Oral Condition of Adolescents who Participated in an Oral Health Program During the First Decade of Life

ABSTRACT Objective: To evaluate the oral health of adolescents who participated in an oral health preventive program during the first decade of life. Material and Methods: For the evaluation of dental caries and gingival condition, DMFT and Community Periodontal Index were used, both recommended by the World Health Organization. To verify the occurrence of dental fluorosis, the Dean index was used. Results: Data collection was obtained from 252 patients aged 12 to 16 years. The average DMFT index was 1.14; in relation to the gingival condition, the index of healthy gingival tissue prevailed and the average of this value was 84%, with code 0 being more registered in tooth 11, code 1, more frequently in teeth 16/17 and 36/37 and for last, code 2, in tooth 31 most frequently. Dean's index showed a percentage of 89% of patients without clinical signs of dental fluorosis. Conclusion: Adolescents participating in an oral health preventive program in the first decade of life exhibited very satisfactory results regarding the prevention of caries disease, healthy periodontal condition and reduced prevalence of dental fluorosis.

Fractura radicular en los incisivos centrales maxilares permanentes: reporte de un caso de 10 años de seguimiento / Fratura radicular nos incisivos centrais superiores permanentes. Relato de caso de 10 anos de acompanhamento longitudinal / Root fracture in the permanent maxillary central incisors: a case report of 10 years follow-up

El objetivo de este trabajo es referir, a través de un reporte de caso clínico, a una paciente de sexo femenino de 9 años que sufrió una caída de su propia altura en el colegio. Inicialmente, la paciente acudió a urgencias en su ciudad natal, en la que al examen clínico se objetivó un traumatismo dentario en los dientes 11 y 21 y el diente 11 sufrió una luxación extrusiva leve, siendo reposicionada por el odontólogo que le brindó la primera atención. El examen radiográfico reveló una fractura radicular horizontal en el tercio medio de los dos incisivos centrales superiores. Los dientes fueron ferulizados con resina compuesta en los dientes proximales involucrados en el trauma. Posteriormente, la paciente fue remitida a la consulta de odontopediatría de la FOA-Unesp, donde recibió atención clínica y radiográfica por un período de diez años. No fue necesaria la intervención endodóntica en ambos dientes incisivos centrales, y los procesos de cicatrización se dieron de dos maneras diferentes. Cicatrización del diente 11 por interposición de hueso y tejido conectivo, y cicatrización del diente 21 por interposición de tejido conectivo. Después de diez años, los dientes se presentaban sin signos o síntomas significativos que requirieran una intervención invasiva. Se concluye que en un mismo paciente ocurren diferentes procesos de cicatrización en dientes muy próximos entre sí y que la cooperación del paciente en cuanto a cuidados, higiene bucal y asistencia a las citas de retorno, puede ser determinante para el éxito del tratamiento

The objective of this case report is to present a 9-year-old female patient who suffered horizontal root fracture in the middle third of the two upper central permanent incisors. The teeth were splinted with composite resin in the proximal teeth involved in the trauma. After, the patient was referred to the pediatric dentistry clinic, where she received clinical and radiographic care for a period of ten years. Endodontic intervention was not necessary on both central incisors teeth. Tooth 11 healing by interposition of bone and connective tissue, and teeth 21 healing by interposition of connective tissue. After ten years, the teeth presented without any significant signs or symptoms requiring an invasive intervention. It is concluded that the patient's cooperation regarding care, oral hygiene and attendance at the return appointments, can be decisive for the success of the treatment

O objetivo deste trabalho é referir-se, por meio de um relato de caso clínico, sobre um paciente de 9 anos de idade, sexo feminino, que sofreu queda da própria altura na escola. A paciente recebeu atendimento em sua cidade de origem, em que ao exame clínico foi observado traumatismo dentário sobre os dentes 11 e 21 e o dente 11 sofreu suave luxação extrusiva sendo reposicionado pelo cirurgião dentista que prestou os primeiros atendimentos. Ao exame radiográfico foi constatada fratura radicular horizontal de terço médio nos dois elementos dentários. Foi realizada a contenção dos dentes com resina composta nas proximais dos dentes envolvidos no trauma. A paciente foi encaminhada para a clínica de Odontopediatria da FOA-Unesp onde recebeu atendimento clínico e radiográfico por um período de dez anos, sem que a mesma apresentasse sinais ou sintomas significativos que necessitasse de uma intervenção invasiva. Dessa forma, infere-se que uma correta atuação no primeiro atendimento e a proservação do caso, pode ser determinante para o sucesso do tratamento, assim como a colaboração do paciente quanto aos cuidados, higienização bucal e comparecimento nas consultas de retorno

Effect of daily use of fluoridated dentifrice and bleaching gels containing calcium, fluoride, or trimetaphosphate on enamel hardness: an in vitro study.

OBJECTIVE: This study evaluated the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium trimetaphosphate (TMP), and NaF/TMP added to a 35% hydrogen peroxide (HP) bleaching gel for the reduction in enamel demineralization in vitro, with and without the use of a fluoridated dentifrice. DESIGN: Enamel blocks (n = 100) were obtained from bovine incisors (n = 200) after flattening and subjected to initial surface hardness (SH) analysis. The blocks were divided according to the bleaching gel (35% HP; 35% HP + 0.05% NaF; 35% HP + 0.25% TMP; 35% HP + 0.05% NaF + 0.25% TMP; 35% HP + 2% CaGlu) and were treated with ether non-fluoridated or fluoridated (1100 ppm) dentifrice. The bleaching gels were applied thrice (40 min/session) at the intervals of 7 days between each application. After 21 days, the final SH for the calculation of the percentage of SH loss (%SH) and cross-sectional hardness for the evaluation of the integrated hardness area (IH) were determined. RESULTS: Bleaching containing HP + NaF + TMP presented lowest %SH (p < 0.001), regardless of the dentifrice used. HP + NaF + TMP bleaching gel led to lower subsurface enamel mineral loss (IH) compared to the other groups (p < 0.001), and these did not differ from each other (p > 0.05). Daily use of fluoride dentifrice led to higher IH values (p < 0.001), regardless of the bleaching gels. CONCLUSION: The addition of NaF/TMP to a 35% HP bleaching gel remarkably reduced the mineral loss compared to the cases of the other bleaching gels, regardless of dentifrice. CLINICAL RELEVANCE: The association of TMP/NaF can be used as a strategy for reducing mineral loss during the bleaching procedure, even without the daily use of fluoride dentifrice.

Profile of Breastfeeding Practice among Mothers of Brazilian Children Attended in a Dentistry Preventive Program

ABSTRACT Objective: To evaluate the breastfeeding practice of mothers of children assisted in the educational and preventive dentistry program to create actions to promote, protect and support breastfeeding. Material and Methods: This is a cross-sectional study with a quantitative approach carried out in a dental clinic for babies. A questionnaire was applied to the mothers containing 10 multiple choice questions about breastfeeding practices and attitudes. Data were stored in a Microsoft Excel database for descriptive statistical analysis. Results: 614 mothers answered the questionnaire. It was found that 96.4% of mothers considered breastfeeding the best way to feed a baby and the child's health benefits stood out as the main reason (98.7%) for breastfeeding. According to 82.9% of mothers, the ideal time to breastfeed the baby is up to 2 years of age; 81.8% breastfed or intended to breastfeed their children up to this age, finding it perfectly natural to breastfeed in public (72.1%). The greatest fear of mothers was not being able to breastfeed their child long enough (61.4%), feeling guilty about it (77%). On the other hand, breastfeeding in public was considered a fantastic attitude (56.8%). Conclusion: Mothers in this sample have information about the recommendations of the health agencies regarding breastfeeding; however, there was a large weaning index among them.

Amount of Dentifrice and Fluoride Concentration Influence Salivary Fluoride Concentrations and Fluoride Intake by Toddlers.

The present study evaluated fluoride (F) concentrations in saliva of toddlers after brushing with dentifrices containing different F concentrations, applied in different quantities, and estimated F intake from toothbrushing. The study comprised a double-blind, crossover protocol, in which toddlers (n = 18, 2-3 years old) were randomly assigned into six groups, according to possible combinations of dentifrices (0/550/1,100 ppm F, as NaF) and amounts (rice grain, pea size, and transverse technique). Volunteers used a F-free dentifrice during 1 week. On the 7th day, saliva samples were collected before (baseline), and at 5/15/30/60 min after toothbrushing. All dentifrice expectorated after brushing was collected. F concentrations (saliva and expectorate) were determined with an ion-specific electrode. Data were submitted to ANOVA or Kruskal-Wallis test, followed by Fisher's LSD or Student-Newman-Keuls' tests (p <0.05). Brushing with 550 ppm F dentifrice (pea size or transversal technique) increased the area under the curve (AUC) at similar levels compared to 1,100 ppm F (rice grain). The highest AUC and salivary F at 5 min after brushing were achieved by 1,100 ppm F (pea size), followed by 550 ppm F (transversal technique). Regarding F intake, the highest values were observed for 550 ppm F (transversal technique), followed by 1,100 ppm F (pea size). It is possible to conclude that the amount of dentifrice and F concentration in the product significantly affected both salivary F concentrations and F intake during toothbrushing.

Microorganisms related to early childhood caries in a sample of an oral preventive-educative program: a longitudinal study / Microorganismos relacionados a cárie precoce da infância em uma amostra de um programa preventivo de cárie dentária: um estudo longitudinal

Objetivo: Premature acquisition of cariogenic microorganisms seems to be related to higher prevalence and activity of caries lesions. The aim of the study was to evaluate the prevalence of Streptococcus mutans and Streptococcus sobrinus in infants enrolled in a dental preventive program and in their mothers, as well as to assess the influence of bacterial prevalence, diet and oral hygiene in dental caries prevalence. Material and methods: After clinical examinations (n = 50), saliva and oral biofilms were collected and stored prior to real-time PCR at 6, 12, 18 and 24 months of age. Results: No correlation was observed between the presence of cariogenic pathogens and diet or hygiene habits at all ages; however, association increased with number of erupted teeth. Salivary levels of bacteria were lower in children than in their mothers at all ages, and children with carious lesions had high ingestion of sugared food. Conclusion: As the levels of cariogenic pathogens were low in the patients that were enrolled in a preventive program, we can conclude that control of oral biofilm as eruption of infants' teeth occurs and sugar ingestion should be considered of great importance in preventive dentistry, because the association between them was highly positive. (AU)

Objetivo: A aquisição precoce de microorganismos cariogênicos está correlacionada a alta prevalência e atividade de lesões de cárie. O objetivo deste estudo foi avaliar a prevalência de Streptococcus mutans e Streptococcus sobrinus em bebês e pares de mães, matriculados no programa educativo e preventivo da Bebê Clínica da Faculdade de Odontologia de Araçatuba (UNESP), como também foi avaliada influência da prevalência bacteriana, dieta e higiene oral na prevalência de cárie dentária. Material e métodos: Após exame clínico (n=50), foram coletados saliva e biofilme e submetidos a real-time PCR aos 6, 12, 18 e 24 meses de idade. Resultados: Não foi observada correlação entre a presence de patógenos cariogênicos e hábitos de dieta e higiene em todas as idades avaliadas. Níveis salivares foram mais baixos nas crianças do que em suas mães em todas as idades, e as crianças portadoras de lesões cariosas tinham maior ingestão de alimentos açúcarados. Conclusão: Uma vez que os níveis de patógenos cariogênicos foram baixos nos pacientes que frequentam um programa preventivo, podemos concluir que o controle de biofilme durante a erupção dentária e da ingestão de açúcares pode ser considerada medida de grande relevância em prevenção odontológica, uma vez que a associação foi altamente positiva. (AU)

Retención de molares primarios: diagnóstico, etiología, tratamiento y relato de caso clínico / Retenção de molares decíduos: diagnóstico, etiologia, tratamento e relato de caso clínico / Retention of primary molars: diagnosis, etiology, treatment and clinical case report

Este estudio presenta un relato de caso clínico sobre la retención de molares primarios, el objetivo es describir los medios de diagnóstico, la etiología, las implicaciones clínicas y el tratamiento de esta condición. Factores etiológicos locales, ambientales o genéticos pueden llevar a la retención de molares primarios, interfiriendo en la secuencia normal de erupción de los premolares. Paciente de sexo femenino, 12 años de edad, compareció a la clínica de Odontopediatría de la Facultad de Odontología de Araçatuba (FOA/UNESP), Brasil, con queja de dolor y aumento volumétrico en la región vestibular del diente 63 y cuadro casode erupción dentaria incompatible con la edad cronológica de los dientes 54/55, 75, 84/85. Exámenes complementarios fueron realizados para el establecimiento del diagnóstico, el cual se definió como retención prolongada de molares primarios. La conducta terapéutica fue basada en la realización de exodoncia de los dientes con retención prolongada, seguida del control clínico y radiográfico, hasta la erupción de los sucesores. Se concluye que el diagnóstico y la intervención temprana para la retención prolongada son de fundamental importancia para evitar daños a la oclusión.

Objetivo: Apresentar um relato de caso clínico sobre a retenção de molares de dentes decíduos, como o objetivo de descrever os meios de diagnóstico, a etiologia, as implicações clínicas e o tratamento desta condição. Fatores etiológicos locais, ambientais ou genéticos podem levar à retenção de molares decíduos, interferindo na sequência normal de erupção dos pré-molares. Paciente do sexo feminino, 12 anos de idade, compareceu à clínica de Odontopediatria da Faculdade de Odontologia de Araçatuba (FOA/UNESP), Brasil queixando-se de dor e aumento volumétrico na região vestibular do dente 63 e quadro de erupção dentária incompatível com a idade cronológica dos dentes 54/55, 65, 74/75, 84/85. Exames complementares foram realizados para o estabelecimento do diagnóstico, o qual foi definiu-se como retenção prolongada de molares decíduos. A conduta terapêutica baseou-se na realização de exodontia dos dentes com retenção prolongada, seguida do controle clínico e radiográfico, até a erupção dos sucessores. Conclui-se que o diagnóstico e a intervenção precoces para a retenção prolongada são de fundamental importância para evitar danos à oclusão.

This study shows a clinical case report about the retention of primary molars, with the aim of describing diagnosis, etiology, clinical implications and treatment of this condition. Local, environmental or genetic etiologic factors may lead to retention of primary molars, interfering with the normal sequence of eruption of the premolars. A 12-year-old female patient attended the Pediatric Dentistry Clinic of the Faculty of Dentistry of Araçatuba (FOA / UNESP), complaining of pain and volumetric increase in the buccal region of the tooth 63 and a scenario of age-incompatible eruption chronological analysis of teeth 54/55, 64/65, 74/75, 84/85. Complementary examinations were performed to establish the diagnosis, which was defined as prolonged retention of deciduous molars. Therapeutic conduct was based on the extraction of teeth with prolonged retention, followed by clinical and radiographic control until the successors erupted. It is concluded that the early diagnosis and intervention for prolonged retention are of fundamental Latinoamericanaimportance to avoid occlusal complications.

Clinical performance of glass ionomer cement and composite resin in Class II restorations in primary teeth: A systematic review and meta-analysis.

OBJECTIVES: This study compared the clinical performance of glass ionomer cement (GIC) compared to composite resin (CR) in Class II restorations in primary teeth. DATA: Literature search according to PRISMA guidelines including randomized controlled trials comparing Class II restorations performed with GIC, compared to CR, in primary teeth. SOURCES: PubMeb, Scopus, Web of Science, VHL, Cochrane Library, Clinical Trials and OpenGrey, regardless of date or language. STUDY: Ten studies were included in qualitative synthesis, and 9 in the meta-analyses (MA). Six studies were classified as low risk of bias, and 4 as "unclear". Heterogeneity ranged from null to high (0% to 73%). GIC and CR presented similar failure patterns (risk difference -0.04 [-0.11, 0.03]; p = 0.25, I2 = 51%), and the exclusion of studies with follow-up period <24 months, or grouping according to the type of GIC (conventional or resin-modified), or according to the type of isolation (cotton roll or rubber dam), or according to the evaluation criteria applied did not affect the pattern of the results obtained. GIC exhibited significantly lower values of secondary carious lesions (SCL) than CR (SCL: risk difference 0.06 [0.02, 0.10], p = 0.008, I2 = 0%). The materials presented similar performance (p > 0.05) regarding the overall effect, as well as for marginal discoloration, marginal adaptation and anatomical form. The superiority of GIC was maintained when resin-modified GIC and rubber dam isolation were analyzed separately. CONCLUSIONS: GIC and CR presented similar clinical performance for all criteria analyzed, except for secondary carious lesions, in which GIC presented superior performance, especially for the resin-modified GIC and with rubber dam isolation.

Periodontal Pathogen Colonization in Young Children by PCR Quantification - A Longitudinal Survey.

INTRODUCTION: Periodontal diseases are among the leading causes of premature tooth loss in adults, but the microbiota associated with this problem is established over time in childhood. AIM: This longitudinal study aimed to verify the occurrence of periodontal pathogens in the oral cavity of children aged six, twelve, eighteen and twenty-four months through PCR quantification, correlating them with the oral microbiota of their mothers. STUDY DESIGN: Saliva and oral biofilm samples were collected from mothers and children by using sterilized paper points. Furthermore, a questionnaire was applied in all periods to evaluate hygiene and dietary habits. RESULTS: A positive correlation was found between mother-child pairs in all periods. No correlation was observed between hygiene and dietary habits and occurrence of periodontal pathogens. CONCLUSION: Early inclusion of children in preventive and biofilm control programs could contribute to preventing acquisition of aggressive pathogens.

Periodontal Pathogen Colonization in Young Children by PCR Quantification - A Longitudinal Survey.

INTRODUCTION: Periodontal diseases are among the leading causes of premature tooth loss in adults, but the microbiota associated with this problem is established over time in childhood. AIM: This longitudinal study aimed to verify the occurrence of periodontal pathogens in the oral cavity of children aged six, twelve, eighteen and twenty-four months through PCR quantification, correlating them with the oral microbiota of their mothers. STUDY DESIGN: Saliva and oral biofilm samples were collected from mothers and children by using sterilized paper points. Furthermore, a questionnaire was applied in all periods to evaluate hygiene and dietary habits. RESULTS: A positive correlation was found between mother-child pairs in all periods. No correlation was observed between hygiene and dietary habits and occurrence of periodontal pathogens. CONCLUSION: Early inclusion of children in preventive and biofilm control programs could contribute to preventing acquisition of aggressive pathogens.

Influence of the Amount of Dentifrice and Fluoride Concentrations on Salivary Fluoride Levels in Children.

PURPOSE: This study evaluated fluoride (F) concentrations in saliva of children after brushing with dentifrices containing different F concentrations (zero, 550, and 1,100 ppm F) in different quantities (full bristles, transversal technique, and pea-sized). METHODS: Eight- to 10-year-old volunteers (N=24) were randomly assigned into nine experimental groups (dentifrice type versus amounts) following a double-blind, crossover protocol. After a one-week washout period (use of placebo toothpaste), stimulated saliva was collected prior to toothbrushing (baseline) and at five, 15, 30, 60, and 120 minutes after toothbrushing with one of the possible combinations. Centrifuged saliva was used for F analysis after buffering with TISAB III. Data were submitted to repeated-measures ANOVA followed by Student-Newman-Keuls' test (P<0.05). RESULTS: Salivary F peaked at five minutes after brushing, decreasing exponentially afterward. A clear dose-response relationship was seen between F concentration/amount of dentifrice applied and the mean area under the curve (AUC) of salivary F concentrations (P<0.001). The low-fluoride toothpaste applied using transversal technique or full bristles led to a significantly higher AUC than the conventional toothpaste using a pea-sized amount. CONCLUSIONS: Brushing with a low-fluoride toothpaste applied using the transversal technique delivers more fluoride to saliva compared to a conventional toothpaste in a pea-sized amount.

Avaliação da resposta tecidual de ratos à pasta Guedes-Pinto e ao hidróxido de cálcio, por meio de análise morfológica de implante alveolar em ratos / Evaluation of tissue response of mice to folder Guedes-Pinto and calcium hydroxide, through Morphological analysis of cellular implantation in rats

Com o propósito de avaliar a resposta biológica tardia da pasta Guedes-Pinto e da pasta de hidróxido de cálcio, materiais obturadores para dentes decíduos, foi empregada a técnica do implante em alvéolos. Quarenta e oito ratos sofreram exodontia do incisivo central superior direito, e um implante de tubo de polietileno contendo uma das pastas foi posicionado no alvéolo, para análise após 7 e 28 dias. A pasta de hidróxido de cálcio causou maior edema do que a pasta Guedes-Pinto. Na análise microscópica aos 7 dias, ambos os materiais evidenciaram a formação de tecido conjuntivo rico em fbroblastos e vasos sanguíneos, com alguns macrófagos e linfócitos. Aos 28 dias, a pasta de hidróxido de cálcio apresentou, nas áreas próximas ao material, tecido conjuntivo com elevado número de macrófagos e linfócitos, enquanto nas áreas mais distantes havia trabéculas ósseas neofomadas. Para a pasta Guedes-Pinto, verifcou-se presença de trabéculas ósseas neoformadas junto à superfície do material, e número maior dessas em áreas mais distantes. Pode-se concluir que a pasta Guedes-Pinto causou menor edema e proporcionou menor interferência no processo de reparo.

Molar incisor hypomineralization: considerations about treatment in a controlled longitudinal case.

Molar incisor hypomineralization (MIH) is a defect in the tooth enamel of systemic origin and may affect one or all four first permanent molars frequently associated with the permanent incisors. This case reports a 7-year-old child with severe MIH in the permanent molars associated with tooth decay and intense pain. In the first stage of treatment, therapy was performed with fluoride varnish and restoration with glass ionomer cement (GIC). After 6 years of clinical and radiographic follow-up, the restorations presented wear and fractures on the margins, indicating their replacement with composite resin. Severe cases of MIH in the early permanent molars can be treated with varnish and GIC to restore the patient's comfort and strengthen the hypomineralized dental structures. The clinical and radiographic monitoring frequently indicated when the restoration with composite resin should be performed.

Condyloma acuminata in the tongue and palate of a sexually abused child: a case report.

BACKGROUND: Condyloma acuminata caused by human papilloma viruses, (HPV) is a sexually transmitted disease (STD) appearing most frequently as soft, pink cauliflower like growths in moist areas, such as the genitalia, mouth and other places. The disease is highly contagious, can appear singly or in groups, small or large. In children, the isolation of a sexually transmitted organism may be the first indication that an abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist. CASE PRESENTATION: The authors report the clinical case of a five-year-old Caucasian male with lesions located in the dorsal surfaces of the posterior tongue and palate. Both lesions had a firm consistency, reddish appearance and presence of whitish areas and regions of ulceration. During the interview, the mother reported that the boy had been sexually abused. CONCLUSION: Sexually transmitted disease may occur during sexual abuse. Dentists as well as pediatricians have a role to play in identifying and treating these children. The diagnosis is essentially clinical (anamnesis and physical examination), but also the use of cytology eventually resorts to biopsy of the suspicious lesions for histological examination. The therapeutic option was the excision of the lesions.

Comparison of the caries-preventive effect of a glass ionomer sealant and fluoride varnish on newly erupted first permanent molars of children with and without dental caries experience.

PURPOSE: This longitudinal clinic study evaluated the effect of a glass ionomer sealant (GIS) and a fluoride varnish (FV) in the prevention of dental decay on newly erupted permanent molars of children with and without caries experience. MATERIALS AND METHODS: Eighty children, aged 6-8 years, with all four newly erupted first permanent molars, were divided into two groups. Group 1 consisted of 53 children without caries experience and group 2 consisted of 27 children with dental caries experience. Permanent molars of the right side were sealed with GIS and the fluoride varnish was applied on the other two permanent first molars. Evaluation of GIS retention and the effectiveness of both materials in the prevention of dental caries were performed after 6, 12 and 18 months. RESULTS: After 18 months, of the 299 teeth, 271 (91%) showed no caries lesions and 28 presented caries lesions (9%). Teeth sealed with GIS had more carious lesions (15) than teeth with fluoride varnish (13). Most of the teeth (70%) that presented carious lesions were in group 2. Of the 138 sealed teeth, only one showed GIS to be totally present, 95 were partially present and 42 teeth were absent. CONCLUSION: The caries-preventive effect was very similar between both treatments. The presence of dental caries prevailed in the children with caries experience.

The association between prune belly syndrome and dental anomalies: a case report.

BACKGROUND: Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged. CASE PRESENTATION: The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted. CONCLUSION: This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

Programa de prevenção aplicado em crianças de 5 a 8 anos de idade, atendidos desde o primeiro ano de vida na Bebê-Clínica da Faculdade de Odontologia de Araçatuba, Brasil / A dental caries preventive program applied to children aged 5 to 8 years attending since the first year of age at the Baby Clinic of the Araçatuba Dental School, Brazil

Objetivo: Este trabalho avaliou um programa de prevenção aplicado em crianças de 5 a 8 anos de idade considerando como fatores a manutenção da saúde bucal, a relação entre experiência prévia e atual de cárie dentária e relação entre a ocorrência de cárie dentária e a freqüência às consultas de retorno. Material e método: Foram realizados exames clínicos intrabucais e radiografias interproximais em 171 pacientes e a partir de seus prontuários obtivemos informações sobre idade, gênero, a experiência anterior de cárie e freqüência às consultas de retorno. O tratamento estatístico utilizado foi o Teste de McNemar em nível de significância de 1 porcentagem. Resultado: Os resultados dos exames clínicos e radiográficos mostraram que a maioria das crianças participantes do programa apresentava dentes hígidos (77,2 e 84,8 porcentagem respectivamente). Conclusão: A estratégia preventiva exerceu influência positiva sobre a manutenção da saúde bucal nas crianças examinadas. A experiência prévia de cárie e a ausência às consultas de retorno influenciaram a condição clínica bucal das crianças durante a participação no programa preventivo.

Objective: Tooth decay is one of the more common diseases of childhood. Several studies recommend that early preventive measures must be implemented since the first years of life and continue throughout childhood and adolescence. The aim of the this study was to present results of a preventive dental program considering oral health maintenance, dental caries experience and the prevalence of dental caries relation with follow-up compliance visits. Material end method: Intraoral and interproximal radiographic exams were performed on 171 patients participants of a preventive dental program. Data regarding age, gender, previous caries experience and the frequency at which the patients attended return visits were obtained from the records. The data were analyzed statistically by the McNemar test, with the level of significance set at 1 percentage. Result: Clinical and radiographic examination revealed that most children participating in the program had sound teeth (77.2 and 84.8 percentage, respectively). The past dental history of the dental caries from patients included in this study showed statistical relevance when associated with the present dental caries experience and a statistical relationship was found from the absence of compliance to clinical visits and the dental caries presence. Conclusion: The preventive strategy had a positive influence on oral health maintenance in the children examined. Previous caries experience and the lack of compliance with return visits influenced the clinical oral condition of the children during participation in the preventive program.

Luxation injuries in primary teeth: a retrospective study in children assisted at an emergency service.

The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5%. Trauma incidence was higher in boys (57.0%) and in children less than two years of age (40.3%). Falling while walking or running was the most predominant etiologic factor (37.7%), and the most prevalent type of injury was subluxation (32.6%). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0%). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

Luxation injuries in primary teeth: a retrospective study in children assisted at an emergency service

The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5 percent. Trauma incidence was higher in boys (57.0 percent) and in children less than two years of age (40.3 percent). Falling while walking or running was the most predominant etiologic factor (37.7 percent), and the most prevalent type of injury was subluxation (32.6 percent). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0 percent). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

Developmental disturbance of an unerupted permanent incisor due to trauma to its predecessor.

Developmental disturbances of permanent teeth can result from trauma to primary teeth because of the proximity of the root of the primary teeth to their permanent successors. We describe the case of a 14-month-old boy who was referred to the baby clinic of the School of Dentistry, Universidad Estadual Paulista, Araçatuba, Brazil, after sustaining a severe trauma that led to intrusion of the right primary central incisor. Radiographic examination 4 years after the trauma showed a developing morphological change in the germ of the permanent successor. On eruption of the permanent central incisor, a crown malformation along with enamel hypoplasia was observed. We conclude that radiographic follow-up is indicated after trauma to monitor possible sequelae in the permanent successors even before their eruption