Immunohistochemistry of resorption and inflammation factors in the periodontal ligament of human deciduous teeth

Abstract: The understanding of the biological mechanisms involved in root resorption in deciduous teeth is important to the future development of preventive measures and treatments of this condition. The aim of the present study was to compare the expression and immunostaining of iNOS, MMP-9, OPG and RANKL in the periodontal ligament (PDL) of deciduous teeth with physiologic root resorption (GI), inflammatory pathological root resorption (GII) and permanent teeth (GIII), the negative control. Teeth in GI (n = 10), GII (n = 10) and (GIII) (n = 10) were submitted to immunohistochemical analysis to determine the expression of iNOS, MMP-9, OPG, and RANKL. The immunostaining was analysed by optical density. Statistical analysis included one-way ANOVA, followed by Student-Newman-Keuls post hoc test (p < 0.05). The results showed that iNOS, MMP-9 and RANKL expression in the PDL was higher in GII compared to GI and GIII (p < 0.05). Moreover, RANKL expression was higher in GI compared to GIII (p < 0.001), while OPG immunolabelling was lower in GII compared to GI and GIII (p < 0.001). The PDL of deciduous teeth bearing inflammatory processed exhibited upregulation of resorption-associated factors as well as enzymes related to tissue degradation which, in turn explains the exacerbation and greater susceptibility of those teeth to root resorption process.

Teaching and Learning Regarding the Dentist-Pediatric Patient Relationship: A Qualitative Study

Objective: To investigate the perceptions of dental students on the learning process regarding the dentist-pediatric patient relationship. Material and Methods: A qualitative study with an exploratory approach was conducted involving semistructured interviews with sixteen dental undergraduate students randomly selected from the thirty-two students in the last semester of the dentistry course. The transcribed interviews were submitted to content analysis. Results: The sample was composed of nine female (56.3%) and seven male (43.7%) students (median age: 23 years). The factors perceived as most influential with regard to learning the dentistpediatric patient relationship were observations of professors, other dentists or colleagues and the regular practice of dental procedures. While half of the participants considered lectures on the subject satisfactory, the other half reported a need for more instruction on how to deal with specific clinical situations. Most of the participants would like to have learned more about the dentist-pediatric patient relationship. Conclusion: The majority of students recognized that the teaching and learning process regarding the dentist-pediatric patient relationship is not easy. They reported having little counseling on the how to develop this relationship. The students suggested that the dentist-patient relationship should be addressed more during the course through the inclusion of lectures or classes on this issue as well as the demonstration of specific clinical situations.

Natal and neonatal teeth: two clinical cases report / Dentes natais e neonatais: relato de dois casos clínicos

ABSTRACT The aim of this study was to report two cases of newborns with natal and neonatal teeth. Case 1 - a female child presented a natal tooth in the region of lower central incisors since birth. Mother's child reported a family history of this feature. Since the tooth did not present either mobility, prevent breastfeeding, cause discomfort to the child or hurt mother's breast, it was chosen for its maintenance and monitoring. Case 2 - a male child presented, during the first two weeks of life, the eruption of two neonatal teeth in the region of lower central incisors. During the interview, his mother reported no familiar history of this condition. Because the teeth has tapered edges, causing the Riga-Fede's disease, impairing breastfeeding, causing discomfort to the child and injuring the mother's breast, it was decided for its extraction. It may be concluded that the presence of natal and neonatal teeth represent a rare condition that requires further studies to confirm its etiology. Therapeutic approaches must be preceded by a careful clinical evaluation since, as it was seen in this report, both cases were submitted to different treatments showing good evolution.

RESUMO O objetivo deste estudo foi relatar dois casos clínicos de recém-nascidos que apresentaram dentes natais e neonatais. Caso 1 - criança do gênero feminino, apresentou ao nascimento, um dente natal na região de incisivos centrais inferiores. Durante a anamnese, a mãe relatou histórico familiar desta alteração. Devido o elemento dentário não apresentar mobilidade, não impedir a amamentação, não causar desconforto à criança e não ferir a mama da mãe, optou-se pela sua manutenção e acompanhamento. Caso 2 - criança do gênero masculino, apresentou na primeira quinzena de vida, o irrompimento de dois dentes neonatais na região de incisivos centrais inferiores. Durante a anamnese, a mãe relatou não haver histórico familiar desta alteração. Devido a esses elementos dentários apresentarem bordas afiladas, causando a doença de Riga-Fede, comprometerem a amamentação, causarem desconforto à criança e ferirem a mama da mãe, optou-se pela sua exodontia. Conclui-se que a presença de dentes natais e neonatais é uma condição rara e mais estudos são necessários para se confirmar sua etiologia. As abordagens terapêuticas devem seguir uma criteriosa avaliação clínica, pois, como visto neste relato, os dois casos foram submetidos a diferentes tratamentos e ambos apresentaram boa evolução.

Crown discoloration promoted by materials used in regenerative endodontic procedures and effect of dental bleaching: spectrophotometric analysis

Abstract Regenerative endodontic procedure (REP) has been proposed as a new approach to treat immature permanent teeth. However, materials used in REP for root canal disinfection or cervical sealing may induce tooth discoloration. Objectives To assess tooth crown’s color after intracanal treatment with triple antibiotic paste (TAP) or calcium hydroxide (CH); cervical sealing with glass ionomer cement (GIC) or mineral trioxide aggregate (MTA); and bleaching with carbamide peroxide. Material and Methods After pulp removal and color spectrophotometer measurement, 50 bovine incisors were divided into 4 experimental groups and one control (untreated). Experiments were performed in phases (Ph). Ph1: TAP (ciprofloxacin, metronidazole, minocycline), TAPM (ciprofloxacin, metronidazole, amoxicillin), DAP (ciprofloxacin, metronidazole), or CH treatment groups. After 1 and 3 days (d); 1, 2, 3 weeks (w); and 1, 2, 3 and 4 months (m), color was measured and medications were removed. Ph2: GIC or MTA cervical sealing, each using half of the specimens from each group. Color was assessed after 1d, 3d; 1w, 2w, 3w; 1m and 2m. Ph3: Two bleaching sessions, each followed by color measurement. Data were analyzed with ANOVA and post-hoc Holm-Sidak method. Results Ph1: Specimens of TAP group presented higher color alteration (ΔE) mean than those of TAPM group. No significant difference was found among TAP or TAPM and CH, DAP or Control groups. Ph2: cervical sealing materials showed no influence on color alteration. Ph3: Different ΔE means (from different groups), prior to bleaching, became equivalent after one bleaching session. Conclusions TAP induces higher color alteration than TAPM; color alteration increases over time; cervical sealing material has no influence on color alteration; and, dental bleaching was able to recover, at least partially, the tooth crown’s color.

Avaliação radiográfica e em microscopica eletrônica de varredura de remanescentes de obturação após a re-instrumentação endodôntica / Radiographic and scanning electron microscopic assessment of root canal filling remnants after endodontic re-instrumentation

Objetivo: Falhas no tratamento endodôntico podem ocorrer por várias razões. O retratamento endodôntico é uma alternativa interessante para tratar esse problema clínico. No entanto, não é possível remover completamente o material obturador do canal radicular por qualquer das técnicas atuais de retratamento. O objetivo deste estudo foi avaliar a presença de resíduos de material obturador após a re-instrumentação endodôntica. Material e Métodos: Sessenta dentes anteriores humanos foram preparados pela técnica escalonada com Flexofiles, limas K e brocas GatesGlidden (GG). Entre o uso de cada instrumento ou broca, os canais radiculares foram irrigados com hipoclorito de sódio (NaOCl). A lama dentinária foi removida por irrigação com ácido etilenodiaminotetraacético e NaOCl. Após secagem com pontas de papel, os canais radiculares foram divididos aleatoriamente em 5 grupos (n = 12), de acordo com o material obturador: cones Resilon/cimento Real Seal ou cones de guta-percha e cimento Endofill, Sealapex, AH Plus ou MTA Fillapex. Após uma semana, o material obturador foi removido usando Eucaliptol e K-files. Os canais radiculares foram re-instrumentados com limas K e brocas GG de tamanhos maiores do que as anteriormente usadas. A presença de remanescente de material obturador no canal radicular foi analisada por radiografia e microscopia eletrônica de varredura (MEV). A análise estatística foi realizada pelo teste de Regressão Logística Binária (P < 0,05). Resultados: As análises radiográfica e por MEV mostraram que o material do grupo MTA Fillapex foi melhor removido do que o dos grupos Endofill, Sealapex, AH Plus e Real Seal. Conclusão: Após a re-instrumentação, o grupo MTA Fillapex apresentou menos remanescentes nos canais radiculares que os grupos Endofill, Sealapex, AH Plus e Real Seal. O material residual foi encontrado mais frequentemente no terço apical. (AU)

Objective: Failures in endodontic treatment may occur by several reasons. Endodontic retreatment is an interesting alternative to manage this clinical problem. However, it is not possible to completely remove the root canal filling by any current retreatment technique. The aim of this study was to evaluate the presence of residual root canal filling materials after endodontic reinstrumentation. Material and Methods: Sixty extracted anterior human teeth were prepared by step-back technique with Flexofiles, K-files and Gates-Glidden (GG) burs. Between the use of each file or bur, root canals were irrigated with sodium hypochlorite (NaOCl). Smear layer was removed by irrigation with ethylenediaminetetraacetic acid and NaOCl. After drying with paper points the root canals were randomly divided into 5 groups (n = 12), according to filling material: Resilon cones/Real Seal sealer or gutta-percha cones and Endofill, Sealapex, AH Plus or MTA Fillapex sealers. After one week, root canal fillings were removed using Eucaliptol and K-files. Root canals were reinstrumented with K-files and GG burs sized larger than the first ones. The removal of root canal filling material was analyzed by radiography and scanning electron microscopy (SEM). Statistical analysis was performed using Binary Logistic Regression test (P < 0.05). Results: Radiographic and SEM analysis showed that material from the MTA Fillapex group was better removed than that from Endofill, Sealapex, AH Plus and Real Seal groups. Conclusion: After re-instrumentation, MTA Fillapex group showed less remnants into the root canals than Endofill, Sealapex, AH Plus and Real Seal groups. Residual material was most often found in the apical third(AU)

Knowledge of stem cells among Dentistry undergraduates

Introduction:Stem cells (SCs) enabled great advances in different health fields, including Dentistry. Objective: To investigate the knowledge of last year Dentistry undergraduate students regarding SCs and its applications. Material and methods: A questionnaire with open-ended questions was applied to the students, followed by qualitative-quantitative analysis involving the clustering of the answers. Results: The majority of students (70%) defined SCs adequately, only half of the interviewees (48.8%) were unable to classify SCs and just 26.2% classified it correctly. On the question about SCs from dental tissues, 77.5% reported it was possible and 70.9% knew which tissues could be used. The main source of knowledge was the media (36.4%), followed by the University (26.6%); 88.5% stated that the topic was only addressed in the first year of the course. Consequently, only 7.5% reported being capable of answering questions about it. Conclusion:The students are not receiving enough information about the topic.

A versatilidade do uso da tuberosidade maxilar para pequenas reconstruções teciduais na Implantodontia / The versatility of the use of maxillary tuberosity for small tissue reconstructions in Implant Dentistry

As alterações alveolares após a exodontia de um elemento dental desafiam a Implantodontia na busca por técnicas e materiais que devolvam ao rebordo alveolar os tecidos perdidos com previsibilidade e menor morbidade ao paciente. Este relato de casos clínicos mostra a instalação de implantes imediato ou tardio, associados ou não ao procedimento de carga imediata utilizando o enxerto misto da tuberosidade maxilar como alternativa viável para essas reconstruções, tendo como objetivo principal a redução do número de procedimentos cirúrgicos e a previsibilidade no período pós operatório. O osso da tuberosidade maxilar é composto por uma fina camada de osso cortical externo e medular interno que apresentam alta capacidade de revascularização e integração à área receptora. A vantagem em se manter o periósteo entre o enxerto corticomedular do túber e o tecido conjuntivo é conter a reabsorção óssea periosteal na região cervical e melhorar a qualidade do tecido mole. A limitação do uso da tuberosidade maxilar está relacionada a sua dimensão, que pode permitir a reconstrução de um ou dois dentes por área doadora ou, em alguns casos, pode não haver área doadora disponível. As características únicas da tuberosidade maxilar de fornecer osso corticomedular e tecido conjuntivo subepitelial permitem a sua associação no enxerto misto de túber e mostra grande versatilidade para a reconstrução dos tecidos duros e moles, permitindo técnicas refinadas capazes de solucionar casos complexos em um único procedimento cirúrgico...

Alveolar alterations after extraction constitute a challenge and lead to the search for techniques and materials to reconstruct the lost tissues with previsibility and less morbidity to the patients. These case report shows the placement of immediate implants, delayed implants, with or without the immediate loading procedure and maxillary sinus lift with immediate implant placement using the maxillary tuberosity mixed graft as a viable alternative to these reconstructions aiming to reduce the number of surgical procedures and improve predictability in the post-operative period. The tuberosity jaw bone consists of a thin outer layer of cortical bone and inner medullary bone that have a high capacity of revascularization and integrating into the receiving area. The advantage of keeping the periosteum between tuberosity corticomedular graft and the connective tissue is to contain the periosteal bone resorption in the cervical area and improve the quality of the soft tissue. Limitation to the use of maxillary tuberosity is related to their dimensions that may allow the reconstruction of one or two teeth per donor area or, in some cases, it may not be available. The unique characteristics of the maxillary tuberosity to provide corticomedular bone and subepitelial connective tissue allow their association in the maxillary tuberosity mixed graft and show great versatility for the reconstruction of hard and soft tissue, allowing refined techniques to solve complex cases in a single surgical procedure...

Knowledge of Human Genome Project among Dentistry undergraduates

Introduction: The Human Genome Project (HGP) has allowed for advances in diagnosis and prevention of diseases. Objective: The aim of this study was to investigate the knowledge of undergraduates from the Federal University of Santa Catarina, regarding HGP and its applicability. Material and methods: Thirty-one students were interviewed by using a questionnaire with open questions, followed by qualitative and quantitative analysis through answers' grouping. Results: Only 4.5% did not know HGP, while most of them (83%) demonstrated knowledge gained from the media. Only 21% cited the undergraduate program as a source of information, 56% recognized advances in disease prevention and 81% reported applicability in Dentistry. 97% students would give blood samples for research, 28% reported concern about misuse of this information, while 31% did not report any disadvantage. Conclusion: It may be concluded that the students have some knowledge on HGP. However, it is not widely discussed during course, because the media was the main source of information.

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

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

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

Consequences of dental trauma to the primary teeth on the permanent dentition

Introduction: Dental trauma to primary teeth or to the jaws may cause disorders on the development of permanent successor teeth. The alterations may either occur at the time of accident or be caused by post-traumatic consequences. Objective: The aim of this paper is to present cases of alterations on permanent dentition following dental trauma to primary teeth. Case reports: Three cases are presented in this paper. The severity of the post-traumatic sequels shown by the permanent teeth kept a direct relationship with the extent of the impact and patient's age at the accident. These sequels resulted in whitish or brownish opacities, enamel hypoplasia, root dilacerations, and total arrest of root development. Conclusion: It can be concluded that the protocols for patients who had experienced dental trauma must observe a systematic clinical and radiographic follow-up as well as alternatives of treatment for the primary and permanent teeth involved. Prognostics and treatments related to the sequels in permanent teeth may be obtained from a close analysis of clinical and radiographic aspects, avoiding more damages to the stomatognathic system. The severity of the sequels is directly related to the degree of permanent tooth formation (child's age), type of dental trauma and extent of the impact.

Influência de fatores genéticos e ambientais no desenvolvimento da cavidade bucal: relato de caso de gêmeos bivitelinos / Influence of genetics and environmental factors on oral cavity development: a case report of twins

O objetivo deste trabalho é relatar o caso clínico de gêmeos bivitelinos que apresentaram alterações semelhantes nas estruturas do sistema estomatognático. Os pacientes, com 3 anos e 6 meses de idade, foram atendidos na Clínica de Odontopediatria da UFSC, devido a traumatismos nos dentes 51 e 61 no menino e primeira consulta odontológica da menina. A mãe relatou que as crianças nunca haviam ido ao dentista antes e que os dois tinham o hábito de sucção de chupeta. Os irmãos apresentavam mordida aberta anterior e alterações generalizadas nas estruturas dentárias, diagnosticadas como hipoplasia de esmalte. Já na primeira consulta, foram repassadas orientações quanto às consequências do hábito no desenvolvimento craniofacial, bem como quanto à importância da sua interrupção. Em quinze dias foi realizada a exodontia dos elementos 51 e 61 do menino, e nessa consulta, a mãe relatou que ambos já haviam abandonado o hábito. Dois meses após a consulta inicial, foi possível observar redução significante da mordida aberta anterior, nas duas crianças. Os pacientes foram incluídos em um esquema de proservação, com consultas periódicas para acompanhar o fechamento da mordida e a troca dentária para a dentadura permanente, a qual também pode vir a apresentar comprometimento por alterações no esmalte.Conclui-se tratar de um caso de combinação de alterações morfológicas por influência do meio (uso de chupeta) e de alterações estruturais por influência genética (hipoplasia de esmalte).

The aim of this article is to report the case of dizygotic twins who presented similar alterations in their oral cavity. Patients were 3 years and 6 months old and attended the Pediatric Dentistry Clinic at UFSC because of dental trauma on 51 and 61 in the boy and for first visit to the dentist’s for the girl. Their mother reported the children had never visited the dentist’s before and that both had the habit of sucking pacifiers. The siblings presented anterior open bite and alterations in the dental structures diagnosed as enamel hypoplasia. During the first visit, orientations were given regarding the consequences of the use of pacifiers on the craniofacial development and it was recommended its interruption. Fifteen days after, it was performed the extraction of teeth 51 and 61 from the boy. In this same visit, the mother reported that both children had abandoned the sucking habit. Two months later, it was possible to observe a significant reduction in the open bite, on both children. The patients were included in a follow-up scheme, with regular and programmed visits, in order to evaluate the closing of their open bite and follow the eruption of the permanent teeth in the future, as it is known that the enamel alterations may show the same characteristics on the succedaneum teeth. It may be concluded that the cases reported here are combinations of morphological alterations as consequence of environmental factors (use of pacifiers) and structural alterations as genetic influence (enamel hypoplasia).

Mecanismos e fatores fisiológicos e patológicos no processo de reabsorção radicular de dentes decíduos / Physiological and pathological factors and mechanisms in the process of root resorption in primary teeth

Introdução: A reabsorção dentária é fundamental no processo de rizólise (reabsorção radicular fisiológica) dos dentes decíduos, entretanto as reabsorções dentárias patológicas, especialmente a do tipo inflamatória, caracterizam-se em consequência e/ou complicação de várias situações clínicas, como traumatismos dentários e lesões periapicais inflamatórias provenientes da doença cárie, constituindo causa comum de perda de dentes. Objetivo: Procurou-se apresentar e discutir uma revisão de literatura acerca do mecanismo das reabsorções radiculares fisiológica e patológica inflamatória em dentes decíduos, enfatizando seus eventos bioquímicos e celulares. Revisão de literatura: As células responsáveis pela reabsorção dos tecidos dentais são os odontoclastos, sob a influência de inúmeros estímulos e sinalizações moleculares oriundos de citocinas, neuropeptídeos, hormônios e produtos de degradação liberados quando o tecido é lesado. Porém até hoje não se sabe exatamente o que leva à diferenciação das células precursoras dos odontoclastos, o que lhes dá o sinal para iniciar a reabsorção em local e momento específicos (principalmente nos dentes decíduos) e por que eles são prematuramente ativados em algumas condições patológicas, mas não em outras. Conclusão: O conhecimento sobre o mecanismo molecular e os fatores que regulam o processo de reabsorção radicular ainda é escasso. A pesquisa nessa área mostra-se de grande relevância, uma vez que novos conhecimentos sobre a(s) via(s) molecular(es) da reabsorção dental podem permitir o desenvolvimento de terapias diferenciadas, mais biológicas, que controlem ou impeçam a reabsorção, evitando assim a extração do dente acometido e suas consequências.

Introduction: Tooth resorption is essential in the process of root resorption in primary teeth. However, pathological root resorption, mainly the inflammatory one, is a consequence and/or complication of several clinical conditions, such as dental trauma and periapical inflammatory lesions from dental caries, thus becoming a common cause of tooth loss. Objective: To present and discuss a literature review regarding the mechanisms of physiological and inflammatory pathological root resorption in primary teeth, emphasizing their biochemical and cellular events. Literature review: The odontoclasts cells are responsible for resorption of dental tissues, and they are influenced by several stimuli and molecular signals derived from cytokines, neuropeptides, hormones and degradation products released when tissue is injured. However, so far it is not clear what leads to the differentiation of the precursor cells of odontoclasts, what gives them the signal to start the resorption in a specific place and time (especially in primary teeth) and why they are activated in some pathological conditions, but not in others. Conclusion: The knowledge regarding molecular mechanisms and factors that regulate the process of root resorption is still meager. Research in this area is of great relevance, since new knowledge about the molecular pathway(s) involved in root resorption may allow the development of different therapies, more biological ones, in order to control or prevent resorption, thus preventing tooth loss and its consequences.

Injúrias não Intencionais na Infância: Estudo Piloto com Mães que Frequentam a Clínica de Bebês da Universidade Federal de Santa Catarina, Brasil / Non-intentional injuries in childhood: pilot-study with mothers attending the baby clinic of the Federal University of Santa Catarina, Brazil

Objetivo: Identificar a ocorrencia de injurias nao intencionais entre criancas de ate 3 anos de idade, que frequentam a Clinica de Bebes da Universidade Federal de Santa Catarina, junto a suas maes. Metodo: Estudo piloto transversal descritivo, com eixo temporal contemporaneo, realizado a partir de entrevistas guiadas por um questionario, com questoes abertas e fechadas, aplicadas a 28 maes de criancas que frequentaram a Clinica de Bebes da disciplina de Odontopediatria da Universidade Federal de Santa Catarina (UFSC), durante o ulti mo trimestre do ano de 2007. Resultados: Entre as maes entrevistadas 10 (35,7%) referiram a ocorrencia de injuria(s) nao intencional(is) no seu filho, perfazendo um total de 21 casos. A residencia das criancas foi o local onde ocorreram 12 (57,1%) das 21 injurias citadas, e 15 (71,4%) delas foram causadas por quedas. Em 18 (85,7%) casos a mae ou o pai acompanhavam a crianca no momento do agravo, e 12 (57,1%) das injurias tiveram gravidade moderada, exigindo atendimento hospitalar sem internacao. Em relacao ao recebimento de informacoes sobre a prevencao de injurias nao intencionais, 10 (35,7%) maes declararam nunca terem sido orientadas a respeito. Conclusao: A incidencia de injurias nao intencionais foi alta na amostra estudada, havendo a necessidade de estudos a nivel populacional, que possam orientar acoes praticas de prevencao deste agravo. Ainda, cirurgioes-dentistas, especialmente odontopediatras, tem contato regular com criancas e suas familias, portanto e de grande valia sua participacao em acoes conjuntas entre governo, profissionais da saude e sociedade civil, visando a promocao da seguranca infantil.

Objective: To identify the occurrence of non-intentional injuries in children under the age of 3 att ending the Baby Clinic of the Federal University of Santa Catarina, SC, Brazil, with their mothers. Method: This investigation was a descriptive cross-sectional pilot-study with a contemporaneous temporal axis, which conducted from interviews guided by a questionnaire with open and multiple-choice questions applied to 28 mothers of children who attended the Baby Clinic of the Discipline of Pediatric Dentistry of the Federal University of Santa Catarina during the last trimester of 2007. Results: Among the interviewed mothers, 10 (35.7%) reported that their children had suffered non-intentional injuries, totalizing 21 cases. Home was the site of accident of 12 (57.1%) of the 21 injuries, and 15 (71.4%) of them were caused by falls. In 18 (85.7%) cases, either the mother or the father was with the child at the moment of the accident, and 12 (57.1%) injuries had moderate severity, requiring in-hospital treatment without need of admission. Ten (35.7%) mothers affirmed that they had never received information about prevention of non-intentional injuries. Conclusion: The incidence of non-intentional injuries was high in the surveyed population, showing the need of studies with a national sample that may guide practical actions to prevent this type of injury. In addition, as dentists ? especially pediatric dentists - have regular contact with children and their families, their engagement in collective actions with the government, health professionals and civil society, is very important to promote childrens safety.

Aceitação dos pais quanto ao uso do Diaminofluoreto de Prata em crianças de 0 a 3 anos de Cascavel/PR / Parental acceptance of the use of Diamine Silver Fluoride in children aged 0 to 3 years in the city of Cascavel, PR, Brazil

Objetivo: Avaliar a aceitação estética quanto ao uso do cariostático em pais de crianças de zero a três anos de idade, atendidas na Clínica de Bebês da UNIPAR, de Cascavel/PR. Método: Os 50 sujeitos foram divididos em dois grupos (n=25) e receberam um questionário referente a uma proposta de tratamento com cariostático em seu(sua) filho(a). O Grupo I não recebeu nenhuma informação sobre o procedimento, apenas visualizou uma foto com dentes submeti dos ao tratamento;já o Grupo II, além de visualizar a foto, foi informado sobre o tratamento. Os dados coletados foram analisados por porcentagem simples. Resultados: No Grupo I, 4% dos pais jamais aceitariam o tratamento proposto para os seus filhos; já no II, nenhum pai/mãe relatou não permiti r o tratamento com cariostático. Os resultados mostraram que, independente da informação (Grupo II - 60%) ou não (Grupo I - 44%) sobre o tratamento, os pais não se importaram que o resultado não fosse estético, desde que resolva o problema, por acreditarem que saúde é mais importante que estética. Conclusão: O uso do Diaminofluoreto de Prata foi aceito na amostra estudada, visto que, tanto os pais que não receberam orientação como os que receberam, consideraram que a estética não é um fator decisivo no momento da indicação do cariostático.

Objective: To evaluate the parent's esthetic acceptance of the use of the cariostatic agent diamine silver fluoride in children aged 0 to 3 years treated at UNIPAR's (State University of Paraná, Brazil) Baby Clinicin the city of Cascavel, PR, Brazil. Method: Fifty individuals were assigned to two groups (n=25) and were handed a questionnaire regarding a treatment proposal using a cariostatic agent (diamine silver fluoride) on their children. Group I did not receive instructions about the procedure, and only saw a picture of teeth after the treatment; Group II received instructions about the procedure and saw a picture of teeth after the treatment. The collected data were analyzed by plain percentage. Results: In Group I, 4% of the parents stated they would never accept the treatment proposed for their children; in Group II, no parent was against the cariostatic treatment. The results revealed that regardless of receiving information (60% in Group II) or not (44% in Group I) about the procedure, the parents did not care about the treatment being unaesthetic, as long as it solved the problem, as they believed that health is more important than esthetics. Conclusion: The use of diamine silver fluoride was approved by the studied sample, since both the informed and non-informed parents considered that esthetics is not a decisive factor for indication of the cariostatic agent.

Análise histopatológica de dentes decíduos traumatizados com insucesso do tratamento endodôntico / Histopathological analysis of the failure of endodontic treatment of traumatized primary teeth

O objetivo deste estudo é identificar, histopatologicamente, os possíveis fatores associados ao insucesso do tratamento endodôntico de dentes decíduos. Para tanto, 13 dentes decíduos com insucesso do tratamento endodôntico pós-trauma foram processados histologicamente e corados pelas técnicas da hematoxilinaeosina e Brown e Brenn. As lâminas foram avaliadas quanto à loca-lização e intensidade da infecção. Em 11 dentes, havia infecção de média e baixa intensidade. Os locais mais freqüentes da presença de bactérias foram a luz do canal e o ligamento periodontal, princi-palmente nos casos de trauma severo e reincidente. Não se encontrou associação entre a presença e a severidade da infecção relacionadas à severidade do trauma, à reincidência dele ou à condição do tecido pulpar. O insucesso do tratamento endodôntico em dentes decíduos traumatizados está relacionado, principalmente, com infecção e comprometimento irreversível do ligamento periodontal.