2014 - agosto 2015). Formaron parte de la investigación 44 molares primarios con diagnóstico de necrosis pulpar, de 36 niños (6,07 +/- 1,63 años), sin compromiso inmunológico ni metabólico y que junto con sus responsables legales brindaron el consentimiento informado. Se realizó el tratamiento endodóntico no instrumentado con pasta 3Mix-MP (metronidazol, minociclina, ciprofloxacina 1:1:1 y vehículos macrogol, propilenglicol 1:1) y restauración definitiva con corona de acero. Los molares fueron evaluados por dos examinadores al mes, 3, 6 y 12 meses. Se calcularon porcentajes con sus intervalos de confianza del 95 por ciento. Resultados: al mes, la tasa de éxito clínico fue de 97.72 por ciento (87.96-99.97) y la de éxito radiográfico de 93.18 por ciento (81.31-98.61). Fue posible el seguimiento del 65.85 por ciento de la muestra a los 3 meses, del 34.14 por ciento a los 6 meses y del 24.39 por ciento a los 12 meses, revelando un 100 por ciento de éxito clínico-radiográfico en los tratamientos evaluados. Conclusión: en los casos y períodos estudiados, esta terapéutica mostró un buen comportamiento clínico y radiográfico. Son necesarios estudios con mayor tamaño muestral y mayor período de seguimiento para proponerla como alternativa de tratamento...

Should deciduous teeth be preserved in adult patients? How about stem cells? Is it reasonable to preserve them?

Abstract When seeking orthodontic treatment, many adolescents and adult patients present with deciduous teeth. Naturally, deciduous teeth will inevitably undergo exfoliation at the expected time or at a later time. Apoptosis is the biological trigger of root resorption. In adult patients, deciduous teeth should not be preserved, as they promote: infraocclusion, traumatic occlusion, occlusal trauma, diastemata and size as well as morphology discrepancy malocclusion. Orthodontic movement speeds root resorption up, and so do restoring or recontouring deciduous teeth in order to establish esthetics and function. Deciduous teeth cells are dying as a result of apoptosis, and their regeneration potential, which allows them to act as stem cells, is limited. On the contrary, adult teeth cells have a greater proliferative potential. All kinds of stem cell therapies are laboratory investigative non authorized trials.

Resumo Muitos adolescentes e adultos, ao procurar pelo tratamento ortodôntico, apresentam dentes decíduos persistentes. Naturalmente, os dentes decíduos ou se esfoliam na época esperada ou mais tardiamente, de forma inevitável. A apoptose é o gatilho biológico da rizólise. Em adultos, os dentes decíduos não devem ser preservados, pois promovem: infraoclusão, oclusão traumática, trauma oclusal, além de diastemas e má oclusão por discrepância de tamanho e morfologia. O movimento ortodôntico acelera o processo de rizólise, assim como restaurar ou reanatomizar dentes decíduos para inseri-los em uma estética e função. As células dos dentes decíduos estão morrendo por apoptose e seu potencial regenerativo para atuarem como células-tronco tem limitações, ao contrário das células de dentes adultos, que têm maior potencial proliferativo. Todas as terapias com células-tronco ainda são laboratoriais e se enquadram como ensaios investigativos não autorizados.

Odontoma, revisión de la literatura a propósito de un caso clínico / Odontoma, literature review regarding a clinical case

Los odontomas son los tumores odontogénicos más frecuentes. Se presenta una revisión de la literatura, seguida de un reporte de un caso de odontoma complejo en el maxilar superior en un paciente de sexo masculino de 10 años de edad asociado con la presencia de piezas deciduas. El tumor fue enucleado y se realizó la correspondiente biopsia para confirmación de el diagnóstico clínico.

Odontomas are the most common odontogenic tumors. A literature review of the odontomas is presented followed by a case report of a complex odontoma of the anterior maxillar in a 10 year old male patient, associated with the persistence of deciduous teeth. The tumor was enucleated and the corresponding biopsy was performed which confirmed the clinical diagnosis

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.

Selamento de lesão de cárie em metade externa de dentina em molar decíduo ­ relato de caso clínico com proservação de 12 meses / Caries lesion sealing in outer dentin half in primary molars ­ a case report with 12-month follow-up

Introdução: A paralisação de lesões de cárie em metade externa de dentina é feita por meio de tratamentos conservadores. Objetivos: Relatar um caso clínico de um dente decíduo com lesão de cárie oclusal com pequena abertura e envolvimento dentinário radiograficamente restrito à metade externa de dentina; lesão controlada pela aplicação de um selante resinoso. Métodos: O selamento da superfície foi feito com o selante Fluoroshield aplicado com auxílio de uma sonda exploradora após condicionamento ácido da superfície. Resultados: As reavaliações foram feitas clínica e radiograficamente por 12 meses, sendo analisada a integridade do material e a estabilização da lesão de cárie. Após um ano, a integridade do selante e a não evolução radiográfica da lesão favoreceram um bom prognóstico ao caso. Conclusão: O selamento, desde que controlado periodicamente, atua de modo positivo na paralisação das lesões, podendo ser considerado como uma alternativa conservadora ao tratamento restaurador convencional.

Introduction: Caries lesion cessation in outer dentin half is through conservative treatments. Objectives: To show a case report of a primary tooth with occlusal caries lesion with small opening and dentin involvement restricted to the outer dentin half, which has been controlled through application of a resin-based sealant. Methods: The surface sealing was performed with Fluoroshield sealant applied with aid of an exploratory probe following the acid etching the surface. Results: The reevaluations were carried out both clinically and radiographically for a period of 12 months, with analyses of the material's integrity and of the stabilization of the caries lesions. One year later, the integrity of the sealant and the radiographic evidence showing absence of any evolution of the lesion signaled a good prognosis for this case. Conclusion: The sealing, since periodically controlled, act positively in stopping the lesions, which may be considered as a conservative alternative to conventional restorative treatment.

Transverse effect of Haas and Hyrax appliances on the upper dental arch in patients with unilateral complete cleft lip and palate: A comparative study

Objective: The aim of the present study was to evaluate the transverse effect of rapid maxillary expansion in patients with unilateral complete cleft lip and palate while comparing the Haas and Hyrax appliances. Methods: The sample consisted of 48 patients divided into two groups: Group I - 25 patients treated with modified Haas appliance (mean age: 10 years 8 months); and Group II - 23 patients treated with Hyrax appliance (mean age: 10 years 6 months). Casts were taken during pre-expansion and after removal of the appliance at the end of the retention period. The models were scanned with the aid of the 3 Shape R700 3D scanner. Initial and final transverse distances were measured at cusp tips and cervical-palatal points of maxillary teeth by using the Ortho Analyzer(tm) 3D software. Results: The mean expansion obtained between cusp tips and cervical-palatal points for inter-canine width was 4.80 mm and 4.35 mm with the Haas appliance and 5.91 mm and 5.91 mm with the Hyrax appliance. As for first premolars or first deciduous molars, the values obtained were 6.46 mm and 5.90 mm in the Haas group and 7.11 mm and 6.65 mm in the Hyrax group. With regard to first molars, values were 6.11 mm and 5.24 mm in the Haas group and 7.55 mm and 6.31 mm in the Hyrax group. Conclusion: Rapid maxillary expansion significantly increased the transverse dimensions of the upper dental arch in patients with cleft palate, with no significant differences between the Hass and Hyrax expanders. .

Objetivo: avaliar o efeito transversal na arcada dentária superior do procedimento de expansão rápida da maxila em pacientes com fissura transforame incisivo Aunilateral, comparando os expansores tipo Haas modificado e de Hyrax. Métodos: a amostra constou de 48 pacientes divididos em dois grupos: grupo I, 25 pacientes que utilizaram o aparelho expansor tipo Haas modificado, com média de idade de 10 anos e 8 meses; e grupo II, 23 pacientes que utilizaram o Hyrax, com média de idade de 10 anos e 6 meses. Modelos de gesso foram realizados na fase pré-expansão e após 6 meses de contenção, após a remoção do aparelho. Os modelos foram digitalizados com auxílio do scanner 3Shape R700 3D e as distâncias transversais iniciais e finais foram medidas entre as pontas de cúspides e pontos cervicopalatinos de dentes superiores pelo método digital no software OrthoAnalyserT 3D. Resultados: a média de expansão obtida entre as pontas de cúspides e entre os pontos cervicopalatinos, respectivamente, para a distância intercaninos, foi de 4,80mm e 4,35mm para o Haas e de 5,91mm e 5,91mm para o Hyrax; 6,46mm e 5,90mm para os primeiros molares decíduos ou primeiros pré-molares no grupo Haas, 7,11mm e 6,65mm no grupo Hyrax; e 6,11mm e 5,24mm para os primeiros molares no grupo Haas e 7,55mm e 6,31mm no grupo Hyrax. Conclusão: o procedimento de expansão rápida da maxila produziu aumentos significativos das dimensões transversais da arcada dentária superior em pacientes com fissura, sem diferenças significativas entre os expansores Haas modificado e Hyrax. .

Avaliacão clínica de restauracões de resina composta em molares decíduos estudo piloto / A clinical evaluation of composite restorations in primary molars - an interim study

As restaurações de resina composta têm sido amplamente utilizadas na Clínica Infantil, pois além de preservarem a estrutura dental sadia são mais estéticas e o seu desgaste é semelhante ao desgaste fisiológico do dente decíduo. Objetivos: avaliar o comportamento e a longevidade das restaurações realizadas com resina composta em dentes decíduos posteriores utilizando os métodos USPHS e FDI. Materiais e Métodos: foram selecionadas 09 crianças que possuíam 34 restaurações eclusas ou ocluso-proximal em molares decíduos, realizadas no curso de graduação da Universidade Luterana do Brasil Cachoeira do Sul/RS com as resinas Charisma®, Filtekl P60, Filtekl Z250 XT. As restaurações foram avaliadas por um examinador cego para os objetivos do estudo, segundo critérios dos métodos USPHS e FOI. A análise estatística foi realizada com o teste Kruskal-Wallis, com nível de significãncia 5%. Resultados: as 34 restaurações feitas com as três resinas compostas não apresentaram diferenças em relação à maioria dos critérios nos dois métodos empregados. Apenas para o critério manchamento superficial houve diferença entre as resinas compostas (p=0,006), sendo que a resina Filtek P60 demonstrou maior manchamento superficial do que as resinas Charisma e Filtek Z250. Conclusões: as três resinas compostas mostraram-se satisfatórias durante o período de tempo avaliado, confirmando a sua indicação para tratamentos restauradores dos dentes decíduos. As resinas Charisma e Filtek Z250 apresentaram melhor desempenho em relação ao manchamento superficial do que a Filtek P60. Os dois métodos de avaliação clínica podem ser utilizados para avaliação de restaurações em dentes decíduos, sendo o método FDI mais completo e promissor.

The composite resins have been widely used in Pediatric Dentistry, because they preserve the health dental structure, are more esthetics and their abrasion levei is similar that of the deciduous teeth. Objectives: to evaluate the behavior and the longevity of the composite resins fillings in posterior deciduous teeth using the USPHS and FDI methods. Materiais and methods: 09 children were selected who had 34 restorations (occlusal and occlusoproximal) in primary molars performed by undergraduate students of Lutheran University of Brazil Cachoeira do Sul/RS with Charisma®, Filtekl P60, Filtekl Z250 XT composite resins). The restorations were evaluated by an examiner blinded to the study objectives, through USPHS and FDI methods criteria. Statistical analysis was performed by the Kruskal-Wallis test, with the significance level set at 5%. Results: the 3 composite resins did not show any difference regarding to majority of criteria employed in the two methods. For the superficial staining criterion there was statistically significant difference among the composite resins (p=0,OO6), being Filtek P60 the resin that showed worst superficial staining than Charisma and Filtek Z250. Conclusions: the composite resins evaluated were satisfactory and available to fill deciduous teeth. lhe composite resins Charisma and Filtek Z250 showed better performance than Filtek P60 in relation to superficial staining criterion. The two evaluation methods can be used to evaluate restorative procedures in deciduous teeth, being FOI method the most complete and promising though.

Papillon-Lefevre syndrome: a case report of two siblings and review of the literature

Papillon-Lefevre syndrome is a rare autosomal recessive genodermatosis which is characterised by periodontitis, palmoplantar keratoderma and predisposition to pyogenic infections and occurs due to cathepsin C gene mutation [located on chromosome11].The loss of primary teeth usually occurs by the age of 4 years and secondary teeth by second decade. The disorder is associated with significant cosmetic and functional disability

Microbial Reduction by Two Chemical-Mechanical Protocols in Primary Teeth with Pulp Necrosis and Periradicular Lesion - An In Vivo Study

The objective of this study was to determine the efficacy of chemical-mechanical procedures of two endodontic protocols for septic content reduction of root canals from primary teeth with pulp necrosis and periradicular lesion. Twenty-four primary root canals with pulp necrosis and periradicular lesion were divided into two treatment groups (n=12): multiple-visit and single-visit protocols. Samples were collected using sterile paper points before and after endodontic cleaning followed by microbiological identification through checkerboard DNA-DNA hybridization. Statistical analysis was performed using Proportion Test for score=0 comparing the findings before and after treatment for each group (Wilcoxon's test) as well as the differences in scores between protocols (Mann-Whitney's test) (p<0.05). Data were expressed as prevalence (presence or absence) and estimate of the average count (x105 cells) of each species. Differences in proportions of score=0 prior to treatment were non-significant (p=0.415), demonstrating equivalence between groups. A significant increase in score=0 was detected after treatment for both groups (p<0.0001). Single-visit protocol achieved a significantly greater reduction in mean scoring following endodontic treatment (p=0.024). Both protocols were capable of significantly reducing septic content in root canals of primary teeth with periradicular lesion. Moreover, single-visit protocol showed greater efficacy in reducing endodontic infection.

O objetivo deste estudo foi determinar a eficácia das manobras químico-mecânicas de dois protocolos endodônticos, na redução do conteúdo séptico de canais radiculares de dentes decíduos com polpa necrosada e lesão perirradicular. Vinte e quatro canais radiculares decíduos com necrose pulpar e lesão perirradicular foram divididos em dois grupos de tratamento (n=12): multisessões e sessão única. Amostras foram coletadas usando pontas de papel estéreis, antes e após a limpeza endodôntica, seguido de identificação microbiológica por hibridização DNA-DNA checkerboard. A análise estatística foi realizada usando teste de proporções para escore=0, comparando os achados antes e após tratamento para cada grupo (teste de Wilcoxon) e as diferenças dos escores entre os protocolos (teste de Mann-Whitney) (p<0,05). Os dados foram expressos em prevalência (presença ou ausência) e contagem média (x105 células) de cada espécie. As diferenças nas proporções de escore=0 antes do tratamento não foram significativas (p=0,415), mostrando equivalência entre os grupos. Um aumento significativo de escore=0 foi detectado após o tratamento para ambos os grupos (p<0,0001). O protocolo de sessão única mostrou uma redução significativamente maior dos escores médios após o tratamento endodôntico (p=0,024). Ambos os protocolos são capazes de reduzir significativamente o conteúdo séptico de canais radiculares de dentes decíduos com lesão perirradicular. Entretanto, o protocolo de sessão única mostrou uma maior eficácia na redução da infecção endodôntica.

Submersão severa de dentes decíduos: diferentes abordagens de acordo com o momento do diagnóstico / Severe submerged deciduous teeth: different approaches in accordance with the time of diagnosis

Introdução: a submersão severa de dentes decíduos, condição em que a superfície oclusal do dente apresenta-se nivelada ou abaixo da margem gengival, é rara e são poucos os casos relatados na literatura. Devida importância deve ser atribuída aos casos de submersão severa a fim de evitar potenciais problemas de desenvolvimento oclusal. Quanto mais precoce o diagnóstico e a intervenção, maior a chance de restabelecimento do desenvolvimento normal da dentição. Objetivo: apresentar dois casos de submersão severa de dentes decíduos com diferentes abordagens cirúrgico-ortodônticas de acordo com o momento do diagnóstico, englobando as possíveis etiologias, diagnóstico e opções de tratamento. Conclusão: a intervenção precoce nos casos de submersão severa de dentes decíduos previne problemas durante o desenvolvimento da dentição.

Introduction: the severe submersion of deciduous teeth, a condition in which the occlusal surface of the tooth presents in the level or below of the gingival margin, is rare and few cases have been reported in the literature. Due importance should be given to cases of severe submersion in order to avoid potential problems of occlusal development. How early diagnosis and intervention should be realized, greater the chance of restoring the normal development of teeth. Objective: to present two cases of severe submerged deciduous teeth with different orthodontic-surgical approaches according to the time of diagnosis, involving the possible etiology, diagnosis and treatment options. Conclusion: early intervention in cases of severe submersion of deciduous teeth prevents problems during the development of the dentition.

Comparison of def index with Nyvad's new caries diagnostic criteria among three to six years old children in a school at Bangalore city

Background: Dental caries is a multifactorial disease with varying clinical picture and its diagnostic criteria is complicated, when initial lesion is considered. Hence, there is a need for an index which measures cavitated, non-cavitated, and initial lesion in dental caries. So, the purpose of this study was to compare the of def index with Nyvad's new diagnostic criteria. Materials and Methods: A total of 249 school children in the age group of three to six years were selected for the study from Sajjan Rao School at Bangalore city. Children teeth were cleaned and dried with cotton rolls and chip blower. The dental caries examinations were conducted under standardized conditions using plane mouth mirrors and explorers with the help of artificial illumination. The diagnostic criteria used were deft and d, e, and f component of Nyvad's new caries diagnostic criteria. Mann Whitney 'U' test was used to compare the two indexes at five percent significant level. Results: The mean value for deft was 2.48 and the mean for d, e, and f component of Nyvad's new caries diagnostic criteria was 3.18 which shows statistically significant difference with P value of <0.05. Conclusion: The result obtained by Nyvad's new caries diagnostic criteria produces values much higher than those with def caries index system. Hence, Nyvad's new caries diagnostic criteria can be used to diagnose dental caries at the initial stages, which in turn will reflect exact prevalence of caries.

Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: a case-control study

Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or less commonly in daytime. The aim of this study was to investigate the association between clinical signs and symptoms, parafunctions and associated factors of sleep bruxism in children. A population-based case-control study was carried out involving 120 children, 8 years of age, with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from public and private schools in the city of Belo Horizonte, MG, Brazil. Groups were matched by gender and social class. The Social Vulnerability Index (SVI) drawn up by the city of Belo Horizonte was employed for social classification. Data collection instruments included clinical forms and pre-tested questionnaires. The diagnosis of sleep bruxism was supported by the American Association of Sleep Medicine (AASM) criteria. The McNemar test, binary and multivariate logistic regression models were used for statistical analysis. The risk factors associated with sleep bruxism included: primary canine wear (OR=2.3 IC 95% 1.2-4.3), biting of objects like pencils or pens (OR=2.0 IC 95% 1.2-3.3) and wake-time bruxism (tooth clenching) (OR=2.3 IC 95% 1.2-4.3). Children that present the parafunctions of object biting and wake-time bruxism were more susceptible to sleep bruxism.

Bruxismo é o ato não funcional de ranger os dentes enquanto se dorme ou apertar os dentes em vigília. O objetivo deste estudo foi investigar a associação entre sinais e sintomas clínicos associados ao bruxismo noturno em crianças. Foi desenvolvido um estudo de base populacional com desenho caso-controle, envolvendo 120 crianças, de 8 anos de idade, com bruxismo e 240 crianças sem bruxismo. A amostra foi selecionada de forma randomizada em escolas públicas e particulares da cidade de Belo Horizonte, Brasil. Os grupos caso e controle foram pareados por gênero e classe social. O Índice de Vulnerabilidade Social (IVS) desenvolvido pela prefeitura da cidade de Belo Horizonte foi utilizado para a classificação social. Como instrumentos de coleta foram utilizados: uma ficha clínica e um questionário pré-testados. O diagnóstico de bruxismo noturno foi baseado nos critérios da American Association of Sleep Medicine (AASM). Os testes estatísticos de McNemar, regressão logística binária e multivariada com modelo de regressão foram utilizados para análise dos dados. Foram considerados fatores de risco para o bruxismo noturno: desgaste em caninos decíduos (OR=2,3 IC 95% 1,2-4,3), morder objetos como lápis e canetas (OR=2,0 IC 95% 1,2-3,3) e apertar os dentes em vigília (OR=2,3 IC 95% 1,2-4,3). Crianças que apresentam outras parafunções tais como: morder objetos e apertar os dentes em vigília são mais susceptíveis ao bruxismo noturno.

Avaliação da comunidade microbiana, com ênfase para a espécie Enterococus faecalis, em dentes decíduos com necrose pulpar através de técnicas fenotípicas e moleculares / Evaluation of microbiota with emphasis on species of Enterococcus faecalis, in primary teeth root canals with pulp necrosis, using conventional and molecular microbiological techniques

Infecção endodôntica em dentes decíduos tem sido pouca avaliada, apesar da influência destes sobre a dentição permanente. No presente estudo foi avaliada a microbiota, com ênfase na espécie de Enterococcus faecalis, de canais radiculares de dentes decíduos com diagnóstico de necrose pulpar, utilizando-se técnicas microbiológicas convencionais e moleculares. Para tanto, um estudo do tipo seccional, clínico e laboratorial foi desenvolvido, sendo a coleta do material endodôntico realizada na clínica de Odontopediatria da Faculdade de Odontologia da UFRJ. Para o estudo, 244 crianças saudáveis foram examinadas no período de um ano, e destas, 43 se enquadravam nos critérios de inclusão. O material foi coletado do canal radicular utilizando-se cones estéreis de papel, dos quais dois foram inoculados em caldo seletivo-indicador Enterococcosel e os outros dois em TSB-DMSO sob congelamento a -20º C. A identificação de E. faecalis foi realizada a partir do cultivo inicial no caldo e subcultivo em agar sangue para observação de colônias bacterianas características. Testes bioquímicos e enzimáticos e a Reação em Cadeia da Polimerase (PCR) para o gene do rRNA 16S também foram utilizados para identificação da espécie. A técnica de Eletroforese em Gel com Gradiente Desnaturante (DGGE) foi utilizada para avaliação do perfil da comunidade microbiana presentes nos espécimes clínicos. Os resultados mostraram que dos 43 espécimes clínicos obtidos, 18 foram excluídos devido à contaminação no controle. Entre os 25 casos estudados, 10 foram positivos no caldo de enterococcosel, sendo cinco (20%) positivos para a espécie E. faecalis nos testes fenotípicos e na PCR. Outros cinco espécimes foram positivos no caldo, mas as amostras bacterianas não apresentaram bioquímica compatível com a espécie E. faecalis, e foram então submetidas ao seqüenciamento de um fragmento do gene do rRNA 16S. Foram identificados Lactobacillus plantarum (4 amostras) e Lactobacillus rhamnosus (1 amostra). Não houve relação dos dados clínicos com a presença de E. faecalis (p > 0,05). A técnica de DGGE mostrou uma comunidade polimicrobiana nos 25 espécimes analisados e, considerando-se o número de bandas no gel, um número ≥ 20 foi relacionado com pacientes com idade ≤ 4 anos e  20 bandas com pacientes com mais de 4 anos de idade (p  0,05). Relação significativa também foi observada entre idade  4 anos e cárie em dente posterior, assim como entre idade  4 anos e cárie em dente anterior. Trauma como causa de infecção endodôntica foi significativa entre crianças com 4 anos de idade. Os resultados demostram a presença de E. faecalis em infecções endodônticas com necrose pulpar em dentição decídua, confirmando sua presença na cavidade oral destes pacientes. Adicionalmente, a técnica de DGGE mostrou uma comunidade polimicrobiana, indicando associação entre idade do paciente e doença cárie.

Endodontic infections in primary teeth have been poorly evaluated despite their influence on permanent dentition. In the present study we assessed the microbiota, with emphasis on species of Enterococcus faecalis, in primary teeth root canals with pulp necrosis, using conventional and molecular microbiological techniques. Thus, a cross-sectional study of clinical and laboratory data was developed. The material was collected at the endodontic clinic of Pediatric Dentistry, Faculty of Dentistry, UFRJ. For the study, 244 healthy children were examined during one year, and of these, 43 met the inclusion criteria. Material was collected from root canals using sterile paper cones. Four paper cones were used for each canal: two were inoculated in the selective broth indicator Enterococcosel and anothers two placed in TSB-DMSO and frozen at -20 ° C until required. Identification of E. faecalis was initially made using culture in broth and subculture on blood agar for observational characteristics of bacterial colonies. Biochemical and enzymatic analysis as well as Polymerase Chain Reaction (PCR) for the 16S rRNA gene were also used for species identification. The Gradient Gel Electrophoresis Agents denaturants (DGGE) technique was used to assess the profile of the microbial communities present in the clinical specimens. Eighteen (18) of the 43 clinical specimens obtained were excluded due to contamination. Among the 25 cases studied, 10 were positive for the species E. faecalis in Enterococcosel broth, five (20%) were positive in the phenotypic tests and PCR. Another five specimens were positive in the broth medium, but the bacterial samples showed no biochemical species compatible with E. faecalis, and so were subjected to sequencing of a fragment of the 16S rRNA gene. Lactobacillus plantarum were identified (4 samples) and Lactobacillus rhamnosus (1 sample). There was no statistically significant correlation of clinical data with the presence of E. faecalis (p> 0.05). The DGGE analysis showed a community polymicrobial. About 20 bands or more were associated with patients ≤ 4 years old and that lesser 20 bands were associated with patients over 4 years old (p  0,05). A significant relationship was also found between patients > 4 years old and caries in posterior teeth, as well as between patients  4 years and anterior tooth caries. Trauma as the cause of endodontic infection was significant among children  4 years old. The results show the presence of E. faecalis in endodontic infections with pulp necrosis in the primary dentition, confirming its presence in the oral cavity of patients. Additionally, DGGE showed a polymicrobial community in 25 samples obtained, suggesting an association between patient age and tooth decay.

La prevalencia de caries dental y evaluación de los factores de riesgo en niños que participaron o no / Prevalence of dental caries and evaluation of risk factors in children participating or not of a preventive program

El objetivo de este estudio fue comparar la prevalencia de la caries dental y evaluar los factores de riesgo en los niños que presentaron o no caries dental en el Programa de Atención Odontológica a partir de la Primera Infancia (PAOPI) y en la Clínica de Atención Primaria (CAP), ambos pertenecientes la Clínica del Bebé de UNIGRANRIO. Este estudio fue retrospectivo, observacional y transversal. Se evaluaron 330 niños entre 12 y 36 meses, que fueron divididos en dos grupos: G1- PAOPI(n = 108) y G2- CAP(n = 222). CEP: 032/2005. Los datos fueron extraídos de las historias clínicas de los pacientes entre los meses de febrero y novienbre de 2008, por un único investigador. Los niños del G1, debían iniciar el PAOPI hasta los 12 meses de edad, sin perder las consultas de examen; los niños del G2 debían ser niños que nunca participaron de programas de prevención y que estaban iniciando el tratamiento en la CAP. Los datos fueron tabulados utilizando el EPI-Info 6.04, evaluados a través de los tests del "Chi-cuadrado" y "t-Student", p<0,05. Hubo datos significativos en cuanto a: los años de estudio de los padres o tutores, frecuencia de lactancia y limpieza posterior, y contaminación salival. La prevalencia de la caries dental para el G1 fue de 4,6% y 45,0% en el G2. El PAOPI fue capaz de prevenir y/o controlar el desarrollo de caries en la edad estudiada, en comparación a CAP

The objective of this study was to compare the dental caries prevalence and to evaluate the risk factors in children that presented or not carious lesions at the Program of Odontological Attention from First Infancy (PAOPI) and at the Clinic of Primary Attention (CAP), both belonging to the Baby-Clinic of UNIGRANRIO. This study had a retrospective, observational and transversal character. A total of 330 children between 12 and 36 months old were evaluated and divided into two groups: G1- PAOPI (n=108) and G2- CAP (n=222). CEP:032/2005. The data were collected from prontuaries between February 2008 and Novenber 2008 by a single researcher. The G1 children should have initiated the PAOPI program under the age of 12 months old and should not have missed the dental revision examinations. The G2 children should have been those that had never taken part of prevention programs and that were initiating the treatment at CAP. The data were tabulated at EPI-Info 6.04 and evaluated using both the Chi-square and t-Student tests, p<0.05. There was significance regarding the years of study of the father, the frequency of breast-feeding and later cleanness and salivary contamination. The caries prevalence was 4.6% and 45.0% for G1 and G2, respectively. The PAOPI was capable of preventing and/or controlling the development of carious lesions within the studied age range, when compared to CAP

Evaluation of treatment for functional posterior crossbite of the deciduous dentition using Planas' direct tracks.

Background: Functional posterior crossbites are a common finding in children with deciduous teeth and must be treated as soon as they are diagnosed in order to avoid unwanted changes in normal growth and development patterns. Objective: This study objective was to evaluate the changes caused by Planas' direct tracks treatment on the arch dimensions of patients with functional posterior crossbite in first dentition. Materials and Methods: The sample consisted of 20 children, 4 to 6 years old, divided into two groups, paired up according to age and gender. Group test was composed of 10 patients with functional posterior crossbite treated with PDT. Group control consisted of 10 children with normal occlusion. The evaluation criteria were intercanine and intermolar distances and Carrea's analysis (arch perimeter). All data were collected by a pre-calibrated examiner on study casts obtained at baseline and after 4 months of treatment. The statistical analysis of the data was achieved using GraphPad InStat software, version 3.05 for Windows, with the level of significance set at 0.05. For the comparison between intercanine and intermolar distances, the Tukey-Kramer Multiple Comparisons test was used. When Carrea's analysis was considered, the Mann-Whitney test was used. Results: At the beginning of the study, all the evaluated criteria showed lower mean values in patients with posterior crossbites, and significant differences between test and control groups were noticed (P<0.05). After the end of follow-up period, these differences could not be verified (P>0.05). Conclusions: Within the limits of the present study, it is possible to conclude that the treatment with Planas' direct tracks was able to give back the normal dimensions of deciduous arch in patients with unilateral functional posterior crossbites, thus making it possible a better growth pattern.