Knowledge of Brazilian Dentists about Dentoalveolar Trauma Care and their Experiences during the COVID-19 Pandemic

ABSTRACT Objective: To assess dentists' knowledge from Minas Gerais, Brazil, about dentoalveolar trauma (DT) and their experiences during the COVID-19 pandemic. Material and Methods: An online questionnaire with 34 questions was applied to collect personal data, professional training, self-assessment of experience/knowledge about DT, experience in care provided during the social distancing, and knowledge/conduct. The specific responses were evaluated based on the guidelines of the International Association of Dental Traumatology (IADT). Descriptive analysis and Pearson's chi-square test were performed. The level of significance was set at p≤0.05. Results: Most professionals (97.7%) had received information on DT, and only 4.6% of the participants considered their knowledge poor or very poor. However, 92.7% felt the need for more information on the subject. Regarding experiences during the pandemic, 55.7% provided trauma care during that period. Forty percent of the consultations were performed in person, and 33.3% of the professionals noted an increase in cases during the pandemic; 56.6% reported that the frequency did not change. The overall mean number of correct answers about DT was 5.29±2.11, indicating an acceptable level of knowledge. The mean percentage of hits for the specific questions was 44.1%. Conclusion: Although the level of knowledge of the dentists evaluated was acceptable, some aspects were deficient, with the need for more information about the IADT guidelines.

Elementary school teachers' knowledge and attitudes toward emergency management of traumatic dental injuries

Abstract The consequences of traumatic dental injuries can be even more serious when their emergency management procedures are inadequate. Since traumatic accidents frequently occur at school, it is crucial that teachers be knowledgeable enough to assist an injured child. This study aimed to assess the knowledge and attitudes of the elementary school teachers of a Brazilian city toward dental trauma in permanent teeth, and its emergency practices. A combination of convenience and snowball sampling methods was used. An online questionnaire was distributed through social media, consisting of three parts: demographic characteristics and professional information; previous experiences and attitudes toward dental trauma; teachers' knowledge of this subject. Descriptive and statistical analyses were carried out. Pearson chi-squared test (p < 0.05) was used. A total of 217 teachers participated in the study. The power of the sample was 95%. Half of the teachers had already witnessed a dental trauma incident involving students, and 70.5% never received any information on the subject. The teachers who were provided previous information were the ones who opted to search for the tooth fragment (p=0.036) in cases of crown fracture, and for the lost tooth (p = 0.025) in cases of avulsion. They were also the ones who chose to wash the tooth in running water (p = 0.018), and look for a dentist in the first 30 or 60 minutes after the trauma (p = 0.026). Most of the teachers assessed did not have adequate knowledge of dental trauma. Having previous information was associated with more assertive practices in trauma management.

Efeito da intervenção educativa sobre o nível de conhecimento de acadêmicos de medicina, participantes de uma equipe do Serviço de Atendimento Móvel de Urgência (SAMU), em relação a avulsão de dentes permanentes / Effect of educational intervention on the level of knowledge of participants in a mobile emergency care team (SAMU) in cases of avulsion of permanent teeth

Objetivo: Avaliar o efeito de uma intervenção educativa, sobre avulsão de dentes permanentes, no nível de conhecimento de participantes de uma equipe do SAMU. Métodos: Participaram acadêmicos de Medicina que compunham a equipe do SAMU de Juiz de Fora (MG). A intervenção educativa foi realizada por meio de uma palestra com duração de 15 minutos. Para coleta dos dados foi utilizado um questionário, contendo 13 perguntas sobre avulsão dentária, aplicado em três etapas: antes da palestra (T0), imediatamente após a palestra (T1) e quinze dias após a palestra (T2). Foi realizada análise descritiva e teste McNemar para análise estatística (p < 0,05). Resultados:A amostra foi composta por 36 indivíduos. Nenhum participante relatou ter prestado atendimento a um caso de avulsão dentária. Trinta e quatro acadêmicos informaram não ter recebido orientações anteriores sobre o que fazer diante desse episódio e 35 afirmaram que esse conhecimento é necessário para o médico do SAMU. Houve aumento na porcentagem de acertos após os acadêmicos assistirem a palestra educativa (T1), para sete questões avaliadas. As mesmas questões também apresentaram maior percentual de acertos quinze dias após a palestra educativa (T2). Não houve diferença na capacidade dos acadêmicos reimplantarem um dente avulsionado tanto imediatamente após a palestra educativa (T1), quanto quinze dias após as orientações (T2) (T0-T1: p = 0,999; T0-T2: p = 0,999). Conclusão:A palestra educativa influenciou de forma significativa à melhora do conhecimento sobre avulsão dentária dos acadêmicos de Medicina que fazem parte da equipe do SAMU-JF.

Aim: To evaluate the effect of an educational intervention concerning the avulsion of permanent teeth upon the level of knowledge of members of a SAMU (Ambulance) team. Methods:Medical students who were members of the SAMU team in Juiz de Fora (MG) participated in this study. The educational intervention on the theme was carried out by means of a 15-minute lecture. Data collection was conducted using a structured questionnaire containing 13 objective questions on tooth avulsion, applied to the medical students in three stages: before the lecture (T0), immediately after the lecture (T1), and fifteen days after the lecture (T2). Descriptive analysis and the McNemar test were performed (p < 0.05). Results: The sample consisted of 36 individuals. All participants reported never having attended a dental avulsion case. Thirty-four students reported that they had not received previous guidance on what to do when faced with this type of episode, and 35 stated that information about dental avulsion is necessary for SAMU doctors. For seven of the evaluated questions, an increase was identified in the percentage of correct answers after the students attended the educational lecture (T1). The same questions also showed a higher percentage of correct answers fifteen days after the educational lecture (T2). No difference was found in the students' ability to reimplant an avulsed tooth either immediately after the educational lecture (T1) or fifteen days after receiving guidance on the subject (T2) (T0-T1: p = 0.999; T0-T2: p = 0.999). Conclusion: The educational lecture significantly influenced the improvement of knowledge about dental avulsion among medical students who are members of the SAMU-JF team.

Traumatic dental injuries in children: experience during the Covid-19 pandemic and parents' knowledge about their management

Abstract The social isolation measures adopted during the critical phase of the COVID-19 pandemic led children to spend most of their time at home. Isolation may alter the pattern of traumatic dental injury occurrences, inasmuch as studies point out that most traumatic accidents occur at home. Considering this scenario and the influence of emergency management on the prognosis of the injury, the aim of this study was to evaluate the experience of traumatic dental injuries in children before and during the pandemic, and the knowledge of this topic by the children's guardians. This cross-sectional study was conducted with guardians of children aged 0 to 6 years, residing in Juiz de Fora, MG, Brazil. The guardians answered an online questionnaire addressing personal information, traumatic dental injury experience before and during the pandemic, and knowledge of this topic. Descriptive and statistical analyses were performed using Pearson's chi-square test at a 5% significance level. The total sample consisted of 343 volunteers. A total of 95 and 92 injuries were reported before and during the pandemic, respectively; the home was the place of greatest occurrence. Most volunteers (88.1%) agreed that traumatic dental injuries are emergency situations, and were aware that the tooth/fragment had to be taken to the dentist after a fracture or avulsion (97.4%). This study revealed that the traumatic dental injury experience was similar before and during the pandemic, and that the volunteers had satisfactory knowledge, especially in recognizing the importance of immediate attention for a more favorable prognosis of these injuries.

Association Between Dental Caries Experience and Socioeconomic Determinants on Oral Health-Related Quality of Life among Children and their Families

ABSTRACT Objective: To assess the association between dental caries experience, severe dental caries experience and socioeconomic determinants on oral health-related quality of life among children and their families. Material and Methods: This is a cross-sectional study whose sample was composed of children aged 4-12 years, who sought dental care in a dentistry school clinic, and their parents/caregivers. Dental caries experience and severe dental caries experience were assessed according to the DMF-T/dmf-t indexes. Parents/caregivers answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ), the Family Impact Scale (FIS) and a questionnaire on socioeconomic and demographic conditions. Data analysis included the chi-square test and Poisson regression (PR). Results: The sample was composed of 105 children and their parents/caregivers. Severe dental caries experience in children was determinant for negative perception of children's OHRQoL by parents/caregivers (PR = 1.22; CI = 1.05-1.41). Negative impact on OHRQoL perceived by family members was determined by severe dental caries experience in children (PR = 1.22; CI = 1.05-1.42) and family income <5 minimum wage (PR = 1.32; CI = 1.08-1.61). Conclusion: Severe dental caries experience was associated with a negative impact on OHRQoL perceived by children and their families. Low family income was associated with a negative impact on the OHRQoL perceived by children and their families.

Qualitative and quantitative molecular analysis of bacteria in root canals of primary teeth with pulp necrosis

Abstract Information about bacterial diversity, such as the number of each species in the root canals of primary teeth, contributes to improving our effective management of infections of endodontic origin in primary teeth. This study made a qualitative and quantitative assessment of the bacteria in the root canals of primary teeth with necrotic pulp, using the fluorescence in situ hybridization (FISH) technique. Thirty-one primary teeth with pulp necrosis from 31 children were evaluated using the FISH technique, to detect the presence and density of Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Streptococcus, Streptococcus mutans, Streptococcus sobrinus, Tannerella forsythia and Treponema denticola. Descriptive measures explained the data related to density, and Student's t-test assessed the differences among the densities of each bacterium, according to signs and symptoms. The bacterial density was paired and correlated. All bacteria tested were detected and identified in all the samples. The average number of bacterial individuals from each species ranged from 1.9 x 108 cells/mL (S. mutans) to 3.1 x 108 cells/mL (F. nucleatum) (p > 0.05). The sum of the mean counts of each bacterium represented almost 80% of the entire microbial community. Patients with pain had significantly more T. denticola, and those with edema showed a greater density of Streptococcus and P. nigrescens (p < 0.05). This study revealed that all 12 bacteria evaluated were found in all primary teeth with pulp necrosis. There was no predominance among the species studied; all species had a similar number of individuals.

The Novel Coronavirus: An Alert for Pacifiers' Disinfection

Abstract Objective: To evaluate the best strategy for pacifier disinfection methods. Material and Methods: The literature search was conducted on MEDLINE/PubMed, Scielo, Lilacs, Web of Science, and Scopus databases to find all relevant articles published over the past 20 years, based on PRISMA guidelines. Two reviewers extracted data independently by using a standardized form. The following factors were recorded: country of study, type of study, pacifier material, sample number, microorganisms analyzed, decontamination methods used, method accessibility and results found. Results: A total of 121 articles were obtained from all databases. The selected documents underwent a final screening, resulting in 8 articles. The method of disinfection analyzed by the literature were: 3.5% neutral detergent, apple cider vinegar 70% spray, boiling water during 15 minutes, sodium hypochlorite 2.5, hydrogen peroxide 70% spray, chlorhexidine 0.12%, Brushtox®, sterile water and microwave. Conclusion: Because of the broad methods for pacifier disinfection and different levels of accessibility to disinfectant agents, the pacifier consensus for decontamination remains unclear. Although the disinfection methods are diverse, the methods suggested to its disinfection were identified and described in this article.

Bruxismo infantil e sua associação com fatores psicológicos ­ revisão sistemática da literatura / Bruxism in children and its association with psychological factors - a systematic review of literature

O bruxismo compreende uma atividade parafuncional caracterizado pelo ato de ranger ou apertar os dentes de forma voluntária e/ou involuntariamente, ocorrendo durante o período diurno e/ou noturno, podendo acarretar vários prejuízos ao sistema estomatognático. Diversos são os fatores etiológicos que podem estar associados a esta desordem, como fatores locais, sistêmicos, hereditários, psicossociais e comportamentais. Pesquisadores têm sugerido que fatores comportamentais, como estresse, ansiedade e traços de personalidade se sobressaem a fatores locais. Portanto, o objetivo deste estudo foi realizar uma revisão sistemática da literatura a fim de avaliar se há relação entre bruxismo e fatores psicológicos em crianças. Foram realizados levantamentos nas bases de dados: PubMed, BVS Biblioteca Virtual em Saúde e SciELO no período de fevereiro de 2007 a setembro de 2017. Os descritores utilizados foram "bruxism", "children", "stress", "anxiety", "pshychological factors". Sendo assim, 97 publicações foram identificadas na busca inicial. Após aplicação dos critérios de inclusão e exclusão, a amostra final foi composta por sete estudos. Houve evidência significativa de uma associação entre estresse, ansiedade e fatores psicológicos com o bruxismo infantil. Porém, ainda existe uma enorme necessidade de estudos bem delineados e com metodologias padronizadas a fim de verificar a associação entre o bruxismo e fatores psicológicos.

Bruxism comprises a parafunctional activity characterized by the act of grinding or clenching the teeth voluntarily and/or involuntarily, occurring during the day and / or night, and may cause several damages to the stomatognathic system. Several etiological factors may be associated with this disorder, such as local, systemic, hereditary, psychosocial and behavioral factors. Researchers have suggested that behavioral factors such as stress, anxiety, and personality traits stand out from local factors. Therefore, the aim of this study was to perform a systematic review of the literature in order to evaluate if there is a relation between bruxism and psychological factors in children. Data were collected in the databases: PubMed, BVS Virtual Health Library and SciELO from February 2007 to September 2017. The descriptors used were "bruxism", "children", "stress", "anxiety" and "pshychological factors". Thus, 97 publications were identified in the initial search. After applying the inclusion and exclusion criteria, the final sample consisted of seven studies. There was significant evidence of an association between stress, anxiety, and psychological factors with infant bruxism. However, there is still a great need for well-designed studies with standardized methodologies in order to verify the association between bruxism and psychological factors.

Longitudinal study on clinical and microbial analysis of periodontal status in pregnancy

Abstract This study was aimed to provide a longitudinal overview of the subgingival bacterial microbiome using fluorescence in situ hybridization (FISH) technique, in women in the second trimester of pregnancy (between 14 and 24 weeks), and 48 h and 8 weeks postpartum. Of 31 women evaluated during pregnancy, 24 returned for the 48-h and 18 for their 8-week exams postpartum. Probing depth (PD), bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were collected, and FISH was used to identify the numbers of eight periodontal pathogens. Friedman test was used to compare differences between follow-up examinations, followed by a multiple comparison test for a post hoc pairwise comparison. Clinically, a significantly greater number of teeth with PD = 4-5 mm were found during pregnancy than on postpartum examinations. Microbial analysis showed a statistically significant decrease in cell count over the study period for Prevotella nigrescens. P. intermedia, Campylobacter rectus, and Porphyromonas gingivalis also decrease, although not significantly, and Aggregatibacter actinomycetemcomitans increased. No significant changes were found for Fusobacterium nucleatum, Treponema denticola, or Tannerella forsythia. Our data demonstrate a change in the subgingival microbiota during pregnancy, at least for P. nigrescens.

Clinical Effectiveness of Two Commercial Fluoride Varnish Formulations on the Control of White Spot Lesion in Primary Teeth: A Pilot Study

To evaluate the in vivo clinical effectiveness of two commercial fluoride varnish formulations.Material and Methods:The sample consisted of seven children aged 2-5 years for a total of 24 active white spot lesions (WSL) in primary teeth. Children were randomly divided into two groups in accordance with the varnish used: G1 -Duraphat® -DR (n = 14 WSL); and G2 -Duofluorid XII® -DF (n = 10 WSL). Children were submitted to treatment with varnishes applied once a week for four consecutive weeks. Maximum mesiodistal and incisogengival dimensions were measured with a periodontal probe at the beginning of treatment and on the fifth week of treatment. The average between the two dimensions represented the value of the WSL dimension. The comparison of the mean final values of WSL dimensions between groups of fluoride varnishes tested was analyzed by the Mann-Whitney U test. The significance level adopted was 5%. Results:After five weeks, most WSL were ranked as inactive (G1 = 71.4% and G2 = 40%). No significant difference between G1 and G2 in relation to lesion activity was observed (p = 0.124). There was a significant decrease of 24% between initial (3.12 mm ± 1.49 mm) and final WSL dimension (2.35 mm ± 1.06 mm) (p = 0.012) in G1. In G2, there was a significant reduction of 40% in lesion dimension with initial value of 5.7 mm (± 3.82 mm) and final value of 3.4 mm (± 3.35 mm) (p = 0.013). Regarding the reduction in the WSL dimension, no significant difference between groups was observed (p = 0.931). Conclusion:Both fluoride varnish formulations tested had similar effect on the control of active white spot lesions in primary teeth...

Detection and enumeration of periodontopathogenic bacteria in subgingival biofilm of pregnant women

The aim of this study was to use the fluorescence in situ hybridization (FISH) technique to test the hypothesis of qualitative and quantitative differences of 8 periodontopathogens between pregnant and non-pregnant women. This cross-sectional study included 20 pregnant women in their second trimester of pregnancy and 20 non-pregnant women. Probing depth, bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were collected and the FISH technique identified the presence and numbers of Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Campylobacter rectus, Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia and Prevotella nigrescens. The Mann-Whitney U-test was applied to compare the data between the two groups. The mean age, ethnicity, marital status, education, and economic level in both groups were similar. The clinical parameters showed no significant differences between pregnant and non-pregnant women. The numbers of subgingival periodontopathogens were not found to be significantly different between groups, despite the higher mean counts of P. intermedia in pregnant women. Colonization patterns of the different bacteria most commonly associated with periodontal disease were not different in the subgingival plaque of pregnant and non-pregnant women.

A experiência de um programa de atenção à saúde bucal no atendimento às gestantes / Experience of an oral health attention program in attendance of pregnant women

O Projeto Só-Riso - Atenção Materno-Infantil é um projeto de extensão no qual alunos da Faculdade de Odontologia da Universidade Federal de Juiz de Fora, MG, realizam tratamento de gestantes visando a preservação da sanidade gestacional e promoção de saúde ao binômio mãe-filho. O objetivo deste estudo foi relatar a experiência da instituição no atendimento às gestantes. Foi coletado do prontuário dados sociodemográficos, distúrbios sistêmicos, condição de saúde bucal, tratamentos executados e encaminhamentos necessários. Utilizou-se análise descritiva da frequência absoluta e relativa. Foram atendidas 78 gestantes, com média de idade de 27,9 anos. Infecção geniturinária foi o distúrbio sistêmico mais comum (11/78). Todas as gestantes receberam orientação sobre saúde geral e bucal e foram submetidas à profilaxia antes do exame clínico. Selamento provisório de lesões cavitadas (66/78) e raspagem periodontal (60/78) representaram a maioria dos procedimentos executados. A alta prevalência de cárie dentária e doença periodontal encontrada demonstra a necessidade de atenção a esta população. Demonstrou-se que é possível o tratamento e a desmistificação do atendimento à gestante, principalmente em nível de atenção básica.

“Só-Riso – Atenção Materno-Infantil” is a extension project where students of the Dental School of Federal University of Juiz de Fora, Brazil, accomplish treatment of pregnant women in order to achieve preservation of the gestational sanity and health promotion of mother and child. The purpose of this study was to relate the experience of this institution in the assistance of these women. It was registered from the records information about socio-demographic data, systemic disturbances, condition of oral health, preventive and curative procedures performed and directions to other levels of attention. Descriptive analysis, which registered absolute and relative frequency were used. Seventy eight pregnant women, mean age 27.9 years, were assisted. Urinary tract infections were the most common (11/78) systemic disturbance. All women received guidance on general and oral health and were submitted to dental prophylaxis before oral examination. Temporary cavity sealing (66/78) and periodontal scaling (60/78) represented most of procedures carried out. The high prevalence of dental caries and periodontal disease has shown the need of continuing attention. It was also demonstrated that it is possible the treatment and demystification of pregnant women’s assistance, mainly at basic assistance.

Atividade antifúngica da clorexidina em biofilmes de Candida spp / Antifungal activity of chlorhexidine on Candida spp. biofilm

Candidíase oral é a infecção oportunista mais comum em pacientes imunocomprometidos, sendo a clorexidina um importante antimicrobiano auxiliar no seu tratamento. O objetivo do presente estudo foi avaliar o efeito antifúngico de diferentes soluções de clorexidina (Periogard®, NoPlak Max®, Noplak®, Perioxidin®, Clorexidina 0.06%, Paradontax® e Clorexidina 1%) sobre biofilmes artificiais de Candida spp.: C. albicans (ATCC36801); C. parapsilosis (ATCC22019); C. krusei (ATCC6258); C. glabrata (ATCC2001) e C. tropicalis (ATCC750). As cepas foram cultivadas em meio de cultura BHI ágar sobre fragmentos de esmalte bovino por 72 horas a 37 °C. Após o crescimento, cada fragmento de esmalte bovino foi imerso nas diferentes soluções de Clorexidina por 3 minutos. Nistatina e solução salina foram utilizadas como controle negativo e positivo, respectivamente. Para remoção das células não aderidas, os fragmentos foram então imersos em solução salina por 10 minutos e agitados em vortex. Alíquotas de 100 µL foram inoculadas em placas contendo BHI ágar por 24 horas a 37 °C para contagem de unidades formadoras de colônias (UFC). Observamos que o número de UFC de C. albicans e C. parapsilosis, apresentou um percentual de redução variando de 79 a 99% quando do uso das diferentes soluções (p < 0,001), o mesmo não foi observado para o NoPlak Max® (2,94 e 1,3%, respectivamente); Para C. krusei e C. glabrata, a solução menos efetiva foi a Nistatina (23 e 3,4%, respectivamente) enquanto que para C. tropicalis, todas as soluções apresentaram um alto percentual de redução (99 a 100%). As soluções de clorexidina foram capazes de reduzir significativamente o número de UFC provenientes de biofilme de Candida spp. in vitro.

Oral candidiasis is the most common opportunistic infection in immunocompromised patients and chlorhexidine is an important antimicrobial for its treatment. The antifungal effect of different CHX solutions (Periogard®, NoPlak Max®, Noplak®, Perioxidin®, Chlorhexidine 0.06%, Paradontax® and Chlorhexidine 1%) was evaluated on artificial biofilms of Candida spps: C. albicans (ATCC36801), C. parapsilosis (ATCC22019), C. krusei (ATCC6258), C. glabrata (ATCC2001) and Candida tropicalis (ATCC750). The strains were grown, in a BHI agar medium on bovine teeth enamel for 72 hours at 37 °C. After growth, the fragments were immersed in the CHX solutions for 3 minutes. Nystatin and saline solutions were used as positive and negative controls respectively. To remove the non-adhered cells, the fragments were inoculated in saline solution for 10 minutes, transferred to Falcon tubes containing saline solution and mixed in a vortex. Aliquots of 100 µL were inoculated on BHI agar for 24 hours at 37 °C to count the number of colony forming units (CFU). We observed that the number of (CFU) of C. albicans and C. parapsilosis, showed a reduction rate ranging from 79 to 99% with the use of different solutions (p < 0.001), except for NoPlak Max® (2.94 and 1.3%, respectively). For C. krusei and C. glabrata, nystatin was the least effective solution (23 and 3.4%, respectively); and for C. tropicalis, all the substances presented a high reduction percentage (99-100%). The chlorhexidine solutions were able to reduce the colony forming units of Candida biofilm.

Reabilitação estético-funcional em odontopediatria: relato de um caso clínico / Aesthetic and functional rehabilitation in pediatric dentistry: a case report

Apesar de todos os procedimentos preventivos utilizados em Odontopediatria, ainda são frequentes os casos de crianças com necessidade de reabilitação estético-funcional, devido à perda de dentes decíduos por cárie precoce da infância. As alterações estéticas e funcionais causadas por estas perdas podem influenciar no desenvolvimento biopsicossocial da criança. Nestes casos, a prótese total é o último recurso a ser utilizado com a finalidade de restaurar a função mastigatória, normalizar a fonação, a estética, e possibilitar um ajuste social e emocional do paciente. Este estudo relata um caso de reabilitação estético-funcional de uma paciente de 5 anos de idade, portadora de cárie precoce da infância, em quem foi necessário utilizar a confecção de uma prótese total superior. Após exodontia de todos os dentes decíduos superiores, controle da doença (cárie) e restauração dos elementos inferiores comprometidos, uma prótese total superior foi confeccionada para a paciente, por meio de uma técnica semelhante à utilizada para adultos. A técnica proposta permitiu restabelecer a função mastigatória, melhorar a fonação e a estética da criança bem como resultou na satisfação com o tratamento, demonstrada pela paciente, sua mãe e seus familiares.

In spite of all preventive procedures used in Pediatric Dentistry, cases of children in the need of aesthetic and functional rehabilitation are still frequent due to the loss of deciduous teeth caused by early childhood caries. The aesthetic and functional changes caused by such losses may influence the child's bio-psychosocial development. In such cases, the total prosthesis is the last resource used in order to restore the masticatory function, normalize speech and aesthetics, and allow social and emotional adjustment. This article reports a case of aesthetic and functional rehabilitation of a five year old patient carrying early childhood caries. Therefore, an upper total prosthesis was made. After exodontia of all upper deciduous teeth, caries control and restoration of compromised lower teeth, an upper total prosthesis was made, similar to the one used for adults. The proposed technique allowed recovering of the masticatory function, improvement of speech and aesthetics, and the results of the treatment were considered satisfactory by the patient, the mother and relatives.

Adesão a um programa de atenção à saúde bucal para crianças e adolescentes infectados pelo HIV e atitude dos responsáveis / Adherence to an oral health program for HIV infected children and adolescents and the attitudes of their caretakers

O estudo avaliou a adesão a um Programa de Atenção à Saúde Bucal (PASB) por crianças e adolescentes infectados pelo HIV, bem como a atitude de seus responsáveis quanto a cuidados em relação à saúde bucal. Foram entrevistados 58 responsáveis que acompanhavam crianças e adolescentes HIV+ nas consultas médicas de rotina no ambulatório de aids, os quais foram indagados sobre os dados pessoais, adesão ao PASB ou a outros serviços odontológicos e atitudes quanto aos cuidados bucais. Aproximadamente 70 por cento dos responsáveis disseram que a criança participava do PASB; entretanto, 20 por cento delas não retornavam às consultas de prevenção quando solicitadas, e este retorno era menor quando os responsáveis não eram os próprios pais (p=0,036). A adesão desta população ao tratamento odontológico fora do PASB foi pequena, visto que 48 por cento dos responsáveis relataram que a criança não concluiu o tratamento quando este não foi realizado no PASB. A atitude dos responsáveis em relação aos cuidados bucais das crianças HIV+ também não foi considerada satisfatória. Desta forma, ressalta-se a importância da inserção do odontopediatra em equipes multidisciplinares que atendem crianças e adolescentes HIV+, bem como da divulgação deste serviço para os familiares e para todas as equipes médicas envolvidas com estes pacientes.

This study aimed to evaluate the adherence to an Oral Health Program (OHP) for HIV infected children and adolescents, as well as the attitudes of their caretakers regarding oral care. A total of 58 caretakers that accompany the children in medical appointments at an AIDS ambulatory were interviewed for collecting personal data and data regarding adherence to the OHP or other odontological treatment and attitudes related to oral care. Approximately 70 percent of the caretakers stated that their children participated in the OHAP, however 20 percent of them did not return to the recall appointments; such visits were even less frequent when the caretakers were not the parents themselves (p= 0.036). The adherence of this population to dental treatment outside the OHP was small, 48 percent of the caretakers stated that the child did not conclude the treatment when referred to another place for treatment. The attitude of the caretakers regarding dental care of HIV+ children was not considered satisfactory. Furthermore, it is very important to have pediatric dentists in the multi-professional teams that attend HIV+ children and adolescents and to promote this program among the parents and all medical teams involved with such patients.

Defeito de esmalte e cárie dentária em crianças prematuras e/ou de baixo peso ao nascimento / Enamel defects and dental caries in premature and/or low birthweight children

O objetivo deste estudo de revisão foi verificar a associação entre prematuridade e/ou baixo peso ao nascimento e prevalência de defeitos de esmalte e cárie dentária na dentiçao decídua. De acordo com a literatura consultada, crianças prematuras e/ou de baixo peso ao nascimento apresentam uma prevalência mais alta de hipoplasia de esmalte na dentição decídua, em comparação com crianças a termo e peso normal ao nascimento. Distúrbios sistêmicos frequentes e traumas locais, devido ao uso de laringoscópio e intubação endotraqueal, são sugeridos na patogênese desta condição clínica. Em relação à cárie dentária, os estudos são pouco conclusivos. Entretanto, as crianças prematuras são susceptíveis a um acúmulo maior de placa bacteriana nos dentes hipoplásicos e/ou hipocalcificados, podendo levar a uma progressão mais rápida da doença