Occlusion development after premature loss of deciduous anterior teeth: preliminary results of a 24-month prospective cohort study

ABSTRACT Objective: This study aimed to evaluate occlusion development after premature loss or extraction of deciduous anterior teeth, by means of a prospective cohort study. Methods: Fifteen infants and children aged 1 to 5 years old were longitudinally assessed (with loss or extraction of deciduous anterior teeth [n = 9], and without tooth losses [n = 6]). Photographs and dental casts at the baseline and after 24 months of follow-up were performed. Dental casts were scanned, and linear measurements were made on the digitalized models (missing tooth space, arch perimeter, arch length, arch width, intercanine length and intercanine width). The t-test was used for groups comparisons (α = 0.05). Results: Individuals' mean age at baseline was 2.93 (± 1.18) years. No statistically significant differences were observed in the missing tooth space in the group with tooth loss during the 24 months of follow-up (p > 0.05). Arch perimeter, arch length, arch width, intercanine length and intercanine width did not show differences between the groups (p > 0.05). Qualitative photographic evaluation revealed other changes in the dental arches and occlusion, such as exfoliation and eruption of deciduous teeth, eruption of permanent teeth, self-correction or establishment of malocclusion, among others. Conclusion: The results suggest that the premature loss of deciduous anterior teeth does not affect the perimeter, length and width of the dental arches; however, other alterations that lead to malocclusion could be established.

RESUMO Objetivo: Este estudo teve como objetivo avaliar o desenvolvimento da oclusão após perda prematura ou extração de dentes decíduos anteriores, por meio de um estudo de coorte prospectivo. Métodos: Quinze bebês e crianças de 1 a 5 anos foram avaliados longitudinalmente (com perda ou extração de dentes anteriores decíduos [n = 9] e sem perdas dentárias [n = 6]). Foram realizadas fotografias e modelos dentais no início e após 24 meses de acompanhamento. Os modelos dentários foram escaneados e medidas lineares foram feitas nos modelos digitalizados (espaço dentário perdido, perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos). O teste t foi utilizado para comparações entre grupos (α = 0,05). Resultados: A média de idade dos indivíduos no início do estudo foi de 2,93 (± 1,18) anos. Não foram observadas diferenças estatisticamente significativas no espaço dentário perdido no grupo com perda dentária durante os 24 meses de acompanhamento (p > 0,05). O perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos não apresentaram diferenças entre os grupos (p> 0,05). A avaliação fotográfica qualitativa revelou alterações nas arcadas dentárias e na oclusão, como: esfoliação e erupção de dentes decíduos, erupção de dentes permanentes, autocorreção ou estabelecimento de má oclusão, entre outras. Conclusão: Os resultados sugerem que a perda prematura de dentes anteriores decíduos não afeta o perímetro, comprimento e largura das arcadas dentárias; entretanto, outras alterações que levam à má oclusão poderiam ser estabelecidas.

The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial

Abstract This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

Seed removal by the squirrel Notocitellus adocetus (Rodentia: Sciuridae) in Western México

Introduction: Seed dispersal and seed predation have important impacts on plant diversity and community structure. Rodents participate in both of these types of interactions. Objectives: To evaluate the removal of the seeds of Crescentia alata, Randia capitata, and Zea mays by the squirrel Notocitellus adocetus to determine how it affects these plant species, by dispersing or preying on their seeds. Methods: We studied 14 individuals for C. alata, 24 for R. capitata, and for Z. mays 35 individuals. We observed foraging and used camera traps to determine the part of the fruit (seed and/or pulp) consumed by the squirrels and the amount of fruit or seed consumed. We also placed fine sand traps (FST) to measure the percentage of seed removal. We quantified the fruits produced by the plant species studied and the percentage of damage caused by N. adocetus throughout the plots. Results: Notocitellus adocetus feeds on the seeds and pulp of C. alata and Z. mays. The species with the highest removal rate and the highest percentage of damage was C. alata. Zea mays was the plant species that had the highest percentage of removal from FST, the largest number of fruits, and the lowest percentage of damage. On FST, R. capitata had the lowest seed remotion. Conclusions: Notocitellus adocetus is considered a seed predator; however, due to its behavior and the characteristics of the fruits of C. alata and R. capitata, this rodent could make the seeds available to secondary seed dispersers.

Introducción: La dispersión y depredación de semillas tienen efectos importantes en la diversidad de plantas y estructura de las comunidades. Los roedores participan en estos tipos de interacciones. Objetivos: Evaluar la remoción de semillas de Crescentia alata, Randia capitata y Zea mays por la ardilla Notocitellus adocetus, para determinar su efecto en estas especies de plantas, dispersando o depredando semillas. Métodos: Estudiamos 14 individuos de C. alata, 24 para R. capitata y 35 individuos para Z. mays. Observamos el forrajeo y usamos cámaras trampas para determinar la parte del fruto (semilla y/o pulpa) consumida y la intensidad de consumo por las ardillas. También colocamos trampas de arena fina (FST) para medir el porcentaje de remoción de semillas. Cuantificamos los frutos producidos por las especies estudiadas y el porcentaje de daño ocasionado por N. adocetus, mediante parcelas. Resultados: Notocitellus adocetus se alimenta de las semillas y pulpa de C. alata y Z. mays. La especie que tuvo mayor tasa de remoción y mayor porcentaje de daño fue C. alata. La especie con mayor porcentaje de remoción, mayor número de frutos y menor daño en las FST fue Z. mays. En las trampas de arena fina, R. capitata tuvo la menor remoción de semillas. Conclusiones: Notocitellus adocetus es considerada depredadora de semillas, no obstante, por su comportamiento y las características de los frutos de C. alata y R. capitata, este roedor podría dejar disponibles las semillas a dispersores secundarios de semillas.

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)

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

Resumen Objetivo La periodontitis en dentición primaria es excepcional en niños sin enfermedades sistémicas. El objetivo de este informe es describir las características clínicas y radiográficas 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 incisivos inferiores. El examen clínico y radiográfico mostró pérdida de inserción clínica, pérdida ósea y movilidad dental en otros incisivos superiores e inferiores. Se realizó la interconsulta médica y se descartó que los niños padecieran enfermedades 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, instrumentación subgingival, antisépticos locales, medicación antibiótica sistémica y mantenimiento periodontal. No se realizaron extracciones como parte del tratamiento. En ambos casos uno de los incisivos presentes al momento de la consulta 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.

Abstract Aim Periodontitis in primary dentition is exceptional in children without systemic diseases. The objective of this article is to describe the clinical and radiographic characteristics of two cases of systemically healthy 3-year-old children with periodontitis, and their treatment, with a 5-year follow-up. Clinical cases In both cases, at 3 years of age, the children were referred to a periodontic specialist by their pediatric dentist, due to the very early loss of lower incisors. Clinical 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 manifestation 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 periodontal 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.

Valoración de un método de osmoguiado a flores de durazno (Prunus persica) aplicado en abejas Apis mellifera

Diversos estudios demuestran que la inclusión de polinizadores, como las abejas Apis mellifera, generan efectos positivos sobre la productividad de cultivos de durazno (Prunus persica). Esto lleva a probar metodologías que estimulen a las abejas para visitar, con mayor frecuencia, el cultivo de interés, sugiriendo el uso de la técnica de osmoguiado, como herramienta para potencializar el efecto de la polinización. Este estudio valoró un protocolo de osmoguiado, para estimular híbridos africanizados de Apis mellifera, a recolectar polen de flores de durazno, utilizando, como indicador indirecto, el análisis palinológico en muestras de polen. Los tratamientos utilizados fueron con osmoguiado y sin osmoguiado. Cada tratamiento contó con tres colmenas y el periodo de evaluación fue de cinco semanas, coincidiendo con el mayor periodo de floración del durazno. Los resultados evidenciaron que este protocolo no logró estimular a las abejas a visitar la flor de durazno para la búsqueda de polen. La disponibilidad permanente de otras plantas productoras de polen, reportadas previamente como importantes en el aporte de este recurso, pudo influir en la selección de fuentes por parte de las abejas. El polen obtenido provino, principalmente, de plantas de las familias Fabaceae, Asteraceae, Malvaceae y Passifloraceae.

Several studies show that the inclusion of pollinators such as honeybee Apis mellifera generates positive effects in the productivity of peach (Prunus persica) crops. It led to test methodologies that stimulate bees to improve the visit of crops of interest, suggesting the use of the osmoguiding technique, as a tool to potentiate the effect of pollination. This study evaluated an osmoguided protocol to stimulate Africanized hybrids of Apis mellifera to collect pollen from peach flowers, using palynological analysis of pollen samples as an indirect indicator. The treatments used were with osmoguided and without osmoguided. Each treatment had three hives, and the evaluation period was five weeks, coinciding with the peak flowering period of the peach. The results showed that this protocol did not stimulate the bees to visit the peach blossom to search pollen. The permanent availability of other pollen-producing plants, previously reported as significant in the contribution of this resource, could influence bee source selection. The pollen obtained came mainly from plants of the families Fabaceae, Asteraceae, Malvaceae, and Passifloraceae.

Fluorosis dental en la primera infancia: estado del arte

La fluorosis dental se caracteriza por una hipomineralización de la estructura dental causada por ingesta excesiva de flúor sistémico. En la dentición decidua, su diagnóstico precoz es importante, dado que será un predictor para la aparición de lesiones en la dentición permanente. El objetivo de esta revisión fue describir la evidencia científica sobre la fluorosis dental en dentición decidua reportando su etiología y factores relacionados, prevalencia, diagnóstico y tratamiento. Se realizaron búsquedas electrónicas en las bases de datos Pub-Med/Medline, EbscoHost y ScienceDirect (noviembre/2020), utilizando las palabras clave "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". El desarrollo de fluorosis dental en dentición decidua se relacionó con la ingesta de múltiples fuentes de flúor principalmente, agua potable, alimentos de la dieta, fórmulas infantiles, suplementos y uso de dentífricos fluorados en dosis inadecuadas. Algunos factores prenatales, como vivir en terrenos montañosos o de gran altitud y habitar en lugares cercanos a minas de combustión de carbón, también fueron asociados. La prevalencia de fluorosis dental reportada en los estudios varió entre 6,2 y 96,6 %, dependiendo principalmente de la concentración de flúor en agua potable. Para el diagnóstico de la fluorosis dental en la dentición decidua se deben considerar características como la localización, aspecto, extensión y color de la lesión, realizando diagnóstico diferencial con otro tipo de defectos en esmalte y dentina. Así mismo, el tratamiento de las lesiones dependerá de la severidad del defecto y condiciones individuales del paciente.

Dental fluorosis is characterized by a hypomineralization of the tooth structure caused by excessive intake of systemic fluoride. In the deciduous dentition, its early diagnosis is important since it will be a predictor for the appearance of lesions in the permanent dentition. The objective of this review was to describe the scientific evidence on dental fluorosis in deciduous dentition, reporting its etiology and related factors, prevalence, diagnosis and treatment. Electronic searches were conducted PubMed / Medline, EbscoHost and ScienceDirect (November / 2020) databases, using the keywords "dental fluorosis", "deciduous teeth", "primary tooth", "primary teeth". The development of Dental fluorosis in deciduous dentition was related to the intake of multiple sources of fluoride mainly; drinking water, diet foods, infant formulas, supplements and the use of luoridated toothpastes in inadequate doses. Some prenatal factors such as living in mountainous or high altitude terrain and living in places near coal-burning mines were also associated. The prevalence of dental fluorosis in early childhood reported in the studies varied between 6.2% and 96.6%, depending mainly on the concentration of fluoride in drinking water. For the diagnosis of dental fluorosis in the deciduous dentition, characteristics such as the location, appearance, extension and color of the lesion must be considered, making a differential diagnosis with other types of enamel and dentin defects. Evenly, the treatment of lesions will depend on the severity defects and individual patient conditions.

Analysis of congenital deciduous teeth absence and its permanent teeth phenotype / 华西口腔医学杂志

OBJECTIVES@#This study aimed to investigate the clinical characteristics of congenital deciduous teeth absence and its permanent teeth performance type by using panoramic radiographs.@*METHODS@#A total of 15 749 panora-mic radiographs of 3-6-year-old children with deciduous dentition were collected from January 2020 to December 2021. The incidence of congenital deciduous teeth absence was observed, and the abnormality of permanent teeth was recor-ded. SPSS 24.0 software was used for statistical analysis.@*RESULTS@#The incidence of congenital deciduous teeth absence was 2.54% (400/15 749), which was found in 217 girls and 183 boys, and the difference between the genders was statistically significant (P=0.003). The absence of one and two deciduous teeth accounted for 99.75% (399/400) of the subjects. In addition, 92.63% (490/529) of mandibular deciduous lateral incisor was congenitally absent, 44.80% (237/529) of deciduous teeth was absent in the left jaw, and less than 55.20% (292/529) was absent in the right; the difference between them was statistically significant (P=0.017). The absence of 96.41% (510/529) deciduous teeth in the mandibular was significantly more than that of 3.59% (19/529) in the maxillary, and the difference between was statistically significant (P=0.000). Furthermore, 68.00% (272/400) and 32.00% (128/400) of deciduous teeth were absent in unilateral and bilateral, respectively, and the difference was statistically significant (P=0.000). Four types of congenital deciduous teeth absence with permanent teeth were observed as follows: 1) 73.91% (391/529) of permanent teeth was absent; 2) 20.60% (109/529) of permanent teeth was not absent; 3) the number of fused permanent teeth accounted for 4.91% (26/529); 4) the number of supernumerary teeth was 0.57% (3/529).@*CONCLUSIONS@#Although the absence of congenital deciduous teeth is less common than that of permanent teeth, it affects deciduous and permanent teeth to some extent. Dentists should pay attention to trace and observe whether abnormalities are present in the permanent teeth and take timely measures to maintain children's oral health.

Woody species distribution across a savanna-dry forest soil gradient in the Brazilian Cerrado / Distribuição de espécies arbóreas em gradiente de solo savana-floresta seca no Cerrado brasileiro

Although richness and distribution of woody species in the Cerrado physiognomies have been extensively studied, the shifts of woody species from savanna physiognomies to dry forests have not yet been addressed. Here, we investigate the effect of soil physical-chemical traits on the woody species turnover between adjacent cerrado stricto sensu and dry forest physiognomies. Woody species were surveyed, and soil and topographic variables measured, in 30 10×40 m plots systematically distributed, with 15 plots in each physiognomy. We found a spatially structured distribution of woody species, and differences of soil traits between cerrado stricto sensu and dry forest areas, mainly related to the aluminum saturation, base saturation, and available phosphorus. Aluminum saturation increased toward the savanna area, while base saturation increased toward the dry forest. Most woody species predominated in one physiognomy, such as Callisthene major in the cerrado stricto sensu and Anadenanthera colubrina in the dry forest. Only 20% of the species were widely distributed across both physiognomies or, not often, restricted to the intermediary values of the soil gradient. General results indicate that contrasting soil traits between cerrado stricto sensu and dry forest produce a strongly spatially organized and sharp transition in terms of species distribution between these physiognomies.

Embora a distribuição e a riqueza em espécies arbóreas nas fitofisionomias do Cerrado venham sendo bastante estudadas, a transição entre savanas e florestas deciduais ainda não foi abordada. Investigamos o efeito de características físico-químicas do solo sobre a distribuição de espécies arbóreas em região de contato entre cerrado sentido restrito e floresta estacional decidual (FED). As espécies arbóreas foram amostradas sistematicamente, e variáveis de topografia e características do solo foram medidas em 30 parcelas de 10×40 m, sendo 15 parcelas em cada fisionomia. A distribuição das espécies arbóreas foi espacialmente estruturada, e as características do solo diferiram entre as áreas de cerrado sentido restrito e FED, principalmente relacionadas à saturação de alumínio, saturação de bases e teores de fósforo. A saturação de alumínio aumentou em direção ao cerrado sentido restrito, enquanto a saturação de bases aumentou em direção à FED. A maioria das espécies arbóreas predominou em uma das fisionomias, como Callisthene major em cerrado sentido restrito e Anadenanthera colubrina em FED. Apenas 20% das espécies foram amplamente distribuídas em ambas as fisionomias ou, em poucos casos, restritas aos valores intermediários do gradiente de solo. Os resultados indicam um forte contraste de características do solo entre o cerrado sentido restrito e a FED, assim como uma transição acentuada e espacialmente organizada quanto à distribuição de espécies arbóreas.

Woody species distribution across a savanna-dry forest soil gradient in the Brazilian Cerrado

Abstract Although richness and distribution of woody species in the Cerrado physiognomies have been extensively studied, the shifts of woody species from savanna physiognomies to dry forests have not yet been addressed. Here, we investigate the effect of soil physical-chemical traits on the woody species turnover between adjacent cerrado stricto sensu and dry forest physiognomies. Woody species were surveyed, and soil and topographic variables measured, in 30 10×40 m plots systematically distributed, with 15 plots in each physiognomy. We found a spatially structured distribution of woody species, and differences of soil traits between cerrado stricto sensu and dry forest areas, mainly related to the aluminum saturation, base saturation, and available phosphorus. Aluminum saturation increased toward the savanna area, while base saturation increased toward the dry forest. Most woody species predominated in one physiognomy, such as Callisthene major in the cerrado stricto sensu and Anadenanthera colubrina in the dry forest. Only 20% of the species were widely distributed across both physiognomies or, not often, restricted to the intermediary values of the soil gradient. General results indicate that contrasting soil traits between cerrado stricto sensu and dry forest produce a strongly spatially organized and sharp transition in terms of species distribution between these physiognomies.

Resumo Embora a distribuição e a riqueza em espécies arbóreas nas fitofisionomias do Cerrado venham sendo bastante estudadas, a transição entre savanas e florestas deciduais ainda não foi abordada. Investigamos o efeito de características físico-químicas do solo sobre a distribuição de espécies arbóreas em região de contato entre cerrado sentido restrito e floresta estacional decidual (FED). As espécies arbóreas foram amostradas sistematicamente, e variáveis de topografia e características do solo foram medidas em 30 parcelas de 10×40 m, sendo 15 parcelas em cada fisionomia. A distribuição das espécies arbóreas foi espacialmente estruturada, e as características do solo diferiram entre as áreas de cerrado sentido restrito e FED, principalmente relacionadas à saturação de alumínio, saturação de bases e teores de fósforo. A saturação de alumínio aumentou em direção ao cerrado sentido restrito, enquanto a saturação de bases aumentou em direção à FED. A maioria das espécies arbóreas predominou em uma das fisionomias, como Callisthene major em cerrado sentido restrito e Anadenanthera colubrina em FED. Apenas 20% das espécies foram amplamente distribuídas em ambas as fisionomias ou, em poucos casos, restritas aos valores intermediários do gradiente de solo. Os resultados indicam um forte contraste de características do solo entre o cerrado sentido restrito e a FED, assim como uma transição acentuada e espacialmente organizada quanto à distribuição de espécies arbóreas.

Uso de la pasta CDZ en dientes temporarios necrosados con una técnica mínimamente invasiva / Use of CDZ paste in necrotic primary teeth with a minimally invasive technique

Introducción: El tratamiento de los canales radiculares de molares temporales con pulpas infectadas ha sido ampliamente descrito y motivo de discusión por muchos años, no existiendo aún un consenso en cuanto al material de obturación. La pasta CTZ (cloranfenicol, tetraciclina y óxido de zinc más eugenol) acompañada de la Técnica de Endodoncia No Instrumentada ha mostrado una alta efectividad clínica y radiográfica para el tratamiento de molares temporales con compromiso pulpar. Se ha propuesto el reemplazo del componente Tetraciclina por Doxiciclina de la formulación, por las implicancias de un posible amelo-génesis imperfecta y la coloración en la corona de dicho componente. Objetivo. Evaluar la efectividad clínica de la pasta CDZ en el tratamiento endodóntico de dientes primarios necrosados con una técnica mínimamente invasiva. Metodología. Estudio de intervención en el que se incluyeron pacientes que presentaban dientes temporales con indicación de terapia pulpar y en quienes se utilizó la pasta CDZ. El éxito del tratamiento se midió por la desaparición de la sintomatología. Resultados. Se incluyeron en el estudio 76 pacientes entre 2 a 9 años. La eficacia del tratamiento con CDZ fue del 97,6% en 125 dientes. Conclusiones. Los hallazgos son comparables a los estudios que utilizaron el CTZ. Debido a las características biológicas del material, su bajo costo, fácil manipulación y excelentes resultados clínicos, se considera una opción en la terapia pulpar en dientes temporales, como una alternativa en el uso de programas de salud pública.

Introduction: Treatment of root canals of primary molars with infected pulps has been widely described and has been the subject of discussion for many years, and there is still no consensus regarding the filling material. The CTZ paste (chloramphenicol, tetracycline and zinc oxide plus eugenol) accompanied by the Non-Instrumented Endodontic Technique has shown high clinical and radiographic effectiveness for the treatment of primary molars with pulp involvement. The replacement of the Tetracycline component by Doxycycline of the formulation has been proposed, due to the implications of a possible amelogenesis imperfecta and the coloration in the crown of said component. Goal. To evaluate the clinical effectiveness of CDZ paste in the endodontic treatment of necrotic primary teeth with a minimally invasive technique. Methodology: Intervention study in which patients with temporary teeth with an indication for pulp therapy and in whom CDZ paste was used were included. Treatment success was measured by the disappearance of symptoms. Results. 76 patients between 2 and 9 years old were included in the study. The efficacy of CDZ treatment was 97.6% in 125 teeth. Conclusions: The findings are comparable to studies using CTZ. Due to the biological characteristics of the material, its low cost, easy handling and excellent clinical results, it is considered an option in pulp therapy in primary teeth, as an alternative in the use of public health programs.

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.

A 14-Year Follow-Up Study of Sequelae in Primary Teeth and Permanent Successors After Dental Trauma

ABSTRACT Objective: To evaluate the presence of sequelae in primary teeth and their permanent successors, as well as associations between TDI and the presence of sequelae in both teeth. Material and Methods: In this 14-year retrospective study, 2.290 records were reviewed, 192 patients who suffered dental trauma in primary teeth were followed until the eruption of successor teeth were included. Descriptive, chi-square, and regression logistic with generalized estimating equations tests were performed (p<0.05). Results: 362 primary and successor teeth were followed. Sequelae were present in 71.8% of primary teeth and 25.7% of their successors. Teeth with complicated fracture (100%), extrusion (100%) and avulsion (100%) resulted in the largest amounts of sequelae in primary teeth and intrusion (61%) on their successors. Age was associated with sequelae in permanent teeth (p<0.01). Extrusion (OR 10.06; CI 2.12-47.63) and intrusion (OR 7.51; CI 2.73-20.70) had a higher risk to cause sequelae in primary and permanent teeth, respectively. Conclusion: The type of injury involved influenced the sequelae in traumatized teeth and their successors, and the age of the child influenced the presence of sequelae in permanent teeth.

Clinical and Radiographic Success Rates of Pulpotomies in Primary Molars Treated with Formocresol, BiodentineTM, and Endo Repair: A Randomized Clinical Trial

ABSTRACT Objective: To compare the clinical and radiographic success rates of formocresol, BiodentineTM, and Endo Repair agents in primary molars after 12 months. Material and Methods: This randomized double-blind clinical trial was conducted on healthy children referred to the Department of Pediatric Dentistry, Kerman, Iran, in 2018. One hundred twenty children (human primary molar teeth) aged 3-9 years were selected and randomly divided into three interventions (with pulpotomy medicament agents), including formocresol, BiodentineTM, and Endo Repair. All pulpotomized teeth were restored using stainless steel crowns and evaluated clinically and radiographically during a 12-month follow-up. Fisher exact test was used to determine the association of categorical variables and the data were analysed with SPSS 25. Results: All the available teeth in formocresol and BiodentineTM groups obtained clinical success, whereas 62.5% of the Endo Repair group was successful in this regard. Radiographic success rates of the formocresol, BiodentineTM, and Endo Repair groups were 94.7%, 70%, and 28.1% after a 12-month follow-up, respectively. Moreover, pulp canal obliteration was observed in 26.3%, 25%, and 12.5% of the formocresol, BiodentineTM, and Endo Repair groups. Conclusion: This study reported a high rate of clinical success using both BiodentineTM and formocresol pulpotomy techniques. However, the radiographic success rate of formocresol was higher than that of BiodentineTM, and Endo Repair was not considered a suitable pulpotomy medicament agent.

A 12-month Follow-Up Study of Pulp Oxygen Saturation in Deciduous Molars After Selective and Nonselective Carious-Tissue Removal: A Randomized Pilot Trial

ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.

Association of salivary parameters and erosive tooth wear in preschool children

Abstract The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013-0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985-1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).

Survival rate of the Hall technique compared with resin composite restoration in multi-surface cavities in primary teeth: a 1-year randomized clinical trial

Abstract Background Hall technique (HT) has been indicated for teeth with dentinal caries lesion; however, extensive cavities, with more than two surfaces still seem challenging for restorative treatment in pediatric dentistry, resulting in a higher failure rate and an increased need for retreatment. Objectives To compare the survival rate of the Hall technique preformed metal crown (HT) with resin composite restoration (RC) for multi-surface cavitated caries lesions in primary molars. Methodology In this multicenter two-arm randomized clinical trial, children between 4 and 9 years of age with at least one primary molar with cavitated caries lesion involving more than two surfaces, including one buccal or palatal/lingual surface, were selected from 17 Brazilian cities. A total of 364 teeth were allocated into two groups: (1) teeth treated with selective caries removal and RC and (2) treated with the HT. The survival rate was assessed at 6 and 12 months after the interventions. Survival analysis was performed with the Kaplan‒Meier method. Cox regression was used to determine the influence of explanatory variables on the survival rate (α=5%). Results After 12 months, 292 teeth were re-evaluated. A total of 358 teeth were re-evaluated at least once during the study and included in the survival analysis. The HT (87.8%) resulted in a higher survival rate than RC restoration (75.7%) (p=0.004). Conclusion HT has a higher survival rate than RC as a treatment for multi-surface cavitated caries lesions in primary teeth. ClinicalTrials.gov: NCT02782390

Primary tooth restoration with colored compomer: case report / Restauração de dente decíduo com compômero colorido: relato de caso

ABSTRACT In pediatric dentistry, restorative treatment requires a material with good mechanical properties, ease of handling, and usability. For the restoration of deciduous teeth, colored compomers are an alternative material for motivating children in dental treatment and, consequently, behavior management. This study aimed to provide information about colored compomers by presenting a case of restoration in a deciduous molar with a five-year follow-up. Additionally, the study highlights the child's motivation toward dental treatment and oral care, thus offering an alternative to other restorative materials for clinicians to consider. The treatment plan for tooth 75 was selective removal of decayed tissue and restoration with compomer blue- colored Twinkly Star. The restoration was performed without anesthesia under relative isolation following the clinical protocol recommended by the manufacturer. As a result, it was observed that the restoration in colored Twinky Star compomer remained aesthetically and functionally satisfactory after five years. In addition, it was favorable for the child's collaboration in dental treatment. It is concluded that colored Twinky Star compomer can be a viable alternative for restoring deciduous teeth, contributing to children's dental treatment and oral care motivation.

RESUMO Em Odontopediatria, o tratamento restaurador exige um material que tenha boas propriedades mecânicas, facilidade de manipulação e de uso. Para a restauração de dentes decíduos, os compômeros coloridos são uma alternativa de material para a motivação de crianças no tratamento odontológico e consequentemente manejo de comportamento. Sabendo da necessidade de conhecer melhor os compômeros coloridos, o objetivo deste estudo foi relatar um caso de restauração com compômero colorido em molar decíduo com acompanhamento de cinco anos, bem como a motivação da criança perante o tratamento odontológico e cuidados bucais a fim de apresentar ao clínico uma alternativa a outros materiais restauradores. O plano de tratamento para este dente 75 foi remoção seletiva de tecido cariado e restauração com compômero colorido twinky star na cor azul. A restauração foi feita sem anestesia sob isolamento relativo seguindo o protocolo clínico preconizado pelo fabricante. Como resultado observou-se que a restauração em compômero Twinky Star colorido manteve-se satisfatória tanto estética quanto funcionalmente após cinco anos. Além disso, mostrou-se favorável para a colaboração da criança no tratamento odontológico. Conclui-se que o uso do compômero Twinky Star colorido pode ser uma alternativa viável para restauração de dente decíduo, contribuindo para a motivação de crianças no tratamento odontológico e cuidados bucais.

Tumor necrosis factor α, and agonist and antagonists of cannabinoid receptor type 1 and type 2 alter the immunophenotype of stem cells from human exfoliated deciduous teeth

ABSTRACT Objective To verify the involvement of the endocannabinoid system in the immunomodulatory profile of stem cells from human exfoliated deciduous teeth, in the presence or absence of TNF-α, and agonist and antagonists of CB1 and CB2. Methods Stem cells from human exfoliated deciduous teeth were cultured in the presence or absence of an agonist, anandamide, and two antagonists, AM251 and SR144528, of CB1 and CB2 receptors, with or without TNF-α stimulation. For analysis of immunomodulation, surface molecules linked to immunomodulation, namely human leukocyte antigen-DR isotype (HLA-DR), and programmed death ligands 1 (PD-L1) and 2 (PD-L2) were measured using flow cytometry. Results The inhibition of endocannabinoid receptors together with the proinflammatory effect of TNF-α resulted in increased HLA-DR expression in stem cells from human exfoliated deciduous teeth, as well as, in these cells acquiring an anti-inflammatory profile by enhancing the expression of PD-L1 and PD-L2. Conclusion Stem cells from human exfoliated deciduous teeth respond to the endocannabinoid system and TNF-α by altering key immune response molecules.

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.