Factores determinantes de extracción de dientes permanentes en pacientes que asisten a hospitales y/o servicios odontológicos / determinant factors in the permanent teeth extractions in patients attending dental hospitals of dental services

Este artículo tiene como objetivo identificar y analizar los factores determinantes que conducen a la extracción de dientes permanentes en pacientes que asisten a hospitales y/o servicios odontológicos. A través de una revisión exhaustiva de la literatura científica y datos epidemiológicos, se exploran las principales causas de pérdida dental, incluyendo caries, enfermedad periodontal, trauma y factores socioeconómicos. Se discuten las implicaciones clínicas y de salud pública de estos hallazgos, así como estrategias preventivas y terapéuticas para reducir la incidencia de extracciones dentales (AU)

This article aims to identify and analyze the determining factors leading to the extraction of permanent teeth in patients attending hospitals and/or dental services. Through a comprehensive review of scientific literature and epidemiological data, the main causes of tooth loss are explored, including caries, periodontal disease, trauma, and socioeconomic factors. The clinical and public health implications of these findings are discussed, as well as preventive and therapeutic strategies to reduce the incidence of dental extractions (AU)

Riesgo microbiológico de caries y factores predisponentes en mujeres gestantes / Microbiological caries risk and predisposing factors in pregnant women

La caries es una enfermedad multifactorial que afecta los tejidos duros del diente, con la evaluación del riesgo de caries es posible determinar la probabilidad de su incidencia durante un determinado periodo de tiempo. El objetivo consistió en determinar el estado de salud bucal en mujeres gestantes y su relación con factores de riesgo de caries. Se realizó un estudio descriptivo observacional clínico. La población estuvo constituida por mujeres gestantes que concurrieron al Hospital Ángela Llano de la cuidad de Corrientes para su atención. Se confeccionó una historia clínica y se determinó el estado de salud bucal y de riesgo de caries según protocolo CAMBRA. Para la carac- terización y descripción de los datos se utilizaron estadísticas univariadas. Los resultados alcanzados fueron: Índice de Caries de 4.5 a 6.5, en el índice de Placa la media ± DS 56,8% ± 39,9% Min: 28,5%/ Max: 90,9%. Respecto al valor de pH de 7,11 ±0,43, Min.: 7,00, Max.: 8,67. Flujo salival: media ± DS: 0,58ml/m ± 0,28 ml/m Min.:0,2 ml/m Max.: 0,62 ml/m; Edad promedio: 22años. Min.:18 Max.: 33 años. Recuento de Strepto- coccus mutans (SM) con periodo gestacional 1° y 2° trimestre, el conteo de bacterias: 2.3x105 +/- 3.2x 105 UFC/ml de saliva y 3° Trimestre el conteo de 1.2x 106 +/-2.02 x 106 UFC/ml de saliva. La presencia de SM puede aumentar considerable- mente el riesgo de caries, si los mecanismos de defen- sa del huésped no anulan la bacteria (AU)

Caries is a multifactorial disease that affects the hard tissues of the tooth. By evaluating the risk of caries, it is possible to determine the probability of its incidence during a certain period of time. The objective was to determine the oral health status of pregnant women and its relationship with caries risk factors. A clinical observational descriptive study was carried out. The population was made up of pregnant women who attended the Ángela Llano Hospital in the city of Corrientes for care. A clinical history was prepared, and the oral health status and caries risk were determined according to the CAMBRA protocol. Univariate statistics were used to characterize and describe the data. The results achieved were Caries Index from 4.5 to 6.5, in the Plaque index the mean ± SD 56.8% ± 39.9% Min: 28.5%/ Max: 90.9%. Regarding the pH value of 7.11 ±0.43, Min.: 7.00, Max.: 8.67. Salivary flow: mean ± SD: 0.58 ml/m ± 0.28 ml/m Min.: 0.2 ml/m Max.: 0.62 ml/m; Average age: 22 years. Min.:18 Max.: 33 years. Streptococcus mutans (SM) count with gestational period 1st and 2nd trimester, bacteria count: 2.3x105 +/- 3.2x 105 CFU/ml of saliva and 3rd Trimester count 1.2x 106 +/- 2.02 x 106 CFU/ml of saliva. The presence of SM can considerably increase the risk of caries, if the host defense mechanisms do not override the bacteria (AU)

Clinical, Radiographic, and Histological Changes in Enamel and Dentin, According to Caries Care International™ Evaluation, In Permanent Posterior Teeth: An Observational Study / Cambios Clínicos, Radiográficos e Histológicos en Esmalte y Dentina, Según Evaluación de Caries Care International™, en Dientes Posteriores Permanentes: Un Estudio Observacional

SUMMARY: CariesCare International ™ practical guide is a tool for the comprehensive assessment and treatment of caries that synthesizes clinical and radiographic diagnosis and risk factors, classifying the severity, progression, and activity of lesions. The objective of this study was to analyze the validity and prediction characteristics of the proposed dental caries classification in the CariesCare International ™ practical guide as a reference through clinical and radiographic evaluation versus histological evaluation. Ninety-seven permanent posterior teeth were evaluated, and clinical and radiographic diagnoses were determined according to parameters defined in the CariesCare International™ guide as a reference. Subsequently, histological evaluation was performed to compare each stage of dental caries progression, and statistical analysis was applied. When comparing the validity and prediction values between radiographic and clinical diagnoses in relation to histological evaluation, a low sensitivity and high specificity relationship was found. The sensitivity and specificity percentages between the clinical and radiographic methods show that the clinical method has a lower number of false negatives. Histological changes in dental tissue were evident from the earliest stages of lesions, even in those not related to the caries process, indicating that the dentist should be careful when deciding on a treatment plan and take into account all variables involved in the caries process, as proposed by the CariesCare International ™ guide.

La guía práctica CariesCare International™ es una herramienta para la evaluación y tratamiento integral de la caries que sintetiza el diagnóstico clínico y radiográfico y los factores de riesgo, clasificando la gravedad, progresión y actividad de las lesiones. El objetivo de este estudio fue analizar la validez y características de predicción de la clasificación de caries dental propuesta en la guía práctica CariesCare International™ como referencia a través de la evaluación clínica y radiográfica versus la evaluación histológica. Se evaluaron noventa y siete dientes posteriores permanentes y se determinaron diagnósticos clínicos y radiográficos según parámetros definidos en la guía CariesCare International™ como referencia. Posteriormente se realizó una evaluación histológica para comparar cada etapa de progresión de la caries dental y se aplicó análisis estadístico. Al comparar los valores de validez y predicción entre los diagnósticos radiológicos y clínicos en relación con la evaluación histológica, se encontró una relación de baja sensibilidad y alta especificidad. Los porcentajes de sensibilidad y especificidad entre el método clínico y radiográfico muestran que el método clínico tiene un menor número de falsos negativos. Los cambios histológicos en el tejido dental fueron evidentes desde las primeras etapas de las lesiones, incluso en aquellas no relacionadas con el proceso de caries, lo que indica que el odontólogo debe tener cuidado al decidir un plan de tratamiento y tener en cuenta todas las variables involucradas en el proceso de caries, tal como propone la guía CariesCare International™.

Analysis of primary caregivers' knowledge concerning the cariogenic risk associated with the use of pediatric liquid medications / Análisis del conocimiento de los cuidadores principales sobre el riesgo cariogénico implicado en la ingesta de medicamentos líquidos pediátricos

Introduction: Pediatric liquid medications (PLM) are frequently administered to children, yet their usage may contribute to the onset of dental caries. Despite its prevalence, there is a notable scarcity of scientific research regarding caregivers' knowledge of this potential cariogenic risk. Objective: This study aims to assess the knowledge of the main caregivers of children aged 5 to 12 years concerning the cariogenic potential associated with the use of PLM. Materials and Methods: A cross-sectional analytical obser-vational study involving 152 primary caregivers of children aged 5 to 12 was conducted. Data were collected on caregivers' perceptions of the cariogenic risk associated with PLMs and their consumption habits. The study also assessed oral hygiene routines and evaluated the level of information provided by healthcare professionals. Results: Research findings indicated a significant lack of awa-reness among primary caregivers regarding the cariogenic risks of PLMs, with 78.95% being unaware of these risks and 47.37% unaware of the sugars present in such medications. Additionally, a high rate of PLM consumption was observed, with 63% of caregivers using them in the last year. The study underscored a notable absence of guidance from healthcare professionals, as 91.45% of the caregivers stated that they had not received instructions on tooth brushing after the administration of the PLM. Conclusions: The study highlights a significant lack of awa-reness among primary caregivers regarding the cariogenic risks associated with the ingestion of pediatric liquid medications. This deficit in information and preventive measures presents a substantial obstacle to children's oral health. To address this issue, it is crucial for healthcare professionals to offer comprehensive guidance and promote preventive measures.

Introducción: La administración de medicamentos líquidos pediátricos (MLP) es una práctica común en la población infantil y puede estar vinculada al desarrollo de lesiones de caries dental. Sin embargo, la evidencia científica que aborda el conocimiento de los cuidadores acerca de este riesgo cariogénico es escasa. Objetivo: Este estudio busca determinar el conocimiento de los cuidadores principales de niños de 5 a 12 años sobre el potencial cariogénico asociado al consumo de MLP. Materiales y Métodos: Se llevó a cabo un estudio observacional analítico transversal que incluyó a 152 cuidadores principales de niños en el rango de edad de 5 a 12 años. Se recopiló información sobre la percepción de los cuidadores acerca del riesgo cariogénico de los MLP, así como sobre sus patrones de consumo. Además, se registraron las prácticas de higiene oral y se evaluó el nivel de información proporcionado por los profesionales de la salud. Resultado: Los hallazgos de la investigación revelaron que un 78,95% de los cuidadores principales desconocen el riesgo cariogénico asociado al consumo de medicamentos líquidos pediátricos (MLP), y un 47,37% de ellos no eran conscientes de la presencia de azúcares en dichos medicamentos. Además, se observó un elevado índice de consumo de MLP, con un 63% de los cuidadores que los utilizaron en el último año. Se destacó la falta de orientaciones por parte de los profesionales de la salud, ya que, un 91,45% de los tutores afirmaron no haber recibido instrucciones sobre el cepillado dental posterior a la administración de los MLP. Conclusión: Este estudio evidencia un relevante porcentaje de desconocimiento entre los cuidadores principales acerca del riesgo cariogénico asociado a la ingesta de medicamentos líquidos pediátricos. La falta de información y medidas preventivas constituye un desafío significativo para la salud oral de los niños. Es imperativo que los profesionales de la salud proporcionen información detallada y fomenten prácticas de prevención.

Association between early childhood caries and nutritional status in children in a peruvian social program: a cross-sectional study / Asociación entre caries de la primera infancia y estado nutricional en niños de un programa social peruano: un estudio transversal

Introduction: Early childhood caries is still very prevalent, mainly in developing countries, and it is related to the quality of life of children due to early tooth loss. Objective: The study objective was to determine the association between dental caries and its clinical consequences on nutritional status in children of the "Vaso de Leche (Glass of Milk)'' social program, in Puno City, Peru, during the year 2020. Materials and Methods: An observational, descriptive-correlational, cross-sectional study; the sample consisted of 740 children between 1 and 5 years old who met the selection criteria; the clinical consequences of untreated dental caries were evaluated using the PUFA index and the prevalence of caries with def-t; the nutritional status was determined by the weight and height of the child according to protocols (NTS No. 357 - MINSA /2017/ DGIESP); the data were analyzed with the SPSS-v25 program, the association between variables was evaluated with the chi-square test, Mann-Whitney U test and Spearman's Rho test, considering significance at a p-value <0.05. Results: No significant relationship was found when dental caries was evaluated with the nutritional condition (p<0.05). However, when the def-t index values were related to the nutritional condition of the children, a significant difference was found (p<0.05). There was no significant difference with the PUFA index (p>0.05). Conclusions: There is no association between early childhood caries and nutritional status in children aged between 3 and 5 years; however, a significant relationship was found between the values of the def-t index and the nutritional status of the children.

Introducción: La caries infantil temprana sigue siendo muy prevalente, principalmente en los países en desarrollo, y está relacionada con la calidad de vida de los niños debido a la pérdida temprana de dientes Objetivo: El objetivo del estudio fue determinar la asociación entre la caries dental y sus consecuencias clínicas sobre el estado nutricional en niños del programa social "Vaso de Leche", en la ciudad de Puno, Perú, durante el año 2020. Materiales y Métodos: Estudio observacional, estudio descriptivo-correlacional, transversal; la muestra estuvo conformada por 740 niños entre 1 y 5 años que cumplieron con los criterios de selección, se evaluaron las consecuencias clínicas de la caries dental no tratada mediante el índice PUFA y la prevalencia de caries con d-t; el estado nutricional se determinó mediante el peso y talla del niño según protocolos (NTS N°357 MINSA/2017/DGIESP; los datos se analizaron con el programa SPSS-v25, la asociación entre variables se evaluó con el chi); -cuadrado, U de Mann-Whitney y Rho de Spearman, considerando significancia a un valor de p<0,05. Resultado: No se encontró relación significativa cuando se evaluó la caries dental con la condición nutricional (p<0,05). Sin embargo, cuando los valores del índice d-t se relacionaron con la condición nutricional de los niños, se encontró una diferencia significativa (p<0,05). No hubo diferencia significativa con el índice PUFA (p>0,05). Conclusión: No existe asociación entre caries de la primera infancia y el estado nutricional en niños de 3 a 5 años; sin embargo, se encontró una relación significativa entre los valores del índice d-t y el estado nutricional de los niños.

Dental care in patients with periodontal disease and hearing impairment: a scoping review / Atención odontológica en pacientes con enfermedad periodontal y deficiencia auditiva: scoping review

Introduction: Literature shows that individuals with disabilities, including hearing impairment, often suffer from untreated dental caries, poor oral hygiene, and compromised periodontal health, leading to adverse effects on oral health. Objetive: This study aims to analyze current evidence concerning dental care strategies for controlling, managing, and preventing biofilm accumulation in patients with hearing impairment. Materials and Methods: A systematic search was conducted in the databases Scopus, Web of Science, SciELO and PubMed between April and May 2022 to identify articles establishing a relationship between periodontal disease and hearing disability. Full-text articles published in English or Spanish between 2012 and 2022 were included. Results: Seventeen articles met the inclusion criteria and were analyzed. These included cross-sectional studies, cohort studies, clinical trials, case reports, and case-control studies. Most studies reported fair to poor oral health status among individuals. Nine different interventions or management approaches for treating periodontal disease in patients with hearing impairment were identified. Conclusions: The current global evidence on the association between periodontal disease and hearing impairment is very limited. Dentists may need to employ various strategies to address communication barriers, as outlined in this study.

Introducción: Según la literatura, las personas en situación de discapacidad presentan caries dentales no tratadas, higiene bucal y estado periodontal deficiente, lo cual puede resultar en efectos negativos para su salud bucal. Objetivo: Analizar la evidencia existente con relación a la atención odontológica enfocada en el control, manejo y prevención de acumulación de biofilm en pacientes con deficiencia auditiva. Materiales y Métodos: Se realizó la búsqueda de artículos en las bases de datos y motor de búsqueda (Scopus, Web of Science, SciELO y PubMed) entre abril y mayo 2022, de acuerdo con la evidencia existente que relacione la enfermedad periodontal y la discapacidad auditiva en la atención odontológica. Se incluyeron artículos de texto completo en idioma inglés o español, con fecha de publicación entre 2012 a 2022. Resultado: Se seleccionó un total de 17 artículos para su análisis. Se encontró estudios transversales, estudios de cohorte, ensayos clínicos, reporte de caso y estudios de casos y controles. La salud oral fue catalogada en estado regular y deficiente en la mayoría de los estudios. Se encontró 9 tipos de intervenciones o manejos para el tratamiento de la enfermedad periodontal en pacientes con hipoacusia. Conclusión: La evidencia existente respecto a la enfermedad periodontal y la deficiencia auditiva es insuficiente a nivel global. Debido a lo anterior, el odontólogo puede abordar los obstáculos comunicativos de diferentes maneras de acuerdo a los métodos descritos en esta publicación.

Modificação de uma resina composta Bulk Fill Flow com extrato acetônico da casca da romã / Modification of a Bulk Fill Flow composite resin with acetonic extract from pomegranate peel

Introdução: A cárie dentária ainda se constitui um problema de saúde pública. Áreas adjacentes a restaurações são frequentemente acometidas por cárie. Por mais que as resinas compostas estejam sendo estudadas e melhoradas, ainda não apresentam atividade antimicrobiana. As cascas da romã (Punica Granatum) são um recurso potencial para compostos bioativos como fenólicos, proantocianidinas e flavonoides, além de apresentarem atividade antioxidante e efeito inibitório contra bactérias Gram-negativas e Gram-positivas. Objetivo: modificar a resina composta Opus Bulk Fill Flow (FGM®) com o extrato acetônico da casca da romã em diferentes concentrações e avaliar a rugosidade da superfície e mudança de cor. Metodologia: foi realizada a extração de 5g de casca da romã utilizando 100mL de solvente acetona 70%. Após rotaevaporação, filtragem e liofilização do extrato, este foi macerado, peneirado e pesado em concentrações diferentes a partir da concentração inibitória mínima capaz de inibir o crescimento de Streptococcus mutans ATCC 700610. A resina composta Opus Bulk Fill Flow foi modificada com esse extrato em diferentes concentrações de forma a gerar 5 grupos: Controle 0 µg (n=10), G930 µg (n=10), G1860 µg (n=10), G3730 µg (n=10) e G7460 µg (n=10). Rugosidade (Ra), diferença de cor (ΔE00) e índice de brancura (WID) foram submetidos aos testes de normalidade. Os dados não-paramétricos de Ra foram submetidos ao teste de Kruskal-Wallis com pós-teste de Dunn e os dados paramétricos do ΔE00 e WID foram submetidos ao teste ANOVA 1 Fator com pósteste de Tukey por meio do software GraphPad Prism 8 e Microsoft Excel 2019. Resultados: Verificou-se que a média do índice de brancura (WID) diminuiu conforme o aumento da concentração do extrato na resina modificada (p<0,05), assim como, as resinas modificadas se tornaram, visivelmente a olho nu, um pouco mais amareladas. Após 1 mês, as amostras dos grupos experimentais sofreram a mesma variação de cor (ΔE00) que o grupo controle, uma vez que os valores das médias foram semelhantes. Portanto, todos os grupos apresentaram estabilidade de cor. A rugosidade superficial (Ra) não mostrou diferença estatisticamente significativa (p>0,05). Todos os grupos apresentaram médias com valores similares a 0,06µm. Conclusão: A alteração de cor na resina, com a inserção do extrato, ainda na maior concentração, se manteve na classificação do matiz A. O que não afeta as propriedades organolépticas e pode ser considerada uma cor similar à cor dos dentes naturais. A adição do extrato na resina manteve a rugosidade superficial de todos os grupos dentro do valor ideal, prevenindo a adesão de biofilmes e microrganismos e proporcionando conforto ao toque da língua (AU).

Introduction: Dental caries still constitutes a public health problem. Areas adjacent to restorations are often affected by caries. Even though resin composites are being studied and improved, they still do not have antimicrobial activity. Pomegranate peels (Punica Granatum) are a potential resource for bioactive compounds such as phenolics, proanthocyanidins and flavonoids, in addition to presenting antioxidant activity and inhibitory effects against Gram-negative and Gram-positive bacteria. Objective: to modify the Opus Bulk Fill Flow (FGM™) resin composite with the acetone extract of pomegranate peel in different concentrations and evaluate the surface roughness, and color change. Methodology: 5g of pomegranate peel was extracted using 100mL of 70% acetone solvent. After rotary evaporation, filtering and lyophilization of the extract, it was macerated, sieved and weighed at different concentrations based on the minimum inhibitory concentration capable of inhibiting the growth of Streptococcus mutans ATCC 700610. The Opus Bulk Fill Flow resin composite was modified with this extract in different concentrations to generate 5 groups: Control 0 µg (n=10), G930 µg (n=10), G1860 µg (n=10), G3730 µg (n=10) e G7460 µg (n=10). Roughness (Ra) and color difference (ΔE00) were subjected to normality tests and non-parametric data were subjected to the Kruskal-Wallis test with Dunn's post-test using GraphPad Prism 8 and Microsoft Excel 2019 software. Results: It was found that the average whiteness index (WID) decreased as the concentration of the extract in the modified resin increased (p<0.05), as well as the modified resins became, visibly to the naked eye, a little more yellowish. After 1 month, samples from the experimental groups suffered the same color variation (ΔE00) as the control group, since the average values were similar. Therefore, all groups showed color stability. Surface roughness (Ra) did not show a statistically significant difference (p>0.05). All groups presented average values similar to 0.06µm. Conclusion: The color change in the resin, with the insertion of the extract, even at the highest concentration, remained in the classification of hue A. This does not affect the organoleptic properties and can be considered a color similar to the color of natural teeth. The addition of the extract to the resin composite maintained the surface roughness of all groups within the ideal value, preventing the adhesion of biofilms and microorganisms and providing comfort to the touch of the tongue (AU).

Metodologias ativas no ensino de diagnóstico radiográfico da cárie proximal / Active methodologies in teaching radiographic diagnosis of proximal caries

O objetivo deste estudo foi avaliar o desempenho do estudante de Odontologia no diagnóstico radiográfico de cáries proximais. Sessenta e oito estudantes de Odontologia passaram pelas etapas de treinamento teórico e prático para o diagnóstico radiográfico de cárie. O material foi constituído de exames radiográficos convencionais e digitalizados de 40 dentes humanos, sendo 20 pré-molares e 20 molares com alterações clínicas não tratadas em uma das superfícies proximais. Para avaliar a semelhança entre as referências de escores de diagnóstico radiográfico da cárie e a avaliação histológica foi aplicado o Coeficiente de Correlação Intraclasse, que mediu a assertividade entre os escores dos estudantes e o verdadeiro diagnóstico, a qual foi classificada em níveis de reprodutibilidade. Na avaliação da reprodutibilidade utilizando o coeficiente de correlação intraclasse, os valores obtidos para as imagens digitalizadas dos dentes pré-molares foram considerados satisfatórios, onde os estudantes do sétimo semestre mais se aproximaram do diagnóstico correto. Conclui-se que os estudantes do sétimo semestre tiveram melhor desempenho no diagnóstico radiográfico de cáries proximais.

The objective of this study was to evaluate the performance of the dental student in the diagnosis of proximal caries. Sixty-eight students of Dentistry underwent the stages of theoretical and practical training for the radiographic diagnosis of caries. The sample consisted of conventional and digitized radiographic examinations of 40 human teeth, 20 premolars and 20 molars with untreated clinical alterations on one of the proximal surfaces. To evaluate the similarity between the references of the radiographic diagnosis scores of the caries and the histological evaluation, the Intraclass Correlation Coefficient was used, which measured the assertiveness between the students' scores and the true diagnosis, which was classified in levels of reproducibility. In the evaluation of reproducibility using the intraclass correlation coefficient, the values obtained for the digitized images of the premolar teeth were considered satisfactory, where the students of the seventh semester more approached the correct diagnosis. It was concluded that the seventh semester students had better performance in the radiographic diagnosis of proximal caries.

Infiltração resinosa em lesões brancas cariosas e não cariosas: relato de casos / Infiltración resinosa em lesiones blancas cariosas y no cariosas: Reporte de Casos / Resinous infiltration in carious and non-carious white lesions: Case Reports

Introdução: O processo de desmineralização proveniente da cárie leva à formação de manchas brancas que são a primeira manifestação visível da doença. Os infiltrantes resinosos surgem como uma alternativa para o tratamento dessas lesões não cavitadas, pois sãoresinas de baixa viscosidade e faz parte dos procedimentos que visam uma odontologia menos invasiva. Objetivo: Este estudo objetiva relatar a experiência clínica no uso de infiltrante resinoso, Icon, em lesões de mancha branca de etiologias cariosa e não cariosa em dois pacientes distintos, insatisfeitos com a estética do seu sorriso. Descrição do caso: Ao exame clínico foi observado nos pacientes com lesões brancas. No primeiro paciente, de 14 anos, verificou-se a presença da atividade de cárie e micro cavitações. Dessa forma, o plano de tratamento perpassou orientação de higiene oral supervisionada, aplicação de verniz fluoretado, Enamelast, semanal, adequação do meio com restaurações em resina, e só então o uso do infiltrante. A segunda paciente, de 11 anos, já possuía saúde bucal adequada e tinha queixa estética devido à lesão branca não cariosa, hipoplasia, cujo plano de tratamento foi à utilização do Icon apenas. Conclusões: Nos dois casos obteve-se melhoria estética considerável com este procedimento microinvasivo. Melhoria na saúde bucal, aliado à devolução da estética, pode ser observada com o uso de infiltrantes resinosos (AU).

Introduction: The process of demineralization resulting from caries leads to the formation of white spots that are the first visible manifestation of the disease. Resin infiltrants appear as an alternative for the treatment of these non-cavitated lesions, since they are low viscosity resins and are part of the procedures that aim at a less invasive dentistry.Objective:This study aims to report the clinical experience in the use of a resin infiltrant, Icon,in white spot lesions of carious and non-carious etiologies in two different patients who were dissatisfied with the esthetics of their smiles.Methodology: On clinical examination, white lesions were observed in both patients. In the first patient,14 years old,the presence of caries activity and micro cavitations was verified. Thus, the treatment plan included supervised oral hygiene guidance, weekly application of fluoride varnish,Enamelast, adaptation of the environment with resin restorations, and, onlythen, the use of the infiltrant, Icon. The second patient, 11 years old,already had adequate oral health and had an esthetic complaint due to a non-carious white lesion, hypoplasia, whose treatment plan consisted of the use of Icon only.Conclusions:In both cases considerable esthetic improvement was obtained with this microinvasive procedure. Improvement in oral health, combined with the return of esthetics, can be observed with the use of resin infiltrants (AU).

Introducción: El proceso de desmineralización resultante de la caries conduce a la formación de manchas blancas, que son la primera manifestación visible de la enfermedad. Losinfiltrantes de resina aparecen como una alternativa para el tratamiento de estas lesiones no cavitadas, pues se tratan de resinas de baja viscosidad y forman parte de los procedimientos que buscan una odontología menos invasiva. Objetivo:Este estudio tiene como objetivo relatar la experiencia clínica en el uso del infiltrante de resina,Iconen lesiones de mancha blanca de etiologías cariosas y no cariosas en dos pacientes diferentes, insatisfechos con la estética de sus sonrisas.Metodología: En el examen clínico se observaron lesiones blancas en ambos pacientes. En el primer paciente, 14 añosse verificó la presencia de actividad de caries y micro cavitaciones. De ese modo, el plan de tratamiento incluyó la orientación supervisada de la higiene bucal,la aplicación semanal de barniz de flúor (Enamelast), la adaptación del entorno con restauraciones de resina y, sólo después, el uso del infiltrante,Icon. La segunda paciente, 11 años,ya tenía una salud bucal adecuada y presentaba una queja estética debido a una lesión blanca no cariosa, hipoplasia, cuyo plan de tratamiento fue el uso exclusivo de Icon. Conclusiones: En ambos casos, se consiguió una mejora estética considerable con este procedimiento microinvasivo. La mejora de la salud bucal, unida a la recuperación de la estética, puede observarse con el uso de infiltrantes de resina (AU).

Effect of lacteal products containing probiotic in the progression of tooth decay around orthodontic brackets

Objective: To evaluate the progression of caries around orthodontic brackets after the enamel has been exposed to lacteal products containing probiotics. Methods: Orthodontic brackets were bonded to the enamel surfaces. The test specimens were randomly divided into six groups: G1-negative control; G2-positive control, exposed to culture environment only (without microorganisms); G3-exposed to the cariogenic environment and the fermented cow's milk without probiotic; G4-exposed to the cariogenic environment and fermented cow's milk with probiotic; G5-exposed to the cariogenic environment and yogurt without probiotic; and G6-exposed to the cariogenic environment and yogurt with probiotic. The groups were placed in brain heart infusion medium, supplemented with 2% sucrose and with 1x106 cells/ml of Streptococcus mutans and Streptococcus salivarius (ATCC). The Shapiro-Wilk, Levene, Student t, Kruskal-Wallis, and Mann-Whitney tests were used. Results: all groups exposed to the ATCC strains showed lower final microhardness, compared to the negative control (p0.05). Conclusions: Lacteal products are not able to prevent the progression of caries around orthodontic brackets.

Indicaciones y contraindicaciones de los selladores de fosas y fisuras en pacientes adultos / Indications and contraindications of pit and fissure sealants in adult patients

El objetivo de la odontología preventiva es reducir al máximo el riesgo de desarrollar enfermedades bucodentales; para lograrlo, existen múltiples métodos como la aplicación de flúor, así como la colocación de selladores de fosas y fisuras. Los selladores son materiales resinosos capaces de cubrir y eliminar las retenciones de las fosas y fisuras características de la anatomía oclusal. Si bien los selladores son ampliamente utilizados en pacientes pediátricos, erróneamente se cree que su colocación está contraindicada en adultos. Los selladores son métodos preventivos capaces de beneficiar a cualquier paciente que los necesite, independientemente de su edad. El objetivo de este artículo es analizar y esclarecer las indicaciones y contraindicaciones de los selladores de fosas y fisuras en pacientes adultos (AU)

The objective of preventive dentistry is to minimize the risk of developing oral diseases and to achieve this there are multiple methods such as the application of fluoride, as well as the placement of pit and fissure sealants. Sealants are resinous materials capable of covering and eliminating retentions in pits and fissures characteristic of occlusal anatomy. Although sealants are widely used in pediatric patients, it is erroneously believed that their placement is contraindicated in adult patients. Sealants are preventive methods capable to benefiting any patient who needs them regardless of age. The aim of this article is to analyze and clarify the indications and contraindications of pit and fissure sealants in adult patients (AU)

Microbiota of dental caries in primary teeth of a Costa Rican Child population / Microbiota de la caries dental en piezas primarias de una población infantil costarricense

Abstract The objective of this research was to identify bacteria present in the microbiota of dentinal carious lesions in primary molars of some Costa Rican pediatric patients. Data were collected from 15 children aged between 4 and 8 years old who attended the Pediatric Dentistry Clinic at the Faculty of Dentistry from the University of Costa Rica (UCR). The inclusion criteria were: infants between 4 and 8 years old who presented cavitated carious lesions in primary teeth, who were actively attended by students at the Faculty of Dentistry from the UCR, and whose parents or legal guardians signed the informed consent to participate in this research. Samples were taken using a sterile spoon, placed in storage vials, and subjected to various conventional and molecular microbial identification techniques, such as Gram stain identification, catalase tests, oxidase, TSI, API 20E, API STAPH, and VITEK 2. Of the 60 bacterial strains subjected to Gram staining, the following was obtained: 28 Gram-positive bacteria and 32 Gram-negative bacteria. The main isolated organisms were species of Staphylococcus epidermidis, Pasteurella pneumotropica/Mannheimia haemolytica, Pantoea spp, and Streptococcus mutans.

Resumen El objetivo de esta investigación fue identificar las bacterias presentes en la microbiota de lesiones cariosas dentinales en molares primarias de pacientes pediátricos costarricenses. Las muestras fueron recolectadas de 15 niños entre los 4 y 8 años que fueron atendidos en la Clínica de Odontopediatría en la Facultad de Odontología de la Universidad de Costa Rica (UCR). Los criterios de inclusión fueron: pacientes entre los 4 y los 8 años de edad que presentaran lesiones cariosas cavitadas en dientes primarios, que se encuentraran activos para su atención por estudiantes de la Facultad de Odontología de la UCR, y que los padres o encargados legales firmaran el consentimiento informado para participar en esta investigación. Las muestras se tomaron utilizando una cuchareta estéril, colocándolas en viales de almacenamiento y fueron sometidas a diversas técnicas de identificación microbiana convencionales y moleculares tales como: identificación por Tinción de Gram, pruebas catalasa, oxidasa, TSI, API 20E, API STAPH y VITEK. De las 60 cepas bacterianas sometidas a tinción de Gram se obtuvo: 28 bacterias Gram Positivas y 32 bacterias Gram Negativas. Los principales organismos aislados fueron: especies de Staphylococcus epidermidis, Pasteurella pneumotropica/ Mannheimia haemolytica, Pantoea spp y Streptococcus mutans.

Determinación del pH salival después de la aplicación de aceite ozonizado / Determination of salivary pH after application of ozonated oil

La saliva, compuesta principalmente por 99% de agua y 1% de moléculas orgánicas e inorgánicas, mantiene un rango de pH de 6.0 a 7.5, pero puede verse alterada por ciertos factores. En este estudio se determinó la variación del pH salival, luego de la aplicación tópica manual en mucosa masticatoria y órganos dentarios con aceite de girasol ozonizado de 300 mEq/kgO2, en jóvenes estudiantes de entre 21 a 23 años, como agente de neutralización en los cambios de pH. Se realizó un estudio comparativo longitudinal en 13 sujetos después de su cepillado dental; se tomaron dos muestras en saliva estimulada con el test estandarizado Saliva-Check BUFFER (GC®EUROPE). La medición basal de pH fue 7.66 ± 0.09, cifra por encima del rango normal; después de la aplicación del aceite de girasol ozonizado (O3MX®300IP) el pH fue de 7.27 ± 0.19, estableciéndose una variación de 0.28 ± 0.48, t = 8.04, p < 0.05 (0.000). Este estudio revela una caída significativa en el pH salival después de aplicar aceite de girasol ozonizado, lo que sugiere su potencial como buffer del pH salival. Se necesitan más investigaciones para explorar las implicaciones clínicas para el manejo de la salud oral (AU)

Saliva, primarily composed of 99% water and 1% organic and inorganic molecules, typically maintains a pH range of 6.0 to 7.5 but can be influenced by various factors. This study aimed to assess the variation in salivary pH following manual topical application of 300 mEq/kgO2 ozonated sunflower oil to the masticatory mucosa and dental structures in young individuals aged 21 to 23 years, using it as a pH-neutralizing agent. A longitudinal comparative study was conducted on 13 subjects after dental brushing. Stimulated saliva samples were collected using the standardized Saliva-Check BUFFER Test (GC®EUROPE). An initial baseline pH measurement of 7.66 ± 0.09 was obtained, which was above the normal range. Following the application of ozonated sunflower oil (O3MX®300IP), the pH dropped to 7.27 ± 0.19, indicating a variation of 0.28 ± 0.48 (t = 8.04, p < 0.05 (0.000). In conclusion, this study reveals a significant decrease in salivary pH after applying ozonated sunflower oil, suggesting its potential as a salivary pH buffer. Further research is needed to explore the clinical implications for oral health management.(AU)

Fluoruro de estaño en el control de cavidades sin restauración en dientes temporales / Stannous fluoride in nonrestorative cavity control in primary teeth

Introducción: el control de cavidades sin restauración (NRCC, por sus siglas en inglés), es una opción de tratamiento conservador y no invasivo para dentina cariosa, sobre todo en dentición temporal. Una de las estrategias del NRCC es la remineralización. El fluoruro de estaño (FDE) puede considerarse, como una opción viable ya que existe evidencia de su eficacia cariostática. Objetivo: valorar al FDE como remineralizante alternativo en dentina de molares temporales, asociado al NRCC. Material y métodos: se efectuó un estudio clínico, epidemiológico, y descriptivo con preescolares voluntarios de 3 a 5 años de edad con consentimiento firmado de participación en el estudio, y que presentaron molares con ICDAS 5 y 6. La aplicación del FDE a 0.8%, la evaluación de la dureza de la dentina con los criterios de Nyvad, y el diagnóstico del estado pulpar, la efectuó un operador entrenado para esta finalidad. Se aplicó un análisis estadístico descriptivo y uno no paramétrico. Resultados: el efecto cariostático producido por el FDE a 0.8%, sobre dentina afectada de molares temporales de niños mexicanos fue estadísticamente significativo durante cinco meses. Conclusiones: la aplicación de fluoruro de estaño puede considerarse como una alternativa de tratamiento cariostático asociado al NRCC para niños de 3 a 5 años de edad (AU)

Introduction: nonrestorative cavity control (NRCC), is a conservative and non-invasive treatment option for carious dentin, especially in primary dentition. One of the NRCC strategies is remineralization. Stannous Fluoride (SDF) can be considered as a viable option since there is evidence of its cariostatic efficacy. Objective: to evaluate FDE as an alternative remineralizing agent in the dentin of primary molars, associated with NRCC. Material and methods: a clinical, epidemiological, and descriptive study was carried out with preschool volunteers aged 3 to 5 years with signed consent to participate in the study, and who presented molars with ICDAS 5 and 6. The application of FDE at 0.8%, the evaluation of dentin hardness with the Nyvad criteria, and the diagnosis of pulp status, was carried out by an operator trained for this purpose. A descriptive and non-parametric statistical analysis was applied. Results: the cariostatic effect produced by 0.8% FDE on affected dentin of primary molars of Mexican children was statistically significant for five months. Conclusions: the application of stannous fluoride can be considered as an alternative cariostatic treatment associated with NRCC for children 3 to 5 years of age (AU)

O Diamino Fluoreto de Prata é uma opção para o tratamento de lesões de cárie não francamente cavitadas em superfícies oclusais em crianças?: achados sobre sua eficácia e aceitação dos pais em um ensaio clínico randomizado / Is Silver Diamine Fluoride an option for treating non-frankly cavitated caries lesions on occlusal surfaces in toddlers?: findings on its efficacy and parents acceptance from a randomized controlled trial

O uso do diamino fluoreto de prata (DFP) em lesões não fracamente cavitadas raramente é investigado. Esta dissertação apresenta resultados de um ensaio clínico controlado randomizado (ECR) delineado para avaliar se o DFP seria uma opção eficaz ao verniz fluoretado no tratamento dessas lesões na superfície oclusal de molares decíduos (NCT02789202). Além disso, trouxemos os resultados de uma revisão sistemática com meta-análise (CRD42020186245) sobre a percepção de responsáveis em relação ao uso do DFP e os resultado do ensaio sobre a aceitação deles ao tratamento de lesões de cárie não francamente cavitadas com DFP em crianças. No Capítulo 1, 109 crianças de 1 a 4 anos com pelo menos uma lesão de cárie ativa (ICDAS 1 a 3) em molares decíduos foram randomizadas em DFP e verniz fluoretado e acompanhadas por 24 meses. Análises por intenção de tratar adotando regressão logística multinível e regressão de Cox com fragilidade compartilhada foram realizadas. 309 molares foram incluídos e 239 reavaliados. DFP preveniu mais progressão (91%) do que o verniz (81%). As lesões tratadas com DFP apresentaram, em media, 69% menos chance de progressão quando o modelo foi ajustado pela severidade (lesões iniciais vs microcavitadas). A progressão demorou mais para ocorrer no grupo do DFP. Para o Capítulo 2, foi realizada uma busca nas bases de dados MEDLINE, Scopus, Web of Science, Embase e Open Grey até maio de 2020. Foram incluídos ECR, estudos clínicos não randomizados e estudos observacionais que avaliaram a percepção de responsáveis sobre compostos de prata no tratamento de lesões de cárie. O risco de viés foi avaliado utilizando uma ferramenta específica para estudos de atitutes e práticas. Para a meta-análise, os estudos foram separados considerando se os entrevistados receberam o DFP como tratamento de seus filhos ou não e se foram obtidos quanto a satisfação geral ou quanto, especificamente, a descoloração. Análises de subgrupo e meta-regressão foram realizadas para avaliar a influência de variáveis associadas ao instrumento na percepção e explorar possíveis fontes de heterogeneidade. 19 estudos foram incluídos na revisão sistemática e 12 na metaanálise. A aceitação geral do tratamento foi de moderada a bem aceita (26.9% a 100%) e variou de acordo com a metodologia utilizada. Em geral, responsáveis responderam mais positivamente quando a criança recebeu o tratamento (90%) do que quando a aplicação foi mostrada com uma foto (59%). Por fim, avaliou-se a percepção dos responsáveis sobre a saúde e estética em crianças que tiveram lesões em esmalte tratadas com DFP (Capítulo 3). Crianças incluídas em três ECR que tiveram as lesões em esmalte tratadas com DFP ou não foram consideradas. Um questionário padrão foi utilizado. Primeiramente, avaliamos a percepção geral e, em seguida, focada nos dentes tratados. Análise multiníveis foram realizadas para comparar a percepção de responsáveis de crianças tratadas vs não tratadas com DFP. Os níveis foram definidos conforme o dente e a criança/responsável. O tratamento com DFP não afetou a percepção geral dos responsáveis sobre as condições estética e de saúde bucal relacionadas a criança (85%). No entanto, quando a avaliação foi focada no dente tratado, a percepção naquelas crianças que receberam tratamento com DFP foi pior do que naquelas que não receberam. Concluindo, o DFP é uma opção eficaz no controle de lesões de cárie não francamente cavitadas. Além disso, geralmente, parece ser aceito de maneira adequada pelos cuidadores. No entanto, um padrão diferente de aceitação é observada quando destacamos o dente tratado, mostrando que a educação/informação é uma questão importante na indicação desse tratamento em crianças.

Vitalidade pulpar em lesões de cárie profundas após restaurações pelo Tratamento Restaurador Atraumático (ART) em molares decíduos: resultado após 24 meses de um ensaio clínico randomizado / Pulp vitality in deep carious lesions after Atraumatic Restorative Treatment (ART) restorations in primary molars: 24 months results of a randomized clinical trial

O objetivo desta tese foi avaliar a vitalidade pulpar de dentes decíduos com lesão de cárie profunda tratados com duas técnicas restauradoras. A taxa de sobrevivência da restauração foi avaliada como um desfecho secundário. Este volume apresenta um compilado do protocolo de pesquisa e os resultados de ensaio clínico randomizado (Clinicaltrials.gov registration NCT02903979) de não inferioridade com dois braços paralelos relatados pelas recomendações SPIRIT e CONSORT, respectivamente. Crianças de 4 a 8 anos com pelo menos uma lesão cariosa profunda oclusal ou ocluso-proximal em molares decíduos foram selecionadas na clínica odontológica da Universidade Ibirapuera. Cento e oito molares decíduos foram alocados em dois grupos: (1) restauração com cimento de hidróxido de cálcio seguido do cimento de ionômero de vidro de alta viscosidade (CHC + HVGIC) ou (2) restauração com HVGIC. A vitalidade pulpar e a sobrevivência da restauração foram avaliadas em 6, 12 e 24 meses. A análise por intenção de tratar foi usada para a vitalidade pulpar e a análise de sobrevida foi realizada com o método de Kaplan-Meier ( = 5%). Aos 24 meses, 86 restaurações foram avaliadas e 91 foram avaliadas pelo menos uma vez durante o estudo. A perda foi de 20%, e o número de participantes no início e no final do estudo foi semelhante entre os grupos (p = 0,872). Não houve diferença significativa entre os tratamentos restauradores em relação à vitalidade pulpar (CHC + HVGIC = 70% e HVGIC = 68,5%) (OR = 1,09; IC95% = 0,48-2,48). No entanto, as restaurações HVGIC (73%) apresentaram uma taxa de sobrevivência maior do que CHC + HVGIC (50%) (p = 0,021). Na análise de regressão de Cox apenas a variável tratamento apresentou p <0,20. Nesse sentido, a análise ajustada não foi realizada. Os dentes tratados com HVGIC tiveram 65% menos chance de falha do que aqueles tratados com CHC + HVGIC. Assim, pode-se sugerir que a aplicação de CHC é dispensável em lesões profundas de molares decíduos, visto que a longevidade da restauração é menor e a vitalidade pulpar não se altera com sua utilização.

Exodontia de supranumerário paramolar e de primeiro molar com destruição coronária em região de maxila: relato de caso / Extraction of a supernumerary paramolar and first molar with coronary destruction in the maxilla area: case report

Os dentes supranumerários são descritos como uma espécie de anomalia dentária, determinada pela formação de dentes além daqueles pertencentes à dentição convencional, que geralmente promovem complicações na cavidade oral. Diversos fatores etiológicos podem estar relacionados e de acordo com sua localização, são classificados em mesiodens, distomolar e paramolar. O presente estudo tem como objetivo apresentar e descrever a exodontia de um elemento supranumerário paramolar em região de maxila, bem como a remoção cirúrgica do primeiro molar com destruição coronária em região subjacente, através de um relato de caso. Paciente E.M.J., sexo feminino, 38 anos de idade, ASA 1, procurou atendimento odontológico devido à queixa principal de dor em região do 1° molar superior esquerdo. Ao exame físico e radiográfico, foi observada grande destruição coronária do elemento 26 associado a uma fístula intraoral, além da presença de dente supranumerário paramolar na região vestibular do dente 26. O tratamento preconizado foi a remoção cirúrgica de ambos elementos e a paciente evoluiu sem intercorrências no pós-operatório. Desta maneira, pode-se concluir que a remoção cirúrgica de dente supranumerário paramolar e de unidade dentária com grande destruição coronária por lesão cariosa, mostrou-se uma alternativa segura e eficaz no presente caso.

Supernumerary teeth are described as a kind of dental anomaly, determined by the teeth´s formation other than those belonging to the conventional dentition, which generally promote complications in the oral cavity. Several etiological factors may be related and, according to their location, they are classified into mesiodens, distomolar and paramolar. This study aims to present and describe the extraction of a paramolar supernumerary element in the maxillary region, as well as the surgical removal of the first molar with coronary destruction in the underlying region, through a case report. Patient E.M.J., female, 38 years old, ASA 1, sought dental care due to the main complaint of pain in the region of the upper left 1st molar. At the clinical and radiographic examination, a great coronal destruction of element 26 associated with a intraoral fistula was observed, in addition to the presence of a supernumerary paramolar tooth on the buccal side of tooth 26. The recommended treatment was the surgical removal of both elements and the patient evolved uneventfully in the post-operative. Thus, it can be concluded that the surgical removal of a supernumerary paramolar tooth and a dental unit with great coronary destruction due to a carious lesion proved to be a safe and effective alternative in the present case.

Santé bucco-dentaire des enfants diabétiques: aspects épidémiologiques et cliniques au centre hospitalier universitaire Donka / Oral health of children with diabetes: epidemiological and clinical aspects at Donka University hospital

Le diabète sucré est l'une des pathologies chroniques les plus rependues chez l'enfant à cause de son apparition dans la tranche d'âge pédiatrique. Les lésions gingivales liées à la micro-angiopathie et la présence du tartre sont exceptionnelles chez l'enfant. La parodontopathie peut rendre plus difficile le contrôle de la glycémie. Les données actuelles de la littérature ont révélé qu'un enfant diabétique est plus susceptible de développer une pathologie bucco-dentaire qu'un enfant non diabétique. L'objectif de cette étude était d'évaluer l'état de santé bucco-dentaire des enfants diabétiques suivis dans le service d'Endocrinologie à l'hôpital National Donka. Il s'agissait d'une étude transversale de type descriptif et analytique, portant sur les affections orales et métaboliques des enfants diabétiques suivis ou hospitalisés dans le service d'Endocrinologie par un recrutement exhaustif sur une période de 6 mois. La population cible était composée de 72 enfants âgés de 6 à 18 ans au moment de l'étude. Un questionnaire a été utilisé pour obtenir des données sur le niveau socio-économique, le niveau sociodémographique, le niveau comportemental, les habitudes d'hygiène bucco-dentaire et les antécédents familiaux associés à un examen oral. Les paramètres diabétiques sont contenus dans le dossier médical. L'impact du diabète sur l'état oral des jeunes patients a été étudié par des variables qualitative et quantitative. Une corrélation entre l'ancienneté du diabète et l'indice d'hygiène orale simplifiée (p<0,05) a été observée avec p=0,03. IC95% [0,00 ; 0,06]. Mais aucun lien statistique n'a été enregistré entre la tranche d'âge et l'IHOS, d'autre part entre et aussi l'IHOS et la présence de variable clinique (p>0,05). La plupart des bouches présentaient des lésions carieuses avec un taux de 91,98% et un indice C.A.O moyen de 2,94 ± 2,82. Une gencive inflammatoire était présente chez 84,73% des patients et presque tous (95,83%) avaient une affection buccale au moins. La maladie bucco-dentaire est un marqueur social, les enfants diabétiques issus de milieux défavorisés doivent donc être ciblés plus particulièrement par les programmes de prévention

Diabetes mellitus is one of the most common chronic pathologies in children because of its appearance in the pediatric age group. Gingival lesions linked to microangiopathy and the presence of tartar are exceptional in children. Periodontal disease can make it more difficult to control blood sugar. Current data from the literature has revealed that a diabetic child is more likely to develop an oral pathology than a non-diabetic child. The objective of this study was to assess the oral health status of diabetic children followed in the endocrinology department at the national donka hospital. This was a descriptive and analytical cross-sectional study on the oral and metabolic disorders of diabetic children followed or hospitalized in the endocrinology department by exhaustive recruitment over a period of 6 months. The target population consisted of 72 children aged 6 to 18 at the time of the study. A questionnaire was used to obtain data on socioeconomic level, sociodemographic level, behavioral level, oral hygiene habits and family history associated with an oral examination. The diabetic parameters are contained in the medical file. The impact of diabetes on the oral status of young patients was studied by qualitative and quantitative variables. A correlation between the duration of diabetes and the simplified oral hygiene index (p0.05). Most of the mouths presented carious lesions with a rate of 91.98% and an average c.a.o index of 2.94 ± 2.82. Inflammatory gingiva was present in 84.73% of patients and almost all (95.83%) had at least one oral condition. Oral disease is a social marker, diabetic children from disadvantaged backgrounds must therefore be targeted more specifically by prevention programs.

Risk factors associated with occlusal caries in first permanent molars in a school program: longitudinal study

Aim: Evaluate the longitudinal status of dental caries in the occlusal surface of first permanent molars (FPM) and to identify risk factors for the progression to cavitated caries lesions in a school oral health program. Methods: Children who were enrolled in the program between September 2017 and October 2019, 5 to 10 years-old, presenting the four FPM were included. Four calibrated examiners assessed dental caries according to Nyvad criteria. Descriptive analysis included frequency, mean, and standard deviation calculations. Chi-square test was used in the bivariate analysis and, logistic regression adjusted for cluster effect was used to identify significant risk factors for cavity among the following independent variables: gender, age in the baseline, deft, upper/lower molar, initial caries score, Molar Incisor Hypomineralization (MIH), fluorosis, occlusal sealing. Odds ratio (OR) and respective confidence intervals (CI) are presented. Results: From 174 children enrolled in the program between 2017/2019, 120 were reevaluated in 2022. Eleven (2.6%) FPM in 11 children (9.2%) presented cavitated caries in the follow up examination. Significant risk factors for cavity were caries experience in the primary teeth (OR = 5.59; CI: 1.4 ­ 22.3) and the presence of MIH (OR = 5.33; CI: 1.6 ­ 18.1). Most of the active lesions in the follow up were considered active in the baseline examination. Conclusions: The progression to cavity was relatively low, significantly influenced by past caries experience and MIH

Can oral health have an impact on academic performance and school absenteeism?: a systematic review and meta-analysis

Aim: The study aimed to evaluate the association between oral health and academic performance and/or school absenteeism. Methods: Electronic searches were performed of the PubMed, Web of Science, SCOPUS and LILACS/BVS databases. We included observational studies that evaluated the association between dental caries, tooth loss, dental pain or oral health status with school absenteeism or academic performance. The studies had to contain a representative sample of the population: schoolchildren, children or adolescents. After the removal of duplicates, the electronic searches produced 3,789 articles. Of these, 25 studies were included in the systematic review and 13 in the meta-analysis. Results: Considering all the studies evaluated in the meta-analysis, seven articles satisfied 100% of the Joanna Briggs Institute Critical Appraisal checklist, and six contained between 90% and 75% positive answers. The pooled effects showed that the chances of school absenteeism were 31% higher in subjects with dental caries (OR 1.31; 95%CI 1.12-1.54). Students with fair/poor dental health had a 50% higher chance of suffering poor academic performance (OR 1.50; 95%CI 1.22-1.84) and 34% higher chance of having problems at school (OR 1.34; 95%CI 1.06-1.70). Students with a history of toothache had a 3.7 higher chance of being absent from school (OR 6.65; 95%CI 1.60-8.32) and 71% higher chance of missing class due to toothache (OR 1.71; 95%CI 1.15-2.56). Subjects with a history of toothache had a 2.5 times higher chance of suffering poor academic performance (OR 2.58; 95% CI 2.04-3.27). Conclusion: Therefore, students with oral problems were more likely to take time off school and present inferior academic performance