Photobiomodulation efficacy of major salivary glands in children with caries activity: study protocol for randomized, double-blind, placebo-controlled, parallel-group clinical trial / Efeito da fotobiomodulação das principais glândulas salivares em crianças com actividade de cárie: ensaio clínico aleatório duplo-cego

Background: Dental caries is one of the most prevalent diseases among children worldwide. Saliva plays a significant role in the demineralization/remineralization of the dental surface. Several salivary characteristics, such as flow rate, pH, and buffering capacity, provide relevant information regarding the development of carious lesions. Photobiomodulation has shown promising results in improving salivary flow rate and buffer capacity in the adult population. Purpose: of this trial was to evaluate the efficacy of photobiomodulation of the major salivary glands on salivary parameters in children with caries. Methods: This protocol details a randomized, double-blind, parallel-group, controlled trial that evaluated salivary parameters through photobiomodulation in children. Fifty 6- to 12-year-old participants will be randomly divided into two groups:1) photobiomodulation experimental group (G1) (n=25) and 2) photobiomodulation placebo group (G2) (n=25). Infrared light will be applied at 16 intra-and extraoral points and placebo, respectively. Unstimulated salivary samples will be collected before and immediately after application once a week for three consecutive weeks. Salivary samples will be analyzed for their flow rate, pH, and buffering capacity. The primary outcomes are the differences in salivary flow rates between G1 and G2. The secondary outcomes are differences in salivary pH and buffering capacity between G1 and G2. Discussion: The results of this clinical trial will offer evidence for the efficacy of photobiomodulation in salivary parameters and to support decision-making regarding non-invasive treatments to control dental caries.

Contexto: A cárie dentária é uma das doenças mais prevalentes entre as crianças em todo o mundo. A saliva desempenha um papel significativo na desmineralização/remineralização da superfície dentária. Várias características salivares, como a taxa de fluxo, o pH e a capacidade de tamponamento, fornecem informações relevantes sobre o desenvolvimento de lesões de cárie. A fotobiomodulação demonstrou resultados promissores na melhoria da taxa de fluxo salivar e da capacidade de tamponamento na população adulta. Objetivo: deste estudo foi avaliar a eficácia da fotobiomodulação das glândulas salivares principais sobre os parâmetros salivares em crianças com cárie. Métodos: Este protocolo detalha um estudo randomizado, duplo-cego, de grupos paralelos e controlado que avaliou parâmetros salivares por meio da fotobiomodulação em crianças. Cinquenta participantes de 6 a 12 anos de idade serão divididos aleatoriamente em dois grupos: 1) grupo experimental de fotobiomodulação (G1) (n=25) e 2) grupo placebo de fotobiomodulação (G2) (n=25). A luz infravermelha será aplicada em 16 pontos intra e extraorais e o placebo, respectivamente. Amostras salivares não estimuladas serão coletadas antes e imediatamente após a aplicação, uma vez por semana, durante três semanas consecutivas. As amostras salivares serão analisadas quanto à sua taxa de fluxo, pH e capacidade de tamponamento. Os resultados primários são as diferenças nas taxas de fluxo salivar entre G1 e G2. Os resultados secundários são as diferenças no pH salivar e na capacidade de tamponamento entre G1 e G2. Discussão: Os resultados desse ensaio clínico oferecerão evidências da eficácia da fotobiomodulação nos parâmetros salivares e apoiarão a tomada de decisões em relação a tratamentos não invasivos para o controle da cárie dentária.

Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents

OBJECTIVES: This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS: A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg's organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer's instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS: A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION: In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.

Atenção básica em saúde bucal: a experiência no curso de graduação / Primary dental care: the experience in the undergraduate courses

INTRODUÇÃO: A participação do cirurgião-dentista na atenção básica fomenta a importância da formação do profissional de clínica geral como generalista, bem como a necessidade do perfil de um profissional de saúde, com olhar holístico sobre o paciente. RELATO DE EXPERIÊNCIA: O presente artigo tem como objetivo relatar a experiência vivenciada na implantação da Clínica de Atenção Básica no curso de Odontologia (CAB). A análise reflexiva da experiência vivida se deu por meio do relato dos discentes participantes do projeto. CONCLUSÃO: A nova proposta de atendimento, uniu a teoria com as práticas técnicas tão importantes para o discente, permitindo que os discentes ampliassem os seus conhecimentos quando expostos à situações e processo de trabalho compatíveis com a realidade da comunidade e do serviço.

INTRODUCTION: The activities developed promote the importance of professional training general practitioners, generalist, as well as the need for access to a health professional with a comprehensive view. EXPERIENCE REPORT: This study aims to report an experience about implementation of the Primary Care at the dental clinic. The reflective analysis of this experiencewas through the story of students. CONCLUSION: This new proposal united theory with practical techniques as important to the student, allowing students broaden their knowledge when exposed to situations and work process compatible with the reality of community and service.

Disfunção Temporomandibular segundo o Nível de Ansiedade em Adolescentes / Temporomandibular Disorder According to the Level of Anxiety in Adolescents

RESUMOO objetivo do estudo foi determinar a prevalência de sinais e sintomas de disfunção temporomandibular (DTM), segundo o nível de ansiedade de adolescentes da cidade de São Roque-SP. Foi utilizado o Índice de Fonseca para determinar a presença e o grau de severidade da DTM. Para avaliar o nível de ansiedade, foi utilizado o Inventário de Ansiedade Traço-Estado. Os participantes foram 3538 adolescentes entre 10 e 19 anos. Os resultados revelaram que 73,3% dos adolescentes apresentavam DTM e 72,7%, apresentavam ansiedade. Foram observadas associações estatisticamente significativas entre a presença de DTM e a presença de ansiedade, mas apenas com o sexo feminino, e correlação positiva, embora baixa, entre o grau de DTM e o nível de ansiedade. Conclui-se que adolescentes do sexo feminino apresentam maior chance de desenvolver DTM que os do sexo masculino, e quanto maior o nível de ansiedade do adolescente, maior a chance de desenvolver DTM.

ABSTRACTThe aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorder (TMD), according to the level of anxiety in adolescents in the city of São Roque-SP. The Fonseca Index was used to determine the presence and severity of TMD. To assess the level of anxiety the State-Trait Anxiety Inventory it was used. The participants were 3,538 adolescents with ages varying between 10 and 19 years. The results revealed that 73.3% of the adolescents had TMD, and that a "slight" degree of TMD was the most prevalent category. Anxiety was present in 72.7% of the adolescents. The analysis showed the existence of a significant association among female students between the presence of TMD and anxiety. A significant positive correlation was observed between the degree of TMD and the level of anxiety. The results indicate that female adolescents have a higher chance of developing TMD than male adolescents, and that the chance of developing TMD augments with the level of anxiety.

Avaliação dos ruídos da articulação temporomandibular em crianças com bruxismo / Assessment of temporomandibular joint sounds in children with bruxism

OBJETIVO: avaliar se há relação entre bruxismo e presença de ruídos articulares em crianças. MÉTODOS: participaram do estudo 48 crianças entre 6 e 9 anos atendidas na Clínica Infantil da Faculdade de Odontologia da Universidade Nove de Julho. Foram selecionadas 21 crianças com bruxismo e 27 crianças no grupo controle. Um único examinador previamente treinado e "cego" em relação aos grupos realizou exame de palpação manual e auscultação bilateral das Articulações Temporomandibulares com a utilização de estetoscópio, extra-auricular lateral e dorsal para a análise dos ruídos articulares, diferenciando-os em crepitação e estalidos. Foi realizado o número mínimo de 3 repetições nas mensurações dos ruídos para cada criança. Foram realizadas as análises descritivas de todas as variáveis e o teste qui-quadrado foi utilizado para avaliar a associação entre as variáveis, adotando-se um nível de significância de 5%. RESULTADOS: em relação à presença de ruído 37,5% (n=18) apresentaram algum tipo de ruído articular, sendo que 72,2% (n=13) apresentaram estalido e 27,8% (n=5) apresentaram crepitação. Das 18 crianças que apresentaram algum tipo de ruído, 66,7% (n=12) também eram bruxistas. Foi observada associação estatisticamente significante entre a presença de ruído e bruxismo. Ao analisar a associação entre ruído e as variáveis gênero e idade, o grupo estudado não houve associação entre ruído e gênero, porém em relação à idade, houve uma maior porcentagem de crianças sem a presença de ruído articular aos 6 anos de idade, sendo estatisticamente significante. CONCLUSÃO: os dados do presente estudo mostraram associação entre bruxismo e ruídos articulares em crianças. .

PURPOSE: the aim of the present study was to determine whether bruxism is associated with joint sounds in children. METHODS: children aged six to nine years were recruited from the pediatric clinic of the School of Dentistry of University Nove de Julho (Brazil). Twenty-one children with bruxism and 27 children without this condition (control group) were selected. The evaluation was performed by a previously trained examiner who was blinded to the allocation of the groups and involved manual palpation as well as lateral and dorsal extra-auricular auscultation of the temporomandibular joints with the aid of a stethoscope for the determination of joint sounds, differentiating a click/pop from crepitus. At least three readings were performed on each child. Descriptive statistics were conducted and the chi-square test was used to test associations among the variables, with the level of significance set to 5% (p < 0.05). RESULTS: a total of 37.5% (n = 18) of the sample exhibited some type of joint sound. Among these children, 72.2% (n = 13) exhibited a click/pop and 27.8% (n = 5) exhibited crepitus. Among the 18 children with joint sounds, 66.7% (n = 12) also had bruxism. A statistically significant association was found between joint sounds and bruxism. No association was found between joints sounds and sex. However, a significant association was found with regard to age, as a greater percentage of children at six years of age had no joint sounds. CONCLUSION: the present findings demonstrate an association between bruxism and joint sounds in children. .

Randomized controlled clinical trial of long-term chemo-mechanical caries removal using PapacarieTM gel

Objectives: Compare the effectiveness of PapacarieTM gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings. Material and Methods: A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with PapacarieTM and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations. Results: No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment. Conclusion: PapacarieTM is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia. .

Efeito citotóxico dos cimentos de ionômero de vidro em cultura celular / Cytotoxic effect of glass ionomer cements in cell culture

Objetivo: Avaliar a toxicidade de cimentos de ionômero de vidro (CIV) quimicamente ativados em culturas de células, após aglutinação do material e reação de presa. Materiais e Métodos: Dividiu-se os materiais em 9 grupos experimentais: I: controle, li (AP) Riva Self Cure (SOl), 111 (PP) Riva Self Cure (SOl), IV (AP) Maxxion R (FGM), V (PP) Maxxion (FGM), VI (AP) Vitro Molar (DFL), VII (PP) Vitro Molar (OFL), VIII (AP) KetacMolar Easymix, IX (PP) Ketac Molar Easymix (3M!ESPE). Manipularam-se os CIV conforme instruções do fabricante sendo depositados em laminulas em contato com a cultura de células logo após a aglutinação do material e após a reação de presa. A ação dos materiais sobre os fibroblastos cultivados foi analisada sobre o crescimento celular no curto, longo prazo e no ensaio de viabilidade e proliferação celular. Resultados: Grupos que receberam materiais após a presa apresentaram número de células viáveis e porcentagens menores que o grupo controle, porém permitiram crescimento celular durante todo experimento. Quando colocados em contato com as células logo após a aglutinação, induziram morte celular imediata. O material que demonstrou menor atividade citotóxica em fibroblastos foi o Ketac- Molar Easymix (3M!ESPE). Conclusão: Todos os CIV testados apresentaram-se tóxicos antes da reação de presa, entretanto após a reação de presa, permitiram crescimento celular

Aim: The aim of the present study was to assess the toxicity of different chemically activated GICs in fibroblast cell cultures post-agglutination (PA) and post-setting reaction (PS). Material and Methods: The materiais were divided into nine experimental groups: Group I - control; Group li (PA) - Riva Self Cure (SOl); Group 111 (PS) - Riva Self Cure (SOl); Group IV (PA) - Maxxion R (FGM); Group V (PS) - Maxxion (FGM); Group VI (PA) - Vitro Molar (OFL); Group VII (PS) - Vitro Molar (OFL); VIII (PA) - Ketac Molar Easymix; and Group IX (PS) - Ketac Molar Easymix (3M! ESPE). The cements were mixed following the manufacturers' instructions, deposited on glass slip covers and placed into contact with the cell cultures immediately following the agglutination of the material or after the setting reaction. The effect of the materiais on the cultivated fibroblasts was analyzed in terms of short-term and long-term cell growth as well as in viability and cell proliferation assays. Results: When placed in contact with the cells immediately follo- wing agglutination, the materiais caused immediate cell death. The groups having received the materiais following the setting reaction had a lower number and percentage of viable cells in comparison to the control, but the materiais allowed cell growth throughout the experiment. KetacMolar Easymix (3M!ESPE) was the glass ionomer cement with the least amount of cytoto- xic activity on fibroblasts. Conclusion: Ali glass ionomer cements tested were toxic prior to the setting reaction.However after setting reaction, allowed cell growth

Avaliação da relação entre disfunção temporomandibular e dimensão vertical de oclusão em crianças de 7 A 12 anos / Evaluation of the association between temporomandibular disorder and vertical dimension of occlusion in children and adolescents aged seven to 12 years

Objetivo verificar se existe relação entre a presença de disfunção temporomandibular (DTM) relacionada à variabilidade da dimensão vertical de oclusão em crianças e adolescentes na faixa etária de 7 a 12 anos. Métodos foram avaliadas 96 crianças e adolescentes do Instituto Rogacionista em São Paulo. A pesquisa diagnóstica da disfunção temporomandibular foi por meio do Índice de Helkimo e exame clínico posterior. Para a mensuração dos dados referentes à dimensão vertical foram empregadas as distâncias comissura labial - canto externo do olho e base do nariz – mento. A comparação dos valores médios das medidas antropométricas entre os gêneros e os grupos com e sem disfunção temporomandibular foi realizada empregando-se a análise de variância (ANOVA) complementada pelo teste least significance diference. Resultados a dimensão vertical de oclusão demonstrou medidas distintas nas crianças e adolescentes em todas as faixas etárias avaliadas, foram observadas alterações significantes dessa medida nas idades de 10 e 12 anos de ambos os gêneros. Conclusão pode -se concluir que na amostra estudada houve relação direta entre a presença  de DTM e  Dimensão vertical de oclusão (DVO), correlação positiva entre as medidas  comissura labial – canto do olho externo e Násio – Mento no sexo feminino e alterações significantes na dimensão vertical de oclusão nas idades de 10 e 12 anos para ambos os sexos. .

Purpose to establish the relationship between the presence of temporomandibular disorders and variability of vertical dimension of occlusion aged between 7 and 12 years. Methods it was analyzed 96 children and adolescents of Rogacionista Institute in Sao Paulo, Brazil. The diagnostic investigation of temporomandibular disorders was through Helkimo index and subsequent clinical examination. To measure the data on the vertical dimension were employed distances labial - corner of his eye and nose base - ment. To compare the mean values of anthropometric measurements between genders and the groups with and without TMD, we used analysis of variance (ANOVA) complemented by least significance diference test. Results the vertical dimension of occlusion showed distinct measures in children and adolescents in all age groups studied, significant changes were observed for this measure at ages 10 and 12 years of both genders. Conclusion we can conclude that in this sample there was a direct relationship between TMD and DVO, positive correlation between the measures lip commissure – corner of eye and nasium - mentum in females and significant changes in the vertical dimension of occlusion at the ages of 10 and 12 years for both sexes. .

Association between respiratory problems and dental caries in children with bruxism.

Context: Bruxism is the habit of clenching or grinding one's teeth in non-functional activities and affects both children and adults alike. Respiratory problems, such as asthma and upper airway infections, are reported to be the etiological factors of bruxism. Aims: The aim of the present study was to determine whether there is an association between respiratory problems and dental caries in children who exhibit the habit of bruxism. Setting and Design: An observational cross-sectional study was carried out. Materials and Methods: Patient histories were taken and clinical exams were performed on 90 children for selection and allocation to one of two groups. For the determination of bruxism, a questionnaire was administered to parents/guardians and an oral clinical exam was performed based on the criteria of the American Academy of Sleep Medicine. Thirty-three male and female children between 4 and 7 years of age participated in the study - 14 children with bruxism and 19 children without bruxism. Statistical Analysis: The data were statistically analyzed using the chi-square test, with level of significance set at 5% (P < 0.05). Results: Mean age of the participants was 5.73 years. The male gender accounted for 45.5% (n = 15) of the sample and the female gender accounted for 54.5% (n = 18). A statistically significant association was found between respiratory problems and dental caries among the children with bruxism. Seventy-seven percent of the children with bruxism had caries and 62.5% the children with respiratory problems exhibited the habit of bruxism. Conclusions: There seems to be an association between bruxism, respiratory problems, and dental caries in children.

Efficacy of Papacarie¯ in reduction of residual bacteria in deciduous teeth: a randomized, controlled clinical trial

OBJECTIVES: The aim of the present study was to analyze the efficacy of Papacarie¯ gel compared with the traditional method (low-speed bur) in reducing the counts of total bacteria, Lactobacillus, total Streptococcus and Streptococcus mutans group. METHODS: A randomized, controlled clinical trial with a split-mouth design was performed. The sample comprised 40 deciduous teeth in 20 children (10 males and 10 females) aged four to seven years. The teeth were randomly allocated to two groups: G1, or chemomechanical caries removal with Papacarie Duo¯, and G2, or the removal of carious dentin tissue with a low-speed bur. Infected dentin was collected prior to the procedure, and the remaining dentin was collected immediately following the removal of the carious tissue. Initial and final counts of bacterial colonies were performed to determine whether there was a reduction in the number of colony-forming units (CFUs) of each microorganism studied. ClinicalTrials.gov: NCT01811420. RESULTS: Reductions were found in the numbers of total bacteria, total Streptococcus and Streptococcus mutans group following either of the caries removal methods (p<0.05). A reduction was also noted in the number of Lactobacillus CFUs; however, this difference did not achieve statistical significance (p>0.05). CONCLUSION: Papacarie¯ is an excellent option for the minimally invasive removal of carious tissue, achieving significant reductions in total bacteria, total Streptococcus and S. mutans with the same effectiveness as the traditional caries removal method. .

Assessment of chemomechanical removal of carious lesions using Papacarie Duo ™: Randomized longitudinal clinical trial.

Background: Chemomechanical removal of carious lesions consists of the dissolution of carious tissue by the application of a natural or synthetic agent, followed by atraumatic mechanical removal. Aim: The aim of the present study was to assess the effectiveness of Papacarie Duo® gel in the chemomechanical removal of carious lesions in primary teeth in comparison to the traditional method (low-speed bur). Settings and Design: A randomized clinical trial was conducted with 20 children between 5 and 8 years of age. Materials and Methods: Two teeth were treated in each child (split-mouth design), with the randomization of two methods: Group 1 – chemomechanical caries removal with Papacarie Duo™; and Group 2 – removal of carious dentin tissue using a low-speed bur. Both methods involved restoration with glass ionomer cement and follow up. The following aspects were evaluated: time required for the procedure; pain (face evaluation scale); rtention of the restorative material in the cavity; and the presence of secondary caries after 30 days. Statistical Analysis Used: Chi-squared test, Student’s t-test, and Wilcoxon test. Results: No statistically significant differences between methods were found regarding time required for the procedure (P = 0.13), the occurrence of pain (P = 0.585), or restoration status at the 30-day clinical evaluation (P = 0.713). Conclusion: The findings of the present study demonstrate that the two methods achieve similar results. The advantages of minimally invasive treatment, such as chemomechanical caries removal with Papacarie Duo™, are its ease of use, patient comfort, and the fact that it causes less damage to dental tissue.

Influence of acid etching on shear strength of different glass ionomer cements

Aim: To assess the influence of dental etching on the shear strength of different glass ionomer cements. Methods: The crown of 60 bovine incisors was prepared to obtain a flat, smooth surface, were attached to a PVC tube and randomly divided into six groups: Group 1 – Riva Self Cure without etching; Group II – Riva Self Cure with pre-etching; Group III – Maxxion R without etching; Group IV – Maxxion R with pre-etching; Group V – Ketac™Molar Easymix without etching; and Group VI – Ketac™Molar Easymix with pre-etching. Etching was performed with 10% polyacrylic acid for 30 s. A standardizing device was used for preparation of the test specimens (SBS Test Method). Following preparation, the specimens were stored in distilled water at 37º Cfor 24 h. The shear test was performed on a Kratos universal testing machine at a crosshead speed of 0.5 mm/min. The specimens were then viewed under a stereomicroscope at a magnification of x90 for analysis of fractures. Results: The results revealed that pre-etching increased the shear strength of Riva glass ionomer cement (SDI) alone, where as no statistically significant differences were found with regard to the other materials tested. Conclusions: Pre-etching with 10% polyacrylic acid for 30 s increased the shear strength of Riva glass ionomer cement.

Tratamento de cárie proximal com infiltrante de resina em paciente adolescente / Treatment of proximal caries with resin infiltration in an adolescent patient

Este artigo apresenta um relato de caso de um paciente de 12 anos de idade, atendido em clínica de odontopediatria de instituição privada de odontologia. Mancha branca foi detectada na mesial do dente 16 durante o exame oral e foi confirmada através de radiografia bitewing. Tratamento microinvasivo da cárie foi realizado utilizando o Icon® (DMG). Verificação radiológica foi feita após 12 meses de acompanhamento e nenhuma lesão foi observada no dente tratado. Esse caso demonstra que o tratamento microinvasivo é uma alternativa viável para cáries proximais.

This article presents a case report of a twelve-year-old female patient treated at a pediatric clinic of a private school of dentistry. A mesial bright spot was detected on tooth 16 during the oral examination and confirmed by a bitewing x-ray. Micro-invasive treatment of caries was carried out using Icon® (DMG). A radiological check was made at the 12-month follow up and no lesion was observed in the treated tooth. This case report demonstrates that micro-invasive treatment is a viable alternative for proximal caries.

Clinical status of permanent first molars in children aged seven to ten years in a Brazilian rural community

Aim: To evaluate the clinical status of permanent first molars and associations with dental caries, gingival bleeding, dental fluorosis and malocclusion. Methods: An observational study wascarried out in a rural community denominated Morro do Saboó in the city of São Roque, state of São Paulo, Brazil. A total of 194 children aged seven to ten years were examined for dental caries using the index proposed by the World Health Organization. Other conditions were determined using the Gingival Alterations Index, Dean’s Index and Dental Aesthetic Index. The chi-squared test was used for the statistical analysis of the data. Results: A total of 85.5% of the sample exhibited gingival bleeding and 69.9% exhibited malocclusion. A total of 53.6% had a clinical aspect of normality with regard to dental fluorosis. There was a predominance of sound teeth in the upper arch and teeth with carious lesions in the lower arch. No significant differences were found between sexes regarding gingival bleeding, dental fluorosis or malocclusion. Significant associations were found between tooth status and oral alterations (gingival bleeding, malocclusion and fluorosis) in teeth 16, 26 and 46 and between tooth status and gingival bleeding in tooth 36 (p<0.001). Conclusions: Caries activity in the permanent first molars was mainly associated with dental fluorosis and malocclusion. Strategies aimed at health promotion should be adopted on a large scale to minimize the prevalence of oral diseases.

Remoción quimico-mecánica de lesión de caries en diente permanente con Papacárie Duo(TM): reporte de un caso / Chemomechanical removal of carious lesion in a permanent tooth with Papacárie Duo(TM): report of a case

Este trabajo tiene como objetivo presentar el protocolo clínico de Papacárie Duo(TM), desde el diagnóstico de la lesión de caries hasta el procedimiento restaurador. Una paciente femenina de 12 años de edad se presentó a la consulta odontopediátrica por dolor al frío y durante la ingesta de alimentos dulces. El examen clínico y radiográfico reveló caries en la pieza 46, clasificada como score 6, según el sistema ICDAS (cavidad extensa con exposición de la dentina). La conducta clínica consistió en la eliminación del tejido infectado por medio de la remoción quimico-mecánica de la caries utilizando el gel a base de papaína y restauración con ionómero vítreo. Se concluye, a partir de este protocolo, que la eliminación quimico-mecánica de la lesión de caries es un método de fácil aplicación basdado en la odontología mínimamente invasiva.

Gender as risk factor for mouth breathing and other harmful oral habits in preschoolers

Aim: To analyze associations between the mouth-breathing pattern and other harmful oral habits among preschoolers. Methods: An observational, cross-sectional study was carried out involving 198 children from 3 to five 5 of age. A questionnaire, clinical evaluation and specific tests (mirror and water tests) were used for confirmation of the mouth-breathing pattern. Results: Mean age of the participants was 4.13 ± 0.8 years and 57.1% were male. A total of 87.4% exhibited one or more harmful oral habits. Harmful habits were more common in the male gender (61.8%); this association was statistically significant (p<0.001). Mouth breathing was the most prevalent habit (49%), followed by biting/sucking on objects (33.3%). Regarding gender, statistically significant associations were found for bottle feeding (p=0.02) and nail biting (p=0.02). Mouth breathing was associated with biting on object (p=0.00), pacifier use (p=0.02) and thumb sucking (p=0.00). Conclusions: The results of the present study suggest that mouth breathing is significantly associated with biting/sucking on objects, pacifier use and thumb sucking in preschoolers and that the occurrence of harmful oral habits is more prevalent among the male gender. Early diagnosis and intervention should be established in order to avoid future consequences involving the orofacial region.

Temporomandibular dysfunction and cervical posture and occlusion in adolescents

Aim: To evaluate the effect to the degree of temporomandibular dysfunctions (TMD) in adolescents and occlusal classes in the cervical posture. Methods: A cross-section, observational study was carried out, in which 296 adolescents took part. For the evaluation, the patients were divided into groups according to the presence and severity of the TMD, using the Helkimo questionnaire and occlusal Angle classification. The posture analysis was carried out using photogrammetry and the software Alcimage® to measure the predefined angle based on the protuberances of the Spinous Process of the 7th cervical vertebra (C7), manubrium of the sternum and mentum vertex. Results: 48% (n= 142) of the 296 adolescents evaluated presented no dysfunction, while 52% (n= 154) presented some degree of TMD. Of the different degrees of TMD, the highest average cervical angulation observed in the group with moderate dysfunction was 97.59º ±7.40, followed by a mild degree, of 96.32º± 9.36, and the lowest average was 93.01º±10.08 in the patients with a severe degree in the different occlusal classes. In relation to occlusal class, higher values for this angulation were observed in class II (96.77º± 8.79), compared with class I (90.64º±8.80) and class III (94.67º± 10.70), a difference which was statistically significant. Conclusions: The subjects with TMD presented a greater alteration in head posture, compared with those without TMD. In particular, the Class II Angle was correlated with TMD and alterations in cervical posture.

Análisis clínico y radiográfico de las técnicas ART y remoción químico-mecánica de caries: estudio piloto / Clinical and radiographic assess of ART technique and chemical and mechanical caries removal: pilot study

Objetivo: Comparar clínica y radiográficamente el Tratamiento Restaurador Atraumático (ART) y remoción químico-mecánica con Papacárie® en molares deciduos con caries oclusal verificando dolor, integridad clínica de las restauraciones y evolución de la lesión. Metodología: Estudio clínico randomizado en 16 molares deciduos, en pacientes de ambos sexos, con edades entre 3 y 6 años. Esos dientes fueron divididos aleatoriamente en G1 (n=8) ART convencional y G2 (n=8) Papacárie® y restaurados con ionómero de vidrio. La sintomatología se analizó mediante la Escala de Evaluación Facial. Seis meses después se evaluó clínicamente la integridad de las restauraciones (Escala de Frencken) y radiográficamente el aumento o no del área radiolúcida de la lesión. Resultados: No fue relatado dolor durante la ejecución de ambas técnicas. Luego de seis meses no hubo progresión de las lesiones y el material restaurador se mantuvo retenido adecuadamente. Conclusiones: Ambas técnicas demostraron éxito clínico y radiográfico luego de seis meses de evaluación.

Association between halitosis and mouth breathing in children

OBJECTIVE: To determine whether there is a correlation between halitosis and mouth breathing in children. STUDY DESIGN: Fifty-five children between 3 and 14 years of age were divided into two groups (nasal and mouth breathing) for the assessment of halitosis. A descriptive analysis was conducted on the degree of halitosis in each group. The chi-square test was used for comparison between groups, with a 5 percent level of significance. RESULTS: There was a significantly greater number of boys with the mouth-breathing pattern than girls. A total of 23.6 percent of the participants had no mouth odor, 12.7 percent had mild odor, 12.7 percent had moderate odor and 50.9 percent had strong odor. There was a statistically significant association between halitosis and mouth breathing. CONCLUSIONS: The occurrence of halitosis was high among the children evaluated, and there was a statistically significant association between halitosis and mouth breathing.